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Sample records for spiral nerve cuff

  1. An improved method of crafting a multi-electrode spiral cuff for the selective.

    Science.gov (United States)

    Rozman, Janez; Pečlin, Polona; Ribarič, Samo; Godec, Matjaž; Burja, Jaka

    2018-01-17

    This article reviews an improved methodology and technology for crafting a multi-electrode spiral cuff for the selective activation of nerve fibres in particular superficial regions of a peripheral nerve. The analysis, structural and mechanical properties of the spot welds used for the interconnections between the stimulating electrodes and stainless-steel lead wires are presented. The cuff consisted of 33 platinum electrodes embedded within a self-curling 17-mm-long silicone spiral sheet with a nominal internal diameter of 2.5 mm. The weld was analyzed using scanning electron microscopy and nanohardness tests, while the interconnection was investigated using destructive load tests. The functionality of the cuff was tested in an isolated porcine vagus nerve. The results of the scanning electron microscopy show good alloying and none of the typical welding defects that occur between the wire and the platinum foil. The results of the destructive load tests show that the breaking loads were between 3.22 and 5 N. The results of the nanohardness testing show that the hardness of the weld was different for the particular sites on the weld sample. Finally, the results of the functional testing show that for different stimulation intensities both the compound action potential deflection and the shape are modulated.

  2. A model of electrical impedance tomography implemented in nerve-cuff for neural-prosthetics control.

    Science.gov (United States)

    Hope, James; Vanholsbeeck, Frederique; McDaid, A J

    2018-03-16

    In neural interfaces for peripheral nerve a trade-off exists between the level of invasiveness and the selectivity of neural recordings. In this study, we implement electrical impedance tomography (EIT) in a nerve cuff with the aim to investigate the achievable level of selectivity. Approach: Established modelling approaches in neural-EIT are expanded on to be used, for the first time, on myelinated fibres which are abundant in mammalian peripheral nerves and transmit motor commands. The model is then used to evaluate the viability of using EIT with a nerve cuff to record neural activity in peripheral nerves. Main results: Fibre impedance models indicate activity in unmyelinated fibres can be screened out from activity in myelinated fibres using operating frequencies above 100 Hz. At 1 kHz the transverse impedance magnitude, which is perpendicular to the fibre length axis, of inactive intra-fascicle tissue and the fraction change during neural activity are estimated to be 1,142 Ω.cm and -8.8x10-4, respectively. At 1 kHz and 10 mm spacing between the impedance measurement electrode pair, the longitudinal impedance magnitude, which is parallel to the fibre length axis, and the fraction change during neural activity are estimated to be 328 Ω.cm and -0.30, respectively. We show that a novel EIT drive and measurement electrode pattern which utilises longitudinal current and longitudinal differential boundary voltage measurements could distinguish activity in different fascicles, as well as simultaneous activity in multiple fascicles, of a three-fascicle mammalian nerve using simulated data. Significance: The results of this study provide an estimate of the transient change in impedance of intra-fascicle tissue during neural activity in mammalian nerve, and present a viable EIT electrode pattern, both of which are critical steps towards implementing EIT in a nerve cuff for a recording neural interface. © 2018 Institute of Physics and Engineering in Medicine.

  3. Concurrent Rotator Cuff Tear and Axillary Nerve Palsy Associated with Anterior Dislocation of the Shoulder and Large Glenoid Rim Fracture: A “Terrible Tetrad”

    Directory of Open Access Journals (Sweden)

    Fumiaki Takase

    2014-01-01

    Full Text Available We present a case of concurrent rotator cuff tear and axillary nerve palsy resulting from anterior dislocation of the shoulder and a large glenoid rim fracture—a “terrible tetrad.” A 61-year-old woman fell on her right shoulder. Radiographs showed anterior dislocation of the shoulder with a glenoid rim fracture, and an MRI two months after injury revealed a rotator cuff tear. Upon referral to our hospital, physical and electrophysiological examinations revealed axillary nerve palsy. The axillary nerve palsy was incomplete and recovering, and displacement of the glenoid rim fracture was minimal and already united; therefore, we surgically repaired only the rotator cuff tear three months after injury. The patient recovered satisfactorily following the operation. In patients whose axillary nerve palsy is recovering, surgeons should consider operating on rotator cuff tears in an attempt to prevent rotator cuff degeneration.

  4. Improvement of signal-to-interference ratio and signal-to-noise ratio in nerve cuff electrode systems

    International Nuclear Information System (INIS)

    Chu, Jun-Uk; Song, Kang-Il; Han, Sungmin; Kim, Jinseok; Suh, Jun-Kyo Francis; Choi, Kuiwon; Youn, Inchan; Lee, Soo Hyun; Kang, Ji Yoon; Hwang, Dosik

    2012-01-01

    Cuff electrodes are effective for chronic electroneurogram (ENG) recording while minimizing nerve damage. However, the ENG signals are usually contaminated by electromyogram (EMG) activity from the surrounding muscles, stimulus artifacts produced by the electrical stimulation and noise generated in the first stage of the neural signal amplifier. This paper proposed a new cuff electrode to reduce the interference from EMG signals and stimulus artifacts. As a result, when an additional middle electrode was placed at the center of the cuff electrode, a significant improvement in the signal-to-interference ratio was achieved at 11% for the EMG signals and 12% for the stimulus artifacts when compared to a conventional tripolar cuff. Furthermore, a new low-noise amplifier was proposed to improve the signal-to-noise ratio. The circuit was designed based on a noise analysis to minimize the noise, and the results show that the total noise of the amplifier was below 1 μV for a cuff impedance of 1 kΩ and a frequency bandwidth of 300 to 5000 Hz. (paper)

  5. Efficacy of arthroscopically placed pain catheter adjacent to the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block following arthroscopic rotator-cuff repair

    Directory of Open Access Journals (Sweden)

    Yamakado K

    2014-05-01

    Full Text Available Kotaro YamakadoDepartment of Orthopaedics, Fukui General Hospital, Fukui, JapanBackground: Rotator-cuff surgery is well recognized to be a painful procedure.Objectives: The purpose of this study was to examine the effectiveness of an arthroscopically placed perineural catheter at the scapular notch to provide a continuous block of the suprascapular nerve (continuous arthroscopically assisted suprascapular nerve block [ca-SSNB] following arthroscopic rotator-cuff repair (ARCR.Materials and methods: This level II, prospective, randomized, controlled trial without postoperative blinding included 40 patients, who had a 48-hour pain pump, with 0.2% ropivacaine infusion and a continuous rate of 3 mL/hour, placed via an arthroscopically placed catheter following ARCR with arthroscopic release of the superior transverse ligament: 21 patients had a ca-SSNB, and 19 patients had a continuous subacromial bursal block (SAB. The visual analog scale (at 6 hours and on the first, second, and third postoperative days and the total number of additional pain-reduction attempts during the 3 postoperative days were calculated.Results: The respective visual analog scale scores (mm obtained from the ca-SSNB and SAB groups were 62.4 and 67.6 (P=0.73 before surgery, 9.1 and 19.4 (P=0.12 at 6 hours after surgery, 24.4 and 44.6 (P=0.019 on the first postoperative day, 19.4 and 40.4 (P=0.0060 on the second postoperative day, and 18.5 and 27.8 (P=0.21 on the third postoperative day. Total additional pain-reduction attempts recorded for the ca-SSNB and SAB groups during the 3 postoperative days were 0.3 times and 1.2 times (P=0.0020, respectively.Conclusion: ca-SSNB was highly effective in controlling postoperative pain after ARCR.Keywords: shoulder, rotator cuff tear, postoperative pain control, continuous suprascapular nerve block, arthroscopic rotator cuff repair

  6. Injury to the axillary and suprascapular nerves in rotator cuff arthropathy and after reverse shoulder arthroplasty: a prospective electromyographic analysis.

    Science.gov (United States)

    Lopiz, Yaiza; Rodriguez-González, Alberto; Martín-Albarrán, Susana; Marcelo, Hector; García-Fernández, Carlos; Marco, Fernando

    2018-02-20

    Neurologic pre- and postoperative injuries to the axillary and/or suprascapular nerve (SSN) have a higher incidence than expected and may lead to significantly decreased functional outcomes and increased risk of reverse shoulder arthroplasty (RSA) failure. Patients who underwent a RSA for rotator cuff tear arthropathy (RCTA) were included from December 2014 to December 2015. This study focused on the clinical (Constant score), radiographic, and pre- and postoperative electromyographic evaluations at 3 and 6 months. Twenty patients met the inclusion criteria. One was lost to follow-up. Preoperatively, 15 patients showed changes on electromyography (9 SSN and 15 axillary nerve lesions); all of them were chronic and disuse injuries. The mean preoperative relative Constant score (rCS) of all included patients was 39 ± 9 (range, 19-64). At 3 months postsurgery, the prevalence of acute injuries for both nerves was 31.5%. At 6 months postsurgery, 2 axillary nerve injuries and 6 SSN injuries remain unchanged, and the rest improved or normalized. The mean postsurgery rCS of the entire cohort at 6-month follow-up was 78 ± 6.5. Mean postoperative rCS for acute postoperative nerve injury was 71 ± 3 for the axillary nerve and 64 ± 5 for SSN. Axillary and SSN injuries in RCTA have a much higher incidence than expected. Most of these axillary lesions are transient, with an almost complete recovery seen on electromyography at 6 months and with scarce functional impact. However, SSN lesions appear to behave differently, with poor functional results and having a lower potential for a complete recovery. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  7. An Implantable Wireless Neural Interface System for Simultaneous Recording and Stimulation of Peripheral Nerve with a Single Cuff Electrode

    Directory of Open Access Journals (Sweden)

    Ahnsei Shon

    2017-12-01

    Full Text Available Recently, implantable devices have become widely used in neural prostheses because they eliminate endemic drawbacks of conventional percutaneous neural interface systems. However, there are still several issues to be considered: low-efficiency wireless power transmission; wireless data communication over restricted operating distance with high power consumption; and limited functionality, working either as a neural signal recorder or as a stimulator. To overcome these issues, we suggest a novel implantable wireless neural interface system for simultaneous neural signal recording and stimulation using a single cuff electrode. By using widely available commercial off-the-shelf (COTS components, an easily reconfigurable implantable wireless neural interface system was implemented into one compact module. The implantable device includes a wireless power consortium (WPC-compliant power transmission circuit, a medical implant communication service (MICS-band-based radio link and a cuff-electrode path controller for simultaneous neural signal recording and stimulation. During in vivo experiments with rabbit models, the implantable device successfully recorded and stimulated the tibial and peroneal nerves while communicating with the external device. The proposed system can be modified for various implantable medical devices, especially such as closed-loop control based implantable neural prostheses requiring neural signal recording and stimulation at the same time.

  8. Chronic implantation of cuff electrodes on the pelvic nerve in rats is well tolerated and does not compromise afferent or efferent fibre functionality

    Science.gov (United States)

    Crook, J. J.; Brouillard, C. B. J.; Irazoqui, P. P.; Lovick, T. A.

    2018-04-01

    Objective. Neuromodulation of autonomic nerve activity to regulate physiological processes is an emerging field. Vagal stimulation has received most attention whereas the potential of modulate visceral function by targeting autonomic nerves within the abdominal cavity remains under-exploited. Surgery to locate intra-abdominal targets is inherently more stressful than for peripheral nerves. Electrode leads risk becoming entrapped by intestines and loss of functionality in the nerve-target organ connection could result from electrode migration or twisting. Since nociceptor afferents are intermingled with similar-sized visceral autonomic fibres, stimulation may induce pain. In anaesthetised rats high frequency stimulation of the pelvic nerve can suppress urinary voiding but it is not known how conscious animals would react to this procedure. Our objective therefore was to determine how rats tolerated chronic implantation of cuff electrodes on the pelvic nerve, whether nerve stimulation would be aversive and whether nerve-bladder functionality would be compromised. Approach. We carried out a preliminary de-risking study to investigate how conscious rats tolerated chronic implantation of electrodes on the pelvic nerve, their responsiveness to intermittent high frequency stimulation and whether functionality of the nerve-bladder connection became compromised. Main results. Implantation of cuff electrodes was well-tolerated. The normal diurnal pattern of urinary voiding was not disrupted. Pelvic nerve stimulation (up to 4 mA, 3 kHz) for 30 min periods evoked mild alerting at stimulus onset but no signs of pain. Stimulation evoked a modest (<0.5 °C) increase in nerve temperature but the functional integrity of the nerve-bladder connection, reflected by contraction of the detrusor muscle in response to 10 Hz nerve stimulation, was not compromised. Significance. Chronic implantation of cuff electrodes on the pelvic nerve was found to be a well-tolerated procedure in

  9. A comparison of functional outcomes in patients undergoing revision arthroscopic repair of massive rotator cuff tears with and without arthroscopic suprascapular nerve release

    Directory of Open Access Journals (Sweden)

    Savoie III FH

    2016-10-01

    Full Text Available Felix H Savoie III,1 Mark Zunkiewicz,2 Larry D Field,2 William H Replogle,3 Michael J O’Brien1 1Tulane Institute of Sports Medicine, Tulane University School of Medicine, New Orleans, LA, USA; 2Mississippi Sports Medicine and Orthopaedic Center, Jackson, MS, USA; 3Department of Family Medicine, University of Mississippi Medical Center, Jackson, MS, USA Purpose: This study was designed to compare functional outcomes in patients undergoing revision repair of massive rotator cuff tears (retracted medial to the glenoid with Goutallier Grade 4 atrophy and concomitant release of the suprascapular nerve to a similar group of patients with Grade 3 atrophy undergoing revision rotator cuff repair (RTCR without nerve release. We hypothesized that patients undergoing nerve release would have more favorable functional outcomes as measured by the Modified University of California at Los Angeles shoulder rating scale (UCLA. Patients and methods: Twenty-two patients underwent revision repair of massive rotator cuff tears with release of the suprascapular nerve at the suprascapular notch. We compared total preoperative, postoperative, and change in UCLA score in these patients to a similar group of 22 patients undergoing revision RTCR without suprascapular nerve release. Additionally, UCLA subscores between the two groups were compared preoperatively and at final follow-up. Results: The average preoperative UCLA score in the nerve-release group was 7.91, and final follow-up average was 27.86; average 3.05 grades of strength were recovered. In the comparison group, average preoperative UCLA score was 11.77, and final follow-up average was 29.09; average 1.32 grades of strength were recovered. The average preoperative UCLA score was significantly worse in the nerve-release group (P=0.007. The average postoperative UCLA score was not significantly different (P=0.590 between the groups, indicating a better improvement in the nerve-release group with significantly

  10. Effects of arthroscopy-guided suprascapular nerve block combined with ultrasound-guided interscalene brachial plexus block for arthroscopic rotator cuff repair: a randomized controlled trial.

    Science.gov (United States)

    Lee, Jae Jun; Hwang, Jung-Taek; Kim, Do-Young; Lee, Sang-Soo; Hwang, Sung Mi; Lee, Na Rea; Kwak, Byung-Chan

    2017-07-01

    The aim of this study was to compare the pain relieving effect of ultrasound-guided interscalene brachial plexus block (ISB) combined with arthroscopy-guided suprascapular nerve block (SSNB) with that of ultrasound-guided ISB alone within the first 48 h after arthroscopic rotator cuff repair. Forty-eight patients with rotator cuff tears who had undergone arthroscopic rotator cuff repair were enrolled. The 24 patients in group 1 received ultrasound-guided ISB and arthroscopy-guided SSNB; the remaining 24 patients in group 2 underwent ultrasound-guided ISB alone. Visual analogue scale pain score and patient satisfaction score were checked at 1, 3, 6, 12, 18, 24, and 48 h post-operatively. Group 1 had a lower visual analogue scale pain score at 3, 6, 12, 18, 24, and 48 h post-operatively (1.7  6.0, 6.2 > 4.3, 6.4 > 5.1, 6.9 > 5.9, 7.9 > 7.1). Six patients in group 1 developed rebound pain twice, and the others in group 1 developed it once. All of the patients in group 2 had one rebound phenomenon each (p = 0.010). The mean timing of rebound pain in group 1 was later than that in group 2 (15.5 > 9.3 h, p  4.0, p = 0.001). Arthroscopy-guided SSNB combined with ultrasound-guided ISB resulted in lower visual analogue scale pain scores at 3-24 and 48 h post-operatively, and higher patient satisfaction scores at 6-36 h post-operatively with the attenuated rebound pain compared to scores in patients who received ultrasound-guided ISB alone after arthroscopic rotator cuff repair. The combined blocks may relieve post-operative pain more effectively than the single block within 48 h after arthroscopic cuff repair. Randomized controlled trial, Level I. ClinicalTrials.gov Identifier: NCT02424630.

  11. Suprascapular Nerve Block Versus Interscalene Block as Analgesia After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Noninferiority Trial.

    Science.gov (United States)

    Desroches, Asuka; Klouche, Shahnaz; Schlur, Charles; Bauer, Thomas; Waitzenegger, Thomas; Hardy, Philippe

    2016-11-01

    To compare the efficacy of suprascapular nerve block (SSB) and interscalene block (ISB) as postoperative analgesia within the first 24 hours after arthroscopic supraspinatus and/or infraspinatus tendon repair. A single-blind, randomized controlled study was performed between 2013 and 2014. The inclusion criteria were arthroscopic supraspinatus and/or infraspinatus tendon repair confirmed intraoperatively, with or without associated procedures, and informed consent. The exclusion criteria were a previously operated shoulder, repair of the subscapularis tendon, and an allergy to local anesthetics. ISB was performed under ultrasound guidance by an anesthesiologist, whereas SSB was performed based on specific anatomic landmarks by a surgeon. The primary evaluation criterion was mean shoulder pain score during the first postoperative 24 hours assessed on a visual analog scale by the patient. The secondary criteria were complications of locoregional anesthesia, the use of analgesics in the recovery room (the first 2 hours) until postoperative day 7, and pain (visual analog scale) during the first week. Forty-four patients were needed for this noninferiority study. An institutional review board approved the study. Seventy-four patients were randomized, and 59 met the intraoperative inclusion criteria. Six patients were excluded (1 for pneumothorax after ISB, 1 for unsuccessful SSB, and 4 for incomplete questionnaires). None of the patients were lost to follow-up. There was no significant difference between the SSB and ISB groups in mean pain score for the first 24 hours (P = .92) or the first 7 days (P = .05). However, there was significantly less pain in the ISB group in the recovery room (P = .01). Consumption of analgesics was comparable between the groups, but the SSB group took significantly more morphine in the recovery room. In this prospective, randomized controlled study, SSB was as effective as ISB for mean pain control within the first 24 hours but

  12. Logarithmic Spiral

    Indian Academy of Sciences (India)

    anti-clockwise direction and we get a right-handed spiral. (Figure 2). We know that the derivative of eX is also eX. Various properties of logarithmic spiral depend on this property of eX. Properties of Logarithmic Spiral. 1. The most important property of a logarithmic spiral is that r (i.e. the distance from the origin) increases.

  13. A novel flexible cuff-like microelectrode for dual purpose, acute and chronic electrical interfacing with the mouse cervical vagus nerve.

    Science.gov (United States)

    Caravaca, A S; Tsaava, T; Goldman, L; Silverman, H; Riggott, G; Chavan, S S; Bouton, C; Tracey, K J; Desimone, R; Boyden, E S; Sohal, H S; Olofsson, P S

    2017-12-01

    Neural reflexes regulate immune responses and homeostasis. Advances in bioelectronic medicine indicate that electrical stimulation of the vagus nerve can be used to treat inflammatory disease, yet the understanding of neural signals that regulate inflammation is incomplete. Current interfaces with the vagus nerve do not permit effective chronic stimulation or recording in mouse models, which is vital to studying the molecular and neurophysiological mechanisms that control inflammation homeostasis in health and disease. We developed an implantable, dual purpose, multi-channel, flexible 'microelectrode' array, for recording and stimulation of the mouse vagus nerve. The array was microfabricated on an 8 µm layer of highly biocompatible parylene configured with 16 sites. The microelectrode was evaluated by studying the recording and stimulation performance. Mice were chronically implanted with devices for up to 12 weeks. Using the microelectrode in vivo, high fidelity signals were recorded during physiological challenges (e.g potassium chloride and interleukin-1β), and electrical stimulation of the vagus nerve produced the expected significant reduction of blood levels of tumor necrosis factor (TNF) in endotoxemia. Inflammatory cell infiltration at the microelectrode 12 weeks of implantation was limited according to radial distribution analysis of inflammatory cells. This novel device provides an important step towards a viable chronic interface for cervical vagus nerve stimulation and recording in mice.

  14. A novel flexible cuff-like microelectrode for dual purpose, acute and chronic electrical interfacing with the mouse cervical vagus nerve

    Science.gov (United States)

    Caravaca, A. S.; Tsaava, T.; Goldman, L.; Silverman, H.; Riggott, G.; Chavan, S. S.; Bouton, C.; Tracey, K. J.; Desimone, R.; Boyden, E. S.; Sohal, H. S.; Olofsson, P. S.

    2017-12-01

    Objective. Neural reflexes regulate immune responses and homeostasis. Advances in bioelectronic medicine indicate that electrical stimulation of the vagus nerve can be used to treat inflammatory disease, yet the understanding of neural signals that regulate inflammation is incomplete. Current interfaces with the vagus nerve do not permit effective chronic stimulation or recording in mouse models, which is vital to studying the molecular and neurophysiological mechanisms that control inflammation homeostasis in health and disease. We developed an implantable, dual purpose, multi-channel, flexible ‘microelectrode’ array, for recording and stimulation of the mouse vagus nerve. Approach. The array was microfabricated on an 8 µm layer of highly biocompatible parylene configured with 16 sites. The microelectrode was evaluated by studying the recording and stimulation performance. Mice were chronically implanted with devices for up to 12 weeks. Main results. Using the microelectrode in vivo, high fidelity signals were recorded during physiological challenges (e.g potassium chloride and interleukin-1β), and electrical stimulation of the vagus nerve produced the expected significant reduction of blood levels of tumor necrosis factor (TNF) in endotoxemia. Inflammatory cell infiltration at the microelectrode 12 weeks of implantation was limited according to radial distribution analysis of inflammatory cells. Significance. This novel device provides an important step towards a viable chronic interface for cervical vagus nerve stimulation and recording in mice.

  15. Chronic recordings of hypoglossal nerve activity in a dog model of upper airway obstruction.

    Science.gov (United States)

    Sahin, M; Durand, D M; Haxhiu, M A

    1999-12-01

    The activity of the hypoglossal nerve was recorded during pharyngeal loading in sleeping dogs with chronically implanted cuff electrodes. Three self-coiling spiral-cuff electrodes were implanted in two beagles for durations of 17, 7, and 6 mo. During quiet wakefulness and sleep, phasic hypoglossal activity was either very small or not observable above the baseline noise. Applying a perpendicular force on the submental region by using a mechanical device to narrow the pharyngeal airway passage increased the phasic hypoglossal activity, the phasic esophageal pressure, and the inspiratory time in the next breath during non-rapid-eye-movement sleep. The phasic hypoglossal activity sustained at the elevated level while the force was present and increased with increasing amounts of loading. The hypoglossal nerve was very active in rapid-eye-movement sleep, especially when the submental force was present. The data demonstrate the feasibility of chronic recordings of the hypoglossal nerve with cuff electrodes and show that hypoglossal activity has a fast and sustained response to the internal loading of the pharynx induced by applying a submental force during non-rapid-eye-movement sleep.

  16. Spiral symmetry

    CERN Document Server

    Hargittai, Istvan

    1992-01-01

    From the tiny twisted biological molecules to the gargantuan curling arms of many galaxies, the physical world contains a startling repetition of spiral patterns. Today, researchers have a keen interest in identifying, measuring, and defining these patterns in scientific terms. Spirals play an important role in the growth processes of many biological forms and organisms. Also, through time, humans have imitated spiral motifs in their art forms, and invented new and unusual spirals which have no counterparts in the natural world. Therefore, one goal of this multiauthored book is to stress the c

  17. Nerve Transfers for Treatment of Isolated Axillary Nerve Injuries

    OpenAIRE

    Wheelock, Margie; Clark, Tod A; Giuffre, Jennifer L

    2015-01-01

    Almost one-half of all dislocations involve the shoulder and may also involve the axillary nerves, which may influence functional recovery and result in persistent shoulder neuropathy. Although individuals with intact rotator cuffs may be able to compensate for axillary nerve dysfunction, the injury may become problematic in later years, especially given the increasing incidence of rotator cuff tears in aging populations, thus placing increased importance on the immediate success of acute man...

  18. Rotator Cuff Exercises

    Science.gov (United States)

    ... reach around behind your back and underneath to grab the bottom of the towel. Hold for 30 ... Cuff Exercises Last Updated: May 1, 2017 This article was contributed by: familydoctor.org editorial staff Categories: ...

  19. Nerve Transfers for Treatment of Isolated Axillary Nerve Injuries.

    Science.gov (United States)

    Wheelock, Margie; Clark, Tod A; Giuffre, Jennifer L

    2015-01-01

    The most common neurological defect in traumatic anterior glenohumeral dislocation is isolated axillary nerve palsy. Most recover spontaneously; however, some have persistent axillary neuropathy. An intact rotator cuff may compensate for an isolated axillary nerve injury; however, given the high rate of rotator cuff pathology with advancing age, patients with an axillary nerve injury are at risk for complete shoulder disability. To review reconstruction of the axillary nerve to alleviate shoulder pain, augment shoulder stability, abduction and external rotation to alleviate sole reliance on the rotator cuff to move and stabilize the shoulder. A retrospective review of 10 patients with an isolated axillary nerve injury and an intact rotator cuff who underwent a triceps nerve branch to axillary nerve transfer was performed. Patient demographics, surgical technique, deltoid strength, donor-site morbidity, complications and time to surgery were evaluated. Ten male patients, mean age 38.3 years (range 18 to 66 years), underwent a triceps to axillary nerve transfer for isolated axillary nerve injury 7.4 months (range five to 12 months) post-traumatic shoulder dislocation. Deltoid function was British Medical Research Council grade 0/5 in all patients preoperatively and ≥3/5 deltoid strength in eight patients at final follow-up (14.8 months [range 12 to 25 months]). There were no complications and no donor-site morbidity. A triceps to axillary nerve transfer for isolated axillary neuropathy following traumatic shoulder dislocation improved shoulder pain, stability and deltoid strength, and potentially preserves shoulder function with advancing age by alleviating sole reliance on the rotator cuff for shoulder abduction and external rotation.

  20. Tracheal tube and laryngeal mask cuff pressure during anaesthesia - mandatory monitoring is in need

    Directory of Open Access Journals (Sweden)

    Møller Ann M

    2010-12-01

    Full Text Available Abstract Background To prevent endothelium and nerve lesions, tracheal tube and laryngeal mask cuff pressure is to be maintained at a low level and yet be high enough to secure air sealing. Method In a prospective quality-control study, 201 patients undergoing surgery during anaesthesia (without the use of nitrous oxide were included for determination of the cuff pressure of the tracheal tubes and laryngeal masks. Results In the 119 patients provided with a tracheal tube, the median cuff pressure was 30 (range 8 - 100 cm H2O and the pressure exceeded 30 cm H2O (upper recommended level for 54 patients. In the 82 patients provided with a laryngeal mask, the cuff pressure was 95 (10 - 121 cm H2O and above 60 cm H2O (upper recommended level for 56 patients and in 34 of these patients, the pressure exceeded the upper cuff gauge limit (120 cm H2O. There was no association between cuff pressure and age, body mass index, type of surgery, or time from induction of anaesthesia to the time the cuff pressure was measured. Conclusion For maintenance of epithelia flow and nerve function and at the same time secure air sealing, this evaluation indicates that the cuff pressure needs to be checked as part of the procedures involved in induction of anaesthesia and eventually checked during surgery.

  1. Rotator Cuff Injuries.

    Science.gov (United States)

    Connors, G. Patrick

    Many baseball players suffer from shoulder injuries related to the rotator cuff muscles. These injuries may be classified as muscular strain, tendonitis or tenosynovitis, and impingement syndrome. Treatment varies from simple rest to surgery, so it is important to be seen by a physician as soon as possible. In order to prevent these injuries, the…

  2. The spiral

    DEFF Research Database (Denmark)

    Bibace, Roger; Kharlamov, Nikita

    2013-01-01

    ’s work with Bernard Kaplan on symbol formation is a primer on this idea. This paper examines the idea of spirality and develops the notion of dynamic coexistence that can clarify the issue of directionality of development; that is, what is the general trajectory or ground plan that development assumes....... Directionality is discussed in terms of the organism-in-environment unfolding over time as the unit of developmental analysis. Thinking on this issue has proceeded from the nature–nurture debates, to recognition of the interaction of external and internal processes, to transactions between the organism...

  3. Axonal elongation through long acellular nerve segments depends on recruitment of phagocytic cells from the near-nerve environment. Electrophysiological and morphological studies in the cat

    DEFF Research Database (Denmark)

    Sørensen, J; Fugleholm, K; Moldovan, M

    2001-01-01

    The distal nerve stump plays a central role in the regeneration of peripheral nerve but the relative importance of cellular and humoral factors is not clear. We have studied this question by freezing the tibial nerve distal to a crush lesion in cat. The importance of constituents from the near......-nerve environment was assessed by modification of the contact between the tibial nerve and the environment. Silicone cuffs, containing electrodes for electrophysiological assessment of nerve regeneration, were placed around the tibial nerve distal to the crush site. The interaction between long acellular frozen...... nerve segments (ANS) and the near-nerve environment was ascertained by breaching the silicone cuff to allow access of cellular or humoral components. Tibial nerves were crushed and frozen for 40 mm and enclosed in nerve cuffs with 0.45-microm holes or 2.0-mm holes to allow access of humoral factors...

  4. Interposition vein cuffs.

    Science.gov (United States)

    Harris, P; Da Silva, T; How, T

    1996-01-01

    A vein cuff interposed at the distal anastomosis between a prosthetic vascular graft and a recipient infrageniculate artery improves the chances of continued patency of the graft, at least in the short and medium term. The mode of effect appears to be suppression or modification of anastomotic myointimal hyperplasia (MIH). In the event of graft failure the recipient artery and run-off vessels remain free from MIH and their patency is preserved thereby improving the prospects for further vascular reconstruction and limb salvage. The mechanisms by which interposition vein cuffs might modulate MIH are reviewed. Experimental evidence is described to show that the geometry of a cuffed anastomosis promotes a characteristic haemodynamic flow structure with a stable vortex. It is suggested that this vortex exerts greater shear stress upon the wall of the artery than the normal laminar flow observed in conventional anastomoses. High shear stress is known to inhibit MIH.

  5. Spiral tectonics

    Science.gov (United States)

    Hassan Asadiyan, Mohammad

    2014-05-01

    Spiral Tectonics (ST) is a new window to global tectonics introduced as alternative model for Plate Tectonics (PT). ST based upon Dahw(rolling) and Tahw(spreading) dynamics. Analogues to electric and magnetic components in the electromagnetic theory we could consider Dahw and Tahw as components of geodynamics, when one component increases the other decreases and vice versa. They are changed to each other during geological history. D-component represents continental crust and T-component represents oceanic crust. D and T are two arm of spiral-cell. T-arm 180 degree lags behind D-arm so named Retard-arm with respect to D or Forward-arm. It seems primary cell injected several billions years ago from Earth's center therefore the Earth's core was built up first then mantel and finally the crust was build up. Crust building initiate from Arabia (Mecca). As the universe extended gravitation wave swirled the earth fractaly along cycloid path from big to small scale. In global scale (order-0) ST collect continents in one side and abandoned Pacific Ocean in the other side. Recent researches also show two mantels upwelling in opposite side of the Earth: one under Africa (tectonic pose) and the other under Pacific Ocean (tectonic tail). In higher order (order-1) ST build up Africa in one side and S.America in the other side therefore left Atlantic Ocean meandered in between. In order-n e.g. Khoor Musa and Bandar-Deylam bay are seen meandered easterly in the Iranian part but Khoor Abdullah and Kuwait bay meandered westerly in the Arabian part, they are distributed symmetrically with respect to axis of Persian Gulf(PG), these two are fractal components of easterly Caspian-wing and westerly Black Sea-wing which split up from Anatoly. Caspian Sea and Black Sea make two legs of Y-like structure, this shape completely fitted with GPS-velocity map which start from PG and split up in the Catastrophic Point(Anatoly). We could consider PG as remnants of Ancient Ocean which spent up

  6. The Spiral of Euroscepticism

    DEFF Research Database (Denmark)

    Galpin, Charlotte; Trenz, Hans-Jörg

    2017-01-01

    Media scholars have increasingly examined the effects of a negativity bias that applies to political news. In the ‘spiral of cynicism’, journalist preferences for negative news correspond to public demands for sensational news. We argue that this spiral of cynicism in EU news results in a ‘spiral...

  7. Biceps tendinitis in chronic rotator cuff tears: a histologic perspective.

    Science.gov (United States)

    Singaraju, Vamsi M; Kang, Richard W; Yanke, Adam B; McNickle, Allison G; Lewis, Paul B; Wang, Vincent M; Williams, James M; Chubinskaya, Susan; Romeo, Anthony A; Cole, Brian J

    2008-01-01

    Patients with chronic rotator cuff tears frequently have anterior shoulder pain attributed to the long head of the biceps brachii (LHBB) tendon. In this study, tenodesis or tenotomy samples and cadaveric controls were assessed by use of immunohistochemical and histologic methods to quantify inflammation, vascularity, and neuronal plasticity. Patients had moderate pain and positive results on at least 1 clinical test of shoulder function. The number of axons in the distal LHBB was significantly less in patients with biceps tendinitis. Calcitonin gene-related peptide and substance P immunostaining was predominantly within nerve roots and blood vessels. A moderate correlation (R = 0.5) was identified between LHBB vascularity and pain scores. On the basis of these results, we conclude that, in the context of rotator cuff disease, the etiology of anterior shoulder pain with macroscopic changes in the biceps tendon is related to the complex interaction of the tendon and surrounding soft tissues, rather than a single entity.

  8. Dose-Response Evaluation of Braslet-M Occlusion Cuffs

    Science.gov (United States)

    Ebert, Douglas; Garcia, Kathleen; Sargsyan, Ashot E.; Ham, David; Hamilton, Douglas; Dulchavsky, Scott A.

    2010-01-01

    Introduction: Braslet-M is a set of special elasticized thigh cuffs used by the Russian space agency to reduce the effects of the head-ward fluid shift during early adaptation to microgravity by sequestering fluid in the lower extremities. Currently, no imaging modalities are used in the calibration of the device, and the pressure required to produce a predictable physiological response is unknown. This investigation intends to relate the pressure exerted by the cuffs to the extent of fluid redistribution and commensurate physiological effects. Materials and Methods: Ten healthy subjects with standardized fluid intake participated in the study. Data collection included femoral and internal jugular vein imaging in two orthogonal planes, pulsed Doppler of cervical and femoral vessels and middle cerebral artery, optic nerve imaging, and echocardiography. Braslet-M cuff pressure was monitored at the skin interface using pre-calibrated pressure sensors. Using 6 and 30 head-down tilt in two separate sessions, the effect of Braslet-M was assessed while incrementally tightening the cuffs. Cuffs were then simultaneously released to document the resulting hemodynamic change. Results: Preliminary analysis shows correlation between physical pressure exerted by the Braslet-M device and several parameters such as jugular and femoral vein cross-sections, resistivity of the lower extremity vascular bed, and others. A number of parameters reflect blood redistribution and will be used to determine the therapeutic range of the device and to prevent unsafe application. Conclusion: Braslet-M exerts a physical effect that can be measured and correlated with many changes in central and peripheral hemodynamics. Analysis of the full data set will be required to make definitive recommendations regarding the range of safe therapeutic application. Objective data and subjective responses suggest that a safer and equally effective use of Braslet can be achieved when compared with the current

  9. An implantable wireless optogenetic stimulation system for peripheral nerve control.

    Science.gov (United States)

    Kang-Il Song; Park, Sunghee E; Myoung-Soo Kim; Chulmin Joo; Yong-Jun Kim; Suh, Jun-Kyo F; Dosik Hwang; Inchan Youn

    2015-08-01

    An implantable wireless optogenetic stimulation system with an LED-based optical stimulation cuff electrode was developed for peripheral nerve control. The proposed system consisted of a battery-powered optical cuff electrode, optical stimulation controller, and wireless communication system. The optical cuff electrode had a polydimethylsiloxane (PDMS) structure was designed to illuminate the entire sciatic nerve. The wireless communication system was designed to comply with medical implant communication service (MICS) regulations. To evaluate the proposed system, optogenetic stimulation was performed in optogenetic transgenic mice (Thy1::ChR2). The optical cuff electrode was implanted on the sciatic nerve, and movement was elicited during optical stimulation. The experimental results show that ankle movement can be generated wirelessly using optical stimulation pulse parameters.

  10. Endotracheal Tube Cuff Management at Altitude

    Science.gov (United States)

    2014-02-05

    pressure of 20-22 mmHg using a cuff pressure manometer (Rusch Endotest, Teleflex Inc., Limerick, PA) and not manipulated again. 2. Manual – The...ETT cuff was inflated with air to a pressure of 20-22 mmHg using a cuff pressure manometer (Rusch Endotest, Teleflex Inc., Limerick, PA). At a

  11. Tracheal tube and laryngeal mask cuff pressure during anaesthesia - mandatory monitoring is in need

    DEFF Research Database (Denmark)

    Rokamp, K.Z.; Secher, N.H.; Møller, Ann

    2010-01-01

    patients. In the 82 patients provided with a laryngeal mask, the cuff pressure was 95 (10 - 121) cm H2O and above 60 cm H2O (upper recommended level) for 56 patients and in 34 of these patients, the pressure exceeded the upper cuff gauge limit (120 cm H2O). There was no association between cuff pressure......ABSTRACT: BACKGROUND: To prevent endothelium and nerve lesions, tracheal tube and laryngeal mask cuff pressure is to be maintained at a low level and yet be high enough to secure air sealing. METHOD: In a prospective quality-control study, 201 patients undergoing surgery during anaesthesia (without...... the use of nitrous oxide) were included for determination of the cuff pressure of the tracheal tubes and laryngeal masks. RESULTS: In the 119 patients provided with a tracheal tube, the median cuff pressure was 30 (range 8 - 100) cm H2O and the pressure exceeded 30 cm H2O (upper recommended level) for 54...

  12. Tracheal tube and laryngeal mask cuff pressure during anaesthesia - mandatory monitoring is in need

    DEFF Research Database (Denmark)

    Rokamp, K.Z.; Secher, N.H.; Møller, Ann

    2010-01-01

    ABSTRACT: BACKGROUND: To prevent endothelium and nerve lesions, tracheal tube and laryngeal mask cuff pressure is to be maintained at a low level and yet be high enough to secure air sealing. METHOD: In a prospective quality-control study, 201 patients undergoing surgery during anaesthesia (without...... the use of nitrous oxide) were included for determination of the cuff pressure of the tracheal tubes and laryngeal masks. RESULTS: In the 119 patients provided with a tracheal tube, the median cuff pressure was 30 (range 8 - 100) cm H2O and the pressure exceeded 30 cm H2O (upper recommended level) for 54...... patients. In the 82 patients provided with a laryngeal mask, the cuff pressure was 95 (10 - 121) cm H2O and above 60 cm H2O (upper recommended level) for 56 patients and in 34 of these patients, the pressure exceeded the upper cuff gauge limit (120 cm H2O). There was no association between cuff pressure...

  13. Triangular spiral tilings

    International Nuclear Information System (INIS)

    Sushida, Takamichi; Hizume, Akio; Yamagishi, Yoshikazu

    2012-01-01

    The topology of spiral tilings is intimately related to phyllotaxis theory and continued fractions. A quadrilateral spiral tiling is determined by a suitable chosen triple (ζ, m, n), where ζ element of D/R, and m and n are relatively prime integers. We give a simple characterization when (ζ, m, n) produce a triangular spiral tiling. When m and n are fixed, the admissible generators ζ form a curve in the unit disk. The family of triangular spiral tilings with opposed parastichy pairs (m, n) is parameterized by the divergence angle arg (ζ), while triangular spiral tilings with non-opposed parastichy pairs are parameterized by the plastochrone ratio 1/|ζ|. The generators for triangular spiral tilings with opposed parastichy pairs are not dense in the complex parameter space, while those with non-opposed parastichy pairs are dense. The proofs will be given in a general setting of spiral multiple tilings. We present paper-folding (origami) sheets that build spiral towers whose top-down views are triangular tilings. (paper)

  14. Ultrasonography of the Rotator Cuff

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yong Cheol [Samsung Medica Center, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

    2006-09-15

    The ultrasonography (US) is an important modality in evaluating shoulder disease. It is accurate in diagnosing the various shoulder diseases including tendinosis, calcific tendinitis, and subacromial bursitis as well as rotator cuff tears. This article presents a pictorial review of US anatomy of the shoulder, the technical aspects of shoulder US, major types of shoulder pathology, and interventional procedure under US guidance

  15. Ultrasonography of the Rotator Cuff

    International Nuclear Information System (INIS)

    Yoon, Yong Cheol

    2006-01-01

    The ultrasonography (US) is an important modality in evaluating shoulder disease. It is accurate in diagnosing the various shoulder diseases including tendinosis, calcific tendinitis, and subacromial bursitis as well as rotator cuff tears. This article presents a pictorial review of US anatomy of the shoulder, the technical aspects of shoulder US, major types of shoulder pathology, and interventional procedure under US guidance

  16. Spiral Countercurrent Chromatography

    Science.gov (United States)

    Ito, Yoichiro; Knight, Martha; Finn, Thomas M.

    2013-01-01

    For many years, high-speed countercurrent chromatography conducted in open tubing coils has been widely used for the separation of natural and synthetic compounds. In this method, the retention of the stationary phase is solely provided by the Archimedean screw effect by rotating the coiled column in the centrifugal force field. However, the system fails to retain enough of the stationary phase for polar solvent systems such as the aqueous–aqueous polymer phase systems. To address this problem, the geometry of the coiled channel was modified to a spiral configuration so that the system could utilize the radially acting centrifugal force. This successfully improved the retention of the stationary phase. Two different types of spiral columns were fabricated: the spiral disk assembly, made by stacking multiple plastic disks with single or four interwoven spiral channels connected in series, and the spiral tube assembly, made by inserting the tetrafluoroethylene tubing into a spiral frame (spiral tube support). The capabilities of these column assemblies were successfully demonstrated by separations of peptides and proteins with polar two-phase solvent systems whose stationary phases had not been well retained in the earlier multilayer coil separation column for high-speed countercurrent chromatography. PMID:23833207

  17. Spiral finned crucible pot

    Science.gov (United States)

    Soemowidagdo, Arianto Leman; Tiwan, Widarto, Ardian, Aan

    2018-02-01

    Innovation on a crucible furnace to increase its efficiency in aluminum melting has been done. The innovation was a spiral finned crucible pot. The inclination of the spiral finned was vary of 5, 10, 15, and 20 degrees. The spiral finned effects was determined from the performance test result. A crucible pot without fin was also tested as a control. The crucible pot was examined at the same process condition. The crucible pot with the inclined fin of 10 degrees gives an optimum performance. It gives effective heating rate so that more efficient in LPG consumption. Therefore it saves energy in the aluminum melting process.

  18. Handcrafted cuff manometers do not accurately measure endotracheal tube cuff pressure.

    Science.gov (United States)

    Annoni, Raquel; de Almeida Junior, Antonio Evanir

    2015-01-01

    To test the agreement between two handcrafted devices and a cuff-specific manometer. The agreement between two handcrafted devices adapted to measure tracheal tube cuff pressure and a cuff-specific manometer was tested on 79 subjects. The cuff pressure was measured with a commercial manometer and with two handcrafted devices (HD) assembled with aneroid sphygmomanometers (HD1 and HD2). The data were compared using Wilcoxon and Spearman tests, the intraclass correlation coefficient (ICC) and limit-of-agreement analysis. Cuff pressures assessed with handcrafted devices were significantly different from commercial device measurements (pressures were higher when measured with HD1 and lower with HD2). The ICCs between the commercial device and HD1 and HD2 were excellent (ICC = 0.8 p manometers do not provide accurate cuff pressure measurements when compared to a cuff-specific device and should not be used to replace the commercial cuff manometers in mechanically ventilated patients.

  19. Repeated deflation of a gas-barrier cuff to stabilize cuff pressure during nitrous oxide anesthesia.

    Science.gov (United States)

    Karasawa, Fujio; Matsuoka, Nobuhiro; Kodama, Mitsuyoshi; Okuda, Tomohiro; Mori, Tomohisa; Kawatani, Yasushi

    2002-07-01

    Although a nitrous oxide (N(2)O) gas-barrier cuff effectively limits the increase of cuff pressure during N(2)O anesthesia, there are few data assessing whether an N(2)O gas-barrier cuff is more beneficial for stabilizing intracuff pressure than standard endotracheal tubes when cuffs are repeatedly deflated to stabilize pressure during N(2)O anesthesia. In the present study, the pressure of air-filled standard-type cuffs (Trachelon; Terumo, Tokyo, Japan) and N(2)O gas-barrier type endotracheal tube cuffs (Profile Soft-Seal Cuff [PSSC]; Sims Portex, Kent, UK) was measured during 67% N(2)O anesthesia (n = 8 in each), during which the cuffs were repeatedly deflated every 30 min (Trachelon) or 60 min (PSSC) for the first 3 or 4 h. After aspirating the cuffs for 3 h, the cuff pressure exceeded 22 mm Hg in more than half of the patients in both groups. However, aspiration of the cuffs for 4 h decreased the maximal cuff pressure between deflation intervals in both groups (P deflating the cuffs over 4 h, the cuff pressure in both groups never exceeded 22 mm Hg during the subsequent 3 h, and intracuff N(2)O concentrations did not significantly change. Therefore, deflation of cuffs for 4 h during N(2)O anesthesia sufficiently stabilized cuff pressure and equilibrated the intracuff N(2)O concentrations in both groups. The use of the PSSC endotracheal tube might be more practical because of the smaller number of cuff deflations required, but the PSSC does not reduce the duration of cuff deflations to stabilize the pressure. We demonstrated that the N(2)O concentration and pressure in the N(2)O-barrier Profile Soft-Seal Cuff stabilized when the cuff was aspirated once an hour for 4 h during N(2)O anesthesia. The Profile Soft-Seal Cuff might be easier to use in clinical practice than standard endotracheal tubes because of the smaller number of cuff deflations required.

  20. Vaginal cuff dehiscence after vaginal cuff brachytherapy for uterine cancer. A case report

    OpenAIRE

    Cattaneo, Richard; Bellon, Maria; Elshaikh, Mohamed A.

    2013-01-01

    Vaginal cuff dehiscence is a rare, but potentially serious complication after total hysterectomy. We report a case of vaginal cuff dehiscence after vaginal cuff brachytherapy. A 62 year old female underwent a robotic-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy, and was found to have International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB endometrioid adenocarcinoma of the uterus. The patient was referred for adjuvant vaginal cuff brachytherapy. D...

  1. Spiral 2 Week

    International Nuclear Information System (INIS)

    2007-01-01

    The main goal of this meeting is to present and discuss the current status of the Spiral-2 project at GANIL in front of a large community of scientists and engineers. Different issues have been tackled particularly the equipment around Spiral-2 like injectors, cryo-modules or beam diagnostics, a workshop was devoted to other facilities dedicated to radioactive ion beam production. This document gathers only the slides of the presentations

  2. Spiral 2 Week

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    The main goal of this meeting is to present and discuss the current status of the Spiral-2 project at GANIL in front of a large community of scientists and engineers. Different issues have been tackled particularly the equipment around Spiral-2 like injectors, cryo-modules or beam diagnostics, a workshop was devoted to other facilities dedicated to radioactive ion beam production. This document gathers only the slides of the presentations.

  3. Difficulty with cuff deflation of reinforced tracheal tube caused by inflation line occlusion with silk thread ligation and fixation.

    Science.gov (United States)

    Gotoh, Sayoko; Sugiyama, Daisuke; Imai, Eriko; Kawamata, Mikito

    2015-03-05

    A reinforced tracheal tube, ligated with silk threads, was inserted into a tracheostomy orifice and fixed to the skin. The cuff inflation line of the reinforced tracheal tube became occluded. Reinforced 'armoured' tracheal tubes have a spiral of wire embedded into the wall of the tube to give strength and flexibility, and may be sharply bent without compromising the tube lumen. The tracheal cuff attached to the tube is inflated by injecting air through a narrow-diameter tube welded to the outside of the tracheal tube. When a reinforced tracheal tube is ligated and fixed with silk threads, it should be confirmed whether the tracheal tube cuff can be deflated and inflated after fixation. Moreover, because occlusion can be eliminated by removing all silk threads used to ligate a tracheal tube, they should be removed before extubation. 2015 BMJ Publishing Group Ltd.

  4. Rotator cuff tear: A detailed update

    Directory of Open Access Journals (Sweden)

    Vivek Pandey

    2015-01-01

    Full Text Available Rotator cuff tear has been a known entity for orthopaedic surgeons for more than two hundred years. Although the exact pathogenesis is controversial, a combination of intrinsic factors proposed by Codman and extrinsic factors theorized by Neer is likely responsible for most rotator cuff tears. Magnetic resonance imaging remains the gold standard for the diagnosis of rotator cuff tears, but the emergence of ultrasound has revolutionized the diagnostic capability. Even though mini-open rotator cuff repair is still commonly performed, and results are comparable to arthroscopic repair, all-arthroscopic repair of rotator cuff tear is now fast becoming a standard care for rotator cuff repair. Appropriate knowledge of pathology and healing pattern of cuff, strong and biological repair techniques, better suture anchors, and gradual rehabilitation of postcuff repair have led to good to excellent outcome after repair. As the healing of degenerative cuff tear remains unpredictable, the role of biological agents such as platelet-rich plasma and stem cells for postcuff repair augmentation is still under evaluation. The role of scaffolds in massive cuff tear is also being probed.

  5. Rotator cuff impingement syndrome: MR imaging

    International Nuclear Information System (INIS)

    Kieft, G.J.; Obermann, W.R.; Rozing, P.M.; Bloem, J.L.

    1987-01-01

    This paper summarizes the authors' experience using MR as a diagnostic tool in evaluating the rotator cuff empingement syndrome. Twenty patients with clinically suspected rotator cuff impingement syndrome were prospectively evaluated using standard radiography, double-contrast arthrography and MR imaging. MR is capable of demonstrating cuff abnormalities due to impingement. The most important findings is an area of abnormal signal intensity on both relatively T1- and T2-weighted spin-echo images. Surgery confirmed that these areas corresponded with inflamed degenerative supraspinatus tendon. Cuff changes can be depicted with MR in patients with arthrographically and radiographically normal shoulders

  6. Electrotherapy modalities for rotator cuff disease.

    Science.gov (United States)

    Page, Matthew J; Green, Sally; Mrocki, Marshall A; Surace, Stephen J; Deitch, Jessica; McBain, Brodwen; Lyttle, Nicolette; Buchbinder, Rachelle

    2016-06-10

    Management of rotator cuff disease may include use of electrotherapy modalities (also known as electrophysical agents), which aim to reduce pain and improve function via an increase in energy (electrical, sound, light, or thermal) into the body. Examples include therapeutic ultrasound, low-level laser therapy (LLLT), transcutaneous electrical nerve stimulation (TENS), and pulsed electromagnetic field therapy (PEMF). These modalities are usually delivered as components of a physical therapy intervention. This review is one of a series of reviews that form an update of the Cochrane review, 'Physiotherapy interventions for shoulder pain'. To synthesise available evidence regarding the benefits and harms of electrotherapy modalities for the treatment of people with rotator cuff disease. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), Ovid MEDLINE (January 1966 to March 2015), Ovid EMBASE (January 1980 to March 2015), CINAHL Plus (EBSCOhost, January 1937 to March 2015), ClinicalTrials.gov and the WHO ICTRP clinical trials registries up to March 2015, unrestricted by language, and reviewed the reference lists of review articles and retrieved trials, to identify potentially relevant trials. We included randomised controlled trials (RCTs) and quasi-randomised trials, including adults with rotator cuff disease (e.g. subacromial impingement syndrome, rotator cuff tendinitis, calcific tendinitis), and comparing any electrotherapy modality with placebo, no intervention, a different electrotherapy modality or any other intervention (e.g. glucocorticoid injection). Trials investigating whether electrotherapy modalities were more effective than placebo or no treatment, or were an effective addition to another physical therapy intervention (e.g. manual therapy or exercise) were the main comparisons of interest. Main outcomes of interest were overall pain, function, pain on motion, patient-reported global assessment of treatment success

  7. Silicone Molding and Lifetime Testing of Peripheral Nerve Interfaces for Neuroprostheses

    Energy Technology Data Exchange (ETDEWEB)

    Gupte, Kimaya [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Biomedical Engineering; Tolosa, Vanessa [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States). Center for Micro- and Nanotechnology

    2016-08-10

    Implantable peripheral nerve cuffs have a large application in neuroprostheses as they can be used to restore sensation to those with upper limb amputations. Modern day prosthetics, while lessening the pain associated with phantom limb syndrome, have limited fine motor control and do not provide sensory feedback to patients. Sensory feedback with prosthetics requires communication between the nervous system and limbs, and is still a challenge to accomplish with amputees. Establishing this communication between the peripheral nerves in the arm and artificial limbs is vital as prosthetics research aims to provide sensory feedback to amputees. Peripheral nerve cuffs restore sensation by electrically stimulating certain parts of the nerve in order to create feeling in the hand. Cuff electrodes have an advantage over standard electrodes as they have high selective stimulation by bringing the electrical interface close to the neural tissue in order to selectively activate targeted regions of a peripheral nerve. In order to further improve the selective stimulation of these nerve cuffs, there is need for finer spatial resolution among electrodes. One method to achieve a higher spatial resolution is to increase the electrode density on the cuff itself. Microfabrication techniques can be used to achieve this higher electrode density. Using L-Edit, a layout editor, microfabricated peripheral nerve cuffs were designed with a higher electrode density than the current model. This increase in electrode density translates to an increase in spatial resolution by at least one order of magnitude. Microfabricated devices also have two separate components that are necessary to understand before implantation: lifetime of the device and assembly to prevent nerve damage. Silicone molding procedures were optimized so that devices do not damage nerves in vivo, and lifetime testing was performed on test microfabricated devices to determine their lifetime in vivo. Future work of this project

  8. Plasma Generator Using Spiral Conductors

    Science.gov (United States)

    Szatkowski, George N. (Inventor); Dudley, Kenneth L. (Inventor); Ticatch, Larry A. (Inventor); Smith, Laura J. (Inventor); Koppen, Sandra V. (Inventor); Nguyen, Truong X. (Inventor); Ely, Jay J. (Inventor)

    2016-01-01

    A plasma generator includes a pair of identical spiraled electrical conductors separated by dielectric material. Both spiraled conductors have inductance and capacitance wherein, in the presence of a time-varying electromagnetic field, the spiraled conductors resonate to generate a harmonic electromagnetic field response. The spiraled conductors lie in parallel planes and partially overlap one another in a direction perpendicular to the parallel planes. The geometric centers of the spiraled conductors define endpoints of a line that is non-perpendicular with respect to the parallel planes. A voltage source coupled across the spiraled conductors applies a voltage sufficient to generate a plasma in at least a portion of the dielectric material.

  9. Cardiorespiratory arrest secondary to tracheostomy cuff herniation.

    Science.gov (United States)

    Barker, Ian R; Stotz, Martin

    2013-08-29

    This report details the case of a 67-year-old man who required intubation following a fall and multiple rib fractures and underwent surgical tracheostomy. Postoperatively, he deteriorated on the intensive care unit with airway obstruction. Bronchoscopy demonstrated tracheostomy cuff herniation obstructing airflow necessitating conventional orotracheal reintubation. On inspection of the tracheostomy an unusual cuff deformation was noted.

  10. Treatment alternative for irreparable rotator cuff ruptures ...

    African Journals Online (AJOL)

    Background: The treatment of massive irreparable rotator cuff rupture has still no consensus among shoulder surgeons. It is assumed that symptomatic rotator cuff tendon rupture is accepted as irreparable if retraction amount of tendon is Patte stage 3 on MRI; degree of fatty atrophy is Goutallier stage 3 or 4; narrowing of ...

  11. The spinning ball spiral

    Science.gov (United States)

    Dupeux, Guillaume; Le Goff, Anne; Quéré, David; Clanet, Christophe

    2010-09-01

    We discuss the trajectory of a fast revolving solid ball moving in a fluid of comparable density. As the ball slows down owing to drag, its trajectory follows an exponential spiral as long as the rotation speed remains constant: at the characteristic distance L where the ball speed is significantly affected by the drag, the bending of the trajectory increases, surprisingly. Later, the rotation speed decreases, which makes the ball follow a second kind of spiral, also described in the paper. Finally, the use of these highly curved trajectories is shown to be relevant to sports.

  12. Quarkyonic Chiral Spirals

    International Nuclear Information System (INIS)

    Toru, Kojo; Hidaka, Y.; Pisarski, R.; McLerran, L.

    2010-01-01

    We argue the properties of confining dense quark matter, 'quarkyonic' matter, from the viewpoint of both bulk properties and excitation modes. After a brief review of confining aspects, the chiral breaking/restoration will be discussed. We argue that the strong infrared correlations induce the chiral spiral, i.e., the spatial modulation of the chiral condensate which breaks the chiral symmetry locally but restore it globally. The effective dimensional reduction takes place, allowing us to analyzing the system as 2D model in which several exact results can be explicitly derived. We also discuss the excitation spectra, both mesonic and baryonic ones, on the chiral spiral. (author)

  13. Biological assessments of multifunctional hydrogel-decorated implantable neural cuff electrode for clinical neurology application.

    Science.gov (United States)

    Kim, Han-Jun; Heo, Dong Nyoung; Lee, Yi Jae; Lee, Sang Jin; Kang, Ji Yoon; Lee, Soo Hyun; Kwon, I I Keun; Do, Sun Hee

    2017-11-10

    The implantable cuff electrode is an effective neuroprosthetic device in current nerve tissue engineering. However, biocompatibility and stability are still a serious dispute in terms of in vivo function and continuous monitoring. In this regard, assessing the host's biological response to biomaterials is one of the key factors of chronic implantation. In this article, we analyzed the peripheral nerve specific-biological responses to the application of multi-functional hydrogel-coated electrodes. The surface of the cuff electrode was modified using a multifunctional hydrogel composed of PEG hydrogel, cyclosporin A(CsA)-microsphere(MS) and electrodeposited PEDOT:PSS. Through our approach, we have found that the multifunctional hydrogel coatings improve the neural electrode function, such as peak-to-peak amplitude increase. Additionally, the multifunctional hydrogel coated electrodes exhibited improved biocompatibility, such as reduced apoptotic properties and increased axonal myelination. Furthermore, 12 genes (BDNF, Gfra1, IL-6, Sox 10, S100B, P75 NTR , GAP43, MBP, MPZ, NrCAM, NE-FL, CB1) were upregulated at 5 weeks post-implant. Finally, double immunofluorescence revealed the effect of endocannabinoid system on neuroprotective properties and tissue remodeling of peripheral nerves during cuff electrode implantation. These results clearly confirmed that multifunctional hydrogel coatings could improve electrode function and biocompatibility by enhancing neuroprotective properties, which may provide a valuable paradigm for clinical neurology application.

  14. Tracking Target and Spiral Waves

    DEFF Research Database (Denmark)

    Jensen, Flemming G.; Sporring, Jon; Nielsen, Mads

    2002-01-01

    A new algorithm for analyzing the evolution of patterns of spiral and target waves in large aspect ratio chemical systems is introduced. The algorithm does not depend on finding the spiral tip but locates the center of the pattern by a new concept, called the spiral focus, which is defined by the...

  15. Are spiral galaxies heavy smokers?

    International Nuclear Information System (INIS)

    Davies, J.; Disney, M.; Phillipps, S

    1990-01-01

    The dustiness of spiral galaxies is discussed. Starburst galaxies and the shortage of truly bright spiral galaxies is cited as evidence that spiral galaxies are far dustier than has been thought. The possibility is considered that the dust may be hiding missing mass

  16. Spiraling into Transformative Learning

    Science.gov (United States)

    Cranton, Patricia

    2010-01-01

    This article explores how technical and vocational learning may spiral into transformative learning. Transformative learning theory is reviewed and the learning tasks of critical theory are used to integrate various approaches to transformative learning. With this as a foundation, the article explores how transformative learning can be fostered in…

  17. Archimedean Voronoi spiral tilings

    Science.gov (United States)

    Yamagishi, Yoshikazu; Sushida, Takamichi

    2018-01-01

    We study the transition of the number of spirals (called parastichy in the theory of phyllotaxis) within a Voronoi tiling for Archimedean spiral lattices. The transition of local parastichy numbers within a tiling is regarded as a transition at the base site point in a continuous family of tilings. This gives a natural description of the quasiperiodic structure of the grain boundaries. It is proved that the number of tiles in the grain boundaries are denominators of rational approximations of the argument (called the divergence angle) of the generator. The local parastichy numbers are non-decreasing functions of the plastochron parameter. The bifurcation diagram of local parastichy numbers has a Farey tree structure. We also prove Richards’ formula of spiral phyllotaxis in the case of Archimedean Voronoi spiral tilings, and show that, if the divergence angle is a quadratic irrational number, then the shapes of tiles in the grain boundaries are close to rectangles. If the divergence angle is linearly equivalent to the golden section, then the shape of tiles in the grain boundaries is close to square.

  18. Properties of spiral resonators

    International Nuclear Information System (INIS)

    Haeuser, J.

    1989-10-01

    The present thesis deals with the calculation and the study of the application possibilities of single and double spiral resonators. The main aim was the development and the construction of reliable and effective high-power spiral resonators for the UNILAC of the GSI in Darmstadt and the H - -injector for the storage ring HERA of DESY in Hamburg. After the presentation of the construction and the properties of spiral resonators and their description by oscillating-circuit models the theoretical foundations of the bunching are presented and some examples of a rebuncher and debuncher and their influence on the longitudinal particle dynamics are shown. After the description of the characteristic accelerator quantities by means of an oscillating-circuit model and the theory of an inhomogeneous λ/4 line it is shown, how the resonance frequency and the efficiency of single and double spiral resonators can be calculated from the geometrical quantities of the structure. In the following the dependence of the maximal reachable resonator voltage in dependence on the gap width and the surface of the drift tubes is studied. Furthermore the high-power resonators are presented, which were built for the different applications for the GSI in Darmstadt, DESY in Hamburg, and for the FOM Institute in Amsterdam. (orig./HSI) [de

  19. Comparison of the fastest regenerating motor and sensory myelinated axons in the same peripheral nerve.

    Science.gov (United States)

    Moldovan, Mihai; Sørensen, Jesper; Krarup, Christian

    2006-09-01

    Functional outcome after peripheral nerve regeneration is often poor, particularly involving nerve injuries far from their targets. Comparison of sensory and motor axon regeneration before target reinnervation is not possible in the clinical setting, and previous experimental studies addressing the question of differences in growth rates of different nerve fibre populations led to conflicting results. We developed an animal model to compare growth and maturation of the fastest growing sensory and motor fibres within the same mixed nerve after Wallerian degeneration. Regeneration of cat tibial nerve after crush (n = 13) and section (n = 7) was monitored for up to 140 days, using implanted cuff electrodes placed around the sciatic and tibial nerves and wire electrodes at plantar muscles. To distinguish between sensory and motor fibres, recordings were carried out from L6-S2 spinal roots using cuff electrodes. The timing of laminectomy was based on the presence of regenerating fibres along the nerve within the tibial cuff. Stimulation of unlesioned tibial nerves (n = 6) evoked the largest motor response in S1 ventral root and the largest sensory response in L7 dorsal root. Growth rates were compared by mapping the regenerating nerve fibres within the tibial nerve cuff to all ventral or dorsal roots and, regardless of the lesion type, the fastest growth was similar in sensory and motor fibres. Maturation was assessed as recovery of the maximum motor and sensory conduction velocities (CVs) within the tibial nerve cuff. Throughout the observation period the CV was approximately 14% faster in regenerated sensory fibres than in motor fibres in accordance with the difference observed in control nerves. Recovery of amplitude was only partial after section, whereas the root distribution pattern was restored. Our data suggest that the fastest growth and maturation rates that can be achieved during regeneration are similar for motor and sensory myelinated fibres.

  20. Salicylate selectively kills cochlear spiral ganglion neurons by paradoxically up-regulating superoxide.

    Science.gov (United States)

    Deng, Lili; Ding, Dalian; Su, Jiping; Manohar, Senthilvelan; Salvi, Richard

    2013-10-01

    Aspirin and its active ingredient salicylate are potent antioxidants that have been reported to be neuro- and otoprotective. However, when consumed in large quantities, these drugs can cause temporary hearing loss and tinnitus. Moreover, recent studies indicate that after several days of treatment, salicylate selectively destroys the spiral ganglion neurons and auditory nerve fibers that relay sounds from the sensory hair cells to the brain. Why salicylate selectively damages spiral ganglion neurons while sparing the hair cells and supports cells is unclear. Here we show that high dose of salicylate trigger an apoptotic response in spiral ganglion neurons characterized morphologically by soma shrinkage and nuclear condensation and fragmentation plus activation of extrinsic initiator caspase-8 and intrinsic initiator caspase-9 several days after the onset of drug treatment. Salicylate treatment triggered an upsurge in the toxic superoxide radical only in spiral ganglion neurons, but not in neighboring hair cells and support cells. Mn TMPyP pentachloride, a cell permeable scavenger of superoxide blocked the expression of superoxide staining in spiral ganglion neurons and almost completely blocked the damage to the nerve fibers and spiral ganglion neurons. NMDA receptor activation is known to increase neuronal superoxide levels. Since NMDA receptors are mainly found on spiral ganglion neurons and since salicylate enhances NMDA receptor currents, the selective killing of spiral ganglion neurons is likely a consequence of enhanced and sustained activation of NMDA receptors by salicylate.

  1. Theory of spiral structure

    International Nuclear Information System (INIS)

    Lin, C.C.

    1977-01-01

    The density wave theory of galactic spirals has now developed into a form suitable for consideration by experts in Applied Mechanics. On the one hand, comparison of theoretical deductions with observational data has convinced astrophysicists of the validity of the basic physical picture and the calculated results. On the other hand, the dynamical problems of a stellar system, such as those concerning the origin of spiral structure in galaxies, have not been completely solved. This paper reviews the current status of such developments, including a brief summary of comparison with observations. A particularly important mechanism, currently called the mechanism of energy exchange, is described in some detail. The mathematical problems and the physical processes involved are similar to those occurring in certain instability mechanisms in the 'magnetic bottle' designed for plasma containment. Speculations are given on the future developments of the theory and on observational programs. (Auth.)

  2. Spiral 2 workshop

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    The accelerator and experimental facilities at GANIL will be transformed over the next 5-10 years. The centerpiece of the additions to the accelerator complex will be Spiral-2. This is the first phase of a new radioactive beam facility based on the ISOL principle. The main aim of Spiral-2 will be to produce intense, high quality beams of neutron-rich nuclei created in neutron-induced fission of heavy elements and accelerated by the existing CIME cyclotron. The principal aims of this workshop will be a) to publicize the new facilities, b) to discuss and define the science which might be carried out with them, c) to discuss the instrumentation and infrastructure required to exploit the new facilities and d) to help form collaborations of scientists wishing to design and construct the equipment needed to undertake the science programme. This document gathers most of the slides presented in the workshop.

  3. Interposition vein cuff in infrainguinal prosthetic bypasses.

    Science.gov (United States)

    D'Andrea, V; Biancari, F; Catania, A; Di Matteo, F M; Sorrenti, S; Spyrou, M; Dibra, A; Foti, N; Ortensi, A

    1999-01-01

    The Authors describe the interposition vein cuff technique as an adjuvant method to infrainguinal prosthetic bypass grafts. The haemodynamic, mechanical and humoral factors thought to be involved in the beneficial effects of the vein cuff are herein discussed. The results of the main series suggest the use of this method particularly in patients without any available autologous vein conduit requiring a below-knee popliteal or crural reconstruction.

  4. Spirality: A Noval Way to Measure Spiral Arm Pitch Angle

    Science.gov (United States)

    Shields, Douglas W.; Boe, Benjamin; Henderson, Casey L.; Hartley, Matthew; Davis, Benjamin L.; Pour Imani, Hamed; Kennefick, Daniel; Kennefick, Julia D.

    2015-01-01

    We present the MATLAB code Spirality, a novel method for measuring spiral arm pitch angles by fitting galaxy images to spiral templates of known pitch. For a given pitch angle template, the mean pixel value is found along each of typically 1000 spiral axes. The fitting function, which shows a local maximum at the best-fit pitch angle, is the variance of these means. Error bars are found by varying the inner radius of the measurement annulus and finding the standard deviation of the best-fit pitches. Computation time is typically on the order of 2 minutes per galaxy, assuming at least 8 GB of working memory. We tested the code using 128 synthetic spiral images of known pitch. These spirals varied in the number of spiral arms, pitch angle, degree of logarithmicity, radius, SNR, inclination angle, bar length, and bulge radius. A correct result is defined as a result that matches the true pitch within the error bars, with error bars no greater than ±7°. For the non-logarithmic spiral sample, the correct answer is similarly defined, with the mean pitch as function of radius in place of the true pitch. For all synthetic spirals, correct results were obtained so long as SNR > 0.25, the bar length was no more than 60% of the spiral's diameter (when the bar was included in the measurement), the input center of the spiral was no more than 6% of the spiral radius away from the true center, and the inclination angle was no more than 30°. The synthetic spirals were not deprojected prior to measurement. The code produced the correct result for all barred spirals when the measurement annulus was placed outside the bar. Additionally, we compared the code's results against 2DFFT results for 203 visually selected spiral galaxies in GOODS North and South. Among the entire sample, Spirality's error bars overlapped 2DFFT's error bars 64% of the time. For those galaxies in which Source code is available by email request from the primary author.

  5. Occult Interpositional Rotator Cuff - an Extremely Rare Case of Traumatic Rotator Cuff Tear

    Energy Technology Data Exchange (ETDEWEB)

    Su, Wei Ren; Jou, I Ming [National Cheng Kung University Hospital, Tainan (China); Lin, Cheng Li [Show-Chwan Memorial Hospital, Changhua (China); Chih, Wei Hsing [Chia-Yi Christian Hospital, Chiayi (China)

    2012-01-15

    Traumatic interposition of a rotator cuff tendon in the glenohumeral joint without recognizable glenohumeral dislocation is an unusual complication after shoulder trauma. Here we report the clinical and imaging presentations of a 17-year-old man with trapped rotator cuff tendons in the glenohumeral joint after a bicycle accident. The possible trauma mechanism is also discussed.

  6. Band-notched spiral antenna

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Jae; Chang, John

    2018-03-13

    A band-notched spiral antenna having one or more spiral arms extending from a radially inner end to a radially outer end for transmitting or receiving electromagnetic radiation over a frequency range, and one or more resonance structures positioned adjacent one or more segments of the spiral arm associated with a notch frequency band or bands of the frequency range so as to resonate and suppress the transmission or reception of electromagnetic radiation over said notch frequency band or bands.

  7. Three phase spiral liver Scanning

    International Nuclear Information System (INIS)

    Kanyanja, T.A.

    2006-01-01

    The ability to perform rapid back-to-back spiral acquisitions is an important recent technical advantage of spiral CT. this allows imaging of the upper abdomen (liver) during peak arterial enhancement (arterial phase) and during peak hepatic parenchymal enhancement (portal venous phase). Breatheld spiral CT has completely replaced dynamic incremental CT for evaluation of the liver. in selected patients with hyper vascular metastasis (hepatoma, neuroendocrine tumors, renal cell carcinoma, etc.) a biphasic examination is performed with one spiral acquisition obtained during the hepatic arterial phase and a second acquisition during the portal venous phase

  8. The subtropical nutrient spiral

    Science.gov (United States)

    Jenkins, William J.; Doney, Scott C.

    2003-12-01

    We present an extended series of observations and more comprehensive analysis of a tracer-based measure of new production in the Sargasso Sea near Bermuda using the 3He flux gauge technique. The estimated annually averaged nitrate flux of 0.84 ± 0.26 mol m-2 yr-1 constitutes only that nitrate physically transported to the euphotic zone, not nitrogen from biological sources (e.g., nitrogen fixation or zooplankton migration). We show that the flux estimate is quantitatively consistent with other observations, including decade timescale evolution of the 3H + 3He inventory in the main thermocline and export production estimates. However, we argue that the flux cannot be supplied in the long term by local diapycnal or isopycnal processes. These considerations lead us to propose a three-dimensional pathway whereby nutrients remineralized within the main thermocline are returned to the seasonally accessible layers within the subtropical gyre. We describe this mechanism, which we call "the nutrient spiral," as a sequence of steps where (1) nutrient-rich thermocline waters are entrained into the Gulf Stream, (2) enhanced diapycnal mixing moves nutrients upward onto lighter densities, (3) detrainment and enhanced isopycnal mixing injects these waters into the seasonally accessible layer of the gyre recirculation region, and (4) the nutrients become available to biota via eddy heaving and wintertime convection. The spiral is closed when nutrients are utilized, exported, and then remineralized within the thermocline. We present evidence regarding the characteristics of the spiral and discuss some implications of its operation within the biogeochemical cycle of the subtropical ocean.

  9. Comparison of the fastest regenerating motor and sensory myelinated axons in the same peripheral nerve

    DEFF Research Database (Denmark)

    Moldovan, Mihai; Sørensen, Jesper; Krarup, Christian

    2006-01-01

    the question of differences in growth rates of different nerve fibre populations led to conflicting results. We developed an animal model to compare growth and maturation of the fastest growing sensory and motor fibres within the same mixed nerve after Wallerian degeneration. Regeneration of cat tibial nerve......Functional outcome after peripheral nerve regeneration is often poor, particularly involving nerve injuries far from their targets. Comparison of sensory and motor axon regeneration before target reinnervation is not possible in the clinical setting, and previous experimental studies addressing...... after crush (n = 13) and section (n = 7) was monitored for up to 140 days, using implanted cuff electrodes placed around the sciatic and tibial nerves and wire electrodes at plantar muscles. To distinguish between sensory and motor fibres, recordings were carried out from L6-S2 spinal roots using cuff...

  10. Systematics of injuries of the rotator cuff and biceps tendon

    International Nuclear Information System (INIS)

    Breitenseher, M.J.; Pones, M.; Breitenseher, J.B.

    2015-01-01

    Injuries of the rotator cuff and the biceps tendon demonstrate different patterns, which can be recognized clinically and radiologically. These patterns are impingement syndrome with additional trauma, isolated trauma of the rotator cuff and shoulder dislocation causing rotator cuff tears. Furthermore, it is clinically crucial to evaluate the extent of a rotator cuff injury. Magnetic resonance imaging (MRI) is the modality of choice to differentiate these patterns. (orig.) [de

  11. 21 CFR 868.5800 - Tracheostomy tube and tube cuff.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tracheostomy tube and tube cuff. 868.5800 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5800 Tracheostomy tube and tube cuff. (a) Identification. A tracheostomy tube and tube cuff is a device intended to be placed into a...

  12. Degenerative full thickness rotator cuff tears : Towards optimal management

    NARCIS (Netherlands)

    Lambers Heerspink, Frederik

    2016-01-01

    The shoulder is one of the most complex joints in the body. Besides a wide range of motion it also has to be stable. The rotator cuff is a major stabiliser of the glenohumoral joint. With increasing age rotator cuff tears are common. Successful treatment is described following surgical (rotator cuff

  13. Endotracheal tube cuff pressures – the worrying reality: A ...

    African Journals Online (AJOL)

    Secondary aims were to determine whether the tube size, tube make or place of intubation affected cuff pressure. Method. Endotracheal tube cuff pressures of 91 patients in the trauma centre and 100 patients in the theatre complex were randomly measured using a Mallinckrodt cuff pressure gauge. The measurements ...

  14. 21 CFR 870.1120 - Blood pressure cuff.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an inelastic...

  15. The perfect shape spiral stories

    CERN Document Server

    Hammer, Øyvind

    2016-01-01

    This book uses the spiral shape as a key to a multitude of strange and seemingly disparate stories about art, nature, science, mathematics, and the human endeavour. In a way, the book is itself organized as a spiral, with almost disconnected chapters circling around and closing in on the common theme. A particular strength of the book is its extremely cross-disciplinary nature - everything is fun, and everything is connected! At the same time, the author puts great emphasis on mathematical and scientific correctness, in contrast, perhaps, with some earlier books on spirals. Subjects include the mathematical properties of spirals, sea shells, sun flowers, Greek architecture, air ships, the history of mathematics, spiral galaxies, the anatomy of the human hand, the art of prehistoric Europe, Alfred Hitchcock, and spider webs, to name a few.

  16. Novel nanofibrous spiral scaffolds for neural tissue engineering

    Science.gov (United States)

    Valmikinathan, Chandra M.; Tian, Jingjing; Wang, Junping; Yu, Xiaojun

    2008-12-01

    Due to several drawbacks associated with autografts and allografts, tissue-engineering approaches have been widely used to repair peripheral nerve injuries. Most of the traditional tissue-engineered scaffolds in use are either tubular (single or multi-lumen) or hydrogel-based cylindrical grafts, which provide limited surface area for cell attachment and regeneration. Here, we show a novel poly(lactide-co-glycotide) (PLGA) microsphere-based spiral scaffold design with a nanofibrous surface that has enhanced surface areas and possesses sufficient mechanical properties and porosities to support the nerve regeneration process. These scaffolds have an open architecture that goes evenly throughout the scaffolds hence leaving enough volume for media influx and deeper cell penetration into the scaffolds. The in vitro tests conducted using Schwann cells show that the nanofibrous spiral scaffolds promote higher cell attachment and proliferation when compared to contemporary tubular scaffolds or nanofiber-based tubular scaffolds. Also, the nanofiber coating on the surfaces enhances the surface area, mimics the extracellular matrix and provides unidirectional alignment of cells along its direction. Hence, we propose that these scaffolds could alleviate some drawbacks in current nerve grafts and could potentially be used in nerve regeneration.

  17. Identification of a Very High Cuff Pressure by Manual Palpation of the External Cuff Balloon on an Endotracheal Tube.

    Science.gov (United States)

    Hedberg, Pia; Eklund, Carolina; Högqvist, Sandra

    2015-06-01

    The most common complication due to intubation is a high cuff pressure. A high cuff pressure can cause postanesthetic tracheal mucosal injuries in patients undergoing surgery. The aim of this cross-sectional study was to describe whether anesthetic nurses and anesthesiologists identified a very high cuff pressure by manual palpation of the external cuff balloon on an endotracheal tube. An airway device was intubated with an endotracheal tube cuffed to 95 cm H2O. Each participant palpated the external cuff balloon and then filled out a questionnaire, including estimation of the cuff pressure and user frequency of the cuff pressure manometer. The results showed that 89.1% estimated that the cuff pressure was high. Among the participants who rated the cuff pressure as high, 44.8% rated the pressure as quite high and 60.6% rated the pressure as very high. There was no significant relationship between profession and skill in identifying a very high cuff pressure (P = .843) or between work experience and skill in terms of identifying a very high cuff pressure (P = .816). These findings indicate that 10% of patients are at risk of tracheal erosion because of a high cuff pressure.

  18. Hurricane Spiral Bands.

    Science.gov (United States)

    Guinn, Thomas A.; Schubert, Wayne H.

    1993-10-01

    The spiral bands that occur in tropical cyclones can be conveniently divided into two classes-outer bands and inner bands. Evidence is presented here that the outer bands form as the result of nonlinear effects during the breakdown of the intertropical convergence zone (ITCZ) through barotropic instability. In this process a zonal strip of high potential vorticity (the ITCZ shear zone or monsoon trough) begins to distort in a varicose fashion, with the potential vorticity (PV) becoming pooled in local regions that are connected by filaments of high PV. As the pooled regions become more axisymmetric, the filaments become thinner and begin to wrap around the PV centers.It is argued that inner bands form in a different manner. As a tropical cyclone intensifies due to latent heat release, the PV field becomes nearly circular with the highest values of PV in the cyclone center. The radial gradient of PV provides a state on which PV waves (the generalization of Rossby waves) can propagate. The nonlinear breaking of PV waves then leads to an irreversible distortion of the PV contours and a downgradient flux of PV. The continuation of this proem tends to erode the high PV core of the tropical cyclone, to produce a surrounding surf zone, and hence to spread the PV horizontally. In a similar fashion, inner bands can also form by the merger of a vortex with a patch of relatively high PV air. As the merger proem occurs the patch of PV is quickly elongated and wrapped around the vortex. The resulting vortex is generally larger in horizontal extent and exhibits a spiral band of PV.When the formation of outer and inner bands is interpreted in the context of a normal-mode spectral model, they emerge as slow manifold phenomena; that is, they have both rotational and (balanced or slaved) gravitational mode aspects. In this sense, regarding them as simply gravity waves leads to an incomplete dynamical picture.

  19. Fibrosis, low vascularity, and fewer slow fibers after rotator-cuff injury.

    Science.gov (United States)

    Gigliotti, Deanna; Xu, Mark C; Davidson, Michael J; Macdonald, Peter B; Leiter, Jeff R S; Anderson, Judy E

    2017-05-01

    Rotator-cuff injury (RCI) represents 50% of shoulder injuries, and prevalence increases with age. Even with successful tendon repair, muscle and joint function may not return. To explore the dysfunction, supraspinatus and ipsilateral deltoid (control) muscles were biopsied during arthroscopic RCI repair for pair-wise histological and protein-expression studies. Supraspinatus showed fiber atrophy (P atrophy from mechanical unloading of supraspinatus after tendon tear. Treatment to promote growth and vascularity in atrophic supraspinatus muscle may help improve functional outcome after surgical repair. Muscle Nerve 55: 715-726, 2017. © 2016 Wiley Periodicals, Inc.

  20. Composition of Muscle Fiber Types in Rat Rotator Cuff Muscles.

    Science.gov (United States)

    Rui, Yongjun; Pan, Feng; Mi, Jingyi

    2016-10-01

    The rat is a suitable model to study human rotator cuff pathology owing to the similarities in morphological anatomy structure. However, few studies have reported the composition muscle fiber types of rotator cuff muscles in the rat. In this study, the myosin heavy chain (MyHC) isoforms were stained by immunofluorescence to show the muscle fiber types composition and distribution in rotator cuff muscles of the rat. It was found that rotator cuff muscles in the rat were of mixed fiber type composition. The majority of rotator cuff fibers labeled positively for MyHCII. Moreover, the rat rotator cuff muscles contained hybrid fibers. So, compared with human rotator cuff muscles composed partly of slow-twitch fibers, the majority of fast-twitch fibers in rat rotator cuff muscles should be considered when the rat model study focus on the pathological process of rotator cuff muscles after injury. Gaining greater insight into muscle fiber types in rotator cuff muscles of the rat may contribute to elucidate the mechanism of pathological change in rotator cuff muscles-related diseases. Anat Rec, 299:1397-1401, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. MRI of the rotator cuff and internal derangement

    Energy Technology Data Exchange (ETDEWEB)

    Opsha, Oleg [Department of Radiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219 (United States)], E-mail: oopsha@hotmail.com; Malik, Archana [Department of Radiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219 (United States)], E-mail: dr.armal@gmail.com; Baltazar, Romulo [Department of Radiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219 (United States)], E-mail: rbaltazar@gmail.com; Primakov, Denis [Department of Radiology, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030 (United States)], E-mail: dgprim@yahoo.com; Beltran, Salvador [Dr. Ramon Marti, 2 Albons, Ginrona 17136 (Spain); Miller, Theodore T. [Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 (United States)], E-mail: MillerTT@hss.edu; Beltran, Javier [Department of Radiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219 (United States)], E-mail: jbeltran46@msn.com

    2008-10-15

    Disease to the rotator cuff is the most common cause of shoulder pain and dysfunction in adults. This group of muscles performs multiple functions and is often stressed during various activities. The anatomy and physiology of the rotator cuff is complex and interconnected to other muscle groups in the shoulder. One must take the anatomic status of the rotator cuff tendons into account when planning the treatment of the rotator cuff injury. Diagnostic imaging of the rotator cuff, performed by MRI, provides valuable information about the nature of the injury. In this article, we will review the various types and causes of rotator cuff injuries, normal MR anatomy, function, patho-anatomy, and the biomechanics of the rotator cuff. We will also review shoulder impingement syndromes.

  2. MRI of the rotator cuff and internal derangement.

    Science.gov (United States)

    Opsha, Oleg; Malik, Archana; Baltazar, Romulo; Primakov, Denis; Beltran, Salvador; Miller, Theodore T; Beltran, Javier

    2008-10-01

    Disease to the rotator cuff is the most common cause of shoulder pain and dysfunction in adults. This group of muscles performs multiple functions and is often stressed during various activities. The anatomy and physiology of the rotator cuff is complex and interconnected to other muscle groups in the shoulder. One must take the anatomic status of the rotator cuff tendons into account when planning the treatment of the rotator cuff injury. Diagnostic imaging of the rotator cuff, performed by MRI, provides valuable information about the nature of the injury. In this article, we will review the various types and causes of rotator cuff injuries, normal MR anatomy, function, patho-anatomy, and the biomechanics of the rotator cuff. We will also review shoulder impingement syndromes.

  3. MRI of the rotator cuff and internal derangement

    International Nuclear Information System (INIS)

    Opsha, Oleg; Malik, Archana; Baltazar, Romulo; Primakov, Denis; Beltran, Salvador; Miller, Theodore T.; Beltran, Javier

    2008-01-01

    Disease to the rotator cuff is the most common cause of shoulder pain and dysfunction in adults. This group of muscles performs multiple functions and is often stressed during various activities. The anatomy and physiology of the rotator cuff is complex and interconnected to other muscle groups in the shoulder. One must take the anatomic status of the rotator cuff tendons into account when planning the treatment of the rotator cuff injury. Diagnostic imaging of the rotator cuff, performed by MRI, provides valuable information about the nature of the injury. In this article, we will review the various types and causes of rotator cuff injuries, normal MR anatomy, function, patho-anatomy, and the biomechanics of the rotator cuff. We will also review shoulder impingement syndromes

  4. Diagnostic imaging of shoulder rotator cuff lesions

    Directory of Open Access Journals (Sweden)

    Nogueira-Barbosa Marcello Henrique

    2002-01-01

    Full Text Available Shoulder rotator cuff tendon tears were evaluated with ultrasonography (US and magnetic resonance imaging (MRI. Surgical or arthroscopical correlation were available in 25 cases. Overall costs were also considered. Shoulder impingement syndrome diagnosis was done on a clinical basis. Surgery or arthroscopy was considered when conservative treatment failure for 6 months, or when rotator cuff repair was indicated. Ultrasound was performed in 22 patients and MRI in 17 of the 25 patients. Sensitivity, specificity and accuracy were 80%, 100% and 90.9% for US and 90%, 100% and 94.12% for MRI, respectively. In 16 cases both US and MRI were obtained and in this subgroup statistical correlation was excellent (p< 0.001. We concluded that both methods are reliable for rotator cuff full thickness tear evaluation. Since US is less expensive, it could be considered as the screening method when rotator cuff integrity is the main question, and when well trained radiologists and high resolution equipment are available.

  5. Cuff deflation: rehabilitation in critical care.

    Science.gov (United States)

    Bach, John R; Gonçalves, Miguel R; Rodriguez, Pedro Landete; Saporito, Louis; Soares, Luisa

    2014-08-01

    This is a case series of rehabilitation failures that resulted in severe reactive depression from patients unnecessarily bereft of verbal communication by being left to breathe or be ventilated via tracheostomy tubes, with or without inflated cuffs, for months to years.

  6. Glenohumeral stability in simulated rotator cuff tears

    NARCIS (Netherlands)

    Steenbrink, F.; Groot, J.H.; Veeger, H.E.J.; Helm, F.C.; Rozing, P.M.

    2009-01-01

    Rotator cuff tears disrupt the force balance in the shoulder and the glenohumeral joint in particular, resulting in compromised arm elevation torques. The trade-off between glenohumeral torque and glenohumeral stability is not yet understood. We hypothesize that compensation of lost abduction torque

  7. Measuring with the spiral reader

    CERN Multimedia

    1974-01-01

    The spiral reader shown here was at the time, together with the Shivamatic scanning system, the basic equipment used for measuring bubble chamber pictures. Anne Anton sits at the table. (See Photo Archive 7408343.)

  8. Nerve conduction

    Science.gov (United States)

    ... the central nervous system (CNS) and peripheral nervous system (PNS). The CNS contains the brain and the spinal cord and the PNS consists of thousands of nerves that connect the spinal cord to muscles and sensory receptors. A peripheral nerve is composed of nerve ...

  9. Spiral-shaped disinfection reactors

    KAUST Repository

    Ghaffour, Noreddine

    2015-08-20

    This disclosure includes disinfection reactors and processes for the disinfection of water. Some disinfection reactors include a body that defines an inlet, an outlet, and a spiral flow path between the inlet and the outlet, in which the body is configured to receive water and a disinfectant at the inlet such that the water is exposed to the disinfectant as the water flows through the spiral flow path. Also disclosed are processes for disinfecting water in such disinfection reactors.

  10. Spiral inlets for steam turbines

    Science.gov (United States)

    Škach, Radek; Uher, Jan

    2017-09-01

    This paper deals with the design process of special nozzle blades for spiral inlets. Spiral inlets are used for the first stages of high pressure and intermediate pressure steam turbines with both reaction and impulse blades when throttling or sliding pressure control is applied. They improve the steam flow uniformity from the inlet pipe and thus decrease the aerodynamic losses. The proposed evaluation of the inlet angle is based on the free vortex law.

  11. Endotracheal tube cuff pressure: need for precise measurement

    Directory of Open Access Journals (Sweden)

    José Reinaldo Cerqueira Braz

    1999-11-01

    Full Text Available CONTEXT: High compliance endotracheal tubes cuffs are used to prevent gas leak and also pulmonary aspiration in mechanically ventilated patients. However, the use of the usual cuff inflation volumes may cause tracheal damage. OBJECTIVE: We tested the hypothesis that endotracheal tube cuff pressures are routinely high (above 40 cmH2O in the Post Anesthesia Care Unit (PACU or Intensive Care Units (ICU. DESIGN: Cross-sectional study. SETTING: Post anesthesia care unit and intensive care unit. PARTICIPANTS: We measured endotracheal tubes cuff pressure in 85 adult patients, as follows: G1 (n = 31 patients from the ICU; G2 (n = 32 patients from the PACU, after anesthesia with nitrous oxide; G3 (n = 22 patients from the PACU, after anesthesia without nitrous oxide. Intracuff pressure was measured using a manometer (Mallinckrodt, USA. Gas was removed as necessary to adjust cuff pressure to 30 cmH2O. MAIN MEASUREMENTS: Endotracheal tube cuff pressure. RESULTS: High cuff pressure (> 40 cmH2O was observed in 90.6% patients of G2, 54.8% of G1 and 45.4% of G3 (P < 0.001. The volume removed from the cuff in G2 was higher than G3 (P < 0.05. CONCLUSION: Endotracheal tubes cuff pressures in ICU and PACU are routinely high and significant higher when nitrous oxide is used. Endotracheal tubes cuff pressure should be routinely measured to minimize tracheal trauma.

  12. Anterior transposition of the radial nerve--a cadaveric study.

    Science.gov (United States)

    Yakkanti, Madhusudhan R; Roberts, Craig S; Murphy, Joshua; Acland, Robert D

    2008-01-01

    The radial nerve is at risk during the posterior plating of the humerus. The purpose of this anatomic study was to assess the extent of radial nerve dissection required for anterior transposition through the fracture site (transfracture anterior transposition). A cadaver study was conducted approaching the humerus by a posterior midline incision. The extent of dissection of the nerve necessary for plate fixation of the humerus fracture was measured. An osteotomy was created to model a humeral shaft fracture at the spiral groove (OTA classification 12-A2, 12-A3). The radial nerve was then transposed anterior to the humeral shaft through the fracture site. The additional dissection of the radial nerve and the extent of release of soft tissue from the humerus shaft to achieve the transposition were measured. Plating required a dissection of the radial nerve 1.78 cm proximal and 2.13 cm distal to the spiral groove. Transfracture anterior transposition of the radial nerve required an average dissection of 2.24 cm proximal and 2.68 cm distal to the spiral groove. The lateral intermuscular septum had to be released for 2.21 cm on the distal fragment to maintain laxity of the transposed nerve. Transfracture anterior transposition of the radial nerve before plating is feasible with dissection proximal and distal to the spiral groove and elevation of the lateral intermuscular septum. Potential clinical advantages of this technique include enhanced fracture site visualization, application of broader plates, and protection of the radial nerve during the internal fixation.

  13. Severed cuff inflation tubing of endotracheal tube: A novel way to prevent cuff deflation.

    Science.gov (United States)

    Rao, Amrut K; Chaudhuri, Souvik; Joseph, Tim T; Kamble, Deependra; Gotur, Gopal; Venkatesh, Sandeep

    2014-01-01

    A well-secured endotracheal tube (ETT) is essential for safe anesthesia. The ETT has to be fixed with the adhesive plasters or with tie along with adhesive plasters appropriately. It is specially required in patients having beard, in intensive care unit (ICU) patients or in oral surgeries. If re-adjustment of the ETT is necessary, we should be cautious while removal of the plasters and tie, as there may be damage to the cuff inflation system. This can be a rare cause of ETT cuff leak, thus making maintenance of adequate ventilation difficult and requiring re-intubation. In a difficult airway scenario, it can be extremely challenging to re-intubate again. We report an incidence where the ETT cuff tubing was severed while attempting to re-adjust and re-fix the ETT and the patient required re-intubation. Retrospectively, we thought of and describe a safe, reliable and novel technique to prevent cuff deflation of the severed inflation tube. The technique can also be used to monitor cuff pressure in such scenarios.

  14. Cuff inflations do not affect night-time blood pressure

    DEFF Research Database (Denmark)

    Petersen, Emilie H; Theilade, Simone; Hansen, Tine W

    2015-01-01

    Discomfort related to cuff inflation may bias 24 h ambulatory blood pressure (BP) measurements, especially during night-time. We accessed the impact of cuff inflations by comparing 24 h BP recorded with a cuff-less tonometric wrist device and an upper-arm oscillometric cuff device. Fifty.......3±14.6 mmHg, P≤0.01), as was nocturnal BP (6.7±5.3 vs. 10.3±7.6%, P=0.002). In conclusion, nocturnal BP decline was higher when measured with the cuff device, suggesting that cuff inflations did not increase night-time BP. Further evaluation of the tonometric device using the updated European Society...

  15. Terminal nerve: cranial nerve zero

    Directory of Open Access Journals (Sweden)

    Jorge Eduardo Duque Parra

    2006-12-01

    Full Text Available It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH. In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a common nerve that integrates the terminal nerve with the olfactory nerves and the vomeronasals nerves which seem to carry out the odors detection function as well as in the food search, pheromone detection and nasal vascular regulation.

  16. Anomalous biceps origin from the rotator cuff

    Directory of Open Access Journals (Sweden)

    Samik Banerjee

    2015-01-01

    Full Text Available Variations in the origin of the long head of biceps tendon (LHBT have been described in literature; however, its clinical significance remains uncertain. We describe in this report, the history, physical examination and the arthroscopic findings in a patient who had an anomalous origin of the LHBT from the rotator cuff, resulting in restriction of range of motion. This anomalous origin of the long head of biceps tendon causing capsular contracture and restriction of movements leading to secondary internal impingement, has not been extensively reported in the literature. Shoulder arthroscopists should be aware that, although, an uncommon clinical condition, the aberrant congenital origin of the LHBT from the rotator cuff can rarely become pathologic in middle age and lead to shoulder dysfunction. In such cases, release of the anomalous band may be required, along with the treatment of other concomitant intraarticular pathologies in the glenohumeral joint.

  17. Proteomics perspectives in rotator cuff research

    DEFF Research Database (Denmark)

    Sejersen, Maria Hee Jung; Frost, Poul; Hansen, Torben Bæk

    2015-01-01

    Background Rotator cuff tendinopathy including tears is a cause of significant morbidity. The molecular pathogenesis of the disorder is largely unknown. This review aimed to present an overview of the literature on gene expression and protein composition in human rotator cuff tendinopathy and other...... tendinopathies, and to evaluate perspectives of proteomics – the comprehensive study of protein composition - in tendon research. Materials and Methods We conducted a systematic search of the literature published between 1 January 1990 and 18 December 2012 in PubMed, Embase, and Web of Science. We included......), tissue inhibitor of metalloproteinase (TIMP)-1 (4 of 7), and vascular endothelial growth factor (4 of 7), and a decrease in MMP-3 (10 of 12). Fourteen proteomics studies of tendon tissues/cells failed inclusion, mostly because they were conducted in animals or in vitro. Conclusions Based on methods...

  18. Arthroscopic rotator cuff repair in elite rugby players

    OpenAIRE

    Tambe, Amol; Badge, Ravi; Funk, Lennard

    2009-01-01

    Background: Rugby is an increasingly popular collision sport. A wide spectrum of injuries can be sustained during training and match play. Rotator cuff injury is uncommon in contact sports and there is little published literature on the treatment of rotator cuff tears in rugby players. Aims: We therefore reviewed the results and functional outcomes of arthroscopic rotator cuff repair in elite rugby players. Materials and Methods: Eleven professional rugby players underwent arthroscopic ...

  19. Automated Control of Endotracheal Tube Cuff Pressure during Simulated Flight

    Science.gov (United States)

    2016-06-21

    endotracheal cuff pressure in intubated critically ill patients: prevalence and risk factors . Eur J Anaesthesiol. 2009; 26(3):229-234. 10...of secretions from the oropharynx that are implicated in the development of ventilator-associated pneumonia [4]. Clinically important changes in cuff...related mucosal damage as well as underinflation promoting fluid leakage around the cuff, which is associated with pneumonia . Aeromedical transport

  20. Glenohumeral interposition of rotator cuff stumps: a rare complication of traumatic rotator cuff tear

    Directory of Open Access Journals (Sweden)

    Paulo Moraes Agnollitto

    2016-02-01

    Full Text Available Abstract The present report describes a case where typical findings of traumatic glenohumeral interposition of rotator cuff stumps were surgically confirmed. This condition is a rare complication of shoulder trauma. Generally, it occurs in high-energy trauma, frequently in association with glenohumeral joint dislocation. Radiography demonstrated increased joint space, internal rotation of the humerus and coracoid process fracture. In addition to the mentioned findings, magnetic resonance imaging showed massive rotator cuff tear with interposition of the supraspinatus, infraspinatus and subscapularis stumps within the glenohumeral joint. Surgical treatment was performed confirming the injury and the rotator cuff stumps interposition. It is important that radiologists and orthopedic surgeons become familiar with this entity which, because of its rarity, might be neglected in cases of shoulder trauma.

  1. Effect of Nitrous Oxide Anaesthesia on Endotracheal Cuff Pressure

    Directory of Open Access Journals (Sweden)

    Özlem Koşar

    2017-03-01

    Full Text Available Aim: When N2Ois used for general anaesthesia, it diffuses into the air-filled endotracheal cuff causing the cuff pressure to rise by over inflating the cuff, which results in tracheal damage. This study aimed to estimate changes in the endotracheal-cuff pressure with time during oxygen-air- and oxygen-N2O -induced anaesthesia and to determine its sore throat and hoarseness incidence. Methods: Fifty patients with American Society of Anesthesiologists physical status 1-2, aged 18-60 years were icluded to our study. Orotracheal intubation was performed using polyvinyl chloride high volume-low pressure endotracheal tubes. The AIR group 40% O2/60% air and N2O group 40% O2/60% N2O was used. The endotracheal cuff pressure at 5, 10, 15, 20 minutes immediately after intubation and at 10-minute intervals were recorded. When the cuff pressure reached 45 cm H2O, was attenuated to 25-30-cm H2O. At the post operative first and the 24th hour, the patients were queried for sore throat and hoarseness. Results: The N2O -group cuff pressure rose from the fifth minute onwards. Also, the N2O group had a higher incidence of sore throat and hoarseness. Conclusion: N2O results in elevated cuff pressure and tracheal morbidities. Cuff-pressure should be routinely monitored during anaesthesia using N2O.

  2. An in vitro comparison of tracheostomy tube cuffs

    Directory of Open Access Journals (Sweden)

    Maguire S

    2015-04-01

    Full Text Available Seamus Maguire,1 Frances Haury,2 Korinne Jew2 1Research and Development, Covidien Respiratory and Monitoring Solutions, Athlone, Ireland; 2Medical Affairs, Covidien Respiratory and Monitoring Solutions, Boulder, CO, USA Introduction: The Shiley™ Flexible adult tracheostomy tube with TaperGuard™ cuff has been designed through its geometry, materials, diameter, and wall thickness to minimize micro-aspiration of fluids past the cuff and to provide an effective air seal in the trachea while also minimizing the risk of excessive contact pressure on the tracheal mucosa. The cuff also has a deflated profile that may allow for easier insertion through the stoma site. This unique design is known as the TaperGuard™ cuff. The purpose of the observational, in vitro study reported here was to compare the TaperGuard™ taper-shaped cuff to a conventional high-volume low-pressure cylindrical-shaped cuff (Shiley™ Disposable Inner Cannula Tracheostomy Tube [DCT] with respect to applied tracheal wall pressure, air and fluid sealing efficacy, and insertion force.Methods: Three sizes of tracheostomy tubes with the two cuff types were placed in appropriately sized tracheal models and lateral wall pressure was measured via pressure-sensing elements on the inner surface. Fluid sealing performance was assessed by inflating the cuffs within the tracheal models (25 cmH2O, instilling water above the cuff, and measuring fluid leakage past the cuff. To measure air leak, tubes were attached to a test lung and ventilator, and leak was calculated by subtracting the average exhaled tidal volume from the average delivered tidal volume. A tensile test machine was used to measure insertion force for each tube with the cuff deflated to simulate clinical insertion through a stoma site.Results: The average pressure exerted on the lateral wall of the model trachea was lower for the taper-shaped cuff than for the cylindrical cuff under all test conditions (P<0.05. The taper

  3. Analysis of failed rotator cuff repair – Retrospective survey of revisions after open rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Rupert Schupfner

    2017-07-01

    Full Text Available Background Rotator cuff defects are frequently occurring shoulder pathologies associated with pain and movement impairment. Aims The aim of the study was to analyse the pathologies that lead to operative revisions after primary open rotator cuff repair. Methods In 216 patients who underwent primary rotator cuff repair and later required operative revision between 1996 to 2005, pathologies found intraoperatively during the primary operation and during revision surgery were collected, analysed and compared. Results The average age at the time of revision surgery was 54.3 years. The right shoulder (61.6 per cent was more often affected than the left, males (63.4 per cent more often than females. At primary operation – apart from rotator cuff repair – there were the following surgical procedures performed: 190 acromioplasty, 86 Acromiclavicular joint resections, 68 tenodesis, 40 adhesiolysis and 1 tenotomy. If an ACJ-resection had been performed in the primary operation, ACJ-problems were rare in revision surgery (p<0.01. Primary gleno-humeral adhesions were associated with a significant rise in re-tearing rate (p=0.049. Primary absence of adhesions went along with a significant lower rate of adhesions found at revision (p=0.018. Primary performed acromioplasty had no influence on re-tearing rate (p=0.408 or on the rate of subacromial impingement at revision surgery (p=0.709. Conclusion To avoid operative revision after rotator cuff repair relevant copathologies of the shoulder have to be identified before or during operation and treated accordingly. Therefore, even during open rotator cuff repair, the surgeon should initially start with arthroscopy of the shoulder joint and subacromial space to recognise co-pathologies.

  4. Spiral Inflector For Compact Cyclotron

    CERN Document Server

    Karamysheva, G A

    2004-01-01

    Compact cyclotron for explosives detection by nuclear resonance absorption of γ-rays in nitrogen is under development [1] Cyclotron will be equipped with the external ion source. The injection system consists of a double-drift beam bunching system, a spiral inflector, beam diagnostics, focusing and adjustment elements [2]. The spiral inflector for ion bending from axial to median plane is used. Computer model of spiral inflector for the Customs cyclotron is developed. 3D electrostatic field calculations of the designed inflector are performed. Calculated electric field map and magnetic field map of the cyclotron [3] are used for beam dynamic simulations. Numeric simulations are carried out for 500 particles using code for calculation of particle dynamics by integration of differential equations in Cartesian coordinate system written in MATLAB. Direct Coulomb particle-to-particle method is used to take into account space-charge effects.

  5. Terminal nerve: cranial nerve zero

    OpenAIRE

    Jorge Eduardo Duque Parra; Carlos Alberto Duque Parra

    2006-01-01

    It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH). In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a co...

  6. Clinical indicators associated with successful tracheostomy cuff deflation.

    Science.gov (United States)

    Pryor, Lee N; Ward, Elizabeth C; Cornwell, Petrea L; O'Connor, Stephanie N; Chapman, Marianne J

    2016-08-01

    Tracheostomy cuff deflation is a necessary stage of the decannulation pathway, yet the optimal clinical indicators to guide successful cuff deflation are unknown. The study aims were to identify (1) the proportion of patients tolerating continuous cuff deflation at first attempt; (2) the clinical observations associated with cuff deflation success or failure, including volume of above cuff secretions and (3) the predictive capacity of these observations within a heterogeneous cohort. A retrospective review of 113 acutely tracheostomised patients with a subglottic suction tube in situ was conducted. Ninety-five percent of patients (n=107) achieved continuous cuff deflation on the first attempt. The clinical observations recorded as present in the 24h preceding cuff deflation included: (1) medical stability, (2) respiratory stability, (3) fraction of inspired oxygen ≤0.4, (4) tracheal suction ≤1-2 hourly, (5) sputum thin and easy to suction, (6) sputum clear or white, (7) ≥moderate cough strength, (8) above cuff secretions ≤1ml per hour and (9) alertness≥eyes open to voice. Using the presence of all 9 indicators as predictors of successful cuff deflation tolerance, specificity and positive predictive value were 100%, although sensitivity was only 77% and negative predictive value 19%. Refinement to a set of 3 clinically driven criteria (medical and respiratory stability, above cuff secretions ≤1ml/h) provided high specificity (100%), sensitivity (95%), positive predictive value (100%) and an improved negative predictive value (55%). Key criteria can help guide clinical decision-making on patient readiness for cuff deflation. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  7. GANIL-SPIRAL1-SPIRAL2: Highlights and Perspectives

    Science.gov (United States)

    Gales, S.

    2010-06-01

    GANIL presently offers unique opportunities in nuclear physics and many other fields that arise from not only the provision of low-energy stable beams, fragmentation beams and re-accelerated radioactive species, but also from the availability of a wide range of state-of-the-art spectrometers and instrumentation. A few examples of recent highlights are presented. With the construction of SPIRAL2 over the next few years, GANIL is in a good position to retain its world-leading capability. As selected by the ESFRI committee, the next generation of ISOL facility in Europe is represented by the SPIRAL2 project to be built at GANIL (Caen, France). SPIRAL 2 is based on a high power, CW, superconducting LINAC, delivering 5 mA of deuteron beams at 40 MeV (200 KW) directed on a C converter+ Uranium target and producing therefore more 1013 fissions/s. The expected radioactive beams intensities in the mass range from A = 60 to A = 140, will surpass by two order of magnitude any existing facilities in the world. These unstable atoms will be available at energies between few KeV/n to 15 MeV/n. The same driver will accelerate high intensity (100*A to 1 mA), heavier ions (Ar up to Xe) at maximum energy of 14 MeV/n. Under the 7FP program of European Union called*Preparatory phase*, the SPIRAL2 project has been granted a budget of about 4 M€ to build up an international consortium around this new venture. The status of the construction of SPIRAL2 accelerator and associated physics instruments in collaboration with EU and International partners will be presented.

  8. Quasicrystallography on the spiral of Archimedes

    International Nuclear Information System (INIS)

    Bursill, L.A.

    1990-01-01

    The concept of a spiral lattice is discussed. Some examples of known mineral structures, namely clino asbestos, halloysite and cylindrite, are then interpreted in terms of this structural principle. An example of a synthetic sulphide catalyst spiral structure having atomic dimensions is also described. All of these inorganic spiral structures are based on the sprial of Archimedes. The principles for a new type of crystallography, based on the Archimedian spiral, are then presented. 45 refs., 8 figs

  9. Inspired Spirals. Teaching Art with Art.

    Science.gov (United States)

    Hubbard, Guy

    2001-01-01

    Discusses spirals in nature, man-made objects, and art. Focuses on art that incorporates the spiral, including works by M. C. Escher and Frank Lloyd Wright, an African headdress, and a burial urn. Describes activities to help students make spirals of their own, such as constructing a coil clay pot. (CMK)

  10. Cuff filling volumes for pediatric classic laryngeal mask airways: comparison of clinical end points versus adjusted cuff pressure.

    Science.gov (United States)

    Ghai, Babita; Sethi, Sameer; Ram, Jagat; Wig, Jyotsna

    2013-02-01

    Clinical end points are often used to guide inflation and adequacy of cuff seal after laryngeal mask airway placement. However, clinical end points for cuff inflation have been shown to have significantly higher intracuff pressure. The adjusted cuff pressure between 55 and 60 cm H(2)O causes significantly better seal of laryngeal mask airway. We prospectively assessed the cuff pressures generated by cuff inflation guided by clinical end points, and the actual volume of air required to achieve cuff pressures between 55 and 60 cm H(2)O for sizes 1-2.5 reusable classic laryngeal mask airway. Two hundred and three ASA I and II children undergoing elective cataract surgery requiring general anesthesia receiving laryngeal mask airway sizes 1-2.5 were recruited to this study. The laryngeal mask airway was placed using standard technique. After insertion of laryngeal mask airway, the cuff was slowly inflated until a slight outward shift of device was noted. Cuff pressures were measured using calibrated hand held Portex Cuff Inflator Pressure Gauge (Portex Limited, Hythe, Kent, UK). If the cuff pressure was >60 cm H(2)O, the cuff was deflated to achieve a cuff pressure of 55-60 cm H(2)O. The volume of air required to achieve this pressure was recorded. The volume of air required to achieve the pressure between 55 and 60 cm H(2)O in laryngeal mask airway size 1, 1.5, 2.0, and 2.5 were 2.750 ± 0.2565, 4.951 ± 0.5378, 6.927 ± 0.6328, and 10.208 ± 1.4535 ml, respectively. The difference between the initial and the final cuff volumes and pressures in all laryngeal mask airway sizes were statistically significant(P = 0.000). Lower cuff volumes are required to achieve a pressure of 60 cm H(2)O than those required if clinical end points are used as a sole guide for determining cuff inflation for patients receiving pediatric laryngeal mask airways. © 2012 Blackwell Publishing Ltd.

  11. The Spiral Pattern During Development*

    African Journals Online (AJOL)

    1971-08-07

    Aug 7, 1971 ... which are destined to become the limb areas bud out laterally. Fig. 8. The early cells, which are destined to develop into the upper and the lower limbs, after lateral budding has occurred. Fig. 11 demonstrates the human embryo of about 5 mm. CR length and age of about 32 days. The spiral pattern is.

  12. A study of spiral galaxies

    International Nuclear Information System (INIS)

    Wevers, B.M.H.R.

    1984-01-01

    Attempts have been made to look for possible correlations between integral properties of spiral galaxies as a function of morphological type. To investigate this problem, one needs the detailed distribution of both the gaseous and the stellar components for a well-defined sample of spiral galaxies. A sample of about 20 spiral galaxies was therefore defined; these galaxies were observed in the 21 cm neutral hydrogen line with the Westerbork Synthesis Radio Telescope and in three broad-band optical colours with the 48-inch Palomar Smidt Telescope. First, an atlas of the combined radio and optical observations of 16 nearby northern-hemisphere spiral galaxies is presented. Luminosity profiles are discussed and the scale lengths of the exponential disks and extrapolated central surface brightnesses are derived, as well as radial color distributions; azimuthal surface brightness distributions and rotation curves. Possible correlations with optical features are investigated. It is found that 20 to 50 per cent of the total mass is in the disk. (Auth.)

  13. Excessive pressure in multichambered cuffs used for sequential compression therapy

    NARCIS (Netherlands)

    Segers, P; Belgrado, JP; Leduc, A; Leduc, O; Verdonck, P

    2002-01-01

    Background and Purpose. Pneumatic compression devices, used as part of the therapeutic strategy for lymphatic drainage, often have cuffs with multiple chambers that are, inflated sequentially. The purpose of this study was to investigate (1) the relationship between cuff chamber pressure

  14. Arthroscopic repair for subacromial incarceration of a torn rotator cuff

    Directory of Open Access Journals (Sweden)

    Hiroyuki Nakamizo

    2015-07-01

    Conclusion: Arthroscopic reduction and repair are applicable for inverted flap tears of the rotator cuff. The findings of the present study indicated that patients with a heel-type acromion in the anteroposterior view of radiographs are at greater risk for inverted flap tears of the rotator cuff.

  15. Endotracheal tube cuff pressure management in adult critical care ...

    African Journals Online (AJOL)

    healthcare sectors in the Nelson Mandela Metropole, Eastern Cape, South Africa, using a structured self-administered questionnaire based on a literature review. Results. The survey response was 75% (100/134). Practice variances included the frequency of cuff pressure monitoring: only 52% of respondents performed cuff ...

  16. Shouldering the blame for impingement: the rotator cuff continuum ...

    African Journals Online (AJOL)

    The aim of this article was to summarise recent research on shoulder impingement and rotator cuff pathology. A continuum model of rotator cuff pathology is described, and the challenges of accurate clinical diagnosis, imaging and best management discussed. Keywords: shoulder impingement syndrome, subacromial ...

  17. Arthroscopic repair techniques for massive rotator cuff tears.

    Science.gov (United States)

    Abrams, Jeffrey S; Song, Frederick S

    2012-01-01

    Patients with massive rotator cuff tears present with pain, weakness, and loss of function. Candidates for arthroscopic repair include symptomatic, young, active patients; those with an acute tear or tears with early changes of atrophy; and patients willing to comply with recovery and rehabilitation processes after surgery. As massive rotator cuff tears extend, the glenohumeral articulation is destabilized, allowing superior migration. Repair of the force couples and reinforcement of the anterosuperior rotator cuff cable can restore functional elevation via the deltoid. Muscle changes, including rotator cuff atrophy and fatty infiltration, will affect shoulder strength and function. As chronic changes become more extensive (such as the absence of the acromiohumeral interval and degenerative joint changes), other repair options may be more durable. Other arthroscopic options, including partial rotator cuff closure, graft to augment the repair, and use of the long head of the biceps tendon, have been helpful in pain relief and functional gains.

  18. Medialized repair for retracted rotator cuff tears.

    Science.gov (United States)

    Kim, Young-Kyu; Jung, Kyu-Hak; Won, Jun-Sung; Cho, Seung-Hyun

    2017-08-01

    The purpose of this study was to evaluate the functional outcomes of medialized rotator cuff repair and the continuity of repaired tendon in chronic retracted rotator cuff tears. Thirty-five consecutive patients were selected from 153 cases that underwent arthroscopic rotator cuff repair for more than medium-sized posterosuperior rotator cuff tears between July 2009 and July 2012 performed with the medialized repair. All cases were available for at least 2 years of postoperative follow-up. The visual analog scale of pain, muscle strength, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and University of California-Los Angeles score were evaluated. At the final follow-up, all clinical outcomes were significantly improved. The visual analog scale score for pain improved from 6 ± 1 preoperatively to 2 ± 1 postoperatively. The range of motion increased from preoperatively to postoperatively: active forward elevation, from 134° ± 49° to 150° ± 16°; active external rotation at the side, from 47° ± 15° to 55° ± 10°; and active internal rotation, from L3 to L1. The shoulder score also improved: Constant score, from 53.5 ± 16.7 to 79 ± 10; American Shoulder and Elbow Surgeons score, from 51 ± 15 to 82 ± 8; and University of California-Los Angeles score, from 14 ± 4 to 28 ± 4. The retear cases at the final follow-up were 6 (17%). Medialized repair may be useful in cases in which anatomic bone-to-tendon repair would be difficult because of the excessive tension of the repaired tendon and a torn tendon that does not reach the anatomic insertion. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  19. Degeneration of auditory nerve fibers in guinea pigs with severe sensorineural hearing loss

    NARCIS (Netherlands)

    Kroon, Steven; Ramekers, Dyan; Smeets, Emma M; Hendriksen, Ferry G J; Klis, Sjaak F L; Versnel, Huib

    Damage to and loss of the organ of Corti leads to secondary degeneration of the spiral ganglion cell (SGC) somata of the auditory nerve. Extensively examined in animal models, this degeneration process of SGC somata following deafening is well known. However, degeneration of auditory nerve axons,

  20. Endotracheal tube cuff pressure in three hospitals, and the volume required to produce an appropriate cuff pressure

    Directory of Open Access Journals (Sweden)

    Sengupta Papiya

    2004-11-01

    Full Text Available Abstract Background Cuff pressure in endotracheal (ET tubes should be in the range of 20–30 cm H2O. We tested the hypothesis that the tube cuff is inadequately inflated when manometers are not used. Methods With IRB approval, we studied 93 patients under general anesthesia with an ET tube in place in one teaching and two private hospitals. Anesthetists were blinded to study purpose. Cuff pressure in tube sizes 7.0 to 8.5 mm was evaluated 60 min after induction of general anesthesia using a manometer connected to the cuff pilot balloon. Nitrous oxide was disallowed. After deflating the cuff, we reinflated it in 0.5-ml increments until pressure was 20 cmH2O. Results Neither patient morphometrics, institution, experience of anesthesia provider, nor tube size influenced measured cuff pressure (35.3 ± 21.6 cmH2O. Only 27% of pressures were within 20–30 cmH2O; 27% exceeded 40 cmH2O. Although it varied considerably, the amount of air required to achieve a cuff pressure of 20 cmH2O was similar with each tube size. Conclusion We recommend that ET cuff pressure be set and monitored with a manometer.

  1. Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees.

    Science.gov (United States)

    Tan, Daniel W; Schiefer, Matthew A; Keith, Michael W; Anderson, J Robert; Tyler, Dustin J

    2015-04-01

    Stability and selectivity are important when restoring long-term, functional sensory feedback in individuals with limb-loss. Our objective is to demonstrate a chronic, clinical neural stimulation system for providing selective sensory response in two upper-limb amputees. Multi-contact cuff electrodes were implanted in the median, ulnar, and radial nerves of the upper-limb. Nerve stimulation produced a selective sensory response on 19 of 20 contacts and 16 of 16 contacts in subjects 1 and 2, respectively. Stimulation elicited multiple, distinct percept areas on the phantom and residual limb. Consistent threshold, impedance, and percept areas have demonstrated that the neural interface is stable for the duration of this on-going, chronic study. We have achieved selective nerve response from multi-contact cuff electrodes by demonstrating characteristic percept areas and thresholds for each contact. Selective sensory response remains consistent in two upper-limb amputees for 1 and 2 years, the longest multi-contact sensory feedback system to date. Our approach demonstrates selectivity and stability can be achieved through an extraneural interface, which can provide sensory feedback to amputees.

  2. Low surface brightness spiral galaxies

    International Nuclear Information System (INIS)

    Romanishin, W.

    1980-01-01

    This dissertation presents an observational overview of a sample of low surface brightness (LSB) spiral galaxies. The sample galaxies were chosen to have low surface brightness disks and indications of spiral structure visible on the Palomar Sky Survey. They are of sufficient angular size (diameter > 2.5 arcmin), to allow detailed surface photometry using Mayall 4-m prime focus plates. The major findings of this dissertation are: (1) The average disk central surface brightness of the LSB galaxies is 22.88 magnitude/arcsec 2 in the B passband. (2) From broadband color measurements of the old stellar population, we infer a low average stellar metallicity, on the order of 1/5 solar. (3) The spectra and optical colors of the HII regions in the LSB galaxies indicate a lack of hot ionizing stars compared to HII regions in other late-type galaxies. (4) The average surface mass density, measured within the radius containing half the total mass, is less than half that of a sample of normal late-type spirals. (5) The average LSB galaxy neutral hydrogen mass to blue luminosity ratio is about 0.6, significantly higher than in a sample of normal late-type galaxies. (6) We find no conclusive evidence of an abnormal mass-to-light ratio in the LSB galaxies. (7) Some of the LSB galaxies exhibit well-developed density wave patterns. (8) A very crude calculation shows the lower metallicity of the LSB galaxies compared with normal late-type spirals might be explained simply by the deficiency of massive stars in the LSB galaxies

  3. Mechanisms of rotator cuff tendinopathy: intrinsic, extrinsic, or both?

    Science.gov (United States)

    Seitz, Amee L; McClure, Philip W; Finucane, Sheryl; Boardman, N Douglas; Michener, Lori A

    2011-01-01

    The etiology of rotator cuff tendinopathy is multi-factorial, and has been attributed to both extrinsic and intrinsic mechanisms. Extrinsic factors that encroach upon the subacromial space and contribute to bursal side compression of the rotator cuff tendons include anatomical variants of the acromion, alterations in scapular or humeral kinematics, postural abnormalities, rotator cuff and scapular muscle performance deficits, and decreased extensibility of pectoralis minor or posterior shoulder. A unique extrinsic mechanism, internal impingement, is attributed to compression of the posterior articular surface of the tendons between the humeral head and glenoid and is not related to subacromial space narrowing. Intrinsic factors that contribute to rotator cuff tendon degradation with tensile/shear overload include alterations in biology, mechanical properties, morphology, and vascularity. The varied nature of these mechanisms indicates that rotator cuff tendinopathy is not a homogenous entity, and thus may require different treatment interventions. Treatment aimed at addressing mechanistic factors appears to be beneficial for patients with rotator cuff tendinopathy, however, not for all patients. Classification of rotator cuff tendinopathy into subgroups based on underlying mechanism may improve treatment outcomes. 2010 Elsevier Ltd. All rights reserved.

  4. Three-dimensional computed display of otosurgical operation sites by spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, O. [Department of Otorhinolaryngology, University of Heidelberg Medical School, Heidelberg (Germany); Sartor, K. [Department of Neuroradiology, University of Heidelberg Medical School (Germany); Forsting, M. [Department of Neuroradiology, University of Heidelberg Medical School (Germany); Reisser, C. [Department of Otorhinolaryngology, University of Heidelberg Medical School, Heidelberg (Germany)

    1996-10-01

    We studied the usefulness of spiral CT for preoperative information on the individual anatomy of the temporal bone in a computed three-dimensional (3D) display. In 87 patients with various otological diseases, 3D reconstructions were performed based on spiral high-resolution CT (HR-CT) by volume-rendering on an independent workstation. The positions of the ossicles, facial nerve, labyrinth and vestibular aqueduct relative to reference points were comprehensively demonstrated by thresholding or interactive segmentation. Spiral CT enables 3D display of otosurgical operation sites in a shorter scan time than conventional CT. 3D reconstructions improve the surgeon`s understanding of individual anatomy and thus help in surgical planning. This is particularly important for surgery of temporal bone tumours, middle ear deformities, cochlear implants and saccotomy. (orig.). With 6 figs.

  5. Three-dimensional computed display of otosurgical operation sites by spiral CT

    International Nuclear Information System (INIS)

    Schubert, O.; Sartor, K.; Forsting, M.; Reisser, C.

    1996-01-01

    We studied the usefulness of spiral CT for preoperative information on the individual anatomy of the temporal bone in a computed three-dimensional (3D) display. In 87 patients with various otological diseases, 3D reconstructions were performed based on spiral high-resolution CT (HR-CT) by volume-rendering on an independent workstation. The positions of the ossicles, facial nerve, labyrinth and vestibular aqueduct relative to reference points were comprehensively demonstrated by thresholding or interactive segmentation. Spiral CT enables 3D display of otosurgical operation sites in a shorter scan time than conventional CT. 3D reconstructions improve the surgeon's understanding of individual anatomy and thus help in surgical planning. This is particularly important for surgery of temporal bone tumours, middle ear deformities, cochlear implants and saccotomy. (orig.). With 6 figs

  6. Magnitude of Interfractional Vaginal Cuff Movement: Implications for External Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Daniel J. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Michaletz-Lorenz, Martha [Department of Education and Training, Elekta, Maryland Heights, MO (United States); Goddu, S. Murty [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Grigsby, Perry W., E-mail: pgrigsby@wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States); Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO (United States)

    2012-03-15

    Purpose: To quantify the extent of interfractional vaginal cuff movement in patients receiving postoperative irradiation for cervical or endometrial cancer in the absence of bowel/bladder instruction. Methods and Materials: Eleven consecutive patients with cervical or endometrial cancer underwent placement of three gold seed fiducial markers in the vaginal cuff apex as part of standard of care before simulation. Patients subsequently underwent external irradiation and brachytherapy treatment based on institutional guidelines. Daily megavoltage CT imaging was performed during each external radiation treatment fraction. The daily positions of the vaginal apex fiducial markers were subsequently compared with the original position of the fiducial markers on the simulation CT. Composite dose-volume histograms were also created by summing daily target positions. Results: The average ({+-} standard deviation) vaginal cuff movement throughout daily pelvic external radiotherapy when referenced to the simulation position was 16.2 {+-} 8.3 mm. The maximum vaginal cuff movement for any patient during treatment was 34.5 mm. In the axial plane the mean vaginal cuff movement was 12.9 {+-} 6.7 mm. The maximum vaginal cuff axial movement was 30.7 mm. In the craniocaudal axis the mean movement was 10.3 {+-} 7.6 mm, with a maximum movement of 27.0 mm. Probability of cuff excursion outside of the clinical target volume steadily dropped as margin size increased (53%, 26%, 4.2%, and 1.4% for 1.0, 1.5, 2.0, and 2.5 cm, respectively.) However, rectal and bladder doses steadily increased with larger margin sizes. Conclusions: The magnitude of vaginal cuff movement is highly patient specific and can impact target coverage in patients without bowel/bladder instructions at simulation. The use of vaginal cuff fiducials can help identify patients at risk for target volume excursion.

  7. Multiple mechanisms quench passive spiral galaxies

    Science.gov (United States)

    Fraser-McKelvie, Amelia; Brown, Michael J. I.; Pimbblet, Kevin; Dolley, Tim; Bonne, Nicolas J.

    2018-02-01

    We examine the properties of a sample of 35 nearby passive spiral galaxies in order to determine their dominant quenching mechanism(s). All five low-mass (M⋆ environments. We postulate that cluster-scale gas stripping and heating mechanisms operating only in rich clusters are required to quench low-mass passive spirals, and ram-pressure stripping and strangulation are obvious candidates. For higher mass passive spirals, while trends are present, the story is less clear. The passive spiral bar fraction is high: 74 ± 15 per cent, compared with 36 ± 5 per cent for a mass, redshift and T-type matched comparison sample of star-forming spiral galaxies. The high mass passive spirals occur mostly, but not exclusively, in groups, and can be central or satellite galaxies. The passive spiral group fraction of 74 ± 15 per cent is similar to that of the comparison sample of star-forming galaxies at 61 ± 7 per cent. We find evidence for both quenching via internal structure and environment in our passive spiral sample, though some galaxies have evidence of neither. From this, we conclude no one mechanism is responsible for quenching star formation in passive spiral galaxies - rather, a mixture of mechanisms is required to produce the passive spiral distribution we see today.

  8. Reliability of Pain Measurements Using Computerized Cuff Algometry: A DoloCuff Reliability and Agreement Study.

    Science.gov (United States)

    Kvistgaard Olsen, Jack; Fener, Dilay Kesgin; Waehrens, Eva Elisabet; Wulf Christensen, Anton; Jespersen, Anders; Danneskiold-Samsøe, Bente; Bartels, Else Marie

    2017-07-01

    Computerized pneumatic cuff pressure algometry (CPA) using the DoloCuff is a new method for pain assessment. Intra- and inter-rater reliabilities have not yet been established. Our aim was to examine the inter- and intrarater reliabilities of DoloCuff measures in healthy subjects. Twenty healthy subjects (ages 20 to 29 years) were assessed three times at 24-hour intervals by two trained raters. Inter-rater reliability was established based on the first and second assessments, whereas intrarater reliability was based on the second and third assessments. Subjects were randomized 1:1 to first assessment at either rater 1 or rater 2. The variables of interest were pressure pain threshold (PT), pressure pain tolerance (PTol), and temporal summation index (TSI). Reliability was estimated by a two-way mixed intraclass correlation coefficient (ICC) absolute agreement analysis. Reliability was considered excellent if ICC > 0.75, fair to good if 0.4 TSI was 0.88 (95% CI: 0.69 to 0.95), 0.86 (95% CI: 0.65 to 0.95), and 0.81 (95% CI: 0.42 to 0.94), respectively. The intrarater reliability for PT, PTol, and TSI was 0.81 (95% CI: 0.53 to 0.92), 0.89 (95% CI: 0.74 to 0.96), and 0.75 (95% CI: 0.28 to 0.91), respectively. Inter-rater reliability was excellent for PT, PTol, and TSI. Similarly, the intrarater reliability for PT and PTol was excellent, while borderline excellent/good for TSI. Therefore, the DoloCuff can be used to obtain reliable measures of pressure pain parameters in healthy subjects. © 2016 World Institute of Pain.

  9. Intense focused ultrasound stimulation of the rotator cuff: evaluation of the source of pain in rotator cuff tears and tendinopathy.

    Science.gov (United States)

    Gellhorn, Alfred C; Gillenwater, Cody; Mourad, Pierre D

    2015-09-01

    The objective of this preliminary study was to evaluate the ability of individual 0.1-s long pulses of intense focused ultrasound (iFU) emitted with a carrier frequency of 2 MHz to evoke diagnostic sensations when applied to patients whose shoulders have rotator cuff tears or tendinopathy. Patients were adults with painful shoulders and clinical and imaging findings consistent with rotator cuff disease. iFU stimulation of the shoulder was performed using B-mode ultrasound coupled with a focused ultrasound transducer that allowed image-guided delivery of precisely localized pulses of energy to different anatomic areas around the rotator cuff. The main outcome measure was iFU spatial average-temporal average intensity (I_SATA), and location required to elicit sensation. In control patients, iFU produced no sensation throughout the range of stimulation intensities (≤2000 W/cm(2) I_SATA). In patients with rotator cuff disease, iFU was able to induce sensation in the tendons of the rotator cuff, the subacromial bursa, and the subchondral bone in patients with chronic shoulder pain and rotator cuff disease, with an average ± standard deviation intensity equaling 680 ± 281 W/cm(2) I_SATA. This result suggests a primary role for these tissues in the pathogenesis of shoulder pain related to rotator cuff tendinopathy. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  10. Effect of mechanical behaviour of the brachial artery on blood pressure measurement during both cuff inflation and cuff deflation.

    Science.gov (United States)

    Zheng, Dingchang; Pan, Fan; Murray, Alan

    2013-10-01

    The aim of this study was to investigate the effect of different mechanical behaviour of the brachial artery on blood pressure (BP) measurements during cuff inflation and deflation. BP measurements were taken from each of 40 participants, with three repeat sessions under three randomized cuff deflation/inflation conditions. Cuff pressure was linearly deflated and inflated at a standard rate of 2-3 mmHg/s and also linearly inflated at a fast rate of 5-6 mmHg/s. Manual auscultatory systolic and diastolic BPs, and pulse pressure (SBP, DBP, PP) were measured. Automated BPs were determined from digitally recorded cuff pressures by fitting a polynomial model to the oscillometric pulse amplitudes. The BPs from cuff deflation and inflation were then compared. Repeatable measurements between sessions and between the sequential order of inflation/deflation conditions (all P > 0.1) indicated stability of arterial mechanical behaviour with repeat measurements. Comparing BPs obtained by standard inflation with those from standard deflation, manual SBP was 2.6 mmHg lower (P deflation suggest different arterial mechanical behaviour between arterial opening and closing during BP measurement. We have shown that the mechanical behaviour of the brachial artery during BP measurement differs between cuff deflation and cuff inflation.

  11. Median nerve fascicular anatomy as a basis for distal neural prostheses.

    Science.gov (United States)

    Planitzer, Uwe; Steinke, Hanno; Meixensberger, Jürgen; Bechmann, Ingo; Hammer, Niels; Winkler, Dirk

    2014-05-01

    Functional electrical stimulation (FES) serves as a possible therapy to restore missing motor functions of peripheral nerves by means of cuff electrodes. FES is established for improving lower limb function. Transferring this method to the upper extremity is complex, due to a lack of anatomical data on the physiological configuration of nerve fascicles. Our study's aim was to provide an anatomical basis for FES of the median nerve in the distal forearm and hand. We investigated 21 distal median nerves from 12 body donors. The peripheral fascicles were traced back by removing the external and interfascicular epineurium and then assigned to 4 quadrants. A distinct motor and sensory distribution was observed. The fascicles innervating the thenar eminence and the first lumbrical muscle originated from the nerves' radial parts in 82%. The fascicle supplying the second lumbrical muscle originated from the ulnar side in 78%. No macroscopically visible plexus formation was observed for the distal median nerve in the forearm. The findings on the distribution of the motor branches of the median nerve and the missing plexus formation may likely serve as an anatomical basis for FES of the distal forearm. However, due to the considerable variability of the motor branches, cuff electrodes will need to be adapted individually in FES. Taking into account the sensory distribution of the median nerve, FES may also possibly be applied in the treatment of regional pain syndromes. Copyright © 2013 Elsevier GmbH. All rights reserved.

  12. Shouldering the blame for impingement: the rotator cuff continuum

    African Journals Online (AJOL)

    . ... of rotator cuff pathology is described, and the challenges of accurate clinical diagnosis, imaging and best management discussed. Keywords: shoulder ... actions.10 Extension, abduction and external rotation of the humerus causes ...

  13. Reliability of Pain Measurements Using Computerized Cuff Algometry

    DEFF Research Database (Denmark)

    Kvistgaard Olsen, Jack; Fener, Dilay Kesgin; Wæhrens, Eva Elisabet

    2017-01-01

    INTRODUCTION: Computerized pneumatic cuff pressure algometry (CPA) using the DoloCuff is a new method for pain assessment. Intra- and inter-rater reliabilities have not yet been established. Our aim was to examine the inter- and intrarater reliabilities of DoloCuff measures in healthy subjects...... randomized 1:1 to first assessment at either rater 1 or rater 2. The variables of interest were pressure pain threshold (PT), pressure pain tolerance (PTol), and temporal summation index (TSI). Reliability was estimated by a two-way mixed intraclass correlation coefficient (ICC) absolute agreement analysis...... for PT, PTol, and TSI. Similarly, the intrarater reliability for PT and PTol was excellent, while borderline excellent/good for TSI. Therefore, the DoloCuff can be used to obtain reliable measures of pressure pain parameters in healthy subjects....

  14. Rotator cuff troublemakers: pitfalls of MRI and ultrasound

    Directory of Open Access Journals (Sweden)

    Christina M Chingkoe

    2009-12-01

    Full Text Available Christina M Chingkoe1, Jeremy H White2, Luck J Louis2, Gordon Andrews2, Bruce B Forster21Faculty of Medicine, University of British Columbia, Vancouver BC, Canada; 2Department of Radiology, University of British Columbia, Vancouver BC, CanadaAbstract: Rotator cuff pathology is routinely evaluated in many imaging centers with both magnetic resonance imaging (MRI and ultrasound. Despite good diagnostic accuracy using each of these modalities, certain limitations persist. In this pictorial essay, we describe five potential “troublemakers” of rotator cuff pathology which are recurrent themes in our busy shoulder referral center. The comparison of imaging findings on MRI and ultrasound are discussed. An awareness of these potential pitfalls will help improve radiologists’ diagnostic accuracy of rotator cuff pathology, and allow the clinician to optimize imaging referral and better interpret the subsequent report.Keywords: rotator cuff, ultrasound, MRI, correlation, shoulder

  15. Progression from calcifying tendinitis to rotator cuff tear

    International Nuclear Information System (INIS)

    Gotoh, Masafumi; Higuchi, Fujio; Suzuki, Ritsu; Yamanaka, Kensuke

    2003-01-01

    This report documents the clinical, radiographic and histologic findings in a 46-year-old man with calcifying tendinitis in his left shoulder which progressed to rotator cuff tear. The patient had a 1-year history of repeated calcifying tendinitis before being referred to our hospital. On the initial visit, radiographs and magnetic resonance imaging (MRI) revealed calcium deposition localized in the supraspinatus tendon without apparent tear. Three months after the first visit, MRI revealed a partial-thickness rotator cuff tear at the site of calcium deposition. Surgical and histologic findings demonstrated that calcium deposition was the cause of cuff rupture. To our knowledge, based on a review of the English literature, this is the first case report in which the progression from calcifying tendinitis to rotator cuff tear has been serially observed. (orig.)

  16. Ultrasound of the rotator cuff with MRI and anatomic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Rutten, Matthieu J.C.M. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail: M.Rutten@JBZ.nl; Maresch, Bas J. [Department of Radiology, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6710 HN Ede (Netherlands)]. E-mail: MareschB@zgv.nl; Jager, Gerrit J. [Department of Radiology, Jeroen Bosch Hospital, Nieuwstraat 34, 5211 NL ' s-Hertogenbosch (Netherlands)]. E-mail: G.Jager@JBZ.nl; Blickman, Johan G. [Department of Radiology, University Medical Center Nijmegen, Geert Grooteplein Zuid 18, 6500 HB Nijmegen (Netherlands)]. E-mail: J.Blickman@rad.umcn.nl; Holsbeeck, Marnix T. van [Department of Radiology, Henry Ford Hospital, 2799 W Grand Boulevard, Detroit, MI 48202 (United States)]. E-mail: vanholsbeeck@comcast.net

    2007-06-15

    Magnetic resonance imaging and high-resolution ultrasound (US) are frequently used for the detection of rotator cuff tears. The diagnostic yield of US is influenced by several factors as technique, knowledge of the imaging characteristics of anatomic and pathologic findings and of pitfalls. The purpose of this article is to illustrates that the standardized high-resolution US examination of the shoulder covers the entire rotator cuff and correlates with MR imaging and anatomic sections.

  17. Spiral 2 the scientific objectives

    International Nuclear Information System (INIS)

    2006-06-01

    The French ministry of research took the decision to build Spiral-2 in May 2005. Its construction costs are estimated to 130 million euros while its operating costs will near 8.5 million euros per year. The construction works will last 5 years. The Spiral-2 facility is based on a high power, superconducting driver Linac, which will deliver a high intensity, 40 MeV deuteron beam as well as a variety of heavy-ion beams with mass over charge ratio equal to 3 and energy up to 14.5 MeV/nucleon. Using a carbon converter, fast neutrons from the breakup of the 5 mA of deuterons impinging on a uranium carbide target will induce a rate of up to 10 14 fissions/s. The radioactive ion beam intensities in the mass range from A = 60 to 140 will be of the order of 10 6 to 10 11 particles/s surpassing by one or two orders-of-magnitude any existing facility in the world. A direct irradiation of the UC 2 target with 3,4 He, 6,7 Li or 12 C may also be used. Different production targets will be used to produce high-intensity beams of light radioactive species with the Isol technique. The extracted radioactive ion beam will be accelerated to energies up to 20 MeV/nucleons by the existing Cime cyclotron. One of the most important features of the future Ganil accelerator complex will be the capability of delivering up to 5 stable or radioactive beams simultaneously in the energy range from the keV to several tens of MeV/nucleons. The document details also the future contribution of Spiral-2 concerning the structure of exotic nuclei, the thermodynamical aspects of nuclear matter, nucleosynthesis, the fundamental basic interactions, and the use of neutrons. (A.C.)

  18. Spiral 2 the scientific objectives

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-06-15

    The French ministry of research took the decision to build Spiral-2 in May 2005. Its construction costs are estimated to 130 million euros while its operating costs will near 8.5 million euros per year. The construction works will last 5 years. The Spiral-2 facility is based on a high power, superconducting driver Linac, which will deliver a high intensity, 40 MeV deuteron beam as well as a variety of heavy-ion beams with mass over charge ratio equal to 3 and energy up to 14.5 MeV/nucleon. Using a carbon converter, fast neutrons from the breakup of the 5 mA of deuterons impinging on a uranium carbide target will induce a rate of up to 10{sup 14} fissions/s. The radioactive ion beam intensities in the mass range from A = 60 to 140 will be of the order of 10{sup 6} to 10{sup 11} particles/s surpassing by one or two orders-of-magnitude any existing facility in the world. A direct irradiation of the UC{sub 2} target with {sup 3,4}He, {sup 6,7}Li or {sup 12}C may also be used. Different production targets will be used to produce high-intensity beams of light radioactive species with the Isol technique. The extracted radioactive ion beam will be accelerated to energies up to 20 MeV/nucleons by the existing Cime cyclotron. One of the most important features of the future Ganil accelerator complex will be the capability of delivering up to 5 stable or radioactive beams simultaneously in the energy range from the keV to several tens of MeV/nucleons. The document details also the future contribution of Spiral-2 concerning the structure of exotic nuclei, the thermodynamical aspects of nuclear matter, nucleosynthesis, the fundamental basic interactions, and the use of neutrons. (A.C.)

  19. Bench study of a new device to display and maintain stable artificial airway cuff pressure.

    Science.gov (United States)

    Howard, William R

    2011-10-01

    Artificial airway cuff pressure should be maintained within a narrow range. Excessive cuff pressure presents a risk of tracheal damage and stenosis. Insufficient cuff pressure adds the risk of secretion leak past the cuff, tidal-volume leakage, and accidental extubation. The available cuff-inflation devices do not address these problems. In the laboratory I developed and evaluated a new cuff-inflation device that continuously displays the cuff pressure and maintains stable cuff pressure. The cuff-inflation device evaluation included: test the manometer accuracy; compare the displayed pressure to the pressure delivered to the pilot balloon; determine the device's response to cuff-pressure changes with the addition of 5 mL or 10 mL of air after achieving a 30 cm H(2)O baseline; measure the V(T) leak in an intubated artificial trachea by comparing the device results to benchmark measurements; and determine the stability of baseline cuff pressure during routine cuff checks. The mean ± SD bias and precision of device's display, compared to the calibration analyzer, was 1.3 ± 2.6 cm H(2)O. The pressure delivered by the cuff-inflation device's gas-sampling line to the pilot balloon was equal to the pressure displayed by the cuff-inflation device. With the cuff-inflation device the cuff pressure was unchanged, compared to baseline, after adding 5 mL or 10 mL of air. With 2 current cuff methods, cuff pressure increased to means exceeding 160 cm H(2)O and 300 cm H(2)O, respectively. Compared to the benchmark, the difference in exhaled V(T) mean ± SD bias and precision were: cuff-inflation device 1.4 ± 4.8 mL, and syringe-inflation method 2.4 ± 6.2 mL. Representing a single cuff pressure check, disconnecting the endotracheal-tube pilot balloon from the cuff-inflation device's gas-sampling line and then reconnecting it had no effect on baseline cuff pressure at 2 seconds or 60 seconds. The cuff-inflation device demonstrated possible improvements over available cuff

  20. The rotation of spiral galaxies.

    Science.gov (United States)

    Rubin, V C

    1983-06-24

    There is accumulating evidence that as much as 90 percent of the mass of the universe is nonluminous and is clumped, halo-like, around individual galaxies. The gravitational force of this dark matter is presumed to be responsible for the high rotational velocities of stars and gas in the disks of spiral galaxie. At present, the form of the dark matter is unknown. Possible candidates span a range in mass of 10(70), from non-zero-mass neutrinos to massive black holes.

  1. Relationships between rotator cuff tear types and radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying [Dept. of Diagnostic Radiology, College of Medicine, Chungbuk National University, Cheongju (Korea, Republic of)

    2014-11-15

    To determine relationships between different types of rotator cuff tears and radiographic abnormalities. The shoulder radiographs of 104 patients with an arthroscopically proven rotator cuff tear were compared with similar radiographs of 54 age-matched controls with intact cuffs. Two radiologists independently interpreted all radiographs for; cortical thickening with subcortical sclerosis, subcortical cysts, osteophytes in the humeral greater tuberosity, humeral migration, degenerations of the acromioclavicular and glenohumeral joints, and subacromial spurs. Statistical analysis was performed to determine relationships between each type of rotator cuff tears and radiographic abnormalities. Inter-observer agreements with respect to radiographic findings were analyzed. Humeral migration and degenerative change of the greater tuberosity, including sclerosis, subcortical cysts, and osteophytes, were more associated with full-thickness tears (p < 0.01). Subacromial spurs were more common for full-thickness and bursal-sided tears (p < 0.01). No association was found between degeneration of the acromioclavicular or glenohumeral joint and the presence of a cuff tear. Different types of rotator cuff tears are associated with different radiographic abnormalities.

  2. Improved apparatus for predictive diagnosis of rotator cuff disease

    Science.gov (United States)

    Pillai, Anup; Hall, Brittany N.; Thigpen, Charles A.; Kwartowitz, David M.

    2014-03-01

    Rotator cuff disease impacts over 50% of the population over 60, with reports of incidence being as high as 90% within this population, causing pain and possible loss of function. The rotator cuff is composed of muscles and tendons that work in tandem to support the shoulder. Heavy use of these muscles can lead to rotator cuff tear, with the most common causes is age-related degeneration or sport injuries, both being a function of overuse. Tears ranges in severity from partial thickness tear to total rupture. Diagnostic techniques are based on physical assessment, detailed patient history, and medical imaging; primarily X-ray, MRI and ultrasonography are the chosen modalities for assessment. The final treatment technique and imaging modality; however, is chosen by the clinician is at their discretion. Ultrasound has been shown to have good accuracy for identification and measurement of full-thickness and partial-thickness rotator cuff tears. In this study, we report on the progress and improvement of our method of transduction and analysis of in situ measurement of rotator cuff biomechanics. We have improved the ability of the clinician to apply a uniform force to the underlying musculotendentious tissues while simultaneously obtaining the ultrasound image. This measurement protocol combined with region of interest (ROI) based image processing will help in developing a predictive diagnostic model for treatment of rotator cuff disease and help the clinicians choose the best treatment technique.

  3. Compensatory hypertrophy of the teres minor muscle after large rotator cuff tear model in adult male rat.

    Science.gov (United States)

    Ichinose, Tsuyoshi; Yamamoto, Atsushi; Kobayashi, Tsutomu; Shitara, Hitoshi; Shimoyama, Daisuke; Iizuka, Haku; Koibuchi, Noriyuki; Takagishi, Kenji

    2016-02-01

    Rotator cuff tear (RCT) is a common musculoskeletal disorder in the elderly. The large RCT is often irreparable due to the retraction and degeneration of the rotator cuff muscle. The integrity of the teres minor (TM) muscle is thought to affect postoperative functional recovery in some surgical treatments. Hypertrophy of the TM is found in some patients with large RCTs; however, the process underlying this hypertrophy is still unclear. The objective of this study was to determine if compensatory hypertrophy of the TM muscle occurs in a large RCT rat model. Twelve Wistar rats underwent transection of the suprascapular nerve and the supraspinatus and infraspinatus tendons in the left shoulder. The rats were euthanized 4 weeks after the surgery, and the cuff muscles were collected and weighed. The cross-sectional area and the involvement of Akt/mammalian target of rapamycin (mTOR) signaling were examined in the remaining TM muscle. The weight and cross-sectional area of the TM muscle was higher in the operated-on side than in the control side. The phosphorylated Akt/Akt protein ratio was not significantly different between these sides. The phosphorylated-mTOR/mTOR protein ratio was significantly higher on the operated-on side. Transection of the suprascapular nerve and the supraspinatus and infraspinatus tendons activates mTOR signaling in the TM muscle, which results in muscle hypertrophy. The Akt-signaling pathway may not be involved in this process. Nevertheless, activation of mTOR signaling in the TM muscle after RCT may be an effective therapeutic target of a large RCT. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. The societal and economic value of rotator cuff repair.

    Science.gov (United States)

    Mather, Richard C; Koenig, Lane; Acevedo, Daniel; Dall, Timothy M; Gallo, Paul; Romeo, Anthony; Tongue, John; Williams, Gerald

    2013-11-20

    Although rotator cuff disease is a common musculoskeletal problem in the United States, the impact of this condition on earnings, missed workdays, and disability payments is largely unknown. This study examines the value of surgical treatment for full-thickness rotator cuff tears from a societal perspective. A Markov decision model was constructed to estimate lifetime direct and indirect costs associated with surgical and continued nonoperative treatment for symptomatic full-thickness rotator cuff tears. All patients were assumed to have been unresponsive to one six-week trial of nonoperative treatment prior to entering the model. Model assumptions were obtained from the literature and data analysis. We obtained estimates of indirect costs using national survey data and patient-reported outcomes. Four indirect costs were modeled: probability of employment, household income, missed workdays, and disability payments. Direct cost estimates were based on average Medicare reimbursements with adjustments to an all-payer population. Effectiveness was expressed in quality-adjusted life years (QALYs). The age-weighted mean total societal savings from rotator cuff repair compared with nonoperative treatment was $13,771 over a patient's lifetime. Savings ranged from $77,662 for patients who are thirty to thirty-nine years old to a net cost to society of $11,997 for those who are seventy to seventy-nine years old. In addition, surgical treatment results in an average improvement of 0.62 QALY. Societal savings were highly sensitive to age, with savings being positive at the age of sixty-one years and younger. The estimated lifetime societal savings of the approximately 250,000 rotator cuff repairs performed in the U.S. each year was $3.44 billion. Rotator cuff repair for full-thickness tears produces net societal cost savings for patients under the age of sixty-one years and greater QALYs for all patients. Rotator cuff repair is cost-effective for all populations. The results

  5. The DESIR Facility at SPIRAL2

    Indian Academy of Sciences (India)

    Beams from the low-energy branch of the separator spectrometer S3 and from SPIRAL1 will allow complementary studies of refrac- tory elements produced by means of fusion reactions as well as of light and intense exotic beams, respectively. Keywords. SPIRAL2; low-energy facility; nuclear physics; weak interaction; astro-.

  6. ANGULAR-MOMENTUM IN BINARY SPIRAL GALAXIES

    NARCIS (Netherlands)

    OOSTERLOO, T

    In order to investigate the relative orientations of spiral galaxies in pairs, the distribution of the angle between the spin-vectors for a new sample of 40 binary spiral galaxies is determined. From this distribution it is found, contrary to an earlier result obtained by Helou (1984), that there is

  7. Scaling effects in spiral capsule robots.

    Science.gov (United States)

    Liang, Liang; Hu, Rong; Chen, Bai; Tang, Yong; Xu, Yan

    2017-04-01

    Spiral capsule robots can be applied to human gastrointestinal tracts and blood vessels. Because of significant variations in the sizes of the inner diameters of the intestines as well as blood vessels, this research has been unable to meet the requirements for medical applications. By applying the fluid dynamic equations, using the computational fluid dynamics method, to a robot axial length ranging from 10 -5 to 10 -2  m, the operational performance indicators (axial driving force, load torque, and maximum fluid pressure on the pipe wall) of the spiral capsule robot and the fluid turbulent intensity around the robot spiral surfaces was numerically calculated in a straight rigid pipe filled with fluid. The reasonableness and validity of the calculation method adopted in this study were verified by the consistency of the calculated values by the computational fluid dynamics method and the experimental values from a relevant literature. The results show that the greater the fluid turbulent intensity, the greater the impact of the fluid turbulence on the driving performance of the spiral capsule robot and the higher the energy consumption of the robot. For the same level of size of the robot, the axial driving force, the load torque, and the maximum fluid pressure on the pipe wall of the outer spiral robot were larger than those of the inner spiral robot. For different requirements of the operating environment, we can choose a certain kind of spiral capsule robot. This study provides a theoretical foundation for spiral capsule robots.

  8. QS Spiral: Visualizing Periodic Quantified Self Data

    DEFF Research Database (Denmark)

    Larsen, Jakob Eg; Cuttone, Andrea; Jørgensen, Sune Lehmann

    2013-01-01

    In this paper we propose an interactive visualization technique QS Spiral that aims to capture the periodic properties of quantified self data and let the user explore those recurring patterns. The approach is based on time-series data visualized as a spiral structure. The interactivity includes ...

  9. Analysis of dynamic autoregulation assessed by the cuff deflation method.

    Science.gov (United States)

    Hlatky, Roman; Valadka, Alex B; Robertson, Claudia S

    2006-01-01

    Dynamic testing of cerebral pressure autoregulation is more practical than static testing for critically ill patients. The process of cuff deflation is innocuous in the normal subject, but the systemic and cerebral effects of cuff deflation in severely head-injured patients have not been studied. The purposes of this study were to examine the physiological effects of cuff deflation and to study their impact on the calculation of autoregulatory index (ARI). In 24 severely head-injured patients, 388 thigh cuff deflations were analyzed. The physiological parameters were recorded before, during, and after a transient decrease in blood pressure. Autoregulation was graded by generating an ARI value from 0 to 9. Mean arterial blood pressure (MAP) dropped rapidly during the first 2-3 seconds, but the nadir MAP was not reached until 8 +/- 7 seconds after the cuff deflation. MAP decreased by an average value of 19 +/- 5 mmHg. Initially the tracings for MAP and cerebral perfusion pressure (CPP) were nearly identical, but after 30 seconds, variable increases in intracranial pressure caused some differences between the MAP and CPP curves. The difference between the ARI values calculated twice using MAP as well as CPP was zero for 70% of left-sided studies and 73% for right-sided studies and less than or equal to 1 for 93% of left- and 95% of right-sided cuff deflations. Transient and relatively minor perturbations were detected in systemic physiology induced by dynamic testing of cerebral pressure autoregulation. Furthermore, this study confirms that the early changes in MAP and CPP after cuff deflation are nearly identical. MAP can substitute for CPP in the calculation of ARI even in the severely brain-injured patient.

  10. Comparison of 2 cuff inflation methods before insertion of laryngeal mask airway for safe use without cuff manometer in children.

    Science.gov (United States)

    Kim, Min-Soo; Bai, Sun-Joon; Oh, Jung-Tak; Youm, Seung-Mok; Lee, Jeong-Rim

    2013-02-01

    This prospective, randomized trial was conducted to establish whether the pediatric laryngeal mask airway (LMA) could be used without any concerns for abnormally high intra-cuff pressure when a cuff of the LMA was inflated with half the maximum recommended inflation volume or the resting volume before insertion. Eighty children 0 to 9 years of age and weighing of 5 to 30 kg scheduled for general anesthesia were included. Before insertion, the cuff of the LMA was filled with half the maximum recommended inflation volume in the Half volume group, or the resting volume by opening the pilot balloon valve to atmospheric pressure in the Resting volume group. After insertion of the LMA, intra-cuff pressure, oropharyngeal leak pressure, and leakage volume were investigated. The Half volume group showed lower mean intra-cuff pressure than the Resting volume group (49.6 ± 12.1 cm H(2)O vs 58.1 ± 13.8 cm H(2)O, P = .005). There was no difference in oropharyngeal leak pressure (22.1 ± 5.8 vs 21.7 ± 5.1 cm H(2)O, P = .757) or leakage volume between the Half volume group and the Resting volume group (0.13 ± 0.13 ml/kg vs 0.11 ± 0.12 ml/kg, P = .494) under spontaneous respiration. Both methods of the LMA cuff inflation before insertion provided an acceptable range of intra-cuff pressure with adequate pharyngeal sealing without any intervention after insertion. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Occlusion cuff for routine measurement of digital blood pressure and blood flow

    DEFF Research Database (Denmark)

    Lassen, N A; Krähenbühl, B; Hirai, M

    1977-01-01

    A miniaturized blood pressure cuff made of plastic material and applicable to fingers and toes is described. The cuff was compared to rubber cuffs and to bladder-free cuffs. It was found to be more reliable than the former type and much easier to use than the latter type. It is recommended for us...... in conjunction with a mercury-in-Silastic strain gauge for routine measurement of digital blood pressure and blood flow in patients with arterial disease.......A miniaturized blood pressure cuff made of plastic material and applicable to fingers and toes is described. The cuff was compared to rubber cuffs and to bladder-free cuffs. It was found to be more reliable than the former type and much easier to use than the latter type. It is recommended for use...

  12. Analisa Kekuatan Spiral Bevel Gear Dengan Variasi Sudut Spiral Menggunakan Metode Elemen Hingga

    Directory of Open Access Journals (Sweden)

    Deta Rachmat Andika

    2017-01-01

    Full Text Available Seiring perkembangan zaman,  teknologi roda gigi dituntut untuk mampu mentransmisikan daya yang besar dengan efisiensi yang besar pula. Pada jenis intersecting shaft gear, tipe roda gigi payung spiral (spiral bevel gear  merupakan perkembangan dari roda gigi payung bergigi lurus (straight bevel gear. Kelebihan dari spiral bevel gear antara  lain adalah kemampuan transmisi daya dan efisiensi yang lebih besar pada geometri yang sama serta tidak terlalu berisik. Akan tetapi spiral bevel gear juga mempunyai kelemahan jika dibandingkan dengan straight bevel gear. Selain proses manufaktur yang lebih rumit, profil lengkung gigi spiral ini membuat distribusi tegangan yang terjadi menjadi lebih rumit untuk dimodelkan dengan persamaan matematika. Salah satu pendekatan yang dapat dilakukan adalah dengan menggunakan metode elemen hingga. Penelitian diawali dengan membuat model dari straight bevel gear dan juga spiral bevel gear yang sudut spiralnya divariasikan 20, 35, dan 45 derajat. Model dibuat dengan dimensi yang sama baik diameter maupun jumlah gigi gear. Langkah selanjutnya yaitu perhitungan analitis pada straight bevel gear dimana hasilnya akan dibandingkan dengan hasil simulasi statis. Setelah eror yang terjadi dibawah 15% maka dilakukan simulasi dinamis pada semua model yang telah dibuat yaitu straight bevel dan juga spira bevel gear. Hasil yang didapatkan dari penelitian ini adalah secara keseluruhan spiral bevel gear lebih kuat daripada straight bevel gear pada dimensi dan beban yang sama jika dilihat dari lebih kecilnya tegangan bending dan tegangan kontak maksimum yang terjadi. Tegangan terbesar terjadi pada jenis straight bevel gear baik pada tegangan bending maupun tegangan kontak sedangkan spiral bevel gear dengan variasi sudut Seiring spiral 35 mempunyai nilai tegangan terkecil. Prosntase selisih tegangan bending maksimum yang terjadi antara straight bevel gear dan spiral bevel gear dengan variasi sudut spiral 35 derajat  sebesar 44

  13. On Density Waves in Spiral Galaxies

    Science.gov (United States)

    Grosbol, P.; Patsis, P. A.

    The spiral structure of five ordinary spiral galaxies was studied using deep BVIK' surface photometry maps obtained at the 2.2m ESO/MPI telescope. The detailed shape of the arms was analyzed in terms of the spiral density wave theory. Grand design spirals were found on the K' maps in all five galaxies although at least two would be classified as flocculent on the blue images. In several of the galaxies, bulges with weak oval distortion (~10%) were observed. Dust spirals also continue, in some cases, inside the ILR where the stellar arms terminate. This emphasizes the strong bias of morphological classifications of spiral galaxies based on blue image due to dust and young stars. The 2--armed spirals were systematically found to be wound tighter on I than on K' maps suggesting the existence of a density wave. Locations of the ILR and the 4/1 resonance were estimated based on the arm morphology and the amplitude ratio between the m = 2,4 Fourier components. The wavenumber of the stellar 2--armed pattern is increasing towards the ILR which could suggest that the density wave is associated to the long waved branch of the dispersion relation. A possible scenario is discussed.

  14. Spiral arms in thermally stratified protoplanetary discs

    Science.gov (United States)

    Juhász, Attila; Rosotti, Giovanni P.

    2018-02-01

    Spiral arms have been observed in nearly a dozen protoplanetary discs in near-infrared scattered light and recently also in the submillimetre continuum. While one of the most compelling explanations is that they are driven by planetary or stellar companions, in all but one cases such companions have not yet been detected and there is even ambiguity on whether the planet should be located inside or outside the spirals. Here, we use 3D hydrodynamic simulations to study the morphology of spiral density waves launched by embedded planets taking into account the vertical temperature gradient, a natural consequence of stellar irradiation. Our simulations show that the pitch angle of the spirals in thermally stratified discs is the lowest in the disc mid-plane and increases towards the disc surface. We combine the hydrodynamic simulations with 3D radiative transfer calculations to predict that the pitch angle of planetary spirals observed in the near-infrared is higher than in the submillimetre. We also find that in both cases the spirals converge towards the planet. This provides a new powerful observational method to determine if the perturbing planet is inside or outside the spirals, as well as map the thermal stratification of the disc.

  15. Relief of upper airway obstruction with hypoglossal nerve stimulation in the canine.

    Science.gov (United States)

    Goding, G S; Eisele, D W; Testerman, R; Smith, P L; Roertgen, K; Schwartz, A R

    1998-02-01

    Hypoglossal nerve stimulation was investigated as a method to relieve an induced upper airway obstruction. Six dogs were implanted with a cuff electrode applied to each hypoglossal nerve and a pulse generator. After 4 weeks, the hypoglossal nerve was stimulated (50% duty cycle) for up to 8 weeks. At 12 weeks a double tracheotomy was placed, with a negative pressure intermittently applied to the upper limb, simulating inspiratory airway pressure. Unilateral hypoglossal nerve stimulation improved peak upper airway flow from an average of 0.1 L/s to 1.6 L/s (P = 0.0001). Seventy-seven percent of the maximum possible flow (explanted tracheotomy tube) was obtained with unilateral stimulation. Histopathological evaluation revealed no nerve damage secondary to chronic stimulation. This study provides support for clinical trials of hypoglossal stimulation for obstructive sleep apnea.

  16. Effect of rotator cuff dysfunction on the initial mechanical stability of cementless glenoid components

    NARCIS (Netherlands)

    D.R. Suárez (Daniel); E.R. Valstar (Edward); J.C. Linden (Jacqueline); F. van Keulen (Fred); P.M. Rozing (Piet)

    2009-01-01

    textabstractThe functional outcome of shoulder replacement is related to the condition of the rotator cuff. Rotator cuff disease is a common problem in candidates for total shoulder arthroplasty; this study relates the functional status of the rotator cuff to the initial stability of a cementless

  17. Effects of Wing-Cuff on NACA 23015 Aerodynamic Performances

    Directory of Open Access Journals (Sweden)

    Meftah S.M.A

    2014-03-01

    Full Text Available The main subject of this work is the numerical study control of flow separation on a NACA 23015 airfoil by using wing cuff. This last is a leading edge modification done to the wing. The modification consists of a slight extension of the chord on the outboard section of the wings. Different numerical cases are considered for the baseline and modified airfoil NACA 23015 according at different angle of incidence. The turbulence is modeled by two equations k-epsilon model. The results of this numerical investigation showed several benefits of the wing cuff compared with a conventional airfoil and an agreement is observed between the experimental data and the present study. The most intriguing result of this research is the capability for wing cuff to perform short take-offs and landings.

  18. Rotator Cuff Strength Ratio and Injury in Glovebox Workers

    Energy Technology Data Exchange (ETDEWEB)

    Weaver, Amelia M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2014-01-30

    Rotator cuff integrity is critical to shoulder health. Due to the high workload imposed upon the shoulder while working in an industrial glovebox, this study investigated the strength ratio of the rotator cuff muscles in glovebox workers and compared this ratio to the healthy norm. Descriptive statistics were collected using a short questionnaire. Handheld dynamometry was used to quantify the ratio of forces produced in the motions of shoulder internal and external rotation. Results showed this population to have shoulder strength ratios that were significantly different from the healthy norm. The deviation from the normal ratio demonstrates the need for solutions designed to reduce the workload on the rotator cuff musculature of glovebox workers in order to improve health and safety. Assessment of strength ratios can be used to screen for risk of symptom development.

  19. All-Extra-articular Repair of Anterosuperior Rotator Cuff Tears.

    Science.gov (United States)

    Holschen, Malte; Witt, Kai-Axel; Steinbeck, Jörn

    2018-02-01

    Anterosuperior rotator cuff tears involve the subscapularis tendon, supraspinatus tendon, and rotator interval. The long head of the biceps is usually affected and unstable in these complex lesions. Arthroscopic repair of anterosuperior rotator cuff tears often consists of 2 different procedures. Whereas the subscapularis tendon is reconstructed under intra-articular visualization, the supraspinatus tendon is reconstructed under extra-articular visualization. The rotator interval is often sacrificed to improve visualization and instrumentation. The presented technique uses an all-extra-articular approach, which helps to reconstruct these complex rotator cuff lesions in their whole extent without switching from the inside to the outside of the shoulder joint. The preservation of the rotator interval leads to a more stable and anatomic reconstruction.

  20. CT and MR imaging of the normal and pathologic conditions of the facial nerve

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, Lorenz E-mail: jaeger@ikra.med.uni-muenchen.de; Reiser, Maximilian

    2001-11-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are well established imaging modalities to examine the facial nerve as well as the course of the facial nerve itself. High spatial resolution is guaranteed not only in the x- and y-axis, but also in the z-axis using multislice spiral CT. With this technique, reformatted multiplanar images in oblique planes, avoiding additional examinations in the coronal plane, facilitate the delineation of the facial nerve canal. This is beneficial in patients with temporal bone trauma, malformation or osseous changes. MR has a superior soft-tissue contrast to CT that enables imaging of the facial nerve itself. Therefore the normal facial nerve as well as pathologic changes of the facial nerve is readily visualized from the brain stem to the parotid gland. This review article presents anatomy, pathology and imaging strategies in the diagnostics of the facial nerve.

  1. Evaluation and nonsurgical management of rotator cuff calcific tendinopathy.

    Science.gov (United States)

    Greis, Ari C; Derrington, Stephen M; McAuliffe, Matthew

    2015-04-01

    Rotator cuff calcific tendinopathy is a common finding that accounts for about 7% of patients with shoulder pain. There are numerous theories on the pathogenesis of rotator cuff calcific tendinopathy. The diagnosis is confirmed with radiography, MRI or ultrasound. There are numerous conservative treatment options available and most patients can be managed successfully without surgical intervention. Nonsteroidal anti-inflammatory drugs and multiple modalities are often used to manage pain and inflammation; physical therapy can help improve scapular mechanics and decrease dynamic impingement; ultrasound-guided needle aspiration and lavage techniques can provide long-term improvement in pain and function in these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Corrosion of Spiral Rib Aluminized Pipe

    Science.gov (United States)

    2012-08-01

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

  3. Corrosion of Spiral Rib Aluminized Pipe : [Summary

    Science.gov (United States)

    2012-01-01

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

  4. Magnetic spiral arms in galaxy haloes

    Science.gov (United States)

    Henriksen, R. N.

    2017-08-01

    We seek the conditions for a steady mean field galactic dynamo. The parameter set is reduced to those appearing in the α2 and α/ω dynamo, namely velocity amplitudes, and the ratio of sub-scale helicity to diffusivity. The parameters can be allowed to vary on conical spirals. We analyse the mean field dynamo equations in terms of scale invariant logarithmic spiral modes and special exact solutions. Compatible scale invariant gravitational spiral arms are introduced and illustrated in an appendix, but the detailed dynamical interaction with the magnetic field is left for another work. As a result of planar magnetic spirals `lifting' into the halo, multiple sign changes in average rotation measures forming a regular pattern on each side of the galactic minor axis, are predicted. Such changes have recently been detected in the Continuum Halos in Nearby Galaxies-an EVLA Survey (CHANG-ES) survey.

  5. Cylindrical spirals in human skeletal muscle.

    Science.gov (United States)

    Carpenter, S; Karpati, G; Robitaille, Y; Melmed, C

    1979-01-01

    Muscle biopsies from two patients revealed that numerous type 2 fibers contained large abnormal areas filled with cylindrical spirals. The cytochemical profile of these cylindrical spirals was sufficiently characteristic that they could be distinguished from tubular aggregates. Their electron microscopic appearance was unmistakable. Their origin and significance are uncertain. The diverse nature of the patients' conditions (cramps and malignancy, and an unusual form of spinocerebellar degeneration) indicate that these abnormal structures are not disease specific.

  6. Wavelet Scattering on the Pitch Spiral

    OpenAIRE

    Lostanlen, Vincent; Mallat, Stéphane

    2016-01-01

    We present a new representation of harmonic sounds that linearizes the dynamics of pitch and spectral envelope, while remaining stable to deformations in the time-frequency plane. It is an instance of the scattering transform, a generic operator which cascades wavelet convolutions and modulus nonlinearities. It is derived from the pitch spiral, in that convolutions are successively performed in time, log-frequency, and octave index. We give a closed-form approximation of spiral scattering coe...

  7. Review of the surgical anatomy of the axillary nerve and the anatomic basis of its iatrogenic and traumatic injury.

    Science.gov (United States)

    Apaydin, Nihal; Tubbs, R Shane; Loukas, Marios; Duparc, Fabrice

    2010-03-01

    The axillary nerve is invariably reported to be one of the most commonly injured nerves during surgical procedures of the shoulder, and the importance of protecting it cannot be overemphasized. Many researchers have tried to identify safe regions, but the results vary among published studies. The axillary nerve may also be injured during acute trauma to the shoulder or by chronic repeated trauma as has been described in the quadrilateral space syndrome. The nerve injury may occur together with shoulder dislocation and rotator cuff tear, thus comprising the so-called "unhappy triad" of the shoulder joint. Simple attention to potential variations in the origin and course of the axillary nerve and its relationship to the shoulder capsule and having a precise knowledge of "safe zones" during operations can enhance clinical outcomes. The objective of this review, therefore, is to discuss the surgical anatomy of the axillary nerve and further emphasize the clinical importance of the its injury following shoulder trauma.

  8. Dark matter in spiral galaxies

    International Nuclear Information System (INIS)

    Albada, T.S. van; Sancisi, R.

    1986-01-01

    Mass models of spiral galaxies based on the observed light distribution, assuming constant M/L for bulge and disc, are able to reproduce the observed rotation curves in the inner regions, but fail to do so increasingly towards and beyond the edge of the visible material. The discrepancy in the outer region can be accounted for by invoking dark matter; some galaxies require at least four times as much dark matter as luminous matter. There is no evidence for a dependence on galaxy luminosity or morphological type. Various arguments support the idea that a distribution of visible matter with constant M/L is responsible for the circular velocity in the inner region, i.e. inside approximately 2.5 disc scalelengths. Luminous matter and dark matter seem to 'conspire' to produce the flat observed rotation curves in the outer region. It seems unlikely that this coupling between disc and halo results from the large-scale gravitational interaction between the two components. Attempts to determine the shape of dark halos have not yet produced convincing results. (author)

  9. SIGNATURES OF LONG-LIVED SPIRAL PATTERNS

    International Nuclear Information System (INIS)

    Martínez-García, Eric E.; González-Lópezlira, Rosa A.

    2013-01-01

    Azimuthal age/color gradients across spiral arms are a signature of long-lived spirals. From a sample of 19 normal (or weakly barred) spirals where we have previously found azimuthal age/color gradient candidates, 13 objects were further selected if a two-armed grand-design pattern survived in a surface density stellar mass map. Mass maps were obtained from optical and near-infrared imaging, by comparison with a Monte Carlo library of stellar population synthesis models that allowed us to obtain the mass-to-light ratio in the J band, (M/L) J , as a function of (g – i) versus (i – J) color. The selected spirals were analyzed with Fourier methods in search of other signatures of long-lived modes related to the gradients, such as the gradient divergence toward corotation, and the behavior of the phase angle of the two-armed spiral in different wavebands, as expected from theory. The results show additional signatures of long-lived spirals in at least 50% of the objects.

  10. SIGNATURES OF LONG-LIVED SPIRAL PATTERNS

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Garcia, Eric E. [Instituto Nacional de Astrofisica, Optica y Electronica (INAOE), Aptdo. Postal 51 y 216, 72000 Puebla, Pue. (Mexico); Gonzalez-Lopezlira, Rosa A., E-mail: ericmartinez@inaoep.mx, E-mail: martinez@astro.unam.mx, E-mail: r.gonzalez@crya.unam.mx [Centro de Radioastronomia y Astrofisica, UNAM, Campus Morelia, Michoacan, C.P. 58089 (Mexico)

    2013-03-10

    Azimuthal age/color gradients across spiral arms are a signature of long-lived spirals. From a sample of 19 normal (or weakly barred) spirals where we have previously found azimuthal age/color gradient candidates, 13 objects were further selected if a two-armed grand-design pattern survived in a surface density stellar mass map. Mass maps were obtained from optical and near-infrared imaging, by comparison with a Monte Carlo library of stellar population synthesis models that allowed us to obtain the mass-to-light ratio in the J band, (M/L){sub J}, as a function of (g - i) versus (i - J) color. The selected spirals were analyzed with Fourier methods in search of other signatures of long-lived modes related to the gradients, such as the gradient divergence toward corotation, and the behavior of the phase angle of the two-armed spiral in different wavebands, as expected from theory. The results show additional signatures of long-lived spirals in at least 50% of the objects.

  11. Chiralities of spiral waves and their transitions

    Science.gov (United States)

    Pan, Jun-ting; Cai, Mei-chun; Li, Bing-wei; Zhang, Hong

    2013-06-01

    The chiralities of spiral waves usually refer to their rotation directions (the turning orientations of the spiral temporal movements as time elapses) and their curl directions (the winding orientations of the spiral spatial geometrical structures themselves). Traditionally, they are the same as each other. Namely, they are both clockwise or both counterclockwise. Moreover, the chiralities are determined by the topological charges of spiral waves, and thus they are conserved quantities. After the inwardly propagating spirals were experimentally observed, the relationship between the chiralities and the one between the chiralities and the topological charges are no longer preserved. The chiralities thus become more complex than ever before. As a result, there is now a desire to further study them. In this paper, the chiralities and their transition properties for all kinds of spiral waves are systemically studied in the framework of the complex Ginzburg-Landau equation, and the general relationships both between the chiralities and between the chiralities and the topological charges are obtained. The investigation of some other models, such as the FitzHugh-Nagumo model, the nonuniform Oregonator model, the modified standard model, etc., is also discussed for comparison.

  12. Cranial nerves neuropraxia after shoulder arthroscopy in beach chair position.

    Science.gov (United States)

    Cogan, A; Boyer, P; Soubeyrand, M; Hamida, F Ben; Vannier, J-L; Massin, P

    2011-05-01

    We report a case of neuropraxia of the 9th, 10th and 12th cranial nerve pairs after arthroscopic rotator cuff repair in the beach chair position. The elements in the medical file seem to exclude an intracranial cause of the lesions and support a mechanical, extracranial cause due to intubation and/or the beach chair position. This clinical case report shows the neurological risks of the beach chair position during arthroscopic shoulder surgery and presents the essential safety measures to prevent these risks. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  13. Impingement syndrome and rotator cuff tears: US findings in 140 patients

    International Nuclear Information System (INIS)

    Malvestiti, Oreste; Scorsolini, Alessandro; Ratti, Francesco; Ferraris, Giuseppe; Columbaro, Guido; Mariani, Claudio

    1997-01-01

    The authors investigated the role of rotator cuff impingement in causing tears of supraspinatus and biceps tendons and the comparative reliability of plain radiography and sonography (US). One hundred forty patients with symtoms referrable to the rotator cuff were examined with plain radiography and US of the shoulder. The differential diagnosis must distinguish all these common causes of shoulder dysfunction and cuff problems from other conditions. The authors conclude that US and plain radiography are accurate routine tests of rotator cuff integrity and rotator cuff impingement

  14. Xanthomatous Infiltration of the Rotator Cuff and Long Head of Biceps with Rotator Cuff Tear in a Patient with Mixed Hyperlipidemia: A Case Report with MRI Imaging

    Directory of Open Access Journals (Sweden)

    Shelley S. Bath

    2010-01-01

    Full Text Available Xanthomatous infiltration may rarely affect the rotator cuff muscles and long head of the biceps tendon. It is the deposition of cholesterol within the rotator cuff muscles and long head of the biceps tendon resulting from hyperlipidemia, specifically high triglyceride and total cholesterol levels. As more commonly seen with xanthomatous infiltration and tear of the Achilles tendon, there may also be an association with rotator cuff tendon deposition and tear. MRI images of xanthomatous infiltration with rotator cuff tear in a 77 year old man with hyperlipidemia are detailed in the following case report.

  15. LB03.04: SPHYGMOMANOMETER CUFF CONSTRUCTION AND MATERIALS AFFECT TRANSMISSION OF PRESSURE FROM CUFF TO ARTERIAL WALL. FINITE ELEMENT ANALYSIS OF HUMAN PRESSURE MEASUREMENTS AND DICOM DATA.

    Science.gov (United States)

    Lewis, P; Naqvi, S; Mandal, P; Potluri, P

    2015-06-01

    Sphygmomanometer cuff pressure during deflation is assumed to equal systolic arterial pressure at the point of resumption of flow. Previous studies demonstrated that pressure decreases with increasing depth of soft tissues whilst visco-elastic characteristics of the arm tissue cause spatial and temporal variation in pressure magnitude. These generally used non-anatomical axisymmetrical arm simulations without incorporating arterial pressure variation. We used data from a volunteer's Magnetic Resonance (MR) arm scan and investigated the effect of variations in cuff materials and construction on the simulated transmission of pressure from under the cuff to the arterial wall under sinusoidal flow conditions. Pressure was measured under 8 different cuffs using Oxford Pressure Monitor Sensors placed at 90 degrees around the mid upper arm of a healthy male. Each cuff was inflated 3 times to 155 mmHg and then deflated to zero with 90 seconds between inflations. Young's modulus, flexural rigidity and thickness of each cuff was measured.Using DICOM data from the MR scan of the arm, a 3D model was derived using ScanIP and imported into Abaqus for Finite Element Analysis (FEA). Published mechanical properties of arm tissues and geometric non-linearity were assumed. The measured sub-cuff pressures were applied to the simulated arm and pressure was calculated around the brachial arterial wall. which was loaded with a sinusoidal pressure of 125/85 mmHg. FEA estimates of pressure around the brachial artery cuffs varied by up to 27 mmHg SBP and 17 mmHg DBP with different cuffs. Pressures within the cuffs varied up to 27 mmHg. Pressure transmission from the cuff to the arterial surface achieved a 95% transmission ratio with one rubber-bladdered cuff but varied between 76 and 88% for the others. Non-uniform pressure distribution around the arterial wall was strongly related to cuff fabric elastic modulus. Identical size cuffs with a separate rubber bladder produced peri

  16. Rotator cuff tears in luxatio erecta: an arthroscopic perspective of two cases

    Science.gov (United States)

    Pandey, Vivek; Madi, Sandesh; Tapashetti, Sandeep; Acharya, Kiran

    2015-01-01

    Luxatio erecta accounts for only 0.5% of all shoulder dislocations. More than 150 cases have been described in the literature, focusing mainly on the method of reduction and/or associated complications. Some of the well-described complications include injuries to the humeral head, glenoid, clavicle, rotator cuff, capsules and ligaments, brachial plexus and axillary artery/vein. Among these, rotator cuff injuries are reported to occur in about 80% of cases. However, in the majority of instances, cuff injuries have been managed conservatively and have been reported to apparently provide optimal functional outcomes. We report our experience with two cases of luxatio erecta associated with massive rotator cuff injuries, which were evaluated and further managed by arthroscopic repair. The emphasis in these cases is to define cuff injuries and proceed based on patients’ age, demands and characteristics of the cuff tears. Arthroscopic evaluation and cuff repairs should be contemplated in these patients, to improve shoulder functions. PMID:26561229

  17. Six Decades of Spiral Density Wave Theory

    Science.gov (United States)

    Shu, Frank H.

    2016-09-01

    The theory of spiral density waves had its origin approximately six decades ago in an attempt to reconcile the winding dilemma of material spiral arms in flattened disk galaxies. We begin with the earliest calculations of linear and nonlinear spiral density waves in disk galaxies, in which the hypothesis of quasi-stationary spiral structure (QSSS) plays a central role. The earliest success was the prediction of the nonlinear compression of the interstellar medium and its embedded magnetic field; the earliest failure, seemingly, was not detecting color gradients associated with the migration of OB stars whose formation is triggered downstream from the spiral shock front. We give the reasons for this apparent failure with an update on the current status of the problem of OB star formation, including its relationship to the feathering substructure of galactic spiral arms. Infrared images can show two-armed, grand design spirals, even when the optical and UV images show flocculent structures. We suggest how the nonlinear response of the interstellar gas, coupled with overlapping subharmonic resonances, might introduce chaotic behavior in the dynamics of the interstellar medium and Population I objects, even though the underlying forces to which they are subject are regular. We then move to a discussion of resonantly forced spiral density waves in a planetary ring and their relationship to the ideas of disk truncation, and the shepherding of narrow rings by satellites orbiting nearby. The back reaction of the rings on the satellites led to the prediction of planet migration in protoplanetary disks, which has had widespread application in the exploding data sets concerning hot Jupiters and extrasolar planetary systems. We then return to the issue of global normal modes in the stellar disk of spiral galaxies and its relationship to the QSSS hypothesis, where the central theoretical concepts involve waves with negative and positive surface densities of energy and angular

  18. Correlation between Rotator Cuff Tears and Systemic Atherosclerotic Disease

    Directory of Open Access Journals (Sweden)

    Andrea Donovan

    2011-01-01

    Full Text Available The purpose of this study was to investigate the association of aortic arch calcification, a surrogate marker of atherosclerosis, with rotator cuff tendinosis and tears given the hypothesis that decreased tendon vascularity is a contributing factor in the etiology of tendon degeneration. A retrospective review was performed to identify patients ages 50 to 90 years who had a shoulder MRI and a chest radiograph performed within 6 months of each other. Chest radiographs and shoulder MRIs from 120 patients were reviewed by two sets of observers blinded to the others' conclusions. Rotator cuff disease was classified as tendinosis, partial thickness tear, and full thickness tear. The presence or absence of aortic arch calcification was graded and compared with the MRI appearance of the rotator cuff. The tendon tear grading was positively correlated with patient age. However, the tendon tear grading on MRI was not significantly correlated with the aorta calcification scores on chest radiographs. Furthermore, there was no significant correlation between aorta calcification severity and tendon tear grading. In conclusion, rotator cuff tears did not significantly correlate with aortic calcification severity. This suggests that tendon ischemia may not be associated with the degree of macrovascular disease.

  19. Compensatory muscle activation in patients with glenohumeral cuff tears

    NARCIS (Netherlands)

    Steenbrink, Franciscus

    2010-01-01

    Patients suffering tendon tears in the glenohumeral cuff muscles show activation of muscles which pull the arm downwards during arm elevation tasks. This so-called co-activation deviates from healthy controls and is triggered by pain. Goal of this thesis was to demonstrate that deviating muscle

  20. Release of obstructing rectal cuff following transanal endorectal ...

    African Journals Online (AJOL)

    rectal cuff in the second, both treated by laparoscopic approach after the approval of the review board. ... developed constipation and needed suppositories for rectal evacuation and he developed abdominal distension .... multicenter experience with 141 children. Ann Surg 2003; 238:569–576. 3 Langer JC, Seifert M, ...

  1. Ultrasonography and arthrography in rotator cuff lesions: algorithmic approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eui Jong; Ryu, Kyung Nam; Lee, Sun Wha; Lim, Jae Hoon; Rhee, Yong Girl [Kyung Hee University Hospital, Seoul (Korea, Republic of); Yu, Pil Mun [Dankuk University College of Medicine, Chenona (Korea, Republic of)

    1992-11-15

    Twenty-six patients with chief complaint of shoulder pain who underwent both ultrasonographic examination and arthrography of the shoulder were analyzed. Ten out of 12 cases with clinical impression of frozen shoulder, showed normal findings on the ultrasonographic examination of the shoulder. Among these ten cases, nine cases showed adhesive capsulitis and one case showed rotator cuff tear on arthrography. Among six cases with the clinical impression of rotator cuff tear, five cases showed rotator cuff tear and one case showed combined calcific tendinitis and adhesive capsulitis on ultrasonographic examination. In arthrography, four cases of rotator cuff tear, one case of calcific tendinitis and biceps tendinitis and one case of normal finding were diagnosed. For the remaining eight cases in the ultrasonographic examination, normal finding or biceps tendinitis were found and for the remaining of the cases in arthrography adhesive capsulitis were found. With the above results, we recommend that the shoulder ultrasonography as the first line diagnostic modality for a patient with chief complaint of shoulder pain.

  2. A comparative study of the identification of rotator cuff calcifications ...

    African Journals Online (AJOL)

    With ultrasound calcifications were detected in 9 patients; in 6 of these patients the calcification was located in the supraspinatus tendon and in 3 patients in the infraspinatus tendon. This study indicated that calcifications in the rotator cuff were more often seen on x-ray examination than on ultrasound, though the difference ...

  3. Arthroscopic rotator cuff repair for the elderly (over 75-years)

    International Nuclear Information System (INIS)

    Ikeda, Rintaro; Furukawa, Keizo; Kajiyama, Shiro; Sakimura, Toshiyuki; Shindo, Hiroyuki; Eto, Masao

    2010-01-01

    The purpose of this study was to evaluate the surgical results of arthroscopic rotator cuff repair (ARCR) and investigate the interoperative complications for elderly people (over 75-years). We evaluated nine patients 75 and over who underwent rotator cuff repair, followed up for more than 12 months, and underwent MRI six months or more after the operation which was performed between December 2004 to July 2008. Their average age was 77.3 years. The control patients were 61 patients less than 75 who underwent ARCR during same term. Their average age was 59.9 years. Clinical outcome was evaluated based on interoperative complications, the Japanese Orthopaedic Association score (JOA score), and cuff integrity using MRI Sugaya's classification. In the over 75 patients, anchors came out from the tuberosity in three patients. Postoperative complications were not seen in both groups. No differences were observed in JOA score and cuff integrity using MRI Sugaya's classification compared with patients under 75. The surgical outcome of ARCR for elderly people (over 75-years) was satisfactory, and ARCR for elderly people (over 75-years) shoud be performed with caution because of the coming out of anchors. (author)

  4. Open versus arthroscopic treatment of chronic rotator cuff impingement

    NARCIS (Netherlands)

    Schröder, J.; van Dijk, C. N.; Wielinga, A.; Kerkhoffs, G. M.; Marti, R. K.

    2001-01-01

    We report the results of 238 consecutive patients who underwent in total 261 acromioplasties because of chronic rotator cuff impingement. The procedure was performed either in conventional open technique (80) or arthroscopically (181). Two years (1-10) after the operation 68% of the patients treated

  5. Ultrasonography and arthrography in rotator cuff lesions: algorithmic approach

    International Nuclear Information System (INIS)

    Kim, Eui Jong; Ryu, Kyung Nam; Lee, Sun Wha; Lim, Jae Hoon; Rhee, Yong Girl; Yu, Pil Mun

    1992-01-01

    Twenty-six patients with chief complaint of shoulder pain who underwent both ultrasonographic examination and arthrography of the shoulder were analyzed. Ten out of 12 cases with clinical impression of frozen shoulder, showed normal findings on the ultrasonographic examination of the shoulder. Among these ten cases, nine cases showed adhesive capsulitis and one case showed rotator cuff tear on arthrography. Among six cases with the clinical impression of rotator cuff tear, five cases showed rotator cuff tear and one case showed combined calcific tendinitis and adhesive capsulitis on ultrasonographic examination. In arthrography, four cases of rotator cuff tear, one case of calcific tendinitis and biceps tendinitis and one case of normal finding were diagnosed. For the remaining eight cases in the ultrasonographic examination, normal finding or biceps tendinitis were found and for the remaining of the cases in arthrography adhesive capsulitis were found. With the above results, we recommend that the shoulder ultrasonography as the first line diagnostic modality for a patient with chief complaint of shoulder pain

  6. Atrophy of the deltoid muscle following rotator cuff surgery.

    Science.gov (United States)

    Hata, Yukihiko; Saitoh, Satoru; Murakami, Narumichi; Kobayashi, Hirokazu; Takaoka, Kunio

    2004-07-01

    Less invasive procedures have recently been introduced to facilitate an earlier return to sports or work activities after rotator cuff repair. Few reports, however, have verified whether such procedures are really less invasive than conventional open repair. The purpose of this study was to compare the postoperative thickness of the deltoid muscle in patients treated with either conventional or mini-open rotator cuff repair. Conventional open repair was performed from 1994 through 1997 in forty-three patients with rotator cuff tears. The mini-open deltoid-splitting approach was introduced in 1997, and the cases of thirty-five patients who underwent that procedure were reviewed. The two groups were compared with respect to the thickness of the anterior fibers of the deltoid muscle measured on the transverse magnetic resonance images, the degree of active forward flexion, and the times required for return to work and sports activities. The thickness of the anterior deltoid fibers did not change significantly after surgery in the mini-open repair group, whereas it was significantly decreased in the open repair group at six months as well as at twelve months postoperatively (p atrophy of the deltoid muscle than did the conventional open rotator cuff repair, and patients treated with the mini-open repair recovered more quickly.

  7. Arthroscopic rotator cuff repair in elite rugby players.

    Science.gov (United States)

    Tambe, Amol; Badge, Ravi; Funk, Lennard

    2009-01-01

    Rugby is an increasingly popular collision sport. A wide spectrum of injuries can be sustained during training and match play. Rotator cuff injury is uncommon in contact sports and there is little published literature on the treatment of rotator cuff tears in rugby players. We therefore reviewed the results and functional outcomes of arthroscopic rotator cuff repair in elite rugby players. Eleven professional rugby players underwent arthroscopic rotator cuff repair at our hospital over a 2-year period. We collected data on these patients from the operative records. The patients were recalled for outcome scoring and ultrasound scans. There were seven rugby league players and four rugby union players, including six internationals. Their mean age was 25.7 years. All had had a traumatic episode during match play and could not return to the game after the injury. The mean time to surgery was 5 weeks. The mean width of the cuff tear was 1.8 cm. All were full- thickness cuff tears. Associated injuries included two Bankart lesions, one bony Bankart lesion, one posterior labral tear, and two 360 degrees labral tears. The biceps was involved in three cases. Two were debrided and a tenodesis was performed in one. Repair was with suture anchors. Following surgery, all patients underwent a supervised accelerated rehabilitation programme. The final follow-up was at 18 months (range: 6-31 months) post surgery. The Constant scores improved from 44 preoperatively to 99 at the last follow-up. The mean score at 3 months was 95. The Oxford shoulder score improved from 34 to 12, with the mean third month score being 18. The mean time taken to return to full match play at the preinjury level was 4.8 months. There were no complications in any of the patients and postoperative scans in nine patients confirmed that the repairs had healed. We conclude that full-thickness rotator cuff tears in the contact athlete can be addressed successfully by arthroscopic repair, with a rapid return to

  8. Muscle gene expression patterns in human rotator cuff pathology.

    Science.gov (United States)

    Choo, Alexander; McCarthy, Meagan; Pichika, Rajeswari; Sato, Eugene J; Lieber, Richard L; Schenk, Simon; Lane, John G; Ward, Samuel R

    2014-09-17

    Rotator cuff pathology is a common source of shoulder pain with variable etiology and pathoanatomical characteristics. Pathological processes of fatty infiltration, muscle atrophy, and fibrosis have all been invoked as causes for poor outcomes after rotator cuff tear repair. The aims of this study were to measure the expression of key genes associated with adipogenesis, myogenesis, and fibrosis in human rotator cuff muscle after injury and to compare the expression among groups of patients with varied severities of rotator cuff pathology. Biopsies of the supraspinatus muscle were obtained arthroscopically from twenty-seven patients in the following operative groups: bursitis (n = 10), tendinopathy (n = 7), full-thickness rotator cuff tear (n = 8), and massive rotator cuff tear (n = 2). Quantitative polymerase chain reaction (qPCR) was performed to characterize gene expression pathways involved in myogenesis, adipogenesis, and fibrosis. Patients with a massive tear demonstrated downregulation of the fibrogenic, adipogenic, and myogenic genes, indicating that the muscle was not in a state of active change and may have difficulty responding to stimuli. Patients with a full-thickness tear showed upregulation of fibrotic and adipogenic genes; at the tissue level, these correspond to the pathologies most detrimental to outcomes of surgical repair. Patients with bursitis or tendinopathy still expressed myogenic genes, indicating that the muscle may be attempting to accommodate the mechanical deficiencies induced by the tendon tear. Gene expression in human rotator cuff muscles varied according to tendon injury severity. Patients with bursitis and tendinopathy appeared to be expressing pro-myogenic genes, whereas patients with a full-thickness tear were expressing genes associated with fatty atrophy and fibrosis. In contrast, patients with a massive tear appeared to have downregulation of all gene programs except inhibition of myogenesis. These data highlight the

  9. Some INDRA experiments on SPIRAL

    International Nuclear Information System (INIS)

    Cussol, D.; Orr, N.A.

    1997-01-01

    A panel joining members of INDRA collaboration and physicists off collaboration was gathered to debate the question whether the INDRA detector, designed to study multifragmentation with beams of stable nuclei, could be used also in experiments with beams of exotic nuclei. Four experiments were discussed as well as the implied detector modifications. In the frame of experiments with SISSI the study of the multifragmentation as a function of N/Z of the system should answer questions related to the system stability as a function of N/Z and origin of the particles emitted during the collision. Among the experiments with SPIRAL to study de-excitation of hot nuclei the following topics were examined: nuclear stability as a function of N/Z, α-n competition, emission of neutron-rich particles as a function of N/Z, evolution of emission modes near the shell closure. The de-excitation of the resonant excited states through 2p decay will be studied in the following three channels: 1p-1p sequential decay, un-correlated simultaneous 2p emission and correlated simultaneous 2p emission ( 2 He emission). Such experiments were carried out on 6 Be, 12 O and 14 O. The only first two channels were observed so far. The 16 Ne could be a good candidate to observe the third channel. Finally sub-barrier Coulomb fusion experiments were also discussed. Concerning the modifications to be undertaken on INDRA detector two were obvious: a modification at the level of electronics to make possible time-of-flight measurements with silicon detectors and transformations of ionization chambers in Bragg chambers. Simulation studies are under way to test the pertinence and validity of the solution

  10. Partial rotator cuff injury in athletes: bursal or articular?

    Directory of Open Access Journals (Sweden)

    Cassiano Diniz Carvalho

    2015-08-01

    Full Text Available ABSTRACTA painful shoulder is a very common complaint among athletes, especially in the case of those in sports involving throwing. Partial lesions of the rotator cuff may be very painful and cause significant functional limitation to athletes' sports practice. The incidence of partial lesions of the cuff is variable (13-37%. It is difficult to make the clinical and radiological diagnosis, and this condition should be borne in mind in the cases of all athletes who present symptoms of rotator cuff syndrome, including in patients who are diagnosed only with tendinopathy. OBJECTIVE: To evaluate the epidemiological behavior of partial lesions of the rotator cuff in both amateur and professional athletes in different types of sports. METHODS: We evaluated 720 medical files on athletes attended at the shoulder service of the Discipline of Sports Medicine at the Sports Traumatology Center, Federal University of São Paulo. The majority of them were men (65%. Among all the patients, 83 of them were diagnosed with partial lesions of the rotator cuff, by means of ultrasonography or magnetic resonance, or in some cases using both. We applied the binomial test to compare the proportions found. RESULT: It was observed that intra-articular lesions predominated (67.6% and that these occurred more frequently in athletes in sports involving throwing (66%. Bursal lesions occurred in 32.4% of the athletes, predominantly in those who did muscle building (75%. CONCLUSION: Intra-articular lesions are more frequent than bursal lesions and they occur predominantly in athletes in sports involving throwing, while bursal lesions were more prevalent in athletes who did muscle building.

  11. Partial rotator cuff injury in athletes: bursal or articular?

    Science.gov (United States)

    Carvalho, Cassiano Diniz; Cohen, Carina; Belangero, Paulo Santoro; Figueiredo, Eduardo Antônio; Monteiro, Gustavo Cará; de Castro Pochini, Alberto; Andreoli, Carlos Vicente; Ejnisman, Benno

    2015-01-01

    A painful shoulder is a very common complaint among athletes, especially in the case of those in sports involving throwing. Partial lesions of the rotator cuff may be very painful and cause significant functional limitation to athletes' sports practice. The incidence of partial lesions of the cuff is variable (13-37%). It is difficult to make the clinical and radiological diagnosis, and this condition should be borne in mind in the cases of all athletes who present symptoms of rotator cuff syndrome, including in patients who are diagnosed only with tendinopathy. To evaluate the epidemiological behavior of partial lesions of the rotator cuff in both amateur and professional athletes in different types of sports. We evaluated 720 medical files on athletes attended at the shoulder service of the Discipline of Sports Medicine at the Sports Traumatology Center, Federal University of São Paulo. The majority of them were men (65%). Among all the patients, 83 of them were diagnosed with partial lesions of the rotator cuff, by means of ultrasonography or magnetic resonance, or in some cases using both. We applied the binomial test to compare the proportions found. It was observed that intra-articular lesions predominated (67.6%) and that these occurred more frequently in athletes in sports involving throwing (66%). Bursal lesions occurred in 32.4% of the athletes, predominantly in those who did muscle building (75%). Intra-articular lesions are more frequent than bursal lesions and they occur predominantly in athletes in sports involving throwing, while bursal lesions were more prevalent in athletes who did muscle building.

  12. Transformation of medical grade silicone rubber under Nd:YAG and excimer laser irradiation: First step towards a new miniaturized nerve electrode fabrication process

    Science.gov (United States)

    Dupas-Bruzek, C.; Robbe, O.; Addad, A.; Turrell, S.; Derozier, D.

    2009-08-01

    Medical grade silicone rubber, poly-dimethylsiloxane (PDMS) is a widely used biomaterial. Like for many polymers, its surface can be modified in order to change one or several of its properties which further allow this surface to be functionalized. Laser-induced surface modification of PDMS under ambient conditions is an easy and powerful method for the surface modification of PDMS without altering its bulk properties. In particular, we profit from both UV laser inducing surface modification and of UV laser micromachining to develop a first part of a new process aiming at increasing the number of contacts and tracks within the same electrode surface to improve the nerve selectivity of implantable self sizing spiral cuff electrodes. The second and last part of the process is to further immerse the engraved electrode in an autocatalytic Pt bath leading in a selective Pt metallization of the laser irradiated tracks and contacts and thus to a functionalized PDMS surface. In the present work, we describe the different physical and chemical transformations of a medical grade PDMS as a function of the UV laser and of the irradiation conditions used. We show that the ablation depths, chemical composition, structure and morphology vary with (i) the laser wavelength (using an excimer laser at 248 nm and a frequency-quadrupled Nd:YAG laser at 266 nm), (ii) the conditions of irradiation and (iii) the pulse duration. These different modified properties are expected to have a strong influence on the nucleation and growth rates of platinum which govern the adhesion and the thickness of the Pt layer on the electrodes and thus the DC resistance of tracks.

  13. Transformation of medical grade silicone rubber under Nd:YAG and excimer laser irradiation: First step towards a new miniaturized nerve electrode fabrication process

    Energy Technology Data Exchange (ETDEWEB)

    Dupas-Bruzek, C., E-mail: catherine.dupas@univ-lille1.fr [Universite des Sciences et Technologies de Lille (USTL), 59655 Villeneuve d' Ascq (France); Laboratoire de Physique des Lasers, Atomes et Molecules (PhLAM), UMR CNRS 8523, Centre d' Etudes et de Recherches Lasers et Applications (CERLA), FR CNRS 2416 (France); Robbe, O. [Universite des Sciences et Technologies de Lille (USTL), 59655 Villeneuve d' Ascq (France); Laboratoire de Spectroscopie Infrarouge et Raman (LASIR), UMR CNRS 8516, Centre d' Etudes et de Recherches Lasers et Applications (CERLA), FR CNRS 2416 (France); Addad, A. [Universite des Sciences et Technologies de Lille (USTL), 59655 Villeneuve d' Ascq (France); Laboratoire de Structures et Proprietes de l' Etat Solide (LSPES), UMR CNRS 8008 (France); Turrell, S. [Universite des Sciences et Technologies de Lille (USTL), 59655 Villeneuve d' Ascq (France); Laboratoire de Spectroscopie Infrarouge et Raman (LASIR), UMR CNRS 8516, Centre d' Etudes et de Recherches Lasers et Applications (CERLA), FR CNRS 2416 (France); Derozier, D. [Universite des Sciences et Technologies de Lille (USTL), 59655 Villeneuve d' Ascq (France); Laboratoire de Physique des Lasers, Atomes et Molecules (PhLAM), UMR CNRS 8523, Centre d' Etudes et de Recherches Lasers et Applications (CERLA), FR CNRS 2416 (France)

    2009-08-15

    Medical grade silicone rubber, poly-dimethylsiloxane (PDMS) is a widely used biomaterial. Like for many polymers, its surface can be modified in order to change one or several of its properties which further allow this surface to be functionalized. Laser-induced surface modification of PDMS under ambient conditions is an easy and powerful method for the surface modification of PDMS without altering its bulk properties. In particular, we profit from both UV laser inducing surface modification and of UV laser micromachining to develop a first part of a new process aiming at increasing the number of contacts and tracks within the same electrode surface to improve the nerve selectivity of implantable self sizing spiral cuff electrodes. The second and last part of the process is to further immerse the engraved electrode in an autocatalytic Pt bath leading in a selective Pt metallization of the laser irradiated tracks and contacts and thus to a functionalized PDMS surface. In the present work, we describe the different physical and chemical transformations of a medical grade PDMS as a function of the UV laser and of the irradiation conditions used. We show that the ablation depths, chemical composition, structure and morphology vary with (i) the laser wavelength (using an excimer laser at 248 nm and a frequency-quadrupled Nd:YAG laser at 266 nm), (ii) the conditions of irradiation and (iii) the pulse duration. These different modified properties are expected to have a strong influence on the nucleation and growth rates of platinum which govern the adhesion and the thickness of the Pt layer on the electrodes and thus the DC resistance of tracks.

  14. Galaxy Zoo: dust in spiral galaxies

    Science.gov (United States)

    Masters, Karen L.; Nichol, Robert; Bamford, Steven; Mosleh, Moein; Lintott, Chris J.; Andreescu, Dan; Edmondson, Edward M.; Keel, William C.; Murray, Phil; Raddick, M. Jordan; Schawinski, Kevin; Slosar, Anže; Szalay, Alexander S.; Thomas, Daniel; Vandenberg, Jan

    2010-05-01

    We investigate the effect of dust on spiral galaxies by measuring the inclination dependence of optical colours for 24276 well-resolved Sloan Digital Sky Survey (SDSS) galaxies visually classified via the Galaxy Zoo project. We find clear trends of reddening with inclination which imply a total extinction from face-on to edge-on of 0.7, 0.6, 0.5 and 0.4mag for the ugri passbands (estimating 0.3mag of extinction in z band). We split the sample into `bulgy' (early-type) and `discy' (late-type) spirals using the SDSS fracdeV (or fDeV) parameter and show that the average face-on colour of `bulgy' spirals is redder than the average edge-on colour of `discy' spirals. This shows that the observed optical colour of a spiral galaxy is determined almost equally by the spiral type (via the bulge-disc ratio and stellar populations), and reddening due to dust. We find that both luminosity and spiral type affect the total amount of extinction, with discy spirals at Mr ~ -21.5mag having the most reddening - more than twice as much as both the lowest luminosity and most massive, bulge-dominated spirals. An increase in dust content is well known for more luminous galaxies, but the decrease of the trend for the most luminous has not been observed before and may be related to their lower levels of recent star formation. We compare our results with the latest dust attenuation models of Tuffs et al. We find that the model reproduces the observed trends reasonably well but overpredicts the amount of u-band attenuation in edge-on galaxies. This could be an inadequacy in the Milky Way extinction law (when applied to external galaxies), but more likely indicates the need for a wider range of dust-star geometries. We end by discussing the effects of dust on large galaxy surveys and emphasize that these effects will become important as we push to higher precision measurements of galaxy properties and their clustering. This publication has been made possible by the participation of more than

  15. Gait phase detection from sciatic nerve recordings in functional electrical stimulation systems for foot drop correction

    International Nuclear Information System (INIS)

    Chu, Jun-Uk; Song, Kang-Il; Han, Sungmin; Suh, Jun-Kyo Francis; Choi, Kuiwon; Youn, Inchan; Lee, Soo Hyun; Kang, Ji Yoon; Hwang, Dosik

    2013-01-01

    Cutaneous afferent activities recorded by a nerve cuff electrode have been used to detect the stance phase in a functional electrical stimulation system for foot drop correction. However, the implantation procedure was difficult, as the cuff electrode had to be located on the distal branches of a multi-fascicular nerve to exclude muscle afferent and efferent activities. This paper proposes a new gait phase detection scheme that can be applied to a proximal nerve root that includes cutaneous afferent fibers as well as muscle afferent and efferent fibers. To test the feasibility of this scheme, electroneurogram (ENG) signals were measured from the rat sciatic nerve during treadmill walking at several speeds, and the signal properties of the sciatic nerve were analyzed for a comparison with kinematic data from the ankle joint. On the basis of these experiments, a wavelet packet transform was tested to define a feature vector from the sciatic ENG signals according to the gait phases. We also propose a Gaussian mixture model (GMM) classifier and investigate whether it could be used successfully to discriminate feature vectors into the stance and swing phases. In spite of no significant differences in the rectified bin-integrated values between the stance and swing phases, the sciatic ENG signals could be reliably classified using the proposed wavelet packet transform and GMM classification methods. (paper)

  16. Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

    Directory of Open Access Journals (Sweden)

    Kenichi Takahoko

    2014-01-01

    Full Text Available Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4 LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60 cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%, and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery.

  17. Transtendon rotator-cuff repair of partial-thickness articular surface tears can lead to medial rotator-cuff failure

    Directory of Open Access Journals (Sweden)

    Woods TC

    2014-06-01

    Full Text Available Tom C Woods,4 Michael J Carroll,1 Atiba A Nelson,2 Kristie D More,2 Randa Berdusco,1 Stephen Sohmer,3 Richard S Boorman,1,2 Ian KY Lo1,21Department of Surgery, 2Sport Medicine Centre, University of Calgary, Calgary, AB, Canada; 3Department of Orthopaedics, University of British Columbia, Vancouver, 4St Joseph's Hospital, Comox, BC, CanadaPurpose: The purpose of this study was to evaluate clinical and anatomic outcomes of patients following transtendon rotator-cuff repair of partial articular supraspinatus tendon avulsion (PASTA lesions.Patients and methods: Patients in the senior author's practice who had isolated PASTA lesions treated by transtendon rotator-cuff repair were included (n=8 and retrospectively reviewed. All patients were evaluated preoperatively and at a mean of 21.2 months (±9.7 months postoperatively using standardized clinical evaluation (physical exam, American Shoulder and Elbow Surgeons, and Simple Shoulder Test. All patients underwent postoperative imaging with a magnetic resonance imaging arthrogram.Results: There was a significant improvement in American Shoulder and Elbow Surgeons (42.7±17.5 to 86.9±25.2 and Simple Shoulder Test (4.6±3.2 to 10.1±3.8 scores from pre- to postoperative, respectively. Postoperative imaging demonstrated full-thickness medial cuff tearing in seven patients, and one patient with a persistent partial articular surface defect.Conclusion: Transtendon repair of PASTA lesions may lead to improvements in clinical outcome. However, postoperative imaging demonstrated a high incidence of full-thickness rotator-cuff defects following repair.Keywords: rotator cuff, PASTA lesion, transtendon repair

  18. Comparison of 2 cuff inflation methods of laryngeal mask airway Classic for safe use without cuff manometer in adults.

    Science.gov (United States)

    Kim, Min-Soo; Lee, Jeong-Rim; Shin, Yang-Sik; Chung, Ji-Won; Lee, Kyu-Ho; Ahn, Ki Ryang

    2014-03-01

    This single-center, prospective, randomized, double-blind, 2-arm, parallel group comparison trial was performed to establish whether the adult-sized laryngeal mask airway (LMA) Classic (The Laryngeal Mask Company Ltd, Henley-on-Thames, UK) could be used safely without any consideration of cuff hyperinflation when a cuff of the LMA Classic was inflated using half the maximum inflation volume or the resting volume before insertion of device. Eighty patients aged 20 to 70 years scheduled for general anesthesia using the LMA Classic were included. Before insertion, the cuff was partially filled with half the maximum inflation volume in the half volume group or the resting volume created by opening the pilot balloon valve to equalize with atmospheric pressure in the resting volume group. Several parameters regarding insertion, intracuff pressure, airway leak pressure, and leakage volume/fraction were collected after LMA insertion. The LMA Classic with a partially inflated cuff was successfully inserted in all enrolled patients. Both groups had the same success rate of 95% at the first insertion attempt. The half volume group had a lower mean intracuff pressure compared with the resting volume group (54.5 ± 16.1 cm H2O vs 61.8 ± 16.1 cm H2O; P = .047). There was no difference in airway leak pressure or leakage volume/fraction between the 2 groups under mechanical ventilation. The partially inflated cuff method using half the maximum recommended inflation volume or the resting volume is feasible with the adult-sized LMA Classic, resulting in a high success rate of insertion and adequate range of intracuff pressures. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Assessment and Preservation of Auditory Nerve Integrity in the Deafened Guinea Pig

    NARCIS (Netherlands)

    Ramekers, D.

    2014-01-01

    Profound hearing loss is often caused by cochlear hair cell loss. Cochlear implants (CIs) essentially replace hair cells by encoding sound and conveying the signal by means of pulsatile electrical stimulation to the spiral ganglion cells (SGCs) which form the auditory nerve. SGCs progressively

  20. Evaluation of Endotracheal Tube Cuff Pressure in Laparoscopic Cholecystectomy and Postoperative Sore Throat.

    Science.gov (United States)

    Lakhe, Gajal; Sharma, Surendra Mohan

    2018-01-01

    The use of nitrous oxide and carboperitoneum in laparoscopic cholecystectomy lead to increase in endotracheal tube cuff pressure. It may impair tracheal mucosal perfusion with subsequent tracheal damage. The purpose of this study was to evaluate cuff pressure and incidence of post-operative sore throat in patients undergoing laparoscopic cholecystectomy. In this prospective observational study, 128 patients aged 18-65 years of American Society of Anesthesiologist physical status I and II undergoing laparoscopic cholecystectomy were enrolled and allocated alternately into two groups, Study Group (Maintenance of anesthesia with sevoflurane 1-2%, oxygen/nitrous oxide mixture; 40/60), Control Group (Maintenance of anesthesia with sevoflurane 1-2%, oxygen/air mixture; 40/60) were analysed and comapared. Each group contained 64 patients. Aneroid manometer was used to monitor cuff pressure. Volume of air used to inflate the cuff, baseline cuff pressure, comparison of intraoperative cuff pressure and incidence of post-operative sore throat were measured. The study results demonstrated higher cuff pressure in study group at all times after the creation of carboperitoneum (p=0.00) with increased incidence of sore throat(p=0.004). Increase in endotracheal tube cuff pressure was noted with the use of nitrous oxide in laparoscopic cholecystectomy with subsequent post-operative airway complication. Monitoring of cuff pressure is simple, noninvasive and efficient way of achieving therapeutic cuff pressure of 20-30 cm of H2O and thus recommends its use.

  1. Validation of simple and inexpensive algometry using sphygmomanometer cuff and neuromuscular junction monitor with standardized laboratory algometer

    Science.gov (United States)

    Durga, Padmaja; Wudaru, Sreedhar Reddy; Khambam, Sunil Kumar Reddy; Chandra, Shobha Jagadish; Ramachandran, Gopinath

    2016-01-01

    Background and Aims: The availability, ergonomics and economics prohibit the routine use of algometers in clinical practice and research by the anesthesiologists. A simple bedside technique of quantitative pain measurement would enable the routine use of algometry. We proposed to validate simple pain provocation using sphygmomanometer cuff and the electric stimulation of neuromuscular junction monitor (TOF-guard, Organon Teknika) to measure pain against a standardized laboratory pressure algometer. Material and Methods: Pain detection threshold (Pdt) and pain tolerance threshold (Ptt) were measured in forty healthy volunteers of both genders, using the above three techniques. All measurements were repeated three times. The co-efficient of inter-rater reliability (or consistency) between three independent measurements obtained from each of the techniques was determined by Cronbach's co-efficient alpha (α C). The correlation between the mean Pdt and Ptt values recorded by standardized algometer and the sphygmomanometer technique and nerve stimulator technique was performed using Pearson Correlation. An r >0.5 and a two-tailed significance of algometer and the tested techniques. Results: There was a good inter-rater reliability (α C > 0.7) for the three techniques. There was a good correlation with r >0.65 (P algometer and the two techniques being tested as alternatives for algometer to measure pain. Conclusion: The sphygmomanometer cuff technique and electrical stimulation with the peripheral nerve stimulator to measure pain threshold and tolerance provide a simple, efficient, repeatable measure of pain intensity and can be used as suitable alternatives to standard algometers. PMID:27006546

  2. Right hypoglossal nerve paralysis after tracheal intubation for aesthetic breast surgery

    Directory of Open Access Journals (Sweden)

    Sammy Al-Benna

    2013-01-01

    Full Text Available Aesthetic and functional complications caused by general anesthesia have been rarely described after aesthetic surgery. We report a case of unilateral right hypoglossal nerve paralysis following the use of a cuffed endotracheal airway in a 24-year-old woman undergoing aesthetic breast surgery. Neurological examination and magnetic resonance imaging of the head failed to provide additional insights into the cause of the nerve injury. Postoperatively, the patient was carefully monitored and made a full recovery within 2 weeks without any pharmacological treatment. The transient hypoglossal nerve paralysis seemed to be due to neuropraxia. In this patient, we postulate that the right hypoglossal nerve was compressed between the endotracheal tube cuff and the hyoid bone, which was inflated with 30 cm H 2 O. Patients undergoing aesthetic surgery must be appropriately and adequately informed that postoperative aesthetic and functional deficits can occur due to anesthesia as well as the surgery.

  3. Spiral CT manifestations of spherical pneumonia

    International Nuclear Information System (INIS)

    Li Xiaohong; Yang Hongwei; Xu Chunmin; Qin Xiu

    2008-01-01

    Objective: To explore the Spiral CT manifestations and differential diagnosis of spherical pneumonia. Methods: 18 cases of spherical pneumonia and 20 cases of peripheral pulmonary carcinoma were selected, both of them were confirmed by clinic and/or pathology. The SCT findings of both groups were compared retrospectively. Results: Main spiral CT findings of spherical pneumonia were showed as followings: square or triangular lesions adjacent to pleura; with irregular shape, blurry, slightly lobulated margin, sometimes with halo sign. Small inflammatory patches and intensified vascular markings around the lesions were seen. Lesions became smaller or vanished after short-term anti-inflammatory treatment. Conclusion: Spherical pneumonia showed some characteristics on Spiral CT scan, which are helpful in diagnosis and differential diagnosis of this disease. (authors)

  4. Vitamin D and the immunomodulation of rotator cuff injury

    Directory of Open Access Journals (Sweden)

    Dougherty KA

    2016-06-01

    Full Text Available Kaitlin A Dougherty,1 Matthew F Dilisio,2 Devendra K Agrawal1 1Department of Clinical & Translational Science, 2Department of Orthopedic Surgery, Creighton University School of Medicine, Omaha, NE, USA Abstract: Tendon-to-bone healing after rotator cuff repair surgery has a failure rate of 20%–94%. There has been a recent interest to determine the factors that act as determinants between successful and unsuccessful rotator cuff repair. Vitamin D level in patients is one of the factors that have been linked to bone and muscle proliferation and healing, and it may have an effect on tendon-to-bone healing. The purpose of this article is to critically review relevant published research that relates to the effect of vitamin D on rotator cuff tears and subsequent healing. A review of the literature was conducted to identify all studies that investigate the relationship between vitamin D and tendon healing, in addition to its mechanism of action. The data were then analyzed in order to summarize what is currently known about vitamin D, rotator cuff pathology, and tendon-to-bone healing. The activated metabolite of vitamin D, 1α,25-dihydroxyvitamin D3, affects osteoblast proliferation and differentiation. Likewise, vitamin D plays a significant role in the tendon-to-bone healing process by increasing the bone mineral density and strengthening the skeletal muscles. The 1α,25-dihydroxyvitamin D3 binds to vitamin D receptors on myocytes to stimulate growth and proliferation. The form of vitamin D produced by the liver, calcifediol, is a key initiator of the myocyte healing process by moving phosphate into myocytes, which improves function and metabolism. Investigation into the effect of vitamin D on tendons has been sparse, but limited studies have been promising. Matrix metalloproteinases play an active role in remodeling the extracellular matrix (ECM of tendons, particularly deleterious remodeling of the collagen fibers. Also, the levels of

  5. Selection of muscle and nerve-cuff electrodes for neuroprostheses using customizable musculoskeletal model

    OpenAIRE

    Dimitra Blana, PhD; Juan G. Hincapie, PhD; Edward K. Chadwick, PhD; Robert F. Kirsch, PhD

    2013-01-01

    Neuroprosthetic systems based on functional electrical stimulation aim to restore motor function to individuals with paralysis following spinal cord injury. Identifying the optimal electrode set for the neuroprosthesis is complicated because it depends on the characteristics of the individual (such as injury level), the force capacities of the muscles, the movements the system aims to restore, and the hardware limitations (number and type of electrodes available). An electrode-selection metho...

  6. Selective Stimulation of the Hypoglossal Nerve with a Multi-Contact Cuff Electrode

    National Research Council Canada - National Science Library

    Yoo, P

    2001-01-01

    ...) was investigated for the potential application of treating obstructive sleep apnea (OSA) The main trunk of the XII was stimulated with monophasic cathodic pulses, while the elicited electroneurographic (ENG...

  7. Reducing Stiffness and Electrical Losses of High Channel Hybrid Nerve Cuff Electrodes

    National Research Council Canada - National Science Library

    Schuettler, M

    2001-01-01

    .... Interconnection lines were made of only 300 nm of sputtered gold, which led to high line drops. Cold electroplating was used to thicken the lines to 3 microns, which reduced the mean track resistance from 480 ohms to 10 ohms...

  8. Graphite target for the spiral project

    Energy Technology Data Exchange (ETDEWEB)

    Putaux, J.C.; Ducourtieux, M.; Ferro, A.; Foury, P.; Kotfila, L.; Mueller, A.C.; Obert, J.; Pauwels, N.; Potier, J.C.; Proust, J. [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire; Bertrand, P. [Grand Accelerateur National d`Ions Lourds (GANIL), 14 - Caen (France); Loiselet, M. [Universite Catholique de Louvain, Louvain-La-Neuve (Belgium)] [and others

    1996-12-31

    A study of the thermal and physical properties of graphite targets for the SPIRAL project is presented. The main objective is to develop an optimized set-up both mechanically and thermally resistant, presenting good release properties (hot targets with thin slices). The results of irradiation tests concerning the mechanical and thermal resistance of the first prototype of SPIRAL target with conical geometry are presented. The micro-structural properties of the graphite target is also studied, in order to check that the release properties are not deteriorated by the irradiation. Finally, the results concerning the latest pilot target internally heated by an electrical current are shown. (author). 5 refs.

  9. Photometry and mass modeling of spiral galaxies

    International Nuclear Information System (INIS)

    Kent, S.

    1987-01-01

    Recent estimates of the relative contributions of dark and luminous matter to the mass of spiral galaxies are reviewed. In these studies, the galactic mass distribution is modeled on the basis of photometric and kinematic observational data. The accuracy of current photometry is discussed; the three-dimensional structure of spiral galaxies and the techniques used in bulge-disk decomposition are examined; and mass models incorporating rotation curves are presented. The disk mass/luminosity ratios in the red band (corrected for internal extinction) are found to range from 1.6 to 3.2, with no particular radius at which dark matter dominates. 20 references

  10. Comparison of prophylactic effects of polyurethane cylindrical or tapered cuff and polyvinyl chloride cuff endotracheal tubes on ventilator-associated pneumonia.

    Directory of Open Access Journals (Sweden)

    Ata Mahmoodpoor

    2013-07-01

    Full Text Available Because microaspiration of contaminated supraglottic secretions past the endotracheal tube cuff is considered to be central in the pathogenesis of pneumonia, improved design of tracheal tubes with new cuff material and shape have reduced the size and number of folds, which together with the addition of suction ports above the cuff to drain pooled subglottic secretions leads to reduced aspiration of oropharyngeal secretions. So we conducted a study to compare the prophylactic effects of polyurethane-cylindrical or tapered cuff and polyvinyl chloride cuff endotracheal tubes (ETT on ventilator-associated pneumonia. This randomized clinical trial was carried out in a 12 bed surgical intensive care unit. 96 patients expected to require mechanical ventilation more than 96 hours were randomly allocated to one of three following groups: Polyvinyl chloride cuff (PCV ETT, Polyurethane (PU cylindrical Sealguard ETT and PU Taperguard ETT. Cuff pressure monitored every three hours 3 days in all patients. Mean cuff pressure didn't have significant difference between three groups during 72 hours. Pneumonia was seen in 11 patients (34% in group PVC, 8 (25% in Sealguard and 7 (21% in Taperguard group. Changes in mean cuff pressure between Sealguard and PVC tubes and also between Taperguard and PVC tubes did not show any significant difference. There was no significant difference in overinflation between three groups. The use of ETT with PU material results in reducing ventilator-associated pneumonia compared to ETT with PVC cuff. In PU tubes Taperguard has less incidence of ventilator-associated pneumonia compared to Sealguard tubes.

  11. Optical cuff for optogenetic control of the peripheral nervous system

    Science.gov (United States)

    Michoud, Frédéric; Sottas, Loïc; Browne, Liam E.; Asboth, Léonie; Latremoliere, Alban; Sakuma, Miyuki; Courtine, Grégoire; Woolf, Clifford J.; Lacour, Stéphanie P.

    2018-02-01

    Objective. Nerves in the peripheral nervous system (PNS) contain axons with specific motor, somatosensory and autonomic functions. Optogenetics offers an efficient approach to selectively activate axons within the nerve. However, the heterogeneous nature of nerves and their tortuous route through the body create a challenging environment to reliably implant a light delivery interface. Approach. Here, we propose an optical peripheral nerve interface—an optocuff—, so that optogenetic modulation of peripheral nerves become possible in freely behaving mice. Main results. Using this optocuff, we demonstrate orderly recruitment of motor units with epineural optical stimulation of genetically targeted sciatic nerve axons, both in anaesthetized and in awake, freely behaving animals. Behavioural experiments and histology show the optocuff does not damage the nerve thus is suitable for long-term experiments. Significance. These results suggest that the soft optocuff might be a straightforward and efficient tool to support more extensive study of the PNS using optogenetics.

  12. Functional and magnetic resonance imaging evaluation after single-tendon rotator cuff reconstruction

    DEFF Research Database (Denmark)

    Knudsen, H B; Gelineck, J; Søjbjerg, Jens Ole

    1999-01-01

    The aim of this study was to investigate tendon integrity after surgical repair of single-tendon rotator cuff lesions. In 31 patients, 31 single-tendon repairs were evaluated. Thirty-one patients were available for clinical assessment and magnetic resonance imaging (MRI) at follow-up. A standard...... series of MR images was obtained for each. The results of functional assessment were scored according to the system of Constant. According to MRI evaluation, 21 (68%) patients had an intact or thinned rotator cuff and 10 (32%) had recurrence of a full-thickness cuff defect at follow-up. Patients...... with an intact or thinned rotator cuff had a median Constant score of 75.5 points; patients with a full-thickness cuff defect had a median score of 62 points. There was no correlation between tendon integrity on postoperative MR images and functional outcome. Patients with intact or thinned cuffs did not have...

  13. COMPARISON OF ASTYM THERAPY AND KINESIOTAPING FOR ROTATOR CUFF TENDINOPATHY IN DIABETIC PATIENTS: RANDOMIZED CONTROLLED TRIAL

    OpenAIRE

    Azza Atya; Mahmoud Nasser; Aisha Hagag

    2017-01-01

    Background: Rotator cuff tendinopathy is a significant problem among diabetics that frequently restricts patient’s activity in terms of pain and disability. The purpose of this study was to compare between the effect of Astym therapy and kinesiotaping in treating diabetic patients with chronic rotator cuff tendinopathy. Methods: 56 diabetic patients diagnosed with chronic rotator cuff tendinopathy were randomly assigned into Astym therapy group (n=28) or kinesiotaping group (n= 28). All pa...

  14. Increased Upper Trapezius Muscle Stiffness in Overhead Athletes with Rotator Cuff Tendinopathy

    OpenAIRE

    Leong, Hio Teng; Hug, Fran?ois; Fu, Siu Ngor

    2016-01-01

    Although excessive tension of the upper trapezius (UT) is thought to contribute to rotator cuff tendinopathy, no study examined UT tension in athletes with and without rotator cuff tendinopathy. Here we used UT shear modulus measured using ultrasound shear wave elastography as an index of muscle stiffness/tension. The aims of this study were twofold: 1) to determine whether the UT muscle shear modulus is altered in athletes with rotator cuff tendinopathy compared to asymptomatic athletes, and...

  15. Early postoperative fluoroquinolone use is associated with an increased revision rate after arthroscopic rotator cuff repair.

    Science.gov (United States)

    Cancienne, Jourdan M; Brockmeier, Stephen F; Rodeo, Scott A; Young, Chris; Werner, Brian C

    2017-07-01

    To evaluate the association of postoperative fluoroquinolone use following arthroscopic primary rotator cuff repair with failure requiring revision rotator cuff repair. An insurance database was queried for patients undergoing rotator cuff repair from 2007 to 2015. These patients were divided into three groups: (1) patients prescribed fluoroquinolones within 6 months postoperatively (divided into 0-2, 2-4, and 4-6 months), (2) a matched negative control cohort of patients not prescribed fluoroquinolones, and (3) a matched positive control cohort of patients prescribed fluoroquinolones between 6 and 18 months following rotator cuff repair. Rates of failure requiring revision rotator cuff repair were compared within 2 years. A total of 1292 patients were prescribed fluoroquinolones within 6 months after rotator cuff repair, including 442 within 2 months, 433 within 2 to 4 months, and 417 within 4 to 6 months, and were compared to 5225 matched negative controls and 1597 matched positive controls. The rate of revision rotator cuff repair was significantly higher in patients prescribed fluoroquinolones within 2 months (6.1 %) compared to matched negative (2.2 %, P = 0.0009) and positive controls (2.4 %, P = 0.0026). There were no significant differences in the rate of revision rotator cuff repair when fluoroquinolones were prescribed >2 months after rotator cuff repair. Early use of fluoroquinolones following rotator cuff repair was independently associated with significantly increased rates of failure requiring revision rotator cuff repair. This is the first clinical study examining the association of postoperative fluoroquinolone use with failure following arthroscopic rotator cuff repair. III.

  16. Tracheal Stenosis and Cuff Pressure: Comparison of Minimal Occlusive Volume and Palpation Techniques.

    Science.gov (United States)

    Totonchi, Ziae; Jalili, Fatemeh; Hashemian, Seyed Mohammadreza; Jabardarjani, Hamid Reza

    2015-01-01

    Tracheal stenosis, which has received more emphasis recently, is a common post intubation complication and may develop due to different reasons. One important reason is the endotracheal tube cuff pressure. Therefore, this study sought to examine the accuracy of diagnostic test for palpation and minimal occlusive volume techniques to measure the endotracheal tube cuff pressure. In this cross sectional study, the accuracy of diagnostic tests for palpation and minimal occlusive volume techniques to measure the endotracheal tube cuff pressure was assessed in 101 patients aged over 18 years who had undergone open heart surgery and post-surgical mechanical ventilation in the ICU. In the palpation technique, the cuff pressure of 27 patients (26.7%) was reported to be out of the permissible range and for the rest of them (74 patients, 73.3%) it was within the permissible range. Then, the cuff pressure was checked by the standard method using a manometer and after comparing the results it was found that the cuff pressure of 92 patients (91.1%) was not in the permissible range and only nine patients (8.9%) had a cuff pressure within the permissible range (20-30 cm H2O). In minimal occlusive volume method compared with the standard method, 22 patients (21.7%) had cuff pressure within the permissible range of 20-30 cm H2O, and 79 of them (78.2%) had cuff pressure out of the permissible range and higher than the upper limit. This study recommends that the best way to measure the endotracheal tube cuff pressure is to use a cuff manometer, and when it is not available, the minimal occlusive volume would be a better alternative compared to the palpation technique to keep the cuff pressure within a proper range to avoid tracheotomy complications such as tracheal stenosis.

  17. Adaptation of the control system in view of SPIRAL integration

    International Nuclear Information System (INIS)

    Lecorche, E.

    1998-01-01

    As soon as the collaboration between the SPIRAL project and the Control Group has been defined, the first implementation of the SPIRAL control system started following various directions. Both the global hardware and software architectures has been specified and some practical works have been undertaken such as the Ethernet network installation or the first SPIRAL oriented software design and coding. (authors)

  18. The dynamics of the spiral galaxy M81

    International Nuclear Information System (INIS)

    Visser, H.C.D.

    1978-01-01

    A detailed comparison of the observations of the spiral galaxy M81 with the density-wave theory for tightly-wound spirals is presented. In particular, hydrogen-line observations are compared with the nonlinear density-wave theory for the gas with the aim of constructing a density-wave model for the spiral galaxy M81

  19. Geometric studies on variable radius spiral cone-beam scanning

    International Nuclear Information System (INIS)

    Ye Yangbo; Zhu Jiehua; Wang Ge

    2004-01-01

    The goal is to perform geometric studies on cone-beam CT scanning along a three-dimensional (3D) spiral of variable radius. First, the background for variable radius spiral cone-beam scanning is given in the context of electron-beam CT/micro-CT. Then, necessary and sufficient conditions are proved for existence and uniqueness of PI lines inside the variable radius 3D spiral. These results are necessary steps toward exact cone-beam reconstruction from a 3D spiral scan of variable radius, adapting Katsevich's formula for the standard helical cone-beam scanning. It is shown in the paper that when the longitudinally projected planar spiral is not always convex toward the origin, the PI line may not be unique in the envelope defined by the tangents of the spiral. This situation can be avoided by using planar spirals whose curvatures are always positive. Using such a spiral, a longitudinally homogeneous region inside the corresponding 3D spiral is constructed in which any point is passed by one and only one PI line, provided the angle ω between planar spiral's tangent and radius is bounded by vertical bar ω-90 deg. vertical bar ≤ε for some positive ε≤32.48 deg. If the radius varies monotonically, this region is larger and one may allow ε≤51.85 deg. Examples for 3D spirals based on logarithmic and Archimedean spirals are given. The corresponding generalized Tam-Danielsson detection windows are also formulated

  20. A nutrient’s downstream spiral

    Science.gov (United States)

    Indicators of a stream’s ability to remove nutrients provide insights on watershed integrity and stream habitat characteristics that are needed to help managers to restore stream ecosystem services. We used the Tracer Additon Spiraling Characterization Curve (TASCC) to mea...

  1. The Distribution of Mass in Spiral Galaxies.

    NARCIS (Netherlands)

    Swaters, Rob; Andersen, David; Bershady, Matthew; Verheijen, Marc

    2002-01-01

    Little is known about the content and distribution of dark matter in spiral galaxies. Mass modeling of any rotation curve can yield an alarming range of results - from entirely halo-dominated, centrally- concentrated dark distributions, to disk-dominated inner potentials with shallow, low density

  2. The surface brightness of spiral galaxies

    International Nuclear Information System (INIS)

    Phillipps, S.; Disney, M.

    1983-01-01

    Correlations between optical surface brightness and the radio properties of spiral galaxies are investigated. It is found that galaxies with high surface brightness are more likely to be strong continuum radio sources and that galaxies with low surface brightness have high 21-cm line emission. (author)

  3. Logarithmic spiral trajectories generated by Solar sails

    Science.gov (United States)

    Bassetto, Marco; Niccolai, Lorenzo; Quarta, Alessandro A.; Mengali, Giovanni

    2018-02-01

    Analytic solutions to continuous thrust-propelled trajectories are available in a few cases only. An interesting case is offered by the logarithmic spiral, that is, a trajectory characterized by a constant flight path angle and a fixed thrust vector direction in an orbital reference frame. The logarithmic spiral is important from a practical point of view, because it may be passively maintained by a Solar sail-based spacecraft. The aim of this paper is to provide a systematic study concerning the possibility of inserting a Solar sail-based spacecraft into a heliocentric logarithmic spiral trajectory without using any impulsive maneuver. The required conditions to be met by the sail in terms of attitude angle, propulsive performance, parking orbit characteristics, and initial position are thoroughly investigated. The closed-form variations of the osculating orbital parameters are analyzed, and the obtained analytical results are used for investigating the phasing maneuver of a Solar sail along an elliptic heliocentric orbit. In this mission scenario, the phasing orbit is composed of two symmetric logarithmic spiral trajectories connected with a coasting arc.

  4. Importance of packing in spiral defect chaos

    Indian Academy of Sciences (India)

    We develop two measures to characterize the geometry of patterns exhibited by the state of spiral defect chaos, a weakly turbulent regime of Rayleigh-Bénard convection. These describe the packing of contiguous stripes within the pattern by quantifying their length and nearest-neighbor distributions. The distributions ...

  5. High-displacement spiral piezoelectric actuators

    Science.gov (United States)

    Mohammadi, F.; Kholkin, A. L.; Jadidian, B.; Safari, A.

    1999-10-01

    A high-displacement piezoelectric actuator, employing spiral geometry of a curved piezoelectric strip is described. The monolithic actuators are fabricated using a layered manufacturing technique, fused deposition of ceramics, which is capable of prototyping electroceramic components with complex shapes. The spiral actuators (2-3 cm in diameter) consisted of 4-5 turns of a lead zirconate titanate ceramic strip with an effective length up to 28 cm. The width was varied from 0.9 to 1.75 mm with a height of 3 mm. When driven by the electric field applied across the width of the spiral wall, the tip of the actuator was found to displace in both radial and tangential directions. The tangential displacement of the tip was about 210 μm under the field of 5 kV/cm. Both the displacement and resonant frequency of the spirals could be tailored by changing the effective length and wall width. The blocking force of the actuator in tangential direction was about 1 N under the field of 5 kV/cm. These properties are advantageous for high-displacement low-force applications where bimorph or monomorph actuators are currently employed.

  6. The Spiral Curriculum. Research into Practice

    Science.gov (United States)

    Johnston, Howard

    2012-01-01

    The Spiral Curriculum is predicated on cognitive theory advanced by Jerome Bruner (1960), who wrote, "We begin with the hypothesis that any subject can be taught in some intellectually honest form to any child at any stage of development." In other words, even the most complex material, if properly structured and presented, can be understood by…

  7. Nobeyama CO Atlas of Nearby Spiral Galaxies

    Science.gov (United States)

    Kuno, N.; Nakai, N.; Sorai, K.; Sato, N..; Yamauchi, A.; Tosaki, T.; Shioya, Y.; Vila-Vilaró, B.; Nishiyama, K.; Ishihara, Y.; Cepa, J.

    BEARS is a 25-beam focal plane array receiver mounted on the Nobeyama 45-m telescope. The combination of the large dish size of the telescope with the excellent performance of this receiver makes it an ideal tool for mapping observations of extended regions of the sky. We present here one of its current applications in a CO mapping survey of nearby spiral galaxies.

  8. A section of a spiral coal chute

    Energy Technology Data Exchange (ETDEWEB)

    Bakhtin, V.N.; Gorodilov, N.N.

    1981-01-01

    A section of a spiral coal chute includes a housing with support brackets. It differs in that to decrease the amount of work necessary for assembly, each support bracket is made with a guide slot and equipped with a pull-out cantilever in the shape of a fork which covers the slot from the lateral sides.

  9. Biofouling of spiral wound membrane systems

    NARCIS (Netherlands)

    Vrouwenvelder, J.S.

    2009-01-01

    Biofouling of spiral wound membrane systems High quality drinking water can be produced with membrane filtration processes like reverse osmosis (RO) and nanofiltration (NF). Because the global demand for fresh clean water is increasing, these membrane technologies will increase in importance in the

  10. SPIRAL2 at GANIL: Status and Perspectives

    Science.gov (United States)

    Gales, S.

    2008-05-01

    To pursue the investigation of a new territory of nuclei with extreme N/Z called ``terra incognita'' several projects, all aiming at the increase by several orders of magnitude of the RIB intensities are now under discussions worldwide. In Europe, two major new projects have been approved recently FAIRatGSI using the so-called ``in-flight'' method and SPIRAL2atGANIL, based on the ISOL method. Both projects were selected in the European Strategic Roadmap For research Infrastructures (ESFRI). The main goal of SPIRAL2 is clearly to extend our knowledge of the limit of existence and the structure of nuclei deeply in the medium and heavy mass region (A = 60 to 140) which is to day an almost unexplored continent. SPIRAL 2 is based on a high power, CW, superconducting driver LINAC, delivering 5 mA of deuteron beams at 40 MeV (200 KW) directed on a C converter+ Uranium target and producing therefore more 1013 fissions/s. The expected radioactive beams intensities for exotic species in the mass range from A = 60 to A = 140, of the order of 106 to 1010 pps will surpass by two order of magnitude any existing facilities in the world. These unstable atoms will be available at energies between few KeV/n to 15 MeV/n. The same driver will accelerate high intensity (100 μA to 1 mA), heavier ions up to Ar at 14 MeV/n producing also proton rich exotic nuclei. In applied areas SPIRAL2 is considered as a powerful variable energy neutron source, a must to study the impact of nuclear fission and fusion on materials. The intensities of these unstable species are excellent opportunities for new tracers and diagnostics either for solid state, material or for radiobiological science and medicine. The ``Go'' decision has been taken in May 2005. The investments and personnel costs amount to 190 M€, for the construction period 2006-2012. Construction of the SPIRAL2 facility is shared by ten French laboratories and a network of international partners. Under the 7FP program of European Union

  11. Vagus nerve stimulation delivered during motor rehabilitation improves recovery in a rat model of stroke.

    Science.gov (United States)

    Khodaparast, Navid; Hays, Seth A; Sloan, Andrew M; Fayyaz, Tabbassum; Hulsey, Daniel R; Rennaker, Robert L; Kilgard, Michael P

    2014-09-01

    Neural plasticity is widely believed to support functional recovery following brain damage. Vagus nerve stimulation paired with different forelimb movements causes long-lasting map plasticity in rat primary motor cortex that is specific to the paired movement. We tested the hypothesis that repeatedly pairing vagus nerve stimulation with upper forelimb movements would improve recovery of motor function in a rat model of stroke. Rats were separated into 3 groups: vagus nerve stimulation during rehabilitation (rehab), vagus nerve stimulation after rehab, and rehab alone. Animals underwent 4 training stages: shaping (motor skill learning), prelesion training, postlesion training, and therapeutic training. Rats were given a unilateral ischemic lesion within motor cortex and implanted with a left vagus nerve cuff. Animals were allowed 1 week of recovery before postlesion baseline training. During the therapeutic training stage, rats received vagus nerve stimulation paired with each successful trial. All 17 trained rats demonstrated significant contralateral forelimb impairment when performing a bradykinesia assessment task. Forelimb function was recovered completely to prelesion levels when vagus nerve stimulation was delivered during rehab training. Alternatively, intensive rehab training alone (without stimulation) failed to restore function to prelesion levels. Delivering the same amount of stimulation after rehab training did not yield improvements compared with rehab alone. These results demonstrate that vagus nerve stimulation repeatedly paired with successful forelimb movements can improve recovery after motor cortex ischemia and may be a viable option for stroke rehabilitation. © The Author(s) 2014.

  12. Standard sonography and arthrosonography in the study of rotator cuff tears

    International Nuclear Information System (INIS)

    El-Dalati, Ghassan; Martone, Enrico; Caffarri, Sabrina; Fusaro, Michele; Pozzi Mucelli, Roberto; Castellarin, Gianluca; Ricci, Matteo; Vecchini, Eugenio

    2005-01-01

    Purpose. The aim of this study was to evaluate the sensitivity of ultrasonography, integrating standard ultrasound and arthrosonography after injecting a saline solution into the glenohumeral cavity in cases of suspected rotator cuff tears. Materials and methods. We respectively examinated 40 patients awaiting shoulder arthroscopy for suspected or diagnosed tears of the rotator cuff. A radiologist, unaware of the pre-operative diagnosis, performed an ultrasound scan on all the patients before and after the injection of saline solution into the glenohumeral cavity. The parameters considered were presence or absence of a rotator cuff injury; type of injury according to Snyder and its extent along the longitudinal and transverse planes; presence or absence of effusion into the articular cavity; subacromial/subdeltoid bursal distension. All the patients underwent arthroscopy either the same day of the day after the ultrasound examination. Results. Standard sonography showed 26 complete rotator cuff tears (type C according to Snyder), 2 partial tears (type B according to Snyder) and 12 intact rotator cuffs. Arthrosonography detected 31 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Arthroscopy identified 32 complete rotator cuff tears (type C according to Snyder), 1 partial tear (type B according to Snyder) and 8 intact rotator cuffs. Analysis of the results shows that, taking arthroscopy as the gold standard, the sensitivity of normal sonography is 81.2%, whereas that of arthosonography is 96.8% (p [it

  13. Use of cuff tear arthroplasty head prosthesis for rotator cuff arthropathy treatment in elderly patients with comorbidities.

    Science.gov (United States)

    Carvalho, Cassiano Diniz; Andreoli, Carlos Vicente; Pochini, Alberto de Castro; Ejnisman, Benno

    2016-01-01

    To evaluate the clinical and functional behavior of patients undergoing cuff tear arthroplasty at different stages of the disease. Cuff tear arthroplasty hemiarthroplasties were performed in 34 patients with rotator cuff arthropathy and associated comorbidities, classified according to Seebauer. The mean age was 76.3 years, and the sample comprised 23 females (67.6%) and 11 males (32.4%). The mean follow-up period was 21.7 months, and evaluations were performed using the Visual Analog Scale for pain and the Constant scale. There were no statistically significant differences in the mean reduction in the Visual Analog Scale or in the Constant scale increase between the female and male groups. The variation between the pre- and postoperative Visual Analog Scale and Constant scale evaluations was significant. There was also no statistically significant difference between the Seebauer classification groups regarding the mean Visual Analog Scale reduction, or the mean Constant scale increase. Cuff tear arthroplasty shoulder hemiarthroplasty is a good option for rotator cuff arthropathy in patients with comorbidities. Avaliar o comportamento clínico e funcional dos pacientes submetidos à artroplastia do tipo cuff tear arthroplasty para o tratamento da artropatia do manguito rotador em diferentes estágios da afecção. Foram realizadas 34 hemiartroplastias do tipo cuff tear arthroplasty em 34 pacientes com artropatia do manguito rotador e comorbidades associadas, classificadas de acordo com Seebauer. A média de idade foi de 76,3 anos, sendo 23 pacientes do sexo feminino (67,6%) e 11 do sexo masculino (32,4%). O seguimento médio foi de 21,7 meses e a avaliação foi realizada por meio da Escala Visual Analógica da dor e pela escala de Constant. Não houve diferença estatisticamente significante entre os grupos feminino e masculino, tanto nas médias de redução na Escala Visual Analógica quanto nas de aumento na escala de Constant. A variação entre as avalia

  14. Nutrient spiraling in streams and river networks

    Science.gov (United States)

    Ensign, Scott H.; Doyle, Martin W.

    2006-12-01

    Over the past 3 decades, nutrient spiraling has become a unifying paradigm for stream biogeochemical research. This paper presents (1) a quantitative synthesis of the nutrient spiraling literature and (2) application of these data to elucidate trends in nutrient spiraling within stream networks. Results are based on 404 individual experiments on ammonium (NH4), nitrate (NO3), and phosphate (PO4) from 52 published studies. Sixty-nine percent of the experiments were performed in first- and second-order streams, and 31% were performed in third- to fifth-order streams. Uptake lengths, Sw, of NH4 (median = 86 m) and PO4 (median = 96 m) were significantly different (α = 0.05) than NO3 (median = 236 m). Areal uptake rates of NH4 (median = 28 μg m-2 min-1) were significantly different than NO3 and PO4 (median = 15 and 14 μg m-2 min-1, respectively). There were significant differences among NH4, NO3, and PO4 uptake velocity (median = 5, 1, and 2 mm min-1, respectively). Correlation analysis results were equivocal on the effect of transient storage on nutrient spiraling. Application of these data to a stream network model showed that recycling (defined here as stream length ÷ Sw) of NH4 and NO3 generally increased with stream order, while PO4 recycling remained constant along a first- to fifth-order stream gradient. Within this hypothetical stream network, cumulative NH4 uptake decreased slightly with stream order, while cumulative NO3 and PO4 uptake increased with stream order. These data suggest the importance of larger rivers to nutrient spiraling and the need to consider how stream networks affect nutrient flux between terrestrial and marine ecosystems.

  15. GANIL-SPIRAL2: A new era

    Science.gov (United States)

    Gales, Sydney

    2011-05-01

    GANIL presently offers unique opportunities in nuclear physics and many other fields that arise from not only the provision of low-energy stable beams, fragmentation beams and re-accelerated radioactive species, but also from the availability of a wide range of state-of-the-art spectrometers and instrumentation. A few examples of recent highlights are discussed in the present paper. With the construction of SPIRAL2 over the next few years, GANIL is in a good position to retain its world-leading capability. As selected by the ESFRI committee, the next generation of ISOL facility in Europe is represented by the SPIRAL2 project to be built at GANIL (Caen, France). SPIRAL 2 is based on a high power, CW, superconducting LINAC, delivering 5 mA of deuteron beams at 40 MeV (200 KW) directed on a C converter+ Uranium target and producing therefore more than 1013 fissions/s. The expected radioactive beam intensities in the mass range from A = 60 to A = 140, will surpass by two orders of magnitude any existing facilities in the world. These unstable atoms will be available at energies between few KeV/n to 15 MeV/n. The same driver will accelerate high intensity (100 μA to 1 mA), heavier ions (Ar up to Xe) at maximum energy of 14 MeV/n. Under the 7FP program of European Union called *Preparatory phase*, the SPIRAL2 project has been granted a budget of about 4M€ to build up an international consortium around this new venture. The status of the construction of SPIRAL2 accelerator and associated physics instruments in collaboration with EU and International partners will be presented.

  16. Nerve Injuries in Athletes.

    Science.gov (United States)

    Collins, Kathryn; And Others

    1988-01-01

    Over a two-year period this study evaluated the condition of 65 athletes with nerve injuries. These injuries represent the spectrum of nerve injuries likely to be encountered in sports medicine clinics. (Author/MT)

  17. Experimental chronic entrapment of the sciatic nerve in adult hamsters: an ultrastructural and morphometric study

    Directory of Open Access Journals (Sweden)

    Prinz R.A.D.

    2003-01-01

    Full Text Available Entrapment neuropathy is a group of clinical disorders involving compression of a peripheral nerve and interference with nerve function mostly through traction injury. We have investigated the chronic compression of peripheral nerves as an experimental procedure for detecting changes in ultrastructural nerve morphology. Adult hamsters (Mesocricetus auratus, N = 30 were anesthetized with a 25% pentobarbital solution and received a cuff around the right sciatic nerve. Left sciatic nerves were not operated (control group. Animals survived for varying times (up to 15 weeks, after which they were sacrificed and both sciatic nerves were immediately fixed with a paraformaldehyde solution. Experimental nerves were divided into segments based upon their distance from the site of compression (proximal, entrapment and distal. Semithin and ultrathin sections were obtained and examined by light and electron microscopy. Ultrastructural changes were qualitatively described and data from semithin sections were morphometrically analyzed both in control and in compressed nerves. We observed endoneurial edema along with both perineurial and endoneurial thickening and also the existence of whorled cell-sparse structures (Renaut bodies in the subperineurial space of compressed sciatic nerves. Morphometric analyses of myelinated axons at the compression sites displayed a remarkable increase in the number of small axons (up to 60% in comparison with the control axonal number. The distal segment of compressed nerves presented a distinct decrease in axon number (up to 40% comparatively to the control group. The present experimental model of nerve entrapment in adult hamsters was shown to promote consistent histopathologic alterations analogous to those found in chronic compressive neuropathies.

  18. Selectivity and Longevity of Peripheral-Nerve and Machine Interfaces: A Review

    Science.gov (United States)

    Ghafoor, Usman; Kim, Sohee; Hong, Keum-Shik

    2017-01-01

    For those individuals with upper-extremity amputation, a daily normal living activity is no longer possible or it requires additional effort and time. With the aim of restoring their sensory and motor functions, theoretical and technological investigations have been carried out in the field of neuroprosthetic systems. For transmission of sensory feedback, several interfacing modalities including indirect (non-invasive), direct-to-peripheral-nerve (invasive), and cortical stimulation have been applied. Peripheral nerve interfaces demonstrate an edge over the cortical interfaces due to the sensitivity in attaining cortical brain signals. The peripheral nerve interfaces are highly dependent on interface designs and are required to be biocompatible with the nerves to achieve prolonged stability and longevity. Another criterion is the selection of nerves that allows minimal invasiveness and damages as well as high selectivity for a large number of nerve fascicles. In this paper, we review the nerve-machine interface modalities noted above with more focus on peripheral nerve interfaces, which are responsible for provision of sensory feedback. The invasive interfaces for recording and stimulation of electro-neurographic signals include intra-fascicular, regenerative-type interfaces that provide multiple contact channels to a group of axons inside the nerve and the extra-neural-cuff-type interfaces that enable interaction with many axons around the periphery of the nerve. Section Current Prosthetic Technology summarizes the advancements made to date in the field of neuroprosthetics toward the achievement of a bidirectional nerve-machine interface with more focus on sensory feedback. In the Discussion section, the authors propose a hybrid interface technique for achieving better selectivity and long-term stability using the available nerve interfacing techniques. PMID:29163122

  19. Selectivity and Longevity of Peripheral-Nerve and Machine Interfaces: A Review

    Directory of Open Access Journals (Sweden)

    Usman Ghafoor

    2017-10-01

    Full Text Available For those individuals with upper-extremity amputation, a daily normal living activity is no longer possible or it requires additional effort and time. With the aim of restoring their sensory and motor functions, theoretical and technological investigations have been carried out in the field of neuroprosthetic systems. For transmission of sensory feedback, several interfacing modalities including indirect (non-invasive, direct-to-peripheral-nerve (invasive, and cortical stimulation have been applied. Peripheral nerve interfaces demonstrate an edge over the cortical interfaces due to the sensitivity in attaining cortical brain signals. The peripheral nerve interfaces are highly dependent on interface designs and are required to be biocompatible with the nerves to achieve prolonged stability and longevity. Another criterion is the selection of nerves that allows minimal invasiveness and damages as well as high selectivity for a large number of nerve fascicles. In this paper, we review the nerve-machine interface modalities noted above with more focus on peripheral nerve interfaces, which are responsible for provision of sensory feedback. The invasive interfaces for recording and stimulation of electro-neurographic signals include intra-fascicular, regenerative-type interfaces that provide multiple contact channels to a group of axons inside the nerve and the extra-neural-cuff-type interfaces that enable interaction with many axons around the periphery of the nerve. Section Current Prosthetic Technology summarizes the advancements made to date in the field of neuroprosthetics toward the achievement of a bidirectional nerve-machine interface with more focus on sensory feedback. In the Discussion section, the authors propose a hybrid interface technique for achieving better selectivity and long-term stability using the available nerve interfacing techniques.

  20. A High Density Electrophysiological Data Analysis System for a Peripheral Nerve Interface Communicating with Individual Neurons in the Brain

    Science.gov (United States)

    2016-11-14

    microdevices. Cable to TDT Headplug fixed with dental cement Subcutaneous wires Regenerative microchannel electrode implant Figure 7...s) and should not contrued as an official Department of the Army position, policy or decision, unless so designated by other documentation. 9...nerve interface (μPNI) placed on the peripheral nervous system and custom- designed µCuff/µECoG interfaces on the central nervous system. A neuron

  1. Optic Nerve Pit

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

  2. Modeling the response of small myelinated axons in a compound nerve to kilohertz frequency signals

    Science.gov (United States)

    Pelot, N. A.; Behrend, C. E.; Grill, W. M.

    2017-08-01

    Objective. There is growing interest in electrical neuromodulation of peripheral nerves, particularly autonomic nerves, to treat various diseases. Electrical signals in the kilohertz frequency (KHF) range can produce different responses, including conduction block. For example, EnteroMedics’ vBloc® therapy for obesity delivers 5 kHz stimulation to block the abdominal vagus nerves, but the mechanisms of action are unclear. Approach. We developed a two-part computational model, coupling a 3D finite element model of a cuff electrode around the human abdominal vagus nerve with biophysically-realistic electrical circuit equivalent (cable) model axons (1, 2, and 5.7 µm in diameter). We developed an automated algorithm to classify conduction responses as subthreshold (transmission), KHF-evoked activity (excitation), or block. We quantified neural responses across kilohertz frequencies (5-20 kHz), amplitudes (1-8 mA), and electrode designs. Main results. We found heterogeneous conduction responses across the modeled nerve trunk, both for a given parameter set and across parameter sets, although most suprathreshold responses were excitation, rather than block. The firing patterns were irregular near transmission and block boundaries, but otherwise regular, and mean firing rates varied with electrode-fibre distance. Further, we identified excitation responses at amplitudes above block threshold, termed ‘re-excitation’, arising from action potentials initiated at virtual cathodes. Excitation and block thresholds decreased with smaller electrode-fibre distances, larger fibre diameters, and lower kilohertz frequencies. A point source model predicted a larger fraction of blocked fibres and greater change of threshold with distance as compared to the realistic cuff and nerve model. Significance. Our findings of widespread asynchronous KHF-evoked activity suggest that conduction block in the abdominal vagus nerves is unlikely with current clinical parameters. Our

  3. Spiral analysis-improved clinical utility with center detection.

    Science.gov (United States)

    Wang, Hongzhi; Yu, Qiping; Kurtis, Mónica M; Floyd, Alicia G; Smith, Whitney A; Pullman, Seth L

    2008-06-30

    Spiral analysis is a computerized method that measures human motor performance from handwritten Archimedean spirals. It quantifies normal motor activity, and detects early disease as well as dysfunction in patients with movement disorders. The clinical utility of spiral analysis is based on kinematic and dynamic indices derived from the original spiral trace, which must be detected and transformed into mathematical expressions with great precision. Accurately determining the center of the spiral and reducing spurious low frequency noise caused by center selection error is important to the analysis. Handwritten spirals do not all start at the same point, even when marked on paper, and drawing artifacts are not easily filtered without distortion of the spiral data and corruption of the performance indices. In this report, we describe a method for detecting the optimal spiral center and reducing the unwanted drawing artifacts. To demonstrate overall improvement to spiral analysis, we study the impact of the optimal spiral center detection in different frequency domains separately and find that it notably improves the clinical spiral measurement accuracy in low frequency domains.

  4. HIGH-RESOLUTION ULTRASONOGRAPHY OF SHOULDER FOR ROTATOR CUFF TEAR: CORRELATION WITH ARTHROSCOPIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Vishnumurthy H. Y

    2016-09-01

    Full Text Available INTRODUCTION Rotator cuff disease is the most common cause of shoulder pain. Ultrasonography being non-invasive, widely available, more cost-effective method and is the first choice in imaging of rotator cuff tears. Arthroscopy of shoulder is considered as the gold standard for diagnosis of rotator cuff tears. Objective of this study was to compare the diagnostic accuracy of high-resolution ultrasonography of shoulder for rotator cuff tears with arthroscopy of shoulder. METHODS Thirty patients clinically suspected to have rotator cuff tear who underwent ultrasonography and arthroscopy of shoulder were included in the study. Duration of study was for two years. All ultrasonography examinations were conducted in ultrasound machine using GE Voluson 730 PRO high frequency (10-12 MHz linear array transducer done by two experienced radiologists. Arthroscopies were done by two experienced shoulder arthroscopic surgeons. RESULTS Age of the patients with rotator cuff tears ranged from 40 to 80 years. 57% were females and 43% were males among the patients who had rotator cuff tears. 71.43% of the rotator cuff tears were found in the dominant arm. 64.28% of patients with rotator cuff tear had given history of fall or trauma to the corresponding shoulder within 6 months prior to presentation. 39.28% of patients who had rotator cuff tears were known diabetics. Supraspinatus tendon was the most commonly affected tendon, followed by infraspinatus and subscapularis tendons. For overall detection of rotator cuff tears, ultrasonography in comparison with the arthroscopy has sensitivity and specificity of 92.85% and 100%. For detection of full thickness rotator cuff tear, its sensitivity and specificity was 94.73% and 100% and for partial thickness rotator cuff tears 76.92% and 100%. Ultrasonography has 100% sensitivity and specificity for detection of supraspinatus full thickness tear. For supraspinatus partial thickness tear, sensitivity and specificity was 88

  5. Predicting rotator cuff tears using data mining and Bayesian likelihood ratios.

    Directory of Open Access Journals (Sweden)

    Hsueh-Yi Lu

    Full Text Available Rotator cuff tear is a common cause of shoulder diseases. Correct diagnosis of rotator cuff tears can save patients from further invasive, costly and painful tests. This study used predictive data mining and Bayesian theory to improve the accuracy of diagnosing rotator cuff tears by clinical examination alone.In this retrospective study, 169 patients who had a preliminary diagnosis of rotator cuff tear on the basis of clinical evaluation followed by confirmatory MRI between 2007 and 2011 were identified. MRI was used as a reference standard to classify rotator cuff tears. The predictor variable was the clinical assessment results, which consisted of 16 attributes. This study employed 2 data mining methods (ANN and the decision tree and a statistical method (logistic regression to classify the rotator cuff diagnosis into "tear" and "no tear" groups. Likelihood ratio and Bayesian theory were applied to estimate the probability of rotator cuff tears based on the results of the prediction models.Our proposed data mining procedures outperformed the classic statistical method. The correction rate, sensitivity, specificity and area under the ROC curve of predicting a rotator cuff tear were statistical better in the ANN and decision tree models compared to logistic regression. Based on likelihood ratios derived from our prediction models, Fagan's nomogram could be constructed to assess the probability of a patient who has a rotator cuff tear using a pretest probability and a prediction result (tear or no tear.Our predictive data mining models, combined with likelihood ratios and Bayesian theory, appear to be good tools to classify rotator cuff tears as well as determine the probability of the presence of the disease to enhance diagnostic decision making for rotator cuff tears.

  6. Altitude-Related Change in Endotracheal Tube Cuff Pressures in Helicopter EMS.

    Science.gov (United States)

    Weisberg, Stacy N; McCall, Jonathan C; Tennyson, Joseph

    2017-06-01

    Over-inflation of endotracheal tube (ETT) cuffs has the potential to lead to scarring and stenosis of the trachea.1, 2,3, 4 The air inside an ETT cuff is subject to expansion as atmospheric pressure decreases, as happens with an increase in altitude. Emergency medical services helicopters are not pressurized, thereby providing a good environment for studying the effects of altitude changes ETT cuff pressures. This study aims to explore the relationship between altitude and ETT cuff pressures in a helicopter air-medical transport program. ETT cuffs were initially inflated in a nonstandardized manner and then adjusted to a pressure of 25 cmH 2 O. The pressure was again measured when the helicopter reached maximum altitude. A final pressure was recorded when the helicopter landed at the receiving facility. We enrolled 60 subjects in the study. The mean for initial tube cuff pressures was 70 cmH 2 O. Maximum altitude for the program ranged from 1,000-3,000 feet above sea level, with a change in altitude from 800-2,480 feet. Mean cuff pressure at altitude was 36.52 ± 8.56 cmH 2 O. Despite the significant change in cuff pressure at maximum altitude, there was no relationship found between the maximum altitude and the cuff pressures measured. Our study failed to demonstrate the expected linear relationship between ETT cuff pressures and the maximum altitude achieved during typical air-medical transportation in our system. At altitudes less than 3,000 feet above sea level, the effect of altitude change on ETT pressure is minimal and does not require a change in practice to saline-filled cuffs.

  7. Altitude-Related Change in Endotracheal Tube Cuff Pressures in Helicopter EMS

    Directory of Open Access Journals (Sweden)

    Stacy N. Weisberg

    2017-05-01

    Full Text Available Introduction: Over-inflation of endotracheal tube (ETT cuffs has the potential to lead to scarring and stenosis of the trachea. 1, 2, 3, 4 The air inside an ETT cuff is subject to expansion as atmospheric pressure decreases, as happens with an increase in altitude. Emergency medical services helicopters are not pressurized, thereby providing a good environment for studying the effects of altitude changes ETT cuff pressures. This study aims to explore the relationship between altitude and ETT cuff pressures in a helicopter air-medical transport program. Methods: ETT cuffs were initially inflated in a nonstandardized manner and then adjusted to a pressure of 25 cmH 2O. The pressure was again measured when the helicopter reached maximum altitude. A final pressure was recorded when the helicopter landed at the receiving facility. Results: We enrolled 60 subjects in the study. The mean for initial tube cuff pressures was 70 cmH 2O. Maximum altitude for the program ranged from 1,000–3,000 feet above sea level, with a change in altitude from 800–2,480 feet. Mean cuff pressure at altitude was 36.52 ± 8.56 cmH 2O. Despite the significant change in cuff pressure at maximum altitude, there was no relationship found between the maximum altitude and the cuff pressures measured. Conclusion: Our study failed to demonstrate the expected linear relationship between ETT cuff pressures and the maximum altitude achieved during typical air-medical transportation in our system. At altitudes less than 3,000 feet above sea level, the effect of altitude change on ETT pressure is minimal and does not require a change in practice to saline-filled cuffs.

  8. Eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy: a randomized, single blinded, clinical trial

    NARCIS (Netherlands)

    Dejaco, B.; Habets, B.; Loon, C.J.M. van; Grinsven, S. van; Cingel, R.E. van

    2017-01-01

    PURPOSE: To investigate the effectiveness of isolated eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy. METHODS: Thirty-six patients with rotator cuff tendinopathy, diagnosed by an orthopaedic surgeon, were included and randomly allocated to an isolated

  9. Comparison of muscle sizes and moment arms of two rotator cuff muscles measured by ultrasonography and magnetic resonance imaging

    DEFF Research Database (Denmark)

    Juul-Kristensen, B.; Bojsen-Møller, Finn; Holst, E.

    2000-01-01

    Anatomy, biomechanics, cross-section, magnetic resonance imaging, method comparison, rotator cuff muscles, ultrasound......Anatomy, biomechanics, cross-section, magnetic resonance imaging, method comparison, rotator cuff muscles, ultrasound...

  10. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch

    2005-01-01

    The oxygen tension of the optic nerve is regulated by the intraocular pressure and systemic blood pressure, the resistance in the blood vessels and oxygen consumption of the tissue. The oxygen tension is autoregulated and moderate changes in intraocular pressure or blood pressure do not affect...... the optic nerve oxygen tension. If the intraocular pressure is increased above 40 mmHg or the ocular perfusion pressure decreased below 50 mmHg the autoregulation is overwhelmed and the optic nerve becomes hypoxic. A disturbance in oxidative metabolism in the cytochromes of the optic nerve can be seen...... at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...

  11. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch

    2005-01-01

    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen......-oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...

  12. Fast spiral-scan atomic force microscopy

    International Nuclear Information System (INIS)

    Mahmood, I A; Reza Moheimani, S O

    2009-01-01

    In this paper, we describe a new scanning technique for fast atomic force microscopy. In this method, the sample is scanned in a spiral pattern instead of the well established raster pattern. A spiral scan can be produced by applying single frequency cosine and sine signals with slowly varying amplitudes to the x-axis and y-axis of an atomic force microscope (AFM) scanner respectively. The use of the single tone input signals allows the scanner to move at high speeds without exciting the mechanical resonance of the device and with relatively small control efforts. Experimental results obtained by implementing this technique on a commercial AFM indicate that high-quality images can be generated at scan frequencies well beyond the raster scans.

  13. Spiral optical designs for nonimaging applications

    Science.gov (United States)

    Zamora, Pablo; Benítez, Pablo; Miñano, Juan C.; Vilaplana, Juan; Buljan, Marina

    2011-10-01

    Manufacturing technologies as injection molding or embossing specify their production limits for minimum radii of the vertices or draft angle for demolding, for instance. In some demanding nonimaging applications, these restrictions may limit the system optical efficiency or affect the generation of undesired artifacts on the illumination pattern. A novel manufacturing concept is presented here, in which the optical surfaces are not obtained from the usual revolution symmetry with respect to a central axis (z axis), but they are calculated as free-form surfaces describing a spiral trajectory around z axis. The main advantage of this new concept lies in the manufacturing process: a molded piece can be easily separated from its mold just by applying a combination of rotational movement around axis z and linear movement along axis z, even for negative draft angles. Some of these spiral symmetry examples will be shown here, as well as their simulated results.

  14. Star distribution in the Orion spiral arm

    International Nuclear Information System (INIS)

    Basharina, T.S.; Pavlovskaya, E.D.; Filippova, A.A.

    1985-01-01

    The structure of the Orion spiral arm is studied by numerical experiments, assuming that in each direction considered the star distribution along the line of sight is a combination of two Gaussian laws. The corresponding parameters are evaluated for four Milky Way fields; the bimodal laws now fit the observations by the chi 2 criterion. In the Orion arm the line-of-sight star densities follow asymmetric curves, steeper at the outer edge of the arm

  15. Dark and visible matter in spiral galaxies

    International Nuclear Information System (INIS)

    Persic, M.; Salucci, P.; Durham Univ.

    1988-01-01

    Exploiting relevant information from the profiles of rotation curves, we calculate the dark-to-luminous mass ratio within the disc size for a sample of 43 spiral galaxies. The values we find, while proving the ubiquitous presence of dark matter, vary with luminosity. Faint and bright galaxies are found to be respectively halo- and disc-dominated in the disc regions. The luminosity sequence turns out to be a dark-to-luminous sequence. (author)

  16. The surface brightness of spiral galaxies

    International Nuclear Information System (INIS)

    Phillipps, S.; Disney, M.

    1983-01-01

    It is proposed that Freeman's discovery that the extrapolated central surface brightness of spiral galaxies is approximately constant can be simply explained if the galaxies contain a spheroidal component which dominates the light in their outer isophotes. Calculations of an effective central surface brightness indicate a wide spread of values. This requires either a wide spread in disc properties or significant spheroidal components or, most probably, both. (author)

  17. Critical period and risk factors for retear following arthroscopic repair of the rotator cuff

    NARCIS (Netherlands)

    Barth, J.; Andrieu, K.; Fotiadis, E.; Hannink, G.J.; Barthelemy, R.; Saffarini, M.

    2017-01-01

    PURPOSE: The incidence of retear following rotator cuff repair remains a major concern, and the cause and timing of retear remain unclear. The aim of this study was to prospectively investigate the timing of retears following rotator cuff repair at multiple time intervals. The hypothesis was that

  18. Characteristics and Clinical Outcomes in Overhead Sports Athletes after Rotator Cuff Repair

    Directory of Open Access Journals (Sweden)

    Tomoyuki Muto

    2017-01-01

    Full Text Available Rotator cuff tears in young overhead sports athletes are rare. The pathomechanism causing rotator cuff tears in young overhead athletes is different from that in aged patients. The purpose of this study was to investigate rotator cuff tear characteristics in young overhead sports athletes to reveal the pathomechanism causing these injuries. This study included 25 overhead sports athletes less than 30 years old with atraumatic rotator cuff tears necessitating repair. Rotator cuff tear characteristics were evaluated intraoperatively, including rotator cuff tear shape and injured rotator cuff tendon. Clinical outcome measures were assessed before surgery and at the final follow-up. In this study, 22 patients reported minimal to no shoulder pain and returned to sports without significant complaints at last follow-up. The isolated infraspinatus tendon was most often injured; the incidence rate of the tear at this site was 32% (8 cases. In the deceleration phase of overhead motion, the eccentric contraction force of the ISP (infraspinatus tendon peaks and the increased load leads to injury at the ISP tendon. The pathomechanism of rotator cuff injuries in young overhead athletes might be not only internal or subacromial impingement, but also these mechanisms.

  19. Pain, Disability and Sleep Quality in Patients With Rotator Cuff Tendinopathy and Concurrent Myofascial Pain

    OpenAIRE

    Morteza Nakhaei Amroodi; Hadi Sedghi Asl; Mostafa Salariyeh; Mir Bahram Safari

    2016-01-01

    Background Rotator cuff tendinopathy and concurrent myofascial pain may result in sleep disturbances, poor quality of life, and social dysfunction along with chronic annoying pain and progressive physical disability. Objectives The present study aimed to assess severity of pain, physical disability, and sleep quality in patients with rotator cuff tendinopathy and concurrent myofascial pain. Pat...

  20. Role of ultrasound in the evaluation of rotator cuff muscle quality: A ...

    African Journals Online (AJOL)

    The evaluation of the quality of rotator cuff muscles has become an important part of the preoperative ultrasound examination. ... A number of studies have been directed at the ultrasound assessment of muscle atrophy and fatty infiltration of the rotator cuff, however, no quantitative method or grading systems have been ...

  1. Reproducibility of the Dutch version of the Western Ontario rotator cuff Index

    NARCIS (Netherlands)

    Wiertsema, S.H.; Rietberg, M.B.; Hekman, K.M.; Schothorst, M.; Steultjens, M.P.; Dekker, J.

    2013-01-01

    Background: The Western Ontario Rotator Cuff Index (WORC) is a disease-specific shoulder questionnaire, originally developed at the University of Western Ontario, to measure quality of life in patients with rotator cuff disease (RCD). The aim of the present study was to cross-culturally adapt the

  2. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears : a randomized controlled trial

    NARCIS (Netherlands)

    Lambers Heerspink, Okke; van Raay, Jos J. A. M.; Koorevaar, Rinco C. T.; van Eerden, Pepijn J. M.; Westerbeek, Robin E.; van 't Riet, Esther; van den Akker-Scheek, Inge; Diercks, Ronald L.

    Background: Good clinical results have been reported for both surgical and conservative treatment of rotator cuff tears. The primary aim of this randomized controlled trial was to compare functional and radiologic improvement after surgical and conservative treatment of degenerative rotator cuff

  3. From the RSNA refresher courses - US of the rotator cuff : Pitfalls, limitations, and artifacts

    NARCIS (Netherlands)

    Rutten, Matthieu J. C. M.; Jager, Gerrit J.; Blickman, Johan G.

    2006-01-01

    High-resolution ultrasonography (US) has gained increasing popularity as a diagnostic tool for assessment of the soft tissues in shoulder impingement syndrome. US is a powerful and accurate method for diagnosis of rotator cuff tears and other rotator cuff abnormalities, provided the examiner has a

  4. From the RSNA refresher courses: US of the rotator cuff: pitfalls, limitations, and artifacts.

    NARCIS (Netherlands)

    Rutten, M.J.C.M.; Jager, G.J.; Blickman, J.G.

    2006-01-01

    High-resolution ultrasonography (US) has gained increasing popularity as a diagnostic tool for assessment of the soft tissues in shoulder impingement syndrome. US is a powerful and accurate method for diagnosis of rotator cuff tears and other rotator cuff abnormalities, provided the examiner has a

  5. Is Anesthesiologist’s experience important while inflating the endotracheal tube cuff with the right pressure?

    Directory of Open Access Journals (Sweden)

    Nesrin Turan

    2010-12-01

    Full Text Available Objectives: Cuff pressure in endotracheal tubes should be in the range of 26–30 cm H2O. In this study we aimed to examine whether anesthesiologist’s experience is important while inflating the endotracheal tube correctly after the intubation.Materials and methods: The patients who were included to the study were intubated after the induction of general anesthesia. The patients were divided into 4 groups according to the training year of the anesthesia research assistant resident inflating the endotracheal tube (ET cuff. Group I (n=64 the cuff pressure which were inflated by the first year residents; Group II (n=92 the cuff pressure which were inflated by the 2nd year residents; Group III (n=144 the cuff pressure which were inflated by the 3rd year residents; Group IV (n=93 the cuff pressure which were inflated by the 4th year residents were measured by manometer.Results: When we compared the cases in which the cuff pressure were between 26-30cm H2O we found that the best results were in Group II and respectively in Group III and IV and the worst results were in Group I. The difference between Group II and Group I were statistically significant (p<0.05.Conclusion: We believe that manometer should be used ET for cuff pressure setting and monitoring. J Clin Exp Invest 2010; 1(3: 195-198

  6. Pathological muscle activation patterns in patients with massive rotator cuff tears, with and without subacromial anaesthetics.

    NARCIS (Netherlands)

    Steenbrink, F.; Groot, J.H.; Veeger, H.E.J.; Meskers, C.G.M.; van de Sande, M.A.; Rozing, P.M.

    2006-01-01

    A mechanical deficit due to a massive rotator cuff tear is generally concurrent to a pain-induced decrease of maximum arm elevation and peak elevation torque. The purpose of this study was to measure shoulder muscle coordination in patients with massive cuff tears, including the effect of

  7. Spiral-arm instability: giant clump formation via fragmentation of a galactic spiral arm

    Science.gov (United States)

    Inoue, Shigeki; Yoshida, Naoki

    2018-03-01

    Fragmentation of a spiral arm is thought to drive the formation of giant clumps in galaxies. Using linear perturbation analysis for self-gravitating spiral arms, we derive an instability parameter and define the conditions for clump formation. We extend our analysis to multicomponent systems that consist of gas and stars in an external potential. We then perform numerical simulations of isolated disc galaxies with isothermal gas, and compare the results with the prediction of our analytic model. Our model describes accurately the evolution of the spiral arms in our simulations, even when spiral arms dynamically interact with one another. We show that most of the giant clumps formed in the simulated disc galaxies satisfy the instability condition. The clump masses predicted by our model are in agreement with the simulation results, but the growth time-scale of unstable perturbations is overestimated by a factor of a few. We also apply our instability analysis to derive scaling relations of clump properties. The expected scaling relation between the clump size, velocity dispersion, and circular velocity is slightly different from that given by the Toomre instability analyses, but neither is inconsistent with currently available observations. We argue that the spiral-arm instability is a viable formation mechanism of giant clumps in gas-rich disc galaxies.

  8. The design of and chronic tissue response to a composite nerve electrode with patterned stiffness

    Science.gov (United States)

    Freeberg, M. J.; Stone, M. A.; Triolo, R. J.; Tyler, D. J.

    2017-06-01

    Objective. As neural interfaces demonstrate success in chronic applications, a novel class of reshaping electrodes with patterned regions of stiffness will enable application to a widening range of anatomical locations. Patterning stiff regions and flexible regions of the electrode enables nerve reshaping while accommodating anatomical constraints of various implant locations ranging from peripheral nerves to spinal and autonomic plexi. Approach. Introduced is a new composite electrode enabling patterning of regions of various electrode mechanical properties. The initial demonstration of the composite’s capability is the composite flat interface nerve electrode (C-FINE). The C-FINE is constructed from a sandwich of patterned PEEK within layers of pliable silicone. The shape of the PEEK provides a desired pattern of stiffness: stiff across the width of the nerve to reshape the nerve, but flexible along its length to allow for bending with the nerve. This is particularly important in anatomical locations near joints or organs, and in constrained compartments. We tested pressure and volume design constraints in vitro to verify that the C-FINE can attain a safe cuff-to-nerve ratio (CNR) without impeding intraneural blood flow. We measured nerve function as well as nerve and axonal morphology following 3 month implantation of the C-FINE without wires on feline peripheral nerves in anatomically constrained areas near mobile joints and major blood vessels in both the hind and fore limbs. Main Results. In vitro inflation tests showed effective CNRs (1.93  ±  0.06) that exceeded the industry safety standard of 1.5 at an internal pressure of 20 mmHg. This is less than the 30 mmHg shown to induce loss of conduction or compromise blood flow. Implanted cats showed no changes in physiology or electrophysiology. Behavioral signs were normal suggesting healthy nerves. Motor nerve conduction velocity and compound motor action potential did not change significantly

  9. Incorporating hydrologic variability into nutrient spiraling

    Science.gov (United States)

    Doyle, Martin W.

    2005-09-01

    Nutrient spiraling describes the path of a nutrient molecule within a stream ecosystem, combining the biochemical cycling processes with the downstream driving force of stream discharge. To date, nutrient spiraling approaches have been hampered by their inability to deal with fluctuating flows, as most studies have characterized nutrient retention within only a small range of discharges near base flow. Here hydrologic variability is incorporated into nutrient spiraling theory by drawing on the fluvial geomorphic concept of effective discharge. The effective discharge for nutrient retention is proposed to be that discharge which, over long periods of time, is responsible for the greatest portion of nutrient retention. A developed analytical model predicts that the effective discharge for nutrient retention will equal the modal discharge for small streams or those with little discharge variability. As modal discharge increases or discharge variability increases, the effective discharge becomes increasingly less than the modal discharge. In addition to the effective discharge, a new metric is proposed, the functionally equivalent discharge, which is the single discharge that will reproduce the magnitude of nutrient retention generated by the full hydrologic frequency distribution when all discharge takes place at that rate. The functionally equivalent discharge was found to be the same as the modal discharge at low hydrologic variability, but increasingly different from the modal discharge at large hydrologic variability. The functionally equivalent discharge provides a simple quantitative means of incorporating hydrologic variability into long-term nutrient budgets.

  10. Use of antioxidants for the prophylaxis of cold-induced peripheral nerve injury.

    Science.gov (United States)

    Teixeira, Fernanda; Pollock, Martin; Karim, Alveera; Jiang, Yuying

    2002-09-01

    "Trench foot" is a particular risk for those involved in adventure tourism, for soldiers in winter mountain training exercises, and for the homeless. Nonfreezing cold nerve injury is characterized by axonal degeneration, which is attributed to free radicals released during cycles of ischemia and reperfusion. This pilot study sought to determine whether the administration of antioxidants might prevent or ameliorate the development of cold nerve injury. Twenty-six rats were divided into two groups. Group 1 animals received, by gavage, a mixture of vitamin C (150 mg/kg/d), vitamin E (100 mg/kg/d), and N-acetyl-L-cysteine (250 mg/kg/d) daily for 4 weeks. Allopurinol (20 mg/kg/d) was added in the last 4 days of treatment. Group 2 animals served as controls and did not receive any antioxidant supplements. After 1 month, two cycles of sciatic nerve cooling (0 degrees C) were induced in 10 controls and 10 experimental animals using circulating water through a nerve cuff. Six additional control animals were subjected to surgery but did not undergo nerve cooling. All animals were killed on the third postoperative day, and their nerves were processed for ultrastructural and quantitative studies. The proportion of degenerated myelinated and unmyelinated axons showed no significant difference between treated and untreated animals. We conclude that the administration of commonly used antioxidants does not prevent cold nerve injury.

  11. Injury of the axillary nerve subsequent to recurrence of shoulder dislocation. Clinical and electromyographic study.

    Science.gov (United States)

    Gumina, S; Bertino, A; Di Giorgio, G; Postacchini, F

    2005-01-01

    Injuries of the axillary nerve subsequent to recurrence of glenohumeral dislocation have received only minimal attention. It is the purpose of this study to define the prevalence and the progression in time of injury of the axillary nerve in patients with recurrence of anterior shoulder dislocation. For two years we observed a total of 185 patients who had had primary shoulder dislocation. Excluded from the study were patients who had fractures associated with metabolic disorders that favored neurologic deficit. During the period of study, 98 patients contacted us again after recurrence of the dislocation: there were 89 patients aged over 60 years and 9 aged below 60 years. All of the patients were evaluated clinically and submitted to EMG in order to verify the condition of the axillary nerve. Four patients (4%) had neuroapraxia of the axillary nerve. One of these also had neuroapraxia of the radial nerve. Of the four patients, one was a male aged 34 years; the others were all aged over 60 years. In all of the cases, function of the axillary nerve completely recovered after a mean period of 4 months (3-5.3 months) after recurrence. Injury of the axillary nerve can occur at the time of the first recurrence of the injury. However, prevalence is significantly lower than that observed after primary dislocation. The occurrence of this injury should be taken into consideration, particularly in elderly patients, in order to avoid erroneous clinical diagnosis and massive rupture of the cuff subsequent to recurrence of the dislocation.

  12. Speed of recovery after arthroscopic rotator cuff repair.

    Science.gov (United States)

    Kurowicki, Jennifer; Berglund, Derek D; Momoh, Enesi; Disla, Shanell; Horn, Brandon; Giveans, M Russell; Levy, Jonathan C

    2017-07-01

    The purpose of this study was to delineate the time taken to achieve maximum improvement (plateau of recovery) and the degree of recovery observed at various time points (speed of recovery) for pain and function after arthroscopic rotator cuff repair. An institutional shoulder surgery registry query identified 627 patients who underwent arthroscopic rotator cuff repair between 2006 and 2015. Measured range of motion, patient satisfaction, and patient-reported outcome measures were analyzed for preoperative, 3-month, 6-month, 1-year, and 2-year intervals. Subgroup analysis was performed on the basis of tear size by retraction grade and number of anchors used. As an entire group, the plateau of maximum recovery for pain, function, and motion occurred at 1 year. Satisfaction with surgery was >96% at all time points. At 3 months, 74% of improvement in pain and 45% to 58% of functional improvement were realized. However, only 22% of elevation improvement was achieved (P < .001). At 6 months, 89% of improvement in pain, 81% to 88% of functional improvement, and 78% of elevation improvement were achieved (P < .001). Larger tears had a slower speed of recovery for Single Assessment Numeric Evaluation scores, forward elevation, and external rotation. Smaller tears had higher motion and functional scores across all time points. Tear size did not influence pain levels. The plateau of maximum recovery after rotator cuff repair occurred at 1 year with high satisfaction rates at all time points. At 3 months, approximately 75% of pain relief and 50% of functional recovery can be expected. Larger tears have a slower speed of recovery. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. [Reversed total shoulder arthroplasty in rotator cuff defect arthropathy].

    Science.gov (United States)

    Patzer, T

    2018-03-07

    In a progredient rotator cuff tear with tendon retraction, fatty infiltration and atrophy of rotator cuff muscles the humerus cannot be centered and stabilized sufficiently in the glenohumeral joint. This leads to rotator cuff defect arthropathy as an eccentric osteoarthritis with acetabularization and wear of the acromion, as well as of the glenoid. A painful pseudoparalysis of the shoulder indicates the implantation of a reversed total shoulder arthroplasty (rTSA) to reduce pain and restore active motion. The rTSA improves the motoric function of the deltoid muscle by medialization and caudalization of the center of rotation via an optimized lever arm and is also indicated in cranio-caudally centered osteoarthritis with static posterior humeral decentration due to a bi-concavely eroded glenoid. Currently, humeral anatomical resection with an inclination of 135° and a humeral retrotorsion of 20-40°, in rTSA in contrast to 155° inclination, has been shown to lead to better glenohumeral motion without loss of stability. Additionally, a reduced glenohumeral offset should be restored by especially bony lateral augmentation of the glenoid. In a pre-operatively positive lag sign for external rotation caused by a rupture of the infraspinatus/teres minor tendon, a lateral latissimus/teres major muscle tendon transfer in rTSA can optimize active external rotation. The tendon of the subscapularis muscle should be re-fixated in the deltopectoral approach for rTSA whenever possible for better anterior stability of the glenohumeral joint. Larger diameters of the glenospheres have been shown to have more stability and better motion. Humeral metaphyseal metal liners with corresponding polyethylene glenospheres can avoid osteolysis of the inferior scapular neck caused by polyethylene debris due to impingement of the humeral liner at the scapular neck.

  14. Linear Correlation of Endotracheal Tube Cuff Pressure and Volume

    Directory of Open Access Journals (Sweden)

    Hoffman, Robert J

    2009-08-01

    Full Text Available Objectives: Endotracheal tube cuff (ETTc inflation by standard methods may result in excessive ETTc pressure. Previous studies have indicated that methods of cuff inflation most frequently used to inflate ETTcs include palpation of the tension in the pilot balloon or injection of a predetermined volume of air to inflate the pilot balloon. If a logarithmic relationship exists between ETTc volume and ETTc pressure, small volumes of additional air will result in dramatic pressure increases after a volume threshold is reached. Our goal was to determine whether the relationship between ETTc volume and ETTc pressure is linear or non-linear.Methods: In this Institutional Animal Care and Use Committee-approved study, we recorded ETTc volume and pressure in four anesthetized and mechanically-ventilated canines ranging between 30-40 pounds (mean 34.7lb, SD 3.8lb that were endotracheally intubated with a 7.0 mm ETT. The varying cuff pressures associated with a distribution of 28 progressively increasing volumes of air in the ETTc were recorded. Spearman correlation was performed to determine if a linear or non-linear relationship existed between these variables.Results: The Spearman rho coefficient of correlation between ETTc volume and ETTc pressure was 0.969, or approximately 97%, suggesting near-perfect linear relationship between ETTc volume and ETTc pressure over the range of volumes and pressures tested.Conclusions: Over the range of volumes and pressures tested a linear relationship between volume and pressure results in no precipitous increase in slope of the pressure:volume curve as volume increases.[WestJEM. 2009;10:137-139.

  15. NMR of the rotator cuff. An update; MRT der Rotatorenmanschette. Ein Update

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, Karl-Friedrich; Maehringer-Kunz, Aline [Universitaetsmedizin Mainz (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2016-03-15

    The rotator cuff consists of the tendons of the supscapularis, supraspinatus, infraspinatus and teres minor muscles. This group of muscles performs multiple functions and is often stressed during various activities. This explains, why rotator cuff disease is common and the most often cause of shoulder pain and dysfunction in adults. MR imaging still is the most important imaging modality in assessment of rotator cuff disease. It enables the radiologist to make an accurate diagnosis, the basis for an appropriate management. In this article, current concepts with regard to anatomy and imaging diagnosis will be reviewed. The discussion of the complex anatomy is followed by normal and pathologic MR imaging appearances of the rotator cuff including tendinopathy and tearing, and concluding with a review of the postoperative cuff.

  16. [MRI in the pre-operative evaluation of lesions of the rotator cuff].

    Science.gov (United States)

    Gagey, N; Desmoineaux, P; Gagey, O; Idy-Peretti, I; Mazas, F

    1993-01-01

    The authors report a series of 38 patients who had been examined by MRI and then operated for a rotator cuff syndrome. The correlation between the description of the cuff lesions after MRI and the surgical observations were excellent for 37 patients. In one case MRI showed a false image of tear of the supra spinatus m. on its anterior edge. This was due to a bad knowledge of the anatomy of the muscle and tendon and to a poor orientation of the frontal cut plane. This study was complete with MRI and anatomic study of 12 non embalmed cadaveric shoulders. The results showed that MRI was very sensitive (0.93) and specific (0.94) for the diagnosis of rotator cuff tears. MRI allowed also to show partial tears of the tendons of the rotator cuff. The authors propose a MRI classification of cuff lesions which permits to establish a good surgical planning.

  17. [Contribution of MRI to the preoperative evaluation of rotator cuff tears].

    Science.gov (United States)

    Gagey, N; Desmoineaux, P; Gagey, O; Idy-Peretti, I; Mazas, F

    1991-01-01

    The authors report a series of 38 patients who had been examined by MRI and then operated for a rotator cuff syndrome. The correlation between the description of the cuff lesions after MRI and the surgical observations were excellent for 37 patients. In one case MRI showed a false image of tear of the supra spinatus m. on its anterior edge. This was due to a bad knowledge of the anatomy of the muscle and tendon and to a poor orientation of the frontal cut plane. This study was completed with MRI and anatomic study of 12 non embalmed cadaveric shoulders. The results showed that MRI was very sensitive (0.93) and specific (0.94) for the diagnosis of rotator cuff tears. MRI allowed also to show partial tears of the tendons of the rotator cuff. The authors propose a MRI classification of cuff lesions which permits to establish a good surgical planning.

  18. Dextrose Prolotherapy Versus Control Injections in Painful Rotator Cuff Tendinopathy.

    Science.gov (United States)

    Bertrand, Helene; Reeves, Kenneth Dean; Bennett, Cameron J; Bicknell, Simon; Cheng, An-Lin

    2016-01-01

    To compare the effect of dextrose prolotherapy on pain levels and degenerative changes in painful rotator cuff tendinopathy against 2 potentially active control injection procedures. Randomized controlled trial, blinded to participants and evaluators. Outpatient pain medicine practice. Persons (N=73) with chronic shoulder pain, examination findings of rotator cuff tendinopathy, and ultrasound-confirmed supraspinatus tendinosis/tear. Three monthly injections either (1) onto painful entheses with dextrose (Enthesis-Dextrose), (2) onto entheses with saline (Enthesis-Saline), or (3) above entheses with saline (Superficial-Saline). All solutions included 0.1% lidocaine. All participants received concurrent programmed physical therapy. Primary: participants achieving an improvement in maximal current shoulder pain ≥2.8 (twice the minimal clinically important difference for visual analog scale pain) or not. Secondary: improvement in the Ultrasound Shoulder Pathology Rating Scale (USPRS) and a 0-to-10 satisfaction score (10, completely satisfied). The 73 participants had moderate to severe shoulder pain (7.0±2.0) for 7.6±9.6 years. There were no baseline differences between groups. Blinding was effective. At 9-month follow-up, 59% of Enthesis-Dextrose participants maintained ≥2.8 improvement in pain compared with Enthesis-Saline (37%; P=.088) and Superficial-Saline (27%; P=.017). Enthesis-Dextrose participants' satisfaction was 6.7±3.2 compared with Enthesis-Saline (4.7±4.1; P=.079) and Superficial-Saline (3.9±3.1; P=.003). USPRS findings were not different between groups (P=.734). In participants with painful rotator cuff tendinopathy who receive physical therapy, injection of hypertonic dextrose on painful entheses resulted in superior long-term pain improvement and patient satisfaction compared with blinded saline injection over painful entheses, with intermediate results for entheses injection with saline. These differences could not be attributed to a

  19. Preliminary Results of a Consecutive Series of Large & Massive Rotator Cuff Tears Treated with Arthroscopic Rotator Cuff Repairs Augmented with Extracellular Matrix

    Directory of Open Access Journals (Sweden)

    Paolo Consigliere

    2017-01-01

    Full Text Available Background: Recurrence rate of rotator cuff tears is still high despite the improvements of surgical techniques, materials used and a better knowledge of the healing process of the rotator cuff tendons. Large to massive rotator cuff tears are particularly associated with a high failure rate, especially in elderly. Augmentation of rotator cuff repairs with extracellular matrix or synthetic patches has gained popularity in recent years with the aim of reducing failure.The aim of this study was to investigate the outcome of rotator cuff repairs augmented with denatured extracellular matrix in a series of patients who underwent arthroscopic rotator cuff repair for large to massive tears.Methods: Ten consecutive patients, undergoing arthroscopic rotator cuff repair with extracellular matrix augment for large and massive tears, were prospectively enrolled into this single surgeon study. All repairs were performed arthroscopically with a double row technique augmented with extracellular matrix. Oxford Shoulder Score, Constant Score and pain visual analogue scale (VAS were used to monitor the shoulder function and outcome pre-operatively and at three, six and 12-month follow-up. Minimum follow up was tree months. Mean follow up was 7 months.Results: Mean Constant score improved from 53 (SD=4 pre-operatively to 75 (SD=11 at final follow up. Mean Oxford score also increased from 30 (SD=8 pre-operatively to 47 (SD=10 at the final follow up. The visual analogue scale (VAS improved from seven out of 10 (SD=2 preoperatively to 0.6 (SD=0.8 at final follow up. Additionally, there was significant improvement at three months mark in Constant score. Conclusion: Arthroscopic repair and augmentation of large and massive rotator cuff tears with extracellular matrix patch has good early outcome.

  20. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Radiology Department, Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Rua Prof. Lima Basto, 1093, Lisboa (Portugal)], E-mail: borgalexandra@gmail.com; Casselman, Jan [Department of Radiology, A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals (Belgium)

    2010-05-15

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  1. Neovascularization prevalence in the supraspinatus of patients with rotator cuff tendinopathy.

    Science.gov (United States)

    Kardouni, Joseph R; Seitz, Amee L; Walsworth, Matthew K; Michener, Lori A

    2013-11-01

    A high prevalence of neovascularity in lower extremity tendinopathies has been reported. Neovascularity in those with rotator cuff tendinopathy exclusively has not been examined. The objective was to determine the prevalence of neovascularization in patients with rotator cuff tendinopathy compared with asymptomatic controls. Single-blind cross-sectional study. Research laboratory. Participants (n = 40; age = 44.9 years, 23-62 years; 20 females) with rotator cuff tendinopathy (n = 20) but without full-thickness rotator cuff tears, and asymptomatic controls that were age, gender, and hand dominance matched (n = 20) to the patients. The participants laying in supine had their shoulder positioned in internal rotation and extension. Ultrasound images were collected of the supraspinatus tendon and subacromial bursae in the transverse and longitudinal planes using a linear transducer in color Doppler mode. Images were assessed for neovascularization by 2 trained raters who were blinded to group (rotator cuff tendinopathy or asymptomatic group). No statistically significant difference in neovascularization was identified between participants with and without rotator cuff tendinopathy (χ = 0.13, df = 1, P = 0.72). Neovascularization was identified in 6 of 20 patients with rotator cuff tendinopathy (30%) and 5 of 20 asymptomatic control participants (25%). The authors found no differences in neovascularization rate in patients with rotator cuff tendinopathy (30%) and asymptomatic controls (25%). The study indicates that neovascularization is not related to presence of symptomatic tendinopathy in those with rotator cuff tendinopathy. Neovascularization may not be a relevant sonographic finding to aid the clinical assessment of those with rotator cuff tendinopathy.

  2. What do standard radiography and clinical examination tell about the shoulder with cuff tear arthropathy?

    Directory of Open Access Journals (Sweden)

    Favard Luc

    2011-01-01

    Full Text Available Abstract Background This study evaluates the preoperative conventional anteroposterior radiography and clinical testing in non-operated patients with cuff tear arthropathy. It analyses the radiological findings in relation to the status of the rotator cuff and clinical status as also the clinical testing in relation to the rotator cuff quality. The aim of the study is to define the usefulness of radiography and clinical examination in cuff tear arthropathy. Methods This study analyses the preoperative radiological (AP-view, (Artro-CT-scan or MRI-scan and clinical characteristics (Constant-Murley-score plus active and passive mobility testing and the peroperative findings in a cohort of 307 patients. These patients were part of a multicenter, retrospective, consecutive study of the French Orthopaedic Society (SOFCOT-2006. All patients had no surgical antecedents and were all treated with prosthetic shoulder surgery for a painful irreparable cuff tear arthropathy (reverse-(84% or hemi-(8% or double cup-bipolar prosthesis (8%. Results A positive significancy could be found for the relationship between clinical testing and the rotator cuff quality; between acromiohumeral distance and posterior rotator cuff quality; between femoralization and posterior rotator cuff quality. Conclusion A conventional antero-posterior radiograph can not provide any predictive information on the clinical status of the patient. The subscapular muscle can be well tested by the press belly test and the teres minor muscle can be well tested by the hornblower' sign and by the exorotation lag signs. The upward migration index and the presence of femoralization are good indicators for the evaluation of the posterior rotator cuff. An inferior coracoid tip positioning suggests rotator cuff disease.

  3. Multidetector spiral CT arthrography of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Lecouvet, Frederic E. [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)], E-mail: frederic.lecouvet@uclouvain.be; Simoni, Paolo; Koutaissoff, Sophie; Vande Berg, Bruno C.; Malghem, Jacques; Dubuc, Jean-Emile [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)

    2008-10-15

    Although MR imaging and MR arthrography are the first choice modalities for shoulder imaging, CT arthrography (CTA) may be used successfully to address many clinical questions. The advent of submillimeter multiple detector CT technology and subsequent excellent three-plane resolution has considerably increased the quality of CTA examinations and has propelled this technique to the forefront in a growing number of indications. The combined use of iodinated contrast material for fluoroscopic confirmation of the articular position of the needle before injection of gadolinium chelates for MR arthrography offers the unique opportunity to compare CTA and MRA findings in carefully selected cases. This paper illustrates capabilities and limits of CTA for the study of rotator cuff tears, shoulder instability, cartilage lesions, anatomical variants and abnormalities of the glenoid labrum, with correlations to MR arthrography and surgical findings.

  4. Multidetector spiral CT arthrography of the shoulder

    International Nuclear Information System (INIS)

    Lecouvet, Frederic E.; Simoni, Paolo; Koutaissoff, Sophie; Vande Berg, Bruno C.; Malghem, Jacques; Dubuc, Jean-Emile

    2008-01-01

    Although MR imaging and MR arthrography are the first choice modalities for shoulder imaging, CT arthrography (CTA) may be used successfully to address many clinical questions. The advent of submillimeter multiple detector CT technology and subsequent excellent three-plane resolution has considerably increased the quality of CTA examinations and has propelled this technique to the forefront in a growing number of indications. The combined use of iodinated contrast material for fluoroscopic confirmation of the articular position of the needle before injection of gadolinium chelates for MR arthrography offers the unique opportunity to compare CTA and MRA findings in carefully selected cases. This paper illustrates capabilities and limits of CTA for the study of rotator cuff tears, shoulder instability, cartilage lesions, anatomical variants and abnormalities of the glenoid labrum, with correlations to MR arthrography and surgical findings

  5. Morphology of nerve endings in vocal fold of human newborn.

    Science.gov (United States)

    Gonçalves da Silva Leite, Janaina; Costa Cavalcante, Maria Luzete; Fechine-Jamacaru, Francisco Vagnaldo; de Lima Pompeu, Margarida Maria; Leite, José Alberto Dias; Nascimento Coelho, Dulce Maria; Rabelo de Freitas, Marcos

    2016-10-01

    Sensory receptors are distributed throughout the oral cavity, pharynx, and larynx. Laryngeal sensitivity is crucial for maintaining safe swallowing, thus avoiding silent aspiration. Morphologic description of different receptor types present in larynx vary because of the study of many different species, from mouse to humans. The most commonly sensory structures described in laryngeal mucosa are free nerve endings, taste buds, muscle spindles, glomerular and corpuscular receptors. This study aimed at describing the morphology and the distribution of nerve endings in premature newborn glottic region. Transversal serial frozen sections of the whole vocal folds of three newborns were analyzed using an immuno-histochemical process with a pan-neuronal marker anti-protein gene product 9.5 (PGP 9.5). Imaging was done using a confocal laser microscope. Nerve fiber density in vocal cord was calculated using panoramic images in software Morphometric Analysis System v1.0. Some sensory structures, i.e. glomerular endings and intraepithelial free nerve endings were found in the vocal cord mucosa. Muscle spindles, complex nerve endings (Meissner-like, spherical, rectangular and growing) spiral-wharves nerve structures were identified in larynx intrinsic muscles. Nervous total mean density in vocal cord was similar in the three newborns, although they had different gestational age. The mean nerve fiber density was higher in the posterior region than anterior region of vocal cord. The present results demonstrate the occurrence of different morphotypes of sensory corpuscles and nerve endings premature newborn glottic region and provide information on their sensory systems. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Transtendon rotator-cuff repair of partial-thickness articular surface tears can lead to medial rotator-cuff failure

    OpenAIRE

    Woods TC; Carroll MJ; Nelson AA; More KD; Berdusco R; Sohmer S; Boorman RS; Lo IKY

    2014-01-01

    Tom C Woods,4 Michael J Carroll,1 Atiba A Nelson,2 Kristie D More,2 Randa Berdusco,1 Stephen Sohmer,3 Richard S Boorman,1,2 Ian KY Lo1,21Department of Surgery, 2Sport Medicine Centre, University of Calgary, Calgary, AB, Canada; 3Department of Orthopaedics, University of British Columbia, Vancouver, 4St Joseph's Hospital, Comox, BC, CanadaPurpose: The purpose of this study was to evaluate clinical and anatomic outcomes of patients following transtendon rotator-cuff repair of partial ar...

  7. Ablation acceleration of macroparticle in spiral magnetic fields

    International Nuclear Information System (INIS)

    Ikuta, Kazunari.

    1981-05-01

    The rocket motion of macroparticles heated by energetic pulses in a spiral magnetic field was studied. The purpose of the present work is to study the ablation acceleration of a macroparticle in a spiral magnetic field with the help of the law of conservation of angular momentum. The basic equation of motion of ablatively accelerated projectile in a spiral magnetic field was derived. Any rocket which is ejecting fully ionized plasma in an intense magnetic field with rotational transform is able to have spin by the law of conservation of momentum. The effect of spiral magnetic field on macroparticle acceleration is discussed. The necessary mass ratio increase exponentially with respect to the field parameter. The spiral field should be employed with care to have only to stabilize the position of macroparticles. As conclusion, it can be said that the ablation acceleration of the projectile in a spiral field can give the accelerated body spin quite easily. (Kato, T.)

  8. Mechanical response of spiral interconnect arrays for highly stretchable electronics

    KAUST Repository

    Qaiser, Nadeem

    2017-11-21

    A spiral interconnect array is a commonly used architecture for stretchable electronics, which accommodates large deformations during stretching. Here, we show the effect of different geometrical morphologies on the deformation behavior of the spiral island network. We use numerical modeling to calculate the stresses and strains in the spiral interconnects under the prescribed displacement of 1000 μm. Our result shows that spiral arm elongation depends on the angular position of that particular spiral in the array. We also introduce the concept of a unit-cell, which fairly replicates the deformation mechanism for full complex hexagon, diamond, and square shaped arrays. The spiral interconnects which are axially connected between displaced and fixed islands attain higher stretchability and thus experience the maximum deformations. We perform tensile testing of 3D printed replica and find that experimental observations corroborate with theoretical study.

  9. Wave-particle dualism of spiral waves dynamics.

    Science.gov (United States)

    Biktasheva, I V; Biktashev, V N

    2003-02-01

    We demonstrate and explain a wave-particle dualism of such classical macroscopic phenomena as spiral waves in active media. That means although spiral waves appear as nonlocal processes involving the whole medium, they respond to small perturbations as effectively localized entities. The dualism appears as an emergent property of a nonlinear field and is mathematically expressed in terms of the spiral waves response functions, which are essentially nonzero only in the vicinity of the spiral wave core. Knowledge of the response functions allows quantitatively accurate prediction of the spiral wave drift due to small perturbations of any nature, which makes them as fundamental characteristics for spiral waves as mass is for the condensed matter.

  10. Model-based Bayesian signal extraction algorithm for peripheral nerves

    Science.gov (United States)

    Eggers, Thomas E.; Dweiri, Yazan M.; McCallum, Grant A.; Durand, Dominique M.

    2017-10-01

    Objective. Multi-channel cuff electrodes have recently been investigated for extracting fascicular-level motor commands from mixed neural recordings. Such signals could provide volitional, intuitive control over a robotic prosthesis for amputee patients. Recent work has demonstrated success in extracting these signals in acute and chronic preparations using spatial filtering techniques. These extracted signals, however, had low signal-to-noise ratios and thus limited their utility to binary classification. In this work a new algorithm is proposed which combines previous source localization approaches to create a model based method which operates in real time. Approach. To validate this algorithm, a saline benchtop setup was created to allow the precise placement of artificial sources within a cuff and interference sources outside the cuff. The artificial source was taken from five seconds of chronic neural activity to replicate realistic recordings. The proposed algorithm, hybrid Bayesian signal extraction (HBSE), is then compared to previous algorithms, beamforming and a Bayesian spatial filtering method, on this test data. An example chronic neural recording is also analyzed with all three algorithms. Main results. The proposed algorithm improved the signal to noise and signal to interference ratio of extracted test signals two to three fold, as well as increased the correlation coefficient between the original and recovered signals by 10–20%. These improvements translated to the chronic recording example and increased the calculated bit rate between the recovered signals and the recorded motor activity. Significance. HBSE significantly outperforms previous algorithms in extracting realistic neural signals, even in the presence of external noise sources. These results demonstrate the feasibility of extracting dynamic motor signals from a multi-fascicled intact nerve trunk, which in turn could extract motor command signals from an amputee for the end goal of

  11. Incidence of familial tendon dysfunction in patients with full-thickness rotator cuff tears

    Directory of Open Access Journals (Sweden)

    Tashjian RZ

    2014-05-01

    Full Text Available Robert Z Tashjian, Erik G Saltzman, Erin K Granger, Man Hung Department of Orthopedics, University of Utah Orthopaedic Center, University of Utah School of Medicine, Salt Lake City, UT, USA Background: A familial predisposition to the development of rotator cuff tearing has been previously reported. Very little information exists on the development of global tendon dysfunction in patients with rotator cuff tears. The purpose of the current study was to determine the incidence of global tendon dysfunction as well as the need for surgery for tendon dysfunction in patients with rotator cuff tears and their family members and compare them to age-matched controls. Methods: Ninety two patients with full-thickness rotator cuff tears and 92 age-matched controls with no history of shoulder dysfunction or surgery responded to several questions regarding tendon diseases in themselves as well as their family members. Individuals were queried regarding the presence of tendon diseases other than the rotator cuff, the need for surgery on these other tendinopathies, the presence of family members having tendinopathies including rotator cuff disease, and the need for family members to have surgery for these problems. Chi-square analysis was performed to compare the incidences between cases and controls (P<0.05 was considered significant. Results: The average age of patients in the rotator cuff tear group and control groups were 58.24±7.4 and 58.42±8.5 years, respectively (P=0.876. Results showed 32.3% of patients in the rotator cuff tear group reported that family members had a history of rotator cuff problems or surgery compared to only 18.3% of the controls (P=0.035, and 38.7% of patients in the rotator cuff tear group reported they had a history of other tendon problems compared to only 19.3% of individuals in the control group (P=0.005. Conclusion: Individuals with rotator cuff tears report a higher incidence of family members having rotator cuff problems

  12. Calcific tendinitis of the rotator cuff: a review.

    Science.gov (United States)

    Kachewar, Sushil G; Kulkarni, Devidas S

    2013-07-01

    Calcifying tendinitis of the rotator cuff is a common disorder; its underlying mechanism still remains unknown. Although details of the clinical presentation(s) and pathological changes which are associated with calcific tendinitis are available, conservative management of this condition remains a topic of debate. About 90% of the patients can be treated non - operatively, but as some are resistant to conservative treatment; newer techniques or surgery should be indicated. Rheumatologists and radiologists have often described this shoulder abnormality, leading to its progressive differentiation from other painful shoulder syndromes. The conservative treatment includes the use of non - steroidal anti - inflammatory agents, roentegen therapy, physical modalities for controlling the pain and for preventing loss of joint mobility, local steroid injections, and open or arthroscopic surgeries. Results of non - operative treatments have also been satisfactory. These include heat, cold, range of motion and pendulum exercises, diathermy, short - wave, and radiation therapy. Rest, immobilization with a sling, and oral non - steroidal and steroid anti - inflammatory medications have also been mentioned. This review aimed at looking at calcific tendinitis of the rotator cuff with a wide vision in the light of modern advances; while at the same time, not disregarding the past experiences.

  13. Gene expression analysis in calcific tendinopathy of the rotator cuff

    Directory of Open Access Journals (Sweden)

    F Oliva

    2011-06-01

    Full Text Available We evaluated the expression of several genes involved in tissue remodelling and bone development in patients with calcific tendinopathy of the rotator cuff. Biopsies from calcified and non-calcified areas were obtained from 10 patients (8 women and 2 men; average age: 55 years; range: 40-68 with calcific tendinopathy of the rotator cuff. To evaluate the expression of selected genes, RNA extraction, cDNA synthesis and quantitative polymerase chain reaction (PCR were performed. A significantly increased expression of tissue transglutaminase (tTG2 and its substrate, osteopontin, was detected in the calcific areas compared to the levels observed in the normal tissue from the same subject with calcific tendinopathy, whereas a modest increase was observed for catepsin K. There was also a significant decrease in mRNA expression of Bone Morphogenetic Protein (BMP4 and BMP6 in the calcific area. BMP-2, collagen V and vascular endothelial growth factor (VEGF did not show significant differences. Collagen X and matrix metalloproteinase (MMP-9 were not detectable. A variation in expression of these genes could be characteristic of this form tendinopathy, since an increased level of these genes has not been detected in other forms of tendon lesions.

  14. Nonlinear dynamics of breathers in the spiral structures of magnets

    Energy Technology Data Exchange (ETDEWEB)

    Kiselev, V. V., E-mail: kiselev@imp.uran.ru; Raskovalov, A. A. [Russian Academy of Sciences, Mikheev Institute of Metal Physics, Ural Branch (Russian Federation)

    2016-06-15

    The structure and properties of pulsating solitons (breathers) in the spiral structures of magnets are analyzed within the sine-Gordon model. The breather core pulsations are shown to be accompanied by local shifts and oscillations of the spiral structure with the formation of “precursors” and “tails” in the moving soliton. The possibilities for the observation and excitation of breathers in the spiral structures of magnets and multiferroics are discussed.

  15. Cochlea and other spiral forms in nature and art.

    Science.gov (United States)

    Marinković, Slobodan; Stanković, Predrag; Štrbac, Mile; Tomić, Irina; Ćetković, Mila

    2012-01-01

    The original appearance of the cochlea and the specific shape of a spiral are interesting for both the scientists and artists. Yet, a correlation between the cochlea and the spiral forms in nature and art has been very rarely mentioned. The aim of this study was to investigate the possible correlation between the cochlea and the other spiral objects in nature, as well as the artistic presentation of the spiral forms. We explored data related to many natural objects and examined 13,625 artworks created by 2049 artists. We also dissected 2 human cochleas and prepared histologic slices of a rat cochlea. The cochlea is a spiral, cone-shaped osseous structure that resembles certain other spiral forms in nature. It was noticed that parts of some plants are arranged in a spiral manner, often according to Fibonacci numbers. Certain animals, their parts, or their products also represent various types of spirals. Many of them, including the cochlea, belong to the logarithmic type. Nature created spiral forms in the living world to pack a larger number of structures in a limited space and also to improve their function. Because the cochlea and other spiral forms have a certain aesthetic value, many artists presented them in their works of art. There is a mathematical and geometric correlation between the cochlea and natural spiral objects, and the same functional reason for their formation. The artists' imagery added a new aspect to those domains. Obviously, the creativity of nature and Homo sapiens has no limits--like the infinite distal part of the spiral. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. SPIRAL2 Week 2012 - Slides of the presentations

    International Nuclear Information System (INIS)

    Staley, F.; Jacquemet, M.; Lewitowicz, M.; Bertrand, P.; Tuske, O.; Caruso, A.; Leyge, J.F.; Perrot, L.; Di Giacomo, M.; Ausset, P.; Moscatello, M.H.; Savalle, A.; Rannou, B.; Lambert, M.; Petit, E.; Hulin, X.; Barre-Boscher, N.; Tusseau-Nenez, S.; Tecchio, L.B.

    2013-01-01

    The main goal of the 5. edition of the SPIRAL2 Week is to present and discuss the current status of the SPIRAL2 project in front of a large community of scientists and engineers. The program of the meeting will include presentations on scientific and technical developments related to the baseline project, experiments and theory. The main topics to be discussed at the conference are: -) physics and detectors at SPIRAL2, -) driver accelerators, -) production of radioactive ion beams (RIB), -) safety, -) buildings and infrastructure, -) RIB facilities worldwide, and -) SPIRAL2 preparatory phase. This document is made up of the slides of the presentations

  17. Algorithms for computing efficient, electric-propulsion, spiralling trajectories

    Data.gov (United States)

    National Aeronautics and Space Administration — Develop techniques for rapidly designing many-revolution, electric-propulsion, spiralling trajectories, including the effects of shadowing, gravity harmonics, and...

  18. Self-regulated model of galactic spiral structure formation.

    Science.gov (United States)

    Cartin, Daniel; Khanna, Gaurav

    2002-01-01

    The presence of spiral structure in isolated galaxies is a problem that has only been partially explained by theoretical models. Because the rate and pattern of star formation in the disk must depend only on mechanisms internal to the disk, we may think of the spiral galaxy as a self-regulated system far from equilibrium. This paper uses this idea to look at a reaction-diffusion model for the formation of spiral structures in certain types of galaxies. In numerical runs of the model, spiral structure forms and persists over several revolutions of the disk, but eventually dies out.

  19. Spread of the spiraling white fly Aleurodicus dispersus (Homoptera ...

    African Journals Online (AJOL)

    Spread of the spiraling white fly Aleurodicus dispersus (Homoptera: Aleyrodidae) and its parasitoids Encarcia species (Hymenoptera: Aphelinidae) on horticultural plants in Northwest and Central Nigeria.

  20. Topological Signatures in the Electronic Structure of Graphene Spirals

    DEFF Research Database (Denmark)

    Avdoshenko, Stas.M.; Koskinen, Pekka; Sevincli, Haldun

    2013-01-01

    and graphene systems. Here, we introduce topologically distinct graphene forms - graphene spirals - and employ density-functional theory to investigate their geometric and electronic properties. We found that the spiral topology gives rise to an intrinsic Rashba spin-orbit splitting. Through a Hamiltonian...... constrained by space curvature, graphene spirals have topologically protected states due to time-reversal symmetry. In addition, we argue that the synthesis of such graphene spirals is feasible and can be achieved through advanced bottom-up experimental routes that we indicate in this work....

  1. The relationship of proximal locking screws to the axillary nerve during antegrade humeral nail insertion of four commercially available implants.

    Science.gov (United States)

    Prince, Edward J; Breien, Kristoffer M; Fehringer, Edward V; Mormino, Matthew A

    2004-10-01

    The purpose of this study was to determine the proximity of proximal interlocking mechanisms in 4 current antegrade humeral nails to the axillary nerve and its branches. Cadaveric study. Anatomy laboratory. Anatomic relationships. Four humeral nail designs (labeled SS, SL, SZ, and SN) were each inserted in successive antegrade fashion in 10 cadaveric upper extremity specimens. Three variables were measured: from acromion to the axillary nerve, from acromion to entry sites of proximal locking devices, and from locking devices to axillary nerves and their branches. In nail SS, the proximally directed oblique locking screw came into contact with the ascending branch of the axillary nerve in 6 of 10 specimens. Mean distance from spiral blades in nails SS and SL were 26 mm to the axillary nerve and 16 mm to its ascending branch. Interlocking screws for nails SZ, SN, and SL did not violate the axillary nerve or its branches in any specimen. Mean distance from lateral acromion to the axillary nerve measured 58.7 mm. Nail SS's oblique locking screw may injure the ascending branch of the axillary nerve. Three of the 4 nails tested did not endanger the axillary nerve. However, when transverse proximal locking screws are inserted from a lateral-to-medial direction, they may endanger an arborized axillary nerve. Blunt dissection should be performed with a visible path to bone before instrumentation to reduce the risk of axillary nerve injury. Copyright 2004 Lippincott Williams & Wilkins

  2. Nanofiber Nerve Guide for Peripheral Nerve Repair and Regeneration

    Science.gov (United States)

    2016-04-01

    project was to develop an alternative to autologous nerve grafts used in repair of peripheral nerve injuries in war and civilian life. Based on our...gradient compositions tested in Aim 1 in preparation to studies in the large animal model of peripheral nerve injury and repair . As it was not...this specific aim was to test the efficacy of optimized nanofiber nerve guide in a canine model of peripheral nerve injury and repair . Peripheral nerve

  3. Virtual bronchoscopy based on spiral CT images

    Science.gov (United States)

    Englmeier, Karl-Hans; Haubner, Michael; Krapichler, Christian; Schuhmann, Dietrich; Seemann, Mark; Fuerst, H.; Reiser, Maximilian

    1998-06-01

    Purpose: To improve the diagnosis of pathologic modified airways, a visualization system has been developed and tested based on the techniques of digital image analysis, synthesis of spiral CT and the visualization by methods of virtual reality. Materials and Methods: 20 patients with pathologic modifications of the airways (tumors, obstructions) were examined with Spiral-CT. The three-dimensional shape of the airways and the lung tissue is defined by a semiautomatic volume growing method and a following geometric surface reconstruction. This is the basis of a multidimensional display system which visualizes volumes, surfaces and computation results simultaneously. To enable the intuitive and immersive inspection of the airways a virtual reality system, consisting of two graphic engines, a head mounted display system, data gloves and specialized software was integrated. Results: In 20 cases the extension of the pathologic modification of the airways could be visualized with the virtual bronchoscopy. The user interacts with and manipulates the 3D model of the airways in an intuitive and immersive way. In contrast to previously proposed virtual bronchoscopy systems the described method permits truly interactive navigation and detailed exploration of anatomic structures. The system enables a user oriented and fast inspection of the volumetric image data. Conclusion: To support radiological diagnosis with additional information in an easy to use and fast way a virtual bronchoscopy system was developed. It enables the immersive and intuitive interaction with 3D Spiral CTs by truly 3D navigation within the airway system. The complex anatomy of the central tracheobronchial system could be clearly visualized. Peripheral bronchi are displayed up to 5th degree.

  4. Evaluation of post-exercise magnetic resonance images of the rotator cuff

    International Nuclear Information System (INIS)

    Cahoy, P.M.; Orwin, J.F.; Tuite, M.J.

    1996-01-01

    Objective. To examine the effect of strenuous exercise on the magnetic resonance imaging (MRI) characteristics of the rotator cuff tendon. A second objective was to define an optimal time to image the rotator cuff and possibly eliminate exercise-induced false positives. Design and patients. Five male subjects from 24 to 38 years old with normal rotator cuffs by history, physical examination, and screening MRI underwent a rotator cuff exercise session on the Biodex System 2 (Biodex, Shirley, New York). The exercise sessions were followed by sequential MRI scans of the exercised shoulder. These were performed immediately and at 8 h and 24 h after exercise. Results and conclusions. The rotator cuff tendon and subacromial-subdeltoid bursal signal remained unchanged from the pre-exercise through the 24-h post-exercise scans. The rotator cuff muscle signal was increased in five of five subjects on the immediate post-exercise fat-suppressed T2-weighted images. This signal returned to baseline by the 8-h scan. Positive findings of rotator cuff pathology on MRI after strenuous athletic activity should not be discounted as normal exercise-induced changes. Also, diagnostic MRI scanning may take place after a practice session without an increased risk of false positives. (orig.). With 1 fig

  5. Comparison of nonabsorbable polymer ligating and standard titanium clips with and without a vascular cuff.

    Science.gov (United States)

    Jellison, Forrest C; Baldwin, D Duane; Berger, Kenneth A; Maynes, Lincoln J; Desai, Premal J

    2005-09-01

    To compare the efficacy of nonabsorbable polymer ligating (NPL) and titanium clips applied with and without a 1-mm vascular cuff at physiologic and supraphysiologic pressures. An in vitro equine-vessel model was created to test clip occlusion strength. Ten-millimeter NPL and standard Ti clips were applied to veins (10 mm) and arteries (10, 6, and 5 mm) with and without a 1-mm cuff and tested until they held a pressure of 300 mm Hg (veins) or 760 mm Hg (arteries) for 2 minutes or leaked. The NPL clip was statistically more secure on 10-mm veins with and without a cuff, 10-mm arteries with and without a cuff, and 6-mm arteries with a cuff than was the Ti clip. Leaving a 1-mm cuff resulted in a statistically higher leak point in all vessels tested except the 6-mm arteries secured with the Ti clip. The NPL clip was more secure than the Ti clip on larger arteries and veins. A 1-mm vascular cuff enhances the security of both NPL and Ti clips in vessels of all sizes. The NPL clip is secure and reliable in securing both arteries and veins.

  6. The global percutaneous shuttling technique tip for arthroscopic rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Bryan G. Vopat

    2014-05-01

    Full Text Available Most arthroscopic rotator cuff repairs utilize suture passing devices placed through arthro- scopic cannulas. These devices are limited by the size of the passing device where the suture is passed through the tendon. An alternative technique has been used in the senior author’s practice for the past ten years, where sutures are placed through the rotator cuff tendon using percutaneous passing devices. This technique, dubbed the global percutaneous shuttling technique of rotator cuff repair, affords the placement of sutures from nearly any angle and location in the shoulder, and has the potential advantage of larger suture bites through the tendon edge. These advantages may increase the area of tendon available to compress to the rotator cuff footprint and improve tendon healing and outcomes. The aim of this study is to describe the global percutaneous shuttling (GPS technique and report our results using this method. The GPS technique can be used for any full thickness rotator cuff tear and is particularly useful for massive cuff tears with poor tissue quality. We recently followed up 22 patients with an average follow up of 32 months to validate its usefulness. American Shoulder and Elbow Surgeons scores improved significantly from 37 preoperatively to 90 postoperatively (P<0.0001. This data supports the use of the GPS technique for arthroscopic rotator cuff repair. Further biomechanical studies are currently being performed to assess the improvements in tendon footprint area with this technique.

  7. Changes in cuff pressure of endotracheal tube during laparoscopic and open abdominal surgery.

    Science.gov (United States)

    Yildirim, Zeynep Baysal; Uzunkoy, Ali; Cigdem, Ali; Ganidagli, Suleyman; Ozgonul, Abdullah

    2012-02-01

    The purpose of this study was to investigate endotracheal tube cuff pressure alteration in patients during laparoscopic cholecystectomy surgery. Forty patients with ASA I-II physical status, who were scheduled for elective laparoscopic (group I) or open abdominal surgery (group II) were enrolled in the study. Tracheal intubation was always performed by an experienced anesthesiologist. The endotracheal tube cuff was inflated with air through a 10-ml syringe. The cuff was connected to a manometer. The endotracheal cuff pressure was registered every 5 min after tracheal intubation. At the time of discharge from the Post-Anesthesia Care Unit (PACU) and 12 h after tracheal extubation, patients were asked about their laryngotracheal condition by an independent observer who was uninformed of the patient allocation groups. We investigated laryngotracheal complaints such as sore throat, dysphasia, and hoarseness. The endotracheal cuff pressures in group I were significantly higher than those in the group II at all time points studied (P pressures exceeded the critical pressure of 30 cmH(2)O after 5 min in the group I (intra-abdominal pneumoperitoneum was started). The incidence of sore throat was higher in group I than in group II in the PACU and at 12 h. This study indicates that the CO(2) pneumoperitoneum and Trendelenburg position used during laparoscopy increase endotracheal cuff pressure and lead to discomfort in the postoperative patient. Measurement of endotracheal cuff pressure is a simple and inexpensive procedure and should be applied in patients under going laparoscopic surgery.

  8. Production and post acceleration scheme for spiral

    International Nuclear Information System (INIS)

    Bibet, D.

    2001-01-01

    SPIRAL, the R.I.B. facility of GANIL uses heavy ion beams to produce radioactive atoms inside a thick target. Atoms are ionised in a compact permanent magnet ECR ion source. The compact cyclotron CIME accelerates the radioactive ions in an energy range from 1.7 to 25 MeV/u. The cyclotron acts as a mass separator with resolving power of 2500. Plastic scintillator and silicon detectors are used to tune the machine at a very low intensity. An overview of the facility, stable beam tests results and the R and D program will be presented. (authors)

  9. Controls and automation in the SPIRAL project

    International Nuclear Information System (INIS)

    Bothner, U.; Boulot, A.; Maherault, J.; Martial, L.

    1999-01-01

    The control and automation team of the R and D of Accelerator-Exotic Beam Department has had in the framework of SPIRAL collaboration the following tasks: 1. automation of the resonator high frequency equipment of the CIME cyclotron; 2. automation of the vacuum equipment, i.e. the low energy line (TBE), the CIME cyclotron, the low energy line (BE); 3. automation of load safety for power supply; 4. for each of these tasks a circuitry file based on the SCHEMA software has been worked out. The programs required in the automation of load safety for power supply (STEP5, PROTOOL, DESIGNER 4.1) were developed and implemented for PC

  10. Galaxy Zoo: dust in spiral galaxies star

    OpenAIRE

    Masters, Karen L.; Nichol, Robert; Bamford, Steven; Mosleh, Moein; Lintott, Chris J.; Andreescu, Dan; Edmondson, Edward M.; Keel, William C.; Murray, Phil; Raddick, M. Jordan; Schawinski, Kevin; Slosar, Anze; Szalay, Alexander S.; Thomas, Daniel; Vandenberg, Jan

    2010-01-01

    We investigate the effect of dust on spiral galaxies by measuring the inclination dependence of optical colours for 24 276 well-resolved Sloan Digital Sky Survey (SDSS) galaxies visually classified via the Galaxy Zoo project. We find clear trends of reddening with inclination which imply a total extinction from face-on to edge-on of 0.7, 0.6, 0.5 and 0.4 mag for the ugri passbands (estimating 0.3 mag of extinction in z band). We split the sample into ‘bulgy’ (early-type) and ‘discy’ (late-typ...

  11. The relevance of long head biceps degeneration in the presence of rotator cuff tears

    Directory of Open Access Journals (Sweden)

    Lakemeier Stefan

    2010-08-01

    Full Text Available Abstract Background Long head biceps (LHB degeneration in combination with rotator cuff tears can be a source of chronic shoulder pain. LHB tenotomy is an approved surgical procedure for pain reduction and improvement of joint function, however, the pathophysiology of LHB degeneration is not fully understood. In the literature, neoangiogenesis in tendon tissue has previously been shown to be associated with tendon degeneration. Vascular Endothelial Growth Factor (VEGF is an important inducer of neoangiogenesis. The hypotheses are first that an elevated VEGF expression and vessel density can be found in degenerated LHB tissue and second that there is a relation between VEGF expression, vessel density and the different types of rotator cuff tears. Methods LHB samples of 116 patients with degenerative rotator cuff tears were harvested during arthroscopic tenotomy. The samples were dehydrated and paraffin embedded. VEGF expression was determined using immunohistochemistry. Vessel density and vessel size were determined on Masson-Goldner stained tissue sections. On the basis of intraoperative findings, patients were assigned to 4 different groups (control group, partial thickness rotator cuff tear, full thickness rotator cuff tear and cuff arthropathy. Partial thickness rotator cuff tears were classified according to Ellman grade I-III, full thickness rotator cuff tears according to Bateman's classification (grade I-IV. The control group consisted of eight healthy tendon samples. Results VEGF expression in the LHB was significantly higher in the presence of rotator cuff tears than in healthy tendons (p Conclusion Elevated VEGF expression can be detected in degenerated LHB tissue. The quantity of VEGF expression and vessels are related to the extent of LHB degeneration.

  12. Dynamic Three-Dimensional Shoulder Mri during Active Motion for Investigation of Rotator Cuff Diseases.

    Directory of Open Access Journals (Sweden)

    Christine Tempelaere

    Full Text Available MRI is the standard methodology in diagnosis of rotator cuff diseases. However, many patients continue to have pain despite treatment, and MRI of a static unloaded shoulder seems insufficient for best diagnosis and treatment. This study evaluated if Dynamic MRI provides novel kinematic data that can be used to improve the understanding, diagnosis and best treatment of rotator cuff diseases.Dynamic MRI provided real-time 3D image series and was used to measure changes in the width of subacromial space, superior-inferior translation and anterior-posterior translation of the humeral head relative to the glenoid during active abduction. These measures were investigated for consistency with the rotator cuff diseases classifications from standard MRI.The study included: 4 shoulders with massive rotator cuff tears, 5 shoulders with an isolated full-thickness supraspinatus tear, 5 shoulders with tendinopathy and 6 normal shoulders. A change in the width of subacromial space greater than 4mm differentiated between rotator cuff diseases with tendon tears (massive cuff tears and supraspinatus tear and without tears (tendinopathy (p = 0.012. The range of the superior-inferior translation was higher in the massive cuff tears group (6.4mm than in normals (3.4mm (p = 0.02. The range of the anterior-posterior translation was higher in the massive cuff tears (9.2 mm and supraspinatus tear (9.3 mm shoulders compared to normals (3.5mm and tendinopathy (4.8mm shoulders (p = 0.05.The Dynamic MRI enabled a novel measure; 'Looseness', i.e. the translation of the humeral head on the glenoid during an abduction cycle. Looseness was better able at differentiating different forms of rotator cuff disease than a simple static measure of relative glenohumeral position.

  13. Dynamic Three-Dimensional Shoulder Mri during Active Motion for Investigation of Rotator Cuff Diseases.

    Science.gov (United States)

    Tempelaere, Christine; Pierrart, Jérome; Lefèvre-Colau, Marie-Martine; Vuillemin, Valérie; Cuénod, Charles-André; Hansen, Ulrich; Mir, Olivier; Skalli, Wafa; Gregory, Thomas

    2016-01-01

    MRI is the standard methodology in diagnosis of rotator cuff diseases. However, many patients continue to have pain despite treatment, and MRI of a static unloaded shoulder seems insufficient for best diagnosis and treatment. This study evaluated if Dynamic MRI provides novel kinematic data that can be used to improve the understanding, diagnosis and best treatment of rotator cuff diseases. Dynamic MRI provided real-time 3D image series and was used to measure changes in the width of subacromial space, superior-inferior translation and anterior-posterior translation of the humeral head relative to the glenoid during active abduction. These measures were investigated for consistency with the rotator cuff diseases classifications from standard MRI. The study included: 4 shoulders with massive rotator cuff tears, 5 shoulders with an isolated full-thickness supraspinatus tear, 5 shoulders with tendinopathy and 6 normal shoulders. A change in the width of subacromial space greater than 4mm differentiated between rotator cuff diseases with tendon tears (massive cuff tears and supraspinatus tear) and without tears (tendinopathy) (p = 0.012). The range of the superior-inferior translation was higher in the massive cuff tears group (6.4mm) than in normals (3.4mm) (p = 0.02). The range of the anterior-posterior translation was higher in the massive cuff tears (9.2 mm) and supraspinatus tear (9.3 mm) shoulders compared to normals (3.5mm) and tendinopathy (4.8mm) shoulders (p = 0.05). The Dynamic MRI enabled a novel measure; 'Looseness', i.e. the translation of the humeral head on the glenoid during an abduction cycle. Looseness was better able at differentiating different forms of rotator cuff disease than a simple static measure of relative glenohumeral position.

  14. Pulley lesions in rotator cuff tears: prevalence, etiology, and concomitant pathologies.

    Science.gov (United States)

    Hawi, Nael; Liodakis, Emmanouil; Garving, Christina; Habermeyer, Peter; Tauber, Mark

    2017-08-01

    This study aimed to demonstrate the prevalence of lesions in the biceps pulley complex in a representative, consecutive series of rotator cuff tears and rotator cuff interval treatments. We also analyzed associated tear pattern of rotator cuff injuries and superior labrum anterior-posterior (SLAP) lesions. We evaluated the relationships of these lesions to traumatic genesis and the prevalence of pulley lesions in revision cases. This retrospective study analyzed all pre- and intra-operative documentation on arthroscopic rotator cuff reconstructions and isolated pulley lesion treatments performed by a single surgeon over 2 consecutive years. According to Habermeyer et al., we classified cases into four groups, based on the presence of additional or related complete or partial rotator cuff tears, SLAP lesions, trauma, and primary or revision surgery. Among 382 patients with rotator cuff tears, 345 (90.3%) had an injured pulley system; 151 (43.8%) had partial tears of the rotator cuff; out of these, 106 (30.6%) were articular-sided. All of these articular-sided partial tears showed extension into the pulley complex. In 154 cases (44.6%), history of shoulder trauma was associated with the beginning of symptoms. In addition, concomitant SLAP lesions occurred in 25-62% of pulley lesions, correlating with the severity of pulley lesions. Among the 345 cases, there have been 32 (9.3%) revision cases where a pulley lesion was intra-operatively identified and addressed. Pulley complex lesions are present in 90.3% of surgically treated rotator cuff lesions, particularly in articular-sided injuries. In addition, we found a significant relationship between the incidence of SLAP lesions and the severity of pulley lesions. It seems reasonable to assume an important role of pulley system injuries in the pathogenesis of rotator cuff lesions.

  15. Endotracheal tubes and fluid aspiration: an in vitro evaluation of new cuff technologies.

    Science.gov (United States)

    Mariyaselvam, Maryanne Z; Marsh, Lucy L; Bamford, Sarah; Smith, Ann; Wise, Matt P; Williams, David W

    2017-03-04

    Aspiration of subglottic secretions past the endotracheal tube (ETT) cuff is a prerequisite for developing ventilator-associated pneumonia (VAP). Subglottic secretion drainage (SSD) ETTs reduce aspiration of subglottic secretions and have demonstrated lower VAP rates. We compared the performance of seven SSD ETTs against a non-SSD ETT in preventing aspiration below inflated cuffs. ETTs were positioned vertically in 2 cm diameter cylinders. Four ml of a standard microbial suspension was added above inflated cuffs. After 1 h, aspiration was measured and ETTs demonstrating no leakage were subjected to rotational movement and evaluation over 24 h. Collected aspirated fluid was used to inoculate agar media and incubated aerobically at 37 °C for 24 h. The aspiration rate, volume and number of microorganisms that leaked past the cuff was measured. Experiments were repeated (×10) for each type of ETT, with new ETTs used for each repeat. Best performing ETTs were then tested in five different cylinder diameters (1.6, 1.8, 2.0, 2.2 and 2.4 cm). Experiments were repeated as above using sterile water. Volume and time taken for aspiration past the cuff was measured. Experiments were repeated (×10) for each type of ETT. Results were analysed using non-parametric tests for repeated measures. The PneuX ETT prevented aspiration past the cuff in all experiments. All other ETTs allowed aspiration, with considerable variability in performance. The PneuX ETT was statistically superior in reducing aspiration compared to the SealGuard (p aspiration across the range of diameters compared to the SealGuard (p aspiration, relating to cuff material and design. Variability in performance was likely due to the random manner in which involutional folds form in the inflated ETT cuff. The PneuX ETT was the only ETT able to consistently prevent aspiration past the cuff in all experiments.

  16. Evaluation of the endotracheal tube cuff pressure resulting from four different methods of inflation in dogs.

    Science.gov (United States)

    Briganti, Angela; Portela, Diego A; Barsotti, Giovanni; Romano, Marta; Breghi, Gloria

    2012-09-01

    To evaluate the endotracheal tube cuff pressure achieved by four different inflation methods. Prospective clinical study. Eighty client owned dogs. After anaesthesia induction, endotracheal intubation was performed using plastic or silicone tubes. A clinician unaware of tube type inflated the cuff by simple digital palpation (method A), thereafter the cuff was deflated and inflated again by a second clinician who tried to reproduce a previously learned cuff pressure of between 19 and 24 mmHg (method B). During method C the cuff was inflated to the minimum occlusive volume at an airway pressure of 20 cm H(2) O, and in method D the cuff was incrementally deflated until an audible air leak could be heard from the oral cavity at an airway pressure of 25 cm H(2) O. For all the methods, an operator recorded the actual cuff pressure obtained using a manometer. Heart rate, respiratory rate and mean arterial pressure were monitored throughout the procedure. The mean inflation pressure for plastic tubes was 56 ± 28 mmHg for method A, 20 ± 9 mmHg for method B, 35 ± 32 mmHg for method C and 46 ± 39 mmHg for method D. Pressures using silicone tubes were significantly higher than for plastic tubes, the mean registered pressures being 79 ± 39, 33 ± 16, 77 ± 50 and 92 ± 56 mmHg for methods A, B, C and D. None of the methods evaluated in this study can be considered effective for inflating the endotracheal tube cuff to within the optimal range when using silicone tubes. Direct measurement of the cuff pressure with a manometer is therefore recommended. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  17. Sensory adaptation to electrical stimulation of the somatosensory nerves.

    Science.gov (United States)

    Graczyk, Emily Lauren; Delhaye, Benoit; Schiefer, Matthew A; Bensmaia, Sliman J; Tyler, Dustin J

    2018-03-19

    Sensory systems adapt their sensitivity to ambient stimulation levels to improve their responsiveness to changes in stimulation. The sense of touch is also subject to adaptation, as evidenced by the desensitization produced by prolonged vibratory stimulation of the skin. Electrical stimulation of nerves elicits tactile sensations that can convey feedback for bionic limbs. In this study, we investigate whether artificial touch is also subject to adaptation, despite the fact that the peripheral mechanotransducers are bypassed. Approach: Using well-established psychophysical paradigms, we characterize the time course and magnitude of sensory adaptation caused by extended electrical stimulation of the residual somatosensory nerves in three human amputees implanted with cuff electrodes. Main results: We find that electrical stimulation of the nerve also induces perceptual adaptation that recovers after cessation of the stimulus. The time course and magnitude of electrically-induced adaptation are equivalent to their mechanically-induced counterparts. Significance: We conclude that, in natural touch, the process of mechanotransduction is not required for adaptation, and artificial touch naturally experiences adaptation-induced adjustments of the dynamic range of sensations. Further, as it does for native hands, adaptation confers to bionic hands enhanced sensitivity to changes in stimulation and thus a more natural sensory experience. . Creative Commons Attribution license.

  18. Isolated optic nerve pseudotumour

    International Nuclear Information System (INIS)

    Patankar, T.; Prasad, S.; Krishnan, A.; Laxminarayan, R.

    2000-01-01

    Isolated optic nerve involvement by the idiopathic inflammatory process is a rare finding and very few reports are available. Here a case of an isolated optic nerve inflammatory pseudotumour presenting with gradually progressive unilateral loss of vision is described. It showed dramatic response to a trial of steroids and its differential diagnoses are discussed. Copyright (1999) Blackwell Science Pty Ltd

  19. Diabetic Nerve Problems

    Science.gov (United States)

    ... vessels that bring oxygen to your nerves. Damaged nerves may stop sending messages, or may send messages slowly or at the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get it. Symptoms may include Numbness in your ...

  20. Influence of cuff material on blood flow restriction stimulus in the upper body.

    Science.gov (United States)

    Buckner, Samuel L; Dankel, Scott J; Counts, Brittany R; Jessee, Matthew B; Mouser, J Grant; Mattocks, Kevin T; Laurentino, Gilberto C; Abe, Takashi; Loenneke, Jeremy P

    2017-01-01

    The purpose of this study was to examine the acute skeletal muscle and perceptual responses to blood flow restriction (BFR) exercise to failure between narrow nylon and elastic inflatable cuffs at rest and during exercise. Torque and muscle thickness was measured pre, post, and 5, 20, 40, and 60 min post-exercise with muscle activation being measured throughout exercise. Resting arterial occlusion pressure was different between the nylon [139 (14) mmHg] and elastic [246 (71) mmHg, p material but similar width resulted in the same acute muscular response when the cuffs were inflated to a pressure relative to each individual cuff.

  1. Functional Recovery After Rotator Cuff Repair: The Role of Biceps Surgery.

    Science.gov (United States)

    Gialanella, Bernardo; Grossetti, Francesco; Mazza, Marina; Danna, Laura; Comini, Laura

    2018-01-01

    Surgical cuff repair is recommended in a full-thickness rotator cuff tear when nonoperative treatment fails. Surgical cuff repair can include surgery of the long head of the biceps when concomitant biceps pathology is present. However, the studies executed up till now have not yet clearly defined if additional biceps surgery affects the shoulder functionality in patients who underwent rotator cuff repair. To verify if the concomitant biceps surgery prejudices shoulder functionality during the short-term period in rotator cuff repair patients. Prospective and observational study. Outpatient service for rehabilitation. Ninety-three consecutive patients who had undergone surgery for full-thickness symptomatic rotator cuff tear were enrolled for rehabilitation; 25 underwent rotator cuff repair and tendon biceps surgery (ABS), while 68 underwent rotator cuff repair only (RCR). Motor rehabilitation after surgical treatment of rotator cuff repair. Final Constant score was used as primary outcome measure, and efficiency and effectiveness in Constant score were evaluated both at the end of the last cycle of rehabilitation and 6 mo postsurgery. Patients with rotator cuff repair and tendon biceps surgery had lower final scores (36.5 ± 12.0 vs 49.3 ± 13.0, P < .001), effectiveness (40.6 ± 18.0 vs 60.3 ± 20.0, P < .001), and efficiency (0.80 ± 0.5 vs 1.19 ± 0.6, P = .010) in Constant score than those with rotator cuff repair only at the end of rehabilitation. Moreover, they had a lower final score (53.3 ± 14.0 vs 64.5 ± 10.0, P < .001) and effectiveness (66.9 ± 21.0 vs 84.0 ± 16, P < .001) in Constant score 6 mo postsurgery. Gender was a determinant of final score, efficiency, and effectiveness in Constant score at the end of the rehabilitation period, while tendon biceps surgery was a determinant of final score and effectiveness in Constant score at the end of the rehabilitation period and at 6

  2. MAGNETIC RESONANCE IMAGING EVALUATION OF ROTATOR CUFF IMPINGEMENT

    Directory of Open Access Journals (Sweden)

    Chandrakanth K. S

    2017-06-01

    Full Text Available BACKGROUND Shoulder pain is a common clinical problem. Impingement syndrome of the shoulder is believed to be the most common cause of shoulder pain. The term ‘impingement syndrome’ was first used by Neer to describe a condition of shoulder pain associated with chronic bursitis and partial thickness tear of Rotator Cuff (RC. The incidence of Rotator Cuff (RC tear is estimated to be about 20.7% in the general population. This study is intended to analyse various extrinsic and intrinsic causes of shoulder impingement. MATERIALS AND METHODS 110 consecutive patients referred for MRI with clinical suspicion of shoulder impingement were prospectively studied. All the patients were evaluated for Rotator Cuff (RC degeneration and various extrinsic factors that lead to degeneration like acromial shape, down-sloping acromion, Acromioclavicular (AC joint degeneration and acromial enthesophyte. Intrinsic factors like degeneration and its correlation with age of the patients were evaluated. RESULTS Of the total 110 patients, 19 (17.3% patients had FT RC tear and 31 (28.2% had PT (both bursal and articular surface tears. There was no statistically significant correlation (p=0.76 between acromion types and RC tear. Down-sloping acromion and enthesophytes had statistically significant association with RC tear (p=0.008 and 0.008, respectively. Statistically significant (0.008 correlation between the severity of AC joint degeneration and RC tears was noted. AC joint degeneration and RC pathologies also showed a correlation with the age of the patients with p values of <0.001 and 0.001, respectively. CONCLUSION No statistically significant correlation between RC pathologies with hooked acromion was found, that makes the role played by hooked acromion in FT RC tear questionable. AC joint degeneration association with RC tear is due to the association of both RC tear and AC joint degeneration with age of the patient. Down-sloping acromion, AC joint degeneration

  3. 2D array based on fermat spiral

    Science.gov (United States)

    Martínez, O.; Martín, C. J.; Godoy, G.; Ullate, L. G.

    2010-01-01

    The main challenge faced by 3D ultrasonic imaging with 2D array transducer is the large number of elements required to achieve an acceptable level of quality in the images. Therefore, the optimization of the array layout to reduce the number of active elements in the aperture has been a research topic in the last years. Nowadays, CMUT array technology has made viable the production of 2D arrays with larger flexibility on elements size, shape and position. This is opening new options in 2D array design, allowing to revise as viable alternatives others layouts that had been studied in the past, like circular and Archimedes spiral layout. In this work the problem of designing an imaging system array with a diameter of 60 λ and a limited number of elements using the Fermat spiral layout has been studied. This study has been done for two different numbers of electronic channels (N = 128 and N = 256). As summary, a general discussion of the results and the most interesting cases are presented.

  4. Spiral-shaped reactor for water disinfection

    KAUST Repository

    Soukane, Sofiane

    2016-04-20

    Chlorine-based processes are still widely used for water disinfection. The disinfection process for municipal water consumption is usually carried out in large tanks, specifically designed to verify several hydraulic and disinfection criteria. The hydrodynamic behavior of contact tanks of different shapes, each with an approximate total volume of 50,000 m3, was analyzed by solving turbulent momentum transport equations with a computational fluid dynamics code, namely ANSYS fluent. Numerical experiments of a tracer pulse were performed for each design to generate flow through curves and investigate species residence time distribution for different inlet flow rates, ranging from 3 to 12 m3 s−1. A new nature-inspired Conch tank design whose shape follows an Archimedean spiral was then developed. The spiral design is shown to strongly outperform the other tanks’ designs for all the selected plug flow criteria with an enhancement in efficiency, less short circuiting, and an order of magnitude improvement in mixing and dispersion. Moreover, following the intensification philosophy, after 50% reduction in its size, the new design retains its properties and still gives far better results than the classical shapes.

  5. A phenomenological theory for polarization flop in spiral multiferroic ...

    Indian Academy of Sciences (India)

    driven polarization flop in TbMnO3. The Néel wall-like magnetic structure in spiral multiferroics induces a space-dependent internal magnetic field which exerts a torque on spins to rotate bc-spiral to abspiral. The external magnetic field is argued ...

  6. A phenomenological theory for polarization flop in spiral multiferroic ...

    Indian Academy of Sciences (India)

    a space-dependent internal magnetic field which exerts a torque on spins to rotate bc-spiral to ab- spiral. The external ... Fv; 75.85.+t. Electric control of magnetization and magnetic control of polarization have been long ... divergence of magnetization, an internal field is induced which has important physical. Figure 1. ab ...

  7. On galaxy spiral arms' nature as revealed by rotation frequencies

    NARCIS (Netherlands)

    Roca-Fabrega, Santi; Valenzuela, Octavio; Figueras, Francesca; Romero-Gomez, Merce; Velazquez, Hector; Antoja Castelltort, Teresa; Pichardo, Barbara

    2013-01-01

    High-resolution N-body simulations using different codes and initial condition techniques reveal two different behaviours for the rotation frequency of transient spiral arms like structures. Whereas unbarred discs present spiral arms nearly corotating with disc particles, strong barred models

  8. Star formation and the surface brightness of spiral galaxies

    International Nuclear Information System (INIS)

    Phillipps, S.; Disney, M.

    1985-01-01

    The (blue) surface brightness of spiral galaxies is significantly correlated with their Hα linewidth. This can be most plausibly interpreted as a correlation of surface brightness with star formation rate. There is also a significant difference in surface brightness between galaxies forming stars in a grand design spiral pattern and those with floc star formation regions. (author)

  9. Up the Down Spiral with English: Guidelines, Project Insight.

    Science.gov (United States)

    Catholic Board of Education, Diocese of Cleveland, OH.

    This curriculum guide presents the philosophy, objectives, and processes which unify a student-centered English program based on Jerome Bruner's concept of the spiral curriculum. To illustrate the spiraling of the learning process (i.e., engagement, perception, interpretation, evaluation, and personal integration), the theme of "hero" is traced…

  10. The cold interstellar medium - An HI view of spiral galaxies

    NARCIS (Netherlands)

    Sancisi, R; Bender, R; Davies, RL

    1996-01-01

    An HI view of spiral galaxies is presented. In the first part the standard picture of isolated, normal spiral galaxies is briefly reviewed. In the second part attention is drawn to all those phenomena, such as tidal interactions, accretion and mergers, that depend on the galaxy environment and seem

  11. Horseradish peroxidase dye tracing and embryonic statoacoustic ganglion cell transplantation in the rat auditory nerve trunk.

    Science.gov (United States)

    Palmgren, Björn; Jin, Zhe; Jiao, Yu; Kostyszyn, Beata; Olivius, Petri

    2011-03-04

    At present severe damage to hair cells and sensory neurons in the inner ear results in non-treatable auditory disorders. Cell implantation is a potential treatment for various neurological disorders and has already been used in clinical practice. In the inner ear, delivery of therapeutic substances including neurotrophic factors and stem cells provide strategies that in the future may ameliorate or restore hearing impairment. In order to describe a surgical auditory nerve trunk approach, in the present paper we injected the neuronal tracer horseradish peroxidase (HRP) into the central part of the nerve by an intra cranial approach. We further evaluated the applicability of the present approach by implanting statoacoustic ganglion (SAG) cells into the same location of the auditory nerve in normal hearing rats or animals deafened by application of β-bungarotoxin to the round window niche. The HRP results illustrate labeling in the cochlear nucleus in the brain stem as well as peripherally in the spiral ganglion neurons in the cochlea. The transplanted SAGs were observed within the auditory nerve trunk but no more peripheral than the CNS-PNS transitional zone. Interestingly, the auditory nerve injection did not impair auditory function, as evidenced by the auditory brainstem response. The present findings illustrate that an auditory nerve trunk approach may well access the entire auditory nerve and does not compromise auditory function. We suggest that such an approach might compose a suitable route for cell transplantation into this sensory cranial nerve. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Neurophysiological approach to disorders of peripheral nerve

    DEFF Research Database (Denmark)

    Crone, Clarissa; Krarup, Christian

    2013-01-01

    Disorders of the peripheral nerve system (PNS) are heterogeneous and may involve motor fibers, sensory fibers, small myelinated and unmyelinated fibers and autonomic nerve fibers, with variable anatomical distribution (single nerves, several different nerves, symmetrical affection of all nerves...

  13. Repair of rotator cuff injuries using different composites.

    Science.gov (United States)

    Lopiz, Y; Arvinius, C; García-Fernández, C; Rodriguez-Bobada, M C; González-López, P; Civantos, A; Marco, F

    Rotator cuff repairs have shown a high level of re-ruptures. It is hypothesised that the use of rhBMP-2 in a carrier could improve the biomechanical and histological properties of the repair. Controlled experimental study conducted on 40 rats with section and repair of the supraspinatus tendon and randomisation to one of five groups: Group 1 (control) only suture; Group 2 (double control), suture and alginate-chitin carrier; Group 3 (alginate-control), the rhBMP-2 was added to the alginate; Group 4 (chitin-control) application of the rhBMP-2 to the chitin, and Group 5 (double sample): The two components of the carrier (alginate and chitin) have rhBMP-2. A biomechanical and histological analysis was performed at 4 weeks. A gap was observed in all cases 4 weeks after supraspinatus detachment. The re-rupture rate was 7.5%, with 20% of them in the control-alginate Group. Histologically the best results were obtained in the double sample group: 4.5 (3.3-5.0). Double sample were also able to support higher loads to failure: 62.9N (59.8 to 69.4) with lower rigidity 12.7 (9.7 to 15.9). The use of alginate-chitin carrier with rhBMP-2 improves the biomechanical and histological properties of the repair site in a chronic rotator cuff tear. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Cuff inflation during ambulatory blood pressure monitoring and heart rate

    Directory of Open Access Journals (Sweden)

    Mia Skov-Madsen

    2008-11-01

    Full Text Available Mia Skov-Madsen, My Svensson, Jeppe Hagstrup ChristensenDepartment of Nephrology, Aarhus University Hospital, Aalborg, DenmarkIntroduction: Twenty four-hour ambulatory blood pressure monitoring is a clinically validated procedure in evaluation of blood pressure (BP. We hypothesised that the discomfort during cuff inflation would increase the heart rate (HR measured with 24-h ambulatory BP monitoring compared to a following HR measurement with a 24-h Holter monitor.Methods: The study population (n = 56 were recruited from the outpatient’s clinic at the Department of Nephrology, Aalborg Hospital, Aarhus University Hospital at Aalborg, Denmark. All the patients had chronic kidney disease (CKD. We compared HR measured with a 24-h Holter monitor with a following HR measured by a 24-h ambulatory BP monitoring.Results: We found a highly significant correlation between the HR measured with the Holter monitor and HR measured with 24-h ambulatory blood pressure monitoring (r = 0.77, p < 0.001. Using the Bland-Altman plot, the mean difference in HR was only 0.5 beat/min during 24 hours with acceptable limits of agreement for both high and low HR levels. Dividing the patients into groups according to betablocker treatment, body mass index, age, sex, angiotensin-converting enzyme inhibitor treatment, statins treatment, diuretic treatment, or calcium channel blocker treatment revealed similar results as described above.Conclusion: The results indicate that the discomfort induced by cuff inflation during 24-h ambulatory BP monitoring does not increase HR. Thus, 24-h ambulatory BP monitoring may be a reliable measurement of the BP among people with CKD.Keywords: ambulatory blood pressure monitoring, Holter monitoring, heart rate, chronic kidney disease, hypertension

  15. Rotator cuff-quality of life scale: adaptation to Turkish.

    Science.gov (United States)

    Gunes, Taner; Erkorkmaz, Unal; Kurnaz, Recep; Bilgic, Erkal; Asci, Murat

    2015-02-01

    The adaptation of scales to the native language and cultural setting of the patient is essential for obtaining more reliable results in scientific studies. In this study, the rotator cuff-quality of life scale (RC-QoLS) was translated into Turkish, and validity and reliability testing was performed on the scale. The scale was first translated into Turkish and then from Turkish to English by another language specialist. Subsequently, the two translations were evaluated by two orthopaedic surgeons who had comprehensive knowledge of English to create the final Turkish version of RC-QoLS. The scale was used for the assessment of 54 patients (average age 56 years) with rotator cuff tear scheduled for surgery. The scale was completed by each patient two times with 1-week interval. The Cronbach's alpha coefficients ranged between 0.895 and 0.980 and intraclass correlation coefficients ranged between 0.807 and 0.976, this rendered all domains reliable. The scale gave results very near to those obtained by the original questionnaire with respect to the constructed validity and internal consistency as well as domain relationships. In general, the Turkish version of the RC-QoLS is a valid and reliable test with high differentiating power that may be used in the evaluation the quality of life of patients with RC tear in patients who are native Turkish speaker. The use of the Turkish version of RC-QoLS may contribute to the making of a more reliable evaluation in the studies on RC problems in the Turkish society.

  16. Topographic Beta Spiral and Onshore Intrusion of the Kuroshio Current

    Science.gov (United States)

    Yang, De-Zhou; Huang, Rui Xin; Yin, Bao-shu; Feng, Xing-Ru; Chen, Hai-ying; Qi, Ji-Feng; Xu, Ling-jing; Shi, Yun-long; Cui, Xuan; Gao, Guan-Dong; Benthuysen, Jessica A.

    2018-01-01

    The Kuroshio intrusion plays a vitally important role in carrying nutrients to marginal seas. However, the key mechanism leading to the Kuroshio intrusion remains unclear. In this study we postulate a mechanism: when the Kuroshio runs onto steep topography northeast of Taiwan, the strong inertia gives rise to upwelling over topography, leading to a left-hand spiral in the stratified ocean. This is called the topographic beta spiral, which is a major player regulating the Kuroshio intrusion; this spiral can be inferred from hydrographic surveys. In the world oceans, the topographic beta spirals can be induced by upwelling generated by strong currents running onto steep topography. This is a vital mechanism regulating onshore intruding flow and the cross-shelf transport of energy and nutrients from the Kuroshio Current to the East China Sea. This topographic beta spiral reveals a long-term missing link between the oceanic general circulation theory and shelf dynamic theory.

  17. Spatial and mass distributions of molecular clouds and spiral structure

    International Nuclear Information System (INIS)

    Kwan, J.; Valdes, F.; National Optical Astronomy Observatories, Tucson, AZ)

    1987-01-01

    The growth of molecular clouds resulting from cloud-cloud collisions and coalescence in the Galactic ring between 4 and 8 kpc are modeled, taking into account the presence of a spiral potential and the mutual cloud-cloud gravitational attraction. The mean lifetime of molecular clouds is determined to be about 200 million years. The clouds are present in both spiral arm and interarm regions, but a spiral pattern in their spatial distribution is clearly discernible, with the more massive clouds showing a stronger correlation with the spiral arms. As viewed from within the Galactic disk, however, it is very difficult to ascertain that the molecular cloud distribution in longitude-velocity space has a spiral pattern. 19 references

  18. Some statistical properties of spiral galaxies along the Hubble sequence

    Science.gov (United States)

    Ma, Jun; Zhao, Jun-liang; Zhang, Fei-peng; Peng, Qiu-he

    A statistical study has been made for the variations along the Hubble sequence, os such parameters as the degree of tightness of winding of spiral arm λ, the pitch angle μ, the flatness of the disk H/ D25 and the thickness H along the Hubble sequence for 365 spiral galaxies published in A&Ap Supplement Series. The mean values of these quantities for the various Hubble types have been obtained for the first time. The results of the statistics show clearly 1) that the Hubble classification of spiral galaxies is one which has only a qualitative and statistical significance, and 2) that the dispersion relation in the density wave theory is valid for most spiral galaxies, i.e., the arms of most spiral galaxies satisfy the requirements of being tightly wound.

  19. The Effects of Spiral Taping Treatment on Low Back Pain

    Directory of Open Access Journals (Sweden)

    Hwang Jae-Ok

    2006-02-01

    Full Text Available Objective : The purpose of this study is to estimate the effects of spiral taping treatment on low back pain. Methods : 420 low back pain patients were treated with spiral taping or spiral taping plus herbal medicine, and no other treatments such as acupuncture, herbal acupuncture, and chiropractic therapy were added. We evaluated the improvement by physical examination and pain. Results : 364 patients felt no pain or inconvenience of daily life and 43 patients showed improvement of pain or symptom after 1 month of treatment. 13 patients showed same pain with before treatment. Conclusions : These results suggest spiral taping treatments contribute to the improvement of low back pain. Further study is needed for the confirmation of this effect of spiral taping treatments on low back pain.

  20. Imaging of head and neck tumors -- methods: CT, spiral-CT, multislice-spiral-CT

    Energy Technology Data Exchange (ETDEWEB)

    Baum, Ulrich E-mail: baum@idr.med.uni-erlangen.de; Greess, Holger; Lell, Michael; Noemayr, Anton; Lenz, Martin

    2000-03-01

    Spiral-CT is standard for imaging neck tumors. In correspondence with other groups we routinely use spiral-CT with thin slices (3 mm), a pitch of 1.3-1.5 and an overlapping reconstruction increment (2-3 mm). In patients with dental fillings a short additional spiral parallel to the corpus of the mandible reduces artifacts behind the dental arches and improves the diagnostic value of CT. For the assessment of the base of the skull, the orbital floor, the palate and paranasal sinuses an additional examination in the coronal plane is helpful. Secondary coronal reconstructions of axial scans are helpful in the evaluation of the crossing of the midline by small tumors of the tongue base or palate. For an optimal vascular or tissue contrast a sufficient volume of contrast medium and a start delay greater than 70-80 s are necessary. In our opinion the best results can be achieved with a volume of 150 ml, a flow of 2.5 ml/s and a start delay of 80 s. Dynamic enhanced CT is only necessary in some special cases. There is clear indication for dynamic enhanced CT where a glomus tumor is suspected. Additional functional CT imaging during i-phonation and/or Valsalva's maneuver are of great importance to prove vocal cords mobility. Therefore, imaging during i-phonation is an elemental part of every thorough examination of the hypopharynx and larynx region. Multislice-spiral-CT allows almost isotropic imaging of the head and neck region and improves the assessment of tumor spread and lymph node metastases in arbitrary oblique planes. Thin structures (the base of the skull, the orbital floor, the hard palate) as well as the floor of the mouth can be evaluated sufficiently with multiplanar reformations. Usually, additional coronal scanning is not necessary with multislice-spiral-CT. Multislice-spiral-CT is especially advantageous in defining the critical relationships of tumor and lymph node metastases and for functional imaging of the hypopharynx and larynx not only in the

  1. Imaging of head and neck tumors -- methods: CT, spiral-CT, multislice-spiral-CT

    International Nuclear Information System (INIS)

    Baum, Ulrich; Greess, Holger; Lell, Michael; Noemayr, Anton; Lenz, Martin

    2000-01-01

    Spiral-CT is standard for imaging neck tumors. In correspondence with other groups we routinely use spiral-CT with thin slices (3 mm), a pitch of 1.3-1.5 and an overlapping reconstruction increment (2-3 mm). In patients with dental fillings a short additional spiral parallel to the corpus of the mandible reduces artifacts behind the dental arches and improves the diagnostic value of CT. For the assessment of the base of the skull, the orbital floor, the palate and paranasal sinuses an additional examination in the coronal plane is helpful. Secondary coronal reconstructions of axial scans are helpful in the evaluation of the crossing of the midline by small tumors of the tongue base or palate. For an optimal vascular or tissue contrast a sufficient volume of contrast medium and a start delay greater than 70-80 s are necessary. In our opinion the best results can be achieved with a volume of 150 ml, a flow of 2.5 ml/s and a start delay of 80 s. Dynamic enhanced CT is only necessary in some special cases. There is clear indication for dynamic enhanced CT where a glomus tumor is suspected. Additional functional CT imaging during i-phonation and/or Valsalva's maneuver are of great importance to prove vocal cords mobility. Therefore, imaging during i-phonation is an elemental part of every thorough examination of the hypopharynx and larynx region. Multislice-spiral-CT allows almost isotropic imaging of the head and neck region and improves the assessment of tumor spread and lymph node metastases in arbitrary oblique planes. Thin structures (the base of the skull, the orbital floor, the hard palate) as well as the floor of the mouth can be evaluated sufficiently with multiplanar reformations. Usually, additional coronal scanning is not necessary with multislice-spiral-CT. Multislice-spiral-CT is especially advantageous in defining the critical relationships of tumor and lymph node metastases and for functional imaging of the hypopharynx and larynx not only in the

  2. MEASUREMENT OF ENDOTRACHEAL TUBE CUFF PRESSURE IN MECHANICALLYVENTILATED PATIENTS ON ARRIVAL TO INTENSIVE CARE UNIT - A CROSS-SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Arun Kumar Ajjappa

    2017-04-01

    Full Text Available BACKGROUND The monitoring of Endotracheal Tube (ETT cuff pressure in intubated patients on arrival to intensive care unit is very essential. The cuff pressure must be within an optimal range of 20-30cm H2O ensuring ventilation with no complications related to cuff overinflation and underinflation. This can be measured with a cuff pressure manometer. The aim of the study is to measure the endotracheal tube cuff pressure in patients on arrival to intensive care unit and to identify prevalence of endotracheal cuff underinflation and overinflation. MATERIALS AND METHODS A cross-sectional study was done on mechanically-ventilated patients who were intubated in casualty (emergency department on arrival to intensive care unit in S.S. Institute of Medical Sciences and Research Centre, Davangere. About 50 critically-ill patients intubated with a high volume, low pressure endotracheal tube were included in the study. An analogue manometer was used to measure the endotracheal tube cuff pressure. It was compared with the recommended level. The settings of mechanical ventilation, endotracheal tube size and peak airway pressure were recorded. RESULTS It was found that the mean cuff pressure was 64.10 cm of H2O with a standard deviation of 32.049. Of the measured cuff pressures, only 2% had pressures within an optimal range (20-30cm of H2O. 88% had cuff pressures more than 30cm of H2O. The mean peak airway pressure found to be 20.50cm of H2O with a Standard Deviation (SD of 5.064. CONCLUSION This study is done to emphasise the importance of cuff pressure measurement in all mechanically-ventilated patients as cuff pressure is found to be high in most of the patients admitted to intensive care unit. Complications of overinflation and underinflation can only be prevented if the acceptable cuff pressures are achieved.

  3. Cuff size influences blood pressure measurement in obese children and adolescents

    DEFF Research Database (Denmark)

    Muhamed, P. K.; Olsen, M. H.; Holm, Jens-Christian

    2016-01-01

    Introduction: Recently, we established that a group ofobese children and adolescents had a higher blood pressure(BP) than a healthy control group. In the present study, weinvestigate whether the higher BP in the obese group wasinfluenced by BP cuff sizes.Methods: A total of 104 obese patients aged...... sizes had a significant impact on BP measurements.Despite the influence of cuff size, multiple regressionanalyses revealed that systolic BP was 68 mmHg higherand diastolic BP 32 mmHg higher in the obese groupthan in the control group. A step function, i.e. a sudden fallin BP, was seen at the point...... of switching from small to mediumcuff size in the control group, which suggests that systolicBP was overestimated when using small cuff size andunderestimated when using medium cuff size in subjectswith an AC near 23 cm.Conclusions: BP was higher in the obese group than inthe control group although BP...

  4. A Method to Automate Identification of Spiral Arms in Galaxies

    Science.gov (United States)

    Lacey, Christina K.; Mercer, K.

    2014-01-01

    We present our preliminary results in identifying the spiral arms of NGC 6946 using a nearest-neighbors analysis. NGC 6946 is grand design spiral galaxy with well-defined arms. The spiral arms were previously identified in an Hα image and traced out by Matonick, D. et al., ApJS, 113, 333, (1997) by visual inspection. We want to develop a computer algorithm that will identify the spiral arms automatically. Once the spiral arms have been found digitally, we can use this information to compare the spiral arms with the locations of compact objects such as supernova remnants and perform statistical tests, for example, to determine if the supernova remnants are associated with the spiral arms. We are using the publicly available program PyFITS, a development project of the Science Software Branch at the Space Telescope Science Institute (STScI) that is available for software download from STScI, to perform a computer-based image analysis. We have written python macros that interact with the already written image manipulation and display features of PyFITS to perform the image analysis and implement a nearest-neighbors algorithm to identify and link the centers of the high emission regions from the spiral arm regions. Our code currently identifies the centers of the high emission regions, but more work is needed to link up these sites and draw out the spiral arms. Future work includes improving the code to better identify spiral arms and converting the code to work on the Astropy, a community-developed core Python package for Astronomy (Robitaille, T. P., et al. A&A 558, A33, 2013).

  5. [A design and study of a novel electronic device for cuff-pressure monitoring].

    Science.gov (United States)

    Wang, Shupeng; Li, Wei; Li, Wen; Song, Dejing; Chen, Desheng; Duan, Jun; Li, Chen; Li, Gang

    2017-06-01

    To design a novel electronic device for measuring the pressure in the cuff of the artificial airway; and to study the advantage of this device on continuous and intermittent cuff pressure monitoring. (1) a portable electronic device for cuff pressure measurement was invented, which could turn pressure signal into electrical signal through a pressure transducer. Meantime, it was possible to avoid pressure leak from the joint and the inside of the apparatus by modified Luer taper and sophisticated design. If the cuff pressure was out of the normal range, the apparatus could release a sound and light alarm. (2) Six traditional mechanical manometers were used to determine the cuff pressure in 6 tracheal tubes. The cuff pressure was maintain at 30 cmH 2 O (1 cmH 2 O = 0.098 kPa) by the manometer first, and repeated every 30 seconds for 4 times. (3) Study of continuous cuff pressure monitoring: We used a random number generator to randomize 6 tracheal tubes, 6 mechanical manometers and 6 our products by number 1-6, which has the same number of a group. Every group was further randomized into two balanced groups, one group used the mechanical manometer first, and the other used our product first. The baseline pressure was 30 cmH 2 O, measurement was performed every 4 hours for 6 times. When traditional mechanical manometer was used for cuff pressure monitoring, cuff pressure was decreased by an average of 2.9 cmH 2 O for each measurement (F = 728.2, P = 0.000). In study of continually monitoring, at each monitoring point, the pressure measured by electronic manometer was higher than the mechanical manometer. All the pressures measured by mechanical manometer were dropped below 20 cmH 2 O at 8th hour, and there was no pressure decrease below 20 cmH 2 O measured by electronic manometer in 24 hours by contrast. In study of intermittent monitoring, the same result was found. The pressure was dropped significantly with time when measured by mechanical manometer (F = 61.795, P

  6. Endotracheal Tube Cuff Pressures in Patients Intubated Prior to Helicopter EMS Transport

    Directory of Open Access Journals (Sweden)

    Joseph Tennyson

    2016-11-01

    Full Text Available Introduction Endotracheal intubation is a common intervention in critical care patients undergoing helicopter emergency medical services (HEMS transportation. Measurement of endotracheal tube (ETT cuff pressures is not common practice in patients referred to our service. Animal studies have demonstrated an association between the pressure of the ETT cuff on the tracheal mucosa and decreased blood flow leading to mucosal ischemia and scarring. Cuff pressures greater than 30 cmH2O impede mucosal capillary blood flow. Multiple prior studies have recommended 30 cmH2O as the maximum safe cuff inflation pressure. This study sought to evaluate the inflation pressures in ETT cuffs of patients presenting to HEMS. Methods We enrolled a convenience sample of patients presenting to UMass Memorial LifeFlight who were intubated by the sending facility or emergency medical services (EMS agency. Flight crews measured the ETT cuff pressures using a commercially available device. Those patients intubated by the flight crew were excluded from this analysis as the cuff was inflated with the manometer to a standardized pressure. Crews logged the results on a research form, and we analyzed the data using Microsoft Excel and an online statistical analysis tool. Results We analyzed data for 55 patients. There was a mean age of 57 years (range 18–90. The mean ETT cuff pressure was 70 (95% CI= [61–80] cmH2O. The mean lies 40 cmH2O above the maximum accepted value of 30 cmH2O (p120 cmH2O, the maximum pressure on the analog gauge. Conclusion Patients presenting to HEMS after intubation by the referral agency (EMS or hospital have ETT cuffs inflated to pressures that are, on average, more than double the recommended maximum. These patients are at risk for tracheal mucosal injury and scarring from decreased mucosal capillary blood flow. Hospital and EMS providers should use ETT cuff manometry to ensure that they inflate ETT cuffs to safe pressures.

  7. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    International Nuclear Information System (INIS)

    Zbojniewicz, Andrew M.; Emery, Kathleen H.; Maeder, Matthew E.; Salisbury, Shelia R.

    2014-01-01

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  8. Rotator cuff tears in children and adolescents: experience at a large pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Zbojniewicz, Andrew M.; Emery, Kathleen H. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Maeder, Matthew E. [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States); Lenox Hill Hospital, Department of Radiology, New York, NY (United States); Salisbury, Shelia R. [University of Cincinnati College of Medicine, Division of Biostatistics and Epidemiology, Cincinnati Children' s Hospital Medical Center, Cincinnati, OH (United States)

    2014-06-15

    Prior literature, limited to small case series and case reports, suggests that rotator cuff tears are rare in adolescents. However, we have identified rotator cuff tears in numerous children and adolescents who have undergone shoulder MRI evaluation. The purpose of this study is to describe the prevalence and characteristics of rotator cuff tears in children and adolescents referred for MRI evaluation of the shoulder at a large pediatric hospital and to correlate the presence of rotator cuff tears with concurrent labral pathology, skeletal maturity and patient activity and outcomes. We reviewed reports from 455 consecutive non-contrast MRI and magnetic resonance arthrogram examinations of the shoulder performed during a 2-year period, and following exclusions we yielded 205 examinations in 201 patients (ages 8-18 years; 75 girls, 126 boys). Rotator cuff tears were classified by tendon involved, tear thickness (partial or full), surface and location of tear (when partial) and presence of delamination. We recorded concurrent labral pathology when present. Physeal patency of the proximal humerus was considered open, closing or closed. Statistical analysis was performed to evaluate for a relationship between rotator cuff tears and degree of physeal patency. We obtained patient activity at the time of injury, surgical reports and outcomes from clinical records when available. Twenty-five (12.2%) rotator cuff tears were identified in 17 boys and 7 girls (ages 10-18 years; one patient had bilateral tears). The supraspinatus tendon was most frequently involved (56%). There were 2 full-thickness and 23 partial-thickness tears with articular-side partial-thickness tears most frequent (78%). Insertional partial-thickness tears were more common (78%) than critical zone tears (22%) and 10 (43%) partial-thickness tears were delamination tears. Nine (36%) patients with rotator cuff tears had concurrent labral pathology. There was no statistically significant relationship between

  9. Difference between early versus delayed postoperative physical rehabilitation protocol following arthroscopic rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Samar M Fawzy

    2016-01-01

    Conclusion Significant improvement in pain, ROM, and function after arthroscopic rotator cuff repair was seen at 1 year postoperatively, regardless of early or delayed postoperative rehabilitation protocols. However, early motion increases pain scores and may increase the possibility of rotator cuff retear but with early regain of ROM. A delayed rehabilitation protocol with immobilization for 6 weeks would be better for tendon healing without risk for retear or joint stiffness and easily convalescence with less postoperative pain.

  10. Living with a symptomatic rotator cuff tear 'bad days, bad nights': a qualitative study.

    Science.gov (United States)

    Minns Lowe, Catherine J; Moser, Jane; Barker, Karen

    2014-07-09

    Rotator cuff tears are a common cause of shoulder pain. There is an absence of information about symptomatic rotator cuffs from the patients' perspective; this limits the information clinicians can share with patients and the information that patients can access via sources such as the internet. This study describes the experiences of people with a symptomatic rotator cuff, their symptoms, the impact upon their daily lives and the coping strategies utilised by study participants. An interpretive phenomenological analysis approach was used. 20 participants of the UKUFF trial (The United Kingdom Rotator Cuff Surgery Trial) agreed to participate in in-depth semi-structured interviews about their experiences about living with a symptomatic rotator cuff tear. Interviews were digitally recorded and fully transcribed. Field notes, memos and a reflexive diary were used. Data was coded in accordance with interpretive phenomenological analysis. Peer review, code-recode audits and constant comparison of data, codes and categories occurred throughout. The majority of patients described intense pain and severely disturbed sleep. Limited movement and reduced muscle strength were described by some participants. The predominantly adverse impact that a symptomatic rotator cuff tear had upon activities of daily living, leisure activities and occupation was described. The emotional and financial impact and impact upon caring roles were detailed. Coping strategies included attempting to carry on as normally as possible, accepting their condition, using their other arm, using analgesics, aids and adaptions. Clinicians need to appreciate and understand the intensity and shocking nature of pain that may be experienced by participants with known rotator cuff tears and understand the detrimental impact tears can have upon all areas of patient's lives. Clinicians also need to be aware of the potential emotional impact caused by cuff tears and to ensure that patients needing help for

  11. Effectiveness of shock wave therapy as an alternative to the rotator cuff injury treatment

    OpenAIRE

    Roberto Joaquín Del Gordo-D´Amato; Guillermo Orlando Trout-Guardiola; José Acuña-Pinilla

    2016-01-01

    Rotator cuff injuries are reason for consultation frequent in elderly patients. Most of the time there are no background traumatic acute generating progressive limitations in activities of daily living (ADLS). The objective of this study is to show results in tendonitis of the rotator cuff, in patients treated with extracorporeal shock wave therapy (ESWT). It is a prospective descriptive observational study which presents clinical and functional outcomes in patients with described lesion, tre...

  12. MAGNETIC RESONANCE IMAGING (MRI) SPECTRUM OF Rotator Cuff Tears, with Arthroscopic – MRI Contextualizations

    OpenAIRE

    Batista, Alexandre; Bagulho, Cecília

    2017-01-01

    Our understanding of rotator cuff (RC) pathogenesis and the optimal management of RC pathology is evolving and shoulder magnetic imaging (MRI) has a crucial role in this development, as it functionally depicts pathology in the painful shoulder patient, conveys optimal sensitivity and specificity rates in rotator cuff tear evaluation and characterization, and allows useful additional information in terms of patient management, namely regarding muscle atrophy, reducing unnecessary arthroscopic ...

  13. Delivered growth factor therapy to improve healing after rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Emilie V Cheung

    2010-10-01

    Full Text Available Emilie V Cheung, Luz Silverio, Jeffrey YaoDepartment of Orthopedic Surgery, Stanford University, Redwood City, CA, USABackground: Degenerative rotator cuff tears are a significant cause of shoulder pain in the aging population. Rotator cuff repair surgery may be more successful when growth factors are delivered to the repair site. This study was designed to determine the cellular processes involved in normal bone-to-tendon healing and the current approaches used for biologic augmentation of rotator cuff repair.Methods: This review focuses on animal studies of rotator cuff repair and early human trials.Results: Regular bone-to-tendon healing forms a fibrous junction between tendon and bone that is markedly different from the original bone-to-tendon junction. Tendon augmentation with cellular components serves as scaffolding for endogenous fibroblastic cells and a possible source of growth factors and fibroblastic cells. Extracellular matrices provide a scaffold for incoming fibroblastic cells. However, research in extracellular matrices is not conclusive due to intermanufacturer variation and the lack of human subject research. Growth factors and platelet-rich plasma are established in other fields of research and show promise, but have not yet been rigorously tested in rotator cuff repair augmentation.Conclusions: Rotator cuff repair can benefit from biologic augmentation. However, research in this field is still young and has not yet demonstrated that the benefits in healing rates are significant enough to merit regular clinical use. Randomized controlled trials will elucidate the use of biologic augmentation in rotator cuff repairs.Keywords: rotator cuff, shoulder pain, growth factors, repair

  14. The laryngeal mask in infants and children: what is the cuff pressure?

    Science.gov (United States)

    Schloss, Bryan; Rice, Julie; Tobias, Joseph D

    2012-02-01

    Unintended hyperinflation of the cuff of a laryngeal mask airway (LMA) has been associated with increased airway morbidity and postoperative pain. While the manufacturers recommend a cuff pressure of less than 60 cmH(2)O, in usual clinical practice, there is no method used to determine intracuff pressure of an LMA. The purpose of this prospective quality assurance study is to evaluate the incidence of LMA hyperinflation and excessive intracuff pressure in a busy tertiary care pediatric hospital. There was no change dictated in clinical practice for these patients. Per our usual practice, the LMA was removed from the package and inserted with the cuff partially inflated. The cuff was further inflated as needed to ensure a seal during positive pressure ventilation to a peak inflating pressure of 20-25 cmH(2)O. During the first 30 min of the case, the pressure in the cuff of the LMA was measured using a hand held manometer. Additional data collected included the patient's demographic data (age, weight, and gender), the size of the ETT, and whether nitrous oxide was in use. Of the 200 subjects in the current study, 106 had an LMA cuff pressure ≥ 60 cmH(2)O (53%). Patients who were greater than 8 years of age had significantly higher average cuff pressures and significantly more LMAs with an intracuff pressure ≥ 60 cmH(2)O when compared to patients younger than 4 years of age and patients 4-8 years of age. Similarly, larger LMAs were found to have significantly higher intracuff pressures. Using current clinical practice to inflate the cuff of the LMA, a significant percentage of pediatric patients have an intracuff pressure greater than the generally recommended upper limit of 60 cmH(2)O. Risk factors identified in our study included age of the patient and the size of the LMA. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Cuffed endotracheal tubes in infants and children: should we routinely measure the cuff pressure?

    Science.gov (United States)

    Tobias, Joseph D; Schwartz, Lawrence; Rice, Julie; Jatana, Kris; Kang, D Richard

    2012-01-01

    Over the past 5 years, there has been a change in the clinical practice of pediatric anesthesiology with a transition to the use of cuffed instead of uncuffed endotracheal tubes in infants and children. However, there are few studies evaluating the current practices of inflation of these cuffs and the intracuff pressures. There was no change dictated in clinical practice for these patients. During the first 30 min of the case, the pressure in the cuff was measured using a hand held manometer. Additional data collected included the patient's demographic data (age, weight, and gender), the size of the ETT, whether nitrous oxide was in use, whether the patient was breathing spontaneously or undergoing positive pressure ventilation, and the type of anesthesia provider (resident, fellow, CRNA or SRNA). The cohort for the study included 200 patients ranging in age from 1 month to 17 years and in weight from 3.5 to 99.1 kg. The average cuff pressure was 23 ± 22 cmH(2)O in the total cohort of 200 patients. The cuff pressure was ≥ 30 cmH(2)O in 47 of the 200 patients (23.5%). The average cuff pressure was significantly higher in patients who were 8 years of age or greater compared to younger patients. Additionally, there were significantly more patients with a cuff pressure ≥ 30 cmH(2)O in the ≥ 8 year old age group. Although no difference in the mean cuff pressure was noted when comparing staff anesthesia providers (pediatric anesthesiologist or CRNA) versus trainees (SRNA, anesthesiology resident, medical student or pediatric anesthesiology fellow), the incidence of significantly excessive cuff pressures (≥ 60 cmH(2)O) was higher in the trainee group versus the faculty group (12 of 99 versus 2 of 101, ppressure greater than the generally recommended upper limit of 30 cmH(2)O. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. The impact of faulty posture on rotator cuff tears with and without symptoms.

    Science.gov (United States)

    Yamamoto, Atsushi; Takagishi, Kenji; Kobayashi, Tsutomu; Shitara, Hitoshi; Ichinose, Tsuyoshi; Takasawa, Eiji; Shimoyama, Daisuke; Osawa, Toshihisa

    2015-03-01

    We hypothesized that the prevalence of rotator cuff tears would be higher among individuals with poor posture, regardless of the presence of symptoms. The study initially comprised 525 residents of a mountain village who participated in an annual health check. Participants completed a background questionnaire, and physical examinations were performed to evaluate shoulder function. Ultrasonographic examinations were also performed to identify rotator cuff tears, and participants were grouped according to the presence or absence of tears. Posture was classified by 2 observers into 4 types according to the classification of Kendall, as follows: ideal alignment, kyphotic-lordotic posture, flat-back posture, and sway-back posture. Univariate analyses were performed to compare differences in background characteristics between groups, then multivariate analysis was performed to identify those factors associated with rotator cuff tears. Final analysis was performed for 379 participants (135 men, 244 women; mean age, 62.0 years; range, 31-94 years) showing the same posture classification from both observers. Of these, 93 (24.5%) showed rotator cuff tear in one shoulder and 45 (11.9%) showed tears in both. Prevalence of rotator cuff tears was 2.9% with ideal alignment, 65.8% with kyphotic-lordotic posture, 54.3% with flat-back posture, and 48.9% with sway-back posture. Logistic regression analysis identified increased age, abnormal posture, and past pain as factors associated with rotator cuff tears. Postural abnormality represented an independent predictor of both symptomatic and asymptomatic rotator cuff tears. These results may help define preventive measures for rotator cuff tears and in design ing rehabilitation therapies for shoulder disease. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  17. Overview of the Cranial Nerves

    Science.gov (United States)

    ... to the back). Viewing the Cranial Nerves Twelve pairs of cranial nerves emerge from the underside of the brain, ... eye movement. Eye movement is controlled by 3 pairs of muscles. These muscles move the eye up and down, right and ... nerve 4th cranial nerve 6th ...

  18. Large Extremity Peripheral Nerve Repair

    Science.gov (United States)

    2016-12-01

    rodents as a function of time after surgery. As predicted, those animals in the negative control group (no repair following nerve deficit injury ...80% of penetrating injuries being associated with peripheral nerve damage, typically involve large segmental nerve deficits. Standard repair uses...technology for repair of peripheral nerve injuries involving significant neural deficit with improved functional outcomes for the wounded warrior. The

  19. EGR1 Induces Tenogenic Differentiation of Tendon Stem Cells and Promotes Rabbit Rotator Cuff Repair

    Directory of Open Access Journals (Sweden)

    Xu Tao

    2015-01-01

    Full Text Available Background/Aims: The rate of healing failure after surgical repair of chronic rotator cuff tears is considerably high. The aim of this study was to investigate the function of the zinc finger transcription factor early growth response 1 (EGR1 in the differentiation of tendon stem cells (TSCs and in tendon formation, healing, and tendon tear repair using an animal model of rotator cuff repair. Methods: Tenocyte, adipocyte, osteocyte, and chondrocyte differentiation as well as the expression of related genes were determined in EGR1-overexpressing TSCs (EGR1-TSCs using tissue-specific staining, immunofluorescence staining, quantitative PCR, and western blotting. A rabbit rotator cuff repair model was established, and TSCs and EGR1-TSCs in a fibrin glue carrier were applied onto repair sites. The rabbits were sacrificed 8 weeks after repair operation, and tissues were histologically evaluated and tenocyte-related gene expression was determined. Results: EGR1 induced tenogenic differentiation of TSCs and inhibited non-tenocyte differentiation of TSCs. Furthermore, EGR1 promoted tendon repair in a rabbit model of rotator cuff injury. The BMP12/Smad1/5/8 signaling pathway was involved in EGR1-induced tenogenic differentiation and rotator cuff tendon repair. Conclusion: EGR1 plays a key role in tendon formation, healing, and repair through BMP12/Smad1/5/8 pathway. EGR1-TSCs is a promising treatment for rotator cuff tendon repair surgeries.

  20. Is the Supraspinatus Muscle Atrophy Truly Irreversible after Surgical Repair of Rotator Cuff Tears?

    Science.gov (United States)

    Chung, Seok Won; Kim, Sae Hoon; Tae, Suk-Kee; Yoon, Jong Pil; Choi, Jung-Ah

    2013-01-01

    Background Atrophy of rotator cuff muscles has been considered an irreversible phenomenon. The purpose of this study is to evaluate whether atrophy is truly irreversible after rotator cuff repair. Methods We measured supraspinatus muscle atrophy of 191 patients with full-thickness rotator cuff tears on preoperative magnetic resonance imaging and postoperative multidetector computed tomography images, taken at least 1 year after operation. The occupation ratio was calculated using Photoshop CS3 software. We compared the change between pre- and postoperative occupation ratios after modifying the preoperative occupation ratio. In addition, possible relationship between various clinical factors and the change of atrophy, and between the change of atrophy and cuff integrity after surgical repair were evaluated. Results The mean occupation ratio was significantly increased postoperatively from 0.44 ± 0.17 to 0.52 ± 0.17 (p < 0.001). Among 191 patients, 81 (42.4%) showed improvement of atrophy (more than a 10% increase in occupation ratio) and 33 (17.3%) worsening (more than a 10% decrease). Various clinical factors such as age tear size, or initial degree of atrophy did not affect the change of atrophy. However, the change of atrophy was related to repair integrity: cuff healing failure rate of 48.5% (16 of 33) in worsened atrophy; and 22.2% (18 of 81) in improved atrophy (p = 0.007). Conclusions The supraspinatus muscle atrophy as measured by occupation ratio could be improved postoperatively in case of successful cuff repair. PMID:23467404

  1. Tissue Engineering for Rotator Cuff Repair: An Evidence-Based Systematic Review

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2012-01-01

    Full Text Available The purpose of this systematic review was to address the treatment of rotator cuff tears by applying tissue engineering approaches to improve tendon healing, specifically platelet rich plasma (PRP augmentation, stem cells, and scaffolds. Our systematic search was performed using the combination of the following terms: “rotator cuff”, “shoulder”, “PRP”, “platelet rich plasma”, “stemcells”, “scaffold”, “growth factors”, and “tissue engineering”. No level I or II studies were found on the use of scaffolds and stem cells for rotator cuff repair. Three studies compared rotator cuff repair with or without PRP augmentation. All authors performed arthroscopic rotator cuff repair with different techniques of suture anchor fixation and different PRP augmentation. The three studies found no difference in clinical rating scales and functional outcomes between PRP and control groups. Only one study showed clinical statistically significant difference between the two groups at the 3-month followup. Any statistically significant difference in the rates of tendon rerupture between the control group and the PRP group was found using the magnetic resonance imaging. The current literature on tissue engineering application for rotator cuff repair is scanty. Comparative studies included in this review suggest that PRP augmented repair of a rotator cuff does not yield improved functional and clinical outcome compared with non-augmented repair at a medium and long-term followup.

  2. The influence of the endotracheal tube cuff on the occurrence of ventilator-associated pneumonia

    Directory of Open Access Journals (Sweden)

    Marko Kučan

    2015-09-01

    Full Text Available Introduction: An endotracheal tube enables patient ventilation, but also presents a risk of complications. The accumulation of subglottic secretions above the cuff may cause ventilatorassociated pneumonia. The purpose of the article is to establish the effect of the endotracheal tube cuff (shape and material, method of inflation, verifying and maintaining pressure on the incidence of ventilator-associated pneumonia. Methods: A descriptive method with a systematic review of domestic and foreign literature was used. The literature was retrieved from electronic databases and the cooperative bibliographic/catalogue database. According to eligibility criteria, sixteen original scientific articles published in the last ten years were finally used. Data were processed with qualitative content analysis. Results: Cuff inflation control with a manometer and continuous measuring and adjustment of cuff pressure with modern equipment were found to be the safest methods. According to the articles on shape and material, conical polyurethane cuffs provide the best sealing. Discussion and conclusion: Ventilator-associated pneumonia is a serious complication in mechanically ventilated patients. Maintaining appropriate cuff pressure proved to be a very effective preventive measure. The research presented here is limited by the small number of available articles. Further research is needed before practical applications are attempted.

  3. Electromagnetic, flow and thermal study of a miniature planar spiral transformer with planar, spiral windings

    Directory of Open Access Journals (Sweden)

    J. B. DUMITRU

    2014-04-01

    Full Text Available This paper presents mathematical modeling and numerical simulation results for a miniature, planar, spiral transformer (MPST fabricated in micro-electromechanical MEMS technology. When the MPST is magnetic nanofluid cored, magnetization body forces occur, entraining it into a complex flow. This particular MPST design is then compared with other competing solutions concerning the lumped (circuit parameters. Finally, the heat transfer problem is solved for different electromagnetic working conditions to assess the thermal loads inside the MPST.

  4. Spiral model pilot project information model

    Science.gov (United States)

    1991-01-01

    The objective was an evaluation of the Spiral Model (SM) development approach to allow NASA Marshall to develop an experience base of that software management methodology. A discussion is presented of the Information Model (IM) that was used as part of the SM methodology. A key concept of the SM is the establishment of an IM to be used by management to track the progress of a project. The IM is the set of metrics that is to be measured and reported throughout the life of the project. These metrics measure both the product and the process to ensure the quality of the final delivery item and to ensure the project met programmatic guidelines. The beauty of the SM, along with the IM, is the ability to measure not only the correctness of the specification and implementation of the requirements but to also obtain a measure of customer satisfaction.

  5. Radial to axillary nerve transfer.

    Science.gov (United States)

    Vanaclocha, Vicente; Herrera, Juan Manuel; Rivera-Paz, Marlon; Martínez-Gómez, Deborah; Vanaclocha, Leyre

    2018-01-01

    Axillary nerve injury is common after brachial plexus injuries, particularly with shoulder luxation. Nerve grafting is the traditional procedure for postganglionic injuries. Nerve transfer is emerging as a viable option particularly in late referrals. At the proximal arm the radial and axillary nerves lie close by. Sacrificing one of the triceps muscle nerve branches induces little negative consequences. Transferring the long head of the triceps nerve branch is a good option to recover axillary nerve function. The surgical technique is presented in a video, stressing the steps to achieve a successful result. The video can be found here: https://youtu.be/WbVbpMuPxIE .

  6. Diabetes and nerve damage

    Science.gov (United States)

    Diabetic neuropathy; Diabetes - neuropathy; Diabetes - peripheral neuropathy ... In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is ...

  7. Optic Nerve Drusen

    Science.gov (United States)

    ... nerve. Ocular ultrasound, CT scan and/or fundus photography can also aid in the diagnosis. Drusen can ... Medical Disclaimer Search Site ▶ AAPOS Headquarters 655 Beach Street San Francisco, CA 94109-1336 Phone: (415) 561- ...

  8. Vagus Nerve Stimulation

    Science.gov (United States)

    ... you do certain activities such as public speaking, singing or exercising, or when you're eating if ... of life. Research is still mixed on the benefits of vagus nerve stimulation for the treatment of ...

  9. Laryngeal nerve damage

    Science.gov (United States)

    Symptoms include: Difficulty speaking Difficulty swallowing Hoarseness Injury to the left and right laryngeal nerves at the same time can cause a breathing problem. This can be an urgent medical problem.

  10. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  11. Degenerative Nerve Diseases

    Science.gov (United States)

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  12. Validation of simple and inexpensive algometry using sphygmomanometer cuff and neuromuscular junction monitor with standardized laboratory algometer.

    Science.gov (United States)

    Durga, Padmaja; Wudaru, Sreedhar Reddy; Khambam, Sunil Kumar Reddy; Chandra, Shobha Jagadish; Ramachandran, Gopinath

    2016-01-01

    The availability, ergonomics and economics prohibit the routine use of algometers in clinical practice and research by the anesthesiologists. A simple bedside technique of quantitative pain measurement would enable the routine use of algometry. We proposed to validate simple pain provocation using sphygmomanometer cuff and the electric stimulation of neuromuscular junction monitor (TOF-guard, Organon Teknika) to measure pain against a standardized laboratory pressure algometer. Pain detection threshold (Pdt) and pain tolerance threshold (Ptt) were measured in forty healthy volunteers of both genders, using the above three techniques. All measurements were repeated three times. The co-efficient of inter-rater reliability (or consistency) between three independent measurements obtained from each of the techniques was determined by Cronbach's co-efficient alpha (α C). The correlation between the mean Pdt and Ptt values recorded by standardized algometer and the sphygmomanometer technique and nerve stimulator technique was performed using Pearson Correlation. An r >0.5 and a two-tailed significance of 0.7) for the three techniques. There was a good correlation with r >0.65 (P simple, efficient, repeatable measure of pain intensity and can be used as suitable alternatives to standard algometers.

  13. The Burden of Craft in Arthroscopic Rotator Cuff Repair: Where Have We Been and Where We Are Going.

    Science.gov (United States)

    Burkhart, Stephen S

    2015-08-01

    The rather turbulent history of arthroscopic rotator cuff repair went through stages of innovation, conflict, disruption, assimilation, and transformation that might be anticipated when a new and advanced technology (arthroscopic cuff repair) displaces an entrenched but outdated discipline (open cuff repair). The transition from open to arthroscopic rotator cuff repair has been a major paradigm shift that has greatly benefited patients. However, this technical evolution/revolution has also imposed a higher "burden of craft" on the practitioners of arthroscopic rotator cuff repair. Technological advancements in surgery demand that surgeons accept this burden of craft and master the advanced technology for the benefit of their patients. This article outlines the author's involvement in the development of arthroscopic rotator cuff repair, and it also explores the surgeon's obligation to accept the burden of craft that is imposed by this discipline.

  14. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  15. Conjoined lumbosacral nerve roots

    Directory of Open Access Journals (Sweden)

    Atila Yılmaz

    2012-03-01

    Full Text Available Lumbosacral nerve root anomalies are a rare group ofcongenital anatomical anomalies. Various types of anomaliesof the lumbosacral nerve roots have been documentedin the available international literature. Ttheseanomalies may consist of a bifid, conjoined structure, ofa transverse course or of a characteristic anastomizedappearance. Firstly described as an incidental findingduring autopsies or surgical procedures performed forlumbar disk herniations and often asymptomatic, lumbosacralnerve root anomalies have been more frequentlydescribed in the last years due to the advances made inradiological diagnosis.

  16. Processing fine stainless-steel slag using spiral concentration.

    Science.gov (United States)

    Wolfe, Eric R; Klima, Mark S

    2008-04-01

    In this study, the effectiveness of spiral concentration to process a fine (-1 mm) stainless-steel slag was evaluated. Specifically, testing was conducted to determine the feasibility of producing a high metal content stainless steel product and a low metal content aggregate product. This involved investigating a key operating variable for both five-and seven-turn spiral concentrators. The raw slag and spiral products were characterized to determine their respective size and metal distributions. Separation testing was carried out using the two full-scale spiral concentrators to evaluate the effects of feed solids concentration on spiral performance at solids feed rates ranging from 15 to 30 kg/min. The results indicated that under certain conditions, a high-quality metal fraction could be produced. For example, using the five-turn spiral, a product containing 95% metal was obtained at a low metal recovery. Both spirals were ineffective at concentrating the aggregate fraction. Overall, the feed solids concentration did not significantly affect the quality or recoveries of the products, particularly for feed solids concentrations less than 35% by weight. In order to improve the metal recoveries and to produce a low-metal aggregate material, reprocessing of the product streams and/or additional liberation of the raw slag would be required.

  17. Pancreatic adenocarcinoma : usefulness of two and three phase spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyeong Ah; Kim, Hyung Soo; Park, Cheol Min; Cha, In Ho [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-10-01

    To evaluate the efficacy of each phases in two and three phase spiral CT in the detection of pancreatic adenocarcinoma. Two phase spiral CT images of 18 patients and three phase spiral CT images of 12 patients with pathologically-proven pancreatic ductal adenocarcinoma were retrospectively compared. Using a single spiral scan, images of early and delayed phases were obtained at 43 seconds and 2{approx}3minutes respectively initiating the after administration of 100-120cc of contrast material (2{approx}3cc/sec), Images of arterial, portal and delayed phases were also obtained at 25 and 60 seconds, and 3{approx}4minutes, respectively, by the use of a double spiral scan. CT scans were performed with 10mm collimation at 1:1 pitch table speed. Contrast between the tumor and adjacent pancreatic parenchyma were compared and graded and enhancement pattern of the tumor were analysed together. In 12 patients (66.7%), images of the early phase were superior to those of the delayed phase. images of the portal phase were superior to those of the arterial phase. Enhancement of tumor was seen in four patients;all tumors were less than 3cm in size. The early phase of two phase spiral CT is superior to the delayed phase and the portal phase of three phase spiral CT is superior to the arterial phase. Both arterial and portal phases are superior to the delayed phase.

  18. Spiral Antenna-Coupled Microbridge Structures for THz Application.

    Science.gov (United States)

    Gou, Jun; Zhang, Tian; Wang, Jun; Jiang, Yadong

    2017-12-01

    Bolometer sensor is a good candidate for THz imaging due to its compact system, low cost, and wideband operation. Based on infrared microbolometer structures, two kinds of antenna-coupled microbridge structures are proposed with different spiral antennas: spiral antenna on support layer and spiral antenna with extended legs. Aiming at applications in detection and imaging, simulations are carried out mainly for optimized absorption at 2.52 THz, which is the radiation frequency of far-infrared CO 2 lasers. The effects of rotation angle, line width, and spacing of the spiral antenna on THz wave absorption of microbridge structures are discussed. Spiral antenna, with extended legs, is a good solution for high absorption rate at low absorption frequency and can be used as electrode lead simultaneously for simplified manufacturing process. A spiral antenna-coupled microbridge structure with an absorption rate of more than 75% at 2.52 THz is achieved by optimizing the structure parameters. This research demonstrates the use of different spiral antennas for enhanced and tunable THz absorption of microbridge structures and provides an effective way to fabricate THz microbolometer detectors with great potential in the application of real-time THz imaging.

  19. A Software Development Simulation Model of a Spiral Process

    Science.gov (United States)

    Mizell, Carolyn; Malone, Linda

    2007-01-01

    There is a need for simulation models of software development processes other than the waterfall because processes such as spiral development are becoming more and more popular. The use of a spiral process can make the inherently difficult job of cost and schedule estimation even more challenging due to its evolutionary nature, but this allows for a more flexible process that can better meet customers' needs. This paper will present a discrete event simulation model of spiral development that can be used to analyze cost and schedule effects of using such a process in comparison to a waterfall process.

  20. Fabrication techniques of X-ray spiral zone plates

    International Nuclear Information System (INIS)

    Gao Nan; Zhu Xiaoli; Li Hailiang; Xie Changqing

    2010-01-01

    The techniques to make X-ray spiral zone plates using electron beam and X-ray lithography were studied. A master mask was fabricated on polyimide membrane by E-beam lithography and micro-electroplating. Spiral zone plates were efficiently replicated by X-ray lithography and micro-electroplating. By combining the techniques, spiral zone plates at 1 keV were successfully fabricate. With an outermost zone width of the 200 nm, and the gold absorbers thickness of 700 nm, the high quality zone plates can be used for X-ray phase contrast microscopy.(authors)

  1. Comments on H. Arp 'The persistent problem of spiral galaxies'

    International Nuclear Information System (INIS)

    Alfven, H.

    1987-04-01

    In his paper 'The persistent problem of Spiral Galaxies' H. Arp criticises the standard theory of spiral galaxies and demonstrates that introduction of plasma theory is necessary in order to understand the structure of spiral galaxies. In the present paper arguments are given in support of Arp's theory and suggestions are made how Arp's ideas should be developed. An important result of Arp's new approach is that there is no convincing argument for the belief that there is a 'missing mass'. This is important from a cosmological point of view. (author)

  2. Harmonic oscillator in an elastic medium with a spiral dislocation

    Science.gov (United States)

    Maia, A. V. D. M.; Bakke, K.

    2018-02-01

    We investigate the behaviour of a two-dimensional harmonic oscillator in an elastic medium that possesses a spiral dislocation (an edge dislocation). We show that the Schrödinger equation for harmonic oscillator in the presence of a spiral dislocation can be solved analytically. Further, we discuss the effects of this topological defect on the confinement to a hard-wall confining potential. In both cases, we analyse if the effects of the topology of the spiral dislocation gives rise to an Aharonov-Bohm-type effect for bound states.

  3. What is the prevalence of senior-athlete rotator cuff injuries and are they associated with pain and dysfunction?

    Science.gov (United States)

    McMahon, Patrick J; Prasad, Amitesh; Francis, Kimberly A

    2014-08-01

    Older individuals with rotator cuff injuries may have difficulties not only with activities of daily living, but also with sports activities. (1) How frequent and severe are rotator cuff abnormalities, as identified by ultrasound, in senior athletes? (2) To what degree does the severity of ultrasound-identified rotator cuff pathology correlate with pain and shoulder dysfunction? We assessed pain and shoulder function in 141 elite athletes older than 60 years of age (median age, 70 years; range 60-84) at the Senior Olympics who volunteered to participate. An ultrasound evaluation of the rotator cuff of the dominant shoulder was performed by an experienced musculoskeletal radiologist in all of these elite athletes. We then determined the relationship between ultrasound findings and shoulder pain and shoulder function as assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) and American Shoulder and Elbow Surgeons (ASES) scores. There were 20 shoulders with a normal cuff (14.2% [20 of 141], of which 5% [one of 20] were painful), 23 with tendinosis (16.3% [23 of 141], of which 30% [six of 20] were painful), 68 with a partial-thickness rotator cuff tear (48.2% [68 of 141], of which 32% [20 of 63] were painful), and 30 with a full-thickness rotator cuff tear (21.3% [30 of 141], of which 25% [seven of 28] were painful). Only 5% of athletes (one of 20) with a normal cuff on ultrasound evaluation reported shoulder pain, whereas 30% of athletes (33 of 111) with any degree of rotator cuff damage on ultrasound evaluation reported shoulder pain, This resulted in an odds ratio of 8.0 (95% confidence interval, 1.0-62.5). The proportion of patients who had pain was not different in those with different severities of rotator cuff pathology. Neither the ASES nor the DASH was different in those with different severities. The frequency of full-thickness rotator cuff tears in senior athletes was 21.3% (30 of 141). Pain was a predictor of rotator cuff injury but not of its

  4. Efficacy of surgery for rotator cuff tendinopathy: a systematic review.

    Science.gov (United States)

    Toliopoulos, Panagiota; Desmeules, François; Boudreault, Jennifer; Roy, Jean-Sébastien; Frémont, Pierre; MacDermid, Joy C; Dionne, Clermont E

    2014-01-01

    The objective of this study is to review randomized controlled trials evaluating the efficacy of surgery for the treatment of rotator cuff (RC) tendinopathy. Studies up to August 2013 were located in the PubMed, Embase, CINAHL, and PEDro databases using relevant keywords. Studies were included if: (1) participants had rotator cuff tendinopathy, (2) the trials were conducted on an adult population (≥18 years old), (3) at least one of the interventions studied was a surgical procedure, (4) study design was a randomized controlled trial (RCT), and (5) the article was written in English or French. Characteristics of the included studies were extracted using a standardized form. Two independent raters reviewed the methodological quality of the studies using the Risk of Bias Assessment tool developed by the Cochrane Collaboration Group. Differences were resolved by consensus. Fifteen trials met our inclusion criteria. After consensus, the mean methodological quality for all studies was 58.9 ± 10.8 %. In three out of four RCTs of moderate or low methodological quality, no significant difference in treatment effectiveness was observed between open or arthroscopic acromioplasty compared to exercises in the treatment of RC tendinopathy. Based on two studies of low or moderate methodological quality, no difference in treatment effectiveness was observed between arthroscopic and open acromioplasty. Two other RCTs of low to moderate quality, however, found that arthroscopic acromioplasty yielded better results in the short-term for shoulder range of motion in flexion but that both procedures were comparable in the long-term. One additional study favored open acromioplasty over arthroscopic acromioplasty for the treatment of RC tendinopathy. Based on low- to moderate-quality evidence, acromioplasty, be it open or arthroscopic, is no more effective than exercises for the treatment of RC tendinopathy. Low-grade evidence also suggests that arthroscopic acromioplasty may

  5. MR imaging of delamination tears of the rotator cuff tendons

    Energy Technology Data Exchange (ETDEWEB)

    Walz, Daniel M.; Chen, Steven [North Shore University Hospital, Department of Radiology, Manhasset, NY (United States); Miller, Theodore T. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States); Hofman, Josh [Long Island Jewish Medical Center, New Hyde Park, NY (United States)

    2007-05-15

    The objective was to describe the imaging appearances and location of delamination tears of the rotator cuff tendons on non-contrast conventional MR imaging. This study was reviewed and approved by our Institutional Review Board. The reports of 548 consecutive MR examinations of the shoulder were reviewed, looking for mention or description of delamination tears of the rotator cuff. The images of the identified cases were then reviewed by two radiologists to confirm the findings. Correlation with surgical and arthroscopic information was then performed. Delamination tears were defined as horizontal retraction of either the bursal or articular surface of the tendon, manifest as thickening of the torn retracted edge, and/or interstitial splitting of the tendon, manifest as fluid-like high signal intensity on fat-suppressed T2-weighted oblique coronal images. Fourteen cases of delamination tears were identified in 13 patients. Ten of the cases involved the supraspinatus tendon, all with articular surface involvement. Nine of these supraspinatus cases were isolated tears and one occurred as part of a full thickness tear. All 10 of these supraspinatus cases showed medial retraction of the articular surface of the tendon, with thickening of the retracted edge, and 5 of the 10 had a demonstrable horizontal cleft in the interstitium. Four cases involved the subscapularis tendon, with articular surface disruption in three and pure interstitial delamination in one. Medial subluxation of the tendon of the long head of the biceps was present in all four cases. No delamination tears occurred on the bursal surface. Only three of the 14 shoulders underwent surgical repair with one confirmation of supraspinatus delamination, one confirmation of a subscapularis tear that had become a full thickness tear 10 months after initial imaging and another interstitial subscapularis delamination that was not identified arthroscopically. Delamination tears occur most often in the

  6. Regeneration of Optic Nerve

    Directory of Open Access Journals (Sweden)

    Kwok-Fai So

    2011-05-01

    Full Text Available The optic nerve is part of the central nervous system (CNS and has a structure similar to other CNS tracts. The axons that form the optic nerve originate in the ganglion cell layer of the retina and extend through the optic tract. As a tissue, the optic nerve has the same organization as the white matter of the brain in regard to its glia. There are three types of glial cells: Oligodendrocytes, astrocytes, and microglia. Little structural and functional regeneration of the CNS takes place spontaneously following injury in adult mammals. In contrast, the ability of the mammalian peripheral nervous system (PNS to regenerate axons after injury is well documented. A number of factors are involved in the lack of CNS regeneration, including: (i the response of neuronal cell bodies against the damage; (ii myelin-mediated inhibition by oligodendrocytes; (iii glial scarring, by astrocytes; (iv macrophage infiltration; and (v insufficient trophic factor support. The fundamental difference in the regenerative capacity between CNS and PNS neuronal cell bodies has been the subject of intensive research. In the CNS the target normally conveys a retrograde trophic signal to the cell body. CNS neurons die because of trophic deprivation. Damage to the optic nerve disconnects the neuronal cell body from its target-derived trophic peptides, leading to the death of retinal ganglion cells. Furthermore, the axontomized neurons become less responsive to the peptide trophic signals they do receive. On the other hand, adult PNS neurons are intrinsically responsive to neurotrophic factors and do not lose trophic responsiveness after axotomy. In this talk different strategies to promote optic-nerve regeneration in adult mammals are reviewed. Much work is still needed to resolve many issues. This is a very important area of neuroregeneration and neuroprotection, as currently there is no cure after traumatic optic nerve injury or retinal disease such as glaucoma, which

  7. Disability and satisfaction after Rotator Cuff decompression or repair: a sex and gender analysis

    Directory of Open Access Journals (Sweden)

    Davis Aileen M

    2011-04-01

    Full Text Available Abstract Background Rotator-cuff pathology is the most common cause of pain and disability in the shoulder. Examining the combined effect of biological and societal factors on disability would potentially identify existing differences between men and women with rotator cuff pathology which would help to provide suggestions for better models of care. Purpose of this study was to determine the overall differences in disability between men and women and to examine the relationship between factors that represent sex (biological factors and gender (non-biological factors with disability and satisfaction with surgical outcome 6 months after rotator cuff surgery. Methods Patients with impingement syndrome and/or rotator cuff tear who underwent rotator cuff surgery completed the Western Ontario Rotator Cuff (WORC index, the American Shoulder & Elbow Surgeons (ASES assessment form, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH outcome measures prior to surgery and 6 months post-operatively. They also rated their satisfaction with surgery at their follow-up appointment. Results and Discussion One hundred and seventy patients entered into the study (85 men and 85 women. One hundred and sixty patients (94% completed the 6-month assessment. Women reported more disability both prior to and after surgery. Disability at 6 months was associated with pain-limited range of motion, participation limitation, age and strength. Satisfaction with surgery was associated with level of reported disability, expectations for improved pain, pain-limited range of motion and strength. Conclusions The results of this study indicate that women with rotator cuff pathology suffer from higher levels of pre- and post-operative disability and sex and gender qualities contribute to these differences. Gender-sensitive approach will help to identify existing differences between men and women which will help to promote more effective and tailored care by health

  8. Trabecular microstructure and surface changes in the greater tuberosity in rotator cuff tears

    International Nuclear Information System (INIS)

    Jiang, Yebin; Zhao, Jenny; Ouyang, Xiaolong; Genant, Harry K.; Holsbeeck, Marnix T. van; Flynn, Michael J.

    2002-01-01

    Abstract Objective. When planning surgery in patients with rotator cuff tear, strength of bone at the tendon insertion and trabecular bone structure in the greater tuberosity are usually taken into consideration. We investigated radiographic changes in bone structure of the greater tuberosity in rotator cuff tears.Design. Twenty-two human cadaveric shoulders from subjects ranging from 55 to 75 years of age were obtained. The integrity of the rotator cuff was examined by sonography to determine if it is intact without any tear, or torn partially or completely. The humeral head was sectioned in 3 mm thick coronal slab sections and microradiographed. After digitization of the microradiographs and imaging processing with in-house semi-automated image processing software tools developed using software interfaces on a Sun workstation, the trabecular histomorphometrical structural parameters and connectivity in the greater tuberosity were quantified. The degenerative changes on the surface of the greater tuberosity were interpreted blindly by 2 independent readers.Results. Among the 22 shoulder specimens, the rotator cuff was found intact in 10 shoulders, partially in 7 and fully torn in 5. Statistically significant loss in apparent trabecular bone volume fraction, number of trabecular nodes, and number of trabecular branches, and a statistically significant increase in apparent trabecular separation and number of trabecular free ends were found in the greater tuberosity of the shoulders with tears. The loss was greater in association with full tear than in partial tear. Thickening of the cortical margin of the enthesis, irregularity of its surface, and calcification beyond the tidemark were observed in 2 (20%) shoulders with intact rotator cuff, in 6 (86%) shoulders with partial tear, and in 5 (100%) shoulders with full tear.Conclusions. Rotator cuff tears are associated with degenerative changes on the bone surface and with disuse osteopenia of the greater tuberosity

  9. Effects of age and pathology on shear wave speed of the human rotator cuff.

    Science.gov (United States)

    Baumer, Timothy G; Dischler, Jack; Davis, Leah; Labyed, Yassin; Siegal, Daniel S; van Holsbeeck, Marnix; Moutzouros, Vasilios; Bey, Michael J

    2018-01-01

    Rotator cuff tears are common and often repaired surgically, but post-operative repair tissue healing, and shoulder function can be unpredictable. Tear chronicity is believed to influence clinical outcomes, but conventional clinical approaches for assessing tear chronicity are subjective. Shear wave elastography (SWE) is a promising technique for assessing soft tissue via estimates of shear wave speed (SWS), but this technique has not been used extensively on the rotator cuff. Specifically, the effects of age and pathology on rotator cuff SWS are not well known. The objectives of this study were to assess the association between SWS and age in healthy, asymptomatic subjects, and to compare measures of SWS between patients with a rotator cuff tear and healthy, asymptomatic subjects. SWE images of the supraspinatus muscle and intramuscular tendon were acquired from 19 asymptomatic subjects and 11 patients with a rotator cuff tear. Images were acquired with the supraspinatus under passive and active (i.e., minimal activation) conditions. Mean SWS was positively associated with age in the supraspinatus muscle and tendon under passive and active conditions (p ≤ 0.049). Compared to asymptomatic subjects, patients had a lower mean SWS in their muscle and tendon under active conditions (p ≤ 0.024), but no differences were detected under passive conditions (p ≥ 0.783). These findings identify the influences of age and pathology on SWS in the rotator cuff. These preliminary findings are an important step toward evaluating the clinical utility of SWE for assessing rotator cuff pathology. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:282-288, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. Ineffectiveness of using the pressure relief valve technique during cuff inflation.

    Science.gov (United States)

    Annoni, Raquel; Pires-Neto, Ruy Camargo

    2014-01-01

    To test the effectiveness of using a cuff pressure relief valve technique to maintain cuff pressure levels within the normal in vitro range (Phase 1) in patients admitted to the intensive care unit (Phase 2) and to test the reproducibility of the technique using different syringes. In Phase 1, a tracheal tube was inserted into a trachea model. Ten- and 20mL syringes were used to inflate the cuff through the tracheal tube. The cuff was slowly and steadily inflated until the syringe plunger would move in the opposite direction of the application. After the plunger stopped, the cuff pressures were recorded. In Phase 2, the same maneuvers for inflating the cuff were performed on 20 patients using 5, 10, and 20mL syringes and were compared with manometer measurements. The intraclass correlation coefficient and Bland-Altman analysis were employed to determine the reproducibility and agreement between syringes. Data were expressed as medians (interquartile range). There was no reproducibility between syringes with an intraclass correlation coefficient ranging between -0.33 and 0.8 (p>0.05). The pressures generated with the syringes were higher than the pressures generated using a standard manometer: the 5mL syringe pressure was 105cmH2O (82.5-120cmH2O), the 10mL syringe pressure was 69cmH2O (47.5-111.3cmH2O), and the 20mL syringe pressure was 45cmH2O (35-59.5cmH2O). The Bland-Altman analysis confirmed the large bias and variability between the syringes used, compared with the manometer. The use of syringes is not an effective technique for determining the cuff pressure in patients admitted to the intensive care unit.

  11. Validation of a conical cuff on the forearm for estimating radial artery blood pressure.

    Science.gov (United States)

    Hersh, Lawrence T; Sesing, Jean C; Luczyk, William J; Friedman, Bruce A; Zhou, Shanggen; Batchelder, Paul B

    2014-02-01

    There has been a growing need for and interest in measuring noninvasive blood pressure (NIBP) in obese patients. In many situations, available rectangular upper arm blood pressure cuffs do not fit properly, closing in a crisscross manner or overlapping the elbow. To address this issue, GE Healthcare has designed a conically shaped cuff for use on the forearm to estimate radial arterial blood pressure. This study evaluated using this forearm cuff with an oscillometric NIBP algorithm compared with an invasive radial arterial blood pressure reference. Thirty-four patients were enrolled in the study with an aim to acquire a minimum of 150 paired measurements. Blood pressure was measured and recorded invasively from the radial artery of each patient, while noninvasive oscillometric measurements were acquired from the same limb using a conically shaped cuff placed on the patient's forearm. NIBP values were compared with the invasive blood pressure values acquired in the combined 30-s period preceding cuff inflation and the 30-s period following cuff deflation. The acceptance criteria for measurement accuracy were defined in accordance with the ANSI/AAMI/ISO 81060-2:2009 standard, which requires an absolute average error of 5 mmHg or less, with an SD of 8 mmHg or less. The systolic mean error (-0.82 mmHg) and SD (6.08 mmHg) and the diastolic mean error (1.53 mmHg) and SD (3.83 mmHg) were within the 81060-2 acceptance criteria. The statistical results show that oscillometric NIBP measurements taken with the conically shaped cuff placed on the forearm give an accurate estimation of radial arterial blood pressure.

  12. Urethral Stricture Outcomes After Artificial Urinary Sphincter Cuff Erosion: Results From a Multicenter Retrospective Analysis.

    Science.gov (United States)

    Gross, Martin S; Broghammer, Joshua A; Kaufman, Melissa R; Milam, Douglas F; Brant, William O; Cleves, Mario A; Dum, Travis W; McClung, Christopher; Jones, LeRoy A; Brady, Jeffrey D; Pryor, Michael B; Henry, Gerard D

    2017-06-01

    To evaluate the influence of both repair type and degree of cuff erosion on postoperative urethral stricture rate. Sparse literature exists regarding patient outcomes after artificial urinary sphincter (AUS) cuff erosion. Surgeons from 6 high-volume male continence centers compiled a comprehensive database of post-erosion patients to examine outcomes. This retrospective multi-institution study included 80 patients treated for AUS cuff erosions. Seventy-eight patients had specific information regarding post-cuff erosion urethral strictures. Erosion patients were categorized into 1 of 3 repair types at the time of explant surgery: catheter only, single-layer capsule-to-capsule repair (urethrorrhaphy), and formal urethroplasty. Operative notes and available medical records were extensively reviewed to collect study data. Twenty-five of 78 patients manifested a urethral stricture after AUS cuff erosion (32%). More strictures occurred among patients who underwent urethrorrhaphy (40% vs 29% for catheter only and 14% for urethroplasty). Stricture rates did not vary significantly by repair type (P = .2). Strictures occurred significantly more frequently in patients with complete cuff erosions (58%) as compared to partial erosions (25%, P = .037). A trend was detected regarding increased percentage of erosion correlating with increased stricture rate, but this did not reach statistical significance (P = .057). Partially eroded patients were more likely to undergo urethrorrhaphy repair (60%, P = .002). Urethral stricture was more likely to occur after complete cuff erosion as opposed to partial erosion in this multicenter retrospective population. Repair type, whether catheter only, urethrorrhaphy, or formal urethroplasty, did not appear to influence postoperative stricture rate. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Software trends for both the GANIL and spiral control

    International Nuclear Information System (INIS)

    David, L.; Lecorche, E.

    1999-01-01

    The Ganil facility has been running with a new control system since 1993. Many improvements have been done since that time to bring new capabilities to the system. So, in February 1996, when the Spiral control system was designed, it was mainly considered as an extension of the Ganil control system. This paper briefly recalls the basic architecture of the whole control system and the main choices upon which it relies. Then it presents the new software trends, to show how the Spiral control system has been integrated alongside the existing one. The last part describe the new developments and the most significant functionalities it brings as seen from the operator point of view, with some emphasis about the application programs for beam tuning. Indeed, these new programs have to be provided both for the spiral tuning with exotic ions beams and for the coupling of the Spiral and older Ganil facilities. (authors)

  14. Effects of abnormal excitation on the dynamics of spiral waves

    Science.gov (United States)

    Min-Yi, Deng; Xue-Liang, Zhang; Jing-Yu, Dai

    2016-01-01

    The effect of physiological and pathological abnormal excitation of a myocyte on the spiral waves is investigated based on the cellular automaton model. When the excitability of the medium is high enough, the physiological abnormal excitation causes the spiral wave to meander irregularly and slowly. When the excitability of the medium is low enough, the physiological abnormal excitation leads to a new stable spiral wave. On the other hand, the pathological abnormal excitation destroys the spiral wave and results in the spatiotemporal chaos, which agrees with the clinical conclusion that the early after depolarization is the pro-arrhythmic mechanism of some anti-arrhythmic drugs. The mechanisms underlying these phenomena are analyzed. Project supported by the National Natural Science Foundation of China (Grant Nos. 11365003 and 11165004).

  15. Effects of semiclassical spiral fluctuations on hole dynamics

    Science.gov (United States)

    Hamad, I. J.; Manuel, L. O.; Trumper, A. E.

    2012-01-01

    We investigate the dynamics of a single hole coupled to the spiral fluctuations related to the magnetic ground states of the antiferromagnetic J1-J2-J3 Heisenberg model on a square lattice. Using exact diagonalization on finite size clusters and the self-consistent Born approximation in the thermodynamic limit, we find, as a general feature, a strong reduction of the quasiparticle weight along the spiral phases of the magnetic phase diagram. For an important region of the Brillouin zone the hole spectral functions are completely incoherent, whereas at low energies the spectral weight is redistributed on several irregular peaks. We find a characteristic value of the spiral pitch Q=(0.7,0.7)π, for which the available phase space for hole scattering is maximum. We argue that this behavior is due to the nontrivial interference of the magnon-assisted and the free-hopping mechanism for hole motion, characteristic of a hole coupled to semiclassical spiral fluctuations.

  16. Measurement and structure of spiral wave response functions

    Science.gov (United States)

    Dierckx, Hans; Verschelde, Henri; Panfilov, Alexander V.

    2017-09-01

    The rotating spiral waves that emerge in diverse natural and man-made systems typically exhibit a particle-like behaviour since their adjoint critical eigenmodes (response functions) are often seen to be localised around the spiral core. We present a simple method to numerically compute response functions for circular-core and meandering spirals by recording their drift response to many elementary perturbations. Although our method is computationally more expensive than solving the adjoint system, our technique is fully parallellisable, does not suffer from memory limitations and can be applied to experiments. For a cardiac tissue model with the linear spiral core, we find that the response functions are localised near the turning points of the trajectory.

  17. Data Fusion Tool for Spiral Bevel Gear Condition Indicator Data

    Science.gov (United States)

    Dempsey, Paula J.; Antolick, Lance J.; Branning, Jeremy S.; Thomas, Josiah

    2014-01-01

    Tests were performed on two spiral bevel gear sets in the NASA Glenn Spiral Bevel Gear Fatigue Test Rig to simulate the fielded failures of spiral bevel gears installed in a helicopter. Gear sets were tested until damage initiated and progressed on two or more gear or pinion teeth. During testing, gear health monitoring data was collected with two different health monitoring systems. Operational parameters were measured with a third data acquisition system. Tooth damage progression was documented with photographs taken at inspection intervals throughout the test. A software tool was developed for fusing the operational data and the vibration based gear condition indicator (CI) data collected from the two health monitoring systems. Results of this study illustrate the benefits of combining the data from all three systems to indicate progression of damage for spiral bevel gears. The tool also enabled evaluation of the effectiveness of each CI with respect to operational conditions and fault mode.

  18. Relative frequencies of supernovae versus properties of spiral hosts

    OpenAIRE

    Hakobyan, A. A.; Nazaryan, T. A.; Adibekyan, V. Zh.; Petrosian, A. R.; Aramyan, L. S.; Kunth, D.; Mamon, G. A.; de Lapparent, V.; Bertin, E.; Gomes, J. M.; Turatto, M.

    2013-01-01

    In this work, we present an analysis of SNe number ratios in spiral galaxies with different morphological subtypes, luminosities, sSFR, and metallicities, to provide important information about the physical properties of the progenitor populations.

  19. Simulating Fatigue Crack Growth in Spiral Bevel Pinion

    National Research Council Canada - National Science Library

    Ural, Ani

    2003-01-01

    .... To obtain a more detailed understanding of the contact between a cracked pinion tooth in mesh with an uncracked gear tooth, three-dimensional contact analyses were performed on a spiral bevel gear...

  20. Cassini discovers a kinematic spiral ring around Saturn.

    Science.gov (United States)

    Charnoz, S; Porco, C C; Déau, E; Brahic, A; Spitale, J N; Bacques, G; Baillie, K

    2005-11-25

    Since the time of the Voyager flybys of Saturn in 1980-1981, Saturn's eccentric F ring has been known to be accompanied on either side by faint strands of material. New Cassini observations show that these strands, initially interpreted as concentric ring segments, are in fact connected and form a single one-arm trailing spiral winding at least three times around Saturn. The spiral rotates around Saturn with the orbital motion of its constituent particles. This structure is likely the result of differential orbital motion stretching an initial cloud of particles scattered from the dense core of the F ring. Different scenarios of formation, implying ringlet-satellite interactions, are explored. A recently discovered moon candidate, S/2004 S6, is on an orbit that crosses the F-ring core at the intersection of the spiral with the ring, which suggests a dynamical connection between S/2004 S6 and the spiral.

  1. Rotator cuff injuries and factors associated with reoperation

    Directory of Open Access Journals (Sweden)

    Alexandre Litchina Carvalho

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the prevalence of rotator cuff tears and describe the profile of reoperated patients, causes of repeated tendon tears, tear evolution and range of times between surgical procedures. METHOD: This was a cross-sectional study involving 604 surgical procedures performed at two regional referral hospitals between January 2006 and December 2012. After approval by the ethics committee, data describing the patients' epidemiological profile were gathered at a single time, using Cofield's classification to measure the extent of the tears, all of which underwent arthroscopic surgery. The data were entered into Epi Info 3.5.3 and were analyzed using SPSS version 18.0. RESULTS: Among the 604 surgical procedures, females were affected in more cases (351; 58.1%. When the dominant limb was the right limb, it was affected in 90% of the cases (p < 0.05. The supraspinatus tendon was affected in 574 cases (95% and the tears were of medium size in 300 cases (49.7%. Eighteen reoperations were performed (2.98% and the upper right limb was the most affected (66.6%. The cause was non-traumatic in 12 patients. The repeated tears were mostly smaller (44%, and the length of time between the two surgical procedures ranged from 6 to 298 weeks. CONCLUSION: Female gender, smaller extent in the second procedure and non-traumatic cause were found in most of the cases analyzed.

  2. Acromial Findings Associated with Rotator cuff's Lesions in Magnetic Resonance

    International Nuclear Information System (INIS)

    Avila, Mercedes; Atencio, Elizabeth; Moreno, Franklin

    2008-01-01

    The objective is to evaluate by means of magnetic resonance the acromial alterations associated to rotator cuff (RC) lesions (MR). Materials and methods: A prospective, descriptive and cross-sectional type study was performed in 30 patients aged between 40 and 70 years who attended the Resomer imaging center during the period comprised between October-December 2007, with clinical diagnosis of RC lesion, using a 1.5 T magnet. Results: Most of the studied population were females (66.67%), the mean age being of 56.93 years with a typical deviation of 8.75, with partial lesions in 63.33%, Type II acromion was the dominant acromion in 50%, of anterior orientation (90%), with absent os acromiale (96.66%). Likewise, clavicular and acromial articular hypertrophy was demonstrated in 93.33% of cases. The glenoid-acromion distance had a mean value of 3.15 cm and a typical deviation of 0.55 while the glenoid-humeral distance was 4.65 cm with a typical deviation of 0.46 and the acromial index of 0.67. The humeral-acromion space exhibited a mean value of 6.3 mm with a typical deviation of 1.72. Conclusion: The predominantly degenerative acromial alterations are a conditioning factor of compression resulting from incarceration in the clamp form with a larger > supraspinous tendon wear-out with later affectation to the remaining tendons of the RC as the exposure evolves.

  3. Use of grafts in rotator cuff re-rupture.

    Science.gov (United States)

    Jiménez-Martín, A; Santos-Yubero, F J; Najarro-Cid, F J; Navarro-Martínez, S; Zurera-Carmona, M; Pérez-Hidalgo, S

    2016-01-01

    Rotator cuff re-ruptures appear in 38-65% of cases. In order to reduce this rate, many studies have been performed using different types of biomaterial for purely mechanical aims (re-inforce the suture) and/or biological agents (growth factor transporterts). The aim of this study is to review 22 cases treated with xenografts and analyse various current alternatives. A descriptive and retrospective study was conducted using the variables of age, sex, laterality, time of surgery, involvement in MRI, number of anchors, and final mobility results on the Constant and the University of California Los Angeles (UCLA) validated scales. The study included 22 patients, with a mean age of 51.7±4.6 years. A mean of 2 anchors were used and 13 patients were treated with a porcine intestinal submucosa implant, 6 with equine pericardium, and 3 with porcine dermis. Final results were: 37.6±13 points for the Constant test, and 16.9±3.9 points on the UCLA scale. The follow up was 36±10.2 months. In our experience, xenografts could provide good functional results and they would be a surgical alternative to tendon transfers in cases of massive tears. Further studies should be conducted with other biomaterials. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Assessment and characterization of in situ rotator cuff biomechanics

    Science.gov (United States)

    Trent, Erika A.; Bailey, Lane; Mefleh, Fuad N.; Raikar, Vipul P.; Shanley, Ellen; Thigpen, Charles A.; Dean, Delphine; Kwartowitz, David M.

    2013-03-01

    Rotator cuff disease is a degenerative disorder that is a common, costly, and often debilitating, ranging in severity from partial thickness tear, which may cause pain, to total rupture, leading to loss in function. Currently, clinical diagnosis and determination of disease extent relies primarily on subjective assessment of pain, range of motion, and possibly X-ray or ultrasound images. The final treatment plan however is at the discretion of the clinician, who often bases their decision on personal experiences, and not quantitative standards. The use of ultrasound for the assessment of tissue biomechanics is established, such as in ultrasound elastography, where soft tissue biomechanics are measured. Few studies have investigated the use of ultrasound elastography in the characterization of musculoskeletal biomechanics. To assess tissue biomechanics we have developed a device, which measures the force applied to the underlying musculotendentious tissue while simultaneously obtaining the related ultrasound images. In this work, the musculotendinous region of the infraspinatus of twenty asymptomatic male organized baseball players was examined to access the variability in tissue properties within a single patient and across a normal population. Elastic moduli at percent strains less than 15 were significantly different than those above 15 percent strain within the normal population. No significant difference in tissue properties was demonstrated within a single patient. This analysis demonstrated elastic moduli are variable across individuals and incidence. Therefore threshold elastic moduli will likely be a function of variation in local-tissue moduli as opposed to a specific global value.

  5. Reverse Fosbury Flop Tear of the Rotator Cuff

    Directory of Open Access Journals (Sweden)

    Jérôme Tirefort

    2017-01-01

    Full Text Available Introduction. “Fosbury flop” tear is an avulsion of the posterosuperior rotator cuff from the bone with reversal healing on its medial bursal-side. This case report describes a unique variant of Fosbury flop tear with a lesion of the musculotendinous junction that healed, for its tendon part, on the anterior humerus and coracoid process. Case Presentation. A 62-year-old man developed a posttraumatic painful shoulder with active loss of range of motion. Magnetic resonance arthrography demonstrated a lesion of the musculotendinous junction of the supraspinatus with healing of the tendon on the above-mentioned structures (reverse Fosbury flop. During arthroscopic evaluation, tendon repair was not possible and a debridement to avoid subacromial and anterior impingement associated with a tenotomy of the long head of the biceps were carried out. One year postoperatively, the patient had complete range of motion and was satisfied with the clinical results. Discussion and Conclusion. Different Fosbury flop tears exist. Radiologists and orthopedic surgeons should be aware of these tear patterns as failure to recognize them may lead to inadequate treatment.

  6. Electromyographic assessment of muscle fatigue in massive rotator cuff tear.

    Science.gov (United States)

    Hawkes, D H; Alizadehkhaiyat, O; Kemp, G J; Fisher, A C; Roebuck, M M; Frostick, S P

    2015-02-01

    Shoulder muscle fatigue has not been assessed in massive rotator cuff tear (MRCT). This study used EMG to measure fatigability of 13 shoulder muscles in 14 healthy controls and 11 patients with MRCT. A hand grip protocol was applied to minimise artifacts due to pain experience during measurement. The fatigue index (median frequency slope) was significantly non-zero (negative) for anterior, middle, and posterior parts of deltoid, supraspinatus and subscapularis muscles in the controls, and for anterior, middle, and posterior parts of deltoid, and pectoralis major in patients (p ≤ 0.001). Fatigue was significantly greater in patients compared to the controls for anterior and middle parts of deltoid and pectoralis major (p ≤ 0.001). A submaximal grip task provided a feasible way to assess shoulder muscle fatigue in MRCT patients, however with some limitations. The results suggest increased activation of deltoid is required to compensate for lost supraspinatus abduction torque. Increased pectoralis major fatigue in patients (adduction torque) likely reflected strategy to stabilise the humeral head against superior subluxing force of the deltoid. Considering physiotherapy as a primary or adjunct intervention for the management of MRCT, the findings of this study generate a base for future clinical studies aiming at the development of evidence-based protocols. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Multivariate analyses of rotator cuff pathologies in shoulder disability.

    Science.gov (United States)

    Henseler, Jan F; Raz, Yotam; Nagels, Jochem; van Zwet, Erik W; Raz, Vered; Nelissen, Rob G H H

    2015-01-01

    Disability of the shoulder joint is often caused by a tear in the rotator cuff (RC) muscles. Four RC muscles coordinate shoulder movement and stability, among them the supraspinatus and infraspinatus muscle which are predominantly torn. The contribution of each RC muscle to tear pathology is not fully understood. We hypothesized that muscle atrophy and fatty infiltration, features of RC muscle degeneration, are predictive of superior humeral head translation and shoulder functional disability. Shoulder features, including RC muscle surface area and fatty infiltration, superior humeral translation and RC tear size were obtained from a consecutive series of Magnetic Resonance Imaging with arthrography (MRA). We investigated patients with superior (supraspinatus, n = 39) and posterosuperior (supraspinatus and infraspinatus, n = 30) RC tears, and patients with an intact RC (n = 52) as controls. The individual or combinatorial contribution of RC measures to superior humeral translation, as a sign of RC dysfunction, was investigated with univariate or multivariate models, respectively. Using the univariate model the infraspinatus surface area and fatty infiltration in both the supraspinatus and infraspinatus had a significant contribution to RC dysfunction. With the multivariate model, however, the infraspinatus surface area only affected superior humeral translation (ppathologies. This suggests a pivotal role for the infraspinatus in preventing shoulder disability.

  8. Some Observations on the Fine Structure of the Giant Nerve Fibers of the Earthworm, Eisenia foetida

    Science.gov (United States)

    Hama, Kiyoshi

    1959-01-01

    Sectioned dorsal giant fibers of the earthworm Eisenia foetida have been studied with the electron microscope. The giant axon is surrounded by a Schwannian sheath in which the lamellae are arranged spirally. They can be traced from the outer surface of the Schwann cell to the axon-Schwann membranes. Irregularities in the spiral arrangement are frequently observed. Desmosome-like attachment areas occur on the giant fiber nerve sheath. These structures appear to be arranged bilaterally in columns which are oriented slightly obliquely to the long axis of the giant fiber and aligned linearly from the axon to the periphery of the sheath. At these sites they bind together apposing portions of Schwann cell membrane comprising the sheath. Longitudinal or oblique sections of the nerve sheath attachment areas are reminiscent of the Schmidt-Lantermann clefts of vertebrate peripheral nerve. Septa of the giant fibers have been examined. They are symmetrical or non-polarized and consist of the two plasma membranes of adjacent nerve units. Characteristic vesicular and tubular structures are associated with both cytoplasmic surfaces of these septa. PMID:13673048

  9. Dosimetry in dental radiology. Dentascan spiral CT versus panoramic radiography

    International Nuclear Information System (INIS)

    Villari, N.; Stecco, A.; Zatelli, G.

    1999-01-01

    The study compares the doses absorbed by the dentomaxillary area in spiral CT and panoramic examinations. The dose measurements demonstrate that patients receive smaller doses with panoramic radiography than with spiral CT with Dentascan. After following for some variations from instrumental differences, they are in substantial agreement with literature data. Further investigations are needed considering the radiobiological risk related to the growing spread of Dentascan examinations [it

  10. Scintigraphic diagnosis of spiral fracture in young children

    International Nuclear Information System (INIS)

    Hossein-Foucher, C.; Venel, H.; Lecouffe, P.; Ythier, H.; Legghe, R.; Marchandise, X.

    1988-01-01

    8 cases of unsuspected bone fracture in children, identified at bone scan are reported. Common features were the children's young age (1 to 3 years), the absence of clinical suspicion, the initially normal X-rays, the fracture type (spiral fracture of the tibia undisplaced), and the uniform appearance of the bone scan. These data confim the value of bone scan in limping children and suggest that spiral fracture of the tibia is a frequent and underdiagnosed condition in children [fr

  11. Lung studies with spiral CT. pitch 1 versus pitch 2

    International Nuclear Information System (INIS)

    Sartoni Galloni, S.; Miceli, M.; Lipparino, M.; Burzi, M.; Gigli, F.; Rossi, M.S.; Santoli, G.; Guidarelli, G.

    1999-01-01

    In Spiral CT, the pitch is the ratio of the distance to tabletop travels per 360 degrees rotation to nominal slice width, expressed in mm. Performing Spiral CT examination with pitch 2 allows to reduce examination time, exposure and contrast dose, and X-ray tube overload. The authors investigated the yield of pitch 2 in lung parenchyma studies, particular relative to diagnostic image quality [it

  12. The accelerated ISOL technique and the SPIRAL project

    International Nuclear Information System (INIS)

    Villari, A.C.C.

    2001-01-01

    The accelerated ISOL technique is presented as an introduction to the present status of the SPIRAL facility. SPIRAL is based on the very high intensity light and heavy ion beams available at GANIL. The facility will deliver radioactive beams with energies in the range between 1.7 A and 25 A MeV. The presently target-ion source production system, as well the new developments undertaken by the target ion-source group at GANIL are presented. (authors)

  13. Muscle atrophy as a consequence of rotator cuff tears: should we compare the muscles of the rotator cuff with those of the deltoid?

    Energy Technology Data Exchange (ETDEWEB)

    Ashry, Reem; Schweitzer, Mark E.; Cunningham, Patricia; Cohen, Jodi; Babb, James; Cantos, Andrew [Hospital for Joint Diseases, NYU Medical Center, Department of Radiology, New York, NY (United States)

    2007-09-15

    The quantitative assessment of muscle atrophy has a degree of importance in prognosticating rotator cuff treatment. However, it has been conjectured that muscle fat increases with aging. Therefore, we thought that the quantitative assessment of the supraspinatous would be better if made in comparison with a standard of reference such as the deltoid. Consequently, we performed a two-part study, first evaluating supraspinatous changes compared with the deltoid in ''normals'' with aging, and second, determining if in patients with cuff tears the supraspinatous fat exceeds that of the deltoid. In part 1, we studied 50 patients stratified by decade. In the first sitting, two blinded independent observers quantitatively graded the deltoid (with the supraspinatous obscured) and in the second sitting the same two observers quantitatively graded the supraspinatous (with the deltoid obscured). In part 2 of the study, we evaluated patients with moderate rotator cuff tears (>2 cm) and performed the same blinded, two-sitting, quantitative assessment (with the comparison muscle obscured). We found that muscle atrophy increases with age in patients without tears (0.011/0.028 U/year), although to a greater degree in the deltoid (p = 0.032). Also, in similarly aged patients, quantitative scores of the deltoid closely matched those of the supraspinatous (p = 0.071). Notably, however, in patients with large tears, the supraspinatous showed significant changes disproportionate to those of the deltoid, regardless of patient age (p = 0.044). In the presence of a normal rotator cuff, fatty infiltration increases with age. Age-related changes occur more frequently in the deltoid, verifying this muscle's potential as a standard of reference. With cuff tears, supraspinatous atrophy was disproportionate to that of the deltoid. Therefore, systematic assessment of supraspinatous muscle atrophy may be more reliable using the deltoid as a control for comparison than

  14. Muscle atrophy as a consequence of rotator cuff tears: should we compare the muscles of the rotator cuff with those of the deltoid?

    Science.gov (United States)

    Ashry, Reem; Schweitzer, Mark E; Cunningham, Patricia; Cohen, Jodi; Babb, James; Cantos, Andrew

    2007-09-01

    The quantitative assessment of muscle atrophy has a degree of importance in prognosticating rotator cuff treatment. However, it has been conjectured that muscle fat increases with aging. Therefore, we thought that the quantitative assessment of the supraspinatous would be better if made in comparison with a standard of reference such as the deltoid. Consequently, we performed a two-part study, first evaluating supraspinatous changes compared with the deltoid in "normals" with aging, and second, determining if in patients with cuff tears the supraspinatous fat exceeds that of the deltoid. In part 1, we studied 50 patients stratified by decade. In the first sitting, two blinded independent observers quantitatively graded the deltoid (with the supraspinatous obscured) and in the second sitting the same two observers quantitatively graded the supraspinatous (with the deltoid obscured). In part 2 of the study, we evaluated patients with moderate rotator cuff tears (>2 cm) and performed the same blinded, two-sitting, quantitative assessment (with the comparison muscle obscured). We found that muscle atrophy increases with age in patients without tears (0.011/0.028 U/year), although to a greater degree in the deltoid (p = 0.032). Also, in similarly aged patients, quantitative scores of the deltoid closely matched those of the supraspinatous (p = 0.071). Notably, however, in patients with large tears, the supraspinatous showed significant changes disproportionate to those of the deltoid, regardless of patient age (p = 0.044). In the presence of a normal rotator cuff, fatty infiltration increases with age. Age-related changes occur more frequently in the deltoid, verifying this muscle's potential as a standard of reference. With cuff tears, supraspinatous atrophy was disproportionate to that of the deltoid. Therefore, systematic assessment of supraspinatous muscle atrophy may be more reliable using the deltoid as a control for comparison than assessing it in isolation.

  15. Long-nerve grafts and nerve transfers demonstrate comparable outcomes for axillary nerve injuries.

    Science.gov (United States)

    Wolfe, Scott W; Johnsen, Parker H; Lee, Steve K; Feinberg, Joseph H

    2014-07-01

    To compare the functional and EMG outcomes of long-nerve grafts to nerve transfers for complete axillary nerve palsy. Over a 10-year period at a single institution, 14 patients with axillary nerve palsy were treated with long-nerve grafts and 24 patients were treated with triceps-to-axillary nerve transfers by the same surgeon (S.W.W.). Data were collected prospectively at regular intervals, beginning before surgery and continuing up to 11 years after surgery. Prior to intervention, all patients demonstrated EMG evidence of complete denervation of the deltoid. Deltoid recovery (Medical Research Council [MRC] grade), shoulder abduction (°), improvement in shoulder abduction (°), and EMG evidence of deltoid reinnervation were compared between cohorts. There were no significant differences between the long-nerve graft cohort and the nerve transfer cohort with respect to postoperative range of motion, deltoid recovery, improvement in shoulder abduction, or EMG evidence of deltoid reinnervation. These data demonstrate that outcomes of long-nerve grafts for axillary nerve palsy are comparable with those of modern nerve transfers and question a widely held belief that long-nerve grafts do poorly. When healthy donor roots or trunks are available, long-nerve grafts should not be overlooked as an effective intervention for the treatment of axillary nerve injuries in adults with brachial plexus injuries. Therapeutic III. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  16. Spiralizations and tropisms in Arabidopsis roots.

    Science.gov (United States)

    Migliaccio, F; Piconese, S

    2001-12-01

    When Arabidopsis seedlings are grown on a hard-agar plate, their primary roots show characteristic spiralling movements, apparent as waves, coils and torsions, together with a slanting toward the right-hand side. All these movements are believed to be the result of three different processes acting on the roots: circumnutation, positive gravitropism and negative thigmotropism. The basic movement of the roots is described as that of a growing right-handed helix, which, because of the root tip hitting the agar plate, is continuously switched from the right-hand to the left-hand of the growth direction, and vice versa. This movement also produces a slanting root-growth direction toward the right-hand because of the incomplete waves made by the right-handed root to the left-hand. By contrast, the torsions seen in the coils and waves are interpreted as artefacts that form as an adaptation of the three-dimensional root helix to the flat two-dimensional agar surface.

  17. Noncontrast peripheral MRA with spiral echo train imaging.

    Science.gov (United States)

    Fielden, Samuel W; Mugler, John P; Hagspiel, Klaus D; Norton, Patrick T; Kramer, Christopher M; Meyer, Craig H

    2015-03-01

    To develop a spin echo train sequence with spiral readout gradients with improved artery-vein contrast for noncontrast angiography. Venous T2 becomes shorter as the echo spacing is increased in echo train sequences, improving contrast. Spiral acquisitions, due to their data collection efficiency, facilitate long echo spacings without increasing scan times. Bloch equation simulations were performed to determine optimal sequence parameters, and the sequence was applied in five volunteers. In two volunteers, the sequence was performed with a range of echo times and echo spacings to compare with the theoretical contrast behavior. A Cartesian version of the sequence was used to compare contrast appearance with the spiral sequence. Additionally, spiral parallel imaging was optionally used to improve image resolution. In vivo, artery-vein contrast properties followed the general shape predicted by simulations, and good results were obtained in all stations. Compared with a Cartesian implementation, the spiral sequence had superior artery-vein contrast, better spatial resolution (1.2 mm(2) versus 1.5 mm(2) ), and was acquired in less time (1.4 min versus 7.5 min). The spiral spin echo train sequence can be used for flow-independent angiography to generate three-dimensional angiograms of the periphery quickly and without the use of contrast agents. © 2014 Wiley Periodicals, Inc.

  18. Mechanics and spiral formation in the rat cornea.

    Science.gov (United States)

    Mohammad Nejad, T; Iannaccone, S; Rutherford, W; Iannaccone, P M; Foster, C D

    2015-01-01

    During the maturation of some mammals such as mice and rats, corneal epithelial cells tend to develop into patterns such as spirals over time. A better understanding of these patterns can help to understand how the organ develops and may give insight into some of the diseases affecting corneal development. In this paper, a framework for explaining the development of the epithelial cells forming spiral patterns due to the effect of tensile and shear strains is proposed. Using chimeric animals, made by combining embryonic cells from genetically distinguishable strains, we can observe the development of patterns in the cornea. Aggregates of cell progeny from one strain or the other called patches form as organs and tissue develop. The boundaries of these patches are fitted with logarithmic spirals on confocal images of adult rat corneas. To compare with observed patterns, we develop a three-dimensional large strain finite element model for the rat cornea under intraocular pressure to examine the strain distribution on the cornea surface. The model includes the effects of oriented and dispersed fibrils families throughout the cornea and a nearly incompressible matrix. Tracing the directions of critical strain vectors on the cornea surface leads to spiral-like curves that are compared to the observed logarithmic spirals. Good agreement between the observed and numerical curves supports the proposed assumption that shear and tensile strains facilitate sliding of epithelial cells to develop spiral patterns.

  19. Improved MRI thermometry with multiple-echo spirals.

    Science.gov (United States)

    Marx, Michael; Butts Pauly, Kim

    2016-09-01

    Low-bandwidth PRF shift thermometry is used to guide HIFU ablation treatments. Low sampling bandwidth is needed for high signal-to-noise ratio with short acquisition times, but can lead to off-resonance artifacts. In this work, improved multiple-echo thermometry is presented that allows for high bandwidth and reduced artifacts. It is also demonstrated with spiral sampling, to improve the trade-off between resolution, speed, and measurement precision. Four multiple-echo thermometry sequences were tested in vivo, one using two-dimensional Fourier transform (2DFT) sampling and three using spirals. The spiral sequences were individually optimized for resolution, for speed, and for precision. Multifrequency reconstruction was used to correct for off-resonance spiral artifacts. Additionally, two different multiecho temperature reconstructions were compared. Weighted combination of per-echo phase differences gave significantly better precision than least squares off-resonance estimation. Multiple-echo 2DFT sequence obtained precision similar to single-echo 2DFT, while greatly increasing sampling bandwidth. The multiecho spiral acquisitions achieved 2× better resolution, 2.9× better uncertainty, or 3.4× faster acquisition time, without negatively impacting the other two design parameters as compared to single-echo 2DFT. Multiecho spiral thermometry greatly improves the capabilities of temperature monitoring, and could improve transcranial treatment monitoring capabilities. Magn Reson Med 76:747-756, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  20. Spiral instabilities in media supporting complex oscillations under periodic forcing

    Science.gov (United States)

    Gao, Qingyu; Li, Jun; Zhang, Kailong; Epstein, Irving R.

    2009-09-01

    The periodically forced Brusselator model displays temporal mixed-mode and quasiperiodic oscillations, period doubling, and chaos. We explore the behavior of such media as reaction-diffusion systems for investigating spiral instabilities. Besides near-core breakup and far-field breakup resulting from unstable modes in the radial direction or Doppler-induced instability (destabilization of the core's location), the observed complex phenomena include backfiring, spiral regeneration, and amplitude modulation from line defects. Amplitude modulation of spirals can evolve to chambered spirals resembling those found in nature, such as pine cones and sunflowers. When the forcing amplitude is increased, the spiral-tip meander evolves from simple rotation to complex petals, corresponding to transformation of the local dynamics from simple oscillations to mixed-mode, period-2, and quasiperiodic oscillations. The number of petals is related to the complexity of the mixed-mode oscillations. Spiral turbulence, standing waves, and homogeneous synchronization permeate the entire system when the forcing amplitude is further increased.

  1. Intraoperative Endotracheal Cuff Pressure Study: How Education and Availability of Manometers Help Guide Safer Pressures.

    Science.gov (United States)

    Stevens, Gregory J; Warfel, Joel W; Aden, James K; Blackwell, Scott D

    2018-02-13

    Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae. This study aimed to assess if departmental education paired with ready access to a manometer to assess cuff pressure would result in an improvement in the proportion of ETT cuff pressures in the goal range. A quality improvement study was conducted at the San Antonio Military Medical Center (SAMMC; Department of Defense hospital in San Antonio, TX). The initiative was divided into three key periods: pre-implementation, implementation, and post-implementation. During the pre-implementation period, ETT cuff pressures were obtained to assess the baseline state of ETT cuff pressures for patients in the operating room; the proportion of in-range (20-30 cmH2O) pressures was calculated. During the implementation phase, operating rooms were equipped with manometers and anesthesia departmental education was performed regarding the use of the manometers. Three months later, post-implementation cuff pressures were measured in the OR, and the proportion of in-range pressures was again calculated. The pre-implementation data showed an average cuff pressure of 48.92 cmH2O and a median of 38.5 cmH2O. Of the 100 pre-implementation pressures, 20 were in the goal range. Post-implementation data had an average cuff pressure of 41.96 cmH2O and a median of 30 cmH2O. A chi-squared test of pressures in the safe range from the pre-implementation versus post-implementation values yielded a highly significant p-value of 0.0003. The data from this study clearly demonstrated a statistically significant improvement in the proportion of in-range cuff

  2. Cranial nerve palsies

    International Nuclear Information System (INIS)

    Ruggieri, P.; Adelizzi, J.; Modic, M.T.; Ross, J.S.; Tkach, J.; Masaryk, T.J.

    1990-01-01

    This paper evaluates the utility of multiplanar reconstructions (MPRs) of three-dimensional (3D) MR angiography data sets in the examination of patients with cranial nerve palsies. The authors hypothesis was that 3D data could be reformatted to highlight the intricate spatial relationships of vessels to adjacent neural tissues by taking advantage of the high vessel-parenchyma contrast in high-resolution 3D time-of-flight sequences. Twenty patients with cranial nerve palsies and 10 asymptomatic patients were examined with coronal T1-weighted and axial T2-weighted imaging plus a gadolinium-enhanced 3D MRA sequence (40/7/15 degrees, axial 60-mm volume, 0.9-mm isotropic resolution). Cranial nerves II-VIII were subsequently evaluated on axial and reformatted coronal and/or sagittal images

  3. Tailored endovascular repair of traumatic aortic disruptions with "stacked" abdominal aortic extension cuffs.

    Science.gov (United States)

    Allen, Keith B; Borkon, A Michael; Laster, Steven B; Aggarwal, Sanjeev; Davis, John R; Pak, Alexander F; Stewart, James R; Stuart, R Scott

    2012-01-01

    The management paradigm for traumatic aortic disruptions has evolved from open to endovascular repair. Thoracic stent grafts designed to treat aneurysmal disease, however, have disadvantages, including size mismatch in younger trauma patients and current standard lengths, which may needlessly necessitate coverage of at least 10 cm of thoracic aorta, increasing the risk of spinal cord ischemia. The "off-label" use of abdominal aortic extension cuffs to treat traumatic aortic disruptions may provide an advantage in this regard by better size matching for the younger trauma patient, reduced thoracic aortic coverage, and less cost to the institution. From 2008 to 2011, a total of 16 traumatic aortic disruptions were evaluated and managed with endovascular techniques. The last six were treated with abdominal aortic extensions cuffs (Excluder Extension Cuffs; W.L. Gore & Associates, Flagstaff, AZ) rather than traditional thoracic stent grafts. In addition to demographics and trauma-related data, additional endpoints evaluated in this retrospective review included operative time, number of cuffs used, stent cost data, procedural complications, and follow-up. All six patients (five men/one woman) with traumatic aortic disruption were successfully treated with complete exclusion of the disruption using abdominal aortic cuffs. There were no complications including death or spinal cord ischemia. The average age was 27 years (range, 18-44 years). The average number of cuffs used to cover the traumatic tear was 2.6 per patient (range, 2-3 cuffs per patient), covering an average of 5.3 cm of thoracic aorta (range, 4-6 cm). Mean procedure time was 70 minutes. Hospital cost for each cuff was $2200 (average total stent cost per patient, $5720). For comparison, a single 10-cm conformable thoracic aortic graft (CTAG) (Gore) costs $14,500. Average follow-up of all six patients for up to 3 years demonstrates no complications or migration of the stent grafts. Traumatic aortic

  4. High-Tc Superconducting Thick-Film Spiral Magnet: Development and Characterization of a Single Spiral Module

    National Research Council Canada - National Science Library

    McGinnis, W

    1997-01-01

    The objective of this project was to make characterized and numerically model prototype modules of a new type of superconducting electromagnet based on stacked spirals of superconducting thick films...

  5. Outcome of surgical treatment and the prognostic factors in full-thickness rotator cuff tear

    Directory of Open Access Journals (Sweden)

    M.R. Giti

    2006-07-01

    Full Text Available Background: Rotator cuff tendon tear injury is one of the most frequently seen orthopaedic conditions, and surgical repair of rotator cuff tears is a common procedure. The purpose of the present study was to determine the results of full-thickness rotator cuff repair and to look for predictors of outcomes. Methods: we studied 27 patients (17 men and 10 women with a mean age of 57.7 years who underwent open rotator cuff repair surgery for full-thickness tear between 2001 and 2005 at the Imam Khomeini Hospital and were subsequently followed-up for 6 and 12 months after surgery. The shoulder function was assessed by Constant classification and factors potentially associated with outcomes were Results: The mean of preoperative Constant score (CS was 45.8 ± 14.1 after 12 months, 6 patients (22.2% had good results and 21 patients (77.8% had excellent result according to CS. Pain relief was generally satisfactory. Using multiple regression analysis, treatment was significantly correlated preoperative CS and acromio-humeral interval (AHI however, no correlation was found between the result of the treatment and pretreatment atrophy, tear size, acromial morphology, preoperative symptom duration and age. Conclusion: In this study, a standard rotator cuff repair technique reduced pain severity and was associated with good results, however larger studies are necessary to define the long-term outcome of this procedure.

  6. Using the inflating syringe as a safety valve to limit laryngeal mask airway cuff pressure.

    Science.gov (United States)

    Rice, Mark J; Gravenstein, Nikolaus L; Brull, Sorin J; Morey, Timothy E; Gravenstein, Nikolaus

    2011-12-01

    Hyperinflation of the laryngeal mask airway (LMA) cuff is thought to be the etiology underlying many of the complications associated with the use of this device. Until now, there has not been a clinically acceptable method (besides direct measurement) to assure that the cuff pressure is maintained less than the recommended maximum value of 44 mm Hg (60 cm H(2)O). We inflated sizes #2 and #5 LMAs with air to 40, 60, or 120 mm Hg starting pressures, using 30- and 60-ml BD™ and B Braun™ syringes; we then allowed the syringe plungers to recoil to equilibrium before removing the syringe from the LMA inflation port. Residual LMA cuff pressures following complete passive recoil were measured and recorded. A number of combinations of syringes (30 and 60 ml) and starting pressures (40, 60, 120 mm Hg) resulted in safe residual (#2 and #5 LMA) cuff pressures of inflation pressures, these data demonstrate an efficient, practical and easy method to achieve an initial equilibrium recoil LMA cuff pressure that is less than, or very near to, the recommended upper safe limit of 44 mm Hg.

  7. Can arthroscopic rotator cuff repair prevent proximal migration of the humeral head?

    Directory of Open Access Journals (Sweden)

    Pablo Sanz-Ruiz

    2015-12-01

    Full Text Available Introduction: Shoulder arthroscopy has become increasingly used in recent years, especially in rotator cuff repair. The purpose of this study was to determine whether arthroscopic rotator cuff repair could prevent proximal migration of the humeral head. Material and Methods: We performed a retrospective study of 56 patients suffering from shoulder pain. They were divided into two groups, one comprising patients with impingement syndrome who underwent acromioplasty only and another comprising patients with rotator cuff tear who underwent acromioplasty combined with rotator cuff repair. The pre-operative Hirooka angle and the results of the simple shoulder test (SST were compared after 1 year. Results: We found no differences between the groups for the Hirooka angle or SST results. We did find a significant difference (P<0.05 between pre-operative and post-operative SST results. Conclusions: Rotator cuff repair using arthroscopy is a minimally invasive procedure that improves function and prevents proximal migration of the humeral head after 1 year of follow-up. [Arch Clin Exp Surg 2015; 4(4.000: 190-195

  8. Pain, Disability and Sleep Quality in Patients With Rotator Cuff Tendinopathy and Concurrent Myofascial Pain

    Directory of Open Access Journals (Sweden)

    Morteza Nakhaei Amroodi

    2016-05-01

    Full Text Available Background Rotator cuff tendinopathy and concurrent myofascial pain may result in sleep disturbances, poor quality of life, and social dysfunction along with chronic annoying pain and progressive physical disability. Objectives The present study aimed to assess severity of pain, physical disability, and sleep quality in patients with rotator cuff tendinopathy and concurrent myofascial pain. Patients and Methods This case-control study was conducted on 30 consecutive patients with rotator cuff tendinopathy without tear (impingement syndrome and concurrent myofascial pain referred to the shoulder clinic in Shafa-Yahyaian Hospital during year 2014 (January to April. Eighteen gender and age-matched healthy individuals without any history of rotator cuff tendinopathy were included as controls. Along with baseline assessment, for determining the level of arm, shoulder and hand disability, the quick disabilities of the arm, shoulder and hand questionnaire was also used. Sleep quality was assessed by the pittsburgh sleep quality index (PSQI. Results Compared to healthy individuals, the mean shoulder disability score was significantly higher in the patient group (P = 0.001. Also, regarding sleep quality, the mean score was significantly higher in the patient group when compared with healthy subjects (P = 0.002. Conclusions Patients with rotator cuff tendinopathy concurrent with myofascial pain experienced low level of sleep quality along with severe pain and physical disability. In order to improve clinical outcome of these patients, improving physical function and sleep quality in these patients is necessary.

  9. Macroscopic and microscopic assessments of the glenohumeral and subacromial synovitis in rotator cuff disease.

    Science.gov (United States)

    Jo, Chris H; Shin, Ji Sun; Kim, Ji Eun; Oh, Sohee

    2015-09-30

    Whereas synovitis is one of most common findings during arthroscopic surgery in patients with rotator cuff diseases, no study has investigated its characteristics. We propose a macroscopic assessment system for investigating the characteristics of synovitis. Fifty-four patients with a full-thickness rotator cuff tear undergoing arthroscopic rotator cuff repair with an average age of 62.5 ± 7.0 years were included. For the macroscopic assessment, 3 parameters, villous hypertrophy, hyperemia, and density, were measured and translated into grades in 3 regions-of-interest (ROI) in the glenohumeral joint and 4 ROIs in the subacromial space. For the microscopic assessments, 4 commonly used microscopic assessment systems were used. The reliability and association between the macroscopic and microscopic assessments were investigated. The inter- and intra-observer reliability of all of the macroscopic and microscopic assessments were excellent. The severity of synovitis was significantly greater in the glenohumeral joint than that in the subacromial space, 1.54 ± 0.61 versus 0.94 ± 0.56 (p system. Meanwhile, none of the microscopic assessment systems demonstrated differences between different ROIs in both the glenohumeral joint and the subacromial space. The macroscopic assessment system for synovitis in rotator cuff disease in this study showed excellent reliability. It critically described characteristics of synovitis that microscopic assessment systems could not. Therefore, this system could be a useful tool for investigating synovitis in rotator cuff disease.

  10. Problems of rotator cuff re-tear cases. Examination of operative findings

    International Nuclear Information System (INIS)

    Ishitani, Eiichi; Matsuura, Komei; Shin, Kunichika; Kawamoto, Taisaku; Hosokawa, Akira

    2007-01-01

    High re-tear rate is reported after rotator cuff repair in large and massive tear cases. Previously, we reported that 15% of patients after rotator cuff repair showed re-tear in MRI findings. In this study, 116 consecutive rotator cuff repaired patients who had been operated arthroscopically since 2003 were evaluated for size, torn site, fixation methods, mobility, and tendon quality. In addition, rehabilitation methods and occupation after revision were also evaluated. There were four patients who underwent re-operation. Rotator cuff repairs by revision surgery failed mechanically due to two reasons: the main factor of failure was suture material breakage in three cases and the second was tendon pulling through sutures in one case. The lack of thread strength was suggested. In addition, it is important to pull cuff stump to greater tubercle without excessive tension. Of re-operated cases, three engaging in manual labor suffered large and massive tear. In two cases, premature return to manual labor suggested cause of re-tear. (author)

  11. Ultrasound-Guided Prolotherapy with Polydeoxyribonucleotide for Painful Rotator Cuff Tendinopathy

    Directory of Open Access Journals (Sweden)

    Kyoungho Ryu

    2018-01-01

    Full Text Available Background. Rotator cuff tendinopathy is a primary cause of shoulder pain and dysfunction. Several effective nonsurgical treatment methods have been described for chronic rotator cuff tendinopathy. Prolotherapy with polydeoxyribonucleotide (PDRN, which consists of active deoxyribonucleotide polymers that stimulate tissue repair, is a nonsurgical regenerative injection that may be a viable treatment option. The objective of this study was to assess the efficacy of PDRN in the treatment of chronic rotator cuff tendinopathy. Method. The records of patients with chronic rotator cuff tendinopathy (n=131 were reviewed retrospectively, and the patients treated with PDRN prolotherapy (n=32 were selected. We measured the main outcome of the shoulder pain and disability index score on a numerical rating scale of average shoulder pain. Results. Compared with baseline data, significant improvements in the shoulder pain and disability index and pain visual analog scale scores were demonstrated at one week after the end of treatment, and at one month and three months later. Conclusions. PDRN prolotherapy may improve the conservative treatment of painful rotator cuff tendinopathy for a specific subset of patients.

  12. Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer.

    Science.gov (United States)

    Murakami, Naoya; Norihisa, Yoshiki; Isohashi, Fumiaki; Murofushi, Keiko; Ariga, Takuro; Kato, Tomoyasu; Inaba, Koji; Okamoto, Hiroyuki; Ito, Yoshinori; Toita, Takafumi; Itami, Jun

    2016-01-01

    The aim of this study was to develop an appropriate definition for vaginal cuff and paracolpium clinical target volume (CTV) for postoperative intensity modulated radiation therapy in patients with uterine cervical cancer. A working subgroup was organized within the Radiation Therapy Study Group of the Japan Clinical Oncology Group to develop a definition for the postoperative vaginal cuff and paracolpium CTV in December 2013. The group consisted of 5 radiation oncologists who specialized in gynecologic oncology and a gynecologic oncologist. A comprehensive literature review that included anatomy, surgery, and imaging fields was performed and was followed by multiple discreet face-to-face discussions and e-mail messages before a final consensus was reached. Definitions for the landmark structures in all directions that demarcate the vaginal cuff and paracolpium CTV were decided by consensus agreement of the working group. A table was created that showed boundary structures of the vaginal cuff and paracolpium CTV in each direction. A definition of the postoperative cervical cancer vaginal cuff and paracolpium CTV was developed. It is expected that this definition guideline will serve as a template for future radiation therapy clinical trial protocols, especially protocols involving intensity modulated radiation therapy. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  13. To assess the changes of tracheal cuff pressure after a calibrating orogastric tube insertion.

    Science.gov (United States)

    Hung, Kuo-Chuan

    2014-02-01

    Insertion of a medical instrument into the esophagus may affect tracheal tube pressure. This study evaluated the potential effect of a calibrating orogastric tube insertion on tracheal cuff pressure in patients undergoing laparoscopic bariatric surgery. Adult patients who were scheduled for elective bariatric surgery requiring insertion of a calibrating orogastric tube were assessed for eligibility for this study. After successful tracheal intubation, the tracheal tube with a high-volume, low-pressure cuff was adjusted to range from 25 to 30 cmH2O using a manometer. Tracheal cuff pressure was monitored continuously while the calibrating orogastric tube was being advanced. The change of tracheal cuff pressure was recorded after the calibrating orogastric tube had been left in situ for 3 min. After insertion of the calibrating orogastric tube, the median tracheal cuff pressure increased from 28 [27-28 (25-30)] to 36 [30-42 (26-64)] cmH2O (P pressure should be routinely monitored in patients undergoing laparoscopic bariatric surgery requiring insertion of a calibrating orogastric tube.

  14. The effect of transoesophageal echocardiography probe insertion on tracheal cuff pressure.

    Science.gov (United States)

    Tan, P-H; Lin, V-C; Chen, H-S; Hung, K-C

    2011-09-01

    Increased tracheal cuff pressure during mechanical ventilation is associated with reduced mucosal blood flow and ischaemia, as well as postoperative sore throat. We assessed the potential effects of transoesophageal echocardiography probe insertion on the tracheal cuff pressure in patients undergoing cardiac surgery. Using a manometer, the cuff pressure of a high-volume, low-pressure tracheal tube (inner diameter 7.0 mm for women and 7.5 mm for men) was adjusted to 25-30 cm H(2)O before blind insertion of a transoesophageal echocardiography probe. The pressure changes were then recorded for 1 min. After probe insertion, the mean (SD) intra-cuff pressure increased from 27.7 (1.5) to 36.2 (6.4) cm H(2)O (p 35 cm H(2)0 in 17/38 patients (45%). Our results suggest that transoesophageal echocardiography probe insertion may increase the tracheal cuff pressure more than that is generally recommended and therefore the latter should be routinely monitored under such circumstances. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  15. Nerve Transfers in Tetraplegia.

    Science.gov (United States)

    Fox, Ida K

    2016-05-01

    Hand and upper extremity function is instrumental to basic activities of daily living and level of independence in cervical spinal cord injury (SCI). Nerve transfer surgery is a novel and alternate approach for restoring function in SCI. This article discusses the biologic basis of nerve transfers in SCI, patient evaluation, management, and surgical approaches. Although the application of this technique is not new; recent case reports and case series in the literature have increased interest in this field. The challenges are to improve function, achieve maximal gains in function, avoid complications, and to primum non nocere. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. SPIRAL COUNTER-CURRENT CHROMATOGRAPHY OF SMALL MOLECULES, PEPTIDES AND PROTEINS USING THE SPIRAL TUBING SUPPORT ROTOR

    OpenAIRE

    Knight, Martha; Finn, Thomas M.; Zehmer, John; Clayton, Adam; Pilon, Aprile

    2011-01-01

    An important advance in countercurrent chromatography (CCC) carried out in open flow-tubing coils, rotated in planetary centrifuges, is the new design to spread out the tubing in spirals. More spacing between the tubing was found to significantly increase the stationary phase retention, such that now all types of two-phase solvent systems can be used for liquid-liquid partition chromatography in the J-type planetary centrifuges. A spiral tubing support (STS) frame with circular channels was c...

  17. Specialized Nerve Tests: EMG, NCV and SSEP

    Science.gov (United States)

    ... grouped according to where they leave the spinal column. There are eight pairs of neck (cervical) nerves, 12 pairs of upper back (thoracic) nerves, five pairs of lower back (lumbar) nerves, five pairs of pelvis (sacral) nerves and ...

  18. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

    A variety of lesions may involve the optic nerve. Mainly, these lesions are inflammatory or vascular lesions that rarely necessitate surgery but may induce significant visual morbidity. Orbital tumors may induce proptosis, visual loss, relative afferent pupillary defect, disc edema and optic...... atrophy, but less than one-tenth of these tumors are confined to the optic nerve or its sheaths. No signs or symptoms are pathognomonic for tumors of the optic nerve. The tumors of the optic nerve may originate from the optic nerve itself (primary tumors) as a proliferation of cells normally present...... in the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  19. Nerve Transfer versus Interpositional Nerve Graft Reconstruction for Posttraumatic, Isolated Axillary Nerve Injuries: A Systematic Review.

    Science.gov (United States)

    Koshy, John C; Agrawal, Nikhil A; Seruya, Mitchel

    2017-11-01

    The purpose of this study was to compare functional outcomes between nerve grafting and nerve transfer procedures in the setting of isolated, posttraumatic axillary nerve injuries. A systematic review was performed using the PubMed, Scopus, and Cochrane databases to identify all cases of isolated, posttraumatic axillary nerve injuries in patients aged 18 years or older. Patients who underwent axillary nerve reconstruction were included and categorized by technique: graft or transfer. Demographics were recorded, including age, time to operation, and presence of concomitant injuries. Functional outcomes were evaluated, including British Medical Research Council strength and range of motion for shoulder abduction. Ten retrospective studies met criteria, for a total of 66 patients (20 nerve grafts and 46 nerve transfers). Median time from injury to operation was equivalent across the nerve graft and nerve transfer groups (8.0 months versus 7.0 months; p = 0.41). Postoperative follow-up was 24.0 months for nerve grafting versus 18.5 months for nerve transfer (p = 0.13). Clinically useful shoulder abduction, defined as British Medical Research Council grade M3 or greater, was obtained in 100 percent of nerve graft patients versus 87 percent of nerve transfer patients (p = 0.09). Grade M4 or better strength was obtained in 85 percent of nerve graft patients and 73.9 percent of nerve transfer patients (p = 0.32). Significant differences in functional outcomes between nerve graft and transfer procedures for posttraumatic axillary nerve injuries are not apparent at this time. Prospective outcomes studies are needed to better elucidate whether functional differences do exist. Therapeutic, IV.

  20. Biceps-Related Physical Findings Are Useful to Prevent Misdiagnosis of Cervical Spondylotic Amyotrophy as a Rotator Cuff Tear.

    Science.gov (United States)

    Iwata, Eiichiro; Shigematsu, Hideki; Inoue, Kazuya; Egawa, Takuya; Tanaka, Masato; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Yamamoto, Yusuke; Sakamoto, Yoshihiro; Koizumi, Munehisa; Tanaka, Yasuhito

    2018-02-01

    Case-control study. The aim of the present study was to identify physical findings useful for differentiating between cervical spondylotic amyotrophy (CSA) and rotator cuff tears to prevent the misdiagnosis of CSA as a rotator cuff tear. CSA and rotator cuff tears are often confused among patients presenting with difficulty in shoulder elevation. Twenty-five patients with CSA and 27 with rotator cuff tears were enrolled. We included five physical findings specific to CSA that were observed in both CSA and rotator cuff tear patients. The findings were as follows: (1) weakness of the deltoid muscle, (2) weakness of the biceps muscle, (3) atrophy of the deltoid muscle, (4) atrophy of the biceps muscle, and (5) swallow-tail sign (assessment of the posterior fibers of the deltoid). Among 25 CSA patients, 10 (40.0%) were misdiagnosed with a rotator cuff tear on initial diagnosis. The sensitivity and specificity of each physical finding were as follows: (1) deltoid weakness (sensitivity, 92.0%; specificity, 55.6%), (2) biceps weakness (sensitivity, 80.0%; specificity, 100%), (3) deltoid atrophy (sensitivity, 96.0%; specificity, 77.8%), (4) biceps atrophy (sensitivity, 88.8%; specificity, 92.6%), and (5) swallow-tail sign (sensitivity, 56.0%; specificity, 74.1%). There were statistically significant differences in each physical finding. CSA is likely to be misdiagnosed as a rotator cuff tear; however, weakness and atrophy of the biceps are useful findings for differentiating between CSA and rotator cuff tears to prevent misdiagnosis.

  1. Work above shoulder level and degenerative alterations of the rotator cuff tendons: a magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Svendsen, Susanne Wulff; Gelineck, John; Mathiassen, Svend Erik

    2004-01-01

    To determine whether work performed with the arms in a highly elevated position is associated with alterations in the rotator cuff tendons as assessed by magnetic resonance imaging (MRI).......To determine whether work performed with the arms in a highly elevated position is associated with alterations in the rotator cuff tendons as assessed by magnetic resonance imaging (MRI)....

  2. Achieving the Recommended Endotracheal Tube Cuff Pressure: A Randomized Control Study Comparing Loss of Resistance Syringe to Pilot Balloon Palpation

    Directory of Open Access Journals (Sweden)

    Fred Bulamba

    2017-01-01

    Full Text Available Background. Both under- and overinflation of endotracheal tube cuffs can result in significant harm to the patient. The optimal technique for establishing and maintaining safe cuff pressures (20–30 cmH2O is the cuff pressure manometer, but this is not widely available, especially in resource-limited settings where its use is limited by cost of acquisition and maintenance. Therefore, anesthesia providers commonly rely on subjective methods to estimate safe endotracheal cuff pressure. This study set out to determine the efficacy of the loss of resistance syringe method at estimating endotracheal cuff pressures. Methods. This was a randomized clinical trial. We enrolled adult patients scheduled to undergo general anesthesia for elective surgery at Mulago Hospital, Uganda. Study participants were randomized to have their endotracheal cuff pressures estimated by either loss of resistance syringe or pilot balloon palpation. The pressures measured were recorded. Results. One hundred seventy-eight patients were analyzed. 66.3% (59/89 of patients in the loss of resistance group had cuff pressures in the recommended range compared with 22.5% (20/89 from the pilot balloon palpation method. This was statistically significant. Conclusion. The loss of resistance syringe method was superior to pilot balloon palpation at administering pressures in the recommended range. This method provides a viable option to cuff inflation.

  3. Management of iatrogenic cystoscopic urethral lesion associated with sequela of cuff erosion in a patient after previous AMS 800 implantation. One-step technique with revision, without cuff explantation.

    Science.gov (United States)

    Weibl, P; Rutkowski, M; Huebner, W

    2018-04-01

    Iatrogenic urethral lesion with subsequent cuff erosion during cystoscopy is a rare complication. The alternative surgical strategy with in situ urethroplasty while maintaining the open cuff left in situ will be presented. The authors report 3cases of iatrogenic urethral lesion with cuff erosion during cystoscopic evaluation to exclude stricture or cuff erosion due to new onset of obstructive lower urinary tract symptoms. All patients had a history of a AMS 800 implantation due to posprostatectomy incontinence. Rigid cystoscopy was performed, which revelaed no pathologies; however, iatrogenic small urethral lesion was identified during the removal of the cystoscope at the projection of the cuff. In situ urethroplasty was performed, and the cuff was left open in situ. Additionally a protection fat flap was placed around the urethra from the dorsolateral aspect, separating the cuff and urethra from the direct contact with each other. After 6 weeks the urethral defect was completely healed and via a primary perineal incision the cuff was readapted and closed. The device was fully functioning without any additional adjustments. Our modification should be considered in select cases with absence of infection as part of management strategy for cases of iatrogenic urethral lesions with subsequent cuff erosion. Thereby the original cuff can be spared and the possibly difficult preparation of the urethra during reoperation can be avoided. However, additional more cases should be presented in the world-wide literature, to confirm the utility of this surgical principle. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

    in the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  5. Anatomy of the trigeminal nerve

    NARCIS (Netherlands)

    van Eijden, T.M.G.J.; Langenbach, G.E.J.; Baart, J.A.; Brand, H.S.

    2017-01-01

    The trigeminal nerve is the fifth cranial nerve (n. V), which plays an important role in the innervation of the head and neck area, together with other cranial and spinal nerves. Knowledge of the nerve’s anatomy is very important for the correct application of local anaesthetics.

  6. Imaging the ocular motor nerves.

    NARCIS (Netherlands)

    Ferreira, T.; Verbist, B.M.; Buchem, M. van; Osch, T. van; Webb, A.

    2010-01-01

    The ocular motor nerves (OMNs) comprise the oculomotor, trochlear and the abducens nerves. According to their course, they are divided into four or five anatomic segments: intra-axial, cisternal, cavernous and intra-orbital and, for the abducens nerve, an additional interdural segment. Magnetic

  7. Clear New View of a Classic Spiral

    Science.gov (United States)

    2010-05-01

    ESO is releasing a beautiful image of the nearby galaxy Messier 83 taken by the HAWK-I instrument on ESO's Very Large Telescope (VLT) at the Paranal Observatory in Chile. The picture shows the galaxy in infrared light and demonstrates the impressive power of the camera to create one of the sharpest and most detailed pictures of Messier 83 ever taken from the ground. The galaxy Messier 83 (eso0825) is located about 15 million light-years away in the constellation of Hydra (the Sea Serpent). It spans over 40 000 light-years, only 40 percent the size of the Milky Way, but in many ways is quite similar to our home galaxy, both in its spiral shape and the presence of a bar of stars across its centre. Messier 83 is famous among astronomers for its many supernovae: vast explosions that end the lives of some stars. Over the last century, six supernovae have been observed in Messier 83 - a record number that is matched by only one other galaxy. Even without supernovae, Messier 83 is one of the brightest nearby galaxies, visible using just binoculars. Messier 83 has been observed in the infrared part of the spectrum using HAWK-I [1], a powerful camera on ESO's Very Large Telescope (VLT). When viewed in infrared light most of the obscuring dust that hides much of Messier 83 becomes transparent. The brightly lit gas around hot young stars in the spiral arms is also less prominent in infrared pictures. As a result much more of the structure of the galaxy and the vast hordes of its constituent stars can be seen. This clear view is important for astronomers looking for clusters of young stars, especially those hidden in dusty regions of the galaxy. Studying such star clusters was one of the main scientific goals of these observations [2]. When compared to earlier images, the acute vision of HAWK-I reveals far more stars within the galaxy. The combination of the huge mirror of the VLT, the large field of view and great sensitivity of the camera, and the superb observing conditions

  8. FATTY MUSCLE INFILTRATION IN CUFF TEAR: PRE AND POST OPERATIVE EVALUATION BY MRI.

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Santos, Pedro Doneux; da Silva, Luciana Andrade; Sella, Guilherme do Val; Miranda, Eduardo Régis de Alencar Bona; Zampieri, Rodrigo

    2015-01-01

    To evaluate the fatty infiltration and atrophy of the supraespinatus in the pre- and postoperative of a rotator cuff lesion (RCL), by MRI. Ten patients with full-thickness rotator cuff tears who had undergone surgical arthroscopic rotator cuff repair between September and December 2011 were included. This is a prospective study, with analysis and comparison of fatty infiltration and atrophy of the supraespinatus. The occupation ratio was measured using the magic selection tool in Adobe Photoshop CS3((r)) on T1 oblique sagittal Y-view MRI. Through Photoshop, the proportion occupied by the muscle belly regarding its fossae was calculated. There was a statistically significant increase in the muscle ratio (p=0.013) comparing images pre and postoperative, analyzed by the Wilcoxon T test. The proportion of the supraspinal muscle above the pit increases in the immediate postoperative period, probably due to the traction exerted on the tendon at the time of repair. Level of Evidence II, Cohort Study.

  9. The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears.

    Science.gov (United States)

    Levy, Ofer; Mullett, Hannan; Roberts, Sarah; Copeland, Stephen

    2008-01-01

    The management of massive rotator cuff tears in medically unfit, elderly patients is difficult. We prospectively assessed 17 patients with radiologically confirmed, nontraumatic, massive rotator cuff tears who were treated with an anterior deltoid rehabilitation program. All patients were medically unfit, with an average age of 80 years (range, 70-96 years). Patients were given standard detailed instruction and an illustrated guide. A video recording of shoulder motion was made before and after treatment. The Constant score increased from a mean of 26 (range, 8-41) before treatment to a mean of 60 (range, 43-77) at a minimum of 9 months after treatment. Range of motion in forward elevation improved from a mean of 40 degrees (range, 30 degrees -60 degrees ) at presentation to a mean of 160 degrees (range 150 degrees -180 degrees ) after the deltoid rehabilitation course. We recommend that a structured deltoid rehabilitation program is suitable for elderly patients with massive rotator cuff tears.

  10. Fabrication and performance analysis of a DEA cuff designed for dry-suit applications

    International Nuclear Information System (INIS)

    Ahmadi, S; Camacho Mattos, A; Barbazza, A; Soleimani, M; Boscariol, P; Menon, C

    2013-01-01

    A method for manufacturing a cylindrical dielectric elastomer actuator (DEA) is presented. The cylindrical DEA can be used in fabricating the cuff area of dry-suits where the garment is very tight and wearing the suit is difficult. When electrically actuated, the DEA expands radially and the suit can be worn more comfortably. In order to study the performance of the DEA, a customized testing setup was designed, and silicone-made cuff samples with different material stiffnesses were tested. Analytical and FEM modeling were considered to evaluate the experimental output. The results revealed that although the stiffness of the DEA material has a direct relationship with the radial constrictive pressure caused by mechanically stretching the DEA, it has a minor effect on the actuation pressure. It was also found that stacking multiple layers of the DEA to fabricate a laminated structure enabled the attainment of a desired variation of pressure required for the implementation of an electrically tunable cuff. (paper)

  11. [Influence of intermittently monitoring on endotracheal tube cuff pressure using handheld pressure gauge].

    Science.gov (United States)

    Huang, Ling; Xie, Chen; Zhang, Lifeng; Meng, Liying; Li, Guizheng; Li, Yang; Huang, Bing; Pan, Linghui; Tang, Zhanhong

    2017-01-01

    To discuss the influence of intermittently monitoring on endotracheal tube cuff pressure using handheld pressure gauge, and to provide some reference for the clinical work. The experiment was carried out on the model of the glass tube, which was divided into three parts. Each part of the experiment was divided into normal pressure group and high pressure group according to the different inflation pressure target value. The endotracheal tube cuff pressure was determined intermittently by using the transparent tracheal models which had a static diameter of 2 cm. The target press value of normal pressure group was 32 cmH 2 O (1 cmH 2 O = 0.098 kPa) while that of high pressure group was 40 cmH 2 O. The handheld pressure gauge was connected with the indicated cuff through a tee joint, and the pressure in the cuff in both groups was determined. The pressure loss caused by intermittent measurement of the two groups was compared. By switching the tee joint, the pressure loss through the gauge self-structure and the pressure loss when connecting and disconnecting the indicated cuff were determined to analyze the causes of pressure loss caused by intermittent measurement of pressure gauge. The pressure loss caused by intermittent measurement of high pressure group was significantly higher than that of normal pressure group (cmH 2 O: 15.10±0.43 vs. 10.19±0.45) with statistical significance (t = -24.875, P = 0.000). The pressure loss through the gauge self-structure of high pressure group was also significantly higher than that of normal pressure group (cmH 2 O: 13.91±0.48 vs. 8.77±0.53), which showed a statistics significance (t = -22.854, P = 0.000). The pressure loss when connecting and disconnecting the indicated cuff of the normal pressure and high pressure groups were (1.33±0.49) cmH 2 O and (1.23±0.55) cmH 2 O, respectively, without statistics significance (t = 0.445, P = 0.662). It was figured that the total pressure loss caused by intermittent measurement of the

  12. Nerve conduction and excitability studies in peripheral nerve disorders

    DEFF Research Database (Denmark)

    Krarup, Christian; Moldovan, Mihai

    2009-01-01

    PURPOSE OF REVIEW: The review is aimed at providing information about the role of nerve excitability studies in peripheral nerve disorders. It has been known for many years that the insight into peripheral nerve pathophysiology provided by conventional nerve conduction studies is limited. Nerve....... Studies of different metabolic neuropathies have assessed the influence of uremia, diabetes and ischemia, and the use of these methods in toxic neuropathies has allowed pinpointing damaging factors. Various mutations in ion channels associated with central nervous system disorders have been shown to have...

  13. Rotator Cuff Tendinopathy: Navigating the Diagnosis-Management Conundrum.

    Science.gov (United States)

    Lewis, Jeremy; McCreesh, Karen; Roy, Jean-Sébastien; Ginn, Karen

    2015-11-01

    Synopsis The hallmark characteristics of rotator cuff (RC) tendinopathy are pain and weakness, experienced most commonly during shoulder external rotation and elevation. Assessment is complicated by nonspecific clinical tests and the poor correlation between structural failure and symptoms. As such, diagnosis is best reached by exclusion of other potential sources of symptoms. Symptomatic incidence and prevalence data currently cannot be determined with confidence, primarily as a consequence of a lack of diagnostic accuracy, as well as the uncertainty as to the location of symptoms. People with symptoms of RC tendinopathy should derive considerable comfort from research that consistently demonstrates improvement in symptoms with a well-structured and graduated exercise program. This improvement is equivalent to outcomes reported in surgical trials, with the additional generalized benefits of exercise, less sick leave, a faster return to work, and reduced costs to the health care system. This evidence covers the spectrum of conditions that include symptomatic RC tendinopathy and atraumatic partial- and full-thickness RC tears. The principles guiding exercise treatment for RC tendinopathy include relative rest, modification of painful activities, an exercise strategy that initially does not exacerbate pain, controlled reloading, and gradual progression from simple to complex shoulder movements. Evidence also exists for a specific exercise program being beneficial for people with massive inoperable tears of the RC. Education is an essential component of rehabilitation, and attention to lifestyle factors (smoking cessation, nutrition, stress, and sleep management) may enhance outcomes. Outcomes may also be enhanced by subgrouping RC tendinopathy presentations and directing treatment strategies according to the clinical presentation and the patient's response to shoulder symptom modification procedures outlined herein. There are substantial deficits in our knowledge

  14. [Transdermal nitroglycerin versus corticosteroid infiltration for rotator cuff tendinitis].

    Science.gov (United States)

    Pons, S; Gallardo, C; Caballero, J; Martínez, T

    2001-10-31

    To compare transdermal nitroglycerin (NTG) and corticosteroid infiltration in patients with rotator cuff tendinitis (RCT). Experimental, randomized controlled study. Semirural basic health area in the Garraf region of Barcelona province, Spain, with a population of public health service users of 12000. Patients diagnosed as having RCT of less than 6 weeks' evolution who had not responded to treatment with oral nonsteroid antiinflammatory drugs. The patients were distributed randomly into two groups: a) group A, local infiltration via a posterior approach with a depot corticosteroid and local anesthesia, and b) group B, treated for 3 days with a 5-mg NTC patch. Age, sex, pain (measured with an analog visual scale) and adverse events. In patients who showed a partial response, treatment was repeated up to 3 times at 15-day intervals. Pain was tested after 7-10 days of treatment. Complete improvement was considered a reduction in pain of more than 5 points on the analog visual scale; partial improvement was considered a reduction of 3-5 points, and treatment failure was recorded when there was no improvement in pain or when there was a decrease of less than 3 points. A total of 48 patients were included; 33 (69%) were women and 15 (31%) were men. Mean age was 61 years. In group A, complete improvement was seen in 19 patients and partial improvement in 3; treatment failed in 2 patients. In group B complete improvement was seen in 5 patients, partial improvement in 5, and failure of treatment in 14. The difference between groups was statistically significant. Adverse events were mild pain at the injection site in 4 patients from group A, and headache in 15 patients from group B, 8 of whom abandoned treatment for this reason. Treatment with NTG is not a clear alternative to infiltration of corticosteroids in patients with RCT, because of its lack of effectiveness and because of the greater number of patients who had adverse events that lead them to abandon treatment.

  15. Rotator cuff tears noncontrast MRI compared to MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Yoon, Young Cheol [Sungkyunkwan University, School of Medicine, Department of Radiology, Samsung Medical Center, Gangnam-gu, Seoul (Korea, Republic of); Jung, Jee Young [Chungang University School of Medicine, Department of Radiology, Chungang University Hospital, Seoul (Korea, Republic of); Yoo, Jae Chul [Sungkyunkwan University, School of Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul (Korea, Republic of)

    2015-12-15

    To compare the accuracy of indirect magnetic resonance arthrography and noncontrast magnetic resonance imaging for diagnosing rotator cuff tears. In total, 333 patients who underwent noncontrast magnetic resonance imaging or indirect magnetic resonance arthrography were included retrospectively. Two musculoskeletal radiologists evaluated the images for the presence of supraspinatus-infraspinatus and subscapularis tendon tears. The overall diagnostic performance was calculated using the arthroscopic findings as the reference standard. Statistical differences between the diagnostic performances of the two methods were analyzed. Ninety-six and 237 patients who underwent noncontrast magnetic resonance imaging and indirect magnetic resonance arthrography were assigned into groups A and B, respectively. Sensitivity for diagnosing articular-surface partial-thickness supraspinatus-infraspinatus tendon tear was slightly higher in group B than in group A. Statistical significance was confirmed by multivariate analysis using the generalized estimating equation (p = 0.046). The specificity for diagnosing subscapularis tendon tear (85 % vs. 68 %, p = 0.012) and grading accuracy (57 % vs. 40 %, p = 0.005) was higher in group B than in group A; the differences were statistically significant for one out of two readers. Univariate analysis using the generalized estimating equation showed that the accuracy for diagnosing subscapularis tendon tear in group B was higher than in group A (p = 0.042). There were no statistically significant differences between the diagnostic performances of both methods for any other parameters. Indirect magnetic resonance arthrography may facilitate more accurate diagnosis and grading of subscapularis tendon tears compared with noncontrast magnetic resonance imaging. (orig.)

  16. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T

    2004-01-01

    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta...

  17. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T

    2004-01-01

    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta block...

  18. Optic nerve sheath meningiomas

    NARCIS (Netherlands)

    Saeed, Peerooz; Rootman, Jack; Nugent, Robert A.; White, Valerie A.; Mackenzie, Ian R.; Koornneef, Leo

    2003-01-01

    To study the natural history and growth of optic nerve sheath meningiomas and evaluate their management outcome. Clinicopathologic retrospective noncomparative case series. A retrospective study of 88 patients who were treated between 1976 and 1999 at the University of British Columbia and the

  19. CHARACTERIZING SPIRAL ARM AND INTERARM STAR FORMATION

    Energy Technology Data Exchange (ETDEWEB)

    Kreckel, K.; Schinnerer, E.; Meidt, S. [Max Planck Institut für Astronomie, Königstuhl 17, D-69117 Heidelberg (Germany); Blanc, G. A. [Departamento de Astronomía, Universidad de Chile, Camino del Observatorio 1515, Las Condes, Santiago (Chile); Groves, B. [Research School of Astronomy and Astrophysics, Australian National University, Canberra, ACT 2611 (Australia); Adamo, A. [Department of Astronomy, The Oskar Klein Centre, Stockholm University, AlbaNova University Centre, SE-106 91 Stockholm (Sweden); Hughes, A., E-mail: kreckel@mpia.de [CNRS, IRAP, 9 Av. du Colonel Roche, BP 44346, F-31028 Toulouse cedex 4 (France)

    2016-08-20

    Interarm star formation contributes significantly to a galaxy’s star formation budget and provides an opportunity to study stellar birthplaces unperturbed by spiral arm dynamics. Using optical integral field spectroscopy of the nearby galaxy NGC 628 with VLT/MUSE, we construct H α maps including detailed corrections for dust extinction and stellar absorption to identify 391 H ii regions at 35 pc resolution over 12 kpc{sup 2}. Using tracers sensitive to the underlying gravitational potential, we associate H ii regions with either arm (271) or interarm (120) environments. Using our full spectral coverage of each region, we find that most physical properties (luminosity, size, metallicity, ionization parameter) of H ii regions are independent of environment. We calculate the fraction of H α luminosity due to the background of diffuse ionized gas (DIG) contaminating each H ii region, and find the DIG surface brightness to be higher within H ii regions than in the surroundings, and slightly higher within arm H ii regions. Use of the temperature-sensitive [S ii]/H α line ratio instead of the H α surface brightness to identify the boundaries of H ii regions does not change this result. Using the dust attenuation as a tracer of the gas, we find depletion times consistent with previous work (2 × 10{sup 9} yr) with no differences between the arm and interarm, but this is very sensitive to the DIG correction. Unlike molecular clouds, which can be dynamically affected by the galactic environment, we see fairly consistent properties of H ii regions in both arm and interarm environments. This suggests either a difference in star formation and feedback in arms or a decoupling of dense star-forming clumps from the more extended surrounding molecular gas.

  20. The Globular Cluster System of the Spiral Galaxy NGC 7814

    Science.gov (United States)

    Rhode, Katherine L.; Zepf, Stephen E.

    2003-11-01

    We present the results of a wide-field photometric study of the globular cluster (GC) system of the edge-on Sab spiral NGC 7814. This is the first spiral to be fully analyzed from our survey of the GC systems of a large sample of galaxies beyond the Local Group. NGC 7814 is of particular interest because a previous study estimated that it has 500-1000 GCs, giving it the largest specific frequency (SN) known for a spiral. Understanding this galaxy's GC system is important in terms of our understanding of the GC populations of spirals in general and has implications for the formation of massive galaxies. We observed the galaxy in BVR filters with the WIYN 3.5 m telescope and used image classification and three-color photometry to select GC candidates. We also analyzed archival Hubble Space Telescope (HST) Wide Field Planetary Camera 2 images of NGC 7814, both to help quantify the contamination level of the WIYN GC candidate list and to detect GCs in the inner part of the galaxy halo. Combining HST data with high-quality ground-based images allows us to trace the entire radial extent of this galaxy's GC system and determine the total number of GCs directly through observation. We find that rather than being an especially high-SN spiral, NGC 7814 has <~200 GCs and SN~1, making it comparable to the two most well-studied spiral galaxies, the Milky Way and M31. We explore the implications of these results for models of the formation of galaxies and their GC systems. The initial results from our survey suggest that the GC systems of typical elliptical galaxies can be accounted for by the merger of two or more spirals, but that for highly luminous elliptical galaxies, additional physical processes may be needed.

  1. The impact of rotator cuff tendinopathy on proprioception, measuring force sensation.

    Science.gov (United States)

    Maenhout, Annelies G; Palmans, Tanneke; De Muynck, Martine; De Wilde, Lieven F; Cools, Ann M

    2012-08-01

    The impact of rotator cuff tendinopathy and related impingement on proprioception is not well understood. Numerous quantitative and qualitative changes in shoulder muscles have been shown in patients with rotator cuff tendinopathy. These findings suggest that control of force might be affected. This investigation wants to evaluate force sensation, a submodality of proprioception, in patients with rotator cuff tendinopathy. Thirty-six patients with rotator cuff tendinopathy and 30 matched healthy subjects performed force reproduction tests to isometric external and internal rotation to investigate how accurately they could reproduce a fixed target (50% MVC). Relative error, constant error, and force steadiness were calculated to evaluate respectively magnitude of error made during the test, direction of this error (overshoot or undershoot), and fluctuations of produced forces. Patients significantly overshoot the target (mean, 6.04% of target) while healthy subjects underestimate the target (mean, -5.76% of target). Relative error and force steadiness are similar in patients with rotator cuff tendinopathy and healthy subjects. Force reproduction tests, as executed in this study, were found to be highly reliable (ICC 0.849 and 0.909). Errors were significantly larger during external rotation tests, compared to internal rotation. Patients overestimate the target during force reproduction tests. This should be taken into account in the rehabilitation of patients with rotator cuff tendinopathy; however, precision of force sensation and steadiness of force exertion remains unaltered. This might indicate that control of muscle force is preserved. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  2. A systematic review of cost-effective treatment of postoperative rotator cuff repairs.

    Science.gov (United States)

    Dickinson, Rebecca N; Kuhn, John E; Bergner, Jamie L; Rizzone, Katherine H

    2017-05-01

    The Bundled Payments for Care Improvement initiative combines payment of multiple services for episodes of care into 1 bundle. Rotator cuff repair is a likely candidate for future inclusion. The objective of this study was to determine cost-effective, high-quality postoperative rehabilitation dosing and cryotherapy for patients undergoing rotator cuff repair based on systematic review of the literature. Systematic review of level I and level II articles was performed in PubMed, Cochrane Databases, and PEDro. Conference references and bibliographies were also reviewed. For postoperative therapy, keywords included rotator cuff, rotator cuff repair, exercise therapy, exercise, unsupervised, self-care, postoperative period, physical therapy, and physiotherapy; for cryotherapy, keywords included rotator cuff repair, shoulder, cryotherapy, and ice. Five studies compared postoperative outcomes in participants assigned to supervised therapy vs. unsupervised therapy. Three found no difference between groups. One found improved outcomes in supervised therapy. Limitations included that therapies were not consistently defined and significant methodologic issues were present, decreasing the applicability and validity of the results. Five articles examined cryotherapy outcomes in the postoperative shoulder. Two studies showed improved patient outcomes with cryotherapy vs. no cryotherapy; 2 studies showed no decrease in joint space temperatures at 90 minutes but decrease in temperature at 4 to 23 hours postoperatively. One study indicated that an ice bag and Ace bandage might be as effective as continuous, compressive cryotherapy units using patient-reported outcomes. Further studies are needed to determine effective dosing of physical therapy after rotator cuff repair. Cryotherapy is favorable and cost-effective using simple methods for delivery. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. Massive aspiration past the tracheal tube cuff caused by closed tracheal suction system.

    Science.gov (United States)

    Dave, Mital H; Frotzler, Angela; Madjdpour, Caveh; Koepfer, Nelly; Weiss, Markus

    2011-01-01

    Aspiration past the tracheal tube cuff has been recognized to be a risk factor for the development of ventilator-associated pneumonia (VAP). This study investigated the effect of closed tracheal suctioning on aspiration of fluid past the tracheal tube cuff in an in vitro benchtop model. High-volume low pressure tube cuffs of 7.5 mm internal diameter (ID) were placed in a 22 mm ID artificial trachea connected to a test lung. Positive pressure ventilation (PPV) with 15 cm H₂O peak inspiratory pressure and 5 cm H₂O positive end-expiratory pressure (PEEP) was used. A closed tracheal suction system (CTSS) catheter (size 14Fr) was attached to the tracheal tube and suction was performed for 5, 10, 15, or 20 seconds under 200 or 300 cm H₂O suction pressures. Amount of fluid (mL) aspirated along the tube cuff and the airway pressure changes were recorded for each suction procedure. Fluid aspiration during different suction conditions was compared using Kruskal-Wallis and Mann-Whitney test (Bonferroni correction [α = .01]). During 10, 15, and 20 seconds suction, airway pressure consistently dropped down to -8 to -13 cm H₂O (P aspiration was never observed under PPV + PEEP but occurred always during suctioning. Aspiration along the tube cuff was higher with -300 cm H₂O than with -200 cm H₂O suction pressure (P aspiration of fluid occurs along the tracheal tube cuff during suction with the closed tracheal suction system. © SAGE Publications 2011.

  4. Outcome of Expedited Rotator Cuff Surgery in Injured Workers: Determinants of Successful Recovery.

    Science.gov (United States)

    Razmjou, Helen; Boljanovic, Dragana; Lincoln, Sandra; Holtby, Richard; Gallay, Stephen; Henry, Patrick; Macritchie, Iona; Borthwick, Cheryl; Mayer, Lauren; Roknic, Carolyn; Shore, Deborah; Kamino, Allison; Grossman, Julie; Hill, Joanne; Singh, Gargi; Travers, Niki; Yanofsky, Loraine; Wilson, Marni; Sumar, Shellina; Savona, Alicia; De Medeiros, Filomena; Mann, Helen; Champsi, Aisha; Chau, Stefanie; Medeiros, Danielle; Richards, Robin R

    2017-05-01

    Work-related rotator cuff injuries are a common cause of disability and employee time loss. To examine the effectiveness of expedited rotator cuff surgery in injured workers who underwent rotator cuff decompression or repair and to explore the impact of demographic, clinical, and psychosocial factors in predicting the outcome of surgery. Case series; Level of evidence, 4. Injured workers who were seen at a shoulder specialty program and who underwent expedited arthroscopic rotator cuff decompression or repair were observed for a period of 6 to 12 months based on their type of surgery and recovery trajectory. The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. The impact of surgery was assessed by whether the change in the ASES score exceeded the minimal clinically important difference (MCID) of 17 points. Secondary outcomes were range of motion (ROM), medication consumption, and work status. One hundred forty-six patients (43 women [29%], 103 men [71%]; mean age, 52 years; SD, 8 years) completed the study. Sixty-seven (46%) patients underwent rotator cuff repair. The mean time between the date the patient consented to have surgery and the date of surgery was 82 (SD, 44) days. There was a statistically significant improvement in ASES score and ROM and work status (52 returned to regular duties and 59 to modified duties) ( P satisfaction with the job. Expedited rotator cuff surgery improved disability, ROM, and work status in injured workers. Successful recovery after work-related shoulder injuries may further be facilitated by improving the psychosocial work environment and increasing access to care.

  5. Research on performance of upstream pumping mechanical seal with different deep spiral groove

    International Nuclear Information System (INIS)

    Wang, Q; Chen, H L; Liu, T; Liu, Y H; Liu, Z B; Liu, D H

    2012-01-01

    As one new type of mechanical seal, Upstream Pumping Mechanical Seal has been widely used in fluid machinery. In this paper, structure of spiral groove is innovatively optimized to improve performance of Upstream Pumping Mechanical Seal with Spiral Groove: keeping the dam zone and the weir zone not changed, changing the bottom shape of spiral groove only, substituting different deep spiral groove for equal deep spiral groove. The simulation on Upstream Pumping Mechanical Seal with different deep spiral grooves is done using FVM method. According to calculation, the performances of opening force and pressure distribution on seals face are obtained. Five types of spiral grooves are analyzed, namely equal deep spiral groove, circumferential convergent ladder-like different deep spiral groove, circumferential divergent ladder-like different deep spiral groove, radial convergent ladder-like different deep spiral groove and radial divergent ladder-like different deep spiral groove. This paper works on twenty-five working conditions. The results indicate the performances of circumferential divergent 2-ladder different deep spiral groove are better than the others, with more opening force and better stabilization, while with the same leakage. The outcome provides theoretical support for application of Upstream Pumping Mechanical Seal with circumferential convergent ladder-like different deep spiral groove.

  6. Research on performance of upstream pumping mechanical seal with different deep spiral groove

    Science.gov (United States)

    Wang, Q.; Chen, H. L.; Liu, T.; Liu, Y. H.; Liu, Z. B.; Liu, D. H.

    2012-11-01

    As one new type of mechanical seal, Upstream Pumping Mechanical Seal has been widely used in fluid machinery. In this paper, structure of spiral groove is innovatively optimized to improve performance of Upstream Pumping Mechanical Seal with Spiral Groove: keeping the dam zone and the weir zone not changed, changing the bottom shape of spiral groove only, substituting different deep spiral groove for equal deep spiral groove. The simulation on Upstream Pumping Mechanical Seal with different deep spiral grooves is done using FVM method. According to calculation, the performances of opening force and pressure distribution on seals face are obtained. Five types of spiral grooves are analyzed, namely equal deep spiral groove, circumferential convergent ladder-like different deep spiral groove, circumferential divergent ladder-like different deep spiral groove, radial convergent ladder-like different deep spiral groove and radial divergent ladder-like different deep spiral groove. This paper works on twenty-five working conditions. The results indicate the performances of circumferential divergent 2-ladder different deep spiral groove are better than the others, with more opening force and better stabilization, while with the same leakage. The outcome provides theoretical support for application of Upstream Pumping Mechanical Seal with circumferential convergent ladder-like different deep spiral groove.

  7. [Varicose vein surgery and obesity--experience with a new Boazul cuff in leg circumference up to 90 cm].

    Science.gov (United States)

    Hermanns, H-J

    2008-08-01

    The combination of varicose vein disease and obesity is common in clinical practice. Long operations, high blood loss and extensive bruises are the results. Since 2005, a new roll-on cuff for varicose vein surgery with a thigh circumference of 90 cm is available (big cuff). Between 1.4.1995 and 31.3.2006, surgeons at the Clinic for Vascular Medicine, Venous and Wound Care Centre Krefeld carried out varicose vein surgery in 10 054 cases. 92% (n=9,249) of the operations were done with a roll-on cuff tourniquet. The cuff was inflated to 120 mmHg and rolled up to the thigh of the leg. We present the results of the "big cuff" pilot-study and our general experience with varicose vein surgery in bloodless technique. 1) Big Cuff: A transducer was located between cuff and the skin. A cuff pressure of 120 mmHg and a median thigh circumference of 79.5 cm led to a median pressure of 218.6 mmHg. The tourniquet time was 35 minutes and the systolic blood pressure during the operation did not exceed 120 mmHg. Under these conditions we did not encounter any problems. 2) Bloodless limb technique: 9 249 of our own operations using the Boazul cuff were analysed. We did not find any major complications such as acute arterial occlusion or deep vein thrombosis (DVT) during the procedure. At present the DVT rate amounts to 0.05 %. The use of the bloodless limb technique for varicose vein surgery is very comfortable, especially in cases of severe varicose veins and obesity. Maintenance of operation standards and utmost care of the cuffs lead to the successful use of this procedure.

  8. Increased Upper Trapezius Muscle Stiffness in Overhead Athletes with Rotator Cuff Tendinopathy.

    Science.gov (United States)

    Leong, Hio Teng; Hug, François; Fu, Siu Ngor

    2016-01-01

    Although excessive tension of the upper trapezius (UT) is thought to contribute to rotator cuff tendinopathy, no study examined UT tension in athletes with and without rotator cuff tendinopathy. Here we used UT shear modulus measured using ultrasound shear wave elastography as an index of muscle stiffness/tension. The aims of this study were twofold: 1) to determine whether the UT muscle shear modulus is altered in athletes with rotator cuff tendinopathy compared to asymptomatic athletes, and 2) to detect optimal cut-off points of UT shear modulus in identifying athletes with rotator cuff tendinopathy. Forty-three male volleyball players (17 asymptomatic and 26 with rotator cuff tendinopathy, mean age = 22.9±3.5 years) participated in the study. UT shear modulus was quantified during active arm holding at 30° and 60° of shoulder abduction and passive arm positioning at 0°, 30° and 60° of shoulder abduction. During the active tasks, the UT shear modulus was higher in athletes with rotator cuff tendinopathy than the asymptomatic athletes (p = 0.002), regardless the arm position. During the passive tasks, athletes with rotator cuff tendinopathy exhibited a higher UT shear modulus than asymptomatic athletes only at 0° of shoulder abduction (13.0±2.5 kPa vs 10.2±1.8 kPa, p = 0.001). When considering the active task, an optimal cut-off shear modulus of 12.0 kPa at 30° of shoulder abduction (sensitivity = 0.84, specificity = 0.57, AUC = 0.757, p = 0.008) and 9.5 kPa at 60° of shoulder abduction (sensitivity = 0.88, specificity = 0.67, AUC = 0.816, p = 0.002) was detected. When considering the passive task at 0° of shoulder abduction, a cut-off of 12.2 kPa was found (sensitivity = 0.73, AUC = 0.817, p = 0.001). Findings from the present study show that monitoring passive and active UT muscle shear modulus may provide important information for the prevention/rehabilitation of rotator cuff tendinopathy.

  9. [MRI of the rotator cuff: evaluation of a new symptomatologic classification].

    Science.gov (United States)

    Tavernier, T; Walch, G; Noël, E; Lapra, C; Bochu, M

    1995-05-01

    The different classifications use for the rotator cuff pathology seem to be incomplete. We propose a new classification with many advantages: 1) Differentiate the tendinopathy between less serious (grade 2A) and serious (grade 2B). 2) Recognize the intra-tendinous cleavage of the infra-spinatus associated with complete tear of the supra-spinatus. 3) Differentiate partial and complete tears of the supra-spinatus. We established this classification after a retrospective study of 42 patients operated on for a rotator cuff pathology. Every case had had a preoperative MRI. This classification is simple, reliable, especially for the associated intra tendinous cleavage.

  10. Increased Upper Trapezius Muscle Stiffness in Overhead Athletes with Rotator Cuff Tendinopathy.

    Directory of Open Access Journals (Sweden)

    Hio Teng Leong

    Full Text Available Although excessive tension of the upper trapezius (UT is thought to contribute to rotator cuff tendinopathy, no study examined UT tension in athletes with and without rotator cuff tendinopathy. Here we used UT shear modulus measured using ultrasound shear wave elastography as an index of muscle stiffness/tension. The aims of this study were twofold: 1 to determine whether the UT muscle shear modulus is altered in athletes with rotator cuff tendinopathy compared to asymptomatic athletes, and 2 to detect optimal cut-off points of UT shear modulus in identifying athletes with rotator cuff tendinopathy. Forty-three male volleyball players (17 asymptomatic and 26 with rotator cuff tendinopathy, mean age = 22.9±3.5 years participated in the study. UT shear modulus was quantified during active arm holding at 30° and 60° of shoulder abduction and passive arm positioning at 0°, 30° and 60° of shoulder abduction. During the active tasks, the UT shear modulus was higher in athletes with rotator cuff tendinopathy than the asymptomatic athletes (p = 0.002, regardless the arm position. During the passive tasks, athletes with rotator cuff tendinopathy exhibited a higher UT shear modulus than asymptomatic athletes only at 0° of shoulder abduction (13.0±2.5 kPa vs 10.2±1.8 kPa, p = 0.001. When considering the active task, an optimal cut-off shear modulus of 12.0 kPa at 30° of shoulder abduction (sensitivity = 0.84, specificity = 0.57, AUC = 0.757, p = 0.008 and 9.5 kPa at 60° of shoulder abduction (sensitivity = 0.88, specificity = 0.67, AUC = 0.816, p = 0.002 was detected. When considering the passive task at 0° of shoulder abduction, a cut-off of 12.2 kPa was found (sensitivity = 0.73, AUC = 0.817, p = 0.001. Findings from the present study show that monitoring passive and active UT muscle shear modulus may provide important information for the prevention/rehabilitation of rotator cuff tendinopathy.

  11. Axillary nerve palsy after retrograde humeral nailing: clinical confirmation of an anatomical fear.

    Science.gov (United States)

    Lögters, Tim Tobias; Wild, Michael; Windolf, Joachim; Linhart, Wolfgang

    2008-12-01

    Locked antegrade or retrograde nailing of humeral shaft and proximal humerus fractures is a well established treatment option. Anatomic-morphological studies revealed a potential high risk of axillary nerve injury within proximal interlocking screw insertion. However, clinical experiences do not seem to confirm this, as there is a lack of interlocking screw insertion associated axillary lesions in literature. We report about a 69-year-old man with a humeral shaft fracture (AO-type 12-A3) stabilized by a retrograde implanted interlocking nail. Proximal interlocking screw insertion was performed in a posterior-to-anterior direction. The fracture healed uneventfully. In a follow-up examination 2 years later, an atrophy and paralysis of the deltoid muscle were visible. Electrophysiological evaluation confirmed an isolated axillary nerve injury. Nevertheless, the patient showed good functional recovery with almost free range of motion. Even for clinical practise proximal interlocking screw insertion is associated with a substantial risk of axillary nerve injury. Particularly for posterior-to-anterior screw insertion anatomic conditions should be considered. In spite of axillary nerve lesion, recovery of almost full shoulder function is possible by compensating the loss of deltoid function by rotator cuff muscles.

  12. N-Acetylcysteine protects inner ear hair cells and spiral ganglion neurons from manganese exposure by regulating ROS levels.

    Science.gov (United States)

    Wang, Weilong; Li, Dan; Ding, Xuerui; Zhao, Qianqian; Chen, Jiawei; Tian, Keyong; Qiu, Yang; Lu, Lianjun

    2017-09-05

    Manganese (Mn) is an indispensable cofactor for many enzymes and a basic factor for many reproductive and metabolic pathways. However, exposure to high concentrations of Mn can result in deleterious effects on the central nervous system and peripheral nerves, including nerves associated with the auditory system. Based on our studies of cochlear organotypic cultures, Mn exposure induces a significant loss of hair cells (HCs), auditory nerve fibers (ANFs) and spiral ganglion neurons (SGNs) in a concentration-dependent manner. Additionally, N-acetylcysteine (NAC), a glutathione (GSH) provider and a direct scavenger of reactive oxygen species (ROS), clearly decreases Mn-induced ROS accumulation, caspase-3 activation and TUNEL staining, which indicate increased cell survival. Based on these results, Mn exposure exerts ototoxic and neurotoxic effects on the auditory system. Furthermore, 20mM NAC may prevent 1mM Mn-induced hair cell loss and axonal degeneration, indicating that NAC could be a promising drug for clinical applications. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Pathology of the vestibulocochlear nerve

    Energy Technology Data Exchange (ETDEWEB)

    De Foer, Bert [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: bert.defoer@GZA.be; Kenis, Christoph [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: christophkenis@hotmail.com; Van Melkebeke, Deborah [Department of Neurology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Deborah.vanmelkebeke@Ugent.be; Vercruysse, Jean-Philippe [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: jphver@yahoo.com; Somers, Thomas [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Thomas.somers@GZA.be; Pouillon, Marc [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: marc.pouillon@GZA.be; Offeciers, Erwin [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Erwin.offeciers@GZA.be; Casselman, Jan W. [Department of Radiology, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges (Belgium); Consultant Radiologist, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium); Academic Consultent, University of Ghent (Belgium)], E-mail: jan.casselman@azbrugge.be

    2010-05-15

    There is a large scala of pathology affecting the vestibulocochlear nerve. Magnetic resonance imaging is the method of choice for the investigation of pathology of the vestibulocochlear nerve. Congenital pathology mainly consists of agenesis or hypoplasia of the vestibulocochlear nerve. Tumoral pathology affecting the vestibulocochlear nerve is most frequently located in the internal auditory canal or cerebellopontine angle. Schwannoma of the vestibulocochlear nerve is the most frequently found tumoral lesion followed by meningeoma, arachnoid cyst and epidermoid cyst. The most frequently encountered pathologies as well as some more rare entities are discussed in this chapter.

  14. Spiral Ganglion Cells and Macrophages Initiate Neuro-inflammation and Scarring Following Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Esperanza eBas

    2015-08-01

    Full Text Available Conservation of a patient’s residual hearing and prevention of fibrous tissue/new bone formation around an electrode array are some of the major challenges in cochlear implant (CI surgery. Although it is well known that fibrotic tissue formation around the electrode array can interfere with hearing performance in implanted patients, and that associated intracochlear inflammation can initiate loss of residual hearing, little is known about the molecular and cellular mechanisms that promote this response in the cochlea. In vitro studies in neonatal rats and in vivo studies in adult mice were performed to gain insight into the pro-inflammatory, proliferative, and remodeling phases of pathological wound healing that occur in the cochlea following an electrode analogue insertion. Resident Schwann cells, macrophages/microglia, and fibroblasts had a prominent role in the inflammatory process in the cochlea. Leukocytes were recruited to the cochlea following insertion of a nylon filament in adult mice, where contributed to the inflammatory response. The reparative stages in wound healing are characterized by persistent neuro-inflammation of spiral ganglion neurons and expression of regenerative macrophages in the cochlea. Accordingly, genes involved in extracellular matrix deposition and remodeling were up-regulated in implanted cochleae.Maturation of scar tissue occurs in the remodeling phase of wound healing in the cochlea. Similar to other damaged peripheral nerves, M2 macrophages and de-differentiated Schwann cells were observed in damaged cochleae and may play a role in cell survival and axonal regeneration. In conclusion, the insertion of an electrode analogue into the cochlea is associated with robust early and chronic inflammatory responses characterized by recruitment of leukocytes and expression of pro-inflammatory cytokines that promote intracochlear fibrosis and loss of auditory hair cells and spiral ganglion neurons important for hearing

  15. Dynamic study of the larynx with spiral CT

    International Nuclear Information System (INIS)

    Park, Jong Yeon; Choi, Chang Ho; Yoon, Chi Soon; Kim, Yoon Gyoo; Nam, Sang Hwa; Kim, Kun Il; Kim, Byung Soo; Wang, Soo Guen

    1994-01-01

    It is essential to know the functional and morphologic changes of the larynx in the evaluation of laryngeal lesions. Conventional CT which has relatively long examination time is not suitable for this aim. The purposes of this study are to evaluate the capability of spiral CT in the dynamic study of the larynx and to know whether this new technique can replace conventional laryngography or not. Five healthy volunteers and 20 patients with laryngeal lesions underwent spiral dynamic CT scans with 3-dimensional reconstruction of the mucosal surface. A series of spiral CT scans were done while the volunteers performed various laryngeal positions to obtain the functional and morphologic information. The maneuvers used were: quite breathing, 'E' phonation, Valsalva maneuver, modified Valsalva maneuver, and a new method of our own, 'modified breath holding' technique. The patients were scanned when in quite breathing. Additional scans were obtained by using the 'modified breath holding' technique. The dynamic study with spiral CT could provide high resolutional images which nicely depicted the mobility of vocal cords and the mucosal changes of the laryngeal cavity in both healthy volunteer and patient groups. In patient group, the new 'modified breath holding' technique was easier and more reproducible than other maneuvers. Spiral CT allows a dynamic study of the larynx and can be a new alternative of laryngography

  16. On wave dark matter in spiral and barred galaxies

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Medina, Luis A.; Matos, Tonatiuh [Departamento de Física, Centro de Investigación y de Estudios Avanzados del IPN, A.P. 14-740, 07000 México D.F., México. (Mexico); Bray, Hubert L., E-mail: lmedina@fis.cinvestav.mx, E-mail: bray@math.duke.edu, E-mail: tmatos@fis.cinvestav.mx [Mathematics Department, Duke University, Box 90320, Durham, NC 27708 (United States)

    2015-12-01

    We recover spiral and barred spiral patterns in disk galaxy simulations with a Wave Dark Matter (WDM) background (also known as Scalar Field Dark Matter (SFDM), Ultra-Light Axion (ULA) dark matter, and Bose-Einstein Condensate (BEC) dark matter). Here we show how the interaction between a baryonic disk and its Dark Matter Halo triggers the formation of spiral structures when the halo is allowed to have a triaxial shape and angular momentum. This is a more realistic picture within the WDM model since a non-spherical rotating halo seems to be more natural. By performing hydrodynamic simulations, along with earlier test particles simulations, we demonstrate another important way in which wave dark matter is consistent with observations. The common existence of bars in these simulations is particularly noteworthy. This may have consequences when trying to obtain information about the dark matter distribution in a galaxy, the mere presence of spiral arms or a bar usually indicates that baryonic matter dominates the central region and therefore observations, like rotation curves, may not tell us what the DM distribution is at the halo center. But here we show that spiral arms and bars can develop in DM dominated galaxies with a central density core without supposing its origin on mechanisms intrinsic to the baryonic matter.

  17. Spiral scan long object reconstruction through PI line reconstruction

    International Nuclear Information System (INIS)

    Tam, K C; Hu, J; Sourbelle, K

    2004-01-01

    The response of a point object in a cone beam (CB) spiral scan is analysed. Based on the result, a reconstruction algorithm for long object imaging in spiral scan cone beam CT is developed. A region-of-interest (ROI) of the long object is scanned with a detector smaller than the ROI, and a portion of it can be reconstructed without contamination from overlaying materials. The top and bottom surfaces of the ROI are defined by two sets of PI lines near the two ends of the spiral path. With this novel definition of the top and bottom ROI surfaces and through the use of projective geometry, it is straightforward to partition the cone beam image into regions corresponding to projections of the ROI, the overlaying objects or both. This also simplifies computation at source positions near the spiral ends, and makes it possible to reduce radiation exposure near the spiral ends substantially through simple hardware collimation. Simulation results to validate the algorithm are presented

  18. Continuing research on the classical spiraling photon model

    Science.gov (United States)

    Li, Hongrui

    2014-11-01

    Based no the classical spiraling photon model proposed by Hongrui Li, the laws of reflection, refraction of a single photon can be derived. Moreover, the polarization, total reflection, evanescent wave and Goos-Hanchen shift of a single photon can be elucidated. However, this photon model is still unfinished. Especially, the spiraling diameter of a photon is not definite. In this paper, the continuous research works on this new theory are reported. According to the facts that the diffraction limit of light and the smallest diameter of the focal spot of lenses are all equal to the wavelength λ of the light, we can get that the spiraling diameter of a photon equals to the wavelength λ, so we gain that the angle between the linear velocity of the spiraling photon υ and the component of the linear velocity in the forward direction υb is 45°, and the energy of a classical spiraling photon E = (1/2)mυ2 = (1/2)m2c2 = mc2. This coincides with Einstein's mass-energy relation. While it is obtained that the velocity of the evanescent wave in the vacuum is slower than the velocity of light in glass in straight line. In such a way, the optical fiber can slow the light down. In addition, the force analysis of a single photon in optical tweezers system is discussed. And the reason that the laser beam can capture the particle slightly downstream from the focal point can be explained.

  19. On wave dark matter in spiral and barred galaxies

    International Nuclear Information System (INIS)

    Martinez-Medina, Luis A.; Matos, Tonatiuh; Bray, Hubert L.

    2015-01-01

    We recover spiral and barred spiral patterns in disk galaxy simulations with a Wave Dark Matter (WDM) background (also known as Scalar Field Dark Matter (SFDM), Ultra-Light Axion (ULA) dark matter, and Bose-Einstein Condensate (BEC) dark matter). Here we show how the interaction between a baryonic disk and its Dark Matter Halo triggers the formation of spiral structures when the halo is allowed to have a triaxial shape and angular momentum. This is a more realistic picture within the WDM model since a non-spherical rotating halo seems to be more natural. By performing hydrodynamic simulations, along with earlier test particles simulations, we demonstrate another important way in which wave dark matter is consistent with observations. The common existence of bars in these simulations is particularly noteworthy. This may have consequences when trying to obtain information about the dark matter distribution in a galaxy, the mere presence of spiral arms or a bar usually indicates that baryonic matter dominates the central region and therefore observations, like rotation curves, may not tell us what the DM distribution is at the halo center. But here we show that spiral arms and bars can develop in DM dominated galaxies with a central density core without supposing its origin on mechanisms intrinsic to the baryonic matter

  20. Vascularized nerve grafts for lower extremity nerve reconstruction.

    Science.gov (United States)

    Terzis, Julia K; Kostopoulos, Vasileios K

    2010-02-01

    Vascularized nerve grafts (VNG) were introduced in 1976 but since then, there have been no reports of their usage in lower extremity reconstruction systematically. The factors influencing outcomes as well as a comparison with conventional nerve grafts will be presented.Since 1981, 14 lower extremity nerve injuries in 12 patients have been reconstructed with VNG. Common peroneal nerve was injured in 12 and posterior tibial nerve in 5 patients. The level of the injury was at the knee or thigh. Twelve sural nerves were used as VNG with or without concomitant vascularized posterior calf fascia.All patients regained improved sensibility and adequate posterior tibial nerve function. For common peroneal nerve reconstructions, all patients with denervation time less than 6 months regained muscle strength of grade at least 4, even when long grafts were used for defects of 20 cm or more. Late cases, yielded inadequate muscle function even with the use of VNG.Denervation time of 6 months or less was critical for reconstruction with vascularized nerve graft. Not only the results were statistically significant compared with late cases, but also all early operated patients achieved excellent results. VNG are strongly recommended in traction avulsion injuries of the lower extremity with lengthy nerve damage.

  1. Extending the GANIL control system for the SPIRAL project

    International Nuclear Information System (INIS)

    Lecorche, E.

    1997-01-01

    The SPIRAL project under construction at GANIL aims to deliver radioactive ion beams to the physicists by the end of 1998. In 1996, it has been proposed to achieve most of the SPIRAL control system as an extension of the system currently in use at GANIL. Therefore the main features of the GANIL control system design are first recalled. Then the paper shows how the GANIL control system should have been upgraded and extended to integrate the SPIRAL project. This evolution had to cope with the specific needs brought by the new machine and to consider the size of the project which is around one third of the GANIL control system volume. Lastly current status of the system is given. (author)

  2. Spiral waves in the Belousov-Zhabotinskii reaction

    Science.gov (United States)

    Keener, James P.; Tyson, John J.

    1986-09-01

    The beautiful spiral waves of oxidation in the Belousov-Zhabotinskii reaction are the source of many interesting and important questions about periods structures in excitable media. It has long been known that these spirals are similar to involutes of circles, at least some distance from the center, but until now, no way has been known to determine the correct wavelength and frequency. In this paper, we show that the parameters of a spiral wave can be viwed s eigenvalues of a problem with unique solution. The critical ingredients of the theory are the effects of curvature on the propagation of wavefronts in two-dimensional media, and the dispersion of plane waves Our analytical results are shown to be in good agreement with experimental data for the Belousov-Zhabotinskii reagent.

  3. A Twin Spiral Planar Antenna for UWB Medical Radars

    Directory of Open Access Journals (Sweden)

    Giuseppe A. Zito

    2013-01-01

    Full Text Available A planar-spiral antenna to be used in an ultrawideband (UWB radar system for heart activity monitoring is presented. The antenna, named “twin,” is constituted by two spiral dipoles in a compact structure. The reflection coefficient at the feed point of the dipoles is lower than −8 dB over the 3–12 GHz band, while the two-dipoles coupling is about −20 dB. The radiated beam is perpendicular to the plane of the spiral, so the antenna is wearable and it may be an optimal radiator for a medical UWB radar for heart rate detection. The designed antenna has been also used to check some hypotheses about the UWB radar heart activity detection mechanism. The radiation impedance variation, caused by the thorax vibrations associated with heart activity, seems to be the most likely explanation of the UWB radar operation.

  4. The scientific objectives of the SPIRAL 2 Project

    International Nuclear Information System (INIS)

    Ackermann, D.; Adoui, L.; Angelis, G. de

    2006-06-01

    The construction of SPIRAL 2 at GANIL will open completely new possibilities for parallel beam operation of the whole facility. The whole GANIL/SPIRAL/SPIRAL2 accelerator complex will allow for the simultaneous use of up to 5 different radioactive and stable beams. Several combinations of different beams delivered in parallel for experiments at low (keV/u), medium (few MeV/u) and high (up to 100 MeV/u) energies will be possible. Presently the GANIL/SPIRAL facility delivers about 60 weeks per year of stable and radioactive beams (up to 3 simultaneous beams). Thanks to SPIRAL 2 and the construction of a new beam line connecting the CIME cyclotron and the G1 and G2 experimental rooms the available beam time for experiments may be extended up to about 120 (up to 5 simultaneous beams) weeks per year. The chapters which follow a general introduction deal with the detailed questions to be addressed by experiments with the beams from SPIRAL2. In chapter 2 the many unanswered questions related to the structure of exotic nuclei are posed and the role of SPIRAL2 in answering them outlined. Chapter 3 deals with the dynamics and thermodynamics of asymmetric nuclear systems. Chapter 4 is concerned with questions of nuclear astrophysics which are intimately related to the properties of exotic nuclei. Chapter 5 indicates how the atomic nucleus can act as a laboratory for tests of the Standard model of Particle Physics and Chapter 6 shows how the production of intense fluxes of neutrons at SPIRAL2 make it an excellent tool to address both questions related to damage in materials of importance in nuclear installations and to the s- and r-processes of nucleosynthesis. In chapter 7 we turn to the application, of the radioactive beams from SPIRAL2 and the radionuclides produced by it, to study condensed matter and radiobiology. Finally in the eight and last chapter the reader can find an account of the historical development of the SPIRAL2 facility and this is followed by an outline of

  5. The scientific objectives of the SPIRAL 2 Project

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, D.; Adoui, L.; Angelis, G. de [GANIL, Grand Accelerateur National d' Ions Lourds, BP 55027, 14076 Caen cedex 5 (France)] (and others)

    2006-06-15

    The construction of SPIRAL 2 at GANIL will open completely new possibilities for parallel beam operation of the whole facility. The whole GANIL/SPIRAL/SPIRAL2 accelerator complex will allow for the simultaneous use of up to 5 different radioactive and stable beams. Several combinations of different beams delivered in parallel for experiments at low (keV/u), medium (few MeV/u) and high (up to 100 MeV/u) energies will be possible. Presently the GANIL/SPIRAL facility delivers about 60 weeks per year of stable and radioactive beams (up to 3 simultaneous beams). Thanks to SPIRAL 2 and the construction of a new beam line connecting the CIME cyclotron and the G1 and G2 experimental rooms the available beam time for experiments may be extended up to about 120 (up to 5 simultaneous beams) weeks per year. The chapters which follow a general introduction deal with the detailed questions to be addressed by experiments with the beams from SPIRAL2. In chapter 2 the many unanswered questions related to the structure of exotic nuclei are posed and the role of SPIRAL2 in answering them outlined. Chapter 3 deals with the dynamics and thermodynamics of asymmetric nuclear systems. Chapter 4 is concerned with questions of nuclear astrophysics which are intimately related to the properties of exotic nuclei. Chapter 5 indicates how the atomic nucleus can act as a laboratory for tests of the Standard model of Particle Physics and Chapter 6 shows how the production of intense fluxes of neutrons at SPIRAL2 make it an excellent tool to address both questions related to damage in materials of importance in nuclear installations and to the s- and r-processes of nucleosynthesis. In chapter 7 we turn to the application, of the radioactive beams from SPIRAL2 and the radionuclides produced by it, to study condensed matter and radiobiology. Finally in the eight and last chapter the reader can find an account of the historical development of the SPIRAL2 facility and this is followed by an outline of

  6. Study on a new water purification equipment with spiral lamellas

    Science.gov (United States)

    Feng, X. R.

    2017-08-01

    A new water purification equipment was introduced, especially the section of spiral lamellas. Utilization of spiral lamellas made the sedimentation space reach to 100%, not only improving sedimentation efficiency and reducing the cover space, but also saving investment. Production test results showed that the new water purification equipment with spiral lamellas had characteristics of excellent treatment efficiency and high shock resistant capacity. As the treatment water volume was 240 m3/d, when the turbidity, CODMn and UV254 were 203 NTU, 1.90 mg/L and 0.030 cm-1 in raw water, they were 0.32 NTU, 0.72mg/L and 0.011 cm-1 respectively in effluent water, which could fully meet the drinking water hygiene requirement.

  7. A Spiral And Discipline-Oriented Curriculum In Medical Imaging

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Hanson, Lars G.; Henneberg, Kaj-Åge

    2011-01-01

    This contribution describes and evaluates an experimental combination of a spiral and discipline-oriented curriculum implemented in the bachelor’s and master’s program in Medicine and Technology. The implementation in the master’s program is in the form of a study line in Medical Imaging and Radi......This contribution describes and evaluates an experimental combination of a spiral and discipline-oriented curriculum implemented in the bachelor’s and master’s program in Medicine and Technology. The implementation in the master’s program is in the form of a study line in Medical Imaging...... and Radiation Physics containing three disciplines: Imaging modalities, Radiation therapy and Image processing. The two imaging courses in the bachelor’s program and the first imaging course in the master’s program follow a spiral curriculum in which most disciplines are encountered in all courses...

  8. Auditory Mechanics of the Tectorial Membrane and the Cochlear Spiral

    Science.gov (United States)

    Gavara, Núria; Manoussaki, Daphne; Chadwick, Richard S.

    2012-01-01

    Purpose of review This review is timely and relevant since new experimental and theoretical findings suggest that cochlear mechanics from the nanoscale to the macroscale are affected by mechanical properties of the tectorial membrane and the spiral shape. Recent findings Main tectorial membrane themes covered are i) composition and morphology, ii) nanoscale mechanical interactions with the outer hair cell bundle, iii) macroscale longitudinal coupling, iv) fluid interaction with inner hair cell bundles, v) macroscale dynamics and waves. Main cochlear spiral themes are macroscale low-frequency energy focusing and microscale organ of Corti shear gain. Implications Findings from new experimental and theoretical models reveal exquisite sensitivity of cochlear mechanical performance to tectorial membrane structural organization, mechanics, and its positioning with respect to hair bundles. The cochlear spiral geometry is a major determinant of low frequency hearing. Suggestions are made for future research directions. PMID:21785353

  9. Spiral CT for cervical lymph node enlargement. Early clinical results

    International Nuclear Information System (INIS)

    Steinkamp, H.J.; Keske, U.; Schedel, J.; Hosten, N.; Felix, R.

    1994-01-01

    Spiral CT was performed before treatment in 35 patients with suspected cervical lymph node enlargement. By coronary and sagittal reconstruction it is possible to utilise the M/Q quotient which has become accepted as the result of sonographic and MRI examinations. It is now possible to obtain high diagnostic accuracy (97%) for distinguishing between reactive change from metastatic infiltration of lymph nodes (>8 mm) by using CT. Using spiral CT with 5 mm table movement, three patients diagnosed as stage N1 by axial CT were shown to be N2b. This represents a highly sensitive and highly specific method of lymph node diagnosis. Further diagnostic improvement derives from the ability to relate the lymph nodes to surrounding tissues. Spiral CT is also suitable for defining other space occupying lesions, e.g., the exact extent of retropharyngeal abscesses, abnormalities of the salivary glands or laryngocoeles. (orig.)

  10. Unilateral sixth nerve palsy.

    Science.gov (United States)

    Sotoodehnia, Mehran; Safaei, Arash; Rasooli, Fatemeh; Bahreini, Maryam

    2017-06-01

    The diagnosis of cerebral venous sinus thrombosis still remains a real challenge. Seizure, unusual headache with sudden onset, unexplained persistently unilateral vascular headache and neurologic deficit-which is difficult to be attributed to a vascular territory are some of the suggestive symptoms. An isolated sixth nerve palsy is discussed as a rare presentation for cerebral venous thrombosis. Following the extensive investigation to rule out other possible diagnoses, magnetic resonance venogram revealed the final etiology of sixth nerve palsy that was ipsilateral left transverse sinus thrombosis; therefore, anticoagulant treatment with low molecular weight heparin was administered. Rapid and accurate diagnosis and treatment cause to achieve excellent outcomes for most patients. Considering different clinical features, risk factors and high index of suspicion are helpful to reach the diagnosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats.

    Science.gov (United States)

    Crook, Jonathan J; Lovick, Thelma A

    2017-01-01

    Urge Urinary Incontinence: "a sudden and uncontrollable desire to void which is impossible to defer" is extremely common and considered the most bothersome of lower urinary tract conditions. Current treatments rely on pharmacological, neuromodulatory, and neurotoxicological approaches to manage the disorder, by reducing the excitability of the bladder muscle. However, some patients remain refractory to treatment. An alternative approach would be to temporarily suppress activity of the micturition control circuitry at the time of need i.e., urgency. In this study we investigated, in a rat model, the utility of high frequency pelvic nerve stimulation to produce a rapid onset, reversible suppression of voiding. In urethane-anesthetized rats periodic voiding was induced by continuous infusion of saline into the bladder whilst recording bladder pressure and electrical activity from the external urethral sphincter (EUS). High frequency (1-3 kHz), sinusoidal pelvic nerve stimulation initiated at the onset of the sharp rise in bladder pressure signaling an imminent void aborted the detrusor contraction. Urine output was suppressed and tone in the EUS increased. Stimulating the right or left nerve was equally effective. The effect was rapid in onset, reversible, and reproducible and evoked only minimal "off target" side effects on blood pressure, heart rate, respiration, uterine pressure, or rectal pressure. Transient contraction of abdominal wall was observed in some animals. Stimulation applied during the filling phase evoked a small, transient rise in bladder pressure and increased tonic activity in the EUS, but no urine output. Suppression of micturition persisted after section of the contralateral pelvic nerve or after ligation of the nerve distal to the electrode cuff on the ipsilateral side. We conclude that high frequency pelvic nerve stimulation initiated at the onset of an imminent void provides a potential means to control urinary continence.

  12. High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats

    Directory of Open Access Journals (Sweden)

    Jonathan J. Crook

    2017-08-01

    Full Text Available Urge Urinary Incontinence: “a sudden and uncontrollable desire to void which is impossible to defer” is extremely common and considered the most bothersome of lower urinary tract conditions. Current treatments rely on pharmacological, neuromodulatory, and neurotoxicological approaches to manage the disorder, by reducing the excitability of the bladder muscle. However, some patients remain refractory to treatment. An alternative approach would be to temporarily suppress activity of the micturition control circuitry at the time of need i.e., urgency. In this study we investigated, in a rat model, the utility of high frequency pelvic nerve stimulation to produce a rapid onset, reversible suppression of voiding. In urethane-anesthetized rats periodic voiding was induced by continuous infusion of saline into the bladder whilst recording bladder pressure and electrical activity from the external urethral sphincter (EUS. High frequency (1–3 kHz, sinusoidal pelvic nerve stimulation initiated at the onset of the sharp rise in bladder pressure signaling an imminent void aborted the detrusor contraction. Urine output was suppressed and tone in the EUS increased. Stimulating the right or left nerve was equally effective. The effect was rapid in onset, reversible, and reproducible and evoked only minimal “off target” side effects on blood pressure, heart rate, respiration, uterine pressure, or rectal pressure. Transient contraction of abdominal wall was observed in some animals. Stimulation applied during the filling phase evoked a small, transient rise in bladder pressure and increased tonic activity in the EUS, but no urine output. Suppression of micturition persisted after section of the contralateral pelvic nerve or after ligation of the nerve distal to the electrode cuff on the ipsilateral side. We conclude that high frequency pelvic nerve stimulation initiated at the onset of an imminent void provides a potential means to control urinary

  13. Optic nerve hypoplasia

    Directory of Open Access Journals (Sweden)

    Savleen Kaur

    2013-01-01

    Full Text Available Optic nerve hypoplasia (ONH is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65% than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED.

  14. Rediscovering the Giant Low Surface Brightness Spiral Galaxy Malin 1

    Science.gov (United States)

    Galaz, Gaspar

    2018-01-01

    I summarize the latest discoveries regarding this ramarkable diffuse and giant galaxy, the largest single spiral in the universe so far. I describe how the latest discoveries could have been done easily 20 years ago, but an incredible summation of facts and some astronomical sociology, keeped many of them undisclosed. I present the most conspicuous features of the giant spiral arms of Malin 1, including stellar density, colors, stellar populations and some modeling describing their past evolution to the current state. I conclude with pending issues regarding stellar formation in Malin 1, and the efforts to detect its elusive molecular gas.

  15. Initial clinical experience with spiral CT angiography in the abdomen

    International Nuclear Information System (INIS)

    Gaa, J.; Stehling, M.K.; Costello, P.

    1993-01-01

    The latest developments in modern CT instruments, offering scanning times of a second, opened up new possibilities in CT imaging in combination with the spiral technique. The data set normally taken with single-breath-hold technique is free of respiratory artefacts and thus is a good basis for accurate 3D image reconstruction. Spiral CTA allows a non-invasive 3D imaging of various blood vessels. Patients with abdominal aortic aneurysms of aorto-iliac bypass can be examined as outpatients within 15 minutes. (orig.) [de

  16. The color gradient in spiral galaxies: application to M 81

    International Nuclear Information System (INIS)

    Segalovitz, A.

    1975-01-01

    The calculated development of the color of a star cluster is used to predict the expected color evolution, as a function of radius, in a spiral galaxy. It is assumed that the fraction of gas which is converted into stars during a spiral arm passage is a function of radius only. Applying this model to M 81, it is shown that the observed color and mass distributions can be explained by an initial disk-like gas distribution proportional to the inverse square of the radius and a consumption fraction which is an increasing function of radius. (orig.) [de

  17. Spiral CT angiography of the abdominal aorta and its branches

    Energy Technology Data Exchange (ETDEWEB)

    Costello, P. [Dept. of Radiology, Deaconess Hospital and Harvard Medical School, Boston, MA (United States); Gaa, J. [Dept. of Radiology, Deaconess Hospital and Harvard Medical School, Boston, MA (United States)

    1993-08-01

    Spiral CT angiography (CTA) was performed on 19 patients for the pre-operative assessment of abdominal aortic aneurysms and in 3 post-operative renal artery bypass patients. Spiral CTA performed during intravenous contrast infusion provided a volume of data that was reconstructed at thin increments. Images were edited and reformatted either as surface rendered three-dimensional or maximum intensity projection (MIP) displays. Final images were viewed in a cine-loop presentation of quality comparable to conventional angiograms. The entire aorta can be examined from the coeliac axis to mid-pelvis with only 107 ml of 60% contrast. (orig.)

  18. SPIRAL2 Week 2011 - Slides of the presentations

    International Nuclear Information System (INIS)

    Gales, S.; Jacquemet, M.; Lewitowicz, M.; Petit, E.; Biarrote, J.L.; Uriot, D.; Thuillier, T.; Peaucelle, C.; Barue, C.; Van Hille, C.; Bernaudin, P.E.; Galdemard, P.; Ausset, P.; Dolegieviez, P.; Levallois, R.; Marchetto, M.; Pasini, M.; Quiclet, M.; Danna, O.; Lunney, D.; Di Giacomo, M.

    2013-01-01

    The main goal of the meeting is to present and discuss the current status of the SPIRAL2 project at GANIL in front of a large community of scientists and engineers. The program of the meeting will include presentations on scientific and technical developments related to the baseline project, experiments and theory. The main topics to be discussed at the conference have been: -) Driver Accelerators, -) Production of radioactive ion beams (RIB), -) Safety, -) RIB Facilities Worldwide (FAIR, Riken Nishina Center, SPES project, FRIB project) -) FP7 SPIRAL2 Preparatory Phase, -) Experiments with RIB and Theory. This document is made up of the slides of the presentations

  19. Necessity for High Accuracy Rotation Curves in Spiral Galaxies

    OpenAIRE

    Blais-Ouellette, Sebastien; Carignan, Claude; Amram, Philippe

    1998-01-01

    In the last 20 years, rotation curves derived from H I kinematics obtained on radio synthesis instruments were used to probe the dark matter distribution in spiral and dwarf irregular galaxies. It is shown, with the aid of the Sd galaxy NGC 5585, that high resolution 2--D H II kinematics is necessary to determine accurately the mass distribution of spirals. New CFHT Fabry--Perot Hff observations are combined with low resolution Westerbork H I data to study its mass distribution. Using the com...

  20. A Spiral And Discipline-Oriented Curriculum In Medical Imaging

    DEFF Research Database (Denmark)

    Wilhjelm, Jens E.; Hanson, Lars G.; Henneberg, Kaj-Åge

    2011-01-01

    This contribution describes and evaluates an experimental combination of a spiral and discipline-oriented curriculum implemented in the bachelor’s and master’s program in Medicine and Technology. The implementation in the master’s program is in the form of a study line in Medical Imaging...... and Radiation Physics containing three disciplines: Imaging modalities, Radiation therapy and Image processing. The two imaging courses in the bachelor’s program and the first imaging course in the master’s program follow a spiral curriculum in which most disciplines are encountered in all courses...