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Sample records for spontaneous chordal rupture

  1. Spontaneous Tricuspid Valve Chordal Rupture in Idiopathic Pulmonary Hypertension.

    Science.gov (United States)

    Rodrigues, Ana Clara Tude; Afonso, José E; Cordovil, Adriana; Monaco, Claudia; Piveta, Rafael; Cordovil, Rodrigo; Fischer, Claudio H; Vieira, Marcelo; Lira-Filho, Edgar; Morhy, Samira S

    2016-03-01

    Rupture of tricuspid valve is unusual, occurring mainly in the setting of blunt trauma or endomyocardial biopsy. Spontaneous tricuspid valve chordal rupture is particularly rare. We report herein a case of a patient with severe pulmonary hypertension, on the lung transplantation waiting list, who presented with spontaneous chordal rupture, exacerbation of tricuspid insufficiency and worsening of clinical status. Diagnosis and treatment, along with possible mechanisms for this complication, are discussed. © 2015, Wiley Periodicals, Inc.

  2. Endometriosis-related spontaneous diaphragmatic rupture.

    Science.gov (United States)

    Triponez, Frédéric; Alifano, Marco; Bobbio, Antonio; Regnard, Jean-François

    2010-10-01

    Non-traumatic, spontaneous diaphragmatic rupture is a rare event whose pathophysiology is not known. We report the case of endometriosis-related spontaneous rupture of the right diaphragm with intrathoracic herniation of the liver, gallbladder and colon. We hypothesize that the invasiveness of endometriotic tissue caused diaphragm fragility, which finally lead to its complete rupture without traumatic event. The treatment consisted of a classical management of diaphragmatic rupture, with excision of the endometriotic nodule followed by medical ovarian suppression for six months.

  3. Spontaneous Splenic Rupture in Melanoma

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    Hadi Mirfazaelian

    2014-01-01

    Full Text Available Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

  4. Spontaneous rupture of choledochal cyst: case report

    International Nuclear Information System (INIS)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young

    2002-01-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued

  5. Spontaneous rupture of choledochal cyst: case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young [Dong-a University College of Medicine, Pusan (Korea, Republic of)

    2002-11-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued.

  6. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, J H; Galatius, H; Hansen, P K

    1985-01-01

    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  7. Spontaneous Achilles tendon rupture in alkaptonuria | Mohammed ...

    African Journals Online (AJOL)

    Spontaneous Achilles tendon ruptures are uncommon. We present a 46-year-old man with spontaneous Achilles tendon rupture due to ochronosis. To our knowledge, this has not been previously reported in Sudan literature. The tendon of the reported patient healed well after debridement and primary repairs.

  8. Bilateral spontaneous rupture of flexor digitorum profundus tendons.

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    Spontaneous tendon rupture is an unusual condition usually associated with underlying disease processes such as rheumatoid arthritis, chronic renal failure or bony abnormalities of the hand. We report a case of spontaneous, non-concurrent bilateral rupture of flexor profundus tendons in an otherwise healthy individual. Treatment was successful and consisted of a two-stage reconstruction of the ruptured tendon.

  9. Spontaneous distal rupture of the plantar fascia.

    Science.gov (United States)

    Gitto, Salvatore; Draghi, Ferdinando

    2018-07-01

    Spontaneous ruptures of the plantar fascia are uncommon injuries. They typically occur at its calcaneal insertion and usually represent a complication of plantar fasciitis and local treatment with steroid injections. In contrast, distal ruptures commonly result from traumatic injuries. We describe the case of a spontaneous distal rupture of the plantar fascia in a 48-year-old woman with a low level of physical activity and no history of direct injury to the foot, plantar fasciitis, or steroid injections. © 2017 Wiley Periodicals, Inc.

  10. Hepatic Rupture Induced by Spontaneous Intrahepatic Hematoma

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    Jin-bao Zhou

    2018-01-01

    Full Text Available The etiology of hepatic rupture is usually secondary to trauma, and hepatic rupture induced by spontaneous intrahepatic hematoma is clinically rare. We describe here a 61-year-old female patient who was transferred to our hospital with hepatic rupture induced by spontaneous intrahepatic hematoma. The patient had no history of trauma and had a history of systemic lupus erythematosus for five years, taking a daily dose of 5 mg prednisone for treatment. The patients experienced durative blunt acute right upper abdominal pain one day after satiation, which aggravated in two hours, accompanied by dizziness and sweating. Preoperative diagnosis was rupture of the liver mass. Laparotomy revealed 2500 mL fluid consisting of a mixture of blood and clot in the peritoneal cavity. A 3.5 cm × 2.5 cm rupture was discovered on the hepatic caudate lobe near the vena cava with active arterial bleeding, and a 5  × 6 cm hematoma was reached on the right posterior lobe of the liver. Abdominal computed tomography (CT and laparotomy revealed spontaneous rupture of intrahepatic hematoma with hemorrhagic shock. The patient was successfully managed by suturing the rupture of the hepatic caudate lobe and clearing part of the hematoma. The postoperative course was uneventful, and the patient was discharged after two weeks of hospitalization.

  11. Four cases of spontaneous rupture of the urinary bladder

    International Nuclear Information System (INIS)

    Amano, Toshiyasu; Miwa, Sotaro; Takashima, Hiroshi; Takemae, Katsuro

    2002-01-01

    Between November 1997 and March 2001, 4 female patients from 44 to 65 years of age with a spontaneous rupture of the urinary bladder were analyzed. They complained of abdominal pain and had undergone an intra-pelvic gynecological operation (3 for uterine cancer, 1 for an ovarian cyst) several years before. The three with uterine cancer had also received radiation therapy. For their present condition, spontaneous urinary bladder rupture, their treatment was indwelling a urethral catheter. Two of them have had no recurrence of urinary bladder rupture after one month since having the urethral catheter indwelt. One, however, had to have the catheter re-indwelt due to unsuccessful suturing of the urinary bladder wall. The fourth patient had bilateral nephrostomy tubes due to severe radiation cystitis. Thus, one can infer that intra-pelvic gynecological operations and radiation therapy are major factors causing spontaneous urinary bladder rupture. While indwelling a urethral catheter may be effective for some patients with a spontaneous rupture of the urinary bladder, it may be very difficult to treat more complicated cases. (author)

  12. Spontaneous splenic rupture in Waldenstrom's macroglobulinemia: a case report

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    Charakidis Michail

    2010-09-01

    Full Text Available Abstract Introduction We report the case of a patient with Waldenstrom's macroglobulinemia complicated by spontaneous splenic rupture. Case presentation A 49-year-old Caucasian woman was referred to our emergency department by her general practitioner following a three-week history of malaise, night sweats, six kilograms of weight loss, intermittent nausea and vomiting, progressive upper abdominal pain and easy bruising. On the fourth day following her admission, she had a rapid clinical deterioration, with subsequent radiological investigations revealing a splenic rupture. Her morphology, biochemistry, flow cytometry and histology were strongly suggestive of Waldenstrom's macroglobulinemia. Conclusions Spontaneous splenic rupture is not an expected complication of low-grade lymphoplasmacytic lymphomas, such as Waldenstrom's macroglobulinemia. To the best of our knowledge, this is the only reported case of early spontaneous splenic rupture due to Waldenstrom's macroglobulinemia. Our case highlights that despite the typical disease course of low-grade hematological malignancies, signs and symptoms of imminent splenic rupture should be considered when formulating a clinical assessment.

  13. Spontaneous Hepatic Rupture Associated with Preeclampsia: Treatment with Hepatic Artery Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Goo, Dong Erk; Chang, Yun Woo; Kim, Yong Jae; Hwang, In Cheol; Han, Hyo Sang; Yoon, Jong Hyun; Lee, Tae Il [Soonchunhyang University Hospital, Gumi (Korea, Republic of)

    2010-02-15

    Spontaneous rupture of the liver due to preeclampsia is a rare condition of pregnant women, and it can be very dangerous if not treated. We report here on a case of successfully treating spontaneous liver rupture associated with preeclampsia by performing transcatheter hepatic arterial embolization. A 41-year-old woman with spontaneous rupture of the liver associated with preeclampsia was treated by hepatic arterial embolization

  14. Spontaneous Hepatic Rupture Associated with Preeclampsia: Treatment with Hepatic Artery Embolization

    International Nuclear Information System (INIS)

    Yang, Seung Boo; Goo, Dong Erk; Chang, Yun Woo; Kim, Yong Jae; Hwang, In Cheol; Han, Hyo Sang; Yoon, Jong Hyun; Lee, Tae Il

    2010-01-01

    Spontaneous rupture of the liver due to preeclampsia is a rare condition of pregnant women, and it can be very dangerous if not treated. We report here on a case of successfully treating spontaneous liver rupture associated with preeclampsia by performing transcatheter hepatic arterial embolization. A 41-year-old woman with spontaneous rupture of the liver associated with preeclampsia was treated by hepatic arterial embolization

  15. Surgical management of spontaneous ruptured hepatocellular adenoma

    Directory of Open Access Journals (Sweden)

    Marcelo Augusto Fontenelle Ribeiro Junior

    2009-01-01

    Full Text Available AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006 with a proven diagnosis of hepatocellular adenoma (HA. Three (10.7% of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation, as well as intraperitoneal abscess (re-operation and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.

  16. Spontaneous rupture of ovarian cystadenocarcinoma: pre- and post-rupture computed tomography evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Salvadori, Priscila Silveira; Atzingen, Augusto Castelli von; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Bomfim, Lucas Novais [Universidade Tiradentes (UNIT), Maceio, AL, (Brazil)

    2015-09-15

    Epithelial ovarian tumors are the most common malignant ovarian neoplasms and, in most cases, eventual rupture of such tumors is associated with a surgical procedure. The authors report the case of a 54-year-old woman who presented with spontaneous rupture of ovarian cystadenocarcinoma documented by computed tomography, both before and after the event. In such cases, a post-rupture staging tends to be less favorable, compromising the prognosis. (author)

  17. Case of a spontaneously ruptured epidermoid cyst

    Energy Technology Data Exchange (ETDEWEB)

    Shiroyama, Y; Saiki, M; Ueda, H; Katayama, S; Mitani, T

    1987-02-01

    Intracranial fat-containing congenital tumors are characterized by negative absorption values on CT. We hereby report a case of an epidermoid cyst with subarachnoid free fats diagnosed preoperatively by CT. A 21-year-old female was admitted to our hospital because of continuous mild headache and nausea. At the time of admission, the results of her physical and neurological examinations were normal. CT, however, demonstrated multiple subarachnoid low-density spots and a suprasellar low-density area with high-density spots. In addition, there were negative absorption values (-12 -- -77), suggesting free fats. A spontaneously ruptured epidermoid or dermoid cyst was diagnosed on the basis of these findings. At surgery, a suprasellar tumor containing a yellowish, cheese-like material was confirmed. The patient made an uneventful recovery and was discharged 14 days after surgery. There have been several published reports of CT appearances of intracranial fat-containing tumors. However, spontaneously ruptured cases diagnosed by CT are rare. CT was found to be useful for the diagnosis of spontaneously ruptured cases of fat-containing tumors.

  18. Presence of Bacteria in Spontaneous Achilles Tendon Ruptures.

    Science.gov (United States)

    Rolf, Christer G; Fu, Sai-Chuen; Hopkins, Chelsea; Luan, Ju; Ip, Margaret; Yung, Shu-Hang; Friman, Göran; Qin, Ling; Chan, Kai-Ming

    2017-07-01

    The structural pathology of Achilles tendon (AT) ruptures resembles tendinopathy, but the causes remain unknown. Recently, a number of diseases were found to be attributed to bacterial infections, resulting in low-grade inflammation and progressive matrix disturbance. The authors speculate that spontaneous AT ruptures may also be influenced by the presence of bacteria. Bacteria are present in ruptured ATs but not in healthy tendons. Cross-sectional study; Level of evidence, 3. Patients with spontaneous AT ruptures and patients undergoing anterior cruciate ligament (ACL) reconstruction were recruited for this study. During AT surgical repair, excised tendinopathic tissue was collected, and healthy tendon samples were obtained as controls from hamstring tendon grafts used in ACL reconstruction. Half of every sample was reserved for DNA extraction and the other half for histology. Polymerase chain reaction (PCR) was conducted using 16S rRNA gene universal primers, and the PCR products were sequenced for the identification of bacterial species. A histological examination was performed to compare tendinopathic changes in the case and control samples. Five of 20 AT rupture samples were positive for the presence of bacterial DNA, while none of the 23 hamstring tendon samples were positive. Sterile operating and experimental conditions and tests on samples, controlling for harvesting and processing procedures, ruled out the chance of postoperative bacterial contamination. The species identified predominantly belonged to the Staphylococcus genus. AT rupture samples exhibited histopathological features characteristic of tendinopathy, and most healthy hamstring tendon samples displayed normal tendon features. There were no apparent differences in histopathology between the bacterial DNA-positive and bacterial DNA-negative AT rupture samples. The authors have demonstrated the presence of bacterial DNA in ruptured AT samples. It may suggest the potential involvement of bacteria

  19. Spontaneous splenic rupture. Radiological findings in three cases

    International Nuclear Information System (INIS)

    Arenal, F.; Barrera, J.; Merino, S.; Pedrosa, C. S.

    1999-01-01

    Spontaneous splenic rupture not associated with previous trauma is an uncommon disease. It can appear in the course of multiple systemic diseases or over a normal splenic architecture, which is even more infrequent. An early diagnosis results mandatory, since it is a potentially fatal disease if it is not promptly diagnosed and managed. We present three cases of spontaneous splenic rupture (two sub capsular hematomas opened to peritoneum and a rupture of splenic parenchyma). One patient had infectious mononucleosis, other was in the acute phase of a chronic pancreatitis and the third one had a normal splenic architecture. We emphasize the importance of CT in the early diagnosis of this entity. (Author) 21 refs

  20. Nontraumatic spontaneous rupture of the kidney : etiology and CT findings

    International Nuclear Information System (INIS)

    Heo, Tae Haeng; Jeon, Hae Jeong; Shin, Hyun Joon; Kim, Bo Hyun; Cho, Kyoung Sik; Kim, Young Hwa; Kim, Seung Hyup; Park, Churl Min

    1997-01-01

    To evaluate the usefulness of CT scanning in determining the etiology of spontaneous rupture of the kidney We retrospectively analyzed the CT findings of spontaneous rupture of the kidney in eleven patients, Four were male and seven were female, and they were aged between 20 and 71 (mean, 46.6) years. Both pre- and post-contrast enhanced CT scanning was performed in all patients. Spontaneous renal rupture was induced in seven cases by neoplasms (three angiomyolipomas, three renal cell carcinomas, and one metastatic choriocarcinoma), in three cases by infection or inflammation (acute and chronic pyelonephritis, and renal abscess), and in one, by renal cyst. Common CT findings of rupture of the kidney were the accumulation of high density fluid in the perirenal and anterior pararenal space, and inhomogeneous irregular low density of renal parenchyma and the rupture site. Angiomyolipoma showed fat and an angiomatous component in the lesion, while acute and chronic pyelonephrities revealed thinning of the renal parenchyma and an irregular renal outline. Renal cell carcinoma showed a dense soft tissue mass in the parenchyma. Well-defined, round low-density lesions were noted in the case of renal cyst and renal abscess. CT is very useful in diagnosing and determining the etiology of non-traumatic spontaneous rupture of the kidney and plays an important role in the evaluation of emergency cases

  1. Fluid-Structure Interaction Analysis of Ruptured Mitral Chordae Tendineae.

    Science.gov (United States)

    Toma, Milan; Bloodworth, Charles H; Pierce, Eric L; Einstein, Daniel R; Cochran, Richard P; Yoganathan, Ajit P; Kunzelman, Karyn S

    2017-03-01

    The chordal structure is a part of mitral valve geometry that has been commonly neglected or simplified in computational modeling due to its complexity. However, these simplifications cannot be used when investigating the roles of individual chordae tendineae in mitral valve closure. For the first time, advancements in imaging, computational techniques, and hardware technology make it possible to create models of the mitral valve without simplifications to its complex geometry, and to quickly run validated computer simulations that more realistically capture its function. Such simulations can then be used for a detailed analysis of chordae-related diseases. In this work, a comprehensive model of a subject-specific mitral valve with detailed chordal structure is used to analyze the distinct role played by individual chordae in closure of the mitral valve leaflets. Mitral closure was simulated for 51 possible chordal rupture points. Resultant regurgitant orifice area and strain change in the chordae at the papillary muscle tips were then calculated to examine the role of each ruptured chorda in the mitral valve closure. For certain subclassifications of chordae, regurgitant orifice area was found to trend positively with ruptured chordal diameter, and strain changes correlated negatively with regurgitant orifice area. Further advancements in clinical imaging modalities, coupled with the next generation of computational techniques will enable more physiologically realistic simulations.

  2. Recurrent spontaneous bladder rupture cured by conservative therapy. A case report

    International Nuclear Information System (INIS)

    Hagiwara, Noriyasu; Nishida, Yasuyuki; Fujimoto, Yoshinori; Isogai, Kazutoshi; Fujihiro, Shigeru; Deguchi, Takashi

    2002-01-01

    The patient was a 44-year-old woman, who had undergone radical hysterectomy and postoperative radiation therapy for cervical cancer at the age of 34 years old. In 1998, she was admitted to our hospital with chief complaints of acute abdominal pain and high fever. We made a diagnosis of spontaneous bladder rupture associated with neurogenic bladder dysfunction and radiation cystitis, based on findings of cystoscopy and cystography. She was cured by conservative therapy, including catheter drainage and antibacterial chemotherapy. Thereafter, she was managed with intermittent self-catheterization. In 2000, spontaneous bladder rupture recurred, but conservative therapy was effective again. A review of 12 cases of recurrent spontaneous bladder rupture in Japan, including the present case, suggests that proper management of urination for neurogenic bladder dysfunction may be necessary for prevention of recurrent rupture, when the impaired bladder is left after either successful conservative or surgical treatment of bladder rupture. Urinary diversion and augmentation cystoplasty should be considered for repeated rupture of the bladder. (author)

  3. Spontaneous Pre-Labour Rupture of Membranes at Term ...

    African Journals Online (AJOL)

    BACKGROUND: Spontaneous pre-labour rupture of membranes (SPROM) at term is one of the most common complications of pregnancy. It is an important cause of perinatal morbidity and mortality, particularly because it is associated with a latency period from membrane rupture to delivery. OBJECTIVE: To compare the ...

  4. A case of a spontaneously ruptured epidermoid cyst

    International Nuclear Information System (INIS)

    Shiroyama, Yujiro; Saiki, Masahide; Ueda, Hiroyuki; Katayama, Sanao; Mitani, Tetsumi

    1987-01-01

    Intracranial fat-containing congenital tumors are characterized by negative absorption values on CT. We hereby report a case of an epidermoid cyst with subarachnoid free fats diagnosed preoperatively by CT. A 21-year-old female was admitted to our hospital because of continuous mild headache and nausea. At the time of admission, the results of her physical and neurological examinations were normal. CT, however, demonstrated multiple subarachnoid low-density spots and a suprasellar low-density area with high-density spots. In addition, there were negative absorption values (-12 ∼ -77), suggesting free fats. A spontaneously ruptured epidermoid or dermoid cyst was diagnosed on the basis of these findings. At surgery, a suprasellar tumor containing a yellowish, cheese-like material was confirmed. The patient made an uneventful recovery and was discharged 14 days after surgery. There have been several published reports of CT appearances of intracranial fat-containing tumors. However, spontaneously ruptured cases diagnosed by CT are rare. CT was found to be useful for the diagnosis of spontaneously ruptured cases of fat-containing tumors. (author)

  5. A New Augmentation Based Algorithm for Extracting Maximal Chordal Subgraphs.

    Science.gov (United States)

    Bhowmick, Sanjukta; Chen, Tzu-Yi; Halappanavar, Mahantesh

    2015-02-01

    A graph is chordal if every cycle of length greater than three contains an edge between non-adjacent vertices. Chordal graphs are of interest both theoretically, since they admit polynomial time solutions to a range of NP-hard graph problems, and practically, since they arise in many applications including sparse linear algebra, computer vision, and computational biology. A maximal chordal subgraph is a chordal subgraph that is not a proper subgraph of any other chordal subgraph. Existing algorithms for computing maximal chordal subgraphs depend on dynamically ordering the vertices, which is an inherently sequential process and therefore limits the algorithms' parallelizability. In this paper we explore techniques to develop a scalable parallel algorithm for extracting a maximal chordal subgraph. We demonstrate that an earlier attempt at developing a parallel algorithm may induce a non-optimal vertex ordering and is therefore not guaranteed to terminate with a maximal chordal subgraph. We then give a new algorithm that first computes and then repeatedly augments a spanning chordal subgraph. After proving that the algorithm terminates with a maximal chordal subgraph, we then demonstrate that this algorithm is more amenable to parallelization and that the parallel version also terminates with a maximal chordal subgraph. That said, the complexity of the new algorithm is higher than that of the previous parallel algorithm, although the earlier algorithm computes a chordal subgraph which is not guaranteed to be maximal. We experimented with our augmentation-based algorithm on both synthetic and real-world graphs. We provide scalability results and also explore the effect of different choices for the initial spanning chordal subgraph on both the running time and on the number of edges in the maximal chordal subgraph.

  6. Unusual case of pancreatic inflammatory myofibroblastic tumor associated with spontaneous splenic rupture

    Directory of Open Access Journals (Sweden)

    Hassan Fadi K

    2010-11-01

    Full Text Available Abstract Background Spontaneous splenic rupture considered a relatively rare but life threatening. The three commonest causes of spontaneous splenic rupture are malignant hematological diseases, viral infections and local inflammatory and neoplastic disorders. We describe a unique and unusual case of inflammatory myofibroblastic tumor of the tail of pancreas presented with massively enlarged spleen and spontaneous splenic rupture. Case presentation A 19 years old male patient with no significant past medical history presented to emergency room with abdominal pain and fatigue. Massively enlarged spleen was detected. Hypotension and rapid reduction of hemoglobin level necessitated urgent laparatomy. About 1.75 liters of blood were found in abdominal cavity. A large tumor arising from the tail of pancreas and local rupture of an enlarged spleen adjacent to the tumor were detected. Distal pancreatectomy and splenectomy were performed. To our knowledge, we report the first case of massively enlarged spleen that was complicated with spontaneous splenic rupture as a result of splenic congestion due to mechanical obstruction caused by an inflammatory myofibroblastic tumor of the tail of pancreas. A review of the literature is also presented. Conclusion Inflammatory myofibroblastic tumor of the tail of pancreas should be included in the differential diagnosis of the etiological causes of massively enlarged spleen and spontaneous splenic rupture.

  7. Right Diaphragm Spontaneous Rupture: A Surgical Approach

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    Duilio Divisi

    2011-01-01

    Full Text Available We present a case of spontaneous rupture of the diaphragm, characterized by nonspecific symptoms. The rapid diagnosis and appropriate surgical approach led to a positive resolution of the pathology.

  8. Spontaneous rupture of the spleen – a rare and potentially fatal ...

    African Journals Online (AJOL)

    Spontaneous (non-traumatic) rupture of the normal spleen in pregnancy is a rare clinical event that can endanger the lives of both mother and baby. The aetiology of the condition is unknown, but it occurs most commonly in multiple pregnancies and in the third trimester. We present a case of a spontaneous splenic rupture ...

  9. Spontaneous splenic rupture and Anisakis appendicitis presenting as abdominal pain: a case report

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    Valle Joaquín

    2012-04-01

    Full Text Available Abstract Introduction Anisakidosis, human infection with nematodes of the family Anisakidae, is caused most commonly by Anisakis simplex. Acquired by the consumption of raw or undercooked marine fish or squid, anisakidosis occurs where such dietary customs are practiced, including Japan, the coastal regions of Europe and the United States. Rupture of the spleen is a relatively common complication of trauma and many systemic disorders affecting the reticuloendothelial system, including infections and neoplasias. A rare subtype of rupture occurring spontaneously and arising from a normal spleen has been recognized as a distinct clinicopathologic entity. Herein we discuss the case of a woman who presented to our institution with appendicitis secondary to Anisakis and spontaneous spleen rupture. Case presentation We report the case of a 53-year-old Caucasian woman who presented with hemorrhagic shock and abdominal pain and was subsequently found to have spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. She underwent open surgical resection of the splenic rupture and the appendicitis without any significant postoperative complications. Histopathologic examination revealed appendicitis secondary to Anisakis simplex and splenic rupture of undetermined etiology. Conclusions To the best of our knowledge, this report is the first of a woman with the diagnosis of spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. Digestive anisakiasis may present as an acute abdomen. Emergency physicians should know and consider this diagnosis in patients with ileitis or colitis, especially if an antecedent of raw or undercooked fish ingestion is present. Spontaneous rupture of the spleen is an extremely rare event. Increased awareness of this condition will enhance early diagnosis and effective treatment. Further research is required to identify the possible risk factors associated with spontaneous rupture of the spleen.

  10. Laparoscopic splenectomy for spontaneous rupture of the spleen

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    Pinky M Thapar

    2016-01-01

    Full Text Available Laparoscopic splenectomy is a gold standard for management of planned benign splenic pathologies. Spontaneous rupture of the spleen (SRS leading to acute abdomen occurs in only 1% of all splenic ruptures. Laparoscopic splenectomy in traumatic and atraumatic rupture due to intra-splenic pathology is reported. We present the first reported case of laparoscopic splenectomy in a 23-year-old male who presented with hemoperitoneum due to idiopathic or SRS. The procedure was safely accomplished with slight modified technique and minimum usage of advanced gadgets.

  11. Successful primary repair of late diagnosed spontaneous esophageal rupture: A case report

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    Diana Y. Kircheva

    2017-01-01

    Conclusion: Primary closure of late diagnosed spontaneous esophageal rupture can be successful, even when it is complicated by a prolonged delay in treatment and failed endoscopic procedures. We conclude that primary surgical repair should be attempted in patients with spontaneous esophageal rupture if tissues are viable.

  12. Analysis of Degree 5 Chordal Rings for Network Topologies

    DEFF Research Database (Denmark)

    Riaz, M. Tahir; Pedersen, Jens Myrup; Bujnowski, Sławomir

    2011-01-01

    This paper presents an analysis of degree 5 chordal rings, from a network topology point of view. The chordal rings are mainly evaluated with respect to average distance and diameter. We derive approximation expressions for the related ideal graphs, and show that these matches the real chordal...

  13. Spontaneous Achilles tendon rupture in alkaptonuria

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    Omar A. Alajoulin

    2015-12-01

    Full Text Available Alkaptonuria (AKU is a rare inborn metabolic disease characterized by accumulation of homogentisic acid (HGA. Excretion of HGA in urine causes darkening of urine and its deposition in connective tissues causes dark pigmentation (ochronosis, early degeneration of articular cartilage, weakening of the tendons, and subsequent rupture. In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations. Alkaptonuria patients should avoid strenuous exercises and foot straining especially in patients developing early orthopedic manifestations.

  14. Spontaneous Achilles tendon rupture in alkaptonuria.

    Science.gov (United States)

    Alajoulin, Omar A; Alsbou, Mohammed S; Ja'afreh, Somayya O; Kalbouneh, Heba M

    2015-12-01

    Alkaptonuria (AKU) is a rare inborn metabolic disease characterized by accumulation of homogentisic acid (HGA). Excretion of HGA in urine causes darkening of urine and its deposition in connective tissues causes dark pigmentation (ochronosis), early degeneration of articular cartilage, weakening of the tendons, and subsequent rupture. In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations. Alkaptonuria patients should avoid strenuous exercises and foot straining especially in patients developing early orthopedic manifestations.

  15. Ultrasound evaluation of a spontaneous plantar fascia rupture.

    Science.gov (United States)

    Louwers, Michael J; Sabb, Brian; Pangilinan, Percival H

    2010-11-01

    Plantar fascia rupture is an occasional complication in patients with chronic plantar fasciitis or in patients with plantar fasciitis treated with steroid injection. Very few cases of spontaneous plantar fascia rupture have been reported in the literature (Herrick and Herrick, Am J Sports Med 1983;11:95; Lun et al, Clin J Sports Med 1999;9:48-9; Rolf et al, J Foot Ankle Surg 1997;36:112-4; Saxena and Fullem, Am J Sports Med 2004;32:662-5). Spontaneous medial plantar fascia rupture in a 37-yr-old man with no preceding symptoms or steroid injections was confirmed with diagnostic ultrasound, which revealed severe fasciitis at the calcaneal insertion with partial tearing. After conservative treatment, the patient returned to full activities. We discuss the anatomy, risk factors, examination findings, and treatment for this condition, as well as the unique benefits that ultrasound offers over magnetic resonance imaging. It is important to consider plantar fascia rupture in patients with hindfoot pain and medioplantar ecchymosis, particularly if an injury occurred during acceleration maneuvers. Ultrasound in these cases can be used to diagnose a plantar fascia tear quickly, accurately, and cost-effectively.

  16. Spontaneous and traumatic hepatic rupture: imaging findings and minimally invasive treatment

    International Nuclear Information System (INIS)

    Palacio, Glaucia Andrade e Silva; D'Ippolito, Giuseppe

    2003-01-01

    Spontaneous hepatic bleeding is a rare condition. Our aim was to describe the imaging findings and minimally invasive treatment using transcatheter arterial embolization in patients with spontaneous and traumatic hepatic rupture. Three patients presented acute hemoperitoneum dur to hepatic rupture caused by spontaneous rupture of hepatocellular carcinoma, HELLP syndrome and a blunt hepatic trauma. The patients were submitted to ultrasound and computed tomography of the abdomen and subsequently treated by transcatheter arterial embolization. All patients underwent helical computed tomography before and after treatments. Computed tomography played an important role in the evaluation and follow-up in the therapeutic intervention. Different types of liver injuries were identified. Transcatheter arterial embolization blocked arterial hemorrhage in the patients who were hemodynamically unstable. The conclusion was: transcatheter arterial embolization is an effective and well-tolerated treatment method for the management of hepatic rupture and computed tomography is an excellent method for the diagnosis and follow-up of these patients. (author)

  17. Spontaneous forniceal rupture: Can it be treated conservatively?

    Directory of Open Access Journals (Sweden)

    Ahmed Gaber Al-mujalhem

    2017-01-01

    Conclusion: Spontaneous forniceal rupture is more likely to occur with smaller distal ureteric stones. Conservative management is a valid option in non-complicated cases. Intervention should be reserved to complicated cases or cases with sizable urinoma.

  18. Spontaneous Extensor Tendon Rupture in the Rheumatoid Wrist: Risk Factors and Preventive Role of Extended Tenosynovectomy.

    Science.gov (United States)

    Hsueh, Jung-Hua; Liu, Wen-Chung; Yang, Kuo-Chung; Hsu, Kuei-Chang; Lin, Cheng-Ta; Chen, Lee-Wei

    2016-03-01

    Spontaneous extensor tendon rupture is often seen in rheumatoid arthritis (RA) patients, but the risk factors are not clearly defined. We therefore collected the data of RA patients with previous extensor tendon rupture and those with tenosynovitis and analyzed the relationship between extended tenosynovectomy and spontaneous extensor tendon rupture. We retrospectively reviewed 17 spontaneous extensor tendon rupture episodes in 15 RA patients and 14 tenosynovitis episodes that required tenosynovectomy in 12 RA patients from 1997 to 2013. Correlations between the incidence of tendon rupture, X-ray findings, and clinical findings in the affected wrists before tendon rupture were analyzed statistically using the test for proportion. The following parameters were significantly correlated with spontaneous extensor tendon rupture: disease duration longer than 8 years, persistent tenosynovitis longer than 1 year duration, and Larsen grade greater than 4 (P = 0.02, 0.03, and 0.01, respectively). Dislocation of the distal end of the ulna, carpal collapse, and the scallop sign on X-ray contributed to a higher spontaneous extensor tendon rupture rate among RA patients (P = 0.01, 0.05, and 0.03, respectively). Extended tenosynovectomy was performed on 14 wrists in 12 RA patients with persistent tenosynovitis longer than 6 months, and Larsen grade did not deteriorate in this group compared with those who did not undergo the surgery. No spontaneous extensor tendon rupture occurred following the surgery. Risk factors of spontaneous extensor tendon rupture included disease duration longer than 8 years, persistent tenosynovitis longer than 1 year, and wrist Larsen grade greater than 4. Dislocation of the distal end of the ulna, carpal collapse, and the scallop sign on X-ray indicated a higher probability of extensor tendon rupture. Rheumatologists should consult with hand surgeons promptly to preserve hand function before tendon rupture. Prophylactic extended tenosynovectomy

  19. Spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine (Lasso)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Keon; Park, Heung Il; Kwun, Chung Sik [Chun Nam University College of Medicine, Kwangju (Korea, Republic of)

    1975-06-15

    This is a report of a case of spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine for the purpose of suicide in a 27 year old Korean male whose chief complaints were dyspnea, epigastric pain, swallowing disturbance, and hoarseness for 3 days prior to admission. A review of literature is submitted.

  20. Spontaneous rupture of renal pelvis secondary to ureteral obstruction by urothelial tumor

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Daniel Alvarenga; Palma, Ana Laura Gatti; Kido, Ricardo Yoshio Zanetti; Barros, Ricardo Hoelz de Oliveira; Martins, Daniel Lahan; Penachim, Thiago Jose; Caserta, Nelson Marcio Gomes, E-mail: daniel_alvafer@yahoo.com.br, E-mail: daniel_alvafer@icloud.com [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Fac. de Medicina. Dept. de Radiologia

    2014-09-15

    Partial spontaneous rupture of the upper urinary tract is rare and usually associated with nephrolithiasis. Other reported causes, apart from instrumentation and trauma, involve obstructive ureteral tumor in the pelvic cavity, retroperitoneal fibrosis, fluid overload, and pregnancy. We report a case of spontaneous rupture of renal pelvis secondary to ureteral obstruction caused by urothelial tumor, clinically suspected and evaluated by CT scans and MRIs, discussing the relevant findings for diagnosis.(author)

  1. Long-term functional outcome of bilateral spontaneous and simultaneous Achilles tendon ruptures.

    LENUS (Irish Health Repository)

    Ellanti, Prasad

    2012-10-01

    Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome.

  2. Spontaneous gastric rupture after Sodium Bicarbonate consumption: A case report.

    Science.gov (United States)

    Vásquez, A; Domínguez, C; Perdomo, C F

    2017-08-01

    Spontaneous gastric rupture is a rare condition however a prompt diagnosis and treatment are necessary to decrease mortality and morbidity. We report a case of stomach rupture after the ingestion of Sodium Bicarbonate (SB); imaging findings with a brief review of the literature are presented. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  3. Location of Ruptured Bullae in Secondary Spontaneous Pneumothorax

    Directory of Open Access Journals (Sweden)

    Jinseok Choi

    2017-12-01

    Full Text Available Background: The surgical treatment of secondary spontaneous pneumothorax (SSP can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung in-jury during manipulation of the lung. Common sites of bulla development and ruptured bullae were inves-tigated based on computed tomography (CT and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS. We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. Results: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%, followed by the azygoesophageal recess (27.4%. Of the 75 cases on the left side, the most com-mon rupture site was the apical segment (24.0%, followed by the anterior basal segment (17.3%. Conclusion: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bul-la development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.

  4. Spontaneous Fundal Uterine Rupture in a Pregnant Woman at 32 Weeks Gestation who had Two Previous Cesarean Sections

    Directory of Open Access Journals (Sweden)

    Metin Kaba

    2017-08-01

    Full Text Available Spontaneous uterine rupture during pregnancy can cause severe complications, even maternal and fetal demise. We report successful management of a spontaneous fundal uterine rupture in a 32 week pregnant who had undergone two previous cesarean sections due to preterm delivery. We explain causes of spontaneous uterine rupture and the management of this rare event in the presented case report.

  5. Spontaneous bladder rupture in acute alcohol intoxication

    Directory of Open Access Journals (Sweden)

    Bahjat Barakat

    2014-03-01

    Full Text Available Spontaneous bladder rupture is a rare condition that can be followed by an acute alcohol intoxication and can be associated with significant morbidity and mortality. We report a case diagnosed in a alcoholic young male who was admitted to our emergency room for epigastric pain. The case demonstrates the difficulties with diagnosis and the need for physicians who work in an emergency room to be aware of this condition.

  6. Spontaneous atraumatic extensor pollicis longus rupture in the nonrheumatoid population.

    Science.gov (United States)

    Rada, Erin M; Shridharani, Sachin M; Lifchez, Scott D

    2013-01-01

    Extensor pollicis longus (EPL) tendon rupture is a well-described phenomenon in patients with rheumatoid arthritis. Mechanisms of EPL tendon rupture in the nonrheumatoid population have also been described and include traumatic rupture, repetitive motion strain, and steroid injection into the tendon. The operative records for patients undergoing extensor pollicis longus reconstruction by the senior author were reviewed. Patients with a history of trauma to the wrist or inflammatory arthropathy were excluded. We identified 3 patients who presented with spontaneous EPL tendon rupture. These patients reported no risk factors (as listed earlier) or inciting event. All 3 patients had some exposure to local steroids but this exposure was not at the site of subsequent tendon rupture. All patients were operatively repaired and went on to full recovery of EPL function. In patients with sudden loss of extension of the thumb interphalangeal joint, a thorough history of steroid exposure including local steroid exposure remote to the affected EPL tendon may be relevant.

  7. Successful medical management of a neonate with spontaneous splenic rupture and severe hemophilia A.

    Science.gov (United States)

    Badawy, Sherif M; Rossoff, Jenna; Yallapragada, Sushmita; Liem, Robert I; Sharathkumar, Anjali A

    2017-03-01

    Splenic rupture in neonates is a rare event, usually occurring in the setting of underlying predisposing conditions. Here, we present the case of a term neonate who presented with worsening anemia in the setting of known hemolytic disease during the newborn period and was later found to have a spontaneous splenic rupture. He was subsequently diagnosed with severe hemophilia A, and was managed medically with recombinant factor VIII replacement therapy without any surgical intervention. This is the first reported case of a neonate who had spontaneous splenic rupture and severe hemophilia A, and underwent successful medical treatment without any surgical intervention. Copyright © 2016 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved.

  8. Introducing Modified Degree 4 Chordal Rings with Two Chord Lengths

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup

    2007-01-01

    In this paper an analysis of modified degree 4 Chordal Rings with two chord lengths named CHRm is presented and compared to similar topologies: Chordal Rings, N2R and modified N2R. Formulas for approximating diameters and average path lengths are provided and verified, and it is shown...... that the distances in CHRm are significantly smaller than in traditional Chordal Rings and N2R, and also smaller than modified N2R for topologies with up to 1500 nodes. Despite the proposed CHRm being of degree 4, and the modified N2R of degree 3, CHRm may be better suited for the optical level of fiber rings, due...

  9. Spontaneous Rupture of the Extensor Pollicis Longus Tendon due to Unusual Etiology

    Directory of Open Access Journals (Sweden)

    Süleyman Taş

    2014-03-01

    Full Text Available Background: The etiology of spontaneous rupture of the extensor pollicis longus tendon includes systemic or local steroid injections, wrist fracture, tenosynovitis, synovitis, rheumatoid arthritis, and repetitive wrist motions. Case Report: We encountered a case of extensor pollicis longus tendon rupture with an unusual etiology, cow milking. In this case, transfer of the extensor indicis proprius tendon was performed successfully. At 1 year after surgery, extension of the thumb was sufficient. Conclusion: It appears that patients with occupations involving repetitive motions are at a high risk of closed tendon ruptures.

  10. Spontaneous liver rupture in pregnancy complicating HELLP syndrome: case report

    Directory of Open Access Journals (Sweden)

    Sariyeh Golmahammadlou

    2014-10-01

    Conclusion: Spontaneous liver rupture associated with HELLP syndrome is a rare and life-threatening complication of pregnancy. Unruptured liver hematoma is also a rare condition during pregnancy with a very difficult diagnosis. Using clinical diagnostic tests such as CT scan or MRI would be helpful to improve clinical outcomes.

  11. [PART-KESSLER TECHNIQUE WITH SUTURE ANCHOR IN REPAIR OF SPONTANEOUS Achilles TENDON RUPTURE].

    Science.gov (United States)

    Qi, Jie; Duan, Liang; Li, Weiwei; Wei, Wenbo

    2016-02-01

    To summarize the application and experience of repairing spontaneous Achilles tendon rupture by part-Kessler technique with suture anchor. Between January 2011 and December 2013, 31 patients with spontaneous Achilles tendon rupture were treated by part-Kessler technique with suture anchor. Of 31 cases, 23 were male and 8 were female, aged 16-53 years (mean, 38 years). The left side was involved in 15 cases and the right side in 16 cases. The causes of injury included sudden heel pain and walking weakness during sports in 22 cases; no surefooted down-stairs, slip, and carrying heavy loads in 9 cases. The distance from broken site to the calcaneus adhension of Achilles tendon was 3-6 cm (mean, 4.2 cm). The time from injury to operation was 7 hours to 4 days (mean, 36.8 hours). All incisions healed by first intention without nerve injury or adhering with skin. The patients were followed up 6-24 months (mean, 15 months). All patients could complete 25 times heel raising without difficulty at 6 months after operation. No Achilles tendon rupture occurred again during follow-up. At 6 months after operation, the range of motion of the ankle joint in dorsiflexion and plantar flexion showed no significant difference between normal and affected sides (t=0.648, P=0.525; t=0.524, P=0.605). The circumference of the affected leg was significantly smaller than that of normal leg at 6 months after operation (t=2.074, P=0.041), but no significant difference was found between affected and normal sides at 12 months after operation (t=0.905, P=0.426). The American Orthopedic Foot and Ankle Society (AOFAS) scores at 6, 12, 18, and 24 months after operation were significantly higher than preoperative score (P0.05). Repairing spontaneous Achilles tendon rupture by part-Kessler technique with suture anchor can supply strong strain and decrease the shear forces of suture. So part-Kessler technique with suture anchor is successful in repairing spontaneous Achilles tendon rupture.

  12. Spontaneous rupture of the middle colic artery resulting in delayed ...

    African Journals Online (AJOL)

    mission for three days after delivery due to raised blood pressure which was controlled using antihypertensives. The baby weighed 3.8 kg with good Apgar score. ... Osamu C, Hiroshi K, Makoto S, Soichiro Y, Hiroyuki. K, Yasumasa K, Hiroyasu M. Spontaneous rupture of. Dissecting Aneurysm of the Middle colic Artery. Tokai.

  13. Importance of CT Imaging on Spontaneous Rupture of Renal Angiomyolipoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Fatma Gundogdu

    2016-02-01

    Full Text Available Renal angiomyolipomas have a high risk of rupture when they are large and associated with aneurysms. The most serious complication that may occur is life-threatening intratumoral bleeding. Immediate interventional therapies to stop bleeding are required. Herein, we report on a 16-year-old female patient with a retroperitoneal hematoma due to a spontaneous renal angiomyolipoma rupture by computed tomography.

  14. A Case Report of Ruptured Spontaneous Heterotopic Pregnancy

    Directory of Open Access Journals (Sweden)

    F Seidoshohadaei

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Heterotopic pregnancy refers to the simultaneous occurrence of pregnancy intrauterine and outside of uterine corpus. It is most often manifested in women who have undergone artificial reproductive technology (ART but rarely occurs spontaneously. Heterotopic pregnancy still remains as a diagnostic and therapeutic challenge to practitioners. In this situation physicians should have high suspicion for diagnosis and intrauterine pregnancy protection. This study reported a case of ruptured spontaneous heterotopic pregnancy. Case: A 32 year-old woman with abdominal pain, nausea, vomiting and hypovolumic shock in 1386 referred to emergency department in Sanandaj hospital. She reported one previous cesarean section. On examination, the patient's abdomen was distended. She had generalized tenderness and rebound tenderness in abdomen. The ultrasonographic examination revealed large amount of fluid in pelvic and abdominal cavity with a large hematoma in right adnex but there was intrauterine pregnancy at 7 weeks with normal fetal heart activity. She underwent laparotomy for heterotopic pregnancy and ruptured tube with tubal pregnancy removed. Intrauterine pregnancy continued without problem and led to birth of a healthy female neonate. Conclusion: Physicians should be quite cautious of heterotopic pregnancy in woman at reproductive age. Any abnormality on physical examination or ultrasonography of a patient with intrauterine pregnancy and abdominal pain should heighten the clinician's suspicion for heterotopic pregnancy

  15. An Analysis of Surgical Treatment for the Spontaneous Rupture of Hepatocellular Carcinoma.

    Science.gov (United States)

    Sada, Haruki; Ohira, Masahiro; Kobayashi, Tsuyoshi; Tashiro, Hirotaka; Chayama, Kazuaki; Ohdan, Hideki

    2016-01-01

    The prognosis of spontaneous rupture of hepatocellular carcinoma (HCC) remains unclear. We investigated the prognosis of patients with ruptured HCC based on the treatments and prognostic factors associated with long-term survival. The prognoses of 64 consecutive patients treated for ruptured HCC from 1986 to 2013 were analyzed according to their methods of treatment. The prognostic factors of 16 surgical patients were identified, and their overall survival (OS) and recurrence rates were compared to 1,157 surgical patients who underwent surgery for non-ruptured HCC. The surgical outcomes were also compared using a propensity score matching method. Surgery was associated with a better OS. Curative resection was the only independent prognostic factor in surgical patients with ruptured HCC (p = 0.040). Although the OS of surgical patients with non-ruptured HCC was found to be significantly better than that of the patients with ruptured HCC, no significant difference in OS was observed after propensity score matching. A curative resection should be the objective of treatment, assuming the suitability of the patient's clinical condition. When the liver function reserve and tumor extension of patients with ruptured and non-ruptured HCC are similar, then their surgical outcomes may not be significantly different. © 2015 S. Karger AG, Basel.

  16. Spontaneous Rupture of Splenic Artery Aneurysm during the First Trimester of Pregnancy: Report of an Extremely Rare Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Theodoros Pavlis

    2012-01-01

    Full Text Available Splenic artery aneurysm (SAA occurs predominantly in women and the majority of them are asymptomatic until rupture. In cases of spontaneous rupture of an SAA, maternal and fetal mortality rates remain extremely high. Furthermore, the spontaneous ruptures of SAAs predominantly appear during the third trimester of pregnancy. We present the third known case of spontaneous SAA rupture during the first trimester of pregnancy, which manifested as sudden hypovolemic collapse and was successfully confronted with combined aggressive resuscitation and emergency surgical operation.

  17. Spontaneous haemorrhage and rupture of third ventricular colloid cyst.

    LENUS (Irish Health Repository)

    Ogbodo, Elisha

    2012-01-01

    Acute bleeding within a colloid cyst of the third ventricle represents a rare event causing sudden increase in the cyst volume that may lead to acute hydrocephalus and rapid neurological deterioration. We report a case of spontaneous rupture of haemorrhagic third ventricular colloid cyst and its management. A 77-year-old ex-smoker presented with unsteady gait, incontinence and gradually worsening confusion over a 3-week period. Brain CT scan findings were highly suggestive of a third ventricular colloid cyst with intraventricular rupture. He underwent cyst excision and histopathology, which confirmed the radiological diagnosis with evidence of haemorrhage within the cyst. A ventriculo peritoneal shunt was performed for delayed hydrocephalus. Surgical management of these patients must include emergency ventriculostomy followed by prompt surgical removal of the haemorrhagic cyst.

  18. Spontaneous rupture of the distal iliopsoas tendon: clinical and imaging findings, with anatomic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Lecouvet, Frederic E.; Vande Berg, Bruno C.; Malghem, Jacques [Universite Catholique de Louvain, Department of Radiology and Medical Imaging, Saint Luc University Hospital, Brussels (Belgium); Demondion, Xavier [Centre Hospitalier Universitaire de Lille, Department of Bone Radiology and Laboratory of Anatomy, Lille (France); Leemrijse, Thibaut [Universite Catholique de Louvain, Department of Orthopedic Surgery, Saint Luc University Hospital, Brussels (Belgium); Devogelaer, Jean-Pierre [Universite Catholique de Louvain, Department of Rheumatology, Saint Luc University Hospital, Brussels (Belgium)

    2005-11-01

    We report the clinical and imaging findings in two elderly female patients with spontaneous rupture of the distal iliopsoas tendon from the lesser trochanter of the femur. We emphasize the key contribution of magnetic resonance (MR) imaging to this diagnosis and provide an anatomic correlation. Spontaneous rupture of the distal iliopsoas tendon should be kept in mind in the differential diagnosis of acute groin pain in the elderly. MR imaging enables positive diagnosis, by showing mass effect on the anterior aspect of the hip joint, proximal muscle thickening, and abnormal signal intensity, and by demonstrating interruption of the psoas tendon, whereas the distal insertion of the lateral portion of the iliacus muscle remains muscular and is preserved. (orig.)

  19. Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome

    Directory of Open Access Journals (Sweden)

    David F. Pinal-García

    2018-01-01

    Full Text Available Spontaneous rupture of hepatocellular carcinoma (HCC is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography. Two actively bleeding liver tumors and multiple tumors in a noncirrhotic liver were found. Hemostatic suture and perihepatic packing were performed. The patient remained in critical condition, with a fatal outcome 48 h later. Histopathologic analysis reported HCC and absence of cirrhotic changes. HCC spontaneous rupture incidence is reported between 2.3 and 26%. Median age is 65 years. No liver cirrhosis is found in one-third of patients, with a median age of 51 years. Sudden onset of abdominal pain and shock is observed in the majority of cases. An accurate preoperative diagnosis improves to 75% with ultrasound and computed tomography. Besides hemodynamic stabilization, there is no general agreement on the best treatment option. Transarterial embolization, surgical perihepatic packing, suture plication, and hepatic artery ligation are useful methods of hemostasis in unstable patients. Mortality has been reported from 16.5 to 100%. The histopathologic finding of HCC in a noncirrhotic liver represents a less frequent presentation. A case of spontaneous rupture of HCC carcinoma and a noncirrhotic liver in a young patient is herein reported.

  20. Mixed cryoglobulinemia-associated Sjögren's syndrome leading to spontaneous rupture of the kidney: a case report

    Directory of Open Access Journals (Sweden)

    Haddiya I

    2016-03-01

    Full Text Available Intissar Haddiya,1 Hakim Hamzaoui,1 Zitouna Alhamany,2 Fatime-zohra Berkchi,1 Hakima Rhou,1 Loubna Benamar,1 Naima Ouzeddoun,1 Rabea Bayahia1 1Department of Nephrology-Dialysis-Renal Transplantation, Ibn Sina University Hospital, Rabat, Morocco; 2Department of Pathology, Rabat Children's Hospital, Ibn Sina University Hospital, Rabat, Morocco Background: Spontaneous rupture of the kidney is uncommon and is mainly caused by renal tumors. Only a few cases are caused by vasculitis. We report here the first case of spontaneous rupture of kidney resulting from mixed cryoglobulinemia. Case presentation: A 44-year-old man presented with sudden onset of fever, acute pulmonary edema, left flank abdominal pain unassociated with trauma, and rapidly progressive renal failure requiring dialysis. Computed tomography of the abdomen revealed a large perirenal hematoma of the left kidney. During conservative surgery, the patient underwent renal biopsy that showed renal vasculitis and membranoproliferative glomerulonephritis with intracapillary microthrombi. Tests were positive for mixed cryoglobulinemia caused by Sjögren's syndrome. The patient was better after immunosuppressive therapy, with the disappearance of clinical symptoms and the recovery of baseline renal function. Conclusion: We report on this case and discuss a possible link between spontaneous rupture of kidney and mixed cryoglobulinemia-associated Sjögren's syndrome. Keywords: mixed cryoglobulinemia, Sjögren's syndrome, spontaneous rupture of kidney, renal hematoma, Wünderlich syndrome

  1. Spontaneous Spleen Rupture in a Teenager: An Uncommon Cause of Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Verroiotou Maria

    2013-01-01

    Full Text Available Spontaneous spleen rupture is a rare complication of infectious diseases and it can become a potentially life-threatening condition if not diagnosed in time. A 17-year-old Greek female presented to the ER due to acute abdominal pain, mainly of the left upper quadrant. She had no recent report of trauma. The patient was pale, her blood pressure was 90/70 mmHg, and her pulse was 120 b/min. Clinical examination of the abdomen revealed muscle contraction and resistance. The patient was submitted to an ultrasound of the upper abdomen and to a CT scanning of the abdomen that revealed an extended intraperitoneal hemorrhage due to spleen rupture. Due to the patient’s hemodynamic instability, she was taken to the operation room and splenectomy was performed. Following a series of laboratory examinations, the patient was diagnosed to be positive for current cytomegalovirus infection. The postoperative course was uneventful, and in a two year follow-up the patient is symptom-free. Spontaneous spleen rupture due to Cytomegalovirus infection is a rare clinical entity, described in few case reports in the world literature and should always be taken into consideration in differential diagnosis of acute abdomen, especially in adolescents with no recent report of trauma.

  2. Spontaneous Splenic Rupture in Vascular Ehlers-Danlos Syndrome.

    Science.gov (United States)

    Batagini, Nayara Cioffi; Gornik, Heather; Kirksey, Lee

    2015-01-01

    Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant collagen vascular disorder. Different from other Ehler-Danlos Syndrome subtypes, VEDS has poor prognosis due to severe fragility of connective tissues and association with life-threatening vascular and gastrointestinal complications. Spontaneous splenic rupture is a rare but hazardous complication related to this syndrome. To date, only 2 cases have been reported in the literature. Here we present another case of this uncommon complication, occurring in a 54-year-old woman in clinical follow-up for VEDS who presented with sudden onset of abdominal pain and hypotension. © The Author(s) 2015.

  3. Spontaneous Rupture of the Bicornuate Uterus During 12th Week of Pregnancy

    Directory of Open Access Journals (Sweden)

    Tayfun Özçakır

    2011-12-01

    uterus bicornis was diagnosed. The fetus and placenta were found in the abdominal cavity. Spontaneous rupture of the pregnant uterus generally occurs in congenitally malformed uteri like unicornuate or bicornuate uterus with or without rudimentary communicating-noncommunicating horn. It can be life threatening and should be diagnosed and treated immediately.

  4. Case report: spontaneous rupture of spleen in patient with Plasmodium ovale malaria.

    Science.gov (United States)

    Lemmerer, Raphael; Unger, Manuel; Voßen, Matthias; Forstner, Christina; Jalili, Ahmad; Starzengruber, Peter; Werzowa, Johannes; Ramharter, Michael; Winkler, Stefan; Thalhammer, Florian

    2016-01-01

    Malaria may lead to spontaneous splenic rupture as a rare but potentially lethal complication. Most frequently, this has been reported in patients infected with Plasmodium falciparum and Plasmodium vivax, while other parasitic agents are less likely to be the cause.We report a 29-year-old British Caucasian, who after returning from a business trip in Democratic Republic Congo was diagnosed with tertian malaria caused by Plasmodium ovale.During his in-patient stay, the patient suffered a splenic rupture requiring immediate surgical intervention and splenectomy. Following this surgical intervention, there was an uneventful recovery, and the patient was discharged in a good general condition.

  5. Spontaneous hepatic rupture in a bodybuilder: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Pietro Mascagni

    Full Text Available ABSTRACT This article is the first description of a spontaneous hepatic rupture in a young bodybuilder with a history of clenbuterol and ephedrine alkaloid use. The patient presented with a sudden mid-epigastric pain and vomiting. Hemoglobin levels decreased a few hours later and a computed tomography scan was performed which revealed a rupture of the right liver capsule and hemoperitoneum. Two attempts at transarterial embolization did not control the bleeding and a right hemihepatectomy was performed. The pathological report identified a hepatic adenoma, a capsular tear and diffuse peliosis hepatis. The patient was discharged in a good condition after eleven days. Spontaneous hepatic ruptures are rare and life-threatening and are usually described in association with tumors, connective tissue diseases and gestosis. This article is a review of the available literature with regard to this condition, with a focus on its relation to peliosis hepatis and banned substance used by body image fanatics. The present case highlights the challenging diagnosis of this potentially fatal liver complication in a healthy appearing male, the risk associated with the online trade of performance enhancing drugs and its relation with peliosis hepatis.

  6. Splenic rupture following idiopathic rupture of the urinary bladder presenting as acute abdomen

    Directory of Open Access Journals (Sweden)

    Jurisic D

    2007-01-01

    Full Text Available Idiopathic rupture of the urinary bladder is an uncommon condition and represents less than 1% of all bladder rupture cases. In most of the cases the main etiological factor was heavy alcohol ingestion. A combined injury of the spleen and bladder is a very rare condition that is almost often associated with trauma and foreign bodies. In this paper we present the extremely rare clinical course of acute abdomen caused by a combined spontaneous intraperitoneal injury; spontaneous rupture of the urinary bladder and spleen. According to our opinion, spontaneous bladder rupture caused by bladder distension due to alcohol ingestion led to urinary ascites and abdominal distension. Finally, repeated minor abdominal blunt trauma during everyday life, to a moderately distended abdomen caused a spontaneous splenic rupture in the patient with abnormal coagulation studies.

  7. Spontaneous Rupture of an Unscarred Uterus Caused by Near-Cornual Pregnancy with Placenta Accreta at 4 Months of Pregnancy

    Directory of Open Access Journals (Sweden)

    Wen-Chu Huang

    2005-12-01

    Conclusions: Spontaneous rupture of an unscarred uterus can occur at any stage of pregnancy. The placental implantation near the cornu with accreta may have been the cause of the uterine rupture in this patient. Noting the site of implantation should be an important component during antenatal sonography. Furthermore, uterine rupture should be included in the differential diagnosis of pregnant women with abdominal pain.

  8. Spontaneous esophageal rupture - Boerhaave's syndrome: Clinical symptoms and radiographic findings

    International Nuclear Information System (INIS)

    Gaa, J.; Deininger, H.K.

    1989-01-01

    Spontaneous transmural rupture of the esophagus (Boerhaave's syndrome) is a life-threatening emergency. Prompt diagnosis is essential to a better prognosis, successful operative outcome and patient survival. The chest roentgenogram and the contrast esophagograms to follow are the most helpful diagnostic tests. The clinical manifestations are variable and may be misleading and thus delay accurate recognition. In our case report the major clinical features and radiological signs of Boerhaave's syndrome are described. The pathogenesis, characteristic clinical symptoms and the signs and radiological evaluation are reviewed. (orig.) [de

  9. Spontaneous splenic rupture in infectious mononucleosis: case report and review of the literature.

    Science.gov (United States)

    Rinderknecht, Andrea S; Pomerantz, Wendy J

    2012-12-01

    A 15-year-old previously healthy girl presented in full arrest after 1 week of flu-like symptoms, recent diagnosis of infectious mononucleosis, and 1 day of abdominal pain. There was no history of trauma. Focused assessment with sonography for trauma examination showed free fluid in the abdomen. The patient died despite aggressive resuscitative management and emergency laparotomy with splenectomy, which showed grade V splenic laceration. Infectious mononucleosis is a common viral illness of adolescence. Spontaneous splenic rupture is a rare but potentially fatal complication. Anticipatory guidance about the importance of seeking medical care if abdominal pain develops during infectious mononucleosis is crucial to early diagnosis and intervention in the case of rupture. We discuss the current literature surrounding the outpatient follow-up of splenomegaly associated with infectious mononucleosis, as well as current practice and treatment options when rupture occurs.

  10. Historia morbi atrocis--2 new cases of spontaneous rupture of the esophagus (Boerhaave syndrome).

    Science.gov (United States)

    Tagan, D; Boesch, C; Baur, A; Berger, J P

    1990-11-24

    We report the case of two patients hospitalized within a few weeks of each other and both presenting with spontaneous rupture of the esophagus whose evolution proved fatal. We take the opportunity of drawing attention to this rare and challenging disease, which is often diagnosed too late.

  11. Pre-term Spontaneous Unscarred Uterine Rupture; A Case Report and Review

    OpenAIRE

    Shima Sheybani; Nahid Zirak; Razieh Poorandi; Elnaz Hosseini

    2014-01-01

    Introduction: Spontaneous uterine rupture, a life-threatening condition for both parturient and their fetus, often tends to occur during labour, particularly in those with a scarred uterus (rare in unscarred ones). The diagnosis must be born in mind in case of a pregnant woman presenting with shock, abdominal pain and diminished fetal heart rate. Any additional preoperative evaluation seems redundant as it only wastes golden surgical time. Case:The case we intend to present is a multigravi...

  12. Epidemiological study of 183 patients with spontaneous rupture of cerebral aneurysm

    International Nuclear Information System (INIS)

    Antonova, D.; Tasheva, E.

    2015-01-01

    Cerebral vessels aneurysms represent a significant part of the cerebral vessels pathology. There is no extensive study on that in Bulgaria. We present a study of 183 patients with spontaneous rupture of cerebral aneurysm, diagnosed and treated in UMHATEM ‘Pirogov’, Sofia. We used clinical methods - data from subject history, analysis of the accompanying documentation, subject medical chart; imaging-diagnostics methods - CT, DSA and MRI; and statistical methods. A total of 183 patients with ruptured intracranial aneurysms were studied. 65% were females and 35% were men.The ration female/male is 1.86, The mean age of all patients is 53.1 ±10.1 years. The highest incidence of ruptured aneurysms is seen in the age group 50 to 59 years. Aneurysms of a. cerebri media and a. communicants anterior are the most frequent (63.4% in total); while the lest are those of a basilaris (4.9%). 88.5% of the aneurysms in the studied group are small, 9.8% are large and 1.6% are giant. Intracranial hematomas are seen in 13.1% of the patients with ruptured aneurysms. Most frequently hematomas are connected with a. cerebri media and a.communicants anterior (87.5% in total). Patients with multiple aneurysms are 11.5% in total, 85.7% of them with an aneurysm of a.cerebri media. The incidence of ruptured cerebral aneurysms is higher amongst female. Frequency in the fifth decade of life is the highest. Most often seen are the aneurysms of a. cerebri media and a. communicants anterior, and the least - those of a. basilaris. Intracranial hematomas most frequently are associated with ruptures of a. cerebri media and a. communicants anterior, in patients with multiple aneurysms the highest is the frequency of aneurysms of a. cerebri media. (authors)

  13. Spontaneous and traumatic hepatic rupture: imaging findings and minimally invasive treatment; Ruptura hepatica espontanea e traumatica: aspectos tomograficos e do tratamento minimamente invasivo

    Energy Technology Data Exchange (ETDEWEB)

    Palacio, Glaucia Andrade e Silva; D' Ippolito, Giuseppe [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Disgnostico por Imagem]. E-mail: gl.palacio@bol.com.br; Farias, Andre P. [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Tomografia Computadorizada e Ressonancia Magnetica; Carnevale, Francisco Cesar [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Radiologia Intervencionista; Salem, Marcelo Zindel [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Gastroenterologia Cirurgica; Ricca, Artur Berti [Hospital Sao Luis, Sao Paulo, SP (Brazil)

    2003-12-01

    Spontaneous hepatic bleeding is a rare condition. Our aim was to describe the imaging findings and minimally invasive treatment using transcatheter arterial embolization in patients with spontaneous and traumatic hepatic rupture. Three patients presented acute hemoperitoneum dur to hepatic rupture caused by spontaneous rupture of hepatocellular carcinoma, HELLP syndrome and a blunt hepatic trauma. The patients were submitted to ultrasound and computed tomography of the abdomen and subsequently treated by transcatheter arterial embolization. All patients underwent helical computed tomography before and after treatments. Computed tomography played an important role in the evaluation and follow-up in the therapeutic intervention. Different types of liver injuries were identified. Transcatheter arterial embolization blocked arterial hemorrhage in the patients who were hemodynamically unstable. The conclusion was: transcatheter arterial embolization is an effective and well-tolerated treatment method for the management of hepatic rupture and computed tomography is an excellent method for the diagnosis and follow-up of these patients. (author)

  14. Cervical hemorrhage due to spontaneous rupture of the superior thyroid artery: Case report and review of the literature.

    Science.gov (United States)

    Stenner, Markus; Helmstaedter, Victor; Spuentrup, Elmar; Quante, Gero; Huettenbrink, Karl-Bernd

    2010-09-01

    Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life-threatening condition. We present the rare case of a 62-year-old man who was presented with a dramatically enlarging cervical mass causing respiratory distress because of upper airway compression. An endotracheal intubation was lifesaving and avoided tracheotomy. A CT scan revealed a hematoma in the region of the left external carotid artery. An emergency angiography embolized a ruptured branch of the superior thyroid artery and surgery evacuated the hematoma. We discuss the rarity of the condition, reasons for a spontaneous rupture of the artery, and the diagnostic and treatment strategy. In addition, we review the literature on spontaneous thyroid artery hemorrhages, which, up to now, have been described only for the inferior thyroid artery. We conclude that the optimal management for cases of cervical hematoma is intubation, diagnosis, and angiography before surgery.

  15. Massive spontaneous hemoperitoneum due to rupture of visceral branches of the abdominal aorta.

    Science.gov (United States)

    Pollak, E W; Michas, C A

    1979-10-01

    Review of 153 cases of massive spontaneous hemoperitoneum following visceral arterial rupture showed that 94% of all young women and 100% of all pregnant women had ruptured congenital splenic artery aneurysms at the time of hemorrhage, whereas young males bled from a variety of sources. Individuals who were 45 years old or older bled either from lesions of the celiac axis or its branches (66%) or from arterial mesenteric system lesions (34%). Only 22% of the older individuals of either sex bled from splenic artery sources. Arterial hypertension was present in 40% and previous or simultaneous intracranial hemorrhage occurred in 9% of the older patients. There were no survivors among those in whom the bleeding source was not operatively controlled. With operation, 79% of the younger patients and 57% of the older ones survived. Results emphasize the high mortality of visceral artery rupture with intraperitoneal bleeding. Prophylactic excision is advised for all complicated aneurysms regardless of age and all uncomplicated aneurysms in healthy individuals, especially in fertile or pregnent women.

  16. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  17. Revealing Abrupt and Spontaneous Ruptures of Protein Native Structure under picoNewton Compressive Force Manipulation.

    Science.gov (United States)

    Chowdhury, S Roy; Cao, Jin; He, Yufan; Lu, H Peter

    2018-03-27

    Manipulating protein conformations for exploring protein structure-function relationship has shown great promise. Although protein conformational changes under pulling force manipulation have been extensively studied, protein conformation changes under a compressive force have not been explored quantitatively. The latter is even more biologically significant and relevant in revealing protein functions in living cells associated with protein crowdedness, distribution fluctuations, and cell osmotic stress. Here we report our experimental observations on abrupt ruptures of protein native structures under compressive force, demonstrated and studied by single-molecule AFM-FRET spectroscopic nanoscopy. Our results show that the protein ruptures are abrupt and spontaneous events occurred when the compressive force reaches a threshold of 12-75 pN, a force amplitude accessible from thermal fluctuations in a living cell. The abrupt ruptures are sensitive to local environment, likely a general and important pathway of protein unfolding in living cells.

  18. Spontaneous rupture of intracranial dermoid tumor in a patient with vertigo. Computed tomography and magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    Asil, Kıyasettin; Gunduz, Yasemin; Ayhan, Laçin Tatli; Aksoy, Yakup Ersel; Yildiz, Can

    2013-01-01

    Congenital dermoid cysts are very rare, constituting less than 1% of intracranial tumors. Spontaneous rupture of dermoid tumor is a potentially serious complication that can lead to meningitis, seizures, cerebral ischemia and hydrocephalus. Occasionally, dermoid tumors are incidentally discovered on computed tomography (CT) of the brain or magnetic resonance imaging (MRI) following unrelated clinical complaints. They are also discovered during radiologic investigations of unexplained headaches, seizures, and rarely olfactory delusions. In this report we describe a patient complaining of vertigo caused by spontaneous rupture of dermoid cyst, preoperatively diagnosed by CT and MRI. Cranial CT revealed a dense fatty lesion adjacent to the posterolateral parasellar region on the left with multiple small, dense fat droplets scattered in the subarachnoid space corresponding to a dermoid cyst rupture. Cranial MRI sections revealed a lesion with mixed-signal-intensity and multiple hyperintense droplets scattered through the cerebellar surface on the left. No enhancement was found on axial T1-weighted MRI after intravenous Gadolinium administration. Diffusion weighted image (DWI) and apparent diffusion coefficient map studies exhibited explicit restricted diffusion. Many studies and literature case reports concerning the rupture of dermoid cyst have been reported. However, multimodal imaging of this rare pathology in the same patient is uncommon. Although dermoid cysts are pathognomonic in appearance on a CT examination, the MRI is also of value in helping to understand the effect of extension and pressure of the mass. DWI is also important for support of the diagnosis and patient follow-up

  19. Relief of mitral leaflet tethering following chronic myocardial infarction by chordal cutting diminishes left ventricular remodeling.

    Science.gov (United States)

    Messas, Emmanuel; Bel, Alain; Szymanski, Catherine; Cohen, Iris; Touchot, Bernard; Handschumacher, Mark D; Desnos, Michel; Carpentier, Alain; Menasché, Philippe; Hagège, Albert A; Levine, Robert A

    2010-11-01

    one of the key targets in treating mitral regurgitation (MR) is reducing the otherwise progressive left ventricular (LV) remodeling that exacerbates MR and conveys adverse prognosis. We have previously demonstrated that severing 2 second-order chordae to the anterior mitral leaflet relieves tethering and ischemic MR acutely. The purpose of this study was to test whether this technique reduces the progression of LV remodeling in the chronic ischemic MR setting. a posterolateral MI was created in 18 sheep by obtuse marginal branch ligation. After chronic remodeling and MR development at 3 months, 6 sheep were randomized to sham surgery (control group) and 12 to second-order chordal cutting (6 each to anterior leaflet [AntL] and bileaflet [BiL] chordal cutting, techniques that are in clinical application). At baseline, chronic infarction (3 months), and follow-up at a mean of 6.6 months post-myocardial infarction (MI) (euthanasia), we measured LV end-diastolic (EDV) and end-systolic volume (ESV), ejection fraction, wall motion score index, and posterior leaflet (PL) restriction angle relative to the annulus by 2D and 3D echocardiography. All measurements were comparable among groups at baseline and chronic MI. At euthanasia, AntL and BiL chordal cutting limited the progressive remodeling seen in controls. LVESV increased relative to chronic MI by 109±8.7% in controls versus 30.5±6.1% with chordal cutting (Pbenefits have the potential to improve clinical outcomes.

  20. Spontaneous rupture of adrenal metastasis from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chae Hun; Kim, Hyun Jin; Park, Soo Youn; Hwang, Seong Su; Choi, Hyun Joo [St. Vincent Hospital, Suwon (Korea, Republic of)

    2007-03-15

    Rupture of adrenal tumor from various primary origins is a rather rare event. We report here on a ruptured adrenal metastasis from hepatocellular carcinoma, and this ruptured metastasis was observed at the time of the initial diagnosis.

  1. Radionuclide diagnosis of splenic rupture in infectious mononucleosis

    International Nuclear Information System (INIS)

    Vezina, W.C.; Nicholson, R.L.; Cohen, P.; Chamberlain, M.J.

    1984-01-01

    Spontaneous splenic rupture is a rare but serious complication of infectious mononucleosis. Although radionuclide spleen imaging is a well accepted method for diagnosis of traumatic rupture, interpretation can be difficult in the setting of mononucleosis, as tears may be ill-defined and diagnosis hampered by inhomogeneous splenic uptake. Four proven cases of spontaneous rupture are presented, three of which illustrate these diagnostic problems

  2. Spontaneous Retroperitoneal Hematoma Simulating Ruptured Infrarenal Aortic Aneurysm in a Patient with End-Stage Renal Disease

    Science.gov (United States)

    Li, JYY; Chan, YC; Qing, KX; Cheng, SW

    2014-01-01

    We reported a case of spontaneous retroperitoneal hematoma (SRH) simulating a ruptured infrarenal aortic aneurysm. A 72-year-old man with a history of infrarenal aortic aneurysm and end-stage renal disease on hemodialysis presented with malaise and nonspecific central abdominal pain and left loin discomfort. An emergency computed tomography scan showed a large retroperitoneal hematoma and clinical suspicion of ruptured infrarenal aortic aneurysm. However, the hematoma was discontinuous with the aneurysm sac and raised the clinical suspicion on dual pathology. The SRH was treated conservatively with transfusion of blood products, and the aneurysm was treated with nonemergency endovascular repair electively. This case demonstrates the importance of recognizing different clinical and radiological characteristics and be aware of dual pathology. PMID:28031651

  3. Non‑bleeding Spontaneous Rupture of Hepatocellular Carcinoma

    African Journals Online (AJOL)

    split easily when the vascular load increases from hypertension or minor trauma is another hypothesis for of HCC ruptures.[6]. Abdominal pain is the only independent factor relating to rupture of HCC.[7] Doppler ultrasound and computer tomography (CT) scan are useful to exclude of hemoperitoneum and evaluation.

  4. Spontaneous ICA rupture: a severe late complication after giant nasopharyngeal angiofibroma resection.

    Science.gov (United States)

    Succo, G; Gisolo, M; Crosetti, E; Bergui, M; Danesi, G

    2013-04-01

    Juvenile nasopharyngeal angiofibroma (JNA) is a benign vascular tumor occurring in young males. Surgery for giant JNA is a complex procedure, with a high risk of major complications. We report a rare case of massive epistaxis in a 15-year-old boy resulting from spontaneous rupture of the intracavernous tract of the internal carotid artery 20 days after resection of a giant JNA by midface degloving. The event was managed by an emergency arteriography with coils selectively deployed to occlude the vessel and to stop hemorrhage. This treatment has been shown to be effective in producing immediate hemostasis and stable long-term occlusion. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. A grid-doubling finite-element technique for calculating dynamic three-dimensional spontaneous rupture on an earthquake fault

    Science.gov (United States)

    Barall, Michael

    2009-01-01

    We present a new finite-element technique for calculating dynamic 3-D spontaneous rupture on an earthquake fault, which can reduce the required computational resources by a factor of six or more, without loss of accuracy. The grid-doubling technique employs small cells in a thin layer surrounding the fault. The remainder of the modelling volume is filled with larger cells, typically two or four times as large as the small cells. In the resulting non-conforming mesh, an interpolation method is used to join the thin layer of smaller cells to the volume of larger cells. Grid-doubling is effective because spontaneous rupture calculations typically require higher spatial resolution on and near the fault than elsewhere in the model volume. The technique can be applied to non-planar faults by morphing, or smoothly distorting, the entire mesh to produce the desired 3-D fault geometry. Using our FaultMod finite-element software, we have tested grid-doubling with both slip-weakening and rate-and-state friction laws, by running the SCEC/USGS 3-D dynamic rupture benchmark problems. We have also applied it to a model of the Hayward fault, Northern California, which uses realistic fault geometry and rock properties. FaultMod implements fault slip using common nodes, which represent motion common to both sides of the fault, and differential nodes, which represent motion of one side of the fault relative to the other side. We describe how to modify the traction-at-split-nodes method to work with common and differential nodes, using an implicit time stepping algorithm.

  6. The value of emergency CT studies in spontaneous rupture of hepatocellular carcinoma. Analysis for tumor protrusion and hemorrhagic ascites

    Energy Technology Data Exchange (ETDEWEB)

    Ishihara, Makiko; Kobayashi, Hisashi; Ichikawa, Taro; Cho, Keiichi; Gemma, Kazuhito; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan)

    1997-12-01

    CT characteristics of spontaneous rupture of HCC (n=13) were reviewed retrospectively, and the value of emergency CT studies in this disease was evaluated. Especially, tumor protrusion ratio (TPR) and ascitic CT numbers were measured to for comparison with the data for unruptured HCCs and ordinary, (e.g., non-hemorrhagic) ascites (n=13). As a result, except for diffuse type HCCs, the TPR was significantly higher than for the unruptured HCCs. Nine cases had intraperitoneal HDAs, and the laterality of the HDAs corresponded with that of the ruptured tumors in 8 cases. Also, the ascitic CT numbers apart from the HDA were still higher than the ordinary ascites. Therefore, a high TPR, HDAs adjacent to the tumor, and elevated ascitic CT numbers are important CT manifestations indicating HCC rupture. Diffuse HCCs, however, require careful clinical evaluation. (author)

  7. The value of emergency CT studies in spontaneous rupture of hepatocellular carcinoma. Analysis for tumor protrusion and hemorrhagic ascites

    International Nuclear Information System (INIS)

    Ishihara, Makiko; Kobayashi, Hisashi; Ichikawa, Taro; Cho, Keiichi; Gemma, Kazuhito; Kumazaki, Tatsuo

    1997-01-01

    CT characteristics of spontaneous rupture of HCC (n=13) were reviewed retrospectively, and the value of emergency CT studies in this disease was evaluated. Especially, tumor protrusion ratio (TPR) and ascitic CT numbers were measured to for comparison with the data for unruptured HCCs and ordinary, (e.g., non-hemorrhagic) ascites (n=13). As a result, except for diffuse type HCCs, the TPR was significantly higher than for the unruptured HCCs. Nine cases had intraperitoneal HDAs, and the laterality of the HDAs corresponded with that of the ruptured tumors in 8 cases. Also, the ascitic CT numbers apart from the HDA were still higher than the ordinary ascites. Therefore, a high TPR, HDAs adjacent to the tumor, and elevated ascitic CT numbers are important CT manifestations indicating HCC rupture. Diffuse HCCs, however, require careful clinical evaluation. (author)

  8. Spontaneous rupture of the spleen in Factor XIII deficiency: A report of two cases

    International Nuclear Information System (INIS)

    Bhan, Pankaj; Al-Hilli, Shatha

    2010-01-01

    Spontaneous rupture of spleen due to factor XIII defieciency is a rare cause of abdominal pain with disastrous consequences and can be easily confused with other abdominal pathologies until a strong possibility is entertained.The patients usually present in emergengy with acute abdomen and diagnosis is difficult.The diagnosis is usually made on high degree of clinical suspicion and falling hematorit and failure of conservative management or by imaging. The radiologist need to be aware of this potentially fatal complication since early intervention is life saving. CT imaging can also help in conservative management in non critical patients

  9. Ground Motion Synthetics For Spontaneous Versus Prescribed Rupture On A 45(o) Thrust Fault

    Science.gov (United States)

    Gottschämmer, E.; Olsen, K. B.

    We have compared prescribed (kinematic) and spontaneous dynamic rupture propaga- tion on a 45(o) dipping thrust fault buried up to 5 km in a half-space model, as well as ground motions on the free surface for frequencies less than 1 Hz. The computa- tions are carried out using a 3D finite-difference method with rate-and-state friction on a planar, 20 km by 20 km fault. We use a slip-weakening distance of 15 cm and a slip- velocity weakening distance of 9.2 cm/s, similar to those for the dynamic study for the 1994 M6.7 Northridge earthquake by Nielsen and Olsen (2000) which generated satis- factory fits to selected strong motion data in the San Fernando Valley. The prescribed rupture propagation was designed to mimic that of the dynamic simulation at depth in order to isolate the dynamic free-surface effects. In this way, the results reflect the dy- namic (normal-stress) interaction with the free surface for various depths of burial of the fault. We find that the moment, peak slip and peak sliprate for the rupture breaking the surface are increased by up to 60%, 80%, and 10%, respectively, compared to the values for the scenario buried 5 km. The inclusion of these effects increases the peak displacements and velocities above the fault by factors up 3.4 and 2.9 including the increase in moment due to normal-stress effects at the free surface, and up to 2.1 and 2.0 when scaled to a Northridge-size event with surface rupture. Similar differences were found by Aagaard et al. (2001). Significant dynamic effects on the ground mo- tions include earlier arrival times caused by super-shear rupture velocities (break-out phases), in agreement with the dynamic finite-element simulations by Oglesby et al. (1998, 2000). The presence of shallow low-velocity layers tend to increase the rup- ture time and the sliprate. In particular, they promote earlier transitions to super-shear velocities and decrease the rupture velocity within the layers. Our results suggest that dynamic

  10. Papillary muscle head rupture in a patient with normal coronarography findings

    Directory of Open Access Journals (Sweden)

    Kostić-Mirković Andrijana

    2007-01-01

    Full Text Available Background. Rupture of papillary muscle generally happens during acute myocardial infarction and is the cause of acute mitral regurgitation, pulmonary oedema, so it should be promptly recognized and managed. Case report. A patient, 52 year-old, was admitted to the Thoracic Department with fever, general weakness, dyspnea and cough as a case of suspected pneumonia. Two days before the admission he was treated with antibiotics. At thoracic ward, his clinical status got serious and he transferred to Intensive Care Unit (ICU as pulmonary oedema. At the time of admission to ICU the patient was seriously ill with tachycardia, tachydyspnea, orthopnea and cyanosis image. Auscultatory, he showed pulmonal stasis at both sides and a tachyarrhythmic action, with a systolic murmur 5/6 grade above the mitral valve. Echocardiography showed grave mitral regurgitation with prolapsus of posterior leaflet with suspected chordal rupture. At coronarography no significant lesions of coronary arteries were found. After hemodynamic stabilization the patient was operated. During the operation, Transesophageal echocardiography (TEE examination showed a rupture of the head of the posteromedial papillary muscle. He was surgically treated with atypical quadrantectomy of posterior leaflet with homologous pericardial patch anuloplasty. Conclusion. The recognition of acute mitral regurgitation caused by the papillary muscle rupture and prompt surgical treatment is of vital interest for the survival of patients.

  11. Spontaneous calyceal rupture caused by a ureteral calculus ...

    African Journals Online (AJOL)

    Rupture of the urinary collecting system with perirenal and retroperitoneal extravasation of the urine is an unusual condition that is typically caused by ureteral-obstructing calculi. We report a case of calyceal rupture with urinoma formation, due to a stone in the distal ureter. The diagnosis was confirmed by computed ...

  12. Spontaneous calyceal rupture caused by a ureteral calculus

    African Journals Online (AJOL)

    A. Chaabouni

    Ureteral calculus;. CT;. Ureterel stent. Abstract. Rupture of the urinary collecting system with perirenal and retroperitoneal extravasation of the urine is an unusual condition that is typically caused by ureteral-obstructing calculi. We report a case of calyceal rupture with urinoma formation, due to a stone in the distal ureter.

  13. Towards using the chordal graph polytope in learning decomposable models

    Czech Academy of Sciences Publication Activity Database

    Studený, Milan; Cussens, J.

    2017-01-01

    Roč. 88, č. 1 (2017), s. 259-281 ISSN 0888-613X. [8th International Conference of Probabilistic Graphical Models. Lugano, 06.09.2016-09.09.2016] R&D Projects: GA ČR(CZ) GA16-12010S Institutional support: RVO:67985556 Keywords : learning decomposable models * integer linear programming * characteristic imset * chordal graph polytope * clutter inequalities * separation problem Subject RIV: BA - General Mathematics OBOR OECD: Statistics and probability Impact factor: 2.845, year: 2016 http://library.utia.cas.cz/separaty/2017/MTR/studeny-0475614.pdf

  14. Using Different Chord Lengths in Degree Three Chordal Rings and N2R Topologies

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup; Madsen, Ole Brun; Patel, Ahmed

    2007-01-01

    Degree Three Chordal Rings and N2R Topologies are useful for physial and optical network topologies due to the combination of short distances, regularity and low degrees. In this paper we show how distances in terms of average distances and diameters can be significantly decreased by using chords...

  15. Aggressive natural killer-cell leukemia with jaundice and spontaneous splenic rupture: a case report and review of the literature.

    Science.gov (United States)

    Gao, Li-min; Liu, Wei-ping; Yang, Qun-pei; Li, Hui-fang; Chen, Jun-jie; Tang, Yuan; Zou, Yan; Liao, Dian-Ying; Liu, Yan-mei; Zhao, Sha

    2013-03-11

    Aggressive natural killer cell leukemia/lymphoma (ANKL) is a rare aggressive form of NK-cell neoplasm. We report an uncommon case of 36-year-old male who showed jaundice and spontaneous splenic rupture. The diagnosis was established by the biopsy of liver and spleen. The monomorphous medium-size neoplastic cells infiltrated into portal areas and sinus of liver as well as the cords and sinus of the spleen. Necrosis, mitotic figures and significant apoptosis could be seen easily. These neoplastic cells demonstrated a typical immunophenotype of CD3ε+, CD56+, CD16+, Granzyme B+, TIA-1+. T-cell receptor γ (TCR-γ) gene rearrangement analysis showed germline configuration and the result of in situ hybridization for Epstein-Barr virus-encoded RNA (EBER-ISH) was positive. The patient has undergone an aggressive clinical course and died of multi-organ function failure 14 days later after admission. To the best of our knowledge, this is the first case of ANKL with spontaneous splenic rupture, and we should pay more attention to recognize it. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2048154883890867.

  16. Highly Unusual Tendon Abnormality: Spontaneous Rupture of the Distal Iliopsoas Tendon

    Directory of Open Access Journals (Sweden)

    Gokcen Coban

    2014-06-01

    Full Text Available Iliopsoas tendon injuries are not common and usually occur due to avulsion of the iliopsoas tendon with detachment of the lesser trochanter, secondary to an athletic injury or trauma. In the absence of a trauma, avulsion of the lesser trochanter in an adult is regarded as a sign of metastatic disease until proven otherwise. Complete iliopsoas tendon tears have thus far only been described in elderly women, and without trauma or an underlying systemic disease, a hormonal basis may be a reason for the gender differences. In this article, we present an 87-year-old woman with spontaneous rupture of the left distal iliopsoas tendon unassociated with fracture of the lesser trochanter and in the absence of a recent trauma history. This elderly patient presented with acute groin pain and normal plain radiographs. Magnetic resonance imaging must be kept in mind as a modality of choice for identifying iliopsoas tendon abnormalities.

  17. A hybrid Genetic and Simulated Annealing Algorithm for Chordal Ring implementation in large-scale networks

    DEFF Research Database (Denmark)

    Riaz, M. Tahir; Gutierrez Lopez, Jose Manuel; Pedersen, Jens Myrup

    2011-01-01

    The paper presents a hybrid Genetic and Simulated Annealing algorithm for implementing Chordal Ring structure in optical backbone network. In recent years, topologies based on regular graph structures gained a lot of interest due to their good communication properties for physical topology of the...

  18. Open splenectomy for Varicella zoster induced spontaneous splenic rupture

    Directory of Open Access Journals (Sweden)

    Mark Christopher Sykes

    2018-01-01

    Conclusion: Atraumatic splenic rupture should be considered as an important differential in those presenting with abdominal pain and peritonism without a history of preceding trauma. Haematological and infectious diagnoses should be sought to identify causation for the splenic rupture.

  19. Septal Leaflet versus Chordal Detachment in Closure of Hard-To-Expose Ventricular Septal Defects.

    Science.gov (United States)

    Pourmoghadam, Kamal K; Boron, Agnieszka; Ruzmetov, Mark; Narasimhulu, Sukumar Suguna; Kube, Alicia; O'Brien, Michael C; DeCampli, William M

    2018-04-04

    Different techniques have been used for exposure of ventricular septal defect (VSD) margins when there is crowding of the VSD anatomy by tricuspid valve (TV) subvalvar apparatus. The aim of this study was to compare surgical outcomes, for the two techniques of TV leaflet detachment and the rarely described TV chordal detachment for hard-to-expose VSDs. Patients undergoing transatrial VSD repair were identified from our institutional database. Follow-up echocardiography and patient data were obtained from medical records. Between 1/2005-8/2016, 130 isolated conoventricular VSDs were repaired. Among these, 26patients had leaflet detachment, while 15 underwent chordal detachment, and 89 had regular VSD repair (reference group). There was no significant difference between the groups in age, weight, postoperative length-of-stay, genetic/syndromic abnormalities, time-to-extubation, and left and right ventricular systolic function. The cardiopulmonary bypass and cross-clamp time were significantly higher in leaflet detachment group, when compared with reference group (118+28vs102+32, p=0.02; and 73+20vs61+23, p=0.01, respectively). Echocardiographic follow-up were available for 87patients at a mean of 2.6years (1month-11years). Tricuspid regurgitation was rated as none or trivial in 66(76%), mild in 20(23%) and moderate in one reference group patient. There was no difference in presence of residual VSD, or degree of tricuspid regurgitation amongst the three groups. There was no reoperation for tricuspid regurgitation. Tricuspid valve leaflet and chordal detachment techniques provide equally viable and safe alternative to closure of hard-to-expose VSDs while maintaining appropriate TV function. Their use in our series did not lead to increased TV dysfunction at early-to-midterm echocardiographic assessment. Copyright © 2018. Published by Elsevier Inc.

  20. A case report of spontaneous rupture of a renal angiomyolipoma in a post-partum 21-year-old patient.

    Science.gov (United States)

    Lucky, Marc A; Shingler, Simon N; Stephenson, Richard N

    2009-10-01

    Renal angiomyolipomas (AML) are benign tumours containing vascular, smooth muscle and fatty elements. The majority of renal AML run an asymptomatic, benign course. The main associated complication is that of retro-peritoneal or intra-tumoural haemorrhage. Treatment options include conservative management versus interventional procedures such as total or partial nephrectomy, cryotherapy or embolization. We describe a case of symptomatic, spontaneous rupture of AML in the immediate post-partum period of a patient treated under our care. This case highlights the presentation in the form of an acute abdomen in the immediate post-partum period. This is important as acute abdomen following delivery can be attributed to a number of other causes. It also demonstrates that further complications of renal angiomyolipoma rupture can arise, emphasising the importance of post treatment vigilance for signs of infection, further haemorrhage and post embolic events.

  1. Delivery of a baby with severe combined immunodeficiency at 31 weeks gestation following an extreme preterm prelabour spontaneous rupture of the membranes: a case report

    Directory of Open Access Journals (Sweden)

    Watkinson Sally J

    2009-11-01

    Full Text Available Abstract Introduction If left untreated, severe combined immunodeficiency can lead to an acute susceptibility to infection. The intrauterine environment is sterile until the amniotic membranes rupture. The vaginal flora then ascends into the genital tract, thus increasing the risk of chorioamnionitis. An extremely premature and prolonged membrane rupture is associated with a dismal prognosis for an immunocompetent preterm fetus. There are no case reports to date that detail the outcome of an immunocompromised preterm baby following prolonged rupture of membranes. Case presentation We present the case of a 32-year-old Indian woman who delivered a 31-week gestational baby who had a severe combined immunodeficiency following premature prelabour prolonged rupture of the membranes at the 14th week of gestation. Conclusion Extreme preterm prelabour spontaneous rupture of membranes in an underlying condition of severe combined immunodeficiency does not necessarily lead to an unfavourable outcome.

  2. Traumatic rupture of an intracranial dermoid cyst

    Directory of Open Access Journals (Sweden)

    Raksha Ramlakhan, BMedSc, MBBCh

    2015-01-01

    Full Text Available Intracranial dermoid cysts are congenital tumors of ectodermal origin. Rupture of these cysts can occur spontaneously, but rupture in association with trauma is reported infrequently. The diagnosis of rupture is made by the presence of lipid (cholesterol droplets in the subarachnoid spaces and ventricles. Nonenhanced CT of the head demonstrates multiple foci of low attenuation that correspond with hyperintense signal on T1-weighted MRI. We present a case of an adult patient with rupture of an intracranial dermoid cyst, precipitated by minor trauma.

  3. Analysis of 30 breast implant rupture cases.

    Science.gov (United States)

    Tark, Kwan Chul; Jeong, Hii Sun; Roh, Tae Suk; Choi, Jong Woo

    2005-01-01

    Breast implants used for augmentation mammoplasty or breast reconstruction could rupture from various causes such as trauma or spontaneous failure. The objectives of this study were to investigate the relationships between the causes of implant rupture and the degree of capsular contracture, and then to evaluate the relative efficacies of specific signs on magnetic resonance imaging (MRI) known to be beneficial for diagnosing the rupture. A retrospective review identified patients with prosthetic implant rupture or impending rupture treated by the senior author. The 30 cases of implant rupture available for review were classified into two groups: intracapsular and extracapsular ruptures. The 30 cases of breast implant ruptures were analyzed with respect to the clinical symptoms and signs, the causes of rupture, the degree of capsular contracture, and therapeutic plans. Among the 30 cases, 14 patients who had undergone MRI during the diagnostic period were analyzed with respect to the relationships between MRI readings and operative findings. Spontaneous rupture of membranes was most common (80%), followed by failure because of trauma (7%) and valve or implant base (4%). The symptoms during implant rupture were contour deformity, palpated mass-like lesions, pain, and focal inflammation. According to the analysis of specific MRI signs, the sensitivity and specificity of the linguine sign were 87% and 100%, respectively, for intracapsular rupture. For extracapsular rupture, the sensitivity and specificity of the linguine sign were, respectively, 67% and 75%. The sensitivity and specificity of the rat-tail sign and tear drop sign were 14% and 50%, respectively. Breast implant rupture was correlated with the degree of capsular contracture in our study. Among the various specific MRI signs used in diagnosing the rupture, the linguine sign was reliable and had a high sensitivity and specificity, especially in cases of intracapsular rupture. On the other hand, the rat

  4. Abdominal wall abscess secondary to spontaneous rupture of pyogenic liver abscess

    Directory of Open Access Journals (Sweden)

    Maurizio Zizzo

    2016-01-01

    Conclusion: Pyogenic liver abscess is a serious and life-threatening illness. Abscess rupture might occur. Many authors consider this complication a surgical emergency, but the site of abscess rupture changes the clinical history of the disease: in case of free rupture into the peritoneum, emergency surgery is mandatory, while a rupture localized in neighboring tissues or organs can be successfully treated by a combination of systemic antibiotics and fine needle aspiration and/or percutaneous drainage of the abscess.

  5. The SCEC/USGS dynamic earthquake rupture code verification exercise

    Science.gov (United States)

    Harris, R.A.; Barall, M.; Archuleta, R.; Dunham, E.; Aagaard, Brad T.; Ampuero, J.-P.; Bhat, H.; Cruz-Atienza, Victor M.; Dalguer, L.; Dawson, P.; Day, S.; Duan, B.; Ely, G.; Kaneko, Y.; Kase, Y.; Lapusta, N.; Liu, Yajing; Ma, S.; Oglesby, D.; Olsen, K.; Pitarka, A.; Song, S.; Templeton, E.

    2009-01-01

    Numerical simulations of earthquake rupture dynamics are now common, yet it has been difficult to test the validity of these simulations because there have been few field observations and no analytic solutions with which to compare the results. This paper describes the Southern California Earthquake Center/U.S. Geological Survey (SCEC/USGS) Dynamic Earthquake Rupture Code Verification Exercise, where codes that simulate spontaneous rupture dynamics in three dimensions are evaluated and the results produced by these codes are compared using Web-based tools. This is the first time that a broad and rigorous examination of numerous spontaneous rupture codes has been performed—a significant advance in this science. The automated process developed to attain this achievement provides for a future where testing of codes is easily accomplished.Scientists who use computer simulations to understand earthquakes utilize a range of techniques. Most of these assume that earthquakes are caused by slip at depth on faults in the Earth, but hereafter the strategies vary. Among the methods used in earthquake mechanics studies are kinematic approaches and dynamic approaches.The kinematic approach uses a computer code that prescribes the spatial and temporal evolution of slip on the causative fault (or faults). These types of simulations are very helpful, especially since they can be used in seismic data inversions to relate the ground motions recorded in the field to slip on the fault(s) at depth. However, these kinematic solutions generally provide no insight into the physics driving the fault slip or information about why the involved fault(s) slipped that much (or that little). In other words, these kinematic solutions may lack information about the physical dynamics of earthquake rupture that will be most helpful in forecasting future events.To help address this issue, some researchers use computer codes to numerically simulate earthquakes and construct dynamic, spontaneous

  6. One stage resection of spontaneous rupture of hepatocellular carcinoma in the triangular ligament with diaphragm invasion: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Park Kwang-Kuk

    2012-09-01

    Full Text Available Abstract A spontaneous rupture of hepatocellular carcinoma (HCC can lead to extensive hemorrhage and is a rare but life-threatening event. A 58-year-old male patient with no history of trauma presented at our institution with severe epigastric pain and abdominal distension for 6 h. His blood pressure was a 60/40 mmHg, and pulse rate was 132/min. Abdominal contrast enhanced computed tomography (CT imaging revealed a ruptured mass under the left diaphragm and fluid collection in the upper abdomen, flanks and pelvic cavity. Exploratory laparotomy confirmed the presence of an active bleeding tumor in the triangular ligament invading into the diaphragm. The tumor was resected with an appropriate diaphragm margin. The resected tumor was 5 cm in diameter and pathologically identified as hepatocellular carcinoma with a negative surgical margin. This case report shows that ruptured hepatocellular carcinoma should be considered in the differential diagnosis of non-traumatic hemoperitoneum. And it is necessary to set a surgical plan for unpredictable HCC rupture with direct diaphragm invasion.

  7. Delivery of placenta before baby in ruptured uterus | Ameh | Annals ...

    African Journals Online (AJOL)

    An unusual case of ruptured uterus characterized by spontaneous delivery of the placenta while the foetus is retained in the abdomen is presented. The management and prevention of ruptured uterus in Sub- Saharan Africa is discussed. Key Words: Delivery of placenta, ruptured uterus. Annals of African Medicine Vol.3(3) ...

  8. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Kim, Hee Jin [CHA Medical College, Pundang CHA Gerneral Hospital Sungnam, (Korea, Republic of)

    2000-03-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum.

  9. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    International Nuclear Information System (INIS)

    Ryu, Chang Woo; Kim, Hee Jin

    2000-01-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum

  10. Amniopatch treatment for spontaneous previable, preterm premature rupture of membranes associated or not with incompetent cervix.

    Science.gov (United States)

    Kwak, Hye-Min; Choi, Hyun-Jin; Cha, Hyun-Hwa; Yu, Hee-Jun; Lee, Jee-Hun; Choi, Suk-Joo; Oh, Soo-Young; Roh, Cheong-Rae; Kim, Jong-Hwa

    2013-01-01

    We reviewed women with previable spontaneous premature rupture of membranes (sPPROM) in whom an amniopatch was performed and compared their pregnancy outcomes with a conservative management group. Amniopatch, an amnioinfusion of autologous platelet concentrate followed by cryoprecipitate, was performed in 7 women with sPPROM diagnosed at 17-23 weeks' gestation, including one twin pregnancy. Three patients had incompetent cervices and the other 4 patients had sPPROM without incompetent cervices. Pregnancy outcomes of the cases were compared with the controls who were managed conservatively (n = 22). Amniopatch treatment was successful in 1 of 7 cases (14.3%), in which the ruptured membranes were completely sealed and the patient delivered a healthy baby at 39 weeks' gestation. No procedure-related complications were observed. Overall, neonatal outcome was similar in the amniopatch and conservatively managed groups, although the incidences of early neonatal sepsis and respiratory distress syndrome were lower in the amniopatch group. The overall success rate of amniopatch among our small number of cases was low. However, if successful, amniopatch may prolong a pregnancy with previable sPPROM to term. Copyright © 2012 S. Karger AG, Basel.

  11. Spontaneous rupture of thymic neuroendocrine carcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Yeong; Lee, In Jae; Min, Soo Kee [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2015-11-15

    Thymic neuroendocrine carcinoma (NEC) is a rare neoplasm with tendencies of local invasion and metastasis. Usually, it is detected incidentally or by its symptoms caused by mass effect. Rupture of the tumor is extremely rare. In this study, we report a case of a ruptured thymic NEC that was combined with a potentially fatal hemorrhage. This lesion was manifested as a progressive bulging of the right cardiac border on serial chest radiographs, and on CT as a large anterior mediastinal mass with heterogeneous enhancement, internal necrosis, and hematoma.

  12. Dynamic rupture simulation of the 2017 Mw 7.8 Kaikoura (New Zealand) earthquake: Is spontaneous multi-fault rupture expected?

    Science.gov (United States)

    Ando, R.; Kaneko, Y.

    2017-12-01

    The coseismic rupture of the 2016 Kaikoura earthquake propagated over the distance of 150 km along the NE-SW striking fault system in the northern South Island of New Zealand. The analysis of In-SAR, GPS and field observations (Hamling et al., 2017) revealed that the most of the rupture occurred along the previously mapped active faults, involving more than seven major fault segments. These fault segments, mostly dipping to northwest, are distributed in a quite complex manner, manifested by fault branching and step-over structures. Back-projection rupture imaging shows that the rupture appears to jump between three sub-parallel fault segments in sequence from the south to north (Kaiser et al., 2017). The rupture seems to be terminated on the Needles fault in Cook Strait. One of the main questions is whether this multi-fault rupture can be naturally explained with the physical basis. In order to understand the conditions responsible for the complex rupture process, we conduct fully dynamic rupture simulations that account for 3-D non-planar fault geometry embedded in an elastic half-space. The fault geometry is constrained by previous In-SAR observations and geological inferences. The regional stress field is constrained by the result of stress tensor inversion based on focal mechanisms (Balfour et al., 2005). The fault is governed by a relatively simple, slip-weakening friction law. For simplicity, the frictional parameters are uniformly distributed as there is no direct estimate of them except for a shallow portion of the Kekerengu fault (Kaneko et al., 2017). Our simulations show that the rupture can indeed propagate through the complex fault system once it is nucleated at the southernmost segment. The simulated slip distribution is quite heterogeneous, reflecting the nature of non-planar fault geometry, fault branching and step-over structures. We find that optimally oriented faults exhibit larger slip, which is consistent with the slip model of Hamling et al

  13. Spontaneous Perforation of Pyometra: A Case Report

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Pyometra is the accumulation of purulent material in the uterine cavity. Its reported incidence is 0.01–0.5% in gynecologic patients; however, as far as elderly patients are concerned, its incidence is 13.6% [3]. The most common cause of pyometra is malignant diseases of genital tract and the consequences of their treatment (radiotherapy. Other causes are benign tumors like leiomyoma, endometrial polyps, senile cervicitis, cervical occlusion after surgery, puerperal infections, and congenital cervical anomalies. Spontaneous rupture of the uterus is an extremely rare complication of pyometra. To our knowledge, only 21 cases of spontaneous perforation of pyometra have been reported in English literature since 1980. This paper reports an additional case of spontaneous uterine rupture.

  14. 3-D Spontaneous Rupture Simulations of the 2016 Kumamoto, Japan, Earthquake

    Science.gov (United States)

    Urata, Yumi; Yoshida, Keisuke; Fukuyama, Eiichi

    2017-04-01

    We investigated the M7.3 Kumamoto, Japan, earthquake to illuminate why and how the rupture of the main shock propagated successfully by 3-D dynamic rupture simulations, assuming a complicated fault geometry estimated based on the distributions of aftershocks. The M7.3 main shock occurred along the Futagawa and Hinagu faults. A few days before, three M6-class foreshocks occurred. Their hypocenters were located along by the Hinagu and Futagawa faults and their focal mechanisms were similar to those of the main shock; therefore, an extensive stress shadow can have been generated on the fault plane of the main shock. First, we estimated the geometry of the fault planes of the three foreshocks as well as that of the main shock based on the temporal evolution of relocated aftershock hypocenters. Then, we evaluated static stress changes on the main shock fault plane due to the occurrence of the three foreshocks assuming elliptical cracks with constant stress drops on the estimated fault planes. The obtained static stress change distribution indicated that the hypocenter of the main shock is located on the region with positive Coulomb failure stress change (ΔCFS) while ΔCFS in the shallow region above the hypocenter was negative. Therefore, these foreshocks could encourage the initiation of the main shock rupture and could hinder the rupture propagating toward the shallow region. Finally, we conducted 3-D dynamic rupture simulations of the main shock using the initial stress distribution, which was the sum of the static stress changes by these foreshocks and the regional stress field. Assuming a slip-weakening law with uniform friction parameters, we conducted 3-D dynamic rupture simulations by varying the friction parameters and the values of the principal stresses. We obtained feasible parameter ranges to reproduce the rupture propagation of the main shock consistent with those revealed by seismic waveform analyses. We also demonstrated that the free surface encouraged

  15. Spontaneous puerperal extraperitoneal bladder wall rupture in young woman with diagnostic dilemma.

    Science.gov (United States)

    Sabat, Debabrat Kumar; Panigrahi, Pradeep Kumar; Sahoo, Ranjan Kumar; Acharya, Mousumi; Sahu, Mahesh Ch

    2015-01-01

    A young female presented with an acute abdominal pain and oliguria for 1 week following normal vaginal delivery. No history of hematuria was present. Patient was having lochia rubra. Sealed uterine rupture was suspected clinically. Initial ultrasound of the patient showed distended urinary bladder containing Foley catheter ballon with clamping of Foley catheter and particulate ascites. Abdominal paracentesis revealed hemorrhagic fluid. Contrast-enhanced computed tomography of abdomen revealed ascites, distended urinary bladder and no extraluminal contrast extravasation in delayed scan. As patient condition deteriorated, repeat ultrasound guided abdominal paracentesis was done which revealed transudative peritoneal collection with distended bladder. Cystoscopy revealed urinary bladder ruptures with exudate sealing the rupture site. Exploratory laparotomy was done and a diagnosis of extraperitoneal bladder rupture was confirmed. The rent was repaired in layers. She was put on continuous bladder drainage for 3 weeks followed by bladder training. It presented in a unique way as there was hemorrhagic peritoneal tap, no macroscopic hematuria and urinary bladder was distended in spite of urinary bladder wall rupture which delayed the diagnosis and treatment. Complete emptying of urinary bladder before second stage of labor and during postpartum period with perineal repair is mandatory to prevent urinary bladder rupture.

  16. Hemobilia caused by a ruptured hepatic cyst: a case report

    Directory of Open Access Journals (Sweden)

    Dutta Sudhir

    2011-01-01

    Full Text Available Abstract Introduction Hemobilia is a rare cause of upper gastrointestinal bleeding. More than 50% of hemobilia cases are related to iatrogenic trauma from hepatobiliary procedures, and needle biopsy of the liver represents the most common cause. A minority of hemobilia cases are due to hepatobiliary disorders such as cholangitis, hepatobiliary cancers, choledocholithiasis, and vascular abnormalities in the liver. The classic presentation of hemobilia is the triad of right upper quadrant (biliary pain, obstructive jaundice, and upper gastrointestinal bleeding. We report a rare case of hemobilia caused by a spontaneous hepatic cyst rupture, where our patient presented without the classical symptoms, in the absence of therapeutic or pathological coagulopathy, and in the absence of spontaneous or iatrogenic trauma. Case presentation A 91-year-old African-American woman was referred to our out-patient gastroenterology clinic for evaluation of mild epigastric pain and intermittent melena. An abdominal computed tomography scan was remarkable for multiple hepatic cysts. Esophagogastroduodenoscopy revealed multiple blood clots at the ampulla of Vater. Endoscopic retrograde cholangiopancreatography showed a single 18 mm-sized filling defect in the common hepatic duct wall at the junction of the right and left hepatic duct, adjacent to one of the hepatic cysts. The ruptured hepatic cyst communicated to the bile ducts and was the cause of hemobilia with an atypical clinical presentation. Conclusion Hemobilia is an infrequent cause of upper gastrointestinal bleeding and rarely occurs due to hepatic cyst rupture. To the best of our knowledge, this is only the second case report in the literature that describes hemobilia due to hepatic cyst rupture. However, it is the first case in the literature of hemobilia due to hepatic cyst rupture in the absence of iatrogenic or spontaneous trauma, and in the absence of a spontaneous or pathological coagulopathy.

  17. Spontaneous rupture of the spleen after infectious mononucleosis

    DEFF Research Database (Denmark)

    Gulstad, Mikkel Bak; Thomsen, Henrik

    2013-01-01

    Non-traumatic rupture of the spleen (NRS) is a rare but serious complication to infectious mononucleosis (IM) and it is important to have in mind, when patients have IM. Although splenectomy has been advocated as the appropriate treatment for this problem, the trend goes towards conservative...

  18. Subacute presentation of spontaneous diaphragmal rupture: case report

    Directory of Open Access Journals (Sweden)

    Dejan Hermann

    2005-07-01

    Full Text Available Background: Diaphragmatic injuries are relatively rare and present with non specific symptoms and signs. Late discoveries are almost a rule in all but the most evident cases. Many patients are observed or even treated for suspected other conditions, most often musculosceletal disorders.Patients and methods: We report a case of a 14-year-old boy who presented with left lumbar pain and developed peritonitis six days after strenuous training. A chest X-ray revealed abdominal viscera in the left hemithorax. A large posterolateral rupture of the left diaphragm was found at laparotomy together with herniation of the stomach, spleen and colon. The stomach was perforated and partialy necrotic. Afer partial gastrectomy, repositioning and diaphragmal repair the patient recovered well.Conclusions: If pain in toracoabdominal region is a predominant sign after trauma or endogenous strain, one should consider the posibility of ruptured diaphragm and make a chest X-ray. Operation of diaphragmal hernia is necessary and garanties good results when treated on time.

  19. Plantar Fascia Rupture: Ultrasound to Facilitate Recognition.

    Science.gov (United States)

    Servey, Jessica T; Jonas, Christopher

    2018-01-01

    Plantar fascia rupture in the absence of previous diagnosis of plantar fasciitis, corticosteroid injection, or injury is a rare occurrence with only 7 case reports in the literature since 1978. This is a case of spontaneous plantar fascia rupture in a 38-year-old active-duty US military member with current considerations in musculoskeletal ultrasound, other radiologic imaging, treatment, and followup of this diagnosis. © Copyright 2018 by the American Board of Family Medicine.

  20. Spontaneous subserosal venous rupture overlying a uterine leiomyoma in a young woman.

    Science.gov (United States)

    Jenayah, Amel Achour; Saoudi, Sarah; Sferi, Nour; Skander, Rim; Marzouk, Sofiène Ben; Cherni, Abdallah; Sfar, Ezzeddine; Chelli, Dalenda; Boudaya, Fethia

    2017-01-01

    Uterine leiomyomas are very common tumors found in women. Rupture of veins on the surface of uterine leiomyoma is an unusual source of hemoperitoneum. It is an extremely uncommon gynaecological cause of hemoperitoneum. It is a life threatening emergency. We report a case of massive intraperitoneal hemorrhage due to rupture of vessels on the surface of subserous leiomyoma. A differential diagnosis of rupture of leiomyoma'ssurface vessel should be considered, while dealing with a case of hemoperitoneum with pelvic mass.

  1. A Retrospective Analysis of Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Woo Yeol Baek

    2014-11-01

    Full Text Available BackgroundRupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants.MethodsWe performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone, duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management.ResultsForty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case, microfat graft (2 case, removal only (14 case, and follow-up loss (17 case.ConclusionsSaline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

  2. Spontaneous subdural hematoma associated to Duret hemorrhage

    Directory of Open Access Journals (Sweden)

    William Alves Martins, MD

    2015-03-01

    Full Text Available Subdural hematoma (SH is a neurosurgical emergency, usually caused by head trauma. Non-traumatic causes include aneurysm or arterial–venous malformation rupture, coagulopathy and others. We report the case of a 66 year-old man who developed apparently unprovoked signs of increased intracranial pressure. Brain computed tomography scan showed an acute spontaneous SH, surgically treated. Throughout surgery, a ruptured cortical artery with intensive bleeding appeared and was cauterized. After surgery, patient remained comatose and a new CT demonstrated Duret hemorrhage at the brainstem. Acute spontaneous SH of arterial origin is rare and highly lethal, in which a good prognosis relies on early diagnosis and treatment.

  3. A Near Fatal Sneeze Spontaneous Splenic Rupture: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Gregory W. Reinhold

    2017-05-01

    Full Text Available A 79-year-old female called 911 for abdominal pain in her left upper quadrant with radiation through to her back and left shoulder for three hours. Upon arrival to the emergency department her physical exam was positive only for tenderness in the left upper quadrant of her abdomen. The patient denied any history of trauma but reported she “did sneeze three times” just prior to the onset of her pain. Computed tomography angiography of the abdomen and pelvis was obtained to evaluate for vascular pathology. The radiologist immediately called with concern for splenic laceration. The general surgeon took the patient directly to the operating room where she underwent a splenectomy and recovered without sequelae. This is the first case report of spontaneous splenic rupture that resulted after the act of sneezing. It is important to be aware of this rare clinical entity because early recognition can be life saving.

  4. A deep azygoesophageal recess may increase the risk of secondary spontaneous pneumothorax.

    Science.gov (United States)

    Takahashi, Tsuyoshi; Kawashima, Mitsuaki; Kuwano, Hideki; Nagayama, Kazuhiro; Nitadori, Jyunichi; Anraku, Masaki; Sato, Masaaki; Murakawa, Tomohiro; Nakajima, Jun

    2017-09-01

    The azygoesophageal recess (AER) is known as a possible cause of bulla formation in patients with spontaneous pneumothorax. However, there has been little focus on the depth of the AER. We evaluated the relationship between the depth of the AER and pneumothorax development. We conducted a retrospective study of 80 spontaneous pneumothorax patients who underwent surgery at our institution. We evaluated the depth of the AER on preoperative computed tomography scans. Ruptured bullae at the AER were found in 12 patients (52.2%) with secondary spontaneous pneumothorax (SSP) and 8 patients (14.0%) with primary spontaneous pneumothorax (PSP) (p < 0.001). In patients with ruptured bullae at the AER, 10 SSP patients (83.3%) had a deep AER while only 2 PSP patients (25%) had a deep AER (p = 0.015). A deep AER was more frequently associated with SSP than with PSP. A deep AER may contributes to bulla formation and rupture in SSP patients.

  5. Rupture of a Solid Pseudopapillary Neoplasm of the pancreas

    Directory of Open Access Journals (Sweden)

    Barbara Rampersad

    2018-03-01

    Full Text Available An acute presentation of a spontaneously ruptured Solid-Pseudopapillary Neoplasm (SPN in an 8 year old female is discussed with a review of the world literature. Our literature search revealed 15 other cases of ruptured SPN and with this case the total is now 16. Notably, 12 patients were 16 years of age or less at presentation as in our case. Although rupture of a SPN is rarely reported it appears to be more probable in the pediatric patient. Additionally, larger tumor size and trauma may be contributing factors.

  6. The pathologic splenic rupture of a patient with scrub typhus: a case report

    International Nuclear Information System (INIS)

    Kim, Kum Rae; Park, Won Kyu; Chang, Jay Chun; Cho, Jae Ho; Kim, Jae Woon; Hwang, Mi Soo; Park, Bok Hwan

    2008-01-01

    A pathologic splenic rupture is rare, occurring primarily in a spleen affected by infective, hematological, and neoplastic disease. To the best of our knowledge, no prior reports of a pathologic splenic rupture due to scrub typhus exist. Intrasplenic pseudoaneurysms and focal infarctions are visible on an initial CT scan. Moreover, the spontaneous splenic rupture occurred a week later. We report a case of nontraumatic-splenic rupture in a patient with scrub typhus

  7. The pathologic splenic rupture of a patient with scrub typhus: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kum Rae; Park, Won Kyu; Chang, Jay Chun; Cho, Jae Ho; Kim, Jae Woon; Hwang, Mi Soo; Park, Bok Hwan [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2008-01-15

    A pathologic splenic rupture is rare, occurring primarily in a spleen affected by infective, hematological, and neoplastic disease. To the best of our knowledge, no prior reports of a pathologic splenic rupture due to scrub typhus exist. Intrasplenic pseudoaneurysms and focal infarctions are visible on an initial CT scan. Moreover, the spontaneous splenic rupture occurred a week later. We report a case of nontraumatic-splenic rupture in a patient with scrub typhus.

  8. Spontaneous rupture of pheochromocytoma and its clinical features: a case report.

    Science.gov (United States)

    Maruyama, Mayumi; Sato, Haruhiro; Yagame, Mitsunori; Shoji, Sunao; Terachi, Toshiro; Osamura, Robert Yoshiyuki

    2008-09-20

    Rupture of adrenal pheochromocytoma is extremely rare and can be lethal because of dramatic changes in the circulation. We describe a 58-year-old Japanese man who suffered rupture of a pheochromocytoma. The patient was referred to our hospital because of severe hypertension (256/127 mmHg) and a left adrenal tumor. T2-weighted magnetic resonance imaging showed high signal intensity in the 50-mm left adrenal tumor. Endocrinological examinations showed elevated plasma and urinary catecholamine levels. These findings suggested that the left adrenal tumor was a pheochromocytoma. Phentolamine mesilate was administered intravenously. This resulted in a decrease of the systolic blood pressure to 100 mmHg. On the third hospital day, the patient complained of left back pain, and abdominal computed tomography showed rupture of the pheochromocytoma. Pulmonary congestion and effusion, and paralytic small-intestinal ileus occurred. Blood pressure was controlled, small-intestinal decompression was done with a Miller-Abbot tube, and body water was controlled by fluid replacement. After the general condition of the patient had became stable, laparoscopic adrenalectomy was performed. Phentolamine mesilate is a useful α-adrenergic blocker. However, care is needed with its administration, because rupture of pheochromocytoma may be related to a decrease in blood pressure induced by phentolamine mesilate.

  9. Short- and long-term results of chordal reconstruction using artificial suture material (polytetrafluoroethylene and polypropylene in the dog

    Directory of Open Access Journals (Sweden)

    Isamu Kanemoto

    2017-04-01

    Full Text Available No previous reports have compared the suitability of expanded polytetrafluoroethylene (ePTFE and polypropylene as artificial suture materials for chordal reconstruction in mitral valve plasty (MVP in the dog. Twelve normal dogs were subjected to MVP using surfaceinduced deep hypothermia. In the short-term group (1.5-4 months after surgery, all ePTFE sutures were covered by a tissue sheath including the paired suture arms, which gave the appearance of native chordae from 2 months after surgery. In contrast, all polypropylene sutures were not covered by tissue, and appeared the same as the paired polypropylene suture arms at the operation. In the long-term group (12 months after surgery, all ePTFE sutures were covered by a tissue sheath, which appeared the same as that in the short-term group, and had flexibility without increased thickness with time. In contrast, although the polypropylene suture was covered completely by a tissue sheath in 1 dog, all the other polypropylene sutures were exposed except for both ends of the suture. ePTFE may be superior to polypropylene as an artificial suture material for chordal reconstruction in MVP.

  10. Partial achilles tendon rupture presenting with giant hematoma; MRI findings of 4 year follow up.

    Science.gov (United States)

    Sarsilmaz, Aysegul; Varer, Makbule; Coskun, Gulten; Apaydın, Melda; Oyar, Orhan

    2011-12-01

    In the young population, spontaneous rupture of Achilles tendon is very rare. The big hematoma is also rare finding of the Achilles tendon partial rupture. It is usually seen with complete rupture. We presented imaging findings of 4 years follow up of the spontaneous partial rupture of Achilles tendon presenting with giant expanding hematoma and mimicking complete rupture radiologically. We discussed the alterations of tendon signal intensity and result of conservative therapy after partial rupture with big hematoma in the long term. A 29 year-old man, applied with pain and swelling in the retrocalcaneal region of left ankle. He did not have chronic metabolic disease. He was not active in physical activities. X-ray radiograms were normal. At magnetic resonance images (MRI), there was an intratendinous big hematoma, subcutanous fat planes were edematous around tendon. The diagnosis was partial rupture and giant hematoma. Hematoma was drained. The conservative treatment was applied and his complaints disappeared. After treatment, approximately 4 years later, control MRI showed thickened and hypointense tendon in all images. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  11. Spontaneous Rupture of Superficial Femoral Artery Repaired with Endovascular Stent-Grafting with use of Rendez-Vous Technique, Followed by Delayed Infection

    International Nuclear Information System (INIS)

    Fanelli, Fabrizio; Cannavale, Alessandro; Gazzetti, Marianna; Fantozzi, Cristiano; Taurino, Maurizio; Speziale, Francesco

    2013-01-01

    This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient’s clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.

  12. Spontaneous Rupture of Superficial Femoral Artery Repaired with Endovascular Stent-Grafting with use of Rendez-Vous Technique, Followed by Delayed Infection

    Energy Technology Data Exchange (ETDEWEB)

    Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it; Cannavale, Alessandro [University of Rome ' Sapienza,' , Department of Radiological Sciences, Vascular and Interventional Radiology Unit (Italy); Gazzetti, Marianna [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy); Fantozzi, Cristiano; Taurino, Maurizio [University of Rome ' Sapienza,' , Department of Vascular Surgery (Italy); Speziale, Francesco [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy)

    2013-02-15

    This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient's clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.

  13. Recanalisation of spontaneously occluded vertebral artery dissection after subarachnoid haemorrhage.

    Science.gov (United States)

    Akiyama, Takenori; Onozuka, Satoshi; Horiguchi, Takashi; Yoshida, Kazunari

    2012-10-01

    Spontaneous occlusion is a rare manifestation of ruptured vertebral artery dissection (VAD). Its natural history and treatment strategy have yet to be established due to its rarity. Here, we report five lesions involving spontaneous occlusion of VAD after subarachnoid haemorrhage, among which three lesions showed recanalisation. Based on our experience and previous reports, spontaneous occlusion of ruptured VAD can be classified into two groups-one group with occlusion in the acute stage with a high incidence of recanalisation and another group with occlusion in the chronic stage with a relatively low incidence of recanalisation. The underlying mechanism is likely different in each group, and treatment strategies should also be tailored depending on the pathophysiology.

  14. Computed tomography in the assessment of idiopathic spontaneous pneumothorax

    International Nuclear Information System (INIS)

    Kim, Sang Jin; Lee, Doo Yun; Kim, Hyung Jung

    1991-01-01

    It is well known that idiopathic spontaneous pneumothorax is caused by rupture of the subpleural bleb and presents difficulty in exact detection and localization of the bleb with plain chest X - ray alone. The authors performed chest CT scans for accurate diagnosis of bleb that would act as a guide for optimal management of idiopathic spontaneous pneumothorax patients in order to prevent recurrent pneumothorax. We could detect blebs in 93 % (26/28) of the patients with idiopathic spontaneous pneumothorax, and 68 % (19/ 28) of the patient had bilateral blebs. Sensitivity was 0.63, and false negative was 37% (37/100) of the blebs, and 51% (19/37) of these 37 false negative cases were ruptured blebs. Only 7 % (2/28) of the patients had a single bleb. The authors concluded that CT is a useful method of study for optimal management of idiopathic spontaneous pneumothorax patients

  15. A SURVEY ON CHORDAL RINGS, N2R AND OTHER RELATED TOPOLOGIES

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup; Zabludowski, Antoni; Gutierrez Lopez, Jose Manuel

    2012-01-01

    In this short paper we summarize the main results of 10 years of research on network topologies carried out jointly at Aalborg University (AAU), Aalborg, Denmark, and University of Life Science (UTP), Bydgoszcz, Poland. The starting points are the Chordal Rings, which were mainly studied in UTP......, and provides appropriate references to the work for further details. The paper is presented as a tribute to Professor and Dean Antoni Zabłudowski who passed away during 2012......., and the N2R which were studied at AAU. From here the universities have collaborated intensely, and studied a number of alternatives and variations of the original topologies, based on methodologies developed both independently and jointly over time. This paper gives an overview of the work done...

  16. Preterm Delivery in the Setting of Left Calyceal Rupture

    Directory of Open Access Journals (Sweden)

    Brent Hanson

    2015-01-01

    Full Text Available Spontaneous rupture of the renal collecting system is a rare but serious complication of pregnancy. We report a case of nontraumatic left renal calyceal rupture in a pregnancy which ultimately progressed to preterm delivery. A 29-year-old primigravida with a remote history of urolithiasis presented with left flank pain, suprapubic pain, and signs of preterm labor at 33 weeks of gestation. The patient was believed to have urolithiasis, although initial renal ultrasound failed to demonstrate definitive calculi. After a temporary improvement in flank pain with medication, the patient experienced acute worsening of her left flank pain. Urology was consulted and further imaging was obtained. Magnetic resonance imaging (MRI was consistent with bilateral hydronephrosis and rupture of the left renal calyx. Given the patient’s worsening pain in the setting of left calyceal rupture, the urology team planned for placement of a left ureteral stent. However, before the patient could receive her stent, she progressed to active labor and delivered a viable female infant vaginally. Following delivery, the patient’s flank pain resolved rapidly and spontaneously, so no surgical intervention was performed. A summary of the literature and the details of this specific clinical situation are provided.

  17. Hemothorax caused by spontaneous rupture of hepatocellular carcinoma in the pleural cavity: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Hin Hee; Ohm, Joon Young [Dept. of Radiology, Chungnam National University Hospital, Daejeon (Korea, Republic of); Kim, Song Soo; Kim, Jin Hwan [Dept. of Radiology, Chungnam National University School of Medicine, Daejeon(Korea, Republic of)

    2017-07-15

    Hemothorax resulting from ruptured hepatocellular carcinoma (HCC) is extremely rare and is generally caused by ruptured intrathoracic metastatic lesions. However, we report a rare case of hemothorax resulting from intrathoracic rupture of primary HCC.

  18. Spontaneous Bladder Perforation in an Infant Neurogenic Bladder: Laparoscopic Management

    Directory of Open Access Journals (Sweden)

    Daniel Cabezalí Barbancho

    2013-01-01

    Full Text Available Spontaneous bladder perforation is an uncommon event in childhood. It is usually associated with bladder augmentation. We are presenting a case of bladder rupture in an infant with neurogenic bladder without prior bladder surgery. Three days after lipomyelomeningocele excision the patient showed signs and symptoms of acute abdomen. The ultrasound exploration revealed significant amount of intraperitoneal free fluid and therefore a laparoscopic exploration was performed. A posterior bladder rupture was diagnosed and repaired laparoscopically. Currently, being 3 years old, she keeps successfully dry with clean intermittent catheterization. Neurogenic bladder voiding function can change at any time of its evolution and lead to complications. Early diagnosis of spontaneous bladder rupture is of paramount importance, so it is essential to think about it in the differential diagnosis of acute abdomen.

  19. A Double Whammy: Severe Aortic Stenosis and Cocaine Overwhelm the Mitral Valve.

    Science.gov (United States)

    Maini, Rohit; Lim, Jonathan; Liu, Jing; Birnbaum, Itamar; Mirza, Farooq; Lakkis, Nasser; Hamzeh, Ihab

    2018-01-01

    A 50-year-old man presented with acute onset dyspnea following cocaine use. He had severe aortic stenosis (AS), mild mitral regurgitation (MR) due to mitral valve prolapse, and no coronary artery disease on recent coronary angiography. He was in acute heart failure with signs of impending cardiogenic shock. Urgent bedside echocardiography revealed hyperdynamic left ventricular systolic function with acute severe MR from a ruptured chordae tendineae. The acute cocaine-induced spike of his already elevated left ventricular systolic pressure from severe AS likely precipitated chordal rupture of his vulnerable mitral valve. This patient underwent emergent mitral and aortic valve replacements. Although cocaine use has been associated with a myriad of cardiovascular complications, acute MR due to chordal rupture has not, to our knowledge, been previously reported in this setting. Prompt diagnosis with echocardiography and surgical intervention are of paramount importance in the management of acute MR.

  20. Spontaneous rupture of a left gastroepiploic artery aneurysm.

    Directory of Open Access Journals (Sweden)

    Rohatgi A

    2002-10-01

    Full Text Available Gastroepiploic aneurysms are extremely rare. They occur mainly in elderly men and in 90% of cases are ruptured at presentation. Visceral aneurysms though rare should be borne in mind in cases of unexplained haemorrhagic shock. We present a case of a 79-year-old man who presented with abdominal pain, hypotension and anaemia but no obvious source of bleeding. He had undergone a prior aorto-bifemoral graft. The patient refused an operation and died the following day.

  1. An adolescent with prolapsed omentum per rectum: Spontaneous rectal perforation managed laparoscopically

    Directory of Open Access Journals (Sweden)

    Ameet Kumar

    2017-01-01

    Full Text Available Spontaneous rupture of the rectum is a rare occurrence. A total laparoscopic approach to rectal perforation has only occasionally been reported. We report an unusual case of a young boy who developed a spontaneous rupture of the rectum following a trivial fall. A magnetic resonance imaging revealed a tear in the rectum at the peritoneal reflection with the omentum plugging it. He denied any history of rectal instrumentation or abnormal sexual activity. He had no history of constipation or rectal prolapse. The tear was repaired laparoscopically and a covering loop sigmoid colostomy was added. He made an uneventful post-operative recovery. Spontaneous rupture of the rectum can occur in younger age groups and even in the absence of significant trauma. One needs to diligently bring out a history of rectal trauma. Equally important is to rule out any underlying pathological condition. A laparoscopic approach is feasible, especially in early cases.

  2. Multiple Tophaceous Gout of Hand with Extensor Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Haruki Tobimatsu

    2017-01-01

    Full Text Available A 45-year-old man presented with painless subcutaneous masses bilaterally on his hands and loss of motion or contracture of the fingers. Initially, drug therapy to reduce the serum uric acid was administered and was expected to reduce the tophi. However, during observation at the clinic, spontaneous rupture of an extensor tendon occurred, and surgical repair of the tendon and resection of the masses were performed. Surgical exploration of the right hand showed hypertrophic white-colored crystal deposits that both surrounded and invaded the extensor digitorum communis of the index finger, which was ruptured. Histopathologic examination of the specimen demonstrated findings consistent with gouty tophi. Tophaceous gout can induce a rupture of tendons during clinical observation, and surgical resection of the tophi might be needed to prevent ruptures.

  3. Fetal membrane healing after spontaneous and iatrogenic membrane rupture: A review of current evidence

    OpenAIRE

    Devlieger, R.; Millar, L. K.; Bryant-Greenwood, G.; Lewi, L.; Deprest, J. A.

    2006-01-01

    In view of the important protective role of the fetal membranes, wound sealing, tissue regeneration, or wound healing could be life saving in cases of preterm premature rupture of the membranes. Although many investigators are studying the causes of preterm premature rupture of membranes, the emphasis has not been on the wound healing capacity of the fetal membranes. In this review, the relevant literature on the pathophysiologic condition that leads to preterm premature rupture of membranes ...

  4. Ruptured Cervical Aneurysm with Neurofibromatosis | Smith | South ...

    African Journals Online (AJOL)

    A case is presented of spontaneous rupture of an aneurysm of a lateral branch of the right thyrocervical trunk in a patient suffering from diffuse neurofibromatosis. The operative findings are reported. S. Afr. Med. J., 48, 945 (1974). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT ...

  5. Effects of varying hydraulics on the calibration of eight path chordal ultrasonic meters

    International Nuclear Information System (INIS)

    Hauser, E.; Estrada, H.; Regan, J.

    2003-01-01

    Eight path transit time ultrasonic meters are being used in the US, Europe and Japan to support measurement uncertainty power uprates of nuclear power plants. Power uprates rely on the demonstration of improved power accuracy to justify a reduction in the traditional 2% margin between operating power and the power at which loss of coolant accidents and other transients have been analyzed. The flow, density and enthalpy of the feedwater are key elements in the power calculation, and the eight path ultrasonic meters measure the flow and temperature from which these elements are derived. A key element in the uncertainty analysis for these meters is an allowance for the uncertainties that the feedwater flow profiles introduce in the meters' flow calibrations. To minimize and bound this uncertainty calibration tests are performed on each eight path element to be used in an uprate application. This paper describes extensive testing of a prototype eight path meter, results of which have be used to define the sensitivity of 8 path meters to broad variations in flow profiles, both axial and transverse and to establish a methodology whereby the impact of these changes on the uncertainty of the meters can be minimized. This testing confirms the general insensitivity of 8 path chordal systems to axial and transverse fluid velocity profiles. An 8 path chordal system provides a quantitative measurement of the flatness of the axial profile, which allows a quantitative assessment of the differences in hydraulic profile seen by a meter in a plant versus the hydraulic profile seen by that same meter in the calibration lab. Since the sensitivity of the meter's calibration can be established as a function of profile flatness in the lab through parametric testing, the profile flatness in the plant can be used to confirm or to adapt as necessary the calibration coefficient measured in the lab for use in the plant. (author)

  6. Uterine rupture: UCH, Ibadan experience | Ogunnowo | West African ...

    African Journals Online (AJOL)

    85.7% of the patients were unbooked. Common modes of presentation were bleeding per vaginam and abdominal pain. Spontaneous cause of rupture predominates. The interval between diagnosis and surgery was greater than 7 hours in 75% of cases. Uterine repair with or without tubal ligation was commonly employed.

  7. Bilateral simultaneous quadriceps tendon rupture in a patient with secondary hyperparathyroidism: a case report

    International Nuclear Information System (INIS)

    Lee, Yeon Soo; Son, Sang Beom; Han, Chang Whan; Kang, Si Won

    2001-01-01

    Simultaneous bilateral rupture of the quadriceps tendon without a significant history of trauma may occur in association with chronic metabolic disorders such as chronic renal failure and secondary hyperparathyroidism, though has rarely been reported. We describe a case of spontaneous bilateral quadriceps tendon rupture in a 36-year-old female patient with secondary hyperparathyroidism

  8. Jenis dan Jumlah Mikroorganisme Aerob pada Persalinan Spontan Kurang dan Cukup Bulan tanpa Ketuban Pecah Dini

    Directory of Open Access Journals (Sweden)

    Yan O'Neil S. Meliala

    2012-03-01

    Full Text Available Preterm birth is the main cause of perinatal mortality and morbidity. Prevalence of preterm delivery which is caused by infection is 40–50%. The aim of this study was to determine that spontaneous preterm delivery without premature rupture of the membrane is initiated by chorioamnionitis and to find out the comparison of aerob microorganism species and number from spontaneous preterm and term delivery without premature rupture of the membrane. This was a comparative cross sectional study. This study was conducted in Dr. Hasan Sadikin Hospital Bandung and satelite hospital, from July to August 2009, the subjects were 53 patients. This study analyzed with chi-square and t-test to differentiate average of gestational age with p<0.05. There’s no significant difference of characteristic between two research subject groups, significant difference between two research subject groups with chorioamnionitis (p=0.004, significant difference of aerob microorganism species between two research subject groups (p=0.025 and significant difference number of aerob microorganism between two research subjects (p=0.003. In conclusions, chorioamnionitis can initiate a spontaneous preterm delivery without premature rupture of the membrane and the number of microorganism indicated the virulence of microorganism that caused chorioamnionitis which is initiated spontaneous preterm delivery without premature rupture.

  9. Using MAAP 4.0 to determine risks from steam generator tube leaks or ruptures

    International Nuclear Information System (INIS)

    Fuller, E.L.; Kenton, M.A.

    1996-01-01

    As part of the Electric Power Research Institute (EPRI) program on steam generator degradation specific management (SGDSM), the nuclear industry is investigating the effects on plant risk of severe accidents involving steam generator tube leaks or ruptures. Such accidents fall into three classes: those caused by spontaneous, steam generator tube ruptures (SGTRs) that subsequently result in core damage; those caused by design-basis accidents that lead to induced tube ruptures and subsequent core damage; and those that progress to core damage, such as a station blackout (SBO), with subsequent induced tube leakage or rupture. In each case, the potential exists for a significant fraction of the fission products released from a damaged core to reach the environment through the leaking or ruptured tubes

  10. SPONTANEOUS SPLENIC RUPTURE SECONDARY TO RIVAROXABAN: RARE BUT RAISING

    Directory of Open Access Journals (Sweden)

    Zainab Naseem

    2016-08-01

    Full Text Available A 68-year old male presented to our hospital with sudden onset of left sided chest and abdominal pain. The patient was previously treated for left lower lobe pneumonia and reported no history of chest or abdominal trauma. His medical history included atrial fibrillation which was managed by rivaroxaban 20 mg once daily. Computed tomography of the abdomen demonstrated a splenic haematoma. The patient rapidly deteriorated and developed hypovolaemic shock. Emergency laparotomy revealed haemoperitoneum of 3500 mL and the ruptured spleen. The postoperative course was complicated by pancreatic fistula formation which eventually resolved.

  11. Spontaneous Rupture of Pyometra in a Nonpregnant Young Woman

    Directory of Open Access Journals (Sweden)

    Parvin Mostafa-Gharabaghi

    2017-01-01

    Full Text Available A 40-year-old woman presented with severe vaginal bleeding. Initial workup with an abdominal sonography revealed endometrium for about 3 mm and free fluid in the abdomen. Hemodynamic instability with abdominal pain and free fluid in the abdomen prompted blood transfusion and laparotomy. There were about 1000 cc blood and clots in the abdomen at laparotomy. There was a longitudinal rupture from fundus up to cervix at the left side of the uterus. Tearing was in full thickness from serosa to endometrium. Scar of previous cesarean was transvers and not associated with this tearing. There was not any myomectomy scar.

  12. Ogilvie's syndrome: case report of spontaneous rupture of the ...

    African Journals Online (AJOL)

    In acute colonic pseudo-obstruction (ACPO) there is colonic distension without an organic obstacle (intrinsic or extrinsic to intestinal wall). This becomes a potential site of ceacal rapture which can lead to the demise of the patient. Presented is a case of a mother who had spontaneous caecal rapture five days after ...

  13. Women's expectations and experiences of rupture of membranes and views of the potential use of reagent pads for detecting amniotic fluid.

    Science.gov (United States)

    Spiby, Helen; Borrelli, Sara; Hughes, Anita J

    2017-12-01

    To explore first-time mothers' expectations and experiences regarding rupture of membranes at term and their views on the potential use of reagent pads that detect amniotic fluid. There is little information available on women's experiences of spontaneous rupture of membranes, or interest in using methods to confirm rupture of membranes (e.g. reagent pads). Descriptive qualitative study, using focus groups and telephone interviews with women during pregnancy and after the birth of their first baby. Thematic analysis was undertaken to analyse women's responses. Ethics committee approval was obtained. Twenty-five women participated in the study of whom 13 contributed both during pregnancy and postpartum between October 2015-March 2016. Three overarching themes were identified from the data from women's expectations and experiences: uncertainty in how, when and where membranes may rupture; information which was felt to be limited and confirmation of rupture of membranes. The potential use of reagent pads met with varied responses. Women were interested in having facts and figures regarding rupture of membranes, such as characteristics of liquor; volume and probability of membranes rupturing spontaneously at term. Use of a pad as a means of confirmation was viewed as helpful, although the potential for increasing anxiety was raised. © 2017 John Wiley & Sons Ltd.

  14. A patient with spontaneous rupture of the esophagus and concomitant gastric cancer whose life was saved: case of report and review of the literature in Japan

    Directory of Open Access Journals (Sweden)

    Matsuhashi Nobuhisa

    2011-12-01

    Full Text Available Abstract A 71-year-old man suddenly developed abdominal pain and vomiting on drinking soda after a meal, and visited a physician. Cervical subcutaneous and mediastinal emphysemas were observed on CT, and the patient was transferred to the emergency medical center of our hospital on the same day. Esophagography was performed at our department. A ruptured region was identified on the left side of the lower thoracic esophagus, and surgery was emergently performed employing sequential left thoracoabdominal incision. The chest wall was adhered due to inflammation, and large amounts of residual food and sloughing were present in the thoracic cavity and mediastinum. Moreover, necrotic changes were noted in the superior through inferior mediastinum. An about 2-cm rupture site was confirmed on the left side of the lower thoracic esophagus and closed by suture and filling with pediculate omentum. The presence of a tumorous lesion located mainly in the body of the stomach and lymph node enlargement were also diagnosed before surgery, for which gastric and intestinal fistulae were inserted to prepare for the second-stage surgery. The patient was admitted to an ICU after surgery. ARDS and MRSA-induced pneumonia and enteritis concomitantly developed but remitted. Curative surgery for gastric cancer was performed at 40 POD. Spontaneous rupture of the esophagus is relatively rare and that complicated by gastric caner is very rare, with only six cases being reported in Japan. Herein, we report the case.

  15. Rupture of major vessels after radiation

    International Nuclear Information System (INIS)

    Fajardo, L.F.; Lee, A.

    1975-01-01

    Rupture of irradiated large vessels is an uncommon complication which tends to occur in carotid, aorta, and femoral arteries, in decreasing order of incidence. It particularly affects men subjected to surgery and radiotherapy for epidermoid carcinomas in oropharynx, esophagus, or genitalia. Contrary to some opinion, radiation is not the most significant cause; this spontaneous arterial rupture can occur without radiation. The perforation is not associated with tumor invasion of arterial wall, as has been claimed. Surgical complications, especially necrosis of skin flaps, infection, and fistulas are most important etiologically. Only 2 of the 11 instances that we describe appear to have been caused mainly by radiation. The perforation is usually fatal, but several patients, including 3 of our series (2 carotid, 1 femoral), have been saved by hospital personnel aware of this complication. To prevent it, prolonged exposure or infection of arteries, whether irradiated or not, should be avoided. (auth)

  16. Spontaneous rupture of pedunculate gastric gastrointestinal stromal tumor into the gastrocelic ligament presenting as a stalked mass surrounded by loculated hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Soo; Ahn, Sung Eun; Park, Seong Jin; Moon, Sung Kyoung; Lim, Joo Won; Lee, Dong Ho; Kim, Yong Ho [Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2015-04-15

    Gastric gastrointestinal stromal tumor (GIST) is one of the most common mesenchymal tumors of the stomach, which may be asymptomatic or cause symptoms such as pain, gastrointestinal bleeding, and obstruction. Hemoperitoneum due to spontaneous rupture of the tumor is an extremely rare complication. We described a case of a 52-year-old man with a large pedunculated GIST causing loculated hematoma within the gastrocolic ligament. The patient visited our hospital due to a 3 week history of epigastric pain. A computed tomography scan revealed a 10.3 x 7.5 x 9.4 cm sized mass that was growing exophytically from the greater curvature of the stomach and was surrounded by loculated hematoma within the gastrocolic ligament. Laparotomy revealed a large stalked gastric mass surrounded by loculated hematoma within the gastrocolic ligament and blood fluid in the peritoneal cavity. Pathologic examination confirmed a GIST, of the high risk group.

  17. A support-operator method for 3-D rupture dynamics

    Science.gov (United States)

    Ely, Geoffrey P.; Day, Steven M.; Minster, Jean-Bernard

    2009-06-01

    We present a numerical method to simulate spontaneous shear crack propagation within a heterogeneous, 3-D, viscoelastic medium. Wave motions are computed on a logically rectangular hexahedral mesh, using the generalized finite-difference method of Support Operators (SOM). This approach enables modelling of non-planar surfaces and non-planar fault ruptures. Our implementation, the Support Operator Rupture Dynamics (SORD) code, is highly scalable, enabling large-scale, multiprocessors calculations. The fault surface is modelled by coupled double nodes, where rupture occurs as dictated by the local stress conditions and a frictional failure law. The method successfully performs test problems developed for the Southern California Earthquake Center (SCEC)/U.S. Geological Survey (USGS) dynamic earthquake rupture code validation exercise, showing good agreement with semi-analytical boundary integral method results. We undertake further dynamic rupture tests to quantify numerical errors introduced by shear deformations to the hexahedral mesh. We generate a family of meshes distorted by simple shearing, in the along-strike direction, up to a maximum of 73°. For SCEC/USGS validation problem number 3, grid-induced errors increase with mesh shear angle, with the logarithm of error approximately proportional to angle over the range tested. At 73°, rms misfits are about 10 per cent for peak slip rate, and 0.5 per cent for both rupture time and total slip, indicating that the method (which, up to now, we have applied mainly to near-vertical strike-slip faulting) is also capable of handling geometries appropriate to low-angle surface-rupturing thrust earthquakes. Additionally, we demonstrate non-planar rupture effects, by modifying the test geometry to include, respectively, cylindrical curvature and sharp kinks.

  18. Observation of plasma motion in a coaxial plasma opening switch with a chordal laser interferometer

    International Nuclear Information System (INIS)

    Teramoto, Y.; Urakami, H.; Akiyama, H.; Kohno, S.; Katsuki, S.

    2002-01-01

    Electron densities in a coaxial plasma opening switch were measured at many lines-of-slight. In the present experiment, electron density was measured by a He-Ne laser interferometer with chordal lines-of sight. In order to observe the motion of the POS plasma, the electron density contours during the conduction, opening and post-opening phases were drawn by combining the results of interferometer experiments. The radial and axial motion of POS plasma was investigated from the density contours. As conduction time progressed, the POS plasma moved toward downstream. At 800 ns, which corresponds to the time of opening in the current waveform, low-density region less than 10 15 cm -2 is seen at 10 mm from the cathode. After the opening was completed, the low-density gap disappeared and the shape of the corn-shape-like plasma was distorted. (author)

  19. [Occult rupture of the spleen in a patient with infectious mononucleosis].

    Science.gov (United States)

    Bonsignore, A; Grillone, G; Soliera, M; Fiumara, F; Pettinato, M; Calarco, G; Angiò, L G; Licursi, M

    2010-03-01

    Rupture of the spleen can be secondary to abdominal traumas (usually closed trauma) or spontaneous, can interest an organ normal or with morphological alterations secondary to various pathologies. Among the diseases responsible of occult rupture, infectious diseases are the most frequent and, among these, infectious mononucleosis, that is complicated with splenic rupture in 0.5% of the cases, with 30% of mortality. P.M., 16 years old female, admitted with acute abdomen, progressive anaemia and incipient cardiovascular instability, associated with suggestive clinical diagnosis of infectious mononucleosis, confirmed by serological findings and histological examination. Because of the imaging of subcapsular splenic haematoma, probably ruptured and with peritoneal bleeding we opt for emergency laparotomy intraoperative findings allows to splenectomy. Splenic rupture in infectious mononucleosis often presents as left hypochondrial pain, rare in uncomplicated cases; its occurrence in a patient with a recent diagnosis of infectious mononucleosis or with clinical or laboratory features suggestive of acute EBV infection, should always be investigated with an urgent abdominal ultrasound scan or CT. This approach is mandatory when hypochondrial pain is associated with pain referred to the left shoulder (Kehr's sign), peritoneal irritation and haemodynamic instability. Patients with splenic rupture in infectious mononucleosis generally undergo emergency splenectomy.

  20. Gelatin sponge particle embolization of spontaneously putured intrahepatic arterial aneurysms in a patient with polyarteritis nodosa: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Seol, Myung Jin; Noh, Kyung Hee; Kim, Young Jun; Jeon, Doo Sung [Dept. of Radiology, Presbyterian Medical Center, Jeonju (Korea, Republic of)

    2017-01-15

    Multiple intrahepatic arterial aneurysms and spontaneous aneurysmal rupture associated with polyarteritis nodosa leading to hemoperitoneum are extremely rare occurrences, but the conditions can be life-threatening if left untreated because of the risk of massive hemorrhage. We report a case of a high-risk surgical patient with polyarteritis nodosa complicated by spontaneous rupture of multiple intrahepatic arterial aneurysms. He was initially treated with emergency gelatin sponge particle embolization, followed by maintenance steroid treatment. Complete resolution of intrahepatic arterial aneurysms was observed at follow-up.

  1. Spontaneous Retroperitoneal Hemorrhage from Adrenal Artery Aneurysm

    International Nuclear Information System (INIS)

    Gonzalez Valverde, F.M.; Balsalobre, M.; Torregrosa, N.; Molto, M.; Gomez Ramos, M.J.; Vazquez Rojas, J.L.

    2007-01-01

    Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture

  2. Isokinetic strength and endurance after percutaneous and open surgical repair of Achilles tendon ruptures.

    Science.gov (United States)

    Goren, David; Ayalon, Moshe; Nyska, Meir

    2005-04-01

    Reports on complete spontaneous Achilles tendon ruptures and associated treatment have become more frequent in the literature in the past two decades, as has the request for treatments that enable the finest possible functional recovery. The best available treatment is a matter of considerable controversy in the literature. The purpose of this study was to compare the isokinetic strength and endurance of the plantarflexor muscle-tendon unit in subjects who sustained rupture of the Achilles tendon and underwent either open surgery or closed percutaneous repair of the Achilles tendon. Twenty patients (18 males, 2 females) with spontaneous ruptures of the Achilles tendon were included in this study. Ten patients were treated by open surgery, and 10 patients were treated percutaneously. All patients had ruptured their Achilles tendon more than 6 months before the study, and all of the ruptures occurred 3.5 years or less before the day of the testing. All patients underwent an oriented physical examination. An isokinetic Biodex dynamometer (Biodex Medical System, Shirley, NY) was used to measure ankle joint angle, and in plantarflexion to calculate the torque at the ankle joint (Newton/meter), and the average work (jouls) for both maximal power and endurance. Each measurement was compared to the normal ankle. Biodex dynamometer evaluations at 90 deg/sec demonstrated a significant difference of maximal voluntary plantarflexor torque, endurance performance and range of motion at the ankle joint between the involved and uninvolved sides in patients treated by either mode of treatment. Yet, no statistically significant differences were revealed for the parameters mentioned above between the subjects that were treated either percutaneously or by an open surgery. In functional terms, the biomechanical outcomes of open surgery and percutaneous repair for acute ruptures of the Achilles tendon are both effective.

  3. Trivial trauma and delayed rupture of a normal spleen: a case report

    Directory of Open Access Journals (Sweden)

    Sowers Nicholas

    2011-12-01

    Full Text Available Abstract Introduction Although a majority of splenic ruptures present acutely with a known mechanism of injury, a minority of patients present days to weeks following trauma with a delayed rupture. Also uncommon is the atraumatic rupture, the vast majority of which occur in patients with underlying splenic pathology. A handful of cases of apparently spontaneous rupture of a normal spleen are reported; however, there is debate about whether these actually represent delayed ruptures following a history of trauma that is not elicited. Although a few cases of delayed rupture of the spleen following trivial trauma have been reported, the majority of these present evidence of an underlying disease process. We found only two such cases that documented a normal spleen and three cases where underlying splenic pathology was not reported. We review the literature and discuss the phenomenon of delayed rupture of the normal spleen following trivial trauma. Case presentation A 27-year-old Caucasian man with no underlying splenic pathology presented with splenic rupture one week after playfully wrestling with his partner. The patient did not present at the time of the injury and only recalled it upon repeated questioning after computed tomography diagnosis. Conclusions This case lends support to the theory that the normal spleen can rupture some time after trivial trauma, which seems like a more plausible explanation than rupture without cause. However, given the dearth of similar reports in the literature, the possibility remains that the association we have observed is not causational.

  4. Pulsed cavitational ultrasound for non-invasive chordal cutting guided by real-time 3D echocardiography.

    Science.gov (United States)

    Villemain, Olivier; Kwiecinski, Wojciech; Bel, Alain; Robin, Justine; Bruneval, Patrick; Arnal, Bastien; Tanter, Mickael; Pernot, Mathieu; Messas, Emmanuel

    2016-10-01

    Basal chordae surgical section has been shown to be effective in reducing ischaemic mitral regurgitation (IMR). Achieving this section by non-invasive mean can considerably decrease the morbidity of this intervention on already infarcted myocardium. We investigated in vitro and in vivo the feasibility and safety of pulsed cavitational focused ultrasound (histotripsy) for non-invasive chordal cutting guided by real-time 3D echocardiography. Experiments were performed on 12 sheep hearts, 5 in vitro on explanted sheep hearts and 7 in vivo on beating sheep hearts. In vitro, the mitral valve (MV) apparatus including basal and marginal chordae was removed and fixed on a holder in a water tank. High-intensity ultrasound pulses were emitted from the therapeutic device (1-MHz focused transducer, pulses of 8 µs duration, peak negative pressure of 17 MPa, repetition frequency of 100 Hz), placed at a distance of 64 mm under 3D echocardiography guidance. In vivo, after sternotomy, the same therapeutic device was applied on the beating heart. We analysed MV coaptation and chordae by real-time 3D echocardiography before and after basal chordal cutting. After sacrifice, the MV apparatus were harvested for anatomical and histological post-mortem explorations to confirm the section of the chordae. In vitro, all chordae were completely cut after a mean procedure duration of 5.5 ± 2.5 min. The procedure duration was found to increase linearly with the chordae diameter. In vivo, the central basal chordae of the anterior leaflet were completely cut. The mean procedure duration was 20 ± 9 min (min = 14, max = 26). The sectioned chordae was visible on echocardiography, and MV coaptation remained normal with no significant mitral regurgitation. Anatomical and histological post-mortem explorations of the hearts confirmed the section of the chordae. Histotripsy guided by 3D echo achieved successfully to cut MV chordae in vitro and in vivo in beating heart. We hope that this technique will

  5. Spontaneous pneumothorax in diffuse cystic lung diseases.

    Science.gov (United States)

    Cooley, Joseph; Lee, Yun Chor Gary; Gupta, Nishant

    2017-07-01

    Diffuse cystic lung diseases (DCLDs) are a heterogeneous group of disorders with varying pathophysiologic mechanisms that are characterized by the presence of air-filled lung cysts. These cysts are prone to rupture, leading to the development of recurrent spontaneous pneumothoraces. In this article, we review the epidemiology, clinical features, and management DCLD-associated spontaneous pneumothorax, with a focus on lymphangioleiomyomatosis, Birt-Hogg-Dubé syndrome, and pulmonary Langerhans cell histiocytosis. DCLDs are responsible for approximately 10% of apparent primary spontaneous pneumothoraces. Computed tomography screening for DCLDs (Birt-Hogg-Dubé syndrome, lymphangioleiomyomatosis, and pulmonary Langerhans cell histiocytosis) following the first spontaneous pneumothorax has recently been shown to be cost-effective and can help facilitate early diagnosis of the underlying disorders. Patients with DCLD-associated spontaneous pneumothorax have a very high rate of recurrence, and thus pleurodesis should be considered following the first episode of spontaneous pneumothorax in these patients, rather than waiting for a recurrent episode. Prior pleurodesis is not a contraindication to future lung transplant. Although DCLDs are uncommon, spontaneous pneumothorax is often the sentinel event that provides an opportunity for diagnosis. By understanding the burden and implications of pneumothoraces in DCLDs, clinicians can facilitate early diagnosis and appropriate management of the underlying disorders.

  6. Observation of plasma motion in a coaxial plasma opening switch with a chordal laser interferometer

    Energy Technology Data Exchange (ETDEWEB)

    Teramoto, Y.; Urakami, H.; Akiyama, H. [Kumamoto Univ., Graduate School of Science and Technology, Kumamoto (Japan); Kohno, S. [Ariake National College of Technology, Dept. of Electrical Engineering, Fukuoka (Japan); Katsuki, S. [Kumamoto Univ., Dept. of Electrical and Computer Engineering, Kumamoto (Japan)

    2002-06-01

    Electron densities in a coaxial plasma opening switch were measured at many lines-of-slight. In the present experiment, electron density was measured by a He-Ne laser interferometer with chordal lines-of sight. In order to observe the motion of the POS plasma, the electron density contours during the conduction, opening and post-opening phases were drawn by combining the results of interferometer experiments. The radial and axial motion of POS plasma was investigated from the density contours. As conduction time progressed, the POS plasma moved toward downstream. At 800 ns, which corresponds to the time of opening in the current waveform, low-density region less than 10{sup 15} cm{sup -2} is seen at 10 mm from the cathode. After the opening was completed, the low-density gap disappeared and the shape of the corn-shape-like plasma was distorted. (author)

  7. Unique case of esophageal rupture after a fall from height

    Directory of Open Access Journals (Sweden)

    van Berge Henegouwen Mark I

    2009-12-01

    Full Text Available Abstract Background Traumatic ruptures of the esophagus are relatively rare. This condition is associated with high morbidity and mortality. Most traumatic ruptures occur after motor vehicle accidents. Case Presentation We describe a unique case of a 23 year old woman that presented at our trauma resuscitation room after a fall from 8 meters. During physical examination there were no clinical signs of life-threatening injuries. She did however have a massive amount of subcutaneous emphysema of the chest and neck and pneumomediastinum. Flexible laryngoscopy revealed a lesion in the upper esophagus just below the level of the upper esophageal sphincter. Despite preventive administration of intravenous antibiotics and nutrition via a nasogastric tube, the patient developed a cervical abscess, which drained spontaneously. Normal diet was gradually resumed after 2.5 weeks and the patient was discharged in a reasonable condition 3 weeks after the accident. Conclusions This case report presents a high cervical esophageal rupture without associated local injuries after a fall from height.

  8. Oxidative stress damage-associated molecular signaling pathways differentiate spontaneous preterm birth and preterm premature rupture of the membranes.

    Science.gov (United States)

    Dutta, Eryn H; Behnia, Faranak; Boldogh, Istvan; Saade, George R; Taylor, Brandie D; Kacerovský, Marian; Menon, Ramkumar

    2016-02-01

    In women with preterm premature rupture of the membranes (PPROM), increased oxidative stress may accelerate premature cellular senescence, senescence-associated inflammation and proteolysis, which may predispose them to rupture. We demonstrate mechanistic differences between preterm birth (PTB) and PPROM by revealing differences in fetal membrane redox status, oxidative stress-induced damage, distinct signaling pathways and senescence activation. Oxidative stress-associated fetal membrane damage and cell cycle arrest determine adverse pregnancy outcomes, such as spontaneous PTB and PPROM. Fetal membranes and amniotic fluid samples were collected from women with PTB and PPROM. Molecular, biochemical and histologic markers were used to document differences in oxidative stress and antioxidant enzyme status, DNA damage, secondary signaling activation by Ras-GTPase and mitogen-activated protein kinases, and activation of senescence between membranes from the two groups. Oxidative stress was higher and antioxidant enzymes were lower in PPROM compared with PTB. PTB membranes had minimal DNA damage and showed activation of Ras-GTPase and ERK/JNK signaling pathway with minimal signs of senescence. PPROM had higher numbers of cells with DNA damage, prosenescence stress kinase (p38 MAPK) activation and signs of senescence. Samples were obtained retrospectively after delivery. The markers of senescence that we tested are specific but are not sufficient to confirm senescence as the pathology in PPROM. Oxidative stress-induced DNA damage and senescence are characteristics of fetal membranes from PPROM, compared with PTB with intact membranes. PTB and PPROM arise from distinct pathophysiologic pathways. Oxidative stress and oxidative stress-induced cellular damages are likely determinants of the mechanistic signaling pathways and phenotypic outcome. This study is supported by developmental funds to Dr R. Menon from the Department of Obstetrics and Gynecology at The University of

  9. Traumatic rupture of a solitary splenic hydatid cyst: A case report

    Directory of Open Access Journals (Sweden)

    Moustafa Lakis

    2015-02-01

    Full Text Available Summary: The rupture of an Echinococcus granulosus hydatid cyst in the spleen due to trauma is a rare event. In this case report we describe the case of a 39-year-old Lebanese male victim of a motor vehicle accident with a ruptured solitary splenic hydatid cyst discovered by CT scan and excised during exploratory laparotomy.Echinococcosis or hydatid disease is a parasitic infestation by the Echinococcus genus of tapeworm. The eggs of E. granulosus, a species of Echinococcus, are fecal-orally transmitted to human hosts, most often from dog feces, and manifest as cystic lesions termed hydatid. E. granulosus most commonly affects the liver (75%, lungs (15%, and rarely the spleen (2–5% [1,2]. E. granulosus is particularly endemic to cattle rearing areas of the Middle East. Infected patients most commonly present with vague abdominal pain, as a result of mass effect or spontaneous rupture of the cyst. Nevertheless, patient presentation may be due to traumatic rupture of a hydatid cyst; however, this is very rare. Herein we report a case of traumatic rupture of a solitary splenic hydatid cyst in a 39-year-old male following a motor vehicle crash, managed following the Advanced Trauma Life Support (ATLS protocol. Keywords: Echinococcus, Hydatid, Trauma, Splenectomy, Cysts, Surgery

  10. Spontaneous rupture of the urinary bladder in a woman with radiation cystitis. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kurizaki, Yoshiki; Ishizuka, Osamu [Kofu Municipal Hospital, Yamanashi (Japan)

    1997-07-01

    A 79-year-old woman was admitted to our hospital with gross hematuria and abdominal pain. She had had a uterine cancer 11 years previously and received 56 Gy {sup 60}Co external irradiation combined with 129 Gy {sup 137}Cs internal irradiation. She had a sign of pan-peritonitis. An emergency operation revealed an intraperitoneal rupture of the dome of the urinary bladder 8 cm in length. Because a primary suturing of the bladder wall was unsuccessful, bilateral cutaneous ureterostomy was performed. Histologically, the ruptured bladder wall showed a mucosal erosion and fibrosis of the muscle layer. (author)

  11. Understanding dynamic friction through spontaneously evolving laboratory earthquakes.

    Science.gov (United States)

    Rubino, V; Rosakis, A J; Lapusta, N

    2017-06-29

    Friction plays a key role in how ruptures unzip faults in the Earth's crust and release waves that cause destructive shaking. Yet dynamic friction evolution is one of the biggest uncertainties in earthquake science. Here we report on novel measurements of evolving local friction during spontaneously developing mini-earthquakes in the laboratory, enabled by our ultrahigh speed full-field imaging technique. The technique captures the evolution of displacements, velocities and stresses of dynamic ruptures, whose rupture speed range from sub-Rayleigh to supershear. The observed friction has complex evolution, featuring initial velocity strengthening followed by substantial velocity weakening. Our measurements are consistent with rate-and-state friction formulations supplemented with flash heating but not with widely used slip-weakening friction laws. This study develops a new approach for measuring local evolution of dynamic friction and has important implications for understanding earthquake hazard since laws governing frictional resistance of faults are vital ingredients in physically-based predictive models of the earthquake source.

  12. [Prevention of spontaneous preterm birth (excluding preterm premature rupture of membranes): Guidelines for clinical practice - Text of the Guidelines (short text)].

    Science.gov (United States)

    Sentilhes, L; Sénat, M-V; Ancel, P-Y; Azria, E; Benoist, G; Blanc, J; Brabant, G; Bretelle, F; Brun, S; Doret, M; Ducroux-Schouwey, C; Evrard, A; Kayem, G; Maisonneuve, E; Marcellin, L; Marret, S; Mottet, N; Paysant, S; Riethmuller, D; Rozenberg, P; Schmitz, T; Torchin, H; Langer, B

    2016-12-01

    To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated to a decrease of prematurity (level of evidence [LE] 1). This is therefore recommended (grade A). Routine screening and treatment of vaginal bacteriosis in general population is not recommended (grade A). Asymptomatic women with single pregnancy without history of preterm delivery and a short cervix between 16 and 24 weeks is the only population in which vaginal progesterone is recommended (grade B). A history-indicated cerclage is not recommended in case of only past history of conisation (grade C), uterine malformation (Professional consensus), isolated history of pretem delivery (grade B) or twin pregnancies in primary (grade B) or secondary (grade C) prevention of preterm birth. A history-indicated cerclage is recommended for single pregnancy with a history of at least 3 late miscarriages or preterm deliveries (grade A).). In case of past history of a single pregnancy delivery before 34 weeks gestation (WG), ultrasound cervical length screening is recommended between 16 and 22 WG in order to propose a cerclage in case of lengthpremature rupture of membranes. Maintenance tocolysis is not recomended (grade B). Antenatal corticosteroid administration is recommended to every woman at risk of preterm delivery before 34 weeks of gestation (grade A). After 34 weeks, evidences are not consistent enough to recommend systematic antenatal corticosteroid treatment (grade B), however, a course might be indicated in the clinical situations associated with the

  13. Surgical management of traumatic tricuspid insufficiency.

    Science.gov (United States)

    Zhang, Zhiqi; Yin, Kanhua; Dong, Lili; Sun, Yongxin; Guo, Changfa; Lin, Yi; Wang, Chunsheng

    2017-06-01

    This study reviews our experience with traumatic tricuspid insufficiency (TTI) following blunt chest trauma. From January 2010 to June 2016, 10 patients (nine males, mean age 49.0 ± 12.4 years) underwent surgical treatment of TTI following blunt chest trauma. The mean intervals between trauma and diagnosis and between trauma and surgery were 74.1 and 81.8 months, respectively. Preoperatively, all patients exhibited severe tricuspid regurgitation. Five patients underwent tricuspid valve repair, and the remaining patients underwent valve replacement. The mean follow-up duration (with echocardiography) was 29.7 months. There was no early or late death. Seven patients had anterior chordal rupture, two patients had anterior papillary muscle rupture, and one patient had both anterior chordal and anterior leaflet rupture. The median postoperative intensive care unit and hospital stays were 1 and 6 days, respectively. There were no severe postoperative complications. During follow-up, four patients exhibited trivial to mild tricuspid regurgitation, and the remaining six patients exhibited no regurgitation. Surgical treatment of TTI via either valve repair or replacement can be performed with low perioperative morbidity and mortality. Early surgery is recommended for achieving a successful valve repair and preserving right ventricular function. © 2017 Wiley Periodicals, Inc.

  14. Modeling 3D Dynamic Rupture on Arbitrarily-Shaped faults by Boundary-Conforming Finite Difference Method

    Science.gov (United States)

    Zhu, D.; Zhu, H.; Luo, Y.; Chen, X.

    2008-12-01

    We use a new finite difference method (FDM) and the slip-weakening law to model the rupture dynamics of a non-planar fault embedded in a 3-D elastic media with free surface. The new FDM, based on boundary- conforming grid, sets up the mapping equations between the curvilinear coordinate and the Cartesian coordinate and transforms irregular physical space to regular computational space; it also employs a higher- order non-staggered DRP/opt MacCormack scheme which is of low dispersion and low dissipation so that the high accuracy and stability of our rupture modeling are guaranteed. Compared with the previous methods, not only we can compute the spontaneous rupture of an arbitrarily shaped fault, but also can model the influence of the surface topography on the rupture process of earthquake. In order to verify the feasibility of this method, we compared our results and other previous results, and found out they matched perfectly. Thanks to the boundary-conforming FDM, problems such as dynamic rupture with arbitrary dip, strike and rake over an arbitrary curved plane can be handled; and supershear or subshear rupture can be simulated with different parameters such as the initial stresses and the critical slip displacement Dc. Besides, our rupture modeling is economical to be implemented owing to its high efficiency and does not suffer from displacement leakage. With the help of inversion data of rupture by field observations, this method is convenient to model rupture processes and seismograms of natural earthquakes.

  15. Why Did the Fault Rupture of the 2008 Wenchuan Earthquake Propagate Predominately Northeastwards?

    Science.gov (United States)

    Zhu, S.; Yuan, J.

    2017-12-01

    The rupture processes of the 2008 Wenchuan earthquake are much complex. The rupture propagated northeastward a large distance as long as 300 km, but rupture length is short in the southwest direction. Although a great deal of attention has been paid to why the rupture propagated preponderantly northeastward in the 2008 Wenchuan earthquake, the physical mechanism remains unclear. By means of finite element model, in which bimaterial contrast across the Longmen Shan fault is taken into account, nucleation process is initiated at the center of the fault, ruptures then spread out outward spontaneously in both directions. The simulated results show that the different materials between both sides of the fault lead to tensile changes of normal stresses on the fault, which enhance the propagation of the ruptures in northeastward direction. We found that bimaterial mechanism is important for earthquake ruptures, and mode II rupture evolves with propagation distance along a bimaterial interface to a unilateral wrinkle-like Weertman pulse in the direction of slip on the more compliant side of the fault, namely in the positive direction (i.e, the northeast direction in the study). The Weertman pulse can be self-amplified, self-sustained and self-healing, which gives rise to little frictional energy and long propagation distance. This may be the reason why the Wenchuan earthquake is a unilateral fault rupture and a high seismic magnitude. In addition, the modelling results suggest that the rupture distance is much smaller if the material in the model is homogeneous, in which no huge earthquakes can occur like the 2008 Wenchan event. This research was jointly supported by the National Natural Science Foundation of China (41574041), Beijing Natural Science Foundation (8152034), and by Basic Research Project (ZDJ2017-08).

  16. Application of discrete scale invariance method on pipe rupture

    International Nuclear Information System (INIS)

    Rajkovic, M.; Mihailovic, Z.; Riznic, J.

    2007-01-01

    'Full text:' A process of material failure of a mechanical system in the form of cracks and microcracks, a catastrophic phenomenon of considerable technological and scientific importance, may be forecasted according to the recent advances in the theory of critical phenomena in statistical physics. Critical rupture scenario states that, in many concrete and composite heterogeneous materials under compression and materials with large distributed residual stresses, rupture is a genuine critical point, i.e., the culmination of a self-organization of damage and cracking characterized by power law signatures. The concept of discrete scale invariance leads to a complex critical exponent (or dimension) and may occur spontaneously in systems and materials developing rupture. It establishes, theoretically, the power law dependence of a measurable observable, such as the rate of acoustic emissions radiated during loading or rate of heat released during the process, upon the time to failure. However, the problem is the power law can be distinguished from other parametric functional forms such as an exponential only close to the critical time. In this paper we modify the functional renormalization method to include the noise elimination procedure and dimension reduction. The aim is to obtain the prediction of the critical rupture time only from the knowledge of the power law parameters at early times prior to rupture, and based on the assumption that the dynamics close to rupture is governed by the power law dependence of the temperature measured along the perimeter of the tube upon the time-to-failure. Such an analysis would not only enhance the precision of prediction related to the rupture mechanism but also significantly help in determining and predicting the leak rates. The prediction will be compared to experimental data on Zr-2.5%Nb made tubes. Note: The views expressed in the paper are those of the authors and do not necessary represents those of the commission. (author)

  17. Dynamic Rupture Benchmarking of the ADER-DG Method

    Science.gov (United States)

    Gabriel, Alice; Pelties, Christian

    2013-04-01

    We will verify the arbitrary high-order derivative Discontinuous Galerkin (ADER-DG) method in various test cases of the 'SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise' benchmark suite (Harris et al. 2009). The ADER-DG scheme is able to solve the spontaneous rupture problem with high-order accuracy in space and time on three-dimensional unstructured tetrahedral meshes. Strong mesh coarsening or refinement at areas of interest can be applied to keep the computational costs feasible. Moreover, the method does not generate spurious high-frequency contributions in the slip rate spectra and therefore does not require any artificial damping as demonstrated in previous presentations and publications (Pelties et al. 2010 and 2012). We will show that the mentioned features hold also for more advanced setups as e.g. a branching fault system, heterogeneous background stresses and bimaterial faults. The advanced geometrical flexibility combined with an enhanced accuracy will make the ADER-DG method a useful tool to study earthquake dynamics on complex fault systems in realistic rheologies. References: Harris, R.A., M. Barall, R. Archuleta, B. Aagaard, J.-P. Ampuero, H. Bhat, V. Cruz-Atienza, L. Dalguer, P. Dawson, S. Day, B. Duan, E. Dunham, G. Ely, Y. Kaneko, Y. Kase, N. Lapusta, Y. Liu, S. Ma, D. Oglesby, K. Olsen, A. Pitarka, S. Song, and E. Templeton, The SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise, Seismological Research Letters, vol. 80, no. 1, pages 119-126, 2009 Pelties, C., J. de la Puente, and M. Kaeser, Dynamic Rupture Modeling in Three Dimensions on Unstructured Meshes Using a Discontinuous Galerkin Method, AGU 2010 Fall Meeting, abstract #S21C-2068 Pelties, C., J. de la Puente, J.-P. Ampuero, G. Brietzke, and M. Kaeser, Three-Dimensional Dynamic Rupture Simulation with a High-order Discontinuous Galerkin Method on Unstructured Tetrahedral Meshes, JGR. - Solid Earth, VOL. 117, B02309, 2012

  18. Effect of a Material Contrast on a Dynamic Rupture: 3-D

    Science.gov (United States)

    Harris, R. A.; Day, S. M.

    2003-12-01

    We use numerical simulations of spontaneously propagating ruptures to examine the effect of a material contrast on earthquake dynamics. We specifically study the case of a lateral contrast whereby the fault is the boundary between two different rock-types. This scenario was previously studied in two-dimensions by Harris and Day [BSSA, 1997], and Andrews and Ben-Zion [JGR, 1997], in addition to subsequent 2-D studies, but it has not been known if the two-dimensional results are applicable to the real three-dimensional world. The addition of the third dimension implies a transition from pure mode II (i.e., plane-strain) to mixed-mode crack dynamics, which is more complicated since in mode II the shear and normal stresses are coupled whereas in mode III (i.e., anti-plane strain) they are not coupled. We use a slip-weakening fracture criterion and examine the effect on an earthquake rupture of material contrasts of up to 50 percent across the fault zone. We find a surprisingly good agreement between our earlier 2-D results, and our 3-D results for along-strike propagation. We find that the analytical solution presented in Harris and Day [BSSA, 1997] does an excellent job at predicting the bilateral, along-strike rupture velocities for the three-dimensional situation. In contrast, the along-dip propagation behaves much as expected for a purely mode-III rupture, with the rupture velocities up-dip and down-dip showing the expected symmetries.

  19. Acute appendiceal abscess and atraumatic splenic rupture: A case of dual pathology.

    Science.gov (United States)

    Ananthavarathan, Piriyankan; Patel, Kamlesh; Doran, Catherine; Suggett, Nigel

    2016-01-01

    Atraumatic splenic rupture is a rare surgical emergency that is often attributed to neoplastic or infectious causes. Rarely, it has been identified to also occur in the setting of an acute severe sepsis and in cases of pelvic or splenic abscess formation post-appendicectomy. However, to our knowledge, the co-presentation of acute appendiceal abscess and splenic rupture has not been previously described. We present the case of a 67-year old male with decompensating haemorrhagic shock secondary to atraumatic splenic rupture on a background of an inadequately treated complicated appendicitis originally managed as diverticulitis with antibiotics in the community. Intra-operatively, in addition to a de-gloved, ruptured spleen; an acutely inflamed appendiceal abscess was also identified. A concomitant splenectomy, washout and appendicectomy and was therefore performed. Histopathological examination revealed a normal spleen with a stripped capsular layer. Mucosal ulceration, transmural inflammation and serositis of the appendix appeared to be consistent with acute appendicitis. Our case demonstrates how inadequately treated sepsis may predispose to an acute presentation of splenic rupture with associated haemorrhagic shock; which may initially be interpreted as septic shock. However, we demonstrate how insults such as sepsis and haemorrhagic shock may co-exist warranting careful consideration of possible dual pathologies in complex presentations which may be life-threatening. While the causal relationship between acute appendicitis and atraumatic spontaneous splenic rupture remains unclear, our case considers and highlights the importance of considering dual pathology in patients presenting in the acute setting. Copyright © 2016. Published by Elsevier Ltd.

  20. Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report.

    Science.gov (United States)

    Koutserimpas, C; Papachristou, E; Nikitakis, N; Zannes, N; Tellos, A; Velimezis, G

    2017-01-01

    Splenic artery aneurysm (SAA) is a rare and extremely difficult diagnosis. A rare case of a ruptured SAA in a 38-year old female, firstly treated with endovascular embolization and then with splenectomy, is presented. A 38-year old female presented to the emergency department with epigastric pain and fainting episodes. Direct catheter angiography revealed a ruptured SAA and distal, as well as proximal coil embolization was performed. Due to abdominal compartment syndrome the patient underwent open surgery with splenic artery ligation and splenectomy. Postoperative she showed signs of sepsis and was treated with i.v. fluids, steroids, packed red blood cells, platelets, fresh frozen plasma and antimicrobial treatment. Additionally, a multidrug resistant Acinetobacter baumanni was yielded from the urine culture. She had a satisfactory recovery. She is followed up a total of 5 years with no signs of overwhelming post-splenectomy infection syndrome. Direct catheter angiography is a very helpful option in diagnosis, as well as treatment, but a close monitoring after embolization is essential. Furthermore, post-splenectomy sepsis is a severe disease with high mortality rates that requires immediate appropriate treatment.

  1. RESEARCHES RELATED TO THE REDUCTION OF PREMATURITY THROUGH PREMATURE RUPTURE OF MEMBRANES IN 2017

    Directory of Open Access Journals (Sweden)

    Maria BOLOTA

    2017-06-01

    Full Text Available Data from literature, especially from the US, has provided data on prediction, prevention and treatment of premature membrane rupture (RPM. RPM is a significant cause of premature birth and can cause complications of a term task. Considerable research on RPM has led to a better understanding of the mechanism of spontaneous breakage of membranes, risk factors, and good results for newborns resulting from such obstetrical events. Spontaneous rupture of the membranes increases the risk of intrauterine infection and umbilical cord compression as well as the risk of premature detachment of placenta. Newborn babies resulting from RPM have an increased risk of morbidity compared to gestational age, and the risk of infection is increased compared with other premature babies due to ancillary causes. If RPM occurs in the second trimester, there is an additional risk of pulmonary hypoplasia and hip dysplasia. Pre-term conservative treatment prolongs latency to birth. Antibiotics reduce the risk of infection while corticosteroid treatment (dexamethasone reduces respiratory complications and interventricular haemorrhage without increasing the risk of infection. Birth is necessary or unavoidable in many cases by RPMs and because conservative treatment often results in no results; That is why studies are needed to identify all risk factors and the need to treat pregnant women at risk of RPM; 17-hydroxy-progesterone is a specific treatment for preventing recurrent membrane rupture. (http://www.ginecologultau.ro/ruptura-prematura-a-membranelor, 2013.

  2. Rupture of primigravid uterus and recurrent rupture

    Directory of Open Access Journals (Sweden)

    Nahreen Akhtar

    2016-08-01

    Full Text Available Uterine rupture is a deadly obstetrical emergency endangering the life of both mother and fetus. In Bangladesh, majority of deliveries arc attended by unskilled traditional birth attendant and maternal mortality is still quite high. It is rare Ln developed country but unfortunately it is common in a developing country like Bangladesh. We report a case history of a patient age 32yrs from Daudkandi, Comilla admitted with H/0 previous two rupture uterus and repair with no living issue. We did caesarean section at her 31+ weeks of pregnancy when she developed Jabour pain. A baby of 1.4 kg was delivered. During cesarean section, focal rupture was noted in previous scar of rupture. Unfortunately the baby expired in neonatal ICU after 36 hours.

  3. [Spontaneous tension hemothorax due to rupture of a solitary fibrous tumor of the posterior mediastinum].

    Science.gov (United States)

    Morita, Yohei; Ichimura, Hideo; Kikuchi, Shinji; Ozawa, Yuichiro; Inoue, Kazunari; Uchida, Atsushi; Kikuchi, Kazunori; Shiigai, Masanari; Shiotani, Seiji

    2013-10-01

    A 37-year-old man was transported by ambulance to our hospital due to abrupt chest pain. The pain began when he was practicing a combative-type sport. He denied any impact or blunt trauma. A chest radiograph revealed massive left pleural effusion with a mediastinal shift. Thoracentesis revealed a hemothorax;therefore, we performed an emergency thoracotomy. The intraoperative findings revealed a rupture of a posterior mediastinal tumor itself located between the descending aorta and the thoracic vertebra. After we identified the artery of Adamkiewicz that originates away from the tumor and evaluated the degree of tumor extension into the inter-vertebral foramen, we safely performed an elective tumor resection 1 month after the initial emergency operation. In patients with a hemothorax caused by rupture of the tumor itself, an elective tumor resection after detailed investigation should be considered if hemostasis can be achieved in the emergency thoracotomy.

  4. Globe Rupture

    Directory of Open Access Journals (Sweden)

    Reid Honda

    2017-07-01

    Full Text Available History of present illness: A 46-year-old male presented to the emergency department (ED with severe left eye pain and decreased vision after tripping and striking the left side of his head on the corner of his wooden nightstand. The patient arrived as an inter-facility transfer for a suspected globe rupture with a protective eye covering in place; thus, further physical examination of the eye was not performed by the emergency physician in order to avoid further leakage of aqueous humor. Significant findings: The patient’s computed tomography (CT head demonstrated a deformed left globe, concerning for ruptured globe. The patient had hyperdense material in the posterior segment (see green arrow, consistent with vitreous hemorrhage. CT findings that are consistent with globe rupture may include a collapsed globe, intraocular air, or foreign bodies. Discussion: A globe rupture is a full-thickness defect in the cornea, sclera, or both.1 It is an ophthalmologic emergency. Globe ruptures are almost always secondary to direct perforation via a penetrating mechanism; however, it can occur due to blunt injury if the force generated creates sufficient intraocular pressure to tear the sclera.2 Globes most commonly rupture at the insertions of the intraocular muscles or at the limbus. They are associated with a high rate of concomitant orbital floor fractures.2,3 Possible physical examination findings include a shallow anterior chamber on slit-lamp exam, hyphema, and an irregular “teardrop” pupil. Additionally, a positive Seidel sign, which is performed by instilling fluorescein in the eye and then examining for a dark stream of aqueous humor, is indicative of a globe rupture.4 CT is often used to assess for globe rupture; finds of a foreign body, intraocular air, abnormal contour or volume of the globe, or disruption of the sclera suggest globe rupture.2 The sensitivity of CT scan for diagnosis of globe rupture is only 75%; thus, high clinical

  5. Getting the most out of your new plant with a chordal ultrasonic feedwater flow measurement system

    International Nuclear Information System (INIS)

    Estrada, Herb; Hauser, Ernie

    2007-01-01

    The economic advantages of a chordal ultrasonic feedwater flow measurement system over conventional (flow nozzle-based) feedwater instrumentation are analyzed for new plants having ratings ranging from 1100 MWe to 1600 MWe. Specifically, each of the following topics is considered: The value of a 1.7% increase in the rating of the new plant, made possible by the reduced uncertainty in the determination of thermal power. The value of reduced startup time owing to enhanced steam supply water level control. The value of the reduced feedwater pumping power brought about by the elimination of flow nozzles. The value of the reduced calibration burden owing to the elimination of the feedwater flow differential pressure transmitters and resistance thermometers. The net difference in the acquisition costs of the ultrasonic system versus conventional feedwater flow instrumentation. The net savings in installation costs of the ultrasonic system vis-a-vis conventional feedwater flow instrumentation. The potential savings in outage time due to the reduced frequency of low steam supply water level trips (scrams) of the reactor. (author)

  6. Thompson Test in Achilles Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Spencer Albertson

    2016-07-01

    Full Text Available HPI: A 26-year old male presented to the emergency department after experiencing the acute onset of left ankle pain while playing basketball. Upon jumping, he felt a “pop” in his left posterior ankle, followed by pain and difficulty ambulating. His exam was notable for a defect at the left Achilles tendon on palpation. The practitioner performed a Thompson test, which was positive (abnormal on the left. Significant Findings: The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected calf, the ankle spontaneously plantar flexed, indicating a negative (normal Thompson test. Upon squeeze of the left (affected calf, the ankle did not plantar flex, signifying a positive (abnormal Thompson test. The diagnosis of left Achilles tendon rupture was confirmed intraoperatively one week later. Discussion: The Achilles tendon (also: calcaneal tendon or heel cord is derived from the medial and lateral heads of the gastrocnemius muscle, as well as the soleus muscle. Rupture of the Achilles tendon most commonly occurs in the distal tendon, approximately 2-6 cm from its attachment to the calcaneal tuberosity, in an area of hypovascularity known as the “watershed” or “critical” zone.1-3 The Thompson test (also: Simmonds-Thompson test, described by Simmonds in 1957 and Thompson in 1962, is done while the patient is in the prone position, with feet hanging over the end of a table/gurney, or with the patient kneeling on a stool or chair.4-5 Squeezing the calf of an unaffected limb will cause the ankle to plantar flex, but squeezing the calf of a limb with an Achilles tendon rupture will cause no motion. The sensitivity of the Thompson’s test for the diagnosis of a complete Achilles tendon rupture is 96-100% and the specificity is 93-100%, but data is limited.6-8

  7. [A case-control study on association between OAS1 polymorphism and susceptibility to spontaneous preterm birth and preterm premature rupture of membranes].

    Science.gov (United States)

    Yang, Xiao; Zhang, Xiao-Ai; Wu, Zhi-Hao; Peng, Wei; Zhu, Li-Na; Wang, Yan

    2015-09-01

    To investigate the association between the genetic polymorphism of 2',5'-oligoadenylate synthetase 1 (OAS1) and susceptibility to spontaneous preterm birth (SPTB) and preterm premature rupture of membranes (PPROM). The case-control study consisted of 599 preterm infants including 171 cases of PPROM, and 673 full-term infants without maternal histories of SPTB and PPROM as controls. The single nucleotide polymorphism (SNP) at OAS1 intron 5, rs10774671, was analyzed by polymerase chain reaction-restriction fragment length polymorphism. No significant differences were observed between the case and control groups in the frequencies of genotypes (AA, GA, and GG) and alleles (A and G) of OAS1 rs10774671. When the case group was divided into two subgroups with or without PPROM, no significant differences in the genotype and allele frequencies were found between each subgroup and the control group. When the case group was divided into three subgroups with different gestational ages at SPTB, no significant differences in the genotype and allele frequencies were detected between each subgroup and the control group. No association is identified between OAS1 SNP and susceptibility to SPTB and PPROM.

  8. Quantification of Fault-Zone Plasticity Effects with Spontaneous Rupture Simulations

    Science.gov (United States)

    Roten, D.; Olsen, K. B.; Day, S. M.; Cui, Y.

    2017-09-01

    Previous studies have shown that plastic yielding in crustal rocks in the fault zone may impose a physical limit to extreme ground motions. We explore the effects of fault-zone non-linearity on peak ground velocities (PGVs) by simulating a suite of surface-rupturing strike-slip earthquakes in a medium governed by Drucker-Prager plasticity using the AWP-ODC finite-difference code. Our simulations cover magnitudes ranging from 6.5 to 8.0, three different rock strength models, and average stress drops of 3.5 and 7.0 MPa, with a maximum frequency of 1 Hz and a minimum shear-wave velocity of 500 m/s. Friction angles and cohesions in our rock models are based on strength criteria which are frequently used for fractured rock masses in civil and mining engineering. For an average stress drop of 3.5 MPa, plastic yielding reduces near-fault PGVs by 15-30% in pre-fractured, low strength rock, but less than 1% in massive, high-quality rock. These reductions are almost insensitive to magnitude. If the stress drop is doubled, plasticity reduces near-fault PGVs by 38-45% and 5-15% in rocks of low and high strength, respectively. Because non-linearity reduces slip rates and static slip near the surface, plasticity acts in addition to, and may partially be emulated by, a shallow velocity-strengthening layer. The effects of plasticity are exacerbated if a fault damage zone with reduced shear-wave velocities and reduced rock strength is present. In the linear case, fault-zone trapped waves result in higher near-surface peak slip rates and ground velocities compared to simulations without a low-velocity zone. These amplifications are balanced out by fault-zone plasticity if rocks in the damage zone exhibit low-to-moderate strength throughout the depth extent of the low-velocity zone (˜5 km). We also perform dynamic non-linear simulations of a high stress drop (8 MPa) M 7.8 earthquake rupturing the southern San Andreas fault along 250 km from Indio to Lake Hughes. Non-linearity in the

  9. On the initiation of sustained slip-weakening ruptures by localized stresses

    KAUST Repository

    Galis, Martin

    2014-12-10

    Numerical simulations of dynamic earthquake rupture require an artificial initiation procedure, if they are not integrated in long-term earthquake cycle simulations. A widely applied procedure involves an \\'overstressed asperity\\', a localized region stressed beyond the static frictional strength. The physical properties of the asperity (size, shape and overstress) may significantly impact rupture propagation. In particular, to induce a sustained rupture the asperity size needs to exceed a critical value. Although criteria for estimating the critical nucleation size under linear slip-weakening friction have been proposed for 2-D and 3-D problems based on simplifying assumptions, they do not provide general rules for designing 3-D numerical simulations. We conduct a parametric study to estimate parameters of the asperity that minimize numerical artefacts (e.g. changes of rupture shape and speed, artificial supershear transition, higher slip-rate amplitudes). We examine the critical size of square, circular and elliptical asperities as a function of asperity overstress and background (off-asperity) stress. For a given overstress, we find that asperity area controls rupture initiation while asperity shape is of lesser importance. The critical area obtained from our numerical results contrasts with published theoretical estimates when background stress is low. Therefore, we derive two new theoretical estimates of the critical size under low background stress while also accounting for overstress. Our numerical results suggest that setting the asperity overstress and area close to their critical values eliminates strong numerical artefacts even when the overstress is large. We also find that properly chosen asperity size or overstress may significantly shorten the duration of the initiation. Overall, our results provide guidelines for determining the size of the asperity and overstress to minimize the effects of the forced initiation on the subsequent spontaneous

  10. CT evaluation of underlying cause in spontaneous subcapsular and perirenal hemorrhage

    International Nuclear Information System (INIS)

    Sebastia, M.C.; Perez-Molina, M.O.; Alvarez-Castells, A.; Quiroga, S.; Pallisa, E.

    1997-01-01

    We evaluated the CT scans of 13 patients with spontaneous subcapsular or perinephric hemorrhage (SPH) associated with these underlying causes: 4 angiomyolipomas, 2 renal cell carcinomas, 1 renal metastatic malignant melanoma, 1 ruptured renal artery aneurysm, 1 adrenal myelolipoma, 1 ruptured renal abscess, 2 ruptured hemorrhagic cysts, and 1 patient with undiagnosed coagulation disorder. Our objective was to ascertain whether an underlying cause of SPH was identifiable by CT, and to determine the extension of the hematomas. Computed tomography identified the hematoma in all 13 cases (sensitivity 100 %). In all 12 cases in which there was a renal or adrenal anatomic lesion, the underlying cause was identified with CT (100 %), with correct diagnosis in 11 cases (91.6 %). The case in which no lesion was identified was the undiagnosed coagulation disorder. We conclude that CT is a useful technique for the initial evaluation of SPH, permitting diagnosis of hemorrhage and identification of the underlying cause. (orig.). With 6 figs., 1 tab

  11. CT evaluation of underlying cause in spontaneous subcapsular and perirenal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Sebastia, M.C. [Department of Radiology, IDI, Hospital General Universitari Vall d`Hebron, E-08 305 Barcelona (Spain); Perez-Molina, M.O. [Department of Radiology, IDI, Hospital General Universitari Vall d`Hebron, E-08 305 Barcelona (Spain); Alvarez-Castells, A. [Department of Radiology, IDI, Hospital General Universitari Vall d`Hebron, E-08 305 Barcelona (Spain); Quiroga, S. [Department of Radiology, IDI, Hospital General Universitari Vall d`Hebron, E-08 305 Barcelona (Spain); Pallisa, E. [Department of Radiology, IDI, Hospital General Universitari Vall d`Hebron, E-08 305 Barcelona (Spain)

    1997-06-01

    We evaluated the CT scans of 13 patients with spontaneous subcapsular or perinephric hemorrhage (SPH) associated with these underlying causes: 4 angiomyolipomas, 2 renal cell carcinomas, 1 renal metastatic malignant melanoma, 1 ruptured renal artery aneurysm, 1 adrenal myelolipoma, 1 ruptured renal abscess, 2 ruptured hemorrhagic cysts, and 1 patient with undiagnosed coagulation disorder. Our objective was to ascertain whether an underlying cause of SPH was identifiable by CT, and to determine the extension of the hematomas. Computed tomography identified the hematoma in all 13 cases (sensitivity 100 %). In all 12 cases in which there was a renal or adrenal anatomic lesion, the underlying cause was identified with CT (100 %), with correct diagnosis in 11 cases (91.6 %). The case in which no lesion was identified was the undiagnosed coagulation disorder. We conclude that CT is a useful technique for the initial evaluation of SPH, permitting diagnosis of hemorrhage and identification of the underlying cause. (orig.). With 6 figs., 1 tab.

  12. Spontaneous disappearance of two asymptomatic arachnoid cysts in two different locations.

    Science.gov (United States)

    Cokluk, C; Senel, A; Celik, F; Ergür, H

    2003-04-01

    We report two children with asymptomatic arachnoid cysts which resolved spontaneously without any surgical intervention and history of major head and body trauma. The first child was a 10-year-old boy with an arachnoid cyst in the right sylvian fissure. The second child was a 1-year-old girl with a right cerebral convexity arachnoid cyst. Both of them were asymptomatic. Arachnoid cysts spontaneously disappeared within 2 years following initial diagnosing. There was no major head and body trauma except usual home, school and sports activity. We speculated that the cysts ruptured into cerebrospinal fluid circulation by the mechanical effects of some forced activities to the brain tissue and cyst, such as excessive breathing, coughing and sport activities. These factors may change the balance between intracystic and pericystic pressure and facilitate the rupturing of the cyst into subdural, subarachnoid and intraventricular spaces. These cases demonstrate that neurosurgical intervention of asymptomatic arachnoid cysts is not absolutely indicated in the paediatric age group. Close follow up with computerized tomography (CT) and magnetic resonance imaging (MRI) is a treatment option in the patient with arachnoid cysts located in the middle cranial fossa and cerebral convexity.

  13. Endovascular stent graft for treatment of complicated spontaneous dissection of celiac artery: Report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ung Rae; Lee, Young Hwan [Dept. of Diagnostic Radiology, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of); Kim, Young Hwan [Dept. of Diagnostic Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2013-06-15

    We report 2 cases of complicated spontaneous dissection of the celiac artery, which were successfully treated by a stent graft. The first patient was a 47-year-old man who presented with acute abdominal pain. CT scan showed ruptured saccular aneurysm with surrounding retroperitoneal hematoma. The second patient was a 57-year-old man with progressive dissecting aneurysm. Endovascular stent graft was placed in the celiac trunk to control bleeding, and to prevent rupture in each patient. Follow-up CT scans showed complete obliteration of a dissecting aneurysm.

  14. Rupture disc

    International Nuclear Information System (INIS)

    Newton, R.G.

    1977-01-01

    The intermediate heat transport system for a sodium-cooled fast breeder reactor includes a device for rapidly draining the sodium therefrom should a sodium-water reaction occur within the system. This device includes a rupturable member in a drain line in the system and means for cutting a large opening therein and for positively removing the sheared-out portion from the opening cut in the rupturable member. According to the preferred embodiment of the invention the rupturable member includes a solid head seated in the end of the drain line having a rim extending peripherally therearound, the rim being clamped against the end of the drain line by a clamp ring having an interior shearing edge, the bottom of the rupturable member being convex and extending into the drain line. Means are provided to draw the rupturable member away from the drain line against the shearing edge to clear the drain line for outflow of sodium therethrough

  15. Spontaneous Rupture of Recurrent Gastrointestinal Stromal Tumor Associated with Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Shin-Mae Wang

    2005-11-01

    Full Text Available The incidence of gastrointestinal stromal tumor (GIST among neurofibromatosis type 1 (NF-1 patients is approximately 3.9–25%, and this relationship is generally considered to be non-coincidental. We report a patient with NF-1 who underwent laparotomy 3 times due to recurrent intra-abdominal tumor rupture with internal bleeding in the space of 13 years. The pathologic diagnoses were schwannoma, malignant peripheral nerve sheath tumor and GIST. Because of the similar histologic features of these tumors, we considered them to be of the same nature. Immunohistochemical staining can help in the differential diagnosis. We suggest that NF-1 patients with gastrointestinal symptoms receive further survey to rule out GISTs.

  16. Transabdominal amnioinfusion in preterm premature rupture of membranes.

    Science.gov (United States)

    Singla, Anshuja; Yadav, Poonam; Vaid, Neelam B; Suneja, Amita; Faridi, Mohammad M A

    2010-03-01

    To evaluate the effect of transabdominal amnioinfusion on prolongation of pregnancy, and maternal and neonatal outcomes in preterm premature rupture of membranes (pPROM). We conducted a prospective randomized controlled study of women with pPROM during singleton live pregnancy-between 26 and 33+6weeks-whose amniotic fluid index (AFI) was less than the 5th percentile. The study group underwent transabdominal amnioinfusion at admission and then weekly if their AFI fell below the 5th percentile again. The control group received expectant management. The difference in the mean interval from pPROM to delivery between the groups was not statistically significant. Neonatal and maternal outcomes were significantly improved in the study group compared with the control group (fetal distress [10% vs 37%]; early neonatal sepsis [17% vs 63%]; neonatal mortality [17% vs 63%]; spontaneous delivery [83% vs 53%]; and postpartum sepsis [7% vs 33%]). Transabdominal amnioinfusion reduced fetal distress, early neonatal sepsis, and neonatal mortality. In the study group, more participants delivered spontaneously and there were fewer cases of postpartum sepsis, although the pPROM-delivery interval was not increased.

  17. Hepatic echinococcosis ruptured into the biliary tract

    International Nuclear Information System (INIS)

    Van Steenbergen, W.; Fevery, J.; Broeckaert, L.; Ponette, E.; Marchal, G.; Baert, A.; Penninckx, F.; Kerremans, R.; De Groote, J.

    1987-01-01

    Three patients are described with hepatic involvement by Echinococcus granulosus, complicated by spontaneous rupture into the biliary tract. Abdominal computed tomography, showing the cystic wall, the presence of wall calcifications, daughter cysts and wall enhancement, provided a correct diagnosis of hepatic hydatidosis in all patients. Dilatation of the bile ducts with the presence of intraluminal material was clearly shown by sonography and endoscopic retrograde cholangiography. On sonography, the intraluminal material appeared as amorphous, sludge-like hydatid sand, and as daughter cysts. On ERCP, the intrabiliary parasitic material appeared as non-homogeneous, irregularly shaped and mobile filling defects. Other findings at ERCP were displacement and distortion of intrahepatic bile ducts by the hepatic cysts and a mild dilatation of the pancreatic duct. (Auth.)

  18. Rupture of abdominal aortic aneurysm into sigmoid colon: A case report

    Science.gov (United States)

    Aksoy, Murat; Yanar, Hakan; Taviloglu, Korhan; Ertekin, Cemalettin; Ayalp, Kemal; Yanar, Fatih; Guloglu, Recep; Kurtoglu, Mehmet

    2006-01-01

    Primary aorto-colic fistula is rarely reported in the literature. Although infrequently encountered, it is an important complication since it is usually fatal unless detected. Primary aorto-colic fistula is a spontaneous rupture of abdominal aortic aneurysm into the lumen of the adjacent colon loop. Here we report a case of primary aorto-colic fistula in a 54-year old male. The fistulated sigmoid colon was repaired by end-to-end anastomosis. Despite inotropic support, the patient died of sepsis and multiorgan failure on the first postoperative day. PMID:17167850

  19. Aortocaval fistula (ACF) in patients operated for ruptured aortic aneurysm (rAAA)

    DEFF Research Database (Denmark)

    Warning, Karina; Houlind, Kim Christian; Ravn, Hans

    Aortocaval fistula (ACF) in patients operated for Ruptured Acute Aorta Aneurysm (rAAA): A surgical challenge. Introduction Aortocaval fistula is a rare complication of abdominal aortic aneurysm (AAA). It been reported to be present in less than 1% of all AAAs. ACF arise in patients with large...... aneurysms and is typically discovered peroperatively in patients with rAAA. Open surgical treatment is associated with high mortality and morbidity. ACF is a result of spontaneously rupture of large atherosclerotic aneurysms into the inferior vena cava in 80%, 15% arise after trauma and 5% are iatrogenic....... Patients During the last 9 month, we have operated three cases with rAAA and ACF. All patients had an open, acute operation. All ACFs detected during operation. Common for all operations was that the patients had large aneurysms (>10 cm) and extensive bleeding (3-4 l) immediately when the aneurysm...

  20. Spontaneous intramural haematoma of the oesophagus: radiologic recognition

    Energy Technology Data Exchange (ETDEWEB)

    Clark, W.; Cook, I.J. [St George Hospital, Sydney, NSW (Australia). Depts of Radiology and Gastroenterology

    1996-08-01

    Spontaneous intramural haematoma of the oesophagus (SIHO) is an uncommon disorder. It presents usually with acute chest pain followed by dysphagia. This condition may mimic spontaneous rupture of the oesophagus (Boerhaave Syndrome), dissection of the thoracic aorta or acute myocardial infarction. Hence early accurate confirmation of the diagnosis by radiology is vital for the appropriate acute management. The condition is frequently mistaken for acute myocardial infarction which may prompt inappropriate thrombolytic therapy. The appearances on contrast studies of oesophagus and on CT scanning are characteristic. Despite this, the diagnosis may easily be missed, if appropriate careful radiological technique is not used. This paper reports three consecutive cases of SIHO managed in one institution. These cases illustrate that early gastrografin contrast radiology followed by barium contrast radiology and if necessary by thoracic CT is diagnostic in all cases of this condition. 19 refs., 1 tab., 4 figs.

  1. Spontaneous intramural haematoma of the oesophagus: radiologic recognition

    International Nuclear Information System (INIS)

    Clark, W.; Cook, I.J.

    1996-01-01

    Spontaneous intramural haematoma of the oesophagus (SIHO) is an uncommon disorder. It presents usually with acute chest pain followed by dysphagia. This condition may mimic spontaneous rupture of the oesophagus (Boerhaave Syndrome), dissection of the thoracic aorta or acute myocardial infarction. Hence early accurate confirmation of the diagnosis by radiology is vital for the appropriate acute management. The condition is frequently mistaken for acute myocardial infarction which may prompt inappropriate thrombolytic therapy. The appearances on contrast studies of oesophagus and on CT scanning are characteristic. Despite this, the diagnosis may easily be missed, if appropriate careful radiological technique is not used. This paper reports three consecutive cases of SIHO managed in one institution. These cases illustrate that early gastrografin contrast radiology followed by barium contrast radiology and if necessary by thoracic CT is diagnostic in all cases of this condition. 19 refs., 1 tab., 4 figs

  2. Ruptured eardrum

    Science.gov (United States)

    ... eardrum ruptures. After the rupture, you may have: Drainage from the ear (drainage may be clear, pus, or bloody) Ear noise/ ... doctor to see the eardrum. Audiology testing can measure how much hearing has been lost. Treatment You ...

  3. Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature

    Science.gov (United States)

    Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

    2014-01-01

    Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

  4. [Spontaneous hepatic hematoma in twin pregnancy].

    Science.gov (United States)

    Quesnel, Carlos; Weber, Alejandro; Mendoza, Dalila; Garteiz, Denzil

    2012-02-01

    The hepatic hematoma or rupture appear in 1 of every 100,000 pregnancies. The most common causes of hepatic hematoma in pregnancy are severe preeclampsia and HELLP syndrome; some predisposing factors are seizures, vomiting, labor, preexistent hepatic disease and trauma. A 33 year old primigravid with a normal 33 week twin pregnancy presented abdominal pain and hypovolemic shock due to spontaneous subcapsular hepatic hematoma; laparoscopy was performed to evaluate the possibility of rupture, which was not found, later emergency cesarean section was carried out followed by hepatic hematoma drainage and abdominal packaging by laparoscopy. After surgery the flow through drainage was too high additionally hemodynamic instability and consumption coagulopathy. Abdominal panangiography was performed without identifying bleeding areas. Intesive care was given to the patient evolving satisfactorily, was discharged 19 days after the event. Seven months later she had laparoscopic cholecystectomy due to acute litiasic colecistitis. We found 5 cases in literatura about hepatic hematoma during pregnancy no related to hypertensive disorders of pregnancy; these were related to hepatoma, amebian hepatic abscess, falciform cell anemia, cocaine consumption and molar pregnancy. Hepatics hematomas have high morbidity and mortality so is significant early diagnosis and multidisciplinary approach.

  5. Spontaneous pneumothorax associated with pulmonary fibrosis in a patient with neurofibromatosis type 2

    International Nuclear Information System (INIS)

    Alcala Cerra, Gabriel; Moscote-Salazar, Luis Rafael; Lozano Tagua, Carlos Fernando; Sabogal Barrios, Ruben

    2010-01-01

    Pulmonary involvement in patients with neurofibromatosis has been repetitively reported as a very rare complication in type 1 variety. It is characterized by pulmonary interstitial disease, pulmonary fibrosis and bullaes, the last with high risk of rupture. We described a case of spontaneous pneumothorax in a patient with type 2 neurofibromatosis, as consequence of pulmonary fibrotic changes. To our knowledge this association had not been reported.

  6. Second trimester hepatic rupture in a 35 year old nulliparous woman with HELLP syndrome: a case report

    Directory of Open Access Journals (Sweden)

    O'Brien N

    2009-06-01

    Full Text Available Abstract The HELLP syndrome (haemolysis, elevated liver blood tests and low platelets is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. Hepatic capsular rupture is a rare yet dramatic complication of HELLP syndrome. The majority of cases occur in multiparous women over the age of 30. Classically it presents with acute onset right upper quadrant pain in the presence of constitutional symptoms such as vomiting and pyrexia. However, symptoms and signs are usually non specific. Spontaneous hepatic rupture can be preceded by signs of hypovolaemic shock; yet the diagnosis is infrequently made prior to emergent laparotomy. We present the case of a 35 year old nulliparous woman with a second trimester gestational hepatic rupture associated with HELLP syndrome. We briefly discuss the aetiology, diagnostic difficulties and treatment options associated with this rare presentation.

  7. Second trimester hepatic rupture in a 35 year old nulliparous woman with HELLP syndrome: a case report.

    LENUS (Irish Health Repository)

    Kelly, J

    2009-01-01

    The HELLP syndrome (haemolysis, elevated liver blood tests and low platelets) is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10-20% of cases with severe preeclampsia. Hepatic capsular rupture is a rare yet dramatic complication of HELLP syndrome. The majority of cases occur in multiparous women over the age of 30. Classically it presents with acute onset right upper quadrant pain in the presence of constitutional symptoms such as vomiting and pyrexia. However, symptoms and signs are usually non specific. Spontaneous hepatic rupture can be preceded by signs of hypovolaemic shock; yet the diagnosis is infrequently made prior to emergent laparotomy. We present the case of a 35 year old nulliparous woman with a second trimester gestational hepatic rupture associated with HELLP syndrome. We briefly discuss the aetiology, diagnostic difficulties and treatment options associated with this rare presentation.

  8. Giant renal artery pseudoaneurysm caused by rupture of renal angiomyolipoma following pregnancy: Endovascular treatment and review of the literature

    Directory of Open Access Journals (Sweden)

    Ilkay S Idilman

    2014-01-01

    Full Text Available Renal angiomyolipoma is a hamartomatous, benign tumor composed of blood vessels, fatty tissue and smooth muscle cells, and is often detected incidentally. It can also be associated with the tuberous-sclerosis complex (TSC. Pregnancy and use of oral contraceptives are known to be associated with an increased risk of tumoral rupture and bleeding. Herein, we report a unique case of renal angiomyolipoma associated with TSC who presented with hypovolemic shock as a result of spontaneous rupture of a giant renal pseudoaneurysm, immediately after pregnancy. Emergency endovascular treatment was successful with sparing of most of the affected kidney as demonstrated by follow-up computed tomography imaging.

  9. Spontaneous bleeding from liver after open heart surgery.

    Science.gov (United States)

    Mir, Najeeb H; Shah, Mian T; Obeid, Mahmoud Ali; Gallo, Ricardo; Aliter, Hashem

    2013-01-01

    Intra-abdominal hemorrhage after open heart surgery is very uncommon in routine clinical practice. There are case reports of having bleeding from spleen or liver after starting low molecular weight heparin (LMWH) postoperatively. Our patient is a 58-year-old man with mitral valve regurgitation, who underwent mitral valve repair and developed intra-abdominal hemorrhage 8h after open heart surgery. The exploratory laparotomy revealed the source of bleeding from ruptured sub-capsular liver hematoma and oozing from raw areas of the liver surface. Liver packing was done to control the bleeding. The gastrointestinal complications after open heart surgery are rare and spontaneous bleeding from spleen has been reported. This is the first case from our hospital to have intra-abdominal hemorrhage after open heart surgery. Spontaneous bleeding from liver is a possible complication after open heart surgery. We submit the case for the academic interest and to discuss the possible cause of hemorrhage. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Dynamic fracture network around faults: implications for earthquake ruptures, ground motion and energy budget

    Science.gov (United States)

    Okubo, K.; Bhat, H. S.; Rougier, E.; Lei, Z.; Knight, E. E.; Klinger, Y.

    2017-12-01

    Numerous studies have suggested that spontaneous earthquake ruptures can dynamically induce failure in secondary fracture network, regarded as damage zone around faults. The feedbacks of such fracture network play a crucial role in earthquake rupture, its radiated wave field and the total energy budget. A novel numerical modeling tool based on the combined finite-discrete element method (FDEM), which accounts for the main rupture propagation and nucleation/propagation of secondary cracks, was used to quantify the evolution of the fracture network and evaluate its effects on the main rupture and its associated radiation. The simulations were performed with the FDEM-based software tool, Hybrid Optimization Software Suite (HOSSedu) developed by Los Alamos National Laboratory. We first modeled an earthquake rupture on a planar strike-slip fault surrounded by a brittle medium where secondary cracks can be nucleated/activated by the earthquake rupture. We show that the secondary cracks are dynamically generated dominantly on the extensional side of the fault, mainly behind the rupture front, and it forms an intricate network of fractures in the damage zone. The rupture velocity thereby significantly decreases, by 10 to 20 percent, while the supershear transition length increases in comparison to the one with purely elastic medium. It is also observed that the high-frequency component (10 to 100 Hz) of the near-field ground acceleration is enhanced by the dynamically activated fracture network, consistent with field observations. We then conducted the case study in depth with various sets of initial stress state, and friction properties, to investigate the evolution of damage zone. We show that the width of damage zone decreases in depth, forming "flower-like" structure as the characteristic slip distance in linear slip-weakening law, or the fracture energy on the fault, is kept constant with depth. Finally, we compared the fracture energy on the fault to the energy

  11. Slow rupture of frictional interfaces

    Science.gov (United States)

    Bar Sinai, Yohai; Brener, Efim A.; Bouchbinder, Eran

    2012-02-01

    The failure of frictional interfaces and the spatiotemporal structures that accompany it are central to a wide range of geophysical, physical and engineering systems. Recent geophysical and laboratory observations indicated that interfacial failure can be mediated by slow slip rupture phenomena which are distinct from ordinary, earthquake-like, fast rupture. These discoveries have influenced the way we think about frictional motion, yet the nature and properties of slow rupture are not completely understood. We show that slow rupture is an intrinsic and robust property of simple non-monotonic rate-and-state friction laws. It is associated with a new velocity scale cmin, determined by the friction law, below which steady state rupture cannot propagate. We further show that rupture can occur in a continuum of states, spanning a wide range of velocities from cmin to elastic wave-speeds, and predict different properties for slow rupture and ordinary fast rupture. Our results are qualitatively consistent with recent high-resolution laboratory experiments and may provide a theoretical framework for understanding slow rupture phenomena along frictional interfaces.

  12. Global catalog of earthquake rupture velocities shows anticorrelation between stress drop and rupture velocity

    Science.gov (United States)

    Chounet, Agnès; Vallée, Martin; Causse, Mathieu; Courboulex, Françoise

    2018-05-01

    Application of the SCARDEC method provides the apparent source time functions together with seismic moment, depth, and focal mechanism, for most of the recent earthquakes with magnitude larger than 5.6-6. Using this large dataset, we have developed a method to systematically invert for the rupture direction and average rupture velocity Vr, when unilateral rupture propagation dominates. The approach is applied to all the shallow (z earthquakes of the catalog over the 1992-2015 time period. After a careful validation process, rupture properties for a catalog of 96 earthquakes are obtained. The subsequent analysis of this catalog provides several insights about the seismic rupture process. We first report that up-dip ruptures are more abundant than down-dip ruptures for shallow subduction interface earthquakes, which can be understood as a consequence of the material contrast between the slab and the overriding crust. Rupture velocities, which are searched without any a-priori up to the maximal P wave velocity (6000-8000 m/s), are found between 1200 m/s and 4500 m/s. This observation indicates that no earthquakes propagate over long distances with rupture velocity approaching the P wave velocity. Among the 23 ruptures faster than 3100 m/s, we observe both documented supershear ruptures (e.g. the 2001 Kunlun earthquake), and undocumented ruptures that very likely include a supershear phase. We also find that the correlation of Vr with the source duration scaled to the seismic moment (Ts) is very weak. This directly implies that both Ts and Vr are anticorrelated with the stress drop Δσ. This result has implications for the assessment of the peak ground acceleration (PGA) variability. As shown by Causse and Song (2015), an anticorrelation between Δσ and Vr significantly reduces the predicted PGA variability, and brings it closer to the observed variability.

  13. Pathologic rupture of the spleen in a patient with acute myelogenous leukemia and leukostasis

    Directory of Open Access Journals (Sweden)

    Gil Cunha De Santis

    2014-07-01

    Full Text Available Rupture of the spleen can be classified as spontaneous, traumatic, or pathologic. Pathologic rupture has been reported in infectious diseases such as infectious mononucleosis, and hematologic malignancies such as acute and chronic leukemias. Splenomegaly is considered the most relevant factor that predisposes to splenic rupture. A 66-year-old man with acute myeloid leukemia evolved from an unclassified myeloproliferative neoplasm, complaining of fatigue and mild upper left abdominal pain. He was pale and presented fever and tachypnea. Laboratory analyses showed hemoglobin 8.3 g/dL, white blood cell count 278 × 109/L, platelet count 367 × 109/L, activated partial thromboplastin time (aPTT ratio 2.10, and international normalized ratio (INR 1.60. A blood smear showed 62% of myeloblasts. The immunophenotype of the blasts was positive for CD117, HLA-DR, CD13, CD56, CD64, CD11c and CD14. Lactate dehydrogenase was 2384 U/L and creatinine 2.4 mg/dL (normal range: 0.7-1.6 mg/dL. Two sessions of leukapheresis were performed. At the end of the second session, the patient presented hemodynamic instability that culminated in circulatory shock and death. The post-mortem examination revealed infiltration of the vessels of the lungs, heart, and liver, and massive infiltration of the spleen by leukemic blasts. Blood volume in the peritoneal cavity was 500 mL. Acute leukemia is a rare cause of splenic rupture. Male gender, old age and splenomegaly are factors associated with this condition. As the patient had leukostasis, we hypothesize that this, associated with other factors such as lung and heart leukemic infiltration, had a role in inducing splenic rupture. Finally, we do not believe that leukapheresis in itself contributed to splenic rupture, as it is essentially atraumatic.

  14. A case of generalized peritonitis due to a rupture of the bladder caused by radiation cystitis

    International Nuclear Information System (INIS)

    Fujitake, Shin-ichi; Nozaki, Hideki; Shimizu, Minoru; Maeda, Yoshiyuki; Kataoka, Susumu

    1999-01-01

    An 83-year-old woman was admitted to the department of gastroenterology in our hospital with a diagnosis of adhesive ileus following operation for a uterine cancer on July 22, 1997. Conservative therapy was started, but three days later, peritoneal signs appeared and white blood cell count and CRP level increased. An emergency operation was performed. Upon laparotomy, there were a large volume of ascites and a rupture of the bladder of which wall had become fragile. It was thought that the cause of rupture might result from radiation cystitis because she received irradiation after operation for the uterine cancer. Ruptured site of the bladder was sutured. Possible causes of the ileus were thought to be intestinal paralysis due to generalized peritonitis and a narrowing of the ileum where inflammatory change was remarkable. For this, an excision of the ileum with ileostomy was performed. Thereafter a closure of the ileostomy and ileocolostomy were carried out. The patient had difficulty in management of evacuation for a while, but she was discharged on March 2, 1998. Spontaneous rupture of the bladder is rare. This paper presents such a rare case caused by radiation cystitis, together with 14 cases reported in Japan. It is thought that surgeons who manage acute abdomen may encounter the disease. (author)

  15. A case of generalized peritonitis due to a rupture of the bladder caused by radiation cystitis

    Energy Technology Data Exchange (ETDEWEB)

    Fujitake, Shin-ichi; Nozaki, Hideki; Shimizu, Minoru; Maeda, Yoshiyuki; Kataoka, Susumu [Meitetsu Hospital, Nagoya (Japan)

    1999-03-01

    An 83-year-old woman was admitted to the department of gastroenterology in our hospital with a diagnosis of adhesive ileus following operation for a uterine cancer on July 22, 1997. Conservative therapy was started, but three days later, peritoneal signs appeared and white blood cell count and CRP level increased. An emergency operation was performed. Upon laparotomy, there were a large volume of ascites and a rupture of the bladder of which wall had become fragile. It was thought that the cause of rupture might result from radiation cystitis because she received irradiation after operation for the uterine cancer. Ruptured site of the bladder was sutured. Possible causes of the ileus were thought to be intestinal paralysis due to generalized peritonitis and a narrowing of the ileum where inflammatory change was remarkable. For this, an excision of the ileum with ileostomy was performed. Thereafter a closure of the ileostomy and ileocolostomy were carried out. The patient had difficulty in management of evacuation for a while, but she was discharged on March 2, 1998. Spontaneous rupture of the bladder is rare. This paper presents such a rare case caused by radiation cystitis, together with 14 cases reported in Japan. It is thought that surgeons who manage acute abdomen may encounter the disease. (author)

  16. Spontaneous Superior Mesenteric Artery Branch Pseudoaneurysm: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Mina Guirgis

    Full Text Available : Background: Visceral arterial pseudoaneurysms (VAPAs are rare vascular entities with serious consequences. Traditionally, they are associated with trauma, infection, and inflammatory disease, or they can arise as a post-operative complication. Report: An 87 year old man presented with abdominal pain and was found to have a spontaneous VAPA on a computed tomography angiogram. Serial imaging 4 months previously had demonstrated no aneurysm. Between scans, warfarin was changed to apixaban for aortic valve replacement, but he had no other changes to any other medications. He required urgent endovascular coiling of the pseudoaneurysm, with satisfactory recovery and outcome. Discussion: VAPAs are extremely rare, with splenic artery VAPAs the most commonly reported. Regardless, fewer than 250 cases of splenic artery pseudoaneurysm have been reported. Superior mesenteric artery (SMA pseudoaneurysms are the rarest type of VAPAs. Early identification and urgent treatment are warranted because of the associated high mortality risk, with a 50% risk of rupture in any given VAPA. Treatment options range from open operation to endoscopic and endovascular procedures. Apixaban has been proposed to contribute to pseudoaneurysm formation by slow and continuous bleeding that results in the formation of the pseudoaneurysm. Conclusions: Spontaneous VAPAs are extremely rare and this is the first time a VAPA has been associated with the novel oral anticoagulant “apixaban”. Urgent management of any VAPAs is important because of the high risk of rupture and potential life threatening haemorrhage. Keywords: Visceral arterial pseudoaneurysm, Superior mesenteric artery, Apixaban, Coils

  17. Delayed rupture of common carotid artery following rugby tackle injury: a case report

    Directory of Open Access Journals (Sweden)

    Abbas Saleh

    2008-03-01

    Full Text Available Abstract Background Common Carotid Artery (CCA is an uncommon site of injury following a blunt trauma, its presentation with spontaneous delayed rupture is even more uncommon and a rugby tackle leading to CCA injury is a rare event. What makes this case unique and very rare is combination of all of the above. Case presentation Mr H. presented to the Emergency Department with an expanding neck haematoma and shortness of breath. He was promptly intubated and had contrast CT angiography of neck vessels which localized the bleeding spot on posteromedial aspect of his Right CCA. He underwent emergency surgery with repair of the defect and made an uneventful recovery post operatively. Conclusion Delayed post traumatic rupture of the CCA is an uncommon yet potentially life threatening condition which can be caused by unusual blunt injury mechanism. A high index of suspicion and low threshold for investigating carotid injuries in the setting of blunt trauma is likely to be beneficial.

  18. Common and uncommon CT findings in rupture and impending rupture of abdominal aortic aneurysms

    International Nuclear Information System (INIS)

    Ahmed, M.Z.; Ling, L.; Ettles, D.F.

    2013-01-01

    The rapid imaging evaluation and diagnosis of rupture and impending rupture of an abdominal aortic aneurysm (AAA) is imperative. This article describes the imaging findings of rupture, impending rupture, and other abdominal aortic abnormalities. It is important not to overlook AAA as the consequences can be life threatening. All patients who had open or endovascular repair of AAA rupture over 6 years (2008–2012) were identified from our departmental database. The computed tomography (CT) images of 99 patients were reviewed for relevant findings. The mean age of the patients was 65 years and 85% were male

  19. The preterm cervix reveals a transcriptomic signature in the presence of premature prelabor rupture of membranes.

    Science.gov (United States)

    Makieva, Sofia; Dubicke, Aurelija; Rinaldi, Sara F; Fransson, Emma; Ekman-Ordeberg, Gunvor; Norman, Jane E

    2017-06-01

    Premature prelabor rupture of fetal membranes accounts for 30% of all premature births and is associated with detrimental long-term infant outcomes. Premature cervical remodeling, facilitated by matrix metalloproteinases, may trigger rupture at the zone of the fetal membranes overlying the cervix. The similarities and differences underlying cervical remodeling in premature prelabor rupture of fetal membranes and spontaneous preterm labor with intact membranes are unexplored. We aimed to perform the first transcriptomic assessment of the preterm human cervix to identify differences between premature prelabor rupture of fetal membranes and preterm labor with intact membranes and to compare the enzymatic activities of matrix metalloproteinases-2 and -9 between premature prelabor rupture of fetal membranes and preterm labor with intact membranes. Cervical biopsies were collected following preterm labor with intact membranes (n = 6) and premature prelabor rupture of fetal membranes (n = 5). Biopsies were also collected from reference groups at term labor (n = 12) or term not labor (n = 5). The Illumina HT-12 version 4.0 BeadChips microarray was utilized, and a novel network graph approach determined the specificity of changes between premature prelabor rupture of fetal membranes and preterm labor with intact membranes. Quantitative reverse transcription-polymerase chain reaction and Western blotting confirmed the microarray findings. Immunofluorescence was used for localization studies and gelatin zymography to assess matrix metalloproteinase activity. PML-RARA-regulated adapter molecule 1, FYVE-RhoGEF and PH domain-containing protein 3 and carcinoembryonic antigen-ralated cell adhesion molecule 3 were significantly higher, whereas N-myc downstream regulated gene 2 was lower in the premature prelabor rupture of fetal membranes cervix when compared with the cervix in preterm labor with intact membranes, term labor, and term not labor. PRAM1 and CEACAM3 were localized

  20. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten

    2005-01-01

    participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture...... were in fact ruptured at surgery. Thirty-four of the 43 intact implants were described as intact at surgery. When categorising possible ruptures as ruptures, there were one false positive and nine false negative rupture diagnoses at MRI yielding an accuracy of 92%, a sensitivity of 89...

  1. Esophageal Rupture as a Primary Manifestation in Eosinophilic Esophagitis

    Directory of Open Access Journals (Sweden)

    Natalia Vernon

    2014-01-01

    Full Text Available Eosinophilic esophagitis (EoE is a chronic inflammatory process characterized by symptoms of esophageal dysfunction and, histologically, by eosinophilic infiltration of the esophagus. In adults, it commonly presents with dysphagia, food impaction, and chest or abdominal pain. Chronic inflammation can lead to diffuse narrowing of the esophageal lumen which may cause food impaction. Endoscopic procedures to relieve food impaction may lead to complications such as esophageal perforation due to the friability of the esophageal mucosa. Spontaneous transmural esophageal rupture, also known as Boerhaave’s syndrome, as a primary manifestation of EoE is rare. In this paper, we present two adult patients who presented with esophageal perforation as the initial manifestation of EoE. This rare complication of EoE has been documented in 13 other reports (11 adults, 2 children and only 1 of the patients had been previously diagnosed with EoE. A history of dysphagia was present in 1 of our patients and in the majority of previously documented patients. Esophageal perforation is a potentially severe complication of EoE. Patients with a history of dysphagia and patients with spontaneous esophageal perforation should warrant an evaluation for EoE.

  2. Ruptured Jejunal Diverticulum Due to a Single-Band Small Bowel Obstruction

    Directory of Open Access Journals (Sweden)

    Rajaraman Durai

    2008-01-01

    Full Text Available Jejunal diverticulosis is rare and often goes unnoticed until complications occur. The diverticula are true, acquired diverticula and often asymptomatic. Jejunal diverticulosis can be associated with diverticulosis of the duodenum, ileum, and colon. Here we describe a patient with known severe diverticular disease of the large bowel, who presented acutely with abdominal pain and signs of generalised peritonitis. Laparotomy showed ruptured jejunal diverticulosis with a single band over the terminal ileum, causing small bowel obstruction. Spontaneous perforation of a jejunal diverticulum is rare and is usually an intraoperative finding. One should exclude a precipitating cause, such as coexisting distal obstruction, stricture, or a foreign body.

  3. [In the case of premature live birth, is very early rupture of the membranes an additional risk factor for morbidity and mortality?

    Science.gov (United States)

    Isnard, T; Vincent-Rohfritsch, A; Le Ray, C; Goffinet, F; Patkai, J; Sibiude, J

    2018-02-26

    To describe survival rate after preterm premature rupture of membranes (PPROM) before 25 weeks of gestation and compare neonatal morbidity and mortality among those born alive with a control group of infants born at a similar gestational age without premature rupture of membranes. We conducted a retrospective single-centre study at Port-Royal maternity, from 2007 to 2015, comparing neonatal outcomes between liveborninfants exposed to PPROM prior to 25 weeks of gestation (WG) and a control group not exposed to premature rupture of the membranes. For each live-born child, the next child born after spontaneous labor without PPROM was matched for gestational age at birth, sex, and whether or not they received antenatal corticosteroid therapy. The primary endpoint was severe neonatal complications assessed by a composite endpoint including neonatal deaths, grade 3-4 HIV, bronchopulmonary dysplasia, leukomalacia and stade 3-4 retinopathies. Among 77 cases of very premature rupture of the membranes, 55 children were born alive. Among these, the average gestational age at birth was 28 WG and 1 day. The rate of severe neonatal complications did not differ between the two groups (43.6% in the PPROM group vs. 36.4%, P=0.44) and the survival rate at discharge was also similar in the two groups (85.5% vs. 83.6%, P=0.98). In our cohort and among livebirths after 24 WG, PPROM before 25 WG was not associated with an increased risk of morbidity and mortality compared to children born at the same gestational age after a spontaneous labor with intact membranes. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  4. A Rare Case of Simultaneous Acute Bilateral Quadriceps Tendon Rupture and Unilateral Achilles Tendon Rupture

    Directory of Open Access Journals (Sweden)

    Wei Yee Leong

    2013-07-01

    Full Text Available Introduction: There have been multiple reported cases of bilateral quadriceps tendon ruptures (QTR in the literature. These injuries frequently associated with delayed diagnosis, which results in delayed surgical treatment. In very unusual cases, bilateral QTRs can be associated with other simultaneous tendon ruptures. Case Report: We present a rare case of bilateral QTR with a simultaneous Achilles Tendon Rupture involving a 31 years old Caucasian man who is a semi-professional body builder taking anabolic steroids. To date bilateral QTR with additional TA rupture has only been reported once in the literature and to our knowledge this is the first reported case of bilateral QTR and simultaneous TA rupture in a young, fit and healthy individual. Conclusion: The diagnosis of bilateral QTR alone can sometimes be challenging and the possibility of even further tendon injuries should be carefully assessed. A delay in diagnosis could result in delay in treatment and potentially worse outcome for the patient. Keywords: Quadriceps tendon rupture; Achilles tendon rupture; Bilateral.

  5. Fault geometry, rupture dynamics and ground motion from potential earthquakes on the North Anatolian Fault under the Sea of Marmara

    KAUST Repository

    Oglesby, David D.

    2012-03-01

    Using the 3-D finite-element method, we develop dynamic spontaneous rupture models of earthquakes on the North Anatolian Fault system in the Sea of Marmara, Turkey, considering the geometrical complexity of the fault system in this region. We find that the earthquake size, rupture propagation pattern and ground motion all strongly depend on the interplay between the initial (static) regional pre-stress field and the dynamic stress field radiated by the propagating rupture. By testing several nucleation locations, we observe that those far from an oblique normal fault stepover segment (near Istanbul) lead to large through-going rupture on the entire fault system, whereas nucleation locations closer to the stepover segment tend to produce ruptures that die out in the stepover. However, this pattern can change drastically with only a 10° rotation of the regional stress field. Our simulations also reveal that while dynamic unclamping near fault bends can produce a new mode of supershear rupture propagation, this unclamping has a much smaller effect on the speed of the peak in slip velocity along the fault. Finally, we find that the complex fault geometry leads to a very complex and asymmetric pattern of near-fault ground motion, including greatly amplified ground motion on the insides of fault bends. The ground-motion pattern can change significantly with different hypocentres, even beyond the typical effects of directivity. The results of this study may have implications for seismic hazard in this region, for the dynamics and ground motion of geometrically complex faults, and for the interpretation of kinematic inverse rupture models.

  6. Fault geometry, rupture dynamics and ground motion from potential earthquakes on the North Anatolian Fault under the Sea of Marmara

    KAUST Repository

    Oglesby, David D.; Mai, Paul Martin

    2012-01-01

    Using the 3-D finite-element method, we develop dynamic spontaneous rupture models of earthquakes on the North Anatolian Fault system in the Sea of Marmara, Turkey, considering the geometrical complexity of the fault system in this region. We find that the earthquake size, rupture propagation pattern and ground motion all strongly depend on the interplay between the initial (static) regional pre-stress field and the dynamic stress field radiated by the propagating rupture. By testing several nucleation locations, we observe that those far from an oblique normal fault stepover segment (near Istanbul) lead to large through-going rupture on the entire fault system, whereas nucleation locations closer to the stepover segment tend to produce ruptures that die out in the stepover. However, this pattern can change drastically with only a 10° rotation of the regional stress field. Our simulations also reveal that while dynamic unclamping near fault bends can produce a new mode of supershear rupture propagation, this unclamping has a much smaller effect on the speed of the peak in slip velocity along the fault. Finally, we find that the complex fault geometry leads to a very complex and asymmetric pattern of near-fault ground motion, including greatly amplified ground motion on the insides of fault bends. The ground-motion pattern can change significantly with different hypocentres, even beyond the typical effects of directivity. The results of this study may have implications for seismic hazard in this region, for the dynamics and ground motion of geometrically complex faults, and for the interpretation of kinematic inverse rupture models.

  7. Hepatic rupture in preeclampsia

    International Nuclear Information System (INIS)

    Winer-Muram, H.T.; Muram, D.; Salazar, J.; Massie, J.D.

    1985-01-01

    The diagnosis of hepatic rupture in patients with pregnancy-induced hypertension (preeclampsia and eclampsia) is rarely made preoperatively. Diagnostic imaging can be utilized in some patients to confirm the preoperative diagnosis. Since hematoma formation precedes hepatic rupture, then, when diagnostic modalities such as sonography and computed tomography identify patients with hematomas, these patients are at risk of rupture, and should be hospitalized until the hematomas resolve

  8. Extracranial vertebral artery rupture likely secondary to "cupping therapy" superimposed on spontaneous dissection.

    Science.gov (United States)

    Choi, Jae Young; Huh, Chae Wook; Choi, Chang Hwa; Lee, Jae Il

    2016-12-01

    The extracranial vertebral artery (VA) is vulnerable to dissection and the V3 segment is the most common location for dissection. Dissection accounts for about 2% of all ischemic strokes and can occur after trauma or chiropractic neck maneuvers. We report an extremely rare case of spontaneous extracranial VA dissection presenting with posterior neck hematoma aggravated after cupping therapy, a treatment in traditional Oriental medicine. We treated the patient successfully by endovascular treatment without any complication. © The Author(s) 2016.

  9. Real-Time Detection of Rupture Development: Earthquake Early Warning Using P Waves From Growing Ruptures

    Science.gov (United States)

    Kodera, Yuki

    2018-01-01

    Large earthquakes with long rupture durations emit P wave energy throughout the rupture period. Incorporating late-onset P waves into earthquake early warning (EEW) algorithms could contribute to robust predictions of strong ground motion. Here I describe a technique to detect in real time P waves from growing ruptures to improve the timeliness of an EEW algorithm based on seismic wavefield estimation. The proposed P wave detector, which employs a simple polarization analysis, successfully detected P waves from strong motion generation areas of the 2011 Mw 9.0 Tohoku-oki earthquake rupture. An analysis using 23 large (M ≥ 7) events from Japan confirmed that seismic intensity predictions based on the P wave detector significantly increased lead times without appreciably decreasing the prediction accuracy. P waves from growing ruptures, being one of the fastest carriers of information on ongoing rupture development, have the potential to improve the performance of EEW systems.

  10. [Renal angiomyolipoma rupture as a cause of lumbar pain: report of one case].

    Science.gov (United States)

    Cifuentes, Melissa; Calleja, Félix; Hola, José; Daviú, Antonio; Jara, Danilo; Vallejos, Humberto

    2008-08-01

    Renal angiomyolipoma is a benign tumor formed by smooth muscle, adipose tissue and blood vessels. It is commonly found incidentally and its clinical manifestations are pain and abdominal mass or spontaneous tumor rupture with retroperitoneal bleeding. The clinical presentation of a hemorrhagic shock secondary to a retroperitoneal hematoma is uncommon. We report a 40 year-old male who presented to the emergency room with lumbar pain and deterioration of hemodynamic parameters. The CT scan showed a left renal injury associated to an expansive retroperitoneal process. The abdominal exploration, vascular control of the renal pedicle and nephrectomy allowed a successful outcome.

  11. The effect of tube rupture location on the consequences of multiple steam generator tube rupture event

    International Nuclear Information System (INIS)

    Jeong, Ji Hwan; Kweon, Young Chul

    2002-01-01

    A multiple steam generator tube rupture (MSGTR) event has never occurred in the commercial operation of nuclear reactors while single steam generator tube rupture (SGTR) events are reported to occur every 2 years. As there has been no occurrence of a MSGTR event, the understanding of transients and consequences of this event is very limited. In this study, a postulated MSGTR event in an advanced power reactor 1400 (APR 1400) is analyzed using the thermal-hydraulic system code, MARS1.4. The APR 1400 is a two-loop, 3893 MWt, PWR proposed to be built in 2010. The present study aims to understand the effects of rupture location in heat transfer tubes following a MSGTR event. The effects of five tube rupture locations are compared with each other. The comparison shows that the response of APR1400 allows the shortest time for operator action following a tube rupture in the vicinity of the hot-leg side tube sheet and allows the longest time following a tube rupture at the tube top. The MSSV lift time for rupture at the tube-top is evaluated as 24.5% larger than that for rupture at the hot-leg side tube sheet

  12. Spontaneous Left Renal Subcapsular Hematoma and Right Hip Hematoma in a Hemodialysis Patient: A Case Report and Review of the Literature.

    Science.gov (United States)

    Ye, Muyao; Liu, Yinghong; Zhou, Letian; Wang, Chang; Fu, Xiao; Peng, Youming; Liu, Hong

    2016-01-01

    For maintenance hemodialysis (MHD) patients, the blood is in low hypercoagulable state due to the use of heparin or low molecular weight heparin during dialysis. It is not rare to see hematoma in the puncture site. In recent years, several cases have been reported of spontaneous kidney rupture, but no hip hematoma, let alone both occurred in succession. There was one MHD patient with spontaneous kidney bleeding and hip hematoma in our hospital in 2014, and we provided effective treatment and follow-up. © 2016 S. Karger AG, Basel.

  13. Platelet-to-lymphocyte ratio: A new inflammatory marker for the diagnosis of preterm premature rupture of membranes

    Science.gov (United States)

    Toprak, Erzat; Bozkurt, Murat; Dinçgez Çakmak, Burcu; Özçimen, Emel Ebru; Silahlı, Musa; Ender Yumru, Ayşe; Çalışkan, Eray

    2017-01-01

    Objective: Preterm premature rupture of membranes (PPROM) is closely related with maternal and fetal complications. Therefore, early diagnosis is extremely important to provide maternal and fetal well-being. Many inflammatory markers have been evaluated for their ability to diagnose membrane rupture at early stages. We aimed to investigate the relationship between the platelet-to-lymphocyte ratio (PLR) and preterm premature membrane rupture. Material and Methods: In this study, 121 pregnant women with PPROM and 96 age-matched pregnant women with spontaneous preterm labor who were admitted to our hospital between January 2014 and December 2015 were enrolled. Demographic data, complete blood cell count results, and neonatal outcomes were recorded. Results: The neutrophil and platelet counts were higher in the PPROM group (9948.4±3393.2 vs. 7466.1±1698.5/mm3 and 244.5±60 vs. 210.6±64.8/mm3, respectively, ppremature rupture of membranes was evaluated using an ROC curve. The sensitivity and specificity of the PLR was 57.8% and 73.7%, respectively, at a threshold >117.14 (p<0.001). Conclusion: The PLR might be a cost effective, easy to use, and practical marker for the early diagnosis of PPROM, which can help to determine the appropriate waiting time for delivery and provide maternal and fetal well-being. PMID:28890425

  14. Spontaneous third ventriculostomy 8 years after diagnosis of obstructive hydrocephalus.

    Science.gov (United States)

    Öğrenci, Ahmet; Ekşi, Murat Şakir; Koban, Orkun

    2016-09-01

    Spontaneous ventriculostomy is spontaneous rupture of membranes separating the ventricular system from the subarachnoid space in patients with chronic obstructive hydrocephalus that ends with resolution of symptoms. We present a case of spontaneous third ventriculostomy occurred in a 19-year-old girl 8 years after the initial diagnosis of hydrocephalus. An 11-year-old girl applied to the clinic with intermittent headaches. She was neurologically stable with no visual problems. On her brain MRI, obstructive hydrocephalus was observed. Cerebrospinal fluid diversion procedures were recommended, yet the family denied any interventional procedure. She had routine follow-ups with occasional clinical admissions because of ongoing intermittent headaches. On her last clinical visit, 8 years after the first one, she was in well condition with improvement in her headache in the last 4 months. Her new brain MRI showed an active CSF flow between the basal cistern and the third ventricle. In patients with aqueductal stenosis and without any other mass lesion, wait and see protocol might be conveyed in case of mild symptoms of hydrocephalus. However, there is need for large-scaled studies to make a more comprehensive statement for benign obstructive hydrocephalus cases.

  15. Rupture of Achilles Tendon : Usefulness of Ultrasonography

    International Nuclear Information System (INIS)

    Kim, Nam Hyeon; Ki, Won Woo; Yoon, Kwon Ha; Kim, Song Mun; Shin, Myeong Jin; Kwon, Soon Tae

    1996-01-01

    To differentiate a complete rupture of Achilles tendon from an incomplete one which is important because its treatment is quite different. And it is necessary to know the exact site of the rupture preoperatively. Fifteen cases of fourteen patients which were diagnosed as Achilles tendon rupture by ultrasonography and surgery were reviewed. We compared sonographic rupture site with surgical findings. Ultrasonographic criteria for differentiation of complete and incomplete rupture was defined as follows : the discreteness, which means the proximal intervening hypoechogenicity to the interface echogenicity of distal margin of ruptured tendon : the slant sign, which represents the interface of ruptured distal margin which was seen over the 3/4 of the thickness of the tendon without intervening low echogeneicity : the invagination sign, which means the echogenic invagination from Kager triangle into posterior aspect of Achilles tendon over the half thickness of the tendon. The sites of complete tendon rupture were exactly corresponded to surgical finding in four cases of ten complete ruptures. And the discrepancy between sonographic and surgical findings in the site of complete rupture was 1.2 ± 0.4 cm in six cases. Three of ten complete ruptures showed the discreteness sign, all of ten showed the slant sign and two of ten showed the invagination sign. It is helpful to differentiate a complete from incomplete rupture of the Achilles tendon and to localize the site of the complete rupture with the ultrasonographic evaluation

  16. Rupture of the Pitáycachi Fault in the 1887 Mw 7.5 Sonora, Mexico earthquake (southern Basin-and-Range Province): Rupture kinematics and epicenter inferred from rupture branching patterns

    Science.gov (United States)

    Suter, Max

    2015-01-01

    During the 3 May 1887 Mw 7.5 Sonora earthquake (surface rupture end-to-end length: 101.8 km), an array of three north-south striking Basin-and-Range Province faults (from north to south Pitáycachi, Teras, and Otates) slipped sequentially along the western margin of the Sierra Madre Occidental Plateau. This detailed field survey of the 1887 earthquake rupture zone along the Pitáycachi fault includes mapping the rupture scarp and measurements of surface deformation. The surface rupture has an endpoint-to-endpoint length of ≥41.0 km, dips 70°W, and is characterized by normal left-lateral extension. The maximum surface offset is 487 cm and the mean offset 260 cm. The rupture trace shows a complex pattern of second-order segmentation. However, this segmentation is not expressed in the 1887 along-rupture surface offset profile, which indicates that the secondary segments are linked at depth into a single coherent fault surface. The Pitáycachi surface rupture shows a well-developed bipolar branching pattern suggesting that the rupture originated in its central part, where the polarity of the rupture bifurcations changes. Most likely the rupture first propagated bilaterally along the Pitáycachi fault. The southern rupture front likely jumped across a step over to the Teras fault and from there across a major relay zone to the Otates fault. Branching probably resulted from the lateral propagation of the rupture after breaching the seismogenic part of the crust, given that the much shorter ruptures of the Otates and Teras segments did not develop branches.

  17. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    Science.gov (United States)

    Polzer, Stanislav; Gasser, T Christian

    2015-12-06

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. © 2015 The Author(s).

  18. Dynamic rupture scenarios from Sumatra to Iceland - High-resolution earthquake source physics on natural fault systems

    Science.gov (United States)

    Gabriel, Alice-Agnes; Madden, Elizabeth H.; Ulrich, Thomas; Wollherr, Stephanie

    2017-04-01

    Capturing the observed complexity of earthquake sources in dynamic rupture simulations may require: non-linear fault friction, thermal and fluid effects, heterogeneous fault stress and fault strength initial conditions, fault curvature and roughness, on- and off-fault non-elastic failure. All of these factors have been independently shown to alter dynamic rupture behavior and thus possibly influence the degree of realism attainable via simulated ground motions. In this presentation we will show examples of high-resolution earthquake scenarios, e.g. based on the 2004 Sumatra-Andaman Earthquake, the 1994 Northridge earthquake and a potential rupture of the Husavik-Flatey fault system in Northern Iceland. The simulations combine a multitude of representations of source complexity at the necessary spatio-temporal resolution enabled by excellent scalability on modern HPC systems. Such simulations allow an analysis of the dominant factors impacting earthquake source physics and ground motions given distinct tectonic settings or distinct focuses of seismic hazard assessment. Across all simulations, we find that fault geometry concurrently with the regional background stress state provide a first order influence on source dynamics and the emanated seismic wave field. The dynamic rupture models are performed with SeisSol, a software package based on an ADER-Discontinuous Galerkin scheme for solving the spontaneous dynamic earthquake rupture problem with high-order accuracy in space and time. Use of unstructured tetrahedral meshes allows for a realistic representation of the non-planar fault geometry, subsurface structure and bathymetry. The results presented highlight the fact that modern numerical methods are essential to further our understanding of earthquake source physics and complement both physic-based ground motion research and empirical approaches in seismic hazard analysis.

  19. Continuous amnioinfusion via an epidural catheter following spontaneous membrane rupture: A case report.

    Science.gov (United States)

    Turgut, Abdulkadir; Katar, Selahattin; Sak, Muhammet Erdal; Turgut, Fethiye Gülden; Sahin, Alparslan; Başaranoğlu, Serdar; Yalınkaya, Ahmet

    2013-01-01

    Preterm premature rupture of membranes (PPROM) is seen in 3% of all pregnancies, and is a frequent cause of preterm birth, neonatal mortality and morbidity. The most important complications are maternal and foetal infection, prematurity, umbilical cord compression, hypoxia or asphyxia due to cord prolapse, pulmonary hypoplasia and extremity deformities. The basic approach to PPROM therapy aims to prevent premature birth and the development of foetal distress, and decrease the risk of maternal and foetal infection, and amniotic fluid loss. In compliance with these objectives, alternatives of PPROM therapy demonstrate a wide spectrum, including watchful waiting, amniopatch application, recurrent amnioinfusions and emergency birth. However, repeated amnioinfusions in cases of fluid loss, especially within 6 hours of therapy, provides only minimal benefit. In this case presentation, we attempted to describe a different and cost-effective continuous amnioinfusion technique performed to confer survival benefit for an immature anhydramniotic foetus affected by PPROM at the border of viability.

  20. Aging of intrauterine tissues in spontaneous preterm birth and preterm premature rupture of the membranes: A systematic review of the literature.

    Science.gov (United States)

    Polettini, J; Dutta, E H; Behnia, F; Saade, G R; Torloni, M R; Menon, R

    2015-09-01

    Many adverse pregnancy outcomes (APOs), including spontaneous preterm birth (PTB), are associated with placental dysfunction. Recent clinical and experimental evidences suggest that premature aging of the placenta may be involved in these events. Although placental aging is a well-known concept, the mechanisms of aging during normal pregnancy and premature aging in APOs are still unclear. This review was conducted to assess the knowledge on placental aging related biochemical changes leading to placental dysfunction in PTB and/or preterm premature rupture of membranes (pPROM). We performed a systematic review of studies published over the last 50 years in two electronic databases (Pubmed and Embase) on placental aging and PTB or pPROM. The search yielded 554 citations, 30 relevant studies were selected for full-text review and three were included in the review. Only one study reported oxidative stress-related aging and degenerative changes in human placental membranes and telomere length reduction in fetal cells as part of PTB and/or pPROM mechanisms. Similarly, two animal studies reported findings of decidual senescence and referred to PTB mechanisms. Placental and fetal membrane oxidative damage and telomere reduction are linked to premature aging in PTB and pPROM but the risk factors and biomolecular pathways causing this phenomenon are not established in the literature. However, no biomarkers or clinical indicators of premature aging as a pathology of PTB and pPROM have been reported. We document major knowledge gaps and propose several areas for future research to improve our understanding of premature aging linked to placental dysfunction. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Spontaneous pneumocephalus after commercial air travel complicated by meningitis.

    Science.gov (United States)

    Javan, Ramin; Duszak, Richard; Eisenberg, Alan D; Eggers, Frank M

    2011-12-01

    Pneumocephalus usually results from trauma, infection, neoplasm, or iatrogenic causes. Barotrauma-induced spontaneous pneumocephalus is extremely rare, usually seen in divers or occassionally with air travel. We report a case of a 61-yr-old female presenting with confusion, fever, and respiratory failure one day after developing sudden nausea, vomiting, and headache during descent on a commercial airliner. Pneumocephalus and meningitis were present on admission. Sinus computed tomography (CT) showed pansinusitis and a tiny bone defect in the posterior wall of the right sphenoid sinus, through which a cisternogram later showed free communication with the prepontine cistern. An orbital CT 2 yr earlier after a fall showed the bone defect, with no other areas of abnormality or fracture. After repair of defects by otolaryngology and appropriate antibiotics, she did well and was eventually discharged. Changes in aircraft cabin pressure likely resulted in rupture of dura and arachnoid layers beneath the pre-existing bony defect, predisposed by existing sinus disease. The pathophysiology, implications, and potential sources of spontaneous pneumocephalus, as well as risks of postcraniotomy and post-trauma air-travel, are discussed.

  2. Predicting creep rupture from early strain data

    International Nuclear Information System (INIS)

    Holmstroem, Stefan; Auerkari, Pertti

    2009-01-01

    To extend creep life modelling from classical rupture modelling, a robust and effective parametric strain model has been developed. The model can reproduce with good accuracy all parts of the creep curve, economically utilising the available rupture models. The resulting combined model can also be used to predict rupture from the available strain data, and to further improve the rupture models. The methodology can utilise unfailed specimen data for life assessment at lower stress levels than what is possible from rupture data alone. Master curves for creep strain and rupture have been produced for oxygen-free phosphorus-doped (OFP) copper with a maximum testing time of 51,000 h. Values of time to specific strain at given stress (40-165 MPa) and temperature (125-350 deg. C) were fitted to the models in the strain range of 0.1-38%. With typical inhomogeneous multi-batch creep data, the combined strain and rupture modelling involves the steps of investigation of the data quality, extraction of elastic and creep strain response, rupture modelling, data set balancing and creep strain modelling. Finally, the master curves for strain and rupture are tested and validated for overall fitting efficiency. With the Wilshire equation as the basis for the rupture model, the strain model applies classical parametric principles with an Arrhenius type of thermal activation and a power law type of stress dependence for the strain rate. The strain model also assumes that the processes of primary and secondary creep can be reasonably correlated. The rupture model represents a clear improvement over previous models in the range of the test data. The creep strain information from interrupted and running tests were assessed together with the rupture data investigating the possibility of rupture model improvement towards lower stress levels by inverse utilisation of the combined rupture based strain model. The developed creep strain model together with the improved rupture model is

  3. [Clinical spectrum of patients with spontaneous retroperitoneal hematomas].

    Science.gov (United States)

    Sánchez-González, Amada; Riancho-Zarrabeitia, Leyre; Salmón-González, Zaida; Riancho, José Antonio; Valero, Carmen

    2015-10-05

    Spontaneous retroperitoneal hematoma (SRH) is a potentially fatal clinical entity requiring immediate recognition and intervention. The clinical records of 18-year-old and older patients admitted to the University Hospital Marqués de Valdecilla from 2003 to 2013 were reviewed. "Spontaneous" was defined as unrelated to trauma, invasive procedures or bleeding due to aortic aneurysm rupture. Thirty-four patients with SRH (44% were on anticoagulant drugs). One-third of cases had chronic renal insufficiency. Abdominal pain was the most common symptom both in anticoagulated and non-anticoagulated patients (80% in anticoagulated and 89% in non-anticoagulated patients). About one half of the patients developed shock. A CT scan was the most commonly performed diagnostic test, followed by abdominal ultrasound. Most cases were managed conservatively (80%). More than half of the patients (66%) restarted anticoagulation therapy after the acute event with a mean delay of 19 days (range 2-90 days). None of them suffered a new bleeding episode. Restarting the anticoagulation treatment after hematoma resolution seems to be a safe practice. There is an increasing frequency of SRH in non-anticoagulated patients. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  4. Neglected rupture of the quadriceps tendon in a patient with chronic renal failure (case report and review of the literature).

    Science.gov (United States)

    Hassani, Zouhir Ameziane; Boufettal, Moncef; Mahfoud, Moustapha; Elyaacoubi, Moradh

    2014-01-01

    Spontaneous ruptures of the quadriceps tendon are infrequent injuries, it is seen primarily in patients with predisposing diseases such as gout, rheumatoid arthritis and chronic renal failure. A 32-year-old man had a history of end stage renal disease and received regular hemodialysis treatment for more than 5 years. He was admitted in our service for total functional impotence of the right lower limb with knee pain after a common fall two months ago. The radiogram showed a ''patella baja" with suprapatellar calcifications. The ultrasound and MRI showed an aspect of rupture of the quadriceps tendon in its proximal end with retraction of 3 cm. Quadriceps tendon repair was performed with a lengthening plasty, and the result was satisfactory after a serial rehabilitation program. The diagnosis of quadriceps tendon ruptures needs more attention in patients with predisposing diseases. They should not be unknown because the treatment of neglected lesions is more difficult. We insist on the early surgical repair associated with early rehabilitation that can guarantee recovery of good active extension.

  5. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Takuya, E-mail: okabone@gmail.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Frank, Michael, E-mail: michael.frank@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Pellerin, Olivier, E-mail: olivier@pellerin.as; Primio, Massimiliano Di, E-mail: massimiliano.di.primio@gmail.com; Angelopoulos, Georgios, E-mail: giorginos78@msn.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Boughenou, Marie-Fazia, E-mail: marie-fazia.boughenou@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Anesthesia and Surgical Intensive Care Unit (France); Pagny, Jean-Yves, E-mail: jean-yves.pagny@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Messas, Emmanuel, E-mail: emmanuel.messas@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France)

    2013-05-09

    PurposeTo evaluate the safety and efficacy of transarterial embolization of life-threatening arterial rupture in patients with vascular Ehlers–Danlos syndrome (vEDS) in a single tertiary referral center.MethodsWe retrospectively analyzed transarterial embolization for vEDS performed at our institution from 2000 to 2012. The indication of embolization was spontaneous arterial rupture or pseudoaneurysm with acute bleeding. All interventions used a percutaneous approach through a 5F or less introducer sheath. Embolic agents were microcoils and glue in 3 procedures, glue alone in 2, and microcoils alone in 2.ResultsFive consecutive vEDS patients were treated by 7 embolization procedures (4 women, mean age 29.8 years). All procedures were successfully performed. Two patients required a second procedure for newly arterial lesions at a different site from the first procedure. Four of the five patients were still alive after a mean follow-up of 19.4 (range 1–74.7) months. One patient died of multiple organ failure 2 days after procedure. Minor procedural complications were observed in 3 procedures (43 %), all directly managed during the same session. Remote arterial lesions occurred after 3 procedures (43 %); one underwent a second embolization, and the other 2 were observed conservatively. Puncture site complication was observed in only one procedure (14 %).ConclusionEmbolization for vEDS is a safe and effective method to manage life-threatening arterial rupture.

  6. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome

    International Nuclear Information System (INIS)

    Okada, Takuya; Frank, Michael; Pellerin, Olivier; Primio, Massimiliano Di; Angelopoulos, Georgios; Boughenou, Marie-Fazia; Pagny, Jean-Yves; Messas, Emmanuel; Sapoval, Marc

    2014-01-01

    PurposeTo evaluate the safety and efficacy of transarterial embolization of life-threatening arterial rupture in patients with vascular Ehlers–Danlos syndrome (vEDS) in a single tertiary referral center.MethodsWe retrospectively analyzed transarterial embolization for vEDS performed at our institution from 2000 to 2012. The indication of embolization was spontaneous arterial rupture or pseudoaneurysm with acute bleeding. All interventions used a percutaneous approach through a 5F or less introducer sheath. Embolic agents were microcoils and glue in 3 procedures, glue alone in 2, and microcoils alone in 2.ResultsFive consecutive vEDS patients were treated by 7 embolization procedures (4 women, mean age 29.8 years). All procedures were successfully performed. Two patients required a second procedure for newly arterial lesions at a different site from the first procedure. Four of the five patients were still alive after a mean follow-up of 19.4 (range 1–74.7) months. One patient died of multiple organ failure 2 days after procedure. Minor procedural complications were observed in 3 procedures (43 %), all directly managed during the same session. Remote arterial lesions occurred after 3 procedures (43 %); one underwent a second embolization, and the other 2 were observed conservatively. Puncture site complication was observed in only one procedure (14 %).ConclusionEmbolization for vEDS is a safe and effective method to manage life-threatening arterial rupture

  7. Spontaneous Intracerebral Hemorrhage Image Analysis Methods: A Survey

    Science.gov (United States)

    Pérez, Noel; Valdés, Jose; Guevara, Miguel; Silva, Augusto

    Spontaneous intracerebral hemorrhages (ICH) account for 10-30% of all strokes and are a result of acute bleeding into the brain due to ruptures of small penetrating arteries. Despite major advancements in the management of ischemic strokes and other causes of hemorrhagic strokes, such as ruptured aneurysm, arteriovenous malformations (AVMs), or cavernous angioma, during the past several decades, limited progress has been made in the treatment of ICH, and the prognosis for patients who suffer them remains poor. The societal impact of these hemorrhagic strokes is magnified by the fact that affected patients typically are a decade younger than those afflicted with ischemic strokes. The ICH continues to kill or disable most of their victims. Some studies show that those who suffer ICH have a 30-day mortality rate of 35-44% and a 6-month mortality rate approaching 50%. Approximately 700,000 new strokes occur in the United States annually and approximately 15% are hem-orrhagic strokes related to ICH. The poor outcome associated with ICH is related to the extent of brain damage. ICH produces direct destruction and compression of surrounding brain tissue. Direct compression causes poor perfusion and venous drainage to surrounding penumbra at risk, resulting in ischemia to the tissues that most need perfusion [16].

  8. Incontinence, bladder neck mobility, and sphincter ruptures in primiparous women

    Directory of Open Access Journals (Sweden)

    Jundt K

    2010-06-01

    Full Text Available Abstract Objective To compare the function of the pelvic floor in primiparae before and during pregnancy with the status post partum concerning symptoms of incontinence, sphincter ruptures, bladder-neck mobility and the influence of the different modes of deliveries. Methods Questionnaire evaluating symptoms of urinary and anal incontinence in nulliparous women before and after delivery and correlating these symptoms with functional changes of the pelvic floor based on a careful gynaecologic examination as well as perineal and endoanal ultrasound. Results 112 women were included in our study and came for the first visit, 99 women returned for follow-up 6 months after childbirth. Stress and flatus incontinence significantly increased from before pregnancy (3 and 12% to after childbirth (21 and 28% in women with spontaneous delivery or vacuum extraction. No new symptoms occurred after c-section. There was no significant difference between the bladder neck position before and after delivery. The mobility of the bladder neck was significantly higher after vaginal delivery using a vacuum extraction compared to spontaneous delivery or c-section. The bladder neck in women with post partum urinary stress incontinence was significantly more mobile than in continent controls. The endoanal ultrasound detected seven occult sphincter defects without any correlation to symptoms of anal incontinence. Conclusion Several statistically significant changes of the pelvic floor after delivery were demonstrated. Spontaneous vaginal delivery or vacuum extraction increases the risk for stress or anal incontinence, delivery with vacuum extraction leads to higher bladder neck mobility and stress incontinent women have more mobile bladder necks than continent women.

  9. MRI of tibialis anterior tendon rupture

    International Nuclear Information System (INIS)

    Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

    2004-01-01

    Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

  10. Rupture, waves and earthquakes.

    Science.gov (United States)

    Uenishi, Koji

    2017-01-01

    Normally, an earthquake is considered as a phenomenon of wave energy radiation by rupture (fracture) of solid Earth. However, the physics of dynamic process around seismic sources, which may play a crucial role in the occurrence of earthquakes and generation of strong waves, has not been fully understood yet. Instead, much of former investigation in seismology evaluated earthquake characteristics in terms of kinematics that does not directly treat such dynamic aspects and usually excludes the influence of high-frequency wave components over 1 Hz. There are countless valuable research outcomes obtained through this kinematics-based approach, but "extraordinary" phenomena that are difficult to be explained by this conventional description have been found, for instance, on the occasion of the 1995 Hyogo-ken Nanbu, Japan, earthquake, and more detailed study on rupture and wave dynamics, namely, possible mechanical characteristics of (1) rupture development around seismic sources, (2) earthquake-induced structural failures and (3) wave interaction that connects rupture (1) and failures (2), would be indispensable.

  11. Slow rupture of frictional interfaces

    OpenAIRE

    Sinai, Yohai Bar; Brener, Efim A.; Bouchbinder, Eran

    2011-01-01

    The failure of frictional interfaces and the spatiotemporal structures that accompany it are central to a wide range of geophysical, physical and engineering systems. Recent geophysical and laboratory observations indicated that interfacial failure can be mediated by slow slip rupture phenomena which are distinct from ordinary, earthquake-like, fast rupture. These discoveries have influenced the way we think about frictional motion, yet the nature and properties of slow rupture are not comple...

  12. A clinical and radiological study on spontaneous pneumothorax

    International Nuclear Information System (INIS)

    Jang, Kyung Jae; Kim, Jin Wook; Kim, Byung Soo; Choi, Myung Gwon

    1982-01-01

    A clinical and radiological study was done on 96 cases of spontaneous pneumothorax, encountered in the Dept. of Radiology, Busan National University Hospital during last 3 years from March 1979 to March 1982. The result were summarized as follows: 1. In the age distribution, the ages between 20 and 39 years were most highest, as 54 cases (56.3%). In the sex distribution, the ratio of male to female was 5 : 1 in male predominance. 2. The underlying pathology of the total 96 cases of spontaneous pneumothorax were of tuberculous origin in 33.3 % and non-tuberculous origin in 66.7%. And below 20 years, most were of non- tuberculous origin. 3. In the cases of lung collapse over 2/3, non-tuberculous origin was more than tuberculous origin and had characteristics of significant mediastinal shifting, in contrast to lower percentage of fluid level by chest radiography. 4. The rupture of biebs or bullae was the main immediate causes of spontaneous pneumothorax, independent of the underlying pathology. 5. In only 27 cases (28.1%) among total 96 cases, bullae or biebs could be detected on the chest radiography. 6. In treatment of spontaneous pneumothorax, the closed thoracotomy with under water seal drainage is accepted to be the general method of treatment. But open thoracotomy is considered as the best useful therapeutic procedure to prevent the recurrence, whenever bullae or blebs are found on the chest radiography. 7. In the cases of closed thoracotomy, the recurrent rate was 25.0% and most cases were found at the ipsilateral side of the first attack. 8. Within a week, the collapsed lung were well expanded in most cases of total 96 cases, after closed thoracotomy

  13. Adverse respiratory outcome after premature rupture of membranes before viability.

    Science.gov (United States)

    Verspyck, Eric; Bisson, Violene; Roman, Horace; Marret, Stéphane

    2014-03-01

    To determine whether preterm premature rupture of membranes (PPROM) before 24 weeks is an independent risk factor for poor outcome in preterm neonates. A retrospective comparative cohort study was conducted, including viable premature infants born between 25 and 34-weeks gestation. Each preterm case with early PPROM was matched with two preterm controls of the same gestational age at birth, sex and birth date and who were born spontaneously with intact membranes. Logistic regression was performed to identify independent risk factors associated with composite respiratory and perinatal adverse outcomes for the overall population of preterm infants. Thirty-five PPROM cases were matched with 70 controls. Extreme prematurity (26-28 weeks) was an independent risk factor for composite perinatal adverse outcomes [odds ratio (OR) 43.9; p = 0.001]. Extreme prematurity (OR 42.9; p = 0.001), PPROM (OR 7.1; p = 0.01), male infant (OR 5.2; p = 0.02) and intrauterine growth restriction (IUGR, OR 4.8; p = 0.04) were factors for composite respiratory adverse outcomes. Preterm premature rupture of membranes before viability represents an independent risk factor for composite respiratory adverse outcomes in preterm neonates. Extreme prematurity may represent the main risk factor for both composite respiratory and perinatal adverse outcomes. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  14. Fulminant Epstein-Barr virus - infectious mononucleosis in an adult with liver failure, splenic rupture, and spontaneous esophageal bleeding with ensuing esophageal necrosis: a case report.

    Science.gov (United States)

    Busch, Daniel; Hilswicht, Sarah; Schöb, Dominik S; von Trotha, Klaus T; Junge, Karsten; Gassler, Nikolaus; Truong, Son; Neumann, Ulf P; Binnebösel, Marcel

    2014-02-05

    Infectious mononucleosis is a clinical syndrome most commonly associated with primary Epstein-Barr virus infection. The majority of patients with infectious mononucleosis recovers without apparent sequelae. However, infectious mononucleosis may be associated with several acute complications. In this report we present a rare case of esophageal rupture that has never been described in the literature before. We present the case of an 18-year-old Caucasian man affected by severe infectious mononucleosis complicated by fulminant hepatic failure, splenic rupture and esophageal necrosis. Although primary Epstein-Barr virus infection is rarely fatal, fulminant infection may occur - in this case leading to hepatic failure, splenic rupture and esophageal necrosis, subsequently making several surgical interventions necessary. We show here that infectious mononucleosis is not only a strictly medical condition, but can also lead to severe surgical complications.

  15. Aortic ruptures in seat belt wearers.

    Science.gov (United States)

    Arajärvi, E; Santavirta, S; Tolonen, J

    1989-09-01

    Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the aorta have been intensively investigated, but the relationship between seat belt wearing and injury mechanisms leading to aortic rupture is still largely unknown. This study comprises 4169 fatally injured victims investigated by the Boards of Traffic Accident Investigation of Insurance Companies during the period 1972 to 1985. Chest injuries were recorded as the main cause of death in 1121 (26.9%) victims, 207 (5.0%) of those victims having worn a seat belt. Aortic ruptures were found at autopsy in 98 victims and the exact information of the location of the aortic tears was available in 68. For a control group, we analyzed 72 randomly chosen unbelted victims who had a fatal aortic rupture in similar accidents. The location of the aortic rupture in unbelted victims was more often in the ascending aorta, especially in drivers, whereas in seat belt wearers the distal descending aorta was statistically more often ruptured, especially in right-front passengers (p less than 0.05). The steering wheel predominated statistically as the part of the car estimated to have caused the injury in unbelted victims (37/72), and some interior part of the car was the most common cause of fatal thoracic impacts in seat belt wearers (48/68) (p less than 0.001). The mechanism of rupture of the aorta in the classic site just distal to the subclavian artery seems to be rapid deceleration, although complex body movements are also responsible in side impact collisions. The main mechanism leading to rupture of the ascending aorta seems to be severe blow to the bony thorax. This also often causes associated thoracic injuries, such as heart rupture and sternal fracture. Injuries in the ascending

  16. Initial presentation of a giant gastrointestinal stromal tumour of the stomach with recurrent spontaneous intra-peritoneal haemorrhage

    Directory of Open Access Journals (Sweden)

    Margarida Vinagreiro

    2015-01-01

    Discussion and conclusion: GISTs are uncommon and rarely present with spontaneous intra-peritoneal haemorrhage, which may be life threatening. In our understanding, this is the first reported case of the reviewed literature presenting with a chronic hemoperitoneum, due to recurrent brisk episodes of tumour haemorrhage. Tumour rupture and large tumour size are two poor independent prognostic tumour factors for recurrence. Despite this, the patient remains free of disease after surgery and instituted adjuvant imatinib mesylate.

  17. Spontaneous adrenal pheochromocytoma rupture complicated by intraperitoneal hemorrhage and shock

    Directory of Open Access Journals (Sweden)

    Kwasnik Edward

    2011-08-01

    Full Text Available Abstract MEN2A is a hereditary syndrome characterized by medullary thyroid carcinoma, hyperparathyroidism, and pheochromocytoma. Classically patients with a pheochromocytoma initially present with the triad of paroxysmal headaches, palpitations, and diaphoresis accompanied by marked hypertension. However, although reported as a rare presentation, spontaneous hemorrhage within a pheochromocytoma can present as an abdominal catastrophe. Unrecognized, this transformation can rapidly result in death. We report the only documented case of a thirty eight year old gentleman with MEN2A who presented to a community hospital with hemorrhagic shock and peritonitis secondary to an unrecognized hemorrhagic pheochromocytoma. The clinical course is notable for an inability to localize the source of hemorrhage during an initial damage control laparotomy that stabilized the patient sufficiently to allow emergent transfer to our facility, re-exploration for continued hemorrhage and abdominal compartment syndrome, and ultimately angiographic embolization of the left adrenal artery for control of the bleeding. Following recovery from his critical illness and appropriate medical management for pheochromocytoma, he returned for interval bilateral adrenal gland resection, from which his recovery was unremarkable. Our review of the literature highlights the high mortality associated with the undertaking of an operative intervention in the face of an unrecognized functional pheochromocytoma. This reinforces the need for maintaining a high index of suspicion for pheochromocytoma in similar cases. Our case also demonstrates the need for a mutimodal treatment approach that will often be required in these cases.

  18. Brief communication: sliding displacement of amnion and chorion following controlled laser wounding suggests a mechanism for short-term sealing of ruptured membranes.

    Science.gov (United States)

    Behzad, F; Dickinson, M R; Charlton, A; Aplin, J D

    1994-10-01

    The Erbium-YAG laser was used to produce narrow wounds of defined depth in term amniochorion. The charring effect of the laser meant that sites could be readily localized in histological sections. During brief post-wounding incubations, sliding displacement of the amnion relative to the chorion occurred through the plane of the spongy layer. This suggests a possible short-term mechanism whereby a spontaneous rupture could be sealed in vivo.

  19. Ruptured cornual pregnancy

    International Nuclear Information System (INIS)

    Hussain, M.; Yasmeen, H.; Noorani, K.

    2003-01-01

    A case of ruptured cornual pregnancy is presented here. The patient presented with history of 30 weeks gestational amenorrhoea and pain in the lower abdomen and epigastrium for the last seven days. Ultrasound revealed a 29 weeks abdominal pregnancy with blood in the pelvic cavity. On laparotomy; there was a ruptured right cornual pregnancy, treated cornual resection and uterine repair. An alive male baby of one kg weight was delivered from the resected cornua of the uterus. (author)

  20. Spontaneous fistulization of hepatic hydatid cyst into the duodenum: an exceptional complication

    International Nuclear Information System (INIS)

    Daldoul, S.; Moussi, A.; Zaouche, A.

    2013-01-01

    Hydatid disease is a worldwide zoonosis and is localized in the liver in most cases. Its complications are numerous and include those related to the compression of adjacent viscera, infection of the cyst's contents or perforation of the cyst. Spontaneous rupture of the hepatic hydatid cyst into the duodenum is an extremely rare complication. The communication is, typically, not discovered until surgery. We present two cases of perforation of a liver cyst into the duodenum. One of them was diagnosed pre-operatively by a barium study. The surgical treatment of the lesion and its complications was complex but successful in both cases. (author)

  1. Pulse-Like Rupture Induced by Three-Dimensional Fault Zone Flower Structures

    KAUST Repository

    Pelties, Christian

    2014-07-04

    . The first healing mechanism is dominant for events with hypocenter inside the LVFZ. The second one is dominant if the hypocenter is deeper than a shallow LVFZ. These results suggest that the depth-dependence of rise time might help constrain the depth extent of the LVFZ. We also show that ruptures can spontaneously stop in flower-like LVFZs with uniform velocity reduction, but continue propagating as slip pulses if velocity reduction is depth-dependent.

  2. Triple Achilles Tendon Rupture: Case Report.

    Science.gov (United States)

    Saxena, Amol; Hofer, Deann

    We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill. The patient was able to return to full activity after 26 weeks, including running and refereeing, without limitations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Rupture disc opening property for using pipe rupture test in JAERI

    International Nuclear Information System (INIS)

    Kato, Rokuro

    1983-03-01

    In the Mechanical Strength and Structure Lab of JAERI there are being performed pipe break tests which are a postulated instantaneous guillotine break of the primary coolant piping in nuclear power plants. The test being performed are pipe whip tests and jet discharging tests. The bursting of the rupture disc is initiated by an electrical arc and is concluded by the internal pressure. Because the time characteristics during the opening of the rupture disc affects the dynamic thrust force of the pipe, it is necessary to measure these time characteristics. However, it is difficult to measure the conditions during this continuous opening because at the same time of the opening the high temperature and high pressure water is flashing. Therefore, the rupture disc opening was postulated on the measuring of the effective opening characteristics with electric contraction terminals which were attached to the inner surface of the test pipe downstream of the rupture disc and were extended toward the pipe centerline in a ring whose area is about 60 % of the area of the pipe flow sectional area. The measurement voltage was recorded when the data recorder was started in sequence with the electrical arc release from a trigger signal. As a result, it is evident that under high temperature and high pressure water the effective opening time is delayed by a few milliseconds. (author)

  4. Spontaneous Pneumomediastinum: Hamman Syndrome

    Directory of Open Access Journals (Sweden)

    Tushank Chadha, BS

    2018-04-01

    significant fat stranding. The image also showed an intraluminal stent traversing the gastric antrum and gastric pylorus with no indication of obstruction. Circumferential mural thickening of the gastric antrum and body were consistent with the patient’s history of gastric adenocarcinoma. The shotty perigastric lymph nodes with associated fat stranding, along the greater curvature of the distal gastric body suggested local regional nodal metastases and possible peritoneal carcinomatosis. The thoracic CT scans showed extensive pneumomediastinum that tracked into the soft tissues of the neck, which given the history of vomiting also raised concern for esophageal perforation. There was still no evidence of mediastinal abscess or fat stranding. Additionally, a left subclavian vein port catheter, which terminates with tip at the cavoatrial junction of the superior vena cava can also be seen on the image. Discussion: Spontaneous Pneumomediastinum, also known as Hamman syndrome, is defined by the uncommon incidence of free air in the mediastinum due to the bursting of alveoli, as a result of extended spells of shouting, coughing, or vomiting.1,2 The condition is diagnosed when a clear cause (aerodigestive rupture, barotrauma, infection secondary to gas-forming organisms3 for pneumomediastinum cannot be clearly identified on diagnostic studies. Macklin and Macklin were the first to note the pathogenesis of the syndrome and explained that the common denominator to spontaneous pneumomediastinum was that increased alveolar pressure leads to alveolar rupture.3 Common clinical findings for spontaneous pneumomediastinum include: chest pain, dyspnea, cough, and emesis.4 The condition is not always readily recognized on initial presentation in part for its rare incidence, estimated to be approximately 1 in every 44,500 ED patients3and also because of the non-specific presenting symptoms. For this patient, there was no clear singular cause, and therefore she received care for spontaneous

  5. Splenic rupture masquerading ruptured ectopic pregnancy | Kigbu ...

    African Journals Online (AJOL)

    The classical triad of presentation of delayed menses, irregular vaginal bleeding and abdominal pain may not be encountered at all! Overwhelming features of abdominal pain, amenorrhea, pallor, abdominal tenderness, shifting dullness with positive pregnancy test gave a clinical diagnosis of ruptured ectopic pregnancy.

  6. MRI findings of achilles tendon rupture

    International Nuclear Information System (INIS)

    Zhang Xuezhe

    2009-01-01

    Objective: To evaluate the MRI findings of achilles tendon rupture. Methods: The MRI data of 7 patients with achilles tendon rupture were retrospectively analysed. All 7 patients were male with the age ranging from 34 to 71 years. Routine MR scanning was performed in axial and sagittal planes, including T 1 WI, T 2 WI and a fat suppression MRI (SPIR). Results: Among 7 patients, complete achilles tendon rupture was seen in 6 cases, partial achilles tendon rupture 1 case. The site of tendon disruption were 2.6-11.0 cm( mean 5.4 cm) proximal to the insertion in the calcaneus. The MRI findings of a partial or complete rupture of the achilles tendon included enlarged and thickened achilles tendon (7 cases), wavy lax achilles tendon (2 cases), discontinuity of some or all of its fibers and intratendinous regions of increased signal intensity (7 cases). In the cases of complete tendon rupture, the size of the tendinous gap varied from 3.0-8.0 mm, which was filled with blood and appeared as edema of increase signal intensity on T 2 WI and SPIR. In all 7 patients, MR scanning showed medium signal intensity (7 cases) on T 1 WI, or medium signal intensity (1 cases), medium-high signal intensity (3 cases ), high signal intensity (3 cases) on T 2 WI, and medium-high signal intensity (2 cases), high signal intensity (5 cases) on fat suppression MRI. The preachilles fat pad showed obscure in 6 cases of complete achilles tendon rupture. Conclusion: MRI is an excellent method for revealing achilles tendon rupture and confirming the diagnosis. (authors)

  7. Acute Subdural Hematoma and Subarachnoid Hemorrhage Caused by Ruptured Cortical Artery Aneurysm: Case Report and Review of Literature

    Science.gov (United States)

    Shekarchizadeh, Ahmad; Masih, Saburi; Reza, Pourkhalili; Seif, Bahram

    2017-01-01

    The present report describes an acute subdural hematoma (ASDH) associated with subarachnoid hemorrhage (SAH), due to ruptured cortical aneurysm. To our knowledge, extremely rare cases of this sort have been reported so far. A 23-year-old male patient without previous trauma presented with severe headache and rapidly decreasing level of consciousness to decerebrate status. Computed tomography (CT) scan has demonstrated an ASDH together with SAH. Hematoma has immediately been evacuated without any evaluation by angiography. After evacuation of the thick subdural clot, a 10-mm aneurysm was revealed on a precentral artery of frontal cortex, which was ligated. However, after 35 days the patient discharged with left side hemiparesis and dysphasia, and just after several months of admission he got symptom free. Ruptured cortical aneurysm should be considered as one of the causes of spontaneous ASDH. Vascular anomaly investigations are suggested for these cases, thus CT angiography or digital subtraction angiography has to be considered if clinical condition allows. PMID:28503501

  8. Three-dimensional dynamic rupture simulation with a high-order discontinuous Galerkin method on unstructured tetrahedral meshes

    KAUST Repository

    Pelties, Christian

    2012-02-18

    Accurate and efficient numerical methods to simulate dynamic earthquake rupture and wave propagation in complex media and complex fault geometries are needed to address fundamental questions in earthquake dynamics, to integrate seismic and geodetic data into emerging approaches for dynamic source inversion, and to generate realistic physics-based earthquake scenarios for hazard assessment. Modeling of spontaneous earthquake rupture and seismic wave propagation by a high-order discontinuous Galerkin (DG) method combined with an arbitrarily high-order derivatives (ADER) time integration method was introduced in two dimensions by de la Puente et al. (2009). The ADER-DG method enables high accuracy in space and time and discretization by unstructured meshes. Here we extend this method to three-dimensional dynamic rupture problems. The high geometrical flexibility provided by the usage of tetrahedral elements and the lack of spurious mesh reflections in the ADER-DG method allows the refinement of the mesh close to the fault to model the rupture dynamics adequately while concentrating computational resources only where needed. Moreover, ADER-DG does not generate spurious high-frequency perturbations on the fault and hence does not require artificial Kelvin-Voigt damping. We verify our three-dimensional implementation by comparing results of the SCEC TPV3 test problem with two well-established numerical methods, finite differences, and spectral boundary integral. Furthermore, a convergence study is presented to demonstrate the systematic consistency of the method. To illustrate the capabilities of the high-order accurate ADER-DG scheme on unstructured meshes, we simulate an earthquake scenario, inspired by the 1992 Landers earthquake, that includes curved faults, fault branches, and surface topography. Copyright 2012 by the American Geophysical Union.

  9. Long-term results after repair of ruptured and non-ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Kuzmanović Ilija B.

    2004-01-01

    Full Text Available INTRODUCTION Abdominal aortic aneurysm can be repaired by elective procedure while asymptomatic, or immediately when it is complicated - mostly due to rupture. Treating abdominal aneurysm electively, before it becomes urgent, has medical and economical reason. Today, the first month mortality after elective operations of the abdominal aorta aneurysm is less than 3%; on the other hand, significant mortality (25%-70% has been recorded in patients operated immediately because of rupture of the abdominal aneurysm. In addition, the costs of elective surgical treatment are significantly lower. OBJECTIVE The objective of this study is to compare long-term survival of patients that underwent elective or immediate repair of abdominal aortic aneurysm (due to rupture, and to find out the factors influencing the long-term survival of these patients. MATERIAL AND METHODS Through retrospective review of prospectively collected data of the Institute for Cardiovascular Diseases of Clinical Center of Serbia, Belgrade, 56 patients that had elective surgery and 35 patients that underwent urgent operation due to rupture of abdominal aneurysm were followed up. Only the patients that survived 30 postoperative days were included in this review, and were followed up (ranging from 2 to 126 months. Electively operated patients were followed during 58.82 months on the average (range 7 to 122, and urgently operated were followed over 52.26 months (range 2 to 126. There was no significant difference of the length of postoperative follow-up between these two groups. RESULTS During this period, out of electively operated and immediately operated patients, 27 and 22 cases died, respectively. There was no significant difference (p>0,05a of long-term survival between these two groups. Obesity and early postoperative complications significantly decreased long-term survival of both electively and immediately operated patients. Graft infection, ventral hernia, aneurysm of

  10. Liver Hydatid Cyst with Transdiaphragmatic Rupture and Lung Hydatid Cyst Ruptured into Bronchi and Pleural Space

    International Nuclear Information System (INIS)

    Arıbaş, Bilgin Kadri; Dingil, Gürbüz; Köroğlu, Mert; Üngül, Ümit; Zaralı, Aliye Ceylan

    2011-01-01

    The aim of this case study is to present effectiveness of percutaneous drainage as a treatment option of ruptured lung and liver hydatid cysts. A 65-year-old male patient was admitted with complicated liver and lung hydatid cysts. A liver hydatid cyst had ruptured transdiaphragmatically, and a lung hydatid cyst had ruptured both into bronchi and pleural space. The patient could not undergo surgery because of decreased respiratory function. Both cysts were drained percutaneously using oral albendazole. Povidone–iodine was used to treat the liver cyst after closure of the diaphragmatic rupture. The drainage was considered successful, and the patient had no recurrence of signs and symptoms. Clinical, laboratory, and radiologic recovery was observed during 2.5 months of catheterization. The patient was asymptomatic after catheter drainage. No recurrence was detected during 86 months of follow-up. For inoperable patients with ruptured liver and lung hydatid cysts, percutaneous drainage with oral albendazole is an alternative treatment option to surgery. The percutaneous approach can be life-saving in such cases.

  11. [Simultaneous Traumatic Rupture of Patellar Ligament and Contralateral Rupture of Quadriceps Femoris Muscle].

    Science.gov (United States)

    Hladký, V; Havlas, V

    2017-01-01

    Our paper presents a unique case of a 64-year-old patient after a fall, treated with oral antidiabetic drugs for type II diabetes mellitus. Following a series of examinations, a bilateral injury was diagnosed - patellar ligament tear on the right side and rupture of quadriceps femoris muscle on the left side. It is a rare injury, complicated by simultaneous involvement of both knee joints. The used therapy consisted of a bilateral surgery followed by gradual verticalisation, first with the support of a walking frame and later with the use of forearm crutches. During the final examination, the patient demonstrated full flexion at both knees, while an extension deficit of approx. 5 degrees was still present on the left side. The right knee X-ray showed a proper position of the patella after the removal of temporary tension band wire. Although the clinical results of operative treatment of both the patellar ligament rupture and rupture of quadriceps femoris muscle are in most cases good, early operative treatment, proper technique and post-operative rehabilitation are a prerequisite for success. Key words: knee injuries, patellar ligament, quadriceps muscle, rupture.

  12. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether untre...

  13. Anatomic characteristics of bileaflet mitral valve prolapse--Barlow disease--in patients undergoing mitral valve repair.

    Science.gov (United States)

    Rostagno, Carlo; Droandi, Ginevra; Rossi, Alessandra; Bevilacqua, Sergio; Romagnoli, Stefano; Montesi, Gian Franco; Stefàno, Pier Luigi

    2014-01-01

    Barlow disease is a still challenging pathology for the surgeon. Aim of the present study is to report anatomic abnormalities of mitral valve in patients undergoing mitral valve repair. Between January 1st, 2007, and December 31st, 2010, 85 consecutive patients (54 men and 31 women, mean age 59 +/- 14 years--range: 28-85 years) with the features of a Barlow mitral valve disease underwent mitral repair Forty seven percent of patients were in New York Heart Association functional class III or IV. Preoperative transesophageal echocardiography was compared with anatomical findings at the moment of surgery. Transthoracic echocardiography diagnosis of Barlow disease according to the criteria described by Carpentier was confirmed at anatomical inspection. Annular calcifications were found in 28 patients while 7 patients presented single or multiple clefts. A flail posterior mitral leaflet was detected in 32 subjects, while a flail anterior leaflet in 8. Elongation of chordae tendineae was demonstrated in 45 patients and chordal rupture in 31. All patients showed at trans esophageal echocardiography the typical features of Barlow disease. Seventy-seven (90.6%) patients had severe mitral valve regurgitation, in the remaining 9.4% it was moderate to severe. Transesophageal echocardiography failed to identify clefts in 2/7 and chordal rupture in 4/31. bileaflet prolapse > 2 mm, billowing valve with excess tissue and thickened leaflets > or = 3 mm, and severe annular dilatation, are characteristics of Barlow disease, however the identification of the associated and complex abnormalities of mitral valve is necessary to obtain optimal valve repair.

  14. Arthroscintigraphy in suspected rotator cuff rupture

    International Nuclear Information System (INIS)

    Gratz, S.; Behr, T.; Becker, W.; Koester, G.; Vosshenrich, R.; Grabbe, E.

    1998-01-01

    Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n=20), contrast arthrography (n=20) and arthroscopy (n=10) of the shoulder joint. Methods: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBU-RES 400 μCi/5 ml). The application was performed either in direct combination with contrast arthrography (n=10) or ultrasound conducted mixed with a local anesthetic (n=10). Findings at arthroscopical surgery (n=10) were used as the gold standard. Results: In case of complete rotator cuff rupture (n=5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistant. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. Conclusion: Arthroscinitgraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures. (orig.) [de

  15. Determinants of the competing outcomes of intrauterine infection, abruption, or spontaneous preterm birth after preterm premature rupture of membranes.

    Science.gov (United States)

    Hackney, David N; Kuo, Kelly; Petersen, Rebecca J; Lappen, Justin R

    2016-01-01

    Patients with PPROM are at risk for a variety of outcomes, including chorioamnionitis (CA), placental abruption (PA), or preterm labor (PTL). Competing risk regression can analyze a cohort's risk of individual outcomes while accounting for ongoing deliveries secondary to competing events. A secondary analysis of the subjects from MFMU BEAM study of neuroprotection after preterm birth (BEAM) with conservative PPROM management. Deliveries were categorized as: PA, CA, PTL, "elective" or "indicated". The association between outcomes of PA, CA or PTL and clinical predictors of twins, ethnicity, parity, gestational age at rupture, bleeding, contractions, cervical dilation, preterm birth history, weight, and genitourinary infections were evaluated via competing risk regression. 1970 subjects were included. The significance and directionality of predictors varied according to specific outcomes. Patients with twins had an increased PTL hazard (1.85) though reductions in CA- (0.66) or PA-specific (0.56) hazards. Decreased latency in African-Americans was almost entirely due to an increased CA hazard (1.44) without a significant association with PTL. Increasing gestational age at membrane rupture was associated with a decreasing hazard of CA although increasing hazard of PTL. For patients with PPROM, the hazards associated with different clinical predictors vary according to exact outcomes.

  16. Creep-rupture behavior of candidate Stirling engine iron supperalloys in high-pressure hydrogen. Volume 2: Hydrogen creep-rupture behavior

    Science.gov (United States)

    Bhattacharyya, S.; Peterman, W.; Hales, C.

    1984-01-01

    The creep rupture behavior of nine iron base and one cobalt base candidate Stirling engine alloys is evaluated. Rupture life, minimum creep rate, and time to 1% strain data are analyzed. The 3500 h rupture life stress and stress to obtain 1% strain in 3500 h are also estimated.

  17. Neck curve polynomials in neck rupture model

    International Nuclear Information System (INIS)

    Kurniadi, Rizal; Perkasa, Yudha S.; Waris, Abdul

    2012-01-01

    The Neck Rupture Model is a model that explains the scission process which has smallest radius in liquid drop at certain position. Old fashion of rupture position is determined randomly so that has been called as Random Neck Rupture Model (RNRM). The neck curve polynomials have been employed in the Neck Rupture Model for calculation the fission yield of neutron induced fission reaction of 280 X 90 with changing of order of polynomials as well as temperature. The neck curve polynomials approximation shows the important effects in shaping of fission yield curve.

  18. Comparison between smaller ruptured intracranial aneurysm and larger un-ruptured intracranial aneurysm: gene expression profile analysis.

    Science.gov (United States)

    Li, Hao; Li, Haowen; Yue, Haiyan; Wang, Wen; Yu, Lanbing; ShuoWang; Cao, Yong; Zhao, Jizong

    2017-07-01

    As it grows in size, an intracranial aneurysm (IA) is prone to rupture. In this study, we compared two extreme groups of IAs, ruptured IAs (RIAs) smaller than 10 mm and un-ruptured IAs (UIAs) larger than 10 mm, to investigate the genes involved in the facilitation and prevention of IA rupture. The aneurismal walls of 6 smaller saccular RIAs (size smaller than 10 mm), 6 larger saccular UIAs (size larger than 10 mm) and 12 paired control arteries were obtained during surgery. The transcription profiles of these samples were studied by microarray analysis. RT-qPCR was used to confirm the expression of the genes of interest. In addition, functional group analysis of the differentially expressed genes was performed. Between smaller RIAs and larger UIAs, 101 genes and 179 genes were significantly over-expressed, respectively. In addition, functional group analysis demonstrated that the up-regulated genes in smaller RIAs mainly participated in the cellular response to metal ions and inorganic substances, while most of the up-regulated genes in larger UIAs were involved in inflammation and extracellular matrix (ECM) organization. Moreover, compared with control arteries, inflammation was up-regulated and muscle-related biological processes were down-regulated in both smaller RIAs and larger UIAs. The genes involved in the cellular response to metal ions and inorganic substances may facilitate the rupture of IAs. In addition, the healing process, involving inflammation and ECM organization, may protect IAs from rupture.

  19. Ruptured gastroepiploic artery aneurysm: A case report

    Directory of Open Access Journals (Sweden)

    Ahmad S. Ashrafi

    Full Text Available Introduction: Gastroepiploic artery aneurysms are extremely rare, with few reported cases in the literature. The risk of rupture however, is high and thus warrants attention. Presentation of case: Here we present a rare case of a women who presented to the emergency department in shock and was found to have a ruptured gastroepiploic artery aneurysm during surgical exploration. Suture ligation of the aneurysm was completed. Discussion: Although rare, gastroepiploic artery aneurysms have up to a 90% rate of rupture and therefore require intervention. A laparoscopic approach has been described however, in cases where rupture has occurred, urgent laparotomy and control of hemorrhage is needed. Conclusion: We describe a rare case of a ruptured gastroepiploic aneurysm that was successfully managed with urgent laparotomy and aneurysmal resection. Keywords: Gastroepiploic, Aneurysm, Hemorrhage, Case report

  20. Comparing slow and fast rupture in laboratory experiments

    Science.gov (United States)

    Aben, F. M.; Brantut, N.; David, E.; Mitchell, T. M.

    2017-12-01

    During the brittle failure of rock, elastically stored energy is converted into a localized fracture plane and surrounding fracture damage, seismic radiation, and thermal energy. However, the partitioning of energy might vary with the rate of elastic energy release during failure. Here, we present the results of controlled (slow) and dynamic (fast) rupture experiments on dry Lanhélin granite and Westerly granite samples, performed under triaxial stress conditions at confining pressures of 50 and 100 MPa. During the tests, we measured sample shortening, axial load and local strains (with 2 pairs of strain gauges glued directly onto the sample). In addition, acoustic emissions (AEs) and changes in seismic velocities were monitored. The AE rate was used as an indicator to manually control the axial load on the sample to stabilize rupture in the quasi-static failure experiments. For the dynamic rupture experiments a constant strain rate of 10-5 s-1 was applied until sample failure. A third experiment, labeled semi-controlled rupture, involved controlled rupture up to a point where the rupture became unstable and the remaining elastic energy was released dynamically. All experiments were concluded after a macroscopic fracture had developed across the whole sample and frictional sliding commenced. Post-mortem samples were epoxied, cut and polished to reveal the macroscopic fracture and the surrounding damage zone. The samples failed with average rupture velocities varying from 5x10-6 m/s up to >> 0.1 m/s. The analyses of AE locations on the slow ruptures reveal that within Westerly granite samples - with a smaller grain size - fracture planes are disbanded in favor of other planes when a geometrical irregularity is encountered. For the coarser grained Lanhélin granite a single fracture plane is always formed, although irregularities are recognized as well. The semi-controlled experiments show that for both rock types the rupture can become unstable in response to these

  1. Ruptured Spleen

    Science.gov (United States)

    ... be caused by various underlying problems, such as mononucleosis and other infections, liver disease, and blood cancers. ... cause a ruptured spleen. For instance, people with mononucleosis — a viral infection that can cause an enlarged ...

  2. Comparison of maternal omentin-1 levels and genetic variability between spontaneous term and preterm births.

    Science.gov (United States)

    Šplíchal, Zbyněk; Zlámal, Filip; Máchal, Jan; Lipková, Jolana; Pavlová, Tereza; Hodická, Zuzana; Ventruba, Pavel; Vašků, Anna; Bienertová-Vašků, Julie

    2018-07-01

    To determine maternal omentin-1 levels and genetic variability in the omentin-1 gene in women with spontaneous term and preterm births (PTBs). Maternal serum omentin-1 levels and the role of the omentin-1 Val109Asp (rs2274907) polymorphism were evaluated in 32 women with spontaneous term birth (sTB) and 30 women with spontaneous preterm birth (sPTB) including women with (n = 16) and without (n = 14) preterm premature rupture of membranes (PPROM). Maternal omentin-1 levels were significantly lower in women with sPTBs compared to term births during the hospitalization period (p = .015). However, maternal omentin-1 levels were similar in women with sPTBs with and without PPROM (p = .990). Furthermore, the omentin-1 Val109Asp polymorphism was found to have no significant effect on omentin-1 serum levels. In addition, no significant differences in genotype distributions and allelic frequencies between sTB and sPTB were established. High omentin-1 levels in normal sTBs compared to PTBs without significant differences between cases with and without PPROM suggest that omentin-1 plays a potential role in the pathophysiology of PTB but not in the PPROM mechanism itself.

  3. Acute Iliac Artery Rupture: Endovascular Treatment

    International Nuclear Information System (INIS)

    Chatziioannou, A.; Mourikis, D.; Katsimilis, J.; Skiadas, V.; Koutoulidis, V.; Katsenis, K.; Vlahos, L.

    2007-01-01

    The authors present 7 patients who suffered iliac artery rupture over a 2 year period. In 5 patients, the rupture was iatrogenic: 4 cases were secondary to balloon angioplasty for iliac artery stenosis and 1 occurred during coronary angioplasty. In the last 2 patients, the rupture was secondary to iliac artery mycotic aneurysm. Direct placement of a stent-graft was performed in all cases, which was dilated until extravasation was controlled. Placement of the stent-graft was successful in all the cases, without any complications. The techniques used, results, and mid-term follow-up are presented. In conclusion, endovascular placement of a stent-graft is a quick, minimally invasive, efficient, and safe method for emergency treatment of acute iliac artery rupture, with satisfactory short- and mid-term results

  4. CT diagnosis of ruptured abdominal aortic aneurysm

    International Nuclear Information System (INIS)

    Sacknoff, R.; Novelline, R.A.; Wittenberg, J.; Waltman, A.C.; De Luca, S.A.; Rhea, J.T.; Lawrason, J.N.

    1986-01-01

    Ruptured abdominal aortic aneurysm (AAA) is a life-threatening condition requiring immediate diagnosis and surgery. In a series of 23 consecutive patients scanned by CT for suspected ruptured AAA, CT proved 100% accurate. In seven patients with surgically or pathologically proved ruptured AAA, CT demonstrated a similar distribution of hemorrhage into the perirenal space and to a lesser degree into the anterior and posterior pararenal spaces. The 16 true-negative examinations included ten in patients with unruptured AAA and six in patients with other diseases. The authors conclude that patients in stable condition with suspected ruptured AAA should be examined by CT

  5. High-risk human papillomavirus infection is associated with premature rupture of membranes.

    Science.gov (United States)

    Cho, GeumJoon; Min, Kyung-Jin; Hong, Hye-Ri; Kim, SuhngWook; Hong, Jin-Hwa; Lee, Jae-Kwan; Oh, Min-Jeong; Kim, HaiJoong

    2013-09-06

    Human papillomavirus (HPV) is known to be more prevalent in spontaneous abortions than in elective terminations of pregnancy. More recently, placental infection with HPV was shown to be associated with spontaneous preterm delivery. However, no study has evaluated the prevalence of HPV infection in pregnant Korean females and its association with adverse pregnancy outcomes. We conducted a cross-sectional study of 311 females who gave birth at Korea University Medical Center. Our sample included 45 preterm deliveries, 50 cases of premature rupture of the membranes (PROM), 21 preeclampsia cases, and 8 gestational diabetes mellitus (GDM) patients. We used the Hybrid Capture II system to detect high-risk (HR)-HPV infection at six weeks postpartum. The prevalence of HR-HPV infection was 14.1%. Women with HR-HPV infection had a higher incidence of PROM than those without HR-HPV. HR-HPV infection was associated with an increased risk of PROM (OR, 2.380; 95% CI, 1.103-5.134). The prevalence of preterm delivery, preeclampsia, or GDM was not different between the two groups. We observed a high prevalence of HR-HPV infection in pregnant women. Moreover, HR-HPV infection was associated with a risk of PROM at term. Further studies are needed to evaluate mechanisms by which HR-HPV infection induces PROM.

  6. Metrics for comparing dynamic earthquake rupture simulations

    Science.gov (United States)

    Barall, Michael; Harris, Ruth A.

    2014-01-01

    Earthquakes are complex events that involve a myriad of interactions among multiple geologic features and processes. One of the tools that is available to assist with their study is computer simulation, particularly dynamic rupture simulation. A dynamic rupture simulation is a numerical model of the physical processes that occur during an earthquake. Starting with the fault geometry, friction constitutive law, initial stress conditions, and assumptions about the condition and response of the near‐fault rocks, a dynamic earthquake rupture simulation calculates the evolution of fault slip and stress over time as part of the elastodynamic numerical solution (Ⓔ see the simulation description in the electronic supplement to this article). The complexity of the computations in a dynamic rupture simulation make it challenging to verify that the computer code is operating as intended, because there are no exact analytic solutions against which these codes’ results can be directly compared. One approach for checking if dynamic rupture computer codes are working satisfactorily is to compare each code’s results with the results of other dynamic rupture codes running the same earthquake simulation benchmark. To perform such a comparison consistently, it is necessary to have quantitative metrics. In this paper, we present a new method for quantitatively comparing the results of dynamic earthquake rupture computer simulation codes.

  7. Spontaneous Splenic Rupture Following Intravenous Thrombolysis with Alteplase Applied as Stroke Therapy – Case Report and Review of Literature

    Science.gov (United States)

    Aleksic-Shihabi, Anka; Jadrijevic, Eni; Milekic, Nina; Bulicic, Ana Repic; Titlic, Marina; Suljic, Enra

    2016-01-01

    Introduction: Stroke is a medical emergency in neurology, and is one of the leading causes of death nowadays. At a recent time, a therapeutic method used in adequate conditions is thrombolysis, a treatment of an emerging clot in the brain vascular system by alteplase. The application of alteplase also has a high risk of life threatening conditions. Case report: This is a brief report of a case with thrombolysis complication which manifested as a spleen rupture. PMID:26980937

  8. Physical therapy in the conservative treatment for anterior cruciate ligament rupture followed by contralateral rupture: case report

    OpenAIRE

    Almeida, Gabriel Peixoto Leão; Arruda, Gilvan de Oliveira; Marques, Amélia Pasqual

    2014-01-01

    Although the surgical reconstruction be the obvious indication for the anterior cruciate ligament (ACL) lesion, there is no consensus on whether the results of surgery are superior to those obtained with nonsurgical management. The objective of this report was to describe a case of nonsurgical treatment for ACL rupture followed by a contralateral rupture. A 28-year-old female practitioner of muay-thai and handball suffered a non-contact ACL rupture in the left knee, and three months after the...

  9. Use of ICD-10 codes to monitor uterine rupture

    DEFF Research Database (Denmark)

    Thisted, Dorthe L A; Mortensen, Laust Hvas; Hvidman, Lone

    2014-01-01

    OBJECTIVES: Uterine rupture is a rare but severe complication in pregnancies after a previous cesarean section. In Denmark, the monitoring of uterine rupture is based on reporting of relevant diagnostic codes to the Danish Medical Birth Registry (MBR). The aim of our study was to examine the vali......OBJECTIVES: Uterine rupture is a rare but severe complication in pregnancies after a previous cesarean section. In Denmark, the monitoring of uterine rupture is based on reporting of relevant diagnostic codes to the Danish Medical Birth Registry (MBR). The aim of our study was to examine...... uterine ruptures, the sensitivity and specificity of the codes for uterine rupture were 83.8% and 99.1%, respectively. CONCLUSION: During the study period the monitoring of uterine rupture in the MBR was inadequate....

  10. Traumatic Fundal Rupture of unscarred Uterus in a Primigravida ...

    African Journals Online (AJOL)

    Background: Uterine rupture is an infrequent but life threatening obstetric emergency. Rupture of previously scarred uterus is often encountered especially in multiparous women, but the traumatic rupture of an unscarred primigravid uterus as presented here is a relatively rare event. We report a case of rupture of an ...

  11. Linguine sign in musculoskeletal imaging: calf silicone implant rupture.

    Science.gov (United States)

    Duryea, Dennis; Petscavage-Thomas, Jonelle; Frauenhoffer, Elizabeth E; Walker, Eric A

    2015-08-01

    Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition.

  12. Physics of Earthquake Rupture Propagation

    Science.gov (United States)

    Xu, Shiqing; Fukuyama, Eiichi; Sagy, Amir; Doan, Mai-Linh

    2018-05-01

    A comprehensive understanding of earthquake rupture propagation requires the study of not only the sudden release of elastic strain energy during co-seismic slip, but also of other processes that operate at a variety of spatiotemporal scales. For example, the accumulation of the elastic strain energy usually takes decades to hundreds of years, and rupture propagation and termination modify the bulk properties of the surrounding medium that can influence the behavior of future earthquakes. To share recent findings in the multiscale investigation of earthquake rupture propagation, we held a session entitled "Physics of Earthquake Rupture Propagation" during the 2016 American Geophysical Union (AGU) Fall Meeting in San Francisco. The session included 46 poster and 32 oral presentations, reporting observations of natural earthquakes, numerical and experimental simulations of earthquake ruptures, and studies of earthquake fault friction. These presentations and discussions during and after the session suggested a need to document more formally the research findings, particularly new observations and views different from conventional ones, complexities in fault zone properties and loading conditions, the diversity of fault slip modes and their interactions, the evaluation of observational and model uncertainties, and comparison between empirical and physics-based models. Therefore, we organize this Special Issue (SI) of Tectonophysics under the same title as our AGU session, hoping to inspire future investigations. Eighteen articles (marked with "this issue") are included in this SI and grouped into the following six categories.

  13. Acute Pectoralis Major Rupture Captured on Video

    Directory of Open Access Journals (Sweden)

    Alejandro Ordas Bayon

    2016-01-01

    Full Text Available Pectoralis major (PM ruptures are uncommon injuries, although they are becoming more frequent. We report a case of a PM rupture in a young male who presented with axillar pain and absence of the anterior axillary fold after he perceived a snap while lifting 200 kg in the bench press. Diagnosis of PM rupture was suspected clinically and confirmed with imaging studies. The patient was treated surgically, reinserting the tendon to the humerus with suture anchors. One-year follow-up showed excellent results. The patient was recording his training on video, so we can observe in detail the most common mechanism of injury of PM rupture.

  14. Decision-Based Transcription of Jazz Guitar Solos Using a Harmonic Bident Analysis Filter Bank and Spectral Distribution Weighting

    OpenAIRE

    Gorlow, Stanislaw; Ramona, Mathieu; Pachet, François

    2016-01-01

    Jazz guitar solos are improvised melody lines played on one instrument on top of a chordal accompaniment (comping). As the improvisation happens spontaneously, a reference score is non-existent, only a lead sheet. There are situations, however, when one would like to have the original melody lines in the form of notated music, see the Real Book. The motivation is either for the purpose of practice and imitation or for musical analysis. In this work, an automatic transcriber for jazz guitar so...

  15. ACL Rupture in Collegiate Wrestler

    Directory of Open Access Journals (Sweden)

    Lindsay A. Palmer

    2016-05-01

    Full Text Available Objective: To educate others on unique Anterior Cruciate Ligament tears and percentage of usage of the ACL in normal daily function. Background: Patient is an eighteen year old male participating in wrestling and football at the time of the injury. Patient now only participates in wrestling. No previous knee or chronic injuries were reported prior to this injury. Patient was playing football during the time of injury. The patient stated that he planted his foot down and was tackled at the same time when the injury occurred. The patient felt his knee twist and buckle. Patient complained of clicking inside the knee and had minimal swelling. He also complained of it being difficult to bear weight at the time. The patient did not seek further treatment until two months after the injury occurred when he received an MRI. His MRI showed a positive finding for an Anterior Cruciate Ligament rupture. His previous Athletic Trainer could not find a positive diagnosis for the patient prior to the MRI. Differential Diagnosis: Possible meniscal or ACL injury. Treatment: Doctors officially diagnosed the injury as a complete rupture of the ACL. The patient did not receive surgery immediately. Doctors have stated that he only uses about 50% of his ACL on a daily basis compared to a normal person who uses about 95% of their ACL daily. Because of this, the patient played on his rupture for seven months before receiving surgery. He played a whole season of high school football and a whole season of wrestling his senior year with the ACL ruptured. The patient only used a brace for better comfort during the seven months. The patient then received reconstructive surgery to repair the rupture. A hamstring tendon graft was used to repair the ruptured ACL. Because a tendon was taken from the hamstring, patient experienced a tight ACL and hamstring of the left leg post-surgery. The patient participated in Physical Therapy for five months to strengthen and stretch the new

  16. Describing Soils: Calibration Tool for Teaching Soil Rupture Resistance

    Science.gov (United States)

    Seybold, C. A.; Harms, D. S.; Grossman, R. B.

    2009-01-01

    Rupture resistance is a measure of the strength of a soil to withstand an applied stress or resist deformation. In soil survey, during routine soil descriptions, rupture resistance is described for each horizon or layer in the soil profile. The lower portion of the rupture resistance classes are assigned based on rupture between thumb and…

  17. Spontaneous release of epiretinal membrane in a young weight-lifting athlete by presumed central rupture and centrifugal pull

    Directory of Open Access Journals (Sweden)

    Mansour AM

    2014-11-01

    Full Text Available Ahmad M Mansour,1,2 Hana A Mansour,3 J Fernando Arevalo4,5 1Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon; 2Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 3Department of Biology, American University of Beirut, Beirut, Lebanon; 4Retina Department, The King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia; 5Retina Department, Wilmer Eye Institute, The Johns Hopkins University, Baltimore, MD, USA Abstract: This patient presented for surgery at the age of 32 years, 14 months after his initial complaint of metamorphopsia and visual loss in the right eye. Past tests demonstrated a whitish epiretinal membrane (ERM with translucent stress lines over a thickened macula. Visual acuity was found on last presentation to be normal with minimal alteration on Amsler grid testing. A torn ERM was found in the center with left-over ERM temporally and rolled-over ERM nasally at the site of the epicenter with no posterior vitreous detachment. Visual recovery occurred gradually over several days 2 months prior to presentation apparently following heavy weight-lifting with a sensation of severe eye pressure. Sequential funduscopy and optical coherence tomography scans demonstrated the peeling of an ERM accompanied by normalization of foveal thickness. Valsalva maneuver had put excessive tension on ERM which tore in its center at the weakest line with gradual contraction of the ERM away from the fovea towards the peripapillary area. This is a new mechanism of self-separation of ERM induced by Valsalva. ERM in young subjects is subject to rupture and subsequent separation by tangential traction. There are three mechanisms for spontaneous separation of ERM: 1 posterior vitreous detachment with pulling of ERM by detaching vitreous (most common in adults; 2 the contracting forces of the immature ERM become stronger than its adhesions to the retina resulting in slow tangential traction on the

  18. Linguine sign in musculoskeletal imaging: calf silicone implant rupture

    International Nuclear Information System (INIS)

    Duryea, Dennis; Petscavage-Thomas, Jonelle; Frauenhoffer, Elizabeth E.; Walker, Eric A.

    2015-01-01

    Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition. (orig.)

  19. Linguine sign in musculoskeletal imaging: calf silicone implant rupture

    Energy Technology Data Exchange (ETDEWEB)

    Duryea, Dennis; Petscavage-Thomas, Jonelle [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Frauenhoffer, Elizabeth E. [Milton S. Hershey Medical Center, Department of Pathology, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD, 20814 (United States)

    2015-08-15

    Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition. (orig.)

  20. Uterine rupture without previous caesarean delivery

    DEFF Research Database (Denmark)

    Thisted, Dorthe L. A.; H. Mortensen, Laust; Krebs, Lone

    2015-01-01

    to uterine rupture when adjusted for parity, epidural analgesia and augmentation by oxytocin. CONCLUSION: Although uterine rupture is rare, its association with epidural analgesia and augmentation of labour with oxytocin in multipara should be considered. Thus, vigilance should be exercised when labour...

  1. Coiling of ruptured pericallosal artery aneurysms.

    NARCIS (Netherlands)

    Menovsky, T.; Rooij, W.J.J. van; Sluzewski, M.; Wijnalda, D.

    2002-01-01

    OBJECTIVE: To assess the technical feasibility of treating ruptured pericallosal artery aneurysms with detachable coils and to evaluate the anatomic and clinical results. METHODS: Over a period of 27 months, 12 patients with a ruptured pericallosal artery aneurysm were treated with detachable

  2. Multi-Fault Rupture Scenarios in the Brawley Seismic Zone

    Science.gov (United States)

    Kyriakopoulos, C.; Oglesby, D. D.; Rockwell, T. K.; Meltzner, A. J.; Barall, M.

    2017-12-01

    Dynamic rupture complexity is strongly affected by both the geometric configuration of a network of faults and pre-stress conditions. Between those two, the geometric configuration is more likely to be anticipated prior to an event. An important factor in the unpredictability of the final rupture pattern of a group of faults is the time-dependent interaction between them. Dynamic rupture models provide a means to investigate this otherwise inscrutable processes. The Brawley Seismic Zone in Southern California is an area in which this approach might be important for inferring potential earthquake sizes and rupture patterns. Dynamic modeling can illuminate how the main faults in this area, the Southern San Andreas (SSAF) and Imperial faults, might interact with the intersecting cross faults, and how the cross faults may modulate rupture on the main faults. We perform 3D finite element modeling of potential earthquakes in this zone assuming an extended array of faults (Figure). Our results include a wide range of ruptures and fault behaviors depending on assumptions about nucleation location, geometric setup, pre-stress conditions, and locking depth. For example, in the majority of our models the cross faults do not strongly participate in the rupture process, giving the impression that they are not typically an aid or an obstacle to the rupture propagation. However, in some cases, particularly when rupture proceeds slowly on the main faults, the cross faults indeed can participate with significant slip, and can even cause rupture termination on one of the main faults. Furthermore, in a complex network of faults we should not preclude the possibility of a large event nucleating on a smaller fault (e.g. a cross fault) and eventually promoting rupture on the main structure. Recent examples include the 2010 Mw 7.1 Darfield (New Zealand) and Mw 7.2 El Mayor-Cucapah (Mexico) earthquakes, where rupture started on a smaller adjacent segment and later cascaded into a larger

  3. Physics of Earthquake Disaster: From Crustal Rupture to Building Collapse

    Science.gov (United States)

    Uenishi, Koji

    2018-05-01

    Earthquakes of relatively greater magnitude may cause serious, sometimes unexpected failures of natural and human-made structures, either on the surface, underground, or even at sea. In this review, by treating several examples of extraordinary earthquake-related failures that range from the collapse of every second building in a commune to the initiation of spontaneous crustal rupture at depth, we consider the physical background behind the apparently abnormal earthquake disaster. Simple but rigorous dynamic analyses reveal that such seemingly unusual failures actually occurred for obvious reasons, which may remain unrecognized in part because in conventional seismic analyses only kinematic aspects of the effects of lower-frequency seismic waves below 1 Hz are normally considered. Instead of kinematics, some dynamic approach that takes into account the influence of higher-frequency components of waves over 1 Hz will be needed to anticipate and explain such extraordinary phenomena and mitigate the impact of earthquake disaster in the future.

  4. [Effects of posterior tibial slope on non-contact anterior cruciate ligament rupture and stability of anterior cruciate ligament rupture knee].

    Science.gov (United States)

    Yue, De-bo; E, Sen; Wang, Bai-liang; Wang, Wei-guo; Guo, Wan-shou; Zhang, Qi-dong

    2013-05-07

    To retrospectively explore the correlation between anterior cruciate ligament (ACL)-ruptured knees, stability of ACL-rupture knee and posterior tibial slope (PTS). From January 2008 to October 2012, 150 knees with ACL rupture underwent arthroscopic surgery for ACL reconstruction. A control group was established for subjects undergoing arthroscopic surgery without ACL rupture during the same period. PTS was measured on a digitalized lateral radiograph. Lachman and mechanized pivot shift tests were performed for assessing the stability of knee. There was significant difference (P = 0.007) in PTS angle between the patients with ACL rupture (9.5 ± 2.2 degrees) and the control group (6.6 ± 1.8 degrees). Only among females, increased slope of tibial plateau had effect on the Lachman test. There was a higher positive rate of pivot shift test in patients of increased posterior slope in the ACL rupture group. Increased posterior tibial slope (>6.6) appears to contribute to non-contact ACL injuries in females. And the changes of tibial slope have no effect upon the Lachman test. However, large changes in tibial slope affect pivot shift.

  5. Factors that influence the timing of spontaneous labor at term.

    Science.gov (United States)

    Fogleman, Kelly A; Herring, Amy H; Kaczor, Diane; Pusek, Susan N; Jo, Hyejin; Thorp, John M

    2007-11-01

    Whether pre-term birth culminates as a result of a de novo pathologic process or is more simply early activation of physiologic mechanisms is unknown. Exploration of the onset of labor in term women with classical risk factors for early delivery might provide insights into the mechanisms leading to pre-term birth. This study examines whether sociodemographic factors known to increase the risk of pre-term birth also affect the length of term gestations. From a large prospective cohort composed of women delivering from 1995-2000, a sample was selected of 441 women from Central North Carolina, US, who delivered singletons after 37 weeks gestation. An algorithm was designed to identify induced labors and gestational age was censored at the time of induction. Gestational age was assigned by sonography and menstrual dating. Data were analysed using the Cox proportional hazards model. The main outcome measure was time to spontaneous labor. Women with 12 years of education had longer periods of gestation than women with less than 12 years of education, HR = 0.57 [0.39, 0.84]. Shorter gestational periods were found for women with pre-term premature rupture of membranes (PPROM) in a previous pregnancy, HR = 3.70 [1.60, 8.52], even after adjusting for confounders. Smoking was not associated (p > 0.1) with the timing of labor at term. By studying the timing of spontaneous parturition at term we identified that there is little overlap in risk factors that affect timing of delivery between spontaneous term and pre-term births.

  6. Endovascular therapeutic strategies in ruptured intracranial aneurysms

    International Nuclear Information System (INIS)

    Machi, Paolo; Lobotesis, Kyriakos; Vendrell, Jean Francoise; Riquelme, Carlos; Eker, Omer; Costalat, Vincent; Bonafe, Alain

    2013-01-01

    The aim of the present study was to evaluate endovascular techniques used currently which were not available at the time of ISAT inclusion period, such as balloon remodelling and flow-divertion, in order to assess whether these new technologies have improved the endovascular approach outcomes. We present a review of articles, published in major journals, with the aim to evaluate the efficacy and the safety of coiling with balloon remodelling for the treatment of ruptured aneurysms in comparison to coiling performed without such coadjutant techniques. Furthermore, we reviewed publications reporting on the treatment of ruptured aneurysms in the acute phase with the one of the most recent technologies available nowadays: the flow diverting stent. Looking at the recent literature the results regarding ruptured aneurysms treated with balloon assisted coiling (BAC) have shown an improvement in terms of anatomical results and morbi-mortality rates. Case series of ruptured middle cerebral artery (MCA) aneurysms treated by EVT report results similar to those obtained by surgical clipping. Several articles recently report encouraging results in treating ruptured dissecting and blister aneurysms with flow diverters. Questions regarding the best treatment available for ruptured aneurysms are yet to be answered. Hence there is a need for a subsequent trial aiming to answer these unresolved issues

  7. Cas clinique: Peritonite aigue par rupture non traumatique de la vessie

    Directory of Open Access Journals (Sweden)

    A. Makni

    2012-06-01

    Full Text Available La rupture vésicale spontanée (RVS, aux facteurs étiologiques variés, est rare Un homme âgé de 70 ans présentait une péritonite généralisée, une rétention urinaire aigue et une hématurie. La laparotomie exploratrice avait mis en évidence une perforation du dôme vésical qui a été obturée avec des suites immédiates simples. Les berges de la perforation n'avaient pas de lésion inflammatoire ni tumorale. L'enquête étiologique avait conclu à un cancer prostatique localement avancé. Le décès du patient était survenu 2 mois après. Les auteurs ont revu les causes, le diagnostic et le traitement des RSV.

  8. RESEARCH ON REDUCING PREMATURITY RUPTURE OF MEMBRANE

    Directory of Open Access Journals (Sweden)

    Maria URSACHI (BOLOTA

    2016-12-01

    Full Text Available The membranes surrounding the amniotic cavity are composed from amnion and chorion, tightly adherent layers which are composed of several cell types, including epithelial cells, trophoblasts cells and mesenchyme cells, embedded in a collagenous matrix. They retain amniotic fluid, secret substances into the amniotic fluid, as well as to the uterus and protect the fetus against upward infections from urogenital tract. Normally, the membranes it breaks during labor. Premature rupture of the amniotic sac (PRAS is defined as rupture of membranes before the onset of labor. Premature rupture of the fetal membrane, which occurs before 37 weeks of gestation, usually, refers to preterm premature rupture of membranes. Despite advances in the care period, premature rupture of membranes and premature rupture of membranes preterm continue to be regarded as serious obstetric complications. On the term 8% - 10% of pregnant women have premature rupture of membranes; these women are at increased risk of intrauterine infections, where the interval between membrane rupture and expulsion is rolled-over. Premature rupture of membranes preterm occurs in approximately 1% of all pregnancies and is associated with 30% -40% of preterm births. Thus, it is important to identify the cause of pre-term birth (after less than 37 completed weeks of "gestation" and its complications, including respiratory distress syndrome, neonatal infection and intraventricular hemorrhage. Objectives: the development of the protocol of the clinical trial on patients with impending preterm birth, study clinical and statistical on the socio-demographic characteristics of patients with imminent preterm birth; clinical condition of patients and selection of cases that could benefit from the application of interventional therapy; preclinical investigation (biological and imaging of patients with imminent preterm birth; the modality therapy; clinical investigation of the effectiveness of short

  9. Computed tomography diagnosis of hepatocellular carcinoma rupture haemorrhage

    International Nuclear Information System (INIS)

    Zhi Weike; Jiang Bin; Liu Jinquan; Li Sixia; Zhu Zhichang

    2004-01-01

    Objective: To evaluate the diagnostic value of hepatocellular carcinoma rupture hemorrhage using Computed Tomography. Methods: Six cases diagnosed hepatocellular carcinoma rupture hemorrhage were analyzed by morphic and histologic method and investigated the key point of scan in diagnosis. Result: The correct rate of hepatocellular carcinoma rupture hemorrhage by Computed Tomography is above 83 percent, it characteristic representation is strip and would high-density shadow after enhancement. Conclusion: The characteristic representation of hepatocellular carcinoma rupture hemorrhage is attain by Computed Tomography, which provides effective operation evidences for clinical operation. (authors)

  10. Risk factors affecting chronic rupture of the plantar fascia.

    Science.gov (United States)

    Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung

    2014-03-01

    Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis. We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups. Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33. Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture. Level III, retrospective comparative study.

  11. Cognitive frames in psychology: demarcations and ruptures.

    Science.gov (United States)

    Yurevich, Andrey V

    2009-06-01

    As there seems to be a recurrent feeling of crisis in psychology, its present state is analyzed in this article. The author believes that in addition to the traditional manifestations that have dogged psychology since it emerged as an independent science some new features of the crisis have emerged. Three fundamental "ruptures" are identified: the "horizontal" rupture between various schools and trends, the "vertical" rupture between natural science and humanitarian psychology, and the "diagonal" rupture between academic research and applied practice of psychology. These manifestations of the crisis of psychology have recently been compounded by the crisis of its rationalistic foundations. This situation is described in terms of the cognitive systems in psychology which include meta-theories, paradigms, sociodigms and metadigms.

  12. Induced seismicity provides insight into why earthquake ruptures stop

    KAUST Repository

    Galis, Martin

    2017-12-21

    Injection-induced earthquakes pose a serious seismic hazard but also offer an opportunity to gain insight into earthquake physics. Currently used models relating the maximum magnitude of injection-induced earthquakes to injection parameters do not incorporate rupture physics. We develop theoretical estimates, validated by simulations, of the size of ruptures induced by localized pore-pressure perturbations and propagating on prestressed faults. Our model accounts for ruptures growing beyond the perturbed area and distinguishes self-arrested from runaway ruptures. We develop a theoretical scaling relation between the largest magnitude of self-arrested earthquakes and the injected volume and find it consistent with observed maximum magnitudes of injection-induced earthquakes over a broad range of injected volumes, suggesting that, although runaway ruptures are possible, most injection-induced events so far have been self-arrested ruptures.

  13. Challenging Friesian horse diseases : aortic rupture and megaesophagus

    NARCIS (Netherlands)

    Ploeg, M.

    2015-01-01

    Aortic rupture is quite rare in Warmblood horses and is best known as an acute and fatal rupture of the aortic root in older breeding stallions. It has now become clear that aortic rupture, which is diagnosed around an age of 4 years, is more frequent in the Friesian breed than in others. The high

  14. Coherence of Mach fronts during heterogeneous supershear earthquake rupture propagation: Simulations and comparison with observations

    Science.gov (United States)

    Bizzarri, A.; Dunham, Eric M.; Spudich, P.

    2010-01-01

    We study how heterogeneous rupture propagation affects the coherence of shear and Rayleigh Mach wavefronts radiated by supershear earthquakes. We address this question using numerical simulations of ruptures on a planar, vertical strike-slip fault embedded in a three-dimensional, homogeneous, linear elastic half-space. Ruptures propagate spontaneously in accordance with a linear slip-weakening friction law through both homogeneous and heterogeneous initial shear stress fields. In the 3-D homogeneous case, rupture fronts are curved owing to interactions with the free surface and the finite fault width; however, this curvature does not greatly diminish the coherence of Mach fronts relative to cases in which the rupture front is constrained to be straight, as studied by Dunham and Bhat (2008a). Introducing heterogeneity in the initial shear stress distribution causes ruptures to propagate at speeds that locally fluctuate above and below the shear wave speed. Calculations of the Fourier amplitude spectra (FAS) of ground velocity time histories corroborate the kinematic results of Bizzarri and Spudich (2008a): (1) The ground motion of a supershear rupture is richer in high frequency with respect to a subshear one. (2) When a Mach pulse is present, its high frequency content overwhelms that arising from stress heterogeneity. Present numerical experiments indicate that a Mach pulse causes approximately an ω−1.7 high frequency falloff in the FAS of ground displacement. Moreover, within the context of the employed representation of heterogeneities and over the range of parameter space that is accessible with current computational resources, our simulations suggest that while heterogeneities reduce peak ground velocity and diminish the coherence of the Mach fronts, ground motion at stations experiencing Mach pulses should be richer in high frequencies compared to stations without Mach pulses. In contrast to the foregoing theoretical results, we find no average elevation

  15. Ruptured rectal duplication with urogenital abnormality: Unusual presentation.

    Science.gov (United States)

    Solanki, Shailesh; Babu, M Narendra; Jadhav, Vinay; Shankar, Gowri; Santhanakrishnan, Ramesh

    2015-01-01

    Rectal duplication (RD) accounts for 5% of alimentary tract duplication. A varied presentation and associated anomalies have been described in the literature. Antenatal rupture of the RD is very rare. We present an unusual case of a ruptured RD associated with urogenital abnormalities in newborn male. We are discussing diagnosis, embryology, management and literature review of ruptured RD.

  16. Rupture of esophagus by compressed air.

    Science.gov (United States)

    Wu, Jie; Tan, Yuyong; Huo, Jirong

    2016-11-01

    Currently, beverages containing compressed air such as cola and champagne are widely used in our daily life. Improper ways to unscrew the bottle, usually by teeth, could lead to an injury, even a rupture of the esophagus. This letter to editor describes a case of esophageal rupture caused by compressed air.

  17. The roentgenographic findings of achilles tendon rupture

    Energy Technology Data Exchange (ETDEWEB)

    Seouk, Kang Hyo; Keun, Rho Yong [Shilla General Hospital, Seoul (Korea, Republic of)

    1999-03-01

    To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture. We performed a retrospective analysis of the roentgenographic findings of 15 patients with surgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateral malleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewed with regard to Kager's triangle, Arner's sign, Toygar's angle, ill defined radiolucent shadow through the Achilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posterior skin surface of the ankle. Kager's triangle was deformed and disappeared after rupture of the Achilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positive Arner's sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon, the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendon became serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucent shadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior margin of the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posterior skin surface of the ankle had a nodular surface margin in 13 patients(87%). A deformed Kager's triangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in a lateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture.

  18. The roentgenographic findings of achilles tendon rupture

    International Nuclear Information System (INIS)

    Seouk, Kang Hyo; Keun, Rho Yong

    1999-01-01

    To evaluate the diagnostic value of a lateral view of the ankles in Achilles tendon rupture. We performed a retrospective analysis of the roentgenographic findings of 15 patients with surgically proven Achilles tendon rupture. Four groups of 15 patients(normal, ankle sprain, medial lateral malleolar fracture, and calcaneal fracture) were analysed as reference groups. Plain radiographs were reviewed with regard to Kager's triangle, Arner's sign, Toygar's angle, ill defined radiolucent shadow through the Achilles tendon, sharpness of the anterior margin of Achilles tendon, and meniscoid smooth margin of the posterior skin surface of the ankle. Kager's triangle was deformed and disappeared after rupture of the Achilles tendon in nine patients(60%) with operative verification of the rupture, six patients(40%) had a positive Arner's sign, while none had a diminished Toygars angle. In 13 patients(87%) with a ruptured Achilles tendon, the thickness of this was nonuniform compared with the reference group. The anterior margin of the Achilles tendon became serrated and indistinct in 14 patients(93%) in whom this was ruptured. An abnormal ill defined radiolucent shadow through the Achilles tendon was noted in nine patient(60%), and nonparallelism between the anterior margin of the Achilles tendon and posterior skin surface of the ankle was detected in 11 patients(73%). The posterior skin surface of the ankle had a nodular surface margin in 13 patients(87%). A deformed Kager's triangle and Achilles tendon, and an abnormal ill defined radiolucent shadow through the Achilles tendon in a lateral view of the ankles are important findings for the diagnesis of in diagnosing achilles tendon rupture

  19. Cyclic creep-rupture behavior of three high-temperature alloys.

    Science.gov (United States)

    Halford, G. R.

    1972-01-01

    Study of some important characteristics of the cyclic creep-rupture curves for the titanium alloy 6Al-2Sn-4Zr-2Mo at 900 and 1100 F (755 and 865 K), the cobalt-base alloy L-605 at 1180 F (910 K), and for two hardness levels of 316 stainless steel at 1300 F (980 K). The cyclic creep-rupture curve relates tensile stress and tensile time-to-rupture for strain-limited cyclic loading and has been found to be independent of the total strain range and the level of compressive stress employed in the cyclic creep-rupture tests. The cyclic creep-rupture curve was always found to be above and to the right of the conventional (constant load) monotonic creep-rupture curve by factors ranging from 2 to 10 in time-to-rupture. This factor tends to be greatest when the creep ductility is large. Cyclic creep acceleration was observed in every cyclic creep-rupture test conducted. The phenomenon was most pronounced at the highest stress levels and when the tensile and compressive stresses were completely reversed. In general, creep rates were found to be lower in compression than in tension for equal true stresses. The differences, however, were strongly material-dependent.

  20. Treatment strategy for ruptured abdominal aortic aneurysms.

    Science.gov (United States)

    Davidovic, L

    2014-07-01

    Rupture is the most serious and lethal complication of the abdominal aortic aneurysm. Despite all improvements during the past 50 years, ruptured abdominal aortic aneurysms are still associated with very high mortality. Namely, including patients who die before reaching the hospital, the mortality rate due to abdominal aortic aneurysm rupture is 90%. On the other hand, during the last twenty years, the number of abdominal aortic aneurysms significantly increased. One of the reasons is the fact that in majority of countries the general population is older nowadays. Due to this, the number of degenerative AAA is increasing. This is also the case for patients with abdominal aortic aneurysm rupture. Age must not be the reason of a treatment refusal. Optimal therapeutic option ought to be found. The following article is based on literature analysis including current guidelines but also on my Clinics significant experience. Furthermore, this article show cases options for vascular medicine in undeveloped countries that can not apply endovascular procedures at a sufficient level and to a sufficient extent. At this moment the following is evident. Thirty-day-mortality after repair of ruptured abdominal aortic aneurysms is significantly lower in high-volume hospitals. Due to different reasons all ruptured abdominal aortic aneurysms are not suitable for EVAR. Open repair of ruptured abdominal aortic aneurysm should be performed by experienced open vascular surgeons. This could also be said for the treatment of endovascular complications that require open surgical conversion. There is no ideal procedure for the treatment of AAA. Each has its own advantages and disadvantages, its own limits and complications, as well as indications and contraindications. Future reductions in mortality of ruptured abdominal aortic aneurysms will depend on implementation of population-based screening; on strategies to prevent postoperative organ injury and also on new medical technology

  1. Rupture of the urinary bladder after minimal trauma

    International Nuclear Information System (INIS)

    Myrseth, L.E.; Johansen, T.E.B.

    1991-01-01

    Rupture of the urinary bladder is a rare injury most often encountered after severe trauma and in conjunction with injuries to other organ systems. It may occur, however, without concomitant injury and also after minimal trauma. This diagnosis must be suspected in a patient with abdominal pain who is unable to void or who presents hematuria. The diagnosis is made by means of a retrograde cystogram using 350-400 ml contrast medium and supplemented by a drainage film. Intrapertioneal ruptures should be treated surgically by closure in layers, and drainage. Patients with extraperitoneal ruptures can safely be treated with simple catheter drainage until the rupture has healed, usually within 10-20 days. The authors report three cases of bladder rupture after minimal trauma and describe the state of the art of diagnosis and treatment of these injuries. 15 refs., 3 figs

  2. Download this PDF file

    African Journals Online (AJOL)

    Mr Olusoji

    Spontaneous splenic rupture as a cause of shock and abdominal pain should be considered whenever uterine rupture is suspected in the second half of pregnancy. Keywords:Spontaneous, spleen, rupture, pregnancy, twins. INTRODUCTION intravenous fluids and blood transfusion, early diagnosis and splenectomy.

  3. Computed tomography features and predictive findings of ruptured gastrointestinal stromal tumours

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Sil; Kim, Hyun Jin; Park, Seong Ho; Lee, Jong Seok; Kim, Ah Young; Ha, Hyun Kwon [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Songpa-Gu, Seoul (Korea, Republic of)

    2017-06-15

    To evaluate the CT features of ruptured GISTs and factors that might be predictive of rupture through comparison with CTs taken prior to rupture and CTs of non-ruptured GIST. Forty-nine patients with ruptured GIST and forty-nine patients with non-ruptured GIST matched by age, gender and location were included. Clinical data including pharmacotherapy were reviewed. The imaging features were analyzed. Prior CT obtained before rupture were evaluated. The most common location of ruptured GIST was small bowel with mean size of 12.1 cm. Ruptured GIST commonly showed wall defects, >40 % eccentric necrosis, lobulated shaped, air density in mass, pneumoperitoneum, peritonitis, hemoperitoneum and ascites (p < 0.001-0.030). Twenty-seven of 30 patients with follow up imaging received targeted therapy. During follow-up, thickness of the tumour wall decreased. Increase in size and progression of necrosis were common during targeted therapy (p = 0.017). Newly developed ascites, peritonitis and hemoperitoneum was more common (p < 0.001-0.036). Ruptured GISTs commonly demonstrate large size, >40 % eccentric necrosis, wall defects and lobulated shape. The progression of necrosis with increase in size and decreased wall thickness during targeted therapy may increase the risk of rupture. Rupture should be considered when newly developed peritonitis, hemoperitoneum, or ascites are noted during the follow-up. (orig.)

  4. Development of rupture discs for the FBTR

    International Nuclear Information System (INIS)

    Chetal, S.C.; Raju, C.; Anandkumar, V.; Seetharaman, V.; Rajan, K.K.

    1984-01-01

    Rupture discs are required as a safety device for protecting the secondary sodium circuit and its components against high pressure surges due to accidental water steam leaks in sodium heated steam generator and the consequent sodium water reaction. For identical reasons, rupture discs are also required on the vessels used for decontamination of sodium components. Reverse buckling knife blade concept with austenitic stainless steel disc has been developed for the rupture disc assemblies required for Fast Breeder Test Reactor (FBTR). Hydroforming process without any die has been used for disc fabrication. One rupture disc assembly required for steam generator is undergoing sodium endurance test and has accumulated 4,500 hours. The present status of development work as demonstrated by room temperature experimental results as well as the scope for future work are discussed. (author)

  5. Bladder And Uterine Rupture At Vaginal Birth After Cesarean Section

    African Journals Online (AJOL)

    Rupture of the uterus is still a major obstetric problem in developing countries. The urinary bladder is often affected especially when a lower segment Caesarean scar ruptures. We present a case of bladder rupture associated with uterine rupture in a patient who was attempting vaginal delivery after two previous Caesarean ...

  6. Ruptured rectal duplication with urogenital abnormality: Unusual presentation

    Directory of Open Access Journals (Sweden)

    Shailesh Solanki

    2015-01-01

    Full Text Available Rectal duplication (RD accounts for 5% of alimentary tract duplication. A varied presentation and associated anomalies have been described in the literature. Antenatal rupture of the RD is very rare. We present an unusual case of a ruptured RD associated with urogenital abnormalities in newborn male. We are discussing diagnosis, embryology, management and literature review of ruptured RD.

  7. Ruptured Uterus At Afikpo, Southeast Nigeria. | Eze | Ebonyi Medical ...

    African Journals Online (AJOL)

    Context: Ruptured uterus is an obstetric catastrophe associated with high maternal and perinatal mortality. Objectives: To determine the incidence, causes, management and fetomaternal outcomes of ruptured uterus in Afikpo, Southeast Nigeria. Methods: Delivery records, theatre registers and case notes of all ruptured ...

  8. Retrieving rupture history using waveform inversions in time sequence

    Science.gov (United States)

    Yi, L.; Xu, C.; Zhang, X.

    2017-12-01

    The rupture history of large earthquakes is generally regenerated using the waveform inversion through utilizing seismological waveform records. In the waveform inversion, based on the superposition principle, the rupture process is linearly parameterized. After discretizing the fault plane into sub-faults, the local source time function of each sub-fault is usually parameterized using the multi-time window method, e.g., mutual overlapped triangular functions. Then the forward waveform of each sub-fault is synthesized through convoluting the source time function with its Green function. According to the superposition principle, these forward waveforms generated from the fault plane are summarized in the recorded waveforms after aligning the arrival times. Then the slip history is retrieved using the waveform inversion method after the superposing of all forward waveforms for each correspond seismological waveform records. Apart from the isolation of these forward waveforms generated from each sub-fault, we also realize that these waveforms are gradually and sequentially superimposed in the recorded waveforms. Thus we proposed a idea that the rupture model is possibly detachable in sequent rupture times. According to the constrained waveform length method emphasized in our previous work, the length of inverted waveforms used in the waveform inversion is objectively constrained by the rupture velocity and rise time. And one essential prior condition is the predetermined fault plane that limits the duration of rupture time, which means the waveform inversion is restricted in a pre-set rupture duration time. Therefore, we proposed a strategy to inverse the rupture process sequentially using the progressively shift rupture times as the rupture front expanding in the fault plane. And we have designed a simulation inversion to test the feasibility of the method. Our test result shows the prospect of this idea that requiring furthermore investigation.

  9. Spontaneous mutation by mutagenic repair of spontaneous lesions in DNA

    International Nuclear Information System (INIS)

    Hastings, P.J.; Quah, S.-K.; Borstel, R.C. von

    1976-01-01

    It is stated that strains of yeast carrying mutations in many of the steps in pathways repairing radiation-induced damage to DNA have enhanced spontaneous mutation rates. Most strains isolated because they have enhanced spontaneous mutation carry mutations in DNA repair systems. This suggests that much spontaneous mutation arises by mutagenic repair of spontaneous lesions. (author)

  10. Metallurgical analysis of high pressure gas pipelines rupture

    International Nuclear Information System (INIS)

    Hasan, F.; Ahmed, F.

    2007-01-01

    On 6 July 2004, two parallel-running gas pipelines (18-inch and 24-inch diameters), in the main transmission network of SNGPL (a gas company in Pakistan) were ruptured. The ruptures occurred in the early hours of the morning about 8 miles downstream of the compressor station AC-4. The ruptures were indicated by the increased gas flow at the outlet of AC-4 (1), first at about 0648 hours and then again about 20 minutes later. The gas escaping from the ruptured lines had caught fire, and the flames had also 'affected' a third parallel-running pipeline of 30-inch diameter, lying next to the 24-inch line. The metallurgical examination of the two ruptured lines showed that the 24-inch line was ruptured with the help of an explosive device that had been placed on the underside of the pipe. An examination of the 18-inch line showed that this pipe had failed as a result of the heating of the pipe-wall, presumably, by the flame emanating from the 24-inch line. These two observations clearly suggested that the 24-inch line was the first to rupture (by explosives), and the fire following this rupture had heated the 18-inch pipe to a temperature where its yield strength was unable to support the inside gas pressure. The 20 minutes time interval between the two ruptures was obviously the time taken by the 18 inch pipe to be heated upto the level where it started to yield. The 30-inch line lying next to the 24-inch line was affected to the extent that its coating had been burnt-off over a length of about 40-50 feet. However, the pipe did not exhibit any signs of deshaping or deformation what-so-ever. A replica metallographic examination indicated that the microstructure of the pipe was not measurably affected by the heat. It was thus decided not to replace the affected part of the 30-inch pipe, but only to re-coat this affected portion. (author)

  11. On the unit rupture work of metals and alloys

    International Nuclear Information System (INIS)

    Verkhoturov, A.D.; Kovalenko, V.S.; Dyatel, V.P.

    1980-01-01

    Studied is the effect of the nature of the treated material treatment regimes on their unit rupture work at laser treatment in the regime of quasistationary evaporation. It is shown that the unit rupture work changes its values depending on the treatment regimes, coincidences between experimental and calculation values of unit rupture work are not being observed, especially for refractory metals of the 6th group and for solid alloys. Established are optimum regimes for determination of stable values of unit rupture work

  12. Treatment Alternative for Irreparable Rotator Cuff Ruptures ...

    African Journals Online (AJOL)

    2016-09-03

    Sep 3, 2016 ... and such ruptures also lead to a pseudo-paralysis.[1,2]. Pain during daily ... 2) repairable rotator cuff rupture, as determined on MRI and during arthroscopy ..... functioning and lead to cosmetic deformities.[4]. Arthroplasty is a ...

  13. Premature rupture of the membranes at amnioinfusion in the management of oligohydramnios.

    Science.gov (United States)

    Vergani, Patrizia; Locatelli, Anna; Verderio, Maria; Assi, Francesca

    2004-01-01

    We sought to evaluate whether serial amnioinfusions for persistent oligohydramnios can affect the perinatal and long-term outcomes in extreme cases of preterm premature rupture of membranes. All singleton pregnancies with preterm premature rupture of membranes at 4 days between January 1991 and December 2001 were included. Amniotic fluid volume was assessed as the maximum cord-free pocket with serial ultrasonographic examinations. Consenting women with persistent (>4 days) oligohydramnios (amniotic fluid=2 cm) received serial transabdominal amnioinfusions to maintain an amniotic fluid pocket >2 cm. The pregnancy, neonatal, and long-term neurologic outcomes of the cases that spontaneously maintained a median amniotic fluid pocket >2 cm were compared with those of women with oligohydramnios who underwent amnioinfusion but continued to have persistent oligohydramnios and with those of women in whom oligohydramnios was alleviated. Statistical analysis included the Wilcoxon rank-sum test and the Fisher exact test with a 2-tailed Pamnioinfusions, which successfully restored a median amniotic fluid pocket >2 cm for =48 hours in 11 (30%) patients. This successful amnioinfusion group was comparable with the persistent oligohydramnios group (n=25) in gestational age at first amnioinfusion (median, 20.2 weeks; range, 16-25.6 weeks; vs median, 20.3 weeks; range, 16.5-24.2 weeks; P=.4), number of amnioinfusions (median, 3; range, 1-9; vs median, 3; range, 1-5; P=.4), and interval between amnioinfusions (median, 6 days; range, 4-14 days; vs median, 8 days; range, 6-43 days; P=.1). However, patients in the persistent oligohydramnios group had a significantly shorter interval to delivery, lower neonatal survival (20%), and higher rates of pulmonary hypoplasia (62%) and abnormal neurologic outcomes (60%) than the patients in the groups in which amnioinfusion was not necessary or was successful (all P=.01). Logistic regression analysis demonstrated that after taking into

  14. Achilles Tendon Rupture

    Science.gov (United States)

    ... is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture) completely or just partially. If your Achilles ...

  15. Incidence of plantar fascia ruptures following corticosteroid injection.

    Science.gov (United States)

    Kim, Chul; Cashdollar, Michael R; Mendicino, Robert W; Catanzariti, Alan R; Fuge, LaDonna

    2010-12-01

    Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m². The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.

  16. Micromechanical properties and collagen composition of ruptured human achilles tendon

    DEFF Research Database (Denmark)

    Hansen, Philip; Kovanen, Vuokko; Hölmich, Per

    2013-01-01

    The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive.......The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive....

  17. Vortex dynamics in ruptured and unruptured intracranial aneurysms

    Science.gov (United States)

    Trylesinski, Gabriel

    Intracranial aneurysms (IAs) are a potentially devastating pathological dilation of brain arteries that affect 1.5-5 % of the population. Causing around 500 000 deaths per year worldwide, their detection and treatment to prevent rupture is critical. Multiple recent studies have tried to find a hemodynamics predictor of aneurysm rupture, but concluded with distinct opposite trends using Wall Shear Stress (WSS) based parameters in different clinical datasets. Nevertheless, several research groups tend to converge for now on the fact that the flow patterns and flow dynamics of the ruptured aneurysms are complex and unstable. Following this idea, we investigated the vortex properties of both unruptured and ruptured cerebral aneurysms. A brief comparison of two Eulerian vortex visualization methods (Q-criterion and lambda 2 method) showed that these approaches gave similar results in our complex aneurysm geometries. We were then able to apply either one of them to a large dataset of 74 patient specific cases of intracranial aneurysms. Those real cases were obtained by 3D angiography, numerical reconstruction of the geometry, and then pulsatile CFD simulation before post-processing with the mentioned vortex visualization tools. First we tested the two Eulerian methods on a few cases to verify their implementation we made as well as compare them with each other. After that, the Q-criterion was selected as method of choice for its more obvious physical meaning (it shows the balance between two characteristics of the flow, its swirling and deformation). Using iso-surfaces of Q, we started by categorizing the patient-specific aneurysms based on the gross topology of the aneurysmal vortices. This approach being unfruitful, we found a new vortex-based characteristic property of ruptured aneurysms to stratify the rupture risk of IAs that we called the Wall-Kissing Vortices, or WKV. We observed that most ruptured aneurysms had a large amount of WKV, which appears to agree with

  18. Role of amnioinfusion in the management of premature rupture of the membranes at <26 weeks' gestation.

    Science.gov (United States)

    Locatelli, A; Vergani, P; Di Pirro, G; Doria, V; Biffi, A; Ghidini, A

    2000-10-01

    We sought to evaluate whether serial amnioinfusions for persistent oligohydramnios can affect the perinatal and long-term outcomes in extreme cases of preterm premature rupture of membranes. All singleton pregnancies with preterm premature rupture of membranes at 4 days between January 1991 and June 1998 were included. Amniotic fluid volume was assessed as the maximum cord-free pocket with serial ultrasonographic examinations. Consenting women with persistent (>4 days) oligohydramnios (amniotic fluid amnioinfusions to maintain an amniotic fluid pocket >2 cm. The pregnancy, neonatal, and long-term neurologic outcomes of the cases that spontaneously maintained a median amniotic fluid pocket >2 cm (amnioinfusion-not-necessary group) were compared with those of women with oligohydramnios who underwent amnioinfusion but continued to have a median amniotic fluid pocket after preterm premature rupture of membranes amnioinfusion group). Statistical analysis included the Wilcoxon rank-sum test and the Fisher exact test, with a 2-tailed P amnioinfusions, which successfully restored a median amniotic fluid pocket >2 cm for >/=48 hours in 11 (30%) patients. This successful amnioinfusion group was comparable with the persistent oligohydramnios group (n = 25) in gestational age at first amnioinfusion (median, 20.2 weeks; range, 16-25.6 weeks; vs median, 20.3 weeks; range, 16.5-24.2 weeks; P =.4), number of amnioinfusions (median, 3; range, 1-9; vs median, 3; range, 1-5; P =.4), and interval between amnioinfusions (median, 6 days; range, 4-14 days; vs median, 8 days; range, 6-43 days; P =. 1). However, patients in the persistent oligohydramnios group had a significantly shorter interval to delivery, lower neonatal survival (20%), and higher rates of pulmonary hypoplasia (62%) and abnormal neurologic outcomes (60%) than the patients in the groups in which amnioinfusion was not necessary or was successful (all P amnioinfusions successfully alleviate oligohydramnios have a perinatal

  19. Simultaneous bilateral patellar tendon rupture ?

    OpenAIRE

    Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2016-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

  20. Definitive diagnosis of breast implant rupture using magnetic resonance imaging.

    Science.gov (United States)

    Ahn, C Y; Shaw, W W; Narayanan, K; Gorczyca, D P; Sinha, S; Debruhl, N D; Bassett, L W

    1993-09-01

    Breast implant rupture is an important complication of augmented and reconstructed breasts. Although several techniques such as mammography, xeromammography, ultrasound, thermography, and computed tomographic (CT) scanning have been proven to be useful to detect implant rupture, they have several disadvantages and lack specificity. In the current study, we have established magnetic resonance imaging (MRI) as a definitive, reliable, and reproducible technique to diagnose both intracapsular and extracapsular ruptures. The study was conducted in 100 symptomatic patients. Our imaging parameters were able to identify ruptures in implants with silicone shells. All the ruptures showed the presence of wavy lines, free-floating silicone shell within the gel ("free-floating loose-thread sign" or "linguine sign"). We had a 3.75 percent incidence of false-positive and false-negative results. The sensitivity for detection of silicone implant rupture was 76 percent, with a specificity of 97 percent. In addition, we also were able to identify the artifacts that may interfere with the definitive diagnosis of implant rupture.

  1. Frequency, predisposing factors and fetomaternal outcome in uterine rupture

    International Nuclear Information System (INIS)

    Malik, H.S.

    2006-01-01

    To determine the frequency and to analyze the predisposing factors, maternal and fetal outcome of uterine rupture. All cases of ruptured uterus, who were either admitted with or who developed this complication in the hospital, were included in the study. Demographic data, details regarding the most probable predisposing factor, type of rupture, the management and maternal and fetal outcome were taken into consideration for analysis.During three years, total number of deliveries was 18668, and there were 103 cases of uterine rupture (0.55%).Out of these, only 13 (12.62%) patients were booked. Most of the patients presented between the ages of 26-30 years (42.71%). Majority of ruptures occurred in para 2-4 (44.66%). Fifty five cases (53.39%) had a previous caesarean section scar. In 68 (66.01%) cases, the tear was located in lower uterine segment. In 93 (90.29%) cases, anterior uterine wall was involved. Rupture was complete in 79 (76.69%)cases. Repair of uterus was done in 79 (76.69%) cases. Hysterectomy was performed in 24 (23.30%) cases. There were 8 (7.76% or 77.66/1000) maternal deaths and 85 (81.73% or 825 / 1000) perinatal deaths.This study confirms high frequency of such serious preventable obstetrical problem which can lead to high fetomaternal mortality. Rupture of caesarean section scar was the most common cause of uterine rupture found in this series. (author)

  2. Characterize kinematic rupture history of large earthquakes with Multiple Haskell sources

    Science.gov (United States)

    Jia, Z.; Zhan, Z.

    2017-12-01

    Earthquakes are often regarded as continuous rupture along a single fault, but the occurrence of complex large events involving multiple faults and dynamic triggering challenges this view. Such rupture complexities cause difficulties in existing finite fault inversion algorithms, because they rely on specific parameterizations and regularizations to obtain physically meaningful solutions. Furthermore, it is difficult to assess reliability and uncertainty of obtained rupture models. Here we develop a Multi-Haskell Source (MHS) method to estimate rupture process of large earthquakes as a series of sub-events of varying location, timing and directivity. Each sub-event is characterized by a Haskell rupture model with uniform dislocation and constant unilateral rupture velocity. This flexible yet simple source parameterization allows us to constrain first-order rupture complexity of large earthquakes robustly. Additionally, relatively few parameters in the inverse problem yields improved uncertainty analysis based on Markov chain Monte Carlo sampling in a Bayesian framework. Synthetic tests and application of MHS method on real earthquakes show that our method can capture major features of large earthquake rupture process, and provide information for more detailed rupture history analysis.

  3. Source properties of dynamic rupture pulses with off-fault plasticity

    KAUST Repository

    Gabriel, A.-A.

    2013-08-01

    Large dynamic stresses near earthquake rupture fronts may induce an inelastic response of the surrounding materials, leading to increased energy absorption that may affect dynamic rupture. We systematically investigate the effects of off-fault plastic energy dissipation in 2-D in-plane dynamic rupture simulations under velocity-and-state-dependent friction with severe weakening at high slip velocity. We find that plasticity does not alter the nature of the transitions between different rupture styles (decaying versus growing, pulse-like versus crack-like, and subshear versus supershear ruptures) but increases their required background stress and nucleation size. We systematically quantify the effect of amplitude and orientation of background shear stresses on the asymptotic properties of self-similar pulse-like ruptures: peak slip rate, rupture speed, healing front speed, slip gradient, and the relative contribution of plastic strain to seismic moment. Peak slip velocity and rupture speed remain bounded. From fracture mechanics arguments, we derive a nonlinear relation between their limiting values, appropriate also for crack-like and supershear ruptures. At low background stress, plasticity turns self-similar pulses into steady state pulses, for which plastic strain contributes significantly to the seismic moment. We find that the closeness to failure of the background stress state is an adequate predictor of rupture speed for relatively slow events. Our proposed relations between state of stress and earthquake source properties in the presence of off-fault plasticity may contribute to the improved interpretation of earthquake observations and to pseudodynamic source modeling for ground motion prediction.

  4. MRC ORACLE Children Study. Long term outcomes following prescription of antibiotics to pregnant women with either spontaneous preterm labour or preterm rupture of the membranes

    Directory of Open Access Journals (Sweden)

    Salt Alison

    2008-04-01

    Full Text Available Abstract Background The Medical Research Council (MRC ORACLE trial evaluated the use of co-amoxiclav 375 mg and/or erythromycin 250 mg in women presenting with preterm rupture of membranes (PROM ORACLE I or in spontaneous preterm labour (SPL ORACLE II using a factorial design. The results showed that for women with a singleton baby with PROM the prescription of erythromycin is associated with improvements in short term neonatal outcomes, although co-amoxiclav is associated with prolongation of pregnancy, a significantly higher rate of neonatal necrotising enterocolitis was found in these babies. Prescription of erythromycin is now established practice for women with PROM. For women with SPL antibiotics demonstrated no improvements in short term neonatal outcomes and are not recommended treatment. There is evidence that both these conditions are associated with subclinical infection so perinatal antibiotic administration may reduce the risk of later disabilities, including cerebral palsy, although the risk may be increased through exposure to inflammatory cytokines, so assessment of longer term functional and educational outcomes is appropriate. Methods The MRC ORACLE Children's Study will follow up UK children at age 7 years born to 4809 women with PROM and the 4266 women with SPL enrolled in the earlier ORACLE trials. We will use a parental questionnaire including validated tools to assess disability and behaviour. We will collect the frequency of specific medical conditions: cerebral palsy, epilepsy, respiratory illness including asthma, diabetes, admission to hospital in last year and other diseases, as reported by parents. National standard test results will be collected to assess educational attainment at Key Stage 1 for children in England. Discussion This study is designed to investigate whether or not peripartum antibiotics improve health and disability for children at 7 years of age. Trial registration The ORACLE Trial and Children

  5. MRC ORACLE Children Study. Long term outcomes following prescription of antibiotics to pregnant women with either spontaneous preterm labour or preterm rupture of the membranes.

    Science.gov (United States)

    Kenyon, Sara; Brocklehurst, Peter; Jones, David; Marlow, Neil; Salt, Alison; Taylor, David

    2008-04-24

    The Medical Research Council (MRC) ORACLE trial evaluated the use of co-amoxiclav 375 mg and/or erythromycin 250 mg in women presenting with preterm rupture of membranes (PROM) ORACLE I or in spontaneous preterm labour (SPL) ORACLE II using a factorial design. The results showed that for women with a singleton baby with PROM the prescription of erythromycin is associated with improvements in short term neonatal outcomes, although co-amoxiclav is associated with prolongation of pregnancy, a significantly higher rate of neonatal necrotising enterocolitis was found in these babies. Prescription of erythromycin is now established practice for women with PROM. For women with SPL antibiotics demonstrated no improvements in short term neonatal outcomes and are not recommended treatment. There is evidence that both these conditions are associated with subclinical infection so perinatal antibiotic administration may reduce the risk of later disabilities, including cerebral palsy, although the risk may be increased through exposure to inflammatory cytokines, so assessment of longer term functional and educational outcomes is appropriate. The MRC ORACLE Children's Study will follow up UK children at age 7 years born to 4809 women with PROM and the 4266 women with SPL enrolled in the earlier ORACLE trials. We will use a parental questionnaire including validated tools to assess disability and behaviour. We will collect the frequency of specific medical conditions: cerebral palsy, epilepsy, respiratory illness including asthma, diabetes, admission to hospital in last year and other diseases, as reported by parents. National standard test results will be collected to assess educational attainment at Key Stage 1 for children in England. This study is designed to investigate whether or not peripartum antibiotics improve health and disability for children at 7 years of age. The ORACLE Trial and Children Study is registered in the Current Controlled Trials registry. ISCRTN 52995660.

  6. Misdiagnosed Uterine Rupture of an Advanced Cornual Pregnancy

    Directory of Open Access Journals (Sweden)

    Christian Linus Hastrup Sant

    2012-01-01

    Full Text Available Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability.

  7. Misdiagnosed uterine rupture of an advanced cornual pregnancy

    DEFF Research Database (Denmark)

    Sant, Christian Linus Hastrup; Andersen, Poul Erik

    2012-01-01

    Cornual pregnancy is a diagnostic and therapeutic challenge with potential severe consequences if uterine rupture occurs with following massive intraabdominal bleeding. We report a case of a misdiagnosed ruptured cornual pregnancy occurring at 21 weeks of gestation. Ultrasound examination...... and computer tomography revealed no sign of abnormal pregnancy. The correct diagnosis was first made at emergency laparotomy. Uterine rupture should be considered in pregnant women presenting with abdominal pain and haemodynamic instability....

  8. Ultrasonogram of tubal pregnancy: Unruptured or ruptured?

    International Nuclear Information System (INIS)

    Lee, Hee Jung; Kim, Jung Sik; Lee, Sung Moon; Kim, Hong; Woo, Seong Ku; Yeun, Seong Do; Lee, Doo Ryong

    1993-01-01

    To evaluate the usefulness of ultrasonography in the differentiation of the unruptured ones, we performed prospective ultrasonographic study in 56 patients with tubal pregnancy and subsequently correlated with the surgical (45 cases) and laparoscopic (11 cases) findings. The criterion for unruptured tubal pregnancy was the visualization of extra uterine gestational sac or a mass that was separated from the ipsilateral ovary. All cases were confirmed surgically or laparoscopically within 48 hours after sonographic examination. Forty five (80%)cases were proved as unruptured, tubal pregnancy, while 11 (20%) as ruptured one. Extra uterine gestational sac was seen in 31/45 (69%) in unruptured group and 2/11 (18%) in ruptured group. A mass separated from the ipsilateral ovary was seen in 7 unruptured tubal pregnancies and 2 ruptured pregnancies. A mass that was not separated from the ipsilateral ovary was seen in 13 cases. Seven of these were ruptured pregnancies, while 6 were unrupture dones. Using our criteria, the unruptured tubal pregnancy was diagnosed with a sensitivity of 84%, a specificity of 64%, an accuracy of 80%, a positive predictive value of 90% and a negative predictive value of 50%. We conclude that ultrasonography is useful in the differentiation of the unruptured tubal pregnancy from the ruptured one

  9. Radiologic findings of small bowel rupture due to blunt abdominal trauma

    International Nuclear Information System (INIS)

    Ha, Hyeon Kweun; Bahk, Yong Whee

    1987-01-01

    Bowel rupture due to blunt abdominal trauma is no longer rare, and is among the most challenging problems that confront the physicians and radiologists. It is frequently difficult to diagnose because the symptoms may be trivial during the early stage and masked by more obvious, but less lethal injuries. It is well known that the roentgen examination of the abdomen is also of little value to exclude bowel rupture because of infrequency of positive findings and free gas. The plain films of 23 cases of jejunal rupture and 8 cases of ileal rupture were evaluated to sort and diagnostic features of small bowel rupture caused by blunt abdominal trauma. 1. Free intraperitoneal gas was noted in 6 cases of jejunal rupture (26%) and 1 case of ileal rupture (13%), and definite radiological evidence of free intraperitoneal fluid was present in 16 cases of patients (52%). 2. The contour change of bowel loops such as tapering or indentation were seen in 11 cases of patients (36%), and local opacity along the mesenteric root axis was demonstrated in 19 cases of patients (61%). 3. Paralytic ileus was localized to LUQ in jejunal rupture and to mid-abdomen in ileal rupture, and gastric and transverse-colon distension with gas was noticeable especially in jejunal rupture

  10. Isolated gallbladder rupture following blunt abdominal injury

    African Journals Online (AJOL)

    2015-05-26

    May 26, 2015 ... Kaohsiung Medical University, Kaohsiung, Taiwan. Abstract. Isolated traumatic gallbladder rupture subsequent to blunt abdominal injury is rare. Most literatures on the subjects consist of case reports. We reported a rare case of isolated gallbladder rupture and discussed the possible predisposing factors to ...

  11. Plantar fascia rupture in a professional soccer player.

    Science.gov (United States)

    Suzue, Naoto; Iwame, Toshiyuki; Kato, Kenji; Takao, Shoichiro; Tateishi, Tomohiko; Takeda, Yoshitsugu; Hamada, Daisuke; Goto, Tomohiro; Takata, Yoichiro; Matsuura, Tetsuya; Sairyo, Koichi

    2014-01-01

    We report the case of a 29-year-old male professional soccer player who presented with symptoms of plantar fasciitis. His symptoms occurred with no remarkable triggers and gradually worsened despite conservative treatments including taping, use of insoles, and physical therapy. Local corticosteroid injection was given twice as a further intervention, but his plantar fascia partially ruptured 49 days after the second injection. He was treated conservatively with platelet-rich plasma, and magnetic resonance imaging showed regenerative change of the ruptured fascia. Five months after the rupture, he returned to his original level of training. If professional athletes find it difficult to refrain from athletic activity, as in the present case, the risk of rupture due to corticosteroid injection should not be overlooked.

  12. Ruptured submitral aneurysm

    Directory of Open Access Journals (Sweden)

    V. Shukla

    2016-09-01

    Full Text Available Submitral aneurysm is a rare entity, with around few hundred cases reported till date. Presentation can be varied. We describe here a case of submitral aneurysm in a young male with rupture into the left atrium cavity.

  13. Traumatic rupture of the diaphragm: CT findings

    International Nuclear Information System (INIS)

    Cho, Sung Tae; Kim, Sung Jin; Cha, Sang Hoon; Park, Kil Sun; Kim, Jin Hee; Yim, Se Hwan

    1995-01-01

    The aim of this study was to assess the clinical utility of the known CT signs of the traumatic rupture of the diaphragm. CT scans and chest radiographs were retrospectively reviewed in 13 patients who had diaphragmatic rupture confirmed by surgery. On chest radiographs the elevation of the diaphragm was evaluated. On CT, 1) discontinuity of the diaphragm, 2) lack of depiction of the diaphragm surrounding the herniated intraabdominal organs (absent diaphragm sign), and 3) fat seen lateral to the diaphragm (fat sign) were evaluated. Chest radiographs showed the elevation of the diaphragm in 11 patients (85%). CT scan showed absent diaphragm sign in 11 patients (85%), discontinuity of the diaphragm in 8 (62%), and fat sign in 7 (54%). All of 12 patients who had the left diaphragmatic rupture had one or more of the above findings. Discontinuity of the diaphragm, absent diaphragm sign, and fat sign may be helpful CT findings in the diagnosis of the traumatic rupture of the left diaphragm

  14. Traumatic Gallbladder Rupture Treated by Laparoscopic Cholecystectomy

    Science.gov (United States)

    Egawa, Noriyuki; Ueda, Junji; Hiraki, Masatsugu; Ide, Takao; Inoue, Satoshi; Sakamoto, Yuichiro; Noshiro, Hirokazu

    2016-01-01

    Abstract Gallbladder rupture due to blunt abdominal injury is rare. There are few reports of traumatic gallbladder injury, and it is commonly associated with other concomitant visceral injuries. Therefore, it is difficult to diagnose traumatic gallbladder rupture preoperatively when it is caused by blunt abdominal injury. We report a patient who underwent laparoscopic cholecystectomy after an exact preoperative diagnosis of traumatic gallbladder rupture. A 43-year-old man was admitted to our hospital due to blunt abdominal trauma. The day after admission, abdominal pain and ascites increased and a muscular defense sign appeared. Percutaneous drainage of the ascites was performed, and the aspirated fluid was bloody and almost pure bile. He was diagnosed with gallbladder rupture by the cholangiography using the endoscopic retrograde cholangiopancreatography technique. Laparoscopic cholecystectomy was performed safely, and he promptly recovered. If accumulated fluids contain bile, endoscopic cholangiography is useful not only to diagnose gallbladder injury but also to determine the therapeutic strategy. PMID:27462188

  15. Traumatic Gallbladder Rupture Treated by Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Noriyuki Egawa

    2016-05-01

    Full Text Available Gallbladder rupture due to blunt abdominal injury is rare. There are few reports of traumatic gallbladder injury, and it is commonly associated with other concomitant visceral injuries. Therefore, it is difficult to diagnose traumatic gallbladder rupture preoperatively when it is caused by blunt abdominal injury. We report a patient who underwent laparoscopic cholecystectomy after an exact preoperative diagnosis of traumatic gallbladder rupture. A 43-year-old man was admitted to our hospital due to blunt abdominal trauma. The day after admission, abdominal pain and ascites increased and a muscular defense sign appeared. Percutaneous drainage of the ascites was performed, and the aspirated fluid was bloody and almost pure bile. He was diagnosed with gallbladder rupture by the cholangiography using the endoscopic retrograde cholangiopancreatography technique. Laparoscopic cholecystectomy was performed safely, and he promptly recovered. If accumulated fluids contain bile, endoscopic cholangiography is useful not only to diagnose gallbladder injury but also to determine the therapeutic strategy.

  16. MRI in flexor tendon rupture after collagenase injection

    International Nuclear Information System (INIS)

    Khurana, Shruti; Wadhwa, Vibhor; Chhabra, Avneesh; Amirlak, Bardia

    2017-01-01

    Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture. (orig.)

  17. MRI in flexor tendon rupture after collagenase injection

    Energy Technology Data Exchange (ETDEWEB)

    Khurana, Shruti [Lady Hardinge Medical College, New Delhi (India); Wadhwa, Vibhor [University of Arkansas for Medical Sciences, Little Rock, AR (United States); Chhabra, Avneesh [UT Southwestern Medical Center, Dallas, TX (United States); Johns Hopkins University, Baltimore, MD (United States); Amirlak, Bardia [UT Southwestern Medical Center, Dallas, TX (United States)

    2017-02-15

    Flexor tendon rupture is an unusual complication following collagenase injection to relieve contractures. These patients require a close follow-up and in the event of tendon rupture, a decision has to be made whether to repair the tendon or manage the complication conservatively. The authors report the utility of MRI in the prognostication and management of a patient with Dupuytren's contracture, who underwent collagenase injection and subsequently developed flexor digitorum profundus tendon rupture. (orig.)

  18. CT classification and clinical significance of rupture globe

    International Nuclear Information System (INIS)

    Diao Jinzhong; Zhang Guixiang

    1998-01-01

    Purpose: To discuss CT appearances of the rupture globe, and CT classifications and their clinical significance. Materials and methods: Forty-nine rupture globes were verified; 79% patents were scanned within 24 hours. Axial plane scanning were done with 3 mm slice and 256 x 256 matrix. Bone and soft tissue conditions were adjusted to analyse the bone and globe structures. Results: CT showed that globe circle rupture in one point of 32%, two points of 20%, and multiple points of 28%. Thickening of globe circle was as follows: 5 mm in 10 globes, 6 mm in 24, and 7 mm in 9.20% injured globes were enlarged and 32% were contracted. 14 anterior chambers deepened more than 4 mm. 83% rupture globes also had intraglobe hemorrhage and 48% foreign bodies. 28% injured globes had exophthalmus, and 75% had injured parasinuses or orbits, or brain trauma. Conclusion: The authors classified the rupture globe into three types. Type III showed unrepaired that should ablate the injured globes, whereas type I and II had to repair and to debride

  19. Ruptured Massa Intermedia Secondary to Hydrocephalus.

    Science.gov (United States)

    El Damaty, Ahmed; Langner, Soenke; Schroeder, Henry W S

    2017-01-01

    We report a case of ruptured massa intermedia (MI) as a sequela of hydrocephalus. A single case report is presented describing the sequelae of tumor bed hematoma after a posterior fossa hemangioblastoma resection in which the patient bled 3 days after surgery, resulting in secondary hydrocephalus and subsequently dilatation of the third ventricle, which resulted in rupture of the MI. The patient was managed on emergency basis with an external ventricular drain then endoscopically with a third ventriculostomy and clot extraction. Absent MI is not uncommon in hydrocephalic patients, and it is assumed to be the result of rupture from acute dilatation of the third ventricle. Our case report proves this assumption and documents the presence and absence of the MI before and after developing hydrocephalus. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. A comparison of pre-dropout and temporary rupture sessions in psychotherapy.

    Science.gov (United States)

    Gülüm, I Volkan; Soygüt, Gonca; Safran, Jeremy D

    2016-11-15

    Although numerous studies have investigated the relationship between the therapeutic alliance and dropout, most have focused on the relationship between alliance quality and psychotherapy outcomes. To compare sessions with therapeutic alliance ruptures and two sessions prior to treatment dropout (pre-dropout) in terms of rupture subtypes, psychotherapists' behavior, attitudes, and session content. We implemented quantitative methods to select the sessions and qualitative methods to analyze them. We analyzed 16 temporary rupture sessions from 12 therapist-patient dyads and 16 pre-dropout sessions from 8 different therapist-patient dyads. The sessions originate from clinical psychology Master's or Doctoral students under supervision in either cognitive behavioral or schema therapy. Pre-dropout sessions were considered unrepaired rupture sessions while rupture sessions were subsequently repaired. Results revealed apparent differences and similarities between the session types in positive and negative psychotherapist behaviors, content intensity, and the type and frequency of ruptures. We explored three new rupture subtypes: attributing positive developments to other sources, indirect speech, and sarcastic hostility. A striking implication is that the frequency of positive and negative psychotherapist behaviors, ruptures, and session content is more likely to decrease in the pre-dropout sessions than in the temporary rupture sessions.

  1. In-reactor creep rupture of 20% cold-worked AISI 316 stainless steel

    International Nuclear Information System (INIS)

    Lovell, A.J.; Chin, B.A.; Gilbert, E.R.

    1981-01-01

    Results of an experiment designed to measure in-reactor stress-to-rupture properties of 20% cold-worked AISI 316 stainless steel are reported. The in-reactor rupture data are compared with postirradiation and unirradiated test results. In-reactor rupture lives were found to exceed rupture predictions of postirradiation tests. This longer in-reactor rupture life is attributed to dynamic point defect generation which is absent during postirradiation testing. The in-reactor stress-to-rupture properties are shown to be equal to or greater than the unirradiated material stress-to-rupture properties for times up to 7000 h. (author)

  2. Double rupture disc experience

    International Nuclear Information System (INIS)

    1979-01-01

    Result of these observations, comparisons and evaluations can be summarized in the following list of concerns regarding the use of double rupture discs coupled to the liquid space of a steam generator that is subjected to a large leak sodium water reaction event. Single rupture disc show delayed collapse characteristics in LLTR Series I and double disc assemblies are presumed to be more complex with additional delay before opening to give pressure relief. Delayed failure increases pressures in the IHTS and must be adequately covered by design requirements. With CRBR design, the first disc may fail only partially reducing the loading on the second disc with the result that relief performance may not meet requirements

  3. Fault Branching and Long-Term Earthquake Rupture Scenario for Strike-Slip Earthquake

    Science.gov (United States)

    Klinger, Y.; CHOI, J. H.; Vallage, A.

    2017-12-01

    Careful examination of surface rupture for large continental strike-slip earthquakes reveals that for the majority of earthquakes, at least one major branch is involved in the rupture pattern. Often, branching might be either related to the location of the epicenter or located toward the end of the rupture, and possibly related to the stopping of the rupture. In this work, we examine large continental earthquakes that show significant branches at different scales and for which ground surface rupture has been mapped in great details. In each case, rupture conditions are described, including dynamic parameters, past earthquakes history, and regional stress orientation, to see if the dynamic stress field would a priori favor branching. In one case we show that rupture propagation and branching are directly impacted by preexisting geological structures. These structures serve as pathways for the rupture attempting to propagate out of its shear plane. At larger scale, we show that in some cases, rupturing a branch might be systematic, hampering possibilities for the development of a larger seismic rupture. Long-term geomorphology hints at the existence of a strong asperity in the zone where the rupture branched off the main fault. There, no evidence of throughgoing rupture could be seen along the main fault, while the branch is well connected to the main fault. This set of observations suggests that for specific configurations, some rupture scenarios involving systematic branching are more likely than others.

  4. Pancreatic Pseudocyst Ruptured due to Acute Intracystic Hemorrhage

    Directory of Open Access Journals (Sweden)

    Kunishige Okamura

    2017-12-01

    Full Text Available Rupture of pancreatic pseudocyst is one of the rare complications and usually results in high mortality. The present case was a rupture of pancreatic pseudocyst that could be treated by surgical intervention. A 74-year-old man developed abdominal pain, vomiting, and diarrhea, and he was diagnosed with cholecystitis and pneumonia. Three days later, acute pancreatitis occurred and computed tomography (CT showed slight hemorrhage in the cyst of the pancreatic tail. After another 10 days, CT showed pancreatic cyst ruptured due to intracystic hemorrhage. Endoscopic retrograde cholangiopancreatography revealed leakage of contrast agent from pancreatic tail cyst to enclosed abdominal cavity. His left hypochondrial pain was increasing, and CT showed rupture of the cyst of the pancreatic tail into the peritoneal cavity was increased in 10 days. CT showed also two left renal tumors. Therefore we performed distal pancreatectomy with concomitant resection of transverse colon and left kidney. We histopathologically diagnosed pancreatic pseudocyst ruptured due to intracystic hemorrhage and renal cell carcinoma. Despite postoperative paralytic ileus and fluid collection at pancreatic stump, they improved by conservative management and he could be discharged on postoperative day 29. He has achieved relapse-free survival for 6 months postoperatively. The mortality of pancreatic pseudocyst rupture is very high if some effective medical interventions cannot be performed. It should be necessary to plan appropriate treatment strategy depending on each patient.

  5. Steam generator tube rupture effects on a LOCA

    International Nuclear Information System (INIS)

    LaChance, J.L.

    1979-01-01

    A problem currently experienced in commercial operating pressurized water reactors (PWR) in the United States is the degradation of steam generator tubes. Safety questions have arisen concerning the effect of these degraded tubes rupturing during a postulated loss-of-coolant accident (LOCA). To determine the effect of a small number of tube ruptures on the behavior of a large PWR during a postulated LOCA, a series of computer simulations was performed. The primary concern of the study was to determine whether a small number (10 or less of steam generator tubes rupturing at the beginning surface temperatures. Additional reflood analyses were performed to determine the system behavior when from 10 to 60 tubes rupture at the beginning of core reflood. The FLOOD4 code was selected as being the most applicable code for use in this study after an extensive analysis of the capabilities of existing codes to perform simulations of a LOCA with concurrent steam generator tube ruptures. The results of the study indicate that the rupturing of 10 or less steam generator tubes in any of the steam generators during a 200% cold leg break will not result in a significant increase in the peak cladding temperature. However, because of the vaporization of the steam generator secondary water in the primary side of the steam generator, a significant increase in the core pressure occurs which retards the reflooding process

  6. Eccentric pressurized tube for measuring creep rupture

    International Nuclear Information System (INIS)

    Schwab, P.R.

    1981-01-01

    Creep rupture is a long term failure mode in structural materials that occurs at high temperatures and moderate stress levels. The deterioration of the material preceding rupture, termed creep damage, manifests itself in the formation of small cavities on grain boundaries. To measure creep damage, sometimes uniaxial tests are performed, sometimes density measurements are made, and sometimes the grain boundary cavities are measured by microscopy techniques. The purpose of the present research is to explore a new method of measuring creep rupture, which involves measuring the curvature of eccentric pressurized tubes. Theoretical investigations as well as the design, construction, and operation of an experimental apparatus are included in this research

  7. Crystal plastic earthquakes in dolostones: from slow to fast ruptures.

    Science.gov (United States)

    Passelegue, F. X.; Aubry, J.; Nicolas, A.; Fondriest, M.; Schubnel, A.; Di Toro, G.

    2017-12-01

    Dolostone is the most dominant lithology of the seismogenic upper crust around the Mediterranean Sea. Understanding the internal mechanisms controlling fault friction is crucial for understanding seismicity along active faults. Displacement in such fault zones is frequently highlighted by highly reflective (mirror-like) slip surfaces, created by thin films of nanogranular fault rock. Using saw-cut dolostone samples coming from natural fault zones, we conducted stick-slip experiments under triaxial loading conditions at 30, 60 and 90 MPa confining pressure and temperature ranging from 30 to 100 degrees C. At 30 and 65 degrees C, only slow rupture was observed and the experimental fault exhibits frictional behaviour, i.e. a dependence of normal stress on peak shear stress. At 65 degrees C, a strengthening behaviour is observed after the main rupture, leading to a succession of slow rupture. At 100 degrees C, the macroscopic behaviour of the fault becomes ductile, and no dependence of pressure on the peak shear stress is observed. In addition, the increase of the confining pressure up to 60 and 90 MPa allow the transition from slow to fast rupture, highlighted by the records of acoustic activity and by dynamic stress drop occurring in a few tens of microseconds. Using strain gages located along the fault surface and acoustic transducers, we were able to measure the rupture velocities during slow and fast rupture. Slow ruptures propagated around 0.1 m/s, in agreement with natural observations. Fast ruptures propagated up to supershear velocities, i.e. faster than the shear wave speed (>3500 m/s). A complete study of the microstructures was realized before and after ruptures. Slow ruptures lead to the production of mirror-like surface driven by the production of nanograins due to dislocation processes. Fast ruptures induce the production of amorphous material along the fault surface, which may come from decarbonation and melting processes. We demonstrate that the

  8. [Achilles tendon rupture].

    Science.gov (United States)

    Thermann, H; Hüfner, T; Tscherne, H

    2000-03-01

    The treatment of acute of Achilles tendon rupture experienced a dynamic development in the last ten years. Decisive for this development was the application of MRI and above all the ultrasonography in the diagnostics of the pathological changes and injuries of tendons. The question of rupture morphology as well as different courses of healing could be now evaluated objectively. These advances led consequently to new modalities in treatment concepts and rehabilitation protocols. The decisive input for improvements of the outcome results and particularly the shortening of the rehabilitation period came with introduction of the early functional treatment in contrast to immobilizing plaster treatment. In a prospective randomized study (1987-1989) at the Trauma Dept. of the Hannover Medical School could show no statistical differences comparing functional non-operative with functional operative therapy with a special therapy boot (Variostabil/Adidas). The crucial criteria for therapy selection results from the sonographically measured position of the tendon stumps in plantar flexion (20 degrees). With complete adaptation of the tendons' ends surgical treatment does not achieve better results than non-operative functional treatment in term of tendon healing and functional outcome. Regarding the current therapeutic standards each method has is advantages and disadvantages. Both, the operative and non-operative functional treatment enable a stable tendon healing with a low risk of re-rupture (1-2%). Meanwhile there is consensus for early functional after-treatment of the operated Achilles' tendons. There seems to be a trend towards non-operative functional treatment in cases of adequate sonographical findings, or to minimal invasive surgical techniques.

  9. Rupture Complexity Promoted by Damaged Fault Zones in Earthquake Cycle Models

    Science.gov (United States)

    Idini, B.; Ampuero, J. P.

    2017-12-01

    Pulse-like ruptures tend to be more sensitive to stress heterogeneity than crack-like ones. For instance, a stress-barrier can more easily stop the propagation of a pulse than that of a crack. While crack-like ruptures tend to homogenize the stress field within their rupture area, pulse-like ruptures develop heterogeneous stress fields. This feature of pulse-like ruptures can potentially lead to complex seismicity with a wide range of magnitudes akin to the Gutenberg-Richter law. Previous models required a friction law with severe velocity-weakening to develop pulses and complex seismicity. Recent dynamic rupture simulations show that the presence of a damaged zone around a fault can induce pulse-like rupture, even under a simple slip-weakening friction law, although the mechanism depends strongly on initial stress conditions. Here we aim at testing if fault zone damage is a sufficient ingredient to generate complex seismicity. In particular, we investigate the effects of damaged fault zones on the emergence and sustainability of pulse-like ruptures throughout multiple earthquake cycles, regardless of initial conditions. We consider a fault bisecting a homogeneous low-rigidity layer (the damaged zone) embedded in an intact medium. We conduct a series of earthquake cycle simulations to investigate the effects of two fault zone properties: damage level D and thickness H. The simulations are based on classical rate-and-state friction, the quasi-dynamic approximation and the software QDYN (https://github.com/ydluo/qdyn). Selected fully-dynamic simulations are also performed with a spectral element method. Our numerical results show the development of complex rupture patterns in some damaged fault configurations, including events of different sizes, as well as pulse-like, multi-pulse and hybrid pulse-crack ruptures. We further apply elasto-static theory to assess how D and H affect ruptures with constant stress drop, in particular the flatness of their slip profile

  10. Long-term outcomes of percutaneous lumbar facet synovial cyst rupture

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Bos, Stijn A.; Torriani, Martin; Simeone, F.J.; Chang, Connie Y.; Pomerantz, Stuart R.; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2017-01-15

    To evaluate the therapeutic value, safety, and long-term clinical outcomes of percutaneous lumbar facet synovial cyst (LFSC) rupture. Our study was institutional review board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPAA)-compliant. The study group comprised 71 patients (44 women, mean age: 65 ± 17 years) who underwent CT- or fluoroscopy-guided percutaneous LFSC rupture. The technical success of LFSC rupture, the long-term clinical outcome, including repeat procedures or surgery, and imaging findings on MRI and CT were recorded. Seventy-nine LFSC ruptures were performed in 71 patients. CT guidance was used in 57 cases and fluoroscopy guidance in 22 cases. LFSC rupture was technically successful in 58 out of 79 cases (73 %). Mean injection volume for cyst rupture was 3.6 ± 2.2 mL and a combination of steroid and anesthetic was injected in all cases. Over a mean follow-up time of 44 months, 12 % of patients underwent repeat cyst rupture, and 46 % eventually underwent surgery, whereas the majority of patients (55 %) experienced symptomatic relief and did not undergo surgery. There was no significant association between a successful outcome and age, sex, level, or size of LFSC (p > 0.1). LFSCs with T2 hypointensity were more likely to require surgery (p = 0.02). There was one complication, a bacterial skin infection that completely resolved following antibiotic therapy. Percutaneous LFSC rupture is an effective and safe nonsurgical treatment option for LFSC. More than half of treated patients were able to avoid subsequent surgery. Therefore, percutaneous LFSC rupture should be considered before surgical intervention. (orig.)

  11. Safety design guide for pipe rupture protection for CANDU 9

    International Nuclear Information System (INIS)

    Lee, Duk Su; Chang, Woo Hyun; Lee, Nam Young; A. C. D. Wright

    1996-03-01

    This safety design guide for pipe rupture protection identifies high-energy systems in which pipe ruptures must be postulated to occur, as well as systems that must be protected from the dynamic effects of such ruptures. Dynamic effects considered in this SDG consist of pipe whip (including missiles generated by pipe ruptures, if any) and jet impingement, Requirements for protection against the dynamic effects of a postulated pipe rupture and method of protection of essential structures, systems and components are specified for these effects. The change status for the regulatory requirements, code and standards should be traced and this safety design guide shall be updated accordingly. 2 tabs., 5 refs. (Author) .new

  12. Radionuclide scan findings in delayed splenic rupture

    International Nuclear Information System (INIS)

    Flickinger, F.W.; Jackson, G.L.

    1978-01-01

    An initial liver/spleen scan performed on a patient with blunt abdominal trauma was negative 3 days following the accident. A follow-up scan 7 days later showed definite evidence of splenic rupture, proved surgically. The authors conclude that, in such cases, spleen scans may be negative initially because of delayed splenic ruptures

  13. Size ratio correlates with intracranial aneurysm rupture status: a prospective study.

    Science.gov (United States)

    Rahman, Maryam; Smietana, Janel; Hauck, Erik; Hoh, Brian; Hopkins, Nick; Siddiqui, Adnan; Levy, Elad I; Meng, Hui; Mocco, J

    2010-05-01

    The prediction of intracranial aneurysm (IA) rupture risk has generated significant controversy. The findings of the International Study of Unruptured Intracranial Aneurysms (ISUIA) that small anterior circulation aneurysms (IAs are small. These discrepancies have led to the search for better aneurysm parameters to predict rupture. We previously reported that size ratio (SR), IA size divided by parent vessel diameter, correlated strongly with IA rupture status (ruptured versus unruptured). These data were all collected retrospectively off 3-dimensional angiographic images. Therefore, we performed a blinded prospective collection and evaluation of SR data from 2-dimensional angiographic images for a consecutive series of patients with ruptured and unruptured IAs. We prospectively enrolled 40 consecutive patients presenting to a single institution with either ruptured IA or for first-time evaluation of an incidental IA. Blinded technologists acquired all measurements from 2-dimensional angiographic images. Aneurysm rupture status, location, IA maximum size, and parent vessel diameter were documented. The SR was calculated by dividing the aneurysm size (mm) by the average parent vessel size (mm). A 2-tailed Mann-Whitney test was performed to assess statistical significance between ruptured and unruptured groups. Fisher exact test was used to compare medical comorbidities between the ruptured and unruptured groups. Significant differences between the 2 groups were subsequently tested with logistic regression. SE and probability values are reported. Forty consecutive patients with 24 unruptured and 16 ruptured aneurysms met the inclusion criteria. No significant differences were found in age, gender, smoking status, or medical comorbidities between ruptured and unruptured groups. The average maximum size of the unruptured IAs (6.18 + or - 0.60 mm) was significantly smaller compared with the ruptured IAs (7.91 + or - 0.47 mm; P=0.03), and the unruptured group had

  14. Resolution of alliance ruptures: The special case of animal-assisted psychotherapy.

    Science.gov (United States)

    Zilcha-Mano, Sigal

    2017-01-01

    Many therapists regard alliance ruptures as one of the greatest challenges therapists face in the therapy room. Alliance ruptures has been previously defined as breakdowns in the process of negotiation of treatment tasks and goals and a deterioration in the affective bond between patient and therapist. Alliance ruptures have been found to predict premature termination of treatment and poor treatment outcomes. But ruptures can also present important opportunities for gaining insight and awareness and for facilitating therapeutic change. A process of rupture resolution may lead to beneficial outcomes and serve as a corrective emotional experience. The article describes unique processes of alliance rupture resolution inherent in animal-assisted psychotherapy (AAP). Building on Safran and Muran's model and on clinical examples, the article describes strategies for identifying ruptures in AAP and techniques for repairing them to facilitate a corrective experience in treatment. Implications for clinical practice and future research are discussed.

  15. Shigella subverts the host recycling compartment to rupture its vacuole.

    Science.gov (United States)

    Mellouk, Nora; Weiner, Allon; Aulner, Nathalie; Schmitt, Christine; Elbaum, Michael; Shorte, Spencer L; Danckaert, Anne; Enninga, Jost

    2014-10-08

    Shigella enters epithlial cells via internalization into a vacuole. Subsequent vacuolar membrane rupture allows bacterial escape into the cytosol for replication and cell-to-cell spread. Bacterial effectors such as IpgD, a PI(4,5)P2 phosphatase that generates PI(5)P and alters host actin, facilitate this internalization. Here, we identify host proteins involved in Shigella uptake and vacuolar membrane rupture by high-content siRNA screening and subsequently focus on Rab11, a constituent of the recycling compartment. Rab11-positive vesicles are recruited to the invasion site before vacuolar rupture, and Rab11 knockdown dramatically decreases vacuolar membrane rupture. Additionally, Rab11 recruitment is absent and vacuolar rupture is delayed in the ipgD mutant that does not dephosphorylate PI(4,5)P₂ into PI(5)P. Ultrastructural analyses of Rab11-positive vesicles further reveal that ipgD mutant-containing vacuoles become confined in actin structures that likely contribute to delayed vacular rupture. These findings provide insight into the underlying molecular mechanism of vacuole progression and rupture during Shigella invasion. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. The diagnosis of breast implant rupture: MRI findings compared with findings at explantation

    International Nuclear Information System (INIS)

    Hoelmich, Lisbet R.; Vejborg, Ilse; Conrad, Carsten; Sletting, Susanne; McLaughlin, Joseph K.

    2005-01-01

    Study objective: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone breast implants. Material and methods: The study population consisted of 64 women with 118 implants, who had participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture (intracapsular or extracapsular), possible rupture or intact implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. Results: At MRI, 66 implants were diagnosed as ruptured, nine as possibly ruptured and 43 as intact. Among the ruptured implants, 27 were categorized as extracapsular. At surgery, on average 297 days after the MRI, 65 of the 66 rupture diagnoses were confirmed, as were 20 of the cases with extracapsular silicone. Eight of the nine possibly ruptured implants were in fact ruptured at surgery. Thirty-four of the 43 intact implants were described as intact at surgery. When categorising possible ruptures as ruptures, there were one false positive and nine false negative rupture diagnoses at MRI yielding an accuracy of 92%, a sensitivity of 89%, and a specificity of 97%. Correspondingly, the predictive value of a positive MRI examination was 99% and the predictive value of a negative MRI examination was 79%. Conclusions: We conclude that MRI is highly accurate for identification of silicone breast implant rupture, with a high sensitivity and specificity when evaluation of images are based on presence of well-defined rupture criteria

  17. Morphological parameters associated with ruptured posterior communicating aneurysms.

    Science.gov (United States)

    Ho, Allen; Lin, Ning; Charoenvimolphan, Nareerat; Stanley, Mary; Frerichs, Kai U; Day, Arthur L; Du, Rose

    2014-01-01

    The rupture risk of unruptured intracranial aneurysms is known to be dependent on the size of the aneurysm. However, the association of morphological characteristics with ruptured aneurysms has not been established in a systematic and location specific manner for the most common aneurysm locations. We evaluated posterior communicating artery (PCoA) aneurysms for morphological parameters associated with aneurysm rupture in that location. CT angiograms were evaluated to generate 3-D models of the aneurysms and surrounding vasculature. Univariate and multivariate analyses were performed to evaluate morphological parameters including aneurysm volume, aspect ratio, size ratio, distance to ICA bifurcation, aneurysm angle, vessel angles, flow angles, and vessel-to-vessel angles. From 2005-2012, 148 PCoA aneurysms were treated in a single institution. Preoperative CTAs from 63 patients (40 ruptured, 23 unruptured) were available and analyzed. Multivariate logistic regression revealed that smaller volume (p = 0.011), larger aneurysm neck diameter (0.048), and shorter ICA bifurcation to aneurysm distance (p = 0.005) were the most strongly associated with aneurysm rupture after adjusting for all other clinical and morphological variables. Multivariate subgroup analysis for patients with visualized PCoA demonstrated that larger neck diameter (p = 0.018) and shorter ICA bifurcation to aneurysm distance (p = 0.011) were significantly associated with rupture. Intracerebral hemorrhage was associated with smaller volume, larger maximum height, and smaller aneurysm angle, in addition to lateral projection, male sex, and lack of hypertension. We found that shorter ICA bifurcation to aneurysm distance is significantly associated with PCoA aneurysm rupture. This is a new physically intuitive parameter that can be measured easily and therefore be readily applied in clinical practice to aid in the evaluation of patients with PCoA aneurysms.

  18. Hemoperitoneum from corpus luteum rupture in patients with aplastic anemia.

    Science.gov (United States)

    Wang, Huaquan; Guo, Lifang; Shao, Zonghong

    2015-01-01

    Aplastic anemia is a rare hematopoietic stem-cell disorder that results in pancytopenia and hypocellular bone marrow. Women with aplastic anemia usually are at increased risk of corpus luteum rupture due to thrombocytopenia and infection. Here we report two cases had hemoperitoneum from corpus luteum rupture in patients with aplastic anemia in our center. Case 1 involved two episodes of hemoperitoneum resulting from rupture of the corpus luteum in a 23-year-old unmarried female with severe aplastic anemia. This patient was managed conservatively with platelet and packed red cell transfusion. Case 2 involved two episodes of hemoperitoneum resulting from rupture of the corpus luteum in a 33-year-old married patient with aplastic anemia. Emergency laparoscopy revealed massive hemoperitoneum. Bilateral salpingo-oophorectomy were performed successively with platelet and packed red cell transfusion. Hemoperitoneum resulting from a ruptured corpus luteum is a life-threatening condition in patients with aplastic anemia. Prompt and appropriate evaluation of corpus luteum rupture and emergent therapy are needed.

  19. Morphology parameters for intracranial aneurysm rupture risk assessment.

    Science.gov (United States)

    Dhar, Sujan; Tremmel, Markus; Mocco, J; Kim, Minsuok; Yamamoto, Junichi; Siddiqui, Adnan H; Hopkins, L Nelson; Meng, Hui

    2008-08-01

    The aim of this study is to identify image-based morphological parameters that correlate with human intracranial aneurysm (IA) rupture. For 45 patients with terminal or sidewall saccular IAs (25 unruptured, 20 ruptured), three-dimensional geometries were evaluated for a range of morphological parameters. In addition to five previously studied parameters (aspect ratio, aneurysm size, ellipticity index, nonsphericity index, and undulation index), we defined three novel parameters incorporating the parent vessel geometry (vessel angle, aneurysm [inclination] angle, and [aneurysm-to-vessel] size ratio) and explored their correlation with aneurysm rupture. Parameters were analyzed with a two-tailed independent Student's t test for significance; significant parameters (P 41; 95% confidence interval, 1.03-1.92) and undulation index (odds ratio, 1.51; 95% confidence interval, 1.08-2.11) had the strongest independent correlation with ruptured IA. From the receiver operating characteristic analysis, size ratio and aneurysm angle had the highest area under the curve values of 0.83 and 0.85, respectively. Size ratio and aneurysm angle are promising new morphological metrics for IA rupture risk assessment. Because these parameters account for vessel geometry, they may bridge the gap between morphological studies and more qualitative location-based studies.

  20. Multi-Canister overpack necessity of the rupture disk

    International Nuclear Information System (INIS)

    SMITH, K.E.

    1998-01-01

    The Multi-Canister Overpack (MCO) rupture disk precludes the MCO from pressurization above the design limit during transport from the K Basins to the Cold Vacuum Drying (CVD) Facility and prior to connection of the CVD process piping. Removal of the rupture disk from the MCO design would: (a) result in unacceptable dose consequences in the event a thermal runaway accident occurred; (b) increase residual risk; and (c) remove a degree of specificity from the dose calculations. The potential cost savings of removing the rupture disk from the MCO design is offset by the cost of design modifications, changes to hazard analyses and safety analyses, and changes to existing documentation. Retaining the rupture disk mitigates the consequences of MCO overpressurization, and considering the overall economic impacts to the SNF Project, is the most cost effective approach

  1. Right ventricular hydatid cyst ruptured to pericardium

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-01-01

    Full Text Available Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

  2. CT diagnosis of traumatic bronchial rupture in children

    International Nuclear Information System (INIS)

    Epelman, Monica; Ofer, Amos; Guralnik, Ludmila; Klein, Yoram; Best, Leal H.; Bentur, Lea; Traubici, Jeffrey

    2002-01-01

    Bronchial rupture is a rare and serious complication of blunt chest trauma in children. The diagnosis of this injury is challenging and requires a high degree of clinical suspicion. It is frequently associated with other severe injuries that may draw the focus of attention away from this potentially catastrophic but treatable injury. The radiographic findings of bronchial rupture have been reported in very few series. We report the findings in two children with bronchial rupture diagnosed by CT, in whom CT resulted in a significant change in patient management. (orig.)

  3. Simultaneous bilateral patellar tendon rupture.

    Science.gov (United States)

    Moura, Diogo Lino; Marques, José Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2017-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  4. Rupture luminescence from natural fibers

    Science.gov (United States)

    Li, W.; Haneman, D.

    1999-12-01

    Fibers of cotton and wool, and samples of paper, have been ruptured in tension in vacuum and in air, and give detectable luminescence in the visible range. All have a common emission peak at around 2.0 eV, which is ascribed to the deexcitation of states excited by the rupture of organic chain molecule bonds. Rubber bands give stronger emission in air, but no emission in vacuum, suggesting the material breaks only at weak interchain bonds. Mohair, cat, and horse hair also give emission in air. The phenomena reveal effects that would occur widely in nature.

  5. Rupture of popliteal arterial aneurysm due to salmonella infection

    International Nuclear Information System (INIS)

    Kim, Dong Hun; Oh, Hyung Woo; Kim, Dong Hyun; Byun, Joo Nam

    2006-01-01

    We report here on a case of popliteal aneurysm and rupture that occurred over a 10-day period and this was all secondary to salmonella infection. Computed tomography (CT) angiography of the extremity that was performed before and after aneurysmal rupture showed the aneurysm's rapid evolution to rupture over a short period of time. We also review the pathogenesis, clinical presentation, diagnostic approach and management of salmonella aneurysms

  6. Unusual Cause of Acute Abdomen—Ruptured Retroperitoneal Paraganglioma

    OpenAIRE

    Kwok-Kay Yau; Wing-Tai Siu; Michael Ka-Wah Li

    2008-01-01

    Ruptured retroperitoneal paraganglioma is a rare cause of acute abdomen. Its clinical presentation and laparoscopic features have seldom been reported in the literature. Herein, we report a case of ruptured retroperitoneal paraganglioma that presented as acute abdomen, and its subsequent management.

  7. Ruptured uterus in Kano, Nigeria - study of risk factors | Omole ...

    African Journals Online (AJOL)

    This is a comparative prospective study of the risk factors for ruptured uterus in Aminu Kano Teaching Hospital, Kano, Nigeria, between 1st January 2000 and 31st December 2005. Forty six women with ruptured uterus (cases) were compared with two hundred and thirty women who delivered without ruptured uterus ...

  8. Rupture-control via T-Branches - now with precise indication of the rupture; Abrissueberwachung ueber T-Weichen mit Lokalisierung des Abrisses

    Energy Technology Data Exchange (ETDEWEB)

    Lentz, S. [Roetter Industrieelektronik GmbH, Kaiserslautern (Germany)

    2000-05-01

    In hierarchical monitoring systems, normally only the main line can be checked automatically for rupture of the sensor wire. During the AGFW lecture conference in 1998 in Essen, a solution was introduced, where through closing the branch lines with endpieces by the Roetter Industrieelektronik GmbH, the branch lines could be also monitored for ruptures automatically. This process has been further developed since then and now offers the possibility to directly indicate the ruptured branch and if there is more than one rupture, this can be indicated separately as well. (orig.) [German] In hierarchischen Ueberwachungssystemen kann ueblicherweise nur die Hauptleitung automatisch auf Abriss des Sensordrahtes geprueft werden. Bereits auf der AGFW Vortragstagung 1998 in Essen wurde eine Loesung vorgestellt, durch Abschluss der Abzweigleitungen mit Endstuecken von Roetter Industrieelektronik GmbH auch die Abzweigleitungen automatisch auf Abriss zu ueberwachen. Dieses Verfahren wurde praxisgerecht weiterentwickelt und bietet nun die Moeglichkeit, den vom Abriss betroffenen Abzweig direkt anzuzeigen, bei mehreren Abrissen ist jeder einzelne zuzuordnen. (orig.)

  9. Splenic artery aneurysm rupture in pregnancy

    International Nuclear Information System (INIS)

    Khan, H.R.; Low, S.; Selinger, M.; Nelson, N.

    2004-01-01

    Rupture of a splenic artery aneurysm, commonly associated with pregnancy is a rare and catastrophic event. We report here a case of a patient in her second pregnancy who presented with a short history of left hypochondriac and epigastric pain, followed by collapse at 32 weeks gestation. Sudden fetal distress lead to emergency caesarean delivery when splenic artery aneurysm rupture was diagnosed. With timely involvement of multidisciplinary personnel both mother and baby survived and had an uneventful recovery. (author)

  10. Triceps Ruptures After Fluoroquinolone Antibiotics: A Report of 2 Cases.

    Science.gov (United States)

    Shybut, Theodore B; Puckett, Ernest R

    Rupture of the triceps brachii tendon is exceedingly rare, and surgical repair is generally indicated. Fluoroquinolone antibiotics have been implicated in tendon pathology, including tendon ruptures. Triceps rupture has not been previously reported in the setting of fluoroquinolone antibiotic therapy. We present 2 cases of triceps tendon rupture after treatment with fluoroquinolones. In both cases, triceps repair was performed with good outcomes. These cases highlight a risk of fluoroquinolone-induced tendinopathy to athletes. The sports medicine team should be aware of this risk and consider it when choosing antibiotics to treat athletes.

  11. Complementary Ruptures of Surface Ruptures and Deep Asperity during the 2014 Northern Nagano, Japan, Earthquake (MW 6.3)

    Science.gov (United States)

    Asano, K.; Iwata, T.; Kubo, H.

    2015-12-01

    A thrust earthquake of MW 6.3 occurred along the northern part of the Itoigawa-Shizuoka Tectonic Line (ISTL) in the northern Nagano prefecture, central Japan, on November 22, 2014. This event was reported to be related to an active fault, the Kamishiro fault belonging to the ISTL (e.g., HERP, 2014). The surface rupture is observed along the Kamishiro fault (e.g., Lin et al., 2015; Okada et al., 2015). We estimated the kinematic source rupture process of this earthquake through the multiple time-window linear waveform inversion method (Hartzell and Heaton, 1983). We used velocity waveforms in 0.05-1 Hz from 12 strong motion stations of K-NET, KiK-net (NIED), JMA, and Nagano prefecture (SK-net, ERI). In order to enhance the reliability in Green's functions, we assumed one-dimensional velocity structure models different for the different stations, which were extracted from the nation-wide three-dimensional velocity structure model, Japan Integrated Velocity Structure Model (JIVSM, Koketsu et al., 2012). Considering the spatial distribution of aftershocks (Sakai et al., 2015) and surface ruptures, the assumed fault model consisted of two dip-bending fault segments with different dip angles between the northern and southern segments. The total length and width of the fault plane is 20 km and 13 km, relatively, and the fault model is divided into 260 subfaults of 1 km × 1 km in space and six smoothed ramp functions in time. An asperity or large slip area with a peak slip of 1.9 m was estimated in the lower plane of the northern segment in the approximate depth range of 4 to 8 km. The depth extent of this asperity is consistent with the seismogenic zone revealed by past studies (e.g., Panayotopoulos et al., 2014). In contrast, the slip in the southern segment is relatively concentrated in the shallow portion of the segment where the surface ruptures were found along the Kamishiro fault. The overall spatial rupture pattern of the source fault, in which the deep asperity

  12. Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy.

    Directory of Open Access Journals (Sweden)

    An-Shine Chao

    Full Text Available The incidence of uterine rupture through a previous cesarean scar (CS is declining as a result of a lower parity and fewer options for vaginal birth after cesarean. However, uterine ruptures attributable to other causes that traumatize the myometrium are on the rise. To determine whether changes in the causes of uterine rupture had occurred in recent years, we retrospective retrieved the clinical records of all singletons with uterine rupture observed in the delivery room of a Taiwanese tertiary obstetric center over a 15-year period. The overall uterine rupture rate was 3.8 per 10,000 deliveries. A total of 22 cases in 20 women (with two of them experiencing two episodes. Seven uterine ruptures occurred through a previous cesarean scar (CS ruptures, 32%, 13 through a non-cesarean scar (non-CS ruptures, 59%, whereas the remaining two (9% were in women who did not previously undergo any surgery. All of the 13 non-CS ruptures were identified in women with a history of laparoscopic procedures to the uterus. Specifically, 10 (76% occurred after a previous laparoscopic myomectomy, one (8% following a hysteroscopic myomectomy, and two (16% after a laparoscopic wedge resection of cornual ectopic pregnancy. Severe bleeding (blood loss >1500 mL requiring transfusions was more frequent in women who experienced non-CS compared with CS ruptures (10 versus 1 case, respectively, P = 0.024. Patients with a history of endoscopic uterine surgery should be aware of uterine rupture during pregnancy.

  13. Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy.

    Science.gov (United States)

    Chao, An-Shine; Chang, Yao-Lung; Yang, Lan-Yan; Chao, Angel; Chang, Wei-Yang; Su, Sheng-Yuan; Wang, Chin-Jung

    2018-01-01

    The incidence of uterine rupture through a previous cesarean scar (CS) is declining as a result of a lower parity and fewer options for vaginal birth after cesarean. However, uterine ruptures attributable to other causes that traumatize the myometrium are on the rise. To determine whether changes in the causes of uterine rupture had occurred in recent years, we retrospective retrieved the clinical records of all singletons with uterine rupture observed in the delivery room of a Taiwanese tertiary obstetric center over a 15-year period. The overall uterine rupture rate was 3.8 per 10,000 deliveries. A total of 22 cases in 20 women (with two of them experiencing two episodes). Seven uterine ruptures occurred through a previous cesarean scar (CS ruptures, 32%), 13 through a non-cesarean scar (non-CS ruptures, 59%), whereas the remaining two (9%) were in women who did not previously undergo any surgery. All of the 13 non-CS ruptures were identified in women with a history of laparoscopic procedures to the uterus. Specifically, 10 (76%) occurred after a previous laparoscopic myomectomy, one (8%) following a hysteroscopic myomectomy, and two (16%) after a laparoscopic wedge resection of cornual ectopic pregnancy. Severe bleeding (blood loss >1500 mL) requiring transfusions was more frequent in women who experienced non-CS compared with CS ruptures (10 versus 1 case, respectively, P = 0.024). Patients with a history of endoscopic uterine surgery should be aware of uterine rupture during pregnancy.

  14. Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy

    Science.gov (United States)

    Chao, An-Shine; Chang, Yao-Lung; Yang, Lan-Yan; Chao, Angel; Chang, Wei-Yang; Su, Sheng-Yuan

    2018-01-01

    The incidence of uterine rupture through a previous cesarean scar (CS) is declining as a result of a lower parity and fewer options for vaginal birth after cesarean. However, uterine ruptures attributable to other causes that traumatize the myometrium are on the rise. To determine whether changes in the causes of uterine rupture had occurred in recent years, we retrospective retrieved the clinical records of all singletons with uterine rupture observed in the delivery room of a Taiwanese tertiary obstetric center over a 15-year period. The overall uterine rupture rate was 3.8 per 10,000 deliveries. A total of 22 cases in 20 women (with two of them experiencing two episodes). Seven uterine ruptures occurred through a previous cesarean scar (CS ruptures, 32%), 13 through a non-cesarean scar (non-CS ruptures, 59%), whereas the remaining two (9%) were in women who did not previously undergo any surgery. All of the 13 non-CS ruptures were identified in women with a history of laparoscopic procedures to the uterus. Specifically, 10 (76%) occurred after a previous laparoscopic myomectomy, one (8%) following a hysteroscopic myomectomy, and two (16%) after a laparoscopic wedge resection of cornual ectopic pregnancy. Severe bleeding (blood loss >1500 mL) requiring transfusions was more frequent in women who experienced non-CS compared with CS ruptures (10 versus 1 case, respectively, P = 0.024). Patients with a history of endoscopic uterine surgery should be aware of uterine rupture during pregnancy. PMID:29787604

  15. Does Spontaneous Favorability to Power (vs. Universalism) Values Predict Spontaneous Prejudice and Discrimination?

    Science.gov (United States)

    Souchon, Nicolas; Maio, Gregory R; Hanel, Paul H P; Bardin, Brigitte

    2017-10-01

    We conducted five studies testing whether an implicit measure of favorability toward power over universalism values predicts spontaneous prejudice and discrimination. Studies 1 (N = 192) and 2 (N = 86) examined correlations between spontaneous favorability toward power (vs. universalism) values, achievement (vs. benevolence) values, and a spontaneous measure of prejudice toward ethnic minorities. Study 3 (N = 159) tested whether conditioning participants to associate power values with positive adjectives and universalism values with negative adjectives (or inversely) affects spontaneous prejudice. Study 4 (N = 95) tested whether decision bias toward female handball players could be predicted by spontaneous attitude toward power (vs. universalism) values. Study 5 (N = 123) examined correlations between spontaneous attitude toward power (vs. universalism) values, spontaneous importance toward power (vs. universalism) values, and spontaneous prejudice toward Black African people. Spontaneous positivity toward power (vs. universalism) values was associated with spontaneous negativity toward minorities and predicted gender bias in a decision task, whereas the explicit measures did not. These results indicate that the implicit assessment of evaluative responses attached to human values helps to model value-attitude-behavior relations. © 2016 The Authors. Journal of Personality Published by Wiley Periodicals, Inc.

  16. Amnioinfusion for preterm rupture of membranes.

    Science.gov (United States)

    Hofmeyr, G J

    2000-01-01

    Preterm rupture of membranes places a fetus at risk of cord compression and amnionitis. Amnioinfusion aims to prevent or relieve umbilical cord compression by infusing a solution into the uterine cavity. The objective of this review was to assess the effects of amnioinfusion for preterm rupture of membranes on maternal and perinatal outcomes. The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Randomised trials of amnioinfusion compared to no amnioinfusion in women with preterm rupture of membranes. Eligibility and trial quality were assessed by the reviewer. One trial of 66 women was included. It had some methodological flaws. No significant differences between amnioinfusion and no amnioinfusion were detected for caesarean section (relative risk 0.32, 95% confidence interval 0.07 to 1.40); low Apgar scores (relative risk 0.28, 95% confidence interval 0.03 to 2.33) or neonatal death (relative risk 0.55, 95% confidence interval 0.05 to 5.77). In the amnioinfusion group, the number of severe fetal heart rate decelerations per hour during the first stage of labour were reduced (weighted mean difference -1.20, 95% confidence interval -1.83 to -0.57). These outcomes are consistent with those found in the Cochrane review on amnioinfusion for cord compression. There is not enough evidence concerning the use of amnioinfusion for preterm rupture of membranes.

  17. Premature rupture of membranes

    Science.gov (United States)

    ... gov/ency/patientinstructions/000512.htm Premature rupture of membranes To use the sharing features on this page, ... water that surrounds your baby in the womb. Membranes or layers of tissue hold in this fluid. ...

  18. Component external leakage and rupture frequency estimates

    International Nuclear Information System (INIS)

    Eide, S.A.; Khericha, S.T.; Calley, M.B.; Johnson, D.A.; Marteeny, M.L.

    1991-11-01

    In order to perform detailed internal flooding risk analyses of nuclear power plants, external leakage and rupture frequencies are needed for various types of components - piping, valves, pumps, flanges, and others. However, there appears to be no up-to-date, comprehensive source for such frequency estimates. This report attempts to fill that void. Based on a comprehensive search of Licensee Event Reports (LERs) contained in Nuclear Power Experience (NPE), and estimates of component populations and exposure times, component external leakage and rupture frequencies were generated. The remainder of this report covers the specifies of the NPE search for external leakage and rupture events, analysis of the data, a comparison with frequency estimates from other sources, and a discussion of the results

  19. Unusual Cause of Acute Abdomen—Ruptured Retroperitoneal Paraganglioma

    Directory of Open Access Journals (Sweden)

    Kwok-Kay Yau

    2008-01-01

    Full Text Available Ruptured retroperitoneal paraganglioma is a rare cause of acute abdomen. Its clinical presentation and laparoscopic features have seldom been reported in the literature. Herein, we report a case of ruptured retroperitoneal paraganglioma that presented as acute abdomen, and its subsequent management.

  20. Creep rupture behavior of welded Grade 91 steel

    Energy Technology Data Exchange (ETDEWEB)

    Shrestha, Triratna [Department of Chemical and Materials Engineering, University of Idaho, Moscow, ID 83844 (United States); Basirat, Mehdi [Department of Mechanical Engineering, University of Idaho, Moscow, ID 83844 (United States); Alsagabi, Sultan; Sittiho, Anumat [Department of Chemical and Materials Engineering, University of Idaho, Moscow, ID 83844 (United States); Charit, Indrajit, E-mail: icharit@uidaho.edu [Department of Chemical and Materials Engineering, University of Idaho, Moscow, ID 83844 (United States); Potirniche, Gabriel P. [Department of Mechanical Engineering, University of Idaho, Moscow, ID 83844 (United States)

    2016-07-04

    Creep rupture behavior of fusion welded Grade 91 steel was studied in the temperature range of 600 – 700 °C and at stresses of 50–200 MPa. The creep data were analyzed in terms of the Monkman-Grant relation and Larson-Miller parameter. The creep damage tolerance factor was used to identify the origin of creep damage. The creep damage was identified as the void growth in combination with microstructural degradation. The fracture surface morphology of the ruptured specimens was studied by scanning electron microscopy and deformed microstructure examined by transmission electron microscopy, to further elucidate the rupture mechanisms.

  1. Blunt cardiac rupture in a toddler

    Directory of Open Access Journals (Sweden)

    Peep Talving

    2016-08-01

    Full Text Available Blunt cardiac rupture is typically a fatal injury with overall mortality exceeding 90%. Most of the patients never reach the hospital alive. In pediatric patients, only 0.03% of cases following blunt trauma admissions have a cardiac injury. This report presents a rare survivor of 16-months old toddler injured in a domestic accident suffering a right atrial rupture repaired through a median sternotomy. To the best of our knowledge this is the youngest case reported in the literature.

  2. Creep strength and rupture ductility of creep strength enhanced ferritic steels

    Energy Technology Data Exchange (ETDEWEB)

    Kushima, Hideaki; Sawada, Kota; Kimura, Kazuhiro [National Inst. for Materials Science, Tsukuba, Ibaraki (Japan)

    2010-07-01

    Creep strength and rupture ductility of Creep Strength Enhanced Ferritic (CSEF) steels were investigated from a viewpoint of stress dependence in comparison with conventional low alloy ferritic creep resistant steels. Inflection of stress vs. time to rupture curve was observed at 50% of 0.2% offset yield stress for both CSEF and conventional ferritic steels. Creep rupture ductility tends to decrease with increase in creep exposure time, however, those of conventional low alloy steels indicate increase in the long-term. Creep rupture ductility of the ASME Grades 92 and 122 steels indicates drastic decrease with decrease in stress at 50% of 0.2% offset yield stress. Stress dependence of creep rupture ductility of the ASME Grades 92 and 122 steels is well described by stress ratio to 0.2% offset yield stress, regardless of temperature. Drop of creep rupture ductility is caused by inhomogeneous recovery at the vicinity of prior austenite grain boundary, and remarkable drop of creep rupture ductility of CSEF steels should be derived from those stabilized microstructure. (orig.)

  3. The stress rupture properties of austenitic steel weld metals

    International Nuclear Information System (INIS)

    Wood, D.S.

    Elevated temperature stress rupture data on Mo containing and Mo free austenitic weld metals have been collected from French, Dutch, German and UK sources and the results analysed. The stress rupture strength of Mo containing weld metal is significantly higher than that of Mo free weld metal. At 10,000h the rupture strength of Mo containing weld metal is higher than that of Type 316 steel whereas the Mo free weld metal is about 20% lower than that of Type 304 steel. Austenitic weld metal can give low stress rupture ductility values. It is concluded that there are insufficient data to permit reliable extrapolations to long times and it is recommended that long term tests are performed to overcome this situation

  4. [Achilles tendon ruptures: 25 year's experience in sport-orthopedic treatment].

    Science.gov (United States)

    Majewski, M; Widmer, K H; Steinbrück, K

    2002-12-01

    From 1972 - 1996 570 Achilles tendon ruptures in 565 patients were treated in the Sportklinik Stuttgart. The 499 men and 66 women had an average age of 38 years. For the diagnosis of a Achilles tendon rupture Ultrasound and MRI are important procedures, but clinical history and examination are still the best methods to find an Achilles tendon rupture (100%). However,the Actiology of the Achilles tendon rupture is still controversial and cannot be answered by these methods. Opposed to the degenerative theory, biomechanical experiments show that any Achilles tendon can tear when the calf muscle is tensed before the tendon is quickly stretched. We found that 69.8% of the patients with Achilles tendon rupture had a real trauma. Regardless of that, the treatment of the ruptured Achilles tendon has considerably changed over the last ten years. Responsible for this development are the positive experiences at the field of sports medicine with minimally invasive methods and the early functional treatment after knee surgery. Since we use an early functional rehabilitation concept instead of plaster immobilisation, all methods to treat a ruptured Achilles tendon have been improved. 43.5% of the patients after plaster immobilisation and 28.8% of the patients after early functional rehabilitation had a subjectively felt force reduction. Other important selecting criteria are the risk factors related to treatment method. Minimal invasive percutaneous Achilles tendon repair is considerably better than conservative therapy with a high rate of re-rupture (9.8%) and better than the open surgical repair, which carries a higher risk of infection (2.2%)

  5. Reliability assessment of creep rupture life for Gr. 91 steel

    International Nuclear Information System (INIS)

    Kim, Woo-Gon; Park, Jae-Young; Kim, Seon-Jin; Jang, Jinsung

    2013-01-01

    Highlights: • Statistical analysis of a number of creep rupture data based on Z parameter. • Determination of the constant C in LM parameter and long-term creep life prediction. • Generation of random variables for Z s and Z cr by Monte-Carlo simulation in a SCRI model. • Examples for design application were reasonably drawn from the viewpoints of reliability. - Abstract: This paper presents reliability assessment of the long-term creep life of Gr. 91 steel, which is a major structural material for high temperature structural components of Generation-IV reactor systems. A number of creep rupture data for Gr. 91 steel were collected through literature surveys, and the long-term creep life was predicted by Larson–Miller parameter. A “Z parameter” method was used to describe the magnitude of the deviation of the creep rupture data to a master curve. A “Service Condition-creep Rupture property Interference (SCRI) model” based on the Z parameter was used to simultaneously consider the scattering of the creep rupture data of materials and the fluctuations of service conditions in reliability assessment. A statistical analysis of the creep rupture data was conducted by the Z parameter. To carry out the SCRI model, a number of random variables for Z s describing service conditions and Z cr describing the dispersion of the creep rupture data were generated using a Monte-Carlo simulation technique. As examples for application, the creep rupture life under a certain service conditions of Gr. 91 steel was reasonably drawn from the viewpoints of reliability

  6. Simultaneous bilateral patellar tendon rupture

    Directory of Open Access Journals (Sweden)

    Diogo Lino Moura

    Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  7. Rupture of the neck in nuclear fission

    International Nuclear Information System (INIS)

    Davies, K.T.R.; Managan, R.A.; Nix, J.R.; Sierk, A.J.

    1977-01-01

    We introduce a degree of freedom to describe the rupture of the neck in nuclear fission and calculate the point at which the neck ruptures as the nucleus descends dynamically from its fission saddle point. This is done by mentally slicing the system into two portions at its minimum neck radius and calculating the force required to separate the two portions while keeping their shapes fixed. This force is obtained by differentiating with respect to separation the sum of the Coulomb and nuclear interaction energies between the two portions. For nuclei throughout the Periodic Table we calculate this force along dynamical paths leading from the fission saddle point. The force is initially attractive but becomes repulsive when the neck reaches a critical size. For actinide nuclei the neck radius at which rupture occurs is about 2 fm. This increases the calculated translational kinetic energy of the fission fragments at infinity relative to that calculated for scission occurring at zero neck radius. With the effect of neck rupture taken into account, we calculate and compare with experimental results fission-fragment kinetic energies for two types of nuclear dissipation: ordinary two-body viscosity and one-body dissipation

  8. A Rare Cause of Acute Abdomen: Urinary Bladder Rupture due to Foley Catheter

    Directory of Open Access Journals (Sweden)

    Ömer Engin

    2013-07-01

    Full Text Available Urinary bladder rupture is usually found due to blunt or penetrating traumas and iatrogenic injuries, and spontaneous intraperitoneal perforation is very rare. 57 years old male patient was consulted to general surgery department due to abdominal pain, nausia-vomiting and fever. He had Diabetes Mellitus, Multiple Sclerosis, Leriche Syndrome and operation for benign prostatic hypertrophy 5 years ago on his medical history which the case catheterised him urinary bladder himself frequently in nonsterile conditions. He did not care about sterility. On physical examination, suprapubic defence and rebound was noted more prominently on right lower quadrant. He was taken to operating room with the diagnosis of acute abdomen. On exploration, infection was seen on all layers of the whole urinary bladder, abscess formation and necrosis causing a microperforation which is detected by methylene blue was also present. Intraabdominal abscess drainage, cystostomy and primary suturing of the urinary bladder was performed. Patient died due to sepsis at the 9.th post operative day.

  9. Radiologic analysis of the medical collateral ligament rupture

    International Nuclear Information System (INIS)

    Cho, Chung Che; Lee, Chang Jun; Kim, Kun Sang; Park, Soo Soung

    1979-01-01

    The medical collateral ligament rupture is the most common injury involving the knee joint ligaments. The ruptured medical collateral ligaments of 73 cases with clinical and surgical confirmations were radiologically analyzed. The results were obtained as follows: 1. The most risky age for tearing of the medical collateral ligament was third to fifth decades (50 cases of male and 23 of females). 2. The most common cause of the medical collateral ligament rupture was traffic accident (82.2%). 3. The mean distance of medial knee joint space was 7.9 ± 2.0 mm on the normal side and 13.7 ± 4.2 mm on the affected side. 4. The mean degree of knee joint space was 10.1 ± 2.5 on the normal side and 14.7 ± 3.8 on the affected side. 5. The fibula was the bone fractured most frequently in association with the medial collateral ligament rupture (30.6%).

  10. The transition of dynamic rupture styles in elastic media under velocity-weakening friction

    KAUST Repository

    Gabriel, A.-A.

    2012-09-01

    Although kinematic earthquake source inversions show dominantly pulse-like subshear rupture behavior, seismological observations, laboratory experiments and theoretical models indicate that earthquakes can operate with different rupture styles: either as pulses or cracks, that propagate at subshear or supershear speeds. The determination of rupture style and speed has important implications for ground motions and may inform about the state of stress and strength of active fault zones. We conduct 2D in-plane dynamic rupture simulations with a spectral element method to investigate the diversity of rupture styles on faults governed by velocity-and-state-dependent friction with dramatic velocity-weakening at high slip rate. Our rupture models are governed by uniform initial stresses, and are artificially initiated. We identify the conditions that lead to different rupture styles by investigating the transitions between decaying, steady state and growing pulses, cracks, sub-shear and super-shear ruptures as a function of background stress, nucleation size and characteristic velocity at the onset of severe weakening. Our models show that small changes of background stress or nucleation size may lead to dramatic changes of rupture style. We characterize the asymptotic properties of steady state and self-similar pulses as a function of background stress. We show that an earthquake may not be restricted to a single rupture style, but that complex rupture patterns may emerge that consist of multiple rupture fronts, possibly involving different styles and back-propagating fronts. We also demonstrate the possibility of a super-shear transition for pulse-like ruptures. Finally, we draw connections between our findings and recent seismological observations.

  11. The transition of dynamic rupture styles in elastic media under velocity-weakening friction

    KAUST Repository

    Gabriel, A.-A.; Ampuero, J.-P.; Dalguer, L. A.; Mai, Paul Martin

    2012-01-01

    Although kinematic earthquake source inversions show dominantly pulse-like subshear rupture behavior, seismological observations, laboratory experiments and theoretical models indicate that earthquakes can operate with different rupture styles: either as pulses or cracks, that propagate at subshear or supershear speeds. The determination of rupture style and speed has important implications for ground motions and may inform about the state of stress and strength of active fault zones. We conduct 2D in-plane dynamic rupture simulations with a spectral element method to investigate the diversity of rupture styles on faults governed by velocity-and-state-dependent friction with dramatic velocity-weakening at high slip rate. Our rupture models are governed by uniform initial stresses, and are artificially initiated. We identify the conditions that lead to different rupture styles by investigating the transitions between decaying, steady state and growing pulses, cracks, sub-shear and super-shear ruptures as a function of background stress, nucleation size and characteristic velocity at the onset of severe weakening. Our models show that small changes of background stress or nucleation size may lead to dramatic changes of rupture style. We characterize the asymptotic properties of steady state and self-similar pulses as a function of background stress. We show that an earthquake may not be restricted to a single rupture style, but that complex rupture patterns may emerge that consist of multiple rupture fronts, possibly involving different styles and back-propagating fronts. We also demonstrate the possibility of a super-shear transition for pulse-like ruptures. Finally, we draw connections between our findings and recent seismological observations.

  12. High mass asymmetry in spontaneous and induced desintegration of heavy nuclei

    International Nuclear Information System (INIS)

    Tavares, O.A.P.

    1978-01-01

    The experimental and theoretical results related to a new rupture mode of heavy ions (A>230) in mass fragments more different than ordinary ission products, are presented and disussed. Experiences of long exposure time by nuclear emulsion technique, show that, the U 238 is also a spontaneous emitter of ions with mass number between 20 and 70. The results are interpreted as a high mass asymmetry in fission process or as a nucleon cluster emission mechanism by potential barrier penetration. Preliminary estimation show good agreement with experimental results for U 238 . Glass laminas with uranium thin films prepared 16 years ago, are also analysed aiming to confirm these results. Several experiences with nuclear emulsions and mica sandwich, and radiochemical data show to be possible heavy ion emission from U 238 induced by photons of low energy as well as neutrons of reactor (M.C.K.) [pt

  13. Creep and rupture of an ODS alloy with high stress rupture ductility. [Oxide Dispersion Strengthened

    Science.gov (United States)

    Mcalarney, M. E.; Arsons, R. M.; Howson, T. E.; Tien, J. K.; Baranow, S.

    1982-01-01

    The creep and stress rupture properties of an oxide (Y2O3) dispersion strengthened nickel-base alloy, which also is strengthened by gamma-prime precipitates, was studied at 760 and 1093 C. At both temperatures, the alloy YDNiCrAl exhibits unusually high stress rupture ductility as measured by both elongation and reduction in area. Failure was transgranular, and different modes of failure were observed including crystallographic fracture at intermediate temperatures and tearing or necking almost to a chisel point at higher temperatures. While the rupture ductility was high, the creep strength of the alloy was low relative to conventional gamma prime strengthened superalloys in the intermediate temperature range and to ODS alloys in the higher temperature range. These findings are discussed with respect to the alloy composition; the strengthening oxide phases, which are inhomogeneously dispersed; the grain morphology, which is coarse and elongated and exhibits many included grains; and the second phase inclusion particles occurring at grain boundaries and in the matrix. The creep properties, in particular the high stress dependencies and high creep activation energies measured, are discussed with respect to the resisting stress model of creep in particle strengthened alloys.

  14. Physiotherapy in patients with rupture LCA

    OpenAIRE

    Čížková, Karolína

    2012-01-01

    Author: Karolína Čížková Institution: Rehab clinic LF UK in Hradec Králové Topic of bachelor's thesis: Physiotherapy in patiens with rupture of ACL Supervisor: Mgr. Zuzana Hamarová Number of pages: 108 Number of annex: 11 Year of vindication 2012 Key words: ACL, knee, rupture of ACL, rehabilitation In general part of this bachelor's thesis is described anatomy, kinesiology and biomechanics of the knee joint, mostly anterior cruciate ligament. It contents causes of injury of anterior cruciate ...

  15. Short fetal leukocyte telomere length and preterm prelabor rupture of the membranes.

    Directory of Open Access Journals (Sweden)

    Ramkumar Menon

    Full Text Available BACKGROUND: Rupture of the fetal membranes is a common harbinger of imminent labor and delivery. Telomere shortening is a surrogate for oxidative stress (OS and senescence. Fetal leukocyte and placental membrane DNA telomere lengths were evaluated to determine their association with preterm prelabor rupture of the membranes (pPROM or spontaneous preterm births with intact membranes (PTB, compared to term birth. METHODS: Telomere lengths were quantified in cord blood leukocytes (n = 133 from three major groups: 1 pPROM (n = 28, 2 PTB (n = 69 and 3 uncomplicated full term births (controls, n = 35, using real-time quantitative PCR. Placental membrane specimens (n = 18 were used to correlate fetal leukocyte and placental telomere lengths. Telomere length differences among the groups were analyzed by ANOVA. Pearson correlation coefficients determined relationships between leukocyte and placental membrane telomere lengths. RESULTS: In pregnancies with intact membranes, fetal leukocyte telomere length was inversely proportional to gestational age. The mean telomere length decreased as gestation progressed, with the shortest at term. pPROM had telomere lengths (9962 ± 3124 bp that were significantly shorter than gestational age-matched PTB (11546 ± 4348 bp, p = 0.04, but comparable to term births (9011 ± 2497 bp, p = 0.31. Secondary analyses revealed no effects of race (African American vs. Caucasian or intraamniotic infection on telomere length. A strong Pearson's correlation was noted between fetal leukocyte and placental membrane telomere lengths (ρ = 0.77; p<0.01. CONCLUSIONS: Fetal leukocyte telomere length is reduced in pPROM compared to PTB but is similar to term births. pPROM represents a placental membrane disease likely mediated by OS-induced senescence.

  16. Consistent creep and rupture properties for creep-fatigue evaluation

    International Nuclear Information System (INIS)

    Schultz, C.C.

    1978-01-01

    The currently accepted practice of using inconsistent representations of creep and rupture behaviors in the prediction of creep-fatigue life is shown to introduce a factor of safety beyond that specified in current ASME Code design rules for 304 stainless steel Class 1 nuclear components. Accurate predictions of creep-fatigue life for uniaxial tests on a given heat of material are obtained by using creep and rupture properties for that same heat of material. The use of a consistent representation of creep and rupture properties for a mininum strength heat is also shown to provide adequate predictions. The viability of using consistent properties (either actual or those of a minimum heat) to predict creep-fatigue life thus identifies significant design uses for the results of characterization tests and improved creep and rupture correlations

  17. Rupture Dynamics and Ground Motion from Earthquakes in Heterogeneous Media

    Science.gov (United States)

    Bydlon, S.; Dunham, E. M.; Kozdon, J. E.

    2012-12-01

    Heterogeneities in the material properties of Earth's crust scatter propagating seismic waves. The effects of scattered waves are reflected in the seismic coda and depend on the relative strength of the heterogeneities, spatial arrangement, and distance from source to receiver. In the vicinity of the fault, scattered waves influence the rupture process by introducing fluctuations in the stresses driving propagating ruptures. Further variability in the rupture process is introduced by naturally occurring geometric complexity of fault surfaces, and the stress changes that accompany slip on rough surfaces. We have begun a modeling effort to better understand the origin of complexity in the earthquake source process, and to quantify the relative importance of source complexity and scattering along the propagation path in causing incoherence of high frequency ground motion. To do this we extended our two-dimensional high order finite difference rupture dynamics code to accommodate material heterogeneities. We generate synthetic heterogeneous media using Von Karman correlation functions and their associated power spectral density functions. We then nucleate ruptures on either flat or rough faults, which obey strongly rate-weakening friction laws. Preliminary results for flat faults with uniform frictional properties and initial stresses indicate that off-fault material heterogeneity alone can lead to a complex rupture process. Our simulations reveal the excitation of high frequency bursts of waves, which radiate energy away from the propagating rupture. The average rupture velocity is thus reduced relative to its value in simulations employing homogeneous material properties. In the coming months, we aim to more fully explore parameter space by varying the correlation length, Hurst exponent, and amplitude of medium heterogeneities, as well as the statistical properties characterizing fault roughness.

  18. Radiological features of 80 cases of diaphragmatic rupture

    International Nuclear Information System (INIS)

    Sullivan, M.; Lee, R.

    1989-01-01

    The films from 80 cases of diaphragmatic rupture in the dog and cat over a 10 year period were examined. The most common findings were loss of the cupola and masking of the cardiac shadow. Identification of the stomach or intestine in the thorax made the diagnosis straightforward. However, in some animals these organs were not visible and there was considerable accumulation of free pleural fluid. The use of barium contrast studies and post drainage films were unable to confirm the presence of a rupture in all cases with inconclusive plain film findings. The identification of a rupture was only made by exploratory surgery in these animals

  19. Retrospective Review of Pectoralis Major Ruptures in Rodeo Steer Wrestlers

    Directory of Open Access Journals (Sweden)

    Breda H. F. Lau

    2013-01-01

    Full Text Available Background. Pectoralis major tendon ruptures have been reported in the literature as occupational injuries, accidental injuries, and sporting activities. Few cases have been reported with respect to rodeo activities. Purpose. To describe a series of PM tendon ruptures in professional steer wrestlers. Study Design. Case series, level of evidence, 4. Methods. A retrospective analysis of PM ruptures in a steer wrestling cohort was performed. Injury data between 1992 and 2008 were reviewed using medical records from the University of Calgary Sport Medicine Center. Results. Nine cases of pectoralis major ruptures in professional steer wrestlers were identified. Injuries occurred during the throwing phase of the steer or while breaking a fall. All athletes reported unexpected or abnormal behavior of the steer that contributed to the mechanism of injury. Seven cases were surgically repaired, while two cases opted for nonsurgical intervention. Eight cases reported successful return to competition following the injury. Conclusion. Steer wrestlers represent a unique cohort of PM rupture case studies. Steer wrestling is a demanding sport that involves throwing maneuvers that may predispose the muscle to rupture. All cases demonstrated good functional outcomes regardless of surgical or non-surgical treatment.

  20. Delayed primary realignment of posterior urethral rupture | Shittu ...

    African Journals Online (AJOL)

    The treatment of acute posterior urethral rupture is controversial. Twelve patients who presented with acute posterior urethral rupture over a five--year period were treated by delayed primary realignment of the injury. The technique of this procedure and the outcome are the subject of this presentation. Eight patients had ...

  1. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with cipr......We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...... with ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  2. Alliance Rupture and Resolution in Dialectical Behavior Therapy for Borderline Personality Disorder.

    Science.gov (United States)

    Boritz, Tali; Barnhart, Ryan; Eubanks, Catherine F; McMain, Shelley

    2018-01-01

    The aim of this exploratory study was to investigate alliance rupture and resolution processes in the early sessions of a sample of clients who underwent 1 year of standard dialectical behavior therapy (DBT) for borderline personality disorder (BPD). Participants were three recovered and three unrecovered clients drawn from the DBT arm of a randomized controlled trial that compared the clinical and cost-effectiveness of DBT and general psychiatric management. Alliance rupture and resolution processes were coded using the observer-based Rupture Resolution Rating Scale. Unrecovered clients evidenced a higher frequency of withdrawal ruptures than recovered clients. Withdrawal ruptures tended to persist for unrecovered clients despite the degree of resolution in the prior session, unlike for recovered clients, for whom the probability of withdrawal ruptures decreased as the degree of resolution increased. This study suggests that alliance rupture and resolution processes in early treatment differ between recovered and unrecovered clients in DBT for BPD.

  3. Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms.

    Directory of Open Access Journals (Sweden)

    Nan Lv

    Full Text Available The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA aneurysms.In 129 PCoA aneurysms (85 ruptured, 44 unruptured, clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms.While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR, size ratio (SR, dome-to-neck ratio (DN, inflow angle (IA, normalized wall shear stress (NWSS and percentage of low wall shear stress area (LSA were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p < 0.001 and LSA (OR = 1.393, p = 0.041.Hemodynamics and morphology were related to rupture status of intracranial aneurysms. Higher IA and LSA were identified as discriminators for rupture status of PCoA aneurysms.

  4. Influence of fault steps on rupture termination of strike-slip earthquake faults

    Science.gov (United States)

    Li, Zhengfang; Zhou, Bengang

    2018-03-01

    A statistical analysis was completed on the rupture data of 29 historical strike-slip earthquakes across the world. The purpose of this study is to examine the effects of fault steps on the rupture termination of these events. The results show good correlations between the type and length of steps with the seismic rupture and a poor correlation between the step number and seismic rupture. For different magnitude intervals, the smallest widths of the fault steps (Lt) that can terminate the rupture propagation are variable: Lt = 3 km for Ms 6.5 6.9, Lt = 4 km for Ms 7.0 7.5, Lt = 6 km for Ms 7.5 8.0, and Lt = 8 km for Ms 8.0 8.5. The dilational fault step is easier to rupture through than the compression fault step. The smallest widths of the fault step for the rupture arrest can be used as an indicator to judge the scale of the rupture termination of seismic faults. This is helpful for research on fault segmentation, as well as estimating the magnitude of potential earthquakes, and is thus of significance for the assessment of seismic risks.

  5. Morphological characteristics associated with rupture risk of multiple intracranial aneurysms.

    Science.gov (United States)

    Wang, Guang-Xian; Liu, Lan-Lan; Wen, Li; Cao, Yun-Xing; Pei, Yu-Chun; Zhang, Dong

    2017-10-01

    To identify the morphological parameters that are related to intracranial aneurysms (IAs) rupture using a case-control model. A total of 107 patients with multiple IAs and aneurysmal subarachnoid hemorrhage between August 2011 and February 2017 were enrolled in this study. Characteristics of IAs location, shape, neck width, perpendicular height, depth, maximum size, flow angle, parent vessel diameter (PVD), aspect ratio (AR) and size ratio (SR) were evaluated using CT angiography. Multiple logistic regression analysis was used to identify the independent risk factors associated with IAs rupture. Receiver operating characteristic curve analysis was performed on the final model, and the optimal thresholds were obtained. IAs located in the internal carotid artery (ICA) was associated with a negative risk of rupture, whereas AR, SR1 (height/PVD) and SR2 (depth/PVD) were associated with increased risk of rupture. When SR was calculated differently, the odds ratio values of these factors were also different. The receiver operating characteristic curve showed that AR, SR1 and SR2 had cut-off values of 1.01, 1.48 and 1.40, respectively. SR3 (maximum size/PVD) was not associated with IAs rupture. IAs located in the ICA are associated with a negative risk of rupture, while high AR (>1.01), SR1 (>1.48) or SR2 (>1.40) are risk factors for multiple IAs rupture. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  6. Ruptured Tendons in Anabolic-Androgenic Steroid Users: A Cross-Sectional Cohort Study.

    Science.gov (United States)

    Kanayama, Gen; DeLuca, James; Meehan, William P; Hudson, James I; Isaacs, Stephanie; Baggish, Aaron; Weiner, Rory; Micheli, Lyle; Pope, Harrison G

    2015-11-01

    Accumulating case reports have described tendon rupture in men who use anabolic-androgenic steroids (AAS). However, no controlled study has assessed the history of tendon rupture in a large cohort of AAS users and comparison nonusers. Men reporting long-term AAS abuse would report an elevated lifetime incidence of tendon rupture compared with non-AAS-using bodybuilders. Cohort study; Level of evidence, 3. Medical histories were obtained from 142 experienced male bodybuilders aged 35 to 55 years recruited in the course of 2 studies. Of these men, 88 reported at least 2 years of cumulative lifetime AAS use, and 54 reported no history of AAS use. In men reporting a history of tendon rupture, the circumstances of the injury, prodromal symptoms, concomitant drug or alcohol use, and details of current and lifetime AAS use (if applicable) were recorded. Surgical records were obtained for most participants. Nineteen (22%) of the AAS users, but only 3 (6%) of the nonusers, reported at least 1 lifetime tendon rupture. The hazard ratio for a first ruptured tendon in AAS users versus nonusers was 9.0 (95% CI, 2.5-32.3; P weightlifting, with the majority occurring during other sports activities. Eight (26%) ruptures followed prodromal symptoms of nonspecific pain in the region. Virtually all ruptures were treated surgically, with complete or near-complete ultimate restoration of function. AAS abusers, compared with otherwise similar bodybuilders, showed a markedly increased risk of tendon ruptures, particularly upper-body tendon rupture. © 2015 The Author(s).

  7. Computing broadband accelerograms using kinematic rupture modeling

    International Nuclear Information System (INIS)

    Ruiz Paredes, J.A.

    2007-05-01

    In order to make the broadband kinematic rupture modeling more realistic with respect to dynamic modeling, physical constraints are added to the rupture parameters. To improve the slip velocity function (SVF) modeling, an evolution of the k -2 source model is proposed, which consists to decompose the slip as a sum of sub-events by band of k. This model yields to SVF close to the solution proposed by Kostrov for a crack, while preserving the spectral characteristics of the radiated wave field, i.e. a w 2 model with spectral amplitudes at high frequency scaled to the coefficient of directivity C d . To better control the directivity effects, a composite source description is combined with a scaling law defining the extent of the nucleation area for each sub-event. The resulting model allows to reduce the apparent coefficient of directivity to a fraction of C d , as well as to reproduce the standard deviation of the new empirical attenuation relationships proposed for Japan. To make source models more realistic, a variable rupture velocity in agreement with the physics of the rupture must be considered. The followed approach that is based on an analytical relation between the fracture energy, the slip and the rupture velocity, leads to higher values of the peak ground acceleration in the vicinity of the fault. Finally, to better account for the interaction of the wave field with the geological medium, a semi-empirical methodology is developed combining a composite source model with empirical Green functions, and is applied to the Yamaguchi, M w 5.9 earthquake. The modeled synthetics reproduce satisfactorily well the observed main characteristics of ground motions. (author)

  8. Radiographic Features of Acute Patellar Tendon Rupture.

    Science.gov (United States)

    Fazal, Muhammad Ali; Moonot, Pradeep; Haddad, Fares

    2015-11-01

    The purpose of our study was to assess soft tissue features of acute patellar tendon rupture on lateral knee radiograph that would facilitate early diagnosis. The participants were divided into two groups of 35 patients each. There were 28 men and seven women with a mean age of 46 years in the control group and 26 men and nine women with a mean age of 47 years in the rupture group. The lateral knee radiograph of each patient was evaluated for Insall-Salvati ratio for patella alta, increased density of the infrapatellar fat pad, appearance of the soft tissue margin of the patellar tendon and bony avulsions. In the rupture group there were three consistent soft tissue radiographic features in addition to patellar alta. These were increased density of infrapatellar fat pad; loss of sharp, well-defined linear margins of the patellar tendon and angulated wavy margin of the patellar tendon while in the control group these features were not observed. The soft tissue radiographic features described in the rupture group are consistent and reliable. When coupled with careful clinical assessment, these will aid in early diagnosis and further imaging will be seldom required. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  9. LWR primary coolant pipe rupture test rig

    International Nuclear Information System (INIS)

    Yoshitoshi, Shyoji

    1978-01-01

    The rupture test rig for primary coolant pipes is constructed in the Japan Atomic Energy Research Institute to verify the reliability of the primary coolant pipes for both PWRs and BWRs. The planned test items consisted of reaction force test, restraint test, whip test, jet test and continuous release test. A pressure vessel of about 4 m 3 volume, a circulating pump, a pressurizer, a heater, an air cooler and the related instrumentation and control system are included in this test rig. The coolant test condition is 160 kg/cm 2 g, 325 deg C for PWR test, and 70 kg/cm 2 g, saturated water and steam for BWR test, 100 ton of test load for the ruptured pipe bore of 8B Schedule 160, and 20 lit/min. discharge during 20 h for continuous release of coolant. The maximum pit internal pressure was estimated for various pipe diameters and time under the PWR and BWR conditions. The spark rupturing device was adopted for the rupture mechanics in this test rig. The computer PANAFACOM U-300 is used for the data processing. This test rig is expected to operate in 1978 effectively for the improvement of reliability of LWR primary coolant pipes. (Nakai, Y.)

  10. Three-Dimensional Dynamic Rupture in Brittle Solids and the Volumetric Strain Criterion

    Science.gov (United States)

    Uenishi, K.; Yamachi, H.

    2017-12-01

    As pointed out by Uenishi (2016 AGU Fall Meeting), source dynamics of ordinary earthquakes is often studied in the framework of 3D rupture in brittle solids but our knowledge of mechanics of actual 3D rupture is limited. Typically, criteria derived from 1D frictional observations of sliding materials or post-failure behavior of solids are applied in seismic simulations, and although mode-I cracks are frequently encountered in earthquake-induced ground failures, rupture in tension is in most cases ignored. Even when it is included in analyses, the classical maximum principal tensile stress rupture criterion is repeatedly used. Our recent basic experiments of dynamic rupture of spherical or cylindrical monolithic brittle solids by applying high-voltage electric discharge impulses or impact loads have indicated generation of surprisingly simple and often flat rupture surfaces in 3D specimens even without the initial existence of planes of weakness. However, at the same time, the snapshots taken by a high-speed digital video camera have shown rather complicated histories of rupture development in these 3D solid materials, which seem to be difficult to be explained by, for example, the maximum principal stress criterion. Instead, a (tensile) volumetric strain criterion where the volumetric strain (dilatation or the first invariant of the strain tensor) is a decisive parameter for rupture seems more effective in computationally reproducing the multi-directionally propagating waves and rupture. In this study, we try to show the connection between this volumetric strain criterion and other classical rupture criteria or physical parameters employed in continuum mechanics, and indicate that the criterion has, to some degree, physical meanings. First, we mathematically illustrate that the criterion is equivalent to a criterion based on the mean normal stress, a crucial parameter in plasticity. Then, we mention the relation between the volumetric strain criterion and the

  11. Pancreatic rupture in four cats with high-rise syndrome.

    Science.gov (United States)

    Liehmann, Lea M; Dörner, Judith; Hittmair, Katharina M; Schwendenwein, Ilse; Reifinger, Martin; Dupré, Gilles

    2012-02-01

    Pancreatic trauma and rupture are rare after feline high-rise syndrome; however, should it happen, pancreatic enzymes will leak into the abdominal cavity and may cause pancreatic autodigestion and fatty tissue saponification. If not diagnosed and treated, it can ultimately lead to multiorgan failure and death. In this case series, 700 records of high-rise syndrome cats that presented between April 2001 and May 2006 were analysed, and four cats with pancreatic rupture were identified. Clinical signs, diagnosis using ultrasonography and lipase activity in blood and abdominal effusion, and treatment modalities are reported. Three cats underwent surgical abdominal exploration, one cat was euthanased. Rupture of the left pancreatic limb was confirmed in all cases. Two of the operated cats survived to date. High-rise syndrome can lead to abdominal trauma, including pancreatic rupture. A prompt diagnosis and surgical treatment should be considered.

  12. Consistent creep and rupture properties for creep-fatigue evaluation

    International Nuclear Information System (INIS)

    Schultz, C.C.

    1979-01-01

    The currently accepted practice of using inconsistent representations of creep and rupture behaviors in the prediction of creep-fatigue life is shown to introduce a factor of safety beyond that specified in current ASME Code design rules for 304 stainless steel Class 1 nuclear components. Accurate predictions of creep-fatigue life for uniaxial tests on a given heat of material are obtained by using creep and rupture properties for that same heat of material. The use of a consistent representation of creep and rupture properties for a minimum strength heat is also shown to provide reasonable predictions. The viability of using consistent properties (either actual or those of a minimum strength heat) to predict creep-fatigue life thus identifies significant design uses for the results of characterization tests and improved creep and rupture correlations. 12 refs

  13. Pressure tube rupture in a closed tank

    International Nuclear Information System (INIS)

    Khater, H.A.; Hadaller, G.I.; Stern, F.

    1985-06-01

    A study has been prepared on the feasibility of conducting pressure tube/calandria tube rupture tests in a closed tank, simulating a scaled-down calandria vessel. The study includes: i) a review of previous work, ii) an analytical investigation of the scaling problem of the calandria vessel and relevant in-core structures, iii) selection of a method for initiating pressure tube/calandria tube rupture, iv) a set of specifications for the test assembly, v) general arrangement drawings, vi) a proposal for a test matrix, vii) a survey and evaluation of existing facilities which could provide the required high pressure, temperature and fluid inventory, and viii) a cost estimate for the detailed design and construction, instrumentation, data acquisition and reduction, testing and reporting. The study concludes that it is both technically and practically feasible to conduct pressure tube rupture tests in a closed tank

  14. Bladder rupture caused by postpartum urinary retention.

    Science.gov (United States)

    Dueñas-García, Omar Felipe; Rico, Hugo; Gorbea-Sanchez, Viridiana; Herrerias-Canedo, Tomas

    2008-08-01

    Postpartum bladder rupture is an uncommon surgical emergency and a diagnostic challenge. A primigravida delivered a healthy newborn without complications at 39.4 weeks of gestation. The patient was admitted 80 hours postpartum with abdominal pain, oliguria, hematuria, and pain that worsened during the previous 4 hours. An inserted Foley catheter drained only a small amount of urine, and serum creatinine was elevated (3.5 mg/dL). A laparotomy was performed and revealed a 10-cm hole in the urinary bladder. The bladder was repaired and the patient was discharged 15 days after surgery. The follow-up cystoscopy revealed adequate healing of the bladder. Urinary retention can lead to serious complications, including bladder rupture. Postpartum bladder rupture due to urinary retention should be ruled out if there is a history of abdominal pain, oliguria, and elevated of serum creatinine.

  15. Creep rupture behavior of unidirectional advanced composites

    Science.gov (United States)

    Yeow, Y. T.

    1980-01-01

    A 'material modeling' methodology for predicting the creep rupture behavior of unidirectional advanced composites is proposed. In this approach the parameters (obtained from short-term tests) required to make the predictions are the three principal creep compliance master curves and their corresponding quasi-static strengths tested at room temperature (22 C). Using these parameters in conjunction with a failure criterion, creep rupture envelopes can be generated for any combination of in-plane loading conditions and ambient temperature. The analysis was validated experimentally for one composite system, the T300/934 graphite-epoxy system. This was done by performing short-term creep tests (to generate the principal creep compliance master curves with the time-temperature superposition principle) and relatively long-term creep rupture tensile tests of off-axis specimens at 180 C. Good to reasonable agreement between experimental and analytical results is observed.

  16. [Delayed rupture of the spleen in a multiply injured patient].

    Science.gov (United States)

    Lică, I; Venter, M D; Mehic, R; Marian, R; Ionescu, G

    1997-01-01

    The authors present a case of delayed rupture of the spleen in a polytraumatised patient. This entity was defined as a late occurrence of signs and symptoms attributed to splenic injury not detected by diagnostic computed tomographic scanning during the initial examination. The mechanisms in which the delayed rupture of the spleen occurs are discussed and the conclusion is that the delayed rupture of the spleen represent a real clinical entity.

  17. Rapid Estimates of Rupture Extent for Large Earthquakes Using Aftershocks

    Science.gov (United States)

    Polet, J.; Thio, H. K.; Kremer, M.

    2009-12-01

    The spatial distribution of aftershocks is closely linked to the rupture extent of the mainshock that preceded them and a rapid analysis of aftershock patterns therefore has potential for use in near real-time estimates of earthquake impact. The correlation between aftershocks and slip distribution has frequently been used to estimate the fault dimensions of large historic earthquakes for which no, or insufficient, waveform data is available. With the advent of earthquake inversions that use seismic waveforms and geodetic data to constrain the slip distribution, the study of aftershocks has recently been largely focused on enhancing our understanding of the underlying mechanisms in a broader earthquake mechanics/dynamics framework. However, in a near real-time earthquake monitoring environment, in which aftershocks of large earthquakes are routinely detected and located, these data may also be effective in determining a fast estimate of the mainshock rupture area, which would aid in the rapid assessment of the impact of the earthquake. We have analyzed a considerable number of large recent earthquakes and their aftershock sequences and have developed an effective algorithm that determines the rupture extent of a mainshock from its aftershock distribution, in a fully automatic manner. The algorithm automatically removes outliers by spatial binning, and subsequently determines the best fitting “strike” of the rupture and its length by projecting the aftershock epicenters onto a set of lines that cross the mainshock epicenter with incremental azimuths. For strike-slip or large dip-slip events, for which the surface projection of the rupture is recti-linear, the calculated strike correlates well with the strike of the fault and the corresponding length, determined from the distribution of aftershocks projected onto the line, agrees well with the rupture length. In the case of a smaller dip-slip rupture with an aspect ratio closer to 1, the procedure gives a measure

  18. Endovascular treatment of ruptured true posterior communicating artery aneurysms.

    Science.gov (United States)

    Yang, Yonglin; Su, Wandong; Meng, Qinghai

    2015-01-01

    Although true posterior communicating artery (PCoA) aneurysms are rare, they are of vital importance. We reviewed 9 patients with this fatal disease, who were treated with endovascular embolization, and discussed the meaning of endovascular embolization for the treatment of true PCoA aneurysms. From September 2006 to May 2012, 9 patients with digital substraction angiography (DSA) confirmed true PCoA aneurysms were treated with endovascular embolization. Patients were followed-up with a minimal duration of 17 months and assessed by Glasgow Outcome Scale (GOS) score. All the patients presented with spontaneous subarachnoid hemorrhage from the ruptured aneurysms. The ratio of males to females was 1:2, and the average age of onset was 59.9 (ranging from 52 to 72) years. The preoperative Hunt-Hess grade scores were I to III. All patients had recovered satisfactorily. No permanent neurological deficits were left. Currently, endovascular embolization can be recommended as the top choice for the treatment of most true PCoA aneurysms, due to its advanced technique, especially the application of the stent-assisted coiling technique, combined with its advantage of mininal invasiveness and quick recovery. However, the choice of treatment methods should be based on the clinical and anatomical characteristics of the aneurysm and the skillfulness of the surgeon.

  19. Aneurismas múltiplos de pontes aorto-coronárias de veia safena com ruptura fatal Multiple aneurysms of aortocoronary saphenous vein grafts with fatal rupture

    Directory of Open Access Journals (Sweden)

    Fábio R. Távora

    2007-05-01

    Full Text Available Aneurismas de pontes aorto-coronárias de veia safena são eventos raros, usualmente assintomáticos e detectados de forma incidental. Rupturas espontâneas de pontes de safena são raras, havendo poucos dados radiológicos disponíveis na literatura. Relatamos o caso de um senhor de 39 anos internado com hematêmese dez anos depois de ter sido submetido a cirurgia de revascularização miocárdica. Imagens tomográficas mostraram três aneurismas nas pontes de safena, mas o exame não detectou ruptura. O paciente veio a falecer e a necropsia revelou que a causa do óbito havia sido ruptura de aneurisma de pontes de safena. Esse caso ilustra a necessidade de tratamento agressivo de aneurismas sintomáticos de pontes coronarianas.Aortocoronary saphenous vein graft (SVG aneurysms are rare, and are usually asymptomatic and detected incidentally. Spontaneous rupture of SVG is rare and imaging data are few. We report on a 39-year old man who was admitted to the hospital with hematemesis 10 years after aortocoronary bypass surgery. CT images revealed 3 aortocoronary SVG aneurysms, but failed to detect any rupture. His subsequent death due to rupture of SVG aneurysm was documented at autopsy, illustrating the need for aggressive treatment of symptomatic coronary graft aneurysms.

  20. Antibiotics after preterm premature rupture of the membranes.

    Science.gov (United States)

    Singh, Katherine; Mercer, Brian

    2011-06-01

    Preterm premature rupture of the membranes remains a common cause of preterm deliveries and neonatal morbidities. The goal of this study is to review the evidence with regard to the antibiotic treatment after preterm premature rupture of the membranes, long-term outcomes related to antibiotic treatment, and possible complications with treatment. Future research goals are also discussed.

  1. Shared and Distinct Rupture Discriminants of Small and Large Intracranial Aneurysms.

    Science.gov (United States)

    Varble, Nicole; Tutino, Vincent M; Yu, Jihnhee; Sonig, Ashish; Siddiqui, Adnan H; Davies, Jason M; Meng, Hui

    2018-04-01

    Many ruptured intracranial aneurysms (IAs) are small. Clinical presentations suggest that small and large IAs could have different phenotypes. It is unknown if small and large IAs have different characteristics that discriminate rupture. We analyzed morphological, hemodynamic, and clinical parameters of 413 retrospectively collected IAs (training cohort; 102 ruptured IAs). Hierarchal cluster analysis was performed to determine a size cutoff to dichotomize the IA population into small and large IAs. We applied multivariate logistic regression to build rupture discrimination models for small IAs, large IAs, and an aggregation of all IAs. We validated the ability of these 3 models to predict rupture status in a second, independently collected cohort of 129 IAs (testing cohort; 14 ruptured IAs). Hierarchal cluster analysis in the training cohort confirmed that small and large IAs are best separated at 5 mm based on morphological and hemodynamic features (area under the curve=0.81). For small IAs (IAs (area under the curve=0.84; 95% confidence interval, 0.78-0.88), whereas for large IAs (≥5 mm), the model included undulation index, low wall shear stress, previous subarachnoid hemorrhage, and IA location (area under the curve=0.87; 95% confidence interval, 0.82-0.93). The model for the aggregated training cohort retained all the parameters in the size-dichotomized models. Results in the testing cohort showed that the size-dichotomized rupture discrimination model had higher sensitivity (64% versus 29%) and accuracy (77% versus 74%), marginally higher area under the curve (0.75; 95% confidence interval, 0.61-0.88 versus 0.67; 95% confidence interval, 0.52-0.82), and similar specificity (78% versus 80%) compared with the aggregate-based model. Small (IAs have different hemodynamic and clinical, but not morphological, rupture discriminants. Size-dichotomized rupture discrimination models performed better than the aggregate model. © 2018 American Heart Association, Inc.

  2. Intrinsic, Transitional, and Extrinsic Morphological Factors Associated With Rupture of Intracranial Aneurysms.

    Science.gov (United States)

    Ho, Allen L; Lin, Ning; Frerichs, Kai U; Du, Rose

    2015-09-01

    As diagnosis and treatment of unruptured intracranial aneurysms continues to increase, management principles remain largely based on size. This is despite mounting evidence that aneurysm location and other morphologic variables could play a role in predicting overall risk of rupture. Morphological parameters can be divided into 3 main groups, those that are intrinsic to the aneurysm, those that are extrinsic to the aneurysm, and those that involve both the aneurysm and surrounding vasculature (transitional). We present an evaluation of intrinsic, transitional, and extrinsic factors and their association with ruptured aneurysms. Using preoperative computed tomographic angiography, we generated 3-dimensional models of aneurysms and their surrounding vasculature with Slicer software. Using univariate and multivariate analyses, we examined the association of intrinsic, transitional, and extrinsic aspects of aneurysm morphology with rupture. Between 2005 and 2013, 227 cerebral aneurysms in 4 locations were evaluated/treated at a single institution, and computed tomographic angiographies of 218 patients (97 unruptured and 130 ruptured) were analyzed. Ruptured aneurysms analyzed were associated with clinical factors of absence of multiple aneurysms and history of no prior rupture, and morphologic factors of greater aspect ratio. On multivariate analysis, aneurysm rupture remained associated with history of no prior rupture, greater flow angle, greater daughter-daughter vessel angle, and smaller parent-daughter vessel angle. By studying the morphology of aneurysms and their surrounding vasculature, we identified several parameters associated with ruptured aneurysms that include intrinsic, transitional, and extrinsic factors of cerebral aneurysms and their surrounding vasculature.

  3. Pregnancy Outcomes Complicated by Preterm Premature Rupture of Membranes: Retrospective Review of Cases in Three Institutions in Kazakhstan

    Directory of Open Access Journals (Sweden)

    Balkenzhe Imankulova

    2015-06-01

    Full Text Available Introduction. Pre-term premature rupture of membranes (PPROM is one of the leading causes of perinatal morbidity and mortality. This complication is diagnosed in 3% of pregnant women in Kazakhstan, and it is the leading cause of pre-term deliveries. The aim of this study was to determine the outcomes of pregnancies complicated by PPROM in gestation periods between 24 to 32 weeks among three institutions in Kazakhstan.Methods. This is descriptive analysis of 154 cases with PPROM observed between 24 to 32 weeks of gestation at Perinatal Centers #2 and #3 and the National Research Center for Maternal and Child Health, Astana, Kazakhstan. Cases were selected on the basis of retrospective chart review where PPROM diagnosis occurred in 2013. Descriptive statistics were utilized for data analysis.Results. The most frequent complications associated with PPROM were threat of miscarriage (13.6% of cases and chronic placental insufficiency (7.8%. The mean time between PPROM and onset of spontaneous labor was 12.1 ± 2.3 days.  Spontaneous labor within 3 days after PPROM started in patients with an amniotic fluid index of 3.0 ± 0.2 cm. Complications experienced by PPROM women during delivery and early postpartum period included: precipitous labor (6.4%, weakness of labor activity (16.2%, atonic hemorrhage (1.2%, and chorioamnionitis (3.2%. 37.6% of newborns in this study were admitted to the Intensive Care Unit. Their health complications included pneumonia (7.7%, conjunctivitis (1.3%, omphalitis and infectious-toxic shock (3.8%, intraventricular hemorrhage  (7.8%, and respiratory distress (10.3% .Conclusion. Thus, preterm rupture of membranes is associated with preterm delivery and an increase of neonatal morbidity. Therefore, it is necessary to find ways to effectively manage PPROM, including developing new techniques to restore the amniotic fluid volume in women experiencing PPROM during 24 to 32 weeks of gestation. 

  4. Ectopic pregnancy with tubal rupture: an analysis of 80 cases

    International Nuclear Information System (INIS)

    Ashfaq, S.; Aziz, S.; Hasan, M.; Sultan, S.; Irfan, S.M.

    2017-01-01

    Ectopic pregnancy (EP) is a major problem in obstetrics as there is evidence of increasing incidence throughout the world. It is an important cause of maternal morbidity and mortality. In Pakistan, the care seeking behaviour among female is limited that makes female vulnerable to die due to complication of ectopic pregnancy. The aim of this study is to determine the frequency of tubal rupture in ectopic pregnancy in Pakistani patients. Method: In this cross-sectional study data pertaining to age, gestational age, parity and duration of presenting symptoms were collected and analysed. Result: 80 patients were diagnosed to have ectopic pregnancy. The frequency of tubal rupture was 91.25%. It is encountered significantly more often in women with age of 26 years. More tubal rupture is found in patient with low parity, in which the frequency of tubal rupture is up to 100% and decrease up to 78.6% with increasing parity up to four. Furthermore, it is noted that increase in gestational age from 8 weeks to 10 weeks caused an increase in frequency of tubal rupture from 80 to 100% respectively. It is also noted that earlier the patient presents the lesser is the frequency of tubal rupture, as compared to late presentation beyond 3-4 days which make frequency up to 95%. Conclusion: Tubal rupture is still common cause of maternal morbidity and mortality, and is still a major challenge in gynaecological practice. Creating awareness amongst midwives and GPs regarding early diagnosis can contribute to decrease the mortality, morbidity and fertility loss related to EP. (author)

  5. Ruptured popliteal cyst diagnosed by ultrasound before evaluation for deep vein thrombosis.

    Science.gov (United States)

    Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young; Park, So Young

    2014-12-01

    Most popliteal cysts are asymptomatic. However, cysts may rupture, resulting in pain and swelling of the leg that could also arise from other diseases, including deep vein thrombosis, lymphedema, cellulitis, and tear of a muscle or tendon. Therefore, it is difficult to diagnose a ruptured popliteal cyst based on only a patient's history and physical examination. Musculoskeletal ultrasound has been regarded as a diagnostic tool for ruptured popliteal cyst. Here, we describe a patient who was rapidly diagnosed as ruptured popliteal cyst by ultrasonography. Therefore, ultrasound could be used to distinguish a ruptured popliteal cyst from other diseases in patients with painful swollen legs before evaluation for deep vein thrombosis.

  6. Rotator cuff ruptures of the shoulder joint, sonography - arthrography

    International Nuclear Information System (INIS)

    Triebel, H.J.; Wening, V.; Witte, G.; Hamburg Univ.

    1986-01-01

    47 patients suspected of rutpure of the rotator cuff were sonographed and arthrographed. Rupture of the rotator cuff was diagnosed in 12 cases, both diagnostic methods yielding the same result. In 29 patients sonography and arthrography did not reveal any abnormal findings. Six ruptures evident in sonography were not confirmed by arthrography and were considered false positive. Direct pointers towards rupture of the cuff would be: echoless defects, cuff cannot be visualised fully or in part and irregularities of movement during dynamic examination. Echoless 'cystic' areas in the periarticular soft parts must be considered an indirect pointer. Echorich focal findings in the echopoor cuff represent a differential diagnostic problem and we cannot give a final assessment as yet. Shoulder sonography is justified as a screening method in suspicion of rotator cuff rupture before initiating arthrography. If sonography reveals no abnormal findings, shoulder arthrography need not be performed. (orig.) [de

  7. Morphological and clinical risk factors for posterior communicating artery aneurysm rupture.

    Science.gov (United States)

    Matsukawa, Hidetoshi; Fujii, Motoharu; Akaike, Gensuke; Uemura, Akihiro; Takahashi, Osamu; Niimi, Yasunari; Shinoda, Masaki

    2014-01-01

    Recent studies have shown that posterior circulation aneurysms, specifically posterior communicating artery (PCoA) aneurysms, are more likely to rupture than other aneurysms. To date, few studies have investigated the factors contributing to PCoA aneurysm rupture. The authors aimed to identify morphological and clinical characteristics predisposing to PCoA aneurysm rupture. The authors retrospectively reviewed 134 consecutive patients with PCoA aneurysms managed at their facility between July 2003 and December 2012. The authors divided patients into groups of those with aneurysmal rupture (n = 39) and without aneurysmal rupture (n = 95) and compared morphological and clinical characteristics. Morphological characteristics were mainly evaluated by 3D CT angiography and included diameter of arteries (anterior cerebral artery, middle cerebral artery, and internal carotid artery), size of the aneurysm, dome-to-neck ratio, neck direction of the aneurysmal dome around the PCoA (medial, lateral, superior, inferior, and posterior), aneurysm bleb formation, whether the PCoA was fetal type, and the existence of other intracranial unruptured aneurysm(s). Patients with ruptured PCoA aneurysms were significantly younger (a higher proportion were PCoA aneurysms showed a lateral direction of the aneurysmal dome around the PCoA, had bleb formation, and the aneurysm was > 7 mm in diameter and/or the dome-to-neck ratio was > 2.0. Multivariate logistic regression analysis showed age PCoA (OR 6.7, p = 0.0001), and bleb formation (OR 11, p PCoA aneurysm rupture. The present results demonstrated that lateral projection of a PCoA aneurysm may be related to rupture.

  8. Ruptured liver abscess: Analysis of 50 cases

    Directory of Open Access Journals (Sweden)

    Mohit Bhatia

    2017-01-01

    Full Text Available Background: Liver abscess (pyogenic and amebic is frequently encountered clinical condition; however, it can result in lethal outcome if there is a delay in diagnosis and treatment. Despite modalities to diagnose the condition early, still ruptured liver abscess presents with a common cause of acute abdomen in surgical emergency. In developing countries, ruptured liver abscess is a common cause of mortality. For contained abscess, nonsurgical options are considered; however, for ruptured liver abscess, surgical intervention is considered necessary. Materials and Methods: This was a retrospective study carried in Safdarjung hospital, New Delhi, between 2015 and 2016. All patients with ruptured liver abscess (clear signs of peritonitis were included in this study, and those patients having other causes of peritonitis were excluded. A preformed protocol for management was followed for all the patients, and various parameters contributing to the illness and its prognosis were evaluated and assessed. Results: Out of the fifty patients assessed, male patients were mainly affected (86%. The most affected age group was 31–40 years (64% followed by 41–50 years (22%. Right hypochondrium pain was the most common presenting complaint. Nine patients (18% had presented with signs of toxemia. Only right lobe of the liver was affected the most in 44 patients (88%. Escherichia coli was the most common organism isolated in our study in 19 patients (38%. A total of 19 patients (38% had diabetes in our study and total of 13 patients had mortality in our study. Conclusion: Ruptured liver abscess most commonly involves the right lobe of the liver. Males are affected far higher than the females; probable cause believed to be higher alcohol consumption. Most common affected age group falls between 30 and 60 years of age. If prompt treatment is started in time, mortality involved with it is evitable.

  9. The Danish anal sphincter rupture questionnaire: Validity and reliability

    DEFF Research Database (Denmark)

    Due, Ulla; Ottesen, Marianne

    2008-01-01

    Objective. To revise, validate and test for reliability an anal sphincter rupture questionnaire in relation to construct, content and face validity. Setting and background. Since 1996 women with anal sphincter rupture (ASR) at one of the public university hospitals in Copenhagen, Denmark have bee...

  10. New considerations on variability of creep rupture data and life prediction

    International Nuclear Information System (INIS)

    Kim, Seon Jin; Jeong, Won Taek; Kong, Yu Sik

    2009-01-01

    This paper deals with the variability analysis of short term creep rupture test data based on the previous creep rupture tests and the possibility of the creep life prediction. From creep tests performed by constant uniaxial stresses at 600, 650 and 700 .deg. C elevated temperature, in order to investigate the variability of short-term creep rupture data, the creep curves were analyzed for normalized creep strain divided by initial strain. There are some variability in thee creep rupture data. And, the difference between general creep curves and normalized creep curves were obtained. The effects of the creep rupture time and state steady creep rate on the Weibull distribution parameters were investigated. There were good relation between normal Weibull parameters and normalized Weibull parameters. Finally, the predicted creep life were compared with the Monkman-Grant model.

  11. New Considerations on Variability of Creep Rupture Data and Life Prediction

    International Nuclear Information System (INIS)

    Jung, Won Taek; Kong, Yu Sik; Kim, Seon Jin

    2009-01-01

    This paper deals with the variability analysis of short term creep rupture test data based on the previous creep rupture tests and the possibility of the creep life prediction. From creep tests performed by constant uniaxial stresses at 600, 650 and 700 .deg. C elevated temperature, in order to investigate the variability of short-term creep rupture data, the creep curves were analyzed for normalized creep strain divided by initial strain. There are some variability in the creep rupture data. And, the difference between general creep curves and normalized creep curves were obtained. The effects of the creep rupture time (RT) and steady state creep rate (SSCR) on the Weibull distribution parameters were investigated. There were good relation between normal Weibull parameters and normalized Weibull parameters. Finally, the predicted creep life were compared with the Monkman-Grant model

  12. Magnetic resonance imaging and computed radiography in Achilles tendon rupture

    International Nuclear Information System (INIS)

    Korenaga, Tateo; Hachiya, Junichi; Miyasaka, Yasuo

    1988-01-01

    Magnetic Resonance Imaging (MRI) and Computed Radiography (CR) were performed in 15 patients with complete Achilles tendon rupture who were treated conservatively without surgery. MRI was obtained using Toshiba MRT 50 A superconductive machine, operaing at 0.5 Tesla. CR was performed by CR-101, Fuji Medical System. In fresh cases, ruptured tendons showed intermediate signal intensity on T1-weighted images and high intensity on T2-weighted images. Thickening of the tendon was observed in all cases except in very acute stage. Configuration of thickend tendons tends to be dumbbell shape in subacute stage and fusiform in chronic stage of more than six months after the initial trauma. In cases which showed high signal intensity at the ruptured area both on T1 and T2 weighted images, migration of fat into the sapces between the ruptured tendons was considered to be the major source of increased signal intensity. Computed radiography showed thickening of the tendon, blurring of anterior margin of the tendon, and decreased translucency of pre-Achilles fat pad. However, MRI better demonstrated the details of ruptured tendons when compared to CR, and thought to be an usefull way of following up the healing process of the ruptured tendon to facilitate more reasonable judgement of the time of removing plaster casts and stating exercise. (author)

  13. PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

    African Journals Online (AJOL)

    GB

    BACKGROUND: Literature is scarce about spontaneous rupture of hernia because spontaneous rupture of here is uncommon (1). Reported cases are complications of incisional hernias, recurrent inguinal hernia, and umbilical hernias. It is potentially life threatening (1) because the ensuing entrapment and tension on ...

  14. Multimodality Imaging-based Evaluation of Single-Lumen Silicone Breast Implants for Rupture.

    Science.gov (United States)

    Seiler, Stephen J; Sharma, Pooja B; Hayes, Jody C; Ganti, Ramapriya; Mootz, Ann R; Eads, Emily D; Teotia, Sumeet S; Evans, W Phil

    2017-01-01

    Breast implants are frequently encountered on breast imaging studies, and it is essential for any radiologist interpreting these studies to be able to correctly assess implant integrity. Ruptures of silicone gel-filled implants often occur without becoming clinically obvious and are incidentally detected at imaging. Early diagnosis of implant rupture is important because surgical removal of extracapsular silicone in the breast parenchyma and lymphatics is difficult. Conversely, misdiagnosis of rupture may prompt a patient to undergo unnecessary additional surgery to remove the implant. Mammography is the most common breast imaging examination performed and can readily depict extracapsular free silicone, although it is insensitive for detection of intracapsular implant rupture. Ultrasonography (US) can be used to assess the internal structure of the implant and may provide an economical method for initial implant assessment. Common US signs of intracapsular rupture include the "keyhole" or "noose" sign, subcapsular line sign, and "stepladder" sign; extracapsular silicone has a distinctive "snowstorm" or echogenic noise appearance. Magnetic resonance (MR) imaging is the most accurate and reliable means for assessment of implant rupture and is highly sensitive for detection of both intracapsular and extracapsular rupture. MR imaging findings of intracapsular rupture include the keyhole or noose sign, subcapsular line sign, and "linguine" sign, and silicone-selective MR imaging sequences are highly sensitive to small amounts of extracapsular silicone. © RSNA, 2017.

  15. Spontaneous acute spinal subdural hematoma: spontaneous recovery from severe paraparesis--case report and review.

    Science.gov (United States)

    Payer, Michael; Agosti, Reto

    2010-11-01

    Spontaneous idiopathic acute spinal subdural hematomas are highly exceptional. Neurological symptoms are usually severe, and rapid diagnosis with MRI is mandatory. Surgical evacuation has frequently been used therapeutically; however, spontaneous recovery in mild cases has also been reported. We present a case of spontaneous recovery from severe paraparesis after spontaneous acute SSDH, and review the English-speaking literature.

  16. Endovascular treatment of ruptured splenic artery aneurysm

    DEFF Research Database (Denmark)

    Bjerring, Ole Steen

    2008-01-01

    Splenic artery aneurysms (SAA) are traditionally treated surgically, but endovascular techniques are becoming increasingly popular. A 64 year-old male with chest pain and low blood pressure was admitted under suspicion of AMI. A CT scan showed a 56 mm SAA with signs of rupture. The patient...... was treated with endovascular embolisation of the SAA with coils. Blood pressure and haemoglobin levels were stabilized and the patient was discharged. In the case of rupture the treatment of choice seems to be endovascular....

  17. Acute Associations Between Outdoor Temperature and Premature Rupture of Membranes.

    Science.gov (United States)

    Ha, Sandie; Liu, Danping; Zhu, Yeyi; Sherman, Seth; Mendola, Pauline

    2018-03-01

    Extreme ambient temperatures have been linked to preterm birth. Preterm premature rupture of membranes is a common precursor to preterm birth but is rarely studied in relation to temperature. We linked 15,381 singleton pregnancies with premature rupture of membranes from a nationwide US obstetrics cohort (2002-2008) to local temperature. Case-crossover analyses compared daily temperature during the week preceding delivery and the day of delivery to 2 control periods, before and after the case period. Conditional logistic regression models calculated the odds ratio (OR) and 95% confidence intervals (CIs) of preterm and term premature rupture of membranes for a 1°C increase in temperature during the warm (May-September) and cold (October-April) season separately after adjusting for humidity, barometric pressure, ozone, and particulate matter. During the warm season, 1°C increase during the week before delivery was associated with a 5% (95% CI, 3%, 6%) increased preterm premature rupture of membranes risk, and a 4% (95% CI, 3%, 5%) increased term premature rupture of membranes risk. During the cold season, 1°C increase was associated with a 2% decreased risk for both preterm (95% CI, 1%, 3%) and term premature rupture of membranes (95% CI, 1%, 3%). The day-specific associations for the week before delivery were similar, but somewhat stronger for days closer to delivery. Relatively small ambient temperature changes were associated with the risk of both preterm and term premature of membranes. Given the adverse consequences of premature rupture of membranes and concerns over global climate change, these findings merit further investigation. See video abstract at, http://links.lww.com/EDE/B312.

  18. Emergency endovascular coiling of a ruptured giant splenic artery aneurysm

    DEFF Research Database (Denmark)

    Wernheden, Erika; Brenøe, Anne Sofie; Shahidi, Saeid

    2017-01-01

    Splenic artery aneurysms (SAAs) are the third most common abdominal aneurysm. Endovascular treatment of SAAs is preferred, and coiling is the most commonly used technique. Ruptured giant (>5 cm) SAAs are usually treated with open surgery including splenectomy. We present a rare case of a ruptured...... 15-cm giant SAA in an 84-year-old woman treated successfully with emergency endovascular coiling. To our knowledge, this is one of the few reports of emergency endovascular treatment for ruptured giant SAA....

  19. Surgical repair of a rupture of the pectoralis major muscle

    Science.gov (United States)

    Pochini, Alberto De Castro; Andreoli, Carlos Vicente; Ejnisman, Benno; Maffulli, Nicola

    2015-01-01

    Muscle rupture is rarely treated surgically. Few reports of good outcomes after muscular suture have been published. Usually, muscular lesions or partial ruptures heal with few side effects or result in total recovery. We report a case of an athlete who was treated surgically to repair a total muscular rupture in the pectoralis major muscle. After 6 months, the athlete returned to competitive practice. After a 2-year follow-up, the athlete still competes in skateboard championships. PMID:25716033

  20. Diagnosis of Complex Pulley Ruptures Using Ultrasound in Cadaver Models.

    Science.gov (United States)

    Schöffl, Isabelle; Hugel, Arnica; Schöffl, Volker; Rascher, Wolfgang; Jüngert, Jörg

    2017-03-01

    Pulley ruptures are common in climbing athletes. The purposes of this study were to determine the specific positioning of each pulley with regards to the joint, and to evaluate the ultrasound diagnostics of various pulley rupture combinations. For this, 34 cadaver fingers were analyzed via ultrasound, the results of which were compared to anatomic measurements. Different pulley ruptures were then simulated and evaluated using ultrasound in standardized dynamic forced flexion. Visualization of the A2 and A4 pulleys was achieved 100% of the time, while the A3 pulley was visible in 74% of cases. Similarly, injuries to the A2 and A4 pulleys were readily observable, while A3 pulley injuries were more challenging to identify (sensitivity of 0.2 for singular A3 pulley, 0.5 for A2/A4 pulley and 0.33 for A3/A4 pulley ruptures). Receiver operating characteristic analysis was used to evaluate the optimal tendon-bone distance for pulley rupture diagnosis, a threshold which was determined to be 1.9 mm for A2 pulley ruptures and 1.85 for A4 pulley ruptures. This study was the first to carry out a cadaver ultrasound examination of a wide variety of pulley ruptures. Ultrasound is a highly accurate tool for visualizing the A2 and A4 pulleys in a cadaver model. This method of pathology diagnosis was determined to be suitable for injuries to the A2 and A4 pulleys, but inadequate for A3 pulley injuries. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  1. Hepatic angiographic findings of ruptured hepatocellular carcinoma: 'Sentinel signs' versus extravasation

    International Nuclear Information System (INIS)

    Yun, Seong Jong; Nam, Deok Ho

    2014-01-01

    This study retrospectively compared the accuracy of angiographic sentinel signs (sentinel vessels, hypovascular areas, and delayed dots) with extravasation in the diagnosis of ruptured hepatocellular carcinoma (HCC). Sixteen patients diagnosed with HCC between March 2007 and November 2011 were evaluated. Among the patients, we identified 32 HCCs (19 ruptured, 13 unruptured), and assessed all HCCs by hepatic angiography with regard to extravasation, sentinel vessels, hypovascular areas, and delayed dots. We compared the sensitivity and specificity of the sentinel signs with those of the extravasation for the diagnosis of a ruptured HCC. For the angiographic diagnosis of a ruptured HCC, the sensitivity of the sentinel signs (sentinel vessel, 63.2%; hypovascular area, 89.5%; delayed dot, 72.7%) was higher than the sensitivity of extravasation (15.8%). The difference in sensitivity between each sentinel sign and extravasation was statistically significant (sentinel vessel, p = 0.012; hypovascular area, p < 0.001; delayed dot, p 0.039). The specificity of sentinel signs for the diagnosis of ruptured HCC was not statistically different from the specificity of extravasation. Sentinel signs are more accurate than extravasation for the angiographic diagnosis of a ruptured HCC.

  2. Ruptured uterus in Azare, north eastern Nigeria | Dattijo | Jos ...

    African Journals Online (AJOL)

    Background:-Ruptured uterus is an obstetric emergency and results in significant maternal and perinatal morbidity and mortality in Nigeria. The objective of the review is to determine the incidence, predisposing factors, maternal and foetal outcome in cases of ruptured uterus. Methods:- A 4-year retrospective review of ...

  3. Global variations of large megathrust earthquake rupture characteristics

    Science.gov (United States)

    Kanamori, Hiroo

    2018-01-01

    Despite the surge of great earthquakes along subduction zones over the last decade and advances in observations and analysis techniques, it remains unclear whether earthquake complexity is primarily controlled by persistent fault properties or by dynamics of the failure process. We introduce the radiated energy enhancement factor (REEF), given by the ratio of an event’s directly measured radiated energy to the calculated minimum radiated energy for a source with the same seismic moment and duration, to quantify the rupture complexity. The REEF measurements for 119 large [moment magnitude (Mw) 7.0 to 9.2] megathrust earthquakes distributed globally show marked systematic regional patterns, suggesting that the rupture complexity is strongly influenced by persistent geological factors. We characterize this as the existence of smooth and rough rupture patches with varying interpatch separation, along with failure dynamics producing triggering interactions that augment the regional influences on large events. We present an improved asperity scenario incorporating both effects and categorize global subduction zones and great earthquakes based on their REEF values and slip patterns. Giant earthquakes rupturing over several hundred kilometers can occur in regions with low-REEF patches and small interpatch spacing, such as for the 1960 Chile, 1964 Alaska, and 2011 Tohoku earthquakes, or in regions with high-REEF patches and large interpatch spacing as in the case for the 2004 Sumatra and 1906 Ecuador-Colombia earthquakes. Thus, combining seismic magnitude Mw and REEF, we provide a quantitative framework to better represent the span of rupture characteristics of great earthquakes and to understand global seismicity. PMID:29750186

  4. Sub-Patch Roughness in Earthquake Rupture Investigations

    KAUST Repository

    Zielke, Olaf; Mai, Paul Martin

    2016-01-01

    Fault geometric complexities exhibit fractal characteristics over a wide range of spatial scales (<µm to >km) and strongly affect the rupture process at corresponding scales. Numerical rupture simulations provide a framework to quantitatively investigate the relationship between a fault's roughness and its seismic characteristics. Fault discretization however introduces an artificial lower limit to roughness. Individual fault patches are planar and sub-patch roughness –roughness at spatial scales below fault-patch size– is not incorporated. Does negligence of sub-patch roughness measurably affect the outcome of earthquake rupture simulations? We approach this question with a numerical parameter space investigation and demonstrate that sub-patch roughness significantly modifies the slip-strain relationship –a fundamental aspect of dislocation theory. Faults with sub-patch roughness induce less strain than their planar-fault equivalents at distances beyond the length of a slipping fault. We further provide regression functions that characterize the stochastic effect sub-patch roughness.

  5. Sub-Patch Roughness in Earthquake Rupture Investigations

    KAUST Repository

    Zielke, Olaf

    2016-02-13

    Fault geometric complexities exhibit fractal characteristics over a wide range of spatial scales (<µm to >km) and strongly affect the rupture process at corresponding scales. Numerical rupture simulations provide a framework to quantitatively investigate the relationship between a fault\\'s roughness and its seismic characteristics. Fault discretization however introduces an artificial lower limit to roughness. Individual fault patches are planar and sub-patch roughness –roughness at spatial scales below fault-patch size– is not incorporated. Does negligence of sub-patch roughness measurably affect the outcome of earthquake rupture simulations? We approach this question with a numerical parameter space investigation and demonstrate that sub-patch roughness significantly modifies the slip-strain relationship –a fundamental aspect of dislocation theory. Faults with sub-patch roughness induce less strain than their planar-fault equivalents at distances beyond the length of a slipping fault. We further provide regression functions that characterize the stochastic effect sub-patch roughness.

  6. Computed tomography in ruptured intracranial aneurysm

    International Nuclear Information System (INIS)

    Suzuki, Michiyasu; Ogawa, Akira; Sakurai, Yoshiharu; Komatsu, Shinro; Suzuki, Jiro.

    1983-01-01

    The differences between initial bleeding and rebleeding due to ruptured intracranial aneurysm was investigated by CT. The study included 120 cases of ruptured cerebral aneurysm; 71 cases had only one bleeding and 49 cases had rebleeding. All the cases underwent CT examinations within 2 weeks following bleeding. Subarachnoid hemorrhages were classified into three groups according to the CT findings: Diffuse high type-high density areas in the entire basal cistern; Localized high type-high density area in a restricted part of the basal cistern; and Iso or Low type-no high density areas in the basal cistern. CT scans done within 24 hours following initial bleeding showed Diffuse high type in 96% of the cases and Localized high type in 4%. On the other hand, in rebleeding cases, Diffuse high type was 50%, Localized high type 25% and Iso or Low type 25%. In rebleeding cases within three days following initial bleeding, Diffuse high type was 90% and Iso or Low type 10%. However, between day 4 and day 14, Diffuse high type was 14%, Localized high type 42% and Iso or Low type 42%. After day 15, Diffuse high type was 36%, Localized type 36% and Iso or Low type 28%. Intracerebral hematoma and/or ventricular hemorrhage secondary to ruptured aneurysms were also investigated. Following initial bleeding, 18% of cases showed intracerebral and/or ventricular hemorrhage, however, the incidence increased up to 59% in rebleeding cases. These observations indicate that the subarachnoid hemorrhage due to re-ruptured aneurysm tends to be more localized than in initial bleeding cases and that intracerebral and/or ventricular hemorrhage seems more frequent in rebleeding cases. (author)

  7. Indigenous development of rupture discs for FBTR (Paper No. 028)

    International Nuclear Information System (INIS)

    Chetal, S.C.; Raju, Chander; Anandkumar, V.; Seetharaman, V.

    1987-02-01

    Rupture discs are required as a safety device for protecting the secondary sodium circuit and its components against high pressure surges due to accidental water-steam leaks in sodium heated steam generator and the consequent sodium water reaction. For identical reasons, rupture discs are also required on the vessels used for decontamination of sodium components. As an import substitution of the costly items for the FBTR Project, development of the rupture disc assemblies has been in progress at Indira Gandhi Centre for Atomic Research, Kalpakkam. Reverse buckling knife blade concept with stainless steel disc has been taken up for development. Hydroforming process without any die has been selected for disc fabrication. One rupture disc assembly required for steam generator has been tested in sodium satisfactorily. (author). 4 tables, 5 figs

  8. Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Lv, Nan; Wang, Chi; Karmonik, Christof; Fang, Yibin; Xu, Jinyu; Yu, Ying; Cao, Wei; Liu, Jianmin; Huang, Qinghai

    2016-01-01

    The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA) aneurysms. In 129 PCoA aneurysms (85 ruptured, 44 unruptured), clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms. While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR), size ratio (SR), dome-to-neck ratio (DN), inflow angle (IA), normalized wall shear stress (NWSS) and percentage of low wall shear stress area (LSA) were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p PCoA aneurysms.

  9. Tetraventricular hydrocephalus due to ruptured intracranial dermoid cyst

    International Nuclear Information System (INIS)

    Karabulut, N.; Oguzkurt, L.

    2000-01-01

    We present the MR imaging findings in a patient who developed tetraventricular hydrocephalus after massive rupture of dermoid cysts with generalized subarachnoid and ventricular spread of cyst contents. The development of tetraventricular hydrocephalus due to ruptured dermoid is a very unusual complication, and was attributed to cyst contents interfering with passage of cerebrospinal fluid through the arachnoid granulations and fourth ventricular outlet foramina. (orig.)

  10. Proximal Hamstring Tendinosis and Partial Ruptures.

    Science.gov (United States)

    Startzman, Ashley N; Fowler, Oliver; Carreira, Dominic

    2017-07-01

    Proximal hamstring tendinosis and partial hamstring origin ruptures are painful conditions of the proximal thigh and hip that may occur in the acute, chronic, or acute on chronic setting. Few publications exist related to their diagnosis and management. This systematic review discusses the incidence, treatment, and prognosis of proximal hamstring tendinosis and partial hamstring ruptures. Conservative treatment measures include nonsteroidal anti-inflammatory drugs, physical therapy, rest, and ice. If these measures fail, platelet-rich plasma or shockwave therapy may be considered. When refractory to conservative management, these injuries may be treated with surgical debridement and hamstring reattachment. [Orthopedics. 2017; 40(4):e574-e582.]. Copyright 2017, SLACK Incorporated.

  11. Standards for Documenting Finite‐Fault Earthquake Rupture Models

    KAUST Repository

    Mai, Paul Martin

    2016-04-06

    In this article, we propose standards for documenting and disseminating finite‐fault earthquake rupture models, and related data and metadata. A comprehensive documentation of the rupture models, a detailed description of the data processing steps, and facilitating the access to the actual data that went into the earthquake source inversion are required to promote follow‐up research and to ensure interoperability, transparency, and reproducibility of the published slip‐inversion solutions. We suggest a formatting scheme that describes the kinematic rupture process in an unambiguous way to support subsequent research. We also provide guidelines on how to document the data, metadata, and data processing. The proposed standards and formats represent a first step to establishing best practices for comprehensively documenting input and output of finite‐fault earthquake source studies.

  12. Standards for Documenting Finite‐Fault Earthquake Rupture Models

    KAUST Repository

    Mai, Paul Martin; Shearer, Peter; Ampuero, Jean‐Paul; Lay, Thorne

    2016-01-01

    In this article, we propose standards for documenting and disseminating finite‐fault earthquake rupture models, and related data and metadata. A comprehensive documentation of the rupture models, a detailed description of the data processing steps, and facilitating the access to the actual data that went into the earthquake source inversion are required to promote follow‐up research and to ensure interoperability, transparency, and reproducibility of the published slip‐inversion solutions. We suggest a formatting scheme that describes the kinematic rupture process in an unambiguous way to support subsequent research. We also provide guidelines on how to document the data, metadata, and data processing. The proposed standards and formats represent a first step to establishing best practices for comprehensively documenting input and output of finite‐fault earthquake source studies.

  13. Toward tsunami early warning system in Indonesia by using rapid rupture durations estimation

    International Nuclear Information System (INIS)

    Madlazim

    2012-01-01

    Indonesia has Indonesian Tsunami Early Warning System (Ina-TEWS) since 2008. The Ina-TEWS has used automatic processing on hypocenter; Mwp, Mw (mB) and Mj. If earthquake occurred in Ocean, depth 7, then Ina-TEWS announce early warning that the earthquake can generate tsunami. However, the announcement of the Ina-TEWS is still not accuracy. Purposes of this research are to estimate earthquake rupture duration of large Indonesia earthquakes that occurred in Indian Ocean, Java, Timor sea, Banda sea, Arafura sea and Pasific ocean. We analyzed at least 330 vertical seismogram recorded by IRIS-DMC network using a direct procedure for rapid assessment of earthquake tsunami potential using simple measures on P-wave vertical seismograms on the velocity records, and the likelihood that the high-frequency, apparent rupture duration, T dur . T dur can be related to the critical parameters rupture length (L), depth (z), and shear modulus (μ) while T dur may be related to wide (W), slip (D), z or μ. Our analysis shows that the rupture duration has a stronger influence to generate tsunami than Mw and depth. The rupture duration gives more information on tsunami impact, Mo/μ, depth and size than Mw and other currently used discriminants. We show more information which known from the rupture durations. The longer rupture duration, the shallower source of the earthquake. For rupture duration greater than 50 s, the depth less than 50 km, Mw greater than 7, the longer rupture length, because T dur is proportional L and greater Mo/μ. Because Mo/μ is proportional L. So, with rupture duration information can be known information of the four parameters. We also suggest that tsunami potential is not directly related to the faulting type of source and for events that have rupture duration greater than 50 s, the earthquakes generated tsunami. With available real-time seismogram data, rapid calculation, rupture duration discriminant can be completed within 4–5 min after an earthquake

  14. Splenic rupture in a neonate – a rare complication

    African Journals Online (AJOL)

    differential diagnosis of a hypovolaemic shocked infant with an abdominal mass. The symptoms of splenic rupture are ... A diagnosis of splenic rupture due to possible birth trauma was made. The mother admitted a month later ... parenchyma, e.g. erythroblastosis fetalis and congenital syphilis, as an enlarged spleen is more ...

  15. Thermal-hydraulic analyses of pressurized-thermal-shock-induced vessel ruptures

    International Nuclear Information System (INIS)

    Dobranich, D.

    1982-05-01

    A severe overcooling transient was postulated to produce vessel wall temperatures below the nil-ductility transition temperature which in conjunction with system repressurization, led to vessel rupture at the core midplane. Such transients are referred to as pressurized-thermal-shock transients. A wide range of vessel rupture sizes were investigated to assess the emergency system's ability to cool the fuel rods. Ruptures greater than approximately 0.015 m 2 produced flows greater than those of the emergency system and resulted in core uncovery and subsequent core damage

  16. Emergency endovascular coiling of a ruptured giant splenic artery aneurysm

    Directory of Open Access Journals (Sweden)

    Erika Wernheden, MD

    2017-12-01

    Full Text Available Splenic artery aneurysms (SAAs are the third most common abdominal aneurysm. Endovascular treatment of SAAs is preferred, and coiling is the most commonly used technique. Ruptured giant (>5 cm SAAs are usually treated with open surgery including splenectomy. We present a rare case of a ruptured 15-cm giant SAA in an 84-year-old woman treated successfully with emergency endovascular coiling. To our knowledge, this is one of the few reports of emergency endovascular treatment for ruptured giant SAA.

  17. Tracheal rupture caused by blunt chest trauma: radiological and clinical features

    Energy Technology Data Exchange (ETDEWEB)

    Kunisch-Hoppe, M.; Rauber, K.; Rau, W.S. [Dept. of Diagnostic Radiology, Justus Liebig Univ., Giessen (Germany); Hoppe, M. [Dept. of Diagnostic Radiology, University Hospital, Philipps University, Marburg (Germany); Popella, C. [Dept. of ENT, Justus Liebig University, Giessen (Germany)

    2000-03-01

    The aim of this study was to assess radiomorphologic and clinical features of tracheal rupture due to blunt chest trauma. From 1992 until 1998 the radiomorphologic and clinical key findings of all consecutive tracheal ruptures were retrospectively analyzed. The study included ten patients (7 men and 3 women; mean age 35 years); all had pneumothoraces which were persistent despite suction drainage. Seven patients developed a pneumomediastinum as well as a subcutaneous emphysema on conventional chest X-rays. In five patients, one major hint leading to the diagnosis was a cervical emphysema, discovered on the lateral cervical spine view. Contrast-media-enhanced thoracic CT was obtained in all ten cases and showed additional injuries (atelectasis n = 5; lung contusion n = 4; lung laceration n = 2; hematothorax n = 2 and hematomediastinum n = 4). The definite diagnosis of tracheal rupture was made by bronchoscopy, which was obtained in all patients. Tracheal rupture due to blunt chest trauma occurs rarely. Key findings were all provided by conventional chest X-ray. Tracheal rupture is suspected in front of a pneumothorax, a pneumomediastinum, or a subcutaneous emphysema on lateral cervical spine and chest films. Routine thoracic CT could also demonstrate these findings but could not confirm the definite diagnosis of an tracheal rupture except in one case; in the other 9 cases this was done by bronchoscopy. Thus, bronchoscopy should be mandatory in all suspicious cases of tracheal rupture and remains the gold standard. (orig.)

  18. Tracheal rupture caused by blunt chest trauma: radiological and clinical features

    International Nuclear Information System (INIS)

    Kunisch-Hoppe, M.; Rauber, K.; Rau, W.S.; Hoppe, M.; Popella, C.

    2000-01-01

    The aim of this study was to assess radiomorphologic and clinical features of tracheal rupture due to blunt chest trauma. From 1992 until 1998 the radiomorphologic and clinical key findings of all consecutive tracheal ruptures were retrospectively analyzed. The study included ten patients (7 men and 3 women; mean age 35 years); all had pneumothoraces which were persistent despite suction drainage. Seven patients developed a pneumomediastinum as well as a subcutaneous emphysema on conventional chest X-rays. In five patients, one major hint leading to the diagnosis was a cervical emphysema, discovered on the lateral cervical spine view. Contrast-media-enhanced thoracic CT was obtained in all ten cases and showed additional injuries (atelectasis n = 5; lung contusion n = 4; lung laceration n = 2; hematothorax n = 2 and hematomediastinum n = 4). The definite diagnosis of tracheal rupture was made by bronchoscopy, which was obtained in all patients. Tracheal rupture due to blunt chest trauma occurs rarely. Key findings were all provided by conventional chest X-ray. Tracheal rupture is suspected in front of a pneumothorax, a pneumomediastinum, or a subcutaneous emphysema on lateral cervical spine and chest films. Routine thoracic CT could also demonstrate these findings but could not confirm the definite diagnosis of an tracheal rupture except in one case; in the other 9 cases this was done by bronchoscopy. Thus, bronchoscopy should be mandatory in all suspicious cases of tracheal rupture and remains the gold standard. (orig.)

  19. Intracapsular implant rupture: MR findings of incomplete shell collapse.

    Science.gov (United States)

    Soo, M S; Kornguth, P J; Walsh, R; Elenberger, C; Georgiade, G S; DeLong, D; Spritzer, C E

    1997-01-01

    The objective of this study was to determine the frequency and significance of the MR findings of incomplete shell collapse for detecting implant rupture in a series of surgically removed breast prostheses. MR images of 86 breast implants in 44 patients were studied retrospectively and correlated with surgical findings at explantation. MR findings included (a) complete shell collapse (linguine sign), 21 implants; (b) incomplete shell collapse (subcapsular line sign, teardrop sign, and keyhole sign), 33 implants; (c) radial folds, 31 implants; and (d) normal, 1 implant. The subcapsular line sign was seen in 26 implants, the teardrop sign was seen in 27 implants, and the keyhole sign was seen in 23 implants. At surgery, 48 implants were found to be ruptured and 38 were intact. The MR findings of ruptured implants showed signs of incomplete collapse in 52% (n = 25), linguine sign in 44% (n = 21), and radial folds in 4% (n = 2). The linguine sign perfectly predicted implant rupture, but sensitivity was low. Findings of incomplete shell collapse improved sensitivity and negative predictive values, and the subcapsular line sign produced a significant incremental increase in predictive ability. MRI signs of incomplete shell collapse were more common than the linguine sign in ruptured implants and are significant contributors to the high sensitivity and negative predictive values of MRI for evaluating implant integrity.

  20. Composite Overwrap Pressure Vessels: Mechanics and Stress Rupture Lifting Philosophy

    Science.gov (United States)

    Thesken, John C.; Murthy, Pappu L. N.; Phoenix, S. L.

    2009-01-01

    The NASA Engineering and Safety Center (NESC) has been conducting an independent technical assessment to address safety concerns related to the known stress rupture failure mode of filament wound pressure vessels in use on Shuttle and the International Space Station. The Shuttle s Kevlar-49 (DuPont) fiber overwrapped tanks are of particular concern due to their long usage and the poorly understood stress rupture process in Kevlar-49 filaments. Existing long term data show that the rupture process is a function of stress, temperature and time. However due to the presence of load sharing liners and the complex manufacturing procedures, the state of actual fiber stress in flight hardware and test articles is not clearly known. Indeed nonconservative life predictions have been made where stress rupture data and lifing procedures have ignored the contribution of the liner in favor of applied pressure as the controlling load parameter. With the aid of analytical and finite element results, this paper examines the fundamental mechanical response of composite overwrapped pressure vessels including the influence of elastic plastic liners and degraded/creeping overwrap properties. Graphical methods are presented describing the non-linear relationship of applied pressure to Kevlar-49 fiber stress/strain during manufacturing, operations and burst loadings. These are applied to experimental measurements made on a variety of vessel systems to demonstrate the correct calibration of fiber stress as a function of pressure. Applying this analysis to the actual qualification burst data for Shuttle flight hardware revealed that the nominal fiber stress at burst was in some cases 23 percent lower than what had previously been used to predict stress rupture life. These results motivate a detailed discussion of the appropriate stress rupture lifing philosophy for COPVs including the correct transference of stress rupture life data between dissimilar vessels and test articles.

  1. Composite Overwrap Pressure Vessels: Mechanics and Stress Rupture Lifing Philosophy

    Science.gov (United States)

    Thesken, John C.; Murthy, Pappu L. N.; Phoenix, Leigh

    2007-01-01

    The NASA Engineering and Safety Center (NESC) has been conducting an independent technical assessment to address safety concerns related to the known stress rupture failure mode of filament wound pressure vessels in use on Shuttle and the International Space Station. The Shuttle's Kevlar-49 fiber overwrapped tanks are of particular concern due to their long usage and the poorly understood stress rupture process in Kevlar-49 filaments. Existing long term data show that the rupture process is a function of stress, temperature and time. However due to the presence of load sharing liners and the complex manufacturing procedures, the state of actual fiber stress in flight hardware and test articles is not clearly known. Indeed non-conservative life predictions have been made where stress rupture data and lifing procedures have ignored the contribution of the liner in favor of applied pressure as the controlling load parameter. With the aid of analytical and finite element results, this paper examines the fundamental mechanical response of composite overwrapped pressure vessels including the influence of elastic-plastic liners and degraded/creeping overwrap properties. Graphical methods are presented describing the non-linear relationship of applied pressure to Kevlar-49 fiber stress/strain during manufacturing, operations and burst loadings. These are applied to experimental measurements made on a variety of vessel systems to demonstrate the correct calibration of fiber stress as a function of pressure. Applying this analysis to the actual qualification burst data for Shuttle flight hardware revealed that the nominal fiber stress at burst was in some cases 23% lower than what had previously been used to predict stress rupture life. These results motivate a detailed discussion of the appropriate stress rupture lifing philosophy for COPVs including the correct transference of stress rupture life data between dissimilar vessels and test articles.

  2. In-reactor creep rupture behavior of the D9 alloys

    International Nuclear Information System (INIS)

    Puigh, R.J.; Hamilton, M.L.

    1986-06-01

    The uncertainties in the in-reactor stress rupture data have been significantly reduced with the acquisition of the Materials Open Test Assembly (MOTA) for testing of materials in the Fast Flux Test Facility (FFTF). The temperature uncertainty associated with irradiation in this vehicle is +- 5 0 C. Moreover, through the use of tag gases and an on-line cover gas monitoring system, on-line detection of specimen ruptures is possible during irradiation, thereby significantly reducing the uncertainty associated with the rupture times. Titanium additions, increases in nickel content and decreases in chromium content, which were made to improve the swelling response of 316 SS, resulted in an alloy class referred to as ''D9''. In-reactor stress rupture data from the MOTA experiment have been reported on two conditions of the D9-type alloys for exposure times corresponding to 2,400 hours at irradiation temperatures of 575, 605, 670, and 750 0 C. For these conditions the in-reactor rupture times were similar to those observed in thermal control tests. This report will describe both the in-reactor stress rupture behavior and the thermal control data for 20% cold work (CW) 316 SS and for 10 and 20% CW D9-type alloy over a similar temperature range for in-reactor exposure times corresponding to 13170 hr. and peak fast fluences corresponding to 17 x 10 22 n/cm 2 (E > 0.1 MeV)

  3. Influence of steam generator tube ruptures during semiscale loss-of-coolant experiments

    International Nuclear Information System (INIS)

    Cozzuol, J.M.; Larson, T.K.

    1978-01-01

    Tests which simulated rupture of steam generator tubes during loss-of-coolant experiments in a PWR type system have been conducted in the Semiscale Mod-1 system. Analysis of test data indicates that high rod cladding temperatures occured only for a band of tube ruptures (between 12 and 20 tubes) and that the peak cladding temperatures attained within this band were strongly dependent on the magnitude of the tube rupture flow rates. Maximum cladding temperature of about 1255 K was observed for tests which simulated tube ruptures within this narrow band. (author)

  4. Traumatic rupture of the diaphragm | Jamabo | Sahel Medical Journal

    African Journals Online (AJOL)

    Those treated for traumatic rupture of the diaphragm were selected and analyzed for age, gender, cause of injury, associated injuries sustained and mode of treatment. They were all treated at the University of Port Harcourt Teaching Hospital and a private clinic in Port Harcourt. Results: 12 patients had traumatic rupture of ...

  5. Prevention and management of intraprocedural rupture of intracranial aneurysm with detachable coils during embolization

    International Nuclear Information System (INIS)

    Li, Ming-Hua; Gao, Bu-Lang; Fang, Chun; Cheng, Ying-Sheng; Li, Yong-Dong; Wang, Jue; Xu, Guo-Ping

    2006-01-01

    Intracranial aneurysm rupture during embolization with detachable coils is reportedly among the gravest of intraprocedural complications. We present here our experiences with this outcome, and a potential intervention for managing this life-threatening complication. From April 1998 to March 2005, 284 patients with cerebral aneurysms were treated with detachable coils. Intraprocedural aneurysm rupture occurred in ten patients with a history of a previously ruptured aneurysm. In the event of intraprocedural hemorrhage, we routinely performed heparin reversal with protamine sulfate. Of the 221 patients with a previously ruptured aneurysm, intraprocedural aneurysm rupture occurred in 10 (4.5%). These ruptures were caused by a microguidewire in one patient, a microcatheter in one, over-packing in two and a coil perforation in three. In the remaining three patients the ruptures were caused by both the microcatheter and the coils. Three patients died because of aneurysm re-rupture, yielding a mortality rate of 30%. One patient presented with a slight disability in the left leg and no neurological deficits were observed in the remaining six patients. Intraprocedural aneurysm rupture during embolization is a rare, but unavoidable and life-threatening event. Proper measures should be taken to reduce and improve the outcome of this tragic occurrence. The majority of patients with an intraprocedural ruptured aneurysm can survive without severe sequelae if managed appropriately. (orig.)

  6. Creep-rupture behavior of iron superalloys in high-pressure hydrogen

    Science.gov (United States)

    Bhattacharyya, S.; Peterman, W.

    1984-01-01

    The creep-rupture properties of five iron-base and one cobalt-base high temperature alloys were investigated to assess the feasibility of using the alloys as construction materials in a Stirling engine. The alloys were heat treated and hardness measurements were taken. Typical microstructures of the alloys are shown. The creep-rupture properties of the alloys were determined at 760 and 815 C in 15.0 MPa H2 for 200 to 1000 hours. Plots of rupture life versus stress for the six superalloys are presented along with creep strain-time plots.

  7. Endocytic vesicle rupture is a conserved mechanism of cellular invasion by amyloid proteins.

    Science.gov (United States)

    Flavin, William P; Bousset, Luc; Green, Zachary C; Chu, Yaping; Skarpathiotis, Stratos; Chaney, Michael J; Kordower, Jeffrey H; Melki, Ronald; Campbell, Edward M

    2017-10-01

    Numerous pathological amyloid proteins spread from cell to cell during neurodegenerative disease, facilitating the propagation of cellular pathology and disease progression. Understanding the mechanism by which disease-associated amyloid protein assemblies enter target cells and induce cellular dysfunction is, therefore, key to understanding the progressive nature of such neurodegenerative diseases. In this study, we utilized an imaging-based assay to monitor the ability of disease-associated amyloid assemblies to rupture intracellular vesicles following endocytosis. We observe that the ability to induce vesicle rupture is a common feature of α-synuclein (α-syn) assemblies, as assemblies derived from WT or familial disease-associated mutant α-syn all exhibited the ability to induce vesicle rupture. Similarly, different conformational strains of WT α-syn assemblies, but not monomeric or oligomeric forms, efficiently induced vesicle rupture following endocytosis. The ability to induce vesicle rupture was not specific to α-syn, as amyloid assemblies of tau and huntingtin Exon1 with pathologic polyglutamine repeats also exhibited the ability to induce vesicle rupture. We also observe that vesicles ruptured by α-syn are positive for the autophagic marker LC3 and can accumulate and fuse into large, intracellular structures resembling Lewy bodies in vitro. Finally, we show that the same markers of vesicle rupture surround Lewy bodies in brain sections from PD patients. These data underscore the importance of this conserved endocytic vesicle rupture event as a damaging mechanism of cellular invasion by amyloid assemblies of multiple neurodegenerative disease-associated proteins, and suggest that proteinaceous inclusions such as Lewy bodies form as a consequence of continued fusion of autophagic vesicles in cells unable to degrade ruptured vesicles and their amyloid contents.

  8. Rupture Dynamics and Seismic Radiation on Rough Faults for Simulation-Based PSHA

    Science.gov (United States)

    Mai, P. M.; Galis, M.; Thingbaijam, K. K. S.; Vyas, J. C.; Dunham, E. M.

    2017-12-01

    Simulation-based ground-motion predictions may augment PSHA studies in data-poor regions or provide additional shaking estimations, incl. seismic waveforms, for critical facilities. Validation and calibration of such simulation approaches, based on observations and GMPE's, is important for engineering applications, while seismologists push to include the precise physics of the earthquake rupture process and seismic wave propagation in 3D heterogeneous Earth. Geological faults comprise both large-scale segmentation and small-scale roughness that determine the dynamics of the earthquake rupture process and its radiated seismic wavefield. We investigate how different parameterizations of fractal fault roughness affect the rupture evolution and resulting near-fault ground motions. Rupture incoherence induced by fault roughness generates realistic ω-2 decay for high-frequency displacement amplitude spectra. Waveform characteristics and GMPE-based comparisons corroborate that these rough-fault rupture simulations generate realistic synthetic seismogram for subsequent engineering application. Since dynamic rupture simulations are computationally expensive, we develop kinematic approximations that emulate the observed dynamics. Simplifying the rough-fault geometry, we find that perturbations in local moment tensor orientation are important, while perturbations in local source location are not. Thus, a planar fault can be assumed if the local strike, dip, and rake are maintained. The dynamic rake angle variations are anti-correlated with local dip angles. Based on a dynamically consistent Yoffe source-time function, we show that the seismic wavefield of the approximated kinematic rupture well reproduces the seismic radiation of the full dynamic source process. Our findings provide an innovative pseudo-dynamic source characterization that captures fault roughness effects on rupture dynamics. Including the correlations between kinematic source parameters, we present a new

  9. Influence of steam generator tube ruptures during semiscale loss-of-coolant experiments

    International Nuclear Information System (INIS)

    Cozzuol, J.M.; Larson, T.K.

    1978-01-01

    Examination of the U-tubes in the steam generators of some large commercial pressurized water reactors (PWR) has revealed the existence of leakage and in some cases structural weakening of the tubes. This structural weakening enhances the possibility of tubes rupturing during a hypothesized loss-of-coolant accident (LOCA). Considerable interest has been shown in the analysis of tube ruptures concurrent with a hypothesized LOCA since the presence of tube ruptures has the potential to influence the system thermal-hydraulic response and could foreseeably result in a more severe core thermal behavior than might otherwise occur. To experimentally investigate the influence of steam generator tube ruptures on the thermal-hydraulic response of PWR type system, a series of experiments was conducted in the Semiscale Mod-1 system by EG and G Idaho, Inc., for the U.S. Nuclear Regulatory Commission and the Department of Energy. The primary objective of the experiments was to obtain data which could be used to evaluate the influence of the simulated tube ruptures on the system and core thermal-hydraulic response for a range of tube ruptures that was expected to provide the potential for high cladding temperatures in the Semiscale facility. The experiments were conducted assuming a variety in the number of tubes ruptured during large break loss-of-coolant conditions. The number of experiments conducted permitted determination of the range of tube ruptures for which high peak cladding temperatures could result in the Semiscale Mod-1 system. The paper contains a description of the Semiscale Mod-1 system and a discussion of the steam generator tube rupture tests conducted. The experimental results from the test series and the thermal-hydraulic phenomena found to influence the core thermal response during the experiments are discussed

  10. Apoptosis of rabbit retinal cell after eyeball rupture.

    Science.gov (United States)

    Tian, Xue-Min; Zhu, Yu

    2013-04-13

    To establish rabbit eyeball rupture model by air gun in order to observe and analyze the early injury condition and reasons of retinal cell after eyeball rupture. Forty eight healthy rabbits were randomly divided into control group and 1, 3, 6, 12 and 24 h after injury groups. After anesthesia, the rabbit eyeball rupture model was established by air gun. Then the early pathological changes of rabbit retina were observed, and apoptotic index (AI), oncosis index (OI), the relationship between the expression amounts of apoptosis-related genes and AI were analyzed. Obvious pathological lesion appeared in retina 6 h after injury. Irreversible damage occurred 12-24 h after injury. The results of AI and OI indicated that the OI peak appeared 6 h after injury and then gradually declined, while the AI increased with the prolongation of time, and the AI was higher than OI in 12 h after injury. Immunohistochemical results indicated that there was no obvious bcl-2 protein expression change. Compared with the control group and the 3, 6, 12 and 24 h after the injury groups, the expressions of p53 and Caspase-3 were significantly improved and peaked at 12 h (Peyeball rupture. Copyright © 2013 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  11. A minimal rupture cascade model for living cell plasticity

    Science.gov (United States)

    Polizzi, Stefano; Laperrousaz, Bastien; Perez-Reche, Francisco J.; Nicolini, Franck E.; Maguer Satta, Véronique; Arneodo, Alain; Argoul, Françoise

    2018-05-01

    Under physiological and pathological conditions, cells experience large forces and deformations that often exceed the linear viscoelastic regime. Here we drive CD34+ cells isolated from healthy and leukemic bone marrows in the highly nonlinear elasto-plastic regime, by poking their perinuclear region with a sharp AFM cantilever tip. We use the wavelet transform mathematical microscope to identify singular events in the force-indentation curves induced by local rupture events in the cytoskeleton (CSK). We distinguish two types of rupture events, brittle failures likely corresponding to irreversible ruptures in a stiff and highly cross-linked CSK and ductile failures resulting from dynamic cross-linker unbindings during plastic deformation without loss of CSK integrity. We propose a stochastic multiplicative cascade model of mechanical ruptures that reproduces quantitatively the experimental distributions of the energy released during these events, and provides some mathematical and mechanistic understanding of the robustness of the log-normal statistics observed in both brittle and ductile situations. We also show that brittle failures are relatively more prominent in leukemia than in healthy cells suggesting their greater fragility.

  12. NEONATAL COMPLICATIONS OF PREMATURE RUPTURE OF MEMBRANES

    Directory of Open Access Journals (Sweden)

    F. Nili AA. Shams Ansari

    2003-07-01

    Full Text Available Premature rupture of membranes (PROM is one of the most common complications of pregnancy that has a major impact on neonatal outcomes. With respect to racial, nutritional and cultural differences between developed and developing countries, this study was conducted to detect the prevalence of neonatal complications following PROM and the role of the duration of rupture of membranes in producing morbidities and mortalities in these neonates in our hospital. Among 2357 pregnant women, we found 163 (6.91% cases of premature rupture of the fetal membranes in Tehran Vali-e-Asr Hospital during April 2001 to April 2002. Route of delivery was cesarean section in 65.6% of women. Urinary tract infection occured in 1.8%, maternal leukocytosis and fever in 20.2% and 5.5%, chorioamnionitis in 6.1%, fetal tachycardia in 1.2% and olygohydramnios in 4.9%. Gestational age in 138 (86% of neonates was less than 37 completed weeks. Thirty five infants (21.47% had respiratory distress syndrome and 33 (20.245% had clinical sepsis. Pneumonia in 6 (3.7% and skeletal deformity in 7 (4.294% were seen. Rupture of membrane of more than 24 hours duration occurred in 71 (43.6% of the patients. Comparison of morbidities between two groups of neonates and their mothers according to the duration of PROM (less and more than 24 hours showed significant differences in NICU admission, olygohydramnios, maternal fever, leukocytosis and chorioamnionitis rates (p24 hr of PROM with an odds ratio of 2.68 and 2.73, respectively. Positive blood and eye cultures were detected in 16 cases during 72 hours of age. Staphylococcus species, klebsiella, E.coli and streptococcus were the predominant organisms among positive blood cultures. Mortality was seen in 18 (11% of neonates because of respiratory failure, disseminated intravascular coagulation, septic shock, and a single case of congenital toxoplasmosis. In this study, the prevalence of prematurity, sepsis and prolonged rupture of membrane

  13. Management of diaphragmatic rupture from blunt trauma.

    Science.gov (United States)

    Tan, K K; Yan, Z Y; Vijayan, A; Chiu, M T

    2009-12-01

    Diagnosis of diaphragmatic rupture is difficult, and delays could result in a catastrophic outcome. We reviewed our institution's management of patients with diaphragmatic rupture after blunt trauma. All patients in this study were treated at Tan Tock Seng Hospital, Singapore, from March 2002 to October 2008. Patients with penetrating injuries were excluded. The parameters included age, mechanism of injury, haemodynamic status at admission, Glasgow coma scale (GCS) score, injury severity score (ISS), imaging studies, location of diaphragmatic injuries, associated injuries and outcome. 14 patients with a median age of 38 years formed the study group. Vehicular-related incidents accounted for 71.4 percent of the injuries. The median GCS score on admission was 14 (range 3-15), while the median systolic blood pressure and heart rate were 94 (range 50-164) mmHg and 110 (range 76-140) beats per minute, respectively. The median ISS was 41 (range 14-66). All had chest radiographs performed in the emergency department, six (42.9 percent) had computed tomography performed before surgery, while the remaining eight (57.1 percent) were sent straight to the operating theatre from the emergency department. There were five (35.7 percent) right-sided and nine (64.3 percent) left-sided diaphragmatic ruptures. The mortality rate was 35.7 percent. Some of the associated injuries included eight (57.1 percent) splenic lacerations, five (35.7 percent) haemothorax and lung injuries, four (28.6 percent) bone fractures and three (21.4 percent) liver lacerations. 12 (85.7 percent) patients underwent repair of the diaphragmatic rupture using interrupted polypropylene suture, while the remaining two (14.3 percent) were too haemodynamically unstable to undergo definitive treatment. Advanced age, haemodynamic instability and raised ISS were associated with mortality. An accurate diagnosis of diaphragmatic rupture in trauma patients is difficult, and a thorough examination of both the

  14. A Case of Post Myocardial Infarction Papillary Muscle Rupture.

    Science.gov (United States)

    Anuwatworn, Amornpol; Milnes, Christopher; Kumar, Vishesh; Raizada, Amol; Nykamp, Verlyn; Stys, Adam

    2016-06-01

    Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. We present a case of inferior ST elevation myocardial infarction complicated by posteromedial papillary muscle rupture resulting in severe acute mitral regurgitation (flail anterior mitral leaflet), acute pulmonary edema and cardiogenic shock. In our patient, a new mitral regurgitation murmur suggested this mechanical complication. Complete disruption of papillary muscle was visualized by transesophageal echocardiography. This case illustrates the importance of good physical examination for early diagnosis of papillary muscle rupture, so that life-saving treatment can be administered without delay.

  15. A Case of Ruptured Splenic Artery Aneurysm in Pregnancy

    Directory of Open Access Journals (Sweden)

    Elizabeth K. Corey

    2014-01-01

    Full Text Available Background. Rupture of a splenic artery aneurysm is rare complication of pregnancy that is associated with a significant maternal and fetal mortality. Case. A multiparous female presented in the third trimester with hypotension, tachycardia, and altered mental status. A ruptured splenic artery aneurysm was discovered at the time of laparotomy and cesarean delivery. The patient made a full recovery following resection of the aneurysm. The neonate survived but suffered severe neurologic impairment. Conclusion. The diagnosis of ruptured splenic artery aneurysm should be considered in a pregnant woman presenting with signs of intra-abdominal hemorrhage. Early intervention by a multidisciplinary surgical team is key to preserving the life of the mother and fetus.

  16. Instationary discharge rates and shear factors in pipe ruptures

    International Nuclear Information System (INIS)

    Pana, P.

    1976-01-01

    The loads observed in ruptures of steam- or water-conducting pipes may occur as reactive forces on the pipes themselves or as jet forces on the structural components adjacent to the point of rupture. The present paper deals with the instationary acceleration phase directly after rupture. The general laws of conservation (mass, energy, momentum) may be used, but in their instationary form. This results in a system of partial differential equations which does not provide a comprehensive mathematical solution. However, since efficient electronic computer systems are available, difference methods are increasingly often used. Such calculations were carried out for water-steam as an ideal gas and under simplifying assumptions. (orig./AK) [de

  17. Aetiology and pathogenesis of cranial cruciate ligament rupture in cats by histological examination.

    Science.gov (United States)

    Wessely, Marlis; Reese, Sven; Schnabl-Feichter, Eva

    2017-06-01

    Objectives The aim of this study was to examine histologically intact and ruptured cranial cruciate ligaments in cats, in order to evaluate whether degeneration is a prerequisite for rupture. Methods We performed a histological examination of 50 intact and 19 ruptured cranial cruciate ligaments in cadaver or client-owned cats, respectively, using light microscopy. Cats with stifle pathology were further divided into five age groups in order to investigate the relationship of changes in the ligament with lifespan. Cats with ruptured cranial cruciate ligaments were divided into two groups according to medical history (with presumed history of trauma or without any known history of trauma) in order to investigate the relationship of ligament rupture with a traumatic event. Data from 200 healthy cats were selected randomly and reviewed to make a statistical comparison of cats with and without cranial cruciate ligament rupture (reference group). Results On histological examination, the intact cranial cruciate ligaments showed basic parallel arrangement of the collagen fibres, with no relation to age. While cats of a more advanced age showed fibrocartilage in the middle of the cranial cruciate ligament - a likely physiological reaction to compression forces over the lifespan - degenerative changes within the fibrocartilage were absent in all cases, regardless of age or rupture status. Cats suffering from cranial cruciate ligament rupture without history of trauma were significantly older than cats in the reference group. Conclusions and relevance This study showed that differentiation of fibrocartilage in the middle of the cranial cruciate ligament is likely a physiological reaction to compressive forces and not a degenerative change associated with greater risk of rupture in advanced age. This finding in cats is distinct from the known decrease in differentiation of fibrocartilage in dogs with cranial cruciate ligament rupture. Furthermore, the histological examination

  18. Time-resolved observation of thermally activated rupture of a capillary-condensed water nanobridge

    International Nuclear Information System (INIS)

    Bak, Wan; Sung, Baekman; Kim, Jongwoo; Kwon, Soyoung; Kim, Bongsu; Jhe, Wonho

    2015-01-01

    The capillary-condensed liquid bridge is one of the most ubiquitous forms of liquid in nature and contributes significantly to adhesion and friction of biological molecules as well as microscopic objects. Despite its important role in nanoscience and technology, the rupture process of the bridge is not well understood and needs more experimental works. Here, we report real-time observation of rupture of a capillary-condensed water nanobridge in ambient condition. During slow and stepwise stretch of the nanobridge, we measured the activation time for rupture, or the latency time required for the bridge breakup. By statistical analysis of the time-resolved distribution of activation time, we show that rupture is a thermally activated stochastic process and follows the Poisson statistics. In particular, from the Arrhenius law that the rupture rate satisfies, we estimate the position-dependent activation energies for the capillary-bridge rupture

  19. A retrospective study of eyeball rupture in patients with or without orbital fracture.

    Science.gov (United States)

    Chen, Xiang; Yao, Yi; Wang, Fengxiang; Liu, Tiecheng; Zhao, Xiao

    2017-06-01

    To summarize the clinical features of eyeball rupture with or without orbital fracture and explore the differences between them.In all, 197 patients were observed, and the following data were recorded: sex, age, time of injury, place of injury, cause of trauma, zone of eye injury, intraocular content prolapse, surgical methods and the therapeutic process, visual acuity after injury, and the final best corrected visual acuity. The results were analyzed for statistically significant differences.There was no significant difference (P > .05) in the age, sex, or cause of injury. Patients with eyeball rupture with fracture had poorer vision than did those in the simple eyeball rupture group; eyeball rupture with fracture also had a higher probability of enucleation.In this study, the clinical results show that prognosis of eyeball rupture with orbital fracture is worse than that of eyeball rupture without orbital fracture.

  20. Mathematical modeling and numerical simulation of unilateral dynamic rupture propagation along very-long reverse faults

    Science.gov (United States)

    Hirano, S.

    2017-12-01

    For some great earthquakes, dynamic rupture propagates unilaterally along a horizontal direction of very-long reverse faults (e.g., the Mw9.1 Sumatra earthquake in 2004, the Mw8.0 Wenchuan earthquake in 2008, and the Mw8.8 Maule earthquake in 2010, etc.). It seems that barriers or creeping sections may not lay along the opposite region of the co-seismically ruptured direction. In fact, in the case of Sumatra, the Mw8.6 earthquake occurred in the opposite region only three months after the mainshock. Mechanism of unilateral mode-II rupture along a material interface has been investigated theoretically and numerically. For mode-II rupture propagating along a material interface, an analytical solution implies that co-seismic stress perturbation depends on the rupture direction (Weertman, 1980 JGR; Hirano & Yamashita, 2016 BSSA), and numerical modeling of plastic yielding contributes to simulating the unilateral rupture (DeDonteny et al., 2011 JGR). However, mode-III rupture may dominate for the very-long reverse faults, and it can be shown that stress perturbation due to mode-III rupture does not depend on the rupture direction. Hence, an effect of the material interface is insufficient to understand the mechanism of unilateral rupture along the very-long reverse faults. In this study, I consider a two-dimensional bimaterial system with interfacial dynamic mode-III rupture under an obliquely pre-stressed configuration (i.e., the maximum shear direction of the background stress is inclined from the interfacial fault). First, I derived an analytical solution of regularized elastic stress field around a steady-state interfacial slip pulse using the method of Rice et al. (2005 BSSA). Then I found that the total stress, which is the sum of the background stress and co-seismic stress perturbation, depends on the rupture direction even in the mode-III case. Second, I executed a finite difference numerical simulation with a plastic yielding model of Andrews (1978 JGR; 2005