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  1. Subacromial impingement syndrome

    NARCIS (Netherlands)

    Umer, M.; Qadir, I.; Azam, M.

    2012-01-01

    Subacromial impingement syndrome (SAIS) represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a

  2. Subacromial impingement syndrome

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2012-05-01

    Full Text Available Subacromial impingement syndrome (SAIS represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a matter of debate. However the etiology is multi-factorial, and has been attributed to both extrinsic and intrinsic mechanisms. Management includes physical therapy, injections, and, for some patients, surgery. No high-quality RCTs are available so far to provide possible evidence for differences in outcome of different treatment strategies. There remains a need for high-quality clinical research on the diagnosis and treatment of SAIS.

  3. Guideline for diagnosis and treatment of subacromial pain syndrome

    NARCIS (Netherlands)

    Diercks, Ronald; Bron, Carel; Dorrestijn, Oscar; Meskers, Carel; Naber, René; de Ruiter, Tjerk; Willems, Jaap; Winters, Jan; van der Woude, Henk Jan

    Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group

  4. Ultrasound measurement of rotator cuff thickness and acromio-humeral distance in the diagnosis of subacromial impingement syndrome of the shoulder.

    Science.gov (United States)

    Cholewinski, Jerzy J; Kusz, Damian J; Wojciechowski, Piotr; Cielinski, Lukasz S; Zoladz, Miroslaw P

    2008-04-01

    The usefulness of ultrasound measurements in the diagnosis of the subacromial impingement syndrome of the shoulder was evaluated. Fifty-seven patients with unilateral symptoms of the impingement syndrome underwent ultrasound examination of both shoulder joints, which included assessment of rotator cuff integrity, measurement of rotator cuff thickness and the distance between the infero-lateral edge of acromion and the apex of the greater tuberosity of humerus (AGT distance) in the standard ultrasonographic positions. As a control group, 36 volunteers (72 shoulders) with no history of shoulder pain were examined sonographically. Ultrasonographic assessment of humeral head elevation, measured as the AGT distance, proved to be useful in establishing the diagnosis of the subacromial impingement syndrome of the shoulder. A difference in rotator cuff thickness of more than 1.1 mm and a difference in the AGT distance of more than 2.1 mm between both shoulder joints may reflect dysfunction of rotator cuff muscles.

  5. Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

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    Jean-Christophe Murray

    2014-01-01

    Full Text Available Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.

  6. Prevalence of calcific deposits within the rotator cuff tendons in adults with and without subacromial pain syndrome: clinical and radiologic analysis of 1219 patients.

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    Louwerens, Jan K G; Sierevelt, Inger N; van Hove, Ruud P; van den Bekerom, Michel P J; van Noort, Arthur

    2015-10-01

    Calcific tendinopathy is one of the most frequent causes of pain in the shoulder and is characterized by the presence of calcific deposits in the rotator cuff; however, calcific deposits have also been described in asymptomatic individuals. Only a few authors have reported epidemiologic data on the prevalence of calcific deposits in the rotator cuff. This study analyzed clinical and radiological data of 1219 adults with and without subacromial pain syndrome (SAPS) to assess the prevalence of calcific deposits in the rotator cuff. Multivariate analysis was used to define risk factors associated with the presence of symptomatic calcific tendinopathy. Calcific deposits were found in the rotator cuff of 57 of 734 asymptomatic patients (7.8%). Of 485 patients with SAPS, 42.5% had calcific deposits. Age between 30 and 60 years (odds ratio [OR], 8.0; 95% confidence interval [CI], 2.5-26.3; P pain (OR, 7.1; 95% CI, 5.1-9.9, P 1.5 cm in length have the highest chance of suffering from symptomatic calcific tendinopathy of the rotator cuff. The prevalence rates of 7.8% in asymptomatic patients and 42.5% in patients with SAPS provide a current view on the epidemiology of calcific deposits in the rotator cuff. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  7. Internal- and External-Rotation Peak Toque in Little League Baseball Players With Subacromial Impingement Syndrome: Improved by Closed Kinetic Chain Shoulder Training.

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    Lee, Dong-Rour; Kim, Laurentius Jongsoon

    2016-08-01

    Many studies have explored closed kinetic chain (CKC) shoulder exercises (SEs) with a sling because they are safer and more effective than open-chain exercises, especially in early stages of treatment. However, the application of CKC SE in youth baseball players has rarely been attempted, although teenage baseball players also experience shoulder pain. To investigate the effects of CKC SE on the peak torque of shoulder internal rotation (IR) and external rotation (ER) in youth baseball players. Single-group pretest, posttest. Biomechanics laboratory. 23 Little League Baseball players with subacromial impingement syndrome. The CKC SE with a sling was CKC shoulder-flexion exercise, extension exercise, IR exercise, and ER exercise. This exercise regimen was conducted 2 or 3 times/wk for 8 wk. The peak torque of shoulder IR and ER was measured using an isokinetic dynamometer. Concentric shoulder rotation was performed, with 5 repetitions at an angular velocity of 60°/s and 15 at 180°/s. The IR and ER peak torque significantly increased at each angular velocity after the exercise program. In particular, the increase in IR and ER peak torque values was statistically significant at an angular velocity of 180°/s. CKC SE was effective in increasing shoulder IR and ER strength, demonstrating its potential benefits in the prevention and treatment of shoulder injury. In addition, increased IR peak torque appears to improve throwing velocity in baseball players.

  8. Guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopaedic Association

    NARCIS (Netherlands)

    Diercks, R.; Bron, C.; Dorrestijn, O.; Meskers, C.; Naber, R.; Ruiter, T. de; Willems, J.; Winters, J.; Woude, H.J. van der; et al.,

    2014-01-01

    Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group

  9. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  10. Relation Between Subacromial Bursitis on Ultrasonography and Efficacy of Subacromial Corticosteroid Injection in Rotator Cuff Disease: A Prospective Comparison Study.

    Science.gov (United States)

    Lee, Doo-Hyung; Hong, Ji Yeon; Lee, Michael Young; Kwack, Kyu-Sung; Yoon, Seung-Hyun

    2017-05-01

    To evaluate the correlations between subacromial bursitis (bursal thickening and effusion) on ultrasonography and its response to subacromial corticosteroid injection in patients with rotator cuff disease. Prospective, longitudinal comparison study. University-affiliated tertiary care hospital. Patients with rotator cuff disease (N=69) were classified into 3 groups based on ultrasonographic findings; (1) normative bursa group (group 1, n=23): bursa and effusion thickness 2mm and effusion thickness 2mm. A single subacromial injection with 20mg of triamcinolone acetonide. Visual analog scale (VAS) of shoulder pain, Shoulder Disability Questionnaire (SDQ), angles of active shoulder range of motion (flexion, abduction, external rotation, and internal rotation), and bursa and effusion thickness at pre- and posttreatment at week 8. There were no significant differences between the 3 groups in demographic characteristics pretreatment. Groups 2 and 3 showed a significant difference compared with group 1 in changes on the VAS and abduction; group 3 showed a significant difference compared with group 1 in changes of the SDQ, internal rotation, and external rotation; and all groups showed significant differences when compared with each other (groups 1 and 3, 2 and 3, and 1 and 2) in changes of thickness. A patient with ultrasonographic observation of subacromial bursitis, instead of normative bursa, can expect better outcome with subacromial corticosteroid injection. Therefore, we recommend a careful selection of patients using ultrasonography prior to injection. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. The analysis of spatial relationship between the rotator cuff and the subacromial space in different arm positions

    International Nuclear Information System (INIS)

    Zou Yuefen; Wang Dehang; Wang Xiaoning; Li Shener

    2003-01-01

    Objective: To explore the distance between the acromion and the humerus head at different arm abduction to observe whether it changes or not, to determine at which position the distance is smallest, and to evaluate the relationship between the subacromial space and the rotator cuff. Methods: Fifteen normal volunteers were examined with MRI in six arm positions, and the coronal thin images were obtained with a spin echo sequence. Using a special positioning device, the arm was placed at 0 degree, 30 degree, 60 degree, 90 degree, 120 degree and 150 degree arm abduction, respectively. Of them, 0 degree-90 degree positions were not rotated, while 120 degree and 150 degree positions were slight internal rotated. The minimal distance of acromion-humerus (A-H) and clavicle-humerus (C-H), and the spatial relationship between the rotator cuff and the subacromial space were measured and observed. Results: The values of A-H and C-H at 60 degree - 150 degree arm abduction were obviously smaller than those at 0 degree-30 degree arm abduction (P 0.05). The rotator cuff (mainly supraspinatus tendon) just went through between the acromion and the humerus at 60 degree - 120 degree arm positions but not at 0 degree, 30 degree and 150 degree arm positions. So at 60 degree - 120 degree arm positions, rotator cuff between the humerus and the acromion was often impinged. Conclusion: The closest contact between the supraspinatus tendon and subacromial space occurs at 60 degree - 120 degree abduction. The findings testify that the patients with impingement syndrome have shoulder pain at 60 degree - 120 degree abduction in clinic from etiology and pathology. In the future, MRI-based analyses should allow investigating the morphological basis of the impingement syndrome, choosing the appropriate therapy, and minimizing failure rates of surgery

  12. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

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    José L. Arias-Buría

    2015-01-01

    Full Text Available Objective. To compare effects of ultrasound- (US- guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n=17 group or exercise (n=19 group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous electrolysis group also received the application of galvanic current through acupuncture needle on each session once a week (total 4 sessions. Shoulder pain (NPRS and disability (DASH were assessed at baseline, after 2 sessions, and 1 week after the last session. Results. The ANOVA revealed significant Group∗Time interactions for shoulder pain and disability (all, P<0.01: individuals receiving US-guided percutaneous electrolysis combined with the eccentric exercises experienced greater improvement than those receiving eccentric exercise alone. Conclusions. US-guided percutaneous electrolysis combined with eccentric exercises resulted in small better outcomes at short term compared to when only eccentric exercises were applied in subacromial pain syndrome. The effect was statistically and clinically significant for shoulder pain but below minimal clinical difference for function. Future studies should investigate the long-term effects and potential placebo effect of this intervention.

  13. The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik

    2016-01-01

    BACKGROUND: Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). OBJECTIVE: We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment...... and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. METHODS: Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1-75.9, 1 July 2007...... to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. RESULTS: Within...

  14. Synovial Chondromatosis of the Subacromial Bursa Causing a Bursal-Sided Rotator Cuff Tear

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    Julie A. Neumann

    2015-01-01

    Full Text Available Synovial chondromatosis is an uncommon condition, and involvement of the shoulder is even more rare. We report on a 39-year-old female who presented with symptoms, radiographic features, and intraoperative findings consistent with multiple subacromial loose bodies resulting in a partial-thickness, bursal-sided rotator cuff tear of the supraspinatus muscle. She was treated with an arthroscopic removal of loose bodies, complete excision of the subacromial/subdeltoid bursa, acromioplasty, and rotator cuff repair. To our knowledge, this is the first report of arthroscopic treatment for a bursal-sided, partial-thickness rotator cuff tear treated with greater than two-year clinical and radiographic follow-up. We utilized shoulder scores, preoperative and postoperative range of motion, and imaging to assess the results of treatment and surveillance for recurrence in our patient after two-year follow-up.

  15. Preoperative conventional magnetic resonance images versus magnetic resonance arthrography of subacromial impingement syndrome

    International Nuclear Information System (INIS)

    Ahn, Sang Hyuk; Park, Jung Hwan; Moon, Tae Yong; Lee, In Sook; Lee, Seung Jun

    2012-01-01

    To evaluate the usefulness of conventional magnetic resonance images (MRI) for arthroscopic surgery in subacromial impingement syndrome of the shoulder, as an alternative to MR arthrography with additional T2 fat saturation images (MRA). The preoperative MRI of 77 patients (45 females, 32 males) (52 right, 25 left) and MRA of 34 patients (14 females, 20 males) (24 right, 10 left) with subsequent arthroscopic confirmation of subacromial impingement syndrome were reviewed retrospectively. The lesions requiring arthroscopic surgery were 95 subacromial spurs, 101 subacromial bursitis, and 51 full-thickness and 44 partial thickness tears of the supraspinatus among 111 cases for both studies. A two by two table was constructed in order to calculate the sensitivity and specificity of both studies against arthroscopic outcomes. Also we analyzed the false positive and false negative cases of the full-thickness tears individually. The detection rates of subacromial spur and bursitis and full and partial thickness tears of the supraspinatus were 91%, 94%, 77%, and 65% in MRI and 93%, 100%, 83%, and 77% in MRA respectively. Their specificities were 33%, 33%, 90%, and 76% in MRI and 50%, 75%, 100%, and 71% in MRA respectively. Eleven false negative cases in regards to MRI resulted in Ellman's grade 3 partial thickness tear (72.7%), mild bursitis (63.6%), greater tuberosity erosion (45.5%), and negative fluid signal of the glenohumeral joint (81.8%). Three false positive cases on the MRI were induced from errors with lower window depth and width on the imagings. Two false negative cases on MRA were induced from the adhesion between Ellman's grade 3 rim rent tear and the glenohumeral joint cavity. Conventional MR images could be used to decide the arthroscopic surgery in subacromial impingement syndrome, as an alternative to MR arthrography with additional T2 fat saturation images

  16. Preoperative conventional magnetic resonance images versus magnetic resonance arthrography of subacromial impingement syndrome

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    Ahn, Sang Hyuk; Park, Jung Hwan; Moon, Tae Yong [Pusan National Univ. Yangsan Hospital, Yangsan (Korea, Republic of); Lee, In Sook; Lee, Seung Jun [Pusan National Univ. Hospital, Busan (Korea, Republic of)

    2012-09-15

    To evaluate the usefulness of conventional magnetic resonance images (MRI) for arthroscopic surgery in subacromial impingement syndrome of the shoulder, as an alternative to MR arthrography with additional T2 fat saturation images (MRA). The preoperative MRI of 77 patients (45 females, 32 males) (52 right, 25 left) and MRA of 34 patients (14 females, 20 males) (24 right, 10 left) with subsequent arthroscopic confirmation of subacromial impingement syndrome were reviewed retrospectively. The lesions requiring arthroscopic surgery were 95 subacromial spurs, 101 subacromial bursitis, and 51 full-thickness and 44 partial thickness tears of the supraspinatus among 111 cases for both studies. A two by two table was constructed in order to calculate the sensitivity and specificity of both studies against arthroscopic outcomes. Also we analyzed the false positive and false negative cases of the full-thickness tears individually. The detection rates of subacromial spur and bursitis and full and partial thickness tears of the supraspinatus were 91%, 94%, 77%, and 65% in MRI and 93%, 100%, 83%, and 77% in MRA respectively. Their specificities were 33%, 33%, 90%, and 76% in MRI and 50%, 75%, 100%, and 71% in MRA respectively. Eleven false negative cases in regards to MRI resulted in Ellman's grade 3 partial thickness tear (72.7%), mild bursitis (63.6%), greater tuberosity erosion (45.5%), and negative fluid signal of the glenohumeral joint (81.8%). Three false positive cases on the MRI were induced from errors with lower window depth and width on the imagings. Two false negative cases on MRA were induced from the adhesion between Ellman's grade 3 rim rent tear and the glenohumeral joint cavity. Conventional MR images could be used to decide the arthroscopic surgery in subacromial impingement syndrome, as an alternative to MR arthrography with additional T2 fat saturation images.

  17. Specific or general exercise strategy for subacromial impingement syndrome-does it matter?

    DEFF Research Database (Denmark)

    Shire, Alison R; Stæhr, Thor A B; Overby, Jesper B

    2017-01-01

    Background Exercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special focus on correction of kinematic deficits would be superior to general exercise stra...

  18. Rotator cuff healing after continuous subacromial bupivacaine infusion: an in vivo rabbit study

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    FRIEL, NICOLE A.; WANG, VINCENT M.; SLABAUGH, MARK A.; WANG, FANCHIA; CHUBINSKAYA, SUSAN; COLE, BRIAN J.

    2013-01-01

    Background The objective of this study was to evaluate the effects of continuous subacromial bupivacaine infusion on supraspinatus muscle and rotator cuff tendon healing via gross, biomechanical, and histologic analyses. Methods Thirty-three New Zealand White rabbits underwent unilateral supraspinatus transection and rotator cuff repair (RCR). Rabbits were assigned to 1 of 3 groups: (1)RCR only, (2)RCR with continuous saline infusion for 48 hours, or (3)RCR with continuous 0.25% bupivacaine with epinephrine (1:200,000) infusion for 48 hours. Rabbits were sacrificed at either 2 (for histologic assessment) or 8 weeks post-operatively (for biomechanical and histologic assessment). Results Tensile testing showed significantly higher load to failure in intact tendons compared to repaired tendons (pBupivacaine groups. Histologically, the enthesis of repaired tendons showed increased cellularity and disorganized collagen fibers compared to intact tendons, with no differences between treatment groups. Muscle histology demonstrated scattered degenerative muscle fibers at 2 weeks in both RCR Saline and RCR Bupivacaine, but no degeneration was noted at 8 weeks. Conclusions The healing supraspinatus tendons exposed to bupivacaine infusion showed similar histologic and biomechanical characteristics compared to untreated and saline infused RCR groups. Muscle histology showed fiber damage at 2 weeks for both the saline and bupivacaine treated groups, with no apparent disruption at 8 weeks, suggesting a recovery process. Therefore, subacromial bupivacaine infusion in this rabbit rotator cuff model does not appear to impair muscle or tendon following acute injury and repair. Level Of Evidence Basic science study PMID:22818894

  19. Exercise therapy after ultrasound-guided corticosteroid injections in patients with subacromial pain syndrome

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    Ellegaard, Karen; Christensen, Robin; Rosager, Sara

    2016-01-01

    BACKGROUND: Subacromial pain syndrome (SAPS) accounts for around 50 % of all cases of shoulder pain. The most commonly used treatments are glucocorticosteroid (steroid) injections and exercise therapy; however, despite treatment SAPS patients often experience relapse of their symptoms. Therefore...... the clinical effect of combining steroid and exercise therapy is highly relevant to clarify. The aim of this randomized controlled trial was to investigate if exercise therapy added to steroid injection in patients with SAPS will improve the effect of the injection therapy on shoulder pain. METHODS......: In this two-arm randomized trial running over 26 weeks, patients with unilateral shoulder pain (> 4 weeks) and thickened subacromial bursa (> 2 mm on US) were included. At baseline all participants received two steroid injections into the painful shoulder with an interval of one week. Subsequently they were...

  20. MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects

    International Nuclear Information System (INIS)

    Zanetti, M.; Hodler, J.; Jost, B.; Gerber, C.

    2000-01-01

    Objective. To determine the prevalence and extent of residual defects or retears and bursitis-like subacromial abnormalities on MR images after rotator cuff repair in asymptomatic subjects, and to define the clinical relevance of these findings.Design and patients. Fourteen completely asymptomatic patients and 32 patients with residual symptoms were investigated 27-53 months (mean 39 months) after open transosseous reinsertion of the rotator cuff. Coronal T2-weighted turbo spin-echo and turbo STIR or T2-weighted fat-suppressed MR images were obtained. The prevalence and extent of residual defects or retears of the rotator cuff and bursitis-like subacromial abnormalities were determined.Results. Residual defects or retears were detected in three (21%) and bursitis-like abnormalities in 14 (100%) of the 14 asymptomatic patients. Fifteen (47%) residual defects or retears and 31 (97%) bursitis-like abnormalities were diagnosed in the 32 patients with residual symptoms. The size of the residual defects/retears was significantly smaller in the asymptomatic group (mean 8 mm, range 6-11 mm) than in the symptomatic group (mean 32 mm, range 7-50 mm) (t-test, P=0.001). The extent of the bursitis-like subacromial abnormalities did not significantly differ (t-test, P>0.05) between asymptomatic (mean 28 x 3 mm) and symptomatic patients (mean 32 x 3 mm).Conclusion. Small residual defects or retears (<1 cm) of the rotator cuff are not necessarily associated with clinical symptoms. Subacromial bursitis-like MR abnormalities are almost always seen after rotator cuff repair even in patients without residual complaints. They may persist for several years after rotator cuff repair and appear to be clinically irrelevant. (orig.)

  1. MR imaging after rotator cuff repair: full-thickness defects and bursitis-like subacromial abnormalities in asymptomatic subjects

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    Zanetti, M.; Hodler, J. [Dept. of Radiology, University Hospital Balgrist, Zurich (Switzerland); Jost, B.; Gerber, C. [Dept. of Orthopedic Surgery, University Hospital Balgrist, Zurich (Switzerland)

    2000-06-01

    Objective. To determine the prevalence and extent of residual defects or retears and bursitis-like subacromial abnormalities on MR images after rotator cuff repair in asymptomatic subjects, and to define the clinical relevance of these findings.Design and patients. Fourteen completely asymptomatic patients and 32 patients with residual symptoms were investigated 27-53 months (mean 39 months) after open transosseous reinsertion of the rotator cuff. Coronal T2-weighted turbo spin-echo and turbo STIR or T2-weighted fat-suppressed MR images were obtained. The prevalence and extent of residual defects or retears of the rotator cuff and bursitis-like subacromial abnormalities were determined.Results. Residual defects or retears were detected in three (21%) and bursitis-like abnormalities in 14 (100%) of the 14 asymptomatic patients. Fifteen (47%) residual defects or retears and 31 (97%) bursitis-like abnormalities were diagnosed in the 32 patients with residual symptoms. The size of the residual defects/retears was significantly smaller in the asymptomatic group (mean 8 mm, range 6-11 mm) than in the symptomatic group (mean 32 mm, range 7-50 mm) (t-test, P=0.001). The extent of the bursitis-like subacromial abnormalities did not significantly differ (t-test, P>0.05) between asymptomatic (mean 28 x 3 mm) and symptomatic patients (mean 32 x 3 mm).Conclusion. Small residual defects or retears (<1 cm) of the rotator cuff are not necessarily associated with clinical symptoms. Subacromial bursitis-like MR abnormalities are almost always seen after rotator cuff repair even in patients without residual complaints. They may persist for several years after rotator cuff repair and appear to be clinically irrelevant. (orig.)

  2. Force steadiness, muscle activity, and maximal muscle strength in subjects with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Rasmussen, Lars; Aagaard, Per

    2006-01-01

    physically active in spite of shoulder pain and nine healthy matched controls were examined to determine isometric and isokinetic submaximal shoulder-abduction force steadiness at target forces corresponding to 20%, 27.5%, and 35% of the maximal shoulder abductor torque, and maximal shoulder muscle strength......We investigated the effects of the subacromial impingement syndrome (SIS) on shoulder sensory-motor control and maximal shoulder muscle strength. It was hypothesized that both would be impaired due to chronic shoulder pain associated with the syndrome. Nine subjects with unilateral SIS who remained...

  3. Effectiveness of Standardized Physiotherapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Frost, Poul; Falla, Deborah

    2016-01-01

    BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. OBJECTIVE: The purpose of this study w...

  4. Effectiveness of Kinesiotaping and Subacromial Corticosteroid Injection in Shoulder Impingement Syndrome.

    Science.gov (United States)

    Şahin Onat, Şule; Biçer, Seda; Şahin, Zehra; Küçükali Türkyilmaz, Ayşegül; Kara, Murat; Özbudak Demir, Sibel

    2016-08-01

    The aim of this study was to investigate whether kinesiotaping or subacromial corticosteroid injection provides additional benefit when used with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with shoulder impingement syndrome. Patients with shoulder impingement syndrome were divided into 3 groups as follows: NSAID group (n = 33), kinesiotaping group (kinesiotaping + NSAID) (n = 33), and injection group (subacromial corticosteroid injection + NSAID) (n = 33). Outcome measures including visual analog scale, shoulder ranges of motion, Shoulder Disability Questionnaire, and University of California-Los Angeles (UCLA) scale were evaluated before and after the treatment (fourth week). A total of 99 patients (21 male and 78 female patients) were enrolled in this study. Demographic and baseline clinical characteristics of the groups (except for body mass index and visual analog scale at night, both P = 0.05) were similar between the groups (all P > 0.05). Clinical parameters were found to have improved in the 3 groups (all P kinesiotaping and injection groups showed similar improvements (all P > 0.05), each group had better outcome than did the NSAID group as regards pain (activity visual analog scale), ranges of motion, and Shoulder Disability Questionnaire and UCLA scale scores (all P kinesiotaping or subacromial corticosteroid injection to NSAID treatment seems to have better/similar effectiveness in patients with shoulder impingement syndrome. Therefore, kinesiotaping might serve as an alternative treatment in case (injection of) corticosteroids are contraindicated. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Delineate appropriate treatment options for shoulder impingement syndrome; (2) Identify treatment benefits of kinesiotaping and corticosteroid injections in shoulder impingement syndrome; and (3) Incorporate

  5. The Effect of Platelet-Rich Plasma (PRP on Improvement in Pain and Symptoms of Shoulder Subacromial Impingement Syndrome

    Directory of Open Access Journals (Sweden)

    Parisa Nejati

    2015-08-01

    Full Text Available Abstract Background: Subacromial impingement is one of the most common complaints of shoulder. Treatments include avoiding of painful activities, oral anti-pain drugs, physical therapy modalities, corticosteroid injection and exercise therapy. Some studies have shown that platelet- rich plasma(PRP is effective on tendinitis and tearing of tendons, ligaments and muscles, but evidence that has proved PRP as a conservative treatment in shoulder pathologies is very limited. This study aims to investigate the effect of PRP injection on relieving pain and improving daily function of patients with shoulder impingement syndrome. Materials and Methods: In this clinical trial study, patients older than 40 with pain more than three months were included. If they had three of four positive diagnostic clinical tests of shoulder impingement that were confirmed by shoulder MRI, could be injected PRP twice. The time between injections was 1 month. Pain was measured by visual analog scale (VAS and function was measured by two questionnaires named disabilities of the arm, shoulder and hand (DASH and western Ontario rotator cuff index (WORC. Range of motion (ROM of shoulder was measured in five directions by goniometry . All of these parameters were evaluated before intervention and in 1, 3, 6 months later. Results: with due attention to a six-month folloe-up, PRR injection was effective in pain reduction and improvement of patient's function (p<0.05. Shoulder Rom increased in all directions except external rotation and the power of shoulder muscles was evidently improved statistically in flexion, abduction and internal toration. Conclusion: PRP injection could effectively reduce pain and improve daily activities in patients with shoulder impingement syndrome.

  6. Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures

    DEFF Research Database (Denmark)

    Svendsen, Susanne Wulff; Dalbøge, Annett; Andersen, JH

    2013-01-01

    OBJECTIVES: The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures. METHODS: The study was based on the Musculoskeletal Research Database at the Dan......OBJECTIVES: The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures. METHODS: The study was based on the Musculoskeletal Research Database....... Using no neck-shoulder complaints and low shoulder load at baseline as a reference, no neck-shoulder complaints and high shoulder load showed an adjusted hazard ratio (HR adj) of 2.55 [95% confidence interval (95% CI) 1.59-4.09], while neck-shoulder complaints in combination with high shoulder load...

  7. Muscle shortening maneuver and not topical anti-inflammatory therapy is effective in reducing the width of subacromial-subdeltoid bursa in shoulder impingement syndrome

    Science.gov (United States)

    Melchiorre, Daniela; Lippi, Paolo; Marchi, Alberto; Maresca, Marco; Bravi, Riccardo; Eros, Quarta; Lazzerini, Patrizia; Bagni, Maria Angela

    2018-04-01

    Aim of the study was to compare the efficacy of a muscle shortening maneuver (MSM) with the efficacy of a topical NSAID (flurbiprofen) in patients with subacromial impingement syndrome (SIS). The effects of these therapies were evaluated by sonographic exam (US). SIS was diagnosed by US in 78 patients with painful shoulder. Thirty patients (first group) were treated with topical flurbiprofen for 15 days. Forty-eight patients (second group) were treated with MSM, which was performed once. The shoulder was analyzed in all patients by US before and after treatment. Before treatment and 15 days after treatment, pain by Visual Analogue Scale (VAS), range of motion (ROM) and Neer's Test were evaluated. Pain was decreased by both treatments. In only 8 patients of the first group, the encroachment of acromion into the rotator cuff was no more detectable by US after the treatment; ROM increased (> 45°) only in 11 patients (36%) and the width of subacromial-subdeltoid bursa (SSB) was not significantly reduced. At variance with the results obtained in the first group, in all patients of the second group the encroachment of acromion was no more detectable by US, ROM increased (> 45°) and the width of SSB was significantly reduced after the maneuver. Both topical flurbiprofen and MSM were helpful in pain control, but better results, with decrease of width of SSB assessed by US, were obtained by MSM.

  8. Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    de Bie Rob A

    2010-06-01

    Full Text Available Abstract Background Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome. Methods/Design This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization. The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks. Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants

  9. Calcific tendinitis of the rotator cuff: a randomized controlled trial of ultrasound-guided needling and lavage versus subacromial corticosteroids.

    Science.gov (United States)

    de Witte, Pieter Bas; Selten, Jasmijn W; Navas, Ana; Nagels, Jochem; Visser, Cornelis P J; Nelissen, Rob G H H; Reijnierse, Monique

    2013-07-01

    Calcific tendinitis of the rotator cuff (RCCT) is frequently diagnosed in patients with shoulder pain, but there is no consensus on its treatment. To compare 2 regularly applied RCCT treatments: ultrasound (US)-guided needling and lavage (barbotage) combined with a US-guided corticosteroid injection in the subacromial bursa (subacromial bursa injection [SAI]) (group 1) versus an isolated SAI (group 2). Randomized controlled trial; Level of evidence, 1. Patients were randomly assigned to the 2 groups. Shoulder function was assessed before treatment and at regular follow-up intervals (6 weeks and 3, 6, and 12 months) using the Constant shoulder score (CS, primary outcome), the Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Additionally, calcification location, size, and Gärtner classification were assessed on radiographs. Results were analyzed using the t test, linear regression, and a mixed model for repeated measures. This study included 48 patients (25 female, 52.1%; mean age, 52.0 ± 7.3 years; 23 patients in group 1) with a mean baseline CS of 68.7 ± 11.9. No patients were lost to follow-up. Four patients in group 1 and 11 in group 2 (P = .06) had an additional barbotage procedure or surgery during the follow-up period because of persisting symptoms and no resorption. At 1-year follow-up, the mean CS in group 1 was 86.0 (95% CI, 80.3-91.6) versus 73.9 (95% CI, 67.7-80.1) in group 2 (P = .005). The mean calcification size decreased by 11.6 ± 6.4 mm in group 1 and 5.1 ± 5.7 mm in group 2 (P = .001). There was total resorption in 13 patients in group 1 and 6 patients in group 2 (P = .07). With regression analyses, correcting for baseline CS and Gärtner type, the mean treatment effect was 20.5 points (P = .05) in favor of barbotage. Follow-up scores were significantly influenced by baseline scores. Results for the DASH and WORC were similar. On average, there was improvement at 1-year follow

  10. Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study.

    Science.gov (United States)

    Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

    2014-11-01

    The primary aim was to examine exposure-response relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sex-specific exposure-response relationships. The secondary aim was to examine the time window of relevant exposures. We conducted a nationwide register study of all persons born in Denmark (1933-1977), who had at least 5 years of full-time employment. In the follow-up period (2003-2008), we identified first-time events of surgery for SIS. Cumulative exposure estimates for a 10-year exposure time window with a 1-year lag time were obtained by linking occupational codes with a job exposure matrix. The exposure estimates were expressed as, for example, arm-elevation-years in accordance with the pack-year concept of tobacco consumption. We used a multivariable logistic regression technique equivalent to discrete survival analysis. The adjusted OR (ORadj) increased to a maximum of 2.1 for arm-elevation-years, repetition-years and force-years, and to 1.5 for hand-arm-vibration-years. Sex-specific exposure-response relationships were similar for men and women, when assessed using a relative risk scale. The ORadj increased gradually with the number of years contributing to the cumulative exposure estimates. The excess fraction was 24%. Cumulative occupational shoulder exposures carried an increase in risk of surgery for SIS with similar exposure-response curves for men and women. The risk of surgery for SIS increased gradually, when the period of exposure assessment was extended. In the general working population, a substantial fraction of all first-time operations for SIS could be related to occupational exposures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Inter- and intrarater reliability of goniometry and hand held dynamometry for patients with subacromial impingement syndrome.

    Science.gov (United States)

    Fieseler, Georg; Laudner, Kevin G; Irlenbusch, Lars; Meyer, Henrike; Schulze, Stephan; Delank, Karl-Stefan; Hermassi, Souhail; Bartels, Thomas; Schwesig, René

    2017-12-01

    The purpose of this study was to examine the intra- and interrater reliability of measuring shoulder range of motion (ROM) and strength among patients diagnosed with subacromial impingement syndrome (SAIS). Twenty-five patients (14 female patients; mean age, 60.4± 7.84 years) diagnosed with SAIS were assessed to determine the intrarater reliability for glenohumeral ROM. Twenty-five patients (16 female patients; mean age, 60.4± 7.80 years) and 76 asymptomatic volunteers (52 female volunteers; mean age, 29.4± 14.1 years) were assessed for interrater reliability. Dependent variables were active shoulder ROM and isometric strength. Intrarater reliability was fair-to-excellent for the SAIS patients (intraclass correlation coefficient [ICC], 0.52-0.97; standard error of measurement [SEM], 4.4°-9.9° N; coefficient of variation [CV], 7.1%-44.9%). Based on the ICC, 11 of 12 parameters (92%) displayed an excellent reliability (ICC> 0.75). The interrater reliability showed fair-to-excellent results (SAIS patients: ICC, 0.13-0.98; SEM, 2.3°-8.8°; CV, 3.6%-37.0%; controls: ICC, 0.11-0.96; SEM, 3.0°-35.4°; CV, 5.6%-26.4%). In accordance with the intrarater reliability, glenohumeral adduction ROM was the only parameter with an ICC below 0.75 for both samples. Painful shoulder ROM in the SAIS patients showed no influence on the quality of reliability for measurement. Therefore, these protocols should be considered reliable assessment techniques in the prevention, diagnosis, and treatment of painful shoulder conditions such as SAIS.

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  13. Subacromial-subdeltoid lipoma arborescens associated with a rotator cuff tear

    International Nuclear Information System (INIS)

    Nisolle, J.F.; Baudrez, V.; Blouard, E.; Cloedt, P. de; Boutsen, Y.; Esselinckx, W.

    1999-01-01

    A 44-year-old man presented with lipoma arborescens of the right shoulder, associated with a rotator cuff tear. MRI revealed villous proliferations with signal intensity of fat on all pulse sequences. At surgery, this bursa was found to contain moderately yellow cloudy fluid without fat globules. Histological examination of the lesion showed subsynovial accumulation of mature fat cells. (orig.)

  14. Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows

    DEFF Research Database (Denmark)

    Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid

    2018-01-01

    OBJECTIVES: We aimed to identify intensities of occupational mechanical exposures (force, arm elevation and repetition) that do not entail an increased risk of surgery for subacromial impingement syndrome (SIS) even after prolonged durations of exposure. Additionally, we wanted to evaluate...... if exposure to hand-arm vibration (HAV) is an independent risk factor. METHODS: We used data from a register-based cohort study of the entire Danish working population (n=2 374 403). During follow-up (2003-2008), 14 118 first-time events of surgery for SIS occurred. For each person, we linked register...... of exposure at specific intensities above minimal (low, medium and high). We used a logistic regression technique equivalent to discrete survival analysis adjusting for cumulative effects of other mechanical exposures. RESULTS: We found indications of safe exposure intensities for repetition (median angular...

  15. Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: a Randomized Clinical Trial.

    Science.gov (United States)

    de-Miguel-Valtierra, Lorena; Salom-Moreno, Jaime; Fernández-de-Las-Peñas, César; Cleland, Joshua A; Arias-Buría, José L

    2018-05-16

    This randomized clinical trial compared the effects of adding US-guided percutaneous electrolysis into a program consisting of manual therapy and exercise on pain, related-disability, function and pressure sensitivity in subacromial pain syndrome. Fifty patients with subacromial pain syndrome were randomized into manual therapy and exercise or percutaneous electrolysis group. All patients received the same manual therapy and exercise program, one session per week for 5 consecutive weeks. Patients assigned to the electrolysis group also received the application of percutaneous electrolysis at each session. The primary outcome was Disabilities of the Arm, Shoulder and Hand (DASH). Secondary outcomes included pain, function (Shoulder Pain and Disability Index-SPADI) pressure pain thresholds (PPTs) and Global Rating of Change (GROC). They were assessed at baseline, post-treatment, and 3, and 6 months after treatment. Both groups showed similar improvements in the primary outcome (DASH) at all follow-ups (P=0.051). Subjects receiving manual therapy, exercise, and percutaneous electrolysis showed significantly greater changes in shoulder pain (P0.91) for shoulder pain and function at 3 and 6 months in favour of the percutaneous electrolysis group. No between-groups differences in PPT were found. The current clinical trial found that the inclusion of US-guided percutaneous electrolysis in combination with manual therapy and exercise resulted in no significant differences for related-disability (DASH) than the application of manual therapy and exercise alone in patients with subacromial pain syndrome. Nevertheless, differences were reported for some secondary outcomes such as shoulder pain and function (SPADI). Whether or not these effects are reliable should be addressed in future studies Perspective This study found that the inclusion of US-guided percutaneous electrolysis into a manual therapy and exercise program resulted in no significant differences for disability

  16. Vascular endothelial growth factor 121 and 165 in the subacromial bursa are involved in shoulder joint contracture in type II diabetics with rotator cuff disease.

    Science.gov (United States)

    Handa, Akiyoshi; Gotoh, Masafumi; Hamada, Kazutoshi; Yanagisawa, Kazuhiro; Yamazaki, Hitoshi; Nakamura, Masato; Ueyama, Yoshito; Mochida, Joji; Fukuda, Hiroaki

    2003-11-01

    Vascular endothelial growth factor (VEGF) is a glycoprotein that plays an important role in neovascularization and increases vascular permeability. We reported that VEGF is involved in motion pain of patients with rotator cuff disease by causing synovial proliferation in the subacromial bursa (SAB). The present study investigates whether VEGF is also involved in the development of shoulder contracture in diabetics with rotator cuff disease. We examined 67 patients with rotator cuff disease, including 36 with complete cuff tears, 20 with incomplete tears, and 11 without apparent tears (subacromial bursitis). The patients were into groups according to the presence or absence of diabetes (14 type II diabetics and 53 non-diabetics). Specimens of the synovium of the SAB were obtained from all patients during surgery. Expression of the VEGF gene in the synovium of the subacromial bursa was evaluated by using the reverse transcriptase polymerase chain reaction. The VEGF protein was localized by immunohistochemistry, and the number of vessels was evaluated based on CD34 immunoreactivity. The results showed that VEGF mRNA was expressed in significantly more diabetics (100%, 14/14) than in non-diabetics (70%, 37/53) (P=0.0159, Fisher's test). Investigation of VEGF isoform expression revealed VEGF121 in all 14 diabetics and in 37 of the 53 non-diabetics, VEGF165 in 12 of the 14 diabetics and in 21 of the 53 non-diabetics, and VEGF189 in 1 of the 14 diabetics and in 2 of the 53 non-diabetics. No VEGF206 was expressed in either group. VEGF protein was localized in both vascular endothelial cells and synovial lining cells. The mean number of VEGF-positive vessels and the vessel area were also significantly greater in the diabetics (pshoulder joint contracture were more common in the diabetics (P=0.0329 and P=0.073, respectively; Fisher's test). The mean preoperative range of shoulder motion significantly differed in terms of elevation between two groups: 103.8 degrees in

  17. Ultrasound-guided subacromial injections of sodium hyaluronate for the management of rotator cuff tendinopathy: a prospective comparative study with rehabilitation therapy.

    Science.gov (United States)

    Merolla, G; Bianchi, P; Porcellini, G

    2013-06-01

    Rotator cuff (RC) tendinopathy is a common cause of pain and shoulder dysfunction. The literature evidence suggests that a combination of overuse and extrinsic compression may induce chronic RC tendinopathy. Aim of the current study was to compare the results of subacromial sodium hyaluronate injections with rehabilitation therapy. We enrolled 48 patients (M/F: 26/22; mean age: 50 years; shoulder right/left: 29/19) with persistent shoulder pain for at least 4 months. Exclusion criteria were as follows: RC tear, calcifying tendinitis, glenohumeral instability, osteoarthritis, rheumatic diseases, physical therapy and/or injection in the previous 4 months, shoulder surgery, anesthetic nerve block, trauma, and severe medical diseases. The included subjects received either two ultrasound-guided subacromial hyaluronic acid (HA) injections (25 patients, HA group) at baseline and 14 days, or underwent rehabilitation therapy (23 patients, Physio group) including active shoulder mobilization, soft tissue stretching and humeral head positioner and propeller muscles strengthening for 30 days (3 sessions every week). Clinical assessment of shoulder function was performed with visual analog scale score for pain (0-100), Oxford Shoulder Score (OSS), and Constant-Murley Score (CS). Overall, patients were examined at baseline, week 2, week 4, week 12, and week 24. Statistical significance was set at 5 % (p  0.05), week 12 (p > 0.05), and week 24 (p > 0.05). CS and OSS in the HA group increased significantly at week 2 (p  0.05). A significant improvement of CS and OSS we found in the Physio group at week 2 (p  0.05). Subacromial HA injections could be an effective and safe alternative treatment for patients suffering from RC tendinopathy. We believe that the results of this study are encouraging but not lasting and we might suppose that a series of three to four subacromial sodium hyaluronate injections could provide good mid- and long-term clinical benefits.

  18. Pathological Fracture of Clavicle Following Sub-Acromial Decompression-Infraclavicular Compartment Syndrome?

    Directory of Open Access Journals (Sweden)

    S Mukhopadhyay

    2009-11-01

    Full Text Available A 34-year-old factory worker presented with pain and weakness of the left shoulder following a fall on ice on her left shoulder. An ultrasound scan of the shoulder taken 4 months after injury showed small partial articular surface tear of the supraspinatus tendon. Ten days following subacromial decompression she suffered a pathological fracture of her left clavicle. MRI, CT, and isotope bone scans showed no evidence of malignancy or infection but a collection of fluid was noted underlying the clavicle communicating to the acromioclavicular joint. Ultrasound scan guided aspiration of 20 millilitres of bloodstained fluid underlying the clavicle resulted in gradual recovery and adequate healing of the fracture.

  19. The clinical and sonographic effects of kinesiotaping and exercise in comparison with manual therapy and exercise for patients with subacromial impingement syndrome: a preliminary trial.

    Science.gov (United States)

    Kaya, Derya Ozer; Baltaci, Gul; Toprak, Ugur; Atay, Ahmet Ozgur

    2014-01-01

    The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions. At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  20. The impact of subacromial impingement syndrome on muscle activity patterns of the shoulder complex: a systematic review of electromyographic studies

    Directory of Open Access Journals (Sweden)

    Smith Toby O

    2010-03-01

    Full Text Available Abstract Background Subacromial impingement syndrome (SIS is a commonly reported cause of shoulder pain. The purpose of this study was to systematically review the literature to examine whether a difference in electromyographic (EMG activity of the shoulder complex exists between people with SIS and healthy controls. Methods Medline, CINAHL, AMED, EMBASE, and grey literature databases were searched from their inception to November 2008. Inclusion, data extraction and trial quality were assessed in duplicate. Results Nine studies documented in eleven papers, eight comparing EMG intensity and three comparing EMG onset timing, representing 141 people with SIS and 138 controls were included. Between one and five studies investigated each muscle totalling between 20 and 182 participants. The two highest quality studies of five report a significant increase in EMG intensity in upper trapezius during scaption in subjects with SIS. There was evidence from 2 studies of a delayed activation of lower trapezius in patients with SIS. There was otherwise no evidence of a consistent difference in EMG activity between the shoulders of subjects with painful SIS and healthy controls. Conclusions A difference may exist in EMG activity within some muscles, in particular upper and lower trapezius, between people with SIS and healthy controls. These muscles may be targets for clinical interventions aiding rehabilitation for people with SIS. These differences should be investigated in a larger, high quality survey and the effects of therapeutically targeting these muscles in a randomised controlled trial.

  1. Physiotherapy after subacromial decompression surgery

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Falla, Deborah; Frost, Poul

    2015-01-01

    This paper describes the development and details of a standardised physiotherapy exercise intervention designed to address pain and disability in patients with difficulty returning to usual activities after arthroscopic decompression surgery for subacromial impingement syndrome. To develop...... the intervention, the literature was reviewed with respect to the effectiveness of postoperative exercises, components of previous exercise programmes were extracted, and input from clinical physiotherapists in the field was obtained through a series of workshops. The physiotherapy exercise intervention...

  2. Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows.

    Science.gov (United States)

    Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

    2018-03-01

    We aimed to identify intensities of occupational mechanical exposures (force, arm elevation and repetition) that do not entail an increased risk of surgery for subacromial impingement syndrome (SIS) even after prolonged durations of exposure. Additionally, we wanted to evaluate if exposure to hand-arm vibration (HAV) is an independent risk factor. We used data from a register-based cohort study of the entire Danish working population (n=2 374 403). During follow-up (2003-2008), 14 118 first-time events of surgery for SIS occurred. For each person, we linked register-based occupational codes (1993-2007) to a general population job exposure matrix to obtain year-by-year exposure intensities on measurement scales for force, upper arm elevation >90° and repetition and expert rated intensities of exposure to HAV. For 10-year exposure time windows, we calculated the duration of exposure at specific intensities above minimal (low, medium and high). We used a logistic regression technique equivalent to discrete survival analysis adjusting for cumulative effects of other mechanical exposures. We found indications of safe exposure intensities for repetition (median angular velocity 90° >2 min/day implied an increased risk reaching ORs of 1.7 and 1.5 after 10 years at low intensities. No associations were found for HAV. We found indications of safe exposure intensities for repetition. Any intensities of force and upper arm elevation >90° above minimal implied an increased risk across 10-year exposure time windows. No independent associations were found for HAV. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome: Impact of Sex, Socio-Demographic and Clinical Factors

    Science.gov (United States)

    Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik; Falla, Deborah; Svendsen, Susanne Wulff

    2016-01-01

    Background Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). Objective We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. Methods Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1–75.9, 1 July 2007 to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. Results Within 52 weeks after first contact, 43% of the patients had physiotherapy and 30% underwent surgery. Within 26 weeks after surgery, 80% had a record of physiotherapy. After first contact and after surgery, exercise was part of physiotherapy in 65% and 84% of the patients, respectively. A public hospital contact, physiotherapy before hospital contact, administrative region, female sex, a diagnosis of other or unspecified disorders (M75.8-M75.9), and surgical procedure predicted higher use of physiotherapy. Low education level predicted slightly lower use of physiotherapy after first contact, but not after surgery. Conclusion In patients with SIS in Danish hospital settings, physiotherapy was more often used after surgery than as part of initial non-surgical treatment. The use of physiotherapy was less common among men than women, whereas unequal use of physiotherapy in relation to education level was not noticeable. The use of physiotherapy with exercises in initial non-surgical treatment was relatively limited. PMID:26954692

  4. Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up

    DEFF Research Database (Denmark)

    Haahr, J. P.; Ostergaard, S.; Dalsgaard, J.

    2005-01-01

    , the difference being non-significant. No group differences in mean pain and dysfunction score improvement were found. CONCLUSIONS: Surgical treatment of rotator cuff syndrome with subacromial impingement was not superior to physiotherapy with training. Further studies are needed to qualify treatment choice...

  5. Ultrasound guided versus landmark guided corticosteroid injection in patients with rotator cuff syndrome: Randomised controlled trial.

    Science.gov (United States)

    Bhayana, Himanshu; Mishra, Puneet; Tandon, Anupama; Pankaj, Amite; Pandey, Rohit; Malhotra, Raskesh

    2018-03-01

    Impingement syndrome is the most common differential in a patient presenting to an orthopaedic OPD with shoulder pain. Impingement syndrome is often managed with subacromial corticosteroid injection, which can be instilled using either landmark guided (LMG) approach or with the assistance of ultrasound (US). This study was envisaged to enquire whether ultrasound assistance improves the accuracy, efficacy or safety profile of the injection. 60 patients of rotator cuff syndrome underwent diagnostic ultrasound. They were randomly assigned to receive subacromial injection of 2 ml (40 mg/ml) methylprenisolone and 2 ml of 1% lignocaine combination either by US assistance (n = 30) or using LMG assistance (n = 30). The patients were evaluated before injection and on follow up visits at day 5, week 3, week 6 and 3rd month by a single assessor. The assessor was blinded of the treatment group to which patient belonged. Clinical assessment included demographic and clinical data, accuracy of injection, VAS (0-100) for pain, Constant score with goniometer evaluation of range of motion, patient's self assessment proforma and post injection side effects if any. Initial demographic, clinical and US findings in the groups exhibited no significant differences. The accuracy of US guided injections (100%) was more when compared from LMG injection (93.3%). Both VAS and Constant score showed significant improvement following steroid injection up to 3 months of follow up. However the differences in the two groups were not significant suggesting comparable efficacy of the two approaches. (Mean VAS score decrease: 27.23 for US and 25.16 for LMG, p guided injections have a higher accuracy of drug placement in the subacromial bursa, there is no difference in terms of clinical outcomes or safety profile of either of the method. Hence US guided injections seems to be unjustified, when compared to equally efficacious and cost effective LMG steroid injection.

  6. Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial.

    Science.gov (United States)

    Christiansen, David Høyrup; Frost, Poul; Falla, Deborah; Haahr, Jens Peder; Frich, Lars Henrik; Andrea, Linda Christie; Svendsen, Susanne Wulff

    2016-06-01

    Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery. A multicenter randomized controlled trial was conducted. The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region. One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated. A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used. The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire. At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures. The nature of the exercise intervention did not allow blinding of patients and care providers. The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and

  7. Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review.

    Science.gov (United States)

    Saracoglu, Ismail; Emuk, Yusuf; Taspinar, Ferruh

    2018-04-01

    Taping is used with or without other interventions for many purposes, especially to manage pain and improve functional activity in patients with shoulder pain. The aim of this review was to determine whether any taping technique in addition to physiotherapy care is more effective than physiotherapy care alone in patients with shoulder impingement syndrome. A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID), The Kinesio Kinesio® Taping Method, Kinesio® Tex Tape UK and International websites ( www.kinesiotaping.co.uk ; www.kinesiotaping.com ) was conducted to June 2015. The outcome measures were pain, disability, range of motion and muscle strength. As data were not suitable for meta-analysis, narrative synthesis were applied. Three randomized controlled trials and one controlled trial (135 patients) were included. The results were conflicting and weak on the effectiveness of taping as an adjunct therapy for improvement of pain, disability, range of motion and muscle strength. Clinical taping in addition to physiotherapy interventions (e.g. exercise, electrotherapy, and manual therapy) might be an optional modality for managing patients with shoulder impingement syndrome, especially for the initial stage of the treatment; however, we need further robust, placebo controlled and consistent studies to prove whether it is more effective than physiotherapy interventions without taping.

  8. SHORT-TERM EFFECTS OF INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION ON PAIN FREE RANGE OF MOTION IN A WEIGHTLIFTER WITH SUBACROMIAL PAIN SYNDROME.

    Science.gov (United States)

    Coviello, Joseph Paul; Kakar, Rumit Singh; Reynolds, Timothy James

    2017-02-01

    While there is limited evidence supporting the use of soft tissue mobilization techniques for Subacromial Pain Syndrome (SAPS), synonymous with subacromial impingement syndrome, previous studies have reported successful outcomes using soft tissue mobilization as a treatment technique. The purpose of this case report is to document the results of Instrument-Assisted Soft Tissue Mobilization (IASTM) for the treatment of SAPS. Diagnosis was reached based on the subject's history, tenderness to palpation, and four out of five positive tests in the diagnostic cluster. Treatment consisted of three visits where the IASTM technique was applied to the pectoral muscles as well as periscapular musculature followed by retesting pain-free shoulder flexion active range of motion (AROM) and Numerical Pain Rating Scale (NPRS) during active shoulder flexion. Scapulothoracic mobilization and stretching were performed after AROM measurement. The subject reported an NPRS of 0/10 and demonstrated improvements in pain free flexion AROM in each of the three treatment sessions post-IASTM: 85 ° to 181 °, 110 ° to 171 °, and 163 ° to 174 ° with some carryover in pain reduction and pain free AROM to the next treatment. Through three treatments, DASH score improved by 17.34%, Penn Shoulder Score improved 29%, worst NPRS decreased from 4/10 to 0/10, and a GROC score of 6. IASTM may have a beneficial acute effect on pain free shoulder flexion. In conjunction with scapulothoracic mobilizations and stretching, IASTM may improve function, decrease pain, and improve patient satisfaction. While this technique will not ameliorate the underlying pathomechanics contributing to SAPS, it may serve as a valuable tool to restore ROM and decrease pain allowing the patient to reap the full benefits of a multi-modal treatment approach. 5.

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

    African Journals Online (AJOL)

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

  10. Cost-effectiveness of exercise therapy after corticosteroid injection for moderate to severe shoulder pain due to subacromial impingement syndrome: a trial-based analysis.

    Science.gov (United States)

    Jowett, Sue; Crawshaw, Dickon P; Helliwell, Philip S; Hensor, Elizabeth M A; Hay, Elaine M; Conaghan, Philip G

    2013-08-01

    To perform a cost-effectiveness analysis of subacromial corticosteroid injection combined with exercise compared with exercise alone in patients with moderate to severe shoulder pain from subacromial impingement syndrome. A within-trial cost-effectiveness analysis with 232 patients randomized to physiotherapy-led injection combined with exercise (n = 115) or exercise alone (n = 117). The analysis was from a health care perspective with 24-week follow-up. Resource use information was collected from all patients on interventions, medication, primary and secondary care contacts, private health care use and over-the-counter purchases. The measure of outcome was quality-adjusted life years (QALYs), calculated from EQ-5D responses at baseline and three further time points. An incremental cost-effectiveness analysis was conducted. Mean per patient NHS costs (£255 vs £297) and overall health care costs (£261 vs £318) were lower in the injection plus exercise arm, but this difference was not statistically significant. Total QALYs gained were very similar in the two trial arms (0.3514 vs 0.3494 QALYs), although slightly higher in the injection plus exercise arm, indicating that injection plus exercise may be the dominant treatment option. At a willingness to pay of £20,000 per additional QALY gained, there was a 61% probability that injection plus exercise was the most cost-effective option. Injection plus exercise delivered by therapists may be a cost-effective use of resources compared with exercise alone and lead to lower health care costs and less time off work. International Standard Randomised Controlled Trial Number Register, http://www.controlled-trials.com/isrctn/, ISRCT 25817033.

  11. Rotator Cuff Calcific Tendinitis: Ultrasound-Guided Needling and Lavage Versus Subacromial Corticosteroids: Five-Year Outcomes of a Randomized Controlled Trial.

    Science.gov (United States)

    de Witte, Pieter Bas; Kolk, Arjen; Overes, Ferdinand; Nelissen, Rob G H H; Reijnierse, Monique

    2017-12-01

    Barbotage (needling and lavage) is often applied in the treatment of calcific tendinitis of the rotator cuff (RCCT). In a previously published randomized controlled trial, we reported superior clinical and radiological 1-year outcomes for barbotage combined with a corticosteroid injection in the subacromial bursa (SAIC) compared with an isolated SAIC. There are no trials with a midterm or long-term follow-up of barbotage available. To compare the 5-year results of 2 regularly applied treatments of RCCT: ultrasound (US)-guided barbotage combined with a SAIC (group 1) versus an isolated US-guided SAIC (group 2). Randomized controlled trial; Level of evidence, 1. Patients were randomly assigned to group 1 or 2 and evaluated before and after treatment at regular time points until 12 months and also at 5 years using the Constant score (CS), the Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder and Hand (DASH). The calcification location and size and Gärtner classification were assessed on radiographs. The rotator cuff condition was evaluated with US. Results were analyzed using t tests, linear regression, and a mixed model for repeated measures. Forty-eight patients were included (mean age, 52.0 ± 7.3 years; 25 [52%] female) with a mean baseline CS of 68.7 ± 11.9. After a mean follow-up of 5.1 ± 0.5 years, the mean CS was 90 (95% CI, 83.0-95.9) in group 1 versus 87 (95% CI, 80.5-93.5) in group 2 ( P = .58). The mean improvement in the CS in group 1 was 18 (95% CI, 12.3-23.0) versus 21 (95% CI, 16.2-26.2) in group 2 ( P = .32). There was total resorption in 62% of group 1 and 73% of group 2 ( P = .45). The US evaluation of the rotator cuff condition showed no significant differences between the groups. With the mixed model for repeated measures, taking into account the baseline CS and Gärtner classification, the mean treatment effect for barbotage was 6 (95% CI, -8.9 to 21.5), but without statistical significance. Follow-up scores

  12. Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome.

    Science.gov (United States)

    Nörenberg, Dominik; Armbruster, Marco; Bender, Yi-Na; Walter, Thula; Ebersberger, Hans U; Diederichs, Gerd; Hamm, Bernd; Ockert, Ben; Makowski, Marcus R

    2017-03-01

    To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (pformation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. • SWMR has the potential to reliably identify sub-coracoacromial spurs without radiation exposure. • SWMR provides comparable detection rates to conventional radiography for sub-coracoacromial spur formation. • SWMR yields higher detection rates compared to standard-MR regarding sub-coracoacromial spur formation. • SWMR can be implemented in routine shoulder MRI protocols.

  13. Lipoma arborescens: rare case of rotator cuff tear associated with the presence of lipoma arborescens in the subacromial-subdeltoid and glenohumeral bursa

    OpenAIRE

    Benegas, Eduardo; Ferreiro Neto, Arnaldo Amado; Teodoro, Daniel Sabatini; Silva, Marcos Vinícius Muriano da; Oliveira, Augusto Medaglia de; Filippi, Renée Zon; Prada, Flávia de Santis

    2012-01-01

    Lipoma arborescens é uma condição rara de moléstia intra-articular, usualmente monoarticular, caracterizada por extensa proliferação dos vilos sinoviais e hiperplasia da gordura subsinovial. O tecido sinovial é progressivamente substituído por células maduras de gordura na membrana sinovial. O presente trabalho é o relato de caso de uma condição rara de lipoma arborescens tanto intra-articular (glenoumeral) como da bursa subacromial-subdeltoide além de ruptura do tendão do supraespinhoso. As ...

  14. PERBANDINGAN ANTARA KOMBINASI LATIHAN STABILISASI BAHU DAN TRAKSI HUMERUS KE INFERIOR DENGAN KOMBINASI LATIHAN FUNGSIONAL BAHU DAN TRAKSI HUMERUS KE INFERIOR DALAM MENURUNKAN DISABILITAS BAHU DAN LENGAN PADA SUBACROMIAL IMPINGEMENT SYNDROME MAHASISWA AKAD

    Directory of Open Access Journals (Sweden)

    Mawaddah -

    2015-08-01

    Full Text Available Shoulder impingement causing interference on the motion of the shoulder joint activities and result in functional activity disorder. These injuries usually are caused by faulty movement, overuse, poor posture, occupational factors and trauma. This will cause a burden on one part of the body and cause imbalances in anatomy, which will eventually lead to disruption of the body that experienced work. This study aimed to investigate the effect of functional shoulder exercise and traction humerus to inferior with shoulder stabilization exercises and traction humerus to inferior to the decline in the shoulder and arm disabilities in subacromial impingement syndrome. This research method was experimental clinical trials with pre test and post test group design. Population student Academy Physiotherapy Widya Husada Semarang, which consists of 3 men and 12 women, aged between 18-21 years, divided into two groups. Group I was given Shoulder Stabilization exercises and Traction humerus to Inferior (n=7 and group II Functional Shoulder Exercise and Traction humerus to Inferior (n=8. This research was conducted for 3 weeks. Measurement of the value of disability shoulder and arm by using the Shoulder Pain and Disability Index (SPADI. The test results on the group I average value pre 34.17, SB = 6.31, and the average value of post 11.54, SB = 4.02, p = 0.001 found significant differences obtained test results paired sample t-test, and testing group II average value pre 40.18, SB = 3.53, and the average value of post 7.82, SB = 1.57, p = 0.001 found significant differences obtained test results paired sample t-test. Comparison of Group I and II, p = 0.005 there were significant differences, test results obtained independent sample t-test. Conclusions: The combination of shoulder stabilization exercises and traction humerus to inferior can reduce disability shoulder and arm on subacromial impingement syndrome. The combination functional shoulder exercise and

  15. Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Noerenberg, Dominik; Armbruster, Marco [Munich University Hospitals Campus Grosshadern, Department of Clinical Radiology, Munich (Germany); Bender, Yi-Na; Walter, Thula; Diederichs, Gerd; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); Ebersberger, Hans U. [Heart Center Munich-Bogenhausen, Department of Cardiology and Intensive Care Medicine, Munich (Germany); Ockert, Ben [Munich University Hospitals Campus Grosshadern, Department of Trauma and Orthopedic Surgery, Shoulder and Elbow Service, Munich (Germany); Makowski, Marcus R. [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)

    2017-03-15

    To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (p<0.001). SWMR demonstrated a sensitivity of 97.7 % (CI=0.92-1) and a specificity of 91.3 % (CI=0.788-1) for the identification of spurs. Standard MR-sequences achieved a sensitivity of 47.8 % (CI=0.185-0.775) and a specificity of 80.8 % (CI=0.642-0.978). Size measurements between SWMR and radiography showed a good correlation (R{sup 2}=0.75;p<0.0001), while overestimating lesion size (5.7±1.2 mm; 4.3±1.3 mm;p<0.0001). Interobserver-agreement for spurs was high on SWMR (R{sup 2}=0.74;p<0.0001), but low on standard MRI (R{sup 2}=0.24;p<0.0001). SWMR allows a reliable detection of sub-coracoacromial spur formation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. (orig.)

  16. Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

    International Nuclear Information System (INIS)

    Noerenberg, Dominik; Armbruster, Marco; Bender, Yi-Na; Walter, Thula; Diederichs, Gerd; Hamm, Bernd; Ebersberger, Hans U.; Ockert, Ben; Makowski, Marcus R.

    2017-01-01

    To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (p<0.001). SWMR demonstrated a sensitivity of 97.7 % (CI=0.92-1) and a specificity of 91.3 % (CI=0.788-1) for the identification of spurs. Standard MR-sequences achieved a sensitivity of 47.8 % (CI=0.185-0.775) and a specificity of 80.8 % (CI=0.642-0.978). Size measurements between SWMR and radiography showed a good correlation (R 2 =0.75;p<0.0001), while overestimating lesion size (5.7±1.2 mm; 4.3±1.3 mm;p<0.0001). Interobserver-agreement for spurs was high on SWMR (R 2 =0.74;p<0.0001), but low on standard MRI (R 2 =0.24;p<0.0001). SWMR allows a reliable detection of sub-coracoacromial spur formation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. (orig.)

  17. Clinical and radiological outcome of conservative vs. surgical treatment of atraumatic degenerative rotator cuff rupture : design of a randomized controlled trial

    NARCIS (Netherlands)

    Heerspink, Frederik O. Lambers; Hoogeslag, Roy A. G.; Diercks, Ron L.; van Eerden, Pepijn J. M.; van den Akker-Scheek, Inge; van Raay, Jos J. A. M.

    2011-01-01

    Background: Subacromial impingement syndrome is a frequently observed disorder in orthopedic practice. Lasting symptoms and impairment may occur when a subsequent atraumatic rotator cuff rupture is also present. However, degenerative ruptures of the rotator cuff can also be observed in asymptomatic

  18. Surgery for subacromial impingement syndrome in relation to occupational exposures, lifestyle factors and diabetes mellitus: a nationwide nested case-control study.

    Science.gov (United States)

    Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

    2017-10-01

    To estimate the risk of surgery for subacromial impingement syndrome (SIS) in relation to occupational exposures, lifestyle factors and diabetes mellitus. We conducted a case-control study nested in a register-based cohort study of the Danish working population. For each of 3000 first-time cases of surgery for SIS, two age-matched and sex-matched controls were drawn. Cases and controls received a questionnaire on job history and other factors. Job histories were combined with a psychosocial job exposure matrix (JEM) and the updated Shoulder JEM, which provided exposure intensities on measurement scales. Ten-year cumulative exposures to upper arm elevation >90°, repetitive shoulder movements, forceful shoulder exertions and hand-arm vibrations (HAVs) were estimated. We used conditional logistic regression. There were 5396 persons (60%) who answered the questionnaire. For occupational mechanical exposures, the adjusted OR (OR adj ) ranged from 1.9 (95% CI 1.5 to 2.5 for HAVs) to 2.5 (95% CI 1.9 to 3.5 for force) among men and 1.7 (95% CI 1.2 to 2.5 for HAVs) to 2.0 (95% CI 1.3 to 2.9 for force) among women. No statistically significant associations were found for occupational psychosocial factors. Body mass index (BMI) and pack-years of smoking showed OR adj up to 2.0. Diabetes mellitus showed OR adj of 1.5 (95% CI 1.1 to 2.2) for men and 2.2 (95% CI 1.4 to 3.4) for women. Our findings add to the evidence of an increased risk of surgery for SIS in relation to occupational cumulative mechanical exposures, even when an increased risk in relation to BMI, smoking and diabetes mellitus is taken into account. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Magnetic Resonance Imaging of Rotator Cuff Tears in Shoulder Impingement Syndrome

    International Nuclear Information System (INIS)

    Freygant, Magdalena; Dziurzyńska-Białek, Ewa; Guz, Wiesław; Samojedny, Antoni; Gołofit, Andrzej; Kostkiewicz, Agnieszka; Terpin, Krzysztof

    2014-01-01

    Shoulder joint is a common site of musculoskeletal pain caused, among other things, by rotator cuff tears due to narrowing of subacromial space, acute trauma or chronic shoulder overload. Magnetic resonance imaging (MRI) is an excellent modality for imaging of soft tissues of the shoulder joint considering a possibility of multiplanar image acquisition and non-invasive nature of the study. The aim of this study was to evaluate the prevalence of partial and complete rotator cuff tears in magnetic resonance images of patients with shoulder impingement syndrome and to review the literature on the causes and classification of rotator cuff tears. We retrospectively analyzed the results of 137 shoulder MRI examinations performed in 57 women and 72 men in Magnetic Resonance facility of the Department of Radiology and Diagnostic Imaging at the St. Jadwiga the Queen Regional Hospital No. 2 in Rzeszow between June 2010 and February 2013. Examinations were performed using Philips Achieva 1.5T device, including spin echo and gradient echo sequences with T1-, T2- and PD-weighted as well as fat saturation sequences in transverse, frontal and sagittal oblique planes. Patients were referred from hospital wards as well as from outpatient clinics of the subcarpathian province. The most frequently reported injuries included partial supraspinatus tendon tear and complete tearing most commonly involved the supraspinatus muscle tendon. The smallest group comprised patients with complete tear of subscapularis muscle tendon. Among 137 patients in the study population, 129 patients suffered from shoulder pain, including 57 patients who reported a history of trauma. There was 44% women and 56% men in a group of patients with shoulder pain. Posttraumatic shoulder pain was predominantly reported by men, while women comprised a larger group of patients with shoulder pain not preceded by injury. Rotator cuff injury is a very common pathology in patients with shoulder impingement syndrome

  20. The effect of a rotator cuff tear and its size on three-dimensional shoulder motion.

    Science.gov (United States)

    Kolk, Arjen; Henseler, Jan Ferdinand; de Witte, Pieter Bas; van Zwet, Erik W; van der Zwaal, Peer; Visser, Cornelis P J; Nagels, Jochem; Nelissen, Rob G H H; de Groot, Jurriaan H

    2017-06-01

    Rotator cuff-disease is associated with changes in kinematics, but the effect of a rotator cuff-tear and its size on shoulder kinematics is still unknown in-vivo. In this cross-sectional study, glenohumeral and scapulothoracic kinematics of the affected shoulder were evaluated using electromagnetic motion analysis in 109 patients with 1) subacromial pain syndrome (n=34), 2) an isolated supraspinatus tear (n=21), and 3) a massive rotator cuff tear involving the supraspinatus and infraspinatus (n=54). Mixed models were applied for the comparisons of shoulder kinematics between the three groups during abduction and forward flexion. In the massive rotator cuff-tear group, we found reduced glenohumeral elevation compared to the subacromial pain syndrome (16°, 95% CI [10.5, 21.2], protator cuff tears coincides with an increase in scapulothoracic lateral rotation compared to subacromial pain syndrome (11°, 95% CI [6.5, 15.2], protator cuff-tear group had substantially less glenohumeral elevation and more scapulothoracic lateral rotation compared to the other groups. These observations suggest that the infraspinatus is essential to preserve glenohumeral elevation in the presence of a supraspinatus tear. Shoulder kinematics are associated with rotator cuff-tear size and may have diagnostic potential. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Fluid Signal Intensity That Mimicked A Supraspinatus Tendon Tear In A Subacromial Injected Shoulder: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hun; Kim, Tae Eun; Shin, Hyun Woong [Daegu Fatima Hospital, Daegu (Korea, Republic of)

    2010-06-15

    Subacromial steroid injections are a common procedure for treating shoulder pain. Several studies have reported on the difficulty of performing an accurate injection into the subacromial bursa, as well as the injected material infiltrated into other regional structures even when an accurate injection was done into the subacromial space. These misplacements, and especially in the rotator cuff, creates high signal intensity on T2WI that can mimic a rotator cuff tear. Bergman and Fredericson found that the bursal and extrabursal fluid is resolved or decreased 3 days after the injection, so they recommended a 3-day delay after the shoulder injection before performing MRI to prevent misinterpretation of the signal changes. We report here on a case of a false fullthickness tear of the supraspinatus tendon on MRI one month after subacromial injection, and the supraspinatus tendon turned out to be intact on the follow up ultrasonography and arthroscopic examination

  2. Lipoma arborescens: caso raro de ruptura do manguito rotador associado à presença de lipoma arborescens na bursa subacromial-subdeltoidea e glenoumeral Lipoma arborescens: rare case of rotator cuff tear associated with the presence of lipoma arborescens in the subacromial-subdeltoid and glenohumeral bursa

    Directory of Open Access Journals (Sweden)

    Eduardo Benegas

    2012-01-01

    Full Text Available Lipoma arborescens é uma condição rara de moléstia intra-articular, usualmente monoarticular, caracterizada por extensa proliferação dos vilos sinoviais e hiperplasia da gordura subsinovial. O tecido sinovial é progressivamente substituído por células maduras de gordura na membrana sinovial. O presente trabalho é o relato de caso de uma condição rara de lipoma arborescens tanto intra-articular (glenoumeral como da bursa subacromial-subdeltoide além de ruptura do tendão do supraespinhoso. As apresentações clínicas, histológicas e radiográficas assim como o tratamento são discutidos no presente estudo. A apresentação do caso contempla também a avaliação radiográfica, ressonância magnética e exame patológico. Apesar do lipoma arborescens ser uma condição rara, tal hipótese deve ser considerada frente a um caso com hiperproliferação sinovial e lipossubstituição da sinovial.Lipoma arborescens is a rare intra-articular disease that is usually monoarticular and is characterized by extensive proliferation of the synovial villi and hyperplasia of the subsynovial fat. The synovial tissue is progressively replaced by mature fat cells in the synovial membrane. The present study reports a case of a rare condition of lipoma arborescens that was simultaneously intra-articular (glenohumeral joint and in the subacromial-subdeltoid bursa, in association with a torn supraspinatus tendon. The clinical, histological and radiographic presentations and treatment are discussed here. The description of this case includes radiographic and magnetic resonance evaluations and pathological examination. Although lipoma arborescens is a rare condition, it should be taken into consideration in cases presenting synovial hyperproliferation and synovial fat replacement.

  3. Arthroscopic Resection of The Distal Clavicle With Concomitant Subacromial Decompression: A Case Series

    Directory of Open Access Journals (Sweden)

    HZ Chan

    2014-07-01

    Full Text Available Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders. Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with direct arthroscopic distal clavicle excision and subacromial decompression in single setting. Both patients gained good postoperative outcome in terms of pain score, function and strength improvement assessed objectively with visual analogue score (VAS and University of California Los Angeles Score (UCLA.

  4. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  5. Heterotaxy syndromes and abnormal bowel rotation

    International Nuclear Information System (INIS)

    Newman, Beverley; Koppolu, Raji; Sylvester, Karl; Murphy, Daniel

    2014-01-01

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  6. Intestinal rotational abnormalities in polysplenia and asplenia syndromes

    International Nuclear Information System (INIS)

    Ditchfield, M.R.; Hutson, J.M.

    1998-01-01

    Objective. To review the anomalies of intestinal rotation occurring in association with asplenia (right isomerism) and polysplenia (left isomerism) syndromes. Materials and methods. A retrospective study was performed of 27 children with asplenia (21) or polysplenia (6) identified from the cardiology and radiology databases from 1988 to 1996 and in whom an upper gastrointestinal barium study had been performed. The intestinal rotation was determined by reviewing the barium meal and could be divided into four groups: (1) normal rotation, (2) incomplete rotation or nonrotation, (3) reversed rotation and (4) reversed incomplete rotation or nonrotation. Surgical correlation was obtained at laparotomy in 17 patients. Results. Of the 27 children studied, 3 (11 %) had normal rotation; incomplete rotation or nonrotation occurred in 5 (19 %), and 2 in this group developed midgut volvulus; 5 (19 %) had reversed rotation; 14 (52 %) had reversed incomplete rotation or nonrotation. Conclusion. Asplenia and polysplenia are frequently associated with intestinal malrotation, and a barium study is recommended in all of these children, as many will be at risk of midgut volvulus. (orig.)

  7. Intestinal rotational abnormalities in polysplenia and asplenia syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Ditchfield, M.R. [Department of Radiology, Royal Children`s Hospital, Parkville (Australia); Hutson, J.M. [Department of General Surgery, Royal Children`s Hospital, Parkville (Australia)

    1998-05-01

    Objective. To review the anomalies of intestinal rotation occurring in association with asplenia (right isomerism) and polysplenia (left isomerism) syndromes. Materials and methods. A retrospective study was performed of 27 children with asplenia (21) or polysplenia (6) identified from the cardiology and radiology databases from 1988 to 1996 and in whom an upper gastrointestinal barium study had been performed. The intestinal rotation was determined by reviewing the barium meal and could be divided into four groups: (1) normal rotation, (2) incomplete rotation or nonrotation, (3) reversed rotation and (4) reversed incomplete rotation or nonrotation. Surgical correlation was obtained at laparotomy in 17 patients. Results. Of the 27 children studied, 3 (11 %) had normal rotation; incomplete rotation or nonrotation occurred in 5 (19 %), and 2 in this group developed midgut volvulus; 5 (19 %) had reversed rotation; 14 (52 %) had reversed incomplete rotation or nonrotation. Conclusion. Asplenia and polysplenia are frequently associated with intestinal malrotation, and a barium study is recommended in all of these children, as many will be at risk of midgut volvulus. (orig.) With 4 figs., 1 tab., 13 refs.

  8. Subacromial shoulder disorders among baggage handlers

    DEFF Research Database (Denmark)

    Thygesen, Lau Caspar; Mikkelsen, Sigurd; Pedersen, Ellen Bøtker

    2016-01-01

    PURPOSE: To assess the influence of cumulative employment as baggage handler on the risk of incident subacromial shoulder disorders. Baggage handling is characterized by repetitive work primarily consisting of heavy lifting in awkward positions and time pressure. METHODS: This cohort study is based...... increased incidence of subacromial shoulder disorders for workers with longer cumulative years of employment. These results support that long-term lifting in awkward positions and time pressure influences the risk of subacromial shoulder disorders....... System. The primary exposure was cumulative years of employment as a baggage handler, and the primary outcome was diagnoses and surgical treatment of subacromial shoulder disorders. RESULTS: The cohort contained 3396 baggage handlers and 63,909 workers in the reference group. Baggage handlers with longer...

  9. Dynamic enhanced MRI of the subacromial bursa: correlation with arthroscopic and histological findings

    International Nuclear Information System (INIS)

    Matsuzaki, S.; Yoneda, M.; Kobayashi, Y.; Fukushima, S.; Wakitani, S.

    2003-01-01

    Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder pain, this study included those with rotator cuff injury; patients with rheumatoid arthritis or pitching shoulder disorders were excluded. There were 27 patients (15 men, 12 women) ranging in age from 25 to 73 years (mean 49.1 years). Dynamic MRI of the shoulder was also performed on the healthy side of 10 patients and in five normal young volunteers. Results and conclusions: Changes in signal intensity on dynamic MRI were measured in the subacromial bursa. The E ratio (80 s) and CE (0-80 s) were significantly correlated with redness and villous formation as arthroscopic findings, positively correlated with capillary proliferation and papillary hyperplasia as histological findings (p < 0.05), and negatively correlated with fibrosis as a histological finding (p < 0.05) in the subacromial bursa. The patterns of dynamic curves were well correlated with the bursoscopic and histological findings of the synovium of the subacromial bursa. Dynamic MRI appears to correlate with inflammatory activity of synovium of the subacromial

  10. MR imaging after therapeutic injection of the subacromial bursa

    Energy Technology Data Exchange (ETDEWEB)

    Major, N.M. [Duke University Medical Center, Department of Radiology, Division Musculoskeletal, Durham, NC (United States)

    1999-11-01

    Objective. As a therapeutic injection into the subacromial bursa (SAB) is commonly performed for impingement syndrome, it is important to know whether this fluid can be retained for a period of time and cause confusion with a pathologic collection of fluid. This study identifies and describes the appearance of recent subacromial injection using MR imaging, and the appearance of a potential complication.Design and patients. Fourteen asymptomatic shoulders were studied with MR imaging using fast spin echo T2-weighted imaging (1.5 T) prior to injection with 7 cm{sup 3} of xylocaine. Four shoulders had subacromial fluid and were eliminated from the study. The remaining 10 (9 men, 1 woman; age range 27-36 years, average age 33 years) were then re-imaged immediately, and at 6, 12 and 24 h after the injection or until fluid resolved. Each set of images was reviewed for the presence of fluid in the SAB and for additional abnormalities.Results. Fluid was identified in all subjects in the SAB in the immediate, 6 and 12 h post-injection images. At 24 h, fluid was not identified within the SAB in eight of 10 patients. In one patient fluid resolved in 48 h. The other continued to demonstrate fluid in the SAB and in the joint as well as abnormal signal in the infraspinatus muscle from a presumed myositis. Imaging was performed up to 10 days after the injection in this patient.Conclusions. It is known that fluid identified in the SAB without evidence of a cuff tear may be due to bursitis. However, if MR imaging is performed within 24 h of injection, the presence of the fluid may be iatrogenic. In addition, the history of recent therapeutic injection is very important as complications such as myositis can occur as a result of the injection. Knowledge of injection prior to imaging is vital for accurate interpretation of MR shoulder examinations. (orig.)

  11. MR imaging after therapeutic injection of the subacromial bursa

    International Nuclear Information System (INIS)

    Major, N.M.

    1999-01-01

    Objective. As a therapeutic injection into the subacromial bursa (SAB) is commonly performed for impingement syndrome, it is important to know whether this fluid can be retained for a period of time and cause confusion with a pathologic collection of fluid. This study identifies and describes the appearance of recent subacromial injection using MR imaging, and the appearance of a potential complication.Design and patients. Fourteen asymptomatic shoulders were studied with MR imaging using fast spin echo T2-weighted imaging (1.5 T) prior to injection with 7 cm 3 of xylocaine. Four shoulders had subacromial fluid and were eliminated from the study. The remaining 10 (9 men, 1 woman; age range 27-36 years, average age 33 years) were then re-imaged immediately, and at 6, 12 and 24 h after the injection or until fluid resolved. Each set of images was reviewed for the presence of fluid in the SAB and for additional abnormalities.Results. Fluid was identified in all subjects in the SAB in the immediate, 6 and 12 h post-injection images. At 24 h, fluid was not identified within the SAB in eight of 10 patients. In one patient fluid resolved in 48 h. The other continued to demonstrate fluid in the SAB and in the joint as well as abnormal signal in the infraspinatus muscle from a presumed myositis. Imaging was performed up to 10 days after the injection in this patient.Conclusions. It is known that fluid identified in the SAB without evidence of a cuff tear may be due to bursitis. However, if MR imaging is performed within 24 h of injection, the presence of the fluid may be iatrogenic. In addition, the history of recent therapeutic injection is very important as complications such as myositis can occur as a result of the injection. Knowledge of injection prior to imaging is vital for accurate interpretation of MR shoulder examinations. (orig.)

  12. Effect of glenohumeral elevation on subacromial supraspinatus compression risk during simulated reaching.

    Science.gov (United States)

    Lawrence, Rebekah L; Schlangen, Dustin M; Schneider, Katelyn A; Schoenecker, Jonathan; Senger, Andrea L; Starr, William C; Staker, Justin L; Ellermann, Jutta M; Braman, Jonathan P; Ludewig, Paula M

    2017-10-01

    Mechanical subacromial rotator cuff compression is one theoretical mechanism in the pathogenesis of rotator cuff disease. However, the relationship between shoulder kinematics and mechanical subacromial rotator cuff compression across the range of humeral elevation motion is not well understood. The purpose of this study was to investigate the effect of humeral elevation on subacromial compression risk of the supraspinatus during a simulated functional reaching task. Three-dimensional anatomical models were reconstructed from shoulder magnetic resonance images acquired from 20 subjects (10 asymptomatic, 10 symptomatic). Standardized glenohumeral kinematics from a simulated reaching task were imposed on the anatomic models and analyzed at 0, 30, 60, and 90° humerothoracic elevation. Five magnitudes of humeral retroversion were also imposed on the models at each angle of humerothoracic elevation to investigate the impact of retroversion on subacromial proximities. The minimum distance between the coracoacromial arch and supraspinatus tendon and footprint were quantified. When contact occurred, the magnitude of the intersecting volume between the supraspinatus tendon and coracoacromial arch was also quantified. The smallest minimum distance from the coracoacromial arch to the supraspinatus footprint occurred between 30 and 90°, while the smallest minimum distance to the supraspinatus tendon occurred between 0 and 60°. The magnitude of humeral retroversion did not significantly affect minimum distance to the supraspinatus tendon except at 60 or 90° humerothoracic elevation. The results of this study provide support for mechanical rotator cuff compression as a potential mechanism for the development of rotator cuff disease. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2329-2337, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  13. Eagle Syndrome Causing Vascular Compression with Cervical Rotation: Case Report

    International Nuclear Information System (INIS)

    Demirtaş, Hakan; Kayan, Mustafa; Koyuncuoğlu, Hasan Rıfat; Çelik, Ahmet Orhan; Kara, Mustafa; Şengeze, Nihat

    2016-01-01

    Eagle syndrome is a condition caused by an elongated styloid process. Unilateral face, neck and ear pain, stinging pain, foreign body sensation and dysphagia can be observed with this syndrome. Rarely, the elongated styloid process may cause pain by compressing the cervical segment of the internal carotid and the surrounding sympathetic plexus, and that pain spreading along the artery can cause neurological symptoms such as vertigo and syncope. In this case report we presented a very rare eagle syndrome with neurological symptoms that occurred suddenly with cervical rotation. The symptoms disappeared as suddenly as they occurred, with the release of pressure in neutral position. We also discussed CT angiographic findings of this case. Radiological diagnosis of the Eagle syndrome that is manifested with a wide variety of symptoms and causes diagnostic difficulties when it is not considered in the differential diagnosis is easy in patients with specific findings. CT angiography is a fast and effective examination in terms of showing compression in patients with the Eagle syndrome that is considered to be atypical and causes vascular compression

  14. Subacromial impingement in patients with whiplash injury to the cervical spine

    Directory of Open Access Journals (Sweden)

    Giddins Grey E

    2008-06-01

    Full Text Available Abstract Background Impingement syndrome and shoulder pain have been reported to occur in a proportion of patients following whiplash injuries to the neck. In this study we aim to examine these findings to establish the association between subacromial impingement and whiplash injuries to the cervical spine. Methods and results We examined 220 patients who had presented to the senior author for a medico-legal report following a whiplash injury to the neck. All patients were assessed for clinical evidence of subacromial impingement. 56/220 patients (26% had developed shoulder pain following the injury; of these, 11/220 (5% had clinical evidence of impingement syndrome. Only 3/11 patients (27% had the diagnosis made prior to evaluation for their medico-legal report. In the majority, other clinicians had overlooked the diagnosis. The seatbelt shoulder was involved in 83% of cases (p Conclusion After a neck injury a significant proportion of patients present with shoulder pain, some of whom have treatable shoulder pathology such as impingement syndrome. The diagnosis is, however, frequently overlooked and shoulder pain is attributed to pain radiating from the neck resulting in long delays before treatment. It is important that this is appreciated and patients are specifically examined for signs of subacromial impingement after whiplash injuries to the neck. Direct seatbelt trauma to the shoulder is one possible explanation for its aetiology.

  15. The effect of scapular position on subacromial contact behavior: a cadaver study.

    Science.gov (United States)

    Muraki, Takayuki; Yamamoto, Nobuyuki; Sperling, John W; Steinmann, Scott P; Cofield, Robert H; An, Kai-Nan

    2017-05-01

    Patients with subacromial impingement were reported to show abnormal scapular positions during shoulder elevation. However, the relationship between the scapular positions and subacromial impingement is unclear. The purpose of this study was to biomechanically determine the effect of scapular position on subacromial contact behavior by using fresh frozen cadavers. The peak contact pressure on the coracoacromial arch was measured with a flexible tactile force sensor in 9 fresh frozen cadaver shoulders. The measurement was performed during passive glenohumeral elevation in the scapular plane ranging from 30° to 75°. The scapular downward and internal rotations and anterior tilt were simulated by tilting the scapula in 5° increments up to 20°. The measurement was also performed with combination of scapular downward and internal rotations and anterior tilt positions. The peak contact pressure decreased linearly with anterior tilt, and a significant difference between neutral scapular position (1.06 ± 0.89 MPa) and anterior tilt by 20° (0.46 ± 0.18 MPa) was observed (P < .05). However, the scapular positioning in the other directions did not change the peak contact pressure significantly. Furthermore, any combination of abnormal scapular positions did not affect peak contact pressure significantly. Scapular anterior tilt decreased peak contact pressure during passive shoulder elevation. In addition, scapular downward and internal rotations had little effect on peak contact pressure. The abnormal scapular motion reported in previous studies might not be directly related to symptoms caused by subacromial impingement. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Subacute effects of cervicothoracic spinal thrust/non-thrust in addition to shoulder manual therapy plus exercise intervention in individuals with subacromial impingement syndrome: a prospective, randomized controlled clinical trial pilot study.

    Science.gov (United States)

    Wright, Alexis A; Donaldson, Megan; Wassinger, Craig A; Emerson-Kavchak, Alicia J

    2017-09-01

    To determine the subacute effects of cervicothoracic spinal thrust/non-thrust in addition to shoulder non-thrust plus exercise in patients with subacromial pathology. This was a randomized, single blinded controlled trial pilot study. This trial was registered at ClinicalTrials.gov (NCT01753271) and reported according to Consolidated Standards of Reporting Trials requirements. Patients were randomly assigned to either shoulder treatment plus cervicothoracic spinal thrust/non-thrust or shoulder treatment-only group. Primary outcomes were average pain intensity (Numeric Pain Rating Scale) and physical function (Shoulder Pain and Disability Index) at 2 weeks, 4 weeks, and patient discharge. 18 patients, mean age 43.1(15.8) years satisfied the eligibility criteria and were analyzed for follow-up data. Both groups showed statistically significant improvements in both pain and function at 2 weeks, 4 weeks, and discharge. The between-group differences for changes in pain or physical function were not significant at any time point. The addition of cervicothoracic spinal thrust/non-thrust to the shoulder treatment-only group did not significantly alter improvement in pain or function in patients with subacromial pathology. Both approaches appeared to provide an equally notable benefit. Both groups improved on all outcomes and met the criteria for clinical relevance for both pain and function. 2b.

  17. Impingement syndrome of the shoulder

    International Nuclear Information System (INIS)

    Mayerhoefer, M.E.; Breitenseher, M.J.

    2004-01-01

    The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.) [de

  18. Prevalence of Propionibacterium acnes in the glenohumeral compared with the subacromial space in primary shoulder arthroscopies.

    Science.gov (United States)

    Patzer, Thilo; Petersdorf, Sabine; Krauspe, Ruediger; Verde, Pablo Emilio; Henrich, Birgit; Hufeland, Martin

    2018-05-01

    We hypothesized that the prevalence of Propionibacterium acnes in patients undergoing primary shoulder arthroscopy is equal in the glenohumeral space compared with the subacromial space. Patients aged 18 years or older with shoulder arthroscopies were included. The exclusion criteria were prior shoulder operations, complete rotator cuff tears, systemic inflammatory diseases, tumors, shoulder injections within 6 months of surgery, and antibiotic therapy within 14 days preoperatively. After standardized skin disinfection with Kodan Tinktur Forte Gefärbt, a skin swab was taken at the posterior portal. Arthroscopy was performed without cannulas, prospectively randomized to start either in the glenohumeral space or in the subacromial space, with direct harvesting of a soft-tissue biopsy specimen. Sample cultivation was conducted according to standardized criteria for bone and joint aspirate samples and incubated for 14 days. Matrix-assisted laser desorption-ionization time-of-flight spectrometry was used for specimen identification in positive culture results. The study prospectively included 115 consecutive patients with normal C-reactive protein levels prior to surgery (54.8% men; mean age, 47.2 ± 14.6 years). P acnes was detected on the skin after disinfection in 36.5% of patients, in the glenohumeral space in 18.9%, and in the subacromial space in 3.5% (P = .016). The prevalence of P acnes is significantly higher in the glenohumeral space compared with the subacromial space in primary shoulder arthroscopies. The results do not confirm the contamination theory but also cannot clarify whether P acnes is a commensal or enters the joint hematologically or even lymphatically or via an unknown pathway. Despite standardized surgical skin disinfection, P acnes can be detected in skin swab samples in more than one-third of patients. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  19. Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain.

    Science.gov (United States)

    Cadogan, Angela; McNair, Peter J; Laslett, Mark; Hing, Wayne A

    2016-01-01

    The diagnosis of subacromial pathology is limited by the poor accuracy of clinical tests for specific pathologies. The aim of this study was to estimate the diagnostic accuracy of clinical examination and imaging features for identifying subacromial pain (SAP) defined by a positive response to diagnostic injection, and to evaluate the influence of imaging findings on the clinical diagnosis of SAP. In a prospective, diagnostic accuracy design, 208 consecutive patients presenting to their primary healthcare practitioner for the first time with a new episode of shoulder pain were recruited. All participants underwent a standardized clinical examination, shoulder x-ray series and diagnostic ultrasound scan. Results were compared with the response to a diagnostic block of xylocaineTM injected into the SAB under ultrasound guidance using ≥80% post-injection reduction in pain intensity as the positive anaesthetic response (PAR) criterion. Diagnostic accuracy statistics were calculated for combinations of clinical and imaging variables demonstrating the highest likelihood of a PAR. A PAR was reported by 34% of participants. In participants with no loss of passive external rotation, combinations of three clinical variables (anterior shoulder pain, strain injury, absence of symptoms at end-range external rotation (in abduction)) demonstrated 100% specificity for a PAR when all three were positive (LR+ infinity; 95%CI 2.9, infinity). A full-thickness supraspinatus tear on ultrasound increased the likelihood of a PAR irrespective of age (specificity 98% (95%CI 94, 100); LR+ 6.2; 95% CI 1.5, 25.7)). Imaging did not improve the ability to rule-out a PAR. Combinations of clinical examination findings and a full-thickness supraspinatus tear on ultrasound scan can help confirm, but not exclude, the presence of subacromial pain. Other imaging findings were of limited value for diagnosing SAP.

  20. Mycobacterium avium-intracellulare: a rare cause of subacromial bursitis.

    Science.gov (United States)

    Sinha, Raj; Tuckett, John; Hide, Geoff; Dildey, Petra; Karsandas, Alvin

    2015-01-01

    Septic subacromial bursitis is an uncommon disorder with only a few reported cases in the literature. The most common causative organism is Staphylococcus aureus. We report the case of a 61-year-old female with a septic subacromial bursitis where the causative organism was found to be Mycobacterium avium-intracellulare (MAI). The diagnosis was only made following a biopsy, and we use this case to highlight the importance of recognising the need to consider a biopsy and aspiration in atypical situations.

  1. Current UK practices in the management of subacromial impingement

    Science.gov (United States)

    Drury, Colin; Tait, Gavin R

    2015-01-01

    Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections. PMID:27582972

  2. Current UK practices in the management of subacromial impingement.

    Science.gov (United States)

    Bryceland, James K; Drury, Colin; Tait, Gavin R

    2015-07-01

    Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections.

  3. Suture slippage in knotless suture anchors resulting in subacromial-subdeltoid bursitis.

    Science.gov (United States)

    Hayeri, Mohammad Reza; Keefe, Daniel T; Chang, Eric Y

    2016-05-01

    Rotator cuff repair using a suture bridge and knotless suture anchors is a relatively new, but increasingly used technique. The suture bridge technique creates an anatomically similar and more secure rotator cuff repair compared with conventional arthroscopic techniques and the use of knotless anchors eliminates the challenges associated with knot tying during arthroscopic surgery. However, previous in vitro biomechanical tests have shown that the hold of the suture in a knotless suture anchor is far lower than the pullout strength of the anchor from bone. Up until now slippage has been a theoretical concern. We present a prospectively diagnosed case of in vivo suture loosening after rotator cuff repair using a knotless bridge technique resulting in subacromial-subdeltoid bursitis.

  4. Analgesia para a sutura artroscópica do manguito rotador: estudo comparativo entre o bloqueio interescalênico do plexo braquial e o bloqueio da bursa subacromial contínuo Management of pain after the rotator cuff arthroscopic suture: comparative study among the interescalenic blockade and the continuous intrabursal infusion

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2007-10-01

    Full Text Available OBJETIVO: Comparar o nível de dor pós-operatória de pacientes submetidos à sutura artroscópica da lesão do manguito rotador (MR que receberam protocolos diferentes de analgesia pós-operatória. Demonstrar a relação entre dor e o sexo do paciente, a dimensão da lesão suturada e a utilização da capsulotomia interna. Verificar a prevalência dos efeitos colaterais. MÉTODO: Foram analisados três grupos de pacientes operados entre 1º de junho de 2004 e 31 de maio de 2007. O grupo I foi composto pelos pacientes que receberam bloqueio interescalênico com ropivacaína a 0,75%. No grupo II, o mesmo bloqueio foi acrescido de 150µg de clonidina. No grupo III foi administrado um bolus de 30ml de ropivacaína a 0,75% para infiltração dos portais artroscópicos e diretamente no espaço subacromial, seguido de infusão contínua de ropivacaína a 0,2% em bomba de infusão. Os pacientes foram submetidos à medição da escala analógica visual (EAV com 24 horas após o procedimento. As variáveis estudadas foram: EAV, sexo, tamanho da lesão, necessidade de capsulotomia interna e prevalência dos efeitos colaterais. O estudo avaliou 196 pacientes, dos quais foram excluídos 51, totalizando n = 145 pacientes. O total de pacientes no grupo I foi de 65; no grupo II, de 19; e no grupo III, de 61. RESULTADOS: O índice da EAV médio encontrado no grupo I foi de 3,88 ± 1,737 (3; no grupo II, de 3,8 ± 1,6 (3; e no grupo III, de 1,95 ± 1,6 (2. Houve diferença significativa ao comparar os grupos I e III (p OBJECTIVE: To compare the level of postoperative pain in patients submitted to arthroscopic suture of a rotator cuff lesion who had different analgesia protocols. To demonstrate the relationship between pain and the gender of the patient, the dimension of the lesion sutured, and the use of internal capsulotomy. To check the prevalence of side effects. METHODS: Three groups of patients operated on between June 01, 2004 and May 31, 2007 were

  5. Postoperative fentanyl patch versus subacromial bupivacaine infusion in arthroscopic shoulder surgery.

    Science.gov (United States)

    Merivirta, Riika; Äärimaa, Ville; Aantaa, Riku; Koivisto, Mari; Leino, Kari; Liukas, Antti; Kuusniemi, Kristiina

    2013-07-01

    The purpose of our study was to compare the effectiveness of subacromial bupivacaine infusion and a transdermal fentanyl patch in the treatment of postoperative pain after arthroscopic shoulder surgery. Sixty patients with rotator cuff disease scheduled for elective arthroscopic shoulder surgery were enrolled in the study. For the treatment of postoperative pain, 30 patients constituted group F and received a 12.0-μg/h fentanyl patch for 72 hours and saline solution infusion in a subacromial manner at the rate of 4 mL/h. The remaining 30 patients constituted group B and received a placebo patch and an infusion of 2.5-mg/mL bupivacaine in a subacromial manner for 72 hours. The primary outcome measure was the postoperative numerical rating scale pain score. The consumption of opioids, ibuprofen, and acetaminophen was also recorded. The Constant scores and general recovery were followed up until the 90th postoperative day. There was no statistically significant difference in the numerical rating scale scores (P = .60) between the groups. No differences in the use of rescue analgesic were observed except that the patients receiving bupivacaine used more ibuprofen (median, 1,200 mg v 600 mg) during the day of surgery (P = .042). No difference was found in general recovery between the groups. A fentanyl patch delivering 12-μg/h fentanyl offers an easy and safe treatment option as a part of multimodal analgesia with few adverse effects in the treatment of postoperative pain in a carefully selected patient group after arthroscopic shoulder surgery. Level I, randomized controlled trial. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Ultrasonography of the Rotator Cuff

    International Nuclear Information System (INIS)

    Yoon, Yong Cheol

    2006-01-01

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

  7. Ultrasonography of the Rotator Cuff

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-09-15

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

  8. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    Energy Technology Data Exchange (ETDEWEB)

    Monu, J.U.V. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pruett, S. [Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Vanarthos, W.J. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States); Pope, T.L. Jr. [Dept. of Radiology, Bowman Gray School of Medicine, Wake Forest Univ., Winston-Salem, NC (United States)

    1994-10-01

    Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenbid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery. (orig.)

  9. Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings

    International Nuclear Information System (INIS)

    Monu, J.U.V.; Pruett, S.; Vanarthos, W.J.; Pope, T.L. Jr.

    1994-01-01

    Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenbid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery. (orig.)

  10. Effects of Repetitive Shoulder Activity on the Subacromial Space in Manual Wheelchair Users

    Directory of Open Access Journals (Sweden)

    Yen-Sheng Lin

    2014-01-01

    Full Text Available This study investigated (1 the effect of repetitive weight-relief raises (WR and shoulder external rotation (ER on the acromiohumeral distance (AHD among manual wheelchair users (MWUs and (2 the relationship between shoulder pain, subject characteristics, and AHD changes. Twenty-three MWUs underwent ultrasound imaging of the nondominant shoulder in an unloaded baseline position and while holding a WR position before and after the WR/ER tasks. Paired t-tests and Spearman correlational analysis were used to assess differences in the AHD before and after each task and the relationships between pain, subject characteristics, and the AHD measures. A significant reduction in the subacromial space (P<0.01 occurred when subjects performed a WR position compared to baseline. Individuals with increased years of disability had greater AHD percentage narrowing after WR (P=0.008. Increased shoulder pain was associated with AHD percentage narrowing after ER (P≤0.007. The results support clinical practice guidelines that recommend MWUs limit WR to preserve shoulder function. The isolated repetitive shoulder activity did not contribute to the changes of subacromial space in MWUs. The ultrasonographic measurement of the AHD may be a target for identifying future interventions that prevent pain.

  11. Risk of subacromial shoulder disorder in airport baggage handlers

    DEFF Research Database (Denmark)

    Møller, Sanne Pagh; Brauer, Charlotte; Mikkelsen, Sigurd

    2018-01-01

    age,exposure variables showed close to significant associations with subacromial shoulder disorder.Results could not confirm our hypothesis that combined information on work task duration and shoulder load intensity was stronger associated with subacromial shoulder disorder than seniority.......Musculoskeletal shoulder-load among baggage handlers measured by combining duration and intensity based on biomechanical and epidemiological information may be a stronger predictor of subacromial shoulder disordersthanbaggage handler seniority.In 2012, a cohort of baggage handlers employed...... at Copenhagen Airport in 1990-2012, and a cohort of unskilledotherwise employed men answered a survey.Self-reported information on work tasks during employment in the airport in combination with work task specific biomechanically modelled forces in the shoulder joint was used to estimate shoulder-load. Exposure...

  12. Subacromial bursitis with rice bodies : a case report

    International Nuclear Information System (INIS)

    Kim, Bong Soo; Joo, Kyung Bin; Park, Dong Woo; Lee, Hak Soo; Oh, Jae Cheon; Lee, Yong Joo; Lee, Won Mi

    1998-01-01

    Multiple rice bodies in joints or bursae are rarely encountered in patients with rheumatoid arthritis. We report the radiologic findings of massive subacromial bursitis with innumerable rice bodies on the right shoulder of a 38-year-old man with rheumatoid arthritis. Subacromial bursography showed markedly distended bursa with multiple nodular filling defects. Precontrast CT scanning revealed well-demarcated hypodense lesion without calcification in subacromio-subdeltoid bursa. Multiple rice bodies showed slightly high signal intensity of T1WI and T2WI, and no enhancement after gadolinium injection. (author). 7 refs., 4 figs

  13. Subacromial bursitis with rice bodies : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Soo; Joo, Kyung Bin; Park, Dong Woo; Lee, Hak Soo; Oh, Jae Cheon; Lee, Yong Joo; Lee, Won Mi [Hanyang Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-04-01

    Multiple rice bodies in joints or bursae are rarely encountered in patients with rheumatoid arthritis. We report the radiologic findings of massive subacromial bursitis with innumerable rice bodies on the right shoulder of a 38-year-old man with rheumatoid arthritis. Subacromial bursography showed markedly distended bursa with multiple nodular filling defects. Precontrast CT scanning revealed well-demarcated hypodense lesion without calcification in subacromio-subdeltoid bursa. Multiple rice bodies showed slightly high signal intensity of T1WI and T2WI, and no enhancement after gadolinium injection. (author). 7 refs., 4 figs.

  14. Subacromial bursitis with rice bodies. Finding in magnetic resonance

    International Nuclear Information System (INIS)

    Miguel Campos, E. de; Hernandez Moreno, L.; Lafuente Martinez, J.; Godoy Lopez, M.A.; Ruiz Noguero, P.

    1994-01-01

    We present a case of subacromial bursitis associated with intraarticular loose bodies, constituted by accumulations of fibrin referred to as rice bodies, in a woman with seronegative rheumatoid arthritis. We demonstrate the clinical and imaging features of this disorder, especially stressing the magnetic resonance (MR) findings. The literature is reviewed. (Author) 14 refs

  15. Subdeltoid/subacromial bursitis associated with influenza vaccination.

    Science.gov (United States)

    Cook, Ian F

    2014-01-01

    A 76-year-old male presented with subacromial/subdeltoid bursitis following influenza vaccine administration into the left deltoid muscle. This shoulder injury related to vaccine administration (SIRVA) could have been prevented by the use of a safe, evidence based protocol for the intramuscular injection of the deltoid muscle.

  16. Arthroscopic treatment of bony loose bodies in the subacromial space

    Directory of Open Access Journals (Sweden)

    Wei Li

    2015-01-01

    Conclusion: The mechanism of formation of bony loose bodies is not clear, may be associated with synovial cartilage metaplasia. Arthroscopic removal of loose bodies and bursa debridement is a good option for treatment of the loose body in the subacromial space, which can receive good function.

  17. Does Subacromial Osteolysis Affect Shoulder Function after Clavicle Hook Plating?

    Directory of Open Access Journals (Sweden)

    Siwei Sun

    2016-01-01

    Full Text Available Purpose. To evaluate whether subacromial osteolysis, one of the major complications of the clavicle hook plate procedure, affects shoulder function. Methods. We had performed a retrospective study of 72 patients diagnosed with a Neer II lateral clavicle fracture or Degree-III acromioclavicular joint dislocation in our hospital from July 2012 to December 2013. All these patients had undergone surgery with clavicle hook plate and were divided into two groups based on the occurrence of subacromial osteolysis. By using the Constant-Murley at the first follow-up visit after plates removal, we evaluated patients’ shoulder function to judge if it has been affected by subacromial osteolysis. Results. We have analyzed clinical data for these 72 patients, which shows that there is no significant difference between group A (39 patients and group B (33 patients in age, gender, injury types or side, and shoulder function (the Constant-Murley scores are 93.38±3.56 versus 94.24±3.60, P>0.05. Conclusion. The occurrence of subacromial osteolysis is not rare, and also it does not significantly affect shoulder function.

  18. Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

    Directory of Open Access Journals (Sweden)

    Rambani Rohit

    2009-06-01

    Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

  19. The Strengthening Exercises in Shoulder Impingement trial (The SExSI-trial) investigating the effectiveness of a simple add-on shoulder strengthening exercise programme in patients with long-lasting subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Clausen, Mikkel Bek; Bandholm, Thomas; Rathleff, Michael Skovdal

    2018-01-01

    with pronounced and long-lasting SIS. However, the current rehabilitation of such strength impairments may be inadequate, with novel rehabilitation programmes including exercise therapy only improving external rotation strength by 4-13%. As these previous studies are the basis of current practice, this suggests...... that the strengthening component could be inadequate in the rehabilitation of these patients, and it seems likely that more emphasis should be placed on intensifying this part of the rehabilitation. The purpose of this study is to investigate the effectiveness of a programme consisting of progressive home...... with pronounced and long-lasting SIS, diagnosed using predefined criteria. Participants will be randomised to receive either an add-on intervention of progressive home-based resistance training using an elastic band in addition to usual care or usual care alone in a 1:1 allocation ratio. The randomisation...

  20. Subacromial bursitis following human papilloma virus vaccine misinjection.

    Science.gov (United States)

    Uchida, Soshi; Sakai, Akinori; Nakamura, Toshitaka

    2012-12-17

    A patient presented at our clinic with severe subacromial bursitis, which persisted for several months following a third booster injection with Cervarix™. Chronic subacromial bursitis manifested itself in this patient after what appeared to be the misinjection of vaccine in close proximity to the acromion. This bursitis was resistant to conventional physiotherapy and to corticosteroid therapy, but was responsive to arthroscopic surgery. Since such patients may present to an arthroscopic surgeon only months after receiving a vaccine injection, this etiological link may not be fully appreciated by treating clinicians. Further, the accuracy of injection in the deltoid region also appears under appreciated, and this report highlights the importance of accurate injection to the deltoid region or in certain cases, the value of simply changing the injection site to another larger muscle. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Diagnosis of shoulder impingement syndrome

    International Nuclear Information System (INIS)

    Hodler, J.

    1996-01-01

    This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.) [de

  2. Targeted knockout of TNF-α by injection of lentivirus-mediated siRNA into the subacromial bursa for the treatment of subacromial bursitis in rats.

    Science.gov (United States)

    Wang, Yi; Li, Quan; Wei, Xianzhao; Xu, Jie; Chen, Qi; Song, Shuang; Lu, Zhe; Wang, Zimin

    2015-09-01

    Subacromial bursitis (SAB) is the major source of pain in rotator cuff disease. Although multiple investigations have provided support for the role of inflammatory cytokines in SAB, few have focussed on the use these cytokines in the treatment of SAB. The aim of the present study was to observe the therapeutic efficacy of lentivirus‑mediated RNA interference (RNAi) on carrageenan‑induced SAB by injecting lentivirus‑tumor necrosis factor (TNF)‑α‑RNAi expressing TNF‑α small interfering (si)RNA. Using screened siRNA segments, an siRNA was designed. A lentivirus vector expressing siRNA was established and packed as lentivirus particles. A lentivirus that expressed the negative sequence was used as a lentivirus‑negative control (NC). The carrageenan‑induced SAB model was established in 32 male Sprague‑Dawley rats. The modeled rats were randomly assigned to four groups: Lentivirus‑RNAi treatment group, lentivirus‑NC group, SAB group and phosphate‑buffered saline (PBS) blank control group. The lentivirus was injected (1x10(7) transducing units) into the subacromial bursa of the rats in the lentivirus‑RNAi group and lentivirus‑NC group, whereas 100 µl PBS was injected at the same site in the SAB group and the PBS blank control group. At 5 weeks following injection, the animals were sacrificed and venous blood was obtained. The effect of TNF‑α interference and the expression of inflammatory cytokines were determined by reverse transcription‑quantitative polymerase chain reaction, western blotting, hematoxylin and eosin staining, Van Gieson's staining and immunofluorescence. The expression of TNF‑α was decreased in the lentivirus‑TNF‑α‑RNAi group compared with that in the SAB group. Morphological observations revealed that the number of inflammatory cells were reduced and damage to tendon fibers was attenuated in this group, suggesting that the downregulation of the protein expression levels of TNF‑α‑associated nuclear

  3. Patients who are candidates for subacromial decompression have more pronounced range of motion deficits, but do not differ in self-reported shoulder function, strength or pain compared to non-candidates

    DEFF Research Database (Denmark)

    Witten, Adam; Clausen, Mikkel B; Thorborg, Kristian

    2018-01-01

    -reported shoulder function, shoulder strength, ROM, and pain in patients with SIS considered candidates and non-candidates for subacromial decompression (SAD). METHOD: Self-reported shoulder function (Q-DASH and SPADI), maximum isometric muscle strength in shoulder abduction (Abd-strength) and external rotation (ER...... or non-candidates for SAD based on their consultation with an orthopedic specialist blinded to test results and self-reported shoulder function. All outcomes and age, gender, weight and duration of symptoms were compared using the unpaired t test or Mann-Whitney's U test as appropriate. RESULTS: One.......3 vs. 3.7, p = 0.02, effect size = 0.21). No other differences were found between the groups. CONCLUSION: A decrease in abduction and internal rotation range of motion, and increased pain during maximal abduction strength effort are associated with being considered a candidate for subacromial...

  4. Conservative treatment for patients with subacromial impingement

    DEFF Research Database (Denmark)

    Clausen, Mikkel B; Merrild, Mikas B; Witten, Adam

    2018-01-01

    -injections was recorded at follow-up. Changes in outcomes were analyzed using Wilcoxon Signed-Rank test, and the corresponding effect sizes (ES) were estimated. The associations between changes in outcomes and rehabilitation parameters were explored using multiple regression analyses. Results: Sixty-three patients....... The outcomes Shoulder Pain and Disability Index (SPADI:0-100), average pain (NRS:0-10), external rotation strength, abduction strength and abduction ROM, pain during each test (NRS:0-10), were collected at baseline and at six month follow-up. Amount of exercise-time, physio-sessions and steroid...... completed both baseline and follow-up testing. Significant improvements were seen in SPADI (19 points, ES:0.53, p 0.2). A higher number of physio-sessions was significantly associated...

  5. Is ultrasound-guided injection more effective in chronic subacromial bursitis?

    Science.gov (United States)

    Hsieh, Lin-Fen; Hsu, Wei-Chun; Lin, Yi-Jia; Wu, Shih-Hui; Chang, Kae-Chwen; Chang, Hsiao-Lan

    2013-12-01

    Although ultrasound (US)-guided subacromial injection has shown increased accuracy in needle placement, whether US-guided injection produces better clinical outcome is still controversial. Therefore, this study aimed to compare the efficacy of subacromial corticosteroid injection under US guidance with palpation-guided subacromial injection in patients with chronic subacromial bursitis. Patients with chronic subacromial bursitis were randomized to a US-guided injection group and a palpation-guided injection group. The subjects in each group were injected with a mixture of 0.5 mL dexamethasone suspension and 3 mL lidocaine into the subacromial bursa. The primary outcome measures were the visual analog scale for pain and active and passive ranges of motion of the affected shoulder. Secondary outcome measures were the Shoulder Pain and Disability Index, the Shoulder Disability Questionnaire, and the 36-item Short-Form Health Survey (SF-36). The primary outcome measures were evaluated before, immediately, 1 wk, and 1 month after the injection; the secondary outcome measures were evaluated before, 1 wk, and 1 month after the injection. Of the 145 subjects screened, 46 in each group completed the study. Significantly greater improvement in passive shoulder abduction and in physical functioning and vitality scores on the SF-36 were observed in the US-guided group. The pre- and postinjection within-group comparison revealed significant improvement in the visual analog scale for pain and range of motion, as well as in the Shoulder Pain and Disability Index, Shoulder Disability Questionnaire, and SF-36 scores, in both groups. The US-guided subacromial injection technique produced significantly greater improvements in passive shoulder abduction and in some items of the SF-36. US is effective in guiding the needle into the subacromial bursa in patients with chronic subacromial bursitis.

  6. Acromion types and role of corticosteroid with shoulder impingement syndrome

    International Nuclear Information System (INIS)

    Akram, M.; Gillani, S.F.U.S.; Awais, S.M.

    2016-01-01

    To determine the association between shoulder impingement and morphological characteristics of acromion and the role of sub-acromial injection of methylprednisolone in the short-term treatment for relieving pain and improve functional disability of these patients. Study Design: A descriptive study. Place and Duration of Study: Department of Orthopedic Surgery and Traumatology Unit-I (DOST-I), Mayo Hospital, Lahore, between November 2013 to June 2014. Methodology: All patients presented in OPD with shoulder pain were included as subjects and evaluated by clinical test and categorised using X-ray scapula Y-view. Patients with impingement syndrome were correlated with Bigliani types and offered intra-lesional injection into sub-acromial space with 2ml of xylocaine 2% and 40 mg of methylprednisolone using 22 gauge needle. The effectiveness was assessed in terms of relieving pain and good functional outcomes; and rotator cuff tear was clinically assessed among impingement positive patient. The pain was assessed using visual analogue score before and after the administration of the injection. Demographic variables for frequencies and their associations were analysed using SPSS version 20.0. Significance level was p<0.05. Among the 101 cases, there was no case of tear of rotator cuff tendon on clinical assessment. Majority of the patients (58.4%) were females with mean age of 31.38 +-1.13 years. Majority 57 (56.4%) of the patients had acromion type II (curved), which was the most common cause of shoulder impingement. Most had moderate pain. Thirty-four patients required intralesional steroid, which relieved the pain in 31 of them. Conclusion: Shoulder impingement syndrome without tear of rotator cuff tendon was found in younger age group between 40 to 45 years, which was relieved by intralesional corticosteroid administration. These patients had type II (curved) acromion, according to Bigliani classification. (author)

  7. Association between rotating night shift work and metabolic syndrome in Korean workers: differences between 8-hour and 12-hour rotating shift work.

    Science.gov (United States)

    Oh, Jae-Il; Yim, Hyeon Woo

    2018-02-07

    This study aimed to analyze the association between the shift work schedule and metabolic syndrome (MetS). This is a retrospective longitudinal study based on the 2015 health checkup data of 2,090 workers evaluated for MetS in 2010 at a general hospital in Korea. The participants were divided according to their shift work schedule into daytime, three-shift (8-h rotation), and two-shift (12-h rotation) workers. The index that indicates the association between the shift work schedule and MetS is the odds ratio (OR) calculated using multivariate logistic regression. The analysis for the entire group of workers indicated that there was positive association between two-shift rotation and MetS (OR=1.58, 95% confidence interval [CI]: 1.09, 2.29). In the analysis of rotating night-shift workers, the years of rotating night shifts, frequency of night-shift work, and sleep disturbance were added to the confounding variables, and two-shift work remained positively associated with MetS (OR=1.72, 95% CI: 1.10, 2.70). The risk of MetS differs based on the shift work schedules they engage in. Hence, structural changes to the shift work schedules are required to prevent MetS in night-shift workers.

  8. The active abduction view: A new maneuvre in the diagnosis of rotator cuff tears

    International Nuclear Information System (INIS)

    Bloom, R.A.

    1991-01-01

    A new projection is described, the active abduction view of the shoulder, where in many patients with a comlete rotator cuff tear the humeral head is closely apposed to the acromion, obliterating the subacromial space. In such a situation,the medial portion of the torn rotator cuff retracts during active abduction, allowing approximation of the two bones. (orig./GDG)

  9. Injection Therapies for Rotator Cuff Disease.

    Science.gov (United States)

    Lin, Kenneth M; Wang, Dean; Dines, Joshua S

    2018-04-01

    Rotator cuff disease affects a large proportion of the overall population and encompasses a wide spectrum of pathologies, including subacromial impingement, rotator cuff tendinopathy or tear, and calcific tendinitis. Various injection therapies have been used for the treatment of rotator cuff disease, including corticosteroid, prolotherapy, platelet-rich plasma, stem cells, and ultrasound-guided barbotage for calcific tendinitis. However, the existing evidence for these therapies remains controversial or sparse. Ultimately, improved understanding of the underlying structural and compositional deficiencies of the injured rotator cuff tissue is needed to identify the biological needs that can potentially be targeted with injection therapies. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Quantitative and qualitative analyses of subacromial impingement by kinematic open MRI.

    Science.gov (United States)

    Tasaki, Atsushi; Nimura, Akimoto; Nozaki, Taiki; Yamakawa, Akira; Niitsu, Mamoru; Morita, Wataru; Hoshikawa, Yoshimitsu; Akita, Keiichi

    2015-05-01

    Quantitative and qualitative kinematic analyses of subacromial impingement by 1.2T open MRI were performed to determine the location of impingement and the involvement of the acromioclavicular joint. In 20 healthy shoulders, 10 sequential images in the scapular plane were taken in a 10-s pause at equal intervals from 30° to maximum abduction in neutral and internal rotation. The distances between the rotator cuff (RC) and the acromion and the acromioclavicular joint were measured. To comprehend the positional relationships, cadaveric specimens were also observed. Although asymptomatic, the RC came into contact with the acromion and the acromioclavicular joint in six and five cases, respectively. The superior RC acted as a depressor for the humeral head against the acromion as the shoulder elevated. The mean elevation angle and distance at the closest position between the RC and the acromion in neutral rotation were 93.5° and 1.6 mm, respectively, while those between the RC and the acromioclavicular joint were 86.7° and 2.0 mm. When comparing this distance and angle, there was no significant difference between the RC to the acromion and to the acromioclavicular joint. The minimum distance between the RC and the acromion was significantly shorter than that between the greater tuberosity and the acromion. The location of RC closest to the acromion and the acromioclavicular joint differed significantly. Although asymptomatic, contact was found between the RC and the acromion and the acromioclavicular joint. The important role of the RC to prevent impingement was observed, and hence, dysfunction of the RC could lead to impingement that could result in a RC lesion. The RC lesions may differ when they are caused by impingement from either the acromion or the acromioclavicular joint.

  11. MR imaging in the diagnosis of impingement syndrome

    International Nuclear Information System (INIS)

    Seeger, L.L.; Gold, R.H.; Bassett, L.W.; Ellman, H.

    1986-01-01

    The impingement syndrome is entrapment of the supraspinatus tendon by either the acromion, or a subacromial or acromioclavicular spur. Arthrography is normal during stages I (tendon inflammation) and II (fibrosis). The lack of objective findings often delays diagnosis until stage III (ischemic rotator cuff tear) is present. The purpose was to determine if MR imaging is useful in diagnosing this condition. T1-weighted surface coil scans were obtained on eight patients using a 0.3-T MR system. An axial scout allowed oblique alignment for imaging the osseous-soft tissue relationship and the supraspinatus tendon. MR is capable of displaying the specific pathologic anatomy of this disorder. Impinging spurs can be seen, and the adjacent tendon shows inferior displacement and abnormal signal intensity

  12. Reliability of levator scapulae index in subjects with and without scapular downward rotation syndrome.

    Science.gov (United States)

    Lee, Ji-Hyun; Cynn, Heon-Seock; Choi, Woo-Jeong; Jeong, Hyo-Jung; Yoon, Tae-Lim

    2016-05-01

    The objective of this study was to introduce levator scapulae (LS) measurement using a caliper and the levator scapulae index (LSI) and to investigate intra- and interrater reliability of the LSI in subjects with and without scapular downward rotation syndrome (SDRS). Two raters measured LS length twice in 38 subjects (19 with SDRS and 19 without SDRS). For reliability testing, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated. Intrarater reliability analysis resulted with ICCs ranging from 0.94 to 0.98 in subjects with SDRS and 0.96 to 0.98 in subjects without SDRS. These results represented that intrarater reliability in both groups were excellent for measuring LS length with the LSI. Interrater reliability was good (ICC: 0.82) in subjects with SDRS; however, interrater reliability was moderate (ICC: 0.75) in subjects without SDRS. Additionally, SEM and MDC were 0.13% and 0.36% in subjects with SDRS and 0.35% and 0.97% in subjects without SDRS. In subjects with SDRS, low dispersion of the measurement errors and MDC were shown. This study suggested that the LSI is a reliable method to measure LS length and is more reliable for subjects with SDRS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Secondary Subacromial Impingement after Valgus Closing-Wedge Osteotomy for Proximal Humerus Varus

    Directory of Open Access Journals (Sweden)

    Hirotaka Sano

    2015-01-01

    Full Text Available A 31-year-old construction worker had been suffering from both the motion pain and the restriction of elevation in his right shoulder due to severe varus deformity of humeral neck, which occurred after proximal humeral fracture. The angle for shoulder flexion and abduction was restricted to 50 and 80 degrees, respectively. Valgus closing-wedge osteotomy followed by the internal fixation using a locking plate was carried out at 12 months after injury. Postoperatively, the head-shaft angle of the humerus improved from 65 to 138 degrees. Active flexion and abduction angles improved from 80 to 135 degrees and from 50 to 135 degrees, respectively. However, the patient complained from a sharp pain with a clicking sound during shoulder abduction even after removal of the locking plate. Since subacromial steroid injection temporarily relieved his shoulder pain, we assumed that the secondary subacromial impingement was provoked after osteotomy. Thus, arthroscopic subacromial decompression was carried out at 27 months after the initial operation, which finally relieved his symptoms. In the valgus closing-wedge osteotomy, surgeons should pay attention to the condition of subacromial space to avoid causing the secondary subacromial impingement.

  14. Subacromial bursitis with giant rice bodies as initial presentation of rheumatoid arthritis.

    Science.gov (United States)

    Subramaniam, Ramesh; Tan, Justina Wei Lyn; Chau, Cora Yuk Ping; Lee, Keng Thiam

    2012-10-01

    Rice body formation is a nonspecific response to chronic synovial inflammation associated with tuberculous arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, seronegative inflammatory arthritis, and even osteoarthritis. Such bodies were termed rice bodies because of their close resemblance to grains of polished white rice. We present a case report of a middle-aged woman with right shoulder subacromial/subdeltoid bursitis with giant rice body formation as her initial presentation of rheumatoid arthritis. Her right shoulder symptoms resolved after subacromial and subdeltoid bursectomy and removal of the rice bodies. She subsequently developed inflammatory arthritis of other joints, met the criteria for rheumatoid arthritis, and has been treated medically.

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  16. Effect of Battlefield Acupuncture and Physical Therapy Versus Physical Therapy Alone After Shoulder Surgery

    Science.gov (United States)

    2018-05-14

    Opioid Use; Pain, Postoperative; SLAP Lesion; Bankart Lesion; Subacromial Impingement Syndrome; Rotator Cuff Tear; Glenohumeral Dislocation; Glenohumeral Subluxation; Hill Sach Lesion; Bony Bankart Lesion; Acromioclavicular Separation

  17. The activity pattern of shoulder muscles in subjects with and without subacromial impingement

    DEFF Research Database (Denmark)

    Diederichsen, Louise Pyndt; Nørregaard, Jesper; Dyhre-Poulsen, Poul

    2009-01-01

    Altered shoulder muscle activity is frequently believed to be a pathogenetic factor of subacromial impingement (SI) and therapeutic interventions have been directed towards restoring normal motor patterns. Still, there is a lack of scientific evidence regarding the changes in muscle activity in p...... that the different motor patterns might be a pathogenetic factor of SI, perhaps due to inappropriate neuromuscular strategies affecting both shoulders....

  18. Bilateral subacromial bursitis with macroscopic rice bodies: Ultrasound, CT and MR appearance

    International Nuclear Information System (INIS)

    Law, T.C.; Chong, S.F.; Lu, P.P.; Mak, K.H.

    1998-01-01

    The radiological findings of ultrasound, CT and MR of a case of bilateral subacromial bursitis with macroscopic rice bodies is described. MRI is the investigation of choice and the intravenous gadolinium-enhanced usefulness was noted. The previous literature is also reviewed. Copyright (1998) Blackwell Science Pty Ltd

  19. Bilateral subacromial bursitis with macroscopic rice bodies: Ultrasound, CT and MR appearance

    Energy Technology Data Exchange (ETDEWEB)

    Law, T.C.; Chong, S.F.; Lu, P.P. [Kwong Wah Hospital (Hong Kong). Department of Radiology; Mak, K.H. [Kwong Wah Hospital (Hong Kong). Department of Orthopaedics and Traumatology

    1998-05-01

    The radiological findings of ultrasound, CT and MR of a case of bilateral subacromial bursitis with macroscopic rice bodies is described. MRI is the investigation of choice and the intravenous gadolinium-enhanced usefulness was noted. The previous literature is also reviewed. Copyright (1998) Blackwell Science Pty Ltd 5 refs., 1 tab., 4 figs.

  20. Exogenous application of platelet-leukocyte gel during open subacromial decompression contributes to improved patient outcome

    NARCIS (Netherlands)

    Everts, P. A.; Devilee, R. J. J.; Mahoney, C. Brown; van Erp, A.; Oosterbos, C. J. M.; Stellenboom, M.; Knape, J. T. A.; van Zundert, A.

    2008-01-01

    Background: Platelet-leukocyte gel (PLG) is being used during various surgical procedures in an attempt to enhance the healing process. We studied the effects of PLG on postoperative recovery of patients undergoing open subacromial decompression (OSD). Methods: PLG was produced from

  1. Shoulder impingement syndrome: diagnostic accuracy of magnetic resonance imaging and radiographic signs

    International Nuclear Information System (INIS)

    Williamson, M.P.; Chandnani, V.P.; Baird, D.E.; Deberardino, T.M.; Swenson, G.W.; Hansen, M.F.

    1994-01-01

    Shoulder impingement syndrome is commonly encountered in orthopaedics. In a blinded retrospective study, magnetic resonance imaging and roentgenographic signs in 41 patients with clinical signs of impingement syndrome were compared with 40 control patients. Statistically significant differences between the groups included the absence of subacromial fat, as well as the presence of a supraspinatus tear, subacromial osteophytes, and a decreased coracohumeral distance. Other signs reported to occur in patients with impingement syndrome did not vary significantly in the population studied. 20 refs., 12 figs

  2. Calcific tendinitis of the rotator cuff: management options.

    Science.gov (United States)

    Suzuki, Kentaro; Potts, Aaron; Anakwenze, Oke; Singh, Anshu

    2014-11-01

    Calcific tendinitis of the rotator cuff tendons is a common cause of shoulder pain in adults and typically presents as activity-related shoulder pain. It is thought to be an active, cell-mediated process, although the exact pathophysiology remains unclear. Nonsurgical management continues to be the mainstay of treatment; most patients improve with modalities such as oral anti-inflammatory medication, physical therapy, and corticosteroid injections. Several options are available for patients who fail nonsurgical treatment, including extracorporeal shock wave therapy, ultrasound-guided needle lavage, and surgical débridement. These modalities alleviate pain by eliminating the calcific deposit, and several recent studies have demonstrated success with the use of these treatment options. Surgical management options include arthroscopic procedures to remove calcific deposits and subacromial decompression; however, the role of subacromial decompression and repair of rotator cuff defects created by removing these deposits remains controversial. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

  3. Comparison of erector spinae and hamstring muscle activities and lumbar motion during standing knee flexion in subjects with and without lumbar extension rotation syndrome.

    Science.gov (United States)

    Kim, Si-hyun; Kwon, Oh-yun; Park, Kyue-nam; Kim, Moon-Hwan

    2013-12-01

    The aim of this study was to compare the activity of the erector spinae (ES) and hamstring muscles and the amount and onset of lumbar motion during standing knee flexion between individuals with and without lumbar extension rotation syndrome. Sixteen subjects with lumbar extension rotation syndrome (10 males, 6 females) and 14 healthy subjects (8 males, 6 females) participated in this study. During the standing knee flexion, surface electromyography (EMG) was used to measure muscle activity, and surface EMG electrodes were attached to both the ES and hamstring (medial and lateral) muscles. A three-dimensional motion analysis system was used to measure kinematic data of the lumbar spine. An independent-t test was conducted for the statistical analysis. The group suffering from lumbar extension rotation syndrome exhibited asymmetric muscle activation of the ES and decreased hamstring activity. Additionally, the group with lumbar extension rotation syndrome showed greater and earlier lumbar extension and rotation during standing knee flexion compared to the control group. These data suggest that asymmetric ES muscle activation and a greater amount of and earlier lumbar motion in the sagittal and transverse plane during standing knee flexion may be an important factor contributing to low back pain. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Impingement syndrome of the shoulder; Schulterimpingement

    Energy Technology Data Exchange (ETDEWEB)

    Mayerhoefer, M.E. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung Radiodiagnostik fuer chirurgische Faecher, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet, Waehringer Guertel 18-20, 1090, Wien (Austria); Breitenseher, M.J. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Waldviertelklinikum Horn (Austria)

    2004-06-01

    The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.) [German] Das Impingementsyndrom ist ein klinisches Krankheitsbild multifaktorieller Genese, bei dem es primaer oder sekundaer zu einer schmerzhaften mechanischen Beeintraechtigung der Rotatorenmanschette kommt. Als primaere Faktoren gelten ein gebogener oder hakenfoermiger Vorderrand des Akromions oder von diesem entspringende Osteophyten, was zu Laesionen der Supraspinatussehne fuehren kann. Zu den sekundaeren Faktoren zaehlt man v. a. eine Tendinitis calcarea, eine glenohumerale Instabilitaet, ein Os acromiale sowie degenerative Veraenderungen im Bereich des Akromioklavikulargelenks. Bildgebend steht an erster Stelle ein Nativroentgen, mit dem sich die knoechernen Strukturen gut darstellen lassen. Falls vorhanden, kann in weiterer Folge die Sonographie Auskunft ueber den Zustand der Rotatorenmanschette geben. Mit der MRT schliesslich laesst sich die Beziehung von Akromion und gelenkassoziierten Strukturen zur Rotatorenmanschette

  5. Exercises may be as efficient as subacromial decompression in patients with subacromial stage II impingement: 4-8-years' follow-up in a prospective, randomized study

    DEFF Research Database (Denmark)

    Haahr, J. P.; Andersen, JH

    2006-01-01

    with graded physiotherapy and exercises or arthroscopic subacromial decompression. Outcomes were proportion of time per year with income transfers (indexed 0-1), including total transfers (marginalization), sick leave and disability pension obtained from the registry at the Ministry of Work. Self......-reported function, working capability, employment status and global improvement were obtained by questionnaire in September 2004. The main outcomes are given as differences in development from baseline. RESULTS: Seventy-nine (88%) responded to the questionnaire and registry data were obtained from 81. After 1 year...

  6. Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis

    International Nuclear Information System (INIS)

    Chen, Albert; Wong, Lun-Yick; Sheu, Chin-Yin; Chen, Be-Fong

    2002-01-01

    Multiple rice body formation is a complication of chronic bursitis. Although it resembles synovial chondromatosis clinically and on imaging, the literature suggests that analysis of radiographic and MR appearances should allow discrimination. We report the imaging findings in a 41-year-old man presenting with rice body formation in chronic subacromial-subdeltoid bursitis. We found that the signal intensity of the rice bodies is helpful in making the diagnosis. (orig.)

  7. Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Albert; Wong, Lun-Yick; Sheu, Chin-Yin [Department of Radiology, Mackay Memorial Hospital, Taipei (Taiwan); Chen, Be-Fong [Department of Pathology, Mackay Memorial Hospital, Taipei (Taiwan)

    2002-02-01

    Multiple rice body formation is a complication of chronic bursitis. Although it resembles synovial chondromatosis clinically and on imaging, the literature suggests that analysis of radiographic and MR appearances should allow discrimination. We report the imaging findings in a 41-year-old man presenting with rice body formation in chronic subacromial-subdeltoid bursitis. We found that the signal intensity of the rice bodies is helpful in making the diagnosis. (orig.)

  8. The Effect of Theraband Training on Position Sense of Internal and External Rotator Muscles in Male Athletes with Shoulder Impingement Syndrome

    Directory of Open Access Journals (Sweden)

    Ramin Moharrami

    2015-10-01

    Full Text Available Objective: This study evaluated the effect of theraband training on Position sense of internal and external rotator muscles in male athletes with shoulder impingement syndrome. Materials & Methods: In this semi-experimental interventional study 30 cases of men with Shoulder syndrome with age range of 20 to 30 years participated. They were divided in test and control groups, each group including 15 people through non-random and purposeful method Biodex System 3 Made in America was used to measure position sense of internal and external rotator muscles. For data analysis independent 7 paired t-test was used in SPSS software (version 21. Results: The experimental group showed significant improvement after six weeks of theraband training in the internal and external rotator muscles in three 90,45,0 degree angle at a significance level of 0.05 (P=0.05. Conclusion: The results of this study showed that of theraband training resulted in improved position sense of internal and external rotator muscles in male athletes with impingement syndrome thus, the benefits of these exercises can be used widely in team sports and also for easy and quick rehabilitation of patients.

  9. [Benefit of rotational exercises for patients with Meniere's syndrome, method used by the ENT department of St-Luc university clinic].

    Science.gov (United States)

    Nyabenda, A; Briart, C; Deggouj, N; Gersdorff, M

    2003-12-01

    To date, the effectiveness of balanced rehabilitation for patients with Meniere's syndrome has not been unanimously acknowledged by all physicians and physiotherapists. The purpose of this study is to assess the therapeutic efficacy of rotational exercises in the treatment of disequilibrium for patients with unilateral Meniere's syndrome. Rotational stimuli were used to symmetrize and reduce postrotatory nystagmic response. Three reference sources were used to assess the efficacy of this management: vestibulospinal function tests: pre- and post-treatment results at the Romberg test, the Unterberger-Fukuda stepping test, the Babinski-Weil test, and gait testing with eyes closed; rotational tests: pre- and post-treatment results; and the self-perceived impact of vertigo: assessed by the Dizziness Handicap Inventory (DHI) and a scale based on the guidelines of the Japanese Society of Equilibrium Research (JSER, 1993). The JSER scale provides quantitative vertigo evaluation; the DHI reflects the patient's perceptual evaluation of handicap. Patients required 11 sessions (mean value) to attain subjective improvement. Of the 23 patients, only seven required optokinetic stimulation (mean requirement: three sessions). Rotational tests and dynamic tests of the vestibulospinal function improved. The DHI and JSER results show that patients' post-rehabilitation perceptual evaluation significantly improved. The objective and subjective measures of disequilibrium in patients with unilateral Meniere's syndrome were significantly improved.

  10. Functional incapacity related to rotator cuff syndrome in workers. Is it influenced by social characteristics and medical management?

    Science.gov (United States)

    Champagne, Romain; Bodin, Julie; Fouquet, Natacha; Roquelaure, Yves; Petit, Audrey

    2017-12-04

    Survey. Rotator cuff syndrome (RCS) is one of the most common musculoskeletal disorders reported in workers. The functional incapacity related to RCS may vary according to the sociodemographic context and to the medical management. The purpose of this is to analyze the RCS-related functional incapacity assessed by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires in workers according to their sociodemographic characteristics and the use of care. A cross-sectional study was carried out on a French sample of workers diagnosed with RCS. The DASH and DASH-work scores were studied according to the sociodemographic factors, musculoskeletal symptoms, and RCS medical management during the preceding 12 months. Two hundred seven workers who suffered from RCS filled out the questionnaire of which 80% were still working. The DASH score was significantly higher in women (24.0 vs 17.4; P 0.6). The demographic factors and the RCS medical management influenced the overall incapacity assessed by the DASH questionnaire. Work incapacity was more especially related to the use of care for RCS. The sociodemographic and medical parameters added to other established predictors could help guide clinicians in managing their patients. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  11. Diagnosis of shoulder impingement syndrome; Diagnostik des Schulterimpingementsyndroms

    Energy Technology Data Exchange (ETDEWEB)

    Hodler, J. [Orthopaedische Universitaetsklinik Balgrist, Zuerich (Switzerland)

    1996-12-01

    This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.) [Deutsch] Grundlage des Impingementsyndroms ist eine Kompression des Supraspinatus am akromioklavikularen Bogen vor allem bei Flexion

  12. Accuracy of diagnostic ultrasound in patients with suspected subacromial disorders: a systematic review and meta-analysis.

    NARCIS (Netherlands)

    Ottenheijm, R.P.; Jansen, M.J.; Staal, J.B.; Bruel, A. van den; Weijers, R.E.; Bie, R.A. de; Dinant, G.J.

    2010-01-01

    OBJECTIVE: To determine the diagnostic accuracy of ultrasound for detecting subacromial disorders in patients presenting in primary and secondary care settings. DATA SOURCES: Medline and Embase were searched on June 9, 2010. In addition, the reference list of 1 systematic review and all included

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

    Directory of Open Access Journals (Sweden)

    Rupert Schupfner

    2017-07-01

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

  14. Role of ultrasound in rotator cuff tears

    International Nuclear Information System (INIS)

    Siddiqi, H.A.; Mirza, T.

    2010-01-01

    The study was designed to evaluate the efficacy of ultrasound in rotator cuff tears and to compare it with MRI. Total number of patients was thirty. All of these were above thirty years of age and were referred by clinicians, with shoulder pain for diagnostic workup. Post operative patients were excluded. Ultrasound and Magnetic Resonance Imaging (MRI) were performed on each patient. Same operator performed ultrasound in all patients. Ultrasound (US) and Magnetic Resonance Imaging (MRI) detected equal number of full thickness tears while two partial thickness tears were missed on US. Hypoechoic defect was the most important primary sign while cortical irregularity and fluid in subacromial and subdeltroid busra were the most important secondary signs on US. US was equally effective to MRI in detection of rotator cuff tears. It should be the primary investigation because of its availability, cost effective and real time evaluation provided significant expertise is developed, as it is highly operator dependent. (author)

  15. Relationships between rotator cuff tear types and radiographic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-15

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

  16. Relationships between rotator cuff tear types and radiographic abnormalities

    International Nuclear Information System (INIS)

    Lee, Soo Hyun; Chun, Kyung Ah; Lee Soo Jung; Kang, Min Ho; Yi, Kyung Sik; Zhang, Ying

    2014-01-01

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

  17. Rotator cuff tendinopathy: is there a role for polyunsaturated Fatty acids and antioxidants?

    Science.gov (United States)

    Lewis, Jeremy S; Sandford, Fiona M

    2009-01-01

    Despite the lack of robust evidence, there has been a steady increase in the use of dietary supplements, including Omega 3 fatty acids and antioxidants, in the management of musculoskeletal conditions. One reason for this is that unsatisfactory outcomes with conventional treatments have lead sufferers to seek alternative solutions including the use of nutritional supplements. In the United Kingdom alone, the current supplement market is estimated to be over 300 pounds million per annum. One target market for nutritional supplements is tendinopathies including conditions involving the rotator cuff. This condition is debilitating and associated with considerable morbidity. Incidence increases with advancing age. High levels of cytokines, such as the pro-inflammatory interleukin 1 beta and vascular endothelial growth factor, have been reported within the bursa of patients with rotator cuff disease. There is also evidence that high concentrations of free-radical oxidants may also be involved in tendon pathology. Therefore, the possibility exists that dietary supplements may have a beneficial effect on tendon pathology, including that of the rotator cuff. A review was conducted to synthesize the available research literature on the histopathology of rotator cuff disease and the effectiveness of polyunsaturated fatty acids (PUFAs) and antioxidants on tendinopathies. A search was conducted using the MEDLINE, CINAHL, AMED, EMBASE, Cochrane, and PEDro databases using the terms "rotator cuff" and "tear/s" and "subacromial impingement syndrome," "burase," "bursitis," "tendinopathy," "tendinitis," "tendinosis," "polyunsaturated fatty acids," "PUFA," "Omega 3," "histopathology," "etiology," and "antioxidants." English language was an inclusion criterion. There were no randomized clinical trials found relating specifically to the rotator cuff. Only one trial was found that investigated the efficacy of PUFAs and antioxidants on tendinopathies. The findings suggest that some (low

  18. The Diagnostic Reproducibility of Tomosynthesis for the Correlation between Acromiohumeral Distance and Rotator Cuff Size or Type.

    Science.gov (United States)

    Song, Yoonah; Lee, Seunghun; Lee, Bong Gun; Joo, Young Bin; Song, Soon-Young

    2018-01-01

    To correlate the acromiohumeral distance (AHD) using tomosynthesis and rotator cuff (RC) pathology and various anatomical indices and to assess the diagnostic reproducibility of tomosynthesis for the evaluation of subacromial impingement. A retrospective review of 63 patients with clinically suspected subacromial impingement was conducted. Two musculoskeletal radiologists independently measured the following quantitative data: the AHD on plain radiographs and the AHD at three compartments (anterior, middle, and posterior) using tomosynthesis, computed tomography (CT) arthrography, or magnetic resonance (MR) arthrography. To investigate the association between the AHD and RC pathology and various anatomical indices, we reviewed the arthroscopic operation record as the referenced standard. The size of rotator cuff tear (RCT) in full-thickness tears displayed a significant inverse correlation with the middle and the posterior tomosynthetic AHDs ( p tomosynthesis, and CT or MR arthrography ( p tomosynthesis is reproducible compared with other modalities.

  19. Arthroscopic Treatment of a Case with Concomitant Subacromial and Subdeltoid Synovial Chondromatosis and Labrum Tear

    Directory of Open Access Journals (Sweden)

    Nevres Hurriyet Aydogan

    2013-01-01

    Full Text Available Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed.

  20. Shoulder impingement syndrome : evaluation of the causes with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang [Chungang Univ. College of Medicine, Seoul (Korea, Republic of); Choi, Yun Sun [Eulji Hospital, College of Medicine, Seoul (Korea, Republic of)

    1999-12-01

    Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause.

  1. Shoulder impingement syndrome : evaluation of the causes with MRI

    International Nuclear Information System (INIS)

    Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang; Choi, Yun Sun

    1999-01-01

    Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause

  2. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Larsen, C M; Søgaard, Karen; Chreiteh, S S

    2013-01-01

    and time to activity onset. In spite of a tendency to higher activity among SIS 0.10-0.30 between-group differences were not significant neither in ratio of muscle activation 0.80-0.98 nor time to activity onset 0.53-0.98. The hypothesized between-group differences in neuromuscular activity of Trapezius...

  3. Inter-examiner reproducibility of clinical tests and criteria to identify subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Vind, Mikkel; Bogh, Søren Bie; Larsen, Camilla Marie

    2011-01-01

    for cases was ≥3, and for controls ≤1 positive test out of four. Cohen's κ statistics were used for calculating agreement. Results In the overall agreement phase, an agreement of 0.90 was obtained, while in the study phase it was 0.98 with a κ of 0.95 for SIS. κ Values for the individual tests varied...... was followed, consisting of a training, an overall agreement and a study phase. To proceed to the study phase, an overall agreement of 0.80 was required. In total 10, 20 and 44 subjects were included in the three phases, respectively. The case prevalence in the study phase was 50%. The inclusion criterion...

  4. Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Lund, Hans; Juul-Kristensen, Birgit

    study being rated as ‘good’. Few of the assessment methods in the included studies with ‘fair’ or ‘good’ measurement property ratings demonstrated acceptable results for reliability and validity. Responsiveness was not investigated. CONCLUSION: 1) No between-group differences of SIS and No-SIS subjects...... patient sample with SIS, and to assess the clinimetric properties of clinical assessment methods of scapular kinematics as important aspects for optimising effect measures of treatment in order to improve clinical guidelines in this area. METHODS: Scapular muscle activity was examined, 1) during...... a voluntary arm movement task and 2) selective activation tasks during sessions with and without on-line biofeedback, in a general population consisting of 16 SIS patients and 15 controls (No-SIS). Furthermore, 3) a systematic review was conducted of all available clinical scapular assessment methods...

  5. Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie

    muskeldele.I det andet studie blev evnen til selektiv aktivering af de individuelle skapulære muskeldele undersøgt hos 15patienter med SIS under en session med og uden visuel biofeedback, sammenlignet med denne evne hos 15raske kontroller. Med udgangspunkt i præ-definerede kriterier for selektiv aktivering...... kontrolpersonerne opnåede selektiv aktiveringaf individuelle skapulære muskeldele, når de ikke modtog visuel biofeedback af muskelaktiviteten af deenkelte muskeldele.I det tredje studie blev der udarbejdet et systematisk review af alle tilgængelige kliniske målemetoder tilvurdering af skapulas position og bevægelse...... den neuromuskulære aktivitet blandt SIS patienter ograske kontrolpersoner ikke fundet. Derimod viste undersøgelsen af den neuromuskulære funktion med og udenbrug af visuel biofeedback, at uden brug af biofeedback havde kontrolgruppen en bedre kontrol af deskapulære muskler. Dog præsterede SIS...

  6. Conservative treatment for patients with subacromial impingement: Changes in clinical core outcomes and their relation to specific rehabilitation parameters

    Directory of Open Access Journals (Sweden)

    Mikkel B. Clausen

    2018-02-01

    Full Text Available Background Impaired patient-reported shoulder function and pain, external-rotation strength, abduction strength, and abduction range-of-motion (ROM is reported in patients with subacromial impingement (SIS. However, it is unknown how much strength and ROM improves in real-life practice settings with current care. Furthermore, outcomes of treatment might depend on specific rehabilitation parameters, such as the time spent on exercises (exercise-time, number of physiotherapy sessions (physio-sessions and number of corticosteroid injections, respectively. However, this has not previously been investigated. The purpose of this study was to describe changes in shoulder strength, ROM, patient-reported function and pain, in real-life practice settings, and explore the association between changes in clinical core outcomes and specific rehabilitation parameters. Methods Patients diagnosed with SIS at initial assessment at an outpatient hospital clinic using predefined criteria’s, who had not undergone surgery after 6 months, were included in this prospective cohort study. After initial assessment (baseline, all patients underwent treatment as usual, with no interference from the investigators. The outcomes Shoulder Pain and Disability Index (SPADI:0–100, average pain (NRS:0–10, external rotation strength, abduction strength and abduction ROM, pain during each test (NRS:0–10, were collected at baseline and at six month follow-up. Amount of exercise-time, physio-sessions and steroid-injections was recorded at follow-up. Changes in outcomes were analyzed using Wilcoxon Signed-Rank test, and the corresponding effect sizes (ES were estimated. The associations between changes in outcomes and rehabilitation parameters were explored using multiple regression analyses. Results Sixty-three patients completed both baseline and follow-up testing. Significant improvements were seen in SPADI (19 points, ES:0.53, p  0.2. A higher number of physio-sessions was

  7. Intra-rater and inter-rater reliability of the standardized ultrasound protocol for assessing subacromial structures

    DEFF Research Database (Denmark)

    Hougs Kjær, Birgitte; Ellegaard, Karen; Wieland, Ina

    2017-01-01

    BACKGROUND: US-examinations related to shoulder impingement (SI) often vary due to methodological differences, examiner positions, transducers, and recording parameters. Reliable US protocols for examination of different structures related to shoulder impingement are therefore needed. OBJECTIVES...... of the supraspinatus tendon (SUPRA) and subacromial subdeltoid (SASD) bursa in two imaging positions, and the acromial humeral distance (AHD) in one position. Additionally, agreement on dynamic impingement (DI) examination was performed. The intra- and inter-rater reliability was carried out on the same day...

  8. Efficacy and safety of rotating pigtail catheter: lower extremity deep vein thrombosis of may-thurner syndrome

    International Nuclear Information System (INIS)

    Kim, Yoon Kyung; Kang, Byung Chul; Gang, Sung Gown

    2004-01-01

    The purpose of this study was to evaluate the efficacy and safety of mechanical fragmentation of iliofemoral deep vein thromboses (DVTs) with a rotating pigtail catheter followed by aspiration thrombectomy. Ten patients (eight females, two males, 56.8 +/- 21.37 years) with iliofemoral DVT underwent treatment for a total of ten affected limbs. Approximately 5-10 min after infusing 400,000-700,000 IU urokinase (UK) into the thrombosed deep veins, the thromboses were fragmented by the mechanical action of the rotating pigtail catheter tip. Following their fragmentation, the fragmented thromboses were aspirated. After completion of the above procedure, a stent was inserted if iliac vein stenosis was demonstrated. We evaluated the total procedure time, volume of thrombolytic agent (urokinase), valvular injury, symptom-free time interval and success rate (primary patency rate). In all 10 patients, the iliofemoral deep vein thrombosis was successfully fragmented and aspirated using the combination method of a rotating pigtail catheter and aspiration thrombectomy (clinical and technical success rate, 100%). The thromboses were declotted by means of a rotating pigtail catheter with an average treatment time of 5.7 minutes. The average duration of the total intervention was 108 min. The mean primary patency was approximately 4 months with no recurrence. The total UK dose was 890,000 IU on average. There were no major complications, such as pulmonary embolism or cerebral hemorrhage, while performing the thrombus-fragmentation procedure using the rotating pigtail catheter. The combination method of a rotating pigtail catheter and aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis was found to be rapid, safe and effective for accomplishing recanalization in all cases without complication. Therefore, this procedure constitutes a potential treatment option in patients presenting with iliofemoral vein thrombosis

  9. Evaluation of the Trends, Concomitant Procedures, and Complications With Open and Arthroscopic Rotator Cuff Repairs in the Medicare Population.

    Science.gov (United States)

    Jensen, Andrew R; Cha, Peter S; Devana, Sai K; Ishmael, Chad; Di Pauli von Treuheim, Theo; D'Oro, Anthony; Wang, Jeffrey C; McAllister, David R; Petrigliano, Frank A

    2017-10-01

    Medicare insures the largest population of patients at risk for rotator cuff tears in the United States. To evaluate the trends in incidence, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in Medicare patients. Cohort study; Level of evidence, 3. All Medicare patients who had undergone open or arthroscopic rotator cuff repair from 2005 through 2011 were identified with a claims database. Annual incidence, concomitant procedures, and postoperative complications were compared between these 2 groups. In total, 372,109 rotator cuff repairs were analyzed. The incidence of open repairs decreased (from 6.0 to 4.3 per 10,000 patients, P rotator cuff repairs have increased in incidence and now represent the majority of rotator cuff repair surgery. Among concomitant procedures, subacromial decompression was most commonly performed despite evidence suggesting a lack of efficacy. Infections and stiffness were rare complications that were slightly but significantly more frequent in open rotator cuff repairs.

  10. Long-Term MRI Findings in Operated Rotator Cuff Tear

    International Nuclear Information System (INIS)

    Kyroelae, K.; Niemitukia, L.; Jaroma, H.; Vaeaetaeinen, U.

    2004-01-01

    Purpose: To describe magnetic resonance imaging (MRI) findings at long-term follow-up after rotator cuff (RC) tear using standard MRI sequences without fat saturation. Material and Methods: Twenty-eight patients aged 55.8±7.6 underwent MRI examination 4.6±2.1 years after surgery for RC tear. Standard sequences in oblique coronal, oblique sagittal, and axial planes were obtained. The RC, including re-tears and tendon degeneration, was independently evaluated by two observers. Thickness of the supraspinatus tendon and narrowing of the subacromial space were measured. The clinical outcome was evaluated with the Constant score and compared with the MRI findings. Results: The RC tear was traumatic in 18 (64%) patients and degenerative in 10 (36%). At follow-up, 11 (39%) had normal RC tendons with good clinical outcome. Four (14%) patients had painful tendinosis without RC tear. A full-thickness RC tear was found in 7 (25%) patients and a partial tear in 6 (21%). In one patient with a full-thickness tear, and in two with partial tear, tendinosis was found in another of the RC tendons. The subacromial space was narrowed in 13 (46%) of the patients. A narrowing of the subacromial space correlated with re-tear (P<0.05). Conclusions: The RC may be evaluated with standard MRI sequences without fat saturation at long-term follow-up. A normal appearance of the RC is correlated with good clinical outcome, while re-tear and tendinosis are associated with pain

  11. Regenerative Medicine in Rotator Cuff Injuries

    Science.gov (United States)

    Randelli, Pietro; Ragone, Vincenza; Menon, Alessandra; Cabitza, Paolo; Banfi, Giuseppe

    2014-01-01

    Rotator cuff injuries are a common source of shoulder pathology and result in an important decrease in quality of patient life. Given the frequency of these injuries, as well as the relatively poor result of surgical intervention, it is not surprising that new and innovative strategies like tissue engineering have become more appealing. Tissue-engineering strategies involve the use of cells and/or bioactive factors to promote tendon regeneration via natural processes. The ability of numerous growth factors to affect tendon healing has been extensively analyzed in vitro and in animal models, showing promising results. Platelet-rich plasma (PRP) is a whole blood fraction which contains several growth factors. Controlled clinical studies using different autologous PRP formulations have provided controversial results. However, favourable structural healing rates have been observed for surgical repair of small and medium rotator cuff tears. Cell-based approaches have also been suggested to enhance tendon healing. Bone marrow is a well known source of mesenchymal stem cells (MSCs). Recently, ex vivo human studies have isolated and cultured distinct populations of MSCs from rotator cuff tendons, long head of the biceps tendon, subacromial bursa, and glenohumeral synovia. Stem cells therapies represent a novel frontier in the management of rotator cuff disease that required further basic and clinical research. PMID:25184132

  12. Regenerative Medicine in Rotator Cuff Injuries

    Directory of Open Access Journals (Sweden)

    Pietro Randelli

    2014-01-01

    Full Text Available Rotator cuff injuries are a common source of shoulder pathology and result in an important decrease in quality of patient life. Given the frequency of these injuries, as well as the relatively poor result of surgical intervention, it is not surprising that new and innovative strategies like tissue engineering have become more appealing. Tissue-engineering strategies involve the use of cells and/or bioactive factors to promote tendon regeneration via natural processes. The ability of numerous growth factors to affect tendon healing has been extensively analyzed in vitro and in animal models, showing promising results. Platelet-rich plasma (PRP is a whole blood fraction which contains several growth factors. Controlled clinical studies using different autologous PRP formulations have provided controversial results. However, favourable structural healing rates have been observed for surgical repair of small and medium rotator cuff tears. Cell-based approaches have also been suggested to enhance tendon healing. Bone marrow is a well known source of mesenchymal stem cells (MSCs. Recently, ex vivo human studies have isolated and cultured distinct populations of MSCs from rotator cuff tendons, long head of the biceps tendon, subacromial bursa, and glenohumeral synovia. Stem cells therapies represent a novel frontier in the management of rotator cuff disease that required further basic and clinical research.

  13. Blood Glucose Levels in Diabetic Patients Following Corticosteroid Injections into the Subacromial Space of the Shoulder.

    Science.gov (United States)

    Aleem, Alexander W; Syed, Usman Ali M; Nicholson, Thema; Getz, Charles L; Namdari, Surena; Beredjiklian, Pedro K; Abboud, Joseph A

    2017-09-01

    Corticosteroid injections are used to treat a variety of orthopedic conditions with the goal of decreasing pain and inflammation. Administration of systemic or local corticosteroids risks temporarily increasing blood glucose levels, especially diabetic patients. The purpose of this study is to quantify the effects of corticosteroid injections on blood glucose levels in diabetic patients with shoulder pathology. Diabetic patients who regularly monitored their blood glucose levels and were indicated for a subacromial corticosteroid injection were included in this prospective investigation. The typical normal morning fasting glucose and most recent hemoglobin A1c level was recorded for each patient. After injection, patients were contacted daily to confirm their fasting morning glucose level for 10 days post-injection. Seventeen consecutive patients were enrolled. Patients with hemoglobin A1c of patients' glucose levels returned to near baseline levels around post-injection day 8, while poorly controlled patients levels remained elevated. Similarly, insulin-dependent diabetic patients had an average increase in fasting glucose level of 99 mg/dL versus 50 mg/dL in non-insulin-dependent diabetic patients ( P patients with well-controlled diabetes experience smaller elevations and faster return to baseline glucose levels than patients with poor control. Insulin dependent diabetics experienced similar findings as patients with poor control. Future studies are needed to evaluate dosing to optimize the risks of blood glucose elevation while maintaining therapeutic benefit.

  14. Effect of methylprednisolone use on the rotator cuff in rats: biomechanical and histological study

    Directory of Open Access Journals (Sweden)

    Gustavo Vinícius Ghellioni

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the influence of treatment with different doses of methylprednisolone on the mechanical resistance and possible histological alterations of the rotator cuff tendon in rats.METHODS: Male Wistar rats were divided randomly into four treatment groups: sham, vehicle or 0.6 mg/kg or 6.0 mg/kg of methylprednisolone. Changes to mechanical resistance (in N and histological parameters (fibrillar appearance, presence of collagen, edema and vascular proliferation of the rotator cuff tendon were evaluated. The analyses were conducted after administration of one treatment (24 h afterwards, two treatments (7 days afterward or three treatments (14 days afterwards, into the subacromial space.RESULTS: Seven and fourteen days after the treatments were started, it was found that in a dose-dependent manner, methylprednisolone reduced the mechanical resistance of the rotator cuff tendon (p < 0.05 in relation to the vehicle group. Modifications to the histological parameters were observed on the 7th and 14th days after the first infiltration, especially regarding the presence of collagen and vascular proliferation, for the dose of 0.6 mg/kg of methylprednisolone, and also regarding the presence of collagen, edema and vascular proliferation for the dose of 6.0 mg/kg of corticoid.CONCLUSION: The results obtained demonstrated a relationship between methylprednisolone use through infiltration into the subacromial space and reduction of the mechanical resistance of and histological modifications to the rotator cuff tendon in rats.

  15. Arthroscopic Double-Row Transosseous Equivalent Rotator Cuff Repair with a Knotless Self-Reinforcing Technique.

    Science.gov (United States)

    Mook, William R; Greenspoon, Joshua A; Millett, Peter J

    2016-01-01

    Rotator cuff tears are a significant cause of shoulder morbidity. Surgical techniques for repair have evolved to optimize the biologic and mechanical variables critical to tendon healing. Double-row repairs have demonstrated superior biomechanical advantages to a single-row. The preferred technique for rotator cuff repair of the senior author was reviewed and described in a step by step fashion. The final construct is a knotless double row transosseous equivalent construct. The described technique includes the advantages of a double-row construct while also offering self reinforcement, decreased risk of suture cut through, decreased risk of medial row overtensioning and tissue strangulation, improved vascularity, the efficiency of a knotless system, and no increased risk for subacromial impingement from the burden of suture knots. Arthroscopic knotless double row rotator cuff repair is a safe and effective method to repair rotator cuff tears.

  16. Rotator Cuff Injuries.

    Science.gov (United States)

    Connors, G. Patrick

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

  17. The Repaired Rotator Cuff: MRI and Ultrasound Evaluation.

    Science.gov (United States)

    Lee, Susan C; Williams, Danielle; Endo, Yoshimi

    2018-03-01

    The purposes of this review were to provide an overview of the current practice of evaluating the postoperative rotator cuff on imaging and to review the salient imaging findings of the normal and abnormal postoperative rotator cuff, as well as of postoperative complications. The repaired rotator cuff frequently appears abnormal on magnetic resonance imaging (MRI) and ultrasound (US). Recent studies have shown that while the tendons typically normalize, they can demonstrate clinically insignificant abnormal imaging appearances for longer than 6 months. Features of capsular thickening or subacromial-subdeltoid bursal thickening and fluid distension were found to decrease substantially in the first 6-month postoperative period. MRI and US were found to be highly comparable in the postoperative assessment of the rotator cuff, although they had a lower sensitivity for partial thickness tears. Imaging evaluation of newer techniques such as patch augmentation and superior capsular reconstruction needs to be further investigated. MRI and US are useful in the postoperative assessment of the rotator cuff, not only for evaluation of the integrity of the rotator cuff, but also for detecting hardware complications and other etiologies of shoulder pain.

  18. Efeito da rotação do quadril na síndrome da dor femoropatelar Effect of hip rotation on patellofemoral pain syndrome

    Directory of Open Access Journals (Sweden)

    K Gramani-Say

    2006-01-01

    Full Text Available Objetivo: A proposta desse trabalho foi investigar o efeito da rotação do quadril na atividade elétrica dos músculos Vasto Medial Oblíquo (VMO, Vasto Lateral Oblíquo (VLO e Vasto Lateral Longo (VLL no agachamento a 45º de flexão do joelho associado à posição neutra, rotação lateral a 45º e rotação medial a 15 e 30º de quadril. Materiais e Método: Foram avaliadas 27 mulheres, sendo 15 mulheres normais do grupo Controle (21,1±2,1 anos e 12 portadoras de Síndrome da Dor Femoropatelar (SDFP (21,0±2,3 anos. A atividade elétrica do músculo quadríceps foi captada por eletrodos ativos diferenciais simples de superfície, eletromiógrafo de 8 canais e programa Aqdados 7.2.6. Os dados foram normalizados pela porcentagem da média do agachamento a 75º com o quadril em posição neutra RMS (µV. A análise estatística utilizada foi a ANOVA two way com medidas repetidas e Turkey post hoc (pObjective: The purpose of this study was to evaluate the effect of hip rotation on the electrical activity of the Vastus Medialis Obliquus (VMO, Vastus Lateralis Obliquus (VLO and Vastus Lateralis Longus (VLL muscles when squatting with 45º knee flexion, in association with the neutral position, 45º lateral rotation and 15 and 30º medial hip rotation. Method: 27 women were evaluated: 15 healthy women as a control group (21.1 ± 2.1 years and 12 subjects with patellofemoral pain syndrome (PFPS (21.0 ± 2.3 years. The electrical activity of the quadriceps muscle was detected using simple active differential surface electrodes, an eight-channel electromyography system and the Aqdados 7.2.6 software. The data were normalized by the mean squatting percentage at 75º with the hip in the neutral position RMS (µV. Two-way ANOVA with repeated measurements followed by the Tukey post hoc test (p<0.05 was used for statistical analysis. Results: The results revealed interaction between groups and muscles (p=0.00, independent of hip position (p=0.39, and

  19. Rotating flow

    CERN Document Server

    Childs, Peter R N

    2010-01-01

    Rotating flow is critically important across a wide range of scientific, engineering and product applications, providing design and modeling capability for diverse products such as jet engines, pumps and vacuum cleaners, as well as geophysical flows. Developed over the course of 20 years' research into rotating fluids and associated heat transfer at the University of Sussex Thermo-Fluid Mechanics Research Centre (TFMRC), Rotating Flow is an indispensable reference and resource for all those working within the gas turbine and rotating machinery industries. Traditional fluid and flow dynamics titles offer the essential background but generally include very sparse coverage of rotating flows-which is where this book comes in. Beginning with an accessible introduction to rotating flow, recognized expert Peter Childs takes you through fundamental equations, vorticity and vortices, rotating disc flow, flow around rotating cylinders and flow in rotating cavities, with an introduction to atmospheric and oceanic circul...

  20. Rotational seismology

    Science.gov (United States)

    Lee, William H K.

    2016-01-01

    Rotational seismology is an emerging study of all aspects of rotational motions induced by earthquakes, explosions, and ambient vibrations. It is of interest to several disciplines, including seismology, earthquake engineering, geodesy, and earth-based detection of Einstein’s gravitation waves.Rotational effects of seismic waves, together with rotations caused by soil–structure interaction, have been observed for centuries (e.g., rotated chimneys, monuments, and tombstones). Figure 1a shows the rotated monument to George Inglis observed after the 1897 Great Shillong earthquake. This monument had the form of an obelisk rising over 19 metres high from a 4 metre base. During the earthquake, the top part broke off and the remnant of some 6 metres rotated about 15° relative to the base. The study of rotational seismology began only recently when sensitive rotational sensors became available due to advances in aeronautical and astronomical instrumentations.

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

    Directory of Open Access Journals (Sweden)

    Christine Tempelaere

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

  2. Global rotation

    International Nuclear Information System (INIS)

    Rosquist, K.

    1980-01-01

    Global rotation in cosmological models is defined on an observational basis. A theorem is proved saying that, for rigid motion, the global rotation is equal to the ordinary local vorticity. The global rotation is calculated in the space-time homogeneous class III models, with Godel's model as a special case. It is shown that, with the exception of Godel's model, the rotation in these models becomes infinite for finite affine parameter values. In some directions the rotation changes sign and becomes infinite in a direction opposite to the local vorticity. The points of infinite rotation are identified as conjugate points along the null geodesics. The physical interpretation of the infinite rotation is discussed, and a comparison with the behaviour of the area distance at conjugate points is given. (author)

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  4. Prospective evaluation of the development of contrast-induced nephropathy in patients with acute coronary syndrome undergoing rotational coronary angiography vs. conventional coronary angiography: CINERAMA study

    Directory of Open Access Journals (Sweden)

    Diego Fernández-Rodríguez

    2018-03-01

    Full Text Available Introduction and objectives: Rotational coronary angiography (RCA requires less contrast to be administered and can prevent the onset of contrast-induced nephropathy (CIN during invasive coronary procedures. The aim of the study is to evaluate the impact of RCA on CIN (increase in serum creatinine ≥0.5 mg/dL or ≥25% after an acute coronary syndrome. Methods: From April to September 2016, patients suffering acute coronary syndromes who underwent diagnostic coronary angiography, with the possibility of ad hoc coronary angioplasty, were prospectively enrolled. At the operator's discretion, patients underwent RCA or conventional coronary angiography (CCA. CIN (primary endpoint, as well as analytical, angiographic and clinical endpoints, were compared between groups. Results: Of the 235 patients enrolled, 116 patients received RCA and 119 patients received CCA. The RCA group was composed of older patients (64.0 ± 11.8 years vs. 59.7 ± 12.1 years; p = 0.006, a higher proportion of women (44.8 vs. 17.6%; p < 0.001, patients with a lower estimated glomerular filtration rate (76 ± 25 vs. 86 ± 27 ml/min/1.73 m2; p = 0.001, and patients who underwent fewer coronary angioplasties (p < 0.001 compared with the CCA group. Furthermore, the RCA group, received less contrast (113 ± 92 vs. 169 ± 103 ml; p < 0.001, including in diagnostic procedures (54 ± 24 vs. 85 ± 56 ml; p < 0.001 and diagnostic-therapeutic procedures (174 ± 64 vs. 205 ± 98 ml; p = 0.049 compared with the CCA group. The RCA group presented less CIN (4.3 vs. 22.7%; p < 0.001 compared to the CCA group, and this finding was maintained in the regression analysis (Adjusted relative risk: 0.868; 95% CI: 0.794–0.949; p = 0.002. There were no differences in clinical endpoints between the groups. Conclusions: RCA was associated

  5. Rotating Wavepackets

    Science.gov (United States)

    Lekner, John

    2008-01-01

    Any free-particle wavepacket solution of Schrodinger's equation can be converted by differentiations to wavepackets rotating about the original direction of motion. The angular momentum component along the motion associated with this rotation is an integral multiple of [h-bar]. It is an "intrinsic" angular momentum: independent of origin and…

  6. Rotating dryer

    International Nuclear Information System (INIS)

    Noe, C.

    1984-01-01

    Products to dry are introduced inside a rotating tube placed in an oven, the cross section of the tube is an arc of spiral. During clockwise rotation of the tube products are maintained inside and mixed, during anticlockwise products are removed. Application is made to drying of radioactive wastes [fr

  7. Subacromial triamcinolone acetonide, hyaluronic acid and saline injections for shoulder pain an RCT investigating the effectiveness in the first days.

    Science.gov (United States)

    Penning, Ludo I F; de Bie, Rob A; Walenkamp, Geert H I M

    2014-10-23

    Subacromial impingement is a common cause of shoulder complaints in general practice. When the initial treatment with acetaminophen and low dose Non Steroidal Anti Inflammatory Drugs fails, triamcinolone acetonide injections are commonly used. Triamcinolone acetonide injections are effective at four to six weeks. Little is known about the pain relief effect of triamcinolone acetonide injections in the first days after injection and the effect of repeated injection. In this study we investigate the effect of triamcinolone acetonide injections compared to hyaluronic acid and NaCl injections using a pain diary. 159 Patients recruited for an RCT comparing the effect of subacromial injections of triamcinolone acetonide, hyaluronic acid and sodium chloride (NaCl) were used in this study. They were blinded for their treatment and could receive up to three injections. Primary outcome consisted of the patient perceived pain on a VAS score recorded on a daily basis during 21 days following injection. Secondary outcome consisted of the amount of taken escape medication following injection and adverse effects. All patients received the first injection. 150 patients also received the second and third injections. 97% Of the paper and pencil pain diaries were returned for data analysis.The triamcinolone acetonide group showed the largest decrease in pain on the VAS scores after injection compared to the hyaluronic acid and NaCl group in the first week after injection. The reduction in pain was best achieved after the first injection, the second triamcinolone acetonide injection showed a further reduction in pain. The third triamcinolone acetonide injection only showed a slight improvement in pain reduction. In this study we could show a booster effect in pain reduction after repeated triamcinolone acetonide injection. The triamcinolone acetonide group showed a faster reduction in pain after injection compared to the hyaluronic acid and NaCl group. The effect was best seen after

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Cahoy, P M [Division of Orthopedic Surgery G5/358, University of Wisconsin Hospital and Clinics, Madison, WI (United States); Orwin, J F [Division of Orthopedic Surgery G5/358, University of Wisconsin Hospital and Clinics, Madison, WI (United States); Tuite, M J [Department of Radiology, University of Wisconsin Hospital and Clinics, Madison, WI (United States)

    1996-11-01

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

  10. Effectiveness of ultrasound-guided injections combined with shoulder exercises in the treatment of subacromial adhesive bursitis.

    Science.gov (United States)

    Gasparre, Giuseppe; Fusaro, Isabella; Galletti, Stefano; Volini, Silvia; Benedetti, Maria Grazia

    2012-05-01

    The aim of this study was to evaluate whether the association of exercises for the shoulder with ultrasound-guided injection into the bursa significantly improves the treatment outcome in adhesive bursitis. Two groups of 35 patients, one treated with ultrasound-guided injection (UGI) and the other one with ultrasound-guided injection and home exercise program (UGI-exercise) for 1 month, were assessed for pain and shoulder function before treatment, 1 and 3 months post-treatment. Fourteen patients in UGI group and 23 patients in the UGI-exercises group were completely free of pain after 1 month (p = 0.031). At 3 months' follow-up, patients in the UGI-exercise group showed a significant improvement with respect to the other group (p = 0.005). No differences were found in function assessment. The UGI combined with shoulder exercises in the treatment of subacromial adhesive bursitis is effective to ensure a more frequent complete pain relief in the medium term.

  11. Comparison of continuous interscalene block and subacromial infusion of local anesthetic for postoperative analgesia after open shoulder surgery.

    Science.gov (United States)

    Baskan, Semih; Cankaya, Deniz; Unal, Hidayet; Yoldas, Burak; Taspinar, Vildan; Deveci, Alper; Tabak, Yalcin; Baydar, Mustafa

    2017-01-01

    This study compared the efficacy of continuous interscalene block (CISB) and subacromial infusion of local anesthetic (CSIA) for postoperative analgesia after open shoulder surgery. This randomized, prospective, double-blinded, single-center study included 40 adult patients undergoing open shoulder surgery. All patients received a standardized general anesthetic. The patients were separated into group CISB and group CSIA. A loading dose of 40 mL 0.25% bupivacaine was administered and patient-controlled analgesia was applied by catheter with 0.1% bupivacaine 5 mL/h throughout 24 h basal infusion, 2 mL bolus dose, and 20 min knocked time in both groups postoperatively. Visual analog scale (VAS) scores, additional analgesia need, local anesthetic consumption, complications, and side effects were recorded during the first 24 h postoperatively. The range of motion (ROM) score was recorded preoperatively and in the first and third weeks postoperatively. A statistically significant difference was determined between the groups in respect of consumption of local anesthetic, VAS scores, additional analgesia consumption, complications, and side effects, with lower values recorded in the CISB group. There were no significant differences in ROM scoring in the preoperative and postoperative third week between the two groups but there were significant differences in ROM scoring in the postoperative first week, with higher ROM scoring values in the group CISB patients. The results of this study have shown that continuous interscalene infusion of bupivacaine is an effective and safe method of postoperative analgesia after open shoulder surgery.

  12. Rotating preventers

    International Nuclear Information System (INIS)

    Tangedahl, M.J.; Stone, C.R.

    1992-01-01

    This paper reports that recent changes in the oil and gas industry and ongoing developments in horizontal and underbalanced drilling necessitated development of a better rotating head. A new device called the rotating blowout preventer (RBOP) was developed by Seal-Tech. It is designed to replace the conventional rotating control head on top of BOP stacks and allows drilling operations to continue even on live (underbalanced) wells. Its low wear characteristics and high working pressure (1,500 psi) allow drilling rig crews to drill safely in slightly underbalanced conditions or handle severe well control problems during the time required to actuate other BOPs in the stack. Drilling with a RBOP allows wellbores to be completely closed in tat the drill floor rather than open as with conventional BOPs

  13. Earth Rotation

    Science.gov (United States)

    Dickey, Jean O.

    1995-01-01

    The study of the Earth's rotation in space (encompassing Universal Time (UT1), length of day, polar motion, and the phenomena of precession and nutation) addresses the complex nature of Earth orientation changes, the mechanisms of excitation of these changes and their geophysical implications in a broad variety of areas. In the absence of internal sources of energy or interactions with astronomical objects, the Earth would move as a rigid body with its various parts (the crust, mantle, inner and outer cores, atmosphere and oceans) rotating together at a constant fixed rate. In reality, the world is considerably more complicated, as is schematically illustrated. The rotation rate of the Earth's crust is not constant, but exhibits complicated fluctuations in speed amounting to several parts in 10(exp 8) [corresponding to a variation of several milliseconds (ms) in the Length Of the Day (LOD) and about one part in 10(exp 6) in the orientation of the rotation axis relative to the solid Earth's axis of figure (polar motion). These changes occur over a broad spectrum of time scales, ranging from hours to centuries and longer, reflecting the fact that they are produced by a wide variety of geophysical and astronomical processes. Geodetic observations of Earth rotation changes thus provide insights into the geophysical processes illustrated, which are often difficult to obtain by other means. In addition, these measurements are required for engineering purposes. Theoretical studies of Earth rotation variations are based on the application of Euler's dynamical equations to the problem of finding the response of slightly deformable solid Earth to variety of surface and internal stresses.

  14. Rilonacept in the treatment of subacromial bursitis: A randomized, non-inferiority, unblinded study versus triamcinolone acetonide.

    Science.gov (United States)

    Carroll, Matthew B; Motley, Spencer A; Wohlford, Susanna; Ramsey, Bryan C

    2015-12-01

    Subacromial bursitis is caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament and acromion. While multiple cytokines are implicated, interleukin-1 beta appears to play a prominent role. Rilonacept, an interleukin-1 trap, may be an alternative to corticosteroid injection for the management of this condition. This single center, randomized, non-inferiority, unblinded study recruited 33 subjects over 9 months. Twenty subjects received 160mg intrabursal injection of rilonacept and 13 received a 6mL mixture of lidocaine, bupivacaine, and 80mg triamcinolone acetonide. QuickDASH, subject reported pain, and adverse events were recorded at time of injection, 2 days later, 2 weeks later, and 4 weeks later. Primary outcome was improvement in QuickDASH 4 weeks post-injection. Secondary outcomes were improvement in subject reported pain and occurrence of adverse events at 4 weeks. Both study groups were equally matched for age, gender, ethnicity, and site of bursa injection. Both medications demonstrated a statistically significant improvement in QuickDASH 4 weeks post-injection, but triamcinolone acetonide injection offered greater improvement (P=0.004). Both medications demonstrated improvement in subject reported pain but between group comparison at 4 weeks showed that triamcinolone was superior (P=0.044). No statistically significant differences in adverse events were noted between groups, but subjects who received rilonacept experienced more episodes of diarrhea and headache. While improvement in QuickDASH and pain was noted with a single intrabursal injection of rilonacept at 4 weeks, injection with triamcinolone acetonide was more efficacious. This trial was registered with www.clinicaltrials.gov (NCT01830699). Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  15. The effectiveness of injections of hyaluronic acid or corticosteroid in patients with subacromial impingement: a three-arm randomised controlled trial.

    Science.gov (United States)

    Penning, L I F; de Bie, R A; Walenkamp, G H I M

    2012-09-01

    A total of 159 patients (84 women and 75 men, mean age of 53 (20 to 87)) with subacromial impingement were randomised to treatment with subacromial injections using lidocaine with one of hyaluronic acid (51 patients), corticosteroid (53 patients) or placebo (55 patients). Patients were followed up for 26 weeks. The primary outcome was pain on a visual analogue score (VAS), and secondary outcomes included the Constant Murley score, shoulder pain score, functional mobility score, shoulder disability questionnaire and pain-specific disability score. The different outcome measures showed similar results. After three, six and 12 weeks corticosteroid injections were superior to hyaluronic acid injections and only at six weeks significantly better than placebo injections. The mean short-term reduction in pain on the VAS score at 12 weeks was 7% (SD 2.7; 97.5% confidence interval (CI) 0.207 to 1.55; p = 0.084) in the hyaluronic acid group, 28% (SD 2.8; 97.5% CI 1.86 to 3.65; p hyaluronic acid group, 72% (38 of 53) of those in the corticosteroid group and 69% (38 of 55) of those in the placebo group. We were not able to show a convincing benefit from hyaluronic acid injections compared with corticosteroid or placebo injections. Corticosteroid injections produced a significant reduction in pain in the short term (three to 12 weeks), but in the long term the placebo injection produced the best results.

  16. Evaluation of the Trends, Concomitant Procedures, and Complications With Open and Arthroscopic Rotator Cuff Repairs in the Medicare Population

    Science.gov (United States)

    Jensen, Andrew R.; Cha, Peter S.; Devana, Sai K.; Ishmael, Chad; Di Pauli von Treuheim, Theo; D’Oro, Anthony; Wang, Jeffrey C.; McAllister, David R.; Petrigliano, Frank A.

    2017-01-01

    Background: Medicare insures the largest population of patients at risk for rotator cuff tears in the United States. Purpose: To evaluate the trends in incidence, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in Medicare patients. Study Design: Cohort study; Level of evidence, 3. Methods: All Medicare patients who had undergone open or arthroscopic rotator cuff repair from 2005 through 2011 were identified with a claims database. Annual incidence, concomitant procedures, and postoperative complications were compared between these 2 groups. Results: In total, 372,109 rotator cuff repairs were analyzed. The incidence of open repairs decreased (from 6.0 to 4.3 per 10,000 patients, P repairs increased (from 4.5 to 7.8 per 10,000 patients, P rotator cuff repairs have increased in incidence and now represent the majority of rotator cuff repair surgery. Among concomitant procedures, subacromial decompression was most commonly performed despite evidence suggesting a lack of efficacy. Infections and stiffness were rare complications that were slightly but significantly more frequent in open rotator cuff repairs. PMID:29051905

  17. [Contribution of echogradient magnetic resonance imaging in the study of subacromial diseases. Surgical and arthrographic correlations].

    Science.gov (United States)

    Touzard, R C; Pigeau, I; Doursounian, L; Maigne, J Y; Vadrot, D

    1991-01-01

    Fifteen asymptomatic volunteers and 300 patients with suspected lesions of the rotator cuff were examined with T2*- and proton density-weighted gradient echo (T2*-Rho-GEI) MRI sequences (500-700 ms/30 ms/30 degrees) with a 0.5 T (GE-CGR) system and an adapted surface coil. For the patients, the findings were compared with those of arthrography in 130 cases and of surgery in 42 cases. For the operated patients, T2*-Rho-GEI and arthrography allowed correctly diagnosing 31 complete ruptures (CR). However, surgical exploration of the ruptures showed that T2*-Rho-GEI showed the actual extent of the rupture and the degree of tendon retraction better than arthrography. T2*-Rho-GEI also provides information about the thickness and trophicity of the remaining cuff and on local muscle trophicity. T2*-Rho-GEI allows directly evaluating the tendon of the long head of the biceps both in its extra-articular and its intra-articular parts. In 3 cases of complete cuff rupture, MRI allowed detecting 3 associated lesions of the anterior labrum, which had not been suspected on the clinical examination and had not been demonstrated by conventional arthrography. Lastly, out of 12 cases of deep incomplete rupture (n = 12) correctly diagnosed with MRI, 5 had been undetected on arthrography. Similarly, 8 cases of inflammatory alterations suspected with T2*-Rho-GEI and confirmed by surgery had not been recognized with arthrography. For the non-operated patients, T2*-Rho-GEI and arthrography had corresponding results for the diagnosis of CR (8 cases), of DIR (6 cases) and of intact cuff (6 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  19. Prospective randomized study of arthroscopic rotator cuff repair using an early versus delayed postoperative physical therapy protocol.

    Science.gov (United States)

    Cuff, Derek J; Pupello, Derek R

    2012-11-01

    This study evaluated patient outcomes and rotator cuff healing after arthroscopic rotator cuff repair using a postoperative physical therapy protocol with early passive motion compared with a delayed protocol that limited early passive motion. The study enrolled 68 patients (average age, 63.2 years) who met inclusion criteria. All patients had a full-thickness crescent-shaped tear of the supraspinatus that was repaired using a transosseous equivalent suture-bridge technique along with subacromial decompression. In the early group, 33 patients were randomized to passive elevation and rotation that began at postoperative day 2. In the delayed group, 35 patients began the same protocol at 6 weeks. Patients were monitored clinically for a minimum of 12 months, and rotator cuff healing was assessed using ultrasound imaging. Both groups had similar improvements in preoperative to postoperative American Shoulder and Elbow Surgeons scores (early group: 43.9 to 91.9, P rotator cuff healing, or range of motion between the early and delayed groups. Patients in the early group and delayed group both demonstrated very similar outcomes and range of motion at 1 year. There was a slightly higher rotator cuff healing rate in the delayed passive range of motion group compared with the early passive range of motion group (91% vs 85%). Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  20. Rotator cuff disease – basics of diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Robert E. Boykin

    2010-03-01

    Full Text Available Rotator cuff (RTC disease is a particularly prevalent cause of shoulder pain and weakness presenting to primary care physicians, internists, rheumatologists, and orthopedists. An understanding of the anatomy of the RTC tendons and the underlying pathogenesis aids in the diagnosis, which is based largely on history and specific physical examination tests. Imaging may further define the pathology and aid in the evaluation of other sources of shoulder pain. Injuries to the RTC range from tendonitis to partial thickness tears to full thickness tears. The majority of patients with impingement and some cases of partial thickness tears may be managed effectively with non-operative measures including non-steroidal anti-inflammatory drugs, local injections, and physical therapy. Predictors of a good outcome with non-operative treatment include pre-injury strength, ability to raise the arm to the level of the shoulder, and a more acute presentation. Persistent symptoms may require operative intervention including debridement, subacromial decompression, and/or RTC repair. Acute full thickness tears in younger patients in addition to failed non-operative management of full thickness tears in older patients are the most likely to require surgery, which may be done open or arthroscopically. The majority of tears are amenable to the less invasive arthroscopic method, which yields good success rates and high patient satisfaction.

  1. ARTHROSCOPIC TREATMENT OF CALCIFYING TENDINITIS OF THE ROTATOR CUFF.

    Science.gov (United States)

    Neto, Arnaldo Amado Ferreira; Trevizani, Cassio Silva; Benegas, Eduardo; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emílio Conforto; Bitar, Alexandre Carneiro; Neto, Francisco José Dos Santos

    2010-01-01

    To evaluate the clinical and radiographic results from arthroscopic surgical treatment of the rotator cuff in patients with calcifying tendinitis. A retrospective study was conducted on twenty patients who underwent arthroscopic treatment for calcifying tendinitis of the shoulder between March 1999 and November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57%) were female and six (43%) were male. The right side was affected in 10 cases (71%) and the left in four cases (29%). Nine cases (64%) had calcification in the supraspinatus tendon, two (14%) in the infraspinatus tendon, and three (21%) in both tendons. In all cases, resection of the calcium deposits was performed by means of a needle (Jelco® No. 14) in combination with curettage (mini-curette). Two shoulders (14%) underwent subacromial decompression, and one (7%) underwent excision of the distal clavicle. A tendon-tendon suture was performed in three shoulders (21%). None of the patients underwent tendon-bone reinsertion. The mean score obtained on the UCLA scale was 33 points (26-35), thus indicating that a majority of patients had good results. In the final radiographic evaluation, none of the patients showed signs of calcification. Arthroscopic treatment of calcifying tendinitis of the shoulder safely allows excision of the calcification, leading to good results in relation to shoulder pain and function.

  2. Rotator cuff exercises

    Science.gov (United States)

    ... 25560729 . Read More Frozen shoulder Rotator cuff problems Rotator cuff repair Shoulder arthroscopy Shoulder CT scan Shoulder MRI scan Shoulder pain Patient Instructions Rotator cuff - self-care Shoulder surgery - discharge Using your ...

  3. Rotational motion in nuclei

    International Nuclear Information System (INIS)

    Bohr, A.

    1977-01-01

    History is surveyed of the development of the theory of rotational states in nuclei. The situation in the 40's when ideas formed of the collective states of a nucleus is evoked. The general rotation theory and the relation between the single-particle and rotational motion are briefly discussed. Future prospects of the rotation theory development are indicated. (I.W.)

  4. Rotational motion in nuclei

    International Nuclear Information System (INIS)

    Bohr, A.

    1976-01-01

    Nuclear structure theories are reviewed concerned with nuclei rotational motion. The development of the deformed nucleus model facilitated a discovery of rotational spectra of nuclei. Comprehensive verification of the rotational scheme and a successful classification of corresponding spectra stimulated investigations of the rotational movement dynamics. Values of nuclear moments of inertia proved to fall between two marginal values corresponding to rotation of a solid and hydrodynamic pattern of an unrotating flow, respectively. The discovery of governing role of the deformation and a degree of a symmetry violence for determining rotational degrees of freedon is pointed out to pave the way for generalization of the rotational spectra

  5. Rotationally invariant correlation filtering

    International Nuclear Information System (INIS)

    Schils, G.F.; Sweeney, D.W.

    1985-01-01

    A method is presented for analyzing and designing optical correlation filters that have tailored rotational invariance properties. The concept of a correlation of an image with a rotation of itself is introduced. A unified theory of rotation-invariant filtering is then formulated. The unified approach describes matched filters (with no rotation invariance) and circular-harmonic filters (with full rotation invariance) as special cases. The continuum of intermediate cases is described in terms of a cyclic convolution operation over angle. The angular filtering approach allows an exact choice for the continuous trade-off between loss of the correlation energy (or specificity regarding the image) and the amount of rotational invariance desired

  6. MRI of the rotator cuff and internal derangement

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

  7. MRI of the rotator cuff and internal derangement

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  8. Parameterization of rotational spectra

    International Nuclear Information System (INIS)

    Zhou Chunmei; Liu Tong

    1992-01-01

    The rotational spectra of the strongly deformed nuclei with low rotational frequencies and weak band mixture are analyzed. The strongly deformed nuclei are commonly encountered in the rare-earth region (e. g., 150 220). A lot of rotational band knowledge are presented

  9. Rotating reactors : a review

    NARCIS (Netherlands)

    Visscher, F.; Schaaf, van der J.; Nijhuis, T.A.; Schouten, J.C.

    2013-01-01

    This review-perspective paper describes the current state-of-the-art in the field of rotating reactors. The paper has a focus on rotating reactor technology with applications at lab scale, pilot scale and industrial scale. Rotating reactors are classified and discussed according to their geometry:

  10. Serotonin syndrome

    Science.gov (United States)

    Hyperserotonemia; Serotonergic syndrome; Serotonin toxicity; SSRI - serotonin syndrome; MAO - serotonin syndrome ... brain area. For example, you can develop this syndrome if you take migraine medicines called triptans together ...

  11. Musculoskeletal ultrasound: how to treat calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique.

    Science.gov (United States)

    Lee, Kenneth S; Rosas, Humberto G

    2010-09-01

    The purpose of this video article is to illustrate the ultrasound appearance of calcium deposition in the rotator cuff and provide a detailed step-by-step protocol for performing the ultrasound-guided single-needle lavage technique for the treatment of calcific tendinitis with emphasis on patient positioning, necessary supplies, real-time lavage technique, and steroid injection into the subacromial subdeltoid bursa. Musculoskeletal ultrasound is well established as a safe, cost-effective imaging tool in diagnosing and treating common musculoskeletal disorders. Calcific tendinitis of the rotator cuff is a common disabling cause of shoulder pain. Although most cases are self-limiting, a subset of patients is refractory to conservative therapy and requires treatment intervention. Ultrasound-guided lavage is an effective and safe minimally-invasive treatment not readily offered in the United States as an alternative to surgery, perhaps because of the limited prevalence of musculoskeletal ultrasound programs and limited training. On completion of this video article, the participant should be able to develop an appropriate diagnostic and therapeutic algorithm for the treatment of calcific tendinitis of the rotator cuff using ultrasound.

  12. Rotating Stars in Relativity

    Directory of Open Access Journals (Sweden)

    Stergioulas Nikolaos

    2003-01-01

    Full Text Available Rotating relativistic stars have been studied extensively in recent years, both theoretically and observationally, because of the information they might yield about the equation of state of matter at extremely high densities and because they are considered to be promising sources of gravitational waves. The latest theoretical understanding of rotating stars in relativity is reviewed in this updated article. The sections on the equilibrium properties and on the nonaxisymmetric instabilities in f-modes and r-modes have been updated and several new sections have been added on analytic solutions for the exterior spacetime, rotating stars in LMXBs, rotating strange stars, and on rotating stars in numerical relativity.

  13. No difference in outcome for open versus arthroscopic rotator cuff repair: a prospective comparative trial.

    Science.gov (United States)

    Bayle, Xavier; Pham, Thuy-Trang; Faruch, Marie; Gobet, Aurelie; Mansat, Pierre; Bonnevialle, Nicolas

    2017-12-01

    Arthroscopic techniques tend to become the gold standard in rotator cuff repair. However, little data are reported in the literature regarding the improvement of postoperative outcomes and re-tear rate relative to conventional open surgery. The aim of this study was to compare clinical outcomes and cuff integrity after arthroscopic versus open cuff repair. We prospectively assessed clinical outcomes and cuff integrity after an arthroscopic or open rotator cuff repair with a minimum follow-up of 12 months. Clinical evaluation was based on Constant score, Simple Shoulder Value (SSV) and American Shoulder and Elbow Score (ASES). Rotator cuff healing was explored with ultrasound. 44 patients in arthroscopic group A (mean age 56-year-old) and 43 in open group O (mean age 61-year-old) fulfilled the inclusion criteria. Tendons were repaired with a single row technique associated with biceps tenodesis and subacromial decompression. All objective clinical scores significantly improved postoperatively in both groups. No statistical difference was identified between group A and O regarding, respectively, Constant score (72 vs 75 points; p = 0.3), ASES score (88 vs 91 points; p = 0.3), and SSV (81 vs 85%). The overall rate of re-tear (Sugaya type IV or V) reached 7 and 9%, respectively, in group A and O (p = 0.8). This study did not prove any difference of arthroscopic over open surgery in case of rotator cuff repair regarding clinical outcome and cuff integrity at 1-year follow-up. Prospective comparative study.

  14. Selective activation of intra-muscular compartments within the trapezius muscle in subjects with Subacromial Impingement Syndrome. A case-control study

    DEFF Research Database (Denmark)

    Larsen, C M; Juul-Kristensen, B; Olsen, H B

    2014-01-01

    Neuromuscular control of the scapular muscles is important in the etiology of shoulder pain. Electromyographical (EMG) biofeedback in healthy people has been shown to support a selective activation of the lower compartment of the trapezius muscle, specifically. The aim of the present paper was to...

  15. On Averaging Rotations

    DEFF Research Database (Denmark)

    Gramkow, Claus

    1999-01-01

    In this article two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very offten the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belo...... approximations to the Riemannian metric, and that the subsequent corrections are inherient in the least squares estimation. Keywords: averaging rotations, Riemannian metric, matrix, quaternion......In this article two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very offten the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong...

  16. Failed healing of rotator cuff repair correlates with altered collagenase and gelatinase in supraspinatus and subscapularis tendons.

    Science.gov (United States)

    Robertson, Catherine M; Chen, Christopher T; Shindle, Michael K; Cordasco, Frank A; Rodeo, Scott A; Warren, Russell F

    2012-09-01

    Despite improvements in arthroscopic rotator cuff repair technique and technology, a significant rate of failed tendon healing persists. Improving the biology of rotator cuff repairs may be an important focus to decrease this failure rate. The objective of this study was to determine the mRNA biomarkers and histological characteristics of repaired rotator cuffs that healed or developed persistent defects as determined by postoperative ultrasound. Increased synovial inflammation and tendon degeneration at the time of surgery are correlated with the failed healing of rotator cuff tendons. Case-control study; Level of evidence, 3. Biopsy specimens from the subscapularis tendon, supraspinatus tendon, glenohumeral synovium, and subacromial bursa of 35 patients undergoing arthroscopic rotator cuff repair were taken at the time of surgery. Expression of proinflammatory cytokines, tissue remodeling genes, and angiogenesis factors was evaluated by quantitative real-time polymerase chain reaction. Histological characteristics of the affected tissue were also assessed. Postoperative (>6 months) ultrasound was used to evaluate the healing of the rotator cuff. General linear modeling with selected mRNA biomarkers was used to predict rotator cuff healing. Thirty patients completed all analyses, of which 7 patients (23%) had failed healing of the rotator cuff. No differences in demographic data were found between the defect and healed groups. American Shoulder and Elbow Surgeons shoulder scores collected at baseline and follow-up showed improvement in both groups, but there was no significant difference between groups. Increased expression of matrix metalloproteinase 1 (MMP-1) and MMP-9 was found in the supraspinatus tendon in the defect group versus the healed group (P = .006 and .02, respectively). Similar upregulation of MMP-9 was also found in the subscapularis tendon of the defect group (P = .001), which was consistent with the loss of collagen organization as determined by

  17. Beals Syndrome

    Science.gov (United States)

    ... the syndrome. How does Beals syndrome compare with Marfan syndrome? People with Beals syndrome have many of the ... bone) and aortic enlargement problems as people with Marfan syndrome, and treatments for these problems are the same. ...

  18. Rotations with Rodrigues' vector

    International Nuclear Information System (INIS)

    Pina, E

    2011-01-01

    The rotational dynamics was studied from the point of view of Rodrigues' vector. This vector is defined here by its connection with other forms of parametrization of the rotation matrix. The rotation matrix was expressed in terms of this vector. The angular velocity was computed using the components of Rodrigues' vector as coordinates. It appears to be a fundamental matrix that is used to express the components of the angular velocity, the rotation matrix and the angular momentum vector. The Hamiltonian formalism of rotational dynamics in terms of this vector uses the same matrix. The quantization of the rotational dynamics is performed with simple rules if one uses Rodrigues' vector and similar formal expressions for the quantum operators that mimic the Hamiltonian classical dynamics.

  19. On Averaging Rotations

    DEFF Research Database (Denmark)

    Gramkow, Claus

    2001-01-01

    In this paper two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very often the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong ...... approximations to the Riemannian metric, and that the subsequent corrections are inherent in the least squares estimation.......In this paper two common approaches to averaging rotations are compared to a more advanced approach based on a Riemannian metric. Very often the barycenter of the quaternions or matrices that represent the rotations are used as an estimate of the mean. These methods neglect that rotations belong...

  20. The prevalence of neovascularity in patients clinically diagnosed with rotator cuff tendinopathy

    Directory of Open Access Journals (Sweden)

    Raza Syed A

    2009-12-01

    Full Text Available Abstract Background Shoulder dysfunction is common and pathology of the rotator cuff tendons and subacromial bursa are considered to be a major cause of pain and morbidity. Although many hypotheses exist there is no definitive understanding as to the origin of the pain arising from these structures. Research investigations from other tendons have placed intra-tendinous neovascularity as a potential mechanism of pain production. The prevalence of neovascularity in patients with a clinical diagnosis of rotator cuff tendinopathy is unknown. As such the primary aim of this pilot study was to investigate if neovascularity could be identified and to determine the prevalence of neovascularity in the rotator cuff tendons and subacromial bursa in subjects with unilateral shoulder pain clinically assessed to be rotator cuff tendinopathy. The secondary aims were to investigate the association between the presence of neovascularity and pain, duration of symptoms, and, neovascularity and shoulder function. Methods Patients with a clinical diagnosis of unilateral rotator cuff tendinopathy referred for a routine diagnostic ultrasound (US scan in a major London teaching hospital formed the study population. At referral patients were provided with an information document. On the day of the scan (on average, at least one week later the patients agreeing to participate were taken through the consent process and underwent an additional clinical examination prior to undergoing a bilateral grey scale and colour Doppler US examination (symptomatic and asymptomatic shoulder using a Philips HDI 5000 Sono CT US machine. The ultrasound scans were performed by one of two radiologists who recorded their findings and the final assessment was made by a third radiologist blinded both to the clinical examination and the ultrasound examination. The findings of the radiologists who performed the scans and the blinded radiologist were compared and any disagreements were resolved

  1. Deltoid muscular flap transfer for the treatment of irreparable rotator cuff tears

    Directory of Open Access Journals (Sweden)

    Justus Gille

    2009-09-01

    Full Text Available The purpose of this study was to evaluate the outcome of deltoid muscle flap transfer for the treatment of irreparable rotator cuff tears. In a retrospective study 20 consecutive patients were evaluated. The index procedure took place between 2000 and 2003. Fifteen patients were male, mean age was 62 years. Inclusion criterion was a rotator cuff defect Bateman grade IV. Exclusion criteria were smaller defects, shoulder instability and fractures of the injured shoulder. An open reconstruction with acromioplasty and a pedicled delta flap was performed. Follow up period was mean 42 months. Follow-up included clinical examination, Magnetic Resonance Imaging (MRI and the Constant and Simple (CS shoulder tests. According to the Constant shoulder test the results were good in 13 patients, fair in 5 and unsatisfactory in 2. The pre-operative Constant Score improved from mean 25.7 points (±5.3 to 72.3 (±7.8 at follow-up. The mean values for the subcategories of CS increased significantly from 3.9 to 14.4 points for pain and from 4.2 to 15.9 points for activities daily routine (p0.05. Results of the Simple Shoulder Test showed a significant increase of the mean values from pre-operative 4.3 to 14.7 points post-operatively. MRI showed a subacromial covering of the defect in all cases, all flaps where intact on MRI but always the flap showed marked fatty degeneration. In conclusion, the delta flap is a simple method for the repair of large defects of the rotator cuff leading to satisfying medium results.

  2. Asteroid rotation rates

    International Nuclear Information System (INIS)

    Binzel, R.P.; Farinella, P.

    1989-01-01

    Within the last decade the data base of asteroid rotation parameters (rotation rates and lightcurve amplitudes) has become sufficiently large to identify some definite rends and properties which can help us to interpret asteroid collisional evolution. Many significant correlations are found between rotation parameters and diameter, with distinct changes occurring near 125 km. The size range, which is also the diameter above which self-gravity may become important, perhaps represents a division between surviving primordial asteroids and collisional fragments. A Maxwellian is able to fit the observed rotation rate distributions of asteroids with D>125 km, implying that their rotation rates may be determined by collisional evolution. Asteroids with D<125 km show an excess of slow rotators and their non-Maxwellian distributions suggests that their rotation rates are more strongly influenced by other processes, such as the distribution resulting from their formation in catastrophic disruption events. Other correlations observed in the data set include different mean rotation rates for C, S and M type asteroids implying that their surface spectra are indicative of bulk properties

  3. The spatial rotator

    DEFF Research Database (Denmark)

    Rasmusson, Allan; Hahn, Ute; Larsen, Jytte Overgaard

    2013-01-01

    This paper presents a new local volume estimator, the spatial rotator, which is based on measurements on a virtual 3D probe, using computer assisted microscopy. The basic design of the probe builds upon the rotator principle which requires only a few manual intersection markings, thus making...

  4. Superconducting rotating machines

    International Nuclear Information System (INIS)

    Smith, J.L. Jr.; Kirtley, J.L. Jr.; Thullen, P.

    1975-01-01

    The opportunities and limitations of the applications of superconductors in rotating electric machines are given. The relevant properties of superconductors and the fundamental requirements for rotating electric machines are discussed. The current state-of-the-art of superconducting machines is reviewed. Key problems, future developments and the long range potential of superconducting machines are assessed

  5. Fundamental Relativistic Rotator

    International Nuclear Information System (INIS)

    Staruszkiewicz, A.

    2008-01-01

    Professor Jan Weyssenhoff was Myron Mathisson's sponsor and collaborator. He introduced a class of objects known in Cracow as '' kreciolki Weyssenhoffa '', '' Weyssenhoff's rotating little beasts ''. The Author describes a particularly simple object from this class. The relativistic rotator described in the paper is such that its both Casimir invariants are parameters rather than constants of motion. (author)

  6. SMAP Faraday Rotation

    Science.gov (United States)

    Le Vine, David

    2016-01-01

    Faraday rotation is a change in the polarization as signal propagates through the ionosphere. At L-band it is necessary to correct for this change and measurements are made on the spacecraft of the rotation angle. These figures show that there is good agreement between the SMAP measurements (blue) and predictions based on models (red).

  7. Units of rotational information

    Science.gov (United States)

    Yang, Yuxiang; Chiribella, Giulio; Hu, Qinheping

    2017-12-01

    Entanglement in angular momentum degrees of freedom is a precious resource for quantum metrology and control. Here we study the conversions of this resource, focusing on Bell pairs of spin-J particles, where one particle is used to probe unknown rotations and the other particle is used as reference. When a large number of pairs are given, we show that every rotated spin-J Bell state can be reversibly converted into an equivalent number of rotated spin one-half Bell states, at a rate determined by the quantum Fisher information. This result provides the foundation for the definition of an elementary unit of information about rotations in space, which we call the Cartesian refbit. In the finite copy scenario, we design machines that approximately break down Bell states of higher spins into Cartesian refbits, as well as machines that approximately implement the inverse process. In addition, we establish a quantitative link between the conversion of Bell states and the simulation of unitary gates, showing that the fidelity of probabilistic state conversion provides upper and lower bounds on the fidelity of deterministic gate simulation. The result holds not only for rotation gates, but also to all sets of gates that form finite-dimensional representations of compact groups. For rotation gates, we show how rotations on a system of given spin can simulate rotations on a system of different spin.

  8. MR patterns of rotator cuff impingement lesions and histopathologic correlation of cadaver tendons

    International Nuclear Information System (INIS)

    Rafii, M.; Firooznia, H.; Minkoff, J.; Sherman, O.; Schinella, R.; Weinreb, J.C.; Golimbu, C.; Zazlav, K.

    1989-01-01

    This paper reports shoulder MR examinations of 250 patients retrospectively evaluated and correlated with surgical/arthrographic results in 68 patients and with clinical data in all for assessment of the signal pattern and the configuration of rotator cuff lesions. MR-histopathologic evaluation of the supraspinatus tendon of 8 cadaver shoulders was also correlated with these findings. MR imaging had a sensitivity of 92% in the diagnosis of cuff tears. The most common and accurate criterion for a tear was a tendinous defect, characterized by intense signal on T2-weighted images; less often the torn region consisted of an extremely degenerated and attenuated tendon or was obscured by scar. Presence of secondary findings was mandatory for diagnosis in the latter group. Signal pattern associated with tendonitis varied, and in some simulated that of tendon degeneration (fatty infiltration and fibrillation) or cellular proliferation observed on anatomic specimens. Associated tendinous enlargement and subacromial-subdeltoid bursitis in these patients best correlated with the severity of clinical and surgical findings

  9. Manual therapy and exercise for rotator cuff disease.

    Science.gov (United States)

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

    2016-06-10

    43 trials. We were unable to perform any meta-analyses because of clinical heterogeneity or incomplete outcome reporting. One trial compared manual therapy and exercise with placebo (inactive ultrasound therapy) in 120 participants with chronic rotator cuff disease (high quality evidence). At 22 weeks, the mean change in overall pain with placebo was 17.3 points on a 100-point scale, and 24.8 points with manual therapy and exercise (adjusted mean difference (MD) 6.8 points, 95% confidence interval (CI) -0.70 to 14.30 points; absolute risk difference 7%, 1% fewer to 14% more). Mean change in function with placebo was 15.6 points on a 100-point scale, and 22.4 points with manual therapy and exercise (adjusted MD 7.1 points, 95% CI 0.30 to 13.90 points; absolute risk difference 7%, 1% to 14% more). Fifty-seven per cent (31/54) of participants reported treatment success with manual therapy and exercise compared with 41% (24/58) of participants receiving placebo (risk ratio (RR) 1.39, 95% CI 0.94 to 2.03; absolute risk difference 16% (2% fewer to 34% more). Thirty-one per cent (17/55) of participants reported adverse events with manual therapy and exercise compared with 8% (5/61) of participants receiving placebo (RR 3.77, 95% CI 1.49 to 9.54; absolute risk difference 23% (9% to 37% more). However adverse events were mild (short-term pain following treatment).Five trials (low quality evidence) found no important differences between manual therapy and exercise compared with glucocorticoid injection with respect to overall pain, function, active shoulder abduction and quality of life from four weeks up to 12 months. However, global treatment success was more common up to 11 weeks in people receiving glucocorticoid injection (low quality evidence). One trial (low quality evidence) showed no important differences between manual therapy and exercise and arthroscopic subacromial decompression with respect to overall pain, function, active range of motion and strength at six and

  10. The rotating universe

    International Nuclear Information System (INIS)

    Ruben, G.; Treder, H.J.

    1987-01-01

    For a long time the question whether the universe rotates or not is discussed. Aspects of Huygens, Newton, Mach and other important historical scientists in this field are reported. The investigations of the mathematician Kurt Groedel in order to prove the rotation of the universe are illustrated. Kurt Groedel has shown that Einstein's gravitational equations of general relativity theory and the cosmological postulate of global homogeneity of cosmic matter (that is the Copernical principle) are not contradictionary to a rotating universe. Abberation measurements, position determination by means of radiointerferometry and methods for the determination of the rotation of the universe from the isotropy of the background radiation are presented. From these experiments it can be concluded that the universe seems not to rotate as already Einstein expected

  11. Rotation sensor switch

    International Nuclear Information System (INIS)

    Sevec, J.B.

    1978-01-01

    A protective device to provide a warning if a piece of rotating machinery slows or stops is comprised of a pair of hinged weights disposed to rotate on a rotating shaft of the equipment. When the equipment is rotating, the weights remain in a plane essentially perpendicular to the shaft and constitute part of an electrical circuit that is open. When the shaft slows or stops, the weights are attracted to a pair of concentric electrically conducting disks disposed in a plane perpendicular to the shaft and parallel to the plane of the weights when rotating. A disk magnet attracts the weights to the electrically conducting plates and maintains the electrical contact at the plates to complete an electrical circuit that can then provide an alarm signal

  12. Rotating stars in relativity.

    Science.gov (United States)

    Paschalidis, Vasileios; Stergioulas, Nikolaos

    2017-01-01

    Rotating relativistic stars have been studied extensively in recent years, both theoretically and observationally, because of the information they might yield about the equation of state of matter at extremely high densities and because they are considered to be promising sources of gravitational waves. The latest theoretical understanding of rotating stars in relativity is reviewed in this updated article. The sections on equilibrium properties and on nonaxisymmetric oscillations and instabilities in f -modes and r -modes have been updated. Several new sections have been added on equilibria in modified theories of gravity, approximate universal relationships, the one-arm spiral instability, on analytic solutions for the exterior spacetime, rotating stars in LMXBs, rotating strange stars, and on rotating stars in numerical relativity including both hydrodynamic and magnetohydrodynamic studies of these objects.

  13. Cushing syndrome

    Science.gov (United States)

    Hypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndrome ... The most common cause of Cushing syndrome is taking too much ... Cushing syndrome . Prednisone, dexamethasone, and prednisolone ...

  14. LEOPARD syndrome

    Science.gov (United States)

    Multiple lentigines syndrome; Noonan syndrome with multiple lentigines ... Genetics Home Reference -- ghr.nlm.nih.gov/condition/noonan-syndrome-with-multiple-lentigines National Organization for Rare Disorders -- ...

  15. The effect of coracoacromial ligament excision and acromioplasty on the amount of rotator cuff force production necessary to restore intact glenohumeral biomechanics.

    Science.gov (United States)

    Budoff, Jeffrey E; Lin, Cheng-Li; Hong, Chih-Kai; Chiang, Florence L; Su, Wei-Ren

    2016-06-01

    Coracoacromial ligament (CAL) excision and acromioplasty increase superior and anterosuperior glenohumeral translation. It is unknown how much of an increase in rotator cuff force production is required to re-establish intact glenohumeral biomechanics after these surgical procedures. We hypothesized that, after CAL excision and acromioplasty, an increase in rotator cuff force production would not be necessary to reproduce the anterosuperior and superior translations of the intact specimens. Nine cadaveric shoulders were subjected to loading in the superior and anterosuperior directions in the intact state after CAL excision, acromioplasty, and recording of the translations. The rotator cuff force was then increased to normalize glenohumeral biomechanics. After CAL excision at 150 and 200 N of loading, an increase in the rotator cuff force by 25% decreased anterosuperior translation to the point where there was no significant difference from the intact specimen's translation. After acromioplasty (and CAL excision) at 150 and 200 N, an increase in the rotator cuff force of 25% and 30%, respectively, decreased superior translation to the point where there was no significant difference from the intact specimen's translation. At 150 to 200 N of loading, CAL excision and acromioplasty increase the rotator cuff force required to maintain normal glenohumeral biomechanics by 25% to 30%. After a subacromial decompression, the rotator cuff has an increased force production requirement to maintain baseline glenohumeral mechanics. Under many circumstances, in vivo force requirements may be even greater after surgical attenuation of the coracoacromial arch. Basic Science Study; Biomechanics. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Rotation, Stability and Transport

    Energy Technology Data Exchange (ETDEWEB)

    Connor, J. W.

    2007-07-01

    Tokamak plasmas can frequently exhibit high levels of rotation and rotation shear. This can usually be attributed to various sources: injection of momentum, e.g. through neutral beams, flows driven by plasma gradients or torques resulting from non-ambipolar particle loss; however, the source sometimes remains a mystery, such as the spontaneous rotation observed in Ohmic plasmas. The equilibrium rotation profile is given by the balance of these sources with transport and other losses; the edge boundary conditions can play an important role in determining this profile . Such plasma rotation, particularly sheared rotation, is predicted theoretically to have a significant influence on plasma behaviour. In the first place, sonic flows can significantly affect tokamak equilibria and neoclassical transport losses. However, the influence of rotation on plasma stability and turbulence is more profound. At the macroscopic level it affects the behaviour of the gross MHD modes that influence plasma operational limits. This includes sawteeth, the seeding of neoclassical tearing modes, resistive wall modes and the onset of disruptions through error fields, mode locking and reconnection. At the microscopic level it has a major effect on the stability of ballooning modes, both ideal MHD and drift wave instabilities such as ion temperature gradient (ITG) modes. In the non-linear state, as unstable drift waves evolve into turbulent structures, sheared rotation also tears apart eddies, thereby reducing the resulting transport. There is considerable experimental evidence for these effects on both MHD stability and plasma confinement. In particular, the appearance of improved confinement modes with transport barriers, such as edge H-mode barriers and internal transport barriers (ITBs) appears to correlate well with the presence of sheared plasma rotation. This talk will describe the theory underlying some of these phenomena involving plasma rotation, on both macroscopic and microscopic

  17. On Job Rotation

    OpenAIRE

    Metin M. Cosgel; Thomas J. Miceli

    1998-01-01

    A fundamental principle of economics with which Adam Smith begins The Wealth of Nations is the division of labor. Some firms, however, have been pursuing a practice called job rotation, which assigns each worker not to a single and specific task but to a set of several tasks among which he or she rotates with some frequency. We examine the practice of job rotation as a serious alternative to specialization, with three objectives. The first is to consider current and historical examples of job...

  18. Rotator cuff - self-care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000358.htm Rotator cuff - self-care To use the sharing features on ... and shoulder exercises may help ease your symptoms. Rotator Cuff Problems Common rotator cuff problems include: Tendinitis , which ...

  19. Fanconi syndrome

    Science.gov (United States)

    De Toni-Fanconi syndrome ... Fanconi syndrome can be caused by faulty genes, or it may result later in life due to kidney damage. Sometimes the cause of Fanconi syndrome is unknown. Common causes of Fanconi syndrome in ...

  20. Duane Syndrome

    Science.gov (United States)

    ... Frequently Asked Questions Español Condiciones Chinese Conditions Duane Syndrome En Español Read in Chinese What is Duane Syndrome? Duane syndrome, also called Duane retraction syndrome (DRS), ...

  1. Rotating universe models

    International Nuclear Information System (INIS)

    Tozini, A.V.

    1984-01-01

    A review is made of some properties of the rotating Universe models. Godel's model is identified as a generalized filted model. Some properties of new solutions of the Einstein's equations, which are rotating non-stationary Universe models, are presented and analyzed. These models have the Godel's model as a particular case. Non-stationary cosmological models are found which are a generalization of the Godel's metrics in an analogous way in which Friedmann is to the Einstein's model. (L.C.) [pt

  2. Rotation Invariance Neural Network

    OpenAIRE

    Li, Shiyuan

    2017-01-01

    Rotation invariance and translation invariance have great values in image recognition tasks. In this paper, we bring a new architecture in convolutional neural network (CNN) named cyclic convolutional layer to achieve rotation invariance in 2-D symbol recognition. We can also get the position and orientation of the 2-D symbol by the network to achieve detection purpose for multiple non-overlap target. Last but not least, this architecture can achieve one-shot learning in some cases using thos...

  3. Hamartomatous polyposis syndromes

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie; Qvist, Niels; Brusgaard, Klaus

    2014-01-01

    Hamartomatous Polyposis Syndromes (HPS) are genetic syndromes, which include Peutz-Jeghers syndrome, Juvenile polyposis syndrome, PTEN hamartoma tumour syndrome (Cowden Syndrom, Bannayan-Riley-Ruvalcaba and Proteus Syndrome) as well as hereditary mixed polyposis syndrome. Other syndromes such as ......Hamartomatous Polyposis Syndromes (HPS) are genetic syndromes, which include Peutz-Jeghers syndrome, Juvenile polyposis syndrome, PTEN hamartoma tumour syndrome (Cowden Syndrom, Bannayan-Riley-Ruvalcaba and Proteus Syndrome) as well as hereditary mixed polyposis syndrome. Other syndromes...

  4. Diagnostic imaging of shoulder rotator cuff lesions

    Directory of Open Access Journals (Sweden)

    Nogueira-Barbosa Marcello Henrique

    2002-01-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  7. Comorbidities in rotator cuff disease: a case-control study.

    Science.gov (United States)

    Titchener, Andrew G; White, Jonathan J E; Hinchliffe, Sally R; Tambe, Amol A; Hubbard, Richard B; Clark, David I

    2014-09-01

    Rotator cuff disease is a common condition in the general population, but relatively little is known about its associated risk factors. We have undertaken a large case-control study using The Health Improvement Network database to assess and to quantify the relative contributions of some constitutional and environmental risk factors for rotator cuff disease in the community. Our data set included 5000 patients with rotator cuff disease who were individually matched with a single control by age, sex, and general practice (primary care practice). The median age at diagnosis was 55 years (interquartile range, 44-65 years). Multivariate analysis showed that the risk factors associated with rotator cuff disease were Achilles tendinitis (odds ratio [OR] = 1.78), trigger finger (OR = 1.99), lateral epicondylitis (OR = 1.71), and carpal tunnel syndrome (OR = 1.55). Oral corticosteroid therapy (OR = 2.03), oral antidiabetic use (OR = 1.66), insulin use (OR = 1.77), and "overweight" body mass index of 25.1 to 30 (OR = 1.15) were also significantly associated. Current or previous smoking history, body mass index of greater than 30, any alcohol intake, medial epicondylitis, de Quervain syndrome, cubital tunnel syndrome, and rheumatoid arthritis were not found to be associated with rotator cuff disease. We have identified a number of comorbidities and risk factors for rotator cuff disease. These include lateral epicondylitis, carpal tunnel syndrome, trigger finger, Achilles tendinitis, oral corticosteroid use, and diabetes mellitus. The findings should alert the clinician to comorbid pathologic processes and guide future research into the etiology of this condition. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  8. Rotating positron tomographs revisited

    International Nuclear Information System (INIS)

    Townsend, D.; Defrise, M.; Geissbuhler, A.

    1994-01-01

    We have compared the performance of a PET scanner comprising two rotating arrays of detectors with that of the more conventional stationary-ring design. The same total number of detectors was used in each, and neither scanner had septa. For brain imaging, we find that the noise-equivalent count rate is greater for the rotating arrays by a factor of two. Rotating arrays have a sensitivity profile that peaks in the centre of the field of view, both axially and transaxially. In the transaxial plane, this effect offsets to a certain extent the decrease in the number of photons detected towards the centre of the brain due to self-absorption. We have also compared the performance of a rotating scanner to that of a full-ring scanner with the same number of rings. We find that a full-ring scanner with an axial extent of 16.2 cm (24 rings) is a factor of 3.5 more sensitive than a rotating scanner with 40% of the detectors and the same axial extent. (Author)

  9. Jacobsen syndrome

    Directory of Open Access Journals (Sweden)

    Grossfeld Paul

    2009-03-01

    Full Text Available Abstract Jacobsen syndrome is a MCA/MR contiguous gene syndrome caused by partial deletion of the long arm of chromosome 11. To date, over 200 cases have been reported. The prevalence has been estimated at 1/100,000 births, with a female/male ratio 2:1. The most common clinical features include pre- and postnatal physical growth retardation, psychomotor retardation, and characteristic facial dysmorphism (skull deformities, hypertelorism, ptosis, coloboma, downslanting palpebral fissures, epicanthal folds, broad nasal bridge, short nose, v-shaped mouth, small ears, low set posteriorly rotated ears. Abnormal platelet function, thrombocytopenia or pancytopenia are usually present at birth. Patients commonly have malformations of the heart, kidney, gastrointestinal tract, genitalia, central nervous system and skeleton. Ocular, hearing, immunological and hormonal problems may be also present. The deletion size ranges from ~7 to 20 Mb, with the proximal breakpoint within or telomeric to subband 11q23.3 and the deletion extending usually to the telomere. The deletion is de novo in 85% of reported cases, and in 15% of cases it results from an unbalanced segregation of a familial balanced translocation or from other chromosome rearrangements. In a minority of cases the breakpoint is at the FRA11B fragile site. Diagnosis is based on clinical findings (intellectual deficit, facial dysmorphic features and thrombocytopenia and confirmed by cytogenetics analysis. Differential diagnoses include Turner and Noonan syndromes, and acquired thrombocytopenia due to sepsis. Prenatal diagnosis of 11q deletion is possible by amniocentesis or chorionic villus sampling and cytogenetic analysis. Management is multi-disciplinary and requires evaluation by general pediatrician, pediatric cardiologist, neurologist, ophthalmologist. Auditory tests, blood tests, endocrine and immunological assessment and follow-up should be offered to all patients. Cardiac malformations can be

  10. The optical rotator

    DEFF Research Database (Denmark)

    Tandrup, T; Gundersen, Hans Jørgen Gottlieb; Jensen, Eva B. Vedel

    1997-01-01

    further discuss the methods derived from this principle and present two new local volume estimators. The optical rotator benefits from information obtained in all three dimensions in thick sections but avoids over-/ underprojection problems at the extremes of the cell. Using computer-assisted microscopes......The optical rotator is an unbiased, local stereological principle for estimation of cell volume and cell surface area in thick, transparent slabs, The underlying principle was first described in 1993 by Kieu Jensen (T. Microsc. 170, 45-51) who also derived an estimator of length, In this study we...... the extra measurements demand minimal extra effort and make this estimator even more efficient when it comes to estimation of individual cell size than many of the previous local estimators, We demonstrate the principle of the optical rotator in an example (the cells in the dorsal root ganglion of the rat...

  11. Vibrations of rotating machinery

    CERN Document Server

    Matsushita, Osami; Kanki, Hiroshi; Kobayashi, Masao; Keogh, Patrick

    2017-01-01

    This book opens with an explanation of the vibrations of a single degree-of-freedom (dof) system for all beginners. Subsequently, vibration analysis of multi-dof systems is explained by modal analysis. Mode synthesis modeling is then introduced for system reduction, which aids understanding in a simplified manner of how complicated rotors behave. Rotor balancing techniques are offered for rigid and flexible rotors through several examples. Consideration of gyroscopic influences on the rotordynamics is then provided and vibration evaluation of a rotor-bearing system is emphasized in terms of forward and backward whirl rotor motions through eigenvalue (natural frequency and damping ratio) analysis. In addition to these rotordynamics concerning rotating shaft vibration measured in a stationary reference frame, blade vibrations are analyzed with Coriolis forces expressed in a rotating reference frame. Other phenomena that may be assessed in stationary and rotating reference frames include stability characteristic...

  12. Rotating quantum states

    International Nuclear Information System (INIS)

    Ambruş, Victor E.; Winstanley, Elizabeth

    2014-01-01

    We revisit the definition of rotating thermal states for scalar and fermion fields in unbounded Minkowski space–time. For scalar fields such states are ill-defined everywhere, but for fermion fields an appropriate definition of the vacuum gives thermal states regular inside the speed-of-light surface. For a massless fermion field, we derive analytic expressions for the thermal expectation values of the fermion current and stress–energy tensor. These expressions may provide qualitative insights into the behaviour of thermal rotating states on more complex space–time geometries

  13. Rotating bubble membrane radiator

    Science.gov (United States)

    Webb, Brent J.; Coomes, Edmund P.

    1988-12-06

    A heat radiator useful for expelling waste heat from a power generating system aboard a space vehicle is disclosed. Liquid to be cooled is passed to the interior of a rotating bubble membrane radiator, where it is sprayed into the interior of the bubble. Liquid impacting upon the interior surface of the bubble is cooled and the heat radiated from the outer surface of the membrane. Cooled liquid is collected by the action of centrifical force about the equator of the rotating membrane and returned to the power system. Details regarding a complete space power system employing the radiator are given.

  14. Differences between two subgroups of low back pain patients in lumbopelvic rotation and symmetry in the erector spinae and hamstring muscles during trunk flexion when standing.

    Science.gov (United States)

    Kim, Min-hee; Yoo, Won-gyu; Choi, Bo-ram

    2013-04-01

    The present study was performed to examine lumbopelvic rotation and to identify asymmetry of the erector spinae and hamstring muscles in people with and without low back pain (LBP). The control group included 16 healthy subjects, the lumbar-flexion-rotation syndrome LBP group included 17 subjects, and the lumbar-extension-rotation syndrome LBP group included 14 subjects. Kinematic parameters were recorded using a 3D motion-capture system, and electromyography parameters were measured using a Noraxon TeleMyo 2400T. The two LBP subgroups showed significantly more lumbopelvic rotation during trunk flexion in standing than did the control group. The muscle activity and flexion-relaxation ratio asymmetries of the erector spinae muscles in the lumbar-flexion-rotation syndrome LBP group were significantly greater than those in the control group, and the muscle activity and flexion-relaxation ratio asymmetry of the hamstring muscles in the lumbar-extension-rotation syndrome LBP group were significantly greater than those in the control group. Imbalance or asymmetry of passive tissue could lead to asymmetry of muscular activation. Muscle imbalance can cause asymmetrical alignment or movements such as unexpected rotation. The results showed a greater increase in lumbopelvic rotation during trunk flexion in standing among the lumbar-flexion-rotation syndrome and lumbar-extension-rotation syndrome LBP groups compared with the control group. The differences between the two LBP subgroups may be a result of imbalance and asymmetry in erector spinae and hamstring muscle properties. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Rotations and angular momentum

    International Nuclear Information System (INIS)

    Nyborg, P.; Froyland, J.

    1979-01-01

    This paper is devoted to the analysis of rotational invariance and the properties of angular momentum in quantum mechanics. In particular, the problem of addition of angular momenta is treated in detail, and tables of Clebsch-Gordan coefficients are included

  16. Negative Rotation Cinch Strap.

    Science.gov (United States)

    This project discloses an improved unitary parachute torso harness, having a single fastening means, wherein an auxillary tightening strap is...attached to the groin straps of said harness. Said auxillary straps are used to prevent torso rotation or harness slippage and to prevent harness elongation

  17. A rotating string

    International Nuclear Information System (INIS)

    Jensen, B.

    1993-06-01

    The author presents a global solution of Einstein's equations which represents a rotating cosmic string with a finite coreradius. The importance of pressure for the generation of closed timelike curves outside the coreregion of such strings is clearly displayed in this model due to the simplicity of the source. 10 refs

  18. Rotational dynamics with Tracker

    International Nuclear Information System (INIS)

    Eadkhong, T; Danworaphong, S; Rajsadorn, R; Jannual, P

    2012-01-01

    We propose the use of Tracker, freeware for video analysis, to analyse the moment of inertia (I) of a cylindrical plate. Three experiments are performed to validate the proposed method. The first experiment is dedicated to find the linear coefficient of rotational friction (b) for our system. By omitting the effect of such friction, we derive I for a cylindrical plate rotated around its central axis from the other two experiments based on the relation between torque and angular acceleration of rotational motion and conservation of energy. Movies of the rotating plate and hung masses are recorded. As a result, we have the deviation of I from its theoretical value of 0.4% and 3.3%, respectively. Our setup is completely constructed from locally available inexpensive materials and the experimental results indicate that the system is highly reliable. This work should pave the way for those who prefer to build a similar setup from scratch at relatively low cost compared to commercial units. (paper)

  19. The Axial Curve Rotator.

    Science.gov (United States)

    Hunter, Walter M.

    This document contains detailed directions for constructing a device that mechanically produces the three-dimensional shape resulting from the rotation of any algebraic line or curve around either axis on the coordinate plant. The device was developed in response to student difficulty in visualizing, and thus grasping the mathematical principles…

  20. Can planetary nebulae rotate

    International Nuclear Information System (INIS)

    Grinin, V.P.

    1982-01-01

    It is shown that the inclination of spectral lines observed in a number of planetary nebulae when the spectrograph slit is placed along the major axis, which is presently ascribed to nonuniform expansion of the shells, actually may be due to rotation of the nebulae about their minor axes, as Campbell and Moore have suggested in their reports. It is assumed that the rotation of the central star (or, if the core is a binary system, circular motions of gas along quasi-Keplerian orbits) serves as the source of the original rotation of a protoplanetary nebula. The mechanism providing for strengthening of the original rotation in the process of expansion of the shell is the tangential pressure of L/sub α/ radiation due to the anisotropic properties of the medium and radiation field. The dynamic effect produced by them is evidently greatest in the epoch when the optical depth of the nebula in the L/sub c/ continuum becomes on the order of unity in the course of its expansion

  1. Noonan syndrome

    Directory of Open Access Journals (Sweden)

    van der Burgt Ineke

    2007-01-01

    Full Text Available Abstract Noonan Syndrome (NS is characterised by short stature, typical facial dysmorphology and congenital heart defects. The incidence of NS is estimated to be between 1:1000 and 1:2500 live births. The main facial features of NS are hypertelorism with down-slanting palpebral fissures, ptosis and low-set posteriorly rotated ears with a thickened helix. The cardiovascular defects most commonly associated with this condition are pulmonary stenosis and hypertrophic cardiomyopathy. Other associated features are webbed neck, chest deformity, mild intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency and lymphatic dysplasias. The syndrome is transmitted as an autosomal dominant trait. In approximately 50% of cases, the disease is caused by missense mutations in the PTPN11 gene on chromosome 12, resulting in a gain of function of the non-receptor protein tyrosine phosphatase SHP-2 protein. Recently, mutations in the KRAS gene have been identified in a small proportion of patients with NS. A DNA test for mutation analysis can be carried out on blood, chorionic villi and amniotic fluid samples. NS should be considered in all foetuses with polyhydramnion, pleural effusions, oedema and increased nuchal fluid with a normal karyotype. With special care and counselling, the majority of children with NS will grow up and function normally in the adult world. Management should address feeding problems in early childhood, evaluation of cardiac function and assessment of growth and motor development. Physiotherapy and/or speech therapy should be offered if indicated. A complete eye examination and hearing evaluation should be performed during the first few years of schooling. Preoperative coagulation studies are indicated. Signs and symptoms lessen with age and most adults with NS do not require special medical care.

  2. Marfan Syndrome

    Science.gov (United States)

    Marfan syndrome is a disorder that affects connective tissue. Connective tissues are proteins that support skin, bones, blood vessels, ... A problem with the fibrillin gene causes Marfan syndrome. Marfan syndrome can be mild to severe, and ...

  3. Aarskog syndrome

    Science.gov (United States)

    Aarskog disease; Aarskog-Scott syndrome; AAS; Faciodigitogenital syndrome; Gaciogenital dysplasia ... Aarskog syndrome is a genetic disorder that is linked to the X chromosome. It affects mainly males, but females ...

  4. Williams syndrome

    Science.gov (United States)

    Williams-Beuren syndrome ... Williams syndrome is caused by not having a copy of several genes. It may be passed down in families. ... history of the condition. However, people with Williams syndrome have a 50% chance of passing the disorder ...

  5. Cushing's Syndrome

    OpenAIRE

    宗, 友厚; 伊藤, 勇; 諏訪, 哲也; 武田, 純; MUNE, Tomoatsu

    2003-01-01

    Sixteen cases of verified Cushing's syndrome, and twelve cases of probable Cushing's syndrome were reviewed and data on them were compared with various reports on Cushing's syndrome in the literature.

  6. Tourette syndrome

    Science.gov (United States)

    Gilles de la Tourette syndrome; Tic disorders - Tourette syndrome ... Tourette syndrome is named for Georges Gilles de la Tourette, who first described this disorder in 1885. The disorder is likely passed down through families. ...

  7. Comparative outcomes of extracorporeal shockwave therapy for shoulder tendinitis or partial tears of the rotator cuff in athletes and non-athletes: Retrospective study.

    Science.gov (United States)

    Chou, Wen-Yi; Wang, Ching-Jen; Wu, Kuan-Ting; Yang, Ya-Ju; Cheng, Jai-Hong; Wang, Shih-Wei

    2018-03-01

    Refractory shoulder tendinitis or partial thickness rotator cuff tears (PTRCTs) are common findings in overhead athletes. Previous studies have examined the effectiveness of extracorporeal shockwave therapy (ESWT) for shoulder tendinitis. In the current study, we recruited 36 shoulders and performed a comparison between the professional athletes (13 shoulders, athletic group; AG) and the non-athletic population (23 shoulders, non-athletic group, NAG) with PTRCTs or shoulder tendinitis of the shoulder after ESWT. Patients with symptomatic tendinitis of the shoulder with or without a partial tear of the rotator cuff tendon and failed oral medication and physical therapy for more than 3 months were treated with electrohydraulic mode of ESWT. All patients that met the inclusion criteria were categorized into two groups according to their pre-treatment activity level. We found that NAG exhibited significant aging and degenerative change around the glenohumeral joint and subacromial space. After ESWT treatment, the patients in AG were with 53.8% high satisfaction rating and patients in NAG were 52.1% by one-year followed up. The results showed ESWT was equally effective treatment in both AG and NAG. In light of its efficacy and less-invasive nature, we suggest ESWT can be used to treat athletes with refractory tendinitis or PTRCTs before proceeding to arthroscopic intervention. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Wave-driven Rotation in Supersonically Rotating Mirrors

    Energy Technology Data Exchange (ETDEWEB)

    A. Fetterman and N.J. Fisch

    2010-02-15

    Supersonic rotation in mirrors may be produced by radio frequency waves. The waves produce coupled diffusion in ion kinetic and potential energy. A population inversion along the diffusion path then produces rotation. Waves may be designed to exploit a natural kinetic energy source or may provide the rotation energy on their own. Centrifugal traps for fusion and isotope separation may benefit from this wave-driven rotation.

  9. Wave-driven Rotation in Supersonically Rotating Mirrors

    International Nuclear Information System (INIS)

    Fetterman, A.; Fisch, N.J.

    2010-01-01

    Supersonic rotation in mirrors may be produced by radio frequency waves. The waves produce coupled diffusion in ion kinetic and potential energy. A population inversion along the diffusion path then produces rotation. Waves may be designed to exploit a natural kinetic energy source or may provide the rotation energy on their own. Centrifugal traps for fusion and isotope separation may benefit from this wave-driven rotation.

  10. Hepatorenal syndrome

    Science.gov (United States)

    ... 2016:chap 153. Nevah MI, Fallon MB. Hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, and other systemic complications of liver disease. In: Feldman M, Friedman LS, Brandt LJ, ...

  11. Rotator Cuff Injuries - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Rotator Cuff Injuries URL of this page: https://medlineplus.gov/ ... V W XYZ List of All Topics All Rotator Cuff Injuries - Multiple Languages To use the sharing features ...

  12. Asteroid rotation. IV

    International Nuclear Information System (INIS)

    Harris, A.W.; Young, J.W.

    1983-01-01

    The results from the year 1979 of an ongoing program of asteroid photometry at Table Mountain Observatory are presented. The results for 53 asteroids are summarized in a table, showing the number, name, opposition date, taxonomic class, diameter, absolute magnitude, mean absolute magnitude at zero phase angle and values of the absolute magnitude and linear phase coefficient derived from it, the rotation period in hours, peak-to-peak amplitude of variation, difference between mean and maximum brightness, and reliability index. Another table presents data on aspect and comparison stars, including brightness and distance data. Reliable rotation periods are reported for 22 asteroids for which no previous values are known. For seven asteroids, periods are reported which are revisions of previously reported values

  13. Rotatable seal assembly

    International Nuclear Information System (INIS)

    Garibaldi, J.L.; Logan, C.M.

    1982-01-01

    An assembly is provided for rotatably supporting a rotor on a stator so that vacuum chambers in the rotor and stator remain in communication while the chambers are sealed from ambient air, which enables the use of a ball bearing or the like to support most of the weight of the rotor. The apparatus includes a seal device mounted on the rotor to rotate therewith, but shiftable in position on the rotor while being sealed to the rotor as by an oring. The seal device has a flat face that is biased towards a flat face on the stator, and pressurized air is pumped between the faces to prevent contact between them while spacing them a small distance apart to avoid the inflow of large amounts of air between the faces and into the vacuum chambers

  14. Rotator cuff disease

    International Nuclear Information System (INIS)

    Ziatkin, M.B.; Iannotti, J.P.; Roberts, M.; Dalinka, M.K.; Esterhai, J.L.; Kressel, H.Y.; Lenkinski, R.E.

    1988-01-01

    A dual-surface-coil array in a Helmholtz configuration was used to evaluate th rotator cuff in ten normal volunteers and 44 patients. Studies were performed with a General Electric 1.5-T MR imager. Thirty-two patients underwent surgery, 25 of whom also underwent arthrography. In comparison with surgery, MR imaging was more sensitive than arthrography for rotator cuff tears (91% vs 71%). The specificity and accuracy of MR imaging were 88% and 91%. The accuracy increased with use of an MR grading system. MR findings correlated with surgical findings with regard to the size and site of tears. MR findings of cuff tears were studied with multivariate analysis. Correlation was also found between a clinical score, the MR grade, and the clinical outcome

  15. The Spatiale Rotator

    DEFF Research Database (Denmark)

    Rasmusson, Allan

    2009-01-01

    it is embedded and sectioned. This has the unfortunate side effect that all information about positioning within the object is lost for blocks and sections. For complex tissue, like the mammalian brain, this information is of utmost importance to ensure measurements are performed in the correct region......The inherent demand for unbiasedness for some stereological estimators imposes a demand of not only positional uniform randomness but also isotropic randomness, i.e. directional uniform randomness. In order to comply with isotropy, one must perform a random rotation of the object of interest before...... is obeyed by randomizing the orientation of the virtual probe itself within the thick section. Overall, the benefit is that positional information is kept for any block and section of the specimen. As the Spatial Rotator is a 3D probe, data must be gathered from sections thicker than 25 micro meters to form...

  16. Rotational spectrum of tryptophan

    Energy Technology Data Exchange (ETDEWEB)

    Sanz, M. Eugenia, E-mail: maria.sanz@kcl.ac.uk; Cabezas, Carlos, E-mail: ccabezas@qf.uva.es; Mata, Santiago, E-mail: santiago.mata@uva.es; Alonso, Josè L., E-mail: jlalonso@qf.uva.es [Grupo de Espectroscopia Molecular (GEM), Edificio Quifima, Laboratorios de Espectroscopia y Bioespectroscopia, Unidad Asociada CSIC, Parque Científico Uva, Universidad de Valladolid, 47011 Valladolid (Spain)

    2014-05-28

    The rotational spectrum of the natural amino acid tryptophan has been observed for the first time using a combination of laser ablation, molecular beams, and Fourier transform microwave spectroscopy. Independent analysis of the rotational spectra of individual conformers has conducted to a definitive identification of two different conformers of tryptophan, with one of the observed conformers never reported before. The analysis of the {sup 14}N nuclear quadrupole coupling constants is of particular significance since it allows discrimination between structures, thus providing structural information on the orientation of the amino group. Both observed conformers are stabilized by an O–H···N hydrogen bond in the side chain and a N–H···π interaction forming a chain that reinforce the strength of hydrogen bonds through cooperative effects.

  17. Rotator cuff tendon connections with the rotator cable.

    Science.gov (United States)

    Rahu, Madis; Kolts, Ivo; Põldoja, Elle; Kask, Kristo

    2017-07-01

    The literature currently contains no descriptions of the rotator cuff tendons, which also describes in relation to the presence and characteristics of the rotator cable (anatomically known as the ligamentum semicirculare humeri). The aim of the current study was to elucidate the detailed anatomy of the rotator cuff tendons in association with the rotator cable. Anatomic dissection was performed on 21 fresh-frozen shoulder specimens with an average age of 68 years. The rotator cuff tendons were dissected from each other and from the glenohumeral joint capsule, and the superior glenohumeral, coracohumeral, coracoglenoidal and semicircular (rotator cable) ligaments were dissected. Dissection was performed layer by layer and from the bursal side to the joint. All ligaments and tendons were dissected in fine detail. The rotator cable was found in all specimens. It was tightly connected to the supraspinatus (SSP) tendon, which was partly covered by the infraspinatus (ISP) tendon. The posterior insertion area of the rotator cable was located in the region between the middle and inferior facets of the greater tubercle of the humerus insertion areas for the teres minor (TM), and ISP tendons were also present and fibres from the SSP extended through the rotator cable to those areas. The connection between the rotator cable and rotator cuff tendons is tight and confirms the suspension bridge theory for rotator cuff tears in most areas between the SSP tendons and rotator cable. In its posterior insertion area, the rotator cable is a connecting structure between the TM, ISP and SSP tendons. These findings might explain why some patients with relatively large rotator cuff tears can maintain seamless shoulder function.

  18. Broadband Rotational Spectroscopy

    Science.gov (United States)

    Pate, Brooks

    2014-06-01

    The past decade has seen several major technology advances in electronics operating at microwave frequencies making it possible to develop a new generation of spectrometers for molecular rotational spectroscopy. High-speed digital electronics, both arbitrary waveform generators and digitizers, continue on a Moore's Law-like development cycle that started around 1993 with device bandwidth doubling about every 36 months. These enabling technologies were the key to designing chirped-pulse Fourier transform microwave (CP-FTMW) spectrometers which offer significant sensitivity enhancements for broadband spectrum acquisition in molecular rotational spectroscopy. A special feature of the chirped-pulse spectrometer design is that it is easily implemented at low frequency (below 8 GHz) where Balle-Flygare type spectrometers with Fabry-Perot cavity designs become technologically challenging due to the mirror size requirements. The capabilities of CP-FTMW spectrometers for studies of molecular structure will be illustrated by the collaborative research effort we have been a part of to determine the structures of water clusters - a project which has identified clusters up to the pentadecamer. A second technology trend that impacts molecular rotational spectroscopy is the development of high power, solid state sources in the mm-wave/THz regions. Results from the field of mm-wave chirped-pulse Fourier transform spectroscopy will be described with an emphasis on new problems in chemical dynamics and analytical chemistry that these methods can tackle. The third (and potentially most important) technological trend is the reduction of microwave components to chip level using monolithic microwave integrated circuits (MMIC) - a technology driven by an enormous mass market in communications. Some recent advances in rotational spectrometer designs that incorporate low-cost components will be highlighted. The challenge to the high-resolution spectroscopy community - as posed by Frank De

  19. The rotational spectrum of IBr

    International Nuclear Information System (INIS)

    Tiemann, E.; Moeller, T.

    1975-01-01

    The microwave spectrum of IBr was measured in the low rotational transition J = 3 → 2 in order to resolve the hyperfine structure as completely as possible. Rotational constants and quadrupole coupling constants were derived for both nuclei. The observation of the rotational spectrum in different vibrational states yields the vibrational dependence of the rotational constants as well as of the hyperfine parameters. The Dunham potential coefficients α 0 , α 1 , α 2 , α 3 are given. (orig.) [de

  20. Glenohumeral and scapulothoracic strength impairments exists in patients with subacromial impingement, but these are not reflected in the shoulder pain and disability index

    DEFF Research Database (Denmark)

    Clausen, M B; Witten, A; Holm, K

    2017-01-01

    in strength and ROM to patient-reported shoulder function is not well described, even though testing of strength is recommended in clinical guidelines. The purpose of this study was, first, to investigate impairments in glenohumeral and scapulothoracic strength and in abduction and internal rotation ROM...

  1. Snakes and spin rotators

    International Nuclear Information System (INIS)

    Lee, S.Y.

    1990-01-01

    The generalized snake configuration offers advantages of either shorter total snake length and smaller orbit displacement in the compact configuration or the multi-functions in the split configuration. We found that the compact configuration can save about 10% of the total length of a snake. On other hand, the spilt snake configuration can be used both as a snake and as a spin rotator for the helicity state. Using the orbit compensation dipoles, the spilt snake configuration can be located at any distance on both sides of the interaction point of a collider provided that there is no net dipole rotation between two halves of the snake. The generalized configuration is then applied to the partial snake excitation. Simple formula have been obtained to understand the behavior of the partial snake. Similar principle can also be applied to the spin rotators. We also estimate the possible snake imperfections are due to various construction errors of the dipole magnets. Accuracy of field error of better than 10 -4 will be significant. 2 refs., 5 figs

  2. CISM Course on Rotating Fluids

    CERN Document Server

    1992-01-01

    The volume presents a comprehensive overview of rotation effects on fluid behavior, emphasizing non-linear processes. The subject is introduced by giving a range of examples of rotating fluids encountered in geophysics and engineering. This is then followed by a discussion of the relevant scales and parameters of rotating flow, and an introduction to geostrophic balance and vorticity concepts. There are few books on rotating fluids and this volume is, therefore, a welcome addition. It is the first volume which contains a unified view of turbulence in rotating fluids, instability and vortex dynamics. Some aspects of wave motions covered here are not found elsewhere.

  3. COMMISSIONING SPIN ROTATORS IN RHIC

    International Nuclear Information System (INIS)

    MACKAY, W.W.; AHRENS, L.; BAI, M.; COURANT, E.D.; FISCHER, W.; HUANG, H.; LUCCIO, A.; MONTAG, C.; PILAT, F.; PTITSYN, V.; ROSER, T.; SATOGATA, T.; TRBOJEVIC, D.; VANZIEJTS, J.

    2003-01-01

    During the summer of 2002, eight superconducting helical spin rotators were installed into RHIC in order to control the polarization directions independently at the STAR and PHENIX experiments. Without the rotators, the orientation of polarization at the interaction points would only be vertical. With four rotators around each of the two experiments, we can rotate either or both beams from vertical into the horizontal plane through the interaction region and then back to vertical on the other side. This allows independent control for each beam with vertical, longitudinal, or radial polarization at the experiment. In this paper, we present results from the first run using the new spin rotators at PHENIX

  4. Preservation of bursal-sided tendon in partial-thickness articular-sided rotator cuff tears: a novel arthroscopic transtendon anatomic repair technique.

    Science.gov (United States)

    Shin, Sang-Jin; Jeong, Jae-Hoon; Jeon, Yoon Sang; Kim, Rag Gyu

    2016-12-01

    The purpose of this study was to introduce a novel arthroscopic transtendon anatomic repair technique that spares the intact bursal-sided tendon in articular-sided partial-thickness rotator cuff tears (PTRCT) and to present shoulder functional outcomes in patients with symptomatic articular-sided PCRCT that involves more than 50 % of its thickness after arthroscopic repair using a novel technique. Eighteen patients with symptomatic articular-sided PCRCT involving more than 50 % of the tendon's thickness underwent arthroscopic repair using a devised technique. The devised technique restores only the torn articular portion of the rotator cuff at the anatomical footprint using a suture anchor, and preserves the integrity of the corresponding bursal-sided tendon by tying knots at the most lateral bursal side on the subacromial space. Clinical and functional outcome using ASES and Constant scores were evaluated. The structural integrity of the rotator cuff was evaluated by MRI at 6 months postoperatively. Pain relief and shoulder functional outcomes were encouraging during the recovery phase after operation. ASES (preoperative 54.0 ± 10.3 to postoperative 92.6 ± 8.0), Constant score (61.2 ± 8.5-88.0 ± 5.3), VAS for pain (4.9 ± 2.6-0.6 ± 0.7) improved significantly after arthroscopic transtendon anatomic repair (p rotator cuff retears on 6-month MRI. No complications related to surgical procedures had occurred. The devised technique of arthroscopic transtendon repair provided satisfactory functional outcomes without postoperative discomforts. This technique minimizes over-tightening of the articular layer and reduces tension mismatches between the articular and bursal layers, which are considered as important factors for improvement of postoperative shoulder motion.

  5. CONFERENCE: Muon spin rotation

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Erik

    1986-11-15

    An international physics conference centred on muons without a word about leptons, weak interactions, EMC effects, exotic decay modes or any other standard high energy physics jargon. Could such a thing even have been imagined ten years ago? Yet about 120 physicists and chemists from 16 nations gathered at the end of June in Uppsala (Sweden) for their fourth meeting on Muon Spin Rotation, Relaxation and Resonance, without worrying about the muon as an elementary particle. This reflects how the experimental techniques based on the muon spin interactions have reached maturity and are widely recognized by condensed matter physicists and specialized chemists as useful tools.

  6. Autonomous quantum rotator

    DEFF Research Database (Denmark)

    Fogedby, Hans C.; Imparato, Alberto

    2018-01-01

    to a directed rotary motion. At variance with the classical case, the thermal fluctuations in the baths give rise to a non-vanishing average torque contribution; this is a genuine quantum effect akin to the Casimir effect. In the steady state the heat current flowing between the two baths is systematically......, the rotator cannot work either as a heat pump or as a heat engine. We finally use our exact results to extend an ab initio quantum simulation algorithm to the out-of-equilibrium regime. Copyright (C) EPLA, 2018...

  7. Rotating specimen rack repair

    International Nuclear Information System (INIS)

    Miller, G.E.; Rogers, P.J.; Nabor, W.G.; Bair, H.

    1984-01-01

    In 1980, an operator at the UCI TRIGA Reactor noticed difficulties with the rotation of the specimen rack. Investigations showed that the drive bearing in the rack had failed and allowed the bearings to enter the rack. After some time of operation in static mode it was decided that installation of a bearing substitute - a graphite sleeve - would be undertaken. Procedures were written and approved for removal of the rack, fabrication and installation of the sleeve, and re-installation of the rack. This paper describes these procedures in some detail. Detailed drawings of the necessary parts may be obtained from the authors

  8. Rotational anomalies without anyons

    International Nuclear Information System (INIS)

    Hagen, C.R.

    1985-01-01

    A specific field theory is proposed in two spatial dimensions which has anomalous rotational properties. Although this might be expected to lead to a concrete realization of what Wilczek refers to as the anyon, it is shown by utilizing the transformation properties of the system and the statistics of the underlying charge fields that anyonic interpolations between bosons and fermions do not occur. This leads to the suggestion that anyons inferred from semiclassical considerations will not survive the transition to a fully relativistic field theory

  9. Rotating electrical machines

    CERN Document Server

    Le Doeuff, René

    2013-01-01

    In this book a general matrix-based approach to modeling electrical machines is promulgated. The model uses instantaneous quantities for key variables and enables the user to easily take into account associations between rotating machines and static converters (such as in variable speed drives).   General equations of electromechanical energy conversion are established early in the treatment of the topic and then applied to synchronous, induction and DC machines. The primary characteristics of these machines are established for steady state behavior as well as for variable speed scenarios. I

  10. The effect of postoperative passive motion on rotator cuff healing in a rat model.

    Science.gov (United States)

    Peltz, Cathryn D; Dourte, Leann M; Kuntz, Andrew F; Sarver, Joseph J; Kim, Soung-Yon; Williams, Gerald R; Soslowsky, Louis J

    2009-10-01

    Surgical repairs of torn rotator cuff tendons frequently fail. Immobilization has been shown to improve tissue mechanical properties in an animal model of rotator cuff repair, and passive motion has been shown to improve joint mechanics in animal models of flexor tendon repair. Our objective was to determine if daily passive motion would improve joint mechanics in comparison with continuous immobilization in a rat rotator cuff repair model. We hypothesized that daily passive motion would result in improved passive shoulder joint mechanics in comparison with continuous immobilization initially and that there would be no differences in passive joint mechanics or insertion site mechanical properties after four weeks of remobilization. A supraspinatus injury was created and was surgically repaired in sixty-five Sprague-Dawley rats. Rats were separated into three postoperative groups (continuous immobilization, passive motion protocol 1, and passive motion protocol 2) for two weeks before all underwent a remobilization protocol for four weeks. Serial measurements of passive shoulder mechanics (internal and external range of motion and joint stiffness) were made before surgery and at two and six weeks after surgery. After the animals were killed, collagen organization and mechanical properties of the tendon-to-bone insertion site were determined. Total range of motion for both passive motion groups (49% and 45% of the pre-injury values) was less than that for the continuous immobilization group (59% of the pre-injury value) at two weeks and remained significantly less following four weeks of remobilization exercise. Joint stiffness at two weeks was increased for both passive motion groups in comparison with the continuous immobilization group. At both two and six weeks after repair, internal range of motion was significantly decreased whereas external range of motion was not. There were no differences between the groups in terms of collagen organization or mechanical

  11. Lunar Rotation, Orientation and Science

    Science.gov (United States)

    Williams, J. G.; Ratcliff, J. T.; Boggs, D. H.

    2004-12-01

    The Moon is the most familiar example of the many satellites that exhibit synchronous rotation. For the Moon there is Lunar Laser Ranging measurements of tides and three-dimensional rotation variations plus supporting theoretical understanding of both effects. Compared to uniform rotation and precession the lunar rotational variations are up to 1 km, while tidal variations are about 0.1 m. Analysis of the lunar variations in pole direction and rotation about the pole gives moment of inertia differences, third-degree gravity harmonics, tidal Love number k2, tidal dissipation Q vs. frequency, dissipation at the fluid-core/solid-mantle boundary, and emerging evidence for an oblate boundary. The last two indicate a fluid core, but a solid inner core is not ruled out. Four retroreflectors provide very accurate positions on the Moon. The experience with the Moon is a starting point for exploring the tides, rotation and orientation of the other synchronous bodies of the solar system.

  12. A compact rotating dilution refrigerator

    Science.gov (United States)

    Fear, M. J.; Walmsley, P. M.; Chorlton, D. A.; Zmeev, D. E.; Gillott, S. J.; Sellers, M. C.; Richardson, P. P.; Agrawal, H.; Batey, G.; Golov, A. I.

    2013-10-01

    We describe the design and performance of a new rotating dilution refrigerator that will primarily be used for investigating the dynamics of quantized vortices in superfluid 4He. All equipment required to operate the refrigerator and perform experimental measurements is mounted on two synchronously driven, but mechanically decoupled, rotating carousels. The design allows for relative simplicity of operation and maintenance and occupies a minimal amount of space in the laboratory. Only two connections between the laboratory and rotating frames are required for the transmission of electrical power and helium gas recovery. Measurements on the stability of rotation show that rotation is smooth to around 10-3 rad s-1 up to angular velocities in excess of 2.5 rad s-1. The behavior of a high-Q mechanical resonator during rapid changes in rotation has also been investigated.

  13. Wormholes immersed in rotating matter

    Directory of Open Access Journals (Sweden)

    Christian Hoffmann

    2018-03-01

    Full Text Available We demonstrate that rotating matter sets the throat of an Ellis wormhole into rotation, allowing for wormholes which possess full reflection symmetry with respect to the two asymptotically flat spacetime regions. We analyze the properties of this new type of rotating wormholes and show that the wormhole geometry can change from a single throat to a double throat configuration. We further discuss the ergoregions and the lightring structure of these wormholes.

  14. Internal rotation of the Sun

    International Nuclear Information System (INIS)

    Duvall, T.L. Jr.; Goode, P.R.; Gouch, D.O.

    1984-01-01

    The frequency difference between prograde and retrograde sectoral solar oscillations is analysed to determine the rotation rate of the solar interior, assuming no latitudinal dependence. Much of the solar interior rotates slightly less rapidly than the surface, while the innermost part apparently rotates more rapidly. The resulting solar gravitational quadrupole moment is J 2 = (1.7 +- 0.4) x 10 -7 and provides a negligible contribution to current planetary tests of Einstein's theory of general relativity. (author)

  15. Earth's variable rotation

    Science.gov (United States)

    Hide, Raymond; Dickey, Jean O.

    1991-01-01

    Recent improvements in geodetic data and practical meteorology have advanced research on fluctuations in the earth's rotation. The interpretation of these fluctuations is inextricably linked with studies of the dynamics of the earth-moon system and dynamical processes in the liquid metallic core of the earth (where the geomagnetic field originates), other parts of the earth's interior, and the hydrosphere and atmosphere. Fluctuations in the length of the day occurring on decadal time scales have implications for the topographay of the core-mantle boundary and the electrical, magnetic, ande other properties of the core and lower mantle. Investigations of more rapid fluctuations bear on meteorological studies of interannual, seasonal, and intraseasonal variations in the general circulation of the atmosphere and the response of the oceans to such variations.

  16. Sporcularda rotator cuff problemleri

    OpenAIRE

    Guven, Osman; Guven, Zeynep; Gundes, Hakan; Yalcin, Selim

    2004-01-01

    Rotator cuff tendinitinin etyolojisinde genellikle birden çok faktörün kombinasyonu görülür. Yüzme, raket sporları ve fırlatma sporlarının özellikle gelişmiş ülkelerde giderek yaygınlaşması bu konuya olan ilginin artmasına sebep olmuştur. Eski konseptlerde aktif bir sporcuda tedavinin başarısı genellikle eski atletik seviyesine dönmesi ile ölçülürdü. Son zamanlarda atletik tekniklerin analizi, atroskopik evaluasyon gibi yeni bir Iükse sahip olmamız ve Iiteratürün yeniden gözden geçirilmesi il...

  17. Cushing's Syndrome

    Science.gov (United States)

    Cushing's syndrome is a hormonal disorder. The cause is long-term exposure to too much cortisol, a hormone that ... your body to make too much cortisol. Cushing's syndrome is rare. Some symptoms are Upper body obesity ...

  18. Usher Syndrome

    Science.gov (United States)

    Usher syndrome is an inherited disease that causes serious hearing loss and retinitis pigmentosa, an eye disorder that causes ... and vision. There are three types of Usher syndrome: People with type I are deaf from birth ...

  19. Metabolic Syndrome

    Science.gov (United States)

    Metabolic syndrome is a group of conditions that put you at risk for heart disease and diabetes. These conditions ... agree on the definition or cause of metabolic syndrome. The cause might be insulin resistance. Insulin is ...

  20. Reye Syndrome

    Science.gov (United States)

    Reye syndrome is a rare illness that can affect the blood, liver, and brain of someone who has recently ... a viral illness, seek medical attention immediately. Reye syndrome can lead to a coma and brain death, ...

  1. Rett Syndrome

    Science.gov (United States)

    Rett syndrome is a rare genetic disease that causes developmental and nervous system problems, mostly in girls. It's related to autism spectrum disorder. Babies with Rett syndrome seem to grow and develop normally at first. ...

  2. Caplan syndrome

    Science.gov (United States)

    ... enable JavaScript. Rheumatoid pneumoconiosis (RP; also known as Caplan syndrome) is swelling (inflammation) and scarring of the ... avoid exposure to inorganic dust. Alternative Names RP; Caplan syndrome; Pneumoconiosis - rheumatoid; Silicosis - rheumatoid pneumoconiosis; Coal worker's ...

  3. Turner Syndrome

    Science.gov (United States)

    Turner syndrome is a genetic disorder that affects a girl's development. The cause is a missing or incomplete ... t work properly. Other physical features typical of Turner syndrome are Short, "webbed" neck with folds of skin ...

  4. Gardner's syndrome

    International Nuclear Information System (INIS)

    Sobrado Junior, C.W.; Bresser, A.; Cerri, G.G.; Habr-Gama, A.; Pinotti, H.W.; Magalhaes, A.

    1988-01-01

    A case of familiar poliposis of colon related to a right mandibular osteoma is reported (this association is usually called Gardner's syndrome). Radiologic pictures ae shown and some commentaries about this syndrome concerning the treatment are made. (author) [pt

  5. Sotos Syndrome

    Science.gov (United States)

    ... Clinical Trials Organizations Publications Definition Sotos syndrome (cerebral gigantism) is a rare genetic disorder caused by mutation ... have also been reported. × Definition Sotos syndrome (cerebral gigantism) is a rare genetic disorder caused by mutation ...

  6. Felty syndrome

    Science.gov (United States)

    Seropositive rheumatoid arthritis (RA); Felty's syndrome ... The cause of Felty syndrome is unknown. It is more common in people who have had rheumatoid arthritis (RA) for a long time. People with ...

  7. Bartter syndrome

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000308.htm Bartter syndrome To use the sharing features on this page, please enable JavaScript. Bartter syndrome is a group of rare conditions that affect ...

  8. Pendred Syndrome

    Science.gov (United States)

    ... other possible long-term consequences of the syndrome. Children with Pendred syndrome should start early treatment to gain communication skills, such as learning sign language or cued speech or learning to ...

  9. Dravet Syndrome

    Science.gov (United States)

    ... and supports a broad program of basic and clinical research on all types of epilepsy, including Dravet syndrome. Study of the genetic defects responsible for Dravet syndrome and related ... Publications Definition Dravet ...

  10. Surface dimpling on rotating work piece using rotation cutting tool

    Science.gov (United States)

    Bhapkar, Rohit Arun; Larsen, Eric Richard

    2015-03-31

    A combined method of machining and applying a surface texture to a work piece and a tool assembly that is capable of machining and applying a surface texture to a work piece are disclosed. The disclosed method includes machining portions of an outer or inner surface of a work piece. The method also includes rotating the work piece in front of a rotating cutting tool and engaging the outer surface of the work piece with the rotating cutting tool to cut dimples in the outer surface of the work piece. The disclosed tool assembly includes a rotating cutting tool coupled to an end of a rotational machining device, such as a lathe. The same tool assembly can be used to both machine the work piece and apply a surface texture to the work piece without unloading the work piece from the tool assembly.

  11. Down Syndrome

    Science.gov (United States)

    ... Down syndrome increases as a woman gets older. Down syndrome cannot be cured. Early treatment programs can help improve skills. They may include ... occupational, and/or educational therapy. With support and treatment, many ... Down syndrome live happy, productive lives. NIH: National Institute of ...

  12. Rowell syndrome

    Directory of Open Access Journals (Sweden)

    Ramesh Y Bhat

    2014-01-01

    Full Text Available Rowell syndrome is a rare disease consisting of erythema multiforme-like lesions associated with lupus erythematosus. The syndrome occurs mostly in middle-aged women. The authors describe the syndrome in a 15-year-old boy who responded well to systemic steroids and hydroxychloroquine.

  13. Aicardi Syndrome

    Science.gov (United States)

    ... from Aicardi-Goutieres syndrome, which is an inherited encephalopathy that affects newborn infants.) × Definition Aicardi syndrome is a rare genetic ... from Aicardi-Goutieres syndrome, which is an inherited encephalopathy that affects newborn infants.) View Full Definition Treatment There is no ...

  14. Rotation of the planet mercury.

    Science.gov (United States)

    Jefferys, W H

    1966-04-08

    The equations of motion for the rotation of Mercury are solved for the general case by an asymptotic expansion. The findings of Liu and O'Keefe, obtained by numerical integration of a special case, that it is possible for Mercury's rotation to be locked into a 2:3 resonance with its revolution, are confirmed in detail. The general solution has further applications.

  15. Stabilities of MHD rotational discontinuities

    International Nuclear Information System (INIS)

    Wang, S.

    1984-11-01

    In this paper, the stabilities of MHD rotational discontinuities are analyzed. The results show that the rotational discontinuities in an incompressible magnetofluid are not always stable with respect to infinitesimal perturbation. The instability condition in a special case is obtained. (author)

  16. Optical isolation by Faraday rotator

    International Nuclear Information System (INIS)

    Kasai, Takeshi; Matsushima, Isao; Nemoto, Fusashi; Yano, Masaaki

    1984-01-01

    Three Faraday rotators designed as optical isolators in a high power glass laser system are described. The spatial fluctuation of applied magnetic field is less than 1% throughout the Faraday glass rod. The Faraday rotators transmit more than 80% of the forward-going laser light and reject more than 96% of the backward-going light. (author)

  17. Rotational superradiance in fluid laboratories

    CERN Document Server

    Cardoso, Vitor; Richartz, Mauricio; Weinfurtner, Silke

    2016-01-01

    Rotational superradiance has been predicted theoretically decades ago, and is the chief responsible for a number of important effects and phenomenology in black hole physics. However, rotational superradiance has never been observed experimentally. Here, with the aim of probing superradiance in the lab, we investigate the behaviour of sound and surface waves in fluids resting in a circular basin at the center of which a rotating cylinder is placed. We show that with a suitable choice for the material of the cylinder, surface and sound waves are amplified. By confining the superradiant modes near the rotating cylinder, an instability sets in. Our findings are experimentally testable in existing fluid laboratories and hence offer experimental exploration and comparison of dynamical instabilities arising from rapidly rotating boundary layers in astrophysical as well as in fluid dynamical systems.

  18. Advances in Rotational Seismic Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Pierson, Robert [Applied Technology Associates, Albuquerque, NM (United States); Laughlin, Darren [Applied Technology Associates, Albuquerque, NM (United States); Brune, Robert [Applied Technology Associates, Albuquerque, NM (United States)

    2016-10-19

    Rotational motion is increasingly understood to be a significant part of seismic wave motion. Rotations can be important in earthquake strong motion and in Induced Seismicity Monitoring. Rotational seismic data can also enable shear selectivity and improve wavefield sampling for vertical geophones in 3D surveys, among other applications. However, sensor technology has been a limiting factor to date. The US Department of Energy (DOE) and Applied Technology Associates (ATA) are funding a multi-year project that is now entering Phase 2 to develop and deploy a new generation of rotational sensors for validation of rotational seismic applications. Initial focus is on induced seismicity monitoring, particularly for Enhanced Geothermal Systems (EGS) with fracturing. The sensors employ Magnetohydrodynamic (MHD) principles with broadband response, improved noise floors, robustness, and repeatability. This paper presents a summary of Phase 1 results and Phase 2 status.

  19. Flow past a rotating cylinder

    Science.gov (United States)

    Mittal, Sanjay; Kumar, Bhaskar

    2003-02-01

    Flow past a spinning circular cylinder placed in a uniform stream is investigated via two-dimensional computations. A stabilized finite element method is utilized to solve the incompressible Navier Stokes equations in the primitive variables formulation. The Reynolds number based on the cylinder diameter and free-stream speed of the flow is 200. The non-dimensional rotation rate, [alpha] (ratio of the surface speed and freestream speed), is varied between 0 and 5. The time integration of the flow equations is carried out for very large dimensionless time. Vortex shedding is observed for [alpha] cylinder. The results from the stability analysis for the rotating cylinder are in very good agreement with those from direct numerical simulations. For large rotation rates, very large lift coefficients can be obtained via the Magnus effect. However, the power requirement for rotating the cylinder increases rapidly with rotation rate.

  20. Bidirectional optical rotation of cells

    Directory of Open Access Journals (Sweden)

    Jiyi Wu

    2017-08-01

    Full Text Available Precise and controlled rotation manipulation of cells is extremely important in biological applications and biomedical studies. Particularly, bidirectional rotation manipulation of a single or multiple cells is a challenge for cell tomography and analysis. In this paper, we report an optical method that is capable of bidirectional rotation manipulation of a single or multiple cells. By launching a laser beam at 980 nm into dual-beam tapered fibers, a single or multiple cells in solutions can be trapped and rotated bidirectionally under the action of optical forces. Moreover, the rotational behavior can be controlled by altering the relative distance between the two fibers and the input optical power. Experimental results were interpreted by numerical simulations.

  1. Dravets syndrom

    DEFF Research Database (Denmark)

    Hansen, Lars Kjaersgård; Rasmussen, Niels Henrik; Ousager, Lilian Bomme

    2010-01-01

    Dravet syndrome is an epileptic syndrome of infancy and early childhood. Most cases of Dravet syndrome seem to be due to a genetic defect causing the sodium channel to malfunction. We describe the main features of the syndrome. This epilepsy is medically intractable, but we call attention...... to the fact that some medications are of benefit and some could exacerbate the condition. Early recognition of the syndrome including by genetic testing could possibly improve outcome and reduce the need for other specialized investigations. Udgivelsesdato: 2010-Feb-22...

  2. Hydrodynamics of rotating superfluids

    International Nuclear Information System (INIS)

    Chandler, E.A.

    1981-01-01

    In this thesis, a coarse grained hydrodynamics is developed from the exact description of Tkachenko. To account for the dynamics of the vortex lattice, the macroscopic vortex displacement field is treated as an independent degree of freedom. The conserved energy is written in terms of the coarse-grained normal fluid, superfluid, and vortex velocities and includes an elastic energy associated with deformations of the vortex lattice. Equations of motion consistent with the conservation of energy, entropy and vorticity and containing mutual friction terms arising from microscopic interactions between normal fluid excitations and the vortex lines are derived. When the vortex velocity is eliminated from the damping terms, this system of equations becomes essentially that of BK with added elastic terms in the momentum stress tensor and energy current. The dispersion relation and damping of the first and second sound modes and the two transverse modes sustained by the system are investigated. It is shown that mutual friction mixes the transverse modes of the normal and superfluid components and damps the transverse mode associated with the relative velocity of these components, making this wave evanescent in the plane perpendicular to the rotation axis. The wave associated with transverse motion of the total mass current is a generalized Tkachenko mode, whose dispersion relation reduces to that derived by Tkachenko wave when the wavevector lies in this plane

  3. Magnetostrophic Rotating Magnetoconvection

    Science.gov (United States)

    King, Eric; Aurnou, Jonathan

    2016-11-01

    Planetary magnetic fields are generated by turbulent convection within their vast interior liquid metal cores. Although direct observation is not possible, this liquid metal circulation is thought to be dominated by the controlling influences of Coriolis and Lorentz forces. Theory famously predicts that local-scale convection naturally settles into the so-called magnetostrophic state, where the Coriolis and Lorentz forces partially cancel, and convection is optimally efficient. To date, no laboratory experiments have reached the magnetostrophic regime in turbulent liquid metal convection. Furthermore, computational dynamo simulations have as yet failed to produce a globally magnetostrophic dynamo, which has led some to question the existence of the magnetostrophic state. Here, we present results from the first turbulent magnetostrophic rotating magnetoconvection experiments using the liquid metal gallium. We find that turbulent convection in the magnetostrophic regime is, in fact, maximally efficient. The experimental results clarify these previously disparate results, suggesting that the fluid dynamics saturate in magnetostrophic balance within turbulent liquid metal, planetary cores. The authors thank the NSF Geophysics Program for financial support.

  4. Rotating quantum Gaussian packets

    International Nuclear Information System (INIS)

    Dodonov, V V

    2015-01-01

    We study two-dimensional quantum Gaussian packets with a fixed value of mean angular momentum. This value is the sum of two independent parts: the ‘external’ momentum related to the motion of the packet center and the ‘internal’ momentum due to quantum fluctuations. The packets minimizing the mean energy of an isotropic oscillator with the fixed mean angular momentum are found. They exist for ‘co-rotating’ external and internal motions, and they have nonzero correlation coefficients between coordinates and momenta, together with some (moderate) amount of quadrature squeezing. Variances of angular momentum and energy are calculated, too. Differences in the behavior of ‘co-rotating’ and ‘anti-rotating’ packets are shown. The time evolution of rotating Gaussian packets is analyzed, including the cases of a charge in a homogeneous magnetic field and a free particle. In the latter case, the effect of initial shrinking of packets with big enough coordinate-momentum correlation coefficients (followed by the well known expansion) is discovered. This happens due to a competition of ‘focusing’ and ‘de-focusing’ in the orthogonal directions. (paper)

  5. Rotator cuff pathology

    International Nuclear Information System (INIS)

    Pigeau, I.; Doursounian, L.; Maigne, J.Y.; Guinet, C.; Meary, E.; Buy, J.N.; Touzard, R.C.; Vadrot, D.; Laval-Jeantet, M.

    1989-01-01

    Fifteen volunteers and 73 patients with suspected rotator cuff lesions were examined at 0.5 T with T2 * -weighted gradient-echo (GE) MR imaging (700/33/30 degrees) (oblique coronal and sagittal 3 mm thick, surface coil). Results were compared with those of arthrography (all cases), T1-weighted GE imaging (400/20/90 degrees) (35 cases), surgery (28 cases), and T2-weighted spin-echo (SE) images (2,000/60-120) (17 cases). GE images demonstrated all tears (complete, 32, partial, 12) and was superior to arthrography in determining site and size and in displaying muscles (critical point in surgical planning). In 20 cases without tears on arthrography, GE imaging demonstrated five cases of tendinitis, five cases of bursitis, and six probable intratendinous or superficial partial tears. T2 * -weighted GE imaging was superior to T2-weighted SE and T1-weighted GE imaging, with higher fluid contrast and a low fat signal. Therefore, it might replace arthrography in the diagnosis and surgical approach to this pathology

  6. The ability of preoperative factors to predict patient-reported disability following surgery for rotator cuff pathology.

    Science.gov (United States)

    Woollard, Jason D; Bost, James E; Piva, Sara R; Kelley Fitzgerald, G; Rodosky, Mark W; Irrgang, James J

    2017-10-01

    Minimal research has examined the prognostic ability of shoulder examination data or psychosocial factors in predicting patient-reported disability following surgery for rotator cuff pathology. The purpose of this study was to examine these factors for prognostic value in order to help clinicians and patients understand preoperative factors that impact disability following surgery. Sixty-two patients scheduled for subacromial decompression with or without supraspinatus repair were recruited. Six-month follow-up data were available for 46 patients. Patient characteristics, history of the condition, shoulder impairments, psychosocial factors, and patient-reported disability questionnaires were collected preoperatively. Six months following surgery, the Western Ontario Rotator Cuff Index (WORC) and global rating of change dichotomized subjects into responders versus nonresponders. Logistic regression quantified prognostic ability and created the most parsimonious model to predict outcome. Being on modified job duty (OR = .17, 95%CI: 0.03-0.94), and having a worker's compensation claim (OR = 0.08, 95%CI: 0.01-0.74) decreased probability of a positive outcome, while surgery on the dominant shoulder (OR = 11.96, 95%CI: 2.91-49.18) increased probability. From the examination, only impaired internal rotation strength was a significant univariate predictor. The Fear-avoidance Beliefs Questionnaire (FABQ) score (OR = 0.95, 95%CI: 0.91-0.98) and the FABQ_work subscale (OR = 0.92, 95%CI: 0.87-0.97) were univariate predictors. In the final model, surgery on the dominant shoulder (OR = 8.9, 95%CI 1.75-45.7) and FABQ_work subscale score ≤25 (OR = 15.3, 95%CI 2.3-101.9) remained significant. Surgery on the dominant arm resulted in greater improvement in patient-reported disability, thereby increasing the odds of a successful surgery. The predictive ability of the FABQ_work subscale highlights the potential impact of psychosocial factors on patient

  7. The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up

    Directory of Open Access Journals (Sweden)

    Ibrahim Khalid A

    2007-12-01

    Full Text Available Abstract Background To prospectively evaluate patients who underwent a "mini-open" repair versus a completely arthroscopic technique for small to large size rotator cuff tears. Methods Fifty-two patients underwent "mini-open" or all arthroscopic repair of a full thickness tear of the rotator cuff. Patients who complained of shoulder pain and/or weakness and who had failed a minimum of 6 weeks of physical therapy and had at least one sub-acromial injection were surgical candidates. Pre and post-operative clinical evaluations included the following: 1 demographics; 2 Simple Shoulder Test (SST; 3 University of California, Los Angeles (UCLA rating scale; 4 visual analog pain assessment (VAS; and 5 pre-op SF12 assessment. Descriptive analysis was performed for patient demographics and for all variables. Pre and post outcome scores, range of motion and pain scale were compared using paired t-tests. Analysis of variance (ANOVA was used to evaluate any effect between dependent and independent variables. Significance was set at p is less than or equal to 0.05. Results There were 31 females and 21 males. The average follow-up was 50.6 months (27 – 84 months. The average age was similar between the two groups [arthroscopic x = 55 years/mini-open x = 58 years, p = 0.7]. Twenty-seven patients underwent arthroscopic repair and 25 underwent repair with a mini-open incision. The average rotator cuff tear size was 3.1 cm (range: 1–5 centimeters. There was no significant difference in tear size between the two groups (arthroscopic group = 2.9 cm/mini-open group = 3.2 cm, p = 0.3. Overall, there was a significant improvement from pre-operative status in shoulder pain, shoulder function as measured on the Simple Shoulder test and UCLA Shoulder Form. Visual analog pain improved, on average, 4.4 points and the most recent Short Shoulder Form and UCLA scores were 8 and 26 respectively. Both active and passive glenohumeral joint range of motion improved

  8. Toroidal rotation studies in KSTAR

    Science.gov (United States)

    Lee, S. G.; Lee, H. H.; Yoo, J. W.; Kim, Y. S.; Ko, W. H.; Terzolo, L.; Bitter, M.; Hill, K.; KSTAR Team

    2014-10-01

    Investigation of the toroidal rotation is one of the most important topics for the magnetically confined fusion plasma researches since it is essential for the stabilization of resistive wall modes and its shear plays an important role to improve plasma confinement by suppressing turbulent transport. The most advantage of KSTAR tokamak for toroidal rotation studies is that it equips two main diagnostics including the high-resolution X-ray imaging crystal spectrometer (XICS) and charge exchange spectroscopy (CES). Simultaneous core toroidal rotation and ion temperature measurements of different impurity species from the XICS and CES have shown in reasonable agreement with various plasma discharges in KSTAR. It has been observed that the toroidal rotation in KSTAR is faster than that of other tokamak devices with similar machine size and momentum input. This may due to an intrinsically low toroidal field ripple and error field of the KSTAR device. A strong braking of the toroidal rotation by the n = 1 non-resonant magnetic perturbations (NRMPs) also indicates these low toroidal field ripple and error field. Recently, it has been found that n = 2 NRMPs can also damp the toroidal rotation in KSTAR. The detail toroidal rotation studies will be presented. Work supported by the Korea Ministry of Science, ICT and Future Planning under the KSTAR project.

  9. Rotational discontinuities in anisotropic plasmas

    International Nuclear Information System (INIS)

    Omidi, N.

    1992-01-01

    The kinetic structure of rotational discontinuities (RDs) in anisotropic plasmas with T perpendicular /T parallel > 1 is investigated by using a one-dimensional electromagnetic hybrid code. To form the RD, a new approach is used where the plasma is injected from one boundary and reflected from the other, resulting in the generation of a traveling fast shock and an RD. Unlike the previously used methods, no a priori assumptions are made regarding the initial structure (i.e. width or sense of rotation) of the rotational discontinuity. The results show that across the RD both the magnetic field strength and direction, as well as the plasma density change. Given that such a change can also be associated with an intermediate shock, the Rankine-Hugoniot relations are used to confirm that the observed structures are indeed RDs. It is found that the thickness of RDs is a few ion inertial lengths and is independent of the rotation angle. Also, the preferred sense of rotation is in the electron sense; however, RDs with a rotation angle larger than 180 degree are found to be unstable, changing their rotation to a stable ion sense

  10. [Rotator cuff tear athropathy prevalence].

    Science.gov (United States)

    Guerra-Soriano, F; Encalada-Díaz, M I; Ruiz-Suárez, M; Valero-González, F S

    2017-01-01

    Glenohumeral arthritis secondary to massive rotator cuff tear presents with a superior displacement and femoralization of the humeral head with coracoacromial arch acetabularization. The purpose of this study was to establish prevalence of rotator cuff tear artropathy (CTA) at our institution. Four hundred electronic records were reviewed from which we identified 136 patients with rotator cuff tears. A second group was composed with patients with massive cuff tears that were analized and staged by the Seebauer cuff tear arthropathy classification. Thirty four patients with massive rotator cuff tears were identified, 8 male and 26 female (age 60.1 ± 10.26 years). Massive rotator cuff tear prevalence was 25%. CTA prevalence found in the rotator cuff group was 19 and 76% in the massive cuff tears group. Patients were staged according to the classification with 32% in stage 1a, 11% 1b, 32% 2a and 0% 2b. CTA prevalence in patients with rotator cuff tears and massive cuff tears is higher than the one reported in American population. We consider that a revision of the Seebauer classification to be appropriate to determine its reliability.

  11. Rotating relativistic neutron stars

    Energy Technology Data Exchange (ETDEWEB)

    Weber, F.; Glendenning, N.K.

    1991-07-21

    Models of rotating neutron stars are constructed in the framework of Einstein's theory of general relativity. For this purpose a refined version of Hartle's method is applied. The properties of these objects, e.g. gravitational mass, equatorial and polar radius, eccentricity, red- and blueshift, quadrupole moment, are investigated for Kepler frequencies of 4000 s{sup {minus}1} {le} {Omega}{sub K} {le} 9000 s{sup {minus}1}. Therefore a self-consistency problem inherent in the determination of {Omega}{sub K} must be solved. The investigation is based on neutron star matter equations of state derived from the relativistic Martin-Schwinger hierarch of coupled Green's functions. By means of introducing the Hartree, Hartree-Fock, and ladder ({Lambda}) approximations, models of the equation of state derived. A special feature of the latter approximation scheme is the inclusion of dynamical two-particle correlations. These have been calculated from the relativistic T-matrix applying both the HEA and Bonn meson-exchange potentials of the nucleon-nucleon force. The nuclear forces of the former two treatments are those of the standard scalar-vector-isovector model of quantum hadron dynamics, with parameters adjusted to the nuclear matter data. An important aspect of this work consists in testing the compatibility of different competing models of the nuclear equation of state with data on pulsar periods. By this the fundamental problem of nuclear physics concerning the behavior of the equation of state at supernuclear densities can be treated.

  12. Effect of rotation on convective mass transfer in rotating channels

    International Nuclear Information System (INIS)

    Pharoah, J.G.; Djilali, N.

    2002-01-01

    Laminar flow and mass transfer in rotating channels is investigated in the context of centrifugal membrane separation. The effect of orientation with respect to the rotational axis is examined for rectangular channels of aspect ratio 3 and the Rossby number is varied from 0.3 to 20.9. Both Ro and the channel orientation are found to have a significant effect on the flow. Mass transfer calculations corresponding to reverse osmosis desalination are carried out at various operating pressures and all rotating cases exhibit significant process enhancements at relatively low rotation rates. Finally, while it is common in the membrane literature to correlate mass transfer performance with membrane shear rates this is shown not to be valid in the cases presented herein. (author)

  13. Axial gap rotating electrical machine

    Science.gov (United States)

    None

    2016-02-23

    Direct drive rotating electrical machines with axial air gaps are disclosed. In these machines, a rotor ring and stator ring define an axial air gap between them. Sets of gap-maintaining rolling supports bear between the rotor ring and the stator ring at their peripheries to maintain the axial air gap. Also disclosed are wind turbines using these generators, and structures and methods for mounting direct drive rotating electrical generators to the hubs of wind turbines. In particular, the rotor ring of the generator may be carried directly by the hub of a wind turbine to rotate relative to a shaft without being mounted directly to the shaft.

  14. On the relativity of rotation

    International Nuclear Information System (INIS)

    Gron, O.

    2010-01-01

    The question whether rotational motion is relative according to the general theory of relativity is discussed. Einstein's ambivalence concerning this question is pointed out. In the present article I defend Einstein's way of thinking on this when he presented the theory in 1916. The significance of the phenomenon of perfect inertial dragging in connection with the relativity of rotational motion is discussed. The necessity of introducing an extended model of the Minkowski spacetime, in which a globally empty space is supplied with a cosmic mass shell with radius equal to its own Schwarzschild radius, in order to extend the principle of relativity to accelerated and rotational motion, is made clear.

  15. On rapid rotation in stellarators

    International Nuclear Information System (INIS)

    Helander, Per

    2008-01-01

    The conditions under which rapid plasma rotation may occur in a three-dimensional magnetic field, such as that of a stellarator, are investigated. Rotation velocities comparable to the ion thermal speed are found to be attainable only in magnetic fields which are approximately isometric. In an isometric magnetic field the dependence of the magnetic field strength B on the arc length l along the field is the same for all field lines on each flux surface ψ. Only in fields where the departure from exact isometry, B=B(ψ,l), is of the order of the ion gyroradius divided by the macroscopic length scale are rotation speeds comparable to the ion thermal speed possible. Moreover, it is shown that the rotation must be in the direction of the vector ∇ψx∇B. (author)

  16. Spontaneous Rotational Inversion in Phycomyces

    KAUST Repository

    Goriely, Alain

    2011-03-01

    The filamentary fungus Phycomyces blakesleeanus undergoes a series of remarkable transitions during aerial growth. During what is known as the stagea IV growth phase, the fungus extends while rotating in a counterclockwise manner when viewed from above (stagea IVa) and then, while continuing to grow, spontaneously reverses to a clockwise rotation (stagea IVb). This phase lasts for 24-48Ah and is sometimes followed by yet another reversal (stageAIVc) before the overall growth ends. Here, we propose a continuum mechanical model of this entire process using nonlinear, anisotropic, elasticity and show how helical anisotropy associated with the cell wall structure can induce spontaneous rotation and, under appropriate circumstances, the observed reversal of rotational handedness. © 2011 American Physical Society.

  17. Differential rotation in magnetic stars

    International Nuclear Information System (INIS)

    Moss, D.

    1981-01-01

    The possibility that large-scale magnetic fields in stars are the product of a contemporary dynamo situated in the convective stellar core, rather than being a fossil from an earlier stage in the history of the star, is investigated. It is demonstrated that then the envelope will almost inevitably be in a state of differential rotation. Some simple models are constructed to illustrate the magnitude of the effects on the structure of the envelope and magnetic field. It is found that, for models which are relatively rapidly rotating, a modest differential rotation at the surface of the core may increase considerably the ratio of internal to surface field, but only give rise to a small surface differential rotation. (author)

  18. Conjunct rotation: Codman's paradox revisited.

    Science.gov (United States)

    Wolf, Sebastian I; Fradet, Laetitia; Rettig, Oliver

    2009-05-01

    This contribution mathematically formalizes Codman's idea of conjunct rotation, a term he used in 1934 to describe a paradoxical phenomenon arising from a closed-loop arm movement. Real (axial) rotation is distinguished from conjunct rotation. For characterizing the latter, the idea of reference vector fields is developed to define the neutral axial position of the humerus for any given orientation of its long axis. This concept largely avoids typical coordinate singularities arising from decomposition of 3D joint motion and therefore can be used for postural (axial) assessment of the shoulder joint both clinically and in sports science in almost the complete accessible range of motion. The concept, even though algebraic rather complex, might help to get an easier and more intuitive understanding of axial rotation of the shoulder in complex movements present in daily life and in sports.

  19. Urofacial syndrome

    Directory of Open Access Journals (Sweden)

    Kamal F Akl

    2012-01-01

    Full Text Available The urofacial syndrome is characterized by functional obstructive uropathy asso-ciated with an inverted smile. The importance of the subject is that it sheds light, not only on the muscles of facial expression, but also on the inheritance of voiding disorders and lower urinary tract malformations. We report a 10-year-old-male patient who had the urofacial syndrome. Early diagnosis of the urofacial syndrome is important to avoid upper urinary tract damage and renal failure.

  20. Refeeding syndrome

    OpenAIRE

    Tripathy, Swagata; Mishra, Padmini; Dash, S. C.

    2008-01-01

    Refeeding syndrome is a potentially fatal medical condition that may affect malnourished patients in response to an inappropriately rapid overfeeding. This commonly occurs following the institution of nutritional support, especially parenteral or enteral nutrition. The most characteristic pathophysiology of refeeding syndrome relates to the rapid consumption of phosphate after glucose intake and subsequent hypophosphatemia. Refeeding syndrome can manifest as either metabolic changes (hypokala...

  1. Revesz syndrome

    Directory of Open Access Journals (Sweden)

    Dayane Cristine Issaho

    2015-04-01

    Full Text Available Revesz syndrome is a rare variant of dyskeratosis congenita and is characterized by bilateral exudative retinopathy, alterations in the anterior ocular segment, intrauterine growth retardation, fine sparse hair, reticulate skin pigmentation, bone marrow failure, cerebral calcification, cerebellar hypoplasia and psychomotor retardation. Few patients with this syndrome have been reported, and significant clinical variations exist among patients. This report describes the first Brazilian case of Revesz syndrome and its ocular and clinical features.

  2. Current status of rotational atherectomy.

    Science.gov (United States)

    Tomey, Matthew I; Kini, Annapoorna S; Sharma, Samin K

    2014-04-01

    Rotational atherectomy facilitates percutaneous coronary intervention for complex de novo lesions with severe calcification. A strategy of routine rotational atherectomy has not, however, conferred reduction in restenosis or major adverse cardiac events. As it is technically demanding, rotational atherectomy is also uncommon. At this 25-year anniversary since the introduction of rotational atherectomy, we sought to review the current state-of-the-art in rotational atherectomy technique, safety, and efficacy data in the modern era of drug-eluting stents, strategies to prevent and manage complications, including slow-flow/no-reflow and burr entrapment, and appropriate use in the context of the broader evolution in the management of stable ischemic heart disease. Fundamental elements of optimal technique include use of a single burr with burr-to-artery ratio of 0.5 to 0.6-rotational speed of 140,000 to 150,000 rpm, gradual burr advancement using a pecking motion, short ablation runs of 15 to 20 s, and avoidance of decelerations >5,000 rpm. Combined with meticulous technique, optimal antiplatelet therapy, vasodilators, flush solution, and provisional use of atropine, temporary pacing, vasopressors, and mechanical support may prevent slow-flow/no-reflow, which in contemporary series is reported in 0.0% to 2.6% of cases. On the basis of the results of recent large clinical trials, a subset of patients with complex coronary artery disease previously assigned to rotational atherectomy may be directed instead to medical therapy alone or bypass surgery. For patients with de novo severely calcified lesions for which rotational atherectomy remains appropriate, referral centers of excellence are required. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Rotating Shadowband Spectroradiometer (RSS) Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Kiedron, P; Schlemmer, J; Klassen, M

    2005-01-01

    The rotating shawdowband spectroradiometer (RSS) implements the same automated shadowbanding technique used by the multifilter rotating shadowband radiometer (MFRSR), and so it too provides spectrally-resolved, direct-normal, diffuse-horizontal, and total-horizontal irradiances, and can be calibrated in situ via Langley regression. The irradiance spectra are measured simultaneously at all spectral elements (pixels) in 360-nm to 1050-nm range.

  4. Faraday rotation measurements at Ootacamund

    Science.gov (United States)

    Sethia, G.; Chandra, H.; Deshpande, M. R.; Rastogi, R. G.

    1978-01-01

    The results of Faraday rotation measurements made at Ootacamund during ATS-6 phase II are presented. For summer and equinoctial months, even though no clear noon bite-out is observed in the variation of Faraday a decrease is observed in the rate of increase of rotation around 0900-1000 hours LT. This is attributed to the 'fountain effect' which is responsible for the noontime bite-out in F2-region peak electron density.

  5. Relaxation processes in rotational motion

    International Nuclear Information System (INIS)

    Broglia, R.A.

    1986-01-01

    At few MeV above the yrast line the normally strong correlations among γ-ray energies in a rotational sequence become weaker. This observation can be interpreted as evidence for the damping of rotational motion in hot nuclei. It seems possible to relate the spreading width of the E2-rotational decay strength to the spread in frequency Δω 0 of rotational bands. The origin of these fluctuations is found in: (1) fluctuations in the occupation of special single-particle orbits which contribute a significant part of the total angular momentum; and (2) fluctuations in the moment of inertia induced by vibrations of the nuclear shape. Estimates of Δω 0 done making use of the hundred-odd known discrete rotational bands in the rare-earth region lead, for moderate spin and excitation energies (I ≅ 30 and U ≅ 3 to 4 MeV), to rotational spreading widths of the order of 60 to 160 keV in overall agreement with the data. 24 refs

  6. The rotation of galaxy clusters

    International Nuclear Information System (INIS)

    Tovmassian, H.M.

    2015-01-01

    The method for detection of the galaxy cluster rotation based on the study of distribution of member galaxies with velocities lower and higher of the cluster mean velocity over the cluster image is proposed. The search for rotation is made for flat clusters with a/b> 1.8 and BMI type clusters which are expected to be rotating. For comparison there were studied also round clusters and clusters of NBMI type, the second by brightness galaxy in which does not differ significantly from the cluster cD galaxy. Seventeen out of studied 65 clusters are found to be rotating. It was found that the detection rate is sufficiently high for flat clusters, over 60 per cent, and clusters of BMI type with dominant cD galaxy, ≈ 35 per cent. The obtained results show that clusters were formed from the huge primordial gas clouds and preserved the rotation of the primordial clouds, unless they did not have mergings with other clusters and groups of galaxies, in the result of which the rotation has been prevented

  7. Reye's Syndrome

    Science.gov (United States)

    ... that contain aspirin. Some hospitals and medical facilities conduct newborn screenings for fatty acid oxidation disorders to determine which children are at greater risk of developing Reye's syndrome. ...

  8. Marfan Syndrome (For Teens)

    Science.gov (United States)

    ... genetic disorder called Marfan syndrome. What Is Marfan Syndrome? Marfan syndrome is named after Antoine Marfan, the French ... immediately. What's Life Like for Teens With Marfan Syndrome? Marfan syndrome affects people differently, so life is not ...

  9. Learning about Marfan Syndrome

    Science.gov (United States)

    ... Additional Resources for Marfan Syndrome What is Marfan syndrome? Marfan syndrome is one of the most common inherited ... FAQ Top of page Additional Resources For Marfan Syndrome Marfan syndrome [nlm.nih.gov] From Medline Plus Marfan ...

  10. Russell-Silver syndrome

    Science.gov (United States)

    Silver-Russell syndrome; Silver syndrome; RSS; Russell-Silver syndrome ... One in 10 children with this syndrome has a problem involving chromosome 7. In other people with the syndrome, it may affect chromosome 11. Most of the time, it ...

  11. What Is Usher Syndrome?

    Science.gov (United States)

    ... Action You are here Home › Retinal Diseases Listen Usher Syndrome What is Usher syndrome? How is Usher syndrome ... available? Are there any related diseases? What is Usher Syndrome? Usher syndrome is an inherited condition characterized by ...

  12. Seckel syndrome: an overdiagnosed syndrome.

    OpenAIRE

    Thompson, E; Pembrey, M

    1985-01-01

    Five children in whom a diagnosis of Seckel syndrome had previously been made were re-examined in the genetic unit. One child had classical Seckel syndrome, a sib pair had the features of the syndrome with less severe short stature, and in two children the diagnosis was not confirmed. Seckel syndrome is only one of a group of low birth weight microcephalic dwarfism and careful attention should be paid to fulfillment of the major criteria defined by Seckel before the diagnosis is made. There r...

  13. Critical rotation of general-relativistic polytropic models revisited

    Science.gov (United States)

    Geroyannis, V.; Karageorgopoulos, V.

    2013-09-01

    We develop a perturbation method for computing the critical rotational parameter as a function of the equatorial radius of a rigidly rotating polytropic model in the "post-Newtonia approximation" (PNA). We treat our models as "initial value problems" (IVP) of ordinary differential equations in the complex plane. The computations are carried out by the code dcrkf54.f95 (Geroyannis and Valvi 2012 [P1]; modified Runge-Kutta-Fehlberg code of fourth and fifth order for solving initial value problems in the complex plane). Such a complex-plane treatment removes the syndromes appearing in this particular family of IVPs (see e.g. P1, Sec. 3) and allows continuation of the numerical integrations beyond the surface of the star. Thus all the required values of the Lane-Emden function(s) in the post-Newtonian approximation are calculated by interpolation (so avoiding any extrapolation). An interesting point is that, in our computations, we take into account the complete correction due to the gravitational term, and this issue is a remarkable difference compared to the classical PNA. We solve the generalized density as a function of the equatorial radius and find the critical rotational parameter. Our computations are extended to certain other physical characteristics (like mass, angular momentum, rotational kinetic energy, etc). We find that our method yields results comparable with those of other reliable methods. REFERENCE: V.S. Geroyannis and F.N. Valvi 2012, International Journal of Modern Physics C, 23, No 5, 1250038:1-15.

  14. Burnout Syndrome

    OpenAIRE

    Panova, Gordana; Panov, Nenad; Stojanov, H; Sumanov, Gorgi; Panova, Blagica; Stojanovski, Angel; Nikolovska, Lence; Jovevska, Svetlana; Trajanovski, D; Asanova, D

    2013-01-01

    Introduction: Increasing work responsibilities, allocation of duties, loss of energy and motivation in everyday activities, emotional exhaustion, lack of time for themselves, insuffi cient time for rest and recreation, dissatisfaction in private life. All these symptoms can be cause of Burnout Syndrome. Aim: To see the importance of this syndrome, the consequences of job dissatisfaction, the environment, family and expression in drastic chan...

  15. Tourette Syndrome

    Science.gov (United States)

    If you have Tourette syndrome, you make unusual movements or sounds, called tics. You have little or no control over them. Common tics are throat- ... spin, or, rarely, blurt out swear words. Tourette syndrome is a disorder of the nervous system. It ...

  16. Fahr's Syndrome

    Science.gov (United States)

    ... or 50s, although it can occur at any time in childhood or adolescence. × Definition Fahr's Syndrome is a rare, genetically dominant, inherited ... or 50s, although it can occur at any time in childhood or adolescence. View Full Definition Treatment There is no cure for Fahr's Syndrome, ...

  17. Lemierre's syndrome

    DEFF Research Database (Denmark)

    Johannesen, Katrine; Bødtger, Uffe; Heltberg, Ole

    2014-01-01

    Lemierre's syndrome is an often un-diagnosed disease seen in previously healthy young subjects, presenting with symptoms of pharyngitis, fever and elevated markers of inflammation. The syndrome is characterised by infectious thrombosis of the jugular vein due to infection with Fusobacteria, causing...

  18. Ambras syndrome

    Directory of Open Access Journals (Sweden)

    Sudhir Malwade

    2015-01-01

    Full Text Available Ambras syndrome, a form of congenital hypertrichosis lanuginosa, is extremely rare in neonates. It is characterized by typical pattern of hair distribution, dysmorphic facial features and a familial pattern of inheritance. We report a case of Ambras syndrome in a preterm neonate with history of consanguinity and positive family history.

  19. Antiphospholipid syndrome

    DEFF Research Database (Denmark)

    Cervera, Ricard; Piette, Jean-Charles; Font, Josep

    2002-01-01

    To analyze the clinical and immunologic manifestations of antiphospholipid syndrome (APS) in a large cohort of patients and to define patterns of disease expression.......To analyze the clinical and immunologic manifestations of antiphospholipid syndrome (APS) in a large cohort of patients and to define patterns of disease expression....

  20. Noonan syndrome

    OpenAIRE

    Roberts, Amy E; Allanson, Judith E; Tartaglia, Marco; Gelb, Bruce D

    2013-01-01

    Noonan syndrome is a genetic multisystem disorder characterised by distinctive facial features, developmental delay, learning difficulties, short stature, congenital heart disease, renal anomalies, lymphatic malformations, and bleeding difficulties. Mutations that cause Noonan syndrome alter genes encoding proteins with roles in the RAS–MAPK pathway, leading to pathway dysregulation. Management guidelines have been developed. Several clinically relevant genotype–phenotype correlations aid ris...

  1. TAFRO Syndrome.

    Science.gov (United States)

    Igawa, Takuro; Sato, Yasuharu

    2018-02-01

    TAFRO syndrome is a newly recognized variant of idiopathic multicentric Castleman disease (iMCD) that involves a constellation of syndromes: thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O). Thrombocytopenia and severe anasarca accompanied by relatively low serum immunoglobulin levels are characteristic clinical findings of TAFRO syndrome that are not present in iMCD-not otherwise specified (iMCD-NOS). Lymph node biopsy is recommended to exclude other diseases and to diagnose TAFRO syndrome, which reveals characteristic histopathological findings similar to hyaline vascular-type CD. TAFRO syndrome follows a more aggressive course, compared with iMCD-NOS, and there is no standard treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Refueling system with small diameter rotatable plugs

    International Nuclear Information System (INIS)

    Ritz, W.C.

    1987-01-01

    This patent describes a liquid-metal fastbreeder nuclear reactor comprising a reactor pressure vessel and closure head therefor, a reactor core barrel disposed within the reactor vessel and enclosing a reactor core having therein a large number of closely spaced fuel assemblies, and the reactor core barrel and the reactor core having an approximately concentric circular cross-sectional configuration with a geometric center in predetermined location within the reactor vessel. The improved refueling system described here comprises: a large controllably rotatable plug means comprising the substantial portion of the closure head, a reactor upper internals structure mounted from the large rotatable plug means. The large rotatable plug means has an approximately circular configuration which approximates the cross-sectional configuration of the reactor core barrel with a center of rotation positioned a first predetermined distance from the geometric center of the reactor core barrel so that the large rotatable plug means rotates eccentrically with respect to the reactor core barrel; a small controllably rotatable plug means affixed to the large rotatable plug means and rotatable with respect thereto. The small rotatable plug means has a center of rotation which is offset a second predetermined distance from the rotational center of the large rotatable plug means so that the small rotatable plug means rotates eccentrically with respect to the large rotatable plug means

  3. Tokamak rotation and charge exchange

    International Nuclear Information System (INIS)

    Hazeltine, R.D.; Rowan, W.L.; Solano, E.R.; Valanju, P.M.

    1991-01-01

    In the absence of momentum input, tokamak toroidal rotation rates are typically small - no larger in particular than poloidal rotation - even when the radial electric field is strong, as near the plasma edge. This circumstance, contradicting conventional neoclassical theory, is commonly attributed to the rotation damping effect of charge exchange, although a detailed comparison between charge-exchange damping theory and experiment is apparently unavailable. Such a comparison is attempted here in the context of recent TEXT experiments, which compare rotation rates, both poloidal and toroidal, in helium and hydrogen discharges. The helium discharges provide useful data because they are nearly free of ion-neutral charge exchange; they have been found to rotate toroidally in reasonable agreement with neoclassical predictions. The hydrogen experiments show much smaller toroidal motion as usual. The theoretical calculation uses the full charge-exchange operator and assumes plateau collisionality, roughly consistent with the experimental conditions. The authors calculate the ion flow as a function of v cx /v c , where v cx is the charge exchange rate and v c the Coulomb collision frequency. The results are in reasonable accord with the observations. 1 ref

  4. The structure of rotational discontinuities

    International Nuclear Information System (INIS)

    Neugebauer, M.

    1989-01-01

    This study examines the structures of a set of rotational discontinuities detected in the solar wind by the ISEE-3 spacecraft. It is found that the complexity of the structure increases as the angle θ between the propagation vector k and the magnetic field decreases. For rotational discontinuities that propagate at a large angle to the field with an ion (left-hand) sense of rotation, the magnetic hodograms tend to be flattened, in agreement with prior numerical simulations. When θ is large, angular overshoots are often observed at one or both ends of the discontinuity. When the propagation is nearly parallel to the field (i.e., when θ is small), many different types of structure are seen, ranging from straight lines, the S-shaped curves, to complex, disorganized shapes

  5. Motions on a rotating planet

    Science.gov (United States)

    Schröer, H.

    In chapter 1 we want to describe the motion of a falling body on a rotating planet. The planet rotates with an arbitrary changable angular velocity and has a translational acceleration. We obtain 3 differential equations. For the general gravitational field an exact solution is possible, when the differential equation system is explicit solvable. Then we consider the case, if the angular velocity and the translational acceleration is constant. With a special transformation we get 3 partial differential equations of first order. Instead of a planet sphere we can choose a general body of rotation. Even general bodies are possible. Chapter 2 contains the motion in a local coordinate system on planet's surface. We have an inhomogeneous linear differential equation of first order. If the angular velocity is constant, we get a system with constant coefficients. There is an english and a german edition.

  6. Rotated balance in humans due to repetitive rotational movement

    Science.gov (United States)

    Zakynthinaki, M. S.; Madera Milla, J.; López Diaz De Durana, A.; Cordente Martínez, C. A.; Rodríguez Romo, G.; Sillero Quintana, M.; Sampedro Molinuevo, J.

    2010-03-01

    We show how asymmetries in the movement patterns during the process of regaining balance after perturbation from quiet stance can be modeled by a set of coupled vector fields for the derivative with respect to time of the angles between the resultant ground reaction forces and the vertical in the anteroposterior and mediolateral directions. In our model, which is an adaption of the model of Stirling and Zakynthinaki (2004), the critical curve, defining the set of maximum angles one can lean to and still correct to regain balance, can be rotated and skewed so as to model the effects of a repetitive training of a rotational movement pattern. For the purposes of our study a rotation and a skew matrix is applied to the critical curve of the model. We present here a linear stability analysis of the modified model, as well as a fit of the model to experimental data of two characteristic "asymmetric" elite athletes and to a "symmetric" elite athlete for comparison. The new adapted model has many uses not just in sport but also in rehabilitation, as many work place injuries are caused by excessive repetition of unaligned and rotational movement patterns.

  7. Mach's principle and rotating universes

    International Nuclear Information System (INIS)

    King, D.H.

    1990-01-01

    It is shown that the Bianchi 9 model universe satisfies the Mach principle. These closed rotating universes were previously thought to be counter-examples to the principle. The Mach principle is satisfied because the angular momentum of the rotating matter is compensated by the effective angular momentum of gravitational waves. A new formulation of the Mach principle is given that is based on the field theory interpretation of general relativity. Every closed universe with 3-sphere topology is shown to satisfy this formulation of the Mach principle. It is shown that the total angular momentum of the matter and gravitational waves in a closed 3-sphere topology universe is zero

  8. NH3 quantum rotators in Hofmann clathrates: intensity and width of rotational transition lines

    International Nuclear Information System (INIS)

    Vorderwisch, Peter; Sobolev, Oleg; Desmedt, Arnaud

    2004-01-01

    Inelastic structure factors for rotational transitions of uniaxial NH 3 quantum rotators, measured in a Hofmann clathrate with biphenyl as guest molecule, agree with those calculated for free rotators. A finite intrinsic line width, found for rotational transitions involving the rotational level j=3 at low temperature, supports a recently suggested model based on resonant rotor-rotor coupling

  9. Goldenhar syndrome

    Directory of Open Access Journals (Sweden)

    Neeraj Sharma

    2013-01-01

    Full Text Available Goldenhar syndrome is a syndrome of complex structures developing from first and second branchial arches during blastogenesis. The etiology of this rare disease is not fully understood, as it has shown itself variable genetically and of unclear causes. The disorder is characterized by a wide spectrum of symptoms and physical features that may vary greatly in range and severity from case to case. Here we present a unique case of Goldenhar syndrome with absence of left condyle, hypoplasia of the zygomatic bone, no pneumatization of the mastoid process, underdeveloped mandible, bifid tongue and the skin tags in the preauricular area.

  10. Cowden syndrome

    Directory of Open Access Journals (Sweden)

    Ravi Prakash S

    2010-01-01

    Full Text Available Cowden syndrome or multiple hamartoma syndrome is an autosomal dominant condition with variable expressions that result mainly from mutation in the PTEN gene on arm 10q. It is characterized by multiple hamartomatous neoplasms of the skin, oral mucosa, gastrointestinal tract, bones, CNS, eyes, and genitourinary tract. Mucocutaneous features include trichilemmomas, oral mucosal papillomatosis, acral keratosis, and palmoplantar keratosis. Here we present a case of Cowden syndrome in a 14-year-old female patient with the chief complaint of multiple oral papillomatous lesions.

  11. Costello syndrome

    Directory of Open Access Journals (Sweden)

    Madhukara J

    2007-01-01

    Full Text Available Costello syndrome is a rare, distinctive, multiple congenital anomaly syndrome, characterized by soft, loose skin with deep palmar and plantar creases, loose joints, distinctive coarse facial features and skeletal and cardiac abnormalities. The affected patients have a predisposition to develop malignancy, developmental delays and mental retardation. Recently, a 7-year-old male child born to normal nonconsanguineous parents presented to us with abnormal facial features, arrhythmia, mitral valve dysfunction and growth retardation. His cutaneous examination revealed lax and pigmented skin over hands and feet with deep creases, acanthosis nigricans and short curly hairs. Its differentiation from other syndromes with similar clinical features is discussed in this article.

  12. Tratamento artroscópico da tendinite calcária do manguito rotador Arthroscopic treatment of calcifying tendinitis of the rotator cuff

    Directory of Open Access Journals (Sweden)

    Arnaldo Amado Ferreira Neto

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos e radiográficos do tratamento cirúrgico por via artroscópica em pacientes com tendinite calcária do manguito rotador. MÉTODO: Foi realizado um estudo retrospectivo com análise de 20 pacientes que foram submetidos ao tratamento artroscópico da tendinite calcária do ombro, de março de 1999 a novembro de 2005. Seis pacientes foram excluídos devido à perda do seguimento. Com seguimento médio de 41,4 meses, oito pacientes (57% eram do sexo feminino e seis (43% do masculino; sendo o lado direito acometido em 10 (71% e o esquerdo em quatro (29%. Nove casos (64% apresentavam calcificação no tendão supraespinal, dois (14% no infraespinal e três (21% envolvendo os dois tendões. RESULTADOS: Em todos os casos, realizou-se a ressecção dos depósitos de cálcio através da perfuração com agulha (Jelco® nº 14 e curetagem (minicureta. Dois ombros (14% foram submetidos à descompressão subacromial; um, (7% à exérese distal da clavícula; e, em três, (21% houve a necessidade de se fazer sutura tendão-tendão. Nenhum paciente foi submetido à reinserção tendão-osso. Pela escala da UCLA, a média da pontuação foi de 33 pontos (26-35, indicando que a maioria teve resultados bons. Na avaliação final radiográfica, nenhum paciente apresentava sinais de calcificações. CONCLUSÃO: O tratamento artroscópico da tendinite calcária do ombro permite a exérese da calcificação com segurança, obtendo-se resultados bons com relação à dor e à função do ombro.OBJECTIVE: To evaluate the clinical and radiographic results of arthroscopic treatment of the rotator cuff in patients with Calcifying Tendinitis. METHOD: A retrospective study of twenty patients submitted to arthroscopic treatment for rotator cuff Calcifying Tendinitis from March 1999 to November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57% were female and

  13. Rotation of White Dwarf Stars

    OpenAIRE

    Kawaler, Steven D.

    2014-01-01

    I discuss and consider the status of observational determinations of the rotation velocities of white dwarf stars via asteroseismology and spectroscopy. While these observations have important implications on our understanding of the angular momentum evolution of stars in their late stages of evolution, more direct methods are sorely needed to disentangle ambiguities.

  14. Rotational damping motion in nuclei

    International Nuclear Information System (INIS)

    Egido, J.L.; Faessler, A.

    1991-01-01

    The recently proposed model to explain the mechanism of the rotational motion damping in nuclei is exactly solved. When compared with the earlier approximative solution, we find significative differences in the low excitation energy limit (i.e. Γ μ 0 ). For the strength functions we find distributions going from the Wigner semicircle through gaussians to Breit-Wigner shapes. (orig.)

  15. Rotation in a gravitational billiard

    Science.gov (United States)

    Peraza-Mues, G. G.; Carvente, Osvaldo; Moukarzel, Cristian F.

    Gravitational billiards composed of a viscoelastic frictional disk bouncing on a vibrating wedge have been studied previously, but only from the point of view of their translational behavior. In this work, the average rotational velocity of the disk is studied under various circumstances. First, an experimental realization is briefly presented, which shows sustained rotation when the wedge is tilted. Next, this phenomenon is scrutinized in close detail using a precise numerical implementation of frictional forces. We show that the bouncing disk acquires a spontaneous rotational velocity whenever the wedge angle is not bisected by the direction of gravity. Our molecular dynamics (MD) results are well reproduced by event-driven (ED) simulations. When the wedge aperture angle θW>π/2, the average tangential velocity Rω¯ of the disk scales with the typical wedge vibration velocity vb, and is in general a nonmonotonic function of the overall tilt angle θT of the wedge. The present work focuses on wedges with θW=2π/3, which are relevant for the problem of spontaneous rotation in vibrated disk packings. This study makes part of the PhD Thesis of G. G. Peraza-Mues.

  16. Visual and Haptic Mental Rotation

    Directory of Open Access Journals (Sweden)

    Satoshi Shioiri

    2011-10-01

    Full Text Available It is well known that visual information can be retained in several types of memory systems. Haptic information can also be retained in a memory because we can repeat a hand movement. There may be a common memory system for vision and action. On the one hand, it may be convenient to have a common system for acting with visual information. On the other hand, different modalities may have their own memory and use retained information without transforming specific to the modality. We compared memory properties of visual and haptic information. There is a phenomenon known as mental rotation, which is possibly unique to visual representation. The mental rotation is a phenomenon where reaction time increases with the angle of visual target (eg,, a letter to identify. The phenomenon is explained by the difference in time to rotate the representation of the target in the visual sytem. In this study, we compared the effect of stimulus angle on visual and haptic shape identification (two-line shapes were used. We found that a typical effect of mental rotation for the visual stimulus. However, no such effect was found for the haptic stimulus. This difference cannot be explained by the modality differences in response because similar difference was found even when haptical response was used for visual representation and visual response was used for haptic representation. These results indicate that there are independent systems for visual and haptic representations.

  17. A rotating arc plasma invertor

    International Nuclear Information System (INIS)

    Reusch, M.F.; Jayaram, K.

    1987-02-01

    A device is described for the inversion of direct current to alternating current. The main feature is the use of a rotating plasma arc in crossed electric and magnetic fields as a switch. This device may provide an economic alternative to other inversion methods in some circumstances

  18. Rotations in a Vertebrate Setting

    Science.gov (United States)

    McCollum, Gin

    2003-05-01

    Rotational movements of the head are often considered to be measured in a single three dimensional coordinate system implemented by the semicircular canals of the vestibular system of the inner ear. However, the vertebrate body -- including the nervous system -- obeys rectangular symmetries alien to rotation groups. At best, nervous systems mimic the physical rotation group in a fragmented way, only partially reintegrating physical movements in whole organism responses. The vestibular canal reference frame is widely used in nervous systems, for example by eye movements. It is used to some extent even in the cerebrum, as evidenced by the remission of hemineglect -- in which half of space is ignored -- when the vestibular system is stimulated. However, reintegration of space by the organism remains incomplete. For example, compensatory eye movements (which in most cases aid visual fixation) may disagree with conscious self-motion perception. In addition, movement-induced nausea, illusions, and cue-free perceptions demonstrate symmetry breaking or incomplete spatial symmetries. As part of a long-term project to investigate rotation groups in nervous systems, we have analyzed the symmetry group of a primary vestibulo-spinal projection.

  19. Synchrotron Radiation and Faraday Rotation

    NARCIS (Netherlands)

    Heald, George

    2015-01-01

    Synchrotron radiation and its degree of linear polarization are powerful tracers of magnetic fields that are illuminated by cosmic ray electrons. Faraday rotation of the linearly polarized radiation is induced by intervening line-of-sight magnetic fields that are embedded in ionized plasmas. For

  20. Black hole vacua and rotation

    International Nuclear Information System (INIS)

    Krishnan, Chethan

    2011-01-01

    Recent developments suggest that the near-region of rotating black holes behaves like a CFT. To understand this better, I propose to study quantum fields in this region. An instructive approach for this might be to put a large black hole in AdS and to think of the entire geometry as a toy model for the 'near-region'. Quantum field theory on rotating black holes in AdS can be well-defined (unlike in flat space), if fields are quantized in the co-rotating-with-the-horizon frame. First, some generalities of constructing Hartle-Hawking Green functions in this approach are discussed. Then as a specific example where the details are easy to handle, I turn to 2+1 dimensions (BTZ), write down the Green functions explicitly starting with the co-rotating frame, and observe some structural similarities they have with the Kerr-CFT scattering amplitudes. Finally, in BTZ, there is also an alternate construction for the Green functions: we can start from the covering AdS 3 space and use the method of images. Using a 19th century integral formula, I show the equality between the boundary correlators arising via the two constructions.

  1. Perturbative treatment of nuclear rotations

    International Nuclear Information System (INIS)

    Civitarese, O.

    1980-01-01

    In this work, it is described the case corresponding to perturbative quantum treatment of a fermion system in free rotation and the divergences which resulted from the 'break' in symmetry, associated by the adoption of a deformed basis as a non pertubed solution. (A.C.A.S.) [pt

  2. Meniscus Stability in Rotating Systems

    Science.gov (United States)

    Reichel, Yvonne; Dreyer, Michael

    2013-11-01

    In this study, the stability of free surfaces of fluid between two rotating coaxial, circular disks is examined. Radially mounted baffles are used to form menisci of equal size. To the center of the upper disk, a tube is connected in which a separate meniscus is formed. Assuming solid-body rotation and ignoring dynamic effects, it is observed that the free surfaces between the disks fail to remain stable once the rotation speed exceeds a critical value. In other words, Rayleigh-Taylor instability ensues when the capillary forces fail to balance centrifugal forces. Dimensionless critical rotation speeds are studied by means of the Surface Evolver via SE-FIT for varied number of baffles, the normalized distance between the disks, and the normalized central tube radius. Drop tower tests are performed to confirm some of the numerical results. The computation also reveals that there are different modes of instability as a function of the relevant parameters. This study was funded by the space agency of the German Aerospace Center with resources of the Federal Ministry of Economics and Technology on the basis of a resolution of the German Bundestag under grant number 50 RL 1320.

  3. Reye Syndrome

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now What Is Reye’s Syndrome? ...

  4. Alagille Syndrome

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now Alagille Syndrome Back Alagille ...

  5. Turner Syndrome

    Science.gov (United States)

    ... Failure to begin sexual changes expected during puberty Sexual development that "stalls" during teenage years Early end to menstrual cycles not due to pregnancy For most women with Turner syndrome, inability to ...

  6. [Refeeding syndrome].

    Science.gov (United States)

    Ševela, Stanislav; Novák, František; Kazda, Antonín; Brodská, Helena

    Despite being known more than 60 years, refeeding syndrome (RS) still bears many uncertainties. For example, its definition is not clear and definite, and the attitude to it varies from the complete neglect to over-prevention.The term "refeeding syndrome" refers to electrolyte and metabolic changes occurring in malnourished patients after the readministration of nutrition. These changes concern especially to phosphates and ions. Potassium, magnesium, naturism and fluids balance are involved. The changes lead to cell energetic metabolism and electric potential disturbances, with related clinical symptoms.Fully developed refeeding syndrome is quite rare; nevertheless it can be fatal for the patient. However, even its development can lead to many complications increasing the patient's morbidity and the length of stay in the hospital. Yet the refeeding syndrome is more or less predictable and if kept in mind also preventable.The aim of this article is to get the reader to know more about this metabolic phenomenon and possible attitudes towards it.

  7. Cockayne syndrome

    DEFF Research Database (Denmark)

    Karikkineth, Ajoy C; Scheibye-Knudsen, Morten; Fivenson, Elayne

    2017-01-01

    Cockayne syndrome (CS) is a disorder characterized by a variety of clinical features including cachectic dwarfism, severe neurological manifestations including microcephaly and cognitive deficits, pigmentary retinopathy, cataracts, sensorineural deafness, and ambulatory and feeding difficulties...

  8. Alagille Syndrome

    Science.gov (United States)

    ... Liver Function Tests Clinical Trials Liver Transplant FAQs Medical Terminology Diseases of the Liver Alagille Syndrome Alcohol-Related ... the Liver The Progression of Liver Disease FAQs Medical Terminology HOW YOU CAN HELP Sponsorship Ways to Give ...

  9. Reye Syndrome

    Science.gov (United States)

    ... Liver Function Tests Clinical Trials Liver Transplant FAQs Medical Terminology Diseases of the Liver Alagille Syndrome Alcohol-Related ... the Liver The Progression of Liver Disease FAQs Medical Terminology HOW YOU CAN HELP Sponsorship Ways to Give ...

  10. Turner Syndrome

    Science.gov (United States)

    ... crowding, and osteoporosis (brittle bones). Because of their physical conditions, health concerns, and infertility, some girls and women with TS may have low self- esteem, anxiety, or depression. How is Turner syndrome diagnosed? Physical features may ...

  11. Cushing's Syndrome

    Science.gov (United States)

    ... person cured of Cushing’s syndrome might have some memory loss and slight mental decline. But the change is ... Categories: Family Health, Infants and Toddlers, Kids and Teens, Men, Seniors, WomenTags: acth, adenomas, hormone, sickness September ...

  12. Levator Syndrome

    Science.gov (United States)

    ... Abscess Anorectal Fistula Foreign Objects in the Rectum Hemorrhoids Levator Syndrome Pilonidal Disease Proctitis Rectal Prolapse (See ... out other painful rectal conditions (such as thrombosed hemorrhoids , fissures , or abscesses ). The physical examination is often ...

  13. Alport Syndrome

    Science.gov (United States)

    ... signs and symptoms may differ, based on age, gender and inherited type of Alport syndrome. For example, ... prevention and treatment of kidney disease. The Better Business Bureau Wise Giving Alliance Charity Seal provides the ...

  14. Gilbert's Syndrome

    Science.gov (United States)

    ... not know you have the condition until it's discovered by accident, such as when a blood test ... chemotherapy drug Some protease inhibitors used to treat HIV If you have Gilbert's syndrome, talk to your ...

  15. Potter syndrome

    Science.gov (United States)

    Potter phenotype ... In Potter syndrome, the primary problem is kidney failure. The kidneys fail to develop properly as the baby is ... kidneys normally produce the amniotic fluid (as urine). Potter phenotype refers to a typical facial appearance that ...

  16. Moebius Syndrome

    Science.gov (United States)

    ... delays; high or cleft palate; hearing problems and speech difficulties. Children with Moebius syndrome are unable to move their eyes back and forth. Decreased numbers of muscle fibers have been reported. Deformities of the tongue, jaw, and limbs, such ...

  17. Fraser syndrome

    DEFF Research Database (Denmark)

    Barisic, Ingeborg; Odak, Ljubica; Loane, Maria

    2013-01-01

    Fraser syndrome is a rare autosomal recessive disorder characterized by cryptophthalmos, cutaneous syndactyly, laryngeal, and urogenital malformations. We present a population-based epidemiological study using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network of...

  18. Angelman Syndrome

    Science.gov (United States)

    ... therapy for seizures is usually necessary. Physical and occupational therapies, communication therapy, and behavioral therapies are important in allowing individuals with Angelman syndrome to reach their maximum developmental potential. × Treatment There ...

  19. Joubert Syndrome

    Science.gov (United States)

    ... CEP290 . View Full Definition Treatment Treatment for Joubert syndrome is symptomatic and supportive. Infant stimulation and physical, occupational, and speech therapy may benefit some children. Infants with abnormal breathing ...

  20. Zellweger Syndrome

    Science.gov (United States)

    ... swallow. Some babies will be born with glaucoma, retinal degeneration, and impaired hearing. Jaundice and gastrointestinal bleeding also may occur. Treatment There is no cure for Zellweger syndrome, nor ...

  1. Nephrotic Syndrome

    Science.gov (United States)

    ... your blood — typically with an artificial kidney machine (dialyzer). Chronic kidney disease. Nephrotic syndrome may cause your ... opportunities Reprint Permissions A single copy of these materials may be reprinted for noncommercial personal use only. " ...

  2. Ohtahara Syndrome

    Science.gov (United States)

    ... are more often affected than girls. View Full Definition Treatment Antiepileptic drugs are used to control seizures, but are unfortunately ... Other therapies are symptomatic and supportive. × ... Definition Ohtahara syndrome is a neurological disorder characterized by ...

  3. Usher Syndrome

    Science.gov (United States)

    ... to abnormal development of the vestibular hair cells, sensory cells that detect gravity and head movement. RP ... 3 Ben-Rebeh, I., et al. (2016). Genetic analysis of Tunisian families with Usher syndrome type 1: ...

  4. Eagle's Syndrome

    OpenAIRE

    Pinheiro,Thaís Gonçalves; Soares,Vítor Yamashiro Rocha; Ferreira,Denise Bastos Lage; Raymundo,Igor Teixeira; Nascimento,Luiz Augusto; Oliveira,Carlos Augusto Costa Pires de

    2013-01-01

    Summary Introduction:?Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is diffic...

  5. Barth Syndrome

    DEFF Research Database (Denmark)

    Saric, Ana; Andreau, Karine; Armand, Anne-Sophie

    2016-01-01

    Mutations in the gene encoding the enzyme tafazzin, TAZ, cause Barth syndrome (BTHS). Individuals with this X-linked multisystem disorder present cardiomyopathy (CM) (often dilated), skeletal muscle weakness, neutropenia, growth retardation, and 3-methylglutaconic aciduria. Biopsies of the heart......, liver and skeletal muscle of patients have revealed mitochondrial malformations and dysfunctions. It is the purpose of this review to summarize recent results of studies on various animal or cell models of Barth syndrome, which have characterized biochemically the strong cellular defects associated...

  6. Pendred's syndrome

    International Nuclear Information System (INIS)

    Hashmi, M.I.; Cheema, I.A.; Qasim, G.

    2003-01-01

    This report describes Pendred's syndrome in three siblings of a consanguineous marriage, belonging to Rahimyar Khan. The children presented with deafmutism and goiters. The investigations included scintigram, perchlorate discharge test and audiometery. The perchlorate discharge was positive in index case. Bilateral sensorineural hearing defect was detected on Pure Tone Average (PTA) audiometry. Meticulous clinical and laboratory evaluation is mandatory for the detection of rare disorders like Pendred's syndrome. (author)

  7. [Poland's syndrome].

    Science.gov (United States)

    Slezak, R; Sasiadek, M

    2000-08-01

    Poland's syndrome consists of the variable clinical features, but always includes unilateral aplasia of the chest wall muscles and ipsilateral anomalies of upper extremity. The incidence of Poland's syndrome, reported by different authors ranges from 1:10,000 to 1:100,000 and is observed more frequently in males than in females with the right side of the body affected more often than the left. The etiology of this syndrome is still discussed. However most of described cases were sporadic, rare familial incidence of Poland's syndrome were also presented. Therefore different etiologic factors of the Poland's syndrome are taken into account: genetic, vascular compromise during early stages of embriogenesis but also teratogenic effect of environmental xenobiotics (e.g. cigarette smoking by pregnant women). The authors present also the case of 20-years old man with inherited bilateral syndactyly with the right side aplasia of major pectoralis muscle and face asymmetry. The familial history was negative in respect to the features, associated with Poland's syndrome.

  8. Structure of molecules and internal rotation

    CERN Document Server

    Mizushima, San-Ichiro

    1954-01-01

    Structure of Molecules and Internal Rotation reviews early studies on dihalogenoethanes. This book is organized into two parts encompassing 8 chapters that evaluate the Raman effect in ethane derivatives, the energy difference between rotational isomers, and the infrared absorption of ethane derivatives. Some of the topics covered in the book are the potential barrier to internal rotation; nature of the hindering potential; entropy difference between the rotational isomers; internal rotation in butane, pentane, and hexane; and internal rotation in long chain n-paraffins. Other chapters deal wi

  9. Wave-Driven Rotation In Centrifugal Mirrors

    International Nuclear Information System (INIS)

    Fetterman, Abraham J.; Fisch, Nathaniel J.

    2011-01-01

    Centrifugal mirrors use supersonic rotation to provide axial confinement and enhanced stability. Usually the rotation is produced using electrodes, but these electrodes have limited the rotation to the Alfven critical ionization velocity, which is too slow to be useful for fusion. Instead, the rotation could be produced using radio frequency waves. A fixed azimuthal ripple is a simple and efficient wave that could produce rotation by harnessing alpha particle energy. This is an extension of the alpha channeling effect. The alpha particle power and efficiency in a simulated devices is sufficient to produce rotation without external energy input. By eliminating the need for electrodes, this opens new opportunities for centrifugal traps.

  10. What is Metabolic Syndrome?

    Science.gov (United States)

    ... Intramural Research Home / Metabolic Syndrome Metabolic Syndrome Also known as What Is Metabolic syndrome ... metabolic risk factors to be diagnosed with metabolic syndrome. Metabolic Risk Factors A Large Waistline Having a large ...

  11. Loeys-Dietz Syndrome

    Science.gov (United States)

    ... to the signs and symptoms of Loeys-Dietz syndrome. Marfan syndrome is different from Loeys-Dietz syndrome in that the gene mutation which causes Marfan syndrome is in fibrillin-1 (FBN-1), a protein ...

  12. Milk-alkali syndrome

    Science.gov (United States)

    Calcium-alkali syndrome; Cope syndrome; Burnett syndrome; Hypercalcemia; Calcium metabolism disorder ... Milk-alkali syndrome is almost always caused by taking too many calcium supplements, usually in the form of calcium carbonate. Calcium ...

  13. Exogenous Cushing syndrome

    Science.gov (United States)

    Cushing syndrome - corticosteroid induced; Corticosteroid-induced Cushing syndrome; Iatrogenic Cushing syndrome ... Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the hormone ...

  14. Turner Syndrome: Other FAQs

    Science.gov (United States)

    ... Other FAQs Share Facebook Twitter Pinterest Email Print Turner Syndrome: Other FAQs Basic information for topics, such as " ... been diagnosed with Turner syndrome. Now what? Is Turner syndrome inherited? Turner syndrome is usually not inherited, but ...

  15. Magneto-rotational instability in differentially rotating liquid metals

    International Nuclear Information System (INIS)

    Velikhov, E.P.; Ivanov, A.A.; Lakhin, V.P.; Serebrennikov, K.S.

    2006-01-01

    We study the stability of Couette flow between two cylinders in the presence of axial magnetic field in local WKB approximation. We find the analytical expression of the critical angular velocity minimized over the wave number and the imposed magnetic field as a function of the measure of deviation of the rotation law from the Rayleigh line. The result found is in a good agreement with the previously known numerical results based on the global analysis. We perform a minimization of the critical Reynolds number over the wave number at fixed magnetic field both analytically and numerically. We show that a compromise between resistive suppression of magneto-rotational instability at weak magnetic field and the increase of the critical Reynolds number with the increase of magnetic field is possible. It takes place at moderate values of magnetic field of order 3x10 2 gauss giving the critical Reynolds number of order 4x10 4

  16. [Childhood periodic syndromes].

    Science.gov (United States)

    Cuvellier, J-C; Lépine, A

    2010-01-01

    This review focuses on the so-called "periodic syndromes of childhood that are precursors to migraine", as included in the Second Edition of the International Classification of Headache Disorders. Three periodic syndromes of childhood are included in the Second Edition of the International Classification of Headache Disorders: abdominal migraine, cyclic vomiting syndrome and benign paroxysmal vertigo, and a fourth, benign paroxysmal torticollis is presented in the Appendix. The key clinical features of this group of disorders are the episodic pattern and intervals of complete health. Episodes of benign paroxysmal torticollis begin between 2 and 8 months of age. Attacks are characterized by an abnormal inclination and/or rotation of the head to one side, due to cervical dystonia. They usually resolve by 5 years. Benign paroxysmal vertigo presents as sudden attacks of vertigo, accompanied by inability to stand without support, and lasting seconds to minutes. Age at onset is between 2 and 4 years, and the symptoms disappear by the age of 5. Cyclic vomiting syndrome is characterized in young infants and children by repeated stereotyped episodes of pernicious vomiting, at times to the point of dehydration, and impacting quality of life. Mean age of onset is 5 years. Abdominal migraine remains a controversial issue and presents in childhood with repeated stereotyped episodes of unexplained abdominal pain, nausea and vomiting occurring in the absence of headache. Mean age of onset is 7 years. Both cyclic vomiting syndrome and abdominal migraine are noted for the absence of pathognomonic clinical features but also for the large number of other conditions to be considered in their differential diagnoses. Diagnostic criteria, such as those of the Second Edition of the International Classification of Headache Disorders and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, have made diagnostic approach and management easier. Their diagnosis

  17. Rapidly rotating general relativistic stars. Pt. 2. Differentially rotating polytropes

    Energy Technology Data Exchange (ETDEWEB)

    Komatsu, Hidemi [Tokyo Univ. (Japan). Faculty of Science; Eriguchi, Yoshiharu [Tokyo Univ. (Japan). Dept. of Astronomy; Hachisu, Izumi [Kyoto Univ. (Japan). Dept. of Aeronautical Engineering

    1989-07-01

    We have applied the numerical method which was developed for Newtonian gravity to general relativistic, differentially rotating bodies including ring-like structures. A number of equilibrium structures are obtained for two different polytropic indices N=1/2 and N=3/2, because the various proposed equations of state for the nuclear density region fall into the range N=1/2 to 3/2 from the viewpoint of its softness. (author).

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

    Directory of Open Access Journals (Sweden)

    Yamakado K

    2014-05-01

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

  19. Hyaluronic Acid Accelerates Tendon-to-Bone Healing After Rotator Cuff Repair.

    Science.gov (United States)

    Honda, Hirokazu; Gotoh, Masafumi; Kanazawa, Tomonoshin; Ohzono, Hiroki; Nakamura, Hidehiro; Ohta, Keisuke; Nakamura, Kei-Ichiro; Fukuda, Kanji; Teramura, Takeshi; Hashimoto, Takashi; Shichijo, Shigeki; Shiba, Naoto

    2017-12-01

    There is growing evidence that the subacromial injection of hyaluronic acid (HA) is effective for pain relief in rotator cuff tears; however, its effect on tendon-to-bone healing remains unknown. To examine the effect of HA on the chondrogenesis of mesenchymal stem cells (MSCs) in vitro and on tendon-to-bone healing in a rotator cuff repair model. Controlled laboratory study. Bilateral complete tears of the infraspinatus tendon were made in rabbits and subsequently repaired. Before closure, 1 mL HA was applied to the repaired site, and phosphate-buffered saline was used in the opposite side as a control. Biomechanical, histological, and immunohistochemical analyses were performed at 4, 8, and 12 weeks after surgery. After euthanizing each animal, the bone marrow was isolated from the femoral bone in the same rabbits. Then, MSCs were cultured in media for chondrogenic differentiation, and the chondral pellet production and cartilage-related gene expression levels in the cells were examined at various concentrations of HA. At 4 and 8 weeks after surgery, ultimate load-to-failure was significantly greater in the HA group than in the control group (45.61 ± 9.0 N vs 32.42 ± 9.4 N at 4 weeks, 90.7 ± 16.0 N vs 66.97 ± 10.0 N at 8 weeks; both P .05). Linear stiffness was not significant throughout the time point evaluation. The chondroid formation area at the tendon-bone interface stained by safranin O (control vs HA group) was 0.33% ± 0.7% versus 13.5% ± 12.3% at 4 weeks after surgery ( P repaired site stained by PicroSirius Red (control vs HA group) was 16.2 ± 10.6 versus 43.5 ± 21.3 at 4 weeks after surgery ( P .05), and 1.8% ± 4.0% versus 5.4% ± 4.2% at 12 weeks after surgery ( P > .05). Compared with the control group, HA significantly increased the volume of cartilaginous pellet produced by MSCs (0.0016 ± 0.0015 mm 3 at 0 mg/mL of HA, 0.0041 ± 0.0023 mm 3 at 1.0 mg/mL, and 0.0041 ± 0.0018 mm 3 at 4.0 mg/mL), with increased mRNA expression (relative ratio

  20. MRI of atraumatic sports injuries of the shoulder

    International Nuclear Information System (INIS)

    Sasaki, Taisuke; Saito, Yoko; Sasaki, Yukio; Yodono, Hiraku; Takekawa, Shoichi; Nakamura, Ryujiro; Harata, Seiko

    1992-01-01

    MRI of operatively or arthroscopically proven atraumatic sports injuries of 12 shoulders were reviewed retrospectively. Although it is difficult to diagnose the lesions localised at the superior glenoid labrum and to decide whether rotator interval is injured or not by MRI, MRI could detect thickening of subacromial bursae or rotator cuff injuries due to impingement syndrome and glenoid labrum injuries, such as Bankart lesion. On our limited experience, MRI was more valuable examination than arthrography and CT arthrography. MRI is a useful modality for screening or preoperative evaluation of atraumatic sports injuries of the shoulder. (author)

  1. Development of coaxial rotating-plasma gun

    International Nuclear Information System (INIS)

    Ikehata, Takashi; Tanabe, Toshio; Mase, Hiroshi

    1985-01-01

    A rotating-plasma gun has been devised to produce plasma streams with higher rotational velocities. The working mechanism of the gun and the results of a preliminary experiment have been described. (author)

  2. SEG Advances in Rotational Seismic Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Pierson, Robert; Laughlin, Darren; Brune, Bob

    2016-10-17

    Significant advancements in the development of sensors to enable rotational seismic measurements have been achieved. Prototypes are available now to support experiments that help validate the utility of rotational seismic measurements.

  3. Learning Rotation for Kernel Correlation Filter

    KAUST Repository

    Hamdi, Abdullah; Ghanem, Bernard

    2017-01-01

    . This paper tries to tackle the problem of rotation by reformulating the optimization problem for learning the correlation filter. This modification (RKCF) includes learning rotation filter that utilizes circulant structure of HOG feature to guesstimate

  4. Aerospike Nozzle for Rotating Detonation Engine Application

    Data.gov (United States)

    National Aeronautics and Space Administration — This proposal presents a graduate MS research thesis on improving the efficiency of rotating detonation engines by using aerospike nozzle technologies. A rotating...

  5. Transformation of Real Spherical Harmonics under Rotations

    Science.gov (United States)

    Romanowski, Z.; Krukowski, St.; Jalbout, A. F.

    2008-08-01

    The algorithm rotating the real spherical harmonics is presented. The convenient and ready to use formulae for l = 0, 1, 2, 3 are listed. The rotation in R3 space is determined by the rotation axis and the rotation angle; the Euler angles are not used. The proposed algorithm consists of three steps. (i) Express the real spherical harmonics as the linear combination of canonical polynomials. (ii) Rotate the canonical polynomials. (iii) Express the rotated canonical polynomials as the linear combination of real spherical harmonics. Since the three step procedure can be treated as a superposition of rotations, the searched rotation matrix for real spherical harmonics is a product of three matrices. The explicit formulae of matrix elements are given for l = 0, 1, 2, 3, what corresponds to s, p, d, f atomic orbitals.

  6. Rotational effects on impingement cooling

    Science.gov (United States)

    Epstein, A. H.; Kerrebrock, J. L.; Koo, J. J.; Preiser, U. Z.

    1987-01-01

    The present consideration of rotation effects on heat transfer in a radially exhausted, impingement-cooled turbine blade model gives attention to experimental results for Reynolds and Rossby numbers and blade/coolant temperature ratio values that are representative of small gas turbine engines. On the basis of a model that encompasses the effects of Coriolis force and buoyancy on heat transfer, bouyancy is identified as the cause of an average Nusselt number that is 20-30 percent lower than expected from previous nonrotating data. A heuristic model is proposed which predicts that the impingement jets nearest the blade roots should deflect inward, due to a centripetal force generated by their tangential velocity counter to the blade motion. Potentially serious thermal stresses must be anticipated from rotation effects in the course of blade design.

  7. Secular stability of rotating stars

    International Nuclear Information System (INIS)

    Imamura, J.N.; Friedman, J.L.; Durisen, R.H.

    1984-01-01

    In this work, we calculate the secular stability limits of rotating polytropes to nonaxisymmetric perturbations of low m. We consider polytropic indices ranging from 1 to 3 and several angular momentum distributions. Results are most conveniently presented in terms of the t-parameter, defined as the ratio of the rotational kinetic energy to the absolute value of the gravitational energy of the fluid. Previous work on polytropes considered only the m = 2 mode, which is unstable for values of the t-parameter greater than 0.14 +- 0.01 for the n values n = 1.5 and 3 and the angular momentum distributions tested (see Durisen and Imamura 1981). The GRR secular stability limit of the m = 2 mode for the Maclaurin spheroids (n = O) was determined by Chandrasekhar (1970). GRR stability limits of higher m modes for the Maclaurin spheroids were located approximately by Comins (1979a,b) and more precisely by Friedman (1983)

  8. Tidal variations of earth rotation

    Science.gov (United States)

    Yoder, C. F.; Williams, J. G.; Parke, M. E.

    1981-01-01

    The periodic variations of the earths' rotation resulting from the tidal deformation of the earth by the sun and moon were rederived including terms with amplitudes of 0.002 millisec and greater. The series applies to the mantle, crust, and oceans which rotate together for characteristic tidal periods; the scaling parameter is the ratio of the fraction of the Love number producing tidal variations in the moment of inertia of the coupled mantle and oceans (k) to the dimensionless polar moment of inertia of the coupled moments (C). The lunar laser ranging data shows that k/C at monthly and fortnightly frequencies equals 0.99 + or - 0.15 and 0.99 + or - 0.20 as compared to the theoretical value of 0.94 + or - 0.04.

  9. Understand rotating isothermal collapses yet

    International Nuclear Information System (INIS)

    Tohline, J.E.

    1985-01-01

    A scalar virial equation is used to describe the dynamic properties of equilibrium gas clouds, taking into account the relative effects of surface pressure, rotation, self gravity and internal isothermal pressure. Details concerning the internal structure of the clouds are ignored in order to obtain a globalized analytical expression. The obtained solution to the equation is found to agree with the surface-pressure-dominated model of Stahler (1983), and the rotation-dominated model of Hayashi, Narita, and Miyama (1982). On the basis of the analytical expression of virial equilibrium in the clouds, some of the limiting properties of isothermal clouds are described, and a realistic starting model for cloud collapse is proposed. 18 references

  10. MHD equilibrium with toroidal rotation

    International Nuclear Information System (INIS)

    Li, J.

    1987-03-01

    The present work attempts to formulate the equilibrium of axisymmetric plasma with purely toroidal flow within ideal MHD theory. In general, the inertial term Rho(v.Del)v caused by plasma flow is so complicated that the equilibrium equation is completely different from the Grad-Shafranov equation. However, in the case of purely toroidal flow the equilibrium equation can be simplified so that it resembles the Grad-Shafranov equation. Generally one arbitrary two-variable functions and two arbitrary single variable functions, instead of only four single-variable functions, are allowed in the new equilibrium equations. Also, the boundary conditions of the rotating (with purely toroidal fluid flow, static - without any fluid flow) equilibrium are the same as those of the static equilibrium. So numerically one can calculate the rotating equilibrium as a static equilibrium. (author)

  11. Twiddler's syndrome in spinal cord stimulation.

    Science.gov (United States)

    Al-Mahfoudh, Rafid; Chan, Yuen; Chong, Hsu Pheen; Farah, Jibril Osman

    2016-01-01

    The aims are to present a case series of Twiddler's syndrome in spinal cord stimulators with analysis of the possible mechanism of this syndrome and discuss how this phenomenon can be prevented. Data were collected retrospectively between 2007 and 2013 for all patients presenting with failure of spinal cord stimulators. The diagnostic criterion for Twiddler's syndrome is radiological evidence of twisting of wires in the presence of failure of spinal cord stimulation. Our unit implants on average 110 spinal cord stimulators a year. Over the 5-year study period, all consecutive cases of spinal cord stimulation failure were studied. Three patients with Twiddler's syndrome were identified. Presentation ranged from 4 to 228 weeks after implantation. Imaging revealed repeated rotations and twisting of the wires of the spinal cord stimulators leading to hardware failure. To the best of our knowledge this is the first reported series of Twiddler's syndrome with implantable pulse generators (IPGs) for spinal cord stimulation. Hardware failure is not uncommon in spinal cord stimulation. Awareness and identification of Twiddler's syndrome may help prevent its occurrence and further revisions. This may be achieved by implanting the IPG in the lumbar region subcutaneously above the belt line. Psychological intervention may have a preventative role for those who are deemed at high risk of Twiddler's syndrome from initial psychological screening.

  12. Muon spin rotation in superconductors

    International Nuclear Information System (INIS)

    Gladisch, M.; Orth, H.; Putlitz, G. zu; Wahl, W.; Wigand, M.; Herlach, D.; Seeger, A.; Metz, H.; Teichler, H.

    1979-01-01

    By means of the muon spin rotation technique (μ + SR), the temperature dependence of the magnetic field inside the normal-conducting domains of high-purity tantalum crystals in the intermediate state has been measured in the temperature range 2.36 K + SR. Possible applications of these findings to the study of long-range diffusion of positive muons at low temperatures are indicated. (Auth.)

  13. Rotation of a Moonless Earth

    Science.gov (United States)

    Lissauer, Jack J.; Barnes, Jason W.; Chambers, John E.

    2013-01-01

    We numerically explore the obliquity (axial tilt) variations of a hypothetical moonless Earth. Previous work has shown that the Earth's Moon stabilizes Earth's obliquity such that it remains within a narrow range, between 22.1 deg and 24.5 deg. Without lunar influence, a frequency-map analysis by Laskar et al. showed that the obliquity could vary between 0 deg. and 85 deg. This has left an impression in the astrobiology community that a large moon is necessary to maintain a habitable climate on an Earth-like planet. Using a modified version of the orbital integrator mercury, we calculate the obliquity evolution for moonless Earths with various initial conditions for up to 4 Gyr. We find that while obliquity varies significantly more than that of the actual Earth over 100,000 year timescales, the obliquity remains within a constrained range, typically 20-25 deg. in extent, for timescales of hundreds of millions of years. None of our Solar System integrations in which planetary orbits behave in a typical manner show obliquity accessing more than 65% of the full range allowed by frequency-map analysis. The obliquities of moonless Earths that rotate in the retrograde direction are more stable than those of pro-grade rotators. The total obliquity range explored for moonless Earths with rotation periods shorter than 12 h is much less than that for slower-rotating moonless Earths. A large moon thus does not seem to be needed to stabilize the obliquity of an Earth-like planet on timescales relevant to the development of advanced life.

  14. Fluctuation analysis of rotational spectra

    International Nuclear Information System (INIS)

    Doessing, T.; Bracco, A.; Broglia, R.A.; Matsuo, M.

    1996-01-01

    The compound state rotational degree of freedom is ''damped'' in the sense that the electric quadrupole decay of a single quantum state with angular momentum I exhibits a spectrum of final states all having spin I-2. In actual experiments, the cascade of γ-rays associated with each of the members of the ensemble of compound nuclei uses each of the ''discrete'' transitions many more times than the ''continuum'' transitions. Relatively large and small fluctuations in the recorded coincidence spectrum ensue, respectively. The analysis of the fluctuations will be shown to be instrumental to gain insight into the phenomenon of rotational damping. For this purpose, two- and higher-fold coincidence spectra emitted from rotating nuclei are analyzed with respect to the count fluctuations. The coincidences from consecutive γ-rays emitted from discrete rotational bands generate ridges in the E γ1 .E γ2 spectrum, and the fluctuation analysis of the ridges is based upon the ansatz of a random selection of transition energies from band to band. This ansatz is supported by a cranked mean-field calculation for the nucleus 168 Yb, as well as by analyzing resolved bands in 168 Yb and its neighbors. The fluctuation analysis of the central valley (E γ1 =E γ2 ) is based upon the ansatz of fluctuations in the intensity of the transitions of Porter-Thomas type superposed on a smooth spectrum of transition energies. This ansatz is again supported by a mixed-band calculation. The mathematical treatment of count fluctuations is formulated in general (orig.)

  15. Pfeiffer syndrome

    Directory of Open Access Journals (Sweden)

    Fryns Jean-Pierre

    2006-06-01

    Full Text Available Abstract Pfeiffer syndrome is a rare autosomal dominantly inherited disorder that associates craniosynostosis, broad and deviated thumbs and big toes, and partial syndactyly on hands and feet. Hydrocephaly may be found occasionally, along with severe ocular proptosis, ankylosed elbows, abnormal viscera, and slow development. Based on the severity of the phenotype, Pfeiffer syndrome is divided into three clinical subtypes. Type 1 "classic" Pfeiffer syndrome involves individuals with mild manifestations including brachycephaly, midface hypoplasia and finger and toe abnormalities; it is associated with normal intelligence and generally good outcome. Type 2 consists of cloverleaf skull, extreme proptosis, finger and toe abnormalities, elbow ankylosis or synostosis, developmental delay and neurological complications. Type 3 is similar to type 2 but without a cloverleaf skull. Clinical overlap between the three types may occur. Pfeiffer syndrome affects about 1 in 100,000 individuals. The disorder can be caused by mutations in the fibroblast growth factor receptor genes FGFR-1 or FGFR-2. Pfeiffer syndrome can be diagnosed prenatally by sonography showing craniosynostosis, hypertelorism with proptosis, and broad thumb, or molecularly if it concerns a recurrence and the causative mutation was found. Molecular genetic testing is important to confirm the diagnosis. Management includes multiple-staged surgery of craniosynostosis. Midfacial surgery is performed to reduce the exophthalmos and the midfacial hypoplasia.

  16. Rotational Symmetry Breaking in Baby Skyrme Models

    Science.gov (United States)

    Karliner, Marek; Hen, Itay

    We discuss one of the most interesting phenomena exhibited by baby skyrmions - breaking of rotational symmetry. The topics we will deal with here include the appearance of rotational symmetry breaking in the static solutions of baby Skyrme models, both in flat as well as in curved spaces, the zero-temperature crystalline structure of baby skyrmions, and finally, the appearance of spontaneous breaking of rotational symmetry in rotating baby skyrmions.

  17. Exact solutions for rotating charged dust

    International Nuclear Information System (INIS)

    Islam, J.N.

    1984-01-01

    Earlier work by the author on rotating charged dust is summarized. An incomplete class of exact solutions for differentially rotating charged dust in Newton-Maxwell theory for the equal mass and charge case that was found earlier is completed. A new global exact solution for cylindrically symmetric differentially rotating charged dust in Newton-Maxwell theory is presented. Lastly, a new exact solution for cylindrically symmetric rigidly rotating charged dust in general relativity is given. (author)

  18. Optical illusions induced by rotating medium

    Science.gov (United States)

    Zang, XiaoFei; Huang, PengCheng; Zhu, YiMing

    2018-03-01

    Different from the traditional single-function electromagnetic wave rotators (rotate the electromagnetic wavefronts), we propose that rotating medium can be extended to optical illusions such as breaking the diffraction limit and overlapping illusion. Furthermore, the homogeneous but anisotropic rotating medium is simplified by homogeneous and isotropic positive-index materials according to the effective medium theory, which is helpful for future device fabrication. Finite element simulations for the two-dimensional case are performed to demonstrate these properties.

  19. Developing an Asteroid Rotational Theory

    Science.gov (United States)

    Geis, Gena; Williams, Miguel; Linder, Tyler; Pakey, Donald

    2018-01-01

    The goal of this project is to develop a theoretical asteroid rotational theory from first principles. Starting at first principles provides a firm foundation for computer simulations which can be used to analyze multiple variables at once such as size, rotation period, tensile strength, and density. The initial theory will be presented along with early models of applying the theory to the asteroid population. Early results confirm previous work by Pravec et al. (2002) that show the majority of the asteroids larger than 200m have negligible tensile strength and have spin rates close to their critical breakup point. Additionally, results show that an object with zero tensile strength has a maximum rotational rate determined by the object’s density, not size. Therefore, an iron asteroid with a density of 8000 kg/m^3 would have a minimum spin period of 1.16h if the only forces were gravitational and centrifugal. The short-term goal is to include material forces in the simulations to determine what tensile strength will allow the high spin rates of asteroids smaller than 150m.

  20. Nevoid basal cell carcinoma syndrome

    Science.gov (United States)

    NBCC syndrome; Gorlin-Goltz syndrome; Basal cell nevus syndrome; BCNS; Basal cell cancer - nevoid basal cell carcinoma syndrome ... Nevoid basal cell carcinoma nevus syndrome is a rare genetic ... syndrome is known as PTCH ("patched"). The gene is passed down ...

  1. Motor Processes in Children's Mental Rotation

    Science.gov (United States)

    Frick, Andrea; Daum, Moritz M.; Walser, Simone; Mast, Fred W.

    2009-01-01

    Previous studies with adult human participants revealed that motor activities can influence mental rotation of body parts and abstract shapes. In this study, we investigated the influence of a rotational hand movement on mental rotation performance from a developmental perspective. Children at the age of 5, 8, and 11 years and adults performed a…

  2. Visualizing Compound Rotations with Virtual Reality

    Science.gov (United States)

    Flanders, Megan; Kavanagh, Richard C.

    2013-01-01

    Mental rotations are among the most difficult of all spatial tasks to perform, and even those with high levels of spatial ability can struggle to visualize the result of compound rotations. This pilot study investigates the use of the virtual reality-based Rotation Tool, created using the Virtual Reality Modeling Language (VRML) together with…

  3. Investigation of antimagnetic rotation in 100Pd

    International Nuclear Information System (INIS)

    Zhu, S.; Garg, U.; Afanasjev, A. V.; Frauendorf, S.; Kharraja, B.; Ghugre, S. S.; Chintalapudi, S. N.; Janssens, R. V. F.; Carpenter, M. P.; Kondev, F. G.

    2001-01-01

    High spin states have been studied in the nucleus 100 Pd with the aim of investigating the novel phenomenon of ''antimagnetic rotation.'' A cascade of four ''rotational-band-like'' transitions is proposed as corresponding to antimagnetic rotation, based on the observed spectroscopic properties and a comparison with calculations in the configuration-dependent cranked Nilsson-Strutinsky formalism

  4. Flow Visualization of a Rotating Detonation Engine

    Science.gov (United States)

    2016-10-05

    SUPPLEMENTARY NOTES 14. ABSTRACT The rotating detonation engine ( RDE ) is a propulsion system that obtains thrust using continuously existing...2014 – 12/4/2015 Summary: The rotating detonation engine ( RDE ) is a propulsion system that obtains thrust using continuously existing detonation...structure. Studies have been conducted on rotating detonation engines ( RDE ) that obtain thrust from the continuously propagating detonation waves in the

  5. Nutcracker syndrome

    International Nuclear Information System (INIS)

    Jolley, Ingrid

    2014-01-01

    Purpose: The purpose of this case study is to highlight the symptoms of the Nutcracker Syndrome (NCS), the methods of clinical investigations and the importance of differential diagnosis. Introduction: The NCS refers to left renal vein entrapment caused by abnormal branching patterns of the superior mesenteric artery from the aorta. 1,2 Clinical case presentation: A 27 years old female presented to the emergency department with complaints of abdominal discomfort, bloating, loose bowel motions and irregular micro-haematuria. The radiologist's report indicated the findings from computed tomography examination to be consistent with anterior NCS. Discussion: In most of the NCS cases the clinical symptoms are non-specific. 3 The syndrome is caused by a vascular disorder, but its clinical manifestation can relate to a wide range of abdominal, urological, endovascular or gynaecological pathologies. 4 Conclusion: Nutcracker Syndrome is a relatively rare disease and underdiagnosed may lead to left renal vein thrombosis

  6. Compartment syndromes

    Science.gov (United States)

    Mubarak, S. J.; Pedowitz, R. A.; Hargens, A. R.

    1989-01-01

    The compartment syndrome is defined as a condition in which high pressure within a closed fascial space (muscle compartment) reduces capillary blood perfusion below the level necessary for tissue viability'. This condition occurs in acute and chronic (exertional) forms, and may be secondary to a variety of causes. The end-result of an extended period of elevated intramuscular pressure may be the development of irreversible tissue injury and Volkmann's contracture. The goal of treatment of the compartment syndrome is the reduction of intracompartmental pressure thus facilitating reperfusion of ischaemic tissue and this goal may be achieved by decompressive fasciotomy. Controversy exists regarding the critical pressure-time thresholds for surgical decompression and the optimal diagnostic methods of measuring intracompartmental pressures. This paper will update and review some current knowledge regarding the pathophysiology, aetiology, diagnosis, and treatment of the acute compartment syndrome.

  7. Usher Syndrome

    Directory of Open Access Journals (Sweden)

    Ana Fakin

    2012-06-01

    Full Text Available Usher syndrome is an autosomal recessive disease with prevalence of 3–6/100.000 and is the most common syndrome that affects vision and hearing. Three subtypes are distinguished on the basis of different degree of hearing loss. All patients develop retinitis pigmentosa with night vision difficulties and constriction of visual field, and ultimately a decline in visual acuity and color vision. Future holds promise for gene therapy. We present a patient with typical clinical picture of Usher syndrome, who started noticing night vision problems at age 13. At age 25 he was operated on for posterior cortical cataracts. At age 34 he has only 5–10° of visual field remaining with 1.0 visual acuity in both eyes. Fundus autofluorescence imaging revealed a typical hyperautofluorescent ring on the border between normal and affected retina.

  8. Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Sevil Ikinci

    2010-10-01

    Full Text Available Metabolic Syndrome is a combination of risk factors including common etiopathogenesis. These risk factors play different roles in occurence of atherosclerotic diseases, type 2 diabetes, and cancers. Although a compromise can not be achieved on differential diagnosis for MS, the existence of any three criterias enable to diagnose MS. These are abdominal obesity, dislipidemia (hypertrigliceridemia, hypercholesterolemia, and reduced high density lipoprotein hypertension, and elevated fasting blood glucose. According to the results of Metabolic Syndrome Research (METSAR, the overall prevalence of MS in Turkey is 34%; in females 40%, and in males it is 28%. As a result of “Western” diet, and increased frequency of obesity, MS is observed in children and in adolescents both in the world and in Turkey. Resulting in chronic diseases, it is thought that the syndrome can be prevented by healthy lifestyle behaviours. [TAF Prev Med Bull 2010; 9(5.000: 535-540

  9. Eagle's Syndrome

    Science.gov (United States)

    Pinheiro, Thaís Gonçalves; Soares, Vítor Yamashiro Rocha; Ferreira, Denise Bastos Lage; Raymundo, Igor Teixeira; Nascimento, Luiz Augusto; Oliveira, Carlos Augusto Costa Pires de

    2013-01-01

    Summary Introduction: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. Objective: To describe a case of Eagle's syndrome. Case Report: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT) of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. Final Comments: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical. PMID:25992033

  10. Eagle's Syndrome

    Directory of Open Access Journals (Sweden)

    Pinheiro, Thaís Gonçalves

    2014-01-01

    Full Text Available Introduction: Eagle's syndrome is characterized by cervicopharyngeal signs and symptoms associated with elongation of the styloid apophysis. This elongation may occur through ossification of the stylohyoid ligament, or through growth of the apophysis due to osteogenesis triggered by a factor such as trauma. Elongation of the styloid apophysis may give rise to intense facial pain, headache, dysphagia, otalgia, buzzing sensations, and trismus. Precise diagnosis of the syndrome is difficult, and it is generally confounded by other manifestations of cervicopharyngeal pain. Objective: To describe a case of Eagle's syndrome. Case Report: A 53-year-old man reported lateral pain in his neck that had been present for 30 years. Computed tomography (CT of the neck showed elongation and ossification of the styloid processes of the temporal bone, which was compatible with Eagle's syndrome. Surgery was performed for bilateral resection of the stylohyoid ligament by using a transoral and endoscopic access route. The patient continued to present pain laterally in the neck, predominantly on his left side. CT was performed again, which showed elongation of the styloid processes. The patient then underwent lateral cervicotomy with resection of the stylohyoid process, which partially resolved his painful condition. Final Comments: Patients with Eagle's syndrome generally have a history of chronic pain. Appropriate knowledge of this disease is necessary for adequate treatment to be provided. The importance of diagnosing this uncommon and often unsuspected disease should be emphasized, given that correct clinical-surgical treatment is frequently delayed. The diagnosis of Eagle's syndrome is clinical and radiographic, and the definitive treatment in cases of difficult-to-control pain is surgical.

  11. Rapunzel syndrome

    International Nuclear Information System (INIS)

    Al-Wadan, Ali H.; Al-Saai, Azan S.; Abdoulgafour, Mohamed; Al-Absi, Mohamed

    2006-01-01

    An 18-year-old single female patient, presented with non specific gastrointestinal symptoms of anorexia, abdominal pain, and change in bowel habit. Clinically she was anemic, cachectic, and depressed. Abdominal examination revealed mobile epigastric mass. The scalp alopecia and endoscopy coupled by computed tomography scan, confirmed the diagnoses of trichobezoar, but it was not diagnosed as Rapunzel syndrome except after laparotomy, gastrotomy, and enterotomy. There are less than 16 cases of Rapunzel syndrome described worldwide, and this is the first case to be described in the middle east. (author)

  12. Waardenburg syndrome

    Directory of Open Access Journals (Sweden)

    Tagra Sunita

    2006-01-01

    Full Text Available Waardenburg syndrome is a rare inherited and genetically heterogenous disorder of neural crest cell development. Four distinct subtypes showing marked interfamilial and intrafamilial variability have been described. We report a girl showing constellation of congenital hearing impairment with 110 dB and 105 dB loss in right and left ear respectively, hypoplastic blue iridis, white forelock, dystopia canthorum and broad nasal root. Other affected relatives of the family, with variable features of the syndrome, have been depicted in the pedigree.

  13. Olmsted syndrome

    Directory of Open Access Journals (Sweden)

    Kumar Pramod

    2008-01-01

    Full Text Available Olmsted syndrome is a rare disorder characterized by the combination of periorificial, keratotic plaques and bilateral palmoplantar keratoderma. New associated features are being reported. Olmsted syndrome is particularly rare in a female patient, and we report such a case in a six year-old Indian girl, who presented with keratoderma of her soles since birth and on her palms since the age of two years along with perioral and perinasal hyperkeratosis. She had sparse, light brown, thin hair. Although the psychomotor development of the child was normal until 18 months of age, the keratoderma plaques had restricted the child′s mobility after that stage.

  14. Eagle syndrome

    International Nuclear Information System (INIS)

    Raina, Deepika; Gothi, Rajesh; Rajan, Sriram

    2009-01-01

    Eagle syndrome occurs due to elongation of the styloid process or calcification of the stylohyoid ligament, which then may produce a pain sensation due the pressure exerted on various structures in the head and neck. When suspected, imaging helps in identifying the abnormally elongated styloid process or the calcified ligament. In recent years, three-dimensional CT (3DCT) has proved to be valuable in these cases. We report the case of a 62-year-old man with this syndrome in whom imaging with 3DCT conclusively established the diagnosis

  15. Turner Syndrome

    Directory of Open Access Journals (Sweden)

    Ramachandran Sudarshan

    2012-08-01

    Full Text Available Turner syndrome is a genetic disorder that affects mostly females. Affected females have characteristic features such as short stature, premature ovarian failure, and several other features. Oral manifestations of this condition are not much discussed in the literature. But reported literature includes teeth, palate, periodontal and salivary changes. So the aim of this review is to illustrate the general manifestations, and especially the oral manifestations of Turner syndrome and evaluate their possible management. [Archives Medical Review Journal 2012; 21(4.000: 246-252

  16. Fenton's syndrome

    International Nuclear Information System (INIS)

    Rimondi, E.; Albasini, V.

    1989-01-01

    The authors report two recent cases of Fenton's syndrome, a very rare carpal fracture-dislocation. After some anatomophysiopathological considerations and a review of the literature, a wider nosographic frame is proposed in which the entity of the dislocation of the head of capitate bone is not essential. According to both the literature and personal findings, the authors remark that this syndrome is always found in the presence of two morphological variants of the distal radioulnar joint. Finally, the authors stress the importance of a corect diagnosis of this lesion to avoid unnecessary attempts of reduction

  17. Reiter's Syndrome.

    Science.gov (United States)

    Savant, S S; Fernandez, J C; Dhurandhar, M W; Fernandez, R J

    1979-01-01

    A case of Reiter's syndrome occurring in a young mate aged 20 years having extensive skin lesions of keratoderina blenoffhagica is presented along with a review of literature. Although urethritis was absent, other clinical and histopathological features of the cutaneous lesions led us to the diagnosis. The-possible relationship of postural psoriasis to Reiter's syndrome is discussed. Failure of the patient to respond satisfactorily to steroids, antibiotics etc, prompted the use of rnethotrexate in the case. The result was dramatic, as the patient completely recovered within ten days of starting treatment.

  18. Larsen syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Mahbubul Islam

    2016-08-01

    Full Text Available Larsen syndrome is a rare inherited disorder characterized by congenital dislocation of multiple joints along with other anomalies of heart, face, hands and bones. Larsen syndrome was first described in 1950 by Larsen, Schottstaedt and Bost. In the present report, we describe a 10 year old girl who presented with mid facial hypoplasia with depressed nasal bridge, high arched palate, bilateral talipes equinovarus and high arched feet. On examination, she had short stature (HAZ -3.5 SD with hyperextension of knee joint, fixed flexion of elbow joint. Awareness of this condition and associated complications may help in management and follow up of these patients. 

  19. Joubert syndrome

    International Nuclear Information System (INIS)

    Villanua, J.A.; Lopez, J.M.; Recondo, J.A.; Garcia, J.M.; Gaztanaga, R.

    1998-01-01

    Joubert syndrome is a rare malformation of the posterior fossa, mainly affecting the cerebellar vermis, which generally appears as a dysplastic lesion. Other structures of the cervico medullary junction may be involved, with accompanying brainstem hypoplasia according to neuroimaging studies. The diagnosis is usually reached during, childhood, based on a constellation of changes in the child's neurological development that are supported by the results of imaging studied. Respiratory problems are the most common signs in newborns,leading to the suspicion of the presence of this syndrome. (Author) 11 refs

  20. Lemierre's syndrome.

    LENUS (Irish Health Repository)

    O'Dwyer, D N

    2012-02-01

    Lemierre\\'s syndrome is a rare disease that results in an oropharyngeal infection, which precipitates an internal jugular vein thrombosis and metastatic infection. Fusobacterium necrophorum is an anaerobic Gram-negative bacillus and has been identified as the causative agent. We describe the case of a young girl whose presentation and diagnosis were confounded by a history of valvular heart disease. Infection of heart valves can produce many of the signs and symptoms associated with Lemierre\\'s syndrome. We describe the diagnosis, investigation and optimal management of this rare disorder.

  1. Meigs' Syndrome

    International Nuclear Information System (INIS)

    Baloch, S.; Khaskheli, M.; Farooq, S.

    2006-01-01

    Meigs' syndrome is a rare clinical condition commonly considered to be associated with malignant ovarian tumour. A case of unmarried female is presented who came with a slowly increasing abdominal mass. Clinical and ultrasonic investigations revealed a mobile, solid right adenexal tumour in the lower abdomen, along with ascites and pleural effusion of the right lung. The level of CA 125 was also raised. Diagnosis of Meigs' syndrome was confirmed after surgical intervention. The tumour was successfully removed and pleural effusion disappeared 15 days after the intervention. Cytomorphologic study of both the tumour and ascitic fluid was negative for malignancy. (author)

  2. [Elsberg syndrome].

    Science.gov (United States)

    Nielsen, Kristine Esbjerg; Knudsen, Troels Bygum

    2013-12-16

    A syndrome involving acute urinary retention in combination with sacral radiculitis and cerebrospinal fluid pleocytosis was first described by the American neurosurgeon Charles Elsberg in 1931. In many instances the aetiology is herpes simplex virus type 2 (HSV-2) reactivation from sensory neurons. In this case report we present a 34-year-old pregnant woman with previous undiagnosed sensory lumbosacral symptoms. She was hospitalized with HSV-2 meningitis and lumbosacral radiculitis but no genital rash. A week after the onset of symptoms she developed acute urinary retention, thus indicating Elsberg syndrome.

  3. Friction, Free Axes of Rotation and Entropy

    Directory of Open Access Journals (Sweden)

    Alexander Kazachkov

    2017-03-01

    Full Text Available Friction forces acting on rotators may promote their alignment and therefore eliminate degrees of freedom in their movement. The alignment of rotators by friction force was shown by experiments performed with different spinners, demonstrating how friction generates negentropy in a system of rotators. A gas of rigid rotators influenced by friction force is considered. The orientational negentropy generated by a friction force was estimated with the Sackur-Tetrode equation. The minimal change in total entropy of a system of rotators, corresponding to their eventual alignment, decreases with temperature. The reported effect may be of primary importance for the phase equilibrium and motion of ubiquitous colloidal and granular systems.

  4. Visual perception of axes of head rotation

    Science.gov (United States)

    Arnoldussen, D. M.; Goossens, J.; van den Berg, A. V.

    2013-01-01

    Registration of ego-motion is important to accurately navigate through space. Movements of the head and eye relative to space are registered through the vestibular system and optical flow, respectively. Here, we address three questions concerning the visual registration of self-rotation. (1) Eye-in-head movements provide a link between the motion signals received by sensors in the moving eye and sensors in the moving head. How are these signals combined into an ego-rotation percept? We combined optic flow of simulated forward and rotational motion of the eye with different levels of eye-in-head rotation for a stationary head. We dissociated simulated gaze rotation and head rotation by different levels of eye-in-head pursuit. We found that perceived rotation matches simulated head- not gaze-rotation. This rejects a model for perceived self-rotation that relies on the rotation of the gaze line. Rather, eye-in-head signals serve to transform the optic flow's rotation information, that specifies rotation of the scene relative to the eye, into a rotation relative to the head. This suggests that transformed visual self-rotation signals may combine with vestibular signals. (2) Do transformed visual self-rotation signals reflect the arrangement of the semi-circular canals (SCC)? Previously, we found sub-regions within MST and V6+ that respond to the speed of the simulated head rotation. Here, we re-analyzed those Blood oxygenated level-dependent (BOLD) signals for the presence of a spatial dissociation related to the axes of visually simulated head rotation, such as have been found in sub-cortical regions of various animals. Contrary, we found a rather uniform BOLD response to simulated rotation along the three SCC axes. (3) We investigated if subject's sensitivity to the direction of the head rotation axis shows SCC axes specifcity. We found that sensitivity to head rotation is rather uniformly distributed, suggesting that in human cortex, visuo-vestibular integration is

  5. Collective rotation from ab initio theory

    International Nuclear Information System (INIS)

    Caprio, M.A.; Maris, P.; Vary, J.P.; Smith, R.

    2015-01-01

    Through ab initio approaches in nuclear theory, we may now seek to quantitatively understand the wealth of nuclear collective phenomena starting from the underlying internucleon interactions. No-core configuration interaction (NCCI) calculations for p-shell nuclei give rise to rotational bands, as evidenced by rotational patterns for excitation energies, electromagnetic moments and electromagnetic transitions. In this review, NCCI calculations of 7–9 Be are used to illustrate and explore ab initio rotational structure, and the resulting predictions for rotational band properties are compared with experiment. We highlight the robustness of ab initio rotational predictions across different choices for the internucleon interaction. (author)

  6. Visual perception of axes of head rotation

    Directory of Open Access Journals (Sweden)

    David Mattijs Arnoldussen

    2013-02-01

    Full Text Available Registration of ego-motion is important to accurately navigate through space. Movements of the head and eye relative to space are registered through the vestibular system and optical flow, respectively. Here, we address three questions concerning the visual registration of self-rotation. 1. Eye-in-head movements provide a link between the motion signals received by sensors in the moving eye and sensors in the moving head. How are these signals combined into an ego-rotation percept? We combined optic flow of simulated forward and rotational motion of the eye with different levels of eye-in-head rotation for a stationary head. We dissociated simulated gaze rotation and head rotation by different levels of eye-in-head pursuit.We found that perceived rotation matches simulated head- not gaze-rotation. This rejects a model for perceived self-rotation that relies on the rotation of the gaze line. Rather, eye-in-head signals serve to transform the optic flow’s rotation information, that specifies rotation of the scene relative to the eye, into a rotation relative to the head. This suggests that transformed visual self-rotation signals may combine with vestibular signals.2. Do transformed visual self-rotation signals reflect the arrangement of the semicircular canals (SCC? Previously, we found sub-regions within MST and V6+ that respond to the speed of the simulated head rotation. Here, we re-analyzed those BOLD signals for the presence of a spatial dissociation related to the axes of visually simulated head rotation, such as have been found in sub-cortical regions of various animals. Contrary, we found a rather uniform BOLD response to simulated rotation along the three SCC axes.3. We investigated if subject’s sensitivity to the direction of the head rotation axis shows SCC axes specifcity. We found that sensitivity to head rotation is rather uniformly distributed, suggesting that in human cortex, visuo-vestibular integration is not arranged into

  7. Examining cotton in rotation with rice and cotton in rotation with other crops using natural experiment

    Science.gov (United States)

    Sun, Ling; Zhu, Zesheng

    2017-08-01

    This paper is to show the ability of remote sensing image analysis combined with statistical analysis to characterize the environmental risk assessment of cotton in rotation with rice and cotton in rotation with other crops in two ways: (1) description of rotation period of cotton in rotation with rice and cotton in rotation with other crops by the observational study or natural experiment; (2) analysis of rotation period calculation of cotton in rotation with rice and cotton in rotation with other crops. Natural experimental results show that this new method is very promising for determining crop rotation period for estimating regional averages of environmental risk. When it is applied to determining crop rotation period, two requested remote sensing images of regional crop are required at least.

  8. Rotation and Accretion Powered Pulsars

    Energy Technology Data Exchange (ETDEWEB)

    Kaspi, V M [Department of Physics, McGill University, 3600 University St, Montreal, QC H3A 2T8 (Canada)

    2008-03-07

    Pulsar astrophysics has come a long way in the 40 years since the discovery of the first pulsar by Bell and Hewish. From humble beginnings as bits of 'scruff' on the Cambridge University group's chart recorder paper, the field of pulsars has blossomed into a major area of mainstream astrophysics, with an unparalleled diversity of astrophysical applications. These range from Nobel-celebrated testing of general relativity in the strong-field regime to constraining the equation-of-state of ultradense matter; from probing the winds of massive stars to globular cluster evolution. Previous notable books on the subject of pulsars have tended to focus on some particular topic in the field. The classic text Pulsars by Manchester and Taylor (1977 San Francisco, CA: Freeman) targeted almost exclusively rotation-powered radio pulsars, while the Meszaros book High-Energy Radiation from Magnetized Neutron Stars (1992 Chicago, IL: University of Chicago Press) considered both rotation- and accretion-powered neutron stars, but focused on their radiation at x-ray energies and above. The recent book Neutron Stars 1 by Haensel et al (2007 Berlin: Springer) considers only the equation of state and neutron-star structure. Into this context appears Rotation and Accretion Powered Pulsars, by Pranab Ghosh. In contrast to other books, here the author takes an encyclopedic approach and attempts to synthesize practically all of the major aspects of the two main types of neutron star. This is ambitious. The only comparable undertaking is the useful but more elementary Lyne and Graham-Smith text Pulsar Astronomy (1998 Cambridge: Cambridge University Press), or Compact Stellar X-ray Sources (eds Lewin and van der Klis, 2006 Cambridge: Cambridge University Press), an anthology of technical review articles that also includes black hole topics. Rotation and Accretion Powered Pulsars thus fills a clear void in the field, providing a readable, graduate-level book that covers nearly

  9. Rotation and Accretion Powered Pulsars

    International Nuclear Information System (INIS)

    Kaspi, V M

    2008-01-01

    Pulsar astrophysics has come a long way in the 40 years since the discovery of the first pulsar by Bell and Hewish. From humble beginnings as bits of 'scruff' on the Cambridge University group's chart recorder paper, the field of pulsars has blossomed into a major area of mainstream astrophysics, with an unparalleled diversity of astrophysical applications. These range from Nobel-celebrated testing of general relativity in the strong-field regime to constraining the equation-of-state of ultradense matter; from probing the winds of massive stars to globular cluster evolution. Previous notable books on the subject of pulsars have tended to focus on some particular topic in the field. The classic text Pulsars by Manchester and Taylor (1977 San Francisco, CA: Freeman) targeted almost exclusively rotation-powered radio pulsars, while the Meszaros book High-Energy Radiation from Magnetized Neutron Stars (1992 Chicago, IL: University of Chicago Press) considered both rotation- and accretion-powered neutron stars, but focused on their radiation at x-ray energies and above. The recent book Neutron Stars 1 by Haensel et al (2007 Berlin: Springer) considers only the equation of state and neutron-star structure. Into this context appears Rotation and Accretion Powered Pulsars, by Pranab Ghosh. In contrast to other books, here the author takes an encyclopedic approach and attempts to synthesize practically all of the major aspects of the two main types of neutron star. This is ambitious. The only comparable undertaking is the useful but more elementary Lyne and Graham-Smith text Pulsar Astronomy (1998 Cambridge: Cambridge University Press), or Compact Stellar X-ray Sources (eds Lewin and van der Klis, 2006 Cambridge: Cambridge University Press), an anthology of technical review articles that also includes black hole topics. Rotation and Accretion Powered Pulsars thus fills a clear void in the field, providing a readable, graduate-level book that covers nearly everything you

  10. On the stability of rotational discontinuities

    International Nuclear Information System (INIS)

    Richter, P.; Scholer, M.

    1989-01-01

    The stability of symmetric rotational discontinuities in which the magnetic field rotates by 180 degree is investigated by means of a one-dimensional self-consistent hybrid code. Rotational discontinuities with an angle Θ > 45 degree between the discontinuity normal direction and the upstream magnetic field are found to be relatively stable. The discontinuity normal is in the x direction and the initial magnetic field has finite y component only in the transition region. In the case of the ion (left-handed) sense of rotation of the tangential magnetic field, the transition region does not broaden with time. In the case of the electron (right-handed) sense of rotation, a damped wavetrain builds up in the B y component downstream of the rotational discontinuity and the discontinuity broadens with time. Rotational discontinuities with smaller angles, Θ, are unstable. Examples for a rotational discontinuity with Θ = 30 degree and the electron sense of rotation as well as a rotational discontinuity with Θ = 15 degree and the ion sense of rotation show that these discontinuities into waves. These waves travel approximately with Alfven velocity in the upstream direction and are therefore phase standing in the simulation system. The magnetic hodograms of these disintegrated discontinuities are S-shaped. The upstream portion of the hodogram is always right-handed; the downstream portion is always left-handed

  11. Relativistic rotation and the anholonomic object

    International Nuclear Information System (INIS)

    Corum, J.F.

    1977-01-01

    The purpose of this communication is to call attention to the conceptual economy provided by the object of anholonomity for the theory of relativity. This geometric object expresses certain consequences of relativity theory and provides a single, simple framework for discussing a variety of phenomena. It particularly clarifies the description of relativistic rotation. The relativistic rotational transformation of the four coordinate differentials of flat space--time generates a set of anholonomic, or inexact differentials, whose duals are an orthogonal set of basis vectors. How should a rotating observer interpret physical events referred to such orthogonal, but anholonomic frames The answer to this question rests upon the origin and physical significance of the object of anholonomity. It is demonstrated that not only is the rotational Lorentz transformation an anholonomic transformation, but that the intrinsic anholonomic effects are essential to interpreting rotational phenomena. In particular, the Sagnac effect may be interpreted as the physical manifestation of temporal anholonomity under rotation. The Thomas precession of a reference axis may be interpreted as a consequence of the spatial anholonomity of the rotating frame. Further, the full four-dimensional covariance of Maxwellian electrodynamics, under a relativistic Lorentz rotation, is possible only with the inclusion of anholonomic effects. The anholonomic approach clarifies the distinction between the physically different operations of source rotation and observer rotation in a flat space--time. It is finally concluded that a consistant theory of relativistic rotation, satisfying the principle of general covariance, inherently requires the presence of the object of anholonomity

  12. Marfan syndrome masked by Down syndrome?

    NARCIS (Netherlands)

    Vis, J.C.; Engelen, K. van; Timmermans, J.; Hamel, B.C.J.; Mulder, B.J.

    2009-01-01

    Down syndrome is the most common chromosomal abnormality. A simultaneous occurrence with Marfan syndrome is extremely rare. We present a case of a 28-year-old female with Down syndrome and a mutation in the fibrillin-1 gene. The patient showed strikingly few manifestations of Marfan syndrome.

  13. Staff rotation: implications for occupational therapy.

    Science.gov (United States)

    Taylor, A; Andriuk, M L; Langlois, P; Provost, E

    1995-10-01

    Occupational therapy departments of tertiary care hospitals can provide staff with opportunities to gain diverse clinical experience if they rotate through the various services such as surgery, medicine, geriatrics, plastic surgery and orthopaedics. The system of rotation offers both advantages and disadvantages for the staff and the institution. The Royal Victoria Hospital in Montreal, a large university teaching hospital, had traditionally offered staff the opportunity to rotate. Changes in staffing and their needs however, resulted in rotation becoming an important issue within the department. This article presents the pros and the cons of rotation and non-rotation systems as identified by therapists and administrators across Canada. Staff rotation was found to have an effect on job satisfaction and a therapist's career orientation. Given these findings, administrators may want to reconsider the role of the generalist and specialist in their facilities.

  14. Lemierre's syndrome

    DEFF Research Database (Denmark)

    Johannesen, Katrine M; Bodtger, Uffe

    2016-01-01

    This is a systematic review of cases with Lemierre's syndrome (LS) in the past 5 years. LS is characterized by sepsis often evolving after a sore throat or tonsillitis and then complicated by various septic emboli and thrombosis of the internal jugular vein. Symptoms include sepsis, pain, and/or ...... LS in this day and age appears to be low, however the syndrome is difficult to recognize, and still requires the full attention of the clinician.......This is a systematic review of cases with Lemierre's syndrome (LS) in the past 5 years. LS is characterized by sepsis often evolving after a sore throat or tonsillitis and then complicated by various septic emboli and thrombosis of the internal jugular vein. Symptoms include sepsis, pain, and....../or swelling in the throat or neck, as well as respiratory symptoms. Laboratory findings show elevated infectious parameters and radiological findings show thrombosis of the internal jugular vein and emboli in the lungs or other organs. The syndrome is often associated with an infection with Fusobacterium...

  15. Sjogren syndrome

    NARCIS (Netherlands)

    Brito-Zeron, Pilar; Baldini, Chiara; Bootsma, Hendrika; Bowman, Simon J.; Jonsson, Roland; Mariette, Xavier; Sivils, Kathy; Theander, Elke; Tzioufas, Athanasios; Ramos-Casals, Manuel

    2016-01-01

    Sjogren syndrome (SjS) is a systemic autoimmune disease that primarily affects the exocrine glands (mainly the salivary and lacrimal glands) and results in the severe dryness of mucosal surfaces, principally in the mouth and eyes. This disease predominantly affects middle-aged women, but can also be

  16. Rett Syndrome

    Science.gov (United States)

    ... loss of interest in normal play Delayed speech development or loss of previously acquired speech abilities Problem behavior or marked mood swings Any clear loss of previously gained milestones in gross motor or fine motor skills Causes Rett syndrome is a rare genetic disorder. ...

  17. Nodding Syndrome

    Centers for Disease Control (CDC) Podcasts

    2013-12-19

    Dr. Scott Dowell, a CDC director, discusses the rare illness, nodding syndrome, in children in Africa.  Created: 12/19/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/27/2014.

  18. Piriformis Syndrome

    Science.gov (United States)

    ... can usually resume their normal activities. In some cases, exercise regimens may need to be modified in order to reduce the likelihood of recurrence or worsening. Clinical Trials Throughout the U.S. ... Definition Piriformis syndrome is a rare neuromuscular disorder that ...

  19. Hellp syndrome

    International Nuclear Information System (INIS)

    Chaudhry, A.A.

    2002-01-01

    A 24 years old female presented with hypertension, haemolysis, elevated liver enzymes and thrombocytopenia in an unconscious state after undergoing an emergency caesarian section. A diagnosis of HELLP syndrome was made on the above findings. Patient made an uneventful recovery with conservative management. A brief review of the literature is included along with the case report. (author)

  20. Kartagener's Syndrome.

    Science.gov (United States)

    Dhar, D K; Ganguly, K C; Alam, S; Hossain, A; Sarker, U K; Das, B K; Haque, M J

    2009-01-01

    Kartagener's Syndrome or Immotile Cilia Syndrome, a variant of Primary Ciliary Dyskinesia (PCD), is a rare autosomal recessive genetic disorder caused by defect in the tiny hair like structure, the cilia lining the respiratory tract (upper and lower), sinuses, eustachian tubes, middle ear and fallopian tubes. Here electron microscopy shows abnormal arrangement of ciliary tubules and patients with Kartagener's syndrome has an absence of dynein arms at the base of the cilia. The inability of cilia to move results in inadequate clearance of bacteria from the air passages, resulting in an increased risk of infection and causing bronchiectasis. Another result of ciliary immobility is infertility. A 60 years old lady was diagnosed as a case of Kartagener's syndrome. She had history of chronic cough for 20 years, irregular fever for 20 years and occasional shortness of breath for 5 years. Relevant investigations revealed dextrocardia, situs inversus, bilateral maxillary sinusitis with non pneumatised frontal sinus and bronchiectasis. She was treated with low concentration oxygen inhalation, antibiotic, bronchodilator, chest physiotherapy including postural drainage, vitamins and other supportive treatment.

  1. Carraro syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Wendler, H.; Schwarz, R.

    1980-07-01

    The report concerns a girl aged 9 1/2 years who was deaf and dumb and had marked shortening of the calves with deformities of the feet and bilateral, congenital hypoplasia of the tibiae. This syndrome was first described by Carraro in 1931, but there have been no further reports since then.

  2. Rett Syndrome.

    Science.gov (United States)

    Culbert, Linda A.

    This pamphlet reviews the historical process involved in initially recognizing Rett Syndrome as a specific disorder in girls. Its etiology is unknown, but studies have considered factors as hyperammonemia, a two-step mutation, a fragile X chromosome, metabolic disorder, environmental causation, dopamine deficiency, and an inactive X chromosome.…

  3. Alagille Syndrome

    Science.gov (United States)

    ... 3] Kamath BM, Loomes KM, Piccoli DA. Medical management of Alagille syndrome. Journal of Pediatric Gastroenterology and Nutrition. 2010;50(6): ... 30 a.m. to 5 p.m. eastern time, M-F Follow Us NIH… Turning Discovery Into ... Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  4. Kounis syndrome

    African Journals Online (AJOL)

    neoplastic agents), exposure to radiological contrast media, poison ivy, bee stings, shellfish and coronary stents. In addition to coronary arterial involvement, Kounis syndrome com prises other arterial systems with similar physiologies, such as mesenteric and cerebral circulation resulting in ischaemia/infarction of the vital ...

  5. Proteus syndrome

    Directory of Open Access Journals (Sweden)

    Debi Basanti

    2005-01-01

    Full Text Available Proteus syndrome is a variable and complex disorder characterized by multifocal overgrowths affecting any tissue or structure of the body. We present a girl aged 3 years and 8 months with an epidermal nevus, port-wine stain, macrodactyly with gigantism of the feet, lymphohemagiomas and multiple lipomas.

  6. Crest syndrome

    International Nuclear Information System (INIS)

    Koch, B.; Roedl, W.

    1988-01-01

    If a patient has peri- and intra-articular calcinosis, as well as acro-osteolysis and esophageal hypomotility, and rheumatic symptoms, Crest syndrome should be considered as a manifestation of progressive systemic sclerosis. In connection with relevant symptoms on the skin and visceral involvement, radiological studies offer the possibility of classifying progressive systemic sclerosis more accurately. (orig.) [de

  7. Gitelman syndrome.

    NARCIS (Netherlands)

    Knoers, N.V.A.M.; Levtchenko, E.N.

    2008-01-01

    Gitelman syndrome (GS), also referred to as familial hypokalemia-hypomagnesemia, is characterized by hypokalemic metabolic alkalosis in combination with significant hypomagnesemia and low urinary calcium excretion. The prevalence is estimated at approximately 1:40,000 and accordingly, the prevalence

  8. Marfan Syndrome

    Science.gov (United States)

    ... can treat many of its symptoms. Thanks to new research and treatments, people with Marfan syndrome who are diagnosed early ... This helps doctors stay on top of any new problems. Doctors might also ... or kids with amblyopia or strabismus will probably need to wear glasses. ...

  9. Kartagener's Syndrome

    African Journals Online (AJOL)

    GB

    presenting with recurrent upper and lower respiratory tract infections, sinusitis or bronchiectasis. Inability to diagnose this condition may subject the patient to unnecessary and repeated hospital admissions, investigations and treatment failure. KEY WORDS: Kartagener's syndrome, primary cilliary dyskinesia, situs inversus, ...

  10. Parallel computation of rotating flows

    DEFF Research Database (Denmark)

    Lundin, Lars Kristian; Barker, Vincent A.; Sørensen, Jens Nørkær

    1999-01-01

    This paper deals with the simulation of 3‐D rotating flows based on the velocity‐vorticity formulation of the Navier‐Stokes equations in cylindrical coordinates. The governing equations are discretized by a finite difference method. The solution is advanced to a new time level by a two‐step process....... In the first step, the vorticity at the new time level is computed using the velocity at the previous time level. In the second step, the velocity at the new time level is computed using the new vorticity. We discuss here the second part which is by far the most time‐consuming. The numerical problem...

  11. Nondestructive testing bench without rotation

    International Nuclear Information System (INIS)

    Perdijon, J.

    1976-01-01

    On-line testing by ultrasonics in combination with eddy currents represents a large saving in time and equipment since the tube to be checked only needs to pass once quickly and without rotation. The answer to this problem is to use encircling transducers, which means that the mirror interposed to detect transverse defects must be conical while that used to detect longitudinal defects is helically shaped. A cell combining these two mirrors with an eddy current coil to test thin small-diameter tubes is described. The first trial year shows that defects are detected independently of their position, with a sensitivity at least equal to that of conventional systems [fr

  12. Rotational and translational Brownian motion

    International Nuclear Information System (INIS)

    Coffey, W.T.; Salford Univ.

    1980-01-01

    In this review it is proposed to summarise the work on the theory of the translational and rotational Brownian movement which has been carried on over roughly the past 30 years. The review is intended to take the form of a tutorial paper rather than a list of the results obtained by the various investigators over the period in question. In this vein then it seems appropriate to firstly give a brief account of those parts of the theory of probability which are relevant to the problems under discussion. (orig.)

  13. Rotating detectors and Mach's principle

    International Nuclear Information System (INIS)

    Paola, R.D.M. de; Svaiter, N.F.

    2000-08-01

    In this work we consider a quantum version of Newton s bucket experiment in a fl;at spacetime: we take an Unruh-DeWitt detector in interaction with a real massless scalar field. We calculate the detector's excitation rate when it is uniformly rotating around some fixed point and the field is prepared in the Minkowski vacuum and also when the detector is inertial and the field is in the Trocheries-Takeno vacuum state. These results are compared and the relations with Mach's principle are discussed. (author)

  14. Generalization of stochastic visuomotor rotations.

    Directory of Open Access Journals (Sweden)

    Hugo L Fernandes

    Full Text Available Generalization studies examine the influence of perturbations imposed on one movement onto other movements. The strength of generalization is traditionally interpreted as a reflection of the similarity of the underlying neural representations. Uncertainty fundamentally affects both sensory integration and learning and is at the heart of many theories of neural representation. However, little is known about how uncertainty, resulting from variability in the environment, affects generalization curves. Here we extend standard movement generalization experiments to ask how uncertainty affects the generalization of visuomotor rotations. We find that although uncertainty affects how fast subjects learn, the perturbation generalizes independently of uncertainty.

  15. Qubit rotation and Berry phase

    International Nuclear Information System (INIS)

    Banerjee, D.; Bandyopadhyay, P.

    2005-11-01

    A quantized fermion is represented by a scalar particle encircling a magnetic flux line. It has the spinor structure which can be constructed from quantum gates and qubits. We have studied here the role of Berry phase in removing dynamical phase during one qubit rotation of a quantized fermion. The entanglement of two qubits inserting spin-echo to one of them results the trapped Berry phase to measure entanglement. Some effort is given to study the effect of noise on the Berry phase of spinors and their entangled states. (author)

  16. Design of rotating electrical machines

    CERN Document Server

    Pyrhonen , Juha; Hrabovcova , Valeria

    2013-01-01

    In one complete volume, this essential reference presents an in-depth overview of the theoretical principles and techniques of electrical machine design. This timely new edition offers up-to-date theory and guidelines for the design of electrical machines, taking into account recent advances in permanent magnet machines as well as synchronous reluctance machines. New coverage includes: Brand new material on the ecological impact of the motors, covering the eco-design principles of rotating electrical machinesAn expanded section on the design of permanent magnet synchronous machines, now repo

  17. ROTATIONAL VELOCITIES FOR M DWARFS

    International Nuclear Information System (INIS)

    Jenkins, J. S.; Ramsey, L. W.; Jones, H. R. A.; Pavlenko, Y.; Barnes, J. R.; Pinfield, D. J.; Gallardo, J.

    2009-01-01

    We present spectroscopic rotation velocities (v sin i) for 56 M dwarf stars using high-resolution Hobby-Eberly Telescope High Resolution Spectrograph red spectroscopy. In addition, we have also determined photometric effective temperatures, masses, and metallicities ([Fe/H]) for some stars observed here and in the literature where we could acquire accurate parallax measurements and relevant photometry. We have increased the number of known v sin i values for mid M stars by around 80% and can confirm a weakly increasing rotation velocity with decreasing effective temperature. Our sample of v sin is peak at low velocities (∼3 km s -1 ). We find a change in the rotational velocity distribution between early M and late M stars, which is likely due to the changing field topology between partially and fully convective stars. There is also a possible further change in the rotational distribution toward the late M dwarfs where dust begins to play a role in the stellar atmospheres. We also link v sin i to age and show how it can be used to provide mid-M star age limits. When all literature velocities for M dwarfs are added to our sample, there are 198 with v sin i ≤ 10 km s -1 and 124 in the mid-to-late M star regime (M3.0-M9.5) where measuring precision optical radial velocities is difficult. In addition, we also search the spectra for any significant Hα emission or absorption. Forty three percent were found to exhibit such emission and could represent young, active objects with high levels of radial-velocity noise. We acquired two epochs of spectra for the star GJ1253 spread by almost one month and the Hα profile changed from showing no clear signs of emission, to exhibiting a clear emission peak. Four stars in our sample appear to be low-mass binaries (GJ1080, GJ3129, Gl802, and LHS3080), with both GJ3129 and Gl802 exhibiting double Hα emission features. The tables presented here will aid any future M star planet search target selection to extract stars with low v

  18. The rotation of spiral galaxies.

    Science.gov (United States)

    Rubin, V C

    1983-06-24

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

  19. Parallel computation of rotating flows

    DEFF Research Database (Denmark)

    Lundin, Lars Kristian; Barker, Vincent A.; Sørensen, Jens Nørkær

    1999-01-01

    This paper deals with the simulation of 3‐D rotating flows based on the velocity‐vorticity formulation of the Navier‐Stokes equations in cylindrical coordinates. The governing equations are discretized by a finite difference method. The solution is advanced to a new time level by a two‐step process...... is that of solving a singular, large, sparse, over‐determined linear system of equations, and the iterative method CGLS is applied for this purpose. We discuss some of the mathematical and numerical aspects of this procedure and report on the performance of our software on a wide range of parallel computers. Darbe...

  20. Qubit rotation and Berry phase

    International Nuclear Information System (INIS)

    Banerjee, Dipti; Bandyopadhyay, Pratul

    2006-01-01

    A quantized fermion is represented by a scalar particle encircling a magnetic flux line. It has a spinor structure which can be constructed from quantum gates and qubits. We have studied here the role of Berry phase in removing dynamical phase during one qubit rotation of a quantized fermion. The entanglement of two qubits inserting spin-echo to one of them allows the trapped Berry phase to measure entanglement. Some effort is given to study the effect of noise on the Berry phase of spinors and their entangled states

  1. Shoulder Girdle Muscles Endurance in Subjects with and without Impingement Syndrome

    Directory of Open Access Journals (Sweden)

    Afsoun Nodehi-Moghadam

    2011-07-01

    Full Text Available Objective: Any minimal alteration in performance and coordination of scapular and glenohumeral muscles has the potential to lead to shoulder joint dysfunction. The impingement syndrome has been reported as is the most common diagnosis of shoulder pain. The purpose of this study was to determine whether endurance deficits could be detected in patients with shoulder impingement. Materials & Methods: By convenient sampling 15 patients with impingement syndrome at average of 45.3 years of age and 15 healthy persons (age 45.8 years through a case–control design participated in the study. Endurance of glenohumeral and scapulothoracic muscles were tested with a hand held dynamometer. Independent t–test was used to statistically analyze different groups. Results: Compared to non–impaired subjects, those with impingement syndrome demonstrated a significantly lower endurance of external rotation, scaption and scapular abduction and upward rotation movements (P<0.05. In impingement syndrome patients, the external–to–internal rotator muscles endurance ratio was significantly lower than the control group (P<0.05. Conclusion: The result of the study suggests that endurance deficit of rotator cuff and scapular upward rotator muscles may be an important aspect of the impingement syndrome. Shoulder girdle muscles endurance should be considered in evaluation and physical therapy of impingement syndrome patients.

  2. Fragmentation of rotating protostellar clouds

    International Nuclear Information System (INIS)

    Tohline, J.E.

    1980-01-01

    We examine, with a three-dimensional hydrodynamic computer code, the behavior of rotating, isothermal gas clouds as they collapse from Jeans unstable configurations, in order to determine whether they are susceptible to fragmentation during the initial dynamic collapse phase of their evolution. We find that a gas cloud will not fragment unless (a) it begins collapsing from a radius much smaller than the Jeans radius (i.e., the cloud initially encloses many Jeans masses) and (b) irregularities in the cloud's initial structure (specifically, density inhomogeneities) enclose more than one Jeans mass of material. Gas pressure smooths out features that are not initially Jeans unstable while rotation plays no direct role in damping inhomogeneities. Instead of fragmenting, most of our models collapse to a ring configuration (as has been observed by other investigators in two-dimensional, axisymmetric models). The rings appear to be less susceptible to gragmentation from arbitrary perturbations in their structure than has previously been indicated in other work. Because our models, which include the effects of gas pressure, do not readily fragment during a phase of dynamic collapse, we suggest that gas clouds in the galactic disk undergo fragmentation only during quasi-equilibrium phases of their evolution

  3. A nonsingular rotating black hole

    International Nuclear Information System (INIS)

    Ghosh, Sushant G.

    2015-01-01

    The spacetime singularities in classical general relativity are inevitable, as predicated by the celebrated singularity theorems. However, it is a general belief that singularities do not exist in Nature and that they are the limitations of the general relativity. In the absence of a welldefined quantum gravity, models of regular black holes have been studied. We employ a probability distribution inspired mass function m(r) to replace the Kerr black hole mass M to represent a nonsingular rotating black hole that is identified asymptotically (r >> k, k > 0 constant) exactly as the Kerr-Newman black hole, and as the Kerr black hole when k = 0. The radiating counterpart renders a nonsingular generalization of Carmeli's spacetime as well as Vaidya's spacetime, in the appropriate limits. The exponential correction factor changing the geometry of the classical black hole to remove the curvature singularity can also be motivated by quantum arguments. The regular rotating spacetime can also be understood as a black hole of general relativity coupled to nonlinear electrodynamics. (orig.)

  4. Mars geodesy, rotation and gravity

    International Nuclear Information System (INIS)

    Rosenblatt, Pascal; Dehant, Veronique

    2010-01-01

    This review provides explanations of how geodesy, rotation and gravity can be addressed using radioscience data of an orbiter around a planet or of the lander on its surface. The planet Mars is the center of the discussion. The information one can get from orbitography and radioscience in general concerns the global static gravitational field, the time variation of the gravitational field induced by mass exchange between the atmosphere and the ice caps, the time variation of the gravitational field induced by the tides, the secular changes in the spacecraft's orbit induced by the little moons of Mars named Phobos and Deimos, the gravity induced by particular targets, the Martian ephemerides, and Mars' rotation and orientation. The paper addresses as well the determination of the geophysical parameters of Mars and, in particular, the state of Mars' core and its size, which is important for understanding the planet's evolution. Indeed, the state and dimension of the core determined from the moment of inertia and nutation depend in turn on the percentage of light elements in the core as well as on the core temperature, which is related to heat transport in the mantle. For example, the radius of the core has implications for possible mantle convection scenarios and, in particular, for the presence of a perovskite phase transition at the bottom of the mantle. This is also important for our understanding of the large volcanic province Tharsis on the surface of Mars. (invited reviews)

  5. Ring wormholes via duality rotations

    Directory of Open Access Journals (Sweden)

    Gary W. Gibbons

    2016-09-01

    Full Text Available We apply duality rotations and complex transformations to the Schwarzschild metric to obtain wormhole geometries with two asymptotically flat regions connected by a throat. In the simplest case these are the well-known wormholes supported by phantom scalar field. Further duality rotations remove the scalar field to yield less well known vacuum metrics of the oblate Zipoy–Voorhees–Weyl class, which describe ring wormholes. The ring encircles the wormhole throat and can have any radius, whereas its tension is always negative and should be less than −c4/4G. If the tension reaches the maximal value, the geometry becomes exactly flat, but the topology remains non-trivial and corresponds to two copies of Minkowski space glued together along the disk encircled by the ring. The geodesics are straight lines, and those which traverse the ring get to the other universe. The ring therefore literally produces a hole in space. Such wormholes could perhaps be created by negative energies concentrated in toroidal volumes, for example by vacuum fluctuations.

  6. Short rotation Wood Crops Program

    Energy Technology Data Exchange (ETDEWEB)

    Wright, L.L.; Ehrenshaft, A.R.

    1990-08-01

    This report synthesizes the technical progress of research projects in the Short Rotation Woody Crops Program for the year ending September 30, 1989. The primary goal of this research program, sponsored by the US Department of Energy's Biofuels and Municipal Waste Technology Division, is the development of a viable technology for producing renewable feedstocks for conversion to biofuels. One of the more significant accomplishments was the documentation that short-rotation woody crops total delivered costs could be $40/Mg or less under optimistic but attainable conditions. By taking advantage of federal subsidies such as those offered under the Conservation Reserve Program, wood energy feedstock costs could be lower. Genetic improvement studies are broadening species performance within geographic regions and under less-than-optimum site conditions. Advances in physiological research are identifying key characteristics of species productivity and response to nutrient applications. Recent developments utilizing biotechnology have achieved success in cell and tissue culture, somaclonal variation, and gene-insertion studies. Productivity gains have been realized with advanced cultural studies of spacing, coppice, and mixed-species trials. 8 figs., 20 tabs.

  7. Reciprocally-Rotating Velocity Obstacles

    KAUST Repository

    Giese, Andrew

    2014-05-01

    © 2014 IEEE. Modern multi-agent systems frequently use highlevel planners to extract basic paths for agents, and then rely on local collision avoidance to ensure that the agents reach their destinations without colliding with one another or dynamic obstacles. One state-of-the-art local collision avoidance technique is Optimal Reciprocal Collision Avoidance (ORCA). Despite being fast and efficient for circular-shaped agents, ORCA may deadlock when polygonal shapes are used. To address this shortcoming, we introduce Reciprocally-Rotating Velocity Obstacles (RRVO). RRVO generalizes ORCA by introducing a notion of rotation for polygonally-shaped agents. This generalization permits more realistic motion than ORCA and does not suffer from as much deadlock. In this paper, we present the theory of RRVO and show empirically that it does not suffer from the deadlock issue ORCA has, permits agents to reach goals faster, and has a comparable collision rate at the cost of performance overhead quadratic in the (typically small) user-defined parameter δ.

  8. Slowly braked, rotating neutron stars

    Science.gov (United States)

    Sato, H.

    1975-01-01

    A slowly braked, rotating neutron star is believed to be a star which rapidly rotates, has no nebula, is nonpulsing, and has a long initial braking time of ten thousand to a million years because of a low magnetic field. Such an object might be observable as an extended weak source of infrared or radio wave radiation due to the scattering of low-frequency strong-wave photons by accelerated electrons. If these objects exist abundantly in the Galaxy, they would act as sources of relatively low-energy cosmic rays. Pulsars (rapidly braked neutron stars) are shown to have difficulties in providing an adequate amount of cosmic-ray matter, making these new sources seem necessary. The possibility that the acceleration mechanism around a slowly braked star may be not a direct acceleration by the strong wave but an acceleration due to plasma turbulence excited by the strong wave is briefly explored. It is shown that white dwarfs may also be slowly braked stars with braking times longer than 3.15 million years.

  9. Secular stability of rotating stars

    International Nuclear Information System (INIS)

    Imamura, J.N.; Friedman, J.L.; Durisen, R.H.

    1984-01-01

    In this work, the authors calculate the secular stability limits of rotating polytropes to nonaxisymmetric perturbations of low m. Polytropic indices ranging from 1 to 3 and several angular momentum distributions are considered. Results are most conveniently presented in terms of the t-parameter, defined as the ratio of the rotational kinetic energy to the absolute value of the gravitational energy of the fluid. Previous work on polytropes considered only the m = 2 mode, which is unstable for values of the t-parameter greater than 0.14 +- 0.01 for the n values n = 1.5 and 3 and the angular momentum distributions tested (see Durisen and Imamura 1981). The GRR secular stability limit of the m - 2 mode for the Maclaurin spheroids (n = 0) was determined by Chandrasekhar (1970). GRR stability limits of higher m modes for the Maclaurin spheroids were located approximately by Comins (1979a,b) and more precisely by Friedman (1983). 16 references, 2 tables

  10. Rotating frames in special relativity

    International Nuclear Information System (INIS)

    Strauss, M.

    1979-01-01

    The transformation theory for rotating frames presented in a previous paper is generalized by replacing the usual condition r = R for ωR < c (invariance of radius) by r = Rg(βsub(R)) so that r is now defined for all values of R, 0 <= R <= infinity. This generalization does not affect the kinematic transformation bracetheta, T → bracethetasup(r), bracesup(r) and the result group structure required by the theoretical constraints previously established, provided the old parameter 'r' (=R) is now identified throughout with either r or R; for physical reasons it must be identified with R. The function g, which cannot be fixed by theoretical constraints, determines the degree of geometrical anisotropy in the rotating plane z = const. More specifically, since g enters the expression for the ratio C/D (circumference/diameter) its choice corresponds to the choice of a congruence definition for lengths in radial and tangential directions. While on this (purely geometrical) level g remains undetermined, it can be uniquely determined experimentally on the kinematic level, e.g. by observing in Σsup(ω) the motion of a free particle. Thus the supremacy of kinematics over geometry is explicated by a further instance. At the same time, special relativity theory (SRT) is shown to belong to the class of theories with theoretically unsolvable problems. (author)

  11. Validation of the Rotation Ratios Method

    International Nuclear Information System (INIS)

    Foss, O.A.; Klaksvik, J.; Benum, P.; Anda, S.

    2007-01-01

    Background: The rotation ratios method describes rotations between pairs of sequential pelvic radiographs. The method seems promising but has not been validated. Purpose: To validate the accuracy of the rotation ratios method. Material and Methods: Known pelvic rotations between 165 radiographs obtained from five skeletal pelvises in an experimental material were compared with the corresponding calculated rotations to describe the accuracy of the method. The results from a clinical material of 262 pelvic radiographs from 46 patients defined the ranges of rotational differences compared. Repeated analyses, both on the experimental and the clinical material, were performed using the selected reference points to describe the robustness and the repeatability of the method. Results: The reference points were easy to identify and barely influenced by pelvic rotations. The mean differences between calculated and real pelvic rotations were 0.0 deg (SD 0.6) for vertical rotations and 0.1 deg (SD 0.7) for transversal rotations in the experimental material. The intra- and interobserver repeatability of the method was good. Conclusion: The accuracy of the method was reasonably high, and the method may prove to be clinically useful

  12. The scapular dyskinesis test

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Møller, Anders Damgaard; Vestergaard, Jesper Medom

    2017-01-01

    tests with which to identify scapular dyskinesis. PURPOSE OF THE STUDY: To evaluate intrarater and interrater reliability and predictive value of the Scapular Dyskinesis Test (SDT) in patients with subacromial impingement syndrome. METHODS: Forty-five patients with subacromial impingement syndrome were...

  13. Femoral component rotation in patellofemoral joint replacement.

    Science.gov (United States)

    van Jonbergen, Hans-Peter W; Westerbeek, Robin E

    2018-06-01

    Clinical outcomes in patellofemoral joint replacement may be related to femoral component rotation. Assessment of rotational alignment is however difficult as patients with isolated patellofemoral osteoarthritis often have trochlear dysplasia. The use of the medial malleolus as a landmark to guide rotation has been suggested. The purpose of our study was to evaluate this technique with regard to femoral component rotation, and to correlate rotation with clinical outcomes at one-year follow-up. Forty-one knees in 39 patients had patellofemoral joint replacement using the Zimmer Gender-Solutions patellofemoral prosthesis. Intraoperatively, we determined femoral component rotational alignment using an extramedullary rod aimed at the inferior tip of the medial malleolus. Postoperatively, we measured the angle between the femoral component and the anatomical transepicondylar axis using CT. The amount of rotation was correlated with clinical outcomes at one-year follow-up. Forty knees in 38 patients were available for one-year follow-up. Mean femoral component rotation relative to the anatomical transepicondylar axis was 1.4° external rotation (range, -3.8 to 5.7°). We found no statistically significant correlation between femoral component rotation and change from baseline KOOS subscales at one-year follow-up. Our findings show that when using the medial malleolus as a landmark to guide rotation, the femoral component of the patellofemoral prosthesis was oriented in external rotation relative to the anatomical transepicondylar axis in 80% of knees. Our study did not show a relation between the amount of external rotation and clinical outcomes. Level III. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Shaken baby syndrome; Shaken-baby-Syndrom

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W.; Ahlhelm, F.; Papanagiotou, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Rohrer, T. [Universitaetsklinikum des Saarlandes, Klinik fuer Allgemeine Paediatrie und Neonatologie, Homburg/Saar (Germany)

    2009-10-15

    Shaken baby syndrome (SBS) describes the coincidence of subdural hematoma, retinal bleeding and, disadvantageous for the prognosis, diffuse brain damage caused by powerful shaking of the infant. The clinical symptoms include irritability, difficulty with drinking, somnolence, apathy, cerebral cramp attacks, apnoea, temperature regulation disorders and vomiting due to cranial pressure. Milder symptoms of SBS are often not diagnosed and the number of unregistered cases is probably much greater. The diagnosis of SBS is made through the typical symptom constellation, but the lack of retinal bleeding does not exclude the diagnosis. Normally the infants are held by the thorax or upper arms and shaken in a sagittal direction during which the head falls backwards and forwards and is stopped abruptly at each extreme position. The injurious mechanism is considered to be caused by rotational forces which force tissue layers in the brain against each other and also lead to rupture of bridging veins between the skull and the brain. The prognosis is poor and approximately 25% of infants die of SBS within days or weeks. Approximately 75% of survivors suffer from long term damage with physical handicaps, limitations in hearing, visual disturbances up to blindness and mental disorders or combinations of these conditions. Prevention is therefore the most important aspect. (orig.) [German] Das Shaken-baby-Syndrom (SBS) oder Schuetteltrauma des Saeuglings beschreibt die Koinzidenz subduraler Haematome, retinaler Blutungen und prognostisch unguenstiger, diffuser Hirnschaeden durch heftiges Schuetteln eines Saeuglings. Die klinischen Symptome umfassen Irritabilitaet, Trinkschwierigkeiten, Somnolenz, Apathie, zerebrale Krampfanfaelle, Apnoe, Temperaturregulationsstoerungen und Erbrechen durch Hirndruck. Leichtere Symptome des SBS werden haeufig nicht diagnostiziert, die Dunkelziffer ist wahrscheinlich viel hoeher. Die Diagnose des SBS wird durch die typische Symptomkonstellation gestellt

  15. Hepatorenal Syndrome

    Directory of Open Access Journals (Sweden)

    Ebru Yilmaz

    2014-06-01

    Full Text Available Hepatorenal syndrome (HRS is functional renal failure that occurs with advanced liver failure. HRS is considered the most severe complication of cirrhosis. Type 1 HRS develops due to severe reduction of effective circulating volume results in hemodynamic dysfunction. Type 1 HRS is characterized by acute renal failure and rapid deterioration in the function of other organs. It can ocur spontaneously or in the setting of a precipitating event. Type 2 hepatorenal syndrome (HRS, which is characterized by slowly progressive renal failure and refractory ascites. Liver transplantation is the only definitive treatment for both type. The most suitable and ldquo;bridge treatments and rdquo; or treatment for patients ineligible for a liver transplant include terlipressin plus albumin. [J Contemp Med 2014; 4(2.000: 106-113

  16. Dravet syndrome

    Directory of Open Access Journals (Sweden)

    Incorpora Gemma

    2009-09-01

    Full Text Available Abstract "Dravet syndrome" (DS previously named severe myoclonic epilepsy of infancy (SMEI, or epilepsy with polymorphic seizures, is a rare disorder characterized by an early, severe, generalized, epileptic encephalopathy. DS is characterized by febrile and afebrile seizures beginning in the 1st year of life followed by different types of seizures (either focal or generalized, which are typically resistant to antiepileptic drugs. A developmental delay from the 2nd to 3rd year of life becomes evident, together with motor disturbances and personality disorders. Beside the classic syndrome, there are milder cases which have been called severe myoclonic epilepsy borderline (SMEB. DS is caused by a mutation in the neuronal sodium channel gene, SCN1A , that is also mutated in generalized epilepsy with FS+ (GEFS+.

  17. Apert syndrome

    Directory of Open Access Journals (Sweden)

    Premalatha

    2010-01-01

    Full Text Available Apert syndrome (acrocephalosyndactyly is a rare developmental malformation characterized by craniosynostosis, mid-face hypoplasia, symmetrical syndactyly of hands and feet. The prodromal characteristics for the typical cranio-facial appearance are early craniosynostosis of the coronal suture, cranial base and agenesis of the sagittal suture. The purpose of this paper is to report a case of Apert syndrome with emphasis on craniofacial and oral features in an eighteen-month-old male child. The patient presented with several craniofacial deformities, including brachycephaly, midface hypoplasia, flat face, hypertelorism, ocular proptosis, downslanting palpebral fissures. Syndactylies with osseous fusion of the hands and feet were also observed. Intraoral findings included delayed eruption of teeth, high arched palate with pseudo cleft in the posterior one third.

  18. Paraneoplastic syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1994-03-01

    Paraneoplastic syndromes (PNS) comprise a diverse group of disorders that are associated with cancer but unrelated to the size, location, metastases, or physiologic activities of the mature tissue of origin. They are remote effects of tumors that may appear as signs, symptoms, or syndromes which can mimic other disease conditions encountered in veterinary medicine. Recognition of PNS is valuable for several reasons: the observed abnormalities may represent tumor cell markers and facilitate early diagnosis of the tumor; they may allow assessment of premalignant states; they may aid in the search metastases; they may help quantify and monitor response to therapy; and, they may provide insight into the study of malignant transformation and oncogene expression. This review will concentrate on the pathophysiology, diagnosis, and treatment of some of the common PNS encountered in veterinary medicine.

  19. Contributions of myofascial pain in diagnosis and treatment of shoulder pain. A randomized control trial

    Directory of Open Access Journals (Sweden)

    Gaspar-Calvo Elena

    2009-07-01

    Full Text Available Abstract Background Rotator cuff tendinopathy and subacromial impingement syndrome present complex patomechanical situations, frequent difficulties in clinical diagnosis and lack of effectiveness in treatment. Based on clinical experience, we have therefore considered the existence of another pathological entity as the possible origin of pain and dysfunction. The hypothesis of this study is to relate subacromial impingement syndrome (SIS with myofascial pain syndrome (MPS, since myofascial trigger points (MTrPs cause pain, functional limitation, lack of coordination and alterations in quality of movement, even prior to a tendinopathy. MTrPs can coexist with any degenerative subacromial condition. If they are not taken into consideration, they could perpetuate and aggravate the problem, hindering diagnosis and making the applied treatments ineffective. The aims and methods of this study are related with providing evidence of the relationship that may exist between this condition and MPS in the diagnosis and treatment of rotator cuff tendonitis and/or SIS. Method/design A descriptive transversal study will be made to find the correlation between the diagnosis of SIS and rotator cuff tendonitis, positive provocation test responses, the existence of active MTrPs and the results obtained with ultrasonography (US and Magnetic Renonance Imaging (MRI. A randomized double blinded clinical trial will be carried out in experimental conditions: A Protocolized treatment based on active and passive joint repositioning, stabilization exercises, stretching of the periarticular shoulder muscles and postural reeducation. B. The previously described protocolized treatment, with the addition of dry needling applied to active MTrPs with the purpose of isolating the efficacy of dry needling in treatment. Discussion This study aims to provide a new vision of shoulder pain, from the perspective of MPS. This syndrome can, by itself, account for shoulder pain and

  20. Physics, Formation and Evolution of Rotating Stars

    CERN Document Server

    Maeder, André

    2009-01-01

    Rotation is ubiquitous at each step of stellar evolution, from star formation to the final stages, and it affects the course of evolution, the timescales and nucleosynthesis. Stellar rotation is also an essential prerequisite for the occurrence of Gamma-Ray Bursts. In this book the author thoroughly examines the basic mechanical and thermal effects of rotation, their influence on mass loss by stellar winds, the effects of differential rotation and its associated instabilities, the relation with magnetic fields and the evolution of the internal and surface rotation. Further, he discusses the numerous observational signatures of rotational effects obtained from spectroscopy and interferometric observations, as well as from chemical abundance determinations, helioseismology and asteroseismology, etc. On an introductory level, this book presents in a didactical way the basic concepts of stellar structure and evolution in "track 1" chapters. The other more specialized chapters form an advanced course on the gradua...