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.

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...

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...

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 ...

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

DEFF Research Database (Denmark)

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...

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...

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.

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...

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

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

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

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...

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.

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.

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...

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.

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.

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.

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.

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

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

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.

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

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...

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

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

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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.

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

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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.

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

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

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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

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

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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.

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

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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

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

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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.

Current UK practices in the management of subacromial impingement.

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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.

Current UK practices in the management of subacromial impingement

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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

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...

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

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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.

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

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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.

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

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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

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...

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.)

MR imaging after therapeutic injection of the subacromial bursa

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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.)

Does Subacromial Osteolysis Affect Shoulder Function after Clavicle Hook Plating?

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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.

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

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

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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.

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

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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.

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

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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.

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

Subacromial bursitis with rice bodies : a case report

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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.

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

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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.

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

Relationships between rotator cuff tear types and radiographic abnormalities

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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.

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.

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

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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.

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)

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

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

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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...

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.

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

Ultrasonography of the Rotator Cuff

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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

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.

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.

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

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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.

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

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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.

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)

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.

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.

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

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

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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.)

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.)

Shoulder impingement syndrome : evaluation of the causes with MRI

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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.

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

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

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.

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.)

Intestinal rotational abnormalities in polysplenia and asplenia syndromes

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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.

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

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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.

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

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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.

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

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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.

Contributions of myofascial pain in diagnosis and treatment of shoulder pain. A randomized control trial

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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

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

Arthroscopic treatment of bony loose bodies in the subacromial space

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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.

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

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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 ...

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

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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.

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

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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.

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

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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.

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

Impingement syndrome of the shoulder; Schulterimpingement

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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

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

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

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

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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

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

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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.

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

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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.)

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.)

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.

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.)

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.

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.

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.

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

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

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

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

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.

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

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...

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.

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)

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...

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

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.

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.

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....

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

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)

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.

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.)

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.)

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

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

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.

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.

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

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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.

[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.

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.

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.

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...

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.

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

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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.

Heterotaxy syndromes and abnormal bowel rotation

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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.)

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.)

Current concepts in the diagnosis and treatment of shoulder impingement

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Bijayendra Singh

2017-01-01

Full Text Available Subacromial impingement syndrome (SIS is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS.

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

Acupuncture and rehabilitation of the painful shoulder: study protocol of an ongoing multicentre randomised controlled clinical trial [ISRCTN28687220

Directory of Open Access Journals (Sweden)

Jimenez Carmen

2005-10-01

Full Text Available Abstract Background Although the painful shoulder is one of the most common dysfunctions of the locomotor apparatus, and is frequently treated both at primary healthcare centres and by specialists, little evidence has been reported to support or refute the effectiveness of the treatments most commonly applied. According to the bibliography reviewed, physiotherapy, which is the most common action taken to alleviate this problem, has not yet been proven to be effective, because of the small size of sample groups and the lack of methodological rigor in the papers published on the subject. No reviews have been made to assess the effectiveness of acupuncture in treating this complaint, but in recent years controlled randomised studies have been made and these demonstrate an increasing use of acupuncture to treat pathologies of the soft tissues of the shoulder. In this study, we seek to evaluate the effectiveness of physiotherapy applied jointly with acupuncture, compared with physiotherapy applied with a TENS-placebo, in the treatment of painful shoulder caused by subacromial syndrome (rotator cuff tendinitis and subacromial bursitis. Methods/design Randomised controlled multicentre study with blind evaluation by an independent observer and blind, independent analysis. A study will be made of 465 patients referred to the rehabilitation services at participating healthcare centres, belonging to the regional public health systems of Andalusia and Murcia, these patients presenting symptoms of painful shoulder and a diagnosis of subacromial syndrome (rotator cuff tendinitis and subacromial bursitis. The patients will be randomised into two groups: 1 experimental (acupuncture + physiotherapy; 2 control (TENS-placebo + physiotherapy; the administration of rescue medication will also be allowed. The treatment period will have a duration of three weeks. The main result variable will be the change produced on Constant's Shoulder Function Assessment (SFA Scale

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

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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

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

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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.

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.

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

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.

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.

Biomechanical Effects of Acromioplasty on Superior Capsule Reconstruction for Irreparable Supraspinatus Tendon Tears.

Science.gov (United States)

Mihata, Teruhisa; McGarry, Michelle H; Kahn, Timothy; Goldberg, Iliya; Neo, Masashi; Lee, Thay Q

2016-01-01

Acromioplasty is increasingly being performed for both reparable and irreparable rotator cuff tears. However, acromioplasty may destroy the coracoacromial arch, including the coracoacromial ligament, consequently causing a deterioration in superior stability even after superior capsule reconstruction. The purpose of this study was to investigate the effects of acromioplasty on shoulder biomechanics after superior capsule reconstruction for irreparable supraspinatus tendon tears. The hypothesis was that acromioplasty with superior capsule reconstruction would decrease the area of subacromial impingement without increasing superior translation and subacromial contact pressure. Controlled laboratory study. Seven fresh-frozen cadaveric shoulders were evaluated using a custom shoulder testing system. Glenohumeral superior translation, the location of the humeral head relative to the glenoid, and subacromial contact pressure and area were compared among 4 conditions: (1) intact shoulder, (2) irreparable supraspinatus tendon tear, (3) superior capsule reconstruction without acromioplasty, and (4) superior capsule reconstruction with acromioplasty. Superior capsule reconstruction was performed using the fascia lata. Compared with the intact shoulder, the creation of an irreparable supraspinatus tear significantly shifted the humeral head superiorly in the balanced muscle loading condition (without superior force applied) (0° of abduction: 2.8-mm superior shift [P = .0005]; 30° of abduction: 1.9-mm superior shift [P = .003]) and increased both superior translation (0° of abduction: 239% of intact [P = .04]; 30° of abduction: 199% of intact [P = .02]) and subacromial peak contact pressure (0° of abduction: 308% of intact [P = .0002]; 30° of abduction: 252% of intact [P = .001]) by applying superior force. Superior capsule reconstruction without acromioplasty significantly decreased superior translation (0° of abduction: 86% of intact [P = .02]; 30° of abduction: 75

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

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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.

Diclofenac Patch for Treatment of Mild to Moderate Tendonitis or Bursitis

Science.gov (United States)

2008-08-05

Rotator Cuff Tendonitis; Bicipital Tendonitis; Subdeltoid Bursitis of the Shoulder; Subacromial Bursitis of the Shoulder; Medial Epicondylitis of the Elbow; Lateral Epicondylitis of the Elbow; DeQuervain's Tenosynovitis of the Wrist

The incidence of pathologic changes of the long head of the biceps tendon.

Science.gov (United States)

Murthi, A M; Vosburgh, C L; Neviaser, T J

2000-01-01

The incidence of primary and secondary bicipital tendinitis remains unknown. In our prospective study, 200 consecutive shoulders underwent arthroscopic subacromial decompression for impingement syndrome. A biceps tenodesis was performed in 80 shoulders (40%) featuring macroscopic degeneration of the long head of the biceps; rotator cuff tears were apparent in 91% of these shoulders, the mean patient age being 55 years. In each of 120 shoulders (60%), an extraarticular tenosynovectomy was performed, and histopathologic studies revealed chronic inflammation in 63% and fibrotic degeneration in 13% of the specimens; rotator cuff tears were evident in 70% (23% full thickness) of these cases, the mean patient age being 47 years. In addition, when glenohumeral arthritis was present, it was uniformly associated with pathologic biceps tenosynovium. In summary, the high incidence of chronic inflammation of the long head of the biceps in shoulders with benign-appearing intraarticular portions viewed arthroscopically is significant, and long head of the biceps disease should also be considered in patients with painful rotator cuff disease and arthritic shoulder conditions.

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…

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

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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

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

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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

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

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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.

Radiotherapy for shoulder impingement; Bestrahlung beim Impingementsyndrom des Schultergelenks

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Adamietz, B. [Universitaetsklinikum Erlangen (Germany). Inst. fuer Radiologie; Sauer, R.; Keilholz, L. [Universitaetsklinikum Erlangen (Germany). Strahlentherapeutische Klinik

2008-05-15

Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term 'periarthritis humeroscapularis'. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

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

MRI of the rotator cuff and internal derangement

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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.

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

MRI of the posttraumatic shoulder

International Nuclear Information System (INIS)

Dimitrov, N.

2013-01-01

Full text: Abnormalities of the shoulder are common but still unclear for both GPs and the orthopedic surgeon in our community. Difficult and late these patients are directed to a specialist for diagnosis and treatment. Our goal is to address some of the key and most common problem conditions related to the complaints in this area. Incidence of symptomatic ruptures of the shoulder’s rotator cuff is difficult to be evaluated. But it is by no means rare, concerning the research in the world - historically and today. It is also known that ruptures can be asymptomatic. Despite the large percentage of them, many of them are at risk for progression of the symptoms. While, on the world, the authors explicitly state that dealing with a rotator cuff rupture is one of the top 10 issues that are most important for orthopedic surgeons, in our country the most common diagnosis for shoulder complaints is still periarthritis, without specifying of individual muscles pathology. Another major concern is shoulder instability associated with multiple incidents of luxation started either in adolescence with minor traumatic incident, such as recurrent dislocation, or started after severe trauma in older ages. It has to be specified diagnostic type of instability: front, rear or multidirection. Especially it is important to make the initial stabilization period of unavoidable long series of repeated dislocations in adolescents and young people, whether actively practicing sports or not. This point is often missed, and later for large lesions it leads to more invasive surgery. Not infrequently this condition is characterized by pain and limited movement without true dislocation. Then it is mandatory to assess the diagnostic changes in labrum, ligaments and muscles, not to leave the patient to reach first dislocation. Impingement syndrome (IC) is a common suffering, engaging soft tissues in the subacromial bursitis. IC characterizes by pain during the upper limb removal and the

Shoulder strengthening exercises adapted to specific shoulder pathologies can be selected using new simulation techniques: a pilot study.

Science.gov (United States)

Charbonnier, Caecilia; Lädermann, Alexandre; Kevelham, Bart; Chagué, Sylvain; Hoffmeyer, Pierre; Holzer, Nicolas

2018-02-01

Shoulder strength training exercises represent a major component of rehabilitation protocols designed for conservative or postsurgical management of shoulder pathologies. Numerous methods are described for exercising each shoulder muscle or muscle group. Limited information is available to assess potential deleterious effects of individual methods with respect to specific shoulder pathologies. Thus, the goal of this pilot study was to use a patient-specific 3D measurement technique coupling medical imaging and optical motion capture for evaluation of a set of shoulder strength training exercises regarding glenohumeral, labral and subacromial compression, as well as elongation of the rotator cuff muscles. One volunteer underwent magnetic resonance imaging (MRI) and motion capture of the shoulder. Motion data from the volunteer were recorded during three passive rehabilitation exercises and twenty-nine strengthening exercises targeting eleven of the most frequently trained shoulder muscles or muscle groups and using four different techniques when available. For each exercise, glenohumeral and labral compression, subacromial space height and rotator cuff muscles elongation were measured on the entire range of motion. Significant differences in glenohumeral, subacromial and labral compressions were observed between sets of exercises targeting individual shoulder muscles. Muscle lengths computed by simulation compared to MRI measurements showed differences of 0-5%. This study represents the first screening of shoulder strengthening exercises to identify potential deleterious effects on the shoulder joint. Motion capture combined with medical imaging allows for reliable assessment of glenohumeral, labral and subacromial compression, as well as muscle-tendon elongation during shoulder strength training exercises.

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.

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.

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

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

Imaging of the shoulder after surgery

International Nuclear Information System (INIS)

McMenamin, Drew; Koulouris, George; Morrison, William B.

2008-01-01

Postoperative imaging of the shoulder is challenging. This article reviews the radiologic evaluation following surgery for subacromial impingment, rotator cuff lesions and glenohumeral instability, including the common surgical procedures, the expected postoperative findings and potential complications. A specific emphasis is made on magnetic resonance imaging

Imaging of the shoulder after surgery

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McMenamin, Drew [Department of Radiology, University of Washington, Box 354755, 4245 Roosevelt Way NE, Seattle, WA 98105 (United States)], E-mail: drewmcm@u.washington.edu; Koulouris, George [Gold Coast Medical Imaging, 123 Nerang Street, Southport, QLD 4215 (Australia); Morrison, William B. [Thomas Jefferson University Hospital, 132 South 10th Street, Suite 1079a, Philadelphia, PA 19107 (United States)

2008-10-15

Postoperative imaging of the shoulder is challenging. This article reviews the radiologic evaluation following surgery for subacromial impingment, rotator cuff lesions and glenohumeral instability, including the common surgical procedures, the expected postoperative findings and potential complications. A specific emphasis is made on magnetic resonance imaging.

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.

The value of clinical tests in acute full-thickness tears of the supraspinatus tendon

DEFF Research Database (Denmark)

Bak, Klaus; Sørensen, Anne Kathrine Belling; Jørgensen, Uffe Viegh

2010-01-01

Early repair of rotator cuff tears leads to superior results. To detect symptomatic full-thickness tears of the supraspinatus tendon at an early stage, we conducted a prospective study to evaluate the value of clinical examination with and without subacromial lidocaine within the first weeks after...

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.

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.

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.

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

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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

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

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

Effects of experimental muscle pain on shoulder-abduction force steadiness and muscle activity in healthy subjects

DEFF Research Database (Denmark)

Bandholm, Thomas Quaade; Rasmussen, Lars; Aagaard, Per

2007-01-01

We previously demonstrated that the steadiness of shoulder abduction is reduced in patients with subacromial impingement syndrome (SIS), which might be related to shoulder pain associated with the SIS. The aim of the present study was to examine the acute effects of experimental shoulder muscle p...

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

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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.

Diagnostic imaging of shoulder rotator cuff lesions

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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.

Sonography of the painful shoulder: role of the operator's experience

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Corroller, Thomas Le; Cohen, Michel; Champsaur, Pierre [Hopital Sainte-Marguerite, Service d' Imagerie Medicale, Marseille (France); Aswad, Richard [Clinique Juge, Service de Chirurgie Orthopedique, Marseille (France); Pauly, Vanessa [Hopital Sainte-Marguerite, D.I.M., Marseille (France)

2008-11-15

The aim of our study was to determine the role of the operator's experience in the sonographic evaluation of the painful shoulder and to validate assumptions about its technical performance in routine practice. Two radiologists, respectively standard and expert sonographic operators, independently and prospectively scanned 65 patients with clinical suspicion of rotator cuff lesion. Magnetic resonance arthrography was the reference standard. The sensitivity of the expert ultrasound operator was 95.3% for full-thickness rotator cuff tears (41/43), 70.6% for partial-thickness tears (12/17), 64.3% for intratendinous tears (9/14), 100% for abnormality of the long head of biceps tendon (seven of seven), 88.9% for supraspinatus tendinosis (16/18), 96.4% for subacromial bursa abnormalities (53/55), and 91.7%for acromioclavicular joint osteoarthritis (33/36). The two sonographic operators were in very good agreement about full-thickness rotator cuff tears ({kappa}=0.90), supraspinatus tendinosis ({kappa} =0.80), abnormalities of the long head of biceps tendon ({kappa}=0.84), subacromial bursa abnormalities ({kappa}=0.89), and acromioclavicular osteoarthritis ({kappa}=0.81). The agreement was only moderate for partial-thickness tears ({kappa}=0.63) and intratendinous tears ({kappa}=0.57). Our results show that in moderately experienced hands as in experts' hands, sonography has a low level of interobserver variability for full-thickness rotator cuff tears. Considering partial-thickness and intratendinous rotator cuff tears, our data suggest that interobserver variability is higher. (orig.)

Sonography of the painful shoulder: role of the operator's experience

International Nuclear Information System (INIS)

Corroller, Thomas Le; Cohen, Michel; Champsaur, Pierre; Aswad, Richard; Pauly, Vanessa

2008-01-01

The aim of our study was to determine the role of the operator's experience in the sonographic evaluation of the painful shoulder and to validate assumptions about its technical performance in routine practice. Two radiologists, respectively standard and expert sonographic operators, independently and prospectively scanned 65 patients with clinical suspicion of rotator cuff lesion. Magnetic resonance arthrography was the reference standard. The sensitivity of the expert ultrasound operator was 95.3% for full-thickness rotator cuff tears (41/43), 70.6% for partial-thickness tears (12/17), 64.3% for intratendinous tears (9/14), 100% for abnormality of the long head of biceps tendon (seven of seven), 88.9% for supraspinatus tendinosis (16/18), 96.4% for subacromial bursa abnormalities (53/55), and 91.7%for acromioclavicular joint osteoarthritis (33/36). The two sonographic operators were in very good agreement about full-thickness rotator cuff tears (κ=0.90), supraspinatus tendinosis (κ =0.80), abnormalities of the long head of biceps tendon (κ=0.84), subacromial bursa abnormalities (κ=0.89), and acromioclavicular osteoarthritis (κ=0.81). The agreement was only moderate for partial-thickness tears (κ=0.63) and intratendinous tears (κ=0.57). Our results show that in moderately experienced hands as in experts' hands, sonography has a low level of interobserver variability for full-thickness rotator cuff tears. Considering partial-thickness and intratendinous rotator cuff tears, our data suggest that interobserver variability is higher. (orig.)

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

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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

Rotational injury of cervical facets: CT analysis of fracture patterns with implications for management and neurologic outcome.

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Shanmuganathan, K; Mirvis, S E; Levine, A M

1994-11-01

Imaging studies of patients with rotational facet injuries of the cervical spine were retrospectively reviewed to determine the prevalence and pattern of associated fractures, to correlate injury pattern with recommended surgical stabilization, and to assess neurologic outcome. Radiographs and CT scans obtained for 40 consecutive patients with rotational facet injuries of the cervical spine during a 70-month period were retrospectively reviewed to determine injury level, presence, and orientation of facet fractures, and concurrent nonfacet injuries. Imaging findings were reviewed to assess the likelihood of instability and to determine the most appropriate stabilization requirement. Medical records were reviewed to ascertain mechanism of injury, initial neurologic deficit, and surgical findings. Among the 40 patients with cervical rotational facet injuries, 11 (27%) had pure unilateral facet dislocation or subluxation without associated fractures, and 29 (73%) had concurrent facet fractures involving the inferior facet of the rotated vertebra (n = 13), the superior facet of the subjacent vertebra (n = 9), or both (n = 7). Injury of the rotated vertebra was unilateral in 22 patients but bilateral in 18 patients. Facet fractures frequently extended into the ipsilateral lamina or articular pillar or both. An avulsion fracture from the posteroinferior aspect of the rotated vertebral body, indicating disk disruption, occurred in 10 patients (25%), and seven patients (17%) had complete isolation of an articular pillar. Facet fractures were confirmed for 27 patients who underwent surgical stabilization. Neurologic deficits developed in 29 (73%) of the 40 patients and included radiculopathy in 11 patients and cord syndromes in 18 patients. Pure dislocation without a facet fracture was more likely to lead to a cord syndrome (p = .006). Cervical rotational facet injuries are often accompanied by facet fractures and bilateral damage of the rotated vertebra. These injuries

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

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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.

Fluid collections and juxta-articular cystic lesions of the shoulder: spectrum of MRI findings

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Mellado, J.M.; Salvado, E.; Camins, A.; Ramos, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Joan XXIII, Tarragona (Spain); Merino, X. [Institut de Diagnostic per la Imatge, Hospital Vall' Ebron, Barcelona (Spain); Calmet, J. [Orthopaedic Surgery, Hospital Joan XXIII, Carrer Doctor Mallafre Guasch, Tarragona (Spain)

2002-03-01

The MR imaging features of fluid collections and juxta-articular cystic lesions of the shoulder are discussed, with special focus on those related to subacromial impingement and rotator cuff tears. Other more unusual fluid collections and cystic lesions are described, including rice-bodies bursitis, idiopathic synovial osteochondromatosis, dialysis-related amyloid arthropathy, hemophilic arthropathy, infectious conditions, non-infectious inflammatory arthritis, and paralabral cysts. (orig.)

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

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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.

Shoulder arthography in rheumatoid arthritis

International Nuclear Information System (INIS)

Reinbold, W.D.; Hehne, H.J.; Rau, W.S.; Freiburg Univ.

1983-01-01

Shoulder arthrography in a patient with rheumatoid arthritis is performed to differentiate between a rheumatoid flare and limitation of motion secondary to tear in the rotator cuff. Accurate diagnosis is important because of the therapeutic implications. The arthrographic findings characteristic of rheumatoid involvement of the shoulder joint are nodular filling defects of the joint, the subacromial and subdeltoideal bursa in case of rotator cuff tear, irregular capsular attachment, contracted joint space and visualized lymphatic drainage. A dilatation of the biceps tendon sheath has not been shown. (orig.) [de

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

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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

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

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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

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

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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.

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

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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

Muscle Activation Pattern during Selected Functional Task in Shoulder Impingement Syndrome vs. Normal Subjects

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Mehrnaz Kajbaf-Vala

2009-10-01

Conclusion: Changes in muscle recruitment pattern are task dependent that this may be due to direction of movement and axial compression loading in subacromial space. Among all selected exercises in D2E (Diagonal 2 Extension minimum changes and in tripod maximum changes (in time domain were seen.

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

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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

Can arthroscopic rotator cuff repair prevent proximal migration of the humeral head?

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Pablo Sanz-Ruiz

2015-12-01

Full Text Available Introduction: Shoulder arthroscopy has become increasingly used in recent years, especially in rotator cuff repair. The purpose of this study was to determine whether arthroscopic rotator cuff repair could prevent proximal migration of the humeral head. Material and Methods: We performed a retrospective study of 56 patients suffering from shoulder pain. They were divided into two groups, one comprising patients with impingement syndrome who underwent acromioplasty only and another comprising patients with rotator cuff tear who underwent acromioplasty combined with rotator cuff repair. The pre-operative Hirooka angle and the results of the simple shoulder test (SST were compared after 1 year. Results: We found no differences between the groups for the Hirooka angle or SST results. We did find a significant difference (P<0.05 between pre-operative and post-operative SST results. Conclusions: Rotator cuff repair using arthroscopy is a minimally invasive procedure that improves function and prevents proximal migration of the humeral head after 1 year of follow-up. [Arch Clin Exp Surg 2015; 4(4.000: 190-195

Scapula kinematics of pull-up techniques: Avoiding impingement risk with training changes.

Science.gov (United States)

Prinold, Joe A I; Bull, Anthony M J

2016-08-01

Overhead athletic activities and scapula dyskinesia are linked with shoulder pathology; pull-ups are a common training method for some overhead sports. Different pull-up techniques exist: anecdotally some are easier to perform, and others linked to greater incidences of pathology. This study aims to quantify scapular kinematics and external forces for three pull-up techniques, thus discussing potential injury implications. An observational study was performed with eleven participants (age=26.8±2.4 years) who regularly perform pull-ups. The upward motions of three pull-up techniques were analysed: palms facing anterior, palms facing posterior and wide-grip. A skin-fixed scapula tracking technique with attached retro-reflective markers was used. High intra-participant repeatability was observed: mean coefficients of multiple correlations of 0.87-1.00 in humerothoracic rotations and 0.77-0.90 for scapulothoracic rotations. Standard deviations of hand force was low: kinematics were observed between the pull-up techniques. The reverse technique has extreme glenohumeral internal-external rotation and large deviation from the scapula plane. The wide technique has a reduced range of pro/retraction in the same HT plane of elevation and 90° of arm abduction with 45° external rotation was observed. All these factors suggest increased sub-acromial impingement risk. The scapula tracking technique showed high repeatability. High arm elevation during pull-ups reduces sub-acromial space and increases pressure, increasing the risk of impingement injury. Wide and reverse pull-ups demonstrate kinematics patterns linked with increased impingement risk. Weight-assisted front pull-ups require further investigation and could be recommended for weaker participants. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

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

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...

Hamstring Injury After Swimming in a Patient With Multiple Hereditary Osteochondromatosis.

Science.gov (United States)

Dönmez, Gürhan; Özçakar, Levent; Korkusuz, Feza

2016-09-01

Reported here is a 20-year-old male suffered a hamstring strain after a prolonged bout of swimming. After ultrasound imaging, the patient's injury was considered to be the result of nearby osteochondromas. Case reports have been previously published concerning anterior cruciate ligament injury, rotator cuff tears, subacromial impingement, or femoroacetabular impingement in multiple osteochondromatosis. However, to the best of our knowledge, this is the first reported case of a hamstring injury secondary to an osteochondroma.

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.

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.

Systematics of injuries of the rotator cuff and biceps tendon; Systematik der Verletzungen von Rotatorenmanschette und Bizepssehne

Energy Technology Data Exchange (ETDEWEB)

Breitenseher, M.J. [Landesklinikum Horn, Institut fuer Radiologie und interventionelle Radiologie, Horn (Austria); Pones, M.; Breitenseher, J.B. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria)

2015-03-01

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.) [German] Bei der Verletzung von Rotatorenmanschette und Bizepssehne koennen verschiedene Muster klinisch und radiologisch erkannt werden. Diese Muster sind das Impingementsyndrom mit einem zusaetzlichen Trauma, das isolierte Trauma und die Verletzung der Rotatorenmanschette im Rahmen einer Schulterluxation. Darueber hinaus ist die Beurteilung des Ausmasses einer Verletzung von zentraler klinischer Relevanz. Die MRT kann die Differenzierung dieser Muster bestmoeglich durchfuehren. (orig.)

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.

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.

The role of tendinitis in fibromyalgia syndrome.

Science.gov (United States)

Genç, Hakan; Saracoğlu, Meryem; Duyur, Burcu; Erdem, Hatice Rana

2003-08-30

Fibromyalgia Syndrome (FS) is a common disease characterized by diffuse, widespread pain and multiple tender points. The syndrome has been subclassified as primary (PFS) and secondary (SFS) fibromyalgia. The aim of this study was to evaluate the role of common tendinitis (rotator cuff tendinitis, bicipital tendinitis, lateral epicondylitis, De-Quervain's tendinitis and pes anserinus tendinitis) in FS. Twenty female patients with PFS, 20 with SFS and 20 female controls, matched by age and body mass index, participated in the study. Existence of common tendinitis was evaluated with specific examination methods. Right and left rotator cuff tendinitis, pes anserinus tendinitis and left lateral epicondylitis were significantly more common in patients with PFS and SFS than in control subjects. As a result, considering the central hyperexcitability present in the fibromyalgia patients, concomitant pathologies such as tendinitis which lead to shoulder, arm, and leg pain must be evaluated. Follow up and therapy for the disease must be planned according to these factors which are not only probable symptoms of FS, but also leading causes for the occurrence and continuity of the pain in this disease.

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...

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.

Musculoskeletal and Medical Morbidity Associated with Rigorous Physical Training

Science.gov (United States)

1992-08-01

71881 I 0.2 Tendinitis , rotator cuff (RC) 72610 1 0.2 Subacromial bursitis 72619 1 0.2 Sprain/strain/tear, RC 84040 1 0.2 TABLE 4. Incidence’ of...84509 5 1.0 military investigators, although iliotibial band syn- Tendinitis , ant/post tibialis 72672 5 1.0 Tendinitis /bursitis, Achilles 72671 4 0.8...91730 3 0.6 SEAL clinic providers with ITBS and other muscu- Tendinitis /bursitis, peroneal 72679 3 0.6 Sprain/strain, foot, cuboid 84519 2 0.4

Sonography as a new diagnostic procedure for investigating abnormalities of the shoulder

International Nuclear Information System (INIS)

Rapf, C.; Furtschegger, A.; Resch, H.; Innsbruck Univ.

1986-01-01

Eighty-one sonographic examinations of patients with complaints relating to the shoulder joint have shown that this is the method next in value to radiological examination. So far, lesions of the rotator cuff and of the long head of the biceps could only be demonstrated by invasive procedures such as arthrography or arthroscopy. In these situations, sonography attains a similar accuracy. Diffuse lesions can also be diagnosed correctly, making arthrography and arthroscopy unnecessary. In addition, sonography can demonstrate inflammatory and degenerative changes and incomplete sub-acromial and intermediary tears of the rotator cuff, unlike conventional diagnostic methods. In future, arthrography and arthroscopy will only be necessary as additional diagnostic methods if sonography remains inconclusive. (orig.) [de

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.

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.

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.

A review of biomechanics of the shoulder and biomechanical concepts of rotator cuff repair

Directory of Open Access Journals (Sweden)

Nobuyuki Yamamoto

2015-01-01

Full Text Available In this article, we describe the basic knowledge about shoulder biomechanics, which is thought to be useful for surgeons. Some clinical reports have described that the excellent outcome after cuff repair without acromioplasty and a limited acromioplasty might be enough for subacromial decompression. It was biomechanically demonstrated that a 10-mm medial shift of the tendon repair site has a minimum effect on biomechanics. Many biomechanical studies reported that the transosseous equivalent repair was superior to other techniques, although the tendon may lose its inherent elasticity. We herein introduce our recent experiment data and latest information on biomechanics.

Scapular Kinematics: A Comparison between Females with and Without General Hypermobility Syndrome in Arm Elevation

Directory of Open Access Journals (Sweden)

Salman Nazary-Moghadam

2010-07-01

Full Text Available Objective: Numerous studies showed increasing incidence of acute or recurrent dislocations of the shoulder joint in people with General Hypermobility Syndrome (GHS. Given the critical role of scapular orientation in function of shoulder, the aim of this study is to compare the parameters indicating position and orientation of scapula between females with and without General Hypermobility Syndrome in frontal and sagital plane in arm elevation. Materials & Methods: In this cross sectional and case-control study, 16 females with General Hypermobility Syndrome were selected simply and conveniently and 16 healthy females were selected and matched by age, body mass index and menstrual status. A three dimensional motion analysis system (vicon 460 was used to measure scapular position (upper-lower and medial-lateral translations and orientation (upward rotation, posterior tilt and internal rotation angle. Measurement were taken with the arm placed in different angles of arm elevation. Date analysis was performed with Independent T test. Results: Upward rotation angles in sagital plane in 90º (P=0.03, 120º (P=0.01 and full range of arm elevation (P=0.04 were lower in case group as compared to control group. Also patients with General Hypermobility Syndrome showed a lesser amount of lateral scapular translation in 90º (P=0.02 and full range of sagital plane arm elevation (P=0.02. In addition, lateral scapular translation in 120º (P=0.02 and full range of frontal plane arm elevation (P=0.01 was lower in case group compared with control group. Conclusion: Altered kinematics in General Hypermobility Syndrome has a greater role in shoulder injuries and neuromuscular defect  seems to be an underlying cause of scapular kinematics' changes in people with hypermobility syndrome.

Anophthalmia, cleft lip/palate, absent vomer bone, nystagmus, and mental-motor retardation: a new syndrome or Fryns "anophthalmia-plus" syndrome?

Science.gov (United States)

Ozçelik, Derya; Sağlam, Ibrahim; SIlan, Fatma; Sezen, Gülbin; Unveren, Toygar

2008-05-01

We report that a 4-year-old boy presented with right unilateral complete cleft lip and palate, right anophthalmos, left congenital nystagmus, absence of the vomer bone, mental-motor retardation, and normal lymphocyte karyotype (46, XY). For reconstruction of the deformities, we performed cleft lip repair by Millard's rotation-advancement technique and planned cleft palate repair. This combination of cleft lip and palate, anophthalmos, congenital nystagmus, absent vomer bone, and mental-motor retardation has not, to our knowledge, previously been described. We suggest that this represents either another case of the rare Fryns "anophthalmia-plus" syndrome or a new syndrome.

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

[Twiddler's syndrome in a patient with obsessive-compulsive disorder treated with deep brain stimulation].

Science.gov (United States)

Moliz, Nicolás; Katati, Majed J; Iañez, Benjamín; García, Asunción; Yagui, Eskandar; Horcajadas, Ángel

2015-01-01

Twiddler's syndrome is a rare complication associated with implantable electrical stimulation devices. First described in a patient with a pacemaker, it is a known complication in the field of cardiology. However, it is not so recognised in the world of neurosurgery, in which it has been described in relation to deep brain stimulation (DBS) devices. Characterised by manipulating either consciously or unconsciously the generator of such devices, which causes it to rotate on itself, the syndrome causes the coiling of the wiring of these systems and can lead to their rupture or the displacement of intracranial electrodes. We describe a case of twiddler's syndrome in a patient treated with DBS for obsessive-compulsive disorder, in which clinical deterioration presented after a good initial response. Control radiographs revealed rotation of the wiring system and displacement of the intracranial electrodes. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

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)

The impact of job rotation on nurses burnout in Ayatollah Kashani hospital, Tehran: A case study

Directory of Open Access Journals (Sweden)

M. Shahabi

2011-01-01

Full Text Available Background and aims Job burnout is one of the syndromes which is known by emotional exhaustion, depersonalization, and deterioration of job performance. Due to the negative impact this syndrome on patients, employees, and organization in healthcare settings this issue has drawn attention of many researchers to itself during recent years. Despite the large number of publications in this area however, limited attention has been paid to the factors influencing job burnout. The goal of the present study was to determine the level of job burnout and impacts of job rotation on nurses burnout in Ayatollah Kashani hospital , Tehran.   Methods In order to do this research a historical cohort study was done to determine degree of job burnout among nurses with and without job rotation in Ayatollah Kashani Hospital in Tehran. The number for nurses with job rotation was (n=59 and without job rotation (n=29. Data was collected via a self-report ques tionnaire. Maslach Burnout Inventory (MBI was used to assess the job burnout of the subjects.   Results The overall findings revealed that nurses had low level of emotional exhaustion, low level of depersonalization and middle level of declining in personal accomplishment. No significant difference was observed between the job burnout of the tow group of nurses - with and without rotation. In comparing the level of job burnout among the nurses of different wards (i.e. between wards comparison the findings revealed that nurses of the emergency ward, had higher rate of depersonalization (P=0.012. Conclusion The nurses burnout showed to be at the medium level with respect to the personal accomplishment subscale, which seems to require a managerial intervention in this hospital. Apparently job rotation as it is done currently has no significant impact on the nurses’ job burnout in Ayatollah Kashani hospital and these researchers suggest that other alternative approaches to be consider  to be used to improve

Twiddler's syndrome in a patient with CRT-D device – A case report

Directory of Open Access Journals (Sweden)

Dheeraj D. Bhatt

2015-11-01

Full Text Available Twiddler's syndrome is a rare cause of pacemaker lead dislodgement. A 61-year-old female patient was implanted with a defibrillator capable of cardiac re-synchronization therapy (CRT-D; 10 months later, she presented with uneasiness and vibratory sensations in the chest. Fluoroscopy revealed rotation of the pulse generator along its longitudinal axis and dislodgement of all three leads. Diagnosis of Twiddler's syndrome was made.

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.

Intraarticular findings in the chronically painful shoulder. A study of 32 posttraumatic cases

DEFF Research Database (Denmark)

Suder, P.A.; Hougaard, K.; Frich, Lars Henrik

1994-01-01

the head activities. Symptoms of a "dead arm" and instability were also present. Patients with previous dislocations, traumas or radiographic signs of degenerative shoulder lesions were excluded. The patients had a decreased active range of motion and positive signs of apprehension and impingement......32 consecutive patients suffering from chronic shoulder pain for more than 6 months after a single, nondislocating shoulder trauma were examined clinically and by special radiographs, dynamic sonography, MRI and arthroscopy. Typical complaints were pain during loading, especially during over......, but only 4 had clinical signs of shoulder instability. Diagnostic evaluation identified labral tears, partial and total rotator cuff lesions with subacromial impingement and tendinitis of the biceps tendon. Surgery was performed in 24 patients, using capsulolabral and rotator cuff reconstruction...

Correlation between physical examination and intraoperative findings in shoulder disease treated by arthroscopy. Statistical analysis of 150 patients.

Science.gov (United States)

García Parra, P; Anaya Rojas, M; Jiménez Bravo, B; González Oria, M O; Lisbona Muñoz, M; Gil Álvarez, J J; Cano Luis, P

2016-01-01

Only a few clinical exploratory manoeuvres are truly discriminatory and useful in shoulder disease. The aim of this study is to correlate the physical examination results of the shoulder with the true diagnosis found by arthroscopy. A retrospective case series of 150 patients with the most common surgical conditions of the shoulder. Data were collected on the suspicion of each pathology, the physical examination of the patient, and the actual discovery of the disease during arthroscopic surgery. The Bankart examination manoeuvres of the lesion show the best results, with a 92.1% positive prediction value (PPV), a 99.1% negative predictive value (NPV), followed by the impingement syndrome, with a PPV of 94.4%, and total cuff rupture with a PPV of 92.3%.Exploration of the superior labrum anterior to posterior (SLAP) lesion had an NPV of 99.1%. Physical examination is sufficient to diagnose or rule out Bankart. A positive physical examination provides the complete rupture of the rotator cuff, and requires further studies. The patients suspected of subacromial syndrome only need an NMR if the physical tests are negative. The conclusions drawn from this work can have a significant impact on both cost savings (by reducing forward tests), and saving time in certain cases in which, after appropriate physical examination, surgery may be indicated without losing time in intermediate steps. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

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...

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

A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

Directory of Open Access Journals (Sweden)

McNair Peter J

2011-05-01

Full Text Available Abstract Background The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB, acromioclavicular joint (ACJ and glenohumeral joint (GHJ. Methods Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR to diagnostic blocks. Results In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively and MRA (65% and 76% respectively. The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; p p p p ≤ 0.05. Conclusions Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion and an intact rotator cuff were associated with an intra-articular GHJ pain source. When combined with clinical information, these results may help guide diagnostic decision making in primary care.

Tullio phenomenon in superior semicircular canal dehiscence syndrome.

Science.gov (United States)

Basura, Gregory J; Cronin, Scott J; Heidenreich, Katherine D

2014-03-18

Tullio phenomenon refers to eye movements induced by sound.(1) This unusual examination finding may be seen in superior semicircular canal dehiscence (SSCD) syndrome.(2) This disorder is due to absent bone over the superior semicircular canal (figure). Patients complain of dizziness triggered by loud sound, aural fullness, autophony, and pulsatile tinnitus. When Tullio phenomenon exists in SSCD syndrome, the patient develops a mixed vertical-torsional nystagmus in which the slow phase rotates up and away from the affected ear (video on the Neurology® Web site at Neurology.org). This pattern of nystagmus aligns in the plane of the dehiscent semicircular canal and is due to excitation of its afferent nerves.

Neuroblastoma in a patient with Coffin-Siris syndrome.

Science.gov (United States)

Pollono, Daniel; Drut, Ricardo; Cecotti, Norma; Pollono, Agustina

2009-01-01

We report the case of an 8-year-old boy with the phenotypic features of Coffin-Siris syndrome diffuse hypertrichosis, flat occiput, scant scalp hair, flat supraorbital arch, triangular eyebrows, horizontal palpebral fissure, anteverted nares, triangular philtrum, coarse lips, high-arched palate, micrognathia, low set and dorsaly rotated ears, short neck, wide thorax, widely set nipples, transverse palmar crease, psychomotor delay, urinary malformations (paraurethral diverticulum, hypoplasia of left kidney associated with vesicoureteral reflux grade 3-4), bilateral inguinal hernia, and dorsolumbar kyphoscoliosis. In the follow-up he presented a retroperitoneal neuroblastoma. Although this type of tumor has been referred to develop in several genetic and mutimalformative syndromes, it seems that present association has not been previously reported.

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

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...

Normal anatomy and abnormal patterns of the supraspinatus muscle: Ultrasound versus surgery. Analysis of the possible sources of misdiagnosis; Anatomia normale e quadri patologici del muscolo sovraspinato: Confronto tra ecografia e chirurgia. Analisi delle possibili fonti di errore diagnostico

Energy Technology Data Exchange (ETDEWEB)

Montrucchio, Edgardo [Ospedale S. Andrea, La Spezia (Italy); Iovane, Angelo; Midiri, Massimo; Finazzo, Mario; La Tona, Giuseppe; Lagalla, Roberto [Palermo, Univ. (Italy). Istituto di Radiologia ``Piero Cignolini``

1997-04-01

The supraspinatus muscle performs about 60 % of the elevation-abduction motion of the arm; it has a prominent functional role among the extra rotational muscles of the shoulder and is the most injured in subacromial space conditions. Seventy-four patients, aged 21-64 years, were examined to compare ultrasonography (US) results with surgical findings in supraspinatus conditions and to analyze the possible pitfalls in US diagnosis. All the patients underwent conventional X-ray US and then surgery or arthroscopy. The following criteria were considered: morphology, thickness, echotexture, the convexity of the superior border of supraspinatus tendon, the relationships with the subacromial bursa and the tendon of the biceps long head, the regularity of the bone cortex of the humeral head. US showed: perforating focal injuries in 21 patients; deep focal injuries in 10 patients; intramural focal injuries in 6 patients; superficial focal injuries in 8 patients; complete tendon tear with detachment in 19 cases. 62/74 US diagnoses were surgically confirmed, with a specificity of 83.7 %. In their experience, US provided very useful information about the pattern, size and site of the injuries and was very helpful in the surgical planning.

Normal anatomy and abnormal patterns of the supraspinatus muscle: Ultrasound versus surgery. Analysis of the possible sources of misdiagnosis

International Nuclear Information System (INIS)

Montrucchio, Edgardo; Iovane, Angelo; Midiri, Massimo; Finazzo, Mario; La Tona, Giuseppe; Lagalla, Roberto

1997-01-01

The supraspinatus muscle performs about 60 % of the elevation-abduction motion of the arm; it has a prominent functional role among the extra rotational muscles of the shoulder and is the most injured in subacromial space conditions. Seventy-four patients, aged 21-64 years, were examined to compare ultrasonography (US) results with surgical findings in supraspinatus conditions and to analyze the possible pitfalls in US diagnosis. All the patients underwent conventional X-ray US and then surgery or arthroscopy. The following criteria were considered: morphology, thickness, echotexture, the convexity of the superior border of supraspinatus tendon, the relationships with the subacromial bursa and the tendon of the biceps long head, the regularity of the bone cortex of the humeral head. US showed: perforating focal injuries in 21 patients; deep focal injuries in 10 patients; intramural focal injuries in 6 patients; superficial focal injuries in 8 patients; complete tendon tear with detachment in 19 cases. 62/74 US diagnoses were surgically confirmed, with a specificity of 83.7 %. In their experience, US provided very useful information about the pattern, size and site of the injuries and was very helpful in the surgical planning

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 ...

Effectiveness of telerehabilitation programme following surgery in shoulder impingement syndrome (SIS): study protocol for a randomized controlled non-inferiority trial.

Science.gov (United States)

Pastora-Bernal, Jose-Manuel; Martín-Valero, Rocío; Barón-López, Francisco Javier; García-Gómez, Oscar

2017-02-23

Shoulder pain is common in society, with high prevalence in the general population. Shoulder impingement syndrome (SIS) is the most frequent cause. Patients suffer pain, muscle weakness and loss of movement in the affected joint. Initial treatment is predominantly conservative. The surgical option has high success rates and is often used when conservative strategy fails. Traditional physiotherapy and post-operative exercises are needed for the recovery of joint range, muscle strength, stability and functionality. Telerehabilitation programmes have shown positive results in some orthopaedic conditions after surgery. Customized telerehabilitation intervention programmes should be developed to recover shoulder function after SIS surgery. The objective of this study is to evaluate the feasibility and effectiveness of a telerehabilitation intervention compared with usual care in patients after subacromial decompression surgery. We will compare an intervention group receiving videoconferences and a telerehabilitation programme to a control group receiving traditional physiotherapy intervention in a single-blind, randomized controlled non-inferiority trial study design. Through this study, we will further develop our preliminary data set and practical experience with the telerehabilitation programmes to evaluate their effectiveness and compare this with traditional intervention. We will also explore patient satisfaction and cost-effectiveness. Patient enrolment is ongoing. ClinicalTrials.gov, NCT02909920 . 14 September 2016.

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

Periarthritis of the shoulder-MRI findings

Energy Technology Data Exchange (ETDEWEB)

Hirano, Mako; Nomura, Kazutoshi; Hashimoto, Noburo; Fukumoto, Tetsuya; Oshima, Suguru; Katahira, Kazuhiro [Kumamoto National Hospital (Japan)

1997-09-01

We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

Periarthritis of the shoulder-MRI findings

International Nuclear Information System (INIS)

Hirano, Mako; Nomura, Kazutoshi; Hashimoto, Noburo; Fukumoto, Tetsuya; Oshima, Suguru; Katahira, Kazuhiro

1997-01-01

We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

Disability and satisfaction after Rotator Cuff decompression or repair: a sex and gender analysis

Directory of Open Access Journals (Sweden)

Davis Aileen M

2011-04-01

Full Text Available Abstract Background Rotator-cuff pathology is the most common cause of pain and disability in the shoulder. Examining the combined effect of biological and societal factors on disability would potentially identify existing differences between men and women with rotator cuff pathology which would help to provide suggestions for better models of care. Purpose of this study was to determine the overall differences in disability between men and women and to examine the relationship between factors that represent sex (biological factors and gender (non-biological factors with disability and satisfaction with surgical outcome 6 months after rotator cuff surgery. Methods Patients with impingement syndrome and/or rotator cuff tear who underwent rotator cuff surgery completed the Western Ontario Rotator Cuff (WORC index, the American Shoulder & Elbow Surgeons (ASES assessment form, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH outcome measures prior to surgery and 6 months post-operatively. They also rated their satisfaction with surgery at their follow-up appointment. Results and Discussion One hundred and seventy patients entered into the study (85 men and 85 women. One hundred and sixty patients (94% completed the 6-month assessment. Women reported more disability both prior to and after surgery. Disability at 6 months was associated with pain-limited range of motion, participation limitation, age and strength. Satisfaction with surgery was associated with level of reported disability, expectations for improved pain, pain-limited range of motion and strength. Conclusions The results of this study indicate that women with rotator cuff pathology suffer from higher levels of pre- and post-operative disability and sex and gender qualities contribute to these differences. Gender-sensitive approach will help to identify existing differences between men and women which will help to promote more effective and tailored care by health

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.

Restless Legs Syndrome in shift workers: A cross sectional study on male assembly workers

Directory of Open Access Journals (Sweden)

Rahimi Mohsen

2009-09-01

Full Text Available Abstract Background Restless Legs Syndrome (RLS is a common neurological movement disorder characterized by symptoms that follow a circadian pattern. Night and rotating shift work schedules exert adverse effects on functions of the human body by disturbing circadian rhythms, and they are known to cause sleep disturbances and insomnia. In this paper, we investigate the possible association between shift work and RLS. Methods This cross sectional study was conducted in an automobile manufacturing factory in Tehran, Iran. A total of 780 male assembly workers were recruited in three groups, each with 260 workers: workers on a permanent morning shift (A and two different rotating shift schedules (B and C with morning, afternoon and night shifts. We used the international RLS study group criteria for diagnosis of RLS, and the severity scale for severity assessment in subjects with RLS. Self administered questionnaires were used to gather information on age, smoking, work history, medical condition, and existence and severity of RLS symptoms. Results The prevalence of RLS was significantly higher in rotational shift workers (15% than workers with permanent morning work schedule (8.5%. In workers suffering from RLS, we found greater mean values of age and work experience, higher percentages of drug consumption, smoking, and co-morbid illnesses compared with subjects who did not have RLS, although these differences were statistically significant only for age, work experience and drug consumption. Conclusion Rotational shift work acts as a risk or exacerbating factor for Restless Legs Syndrome.

Restless Legs Syndrome in shift workers: A cross sectional study on male assembly workers.

Science.gov (United States)

Sharifian, Akbar; Firoozeh, Marjan; Pouryaghoub, Gholamreza; Shahryari, Mehran; Rahimi, Mohsen; Hesamian, Mohammad; Fardi, Ali

2009-09-14

Restless Legs Syndrome (RLS) is a common neurological movement disorder characterized by symptoms that follow a circadian pattern. Night and rotating shift work schedules exert adverse effects on functions of the human body by disturbing circadian rhythms, and they are known to cause sleep disturbances and insomnia. In this paper, we investigate the possible association between shift work and RLS. This cross sectional study was conducted in an automobile manufacturing factory in Tehran, Iran. A total of 780 male assembly workers were recruited in three groups, each with 260 workers: workers on a permanent morning shift (A) and two different rotating shift schedules (B and C) with morning, afternoon and night shifts. We used the international RLS study group criteria for diagnosis of RLS, and the severity scale for severity assessment in subjects with RLS. Self administered questionnaires were used to gather information on age, smoking, work history, medical condition, and existence and severity of RLS symptoms. The prevalence of RLS was significantly higher in rotational shift workers (15%) than workers with permanent morning work schedule (8.5%). In workers suffering from RLS, we found greater mean values of age and work experience, higher percentages of drug consumption, smoking, and co-morbid illnesses compared with subjects who did not have RLS, although these differences were statistically significant only for age, work experience and drug consumption. Rotational shift work acts as a risk or exacerbating factor for Restless Legs Syndrome.

Prolonged lateral steep position impairs respiratory mechanics during continuous lateral rotation therapy in respiratory failure.

Science.gov (United States)

Schellongowski, Peter; Losert, Heidrun; Locker, Gottfried J; Laczika, Klaus; Frass, Michael; Holzinger, Ulrike; Bojic, Andja; Staudinger, Thomas

2007-04-01

To establish whether prolonged lateral steep position during continuous rotation therapy leads to improvement on pulmonary gas exchange, respiratory mechanics and hemodynamics. Prospective observational study. Intensive care unit of a university hospital. Twelve consecutive patients suffering from acute lung injury or adult respiratory distress syndrome undergoing continuous rotation therapy. Blood gas analysis, static lung compliance, blood pressure, cardiac index and pulmonary shunt fraction were measured in supine as well as in left and right lateral steep position at 62 degrees during continuous rotation therapy (phase I). Rotation was then stopped for 30 min with the patients in supine position, left and right lateral steep position, and the same measurements were performed every 10 min (phase II). Phase I and II revealed no significant changes in PaO(2)/FiO(2) ratio, mean arterial blood pressure, pulmonary shunt fraction, or cardiac index. Significantly lower static compliance was observed in lateral steep position than in supine position (pposition than in left and right lateral steep position (ppositioning impairs the compliance of the respiratory system. Prolonged lateral steep position does not lead to benefits with respect to oxygenation or hemodynamics. Individual response to the different positions is unpredictable. The pauses in "extreme" positions should be as short as possible.

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

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

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

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

Rotation Frequencies of Small Jovian Trojan Asteroids: An Excess of Slow Rotators

Science.gov (United States)

French, Linda M.; Stephens, Robert D.; James, David J.; Coley, Daniel; Connour, Kyle

2015-11-01

Several lines of evidence support a common origin for, and possible hereditary link between, cometary nuclei and jovian Trojan asteroids. Due to their distance and low albedos, few comet-sized Trojans have been studied. We discuss the rotation properties of Jovian Trojan asteroids less than 30 km in diameter. Approximately half the 131 objects discussed here were studied using densely sampled lightcurves (French et al. 2015a, b); Stephens et al. 2015), and the other half were sparse lightcurves obtained by the Palomar Transient Factory (PTF; Waszcazk et al. 2015).A significant fraction (~40%) of the objects in the ground-based sample rotate slowly (P > 24h), with measured periods as long as 375 h (Warner and Stephens 2011). The PTF data show a similar excess of slow rotators. Only 5 objects in the combined data set have rotation periods of less than six hours. Three of these fast rotators were contained in the data set of French et al. these three had a geometric mean rotation period of 5.29 hours. A prolate spheroid held together by gravity rotating with this period would have a critical density of 0.43 gm/cm3, a density similar to that of comets (Lamy et al. 2004).Harris et al. (2012) and Warner et al. (2011) have explored the possible effects on asteroid rotational statistics with the results from wide-field surveys. We will examine Trojan rotation statistics with and without the results from the PTF.

Undilatable Stent Neoatherosclerosis Treated with Ad Hoc Rotational Atherectomy

Directory of Open Access Journals (Sweden)

Michael Koutouzis

2017-01-01

Full Text Available A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal part of the undilatable lesion. We proceeded with a challenging ad hoc rotational atherectomy of the lesion and finally stenting of the lesion. In-stent restenosis many years after stent implantation is considered to be mainly due to neoatheromatosis compared to intimal hyperplasia, making lesion treatment more difficult and unpredictable.

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.)

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.

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)

Surgical Orthodontic Treatment for Open Bite in Noonan Syndrome Patient: A Case Report.

Science.gov (United States)

Kawakami, Masayoshi; Yamamoto, Kazuhiko; Shimomura, Tadahiro; Kirita, Tadaaki

2016-03-01

Noonan syndrome, characterized by short stature, facial anomalies, and congenital heart defects, may also be associated with hematopoietic disorders. Craniofacial anomalies in affected patients include hypertelorism and severe open bite associated with masticatory dysfunction. We treated a Noonan syndrome patient with a skeletal open bite. Surgical orthodontic treatment including two-jaw surgery established a good occlusal relationship after correction of severe anemia. Both upper and lower incisors were moved to upright positions, while clockwise rotation of the palatal plane and decreased mandibular plane angle were accomplished. Lower masticatory activity may affect posttreatment occlusion in such cases.

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

Three-dimensional scapular dyskinesis in hook-plated acromioclavicular dislocation including hook motion.

Science.gov (United States)

Kim, Eugene; Lee, Seunghee; Jeong, Hwa-Jae; Park, Jai Hyung; Park, Se-Jin; Lee, Jaewook; Kim, Woosub; Park, Hee Jin; Lee, So Yeon; Murase, Tsuyoshi; Sugamoto, Kazuomi; Ikemoto, Sumika

2018-06-01

The purpose of this study is to analyze the 3-dimensional scapular dyskinesis and the kinematics of a hook plate relative to the acromion after hook-plated acromioclavicular dislocation in vivo. Reported complications of acromioclavicular reduction using a hook plate include subacromial erosion and impingement. However, there are few reports of the 3-dimensional kinematics of the hook and scapula after the aforementioned surgical procedure. We studied 15 cases of acromioclavicular dislocation treated with a hook plate and 15 contralateral normal shoulders using computed tomography in the neutral and full forward flexion positions. Three-dimensional motion of the scapula relative to the thorax during arm elevation was analyzed using a computer simulation program. We also measured the distance from the tip of the hook plate to the greater tuberosity, as well as the angular motion of the plate tip in the subacromial space. Decreased posterior tilting (22° ± 10° vs 31° ± 8°) in the sagittal plane and increased external rotation (19° ± 9° vs 7° ± 5°) in the axial plane were evident in the affected shoulders. The mean values of translation of the hook plate and angular motion against the acromion were 4.0 ± 1.6 mm and 15° ± 8°, respectively. The minimum value of the distance from the hook plate to the humeral head tuberosity was 6.9 mm during arm elevation. Acromioclavicular reduction using a hook plate may cause scapular dyskinesis. Translational and angular motion of the hook plate against the acromion could lead to subacromial erosion. However, the hook does not seem to impinge directly on the humeral head. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

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.

Rotated alphanumeric characters do not automatically activate frontoparietal areas subserving mental rotation

DEFF Research Database (Denmark)

Weiss, Michael M; Wolbers, Thomas; Peller, Martin

2008-01-01

Functional neuroimaging studies have identified a set of areas in the intraparietal sulcus and dorsal precentral cortex which show a linear increase in activity with the angle of rotation across a variety of mental rotation tasks. This linear increase in activity with angular disparity suggests t...... modulated by angular disparity during the stimulus categorization task. These results suggest that at least for alphanumerical characters, areas implicated in mental rotation will only be called into action if the task requires a rotational transformation....

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

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…

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 ...

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.

Jet Engine Bird Ingestion Simulations: Comparison of Rotating to Non-Rotating Fan Blades

Science.gov (United States)

Howard, Samuel A.; Hammer, Jeremiah T.; Carney, Kelly S.; Pereira, J. Michael

2013-01-01

Bird strike events in commercial airliners are a fairly common occurrence. According to data collected by the US Department of Agriculture, over 80,000 bird strikes were reported in the period 1990 to 2007 in the US alone (Ref. 1). As a result, bird ingestion is an important factor in aero engine design and FAA certification. When it comes to bird impacts on engine fan blades, the FAA requires full-scale bird ingestion tests on an engine running at full speed to pass certification requirements. These rotating tests are complex and very expensive. To reduce development costs associated with new materials for fan blades, it is desirable to develop more cost effective testing procedures than full-scale rotating engine tests for material evaluation. An impact test on a nonrotating single blade that captures most of the salient physics of the rotating test would go a long way towards enabling large numbers of evaluative material screening tests. NASA Glenn Research Center has been working to identify a static blade test procedure that would be effective at reproducing similar results as seen in rotating tests. The current effort compares analytical simulations of a bird strike on various non-rotating blades to a bird strike simulation on a rotating blade as a baseline case. Several different concepts for simulating the rotating loads on a non-rotating blade were analyzed with little success in duplicating the deformation results seen in the rotating case. The rotating blade behaves as if it were stiffer than the non-rotating blade resulting in less plastic deformation from a given bird impact. The key factor limiting the success of the non-rotating blade simulations is thought to be the effect of gyroscopics. Prior to this effort, it was anticipated the difficulty would be in matching the prestress in the blade due to centrifugal forces Additional work is needed to verify this assertion, and to determine if a static test procedure can simulate the gyroscopic effects in

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.

Sex differences and autism: brain function during verbal fluency and mental rotation.

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Felix D C C Beacher

Full Text Available Autism spectrum conditions (ASC affect more males than females. This suggests that the neurobiology of autism: 1 may overlap with mechanisms underlying typical sex-differentiation or 2 alternately reflect sex-specificity in how autism is expressed in males and females. Here we used functional magnetic resonance imaging (fMRI to test these alternate hypotheses. Fifteen men and fourteen women with Asperger syndrome (AS, and sixteen typically developing men and sixteen typically developing women underwent fMRI during performance of mental rotation and verbal fluency tasks. All groups performed the tasks equally well. On the verbal fluency task, despite equivalent task-performance, both males and females with AS showed enhanced activation of left occipitoparietal and inferior prefrontal activity compared to controls. During mental rotation, there was a significant diagnosis-by-sex interaction across occipital, temporal, parietal, middle frontal regions, with greater activation in AS males and typical females compared to AS females and typical males. These findings suggest a complex relationship between autism and sex that is differentially expressed in verbal and visuospatial domains.

Sex differences and autism: brain function during verbal fluency and mental rotation.

Science.gov (United States)

Beacher, Felix D C C; Radulescu, Eugenia; Minati, Ludovico; Baron-Cohen, Simon; Lombardo, Michael V; Lai, Meng-Chuan; Walker, Anne; Howard, Dawn; Gray, Marcus A; Harrison, Neil A; Critchley, Hugo D

2012-01-01

Autism spectrum conditions (ASC) affect more males than females. This suggests that the neurobiology of autism: 1) may overlap with mechanisms underlying typical sex-differentiation or 2) alternately reflect sex-specificity in how autism is expressed in males and females. Here we used functional magnetic resonance imaging (fMRI) to test these alternate hypotheses. Fifteen men and fourteen women with Asperger syndrome (AS), and sixteen typically developing men and sixteen typically developing women underwent fMRI during performance of mental rotation and verbal fluency tasks. All groups performed the tasks equally well. On the verbal fluency task, despite equivalent task-performance, both males and females with AS showed enhanced activation of left occipitoparietal and inferior prefrontal activity compared to controls. During mental rotation, there was a significant diagnosis-by-sex interaction across occipital, temporal, parietal, middle frontal regions, with greater activation in AS males and typical females compared to AS females and typical males. These findings suggest a complex relationship between autism and sex that is differentially expressed in verbal and visuospatial domains.

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

A osteogenesis distraction device enabling control of vertical direction for syndromic craniosynostosis.

Science.gov (United States)

Kobayashi, Shinji; Fukawa, Toshihiko; Hirakawa, Takashi; Maegawa, Jiro

2014-02-01

We have developed a hybrid facial osteogenesis distraction system that combines the advantages of external and internal distraction devices to enable control of both the distraction distance and vector. However, when the advanced maxilla has excessive clockwise rotation and shifts more downward vertically than planned, it might be impossible to pull it up to correct it. We invented devices attached to external distraction systems that can control the vertical vector of distraction to resolve this problem. The purpose of this article is to describe the result of utilizing the distraction system for syndromic craniosynostosis. In addition to a previously reported hybrid facial distraction system, the devices for controlling the vertical direction of the advanced maxilla were attached to the external distraction device. The vertical direction of the advanced maxilla can be controlled by adjustment of the spindle units. This system was used for 2 patients with Crouzon and Apert syndrome. The system enabled control of the vertical distance, with no complications during the procedures. As a result, the maxilla could be advanced into the planned position including overcorrection without excessive clockwise rotation of distraction. Our system can alter the cases and bring them into the planned position, by controlling the vertical vector of distraction. We believe that this system might be effective in infants with syndromic craniosynostosis as it involves 2 osteotomies and horizontal and vertical direction of elongation can be controlled.

Neck-tongue syndrome on sudden turning of the head.

Science.gov (United States)

Lance, J W; Anthony, M

1980-01-01

A syndrome of unilateral upper nuchal or occipital pain, with or without numbness in these areas, accompanied by simultaneous ipsilateral numbness of the tongue is explicable by compression of the second cervical root in the atlantoaxial space on sharp rotation of the neck. Afferents fibres from the lingual nerve travelling via the hypoglossal nerve to the second cervical root provide a plausible anatomical explanation for compression of that root causing numbness of half the tongue. PMID:7359159

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

THE EFFECT OF ADDING SPECIFIC HIP STRENGTHENING EXERCISES TO CONVENTIONAL KNEE EXERCISES IN PATIENTS WITH PATELLO FEMORAL PAIN SYNDROME

Directory of Open Access Journals (Sweden)

Raghav Monika

2016-02-01

Full Text Available Background: Patello femoral pain Syndrome is an over use injury and one of the commonest problems seen in adolescents who are physically active. Till date no study has been done comparing the effect of adding specific hip strengthening exercises (gluteus medius, gluteus maximus & lateral rotators to conventional exercises in patients with Patello femoral Pain Syndrome (PFPS while minimizing the effect of minimizing the activation of tensor fascia lata (TFL. Methods: 30 subjects were randomly allocated using convenience random sampling into 2 Groups Group A and Group B with 15 subjects in each group. Readings were taken for Numeric Pain Rating Scale (NPRS, Manual Muscle Testing (MMT for hip abductors, extensors and external rotators muscles quadriceps and hamstrings, and Anterior Knee Pain Scale (AKPS on baseline and at the end of 4th week. Results: Analysis of the data collected for NPRS, AKPS and MMT of Quadriceps, Hamstrings, Hip Abductors and Hip External Rotators of 30 subjects was done by statistical analysis tests using STATA and software version 11.2. Although improvement was seen in both the groups but group B improved better compared to group A. Conclusion: Group B treatment protocol i.e. Hip specific strengthening (gluteus medius and gluteus maximus in addition to conventional treatment in patients with patello-femoral pain syndrome, was found to be effective in reducing pain, improving functional status and increasing muscle strength than Group A treatment protocol i.e. Knee strengthening and stretching.

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.

Imaging of bursae around the shoulder joint

International Nuclear Information System (INIS)

Bureau, N.J.; Dussault, R.G.; Keats, T.E.

1996-01-01

The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance. (orig.). With 6 figs

Imaging of bursae around the shoulder joint

Energy Technology Data Exchange (ETDEWEB)

Bureau, N.J. [Department of Radiology, Hotel-Dieu de Montreal Hospital, Montreal, Quebec (Canada); Dussault, R.G. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States); Keats, T.E. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States)

1996-08-01

The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance. (orig.). With 6 figs.

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:

Reproducibility of a 3-dimensional gyroscope in measuring shoulder anteflexion and abduction

Directory of Open Access Journals (Sweden)

Penning Ludo I F

2012-07-01

Full Text Available Abstract Background Few studies have investigated the use of a 3-dimensional gyroscope for measuring the range of motion (ROM in the impaired shoulder. Reproducibility of digital inclinometer and visual estimation is poor. This study aims to investigate the reproducibility of a tri axial gyroscope in measurement of anteflexion, abduction and related rotations in the impaired shoulder. Methods Fifty-eight patients with either subacromial impingement (27 or osteoarthritis of the shoulder (31 participated. Active anteflexion, abduction and related rotations were measured with a tri axial gyroscope according to a test retest protocol. Severity of shoulder impairment and patient perceived pain were assessed by the Disability of Arm Shoulder and Hand score (DASH and the Visual Analogue Scale (VAS. VAS scores were recorded before and after testing. Results In two out of three hospitals patients with osteoarthritis (n = 31 were measured, in the third hospital patients with subacromial impingement (n = 27. There were significant differences among hospitals for the VAS and DASH scores measured before and after testing. The mean differences between the test and retest means for anteflexion were −6 degrees (affected side, 9 (contralateral side and for abduction 15 degrees (affected side and 10 degrees (contralateral side. Bland & Altman plots showed that the confidence intervals for the mean differences fall within −6 up to 15 degrees, individual test - retest differences could exceed these limits. A simulation according to ‘Generalizability Theory’ produces very good coefficients for anteflexion and related rotation as a comprehensive measure of reproducibility. Optimal reproducibility is achieved with 2 repetitions for anteflexion. Conclusions Measurements were influenced by patient perceived pain. Differences in VAS and DASH might be explained by different underlying pathology. These differences in shoulder pathology however did not alter

Rotational Spectrum of 1,1-Difluoroethane: Internal Rotation Analysis and Structure

Science.gov (United States)

Villamanan, R. M.; Chen, W. D.; Wlodarczak, G.; Demaison, J.; Lesarri, A. G.; Lopez, J. C.; Alonso, J. L.

1995-05-01

The rotational spectrum of CH3CHF2 in its ground state was measured up to 653 GHz. Accurate rotational and centrifugal distortion constants were determined. The internal rotation splittings were analyzed using the internal axis method. An ab initio structure has been calculated and a near-equilibrium structure has been estimated using offsets derived empirically. This structure was compared to an experimental r0 structure. The four lowest excited states (including the methyl torsion) have also been assigned.

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...

Sirenomelia (mermaid syndrome): an infant from parents who used a special form of snuff.

Science.gov (United States)

Taghavi, M M; Jafari Naveh, H R; Shariati, M; Morteza Zade, F

2009-05-01

We report the first case of a fetus with sirenomelia or mermaid syndrome, whose Afghanian parents were heavy user of a special form of snuff. The case was diagnosed as a mermaid syndrome but some of the features were common to both symmelia dipus and symmelia apus, for example, the single lower extremity had the normal femur, tibia and fibula, but the single foot was rotated medially. The digestive tube ended to a massive closed saclike structure and the anus was absence. The external genital organs were rudiment and the normal testes were undescended. Aorta was divided to branches, such that the external iliac arteries were very small in comparison to the internal iliac arteries. Inferior Vena cava was placed on to the left side of the aorta and unlike the majority of reported mermaid syndrome, the bladder was present. So, the researchers believe that the present case is a rare variant of the mermaid syndrome.

Gastric Dilation and Volvulus Syndrome in Dog

Directory of Open Access Journals (Sweden)

Ami S. Bhatia

Full Text Available Gastric dilatation and volvulus syndrome (GDV in dogs is an abnormal accumulation of gastric gas (dilatation, which may be complicated by rotation of the stomach (volvulus about its mesentric axis. A number of factors, both environmental and host have been implicated in GDV. This syndrome has a variety of effects on the cardiovascular, respiratory, gastrointestinal, metabolic, haemolymphatic-immune, renal and central nervous systems. Clinical signs include distended, painful, tympanic abdomen, retching, unproductive vomiting, hypersalivation, respiratory distress accompanied by varying degrees of shock. Treatment of GDV includes medical and fluid therapy at shock dosages to initially stabilize the patient followed by gastric decompression. Surgical procedure comprises of gastric derotation followed by partial gastrectomy or spleenectomy depending upon gastric or spleenic viability and lastly, permanent right sided gastropexy. Post surgical considerations include frequent small meals instead of one large meal, avoiding vigorous activity immediately after meals and not allowing animal to gorge on water after meals or activities. [Veterinary World 2010; 3(12.000: 554-557

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.

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

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

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.

Molecular equilibrium structures from experimental rotational constants and calculated vibration-rotation interaction constants

DEFF Research Database (Denmark)

Pawlowski, F; Jorgensen, P; Olsen, Jeppe

2002-01-01

A detailed study is carried out of the accuracy of molecular equilibrium geometries obtained from least-squares fits involving experimental rotational constants B(0) and sums of ab initio vibration-rotation interaction constants alpha(r)(B). The vibration-rotation interaction constants have been...... calculated for 18 single-configuration dominated molecules containing hydrogen and first-row atoms at various standard levels of ab initio theory. Comparisons with the experimental data and tests for the internal consistency of the calculations show that the equilibrium structures generated using Hartree......-Fock vibration-rotation interaction constants have an accuracy similar to that obtained by a direct minimization of the CCSD(T) energy. The most accurate vibration-rotation interaction constants are those calculated at the CCSD(T)/cc-pVQZ level. The equilibrium bond distances determined from these interaction...

Infection and twiddler syndrome in a dog with addison's disease, complete heart block, and wandering artificial pacemakers

International Nuclear Information System (INIS)

Hill, R.C.; Buchanan, J.W.

1990-01-01

Third degree heart block developed in an obese, 10-year-old Labrador retriever with adrenocortical failure. A permanent transthoracic pacemaker was fitted, but the pulse generator migrated 2 years later, to the ventral part of the flank, where an abscess formed. A new pacemaker was fitted, but also migrated and rotated and a syndrome analogous to Twiddler's syndrome in man developed. After a further 2 years the second pacemaker was located, encapsulated within the right pleural cavity. Culture of the brownish exudate around the pulse generator yielded Pseudomonas sp

The rotation of P/Halley

International Nuclear Information System (INIS)

Sagdeev, R.Z.; Szegoe, K.; Kondor, A.; Merenyi, E.; Smith, B.A.; Larson, S.; Toth, I.

1987-11-01

The nucleus of the comet Halley rotates as a slightly asymmetric top, the orientation of the rotation axis (the orientation of the angular momentum vector) is b=54 deg +-15 deg, l=219 deg +-15 deg in the ecliptic system. In the case of the rotation of an asymmetric top the rotation axis is not fixed rigidly to the body, which means that while the nucleus rotates around the axis with a period of 2.2+-0.05 d, its long axis 'nods' periodically with a period of 7.4+-0.05 d. The amplitude of the 'nodding' is about 15 deg +-3 deg in both directions relative to a plane perpendicular to the rotation axis. (author) 21 refs.; 6 figs.; 2 tabs

A vestibular phenotype for Waardenburg syndrome?

Science.gov (United States)

Black, F. O.; Pesznecker, S. C.; Allen, K.; Gianna, C.

2001-01-01

OBJECTIVE: To investigate vestibular abnormalities in subjects with Waardenburg syndrome. STUDY DESIGN: Retrospective record review. SETTING: Tertiary referral neurotology clinic. SUBJECTS: Twenty-two adult white subjects with clinical diagnosis of Waardenburg syndrome (10 type I and 12 type II). INTERVENTIONS: Evaluation for Waardenburg phenotype, history of vestibular and auditory symptoms, tests of vestibular and auditory function. MAIN OUTCOME MEASURES: Results of phenotyping, results of vestibular and auditory symptom review (history), results of vestibular and auditory function testing. RESULTS: Seventeen subjects were women, and 5 were men. Their ages ranged from 21 to 58 years (mean, 38 years). Sixteen of the 22 subjects sought treatment for vertigo, dizziness, or imbalance. For subjects with vestibular symptoms, the results of vestibuloocular tests (calorics, vestibular autorotation, and/or pseudorandom rotation) were abnormal in 77%, and the results of vestibulospinal function tests (computerized dynamic posturography, EquiTest) were abnormal in 57%, but there were no specific patterns of abnormality. Six had objective sensorineural hearing loss. Thirteen had an elevated summating/action potential (>0.40) on electrocochleography. All subjects except those with severe hearing loss (n = 3) had normal auditory brainstem response results. CONCLUSION: Patients with Waardenburg syndrome may experience primarily vestibular symptoms without hearing loss. Electrocochleography and vestibular function tests appear to be the most sensitive measures of otologic abnormalities in such patients.

THE OPTIMAL ROTATIONS OF GMELINA STAND ON TWO CARBON PROJECTS: LENGTHENING ROTATION AND AFFORESTATION

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Yonky Indrajaya

2016-12-01

Full Text Available Forest plantation may contribute economically and socially as a provider of wood raw materials for industry and providing jobs for local people. In addition, forest plantation may also contribute as watershed protection and carbon sequestration. Projects on carbon sequestration from plantation forest can be conducted in two types: (1 afforestation and (2 lengthening forest rotation. One of the potential carbon markets operationalized in the field is voluntary market with Verified Carbon Standard mechanism. This study aimed to analyze the optimal rotations of gmelina forests on two carbon projects: lengthening rotation and afforestation. The method used in this study was by using Hartman model ( i.e. Faustmann by maximizing profit with the revenue source from timber and carbon sequestration project. The results of this study showed that carbon price will affect the optimal rotation for lengthening forest rotation of VCS project. Meanwhile, for VCS afforestation project, carbon price had no effect on the optimal rotation on gmelina forest. The NPV value of afforestation project was relatively higher than that of NPV value of lengthening forest rotation project, since the amount of carbon that can be credited relatively higher in afforestation project.

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...

How good a clock is rotation? The stellar rotation-mass-age relationship for old field stars

International Nuclear Information System (INIS)

Epstein, Courtney R.; Pinsonneault, Marc H.

2014-01-01

The rotation-mass-age relationship offers a promising avenue for measuring the ages of field stars, assuming the attendant uncertainties to this technique can be well characterized. We model stellar angular momentum evolution starting with a rotation distribution from open cluster M37. Our predicted rotation-mass-age relationship shows significant zero-point offsets compared to an alternative angular momentum loss law and published gyrochronology relations. Systematic errors at the 30% level are permitted by current data, highlighting the need for empirical guidance. We identify two fundamental sources of uncertainty that limit the precision of rotation-based ages and quantify their impact. Stars are born with a range of rotation rates, which leads to an age range at fixed rotation period. We find that the inherent ambiguity from the initial conditions is important for all young stars, and remains large for old stars below 0.6 M ☉ . Latitudinal surface differential rotation also introduces a minimum uncertainty into rotation period measurements and, by extension, rotation-based ages. Both models and the data from binary star systems 61 Cyg and α Cen demonstrate that latitudinal differential rotation is the limiting factor for rotation-based age precision among old field stars, inducing uncertainties at the ∼2 Gyr level. We also examine the relationship between variability amplitude, rotation period, and age. Existing ground-based surveys can detect field populations with ages as old as 1-2 Gyr, while space missions can detect stars as old as the Galactic disk. In comparison with other techniques for measuring the ages of lower main sequence stars, including geometric parallax and asteroseismology, rotation-based ages have the potential to be the most precise chronometer for 0.6-1.0 M ☉ stars.

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

The role of rotational hand movements and general motor ability in children’s mental rotation performance

Directory of Open Access Journals (Sweden)

Petra eJansen

2015-07-01

Full Text Available Mental rotation of visual images of body parts and abstract shapes can be influenced by simultaneous motor activity. Children in particular seem to have a strong coupling between motor and cognitive processes. We investigated the influence of a rotational hand movement performed by rotating a knob on mental rotation performance in primary school-age children (N= 83; Age range: 7.0-8.3 and 9.0-10.11 years. In addition, we assessed the role of motor ability in this relationship. Boys in the 7-8-year-old group were faster when mentally and manually rotating in the same direction than in the opposite direction. For girls and older children this effect was not found. A positive relationship was found between motor ability and accuracy on the mental rotation task: stronger motor ability related to improved mental rotation performance. In both age groups, children with more advanced motor abilities were more likely to adopt motor processes to solve mental rotation tasks if the mental rotation task was primed by a motor task. Our evidence supports the idea that an overlap between motor and visual cognitive processes in children is influenced by motor ability.

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.

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.

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

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

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

Ganglionic cysts related to the scapula: MR findings

International Nuclear Information System (INIS)

Jeong, Ae Kyeong; Kim, Sung Moon; Kim, Kyung Sook; Shin, Myung Jin; Chun, Jae Myeung; Ahn, Joong Mo

1999-01-01

To evaluate the magnetic resonance (MR) imaging characteristics of ganglionic cysts related to the scapula. We retrospectively reviewed 15 ganglionic cysts diagnosed by MR imaging in 14 patients who subsequently underwent surgical excision (n=8) or needle aspiration (n=1). Five other patients whose lesion-related symptoms were not too severe to manage underwent conservative treatment. We analyzed MR findings with regard to the size, shape and presence of internal septa, the location and signal intensity of the lesion, and associated findings such as change of rotator cuff muscle, labral tear and bone erosion. We also evaluated the presence of tear of rotator cuff tendon, tendinosis, and subacromial enthesophyte. The diameter of ganglionic cysts was 0.5-5.5 (mean, 2.8)cm, and they were round (n=2), ovoid (n=6), or elongated (n=7). Where internal septa were present (n=13), cysts were lobulated. Lesions were located in both scapular and spinoglenoid notches (n=9), only in the scapular notch (n=2), only in the spinoglenoid notch (n=2) or within the bone (n=2). In eleven cases they were very close to the superoposterior aspect of the glenoid labrum (n=11). On T1-weighted images, all lesions were seen to be iso- or hypointense to muscle, while on T2-weighted images, they were hyperintense, resembling joint fluid (n=14), except in one patient with hemorrhage. Associated findings were edema of the infraspinatus muscle (n=4), pressure erosion of the scapular neck (n=1), and labral tear (n=1). A torn supraspinatus tendon (n=2), supraspinatus tendinosis (n=3), and subacromial enthesophyte (n=2) were also present. MR imaging was helpful in diagnosing ganglionic cysts and detecting associated lesions

[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

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

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

MAGNETIC RESONANCE IMAGING EVALUATION OF ROTATOR CUFF IMPINGEMENT

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Chandrakanth K. S

2017-06-01

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

Anatomical glenohumeral internal rotation deficit and symmetric rotational strength in male and female young beach volleyball players.

Science.gov (United States)

Saccol, Michele Forgiarini; Almeida, Gabriel Peixoto Leão; de Souza, Vivian Lima

2016-08-01

Beach volleyball is a sport with a high demand of shoulder structures that may lead to adaptations in range of motion (ROM) and strength like in other overhead sports. Despite of these possible alterations, no study evaluated the shoulder adaptations in young beach volleyball athletes. The aim of this study was to compare the bilateral ROM and rotation strength in the shoulders of young beach volleyball players. Goniometric passive shoulder ROM of motion and isometric rotational strength were evaluated in 19 male and 14 female asymptomatic athletes. External and internal ROM, total rotation motion, glenohumeral internal rotation deficit (GIRD), external rotation and internal rotation strength, bilateral deficits and external rotation to internal rotation ratio were measured. The statistical analysis included paired Student's t-test and analysis of variance with repeated measures. Significantly lower dominant GIRD was found in both groups (pvolleyball athletes present symmetric rotational strength and shoulder ROM rotational adaptations that can be considered as anatomical. These results indicate that young practitioners of beach volleyball are subject to moderate adaptations compared to those reported for other overhead sports. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

The reliability of three-dimensional scapular attitudes in healthy people and people with shoulder impingement syndrome

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Hébert Luc J

2007-06-01

Full Text Available Abstract Background Abnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome. These abnormal scapular displacements were evaluated using different methods and instruments allowing a 3-dimensional representation of the scapular kinematics. The validity and the intrasession reliability have been shown for the majority of these methods for healthy people. However, the intersession reliability on healthy people and people with impaired shoulders is not well documented. This measurement property needs to be assessed before using such methods in longitudinal comparative studies. The objective of this study is to evaluate the intra and intersession reliability of 3-dimensional scapular attitudes measured at different arm positions in healthy people and to explore the same measurement properties in people with shoulder impingement syndrome using the Optotrak Probing System. Methods Three-dimensional scapular attitudes were measured twice (test and retest interspaced by one week on fifteen healthy subjects (mean age 37.3 years and eight subjects with subacromial shoulder impingement syndrome (mean age 46.1 years in three arm positions (arm at rest, 70° of humerothoracic flexion and 90° of humerothoracic abduction using the Optotrak Probing System. Two different methods of calculation of 3-dimensional scapular attitudes were used: relative to the position of the scapula at rest and relative to the trunk. Intraclass correlation coefficient (ICC and standard error of measure (SEM were used to estimate intra and intersession reliability. Results For both groups, the reliability of the three-dimensional scapular attitudes for elevation positions was very good during the same session (ICCs from 0.84 to 0.99; SEM from 0.6° to 1.9° and good to very good between sessions (ICCs from 0.62 to 0.97; SEM from 1.2° to 4.2° when using the method of calculation relative to the trunk. Higher levels of

Scaling laws for the rotational velocity of a J x B driven rotating plasma

International Nuclear Information System (INIS)

Igarashi, Yasuhito; Kataoka, Tomohiro; Ikehata, Takashi; Sato, Naoyuki; Tanabe, Toshio; Mase, Hiroshi

1994-01-01

Rapidly rotating plasmas of helium and argon have been extracted from a coaxial plasma gun operated in pulsed glow mode. The rotational velocity and its parametric dependence have been analyzed systematically by means of visible - emission spectroscopy. The plasma is observed to rotate rigidly inside the diameter of the gun anode while outside the velocity decreases rapidly ; furthermore, different ions are found to rotate at different angular frequencies as ω (Ar + ) = 0.5 x 10 6 rad/sec, ω (Ar 2+ ) = 1.1 x 10 6 rad/sec, ω (C 2+ ) = 1.8 x 10 6 rad/sec, ω (N + ) = 1.2 x 10 6 rad/sec. The plasma density and rotational velocity have been measured as a function of the discharge current and magnetic field to derive experimental scaling laws. They are summarized as : 1. Ion density is proportional to the square of discharge current. 2. Rotational and axial velocities are proportional to the driving force per ion. These results are confirmed to agree well with a theoretical prediction. (author)

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

Visual perception of axes of head rotation

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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

Motor imagery in Asperger syndrome: testing action simulation by the hand laterality task.

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Massimiliano Conson

Full Text Available Asperger syndrome (AS is a neurodevelopmental condition within the Autism Spectrum Disorders (ASD characterized by specific difficulties in social interaction, communication and behavioural control. In recent years, it has been suggested that ASD is related to a dysfunction of action simulation processes, but studies employing imitation or action observation tasks provided mixed results. Here, we addressed action simulation processes in adolescents with AS by means of a motor imagery task, the classical hand laterality task (to decide whether a rotated hand image is left or right; mental rotation of letters was also evaluated. As a specific marker of action simulation in hand rotation, we assessed the so-called biomechanical effect, that is the advantage for judging hand pictures showing physically comfortable versus physically awkward positions. We found the biomechanical effect in typically-developing participants but not in participants with AS. Overall performance on both hand laterality and letter rotation tasks, instead, did not differ in the two groups. These findings demonstrated a specific alteration of motor imagery skills in AS. We suggest that impaired mental simulation and imitation of goal-less movements in ASD could be related to shared cognitive mechanisms.

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

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).

[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.

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

Multimodality imaging of the postoperative shoulder

Energy Technology Data Exchange (ETDEWEB)

Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany)

2007-12-15

Multimodality imaging of the postoperative shoulder includes radiography, magnetic resonance (MR) imaging, MR arthrography, computed tomography (CT), CT arthrography, and ultrasound. Target-oriented evaluation of the postoperative shoulder necessitates familiarity with surgical techniques, their typical complications and sources of failure, knowledge of normal and abnormal postoperative findings, awareness of the advantages and weaknesses with the different radiologic techniques, and clinical information on current symptoms and function. This article reviews the most commonly used surgical procedures for treatment of anterior glenohumeral instability, lesions of the labral-bicipital complex, subacromial impingement, and rotator cuff lesions and highlights the significance of imaging findings with a view to detection of recurrent lesions and postoperative complications in a multimodality approach. (orig.)

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

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.

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)

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)

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.

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.

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

Precision grip responses to unexpected rotational perturbations scale with axis of rotation.

Science.gov (United States)

De Gregorio, Michael; Santos, Veronica J

2013-04-05

It has been established that rapid, pulse-like increases in precision grip forces ("catch-up responses") are elicited by unexpected translational perturbations and that response latency and strength scale according to the direction of linear slip relative to the hand as well as gravity. To determine if catch-up responses are elicited by unexpected rotational perturbations and are strength-, axis-, and/or direction-dependent, we imposed step torque loads about each of two axes which were defined relative to the subject's hand: the distal-proximal axis away from and towards the subject's palm, and the grip axis which connects the two fingertips. Precision grip responses were dominated initially by passive mechanics and then by active, unimodal catch-up responses. First dorsal interosseous activity, marking the start of the catch-up response, began 71-89 ms after the onset of perturbation. The onset latency, shape, and duration (217-231 ms) of the catch-up response were not affected by the axis, direction, or magnitude of the rotational perturbation, while strength was scaled by axis of rotation and slip conditions. Rotations about the grip axis that tilted the object away from the palm and induced rotational slip elicited stronger catch-up responses than rotations about the distal-proximal axis that twisted the object between the digits. To our knowledge, this study is the first to investigate grip responses to unexpected torque loads and to show characteristic, yet axis-dependent, catch-up responses for conditions other than pure linear slip. Copyright © 2013 Elsevier Ltd. All rights reserved.

Calculation of impurity poloidal rotation from measured poloidal asymmetries in the toroidal rotation of a tokamak plasma

Energy Technology Data Exchange (ETDEWEB)

Chrystal, C. [University of California-San Diego, La Jolla, California 92186-5608 (United States); Burrell, K. H.; Groebner, R. J.; Kaplan, D. H. [General Atomics, San Diego, California 92186-5608 (United States); Grierson, B. A. [Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543-0451 (United States)

2012-10-15

To improve poloidal rotation measurement capabilities on the DIII-D tokamak, new chords for the charge exchange recombination spectroscopy (CER) diagnostic have been installed. CER is a common method for measuring impurity rotation in tokamak plasmas. These new chords make measurements on the high-field side of the plasma. They are designed so that they can measure toroidal rotation without the need for the calculation of atomic physics corrections. Asymmetry between toroidal rotation on the high- and low-field sides of the plasma is used to calculate poloidal rotation. Results for the main impurity in the plasma are shown and compared with a neoclassical calculation of poloidal rotation.

Calculation of impurity poloidal rotation from measured poloidal asymmetries in the toroidal rotation of a tokamak plasma.

Science.gov (United States)

Chrystal, C; Burrell, K H; Grierson, B A; Groebner, R J; Kaplan, D H

2012-10-01

To improve poloidal rotation measurement capabilities on the DIII-D tokamak, new chords for the charge exchange recombination spectroscopy (CER) diagnostic have been installed. CER is a common method for measuring impurity rotation in tokamak plasmas. These new chords make measurements on the high-field side of the plasma. They are designed so that they can measure toroidal rotation without the need for the calculation of atomic physics corrections. Asymmetry between toroidal rotation on the high- and low-field sides of the plasma is used to calculate poloidal rotation. Results for the main impurity in the plasma are shown and compared with a neoclassical calculation of poloidal rotation.

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.

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.

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

Lifestyle and metabolic factors in relation to shoulder pain and rotator cuff tendinitis: a population-based study.

Science.gov (United States)

Rechardt, Martti; Shiri, Rahman; Karppinen, Jaro; Jula, Antti; Heliövaara, Markku; Viikari-Juntura, Eira

2010-07-20

Shoulder pain is a common health problem. The purpose of this study was to assess the associations of lifestyle factors, metabolic factors and carotid intima-media thickness with shoulder pain and chronic (> 3 months) rotator cuff tendinitis. In this cross-sectional study, the target population consisted of subjects aged 30 years or older participating in a national Finnish Health Survey during 2000-2001. Of the 7,977 eligible subjects, 6,237 (78.2%) participated in a structured interview and clinical examination. Chronic rotator cuff tendinitis was diagnosed clinically. Weight-related factors, C-reactive protein and carotid intima-media thickness were measured. The prevalence of shoulder joint pain during the preceding 30 days was 16% and that of chronic rotator cuff tendinitis 2.8%. Smoking, waist circumference and waist-to-hip ratio were related to an increased prevalence of shoulder pain in both genders. Metabolic syndrome, type 2 diabetes mellitus and carotid intima-media thickness were associated with shoulder pain in men, whereas high level of C-reactive protein was associated with shoulder pain in women. Increased waist circumference and type 1 diabetes mellitus were associated with chronic rotator cuff tendinitis in men. Our findings showed associations of abdominal obesity, some other metabolic factors and carotid intima-media thickness with shoulder pain. Disturbed glucose metabolism and atherosclerosis may be underlying mechanisms, although not fully supported by the findings of this study. Prospective studies are needed to further investigate the role of lifestyle and metabolic factors in shoulder disorders.

Rotational Spectrum and Internal Rotation Barrier of 1-Chloro-1,1-difluoroethane

Science.gov (United States)

Alonso, José L.; López, Juan C.; Blanco, Susana; Guarnieri, Antonio

1997-03-01

The rotational spectra of 1-chloro-1,1-difluoroethane (HCFC-142b) has been investigated in the frequency region 8-115 GHz with Stark, waveguide Fourier transform (FTMW), and millimeter-wave spectrometers. Assignments in large frequency regions with the corresponding frequency measurements have been made for the ground andv18= 1 (CH3torsion) vibrational states of the35Cl isotopomer and for the ground state of the37Cl species. Accurate rotational, quartic centrifugal distortion, and quadrupole coupling constants have been determined from global fits considering all these states. SmallA-Einternal rotation splittings have been observed for thev18= 1 vibrational state using FTMW spectroscopy. The barrier height for the internal rotation of the methyl group has been determined to be 3751 (4) cal mol-1, in disagreement with the previous microwave value of 4400 (100) cal mol-1reported by G. Graner and C. Thomas [J. Chem. Phys.49,4160-4167 (1968)].

Enstrophy-based proper orthogonal decomposition of flow past rotating cylinder at super-critical rotating rate

Science.gov (United States)

Sengupta, Tapan K.; Gullapalli, Atchyut

2016-11-01

Spinning cylinder rotating about its axis experiences a transverse force/lift, an account of this basic aerodynamic phenomenon is known as the Robins-Magnus effect in text books. Prandtl studied this flow by an inviscid irrotational model and postulated an upper limit of the lift experienced by the cylinder for a critical rotation rate. This non-dimensional rate is the ratio of oncoming free stream speed and the surface speed due to rotation. Prandtl predicted a maximum lift coefficient as CLmax = 4π for the critical rotation rate of two. In recent times, evidences show the violation of this upper limit, as in the experiments of Tokumaru and Dimotakis ["The lift of a cylinder executing rotary motions in a uniform flow," J. Fluid Mech. 255, 1-10 (1993)] and in the computed solution in Sengupta et al. ["Temporal flow instability for Magnus-robins effect at high rotation rates," J. Fluids Struct. 17, 941-953 (2003)]. In the latter reference, this was explained as the temporal instability affecting the flow at higher Reynolds number and rotation rates (>2). Here, we analyze the flow past a rotating cylinder at a super-critical rotation rate (=2.5) by the enstrophy-based proper orthogonal decomposition (POD) of direct simulation results. POD identifies the most energetic modes and helps flow field reconstruction by reduced number of modes. One of the motivations for the present study is to explain the shedding of puffs of vortices at low Reynolds number (Re = 60), for the high rotation rate, due to an instability originating in the vicinity of the cylinder, using the computed Navier-Stokes equation (NSE) from t = 0 to t = 300 following an impulsive start. This instability is also explained through the disturbance mechanical energy equation, which has been established earlier in Sengupta et al. ["Temporal flow instability for Magnus-robins effect at high rotation rates," J. Fluids Struct. 17, 941-953 (2003)].

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.

An unusual complication after craniofacial surgery for Apert syndrome

Directory of Open Access Journals (Sweden)

Abhay A Lune

2014-01-01

A case of Apert syndrome who had undergone craniofacial surgery elsewhere 4 years back presented to us with purulent discharge near the lateral orbital margin of right orbit, watering and redness of the right eye. He had telltale signs of this syndrome in the form of skull deformities such as brachycephaly, frontal bony prominence, mid-face hypoplasia, proptosis and syndactyly of both hands and feet. There was a surgical scar of previous craniofacial surgery over the bi-coronal region. He had a discharging granuloma over the lateral orbital margin and the adjacent lower eyelid had developed cicatricial ectropion. X-ray and computed tomography scan orbit confirmed the clinical suspicion of osteomyelitis of the underlying zygomatic bone at the site of miniplate and screw fixation of the earlier surgery. He was treated with excision of granuloma and extraction of loose screw and infected miniplate while ectropion was corrected by rotation advancement of temporal skin flap.

Coherent spin-rotational dynamics of oxygen superrotors

Science.gov (United States)

Milner, Alexander A.; Korobenko, Aleksey; Milner, Valery

2014-09-01

We use state- and time-resolved coherent Raman spectroscopy to study the rotational dynamics of oxygen molecules in ultra-high rotational states. While it is possible to reach rotational quantum numbers up to N≈ 50 by increasing the gas temperature to 1500 K, low population levels and gas densities result in correspondingly weak optical response. By spinning {{O}2} molecules with an optical centrifuge, we efficiently excite extreme rotational states with N≤slant 109 in high-density room temperature ensembles. Fast molecular rotation results in the enhanced robustness of the created rotational wave packets against collisions, enabling us to observe the effects of weak spin-rotation coupling in the coherent rotational dynamics of oxygen. The decay rate of spin-rotational coherence due to collisions is measured as a function of the molecular angular momentum and its dependence on the collisional adiabaticity parameter is discussed. We find that at high values of N, the rotational decoherence of oxygen is much faster than that of the previously studied non-magnetic nitrogen molecules, pointing at the effects of spin relaxation in paramagnetic gases.

Eagle's syndrome associated with lingual nerve paresthesia: a case report.

Science.gov (United States)

Dong, Zhiwei; Bao, Haihong; Zhang, Li; Hua, Zequan

2014-05-01

Eagle's syndrome is characterized by a variety of symptoms, including throat pain, sensation of a foreign body in the pharynx, dysphagia, referred otalgia, and neck and throat pain exacerbated by head rotation. Any styloid process longer than 25 mm should be considered elongated and will usually be responsible for Eagle's syndrome. Surgical resection of the elongated styloid is a routine treatment and can be accomplished using a transoral or an extraoral approach. We report a patient with a rare giant styloid process that was approximately 81.7 mm. He complained of a rare symptom: hemitongue paresthesia. After removal of the elongated styloid process using the extraoral approach, his symptoms, including the hemitongue paresthesia, were alleviated. We concluded that if the styloid process displays medium to severe elongation, the extraoral approach will be appropriate. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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)

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.

The effect of rotations on Michelson interferometers

Energy Technology Data Exchange (ETDEWEB)

Maraner, Paolo, E-mail: pmaraner@unibz.it

2014-11-15

In the contest of the special theory of relativity, it is shown that uniform rotations induce a phase shift in Michelson interferometers. The effect is second order in the ratio of the interferometer’s speed to the speed of light, further suppressed by the ratio of the interferometer’s arms length to the radius of rotation and depends on the interferometer’s position in the co-rotating frame. The magnitude of the phase shift is just beyond the sensitivity of turntable rotated optical resonators used in present tests of Lorentz invariance. It grows significantly large in Earth’s rotated kilometer-scale Fabry–Perot enhanced interferometric gravitational-wave detectors where it appears as a constant bias. The effect can provide the means of sensing center and radius of rotations. - Highlights: • Rotations induce a phase shift in Michelson interferometers. • Earth’s rotation induces a constant bias in Michelson interferometers. • Michelson interferometers can be used to sense center and radius of rotations.

The effect of rotations on Michelson interferometers

International Nuclear Information System (INIS)

Maraner, Paolo

2014-01-01

In the contest of the special theory of relativity, it is shown that uniform rotations induce a phase shift in Michelson interferometers. The effect is second order in the ratio of the interferometer’s speed to the speed of light, further suppressed by the ratio of the interferometer’s arms length to the radius of rotation and depends on the interferometer’s position in the co-rotating frame. The magnitude of the phase shift is just beyond the sensitivity of turntable rotated optical resonators used in present tests of Lorentz invariance. It grows significantly large in Earth’s rotated kilometer-scale Fabry–Perot enhanced interferometric gravitational-wave detectors where it appears as a constant bias. The effect can provide the means of sensing center and radius of rotations. - Highlights: • Rotations induce a phase shift in Michelson interferometers. • Earth’s rotation induces a constant bias in Michelson interferometers. • Michelson interferometers can be used to sense center and radius of rotations

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.

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.

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.

Intraoperative "Kounis syndrome" that improved electrocardiography changes and hemodynamic situation afteradministering nitroglycerine

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Victoria O. Sánchez

2014-07-01

Full Text Available A 58-year-old female without cardiovascular risk factors, was going to be operated to repair the rotator cuff. Induction and interscalene brachial plexus block were uneventful, but after her placement for surgery the patient started with severe bronchospasm, hypotension, cutaneous allergic reaction and ST elevation on the electrocardiogram. An anaphylactic shock was suspected and treated but until the perfusion of nitroglycerina was started no electrocardiographic changes resolved. After necessary diagnostic test the final diagnosis was variant I of Kounis syndrome due to cefazolin and rocuronium. Ephinephrine is the cornerstone of treatment for anaphylaxis but should we use it if the anaphylactic reaction is also accompanied by myocardial ischemia? The answer is that we should not use it because myocardial ischemia in this syndrome is caused by vasospasm, so it would be more useful drugs such as nitroglycerin. But what if we do not know if it is a Kounis syndrome or not? In this article we report our experience that maybe could help you in a similar situation.

Understanding Bartter syndrome and Gitelman syndrome.

Science.gov (United States)

Fremont, Oliver T; Chan, James C M

2012-02-01

We aim to review the clinical features of two renal tubular disorders characterized by sodium and potassium wasting: Bartter syndrome and Gitelman syndrome. Selected key references concerning these syndromes were analyzed, together with a PubMed search of the literature from 2000 to 2011. The clinical features common to both conditions and those which are distinct to each syndrome were presented. The new findings on the genetics of the five types of Bartter syndrome and the discrete mutations in Gitelman syndrome were reviewed, together with the diagnostic workup and treatment for each condition. Patients with Bartter syndrome types 1, 2 and 4 present at a younger age than classic Bartter syndrome type 3. They present with symptoms, often quite severe in the neonatal period. Patients with classic Bartter syndrome type 3 present later in life and may be sporadically asymptomatic or mildly symptomatic. The severe, steady-state hypokalemia in Bartter syndrome and Gitelman syndrome may abruptly become life-threatening under certain aggravating conditions. Clinicians need to be cognizant of such renal tubular disorders, and promptly treat at-risk patients.

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

Directory of Open Access Journals (Sweden)

Paulo Moraes Agnollitto

2016-02-01

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

Rotational movements of mandibular two-implant overdentures.

Science.gov (United States)

Kimoto, Suguru; Pan, Shaoxia; Drolet, Nicolas; Feine, Jocelyne S

2009-08-01

Clinicians have reported that their patients complain that their mandibular two-implant overdentures (IOD) rotate. Therefore, we studied the frequency and severity of rotation of IODs with two-ball attachments, how rotation may influence perceived satisfaction ratings of chewing ability, and the factors that are involved in the rotation of IODs. Seventy-nine participants were recruited and asked to rate their general satisfaction of their IODs, as well as their ability to chew foods, the existence of any mandibular denture rotation, and to what degree denture rotation bothered them. Data on participant sociodemographic, anatomical, and prosthesis characteristics were also collected. Student's t-test and logistic regression analyses were performed to analyze the differences between participants who did (R group) and did not report (NR group) denture rotation. Thirty-seven of 79 participants were aware of rotational movement in their IODs. These patients were significantly less satisfied with their chewing ability than those who felt no rotation (69.1 mm R group vs. 82.9 mm), and discomfort caused by the rotation bothered them moderately (39/100 mm). The multivariate logistic regression analysis revealed that the arrangement of the anterior teeth and the length of the denture are significantly associated with awareness of denture rotation. Thirty-eight percent in the R group and 31% in the NR group had non-scheduled visits. Rotational movement with a mandibular two-IOD has a negative effect on perceived chewing ability and is associated with anterior tooth arrangement and denture length.

Rotational velocities of low-mass stars

International Nuclear Information System (INIS)

Stauffer, J.B.; Hartmann, L.W.; Harvard-Smithsonian Center for Astrophysics, Cambridge, MA)

1986-01-01

The rotational velocities of stars provide important clues to how stars form and evolve. Yet until recently, studies of stellar rotation were limited to stars more massive than the sun. This is beginning to change, and an observational outline of the rotational velocity evolution of stars less massive than the sun can now be provided. Low-mass stars rotate slowly during the early stages of premain-sequence evolution, and spin up as they contract to the main sequence. This spin-up culminates in a brief period of very rapid rotation at an age of order 50 million years. Physical interpretation of this increase in rotation and the subsequent main-sequence spin-down are complicated by the possibility of differential internal rotation. The observed rapidity of spin-down among G dwarfs suggests that initially only the outer convective envelopes of these stars are slowed. The data suggest an intrinsic spread in angular momentum among young stars of the same mass and age, a spread which is apparently minimized by the angular-momentum loss mechanism in old low-mass stars. 83 references

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)

Development of a fast response rotating polarimeter for a faraday rotation measurement

International Nuclear Information System (INIS)

Maeno, Masaki; Ogiwara, Norio; Ogawa, Hiroaki; Matsuda, Toshiaki

1994-03-01

This paper describes a method for using a spindle sustained with active magnetic bearing to make a rotating half waveplate frequency more fast. The time interval of the zero-cross phase measurement is 189 μsec in this experiment. The magnetic bearing is applicable to increase the rotating waveplate frequency by a factor of 2-3 compared with the conventional one. The waveplate speed as well as the deviation with respect to the stationary laser beam has no influence on the amplitude and phase shift of the rotating polarized beam signal. There is also no influence of the mirror reflections on the phase shift. The overall phase resolution is estimated to be about 0.1 degrees. (author)

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)

Os acromiale causing shoulder impingement syndrome: a case report

International Nuclear Information System (INIS)

Romero, I.; Rodriguez, A.; Roca, M.; Garcia, Y.

2001-01-01

Shoulder impingement syndrome is caused by repeated mechanical trauma to the rotator cuff due to encroachment of the coracoacromial ligament; in most cases, it is a primary lesion. Os acromiale, an anatomic variant of the shoulder structures, is one of the predisposing factors for the development of this entity. We present a case of os acromiale complicated by complete rupture of the tendon of the supraspinatus muscle and luxation of the long head of the biceps tendon. We stress the importance of magnetic resonance in the study of this anatomic variant and in the detection of complications or associated lesions. (Author) 10 refs

STUDY OF ACROMIAL MORPHOLOGY IN INDIAN POPULATION. Estudio de la morfología acromial en la población India

Directory of Open Access Journals (Sweden)

susmita Saha

2016-03-01

absence of enthesophyte was noted on the undersurface of the anterior aspect of the acromion process. Results: 28% scapulae exhibited type I acromion, 67% exhibited type II and 5% exhibited type III. The presence of enthesophytes on the anterior undersurface of the acromion was also studied; enthesophytes were observed in 3.5% in type I acromion, 15.67% in type II and 40% in type III acromion process. Conclusions: Association between subacromial impingement syndrome and acromial type is well established. This will assist the clinicians in deciding the modality of treatment: conservative or operative. Association of subacromial enthesophytes with acromial morphology and rotator cuff tears should be borne in mind when interpreting opacities on radiographs.

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)

A complex-plane strategy for computing rotating polytropic models - Numerical results for strong and rapid differential rotation

International Nuclear Information System (INIS)

Geroyannis, V.S.

1990-01-01

In this paper, a numerical method, called complex-plane strategy, is implemented in the computation of polytropic models distorted by strong and rapid differential rotation. The differential rotation model results from a direct generalization of the classical model, in the framework of the complex-plane strategy; this generalization yields very strong differential rotation. Accordingly, the polytropic models assume extremely distorted interiors, while their boundaries are slightly distorted. For an accurate simulation of differential rotation, a versatile method, called multiple partition technique is developed and implemented. It is shown that the method remains reliable up to rotation states where other elaborate techniques fail to give accurate results. 11 refs

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.

From Newton's bucket to rotating polygons

DEFF Research Database (Denmark)

Bach, B.; Linnartz, E. C.; Vested, Malene Louise Hovgaard

2014-01-01

We present an experimental study of 'polygons' forming on the free surface of a swirling water flow in a partially filled cylindrical container. In our set-up, we rotate the bottom plate and the cylinder wall with separate motors. We thereby vary rotation rate and shear strength independently...... and move from a rigidly rotating 'Newton's bucket' flow to one where bottom and cylinder wall are rotating oppositely and the surface is strongly turbulent but flat on average. Between those two extremes, we find polygonal states for which the rotational symmetry is spontaneously broken. We investigate...... the phase diagram spanned by the two rotational frequencies at a given water filling height and find polygons in a regime, where the two frequencies are sufficiently different and, predominantly, when they have opposite signs. In addition to the extension of the family of polygons found with the stationary...

Strengths of lower extremity and lower trunk muscles in females with patellofemoral pain syndrome

Directory of Open Access Journals (Sweden)

Fateme Bokaee

2010-09-01

Full Text Available Introduction: Patellofemoral pain syndrome (PFPS is one of the most common orthopaedic problemsof the knee joint. Muscular weakness considered as a risk factor of this syndrome. Muscular weaknesscan alter lower extremity kinematics and lead to this syndrome. Also according to the kinetic chain,weakness in one motor segment can influence other motor segments. So the aim of this study was todetermine the association between muscular strengths of both lower extremity and trunks muscles andPFPS.Materials and Methods: 40 women participated in this study (20 subjects with PFPS and 20 ascontrols. In both groups isometric strengths of the lower extremity and lower trunk muscles wereevaluated with Nicholas hand-held dynamometer and then compared with each other.Results: There was a significant decrease in strength of the hip abductors, adductors, external rotators,flexors and extensors, quadriceps, ankle plantarflexors, dorsiflexors, flexor and lateral flexors of the trunkin patients with PFPS.Conclusion: Our results indicate that decrease in strength of the hip and trunk muscles is associatedwith the knee injury. It seems strengthening of muscles of these areas to be effective in preventing theinjury, reducing the risk of more injury and treatment of patients with this syndrome.

Shell model for warm rotating nuclei

Energy Technology Data Exchange (ETDEWEB)

Matsuo, M.; Yoshida, K. [Kyoto Univ. (Japan); Dossing, T. [Univ. of Copenhagen (Denmark)] [and others

1996-12-31

Utilizing a shell model which combines the cranked Nilsson mean-field and the residual surface and volume delta two-body forces, the authors discuss the onset of rotational damping in normal- and super-deformed nuclei. Calculation for a typical normal deformed nucleus {sup 168}Yb indicates that the rotational damping sets in at around 0.8 MeV above the yrast line, and about 30 rotational bands of various length exists at a given rotational frequency, in overall agreement with experimental findings. It is predicted that the onset of rotational damping changes significantly in different superdeformed nuclei due to the variety of the shell gaps and single-particle orbits associated with the superdeformed mean-field.

Prevalence of dental anomalies in the permanent dentition of children with Down syndrome.

Science.gov (United States)

Sekerci, Ahmet Ercan; Cantekin, Kenan; Aydinbelge, Mustafa; Ucar, Faruk İzzet

2014-01-01

The purpose of this study was to evaluate the prevalence of various congenital dental anomalies in the permanent dentition of Turkish children with Down syndrome. The sample consisted of 216 diagnostic records of children diagnosed with Down syndrome. All subjects had a clinical examination as well as radiographs and photographs taken. Anomalies in the permanent dentition were documented. There was a high incidence of dental anomalies, the most frequent being taurodontism (81 percent), rotation (28 percent), hypodontia (26 percent), tooth impaction (18 percent), ectopic eruption (14 percent), microdontia (13 percent), and hyperdontia (9 percent). Differences in prevalence of congenitally missing teeth, structural anomalies, and positional anomalies reached a statistically significant level regarding gender (Panomalies affecting the permanent dentition, and, in most cases, individuals presented with more than one anomaly.

Wormholes immersed in rotating matter

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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.

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...

Rotational Laser Cooling of MgH⁺ Ions and Rotational Rate Measurements

DEFF Research Database (Denmark)

Hansen, Anders Kragh; Staanum, Peter; Højbjerre, Klaus

by varying a delay between two such pairs of firings and measuring the yield of the second pair obtain the refilling rates. These rotational transition rate measurements are not only of direct interest for us to understand our rotational state preparation schemes, but will be important input to quantum...

Controle postural na síndrome de Pusher: influência dos canais semicirculares laterais Posture control in Pusher syndrome: influence of lateral semicircular canals

Directory of Open Access Journals (Sweden)

Taiza Elaine Grespan dos Santos Pontelli

2005-08-01

Full Text Available A síndrome de Pusher caracteriza-se por uma alteração do equilíbrio na qual pacientes com lesões encefálicas empurram-se em direção ao lado parético utilizando o membro não-afetado. O papel do sistema vestibular na alteração postural da síndrome de Pusher ainda não foi devidamente elucidado. OBJETIVO: Neste estudo objetivamos avaliar o papel dos canais semicirculares horizontais na expressão clínica da síndrome de Pusher, através da aplicação das provas calórica e rotatória. FORMA DE ESTUDO: Observacional, clínico e prospectivo. MATERIAL E MÉTODO: Avaliamos 9 pacientes com AVC e síndrome de Pusher internados na Enfermaria de Neurologia do HCFMRP-USP. Os pacientes foram submetidos à avaliação neurológica clínica e neuropsicológica, NIHSS, Scale for Contraversive Pushing - SCP, teste calórico e teste rotatório. RESULTADOS: Foram estudados 9 pacientes (5 homens com idade média de 71,8 ± 5,9 anos e com NIHSS médio de 18.33. Três pacientes apresentaram preponderância direcional contralateral à lesão encefálica na prova calórica. Na prova rotatória, foram observados quatro pacientes com preponderância direcional na análise de velocidade da componente lenta. CONCLUSÃO: Os resultados do presente estudo indicam que a disfunção dos canais semicirculares não parece ser fundamental para a expressão da síndrome de Pusher.Pusher syndrome is an interesting disorder of balance in patients with encephalic lesions characterized by the peculiar behavior of actively pushing away from the non-hemiparetic side and resisting against passive correction, with a tendency to fall toward the paralyzed side. The role of vestibular system on the pushing behavior is not clear. AIM: To evaluate horizontal semicircular canal function in patients with Pusher syndrome, using caloric and rotation tests. STUDY DESIGN: Observational prospective. MATERIAL AND METHOD: We evaluated 9 inpatients with stroke and Pusher syndrome at the

Polygons on a rotating fluid surface.

Science.gov (United States)

Jansson, Thomas R N; Haspang, Martin P; Jensen, Kåre H; Hersen, Pascal; Bohr, Tomas

2006-05-05

We report a novel and spectacular instability of a fluid surface in a rotating system. In a flow driven by rotating the bottom plate of a partially filled, stationary cylindrical container, the shape of the free surface can spontaneously break the axial symmetry and assume the form of a polygon rotating rigidly with a speed different from that of the plate. With water, we have observed polygons with up to 6 corners. It has been known for many years that such flows are prone to symmetry breaking, but apparently the polygonal surface shapes have never been observed. The creation of rotating internal waves in a similar setup was observed for much lower rotation rates, where the free surface remains essentially flat [J. M. Lopez, J. Fluid Mech. 502, 99 (2004). We speculate that the instability is caused by the strong azimuthal shear due to the stationary walls and that it is triggered by minute wobbling of the rotating plate.

Lifestyle and metabolic factors in relation to shoulder pain and rotator cuff tendinitis: A population-based study

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Jula Antti

2010-07-01

Full Text Available Abstract Background Shoulder pain is a common health problem. The purpose of this study was to assess the associations of lifestyle factors, metabolic factors and carotid intima-media thickness with shoulder pain and chronic (> 3 months rotator cuff tendinitis. Methods In this cross-sectional study, the target population consisted of subjects aged 30 years or older participating in a national Finnish Health Survey during 2000-2001. Of the 7,977 eligible subjects, 6,237 (78.2% participated in a structured interview and clinical examination. Chronic rotator cuff tendinitis was diagnosed clinically. Weight-related factors, C-reactive protein and carotid intima-media thickness were measured. Results The prevalence of shoulder joint pain during the preceding 30 days was 16% and that of chronic rotator cuff tendinitis 2.8%. Smoking, waist circumference and waist-to-hip ratio were related to an increased prevalence of shoulder pain in both genders. Metabolic syndrome, type 2 diabetes mellitus and carotid intima-media thickness were associated with shoulder pain in men, whereas high level of C-reactive protein was associated with shoulder pain in women. Increased waist circumference and type 1 diabetes mellitus were associated with chronic rotator cuff tendinitis in men. Conclusions Our findings showed associations of abdominal obesity, some other metabolic factors and carotid intima-media thickness with shoulder pain. Disturbed glucose metabolism and atherosclerosis may be underlying mechanisms, although not fully supported by the findings of this study. Prospective studies are needed to further investigate the role of lifestyle and metabolic factors in shoulder disorders.

Morphology of large rotator cuff tears and of the rotator cable and long-term shoulder disability in conservatively treated elderly patients.

Science.gov (United States)

Morag, Yoav; Jamadar, David A; Miller, Bruce; Brandon, Catherine; Gandikota, Girish; Jacobson, Jon A

2013-01-01

The objective of this study was to describe the morphology of the rotator cuff tendon tears and long-term shoulder disability in conservatively treated elderly patients and determine if an association exists between these factors. Assessment of the rotator cuff tendon tear dimensions and depth, rotator interval involvement, rotator cable morphology and location, and rotator cuff muscle status was carried out on magnetic resonance studies of 24 elderly patients treated nonoperatively for rotator cuff tendon tears. Long-term shoulder function was measured using the Western Ontario Rotator Cuff (WORC) index; Disabilities of the Shoulder, Arm, and Hand questionnaire; and the American Shoulder Elbow Self-assessment form, and a correlation between the outcome scores and morphologic magnetic resonance findings was carried out. The majority of large rotator cuff tendon tears are limited to the rotator cuff crescent. Medial rotator interval involvement (isolated or in association with lateral rotator interval involvement) was significantly associated with WORC physical symptoms total (P = 0.01), WORC lifestyle total (P = 0.04), percentage of all WORC domains (P = 0.03), and American Shoulder Elbow Self-assessment total (P = 0.01), with medial rotator interval involvement associated with an inferior outcome. Medial rotator interval tears are associated with long-term inferior outcome scores in conservatively treated elderly patients with large rotator cuff tendon tears.

Analysis of macroscopic and microscopic rotating motions in rotating jets: A direct numerical simulation

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Xingtuan Yang

2015-05-01

Full Text Available A direct numerical simulation study of the characteristics of macroscopic and microscopic rotating motions in swirling jets confined in a rectangular flow domain is carried out. The different structures of vortex cores for different swirl levels are illustrated. It is found that the vortex cores of low swirl flows are of regular cylindrical-helix patterns, whereas those of the high swirl flows are characterized by the formation of the bubble-type vortex breakdown followed by the radiant processing vortex cores. The results of mean velocity fields show the general procedures of vortex origination. Moreover, the effects of macroscopic and microscopic rotating motions with respect to the mean and fluctuation fields of the swirling flows are evaluated. The microscopic rotating effects, especially the effects with respect to the turbulent fluctuation motion, are increasingly intermittent with the increase in the swirl levels. In contrast, the maximum value of the probability density functions with respect to the macroscopic rotating effects of the fluctuation motion occurs at moderate swirl levels since the macroscopic rotating effects are attenuated by the formation of the bubble vortex breakdown with a region of stagnant fluids at supercritical swirl levels.

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.

Non-syndromic supernumerary teeth: report of a case with 6 supernumerary teeth

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Taghibakhsh M

2011-02-01

Full Text Available "nBackground and Aims: Multiple supernumerary teeth are rare and often found in association with syndromes such as Gardner, Cleidocranial dysplasia and cleft lip and palate, with a much less chance for isolated"nnon-syndromic cases. The aim of this study was to report a case with 6 supernumerary teeth without syndromic association."nCase Report: The patient was a 33 year-old female, referred to oral diseases and diagnosis department with chief complaint of sensitivity to cold and hot food in right upper premolar region. Oral examination revealed 5 erupted lingually supernumerary teeth (four in mandibular and one in maxillary premolar region, respectively. Further panoramic radiography clarified an extra impacted tooth in the palatal region of left premolar maxillary area. All extra teeth had been appeared since the age of 17 during one year, as the patient claimed. Medical history and thorough clinical and paraclinical examinations were not significant except for the hypothyroidism, since 5 years ago. No other family member noticed to be the case. Based on our findings, a diagnosis of non-syndromic multiple supernumerary teeth was established."nConclusion: A thorough examination of each patient presented with supernumerary teeth, including panoramic and intraoral radiographic images may provide valuable information regarding accompanying syndromes and unerupted teeth. Early diagnosis is an essential step for orthodontic or surgical decisions making, preventing or avoiding worsening complications such as malocclusion, adjacent normal teeth delayed eruption or rotation, diasthema, cystic lesions and resorption of contiguous teeth.

Two-Year Clinical Outcomes of Newer-Generation Drug-Eluting Stent Implantation Following Rotational Atherectomy for Heavily Calcified Lesions.

Science.gov (United States)

Jinnouchi, Hiroyuki; Kuramitsu, Shoichi; Shinozaki, Tomohiro; Kobayashi, Yohei; Hiromasa, Takashi; Morinaga, Takashi; Mazaki, Toru; Sakakura, Kenichi; Soga, Yoshimitsu; Hyodo, Makoto; Shirai, Shinichi; Ando, Kenji

2015-01-01

Clinical outcomes of implantation of the newer-generation drug-eluting stent (DES) following rotational atherectomy for heavily calcified lesions remain unclear in the real-world setting. We enrolled 252 consecutive patients (273 lesions) treated with newer-generation DES following rotational atherectomy. The primary endpoint was the cumulative 2-year incidence of major adverse cardiovascular events (MACE), defined as cardiac death, myocardial infarction, clinically-driven target lesion revascularization, and definite stent thrombosis. Complete clinical follow-up information at 2-year was obtained for all patients. The mean age was 73.2±9.0 years and 155 patients (61.5%) were male. Cumulative 2-year incidence of MACE (cardiac death, myocardial infarction, clinically-driven target lesion revascularization and definite stent thrombosis) was 20.3% (7.0%, 2.1%, 18.1% and 2.1%, respectively). Predictors of MACE were presenting with acute coronary syndrome (hazard ratio [HR]: 3.80, 95% confidence interval [CI]: 1.29-11.2, P=0.02), hemodialysis (HR: 1.93, 95% CI: 1.04-3.56, P=0.04) and previous coronary artery bypass graft (HR: 2.26, 95% CI: 1.02-5.00, P=0.045). PCI for calcified lesions requiring rotational atherectomy is still challenging even in the era of newer-generation DES.

The low internal rotation barriers of halogenated toluenes: Rotational spectrum of 2,4-difluorotoluene

Science.gov (United States)

Nair, K. P. Rajappan; Herbers, Sven; Obenchain, Daniel A.; Grabow, Jens-Uwe; Lesarri, Alberto

2018-02-01

The rotational spectrum of 2,4-difluorotoluene in the region 5-25 GHz has been studied by pulsed supersonic jet using Fourier transform microwave spectroscopy. The tunneling splitting due to the methyl internal rotation in the ground torsional state could be unambiguously identified and the threefold (V3) potential barrier hindering the internal rotation of the methyl top was determined as 2.80144 (82) kJ/mol. The ground-state rotational parameters for the parent and seven 13C isotopic species in natural abundance were determined with high accuracy, including all quartic centrifugal distortion constants. The electric dipole moment μ = 1.805(42) D was obtained from Stark effect measurements. The molecular structure was derived using the substitution (rs) method. Supporting ab initio (MP2) calculations provided comparative values for the potential barrier and molecular parameters.

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)

Rotational Seismology: AGU Session, Working Group, and Website

Science.gov (United States)

Lee, William H.K.; Igel, Heiner; Todorovska, Maria I.; Evans, John R.

2007-01-01

Introduction Although effects of rotational motions due to earthquakes have long been observed (e. g., Mallet, 1862), nevertheless Richter (1958, p. 213) stated that: 'Perfectly general motion would also involve rotations about three perpendicular axes, and three more instruments for these. Theory indicates, and observation confirms, that such rotations are negligible.' However, Richter provided no references for this claim. Seismology is based primarily on the observation and modeling of three-component translational ground motions. Nevertheless, theoretical seismologists (e.g., Aki and Richards, 1980, 2002) have argued for decades that the rotational part of ground motions should also be recorded. It is well known that standard seismometers are quite sensitive to rotations and therefore subject to rotation-induced errors. The paucity of observations of rotational motions is mainly the result of a lack, until recently, of affordable rotational sensors of sufficient resolution. Nevertheless, in the past decade, a number of authors have reported direct observations of rotational motions and rotations inferred from rigid-body rotations in short baseline accelerometer arrays, creating a burgeoning library of rotational data. For example, ring laser gyros in Germany and New Zealand have led to the first significant and consistent observations of rotational motions from distant earthquakes (Igel et al., 2005, 2007). A monograph on Earthquake Source Asymmetry, Structural Media and Rotation Effects was published recently as well by Teisseyre et al. (2006). Measurement of rotational motions has implications for: (1) recovering the complete ground-displacement history from seismometer recordings; (2) further constraining earthquake rupture properties; (3) extracting information about subsurface properties; and (4) providing additional ground motion information to earthquake engineers for seismic design. A special session on Rotational Motions in Seismology was convened by H

Sex Differences in Mental Rotation Tasks: Not Just in the Mental Rotation Process!

Science.gov (United States)

Boone, Alexander P.; Hegarty, Mary

2017-01-01

The paper-and-pencil Mental Rotation Test (Vandenberg & Kuse, 1978) consistently produces large sex differences favoring men (Voyer, Voyer, & Bryden, 1995). In this task, participants select 2 of 4 answer choices that are rotations of a probe stimulus. Incorrect choices (i.e., foils) are either mirror reflections of the probe or…

Physics of rotation: problems and challenges

Science.gov (United States)

Maeder, Andre; Meynet, Georges

2015-01-01

We examine some debated points in current discussions about rotating stars: the shape, the gravity darkening, the critical velocities, the mass loss rates, the hydrodynamical instabilities, the internal mixing and N-enrichments. The study of rotational mixing requires high quality data and careful analysis. From recent studies where such conditions are fulfilled, rotational mixing is well confirmed. Magnetic coupling with stellar winds may produce an apparent contradiction, i.e. stars with a low rotation and a high N-enrichment. We point out that it rather confirms the large role of shears in differentially rotating stars for the transport processes. New models of interacting binaries also show how shears and mixing may be enhanced in close binaries which are either spun up or down by tidal interactions.

Proteomics perspectives in rotator cuff research

DEFF Research Database (Denmark)

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

2015-01-01

Background Rotator cuff tendinopathy including tears is a cause of significant morbidity. The molecular pathogenesis of the disorder is largely unknown. This review aimed to present an overview of the literature on gene expression and protein composition in human rotator cuff tendinopathy and other...... studies on objectively quantified differential gene expression and/or protein composition in human rotator cuff tendinopathy and other tendinopathies as compared to control tissue. Results We identified 2199 studies, of which 54 were included; 25 studies focussed on rotator cuff or biceps tendinopathy......, which only allowed simultaneous quantification of a limited number of prespecified mRNA molecules or proteins, several proteins appeared to be differentially expressed/represented in rotator cuff tendinopathy and other tendinopathies. No proteomics studies fulfilled our inclusion criteria, although...

Evolution of rotating stars. III. Predicted surface rotation velocities for stars which conserve total angular momentum

International Nuclear Information System (INIS)

Endal, A.S.; Sofia, S.

1979-01-01

Predicted surface rotation velocities are presented for Population I stars at 10, 7, 5, 3, and 1.5M/sub sun/. The surface velocities have been computed for three different cases of angular momentum redistribution: no radial redistribution (rotation on decoupled shells), complete redistribution (rigid-body rotation), and partial redistribution as predicted by detailed consideration of circulation currents in rotation stars. The velocities for these cases are compared to each other and to observed stellar rotation rates (upsilon sin i).Near the main sequence, rotational effects can substantially reduce the moment of inertia of a star, so nonrotating models consistently underestimate the expected velocities for evolving stars. The magnitude of these effects is sufficient to explain the large numbers of Be stars and, perhaps, to explain the bimodal distribution of velocities observed for the O stars.On the red giant branch, angular momentum redistribution reduces the surface velocity by a factor of 2 or more, relative to the velocity expected for no radial redistribution. This removes the discrepancy between predicted and observed rotation rates for the K giants and makes it unlikely that these stars lose significant amounts of angular momentum by stellar winds. Our calculations indicate that improved observations (by the Fourier-transform technique) of the red giants in the Hyades cluster can be used to determine how angular momentum is redistributed by convection

[Maxillofacial and dental abnormalities in some multiple abnormality syndromes. "Cri du chat" syndrome, Wilms' tumor-aniridia syndrome; Sotos syndrome; Goldenhar syndrome].

Science.gov (United States)

Berio, A; Trucchi, R; Meliota, M

1992-05-01

The paper describes the maxillo-facial and dental anomalies observed in some chromosome and non-chromosome poly-malformative syndromes ("Cri du chat" syndrome; Wilms' tumour; Sotos' syndrome; Goldenhar's syndrome). The Authors emphasise the possibility of diagnosing these multiple deformity syndromes from maxillo-facial alterations in early infancy; anomalous tooth position and structure cal also be successfully treated immediately after the first appearance of teeth. This is a particularly promising field of pediatrics and preventive pediatric medicine.

Spin dependence of rotational damping by the rotational plane mapping method

Energy Technology Data Exchange (ETDEWEB)

Leoni, S; Bracco, A; Million, B [Milan Univ. (Italy). Ist. di Fisica; Herskind, B; Dossing, T; Rasmussen, P [Niels Bohr Inst., Copenhagen (Denmark); Bergstrom, M; Brockstedt, A; Carlsson, H; Ekstrom, P; Nordlund, A; Ryde, H [Lund Univ. (Sweden). Dept. of Physics; Ingebretsen, F; Tjom, P O [Oslo Univ. (Norway); Lonnroth, T [Aabo Akademi, Turku (Finland). Dept. of Physics

1992-08-01

In the study of deformed nuclei by gamma spectroscopy, the large quadrupole transition strength known from rotational bands at high excitation energy may be distributed over all final states of a given parity within an interval defined as the rotational damping width {Gamma}{sub rot} The method of rotational plane mapping extracts a value of {Gamma}{sub rot} from the width of valleys in certain planes in the grid plots of triple gamma coincidence data sets. The method was applied to a high spin triple data set on {sup 162,163}Tm taken with NORDBALL at the tandem accelerator of the Niels Bohr Institute, and formed in the reaction {sup 37}Cl + {sup 130}Te. The value {Gamma}{sub rot} = 85 keV was obtained. Generally, experimental values seem to be lower than theoretical predictions, although the only calculation made was for {sup 168}Yb. 6 refs., 3 figs.

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

Initial results of shoulder MRI in external rotation after primary shoulder dislocation and after immobilization in external rotation

International Nuclear Information System (INIS)

Pennekamp, W.; Nicolas, V.; Gekle, C.; Seybold, D.

2006-01-01

Purpose: A change in the strategy for treating primary anterior traumatic dislocation of the shoulder has occurred. To date, brief fixation of internal rotation via a Gilchrist bandage has been used. Depending on the patient's age, a redislocation is seen in up to 90% of cases. This is due to healing of the internally rotated labrum-ligament tear in an incorrect position. In the case of external rotation of the humerus, better repositioning of the labrum ligament complex is achieved. Using MRI of the shoulder in external rotation, the extent of the improved labrum-ligament adjustment can be documented, and the indication of immobilization of the shoulder in external rotation can be derived. The aim of this investigation is to describe the degree of position changing of the labrum-ligament tear in internal and external rotation. Materials and Methods: 10 patients (9 male, 1 female, mean age 30.4 years, range 15-43 years) with a primary anterior dislocation of the shoulder without hyper laxity of the contra lateral side and labrum-ligament lesion substantiated by MRI were investigated using a standard shoulder MRI protocol (PD-TSE axial fs, PD-TSE coronar fs, T2-TSE sagittal, T1-TSE coronar) by an axial PD-TSE sequence in internal and external rotation. The dislocation and separation of the anterior labrum-ligament complex were measured. The shoulders were immobilized in 10 external rotation for 3 weeks. After 6 weeks a shoulder MRI in internal rotation was performed. Results: In all patients there was a significantly better position of the labrum-ligament complex of the inferior rim in external rotation, because of the tension of the ventral capsule and the subscapular muscle. In the initial investigation, the separation of the labrum-ligament complex in internal rotation was 0.44±0.27 mm and the dislocation was 0.45±0.33 mm. In external rotation the separation was 0.01±0.19 mm and the dislocation was -0.08±0.28 mm. After 6 weeks of immobilization in 10 external

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

Ultrasound determination of rotator cuff tear repairability

Science.gov (United States)

Tse, Andrew K; Lam, Patrick H; Walton, Judie R; Hackett, Lisa

2015-01-01

Background Rotator cuff repair aims to reattach the torn tendon to the greater tuberosity footprint with suture anchors. The present study aimed to assess the diagnostic accuracy of ultrasound in predicting rotator cuff tear repairability and to assess which sonographic and pre-operative features are strongest in predicting repairability. Methods The study was a retrospective analysis of measurements made prospectively in a cohort of 373 patients who had ultrasounds of their shoulder and underwent rotator cuff repair. Measurements of rotator cuff tear size and muscle atrophy were made pre-operatively by ultrasound to enable prediction of rotator cuff repairability. Tears were classified following ultrasound as repairable or irreparable, and were correlated with intra-operative repairability. Results Ultrasound assessment of rotator cuff tear repairability has a sensitivity of 86% (p tear size (p tear size ≥4 cm2 or anteroposterior tear length ≥25 mm indicated an irreparable rotator cuff tear. Conclusions Ultrasound assessment is accurate in predicting rotator cuff tear repairability. Tear size or anteroposterior tear length and age were the best predictors of repairability. PMID:27582996

Contained modes in mirrors with sheared rotation

International Nuclear Information System (INIS)

Fetterman, Abraham J.; Fisch, Nathaniel J.

2010-01-01

In mirrors with ExB rotation, a fixed azimuthal perturbation in the laboratory frame can appear as a wave in the rotating frame. If the rotation frequency varies with radius, the plasma-frame wave frequency will also vary radially due to the Doppler shift. A wave that propagates in the high rotation plasma region might therefore be evanescent at the plasma edge. This can lead to radially localized Alfven eigenmodes with high azimuthal mode numbers. Contained Alfven modes are found both for peaked and nonpeaked rotation profiles. These modes might be useful for alpha channeling or ion heating, as the high azimuthal wave number allows the plasma wave frequency in the rotating frame to exceed the ion cyclotron frequency.

INTERNAL-CYCLE VARIATION OF SOLAR DIFFERENTIAL ROTATION

International Nuclear Information System (INIS)

Li, K. J.; Xie, J. L.; Shi, X. J.

2013-01-01

The latitudinal distributions of the yearly mean rotation rates measured by Suzuki in 1998 and 2012 and Pulkkinen and Tuominen in 1998 are utilized to investigate internal-cycle variation of solar differential rotation. The rotation rate at the solar equator seems to have decreased since cycle 10 onward. The coefficient B of solar differential rotation, which represents the latitudinal gradient of rotation, is found to be smaller in the several years after the minimum of a solar cycle than in the several years after the maximum time of the cycle, and it peaks several years after the maximum time of the solar cycle. The internal-cycle variation of the solar rotation rates looks similar in profile to that of the coefficient B. A new explanation is proposed to address such a solar-cycle-related variation of the solar rotation rates. Weak magnetic fields may more effectively reflect differentiation at low latitudes with high rotation rates than at high latitudes with low rotation rates, and strong magnetic fields may more effectively repress differentiation at relatively low latitudes than at high latitudes. The internal-cycle variation is inferred as the result of both the latitudinal migration of the surface torsional pattern and the repression of strong magnetic activity in differentiation.

Nugget Structure Evolution with Rotation Speed for High-Rotation-Speed Friction-Stir-Welded 6061 Aluminum Alloy

Science.gov (United States)

Zhang, H. J.; Wang, M.; Zhu, Z.; Zhang, X.; Yu, T.; Wu, Z. Q.

2018-03-01

High-rotation-speed friction stir welding (HRS-FSW) is a promising technique to reduce the welding loads during FSW and thus facilitates the application of FSW for in situ fabrication and repair. In this study, 6061 aluminum alloy was friction stir welded at high-rotation speeds ranging from 3000 to 7000 rpm at a fixed welding speed of 50 mm/min, and the effects of rotation speed on the nugget zone macro- and microstructures were investigated in detail in order to illuminate the process features. Temperature measurements during HRS-FSW indicated that the peak temperature did not increase consistently with rotation speed; instead, it dropped remarkably at 5000 rpm because of the lowering of material shear stress. The nugget size first increased with rotation speed until 5000 rpm and then decreased due to the change of the dominant tool/workpiece contact condition from sticking to sliding. At the rotation speed of 5000 rpm, where the weld material experienced weaker thermal effect and higher-strain-rate plastic deformation, the nugget exhibited relatively small grain size, large textural intensity, and high dislocation density. Consequently, the joint showed superior nugget hardness and simultaneously a slightly low tensile ductility.

Photoanthropometric study of dysmorphic features of the face in children with autism and asperger syndrome.

Science.gov (United States)

Gorczyca, Piotr; Kapinos-Gorczyca, Agnieszka; Ziora, Katarzyna; Oświęcimska, Joanna

2012-01-01

Childhood autism is a neurodevelopmental disorder characterized by impairments in social interactions, verbal and non-verbal communication and by a pattern of stereotypical behaviors and interests. The aim of this study was to estimate the dysmorphic facial features of children with autism and children with Asperger syndrome. The examination was conducted on 60 children (30 with childhood autism and 30 with Asperger syndrome). The photo anthropometric method used in this study followed the protocol established by Stengel-Rutkowski et al. The performed statistical analysis showed that in patients with childhood autism, the anteriorly rotated ears and the long back of the nose appeared more often. In the group of children with autism, there was a connection between the amount of dysmorphies and the presence of some somatic diseases in the first-degree relatives. There was also a connection between the motor coordination and the age the child began to walk. In patients with childhood autism, there were certain dysmorphies (like the anterior rotated ears and the long back of the nose) which appeared more often. Although the connection was not statistically significant, it seemed to concur with data from the literature. Formulation of the other conclusions would require broader studies e.g. dealing with a familial analysis of dysmorphic features.

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)

Rotational Modulation and Activity Cycles at Rotational Extremes: 25 yrs of NURO Photometry for HII 1883

Science.gov (United States)

Milingo, Jackie; Saar, Steven; Marschall, Laurence

2018-01-01

We present a 25 yr compilation of V-band differential photometry for the Pleiades K dwarf HII 1883 (V660 Tau). HII 1883 has a rotational period of ~ 0.24 d and displays significant rotational modulation due to non-uniform surface brightness or "starspots". Preliminary work yields a cycle period of ~ 9 yrs and rotational shear (ΔP_rot/) considerably less than solar. HII 1883 is one of the fastest rotating single stars with a known cycle. With additional data available we compare newly determined P_cyc and ΔP_rot/ values with those of other stars, putting HII 1883 into the broader context of dynamo properties in single cool dwarfs.

Rotational effects on turbine blade cooling

Energy Technology Data Exchange (ETDEWEB)

Govatzidakis, G.J.; Guenette, G.R.; Kerrebrock, J.L. [Massachusetts Institute of Technology, Cambridge, MA (United States)

1995-10-01

An experimental investigation of the influence of rotation on the heat transfer in a smooth, rectangular passage rotating in the orthogonal mode is presented. The passage simulates one of the cooling channels found in gas turbine blades. A constant heat flux is imposed on the model with either inward or outward flow. The effects of rotation and buoyancy on the Nusselt number were quantified by systematically varying the Rotation number, Density Ratio, Reynolds number, and Buoyancy parameter. The experiment utilizes a high resolution infrared temperature measurement technique in order to measure the wall temperature distribution. The experimental results show that the rotational effects on the Nusselt number are significant and proper turbine blade design must take into account the effects of rotation, buoyancy, and flow direction. The behavior of the Nusselt number distribution depends strongly on the particular side, axial position, flow direction, and the specific range of the scaling parameters. The results show a strong coupling between buoyancy and Corollas effects throughout the passage. For outward flow, the trailing side Nusselt numbers increase with Rotation number relative to stationary values. On the leading side, the Nusselt numbers tended to decrease with rotation near the inlet and subsequently increased farther downstream in the passage. The Nusselt numbers on the side walls generally increased with rotation. For inward flow, the Nusselt numbers generally improved relative to stationary results, but increases in the Nusselt number were relatively smaller than in the case of outward flow. For outward and inward flows, increasing the density ratio generally tended to decrease Nusselt numbers on the leading and trailing sides, but the exact behavior and magnitude depended on the local axial position and specific range of Buoyancy parameters.

Immobilization in External Rotation Versus Internal Rotation After Primary Anterior Shoulder Dislocation: A Meta-analysis of Randomized Controlled Trials.

Science.gov (United States)

Whelan, Daniel B; Kletke, Stephanie N; Schemitsch, Geoffrey; Chahal, Jaskarndip

2016-02-01

The recurrence rate after primary anterior shoulder dislocation is high, especially in young, active individuals. Recent studies have suggested external rotation immobilization as a method to reduce the rate of recurrent shoulder dislocation in comparison to traditional sling immobilization. To assess and summarize evidence from randomized controlled trials on the effect of internal rotation versus external rotation immobilization on the rate of recurrence after primary anterior shoulder dislocation. Meta-analysis. PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and abstracts from recent proceedings were searched for eligible studies. Two reviewers selected studies for inclusion, assessed methodological quality, and extracted data. Six randomized controlled trials (632 patients) were included in this review. Demographic and prognostic variables measured at baseline were similar in the pooled groups. The average age was 30.1 years in the pooled external rotation group and 30.3 years in the pooled internal rotation group. Two studies found that external rotation immobilization reduced the rate of recurrence after initial anterior shoulder dislocation compared with conventional internal rotation immobilization, whereas 4 studies failed to find a significant difference between the 2 groups. This meta-analysis suggested no overall significant difference in the rate of recurrence among patients treated with internal rotation versus external rotation immobilization (risk ratio, 0.69; 95% CI, 0.42-1.14; P = .15). There was no significant difference in the rate of compliance between internal and external rotation immobilization (P = .43). The Western Ontario Shoulder Instability Index scores were pooled across 3 studies, and there was no significant difference between the 2 groups (P = .54). Immobilization in external rotation is not significantly more effective in reducing the recurrence rate after primary anterior shoulder dislocation than

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…

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…

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.

Rotator cuff tear: A detailed update

Directory of Open Access Journals (Sweden)

Vivek Pandey

2015-01-01

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

Contained Modes In Mirrors With Sheared Rotation

International Nuclear Information System (INIS)

Fetterman, Abraham J.; Fisch, Nathaniel J.

2010-01-01

In mirrors with E x B rotation, a fixed azimuthal perturbation in the lab frame can appear as a wave in the rotating frame. If the rotation frequency varies with radius, the plasma-frame wave frequency will also vary radially due to the Doppler shift. A wave that propagates in the high rotation plasma region might therefore be evanescent at the plasma edge. This can lead to radially localized Alfven eigenmodes with high azimuthal mode numbers. Contained Alfven modes are found both for peaked and non-peaked rotation profiles. These modes might be useful for alpha channeling or ion heating, as the high azimuthal wave number allows the plasma wave frequency in the rotating frame to exceed the ion cyclotron frequency.

Contained Modes In Mirrors With Sheared Rotation

Energy Technology Data Exchange (ETDEWEB)

Abraham J. Fetterman and Nathaniel J. Fisch

2010-10-08

In mirrors with E × B rotation, a fixed azimuthal perturbation in the lab frame can appear as a wave in the rotating frame. If the rotation frequency varies with radius, the plasma-frame wave frequency will also vary radially due to the Doppler shift. A wave that propagates in the high rotation plasma region might therefore be evanescent at the plasma edge. This can lead to radially localized Alfven eigenmodes with high azimuthal mode numbers. Contained Alfven modes are found both for peaked and non-peaked rotation profiles. These modes might be useful for alpha channeling or ion heating, as the high azimuthal wave number allows the plasma wave frequency in the rotating frame to exceed the ion cyclotron frequency. __________________________________________________

Rotation and rotation-vibration spectroscopy of the 0+-0- inversion doublet in deuterated cyanamide.

Science.gov (United States)

Kisiel, Zbigniew; Kraśnicki, Adam; Jabs, Wolfgang; Herbst, Eric; Winnewisser, Brenda P; Winnewisser, Manfred

2013-10-03

The pure rotation spectrum of deuterated cyanamide was recorded at frequencies from 118 to 649 GHz, which was complemented by measurement of its high-resolution rotation-vibration spectrum at 8-350 cm(-1). For D2NCN the analysis revealed considerable perturbations between the lowest Ka rotational energy levels in the 0(+) and 0(-) substates of the lowest inversion doublet. The final data set for D2NCN exceeded 3000 measured transitions and was successfully fitted with a Hamiltonian accounting for the 0(+) ↔ 0(-) coupling. A smaller data set, consisting only of pure rotation and rotation-vibration lines observed with microwave techniques was obtained for HDNCN, and additional transitions of this type were also measured for H2NCN. The spectroscopic data for all three isotopic species were fitted with a unified, robust Hamiltonian allowing confident prediction of spectra well into the terahertz frequency region, which is of interest to contemporary radioastronomy. The isotopic dependence of the determined inversion splitting, ΔE = 16.4964789(8), 32.089173(3), and 49.567770(6) cm(-1), for D2NCN, HDNCN, and H2NCN, respectively, is found to be in good agreement with estimates from a simple reduced quartic-quadratic double minimum potential.

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

Energy Technology Data Exchange (ETDEWEB)

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

2012-01-15

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

A Simple and Efficient Numerical Method for Computing the Dynamics of Rotating Bose--Einstein Condensates via Rotating Lagrangian Coordinates

KAUST Repository

Bao, Weizhu

2013-01-01

We propose a simple, efficient, and accurate numerical method for simulating the dynamics of rotating Bose-Einstein condensates (BECs) in a rotational frame with or without longrange dipole-dipole interaction (DDI). We begin with the three-dimensional (3D) Gross-Pitaevskii equation (GPE) with an angular momentum rotation term and/or long-range DDI, state the twodimensional (2D) GPE obtained from the 3D GPE via dimension reduction under anisotropic external potential, and review some dynamical laws related to the 2D and 3D GPEs. By introducing a rotating Lagrangian coordinate system, the original GPEs are reformulated to GPEs without the angular momentum rotation, which is replaced by a time-dependent potential in the new coordinate system. We then cast the conserved quantities and dynamical laws in the new rotating Lagrangian coordinates. Based on the new formulation of the GPE for rotating BECs in the rotating Lagrangian coordinates, a time-splitting spectral method is presented for computing the dynamics of rotating BECs. The new numerical method is explicit, simple to implement, unconditionally stable, and very efficient in computation. It is spectral-order accurate in space and second-order accurate in time and conserves the mass on the discrete level. We compare our method with some representative methods in the literature to demonstrate its efficiency and accuracy. In addition, the numerical method is applied to test the dynamical laws of rotating BECs such as the dynamics of condensate width, angular momentum expectation, and center of mass, and to investigate numerically the dynamics and interaction of quantized vortex lattices in rotating BECs without or with the long-range DDI.Copyright © by SIAM.

Oscillation measuring device for body of rotation

International Nuclear Information System (INIS)

Komita, Hideo.

1994-01-01

The present invention concerns an internal pump of a BWR type reactor and provides a device for detecting oscillations of a rotational shaft. Namely, recesses are formed along an identical circumference on the outer circumferential surface of the rotating portion each at a predetermined distance. The recesses rotate along with the rotation. An eddy current type displacement gage measures the distance to the outer circumferential surface of the rotating portion. The recesses are detected by the displacement gage as pulse signals. When the rotating portion oscillates, it is detected by the displacement gage as waveform signals. Accordingly, the output signals of the eddy current type displacement gage are formed by pulse signals superposed on the waveform signals. A rising detection circuit detects the rising position of the pulse signals as the components of the number of rotation of the rotating portion, and fall detection circuit detects the falling position. A comparator circuit is disposed in parallel with both of rising/falling detection circuits. A predetermined threshold value is set in the comparator circuit to output a signal when the inputted signal exceeds the value. (I.S.)

CENTRAL ROTATIONS OF MILKY WAY GLOBULAR CLUSTERS

International Nuclear Information System (INIS)

Fabricius, Maximilian H.; Rukdee, Surangkhana; Saglia, Roberto P.; Bender, Ralf; Hopp, Ulrich; Thomas, Jens; Williams, Michael J.; Noyola, Eva; Opitsch, Michael

2014-01-01

Most Milky Way globular clusters (GCs) exhibit measurable flattening, even if on a very low level. Both cluster rotation and tidal fields are thought to cause this flattening. Nevertheless, rotation has only been confirmed in a handful of GCs, based mostly on individual radial velocities at large radii. We are conducting a survey of the central kinematics of Galactic GCs using the new Integral Field Unit instrument VIRUS-W. We detect rotation in all 11 GCs that we have observed so far, rendering it likely that a large majority of the Milky Way GCs rotate. We use published catalogs of GCs to derive central ellipticities and position angles. We show that in all cases where the central ellipticity permits an accurate measurement of the position angle, those angles are in excellent agreement with the kinematic position angles that we derive from the VIRUS-W velocity fields. We find an unexpected tight correlation between central rotation and outer ellipticity, indicating that rotation drives flattening for the objects in our sample. We also find a tight correlation between central rotation and published values for the central velocity dispersion, most likely due to rotation impacting the old dispersion measurements

Learning Rotation for Kernel Correlation Filter

KAUST Repository

Hamdi, Abdullah

2017-08-11

Kernel Correlation Filters have shown a very promising scheme for visual tracking in terms of speed and accuracy on several benchmarks. However it suffers from problems that affect its performance like occlusion, rotation and scale change. 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 rotation from one frame to another and enhance the detection of KCF. Hence it gains boost in overall accuracy in many of OBT50 detest videos with minimal additional computation.

Polygons on a rotating fluid surface

DEFF Research Database (Denmark)

Jansson, Thomas R.N.; Haspang, Martin P.; Jensen, Kåre H.

2006-01-01

We report a novel and spectacular instability of a fluid surface in a rotating system. In a flow driven by rotating the bottom plate of a partially filled, stationary cylindrical container, the shape of the free surface can spontaneously break the axial symmetry and assume the form of a polygon...... rotating rigidly with a speed different from that of the plate. With water, we have observed polygons with up to 6 corners. It has been known for many years that such flows are prone to symmetry breaking, but apparently the polygonal surface shapes have never been observed. The creation of rotating...

Rotation of vertically oriented objects during earthquakes

Science.gov (United States)

Hinzen, Klaus-G.

2012-10-01

Vertically oriented objects, such as tombstones, monuments, columns, and stone lanterns, are often observed to shift and rotate during earthquake ground motion. Such observations are usually limited to the mesoseismal zone. Whether near-field rotational ground motion components are necessary in addition to pure translational movements to explain the observed rotations is an open question. We summarize rotation data from seven earthquakes between 1925 and 2009 and perform analog and numeric rotation testing with vertically oriented objects. The free-rocking motion of a marble block on a sliding table is disturbed by a pulse in the direction orthogonal to the rocking motion. When the impulse is sufficiently strong and occurs at the `right' moment, it induces significant rotation of the block. Numeric experiments of a free-rocking block show that the initiation of vertical block rotation by a cycloidal acceleration pulse applied orthogonal to the rocking axis depends on the amplitude of the pulse and its phase relation to the rocking cycle. Rotation occurs when the pulse acceleration exceeds the threshold necessary to provoke rocking of a resting block, and the rocking block approaches its equilibrium position. Experiments with blocks subjected to full 3D strong motion signals measured during the 2009 L'Aquila earthquake confirm the observations from the tests with analytic ground motions. Significant differences in the rotational behavior of a monolithic block and two stacked blocks exist.

Neoclassical poloidal and toroidal rotation in tokamaks

International Nuclear Information System (INIS)

Kim, Y.B.; Diamond, P.H.; Groebner, R.J.

1991-01-01

Explicit expressions for the neoclassical poloidal and toroidal rotation speeds of primary ion and impurity species are derived via the Hirshman and Sigmar moment approach. The rotation speeds of the primary ion can be significantly different from those of impurities in various interesting cases. The rapid increase of impurity poloidal rotation in the edge region of H-mode discharges in tokamaks can be explained by a rapid steepening of the primary ion pressure gradient. Depending on ion collisionality, the poloidal rotation speed of the primary ions at the edge can be quite small and the flow direction may be opposite to that of the impurities. This may cast considerable doubts on current L to H bifurcation models based on primary ion poloidal rotation only. Also, the difference between the toroidal rotation velocities of primary ions and impurities is not negligible in various cases. In Ohmic plasmas, the parallel electric field induces a large impurity toroidal rotation close to the magnetic axis, which seems to agree with experimental observations. In the ion banana and plateau regime, there can be non-negligible disparities between primary ion and impurity toroidal rotation velocities due to the ion density and temperature gradients. Detailed analytic expressions for the primary ion and impurity rotation speeds are presented, and the methodology for generalization to the case of several impurity species is also presented for future numerical evaluation

Rotational structure in molecular infrared spectra

CERN Document Server

di Lauro, Carlo

2013-01-01

Recent advances in infrared molecular spectroscopy have resulted in sophisticated theoretical and laboratory methods that are difficult to grasp without a solid understanding of the basic principles and underlying theory of vibration-rotation absorption spectroscopy. Rotational Structure in Molecular Infrared Spectra fills the gap between these recent, complex topics and the most elementary methods in the field of rotational structure in the infrared spectra of gaseous molecules. There is an increasing need for people with the skills and knowledge to interpret vibration-rotation spectra in many scientific disciplines, including applications in atmospheric and planetary research. Consequently, the basic principles of vibration-rotation absorption spectroscopy are addressed for contemporary applications. In addition to covering operational quantum mechanical methods, spherical tensor algebra, and group theoretical methods applied to molecular symmetry, attention is also given to phase conventions and their effe...

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

The developmental trajectory of disruptive behavior in Down syndrome, fragile X syndrome, Prader-Willi syndrome and Williams syndrome.

Science.gov (United States)

Rice, Lauren J; Gray, Kylie M; Howlin, Patricia; Taffe, John; Tonge, Bruce J; Einfeld, Stewart L

2015-06-01

The aim of this study was to investigate the developmental trajectories of verbal aggression, physical aggression, and temper tantrums in four genetic syndrome groups. Participants were part of the Australian Child to Adult Development Study (ACAD), which collected information from a cohort of individuals with an intellectual disability at five time points over 18 years. Data were examined from a total of 248 people with one of the four following syndromes: Down syndrome, Fragile X syndrome, Prader-Willi syndrome, or Williams syndrome. Changes in behaviors were measured using validated items from the Developmental Behavior Checklist (DBC). The results indicate that, while verbal aggression shows no evidence of diminishing with age, physical aggression, and temper tantrums decline with age before 19 years for people with Down syndrome, Fragile X syndrome, and William syndrome; and after 19 years for people with Prader-Willi syndrome. These findings offer a somewhat more optimistic outlook for people with an intellectual disability than has previously been suggested. Research is needed to investigate the mechanisms predisposing people with PWS to persistence of temper tantrums and physical aggression into adulthood. © 2015 Wiley Periodicals, Inc.

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

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.

Rotating Reverse-Osmosis for Water Purification

Science.gov (United States)

Lueptow, RIchard M.

2004-01-01

A new design for a water-filtering device combines rotating filtration with reverse osmosis to create a rotating reverse- osmosis system. Rotating filtration has been used for separating plasma from whole blood, while reverse osmosis has been used in purification of water and in some chemical processes. Reverse- osmosis membranes are vulnerable to concentration polarization a type of fouling in which the chemicals meant not to pass through the reverse-osmosis membranes accumulate very near the surfaces of the membranes. The combination of rotating filtration and reverse osmosis is intended to prevent concentration polarization and thereby increase the desired flux of filtered water while decreasing the likelihood of passage of undesired chemical species through the filter. Devices based on this concept could be useful in a variety of commercial applications, including purification and desalination of drinking water, purification of pharmaceutical process water, treatment of household and industrial wastewater, and treatment of industrial process water. A rotating filter consists of a cylindrical porous microfilter rotating within a stationary concentric cylindrical outer shell (see figure). The aqueous suspension enters one end of the annulus between the inner and outer cylinders. Filtrate passes through the rotating cylindrical microfilter and is removed via a hollow shaft. The concentrated suspension is removed at the end of the annulus opposite the end where the suspension entered.

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...

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 ...

The Relationship Between Shoulder Stiffness and Rotator Cuff Healing: A Study of 1,533 Consecutive Arthroscopic Rotator Cuff Repairs.

Science.gov (United States)

McNamara, William J; Lam, Patrick H; Murrell, George A C

2016-11-16

Retear and stiffness are not uncommon outcomes of rotator cuff repair. The purpose of this study was to evaluate the relationship between rotator cuff repair healing and shoulder stiffness. A total of 1,533 consecutive shoulders had an arthroscopic rotator cuff repair by a single surgeon. Patients assessed their shoulder stiffness using a Likert scale preoperatively and at 1, 6, 12, and 24 weeks (6 months) postoperatively, and examiners evaluated passive range of motion preoperatively and at 6, 12, and 24 weeks postoperatively. Repair integrity was determined by ultrasound evaluation at 6 months. After rotator cuff repair, there was an overall significant loss of patient-ranked and examiner-assessed shoulder motion at 6 weeks compared with preoperative measurements (p rotator cuff integrity at 6 months postoperatively (r = 0.11 to 0.18; p rotation at 6 weeks postoperatively was 7%, while the retear rate of patients with >20° of external rotation at 6 weeks was 15% (p rotator cuff repair was more likely to heal. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

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)

Investigating stellar surface rotation using observations of starspots

DEFF Research Database (Denmark)

Korhonen, Heidi Helena

2011-01-01

Rapid rotation enhances the dynamo operating in stars, and thus also introduces significantly stronger magnetic activity than is seen in slower rotators. Many young cool stars still have the rapid, primordial rotation rates induced by the interstellar molecular cloud from which they were formed....... Also older stars in close binary systems are often rapid rotators. These types of stars can show strong magnetic activity and large starspots. In the case of large starspots which cause observable changes in the brightness of the star, and even in the shapes of the spectral line profiles, one can get...... information on the rotation of the star. At times even information on the spot rotation at different stellar latitudes can be obtained, similarly to the solar surface differential rotation measurements using magnetic features as tracers. Here, I will review investigations of stellar rotation based...

Path integral of the angular momentum eigenstates evolving with the parameter linked with rotation angle under the space rotation transformation

International Nuclear Information System (INIS)

Zhang Zhongcan; Hu Chenguo; Fang Zhenyun

1998-01-01

The authors study the method which directly adopts the azimuthal angles and the rotation angle of the axis to describe the evolving process of the angular momentum eigenstates under the space rotation transformation. The authors obtain the angular momentum rotation and multi-rotation matrix elements' path integral which evolves with the parameter λ(0→θ,θ the rotation angle), and establish the general method of treating the functional (path) integral as a normal multi-integrals

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.

A method for determining poloidal rotation from poloidal asymmetry in toroidal rotation (invited)

Energy Technology Data Exchange (ETDEWEB)

Chrystal, C., E-mail: chrystal@fusion.gat.com [Department of Physics, University of California-San Diego, 9500 Gilman Dr., La Jolla, California 92093 (United States); Burrell, K. H.; Lao, L. L.; Pace, D. C. [General Atomics, P.O. Box 85608, San Diego, California 92186-5608 (United States); Grierson, B. A. [Princeton Plasma Physics Laboratory, Princeton University, Princeton, New Jersey 08543 (United States)

2014-11-15

A new diagnostic has been developed on DIII-D that determines the impurity poloidal rotation from the poloidal asymmetry in the toroidal angular rotation velocity. This asymmetry is measured with recently added tangential charge exchange viewchords on the high-field side of the tokamak midplane. Measurements are made on co- and counter-current neutral beams, allowing the charge exchange cross section effect to be measured and eliminating the need for atomic physics calculations. The diagnostic implementation on DIII-D restricts the measurement range to the core (r/a < 0.6) where, relative to measurements made with the vertical charge exchange system, the spatial resolution is improved. Significant physics results have been obtained with this new diagnostic; for example, poloidal rotation measurements that significantly exceed neoclassical predictions.

Effects of Successive Rotation Regimes on Carbon Stocks in Eucalyptus Plantations in Subtropical China Measured over a Full Rotation.

Science.gov (United States)

Li, Xiaoqiong; Ye, Duo; Liang, Hongwen; Zhu, Hongguang; Qin, Lin; Zhu, Yuling; Wen, Yuanguang

2015-01-01

Plantations play an important role in carbon sequestration and the global carbon cycle. However, there is a dilemma in that most plantations are managed on short rotations, and the carbon sequestration capacities of these short-rotation plantations remain understudied. Eucalyptus has been widely planted in the tropics and subtropics due to its rapid growth, high adaptability, and large economic return. Eucalyptus plantations are primarily planted in successive rotations with a short rotation length of 6~8 years. In order to estimate the carbon-stock potential of eucalyptus plantations over successive rotations, we chose a first rotation (FR) and a second rotation (SR) stand and monitored the carbon stock dynamics over a full rotation from 1998 to 2005. Our results showed that carbon stock in eucalyptus trees (TC) did not significantly differ between rotations, while understory vegetation (UC) and soil organic matter (SOC) stored less carbon in the SR (1.01 vs. 2.76 Mg.ha(-1) and 70.68 vs. 81.08 Mg. ha(-1), respectively) and forest floor carbon (FFC) conversely stored more (2.80 vs. 2.34 Mg. ha(-1)). The lower UC and SOC stocks in the SR stand resulted in 1.13 times lower overall ecosystem carbon stock. Mineral soils and overstory trees were the two dominant carbon pools in eucalyptus plantations, accounting for 73.77%~75.06% and 20.50%~22.39%, respectively, of the ecosystem carbon pool. However, the relative contribution (to the ecosystem pool) of FFC stocks increased 1.38 times and that of UC decreased 2.30 times in the SR versus FR stand. These carbon pool changes over successive rotations were attributed to intensive successive rotation regimes of eucalyptus plantations. Our eight year study suggests that for the sustainable development of short-rotation plantations, a sound silvicultural strategy is required to achieve the best combination of high wood yield and carbon stock potential.

Effects of Successive Rotation Regimes on Carbon Stocks in Eucalyptus Plantations in Subtropical China Measured over a Full Rotation.

Directory of Open Access Journals (Sweden)

Xiaoqiong Li

Full Text Available Plantations play an important role in carbon sequestration and the global carbon cycle. However, there is a dilemma in that most plantations are managed on short rotations, and the carbon sequestration capacities of these short-rotation plantations remain understudied. Eucalyptus has been widely planted in the tropics and subtropics due to its rapid growth, high adaptability, and large economic return. Eucalyptus plantations are primarily planted in successive rotations with a short rotation length of 6~8 years. In order to estimate the carbon-stock potential of eucalyptus plantations over successive rotations, we chose a first rotation (FR and a second rotation (SR stand and monitored the carbon stock dynamics over a full rotation from 1998 to 2005. Our results showed that carbon stock in eucalyptus trees (TC did not significantly differ between rotations, while understory vegetation (UC and soil organic matter (SOC stored less carbon in the SR (1.01 vs. 2.76 Mg.ha(-1 and 70.68 vs. 81.08 Mg. ha(-1, respectively and forest floor carbon (FFC conversely stored more (2.80 vs. 2.34 Mg. ha(-1. The lower UC and SOC stocks in the SR stand resulted in 1.13 times lower overall ecosystem carbon stock. Mineral soils and overstory trees were the two dominant carbon pools in eucalyptus plantations, accounting for 73.77%~75.06% and 20.50%~22.39%, respectively, of the ecosystem carbon pool. However, the relative contribution (to the ecosystem pool of FFC stocks increased 1.38 times and that of UC decreased 2.30 times in the SR versus FR stand. These carbon pool changes over successive rotations were attributed to intensive successive rotation regimes of eucalyptus plantations. Our eight year study suggests that for the sustainable development of short-rotation plantations, a sound silvicultural strategy is required to achieve the best combination of high wood yield and carbon stock potential.

Gender differences in rotation of the shank during single-legged drop landing and its relation to rotational muscle strength of the knee.

Science.gov (United States)

Kiriyama, Shinya; Sato, Haruhiko; Takahira, Naonobu

2009-01-01

Increased shank rotation during landing has been considered to be one of the factors for noncontact anterior cruciate ligament injuries in female athletes. There have been no known gender differences in rotational knee muscle strength, which is expected to inhibit exaggerated shank rotation. Women have less knee external rotator strength than do men. Lower external rotator strength is associated with increased internal shank rotation at the time of landing. Controlled laboratory study. One hundred sixty-nine healthy young subjects (81 female and 88 male; age, 17.0 +/- 1.0 years) volunteered to participate in this study. The subjects performed single-legged drop landings from a 20-cm height. Femoral and shank kinematics were measured using a 3D optoelectronic tracking system during the drop landings, and then the joint angles around the knee (flexion/extension, valgus/varus, and internal/external rotation) were calculated. The maximal isometric rotational muscle strength of the knee was measured at 30 degrees of knee flexion in a supine position using a dynamometer. The female subjects had significantly less external shank rotation strength than did the male subjects (P external rotation strength and the peak shank internal rotation angle during landing (r = -0.322, P external rotator strength. This may lead to large shank internal rotation movement during the single-legged drop landing. Improving strength training of the external rotator muscle may help decrease the rates of anterior cruciate ligament injury in female athletes.

M Dwarf Rotation from the K2 Young Clusters to the Field. I. A Mass-Rotation Correlation at 10 Myr

Science.gov (United States)

Somers, Garrett; Stauffer, John; Rebull, Luisa; Cody, Ann Marie; Pinsonneault, Marc

2017-12-01

Recent observations of the low-mass (0.1-0.6 {M}⊙ ) rotation distributions of the Pleiades and Praesepe clusters have revealed a ubiquitous correlation between mass and rotation, such that late M dwarfs rotate an order-of-magnitude faster than early M dwarfs. In this paper, we demonstrate that this mass-rotation correlation is present in the 10 Myr Upper Scorpius association, as revealed by new K2 rotation measurements. Using rotational evolution models, we show that the low-mass rotation distribution of the 125 Myr Pleiades cluster can only be produced if it hosted an equally strong mass-rotation correlation at 10 Myr. This suggests that physical processes important in the early pre-main sequence (PMS; star formation, accretion, disk-locking) are primarily responsible for the M dwarf rotation morphology, and not quirks of later angular momentum (AM) evolution. Such early mass trends must be taken into account when constructing initial conditions for future studies of stellar rotation. Finally, we show that the average M star loses ˜25%-40% of its AM between 10 and 125 Myr, a figure accurately and generically predicted by modern solar-calibrated wind models. Their success rules out a lossless PMS and validates the extrapolation of magnetic wind laws designed for solar-type stars to the low-mass regime at early times.

Dynamics of Tidally Locked, Ultrafast Rotating Atmospheres

Science.gov (United States)

Tan, Xianyu; Showman, Adam P.

2017-10-01

Tidally locked gas giants, which exhibit a novel regime of day-night thermal forcing and extreme stellar irradiation, are typically in several-day orbits, implying slow rotation and a modest role for rotation in the atmospheric circulation. Nevertheless, there exist a class of gas-giant, highly irradiated objects - brown dwarfs orbiting white dwarfs in extremely tight orbits - whose orbital and hence rotation periods are as short as 1-2 hours. Spitzer phase curves and other observations have already been obtained for this fascinating class of objects, which raise fundamental questions about the role of rotation in controlling the circulation. So far, most modeling studies have investigated rotation periods exceeding a day, as appropriate for typical hot Jupiters. In this work we investigate the dynamics of tidally locked atmospheres in shorter rotation periods down to about two hours. With increasing rotation rate (decreasing rotation period), we show that the width of the equatorial eastward jet decreases, consistent with the narrowing of wave-mean-flow interacting region due to decrease of the equatorial deformation radius. The eastward-shifted equatorial hot spot offset decreases accordingly, and the westward-shifted hot regions poleward of the equatorial jet associated with Rossby gyres become increasingly distinctive. At high latitudes, winds becomes weaker and more geostrophic. The day-night temperature contrast becomes larger due to the stronger influence of rotation. Our simulated atmospheres exhibit small-scale variability, presumably caused by shear instability. Unlike typical hot Jupiters, phase curves of fast-rotating models show an alignment of peak flux to secondary eclipse. Our results have important implications for phase curve observations of brown dwarfs orbiting white dwarfs in ultra tight orbits.

Boundary Layer Control of Rotating Convection Systems

Science.gov (United States)

King, E. M.; Stellmach, S.; Noir, J.; Hansen, U.; Aurnou, J. M.

2008-12-01

Rotating convection is ubiquitous in the natural universe, and is likely responsible for planetary processes such magnetic field generation. Rapidly rotating convection is typically organized by the Coriolis force into tall, thin, coherent convection columns which are aligned with the axis of rotation. This organizational effect of rotation is thought to be responsible for the strength and structure of magnetic fields generated by convecting planetary interiors. As thermal forcing is increased, the relative influence of rotation weakens, and fully three-dimensional convection can exist. It has long been assumed that rotational effects will dominate convection dynamics when the ratio of buoyancy to the Coriolis force, the convective Rossby number, Roc, is less than unity. We investigate the influence of rotation on turbulent Rayleigh-Benard convection via a suite of coupled laboratory and numerical experiments over a broad parameter range: Rayleigh number, 10310; Ekman number, 10-6≤ E ≤ ∞; and Prandtl number, 1≤ Pr ≤ 100. In particular, we measure heat transfer (as characterized by the Nusselt number, Nu) as a function of the Rayleigh number for several different Ekman and Prandtl numbers. Two distinct heat transfer scaling regimes are identified: non-rotating style heat transfer, Nu ~ Ra2/7, and quasigeostrophic style heat transfer, Nu~ Ra6/5. The transition between the non-rotating regime and the rotationally dominant regime is described as a function of the Ekman number, E. We show that the regime transition depends not on the global force balance Roc, but on the relative thicknesses of the thermal and Ekman boundary layers. The transition scaling provides a predictive criterion for the applicability of convection models to natural systems such as Earth's core.

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.

Central Rotations of Milky Way Globular Clusters

Science.gov (United States)

Fabricius, Maximilian H.; Noyola, Eva; Rukdee, Surangkhana; Saglia, Roberto P.; Bender, Ralf; Hopp, Ulrich; Thomas, Jens; Opitsch, Michael; Williams, Michael J.

2014-06-01

Most Milky Way globular clusters (GCs) exhibit measurable flattening, even if on a very low level. Both cluster rotation and tidal fields are thought to cause this flattening. Nevertheless, rotation has only been confirmed in a handful of GCs, based mostly on individual radial velocities at large radii. We are conducting a survey of the central kinematics of Galactic GCs using the new Integral Field Unit instrument VIRUS-W. We detect rotation in all 11 GCs that we have observed so far, rendering it likely that a large majority of the Milky Way GCs rotate. We use published catalogs of GCs to derive central ellipticities and position angles. We show that in all cases where the central ellipticity permits an accurate measurement of the position angle, those angles are in excellent agreement with the kinematic position angles that we derive from the VIRUS-W velocity fields. We find an unexpected tight correlation between central rotation and outer ellipticity, indicating that rotation drives flattening for the objects in our sample. We also find a tight correlation between central rotation and published values for the central velocity dispersion, most likely due to rotation impacting the old dispersion measurements. This Letter includes data taken at The McDonald Observatory of The University of Texas at Austin.

Rotational spectroscopy with an optical centrifuge.

Science.gov (United States)

Korobenko, Aleksey; Milner, Alexander A; Hepburn, John W; Milner, Valery

2014-03-07

We demonstrate a new spectroscopic method for studying electronic transitions in molecules with extremely broad range of angular momentum. We employ an optical centrifuge to create narrow rotational wave packets in the ground electronic state of (16)O2. Using the technique of resonance-enhanced multi-photon ionization, we record the spectrum of multiple ro-vibrational transitions between X(3)Σg(-) and C(3)Πg electronic manifolds of oxygen. Direct control of rotational excitation, extending to rotational quantum numbers as high as N ≳ 120, enables us to interpret the complex structure of rotational spectra of C(3)Πg beyond thermally accessible levels.

Friction, Free Axes of Rotation and Entropy

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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.

A self-calibration method in single-axis rotational inertial navigation system with rotating mechanism

Science.gov (United States)

Chen, Yuanpei; Wang, Lingcao; Li, Kui

2017-10-01

Rotary inertial navigation modulation mechanism can greatly improve the inertial navigation system (INS) accuracy through the rotation. Based on the single-axis rotational inertial navigation system (RINS), a self-calibration method is put forward. The whole system is applied with the rotation modulation technique so that whole inertial measurement unit (IMU) of system can rotate around the motor shaft without any external input. In the process of modulation, some important errors can be decoupled. Coupled with the initial position information and attitude information of the system as the reference, the velocity errors and attitude errors in the rotation are used as measurement to perform Kalman filtering to estimate part of important errors of the system after which the errors can be compensated into the system. The simulation results show that the method can complete the self-calibration of the single-axis RINS in 15 minutes and estimate gyro drifts of three-axis, the installation error angle of the IMU and the scale factor error of the gyro on z-axis. The calibration accuracy of optic gyro drifts could be about 0.003°/h (1σ) as well as the scale factor error could be about 1 parts per million (1σ). The errors estimate reaches the system requirements which can effectively improve the longtime navigation accuracy of the vehicle or the boat.

Effects of humeral head compression taping on the isokinetic strength of the shoulder external rotator muscle in patients with rotator cuff tendinitis.

Science.gov (United States)

Kim, Moon-Hwan; Oh, Jae-Seop

2015-01-01

[Purpose] The purpose of this study was to examine the effects of humeral head compression taping (HHCT) on the strength of the shoulder external rotator muscle in patients with rotator cuff tendinitis. [Subjects and Methods] Twenty patients with rotator cuff tendinitis were recruited. The shoulder external rotator strength was measured using a Biodex isokinetic dynamometer system. A paired t-test was performed to evaluate within-group differences in the strength of the shoulder external rotator muscle. [Results] Significantly higher shoulder external rotator peak torque and peak torque per body weight were found in the HHCT condition than in the no-taping condition. [Conclusion] HHCT may effectively increase the shoulder external rotator muscle strength in patients with rotator cuff tendinitis.

An evaluation of the metabolic syndrome in the HyperGEN study

Directory of Open Access Journals (Sweden)

Lewis Cora E

2005-01-01

Full Text Available Abstract Background In 2001 the National Cholesterol Education Program (NCEP provided a categorical definition for metabolic syndrome (c-MetS. We studied the extent to which two ethnic groups, Blacks and Whites were affected by c-MetS. The groups were members of the Hypertension Genetic Epidemiology Network (HyperGEN, a part of the Family Blood Pressure Program, supported by the NHLBI. Although the c-MetS definition is of special interest in particular to the clinicians, the quantitative latent traits of the metabolic syndrome (MetS are also important in order to gain further understanding of its etiology. In this study, quantitative evaluation of the MetS latent traits (q-MetS was based on the statistical multivariate method factor analysis (FA. Results The prevalence of the c-MetS was 34% in Blacks and 39% in Whites. c-MetS showed predominance of obesity, hypertension, and dyslipidemia. Three and four factor domains were identified through FA, classified as "Obesity," "Blood pressure," "Lipids," and "Central obesity." They explained approximately 60% of the variance in the 11 original variables. Two factors classified as "Obesity" and "Central Obesity" overlapped when FA was performed without rotation. All four factors in FA with Varimax rotation were consistent between Blacks and Whites, between genders and also after excluding type 2 diabetes (T2D participants. Fasting insulin (INS associated mainly with obesity and lipids factors. Conclusions MetS in the HyperGEN study has a compound phenotype with separate domains for obesity, blood pressure, and lipids. Obesity and its relationship to lipids and insulin is clearly the dominant factor in MetS. Linkage analysis on factor scores for components of MetS, in familial studies such as HyperGEN, can assist in understanding the genetic pathways for MetS and their interactions with the environment, as a first step in identifying the underlying pathophysiological causes of this syndrome.

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...

The Rotator Cuff Organ: Integrating Developmental Biology, Tissue Engineering, and Surgical Considerations to Treat Chronic Massive Rotator Cuff Tears.

Science.gov (United States)

Rothrauff, Benjamin B; Pauyo, Thierry; Debski, Richard E; Rodosky, Mark W; Tuan, Rocky S; Musahl, Volker

2017-08-01

The torn rotator cuff remains a persistent orthopedic challenge, with poor outcomes disproportionately associated with chronic, massive tears. Degenerative changes in the tissues that comprise the rotator cuff organ, including muscle, tendon, and bone, contribute to the poor healing capacity of chronic tears, resulting in poor function and an increased risk for repair failure. Tissue engineering strategies to augment rotator cuff repair have been developed in an effort to improve rotator cuff healing and have focused on three principal aims: (1) immediate mechanical augmentation of the surgical repair, (2) restoration of muscle quality and contractility, and (3) regeneration of native enthesis structure. Work in these areas will be reviewed in sequence, highlighting the relevant pathophysiology, developmental biology, and biomechanics, which must be considered when designing therapeutic applications. While the independent use of these strategies has shown promise, synergistic benefits may emerge from their combined application given the interdependence of the tissues that constitute the rotator cuff organ. Furthermore, controlled mobilization of augmented rotator cuff repairs during postoperative rehabilitation may provide mechanotransductive cues capable of guiding tissue regeneration and restoration of rotator cuff function. Present challenges and future possibilities will be identified, which if realized, may provide solutions to the vexing condition of chronic massive rotator cuff tears.

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...

Rotational inhomogeneities from pre-big bang?

International Nuclear Information System (INIS)

Giovannini, Massimo

2005-01-01

The evolution of the rotational inhomogeneities is investigated in the specific framework of four-dimensional pre-big bang models. While minimal (dilaton-driven) scenarios do not lead to rotational fluctuations, in the case of non-minimal (string-driven) models, fluid sources are present in the pre-big bang phase. The rotational modes of the geometry, coupled to the divergenceless part of the velocity field, can then be amplified depending upon the value of the barotropic index of the perfect fluids. In the light of a possible production of rotational inhomogeneities, solutions describing the coupled evolution of the dilaton field and of the fluid sources are scrutinized in both the string and Einstein frames. In semi-realistic scenarios, where the curvature divergences are regularized by means of a non-local dilaton potential, the rotational inhomogeneities are amplified during the pre-big bang phase but they decay later on. Similar analyses can also be performed when a contraction occurs directly in the string frame metric

Rotational inhomogeneities from pre-big bang?

Energy Technology Data Exchange (ETDEWEB)

Giovannini, Massimo [Department of Physics, Theory Division, CERN, 1211 Geneva 23 (Switzerland)

2005-01-21

The evolution of the rotational inhomogeneities is investigated in the specific framework of four-dimensional pre-big bang models. While minimal (dilaton-driven) scenarios do not lead to rotational fluctuations, in the case of non-minimal (string-driven) models, fluid sources are present in the pre-big bang phase. The rotational modes of the geometry, coupled to the divergenceless part of the velocity field, can then be amplified depending upon the value of the barotropic index of the perfect fluids. In the light of a possible production of rotational inhomogeneities, solutions describing the coupled evolution of the dilaton field and of the fluid sources are scrutinized in both the string and Einstein frames. In semi-realistic scenarios, where the curvature divergences are regularized by means of a non-local dilaton potential, the rotational inhomogeneities are amplified during the pre-big bang phase but they decay later on. Similar analyses can also be performed when a contraction occurs directly in the string frame metric.

Study of insomnia in rotating shift-workers

Directory of Open Access Journals (Sweden)

Kaushik Chatterjee

2017-01-01

Full Text Available Background: Shift-workers commonly suffer from insomnia. This study evaluates different domains of insomnia. Aim: This study was aimed to study sleep and insomnia in rotating shift-workers and compare with day-workers. Materials and Methods: This was case–control study. The sleep of rotating shift-workers is compared with day workers using Athens Insomnia Scale. Results: Rotating shift-workers had significantly higher scores on Athens insomnia scale on domains of initial, intermediate and terminal insomnia than day workers. Duration and quality of sleep and sense of well-being are lower in rotating shift-workers. Rotating shift-workers also experienced more day-time sleepiness than day workers. However, there was no difference in perceived physical and mental functioning between the two groups. Conclusion: Individuals working in rotating shifts for more than 15 days have significantly higher prevalence of insomnia than day-workers.

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...

Controlling Sample Rotation in Acoustic Levitation

Science.gov (United States)

Barmatz, M. B.; Stoneburner, J. D.

1985-01-01

Rotation of acoustically levitated object stopped or controlled according to phase-shift monitoring and control concept. Principle applies to square-cross-section levitation chamber with two perpendicular acoustic drivers operating at same frequency. Phase difference between X and Y acoustic excitation measured at one corner by measuring variation of acoustic amplitude sensed by microphone. Phase of driver adjusted to value that produces no rotation or controlled rotation of levitated object.

INFORMATIONAL MODEL OF MENTAL ROTATION OF FIGURES

Directory of Open Access Journals (Sweden)

V. A. Lyakhovetskiy

2016-01-01

Full Text Available Subject of Study.The subject of research is the information structure of objects internal representations and operations over them, used by man to solve the problem of mental rotation of figures. To analyze this informational structure we considered not only classical dependencies of the correct answers on the angle of rotation, but also the other dependencies obtained recently in cognitive psychology. Method.The language of technical computing Matlab R2010b was used for developing information model of the mental rotation of figures. Such model parameters as the number of bits in the internal representation, an error probability in a single bit, discrete rotation angle, comparison threshold, and the degree of difference during rotation can be changed. Main Results.The model reproduces qualitatively such psychological dependencies as the linear increase of time of correct answers and the number of errors on the angle of rotation for identical figures, "flat" dependence of the time of correct answers and the number of errors on the angle of rotation for mirror-like figures. The simulation results suggest that mental rotation is an iterative process of finding a match between the two figures, each step of which can lead to a significant distortion of the internal representation of the stored objects. Matching is carried out within the internal representations that have no high invariance to rotation angle. Practical Significance.The results may be useful for understanding the role of learning (including the learning with a teacher in the development of effective information representation and operations on them in artificial intelligence systems.

Rotating Quark Stars in General Relativity

Directory of Open Access Journals (Sweden)

Enping Zhou

2018-03-01

Full Text Available We have built quasi-equilibrium models for uniformly rotating quark stars in general relativity. The conformal flatness approximation is employed and the Compact Object CALculator (cocal code is extended to treat rotating stars with surface density discontinuity. In addition to the widely used MIT bag model, we have considered a strangeon star equation of state (EoS, suggested by Lai and Xu, that is based on quark clustering and results in a stiff EoS. We have investigated the maximum mass of uniformly rotating axisymmetric quark stars. We have also built triaxially deformed solutions for extremely fast rotating quark stars and studied the possible gravitational wave emission from such configurations.

Rotational Fourier tracking of diffusing polygons.

Science.gov (United States)

Mayoral, Kenny; Kennair, Terry P; Zhu, Xiaoming; Milazzo, James; Ngo, Kathy; Fryd, Michael M; Mason, Thomas G

2011-11-01

We use optical microscopy to measure the rotational Brownian motion of polygonal platelets that are dispersed in a liquid and confined by depletion attractions near a wall. The depletion attraction inhibits out-of-plane translational and rotational Brownian fluctuations, thereby facilitating in-plane imaging and video analysis. By taking fast Fourier transforms (FFTs) of the images and analyzing the angular position of rays in the FFTs, we determine an isolated particle's rotational trajectory, independent of its position. The measured in-plane rotational diffusion coefficients are significantly smaller than estimates for the bulk; this difference is likely due to the close proximity of the particles to the wall arising from the depletion attraction.

Identifying Broadband Rotational Spectra with Neural Networks

Science.gov (United States)

Zaleski, Daniel P.; Prozument, Kirill

2017-06-01

A typical broadband rotational spectrum may contain several thousand observable transitions, spanning many species. Identifying the individual spectra, particularly when the dynamic range reaches 1,000:1 or even 10,000:1, can be challenging. One approach is to apply automated fitting routines. In this approach, combinations of 3 transitions can be created to form a "triple", which allows fitting of the A, B, and C rotational constants in a Watson-type Hamiltonian. On a standard desktop computer, with a target molecule of interest, a typical AUTOFIT routine takes 2-12 hours depending on the spectral density. A new approach is to utilize machine learning to train a computer to recognize the patterns (frequency spacing and relative intensities) inherit in rotational spectra and to identify the individual spectra in a raw broadband rotational spectrum. Here, recurrent neural networks have been trained to identify different types of rotational spectra and classify them accordingly. Furthermore, early results in applying convolutional neural networks for spectral object recognition in broadband rotational spectra appear promising. Perez et al. "Broadband Fourier transform rotational spectroscopy for structure determination: The water heptamer." Chem. Phys. Lett., 2013, 571, 1-15. Seifert et al. "AUTOFIT, an Automated Fitting Tool for Broadband Rotational Spectra, and Applications to 1-Hexanal." J. Mol. Spectrosc., 2015, 312, 13-21. Bishop. "Neural networks for pattern recognition." Oxford university press, 1995.

From static to rotating to conformal static solutions: rotating imperfect fluid wormholes with(out) electric or magnetic field

Energy Technology Data Exchange (ETDEWEB)

Azreg-Ainou, Mustapha [Baskent University, Department of Mathematics, Ankara (Turkey)

2014-05-15

We derive a shortcut stationary metric formula for generating imperfect fluid rotating solutions, in Boyer-Lindquist coordinates, from spherically symmetric static ones. We explore the properties of the curvature scalar and stress-energy tensor for all types of rotating regular solutions we can generate without restricting ourselves to specific examples of regular solutions (regular black holes or wormholes). We show through examples how it is generally possible to generate an imperfect fluid regular rotating solution via radial coordinate transformations. We derive rotating wormholes that are modeled as imperfect fluids and discuss their physical properties. These are independent on the way the stress-energy tensor is interpreted. A solution modeling an imperfect fluid rotating loop black hole is briefly discussed. We then specialize to the recently discussed stable exotic dust Ellis wormhole as emerged in a source-free radial electric or magnetic field, and we generate its, conjecturally stable, rotating counterpart. This turns out to be an exotic imperfect fluid wormhole, and we determine the stress-energy tensor of both the imperfect fluid and the electric or magnetic field. (orig.)

From static to rotating to conformal static solutions: rotating imperfect fluid wormholes with(out) electric or magnetic field

International Nuclear Information System (INIS)

Azreg-Ainou, Mustapha

2014-01-01

We derive a shortcut stationary metric formula for generating imperfect fluid rotating solutions, in Boyer-Lindquist coordinates, from spherically symmetric static ones. We explore the properties of the curvature scalar and stress-energy tensor for all types of rotating regular solutions we can generate without restricting ourselves to specific examples of regular solutions (regular black holes or wormholes). We show through examples how it is generally possible to generate an imperfect fluid regular rotating solution via radial coordinate transformations. We derive rotating wormholes that are modeled as imperfect fluids and discuss their physical properties. These are independent on the way the stress-energy tensor is interpreted. A solution modeling an imperfect fluid rotating loop black hole is briefly discussed. We then specialize to the recently discussed stable exotic dust Ellis wormhole as emerged in a source-free radial electric or magnetic field, and we generate its, conjecturally stable, rotating counterpart. This turns out to be an exotic imperfect fluid wormhole, and we determine the stress-energy tensor of both the imperfect fluid and the electric or magnetic field. (orig.)

A novel rotational invariants target recognition method for rotating motion blurred images

Science.gov (United States)

Lan, Jinhui; Gong, Meiling; Dong, Mingwei; Zeng, Yiliang; Zhang, Yuzhen

2017-11-01

The imaging of the image sensor is blurred due to the rotational motion of the carrier and reducing the target recognition rate greatly. Although the traditional mode that restores the image first and then identifies the target can improve the recognition rate, it takes a long time to recognize. In order to solve this problem, a rotating fuzzy invariants extracted model was constructed that recognizes target directly. The model includes three metric layers. The object description capability of metric algorithms that contain gray value statistical algorithm, improved round projection transformation algorithm and rotation-convolution moment invariants in the three metric layers ranges from low to high, and the metric layer with the lowest description ability among them is as the input which can eliminate non pixel points of target region from degenerate image gradually. Experimental results show that the proposed model can improve the correct target recognition rate of blurred image and optimum allocation between the computational complexity and function of region.

Superior Mesenteric Artery Syndrome or Wilkie Syndrome

International Nuclear Information System (INIS)

Castano Llano, Rodrigo; Chams Anturi, Abraham; Arango Vargas, Paula

2009-01-01

We described three cases of superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, chronic duodenal ileus, or cast syndrome. This syndrome occurs when the third portion of the duodenum is compressed between the SMA and the aorta. The major risk factors for development of SMA syndrome are rapid weight loss and surgical correction of spinal deformities. The clinical presentation of SMA syndrome is variable and nonspecific, including nausea, vomiting, abdominal pain, and weight loss. The diagnosis is based on endoscopic, radiographic and tomographic findings of duodenal compression by the SMA. The treatment of SMA syndrome is aimed at the precipitating factor, which usually is related to weight loss. Therefore, conservative therapy with nutritional supplementation is the initial approach, and surgery is reserved for those who do not respond to nutritional therapy.

Steroid injection for painful shoulder: Usefulness of ultrasound-guided approach

International Nuclear Information System (INIS)

Lee, Min Hee

2004-01-01

To evaluate the efficacy of steroid injection into the subacromial bursa and biceps tendon sheath for painful shoulders and the usefulness of ultrasound-guided approach. Seventeen shoulders of twelve patients with shoulder pain and limited motion were included, and these patient were clinically diagnosed as a painful arc syndrome. Under ultrasound guidance, steroid injection was performed into the subacormial bursa (13 cases) and biceps tendon sheath (4 cases). In 7 cases, 1 mL of steroid was used while the remaining six patients received a mixture of 1 mL of steroid and 1 ml of lidocaine. Both shoulders of two patients received 0.5 mL of steroid. The location of needle and injection duration of fluid were continuously monitored, and complications such as leakage of steroid were recorded. Medical records were reviewed for the presence of pain relief and increasing range of motion following the injection. On ultrasonogram, the needle within the subacromial bursa and biceps tendon sheath was seen as a linear echogenic structure, and injected fluid was identified. There was neither the leakage of steroid injection nor any other complications. In 16 (94%) of 17 shoulders, there was decreased intensity of shoulder pain while increased range of motion was noted in three patients following the injection. Steroid injection into the subacormial bursa and biceps tendon sheath is effective in treating shoulder pain and limited range of motion of the shoulder, and ultrasound is useful guiding method.

The rotational elements of Mars and its satellites

Science.gov (United States)

Jacobson, R. A.; Konopliv, A. S.; Park, R. S.; Folkner, W. M.

2018-03-01

The International Astronomical Union (IAU) defines planet and satellite coordinate systems relative to their axis of rotation and the angle about that axis. The rotational elements of the bodies are the right ascension and declination of the rotation axis in the International Celestial Reference Frame and the rotation angle, W, measured easterly along the body's equator. The IAU specifies the location of the body's prime meridian by providing a value for W at epoch J2000. We provide new trigonometric series representations of the rotational elements of Mars and its satellites, Phobos and Deimos. The series for Mars are from a least squares fit to the rotation model used to orient the Martian gravity field. The series for the satellites are from a least squares fit to rotation models developed in accordance with IAU conventions from recent ephemerides.

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. ...