WorldWideScience

Sample records for tibiofibular syndesmosis diastases

  1. Three-dimensional volume rendering of tibiofibular joint space and quantitative analysis of change in volume due to tibiofibular syndesmosis diastases

    International Nuclear Information System (INIS)

    Taser, F.; Shafiq, Q.; Ebraheim, N.A.

    2006-01-01

    The diagnosis of ankle syndesmosis injuries is made by various imaging techniques. The present study was undertaken to examine whether the three-dimensional reconstruction of axial CT images and calculation of the volume of tibiofibular joint space enhances the sensitivity of diastases diagnoses or not. Six adult cadaveric ankle specimens were used for spiral CT-scan assessment of tibiofibular syndesmosis. After the specimens were dissected, external fixation was performed and diastases of 1, 2, and 3 mm was simulated by a precalibrated device. Helical CT scans were obtained with 1.0-mm slice thickness. The data was transferred to the computer software AcquariusNET. Then the contours of the tibiofibular syndesmosis joint space were outlined on each axial CT slice and the collection of these slices were stacked using the computer software AutoCAD 2005, according to the spatial arrangement and geometrical coordinates between each slice, to produce a three-dimensional reconstruction of the joint space. The area of each slice and the volume of the entire tibiofibular joint space were calculated. The tibiofibular joint space at the 10th-mm slice level was also measured on axial CT scan images at normal, 1, 2 and 3-mm joint space diastases. The three-dimensional volume-rendering of the tibiofibular syndesmosis joint space from the spiral CT data demonstrated the shape of the joint space and has been found to be a sensitive method for calculating joint space volume. We found that, from normal to 1 mm, a 1-mm diastasis increases approximately 43% of the joint space volume, while from 1 to 3 mm, there is about a 20% increase for each 1-mm increase. Volume calculation using this method can be performed in cases of syndesmotic instability after ankle injuries and for preoperative and postoperative evaluation of the integrity of the tibiofibular syndesmosis. (orig.)

  2. Imaging of the Distal Tibiofibular Syndesmosis: Anatomy in Relation to Radiological Diagnosis

    NARCIS (Netherlands)

    J.J. Hermans (John)

    2011-01-01

    textabstractInjury to the distal tibiofibular syndesmosis can occur after an ankle sprain or after an acute ankle fracture. In an estimated 1-11% of all ankle sprains, injury of the distal tibiofibular syndesmosis occurs which is known as a high ankle sprain. However, depending on the type and

  3. Rehabilitation of distal tibiofibular syndesmosis sprains: a case report

    Science.gov (United States)

    Pajaczkowski, Jason A

    2007-01-01

    Objective To present the epidemiology, etiology, diagnostic criteria and therapeutic interventions for an important clinical entity – tibiofibular syndesmosis or “high ankle” sprains. Clinical Features The most common mechanism of injury is forced external rotation in a dorsiflexed foot. Pain is located anteriorly over the anterior tibiofibular ligament, and is elicited through a variety of tests designed to stress this articulation through diastatic forces. Pain with ambulation is typical, and is usually present during the push-off phase of gait. Radiographs may be useful in determining the extent of this injury, as syndesmotic sprains with malleolar fractures are more common than those without. Intervention and Outcome Convalescence is generally protracted compared with a lateral ankle sprain, and care must be taken to avoid stressing the supporting ligaments during the early course of therapy. Initial treatment is aimed at reducing pain and inflammation using modalities such as microcurrent, electroacupuncture and P.R.I.C.E. principles. Treatment over subsequent weeks involves progressive resistance exercises, proprioceptive challenges, plyometric exercises and sport-specific agility drills, while maintaining cardiovascular fitness. Conclusion The practitioner should also be cognizant of the indolent nature of this injury and possibility for sequelae. Anterior ankle pain and pain with a deep squat or during the push-off phase of gait are typical of this injury. Radiographs to rule out fracture and evaluate the extent of the injury may be warranted. Conservative therapy involving rehabilitation and tissue injury care is appropriate for Grade I and II injuries, while Grade III injuries require a surgical intervention. PMID:17657290

  4. [TREATMENT OF PRONATION EXTERNAL ROTATION ANKLE FRACTURE COMBINED WITH SEPARATION OF DISTAL TIBIOFIBULAR SYNDESMOSIS].

    Science.gov (United States)

    Wu, Benwen; Ding, Zhenqi; Huang, Guofeng; Liu, Guojun; Cai, Zhemin; Ding, Luobin; Li, Xiang

    2016-09-08

    To evaluate the difference between using and not using syndesmotic screw to treat pronation external rotation (PER) ankle fracture combined with separation of distal tibiofibular syndesmosis. Between April 2011 and October 2014, 46 cases of PER ankle fracture combined with separation of distal tibiofibular syndesmosis were treated, and syndesmotic screw was used in 24 cases (fixation group) and syndesmotic screw was not used in 22 cases (non-fixation group). There was no significant difference in gender, age, weight, cause of injury, side, injury to operation time, and fracture type between 2 groups ( P >0.05). The time for full weight-bearing, fracture healing time, and complications were recorded after operation. Anteroposterior and lateral X-ray films were taken to measure the tibiofibular overlap (TBOL) and tibiofibular clear space (TBCS). Baird-Jackson score was used to evaluate functional recovery of the ankle. All incision healed by first intention without complications. The cases were followed up 13-18 months (mean, 15.2 months) in 2 groups. The time for full weight-bearing was 8-12 weeks (median, 11 weeks) in fixation group, which was significantly later than that in non-fixation group (range, 6-10 weeks; median, 8 weeks) ( Z =-5.049, P =0.000). X-ray examination showed reduction of separation of distal tibiofibular syndesmosis. All fractures healed. The fracture healing time was (13.83±1.37) weeks in fixation group, and was (13.91±1.31) weeks in non-fixation group, showing no significant difference ( t =-0.191, P =0.945). No separation of distal tibiofibular syndesmosis, delayed union, nonunion, loosening, or breakage of fixation devices was observed in 2 groups. There was no significant difference in TBOL, TBCS, Baird-Jackson score and the excellent and good rate between 2 groups ( P >0.05). If the medial, lateral, and posterior structures of the ankle could be repaired according to injury, no significant influence on functional outcome of ankle or

  5. Biomechanical evaluation of the locking titanium cable in the fixture of distal tibiofibular syndesmosis injury

    Directory of Open Access Journals (Sweden)

    Shu-zhi YAO

    2016-08-01

    Full Text Available Objective  The article aims at evaluating the biological properties of tibiofibular titanium cable fixation device in terms of both anti-separation and stress shielding by comparison to the interior fixation with lag screw based on experimental observation. Methods  Six corpse ankle specimens were first tested of pressure-separation and stress measurement, the data from which were compared to the normal group, and then a syndesmosis injury model was established. All the samples are randomly divided into 2 groups of 3 specimens each, which were treated with tibiofibula locked titanium cable and lag screw fixation respectively for syndesmosis injury. Then, the samples were tested for pressure-separation and stress measurement. The biomechanical properties as anti-separation ability and stress shielding were analyzed and compared between the two fixation method. Results  Both tibiofibula locked titanium cables and lag screws were able to provide enough strong lateral anti-separation ability, but strong fixation screws were inferior to tibiofibular titanium cable fixation device in fibular longitudinal stress transduction. Conclusion  Tibiofibular titanium cable fixation device not only provide sufficient lateral anti-separation, but also reduces the tibial and fibular longitudinal stress shielding, thus being superior to the traditional lag screw in biomechanical properties. DOI: 10.11855/j.issn.0577-7402.2016.07.09

  6. Chronic instability of the anterior tibiofibular syndesmosis of the ankle. Arthroscopic findings and results of anatomical reconstruction

    Directory of Open Access Journals (Sweden)

    Swierstra Bart A

    2011-09-01

    Full Text Available Abstract Background The arthroscopic findings in patients with chronic anterior syndesmotic instability that need reconstructive surgery have never been described extensively. Methods In 12 patients the clinical suspicion of chronic instability of the syndesmosis was confirmed during arthroscopy of the ankle. All findings during the arthroscopy were scored. Anatomical reconstruction of the anterior tibiofibular syndesmosis was performed in all patients. The AOFAS score was assessed to evaluate the result of the reconstruction. At an average of 43 months after the reconstruction all patients were seen for follow-up. Results The syndesmosis being easily accessible for the 3 mm transverse end of probe which could be rotated around its longitudinal axis in all cases during arthroscopy of the ankle joint, confirmed the diagnosis. Cartilage damage was seen in 8 ankles, of which in 7 patients the damage was situated at the medial side of the ankle joint. The intraarticular part of anterior tibiofibular ligament was visibly damaged in 5 patients. Synovitis was seen in all but one ankle joint. After surgical reconstruction the AOFAS score improved from an average of 72 pre-operatively to 92 post-operatively. Conclusions To confirm the clinical suspicion, the final diagnosis of chronic instability of the anterior syndesmosis can be made during arthroscopy of the ankle. Cartilage damage to the medial side of the tibiotalar joint is often seen and might be the result of syndesmotic instability. Good results are achieved by anatomic reconstruction of the anterior syndesmosis, and all patients in this study would undergo the surgery again if necessary.

  7. Deltoid ligament and tibiofibular syndesmosis injury in chronic lateral ankle instability: Magnetic resonance imaging evaluation at 3T and comparison with arthroscopy

    International Nuclear Information System (INIS)

    Chun, Ka Young; Choi, Yun Sun; Lee, Seok Hoon; Kim, Jin Su; Young, Ki Won; Jeong, Min Sun; Kim, Dae Jung

    2015-01-01

    To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI). Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard. On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively. Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential

  8. Deltoid ligament and tibiofibular syndesmosis injury in chronic lateral ankle instability: Magnetic resonance imaging evaluation at 3T and comparison with arthroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Ka Young; Choi, Yun Sun; Lee, Seok Hoon; Kim, Jin Su; Young, Ki Won; Jeong, Min Sun; Kim, Dae Jung [Eulji Hospital, Eulji University, Seoul (Korea, Republic of)

    2015-10-15

    To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI). Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard. On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively. Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential.

  9. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    International Nuclear Information System (INIS)

    Hermans, John J.; Ginai, Abida Z.; Beumer, Annechien; Moonen, Adrianus F.C.M.; Hop, Wim C.J.

    2012-01-01

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement (κ) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes (κ 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique MRI plane were

  10. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, John J.; Ginai, Abida Z. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Beumer, Annechien; Moonen, Adrianus F.C.M. [Amphia Hospital, Department of Orthopaedics, Breda (Netherlands); Hop, Wim C.J. [Erasmus University Medical Center, Department of Biostatistics, Rotterdam (Netherlands)

    2012-02-15

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement ({kappa}) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes ({kappa} 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique

  11. [Effectiveness comparison of flexible fixation and rigid fixation in treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis].

    Science.gov (United States)

    Li, Yuewei; Zhang, Minghui; Li, Xiaorong; Chen, Xiaoyong; Deng, Jianlong

    2017-07-01

    To compare the effectiveness of flexible fixation and rigid fixation in the treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis. A retrospective analysis was made on the clinical data of 50 patients with ankle pronation-external rotation fractures and distal tibiofibular syndesmosis treated between January 2013 and December 2015. Suture-button fixation was used in 23 patients (flexible fixation group) and cortical screw fixation in 27 patients (rigid fixation group). There was no significant difference in age, gender, weight, side, fracture type, and time from trauma to surgery between 2 groups ( P >0.05). The operation time, medial clear space (MCS), tibiofibular clear space (TFCS), tibiofibular overlap (TFO), American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Disability Index (FADI) score were compared between 2 groups. The operation time was (83.0±9.1) minutes in the flexible fixation group and was (79.6±13.1) minutes in the rigid fixation group, showing no significant difference ( t =1.052, P =0.265). All patients achieved healing of incision by first intention. The patients were followed up 12-20 months (mean, 14 months). The X-ray films showed good healing of fracture in 2 groups. There was no screw fracture, delayed union or nounion. The fracture healing time was (12.1±2.5) months in the flexible fixation group and was (11.3±3.2) months in the rigid fixation group, showing no significant difference between 2 groups ( t =1.024, P =0.192). Reduction loss occurred after removal of screw in 2 cases of the rigid fixation group. At last follow-up, there was no significant difference in MCS, TFCS, TFO, AOFAS score and FADI score between 2 groups ( P >0.05). Suture-button fixation has similar effectiveness to screw fixation in ankle function and imaging findings, and flexible fixation has lower risk of reduction loss of distal tibiofibular syndesmosis than rigid fixation.

  12. Changes in the Width of the Tibiofibular Syndesmosis Related to Lower Extremity Joint Dynamics and Neuromuscular Coordination on Drop Landing During the Menstrual Cycle.

    Science.gov (United States)

    Okazaki, Michie; Kaneko, Masaaki; Ishida, Yukisato; Murase, Norio; Katsumura, Toshihito

    2017-09-01

    Many injuries of the lower extremities, especially the knee and ankle, occur during sports activity, and the incidence rate is higher in women than in men. The hypothesis was that phases of the menstrual cycle affect the width of the tibiofibular syndesmosis during drop landing in healthy young women and that such changes at the tibiofibular joint also affect the dynamics and neuromuscular coordination of the lower extremities. Descriptive laboratory study. Participants included 28 healthy young women (mean age, 21.0 ± 0.8 years). Blood samples were collected to determine plasma levels of estradiol and progesterone immediately before the performance of the task: drop landing on a single leg from a 30-cm platform. Using ultrasonography, the distance between the tibia and the distal end of the fibula, regarded as the width of the tibiofibular syndesmosis, was measured in an upright position without flexion of the ankle. The peak ground-reaction force (GRF) on landing was measured using a force platform. The time to peak GRF (Tp-GRF) was measured as the time from initial ground contact to the peak GRF. Hip, knee, and ankle joint angles during the single-leg landing were calculated using a 3-dimensional motion analysis system. Muscle activities of the lower extremities were measured using surface electromyography. The width of the tibiofibular syndesmosis was significantly greater in the luteal phase when compared with the menstrual, follicular, and ovulation phases (by 5%-8% of control). Also, during the luteal phase, the Tp-GRF was significantly shorter than in the follicular phase (by 6%); hip internal rotation and knee valgus were significantly greater than in the menstrual phase (by 43% and 34%, respectively); knee flexion was significantly less than in the menstrual and follicular phases (by 7%-9%); ankle dorsiflection was significantly less than in the follicular phase (by 11%); ankle adduction and eversion were significantly greater than in the menstrual and

  13. Anterior-inferior tibiofibular ligament anatomical repair and augmentation versus trans-syndesmosis screw fixation for the syndesmotic instability in external-rotation type ankle fracture with posterior malleolus involvement: A prospective and comparative study.

    Science.gov (United States)

    Zhan, Yu; Yan, Xiaoyu; Xia, Ronggang; Cheng, Tao; Luo, Congfeng

    2016-07-01

    Syndesmosis injury is common in external-rotation type ankle fractures (ERAF). Trans-syndesmosis screw fixation, the gold-standard treatment, is currently controversial for its complications and biomechanical disadvantages. The purpose of this study was to introduce a new method of anatomically repairing the anterior-inferior tibiofibular ligament (AITFL) and augmentation with anchor rope system to treat the syndesmotic instability in ERAF with posterior malleolus involvement and to compare its clinical outcomes with that of trans-syndesmosis screw fixation. 53 ERAFs with posterior malleolus involvement received surgery, and the syndesmosis was still unstable after fracture fixation. They were randomised into screw fixation group and AITFL anatomical repair with augmentation group. Reduction quality, syndesmosis diastasis recurrence, pain (VAS score), time back to work, Olerud-Molander ankle score and range of motion (ROM) of ankle were investigated. Olerud-Molander score in AITFL repair group and screw group was 90.4 and 85.8 at 12-month follow-up (P>0.05). Plantar flexion was 31.2° and 34.3° in repair and screw groups (P=0.04). Mal-reduction happened in 5 cases (19.2%) in screw group while 2 cases (7.4%) in repair group. Postoperative syndesmosis re-diastasis occurred in 3 cases in screw group while zero in repair group (P>0.05). Pain score was similar between the two groups (P>0.05). Overall complication rate and back to work time were 26.9% and 3.7% (P=0.04), 7.15 months and 5.26 months (P=0.02) in screw group and repair group, respectively. For syndesmotic instability in ERAF with posterior malleolus involvement, the method of AITFL anatomical repair and augmentation with anchor rope system had an equivalent functional outcome and reduction, earlier rehabilitation and less complication compared with screw fixation. It can be selected as an alternative. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. THE FEATURES OF TIBIOFIBULAR INJURY IN PATENTS WITH ANKLE FRACTURES

    Directory of Open Access Journals (Sweden)

    N. F. Fomin

    2010-01-01

    Full Text Available The role of interposition of soft tissues into tibiofibular syndesmosis is analyzed as a cause of unsatisfactory outcomes in the ankle joint pronation fracture treatment. The study is based on clinical (452 patients and experimental material (36 experiments including unfixed anatomic objects. The elevator for minimal invasive operative elimination of interposition of stumps of distal tibiofibular syndesmosis anterior and posterior ligaments is developed and tested.

  15. Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kotwal, Rahul [Princess of Wales Hospital, Bridgend (United Kingdom); Rath, Narendra [Royal Gwent Hospital, Newport (United Kingdom); Paringe, Vishal; Hemmadi, Sandeep; Thomas, Rhys; Lyons, Kath [University Hospital of Wales, Cardiff (United Kingdom)

    2016-03-15

    To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery. After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %). Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified. (orig.)

  16. Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

    International Nuclear Information System (INIS)

    Kotwal, Rahul; Rath, Narendra; Paringe, Vishal; Hemmadi, Sandeep; Thomas, Rhys; Lyons, Kath

    2016-01-01

    To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery. After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %). Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified. (orig.)

  17. Strain Distribution in the Anterior Inferior Tibiofibular Ligament, Posterior Inferior Tibiofibular Ligament, and Interosseous Membrane Using Digital Image Correlation.

    Science.gov (United States)

    Xu, Daorong; Wang, Yibei; Jiang, Chunyu; Fu, Maoqing; Li, Shiqi; Qian, Lei; Sun, Peidong; Ouyang, Jun

    2018-05-01

    Ligament repair and augmentation techniques can stabilize syndesmosis injuries. However, little is known about the mechanical behavior of syndesmotic ligaments. The aim of this study was to analyze full-field strain, strain trend under foot rotation, and subregional strain differences of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM). Eleven fresh-frozen lower limbs were dissected to expose the AITFL, PITFL, and IOM. The foot underwent rotation from 0° to 25° internal and 35° external, with 3 ankle positions (neutral, 15° dorsiflexion, and 25° plantarflexion) and a vertical load of 430 N. Ligament strain was recorded using digital image correlation. The mean strain on the AITFL with 35° external rotation was greater in the proximal portion compared with distal portion in the neutral position ( P = .009) and dorsiflexion ( P = .003). The mean strain in the tibial insertion and midsubstance near tibial insertion were greater when compared with other regions ( P = .018 and P = .009). The subregions of mean strain in the PITFL and IOM groups were not significantly different. The strain trend of AITFL, PITFL, and IOM showed common transformation, just when the foot was externally rotated. The findings of this study show that a significantly high strain was observed on the proximal part and the midsubstance near the Chaput tubercle of the AITFL when the ankle was externally rotated. All 3 ligaments resisted the torque in the syndesmosis by external rotation of the foot. This study allows for better understanding of the mechanical behavior of the syndesmosis ligaments, which could influence the repair technique and AITFL augmentation techniques.

  18. Incidence and clinical relevance of tibiofibular synostosis in fractures of the ankle which have been treated surgically.

    Science.gov (United States)

    Droog, R; Verhage, S M; Hoogendoorn, J M

    2015-07-01

    In this retrospective cohort study, we analysed the incidence and functional outcome of a distal tibiofibular synostosis. Patients with an isolated AO type 44-B or C fracture of the ankle who underwent surgical treatment between 1995 and 2007 were invited for clinical and radiological review. The American Orthopaedic Foot and Ankle Society score, the American Academy of Orthopaedic Surgeons score and a visual analogue score for pain were used to assess outcome. A total of 274 patients were available; the mean follow-up was 9.7 years (8 to 18). The extent of any calcification or synostosis at the level of the distal interosseous membrane or syndesmosis on the contemporary radiographs was defined as: no or minor calcifications (group 1), severe calcification (group 2), or complete synostosis (group 3). A total of 222 (81%) patients were in group 1, 37 (14%) in group 2 and 15 (5%) in group 3. There was no significant difference in incidence between AO type 44-B and type 44-C fractures (p = 0.89). Severe calcification or synostosis occurred in 21 patients (19%) in whom a syndesmotic screw was used and in 31 (19%) in whom a syndesmotic screw was not used.(p = 0.70). No significant differences were found between the groups except for a greater reduction in mean dorsiflexion in group 2 (p = 0.004). This is the largest study on distal tibiofibular synostosis, and we found that a synostosis is a frequent complication of surgery for a fracture of the ankle. Although it theoretically impairs the range of movement of the ankle, it did not affect the outcome. Our findings suggest that synostosis of the distal tibiofibular syndesmosis in general does not warrant treatment. ©2015 The British Editorial Society of Bone & Joint Surgery.

  19. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  20. The use of autologous concentrated growth factors to promote syndesmosis fusion in the Agility total ankle replacement. A preliminary study.

    Science.gov (United States)

    Coetzee, J Chris; Pomeroy, Gregory C; Watts, J David; Barrow, Craig

    2005-10-01

    The Agility (DePuy, Warsaw, Indiana) total ankle replacement has been in use since 1984. One of the most common complications continues to be delayed union or nonunions of the distal tibiofibular syndesmosis. In the reported studies on the Agility ankle the delayed union and nonunion rate can be as high as 38%. Since 1999, 114 Agility total ankle replacements were done at two centers in the United States without the use of autologous concentrated growth factors. Since July of 2001, 66 Agility ankles were implanted with Symphony (DePuy, Warsaw, Indiana) augmented bone grafting. The standard operative technique was followed in all the patients. Prospective data was collected on all patients. The standard ankle radiographs were taken preoperatively and postoperative at 8 weeks, 12 weeks, 16 weeks, 6 months, and yearly. CT scans were obtained at 6 months if fusion at the syndesmosis was questionable. The Graphpad Instat software (Graphpad Software Inc., San Diego, CA) was used for statistical analysis. The two-tailed unpaired t-test was used, and the value ankle replacements without autologous concentrated growth factors 70 fused at 8 weeks (61%), 14 fused at 12 weeks (12%), 13 fused at 6 months (12%). There were 17 nonunions (15%); delayed unions (3 to 6 months) and nonunions, therefore, equaled 27%. The syndesmosis fused in 50 of the 66 ankle replacements (76%) that had autologous concentrated growth fractures at 8 weeks (76%); 12 fused at 3 months (18%), 2 fused at 6 months (3%), 2 had nonunions (3%). Delayed unions (3 to 6 months) and nonunions equaled 6%. There was a statistically significant improvement in the 8- and 12-week fusion rates, and a statistically significant reduction in delayed unions and nonunions. Autologous concentrated growth factors appear to make a significant positive difference in the syndesmosis union rate in total ankle replacements.

  1. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung [Tuen Mun Hospital, Department of Radiology, Tuen Mun (China); Yeung, Yuk Nam [Tune Mun Hospital, Department of Orthopaedics and Traumatology, Tuen Mun (China)

    2015-06-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  2. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    International Nuclear Information System (INIS)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung; Yeung, Yuk Nam

    2015-01-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  3. Proximal tibiofibular dislocation: a case report and review of literature

    NARCIS (Netherlands)

    Nieuwe Weme, R. A.; Somford, M. P.; Schepers, T.

    2014-01-01

    An isolated dislocation of the proximal tibiofibular joint is uncommon. The mechanism of this injury is usually sports related. We present a case where initial X-rays did not show the tibiofibular joint dislocation conclusively. It was diagnosed after comparative bilateral AP X-rays of the knees

  4. Adsorption of diastase over natural halloysite nanotubes (HNTs)

    Science.gov (United States)

    Twaiq, F.; Chang, K. X.; Ling, J. Y. W.

    2017-06-01

    Adsorption of diastase over natural halloysite nanotubes is studied in order to evaluate the adsorption capacity of diastase. The halloysite surface characteristics were assessed using nitrogen adsorption, x-ray diffraction (XRD), thermal gravimetric analysis (TGA) and Fourier transformed infrared (FTIR). The surface area of the natural halloysite is found to be 51 m2·g-1, with total pore volume of 0.106 cm3·g-1. The natural halloysite has a basal spacing (d001) of 10 Å confirming the structure of the natural halloysite material. TGA results indicated that halloysite loses its interlayer water in the range of 30 to 105 °C and the dehydration in the structural layer above 150 °C. The dehydroxylation of halloysite has occurred at approximately 460 °C. The FTIR result of the thermally treated halloysite sample indicated that the bands observed are assigned to Si-O and Al-O bonds. The effects of solution pH and temperature were studied on the adsorption capacity and percent removal of diastase from the solution. The adsorption kinetic found to fit well with both the Pseudo first-order and Pseudo second-order models, and the values of the kinetic constant were found to be 0.173 min-1 and 0.00018 g·mg-1·min-1 respectively. The Langmuir isotherm model is found to fit well to the adsorption data and a kinetic value is found to be 0.00059 m3·g-1. The maximum adsorption capacity was found to be 370 mg·g-1, indicating the potential for applications of the natural nanostructured halloysite material as an effective adsorbent for diastase.

  5. Monitoring recovery following syndesmosis sprain: a case report.

    Science.gov (United States)

    Spaulding, S J

    1995-10-01

    A sprain to the tibial-fibular syndesmosis often results in prolonged rehabilitation or surgical intervention before recovery occurs. This paper documents gait recovery both before and after surgery for a syndesmosis sprain. Ground reaction force (GRF) data were available before injury and before surgery. Data were also collected every 3 days from 4 days to 4 months after syndesmosis screw removal (8 weeks after surgery). Weightbearing during the stance phase of gait did not approach normal values until approximately 4 months after syndesmosis screw removal. The push-off phase of gait also was slow to recover. When it was possible for the subject to use one or two crutches, differences in GRF were evident, such that walking with one crutch demonstrated increased force production at the ground. Bracing the ankle with a semirigid brace increased GRF, whereas a boot-type lace-up brace resulted in decreased GRF. In this case report of a combined ankle and syndesmosis sprain, results suggest the weightbearing and push-off force were seriously compromised. Decreasing the number of walking assistive devices and wearing a semirigid ankle brace increased the amount of weightbearing through the affected leg and may have merit in encouraging muscle function.

  6. Syndesmosis and deltoid ligament injuries in the athlete

    NARCIS (Netherlands)

    McCollum, Graham A.; van den Bekerom, Michel P. J.; Kerkhoffs, Gino M. M. J.; Calder, James D. F.; van Dijk, C. Niek

    2013-01-01

    Injury to the syndesmosis and deltoid ligament is less common than lateral ligament trauma but can lead to significant time away from sport and prolonged rehabilitation. This literature review will discuss both syndesmotic and deltoid ligament injuries without fracture in the professional athlete. A

  7. Environment friendly approach for size controllable synthesis of biocompatible Silver nanoparticles using diastase.

    Science.gov (United States)

    Maddinedi, Sireesh Babu; Mandal, Badal Kumar; Anna, Kiran Kumar

    2017-01-01

    A green, facile method for the size selective synthesis of silver nanoparticles (AgNPs) using diastase as green reducing and stabilizing agent is reported. The thiol groups present in the diastase are mainly responsible for the rapid reaction rate of silver nanoparticles synthesis. The variation in the size and morphology of AgNPs were studied by changing the pH of diastase. The prepared silver nanoparticles were characterized by using UV-vis, XRD, FTIR, TEM and SAED. The FTIR analysis revealed the stabilization of diastase molecules on the surface of AgNPs. Additionally, in-vitro cytotoxicity experiments concluded that the cytotoxicity of the as-synthesized AgNPs towards mouse fibroblast (3T3) cell lines is dose and size dependent. Furthermore, the present method is an alternative to the traditional chemical methods of size controlled AgNPs synthesis. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Distal tibiofibular synostosis in a Nigerian: A case report | Owoeye ...

    African Journals Online (AJOL)

    X-ray of the bones showed an oblique fracture in the distal end of the shaft of fibula which is suggestive of post traumatic tibiofibular synostosis (TFS). Knowledge of distal TFS is important in resolving the puzzle of chronic shin pain of unknown origin and in accurate diagnosis of causes of ankle deformity and malformations.

  9. Fixation orientation in ankle fractures with syndesmosis injury.

    Science.gov (United States)

    Nimick, Craig J; Collman, David R; Lagaay, Pieter

    2013-01-01

    Accurate reduction of the syndesmosis has been shown to be an important prognostic factor for functional outcome in ankle injuries that disrupt the syndesmosis. The purpose of the present case series was to assess the fixation orientation and the position of the fibula within the tibial incisura after open reduction and internal fixation of ankle fractures with syndesmosis injury. Computed tomography was used to assess the accuracy of the reduction. Twelve patients were included in the present case series. A ratio representing the relationship between the tibia and fibula and the orientation of the syndesmotic fixation was measured preoperatively and postoperatively and compared with the uninjured contralateral ankle, representing the patient's normal anatomy. The measurements were accomplished electronically to one tenth of 1 mm using Stentor Intelligent Informatics, I-site, version 3.3.1 (Phillips Electronics; Andover, MA). Posteriorly oriented syndesmotic fixation caused posterior translation of the fibula with respect to the tibia and anteriorly oriented syndesmotic fixation caused anterior translation. Copyright © 2013. Published by Elsevier Inc.

  10. Quality of Water Content, Diastase Enzyme Activity and Hidroximetilfurfural (HMF in Rubber and Rambutan Honey

    Directory of Open Access Journals (Sweden)

    Sulis Setio Toto Harjo

    2017-03-01

    Full Text Available The purpose of this research was to determine the water content, diastase enzyme activity and HMF of the rubber and rambutan honey. The method was a laboratory experiments with statistical analysis unpaired student t-test by two treatments and fifteen replications. The variable of this research were water content, diastase enzyme activity and HMF. The results of rubber and rambutan honey showed that there were significant difference effect (P0.05 that is 11 DN and there is a highly significant difference (P<0.01 on the HMF content of 17.23±0.54 mg/kg and 7.61±0.23 mg/kg. Rubber and rambutan honey have good quality based on the water content, diastase enzyme activity and HMF. It was concluded that the rubber and rambutan honey used were of good quality because it has met the requirements of SNI.

  11. Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification.

    LENUS (Irish Health Repository)

    Naqvi, Gohar A

    2012-06-01

    Ankle syndesmotic injuries are complex and require anatomic reduction and fixation. Tightrope fixation is a relatively new technique and we present the largest series of syndesmosis fixation using Arthrex Tightrope™ (Naples, FL, USA).

  12. Does distal tibiofibular joint mobilization decrease limitation of ankle dorsiflexion?

    Science.gov (United States)

    Fujii, Misaki; Suzuki, Daisuke; Uchiyama, Eiichi; Muraki, Takayuki; Teramoto, Atsushi; Aoki, Mitsuhiro; Miyamoto, Shigenori

    2010-02-01

    Limitation of ankle motion is in many cases treated by joint mobilization (JM), a kind of manual physical therapy technique. Until now, the JM approach has mainly focused on the talocrural joint, with less attention to the distal tibiofibular joint. We applied cyclic loading to the lateral malleolus as in JM in order to clarify the relationship between the dorsiflexion angle and the excursion of the lateral malleolus. Seven normal, fresh-frozen cadaver legs were used. To each specimen, cyclic loading with a 30N force was applied 1000 times to the lateral malleolus at a speed of 15N/s. The displacement of the lateral malleolus was measured with a magnetic tracking system. The maximum dorsiflexion angle was measured before and after cyclic loading. After the first 100 and 1000 times of cyclic loading, the tibia was displaced 0.44+/-0.30mm and 0.75+/-0.36mm, respectively, and the fibula was displaced 0.44+/-0.28mm and 0.92+/-0.39mm, respectively. The average dorsiflexion angle increased from 14.36+/-7.51 degrees to 16.74+/-7.21 degrees after cyclic loading (Pankle dorsiflexion. These results suggest that tibiofibular JM would be effective for limitation of ankle dorsiflexion.

  13. Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury

    Energy Technology Data Exchange (ETDEWEB)

    Porrino, Jack A. [University of Washington, Department of Radiology, 4245 Roosevelt Way NE, Box 354755, Seattle, WA (United States)

    2015-08-15

    Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee. (orig.)

  14. Disruption of the proximal tibiofibular joint in the setting of multi-ligament knee injury

    International Nuclear Information System (INIS)

    Porrino, Jack A.

    2015-01-01

    Instability of the proximal tibiofibular joint is a relatively uncommon condition when in isolation; however, instability of the proximal tibiofibular joint is far more frequent in those presenting with a severe multi-ligament injury of the knee. If this joint is left unstable, repair of a co-existent injury of the posterolateral corner may fail, regardless of the proficiency of the technique. We present two patients with disruption of the proximal tibiofibular joint, including the MRI appearance, who initially presented to our hospital for management of significant polytrauma, as well as multi-ligament injury of the ipsilateral knee. (orig.)

  15. Stability-based classification for ankle fracture management and the syndesmosis injury in ankle fractures due to a supination external rotation mechanism of injury.

    Science.gov (United States)

    Pakarinen, Harri

    2012-12-01

    The aim of this thesis was to confirm the utility of stability-based ankle fracture classification in choosing between non-operative and operative treatment of ankle fractures, to determine how many ankle fractures are amenable to non-operative treatment, to assess the roles of the exploration and anatomical repair of the AITFL in the outcome of patients with SER ankle fractures, to establish the sensitivities, specificities and interobserver reliabilities of the hook and intraoperative stress tests for diagnosing syndesmosis instability in SER ankle fractures, and to determine whether transfixation of unstable syndesmosis is necessary in SER ankle fractures. The utility of stability based fracture classification to choose between non-operative and operative treatment was assessed in a retrospective study (1) of 253 ankle fractures in skeletally mature patients, 160 of whom were included in the study to obtain an epidemiological profile in a population of 130,000. Outcome was assessed after a minimum follow-up of two years. The role of AITFL repairs was assessed in a retrospective study (2) of 288 patients with Lauge-Hansen SE4 ankle fractures; the AITFL was explored and repaired in one group (n=165), and a similar operative method was used but the AITFL was not explored in another group (n=123). Outcome was measured with a minimum follow-up of two years. Interobserver reliability of clinical syndesomosis tests (study 3) and the role of syndesmosis transfixation (study 4) were assessed in a prospective study of 140 patients with Lauge-Hansen SE4 ankle fractures. The stability of the distal tibiofibular joint was evaluated by the hook and ER stress tests. Clinical tests were carried out by the main surgeon and assistant, separately, after which a 7.5-Nm standardized ER stress test for both ankles was performed; if it was positive, the patient was randomized to either syndesmosis transfixation (13 patients) or no fixation (11 patients) treatment groups. The

  16. REVISION ANKLE SYNDESMOSIS FIXATION - FUNCTIONAL OUTCOME AFTER TIGHTROPE ® FIXATION

    Directory of Open Access Journals (Sweden)

    Sendhilvelan Rajagopalan

    2016-07-01

    Full Text Available BACKGROUND Syndesmotic disruptions are often seen in ankle fractures. Malreduction of these fractures can result in arthritis and instability. A proportion of these patients with malreduction require revision fixation. This study presents the results of revision fixation in such patients, using the Ankle TightRope ® (Arthrex system. METHODS Between January 2000 to December 2009, 124 patients who underwent ankle fracture fixations with syndesmotic stabilisation were analysed. Out of 124 patients, 8 patients were diagnosed with failure of primary stabilisation (based on radiological and clinical criteria and subjected to revision fixation using the Ankle TightRope ® (Arthrex system. Followup was done at periodic time intervals of 3, 6 and 12 months. Both clinical and radiological assessment was performed. Complications and duration of hospital stay was recorded. Functional evaluation was performed using the American Orthopaedic Foot and Ankle Society (AOFAS scoring system. RESULTS Five patients had good results, one satisfactory and two had poor outcomes. CONCLUSIONS Ankle TightRope ® fixation is an alternative method of stabilisation in patients who require revision syndesmosis fixation. Further studies are required to evaluate this method of revision stabilisation as compared to screws.

  17. P-17: Profesyonel Futbolcuda Proksimal Tibiofibular Sindesmoz Yaralanması

    Directory of Open Access Journals (Sweden)

    Nevzad Denerel

    2017-03-01

    Full Text Available GİRİŞ: Tibia ve fibulayı birbirine bağlayan, interosseöz membran ve anterior, posterior tibiofibular bağlardan oluşan fibröz yapı "tibiofibular sindesmoz" olarak adlandırılır. Sindesmoz yaralanması dendiğinde genellikle, ayak bileği inversiyon torsiyonu sonrası meydana gelen üst ayak bileği yaralanmaları akla gelir. Literatür incelendiğinde tibiofibular dislokasyon olmaksızın proksimal sindesmoz bağ yaralanmasının oldukça ender rastlanan bir durum olduğu görülmektedir. Burada, Türkiye Süper Liginde mücadele eden profesyonel bir futbol oyuncusunda meydana gelmiş proksimal sindesmoz yaralanması sunulmaktadır.OLGU: 26 yaşında erkek futbol oyuncusu, maç sırasında rakibinin yaptığı müdahale sonucu oyuna devam edememiştir. İlk muayene neticesinde menisküs ve bağ testlerinin normal olduğu gözlenmiş ancak fibula başı düzeyinde ödem, palpasyon ile ağrı ve perküsyon ile tinel bulgusu saptanmıştır. Ayrıca fibula başının mobilitesinde artış olduğu gözlenmiştir. Sırasıyla bilateral diz grafisi, EMG, BT ve diz MRG tetkikleri yapılmıştır. EMG sonucunun normal olması ile superfisyal peroneal sinir yaralanması ekarte edilmiş olup görüntüleme tetkikleri neticesinde sol fibula başının sağa kıyasla posterolaterale deviye olduğu ancak disloke olmadığı, interosseöz membranda intensite değişiklikleri olduğu rapor edilmiştir. Sporcuya, fizik muayene ve radyolojik görüntüleme tetkikleri sonucunda "Proksimal Sindesmoz Sprain Evre-2" tanısı koyulmuş ve 4-6 hafta iyileşme süresi öngörülmüştür. Sporcu, rehabilitasyon süreci neticesinde 30 gün sonra takımla birlikte çalışmaya başlamıştır. TARTIŞMA: Klasik ortopedi ve spor hekimliği ders kitaplarında Proksimal tibiofibular eklem (PTFE yaralanmalarını açıklayacak spesifik klinik test ve radyolojik belirtilerle ilgili bilgi olmadığı görülmektedir. Bu nedenle oldukça ender görülen PTFE

  18. Modified technique of the treatment for proximal tibiofibular joint dislocation

    Directory of Open Access Journals (Sweden)

    Gvozdenović Nemanja

    2017-01-01

    Full Text Available Introduction. Dislocation of the proximal tibiofibular joint (PTFJ is a rare injury. The diagnosis requires an accurate history of the mechanism and symptoms of the injury, and adequate clinical and radiographic evaluation of both knees. In the literature there is no larger series, only several cases of PTFJ dislocation treated by different methods have been published so far. The aim of the study was to present a modified technique for the treatment of the unstable PTFJ that results in faster recovery of the patient. Case report. A 24-year-old football player was injured at the beginning of training; when tackling the ball he felt a sharp pain in his right knee. He was immediately brought to the Emergency Center of Vojvodina and diagnosed with anterolateral dislocation of the PTFJ. Close reduction in general anesthesia was tried but we failed and then open reduction and internal fixation (ORIF were performed with a single three cortical screw. We preferred not to immobilise the knee after the procedure and immediately employed passive and active exercises in the knee, without bearing weight to the injured leg. After 6 weeks we removed the screw and gave full weight support to the leg and continued physical treatment. Conclusion. In case of acute PTFJ dislocation, the first method of choice is closed reduction in sedation or general anesthesia. If closed reduction fails, ORIF must be performed. ORIF without immobilization and early start of physical therapy lead to the rapid return to sports activities

  19. EXTRACTION AND PHYSICO-CHEMICAL STUDIES OF DIASTASE-LIKE ENZYME FROM PIPER BETLE PETIOLES: PART 1

    Science.gov (United States)

    Ramasarma, G.V.S; Dutta, Sadhan Kumar

    1995-01-01

    Petioles of the plant piper betle-bengal variety have been subjected for extraction employing standard procedure and the crude extract obtained has been evaluated for its diastase like activity and other physico-chemical properties to investigate further its possible biological and pharmacological activities. PMID:22556729

  20. Proximal tibiofibular joint: Rendezvous with a forgotten articulation

    Directory of Open Access Journals (Sweden)

    Amitav Sarma

    2015-01-01

    Full Text Available The proximal tibiofibular joint (PTFJ is a plane type synovial joint. The primary function of the PTFJ is dissipation of torsional stresses applied at the ankle and the lateral tibial bending moments besides a very significant tensile, rather than compressive weight bearing. Though rare, early diagnosis and treatment of the PTFJ dislocation are essential to prevent chronic joint instability and extensive surgical intervention to restore normal PTFJ biomechanics, ankle and knee function, especially in athletes prone to such injuries. PTFJ dislocations often remain undiagnosed in polytrauma scenario with ipsilateral tibial fracture due to the absence of specific signs and symptoms of PTFJ injury. Standard orthopedic textbooks generally describe no specific tests or radiological signs for assessment of the integrity of this joint. The aim of this paper was to review the relevant clinical anatomy, biomechanics and traumatic pathology of PTFJ with its effect on the knee emphasizing the importance of early diagnosis through a high index of suspicion. Dislocation of the joint may have serious implications for the knee joint stability since fibular collateral ligament and posterolateral ligament complex is attached to the upper end of the fibula. Any high energy knee injury with peroneal nerve palsy should immediately raise the suspicion of PTFJ dislocation especially if the mechanism of injury involved knee twisting in flexion beyond 80° and in such cases a comparative radiograph of the contralateral side should be performed. Wider clinical awareness can avoid both embarrassingly extensive surgeries due to diagnostic delays or unnecessary overtreatment due to misinformation on the part of the treating surgeon.

  1. The management of acute distal tibio-fibular syndesmotic injuries: Results of a nationwide survey

    NARCIS (Netherlands)

    Schepers, Tim; van Zuuren, Wouter J.; van den Bekerom, Michel P. J.; Vogels, Lucas M. M.; van Lieshout, Esther M. M.

    2012-01-01

    Ankle fractures are one of the most frequently encountered musculoskeletal injuries, and 10% of patients have a concomitant distal tibiofibular syndesmotic disruption necessitating surgical repair. A national survey was conducted to gain more insight into the current approaches in the management of

  2. The lambda sign: a new radiographic indicator of latent syndesmosis instability.

    Science.gov (United States)

    Ryan, Ltc Paul; Hills, Maj Chad; Chang, James; Wilson, Cpt David

    2014-09-01

    Latent syndesmotic instability is a common cause of chronic ankle pain. The diagnosis is not readily apparent on static imaging as the fibula remains reduced. The hypothesis of this study was that a previously undescribed novel finding on coronal MRI (lambda sign) is an independent indicator of latent syndesmosis instability. We also report on the utility of classic radiographic and physical exam findings. A total of 23 patients with latent syndesmotic instability diagnosed via arthroscopy (group I) were compared to a cohort of 40 patients who were found to have a stable syndesmosis during arthroscopy for unrelated conditions (group II). A retrospective chart review was performed evaluating their clinical history, preoperative physical examination, and radiologic findings. The lambda sign is a high intensity signal seen on coronal MR imaging that resembles the Greek letter lambda. All of the physical exam findings tested were statistically significant. Pain at the syndesmosis had the highest sensitivity (83%), while pain reproduced with the proximal squeeze test resulted in the highest specificity (89%). The external rotation stress test had the highest positive predictive value (75%). Of the radiographic examinations performed, only the lambda sign was found to have statistical significance with a sensitivity of 75% and a specificity of 63%. The presence of a lambda sign on the MRI of patients with physical exam findings suggestive of syndesmotic pain was highly sensitive (75%) and specific (85%). The lambda sign noted on the coronal MRI was both sensitive and specific for injuries involving greater than 2 mm of diastasis on arthroscopic stress examination of the syndesmosis. While neither the lambda sign nor any other finding on physical or radiographic examination represented an independent predictor of syndesmotic instability, the presence of a lambda sign in concert with positive physical exam findings might help health care providers determine which patients

  3. The clinico-anatomic explanation for tibial intraneural ganglion cysts arising from the superior tibiofibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Spinner, Robert J. [Mayo Clinic, Department of Neurologic Surgery, Rochester, Minnesota (United States); Mayo Clinic, Department of Orthopedic Surgery, Rochester, Minnesota (United States); Mayo Clinic, Department of Anatomy, Rochester, Minnesota (United States); Mokhtarzadeh, Ali; Schiefer, Terry K. [Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Krishnan, Kartik G. [Carl Gustav Carus University Hospital, Department of Neurological Surgery, Dresden (Germany); Kliot, Michel [University of Washington, Department of Neurosurgery, Seattle, Washington (United States); Amrami, Kimberly K. [Mayo Clinic, Department of Radiology, Rochester, Minnesota (United States)

    2007-04-15

    To demonstrate that tibial intraneural ganglia in the popliteal fossa are derived from the posterior portion of the superior tibiofibular joint, in a mechanism similar to that of peroneal intraneural ganglia, which have recently been shown to arise from the anterior portion of the same joint. Retrospective clinical study and prospective anatomic study. The clinical records and MRI findings of three patients with tibial intraneural ganglion cysts were analyzed and compared with those of one patient with a tibial extraneural ganglion cyst and one volunteer. Seven cadaveric limbs were dissected to define the articular anatomy of the posterior aspect of the superior tibiofibular joint. The condition of the three patients with intraneural ganglia recurred because their joint connections were not identified initially. In two patients there was no cyst recurrence when the joint connection was treated at revision surgery; the third patient did not wish to undergo additional surgery. The one patient with an extraneural ganglion had the joint connection identified at initial assessment and had successful surgery addressing the cyst and the joint connection. Retrospective evaluation of the tibial intraneural ganglion cysts revealed stereotypic features, which allowed their accurate diagnosis and distinction from extraneural cases. The intraneural cysts had tubular (rather than globular) appearances. They derived from the postero-inferior portion of the superior tibiofibular joint and followed the expected course of the articular branch on the posterior surface of the popliteus muscle. The cysts then extended intra-epineurially into the parent tibial nerves, where they contained displaced nerve fascicles. The extraneural cyst extrinsically compressed the tibial nerve but did not directly involve it. All cadaveric specimens demonstrated a small single articular branch, which derived from the tibial nerve to the popliteus. The branch coursed obliquely across the posterior

  4. Instability of the proximal tibiofibular joint associated with total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Martin Bédard, MD, FRCSC

    2016-09-01

    Full Text Available To our knowledge, proximal tibiofibular joint instability has never been reported in a patient with a total knee arthroplasty (TKA. We present the case of a patient with anterolateral proximal tibiofibular joint instability associated with a complex primary TKA. In 2010, a male patient of 47 years was referred for TKA after posttraumatic osteoarthritis. The patient's history includes a fracture of the left lateral tibial plateau in 2008 and removal of osteosynthesis material in 2009. TKA with a lateral metal augment and intramedullary stem was performed in 2010. After TKA, instability of the left proximal tibiofibular joint (PTFJ was diagnosed. The patient underwent PTFJ arthrodesis and, at 5 years' follow-up, had no residual pain, with full range of motion. In this case, arthrodesis was the only possible surgical option because reconstruction surgeries require the establishment of bone tunnels in the tibia and fibula for the passage of a graft. Low bone quality and the use of an intramedullary stem with a metal augment in the tibia made any reconstruction technique unfeasible because the proximal tibia was obliterated. Although several PTFJ reconstruction techniques are available, they are difficult to apply to patients with a complex TKA.

  5. The use of Taka-diastase in a [3H]poly(A) hybridization assay of oligo(U) sequences in RNA

    International Nuclear Information System (INIS)

    De Herdt, E.; Kondo, M.; Slegers, H.

    1981-01-01

    A reliable assay for uridylate sequences longer than 10 is described. The procedure is based on the hybridization of [ 3 H]poly(A) with poly(U) or oligo(U) sequences in high ionic conditions and a subsequent degradation of single stranded polynucleotides with purified Taka-diastase. A 1:2 complex between poly(A) and poly(U) is formed on which one poly(U) strand is digested by Taka-diastase. The procedure is especially suitable for the detection and quantitation of Usub(n) (n > 10) in RNA preparations. (Auth.)

  6. MRI appearance of surgically proven abnormal accessory anterior-inferior tibiofibular ligament (Bassett's ligament)

    International Nuclear Information System (INIS)

    Subhas, Naveen; Vinson, Emily N.; Cothran, R.L.; Helms, Clyde A.; Santangelo, James R.; Nunley, James A.

    2008-01-01

    A thickened accessory anterior-inferior tibiofibular ligament (Bassett's ligament) of the ankle can be a cause of ankle impingement. Its imaging appearance is not well described. The purpose of this study was to determine if the ligament could be identified on magnetic resonance imaging (MRI), to determine associated abnormalities, and to determine if MRI could be used to differentiate normal from abnormal. Eighteen patients with a preoperative ankle MRI and an abnormal Bassett's ligament reported at surgery were found retrospectively. A separate cohort of 18 patients was selected as a control population. The presence of Bassett's ligament and its thickness were noted. The integrity and appearance of the lateral ankle ligaments, talar dome cartilage, and anterolateral gutter were also noted. In 34 of the 36 cases (94%), Bassett's ligament was identified on MRI. The ligament was seen in all three imaging planes and most frequently in the axial plane. The mean thickness of the ligament in the surgically abnormal cases was 2.37 mm, compared with 1.87 mm in the control with a p value = 0.015 (t test). Nine of the 18 abnormal cases (50%) had talar dome cartilage lesions as a result of contact with the ligament at surgery, with only 3 cases of high-grade defects seen on MRI. Fourteen of the 18 abnormal cases (78%) had of synovitis or scarring in the lateral gutter at surgery, with only 5 cases with scarring seen on MRI. The anterior-inferior tibiofibular ligament was abnormal or torn in 8 of the 18 abnormal cases (44%) by MRI and confirmed in only 3 cases at surgery. Bassett's ligament can be routinely identified on MRI and was significantly thicker in patients who had it resected at surgery. An abnormal Bassett's ligament is often present in the setting of a normal anterior-inferior tibiofibular ligament. The cartilage abnormalities and synovitis associated with an abnormal Bassett's ligament are poorly detected by conventional MRI. (orig.)

  7. Silver nanoparticle (AgNPs) doped gum acacia-gelatin-silica nanohybrid: an effective support for diastase immobilization.

    Science.gov (United States)

    Singh, Vandana; Ahmed, Shakeel

    2012-03-01

    An effective carrier matrix for diastase alpha amylase immobilization has been fabricated by gum acacia-gelatin dual templated polymerization of tetramethoxysilane. Silver nanoparticle (AgNp) doping to this hybrid could significantly enhance the shelf life of the impregnated enzyme while retaining its full bio-catalytic activity. The doped nanohybrid has been characterized as a thermally stable porous material which also showed multipeak photoluminescence under UV excitation. The immobilized diastase alpha amylase has been used to optimize the conditions for soluble starch hydrolysis in comparison to the free enzyme. The optimum pH for both immobilized and free enzyme hydrolysis was found to be same (pH=5), indicating that the immobilization made no major change in enzyme conformation. The immobilized enzyme showed good performance in wide temperature range (from 303 to 323 K), 323 K being the optimum value. The kinetic parameters for the immobilized, (K(m)=10.30 mg/mL, V(max)=4.36 μmol mL(-1)min(-1)) and free enzyme (K(m)=8.85 mg/mL, V(max)=2.81 μmol mL(-1)min(-1)) indicated that the immobilization improved the overall stability and catalytic property of the enzyme. The immobilized enzyme remained usable for repeated cycles and did not lose its activity even after 30 days storage at 40°C, while identically synthesized and stored silver undoped hybrid lost its ~31% activity in 48 h. Present study revealed the hybrids to be potentially useful for biomedical and optical applications. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. Excessively anterior placement of the fibular interfragmentary screw can result in a malreduced ankle syndesmosis – a technical report

    Directory of Open Access Journals (Sweden)

    S Mukhoapadhyay

    2009-12-01

    Full Text Available S Mukhoapadhyay1, A R Guha1, R Thomas1, A M Perera1, P Mullaney21Orthopaedic Foot and Ankle Unit, 2Department of Radiology, University Hospital of Wales, Cardiff, UKAbstract: The detection of often missed, syndesmotic injury in ankle fractures is important to reduce unacceptable clinical outcomes including possible future ankle arthritis. A case is presented in which the malpositioning of an interfragmentary screw has caused malreduction of syndesmosis.Keywords: syndesmotic injury, ankle fracture, arthritis

  9. [Osteosynthesis of Weber B ankle fractures using the one-third tubular plate and refixation of the syndesmosis].

    Science.gov (United States)

    Spering, C; Lesche, V; Dresing, K

    2015-08-01

    Anatomical reconstruction and recovery to complete range of function of the upper ankle joint. Therefore, the most stable but least invasive osteosynthesis is required to enable the patient early functional mobilization. Supination and pronation fracture with luxation mechanism of the upper ankle joint with or without rupture of the syndesmosis. Open fracture of the distal fibula including displaced and instable fractures. Severe peripheral arterial occlusive disease; contaminated open fractures (≥ 2nd degree); pediatric fractures with open epiphyseal plate. Supine position with ipsilateral slightly elevated hip and knee. Incision of about 8 cm length along the dorsal edge of the distal fibula. When reaching the lateral malleolus, a slight ventral angulation is necessary. Open reduction through this posterolateral approach. Secure the reposition using an interfragmentary lag screw and anatomically adjusted third tubular plate. Followed by a revision of the syndesmosis and transfixation using a tricortical position screw. Mobilization on day 1 after surgery with reduced weight-bearing when position screw is not applied; when position screw is implanted with ground contact for 6 weeks. Removal of position screw under local anesthesia after 6 weeks and pain-controlled full weight-bearing. Removal of metal after 1.5 years. Open reduction using the third tubular plate and an interfragmentary lag screw through a dorsolateral approach used in 90 % of all Weber B fractures in our clinic. Additional revision of a ruptured syndesmosis performed in 70 % and transfixation through a position screw in 40 %. Persisting instability in the upper ankle joint significantly reduced after surgical treatment compared to a conservative approach. Revisions necessary in 3.7 % of patients and pseudarthrosis diagnosed in 0.9 %. It has been shown that the preoperative x-ray and clinical examination is limited in detecting a ruptured syndesmosis.

  10. Intramuscular ganglia arising from the superior tibiofibular joint: CT and MR evaluation

    International Nuclear Information System (INIS)

    Bianchi, S.; Abdelwahab, I.F.; Kenan, S.; Zwass, A.; Ricci, G.; Palomba, G.

    1995-01-01

    To evaluate the role of magnetic resonance imaging (MRI) and computed tomography (CT) in the diagnosis of intramuscular ganglia (IMG) that arise from the superior tibiofibular joint (STFJ). Our series consisted of three men and three women. Four patients were studied by MRI, one by CT only, and two by both modalities. Contrast was used in one of the two patients studied by CT. MRI was obtained in at least two orthogonal planes to demonstrate the relation of the ganglia to STFJ. The MR and CT appearance of these ganglia was basically that of a well-defined soft tissue mass with low attenuation on CT images consistent with the presence of fluid. On MR studies, they had an isointense signal on T1-weighted images and a homogenous high-intensity signal on T2-weighted images. MRI demonstrated the attachment of these ganglia to the STFJ. CT and MRI were effective, noninvasive modalities in the evaluation of IMG. The imaging features on both modalities were consistent with the presence of fluid-containing lesions that had close proximity and were attached to the STFJ. The combination of location and the fluid consistency of these lesions facilitated the diagnosis. (orig.)

  11. In vitro activity of natural honey alone and in combination with curcuma starch against Rhodotorula mucilaginosa in correlation with bioactive compounds and diastase activity.

    Science.gov (United States)

    Ahmed, Moussa; Djebli, Noureddine; Aissat, Saad; Khiati, Baghdad; Meslem, Abdelmalek; Bacha, Salima

    2013-10-01

    To evaluate the in vitro activity and synergism of the combinations of natural honey and curcuma starch against Rhodotorula mucilaginosa in correlation with total phenolic, flavonoid contents, and diastase activity. The Folin-Ciocalteu test was used to determine the total polyphenols content and the flavonoid content was analyzed using by the aluminum chloride method. The antifungal activity of the natural honey, determined by an agar well diffusion assay and agar incorporation method. Total phenolic content varied from (63.930.11) to (95.366.08) mg GAE/100 g honey as gallic acid equivalent. Total flavonoids content varied from (5.41±0.04) to (9.94±0.54) mg CE/100 g. Diastase activity values were between (7.3±2.8) and (26±2.8). The zone inhibition diameter for the six honey samples without starch ranged between 6 and 20 mm. When starch was mixed with honey and then added to well, a zone inhibition increase diameter 7 and 21 mm. The percentage increase was noticed with each variety and it ranged between 5% and 62.5%. The minimal inhibitory concentrations for the six varieties of honey without starch against Rhodotorula mucilaginosa ranged between 28% and 36% (v/v). When starch was incubated with honey and then added to media, a minimal inhibitory concentration drop has been noticed with each variety. It ranged between 6.66 % and 20% (w/v). No significant correlation was established between diastase activity and bioactive compounds. The mixture of curcuma starch and honey could lead to the development of new combination antibiotics against Rhodotorula infections. Copyright © 2013 Asian Pacific Tropical Biomedical Magazine. Published by Elsevier B.V. All rights reserved.

  12. T2 Relaxation Time Mapping of Proximal Tibiofibular Cartilage by 3-Tesla Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Kwack, Kyu-Sung; Cho, Jae Hyun; Kim, Jun Man; Kim, Sun Yong; Min, Byoung-Hyun; Yoon, Seung-Hyun

    2009-01-01

    Background: The proximal tibiofibular joint (PTFJ) can be considered the fourth compartment of the knee joint. However, there have been no studies of the T2 values (T2 relaxation time) of PTFJ cartilage. Purpose: To assess the T2 values of PTFJ cartilage at 3T magnetic resonance imaging (MRI), and to show the clinical utility of T2 values of PTFJ cartilage for the diagnosis of osteoarthritis (OA). Material and Methods: 118 patients who had knee MR imaging and knee radiography were enrolled. MRI was performed using a 3T MRI scanner, and T2 maps were calculated from a sagittal multi-echo acquisition. Two regions of interest (ROIs) were positioned within PTFJ cartilage and medial femoral condyle (MFC) cartilage. The average T2 value and standard deviation (SD) of each ROI were recorded. Using PTFJ cartilage as a standard reference, the T2 index ((MFC/PTFJ)x100) and T2SD index ((MFCSD/PTFJSD)x100) were calculated. A paired t test was performed to compare the mean and SD of ROIs within PTFJ and MFC cartilage. Correlation analyses were performed among the parameters age, Kellgren-Lawrence (KL) score, means and SDs of ROIs within PTFJ and MFC cartilage, T2 index, and T2SD index. Results: PTFJ cartilage had a significantly shorter T2 value than did MFC cartilage (P<0.0001). ROIs within PTFJ cartilage showed significantly smaller SDs than did those within MFC cartilage (P<0.0001). The average T2 value and SD of MFC and the T2SD index showed a positive correlation to the KL score (P<0.05). The correlation coefficients for the average T2 value, SD, and T2SD index of MFC were R=0.203, 0.254, and 0.268, respectively. However, there was no significant correlation between T2 values of PTFJ cartilage and KL score (P=0.643). Conclusion: PTFJ cartilage showed shorter and more homogeneous T2 values with a small SD than did MFC cartilage, regardless of the degree of OA at femorotibial compartments. PTFJ cartilage may be a useful internal standard reference to diagnose OA and would be

  13. T2 Relaxation Time Mapping of Proximal Tibiofibular Cartilage by 3-Tesla Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kwack, Kyu-Sung; Cho, Jae Hyun; Kim, Jun Man; Kim, Sun Yong (Dept. of Radiology, Ajou Univ. Medical Center, Suwon (Korea)); Min, Byoung-Hyun; Yoon, Seung-Hyun (Cartilage Regeneration Center, Ajou Univ. Medical Center, Suwon (Korea))

    2009-11-15

    Background: The proximal tibiofibular joint (PTFJ) can be considered the fourth compartment of the knee joint. However, there have been no studies of the T2 values (T2 relaxation time) of PTFJ cartilage. Purpose: To assess the T2 values of PTFJ cartilage at 3T magnetic resonance imaging (MRI), and to show the clinical utility of T2 values of PTFJ cartilage for the diagnosis of osteoarthritis (OA). Material and Methods: 118 patients who had knee MR imaging and knee radiography were enrolled. MRI was performed using a 3T MRI scanner, and T2 maps were calculated from a sagittal multi-echo acquisition. Two regions of interest (ROIs) were positioned within PTFJ cartilage and medial femoral condyle (MFC) cartilage. The average T2 value and standard deviation (SD) of each ROI were recorded. Using PTFJ cartilage as a standard reference, the T2 index ((MFC/PTFJ)x100) and T2SD index ((MFCSD/PTFJSD)x100) were calculated. A paired t test was performed to compare the mean and SD of ROIs within PTFJ and MFC cartilage. Correlation analyses were performed among the parameters age, Kellgren-Lawrence (KL) score, means and SDs of ROIs within PTFJ and MFC cartilage, T2 index, and T2SD index. Results: PTFJ cartilage had a significantly shorter T2 value than did MFC cartilage (P<0.0001). ROIs within PTFJ cartilage showed significantly smaller SDs than did those within MFC cartilage (P<0.0001). The average T2 value and SD of MFC and the T2SD index showed a positive correlation to the KL score (P<0.05). The correlation coefficients for the average T2 value, SD, and T2SD index of MFC were R=0.203, 0.254, and 0.268, respectively. However, there was no significant correlation between T2 values of PTFJ cartilage and KL score (P=0.643). Conclusion: PTFJ cartilage showed shorter and more homogeneous T2 values with a small SD than did MFC cartilage, regardless of the degree of OA at femorotibial compartments. PTFJ cartilage may be a useful internal standard reference to diagnose OA and would be

  14. Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures.

    Science.gov (United States)

    Seyhan, Mustafa; Donmez, Ferdi; Mahirogullari, Mahir; Cakmak, Selami; Mutlu, Serhat; Guler, Olcay

    2015-07-01

    17 patients with ankle syndesmosic injury were treated with a 4.5mm single cortical screw fixation (passage of screw 4 cortices) and 15 patients were treated with single-level elastic fixation material. All patients were evaluated according to the AOFAS ankle and posterior foot scale at the third, sixth and twelfth months after the fixation. The ankle range of movement was recorded together with the healthy side. The Student's t test was used for statistical comparisons. No statistical significant difference was observed between the AOFAS scores (p>0.05). The range of dorsiflexion and plantar flexion motion of the elastic fixation group at the 6th and 12th months were significantly better compared to the screw fixation group (pankle syndesmosis injuries. The unnecessary need of a second surgical intervention for removal of the fixation material is another advantageous aspect of this method of fixation. Copyright © 2015. Published by Elsevier Ltd.

  15. Unique paradoxical atlantoaxial dislocation with C1-C2 facet diastases and isolated ligamentous injury to the craniovertebral junction without neurological deficits: A case report

    Directory of Open Access Journals (Sweden)

    Aniruddha Thekkatte Jagannatha

    2013-01-01

    Full Text Available Study design: Retrospective review of the case file. Objective: The primary objective was to report this rare case and discuss the mechanism of dislocation and technique of manual closed reduction of C1-C2 vertebrae in such scenarios. Summary of background data: Posterior atlantoaxial dislocation (AAD is extremely rare and a few cases have been reported in English literature. This young man sustained a high speed car accident and survived an extreme hyperextension injury to the craniovertebral junction (CVJ without any neurological deficits. On evaluation for neck pain he was noted with a dislocated odontoid lying in front of Atlas. There was C1-C2 facet diastases. No bony injury was noted at CVJ. Transverse axial ligament (TAL was intact. He underwent a successful awake reduction of the dislocation. The joint had to be manually distracted, realigned, and released under the guidance of fluoroscopy. This was followed by single stage C1-C2 Goel′s fusion with awake prone positioning. This patient was able to go back to work at the end of 3 months (GOS 5. Conclusions: This condition is extremely rare, can be carefully reduced manually under adequate neuromonitoring, and requires C1-C2 fusion in the same sitting.

  16. T1ρ and T2 mapping of the proximal tibiofibular joint in relation to aging and cartilage degeneration

    International Nuclear Information System (INIS)

    Hirose, Jun; Nishioka, Hiroaki; Nakamura, Eiichi; Oniki, Yasunari; Yamashita, Yasuyuki; Mizuta, Hiroshi

    2012-01-01

    Objective: To study the effects of aging and cartilage degeneration of the proximal tibiofibular- and femorotibial joint (PTFJ, FTJ) on the cartilage of the PTFJ using T 1 ρ and T 2 mapping. Materials and methods: We performed sagittal T 1 ρ and T 2 mapping of the PTFJ and FTJ on 55 subjects with knee disorders. We placed 3 regions of interest (ROIs) on images of the cartilage in the PTFJ, medial femoral condyle (MFC), and medial tibia plateau (MTP). Correlation analysis was performed for the T 1 ρ and T 2 values of each ROI and the patient age and the osteoarthritic grade of the PTFJ and FTJ. Results: The T 1 ρ and T 2 values of the PTFJ were affected neither by aging nor the osteoarthritic grade of the FTJ. Values of the FTJ normalized to PTFJ values were correlated with the osteoarthritic grade of the FTJ in the MFC (r = 0.851 and 0.779, respectively) and the MTP (r = 0.635 and 0.762, respectively). There was a significant difference in the T 1 ρ but not the T 2 value of the PTFJ and MFC between normal and mildly osteoarthritic cartilage of each joint. Conclusion: We document that the T 1 ρ and T 2 values of PTFJ cartilage were not affected by aging or cartilage degeneration in the FTJ. The T 1 ρ value of the PTFJ may represent a useful internal standard reference for evaluating early degeneration of the FTJ

  17. Arthrographic differential diagnosis between ruptures of the anterior talofibular ligament, the joint capsule and the anterior tibiofibular ligament

    International Nuclear Information System (INIS)

    Moppes, F.I. van; Hoogenband, C.R. van den; Meijer, F.

    1980-01-01

    Aus einem Studium der Literatur, chirurgischen Befunden und Untersuchungen an Leichen kann es als unwahrscheinlich angesehen werden, dass bei einer Fussverstauchung vom Inversionstyp ein Riss des vorderen tibiofibularen Ligraments haeufig zusammen mit einem Gelenkkapselriss und einem seitlichen Baenderriss auftritt. Entgegen der Beobachtung anderer Verfasser fanden wir, dass ein Riss des vorderen tibiofularen Ligaments in keiner Weise aus dem Vorhandensein oder Nichtvorhandensein folgender arthrographischer Befunde geschlossen werden konnte: a) kontrastfreie Zone, b) tibiofibularer Rezessus, oder c) beide zusammen. Ein Gelenkkapselriss kann angenommen werden, wenn Kontrastmittel aus dem Gelenk in das weiche Gewebe austritt, ohne unterhalb oder seitlich in den Aussenknoechel zu dringen. Ein Austritt des Kontrastmittels unterhalb und seitlich des Aussenknoechels deutet auf einen Riss des vorderen tabofibularen Ligaments hin. Die anatomischen Zusammenhaenge zwischen Bandverbindung, Gelenkkapsel, tibiofibularem Rezessus und dem vorderen talofibularen Ligament wurden an Leichen und waehrend der chirurgischen Eingriffe studiert. Ausbreitung des Kontrastmittels im weichen Gewebe wird wahrscheinlich bestimmt durch die Anordnung und Beschaedigung der Weichteile und durch die Groesse des entstandenen Haematoms und folgt dem Weg des kleinsten Widerstandes. (orig.) [de

  18. Use of a Hybrid Operating Room to Improve Reduction of Syndesmotic Injuries in Ankle Fractures: A Case Report.

    Science.gov (United States)

    Cancienne, Jourdan M; Crosen, Matelin P; Yarboro, Seth R

    2016-01-01

    Ankle fractures are one of the most common orthopedic injuries requiring operative treatment, and approximately 1 in 4 ankle fractures will have an associated distal tibiofibular syndesmosis disruption. Syndesmotic reduction is crucial to restoring ankle function and preventing the development of arthritis. The hybrid operating room provides 3-dimensional intraoperative imaging capabilities that can enable the surgeon to ensure the syndesmosis is appropriately reduced, particularly by comparing it with the contralateral ankle. By confirming the syndesmosis reduction intraoperatively, the risk of a return to the operating room for revision surgery is decreased. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Syndesmotic Malreduction after Ankle ORIF; Is Radiography Sufficient?

    Directory of Open Access Journals (Sweden)

    Alireza Manafi Rasi

    2013-12-01

    Full Text Available   Background: Ankle fractures, especially those resulting from external rotation mechanisms are associated with injury to the distal tibiofibular syndesmosis. Some authors have recommended performing CT scanning after open ankle surgery to evaluate the reduction of syndesmosis. In this current study, we aimed to investigate the sensitivity of plain radiography in diagnosing syndesmosis malreduction after open reduction and internal fixation (ORIF in patients with ankle fractures.   Methods: Thirty patients with ankle fractures participated in this prospective study. ORIFs were performed with respect to all of the technical guidelines shown in orthopedic literature for exact syndesmosis reduction, such as fibular length and proper settings. In the operating room, plain radiography was performed in anteroposterior, mortise and lateral views to assess whether syndesmosis was malreduced. If malreduction was detected, the patient was revised. As the gold standard, patients underwent postoperative bilateral CT scanning to investigate the syndesmosis reduction which was then compared to the healthy side. Finally, the sensitivity of plain radiography in the diagnosis of syndesmosis malreduction was determined by comparing this method to CT scanning. Results: In both of the methods we did not find any patient with syndesmosis malreduction. Hence, the sensitivity of plain radiography was determined 100%. Conclusion: Based on our findings, there is no need to perform CT scanning to evaluate syndesmosis reduction after ankle ORIF in patients with ankle fractures. Plain radiography is sufficient and has satisfactory sensitivity in these patients.

  20. Syndesmotic Malreduction after Ankle ORIF; Is Radiography Sufficient?

    Directory of Open Access Journals (Sweden)

    Alireza Manafi Rasi

    2013-12-01

    Full Text Available Background: Ankle fractures, especially those resulting from external rotation mechanisms are associated with injury to the distal tibiofibular syndesmosis. Some authors have recommended performing CT scanning after open ankle surgery to evaluate the reduction of syndesmosis. In this current study, we aimed to investigate the sensitivity of plain radiography in diagnosing syndesmosis malreduction after open reduction and internal fixation (ORIF in patients with ankle fractures.   Methods: Thirty patients with ankle fractures participated in this prospective study. ORIFs were performed with respect to all of the technical guidelines shown in orthopedic literature for exact syndesmosis reduction, such as fibular length and proper settings. In the operating room, plain radiography was performed in anteroposterior, mortise and lateral views to assess whether syndesmosis was malreduced. If malreduction was detected, the patient was revised. As the gold standard, patients underwent postoperative bilateral CT scanning to investigate the syndesmosis reduction which was then compared to the healthy side. Finally, the sensitivity of plain radiography in the diagnosis of syndesmosis malreduction was determined by comparing this method to CT scanning. Results: In both of the methods we did not find any patient with syndesmosis malreduction. Hence, the sensitivity of plain radiography was determined 100%. Conclusion: Based on our findings, there is no need to perform CT scanning to evaluate syndesmosis reduction after ankle ORIF in patients with ankle fractures. Plain radiography is sufficient and has satisfactory sensitivity in these patients.

  1. Is Fibular Fracture Displacement Consistent with Tibiotalar Displacement?

    NARCIS (Netherlands)

    van den Bekerom, Michel P. J.; van Dijk, C. Niek

    2010-01-01

    We believed open reduction with internal fixation is required for supination-external rotation ankle fractures located at the level of the distal tibiofibular syndesmosis (Lauge-Hanssen SER II and Weber B) with 2 mm or more fibular fracture displacement. The rationale for surgery for these ankle

  2. Evaluation of the syndesmotic-only fixation for Weber-C ankle fractures with syndesmotic injury.

    Science.gov (United States)

    Mohammed, R; Syed, S; Metikala, S; Ali, Sa

    2011-09-01

    With the length of the fibula restored and the syndesmosis reduced anatomically, internal fixation using a plating device may not be necessary for supra-syndesmotic fibular fractures combined with diastasis of inferior tibio-fibular joint. A retrospective observational study was performed in patients who had this injury pattern treated with syndesmosis-only fixation. 12 patients who had Weber type-C injury pattern were treated with syndesmosis only fixation. The treatment plan was followed only if the fibular length could be restored and if the syndesmosis could be anatomically reduced. Through a percutaneous or mini-open reduction and clamp stabilization of the syndesmosis, all but one patient had a single tricortical screw fixation across the syndesmosis. Patients were kept non-weight-bearing for 6 weeks, followed by screw removal at an average of 8 weeks. Outcomes were assessed using an objective ankle scoring system (Olerud and Molander scale) and by radiographic assessment of the ankle mortise. At a mean follow-up of 13 months, the functional outcome score was 75. Excellent to good outcomes were noted in 83% of the patients. Ankle mortise was reduced in all cases, and all but one fibular fracture united without loss of fixation. Six patients had more than one malleolar injury, needing either screw or anchor fixations. One patient had late diastasis after removal of the syndesmotic screw and underwent revision surgery with bone grafting of the fibula. This was probably due to early screw removal, before union of the fibular fracture had occurred. We recommend syndesmosis-only fixation as an effective treatment option for a combination of syndesmosis disruption and Weber type-C lateral malleolar fractures.

  3. Correlation between radiological assessment of acute ankle fractures and syndesmotic injury on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, J.J. [Radboud University Nijmegen Medical Center, Department of Radiology, P.O. Box 9101, Nijmegen (Netherlands); Wentink, N. [Atrium Medisch Centrum, Department of Surgery, PO Box 4446, Heerlen (Netherlands); Beumer, A.; Moonen, A.F.C.M. [Amphia Ziekenhuis Hospital, Department of Orthopaedics, PO Box 90158, Breda (Netherlands); Hop, W.C.J. [Erasmus University Medical Center Rotterdam, Department of Biostatistics, PO Box 2040, Rotterdam (Netherlands); Heijboer, M.P. [Erasmus University Medical Center Rotterdam, Department of Orthopaedics, PO Box 2040, Rotterdam (Netherlands); Ginai, A.Z. [Erasmus University Medical Center Rotterdam, Department of Radiology, PO Box 2040, Rotterdam (Netherlands)

    2012-07-15

    Owing to the shortcomings of clinical examination and radiographs, injury to the syndesmotic ligaments is often misdiagnosed. When there is no indication requiring that the fractured ankle be operated on, the syndesmosis is not tested intra-operatively, and rupture of this ligamentous complex may be missed. Subsequently the patient is not treated properly leading to chronic complaints such as instability, pain, and swelling. We evaluated three fracture classification methods and radiographic measurements with respect to syndesmotic injury. Prospectively the radiographs of 51 consecutive ankle fractures were classified according to Weber, AO-Mueller, and Lauge-Hansen. Both the fracture type and additional measurements of the tibiofibular clear space (TFCS), tibiofibular overlap (TFO), medial clear space (MCS), and superior clear space (SCS) were used to assess syndesmotic injury. MRI, as standard of reference, was performed to evaluate the integrity of the distal tibiofibular syndesmosis. The sensitivity and specificity for detection of syndesmotic injury with radiography were compared to MRI. The Weber and AO-Mueller fracture classification system, in combination with additional measurements, detected syndesmotic injury with a sensitivity of 47% and a specificity of 100%, and Lauge-Hansen with both a sensitivity and a specificity of 92%. TFCS and TFO did not correlate with syndesmotic injury, and a widened MCS did not correlate with deltoid ligament injury. Syndesmotic injury as predicted by the Lauge-Hansen fracture classification correlated well with MRI findings. With MRI the extent of syndesmotic injury and therefore fracture stage can be assessed more accurately compared to radiographs. (orig.)

  4. Ankle Joint Contact Loads and Displacement With Progressive Syndesmotic Injury.

    Science.gov (United States)

    Hunt, Kenneth J; Goeb, Yannick; Behn, Anthony W; Criswell, Braden; Chou, Loretta

    2015-09-01

    Ligamentous injuries to the distal tibiofibular syndesmosis are predictive of long-term ankle dysfunction. Mild and moderate syndesmotic injuries are difficult to stratify, and the impact of syndesmosis injury on the magnitude and distribution of forces within the ankle joint during athletic activities is unknown. Eight below-knee cadaveric specimens were tested in the intact state and after sequential sectioning of the following ligaments: anterior-inferior tibiofibular, anterior deltoid (1 cm), interosseous/transverse (IOL/TL), posterior-inferior tibiofibular, and whole deltoid. In each condition, specimens were loaded in axial compression to 700 N and then externally rotated to 20 N·m torque. During axial loading and external rotation, both the fibula and the talus rotated significantly after each ligament sectioning as compared to the intact condition. After IOL/TL release, a significant increase in posterior translation of the fibula was observed, although no syndesmotic widening was observed. Mean tibiotalar contact pressure increased significantly after IOL/TL release, and the center of pressure shifted posterolaterally, relative to more stable conditions, after IOL/TL release. There were significant increases in mean contact pressure and peak pressure along with a reduction in contact area with axial loading and external rotation as compared to axial loading alone for all 5 conditions. Significant increases in tibiotalar contact pressures occur when external rotation stresses are added to axial loading. Moderate and severe injuries are associated with a significant increase in mean contact pressure combined with a shift in the center of pressure and rotation of the fibula and talus. Considerable changes in ankle joint kinematics and contact mechanics may explain why moderate syndesmosis injuries take longer to heal and are more likely to develop long-term dysfunction and, potentially, ankle arthritis. © The Author(s) 2015.

  5. Imaging in syndesmotic injury: a systematic literature review.

    Science.gov (United States)

    Krähenbühl, Nicola; Weinberg, Maxwell W; Davidson, Nathan P; Mills, Megan K; Hintermann, Beat; Saltzman, Charles L; Barg, Alexej

    2018-05-01

    To give a systematic overview of current diagnostic imaging options for assessment of the distal tibio-fibular syndesmosis. A systematic literature search across the following sources was performed: PubMed, ScienceDirect, Google Scholar, and SpringerLink. Forty-two articles were included and subdivided into three groups: group one consists of studies using conventional radiographs (22 articles), group two includes studies using computed tomography (CT) scans (15 articles), and group three comprises studies using magnet resonance imaging (MRI, 9 articles).The following data were extracted: imaging modality, measurement method, number of participants and ankles included, average age of participants, sensitivity, specificity, and accuracy of the measurement technique. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the methodological quality. The three most common techniques used for assessment of the syndesmosis in conventional radiographs are the tibio-fibular clear space (TFCS), the tibio-fibular overlap (TFO), and the medial clear space (MCS). Regarding CT scans, the tibio-fibular width (axial images) was most commonly used. Most of the MRI studies used direct assessment of syndesmotic integrity. Overall, the included studies show low probability of bias and are applicable in daily practice. Conventional radiographs cannot predict syndesmotic injuries reliably. CT scans outperform plain radiographs in detecting syndesmotic mal-reduction. Additionally, the syndesmotic interval can be assessed in greater detail by CT. MRI measurements achieve a sensitivity and specificity of nearly 100%; however, correlating MRI findings with patients' complaints is difficult, and utility with subtle syndesmotic instability needs further investigation. Overall, the methodological quality of these studies was satisfactory.

  6. False negative rate of syndesmotic injury in pronation-external rotation stage IV ankle fractures

    Directory of Open Access Journals (Sweden)

    Kwang-Soon Song

    2013-01-01

    Full Text Available Background: To investigate false negative rate in the diagnosis of diastasis on initial static anteroposterior radiograph and reliability of intraoperative external rotational stress test for detection of concealed disruption of syndesmosis in pronation external rotation (PER stage IV (Lauge-Hansen ankle fractures. Materials and Methods: We prospectively studied 34 PER stage IV ankle fractures between September 2001 and September 2008. Twenty (59% patients show syndesmotic injury on initial anteroposterior radiographs. We performed an intraoperative external rotation stress test in other 14 patients with suspicious PER stage IV ankle fractures, which showed no defined syndesmotic injury on anteroposterior radiographs inspite of a medial malleolar fracture, an oblique fibular fracture above the syndesmosis and fracture of the posterior tubercle of the tibia. Results: All 14 fractures showed different degrees of tibiofibular clear space (TFCS and tibiofibular overlapping (TFO on the external rotation stress test radiograph compared to the initial plain anteroposterior radiograph. It is important to understand the fracture pattern characterstic of PER stage IV ankle fractures even though it appears normal on anteroposterior radiographs, it is to be confirmed for the concealed syndesmotic injury through a routine intraoperative external rotational stress radiograph.

  7. Stable Versus Unstable Grade II High Ankle Sprains: A Prospective Study Predicting the Need for Surgical Stabilization and Time to Return to Sports.

    Science.gov (United States)

    Calder, James D; Bamford, Richard; Petrie, Aviva; McCollum, Graham A

    2016-04-01

    To investigate grade II syndesmosis injuries in athletes and identify factors important in differentiating stable from dynamically unstable ankle sprains and those associated with a longer time to return to sports. Sixty-four athletes with an isolated syndesmosis injury (without fracture) were prospectively assessed, with a mean follow-up period of 37 months (range, 24 to 66 months). Those with an associated deltoid ligament injury or osteochondral lesion were included. Those whose injuries were considered stable (grade IIa) were treated conservatively with a boot and rehabilitation. Those whose injuries were clinically unstable underwent arthroscopy, and if instability was confirmed (grade IIb), the syndesmosis was stabilized. Clinical and magnetic resonance imaging assessments of injury to individual ligaments were recorded, along with time to return to play. A power analysis estimated that each group would need 28 patients. All athletes returned to the same level of professional sport. The 28 patients with grade IIa injuries returned at a mean of 45 days (range, 23 to 63 days) compared with 64 days (range, 27 to 104 days) for those with grade IIb injuries (P < .0001). There was a highly significant relationship between clinical and magnetic resonance imaging assessments of ligament injury (anterior tibiofibular ligament [ATFL], anterior-inferior tibiofibular ligament [AITFL], and deltoid ligament, P < .0001). Instability was 9.5 times as likely with a positive squeeze test and 11 times as likely with a deltoid injury. Combined injury to the anterior-inferior tibiofibular ligament and deltoid ligament was associated with a delay in return to sports. Concomitant injury to the ATFL indicated a different mechanism of injury-the syndesmosis is less likely to be unstable and is associated with an earlier return to sports. A positive squeeze test and injury to the ATFL and deltoid ligament are important factors in differentiating stable from dynamically unstable grade

  8. Evaluation of Transsyndesmotic Fixation and Primary Deltoid Ligament Repair in Ankle Fractures With Suspected Combined Deltoid Ligament Injury.

    Science.gov (United States)

    Wu, Kai; Lin, Jian; Huang, Jianhua; Wang, Qiugen

    2018-04-13

    The present prospective study examined the utility of the intraoperative tap test/technique for distal tibiofibular syndesmosis in the diagnosis of deltoid ligament rupture and compared the outcomes of transsyndesmotic fixation to deltoid ligament repair with suture anchor. This diagnostic technique was performed in 59 ankle fractures with suspected deltoid ligament injury. The width of the medial clear space of 59 cases was evaluated to assess the sensitivity and specificity. Those with deltoid ligament rupture were randomly assigned to 2 groups and treated with deltoid ligament repair with a suture anchor or with syndesmosis screw fixation. All the patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, short-form 36-item questionnaire (SF-36), and visual analog scale (VAS). The tap test was positive in 53 cases. However, surgical exploration demonstrated that 51 cases (86.4%) had a combined deltoid ligament injury and fracture. The sensitivity and specificity of the tap test was 100.0% and 75.0%, respectively. Finally, 26 cases (96.3%) in the syndesmosis screw group and 22 (91.7%) in the deltoid repair group were followed up. No statistically significant differences were found in the AOFAS ankle-hindfoot scale score, SF-36 score, or VAS score between the 2 groups. The malreduction rate in the syndesmosis screw group was 34.6% and that in the deltoid repair group was 9.09%. The tap test is an intraoperative diagnostic method to use to evaluate for deltoid ligament injury. Deltoid ligament repair with a suture anchor had good functional and radiologic outcomes comparable to those with syndesmotic screw fixation but has a lower malreduction rate. We did not encounter the issue of internal fixation failure or implant removal. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Plasma rich in growth factors (PRGF) as a treatment for high ankle sprain in elite athletes: a randomized control trial.

    Science.gov (United States)

    Laver, Lior; Carmont, Michael R; McConkey, Mark O; Palmanovich, Ezequiel; Yaacobi, Eyal; Mann, Gideon; Nyska, Meir; Kots, Eugene; Mei-Dan, Omer

    2015-11-01

    Syndesmotic sprains are uncommon injuries that require prolonged recovery. The influence of ultrasound-guided injections of platelet-rich plasma (PRP) into the injured antero-inferior tibio-fibular ligaments (AITFL) in athletes on return to play (RTP) and dynamic stability was studied. Sixteen elite athletes with AITFL tears were randomized to a treatment group receiving injections of PRP or to a control group. All patients followed an identical rehabilitation protocol and RTP criteria. Patients were prospectively evaluated for clinical ability to return to full activity and residual pain. Dynamic ultrasound examinations were performed at initial examination and at 6 weeks post-injury to demonstrate re-stabilization of the syndesmosis joint and correlation with subjective outcome. All patients presented with a tear to the AITFL with dynamic syndesmosis instability in dorsiflexion-external rotation, and larger neutral tibia-fibula distance on ultrasound. Early diagnosis and treatment lead to shorter RTP, with 40.8 (±8.9) and 59.6 (±12.0) days for the PRP and control groups, respectively (p = 0.006). Significantly less residual pain upon return to activity was found in the PRP group; five patients (62.5 %) in the control group returned to play with minor discomfort versus one patient in the treatment group (12.5 %). One patient in the control group had continuous pain and disability and subsequently underwent syndesmosis reconstruction. Athletes suffering from high ankle sprains benefit from ultrasound-guided PRP injections with a shorter RTP, re-stabilization of the syndesmosis joint and less long-term residual pain. II.

  10. Pylon fractures of the ankle: A distinct clinical and radiological entity

    International Nuclear Information System (INIS)

    Mainwaring, B.L.; Daffner, R.H.; Riemer, B.L.

    1987-01-01

    Pylon fractures are a distinct clinical and radiological entity that should not be confused with trimalleolar fractures. Radiographic and clinical comparison of 20 cases of each fracture type revealed definite distinguishing features. First, pylon fractures inevitably were associated with profound comminution of the distal tibia. The trimalleolar injury was associated with fractures of the medial, lateral, and posterior malleoli without comminution. Second, in contrast to timalleolar fractures, pylon fractures had intraarticular extension of at least one tibial fracture through the dome of the plafond. Third, 60% of all pylon fractures were associated with a fractured talus; the talus was intact in all trimalleolar fractures. Fourth, the distal tibiofibular syndesmosis was constant in the pylon fractures but was separated in all trimalleolar fractures

  11. [Surgical treatment of pronation and supination external rotation trimalleolar fractures].

    Science.gov (United States)

    Xu, Ye-qing; Zhan, Bei-lei; He, Fei-xiong; Wei, Hong-da

    2008-04-01

    To explore the operative method and its clinical effects of pronation and supination external rotation trimalleolar fractures. From March 2000 to July 2006,42 patients of the pronation and supination external rotation trimalleolar fractures treated with open reduction and internal fixation. Thirty-one were males and 11 were females,with an average age of 40.5 years (from 19 to 76 years). Four cases were open fractures and 38 cases close fractures. The fractures were classified as pronation-external rotation (grade IV) injury in 18 cases and supination-external rotation (grade IV)in 24 cases according to the system of Lauge-Hansen. The time of injury to operation was 2 hours to 27 days. The medial, lateral and posterior malleolus were exposed by standard anteromedial and Gatellier-Chastang approaches. The reduction and internal fixation started with the posterior,then the medial and the lateral malleolus and distal tibiofibular syndesmosis in sequence. The anteroposterior, lateral and mostise X-ray films were taken after operation. All the patients were followed up for an average time of 13.5 months(from 6 to 24 months). The time of union was from 12 to 16 weeks. The results were excellent in 20,good in 16, fair in 4 and poor in 2 cases according to Baird-Jackson ankle scoring system based on pain, stability, walking ability,range of motion and radiological manifestations. The excellent and good rate was 85.7%. There were no infection,malunion and nonunion of the fractures except that the inserted screw to distal tibiofibular syndesmosis was broken in 1 case. The key of operative treatment is to restore the anatomy of ankle and to regain the ankle function maximally.

  12. [ANALYSIS OF CLINICAL EFFECT IN SURGICAL TREATMENT OF Maisonneuve FRACTURE].

    Science.gov (United States)

    Zhang, Zhiwen; Cai, Xianhua; Wei, Shijun; Liu, Ximing

    2015-03-01

    To investigate the operative method and short-term effectiveness in the surgical treatment of Maisonneuve fracture. Between January 2010 and February 2013, 23 patients with Maisonneuve fracture were treated. There were 14 males and 9 females with an average age of 40.3 years (range, 30-68 years). The causes of injuries were falling injury in 11 patients, sports related injury in 5 patients, traffic accident injury in 4 patients, and falling injury from height in 3 patients. The interval between injury and operation was 7-10 days (mean, 8.5 days). All of fractures were closed. Three patients had combined injury of deltoid ligament. The surgical procedures included surgical reduction and fixation of medial malleolus fracture and posterior malleolus fracture, repair of the deltoid ligament with ground anchor suture, and fixation of the disrupted distal tibiofibular syndesmosis. All incisions achieved primary healing, no postoperative complications such as infection occurred. Twenty-one patients were followed up 24-36 months (mean, 26.5 months). No patients complained of pain, tenderness, and obvious swelling of the ankle. At 3-6 months (mean, 4.6 months) after operation, X-ray films showed bony union of fractures and normal mortises in 21 patients. And no traumatic arthritis was observed with reliable fixation. The range of motion of ankle dorsi flexion and plantar flexion was 30-40 degrees) (mean, 34.5 degrees) Baird-Jackson anide functional score was 85-100 (mean, 94); 16 cases were rated as excellent, 4 as good, and 1 as fair with an excellent and good rate of 95.2%. Surgical treatments of Maisonneuve fracture include surgical reduction and fixation of the medial malleolus and posterior malleolus, repair of the deltoid ligament and fixation of the disrupted distal tibiofibular syndesmosis, and good effectiveness can be achieved.

  13. Fate of the syndesmotic screw--Search for a prudent solution.

    Science.gov (United States)

    Kaftandziev, Igor; Spasov, Marko; Trpeski, Simon; Zafirova-Ivanovska, Beti; Bakota, Bore

    2015-11-01

    Ankle fractures are common injuries. Since the recognition of the importance of syndesmotic injury in ankle fractures, much of the scientific work has been focused on concomitant syndesmotic injury. Despite the invention of novel devices for restoration and maintenance of the congruent syndesmosis following syndesmotic injury, the metallic syndesmotic screw is still considered to be the "gold standard". The aim of this study was to compare the clinical results in patients who retained the syndesmosis screw with those in whom the screw was removed following open reduction and internal fixation of the malleolar fracture associated with syndesmosis disruption. This was a retrospective study of 82 patients. Minimum follow-up was 12 months. Clinical evaluation included American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analogue Scale (VAS) for patient general satisfaction. The condition of the screw (removed, intact or broken), presence of radiolucency around the syndesmotic screw and the tibiofibular clear space were recorded using final follow-up radiographs. Three cortices were engaged in 66 patients (80%) and quadricortical fixation was performed in the remaining 16 patients (20%). The number of engaged cortices did not correlate with the clinical outcome and screw fracture. A single syndesmotic screw was used in 71 patients (86%. The mean AOFAS score in the group with intact screw (I) was 83; the scores in the group with broken screw (B) and removed screw (R) were 92.5 and 85.5, respectively. There was a statistically significant difference between the three groups: this was due to the difference between groups I and B; the difference between groups I and R and groups B and R were not statistically significant. There were no statistically significant differences in VAS results. There were no statistically significant differences in clinical outcome between the group with the screw retained and the group in which the screw was removed; however, the

  14. The predictive value of MRI in the syndesmotic instability of ankle fracture

    Energy Technology Data Exchange (ETDEWEB)

    Park, Young Hwan; Choi, Won Seok; Kim, Hak Jun [Korea University Guro Hospital, Department of Orthopedic Surgery, Seoul (Korea, Republic of); Yoon, Min A.; Hong, Suk Joo [Korea University Guro Hospital, Department of Radiology, Seoul (Korea, Republic of); Choi, Gi Won [Korea University Ansan Hospital, Department of Orthopedic Surgery, Ansan (Korea, Republic of)

    2018-04-15

    Although many types of ankle fracture can be combined with syndesmosis injury, preoperative imaging studies rarely reveal instability of the syndesmosis. This study assessed the use of magnetic resonance imaging (MRI) for syndesmotic instability in patients with unstable ankle fracture. A total of 74 patients who were treated for Lauge-Hansen supination external rotation/Weber B type fracture or pronation external rotation/Weber C type fracture and who underwent MRI for preoperative assessment were enrolled. The MRI findings of the syndesmotic ligament and the results of an intraoperative stress test were evaluated. Twenty-six patients had a positive result on the intraoperative stress test for syndesmotic instability. The MRI findings of the syndesmotic ligaments revealed that complete tear of the posterior inferior tibiofibular ligament (PITFL) was the most reliable predictor of syndesmotic instability (sensitivity, 74%; specificity, 78%; positive predictive value, 54%). Interobserver agreement for the intraoperative stress test and MRI assessment was excellent, except for the MRI findings of the interosseous ligament (62% agreement; kappa, 0.3). Complete tear of the PITFL on MRI has additional diagnostic value for syndesmotic instability in ankle fracture. However, because the sensitivity might not be sufficient to justify the costs associated with MRI, cost-effectiveness should be considered. (orig.)

  15. The predictive value of MRI in the syndesmotic instability of ankle fracture

    International Nuclear Information System (INIS)

    Park, Young Hwan; Choi, Won Seok; Kim, Hak Jun; Yoon, Min A.; Hong, Suk Joo; Choi, Gi Won

    2018-01-01

    Although many types of ankle fracture can be combined with syndesmosis injury, preoperative imaging studies rarely reveal instability of the syndesmosis. This study assessed the use of magnetic resonance imaging (MRI) for syndesmotic instability in patients with unstable ankle fracture. A total of 74 patients who were treated for Lauge-Hansen supination external rotation/Weber B type fracture or pronation external rotation/Weber C type fracture and who underwent MRI for preoperative assessment were enrolled. The MRI findings of the syndesmotic ligament and the results of an intraoperative stress test were evaluated. Twenty-six patients had a positive result on the intraoperative stress test for syndesmotic instability. The MRI findings of the syndesmotic ligaments revealed that complete tear of the posterior inferior tibiofibular ligament (PITFL) was the most reliable predictor of syndesmotic instability (sensitivity, 74%; specificity, 78%; positive predictive value, 54%). Interobserver agreement for the intraoperative stress test and MRI assessment was excellent, except for the MRI findings of the interosseous ligament (62% agreement; kappa, 0.3). Complete tear of the PITFL on MRI has additional diagnostic value for syndesmotic instability in ankle fracture. However, because the sensitivity might not be sufficient to justify the costs associated with MRI, cost-effectiveness should be considered. (orig.)

  16. Distal tibiofibular synostosis after ankle fracture. A 14-year follow-up study

    NARCIS (Netherlands)

    Albers, G. H.; de Kort, A. F.; Middendorf, P. R.; van Dijk, C. N.

    1996-01-01

    Over an eight-year period up to 1983, a total of 322 consecutive patients had operations for ankle fractures; 176 were Weber type B and 128 type C. We were able to review 230 of these patients after a mean follow-up of six years (1 to 11) including 128 with Weber B and 102 with Weber C fractures. We

  17. Syndesmotic fixation in supination-external rotation ankle fractures: a prospective randomized study.

    Science.gov (United States)

    Pakarinen, Harri J; Flinkkilä, Tapio E; Ohtonen, Pasi P; Hyvönen, Pekka H; Lakovaara, Martti T; Leppilahti, Juhana I; Ristiniemi, Jukka Y

    2011-12-01

    This study was designed to assess whether transfixion of an unstable syndesmosis is necessary in supination-external rotation (Lauge-Hansen SE/Weber B)-type ankle fractures. A prospective study of 140 patients with unilateral Lauge-Hansen supination-external rotation type 4 ankle fractures was done. After bony fixation, the 7.5-Nm standardized external rotation (ER) stress test for both ankles was performed under fluoroscopy. A positive stress examination was defined as a difference of more than 2 mm side-to-side in the tibiotalar or tibiofibular clear spaces on mortise radiographs. If the stress test was positive, the patient was randomized to either syndesmotic transfixion with 3.5-mm tricortical screws or no syndesmotic fixation. Clinical outcome was assessed using the Olerud-Molander scoring system, RAND 36-Item Health Survey, and Visual Analogue Scale (VAS) to measure pain and function after a minimum 1-year of followup. Twenty four (17%) of 140 patients had positive standardized 7.5-Nm ER stress tests after malleolar fixation. The stress view was positive three times on tibiotalar clear space, seven on tibiofibular clear space, and 14 times on both tibiotalar and tibiofibular clear spaces. There was no significant difference between the two randomization groups with regards to Olerud-Molander functional score, VAS scale measuring pain and function, or RAND 36-Item Health Survey pain or physical function at 1 year. Relevant syndesmotic injuries are rare in supination-external rotation ankle fractures, and syndesmotic transfixion with a screw did not influence the functional outcome or pain after the 1-year followup compared with no fixation.

  18. Ankle ligament injuries

    Directory of Open Access Journals (Sweden)

    Per A.F.H. Renström

    1998-06-01

    tibiofibular ligaments is an indication for surgery to place a syndesmosis screw for reduction of the mortise. Protected weight bearing is required for about 6 weeks after surgery, at which time the screw should be removed. A functional rehabilitation program can then begin.

  19. Ankle sprain - aftercare

    Science.gov (United States)

    Lateral ankle sprain - aftercare; Medial ankle sprain - aftercare; Medial ankle injury - aftercare; Ankle syndesmosis sprain - aftercare; Syndesmosis injury - aftercare; ATFL injury - aftercare; CFL injury - ...

  20. Analysis of PITFL injuries in rotationally unstable ankle fractures.

    Science.gov (United States)

    Warner, Stephen J; Garner, Matthew R; Schottel, Patrick C; Hinds, Richard M; Loftus, Michael L; Lorich, Dean G

    2015-04-01

    Reduction and stabilization of the syndesmosis in unstable ankle fractures is important for ankle mortise congruity and restoration of normal tibiotalar contact forces. Of the syndesmotic ligaments, the posterior inferior tibiofibular ligament (PITFL) provides the most strength for maintaining syndesmotic stability, and previous work has demonstrated the significance of restoring PITFL function when it remains attached to a posterior malleolus fracture fragment. However, little is known regarding the nature of a PITFL injury in the absence of a posterior malleolus fracture. The goal of this study was to describe the PITFL injury pattern based on magnetic resonance imaging (MRI) and intraoperative observation. A prospective database of all operatively treated ankle fractures by a single surgeon was used to identify all supination-external rotation (SER) types III and IV ankle fracture patients with complete preoperative orthogonal ankle radiographs and MRI. All patients with a posterior malleolus fracture were excluded. Using a combination of preoperative imaging and intraoperative findings, we analyzed the nature of injuries to the PITFL. In total, 185 SER III and IV operatively treated ankle fractures with complete imaging were initially identified. Analysis of the preoperative imaging and operative reports revealed 34% (63/185) had a posterior malleolus fracture and were excluded. From the remaining 122 ankle fractures, the PITFL was delaminated from the posterior malleolus in 97% (119/122) of cases. A smaller proportion (3%; 3/122) had an intrasubstance PITFL rupture. Accurate and stable syndesmotic reduction is a significant component of restoring the ankle mortise after unstable ankle fractures. In our large cohort of rotationally unstable ankle fractures without posterior malleolus fractures, we found that most PITFL injuries occur as a delamination off the posterior malleolus. This predictable PITFL injury pattern may be used to guide new methods for

  1. The utility of periodic acid schiff with diastase and alcian blue stains on fine needle aspirates of breast and salivary gland neoplasms

    Directory of Open Access Journals (Sweden)

    N K Panicker

    2012-01-01

    Conclusion : Intracytoplasmic PAS-D-positive globules may be useful in differentiating benign and malignant lesions of breast. The presence of PAS-D positive granules are useful in differentiating various lesions of salivary glands. AB staining of stromal fragments in pleomorphic adenoma is useful in differentiating it from basal cell adenoma.

  2. Application of low field intensity joint MRI in ankle injury

    International Nuclear Information System (INIS)

    Zhang Zhenyu; Wang Wei

    2011-01-01

    Objective: To observe the diagnostic value of the low field intensity joint magnetic resonance imaging (MRI) in traumatic ankles. Methods: Through a retrospective examination and collection of 50 cases with complete information and checked by arthroscope or/and operated from Jan 2007 to Jun 2010, the diagnostic value ligament of the ankle joint, bone contusion,occult fracture, talus cartilage, and tendon could be evaluated. Cases of fracture for which could be diagnosed by X rays and CT were not included in this research. Results: The special low field intensity joint MRI had a high diagnostic sensitivity of 88.9% to ligamentum talofibulare anterius, but was only 50% sensitive to ligamentum calcaneofibulare. Its sensitivity to injury of ligamentum deltoideum and distal tibiofibular syndesmosis was up to 100%. Tendon injury, bone contusion and occult fracture could be exactly diagnosed. Its total sensitivity on talus cartilage traumatism was 70.6%. Its diagnosis sensitivity to talus cartilage traumatism at the 3rd-5th period by Mintz was 90%, with a lower one of 42.9% at the 1st-2nd period. Talus cartilage traumatism could be exactly predicted by osseous tissue dropsy below cartilage. Conclusion: The special low field intensity joint MRI is highly applicable to the diagnosis on ankle joint traumatism and facilitates clinical treatment. (authors)

  3. Dgroup: DG00109 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available DG00109 Chemical ... DGroup Diastase ... D03329 ... Diastase (JP17) ... D08705 ... Digestive enzyme derived from asperg...illus ... Gastrointestinal agent ... DG01744 ... digestive enzyme ATC code: A09AA01 Digestive enzyme ...

  4. Isolated syndesmotic injury in acute ankle trauma: Comparison of plain film radiography with 3 T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Schoennagel, B.P., E-mail: b.schoennagel@uke.uni-hamburg.de [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Karul, M.; Avanesov, M.; Bannas, P.; Gold, G. [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Großterlinden, L.G. [Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Rupprecht, M. [Department of Pediatric Orthopedics, Children' s Hospital Hamburg-Altona, Bleickenallee 38, 22763 Hamburg (Germany); Adam, G.; Yamamura, J. [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany)

    2014-10-15

    Highlights: • Isolated syndesmotic injury is a frequent finding after acute ankle trauma. • Cut-off values and accuracy of plain film radiograph measurements were determined. • The TFCS and the MCS have the potential to detect isolated syndesmotic injury. • Appropriate cut-off values allow detection of isolated syndesmotic injury. • Only MRI reveals severity of isolated syndesmotic injury and concomitant injuries. - Abstract: Objectives: To determine cut-off values and the accuracy of plain film measurements for the detection of isolated syndesmotic injury after acute ankle trauma and to investigate MRI findings of concomitant ankle injury. Methods: Eighty-four consecutive patients with absent fracture in plain film radiographs were prospectively evaluated for isolated syndesmotic injury after acute ankle trauma. The tibiofibular clear space (TFCS), the tibiofibular overlap (TFO), and the medial clear space (MCS) were independently assessed in plain radiographs by two readers. MRI performed at 3 T within 24 h served as the reference standard. MRI was evaluated for syndesmotic injury, using a four-scale grading system (0 = normal syndesmosis, 1a = periligamentous edema, 1b = intraligamentous edema, 2 = partial rupture, 3 = complete rupture), and for concomitant ankle injury. Inter-observer variability for x-ray measurements was assessed using Bland–Altman diagrams. ROC analyses were performed to determine cut-off values and sensitivity and specificity for TFCS, TFO, and MCS. Results: Eleven of 84 patients (13.1%) revealed syndesmotic injury (Grade 2 or 3) according to MRI. Between patients with and without syndesmotic injury significantly different measurements were obtained for TFCS (p = 0.003) and MCS (p = 0.04). ROC derived cut-off values were 5.3 mm for TFCS, 2.8 mm for TFO, and 2.8 mm for MCS. Sensitivity and specificity was 82% and 75% for TFCS, 36% and 78% for TFO, and 73% and 59% for MCS. The bias and limits of agreement were −0.04 mm and [−1

  5. Isolated syndesmotic injury in acute ankle trauma: Comparison of plain film radiography with 3 T MRI

    International Nuclear Information System (INIS)

    Schoennagel, B.P.; Karul, M.; Avanesov, M.; Bannas, P.; Gold, G.; Großterlinden, L.G.; Rupprecht, M.; Adam, G.; Yamamura, J.

    2014-01-01

    Highlights: • Isolated syndesmotic injury is a frequent finding after acute ankle trauma. • Cut-off values and accuracy of plain film radiograph measurements were determined. • The TFCS and the MCS have the potential to detect isolated syndesmotic injury. • Appropriate cut-off values allow detection of isolated syndesmotic injury. • Only MRI reveals severity of isolated syndesmotic injury and concomitant injuries. - Abstract: Objectives: To determine cut-off values and the accuracy of plain film measurements for the detection of isolated syndesmotic injury after acute ankle trauma and to investigate MRI findings of concomitant ankle injury. Methods: Eighty-four consecutive patients with absent fracture in plain film radiographs were prospectively evaluated for isolated syndesmotic injury after acute ankle trauma. The tibiofibular clear space (TFCS), the tibiofibular overlap (TFO), and the medial clear space (MCS) were independently assessed in plain radiographs by two readers. MRI performed at 3 T within 24 h served as the reference standard. MRI was evaluated for syndesmotic injury, using a four-scale grading system (0 = normal syndesmosis, 1a = periligamentous edema, 1b = intraligamentous edema, 2 = partial rupture, 3 = complete rupture), and for concomitant ankle injury. Inter-observer variability for x-ray measurements was assessed using Bland–Altman diagrams. ROC analyses were performed to determine cut-off values and sensitivity and specificity for TFCS, TFO, and MCS. Results: Eleven of 84 patients (13.1%) revealed syndesmotic injury (Grade 2 or 3) according to MRI. Between patients with and without syndesmotic injury significantly different measurements were obtained for TFCS (p = 0.003) and MCS (p = 0.04). ROC derived cut-off values were 5.3 mm for TFCS, 2.8 mm for TFO, and 2.8 mm for MCS. Sensitivity and specificity was 82% and 75% for TFCS, 36% and 78% for TFO, and 73% and 59% for MCS. The bias and limits of agreement were −0.04 mm and [−1

  6. Arthroscopy-Assisted Surgery for Acute Ankle Fractures: A Systematic Review.

    Science.gov (United States)

    Chen, Xing-Zuo; Chen, Ying; Liu, Cheng-Gang; Yang, Huan; Xu, Xiao-Dong; Lin, Peng

    2015-11-01

    To summarize the clinical findings of adult patients undergoing arthroscopy-assisted open reduction-internal fixation for acute ankle fractures. A systematic electronic search of the PubMed databases was performed for all published literature on December 8, 2014. All English-language clinical studies on acute ankle fractures treated with arthroscopy-assisted open reduction-internal fixation were eligible for inclusion. Basic information related to the surgical procedure was collected. The search criteria initially identified 187 articles, and 10 studies were included in this systematic review. There were 2 prospective, randomized studies; 2 prognostic studies; and 6 case-series studies. There were a total of 861 patients included in this systematic review. Danis-Weber type B fractures (335 of 483 patients) and supination-external rotation fractures (187 of 366 patients) were the most common types of all the ankle fractures. Concomitant injuries were common: 63.3% of patients had chondral lesions, 60.9% had deltoid ligament injuries, and 77.9% had tibiofibular syndesmosis injuries. Lavage and debridement of the ankle joint were performed by almost all the surgeons. Chondral lesions were treated with shaving, excision, or microfracture. The mean American Orthopaedic Foot & Ankle Society hindfoot score was 91.7. Only mild complications were reported. Acute ankle fractures are commonly concomitant with multiple soft-tissue injuries in which arthroscopy may serve as a method for accurate diagnosis and appropriate treatment. Level IV, systematic review of Level I, II, III, and IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. [Particular posteromedial and posterolateral approaches for the treatment of tibial head fractures].

    Science.gov (United States)

    Lobenhoffer, P; Gerich, T; Bertram, T; Lattermann, C; Pohlemann, T; Tscheme, H

    1997-12-01

    Tibial plateau fractures with depression of posterior aspects of the proximal tibia cause significant therapeutic problems. Posterior fractures on the medial side are mainly highly instable fracture-dislocations (Moore type I). Posterolateral fractures usually cause massive depression and destruction of the chondral surface. Surgical exposure of these fractures from anterior requires major soft tissue dissection and has a significant complication rate. However, incomplete restoration of the joint surface results in chronic postero-inferior joint subluxation, osteoarthritis and pain. We present new specific approaches for posterior fracture types avoiding large skin incisions, but allowing for atraumatic exposure, reduction and fixation. Posteromedial fracture-dislocations are exposed by a direct posteromedial skin incision and a deep incision between medial collateral ligament and posterior oblique ligament. The posteromedial pillar and the posterior flare of the proximal tibia are visualized. The inferior extent of the joint fragment can be reduced by indirect techniques or direct manipulation of the fragment. Fixation is achieved with subchondral lag screws and an anti-glide plate at the tip of the fragment. Posterolateral fractures are exposed by a transfibular approach: the skin is incised laterally, the peroneal nerve is dissected free. The fibula neck is osteotomized, the tibiofibular syndesmosis is divided and the fibula neck is reflected upwards in one layer with the meniscotibial ligament and the iliotibial tract attachment. Reflexion of the fibula head relaxes the lateral collateral ligament, allows for lateral joint opening and internal rotation of the tibia and thus exposes the posterolateral and posterior aspect of the tibial plateau. Fixation and buttressing on the posterolateral side can be achieved easily with this approach. In closure, the fibula head is fixed back with a lag screw or a tension-band system. These two exposures can be combined in

  8. Lower complication rate and faster return to sports in patients with acute syndesmotic rupture treated with a new knotless suture button device.

    Science.gov (United States)

    Colcuc, Christian; Blank, Marc; Stein, Thomas; Raimann, Florian; Weber-Spickschen, Sanjay; Fischer, Sebastian; Hoffmann, Reinhard

    2017-12-09

    Suture button devices for tibiofibular syndesmosis injuries provide semirigid dynamic stabilization, but complications including knot irritation have been reported. No randomized trials of the new knotless suture button devices have been performed. We hypothesized that knotless suture button devices eliminate knot irritation and facilitate quicker return to sports. This study was performed to compare the clinical outcomes, complication rates, and time to return to sports between a new knotless suture button device and syndesmotic screw fixation. This study included 54 patients treated for ankle syndesmotic injury from 2012 to 2014 with a knotless suture button device or syndesmotic screw fixation. Clinical outcomes were measured using the American Orthopaedics Foot and Ankle Society score, Foot and Ankle Disability Index, Olerud and Molander score, and visual analog scale for pain and function. Secondary outcome measures were the complication rate and time required to return to sports. Patients underwent clinical and radiological evaluations preoperatively and three times during the 1-year postoperative follow-up. 54 of 62 eligible patients were analyzed, median age 37 (18-60) and underwent the 1-year follow-up. The screw fixation and knotless suture button groups comprised 26 and 28 patients, respectively. The complication rate was significantly lower (p = 0.03) and time to return to sports was significantly shorter in the knotless suture button than screw fixation group (average, 14 versus 19 weeks, respectively; p = 0.006). No significant differences were identified in clinical outcomes or visual analog scale scores for pain and function between the groups. Age, injury mechanism, and body mass index did not significantly affect the time required to return to sports activities. The type of fixation was the only independent variable that reached statistical significance (p = 0.006). Syndesmotic screw fixation and the new knotless suture button device

  9. Paratrooper's ankle fracture: posterior malleolar fracture.

    Science.gov (United States)

    Young, Ki Won; Kim, Jin-su; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

    2015-03-01

    We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to

  10. Routine versus on demand removal of the syndesmotic screw; a protocol for an international randomised controlled trial (RODEO-trial)

    NARCIS (Netherlands)

    Dingemans, S. A.; Birnie, M. F. N.; Sanders, F. R. K.; van den Bekerom, M. P. J.; Backes, M.; van Beeck, E.; Bloemers, F. W.; van Dijkman, B.; Flikweert, E.; Haverkamp, D.; Holtslag, H. R.; Hoogendoorn, J. M.; Joosse, P.; Parkkinen, M.; Roukema, G.; Sosef, N.; Twigt, B. A.; van Veen, R. N.; van der Veen, A. H.; Vermeulen, J.; Winkelhagen, J.; van der Zwaard, B. C.; van Dieren, S.; Goslings, J. C.; Schepers, T.

    2018-01-01

    Background: Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally the screw is

  11. Routine versus on demand removal of the syndesmotic screw; A protocol for an international randomised controlled trial (RODEO-trial)

    NARCIS (Netherlands)

    S.A. Dingemans (Siem); Birnie, M.F.N. (M. F.N.); Sanders, F.R.K. (F. R.K.); M.P.J. van den Bekerom (Michel); Backes, M. (M.); E.F. van Beeck (Ed); F.W. Bloemers (Frank); B.A. van Dijkman (Bart); E.R. Flikweert (Elvira); D.J. Haverkamp; H.R. Holtslag (Herman); Hoogendoorn, J.M. (J. M.); P. Joosse (Pieter); Parkkinen, M. (M.); G.R. Roukema (Gert); N.L. Sosef (Nico L.); B. Twigt (Bas); R.N. van Veen (Ruben); Van Der Veen, A.H. (A. H.); Vermeulen, J. (J.); Winkelhagen, J. (J.); Van Der Zwaard, B.C. (B. C.); S. Van Dieren (Susan); J.C. Goslings (Carel); T. Schepers (Tim)

    2018-01-01

    textabstractBackground: Syndesmotic injuries are common and their incidence is rising. In case of surgical fixation of the syndesmosis a metal syndesmotic screw is used most often. It is however unclear whether this screw needs to be removed routinely after the syndesmosis has healed. Traditionally

  12. Physicochemical properties of some honeys produced from different plants in Morocco

    Directory of Open Access Journals (Sweden)

    Amina Chakir

    2016-11-01

    As a consequence, we present data on water content, electrical conductivity, pH, free acidity, lactone acidity, total acidity, diastase, 5-(hydroxymethyl-2-furaldehyde (HMF amounts, fructose, glucose and sucrose.

  13. Portuguese Honeys from Different Geographical and Botanical Origins: A 4-Year Stability Study Regarding Quality Parameters and Antioxidant Activity.

    Science.gov (United States)

    Soares, Sonia; Pinto, Diana; Rodrigues, Francisca; Alves, Rita C; Oliveira, M Beatriz P P

    2017-08-11

    Portuguese honeys (n = 15) from different botanical and geographical origins were analysed regarding their quality parameters (diastase activity, hydroxymethylfurfural content, moisture and pH), colour (L*, a*, b*) and antioxidant profile (total phenolics content, total flavonoids content, DPPH• scavenging activity, and ferric reducing power). The samples were analysed fresh and after 4-years of storage (at 25 °C and protected from light). The hydroxymethylfurfural content and diastase activity of the fresh samples were in accordance with the recommended values described in the legislation. In general, the antioxidant activity of the samples correlated more with the bioactive compounds content than with colour. The storage affected differently each individual sample, especially regarding the antioxidant profile. Nevertheless, although in general the lightness of the samples decreased (and the redness increased), after 4 years, 11 samples still presented acceptable diastase activity and hydroxymethylfurfural values.

  14. Role of Ankle Arthroscopy in Management of Acute Ankle Fracture.

    Science.gov (United States)

    Chan, Kwok Bill; Lui, Tun Hing

    2016-11-01

    To report the operative findings of ankle arthroscopy during open reduction and internal fixation of acute ankle fractures. This was a retrospective review of 254 consecutive patients with acute ankle fractures who were treated with open reduction and internal fixation of the fractures, and ankle arthroscopy was performed at the same time. The accuracy of fracture reduction, the presence of syndesmosis disruption and its reduction, and the presence of ligamentous injuries and osteochondral lesions were documented. Second-look ankle arthroscopy was performed during syndesmosis screw removal 6 weeks after the key operation. There were 6 patients with Weber A, 177 patients with Weber B, 51 patients with Weber C, and 20 patients with isolated medial malleolar fractures. Syndesmosis disruption was present in 0% of patients with Weber A fracture, 52% of patients with Weber B fracture, 92% of patients with Weber C fracture, and 20% of the patients with isolated medial malleolar fracture. Three patients with Weber B and one patient with Weber C fracture have occult syndesmosis instability after screw removal. Osteochondral lesion was present in no patient with Weber A fracture, 26% of the Weber B cases, 24% of the Weber C cases, and 20% of isolated medial malleolar fracture cases. The association between the presence of deep deltoid ligament tear and syndesmosis disruption (warranting syndesmosis screw fixation) in Weber B cases was statistically significant but not in Weber C cases. There was no statistically significant association between the presence of posterior malleolar fracture and syndesmosis instability that warrant screw fixation. Ankle arthroscopy is a useful adjuvant tool to understand the severity and complexity of acute ankle fracture. Direct arthroscopic visualization ensures detection and evaluation of intra-articular fractures, syndesmosis disruption, and associated osteochondral lesions and ligamentous injuries. Level IV, case series

  15. Aspect physico-chimique et biochimique Assia Amri, Ali Ladjama et ...

    African Journals Online (AJOL)

    ... analysis of sugars by HPLC, diastase, prolin and protein) local honey, ten ... The analysis of the report Fructose/glucose (F/G) shows that the honey of ... honeybee and the botanical wealth of the region where from interest to take into ...

  16. To retain or remove the syndesmotic screw: a review of literature

    NARCIS (Netherlands)

    T. Schepers (Tim)

    2011-01-01

    textabstractIntroduction: Syndesmotic positioning screws are frequently placed in unstable ankle fractures. Many facets of adequate placement techniques have been the subject of various studies. Whether or not the syndesmosis screw should be removed prior to weight-bearing is still debated. In this

  17. To retain or remove the syndesmotic screw: a review of literature

    NARCIS (Netherlands)

    Schepers, T.

    2011-01-01

    Syndesmotic positioning screws are frequently placed in unstable ankle fractures. Many facets of adequate placement techniques have been the subject of various studies. Whether or not the syndesmosis screw should be removed prior to weight-bearing is still debated. In this study, the recent

  18. approach to and management of acute ankle ligamentous injuries

    African Journals Online (AJOL)

    Enrique

    Tibionavicular part. Medial (deltoid) ligament of ankle {. Table I. Differential diagnosis of acute ankle injury. ATFL sprain. CFL sprain. Syndesmosis sprain. Anterior process calcaneus fracture. Lateral process talus fracture. Fifth metatarsal base fracture. Subtalar injury. Peroneal tendon injury. Osteochondral injury of the talus.

  19. Quadriceps Strength and Anterior Knee Pain following Tibia ...

    African Journals Online (AJOL)

    2017-07-17

    Jul 17, 2017 ... prior history of knee pain, but had unilateral tibiofibular fracture, who had internal fixation with ... It may take several months for healing and subsequent .... time after surgery and those with anterior knee pain may never get ...

  20. Dislocation of the fibular head in an unusual sports injury: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  1. A rare type of ankle fracture : Syndesmotic rupture combined with a high fibular fracture without medial injury

    NARCIS (Netherlands)

    van Wessem, K. J P; Leenen, L. P H

    High fibular spiral fractures are usually caused by pronation-external rotation mechanism. The foot is in pronation and the talus externally rotates, causing a rupture of the medial ligaments or a fracture of the medial malleolus. With continued rotation the anterior and posterior tibiofibular

  2. Adult limb fractures in Tikur Anbessa Hospital caused by road traffic ...

    African Journals Online (AJOL)

    Bernt Lindtjorn

    The highest frequency of fractures occurred in the femur 32 (15.8%) followed by tibio-fibular 29. (14.4%) and humerus 26 (12.9%). Isolated pateelar fracture occurred in 22 (10%), Ankle fractures accounted for 9 (4.5%) patients; Pelvic fracture was seen in 6 (3%) patients. There were 5 combined femur and tibifibular fractures ...

  3. 2329-IJBCS-Article-Dr o Owoeye Tunde

    African Journals Online (AJOL)

    hp

    X-ray of the bones showed an oblique fracture in the distal end of the shaft of fibula which is suggestive of post traumatic tibiofibular synostosis (TFS). Knowledge of distal TFS is important in resolving the puzzle of chronic shin pain of unknown origin and in accurate diagnosis of causes of ankle deformity and malformations.

  4. Changes in the syndesmotic reduction after syndesmotic screw fixation for ankle malleolar fractures: One-year longitudinal evaluations using computer tomography.

    Science.gov (United States)

    Endo, Jun; Yamaguchi, Satoshi; Saito, Masahiko; Morikawa, Tsuguo; Akagi, Ryuichiro; Sasho, Takahisa

    2016-10-01

    To evaluate time-dependent changes in the syndesmotic reduction after syndesmotic screw fixation and one year after screw removal for ankle malleolar fractures, and to assess whether the incidence of syndesmotic malreduction changes depending on the measurement method. We assessed twenty patients who underwent syndesmotic screw fixation for ankle fractures. The syndesmotic screws were removed after six weeks of the fracture surgery. Syndesmotic reduction was assessed within two weeks of the fracture surgery and one year after the screw removal using the axial computer tomographic images. Side-to-side differences in the anterior and posterior tibiofibular distances, anteroposterior fibular translation, and fibular rotation were measured. The mean anterior tibiofibular distance was 0.7mm after syndesmotic fixation. It increased to 1.9mm at one year after screw removal (p=0.002). After syndesmotic fixation, four ankles had malreduction of the anterior tibiofibular distance, including three ankles with widening and one with overtightening. At one year, eight ankles had malreduction, all of whom had widening. The other measurement values did not change over time (0.1mm vs. 0.6mm for the posterior tibiofibular distance, 0.2mm vs. 0.3mm for the anteroposterior fibular translation, and 0.7° vs. 0° for the fibular rotation). The incidences of malreduction were significantly different depending on the definition of malreduction, ranging from 10% to 50% after syndesmotic fixation (p=0.01) and from 20% to 60% at one year after screw removal (p=0.02). The anterior tibiofibular distance widened after one year of syndesmotic screw removal. The incidence of malreduction varied depending on the measurement method. Copyright © 2016. Published by Elsevier Ltd.

  5. Intracytoplasmic Crystalline Inclusions in the Hepatocytes of an Antelope

    Science.gov (United States)

    2010-01-01

    trout [7]. They have never been described in antelopes. The current report describes the his- tological and electron microscopic features of...red O (Figure 2(b)), glycogen with periodic acid-Schiff stain (with and without diastase digestion ) (Figure 2(d)), and acid mucopolysaccharides. The...female Ohrid trout (Salmo letnica Kar.),” Tissue and Cell, vol. 41, no. 4, pp. 281–285, 2009. [8] G. S. Murti and R. Borgmann, “Intracytoplasmic periodic

  6. [Conventional X-Rays of Ankle Joint Fractures in Older Patients are Not Always Predictive].

    Science.gov (United States)

    Jubel, A; Faymonville, C; Andermahr, J; Boxberg, S; Schiffer, G

    2017-02-01

    Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays. Methods: Complete data sets and preoperative X-rays of 84 patients aged above 60 years with ankle fractures were analysed retrospectively. There were 59 women and 25 men, with a mean age of 69.9 years. Operation reports and preoperative X-rays were analysed with respect to four relevant lesions: multifragmentary fracture pattern of the lateral malleolus, involvement of the medial malleolus, posterior malleolar fractures and bony avulsion of anterior syndesmosis. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and prevalence were calculated. Results: The prevalence of specific ankle lesions in the analyzed cohort was 24 % for the multifragmentary fracture pattern of the lateral malleolus, 38 % for fractures of the medial malleolus, 25 % for posterior malleolar fractures and 22.6 % for bony avulsions of the anterior syndesmosis. Multifragmentary fracture patterns of the lateral malleolus (sensitivity 0 %) and bony avulsions of the anterior syndesmosis (sensitivity 5 %) could not be detected in plain X-rays of the ankle joint at all. Fractures of the medial malleolus and involvement of the dorsal tibial facet were detected with a sensitivity of 96.8 % and 76.2 %, respectively, and specificity of 100 % in both cases. Conclusions: This study confirms that complex fracture patterns, such as multifragmentary involvement of the lateral malleolus, additional fracture of the medial malleolus, involvement of the dorsal tibial facet or bony avulsion of the anterior syndesmosis are common in ankle fractures of the elderly. Therefore, CT scans should be routinely considered for primary

  7. [Experimental study on carbon fiber reinforced plastic plate--analysis of stabilizing force required for plate].

    Science.gov (United States)

    Iizuka, H

    1990-11-01

    Plates currently in use for the management of bone fracture made of metal present with various problems. We manufactured carbon fiber reinforced plastic (CFRP) plates from Pyrofil T/530 puriplegs overlaid at cross angles of +/- 10 degrees, +/- 20 degrees, and +/- 30 degrees for trial and carried out an experimental study on rabbit tibiofibular bones using 316L stainless steel plates of comparable shape and size as controls. The results indicate the influence of CFRP plate upon cortical bone was milder than that of stainless steel plate, with an adequate stabilizing force for the repair of fractured rabbit tibiofibular bones. CFRP has the advantages over metals of being virtually free from corrosion and fatigue, reasonably radiolucent and able to meet a wide range of mechanical requirements. This would make CFRP plate quite promising as a new devices of treating fracture of bones.

  8. Radiographic healing and remodelling of cortical and cancellous bone grafts after rigid plate fixation

    International Nuclear Information System (INIS)

    Waris, P.; Karaharju, E.; Slaetis, P.; Paavolainen, P.

    1980-01-01

    Cortical and cancellous interposition grafts, with rigid plate fixation, in the tibiofibular bones of 130 rabbits were followed radiographically for one year. The cancellous grafts healed earlier, but by 12 weeks both graft types had been incorporated, the distal host-graft interface being the last to heal. Progressive cancellous transformation in both the graft and host bone led to an increased over-all bone diameter, a widened medullary canal and a thinned porotic wall. (Auth.)

  9. Calcifications simulating peroneus longus tendinitis

    International Nuclear Information System (INIS)

    Carvalho, A. de; Illum, F.; Joergensen, J.

    1984-01-01

    In two patients with sprains of the ankle joint calcification adjacent to the posterior tibial margin was evident in the lateral projection of a standard radiographic examination. Calcifying peroneus longus tendinitis was suggested. Further tangential views and computed tomography (CT) scan disclosed, however, that the calcifications in both patients were located in the tibial insertion of the posterior and inferior tibio-fibular ligament. In such cases, a correct diagnosis will avoid unnecessary treatment for a non-existent tendinitis. (orig.)

  10. Functional outcomes following syndesmotic fixation: A comparison of screws retained in situ versus routine removal - Is it really necessary?

    Science.gov (United States)

    Tucker, Adam; Street, Julia; Kealey, David; McDonald, Sinead; Stevenson, Mike

    2013-12-01

    Syndesmotic disruption can occur in up to 20% of ankle fractures and is more common in Weber Type C injuries. Syndesmotic repair aims to restore ankle stability. Routine removal of syndesmosis screws is advocated to avoid implant breakage and adverse functional outcome such as pain and stiffness, but conflicting evidence exists to support this. The aim of the current study is to determine whether functional outcome differs in patients who had syndesmosis screws routinely removed, compared to those who did not, and whether a cost benefit exists if removal of screws is not routinely necessary. A retrospective review of consecutive syndesmosis repairs was performed from 1 January 2008 to 31 December 2010 in a single regional trauma centre. We identified 91 patients who had undergone open reduction internal fixation of an ankle fracture with placement of a syndesmosis screw at index procedure. As many as 69 patients were eligible for the study as defined by the inclusion criteria and they completed a validated functional outcome questionnaire. The functional outcomes of patients with 'retained screws' and 'removed screws' were analysed and compared using the Olerud Molander Ankle Score (OMAS). A total of 63 patients responded with a mean follow-up period of 31 months (range 10-43 months). Of those patients, 43 underwent routine screw removal whilst 20 had screws left in situ. The groups were comparable considering age, gender and follow-up time. The 'retained' group scored higher mean OMAS scores, 81.5±19.3 compared to 75±12.9 in the 'removed' group (p=0.107). The retained group achieved higher functional scores in each of the OMAS domains as well as experiencing less pain. When adjusted for gender, the findings were found to be statistically significant (p=0.046). Our study has shown that retained-screw fixation does not significantly impair functional capacity, with additional cost-effectiveness. We therefore advocate that syndesmosis screws be left in situ and

  11. Evaluating the Quality and Physicochemical Properties of Honey Commercialized in Iran

    Directory of Open Access Journals (Sweden)

    Maryam Jalili

    2016-06-01

    Full Text Available This study was intended to evaluate the quality of 30 honey samples, in terms of physicochemical properties such as moisture content, electrical conductivity, ash content, reducing sugars and sucrose, free acidity, pH, diastase activity, and hydroxymethylfurfural (HMF content. Moreover, three methods recommended by the International Honey Commission for the determination of HMF, including 1 high performance liquid chromatography (HPLC, 2 White spectrophotometry and 3 Winkler spectrophotometry methods, were compared. The average moisture content ranged from 12.08±0.36 to 19.36±0.11%. The Electrical conductivity values (0.43±0.00 to 0.77±0.00 mS/cm, ash content (0.24±0.01 to 0.74±0.03%, pH values (3.37±0.01 to 5.21±0.16, free acidity (29.60±0.36 to 39.66±0.37 meq/kg of honey, total reducing sugar (52.28±0.09 to 88.01±0.63%, sucrose content (2.21±0.07 to 7.55±0.35%, diastase activity (2.07±0.28 to 29.01±0.50, and HMF content (17.33±0.18 to 834.46±0.30 mg/kg were observed. Thirteen out of 30 samples (43% showed HMF content higher than standard limits. Results obtained from the current study revealed that except for HMF and diastase activity, all physicochemical properties of samples met the national and international standard limits. Moreover, three methods applied for determination of HMF showed good recovery values and standard deviation. However, Winkler and White methods gave higher HMF value in honey sample than HPLC method.

  12. Caracterização do mel produzido por espécies de Melipona Illiger, 1806 (apidae: meliponini da região nordeste do Brasil: 1. Características físico-químicas Characterization of honey produced by species of Melipona Illiger, 1806 (apidae: meliponini from the northeast area of Brazil: 1. Physico-chemical characteristics

    Directory of Open Access Journals (Sweden)

    Bruno de Almeida Souza

    2009-01-01

    Full Text Available Thirty three honey samples produced by four Melipona species from different areas of the State of Bahia, were analyzed with the aim to determine their physico-chemical characteristics, contributing to the establishment of standards for quality control. The majority of the average values for physico-chemical parameters fulfilled the quality criteria established by the Brazilian and international Legislations for Apis honey, except for moisture content, which afforded higher values. Concerning the high number of samples wich did not fit the limits for reducing sugars, it is necessary to define minimum values in order to characterize Melipona honeys, as well as criteria for use of diastasic activity.

  13. Sister mary joseph′s nodule: A case of umbilical cutaneous metastasis with signet ring cell histology

    Directory of Open Access Journals (Sweden)

    Zadeh Valid

    2009-01-01

    Full Text Available The metastasis of a visceral malignancy to the umbilicus is known as "Sister Mary Joseph′s nodule". It is a rare clinical sign indicating advanced, metastasizing intraabdominal cancer. We report a 50-year-old man who developed metastatic skin cancer in the form of semicircular indurated plaque on top of which was a firm mobile rounded nodule at the umbilical area. Histopathological examination demonstrated diastase-resistant periodic acid-Schiff and mucicarmine positive signet ring cells, suggesting gastric carcinoma. Immunohistochemical staining showed that these cells were positive for cytokeratins and epithelial membrane antigen, suggesting epithelial origin.

  14. Granular cell tumor in an endangered Puerto Rican Amazon parrot (Amazon vittata)

    Science.gov (United States)

    Quist, C.F.; Latimer, K.S.; Goldade, S.L.; Rivera, A.; Dein, F.J.

    1999-01-01

    A 3 cm diameter mass from the metacarpus of a Puerto Rican Amazon parrot was diagnosed as a granular cell tumour based on light microscopy. The cytoplasmic granules were periodic-acid Schiff positive and diastase resistant. Ultrastructural characteristics of the cells included convoluted nuclei and the presence of numerous cytoplasmic tertiary lysosomes. This is only the second granular cell tumour reported in a bird. We speculate that most granular cell tumours are derived from cells that are engaged in some type of cellular degradative process, creating a similar morphologic appearance, but lacking a uniform histogenesis.

  15. Twofold trauma of vertebral column in a calf (case report)

    International Nuclear Information System (INIS)

    Metzner, M.; Weiler, H.

    1991-01-01

    A double spinal cord trauma of an eight weeks old calf is reported, born on pasture from a heifer as a premature birth at the beginning of month 9. Observations made were rupture of intervertebral disk at the crossing of cervical to thoracic vertebrae followed by syndesmosis or synchondrosis resp., as well as a comminutet fracture of the 1st lumbar vertebra including both the adjoining vertebrae, with succeeding reactive callus formation. It is concluded that this traumatization has occurred during parturition. Motoric or sensoric disturbances were observed neither

  16. Ischial hypoplasia, tibial hypoplasia and facial abnormalities: a new syndrome?

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, G. [Department of Radiology, Dokkyo University School of Medicine (Japan); Haga, Yoshihiko [Department of Orthopaedics, Shizuoka Children`s Hospital, Shizuoka (Japan); Aoki, Katsuhiko [Department of Radiology, Shizuoka Children`s Hospital, Shizuoka (Japan); Hasegawa, Tomoko [Division of Clinical Genetics, Shizuoka Children`s Hospital, Shizuoka (Japan)

    1998-12-01

    A child with facial abnormalities, short stature and a variety of skeletal alterations is reported. The facial abnormalities comprised low-set ears, short nose with a long philtrum, micrognathia and cleft palate. The skeletal alterations included ischial hypoplasia, malformations of the cervical spine, hypoplasia of the lesser trochanters, tibial hypoplasia with bowing of the lower legs, tibio-fibular diastasis with malformed distal tibial epiphyses, clubfeet and brachymesophalangy. The constellation of clinical and radiological findings in the present patient do not fit any known malformation syndrome. (orig.) With 4 figs., 8 refs.

  17. Ischial hypoplasia, tibial hypoplasia and facial abnormalities: a new syndrome?

    International Nuclear Information System (INIS)

    Nishimura, G.; Haga, Yoshihiko; Aoki, Katsuhiko; Hasegawa, Tomoko

    1998-01-01

    A child with facial abnormalities, short stature and a variety of skeletal alterations is reported. The facial abnormalities comprised low-set ears, short nose with a long philtrum, micrognathia and cleft palate. The skeletal alterations included ischial hypoplasia, malformations of the cervical spine, hypoplasia of the lesser trochanters, tibial hypoplasia with bowing of the lower legs, tibio-fibular diastasis with malformed distal tibial epiphyses, clubfeet and brachymesophalangy. The constellation of clinical and radiological findings in the present patient do not fit any known malformation syndrome. (orig.)

  18. Red herring: Acute back pain after combined spinal epidural for labor analgesia

    Directory of Open Access Journals (Sweden)

    Yoong Chuan Tay

    2018-04-01

    Full Text Available Symphysis pubis diastases complicate 1:300 to 1:30,000 pregnancies. Peripartum pain in chronological sequence with labor epidural analgesia often attracts instinctive causation and distress. Predisposing risk factors include macrosomia, short second stage of labor, forceps use, multiparity, small pelvis, intense uterine contractions, previous pelvic ring pathology and trauma. A gestational diabetic primigravid parturient presents with acute post-partum back pain after an uneventful analgesic labor epidural. Her pain distributed over the right paravertebral L5-S1 region without radiculopathy, worsened with positional change and accompanied by urinary incontinence, precluding child care. Spine imaging incidentally revealed a 38 mm symphysis pubis diastasis. A pelvic binder by orthopaedics aided physiotherapy and ambulation. Pubic diastases are usually conservatively managed, unless separation exceeds 5 cm when early surgery may improve functional outcomes. Although symptoms may recur in subsequent pregnancies, it does not preclude vaginal delivery. Early recognition and prompt management aim to reduce parturient morbidity and promote resumption of activity. Keywords: Symphysis pubis diasthesis, Pubic symphysis diasthesis, Post-epidural pain, Labor epidural pain, Post-partum pain

  19. Cutaneous sporotrichosis: experience at a thirdlevel hospital in Cali, Colombia = Esporotricosis cutánea: experiencia de un hospital de tercer nivel en Cali, Colombia

    Directory of Open Access Journals (Sweden)

    Castro Alegría, Luz Ángela

    2013-04-01

    Full Text Available Introduction: Sporotrichosis is a subcutaneous mycosis caused by the Sporothrix schenckii species complex; it is acquired by traumatic inoculation of the fungus. Objective: To describe the epidemiological and clinical features of a group of patients with sporotrichosis. Methodology: A retrospective and descriptive study was performed at a third-level hospital in Cali, Colombia, from January 2000 to June 2011. Records from patients having positive cultures for S. schenckii and/or periodic acid-Schiff (PAS-diastase stain showing blastoconidia were included in the analysis. Results: The group was made up of 20 men and three women. Eight patients (34.8% were farmers and four (17.4% worked in construction activities. Six (26.1% were children aged under 15 years. Sporothrix sckenckii was isolated from cultures in 22 patients (95% and in 15 out of 21 (71.4% blastoconidia were observed by direct examination. Fourteen patients (60.9% had the lymphangitic form of the disease. Upper limbs were most frequently affected (16 cases; 69.6%. Twenty two patients were treated with potassium iodine. Conclusions: Lymphangitic sporotrichosis was the most common clinical form of the disease in this study. PAS-diastase stain seems to be a useful diagnostic tool for sporotrichosis

  20. QUALIDADE DO MEL DE ABELHA PRODUZIDOS PELOS INCUBADOS DA IAGRAM E COMERCIALIZADO NO MUNICIPIO DE MOSSORÓ/RN

    Directory of Open Access Journals (Sweden)

    Edna Maria Mendes Aroucha

    2008-01-01

    Full Text Available This experiment had for objective to evaluate some parameters of quality of the bee honey (Apis mellífera L. produced by IAGRAM and commercialized in the city of Mossoró-RN. For this, 19 honey samples had been collected in the local market, these were analyzed, in the Chemistry Laboratory of the Universidade Federal Rural do Semi-Árido (UFERSA, how much to the color, humidity, total acidity, reducing sugars, apparent sucrose and diastase activity. It was utilized districted statistics for analysis of date, with shunting line standard, reliable interval and distribution of frequency. The honeys sample presented the colors clearly extra amber (5,2%, amber (5,2% and dark amber (89,4%. The honey samples presented normal standard established for the Brazilian Legislation as humidity percentage (14,3 18.6% and reducing sugars (66,9 75.0%. About 5,2% and 42% of the analyzed honey samples, not presented, respectively, apparent sucrose content and total acidity, as the standard established for commercialization as floral honey. The diastase activity was remained inside of the quality standard.

  1. Physicochemical properties of honey from Serbia in the period 2014-2016

    Science.gov (United States)

    Vranić, D.; Petronijević, R.; Đinović Stojanović, J.; Korićanac, V.; Babić Milijašević, J.; Milijašević, M.

    2017-09-01

    Honey is a viscous, aromatic, sweet food that is consumed and enjoyed by people around the world due to its unique nutritional and medicinal properties. The physicochemical parameters of natural honeys, such as moisture, reducing sugars, sucrose, hydroxymethylfurfural (HMF), free acidity, diastase activity, water-insoluble content and electrical conductivity are strictly defined and constitute the quality indicators which characterize individual honey varieties. The present study shows results of honey quality investigation from various regions of Serbia, which were evaluated according to the Serbian Regulation. A total of 372 honey samples (132 acacia honey, 221 blossom honey and 19 honeydew honey) were obtained from the Serbian market. All applied methods were performed according to the Harmonized Methods of the International Honey Commission. Summarizing the results presented, the most important parameters for detecting honey that was non-compliant with the regulation were HMF content along with diastase activity and sugar content. Results show that in 2014 and 2015, a great number of honey samples were of insufficient quality to satisfy regulatory requirements. In 2016, the situation on the Serbian honey market improved and became more under control.

  2. Compare the influence of several methods dehydrate of cajuput (Melaleuca cajuputi) honey from Bac Lieu - Vietnam

    Science.gov (United States)

    Nam, Nguyen Xuan; Phuc, Nguyen Chi; Oanh, Huynh Ngoc; Hien, Phan Phuoc

    2017-09-01

    The aim of this research was exhaustive to valuate the effects of 5 methods used to dehydrate of cajuput honey from Bac Lieu - Vietnam include thermal, microwave, ultrasonic wave, silicagel, vacuum processing on water content of honey. Beside that, comparing the effects on honey quality with the industrial-scale processing. The main honey quality paramenters (reducing sugar (RS), hydroxymethylfurfural (HMF), diastase number (DN), water and colour) of cajuput honey were analyzed. RS content were analyzed by DNS method, HMF under AOAC 980.23, diastase activity based on AOAC 958.09, water content according to AOAC 969.38B and colour parameters (L*, a*, b*) were established in the CIE system. The physico-chemical characteristics of fresh honey was as follows: water content 23.18%, RS 717.42 mg/g, HMF 4.24 mg/kg, DN 4.85 mg/kg, colour parameters L*a*b* 39.51-10.51-31.81. The results of the analysis showed that excepts ultrasonic wave processing (22.93%), the other methods allowed to dehydrate of cajuput honey (thermal - 18.73%, microwave - 16.87%, silicagel - 17.86%, vacuum - 17.35% and industrial-scale processing - 16.85%).

  3. Conservative Management for Stable High Ankle Injuries in Professional Football Players.

    Science.gov (United States)

    Knapik, Derrick M; Trem, Anthony; Sheehan, Joseph; Salata, Michael J; Voos, James E

    High ankle "syndesmosis" injuries are common in American football players relative to the general population. At the professional level, syndesmotic sprains represent a challenging and unique injury lacking a standardized rehabilitation protocol during conservative management. PubMed, Biosis Preview, SPORTDiscus, PEDro, and EMBASE databases were searched using the terms syndesmotic injuries, American football, conservative management, and rehabilitation. Clinical review. Level 3. When compared with lateral ankle sprains, syndesmosis injuries result in significantly prolonged recovery times and games lost. For stable syndesmotic injuries, conservative management features a brief period of immobilization and protected weightbearing followed by progressive strengthening exercises and running, and athletes can expect to return to competition in 2 to 6 weeks. Further research investigating the efficacy of dry needling and blood flow restriction therapy is necessary to evaluate the benefit of these techniques in the rehabilitation process. Successful conservative management of stable syndesmotic injuries in professional American football athletes requires a thorough understanding of the anatomy, injury mechanisms, diagnosis, and rehabilitation strategies utilized in elite athletes.

  4. Skeletal unloading induces selective resistance to the anabolic actions of growth hormone on bone

    Science.gov (United States)

    Halloran, B. P.; Bikle, D. D.; Harris, J.; Autry, C. P.; Currier, P. A.; Tanner, S.; Patterson-Buckendahl, P.; Morey-Holton, E.

    1995-01-01

    Loss of skeletal weight bearing or physical unloading of bone in the growing animal inhibits bone formation and induces a bone mineral deficit. To determine whether the inhibition of bone formation induced by skeletal unloading in the growing animal is a consequence of diminished sensitivity to growth hormone (GH) we studied the effects of skeletal unloading in young hypophysectomized rats treated with GH (0, 50, 500 micrograms/100 g body weight/day). Skeletal unloading reduced serum osteocalcin, impaired uptake of 3H-proline into bone, decreased proximal tibial mass, and diminished periosteal bone formation at the tibiofibular junction. When compared with animals receiving excipient alone, GH administration increased bone mass in all animals. The responses in serum osteocalcin, uptake of 3H-proline and 45Ca into the proximal tibia, and proximal tibial mass in non-weight bearing animals were equal to those in weight bearing animals. The responses in trabecular bone volume in the proximal tibia and bone formation at the tibiofibular junction to GH, however, were reduced significantly by skeletal unloading. Bone unloading prevented completely the increase in metaphyseal trabecular bone normally induced by GH and severely dampened the stimulatory effect (158% vs. 313%, p < 0.002) of GH on periosteal bone formation. These results suggest that while GH can stimulate the overall accumulation of bone mineral in both weight bearing and non-weight bearing animals, skeletal unloading selectively impairs the response of trabecular bone and periosteal bone formation to the anabolic actions of GH.

  5. Skeletal unloading induces selective resistance to the anabolic actions of growth hormone on bone

    Science.gov (United States)

    Halloran, B. P.; Bikle, D. D.; Harris, J.; Autry, C. P.; Currier, P. A.; Tanner, S.; Patterson-Buckendahl, P.; Morey-Holton, E.

    1995-01-01

    Loss of skeletal weight bearing or physical unloading of bone in the growing animal inhibits bone formation and induces a bone mineral deficit. To determine whether the inhibition of bone formation induced by skeletal unloading in the growing animal is a consequence of diminished sensitivity to growth hormone (GH) we studied the effects of skeletal unloading in young hypophysectomized rats treated with GH (0, 50, 500 micrograms/100 g body weight/day). Skeletal unloading reduced serum osteocalcin, impaired uptake of 3H-proline into bone, decreased proximal tibial mass, and diminished periosteal bone formation at the tibiofibular junction. When compared with animals receiving excipient alone, GH administration increased bone mass in all animals. The responses in serum osteocalcin, uptake of 3H-proline and 45Ca into the proximal tibia, and proximal tibial mass in non-weight bearing animals were equal to those in weight bearing animals. The responses in trabecular bone volume in the proximal tibia and bone formation at the tibiofibular junction to GH, however, were reduced significantly by skeletal unloading. Bone unloading prevented completely the increase in metaphyseal trabecular bone normally induced by GH and severely dampened the stimulatory effect (158% vs. 313%, p anabolic actions of GH.

  6. Skeletal unloading induces selective resistance to the anabolic actions of growth hormone on bone

    Science.gov (United States)

    Halloran, B. P.; Bikle, D. D.; Harris, J.; Autry, C. P.; Currier, P. A.; Tanner, S.; Patterson-Buckendahl, P.; Morey-Holton, E.

    1995-01-01

    Loss of skeletal weight bearing or physical unloading of bone in the growing animal inhibits bone formation and induces a bone mineral deficit. To determine whether the inhibition of bone formation induced by skeletal unloading in the growing animal is a consequence of diminished sensitivity to growth hormone (GH) we studied the effects of skeletal unloading in young hypophysectomized rats treated with GH (0, 50, 500 micrograms/100 g body weight/day). Skeletal unloading reduced serum osteocalcin, impaired uptake of 3H-proline into bone, decreased proximal tibial mass, and diminished periosteal bone formation at the tibiofibular junction. When compared with animals receiving excipient alone, GH administration increased bone mass in all animals. The responses in serum osteocalcin, uptake of 3H-proline and 45Ca into the proximal tibia, and proximal tibial mass in non-weight bearing animals were equal to those in weight bearing animals. The responses in trabecular bone volume in the proximal tibia and bone formation at the tibiofibular junction to GH, however, were reduced significantly by skeletal unloading. Bone unloading prevented completely the increase in metaphyseal trabecular bone normally induced by GH and severely dampened the stimulatory effect (158% vs. 313%, p bone formation. These results suggest that while GH can stimulate the overall accumulation of bone mineral in both weight bearing and non-weight bearing animals, skeletal unloading selectively impairs the response of trabecular bone and periosteal bone formation to the anabolic actions of GH.

  7. Expanded Endoscopic Transnasal Approach to the Chordoid Glioma of the Third Ventricle : The First Case Ever Reported.

    Science.gov (United States)

    Zeinalizadeh, Mehdi; Sadrehosseini, Seyed Mousa; Tayebi Meybodi, Keyvan; Sharifabadi, Ali Heidari

    2016-11-01

    Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.

  8. Classification of adulterated honeys by multivariate analysis.

    Science.gov (United States)

    Amiry, Saber; Esmaiili, Mohsen; Alizadeh, Mohammad

    2017-06-01

    In this research, honey samples were adulterated with date syrup (DS) and invert sugar syrup (IS) at three concentrations (7%, 15% and 30%). 102 adulterated samples were prepared in six batches with 17 replications for each batch. For each sample, 32 parameters including color indices, rheological, physical, and chemical parameters were determined. To classify the samples, based on type and concentrations of adulterant, a multivariate analysis was applied using principal component analysis (PCA) followed by a linear discriminant analysis (LDA). Then, 21 principal components (PCs) were selected in five sets. Approximately two-thirds were identified correctly using color indices (62.75%) or rheological properties (67.65%). A power discrimination was obtained using physical properties (97.06%), and the best separations were achieved using two sets of chemical properties (set 1: lactone, diastase activity, sucrose - 100%) (set 2: free acidity, HMF, ash - 95%). Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Lafora's-like disease in a fennec fox (Vulpes zerda).

    Science.gov (United States)

    Honnold, Shelley P; Schulman, F Yvonne; Bauman, Karen; Nelson, Kevin

    2010-09-01

    A 6-yr-old captive-born female fennec fox (Vulpes zerda) had a history of multiple seizures and was treated with diazepam and phenobarbital therapy. Despite medical treatment, the seizures continued. They were intermittent and progressive, resulting in neurologic deficits and death of the animal within 6 mo of onset of the clinical signs. At necropsy, the animal was in good nutritional condition, and no gross lesions were noted in the brain. Histologically, amphophilic to basophilic, periodic acid-Schiff (PAS) positive, diastase-resistant inclusions were present in the brain, heart, and liver. Ultrastructurally, the inclusions were variably electron dense, fibrillary to occasionally granular, and non-membrane bound. The clinical, histologic, and ultrastructural findings were consistent with Lafora's disease, which in humans is a rare, fatal, autosomal recessive hereditary neurometabolic disorder characterized by progressive myoclonic epilepsy. This is the first report of Lafora's-like disease in a fennec fox.

  10. Study on microbiological contamination reduction in honey by means of ionizing radiation

    International Nuclear Information System (INIS)

    Kedzia, B.; Holderna-Kedzia, E.; Migdal, W.; Owczarczyk, B.; Madejczyk, D.

    1998-01-01

    3 types of honey; polyfloral, lime and acacia were used in these studies. The above types of honey were located in the plastic containers and irradiated by 10 kGy. It was found that irradiation decreased the amount of aerobic and anaerobic bacteria and fungi by an average of 99%. After irradiation antibiotic index of studied types of honey increased by an average from 1.67 to 2.67. Colour, taste, acidity, diastase activity and 5-HMF content did not change radically either. Above results show that ionizing radiation in a dose of 10 kGy can be used to obtain honey with microbiological purity. This purity is indispensable specially when the honeys are used in surgical treated injuries and in the babies nutrition with food deficiency. (author)

  11. Microbiological decontamination of natural honey by irradiation

    Science.gov (United States)

    Migdał, W.; Owczarczyk, H. B.; K ȩdzia, B.; Hołderna-K ȩdzia, E.; Madajczyk, D.

    2000-03-01

    Degree of microbiological decontamination, organoleptic and physico-chemical properties of natural honeys were investigated after radiation treatment. Seven kinds of honeys were irradiated with the beams of 10 MeV electrons from a 10 kW linear accelerator "Elektronika 10-10" at the dose 10 kGy. It was shown, that after irradiation, the total count of aerobic and anaerobic bacteria and moulds decrease by 99%. The antibiotic value in investigated honeys increased in turn from 1.67 to 2.67 after irradiation. Such factors and parameters of investigated honeys as their consistency, content of water and saccharose, acidity, the diastase and 5-HMF values were not changed significantly after irradiation. Decontamination by irradiation is a process which allows us to obtain high microbiological purity of honeys. It is especially needed, when honeys are used in surgical treatment of injuries and in nutrition of babies with food deficiency.

  12. Microbiological decontamination of natural honey by irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Migdal, W.; Owczarczyk, H.B.; Kedzia, B.; Holderna-Kedzia, E.; Madajczyk, D

    2000-03-01

    Degree of microbiological decontamination, organoleptic and physico-chemical properties of natural honeys were investigated after radiation treatment. Seven kinds of honeys were irradiated with the beams of 10 MeV electrons from a 10 kW linear accelerator ''Elektronika 10-10'' at the dose 10 kGy. It was shown, that after irradiation, the total count of aerobic and anaerobic bacteria and moulds decrease by 99%. The antibiotic value in investigated honeys increased in turn from 1.67 to 2.67 after irradiation. Such factors and parameters of investigated honeys as their consistency, content of water and saccharose, acidity, the diastase and 5-HMF values were not changed significantly after irradiation. Decontamination by irradiation is a process which allows us to obtain high microbiological purity of honeys. It is especially needed, when honeys are used in surgical treatment of injuries and in nutrition of babies with food deficiency.

  13. Physicochemical study of some types of Algerian honeys

    Directory of Open Access Journals (Sweden)

    Djahida. Nabti

    2016-09-01

    Full Text Available The modern bee-keeping proposes various types of honeys of floral and geographical origin, of very varied savor and aspect. It is often the only source of sugar of the most withdrawn indigenous populations of the tropical forests. Good for health, honey is also for the environment. The present manuscript is to determine its physicochemical characteristics, six types of samples were collected in various areas of the East of Algeria. These honeys are analyzed for the determination of the pH, the water content, electric conductivity, the ashes content, acidity, and the content of hydroxyl methylfurfural (HMF, the index of diastase (I.D. The results showed that there were differences of a honeys samples to the other and they which they all answer almost the international norms. The physicochemical analyzes studied is to control quality of Algerian honey who is considered an indicator of the environmental pollution.

  14. Determinação de parâmetros físico-químicos e da origem botânica de méis indicados monoflorais do sudeste do Brasil Physico-chemical parameters and botanical origin of indicated monofloral honeys from the southeast of Brazil

    Directory of Open Access Journals (Sweden)

    Monika O. Barth

    2005-06-01

    Full Text Available O presente trabalho analisou a composição físico-química e origem botânica de 31 amostras de mel indicadas como sendo de origem monofloral, comercializadas e produzidas na região Sudeste do Brasil, a fim de verificar parâmetros de qualidade. As análises físico-químicas compreenderam o teste de Fiehe, a reação de lugol, a determinação do teor de umidade, do pH, de açúcares redutores, de cinzas e do índice de diastase. Todas as amostras apresentaram-se dentro do limite previsto pela legislação brasileira para o teor de umidade. Dez amostras apresentaram teor de açúcares redutores inferior ao previsto na legislação, três tinham número de diastase (unidades Schade/Gothe inferior a 8, uma apresentou pH abaixo do padrão e outra apresentou teor de cinzas superior ao previsto. A análise polínica mostrou que cerca de 57% das amostras poderiam ser classificadas como monoflorais, correspondendo nove amostras a mel de eucalipto (Eucalyptus, Myrtaceae, duas a mel de aroeira (Schinus, Anacardiaceae, duas a mel de assa-peixe (Vernonia, Asteraceae, duas a mel de laranjeira (Citrus, Rutaceae, uma a mel de cambará (Gochnatia, uma a mel de capixingui (Croton, Euphorbiaceae. As demais amostras eram bi- ou heteroflorais. A influência de uma determinada espécie botânica nas variáveis físico-químicas analisadas não foi significativa (p>0,05 segundo a análise de regressão.The physico-chemical properties and the botanical origin of 31 commercial honey samples from Southeast Brazil, indicated as monofloral honeys, were analyzed in order to verify quality parameters. The physico-chemical analyses comprised the test of Fiehe, the lugol reaction, the determination of humidity, pH, reduced sugars, ashes and diastase. In accordance with Brazilian legislation all samples showed adequate water content. The level of reducing sugars from 10 samples was below the Brazilian quality parameters for honey, three presented a Schade/Gothe number of

  15. Microbiological decontamination of natural honey by irradiation

    International Nuclear Information System (INIS)

    Migdal, W.; Owczarczyk, H.B.; Kedzia, B.; Holderna-Kedzia, E.; Madajczyk, D.

    2000-01-01

    Degree of microbiological decontamination, organoleptic and physico-chemical properties of natural honeys were investigated after radiation treatment. Seven kinds of honeys were irradiated with the beams of 10 MeV electrons from a 10 kW linear accelerator ''Elektronika 10-10'' at the dose 10 kGy. It was shown, that after irradiation, the total count of aerobic and anaerobic bacteria and moulds decrease by 99%. The antibiotic value in investigated honeys increased in turn from 1.67 to 2.67 after irradiation. Such factors and parameters of investigated honeys as their consistency, content of water and saccharose, acidity, the diastase and 5-HMF values were not changed significantly after irradiation. Decontamination by irradiation is a process which allows us to obtain high microbiological purity of honeys. It is especially needed, when honeys are used in surgical treatment of injuries and in nutrition of babies with food deficiency

  16. Primary pleomorphic sarcoma of the ovary with rhabdomyosarcomatous differentiation

    Directory of Open Access Journals (Sweden)

    Mukherjee Sumana

    2009-04-01

    Full Text Available A 49-year-old patient presented with a right ovarian mass, which, on microscopy, showed to consist of haphazardly oriented large pleomorphic cells with abundant cytoplasm. Periodic acid Schiff stain was positive but negative with diastase digestion. Immunohistochemical staining with Desmin showed intense cytoplasmic positivity in almost all the cells. Cytokeratin, epithelial membrane antigen, smooth muscle actin, HMB-45, S-100 and neurone-specific enolase were negative. Immunohistochemical staining with Myogenin showed intense nuclear positivity. There was no other primary tumor on extensive search. A diagnosis of primary sarcoma of the ovary with rhabdomyosarcomatous differentiation was made. The incidence of similar tumors of the ovary are low and therefore little data are available on this uniformly lethal tumor. Thus, such cases need to be reported to pool experience so that the tumor can be diagnosed early.

  17. Hepatic lipidosis associated with cobalt deficiency in Omani goats.

    Science.gov (United States)

    Johnson, E H; Muirhead, D E; Annamalai, K; King, G J; Al-Busaidy, R; Hameed, M S

    1999-06-01

    Livers from 36 of 684 (5.3%) apparently healthy goats examined at an abattoir in the greater Muscat area of Oman exhibited gross pathological findings characterized by extremely pale, friable, fatty livers encompassing the entire organ. Histopathologically, diffuse hepatic lipidosis and occasional bile duct proliferation were observed. Periodic acid Schiff-positive, diastase-resistant pigment was observed in the macrophages lining the sinusoids. These histopathological lesions were consistent with those characteristic of ovine white liver disease. Cobalt analysis revealed that normal livers had six times more cobalt and a 3-fold less fat content than those measured in the fatty livers. This is the first report of an association between cobalt deficiency and hepatic lipidosis in Omani goats.

  18. Laparoscopic Cholecystectomy During Abdominoplasty: Case Report

    Directory of Open Access Journals (Sweden)

    Kazim DUMAN

    2013-04-01

    Full Text Available We aimed to present the phenomenon of laparoscopic cholecystectomy and abdominoplasty which we diagnosed at the same period the abdominal laxation, diastase of rectum and cholelithiasis that we think in the literature the first samples without leaving any trocar entrance mark.A 58 year old female patient has consulted to the polyclinic of plastic surgery due to prolapsus on the abdominal region. Gall bladder multiplestones were ascertained through abdominal ultrasonograpy. On request and to provide minimal cosmetic failure to the patient, cholecystectomy and abdominoplasty is performed at the same session. Patients with abdominal pathologies that may occur after operations requiring surgery such as abdominoplasty very serious impact on cosmetics. Concordantly, we strongly suggest to take abdominal USG, even if there is no additional complaints especially before the plastic surgery operations and abdominoplasty, for ascertain the existent patologies. [Cukurova Med J 2013; 38(2.000: 319-324

  19. Clinical, radiographic, pathologic, and genetic features of osteochondrodysplasia in Scottish Deerhounds

    International Nuclear Information System (INIS)

    Breur, G.J.; Zerbe, C.A.; Slocombe, R.F.; Padgett, G.A.; Braden, T.D.

    1989-01-01

    Clinical, radiographic, pathologic, and genetic features of a form of osteochondrodysplasia in 5 related Scottish Deerhound pups from 2 litters were evaluated. All pups appeared to be phenotypically normal at birth. At approximately 4 or 5 weeks, exercise intolerance and retarded growth were observed. Kyphosis, limb deformities, and joint laxity gradually developed. Radiography of the affected pups revealed skeletal changes characterized by abnormalities in long bones and vertebrae, with involvement of epiphyses, growth plates, and metaphyses. Short long bones and vertebrae and irregular and delayed epiphyseal ossification were most noticeable in younger pups; in older pups, bony deformities became more prominent. In skeletally mature dogs, osteopenia and severe deformities were seen. The histologic changes of the growth plate were compatible with a diagnosis of chondrodysplasia. Growth plate chondrocytes contained periodic acid Schiff-positive, diastase-resistant cytoplasmic inclusions. A single autosomal recessive mode of inheritance was suspected

  20. Qualidade dos méis produzidos por Melipona fasciculata Smith da região do cerrado maranhense

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre Holanda

    2012-01-01

    Full Text Available The honey of Melipona fasciculata is few known in terms of composition, and therefore generally associated with the characteristics of the honey of Apis mellifera. This study contributes to the knowledge of the physico-chemical characteristics of honey of M. fasciculata of the municipalities of Barra do Corda, Jenipapo dos Vieiras, Fernando Falcão, Carolina and Riachão, in cerrado region from Maranhão. The parameters studied were: moisture, pH, acidity, reducing sugars, apparent sucrose, hydroxymethylfurfural, diastase activity, insoluble solids, ash and color. Some of the observed patterns may conform to the established for A. mellifera, but others must be accompanied by a specific legislation.

  1. MRI of injuries of the lateral ankle ligaments; MRT bei Verletzungen der lateralen und angrenzenden Baender des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, Martin [Landesklinikum Waldviertel Horn, Horn (Austria). Inst. fuer Radiologie und Interventionelle Radiologie

    2011-09-15

    The most frequent sport injury of the ankle is located in the lateral ankle ligaments. The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and stress radiography, allowing a fair diagnosis for the daily routine. For the direct visualization and precise diagnosis of the lateral ankle ligaments MRI provides the best answer. MRI is used with controlled positioning of the foot, correct angulation of sequenzes, and distinct analysis of MR findings. Sinus tarsi ligaments and ligaments of the distal syndesmosis should be included to the report. In selected patients MRI allows the best evaluation of the extent of the lateral ankle ligaments. MRI is the method of choice for combined osteochondral injuries and soft tissue lesions too. (orig.)

  2. Classification of fractures in the area of the ankle joint for practical surgical conceras

    International Nuclear Information System (INIS)

    Gay, B.

    1983-01-01

    For practical surgical concerns we require radiological diagnosis of all injuries, indication for conservative or operative therapy and prognostic evidence in order to classify fractures of the ankle joint. Due to the fact that joint stability is ensured by the fibula and syndesmosis, we prefer classification according to Weber. Fracture types A, B and C are classified according to radiological findings, the pertinent concomitant injuries introduced and differentiated from the special forms of the ''interligamentary fracture'' and ''flake fractures''. Due to the frequency of injury in children of the distal, tibial epiphyseal cartilage we select classification according to Aitken for practical purposes, which differentiates basically between separation and fracture of the epiphysis and makes for prognosis about disturbances in growth. Delimited from ''crush injury'' the Aitken classification is compared to other conventional forms of classification in tabular form. (orig.) [de

  3. MRI of injuries of the lateral ankle ligaments

    International Nuclear Information System (INIS)

    Breitenseher, Martin

    2011-01-01

    The most frequent sport injury of the ankle is located in the lateral ankle ligaments. The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and stress radiography, allowing a fair diagnosis for the daily routine. For the direct visualization and precise diagnosis of the lateral ankle ligaments MRI provides the best answer. MRI is used with controlled positioning of the foot, correct angulation of sequenzes, and distinct analysis of MR findings. Sinus tarsi ligaments and ligaments of the distal syndesmosis should be included to the report. In selected patients MRI allows the best evaluation of the extent of the lateral ankle ligaments. MRI is the method of choice for combined osteochondral injuries and soft tissue lesions too. (orig.)

  4. Nuclear Glycogen Inclusions in Canine Parietal Cells.

    Science.gov (United States)

    Silvestri, S; Lepri, E; Dall'Aglio, C; Marchesi, M C; Vitellozzi, G

    2017-05-01

    Nuclear glycogen inclusions occur infrequently in pathologic conditions but also in normal human and animal tissues. Their function or significance is unclear. To the best of the authors' knowledge, no reports of nuclear glycogen inclusions in canine parietal cells exist. After initial observations of nuclear inclusions/pseudoinclusions during routine histopathology, the authors retrospectively examined samples of gastric mucosa from dogs presenting with gastrointestinal signs for the presence of intranuclear inclusions/pseudoinclusions and determined their composition using histologic and electron-microscopic methods. In 24 of 108 cases (22%), the authors observed various numbers of intranuclear inclusions/pseudoinclusions within scattered parietal cells. Nuclei were characterized by marked karyomegaly and chromatin margination around a central optically empty or slightly eosinophilic area. The intranuclear inclusions/pseudoinclusions stained positive with periodic acid-Schiff (PAS) and were diastase sensitive, consistent with glycogen. Several PAS-positive/diastase-sensitive sections were further examined by transmission electron microscopy, also using periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) staining to identify polysaccharides. Ultrastructurally, the nuclear inclusions were composed of electron-dense particles that were not membrane bound, without evidence of nuclear membrane invaginations or cytoplasmic organelles in the nuclei, and positive staining with PA-TCH-SP, confirming a glycogen composition. No cytoplasmic glycogen deposits were observed, suggesting that the intranuclear glycogen inclusions were probably synthesized in loco. Nuclear glycogen inclusions were not associated with gastritis or colonization by Helicobacter-like organisms ( P > .05). Our findings suggest that nuclear glycogen inclusions in canine parietal cells could be an incidental finding. Nevertheless, since nuclear glycogen is present in several pathologic

  5. Radiographic evaluation of fracture healing after rigid plate fixation

    International Nuclear Information System (INIS)

    Paavolainen, P.; Karaharju, E.; Slaetis, P.; Waris, P.

    1981-01-01

    Experimental osteotomies were made in 35 rabbit tibio-fibular bones and fixed with rigid stainless steel osteosynthesis plates (DCP/ASIF). The radiographic and histopathologic appearances in the healing osteotomies and adjacent bone were analysed at intervals from 3 up to 24 weeks postoperatively. Radiologically the osteotomy had closed at 9 weeks and microscopically this could be confirmed as longitudinal orientation of the cutter heads across the osteotomy gap with longitudinal orientation of the bone structure. The healing of the osteotomy was accompanied by gross structural changes in the adjacent cortical bone with loss of intracortical and subendosteal osteons, cementing lines and intermediate tissue between the osteons. This was characterized by decreasing attenuation of the cortical bone after healing of the osteotomy and should clinically be regarded as an indication for removal of the implant. (Auth.)

  6. Arthrography of the ankle sprains

    International Nuclear Information System (INIS)

    Han, Moon Hee

    1985-01-01

    Ankle arthrography, by direct puncture of joint cavity, is considered to be a simple and accurate diagnostic method for a precise evaluation of ligamentous injury. Forty-seven cases of ankle arthrography were successively performed in the patients of acute ankle sprains. The purpose of this study is to demonstrate how ankle arthrography can delineate the pathologic anatomy in such cases. The results are as follows: 1. Thirty cases among forty seven revealed the findings of ligament tears. 2. For better diagnostic accuracy, the arthrography should be performed within 72 hrs. after injury. 3. The anterior talofibular ligament tears were the most common (twenty-nine cases) of all and seventeen of them revealed tears without association of any other ligament tears. 4. There were ten cases of calcaneofibular ligament tears and nine of them were associated with anterior talofibular ligament tears. 5. Three cases of anterior tibiofibular and one deltoid ligament tears were demonstrated

  7. Case report 335: Idiopathic hypoparathyroidism (IHP)

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, A. de; Jurik, A.G.; Illum, F.

    1986-01-01

    In summary, the case of a 45-year-old man has been presented with a history of convulsive seizures since infancy and mental retardation. Radiological studies demonstrated calcifications in the basal ganglia, periosteal reaction of the upper segments of the humeri and tibiae together with calcification of the spinal ligaments, paravertebral calcification and soft tissue calcification and/or ossification in the tibiofibular ligament and calcification of the medial tibial collateral ligament. Although trauma undoubtedly could be responsible for some of these changes the chemical determinations of the blood, showing a marked hypocalcemia and a low value of S-iPTH, confirms the diagnosis of IHP - a diagnosis further substantiated by the presence of calcifications radiologically demonstrated in the basal ganglia. (orig./SHA).

  8. Case report 335: Idiopathic hypoparathyroidism (IHP)

    International Nuclear Information System (INIS)

    Carvalho, A. de; Jurik, A.G.; Illum, F.

    1986-01-01

    In summary, the case of a 45-year-old man has been presented with a history of convulsive seizures since infancy and mental retardation. Radiological studies demonstrated calcifications in the basal ganglia, periosteal reaction of the upper segments of the humeri and tibiae together with calcification of the spinal ligaments, paravertebral calcification and soft tissue calcification and/or ossification in the tibiofibular ligament and calcification of the medial tibial collateral ligament. Although trauma undoubtedly could be responsible for some of these changes the chemical determinations of the blood, showing a marked hypocalcemia and a low value of S-iPTH, confirms the diagnosis of IHP - a diagnosis further substantiated by the presence of calcifications radiologically demonstrated in the basal ganglia. (orig./SHA)

  9. ANTROPOMETRI SENDI PERGELANGAN KAKI ETNIS MINANGKABAU

    Directory of Open Access Journals (Sweden)

    Hafni Marsil

    2015-09-01

    Full Text Available AbstrakPenelitian ini bertujuan mengukur antropometri sendi pergelangan kaki etnis Minangkabau. Penelitian cross sectional dilakukan pada 50 orang mahasiswa kedokteran etnis Minangkabau berusia 21-25 tahun di lingkungan RS. dr. M Djamil Padang. Dilakukan pemeriksaan ROM, rontgen ankle proyeksi anteroposterior, lateral dan mortise. Hasil penelitian didapatkan ROM plantarfleksi 48,920±5,820, ROM dorsofleksi 31,300±4,070, inversi 10,320±2,280, eversi 5,940±1,200, talocrural angel anteroposterior 76,530± 2,530 dan mortise 77,380±2,270, tibiofibular overlap anteroposterior 7,51±2,64 mm dan mortise 4,71±2,45 mm, tibiofibular clear space anteroposterior 3,6±1,18 mm dan mortise 3,85±1,09 mm, talar tilt anteroposterior 0,140±0,100 dan mortise 0,190±0,150, medial malleolar length anteroposterior 13,88±1,99 mm dan mortise 14,03±1,69 mm, lateral malleolar length anteroposterior 25,71±2,83 mm dan mortise 26,70±3,40 mm, johnson angle anteroposterior 87,770±1,710 dan mortise 87,570±1,840, medial clear space 2,97±0,75 mm, anteroposterior inclination angle 7,470±2,700, anterior distal tibial angle 82,530± 2,700, dan anteroposterior gap 3,50±1,43 mm.Terdapat perbedaan ukuran antropometri sendi pergelangan kaki mahasiswa kedokteran beretnis Minangkabau di lingkungan RS. Dr. M. Djamil Padang dengan kepustakaan, namun masih dalam rentang normal.AbstractThis study aimed to measure anthropometric of ankle joint of Minangkabau ethnic group. Cross sectional study has been done in 50 Minangkabau ethnic medical students, aged 21-25 years in RSUP. Dr. M Djamil Padang. ROM, anteroposterior, lateral, and mortise X-ray projections of ankle were examined. ROM plantarflexion was 48.920±5.820, ROM dorsiflexion was 4.070±31.300, inversion was 10.320±2.280, eversion was 5.940±1.200, talocrural angel anteroposterior was 76.530±2.530 and mortise was 77.380±2.270, tibiofibular overlapp anteroposterior was 7.51±2,64 mm and mortise was 4.71±2,45 mm

  10. Coexisting secondary intraneural and vascular adventitial ganglion cysts of joint origin: a causal rather than a coincidental relationship supporting an articular theory

    International Nuclear Information System (INIS)

    Spinner, Robert J.; Scheithauer, Bernd W.; Desy, Nicholas M.; Rock, Michael G.; Holdt, Frederik C.; Amrami, Kimberly K.

    2006-01-01

    To introduce the clinical entity of an intraneural ganglion cyst coexisting with a vascular adventitial cyst arising from the same joint. Retrospective review. Two patients presented with predominantly deep peroneal neuropathy due to complex superior tibiofibular joint-related cysts. In addition to having peroneal intraneural ganglion cysts, these patients had vascular adventitial cysts: one involving a capsular arterial branch, the other a capsular vein [as well as a large, recurrent, intramuscular (extraneural) ganglion]. We then reviewed MRIs of 12 other consecutive cases of intraneural ganglia (10 peroneal and 2 tibial) arising from the superior tibiofibular joint that we treated, as well as other reported cases in the literature to determine if there were other (unrecognized) examples supporting the combination of clinical findings and radiographic patterns. Retrospective analysis of MRIs in the two surgically proven cases of peroneal intraneural ganglia with vascular adventitial cyst extension showed a common imaging pattern that we have termed ''the wishbone sign,'' consisting of the connection of the ascending limb of the peroneal intraneural ganglion and the longitudinal limb of the vascular adventitial cyst in the axial plane. Our review suggests that vascular adventitial cyst extension occurs in a large proportion of cases of peroneal intraneural ganglia. A similar growth pattern was noted in a case of a tibial intraneural ganglion. The combination of intraneural and vascular adventitial cysts is understandable given our knowledge of normal and pathologic anatomy of para-articular cysts. The combination of intraneural ganglia and vascular adventitial cysts broadens the spectrum of clinical presentations of these cysts and suggests that cysts and their content can dissect from a joint along neurovascular bundles. These cases provide important evidence to support the articular theory for the pathogenesis of not only neural but vascular adventitial cysts as

  11. MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Haller, Joerg [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Ludwig Boltzmann Institute for Osteology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Bernt, Reinhard [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria)]. E-mail: reinhard.bernt@wgkk.sozvers.at; Seeger, Thomas [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Weissenbaeck, Alexander [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Tuechler, Heinrich [Ludwig Boltzmann Institute for Hematology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Resnick, Donald [Department of Radiology, VA Medical Center, UCSD, 3350 La Jolla Village Dr, San Diego, CA 92161 (United States)

    2006-06-15

    Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome.

  12. MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

    International Nuclear Information System (INIS)

    Haller, Joerg; Bernt, Reinhard; Seeger, Thomas; Weissenbaeck, Alexander; Tuechler, Heinrich; Resnick, Donald

    2006-01-01

    Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome

  13. Contribution to the histology of Biomphalaria glabrata Contribuição à histologia da Biomphalaria glabrata

    Directory of Open Access Journals (Sweden)

    Queli Teixeira Lemos

    1999-08-01

    Full Text Available A combination of histological techniques applied to the study of Biomphalaria glabrata yielded some interesting new data about the histology of this snail, a major intermediate host of Schistosoma mansoni in Brazil. Three kinds of pigments were identified: a dark pigment which bleached following oxidation with potassium permanganate; a lipofuchsin-like, diastase-resistant PAS-positive pigment and an iron-containing pigment, probably related to hemosiderin. Calcium was detected in small deposits within the connective tissue and forming a dense core inside the chitinous radular teeth. The presence of fibrils, staining with sirius-red and birefringence under polarized light strongly suggest primitive collagen tissue. The radular apparatus appeared as a storing site for glycogen, while abundant Alcian-blue positive material (proteoglycans was extremely concentrated in the radular sac.Uma combinação de várias técnicas histológicas permitiu alguns achados de interesse para a histologia da Biomphalaria glabrata, principal hospedeiro intermediário do Schistosoma mansoni no Brasil. Três tipos de pigmentos foram identificados: um pigmento escuro, que se descora após oxidação pelo permanganato de potássio; outro que é semelhante à lipofuscina, que se cora pelo PAS e é diastase- resistente, e um pigmento que contém ferro, provalvelmente, relacionado com a hemossiderina. O cálcio foi identificado em pequenos depósitos no interior do tecido conjuntivo e formando pequenos núcleos no interior dos dentes quitinosos da rádula. A presença de fibrilas coradas pelo sírius-vermelho, exibindo birrefrigência sob luz polarizada, sugere fortemente a presença de um tecido colágeno primitivo. O aparelho radular foi visto como um local de armazenamento do glicogênio, enquanto a presença de abundante material amorfo positivo para o azul de alciano (proteoglicano apareceu em grande concentração no saco radular.

  14. Chemical quality of different argentine honey varieties, irradiated to control american foulbrood

    International Nuclear Information System (INIS)

    Zunich, C.D.; Markowski, I.; Narvaiz, Patricia

    2011-01-01

    'American foulbrood' is a disease that seriously affects bees. Honey may be contaminated with spores of the related bacteria, Paenibacillus larvae larvae, which is a great drawback for trade. The scientific literature reports that these spores, resistant to heat and chemicals, are inactivated in honey when it is irradiated al 10 kGy, being this treatment mandatory in the Republic of Southafrica. Irradiated food wholesomeness is endorsed by the World Health Organization. Considering that Argentina is an important honey producer and exporter, the aim of this work was to evaluate the effect of ionizing radiation on some of its commercial chemical parameters along storage time. Honeys with different characteristics, coming from five different regions of the country: Middle, Patagonia, North, Litoral, Humid Pampa, were provided by producers from a commission called 'Packaged honey' of the National Food, Fishery and Agriculture Ministry. Fifteen kg of each honey variety were packaged in 500 g polypropylene recipes with polyethylene lids, and irradiated at the semi industrial cobalt-60 facility of the Ezeiza Atomic Center, 500,000 Ci of activity, with doses of 0, 10 and 20 kilo Grays. Control and irradiated samples were stored at room temperature for 10 months. Some standardized chemical analysis required by the Argentine Food Code (AFC) were performed on the first, fourth and tenth storage months: water content, acidity, diastase content, reducing sugars, and hydroxymethylfurfural. Reducing sugars and diastase activity slightly diminished, and acidity slightly increased, along storage which is typical in this product; no significant differences were found between control and irradiated samples. Hydroxymethylfurfural values, related to aging or thermal abuse, diminished slightly though significantly due to irradiation, which would not affect the product quality as regulations require not to surpass a maximum value, 40 mg/kg in the AFC. So ionizing

  15. Caracterização físico-química de amostras de méis de Apis mellifera L. (Hymenoptera: Apidae do Estado do Ceará Physical-chemical characterization of honey samples of Apis mellifera L. (Hymenoptera: Apidae from Ceará State

    Directory of Open Access Journals (Sweden)

    Geni da Silva Sodré

    2007-08-01

    Full Text Available Com o objetivo de verificar as características físico-químicas de amostras de méis coletadas em cidades do Estado do Ceará (Araripe, Santana do Cariri, Assaré, Iguatu, Crato, Missão Velha e Pacajús, foram determinados no Laboratório de Apicultura do Departamento de Entomologia, Fitopatologia e Zoologia Agrícola da Escola Superior de Agricultura "Luiz de Queiroz", USP: açúcares totais, açúcares redutores, sacarose aparente, umidade, atividade diastásica, hidroximetilfurfural, proteína, cinzas, pH, acidez, índice de formol, condutividade elétrica, viscosidade e cor de 20 amostras de méis Apis mellifera L., 1758, coletadas entre março de 2002 e agosto de 2002. A maioria das amostras de méis analisadas (65% encontra-se dentro das especificações brasileiras para as características físico-químicas, com exceção das características sacarose aparente (10% das amostras, umidade (10% das amostras, atividade diastásica (35% das amostras e HMF (20% das amostras. Os resultados indicaram condutividade elétrica e a sacarose aparente como as características que mais influenciaram no agrupamento das amostras.This research was aimed at to determining physico-chemical characteristics honey samples collected in cities of Ceara States (Araripe; Santana do Cariri 1 sample; Assaré 1 sample; Iguatu 8 samples; Crato 4 samples; Missão Velha 2 samples and Pacajús 3 samples, they were determined at the laboratory of Apiculture in the "Escola Superior de Agricultura Luiz de Queiroz" (ESALQ University of São Paulo, in Piracicaba, São Paulo State: total sugar, reducing sugars, apparent sucrose, humidity, diastase activity, hydroxymethylfurfural (HMF, protein, ash, pH, acidity, formol index, electrical conductivity, viscosity and color of 20 samples of Apis mellifera L., 1758 honey collected between March of 2002 and August of 2002. Most of the samples of honey analyzed (65% are inside of the Brazilian specifications for the characteristics

  16. The clock face guide to peroneal intraneural ganglia: critical ''times'' and sites for accurate diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Spinner, Robert J. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Orthopedics, Rochester, MN (United States); Mayo Clinic, Department of Anatomy, Rochester, MN (United States); Luthra, Gauri [University College Cork, National University of Ireland, Cork (Ireland); Desy, Nicholas M. [McGill University School of Medicine, Department of Orthopedics, Montreal, Quebec (Canada); Anderson, Meredith L. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Amrami, Kimberly K. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2008-12-15

    The aim of this study is to exploit the normal nature of peroneal nerve anatomy to identify constant magnetic resonance imaging (MRI) patterns in peroneal intraneural ganglia. This study is designed as a retrospective clinical study. MR images of 25 patients with peroneal intraneural ganglia were analyzed and were compared to those of 25 patients with extraneural ganglia and 25 individuals with normal knees. All specimens were interpreted as left-sided. Using conventional axial images, the position of the common peroneal nerve and either intraneural or extraneural cyst was determined relative to the proximal fibula and the superior tibiofibular joint using a symbolic clock face. In all patients, the common peroneal nerve could be seen between the 4 and 5 o'clock position at the mid-portion of the fibular head. In patients with intraneural ganglia, a single axial image could reproducibly and reliably demonstrate both cyst within the common peroneal nerve at the mid-portion of the fibular head (signet ring sign) between 4 and 5 o'clock and within the articular branch at the superior tibiofibular joint connection (tail sign) between 11 and 12 o'clock; in addition, cyst within the transverse limb of the articular branch (transverse limb sign) was seen at the mid-portion of the fibular neck between the 12 and 2 o'clock positions on serial images. Extraneural ganglia typically arose from more superior joint connections with the epicenter of the cyst varying around the entire clock face without a consistent pattern. There was no significant difference between the visual and template assessment of clock face position for all three groups (intraneural, extraneural, and controls). We believe that the normal anatomic and pathologic relationships of the common peroneal nerve in the vicinity of the fibular neck/head region can be established readily and reliably on single axial images. This technique can provide radiologists and surgeons with rapid and

  17. Comparison of the Cellient(™) automated cell block system and agar cell block method.

    Science.gov (United States)

    Kruger, A M; Stevens, M W; Kerley, K J; Carter, C D

    2014-12-01

    To compare the Cellient(TM) automated cell block system with the agar cell block method in terms of quantity and quality of diagnostic material and morphological, histochemical and immunocytochemical features. Cell blocks were prepared from 100 effusion samples using the agar method and Cellient system, and routinely sectioned and stained for haematoxylin and eosin and periodic acid-Schiff with diastase (PASD). A preliminary immunocytochemical study was performed on selected cases (27/100 cases). Sections were evaluated using a three-point grading system to compare a set of morphological parameters. Statistical analysis was performed using Fisher's exact test. Parameters assessing cellularity, presence of single cells and definition of nuclear membrane, nucleoli, chromatin and cytoplasm showed a statistically significant improvement on Cellient cell blocks compared with agar cell blocks (P cell groups, PASD staining or the intensity or clarity of immunocytochemical staining. A discrepant immunocytochemistry (ICC) result was seen in 21% (13/63) of immunostains. The Cellient technique is comparable with the agar method, with statistically significant results achieved for important morphological features. It demonstrates potential as an alternative cell block preparation method which is relevant for the rapid processing of fine needle aspiration samples, malignant effusions and low-cellularity specimens, where optimal cell morphology and architecture are essential. Further investigation is required to optimize immunocytochemical staining using the Cellient method. © 2014 John Wiley & Sons Ltd.

  18. Characterization of Turkish honeys regarding of physicochemical properties, and their adulteration analysis

    Directory of Open Access Journals (Sweden)

    Şeyda KIVRAK

    Full Text Available Abstract This work was conducted to evaluate the quality of 54 honey samples from eighteen different origins from Turkey. Physicochemical properties were examined according to AOAC methods, total phenolic and flavonoid contents by a spectrophotometric method and authenticity of honeys by Combustion Module - Cavity Ring-Down Spectroscopy (CM-CRDS. The microscopic analysis of honey sediment (mellissopalynology was carried out to identify and count the pollen to provide qualitative indicators to confirm botanical origin. The moisture, electrical conductivity and free acidity of honeys ranged from 15.56 to 18.39%, 0.143 to 2.006 mS.cm-1, 16.05 meq.kg-1 and 34.10 meq.kg-1, respectively. Diastase activity of sideritis honey was found highest. Honeys showed HMF level below 40 mg.kg-1. The highest proline was determined in thyme honey. The results showed that honeys contained eminent amounts of phenolics and flavonoids. δ13C values of honeys were more negative than -23.5‰. The C4% sugar ratios were lower than 7% value. The lowest glucose-fructose content was observed in eucalyptus, cedar and pine honey samples. The results obtained for physicochemical characteristics, total phenolic and flavonoid contents an authenticity analysis of Turkish honeys indicate a good quality level, adequate processing, good maturity and freshness. The discrimination between honey types was achieved by PCA.

  19. Characterization of Multifloral Honeys of Pervari Region with Different Properties

    Directory of Open Access Journals (Sweden)

    Mehmet Emre EREZ

    2015-03-01

    Full Text Available The quality of honey from Pervari region was almost known by all over the country in Turkey. This study was undertaken to determine (i physico-chemical parameters, (ii antimicrobial analysis and (iii pollen estimation method with expert computer system obtained from three different sites of Pervari region (Siirt/Turkey. For physico-chemical parameters; moisture, free acidity, diastase activity, hydroxyl methyl furfural (HMF, invert sugar, ash, commercial glucose and proline analysis were examined. For anti-microbial analysis disc dilution method were studied on six different bacteria species. For pollen analysis; different and new expert computer system was used for comparison of pollen of plants and honey samples. The aim of the study was to evaluate the properties of multi floral honey determined from three different locations in the same region and the way to understand to which plants were visited by the bees with comparing of pollen grains of flowers and honey by using the expert computer system. Honey samples of Pervari region were of acceptable quality based on recommended criteria of Turkish Food Codex and International Honey Commission.

  20. Effect of Microwave Treatment on Microbial Contamination of Honeys and on Their Physicochemical and Thermal Properties

    Directory of Open Access Journals (Sweden)

    Paz Moliné María de la

    2015-06-01

    Full Text Available In recent years, microwave heating has become a common method for pasteurization and sterilization of food. Honey is a sweet substance produced by worker honeybees from nectar of flowers. The major microbial contaminants include moulds and yeasts, as well as the spore-forming bacteria, being their counts indicative of honeys’ commercial quality and safety. Paenibacillus larvae is also of interest since it causes American foulbrood (AFB in honeybee larvae. The main quality factors that are used in the honey international trade are moisture, hydroxymethylfurfural content (HMF, and enzymatic indices. Moreover, honey exhibits several thermal events, the most important being the glass transition temperature (Tg. The aim of this work was to evaluate microwave effect (800 watts during 45 and 90 seconds on microbial content in particular over P. larvae spores retained in honey, and on physicochemical and thermal properties. Microwave promoted a decrease of microbial count with time of exposure, including P. larvae. Moisture content diminished after treatment, while Tg increased linearly, and acidity decremented in the majority of cases. Honeys darkened and HMF exceeded the permissible value. Diastase and glucose-oxidase enzymes were totally inactivated by microwave treatment.

  1. CHEMICAL CHARACTERISTICS OF HONEY PRODUCED AND SOLD IN THE CITY OF GOIÂNIA – GOIÁS CARACTERÍSTICAS QUÍMICAS DE MÉIS PRODUZIDOS E COMERCIALIZADOS EM GOIÂNIA - GOIÁS

    Directory of Open Access Journals (Sweden)

    João Carlos Gióia

    2007-09-01

    Full Text Available

    Thirty-nine samples of honey produced in Goiânia-GO and vicinities were analysed in relation to solid solubles, moisture, acidity in formic acid reducing sugars on glucose. The search for falsification was based on LUND’s reaction, the FIEHE test, Lugol test and the determination of the diastasics ferments. Only 30.77% of the samples analyzed were within the established by the legislation.

    Foram analisadas 39 amostras de mel de abelha produzido na região de Goiânia – GO, com o objetivo de se avaliar sua qualidade. Determinou-se: sólidos solúveis, umidade, acidez em ácido fórmico e glicídios redutores em glicose. As pesquisas de fraudes basearam-se nas provas de FIEHE, de LUND, teste do lugol e determinação de fermentos diastásicos. Somente 30,77% das amostras analisadas apresentaram-se conforme os padrões estabelecidos pela legislação vigente em todas as provas realizadas.

  2. Physicochemical analysis of apis dorsata honey from terai forests, Nepal

    International Nuclear Information System (INIS)

    Qamer, S.; Ahmad, F.; Latif, F.; Ali, S.S

    2008-01-01

    The multi floral honey produced by Apis dorsata from Shahabgunj, Dhakeri, Narayanpur and Perari forest, Nepal, were provided by International Center for Integrated Mountain Development (ICIMOD), Nepal. These ninety nine Apis dorsata honey samples were characterized physicochemical and were found to have values of various quality determining parameters well with in the permissible International standards. The honey samples had pH in the range of 3.8-4.68, free acidity 41-48 meq/kg, lactones 13-16 meq/kg, total acidity 55-65 meq/kg, moisture content 20.5-26%, electrical conductivity 0.22-0.63 mS/cm, proline content 76-160 mg/kg, HMF content 30-56 mg/kg, diastase number 5.1-29 DN, invertase number 390-499, apparent reducing sugars 73.78-77.78%, fructose 36.93-44.61%, glucose 19.61-27.51% and sucrose 12.07-20.38%. (author)

  3. THE INFLUENCE OF THE BOTANIC ORIGIN OF HONEY PLANTS ON THE QUALITY OF HONEY

    Directory of Open Access Journals (Sweden)

    Z. Tucak

    2007-06-01

    Full Text Available Numerous parameters affect the quality of honey from different beehive types (Albert – Žindaršić AŽ, Langstroth – Roott LR i Dadant – Blatt DB, i.e. the material of beehives are made of, the origin of queen bees (natural and selected, etc. Our research focuses on the influence of the botanic origin of honey plants (Tilia sp. L. (lime, Amorpha fructirosa L. (desert false indigo, Helianthus annuus L. (sunflower, Brassica napus subsp. olifera DC. (oil beet and Robina pseudoacacia L. (acacia on the quality of honey. The physical and chemical analyses of honey (N=133 (water %, water insoluble compounds %, acidity level, mmol of acid per kg, electrical conductivity, mS/cm, reducing sugar %, sucrose %, HMF, mg/kg, and diastasic number were conducted by Harmonised methods of the European Honey. The pollen analysis was conducted by Harmonised methods of melissopalynology. The pollen analysis indicates that the botanic origin has had a statistically significant influence (P<0.001 on the quality of all investigated characteristics of honey, except on the share of the non–dissolving substances (P=0.088. The research was conducted in the Vukovar-Srijem County, the Republic of Croatia. All bees used in this research belong to the Carniolan honey bee (Apis mellifera carnica, the European bee species.

  4. Characterization of Lavandula spp. Honey Using Multivariate Techniques.

    Science.gov (United States)

    Estevinho, Leticia M; Chambó, Emerson Dechechi; Pereira, Ana Paula Rodrigues; Carvalho, Carlos Alfredo Lopes de; Toledo, Vagner de Alencar Arnaut de

    2016-01-01

    Traditionally, melissopalynological and physicochemical analyses have been the most used to determine the botanical origin of honey. However, when performed individually, these analyses may provide less unambiguous results, making it difficult to discriminate between mono and multifloral honeys. In this context, with the aim of better characterizing this beehive product, a selection of 112 Lavandula spp. monofloral honey samples from several regions were evaluated by association of multivariate statistical techniques with physicochemical, melissopalynological and phenolic compounds analysis. All honey samples fulfilled the quality standards recommended by international legislation, except regarding sucrose content and diastase activity. The content of sucrose and the percentage of Lavandula spp. pollen have a strong positive association. In fact, it was found that higher amounts of sucrose in honey are related with highest percentage of pollen of Lavandula spp.. The samples were very similar for most of the physicochemical parameters, except for proline, flavonoids and phenols (bioactive factors). Concerning the pollen spectrum, the variation of Lavandula spp. pollen percentage in honey had little contribution to the formation of samples groups. The formation of two groups regarding the physicochemical parameters suggests that the presence of other pollen types in small percentages influences the factor termed as "bioactive", which has been linked to diverse beneficial health effects.

  5. Physicochemical characterization of Lavandula spp. honey with FT-Raman spectroscopy.

    Science.gov (United States)

    Anjos, Ofélia; Santos, António J A; Paixão, Vasco; Estevinho, Letícia M

    2018-02-01

    This study aimed to evaluate the potential of FT-Raman spectroscopy in the prediction of the chemical composition of Lavandula spp. monofloral honey. Partial Least Squares (PLS) regression models were performed for the quantitative estimation and the results were correlated with those obtained using reference methods. Good calibration models were obtained for electrical conductivity, ash, total acidity, pH, reducing sugars, hydroxymethylfurfural (HMF), proline, diastase index, apparent sucrose, total flavonoids content and total phenol content. On the other hand, the model was less accurate for pH determination. The calibration models had high r 2 (ranging between 92.8% and 99.9%), high residual prediction deviation - RPD (ranging between 4.2 and 26.8) and low root mean square errors. These results confirm the hypothesis that FT-Raman is a useful technique for the quality control and chemical properties' evaluation of Lavandula spp honey. Its application may allow improving the efficiency, speed and cost of the current laboratory analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Comprehensive Study of Honey with Protected Denomination of Origin and Contribution to the Enhancement of Legal Specifications

    Directory of Open Access Journals (Sweden)

    Leticia M. Estevinho

    2012-07-01

    Full Text Available In this study the characterization of a total of 60 honey samples with Protected Denomination of Origin (PDO collected over three harvests (2009–2011, inclusive, from the Northeast of Portugal was carried out based on the presence of pollen, physicochemical and microbiological characteristics. All samples were found to meet the European Legislation, but some didn’t meet the requirements of the PDO specifications. Concerning the floral origin of honey, our results showed the prevalence of rosemary (Lavandula pedunculata pollen. The microbiological quality of all the analyzed samples was satisfactory, since fecal coliforms, sulfite-reducing clostridia and Salmonella were absent, and molds and yeasts were detected in low counts. Significant differences between the results were studied using one-way analysis of variance (ANOVA, followed by Tukey’s HSD test. The samples were submitted to discriminant function analysis, in order to determine which variables differentiate between two or more naturally occurring groups (Forward Stepwise Analysis. The variables selected were in this order: diastase activity, pH, reducing sugars, free acidity and HMF. The pollen spectrum has perfect discriminatory power. This is the first study in which a honey with PDO was tested, in order to assess its compliance with the PDO book of specifications.

  7. Volatile fraction composition and physicochemical parameters as tools for the differentiation of lemon blossom honey and orange blossom honey.

    Science.gov (United States)

    Kadar, Melinda; Juan-Borrás, Marisol; Carot, Jose M; Domenech, Eva; Escriche, Isabel

    2011-12-01

    Volatile fraction profile and physicochemical parameters were studied with the aim of evaluating their effectiveness for the differentiation between lemon blossom honey (Citrus limon L.) and orange blossom honey (Citrus spp.). They would be useful complementary tools to the traditional analysis based on the percentage of pollen. A stepwise discriminant analysis constructed using 37 volatile compounds (extracted by purge and trap and analysed by gas chromatography-mass spectrometry), and physicochemical and colour parameters (diastase, conductivity, Pfund colour and CIE L a b) together provided a model that permitted the correct classification of 98.3% of the original and 96.6% of the cross-validated cases, indicating its efficiency and robustness. This model proved its effectiveness in the differentiation of both types of honey with another set of batches from the following year. This model, developed from the volatile compounds, physicochemical and colour parameters, has been useful for the differentiation of lemon and orange blossom honeys. Furthermore, it may be of particular interest for the attainment of a suitable classification of orange honey in which the pollen count is very low. These capabilities imply an evident marketing advantage for the beekeeping sector, since lemon blossom honey could be commercialized as unifloral honey and not as generic citrus honey and orange blossom honey could be correctly characterized. Copyright © 2011 Society of Chemical Industry.

  8. The Determination of the Biochemical Properties of Some Monofloral Honey Samples Produced across Turkey

    Directory of Open Access Journals (Sweden)

    Aziz Gül

    2016-12-01

    Full Text Available This study was conducted in 2013 to determine the biochemical properties of 10 different monofloral honey types produced across Turkey. For the study, honey samples were obtained from beekeepers and the identity and relative percentage of dominant pollen types in samples was determined through microscopic analysis. Pollen analysis revealed that honey types chaste tree (Vitex agnus-castus and sunflower (Helianthus annuus contained high proportions of each respective pollen type. These proportions reached as high as 86%, while other honey types such as Anason had low Anasom pollen content, occurring at 45% in whole honey samples. Biochemical analysis revealed that the average honey sample quality characteristics were as followings: ash 0.37±0.04, electricity conductivity 0.79±0.07 mS/cm, moisture 19.15±0.09%, pH 3.97±0.02, acidity 29.07±0.39 meq/kg, hydroxymethylfurfural (HMF, 6.17±0.76 mg/kg, diastase 22.05±0.00, invert sugar 69.72±0.49% and sucrose 2.90±0.30%. These analyses confirmed that honey samples met standards outlined by the Turkish Food Codex Honey Standard, European Union Honey Standard and Codex Standards respectively.

  9. A Case Report of Lipid-Rich Carcinoma of the Breast Including Histological Characteristics and Intrinsic Subtype Profile

    Directory of Open Access Journals (Sweden)

    Ayako Kimura

    2011-05-01

    Full Text Available A 57-year-old Japanese woman with schizophrenia, who had received long-term treatment with neuroleptics, noticed a painless, pea-sized lump in her right breast. She was admitted to our hospital and a malignant tumor was diagnosed. The patient underwent a conservative radical mastectomy (Patey’s operation. The excised tumor measured 2.0 × 1.2 × 1.1 cm in diameter, and its cut surface was grayish-white. Histologically, tumor cells with clear to foamy cytoplasm were invariably Oil Red O-positive and periodic acid Schiff-negative with or without diastase digestion. The tumor was diagnosed as a lipid-rich carcinoma accompanied by an in situ component. Neuroleptics increase serum prolactin levels by interfering with dopaminergic inhibition of prolactin secretion. Immunohistochemical analysis revealed that, although prolactin was not detected, the tumor cells expressed prolactin receptor, indicating prolactin as the genesis of this neoplasm. In immunohistochemical intrinsic subtype analysis, the tumor was negative for estrogen receptor, progesterone receptor, human epidermal growth factor receptor 1 and 2, and basal cytokeratins (CK5, CK6, and CK14, indicating an unclassified (all-marker negative subtype. Axillary lymph nodes were free of metastasis (stage I, and the patient has been well for 20 years without any evidence of recurrence.

  10. Physicochemical Parameters and Bioactive Compounds of Strawberry Tree (Arbutus unedo L. Honey

    Directory of Open Access Journals (Sweden)

    Pablo A. Ulloa

    2015-01-01

    Full Text Available Botanical origin, physicochemical properties (ash, colour, diastase activity, electrical conductivity (EC, hydroxymethylfurfural (HMF, moisture, optical rotation (OP, pH, reducing sugars, total acidity, total soluble solids, and water activity, bioactive compounds (BC, and antioxidant activity obtained from strawberry tree honey from South Portugal were investigated. Results showed that the pollen analysis and physicochemical parameters were found within to meet international honey specifications. Significant differences (P<0.05 in results of ash content, EC, HMF, OP and colour when were compared with analogous famous Italian honey (Sardinia island. For BC, total phenolic and total flavonoid content were 94.47 mg gallic acid/100 g and 5.33 mg quercetin/100 g, respectively. Concerning Portuguese honey, it was also found that radical scavenging activity (DPPH assay was 43.46% and antioxidant activity was 18.85 mg ascorbic acid equivalent/100 g and 9.92 mg quercetin equivalent/100 g. These results confirmed that Portuguese strawberry tree honey has the highest antioxidant activity, when compared with other kinds of honey. This complete report demonstrates advantages and can help to promote consumption and shown their benefical properties (e.g., antioxidant; which will may increase the commercial value.

  11. Influence of temperature and packaging type on quality parameters and antimicrobial properties during Yateí honey storage

    Directory of Open Access Journals (Sweden)

    Ramón Alejandro MARTÍNEZ

    2017-12-01

    Full Text Available Abstract Tetragonisca fiebrigi, is a bee of the subfamily Meliponidae traditionally known as Yateí. Its honey differs from the honey produced by Apis mellifera because it is less viscous, more acidic, has sweetness and particular aromas. It is important to know the behavior of yatei honey in different storage conditions, in order to preserve the characteristics of the honey and ensure the product as harmless. The objective was to determine the influence of temperature, packaging type and storage time of Yateí honey on antimicrobial properties, microbial (Total Mesophilic Aerobic and Mold and Yeast Count and physicochemical parameters (pH, hydroxymethylfurfural (HMF, acidity, moisture content and diastase, with methodology of national and international standards. The antimicrobial effect was variable against strains of the genus Staphylococcus aureus. The most significant microbiological quality levels were Mold and Yeast counts (> 102 CFU / g. The physicochemical parameters with the most significant values were acidity (to: 42.5 meq acid/kg honey, moisture content (to: 26% and HMF (to: 3.8mg/kg honey. Storage at refrigeration temperature maintained standard values close to Apis mellifera honey during 180 days; whereas at room temperature it was better to maintain antimicrobial power. No significant difference was found between plastic storage containers vs. glass.

  12. Primary clear cell ductal adenocarcinoma of the pancreas: A case report and clinicopathologic literature review

    Directory of Open Access Journals (Sweden)

    Yashpal Modi

    2014-01-01

    Full Text Available We present a very rare, interesting case of a carcinoma of the pancreas with predominantly abundant clear cell morphology. According to the WHO classification, primary clear cell carcinoma of the pancreas is classified as a rare "miscellaneous" carcinoma. The tumor was observed in the distal body and tail of the pancreas of a 74-year-old woman. The histopathology of tumor cells showed well-defined cell membranes, clear cytoplasm, and prominent cell boundaries. Immunohistochemical (IHC staining showed positive reactions to antibodies against vimentin, cytokeratin 7 (CK-7, mucicarmine (MUC-1, periodic acid-Schiff (PAS, periodic acid-Schiff with diastase (PASD, carcinoembryonic antigen (CEA, and Carbohydrate Antigen 19-9 (CA 19-9. On the other hand, IHC staining was negative for alpha-fetoprotein (AFP, cytokeratin 20 (CK-20, HMB45, chromogranin, and synaptophysin. The patient was subsequently diagnosed with a primary solid-type pancreatic clear cell carcinoma with hepatic metastasis. Herein, we report this rare case and include a review of the current literature of this tumor.

  13. Honey quality of Melipona sp. bees in Acre, Brazil

    Directory of Open Access Journals (Sweden)

    Marcus Augusto Damaceno do Vale

    2018-04-01

    Full Text Available Honey from stingless bees (Melipona sp. is a nutritious and medicinal product economically valued in the informal Brazilian market, driven by the growing demand for natural products; however, its physicochemical characteristics are still unknown. Thus, the aim of this study is to evaluate the physicochemical profile of the stingless bee honey produced in Cruzeiro do Sul, Acre. Honey samples were analyzed following the methodology recommended by Ministério da Agricultura, Pecuária e Abastecimento; the following parameters were established: moisture, total sugars, reducing sugars, apparent sucrose, ash, crude protein, diastase activity, Brix degrees, free acidity, lactonic acidity, total acidity, pH, hydroxymethylfurfural, electrical conductivity, color and Lugol, Lund and Fiehe reactions. Results show that these parameters are not suitable for all samples, being incompatible with established standards, indicating that the current legislation on Apis mellifera is not suitable for all characters analyzed, mainly moisture content, corroborating the need to standardize guidelines for honey from stingless bees. Moreover, there was no tampering in the honeys analyzed.

  14. Cordyceps sinensis protects against renal ischemia/reperfusion injury in rats.

    Science.gov (United States)

    Wang, Hua-Pin; Liu, Ching-Wen; Chang, Hsueh-Wen; Tsai, Jen-Wei; Sung, Ya-Zhu; Chang, Li-Ching

    2013-03-01

    Cordyceps sinensis (CS) is an entomogenous fungus used as a tonic food and Chinese medicine to replenish health. This study investigated the protective effects of CS in rats post-renal ischemia-reperfusion (I/R) sequence by analyzing the influence on stromal cell-derived factor-1α (SDF-1α and chemokine (C-X-C motif) receptor 4 (CXCR4) expressions and senescence during recovery. Chemokine SDF-1 [now called chemokine C-X-C motif ligand 12 (CXCL12)] and its receptor CXCR4 are crucial in kidney repair after ischemic acute renal failure. CS treatment significantly alleviated I/R-induced renal damage assessed by creatinine levels (p < 0.05) and abated renal tubular damages assessed by periodic acid-Schiff with diastase (PASD) staining. CS induced early SDF-1α expression and increased CXCR4 expression 1-6 h post-reperfusion. Histology studies have revealed that CS induced SDF-1α in squamous cells of Bowman's capsule, mesangial cells, distal convoluted tubules (DCT), and proximal convoluted tubules (PCT). CS also improved renal repair in I/R-induced injury by increasing Ki-67 staining. I/R induced renal senescence after 3 and 6 h of reperfusion. However, CS alleviated I/R-induced senescence at early stage (1 and 3 h). We conclude that CS protects against I/R injury via the SDF-1/CXCR4-signaling axis and alleviates senescence.

  15. Honey Quality as Affected by Handling, Processing and Marketing Channels in Uganda

    Directory of Open Access Journals (Sweden)

    Nabakabya, D.

    2008-01-01

    Full Text Available The factors that affect honey quality in Uganda were surveyed in 120 beekeeping households. Honey was sampled from supermarkets, hawkers and stall markets along four transects across Kampala, the capital. Honey quality parameters assessed were diastase number (DN, free acidity (FA, moisture content (MC, hydroxymethylfurfural (HMF, and water insoluble solids (WIS. Honey was mostly harvested from basket and grass hives. Pressing, boiling and straining were popular honey processing methods. Honey quality was mainly compromised by harvesting immature honey, bad extraction methods and contamination by extraneous materials. Constraints to beekeeping were lack of appropriate equipment (52%, inadequate farmer skills, bad weather and vermin. Honey brands differed (P< 0.05 in DN, most failed the Uganda and Codex Alimentarius standards, and 20% met European Union HMF and DN standards. Correlation was observed between HMF vs. DN (r= 0.94; MC vs. FA (r= 0.56. Supermarket honey (4.65 was more superior (P< 0.05 in DN than stall markets (1.93, and hawkers (2.3. Similarly, WIS levels differed (P< 0.05 between honeys from supermarkets (0.08, stall markets (3.0 and hawkers (3.15. All honeys met MC standards, while DN and WIS were major shortcomings. Farmer training and extension in proper honey harvesting, handling and processing should be strengthened. Quality monitoring at all levels should be emphasized.

  16. Caractérisation des miels produits dans la région steppique de Djelfa en Algérie

    Directory of Open Access Journals (Sweden)

    Mekious, S.

    2015-01-01

    Full Text Available Characterization of honeys produced in the region of Djelfa steppe land in Algeria. Description of the subject. This paper deals with the quality of honeys produced in the steppe areas of Algeria and discusses the possibility of their valorization. Objectives. The objective was to characterize and compare the physical and chemical quality of honeys and to determine their pollen composition according to their geographical origin in three areas of the Djelfa semi-arid region of Algeria. Method. Thirty-eight samples of honey produced in 11 localities in the north, centre and south of the Djelfa semi-arid steppe region were harvested in July for two consecutive years. Pollen analyses were performed and the following properties of the honey samples were determined: water content, pH level, electrical conductivity, color, hydroxymethylfurfural content, saccharase index, diastase index and carbohydrate profile. Results. The results of the pollen analyses identified 34 taxa of pollen. The most abundant pollens were from the Ziziphus lotus, which were present in 97.12% of the samples. The pollens from this shrub were dominant in 27 of the honey samples tested, with a pollen percentage of greater than 45%. Over 55% of the pollen frequencies found came from plants belonging to Asteracae, Brassicaceae, Cistaceae and more particularly to Euphorbia bupleuroides, Peganum harmala, Thapsia garganica, Echium sp. and Retama retam. Conclusions. The physicochemical parameters of the honey samples studied comply with European and international quality standards, which opens up perspectives for their valorization.

  17. Physicochemical and microbiological characterization of cassava flower honey samples produced by africanized honeybees

    Directory of Open Access Journals (Sweden)

    Lucimar Peres de Moura Pontara

    2012-09-01

    Full Text Available Cassava producers in the region of Marília-São Paulo are integrating their farming activity with beekeeping to diversify their income. The aim of this study was to evaluate the physicochemical and microbiological quality of honey samples produced by Africanized honeybees Apis mellifera from cassava flower in 2008. Analysis were carried out for pH, total soluble solids (TSS, acidity, moisture, reducing and total sugars, apparent sucrose, hydroxymethylfurfural, color, ash, proteins, water insoluble solids, diastasic activity, mineral content, microbiological evaluations, and mineral and hydrocyanic acid (HCN content. The honey samples showed physicochemical and microbiological characteristics favorable to commercialization, with the exception of apparent sucrose and acidity, which show the need for a narrow focus of attention to the honey maturation degree at the harvest time and more careful monitoring during production and processing. The commercialization of Brazilian cassava honey, still little explored, can be widely spread in the market since the levels of hydrocyanic acid (HCN showed no consumption risk; in addition the simultaneous production of honey and cassava provides an alternative to family income increase.

  18. Características físico-químicas dos méis do município de São Fidélis-RJ

    Directory of Open Access Journals (Sweden)

    AZEREDO Maria Aparecida Alves

    1999-01-01

    Full Text Available De acordo com a tonalidade as amostras de mel foram divididas em grupos, armazenadas em diferentes condições e analisadas segundo os métodos adotados pelo Instituto Adolfo Lutz, Laboratório Nacional de Referência Animal e Association of Official Analytical Chemists. As amostras foram acondicionadas em recipientes de vidro e de polipropileno e armazenadas à temperatura ambiente. Um grupo de amostras foi armazenada em luminosidade ambiente enquanto o outro grupo ao abrigo da luz. As determinações de umidade, pH, acidez, cor, açúcares redutores e não-redutores, hidroximetilfurfural e índices de Lugol, Lund, Fiehe e diastase foram efetuadas por um período de um ano de armazenamento. Os resultados obtidos indicam que as amostras analisadas mantiveram suas características dentre os padrões aceitáveis e que os produtores devem ser orientados para o uso de técnicas de acondicionamento e armazenamento dos méis, para garantir a qualidade dos seus produtos.

  19. Biomechanical study: resistance comparison of posterior antiglide plate and lateral plate on synthetic bone models simulating Danis-Weber B malleolar fractures

    Directory of Open Access Journals (Sweden)

    Bruna Buscharino

    2013-06-01

    Full Text Available OBJECTIVE : The purpose of this study was to compare different positions of plates in lateral malleolar Danis-Weber B fractures on synthetic bone: a lateral plate and a posterior antiglide plate. METHODS : Short oblique fractures of distal fibula at the level of the syndesmosys were simulated with a fibular osteotomy in sixteen synthetic fibula bones (Synbone®. Eight fractures were fixed with lateral plating associated with an independent lag screw, and the other eight were fixed with posterior antiglide plating with a lag screw through the plate. A strain gage was installed at the center of each plate at the osteotomy site. Supination and external rotation forces were applied to each of the two groups at the bend. RESULTS : The lateral position plate group suffered more deformity in response to supination forces compared to the group with the posterior antiglide plate, but this result was not statistically significant. In the tests with external rotation forces, the posterior antiglide plating group had significantly higher resistance (p < 0.05. CONCLUSION : When subjected to external rotation forces, osteosynthesis with posterior antiglide plate models simulating type B fractures of the lateral malleolus of the ankle is more resistant than that of the neutralization plate.

  20. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel [Ernst-Moritz-Arndt-University Greifswald, Department of Trauma and Orthopedic Surgery, Emergency Department, Greifswald (Germany); Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke [Ernst-Moritz-Arndt-University Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2011-04-15

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  1. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    International Nuclear Information System (INIS)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel; Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke

    2011-01-01

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  2. Ossification of the Interosseous Membrane of the Leg in a Football Player: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Roberto Postacchini

    2016-01-01

    Full Text Available Introduction. We report a case of ossification of the interosseous membrane (OIM of the leg in a football player who had no history of severe local traumas. A review of the literature of the OIM of the leg in athletes was also carried out. Case Report. A 38-year-old Caucasian male patient complained of pain on lateral aspect of the leg when playing football. Pain progressively worsened until he had to stop the sporting activity. Radiographs, and then CT and MRI, showed OIM in the middle third of the left leg. MRI showed inflammation of tibia periosteum and bone adjacent to the ossification, which was then excised. Two months after surgery the patient returned to play football. Conclusion. A thorough analysis of the literature revealed three types of OIM of the leg in athletes. Type I usually occurs after a syndesmosis ankle sprain, Type II appears to result from a tibia fracture, and Type III, of which only one fully recorded case has been published, is probably caused, as in our patient, by repetitive minor traumas to the leg. Awareness of the existence of Type III OIM can avoid erroneous diagnoses leading to useless investigations and treatments.

  3. Roentgenologic diagnostics of capsular ligament lesions

    Energy Technology Data Exchange (ETDEWEB)

    Wirth, C.J.; Jaeger, M.

    1981-10-01

    The X-ray diagnostic is of obvious importance and relevance in the detection of acute or old capsular ligament lesions of the limb joint. On the one hand it serves as the plain radiograph (roentgenogram without contrast medium) for the assessment of osseous secondary lesions, for the documentation of luxationary positions of the joint partners, and in old capsular ligament lesions for the detection of an already existing arthrosis. On the other hand the X-ray images are of main importance, which are made from the hand-held limb in order to permit a comparison of the two sides, and which beyond the clinical detection of a joint instability indicate the extent and the direction of this instability and which also document it, and which allow in adolescents to recognize a separation of the epiphysis as an alternative to the capsular ligament rupture. Only in particular cases arthrography can provide some additional information, so for example in the case of an isolated syndesmosis rupture, ruptures of the rosette of the rotator muscle or of a damaged triangular disk in the hand. Angiography is only required in cases of traumatic luxations of the knee in order to exclude an intimal lesion of the popliteal artery.

  4. A comparison of injuries in elite male and female football players: A five-season prospective study.

    Science.gov (United States)

    Larruskain, J; Lekue, J A; Diaz, N; Odriozola, A; Gil, S M

    2018-01-01

    The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club's medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training, and match exposure hours per player-season were 20% higher for men compared to women (Ppubalgia cases were 1.93 (95% CI 1.16-3.20) and 11.10 (95% CI 1.48-83.44) times more frequent in men, respectively; whereas quadriceps strains, anterior cruciate ligament ruptures, and ankle syndesmosis injuries were 2.25 (95% CI 1.22-4.17), 4.59 (95% CI 0.93-22.76), and 5.36 (95% CI 1.11-25.79) times more common in women, respectively. In conclusion, prevention strategies should be tailored to the needs of male and female football players, with men more predisposed to hamstring strains and hip/groin injuries, and women to quadriceps strains and severe knee and ankle ligament injuries. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Subtalar coalition: usefulness of the C sign on lateral radiographs of the ankle

    International Nuclear Information System (INIS)

    Kim, Seong Hyun; Ahn, Joong Mo; Lee, Min Hee; Yoon, Hye Kyung; Kim, Sung Moon; Shin, Myung Jin; Kang, Heung Sik

    2001-01-01

    To assess the usefulness of the talocalcaneal C sign in the diagnosis of subtalar coalition, as seen on lateral radiographs of the ankle. Lateral radiographs of 12 ankles in 11 patients were included in this study. Twelve subtalar coalitions were confirmed by surgery (n=6), or by CT and/or MR (n=6). The presence of the talocalcaneal C sign on lateral ankle radiographs was determined. The C sign was continuous in six feet and interrupted in the remaining six. Subtalar coalition occurred simultaneously inthe middle and posterior subtalar joints in two cases, the posterior subtalar joint only in six, and in the middle subtalar joint only in four. In six cases confirmed at surgery, subtalar coalitions consisted of both synostosis and non-osseous fusion (synchondrosis and/or syndesmosis) and in one case of middle subtalar coalition, there was a bony bridge. The remaining six cases. confirmed at CT or MRI, involved both synostosis and non-osseous fusion (n=1) or non-osseous fusion only (n=5). In the diagnosis of subtalar coalition, the talocalcaneal C sign, seen on lateral radiographs of the ankle, is a useful indicator

  6. The MRI appearance of cystic lesions around the knee

    International Nuclear Information System (INIS)

    McCarthy, Catherine L.; McNally, Eugene G.

    2004-01-01

    This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. The anatomical extension, imaging features and clinical significance of meniscal cysts are illustrated. Review of ganglia includes intra-articular, extra-articular, intraosseous and periosteal ganglia, highlighting imaging findings and differential diagnoses. The relationship between proximal tibiofibular joint cysts and intraneural peroneal nerve ganglia is discussed. Intraosseous cystic lesions, including insertional and degenerative cysts, as well as lesions mimicking cysts of the knee are described and illustrated. Knowledge of the location, characteristic appearance and distinguishing features of cystic masses around the knee as well as potential imaging pitfalls such as normal anatomical recesses and atypical cyst contents on MR imaging aids in allowing a specific diagnosis to be made. This will prevent unnecessary additional investigations and determine whether intra-articular surgery or conservative management is appropriate. (orig.)

  7. Central bone grafting for nonunion of fractures of the tibia: a retrospective series.

    Science.gov (United States)

    Ryzewicz, M; Morgan, S J; Linford, E; Thwing, J I; de Resende, G V P; Smith, W R

    2009-04-01

    Nonunion of the tibia associated with bone loss, previous infection, obliteration of the intramedullary canal or located in the distal metaphysis poses a challenge to the surgeon and significant morbidity to patients. We retrospectively reviewed the records of 24 patients who were treated by central bone grafting and compared them to those of 20 who were treated with a traditional posterolateral graft. Central bone grafting entails a lateral approach, anterior to the fibula and interosseous membrane which is used to create a central space filled with cancellous iliac crest autograft. Upon consolidation, a tibiofibular synostosis is formed that is strong enough for weight-bearing. This procedure has advantages over other methods of treatment for selected nonunions. Of the 24 patients with central bone grafting, 23 went on to radiographic and clinical union without further intervention. All healed within a mean of 20 weeks (10 to 48). No further bone grafts were required, and few complications were encountered. These results were comparable to those of the 20 patients who underwent posterolateral bone grafting who united at a mean of 31.3 weeks (16 to 60) but one of whom required below-knee amputation for intractable sepsis. Central bone grafting is a safe and effective treatment for difficult nonunions of the tibia.

  8. Effect of Complete Syndesmotic Disruption and Deltoid Injuries and Different Reduction Methods on Ankle Joint Contact Mechanics.

    Science.gov (United States)

    LaMothe, Jeremy; Baxter, Josh R; Gilbert, Susannah; Murphy, Conor I; Karnovsky, Sydney C; Drakos, Mark C

    2017-06-01

    Syndesmotic injuries can be associated with poor patient outcomes and posttraumatic ankle arthritis, particularly in the case of malreduction. However, ankle joint contact mechanics following a syndesmotic injury and reduction remains poorly understood. The purpose of this study was to characterize the effects of a syndesmotic injury and reduction techniques on ankle joint contact mechanics in a biomechanical model. Ten cadaveric whole lower leg specimens with undisturbed proximal tibiofibular joints were prepared and tested in this study. Contact area, contact force, and peak contact pressure were measured in the ankle joint during simulated standing in the intact, injured, and 3 reduction conditions: screw fixation with a clamp, screw fixation without a clamp (thumb technique), and a suture-button construct. Differences in these ankle contact parameters were detected between conditions using repeated-measures analysis of variance. Syndesmotic disruption decreased tibial plafond contact area and force. Syndesmotic reduction did not restore ankle loading mechanics to values measured in the intact condition. Reduction with the thumb technique was able to restore significantly more joint contact area and force than the reduction clamp or suture-button construct. Syndesmotic disruption decreased joint contact area and force. Although the thumb technique performed significantly better than the reduction clamp and suture-button construct, syndesmotic reduction did not restore contact mechanics to intact levels. Decreased contact area and force with disruption imply that other structures are likely receiving more loads (eg, medial and lateral gutters), which may have clinical implications such as the development of posttraumatic arthritis.

  9. A rare type of ankle fracture: Syndesmotic rupture combined with a high fibular fracture without medial injury.

    Science.gov (United States)

    van Wessem, K J P; Leenen, L P H

    2016-03-01

    High fibular spiral fractures are usually caused by pronation-external rotation mechanism. The foot is in pronation and the talus externally rotates, causing a rupture of the medial ligaments or a fracture of the medial malleolus. With continued rotation the anterior and posterior tibiofibular ligament will rupture, and finally, the energy leaves the fibula by creating a spiral fracture from anterior superior to posterior inferior. In this article we demonstrate a type of ankle fracture with syndesmotic injury and high fibular spiral fractures without a medial component. This type of ankle fractures cannot be explained by the Lauge-Hansen classification, since it lacks injury on the medial side of the ankle, but it does have the fibular fracture pattern matching the pronation external rotation injury (anterior superior to posterior inferior fracture). We investigated the mechanism of this injury illustrated by 3 cases and postulate a theory explaining the biomechanics behind this type of injury. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Physicochemical analyses indicated to the quality control of royal jelly with honey Análises físico-químicas indicadas para o controle de qualidade mel com geléia real

    Directory of Open Access Journals (Sweden)

    Lucila Coelho Pamplona

    2004-12-01

    Full Text Available Royal jelly (RJ is used as a revitalizing tonic. In order to avoid rejection to its acid taste, it is added to honey. There are regulations for honey and for royal jelly separately but not for the mixture. The objective of this work is, therefore, to verify if the same methods used for pure honey quality control can be used for honey mixed with royal jelly and also the presence of RJ through 10-HDA determination. The methods used were: moisture, reducing sugars, apparent sucrose, ash, hydroxymethylfurfural, insoluble solids, diastase activity, acidity and 10-HDA. Samples were prepared by adding 0-100% of RJ in honey. The results showed that the ash method was the only suitable one to all the samples. The acidity analysis (direct titration was suitable to 0-30%RJ samples; the reducing sugar analysis was suitable to 0-20% RJ samples. Concerning moisture analysis the refractometric method is suitable to 0-10% RJ and the Infra Red method is suggested to be used for samples with more than 10% RJ. The methods for diastase activity, HMF, apparent sucrose and insoluble solids were inadequate for all samples with RJ. The presence of RJ in the samples was confirmed by the 10-HDA analyses.A geléia real (GR é utilizada como produto revitalizante com sabor ácido e adstringente. Para evitar rejeição a este sabor, existem misturas de mel com GR. Existe legislação específica para o mel e para a GR separadamente, mas não para a mistura. Os objetivos do trabalho são: verificar se os métodos usados para o controle de qualidade do mel puro podem ser utilizados no controle do mel com GR e verificar a presença de GR pela determinação do 10-HDA. As análises incluíram: umidade, açúcares redutores, sacarose aparente, cinzas, hydroxymethylfurfural, sólidos insolúveis, atividade diastásica, acidez e 10-HDA. As amostras foram preparadas com 0-100% de GR no mel. Os resultados obtidos sugerem que dos métodos citados na legislação do mel somente o de

  11. Carcinoma apócrino na glândula parótida e na região submandibular Apocrine carcinoma in the parotid gland and in the submandibular region

    Directory of Open Access Journals (Sweden)

    Jairo S. Francisco

    2005-04-01

    Full Text Available Os objetivos deste trabalho consistem na apresentação de um caso de carcinoma apócrino e na discussão de aspectos relacionados ao seu diagnóstico, tratamento e prognóstico. Os carcinomas com diferenciação apócrina que não correspondem aos casos de doença extramamária de Paget, de carcinoma ductal de mama, de adenocarcinoma das glândulas de Moll e de carcinoma ceruminal são tumores muito raros. Relatamos o caso de uma paciente do sexo feminino, negra, com 51 anos, na qual duas lesões de carcinoma apócrino acometeram a parótida esquerda (processo inicial e recidiva e uma lesão envolveu a pele da região submandibular do mesmo lado. O exame histopatológico destas lesões mostrou a presença de neoplasia epitelial glandular infiltrativa com pleomorfismo celular e nuclear moderados; apresentando células poligonais ou arredondadas, com núcleos grandes e citoplasma eosinofílico e granular. Destacou-se a presença de secreção por decapitação apical na maior parte das células tumorais voltadas para a luz das estruturas císticas neoplásicas. Adicionalmente, foi encontrada a presença de focos de comedo-necrose e de material corado pelo PAS com e sem diastase. Apesar de não podermos definir com certeza qual a sede do tumor primário, com base nos aspectos histopatológicos compatíveis com o carcinoma apócrino cutâneo, consideramos que tenha sido, provavelmente, a lesão retirada da pele da região submandibular. A paciente foi submetida a tratamentos cirúrgicos e não apresentou alterações após um ano de acompanhamento, depois da retirada do tumor recidivante na parótida.The objectives of this paper are to report a case of apocrine carcinoma and the discussion of aspects related to its diagnosis, treatment, and prognosis. Carcinomas with apocrine differentiation not related to extramammary Paget's disease, ductal breast carcinoma, Moll's glands adenocarcinoma and ceruminous glands carcinoma are very uncommon tumors. We

  12. Clear cell carcinoma of the uterine corpus following irradiation therapy for squamous cell carcinoma of the cervix

    International Nuclear Information System (INIS)

    Iwaoki, Yasuhisa; Katsube, Yasuhiro; Nanba, Koji.

    1992-01-01

    A case of clear cell carcinoma of the endometrium following squamous cell carcinoma of the cervix is reported. The patient had had a previous cervical biopsy which revealed squamous cell carcinoma (large cell non-keratinizing type), classified clinically as a stage IIb lesion. She was treated with external pelvic irradiation delivering an estimated tumor dose of approximately 7,000 rads and intracavital radium application delivering 4,995 mg.hr.radiation when she was 51 years old. She complained of post-menopausal bleeding at age 66 and was diagnosed by endometrial cytology as having clear cell carcinoma of the endometrium. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. The clinical stage of the endometrial cancer was Ib. She is alive after 2 years with no evidence of disease. Endometrial cytology revealed several adenocarcinoma cells in small clusters. The shape of the nuclei was somewhat irregular, the chromatin pattern was fine granular, and single or multiple nucleoli were seen. The diameter of these nuclei ranged from 10 to 30 μm. The cytoplasm was pale green or vacuolated. The volume of the cytoplasm varied from scanty to abundant. These findings suggested clear cell carcinoma. Histopathologically, an irregular shaped polypoid tumor, 3 x 1.5 cm in size, was located on the lower anterior wall of the uterine corpus. The tumor was a clear cell carcinoma showing a solid and papillary pattern. A hobnail pattern was not observed. The cytoplasm was clear and abundant, and PAS-positive granules digestible by diastase were seen. These 2 cancers had different pathological features and their immunohistochemical reactivities for CEA and keratin were also different. The patient was regarded as having a rare heterochronous double cancer consisting of squamous cell carcinoma of the cervix and clear cell carcinoma of the endometrium. (author)

  13. Alveolar soft-part sarcoma of the orbit: a clinicopathologic analysis of seventeen cases and a review of the literature.

    Science.gov (United States)

    Font, R L; Jurco, S; Zimmerman, L E

    1982-06-01

    This is a clinicopathologic study of 17 cases of alveolar soft-part sarcoma of the orbit. The mean age of patients was 23 and the median was 18 (range, 11 months to 69 years); 13 patients (76.5 per cent) were women and four were men (ratio, 3.25:1). The right and left orbits were equally involved (eight patients each), and in one the laterality was not specified. Histologically, the tumors had a distinctive organoid pattern outlined by thin-walled capillaries and were composed of nests of large polyhedral cells with abundant, finely granular, acidophilic cytoplasm. Approximately two thirds of the tumors had diagnostic PAS-positive diastase-resistant crystalline structures. Histologically, the differential diagnosis included nonchromaffin paraganglioma, granular cell tumor, metastatic renal cell carcinoma, vascular tumor, alveolar rhabdomyosarcoma, and amelanotic malignant melanoma. Electron microscopic studies of one tumor disclosed mitochondria with abnormal cristae, increased amounts of glycogen, and cytoplasmic crystalline structures with a periodicity of 8 to 10 nm. Smaller membrane-bound electron-dense granules appeared to be precursors of the crystals. Follow-up studies showed that eight patients were alive and well (median follow-up period, 11.4 years). Six of the eight patients at the time of diagnosis were 20 years of age or younger. A ninth patient was alive and well 13 years after excision of the orbital mass and four years after bilateral thoracotomy with resection of nine pulmonary nodules. Two patients died as a result of metastatic disease, one 14 years and the other 21 years after initial orbital surgery. Two patients died of other causes, one of whom had pulmonary metastases at autopsy. The follow-up period on two recent cases was less than three years, and two patients were lost to follow-up. The disease pursued an indolent clinical course. Surgery offers the best chance to control the disease.

  14. Polish natural bee honeys are anti-proliferative and anti-metastatic agents in human glioblastoma multiforme U87MG cell line.

    Directory of Open Access Journals (Sweden)

    Justyna Moskwa

    Full Text Available Honey has been used as food and a traditional medicament since ancient times. However, recently many scientists have been concentrating on the anti-oxidant, anti-proliferative, anti-inflammatory and other properties of honey. In this study, we investigated for the first time an anticancer effect of different honeys from Poland on tumor cell line - glioblastoma multiforme U87MG. Anti-proliferative activity of honeys and its interferences with temozolomide were determined by a cytotoxicity test and DNA binding by [H3]-thymidine incorporation. A gelatin zymography was used to conduct an evaluation of metalloproteinases (MMP-2 and MMP-9 expression in U87MG treatment with honey samples. The honeys were previously tested qualitatively (diastase activity, total phenolic content, lead and cadmium content. The data demonstrated that the examined honeys have a potent anti-proliferative effect on U87MG cell line in a time- and dose-dependent manner, being effective at concentrations as low as 0.5% (multifloral light honey - viability 53% after 72 h of incubation. We observed that after 48 h, combining honey with temozolomide showed a significantly higher inhibitory effect than the samples of honey alone. We observed a strong inhibition of MMP-2 and MMP-9 for the tested honeys (from 20 to 56% and from 5 to 58% compared to control, respectively. Our results suggest that Polish honeys have an anti-proliferative and anti-metastatic effect on U87MG cell line. Therefore, natural bee honey can be considered as a promising adjuvant treatment for brain tumors.

  15. Clear cell carcinoma of the uterine corpus following irradiation therapy for squamous cell carcinoma of the cervix; A case report

    Energy Technology Data Exchange (ETDEWEB)

    Iwaoki, Yasuhisa; Katsube, Yasuhiro (Kure Kyosai Hospital, Hiroshima (Japan)); Nanba, Koji

    1992-01-01

    A case of clear cell carcinoma of the endometrium following squamous cell carcinoma of the cervix is reported. The patient had had a previous cervical biopsy which revealed squamous cell carcinoma (large cell non-keratinizing type), classified clinically as a stage IIb lesion. She was treated with external pelvic irradiation delivering an estimated tumor dose of approximately 7,000 rads and intracavital radium application delivering 4,995 mg.hr.radiation when she was 51 years old. She complained of post-menopausal bleeding at age 66 and was diagnosed by endometrial cytology as having clear cell carcinoma of the endometrium. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed. The clinical stage of the endometrial cancer was Ib. She is alive after 2 years with no evidence of disease. Endometrial cytology revealed several adenocarcinoma cells in small clusters. The shape of the nuclei was somewhat irregular, the chromatin pattern was fine granular, and single or multiple nucleoli were seen. The diameter of these nuclei ranged from 10 to 30 {mu}m. The cytoplasm was pale green or vacuolated. The volume of the cytoplasm varied from scanty to abundant. These findings suggested clear cell carcinoma. Histopathologically, an irregular shaped polypoid tumor, 3 x 1.5 cm in size, was located on the lower anterior wall of the uterine corpus. The tumor was a clear cell carcinoma showing a solid and papillary pattern. A hobnail pattern was not observed. The cytoplasm was clear and abundant, and PAS-positive granules digestible by diastase were seen. These 2 cancers had different pathological features and their immunohistochemical reactivities for CEA and keratin were also different. The patient was regarded as having a rare heterochronous double cancer consisting of squamous cell carcinoma of the cervix and clear cell carcinoma of the endometrium. (author).

  16. Children with Down Syndrome: oral development and morphology after use of palatal plates between 6 and 18 months of age.

    Science.gov (United States)

    Bäckman, B; Grevér-Sjölander, A-C; Holm, A-K; Johansson, I

    2003-09-01

    The aim of this study was to describe oral development and morphology in 18-month-old children with Down syndrome (DS) treated with palatal plates in combination with structured communication and speech training. The aim is further to describe the design of the palatal plates, compliance in their use and to give a brief report of their effect on oral motor function and speech. Forty-two children with DS were followed from language intervention, and oral motor and sensory stimulation provided by speech therapists for all children with DS in Sweden, palatal plates provided by dentists are included in the training programme. In the evaluation, the children in the project were compared with two control groups of children matched for age; one group of children with DS who had not been treated with palatal plates, and one group of children with normal development. Compared to the children with normal development, both groups of children with DS had fewer teeth erupted and a lower prevalence of sucking habits. Deviant morphology of the tongue in the form of diastase, lingua plicata or a sulcus in the anterior third of the tongue was only seen in children with DS. All children with normal development had positive values for overjet compared to 53% of the children with DS. The palatal plates were used 2-3 times daily for a total mean time of 15 min. Compliance in use of the plates decreased with age, mainly due to eruption of teeth and subsequent loss of retention. Evaluation of oral motor function and speech show that the children with DS in the project had better motor prerequisites for articulation than the control children with DS. Palatal plate therapy did not affect oral parameters, i.e., eruption of teeth, types and prevalence of sucking habits, tongue morphology and symptoms of hypotonia. In combination with oral motor and sensory stimulation, palatal plate therapy had a positive effect on oral motor performance and prerequisites for articulation.

  17. A novel transgenic mouse model of lysosomal storage disorder.

    Science.gov (United States)

    Ortiz-Miranda, Sonia; Ji, Rui; Jurczyk, Agata; Aryee, Ken-Edwin; Mo, Shunyan; Fletcher, Terry; Shaffer, Scott A; Greiner, Dale L; Bortell, Rita; Gregg, Ronald G; Cheng, Alan; Hennings, Leah J; Rittenhouse, Ann R

    2016-11-01

    Knockout technology has proven useful for delineating functional roles of specific genes. Here we describe and provide an explanation for striking pathology that occurs in a subset of genetically engineered mice expressing a rat Ca V β2a transgene under control of the cardiac α-myosin heavy chain promoter. Lesions were limited to mice homozygous for transgene and independent of native Cacnb2 genomic copy number. Gross findings included an atrophied pancreas; decreased adipose tissue; thickened, orange intestines; and enlarged liver, spleen, and abdominal lymph nodes. Immune cell infiltration and cell engulfment by macrophages were associated with loss of pancreatic acinar cells. Foamy macrophages diffusely infiltrated the small intestine's lamina propria, while similar macrophage aggregates packed liver and splenic red pulp sinusoids. Periodic acid-Schiff-positive, diastase-resistant, iron-negative, Oil Red O-positive, and autofluorescent cytoplasm was indicative of a lipid storage disorder. Electron microscopic analysis revealed liver sinusoids distended by clusters of macrophages containing intracellular myelin "swirls" and hepatocytes with enlarged lysosomes. Additionally, build up of cholesterol, cholesterol esters, and triglycerides, along with changes in liver metabolic enzyme levels, were consistent with a lipid processing defect. Because of this complex pathology, we examined the transgene insertion site. Multiple transgene copies inserted into chromosome 19; at this same site, an approximate 180,000 base pair deletion occurred, ablating cholesterol 25-hydroxylase and partially deleting lysosomal acid lipase and CD95 Loss of gene function can account for the altered lipid processing, along with hypertrophy of the immune system, which define this phenotype, and serendipitously provides a novel mouse model of lysosomal storage disorder. Copyright © 2016 the American Physiological Society.

  18. Clinical features and nail clippings in 52 children with psoriasis.

    Science.gov (United States)

    Uber, Marjorie; Carvalho, Vânia O; Abagge, Kerstin T; Robl Imoto, Renata; Werner, Betina

    2018-03-01

    Nail clipping, the act of cutting the distal portion of a nail for microscopic analysis, can complement the diagnosis of skin diseases with nail involvement, such as psoriasis. This study aimed to describe histopathologic findings on 81 nails from 52 children and adolescents with skin psoriasis and to determine whether these changes correlated with the severity of skin and nail involvement. Children with psoriasis were enrolled in this cross-sectional study to obtain Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores. The most altered nails were processed using periodic acid-Schiff with diastase staining. Fifty-two patients with a median age of 10.5 years were included. The median Nail Psoriasis Severity Index score of the 20 nails from these patients was 17 (range 3-80). The most common findings were pitting (94.2%), leukonychia (73.0%), and longitudinal ridges (63.5%). Eighty-one nail fragments were collected by clipping. Neutrophils were found in 6 samples (7.6%) and serous lakes in 15 (19%). Median nail plate thickness was 0.3 mm (range 0.1-0.63 mm). Patients whose nails had neutrophils had a higher median PASI score (6.1 vs 2.0, P = .03). Patients whose nails had serous lakes had higher median PASI (5.3 vs 1.9, P = .008) and NAPSI (median 45.0 vs 18.0, P = .006) scores. There seems to be a correlation between some microscopic nail features in children with psoriasis and their PASI and NAPSI scores, so nail clippings from children with suspected psoriasis may help with diagnosis, especially in the presence of neutrophils, and in excluding onychomycosis. © 2018 Wiley Periodicals, Inc.

  19. Histopathological, Ultrastructural and Apoptotic Changes in Diabetic Rat Placenta

    Directory of Open Access Journals (Sweden)

    Mehmet Gül

    2015-09-01

    Full Text Available Background: The exchange of substances between mother and fetus via the placenta plays a vital role during development. A number of developmental disorders in the fetus and placenta are observed during diabetic pregnancies. Diabetes, together with placental apoptosis, can lead to developmental and functional disorders. Aims: Histological, ultrastructural and apoptotic changes were investigated in the placenta of streptozotocin (STZ induced diabetic rats. Study Design: Animal experimentation. Methods: In this study, a total of 12 female Wistar Albino rats (control (n=6 and diabetic (n=6 were used. Rats in the diabetic group, following the administration of a single dose of STZ, showed blood glucose levels higher than 200 mg/dL after 72 hours. When pregnancy was detected after the rats were bred, two pieces of placenta and the fetuses were collected on the 20th day of pregnancy by cesarean incision under ketamine/xylazine anesthesia from in four rats from the control and diabetic groups. Placenta tissues were processed for light microscopy and transmission electron microscopy (TEM. Hematoxylin-eosin (HE and periodic acid Schiff-diastase (PAS-D staining for light microscopic and caspase-3 staining for immunohistochemical investigations were performed for each placenta. Electron microscopy was performed on thin sections contrasted with uranyl acetate and lead nitrate. Results: Weight gain in the placenta and fetuses of diabetic rats and thinning of the decidual layer, thickening of the hemal membrane, apoptotic bodies, congestion in intervillous spaces, increased PAS-D staining in decidual cells and caspase-3 immunoreactivity were observed in the diabetic group. After the ultrastructural examination, the apoptotic appearance of the nuclei of trophoblastic cells, edema and intracytoplasmic vacuolization, glycogen accumulation, dilation of the endoplasmic reticulum and myelin figures were observed. In addition, capillary basement membrane thickening

  20. Effects on physicochemical, microbiological and sensory characteristics of honey bee samples submitted to gamma radiation

    International Nuclear Information System (INIS)

    Bera, Alexandre

    2010-01-01

    Honey production in Brazil has increased considerably and gaining pro eminence on the international market, as a result many demands have become part of the productive honey chain. In addition to the analyses provided for the Brazilian legislation, international market demand products that meet the most stringent quality standards. Honey has interesting characteristics due to its constitution, but even so there are problems that can change some how your identity and quality. The application of gamma radiation is a viable proposal which promotes the reduction of bio burden without changing the constitution and most importantly the physicochemical properties, with smaller nutritional losses when compared to other treatments used in foods. This study beyond the physicochemical parameters required by Brazilian regulation also included other relevant analyses, including FT-IR ATR. Microbiological analyses were carried out on samples of pure honeys and subsequently inoculated microbial known loads to assess the action of gamma radiation in doses of 5 and 10 kGy. The triangular test was used to differentiate the irradiated and not irradiated. samples The major changes that have occurred in samples of honeys were mainly in concentrations of HMF (hydroxymethylfurfural) and diastase activity occurring a significant decrease in all analyzed samples. There was a reduction microbiological from the application of the 5 kGy, reaching absence with 10 kGy dose except Paenibacillus larvae. The sensory analysis conducted on samples of honey and honey irradiated with 5, 10 and 15 kGy doses, pointed out that there is no significant difference (5%) between irradiated and control samples. The application of gamma radiation in honeys proved a very useful method in microbiological decontamination, featuring few changes in the product at doses up to 10 kGy. (author)

  1. Effects on physicochemical, microbiological and sensory characteristics of honey bee samples submitted to gamma radiation; Efeitos nas caracteristicas fisico-quimicas, microbiologicas e sensoriais em amostras de mel de abelhas submetidas a radiacao gama

    Energy Technology Data Exchange (ETDEWEB)

    Bera, Alexandre

    2010-07-01

    Honey production in Brazil has increased considerably and gaining pro eminence on the international market, as a result many demands have become part of the productive honey chain. In addition to the analyses provided for the Brazilian legislation, international market demand products that meet the most stringent quality standards. Honey has interesting characteristics due to its constitution, but even so there are problems that can change some how your identity and quality. The application of gamma radiation is a viable proposal which promotes the reduction of bio burden without changing the constitution and most importantly the physicochemical properties, with smaller nutritional losses when compared to other treatments used in foods. This study beyond the physicochemical parameters required by Brazilian regulation also included other relevant analyses, including FT-IR ATR. Microbiological analyses were carried out on samples of pure honeys and subsequently inoculated microbial known loads to assess the action of gamma radiation in doses of 5 and 10 kGy. The triangular test was used to differentiate the irradiated and not irradiated. samples The major changes that have occurred in samples of honeys were mainly in concentrations of HMF (hydroxymethylfurfural) and diastase activity occurring a significant decrease in all analyzed samples. There was a reduction microbiological from the application of the 5 kGy, reaching absence with 10 kGy dose except Paenibacillus larvae. The sensory analysis conducted on samples of honey and honey irradiated with 5, 10 and 15 kGy doses, pointed out that there is no significant difference (5%) between irradiated and control samples. The application of gamma radiation in honeys proved a very useful method in microbiological decontamination, featuring few changes in the product at doses up to 10 kGy. (author)

  2. Upper ankle joint space detection on low contrast intraoperative fluoroscopic C-arm projections

    Science.gov (United States)

    Thomas, Sarina; Schnetzke, Marc; Brehler, Michael; Swartman, Benedict; Vetter, Sven; Franke, Jochen; Grützner, Paul A.; Meinzer, Hans-Peter; Nolden, Marco

    2017-03-01

    Intraoperative mobile C-arm fluoroscopy is widely used for interventional verification in trauma surgery, high flexibility combined with low cost being the main advantages of the method. However, the lack of global device-to- patient orientation is challenging, when comparing the acquired data to other intrapatient datasets. In upper ankle joint fracture reduction accompanied with an unstable syndesmosis, a comparison to the unfractured contralateral site is helpful for verification of the reduction result. To reduce dose and operation time, our approach aims at the comparison of single projections of the unfractured ankle with volumetric images of the reduced fracture. For precise assessment, a pre-alignment of both datasets is a crucial step. We propose a contour extraction pipeline to estimate the joint space location for a prealignment of fluoroscopic C-arm projections containing the upper ankle joint. A quadtree-based hierarchical variance comparison extracts potential feature points and a Hough transform is applied to identify bone shaft lines together with the tibiotalar joint space. By using this information we can define the coarse orientation of the projections independent from the ankle pose during acquisition in order to align those images to the volume of the fractured ankle. The proposed method was evaluated on thirteen cadaveric datasets consisting of 100 projections each with manually adjusted image planes by three trauma surgeons. The results show that the method can be used to detect the joint space orientation. The correlation between angle deviation and anatomical projection direction gives valuable input on the acquisition direction for future clinical experiments.

  3. Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

    Directory of Open Access Journals (Sweden)

    Hans Polzer

    2012-01-01

    Full Text Available Acute ankle injuries are among the most common injuries in emergency departments. However, a standardized examination and an evidence-based treatment are missing. Therefore, aim of this study was to systematically search the current literature, classify the evidence and develop an algorithm for diagnosis and treatment of acute ankle injuries. We systematically searched PubMed and the Cochrane Database for randomized controlled trials, meta-analysis, systematic reviews, or if applicable observational studies and classified them according to their level of evidence. According to the currently available literature, the following recommendations are given. The Ottawa Ankle/Foot Rule should be applied in order to rule out fractures, Physical examination is sufficient for diagnosing injuries to the lateral ligament complex. Classification into stable and unstable injuries is applicable and of clinical importance. The squeeze-, crossed leg- and external rotation test are indicative for injuries of the syndesmosis. Magnetic resonance imaging is recommended to verify such injuries. Stable ankle sprains have a good prognosis, while for unstable ankle sprains conservative treatment is at least as effective as operative treatment without carrying possible complications. Early functional treatment leads to the fastest recovery and the least rate of re-injury. Supervised rehabilitation reduces residual symptoms and re-injuries. Taken these recommendations into account, we here present an applicable and evidence-based step by step decision pathway for the diagnosis and treatment of acute ankle injuries, which can be implemented in any emergency department or doctor’s practice. It provides quality assurance for the patient and confidence for the attending physician.

  4. Interobserver variation in classification of malleolar fractures

    International Nuclear Information System (INIS)

    Verhage, S.M.; Hoogendoorn, J.M.; Rhemrev, S.J.; Keizer, S.B.; Quarles van Ufford, H.M.E.

    2015-01-01

    Classification of malleolar fractures is a matter of debate. In the ideal situation, a classification system is easy to use, shows good inter- and intraobserver agreement, and has implications for treatment or research. Interobserver study. Four observers distributed 100 X-rays to the Weber, AO and Lauge-Hansen classification. In case of a trimalleolar fracture, the size of the posterior fragment was measured. Interobserver agreement was calculated with Cohen's kappa. Agreement on the size of the posterior fragment was calculated with the intraclass correlation coefficient. Moderate agreement was found with all classification systems: the Weber (K = 0.49), AO (K = 0.45) and Lauge-Hansen (K = 0.47). Interobserver agreement on the presence of a posterior fracture was substantial (K = 0.63). Estimation of the size of the fragment showed moderate agreement (ICC = 0.57). Classification according to the classical systems showed moderate interobserver agreement, probably due to an unclear trauma mechanism or the difficult relation between the level of the fibular fracture and syndesmosis. Substantial agreement on posterior malleolar fractures is mostly due to small (<5 %) posterior fragments. A classification system that describes the presence and location of fibular fractures, presence of medial malleolar fractures or deep deltoid ligament injury, and presence of relevant and dislocated posterior malleolar fractures is more useful in the daily setting than the traditional systems. In case of a trimalleolar fracture, a CT scan is in our opinion very useful in the detection of small posterior fragments and preoperative planning. (orig.)

  5. Deltoid ligament in acute ankle injury: MR imaging analysis

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Min Sun; Choi, Yun Sun; Kim, Yun Jung; Jung, Yoon Young [Eulji University, Department of Radiology, Eulji Hospital, Seoul (Korea, Republic of); Kim, Jin Su; Young, Ki Won [Eulji University, Department of Orthopedic Surgery, Eulji Hospital, Seoul (Korea, Republic of)

    2014-05-15

    To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

  6. Interobserver variation in classification of malleolar fractures

    Energy Technology Data Exchange (ETDEWEB)

    Verhage, S.M.; Hoogendoorn, J.M. [MC Haaglanden, Department of Surgery, The Hague (Netherlands); Secretariaat Heelkunde, MC Haaglanden, locatie Westeinde, Postbus 432, CK, The Hague (Netherlands); Rhemrev, S.J. [MC Haaglanden, Department of Surgery, The Hague (Netherlands); Keizer, S.B. [MC Haaglanden, Department of Orthopaedic Surgery, The Hague (Netherlands); Quarles van Ufford, H.M.E. [MC Haaglanden, Department of Radiology, The Hague (Netherlands)

    2015-10-15

    Classification of malleolar fractures is a matter of debate. In the ideal situation, a classification system is easy to use, shows good inter- and intraobserver agreement, and has implications for treatment or research. Interobserver study. Four observers distributed 100 X-rays to the Weber, AO and Lauge-Hansen classification. In case of a trimalleolar fracture, the size of the posterior fragment was measured. Interobserver agreement was calculated with Cohen's kappa. Agreement on the size of the posterior fragment was calculated with the intraclass correlation coefficient. Moderate agreement was found with all classification systems: the Weber (K = 0.49), AO (K = 0.45) and Lauge-Hansen (K = 0.47). Interobserver agreement on the presence of a posterior fracture was substantial (K = 0.63). Estimation of the size of the fragment showed moderate agreement (ICC = 0.57). Classification according to the classical systems showed moderate interobserver agreement, probably due to an unclear trauma mechanism or the difficult relation between the level of the fibular fracture and syndesmosis. Substantial agreement on posterior malleolar fractures is mostly due to small (<5 %) posterior fragments. A classification system that describes the presence and location of fibular fractures, presence of medial malleolar fractures or deep deltoid ligament injury, and presence of relevant and dislocated posterior malleolar fractures is more useful in the daily setting than the traditional systems. In case of a trimalleolar fracture, a CT scan is in our opinion very useful in the detection of small posterior fragments and preoperative planning. (orig.)

  7. Deltoid ligament in acute ankle injury: MR imaging analysis

    International Nuclear Information System (INIS)

    Jeong, Min Sun; Choi, Yun Sun; Kim, Yun Jung; Jung, Yoon Young; Kim, Jin Su; Young, Ki Won

    2014-01-01

    To identify the pattern of deltoid ligament injury after acute ankle injury and the relationship between ankle fracture and deltoid ligament tear by magnetic resonance imaging (MRI). Thirty-six patients (32 male, and 4 female; mean age, 29.8 years) with acute deltoid ligament injury who had undergone MRI participated in this study. The deltoid ligament was classified as having 3 superficial and 2 deep components. An image analysis included the integrity and tear site of the deltoid ligament, and other associated injuries. Association between ankle fracture and deltoid ligament tear was assessed using Fisher's exact test (P < 0.05). Of the 36 patients, 21 (58.3 %) had tears in the superficial and deep deltoid ligaments, 6 (16.7 %) in the superficial ligaments only, and 4 (11.1 %) in the deep ligaments only. The most common tear site of the three components of the superficial deltoid and deep anterior tibiotalar ligaments was their proximal attachments (94 % and 91.7 % respectively), and that of the deep posterior tibiotalar ligament (pTTL) was its distal attachment (82.6 %). The common associated injuries were ankle fracture (63.9 %), syndesmosis tear (55.6 %), and lateral collateral ligament complex tear (44.4 %). All the components of the deltoid ligament were frequently torn in patients with ankle fractures (tibionavicular ligament, P = 0.009). The observed injury pattern of the deltoid ligament was complex and frequently associated with concomitant ankle pathology. The most common tear site of the superficial deltoid ligament was the medial malleolar attachment, whereas that of the deep pTTL was near its medial talar insertion. (orig.)

  8. Unlocking the talus by eversion limits medial ankle injury risk during external rotation.

    Science.gov (United States)

    Button, Keith D; Wei, Feng; Haut, Roger C

    2015-10-15

    Eversion prior to excessive external foot rotation has been shown to predispose the anterior tibiofibular ligament (ATiFL) to failure, yet protect the anterior deltoid ligament (ADL) from failure despite high levels of foot rotation. The purpose of the current study was to measure the rotations of both the subtalar and talocrural joints during foot external rotation at sub-failure levels in either a neutral or a pre-everted position as a first step towards understanding the mechanisms of injury in previous studies. Fourteen (seven pairs) cadaver lower extremities were externally rotated 20° in either a pre-everted or neutral configuration, without producing injury. Motion capture was performed to track the tibia, talus, and calcaneus motions, and a joint coordinate system was used to analyze motions of the two joints. While talocrural joint rotation was greater in the neutral ankle (13.3±2.0° versus 10.5±2.7°, p=0.006), subtalar joint rotation was greater in the pre-everted ankle (2.4±1.9° versus 1.1±1.0°, p=0.014). Overall, the talocrural joint rotated more than the subtalar joint (11.9±2.8° versus 1.8±1.6°, p<0.001). It was proposed that the calcaneus and talus 'lock' in a neutral position, but 'unlock' when the ankle is everted prior to rotation. This locking/unlocking mechanism could be responsible for an increased subtalar rotation, but decreased talocrural rotation when the ankle is pre-everted, protecting the ADL from failure. This study may provide information valuable to the study of external rotation kinematics and injury risk. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Endovascular treatment of penetrating arterial trauma with stent grafts.

    Science.gov (United States)

    Biagioni, Rodrigo Bruno; Burihan, Marcelo Calil; Nasser, Felipe; Biagioni, Luisa Ciucci; Ingrund, José Carlos

    2018-02-01

    The endovascular management of arterial injuries has resulted in reduced operating time, blood loss, hospital mortality, lower incidence of sepsis, and decrease in mortality rates. For penetrating trauma, however, the benefits of endovascular therapy are questionable. Data were obtained by retrospective analysis of electronic medical records. All patients with vascular trauma seeking care at our institution from January 2010 to December 2015 were reviewed. A total of 223 vascular trauma patients were enrolled. Of these, 18 patients (8 %) were treated with endovascular techniques. The data related to clinical presentation, patient characteristics, technical aspects of the treatment, and follow-up were analysed. The mean patient age was 35.4 ± 17.8 years, 94 % were male. The mean injury severity score was 10.4 ± 2.5. The most commonly observed trauma mechanism was a gunshot in 10 cases (55 %), followed by lesions provoked by arterial catheter misplacement in five cases (27 %), and stab wounds in three cases (16.6 %). The main injury site was the subclavian artery, accounting for eight cases (44 %), followed by the superficial femoral artery and the tibiofibular trunk in two cases, respectively (18 %). The anterior tibial, fibular artery, axillary, common carotid, superior mesenteric, and profunda femoris were each affected once. Arteriovenous fistula was detected in nine cases (50 %), pseudoaneurysms in nine cases (50 %), and short occlusion in two cases (11 %). The mean follow-up duration was 753 days. The primary patency rate was 92.3 and 61.5 % after one and two years, respectively. The survival rate was 94.4 % after one and two years. Infection of the stents or limb amputations were not identified at follow-up. The endovascular treatment of penetrating arterial injuries with covered stents is feasible. However, the criteria used to choose the best method must be individualized.

  10. Using fibula as a reference can be beneficial for the tibial component alignment after total knee arthroplasty, a retrospective study.

    Science.gov (United States)

    Erdem, Mehmet; Gulabi, Deniz; Cecen, Gultekin Sitki; Avci, Cem Coskun; Asci, Murat; Saglam, Fevzi

    2015-07-01

    One of the important factors in a successful arthroplasty is component alignment. The primary objective of this study was to determine whether the fibular shaft reference technique is beneficial for the tibial component position on the postoperative plain radiograph after total knee arthroplasty. A total of 42 patients between 2009 and 2011 were analysed retrospectively. The surgeon prepared the tibia using an extramedullary cutting guide and set the posterior tibial slope with respect to the fibular reference rod. In the postoperative radiographic measurements, a true anteroposterior and lateral radiograph of the lower leg covering the whole length of the tibia was used. Five patients were excluded as they did not meet the inclusion criteria, four patients were excluded due to improper radiographs and the study group was reduced to 33 patients and 35 knees. The mean preoperative tibiofibular angle was 2.1° ± 0.8°. The mean postoperative tibial sagittal angle measurements were 83.3° ± 1.4° (81°-86°). 33 (94 %) Knees gained the desired tibial sagittal angle within the desired alignment (5° ± 3°). The mean postoperative tibial coronal angle was 89.3° ± 1.5°. The tibial component coronal angle of two knees was more than 3 alignment from the neutral mechanical axis. The major clinical relevance of the technique described in the present study is cost-effectiveness, and it does not require any extra time or surgical equipment. This method can be used as an alternative choice for bulky extremities which is a cause of malalignment of the components. Retrospective case series, Level IV.

  11. Minor or occult ankle instability as a cause of anterolateral pain after ankle sprain.

    Science.gov (United States)

    Vega, Jordi; Peña, Fernando; Golanó, Pau

    2016-04-01

    The aim of this study was to determine which intra-articular injuries are associated with chronic anterolateral pain and functional instability after an ankle sprain. From 2008 to 2010, records of all patients who underwent ankle joint arthroscopy with anterolateral pain and functional instability after an ankle sprain were reviewed. A systematic arthroscopic examination of the intra-articular structures of the ankle joint was performed. Location and characteristics of the injuries were identified and recorded. A total of 36 ankle arthroscopic procedures were reviewed. A soft-tissue occupying mass over the lateral recess was present in 18 patients (50%). A partial injury of the anterior talofibular ligament (ATFL) was observed in 24 patients (66.6%). Cartilage abrasion due to the distal fascicle of the anteroinferior tibiofibular ligament coming into contact with the talus was seen in 21 patients (58.3%), but no thickening of the ligament was observed. Injury to the intra-articular posterior structures, including the transverse ligament in 19 patients (52.7%) and the posterior surface of the distal tibia in 21 patients (58.3%), was observed. Intra-articular pathological findings have been observed in patients affected by anterolateral pain after an ankle sprain. Despite no demonstrable abnormal lateral laxity, morphologic ATFL abnormality has been observed on arthroscopic evaluation. An injury of the ATFL is present in patients with chronic anterolateral pain and functional instability after an ankle sprain. A degree of microinstability due to a deficiency of the ATFL could explain the intra-articular pathological findings and the patients' complaints. IV.

  12. Peroneal tendinosis as a predisposing factor for the acute lateral ankle sprain in runners.

    Science.gov (United States)

    Ziai, Pejman; Benca, Emir; Wenzel, Florian; Schuh, Reinhard; Krall, Christoph; Auffahrt, Alexander; Hofstetter, Martin; Windhager, Reinhard; Buchhorn, Tomas

    2016-04-01

    A painful episode in the region of the peroneal tendons, within the retromalleolar groove, is a common precipitating event of an acute lateral ankle sprain. A forefoot striking pattern is suspected to cause peroneal tendinosis. The aim of this study is to analyse the role of peroneal tendinosis as a predisposing factor for ankle sprain trauma in runners. Fifty-eight runners who had experienced acute ankle sprain trauma, with pre-existing pain episodes for up to 4 weeks in the region of the peroneal tendons, were assessed clinically. Fractures were excluded by conventional radiography. An magnetic resonance imaging (MRI) scan had been performed within 14 days after the traumatic event and was subsequently evaluated by two experienced radiologists. MRI revealed peroneal tendinosis in 55 patients (95% of the total study population). Peroneus brevis (PB) tendinosis was found in 48 patients (87% of all patients with peroneal tendinosis), and peroneus longus (PL) tendinosis was observed in 42 cases (76%). Thirty-five patients (64%) had combined PB and PL tendinosis. A lesion of the anterior talofibular ligament was found to be the most common ligament injury associated with peroneal tendinosis (29 cases; 53%), followed by a lesion of the calcaneofibular ligament (16 cases; 29%) and a lesion of the posterior tibiofibular ligament (13 cases; 24%). The results of this study reflect the correlation between peroneal tendinosis and ankle sprain trauma. Injuries of one or more ligaments are associated with further complications. A period of rest or forbearance of sports as well as adequate treatment of the peroneal tendinosis is essential to prevent subsequent ankle injuries, especially in runners. Modification of the running technique would also be beneficial. IV.

  13. The MR imaging features of the posterior intermalleolar ligament in patients with posterior impingement syndrome of the ankle

    International Nuclear Information System (INIS)

    Fiorella, D.

    1999-01-01

    Objective. To describe the MR imaging features of the posterior intermalleolar ligament (IML) in patients with posterior impingement syndrome (PIS) of the ankle.Design and patients. Three patients (one male and two females, 13-25 years of age) are presented. Each patient presented clinically with symptoms of PIS of the ankle. Plain film examination was negative for a structural cause of the PIS in all patients. MR images were obtained with a 1.5 T scanner using an extremity coil. Clinical data and, in one patient, findings at ankle arthroscopy, were correlated with the results of MR imaging.Results. Ankle MR images from the three patients with a clinical diagnosis of PIS are presented. Findings in all patients included: (1) absence of another structural cause of the PIS (i.e., an os trigonum, trigonal process, fracture, loose bodies, etc.), (2) identification of the IML as a structure discrete from the posterior talofibular and tibiofibular ligaments, and (3) prominence of the IML as indicated by (a) identification of the IML in three different imaging planes, and (b) a caliber of the IML comparable to that of the conventional posterior ankle ligaments visualized in the same imaging plane. Arthroscopic resection of a meniscoid IML resulted in resolution of the PIS in one of the patients presented.Conclusions. MR imaging is an effective means of investigating the IML as a potential cause of PIS. The identification of a prominent IML in the absence of another structural cause of PIS indicates that impingement of the IML is the most likely cause of PIS. (orig.)

  14. Gap nonunion of tibia treated by Huntington′s procedure

    Directory of Open Access Journals (Sweden)

    Zile S Kundu

    2012-01-01

    Full Text Available Background: Gap nonunion that may occur following trauma or infection is a challenging problem to treat. The patients with intact or united fibula, preserved sensation in the sole, and adequate vascularity, were managed by tibialization (medialization of the fibula (Huntington′s procedure, to restore continuity of the tibia. The goal of this retrospective analysis study is to report the mid-term results following the Huntington′s procedure. Materials and Methods: 22 patients (20 males and two females age 16-34 years with segmental tibial loss more than 6 cm were operated for tibialization of fibula. The procedure was two-staged in seven and single-staged in the rest 15 patients, where the lateral aspect of the leg was relatively supple. In the two-staged procedure, the distal tibiofibular synostosis was performed six-to-eight weeks after the proximal procedure. Weightbearing (protected was started in a long leg cast after six-to-eight weeks of the second stage and continued for six-to-eight months, followed by the use of a brace. Results: The fibula started showing signs of hypertrophy within the first year after the procedure and it was more than double in breath after the four-year period. Full and unprotected weightbearing on the operated leg was achieved at an average time of 16 months. At the final followup, ten patients were very satisfied, seven satisfied, and five fairly satisfied. One patient had persistent nonunion at the proximal synostotic site even after bone grafting and secondary fixation. Conclusion: Huntington′s procedure is a safe and simple salvage procedure and remains an excellent option for treating difficult infected nonunion of the tibia in the selected indications.

  15. A novel malformation complex of bilateral and symmetric preaxial radial ray-thumb aplasia and lower limb defects with minimal facial dysmorphic features: a case report and literature review.

    Science.gov (United States)

    Al Kaissi, Ali; Klaushofer, Klaus; Krebs, Alexander; Grill, Franz

    2008-10-24

    Radial hemimelia is a congenital abnormality characterised by the partial or complete absence of the radius. The longitudinal hemimelia indicates the absence of one or more bones along the preaxial (medial) or postaxial (lateral) side of the limb. Preaxial limb defects occurred more frequently with a combination of microtia, esophageal atresia, anorectal atresia, heart defects, unilateral kidney dysgenesis, and some axial skeletal defects. Postaxial acrofacial dysostoses are characterised by distinctive facies and postaxial limb deficiencies, involving the 5th finger, metacarpal/ulnar/fibular/and metatarsal. The patient, an 8-year-old-boy with minimal craniofacial dysmorphic features but with profound upper limb defects of bilateral and symmetrical absence of the radius and the thumbs respectively. In addition, there was a unilateral tibio-fibular hypoplasia (hemimelia) associated with hypoplasia of the terminal phalanges and malsegmentation of the upper thoracic vertebrae, causing effectively the development of thoracic kyphosis. In the typical form of the preaxial acrofacial dysostosis, there are aberrations in the development of the first and second branchial arches and limb buds. The craniofacial dysmorphic features are characteristic such as micrognathia, zygomatic hypoplasia, cleft palate, and preaxial limb defects. Nager and de Reynier in 1948, who used the term acrofacial dysostosis (AFD) to distinguish the condition from mandibulofacial dysostosis. Neither the facial features nor the limb defects in our present patient appear to be absolutely typical with the previously reported cases of AFD. Our patient expands the phenotype of syndromic preaxial limb malformation complex. He might represent a new syndromic entity of mild naso-maxillary malformation in connection with axial and extra-axial malformation complex.

  16. A great enigma of the Italian Renaissance: paleopathological study on the death of Giovanni dalle Bande Nere (1498-1526) and historical relevance of a leg amputation.

    Science.gov (United States)

    Fornaciari, Gino; Bartolozzi, Pietro; Bartolozzi, Carlo; Rossi, Barbara; Menchi, Ilario; Piccioli, Andrea

    2014-09-10

    The Medici project consisted in archeological and paleopathological researches on some members of the great dynasty of the Italian Renaissance. The remains of Giovanni de' Medici, so-called "dalle Bande Nere" (Forlì 1498- Mantua 1526) have not been investigated yet. The enigma of the fatal injury and leg amputation of the famous Captain excited curiosity of paleopathologists, medical scientists and Italian Society of Orthopedic and Traumatology which contributed to realize the project of exhumation and study of his skeletal remains. The aim of the study is to report the first anthropological and paleopathological results. The tomb of Giovanni and his wife Maria Salviati was explored and the skeletal remains were investigated. Anthropological and paleopathological examination defined: age at death, physical constitution and activity, skeletal diseases. The bones of the leg were studied macroscopically, under stereoscopic microscope, at X-ray and CT scans to detect type of injury and level of amputation. The skeleton and muscular insertions of Giovanni revealed a young-adult and vigorous man, subjected to stresses of military activity since adolescence. Right tibia was amputated below the proximal half of diaphysis leaving long tibio-fibular stumps with a horizontal cut only at the lateral portion. Thus, the surgeon limited to complete the traumatic hemi-amputation. Amputation in the Sixteenth Century technically consisted in guillotine incisions below the knee using crescent shaped knife and bony saw, usually leaving a quite long tibial stump. Amputations in the Sixteenth Century were contaminated and grossly performed not providing vascular binding nor wound closure. The surgeon performed the procedure in conformity with surgical knowledge of that period.

  17. Anatomy of the distal knee joint and pyarthrosis following external fixation.

    Science.gov (United States)

    Hyman, J; Moore, T

    1999-05-01

    To determine the limits of the distal synovial reflection of the human knee joint. Six paired knees studied by magnetic resonance imaging (MRI), fluoroscopic arthrography, and gross dissection. The right knees of five patients with chronic idiopathic knee effusions were studied by MRI. Cadaveric knees were injected with saline prior to MRI. The joint capsules were dissected to visualize local anatomy and check for capsular tears. In each modality (MRI, fluoroscopy, and dissection), the most distal extent of knee synovial fluid was measured. The right versus left agreement for paired specimens was generally two to three millimeters. Some specimens showed asymmetric capsular reflection. Medial fluid was identified at distances greater than forty-nine millimeters from the subchondral bone in seven knees and less than fifteen millimeters in four knees (range 0 to 70 millimeters, mean thirty-three millimeters). Laterally, the range was ten to thirty-five millimeters (mean twenty-three millimeters). In six of the twelve cadaveric specimens, there was evidence of a communication between the knee joint and the proximal tibiofibularjoint. In the knees of volunteers, joint fluid tracked medially to a range of ten to fifty millimeters and laterally to a range of six to fifteen millimeters, with means of twenty-six and eleven millimeters, respectively. The knees of the volunteers had no evidence of tibiofibular joint communication with the knee. Insertion of external fixation pins within sixty to seventy millimeters of the proximal articular surface of the tibia is associated with a high probability of synovial penetration and possibly provides a conduit for the introduction of bacteria, which may be etiologic in iatrogenic pyarthrosis.

  18. One-degree-of-freedom spherical model for the passive motion of the human ankle joint.

    Science.gov (United States)

    Sancisi, Nicola; Baldisserri, Benedetta; Parenti-Castelli, Vincenzo; Belvedere, Claudio; Leardini, Alberto

    2014-04-01

    Mathematical modelling of mobility at the human ankle joint is essential for prosthetics and orthotic design. The scope of this study is to show that the ankle joint passive motion can be represented by a one-degree-of-freedom spherical motion. Moreover, this motion is modelled by a one-degree-of-freedom spherical parallel mechanism model, and the optimal pivot-point position is determined. Passive motion and anatomical data were taken from in vitro experiments in nine lower limb specimens. For each of these, a spherical mechanism, including the tibiofibular and talocalcaneal segments connected by a spherical pair and by the calcaneofibular and tibiocalcaneal ligament links, was defined from the corresponding experimental kinematics and geometry. An iterative procedure was used to optimize the geometry of the model, able to predict original experimental motion. The results of the simulations showed a good replication of the original natural motion, despite the numerous model assumptions and simplifications, with mean differences between experiments and predictions smaller than 1.3 mm (average 0.33 mm) for the three joint position components and smaller than 0.7° (average 0.32°) for the two out-of-sagittal plane rotations, once plotted versus the full flexion arc. The relevant pivot-point position after model optimization was found within the tibial mortise, but not exactly in a central location. The present combined experimental and modelling analysis of passive motion at the human ankle joint shows that a one degree-of-freedom spherical mechanism predicts well what is observed in real joints, although its computational complexity is comparable to the standard hinge joint model.

  19. Ankle ligamints : comparison of MR arthrography with conventional MR imaging in amputated feet

    International Nuclear Information System (INIS)

    Yoo, Jae Sung; Lee, Sang Yong; Lee, Jeong Min; Han, Young Min; Chung, Kyung Ho; Kim, CHong Soo

    2001-01-01

    To compare magnetic resonance (MR) arthrography with conventional MR imaging in the evaluation of ankle ligaments. Eight freshly amputated human feet underwent conventional MR imaging and MR arthrography. For the former, 1.5-T magnets in the axial, coronal and sagittal planes were used, and T1-weighted sequences were obtained. Following the injection of 6-10 ml of diluted contrast media (Gd-DTPA 1:250), T1-weighted images were obtained in the same positions as conventional MR images. Paired conventional MR imaging and MR arthrography of each ankle ligament were rated on a five-point scale, and to reflect inter-group differences a Wilcoxon singed-rank test was used to compare the different measurements (p<0.05). In two ankles, MR images of the ligaments were correlated with ankle dissection. Anterior and posterior talofibular ligaments were more clearly revealed by MR arthrography than by conventional MR imaging, while calcaneofibular ligaments showed no difference between these two modalities. With regard to deltoid ligaments, visualization of the anterior and posterior tibiotalar ligament was much improved when contrast material was used to outline the ligament's articular aspect. Visualization of the posterior inferior tibiofibular ligament and inferior transverse ligament were also improved when the use of contrast material provided delineation of the articular side of the ligaments and separated them from adjacent bone. In addition, MR arthography was very useful for indentification of the posterior intermalleolar ligament, though its use did not enhance visualization of the calcaneofibular, tibiocalcaneal, spring or tibiospring ligaments. MR arthrography accurately revealed the anatomic details of ankle ligaments, and may therefore be more useful than conventional Mr imaging for evaluation of these structures

  20. The MR imaging features of the posterior intermalleolar ligament in patients with posterior impingement syndrome of the ankle

    Energy Technology Data Exchange (ETDEWEB)

    Fiorella, D. [Duke Univ. Medical Center, Durham, NC (United States). Dept. of Radiology; Duke Univ., Durham, NC (United States). Medical Center; Helms, C.A. [Duke Univ. Medical Center, Durham, NC (United States). Dept. of Radiology; Nunley, J.A. II [Dept. of Orthopedic Surgery, Duke University Medical Center, Durham, NC (United States)

    1999-10-01

    Objective. To describe the MR imaging features of the posterior intermalleolar ligament (IML) in patients with posterior impingement syndrome (PIS) of the ankle.Design and patients. Three patients (one male and two females, 13-25 years of age) are presented. Each patient presented clinically with symptoms of PIS of the ankle. Plain film examination was negative for a structural cause of the PIS in all patients. MR images were obtained with a 1.5 T scanner using an extremity coil. Clinical data and, in one patient, findings at ankle arthroscopy, were correlated with the results of MR imaging.Results. Ankle MR images from the three patients with a clinical diagnosis of PIS are presented. Findings in all patients included: (1) absence of another structural cause of the PIS (i.e., an os trigonum, trigonal process, fracture, loose bodies, etc.), (2) identification of the IML as a structure discrete from the posterior talofibular and tibiofibular ligaments, and (3) prominence of the IML as indicated by (a) identification of the IML in three different imaging planes, and (b) a caliber of the IML comparable to that of the conventional posterior ankle ligaments visualized in the same imaging plane. Arthroscopic resection of a meniscoid IML resulted in resolution of the PIS in one of the patients presented.Conclusions. MR imaging is an effective means of investigating the IML as a potential cause of PIS. The identification of a prominent IML in the absence of another structural cause of PIS indicates that impingement of the IML is the most likely cause of PIS. (orig.)

  1. Biochemical studies of Piper betle L leaf extract on obese treated animal using 1H-NMR-based metabolomic approach of blood serum samples.

    Science.gov (United States)

    Abdul Ghani, Zuleen Delina Fasya; Husin, Juani Mazmin; Rashid, Ahmad Hazri Ab; Shaari, Khozirah; Chik, Zamri

    2016-12-24

    Piper betle L. (PB) belongs to the Piperaceae family. The presence of a fairly large quantity of diastase in the betel leaf is deemed to play an important role in starch digestion and calls for the study of weight loss activities and metabolite profile from PB leaf extracts using metabolomics approach to be performed. PB dried leaves were extracted with 70% ethanol and the extracts were subjected to five groups of rats fed with high fat (HF) and standard diet (SD). They were then fed with the extracts in two doses and compared with a negative control group given water only according to the study protocol. The body weights and food intakes were monitored every week. At the end of the study, blood serum of the experimental animal was analysed to determine the biochemical and metabolite changes. PB treated group demonstrated inhibition of body weight gain without showing an effect on the food intake. In serum bioassay, the PB treated group (HF/PB (100mg/kg and 500mg/kg) showed an increased in glucose and cholesterol levels compared to the Standard Diet (SD/WTR) group, a decrease in LDL level and increase in HDL level when compared with High Fat Diet (HF/WTR) group. For metabolite analysis, two separation models were made to determine the metabolite changes via group activities. The best separation of PCA serum in Model 1 and 2 was achieved in principle component 1 and principle component 2. SUS-Plot model showed that HF group was characterized by high-level of glucose, glycine and alanine. Increase in the β-hydroxybutyrate level similar with SD group animals was evident in the HF/PB(500mg/kg) group. This finding suggested that the administration of 500mg/kg PB extracts leads to increase in oxidation process in the body thus maintaining the body weight and without giving an effect on the appetite even though HF was continuously consumed by the animals until the end of the studies and also a reduction in food intake, thus maintaining their body weight although they

  2. Resultados agronômicos e qualitativos da nova cultivar de cevada MN 743 Agronomic and qualitative results of the new barley cultivar MN 743

    Directory of Open Access Journals (Sweden)

    Eduardo Caierão

    2006-02-01

    Full Text Available A cevada MN 743, criada pela Cia Brasileira de Bebidas (AmBev foi lançada para cultivo no ano de 2004. Originou-se de um cruzamento simples entre as linhagens MN 681 e GIMPEL, realizado em 1992, no campo experimental da antiga Cia Brahma, no município de Encruzilhada do Sul. A cultivar MN 743 é do tipo duas fileiras, possui ciclo precoce e ampla adaptação às condições do sul do Brasil. Das cultivares disponíveis a nível de produção é a que apresenta a maior classificação comercial (grãos de primeira qualidade. Nos anos em que fez parte do ensaio de Valor de Cultivo e Uso (VCU, sempre apresentou médias competitivas em termos de rendimento corrigido em relação à testemunha de maior área no Brasil, MN 698. Com relação às características qualitativas, apresenta excelente performance no que diz respeito ao teor de extrato e poder diastásico. A cultivar é recomendada para os estados do Rio Grande do Sul, Santa Catarina e Paraná. Devido a seu ótimo desempenho no aspecto qualidade, visando a indústria cervejeira, a cultivar representa um importante avanço para o melhoramento deste cereal no Brasil, aliando os interesses do produtor e da indústria.Barley cultivar MN 743, developed by the Cia. Brasileira de Bebidas (AmBev was released in 2004. It resulted from a simple cross between lines MN 681 x GIMPEL, made in 1992, in the Brahma's Experimental Field - Encruzilhada do Sul/RS. MN 743, a two-rowed type cultivar has early cicle and is broadly adapted to southern Brazil. Among the hight producing cultivars available, it shows higher kernel plumpness (first quality kernel. Over the years it was included in the VCU (cost and use value trial, the cultivar has repeatedly showed competitive means in adjusted yield, as compared to the control occupying the largest cropped area in Brazil, MN 698. Regarding quality characteristics, it has an excellent performance as friability and diastasic power. The cultivar is recomended for all

  3. Histochemical analysis of glycoconjugates in the skin of a catfish (arius tenuispinis, day).

    Science.gov (United States)

    Al-Banaw, A; Kenngott, R; Al-Hassan, J M; Mehana, N; Sinowatz, F

    2010-02-01

    A histochemical study using conventional carbohydrate histochemistry (periodic-acid staining including diastase controls, alcian blue staining at pH 1 and 2.5) as well as using a battery of 14 fluorescein isothiocyanate (FITC)-labelled lectins to identify glycoconjugates present in 10 different areas of the skin of a catfish (Arius tenuispinis) was carried out. The lectins used were: mannose-binding lectins (Con A, LCA and PSA), galactose-binding lectins (PNA, RCA), N-acetylgalactosamine-binding lectins (DBA, SBA, SJA and GSL I), N-acetylglucosamine-binding lectins (WGA and WGAs), fucose-binding lectins (UEA) and lectins which bind to complex carbohydrate configurations (PHA E, PHA L). Conventional glycoconjugate staining (PAS staining, alcian blue at pH 1 and 2.5) showed that the mucous goblet cells contain a considerable amount of glycoconjugates in all locations of the skin, whereas the other unicellular gland type, the club cells, lacked these glycoconjugates. The glycoproteins found in goblet cells are neutral and therefore stain magenta when subjected to PAS staining. Alcian blue staining indicating acid glycoproteins was distinctly positive at pH 1, but gave only a comparable staining at pH 2.5. The mucus of the goblet cells therefore also contains acid glycoproteins rich in sulphate groups. Using FITC-labelled lectins, the carbohydrate composition of the glycoproteins of goblet cells could be more fully characterized. A distinct staining of the mucus of goblet cells was found with the mannose-binding lectins LCA and PSA; the galactosamine-binding lectins DBA, SBA and GLS I; the glucosamine-binding lectin WGA; and PHA E which stains glycoproteins with complex carbohydrate configurations. No reaction occurred with the fucose-binding lectin UEA and the sialic acid-specific lectin SNA. In addition, the galactose-binding lectins PNA and RCA showed only a weak or completely negative staining of the mucus in the goblet cells. The specificity of the lectin staining

  4. Resultados agronômicos e qualitativos da nova cultivar de cevada MN 743 Agronomic and qualitative results of the new barley cultivar MN 743

    Directory of Open Access Journals (Sweden)

    Eduardo Caierão

    2005-12-01

    Full Text Available A cevada MN 743, criada pela Cia Brasileira de Bebidas (AmBev foi lançada para cultivo no ano de 2004. Originou-se de um cruzamento simples entre as linhagens MN 681 e GIMPEL, realizado em 1992, no campo experimental da antiga Cia Brahma, no município de Encruzilhada do Sul. A cultivar MN 743 é do tipo duas fileiras, possui ciclo precoce e ampla adaptação às condições do sul do Brasil. Das cultivares disponíveis a nível de produção é a que apresenta a maior classificação comercial (grãos de primeira qualidade. Nos anos em que fez parte do ensaio de Valor de Cultivo e Uso (VCU, sempre apresentou médias competitivas em termos de rendimento corrigido em relação à testemunha de maior área no Brasil, MN 698. Com relação às características qualitativas, apresenta excelente performance no que diz respeito ao teor de extrato e poder diastásico. A cultivar é recomendada para os estados do Rio Grande do Sul, Santa Catarina e Paraná. Devido a seu ótimo desempenho no aspecto qualidade, visando a indústria cervejeira, a cultivar representa um importante avanço para o melhoramento deste cereal no Brasil, aliando os interesses do produtor e da indústria.Barley cultivar MN 743, developed by the Cia. Brasileira de Bebidas (AmBev was released in 2004. It resulted from a simple cross between lines MN 681 x GIMPEL, made in 1992, in the Brahma's Experimental Field - Encruzilhada do Sul/RS. MN 743, a two-rowed type cultivar has early cicle and is broadly adapted to southern Brazil. Among the hight producing cultivars available, it shows higher kernel plumpness (first quality kernel. Over the years it was included in the VCU (cost and use value trial, the cultivar has repeatedly showed competitive means in adjusted yield, as compared to the control occupying the largest cropped area in Brazil, MN 698. Regarding quality characteristics, it has an excellent performance as friability and diastasic power. The cultivar is recomended for all

  5. Composição de amostras de mel de abelha Jataí (Tetragonisca angustula latreille, 1811 Composition of the honey of samples originated from Jataí bees (Tetragonisca angustula latreille, 1811

    Directory of Open Access Journals (Sweden)

    Daniela de Almeida Anacleto

    2009-09-01

    Full Text Available As características físico-químicas do mel produzido pelas abelhas sem ferrão ainda são pouco conhecidas, principalmente devido à elevada diversidade da flora apícola e à baixa produção que é inerente a estas espécies. O objetivo deste trabalho foi determinar as características físico-químicas de 20 amostras de mel de Jataí (Tetragonisca angustula, do município de Piracicaba, estado de São Paulo, contribuindo para o estabelecimento de um padrão de qualidade do mel das abelhas sem ferrão brasileiras, possibilitando o controle da fraude deste produto. Desta maneira, as seguintes análises foram realizadas: açúcares totais, açúcares redutores, sacarose aparente, umidade, hidroximetilfurfural, proteínas, cinzas, pH, acidez, índice de formol, condutividade elétrica, cor, atividade diastásica e atividade de água. Os resultados demonstram que a legislação atual, referente ao mel de Apis mellifera, não é adequada para todos os caracteres analisados, reforçando a necessidade de um padrão próprio para os méis de meliponíneos.The knowledge regarding the physicochemical characteristics of the honey produced by stingless bees is still limited, mainly due to the high diversity of the floral resources and the low production that is inherent to these species. This research deals with the physicochemical characteristics of 20 samples of Tetragonisca angustula honey, from the municipality of Piracicaba, state of São Paulo, Brazil, contributing to the establishment of a quality standard for the honey produced by Brazilian stingless bees making possible the control of this product. Thus, the following parameters were determined: total sugars, reducing sugars, apparent sucrose, moisture content, hydroxymethylfurfural, proteins, ashes, pH, acidity, formol index, electrical conductivity, color, diastase activity, and water activity. The results indicated that the Brazilian standard rules, referring to the Apis mellifera honey, are

  6. Clear cell urothelial carcinoma of the urinary bladder: a case report and review of the literature.

    Science.gov (United States)

    Knez, Virginia M; Barrow, Willis; Lucia, M Scott; Wilson, Shandra; La Rosa, Francisco G

    2014-08-14

    The occurrence of clear cell tumors in the bladder is not uncommon. Clear cell dysplasia is well-described and characterized by focal replacement of transitional mucosa by cells with abundant clear cytoplasm, nuclear enlargement, and a granular chromatin pattern. Clear cells can also be seen in clear cell adenocarcinoma, which is rare, comprising 0.5% to 2.0% of the reported bladder carcinomas. Other clear cell tumors found in the bladder to be considered in the differential diagnosis are tumors of Müllerian origin and metastatic lesions, such as renal cell carcinoma, clear cell sarcoma, and malignant melanoma. Clear cell urothelial carcinoma is exceedingly rare, with only nine clinical cases described in the literature. We report the case of a 75-year-old Caucasian man who presented with intermittent hematuria, in whom a bladder tumor was identified. A final histopathology examination of a cystoprostatectomy specimen revealed a pT3b, G3 urothelial carcinoma of clear cell type (>90% clear cells) and a prostatic adenocarcinoma of Gleason grade 3+3 (score=6). The bladder tumor consisted of sheets of malignant cells with severe nuclear atypia and abundant clear cytoplasm; no glandular or tubular structures were identified. Tumor cells were periodic acid-Schiff positive and negative after diastase treatment; additional mucicarmine and oil red O stains were negative. Immunohistochemical stains showed the tumor cells positive for cytokeratin 7 (CK7), p63 (>80% nuclei), p53 (about 30% nuclei), vimentin, E-cadherin, cluster of differentiation (CD10), and Ki-67 (>70% nuclei). Stains for cell adhesion molecule 5.2 (CAM 5.2), CD117, cytokeratin 20 (CK20), human melanoma black 45 (HMB-45), paired box protein (PAX 8), placental alkaline phosphatase (PLAP), prostate specific antigen (PSA), renal cell carcinoma (RCC), cancer antigen 25 (CA25), leukocyte common antigen (LC), S-100 protein, and uroplakin III were all negative. The tumor marker profile was consistent with clear

  7. Development of a pilot system for converting sweet potato starch into glucose syrup

    Science.gov (United States)

    Silayo, Valerian C K.; Lu, John Y.; Aglan, Heshmat A.; Bovell-Benjamin, A. C. (Principal Investigator)

    2003-01-01

    Sweet potato has been chosen as one of NASA's crops to support human beings in future space missions. One of the possible uses is to make syrup that can be used as a general sweetener. In this work a simple engineering system for converting sweet potato starch into glucose syrup was studied on a laboratory scale. The system comprises the following main units: a blender, continuous stirred tank reactor (CSTR), centrifugal and vacuum filters, deionization column and vacuum evaporator. The system was tested by carrying out conversion processes from fresh sweet potato roots. The roots were pealed, sliced, homogenized, heated and hydrolyzed by diastase of malt and Dextrozyme C (Novo Nordisk BioChem, North America, Inc.) enzymes in the CSTR. After hydrolysis the slurry was filtered, de-ionized and concentrated to get glucose syrup. The performance of the system was evaluated based on the quality of the conversion. The main factor was the level of reducing sugars except for the deionization where ash content and color were the main factors. Through careful control of the system units, good heating performance in the CSTR was obtained and the hydrolysis process attained sufficient conversion. The filtration process that incorporated the centrifuge was faster than when it was by-passed to the vacuum filter but losses in sugars were higher. Deionization removed more than 90% of the ash and reduced pigmentation, with probable insignificant losses in sugars during the deionization process. Recovery levels when the centrifuge was used and when it was by-passed could reach about 65% and 78%, respectively. These correspond to reducing sugar concentration of 259 and 310 mg/ml in 150-ml syrups from 300 g of sweet potatoes in each process. However, from concentration trials, syrups with volumes of 100 and 70 ml with the respective dextrose equivalence of 281 and 213 mg/ml were obtained. The syrups obtained were brownish in color and the process that employed centrifugal filtration

  8. A MULTIDISCIPLINARY APPROACH TO THE REHABILITATION OF A COLLEGIATE FOOTBALL PLAYER FOLLOWING ANKLE FRACTURE: A CASE REPORT.

    Science.gov (United States)

    Feigenbaum, Luis A; Kaplan, Lee D; Musto, Tony; Gaunaurd, Ignacio A; Gailey, Robert S; Kelley, William P; Alemi, Timothy J; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A; West, Dustin C

    2016-06-01

    Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m(2) to 30.6 kg/m(2). This case report illustrates the positive effects of a multidisciplinary approach where combining physical therapy and

  9. A MULTIDISCIPLINARY APPROACH TO THE REHABILITATION OF A COLLEGIATE FOOTBALL PLAYER FOLLOWING ANKLE FRACTURE: A CASE REPORT

    Science.gov (United States)

    Kaplan, Lee D.; Musto, Tony; Gaunaurd, Ignacio A.; Gailey, Robert S.; Kelley, William P.; Alemi, Timothy J.; Espinosa, Braulio; Mandler, Eli; Scavo, Vincent A.; West, Dustin C.

    2016-01-01

    ABSTRACT Background and Purpose Multiple rehabilitation factors including overall wellness need to be considered when an athlete returns to sport after an injury. The purpose of this case report is to describe a multidisciplinary approach for return to sport of a Division I collegiate football player following a traumatic ankle fracture requiring surgical repair. The assessment and treatment approach included the use of a performance-based physical therapy outcome measure, self-reported functional abilities, body composition assessments, and nutritional counseling. Case Description A 21 year-old running back fractured his lateral malleolus due to a mechanism of injury of excessive eversion with external rotation of the ankle. Surgical intervention included an open reduction internal fixation (ORIF) of the fibula and syndesmosis. In addition to six months of rehabilitation, the patient received consultations from the team sports nutritionist specialist to provide dietary counseling and body composition testing. The Comprehensive High-level Activity Mobility Predictor-Sport (CHAMP-S), a performance-based outcome measure, self-report on the Foot and Ankle Disability Index (FADI-ADL, FADI-S), and body composition testing using whole body densitometry (BOD POD®), were administered throughout rehabilitation. Outcomes The subject was successfully rehabilitated, returned to his starting role, and subsequently was drafted by a National Football League (NFL) franchise. High-level mobility returned to above pre-injury values, achieving 105% of his preseason CHAMP-S score at discharge. Self-reported function on the FADI-ADL and FADI-Sport improved to 100% at discharge. Body fat percentages decreased (13.3% to 11.9%) and fat mass decreased (12.0 kg to 11.0kg). Lean body mass (78.1 kg to 81.5 kg) and lbm/in increased (1.14 kg/in to 1.19 kg/in). His BMI changed from 29.8 kg/m2 to 30.6 kg/m2. Discussion This case report illustrates the positive effects of a

  10. Long-term outcome of pronation-external rotation ankle fractures treated with syndesmotic screws only.

    Science.gov (United States)

    Lambers, Kaj T A; van den Bekerom, Michel P J; Doornberg, Job N; Stufkens, Sjoerd A S; van Dijk, C Niek; Kloen, Peter

    2013-09-04

    There is sparse information in the literature on the outcome of Maisonneuve-type pronation-external rotation ankle fractures treated with syndesmotic screws. The primary aim of this study was to determine the long-term results of such treatment of these fractures as indicated by standardized patient-based and physician-based outcome measures. The secondary aim was to identify predictors of the outcome with use of bivariate and multivariate statistical analysis. Fifty patients with pronation-external rotation (predominantly Maisonneuve) fractures were treated with open reduction and internal fixation of the syndesmosis utilizing only one or two screws. The results were evaluated at a mean of twenty-one years after the fracture utilizing three standardized outcomes instruments: (1) the Foot and Ankle Ability Measure (FAAM), (2) the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale, and (3) the Center for Epidemiologic Studies-Depression (CES-D) Scale. Osteoarthritis was graded according to the van Dijk and revised Takakura radiographic scoring systems. Bivariate and multivariate analyses were performed to identify predictors of long-term outcome. Forty-four (92%) of forty-eighty patients had good or excellent AOFAS scores, and forty-four (90%) of forty-nine had good or excellent FAAM scores. Arthrodesis for severe osteoarthritis was performed in two patients. Radiographic evidence of osteoarthritis was observed in twenty-four (49%) of forty-nine patients. Multivariate analysis identified pain as the most important independent predictor of long-term ankle function as indicated by the AOFAS and FAAM scores, explaining 91% and 53% of the variation in scores, respectively. Analysis of pain as the dependent variable in bivariate analyses revealed that depression, ankle range of motion, and a subsequent surgery were significantly correlated with higher pain scores. No firm conclusions could be drawn after multivariate analysis of predictors of pain

  11. Infrapopliteal Angioplasty of One or More than One Artery for Critical Limb Ischaemia: A Randomised Clinical Trial.

    Science.gov (United States)

    Biagioni, Rodrigo B; Biagioni, Luisa C; Nasser, Felipe; Burihan, Marcelo C; Ingrund, José C; Neser, Adnan; Miranda, Fausto

    2018-04-01

    The aim was to analyse the effect of the treatment of more than one infrapopliteal artery with respect to wound healing and limb salvage. Seventy-eight patients were enrolled prospectively for 80 procedures (80 limbs) that were randomly divided into two groups: 40 in the single vessel (SV) group and 40 in the multiple vessel group (MV). All patients had tissue loss. The choice of the first artery to treat was based on an analysis of two factors: the ease of the required endovascular technique and the presence of adequate distal outflow. The randomisation point was after the first successful distal artery angioplasty. The primary endpoints were the wound healing rate and limb salvage. The mean age of the patients was 69.1 ± 4.3 years, and 56% were male. Concomitant treatment of the femoral and popliteal arteries was performed in 38.8% of patients. All demographic characteristics and technical aspects were statistically comparable for both groups. Successful recanalisation was achieved in 95.8%, 86.2%, 86.9%, and 92.5% for the tibio-fibular trunk, anterior tibial, posterior tibial, and fibular artery, respectively. In the MV group, a higher contrast volume (29 mL more; p = .049), longer procedure time (p = .01), and higher radiation exposure (p = .04) were noted. There was no difference in renal function between the groups either before or 30 days after the procedure (p = .165). The limb salvage rates after 1 and 3 years, respectively, were 75.9% and 67% for the SV group and 91.1% and 91.1% for the MV group (log rank p = .052). The wound healing rates after 1 and 3 years, respectively, were 33.6% and 70.9% for the SV and 63.9% and 78.4% for MV group (log rank p = .006). Wound healing was faster in MV (2.11 cm 2 /month) than SV group (0.62 cm 2 /month; p = .004). Endovascular treatment of more than one artery was associated with better wound healing rates but not with better limb salvage. Copyright © 2017 European Society for Vascular Surgery

  12. The percutaneous use of a pointed reduction clamp during intramedullary nailing of distal third tibial shaft fractures.

    Science.gov (United States)

    Forman, Jordanna M; Urruela, Adriana M; Egol, Kenneth A

    2011-12-01

    The purpose of this retrospective chart and radiographic review is to describe an effective reduction technique during intramedullary nailing of distal metaphyseal tibia fractures with the use of a pointed percutaneous clamp. Between 2007 and 2010, 100 patients who sustained 102 tibia fractures were definitively treated with an intramedullary nail at one of two medical centers. Diaphyseal fractures and injuries with an associated disruption of the distal tibiofibular joint were excluded from our study. A total of 27 patients with 27 distal metaphyseal tibia fractures (OTA types 42-A, 43-A, and 43-B) were included. All 27 patients underwent IM nailing of their fractures with anatomic reduction achieved using a percutaneously placed pointed reduction clamp prior to insertion of the IM implant. Fracture alignment and angular deformity was assessed using goniometric measurement functions on the PACS system (GE, Waukeshau, WI) obtained from preoperative and postoperative anteroposterior and lateral images for all subjects. Malalignment was defined as more than 5 degrees of angulation in any plane. Fourteen of the fractures were classified as OTA 42-A, 9 were OTA 43-A, and 4 were OTA 43-B. Analysis of post-closed reduction, preoperative anteroposterior radiographs revealed a mean of 7.9 degrees of coronal plane (range: 0.9 degrees-26 degrees) angulation. Post closed reduction preoperative lateral radiographs revealed a mean of 6.8 degrees sagittal plane (range: 0 degrees-24.6 degrees) angulation. Postoperative anteroposterior and lateral radiographs showed the distal segment returned to its anatomical alignment with a mean angulation of 0.5 degrees (range, 0 degrees-3.5 degrees) and 0.7 degrees (range, 0 degrees-4.2 degrees) of varus/ valgus and apex anterior/posterior angulation, respectively. These results showed an acceptable postopertative alignment in all 27 distal third fractures. No intra-operative or postoperative complications were noted in the study group. This

  13. Outcomes and Return to Activity After Operative Repair of Chronic Latent Syndesmotic Instability.

    Science.gov (United States)

    Ryan, Paul M; Rodriguez, Ryan M

    2016-02-01

    This study is a retrospective review of prospectively gathered data determining the postoperative outcomes of patients who underwent operative treatment to address chronic syndesmotic instability. The cohort is composed of 19 individuals who elected to undergo operative treatment of chronic syndesmotic instability. The operative repair consisted of arthroscopic debridement in all cases with reduction and suture button fixation of those patients who had greater than 4 mm of syndesmotic diastasis on arthroscopic evaluation. All patients had a minimum of 24 months follow-up. This study retrospectively examined the prospectively gathered preoperative and postoperative outcome scores to include a Visual Analog Scale (VAS) pain score and an American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score. In addition, patients were questioned on their ability to return to their preinjury level of activity and their ability to continue running sports. Fourteen patients returned their postoperative surveys. Mean AOFAS scores improved significantly from 48 to 82.7 (P = .014). Mean VAS scores improved from 6.1 to 1.0 (P = .002). Overall, 86% (12/14) of patients were able to return to running and 79% (11/14) of patients were able to return to their preinjury level of sport. Preoperative and postoperative weight-bearing ankle radiographs were reviewed to evaluate the tibiofibular clear space and overlap. The clear space measured on anteroposterior (AP) radiographs decreased from 5.4 mm to 4.6 mm (P = .005), the clear space evaluated on the mortise radiograph decreased from 4.5 mm to 3.6 mm (P = .006), and the overlap measured on the AP radiograph increased from 5.7 mm to 6.9 mm (P = .019). All radiographs were measured by a board-certified musculoskeletal radiologist. This study presents a treatment method that can be instituted at the time of diagnosis for syndesmotic injuries with greater than 4 mm of diastasis that were treated with debridement and stabilization. The

  14. Outcome of tissue sparing surgical intervention in mine blast limb injuries

    International Nuclear Information System (INIS)

    Khan, M.I.; Zafar, A.; Khan, N.; Mufti, N.

    2006-01-01

    To describe the pattern of mine blast limb injuries in civilian population of Kashmir, to evaluate the outcome of tissue sparing surgical intervention in these injuries and to determine the sensitivity of hand-held percutaneous Doppler for tissue viability. One hundred and three patients who sustained mine blast injuries to upper or lower limbs, along side the line of control between the Indian-held Kashmir and Azad Kashmir, regardless of age and gender, were included in this study. Patients who already had amputation after injury at some other place were excluded. All patients were initially managed in emergency and had more than one surgical intervention. Transcutaneous Doppler was used to evaluate the vascularity of the remaining tissue. All patients were operated under spinal or general anaesthesia and had repeated debridements followed by skin cover by split skin graft, full thickness skin graft or rotational flaps. Every patient received at least 5 days course of antibiotics and tetanus prophylaxis. Postoperative rehabilitation and follow-up was conducted for at least 6 months after discharge from the hospital. Mean age of victims in this study was 22 years. Out of 103 patients, 72 (69.9%) received initial wound care in the peripheral primary health care centre but were not amputated while 31 patients (30%) were just dressed and referred for further treatment at tertiary care hospitals. Eighty five patients (82.5%), out of the total, had some sort of traumatic amputation at presentation due to the original injury. That included loss of limb below knee in 19 (18.45%) patients, at distal tibiofibular region in 13 (12.6%), mid tarsal amputations in 39(37.9%), and hemi foot amputation in 15 (14.6%) patients. Nine (8.7%) patients had losses of two or less than two toes, 1 (0.97%) patient had injury at mid palmer region, and 5 (4.9%) patients had 2 fingers traumatic amputation. Eighteen (17.5%) patients had soft tissue ( with or without bony injury) injury only

  15. Sost Deficiency does not Alter Bone’s Lacunar or Vascular Porosity in Mice

    Directory of Open Access Journals (Sweden)

    Henry Mosey

    2017-09-01

    Full Text Available SCLEROSTIN (Sost is expressed predominantly in osteocytes acting as a negative regulator of bone formation. In humans, mutations in the SOST gene lead to skeletal overgrowth and increased bone mineral density, suggesting that SCLEROSTIN is a key regulator of bone mass. The function of SCLEROSTIN as an inhibitor of bone formation is further supported by Sost knockout (KO mice which display a high bone mass with elevated bone formation. Previous studies have indicated that Sost exerts its effect on bone formation through Wnt-mediated regulation of osteoblast differentiation, proliferation, and activity. Recent in vitro studies have also suggested that SCLEROSTIN regulates angiogenesis and osteoblast-to-osteocyte transition. Despite this wealth of knowledge of the mechanisms responsible for SCLEROSTIN action, no previous studies have examined whether SCLEROSTIN regulates osteocyte and vascular configuration in cortices of mouse tibia. Herein, we image tibiae from Sost KO mice and their wild-type (WT counterparts with high-resolution CT to examine whether lack of SCLEROSTIN influences the morphometric properties of lacunae and vascular canal porosity relating to osteocytes and vessels within cortical bone. Male Sost KO and WT mice (n = 6/group were sacrificed at 12 weeks of age. Fixed tibiae were analyzed using microCT to examine cortical bone mass and architecture. Then, samples were imaged by using benchtop and synchrotron nano-computed tomography at the tibiofibular junction. Our data, consistent with previous studies show that, Sost deficiency leads to significant enhancement of bone mass by cortical thickening and bigger cross-sectional area and we find that this occurs without modifications of tibial ellipticity, a measure of bone shape. In addition, our data show that there are no significant differences in any lacunar or vascular morphometric or geometric parameters between Sost KO mouse tibia and WT counterparts. We, therefore

  16. Tibiotalar torsion: bioengineering paradigm.

    Science.gov (United States)

    Michele, A A; Nielsen, P M

    1976-10-01

    1. Medial tibiotalar torsion is the most common disorder peculiar to mankind. 2. The pathogonomic findings are (a) an axial medially rotated and adducted distal third of the shaft of the tibia, (b) the plafond of the tibia with its mortise containing the "track-bound" talus, which is deflected strongly toward the tibial side, (c) an exaggerated midtarsal equinus, (d) ostensible restriction of dorsiflexion of the hindfoot against the tibia, (e) mild separation of the distal tibiofibular articulation, and (f) forward displacement of the gravitational axis to the naviculocunei-form joint. 3. Faulty leg crossing in utero resulting in an abnormal pelvofemoral-tibial design is discussed and its important consequences in the vulnerable 40 per cent of the population are emphasized. 4. The kinesiomechanics of the leg, ankle and foot is reviewed. 5. The radiographic parameters of medial tibiotalar torsion are presented, as well as the multiple facets of the clinical examination. 6. Methods of treatment depending on age and severity of the disorder are recommended. Surgery, detortional casts, and corrective footwear are discussed. Shoes presently available are inadequate for tibiotalar torsion and therefore engineering principles must be applied in the design and construction of all footwear, including sneakers and sportswear. This can be done only if the pathological biomechanics of this group of disorders is recognized. Biplane proximal tibial osteotomy is recommended in refractory cases, especially when tibiotalar torsion is demonstrated. 7. After 30 years of experience, the author finds that results with these patients have been uniformly good to excellent, depending on age and mode of treatment. 8. In medial tibiotalar torsion, the consequent adaptive changes are readily observed, but rarely are they recognized as the inevitable sequelae of medial tibiotalar torsion. 9. Adaptive compensating disorders are identified and their mechanism described. 10. The management of

  17. Fibulectomy for primary proximal fibular bone tumors: A functional and clinical outcome in 46 patients

    Directory of Open Access Journals (Sweden)

    Zile Singh Kundu

    2018-01-01

    knee and ankle movements and stability. The overall average MSTS score was 26.50. Conclusions: With good reconstruction of lateral ligament we can achieve good results after proximal fibulectomy for benign as well as malignant tumor without much instability. With partial upper tibial resection (i.e., the extra-articular resection of proximal tibiofibular joint adequate margins are feasible even in malignant tumors.

  18. MORPHOMETRY OF THE ARTICULAR FACETS ON THE SUPERIOR, MEDIAL AND LATERAL SURFACES OF THE BODY OF TALUS AND ITS CLINICAL RELEVANCE

    Directory of Open Access Journals (Sweden)

    Goda Jatin B, Patel Shailesh M, Parmar Ajay M, Agarwal GC

    2015-07-01

    Full Text Available Background: In the formation of Ankle joint, tibio-fibular mortice receives superior, medial and lateral articular surfaces of body of Talus. Because of very limited availability of the data on the Morphometry of the articular facets on the Body of the dry human tali, this study was undertaken. Aims: To prepare the database on the articular facets on the superior, medial and lateral surfaces of body of talus, to find if there is statistically significant difference between both the sides of measurements and to compare the results with the previous studies. Methods and Material: 40 Dry Human Tali (20 Right and 20 Left were measured with Digital vernier caliper for the following Measurements: On the Trochlear surface: Medial length, Central length, Lateral length, Anterior width, Central width, Posterior width. On the lateral triangular articular facet: Central height, Central width. On the coma shaped medial articular facet: Central height, Central width. Results: Mean values of Medial, Central and Lateral lengths were 31.02, 30.39 and 29.63mm on Right side and 31.79, 30.65 and 29.45mm on Left side. Mean Anterior, Central and Posterior widths were 28.87, 28.16 and 21.59mm on right side and 29.08, 27.54 and 21.78mm on left side. On the medial articular surface, mean central height was 11.93mm on the right side and 11.29mm on the left side, Mean central width was 27.94mm on the right side and 28.29mm on the left side. On the lateral articular surface, mean central height was 22.14mm on the right side and 22.63mm on the left side. Mean central width was 18.93mm on the right side and 18.99mm on the left side. There is no significant difference between right and left sides of measurements. Conclusion: The trochlear articular surface is wider in front, measurements of opposite talus bone can be used as a control during talus bone replacement surgery, it may help surgeons to plan pre-operatively the complex talar fracture surgeries, to design accurate

  19. ALTERNATIVE APIARIES SHADING ALTERNATIVAS DE SOMBREAMENTO PARA APIÁRIOS

    Directory of Open Access Journals (Sweden)

    Ricardo Costa Rodrigues de Camargo

    2011-07-01

    Full Text Available

    Beehives shading can be a strategy to minimize the heat stress suffered by bees in tropical regions such as the Northeastern Brazil. So, the objective of this study was to evaluate the influence of different beehives shading conditions on the development and quality of honey produced in Apis mellifera colonies. The experiment was carried out in an apiary owned by the Embrapa Meio-Norte, in Castelo do Piauí, Piauí State, Brazil. Bee colonies were placed under the shade provided by straw, polypropylene screen (80% shading, and trees, and under direct solar radiation, in a completely randomized design, with six replications. Data concerning beehives weight and breeding and feeding areas were analyzed by using the Kruskal-Wallis test. Honey samples collected from beehives were submitted to chemical analyses, in order to determine hydroxymethylfurfural (HMF, acidity, and diastase activities. It was observed that the artificial covers did not provide significant beneficial effects on the colonies development. Thermoregulation was impaired

  20. Features of pancreatic lesions on the background gastroduodenal pathology associated with H.pylori-infection

    Directory of Open Access Journals (Sweden)

    T.V. Sorokman

    2017-03-01

    Full Text Available Background. There are recent publications about the possible impact of Helicobacter pylori (H.pylori on the mucous membrane of the stomach or duodenum, as well as the pancreas. This relation is theoretically possible considering the close connection of stomach, duodenum and pancreas. The purpose of the study was the determination of the incidence and characteristics of combined lesions of the pancreas and the upper gastrointestinal tract associated with H.pylori infection in children. Material and methods. A retrospective analysis of medical records of 684 children, who were hospitalized in the gastroenterology department of the Chernivtsi regional children’s hospital during the period from 2010 to 2016. A comprehensive examination included ultrasound diagnostics of the abdomen, esophagogastroduodenoscopy, determination of the activity of serum α-amylase, urine diastase, coprogram assessment. A test system HELIC-test “AMA” (Russia, St. Petersburg and histological methods (bioptates were taken from the fundal and antral gastric mucosa, after Giemsa stain of histological sections, the visualization of H.pylori was performed by means of light microscopy were used for the H.pylori diagnosis. The descriptive statistics methods with parametric distribution estimating the mean and standard deviation (M ± SD were applied. Statistical significance of differences was assessed by Student’s t-test for independent samples. Results. Of the 684 children, who completed a survey, 310 were boys (45.3 % and 374 — girls (54.7 % aged 6 to 18 years. The diagnosis of chronic gastroduodenitis was the most frequently registered among examined children (420 out of 684 patients examined, 61.4 %. A rather high number of children had erosive and ulcerative lesions of the stomach and duodenum (157 of 684 patients, 22.9 %. H.pylori infection in a group of the children surveyed was detected in 64.5 % cases. The highest incidence of H.pylori was in children with

  1. Chemical quality of different argentine honey varieties, irradiated to control american foulbrood; Calidad química de diferentes variedades de mieles argentinas, irradiadas para controlar 'loque americana'

    Energy Technology Data Exchange (ETDEWEB)

    Zunich, C.D., E-mail: c.zunich@yahoo.com.ar [Universidad Tecnológica Nacional, Avellaneda (Argentina). Facultad de Ingeniería, Maestria en Tecnologia de Alimentos; Markowski, I., E-mail: imarkowski@unla.edu.ar [Universidad Nacional de Lanús, Buenos Aires (Argentina). Laboratorio de Fisico-Quimica; Narvaiz, Patricia [Comisión Nacional de Energía Atómica, Ezeiza (Argentina). Gerencia de Aplicaciones y tecnologia de Radiaciones, Sector Irradiacion de Alimentos

    2011-07-01

    'American foulbrood' is a disease that seriously affects bees. Honey may be contaminated with spores of the related bacteria, Paenibacillus larvae larvae, which is a great drawback for trade. The scientific literature reports that these spores, resistant to heat and chemicals, are inactivated in honey when it is irradiated al 10 kGy, being this treatment mandatory in the Republic of Southafrica. Irradiated food wholesomeness is endorsed by the World Health Organization. Considering that Argentina is an important honey producer and exporter, the aim of this work was to evaluate the effect of ionizing radiation on some of its commercial chemical parameters along storage time. Honeys with different characteristics, coming from five different regions of the country: Middle, Patagonia, North, Litoral, Humid Pampa, were provided by producers from a commission called 'Packaged honey' of the National Food, Fishery and Agriculture Ministry. Fifteen kg of each honey variety were packaged in 500 g polypropylene recipes with polyethylene lids, and irradiated at the semi industrial cobalt-60 facility of the Ezeiza Atomic Center, 500,000 Ci of activity, with doses of 0, 10 and 20 kilo Grays. Control and irradiated samples were stored at room temperature for 10 months. Some standardized chemical analysis required by the Argentine Food Code (AFC) were performed on the first, fourth and tenth storage months: water content, acidity, diastase content, reducing sugars, and hydroxymethylfurfural. Reducing sugars and diastase activity slightly diminished, and acidity slightly increased, along storage which is typical in this product; no significant differences were found between control and irradiated samples. Hydroxymethylfurfural values, related to aging or thermal abuse, diminished slightly though significantly due to irradiation, which would not affect the product quality as regulations require not to surpass a maximum value, 40 mg/kg in the AFC. So ionizing irradiation at a 10 k

  2. 糖原累积病Ⅳ型的临床和病理特点%The clinical and pathological characteristics of a patient with glycogen storage disease Ⅳ

    Institute of Scientific and Technical Information of China (English)

    姚生; 戚晓昆; 熊斌; 张巍; 郑日亮; 袁云

    2009-01-01

    Objective To report the clinical and pathological characteristics of one patient with glycogen storage disease Ⅳ (Anderson disease). Methods The patient was received detailed clinical examinations, ultrasound, electromyography, head MRI and muscle biopsy. Results The onset of the 22 years old male patient was 7yrs. The main symptoms were intolerance and fatigue in proximal limbs muscular movement, cardiopalmus by chance. Abdominal ultrasound examinations showed cirrhosis, portal hypertension, splenomegaly. Echocardiogram showed left ventricular myohypertrophia, mild mitral and tricuspid valve insufficiency. Electrophysiology study revealed widespread myogenic changes. Cranial MRI, MRA and MRS were normal. Muscle biopsy showed basophilic intracytoplasmic material in a lot of fibers deposits, which was intensively PAS-positive material and partially resistant to diastase digestion. In the electron microscope, the storage material consisted of filamentous and finely granular material. Conclusions There was the first case of glycogen storage disease Ⅳ reported in our country, mainly involved skeletal muscle, liver, spleen and cardiac muscle.%目的 报道1例22岁男性糖原累积病Ⅳ型(Anderson disease)患者临床及病理特点.方法 对该患者行详细的病史询问和体格检查、心脏和腹部超声检查、头颅影像学、肌电图以及肌肉病理检查.结果患者儿童期发病,主要表现为四肢近端肌肉运动不耐受和疲劳感,偶有心悸;腹部超声示肝硬化、门脉高压和巨脾,超声心动图示心肌肥大、二尖瓣和三尖瓣轻度关闭不全;四肢骨骼肌肌电图示肌源性损害.头颅影像正常.肌肉病理HE染色示肌纤维内大量嗜碱性物质沉积,沉积物糖原染色(PAS)染色呈强阳性,淀粉酶处理后部分阳性物质被消化.电镜下嗜碱性沉积物为分支状细丝样结构以及无定型的颗粒样物质.结论 此例为国内首次报告的糖原累积病Ⅳ型,属于分支

  3. Variaciones hematológicas postoperatorias en dermolipectomía Postoperative hematological variations in dermolipectomy

    Directory of Open Access Journals (Sweden)

    W. Giustozzi

    2010-06-01

    Full Text Available La tétrada deformante de la pared abdominal está constituida por la obesidad, la distensión abdominal, la gravidez y la diástasis muscular. Nos planteamos como objetivo de nuestro trabajo el demostrar la variación que sufren el hematocrito y la hemoglobina con relación al porcentaje del peso corporal total que representan los colgajos dermograsos extirpados en una dermolipectomía abdominal, tomando como parámetro los valores obtenidos a las 24 horas de la cirugía y a los 7 días de postoperatorio. Diseñamos un estudio prospectivo observacional en el que analizamos 93 pacientes operados entre el 1 de agosto del 2007 y el 31 de diciembre de 2008. Las variables analizadas fueron las modificaciones sufridas por el hematocrito y la hemoglobina en relación al tanto por ciento de peso corporal total que representan los colgajos extirpados. El promedio de descenso del hematocrito a las 24 horas de la intervención fue del 6,19 % y el de la hemoglobina a las 24 horas de la intervención fue de1,9 gr/l; los valores a los 7 días de postoperatorio fueron de 3,84% y 1,25 gr/l respectivamente. Como conclusión, destacamos la necesidad de comprender la importancia de una correcta preparación prequirúrgica de los pacientes que se van a someter a una dermolipectomía abdominal, para evitar complicaciones en el postoperatorio inmediato y tardío, mejorando así su selección para disminuir la morbilidad de esta intervención quirúrgica.The deforming tetrad of the abdominal wall is formed by obesity, abdominal distension, gravidity and muscle diastases. Our objective is to show the variation of the hematocrit and hemoglobin in relation to the percentage of the total body mass that represents the fatty skin folds extirpated in a dermolipectomy, having as parameter the one obtained 24 hours after surgery and at 7 postoperative day. We design an observational prospective study on 93 patients who underwent an abdominal dermolipectomy between august 1st

  4. Atendimento de puérperas pela fisioterapia em uma maternidade pública humanizada Postpartum women assisted by physical therapy at a humanized public maternity house

    Directory of Open Access Journals (Sweden)

    Mariana Tirolli Rett

    2008-12-01

    been observed; 62,3% of the women presented normal diaphragm kinetics, 85,1% had tympanic sound at abdominal percussion, and normal uterine involution; 87,9% presented pelvic floor muscle contraction, and 30,3% lower limb edema; abdominal muscle diastases measured supra and infra umbilical 2±1 and 1±1 fingers, respectively. As to physical therapy, the women were treated with diaphragm respiratory exercises, abdominal isometric exercises, pelvic floor muscle contractions, lower limb circulatory exercises, flatus elimination maneuvers, deambulation, and guiding. The women's profile was found to be as expected for post-partum physiological recovery. Most had accomplished the physical therapy protocols offered. This study provides useful information on obstetric physical therapy assistance.

  5. Physicochemical and microbiological characterization of cassava flower honey samples produced by africanized honeybees Caracterização físico-química e microbiológica de amostras de mel de flores de mandioca produzido por abelhas africanizadas

    Directory of Open Access Journals (Sweden)

    Lucimar Peres de Moura Pontara

    2012-09-01

    Full Text Available Cassava producers in the region of Marília-São Paulo are integrating their farming activity with beekeeping to diversify their income. The aim of this study was to evaluate the physicochemical and microbiological quality of honey samples produced by Africanized honeybees Apis mellifera from cassava flower in 2008. Analysis were carried out for pH, total soluble solids (TSS, acidity, moisture, reducing and total sugars, apparent sucrose, hydroxymethylfurfural, color, ash, proteins, water insoluble solids, diastasic activity, mineral content, microbiological evaluations, and mineral and hydrocyanic acid (HCN content. The honey samples showed physicochemical and microbiological characteristics favorable to commercialization, with the exception of apparent sucrose and acidity, which show the need for a narrow focus of attention to the honey maturation degree at the harvest time and more careful monitoring during production and processing. The commercialization of Brazilian cassava honey, still little explored, can be widely spread in the market since the levels of hydrocyanic acid (HCN showed no consumption risk; in addition the simultaneous production of honey and cassava provides an alternative to family income increase.Produtores de mandioca da região de Marília, Estado de São Paulo, estão consorciando a atividade da apicultura em meio à cultura visando diversificar a renda obtida pela propriedade rural. Este trabalho teve como objetivo avaliar a qualidade físico-química e microbiológica do mel produzido por abelhas Apis mellifera africanizadas, elaborado a partir de flores de mandioca, no ano de 2008. Foram realizadas análises de pH, sólidos solúveis totais (SST, acidez, umidade, açúcares redutores e totais, sacarose aparente, hidroximetilfurfural, cor, cinzas, proteínas, sólidos insolúveis em água, atividade diastásica, teor de minerais e monitoramento dos teores de ácido cianídrico (HCN, além de avaliações microbiol

  6. Massive intestinal resection in rats fed up on glutamine: hepatic glycogen content valuation Ressecção intestinal extensa em ratos tratados com oferta oral de glutamina: avaliação do conteúdo hepático de glicogênio

    Directory of Open Access Journals (Sweden)

    Ariney Costa de Miranda

    2006-03-01

    Wistar machos foram distribuídos em três grupos enterectomizados. As seguintes dietas foram utilizadas: com glutamina (grupo G, sem glutamina (grupo NG e a dieta padrão do laboratório (grupo R. Em todos os animais a ressecção extensa do intestino delgado incluiu a válvula íleo-cecal. Após 20 dias os animais foram sacrificados. O fígado foi retirado para estudo histológico por microscopia ótica. As lâminas foram coradas pelo ácido periódico com base de Schiff com diastase. RESULTADOS: Todos os animais perderam peso entre o inicio e o final da pesquisa. Na comparação da perda média de peso expressa em percentagem, não houve diferença estatística em relação a essa variável. Nos grupos estudados o conteúdo de glicogênio no hepatócito, avaliado por método histológico, não diferiu estatisticamente. CONCLUSÕES: A oferta de glutamina por via oral não contribuiu para redução da perda de peso dos animais submetidos a ressecção intestinal extensa e não estimulou a síntese e armazenamento de glicogênio nos hepatócitos.

  7. IMPACT OF HONEY DRESSING IN CHRONIC ULCER

    Directory of Open Access Journals (Sweden)

    Santhosh Kumar S. S

    2018-01-01

    Full Text Available BACKGROUND This was an open label study. Although, honey has been used for centuries in wound care, now only it is being integrated into modern medical practice. The resurgence of interest in honey as a medicine for modern wound dressing offers opportunities for both patients and clinicians. The aim of this study is to show the advantage of honey dressing over conventional saline dressing in the management of chronic non-healing ulcer. This property of honey is mentioned in papyruses traced to 3500 years ago among ancient Egyptians and the Hebrews 3000 years ago. Honey naturally contains small amounts of enzymes. The predominant enzymes in honey are diastase (amylase, invertase (alpha-glucosidase and glucose oxidase. Honey has been proven to have significant antibacterial properties and is a useful constituent in wound and burn care. The stimulation of cell growth seen with honey is probably also responsible for ‘kick-starting’ the healing process in chronic wounds that have remained non-healing for long periods. Honey has a broad spectrum of activity against bacteria and fungi. Many randomised and non-randomised study has shown the efficacy of honey as a healing agent and excellent dressing material. MATERIALS AND METHODS Study was conducted in medical college, Trivandrum, which is a tertiary care centre. Patients are selected from orthopaedic and general surgical wards. The study period was one year extending from July 2014 to June 2015. Saline dressing was given for the patients admitted in the first 6 months of study. Honey dressing was given for the next 6 months of study. Outcome was assessed on duration of hospital stay, difference of outcome in different distribution of grades of ulcer, difference of outcome in patients with vascular compromise, which is found out by Doppler ultrasound and difference of outcome in patients with diabetes mellitus. RESULTS Most significant observations made were in regard to duration of hospital stay

  8. MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

    Directory of Open Access Journals (Sweden)

    Neelu Prasad

    2016-06-01

    Full Text Available BACKGROUND The ankle joint is one of the most frequently injured joint. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. The talocrural joint is a major weight bearing joint of the body. The weight of the body is transmitted from the tibia and fibula to the talus which distributes the weight anteriorly and posteriorly within the foot. One sixth of the static load of the leg is carried by the fibula at the tibiofibular joint. These require a high degree of stability which is determined by the passive and dynamic factors. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. Conventionally, X-ray techniques have been used to diagnose ligament injuries. Magnetic resonance (MR imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The anatomy of the deltoid ligament

  9. [Kirschner wire transfixation of unstable ankle fractures: indication, surgical technique and outcomes].

    Science.gov (United States)

    Marvan, J; Džupa, V; Bartoška, R; Kachlík, D; Krbec, M; Báča, V

    2015-01-01

    transfixation, no radiographic evidence of ankle osteoarthritis was recorded in 25 (42%) patients. While tibiofibular synostosis was recorded in only few patients (9%) of the group with one-stage osteosynthesis, it showed a high occurrence in the group with temporary transfixation (35%). The patients with one-stage osteosynthesis (188/68%) had a higher proportion of excellent outcomes measured on the Olerund-Molander ankle scoring scale than the other two groups (temporary transfixation, 47%; definitive transfixation,10%); in both cases the difference was significant (p ankle fractures were assessed. The patients with one-stage osteosynthesis were compared with those treated by temporary or definitive transfixation. The majority of patients undergoing temporary transfixation had a fractured posterior margin of the tibia and major ankle joint dislocation, which suggested serious injuries to bone and ligament structures. Generally, the use of only two K-wires inserted through the calcaneus and talus into the distal tibia is recommended. Patients with K-wire transfixation usually require a longer hospital stay because of the serious nature of their injuries. CONCLUSIONS The therapy of choice for unstable ankle fractures is one-stage osteosynthesis. Temporary transfixation is an effective method of primary management when an unstable fracture cannot be treated by definitive osteosynthesis at the early stage due to local or general health conditions of the patient. The temporary transfixation provides good alignment of the ankle joint necessary for successful healing of soft tissues. A higher occurrence of post-traumatic ankle osteoarthritis, ossification and distal tibiotalar synostosis found in the patients treated by temporary transfixation is more related to serious types of ankle fractures the patient had suffered than to the method itself. Key words: unstable ankle fracture, soft tissue condition, indications for transfixation, treatment outcome.

  10. Effects of Gamma Radiation on the Constituents of Wheat Flour; Action des Rayons Gamma sur les Elements Constitutifs de la Farine de Ble; Dejstvie gamma-luchej na sostavnye ehlementy muki; Accion de los Ratos Gamma Sobre los Elementos Constitutivos de la Harina de Trigo

    Energy Technology Data Exchange (ETDEWEB)

    Deschreider, A. R. [Laboratoire Central du Ministere des Affaires Economiques, Bruxelles (Belgium)

    1966-11-15

    Physical, chemical and biochemical changes occur in the constituents of wheat exposed to gamma radiation. The extent of these changes depends on the origin of the wheat and on the radiation dose. The carotenoids of the oily fraction of the wheat are reduced by the effects of the radiation, disappearing when the dose reaches 4 Mrad. However, the chemical composition of the lipids, which are the seat of reactions similar to those giving rise to hydroperoxides, remains virtually unchanged even at very high doses. The substantial degradation of the starch indicates that the polysaccharides of the wheat are the fractions most severely affected by radiation. This leads to an increase in the reducing substances already present and in the maltose index as the dose rises. However, the increase in autolytic production of reducing sugars in the irradiated wheat is due to the greater susceptibility of the starch to hydrolysis by the diastases. The denaturation of the polysaccharides reduces the viscosity of the starch pastes thanks to an increase in the solubility of the amylopectin. Gamma irradiation generally reduces the proteolytic activity of flour, and, in the case of high doses, causes not only a partial denaturation of the proteins but also their polymerization and/or condensation. This polymerization may be explained by the reaction of free radicals with the gluten proteins having -SH groups and by the interaction of primary radicals in the protein macromolecules (these phenomena occurring during irradiation). The modifications in the proteins cause variations in the solubility of the albumin, gliadin and glutenin, and also in the percentage distribution of the groups of which they consist. It was found that low gamma radiation doses (20 000 - 150 000 rad) produce a maximum in the curves of starch viscosity, substances capable of precipitation by electrodialysis, gliadin solubility and the Hagberg index. This anomaly explains the improvement in baking properties which

  11. Indicii fizico-chimici şi limitele elementelor toxice în mierea de albine

    Directory of Open Access Journals (Sweden)

    EREMIA Nicolae

    2016-06-01

    Full Text Available The purpose of accomplished investigations was to determine physical and chemical indices of polyfloral bee honey and the presence of toxic elements, radionuclides and pesticides. Honey samples submitted by the economic agents to the Testing Laboratory of the Animal Origin Products of the Republican Veterinary Diagnostic Center during 2012-2013 have served as object of these investigations. It was revealed that the mass fraction of water in the investigated polyfloral honey constituted on average 16,61-16,87%, invert sugar – 81,37- 94,6%, sucrose – 1,52-1,97%, diastase index – 17,88-18,58 Gote units, the content of oxymethylfurfural (HMF was 7,83-7,99 mg/kg, total acidity – 2,08-9,74 cm3 NaOH solution (in milliequivalents per 100 g of honey, ash – 0,08%, substances in soluble in water – absence. It was determined that the presence of toxic elementsin polyfloral honey is much lower than the admissible norms for this product, constituting on average: lead – less than 0,02- 0,024 mg/kg, cadmium– 0,004-0,009 mg/kg, arsenic – 0,011-0,031 mg/kg. The level of radionuclides constituted: cesium-137 – 3,26-3,422 Bq/kg, strontium-90 – 2,71-4,485 Bq/kg, hexachlorocyclohexane a, b, g – < 0,001 mg/kg; DDT and metabolites – < 0,005 mg/kg. Polyfloral honey obtained in the Republic of Moldova, according to the organoleptic indices, physical and chemical indices, the presence of toxic elements, radionuclides and pesticides, meets the required norms and is recommended for consumption. Rezumat. În studiul de faţă s-au determinat indicii fizico-chimici ai mierii poliflore şi prezenţa elementelor toxice, radionucleidelor şi pesticidelor. Ca obiect al investigaţiilor au servit mostrele de miere prezentate de agenţii economici în Laboratorul de Încercări ale Produselor de Origine Animalieră de la Centrul Republican Diagnostic Veterinar pe parcursul anilor 2012-2013. S-a relevat că fracţia masică de apă în mierea poliflor