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Sample records for vascularised fibular rotatory

  1. The vascularised fibular graft for limb salvage after bone tumour surgery A MULTICENTRE STUDY

    NARCIS (Netherlands)

    Hilven, P. H.; Bayliss, L.; Cosker, T.; Dijkstra, P. D. S.; Jutte, P. C.; Lahoda, L. U.; Schaap, G. R.; Bramer, J. A. M.; van Drunen, G. K.; Strackee, S. D.; van Vooren, J.; Gibbons, M.; Giele, H.; van de Sande, M. A. J.

    2015-01-01

    Vascularised fibular grafts (VFGs) are a valuable surgical technique in limb salvage after resection of a tumour. The primary objective of this multicentre study was to assess the risk factors for failure and complications for using a VFG after resection of a tumour. The study involved 74

  2. Vascularised Fibular Graft for a Radial Defect following Tumour ...

    African Journals Online (AJOL)

    HP

    The mass was located on the radial aspect of the distal right ... modification, internal or external fixation with bone grafting, structural grafts of ... Our index case report demonstrates that free vascularized fibular graft transfer is a feasible option ... structural support, the potential for graft hypertrophy, relative resistance to ...

  3. Success of dental implants in vascularised fibular osteoseptocutaneous flaps used as onlay grafts after marginal mandibulectomy.

    Science.gov (United States)

    Chang, Y-M; Pan, Y-H; Shen, Y-F; Chen, J-K; ALDeek, N F; Wei, F-C

    2016-12-01

    We have evaluated the survival of dental implants placed in vascularised fibular flap onlay grafts placed over marginal mandibulectomies and the effects on marginal bone loss of different types of soft tissue around implants under functional loading. From 2001-2009 we studied a total of 11 patients (1 woman and10 men), three of whom had had ameloblastoma and eight who had had squamous cell carcinomas resected. A total of 38 dental implants were placed either at the time of transfer of the vascularised fibular ostoseptocutaneous flaps (nine patients with 30 implants) or secondarily (two patients with eight implants). Four patients were given palatal mucosal grafts to replace intraoral skin flaps around the dental implants (n=13), and the other seven had the skin flaps around the dental implants thinned (n=25) at the second stage of implantation of the osteointegrated teeth. All vascularised fibular osteoseptocutaneous flaps were successfully transferred, and all implants survived a mean (range) of 73 (33-113) months after occlusal functional loading. The mean (SD) marginal bone loss was 0.5 (0.3) mm on both mesial and distal sides in patients who had palatal mucosal grafts, but 1.8 (1.6) mm, and 1.7 (1.5) mm, respectively, on the mesial and distal sides in the patients who had had thinning of their skin flaps. This difference is significant (p=0.008) with less resorption of bone in the group who had palatal mucosal grafts. Palatal mucosa around the implants helps to reduce resorption of bone after functional loading of implants. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Quantum optical rotatory dispersion

    Science.gov (United States)

    Tischler, Nora; Krenn, Mario; Fickler, Robert; Vidal, Xavier; Zeilinger, Anton; Molina-Terriza, Gabriel

    2016-01-01

    The phenomenon of molecular optical activity manifests itself as the rotation of the plane of linear polarization when light passes through chiral media. Measurements of optical activity and its wavelength dependence, that is, optical rotatory dispersion, can reveal information about intricate properties of molecules, such as the three-dimensional arrangement of atoms comprising a molecule. Given a limited probe power, quantum metrology offers the possibility of outperforming classical measurements. This has particular appeal when samples may be damaged by high power, which is a potential concern for chiroptical studies. We present the first experiment in which multiwavelength polarization-entangled photon pairs are used to measure the optical activity and optical rotatory dispersion exhibited by a solution of chiral molecules. Our work paves the way for quantum-enhanced measurements of chirality, with potential applications in chemistry, biology, materials science, and the pharmaceutical industry. The scheme that we use for probing wavelength dependence not only allows one to surpass the information extracted per photon in a classical measurement but also can be used for more general differential measurements. PMID:27713928

  5. Fibular hemimelia: a case report

    International Nuclear Information System (INIS)

    Kim, Byung Joon; Hong, Suk Joo; Kim, Kyung Min; Seol, Hae Young; Cha, In Ho; Song, Hae Ryong

    2006-01-01

    Fibular hemimelia is the most common congenital absence or hypoplasia of long bone. In addition to fibular absence or hypoplasia, this entity also includes various combined abnormalities of the lower limbs. We present here three cases of fibular hemimelia who underwent diagnosis and treatment in our hospital. We especially focus on the imaging findings of the plain radiographs, and we compare them with the findings found at another presentation

  6. Posterolateral Rotatory Apprehension Test in Tennis Elbow.

    Science.gov (United States)

    Chanlalit, Cholawish; Phorkhar, Termphong

    2015-11-01

    Tennis elbow is a syndrome that commonly diagnosed in patient who comes with lateral elbow pain. Instability pain in tennis elbow patient was observed and reported in many previous literatures. Posterolateral rotatory apprehension test was proposed for diagnosis of posterolateral rotatory instability of elbow. However, no review literatures that studied about posterolateral rotatory apprehensions test in tennis elbow. To find out the relationship between posterolateral rotatory apprehension test and tennis elbow. There were 44 patients that were recruited in this study. We examined the posterolateral rotatory apprehension test in tennis elbow patients. The examination was done in our outpatient clinic from March 2012 to April 2012. The data was collected to find out the ratio of negative test in tennis elbow patient. The results from the posterolateral rotatory apprehension test were negative in 43 patients. The ratio of the negative test result was 98%. A result from posterolateral rotatory apprehension test should be negative in general tennis elbow patients. If this test is used in a tennis elbow patients who are suspected with hidden instability and the result is positive, further evaluation is strongly suggested.

  7. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  8. The effect of smoking on early chorionic villous vascularisation

    NARCIS (Netherlands)

    van Oppenraaij, R. H. F.; Koning, A. H. J.; van den Hoff, M. J. B.; van der Spek, P. J.; Steegers, E. A. P.; Exalto, N.

    2012-01-01

    The aim aim of the study was to investigate whether first trimester chorionic villous vascularisation is different in women who smoked cigarettes before and during pregnancy in comparison with women who did not smoke. Placentas of smoking (>10 cigarettes/day, n = 13) and non-smoking women (n = 13),

  9. Vascularised endosteal bone tissue in armoured sauropod dinosaurs.

    Science.gov (United States)

    Chinsamy, Anusuya; Cerda, Ignacio; Powell, Jaime

    2016-04-26

    The presence of well-vascularised, endosteal bone in the medullary region of long bones of nonavian dinosaurs has been invoked as being homologous to medullary bone, a specialised bone tissue formed during ovulation in birds. However, similar bone tissues can result as a pathological response in modern birds and in nonavian dinosaurs, and has also been reported in an immature nonavian dinosaur. Here we report on the occurrence of well-vascularised endosteally formed bone tissue in three skeletal elements of armoured titanosaur sauropods from the Upper Cretaceous of Argentina: i) within the medullary cavity of a metatarsal, ii) inside a pneumatic cavity of a posterior caudal vertebra, iii) in intra-trabecular spaces in an osteoderm. We show that considering the criteria of location, origin (or development), and histology, these endosteally derived tissues in the saltasaurine titanosaurs could be described as either medullary bone or pathological bone. Furthermore, we show that similar endosteally formed well-vascularised bone tissue is fairly widely distributed among nondinosaurian Archosauriformes, and are not restricted to long bones, but can occur in the axial, and dermal skeleton. We propose that independent evidence is required to verify whether vascularised endosteal bone tissues in extinct archosaurs are pathological or reproductive in nature.

  10. Tibial and fibular developmental fields defects

    International Nuclear Information System (INIS)

    Khoury, N.J.; Haddad, M.C.; Hourani, M.H.

    1999-01-01

    Malformations of the lower limbs are rare and heterogeneous anomalies. To explain the diversity and complexity of these abnormalities, authors introduced the concept of tibial and fibular developmental fields. Defects in these fields are responsible for different malformations, which have been described, to our knowledge, in only one report in the radiology literature. We present a case of a newborn with femoral bifurcation, absent fibulae and talar bones, ankle and foot malformations, and associated atrial septal defect. Our case is an example of defects in both fibular and tibial developmental fields. (orig.)

  11. Postoperative radiographic evaluation of vascularized fibular grafts

    International Nuclear Information System (INIS)

    Manaster, B.J.; Coleman, D.A.; Bell, D.A.

    1989-01-01

    This paper reports on thirty-five patients with free vascularized fibular grafts examined postoperatively with plain radiography. Early graft incorporation is seen as a fuzziness of the cortex at the site of its insertion into the host bone. Causes of failure in grafting for bone defects include graft fracture, hardware failure, and infection. A high percentage of complications or at least delayed unions occurred when vascularized fibular grafts were used to fill defects in the lower extremity. Conversely, upper extremity defects bridged by vascularized grafts heal quickly and hypertrophy. Vascularized grafts placed in the femoral head and neck for a vascular necrosis incorporate early on their superior aspect. The osseous tunnel in which they are placed is normally wider than the graft and often becomes sclerotic; this appearance does not represent nonunion

  12. Tibial and fibular angles in homozygous sickle cell disease

    International Nuclear Information System (INIS)

    Akamaguna, A.I.; Odita, J.C.; Ugbodaga, C.I.; Okafor, L.A.

    1986-01-01

    Measurements of the tibial and fibular angles made on ankle radiographs of 34 patients with sickle cell disease were compared with those of 36 normal Nigerians. Widening of the fibular angle, which is an indication of tibiotalar slant, was demonstrated in about 79% of sickle cell disease patients. By using fibular angle measurements as an objective method of assessing subtle tibiotalar slant, it is concluded that the incidence of this deformity is much higher among sickle cell disease patients than previously reported. The mean values of tibial and fibular angles in normal Nigerians are higher than has been reported amongst Caucasians. (orig.)

  13. Vascularized fibular graft combined with vacuum assisted closure in ...

    African Journals Online (AJOL)

    The flowthrough fibular graft combined with Vacuum Assisted Closure (VAC) controlled the infection, shortened the course of treatment, and effectively restored limb function when applied to the treatment of tibial defects. Keywords: Tibial defect, Flow-through fibular graft, Vacuum Assisted Closure, Chronic Osteomyelitis ...

  14. Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction

    Science.gov (United States)

    Bhati, Bharat; Kukreja, Pankaj; Kumar, Sanjeev; Rathi, Vidhi C.; Singh, Kanika; Bansal, Shipra

    2017-01-01

    Aim: The aim of this study is to compare piezoelectric surgery versus rotatory osteotomy technique in removal of mandibular impacted third molar. Materials and Methods: Sample size of 30 patients 18 males, 12 females with a mean age of 27.43 ± 5.27. Bilateral extractions were required in all patients. All the patients were randomly allocated to two groups in one group, namely control group, surgical extraction of mandibular third molar was done using conventional rotatory osteotomy and in the other group, namely test group, extraction of lower third molar was done using Piezotome. Results: Parameters assessed in this study were – mouth opening (interincisal opening), pain (visual analog scale VAS score), swelling, incidence of dry socket, paresthesia and duration of surgery in both groups at baseline, 1st, 3rd, and 7th postoperative day. Comparing both groups pain scores with (P piezosurgery group (51.40 ± 17.9) minutes compared to the conventional rotatory group with a mean of (37.33 ± 15.5) minutes showing a statistically significant difference (P = 0.002). Conclusion: The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient, and protection of tooth structures. Therefore, the piezoelectric device was efficient in decreasing the short-term outcomes of pain and swelling although taking longer duration than conventional rotatory technique it significantly reduces the associated postoperative sequelae of third molar surgery. PMID:28713729

  15. Electrocautery effect on intestinal vascularisation in a murine model.

    Science.gov (United States)

    Tremblay, Jean-François; Sideris, Lucas; Leblond, François A; Trépanier, Jean-Sébastien; Badrudin, David; Drolet, Pierre; Mitchell, Andrew; Dubé, Pierre

    2016-09-01

    The use of electrocautery devices is associated with complications such as perforation or fistulisation when used near intestinal structures. This is likely due to its effect on vascularisation of the bowel wall. To test this hypothesis we established a murine model to quantify the effect of electrocautery injury on the intestinal microvascularisation. Sprague-Dawley rats were subjected to five electrocautery injuries on the small bowel in coagulation mode (30 W intensity) and in cut mode (40 W, 80 W and 200 W intensities) for durations of 1, 2 and 5 s. 5 mg/kg of fluorescein was injected intravenously, the injured bowel segments harvested and the rat sacrificed. The segments were analysed to measure the fluorescence of injured bowel compared to adjacent unharmed tissue. A significant decrease in bowel wall microvascularisation occurred with increasing intensity (coag 30 W/cut 40 W versus cut 200 W 1 s: p electrocautery injury (cut 40 W 1/2 s versus 5 s: p electrocautery injury, a significantly greater microvascularisation decrease was observed in jejunum compared to ileum (p electrocautery use. Unsurprisingly, the decrease in microvascularisation is greater with higher intensity and duration of electrocautery and is associated with more perforations in the experimental model. The jejunum seems more vulnerable to electrocautery injury than the ileum. These observations support caution when using electrocautery devices near intestinal structures.

  16. Long-term sequel of posterolateral rotatory instability of the elbow: a case report

    Directory of Open Access Journals (Sweden)

    Cheng Chun-Ying

    2010-01-01

    Full Text Available Abstract The natural course of untreated posterior lateral rotatory instability of the elbow is unclear. A case of elbow arthrosis with progressing deformity and flexion contracture after an episode of elbow dislocation about 20 years ago presented the possibility the long term outcome of untreated posterior lateral rotatory instability of the elbow.

  17. Chronic neglected irreducible atlantoaxial rotatory subluxation in adolescence

    Directory of Open Access Journals (Sweden)

    Pravin Padalkar

    2016-01-01

    Full Text Available Atlantoaxial rotatory fixation (AARF is a rare condition and delayed diagnosis. We report a case of chronic neglected atlantoaxial rotatory subluxation in adolescence child that was treated by serial skull traction followed by posterior fusing by method pioneered by Goel et al. A 15-year-old male presented with signs of high cervical myelopathy 2 years after trauma to neck childhood. There was upper cervical kyphosis, direct tenderness over C2 spinous process, atrophy of both hand muscles with weakness in grip strength. Reflexes in upper and lower extremities were exaggerated. Imaging showed Type 3 (Fielding and Hawkins rotatory atlantoaxial dislocation (AAD. Treatment options available were 1. Staged anterior Transoral release & reduction followed by posterior fusion described by Govender and Kumar et al, 2. Posterior open reduction of joint and fusion, 3. Occipitocervical fusion with decompression. Our case was AARF presented to us with almost 2-year post injury. Considering complications associated with anterior surgery and posterior open reduction, we have opted for closed reduction by serially applying weight to skull traction under closed neurological monitoring. We have serially increased weight up to 15 kg over a period of 1 week before. We have achieved some reduction which was confirmed by traction lateral radiographs and computerized axial tomography scan. Residual subluxation corrected intra-operatively indirectly by using reduction screws in Goel et al. procedure. Finally performed for C1-C2 fusion to take care of Instability. We like to emphasis here role of closed reduction even in delayed and neglected cases.

  18. Reconstruction of congenital tibial pseudarthrosis by revascularized fibular transplants

    NARCIS (Netherlands)

    Bos, K. E.; Besselaar, P. P.; van der Eyken, J. W.; Taminiau, A. H.; Verbout, A. J.

    1993-01-01

    Seven patients with congenital Boyd type II pseudoarthrosis of the tibia and fibula were treated with a revascularized osteocutaneous fibular graft from the contralateral side. Follow-up ranged from 20 to 96 months (mean 67 months). All patients had previously undergone major surgery (mean three

  19. 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

  20. Unilateral proximal focal femoral deficiency, fibular aplasia, tibial ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2014-04-30

    Apr 30, 2014 ... Peer review under responsibility of Ain Shams University. ... The fibular field of the limb bud controls the development of ... The mental and physical developments are ... deficiency, short tibia and absent fibula of the right lower limb compared ... brother has tetrameric transverse defect and a cyanotic con-.

  1. Adipose tissue-derived microvascular fragments from aged donors exhibit an impaired vascularisation capacity

    Directory of Open Access Journals (Sweden)

    MW Laschke

    2014-10-01

    Full Text Available Adipose tissue-derived microvascular fragments are promising vascularisation units for applications in the field of tissue engineering. Elderly patients are the major future target population of such applications due to an increasing human life expectancy. Therefore, we herein investigated the effect of aging on the fragments’ vascularisation capacity. Microvascular fragments were isolated from epididymal fat pads of adult (8 months and aged (16 months C57BL/6 donor mice. These fragments were seeded onto porous polyurethane scaffolds, which were implanted into dorsal skinfold chambers to study their vascularisation using intravital fluorescence microscopy, histology and immunohistochemistry. Scaffolds seeded with fragments from aged donors exhibited a significantly lower functional microvessel density and intravascular blood flow velocity. This was associated with an impaired vessel maturation, as indicated by vessel wall irregularities, constantly elevated diameters and a lower fraction of CD31/α-smooth muscle actin double positive microvessels in the implants’ border and centre zones. Additional in vitro analyses revealed that microvascular fragments from adult and aged donors do not differ in their stem cell content as well as in their release of angiogenic growth factors, survival and proliferative activity under hypoxic conditions. However, fragments from aged donors exhibit a significantly lower number of matrix metalloproteinase -9-positive perivascular cells. Taken together, these findings demonstrate that aging is a crucial determinant for the vascularisation capacity of isolated microvascular fragments.

  2. Rotatory Subluxation and Facet Deformity in the Atlanto-occipital Joint in Patients with Chronic Atlantoaxial Rotatory Fixation: Two Case Reports.

    Science.gov (United States)

    Kashii, Masafumi; Masuhara, Kenta; Kaito, Takashi; Iwasaki, Motoki

    2017-01-01

    The relationship between the morphometry of atlantoaxial joint and chronic atlantoaxial rotatory fixation (AARF) is well known, but disorders in the atlanto-occipital joint in chronic AARF are not fully elucidated. The authors report two rare cases of secondary deformities in the atlanto-occipital joint in chronic AARF. Two patients with chronic AARF were treated with closed manipulation, skull traction and halo-vest immobilization. Clinical outcomes and radiographs were reviewed retrospectively, focusing on pathological changes in the atlanto-occipital joint using multiplanar reconstruction computed tomography and three-dimensional computed tomography images. Case 1 (12-year-old girl) had rotatory subluxation with a superior facet deformity of the atlas in the atlanto-occipital joint before the initiation of treatment. After a series of conservative treatments, both atlantoaxial and atlanto-occipital rotatory fixation could not be reduced, and both the superior facet deformity of the atlas and osteoarthritic changes in the atlanto-occipital developed. She was monitored without surgery because the disorder progressed to the spontaneous fusion of the occipital bone to the axis. Case 2 (13-year-old boy) had rotatory subluxation without facet deformity of the atlas in the atlanto-occipital joint before the initiation of treatment. However, both the superior facet deformity of the atlas and osteoarthritic changes in the atlanto-occipital developed over time, and both atlantoaxial and atlanto-occipital rotatory fixation could not be reduced after a series of conservative treatments. He still had severe neck pain and severely restricted neck mobility and underwent spinal fusion. Atlanto-occipital rotatory subluxation and facet deformity in the atlanto-occipital joint may occur after prolonged AARF. It is necessary to pay attention to pathological changes not only in the atlantoaxial joint but also in the atlanto-occipital joint, when orthopedic surgeons treat patients

  3. Adult outcomes following amputation or lengthening for fibular deficiency.

    Science.gov (United States)

    Walker, Janet L; Knapp, Dwana; Minter, Christin; Boakes, Jennette L; Salazar, Juan Carlos; Sanders, James O; Lubicky, John P; Drvaric, David M; Davids, Jon R

    2009-04-01

    Fibular deficiency results in a small, unstable foot and ankle as well as a limb-length discrepancy. The purpose of this study was to assess outcomes in adults who, as children, had had amputation or limb-lengthening, commonly used treatments for fibular deficiency. Retrospective review of existing data collected since 1950 at six pediatric orthopaedic centers identified 248 patients with fibular deficiency who were twenty-one years of age or older at the time of the review. Excluding patients with other anomalies and other treatments (with the excluded group including six who had had lengthening and then amputation), we identified ninety-eight patients who had had amputation or limb-lengthening for the treatment of isolated unilateral fibular deficiency. Sixty-two patients (with thirty-six amputations and twenty-six lengthening procedures) completed several questionnaires, including one asking general demographic questions, the Beck Depression Inventory-II, the Quality of Life Questionnaire, and the American Academy of Orthopaedic Surgeons Lower Limb Questionnaire including the Short Form-36. A group of twenty-eight control subjects completed the Beck Depression Inventory-II and the Quality of Life Questionnaire. There were forty men and twenty-two women. The average age at the time of the interview was thirty-three years. There were more amputations in those with fewer rays and less fibular preservation. Lengthening resulted in more surgical procedures (6.3 compared with 2.4 in patients treated with amputation) and more days in the hospital (184 compared with sixty-three) (both pemployment, income, public assistance or disability payments, pain or use of pain medicine, sports participation, activity restriction, comfort wearing shorts, dislike of limb appearance, or satisfaction with treatment. No patient who had been treated for fibular deficiency reported signs of depression. The only significant difference between treatment groups shown by the Quality of Life

  4. Grebe syndrome with bilateral fibular hemimelia and thumb duplication

    International Nuclear Information System (INIS)

    Rao, Narasimha; Joseph, Benjamin

    2002-01-01

    Grebe syndrome is a rare recessively inherited form of short-limbed dwarfism. Among the skeletal anomalies reported in the past, complete fibular hemimelia and thumb duplication have not been documented. We report a case of Grebe syndrome with these associated anomalies and review the various skeletal anomalies reported in the literature related to this syndrome. Awareness of the skeletal anomalies that can occur in this syndrome should enable an accurate diagnosis. (orig.)

  5. Grebe syndrome with bilateral fibular hemimelia and thumb duplication

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Narasimha; Joseph, Benjamin [Department of Orthopaedics, Kasturba Medical College, Karnataka State (India)

    2002-03-01

    Grebe syndrome is a rare recessively inherited form of short-limbed dwarfism. Among the skeletal anomalies reported in the past, complete fibular hemimelia and thumb duplication have not been documented. We report a case of Grebe syndrome with these associated anomalies and review the various skeletal anomalies reported in the literature related to this syndrome. Awareness of the skeletal anomalies that can occur in this syndrome should enable an accurate diagnosis. (orig.)

  6. Piezosurgery or conventional rotatory instruments for inferior third molar extractions?

    Science.gov (United States)

    Piersanti, Luigi; Dilorenzo, Matteo; Monaco, Giuseppe; Marchetti, Claudio

    2014-09-01

    The purpose of this study was to compare the discomfort and surgical outcomes of a piezosurgery device with those of rotatory instruments in lower third molar extraction. A split-mouth, randomized, unblinded clinical study was designed; the 2 molars had to have the same extraction difficulty score. The test side was extracted using a piezosurgery technique and the control side was extracted using a conventional handpiece. The primary endpoint was patient discomfort evaluated with the Postoperative Symptom Severity (PoSSe) scale, which was administered to each patient; secondary endpoints were pain, trismus, swelling, and surgical time evaluation. Paired-samples t test and repeated-measures analysis of variance were used to compare outcomes within patients. Ten consecutive patients (6 female, 4 male; mean age, 22.4 ± 2.3 yr) were recruited. The total score on the PoSSe scale was significantly lower for piezosurgery compared with the conventional rotating handpiece (24.7 ± 10.3 vs 36.0 ± 7.6; t = -4.27; P = .002). Moreover, postoperative swelling 1 week after surgery was significantly lower for piezosurgery than for the conventional rotating handpiece (2.75 ± 0.23 vs 3.1 ± 0.39 cm; t = -2.63; P = .027). Piezosurgery was associated with less postoperative discomfort and yielded better results for swelling. Piezosurgery seems to be a good technique in daily surgical practice, especially if applied in the critical steps in which safety and respect for soft tissue, bone, and nerves are necessary. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Leg lengthening in patients with congenital fibular hemimelia.

    Science.gov (United States)

    Jasiewicz, Barbara; Kacki, Wojciech; Koniarski, Arkadiusz; Kasprzyk, Marcin; Zarzycka, Maja; Tesiorowski, Maciej

    2002-08-30

    Background. Anisomelia in patients with congenital fibular deficiencies is a difficult orthopedic problem due to concomitant deformities of the angle and knee. The goal of the present study was to analyze outcomes of tibia lengthening in these patients. Material and methods. In the period 1989-2001 we performed lengthening of 26 limbs in 21 patients with congenital fibular deficiency (11 female, 10 male, average age 10.1 years). Under the Achterman-Kalamchi classification, 8 tibiae were Type 1, 3 were Type 1b, and 10 were Type 2 (including one case with bilateral defect). The average baseline shortening was 4.6 cm, i.e. 15.3%. The Ilizarov method was used in 24 cases, chondrial lengthening in the others. We measured time of lengthening, time of stabilization, total healing time, amount of lengthening, and the lengthening index, as well as the range of ankle and knee movement, the positioning of the foot, and the axis of the tibia at each stage. Problems and complications were classified according to Paley. The average follow-up was 4.9 years Results. The mean time of lengthening was 101 days, stabilization time 177 days, total healing time 269 days, mean lengthening 5.6 cm (22.9%). As of the last examination only 7 patients did not require follow-up surgery, 6 with Type 1a and 1 with Type 1b. Conclusions. Tibia lengthening with axis correction constitutes an alternative to amputation in congenital fibular deficiency. It is a difficult procedure, however, encumbered by a significant risk of complications.

  8. 3D printed microchannel networks to direct vascularisation during endochondral bone repair.

    Science.gov (United States)

    Daly, Andrew C; Pitacco, Pierluca; Nulty, Jessica; Cunniffe, Gráinne M; Kelly, Daniel J

    2018-04-01

    Bone tissue engineering strategies that recapitulate the developmental process of endochondral ossification offer a promising route to bone repair. Clinical translation of such endochondral tissue engineering strategies will require overcoming a number of challenges, including the engineering of large and often anatomically complex cartilage grafts, as well as the persistence of core regions of avascular cartilage following their implantation into large bone defects. Here 3D printing technology is utilized to develop a versatile and scalable approach to guide vascularisation during endochondral bone repair. First, a sacrificial pluronic ink was used to 3D print interconnected microchannel networks in a mesenchymal stem cell (MSC) laden gelatin-methacryloyl (GelMA) hydrogel. These constructs (with and without microchannels) were next chondrogenically primed in vitro and then implanted into critically sized femoral bone defects in rats. The solid and microchanneled cartilage templates enhanced bone repair compared to untreated controls, with the solid cartilage templates (without microchannels) supporting the highest levels of total bone formation. However, the inclusion of 3D printed microchannels was found to promote osteoclast/immune cell invasion, hydrogel degradation, and vascularisation following implantation. In addition, the endochondral bone tissue engineering strategy was found to support comparable levels of bone healing to BMP-2 delivery, whilst promoting lower levels of heterotopic bone formation, with the microchanneled templates supporting the lowest levels of heterotopic bone formation. Taken together, these results demonstrate that 3D printed hypertrophic cartilage grafts represent a promising approach for the repair of complex bone fractures, particularly for larger defects where vascularisation will be a key challenge. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Surgical treatment of AVN of the fibular (lateral) sesamoid.

    Science.gov (United States)

    Waizy, Hazibullah; Jäger, Marcus; Abbara-Czardybon, Mona; Schmidt, Troy G; Frank, Daniel

    2008-02-01

    Despite the fact that the hallucal sesamoids play a crucial role in forefoot mechanics, disorders resulting from pathology of these structures are often overlooked or misdiagnosed. Avascular necrosis (AVN) of the hallucal sesamoids is a rare condition that must be differentiated from other pathologies, such as fractures, pseudarthrosis or osteomyelitis. We report on two patients with AVN of the fibular (lateral) hallucal sesamoid (Morbus Renander). In both patients the necrotic part of the fibular sesamoid was excised surgically after failed conservative therapy. The followup was 29 and 26 months. The clinical and radiological results showed a complete relief of pain in both patients without any complications or forefoot deformities. Recent literature and own experiences support non-operative initial management including anti-inflammatory medications, shoe modification and temporary limited weight bearing. If symptoms persist, surgical treatment with excision of the necrotic part of the sesamoid may be an alternative. Consideration by the surgeon should be given to protecting the neurovascular bundle and reattaching intrinsic tendons and ligaments if necessary. Satisfying results can be achieved by surgical removal.

  10. Vascularized fibular graft in infected tibial bone loss

    Directory of Open Access Journals (Sweden)

    C Cheriyan Kovoor

    2011-01-01

    Full Text Available Background : The treatment options of bone loss with infections include bone transport with external fixators, vascularized bone grafts, non-vascularized autogenous grafts and vascularized allografts. The research hypothesis was that the graft length and intact ipsilateral fibula influenced hypertrophy and stress fracture. We retrospectively studied the graft hypertrophy in 15 patients, in whom vascularized fibular graft was done for post-traumatic tibial defects with infection. Materials and Methods : 15 male patients with mean age 33.7 years (range 18 - 56 years of post traumatic tibial bone loss were analysed. The mean bony defect was 14.5 cm (range 6.5 - 20 cm. The mean length of the graft was 16.7 cm (range 11.5 - 21 cm. The osteoseptocutaneous flap (bone flap with attached overlying skin flap from the contralateral side was used in all patients except one. The graft was fixed to the recipient bone at both ends by one or two AO cortical screws, supplemented by a monolateral external fixator. A standard postoperative protocol was followed in all patients. The hypertrophy percentage of the vascularized fibular graft was calculated by a modification of the formula described by El-Gammal. The followup period averaged 46.5 months (range 24 - 164 months. The Pearson correlation coefficient (r was worked out, to find the relationship between graft length and hypertrophy. The t-test was performed to find out if there was any significant difference in the graft length of those who had a stress fracture and those who did not and to find out whether there was any significant difference in hypertrophy with and without ipsilateral fibula union. The Chi square test was performed to identify whether there was any association between the stress fracture and the fibula union. Given the small sample size we have not used any statistical analysis to determine the relation between the percentage of the graft hypertrophy and stress fracture. Results : Graft

  11. Study of the interaction of Tb (III) with dextran through fluorescence spectroscopy and optical rotatory dispersion

    International Nuclear Information System (INIS)

    Vasconcelos, Sandra S.; Rodrigues, J.F.

    1984-01-01

    A study of the interaction of Tb(III) with dextran in aqueous solution was perform using fluorescence spectroscopy and optical rotatory dispersion. The results indicate the formation of a complex with the displacent of water from the cation coordinated sphere by hydroxyl groups at the second and third carbon atoms of the monomer unit. (Author) [pt

  12. Randomized clinical study comparing piezosurgery and conventional rotatory surgery in mandibular cyst enucleation.

    Science.gov (United States)

    Pappalardo, Sabrina; Guarnieri, Renzo

    2014-07-01

    The aim of the present study is to compare piezoelectric surgery to the conventional rotatory surgery in mandibular cyst enucleation, and to determine the 2 method's suitability and the postoperative outcomes. Eighty patients were included in the study. 35 male and 45 female, which showed cystic mandibular lesions, compared with the inferior alveolar nerve or the mental nerve. The patients were randomly divided into two groups. In the test group, cystectomy was performed using conventional rotatory instrumentation (rotatory-group), and in the other one piezoelectric surgery (piezo-group). The swelling was documented 24/48/72 h and 1 week post-surgery and the patients recorded their subjective postoperative pain daily for 7 days using a Visual Analog Scale (VAS). Patients treated with piezoelectric technique have presented a lower VAS, minor swelling and less recovery time compared to the rotatory-group. No lesions of the mandible nerve were detected with piezosurgery whereas surgery with rotary instruments resulted in 8% hypesthesia at least up to one week. The results of this study suggest that piezosurgery may be considered effective in cyst enucleation compared to traditional procedures with burs, since it grants the patients significantly less post-surgical pain and swelling. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Altering the architecture of tissue engineered hypertrophic cartilaginous grafts facilitates vascularisation and accelerates mineralisation.

    Directory of Open Access Journals (Sweden)

    Eamon J Sheehy

    Full Text Available Cartilaginous tissues engineered using mesenchymal stem cells (MSCs can be leveraged to generate bone in vivo by executing an endochondral program, leading to increased interest in the use of such hypertrophic grafts for the regeneration of osseous defects. During normal skeletogenesis, canals within the developing hypertrophic cartilage play a key role in facilitating endochondral ossification. Inspired by this developmental feature, the objective of this study was to promote endochondral ossification of an engineered cartilaginous construct through modification of scaffold architecture. Our hypothesis was that the introduction of channels into MSC-seeded hydrogels would firstly facilitate the in vitro development of scaled-up hypertrophic cartilaginous tissues, and secondly would accelerate vascularisation and mineralisation of the graft in vivo. MSCs were encapsulated into hydrogels containing either an array of micro-channels, or into non-channelled 'solid' controls, and maintained in culture conditions known to promote a hypertrophic cartilaginous phenotype. Solid constructs accumulated significantly more sGAG and collagen in vitro, while channelled constructs accumulated significantly more calcium. In vivo, the channels acted as conduits for vascularisation and accelerated mineralisation of the engineered graft. Cartilaginous tissue within the channels underwent endochondral ossification, producing lamellar bone surrounding a hematopoietic marrow component. This study highlights the potential of utilising engineering methodologies, inspired by developmental skeletal processes, in order to enhance endochondral bone regeneration strategies.

  14. Altering the architecture of tissue engineered hypertrophic cartilaginous grafts facilitates vascularisation and accelerates mineralisation.

    Science.gov (United States)

    Sheehy, Eamon J; Vinardell, Tatiana; Toner, Mary E; Buckley, Conor T; Kelly, Daniel J

    2014-01-01

    Cartilaginous tissues engineered using mesenchymal stem cells (MSCs) can be leveraged to generate bone in vivo by executing an endochondral program, leading to increased interest in the use of such hypertrophic grafts for the regeneration of osseous defects. During normal skeletogenesis, canals within the developing hypertrophic cartilage play a key role in facilitating endochondral ossification. Inspired by this developmental feature, the objective of this study was to promote endochondral ossification of an engineered cartilaginous construct through modification of scaffold architecture. Our hypothesis was that the introduction of channels into MSC-seeded hydrogels would firstly facilitate the in vitro development of scaled-up hypertrophic cartilaginous tissues, and secondly would accelerate vascularisation and mineralisation of the graft in vivo. MSCs were encapsulated into hydrogels containing either an array of micro-channels, or into non-channelled 'solid' controls, and maintained in culture conditions known to promote a hypertrophic cartilaginous phenotype. Solid constructs accumulated significantly more sGAG and collagen in vitro, while channelled constructs accumulated significantly more calcium. In vivo, the channels acted as conduits for vascularisation and accelerated mineralisation of the engineered graft. Cartilaginous tissue within the channels underwent endochondral ossification, producing lamellar bone surrounding a hematopoietic marrow component. This study highlights the potential of utilising engineering methodologies, inspired by developmental skeletal processes, in order to enhance endochondral bone regeneration strategies.

  15. Quantification of the vascularisation of the orbital implants of coralinehydroxyapatite with 99m Tc-MDP

    International Nuclear Information System (INIS)

    Rodriguez, J.L.; Solano, M.E.; Alvarez, I.; Perez, G.

    1998-01-01

    The use of ocular implants of hydroxyapatite has been increased in the last times owing to that they are well tolerated by the organism and that on the integration they show good mobility on the artificial eye with very few complications. The gammagraphy with 99m Tc-MDP can be used for the evaluation of vascularisation and its relative quantification above on these implants. In this pilot essay 10 normal persons and 37 patients were studied who had an implant of Cuban coraline hydroxyapatite (Coraline HAP-200). Thermography with 99m Tc-MDP was realized between 4 and 18 months after surgery then were obtained plane images in anterior viewing. It was measured the implant vascularisation and it was calculated for each case the relative captivation index (RCI) starting from two regions of ocular interest. As result all patients tolerated the implant without complications. The relation of the activity implant with respect to the contralateral region was 2.31±0.63 (mean ± SD) with a range of 1.17-4.09. The relation between the left intra orbital captivation and the right in the normal persons was 1.01 ±0.66 (mean ± SD). In conclusion, we obtained that the ICR can be very useful in order to measure the integration level of this type of implant.Moreover, it was proved that the implants with Cuban coraline hydroxyapatite showed an acceptable level of integration in all the patients. (Author)

  16. The effect of rotatory inertia on the dynamic response of cantilever structures

    International Nuclear Information System (INIS)

    Lin, Y.J.; Hadjian, A.H.

    1977-01-01

    For the dynamic response of cantilever beams, the error introduced by the bending theory becomes significant as the ratio of the radius of gyration to the beam length (r/l), exceeds 0.1. In this case, the use of Timoshenko's beam equation becomes more appropriate. This equation includes, in addition to the bending effects, both shear deformation and rotatory inertia effects. In the discrete modeling of beam elements, both the shear deformation and rotatory inertia terms play roles in the mass matrix, while only the shear deformation terms appear in the stiffness matrix. The effect of rotatory inertia on the frequencies and dynamic response of cantilever structures subjected to lateral earthquake excitation is thoroughly studied. This is done by using both the consistent and lumped mass matrices and analytical solution. The beam support is treated either as fixed or elastically restrained to consider soil-structure interaction effects. Since containment structures can be treated as hollow beams, the cantilever beam of uniform cross-section is examined first. For those cases where the ratio of the radius of gyration to beam length lies within the range of interest, all the solutions show that rotatory inertia has an important impact on both the frequencies (other than that of the fundamental mode) and the vertical component of the response. However, as the soil-structure interaction effects become significant rotatory inertia effects become secondary. For shear wall structures used in nuclear power plants, the floors may be treated as rigid diaphragms and the shear walls between floors are usually considered to be beam elements of uniform cross-section

  17. Ankle and pantalar arthrodeses using vascularized fibular grafts.

    Science.gov (United States)

    Yajima, Hiroshi; Kobata, Yasunori; Tomita, Yasuharu; Kawate, Kenji; Sugimoto, Kazuya; Takakura, Yoshinori

    2004-01-01

    From 1989 to 1998 ankle and pantalar arthrodeses using vascularized fibular grafts were performed for seven patients. The indications for surgery were chronic nonunion following fracture of the distal tibia in four patients, rheumatoid arthritis in two, and talus necrosis in one. The ankle joint was fused in the two patients with a pilon fracture, and in the other five patients, both the ankle and subtalar joints were fused. In one patient, additional bone grafting was required for delayed union. In the other six patients, the mean period required to obtain radiographic bone union was 6 months (range, 4-9 months). The time until the patients could walk without braces ranged from 6 to 20 months (mean, 12.3 months). Local infection was not encountered in any patients. This procedure represents a viable option for patients in whom a standard, less complicated arthrodesis cannot be performed.

  18. Molecular development of fibular reduction in birds and its evolution from dinosaurs.

    Science.gov (United States)

    Botelho, João Francisco; Smith-Paredes, Daniel; Soto-Acuña, Sergio; O'Connor, Jingmai; Palma, Verónica; Vargas, Alexander O

    2016-03-01

    Birds have a distally reduced, splinter-like fibula that is shorter than the tibia. In embryonic development, both skeletal elements start out with similar lengths. We examined molecular markers of cartilage differentiation in chicken embryos. We found that the distal end of the fibula expresses Indian hedgehog (IHH), undergoing terminal cartilage differentiation, and almost no Parathyroid-related protein (PTHrP), which is required to develop a proliferative growth plate (epiphysis). Reduction of the distal fibula may be influenced earlier by its close contact with the nearby fibulare, which strongly expresses PTHrP. The epiphysis-like fibulare however then separates from the fibula, which fails to maintain a distal growth plate, and fibular reduction ensues. Experimental downregulation of IHH signaling at a postmorphogenetic stage led to a tibia and fibula of equal length: The fibula is longer than in controls and fused to the fibulare, whereas the tibia is shorter and bent. We propose that the presence of a distal fibular epiphysis may constrain greater growth in the tibia. Accordingly, many Mesozoic birds show a fibula that has lost its distal epiphysis, but remains almost as long as the tibia, suggesting that loss of the fibulare preceded and allowed subsequent evolution of great fibulo-tibial disparity. © 2016 The Author(s). Evolution published by Wiley Periodicals, Inc. on behalf of The Society for the Study of Evolution.

  19. Atlantoaxial rotatory fixation as a rare complication from head positioning in otologic surgery: Report of two cases in young children

    OpenAIRE

    Sakaida, Hiroshi; Akeda, Koji; Sudo, Akihiro; Takeuchi, Kazuhiko

    2017-01-01

    Background Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patient...

  20. Use of vascularised free fibula in limb reconstruction (for non-malignant defects).

    Science.gov (United States)

    Hameed, Shahid; Ehtesham-ul-haq, Rana Hassan Javaid; Ahmed, Rao Saood; Majid, Abdul; Waqas, Muhammad; Aslam, Ayesha; Yusuf, Omamah; Butt, Ahsin Masood; Ali, Ghazanfar

    2013-12-01

    The case series was conducted at the Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, from June 2009 to May 2011, and comprised 19 patients in whom free fibula flap was performed for upper and lower limb reconstruction, using SPSS 16. Results showed that flap survival was 100%. One (5.2%) flap was re-explored for venous congestion and was salvaged. One (5.2%) patient of congenital pseudoarthrosis of tibia had a fracture of the fibula and was treated with external fixation. Average follow up was 8 months. Mean union time and full weight-bearing was 6.5 +/- 1.34 months (range 3-8 months) and 9 months, respectively. No recurrence of pseudoathrosis was observed until the last follow up, with only a 1.5 cm length discrepancy in one patient. The results proved that a microvascular free fibular flap heals rapidly, causes early functional recovery and it can be raised as an osteocutaneous flap.

  1. Atlanto-Occipital Rotatory Dislocation: A Case Report and Systematic Review.

    Science.gov (United States)

    Robles, Luis A; Mundis, Greg M; Cuevas-Solórzano, Abel

    2018-02-01

    Atlanto-occipital rotatory dislocation (AORD) has rarely been reported in the literature; for this reason, the clinicoradiologic characteristics of this injury are not well described. We describe the case of a 67-year-old man who sustained a cervical spine trauma. He reported only neck pain and was neurologically intact. A computed tomography scan showed a rotatory displacement of the atlanto-occipital joints associated with a widened condylar-C1 interval; in addition, magnetic resonance imaging showed injuries to the stabilizing ligaments of this area. A systematic literature review was also performed to identify previous cases of patients with AORD. The patient was treated with craniocervical fixation from occipital to C1, achieving a good outcome. The literature review yielded 9 cases of patients with AORD. Compared with patients with atlanto-occipital dislocation, patients with rotatory dislocations have a less severe degree of displacement of the atlanto-occipital joints and better clinical outcome. Compared with previously classified atlanto-occipital dislocations, AORD is an independent and unique variation. AORD presents with different biomechanical, clinicoradiologic, and prognostic characteristics and represents an important addition to the spectrum of atlanto-occipital dislocation injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Evaluation of Fibular Fracture Type vs Location of Tibial Fixation of Pilon Fractures.

    Science.gov (United States)

    Busel, Gennadiy A; Watson, J Tracy; Israel, Heidi

    2017-06-01

    Comminuted fibular fractures can occur with pilon fractures as a result of valgus stress. Transverse fibular fractures can occur with varus deformation. No definitive guide for determining the proper location of tibial fixation exists. The purpose of this study was to identify optimal plate location for fixation of pilon fractures based on the orientation of the fibular fracture. One hundred two patients with 103 pilon fractures were identified who were definitively treated at our institution from 2004 to 2013. Pilon fractures were classified using the AO/OTA classification and included 43-A through 43-C fractures. Inclusion criteria were age of at least 18 years, associated fibular fracture, and definitive tibial plating. Patients were grouped based on the fibular component fracture type (comminuted vs transverse), and the location of plate fixation (medial vs lateral) was noted. Radiographic outcomes were assessed for mechanical failures. Forty fractures were a result of varus force as evidenced by transverse fracture of the fibula and 63 were due to valgus force with a comminuted fibula. For the transverse fibula group, 14.3% mechanical complications were noted for medially placed plate vs 80% for lateral plating ( P = .006). For the comminuted fibular group, 36.4% of medially placed plates demonstrated mechanical complications vs 16.7% for laterally based plates ( P = .156). Time to weight bearing as tolerated was also noted to be significant between groups plated medially and laterally for the comminuted group ( P = .013). Correctly assessing the fibular component for pilon fractures provides valuable information regarding deforming forces. To limit mechanical complications, tibial plates should be applied in such a way as to resist the original deforming forces. Level of Evidence Level III, comparative study.

  3. [Finite element analysis of lumbar pelvic and proximal femur model with simulate lumbar rotatory manipulation].

    Science.gov (United States)

    Hu, Hua; Xiong, Chang-Yuan; Han, Guo-Wu

    2012-07-01

    To study the changes of displacement and stress in the model of lumbar pelvic and proximal femur during lumbar rotatory manipulation. The date of lumbar pelvic and proximal femur CT scan by Mimics 10.01 software was established a lumbar pelvic and proximal femur geometric model, then the model was modified with Geomagic 9, at last the modified model was imported into hypermesh 10 and meshed with tetrahedron, at the same time,add disc and ligaments. According to the principle of lumbar rotatory manipulation,the lumbar rotatory manipulation were decomposed. The mechanical parameters assigned into the three-dimensional finite element model. The changes of displacement and stress in the model of lunbar pelvic and proximal femur under the four conditions were calculated with Abaqus model of Hypermesh 10. 1) Under the same condition,the displacement order of lumbar was L1>L2>L3>L5 L5, anterior column > middle column > posterior column. 2) Under the different conditions, the displacement order of lumbar,case 3>case 1>case 4>case 2. 3) Under the same conditions, the displacement order of lumbar inter-vertebral disc from L1,2 to L5S1 was L1,2>L2,3>L3,4>L4,5>L5S1, as for the same inter-vertebral disc, the order was: second quadrant>third quadrant>first quadrant>fourth quadrant. 4) Under the different conditions,the displacement order of the inter-vertebral disc was L1,2>L2,3>L3,4>L4,5>L5S1, but to same inter-vertebral disc: case 3>case 4>case 1 >case 2. 5) There were apparent displacement and stress concentration in pelvis and hip during the manipulation. 1) The principles of lumbar rotation manipulation closely related to the relative displacement caused by rotation of various parts of lumbar pelvic and proximal femur model; 2) During the process of lumbar rotatory manipulation, the angle of lateral bending and flexion can not be randomly increased; 3) During the process of lumbar rotatory manipulation, all the conditions of lumbar pelvic and proximal femur must be

  4. Atlantoaxial rotatory fixation as a rare complication from head positioning in otologic surgery: Report of two cases in young children.

    Science.gov (United States)

    Sakaida, Hiroshi; Akeda, Koji; Sudo, Akihiro; Takeuchi, Kazuhiko

    2017-01-01

    Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patients who developed atlantoaxial rotatory fixation following otologic surgery and we review the relevant literature. One patient was a 7-year-old boy who underwent tympanoplasty for cholesteatoma. The other patient was a 5-year-old girl with profound sensorineural hearing loss who underwent cochlear implantation. Both patients developed atlantoaxial rotatory fixation on the day after surgery, and they were treated conservatively. Our literature search using relevant terms identified 12 similar published cases. Thus, a total of 14 patients, including our 2 patients, were evaluated. Most of the patients were children and typically they complained of painful torticollis and exhibited a characteristic posture called the "cock-robin" position on the day after surgery. Mostly, the direction of torticollis was opposite to the side of surgery. Most of the patients received conservative treatment alone, but three underwent surgical treatment. The correlation between the direction of torticollis and the side of surgery suggests that rotation of the head during surgery has an impact on development of postoperative atlantoaxial rotatory fixation. Thus, children undergoing otologic surgery are thought to be at a risk of postoperative atlantoaxial rotatory fixation. Although rare, the surgical team needs to be aware of this adverse event and pay close attention to this possibility throughout the perioperative period. Perioperative management should include informed consent, preoperative assessment of the

  5. Harvesting the free fibular graft: A modified approach

    Directory of Open Access Journals (Sweden)

    Amitava Narayan Mukherjee

    2011-01-01

    Full Text Available Background: The conventional technique of free non-vascularized fibular grafting is attended with some amount of morbidity and a long scar. We report a technique with little interference to the surrounding soft tissues to harvest more than one-third of whole length fibula. Patients and Methods: Thirty four patients of average age 23.5 years (range 8 to 51 years having various pathologies like simple bone cysts (n=9, fibrous dysplasias (n=6, giant cell tumors (n=7, fracture non-union (n=10 and aneurysmal bone cysts (n=2 were taken up for the study. The fibula were harvested by two separate incisions, 1 cm each at proximal and distal extent of proposed donor site for taking out of graft after elevating the periosteum circumferentially using a periosteum stripper. Compression bandage and above knee plaster immobilization was applied to reduce the dead space collection . Results: The mean followup is 34 months. The patients were evaluated clinicoradiology. Thirty three patients showed good results. One patient had fair result due to delayed wound healing from hematoma which was treated surgically. Conclusion: The approach of harvesting fibula suggested by author reduces donor site morbidity and is safer than conventional approach.

  6. Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

    Directory of Open Access Journals (Sweden)

    Woo Shik Jeong

    2014-09-01

    Full Text Available In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

  7. Review of vascularised bone tissue-engineering strategies with a focus on co-culture systems.

    Science.gov (United States)

    Liu, Yuchun; Chan, Jerry K Y; Teoh, Swee-Hin

    2015-02-01

    Poor angiogenesis within tissue-engineered grafts has been identified as a main challenge limiting the clinical introduction of bone tissue-engineering (BTE) approaches for the repair of large bone defects. Thick BTE grafts often exhibit poor cellular viability particularly at the core, leading to graft failure and lack of integration with host tissues. Various BTE approaches have been explored for improving vascularisation in tissue-engineered constructs and are briefly discussed in this review. Recent investigations relating to co-culture systems of endothelial and osteoblast-like cells have shown evidence of BTE efficacy in increasing vascularization in thick constructs. This review provides an overview of key concepts related to bone formation and then focuses on the current state of engineered vascularized co-culture systems using bone repair as a model. It will also address key questions regarding the generation of clinically relevant vascularized bone constructs as well as potential directions and considerations for research with the objective of pursuing engineered co-culture systems in other disciplines of vascularized regenerative medicine. The final objective is to generate serious and functional long-lasting vessels for sustainable angiogenesis that will enable enhanced cellular survival within thick voluminous bone grafts, thereby aiding in bone formation and remodelling in the long term. However, more evidence about the quality of blood vessels formed and its associated functional improvement in bone formation as well as a mechanistic understanding of their interactions are necessary for designing better therapeutic strategies for translation to clinical settings. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Novel management of distal tibial and fibular fractures with Acumed fibular nail and minimally invasive plating osteosynthesis technique: A case report.

    Science.gov (United States)

    Wang, Tie-Jun; Ju, Wei-Na; Qi, Bao-Chang

    2017-03-01

    Anatomical characteristics, such as subcutaneous position and minimal muscle cover, contribute to the complexity of fractures of the distal third of the tibia and fibula. Severe damage to soft tissue and instability ensure high risk of delayed bone union and wound complications such as nonunion, infection, and necrosis. This case report discusses management in a 54-year-old woman who sustained fractures of the distal third of the left tibia and fibula, with damage to overlying soft tissue (swelling and blisters). Plating is accepted as the first choice for this type of fracture as it ensures accurate reduction and rigid fixation, but it increases the risk of complications. Closed fracture of the distal third of the left tibia and fibula (AO: 43-A3). After the swelling was alleviated, the patient underwent closed reduction and fixation with an Acumed fibular nail and minimally invasive plating osteosynthesis (MIPO), ensuring a smaller incision and minimal soft-tissue dissection. At the 1-year follow-up, the patient had recovered well and had regained satisfactory function in the treated limb. The Kofoed score of the left ankle was 95. Based on the experience from this case, the operation can be undertaken safely when the swelling has been alleviated. The minimal invasive technique represents the best approach. Considering the merits and good outcome in this case, we recommend the Acumed fibular nail and MIPO technique for treatment of distal tibial and fibular fractures.

  9. MEMS-based non-rotatory circumferential scanning optical probe for endoscopic optical coherence tomography

    Science.gov (United States)

    Xu, Yingshun; Singh, Janak; Siang, Teo Hui; Ramakrishna, Kotlanka; Premchandran, C. S.; Sheng, Chen Wei; Kuan, Chuah Tong; Chen, Nanguang; Olivo, Malini C.; Sheppard, Colin J. R.

    2007-07-01

    In this paper, we present a non-rotatory circumferential scanning optical probe integrated with a MEMS scanner for in vivo endoscopic optical coherence tomography (OCT). OCT is an emerging optical imaging technique that allows high resolution cross-sectional imaging of tissue microstructure. To extend its usage to endoscopic applications, a miniaturized optical probe based on Microelectromechanical Systems (MEMS) fabrication techniques is currently desired. A 3D electrothermally actuated micromirror realized using micromachining single crystal silicon (SCS) process highlights its very large angular deflection, about 45 degree, with low driving voltage for safety consideration. The micromirror is integrated with a GRIN lens into a waterproof package which is compatible with requirements for minimally invasive endoscopic procedures. To implement circumferential scanning substantially for diagnosis on certain pathological conditions, such as Barret's esophagus, the micromirror is mounted on 90 degree to optical axis of GRIN lens. 4 Bimorph actuators that are connected to the mirror on one end via supporting beams and springs are selected in this micromirror design. When actuators of the micromirror are driven by 4 channels of sinusoidal waveforms with 90 degree phase differences, beam focused by a GRIN is redirected out of the endoscope by 45 degree tilting mirror plate and achieve circumferential scanning pattern. This novel driving method making full use of very large angular deflection capability of our micromirror is totally different from previously developed or developing micromotor-like rotatory MEMS device for circumferential scanning.

  10. Occult posterolateral rotatory dislocation of the elbow with olecranon fracture in a child: a case report

    Directory of Open Access Journals (Sweden)

    Fujimori Takahito

    2012-09-01

    Full Text Available Abstract Introduction Acute posterolateral rotator elbow dislocation in a child is rare and can be easily misdiagnosed due to immaturity of the epiphysis. This is the first case of occult posterolateral rotator elbow dislocation in combination with an olecranon fracture. We report our experience with this case, which was not diagnosed correctly by plain radiographs. Case presentation An 11-year-old Asian boy suffered severe pain and swelling of his right elbow after his outstretched arm hit a car dashboard in a motor vehicle accident. Plain radiographs showed only a minimally displaced olecranon fracture and a tiny lateral epicondylar avulsion fracture. However, stress radiographs under general anesthesia revealed severe posterolateral rotatory instability. During surgery, we found that the cartilaginous lateral epicondylar apophysis was much larger than the epicondylar fragment on the radiographs. After the lateral epicondylar osteochondral fragment and lateral collateral ligament complex were fixed, the instability disappeared. Conclusion Our experience with this case shows that it is important to check for instability with pediatric elbow fractures, because a tiny avulsion fracture was able to cause severe posterolateral rotatory instability in a child.

  11. Patterns of astragalar fibular facet orientation in extant and fossil primates and their evolutionary implications.

    Science.gov (United States)

    Boyer, Doug M; Seiffert, Erik R

    2013-07-01

    A laterally sloping fibular facet of the astragalus (=talus) has been proposed as one of few osteological synapomorphies of strepsirrhine primates, but the feature has never been comprehensively quantified. We describe a method for calculating fibular facet orientation on digital models of astragali as the angle between the planes of the fibular facet and the lateral tibial facet. We calculated this value in a sample that includes all major extant primate clades, a diversity of Paleogene primates, and nonprimate euarchontans (n = 304). Results show that previous characterization of a divide between extant haplorhines and strepsirrhines is accurate, with little overlap even when individual data points are considered. Fibular facet orientation is conserved in extant strepsirrhines despite major differences in locomotion and body size, while extant anthropoids are more variable (e.g., low values for catarrhines relative to non-callitrichine platyrrhines). Euprimate outgroups exhibit a mosaic of character states with Cynocephalus having a more obtuse strepsirrhine-like facet and sampled treeshrews and plesiadapiforms having more acute haplorhine-like facets. Surprisingly, the earliest species of the adapiform Cantius have steep haplorhine-like facets as well. We used a Bayesian approach to reconstruct the evolution of fibular facet orientation as a continuous character across a supertree of living and extinct primates. Mean estimates for crown Primatomorpha (97.9°), Primates (99.5°), Haplorhini (98.7°), and Strepsirrhini (108.2°) support the hypothesis that the strepsirrhine condition is derived, while lower values for crown Anthropoidea (92.8°) and Catarrhini (88.9°) are derived in the opposite direction. Copyright © 2013 Wiley Periodicals, Inc.

  12. Assessment of rotatory instability after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft

    International Nuclear Information System (INIS)

    Tashiro, Yasutaka; Okazaki, Ken; Miura, Hiromasa

    2010-01-01

    Anatomically oriented anterior cruciate ligament (ACL) reconstruction has been advocated recently, but its effect on rotatory instability remains to be cleared objectively. The purpose of this study was to quantitatively evaluate rotatory instability in ACL reconstructed knees with a bone-patellar tendon-bone (BTB) graft using an open MRI system. Eighteen subjects underwent arthroscopic ACL reconstruction with a BTB graft. The tibial tunnel was placed in the center of the ACL footprint. The femoral tunnel was drilled transtibially at the 10:00 to 10:30-o'clock position for the right knees. Subjects were examined using a Slocum anterolateral rotatory instability test in open MRI. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Anterior knee stability was evaluated using the KT-2000 arthrometer. The clinical knee function was assessed with the Lysholm and Tegner scoring scales before and after the surgery. Side-to-side differences of anterolateral tibial translation was 0.1 mm. Side-to-side difference on KT-2000 arthrometer measurement was 1.8 mm. The Lysholm score improved to 96 and the latest Tegner score reached substantially the preinjury level. ACL reconstruction with a BTB graft was successful in restoring rotatory stability as well as anterior stability and knee function. (author)

  13. Fusion Surgery Required for Recurrent Pediatric Atlantoaxial Rotatory Fixation after Failure of Temporary Fixation with Instrumentation

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    Yoshiyuki Matsuyama

    2017-01-01

    Full Text Available In cases of chronic irreducible and recurrent unstable atlantoaxial rotatory fixation (AARF, closed reduction and its maintenance are often unsuccessful, requiring surgical treatment. The purpose of the present report is to describe a rare case of pediatric AARF that required multiple treatments. A 6-year-old boy was diagnosed as having type 2 AARF. After conservative treatment, the patient was treated with temporary fixation surgery (C1-C2 Magerl without a bone graft in consideration of motion preservation after screw removal. AARF recurred after the screw removal and required fusion surgery (Magerl–Brooks with an iliac bone graft. Ultimately, bone union was achieved and the screws were removed 11 months after the surgery. We recommend surgeons be cautious when choosing temporary fixation surgery for AARF in small children. Further investigation is needed to determine the optimal time before screw removal.

  14. Ca2+ signalling in endothelial progenitor cells: a novel means to improve cell-based therapy and impair tumour vascularisation.

    Science.gov (United States)

    Moccia, Francesco; Lodola, Francesco; Dragoni, Silvia; Bonetti, Elisa; Bottino, Cinzia; Guerra, Germano; Laforenza, Umberto; Rosti, Vittorio; Tanzi, Franco

    2014-01-01

    Endothelial progenitor cells (EPCs) have recently been employed in cell-based therapy (CBT) to promote regeneration of ischemic organs, such as heart and limbs. Furthermore, EPCs may sustain tumour vascularisation and provide an additional target for anticancer therapies. CBT is limited by the paucity of cells harvested from peripheral blood and suffers from several pitfalls, including the low rate of engrafted EPCs, whereas classic antiangiogenic treatments manifest a number of side effects and may induce resistance into the patients. CBT will benefit of a better understanding of the signal transduction pathway(s) which drive(s) EPC proliferation, trafficking, and incorporation into injured tissues. At the same time, this information might outline alternative molecular targets to impair tumor neovascularisation and improve the therapeutic outcome of antiangiogenic strategies. An increase in intracellular Ca(2+) concentration is the key signal in the regulation of cellular replication, migration, and differentiation. In particular, Ca(2+) signalling may regulate cellcycle progression, due to the Ca(2+)-sensitivity of a number of cycline-dependent kinases, and gene expression, owing to the Ca(2+)-dependence of several transcription factors. Recent work has outlined the role of the so-called store-operated Ca(2+) entry in driving EPC proliferation and migration. Unravelling the mechanisms guiding EPC engraftment into neovessels might supply the biological bases required to improve CBT and anticancer treatments. For example, genetic manipulation of the Ca(2+) signalling machinery could provide a novel approach to increase the extent of limb regeneration or preventing tumour vascularisation by EPCs.

  15. Endogenous lysophosphatidic acid participates in vascularisation and decidualisation at the maternal-fetal interface in the rat.

    Science.gov (United States)

    Sordelli, Micaela S; Beltrame, Jimena S; Zotta, Elsa; Gomez, Natalia; Dmytrenko, Ganna; Sales, María Elena; Blois, Sandra M; Davio, Carlos; Martinez, Silvina Perez; Franchi, Ana M; Ribeiro, María L

    2017-10-01

    Lysophosphatidic acid (LPA) affects several female reproductive functions through G-protein-coupled receptors. LPA contributes to embryo implantation via the lysophospholipid LPA 3 receptor. In the present study we investigated the participation of endogenous LPA signalling through the LPA 3 receptor in vascularisation and decidualisation, two crucial events at the maternal-fetal interface. Pregnant rats were treated with diacylglycerol pyrophosphate (DGPP), a highly selective antagonist of LPA 3 receptors, on Day 5 of gestation. Pregnant rats received intrauterine (i.u.) injections of single doses of DGPP (0.1mgkg -1 ) in a total volume of 2μL in the left horn (treated horn) in the morning of GD5. DGPP treatment produced aberrant embryo spacing and increased embryo resorption. The LPA 3 receptor antagonist decreased the cross-sectional length of the uterine and arcuate arteries and induced histological anomalies in the decidua and placentas. Marked haemorrhagic processes, infiltration of immune cells and tissue disorganisation were observed in decidual and placental tissues from sites of resorption. The mRNA expression of three vascularisation markers, namely interleukin 10 (Il10), vascular endothelial growth factor (Vegfa) and vascular endothelial growth factor receptor 1 (Vegfr1), was reduced at sites of resorption from Day 8. The results show that the disruption of endogenous LPA signalling by blocking the LPA 3 receptor modified the development of uterine vessels with consequences in the formation of the decidua and placenta and in the growth of embryos.

  16. Atlantoaxial Rotatory Fixed Dislocation: Report on a Series of 32 Pediatric Cases.

    Science.gov (United States)

    Wang, Shenglin; Yan, Ming; Passias, Peter G; Wang, Chao

    2016-06-01

    Retrospective case series of atlantoaxial rotatory fixed dislocation (AARFD). To describe clinical features and the surgical treatment of AARFD. The classification and treatment strategy for atlantoaxial rotatory fixation (AARF) were previously described and remained controversial. AARF concomitant with atlantoaxial dislocation has different clinical features and treatment strategy with the most AARF. Due to deficiency of the transverse ligament or odontoid, the atlantoaxial remains unstable even after the torticollis relieved or cured. Because of the rarity, treatment strategy for this special condition has not been specialized and fully explored in the literatures. Thirty-two children with AARFD (sustained torticollis more than 6 weeks and atlanto-dental internal more than 5 mm) were retrospectively reviewed. Treatment methodology, pearls, and pitfalls of the treatment were discussed. Thirty-two cases had sustained torticollis for an average of 5.7 months. ADI of them ranged from 8 to 22 mm, with a mean of 11.3 mm. Eight cases presented with signs and symptoms of spinal cord dysfunction. All 32 cases underwent surgery and had no spinal cord or vertebral artery injury. The surgery included posterior reduction and fusion (reducible dislocation and torticollis, 16 cases), and transoral release followed by posterior reduction and fusion (irreducible dislocation and torticollis, 16 cases). The average follow-up time was 42 months. Solid fusion and torticollis healing were achieved in 31 patients (96.9%) as detected radiologically. Two cases (6.3%, 2/32) suffered complications (cerebrospinal fluid leakage and recurred torticollis followed by revision). AARFD had distinct clinical features relative to common presentations of AARF. Because of deficiency of the transverse ligament or odontoid and subsequent atlantoaxial dislocation, surgical treatments are applied for this condition, including transoral release and posterior C1-2 reduction and fusion. AARFD cases

  17. ASSESSMENT OF EFFECTIVENESS OF TB POSTING DURING THE COMPULSORY ROTATORY RESIDENTIAL INTERNSHIP (CRRI PROGRAMME

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    Pradeep Aggarwal

    2011-12-01

    Full Text Available Research Question: What is the effectiveness of TB posting during the Compulsory Rotatory Residential Internship (CRRI programme? Objectives: To assess the effectiveness of TB posting during the CRRI programme. To find out the need of making Tuberculosis & Respiratory Diseases Department posting mandatory during CRRI Programme. Study Design: Cross Sectional study. Study Duration: 12 months i.e. 01st April 2009 till 31st March 2010 Participants: 90 students who joined the CRRI programme formed the study group. Out of these 90 interns only 57 (64% of them joined their two months Compulsory Rotatory Internship in the Department of Community Medicine and these were posted in Tuberculosis & Respiratory Diseases Department for 15 days. Methodology: A pre-designed pre-tested self-administered questionnaire was administered to the participants on the first day and last day of their posting in Tuberculosis & Respiratory Diseases Department. The results were analysed by using suitable statistical package. Results: The mean pre-test score was 28 (49.6% and the mean post-test score was 38 (61.5%. It was observed that there was a 27% improvement in the knowledge of the participants when the question about the year of launching of RNTCP programme in India was asked. A remarkable improvement (46% was found in the difference between pre and post-test knowledge of the participants when the questions like “Who are the DOTS providers” and “What is the colour coding of boxes for different categories of patients” were asked. A significant difference in the knowledge was found in the pre and post-test assessment in reference to Tuberculosis and its National Programm

  18. MINIMUM INCISION PERCUTANEOUS PLATE OSTEOSYNTHESIS FOR DISTAL FIBULAR FRACTURES: A PROSPECTIVE STUDY

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    Ramkumar Reddy

    2015-09-01

    Full Text Available Distal fibular fractures are usually communitted and most of the times osteoporotic especially if they are occurring in females and in geriatric age group. These fractures are usu ally associated with other fractures, which necessitates them to be fixed accurately. Owing to the fact that distal fragment is subcutaneous with scanty soft tissue over bone, which pose these fracture fixations become difficult by open methods in view of wound healing. A prospective study of 26 patients with distal fibular fractures were treated with MIPPO with hook plate were healed with less complications and better outcome. With this background we suggest a minimally invasive incision over proximal frag ment where sufficient soft tissue cover is present. From there pushing the special hook plate subperiosteally to distal fragment, hooking the tip of fibula and fixing the proximal fragment after reduction gives a simple and effective stable fixation

  19. Effect of hip and knee position on nerve conduction in the common fibular nerve.

    Science.gov (United States)

    Broadhurst, Peter Kaas; Robinson, Lawrence R

    2017-09-01

    The aim of this study was to measure the influence that hip and knee position have on routine fibular motor nerve conduction studies. Healthy subjects under age 40 were recruited (n = 24) to have fibular nerve conduction studies completed in various positions, using hip extension-knee extension as a control. A mean increase in conduction velocity of 2.5 m/s across the knee (P = 0.020) was seen during hip flexion compared with hip extension. A mean decrease in velocity of 1.6 m/s through the leg segment (P = 0.016) was seen during knee flexion compared with knee extension. This study shows that the optimal position of the leg during fibular nerve studies is with the hip in flexion and knee in extension, to more accurately reflect nerve length for velocity calculations. This may have implications for other peripheral nerves with respect to proximal joint position affecting calculated velocity. Muscle Nerve 56: 519-521, 2017. © 2017 Wiley Periodicals, Inc.

  20. Novel Synchronous Linear and Rotatory Micro Motors Based on Polymer Magnets with Organic and Inorganic Insulation Layers

    Directory of Open Access Journals (Sweden)

    Andreas WALDSCHIK

    2008-12-01

    Full Text Available In this work, we report on the development of several synchronous motors with rotatory or linear movements. The synchronous micro motors are brushless DC motors or stepper motors with electrically controlled commutation consisting of a stator and a rotor. The rotor is mounted onto the stator and is adjusted by an integrated guidance. Inside the stator different coil systems are realized, like double layer sector coils or special nested coils. The coil systems can be controlled by three or six phases depending on the operational mode. Furthermore, inorganic insulation layers were used in order to reduce the thickness of the system. By this means four layers of electrical conductors can be realized especially for the 2D devices. The smallest diameter of the rotatory motor is 1 mm and could be successfully driven.

  1. Perfusion pattern and time of vascularisation with CEUS increase accuracy in differentiating between benign and malignant tumours in 216 musculoskeletal soft tissue masses

    Energy Technology Data Exchange (ETDEWEB)

    De Marchi, Armanda, E-mail: armanda.demarchi@tiscali.it [Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Prever, Elena Brach del, E-mail: elena.brach@unito.it [Department of OrthopaedicOncology and ReconstructiveSurgery, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Cavallo, Franco, E-mail: franco.cavallo@unito.it [Department of Public health and Paediatrics, University of Turin, Via Santena 5-bis, 10126 Torino (Italy); Pozza, Simona, E-mail: simona.pozza@tin.it [Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Linari, Alessandra, E-mail: linaralessandra@libero.it [Department of Pathology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, Regina Margherita Hospital, Piazza Polonia, 10126 Torino (Italy); Lombardo, Paolo, E-mail: pao.lombardo82@gmail.com [Department of DiagnosticImaging and Radiotherapy of the University of Turin, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Via Genova 3, 10126 Torino (Italy); Comandone, Alessandro, E-mail: alessandro.comandone@gradenigo.it [Department of Oncology, Gradenigo Hospital, Corso Regina Margherita, 8/10.10153 Torino (Italy); Piana, Raimondo, E-mail: raimondo.piana@libero.it [Department of OrthopaedicOncology and ReconstructiveSurgery, Azienda Ospedaliero Universitaria Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy); Faletti, Carlo [Department of Imaging, Azienda Ospedaliera Città della Salute e della Scienza, CTO Hospital, Via Zuretti 29, 10126 Torino (Italy)

    2015-01-15

    Introduction: Musculoskeletal Soft Tissue Tumours (STT) are frequent heterogeneous lesions. Guidelines consider a mass larger than 5 cm and deep with respect to the deep fascia potentially malignant. Contrast Enhanced Ultrasound (CEUS) can detect both vascularity and tumour neoangiogenesis. We hypothesised that perfusion patterns and vascularisation time could improve the accuracy of CEUS in discriminating malignant tumours from benign lesions. Materials and methods: 216 STT were studied: 40% benign lesions, 60% malignant tumours, 56% in the lower limbs. Seven CEUS perfusion patterns and three types of vascularisation (arterial-venous uptake, absence of uptake) were applied. Accuracy was evaluated by comparing imaging with the histological diagnosis. Univariate and multivariate analysis, Chi-square test and t-test for independent variables were applied; significance was set at p < 0.05 level, 95% computed CI. Results: CEUS pattern 6 (inhomogeneous perfusion), arterial uptake and location in the lower limb were associated with high risk of malignancy. CEUS pattern has PPV 77%, rapidity of vascularisation PPV 69%; location in the limbs is the most sensitive indicator, but NPV 52%, PPV 65%. The combination of CEUS-pattern and vascularisation has 74% PPV, 60% NPV, 70% sensitivity. No correlation with size and location in relation to the deep fascia was found. Conclusion: US with CEUS qualitative analysis could be an accurate technique to identify potentially malignant STT, for which second line imaging and biopsy are indicated in Referral Centers. Intense inhomogeneous enhancement with avascular areas and rapid vascularisation time could be useful in discriminating benign from malignant SST, overall when the lower limbs are involved.

  2. Imaging of childhood torticollis due to atlanto-axial rotatory fixation.

    Science.gov (United States)

    Maheshwaran, S; Sgouros, S; Jeyapalan, K; Chapman, S; Chandy, J; Flint, G

    1995-12-01

    Atlanto-axial rotatory fixation is a rare cause of childhood torticollis. It may occur spontaneously or may be associated with trauma, upper respiratory tract infection or congenital abnormality of the cervical spine. Presentation is usually with persistent torticollis and "cock robin" deformity of the neck. In this paper the radiological experience in three patients is presented. Investigations included plain radiographs, plain anteroposterior tomography, CT and MRI. Displacement of the lateral mass of the atlas and the eccentric position of the odontoid peg can be seen in the plain films. CT scan can exclude fractures and confirm atlanto-axial rotation. The superimposition of CT images is demonstrated as a way of diagnosing subluxation. MRI offers better soft tissue differentiation and allows assessment of the integrity of the transverse ligament. This has an important bearing on the prognosis and may influence surgical treatment. It is important to recognise the plain film features of this uncommon condition and confirm the diagnosis with CT or MRI. The treatment options are discussed with particular reference to long term outcome.

  3. Compressible Analysis of Bénard Convection of Magneto Rotatory Couple-Stress Fluid

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    Mehta C.B.

    2018-02-01

    Full Text Available Thermal Instability (Benard’s Convection in the presence of uniform rotation and uniform magnetic field (separately is studied. Using the linearized stability theory and normal mode analyses the dispersion relation is obtained in each case. In the case of rotatory Benard’s stationary convection compressibility and rotation postpone the onset of convection whereas the couple-stress have duel character onset of convection depending on rotation parameter. While in the absence of rotation couple-stress always postpones the onset of convection. On the other hand, magnetic field on thermal instability problem on couple-stress fluid for stationary convection couple-stress parameter and magnetic field postpones the onset of convection. The effect of compressibility also postpones the onset of convection in both cases as rotation and magnetic field. Graphs have been plotted by giving numerical values to the parameters to depict the stationary characteristics. Further, the magnetic field and rotation are found to introduce oscillatory modes which were non-existent in their absence and then the principle of exchange of stability is valid. The sufficient conditions for non-existence of overstability are also obtained.

  4. Surgical treatment of children with non-traumatic old atlanto-axial rotatory fixation

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    A. V. Gubin

    2015-01-01

    Full Text Available Atlanto-axial rotatory fixation (AORF develops on the background of acute torticollis. Widely adopted terms such as C1 subluxation or atlantooccipital rotational subluxation do not reflect the core of this pathology and carry negative weight in the diagnostics and treatment of AORF. Retrospective analysis of the diagnostics and treatment outcome of 5 children with confirmed AORF diagnosis and literature review were performed. Clinical method, radiography and functional computer tomography were used to verify the diagnosis. De-rotational halo-traction and open correction with screw fixation were applied for treatment. Head position was managed to be improved in all patients. In one case the reduction was performed using correction in suboccipital segments and in other 4 cases the correction and fixation by Harms and de-rotational halo-traction allowed to correct torticollis. The pain syndrome had been arrested completely. Disease outcome resulted in formation of C1-C2 fibrous or bone fusion regardless the method of treatment. The patients with neglected AORF represent a great challenge for diagnostics and treatment. When conservative treatment fails it is necessary to involve de-rotational halo-traction with possible application of open reduction and posterior fusion. The purpose of treatment is to eliminate torticollis and pain using creation of proper C1-C2 alignment. The motions in atlantooccipital joint do not restore due to formation of the fibrous or bone fusion.

  5. Quantification of C2 cervical spine rotatory fixation by X-ray, MRI and CT

    Energy Technology Data Exchange (ETDEWEB)

    Gradl, Georg [Chirurgische Klinik und Poliklinik der Universitaet Rostock, Abteilung Unfall- und Wiederherstellungschirurgie, Rostock (Germany); Maier-Bosse, Tamara; Staebler, Axel [Institut fuer Radiologische Diagnostik der Universitaet Muenchen, Klinikum Grobetahadern, Munich (Germany); Penning, Randolph [Institut fuer Rechtsmedizin der Universitaet Muenchen, Munich (Germany)

    2005-02-01

    Atlanto-axial rotatory displacement is known to be a cause of childhood torticollis and may as well be responsible for chronic neck pain after rear-end automobile collisions. The objective was to determine whether quantification of C2 malrotation is possible by plain radiographs in comparison to CT as the golden standard. MR imaging was evaluated as to whether it was of equal value in the detection of bony landmarks. C2 vertebra of five human cadaveric cervical spine specimens, ligamentously intact, were rotated using a Steinmann pin in steps of 5 up to 15 right and 15 left. Plain radiographs, CT and MRI images were taken in each rotational step. Data were analyzed for quantification of C2 rotation by three independent examiners. A rotation of 5 led to a spinous process deviation (SPD) from the midline of 3 mm as measured on an a.p. plain radiograph. A coefficient of rotation was calculated (1.62 mm{sup -1}). Data analyzed by three examiners revealed a small coefficient of variation (0.03). MRI and CT measurements showed comparable results for the quantification of rotation; however, in both techniques the 15 rotation was underestimated. Quantification of upper cervical spine malrotation was possible on plain radiographs using the SPD and a rotation coefficient. MRI and CT were equally successful in the assessment of C2 malrotation. (orig.)

  6. Treatment of Atlantoaxial Rotatory Fixation With Botulinum Toxin Muscle Block and Manipulation

    Directory of Open Access Journals (Sweden)

    Chia-Hung Lin

    2010-04-01

    Full Text Available Slippage after reduction of atlantoaxial rotatory fixation (AARF is usually treated with repeated cervical traction and brace immobilization. To date, no data have been published on the management of muscle spasm during treatment. Here, we describe the case of a 7-year-old girl with AARF for 1 month who visited our hospital for treatment. During physical examination, spasm of the sternocleidomastoid muscle was noted. The patient was treated with manipulative reduction, and slippage after reduction was managed with botulinum spasticity block of the sternocleidomastoid and splenius capitis muscles, and repeated manipulation. Cervical orthosis immobilization with a rehabilitation program of isometric contract–relax exercise for the neck was conducted for 3 months. The subject had full recovery from AARF at 1-year follow-up. This report demonstrates that, in selected cases of slippage after reduction from AARF, conservative management with manipulation under anesthesia is a good method, and the muscle components may play a crucial role in AARF.

  7. Treatment of atlantoaxial rotatory fixation with botulinum toxin muscle block and manipulation.

    Science.gov (United States)

    Lin, Chia-Hung; Chen, Chun-Jung; Chen, Chuan-Mu; Liao, Su-Lan; Raung, Shue-Ling; Tsai, Sen-Wei

    2010-04-01

    Slippage after reduction of atlantoaxial rotatory fixation (AARF) is usually treated with repeated cervical traction and brace immobilization. To date, no data have been published on the management of muscle spasm during treatment. Here, we describe the case of a 7-year-old girl with AARF for 1 month who visited our hospital for treatment. During physical examination, spasm of the sternocleidomastoid muscle was noted. The patient was treated with manipulative reduction, and slippage after reduction was managed with botulinum spasticity block of the sternocleidomastoid and splenius capitis muscles, and repeated manipulation. Cervical orthosis immobilization with a rehabilitation program of isometric contract-relax exercise for the neck was conducted for 3 months. The subject had full recovery from AARF at 1-year follow-up. This report demonstrates that, in selected cases of slippage after reduction from AARF, conservative management with manipulation under anesthesia is a good method, and the muscle components may play a crucial role in AARF. Copyright 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  8. Quantification of C2 cervical spine rotatory fixation by X-ray, MRI and CT

    International Nuclear Information System (INIS)

    Gradl, Georg; Maier-Bosse, Tamara; Staebler, Axel; Penning, Randolph

    2005-01-01

    Atlanto-axial rotatory displacement is known to be a cause of childhood torticollis and may as well be responsible for chronic neck pain after rear-end automobile collisions. The objective was to determine whether quantification of C2 malrotation is possible by plain radiographs in comparison to CT as the golden standard. MR imaging was evaluated as to whether it was of equal value in the detection of bony landmarks. C2 vertebra of five human cadaveric cervical spine specimens, ligamentously intact, were rotated using a Steinmann pin in steps of 5 up to 15 right and 15 left. Plain radiographs, CT and MRI images were taken in each rotational step. Data were analyzed for quantification of C2 rotation by three independent examiners. A rotation of 5 led to a spinous process deviation (SPD) from the midline of 3 mm as measured on an a.p. plain radiograph. A coefficient of rotation was calculated (1.62 mm -1 ). Data analyzed by three examiners revealed a small coefficient of variation (0.03). MRI and CT measurements showed comparable results for the quantification of rotation; however, in both techniques the 15 rotation was underestimated. Quantification of upper cervical spine malrotation was possible on plain radiographs using the SPD and a rotation coefficient. MRI and CT were equally successful in the assessment of C2 malrotation. (orig.)

  9. Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma.

    Science.gov (United States)

    Yoon, Hyung-In

    2016-10-01

    This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

  10. Fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma

    International Nuclear Information System (INIS)

    Wu Jun; Zhang Qiang

    2003-01-01

    Objective: To evaluate the fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma. Methods: Measure fracture line index of fibular stalk and the ankle joint in 217 adult cases of fracture and dislocation of ankle joint. And the cases were classified by the results of the measurement. Results: Measurement was unavailable in 9 cases of tearing fracture. In 31 cases, the lesions could not be particularly classified. And in the rest 176 cases the trauma were precisely classified. The over all successful rate was 81.6%. Conclusion: Fracture line index of fibular stalk and the ankle joint bone are valuable in classification of the trauma of the angle joint. While the specificity of this method is low in differentiating the adducting and abducting fracture of the medial angle, in which a combined investigation is recommended

  11. Correction of axial deformity during lengthening in fibular hypoplasia: Hexapodal versus monorail external fixation.

    Science.gov (United States)

    Chalopin, A; Geffroy, L; Pesenti, S; Hamel, A; Launay, F

    2017-09-01

    Childhood fibular hypoplasia is a rare pathology which may or may not involve limb-length discrepancy and axial deformity in one or more dimensions. The objective of the present study was to compare the quality of the axial correction achieved in lengthening procedures by hexapodal versus monorail external fixators. The hypothesis was that the hexapodal fixator provides more precise correction. A retrospective multicenter study included 52 children with fibular hypoplasia. Seventy-two tibias were analyzed, in 2 groups: 52 using a hexapodal fixator, and 20 using a monorail fixator. Mean age was 10.2 years. Mean lengthening was 5.7cm. Deformities were analyzed and measured in 3 dimensions and classified in 4 preoperative types and 4 post-lengthening types according to residual deformity. Complete correction was achieved in 26 tibias in the hexapodal group (50%) and 2 tibias in the monorail group (10%). Mean post-correction mechanical axis deviation was smaller in the hexapodal group: 12.83mm, versus 14.29mm in the monorail group. Mean post-correction mechanical lateral distal femoral angle was 87.5° in the hexapodal group, versus 84.3° in the monorail group (P=0.002), and mean mechanical medial proximal tibial angle 86.9° versus 89.5°, respectively (P=0.015). No previous studies focused on this congenital pathology in lengthening and axial correction programs for childhood lower-limb deformity. The present study found the hexapodal fixator to be more effective in conserving or restoring mechanical axes during progressive bone lengthening for fibular hypoplasia. The hexapodal fixator met the requirements of limb-length equalization in childhood congenital lower-limb hypoplasia, providing better axial correction than the monorail fixator. IV. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Infant bone age estimation based on fibular shaft length: model development and clinical validation

    International Nuclear Information System (INIS)

    Tsai, Andy; Stamoulis, Catherine; Bixby, Sarah D.; Breen, Micheal A.; Connolly, Susan A.; Kleinman, Paul K.

    2016-01-01

    Bone age in infants (<1 year old) is generally estimated using hand/wrist or knee radiographs, or by counting ossification centers. The accuracy and reproducibility of these techniques are largely unknown. To develop and validate an infant bone age estimation technique using fibular shaft length and compare it to conventional methods. We retrospectively reviewed negative skeletal surveys of 247 term-born low-risk-of-abuse infants (no persistent child protection team concerns) from July 2005 to February 2013, and randomized them into two datasets: (1) model development (n = 123) and (2) model testing (n = 124). Three pediatric radiologists measured all fibular shaft lengths. An ordinary linear regression model was fitted to dataset 1, and the model was evaluated using dataset 2. Readers also estimated infant bone ages in dataset 2 using (1) the hemiskeleton method of Sontag, (2) the hemiskeleton method of Elgenmark, (3) the hand/wrist atlas of Greulich and Pyle, and (4) the knee atlas of Pyle and Hoerr. For validation, we selected lower-extremity radiographs of 114 normal infants with no suspicion of abuse. Readers measured the fibulas and also estimated bone ages using the knee atlas. Bone age estimates from the proposed method were compared to the other methods. The proposed method outperformed all other methods in accuracy and reproducibility. Its accuracy was similar for the testing and validating datasets, with root-mean-square error of 36 days and 37 days; mean absolute error of 28 days and 31 days; and error variability of 22 days and 20 days, respectively. This study provides strong support for an infant bone age estimation technique based on fibular shaft length as a more accurate alternative to conventional methods. (orig.)

  13. Infant bone age estimation based on fibular shaft length: model development and clinical validation

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Andy; Stamoulis, Catherine; Bixby, Sarah D.; Breen, Micheal A.; Connolly, Susan A.; Kleinman, Paul K. [Boston Children' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2016-03-15

    Bone age in infants (<1 year old) is generally estimated using hand/wrist or knee radiographs, or by counting ossification centers. The accuracy and reproducibility of these techniques are largely unknown. To develop and validate an infant bone age estimation technique using fibular shaft length and compare it to conventional methods. We retrospectively reviewed negative skeletal surveys of 247 term-born low-risk-of-abuse infants (no persistent child protection team concerns) from July 2005 to February 2013, and randomized them into two datasets: (1) model development (n = 123) and (2) model testing (n = 124). Three pediatric radiologists measured all fibular shaft lengths. An ordinary linear regression model was fitted to dataset 1, and the model was evaluated using dataset 2. Readers also estimated infant bone ages in dataset 2 using (1) the hemiskeleton method of Sontag, (2) the hemiskeleton method of Elgenmark, (3) the hand/wrist atlas of Greulich and Pyle, and (4) the knee atlas of Pyle and Hoerr. For validation, we selected lower-extremity radiographs of 114 normal infants with no suspicion of abuse. Readers measured the fibulas and also estimated bone ages using the knee atlas. Bone age estimates from the proposed method were compared to the other methods. The proposed method outperformed all other methods in accuracy and reproducibility. Its accuracy was similar for the testing and validating datasets, with root-mean-square error of 36 days and 37 days; mean absolute error of 28 days and 31 days; and error variability of 22 days and 20 days, respectively. This study provides strong support for an infant bone age estimation technique based on fibular shaft length as a more accurate alternative to conventional methods. (orig.)

  14. Reconstruction of the cervical spine with two osteocutaneous fibular flap after radiotherapy and resection of osteoclastoma

    DEFF Research Database (Denmark)

    Kaltoft, Britta; Kruse, Anders; Jensen, Lisa Toft

    2012-01-01

    to C3. Two months later, rupture of the pharyngeal wall was noted with exposure of the anterior cage. A few days later, the posterior scar ruptured. The anterior cage was removed and the pharyngeal wall was sutured. Revision of the posterior wound was performed, leaving the implants in place. To secure...... stability of the spine, the patient was treated with a HALO. Once again, the pharyngeal wall ruptured. Reconstruction of the posterior pharyngeal wall and the anterior column of the spine was performed with an osteocutaneous fibular flap from the skull base to C3. Five months later, a computed tomography...

  15. Bilateral transverse (bowdler) fibular spurs with hypophosphatasia in an adolescent girl

    Energy Technology Data Exchange (ETDEWEB)

    Uras, Ismail; Uras, Nurdan; Karadag, Ahmet; Yavuz, Osman Yuksel; Atalar, Hakan [Fatih University Faculty of Medicine, Ankara (Turkmenistan)

    2005-03-15

    Hypophosphatasia is a clinically heterogeneous inheritable disorder characterized by defective bone mineralization and the deficiency of serum and tissue liver/bone/kidney alkaline phosphatase activities. Due to the mineralization defect of the bones, various skeletal findings can be radiologically observed in hypophosphatasia. Bowing and Bowdler spurs of long bones are the characteristic findings. The Bowdler spurs reported on in the previous pertinent literature were observed in the perinatal aged patients and these lesions have rarely involved adolescents. We herein report on a 14-year-old girl with fibular Bowdler spurs.

  16. Bilateral transverse (bowdler) fibular spurs with hypophosphatasia in an adolescent girl

    International Nuclear Information System (INIS)

    Uras, Ismail; Uras, Nurdan; Karadag, Ahmet; Yavuz, Osman Yuksel; Atalar, Hakan

    2005-01-01

    Hypophosphatasia is a clinically heterogeneous inheritable disorder characterized by defective bone mineralization and the deficiency of serum and tissue liver/bone/kidney alkaline phosphatase activities. Due to the mineralization defect of the bones, various skeletal findings can be radiologically observed in hypophosphatasia. Bowing and Bowdler spurs of long bones are the characteristic findings. The Bowdler spurs reported on in the previous pertinent literature were observed in the perinatal aged patients and these lesions have rarely involved adolescents. We herein report on a 14-year-old girl with fibular Bowdler spurs

  17. Neuroradiology of the normal and pathological anatomy of the rat brain. Pt. 2. Microangiographic investigations of the vascularisation of transplanted malignant brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, M; Weisser, G; Voigt, K; Mennel, H D

    1980-11-01

    70 BD-IX rats, in which chemically induced mixed gliomas have been transplanted intracerebrally, were investigated by microangiography. The pattern and the degree of tumor vascularisation of all animals was correlated with the histological findings. Dependent on the type of the tumor different localisations of tumor growth could be found: G XII-gliomas preferred the juxta-ventricular region and subarachnoid space whereas GL 2.2-gliomas mainly grew as solid intracerebral space occupying lesions. Microangiograms of all tumor stages from the 14th to 42nd day after transplantation revealed a typical vascular pattern consisting of lacunar glomerulose and netlike vessels. Further, necrosis, bleedings into the tumor, and irregularities of the capillary network could be demonstrated. The volume, age and vascularisation of the tumors are correlated and the results are discussed with regard to the principles of tumor growth and malignancy.

  18. Articular Contact Area and Pressure in Posteromedial Rotatory Instability of the Elbow.

    Science.gov (United States)

    Bellato, Enrico; Fitzsimmons, James S; Kim, Youngbok; Bachman, Daniel R; Berglund, Lawrence J; Hooke, Alexander W; O'Driscoll, Shawn W

    2018-03-21

    Joint incongruity in posteromedial rotatory instability (PMRI) has been theorized to determine early articular degenerative changes. Our hypothesis was that the articular contact area and contact pressure differ significantly between an intact elbow and an elbow affected by PMRI. Seven cadaveric elbows were tested under gravity varus stress using a custom-made machine designed to simulate muscle loads and allow passive elbow flexion (0° to 90°). The mean contact area and contact pressure data were collected and processed using the Tekscan sensor and software. After testing the intact specimen (intact elbow), a PMRI injury was simulated (PMRI elbow) and the specimen was tested again. The PMRI elbows were characterized by initial joint subluxation and significantly elevated articular contact pressure. Both worsened, corresponding with a reduction in contact area, as the elbow was flexed from 0° until the joint subluxation and incongruity spontaneously reduced (at a mean [and standard error] of 60° ± 5° of flexion), at which point the mean contact pressure decreased from 870 ± 50 kPa (pre-reduction) to 440 ± 40 kPa (post-reduction) (p contact area increased from 80 ± 8 mm to 150 ± 58 mm (p contact area from the coronoid fracture edge toward the lower portion of the coronoid. At the flexion angle at which the PMRI elbows reduced, both the contact area and the contact pressure of the intact elbows differed significantly from those of the PMRI elbows, both before and after the elbow reduction (p contact area and increased contact pressures due to joint subluxation and incongruity could explain the progressive arthritis seen in some elbows affected by PMRI. This biomechanical study suggests that the early degenerative changes associated with PMRI reported in the literature could be subsequent to joint incongruity and an increase in contact pressure between the coronoid fracture surface and the trochlea.

  19. Condylus tertius with atlanto-axial rotatory fixation: an unreported association

    Energy Technology Data Exchange (ETDEWEB)

    Udare, Ashlesha Satish [M.G.M. Hospital, Department of Radiology, Kamothe, Navi Mumbai (India); Global Hospital Super Speciality and Transplant Centre, Department of Radiology, Mumbai (India); Navi Mumbai, Maharashtra (India); Bansal, Divya; Patel, Bhavin [M.G.M. Hospital, Department of Radiology, Kamothe, Navi Mumbai (India); Mondel, Prabath Kumar [P.D. Hinduja Hospital, Department of Radiology, Mahim, Mumbai (India); Aiyer, Siddharth [Shatabdi Hospital, Department of Orthopedics, Chembur, Mumbai (India)

    2014-04-15

    The ''condylus tertius'' or the ''third occipital condyle'' is an embryological remnant of the proatlas sclerotome. Anatomically, it is attached to the basion and often articulates with the anterior arch of the atlas and the odontoid apex; hence, it is also called the ''median occipital condyle''. It is a rare anomaly of the cranio-vertebral junction (CVJ) that can lead to instability and compression of important surrounding neurovascular structures. We report a case of a 16-year-old boy who presented with suboccipital neck pain, torticollis and right sided hemiparesis. Plain radiographs revealed an increased atlanto-dental interspace (ADI) with a retroflexed odontoid. Open mouth view showed asymmetry of the articular processes of the atlas with respect to the dens. Computed tomography (CT) of the CVJ delineated the third occipital condyle. Furthermore, on dynamic CT study, a type 3 atlanto-axial rotatory fixation (AARF) was clearly demonstrated. Magnetic resonance imaging (MRI) of the CVJ revealed severe right-sided spinal cord compression by the retroflexed and rightward deviated dens. It also revealed disruption of the left alar and transverse ligaments. The patient was treated with 8 weeks of cranial traction and reasonable alignment was obtained. This was followed by C1-C2 lateral mass screw fixation and C1-C2 interlaminar wiring to maintain the alignment. A review of the literature did not reveal any cases of condylus tertius associated with non-traumatic AARF. An accurate knowledge of the embryology and imaging features of this rare CVJ anomaly is useful in the prompt diagnosis and management of such patients. (orig.)

  20. CT findings and surgical treatment of atlanto-axial rotatory fixation

    International Nuclear Information System (INIS)

    Shoji, Akira; Harano, Hideyuki; Okumura, Terufumi; Nakagawa, Hiroshi; Sugiyama, Tadamitsu.

    1984-01-01

    A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C 2 distribution. Plain films of the cervical spine disclosed abnormal alignment of C 1 -C 2 and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C 1 . On CT metrizamide myelography, there was clockwise rotation of C 1 on C 2 with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C 1 to C 3 with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor trauma was most suggested. For neurological manifestations of AARF, occipital neuralgia, headache, neck pain, limitation of neck movement and cock-robin posture were reported, but the cock-robin posture was most characteristic and was an important symptom for the early diagnosis. In neuroradiological findings of AARF, plain CT and CT metrizamide myelography are very useful. Because they clearly demonstrate the degree of rotation and interlocking of atlanto-axial joints, and the presence of cord compression. (author)

  1. Clinical and stereoradiographic analysis of adult spinal deformity with and without rotatory subluxation.

    Science.gov (United States)

    Ferrero, E; Lafage, R; Challier, V; Diebo, B; Guigui, P; Mazda, K; Schwab, F; Skalli, W; Lafage, V

    2015-09-01

    In degenerative adult spinal deformity (ASD), sagittal malalignment and rotatory subluxation (RS) correlate with clinical symptomatology. RS is defined as axial rotation with lateral listhesis. Stereoradiography, recently developed for medical applications, provides full-body standing radiographs and 3D reconstruction of the spine, with low radiation dose. 3D stereoradiography improves analysis of RS and of its relations with transverse plane and spinopelvic parameters and clinical impact. One hundred and thirty adults with lumbar ASD and full-spine EOS® radiographs (EOS Imaging, Paris, France) were included. Spinopelvic sagittal parameters and lateral listhesis in the coronal plane were measured. The transverse plane study parameters were: apical axial vertebral rotation (apex AVR), axial intervertebral rotation (AIR) and torsion index (TI). Two groups were compared: with RS (lateral listhesis>5mm) and without RS (without lateral listhesis exceeding 5mm: non-RS). Correlations between radiologic and clinical data were assessed. RS patients were significantly older, with larger Cobb angle (37.4° vs. 26.6°, P=0.0001), more severe sagittal deformity, and greater apex AVR and TI (respectively: 22.9° vs. 11.3°, P10° without visible RS on 2D radiographs. RS patients reported significantly more frequent low back pain and radiculalgia. In this EOS® study, ASD patients with RS had greater coronal curvature and sagittal and transverse deformity, as well as greater pain. Further transverse plane analysis could allow earlier diagnosis and prognosis to guide management. 4, retrospective study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Condylus tertius with atlanto-axial rotatory fixation: an unreported association

    International Nuclear Information System (INIS)

    Udare, Ashlesha Satish; Bansal, Divya; Patel, Bhavin; Mondel, Prabath Kumar; Aiyer, Siddharth

    2014-01-01

    The ''condylus tertius'' or the ''third occipital condyle'' is an embryological remnant of the proatlas sclerotome. Anatomically, it is attached to the basion and often articulates with the anterior arch of the atlas and the odontoid apex; hence, it is also called the ''median occipital condyle''. It is a rare anomaly of the cranio-vertebral junction (CVJ) that can lead to instability and compression of important surrounding neurovascular structures. We report a case of a 16-year-old boy who presented with suboccipital neck pain, torticollis and right sided hemiparesis. Plain radiographs revealed an increased atlanto-dental interspace (ADI) with a retroflexed odontoid. Open mouth view showed asymmetry of the articular processes of the atlas with respect to the dens. Computed tomography (CT) of the CVJ delineated the third occipital condyle. Furthermore, on dynamic CT study, a type 3 atlanto-axial rotatory fixation (AARF) was clearly demonstrated. Magnetic resonance imaging (MRI) of the CVJ revealed severe right-sided spinal cord compression by the retroflexed and rightward deviated dens. It also revealed disruption of the left alar and transverse ligaments. The patient was treated with 8 weeks of cranial traction and reasonable alignment was obtained. This was followed by C1-C2 lateral mass screw fixation and C1-C2 interlaminar wiring to maintain the alignment. A review of the literature did not reveal any cases of condylus tertius associated with non-traumatic AARF. An accurate knowledge of the embryology and imaging features of this rare CVJ anomaly is useful in the prompt diagnosis and management of such patients. (orig.)

  3. Reliability analysis for manual radiographic measures of rotatory subluxation or lateral listhesis in adult scoliosis.

    Science.gov (United States)

    Freedman, Brett A; Horton, William C; Rhee, John M; Edwards, Charles C; Kuklo, Timothy R

    2009-03-15

    Retrospective observational study. To define the inter- and intraobserver reliability of 3 measures of rotatory subluxation (RS) in adult scoliosis (AS). RS is a hallmark of AS. To accurately track this measure, one must know its reliability. Reliability testing has not been performed. PA 36" films of 29 AS patients were collected from one surgeon's practice. Three observers on 2 separate occasions measured all levels with >or=3-mm RS (60 levels, 360 measurements) on the convexity of the involved segment using 3 different techniques-midbody (MB), endplate (EP), and centroid (C). These data were then analyzed to determine the intraclass correlation coefficient (ICC) for inter- and intraobserver reliability. The thoracolumbar/lumbar curve (average 58 degrees ) was the major curve for the majority (62%) of patients. RS at L3/4 was most common (35%). The overall inter- and intraobserver reliability was good-excellent for all methods, but the centroid method consistently had the highest ICC. ICC correlated with observer experience. Moderate-severe arthritic change (present in 55%) and poor image quality (52%) decreased ICC, but it still remained good-excellent for each measure. The reproducibility coefficient for each measure was 4 mm for MB and 2.8 mm for C and EP. MB, EP, and C are reliable techniques to measure RS even in elderly arthritic spines, but the methods inherently produce different values for a given level. The centroid method is most reliable and least influenced by experience. The EP method is easy to perform and very reliable. Spine surgeons should pick their preferred method and apply it consistently. Changes >3 mm suggest RS progression. RS may be a useful measure in addition to Cobb angle in AS. Having defined measurement reliability, the role of RS progression in surgical indications and patient outcomes can be evaluated.

  4. CT findings and surgical treatment of atlanto-axial rotatory fixation. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Shoji, Akira; Harano, Hideyuki; Okumura, Terufumi [Fukuroi Municipal Hospital, Shizuoka (Japan); Nakagawa, Hiroshi; Sugiyama, Tadamitsu

    1984-07-01

    A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C/sub 2/ distribution. Plain films of the cervical spine disclosed abnormal alignment of C/sub 1/-C/sub 2/ and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C/sub 1/. On CT metrizamide myelography, there was clockwise rotation of C/sub 1/ on C/sub 2/ with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C/sub 1/ to C/sub 3/ with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor trauma was most suggested. For neurological manifestations of AARF, occipital neuralgia, headache, neck pain, limitation of neck movement and cock-robin posture were reported, but the cock-robin posture was most characteristic and was an important symptom for the early diagnosis. In neuroradiological findings of AARF, plain CT and CT metrizamide myelography are very useful. Because they clearly demonstrate the degree of rotation and interlocking of atlanto-axial joints, and the presence of cord compression.

  5. Rotatory and collic vestibular evoked myogenic potential testing in normal-hearing and hearing-impaired children.

    Science.gov (United States)

    Maes, Leen; De Kegel, Alexandra; Van Waelvelde, Hilde; Dhooge, Ingeborg

    2014-01-01

    Vertigo and imbalance are often underestimated in the pediatric population, due to limited communication abilities, atypical symptoms, and relatively quick adaptation and compensation in children. Moreover, examination and interpretation of vestibular tests are very challenging, because of difficulties with cooperation and maintenance of alertness, and because of the sometimes nauseatic reactions. Therefore, it is of great importance for each vestibular laboratory to implement a child-friendly test protocol with age-appropriate normative data. Because of the often masked appearance of vestibular problems in young children, the vestibular organ should be routinely examined in high-risk pediatric groups, such as children with a hearing impairment. Purposes of the present study were (1) to determine age-appropriate normative data for two child-friendly vestibular laboratory techniques (rotatory and collic vestibular evoked myogenic potential [cVEMP] test) in a group of children without auditory or vestibular complaints, and (2) to examine vestibular function in a group of children presenting with bilateral hearing impairment. Forty-eight typically developing children (mean age 8 years 0 months; range: 4 years 1 month to 12 years 11 months) without any auditory or vestibular complaints as well as 39 children (mean age 7 years 8 months; range: 3 years 8 months to 12 years 10 months) with a bilateral sensorineural hearing loss were included in this study. All children underwent three sinusoidal rotations (0.01, 0.05, and 0.1 Hz at 50 degrees/s) and bilateral cVEMP testing. No significant age differences were found for the rotatory test, whereas a significant increase of N1 latency and a significant threshold decrease was noticeable for the cVEMP, resulting in age-appropriate normative data. Hearing-impaired children demonstrated significantly lower gain values at the 0.01 Hz rotation and a larger percentage of absent cVEMP responses compared with normal-hearing children

  6. Anterograde Intra-Arterial Urokinase Injection for Salvaging Fibular Free Flap

    Directory of Open Access Journals (Sweden)

    Dae-Sung Lee

    2013-05-01

    Full Text Available We present a case of a 57-year-old male patient who presented with squamous cell carcinoma on his mouth floor with cervical and mandibular metastases. Wide glossectomy with intergonial mandibular ostectomy, and sequential reconstruction using fibular osteomyocutaneous free flap were planned. When the anastomosis between the peroneal artery of the fibular free flap and the right lingual artery was performed, no venous flow was observed at the vena comitans. Then re-anastomosis followed by topical application of papaverine and lidocaine was attempted. However, the blood supply was not recovered. Warm saline irrigation over 30 minutes was also useless. Microvascular thromboses of donor vessels were clinically suspected, so a solution of 100,000 units of urokinase was infused once through a 26-gauge angiocatheter inserted into the recipient artery just at the arterial anastomotic site, until the solution gushed out through the flap vena comitans. Immediately after the application of urokinase, arterial flow and venous return were restored. There were no complications during the follow-up period of 11 months. We believe that vibrating injuries from the reciprocating saw during osteotomies and flap insetting might be the cause of microvascular thromboses. The use of urokinase may provide a viable option for the treatment of suspicious intraoperative arterial thrombosis.

  7. Comparison of four different nerve conduction techniques of the superficial fibular sensory nerve.

    Science.gov (United States)

    Saffarian, Mathew R; Condie, Nathan C; Austin, Erica A; Mccausland, Katie E; Andary, Michael T; Sylvain, James R; Mull, Iian R; Zemper, Eric D; Jannausch, Mary L

    2017-09-01

    There are many different nerve conduction study (NCS) techniques to study the superficial fibular sensory nerve (SFSN). We present reference distal latency values and comparative data regarding 4 different NCS for the SFSN. Four different NCS techniques, Spartan technique, Izzo techniques (medial and intermediate dorsal cutaneous branches), and Daube technique, were performed on (114) healthy volunteers. A total of 108 subjects with 164 legs were included. The mean latency of the Spartan technique was longest (3.9 ± 0.3 ms) while the Daube technique was the shortest (3.6 ± 0.7 ms). The mean amplitude of the Daube technique displayed the highest (15.2 ± 8.2 μV) with the Spartan technique having the lowest (8.7 ± 4.2 μV). Among the absent sensory nerve action potentials (SNAPs), the Spartan technique was absent only twice (1.2%) and the Izzo Medial technique was absent more than the other techniques (2.9%). All 4 techniques were reliable methods for obtaining the superficial fibular nerve SNAP, present in 95% of individuals. Muscle Nerve 56: 458-462, 2017. © 2017 Wiley Periodicals, Inc.

  8. Nonvascularized fibular grafting in nonunion of femoral neck fracture: A systematic review

    Directory of Open Access Journals (Sweden)

    Sujit Kumar Tripathy

    2016-01-01

    Full Text Available Nonunion of femoral neck fractures following primary fixation and neglected femoral neck fracture in young adults is a challenging task. Every effort should be directed toward hip joint salvage in these patients. Among different available options of hip salvage, nonvascularized fibular graft (NVFG osteosynthesis is simple, easy to perform, and a successful technique. In this review, the available literature on NVFG in neglected and nonunion femoral neck fractures has been analyzed. After review of 15 articles on NVFG, the average nonunion rate was estimated to be 7.86% (range 0-31%. Six articles that evaluated the preoperative and postoperative osteonecrosis reported improvement in 50% patients. The clinical and/or functional outcome was good to excellent in 56-96% patients following fibular osteosynthesis. Few complications such as coxa vara deformity, limb shortening, and intraarticular penetration of the graft or hardware have been reported. However, there are minimal donor site morbidities such as mild ankle pain, transient loss of toe flexors and extensors and transient lateral popliteal nerve palsy.

  9. Lateral femoral notch depth is not associated with increased rotatory instability in ACL-injured knees: a quantitative pivot shift analysis.

    Science.gov (United States)

    Kanakamedala, Ajay C; Burnham, Jeremy M; Pfeiffer, Thomas R; Herbst, Elmar; Kowalczuk, Marcin; Popchak, Adam; Irrgang, James; Fu, Freddie H; Musahl, Volker

    2018-05-01

    A deep lateral femoral notch (LFN) on lateral radiographs is indicative of ACL injury. Prior studies have suggested that a deep LFN may also be a sign of persistent rotatory instability and a concomitant lateral meniscus tear. Therefore, the purpose of this study was to evaluate the relationship between LFN depth and both quantitative measures of rotatory knee instability and the incidence of lateral meniscus tears. It was hypothesized that greater LFN depth would be correlated with increased rotatory instability, quantified by lateral compartment translation and tibial acceleration during a quantitative pivot shift test, and incidence of lateral meniscus tears. ACL-injured patients enrolled in a prospective ACL registry from 2014 to 2016 were analyzed. To limit confounders, patients were only included if they had primary ACL tears, no concurrent ligamentous or bony injuries requiring operative treatment, and no previous knee injuries or surgeries to either knee. Eighty-four patients were included in the final analysis. A standardized quantitative pivot shift test was performed pre-operatively under anesthesia in both knees, and rotatory instability, specifically lateral compartment translation and tibial acceleration, was quantified using tablet image analysis software and accelerometer sensors. Standard lateral radiographs and sagittal magnetic resonance images (MRI) of the injured knee were evaluated for LFN depth. There were no significant correlations between LFN depth on either imaging modality and ipsilateral lateral compartment translation or tibial acceleration during a quantitative pivot shift test or side-to-side differences in these measurements. Patients with lateral meniscus tears were found to have significantly greater LFN depths than those without on conventional radiograph and MRI (1.0 vs. 0.6 mm, p quantitative measures of rotatory instability. Concomitant lateral meniscus injury was associated with significantly greater LFN depth. Based on

  10. 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

  11. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

    Science.gov (United States)

    Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

    2017-02-01

    Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

  12. The anterolateral supra-fibular-head approach for plating posterolateral tibial plateau fractures: A novel surgical technique.

    Science.gov (United States)

    Hu, Sun-Jun; Chang, Shi-Min; Zhang, Ying-Qi; Ma, Zhuo; Du, Shou-Chao; Zhang, Kai

    2016-02-01

    The posterolateral (PL) tibial plateau quadrant is laterally covered by the fibular head and posteriorly covered by a mass of muscle ligament and important neurovascular structures. There are several limitations in exposing and fixing the PL tibial plateau fractures using a posterior approach. The aim of this study is to present a novel anterolateral supra-fibular-head approach for plating PL tibial plateau fractures. Five fresh and ten preserved knee specimens were dissected to measure the following parameters:1) the vertical distance from the apex of the fibular head to the lateral plateau surface, 2) the transverse distance between the PL platform and fibula collateral ligament (FCL), and 3) the tension of the FCL in different knee flexion positions. Clinically, isolated PL quadrant tibial plateau fractures were treated via an anterolateral supra-fibular-head approach and lateral rafting plate fixation. The outcome of the patients was assessed after a short to medium follow-up period. The distance from the apex of the fibular head to the lateral condylar surface was 12.2 ± 1.6 mm on average. With the knee extended and the FCL tensioned, the transverse distance between the PL platform and the FCL was 6.7 ± 1.1 mm. With the knee flexed to 60° and the FCL was in the most relaxed position, the distance increased to 21.1 ± 3.0 mm. Clinically, a series of 7 cases of PL tibial plateau fractures were treated via this anterolateral supra-fibular-head approach. The patient was placed in a lateral decubitus position with the knee flexed to approximately 60 degrees. After the posterior retraction of the FCL, the plate was placed more posteriorly to provide a raft or horizontal belt fixation of the PL tibial plateau fragment. After an average of 14.3 months of follow up, the knee range of motion(ROM) was 121.4° ± 8.8° (range: 105°-135°), the HSS score was 96.7 ± 2.6 (range: 90-100), and the SMFA dysfunction score was 22.4 ± 3.8 (range: 16-28) points. The

  13. The fibular head projection is of limited use as a radiographic landmark in preoperative planning of total knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Matziolis, Doerte; Meiser, Marius; Matziolis, Georg [University Hospital Jena, Orthopedic Department, Eisenberg (Germany); Sieber, Norbert [Radiology Practice Eisenberg, Eisenberg (Germany); Teichgraeber, Ulf [University Hospital Jena, Institute of Diagnostic and Interventional Radiology, Eisenberg (Germany)

    2017-10-15

    The projection of the fibular head is recommended as a quality indicator of a correct radiographic projection. However, this landmark has yet to be sufficiently validated. The MRIs of 334 knee joints were included. On the MRIs, the distance between the FH and lateral tibial cortical bone was simulated in projections parallel to surgically relevant axes. Then, the Pearson correlation coefficient between the distance of the FH to the lateral tibial cortical bone and the projection plane causing this was determined. A projection of the knee joint perpendicular to Akagi's line projected the center of the fibular head on average 4.8 ± 2.9 mm laterally of the tibial cortical bone, parallel to the maximum mediolateral axis of the tibia 7.5 ± 3.4 mm, parallel to the posterior condylar axis 5.6 ± 3.6 mm and parallel to the surgical epicondylar axis 6.1 ± 3.5 mm laterally of the tibial cortical bone. An almost linear correlation was seen, with 1.9 tilting of the projection plane per mm change in distance between the fibular head and tibial cortical bone. At the same time, the interindividual scatter was over 60 . The rule of thumb for a partial overlap of the fibular head by the tibia in the case of a correct antero-posterior projection plane was also confirmed. However, a considerable interindividual variability of the position of the FH was found, which limits a conclusion regarding the quality of the radiographic projection on the basis of the position of the fibular head. (orig.)

  14. Ilizarov bone transport versus fibular graft for reconstruction of tibial bone defects in children.

    Science.gov (United States)

    Abdelkhalek, Mostafa; El-Alfy, Barakat; Ali, Ayman M

    2016-11-01

    The aim of this study was to compare the results of treatment of segmental tibial defects in the pediatric age group using an Ilizarov external fixator versus a nonvascularized fibular bone graft. This study included 24 patients (age range from 5.5 to 15 years) with tibial bone defects: 13 patients were treated with bone transport (BT) and 11 patients were treated with a nonvascularized fibular graft (FG). The outcome parameters were bone results (union, deformity, infection, leg-length discrepancy) and functional results: external fixation index and external fixation time. In group A (BT), one patient developed refracture at the regenerate site, whereas, in group B (FG), after removal of the external fixator, one of the FGs developed a stress fracture. The external fixator time in group A was 10.7 months (range 8-14.5) versus 7.8 months (range 4-11.5 months) in group B (FG). In group A (BT), one patient had a limb-length discrepancy (LLD), whereas, in group B (FG), three patients had LLD. The functional and bone results of the Ilizarov BT technique were excellent in 23.1 and 30.8%, good in 38.5 and 46.2, fair in 30.8 and 15.4, and poor in 7.6 and 7.6%, respectively. The poor functional result was related to the poor bone result because of prolonged external fixator time resulting in significant pain, limited ankle motion, whereas the functional and bone results of fibular grafting were excellent in 9.1 and 18.2%, good in 63.6 and 45.5%, fair in 18.2 and 27.2%, and poor in 9.1 and 9.1%, respectively. Segmental tibial defects can be effectively treated with both methods. The FG method provides satisfactory results, with early removal of the external fixator. However, it had a limitation in patients with severe infection and those with LLD. Also, it requires a long duration of limb bracing until adequate hypertrophy of the graft. The Ilizarov method has the advantages of early weight bearing, treatment of postinfection bone defect in a one-stage surgery, and the

  15. Multi-fasciculated anterior talo-fibular ligament: reassessment of normal findings

    Energy Technology Data Exchange (ETDEWEB)

    Delfaut, E.M.; Boutry, N.; Cotten, A. [Department of Musculo-Skeletal Radiology, Roger Salengro Hospital, CHRU Lille, Bd du Professeur Jules Leclercq, 59037, Lille (France); Demondion, X. [Department of Musculo-Skeletal Radiology, Roger Salengro Hospital, CHRU Lille, Bd du Professeur Jules Leclercq, 59037, Lille (France); Department of Anatomy, Faculty of Medicine, Roger Salengro Hospital, CHRU Lille, Place de Verdun, 59037, Lille Cedex (France); Cotten, H. [Pathology Laboratory, 128 Bd de la Liberte, 59000, Lille (France); Mestdagh, H. [Department of Orthopaedic Surgery, Roger Salengro Hospital, CHRU Lille, Bd du Professeur Jules Leclercq, 59037, Lille Cedex (France)

    2003-08-01

    The aims of this study were to (a) provide an accurate description of the anterior talo-fibular ligament (ATFL) multifasciculated feature by means of cadaver study, and (b) to further delineate contour and signal variations on MR images related to this feature in a group of asymptomatic subjects. After MR imaging, three cadaveric feet were frozen and cut in the coronal plane. The ATFL were harvested and sent to pathology. Another cadaveric foot was dissected. The MR imaging was performed in 3 healthy volunteers and 19 patients without pathology of the ATFL. For both cadaveric feet and subjects, MR imaging protocol consisted of axial and coronal proton-density (PD) and T2-weighted turbo-spin-echo (TSE) sequences (TR/TE: 3500 ms/17-119 ms). On MR images, ATFL signal and fascicle numbers were assessed, respectively, in the axial and coronal planes. Gross anatomy and pathology confirmed the ATFL bifasciculated aspect. On cadaveric coronal MR images, 3 of 4 ATFLs were bifasciculated and one of four was striated. On patients' coronal MR images, 2 of 22 of the ATFL were monofasciculated, 12 of 22 bifasciculated, and 8 of 22 striated. On axial MR images, 16 of 22 of the ATFL demonstrated a low signal intensity and 8 of 22 an intraligamentous subtle increased signal intensity. Two of 22 of the ATFL had contour irregularities. Isolated anterior talo-fibular intraligamentous signal abnormalities or contour irregularities on axial PD and T2-weighted MR images with an otherwise normal ATFL aspect on coronal MR images and no other MRI criteria for ankle sprain may reflect normal anatomy. (orig.)

  16. Multi-fasciculated anterior talo-fibular ligament: reassessment of normal findings

    International Nuclear Information System (INIS)

    Delfaut, E.M.; Boutry, N.; Cotten, A.; Demondion, X.; Cotten, H.; Mestdagh, H.

    2003-01-01

    The aims of this study were to (a) provide an accurate description of the anterior talo-fibular ligament (ATFL) multifasciculated feature by means of cadaver study, and (b) to further delineate contour and signal variations on MR images related to this feature in a group of asymptomatic subjects. After MR imaging, three cadaveric feet were frozen and cut in the coronal plane. The ATFL were harvested and sent to pathology. Another cadaveric foot was dissected. The MR imaging was performed in 3 healthy volunteers and 19 patients without pathology of the ATFL. For both cadaveric feet and subjects, MR imaging protocol consisted of axial and coronal proton-density (PD) and T2-weighted turbo-spin-echo (TSE) sequences (TR/TE: 3500 ms/17-119 ms). On MR images, ATFL signal and fascicle numbers were assessed, respectively, in the axial and coronal planes. Gross anatomy and pathology confirmed the ATFL bifasciculated aspect. On cadaveric coronal MR images, 3 of 4 ATFLs were bifasciculated and one of four was striated. On patients' coronal MR images, 2 of 22 of the ATFL were monofasciculated, 12 of 22 bifasciculated, and 8 of 22 striated. On axial MR images, 16 of 22 of the ATFL demonstrated a low signal intensity and 8 of 22 an intraligamentous subtle increased signal intensity. Two of 22 of the ATFL had contour irregularities. Isolated anterior talo-fibular intraligamentous signal abnormalities or contour irregularities on axial PD and T2-weighted MR images with an otherwise normal ATFL aspect on coronal MR images and no other MRI criteria for ankle sprain may reflect normal anatomy. (orig.)

  17. Free fibular strut graft in neglected femoral neck fractures in adult

    Directory of Open Access Journals (Sweden)

    Azam Md Quamar

    2009-01-01

    Full Text Available Background: Neglected femoral neck fracture in adults still poses a formidable challenge. Existing treatment options varies from osteotomy (with or without graft to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and nonvascularized fibula. The aim of this study was to assess outcome of nonvascularized fibular strut graft and cancellous screw fixation in neglected femoral neck fractures in the younger age group. Materials and Methods: Medical records of 32 patients of neglected femoral neck fracture, in the age group of 22-45 years (mean 37.8 years, operated between May 1994 to December 2001, were retrospectively reviewed. After the application of inclusion and exclusion criteria, 28 patients having three years minimum follow-up (mean 4.6 years were included. Delay between injury and operation varied from four weeks to 42 weeks (mean 16.4 weeks. Closed reduction was achieved in 17 patients; open reduction through Watson-Jones anterolateral approach was performed in the remaining 15 patients in whom closed reduction failed. The fracture was transfixed with three parallel guide wires. Appropriate sized cannulated lag screw (7 mm was then inserted in two of the wires. Selection of the third guide wire for fibula depended on the space available in both anteroposterior and lateral view. Results: Satisfactory bony union was obtained in 25 patients, of whom in four cases, the union occurred in 10-20° (mean 15° of varus. Nonunion occurred in three patients (9.37%, and aseptic necrosis occurred in another six patients (18.75%. Of the 25 patients where union was achieved, five patients showed excellent results; 14 good and six had poor functional result, as evaluated using modified Anglen criteria. Conclusion: Nonvascularized fibular strut graft along with cancellous screws provides a dependable and technically less-demanding alternative procedure for neglected femoral neck fractures in young adults. Fibula

  18. Oral rehabilitation with dental implants and quality of life following mandibular reconstruction with free fibular flap.

    Science.gov (United States)

    Jacobsen, Hans-Christian; Wahnschaff, Falko; Trenkle, Thomas; Sieg, Peter; Hakim, Samer G

    2016-01-01

    Bony reconstruction of jaw defects using the free fibular flap and dental rehabilitation mostly requires insertion of dental implants within the transferred fibula bone. The aim of this paper was to discuss results of the implant stability with data on the possible benefit for the patient's quality of life after such treatment. For clinical outcome of implants, we evaluated 26 patients with a total number of 94 dental implants after a follow-up period of 12 to 132 months. A group of 38 patients who underwent mandibular reconstruction with free fibular flap could be included in the life-quality study. Evaluation included 23 patients with and 15 patients without implant-borne restoration. The quality of life was assessed using the standard QLQ C-30 questionnaire and the H&N35 module of the European Organisation for Research and Treatment of Cancer (EORTC). Of implants, 94.7 % were stable at the time of investigation and could be used for prosthesis. Patients with dental implants reported improvement of life quality along with better scores in most function and symptom scales; however, only values for global health status (QL2), absence of dyspnea (DY) and absence of feeding tube (HNFE) were significantly better than in the control group. Dental implant insertion in fibula grafts along with implant-borne restoration is a proven concept and might lead to improved quality of life following ablative surgery of the jaw. The effect on the quality of life is not as predictable as on the implant stability. Patients with bony defects of the jaw require bony reconstruction. This allows further masticatory rehabilitation using dental implants and might lead to improved quality of life.

  19. Treatment of osteonecrosis of the femoral head by free vascularized fibular grafting: an analysis of surgical outcome and patient health status

    Science.gov (United States)

    Louie, Brian E.; McKee, Michael D.; Richards, Robin R.; Mahoney, James L.; Waddell, James P.; Beaton, Dorcas E.; Schemitsch, Emil H.; Yoo, Daniel J.

    1999-01-01

    Objective To evaluate the limb-specific outcome and general health status of patients with osteonecrosis of the femoral head treated with vascularized fibular grafting. Design A retrospective review. Setting A single tertiary care centre. Patients Fifty-five consecutive patients with osteonecrosis of the femoral head who underwent fibular grafting (8 bilaterally). Intervention Vascularized fibular grafting. Outcome measures Limb-specific scores (Harris Hip Score, St. Michael’s Hospital Hip Score), general health status (Nottingham Health Profile, SF-36 health status survey) and radiographic outcome measures (Steinberg stage). Results Patients were young (mean age 34 years, range from 18 to 52 years) and 80% had advanced osteonecrosis (Steinberg stages IV and V). Fifty-nine hips were followed up for an average of 50 months (range from 24 to 117 months) after vascularized fibular grafting. Sixteen hips (27%) were converted to total hip arthroplasty (THA). To date, 73% of hips treated with vascularized fibular grafting have required no further surgery. Preoperative and postoperative Harris Hip Scores were 57.3 and 83.6 respectively (p < 0.001). As measured by patient-oriented health status questionnaires (SF-36, Nottingham Health Profile) and compared with population controls, patients had normal mental health scores and only slight decreases in physical component scores. Conclusions Free vascularized fibular grafting for osteonecrosis of the femoral head provides satisfactory pain relief, functional improvement and general health status and halts the progression of symptomatic disease. PMID:10459327

  20. Arteria Tibial Anterior Hipoplásica Asociada con la Continuación de la Arteria Fibular como Arteria Dorsal del Pié: Un Reporte de Caso

    OpenAIRE

    Shetty, Surekha D; Nayak, Satheesha; Kumar, Naveen; Abhinitha, P

    2013-01-01

    Arterial variations of distal parts of lower limb are well documented. However, continuation of fibular artery as dorsalis pedis artery is a rare finding. Unusual course and distribution of the anterior tibial artery and fibular artery were observed during routine anatomical dissection of the right lower limb of an approximately 40-year-old male cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However the anterior tibial artery was hypoplastic. The fibular...

  1. Vibration analysis of carbon nanotubes-based zeptogram masses sensors and taking into account their rotatory inertia

    Directory of Open Access Journals (Sweden)

    Azrar A.

    2018-01-01

    Full Text Available In this research work, the transverse vibration behaviour of single-walled carbon nanotubes (SCNT based mass sensors is studied using the Timoshenko beam and nonlocal elasticity theories. The nonlocal constitutive equations are used in the formulations and the CNT with different lengths, attached mass (viruses and bacteria and the general boundary conditions are considered. The dimensionless frequencies and associated modes are obtained for one and two attached masses and different boundary conditions. The effects of transverse shear deformation and rotatory inertia, nonlocal parameter, length of the carbon nanotubes, and attached mass and its location are investigated in detail for each considered problem. The relationship between the frequencies and mode shapes of the sensor and the attached zeptogramme masses are obtained. The sensing devices for biological objects including viruses and bacteria can be elaborated based on the developed sensitivity and frequency shift methodological approach.

  2. Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

    Directory of Open Access Journals (Sweden)

    Singh Daria

    2006-01-01

    Full Text Available Background: Ununited fracture neck of femur in young adults has been tackled in various ways. Methods: Twenty five patients of ununited fracture neck of femur in age group 21-55 years were treated by closed reduction, cancellous screw fixation and fibular strut graft and followed up for 2-6 years. Time gap between injury and operation was 6 weeks to 58 weeks. Five cases were previously fixed with various fixation devices. Results: Osseous union was achieved in 24 cases with average time of 18.16 weeks. Main complication encountered in follow-up was avascular necrosis of femoral head, others were joint stiffness and shortening. Functional end results were good to excellent in 24 cases. Conclusion: Closed reduction with internal fixation by cancellous screw and fibular strut grafting is easy and useful procedure.

  3. Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

    Directory of Open Access Journals (Sweden)

    Miguel de la Parra

    2013-11-01

    Full Text Available Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence.

  4. Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

    Science.gov (United States)

    Sanchez, Gerardo; Lopez, Jaime; Perez, Adrian; Naal, Norberto

    2013-01-01

    Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence. PMID:24286054

  5. 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.

  6. Failed vascularized proximal fibular epiphyseal transfer for hip reconstruction following infection in children.

    Science.gov (United States)

    Debarge, Romain; Chotel, Franck; Gazarian, Aram; Viola, Jérémy; Berard, Jérôme

    2009-08-01

    Treatment of the sequellae of hip infection with epiphyseal destruction in children has had limited success to date. The aim of this study was to report mid-term results after hip epiphyseal reconstruction using a proximal vascularized fibular graft in three children presenting with massive epiphyseal destruction of the proximal femur following infection. Three children suffered from hip articular destruction type IVB according to the Choi classification after neonatal septic arthritis. The mean age at reconstruction was 4.3 years (range 3-6 years). The Hunka et al. criteria were used to evaluate the functional results, and the clinical evaluation was based on the Musculo-Skeletal Tumor Society (MSTS) score. Growth and fusion of the graft and hip morphology were evaluated on simple X-rays and by magnetic resonance imaging (MRI). A ratio between cephalic diameter and inter-acetabular gap was defined on the MRI scan as the "acetabular filling index". No intraoperative complication was reported. With a mean follow-up of 4.8 years (3-6 years), the MSTS score was 22.7/30 (range 20-26), while the average lower limb length discrepancy was 3 cm. Patient 1 required a secondary derotation osteotomy of the femur because of abnormal external rotation and a bad result due to the unexplained occurrence of a painful and stiff hip joint. A secondary distal transfer of the greater trochanter was performed in patient 2, and good results based on Hunka et al.'s criteria were achieved. The X-rays of patients 1 and 2 showed signs of bone growth and a major remodeling process; the MRI filling indices were 83 and 67%, respectively. Patient 3 developed an early slipped capital (fibular) epiphysis 1 month postoperatively, which was treated by percutaneous pinning; this early complication led to a bad result with full resorption of the graft. In contrast to its success in upper limb reconstruction, in this series of three patients with hip articular destruction, articular reconstruction

  7. [Tibia reconstruction using cross-leg pedicled fibular flaps: report of two cases].

    Science.gov (United States)

    Molski, M

    2000-01-01

    The paper presents the results of treatment of two children with cross-leg pedicle fibular flaps. A boy (10 years old) was operated because of an extensive defect of the proximal tibial shaft (15 cm) and soft tissue deficit due to osteosarcoma. He had been previously operated several times: tumor resection with chemiotherapy, bone reconstruction using allografts and two other procedures because of inflammatory complications. The second case was a 9-year old girl who underwent an extensive excision of congenital pseudoarthrosis of the tibia due to neurofibroma and reconstruction of the further fragment of the tibia. Vascularized fibula was nailed deep into the tibial shaft, beyond the previously implanted metal elements. This allowed to maintain a correct axis of the limb, a firm stabilization of the transplant and probably evoked a quick periosteal reaction of the tibia. Plaster of Paris was used to immobilize the limb. Postoperative course showed no complications. The flap pedicle was cut off after 3-4 weeks. Progressive bone healing followed by bony hypertrophy was observed after 8 weeks. The children were able to fully load the operated extremities and ambulate without crutches (the boys 12 months post-surgery and the girl 6 months post-surgery).

  8. A-Frame free Vascularized Fibular Graft and Femoral Lengthening for Osteosarcoma Pediatric Patients.

    Science.gov (United States)

    Cashin, Megan; Coombs, Christopher; Torode, Ian

    2018-02-01

    Pediatric limb reconstruction after resection of a malignant tumor presents specific challenges. Multiple surgical techniques have been used to treat these patients. This paper describes a staged surgical technique for the reconstruction of large distal femoral defects due to tumor resection in skeletally immature patients. Three pediatric patients with osteosarcoma of the distal femur underwent staged reconstruction. Neoadjuvant chemotherapy was followed by en bloc tumor resection and immediate reconstruction of the distal femoral defect with a vascularized free fibular autograft utilizing a unique A-frame construct combined with intramedullary nail fixation. The second stage was a planned gradual lengthening of the healed construct, over a custom-made magnetically driven expandable intramedullary nail. All patients achieved bony union and satisfactory length with minimal complications. The patients all returned to full, unlimited physical activities. The early results confirm that the described technique is a safe and reliable procedure for the reconstruction of large femoral defects in pediatric patients with osteosarcoma. Level IV-therapeutic.

  9. 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.

  10. [How to make your own custom cutting guides for both mandibular and fibular stair step osteotomies?

    Science.gov (United States)

    Rem, K; Bosc, R; De Kermadec, H; Hersant, B; Meningaud, J-P

    2017-12-01

    Using tailored cutting guides for osteocutaneous free fibula flap in complex mandibular reconstruction after cancer resection surgery constitutes a substantial improvement. Autonomously conceiving and manufacturing the cutting guides within a plastic surgery department with computer-aided design (CAD) and three-dimensional (3D) printing allows planning more complex osteotomies, such as stair-step osteotomies, in order to achieve more stable internal fixations. For the past three years, we have been producing by ourselves patient-tailored cutting guides using CAD and 3D printing. Osteotomies were virtually planned, making the cutting lines more complex in order to optimize the internal fixation stability. We also printed reconstructed mandible templates and shaped the reconstruction plates on them. We recorded data including manufacturing techniques and surgical outcomes. Eleven consecutive patients were operated on for an oral cavity cancer. For each patient, we planned the fibular and mandibular stair-step osteotomies and we produced tailored cutting guides. In all patients, we achieved to get immediately stable internal fixations and in 10 patients, a complete bone consolidation after 6 months. Autonomously manufacturing surgical cutting guides for mandibular reconstruction by free fibula flap is a significant improvement, regarding ergonomics and precision. Planning stair-step osteotomies to perform complementary internal fixation increases contact surface and congruence between the bone segments, thus improving the reconstructed mandible stability. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Vascularised and modified lower-leg rotationplasty for the treatment of severe infection and bone loss of the proximal femur: a case report.

    Science.gov (United States)

    Fischer, Sebastian; Hirche, Christoph; Heppert, Volkmar G; Grützner, Paul A; Kneser, Ulrich; Kremer, Thomas

    2017-09-19

    We report a reconstructive case in a paraplegic patient, who suffers from a severe proximal femur infection. Aiming at the preservation of the capacity to remain in a seated position to operate a wheelchair, lower leg rotationplasty was considered suitable for reconstruction. Due to severe infection and subclinical femoral artery stenosis, rotationplasty was supercharged by the inferior epigastric artery. Furthermore, extensor tendons of the foot were attached to the acetabulum to facilitate stability of the neo-hip joint. Follow-up examination 1 year after surgery revealed no complications and a satisfied patient. Especially in paraplegic patients, lower leg rotationplasty is a possible treatment option for severe femoral infection. Supercharging provides well-vascularised tissue to the former infection site and improves wound healing.

  12. Ipsilateral vascularised ulnar transposition autograft for limb-sparing surgery of the distal radius in 2 dogs with osteosarcoma : clinical communication

    Directory of Open Access Journals (Sweden)

    G.S. Irvine-Smith

    2006-06-01

    Full Text Available Canine osteosarcoma is the most commonly diagnosed primary bone tumour in the dog, affecting mainly large and giant breed dogs with the predilection site being the metaphysis of long bones, specifically the distal radius, proximal humerus, distal femur and proximal tibia and fibula. Treatment options are either palliative or curative intent therapy, the latter limb amputation or limb-sparing surgery together with chemotherapy. This article describes the use of an ipsilateral vascularised ulnar transposition autograft as well as chemotherapy in 2 dogs with osteosarcoma of the distal radius. Both dogs showed minimal complications with the technique and both survived over 381 days following the surgery. Complications seen were loosening of the screws and osteomyelitis. The procedure was well tolerated with excellent limb use. This technique is indicated for use in cases with small tumour size that have not broken through the bone cortex.

  13. Performance evaluation of a rotatory dual-head PET system with 90o increments for small animal imaging

    Science.gov (United States)

    Meng, F.; Zhu, S.; Li, L.; Wang, J.; Cao, X.; Cao, X.; Chen, X.; Liang, J.

    2017-09-01

    A rotatory dual-head positron emission tomography (PET) system with 90o increments has been built up by our lab. In this study, a geometric calibration phantom was designed and then used to calibrate the geometric offset of the system. With the geometric calibration, the artifacts in the reconstructed images were greatly eliminated. Then, we measured the imaging performance including resolution, sensitivity and image quality. The results showed that the full width at half maximum (FWHMs) of the point source were about 1.1 mm in three directions. The peak absolute sensitivity in the center of the field of view varied from 5.66% to 3.17% when the time window was fixed to 10 ns and the energy window was changed from 200-800 keV to 350-650 keV. The recovery coefficients ranged from 0.13 with a standard deviation of 17.5% to 0.98 with a standard deviation of 15.76%. For the air-filled and water-filled chamber, the spill-over ratio was 14.48% and 15.38%, respectively. The in vivo mouse experiment was carried out and further demonstrated the potential of our system in small animal studies.

  14. Performance evaluation of a rotatory dual-head PET system with 90o increments for small animal imaging

    International Nuclear Information System (INIS)

    Meng, F.; Zhu, S.; Li, L.; Wang, J.; Cao, X.; Cao, X.; Chen, X.; Liang, J.

    2017-01-01

    A rotatory dual-head positron emission tomography (PET) system with 90 o increments has been built up by our lab. In this study, a geometric calibration phantom was designed and then used to calibrate the geometric offset of the system. With the geometric calibration, the artifacts in the reconstructed images were greatly eliminated. Then, we measured the imaging performance including resolution, sensitivity and image quality. The results showed that the full width at half maximum (FWHMs) of the point source were about 1.1 mm in three directions. The peak absolute sensitivity in the center of the field of view varied from 5.66% to 3.17% when the time window was fixed to 10 ns and the energy window was changed from 200-800 keV to 350–650 keV. The recovery coefficients ranged from 0.13 with a standard deviation of 17.5% to 0.98 with a standard deviation of 15.76%. For the air-filled and water-filled chamber, the spill-over ratio was 14.48% and 15.38%, respectively. The in vivo mouse experiment was carried out and further demonstrated the potential of our system in small animal studies.

  15. Effect of fibular repositioning taping in adult basketball players with chronic ankle instability: a randomized, placebo-controlled, crossover trial.

    Science.gov (United States)

    Alves, Yanina; Ribeiro, Fernando; Silva, Anabela G

    2017-07-05

    Chronic ankle instability presents a high incidence and prevalence in basketbal players. It's important to develop strategies to reduce the functional and mechanical limitations resulting from this condition. To compare the effect of Mulligan ́s fibular repositioning taping with a placebo taping immediatly after application and after a running test (Yo-Yo IRT). 16 adult basketball players (10 male, 6 female) with chronic ankle instability and mean age 21.50 ± 2.76 years old. Assessment of static postural control (15 seconds of unipedal stance test with eyes closed in a force platform), functional performance (figure 8 hop test and lateral hop test) and neuromuscular control (peroneus longus latency time in sudden inversion) in two conditions: Mulligan and Placebo. No significant effect was found for the intervantion factor in both hop tests (p>0.170), but there was a significant effect for the time factor (p<0.03). For the peroneus longus latency time, there was a significant interaction between factors (p=0.028) and also for time (p=0.042). No significant effect was found for any of the static postural control variables (area, speed and total displacement) (p≥0.10). There was no differences between Mulligan's fibular repositioning taping and Placebo taping in postural control and functional performance in basketball players with chronic ankle instability. However, Mulligan's taping appears to reduce peroneus longus latency time after a running when compared with a placebo taping.

  16. Total Maxillary Reconstruction With a Bi-Paddle Double-Barrel Osteocutaneous Fibular Flap and Arteriovenous Saphenous Loop After a Globe-Sparing Total Maxillectomy Due to Osteosarcoma.

    Science.gov (United States)

    Tseng, Wan-Ling; Chang, Tzu-Yen; Hung, Kuo-Shu; Chen, Szu-Han; Hsiao, Jenn-Ren; Lee, Yao-Chou

    2017-01-01

    The titanium mesh or bone graft is usually used for orbital support after a globe-sparing total maxillectomy. However, its use can invite complications, such as infection, exposure, and absorption, especially for patients who require adjuvant radiotherapy. Here, the authors present a patient who received total maxillary reconstruction with an osteocutaneous fibular flap. A 53-year-old man with the diagnosis of maxillary osteosarcoma received a globe-sparing total maxillectomy. A bi-paddle double-barrel osteocutaneous fibular flap was used for orbital support, alveolar ridge recreation, and oro-sino-nasal separation. The short pedicle length inherent in the double-barrel design of the fibular flap was overcome by creating an arteriovenous saphenous loop. The postoperative recovery was uneventful. During the 9 months follow-up, the patient was tumor-free and satisfied with his appearance, speech, and intake functions. Reconstruction with a bi-paddle double-barrel osteocutaneous fibular flap after a globe-sparing total maxillectomy can achieve satisfactory aesthetic and functional results.

  17. Osteocutaneous Free Fibular Flap for Anatomical Reconstruction of the Mandible Following Tumor Resection

    International Nuclear Information System (INIS)

    Amin, A.A.

    2003-01-01

    The development of microvascular free tissue transfer has revolutionized the current approaches for mandible reconstruction. It allowed one stage reconstruction of complex bony and soft tissue defects with high reliability. This study presents our experience using vascularized free fibular graft for reconstruction of different anatomical mandibular defects following tumor ablation. Methods: This study involves a total of 16 patients who were treated over 3-year period at the National Cancer Institute, Cairo University. All patients underwent mandibular resection and immediate reconstruction using free fibula osteocutaneous flap. Mandibular resections were performed due to either primary mandibular tumors, or tumors directly invading the mandible from adjacent areas. The extent of mandibular involvement by tumor was preoperatively assessed by X-ray panoramic view and CT scan. Mandibular defects were classified according to HCL system where H defects are lateral defect of any length including the condyle, L defects are the same without condyle and C defects represent the central segment between the mental foramina. The success rate, recipient vessels used, complications and functional as well as cosmetic outcome will be discussed. Results: Of sixteen patients, ten were males and 6 were females. The age ranged from 4 to 68 years. Five patients had preoperative chemotherapy; two had radiation therapy, while six patients received postoperative radiation therapy. All patients had preoperative histological diagnosis; squamous cell carcinoma was the most common histology. Mandibular defects consisted of central segment (3 C), lateral defect (9 L) and 4 patients with H defects. The skin island was used to provide inner mucosal lining in II patients and as external monitor in 5 patients. The free flap was successful in 13 patients. There were 3 complete free flap necrosis; all were due to venous thromboses. Salvage surgery was attempted in all failing flaps, however, it was

  18. [Effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation].

    Science.gov (United States)

    Ge, Qihang; Wan, Chunyou; Liu, Yabei; Ji, Xu; Ma, Jihai; Cao, Haikun; Yong, Wei; Liu, Zhao; Zhang, Ningning

    2017-08-01

    To investigate the effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation. The data of 45 cases with tibial and fibular open fractures treated by Taylor space stent fixation who meet the selection criteria between January 2015 and June 2016 were retrospectively analysed. The patients were divided into trial group (23 cases) and control group (22 cases) according to whether the axial stress stimulation was performed after operation. There was no significant difference in gender, age, affected side, cause of injury, type of fracture, and interval time from injury to operation between 2 groups ( P >0.05). The axial stress stimulation was performed in trial group after operation. The axial load sharing ratio was tested, and when the value was less than 10%, the external fixator was removed. The fracture healing time, full weight-bearing time, and external fixator removal time were recorded and compared. After 6 months of external fixator removal, the function of the limb was assessed by Johner-Wruhs criteria for evaluation of final effectiveness of treatment of tibial shaft fractures. There were 2 and 3 cases of needle foreign body reaction in trial group and control group, respectively, and healed after symptomatic anti allergic treatment. All the patients were followed up 8-12 months with an average of 10 months. All the fractures reached clinical healing, no complication such as delayed union, nonunion, or osteomyelitis occurred. The fracture healing time, full weight-bearing time, and external fixator removal time in trial group were significantly shorter than those in control group ( P good in 6 cases, fair in 3 cases, and poor in 1 case in trial group, with an excellent and good rate of 82.6%; and was excellent in 5 cases, good in 10 cases, fair in 4 cases, and poor in 3 cases in control group, with an excellent and good rate of 68.2%, showing significant difference between 2 groups ( Z =-2.146, P =0

  19. [The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation].

    Science.gov (United States)

    Bi, Hong-zheng; Yang, Mao-qing; Tan, Yuan-chao; Fu, Song

    2008-07-01

    To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture. All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups. After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (Pmanual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.

  20. Revision allograft reconstruction of the lateral collateral ligament complex in elbows with previous failed reconstruction and persistent posterolateral rotatory instability.

    Science.gov (United States)

    Baghdadi, Yaser M K; Morrey, Bernard F; O'Driscoll, Shawn W; Steinmann, Scott P; Sanchez-Sotelo, Joaquin

    2014-07-01

    Primary reconstruction of the lateral collateral ligament complex (LCLC) using graft tissue restores elbow stability in many, but not all, elbows with acute or chronic posterolateral rotatory instability (PLRI). Revision reconstruction using a tendon allograft is occasionally considered for persistent PLRI, but the outcome of revision ligament reconstruction in this setting is largely unknown. We determined whether revision allograft ligament reconstruction can (1) restore the stability and (2) result in improved elbow scores for patients with persistent PLRI of the elbow after a previous failed primary reconstructive attempt and in the context of the diverse pathology being addressed. Between 2001 and 2011, 160 surgical elbow procedures were performed at our institution for the LCLC reconstruction using allograft tissue. Only patients undergoing revision allograft reconstruction of the LCLC for persistent PLRI with a previous failed primary reconstructive attempt using graft tissue and at least I year of followup were included in the study. Eleven patients (11 elbows) fulfilled our inclusion criteria and formed our study cohort. The cohort consisted of six female patients and five male patients. The mean age at the time of revision surgery was 36 years (range, 14-59 years). The revision allograft reconstruction was carried out after a mean of 3 years (range, 2.5 months to 9 years) from a failed attempted reconstruction of the LCLC. Osseous deficiency to some extent was identified in the preoperative radiographs of eight elbows. Mean followup was 5 years (range, 1-12 years). Revision allograft reconstruction of the LCLC restored elbow stability in eight of the 11 elbows; two of the three elbows with persistent instability were operated on a third time (at 6 and 7 months after allograft revision reconstruction). For elbows with no persistent instability, the mean Mayo Elbow Performance Score at most recent followup was 83 points (range, 60-100 points), and

  1. Modified Grice-Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy.

    Science.gov (United States)

    Güven, Melih; Tokyay, Abbas; Akman, Budak; Encan, Mehmet E; Altintaş, Faik

    2016-03-01

    The aim of this study was to report the experience with the use of a modified Grice-Green technique, which was performed using a partial subperiosteal fibular bone graft because of valgus unstable foot in children with cerebral palsy. Fifteen feet of 11 patients were evaluated on the basis of the appearance of the feet, clinical symptoms, and radiographic measurements. After an average follow-up duration of 24 (9-39) months, all feet showed satisfactory clinical and radiological results. Solid fusion and sustained correction took place in all feet. The gap at the donor site was bridged with new bone in all cases. No donor-site morbidity was detected. This modification of the Grice-Green technique can be used effectively in the correction of planovalgus foot in cerebral palsy.

  2. Cisto sinovial intraneural do nervo fibular: relato de caso Intraneural synovial cyst of the peroneal nerve: case report

    Directory of Open Access Journals (Sweden)

    Roberto Sergio Martins

    1997-01-01

    Full Text Available Os autores apresentam um caso de um cisto sinovial intraneural ocorrendo no nervo fibular comum. O paciente apresentou-se com quadro de dor e dificuldade para a flexão dorsal e eversão do pé sendo submetido a exploração cirúrgica com exérese do cisto. Neste estudo são discutidos a patogênese, manifestações clínicas e tratamento desta rara lesão.The authors report the case of an intraneural synovial cyst of the peroneal nerve. The initial symptom was pain and weakness of dorsiflexion and eversion of the right foot. The patient was operated on and the cyst was totally resected. The authors discuss the pathogenesis, clinical diagnosis as well as the treatment of that uncommon lesion.

  3. Return to National Basketball Association Competition Following Anterior Cruciate Ligament and Fibular Collateral Ligament Injuries: A Case Report.

    Science.gov (United States)

    LaPrade, Robert F; O'Brien, Luke; Kennedy, Nicholas I; Cinque, Mark E; Chahla, Jorge

    2017-01-01

    Numerous outcome studies regarding anterior cruciate ligament (ACL) reconstruction demonstrate the ability of athletes to return to a high level of play. However, to our knowledge, there is limited literature regarding return to play following injury to both the ACL and the fibular collateral ligament (FCL). We describe the case of a National Basketball Association (NBA) player who sustained a combined ACL and FCL knee injury and subsequently underwent surgical reconstruction of both affected ligaments. He was able to return to a preinjury level of competition at 9 months postoperatively. It is possible for athletes to return to competitive basketball and maintain a high production level following a single-staged reconstruction of both the ACL and the FCL.

  4. [Calcaneo-fibular ligament surgery for chronic lateral instability of the upper ankle : Broström technique with modification by Wille. Video article].

    Science.gov (United States)

    Kosiol, J; Wille, M; Putzer, D; Biedermann, R

    2015-11-01

    An acute ligament rupture of the lateral ligament complex of the ankle joint is treated without surgery. Treatment failure may lead to a chronically unstable situation of the ankle joint, in which case surgery is an effective procedure for stabilizing the ruptured ligaments. Anatomical reconstruction is the best operative technique if the ligament tissue is of good quality. In our video we demonstrate a new possibility for the positioning of an anchor to tighten the calcaneo-fibular ligament. Modified Broström repairs are described in the literature in which the calcaneo-fibular ligament is released and reattached to the fibula to tighten it. We present the option to release the ligament at the calcaneus and reattach it using a suture anchor. This offers the advantage of preventing the possible dislocation of the peroneal tendons.

  5. Maxillary reconstruction with a double-barrel osteocutaneous fibular flap and arteriovenous saphenous loop after a globe-sparing total maxillectomy-A Case Report.

    Science.gov (United States)

    Chen, Szu-Han; Hung, Kuo-Shu; Lee, Yao-Chou

    2017-05-01

    Maxillary reconstruction using titanium mesh or bone grafts can invite unwanted complications, such as graft resorption, infection, and mesh exposure, especially for patients who require postoperative radiotherapy. Here, we reported a 58-year-old male patient who was diagnosed with maxillary sinus squamous cell carcinoma. The patient received cancer ablation by a globe-sparing total maxillectomy and was immediately reconstructed with a double-barrel osteocutaneous fibular flap to simultaneously restore the alveolar ridge, orbital support, and oro-sinonasal separation. The short pedicle length inherent in the double-barrel design of the fibular flap and the depletion of healthy recipient vessels in the midface after cancer ablation were overcome by creating an arteriovenous saphenous loop in the neck region. Though there was venous congestion on postoperative day 2, the postoperative recovery was uneventful after the revision of the venous anastomoses. During the 6-months follow-up, the outcome was functionally and aesthetically satisfactory. We believe that the double-barrel fibular osteocutaneous flap, which avoids using titanium mesh and bone grafts, may be a viable reconstructive option in cancer patients with globe-sparing total maxillectomy defects, especially for those who require postoperative radiotherapy. © 2015 Wiley Periodicals, Inc. Microsurgery 37:334-338, 2017. © 2015 Wiley Periodicals, Inc.

  6. Biomechanical competence of six different bone screws for reconstructive surgery in three different transplants: Fibular, iliac crest, scapular and artificial bone.

    Science.gov (United States)

    Pietsch, Arnold P; Raith, Stefan; Ode, Jan-Eric; Teichmann, Jan; Lethaus, Bernd; Möhlhenrich, Stephan C; Hölzle, Frank; Duda, Georg N; Steiner, Timm

    2016-06-01

    The goal of this study was to determine a combination of screw and transplantation type that offers optimal primary stability for reconstructive surgery. Fibular, iliac crest, and scapular transplants were tested along with artificial bone substrate. Six different kinds of bone screws (Medartis(©)) were compared, each type utilized with one of six specimens from human transplants (n = 6). Controlled screw-in-tests were performed and the required torque was protocolled. Subsequently, pull-out-tests were executed to determine the retention forces. The artificial bone substitute material showed significantly higher retention forces than real bone samples. The self-drilling screws achieved the significantly highest retention values in the synthetic bone substitute material. Cancellous screws achieved the highest retention in the fibular transplants, while self-drilling and cancellous screws demonstrated better retention than cortical screws in the iliac crest. In the scapular graft, no significant differences were found between the screw types. In comparison to the human transplant types, the cortical screws showed the significantly highest values in the fibula and the lowest values in the iliac crest. The best retention was found in the combination of cancellous screws with fibular graft (514.8 N + -252.3 N). For the flat bones (i.e., scapular and illiac crest) we recommend the cancellous screws. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. One-stage treatment and reconstruction of Gustilo Type III open tibial shaft fractures with a vascularized fibular osteoseptocutaneous flap graft.

    Science.gov (United States)

    Zhen, Ping; Hu, Yun-Yu; Luo, Zhuo-Jing; Liu, Xing-Yan; Lu, Hao; Li, Xu-Sheng

    2010-12-01

    This study evaluated the usefulness of a single-stage, free-fibular vascularized osteoseptocutaneous flap transfer for Type III open tibial shaft fractures with segmental bone loss for the reconstruction of combined bone and soft tissue defects. Nonrandomized retrospective study. University Level I trauma center. All Gustilo Type III open tibial shaft fractures with segmental bone loss that were treated at one institution between 2000 and 2007 were identified from a trauma registry. The study group consisted of 28 patients with Type III open tibial fractures: 27 were Gustilo-Anderson Type IIIB and one was Grade IIIC. The cause of tibial injury included eight industrial accidents, seven motor vehicle accidents, five crushing injuries caused by heavy objects, five falls from a height, and three motorcycle crashes. The lengths of the preoperative segmental tibial bone loss ranged from 9 to 17 cm and the size of the associated soft tissue defects ranged from 8 × 6 cm to 15 × 7 cm. The free fibular vascularized osteoseptocutaneous flap was used to graft and reconstruct combined bone and soft tissue defects. The radical wound débridement, soft tissue and bone revision, fracture stabilization, and early soft tissue coverage were achieved by this technique in a one-stage procedure. The average duration from injury to one-stage reconstruction was 15.8 hours (range, 5.3 hours to 6.5 days). Radiographic and functional evaluation of the lower extremity. All free fibular osteoseptocutaneous flaps survived completely. The average time to overall union for the entire group was 32 weeks after surgery (range, 26-41 weeks). None of the patients in this series had a nonunion. Acceptable radiographic alignment, defined as 5° of angulation in any plane, was obtained in 22 patients (78.6%). Malunion affected six (21.4%) fractures. According to the lower extremity functional assessment, excellent and good results were achieved for 82.1% (23 of 28), fair results were seen in 14

  8. Restoring a functional and mobile shoulder following reconstruction of the sternoclavicular joint with a free vascularized fibular flap

    Directory of Open Access Journals (Sweden)

    Abby Choke

    2018-06-01

    Full Text Available Infection of the sternoclavicular joint (SCJ is rare and often missed at early stage. In extensive disease with bony and soft tissue destruction, radical excision is indicated. The loss of SCJ results in exposure of vital structures of the anterior mediastinum and instability of the shoulder girdle. SCJ reconstruction using locoregional muscle flaps like the pectoralis major or latissimus dorsi flap has been well described. While these options can provide soft tissue coverage, they do not restore the structural framework of the SCJ which is important for shoulder excursion and chest wall movement. We describe a case of SCJ reconstruction using a free vascularized fibular flap following the resection of sternoclavicular tubercular osteomyelitis. The fibula bone was used to restore the clavicular strut by anchoring it to the remaining manubrium with a steel wire and by plating the lateral end to the remnant clavicle. The steel wire served as a “defunctioning” cerclage that allowed motion of the joint to induce fibrous union. A strict post-operative rehabilitation protocol keeping the shoulder adducted at the initial phase was prescribed. At one year follow up, the patient achieved good shoulder function with 140 degrees of shoulder abduction and 110 degrees flexion.

  9. Hydatid disease of scapula and upper third of humerus treated by en bloc excision and fibular bone grafting

    Directory of Open Access Journals (Sweden)

    Chari P

    2007-01-01

    Full Text Available 35-year-old male patient presented with gradually increasing painful swelling of the right shoulder, which was incised and drained and wound persisted as a discharging sinus on the anterolateral aspect of the deltoid region with seropurulent discharge. A clinical diagnosis of tuberculosis of the shoulder was made. Plain skiagram of the right shoulder revealed multicystic lesion involving the entire scapula and upper third of the humerus with loss of joint space and pathological fracture at the junction of upper one-third and lower two-thirds of the humerus. A clinico-radiological diagnosis of hydatid disease was made. In view of the extensive involvement of the scapula with stiff shoulder and an active sinus, a two-stage surgical procedure was performed. Stage 1 consisted of en bloc excision of the scapula, upper half of the humerus and lateral end of the clavicle. Stage II surgery, consisting of fibular bone grafting. Tablet albendazole (400 mg, thrice daily was given as systemic scolicidal agent. This case is reported in view of it′s rarity and to highlight the management.

  10. Quantification of the vascularisation of the orbital implants of coralinehydroxyapatite with {sup 99m} Tc-MDP; Cuantificacion de la vascularizacion de los implantes orbitales dehidroxiapatita coralina con {sup 99m} Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, J.L.; Solano, M.E.; Alvarez, I.; Perez, G. [Centro deInvestigaciones Clinicas 34 no.4501 e/45 y 47 Kohly, Playa C. Habana (Cuba)

    1998-12-31

    The use of ocular implants of hydroxyapatite has been increased in the last times owing to that they are well tolerated by the organism and that on the integration they show good mobility on the artificial eye with very few complications. The gammagraphy with {sup 99m} Tc-MDP can be used for the evaluation of vascularisation and its relative quantification above on these implants. In this pilot essay 10 normal persons and 37 patients were studied who had an implant of Cuban coraline hydroxyapatite (Coraline HAP-200). Thermography with {sup 99m} Tc-MDP was realized between 4 and 18 months after surgery then were obtained plane images in anterior viewing. It was measured the implant vascularisation and it was calculated for each case the relative captivation index (RCI) starting from two regions of ocular interest. As result all patients tolerated the implant without complications. The relation of the activity implant with respect to the contralateral region was 2.31{+-}0.63 (mean {+-} SD) with a range of 1.17-4.09. The relation between the left intra orbital captivation and the right in the normal persons was 1.01 {+-}0.66 (mean {+-} SD). In conclusion, we obtained that the ICR can be very useful in order to measure the integration level of this type of implant.Moreover, it was proved that the implants with Cuban coraline hydroxyapatite showed an acceptable level of integration in all the patients. (Author)

  11. Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes: a retrospective cohort study.

    Science.gov (United States)

    Ashman, B D; Kong, C; Wing, K J; Penner, M J; Bugler, K E; White, T O; Younger, A S E

    2016-09-01

    Patients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise. We retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality and functional outcomes was determined. Two patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patients required re-operation for removal of symptomatic hardware. No patient required a below-knee amputation. Six patients died during the study period for unrelated reasons. At a median follow-up of 12 months (7 to 38) the mean Short Form-36 Mental Component Score and Physical Component Score were 53.2 (95% confidence intervals (CI) 48.1 to 58.4) and 39.3 (95% CI 32.1 to 46.4), respectively. The mean Visual Analogue Score for pain was 3.1 (95% 1.4 to 4.9). The mean Ankle Osteoarthritis Scale total score was 32.9 (95% CI 16.0 to 49.7). Fluoroscopy-guided reduction and fibular nail fixation of unstable ankle fractures in patients with diabetes was associated with a low incidence of wound and overall complications, while providing effective surgical fixation. Cite this article: Bone Joint J 2016;98-B:1197-1201. ©2016 The British Editorial Society of Bone & Joint Surgery.

  12. Anterior versus posterior approach in reconstruction of infected nonunion of the tibia using the vascularized fibular graft: potentialities and limitations.

    Science.gov (United States)

    Amr, Sherif M; El-Mofty, Aly O; Amin, Sherif N

    2002-01-01

    The potentialities, limitations, and technical pitfalls of the vascularized fibular grafting in infected nonunions of the tibia are outlined on the basis of 14 patients approached anteriorly or posteriorly. An infected nonunion of the tibia together with a large exposed area over the shin of the tibia is better approached anteriorly. The anastomosis is placed in an end-to-end or end-to-side fashion onto the anterior tibial vessels. To locate the site of the nonunion, the tibialis anterior muscle should be retracted laterally and the proximal and distal ends of the site of the nonunion debrided up to healthy bleeding bone. All the scarred skin over the anterior tibia should be excised, because it becomes devitalized as a result of the exposure. To cover the exposed area, the fibula has to be harvested with a large skin paddle, incorporating the first septocutaneous branch originating from the peroneal vessels before they gain the upper end of the flexor hallucis longus muscle. A disadvantage of harvesting the free fibula together with a skin paddle is that its pedicle is short. The skin paddle lies at the antimesenteric border of the graft, the site of incising and stripping the periosteum. In addition, it has to be sutured to the skin at the recipient site, so the soft tissues (together with the peroneal vessels), cannot be stripped off the graft to prolong its pedicle. Vein grafts should be resorted to, if the pedicle does not reach a healthy segment of the anterior tibial vessels. Defects with limited exposed areas of skin, especially in questionable patency of the vessels of the leg, require primarily a fibula with a long pedicle that could easily reach the popliteal vessels and are thus better approached posteriorly. In this approach, the site of the nonunion is exposed medial to the flexor digitorum muscle and the proximal and distal ends of the site of the nonunion debrided up to healthy bleeding bone. No attempt should be made to strip the scarred skin off

  13. Ground reaction vector re-adjustment-the secret of success in treatment of medial compartment knee osteoarthritis by novel high fibular osteotomy.

    Science.gov (United States)

    Xie, Wenjun; Zhang, Yu; Qin, Xiaodong; Song, Lijun; Chen, Qun

    2018-03-01

    High fibular osteotomy has been preliminarily proved to be an effective treatment of knee osteoarthritis by excising a segment of bone at the proximal part of fibula. This imaginative procedure is clinical validated by its instant and explicit knee pain resorption and eventually deformity correction. The rationale of this treatment is named non-uniform settlement of the tibial plateau and used to elucidate the cause of knee joint degeneration, but cannot illuminate the reason of prompt postoperative pain resorption faithfully. To assist in better understanding of this therapeutic method and raising alert to possible unexpected complications, we proposed a new theory to elucidate the pain relief mechanism.

  14. Reconstruction of juxta-articular huge defects of distal femur with vascularized fibular bone graft and Ilizarov's distraction osteogenesis.

    Science.gov (United States)

    Lai, Davy; Chen, Chuan-Mu; Chiu, Fang-Yao; Chang, Ming-Chau; Chen, Tain-Hsiung

    2007-01-01

    We evaluate the effect of reconstructing huge defects (mean, 15.8 cm) of the distal femur with Ilizarov's distraction osteogenesis and free twin-barreled vascularized fibular bone graft (TVFG). We retrospectively reviewed a consecutive series of five patients who had cases of distal femoral fractures with huge defects and infection that were treated by the Ilizarov's distraction osteogenesis. After radical debridement, two of the five cases had free TVFG and monolocal distraction osteogenesis, and another two cases had multilocal distraction osteogenesis with knee fusion because of loss of the joint congruity. The other case with floating knee injury had bilocal distraction osteogenesis and a preserved knee joint. The mean defect of distal femur was 15.8 cm (range, 14-18 cm) in length. The mean length of distraction osteogenesis by Ilizarov's apparatus was 8.2 cm. The mean length of TVFG was 8 cm. The average duration from application of Ilizarov's apparatus to achievement of bony union was 10.2 months (range, 8-13 months). At the end of the follow-up, ranges of motion of three knees were 0 to 45 degrees, 0 to 60 degrees, and 0 to 90 degrees. Two cases had knee arthrodesis with bony fusion because of loss of the joint congruity. There were no leg length discrepancies in all five patients. In addition, three patients had pin tract infections and one case had a 10 degree varus deformity of the femur. Juxta-articular huge defect (>10 cm) of distal femur remains a challenge to orthopedic surgeons. Ilizarov's technique provides the capability to maintain stability, eradicate infection, restore leg length, and to perform adjuvant reconstructive procedure easily. In this study, we found that combining Ilizarov's distraction osteogenesis with TVFG results in improved patient outcome for patients with injuries such as supracondylar or intercondylar infected fractures or nonunion of distal femur with huge bone defect.

  15. Implant Utilization and Time to Prosthetic Rehabilitation in Conventional and Advanced Fibular Free Flap Reconstruction of the Maxilla and Mandible.

    Science.gov (United States)

    Chuka, Richelle; Abdullah, Wael; Rieger, Jana; Nayar, Suresh; Seikaly, Hadi; Osswald, Martin; Wolfaardt, Johan

    Precisely designed jaw reconstruction rehabilitation (JRR) is important to the integrity of the jaw structure and oral functions. Advanced three-dimensional (3D) digital surgical design and simulation (SDS) techniques have the potential to reduce time to reconstructive and dental treatment completion, thereby promoting early functional oral rehabilitation. This study investigated the use of SDS in JRR procedures. A retrospective chart review was conducted on adult head and neck tumor (HNT) participants who completed JRR treatment with a fibular free flap (FFF) reconstruction. Two treatment approaches, advanced 3D SDS technique (with-SDS) and conventional, nondigitally planned technique (without-SDS), included the use of osseointegrated implants. Data were collected from adult patients treated between January 2000 and March 2014 at the Institute for Reconstructive Sciences in Medicine (iRSM). Participants were excluded if they underwent a bone-containing augmentation to the FFF reconstruction. The without-SDS group underwent a conventional, nonguided FFF reconstruction followed by nonguided implant placement. The with-SDS group underwent a guided FFF reconstruction with guided implant placement during the reconstructive surgery. The outcome measures included implant utilization (ratio of implants placed to connected) and time to prosthetic connection after FFF reconstruction. Mann-Whitney U test was used to analyze the data. The digital SDS technique (with-SDS) group completed prosthetic treatment with a significantly higher utilization of implants as well as a significantly shorter time to prosthetic delivery. SDS allows an interdisciplinary treatment team to work together to create a virtual plan that leads to greater efficiency in patient treatment time and utilization of dental implants.

  16. The necessity of clinical application of tibial reduction for detection of underestimated posterolateral rotatory instability in combined posterior cruciate ligament and posterolateral corner deficient knee.

    Science.gov (United States)

    Lee, Han-Jun; Park, Yong-Beom; Ko, Young-Bong; Kim, Seong-Hwan; Kwon, Hyeok-Bin; Yu, Dong-Seok; Jung, Young-Bok

    2015-10-01

    The purpose of this study was to evaluate the usefulness of tibial reduction during dial test for clinical detection of underestimated posterolateral rotatory instability (PLRI) in combined posterior cruciate ligament (PCL)-posterolateral corner (PLC) deficient knee in terms of external rotation laxity and clinical outcomes. Twenty-one patients who classified as grade I PLRI using dial test with subluxated tibia, but classified as grade II with tibial reduction evaluated retrospectively. The mean follow-up was 39.3 months (range 24-61 months). Each patient was evaluated by the following variables: posterior translation and varus laxity on radiograph, KT-1000 arthrometer, dial test (reduced and subluxated position), International Knee Documentation Committee, Orthopädische Arbeitsgruppe Knie scoring system and Tegner activity scale. There were significant improvements in posterior tibial translation (8.6 ± 2.0 to 2.1 ± 1.0 mm; P application of reduction of posteriorly subluxated tibia during the dial test was essential for an appropriate treatment of underestimated PLRI in combined PCL-PLC deficient knee. Retrospective case series, Level IV.

  17. Use of latissimus dorsi flap pedicle as a T-junction to facilitate simultaneous free fibular flap inset in lower extremity salvage.

    Science.gov (United States)

    Hwang, Kyu Tae; Youn, Seungki; Kim, Jeong Tae; Lee, Seung Hoon; Ng, Siew-Weng; Kim, Youn Hwan

    2012-04-01

    Marjolin's ulcer is a very aggressive form of squamous cell carcinoma arising from chronic wounds or unstable scars. A resection margin of at least 2 cm with clear deep margin is required on removal. A 79-year-old male presented with chronic osteomyelitis of the left anterior tibial region with chronic ulceration. Biopsy revealed squamous cell carcinoma. The tumour, measuring 8 cm, was resected with surrounding unstable scar tissue including en bloc resection of the involved tibial bone, leaving the posterior cortex. Reconstruction was done with a fibular free flap from the contralateral side, but the pedicle length was too short to reach the anterior tibial vessels. To bridge the vascular gap, and to cover the soft-tissue defect, a latissimus dorsi free flap was harvested using the muscle-sparing method. The thoracodorsal vessels were used as an interpositional graft to anastomose the peroneal vessels of the fibular flap. The patient was ambulatory by 4 months, and complete bone union was seen after 6 months. During the 18-month follow-up period, there was no evidence of recurrence. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Locking plate and fibular strut-graft augmentation in the reconstruction of unicameral bone cyst of proximal femur in the paediatric population.

    Science.gov (United States)

    Jamshidi, Khodamorad; Mirkazemi, Masoud; Izanloo, Azra; Mirzaei, Alireza

    2018-01-01

    Several therapeutic strategies have been used for managing unicameral bone cyst (UBC) of the proximal femur. However, there is insufficient evidence to support one treatment over another, and the optimal treatment is controversial. This study aims at describing our experience with surgical reconstruction of paediatric UBCs of the proximal femur using a proximal locking plate and fibular strut allograft. In total, 14 consecutive paediatric patients with Dormans types IB (four cases) and IIB (10 cases) UBC were assessed. Mean patient age was 8.6 ± 2.3 years, and mean follow-up period was 41.7 ± 29.8 months. Six patients (42.8%) were referred with a pathologic fracture. Clinical/radiological outcome and complication rates were evaluated at the final follow-up session. No cysts were Capanna's class III (recurrence) or IV (no response). Complete healing (Capanna's class I) was seen in ten cysts, while four other cysts healed with residual radiolucent areas (Capanna's class II). Mean healing period was 14.1 ± 5.1 (9-24 months). One patient had superficial infection, one heterotopic ossification, and one mild coxa vara, and mean Musculoskeletal Tumor Society (MSTS) score was 99.5%. According to our results, locking plate and fibular strut graft in Dormans classification types IB and IIB results in a favorable outcome in managing UBC of the proximal femur in the paediatric population.

  19. Ressecção ampla e transposição fibular no tratamento do TCG da extremidade distal do rádio Wide resection and fibular transposition in the treatment of GCT on radius distal end

    Directory of Open Access Journals (Sweden)

    Alex Guedes

    2009-01-01

    Full Text Available OBJETIVO: Avaliação funcional e oncológica do tratamento do TCG do segmento distal do rádio (estadio B3 mediante ressecção ampla e reconstrução com enxerto autólogo avascular da extremidade proximal da fíbula. MÉTODOS: A função residual foi avaliada mediante escore ISOLS, medida do arco residual global do punho operado, do percentual residual da força de preensão da mão e da preensão entre o polegar e o indicador. O controle oncológico foi avaliado mediante exame clínico do membro operado e avaliação por imagens do punho e do tórax. RESULTADOS: 17 pacientes avaliados, dez do sexo feminino (58,8% e sete do sexo masculino (41,2% com idades entre 16 e 61 anos (média de 32,3 anos, todos destros. Na avaliação funcional (ISOLS observamos 11 resultados excelentes, dois bons e um ruim; os três casos que demandaram artrodese evoluíram com escore excelente. O arco residual global foi de 196,2 ± 116,6º. O arco residual do punho operada correspondeu a 58,9% do controle. A força de preensão da mão correspondeu a 55,4 ± 17,4% do controle. O percentual de "pinça" foi de 80,6 ± 14,8% do controle. Não constatamos recidiva ou metástases nesta casuística. CONCLUSÃO: A técnica propiciou resultados funcionais alentadores, assegurando o retorno dos pacientes às suas atividades. A ausência de recidiva local e/ou metástases, observada inclusive nos pacientes com seguimento mais longo, permite sugerir que a técnica parece ser segura no controle oncológico do tumor.OBJECTIVE: To functionally and oncologically assess the treatment of GCT on radius distal end (stage B3 following wide resection and reconstruction with avascular autologous graft from proximal fibular end. METHODS: The residual function was assessed using ISOLS score, measurement of the global residual arch of the operated wrist, residual percentage of the hand apprehension strength between thumb and index fingers. The oncologic monitoring was assessed by clinical

  20. Do stress fractures induce hypertrophy of the grafted fibula? A report of three cases received free vascularized fibular graft treatment for tibial defects.

    Science.gov (United States)

    Qi, Yong; Sun, Hong-Tao; Fan, Yue-Guang; Li, Fei-Meng; Lin, Zhou-Sheng

    2016-06-01

    The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy.

  1. Reconstruction of the Midfoot Using a Free Vascularized Fibular Graft After En Bloc Excision for Giant Cell Tumor of the Tarsal Bones: A Case Report.

    Science.gov (United States)

    Hara, Hitomi; Kawamoto, Teruya; Onishi, Yasuo; Fujioka, Hiroyuki; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro; Akisue, Toshihiro

    2016-01-01

    We report the case of a 32-year-old Japanese female with a giant cell tumor of bone involving multiple midfoot bones. Giant cell tumors of bone account for approximately 5% of all primary bone tumors and most often arise at the ends of long bones. The small bones, such as those of the hands and feet, are rare sites for giant cell tumors. Giant cell tumors of the small bones tend to exhibit more aggressive clinical behavior than those of the long bones. The present patient underwent en bloc tumor excision involving multiple tarsals and metatarsals. We reconstructed the longitudinal arch of the foot with a free vascularized fibular graft. At the 2-year follow-up visit, bony union had been achieved, with no tumor recurrence. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Reconstrucción tibial: transferencia sóleo-peroné ipsilateral. Tibialización peroneal Tibial reconstruction: ipsilateral soleus-fibula transfer. Fibular tibialization

    Directory of Open Access Journals (Sweden)

    E. Revelo Jiron

    2009-12-01

    Full Text Available Las transferencias óseas peroneales en forma libre o ipsilateral han sido propuestas para la reconstrucción de grandes defectos tibiales. Están también descritas varias modificaciones al respecto, siendo una de ellas la constitución de un colgajo compuesto soleo-peroné realizado como transferencia libre. En este estudio presentamos nuestra experiencia con esta variante, pero en forma ipsilateral. logrando la reconstrucción del defecto tibial por medio de la tibialización peroneal. Escogimos realizar un colgajo compuesto soleo-peroné ipsilateral a flujo anterógrado o retrogrado para la reconstrucción de una serie personal de 14 pacientes consecutivos, 13 hombre y 1 mujer, con edad media de 30 años, y con amplios defectos tibiales y de tejidos blandos causados por accidentes de transito en 12 casos, 1 por proyectil balístico y 1 por artefacto explosivo artesanal. El promedio de tamaño del defecto tibial fue de 9.4 cm. Elegimos la forma ipsilateral por no disponer de infraestructura adecuada para realizar una transferencia libre. La serie de estudio se realizó durante el periodo comprendido entre Abril de 1995 y Abril del 2005. Todos los colgajos sobrevivieron. Dos pacientes desarrollaron pseudoartrosis. El apoyo completo y la marcha en 12 pacientes, se logró en un periodo promedio de 9 meses. El seguimiento postoperatorio ha sido de 3 a 6 años. Doce pacientes se han incorporado a la vida activa. Discutimos algunos aspectos prácticos de la técnica como resultado de la experiencia quirúrgica obtenida de esta serie personal. Consideramos que el método es fiable, fácil de realizar y proporciona excelentes resultados.Fibular flaps such as in there free form or as ipsilateral transfers have been proposed for reconstruction of large tibial defects. Several modifications have been described for the use of this flap. In this study we will present our experience using the ipsilateral transfer of an osteomuscular soleous fibular flap

  3. Comparison of the effects of dexketoprofen trometamol, meloxicam and diclofenac sodium on fibular fracture healing, kidney and liver: an experimental rat model.

    Science.gov (United States)

    Inal, Sermet; Kabay, Sahin; Cayci, M Kasim; Kuru, H Isa; Altikat, Sayit; Akkas, Gizem; Deger, Aysenur

    2014-03-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are particularly used in patients with bone fractures, but there are limited studies on whether one NSAID is superior to another. In this study, we used histopathological and biochemical parameters to determine whether there are differences between the effects of the administration of clinical doses of dexketoprofen trometamol (DEXT), meloxicam (MEL) and diclofenac sodium (DIC) on the healing of closed fibular fractures and the toxicity of both the liver and kidney. Twenty-eight male Sprague-Dawley rats were randomly divided into four groups of seven each. Closed diaphyseal fractures were formed in the left fibulas of all of the rats. The NSAIDs dexketoprofen trometamol (DEXT) (Arveles(®)), meloxicam (MEL) (Melox(®)) and diclofenac sodium (DIC) (Voltaren(®)) were intramuscularly administered to Groups I, II, and III, respectively, for a period of 10 days after the fibular fractures were performed. No pharmacological agents were administered to Group IV (Control group). Blood samples were collected from all of the rats after the fractures were performed, and the rats were sacrificed on day 28. The histopathological findings were compared, and the blood samples were evaluated to determine any differences between the levels of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA). Our results suggest that DEXT and MEL impair the healing of bone fractures and that DIC does not histopathologically affect the healing process of bone fractures. We also found that DEXT, MEL, and DIC impaired the renal histopathology compared with the control group. However, the liver histopathological analysis showed that DEXT and MEL caused a higher degree of parenchymal necrosis compared with DIC. Based on our results, DIC can be considered a relatively safe medication in patients with fractures. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Dual-fibular reconstruction of a massive tibial defect after Ewing's sarcoma resection in a pediatric patient with a vascular variation.

    Science.gov (United States)

    Saridis, Alkis G; Megas, Panagiotis D; Georgiou, Christos S; Diamantakis, Georgios M; Tyllianakis, Minos E

    2011-01-01

    In the management of malignancies of the extremities, limb salvage procedures have recently taken on greater significance. For those patients under intense adjuvant chemotherapy and with massive bone loss, free vascularized fibular grafting is currently advocated as a reliable reconstructive option, maybe because of the controversial results of bone transport in similar situations. However, when there is a vascular abnormality of either the recipient or donor extremity, microsurgical procedures are not feasible, further limiting potential reconstructive alternatives. We present the case of a 13-year-old female patient with Ewing's sarcoma of the right tibia. Preoperative angiography showed that vascularity of the affected side depended totally on a single peroneal artery. The patient was treated initially with multiagent chemotherapy, followed by an excision of 23 cm. The defect was bridged by a gradual medial transportation of the ipsilateral fibula with the Ilizarov technique and strengthened by nonvascularized transfer of the contralateral fibula. Total external fixation time was 162 days. After the removal of the Ilizarov frame a walking cast was applied for another month. At 5 years postoperatively there was no recurrence of the malignancy. The patient had full weight-bearing ability on the affected limb, with preservation of the ankle and knee joints motion and without any limb length discrepancy or axial deformity. The functional outcome that was visible was graded excellent. Transverse distraction osteogenesis of the ipsilateral fibula performed well under chemotherapy, showing unproblematic callus formation. Supplemented with nonvascularized transfer of the contralateral fibula, provided a reconstructive option with biological affinity, sufficient biomechanical strength and durability, and with a decreased complication rate. This case report presents a viable option, especially in cases in which vascular abnormalities of either the donor or the recipient

  5. Management of non-traumatic avascular necrosis of the femoral head-a comparative analysis of the outcome of multiple small diameter drilling and core decompression with fibular grafting.

    Science.gov (United States)

    Mohanty, S P; Singh, K A; Kundangar, R; Shankar, V

    2017-04-01

    The purpose of this study was to compare the clinical and radiological outcomes of multiple small diameter drilling and core decompression with fibular strut grafting in the management of non-traumatic avascular necrosis (AVN) of the femoral head. Outcomes of patients with AVN treated by multiple small diameter drilling (group 1) were compared retrospectively with patients treated by core decompression and fibular grafting (group 2). Harris hip score (HHS) was used to assess the clinical status pre- and postoperatively. Modified Ficat and Arlet classification was used to assess the radiological stage pre- and postoperatively. Forty-six patients (68 hips) were included in this study. Group 1 consisted of 33 hips, and group 2 consisted of 35 hips. In stages I and IIB, there was no statistically significant difference in the final HHS between the two groups. However, in stages IIA and III, hips in group 2 had a better final HHS (P < 0.05). In terms of radiographic progression, there was no statistical difference between hips in stages I, IIA and stage IIB. However, in stage III, hips belonging to group 2 had better results (P < 0.05). Kaplan-Meier survivorship analysis showed better outcome in group 2 in stage III (P < 0.05). Hips with AVN in the precollapse stage can be salvaged by core decompression with or without fibular grafting. Multiple small diameter drilling is relatively simple and carries less morbidity and hence preferred in stages I and II. However, in stage III disease, core decompression with fibular strut grafting gives better results.

  6. Posibilidad de identificar defectos en máquinas rotatorias utilizando la medición de nivel total de la señal vibratoria // Possibility of identification of defects in rotatory machinery by means of total level mesurations.

    Directory of Open Access Journals (Sweden)

    L. M. Véliz Marrero

    2000-03-01

    Full Text Available Se expone una herramienta propuesta por el Dr. C. Cempel, poco difundida para identificar algunos defectos al realizar eldiagnóstico de máquinas rotatorias utilizando la medición de Nivel Total. Se ilustra a modo de ejemplo el diagnóstico de unreductor de velocidad.Palabras claves: Medición, vibraciones, nivel total, diagnóstico, engranaje, reductor de velocidad.________________________________________________________________________________AbstractIn this paper is exposed a not much divulged tool proposed by Dr. C. Cempel for the identification of some defects by meansof the measurement of Total Level of vibration in diagnosis of rotatory machinery. As example, a speed reducer diagnostic ispresented.Key words: Vibration measurement, total level, diagnostic, gears, speed reducer.

  7. Colgajo libre osteoseptocutáneo de peroné en la reconstrucción primaria de la radionecrosis masiva mandibular Fibular osteoseptocutaneous free flap in the primary reconstruction after massive radionecrosis of the mandible

    Directory of Open Access Journals (Sweden)

    P. Infante Cossío

    2004-06-01

    Full Text Available Resumen: Una de las complicaciones más serias del uso de la radioterapia en el tratamiento del carcinoma epidermoide de la cavidad oral, es la osteorradionecrosis. En este trabajo, presentamos cuatro pacientes afectos de osteorradionecrosis masiva de la mandíbula que habían fracasado inicialmente con medidas conservadoras y que fueron tratados con resección radical y reconstrucción primaria con un colgajo libre osteoseptocutáneo de peroné. El defecto mandibular tras la resección ósea midió una media de 10 cm e incluyó mucosa intraoral, piel o ambos. En dos casos de reconstrucción, se empleó el colgajo libre de peroné con doble paleta para reconstruir defectos extensos intra y extraorales. Se realizaron osteotomías en el peroné vascularizado en todos los casos para recrear el contorno mandibular. Todos los colgajos sobrevivieron completamente. Tres pacientes curaron primariamente con buenos resultados estéticos y funcionales. Una paciente falleció en el primer mes tras la operación por una pancreatitis aguda y fallo renal. En un paciente se han insertado implantes osteointegrados. En nuestra experiencia, el colgajo libre osteoseptocutáneo de peroné puede ser una opción ideal para la reconstrucción en un solo tiempo de defectos complejos mandibulares compuestos en pacientes afectos de osteorradionecrosis masiva.Abstract: Osteoradionecrosis is one of the most serious complications after radiation therapy of squamous carcinoma of the oral cavity. In this article, we report four cases of massive osteoradionecrosis of the mandible, all of whom had failed initial conservative management and treated with radical resection and primary reconstructed with fibular osteoseptocutaneous free flap. Mandible defects after radical resection were around 10 cm long and included intraoral mucosa, skin or both. A doubled-paddle peroneal tissue transfer was used in two cases for reconstruction of an extensive extra- or intraoral defects. The

  8. Resistência à torção de dois instrumentos endodônticos rotatórios de níquel-titânio Torsional resistance of two nickel-titanium rotatory endodontic instruments

    Directory of Open Access Journals (Sweden)

    Cristiane da COSTA

    2000-06-01

    Full Text Available Os autores compararam a resistência à torção entre os instrumentos rotatórios de níquel-titânio Quantec Series 2000 e Pow-R, valendo-se de quarenta instrumentos para cada marca divididos em oito para cada um dos seguintes tamanhos nº 15, nº 20, nº 25, nº 35 e nº 40 com 21 mm e conicidade .02. Com a ajuda de um troptômetro modificado cada instrumento foi fixado em um madril e preso à 3 mm de sua ponta, previamente marcada com uma caneta de tinta permanente, na base do aparelho por uma morsa. Em seguida ativou-se a manivela que continha a escala em graus até notar-se sinal característico da fratura do instrumento registrando-se o valor da quantidade de movimento até este momento. Após tabulação dos dados procedeu-se a análise estatística de acordo com o teste t de Student com nível de significância de 1%. Os resultados mostraram haver diferença estatisticamente significante ao comparar-se limas de mesmo número confrontadas as duas marcas, favorável para o instrumento Pow-R.The authors compared the torsional resistance between the Quantec Series 2000 and Pow-R nickel-titanium rotatory instruments, using forty instruments of each brand, divided in eight of each one of the following numbers: nº 15, nº 20, nº 25, nº 35 and nº 40 with 21 mm and taper .02. Each instrument was fixed in the mandrel of a modified tropometer and held 3 mm away from its tip, on a spot that had been previously stamped with a permanent ink pen, by apprehension claws localized on the base of the equipment. Then the graduated handle was activated until a characteristic break sign of the instrument was noticed, the quantity of movement up to this moment being recorded. After the values were tabulated, the statistical analysis was carried out according to the Student t test. The results revealed a statistically significant difference when instruments of the same number, from both evaluated brands, were compared, favouring the Pow-R instruments.

  9. Suppression of instability in rotatory hydromagnetic convection

    Indian Academy of Sciences (India)

    first time by Lord Rayleigh [9] for the idealized case of two free boundaries. Rayleigh's theory shows that the gravity-dominated thermal instability in liquid layer ... suppressed for oscillatory perturbations by the simultaneous application of a ...

  10. The influence of subchondral vascularisation on chondromalacia patellae.

    Science.gov (United States)

    Neusel, E; Graf, J

    1996-01-01

    An experiment was carried out on 40 rabbits in which the blood supply to the patella was interrupted for periods from 2 weeks to 6 months. With prolonged ischaemia, there were clear changes in the articular cartilage which were comparable with those seen in chondromalacia patellae.

  11. The Strategy of Vascularised Transplantation of the Fallopian Tube

    African Journals Online (AJOL)

    panying veins and surrounding fascia (Fig. 2). At this stage the animal was heparinised by intravenous administration of 20000 units heparin. The vascular arcades were then carefully inspected to ensure that the blood supply to the distal uterine cornu and Fallopian tube (oviduct) would not be interrupted. The intervascular ...

  12. Bloqueio dos nervos tibial e fibular comum em fossa poplítea com punção única utilizando o estimulador percutâneo de nervos: considerações anatômicas e descrição ultrassonográfica

    OpenAIRE

    Rangel, Viviane de Oliveira; Carvalho, Raphael de Almeida; Mandim, Beatriz Lemos da Silva; Alves, Rodrigo Rodrigues; Ruzi, Roberto Araújo; Fonseca, Neuber Martins da

    2011-01-01

    JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios de nervos periféricos têm ganhado popularidade nas últimas duas décadas, tornando-se crescente opção anestésica para a cirurgia de membros. Este estudo propõe uma técnica de abordagem dos nervos tibial e fibular comum na fossa poplítea por punção única e utilizando o estimulador percutâneo de nervos, considerando a correlação com estudo anatômico e ultrassonográfico. MÉTODO: Estudo prospectivo, observacional e aleatório realizado com 28 paci...

  13. Peroneal nerve palsy due to compartment syndrome after facial plastic surgery Paralisia de nervo fibular devido a síndrome compartimental após cirurgia plástica da face

    Directory of Open Access Journals (Sweden)

    Clécio O. Godeiro-Júnior

    2007-09-01

    índrome compartimental crônica. Ele fazia uso de anabolizantes e venlafaxina, não relatado no início do quadro, e a agitação poderia ser explicada por uma síndrome serotoninérgia desencadeada pela interação deste último medicamento e haloperidol. A rabdomiólise secundária a estes eventos causou edema e isquemia nos compartimentos anteriores de ambos os membros inferiores, levando a uma compressão secundária do nervo fibular. O caso em questão ilustra a importância do diagnóstico precoce da síndrome compartimental pois, caso contrário, mesmo com fasciotomia, uma complicação permanente devido à compressão de nervos periféricos pode se estabelecer.

  14. Diagnosis of acute atlanto-axial rotatory fixation in adults

    International Nuclear Information System (INIS)

    Stenson, Debbie

    2011-01-01

    This case report presents a case of a Fielding and Hawkins Type I AARF in an adult following trauma. It is presented to draw attention to the medical and technical details associated with the management of this rare spinal injury. The importance of imaging in the diagnosis and management of AARF is discussed. Early recognition and treatment of AARF is paramount in the avoidance of subsequent deformity and instability in these patients and are the key to the prevention of operable treatment.

  15. fibular osteosynthesis of neglected femoral neck fracture in a young

    African Journals Online (AJOL)

    As soon as a diagnosis of non-displaced fracture of his right hip was made he discharged himself ... in dogs that cortical grafts provided structural support to the necrotic femoral head preventing its collapse ... possibility of future osteoarthritis of the index hip and the need for regular follow-up. In conclusion, the use of ...

  16. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

    Directory of Open Access Journals (Sweden)

    Martin Lanzer

    2015-09-01

    Full Text Available Objectives: Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and Methods: We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units (HU. Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test. Results: Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001. There was a statistical significant increase in bone density in cortical (P < 0.001 and cancellous (P = 0.004 bone. Conclusions: Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time.

  17. Efeitos da fadiga muscular induzida por exercícios no tempo de reação muscular dos fibulares em indivíduos sadios Efectos de la fatiga muscular inducida por ejercicios sobre el tiempo de reacción muscular peronea en individuos sanos Effects of the exercise-induced muscular fatigue on the time of muscular reaction of the fibularis in healthy individuals

    Directory of Open Access Journals (Sweden)

    Bruno Araújo Rego Santos Silva

    2006-04-01

    Full Text Available A fadiga muscular (FM é um fenômeno comum nas atividades esportivas e diárias, resultando numa piora da performance motora. Ela é considerada um dos fatores causadores de lesões músculo-esqueléticas. A entorse de tornozelo é um exemplo: a FM afetaria tanto o sistema aferente quanto o eferente. Vários estudos têm analisado a influência da FM no controle neuromuscular (CNM; entretanto, existe pouca pesquisa sobre essa influência na velocidade de reação dos músculos. O objetivo deste estudo foi verificar os efeitos da FM no tempo de reação muscular (TRM dos músculos fibulares, que são os primeiros a responder a um estresse em inversão do tornozelo. Foram estudados 14 indivíduos saudáveis masculinos (idade: 20-35 anos, que tiveram seus TRM avaliados por meio de eletromiografia (EMG de superfície. O início da atividade muscular foi definido como a média de repouso + 3x o desvio-padrão (DP. O TRM dos fibulares foi mensurado após uma inversão súbita de 20º realizada numa plataforma. A inversão súbita foi realizada antes e depois da fadiga muscular, que foi induzida por exercícios localizados dos fibulares até a exaustão. Os resultados mostraram que houve um aumento significativo do tempo de reação muscular após a fadiga (p La fatiga muscular (FM es un fenómeno común en las actividades diarias, produciendo un empeoramiento de la actuación. Se la considera una de las causas de factores lesionantes musculares de esqueleto. El esguince del tobillo es un ejemplo: La FM afectaría tanto el sistema aferente cuanto el eferente. Varios estudios han estado analizando la influencia de FM en el comando neuromuscular (CNM, sin embargo, la existen pocas investigaciones sobre la influencia en la velocidad de reacción de los músculos. El objetivo de ese estudio era verificar los efectos de FM en el tiempo de reacción muscular (TRM de los músculos peroneos, que son los primeros en responder a una tensión en la inversi

  18. Posterolateral rotatory instability from multiple steroids injections for tennis elbow: a case report.

    Science.gov (United States)

    Chanlalit, Cholawish; Limsricharoen, Warodom

    2013-01-01

    This article reports the complication (lateral collateral ligament rupture) arising from improper numbers of steroids injections for the chronic lateral elbow pain (tennis elbow). Clinical sign and investigation with MRI confirmed a diagnosis of LCL rupture. In the present report, we describe the successful outcome of one year results in surgical debridement and lateral collateral ligament (LCL) reconstruction. A discussion of the proper conservative role for the chronic lateral epicondyalgia and the surgical decision to resolve this complication is also included.

  19. Molecular reorientations in the nematic and rotatory phases of di-n-pentyloxyazoxybenzene

    International Nuclear Information System (INIS)

    Nguyen, X.P.; Krawczyk, J.; Chrusciel, D.

    1986-04-01

    Results of dielectric relaxation (DR), quasielastic neutron scattering (QNS), calorimetric DSC and preliminary X-ray measurements on the fifth member - 5.OAOB - of the alkoxyazoxybenzene homologous series are presented. It has been found that 5.OAOB exhibits two mesophases: a nematic (N) and an ''intermediate'' crystalline phase (Cr I) just below it. From comparison of the DR and QNS studies one can conclude that in the N phase the molecule as a whole performs rotational diffusion around the long axis (τ perpendicular DR ∼150 ps) and at the same time the two moieties perform faster independent reorientations around N - benzene rings bonds with τ QNS ∼5 ps. The Cr I phase is identified as a solid unaxial rotational phase in which fast molecular reorientations exist. It seems that the fast reorientations observed in the N phase to some extent survive to the Cr I phase. A model of molecular arrangements in the Cr I phase is proposed and it explains the reduction of the dielectric increment observed on passing from the N phase to this phase. (author)

  20. Effectiveness of rotatory and reciprocating movements in root canal filling material removal

    Directory of Open Access Journals (Sweden)

    Emmanuel João Nogueira Leal SILVA

    2015-01-01

    Full Text Available The purpose of this study was to compare the efficacy of reciprocating and rotary techniques for removing gutta-percha and sealer from root canals. Forty straight and oval single-rooted premolars were prepared up to size 30, filled with gutta-percha and sealer, and then randomly allocated to two experimental retreatment groups: ProTaper Retreatment System (PTRS and WaveOne System (WS. Procedural errors, time of retreatment and apically extruded material were recorded for all the roots. The roots were radiographed after retreatment. The percentage of residual material was calculated using image analysis software. The data were analyzed by Kolmogorov-Smirnov and t tests, with a significance level set at 5%. No system completely removed the root filling material from the root canal. No significant differences were observed between the systems, in terms of residual filling material in any tested third (p > 0.05. WS was faster in removing filling material than PTRS (p< 0.05. Extrusion was observed in 4 cases in PTRS and in 5 cases in WS. No procedural errors were observed in either group. It can be concluded that although no differences were observed in the efficacy of PTRS and WS for removing root filling material, WS was faster than PTRS.

  1. In-Vitro comparison of the effectiveness of different high-speed rotatory catheters

    International Nuclear Information System (INIS)

    Mueller-Huelsbeck, S.; Dimitte, D.N.; Jahnke, T.; Grimm, J.; Heller, M.; Hedderich, J.

    2003-01-01

    Objective: To determine the in vitro effectiveness of the Amplatz TM and Rotarex TM catheters for thrombus fragmentation and combined thrombus fragmentation and aspiration. Materials and Methods: Clots (n=100) from 5-day-old porcine blood (8.5 g) were fragmented with the 8F Rotarex TM catheter (RR; 40.000 rpm), which was directed with or without a coaxial guide wire (GW 0.020 inch [8F RR GW ], GW 0.014 inch [6F RR GW ]), and with the 7F Amplatz TM catheter (ATD; 150.000 rpm), in an artery flow model (pulsed flow of 700 ml/min) simulating the superficial femoral artery. To increase the wall adherence of the thrombus, an additional equal number of silicon tubes (with an inner diameter of 7 mm) were fitted inside with a metallic mesh (wall-adherent thrombus [WAT]; 6F RR WAT , 8F RR WAT , 6F R WAT-GW , 8F RR WAT-GW , ATD WAT ). The effluent was passed through a three-step filter system (10 to 1000 μm; pressure gradient 35 mmHg). Results: Highest effectiveness was found for 8F RR (no remaining thrombus detectable) compared to 6F RR (0.08 g) and ATD (0.07 g), with a p [de

  2. Anatomy and Histology of the Knee Anterolateral Ligament.

    Science.gov (United States)

    Helito, Camilo Partezani; Demange, Marco Kawamura; Bonadio, Marcelo Batista; Tírico, Luis Eduardo Passarelli; Gobbi, Riccardo Gomes; Pécora, José Ricardo; Camanho, Gilberto Luis

    2013-12-01

    Reconstruction of the anterior cruciate ligament (ACL) is one of the most common procedures in orthopaedic surgery. However, even with advances in surgical techniques and implants, some patients still have residual anterolateral rotatory laxity after reconstruction. A thorough study of the anatomy of the anterolateral region of the knee is needed. To study the anterolateral region and determine the measurements and points of attachments of the anterolateral ligament (ALL). Descriptive laboratory study. Dissections of the anterolateral structures of the knee were performed in 20 human cadavers. After isolating the ALL, its length, thickness, width, and points of attachments were determined. The femoral attachment of the ALL was based on the anterior-posterior and proximal-distal distances from the attachment of the lateral collateral ligament (LCL). The tibial attachment point was based on the distance from the Gerdy tubercle to the fibular head and the distance from the lateral tibial plateau. The ligaments from the first 10 dissections were sent for histological analysis. The ALL was found in all 20 knees. The femoral attachment of the ALL at the lateral epicondyle averaged 3.5 mm distal and 2.2 mm anterior to the attachment of the LCL. Two distal attachments were observed: one inserts into the lateral meniscus, the other between the Gerdy tubercle and the fibular head, approximately 4.4 mm distal to the tibial articular cartilage. The mean measurements for the ligament were 37.3 mm (length), 7.4 mm (width), and 2.7 mm (thickness). The histological analysis of the ligaments revealed dense connective tissue. The ALL is consistently present in the anterolateral region of the knee. Its attachment to the femur is anterior and distal to the attachment of the LCL. Moving distally, it bifurcates at close to half of its length. The ALL features 2 distal attachments, one at the lateral meniscus and the other between the Gerdy tubercle and the fibular head. The ALL may be

  3. Topical application of ex vivo expanded endothelial progenitor cells promotes vascularisation and wound healing in diabetic mice.

    Science.gov (United States)

    Asai, Jun; Takenaka, Hideya; Ii, Masaaki; Asahi, Michio; Kishimoto, Saburo; Katoh, Norito; Losordo, Douglas W

    2013-10-01

    Impaired wound healing leading to skin ulceration is a serious complication of diabetes and may be caused by defective angiogenesis. Endothelial progenitor cells (EPCs) can augment neovascularisation in the ischaemic tissue. Experiments were performed to test the hypothesis that locally administered EPCs can promote wound healing in diabetes. Full-thickness skin wounds were created on the dorsum of diabetic mice. EPCs were obtained from bone marrow mononuclear cells (BMMNCs) and applied topically to the wound immediately after surgery. Vehicle and non-selective BMMNCs were used as controls. Wound size was measured on days 5, 10 and 14 after treatment, followed by resection, histological analysis and quantification of vascularity. Topical application of EPCs significantly promoted wound healing, as assessed by closure rate and wound vascularity. Immunostaining revealed that transplanted EPCs induced increased expression of vascular endothelial growth factor and basic fibroblast growth factor. Few EPCs were observed in the neovasculature based on in vivo staining of the functional vasculature. Ex vivo expanded EPCs promote wound healing in diabetic mice via mechanisms involving increased local cytokine expression and enhanced neovascularisation of the wound. This strategy exploiting the therapeutic capacity of autologously derived EPCs may be a novel approach to skin repair in diabetes. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

  4. Technical analysis of volume-rendering algorithms: application in low-contrast structures using liver vascularisation as a model

    International Nuclear Information System (INIS)

    Cademartiri, Filippo; Luccichenti, Giacomo; Runza, Giuseppe; Bartolotta, Tommaso Vincenzo; Midiri, Massimo; Gualerzi, Massimo; Brambilla, Lorenzo; Coruzzi, Paolo; Soliani, Paolo; Sianesi, Mario

    2005-01-01

    Purpose: To assess the influence of pre-set volume rendering opacity curves (OC) on image quality and to identify which absolute parameters (density of aorta, hepatic parenchyma and portal vein) affect visualization of portal vascular structures (low-contrast structures). Materials and methods: Twenty-two patients underwent a dual-phase spiral CT with the following parameters: collimation 3 mm, pitch 2, increment 1 mm. Three scans were performed: one without contrast medium and the latter two after the injection of contrast material (conventionally identified as 'arterial' and 'portal'). The images were sent to a workstation running on an NT platform equipped with post-processing software allowing three-dimensional (3D) reconstructions to generate volume-rendered images of the vascular supply to the liver. Correlation between the absolute values of aorta, liver and portal vein density, OC parameters, and image quality were assessed. Results: 3D images generated using pre-set OC obtained a much mower overall quality score than those produced with OC set by the operator. High contrast between the liver and the portal vein, for example during the portal vascular phase, allows wider windows, thus improving image quality. Conversely, the OC in the parenchymal phase scans must have a high gradient in order to better differentiate between the vascular structures and the surrounding hepatic parenchyma. Conclusions: Image features considered to be of interest by the operator cannot be simplified by the mean of pre-set OC. Due to their strong individual variability automatic 3D algorithms cannot be universally applied: they should be adapted to both image and patient characteristics [it

  5. High-Frame-Rate Power Doppler Ultrasound Is More Sensitive than Conventional Power Doppler in Detecting Rheumatic Vascularisation

    NARCIS (Netherlands)

    M. van der Ven (Myrthe); J.J. Luime (Jolanda); van der Velden, L.L. (Levinia L.); J.G. Bosch (Hans); J.M.W. Hazes (Mieke); H.J. Vos (Rik)

    2016-01-01

    textabstractEarly recognition of joint inflammation will increase treatment efficacy in rheumatoid arthritis (RA). Yet, conventional power Doppler (PD) ultrasound might not be sufficiently sensitive to detect minor inflammation. We investigated the sensitivity of high-frame rate Doppler, combined

  6. Femoral head vascularisation in Legg-Calve-Perthes disease: comparison of dynamic gadolinium-enhanced subtraction MRI with bone scintigraphy

    International Nuclear Information System (INIS)

    Lamer, Sylvie; Dorgeret, Sophie; Brillet, Pierre-Yves; Hassan, Max; Sebag, Guy H.; Khairouni, Abdeslam; Mazda, Keyvan; Bacheville, Eric; Pennecot, Georges F.; Bloch, Juliette

    2002-01-01

    Heading AbstractBackground. It has been reported that MRI using a dynamic gadolinium-enhanced subtraction technique can allow the early identification of ischaemia and the pattern of revascularisation in Legg-Calve-Perthes (LCP) disease with increased spatial and contrast resolution. Therefore, dynamic gadolinium-enhanced subtraction (DGS) MRI may be a possible non-ionising substitute for bone scintigraphy.Objective. The purpose of this prospective study was to compare DGS MRI and bone scintigraphy in the assessment of femoral head perfusion in LCP disease.Materials and methods. Twenty-six DGS MR images and bone scintigraphies of 25 hips in 23 children were obtained at different stages of LCP disease; three stage I, 12 stage II, six stage III and five stage IV (Waldenstroem classification). The extent of necrosis, epiphyseal revascularisation pathways (lateral pillar, medial pillar, and/or transphyseal perfusion) and metaphyseal changes were analysed.Results. Total agreement between both techniques was noted in the depiction of epiphyseal necrosis (kappa=1), and metaphyseal abnormalities (kappa=0.9). DGS MRI demonstrated better revascularisation in the lateral (kappa=0.62) and medial pillars (kappa=0.52). The presence of basal transphyseal reperfusion was more conspicuous with MRI.Conclusions. DGS MRI allows early detection of epiphyseal ischaemia and accurate analysis of the different revascularisation patterns. These changes are directly related to the prognosis of LCP disease and can aid therapeutic decision making. (orig.)

  7. COMP-angiopoietin-1 recovers molecular biomarkers of neuropathy and improves vascularisation in sciatic nerve of ob/ob mice.

    Directory of Open Access Journals (Sweden)

    Joanna Kosacka

    Full Text Available BACKGROUND: Leptin-deficient ob/ob mice are a model of type 2 diabetes induced peripheral neuropathy. Ob/ob mice exhibit obesity, insulin resistance, hyperglycaemia, and alterations of peripheral nerve fibres and endoneural microvessels. Here we test the hypothesis that cartilage oligomeric matrix protein (COMP-Ang-1, a soluble and stabile form of Ang-1 which promotes angiogenesis and nerve growth, improves regeneration of nerve fibres and endoneural microvessels in ob/ob mice. METHODS AND FINDINGS: COMP-Ang-1 (100 ng/ml or NaCl were intraperitoneally (i.p. injected into male (N = 184, 3-month old, ob/ob or ob/+ mice for 7 and 21 days. We measured expression of Nf68, GAP43, Cx32, Cx26, Cx43, and TNFα in sciatic nerves using Western blot analysis. To investigate the inflammation in sciatic nerves, numbers of macrophages and T-cells were counted after immunofluorescence staining. In ultrathin section, number of myelinated/non-mylinated nerve fibers, g-ratio, the thickness of Schwann cell basal lamina and microvessel endothelium were investigated. Endoneural microvessels were reconstructed with intracardial FITC injection. Treatment with COMP-Ang-1 over 21 days significantly reduced fasting blood glucose and plasma cholesterol concentrations compared to saline treated ob/ob mice. In addition, COMP-Ang-1 treatment: 1 up-regulated expression of Nf68 and GAP43; 2 improved expression of gap junction proteins including connexin 32 and 26; 3 suppressed the expression of TNFα and Cx43 and 4 led to decreased macrophage and T-cell infiltration in sciatic nerve of ob/ob mice. The significant changes of sciatic nerve ultrastructure were not observed after 21-day long COMP-Ang-1 treatment. COMP-Ang-1 treated ob/ob mice displayed regeneration of small-diameter endoneural microvessels. Effects of COMP-Ang-1 corresponded to increased phosphorylation of Akt and p38 MAPK upon Tie-2 receptor. CONCLUSIONS: COMP-Ang-1 recovers molecular biomarkers of neuropathy, promotes angiogenesis and suppresses inflammation in sciatic nerves of ob/ob mice suggesting COMP-Ang-1 as novel treatment option to improve morphologic and protein expression changes associated with diabetic neuropathy.

  8. Deep peroneal nerve palsy due to osteochondroma arising from fibular head and proximal lateral tibia

    Directory of Open Access Journals (Sweden)

    Murat Demiroğlu

    2017-01-01

    In this study, we aimed to present a case with a drop foot resulting from osteochondromas of proximal tibia and fibula and help to guide the clinicians in differential diagnosis according to SCARE criteria Agha (2016 [3].

  9. 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

  10. The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    McKean, D.; Thomee, E.; Grant, D.; Teh, J.L.; Mansour, R. [Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Headington, Oxford (United Kingdom); Yoong, P. [Royal Berkshire NHS Foundation Trust, Royal Berkshire Hospital, Reading (United Kingdom); Yanny, S. [Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury (United Kingdom)

    2015-10-15

    To describe the patterns of injury associated with injury to the popliteofibular ligament injury. A retrospective review was performed of 180 MRI scans undertaken for acute knee trauma. Scans were excluded if the time of injury was over 4 weeks from the time of the scan, or if there was a history of septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. An agreed criterion for assessing the structures of the posterolateral ligamentous complex was defined and in each scan, the popliteofibular ligament (PFL) was scored as normal or injured. The menisci, ligaments, and tendons of each knee were also assessed. The mean age was 25.7 years (range, 9-65 years) and 72.2 % (n = 130) patients were male. The PFL was injured in 36 cases (20 %). There is a significant association between PFL injury and ACL rupture (p = 0.0001), ITB injury (p = 0.0001), PCL injury (p = 0.0373), in addition to associations with injury to other posterolateral corner structures including the lateral collateral ligament (p = 0.0001), biceps femoris tendon (p = 0.0014), and popliteus tendon (p = 0.0014). Of our series of PFL injuries, nine cases (25 %) were associated with further injuries of posterolateral corner structures and in 27 cases (75 %) the PFL was the only posterolateral corner structure torn. PFL injury is not uncommon in acute knee trauma and is associated with significant internal derangement of the knee, especially anterior cruciate ligament rupture, ITB sprain, and injury to other structures within the posterolateral corner. (orig.)

  11. Solid variant aneurysmal bone cyst in the distal fibular metaphysis: radiologic and pathologic challenges to diagnosis

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Johnson, MD

    2017-09-01

    Full Text Available Solid variant aneurysmal bone cyst is a rare benign bone lesion, representing a small fraction of all aneurysmal bone cysts. The imaging appearance and histologic features may overlap with other benign and malignant neoplasms, posing a diagnostic dilemma for clinicians, pathologists, and radiologists. We present a case of solid variant aneurysmal bone cyst of the distal fibula and review the radiologic and histologic features important for diagnosis.

  12. Non union of an epiphyseal fibular fracture in a pediatric patient.

    Science.gov (United States)

    Mirmiran, Roya; Schuberth, John M

    2006-01-01

    There are few reports on delayed or nonunion in the pediatric ankle fracture. The authors present a case of a nonunion of a mid-epiphyseal fracture of the distal fibula, described as a type 7 pediatric fracture. Both the occurrence of this injury pattern and a nonunion has not been reported in the same patient. Operative reduction of the nonunion resulted in a satisfactory outcome.

  13. 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

    Full Text Available Background: Primary benign and malignant tumors of the proximal fibula are not very common. Upper fibula being an expendable bone; the majority of the primary bone tumors at this site are usually treated with en bloc proximal fibulectomy. There is scarce literature on functional results, difficulties faced during dissection when to preserve or sacrifice common peroneal nerve and importance of lateral collateral ligament repair after proximal fibulectomy. The present study attempts at assessing these variables. Materials and Methods: This retrospective study included 46 patients; 30 males and 16 females with age ranging from 12 to 44 years (average: 26 years operated between 2003 and 2014. There were 34 benign and 12 malignant tumors. All were treated with proximal en bloc fibulectomy as indicated and decided by the operating surgeon keeping in view its extent on magnetic resonance imaging. Peroneal nerve sacrifice or preservation was decided as per the type (benign/malignant, its involvement by the tumor and the extent of the tumor. In 14 (for 12 malignant and two benign giant cell tumors [GCTs] patients, the peroneal nerve required resection for the margins. Partial upper tibial resection was performed in cases of malignant tumors and three GCTs. The followup ranged between 24 and 120 months (median: 48 months. Results: Patients with peroneal nerve resection had inferior functional outcome than those without peroneal nerve resection. There was no higher risk of tibia fracture in patients with partial tibial resection. Lateral collateral reconstruction yielded better results and should be performed in all cases. Functional outcome was significantly better in patients with benign tumors than in patients with malignant tumors as these required neither resection of the peroneal nerve nor large amount of muscle excision. The functional results were evaluated using Musculoskeletal Tumor Society (MSTS score, and clinical outcomes were evaluated using 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.

  14. Post-Traumatic Periprosthetic Tibial and Fibular Fracture After Total Ankle Arthroplasty: A Case Report.

    Science.gov (United States)

    Brock, Amanda K; Tan, Eric W; Shafiq, Babar

    Periprosthetic fractures after total ankle arthroplasty are uncommon, with most cases occurring intraoperatively. We describe a post-traumatic periprosthetic fracture of the distal tibia and fibula after total ankle arthroplasty that was treated with minimally invasive plate osteosynthesis. It is important for orthopedic surgeons not only to recognize the risk factors for postoperative periprosthetic total ankle arthroplasty fractures, but also to be familiar with the treatment options available to maximize function and minimize complications. The design of the tibial prosthesis and surgical techniques required to prepare the ankle joint for implantation are important areas of future research to limit the risk of periprosthetic fractures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Ipsilateral Femoral Fracture Non-Union and Delayed Union Treated By Hybrid Plate Nail Fixation and Vascularized Fibula Bone Grafting: A Case Report

    Directory of Open Access Journals (Sweden)

    CK Chan

    2013-07-01

    Full Text Available Non-union is a well recognized complication of femoral neck fractures. The decision whether to attempt fracture fixation or to resort to hip replacement is particularly difficult in patients in the borderline age group in whom complex attempts at gaining union may fail and later present a difficult revision. On the other hand the patient may be young enough that arthroplasty best be avoided . Besides, presence of ipsilateral femoral shaft fracture with delayed union in addition to the femoral neck non-union will pose major problems at operation. We share our experience in treating a femoral neck fracture non-union with ipsilateral femoral shaft delayed union in the shaft and in the distal femur in a fifty years old patient. The fracture was treated with an angle blade plate and supracondylar nail supplemented with a free vascularised fibular bone grafting and autologous cancellous graft. There was radiological union at fourth month. At sixth months, the patient was free of pain and able to walk without support. Thus, we would like to suggest that vascularised fibula bone grafting with supracondylar nailing is a viable option for this pattern of fracture.

  16. Mega alloprosthesis in limb-sparing surgery: a case illustration, Hospital Univ. Science of Malaysia (HUSM) experience

    International Nuclear Information System (INIS)

    Aidura, M.; Zulmi, W.; Zulkefli, A.R.; Sukari Halim

    1999-01-01

    A case illustration of our early experience of limb-sparing surgery in muskuloskeletal tumors using a mega alloprosthesis was discussed. The presentation was of a 42 year olds Malay woman with a solitary pathological fracture in a metastatic lesion to the upper third of right femur. This was found to be histologically identical to the stromal component of malignant metastatic Cytosarcoma Phylloides of the breast. It represented the first reported histologically confirmed skeletal manifestation of rare breast pathology in HUSM. Cytosarcoma Phylloides of the breast appeared to encompass a diverse group of tumors with variable unpredictable behaviors. Although it accounted for 0.3-1.0% of all breast neoplasms, it could behave in a malignant fashion and metastasized hematogenously to the skeletal system. The solitary nature of the metastatic lesion and the pathological fracture which the patient sustained, warranted us to perform a surgical stabilization not only to alleviate the pain, to eradicate the tumor bulk, but also to restore loading capacity and preserving function and mobility. It had been achieved by wide excision of the metastatic lesion and the integration of a massive allograft, polymethylmethacrylate and an implant into a well-structured composite unit. Augmentation to revascularise the avascular allograft bone had also been done with an ipsilateral segmental free vascularised fibular composite graft, which also acted as a live bone strut for mechanical maintenance once resorption of the allograft commenced, and the fibular graft hypertrophied. Adjuvant chemotherapy had been administered to combat systemic micrometastasis. As the tumor margins were histologically confirmed to be free and the patient had passed the early graft rejection period, close monitoring was mandatory for an effective tumor control and avoidance of complications. This new technique of a massive allograft combined with an endoprosthesis and a segmental live fibular graft promises to

  17. On the transferability of atomic contributions to the optical rotatory power of hydrogen peroxide, methyl hydroperoxide and dimethyl peroxide

    DEFF Research Database (Denmark)

    Sánchez, Marina; Alkorta, Ibon; Elguero, José

    2014-01-01

    for the hydrogen, oxygen and carbon atoms as well as for the methyl group at the level of time-dependent density functional theory with the B3LYP exchange-correlation functional employing a large Gaussian basis set. We find that the atomic or group contributions are not transferable among these three molecules....

  18. Uranium prospecting program: memorandum of request United Nations Assistance Rotatory Fund for Naturals resources in Uranium Prospecting

    International Nuclear Information System (INIS)

    1976-01-01

    The Uruguayan government required assistance to Unit Nations funds with the aim of studies the Natural resources in Uranium prospecting, their antecedent, actual and projected works, equipment and end considerations

  19. Endodontic Treatment of Maxillary Premolar with Three Root Canals Using Optical Microscope and NiTi Rotatory Files System.

    Science.gov (United States)

    Relvas, João Bosco Formiga; de Carvalho, Fredsom Marcio Acris; Marques, André Augusto Franco; Sponchiado, Emílio Carlos; Garcia, Lucas da Fonseca Roberti

    2013-01-01

    The aim of the study was to report a clinical case of endodontic treatment of a maxillary first premolar with three root canals using an optical microscope and rotary instrumentation technique. The main complaint of the patient, a 16-year-old girl, was pain in tooth 14. After clinical and radiographic examination, irreversible pulpitis was diagnosed. An alteration in the middle third of the pulp chamber radiographically observed suggested the presence of three root canals. Pulp chamber access and initial catheterization using size number 10 K-files were performed. The optical microscope and radiographic examination were used to confirm the presence of three root canals. PathFiles #13, #16, and #19 were used to perform catheterization and ProTaper files S1 and S2 for cervical preparation. Apical preparation was performed using F1 file in the buccal canals and F2 in the palatal canal up to the working length. The root canals were filled with Endofill sealer by thermal compaction technique using McSpadden #50. The case has been receiving follow-up for 12 months and no painful symptomatology or periapical lesions have been found. The use of technological tools was able to assist the endodontic treatment of teeth with complex internal anatomy, such as three-canal premolars.

  20. A Segmental Hypoplastic Anterior Tibial Artery Coexisting with a Hypertrophied Perforating Fibular Artery a Case Report and Clinical Implications

    OpenAIRE

    Ariyo, Olutayo

    2015-01-01

    Vascular injuries of the lower limb, especially from penetrating gunshot wounds, and peripheral arterial diseases are on the increase and management of these and many other lower limb injuries involve increasing usage of vascular interventions like by-pass surgery, per-cutaneous transluminal angioplasty, arterial cannulation, arterial bypass graft or minimally invasive measures like percutaneous trans-arterial catheterization, among others. A thorough knowledge of infrapopliteal branching mos...

  1. 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

  2. Extensive tumor reconstruction with massive allograft

    International Nuclear Information System (INIS)

    Zulmi Wan

    1999-01-01

    Massive deep-frozen bone allografts were implanted in four patients after wide tumor resection. Two cases were solitary proximal femur metastases, secondary to Thyroid cancer and breast cancer respectively; while the other two cases were primary in nature i.e. Chondrosarcoma proximal humerus and Osteosarcoma proximal femur. All were treated with a cemented alloprosthesis except in the upper limb where shoulder fusion was performed. Augmentation of these techniques were done with a segment 1 free vascularised fibular composite graft to the proximal femur of breast secondaries and proximal humerus Chondrosarcoma. Coverage of the wound of the latter was also contributed by lattisimus dorsi flap. The present investigations demonstrated the massive bone allografts were intimately anchored by host bone and there had been no evidence of aseptic loosening at the graft-cement interface. This study showed that with good effective tumor control, reconstructive surgery with massive allografts represented a good alternative to prosthetic implants in tumors of the limbs. No infection was seen in all four cases

  3. Technical analysis of volume-rendering algorithms: application in low-contrast structures using liver vascularisation as a model; Analisi tecnica degli algoritmi di volume rendering: applicazione alle strutture a basso contrsto usando come modello la vascolarizzazione epatica

    Energy Technology Data Exchange (ETDEWEB)

    Cademartiri, Filippo [Erasmus Medical Center, Rotterdam (Netherlands); Luccichenti, Giacomo [Fondazione Biomedica Europea ONLUS, Roma (Italy); Runza, Giuseppe; Bartolotta, Tommaso Vincenzo; Midiri, Massimo [Palermo Univ., Palermo (Italy). Sezione di scienze radiologiche; Gualerzi, Massimo; Brambilla, Lorenzo; Coruzzi, Paolo [Parma Univ., Parma (Italy). UO di prevenzione e riabilitazione vascolare, Fondazione Don C. Gnocchi ONLUS; Soliani, Paolo; Sianesi, Mario [Parma Univ., Parma (Italy). Dipartimento di chirurgia

    2005-04-01

    Purpose: To assess the influence of pre-set volume rendering opacity curves (OC) on image quality and to identify which absolute parameters (density of aorta, hepatic parenchyma and portal vein) affect visualization of portal vascular structures (low-contrast structures). Materials and methods: Twenty-two patients underwent a dual-phase spiral CT with the following parameters: collimation 3 mm, pitch 2, increment 1 mm. Three scans were performed: one without contrast medium and the latter two after the injection of contrast material (conventionally identified as 'arterial' and 'portal'). The images were sent to a workstation running on an NT platform equipped with post-processing software allowing three-dimensional (3D) reconstructions to generate volume-rendered images of the vascular supply to the liver. Correlation between the absolute values of aorta, liver and portal vein density, OC parameters, and image quality were assessed. Results: 3D images generated using pre-set OC obtained a much mower overall quality score than those produced with OC set by the operator. High contrast between the liver and the portal vein, for example during the portal vascular phase, allows wider windows, thus improving image quality. Conversely, the OC in the parenchymal phase scans must have a high gradient in order to better differentiate between the vascular structures and the surrounding hepatic parenchyma. Conclusions: Image features considered to be of interest by the operator cannot be simplified by the mean of pre-set OC. Due to their strong individual variability automatic 3D algorithms cannot be universally applied: they should be adapted to both image and patient characteristics. [Italian] Scopo: Valutare l'influenza delle curve di opacit� (CO) preimpostate del volume-rendering sulla qualit� delle immagini, ed identificare quali parametri assoluti (attenzione dell'aorta, del parenchima epatico e della vena porta) influenzano la visualizzazione delle strutture vascolari portali (strutture a basso contrasto). Materiale e metodi: Sono stati valutati tramite TC spirale con tecnica bifasica 22 pazienti. I parametri utilizzati per la scansione sono stati: collimazione 3 mm, pitch 2, avanzamento 1 mm. Le scansioni eseguite sono state tre: la prima senza mezzo di contrasto (mdc), le ultime due con iniezioni di mdc (convenzionalmente identificate come 'arteriosa' e 'portale'). Le immagini sono poi state trasferite su una consolle di post-elaborazione dotata di sistema oparativo Windows NT con software per ricostruzioni tridimensionali (3D) in grado di produrre immagini in volume rendering della vascolarizzazione epatica. Sono state valutate: la correlazione tra i valori assoluti dell'aorta, attenuazione del fegato e della vena oprta, i parametri delle CO e la qualit� delle immagini. Risultati: Le immagini 3D ottenute utilizzando le CO preimpostate di ricostruzione possiedono una qualit� molto pi� bassa rispetto a quelle ottenute utilizzando la CO scelta dall'operatore. L'elevato contrasto tra il fegato e la vena porta, per esempio durante la fase portale, utilizza delle finestre pi� larghe, in modo da aumentare la qualit� dell'immagine. Al contrario, nelle scansioni effettuate durante la fase parenchimografica, la CO deve avere un elevato gradiente in modo tale da permettere una migliore distinzione delle strutture vascolari dal parenchima epatico che le circonda. Conclusioni: Le caratteristiche dell'immagine, considerate di interesse per l'operatore, non possono essere semplificate dalla media delle CO preimpostate. Data la loro estrema variabilit� individuale, gli algoritmi 3D automatici non possono essere universalmente applicati: dovrebbero essere adattati sia alle caratteristiche dell'immagine che al paziente.

  4. Rare solitary focal tuberculous involvement of liver masquerading as hepatic metastasis on FDG PET/CT in a case of fibular round cell tumor

    International Nuclear Information System (INIS)

    Puranik, Ameya D; Purandare, Nilendu C; Sridhar, Epari; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2015-01-01

    Finding of focal 18F-fluoro-deoxyglucose (FDG) uptake in liver on FDG positron emission tomography/computed tomography (FDG PET/CT) in a known case of malignancy is often considered to be metastases. We report a similar finding on FDG PET/CT in a case of Ewing's sarcoma of thigh, which turned out to be of tuberculous etiology, an unusual cause of false positive FDG uptake in the liver

  5. The developmental field concept in pediatric pathology--especially with respect to fibular a/hypoplasia and the DiGeorge anomaly.

    Science.gov (United States)

    Opitz, J M; Lewin, S O

    1987-01-01

    Identical anomalies produced by different causes such as aneuploidy, gene mutation, teratogenic chemicals, and certain surgical procedures are a clear indication that embryonic primordia respond as units in the production of developmental anomalies of anatomic structure. Hence, they must also act as units during normal ontogeny. The presence of identical malformations in different mammalian species identifies developmental and anatomic homology by virtue of descent from a common ancestor. These dys- and orthomorphogenetically reactive units are the equivalents of the classic experimental embryologist's epimorphic fields, which are those units of the embryo in which the development of complex structures appropriate to the species is determined and controlled in a spatially coordinated, temporarily synchronous, and epimorphically hierarchical manner that expresses both species-nonspecific (that is, phylogenetic) and species-specific genetically coded developmental information. Thus, it is as important for pathologists as it is for clinical geneticists to steep themselves in the art and science of phenotype analysis and to be able to do all of those studies, including anthropometry, dermatoglyphics, and growth analysis, that are required to arrive at inferences of cause and pathogenesis from the phenotype. There is probably one other incentive besides the ethical and intellectual ones to do this and to do it as well as possible, namely, the medico-legal consequences. If pathologists fail to illuminate the causal genesis of a given case to aid in preventing recurrence, then, in short order, they might be held equally as liable as clinicians for missing high recurrence risk genetic diagnoses. These depressing considerations aside, it is important to close on a positive note. As at the outset, we want to emphasize once more that, without question, this is the most exciting time to be working in the field of developmental pathology. In this specialty a marriage is occurring of several types of investigational methods, ranging from humble morphologic studies to metabolic analysis to the most sophisticated designs of molecular biology, to produce new interdisciplinary approaches to the solution of the oldest intellectual problem confronting medicine--how does the "fabric of the human body" (in the immortal words of Vesalius) come about?(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Utilization of diesel fuel, anhydrous ethanol and additives blend of a stationary diesel engine with rotatory pump; Utilizacao de mistura ternaria alcool, diesel e aditivo em motores do ciclo diesel com bomba de injecao rotativa

    Energy Technology Data Exchange (ETDEWEB)

    Reyes Cruz, Yordanka; Cavado Osorio, Alberto [Centro de Pesquisas de Petroleo (CEINPET), Havana (Cuba); Belchior, Carlos Rodrigues Pereira; Pereira, Pedro P.; Pinto, Nauberto Rodrigues [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Centro de Tecnologia. Dept. de Engenharia Naval e Mecanica; Aranda, Donato A. Gomes [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Escola de Quimica

    2008-07-01

    In this paper is analyzed the performance and fuel consumption of a stationary Diesel engine, with rotary diesel fuel injection pump, using (diesel fuel + anhydrous ethanol + 0.5% additive) blend. The engine performance parameters and fuel consumption tests were performed at the Termic Machine Laboratory, located in Federal University of Rio de Janeiro, and evaluated using a MWM Series 10 model 4.10 TCA. Two test cycles were used for this test program: the tests were carried out starting from the base diesel S-500, used as a reference; the engine operated with (diesel fuel S-500 - 8% anhydrous ethanol - DIOLEFECT additive (0,5% SPAN80 + 0,1% Biomix-D)) blend. The results indicate that: the reduction levels in power and torque of engine are approximately the same which is (2,55{+-}2%), the brake specific fuel consumption increased in 1,8%. (author)

  7. Análise do exercício físico e eletroestimulção do músculo tibial cranial após neurorrafia término-lateral do nervo fibular em ratos

    OpenAIRE

    Rosa, Vívian Cristina [UNESP

    2015-01-01

    Lesions of peripheral nerves can be extremely disabling. In this context, microsurgery has presented a major role in the treatment of patients. However, even with all technical refinement achieved by microsurgery, full motor recovery has not been ensured yet. This can be explained by muscle degeneration, atrophy and functional losses generated by denervation. In the clinical setting, some physiotherapy resources have been suggested in order to minimize losses due to denervation. Among these r...

  8. Vascularized Fibula Flaps for Mandibular Reconstruction: An ...

    African Journals Online (AJOL)

    For decades, osseous vascularised flaps have been used for reconstruction of the mandible with the vascularised fibula flap (VFF) remaining the commonly used osseous free flap, reasons ranging from its adequate bone and pedicle length to its receptive dental implant placement quality. This report considers a modest use ...

  9. Fractures of the shafts of the tibia and fibula

    International Nuclear Information System (INIS)

    Bender, C.E.; Campbell, D.C.

    1985-01-01

    Fractures of the shafts of the tibia and fibula are the most common long bone fractures. This chapter discusses tibial and fibular shaft fractures. Treatment of tibial and fibular fractures is similar and, therefore, reference is primarily made to the tibia. Diagnostic techniques are also evaluated

  10. Bone Gap Management Using Linear Rail System (LRS): Initial ...

    African Journals Online (AJOL)

    Background: Vascularized fibular grafting, free fibular graft, tibia profibula synostosis, amputation with a good prosthesis and Ilizarov technique are some of the suitable options for managing bone gaps that result from trauma or treatment of tumours, bone infection, congenital pseudoarthrosis and repeated failed ...

  11. Liu et al., Afr J Tradit Complement Altern Med. (2015) 12(6):27-32 ...

    African Journals Online (AJOL)

    Proff.Adewunmi

    suffering from fibular fractures at the same side of the defects. ... Vascularized fibular graft was used to recover the integrity of grafting trunk vessel by ... area was located in the lower and middle tibia, the position of reaming bone marrow cavity ...

  12. Uranium prospecting program: memorandum of request United Nations Assistance Rotatory Fund for Naturals resources in Uranium Prospecting; Programa prospeccion Uranio: memorando de solicitud de asistencia al fondo Rotatorio de Naciones Unidas para el estudio de los Recursos Naturales para la prospeccion de Uranio

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1976-07-01

    The Uruguayan government required assistance to Unit Nations funds with the aim of studies the Natural resources in Uranium prospecting, their antecedent, actual and projected works, equipment and end considerations.

  13. Hindfoot Valgus following Interlocking Nail Treatment for Tibial Diaphysis Fractures: Can the Fibula Be Neglected?

    Directory of Open Access Journals (Sweden)

    Metin Uzun

    2014-01-01

    Full Text Available Purpose. We evaluated whether intramedullary nail fixation for tibial diaphysis fractures with concomitant fibula fractures (except at the distal one-third level managed conservatively with an associated fibula fracture resulted in ankle deformity and assessed the impact of the ankle deformity on lower extremity function. Methods. Sixty middle one-third tibial shaft fractures with associated fibular fractures, except the distal one-third level, were included in this study. All tibial shaft fractures were anatomically reduced and fixed with interlocking intramedullary nails. Fibular fractures were managed conservatively. Hindfoot alignment was assessed clinically. Tibia and fibular lengths were compared to contralateral measurements using radiographs. Functional results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS and the Foot and Ankle Disability Index Score (FADI. Results. Anatomic union, defined as equal length in operative and contralateral tibias, was achieved in 60 fractures (100%. Fibular shortening was identified in 42 fractures (68%. Mean fibular shortening was 1.2 cm (range, 0.5–2 cm. Clinical exams showed increased hindfoot valgus in 42 fractures (68%. The mean KOOS was 88.4, and the mean FADI score was 90. Conclusion. Fibular fractures in the middle or proximal one-third may need to be stabilized at the time of tibial intramedullary nail fixation to prevent development of hindfoot valgus due to fibular shortening.

  14. Deuteration effect on the rotary power of hydrogen bonded compounds

    International Nuclear Information System (INIS)

    Kolbe, A.; Kolbe, A.; Martin-Luther-Universitaet Halle-Wittenberg, Halle

    1982-01-01

    The variation of the rotatory power caused by deuteration in menthol, isopulegol, α-terpineol-(4), elemol, and diphenylacetyl-L-leucin has been investigated. The results and a brief discussion are given

  15. Svimmelhed, der er relateret til øjensygdomme

    DEFF Research Database (Denmark)

    Lund-Andersen, Henrik

    2013-01-01

    Dizziness stands for vertigo (rotatory and nautic) and dysbalance/unstability. Vertigo originates from the vestibular central nervous system; no eye disease, but nystagmus is often present. Dysbalance/unstability: normal ophthalmological findings exclude ophthalmological pathogenesis...

  16. Shift of the spectrum in the non-inertial reference frame

    International Nuclear Information System (INIS)

    Kudykina, T. A.; Pervak, A. I.

    2012-01-01

    We propose a new natural explanation of the spectral redshift (blue shift) arguing that the rotatory non-inertial reference frame of cosmological objects is the main reason of the shift of the frequency of emitting light. (Author)

  17. SPECT quality control tests

    International Nuclear Information System (INIS)

    Robilotta, C.C.; Rebelo, M.F.S.; Oliveira, M.A.; Abe, R.

    1987-01-01

    Quality control tests of tomographic system composed by a rotatory chamber (CGR Gammatomome T-9000) and a microcomputer are presented. Traditional quality control tests for scintilation chambers and specific tests for tomographic systems are reported. (M.A.C.) [pt

  18. Deuteration effect on the rotary power of hydrogen bonded compounds

    Energy Technology Data Exchange (ETDEWEB)

    Kolbe, A.; Kolbe, A. (Akademie der Wissenschaften der DDR, Halle/Saale. Inst. fuer Biochemie der Pflanzen; Martin-Luther-Universitaet Halle-Wittenberg, Halle (German Democratic Republic). Sektion Chemie)

    1982-01-01

    The variation of the rotatory power caused by deuteration in menthol, isopulegol, ..cap alpha..-terpineol-(4), elemol, and diphenylacetyl-L-leucin has been investigated. The results and a brief discussion are given.

  19. A Comprehensive Reanalysis of the Distal Iliotibial Band: Quantitative Anatomy, Radiographic Markers, and Biomechanical Properties.

    Science.gov (United States)

    Godin, Jonathan A; Chahla, Jorge; Moatshe, Gilbert; Kruckeberg, Bradley M; Muckenhirn, Kyle J; Vap, Alexander R; Geeslin, Andrew G; LaPrade, Robert F

    2017-09-01

    (ridges). The proximal and distal bundles inserted on the distal femur 53.6 mm (95% CI, 50.7-56.6 mm) and 31.4 mm (95% CI, 27.3-35.5 mm) proximal to the lateral epicondyle, respectively. The centers of the bundle insertions were 22.5 mm (95% CI, 19.1-25.9 mm) apart. The total insertion area of the distal ITB on the proximal tibia was 429.1 mm 2 (95% CI, 349.2-509.1 mm 2 ). A distinct capsulo-osseous layer of the distal ITB was also identified that was intimately related to the lateral knee capsule. Its origin was in close proximity to the lateral gastrocnemius tubercle, and it inserted on the proximal tibia at the lateral tibial tubercle between the fibular head and the Gerdy tubercle. Radiographic analysis supported the quantitative anatomic findings. The mean maximum load during pull-to-failure testing was 71.3 N (95% CI, 41.2-101.4 N) and 170.2 N (95% CI, 123.6-216.8 N) for the proximal and distal Kaplan bundles, respectively. The most important finding of this study was that 2 distinct deep bundles (Kaplan fibers) of the distal ITB were identified. Each bundle of the deep layer of the ITB was associated with a newly identified distinct bony ridge. Radiographic analysis confirmed the measurements previously recorded and established reproducible landmarks for the newly described structures. Biomechanical testing revealed that the Kaplan fibers had a strong attachment to the distal femur, thereby supporting a role in rotational knee stability. The identification of 2 distinct deep fiber (Kaplan) attachments clarifies the function of the ITB more definitively. The results also support the role of the ITB in rotatory knee stability because of the fibers' vectors and their identified maximum loads. These findings provide the anatomic and biomechanical foundation needed for the development of reconstruction or repair techniques to anatomically address these deficiencies in knee ligament injuries.

  20. Doppler echography and utilization of intravenous echo enhancer in the follow-up of hepato carcinoma with percutaneous radiological techniques

    International Nuclear Information System (INIS)

    Forner, J.; Flored de la Torre, M.; Senis, C.; Lozano de Arnilla, M. C.; Ferrer, S.; Celma, M. I.

    2002-01-01

    To evaluate the utilization of Doppler ultrasound scan in conjunction with echographic enhancer in the follow-up of hepato carcinomas treated by means of radiological intervention techniques. We treated 20 hepatic nodules diagnosed with hepato carcinoma either by means of chemo embolization or percutaneously (either injection of acetic acid or radio-frequency thermo-ablation). Doppler ultrasound scan was performed before and after the treatment by means of sectorial and convex multifrequency probes. Evaluated were the absence, presence and degree of vascularisation, as well as its distribution and characteristics. In all cases, a contrast-en-handed spiral CT was performed. Both studies served as a pattern for comparison before and after treatment. In post-treatment enhanced-echo-Doppler controls of the 18 patients treated with acetic acid, vascularisation was not demonstrated in 7 cases, peripheral vascularisation was detected in 4 cases, perforation vascularisation in another four, and central vascularisation was detected in 3 cases. Contrast-enhanced spiral CT demonstrated superimposed findings, except in one cases, in which the spiral CT detected central capitation of the nodule.With enhanced echo-Doppler, peripheral vascularisation was detected. In both nodules treated by means of radio-frequency thermo ablation, there was detected neither vascularisation in the echo-Doppler nor captation of contrast media in the CT. Doppler ultrasound scan is a good method of follow-up for treated hepato carcinomas. The utilization of echoenhancers increases its ability to detect vascularization it being comparable to that of contrast-enhanced CT. As such, Doppler ultrasound scan together with echoenhancers can help us both in the selection of treatment and evaluation of therapeutic response. (Author) 35 refs

  1. Doppler echography and utilization of intravenous echo enhancer in the follow-up of hepato carcinoma with percutaneous radiological techniques; Ecografia Doppler y empleo del ecopotenciador intravenoso en el seguimiento del hepatocarcinoma con tecnicas radiologicas percutaneas

    Energy Technology Data Exchange (ETDEWEB)

    Forner, J; Flored de la Torre, M.; Senis, C; Lozano de Arnilla, M C; Ferrer, S; Celma, M I [Hospital General Universitario de Valencia. Valencia (Spain)

    2002-07-01

    To evaluate the utilization of Doppler ultrasound scan in conjunction with echographic enhancer in the follow-up of hepato carcinomas treated by means of radiological intervention techniques. We treated 20 hepatic nodules diagnosed with hepato carcinoma either by means of chemo embolization or percutaneously (either injection of acetic acid or radio-frequency thermo-ablation). Doppler ultrasound scan was performed before and after the treatment by means of sectorial and convex multifrequency probes. Evaluated were the absence, presence and degree of vascularisation, as well as its distribution and characteristics. In all cases, a contrast-en-handed spiral CT was performed. Both studies served as a pattern for comparison before and after treatment. In post-treatment enhanced-echo-Doppler controls of the 18 patients treated with acetic acid, vascularisation was not demonstrated in 7 cases, peripheral vascularisation was detected in 4 cases, perforation vascularisation in another four, and central vascularisation was detected in 3 cases. Contrast-enhanced spiral CT demonstrated superimposed findings, except in one cases, in which the spiral CT detected central capitation of the nodule.With enhanced echo-Doppler, peripheral vascularisation was detected. In both nodules treated by means of radio-frequency thermo ablation, there was detected neither vascularisation in the echo-Doppler nor captation of contrast media in the CT. Doppler ultrasound scan is a good method of follow-up for treated hepato carcinomas. The utilization of echoenhancers increases its ability to detect vascularization it being comparable to that of contrast-enhanced CT. As such, Doppler ultrasound scan together with echoenhancers can help us both in the selection of treatment and evaluation of therapeutic response. (Author) 35 refs.

  2. Angiogenesis in gliomas.

    Directory of Open Access Journals (Sweden)

    Elzbieta Czykier

    2008-02-01

    Full Text Available Brain gliomas are characterized by invasive growth and neovascularisation potential. Angiogenesis plays a major role in the progression of gliomas and its determination has a great prognostic value. The aim of the study was to assess the vascularisation of chosen brain gliomas and to estimate how it is correlated with tumour histological type, malignancy grade, location and size, and with age and sex of patients. Tumour vascularisation analysis was based on the determination of microvascular proliferation (MVP and microvessel density (MVD. Microvascular proliferation was measured with immunohistochemical methods using mouse monoclonal antibodies to detect cell proliferation antigens. The following antibodies were used Ki-67 and PCNA (DAKO. Identification of vessels was performed by CD31 antibody and anti-human von Willebrand factor (DAKO. The highest microvascular proliferation and microvascular density were observed in multiform glioblastomas and the lowest in oligodendrogliomas. Significant correlation was observed between the vascularisation and malignancy grade.

  3. Retinal vascular speed prematurity requiring treatment.

    Science.gov (United States)

    Solans Pérez de Larraya, Ana M; Ortega Molina, José M; Fernández, José Uberos; Escudero Gómez, Júlia; Salgado Miranda, Andrés D; Chaves Samaniego, Maria J; García Serrano, José L

    2018-03-01

    To analyse the speed of temporal retinal vascularisation in preterm infants included in the screening programme for retinopathy of prematurity. A total of 185 premature infants were studied retrospectively between 2000 and 2017 in San Cecilio University Hospital of Granada, Spain. The method of binocular indirect ophthalmoscopy with indentation was used for the examination. The horizontal disc diameter was used as a unit of length. Speed of temporal retinal vascularisation (disc diameter/week) was calculated as the ratio between the extent of temporal retinal vascularisation (disc diameter) and the time in weeks. The weekly temporal retinal vascularisation (0-1.25 disc diameter/week, confidence interval) was significantly higher in no retinopathy of prematurity (0.73 ± 0.22 disc diameter/week) than in stage 1 retinopathy of prematurity (0.58 ± 0.22 disc diameter/week). It was also higher in stage 1 than in stages 2 (0.46 ± 0.14 disc diameter/week) and 3 of retinopathy of prematurity (0.36 ± 0.18 disc diameter/week). The rate of temporal retinal vascularisation (disc diameter/week) decreases when retinopathy of prematurity stage increases. The area under the receiver operating characteristic curve was 0.85 (95% confidence interval: 0.79-0.91) for retinopathy of prematurity requiring treatment versus not requiring treatment. The best discriminative cut-off point was a speed of retinal vascularisation prematurity may be required. However, before becoming a new standard of care for treatment, it requires careful documentation, with agreement between several ophthalmologists.

  4. Dynamic response of beams on elastic foundations to impact loading

    International Nuclear Information System (INIS)

    Prasad, B.B.; Sinha, B.P.

    1987-01-01

    The beam considered is a Timoshenko beam in which the effects of rotatory inertia and shear deformations are included and the foundation model consists of Winkler-Zimmermann type having Hookean linear elastic springs. The analysis is very useful for predicting the dynamic response of structural components of aircraft or nuclear reactors or even runways if that component may be mathematically idealized as a beam on elastic foundation. The effect of rotatory inertia and shear deformation is very much pronounced and hence should not be neglected in solving such impact problems. In general the effect of foundation modulus is to further increase the values of frequencies of vibrations. (orig./HP)

  5. HORMONE REPLACEMENT TREATMENT IN UROGYNAECOLOGIC SURGERY

    Directory of Open Access Journals (Sweden)

    Matija Barbič

    2008-12-01

    Different studies on influence of the estrogen on urinary incontinence reveal only subjective improvement, but not objective one. There is even less studies, considering local estrogene treatment as pre-operative adjuvant therapy in treating urinary incontinence, however, evidently improved local vascularisation under estrogene influence support thesis,that local estrogene treatment might improve and accelerate post-operative wound healing.The role of systemic and local estrogene treatment is not defined yet precisely. However, itis confirmed that estrogene improve local vascularisation of vaginal and para-vaginaltissues, what gives us impression that pre- and postoperative estrogene local treatmentmight be useful

  6. Chronic ankle instability: evaluation with stress radiography, CT and CT arthrography

    International Nuclear Information System (INIS)

    Faure, Ch.; Deplus, F.; Bochu, M.; Besse, J.L.; Moyen, B.

    1997-01-01

    We retrospectively evaluated the anterior talo-fibular ligament and the tarsal sinus of 17 patients who had complained of chronic ankle external instability. This study based on both surgery and CT-arthrography findings shows the pathologic or normal aspects of the talo-fibular anterior ligament (normal, lax, fibrosis residue, ruptured). It confirms the good anatomic analysis of the tarsal sinus, i particular the anterior talo-calcaneal interosseous ligament and the search for fibrosis. We underline that capsular distension due to subtalar laxity is not detected with medical imaging. Compared with surgery (all patients), CT arthrography demonstrated the different aspects of the anterior talo fibular ligament injuries (normal, lax, discontinuous). (authors)

  7. A case of monostotic fibrous dysplasia of proximal femur managed with curettage and cortical bone grafting

    Directory of Open Access Journals (Sweden)

    A D Sud

    2013-01-01

    Full Text Available We present a case report of a young military personnel with monostotic fibrous dysplasia of proximal femur with painful, dysplasticlesion of the femoral neck and fatigue fracture who underwent cortical bone grafting using autogenous fibular strut graft and iliac crest bone graft. The fibular cortical grafts was used to bridge the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required.

  8. Valgusdeformitet i anklen som følge af distal fibula-epifysefraktur

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid

    2011-01-01

    Ankle fracture with involvement of the growth plate is the second most common paediatric fracture after the distal radius. The most common fracture type according to Salter Harris (SH) is type II of the distal tibia combined with green stick of the fibula. Isolated fracture of the distal fibular...... growth plate is not common and as a rule it does not give any growth arrest. We describe a case of isolated fibular fracture SH type II in a ten year-old girl which ended with symptomatic valgus deformity of the ankle. The patient was operated with good results....

  9. A new optical rotation dispersion formula

    International Nuclear Information System (INIS)

    Kimel, I.

    1981-12-01

    A new dispersion formula for the rotatory power is obtained in the framework of Kubo forlalism for transport coefficients. Unlike the well known Rosenfeld-Condon dispersion law, this formula is consistent with the free electron gas asymptotic behavior. (Author) [pt

  10. Analgesic activity of crude aqueous extract of the root bark of ...

    African Journals Online (AJOL)

    Objective: The analgesic activity of crude aqueous extract of the root bark of Zanthoxylum xanthozyloides was studied in mice and rats with the view to verifying the claim in folklore medicine that the extract has analgesic activity. Method: The extract was obtained by Soxhlet extraction and rotatory evaporation, followed by ...

  11. Large scale production of antitumor cucurbitacins from Ecballium ...

    African Journals Online (AJOL)

    ajl6

    2012-08-16

    Aug 16, 2012 ... 1Department of Plant Biotechnology, National Research Center, Cairo, 12622 Egypt. ... Bioreactor plays a vital role in the commercial production of secondary metabolites .... comparing the peak area with that at the same retention time with ... air dried by rotatory evaporator and then extracted using ethanol:.

  12. MR imaging of the elbow in baseball pitchers

    Energy Technology Data Exchange (ETDEWEB)

    Ouellette, Hugue; Bredella, Miriam; Palmer, William E.; Torriani, Martin [Massachusetts General Hospital, Division of Musculoskeletal Radiology, Boston, MA (United States); Labis, John [Methodist Hospital, Houston, TX (United States)

    2008-02-15

    Baseball pitcher throwing biomechanics are important to understanding the pathophysiology and magnetic resonance (MR) imaging appearances of injuries in baseball pitchers. Baseball pitchers experience repetitive excessive valgus forces at the elbow. Typical injuries are secondary to medial joint distraction, lateral joint compression, and rotatory forces at the olecranon. MR imaging is useful for evaluation of the elbow in baseball pitchers. (orig.)

  13. Pendulum as a model system for driven rotation in molecular nanoscale machines

    DEFF Research Database (Denmark)

    Zolotaryuk, Yaroslav; Christiansen, Peter Leth; Nordén, B.

    2000-01-01

    We suggest a ratchet mechanism of rotatory (or translatory) motion of a Brownian rotator (or a particle) in a spatially symmetric periodic potential. The asymmetry that drives the ratchet motion is due to a special sequence of activation of catalytic sites arranged in space circularly and periodi...

  14. Dynamic Model of a Wind Turbine for the Electric Energy Generation

    Directory of Open Access Journals (Sweden)

    José de Jesús Rubio

    2014-01-01

    Full Text Available A novel dynamic model is introduced for the modeling of the wind turbine behavior. The objective of the wind turbine is the electric energy generation. The analytic model has the characteristic that considers a rotatory tower. Experiments show the validity of the proposed method.

  15. Computer tomographic detection of an intraspinal arachnoidal cyst

    Energy Technology Data Exchange (ETDEWEB)

    Kuckein, D; Walter, K; Paal, G

    1981-03-01

    A 46 year old female patient who after 3-4 weeks of influenza suffered from strong headaches, vomiting and rotatory vertigo was subjected to a myelograph and then to a computerized tomographic investigation due to suspect cerebrospinal fluid. The computerized tomography is better than the myelography in diagnosing intraspinal arachnoidal cysts, however this should be preceded by most accurate possible segment location.

  16. Untitled

    Indian Academy of Sciences (India)

    Unibasic hypergeometric series. A bibasic hypergeometric transformation as- sociated with combinatorial identities of the. Rogers-Ramanujan type 41. Uniform vertical rotation. Some characterization theorems in rotatory magneto thermohaline convection 461. Unique uniform norm property. Uniqueness of the uniform and ...

  17. Translabyrinthine surgery for disabling vertigo in vestibular schwannoma patients

    NARCIS (Netherlands)

    Godefroy, W. P.; Hastan, D.; van der Mey, A. G. L.

    2007-01-01

    To determine the impact of translabyrinthine surgery on the quality of life in vestibular schwannoma patients with rotatory vertigo. Prospective study in 18 vestibular schwannoma patients. The study was conducted in a multispecialty tertiary care clinic. All 18 patients had a unilateral

  18. Journal of Chemical Sciences | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Chemical Sciences. H Karacali. Articles written in Journal of Chemical Sciences. Volume 117 Issue 6 November 2005 pp 677-683. Modified Pippard relationship describing the Raman frequency shifts of the rotatory lattice mode of ammonia solid II in the vicinity of its melting point · H Karacali H ...

  19. Journal of Chemical Sciences | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    1/)( /) for the rotatory lattice (librational) mode in ammonia solid II near its melting point. We have used our calculated Raman frequencies of this mode for pressures of 3.65, 5.02 and 6.57 kbars for this crystalline system. The values of ...

  20. the effects of symphysiotomy on the bantu female sacro-iliac joint

    African Journals Online (AJOL)

    The 75-year-old male therefore has a joint which is a synarthrosis, and the ... made which show a surprisingly wide range of sacral move- ments of a rotatory ... muscular action.12 ... There is very good reason to believe that this reaction is.

  1. Accurate measurement of the optical activity of alanine crystals and the determination of their absolute chirality

    Science.gov (United States)

    Ishikawa, Kazuhiko; Terasawa, Yukana; Tanaka, Masahito; Asahi, Toru

    2017-05-01

    Wavelength dependence measurements of the chiroptical properties in alanine crystals have so far been unsuccessful using conventional spectroscopic techniques. We describe our attempts to measure the wavelength dependence of the optical activity in L- and D-alanine crystals along each crystallographic axis, and to determine the absolute chirality of alanine crystals by correlating the absolute structure to the optical activity using an x-ray diffractometer and a generalized high accuracy universal polarimeter. We have succeeded in accurately measuring the optical rotatory dispersion in the direction, which shows that the optical rotation of the D-alanine crystal is dextrorotatory and that of the L-alanine crystal is laevorotatory, thereby determining the absolute chirality. Furthermore, comparison with the optical activity in solution shows that the optical activity in alanine crystals is different not only in value, but also in the sign. These results have led us to conclude that the optical rotatory power in the crystalline state should not be simply the summation of molecular optical rotatory power values. We propose the necessity of a theory, which contains the contribution of molecular interactions within the crystal, in order to calculate the optical rotatory power of the crystalline state.

  2. Untitled

    Indian Academy of Sciences (India)

    By R. K. ASUNDr and R. SAMUEL - - ( B. ... 562. Dispersion of Depolarisation of Rayleigh Scattering. Part I.-Fatty. Acids. By R. S. KRISHNAN .. (v k. it is. On the Structure and Optical Characters of the Nacre in Iridescent. Shells.-Part I. By V. S. RAJAGOPALAN V &. The Physical Identity of Enantiomers. Part II. (a) The Rotatory.

  3. Electron Correlation Models for Optical Activity

    DEFF Research Database (Denmark)

    Höhn, E. G.; O. E. Weigang, Jr.

    1968-01-01

    A two-system no-overlap model for rotatory strength is developed for electric-dipole forbidden as well as allowed transitions. General equations which allow for full utilization of symmetry in the chromophore and in the environment are obtained. The electron correlation terms are developed in full...

  4. Quantitative analysis of neurological effects induced by cranio-caudal gamma-irradiation of rats

    International Nuclear Information System (INIS)

    Davydov, B.I.; Ushakov, I.B.; Karpov, V.N.

    1987-01-01

    A study was made of the frequency and duration of neurological disorders after cranio-caudal irradiation of rats with doses of 7.5-500 Gy delivered to the head. As the mean effective dose increased the neurological disorders occurred in the following order: tremor, rotatory movements hyperkinesia, opisthotonos, and convulsions. The europhysiological disorders observed were subjected to a pathophysiological analysis

  5. Time to fibrinolytics for acute myocardial infarction: Reasons for ...

    African Journals Online (AJOL)

    The cornerstone of STEMI management is early re vascularisation, either by primary percutaneous coronary intervention or fibrinolytic therapy, in conjunction with other adjunctive pharmaceutical agents.[1] The most important determinant of outcome, irrespective of which form of revascularisation is selected, is the time from ...

  6. on pterygium recurrence

    African Journals Online (AJOL)

    2015-12-01

    Dec 1, 2015 ... and any other ocular disease. Complete ocular examination noted the gross features of the pterygia (fleshy (vascularised), intermediate, or atrophic) based on the translucency of the pterygium, presence or absence of calcification, its laterality. (unilateral or bilateral), location (nasal, temporal or kissing), its ...

  7. Case report

    African Journals Online (AJOL)

    abp

    10 déc. 2015 ... Les ruptures traumatiques du tendon quadricipital: à propos de 3 cas. Youssef Benyass1,& .... environ 1 à 2 cm au dessus du bord supérieur de la rotule. La vascularisation des ... Devant ce tableau clinique, il faut penser à ce ...

  8. Placenta as a source of hematopoietic stem cells

    NARCIS (Netherlands)

    E.A. Dzierzak (Elaine); C. Robin (Catherine)

    2010-01-01

    textabstractThe placenta is a large, highly vascularised hematopoietic tissue that functions during the embryonic and foetal development of eutherian mammals. Although recognised as the interface tissue important in the exchange of oxygen, nutrients and waste products between the foetus and mother,

  9. Haemorrhagic acoustic neuroma with features of a vascular malformation. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Benhaiem-Sigaux, N. [Dept. of Pathology, Hopital Henri Mondor, Creteil (France); Ricolfi, F. [Dept. of Neuroradiology, Henri Mondor Hospital, Creteil (France); Torres-Diaz, A.; Keravel, Y. [Dept. of Neurosurgery, Henri Mondo Hospital, Creteil (France); Poirier, J. [Dept. of Histology, Pitie-Salpetriere Hospital, Paris (France)

    1999-10-01

    A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage. (orig.)

  10. Pulmonary sequestration with histologic changes of cystic adenomatoid malformation

    International Nuclear Information System (INIS)

    Morin, C.; Filiatrault, D.; Russo, P.

    1989-01-01

    Pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM) are two infrequent congenital pulmonary diseases. The combination of these two entities is rare. We report a case where the antenatal ultrasonography showed a left pulmonary mass suggesting CCAM. The US done after birth revealed an aberrant vascularisation. Pathologic examination confirmed the association of both lesions. (orig.)

  11. The management of pelvic pressure ulcers by myocutaneous flaps ...

    African Journals Online (AJOL)

    Pressure ulcers or ischaemic necrosis of tissues over bony eminences due to pressure, heal very slowly. Vascularised tissues such as myocutaneous flaps are necessary to cover the ulcer and accelerate healing. This study was done to share our experience with methods of myocutaneous flaps in the treatment of pressure ...

  12. Haemorrhagic acoustic neuroma with features of a vascular malformation. A case report

    International Nuclear Information System (INIS)

    Benhaiem-Sigaux, N.; Ricolfi, F.; Torres-Diaz, A.; Keravel, Y.; Poirier, J.

    1999-01-01

    A 55-year-old man with hearing loss presented with vertigo and vomiting. CT tomography and MRI demonstrated a cerebellopontine angle mass with foci of haemorrhage. An angiomatous tumour, with large abnormal veins adhering to the capsule, was completely removed. Histologically, the tumour was an acoustic neuroma with abnormal vascularisation and limited intratumoral haemorrhage. (orig.)

  13. Chondromyxoid fibroma of distal 1/3 rd of fibula a rare tumour at rare ...

    African Journals Online (AJOL)

    Chondromyxoid fibromas are rare, benign tumours account for <1% of primary bone neoplasms. Most commonly affected in 2nd and 3rdof life. We report one such case of chondromyxoid fibroma in distal fibula of a 15-year-old girl. The patient was managed with lower 3rd fibulectomy and fibular turnoplasty from middle 3rd ...

  14. associated injuries and complications in floating knee management

    African Journals Online (AJOL)

    Materials and Methods: The investigation lasted ten years from 1st January, 2000 to ... hemarthrosis, 2 paralysis of fibular nerve associated to a displaced fracture of neck of ... Keywords: Associated injuries, complications, Floating knee, Management ... Road traffic accidents were responsible for 51 cases ... cerebral injuries.

  15. The mangled lower leg

    NARCIS (Netherlands)

    Hoogendoorn, Jochem Maarten

    2002-01-01

    A surgeon faced with a patient presenting with an open tibial/fibular fracture in combination with severe damage of the surrounding soft tissues, has to make the difficult decision whether to attempt salvage or to perform an immediate amputation of the leg. Until late in the nineteenth century the

  16. Analysis of Health Data from Ten Years of Polaris Submarine Patrols

    Science.gov (United States)

    1979-01-01

    34’ Crush injury, calf 3 3 ;;" Crush injury, foot 7 7 ’’ 1 Knees, stiff 2 2 Tendonitis, achilles 3 3 Talo fibular lig., tear 2 2 1 Myositis 1 1...Spencer. 1971. Chronic CO. toxicity: species difference physiological and histopathological effects. NSMRL Rep. No, 656. Schaefer, K. E.. S. Pasquale, A

  17. Reconstruction of Complex Post-Traumatic Perineal/Pelvic Defects ...

    African Journals Online (AJOL)

    of the pelvic diaphragm). A composite pedicled. ALT flap was considered adequate for the initial reconstruction and stabilization, with the option of using a free fibular flap later, should the pelvic ring remain unstable. The fascia was used to complete the pelvic ring. It also provided anterior support to the pelvic diaphragm.

  18. Pin Tract Infection after Uniplanar External Fixation of Open ...

    African Journals Online (AJOL)

    ADMIN

    Regionally, a study by Jellis et al in Lusaka, Zambia, compared the rate of severe pin tract infection in HIV negative and positive ... likelihood of infection such as human immunodeficiency virus infection, diabetes mellitus, liver failure, renal failure, tumours ... Combined Open Tibia-Fibular. And Femur Fractures. 2. 2.7. Totals.

  19. BIZARRE CASE OF POLYDACTYLY WITH RIGHT MIRROR FOOT

    OpenAIRE

    Saif Omar; Mehre Darakhshan Mehdi; Provas Benerjee

    2014-01-01

    Mirror foot, a form of polydactyly, is a rare congenital anomaly. In this form of congenital anomaly, there are several additional digits with accessory tarsal bones. It may be associated with fibular dimelia, tibial aplasia and tibial dysplasia. Cause of such anomaly is not known. On experimental basis it appears to involve ectopic SHH (Sonic hedgehog) signaling in the limb bud mesenchyme

  20. Download this PDF file

    African Journals Online (AJOL)

    Proff.Adewunmi

    The operation does not only reconstruct the tibial defects, but increases the blood supply to the distal limb, especially for the patients with only one trunk vessel left. We treated the patients suffering from large tibial defects with flow-through fibular graft combined with Vacuum Assisted Closure, which provides intermittent or ...

  1. Experience with Perforator Based Flaps for Wound Cover of the Leg ...

    African Journals Online (AJOL)

    Background: Open fractures of the distal third of the tibia and fibular offer a challenge to the orthopedic surgeon because of skin coverage. The reconstructive surgeon's help is often required in trying to achieve this. There are several options: - local flap, free flap or a cross leg flap. Local flaps have always had limitations ...

  2. A modified Larson’s method of posterolateral corner reconstruction of the knee reproducing the physiological tensioning pattern of the lateral collateral and popliteofibular ligaments

    Directory of Open Access Journals (Sweden)

    Niki Yasuo

    2012-06-01

    Full Text Available Abstract Background Consensus has been lacking as to how to reconstruct the posterolateral corner (PLC of the knee in patients with posterolateral instability. We describe a new reconstructive technique for PLC based on Larson's method, which reflects the physiological load-sharing pattern of the lateral collateral ligament (LCL and popliteofibular ligament (PFL. Findings Semitendinosus graft is harvested, and one limb of the graft comprises PFL and the other comprises LCL. Femoral bone tunnels for the LCL and popliteus tendon are made at their anatomical insertions. Fibular bone tunnel is prepared from the anatomical insertion of the LCL to the proximal posteromedial portion of the fibular head, which corresponds to the insertion of the PFL. The graft end for popliteus tendon is delivered into the femoral bone tunnel and secured on the medial femoral condyle. The other end for LCL is passed through the fibular tunnel from posterior to anterior. While the knee is held in 90 of flexion, the graft is secured in the fibular tunnel using a 5 mm interference screw. Then, the LCL end is passed into the femoral bone tunnel and secured at the knee in extension. Conclusions Differential tension patterns between LCL and PFL is critical when securing these graft limbs. Intrafibular fixation of the graft using a small interference screw allows us to secure these two graft limbs independently with intended tension at the intended flexion angle of the knee.

  3. 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 ...

  4. An irreducible ankle fracture dislocation: the Bosworth injury

    NARCIS (Netherlands)

    Schepers, Tim; Hagenaars, Tjebbe; den Hartog, Dennis

    2012-01-01

    Irreducible fracture dislocations of the ankle are rare and represent true orthopedic emergencies. We present a case of a fracture dislocation that was irreducible owing to a fixed dislocation of the proximal fibular fragment posterior to the lateral ridge of the tibia. This particular type of

  5. 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.

  6. Kinematics of partial and total ruptures of the medial collateral ligament of the elbow

    DEFF Research Database (Denmark)

    Eygendaal, D; Olsen, Bo Sanderhoff; Jensen, Steen Lund

    2000-01-01

    In this study the kinematics of partial and total ruptures of the medial collateral ligament of the elbow are investigated. After selective transection of the medial collateral ligament of 8 osteoligamentous intact elbow preparations was performed, 3-dimensional measurements of angular displacement......, increase in medial joint opening, and translation of the radial head were examined during application of relevant stress. Increase in joint opening was significant only after complete transection of the anterior part of the medial collateral ligament was performed. The joint opening was detected during...... valgus and internal rotatory stress only. After partial transection of the anterior bundle of the medial collateral ligament was performed, there was an elbow laxity to valgus and internal rotatory force, which became significant after transection of 100% of the anterior bundle of the medial collateral...

  7. Study of intrarenal vasculature in cases of primary and secondary hypertension (by metallic impregnation technique on whole kidney section

    Directory of Open Access Journals (Sweden)

    Mittal B

    1992-10-01

    Full Text Available Study of intrarenal vasculature was carried out by using the metallic impregnation technique on whole kidney sections in 31 [corrected] cases of (primary and secondary hypertension and 10 normal controls. Distinct patterns of intrarenal vasculature were noted in controls and in cases of hypertension. Gradual tapering of vessels, absence of tortuosity and good peripheral vascularisation were noted in controls. Abrupt tapering, tortuosity of vessels and poor peripheral vascularisation were noted in hypertensive cases. In essential hypertension moderate to severe changes of dilatation of the segmental and/or arcuate arteries was noted. The degree of dilatation was related to the level of systolic BP rather than diastolic in cases of essential hypertension. Secondary hypertension even if severe, rarely showed significant dilatation lesions. Avascular zones and conglomeration of vessels at poles was seen only in cases of pyelonephritis. This helped in distinguishing these, from cases of glomerulonephritis.

  8. The effect of OK-432 (Picibanil) injection on the histopathology of nasal turbinate.

    Science.gov (United States)

    Sengul, S; Kaygusuz, I; Akin, M M; Yalcin, Ş; Karlidag, T; Keles, E; Arslan, I

    2015-12-01

    This study aimed to assess the histopathological effect of OK-432 (Picibanil) on rabbit nasal turbinates. A total of 21 rabbits were divided into 3 treatment groups and various parts of both nasal turbinates were injected with 0.5 ml OK-432, 0.2 ml OK-432 or 0.6 ml saline (control). Bilateral nasal turbinates were later excised and studied under light microscopy to assess any histopathological changes. Animals in the 0.2 ml and 0.5 ml OK-432 groups exhibited mild ciliary loss, goblet cell loss and epithelial damage, and a marked increase in inflammatory cell infiltration, submucosal vascularisation and fibrosis. There was a significant difference in histopathological changes between the two OK-432 treated groups. In addition, each OK-432 treated group had significantly more inflammatory cell infiltration, increased submucosal vascularisation and fibrosis compared with controls. The marked fibrosis observed in OK-432-injected turbinates may be responsible for a reduction in turbinate size.

  9. Neuroradiology of the normal and pathological anatomy of the rat brain. Pt. 2

    International Nuclear Information System (INIS)

    Schumacher, M.; Weisser, G.; Voigt, K.; Mennel, H.D.

    1980-01-01

    70 BD-IX rats, in which chemically induced mixed gliomas have been transplanted intracerebrally, were investigated by microangiography. The pattern and the degree of tumor vascularisation of all animals was correlated with the histological findings. Dependent on the type of the tumor different localisations of tumor growth could be found: G XII-gliomas preferred the juxta-ventricular region and subarachnoid space whereas GL 2.2-gliomas mainly grew as solid intracerebral space occupying lesions. Microangiograms of all tumor stages from the 14th to 42nd day after transplantation revealed a typical vascular pattern consisting of lacunar glomerulose and netlike vessels. Further, necrosis, bleedings into the tumor, and irregularities of the capillary network could be demonstrated. The volume, age and vascularisation of the tumors are correlated and the results are discussed with regard to the principles of tumor growth and malignancy. (orig.) [de

  10. [POSSIBILITIES OF VACUUM THERAPY APPLICATION IN DISORDERS OF VENOUS OUTFLOW IN ISLET GRAFTS].

    Science.gov (United States)

    Badyul, P O; Samoylenko, G E; Nor, N M; Slesarenko, K S

    2015-07-01

    The experience of "distressed" (problematic) flaps application in 33 patients with soft tissue defects over 2010-2014 years were analysed. It was proposed to use the local negative pressure for the prevention and treatment of complications associated with venous insufficiency or trombosis in using of plastics with vascularised complexes of tissues. Vacuum-therapy was conducted with the help of negative pressure apparatus "AGATE-Dnepr" (Ukraine) by attaching silver-containing polyurethane sponge on the operating zone, covering the flap with the surrounding skin netting band "Grassolind". The recommended standard of negative pressure of 75-125 mm Hg, both in impulse and in continuous mode was used. The high efficiency of vacuum-therapy for survival of grafts has been demonstrated. Thus, it might be considered as an effective element of prevention and treatment of complications associated with venous insufficiency or trombosis using of vascularised tissue complex plastics of defects.

  11. Gaussian sum rules for optical functions

    International Nuclear Information System (INIS)

    Kimel, I.

    1981-12-01

    A new (Gaussian) type of sum rules (GSR) for several optical functions, is presented. The functions considered are: dielectric permeability, refractive index, energy loss function, rotatory power and ellipticity (circular dichroism). While reducing to the usual type of sum rules in a certain limit, the GSR contain in general, a Gaussian factor that serves to improve convergence. GSR might be useful in analysing experimental data. (Author) [pt

  12. Conservative Semidiscrete Difference Schemes for Timoshenko Systems

    OpenAIRE

    Júnior, D. S. Almeida

    2014-01-01

    We present a parameterized family of finite-difference schemes to analyze the energy properties for linearly elastic constant-coefficient Timoshenko systems considering shear deformation and rotatory inertia. We derive numerical energies showing the positivity, and the energy conservation property and we show how to avoid a numerical anomaly known as locking phenomenon on shear force. Our method of proof relies on discrete multiplier techniques.

  13. Optimization of Bacillus aerius strain JS-786 cell dry mass and its antifungal activity against Botrytis cinerea using response surface methodology

    Directory of Open Access Journals (Sweden)

    Shafi Jamil

    2017-01-01

    Full Text Available The optimization of fermentation conditions is necessary for field application of biological control agents. The present study was designed to optimize the fermentation conditions for the Bacillus aerius strain, JS-786 in terms of cell dry mass and its antifungal activity against Botrytis cinerea with response surface methodology. A strain of bacteria with strong antifungal activity was isolated from the phyllosphere of tomato plant and identified as B. aerius JS-786 based on the sequence homology of its 16S rRNA gene. After the success of preliminary antifungal activity tests, response surface methodology was used to optimize the fermentation conditions (medium pH, gelatin percentage, incubation period, rotatory speed and incubation temperature to maximize the cell dry mass and antifungal activity against B. cinerea. A 25 factorial central composite design was employed and multiple response optimization was used to determine the desirability of the operation. The results of regression analysis showed that at the individual level, all of the experimental parameters were significant for cell dry mass; significant results were obtained for antifungal activity pH, incubation period, rotatory speed and incubation temperature. The interactive effect of the incubation period, rotatory speed and incubation temperature was significant. Maximum cell dry mass (8.7 g/L and inhibition zone (30.4 mm were obtained at pH 6.4, gelatin 3.2%, incubation period 36.92 h, rotatory speed 163 rpm, and temperature 33.5°C. This study should help to formulate a more rational and cost-effective biological product both in terms of bacterial growth and antifungal activity.

  14. Computer tomographic detection of an intraspinal arachnoidal cyst

    International Nuclear Information System (INIS)

    Kuckein, D.; Walter, K.; Paal, G.; Staedtisches Krankenhaus Harlaching, Muenchen

    1981-01-01

    A 46 year old female patient who after 3-4 weeks of influenza suffered from strong headaches, vomiting and rotatory vertigo was subjected to a myelograph and then to a computerized tomographic investigation due to suspect cerebrospinal fluid. The computerized tomography is better than the myelography in diagnosing intraspinal arachnoidal cysts, however this should be preceded by most accurate possible segment location. (MG) [de

  15. Modified Pippard relationship describing the Raman frequency shifts ...

    Indian Academy of Sciences (India)

    Unknown

    Abstract. We relate in this study the thermal expansivity, αP, to the Raman frequency shift (1/ν)(∂ν/∂P)T for the rotatory lattice (librational) mode in ammonia solid II near its melting point. We have used our calculated Raman frequencies of this mode for pressures of 3⋅65, 5⋅02 and 6⋅57 kbars for this crystalline system.

  16. Sewage Sludge Treatment for Energy Purpose in China : Waste Treatment in China

    OpenAIRE

    Nyyssönen, Ville

    2015-01-01

    This thesis is made for ANDRITZ China Technology to find out sludge incineration potential in China. ANDRITZ is looking for markets and customers for ANDRITZ sewage sludge incineration technology in China. In addition ANDRITZ China manufactures centrifuges, skeleton model filter presses, belt presses and rotatory drums to treat the sludge. Sludge in China has become a major problem. It is considered to be toxic waste, because it contains pathogens, which are dangerous for human health. Th...

  17. 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

  18. Vanishing bone disease of the orbital roof: now you see it, now you don't

    International Nuclear Information System (INIS)

    Dharsono, Ferry; Van Heerden, Jolandi; McAuliffe, William; Ardakani, Nima M.; Franconi, Catherine; Honeybul, Stephen; Lind, Christopher R.

    2014-01-01

    We describe a rare case of vascularised orbital roof and calvarial erosions with an associated venous malformation. In the absence of infection, malignancy, trauma and eosinophillic granuloma, the closest previously described entity is vanishing bone disease. Computed tomography (CT), MRI, catheter angiography and pathology were all important in the diagnostic workup to enable surgical planning for biopsy and reconstruction. Ongoing CT and MRI follow-up imaging will determine future treatment planning.

  19. 3D Power Doppler ultrasound and computerised placental assessment in normal pregnancy

    International Nuclear Information System (INIS)

    Moran, Mary; Zombori, Gergely; Ryan, John; McAuliffe, Fionnuala M.

    2014-01-01

    Background: In recent years there have been significant developments in the use of 3D Power Doppler (3DPD) imaging and quantitative 3DPD histogram analysis to estimate both placental volume and intra-placental vasculature. This study aims to determine if placental volume, vascularisation and blood flow are correlated with gestational age in normal pregnancy. It also examines whether or not a new software method for analysis of percentage calcification (the ‘placentometer’) correlates well with gestation. Material and method: This was a prospective cohort study of 250 women with normal pregnancies (12 + 6 to 39 + 5 weeks gestation). 3DPD ultrasound was used to evaluate placental volume, vascularisation index (VI), flow index (FI) and vascularisation-flow index (VFI). Placental volume (calculated at 35–40 weeks gestation), was correlated with birth weight. Following each scan the percentage of calcification was also calculated using the placentometer. Results: Placental volume correlated significantly with gestational age: 66.676 + 0.623 × GA (P < 0.001). No significant change with gestation was noted in VI, FI and VFI (VI: P = 0.199, FI: P = 0.299, VFI: P = 0.557). Software analysis of the percentage of calcification, demonstrated the expected increase in calcification as gestation increased: −4.605 + 0.032 × GA (P < 0.001). From 35 to 40 weeks gestation volume was related to birth weight (P < 0.01). Conclusion: This study shows that in normal low-risk pregnancy placental volume increases with gestational age, whereas vascularisation and blood flow are independent of gestation. Placental volume in late pregnancy is related to birth weight. Software analysis of the percentage of calcification demonstrates an increase with advancing gestation

  20. Colour evaluation in scars: tristimulus colorimeter, narrow-band simple reflectance meter or subjective evaluation?

    Science.gov (United States)

    Draaijers, Lieneke J; Tempelman, Fenike R H; Botman, Yvonne A M; Kreis, Robert W; Middelkoop, Esther; van Zuijlen, Paul P M

    2004-03-01

    The evaluation of scar colour is, at present, usually limited to an assessment according to a scar assessment scale. Although useful, these assessment scales only evaluate subjectively the degree of scar colour. In this study, the reliability of the subjective assessment of scar colour by observers is compared to the reliability of the measurements of two objective colour measurement instruments. Four independent observers subjectively assessed the vascularisation and pigmentation of 49 scar areas in 20 patients. The degree of vascularisation and pigmentation was scored according to a scale ranging from '1', when it appeared to be like healthy skin, to '10', which corresponds to the worst imaginable outcome of vascularisation or pigmentation. The observers also scored the pigmentation categories of the scar (hypopigmention, hyperpigmention or mixed pigmentation). Finally, each observer measured the scar areas with a tristimulus colorimeter (Minolta Chromameter) and a narrow-band simple reflectance meter (DermaSpectrometer). A single observer could reliably carry out measurements of the DermaSpectrometer and the Minolta Chromameter for the evaluation of scar colour (r = 0.72). The vascularisation of scars could also be assessed reliably with a single observer (r = 0.76) whereas for a reliable assessment of pigmentation at least three observers were necessary (r > or = 0.77). The agreement between the observers for the pigmentation categories also turned out to be unacceptably low (k = 0.349). This study shows that an overall evaluation of scar colour with the DermaSpectrometer and the Minolta Chromameter is more reliable than the evaluation of scar colour with observers. Of both instruments for measuring scar colour, we prefer, because of its feasibility, the DermaSpectrometer.

  1. Innate Immunity and Biomaterials at the Nexus: Friends or Foes

    OpenAIRE

    Christo, Susan N.; Diener, Kerrilyn R.; Bachhuka, Akash; Vasilev, Krasimir; Hayball, John D.

    2015-01-01

    Biomaterial implants are an established part of medical practice, encompassing a broad range of devices that widely differ in function and structural composition. However, one common property amongst biomaterials is the induction of the foreign body response: an acute sterile inflammatory reaction which overlaps with tissue vascularisation and remodelling and ultimately fibrotic encapsulation of the biomaterial to prevent further interaction with host tissue. Severity and clinical manifestati...

  2. Erythropoietin promotes network formation of transplanted adipose tissue-derived microvascular fragments

    Directory of Open Access Journals (Sweden)

    P Karschnia

    2018-05-01

    Full Text Available The seeding of tissue constructs with adipose tissue-derived microvascular fragments (ad-MVF is an emerging pre-vascularisation strategy. Ad-MVF rapidly reassemble into new microvascular networks after in vivo implantation. Herein it was analysed whether this process was improved by erythropoietin (EPO. Ad-MVF were isolated from green fluorescent protein (GFP+ as well as wild-type C57BL/6 mice and cultivated for 24 h in medium supplemented with EPO (20 IU/mL or vehicle. Freshly isolated, non-cultivated ad-MVF served as controls. Protein expression, cell viability and proliferation of ad-MVF were assessed by proteome profiler array and fluorescence microscopy. GFP+ ad-MVF were seeded on collagen-glycosaminoglycan matrices, which were implanted into dorsal skinfold chambers of C57BL/6 mice, to analyse their vascularisation over 14 d by intravital fluorescence microscopy, histology and immunohistochemistry. Cultivation up-regulated the expression of pro- and anti-angiogenic factors within both vehicle- and EPO-treated ad-MVF when compared with non-cultivated controls. Moreover, EPO treatment suppressed cultivation-associated apoptosis and significantly increased the number of proliferating endothelial cells in ad-MVF when compared with vehicle-treated and non-cultivated ad-MVF. Accordingly, implanted matrices seeded with EPO-treated ad-MVF exhibited an improved vascularisation, as indicated by a significantly higher functional microvessel density. The matrices of the three groups contained a comparably large fraction of GFP+ microvessels originating from the ad-MVF, whereas the tissue surrounding the matrices seeded with EPO-treated ad-MVF exhibited a significantly increased microvessel density when compared with the other two groups. These findings indicated that EPO represents a promising cytokine to further boost the excellent vascularisation properties of ad-MVF in tissue-engineering applications.

  3. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotary stability

    DEFF Research Database (Denmark)

    Tavlo, Mette; Eljaja, S; Tranum-Jensen, Jørgen

    2016-01-01

    Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction of an insuffici......Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction...... of an insufficient ALL. Eighteen cadaveric knees were included. Stability was tested for intact (+ALL), detached (-ALL) and reconstructed (+ reALL) ALL, with ACL removed (-ACL) and reconstructed (+ACL) in six combinations. All were tested in 0, 30, 60, and 90 °C flexion. Anterior-posterior stability was measured...... with a rolimeter. Rotation with a torque of 8.85 Nm was measured photographically. The ALL was well defined in 78% of knees. ACL reconstruction had a significant effect on anterior-posterior stability. Detaching the ALL had a significant effect on internal rotatory stability and on anterior-posterior stability...

  4. The pro-angiogenic properties of multi-functional bioactive glass composite scaffolds

    KAUST Repository

    Gerhardt, Lutz Christian; Widdows, Kate L.; Erol, Melek M.; Burch, Charles W.; Sanz-Herrera, José A.; Ochoa, Ignacio; Stä mpfli, Rolf; Roqan, Iman S.; Gabe, Simon M.; Ansari, Tahera I.; Boccaccini, Aldo R.

    2011-01-01

    The angiogenic properties of micron-sized (m-BG) and nano-sized (n-BG) bioactive glass (BG) filled poly(D,L lactide) (PDLLA) composites were investigated. On the basis of cell culture work investigating the secretion of vascular endothelial growth factor (VEGF) by human fibroblasts in contact with composite films (0, 5, 10, 20 wt %), porous 3D composite scaffolds, optimised with respect to the BG filler content capable of inducing angiogenic response, were produced. The in vivo vascularisation of the scaffolds was studied in a rat animal model and quantified using stereological analyses. The prepared scaffolds had high porosities (81-93%), permeability (k = 5.4-8.6 × 10-9 m2) and compressive strength values (0.4-1.6 MPa) all in the range of trabecular bone. On composite films containing 20 wt % m-BG or n-BG, human fibroblasts produced 5 times higher VEGF than on pure PDLLA films. After 8 weeks of implantation, m-BG and n-BG containing scaffolds were well-infiltrated with newly formed tissue and demonstrated higher vascularisation and percentage blood vessel to tissue (11.6-15.1%) than PDLLA scaffolds (8.5%). This work thus shows potential for the regeneration of hard-soft tissue defects and increased bone formation arising from enhanced vascularisation of the construct. © 2011 Elsevier Ltd.

  5. New ways for dealing with radiations burns

    International Nuclear Information System (INIS)

    2015-01-01

    Cell therapy has revolutionized the treatment of radiation burns of the skin for 10 years. The injection of mesenchymal stem cells combined with surgery is a successful protocol but the use of mesenchymal stem cell brings risks in terms of time: the intervention on the wound is delayed till a sufficient population of mesenchymal cells is achieved through cultivation. Furthermore the original mesenchymal cells are obtained from an invasive and painful removal of bone marrow and the number of adequate cells in the sampling depends strongly on the patient's age. In order to tackle these issues, various options are being studied. First, a direct injection of the mesenchymal stem cells in the wound without awaiting their cultivation. An experimental study shows that this option favors the restoration of the dermis and the vascularisation of the wounded area. Secondly, the injection of endothelial progenitor cells (they are found in the umbilical cord) favors the vascularisation of the wound and as a consequence its healing. Thirdly, the injection of stem cells removed from fat tissues has proved to be efficient for both vascularisation and for generating skin cells. (A.C.)

  6. [Two- and three-dimensional power Doppler ultrasound in the follow-up of placenta accreta treated conservatively].

    Science.gov (United States)

    Roulot, A; Barranger, E; Morel, O; Soyer, P; Héquet, D

    2015-02-01

    To determinate the potential of 2D and 3D-ultrasound in the follow-up of patients with placenta accreta treated conservatively. Seven patients with placenta accreta treated conservatively during June 2007 and September 2009 were included. The follow-up consisted in clinical examination and 2D/3D-ultrasound once a month. Criteria studied included clinical outcome, echogenicity at 2D-ultrasound, vascularisation at colour Doppler, Mean Grey at 3D-ultrasound and vascularisation, flow and perfusion index. Seven women with invasive placenta (3 placentas accreta and 2 percreta) were studied. The mean follow-up was 228 days [75-369]. Mean delay for complete elimination of residual placenta was 280 days [120-365]. The two main results were: presence of an increased anechogenicpart in residual placenta before complete resorption for all patients; a systematic and concomitant stop of genital haemorrhage and vascularisation at colour Doppler. High degrees of variability in parameters measured at 3D-ultrasound were observed between patients so that correlations with clinical outcome were found. Long and regular follow-up is essential after conservative management but the role of 3D-ultrasound compared to 2D-ultrasound was not demonstrated in this study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. Aggressive posterior retinopathy of prematurity in large preterm babies in South India.

    Science.gov (United States)

    Shah, Parag K; Narendran, Venkatapathy; Kalpana, Narendran

    2012-09-01

    To describe aggressive posterior retinopathy of prematurity (APROP) in a subset of premature babies, having gestational age (GA) of ≥28 weeks and birth weight (BW) of ≥1000 g. Retrospective observational case series. Case records of 99 babies, who were diagnosed to have APROP between July 2002 and October 2010 were reviewed. Fundus fluorescein angiography (FFA) was carried out in 19 babies. The mean GA was 31.7 weeks (range 28-35 weeks) and mean BW was 1572 g (range 1000-2310 g). All these babies received supplemental unblended oxygen 3 days or longer after birth. Of the 52 babies who had an eye exam in the neonatal intensive care unit prior to discharge, 35 babies had loss of vascularised retina from zone II to zone I and four babies from zone III to zone I, when examined as an outpatient. FFA revealed large geographic areas of vaso-obliteration (more than 30 disc areas) posterior to the shunt vessels within vascularised retina. Features of severe capillary bed loss in the vascularised retina were seen in our cases. Oxygen could be a precipitating factor in causing this retinopathy of prematurity in large babies.

  8. The pro-angiogenic properties of multi-functional bioactive glass composite scaffolds

    KAUST Repository

    Gerhardt, Lutz Christian

    2011-06-01

    The angiogenic properties of micron-sized (m-BG) and nano-sized (n-BG) bioactive glass (BG) filled poly(D,L lactide) (PDLLA) composites were investigated. On the basis of cell culture work investigating the secretion of vascular endothelial growth factor (VEGF) by human fibroblasts in contact with composite films (0, 5, 10, 20 wt %), porous 3D composite scaffolds, optimised with respect to the BG filler content capable of inducing angiogenic response, were produced. The in vivo vascularisation of the scaffolds was studied in a rat animal model and quantified using stereological analyses. The prepared scaffolds had high porosities (81-93%), permeability (k = 5.4-8.6 × 10-9 m2) and compressive strength values (0.4-1.6 MPa) all in the range of trabecular bone. On composite films containing 20 wt % m-BG or n-BG, human fibroblasts produced 5 times higher VEGF than on pure PDLLA films. After 8 weeks of implantation, m-BG and n-BG containing scaffolds were well-infiltrated with newly formed tissue and demonstrated higher vascularisation and percentage blood vessel to tissue (11.6-15.1%) than PDLLA scaffolds (8.5%). This work thus shows potential for the regeneration of hard-soft tissue defects and increased bone formation arising from enhanced vascularisation of the construct. © 2011 Elsevier Ltd.

  9. Three-dimensional analysis of injured lateral ligaments of the ankle with FISP MR imaging

    International Nuclear Information System (INIS)

    Vaes, P.; Shahabpour, M.; van Cauteren, M.; Osteaux, M.

    1989-01-01

    In a series of 150 acutely injured or chronically unstable ankles, oblique reconstructions of the anterior talo-fibular (TFA) and calcaneo-fibular (CF) ligaments were performed. Fast three-dimensional (3D) imaging with a flip angle of 40 degrees, a TR/TE of 30/10 msec, and 128 1-mm-thick sections allowed the evaluation of the whole ankle joint in 16 minutes. Partial or complete ruptures of TFA and/or CF ligaments as well as associated bone or cartilage occult fractures are detected. The authors discuss how, by enabling assessment of the severity of ankle sprains, 3D imaging was found to be helpful in defining when surgical therapy was necessary

  10. Antifungal efficacy of natamycin in experimental fusarium solani keratitis.

    Science.gov (United States)

    Dong, Xian-Hui; Gao, Wei-Juan; He, Xiao-Ping

    2012-01-01

    To evaluate the efficacy of topical administration Natamycin, which is produced by China, in an experimental rabbit model of Fusarium solani keratitis, to provide experimental basis for the application of clinical safety. Fusarium solani was induced in the right eye of 30 New Zealand rabbits. Forty-eight hours after inoculation, the animals were divided into 3 different treatment groups, 10 rabbit eyes of each group: Group 1 (Natamycin) treated with topical Natamycin, group 2 (Natacyn) treated with topical Natacyn, group 3 (control) treated with topical saline solution. The eyes of each group was examined clinically with slit lamp using ulcer scoring system on day 4, 10, 15, and 21 for status of healing, corneal vascularisation, iritis, hypopyon and macular nebula. The findings were recorded on day 10 and day 21. Ulcer score on day 10, day 15, day 21: The score of Natamycin group are 1.45±0.16, 1.08±0.11, 0.70±0.40. The score of Natacyn group are 1.35±0.12, 1.10±0.12, 0.65±0.35. the score of control group are 1.30±0.08, 3.63±0.28, 3.80±0.16. Natamycin group and Natacyn group were different from control group (Pday 10 and day 21: The cure rate of the Natamycin group is 90% on day 10, and 100% on day 21. The cure rate of the Natacyn group is 80% on day 10, and 100% on day 21.Natamycin group and Natacyn group were different from control group (Pday 10 and day 21: in Natamycin group, the number of the eyes which have Corner vascularisation, iritis, hypopyon and macular nebula are 2,0,0,2. In Natacyn group, the number of the eyes which have Corner vascularisation, iritis, hypopyon and macular nebula are 1,0,0,2. In control group, the number of the eyes which have Corner vascularisation, iritis, hypopyon and macular nebula are 9,9,8,9.Natamycin group and Natacyn group were different from control group (P<0.01). There is no difference between Natamycin group and Natacyn group. Natamycin was found to be effective in fungal keratitis, similar to Natacyn, and it can

  11. Anatomy and classification of the posterior tibial fragment in ankle fractures.

    Science.gov (United States)

    Bartoníček, Jan; Rammelt, Stefan; Kostlivý, Karel; Vaněček, Václav; Klika, Daniel; Trešl, Ivo

    2015-04-01

    The aim of this study was to analyze the pathoanatomy of the posterior fragment on the basis of a comprehensive CT examination, including 3D reconstructions, in a large patient cohort. One hundred and forty one consecutive individuals with an ankle fracture or fracture-dislocation of types Weber B or Weber C and evidence of a posterior tibial fragment in standard radiographs were included in the study. The mean patient age was 49 years (range 19-83 years). The exclusion criteria were patients below 18 years of age, inability to provide written consent, fractures of the tibial pilon, posttraumatic arthritis and pre-existing deformities. In all patients, post-injury radiographs were obtained in anteroposterior, mortise and lateral views. All patients underwent CT scanning in transverse, sagittal and frontal planes. 3D CT reconstruction was performed in 91 patients. We were able to classify 137 cases into one of the following four types with constant pathoanatomic features: type 1: extraincisural fragment with an intact fibular notch, type 2: posterolateral fragment extending into the fibular notch, type 3: posteromedial two-part fragment involving the medial malleolus, type 4: large posterolateral triangular fragment. In the 4 cases it was not possible to classify the type of the posterior tibial fragment. These were collectively termed type 5 (irregular, osteoporotic fragments). It is impossible to assess the shape and size of the posterior malleolar fragment, involvement of the fibular notch, or the medial malleolus, on the basis of plain radiographs. The system that we propose for classification of fractures of the posterior malleolus is based on CT examination and takes into account the size, shape and location of the fragment, stability of the tibio-talar joint and the integrity of the fibular notch. It may be a useful indication for surgery and defining the most useful approach to these injuries.

  12. 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.)

  13. 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.

  14. Radiographic manifestations of hypochondroplasia

    Energy Technology Data Exchange (ETDEWEB)

    Heselson, N G; Cremin, B J [Groote Schuur Hospital, Cape Town (South Africa); Beighton, P

    1979-01-01

    Hypochrondroplasia is an inherited skeletal dysplasia that resembles achondroplasia in mild degree. Radiographic manifestations encountered in 12 affected individuals in South Africa include slight shortening of all segments of the tubular bones, moderate caudal diminution of the lumbar interpedicular distances, increased lumbar lordosis with cacral tilt and distal prolongation of the fibular. Hypochondroplasia can be distinguished from other osteochondrodystrophies such as achondroplasia, pseudo-achondroplasia and metaphyseal chondroplasia by the recognition of it clinical and radiographic manifestations.

  15. The radiographic manifestations of hypochondroplasia

    International Nuclear Information System (INIS)

    Heselson, N.G.; Cremin, B.J.; Beighton, P.

    1979-01-01

    Hypochrondroplasia is an inherited skeletal dysplasia that resembles achondroplasia in mild degree. Radiographic manifestations encountered in 12 affected individuals in South Africa include slight shortening of all segments of the tubular bones, moderate caudal diminution of the lumbar interpedicular distances, increased lumbar lordosis with cacral tilt and distal prolongation of the fibular. Hypochondroplasia can be distinguished from other osteochondrodystrophies such as achondroplasia, pseudo-achondroplasia and metaphyseal chondroplasia by the recognition of it clinical and radiographic manifestations. (author)

  16. Anatomical aspects of the nerves of the leg and foot of the giant anteater (Myrmecophaga tridactyla, Linnaeus, 1758

    Directory of Open Access Journals (Sweden)

    V.S. Cruz

    2014-10-01

    Full Text Available Although distal stifle joint nerve distribution has been well established in domestic animals, this approach is scarcely reported in wild animals. Therefore, the aim of this study was to describe the nerves of the leg and foot of Myrmecophaga tridactyla with emphasis on their ramification, distribution, topography and territory of innervation. For this purpose, six adult cadavers fixed and preserved in 10% formalin solution were used. The nerves of the leg and foot of the M. tridactyla were the saphenous nerve (femoral nerve branch, fibular and tibial nerves and lateral sural cutaneous nerve (branches of the sciatic nerve and caudal sural cutaneous nerve (tibial nerve branch. The saphenous nerve branches to the skin, the craniomedial surface of the leg, the medial surface of the tarsal and metatarsal regions and the dorsomedial surface of the digits I and II (100% of cases, III (50% of cases and IV (25% of cases. The lateral sural cutaneous nerve innervates the skin of the craniolateral region of the knee and leg. The fibular nerve innervates the flexor and extensor muscles of the tarsal region of the digits and skin of the craniolateral surface of the leg and dorsolateral surface of the foot. The tibial nerve innervates the extensor muscles of the tarsal joint and flexor, adductor and abductor muscles of the digits and the skin of the plantar surface. The caudal sural cutaneous nerve innervates the skin of the caudal surface of the leg. The nerves responsible for the leg and foot innervation were the same as reported in domestic and wild animals, but with some differences, such as the more distal division of the common fibular nerve, the absence of dorsal metatarsal branches of the deep fibular nerve and a greater involvement of the saphenous nerve in the digital innervation with branches to the digits III and IV, in addition to digits I and II.

  17. Hypertrophy and pseudohypertrophy of the lower leg following chronic radiculopathy and neuropathy: imaging findings in two patients

    International Nuclear Information System (INIS)

    Beuckeleer, L. de; Schepper, A. de; Vanhoenacker, F.; Schepper, A. Jr. de; Seynaeve, P.

    1999-01-01

    Enlargement of the ipsilateral muscle compartment is an exceptional finding in patients with chronic radiculopathy, peripheral nerve injury, anterior horn cell diseases, or acquired peripheral neuropathy. We report radiographic, ultrasonographic, CT and MRI findings in a patient with chronic S1 radiculopathy and another with chronic neuropathy of the common fibular nerve (L4-S2), both presenting with painless enlargement of the calf muscles. (orig.)

  18. Atypical Focal Osteomyelitis as Initial Manifestation of AIDS

    OpenAIRE

    A. Akiki; Y. Bilde

    2011-01-01

    Persistent pain development after a skeletal contusion rarely poses the diagnosis of osteomyelitis. We report the case of a fibular head contusion as an initial manifestation of a focal abscess development in a healthy young patient. The traditional treatment of surgical drainage revealed the presence of an atypical Mycobacterium haemophilum isolates in the abscess. This lead to further investigations that concluded and established the diagnosis of AIDS. Conclusion. Isolation of an atypical M...

  19. 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.

  20. Fifteen years of follow-up of a removable prosthetic design to maintain two remaining molars in a patient with mandibular reconstruction

    OpenAIRE

    Ming-Lun Hsu; Jacqueline Chia-Hsuan Wu; Ling-Ming Yu

    2012-01-01

    This clinical report describes a long-term prosthetic solution for a patient who had undergone mandibular reconstruction with a fibular graft, leaving only two right molars. The only retention device for the removable prosthesis design included a telescoping system with an O-ring application, but without fibula graft involvement. This prosthesis design was motivated by the altered bony and muscular architecture resulting in an increased maxillomandibular space and thick soft tissue in the den...

  1. Hypertrophy and pseudohypertrophy of the lower leg following chronic radiculopathy and neuropathy: imaging findings in two patients

    Energy Technology Data Exchange (ETDEWEB)

    Beuckeleer, L. de; Schepper, A. de [Department of Radiology, University Hospital Antwerp, Edegem (Netherlands); Vanhoenacker, F. [Department of Radiology, University Hospital Antwerp, Edegem (Netherlands)]|[Department of Radiology, AZ St. Maarten, Campus Duffel, Duffel (Belgium); Schepper, A. Jr. de [Department of Radiology, University Hospital Antwerp, Edegem (Netherlands)]|[Department of Radiology, AZ Middelheim, Antwerpen (Belgium); Seynaeve, P. [Department of Radiology, AZ Middelheim, Antwerpen (Belgium)

    1999-04-01

    Enlargement of the ipsilateral muscle compartment is an exceptional finding in patients with chronic radiculopathy, peripheral nerve injury, anterior horn cell diseases, or acquired peripheral neuropathy. We report radiographic, ultrasonographic, CT and MRI findings in a patient with chronic S1 radiculopathy and another with chronic neuropathy of the common fibular nerve (L4-S2), both presenting with painless enlargement of the calf muscles. (orig.) With 2 figs., 7 refs.

  2. Problems with Excessive Residual Lower Leg Length in Pediatric Amputees

    OpenAIRE

    Osebold, William R; Lester, Edward L; Christenson, Donald M

    2001-01-01

    We studied six pediatric amputees with long below-knee residual limbs, in order to delineate their functional and prosthetic situations, specifically in relation to problems with fitting for dynamic-response prosthetic feet. Three patients had congenital pseudoarthrosis of the tibia secondary to neurofibromatosis, one had fibular hemimelia, one had a traumatic amputation, and one had amputation secondary to burns. Five patients had Syme's amputations, one had a Boyd amputation. Ages at amputa...

  3. 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.

  4. Differential diagnosis and recovery of acute bilateral foot drop in a patient with a history of low back pain: A case report.

    Science.gov (United States)

    Lomaglio, Melanie; Canale, Bob

    2017-06-01

    Acute bilateral foot drop is rare and may be due to peripheral or central lesions. The purpose of this case report was to describe the differential diagnosis and recovery of a patient with low back pain (LBP) that awoke with bilateral foot drop. A 39-year-old man with a history of LBP awoke with a steppage gait pattern. Spinal imaging and tapping were negative for sinister pathologies. A subsequent history taken by the physical therapist uncovered that the patient had previously taken a narcotic and slept in a kneeling position to relieve his LBP. Strength and sensory testing revealed isolated impairments in the fibular nerve distribution, and bilateral fibular palsy was suspected and later confirmed with electrophysiological studies. Surgical fibular nerve decompression was performed, and the patient underwent physical therapy. Five months later the patient demonstrated antigravity strength and a partial return of sensation. By 17 months, his Lower Extremity Functional Scale had improved from 17/80 to 78/80, revealing a near complete recovery. The patient's history of LBP was a "red herring" that delayed the diagnosis and caused undue stress to the patient. This case stresses the importance of a thorough history and clinical examination.

  5. Oromandibular reconstruction with chimeric double-skin paddle flap based on peroneal vessel axis for synchronous opposite double oral cancer.

    Science.gov (United States)

    Huang, Shih-Tsai; Liu, Wen-Chung; Chen, Lee-Wei; Yang, Kuo-Chung

    2015-05-01

    Synchronous double oral cancer represents the minority of cases of head and neck cancer. After tumor ablation, 2 separate oromandibular defects, even combined with a through-and-through oral defect, pose a serious reconstructive challenge. The ideal method for reconstruction remains controversial. Based on the peroneal vessel axis, a chimeric double-skin paddle peroneal fasciocutaneous or fibular osteomyocutaneous flap could be designed to accomplish the difficult reconstruction. Six male patients, each with 2 separate oromandibular defects after tumor ablation of synchronous double oral cancer, received double-skin paddle flap reconstruction with 3 peroneal fasciocutaneous and 3 fibular osteomyocutaneous flaps. All 6 flaps survived; however, complications included 1 skin paddle lost due to insufficient perfusion of a visible perforator, and 1 superficial necrosis occurring over the tip of a longer skin paddle. One postoperative intraoral infection and 1 donor site infection were also reported. During follow-up, 3 months later, 1 patient succumbed to local recurrence and bony metastasis. One patient developed a new cancer in the maxillary gingiva, and another had osteoradionecrosis 8 months later. Four patients gained acceptable cosmesis with good oral competence. A chimeric flap based on the peroneal artery could provide a segment of fibular bone, 1 or 2 skin paddles, and a cuff of the flexor hallucis longus muscle simultaneously. For 1-stage reconstruction of separate oromandibular defects after tumor ablation of synchronous double oral cancer, this design could provide all components at 1 transfer.

  6. Problems with Excessive Residual Lower Leg Length in Pediatric Amputees

    Science.gov (United States)

    Osebold, William R; Lester, Edward L; Christenson, Donald M

    2001-01-01

    We studied six pediatric amputees with long below-knee residual limbs, in order to delineate their functional and prosthetic situations, specifically in relation to problems with fitting for dynamic-response prosthetic feet. Three patients had congenital pseudoarthrosis of the tibia secondary to neurofibromatosis, one had fibular hemimelia, one had a traumatic amputation, and one had amputation secondary to burns. Five patients had Syme's amputations, one had a Boyd amputation. Ages at amputation ranged from nine months to five years (average age 3 years 1 month). After amputation, the long residual below-knee limbs allowed fitting with only the lowest-profile prostheses, such as deflection plates. In three patients, the femoral dome to tibial plafond length was greater on the amputated side than on the normal side. To allow room for more dynamic-response (and larger) foot prostheses, two patients have undergone proximal and distal tibial-fibular epiphyseodeses (one at age 5 years 10 months, the other at 3 years 7 months) and one had a proximal tibial-fibular epiphyseodesis at age 7 years 10 months. (All three patients are still skeletally immature.) The families of two other patients are considering epiphyseodeses, and one patient is not a candidate (skeletally mature). Scanogram data indicate that at skeletal maturity the epiphyseodesed patients will have adequate length distal to their residual limbs to fit larger and more dynamic-response prosthetic feet. PMID:11813953

  7. The Posterior Bundle's Effect on Posteromedial Elbow Instability After a Transverse Coronoid Fracture: A Biomechanical Study.

    Science.gov (United States)

    Shukla, Dave R; Golan, Elan; Weiser, Mitch C; Nasser, Philip; Choueka, Jack; Hausman, Michael

    2018-04-01

    There has been increased interest in the role of the posterior bundle of the medial collateral ligament (pMUCL) in the elbow, particularly its effects on posteromedial rotatory stability. The ligament's effect in the context of an unfixable coronoid fracture has not been the focus of any study. The purposes of this biomechanical study were to evaluate the stabilizing effect of the pMUCL with a transverse coronoid fracture and to assess the effect of graft reconstruction of the ligament. We simulated a varus and internal rotatory subluxation in 7 cadaveric elbows at 30°, 60°, and 90° elbow flexion. The amount of ulnar rotation and medial ulnohumeral joint gapping were assessed in the intact elbow after we created a transverse coronoid injury, after we divided the pMUCL, and finally, after we performed a graft reconstruction of the pMUCL. At all angles tested, some stability was lost after cutting the pMUCL once the coronoid had been injured, because mean proximal ulnohumeral joint gapping increased afterward by 2.1, 2.2, and 1.3 mm at 90°, 60°, and 30°, respectively. Ulnar internal rotation significantly increased after pMUCL transection at 90°. At 60° and 30° elbow flexion, ulnar rotation increased after resection of the coronoid but not after pMUCL resection. An uninjured pMUCL stabilizes against varus internal rotatory instability in the setting of a transverse coronoid fracture at higher flexion angles. Further research is needed to optimize graft reconstruction of the pMUCL. The pMUCL is an important secondary stabilizer against posteromedial instability in the coronoid-deficient elbow. In the setting of an unfixable coronoid fracture, the surgeon should examine for posteromedial instability and consider addressing the pMUCL surgically. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  8. Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome

    Energy Technology Data Exchange (ETDEWEB)

    Schoierer, Oliver; Bender, Daniel; Schmidmaier, Gerhard [University Hospital Heidelberg, Heidelberg Trauma Research Group, Department of Orthopaedic and Trauma Surgery, Heidelberg (Germany); Bloess, Konstantin; Kauczor, Hans-Ulrich; Weber, Marc-Andre [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Burkholder, Iris [University of Applied Sciences of the Saarland, Department of Nursing and Health, Saarbruecken (Germany)

    2014-02-15

    To prospectively evaluate whether dynamic contrast-enhanced (DCE) MRI can assess vascularity within non-unions and predicts clinical outcome in combination with the clinical Non-Union Scoring System (NUSS). Fifty-eight patients with non-unions of extremities on CT underwent 3-T DCE MRI. Signal intensity curves obtained from a region-of-interest analysis were subdivided into those with more intense contrast agent uptake within the non-union than in adjacent muscle (vascularised non-union) and those with similar or less contrast uptake. The pharmacokinetic parameters of the Tofts model K{sub trans}, K{sub ep}, iAUC and V{sub e} were correlated with union at CT 1 year later (n = 49). Despite inserted osteosynthetic material, DCE parameters could be evaluated in 57 fractures. The sensitivity/specificity of vascularised non-unions as an indicator of good outcome was 83.9 %/50.0 % compared to 96.8 %/33.3 % using NUSS (n = 49). Logistic regression revealed a significant impact of NUSS on outcome (P = 0.04, odds ratio = 0.93). At first examination, median iAUC (initial area under the enhancement curve) for the ratio non-union/muscle was 10.28 in patients with good outcome compared with 3.77 in non-responders (P = 0.023). K{sub trans}, K{sub ep} and V{sub e} within the non-union were not significantly different initially (n = 57) or 1 year later (n = 19). DCE MRI can assess vascularity in fracture non-unions. A vascularised non-union correlates with good outcome. (orig.)

  9. Two-piece cryopreserved tracheal allotransplantation: an experimental study.

    Science.gov (United States)

    Iyikesici, Tuncel; Tuncozgur, Bulent; Sanli, Maruf; Isik, Ahmet Feridun; Meteroglu, Fatih; Elbeyli, Levent

    2009-10-01

    For successful reconstruction with tracheal allotransplants following long tracheal resections, problems related to the preservation and vascularisation of the tracheal graft have to be solved. In this study, instead of using a long-segment single-piece graft, we used a graft that has been split into two. The aim was to use this graft after cryopreservation in order to ease neo-vascularisation and to maintain tracheal integrity by transplanting it to two separate regions of the dog cervical trachea. This experimental study was conducted in animal laboratories of the medical school on 11 half-blood dogs. The trachea obtained from the first dog was 8 cm in length; it was split into two pieces of 4 cm each and stored in the preservation solution at -80 degrees C for 4 weeks. Following this, the dog was sacrificed. Two 2 cm portions of cervical trachea were excised from the second dog. These parts were then reconstructed with two tracheal grafts of the same length as the cryopreserved ones. Ten dogs that were grouped into five groups of two dogs each underwent the same procedure. The subjects had a bronchoscopic evaluation on the third postoperative week. Anastomosis regions of the test tracheas were resected to be examined histopathologically. Seven subjects were found to have third-degree obstructions during bronchoscopy; two had close to fourth-degree obstructions. In the histopathological examination, contrary to the findings of the bronchoscopies, 75% of the anastomoses had intact epithelium. The cartilage was seen to have well-preserved structural characteristics in all the anastomoses. Twelve anastomoses had moderate, seven mild and one had severe inflammation. All anastomoses had either good or very good level of vascularisation. The integrity of the tracheal epithelium can be maintained with cryopreservation and split anastomosis technique. The cartilage preserves its structural characteristics despite losing its viability, thereby offering an advantage to

  10. Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome

    International Nuclear Information System (INIS)

    Schoierer, Oliver; Bender, Daniel; Schmidmaier, Gerhard; Bloess, Konstantin; Kauczor, Hans-Ulrich; Weber, Marc-Andre; Burkholder, Iris

    2014-01-01

    To prospectively evaluate whether dynamic contrast-enhanced (DCE) MRI can assess vascularity within non-unions and predicts clinical outcome in combination with the clinical Non-Union Scoring System (NUSS). Fifty-eight patients with non-unions of extremities on CT underwent 3-T DCE MRI. Signal intensity curves obtained from a region-of-interest analysis were subdivided into those with more intense contrast agent uptake within the non-union than in adjacent muscle (vascularised non-union) and those with similar or less contrast uptake. The pharmacokinetic parameters of the Tofts model K trans , K ep , iAUC and V e were correlated with union at CT 1 year later (n = 49). Despite inserted osteosynthetic material, DCE parameters could be evaluated in 57 fractures. The sensitivity/specificity of vascularised non-unions as an indicator of good outcome was 83.9 %/50.0 % compared to 96.8 %/33.3 % using NUSS (n = 49). Logistic regression revealed a significant impact of NUSS on outcome (P = 0.04, odds ratio = 0.93). At first examination, median iAUC (initial area under the enhancement curve) for the ratio non-union/muscle was 10.28 in patients with good outcome compared with 3.77 in non-responders (P = 0.023). K trans , K ep and V e within the non-union were not significantly different initially (n = 57) or 1 year later (n = 19). DCE MRI can assess vascularity in fracture non-unions. A vascularised non-union correlates with good outcome. (orig.)

  11. Spectropolarimetric analysis. Communication 14. Determination of uranyl with d-tartaric acid

    Energy Technology Data Exchange (ETDEWEB)

    Bakalov, V D; Dunina, V V; Potapov, V M [Moskovskij Gosudarstvennyj Univ. (USSR)

    1982-02-01

    The possibility has been shown of improving the sensitivity and precision of determination of uranium (6) in the form of its tartrate complex by using spectropolarimetry instead of polarimetry and circular dichroism instead of optical rotatory dispersion. The method makes it possible to reduce reagent consumption, to expand a range of uranium(6) concentration, which could be determined, due to changes of the cell length and reading range. On the basis of the circular dichroism spectrum of the uranyl-tartrate complex, its symmetry has been estimated to be Dsub(4h) with the coordination number of four on the equatorial plane.

  12. The tyrosyl residues in creatine kinase. Modification by iodine.

    Science.gov (United States)

    Fattoum, A; Kassab, R; Pradel, L A

    1975-10-20

    The effect of the iodination of tyrosyl residues in creatine kinase from rabbit muscle has been investigated at alkaline pH after reversible masking of the reactive thiol groups. The conversion of 4-5 tyrosyl residues to monoiodotyrosines as measured by spectrotitration and by radioactive iodine labelling resulted in almost total loss of enzymic activity. The modified enzyme was unable to bind its nucleotide substrates but no significant conformational change was revealed by optical rotatory dispersion or Stokes radius measurements. However, change in the reactivity of some non-essential thiol groups, presumably those located near the active thiol groups, was observed.

  13. Dispersion relations and sum rules for natural optical activity

    International Nuclear Information System (INIS)

    Thomaz, M.T.; Nussenzveig, H.M.

    1981-06-01

    Dispersion relations and sum rules are derived for the complex rotatory power of an arbitrary linear (nonmagnetic) isotropic medium showing natural optical activity. Both previously known dispersion relations and sum rules as well as new ones are obtained. It is shown that the Rosenfeld-Condon dispersion formula is inconsistent with the expected asymptotic behavior at high frequencies. A new dispersion formula based on quantum eletro-dynamics removes this inconsistency; however, it still requires modification in the low-frequency limit. (Author) [pt

  14. [Effect of activation and blockade of the GABA-ergic system of the substantia nigra in the midbrain on the realization of conditioned food reflexes in dogs].

    Science.gov (United States)

    Iakimovskiĭ, A F

    1988-01-01

    Bilateral injection of 45 mcg of GABA into substantia nigra pars compacta produced in dogs a manifested improvement of parameters of the conditioned differentiation inhibition but failed to influence the positive Pavlovian alimentary conditioned reflex. Injection of GABA synaptic antagonist--picrotoxin impaired conditioned alimentary behaviour. Numerous injections of the GABAergic pharmacological agents resulted in motor disturbance--rotatory movements--and skin trophic deviations. The data obtained and literature references give ground for discussion of the role of striato-nigral and internal GABAergic substantia nigra systems in the positive modulation of adaptive alimentary behaviour and conditioned stimuli differentiation.

  15. Spectropolarimetric analysis

    International Nuclear Information System (INIS)

    Bakalov, V.D.; Dunina, V.V.; Potapov, V.M.

    1982-01-01

    The possibility has been shown of improving the sensitivity and precision of determination of uranium (6) in the form of its tartrate complex by using spectropolarimetry instead of polarimetry and circular dichroism instead of optical rotatory dispersion. The method makes it possible to reduce reagent consumption, to expand a range of uranium(6) concentration, which could be determined, due to changes of the cell length and reading range. On the basis of the circular dichroism spectrum of the uranyl-tartrate complex, its symmetry has been estimated to be Dsub(4h) with the coordination number of four on the equatorial plane

  16. Stress and Strain Gradients in a Low Carbon Steel Deformed under Heavy Sliding

    DEFF Research Database (Denmark)

    Zhang, Xiaodan; Hansen, Niels; Huang, Xiaoxu

    A recent study [1] has shown that a microstructure can be refined to a record low of 5 nm and that dislocation glide is still a controlling mechanism at this length scale. In this study, by heavy rotatory sliding of a low carbon steel a gradient structure has been produced extending to about 2.5 mm...... on the deformation microstructure using the classic stress-structure relationship. Computational and materials modelling has been advanced from bulk to gradient structures leading to dissemination of constitutive stress-strain equations in gradient structures....

  17. Development and Test of a Contactless Position and Angular Sensor Device for the Application in Synchronous Micro Motors

    Directory of Open Access Journals (Sweden)

    Andreas WALDSCHIK

    2009-09-01

    Full Text Available In this work, we present a contactless micro position and angular sensor system which consists of fixed commercial magnetic sensor elements, such as hall sensors and a movable part with integrated micro structured polymer magnets. This system serves particularly for linear and rotatory synchronous micro motors which we have developed and successfully tested. In order to achieve high precision and control of these motors an integration of the special micro position and angular sensors is pursued to increase the resolution and accuracy of the devices.

  18. Asymmetric vibrations of thick shells of revolution having meridionally varying curvature

    International Nuclear Information System (INIS)

    Suzuki, Katsuyoshi; Kosawada, Tadashi; Yachita, Takumi.

    1988-01-01

    An exact method using power series expansions is presented for solving asymmetric free vibration problems for thick shells of revolution having meridionally varying curvature. Based on the improved thick shell theory, the Lagrangian of the shells of revolution are obtained, and the equations of motion and the boundary conditions are derived from the stationary condition of the Lagrangian. The method is demonstrated for thick shells of revolution having elliptical, cycloidal, parabolical, catenary and hyperbolical meridional curvature. The results by the present method are compared with those by the thin shell theory and the effects of the rotatory inertia and the shear deformation upon the natural frequencies are clarified. (author)

  19. Axisymmetric vibrations of thick shells of revolution having meridionally varying curvature

    International Nuclear Information System (INIS)

    Suzuki, Katsuyoshi; Kosawada, Tadashi; Takahashi, Shin; Takahashi, Fumiaki.

    1987-01-01

    An exact method using power series expansions is presented for solving axisymmetric free vibration problems for thick shells of revolution having meridionally varying curvature. Based on the improved thick shell theory, the Lagrangian of the shells of revolution are obtained, and the equations of motion and the boundary conditions are derived from the stationary condition of the Lagrangian. The method is applied to thick shells of revolution having their generating curves of ellipse, cycloid, parabola, catenary and hyperbola. The results by the present method are compared with those by the thin shell theory and the effects of rotatory inertia and shear deformation upon the natural frequencies and the mode shapes are clarified. (author)

  20. Ab initio calculations of anharmonic vibrational circular dichroism intensities of trans-2,3-dideuteriooxirane

    DEFF Research Database (Denmark)

    Bak, KL; Bludsky, O.; Jorgensen, P

    1995-01-01

    A priori theory is derived for anharmonic calculations of vibrational circular dichroism (VCD). The anharmonic VCD expression is gauge origin independent and reduce to the magnetic field perturbation theory expression in the double-harmonic approximation. The theory has been implemented using...... for the atomic axial tensors and using second-order Moller-Plesset theory for the atomic polar tensors and the force fields, The changes of the vibrational rotatory strengths from anharmonicities are small, and do not explain the previously observed large discrepancies between the double-harmonic results...

  1. Results and validity of renal blood flow measurements using Xenon 133

    International Nuclear Information System (INIS)

    Serres, P.; Danet, B.; Guiraud, R.; Durand, D.; Ader, J.L.

    1975-01-01

    The renal blood flow was measured by external recording of the xenon 133 excretion curve. The study involved 45 patients with permanent high blood pressure and 7 transplant patients. The validity of the method was checked on 10 dogs. From the results it seems that the cortical blood flow, its fraction and the mean flow rate are the most representative of the renal haemodynamics parameters, from which may be established the repercussions of blood pressure on kidney vascularisation. Experiments are in progress on animals to check the compartment idea by comparing injections into the renal artery and into various kidney tissues in situ [fr

  2. L'infiltration d'une dilution ideale des solutions avec epineph rine au ...

    African Journals Online (AJOL)

    L'auteur rapporte un procédé simplifié de dilution d'une solution anesthésique avec épinéphrine passant d'une concentration de 1/100 000 à 1/800 000 pour rechercher une hémostase locale effective sans compromettre dans l'immédiat la vitalité de la vascularisation périphérique des lambeaux cutanés levés. The author ...

  3. Brachial Artery Aneurysm as a Limb Threatening Condition: a Case Report

    Directory of Open Access Journals (Sweden)

    Farhad Heydari

    2015-05-01

    Full Text Available Brachial artery aneurysms are rare but potentially limb threatening condition. The presented case here is a 52-year old male referred to the emergency department complaining a sudden onset and progressive pain with coldness of his right upper extremity during brushing. The right upper extremity was pulseless and three-dimensional computed tomography showed an aneurysm of the proximal right brachial artery associated with arterial occlusion in its distal branch. Embolectomy was done, the aneurysm resected, and the artery successfully re-vascularised by interposing a saphenous vein graft. 

  4. Vissage percutané rétrograde du scaphoïde | Mhammdi | Pan ...

    African Journals Online (AJOL)

    En plus des bénéfices de la chirurgie à ciel ouvert du scaphoïde, la réduction de la durée d'immobilisation et le retour rapide au travail, le vissage percutané permet également de réduire le risque opératoire et d'éviter un délabrement des tissus mous, une dévascularisation du foyer de fracture et par conséquent cette ...

  5. Guide of principles in main dog and cat skin’s afections topical aplications

    Directory of Open Access Journals (Sweden)

    Faltinski, F.,

    2009-06-01

    Full Text Available The report is an attempt to remember of the updated general principles in the main dermatologic affects topical applications’ in in dog and cat. Initially are presented: general principles about drug topic formulation’s application, with the describing of skin’s anatomical bases and functions, active substance’s physic-chemicalproprieties, factors that affects transdermal passage, methods of transdermal amplification. Also are presented: characteristics of dog and cat’s skin, skin’s specific vascularisation, ecology and histochemy. In the last chapter are presented the main known dermatologic entities in dog and cat.

  6. Micro-angiographic investigations of revascularisation of fracture in the canine tibia

    Energy Technology Data Exchange (ETDEWEB)

    Kagel, K.O.; Koecher, W.

    1987-03-01

    Micro-angiograms were performed between eight weeks and one year following osteotomies and pressure osteosyntheses in 34 dog tibiae. Seventeen animals also underwent lumbar sympathectomy. In more than half of the cases, vascularisation of the medulla was reduced by damage to the nutrient artery. Segmental connections could be demonstrated by means of transcortical anastomoses. Following sympathectomy, revascularisation was more marked as a result of numerous trans-osseus anastomoses. This, however, did not lead to improved healing; healing was worse after sympathectomy. Transcortical revascularisation and vessel growth along drill holes are of crucial significance.

  7. Micro-angiographic investigations of revascularisation of fracture in the canine tibia

    International Nuclear Information System (INIS)

    Kagel, K.O.; Koecher, W.; Ernst-Moritz-Arndt-Universitaet, Greifswald

    1987-01-01

    Micro-angiograms were performed between eight weeks and one year following osteotomies and pressure osteosyntheses in 34 dog tibiae. Seventeen animals also underwent lumbar sympathectomy. In more than half of the cases, vascularisation of the medulla was reduced by damage to the nutrient artery. Segmental connections could be demonstrated by means of transcortical anastomoses. Following sympathectomy, revascularisation was more marked as a result of numerous trans-osseus anastomoses. This, however, did not lead to improved healing; healing was worse after sympathectomy. Transcortical revascularisation and vessel growth along drill holes are of crucial significance. (orig.) [de

  8. Keratitis-Ichthyosis-Deafness syndrome: A rare congenital disorder

    Science.gov (United States)

    Shanker, Vinay; Gupta, Mudita; Prashar, Aditi

    2012-01-01

    Keratitis-Icthyosis-Deafness syndrome is a rare congenital disorder characterized by keratitis, ichthyosis, and deafness. We report a 13 year old female child who presented with diffuse alopecia of the scalp and body. There was erythrokeratoderma of face and discrete hyperkeratotic hyperpigmented papulo plaque lesions on the body. Patient also had reticulate hyperkeratosis of palms and soles. There was history of recurrent episodes of folliculitis over the scalp and body. There was no evidence of any malignancy. Eye involvement in the form of bilateral vascularising keratitis was present. There was bilateral mixed hearing loss. PMID:23130264

  9. Keratitis-Ichthyosis-Deafness syndrome: A rare congenital disorder

    Directory of Open Access Journals (Sweden)

    Vinay Shanker

    2012-01-01

    Full Text Available Keratitis-Icthyosis-Deafness syndrome is a rare congenital disorder characterized by keratitis, ichthyosis, and deafness. We report a 13 year old female child who presented with diffuse alopecia of the scalp and body. There was erythrokeratoderma of face and discrete hyperkeratotic hyperpigmented papulo plaque lesions on the body. Patient also had reticulate hyperkeratosis of palms and soles. There was history of recurrent episodes of folliculitis over the scalp and body. There was no evidence of any malignancy. Eye involvement in the form of bilateral vascularising keratitis was present. There was bilateral mixed hearing loss.

  10. Vascularization of soft tissue engineering constructs

    DEFF Research Database (Denmark)

    Pimentel Carletto, Rodrigo

    with mechanical properties in the range of soft tissues has not been fully achieved. My project focused on the fabrication and the active perfusion of hydrogel constructs with multi-dimensional vasculature and controlled mechanical properties targeting soft tissues. Specifically, the initial part of the research...... nanotechnology-based paradigm for engineering vascularised liver tissue for transplantation”) and the Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug delivery and sensing Using microcontainers and Nanomechanics (Danish National Research Foundation (DNRF122)....

  11. The ultrastructure and processing properties of Straumann Bone Ceramic and NanoBone.

    Science.gov (United States)

    Dietze, S; Bayerlein, T; Proff, P; Hoffmann, A; Gedrange, T

    2006-02-01

    The ultrastructure, fundamental chemistry, and processing modes of fully synthetic bone grafting materials are relevant to the reconstruction of osseous defects. Rapid progress in the profitable market of biomaterials has led to the development of various bone substitutes. Despite all these efforts, an ideal and full substitute of autologous bone is not yet in sight. With regard to anorganic calcium phosphate ceramics, Straumann Bone Ceramic and NanoBone are compared. These have a similar composition and are osteoconductive, which indispensably requires contact with well-vascularised bone.

  12. Hyperthermia and massage are effect for the gingivitis improvement; Onnetsu to massaji ga shinikuen kaizen ni koka

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-10-01

    It was confirmed that Kao and research group of Nosaka professor of Iwate Medical Univ. faculty of dentistry that hyperthermia and massage at the 40 degrees C for the gingival activate the gingival lymph duct function and that it improves the gingivitis was effective. By causing the microcirculation disorder of the gingival, the research of the vascularisation is main until now for the gingivitis. Present research demonstrated that the recovery of the lymph duct function was effective for the gingivitis improvement for the first time in the world. (translated by NEDO)

  13. MR imaging of avascular femoral head necrosis - pre- and postoperative studies

    International Nuclear Information System (INIS)

    Schedel, H.; Ziegler, L.; Vogl, T.; Hilbertz, T.; Lissner, J.; Buchner, H.

    1992-01-01

    46 patients with avascular necrosis of the femoral head were examined by T 2 - and T 1 -weighted MR before and after infusion of Gd-DTPA. Both sides were involved in 12 cases. The classification was done according to Ficat. In early stages and in postoperative studies a correlation of signal intensity after infusion of Gd-DTPA and clinical symptoms was found. Hyperintensity of the avascular area or of the implanted material was assumed to be vascularised or vital components in 4 cases of Ficat 1 and 15 postoperative studies. Contrariwise, we found in 5 patients with severe postoperative symptoms, low signal intensity areas due to avascular regions. (orig.) [de

  14. Regenerative therapy and tissue engineering for the treatment of end-stage cardiac failure

    Science.gov (United States)

    Finosh, G.T.; Jayabalan, Muthu

    2012-01-01

    Regeneration of myocardium through regenerative therapy and tissue engineering is appearing as a prospective treatment modality for patients with end-stage heart failure. Focusing on this area, this review highlights the new developments and challenges in the regeneration of myocardial tissue. The role of various cell sources, calcium ion and cytokine on the functional performance of regenerative therapy is discussed. The evolution of tissue engineering and the role of tissue matrix/scaffold, cell adhesion and vascularisation on tissue engineering of cardiac tissue implant are also discussed. PMID:23507781

  15. Regenerative therapy and tissue engineering for the treatment of end-stage cardiac failure: new developments and challenges.

    Science.gov (United States)

    Finosh, G T; Jayabalan, Muthu

    2012-01-01

    Regeneration of myocardium through regenerative therapy and tissue engineering is appearing as a prospective treatment modality for patients with end-stage heart failure. Focusing on this area, this review highlights the new developments and challenges in the regeneration of myocardial tissue. The role of various cell sources, calcium ion and cytokine on the functional performance of regenerative therapy is discussed. The evolution of tissue engineering and the role of tissue matrix/scaffold, cell adhesion and vascularisation on tissue engineering of cardiac tissue implant are also discussed.

  16. [Multiple non-responding ESWL lithiasis in ectopic pelvic kidney: laparotomic surgical management].

    Science.gov (United States)

    Abed El Rahman, D; Zanetti, G; Cozzi, G; Cozzi, L A; Abed El Rahman, S; Maggioni, A; Rocco, F

    2010-01-01

    A 34 year-old male with multiple lithiasis of ectopic pelvic left kidney, which for 5 years had been causing pain in the left iliac region irradiating to ipsilateral inguinal region and testis. 4 ESWL treatments were unsuccessful. The diagnostic imaging (Angio-CT + Uro-CT) showed ectopic pelvic left kidney with abnormal vascularisation, characterised by multiple lithiasis extending in total area of 4x2 cm with shorter ureter. Right kidney was in normal position. A left pyelocalicolithotomy after DJ stent positioning was performed.

  17. Simultaneous transcatheter closure of intralobar pulmonary sequestration and patent ductus arteriosus in a patient with infantile Scimitar syndrome.

    Science.gov (United States)

    Aslan, Eyüp; Tanıdır, İbrahim Cansaran; Saygı, Murat; Onan, Sertaç Hanedan; Güzeltaş, Alper

    2015-03-01

    Scimitar syndrome is a rare disease associated with a right lung sequestration vascularised by arteries arising from the abdominal aorta and abnormal venous drainage into the inferior vena cava. The infantile form is generally presented with severe heart failure, pulmonary hypertension and respiratory distress. It may be associated with various intracardiac defects, including atrial septal defects, ventricular septal defects, patent ductus arteriosus or more complicated structural congenital heart defects. Here, we present a 2-month-old girl with Scimitar syndrome whose pulmonary arterial pressure decreased after transcatheter patent ductus arteriosus closure and embolization of the anomalous systemic arterial supply.

  18. Von Hippel-Lindau Disease

    Directory of Open Access Journals (Sweden)

    Hes Frederik J

    2005-11-01

    Full Text Available Abstract A germline mutation in the Von-Hippel Lindau (VHL gene predisposes carriers to development of abundantly vascularised tumours in the retina, cerebellum, spine, kidney, adrenal gland and pancreas. Most VHL patients die from the consequences of cerebellar haemangioblastoma or renal cell carcinoma. The VHL gene is a tumour suppressor gene and is involved in angiogenesis by regulation of the activity of hypoxia-inducible factor 1-α (HIF1-α. Clinical diagnosis of VHL can be confirmed by molecular genetic analysis of the VHL gene, which is informative in virtually all VHL families. A patient with (suspicion for VHL is an indication for genetic counselling and periodical examination.

  19. MR imaging in congenital lower limb deformities

    International Nuclear Information System (INIS)

    Laor, T.; Jaramillo, D.; Hoffer, F.A.; Kasser, J.R.

    1996-01-01

    Treatment for children with cogenital deformities of the lower extremities may vary, depending on the state of the unossified skeletal structures and surrounding soft tissues. The purpose of our study was to demonstrate the spectrum of the osteochondral and extrasosseous abnormalities as depicted with MR imaging. We retrospectively reviewed MR examinations of 13 limbs of ten children (aged 1 month-9 years, mean 2.1 years) with longitudinal and transverse deformities of the lower extremities. The lesions imaged were fibular hemimelia (n=5), tibial hemimelia (n=5), and congenital constriction bands (n=3). Each examination was assessed for abnormalities in the osteocartilaginous and extraosseous (articular or periarticular components such as ligaments, tendons, and menisci; the muscles and the arteries) structures. Abnormalities were seen in all patients. Osteocartilaginous abnormalities in the patients with longitudinal deformities included abnormal distal femoral epiphyses, abnormal proximal tribial physes, hypertrophied and dislocated proximal fibular epiphyses, unsuspected fibular and tibial remnants, and absence or coalition of the tarsal bones. No osteocartilaginous abnormalities were seen in the patients with congential constriction bands. Articular abormalities in patients with either form of hemimelia included absent cruciate ligaments and menisci, dislocated or absent cartilaginous patellae, absent patellar tendons, and abnormal collateral ligaments. All but one limb imaged had absent or attenuated muscle groups. Of the nine MR arteriograms performed at the level of the knee, eight were abnormal. The normal popliteal trifurcation was absent or in an abnormal location. We conclude that MR imaging of children with congenital lower extremity deformities shows many osteochondral and extraosseous abnormalities that are not depicted by conventional radiogrpahy. This information can help to plan early surgical intervention and prosthetic rehabilitation. (orig.)

  20. Implant rehabilitation in fibula-free flap reconstruction: A retrospective study of cases at 1-18 years following surgery.

    Science.gov (United States)

    Sozzi, Davide; Novelli, Giorgio; Silva, Rebeka; Connelly, Stephen T; Tartaglia, Gianluca M

    2017-10-01

    To determine the dental implant and prostheses success rate in a cohort of patients who underwent a vascularized fibula-free flap (FFF) for maxillary or mandibular reconstruction. The investigators implemented a retrospective cohort study composed of patients who had undergone primary or secondary FFF reconstruction jaw surgery plus placement of 2-6 implants in the reconstructed arch, which were restored with an implant-supported prosthesis. The sample was composed of all patients who underwent FFF surgery between 1998 and 2012 and had either simultaneous or secondary dental implant placement. A total of 28 patients met inclusion criteria. Of these, 22 patients participated in the retrospective review. Patients were examined by an independent observer between January-December 2015. In addition, all patients completed a questionnaire to access satisfaction with the implant-supported prosthesis. The patient cohort consisted of 12 males and 10 females, age 12-70 years. A total of 100 implants were placed, 92 implants in fibular bone and 8 implants in native bone. In the maxilla, 35 implants were placed into fibular bone and 4 into native bone (11 in irradiated patients and 28 in non-irradiated patients). In the mandible, 57 implants were placed into fibular bone and 4 into native bone (15 in irradiated patients and 46 in non-irradiated patients). The mean follow-up after implant loading was 7.8 years (range 1.3-17.5 years). The implant survival rate was 98% (95% CI: 92.2%-99.5%). No statistically significant difference was found in implant success between maxillary and mandibular implants, or between radiated and non-radiated bone. The prostheses success rate, determined by clinical exam and patient satisfaction, was 100%. The results of this study suggest that implant survival is high and implant-supported prostheses are a reliable rehabilitation option in patients whose jaws have been reconstruction with a FFF. Copyright © 2017. Published by Elsevier Ltd.

  1. Different Recipient Vessels for Free Microsurgical Fibula Flaps in the Treatment of Avascular Necrosis of the Femoral Head: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Tu, Yiji; Chen, Zenggan; Lineaweaver, William Charles; Zhang, Feng

    2017-12-01

    Several recipient vessels can be used in free microsurgical fibula flaps (MFFs) for the treatment of avascular necrosis of the femoral head (ANFH). Few articles investigate the influence of different recipient vessels on outcomes of MFF for ANFH. A comprehensive literature search of databases including PubMed-Medline, Ovid-Embase, and Cochrane Library was performed to collect the related studies. The Medical Subject Headings used were "femur head necrosis" and "bone transplantation." The relevant words in title or abstract included but not limited to "fibula flap," "fibular flap," "vascularized fibula," "vascularized fibular," "free fibula," "free fibular," "femoral head necrosis," "avascular necrosis of femoral head," and "ischemic necrosis of femoral head." The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Finally, 15 studies encompassing a total of 1267 patients (1603 hips) with ANFH were pooled in the overall analysis. Recipient vessels for MFF included the ascending branch of the lateral circumflex femoral artery and vein in 8 studies, descending branch of the lateral circumflex femoral artery and vein in 2 studies, second perforating branch of the deep femoral artery and vein in 4 studies, and inferior gluteal artery and vein in 1 study. Preoperative and postoperative average Harris hip score and pooled analyses of the rate of conversion, radiographic progression, and hip surgery-related complications showed no significant difference on the outcomes of MFF on ANFH between using different recipient vessels. Different recipient vessels did not affect outcomes in MFF procedures for ANFH. High-quality randomized controlled trials and prospective studies would be necessary to clarify reliable advantages and disadvantages between different recipient vessels. Until then, surgeons are justified in using ascending branch of the lateral circumflex femoral artery and vein, descending branch of the lateral

  2. Regeneração de nervo periférico após anastomose término-lateral, com manutenção do epineuro, em ratos

    Directory of Open Access Journals (Sweden)

    Rosseto Marcelo

    2001-01-01

    Full Text Available A reinervação dos nervos periféricos pode ser realizada através de anastomoses término - terminais ou término-laterais, e este fenômeno tem sido amplamente estud ado. As anastomoses nervosas término-laterais tem sido utilizadas com pouca freqüência em relação as anastomoses término-terminais e contestada por alguns autores quanto a possibilidade de reinervação, quando a integridade do epineuro é mantida. Devido a estas divergências, estudou-se o efeito do epineuro na reinervação em anastomoses término-laterais, em ratos. Foram utilizados 20 ratos Wistar, adultos, distribuídos em dois grupos (A e B. No grupo A, 10 animais foram submetidos à secção do nervo fibular no membro pélvico direito e fixação desde à musculatura; no membro pélvico esquerdo foi realizada a secção do nervo fibular e anastomasado término-lateral com o nervo tibial. No grupo B, os procedimentos foram idênticos aos realizados no grupo A, sendo somente invertido os membros pélvicos. No nonagésimo dia do ato operatório, foi realizada uma biópsia em cada nervo fibular para análise histológica à microscópia óptica, onde a reinervação foi objeto de estudo. A reinervação ocorreu mostrando que a integridade do epineuro não impediu a regeneração axonal.

  3. "Footdrop in the farmers: Clinical and electromyographical study "

    Directory of Open Access Journals (Sweden)

    Ghaffarpour M

    2002-08-01

    Full Text Available Footdrop is a relatively common deficit among the neurological disorders, which has different causes with various levels of involvement in neuromuscular system, including central nervous system (brain cortex, spinal cord, fifth lumbar root, peripheral nerves and muscles. Peroneal nerve injury at the fibular head has been reported to the most common cause of foot drop, which can be due to infarct, tumor or leprosy but the vast majority of lesions are traumatic. In this article, we report seventeen patients with foot drop in farmers. All of the patients except one, were male with age ranges between 15 to 25 years. They had been doing certain farming activities (harvesting or weeding for 1-5 days before developing foot drop. Electrophysiological studies have been done in only seven of them due to patient’s unwillingness. Nerve conduction velocity and amplitudes distal to the fibular head were normal, but stimulation above the fibular head showed reduced nerve conduction velocity and amplitudes (mean 22.4 m/s in the abnormal side versus 51.5 m/s in the normal side, mean peak to peak amplitude 3.6 mv in the symptomatic side versus 10.4 in the contralateral side respectively. Forty-three percent of patients had also conduction block. F wave latency increased on the affected side in comparison to the normal side (mean 4.7 m/s. The new and perhaps interesting findings in our cases are unilateral involvement and occurrence of peroneal palsy on the side of dominant hand, indicating that type of the hand activity is probably more important in inducing foot drop than the position of seating during harvesting or weeding. We suggest further investigation in this setting in order to find the mechanisms of nerve injury and prophylactic measures.

  4. Changes in ankle joint motion after Supramalleolar osteotomy: a cadaveric model.

    Science.gov (United States)

    Kim, Hak Jun; Yeo, Eui Dong; Rhyu, Im Joo; Lee, Soon-Hyuck; Lee, Yeon Soo; Lee, Young Koo

    2017-09-09

    Malalignment of the ankle joint has been found after trauma, by neurological disorders, genetic predisposition and other unidentified factors, and results in asymmetrical joint loading. For a medial open wedge supramalleolar osteotomy(SMO), there are some debates as to whether concurrent fibular osteotomy should be performed. We assessed the changes in motion of ankle joint and plantar pressure after supramalleolar osteotomy without fibular osteotomy. Ten lower leg specimens below the knee were prepared from fresh-frozen human cadavers. They were harvested from five males (10 ankles)whose average age was 70 years. We assessed the motion of ankle joint as well as plantar pressure for SS(supra-syndesmotic) SMO and IS(intra-syndesmotic) SMO. After the osteotomy, each specimen was subjected to axial compression from 20 N preload to 350 N representing half-body weight. For the measurement of the motion of ankle joint, the changes in gap and point, angles in ankle joint were measured. The plantar pressure were also recorded using TekScan sensors. The changes in the various gap, point, and angles movements on SS-SMO and IS-SMO showed no statistically significant differences between the two groups. Regarding the shift of plantar center of force (COF) were noted in the anterolateral direction, but not statistically significant. SS-SMO and IS-SMO with intact fibula showed similar biomechanical effect on the ankle joint. We propose that IS-SMO should be considered carefully for the treatment of osteoarthrosis when fibular osteotomy is not performed because lateral cortex fracture was less likely using the intrasyndesmosis plane because of soft tissue support.

  5. A 72-year-old patient with bilateral Maisonneuve fractures

    Directory of Open Access Journals (Sweden)

    Thomas Dienstknecht

    2012-07-01

    Full Text Available Maisonneuve fractures result from a disruption of the medial ankle structures and a proximal fibular fracture. Patient complaints can be misleading and there is a significant rate of delayed diagnosed injuries. We present a case of bilateral Maisonneuve fractures after a fall due to a syncopal collapse. A precise clinical examination led to this rare diagnosis. The injuries were treated with syndesmotic screw fixation, removal of hardware followed after 6 weeks. The patient was asymptomatic at threemonths follow up. Patients with bilateral injuries undergoing standard surgical treatment can gain full recovery, but high suspicion in clinical examination is needed to detect this uncommon bilateral injury.

  6. 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.

  7. Outcome of Distal Both Bone Leg Fractures Fixed by Intramedulary Nail for Fibula & MIPPO in Tibia.

    Science.gov (United States)

    Gupta, Anil; Anjum, Rashid; Singh, Navdeep; Hackla, Shafiq

    2015-04-01

    Fractures of the distal third of the tibia are mostly associated with a fibular fracture that often requires fixation. The preferred treatment of distal tibial fracture is the minimally invasive percutaneous plate osteosynthesis (MIPPO) procedure. However, there are no clear cut guidelines on fixation of the fibular fracture and currently most orthopedic surgeons use a plate osteosynthesis for the fibula as well. A common complication associated with dual plating is an increased chance of soft tissue necrosis, infection, and in some cases resulting in an exposed implant. We conducted a prospective study to analyze the results of fractures of the distal in both leg bones managed by the MIPPO procedure for tibial fractures and a rush nail for fibular fractures. The study was conducted in a tertiary care hospital from November 2012 to May 2014, a total of 30 fractures in 30 patients (18 males, 12 females) with a mean age of 42.4 years (26-60 years) were treated in our institution in the aforesaid time period with MIPPO for tibia and rush nail for fibular fractures. All the cases were operated on by a single surgeon in emergency within 24 hours. The patients with skin blistering and compound fractures were excluded from this study. Rehabilitative measures were proceeded as per patient's pain profile, isometric and isotonic exercises were started on the first post-operative day, with full weight bearing at 10-12 weeks after assessing clinical and radiological union. Regular follow up of patients was done, radiographs were taken at the immediate post-operative period and at 3, 6, 12 and 24 weeks. All the patients were available for regular follow up. Radiological and clinical union proceeded normally in all the patients, no patients had signs of any deep infection, delayed union or nonunion, three patients had a superficial infection of the tibial incision that healed with a change in antibiotic. The use of dual plating for fixation of the lower tibia and fibula

  8. Ulcers and thrombotic neuropathy as first manifestations in a patient with antiphospholipid syndrome

    International Nuclear Information System (INIS)

    Bolivar G, Isabel; Cano L, Natalia; Carmona C, Daniela; Correa S Elizabeth, Guerra P Lina and other

    2010-01-01

    This following case report describes a 34 years-old man with chronic clinical skin ulcers and left lower monoparesis. Electromyography revealed sensory neuropathy of the left superficial fibular nerve; the echographic studies showed absence of artery or venous disorder. The patient showed no improvement of skin lesions with aggressive immunosuppression. The biopsy of the skin and the sural nerve reported thrombi and absence of inflammatory infiltrates; findings that support the diagnosis of thrombotic vasculopathy and neuropathy. The presence of lupus anticoagulant, prolonged PTT and positive anti-B2 glycoprotein antibodies were documented.

  9. Longitudinal tibial epiphyseal bracket in Nievergelt syndrome

    International Nuclear Information System (INIS)

    Burnstein, M.I.; De Smet, A.A.; Breed, A.L.; Thomas, J.R.; Hafez, G.R.

    1989-01-01

    A patient is described with lower extremity mesomelic dwarfism associated with bilateral congenital elbow, hip, and knee dislocations. Rhomboid-shaped tibiae and delayed ossification of the primary fibular ossification centers were demonstrated at birth. Plain films and magnetic resonance imaging revealed that the tibial deformities were due to the presence of longitudinal epiphyseal brackets. These brackets were observed at surgery and confirmed histologically. Recognition of the longitudinal epiphyseal bracket and its relationship to the tibial deformities seen in this patient with Nievergelt syndrome is important for planning surgical treatment. (orig.)

  10. Longitudinal tibial epiphyseal bracket in Nievergelt syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Burnstein, M.I.; De Smet, A.A.; Breed, A.L.; Thomas, J.R.; Hafez, G.R.

    1989-04-01

    A patient is described with lower extremity mesomelic dwarfism associated with bilateral congenital elbow, hip, and knee dislocations. Rhomboid-shaped tibiae and delayed ossification of the primary fibular ossification centers were demonstrated at birth. Plain films and magnetic resonance imaging revealed that the tibial deformities were due to the presence of longitudinal epiphyseal brackets. These brackets were observed at surgery and confirmed histologically. Recognition of the longitudinal epiphyseal bracket and its relationship to the tibial deformities seen in this patient with Nievergelt syndrome is important for planning surgical treatment. (orig.).

  11. Giant cells tumor of radius distal end and bone reconstruction

    International Nuclear Information System (INIS)

    La O Duran, Eldis; Monzon Fernandez, Abel Nicolas; Sanz Delgado, Licett

    2009-01-01

    This is the case of a black women aged 40 presenting with a tumor of distal end of right radium with histological diagnosis of low-grade malignancy giant cells tumor and proposal of limb amputation. A conservative surgery was performed with a two-steps total exeresis of lesion sparing the oncologic margin. A fibular free-graft was used and wrist arthrodesis and internal fixation of graft using AO system. There was a good graft consolidation and an active incorporation of patient to social activities. The diagnosis, treatment, follow-up, rehabilitation and case prognosis are exposed

  12. 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.)

  13. Restoration of sensitivity after removal of the sural nerve: a new application of lateroterminal neurorraphy

    Directory of Open Access Journals (Sweden)

    Fausto Viterbo

    Full Text Available Os autores propõem o emprego da neurorrafia término-lateral do coto distal do nervo sural na face lateral do nervo fibular superficial para evitar anestesia ou hipoestesia na face lateral do pé após a retirada do nervo sural para enxertia. A proximidade anatômica entre os nervos em questão tornam o procedimento simples, sem aumentar o tempo cirúrgico. A neurorrafia término-lateral proposta não prejudica as estruturas inervadas pelo nervo doador .

  14. Restoration of sensitivity after removal of the sural nerve: a new application of lateroterminal neurorraphy

    OpenAIRE

    Viterbo, Fausto; Palhares, Aristides; Franciosi, Luis Fernando

    1994-01-01

    Os autores propõem o emprego da neurorrafia término-lateral do coto distal do nervo sural na face lateral do nervo fibular superficial para evitar anestesia ou hipoestesia na face lateral do pé após a retirada do nervo sural para enxertia. A proximidade anatômica entre os nervos em questão tornam o procedimento simples, sem aumentar o tempo cirúrgico. A neurorrafia término-lateral proposta não prejudica as estruturas inervadas pelo nervo doador .

  15. Fifteen years of follow-up of a removable prosthetic design to maintain two remaining molars in a patient with mandibular reconstruction

    Directory of Open Access Journals (Sweden)

    Ming-Lun Hsu

    2012-06-01

    Full Text Available This clinical report describes a long-term prosthetic solution for a patient who had undergone mandibular reconstruction with a fibular graft, leaving only two right molars. The only retention device for the removable prosthesis design included a telescoping system with an O-ring application, but without fibula graft involvement. This prosthesis design was motivated by the altered bony and muscular architecture resulting in an increased maxillomandibular space and thick soft tissue in the denture-bearing area. This case demonstrates that appropriate denture design, consistent recall maintenance, and oral hygiene motivation minimized periodontal destruction and maximized prosthetic use for the patient despite the unfavorable loading conditions.

  16. Peripheral nervous system involvement in chronic spinal cord injury

    DEFF Research Database (Denmark)

    Tankisi, Hatice; Pugdahl, Kirsten; Rasmussen, Mikkel Mylius

    2015-01-01

    Introduction: Upper motor neuron disorders are believed to leave the peripheral nervous system (PNS) intact. In this study we examined whether there is evidence of PNS involvement in spinal cord injury (SCI). Methods: Twelve subjects with chronic low cervical or thoracic SCI were included......), and the amount of SA correlated inversely with reflex activity and nerve length. Fibular nerve entrapment across the knee was seen in 6 subjects, and sciatic nerve entrapment was seen in 1. Apart from entrapment neuropathies, NCS changes were found predominantly in motor nerves. Conclusion: The presence...

  17. Raman spectroscopy of garnet-group minerals

    Science.gov (United States)

    Mingsheng, P.; Mao, Ho-kwang; Dien, L.; Chao, E.C.T.

    1994-01-01

    The Raman spectra of the natural end members of the garnet-group minerals, which include pyrope, almandine and spessarite of Fe-Al garnet series and grossularite, andradite and uvarovite of Ca-Fe garnet series, have been studied. Measured Raman spectra of these minerals are reasonably and qualitatively assigned to the internal modes, translational and rotatory modes of SiO4 tetrahedra, as well as the translational motion of bivalent cations in the X site. The stretch and rotatory Alg modes for the Fe-Al garnet series show obvious Raman shifts as compared with those for the Ca-Fe garnet series, owing to the cations residing in the X site connected with SiO4 tetrahedra by sharing the two edges. The Raman shifts of all members within either of the series are attributed mainly to the properties of cations in the X site for the Fe-Al garnet series and in the Y site for the Ca-Fe garnet series. ?? 1994 Institute of Geochemistry, Chinese Academy of Sciences.

  18. Quantitative structure-retention relationship studies with immobilized artificial membrane chromatography II: partial least squares regression.

    Science.gov (United States)

    Li, Jie; Sun, Jin; He, Zhonggui

    2007-01-26

    We aimed to establish quantitative structure-retention relationship (QSRR) with immobilized artificial membrane (IAM) chromatography using easily understood and obtained physicochemical molecular descriptors and to elucidate which descriptors are critical to affect the interaction process between solutes and immobilized phospholipid membranes. The retention indices (logk(IAM)) of 55 structurally diverse drugs were determined on an immobilized artificial membrane column (IAM.PC.DD2) directly or obtained by extrapolation method for highly hydrophobic compounds. Ten simple physicochemical property descriptors (clogP, rings, rotatory bond, hydro-bond counting, etc.) of these drugs were collected and used to establish QSRR and predict the retention data by partial least squares regression (PLSR). Five descriptors, clogP, rotatory bond (RotB), rings, molecular weight (MW) and total surface area (TSA), were reserved by using the Variable Importance for Projection (VIP) values as criterion to build the final PLSR model. An external test set was employed to verify the QSRR based on the training set with the five variables, and QSRR by PLSR exhibited a satisfying predictive ability with R(p)=0.902 and RMSE(p)=0.400. Comparison of coefficients of centered and scaled variables by PLSR demonstrated that, for the descriptors studied, clogP and TSA have the most significant positive effect but the rotatable bond has significant negative effect on drug IAM chromatographic retention.

  19. Vertigo and nystagmus in orthostatic hypotension.

    Science.gov (United States)

    Choi, J-H; Seo, J-D; Kim, M-J; Choi, B-Y; Choi, Y R; Cho, B M; Kim, J S; Choi, K-D

    2015-04-01

    Generalized cerebral ischaemia from cardiovascular dysfunction usually leads to presyncopal dizziness, but several studies reported a higher frequency of rotatory vertigo in cardiovascular patients. Whether generalized cerebral ischaemia due to cardiovascular disorders may produce objective vestibular dysfunction was investigated. Thirty-three patients with orthostatic dizziness/vertigo due to profound orthostatic hypotension and 30 controls were recruited. All participants underwent recording of eye movements during two orthostatic challenging tests: the Schellong and the squatting-standing tests. Most patients had neuroimaging, and patients with abnormal eye movements were subjected to follow-up evaluations. Symptoms associated with orthostatic dizziness/vertigo included blurred vision, fainting and tinnitus. Ten (30%) of 33 patients developed rotatory vertigo and nystagmus during the Schellong (n = 5) or squatting-standing test (n = 5). Four of them showed pure downbeat nystagmus whilst five had downbeat and horizontal nystagmus with or without torsional component. Patients with orthostatic nystagmus had shorter duration of orthostatic intolerance than those without nystagmus (1.0 ± 1.6 vs. 11.0 ± 9.7 months, P vertigo due to objective vestibular dysfunction. The presence of orthostatic vertigo and nystagmus has an association with the duration of orthostatic intolerance. © 2014 EAN.

  20. Functional anatomy of the lateral collateral ligament of the elbow.

    Science.gov (United States)

    Hackl, M; Bercher, M; Wegmann, K; Müller, L P; Dargel, J

    2016-07-01

    The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors. Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed. The origin of the LCLC was evaluated for isometry. The insertion types of the lateral ulnar collateral ligament (LUCL) were analyzed and classified. The ECU runs parallel to the RCL to dynamically preserve varus stability. The supinator and anconeus muscle fibers coalesce with the LCLC and lengthen during pronation. The anconeus fibers run parallel to the LUCL in full flexion. The LCLC consists of the annular ligament (AL) and the isometric radial collateral ligament (RCL). During elbow flexion, its posterior branches (LUCL) tighten while the anterior branches loosen. When performing a pivot shift test, the loosened LUCL fibers do not fully tighten in full extension. The LUCL inserts along with the AL at the supinator crest. Three different insertion types could be observed. The LUCL represents the posterior branch of the RCL rather than a distinct ligament. It is non-isometric and lengthens during elbow flexion. The RCL was found to be of vital importance for neutralization of posterolateral rotatory forces. Pronation of the forearm actively stabilizes the elbow joint as the supinator, anconeus and biceps muscle work in unison to increase posterolateral rotatory stability.

  1. Isotope effect of optical activity measurements on L-α-alanine

    International Nuclear Information System (INIS)

    Darge, W.; Laczko, I.; Thiemann, W.

    1976-01-01

    If an optically active organic substance is labelled in the chirality center with another isotopic species (such as 15 N for 14 N) a pronounced variation of rotatory power is predicted. It was tried to varify this idea experimentally on L-α-alanine and found an isotope effect in ORD (optical rotatory dispersion). The magnitude of the rotation is mainly dependent on the pH of the solvent. The ratio of the optical activity alanine- 14 N/alanine- 15 N is about 1.02. It can be seen that the ratios of the molecular rotations are consistently lower than the corresponding ratios of the specific rotations. This is of course due to the fact that the molecular mass 15 M is larger than 14 M. This means tthat the mass difference is already taken into account so that the ratio of the molecular rotations could be defined as the ''net'' isotope effect in the ORDs of 15 N-substitued alanine. From the fact the ORD is different for the isotope-substitued alanine, one can reasonably assume that the absorption coefficient is also different. This leads to speculations about certain problems in the chemical evolution of the biosphere, such as the origin of optical activity. (T.G.)

  2. Coronal 2D MR cholangiography overestimates the length of the right hepatic duct in liver transplantation donors

    International Nuclear Information System (INIS)

    Kim, Bohyun; Kim, Kyoung Won; Kim, So Yeon; Park, So Hyun; Lee, Jeongjin; Song, Gi Won; Jung, Dong-Hwan; Ha, Tae-Yong; Lee, Sung Gyu

    2017-01-01

    To compare the length of the right hepatic duct (RHD) measured on rotatory coronal 2D MR cholangiography (MRC), rotatory axial 2D MRC, and reconstructed 3D MRC. Sixty-seven donors underwent coronal and axial 2D projection MRC and 3D MRC. RHD length was measured and categorized as ultrashort (≤1 mm), short (>1-14 mm), and long (>14 mm). The measured length, frequency of overestimation, and the degree of underestimation between two 2D MRC sets were compared to 3D MRC. The length of the RHD from 3D MRC, coronal 2D MRC, and axial 2D MRC showed significant difference (p < 0.05). RHD was frequently overestimated on the coronal than on axial 2D MRC (61.2 % vs. 9 %; p <.0001). On coronal 2D MRC, four (6 %) with short RHD and one (1.5 %) with ultrashort RHD were over-categorized as long RHD. On axial 2D MRC, overestimation was mostly <1 mm (83.3 %), none exceeding 3 mm or over-categorized. The degree of underestimation between the two projection planes was comparable. Coronal 2D MRC overestimates the RHD in liver donors. We suggest adding axial 2D MRC to conventional coronal 2D MRC in the preoperative workup protocol for living liver donors to avoid unexpected confrontation with multiple ductal openings when harvesting the graft. (orig.)

  3. Coronal 2D MR cholangiography overestimates the length of the right hepatic duct in liver transplantation donors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bohyun [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Ajou University School of Medicine, Department of Radiology, Ajou University Medical Center, Suwon (Korea, Republic of); Kim, Kyoung Won; Kim, So Yeon; Park, So Hyun [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Lee, Jeongjin [Soongsil University, School of Computer Science and Engineering, Seoul (Korea, Republic of); Song, Gi Won; Jung, Dong-Hwan; Ha, Tae-Yong; Lee, Sung Gyu [University of Ulsan College of Medicine, Department of Surgery, Division of Hepatobiliary and Liver Transplantation Surgery, Asan Medical Center, Seoul (Korea, Republic of)

    2017-05-15

    To compare the length of the right hepatic duct (RHD) measured on rotatory coronal 2D MR cholangiography (MRC), rotatory axial 2D MRC, and reconstructed 3D MRC. Sixty-seven donors underwent coronal and axial 2D projection MRC and 3D MRC. RHD length was measured and categorized as ultrashort (≤1 mm), short (>1-14 mm), and long (>14 mm). The measured length, frequency of overestimation, and the degree of underestimation between two 2D MRC sets were compared to 3D MRC. The length of the RHD from 3D MRC, coronal 2D MRC, and axial 2D MRC showed significant difference (p < 0.05). RHD was frequently overestimated on the coronal than on axial 2D MRC (61.2 % vs. 9 %; p <.0001). On coronal 2D MRC, four (6 %) with short RHD and one (1.5 %) with ultrashort RHD were over-categorized as long RHD. On axial 2D MRC, overestimation was mostly <1 mm (83.3 %), none exceeding 3 mm or over-categorized. The degree of underestimation between the two projection planes was comparable. Coronal 2D MRC overestimates the RHD in liver donors. We suggest adding axial 2D MRC to conventional coronal 2D MRC in the preoperative workup protocol for living liver donors to avoid unexpected confrontation with multiple ductal openings when harvesting the graft. (orig.)

  4. [Video-nystagmography and vibration test in the diagnosis of vestibular schwannoma. Review of 100 cases].

    Science.gov (United States)

    Négrevergne, M; Ribeiro, S; Moraes, C L; Maunsell, R; Morata, G Celis; Darrouzet, V

    2003-01-01

    To evaluate informations given by the combination of videonystagmography (VNG) including vibratory tests and auditory brainstem responses (ABR) in patients suffering vestibular schwannoma (VS) and try to find the most conclusive test(s). Combination of different functional tests is supposed to improve diagnosis and preoperative evaluation and precise indication for magnetic resonance imaging (MRI) facing audiological and vestibular symptoms. A prospective study of 100 patients with VS. All patients underwent a preoperative work-up including complete audiometry, auditory brainstem response (ABR) and videonystagmography (VNG). VNG protocol included caloric testing, rotatory tests, oculometry tests (saccade testing, optokinetic testing) and spontaneous and gaze-evoked nystagmus. From these six tests a score of positivity could be set, from 0 to 6. The vibratory test is non invasive and easy to realize. Were observed: 1/ a good sensitivity in vibratory test to elicit nystagmus in this context. 2/ a good correlation between subliminal rotatory chair tests and vibratory tests 3/ a better control of caloric testing using vibratory test. 4/ a good but deficient sensitivity of ABR alone with regard to VS (95%) 5/ an increase of sensitivity of VNG when coupling it with ABR and using as a criterion the score of positivity: no patient had all tests negative. The vibratory test is a non-invasive, fast examination with an easy execution. It reinforces VNG-ABR association screening power to diagnose VS. It constitutes, combined to caloric testing a good tool to diagnose and evaluate unilateral vestibular weakness.

  5. Over-expression of Oct4 and Sox2 transcription factors enhances differentiation of human umbilical cord blood cells in vivo

    International Nuclear Information System (INIS)

    Guseva, Daria; Rizvanov, Albert A.; Salafutdinov, Ilnur I.; Kudryashova, Nezhdana V.; Palotás, András; Islamov, Rustem R.

    2014-01-01

    Highlights: • Gene and cell-based therapies comprise innovative aspects of regenerative medicine. • Genetically modified hUCB-MCs enhanced differentiation of cells in a mouse model of ALS. • Stem cells successfully transformed into micro-glial and endothelial lines in spinal cords. • Over-expressing oct4 and sox2 also induced production of neural marker PGP9.5. • Formation of new nerve cells, secreting trophic factors and neo-vascularisation could improve symptoms in ALS. - Abstract: Gene and cell-based therapies comprise innovative aspects of regenerative medicine. Even though stem cells represent a highly potential therapeutic strategy, their wide-spread exploitation is marred by ethical concerns, potential for malignant transformation and a plethora of other technical issues, largely restricting their use to experimental studies. Utilizing genetically modified human umbilical cord blood mono-nuclear cells (hUCB-MCs), this communication reports enhanced differentiation of transplants in a mouse model of amyotrophic lateral sclerosis (ALS). Over-expressing Oct4 and Sox2 induced production of neural marker PGP9.5, as well as transformation of hUCB-MCs into micro-glial and endothelial lines in ALS spinal cords. In addition to producing new nerve cells, providing degenerated areas with trophic factors and neo-vascularisation might prevent and even reverse progressive loss of moto-neurons and skeletal muscle paralysis

  6. Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience

    International Nuclear Information System (INIS)

    Pedrosa, Ivan; Rafatzand, Khashayar; Robson, Philip; Alsop, David C.; Wagner, Andrew A.; Atkins, Michael B.; Rofsky, Neil M.

    2012-01-01

    To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function. Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value 2 (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7). ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation. (orig.)

  7. Arterial spin labeling MR imaging for characterisation of renal masses in patients with impaired renal function: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Pedrosa, Ivan [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Rafatzand, Khashayar; Robson, Philip; Alsop, David C. [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA (United States); Wagner, Andrew A. [Beth Israel Deaconess Medical Center and Harvard Medical School, Surgery, Division of Urology, Boston, MA (United States); Atkins, Michael B. [Beth Israel Deaconess Medical Center and Harvard Medical School, Hematology/Oncology, Boston, MA (United States); Rofsky, Neil M. [University of Texas Southwestern Medical Center, Departments of Radiology, Dallas, TX (United States)

    2012-02-15

    To retrospectively evaluate the feasibility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) for the assessment of vascularity of renal masses in patients with impaired renal function. Between May 2007 and November 2008, 11/67 consecutive patients referred for MRI evaluation of a renal mass underwent unenhanced ASL-MRI due to moderate-to-severe chronic or acute renal failure. Mean blood flow in vascularised and non-vascularised lesions and the relation between blood flow and final diagnosis of malignancy were correlated with a 2-sided homogeneous variance t-test and the Fisher Exact Test, respectively. A p value <0.05 was considered statistically significant. Seventeen renal lesions were evaluated in 11 patients (8 male; mean age = 70 years) (range 57-86). The median eGFR was 24 mL/min/1.73 m{sup 2} (range 7-39). The average blood flow of 11 renal masses interpreted as ASL-positive (134 +/- 85.7 mL/100 g/min) was higher than that of 6 renal masses interpreted as ASL-negative (20.5 +/- 8.1 mL/100 g/min)(p = 0.015). ASL-positivity correlated with malignancy (n = 3) or epithelial atypia (n = 1) at histopathology or progression at follow up (n = 7). ASL detection of vascularity in renal masses in patients with impaired renal function is feasible and seems to indicate neoplasia although the technique requires further evaluation. (orig.)

  8. Osteo-odonto keratoprosthesis in Stevens-Johnson syndrome: a case report.

    Science.gov (United States)

    Sc, Reddy; I, Tajunisah; T, Tan D

    2011-01-01

    To report a successful osteo-odonto keratoprosthesis (OOKP) procedure in a case of end stage of corneal blindness due to Stevens-Johnson syndrome (SJS). An interventional case report. We describe a 35-year-old Indian woman, a known case of SJS with bilateral dry eyes and corneal blindness (failed corneal graft with vascularised total corneal opacity in the right eye and non-healing corneal ulcer in the left eye). Vision was hand movement only in both eyes. The corneal ulcer healed with medical treatment resulting in vascularised total corneal opacity with no improvement in vision. OOKP was performed in the right eye and the vision was improved from hand movement to 6/6. The same vision was maintained in the right eye at the last follow-up 5 years after surgery. OOKP provides good visual rehabilitation with long-term anatomically stable prosthesis in patients with end-stage of ocular surface disorders and corneal blindness secondary to SJS.

  9. Value Of Three Dimensional Power Doppler Ultrasound In Prediction Of Endometrial Carcinoma In Patients With Postmenopausal Bleeding

    International Nuclear Information System (INIS)

    Abou-Gabal, A.; Akl, Sh.A.; Hussain, Sh.H.; Allam, H.A.

    2013-01-01

    Objective: to determine whether endometrial volume or power Doppler indices as measured by 3D ultrasound imaging can discriminate between benign and malignant endometrium in women with postmenopausal bleeding and endometrial thickness > 5 mm. Study design: Eighty-four patients with postmenopausal bleeding and endometrial thickness > 5 mm underwent 3D power Doppler ultrasound examination of the corpus uteri. The endometrial volume was calculated, along with the vascularisation index (VI), flow index and vascularisation flow index (VFI) in the endometrium. The gold standard was the histological diagnosis of the endometrium. Results: There were 56 benign and 28 malignant endometrial. Endometrial thickness and volume were significantly larger in malignant than in benign endometrial, and flow indices in the endometrium were Significantly higher. The area under the ROC curve (AUC) of endometrial thickness was 0.83, that of endometrial volume 0.73, and that of the best power Doppler variable FI 0.93. The best logistic regression model for predicting malignancy contained the variables endometrial thickness and FI. Its AUC was 0.93. Conclusion: the diagnostic performance of endometrial volume measured by 3d imaging with regard to discriminating between benign and malignant endometrium was not superior to that of endometrial thickness measured by 2D ultrasound examination, but 3D power Doppler flow indices are good diagnostic tool in predicting endometrial carcinoma

  10. Over-expression of Oct4 and Sox2 transcription factors enhances differentiation of human umbilical cord blood cells in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Guseva, Daria [Kazan State Medical University, Kazan, Republic of Tatarstan (Russian Federation); Hannover Medical School, Hannover (Germany); Rizvanov, Albert A.; Salafutdinov, Ilnur I.; Kudryashova, Nezhdana V. [Kazan Federal University, Kazan, Republic of Tatarstan (Russian Federation); Palotás, András, E-mail: palotas@asklepios-med.eu [Kazan Federal University, Kazan, Republic of Tatarstan (Russian Federation); Asklepios-Med (Private Medical Practice and Research Center), Szeged (Hungary); Islamov, Rustem R., E-mail: islamru@yahoo.com [Kazan State Medical University, Kazan, Republic of Tatarstan (Russian Federation)

    2014-09-05

    Highlights: • Gene and cell-based therapies comprise innovative aspects of regenerative medicine. • Genetically modified hUCB-MCs enhanced differentiation of cells in a mouse model of ALS. • Stem cells successfully transformed into micro-glial and endothelial lines in spinal cords. • Over-expressing oct4 and sox2 also induced production of neural marker PGP9.5. • Formation of new nerve cells, secreting trophic factors and neo-vascularisation could improve symptoms in ALS. - Abstract: Gene and cell-based therapies comprise innovative aspects of regenerative medicine. Even though stem cells represent a highly potential therapeutic strategy, their wide-spread exploitation is marred by ethical concerns, potential for malignant transformation and a plethora of other technical issues, largely restricting their use to experimental studies. Utilizing genetically modified human umbilical cord blood mono-nuclear cells (hUCB-MCs), this communication reports enhanced differentiation of transplants in a mouse model of amyotrophic lateral sclerosis (ALS). Over-expressing Oct4 and Sox2 induced production of neural marker PGP9.5, as well as transformation of hUCB-MCs into micro-glial and endothelial lines in ALS spinal cords. In addition to producing new nerve cells, providing degenerated areas with trophic factors and neo-vascularisation might prevent and even reverse progressive loss of moto-neurons and skeletal muscle paralysis.

  11. Juvenile nasopharyngeal angiofibroma - study of the tumor extension and vascularization through computerized tomography (CT) scan and angiography and the patient's age; Nasoangiofibroma juvenil - estudo da extensao e vascularizacao do tumor pela tomografia computadorizada e angiografia, e da idade do paciente

    Energy Technology Data Exchange (ETDEWEB)

    Sennes, Luiz Ubirajara

    1997-07-01

    The juvenile nasopharyngeal angiofibroma is a rare benign tumor that affects male adolescents. It is a fibro-vascular tumor with an exuberant intra tumor blood flow and irrigated by several arteries. It originates from the lateral and posterior region of the nasal cavity and, due to its characteristic multidirectional growth, widely affects the paranasal sinuses and skull base, sometimes invading the cranial fossa or the cheek. The determinant factors of its growth and vascularisation are unknown. Attempting to clarify them, 33 patients from the University of Sao Paulo Medicine were studied from 1983 to 1995, with complete history and radiological documentation (CT scan and angiography), as well as with histological confirmation of the diagnosis. In order to take only tumors with natural evolution, patients with recidivant tumor and those already submitted to any previous treatment were excluded. The parameters evaluate were: patient age and tumor extension (by classification, degree of invasion and number of compromised sites in CT scan) and vascularisation (by number and degree of participation of bilateral arteries in angiography). The se data were tabled and correlated one with each other. (author)

  12. Support Immersion Endoscopy in Post-Extraction Alveolar Bone Chambers: A New Window for Microscopic Bone Imaging In Vivo.

    Directory of Open Access Journals (Sweden)

    Wilfried Engelke

    Full Text Available Using an endoscopic approach, small intraoral bone chambers, which are routinely obtained during tooth extraction and implantation, provide visual in vivo access to internal bone structures. The aim of the present paper is to present a new method to quantify bone microstructure and vascularisation in vivo. Ten extraction sockets and 6 implant sites in 14 patients (6 men / 8 women were examined by support immersion endoscopy (SIE. After tooth extraction or implant site preparation, microscopic bone analysis (MBA was performed using short distance SIE video sequences of representative bone areas for off-line analysis with ImageJ. Quantitative assessment of the microstructure and vascularisation of the bone in dental extraction and implant sites in vivo was performed using ImageJ. MBA revealed bone morphology details such as unmineralised and mineralised areas, vascular canals and the presence of bleeding through vascular canals. Morphometric examination revealed that there was more unmineralised bone and less vascular canal area in the implant sites than in the extraction sockets.

  13. A computational model of in vitro angiogenesis based on extracellular matrix fibre orientation.

    Science.gov (United States)

    Edgar, Lowell T; Sibole, Scott C; Underwood, Clayton J; Guilkey, James E; Weiss, Jeffrey A

    2013-01-01

    Recent interest in the process of vascularisation within the biomedical community has motivated numerous new research efforts focusing on the process of angiogenesis. Although the role of chemical factors during angiogenesis has been well documented, the role of mechanical factors, such as the interaction between angiogenic vessels and the extracellular matrix, remains poorly understood. In vitro methods for studying angiogenesis exist; however, measurements available using such techniques often suffer from limited spatial and temporal resolutions. For this reason, computational models have been extensively employed to investigate various aspects of angiogenesis. This paper outlines the formulation and validation of a simple and robust computational model developed to accurately simulate angiogenesis based on length, branching and orientation morphometrics collected from vascularised tissue constructs. Microvessels were represented as a series of connected line segments. The morphology of the vessels was determined by a linear combination of the collagen fibre orientation, the vessel density gradient and a random walk component. Excellent agreement was observed between computational and experimental morphometric data over time. Computational predictions of microvessel orientation within an anisotropic matrix correlated well with experimental data. The accuracy of this modelling approach makes it a valuable platform for investigating the role of mechanical interactions during angiogenesis.

  14. Quantification of antiangiogenic treatment effects on tissue heterogeneity in glioma tumour xenograft model using a combination of DCE-MRI and 3D-ultramicroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Dominietto, Marco [University and ETH Zurich, Institute for Biomedical Engineering, Zurich (Switzerland); University of Basel, Biomaterials Science Center, Allschwil (Switzerland); Dobosz, Michael; Renner, Anja; Scheuer, Werner [Roche Innovation Center Penzberg, Discovery Oncology, Pharmaceutical Research and Early Development (pRED), Penzberg (Germany); Buergi, Sandra; Rudin, Markus [University and ETH Zurich, Institute for Biomedical Engineering, Zurich (Switzerland); Zahlmann, Gudrun [pRED, Oncology DTA, Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel (Switzerland)

    2017-07-15

    This study aimed at assessing the effects of an anti-angiogenic treatment, which neutralises vascular endothelial growth factor (VEGF), on tumour heterogeneity. Murine glioma cells have been inoculated into the right brain frontal lobe of 16 mice. Anti-VEGF antibody was administered to a first group (n = 8), while a second group (n = 8) received a placebo. Magnetic resonance acquisitions, performed at days 10, 12, 15 and 23 following the implantation, allowed the derivation of a three-dimensional features dataset characterising tumour heterogeneity. Three-dimensional ultramicroscopy and standard histochemistry analysis have been performed to verify in vivo results. Placebo-treated mice displayed a highly-vascularised area at the tumour periphery, a monolithic necrotic core and a chaotic dense vasculature across the entire tumour. In contrast, the B20-treated group did not show any highly vascularised regions and presents a fragmented necrotic core. A significant reduction of the number of vessel segments smaller than 17 μm has been observed. There was no difference in overall tumour volume and growth rate between the two groups. Region-specific analysis revealed that VEGF inhibition affects only: (1) highly angiogenic compartments expressing high levels of VEGF and characterised by small capillaries, and also (2) the formation and structure of necrotic regions. These effects appear to be transient and limited in time. (orig.)

  15. Hypoxia-controlled EphA3 marks a human endometrium-derived multipotent mesenchymal stromal cell that supports vascular growth.

    Directory of Open Access Journals (Sweden)

    Catherine To

    Full Text Available Eph and ephrin proteins are essential cell guidance cues that orchestrate cell navigation and control cell-cell interactions during developmental tissue patterning, organogenesis and vasculogenesis. They have been extensively studied in animal models of embryogenesis and adult tissue regeneration, but less is known about their expression and function during human tissue and organ regeneration. We discovered the hypoxia inducible factor (HIF-1α-controlled expression of EphA3, an Eph family member with critical functions during human tumour progression, in the vascularised tissue of regenerating human endometrium and on isolated human endometrial multipotent mesenchymal stromal cells (eMSCs, but not in other highly vascularised human organs. EphA3 affinity-isolation from human biopsy tissue yielded multipotent CD29+/CD73+/CD90+/CD146+ eMSCs that can be clonally propagated and respond to EphA3 agonists with EphA3 phosphorylation, cell contraction, cell-cell segregation and directed cell migration. EphA3 silencing significantly inhibited the ability of transplanted eMSCs to support neovascularisation in immunocompromised mice. In accord with established roles of Eph receptors in mediating interactions between endothelial and perivascular stromal cells during mouse development, our findings suggest that HIF-1α-controlled expression of EphA3 on human MSCs functions during the hypoxia-initiated early stages of adult blood vessel formation.

  16. Perfusion characteristics of parotid gland tumors evaluated by contrast-enhanced ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Klotz, Laura V., E-mail: Laura.Klotz@med.uni-muenchen.de [Department of Surgery, University of Munich, Munich (Germany); Gürkov, Robert [Department of Otorhinolaryngology, University of Munich, Munich (Germany); Eichhorn, Martin E. [Department of Surgery, University of Munich, Munich (Germany); Siedek, Vanessa; Krause, Eike [Department of Otorhinolaryngology, University of Munich, Munich (Germany); Jauch, Karl-Walter [Department of Surgery, University of Munich, Munich (Germany); Reiser, Maximilian F.; Clevert, Dirk-Andre [Department of Clinical Radiology, University of Munich, Munich (Germany)

    2013-12-01

    Purpose: Contrast enhanced ultrasound (CE-US) is a promising imaging modality for non-invasive analysis of parotid gland lesions because their vascularisation differs from normal gland tissue. This clinical study should further investigate CE-US as a diagnostic tool for parotid gland tumors. Materials and methods: 39 patients underwent CE-US measurements after intravenous application of a contrast agent (SonoVue, Bracco, Italy) before surgical tumor resection. Time–intensity curves gradients were calculated and parameters of intratumoral microcirculation were analysed. The vascularisation parameters were compared among the different tumor entities as defined per definitive histological diagnosis. Results: Histological analyses revealed 17 pleomorphic adenoma, 15 cystadenolymphoma and 7 malignoma. A significant difference of area below intensity time curve (AUC) and mean transit time (MTT) was measured in the malignant lesions compared to benign tumors (p < 0.05). A significant difference of AUC and maximum of signal increase (ΔSI{sub max}) for pleomorphic adenoma versus cystadenolymphoma was found (p < 0.05). Conclusion: CE-US seems to be a quantitative and independent method for the assessment of malign and benign parotid gland tumors. Further studies and clinical experience will have to validate this method as a reliable diagnostic tool that facilitates preoperative planning.

  17. A combined technique using a muscular flap and endobronchial stent to repair complex broncho-oesophageal fistulae supported by ECMO.

    Science.gov (United States)

    Baste, Jean-Marc; Haddad, Laura; Philouze, Guillaume

    2018-02-01

    Certain broncho-oesophageal fistulae require surgical repair. Herein, we describe an innovative surgical technique combining intercostal flap and endobronchial stenting. Two patients, each with a with complex broncho-oesophageal fistula 2 years after radio-chemotherapy, were hospitalised for severe respiratory infection and extension of the fistula despite previous endoscopic treatment. The first patient presented with respiratory distress (ARDS). She had emergency surgery under extra corporeal membrane oxygenation: oesophagectomy and reconstruction of the left bronchus by a vascularised intercostal flap. Stenting was performed on day 10, due to persistence of the fistula. At 3 months the bronchus was healed, but the patient died of cerebral bleeding. For the second patient, repair was proposed before severe ARDS with the same surgical and ventilatory strategy and a stent was preventively inserted after surgery. After 3 months, the stent was removed and the left bronchus was healed. Complex post-radiotherapy broncho-oesophageal fistulae should be treated surgically before respiratory complications arise, by combining reconstruction with a vascularised flap and transient stenting.

  18. The effect of UV-blocking contact lenses as a therapy for canine chronic superficial keratitis.

    Science.gov (United States)

    Denk, Nora; Fritsche, Jens; Reese, Sven

    2011-05-01

    To evaluate the effect of UV-blocking soft contact lenses in treatment for chronic superficial keratitus (CSK). Twenty six dogs with CSK were treated continuously with UV-blocking contact lenses for 6 months. A contact lens was placed on one eye of each dog; the other eye remained without a lens as a control eye. After this primary study, five of the dogs were further treated and they wore then contact lenses in both eyes. Continuously, all patients were concurrently treated topically with cyclosporine. The contact lenses were changed every 4 weeks and an ophthalmic examination performed. Evaluation criteria included corneal alterations as pigmentation, edema, pannus and vascularization. To determine the transmittance characteristics of the contact lenses before and after use, 32 contact lenses were measured with a UV-vis-NIR spectrophotometer. Pigmentation increased in eyes wearing lenses and in control eyes over the evaluation period of 6 months. Corneal edema increased in the eyes wearing lenses, but remained unaffected in the control eyes. A significant difference in the incidence of pannus and the extent of corneal vascularisation could not be evaluated. Adverse effects were noted in six cases (corneal edema and vascularisation, conjunctivitis, blepharospasm). All new lenses studied reduced UV-radiation to a safe level, whereas used lenses did not maintain their transmittance characteristics. No positive effect of UV-blocking contact lenses could be proven with the study design used. © 2011 American College of Veterinary Ophthalmologists.

  19. [Preoperative assessment of renal vascular anatomy for donor nephrectomy: Is CT superior to MRI?].

    Science.gov (United States)

    Arvin-Berod, A; Bricault, I; Terrier, N; Skowron, O; Cadi, P; Boillot, B; Thuillier, C; Cluze, C; Descotes, J-L; Rambeaud, J-J; Long, J-A

    2011-01-01

    computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are both used in the preoperative assessment of vascular anatomy before donor nephrectomy. Our objective was to determine retrospectively and to compare the sensitivity of CTA and MRA imaging in preoperative renal vascularisation in living kidney donors. between 1999 and 2007, 42 kidney donors were assessed in our center: 27 by MRA, 10 by CTA, and five by both techniques. Images were interpreted using multiplanar reconstructions. Results were compared retrospectively with peroperative findings; discordant cases were re-examined by an experienced radiologist. Numbers of vessels detected with imaging methods was compared with numbers actually found at the operating time. MRA showed 35/43 arteries (Se 81.4 %) and 33/34 veins (Se 97.1 %), and CTA showed 18/18 arteries (Se 100 %) and 15/16 veins (Se 93.8 %). The presence of multiple arteries was detected in only one third of cases (3/9) on MRI scans; this difference was statistically significant. The missed arteries were not detected on second examination of the MRI scans with the knowledge of peroperative findings. MRA is less sensitive than CTA for preoperative vascularisation imaging in living renal donors, especially in the detection of multiple renal arteries. 2010 Elsevier Masson SAS. All rights reserved.

  20. Juvenile nasopharyngeal angiofibroma - study of the tumor extension and vascularization through computerized tomography (CT) scan and angiography and the patient's age

    International Nuclear Information System (INIS)

    Sennes, Luiz Ubirajara

    1997-01-01

    The juvenile nasopharyngeal angiofibroma is a rare benign tumor that affects male adolescents. It is a fibro-vascular tumor with an exuberant intra tumor blood flow and irrigated by several arteries. It originates from the lateral and posterior region of the nasal cavity and, due to its characteristic multidirectional growth, widely affects the paranasal sinuses and skull base, sometimes invading the cranial fossa or the cheek. The determinant factors of its growth and vascularisation are unknown. Attempting to clarify them, 33 patients from the University of Sao Paulo Medicine were studied from 1983 to 1995, with complete history and radiological documentation (CT scan and angiography), as well as with histological confirmation of the diagnosis. In order to take only tumors with natural evolution, patients with recidivant tumor and those already submitted to any previous treatment were excluded. The parameters evaluate were: patient age and tumor extension (by classification, degree of invasion and number of compromised sites in CT scan) and vascularisation (by number and degree of participation of bilateral arteries in angiography). The se data were tabled and correlated one with each other. (author)

  1. New insights into the development of retinopathy of prematurity--importance of early weight gain.

    Science.gov (United States)

    Hellström, A; Ley, D; Hansen-Pupp, I; Niklasson, A; Smith, L; Löfqvist, C; Hård, A-L

    2010-04-01

    Evidence is accumulating that one of the strongest predictors of retinopathy of prematurity (ROP), in addition to low gestational age, is poor weight gain during the first weeks of life. In infants born preterm, the retina is not fully vascularised. The more premature the child, the larger is the avascular area. In response to hypoxia, vascular endothelial growth factor (VEGF) is secreted. For appropriate VEGF-induced vessel growth, sufficient levels of insulin-like growth factor I (IGF-I) in serum are necessary. IGF-I is a peptide, related to nutrition supply, which is essential for both pre- and post-natal general growth as well as for growth of the retinal vasculature. In prematurely born infants, serum levels are closely related to gestational age and are lower in more prematurely born infants. At preterm birth the placental supply of nutrients is lost, growth factors are suddenly reduced and general as well as vascular growth slows down or ceases. In addition, the relative hyperoxia of the extra-uterine milieu, together with supplemental oxygen, causes a regression of already developed retinal vessels. Postnatal growth retardation is a major problem in very preterm infants. Both poor early weight gain and low serum levels of IGF-I during the first weeks/months of life have been found to be correlated with severity of ROP. This review will focus on the mechanisms leading to ROP by exploring factors responsible for poor early weight gain and abnormal vascularisation of the eye of the preterm infant.

  2. Avaliação do tempo de resposta eletromiográfica em atletas de voleibol e não atletas que sofreram entorse de tornozelo Evaluación del tiempo de respuesta electromiográfica en atletas de voleibol y no atletas que han sufrido esguince de tobillo Evaluation of the time for the electromyographic response in volleyball athletes and non-athletes who had ankle sprain

    Directory of Open Access Journals (Sweden)

    Adriana Moré Pacheco

    2005-12-01

    Full Text Available A proposta deste estudo foi examinar o tempo de resposta eletromiográfica dos músculos fibulares, na inversão repentina do pé, em tornozelos com presença de lesão e saudáveis. Três grupos foram testados, um de atletas normais (grupo 1, um de atletas com história recente de entorse de tornozelo (grupo 2 e o outro de não atletas com história recente de entorse de tornozelo (grupo 3. Para cada sujeito dos três grupos, ambos os tornozelos foram testados. Os sujeitos que sofreram entorse de tornozelo (grupos 2 e 3 não apresentavam sintomas de lesão durante os últimos dois meses antes do teste. Uma plataforma capaz de produzir uma inversão repentina lateral de 20° do tornozelo no plano frontal simulava um evento de entorse de tornozelo. Eletrodos de eletromiografia de superfície foram colocados na pele sobre os músculos fibulares. Os tempos de resposta eletromiográfica dos músculos fibulares foram obtidos e comparados entre os grupos. Para o grupo 1, a média dos tempos de resposta eletromiográfica foi de 71ms para a perna direita e 69ms para a perna esquerda. Para o grupo 2, a média dos tempos de resposta eletromiográfica foi de 72ms para o tornozelo sem lesão e 74ms para o tornozelo com a lesão. Para o grupo 3, a média dos tempos de resposta eletromiográfica foi de 72ms para o tornozelo sem lesão e 73ms para o tornozelo com a lesão. Os resultados indicaram que não houve diferença estatisticamente significante entre as pernas direita e esquerda no grupo 1 e entre os tornozelos sem lesão e com lesão dos grupos 2 e 3 para os músculos fibulares. Os achados do presente estudo sugerem que a resposta eletromiográfica dos músculos fibulares, durante o deslocamento angular repentino do tornozelo, não foi influenciada pela entorse de tornozelo.La propuesta de este estudio era examinar el tiempo de la respuesta electromiográfica de los musculos fibulares, en el esguince agudo del pie, en los tobillos con la presencia de l

  3. Fossil human remains from Bolomor Cave (Valencia, Spain).

    Science.gov (United States)

    Arsuaga, Juan Luis; Fernández Peris, Josep; Gracia-Téllez, Ana; Quam, Rolf; Carretero, José Miguel; Barciela González, Virginia; Blasco, Ruth; Cuartero, Felipe; Sañudo, Pablo

    2012-05-01

    Systematic excavations carried out since 1989 at Bolomor Cave have led to the recovery of four Pleistocene human fossil remains, consisting of a fibular fragment, two isolated teeth, and a nearly complete adult parietal bone. All of these specimens date to the late Middle and early Late Pleistocene (MIS 7-5e). The fibular fragment shows thick cortical bone, an archaic feature found in non-modern (i.e. non-Homo sapiens) members of the genus Homo. Among the dental remains, the lack of a midtrigonid crest in the M(1) represents a departure from the morphology reported for the majority of Neandertal specimens, while the large dimensions and pronounced shoveling of the marginal ridges in the C(1) are similar to other European Middle and late Pleistocene fossils. The parietal bone is very thick, with dimensions that generally fall above Neandertal fossils and resemble more closely the Middle Pleistocene Atapuerca (SH) adult specimens. Based on the presence of archaic features, all the fossils from Bolomor are attributed to the Neandertal evolutionary lineage. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Rapsyn congenital myasthenic syndrome worsened by fluoxetine.

    Science.gov (United States)

    Visser, Amy C; Laughlin, Ruple S; Litchy, William J; Benarroch, Eduardo E; Milone, Margherita

    2017-01-01

    Fluoxetine is a selective serotonin reuptake inhibitor and long-lived open channel blocker of the acetylcholine receptor, often used in the treatment of slow-channel congenital myasthenic syndromes (CMS). We report a 42-year-old woman who had a history of episodic limb weakness that worsened after initiation of fluoxetine for treatment of depression. Genetic testing for CMS revealed a homozygous pathogenic mutation in the rapsyn (RAPSN) gene (p.Asn88Lys). Electrodiagnostic testing was performed before and 1 month after discontinuation of fluoxetine. The 2 Hz repetitive nerve stimulation of the fibular and spinal accessory nerves showed a baseline decrement of 36% and 14%, respectively. One month after discontinuing fluoxetine, the spinal accessory nerve decrement was no longer present, and the decrement in the fibular nerve was improved at 17%. This case demonstrates worsening of both clinical and electrophysiologic findings in a patient with CMS secondary to a RAPSN mutation treated with fluoxetine. Muscle Nerve 55: 131-135, 2017. © 2016 Wiley Periodicals, Inc.

  5. Double muscle innervation using end-to-side neurorrhaphy in rats Dupla inervação muscular com neurorrafia término-lateral em ratos

    Directory of Open Access Journals (Sweden)

    Elisangela Jeronymo Stipp-Brambilla

    2012-01-01

    neurorrafia término-lateral e a manutenção da inervação. TIPO DE ESTUDO E LOCAL: Estudo experimental desenvolvido no Centro de Pesquisa Experimental da Faculdade de Medicina de Botucatu, Unesp. MÉTODOS: Cem ratos foram distribuídos em cinco grupos: G1, controle; G2, secção do nervo fibular; G3, o nervo tibial foi seccionado e o coto proximal suturado na lateral do nervo fibular íntegro; G4, 120 dias após a cirurgia do G3, o nervo fibular foi seccionado proximal à neurorrafia; G5, 120 dias após a cirurgia do G3, os nervos fibular e tibial foram seccionados proximal à neurorrafia. RESULTADOS: Após 150 dias da cirurgia, não foi observada variação na massa do músculo tibial ou no diâmetro das fibras musculares no G3, porém, houve redução do diâmetro da fibra axonal do nervo fibular distal à neurorrafia. Embora, no G4, tenha ocorrido atrofia do músculo tibial cranial 30 dias após a secção do nervo fibular, os resultados do teste eletrofisiológico e da medida do diâmetro axonal confirmaram a ocorrência de reinervação muscular. CONCLUSÃO: Estes resultados sugerem que a dupla inervação muscular não ocorreu através da neurorrafia término-lateral; o nervo tibial não foi capaz de manter a inervação muscular após a secção do nervo fibular; contudo, ocorreu reinervação muscular 30 dias após a secção do nervo fibular.

  6. Patient-specific reconstruction plates are the missing link in computer-assisted mandibular reconstruction: A showcase for technical description.

    Science.gov (United States)

    Cornelius, Carl-Peter; Smolka, Wenko; Giessler, Goetz A; Wilde, Frank; Probst, Florian A

    2015-06-01

    Preoperative planning of mandibular reconstruction has moved from mechanical simulation by dental model casts or stereolithographic models into an almost completely virtual environment. CAD/CAM applications allow a high level of accuracy by providing a custom template-assisted contouring approach for bone flaps. However, the clinical accuracy of CAD reconstruction is limited by the use of prebent reconstruction plates, an analogue step in an otherwise digital workstream. In this paper the integration of computerized, numerically-controlled (CNC) milled, patient-specific mandibular plates (PSMP) within the virtual workflow of computer-assisted mandibular free fibula flap reconstruction is illustrated in a clinical case. Intraoperatively, the bone segments as well as the plate arms showed a very good fit. Postoperative CT imaging demonstrated close approximation of the PSMP and fibular segments, and good alignment of native mandible and fibular segments and intersegmentally. Over a follow-up period of 12 months, there was an uneventful course of healing with good bony consolidation. The virtual design and automated fabrication of patient-specific mandibular reconstruction plates provide the missing link in the virtual workflow of computer-assisted mandibular free fibula flap reconstruction. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. 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

  8. Femoral head osteonecrosis: Volumetric MRI assessment and outcome

    International Nuclear Information System (INIS)

    Bassounas, Athanasios E.; Karantanas, Apostolos H.; Fotiadis, Dimitrios I.; Malizos, Konstantinos N.

    2007-01-01

    Effective treatment of femoral head osteonecrosis (FHON) requires early diagnosis and accurate assessment of the disease severity. The ability to predict in the early stages the risk of collapse is important for selecting a joint salvage procedure. The aim of the present study was to evaluate the outcome in patients treated with vascularized fibular grafts in relation to preoperative MR imaging volumetry. We studied 58 patients (87 hips) with FHON. A semi-automated octant-based lesion measurement method, previously described, was performed on the T1-w MR images. The mean time of postoperative follow-up was 7.8 years. Sixty-three hips were successful and 24 failed and converted to total hip arthroplasty within a period of 2-4 years after the initial operation. The rate of failures for hips of male patients was higher than in female patients. The mean lesion size was 28% of the sphere equivalent of the femoral head, 24 ± 12% for the successful hips and 37 ± 9% for the failed (p < 0.001). The most affected octants were antero-supero-medial (58 ± 26%) and postero-supero-medial (54 ± 31%). All but postero-infero-medial and postero-infero-lateral octants, showed statistically significant differences in the lesion size between patients with successful and failed hips. In conclusion, the volumetric analysis of preoperative MRI provides useful information with regard to a successful outcome in patients treated with vascularized fibular grafts

  9. Is the corticomedullary index valid to distinguish human from nonhuman bones: a multislice computed tomography study.

    Science.gov (United States)

    Rérolle, Camille; Saint-Martin, Pauline; Dedouit, Fabrice; Rousseau, Hervé; Telmon, Norbert

    2013-09-10

    The first step in the identification process of bone remains is to determine whether they are of human or nonhuman origin. This issue may arise when only a fragment of bone is available, as the species of origin is usually easily determined on a complete bone. The present study aims to assess the validity of a morphometric method used by French forensic anthropologists to determine the species of origin: the corticomedullary index (CMI), defined by the ratio of the diameter of the medullary cavity to the total diameter of the bone. We studied the constancy of the CMI from measurements made on computed tomography images (CT scans) of different human bones, and compared our measurements with reference values selected in the literature. The measurements obtained on CT scans at three different sites of 30 human femurs, 24 tibias, and 24 fibulas were compared between themselves and with the CMI reference values for humans, pigs, dogs and sheep. Our results differed significantly from these reference values, with three exceptions: the proximal quarter of the femur and mid-fibular measurements for the human CMI, and the proximal quarter of the tibia for the sheep CMI. Mid-tibial, mid-femoral, and mid-fibular measurements also differed significantly between themselves. Only 22.6% of CT scans of human bones were correctly identified as human. We concluded that the CMI is not an effective method for determining the human origin of bone remains. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Manual therapy and neurodynamic mobilization in a patient with peroneal nerve paralysis: a case report.

    Science.gov (United States)

    Villafañe, Jorge Hugo; Pillastrini, Paolo; Borboni, Alberto

    2013-09-01

    The purpose of this case report is to describe a therapeutic intervention for peroneal nerve paralysis involving the sciatic nerve. A 24-year-old man presented with peroneal nerve paralysis with decreased sensation, severe pain in the popliteal fossa, and steppage gait, which occurred 3 days prior to the consultation. Magnetic resonance imaging and electromyography confirmed lumbar disk herniation with sciatic common peroneal nerve entrapment in the popliteal fossa. A combined treatment protocol of spinal and fibular head manipulation and neurodynamic mobilization including soft tissue work of the psoas and hamstring muscles was performed. Outcome measures were assessed at pretreatment, 1 week posttreatment, and 3-month follow-up and included numeric pain rating scale, range of motion, pressure pain threshold, and manual muscle testing. Treatment interventions were applied for 3 sessions over a period of 1 week. Results showed reduction of the patient's subjective pain and considerable improvement in range of motion, strength, and sensation in his left foot, which was restored to full function. A combined program of spinal and fibular head manipulation and neurodynamic mobilization reduced pain, increased range of motion and strength, and restored full function to the left leg in this patient who had severe functional impairment related to a compressed left common peroneal nerve.

  11. Incidence and variance of foot and ankle injuries in elite college football players.

    Science.gov (United States)

    Kaplan, Lee D; Jost, Patrick W; Honkamp, Nicholas; Norwig, John; West, Robin; Bradley, James P

    2011-01-01

    We conducted a study on the risk for foot and ankle injuries in college football players on the basis of injury type and player position. In February 2006, we evaluated 320 intercollegiate football players at the National Football League Combine. All pathologic conditions and surgical procedures of the foot and ankle were recorded, and data were analyzed by player position to detect any trends. Seventy-two percent (n = 231) of the players had a history of foot and ankle injuries, with a total of 287 foot and ankle injuries (1.24 injuries/player injured). The most common injuries were lateral ankle sprain (n = 115), syndesmotic sprain (50), metatarsophalangeal dislocation/turf toe (36), and fibular fracture (25). Foot and ankle injuries were most common in kickers/punters (100% incidence), special teams (100%), running backs (83%), wide receivers (83%), and offensive linemen (80%). Lateral ankle sprains, the most common injuries, were treated surgically only 2.6% of the time. Offensive linemen were most likely to have had syndesmotic sprains (32%), and quarterbacks had the highest incidence of fibular fractures (16%). Foot and ankle injuries are common in collegiate football players, affecting 72% of players. Thirteen percent underwent surgical treatment. Trends are seen in the types of injuries for the different player positions.

  12. Prefabricated fibula free flap with dental implants for mandibular reconstruction.

    Science.gov (United States)

    Pauchet, D; Pigot, J-L; Chabolle, F; Bach, C-A

    2018-03-02

    Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned. Virtual surgery and computer-assisted design and prefabrication techniques are used to plan the reconstruction and then reproduce this planning by means of tailored fibula and mandible cutting guides, thereby ensuring correct positioning of fibular bone fragments and implants. The prefabricated fibula free flap technique requires two surgical procedures (prefabrication and flap transfer) and precise preoperative planning. Prefabricated fibula free flap with dental implants, by improving the quality of osseointegration of the implants before flap transfer, extends the possibilities of prosthetic rehabilitation in complex secondary mandibular reconstructions. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. Surface Projection of Interosseous Foramen of the Leg: Cadaver Study

    Directory of Open Access Journals (Sweden)

    Eric Arguello

    2016-01-01

    Full Text Available Purpose. This study was conducted to identify the surface projection of the interosseous foramen and associated structures of the proximal leg using the average clinician’s thumb width as a quick measurement to assist in differential diagnosis and treatment. Methods. Twelve cadavers (5 males and 7 females, age range = 51–91 years, and mean age = 76.9 were dissected for analysis. Location and size of interosseous foramen, location of anterior tibial artery, location of deep fibular nerve, and corresponding arterial branches were measured and converted into thumb widths. Results. Mean thumb width measured among the cadavers was 17.94±3.9 mm. The interosseous foramen measured was approximately 1 thumb width vertically (18.47±3.0 mm and 1/2 thumb width horizontally (7.32±2.1 mm and was located approximately 1 thumb width distally to the tibial tuberosity (20.81±6.8 mm and 2 thumb widths (37.47±4.7 mm lateral to the tibial ridge. The anterior tibial artery and deep fibular nerve converged approximately 4 thumb widths (74.31±14.8 mm inferior to the tibial tuberosity and 2 thumb widths (33.46±4.9 mm lateral to the tibial ridge. Conclusion. Clinicians may identify anatomical structures of the proximal leg with palpation using the thumb width for measurement.

  14. Bone graft viability evaluated by three phase bone scan

    International Nuclear Information System (INIS)

    Ljiljana Jaukovic Rajko Spaic; Marijan Novakovic; Srbislav Stosic

    2004-01-01

    Bone defects resulting war injury can be replaced by microvascular bone grafts from fibula. Aim: The aim of this study was to assess the value of three phase (3P) bone scintigraphy in the early detection of the bone graft complications. Method: 3P bone scans were performed in four patients (two after mandible reconstruction with micro vascular fibular bone grafts, one after fibular transplantation for ulnar and one with humeral reconstruction). First dynamic phase scan was performed immediately after iv injection of 740 MBq Tc- 99m DPD, acquiring 15 two seconds duration frames. Second, early static scan was performed during next 300 seconds, and third, delayed scan three hours later. All scans were obtained under the bone graft region. The scans were evaluated using ROI under graft region and the corresponding contra lateral area. Blood flow in graft region was determined using first phase scan, and tracer uptake in the same region was determined using second and third phase scans. Results: in all patients blood flow in graft region was particularly normal. Tracer uptake in one of two patients with mandible reconstruction was diffusely increased in graft, strongly suggesting infection; In the other patient delayed scan showed no tracer uptake in graft center .Both patients with ulnar and humeral reconstruction showed only slightly decreased tracer uptake in bone grafts. 3 phase bone scintigraphy may play a role in the evaluation of bone graft viability by predicting the infection and necrosis. (authors)

  15. Complications of resection and reconstruction in giant cell tumour of distal end of radius - An analysis

    Directory of Open Access Journals (Sweden)

    Saraf S

    2005-01-01

    Full Text Available Background: The bulk of literature on the subject focuses on the resection of the tumor followed by reconstruction using autologous fibula, however, papers analyzing the failures of this procedure are scanty. The aim is to analyze the various factors responsible for the failures. Methods: Study included 42 patients of aggressive GCT of distal radius, resected and reconstructed using nonvascularised autologous fibula. Host graft junction was fixed using screws (6, intramedullary nail (21 and plate (15. The minimum follow-up was 2 years or till a complication occurred requiring second surgery. Result: The major complications were recurrence in 6 cases (spillage of tumor tissue in 3, poor biopsy site 2, recurrence along the nail tract one case; failure of host graft union in 8 cases due to inadequate contact at host graft junction, poor implant selection, inadequate immobilization and infection; significant instability at wrist in 6 cases due to poor stabilization at carpo fibular junction in addition to inherent instability due to poor congruity between fibulocarpal articulations. Conclusion: Reconstruction of distal end of radius using auto fibula has much higher complication rates than usually believed. A meticulous planning and its execution is must to minimize the problems. Use of dynamic plate for host graft junction and fixation of fibular head to adjacent ulna/carpal bones improves the results.

  16. A comparison of surgical exposures for posterolateral osteochondral lesions of the talar dome.

    Science.gov (United States)

    Mayne, Alistair I W; Lawton, Robert; Reidy, Michael J; Harrold, Fraser; Chami, George

    2018-04-01

    Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches. Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2mm k-wire was measured. An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5% vs 58.8%) compared to an anterolateral tibial osteotomy. Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome. Copyright © 2016 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  17. MR imaging of the ankle: Normal variants

    International Nuclear Information System (INIS)

    Noto, A.M.; Cheung, Y.; Rosenberg, Z.S.; Norman, A.; Leeds, N.E.

    1987-01-01

    Thirty asymptomatic ankles were studied with high-resolution surface coil MR imaging. The thirty ankles were reviewed for identification or normal structures. The MR appearance of the deltoid and posterior to talo-fibular ligaments, peroneous brevis and longus tendons, and posterior aspect of the tibial-talar joint demonstrated several normal variants not previously described. These should not be misinterpreted as pathologic processes. The specific findings included (1) cortical irregularity of the posterior tibial-talar joint in 27 of 30 cases which should not be mistaken for osteonecrois; (2) normal posterior talo-fibular ligament with irregular and frayed inhomogeneity, which represents a normal variant in seven of ten cases; and (3) fluid in the shared peroneal tendons sheath which may be confused for a longitudinal tendon tear in three of 30 cases. Ankle imaging with the use of MR is still a relatively new procedure. Further investigation is needed to better define normal anatomy as well as normal variants. The authors described several structures that normally present with variable MR imaging appearances. This is clinically significant in order to maintain a high sensitivity and specificity in MR imaging interpretation

  18. The Use of Harmonic Scalpel for Free Flap Dissection in Head and Neck Reconstructive Surgery

    Directory of Open Access Journals (Sweden)

    Sebastien Albert

    2012-01-01

    Full Text Available Surgeons conventionally use electrocautery dissection and surgical clip appliers to harvest free flaps. The ultrasonic Harmonic Scalpel is a new surgical instrument that provides high-quality dissection and hemostasis and minimizes tissue injury. The aim of this study was to evaluate the effectiveness and advantages of the ultrasonic Harmonic Scalpel compared to conventional surgical instruments in free flap surgery. This prospective study included 20 patients who underwent head and neck reconstructive surgery between March 2009 and May 2010. A forearm free flap was used for reconstruction in 12 patients, and a fibular flap was used in 8 patients. In half of the patients, electrocautery and surgical clips were used for free flap harvesting (the EC group, and in the other half of the patients, ultrasonic dissection was performed using the Harmonic Scalpel (the HS group. The following parameters were significantly lower in the HS group compared to the EC group: the operative time of flap dissection (35% lower in the HS group, blood loss, number of surgical clips and cost of surgical materials. This study demonstrated the effectiveness of the Harmonic Scalpel in forearm and fibular free flap dissections that may be extended to other free flaps.

  19. Meniscofibular Ligament: Morphology and Functional Significance of a Relatively Unknown Anatomical Structure

    Directory of Open Access Journals (Sweden)

    K. Natsis

    2012-01-01

    Full Text Available Purpose. A relatively unknown ligamentous structure of the posterolateral corner of the knee joint, the so-called meniscofibular ligament (MFL, was investigated as regards its macroscopic morphology, its histological features, and its reaction to knee movements. Material and Methods. MFL was exposed on 21 fresh-frozen unpaired knee joints. Its microscopic morphology was examined utilizing for comparison the fibular collateral and the popliteofibular ligament. Results. MFL was encountered in 100% of the specimens as a thin striplike fibrous band extending between the lower border of the lateral meniscus and the head of the fibula. MFL was tense during knee extension and external rotation of the tibia, whereas its histological features were similar to those of fibular collateral and popliteofibular ligament. Discussion. Its precise histological nature is studied as well as its tension alterations during knee movements. The potential functional significance of the MFL with respect to its role in avoidance of lateral meniscus and lateral coronary ligament tears is discussed. Conclusions. MFL presumably provides an additional protection to the lateral meniscus during the last stages of knee extension, as well as to the lateral coronary ligament reducing the possibility of a potential rupture.

  20. Simulation of circularly polarized luminescence spectra using coupled cluster theory

    Energy Technology Data Exchange (ETDEWEB)

    McAlexander, Harley R.; Crawford, T. Daniel, E-mail: crawdad@vt.edu [Department of Chemistry, Virginia Tech, Blacksburg, Virginia 24061 (United States)

    2015-04-21

    We report the first computations of circularly polarized luminescence (CPL) rotatory strengths at the equation-of-motion coupled cluster singles and doubles (EOM-CCSD) level of theory. Using a test set of eight chiral ketones, we compare both dipole and rotatory strengths for absorption (electronic circular dichroism) and emission to the results from time-dependent density-functional theory (TD-DFT) and available experimental data for both valence and Rydberg transitions. For two of the compounds, we obtained optimized geometries of the lowest several excited states using both EOM-CCSD and TD-DFT and determined that structures and EOM-CCSD transition properties obtained with each structure were sufficiently similar that TD-DFT optimizations were acceptable for the remaining test cases. Agreement between EOM-CCSD and the Becke three-parameter exchange function and Lee-Yang-Parr correlation functional (B3LYP) corrected using the Coulomb attenuating method (CAM-B3LYP) is typically good for most of the transitions, though agreement with the uncorrected B3LYP functional is significantly worse for all reported properties. The choice of length vs. velocity representation of the electric dipole operator has little impact on the EOM-CCSD transition strengths for nearly all of the states we examined. For a pair of closely related β, γ-enones, (1R)-7-methylenebicyclo[2.2.1]heptan-2-one and (1S)-2-methylenebicyclo[2.2.1]heptan-7-one, we find that EOM-CCSD and CAM-B3LYP agree with the energetic ordering of the two possible excited-state conformations, resulting in good agreement with experimental rotatory strengths in both absorption and emission, whereas B3LYP yields a qualitatively incorrect result for the CPL signal of (1S)-2-methylenebicyclo[2.2.1]heptan-7-one. Finally, we predict that one of the compounds considered here, trans-bicyclo[3.3.0]octane-3,7-dione, is unique in that it exhibits an achiral ground state and a chiral first excited state, leading to a strong CPL

  1. Is there a role for 3 dimensional power Doppler placental ultrasound and computerised assessment of calcification in post-term pregnancies?

    International Nuclear Information System (INIS)

    Moran, M.; Zombori, G.; Ryan, J.; Downey, P.; McAuliffe, F.M.

    2016-01-01

    Purpose: To assess if three dimensional power Doppler (3DPD) placental ultrasound, evaluating volume, vascularisation, and blood flow in post-term pregnancies differs from normal pre-term third trimester pregnancies and to examine whether computer analysis identifies the continual increase in calcification in post-term pregnancies. Materials and methods: A prospective cohort study of 50 women with post-term pregnancies (40 + 0 to 41 + 6 weeks) and 58 controls (36–40 weeks). 3DPD ultrasound was used to evaluate placental volume, vascularisation index (VI), flow index (FI) and vascularisation-flow index (VFI). Calcification percentage was calculated, by computer analysis. Results were compared with previously determined normal values and correlated with uterine, middle cerebral and umbilical artery Doppler values and placental histology. Results: Placental volume, VI, FI and VFI are not influenced by GA beyond 40 weeks gestation and are similar between post-term and normal pregnancies (36–40 weeks). Placental volume decreased as the mean uterine artery pulsatility index (UtA PI) increased; p = 0.047. FI was reduced where chorangiosis was found at histology (p = 0.033). Computer analysis of placental calcification identified the increased calcification expected after 40 weeks, and showed that calcification continues to increase between 40 and 42 weeks (p = 0.029). Conclusion: Although the sample size limits the generalisability of the findings, we found that calcification of the placenta continues to increase between 40 and 42 weeks gestation, that there is an association between an increasing UtA PI and a decreasing placental volume and that FI measurement may be useful in the identification of chorangiosis in post-term pregnancies. - Highlights: • Placental volume does not increase when pregnancy advances beyond 40 weeks gestation. • Placental volume decreases in post-term pregnancies as the mean uterine artery pulsatility index increases. • Flow

  2. Dorsal skinfold chamber models in mice

    Directory of Open Access Journals (Sweden)

    Schreiter, Jeannine

    2017-07-01

    Full Text Available Background/purpose: The use of dorsal skinfold chamber models has substantially improved the understanding of micro-vascularisation in pathophysiology over the last eight decades. It allows pathophysiological studies of vascularisation over a continuous period of time. The dorsal skinfold chamber is an attractive technique for monitoring the vascularisation of autologous or allogenic transplants, wound healing, tumorigenesis and compatibility of biomaterial implants. To further reduce the animals’ discomfort while carrying the dorsal skinfold chamber, we developed a smaller chamber (the Leipzig Dorsal Skinfold Chamber and summarized the commercial available chamber models. In addition we compared our model to the common chamber. Methods: The Leipzig Dorsal Skinfold Chamber was applied to female mice with a mean weight of 22 g. Angiogenesis within the dorsal skinfold chamber was evaluated after injection of fluorescein isothiocyanate dextran with an Axio Scope microscope. The mean vessel density within the dorsal skinfold chamber was assessed over a period of 21 days at five different time points. The gained data were compared to previous results using a bigger and heavier dorsal skinfold model in mice. A PubMed and a patent search were performed and all papers related to “dorsal skinfold chamber” from 1 of January 2006 to 31 of December 2015 were evaluated regarding the dorsal skinfold chamber models and their technical improvements. The main models are described and compared to our titanium Leipzig Dorsal Skinfold Chamber model.Results: The Leipzig Dorsal Skinfold Chamber fulfils all requirements of continuous models known from previous chamber models while reducing irritation to the mice. Five different chamber models have been identified showing substantial regional diversity. The newly elaborated titanium dorsal skinfold chamber may replace the pre-existing titanium chamber model used in Germany so far, as it is smaller and lighter

  3. The usefulness of contrast-enhanced sonography in the differential diagnostic of adrenal tumors

    International Nuclear Information System (INIS)

    Slonina, J.; Nienartowicz, E.; Malczewska, J.; Moron, K.; Kumar Agrawal, A.

    2006-01-01

    Introduction: The occurrence of gland tumors causes significant clinical problem. Non hormone-secreting tumors provide the most complicated diagnostic difficulties. The application of contrast-enhanced sonography could improve the vessels visualization and point out characteristic features of benign and malignant changes. The authors believe that this new method make possible the differential adrenal tumor diagnostic process more precise and increase the specificity of ultrasonography in the recognition of benign and malignant tumors. The aim of this study was to define the usefulness of contrasting agent Levovist in differential diagnostics of adrenal tumors and its influence on sensitivity and specificity of ultrasound examination and to establish patients qualification criteria for surgical procedures. Material and methods: Ultrasound examinations were made with the use of digital devise by GE Voluson 740, probe 4.6 MHz with Doppler options and volumetric probe 3D according to the following protocol: 26 patients with recognized adrenal tumor were qualified for the examination. Patients in the first stage of tumor vascularisation had Doppler examination with color (CD) and power Doppler (PD). Three-dimensional ultrasonography was used to improve visualization of vascularisation. In the final phase of the examination the patients were administrated of Levovist in the recommended by the producer dose: 2,5 g in the concentration of 400 mg/l. Results: 26 cases of adrenal gland tumours were subjected to analysis. In standard ultrasonographic examination focal changes in 25 patients were hipoechogenic focuses and in one case the focus was hyperechogenic. Heterogeneity of focuses was observed in 16 cases. In Doppler examination with color (CD) and power Doppler (PD) vascular blood flow was revealed within 12. After using contrasting agent Levovist vascular blood flow was achieved in 4 additional cases, which constituted 61% . Conclusions: 1. 3D ultrasound could be

  4. The rat subcutaneous air sac model. A new and simple method for in vivo screening of antiangiogenesis

    International Nuclear Information System (INIS)

    Lichtenberg, J.; Abildgaard Hansen, C.; Skak-Nielsen, T.; Bay, C.; Thing Mortensen, J.; Binderup, L.

    1997-01-01

    An experimental rat model, the Subcutaneous Air Sac (SAS) model, was developed to provide an animal model in which neo-vascularisation can be easily assessed in situ and quantified using a radiolabelled plasma marker. The SAS model was designed to replace a previous model where neo-vascularisation was induced by chemical injury of rat or rabbit cornea or by implantation of tumour cells intracorneally, a methodology which is believed to cause severe pain to the animals. In the SAS model the air sac replaces the cornea as a transparent avascular substratum in which vascularisation can be observed. The air sac is induced by injection of air subcutaneously on the back of the animal. After 8 to 10 days a sufficient air sac has been established. The animal is anaesthesized and by a minor operation the cellulose sponge is implanted upon the air sac under the skin. The vaso-proliferative effect of the cellulose sponge caused formation of new vessels which are macroscopically visible 10 days after implantation. The ability of the in vivo SAS model to show an anti-angiogenic effect of a systemically applied test compound was investigated using the fumagilline analogue TNP-470 (o-chloro-acetylcarbomoyl-fumagillol) as a positive control at dose levels of 0, 1, 2.5, 5 and 10 mg/kg/day given subcutaneously for 10 days. The neo-angio genesis was scored both in situ using a subjective point system and by measuring the 125 I-activity of the implant and the membrane after an intravenous injection of 125 I-labelled antibodies. The neo-angio genesis was reduced by approximately 45-50% in animals treated with 5 or 10 mg/kg/day of TNP-470 compared to animals treated with the vehicle. The animals treated with 10 mg/kg/day TNP-470 showed signs of toxicity. The SAS model is considered highly relevant for in vivo testing of potential anti-angiogenci drugs on humane grounds. The high reproducibility, the low cost and the technical simplicity of the method makes it attractive. (au)

  5. Comparison of radionuclide thyroid angiography, Tc-99m-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules

    International Nuclear Information System (INIS)

    Kapucu, L.O.; Demirel, K.; Unlu, M.; Yucel, C.; Ozdemir, H.; Ayvaz, G.; Taneri, F.

    2002-01-01

    Materials and Methods: RTA (n:70), PD (n:58) and Tc-99m-MIBI (n:43) were performed in 70 patients with solitary cold thyroid nodules. Perfusion of the nodules in RTA was compared with the perfusion in the surrounding normal thyroid tissue and classified as follows: 0=avascular, 1 hypovascular; 2=euvascular; 3=hypervascular. Additionally, retention ratios (counts at 2 minutes/peak count value in the region of the nodule) were calculated. PD patterns were classified as follows: type A, perilesional vascular halo; type B, perilesional vascular halo and intralesional vascularisation, subdivided in: 1) with moderate intralesional vascularisation, homogeneous structure and regular vessel caliber and 2) with rich intralesional vascularisation, anarchical structure and winding vessel caliber and flow; type C, perilesional vascular halo with characteristic peripheral large afferent vessel characterized by winding caliber and flow. MIBI uptake in the nodules were scored for both early and delayed images as follows: 0=cold, 1=decreased; 2=equal and 3=increased uptake compared with surrounding thyroid tissue. Semiquantitative analysis was performed using a lesion to non-lesion ratio on early (ER) and delayed images (DR). Additionally, a retention index (RI) was calculated using the formula RI=(DR-ER) x 100/ER. These data were compared with the results of histolopathology. Results: Histology revealed thyroid carcinoma in 9 patients and benign nodular goiter in 61 patients. 8 of the 9 malignant nodules displayed hypervascularisation in RTA. Mean retention ratios were 0.41 (SD±0.13) in malignant nodules and 0.80 (SD±0.12) in benign nodules. There was significant difference in the retention ratios between malignant and benign lesions (p=0.001). A receiver operating characteristic analysis was performed to determine threshold levels for the differentiation of malignant from benign nodules. The specificities of RTA for hypervascular nodules with retention ratio threshold value <0

  6. Propiedades psicométricas de la Escala MESSY (versión autoinforme en niños argentinos

    Directory of Open Access Journals (Sweden)

    Maria Julia Ipina

    2011-12-01

    Full Text Available Psychometric properties of the MESSY Scale (self-assessment in Argentinean children This study examines the psychometric properties of the Matson Evaluation of Social Skills with Youngsters (Matson, Rotatori & Helsel, 1983, which assesses specific social skills involved in adaptive and non-adaptive behaviors. The factor structure and internal consistency were studied in a sample of children from Cordoba (n = 578 of 7 to 13 years old (M = 9.48, SD = 1.47 of both sexes (52.77% males. An exploratory study of data and variables was conducted; then the factor structure was studied. Results suggest that the structure of five factors was the simplest and theoretically most consistent: Aggressiveness/Antisocial Behavior, Appropriate Social Skills, Friendship, Overconfidence/Jealousy/Pride and Loneliness/ Social Anxiety. The internal consistent coefficients were good or acceptable in most dimensions. Gender differences observed in the dimensions and total score provide evidence of the validity of the instrument.

  7. Giant Cell Tumour of the Distal Ulna: A Rare Presentation

    Directory of Open Access Journals (Sweden)

    Ruben Jaya Kumar

    2011-07-01

    Full Text Available Giant-cell tumour (GCT of bone, a primary yet locally aggressive benign tumour, commonly affects patients between the ages of 20 and 40 years, with the peak incidence occurring in the third decade. Women are affected slightly more than men. The distal end of the ulna is an extremely uncommon site for primary bone tumours in general and giant cell tumours in particular. Wide resection of the distal ulna is the recommended treatment for GCT in such locations. Radio-ulna convergence and dorsal displacement of the ulna stump are known complications following ulna resection proximal to the insertion of the pronator quadratus. This leads to reduction in grip power and forearm rotatory motion. Stabilization of the ulna stump with extensor carpi ulnaris (ECU tendon after wide resection of the tumour has been described in the literature. We report a case of GCT of distal end of ulna treated with wide resection and stabilization with ECU tendon.

  8. A superconductor electromechanical oscillator and its potential application in energy storage

    International Nuclear Information System (INIS)

    Schilling, Osvaldo F

    2004-01-01

    We discuss theoretically the properties of an electromechanical oscillating system whose operation is based upon the cyclic conservative conversion between gravitational potential, kinetic and magnetic energies. The system consists of a superconducting coil subjected to a constant external force and to magnetic fields. The coil oscillates and has induced in it a rectified electrical current whose magnitude may reach hundreds of amperes. The design differs from that of most conventional superconductor machines since the motion is linear (and practically unnoticeable depending on frequency) rather than rotatory and it does not involve high speeds. Furthermore, there is no need for an external electrical power source to start up the system. We also show that the losses for such a system can be made extremely small for certain operational conditions, so that by reaching and keeping resonance the system's main application should be in the generation and storage of electromagnetic energy. (rapid communication)

  9. [Partially unfolded state of lysozyme with a developed secondary structure in dimethylsulfoxide].

    Science.gov (United States)

    Timchenko, A A; Kirkitadze, M D; Prokhorov, D A; Potekhin, S A; Serdiuk, I N

    1996-06-01

    The conformation of a chicken egg lysozyme molecule (dimensions, stoichiometry of its associates, and the degree of helicity) in DMSO was studied by small-angle neutron scattering, dynamic light scattering, and optical rotatory dispersion in the visible region of the spectrum. At high DMSO concentrations (70%), the protein was shown to exist as a dimer. The monomer molecules in the dimer adopt a partially unfolded conformation, with dimensions substantially greater than those in the native state and a high content of secondary structure (the degree of helicity is close to that of native lysozyme). This approach provides a unique possibility to assess the compactness of molecules in associates, which may be very useful in studying protein self-organization.

  10. A Single Chiroptical Spectroscopic Method May Not Be Able To Establish the Absolute Configurations of Diastereomers: Dimethylesters of Hibiscus and Garcinia Acids

    Science.gov (United States)

    Polavarapu, Prasad L.; Donahue, Emily A.; Shanmugam, Ganesh; Scalmani, Giovanni; Hawkins, Edward K.; Rizzo, Carmelo; Ibnusaud, Ibrahim; Thomas, Grace; Habel, Deenamma; Sebastian, Dellamol

    2013-01-01

    Electronic circular dichroism (ECD), optical rotatory dispersion (ORD), and vibrational circular dichroism (VCD) spectra of hibiscus acid dimethyl ester have been measured and analyzed in combination with quantum chemical calculations of corresponding spectra. These results, along with those reported previously for garcinia acid dimethyl ester, reveal that none of these three (ECD, ORD, or VCD) spectroscopic methods, in isolation, can unequivocally establish the absolute configurations of diastereomers. This deficiency is eliminated when a combined spectral analysis of either ECD and VCD or ORD and VCD methods is used. It is also found that the ambiguities in the assignment of absolute configurations of diastereomers may also be overcome when unpolarized vibrational absorption is included in the spectral analysis. PMID:21568330

  11. Elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture

    DEFF Research Database (Denmark)

    Jensen, Steen Lund; Olsen, Bo Sanderhoff; Tyrdal, Stein

    2005-01-01

    The objectives of this experimental study were to investigate the effect of radial head excision and lateral collateral ligament (LCL) division on elbow joint laxity and to determine the efficacy of radial head prosthetic replacement and LCL repair. Valgus, varus, internal rotation, and external...... rotation of the ulna were measured during passive flexion-extension and application of a 0.75-Nm torque in 6 intact cadaveric elbows and after (1) either excision of the radial head or division of the LCL, (2) removal of both constraints, (3) isolated radial head prosthetic replacement, (4) isolated LCL...... normalized varus laxity but resulted in a 2.9 degrees increase in external rotatory laxity. The combined procedures restored laxity completely. The radial head is a constraint to varus and external rotation in the elbow joint, functioning by maintaining tension in the LCL. Still, removal of both constraints...

  12. In Vitro Mass Propagation of Cymbopogon citratus Stapf., a Medicinal Gramineae.

    Science.gov (United States)

    Quiala, Elisa; Barbón, Raúl; Capote, Alina; Pérez, Naivy; Jiménez, Elio

    2016-01-01

    Cymbopogon citratus (D.C.) Stapf. is a medicinal plant source of lemon grass oils with multiple uses in the pharmaceutical and food industry. Conventional propagation in semisolid culture medium has become a fast tool for mass propagation of lemon grass, but the production cost must be lower. A solution could be the application of in vitro propagation methods based on liquid culture advantages and automation. This chapter provides two efficient protocols for in vitro propagation via organogenesis and somatic embryogenesis of this medicinal plant. Firstly, we report the production of shoots using a temporary immersion system (TIS). Secondly, a protocol for somatic embryogenesis using semisolid culture for callus formation and multiplication, and liquid culture in a rotatory shaker and conventional bioreactors for the maintenance of embryogenic culture, is described. Well-developed plants can be achieved from both protocols. Here we provide a fast and efficient technology for mass propagation of this medicinal plant taking the advantage of liquid culture and automation.

  13. Comparison of three techniques for skin total irradiation with electrons; Comparacao de tres tecnicas de irradiacao total da pele com eletrons

    Energy Technology Data Exchange (ETDEWEB)

    Batista, Delano V.S., E-mail: dbatista@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Instituto Nacional de Cancer (INCa), Rio de Janeiro, RJ (Brazil); Bardella, Lucia H. [Instituto Nacional de Cancer (INCa), Rio de Janeiro, RJ (Brazil); Rosa, Luiz A.R. da, E-mail: lrosa@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2011-10-26

    This paper compared three techniques of skin total irradiation with electrons: 1) horizontal positioning, 2) vertical positioning - rotatory technique and 3) vertical positioning - six fields technique. For that, a anthropomorphic phantom was positioned according to the recommendation for each technique and was i radiated at the linear accelerator by using the 6 MeV electrons. Radiochromic films were positioned on the surface in various regions of the phantom for measurement of absorbed dose. A ionization chamber was positioned inside of equivalent issue plates for dose evaluation due to the photons produced by electron stopping. The technique 2 and 3 have shown too similar in the results and number or discrepant points (8 and 10 respectively) of prescription lower than the technique 1 (22 points). The total body dose of photons of the 1, 2 and 3 techniques was 2.2%, 5.3% and 5.2% respectively

  14. Cephalic tetanus presenting as acute vertigo with bilateral vestibulopathy.

    Science.gov (United States)

    Kagoya, Ryoji; Iwasaki, Shinichi; Chihara, Yasuhiro; Ushio, Munetaka; Tsuji, Shoji; Murofushi, Toshihisa; Yamasoba, Tatsuya

    2011-03-01

    Cephalic tetanus is a rare form of tetanus, defined by paralysis of more than one cranial nerve. The seventh cranial nerve is the most frequently involved. We report a 58-year-old man with cephalic tetanus and bilateral vestibulopathy. The patient's initial symptoms were rotatory vertigo and hypertension. He then developed trismus and cranial nerve palsies of the fifth and seventh nerves. The caloric test and vestibular evoked mygenic potentials in response to air-conducted clicks revealed absent responses on both sides, although audiometry and auditory brainstem responses were normal in both ears. To the best of our knowledge, this is the first report of involvement of the eighth cranial nerve in cephalic tetanus.

  15. A hybrid feature selection and health indicator construction scheme for delay-time-based degradation modelling of rolling element bearings

    Science.gov (United States)

    Zhang, Bin; Deng, Congying; Zhang, Yi

    2018-03-01

    Rolling element bearings are mechanical components used frequently in most rotating machinery and they are also vulnerable links representing the main source of failures in such systems. Thus, health condition monitoring and fault diagnosis of rolling element bearings have long been studied to improve operational reliability and maintenance efficiency of rotatory machines. Over the past decade, prognosis that enables forewarning of failure and estimation of residual life attracted increasing attention. To accurately and efficiently predict failure of the rolling element bearing, the degradation requires to be well represented and modelled. For this purpose, degradation of the rolling element bearing is analysed with the delay-time-based model in this paper. Also, a hybrid feature selection and health indicator construction scheme is proposed for extraction of the bearing health relevant information from condition monitoring sensor data. Effectiveness of the presented approach is validated through case studies on rolling element bearing run-to-failure experiments.

  16. The iliotibial band and anterolateral capsule have a combined attachment to the Segond fracture.

    Science.gov (United States)

    Albers, Marcio; Shaikh, Humza; Herbst, Elmar; Onishi, Kentaro; Nagai, Kanto; Musahl, Volker; Fu, Freddie H

    2018-05-01

    The purpose of this report was to describe the injury mechanism, surgical findings, and outcomes in a 21-year-old professional female football player who presented with a complete anterior cruciate ligament (ACL) rupture and Segond fracture. Interview and video analysis were performed to elicit the injury mechanism. Clinical examination and imaging revealed a complete ACL tear, Segond fracture, lateral meniscus tear, MCL sprain, and posterolateral corner sprain. Examination under anaesthesia revealed Grade 2 pivot shift and varus/valgus instability. Surgical examination revealed attachment of the posterior fibres of the iliotibial band and the lateral capsule to the Segond fragment. The fracture was reduced with suture fixation, and an anatomic ACL reconstruction was performed. Follow-up demonstrated rotatory and anterior tibial translation stability, and imaging at 7 months post-operatively revealed no movement and continued osseous integration of the Segond fragment. Level of evidence V.

  17. Spinal instrumentation for unstable C1-2 injury.

    Science.gov (United States)

    Mizuno, J; Nakagawa, H

    1999-06-01

    Seventeen patients with unstable C1-2 injuries were treated between 1990 and 1997. Various methods of instrumentation surgery were performed in 16 patients, excluding a case of atlantoaxial rotatory fixation. Posterior stabilization was carried out in 14 cases using Halifax interlaminar clamp, Sof'wire or Danek cable, or more recently, transarticular screws. Transodontoid anterior screw fixation was performed in four cases of odontoid process fractures, with posterior instrumentation in two cases because of malunion. Rigid internal fixation by instrumentation surgery for the unstable C1-2 injury avoids long-term application of a Halo brace and facilitates early rehabilitation. However, the procedure is technically demanding with the risk of neural and vascular injuries, particularly with posterior screw fixation. Sagittal reconstruction of thin-sliced computed tomography scans at the C1-2 region, neuronavigator, and intraoperative fluoroscopy are essential to allow preoperative surgical planning and intraoperative guidance.

  18. Uniform stable observer for the disturbance estimation in two renewable energy systems.

    Science.gov (United States)

    Rubio, José de Jesús; Ochoa, Genaro; Balcazar, Ricardo; Pacheco, Jaime

    2015-09-01

    In this study, an observer for the states and disturbance estimation in two renewable energy systems is introduced. The restrictions of the gains in the proposed observer are found to guarantee its stability and the convergence of its error; furthermore, these results are utilized to obtain a good estimation. The introduced technique is applied for the states and disturbance estimation in a wind turbine and an electric vehicle. The wind turbine has a rotatory tower to catch the incoming air to be transformed in electricity and the electric vehicle has generators connected with its wheels to catch the vehicle movement to be transformed in electricity. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  19. Magnetic resonance imaging in Pelizaeus-Merzbacher disease

    International Nuclear Information System (INIS)

    Journel, H.; Roussey, M.; Allaire, C.; Le Marec, B.; Gandon, Y.; Carsin, M.

    1987-01-01

    Pelizaeus-Merzbacher's disease is a progressive encephalopathy with demyelination of the cerebral white matter. The diagnosis cannot be made on clinical or biological grounds: pathological investigation is necessary to confirm tigroid demyelination. CT scanning failure to visualize this type of anomaly but detection is now possible with the advent of magnetic resonance imaging (MRI). The authors studied the case of a boy who, at the age of 8 presented with symptoms characeristic of the disease, rotatory nystagmus, progressive encephalopathy, and inherited X-linked recessive traits. Magnetic resonance imaging revealed a high signal in the supra-tentorial white matter and the usual contrast was inverted. The authors believe that MRI can make an important contribution to the diagnosis of the disease. (orig.)

  20. A comprehensive model for in-plane and out-of-plane vibration of CANDU fuel endplate rings

    Energy Technology Data Exchange (ETDEWEB)

    Yu, S.D., E-mail: syu@ryerson.ca; Fadaee, M.

    2016-08-01

    Highlights: • Proposed an effective method for modelling bending and torsional vibration of CANDU fuel endplate rings. • Applied successfully the thick plate theory to curved structural members by accounting for the transverse shear effect. • The proposed method is computationally more efficient compared to the 3D finite element. - Abstract: In this paper, a comprehensive vibration model is developed for analysing in-plane and out-of-plane vibration of CANDU fuel endplate rings by taking into consideration the effects of in-plane extension in the circumferential and radial directions, shear, and rotatory inertia. The model is based on Reddy’s thick plate theory and the nine-node isoparametric Lagrangian plate finite elements. Natural frequencies of various modes of vibration of circular rings obtained using the proposed method are compared with 3D finite element results, experimental data and results available in the literature. Excellent agreement was achieved.

  1. Vibrations And Stability Of Bernoulli-Euler And Timoshenko Beams On Two-Parameter Elastic Foundation

    Directory of Open Access Journals (Sweden)

    Obara P.

    2014-12-01

    Full Text Available The vibration and stability analysis of uniform beams supported on two-parameter elastic foundation are performed. The second foundation parameter is a function of the total rotation of the beam. The effects of axial force, foundation stiffness parameters, transverse shear deformation and rotatory inertia are incorporated into the accurate vibration analysis. The work shows very important question of relationships between the parameters describing the beam vibration, the compressive force and the foundation parameters. For the free supported beam, the exact formulas for the natural vibration frequencies, the critical forces and the formula defining the relationship between the vibration frequency and the compressive forces are derived. For other conditions of the beam support conditional equations were received. These equations determine the dependence of the frequency of vibration of the compressive force for the assumed parameters of elastic foundation and the slenderness of the beam.

  2. Energy flow analysis of out-of-plane vibration in coplanar coupled finite Mindlin plates

    Directory of Open Access Journals (Sweden)

    Young-Ho Park

    2015-01-01

    Full Text Available : In this paper, an Energy Flow Analysis (EFA for coplanar coupled Mindlin plates was performed to estimate their dynamic responses at high frequencies. Mindlin plate theory can consider the effects of shear distortion and rotatory inertia, which are very important at high frequencies. For EFA for coplanar coupled Mindlin plates, the wave transmission and reflection relationship for progressing out-of-plane waves (out-of-plane shear wave, bending dominant flexural wave, and shear dominant flexural wave in coplanar coupled Mindlin plates was newly derived. To verify the validity of the EFA results, numerical analyses were performed for various cases where coplanar coupled Mindlin plates are excited by a harmonic point force, and the energy flow solutions for coplanar coupled Mindlin plates were compared with the classical solutions in the various conditions.

  3. Comparison of three techniques for skin total irradiation with electrons

    International Nuclear Information System (INIS)

    Batista, Delano V.S.; Bardella, Lucia H.; Rosa, Luiz A.R. da

    2011-01-01

    This paper compared three techniques of skin total irradiation with electrons: 1) horizontal positioning, 2) vertical positioning - rotatory technique and 3) vertical positioning - six fields technique. For that, a anthropomorphic phantom was positioned according to the recommendation for each technique and was i radiated at the linear accelerator by using the 6 MeV electrons. Radiochromic films were positioned on the surface in various regions of the phantom for measurement of absorbed dose. A ionization chamber was positioned inside of equivalent issue plates for dose evaluation due to the photons produced by electron stopping. The technique 2 and 3 have shown too similar in the results and number or discrepant points (8 and 10 respectively) of prescription lower than the technique 1 (22 points). The total body dose of photons of the 1, 2 and 3 techniques was 2.2%, 5.3% and 5.2% respectively

  4. Transient ischemic attack presenting in an elderly patient with transient ophthalmic manifestations

    Directory of Open Access Journals (Sweden)

    Sparshi Jain

    2016-01-01

    Full Text Available Transient ischemic attack (TIA is a transient neurological deficit of cerebrovascular origin without infarction which may last only for a short period and can have varying presentations. We report a case of 58-year-old male with presenting features of sudden onset transient vertical diplopia and transient rotatory nystagmus which self-resolved within 12 h. Patient had no history of any systemic illness. On investigating, hematological investigations and neuroimaging could not explain these sudden and transient findings. A TIA could possibly explain these sudden and transient ocular findings in our patient. This case report aims to highlight the importance of TIA for ophthalmologists. We must not ignore these findings as these could be warning signs of an impending stroke which may or may not be detected on neuroimaging. Thus, early recognition, primary prevention strategies, and timely intervention are needed.

  5. FIRST REPORT ON OTOTOXICITY OF MEGLUMINE ANTIMONIATE

    Directory of Open Access Journals (Sweden)

    Cláudia Maria Valete-Rosalino

    2014-09-01

    Full Text Available Introduction: Pentavalent antimonials are the first drug of choice in the treatment of tegumentary leishmaniasis. Data on ototoxicity related with such drugs is scarcely available in literature, leading us to develop a study on cochleovestibular functions. Case Report: A case of a tegumentary leishmaniasis patient, a 78-year-old man who presented a substantial increase in auditory threshold with tinnitus and severe rotatory dizziness during the treatment with meglumine antimoniate, is reported. These symptoms worsened in two weeks after treatment was interrupted. Conclusion: Dizziness and tinnitus had already been related to meglumine antimoniate. However, this is the first well documented case of cochlear-vestibular toxicity related to meglumine antimoniate.

  6. Modeling Electronic Circular Dichroism within the Polarizable Embedding Approach

    DEFF Research Database (Denmark)

    Nørby, Morten S; Olsen, Jógvan Magnus Haugaard; Steinmann, Casper

    2017-01-01

    We present a systematic investigation of the key components needed to model single chromophore electronic circular dichroism (ECD) within the polarizable embedding (PE) approach. By relying on accurate forms of the embedding potential, where especially the inclusion of local field effects...... are in focus, we show that qualitative agreement between rotatory strength parameters calculated by full quantum mechanical calculations and the more efficient embedding calculations can be obtained. An important aspect in the computation of reliable absorption parameters is the need for conformational...... sampling. We show that a significant number of snapshots are needed to avoid artifacts in the calculated electronic circular dichroism parameters due to insufficient configurational sampling, thus highlighting the efficiency of the PE model....

  7. Experimental occlusal interferences. Part II. Masseteric EMG responses to an intercuspal interference.

    Science.gov (United States)

    Christensen, L V; Rassouli, N M

    1995-07-01

    In 12 subjects, a rigid unilateral intercuspal interference (minimum mean height of 0.24 mm) was placed on either the right or left mandibular second premolar and first molar (sagittal physiological equilibrium point of the hemimandibular dental arch). During brisk and forceful clenching on the interference, bipolar surface electromyograms were obtained from the right and left masseter muscles. On the side opposite the interference, myoelectric clenching activity was significantly reduced. Correlation analyses showed that the interference elicited a non-linear (complex) co-ordination of the amplitude, but not the duration, of bilateral masseteric clenching activity, i.e. frequently there was significant motor facilitation on the side of the interference, and significant motor inhibition on the side opposite the interference. Theoretical considerations predicted that brief clenching on the interference would easily lead to frontal plane rotatory motions of the mandible which, indeed, occurred clinically.

  8. Theoretical study of a novel refrigeration compressor - Part II: Performance of a rotating discharge valve in the revolving vane (RV) compressor

    Energy Technology Data Exchange (ETDEWEB)

    Teh, Y.L.; Ooi, K.T. [Thermal and Fluids Engineering Division, School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, S639798 (Singapore); Djamari, D. Wibowo [Engineering Mechanics Division, School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, S639798 (Singapore)

    2009-08-15

    A new refrigeration compressor, named 'Revolving Vane (RV) compressor', has been introduced in Part I of this paper series. For a first time in refrigeration compressors, a rotating discharge valve is employed in the RV compressor mainly due to the rotation of the entire cylinder. This paper presents a theoretical investigation on the dynamic behavior of a reed-type discharge valve undergoing rotatory motion, with the primary objective of elucidating the applicability of such valves in refrigeration compressors. Under the application of the Euler-Bernoulli beam theory, a mathematical model of the rotating valve is formulated and the transient response of the valve under centrifugal loads in addition to pressure forces is analyzed. Results have shown that under careful design considerations, the performance as well as the reliability of the rotating discharge valve can be enhanced as compared to a non-rotating valve that has been used in all refrigeration compressors currently. (author)

  9. Planar reorientation of a free-free beam in space using embedded electromechanical actuators

    Science.gov (United States)

    Kolmanovsky, Ilya V.; Mcclamroch, N. Harris

    1993-01-01

    It is demonstrated that the planar reorientation of a free-free beam in zero gravity space can be accomplished by periodically changing the shape of the beam using embedded electromechanical actuators. The dynamics which determine the shape of the free-free beam is assumed to be characterized by the Euler-Bernoulli equation, including material damping, with appropriate boundary conditions. The coupling between the rigid body motion and the flexible motion is explained using the angular momentum expression which includes rotatory inertia and kinematically exact effects. A control scheme is proposed where the embedded actuators excite the flexible motion of the beam so that it rotates in the desired sense with respect to a fixed inertial reference. Relations are derived which relate the average rotation rate to the amplitudes and the frequencies of the periodic actuation signal and the properties of the beam. These reorientation maneuvers can be implemented by using feedback control.

  10. Synthesis of the natural product building block 5-(3-bromophenyl)-4-hydroxy-5-methylhexan-2-one and its chiral characterization by using chiroptical spectroscopy.

    Science.gov (United States)

    De Gussem, Ewoud; Cornelus, Jelle; Pieters, Sam; Van den Bossche, Dries; Van der Eycken, Johan; Herrebout, Wouter; Bultinck, Patrick

    2013-10-07

    The absolute configuration of 5-(3-bromophenyl)-4-hydroxy-5-methylhexan-2-one, an intermediate in the synthesis of various natural products, is assigned by using vibrational circular dichroism (VCD), electronic circular dichroism (ECD), and optical rotatory dispersion (ORD). Experimental spectra were compared to density functional theory (DFT) calculations of the molecule with known configuration. These three techniques independently confirm that the absolute configuration is (S)-5-(3-bromophenyl)-4-hydroxy-5-methylhexan-2-one, thus enabling us to assign the absolute configuration with high reliability. The reliability of the VCD analysis was assessed quantitatively by using the CompareVOA program. We found that, in cases in which the agreement between theory and experiment was very good, a value of 10 cm(-1) for the triangular weighting function gave a more-realistic discriminative power between enantiomers than the default value of 20 cm(-1). Copyright © 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Rehabilitation of Posterior Maxilla with Obturator Supported by Zygomatic Implants

    Directory of Open Access Journals (Sweden)

    Sankalp Mittal

    2018-01-01

    Full Text Available Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomatic implant-supported prosthesis. Zygomatic implants are an avant-garde to complex and invasive-free vascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany’s classification maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS. The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with two single-piece zygomatic implants. At 1-year follow-up, the patient was comfortable with the prosthesis, and no further complaints were recorded.

  12. 31phosphorus spectroscopy of space-occupying lesions of the salivary glands. Clinic results and differential diagnosis

    International Nuclear Information System (INIS)

    Vogl, T.J.; Dadashi, A.; Jassoy, A.; Becker, C.; Reimann, V.; Lissner, J.

    1993-01-01

    In a prospective study, 15 normals and 20 patients with space-occupying lesions of the salivary glands were examined by MRT images and by in vivo 31 phosphorus spectroscopy. The spectra of malignant tumours showed a significant increase in concentration of phosphomonoesters, phosphodiesters and inorganic phosphates when compared with normals. In addition there was an enormous reduction in creatine phosphates. Increased pH values and marked increase in concentration of inorganic phosphates correlated with poorly vascularised necrotic tumour segments. Concentrations of ATP and PCr were similar to normal muscle tissue. High concentrations of PME and PDE correlated directly with the proliferation of tumour cells and were an important marker for the bioenergy and phospholipid metabolism of the growing tumour. Standardised in vivo 31 phosphorus spectroscopy of space-occupying lesions of the salivary glands provides noninvasive prognostic information on the type and behaviour of the lesion and is complementary to clinical and histological findings. (orig.) [de

  13. Towards gadolinium neutron capture therapy

    International Nuclear Information System (INIS)

    Stalpers, L.; Kuipers, S.; Vroegindeweij, C.; Stecher-Rasmussen, F.; Slotman, B.

    2000-01-01

    As glioblastoma multiforme has macroscopic areas with poor vascularisation, and thereby poor uptake of an NCT-agent, the long-range γ-rays from GdNCT might enhance dose deposition compared to BNCT and to conformal photon therapy. Multicellular spheroids from a human glioblastoma cell line (Gli-6) were irradiated with conventional X-rays, with neutrons only (from the NRG Argonaut Reactor, LFR), and with neutrons (from the LFR) + 157 Gd-DTPA (240 ppm 157 Gd). Preliminary results demonstrate that after neutron irradiation in the presence of 157 Gd, the spheroids showed growth arrest. By 3D treatment planning calculations on MRI's from patients with brain tumours, dose volume histograms (DVH) for GdNCT were compared to DVH for conventional conformal radiotherapy. The calculations indicate that GdNCT on patients with large, deep-seated tumours yields better tumour/brain dose distribution than conformal radiotherapy. (author)

  14. CLOSED TALAR DISLOCATION – A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Igor Dolenc

    2001-11-01

    Full Text Available Background. A case report of closed complete talardislocation and its treatment is presented. At the operative reductionof the talus some connective tissue was observed bridgingthe talar caput with the surrounding structures. Talar bonescan at that time revealed irregular accumulation of theisotope. Six months post injury x-ray of the previously injuriedtalus showed normal spongious bone structure, and repeatedbone scan revealed normal vascularisation.Conclusions. The injuried lower extremity was immobilizedfor five and a half months and weight-bearing was restrictedfor nine and a half months altogether. Five years later the patientis asymptomatic. The range of motion of the previouslyinjuried ankle is normal. X-ray control reveals initial signs ofosteoarthritis at the talocalcanear joints.

  15. LeFort I osteotomy and secondary procedures in full-face transplant patients.

    Science.gov (United States)

    Barret, Juan P; Serracanta, Jordi

    2013-05-01

    Composite tissue allotransplantion has been the latest addition to reconstructive plastic surgery of limbs and faces. These techniques have opened up a new paradigm in reconstruction. However, plastic surgeons will have to face a new patient population that receives the application of vascularised tissue allografts and immunosuppression. Secondary surgery may be necessary in this population, especially in the transplanted tissues, to improve aesthetics and function following the transplant, although little is known regarding the exact clinical protocol to be followed and the feasibility of standard plastic surgery techniques on transplanted tissues. We present our experience of a LeFort I osteotomy, limited ritidectomy and blepharoplasty in a full-face transplant recipient. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. MRI findings in Kirner deformity: normal insertion of the flexor digitorum profundus tendon without soft-tissue enhancement

    International Nuclear Information System (INIS)

    Lee, Jaejoon; Ahn, Joong Kyong; Koh, Eun-Mi; Cha, Hoon-Suk; Choi, Sang-Hee

    2010-01-01

    Kirner deformity is characterized by volar and radial incurvature of the distal phalanx of the 5th finger. A proposed causative mechanism includes abnormal distal insertion of the flexor digitorum profundus tendon along the volar surface of the distal phalanx of the 5th finger. A chronic inflammatory process or altered vascularisation of the soft tissues has also been suggested as the underlying causative mechanism based on MRI findings. We present a teenage boy with Kirner deformity, along with supplementary imaging of his father who also has the deformity, to illustrate MRI findings that dispute the above hypotheses. MRI in both son and father show normal insertion of the deep flexor tendon and no signs of inflammation. (orig.)

  17. Integumentary Histology of the Amphibious Blenny, Isteblennius edentulus (Forester and Schneider, 1801

    Directory of Open Access Journals (Sweden)

    Taher Ba-Omar

    2009-06-01

    Full Text Available The skin of the amphibious blenny, Istiblennius edentulus, was studied using both light and scanning electron microscopy. Rich vascularisation was found immediately below the epidermis and the dermis. Surface epithelial cells displayed microridges in a fingerprint-like pattern.  It was speculated that this increased surface area may aid in the adhesion of mucous secretions as well as to increase the surface area for gas exchange. The number of pores on the dorsal side (6.3x103 per mm2 was significantly higher than that on the ventral side (4.3x103 per mm2. The thickness of the skin on the dorsal side was measured at 31.6±10.0µm and that on the ventral side was 32.9 ± 7.8µm.

  18. 3D printing process of oxidized nanocellulose and gelatin scaffold.

    Science.gov (United States)

    Xu, Xiaodong; Zhou, Jiping; Jiang, Yani; Zhang, Qi; Shi, Hongcan; Liu, Dongfang

    2018-08-01

    For tissue engineering applications tissue scaffolds need to have a porous structure to meet the needs of cell proliferation/differentiation, vascularisation and sufficient mechanical strength for the specific tissue. Here we report the results of a study of the 3D printing process for composite materials based on oxidized nanocellulose and gelatin, that was optimised through measuring rheological properties of different batches of materials after different crosslinking times, simulation of the pneumatic extrusion process and 3D scaffolds fabrication with Solidworks Flow Simulation, observation of its porous structure by SEM, measurement of pressure-pull performance, and experiments aimed at finding out the vitro cytotoxicity and cell morphology. The materials printed are highly porous scaffolds with good mechanical properties.

  19. Quantitatively evaluated dynamic MRT in rheumatoid arthritis of the knee joint

    International Nuclear Information System (INIS)

    Koenig, H.; Bolze, X.; Wolf, K.J.; Sieper, J.

    1992-01-01

    32 patients with chronic polyarthritis were examined by MRT. Following intra-articular application of 25 mg prednisolon, 18 patients were reexamined after two of three weeks and 7 out of 18 patients were re-examined after 8 to 16 weeks, both by MRT and clinically. After an initial double echo sequence, we carried out a dynamic series of FLASH measurements (TR 30, TE 10 ms, 70deg) following an intravenous bolus of 0.1 mmol gadolinium-DTPA. Single intensity-time curves were treated quantitatively in relation to the pannus, muscles and effusions. Two or three weeks after treatment the curve parameters showed a reduction in pannus vascularisation which remained constant for the 8 to 16 weeks of further observation. Contrast diffusion in the pannus is initially reduced but approaches the early measurements at the time of the second examination. (orig.) [de

  20. Quantitatively evaluated dynamic MRT in rheumatoid arthritis of the knee joint. Follow-up after intraarticular steroid therapy. Quantitativ evaluierte dynamische Magnetresonanztomographie bei chronischer Polyarthritis des Kniegelenkes. Therapiekontrolle nach intraartikulaerer Kortisonapplikation

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, H.; Bolze, X.; Wolf, K.J. (Klinikum Steglitz, FU Berlin, Radiologische Klinik und Poliklinik, Abt. fuer Radiologische Diagnostik und Nuklearmedizin (Germany)); Sieper, J. (Klinikum Steglitz, FU Berlin, Medizinische Klinik und Poliklinik, Abt. fuer Allgemeine Innere Medizin und Nephrologie (Germany))

    1992-08-01

    32 patients with chronic polyarthritis were examined by MRT. Following intra-articular application of 25 mg prednisolon, 18 patients were reexamined after two of three weeks and 7 out of 18 patients were re-examined after 8 to 16 weeks, both by MRT and clinically. After an initial double echo sequence, we carried out a dynamic series of FLASH measurements (TR 30, TE 10 ms, 70deg) following an intravenous bolus of 0.1 mmol gadolinium-DTPA. Single intensity-time curves were treated quantitatively in relation to the pannus, muscles and effusions. Two or three weeks after treatment the curve parameters showed a reduction in pannus vascularisation which remained constant for the 8 to 16 weeks of further observation. Contrast diffusion in the pannus is initially reduced but approaches the early measurements at the time of the second examination. (orig.).

  1. Sirenomelia: a new type, showing VACTERL association with Thomas syndrome and a review of literature.

    Science.gov (United States)

    Lhuaire, Martin; Jestin, Agnès; Boulagnon, Camille; Loock, Mélanie; Doco-Fenzy, Martine; Gaillard, Dominique; Diebold, Marie-Danièle; Avisse, Claude; Labrousse, Marc

    2013-03-01

    Sirenomelia or "mermaid syndrome" is a rare congenital anomaly known since antiquity. This congenital anomaly is defined as a polymalformative syndrome that associates major muscle and skeleton abnormalities (unique lower limbs) with visceral abnormalities (unilateral or bilateral renal agenesis, anomalies of the abdominal vascularisation). This phenotype, typical of sirenomelia syndrome, may be more or less severe. The pathogenic mechanisms of this syndrome are still debated and its etiology remains unknown. We report here a new type of sirenomelia that we observed in a fetus belonging to the collection of the Department of Anatomy of Reims, which led us to perform a comprehensive review of the literature on the subject: this type has never been reported and cannot be classified according to the Stocker and Heifetz classification. Moreover, this case also presents a VACTERL association with Thomas syndrome. Copyright © 2013 Wiley Periodicals, Inc.

  2. X linked exudative vitreoretinopathy: clinical features and genetic linkage analysis.

    Science.gov (United States)

    Fullwood, P; Jones, J; Bundey, S; Dudgeon, J; Fielder, A R; Kilpatrick, M W

    1993-03-01

    A four generation family in which familial exudative vitreoretinopathy is inherited as an X linked condition is described. Essentially the condition is one of abnormal vascularisation and signs at birth are those of a retinopathy superficially resembling retinopathy of prematurity, retinal folds, or, in advanced cases, enophthalmos or even phthisis. Prognosis depends on the progression of the retinal changes. The family members, including seven affected males and five obligate carrier females, have been types for 20 DNA markers, and linkage analysis suggests a gene locus either at Xq21.3 or at Xp11. As the latter region includes the locus for the gene for Norrie disease, it is possible that this and X linked vitreoretinopathy are allelic. We can further speculate that the differences in severity of the clinical manifestations are dependent only upon the timing of the insult.

  3. Serial computed tomography and its uses in the diagnosis of pathological changes in the liver, pancreas and kidneys

    International Nuclear Information System (INIS)

    Schmiedel, R.

    1983-01-01

    The investigations described were carried out in such a way as to fulfil the defined requirements of serial computed tomography like short periods of measurement, high scanning frequency and intravasal bolus injection of a contrast medium that would readily be excreted by the renal route. In this connection, the following questions were of particular interest: 1. Is computed serial tomography able to provide better clues to tissue identification and the distinction between normal and pathological structures in the liver, pancreas and kidneys? 2. Would it be possible to obtain information as to the degree of vascularisation in space-occupying pathological processes in the liver, pancreas and kidneys? 3. Is serial computed tomography a useful tool to diagnose specific pathological changes in the liver, pancreas and kidneys? 4. Would this investigation permit predictions to be made about the functional performance of the liver, pancreas and kidneys? (orig./MG) [de

  4. Vascularization of soft tissue engineering constructs

    DEFF Research Database (Denmark)

    Pimentel Carletto, Rodrigo

    nanotechnology-based paradigm for engineering vascularised liver tissue for transplantation”) and the Danish National Research Foundation and Villum Foundation’s Center for Intelligent Drug delivery and sensing Using microcontainers and Nanomechanics (Danish National Research Foundation (DNRF122).......Vascularization is recognized to be the biggest challenge for the fabrication of tissues and finally, organs in vitro. So far, several fabrication techniques have been proposed to create a perfusable vasculature within hydrogels, however, the vascularization and perfusion of hydrogels...... with mechanical properties in the range of soft tissues has not been fully achieved. My project focused on the fabrication and the active perfusion of hydrogel constructs with multi-dimensional vasculature and controlled mechanical properties targeting soft tissues. Specifically, the initial part of the research...

  5. Isotopic location of the placenta. Experience of Lariboisiere Hospital

    International Nuclear Information System (INIS)

    Naccache, Gilbert.

    1974-01-01

    All isotopic placenta location techniques make use of the vascularisation difference between the placenta and the neighbouring tissues. The principle is based on the amount of blood in the intervillous space and the maternal blood circulation rate in the placenta area. The techniques, all based on this principle, differ by the nature of the radioelement and the performance of the instruments used. Mention is made of the qualities governing the choice of radioisotope injected, with emphasis on the need to reduce the foetal irradiation. Two kinds of scintigraphic equipment are used, one with a mobile detector moving above the woman's abdomen and the other using a fixed detector, the scintillation camera, which gives the placenta image very rapidly. The practical details of an experiment covering 49 cases of placenta location, using a scintillation camera and sup(99m)Tc-labelled red blood cells, are described in full [fr

  6. Diagnostic approach of cerebral metastases. Some considerations on the value of gamma-angio encephalography

    International Nuclear Information System (INIS)

    Laferriere, Nicole.

    1975-01-01

    Following the intravenous administration of 10 to 12mCi of sup(99m)Tc-DTPA, an investigation is performed using a gamma camera with its associated interface equipment for computer processing of data. During the vascular phase, rapide sequential pictures are taken every 2 or 3 seconds for about 20 seconds. Various views of the early and delayed diffusion phases, make possible to follow the course of the pathologic focus. A typical aspect of cerebral metastase scanning is described. After a first normal or decreased vascular phase, an accumulation of radioactivity in an homogeneous focus with clear margin is observed, showing a progressive course of isotope uptake. Such a focus appearing only during the second phase suggests a lesion with poor vascularisation. Metastases appearing during the first phase, and increasing during the second phase suggests the presence of intense reactive edema [fr

  7. Galectins in angiogenesis: consequences for gestation.

    Science.gov (United States)

    Blois, Sandra M; Conrad, Melanie L; Freitag, Nancy; Barrientos, Gabriela

    2015-04-01

    Members of the galectin family have been shown to exert several roles in the context of reproduction. They contribute to placentation, maternal immune regulation and facilitate angiogenesis encompassing decidualisation and placenta formation during pregnancy. In the context of neo-vascularisation, galectins have been shown to augment signalling pathways that lead to endothelial cell activation, cell proliferation, migration and tube formation in vitro in addition to angiogenesis in vivo. Angiogenesis during gestation ensures not only proper foetal growth and development, but also maternal health. Consequently, restriction of placental blood flow has major consequences for both foetus and mother, leading to pregnancy diseases. In this review we summarise both the established and the emerging roles of galectin in angiogenesis and discuss the possible implications during healthy and pathological gestation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Platelet lysate gel and endothelial progenitors stimulate microvascular network formation in vitro: tissue engineering implications.

    Science.gov (United States)

    Fortunato, Tiago M; Beltrami, Cristina; Emanueli, Costanza; De Bank, Paul A; Pula, Giordano

    2016-05-04

    Revascularisation is a key step for tissue regeneration and complete organ engineering. We describe the generation of human platelet lysate gel (hPLG), an extracellular matrix preparation from human platelets able to support the proliferation of endothelial colony forming cells (ECFCs) in 2D cultures and the formation of a complete microvascular network in vitro in 3D cultures. Existing extracellular matrix preparations require addition of high concentrations of recombinant growth factors and allow only limited formation of capillary-like structures. Additional advantages of our approach over existing extracellular matrices are the absence of any animal product in the composition hPLG and the possibility of obtaining hPLG from patients to generate homologous scaffolds for re-implantation. This discovery has the potential to accelerate the development of regenerative medicine applications based on implantation of microvascular networks expanded ex vivo or the generation of fully vascularised organs.

  9. Angiography of primary bone tumors

    International Nuclear Information System (INIS)

    Keyl, W.; Kunkel, B.

    1982-01-01

    To determine the type of a tumour by means of angiography is problematical. Considering that tumour-simulating lesions (myositis ossificans, modular synoritis) can also show pathological blood vessel formations and AV-shunts the interpretation of vessel-architectonic criteria must be done very carefully. The finding of some individual signs of malignancy does not justify the diagnosis of ''malignant tumour''. Only the ''anarchic vessel picture'' (Freyschmidt) with changing caliber, corkscrew vessels, interrupted vessels, unregular tumour colouring, arteria-venous shunts and possibly also tumour invasion into vessels makes a malignant process very likely. The absence of these criteria, however, does not exclude malignancy. Non-vascularised malignant tumours can only lead to a displacement of vessels without an angiographic proof of the tumour itself. (orig./APR) [de

  10. Radiosensitizers action on Iodine 131 therapeutical effect

    International Nuclear Information System (INIS)

    Agote, Marcos; Kreimann, Erica L.; Bocanera, Laura V.; Dagrosa, Maria A.; Juvenal, Guillermo J.; Pisarev, Mario A.

    1999-01-01

    Present studies were aimed to research the possible application of a radiosensitizer, nicotinamide, to increase the therapeutical effect of radioiodine. There were used goitrous and normal rats with growing dose of Iodine 131, with and without simultaneous treatment with nicotinamide. The obtained results show that the nicotinamide treatment importantly increases the thyroid radio destructive effect induced by radioiodine. Under these experimental conditions, nicotinamide induces to a significant increase of thyroid vascularisation, without changes in the proteins ADP-ribosylation activity. These results show, for the first time, the radiosensitizer effect of nicotinamide in front of Iodine 131 and give the possibility of using it in the treatment of hyperthyroid or thyroid difference cancer patients. (author)

  11. Epidermal inclusion cyst in male breast: mammographic and ultrasonographic findings in three cases

    International Nuclear Information System (INIS)

    Cubells, M.; Gil de Ramales, V.; Bulto, J. A.; Morcillo, E.; Celma, J.

    2000-01-01

    Three cases of histologically diagnosed epidermal inclusion cysts in male breast are presented. This is a very uncommon condition that results from the inclusion of epidermal remnants beneath the skin, which form a keratin-filled cystic cavity. The clinical presentation is that of palpable breast masses showing medium-to-high density in mammography. They are well defined and do not present calcifications. Ultrasound discloses their cystic form, with moderate posterior reinforcement, although they do not appear as anechoic cysts. Characteristically, echoes are detected in the interior that correspond to the degeneration keratin. The differential diagnosis should include cysts complicated by infection or hemorrhage, fibroadenomas with low echogenicity and even tumors of neoplastic origin. Color Doppler ultrasound disclosed the absence of internal vascularisation, a circumstance that indicated the benignity of the lesion. (Author) 9 refs

  12. Scanning Electron Microscopic Studies of the Pecten Oculi in the Quail (Coturnix coturnix japonica

    Directory of Open Access Journals (Sweden)

    Aris F. Pourlis

    2013-01-01

    Full Text Available The main purpose of this study is to extend the microscopic investigations of the pecten oculi in the quail in order to add some information on the unresolved functional anatomy of this unique avian organ. The pecten oculi of the quail was studied by scanning electron microscopy. Eighteen- to-twenty two highly vascularised accordion-like folds were joined apically by a heavily pigmented bridge of tissue, which holds the pecten in a fanlike shape, widest at the base. The structure of the double layered limiting membrane was recorded. The presence of hyalocytes with macrophage-like appearance was illustrated. It is assumed that the pecten oculi of the quail resembles that of the chicken. Illustrated morphological features of this species may add information on the active physiological role of the pecten. But still, the functional significance of this organ is a matter of controversies.

  13. Olea europaea leaf extract and bevacizumab synergistically exhibit beneficial efficacy upon human glioblastoma cancer stem cells through reducing angiogenesis and invasion in vitro.

    Science.gov (United States)

    Tezcan, Gulcin; Taskapilioglu, Mevlut Ozgur; Tunca, Berrin; Bekar, Ahmet; Demirci, Hilal; Kocaeli, Hasan; Aksoy, Secil Ak; Egeli, Unal; Cecener, Gulsah; Tolunay, Sahsine

    2017-06-01

    Patients with glioblastoma multiforme (GBM) that are cancer stem-cell-positive (GSC [+]) essentially cannot benefit from anti-angiogenic or anti-invasive therapy. In the present study, the potential anti-angiogenic and anti-invasive effects of Olea europaea (olive) leaf extract (OLE) were tested using GSC (+) tumours. OLE (2mg/mL) caused a significant reduction in tumour weight, vascularisation, invasiveness and migration (p=0.0001, p<0.001, p=0.004; respectively) that was associated with reducing the expression of VEGFA, MMP-2 and MMP-9. This effect was synergistically increased in combination with bevacizumab. Therefore, our current findings may contribute to research on drugs that inhibit the invasiveness of GBM. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. A Debilitating Orthopaedic Complication following Corticosteroid Therapy for Polymyalgia Rheumatica

    Directory of Open Access Journals (Sweden)

    Paul Rai

    2014-01-01

    Full Text Available Avascular necrosis (AVN of the scaphoid secondary to corticosteroid use is a rare entity. Previous reports in the literature refer to chronic steroid intake. We report a case secondary to low dose, short term use. AVN has a multifactorial cellular and genetic aetiology and most frequently affects the femoral head. Diagnosis relies on a high index of suspicion and early magnetic resonance (MR scanning. Treatment options are similar to those of traumatic scaphoid nonunions and include vascularised bone grafting and scaphoid excision. Polymyalgia Rheumatica is a common condition and its treatment is led by corticosteroid use. Mild to moderate strengths are advocated. However in our report we show that even with small doses serious adverse effects can be encountered.

  15. MR imaging of avascular femoral head necrosis - pre- and postoperative studies. Prae- und postoperative kernspintomographische Untersuchungen bei avaskulaeren Hueftkopfnekrosen

    Energy Technology Data Exchange (ETDEWEB)

    Schedel, H; Ziegler, L; Vogl, T; Hilbertz, T; Lissner, J [Muenchen Univ. (Germany). Radiologische Klinik und Poliklinik; Buchner, H [Muenchen Univ. (Germany). Orthopaedische Klinik und Poliklinik

    1992-05-01

    46 patients with avascular necrosis of the femoral head were examined by T[sub 2]- and T[sub 1]-weighted MR before and after infusion of Gd-DTPA. Both sides were involved in 12 cases. The classification was done according to Ficat. In early stages and in postoperative studies a correlation of signal intensity after infusion of Gd-DTPA and clinical symptoms was found. Hyperintensity of the avascular area or of the implanted material was assumed to be vascularised or vital components in 4 cases of Ficat 1 and 15 postoperative studies. Contrariwise, we found in 5 patients with severe postoperative symptoms, low signal intensity areas due to avascular regions. (orig.).

  16. [Elective lymph node dissection in malignant melanoma--status of color Doppler findings].

    Science.gov (United States)

    Omlor, G; Dill-Müller, D; Gross, G; Kautz, G; Schüder, G; Zaun, H; Feifel, G

    1996-01-01

    Since there is still a controversial discussion about the ELND in melanoma patients, the purpose of this prospective study was to optimize the indication concerning ELND by ultrasound examinations. 144 patients with primary melanomas were checked every 3 months after excision. Echomorphologic pattern and intranodal vascularisation in the color-flow Doppler modus provide essential information for differential diagnosis. We found 47 patients (32.6%) with suspicious ultrasound lesions. 50% of these patients had no pathological clinical findings, the histological findings of excised lymph nodes were positive in all cases. It must be emphasized, however, that the group with lymph node metastases included 12 patients with low-risk-melanomas (2 x Tis, 10 x T1 historical control group (141 patients), where ELND was performed routinely in high-risk-patients ( > T2), the incidence of ELND in our hospital decreased more than 50%; at the same time the percentage of detected lymph node metastases increased (twice).

  17. Vascularized osseous graft for scaphoid

    International Nuclear Information System (INIS)

    Mendez Daza, Carlos Hernan; Mathoulin, Cristophe

    2004-01-01

    The most commonly used technique for treatment of pseudo-arthrosis of the scaphoid is osteo-synthesis with Kirschnet wires and cortical sponge grafts. Results reported by different teams using this procedure show no more than 90% osseous consolidation, especially in cases where vascularisation of the proximal fragment of the scaphoid is compromised. Here we present a series of ten cases of pseudo-arthrosis of the scaphoid, treated using a new surgical technique involving a vascularized osseous graft of the distal radius. Using this procedure we obtained 100% consolidation, with no complications either during the procedure or immediately post-operatively. Patients returned to work in week 15 on average. In 4 cases we observed discomfort in the area of the scar, which was successfully treated using local cortisone injection. The results obtained are very similar to those seen in the literature on the different techniques for vascularized osseous grafts for pseudo-arthrosis of the scaphoid

  18. High-mobility group B1 (HMGB1) and receptor for advanced glycation end-products (RAGE) expression in canine lymphoma.

    Science.gov (United States)

    Sterenczak, Katharina A; Joetzke, Alexa E; Willenbrock, Saskia; Eberle, Nina; Lange, Sandra; Junghanss, Christian; Nolte, Ingo; Bullerdiek, Jörn; Simon, Daniela; Murua Escobar, Hugo

    2010-12-01

    Canine lymphoma is a commonly occurring, spontaneously developing neoplasia similar to human non-Hodgkin's lymphoma and, thus, is used as a valuable model for human malignancy. HMGB1 and RAGE are strongly associated with tumour progression and vascularisation. Consequently, deregulated RAGE and HMGB1 may play an important role in the mechanisms involved in lymphoma progression. Expression patterns of HMGB1 and RAGE were analysed in 22 canine lymphoma and three canine non-neoplastic control samples via real time PCR and canine beta-glucuronidase gene (GUSB) as endogenous control. HMGB1 was up-regulated in the neoplastic samples, while RAGE expression remained inconspicuous. This study demonstrated similar mechanisms in lymphoma progression in humans and dogs due to overexpression of HMGB1, which was described in human lymphomas. RAGE remained stable in terms of expression indicating that the extracellular HMGB1-induced effects are regulated by HMGB1 itself.

  19. Studies of Cell-Mediated Immunity Against Immune Disorders Using Synthetic Peptides and Rotating Bioreactor System

    Science.gov (United States)

    Sastry, Jagannadha K.

    1997-01-01

    Our proposed experiments included: (1) immunzing mice with synthetic peptides; (2) preparing spleen and lymph node cells; (3) growing them under conventional conditions as well as in the rotatory vessel in appropriate medium reconstituting with synthetic peptides and/or cytokines as needed; and (4) comparing at regular time intervals the specific CTL activity as well as helper T-cell activity (in terms of both proliferative responses and cytokine production) using established procedures in my laboratory. We further proposed that once we demonstrated the merit of rotatory vessel technology to achieve desired results, these studies would be expanded to include immune cells from non-human primates (rhesus monkeys and chimpanzees) and also humans. We conducted a number of experiments to determine CTL induction by the synthetic peptides corresponding to antigenic proteins in HIV and HPV in different mouse strains that express MHC haplotypes H-2b or H-2d. We immunized mice with 100 ug of the synthetic peptide, suspended in sterile water, and emulsified in CFA (1:1). The immune lymph node cells obtained after 7 days were restimulated by culturing in T25 flask, HARV-10, or STLV-50, in the presence of the peptide at 20 ug/ml. The results from the 5'Cr-release assay consistently revealed complete abrogation of CTL activity of cells grown in the bioreactors (both HARV and STLV), while significant antigen-specific CTL activity was observed with cells cultured in tissue culture flasks. Thus, overall the data we generated in this study proved the usefulness of the NASA-developed developed technology for understanding the known immune deficiency during space travel. Additionally, this ex vivo microgravity technology since it mimics effectively the in vivo situation, it is also useful in understanding immune disorders in general. Thus, our proposed studies in TMC-NASA contract round II application benefit from data generated in this TMC-NASA contract round I study.

  20. Clarifying tetrapod embryogenesis by a dorso-ventral analysis of the tissue flows during early stages of chicken development.

    Science.gov (United States)

    Fleury, Vincent

    2012-09-01

    The formation of an animal body remains largely a mystery. It is still not clear whether anything like an organization plan or an "archetype" as coined by Darwin himself, actually exists, or whether animals are organized by a succession of stop-and-go genetic, non-linear, instructions with no global pattern. Nevertheless, it was recognized long ago that the early stages of amniote development consist of large scale rotatory movements over a discoidal blastula (Wetzel, 1924). Such rotatory movements reshuffle a mass inside a finite volume, and thus may have to bear physical conservation laws which contribute to establish the plan of animals in a global fashion. In this article I use dual dorso-ventral imaging of the chicken blastula, to show experimentally that the global movement of early vertebrate embryogenesis is organized with a very simple topology, around and away of a series of hyperbolic points in the vector flow of movement. At the first hyperbolic point, a layer of tissue (the mesoderm) ingresses and moves as a viscous sheet radially. It is found that the sheet flows away with a scaling law for the radius R(t)∼exp(t/τ). Also, the movement of this mesoderm changes the flow on the other layer (the ectoderm) by the principle of action and reaction. By mesoderm wetting the ectoderm, the first hyperbolic point migrates from the anal region, to the umbilical region. The final location of the hyperbolic point defines eventually the central part of the body (the umbilical region). Thus, the formation of the vertebrate body is fixed, as a global movement, by the dynamics of singular points in the visco-elastic flow, governed by mechanical forces within the tissue. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. The role of arthroscopy in chronic elbow instability.

    Science.gov (United States)

    Goodwin, David; Dynin, Maria; Macdonnell, J Ryan; Kessler, Michael W

    2013-12-01

    Elbow arthroscopy has had an emerging role in the management of many disorders of the elbow. In patients with chronic elbow instability, several arthroscopic techniques have been described in the diagnosis and management of posterolateral rotatory instability and valgus instability. We performed a systematic review investigating the role of arthroscopy in posterolateral rotatory instability and valgus instability in the elbow using the PubMed and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases, and the Cochrane Database of Systematic Reviews, consisting of articles from peer-reviewed journals published in the English language after January 1, 1991. Search criteria initially identified 249 articles. Twenty-five articles met criteria for inclusion. This included 17 review articles, 4 cadaveric studies, 3 retrospective studies, and 1 prospective study. Two of the retrospective studies compared arthroscopic and open techniques. Articles included in this systematic review concluded that arthroscopy is an accurate adjunct to physical examination and imaging in the diagnosis of chronic elbow instability and affords an exceptional view of the joint with the ability to address intra-articular pathologic conditions. Arthroscopic surgical techniques have shown equivalent clinical outcomes in a comparison of arthroscopic and open techniques. Elbow arthroscopy is a valuable tool in the diagnosis and management of chronic elbow instability. Patients treated arthroscopically benefit from additional diagnostic techniques, improved visualization of the elbow joint, the ability to address coexisting intra-articular pathologic conditions, and minimal soft tissue injury with no clinical consequences in outcomes. With such significant advantages, the use of elbow arthroscopy is likely to expand in the management of chronic elbow instability. Level IV, systematic review. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc

  2. Semi-supervised weighted kernel clustering based on gravitational search for fault diagnosis.

    Science.gov (United States)

    Li, Chaoshun; Zhou, Jianzhong

    2014-09-01

    Supervised learning method, like support vector machine (SVM), has been widely applied in diagnosing known faults, however this kind of method fails to work correctly when new or unknown fault occurs. Traditional unsupervised kernel clustering can be used for unknown fault diagnosis, but it could not make use of the historical classification information to improve diagnosis accuracy. In this paper, a semi-supervised kernel clustering model is designed to diagnose known and unknown faults. At first, a novel semi-supervised weighted kernel clustering algorithm based on gravitational search (SWKC-GS) is proposed for clustering of dataset composed of labeled and unlabeled fault samples. The clustering model of SWKC-GS is defined based on wrong classification rate of labeled samples and fuzzy clustering index on the whole dataset. Gravitational search algorithm (GSA) is used to solve the clustering model, while centers of clusters, feature weights and parameter of kernel function are selected as optimization variables. And then, new fault samples are identified and diagnosed by calculating the weighted kernel distance between them and the fault cluster centers. If the fault samples are unknown, they will be added in historical dataset and the SWKC-GS is used to partition the mixed dataset and update the clustering results for diagnosing new fault. In experiments, the proposed method has been applied in fault diagnosis for rotatory bearing, while SWKC-GS has been compared not only with traditional clustering methods, but also with SVM and neural network, for known fault diagnosis. In addition, the proposed method has also been applied in unknown fault diagnosis. The results have shown effectiveness of the proposed method in achieving expected diagnosis accuracy for both known and unknown faults of rotatory bearing. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  3. Modified classification and single-stage microsurgical repair of posttraumatic infected massive bone defects in lower extremities.

    Science.gov (United States)

    Yang, Yun-fa; Xu, Zhong-he; Zhang, Guang-ming; Wang, Jian-wei; Hu, Si-wang; Hou, Zhi-qi; Xu, Da-chuan

    2013-11-01

    Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single stage. A total of 51 cases of posttraumatic infected massive bone defect in lower extremity were included in this study. They were classified into four types on the basis of the conditions of the bone defects, soft tissue defects, and injured limb length, including Type A (without soft tissue defects), Type B (with soft tissue defects of 10 × 20 cm or less), Type C (with soft tissue defects of 10 × 20 cm or more), and Type D (with the limb shortening of 3 cm or more). Four types of single-stage microsurgical repair protocols were planned accordingly and implemented respectively. These protocols included the following: Protocol A, where vascularized fibular graft was implemented for Type A; Protocol B, where vascularized fibular osteoseptocutaneous graft was implemented for Type B; Protocol C, where vascularized fibular graft and anterior lateral thigh flap were used for Type C; and Protocol D, where limb lengthening and Protocols A, B, or C were used for Type D. There were 12, 33, 4, and 2 cases of Types A, B, C, and D, respectively, according to this classification. During the surgery, three cases of planned Protocol B had to be shifted into Protocol C; however, all microsurgical repairs were completed. With reference to Johner-Wruhs evaluation method, the total percentage of excellent and good results was 82.35% after 6 to 41 months of follow-up. It was concluded that posttraumatic massive bone defects could be accurately classified into four types on the basis of the conditions of bone defects, soft tissue coverage, and injured limb length, and successfully repaired with the single-stage repair protocols after thorough debridement. Thieme Medical

  4. Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee

    Directory of Open Access Journals (Sweden)

    Aggarwal Aditya

    2007-01-01

    Full Text Available Background: Segmental resection of bone in Giant Cell Tumor (GCT around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Materials and Methods: Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years. Resection arthrodesis with telescoping (shortening over intramedullary nail ( n=5, resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail ( n=3 and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening ( n=5 were the procedure performed. Results: Shortening was the major problem following resection arthrodesis with telescoping (shortening over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (~15cm was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an

  5. Prospective study of the " Inside-Out" arthroscopic ankle ligament technique: Preliminary result.

    Science.gov (United States)

    Nery, Caio; Fonseca, Lucas; Raduan, Fernando; Moreno, Marcus; Baumfeld, Daniel

    2017-03-22

    Lateral ankle ligament injury is among the most common orthopedic injuries. The objective of this study is to present the preliminary prospective results of treatment using the "Inside-Out" variant of the fully arthroscopic Broström-Gould technique. Twenty six patients were included: 20 male and 6 female, aged 19-60 years, mean 41 years. All patients had positive "anterior drawer" and "talar tilt" tests. When necessary, cartilage injuries were treated with microfracture and arthroscopic resection for anterior impingement; three patients had hindfoot varus, on whom Dwyer osteotomy was performed; one patient had peroneal tendinopathy and was treated with tendoscopic debridement and another one had partial injury of the deltoid ligament, which was treated by direct repair. Two arthroscopic surgery portals were used; the anteromedial and anterolateral. After careful inspection of the joint, the anterior surface of the fibula was cleaned to resect the remains of the anterior talo-fibular ligament. An anchor with two sutures was placed on the anterior aspect of the fibula, 1cm from the distal apex of the malleolus. The sutures were passed through the remnant of the anterior talo-fibular ligament as well as the extensor retinaculum using special curved needles. Duncan knots were used to tie the ligament and the inferior extensor retinaculum while the ankle was kept in a neutral position. Patients were kept immobilized non-weight bearing for 2 weeks and were then allowed to start weight bearing in a removable protective boot for 4 weeks. The patients were able to return to sporting activities 6 months after surgery. After a mean follow-up of 27 months (range 21-36 months), patients were functionally evaluated using the American Orthopedics Foot and Ankle Society (AOFAS) ankle score. The mean preoperative value was 58 points, while the mean postoperative value increased to 90 points. One patient had paresthesia in the superficial fibular nerve area, which resolved

  6. Polyethylene glycol and contrast-enhanced MRI of Crohn's disease in children: preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Magnano, Gianmichele; Granata, Claudio; Magnaguagno, Francesca; Rossi, Umberto; Toma, Paolo [Service of Radiology, Giannina Gaslini Hospital, Genoa (Italy); Barabino, Arrigo [Department of Gastroenterology, Giannina Gaslini Hospital, Genoa (Italy); Calevo, Maria Grazia [Service of Epidemiology and Biostatistics, Giannina Gaslini Hospital, Genoa (Italy)

    2003-06-01

    To assess the ability of MRI to detect bowel abnormalities in children affected by Crohn's disease (CD). We studied 22 children (age range 8-18 years) referred to us with a known history of CD. MRI was carried out using a 1.5-T unit with a maximum gradient field strength of 16 mT and a phased-array body coil. The sequences performed were breath-hold coronal and axial T2-weighted, express fat saturation, followed by T1-weighted, spoiled gradient, fast fat saturation after IV injection of gadolinium chelate (0.3 mmol/kg) for contrast enhancement of the bowel wall. Bowel distension was achieved using oral administration of isosmotic polyethylene glycol solution. Ileo-colonoscopy was considered the gold standard for evaluation of superficial abnormalities and stenoses of the colon and terminal ileum. MRI findings of bowel-wall thickening, increased vascularisation and extramural involvement were compared with the findings using B-mode and Doppler US. Concordance between MRI and endoscopy, B-mode US and Doppler US findings was determined by the Kappa statistical method. Superficial lesions were not shown by MRI. MR enteroclysis easily detected stenoses, thickening and hyperaemia of bowel wall. Concordance of findings between MRI and endoscopy was 90% (K=0.79, substantial concordance). Concordance of findings between MRI and US concerning bowel-wall thickening and increased vascularisation was 95% (K=0.875, excellent concordance) and 80% (K=0.6, fairly good concordance), respectively. Our initial results show that MRI can detect intra- and extra-mural lesions of CD. The high concordance observed between MRI, endoscopy, US and Doppler US findings suggests that MRI is at least comparable for diagnostic capability with these techniques offering, thanks to multiplanar projections, an improved visualisation of the bowel without ionising radiation. (orig.)

  7. Polyethylene glycol and contrast-enhanced MRI of Crohn's disease in children: preliminary experience.

    Science.gov (United States)

    Magnano, Gianmichele; Granata, Claudio; Barabino, Arrigo; Magnaguagno, Francesca; Rossi, Umberto; Calevo, Maria Grazia; Toma, Paolo

    2003-06-01

    To assess the ability of MRI to detect bowel abnormalities in children affected by Crohn's disease (CD). We studied 22 children (age range 8-18 years) referred to us with a known history of CD. MRI was carried out using a 1.5-T unit with a maximum gradient field strength of 16 mT and a phased-array body coil. The sequences performed were breath-hold coronal and axial T2-weighted, express fat saturation, followed by T1-weighted, spoiled gradient, fast fat saturation after IV injection of gadolinium chelate (0.3 mmol/kg) for contrast enhancement of the bowel wall. Bowel distension was achieved using oral administration of isosmotic polyethylene glycol solution. Ileo-colonoscopy was considered the gold standard for evaluation of superficial abnormalities and stenoses of the colon and terminal ileum. MRI findings of bowel-wall thickening, increased vascularisation and extramural involvement were compared with the findings using B-mode and Doppler US. Concordance between MRI and endoscopy, B-mode US and Doppler US findings was determined by the Kappa statistical method. Superficial lesions were not shown by MRI. MR enteroclysis easily detected stenoses, thickening and hyperaemia of bowel wall. Concordance of findings between MRI and endoscopy was 90% (K=0.79, substantial concordance). Concordance of findings between MRI and US concerning bowel-wall thickening and increased vascularisation was 95% (K=0.875, excellent concordance) and 80% (K=0.6, fairly good concordance), respectively. Our initial results show that MRI can detect intra- and extra-mural lesions of CD. The high concordance observed between MRI, endoscopy, US and Doppler US findings suggests that MRI is at least comparable for diagnostic capability with these techniques offering, thanks to multiplanar projections, an improved visualisation of the bowel without ionising radiation.

  8. Polyethylene glycol and contrast-enhanced MRI of Crohn's disease in children: preliminary experience

    International Nuclear Information System (INIS)

    Magnano, Gianmichele; Granata, Claudio; Magnaguagno, Francesca; Rossi, Umberto; Toma, Paolo; Barabino, Arrigo; Calevo, Maria Grazia

    2003-01-01

    To assess the ability of MRI to detect bowel abnormalities in children affected by Crohn's disease (CD). We studied 22 children (age range 8-18 years) referred to us with a known history of CD. MRI was carried out using a 1.5-T unit with a maximum gradient field strength of 16 mT and a phased-array body coil. The sequences performed were breath-hold coronal and axial T2-weighted, express fat saturation, followed by T1-weighted, spoiled gradient, fast fat saturation after IV injection of gadolinium chelate (0.3 mmol/kg) for contrast enhancement of the bowel wall. Bowel distension was achieved using oral administration of isosmotic polyethylene glycol solution. Ileo-colonoscopy was considered the gold standard for evaluation of superficial abnormalities and stenoses of the colon and terminal ileum. MRI findings of bowel-wall thickening, increased vascularisation and extramural involvement were compared with the findings using B-mode and Doppler US. Concordance between MRI and endoscopy, B-mode US and Doppler US findings was determined by the Kappa statistical method. Superficial lesions were not shown by MRI. MR enteroclysis easily detected stenoses, thickening and hyperaemia of bowel wall. Concordance of findings between MRI and endoscopy was 90% (K=0.79, substantial concordance). Concordance of findings between MRI and US concerning bowel-wall thickening and increased vascularisation was 95% (K=0.875, excellent concordance) and 80% (K=0.6, fairly good concordance), respectively. Our initial results show that MRI can detect intra- and extra-mural lesions of CD. The high concordance observed between MRI, endoscopy, US and Doppler US findings suggests that MRI is at least comparable for diagnostic capability with these techniques offering, thanks to multiplanar projections, an improved visualisation of the bowel without ionising radiation. (orig.)

  9. Osteogenesis and angiogenesis: The potential for engineering bone

    Directory of Open Access Journals (Sweden)

    JM Kanczler

    2008-05-01

    Full Text Available The repair of large bone defects remains a major clinical orthopaedic challenge. Bone is a highly vascularised tissue reliant on the close spatial and temporal connection between blood vessels and bone cells to maintain skeletal integrity. Angiogenesis thus plays a pivotal role in skeletal development and bone fracture repair. Current procedures to repair bone defects and to provide structural and mechanical support include the use of grafts (autologous, allogeneic or implants (polymeric or metallic. These approaches face significant limitations due to insufficient supply, potential disease transmission, rejection, cost and the inability to integrate with the surrounding host tissue.The engineering of bone tissue offers new therapeutic strategies to aid musculoskeletal healing. Various scaffold constructs have been employed in the development of tissue-engineered bone; however, an active blood vessel network is an essential pre-requisite for these to survive and integrate with existing host tissue. Combination therapies of stem cells and polymeric growth factor release scaffolds tailored to promote angiogenesis and osteogenesis are under evaluation and development actively to stimulate bone regeneration. An understanding of the cellular and molecular interactions of blood vessels and bone cells will enhance and aid the successful development of future vascularised bone scaffold constructs, enabling survival and integration of bioengineered bone with the host tissue. The role of angiogenic and osteogenic factors in the adaptive response and interaction of osteoblasts and endothelial cells during the multi step process of bone development and repair will be highlighted in this review, with consideration of how some of these key mechanisms can be combined with new developments in tissue engineering to enable repair and growth of skeletal fractures. Elucidation of the processes of angiogenesis, osteogenesis and tissue engineering strategies offer

  10. [In Vitro and In Vivo Biocompatibility of a Novel, 3-Dimensional Cellulose Matrix Structure].

    Science.gov (United States)

    Dunda, S E; Ranker, M; Pallua, N; Machens, H-G; Ravichandran, A; Schantz, J-T

    2015-12-01

    Biological and physical characteristics of matrices are one essential factor in creating bioartificial tissue. In this study, a new 3-dimensional cellulose matrix (Xellulin(®)) was tested in terms of biocompatibility and applicability for tissue engineering in vitro and in vivo. The tested matrix Xellulin(®) is a natural hydrological gel-matrix containing bacterial cellulose and water. To evaluate the cell biocompatibilty, cell adherence and proliferation characteristics in vitro, the matrix was cultured with human fibroblasts. Further in vivo studies were carried out by transplanting preadipocytes of 4- to 6-week-old Wistar rats with 3 different conditions: a) Xellulin(®) including 500 000 preadipocytes subcutaneous, b) Xellulin(®) including 500 000 preadipocytes within an in vivo bioreactor chamber, c) Xellulin(®) without cells subcutaneous as control. After explantation on day 14 histomorphological and immunohistochemical evaluations were performed. In vitro study revealed an excellent biocompatibility with good cell adherence of the fibroblasts on the matrix and evidence of cell proliferation and creation of a 3-dimensional cell network. In vivo neocapillarisation could be shown in all groups with evidence of erythrocytes (H/E staining) and endothelial vascular cells (RECA-1-staining). A significantly higher vascular density was shown in vascularised bioreactor group (18.4 vessels/100 000 µm(2) (group b) vs. 8.1 (group a), pmatrix was noticed. The promising in vitro results concerning cell adherence and proliferation on the tested matrix could be confirmed in vivo with an evidence of 3-dimensional neocapillarisation. Cell survival was higher in the vascularised group, but without significance. Long-term tests (28-42 days) need to be carried out to evaluate long-term cell survival and the matrix stability. Furthermore, studies concerning the implementation of the matrix within anatomic structures as well as long-term biocompatibility are needed.

  11. Dynamic contrast-enhanced micro-CT on mice with mammary carcinoma for the assessment of antiangiogenic therapy response

    Energy Technology Data Exchange (ETDEWEB)

    Eisa, Fabian [University of Erlangen-Nuremberg, Institute of Medical Physics, Erlangen (Germany); University of Erlangen-Nuremberg, Graduate School in Advanced Optical Technologies (SAOT), Erlangen (Germany); Brauweiler, Robert; Hupfer, Martin; Nowak, Tristan; Kalender, Willi A. [University of Erlangen-Nuremberg, Institute of Medical Physics, Erlangen (Germany); Lotz, Laura; Hoffmann, Inge; Dittrich, Ralf; Beckmann, Matthias W. [University of Erlangen-Nuremberg, OB/GYN, University Hospital Erlangen, Erlangen (Germany); Wachter, David [University Hospital Erlangen, Institute of Pathology, Erlangen (Germany); Jost, Gregor; Pietsch, Hubertus [Bayer Pharma AG, Berlin (Germany)

    2012-04-15

    To evaluate the potential of in vivo dynamic contrast-enhanced micro-computed tomography (DCE micro-CT) for the assessment of antiangiogenic drug therapy response of mice with mammary carcinoma. 20 female mice with implanted MCF7 tumours were split into control group and therapy group treated with a known effective antiangiogenic drug. All mice underwent DCE micro-CT for the 3D analysis of functional parameters (relative blood volume [rBV], vascular permeability [K], area under the time-enhancement curve [AUC]) and morphology. All parameters were determined for total, peripheral and central tumour volumes of interest (VOIs). Immunohistochemistry was performed to characterise tumour vascularisation. 3D dose distributions were determined. The mean AUCs were significantly lower in therapy with P values of 0.012, 0.007 and 0.023 for total, peripheral and central tumour VOIs. K and rBV showed significant differences for the peripheral (P{sub per}{sup K} = 0.032, P{sub per}{sup rBV} = 0.029), but not for the total and central tumour VOIs (P{sub total}{sup K} = 0.108, P{sub central}{sup K} = 0.246, P{sub total}{sup rBV} = 0.093, P{sub central}{sup rBV} = 0.136). Mean tumour volume was significantly smaller in therapy (P{sub in} {sub vivo} = 0.001, P{sub ex} {sub vivo} = 0.005). Histology revealed greater vascularisation in the controls and central tumour necrosis. Doses ranged from 150 to 300 mGy. This study indicates the great potential of DCE micro-CT for early in vivo assessment of antiangiogenic drug therapy response. (orig.)

  12. A mathematical model of the growth of uterine myomas.

    Science.gov (United States)

    Chen, C Y; Ward, J P

    2014-12-01

    Uterine myomas or fibroids are common, benign smooth muscle tumours that can grow to 10  cm or more in diameter and are routinely removed surgically. They are typically slow- growing, well-vascularised, spherical tumours that, on a macro-scale, are a structurally uniform, hard elastic material. We present a multi-phase mathematical model of a fully vascularised myoma growing within a surrounding elastic tissue. Adopting a continuum approach, the model assumes the conservation of mass and momentum of four phases, namely cells/collagen, extracellular fluid, arterial and venous phases. The cell/collagen phase is treated as a poro-elastic material, based on a linear stress-strain relationship, and Darcy's law is applied to describe flow in the extracellular fluid and the two vascular phases. The supply of extracellular fluid is dependent on the capillary flow rate and mean capillary pressure expressed in terms of the arterial and venous pressures. Cell growth and division is limited to the myoma domain and dependent on the local stress in the material. The resulting model consists of a system of nonlinear partial differential equations with two moving boundaries. Numerical solutions of the model successfully reproduce qualitatively the clinically observed three-phase "fast-slow-fast" growth profile that is typical for myomas. The results suggest that this growth profile requires stress-induced resistance to growth by the surrounding tissue and a switch-like cell growth response to stress. Analysis of large-time solutions reveal that while there is a functioning vasculature throughout the myoma, exponential growth results, otherwise power-law growth is predicted. An extensive survey of the effect of parameters on model solutions is also presented, and in particular, the enhanced growth caused by factors such as oestrogen is predicted by the model.

  13. Screening for retinopathy of prematurity: a report from upper Egypt

    Directory of Open Access Journals (Sweden)

    Mahmoud M. Nassar

    2016-02-01

    Full Text Available AIM: To detect the incidence of retinopathy of prematurity (ROP in a tertiary referral neonatal intensive care unit in upper Egypt and to describe the obstacles faced during implementing the screening protocol for the first time. METHODS: Consecutive infants were enrolled at birth and screened for ROP. We used the UK ROP guideline (May 2008 for infant selection, follow up and treatment. Repeat examinations were performed until retinal vascularisation was complete. RESULTS: Fifty-two infants were enrolled: 24 males and 28 females. Mean gestational age was 31.3wk (±2.8 SD and mean birth weight was 1234.6 g (±221.1 SD. Incidence of ROP was 36.5% (stages 1, 2, 3 and 4a were 9.6%, 9.6%, 15.4% and 1.9% respectively, no stages 4b or 5 were found in this series. Six infants (11.5% died during screening without ROP, 25 infants (48.1% were discharged from screening with retinal vascularisation reaching zone III, 5 infants (9.6% were treated with indirect diode with or without additional cryotherapy and 16 infants (30.8% were lost to follow up. In this series gestational age rather than birth weight was found significantly correlated and predictive (P<0.05 with ROP stages. CONCLUSION: ROP in a single site in Upper Egypt appears to have comparable incidence to other areas worldwide. The main screening obstacle was missing cases due to the absence of a national ROP screening protocol.

  14. Nitrogen mustard (Chlorambucil) has a negative influence on early vascular development

    International Nuclear Information System (INIS)

    Schmidt, Annette; Boelck, Birgit; Jedig, Maria; Steinritz, Dirk; Balszuweit, Frank; Kehe, Kai; Bloch, Wilhelm

    2009-01-01

    The sulphur and nitrogen mustards are strong alkylating agents, which induces inflammations of the skin including blistering right up to ulcerations. Depending on the severity, the wounds may need weeks to heal. In the past it was shown that sulphur mustard has a destructive effect on endothelial precursor cells, which have been shown to play a pivotal role in the wound healing reaction by inducing neovascularisation. However, for these alkylating agents as well as for sulphur mustard nothing is known about their effects on endothelial precursors. Therefore, we investigated and compared the influence of Chlorambucil on proliferation, apoptosis and differentiation of endothelial cells in intact mouse embryoid bodies (EB). EBs were treated at different developmental stages and with different periods of Chlorambucil treatment. It was found that in each developmental stage and under each treatment period's Chlorambucil has an extremely negative effect on the vascularisation with a vessel reduction of around 99%. Of particular importance was the negative effect of treatment around day 3 of the development. On this day we found 377 vessels under control conditions but only 1.6 vessels under 24 h treatment of Chlorambucil. At this point in time many endothelial precursors can be found in the EB. Moreover, a negative effect on all stem cells was evident at this point in time, shown by an extreme reduction in EB size with 17.9 mm 2 for the control and only 1.55 mm 2 under Chlorambucil treatment. This negative effect on the vascularisation, on endothelial precursors but also on stem cells in general is of possible importance for impaired wound healing.

  15. Intercalary defects reconstruction of the femur and tibia after primary malignant bone tumour resection. A series of 13 cases.

    Science.gov (United States)

    Brunet, O; Anract, P; Bouabid, S; Babinet, A; Dumaine, V; Toméno, B; Biau, D

    2011-09-01

    Performing intercalary segment reconstruction after malignant bone tumour resection results in both mechanical and biological challenges. Fixation must be solid enough to avoid short-term or mid-term mechanical failure. The use of an allograft or autograft must ensure long-term survival of the reconstruction. The goal of this study was to analyse the clinical and radiological outcomes of these reconstructions. Thirteen patients were operated on eight femurs and five tibias. The median age was 20 years old (range 14-50). The most common diagnosis was osteosarcoma. The median resection length was 15cm (Q1-Q3: 6-26). A plate was used for fixation in nine cases and an intramedullary locked nail in four cases. An isolated bone autograft was used in two cases, an isolated bone allograft in one case, a dual autograft-allograft composite in six cases, and vascularised fibula and allograft combination in four cases. The cumulative probability of union was 46% (95% CI: 0-99%) at 1 year; at the final follow-up, union was achieved in 12 patients (92%). Because of non-unions, 13 iterative procedures were needed to obtain these results. A non-displaced fracture of a cuboid-shaped tibial graft occurred in one patient, which was treated conservatively. Three infections occurred. The results of intercalary segmental defects reconstruction after bone tumour resection were good, both from an oncologic and radiological point-of-view. One or more iterative procedures are sometimes needed to finally obtain bone union. We prefer to use a free rectangular cuboidal tibial graft since reconstruction with a vascularised autograft is technically more difficult. The choice of fixation methods is still controversial and no approach was found to be superior. Level IV. Retrospective study. Copyright © 2011. Published by Elsevier Masson SAS.

  16. Skeletal lesions in a population of Virginia opossums (Didelphis virginiana) from Baldwin County, Georgia.

    Science.gov (United States)

    Mead, Alfred J; Patterson, David B

    2009-04-01

    Antemortem skeletal lesions were analyzed in 61 Virginia opossums (Didelphis virginiana) collected as roadkill from Baldwin County, Georgia, USA. As evidenced by bridging fracture calluses, misalignments, bone-surface depressions, perforations, localized superficial calluses, periosteal proliferations, and bony bridges across intervertebral disk spaces, 64% of the individuals had signs of one or more healed injuries. Within the subset of skeletons with bone lesions, 54% had healed rib fractures and 23% had scapular, 21% pelvic, 18% fibular, 18% vertebral, 13% dentary, 10% tibial, and 10% podial lesions. Bone lesions occurred most frequently in the cranial portion of the skeletons and averaged approximately four per individual. The majority of the skeletal injuries appeared to be inconsistent with those caused by falls or automobile collisions. The nature and position of the bone lesions suggested that nonfatal predator attacks, possibly from domestic dogs, may be a significant contributor to bodily injury in this species.

  17. 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.)

  18. Al-Awadi/Raas-Rothschild/Schinzel (AARRS) phocomelia syndrome: case report and developmental field analysis.

    Science.gov (United States)

    Subhani, Muhammad; Akangire, Gangaram; Kulkarni, Archana; Wilson, Golder N

    2009-07-01

    We describe a girl infant with anomalies of the left pelvis and lower limb (pelvic, femoral, and tibial hypogenesis with absent fibula), subtle facial changes, patent foraman ovale, single umbilical artery, single kidney, and imperforate anus. The external genitalia were asymmetric and ambiguous with normal uterus and ovaries visualized by ultrasound. The anomalies are compatible with previously reported cases of Al-Awadi/Raas-Rothschild/Schinzel (AARRS) phocomelia, an autosomal recessive disorder with WNT7 gene mutations documented in one family. We suggest that AARRS phocomelia, Fuhrmann syndrome, and similar conditions comprise a spectrum, and that the anomaly pattern derives from serial action of the same signal pathways within primary (e.g., the major axes), secondary (e.g., heart or limb primordia), and/or local (e.g., tibial-fibular differentiation) developmental fields.

  19. Unusual cortical bone features in a patient with gorlin-goltz syndrome: a case report.

    Science.gov (United States)

    Tarnoki, Adam Domonkos; Tarnoki, David Laszlo; Klara Kiss, Katalin; Bata, Pal; Karlinger, Kinga; Banvolgyi, Andras; Wikonkal, Norbert; Berczi, Viktor

    2014-12-01

    Gorlin-Goltz syndrome (GGS) consists of ectodermal and mesodermal abnormalities. In this case report we will investigate lower extremity lesions of GGS. A 52-year-old man with GGS underwent skull and lower extremity computer tomography. Radiographic findings included cervical spondylosis, transparent areas with slurred margins, and cerebral falx calcification. Tibial and fibular specific cortical lesions (thin cortical and subcortical cystic lesions) were seen on the radiography, which was confirmed by computer tomography. To our knowledge, this is the first report of such a long lesion of the tibia and fibula. Specific lower extremity cortical lesions (thin cortical and subcortical cystic lesions) may occur and these abnormalities can be found on radiography or CT, which are most probably attributed to retinoid treatment.

  20. Unusual Cortical Bone Features in a Patient with Gorlin-Goltz Syndrome: A Case Report

    International Nuclear Information System (INIS)

    Tarnoki, Adam Domonkos; Tarnoki, David Laszlo; Klara Kiss, Katalin; Bata, Pal; Karlinger, Kinga; Banvolgyi, Andras; Wikonkal, Norbert; Berczi, Viktor

    2014-01-01

    Gorlin-Goltz syndrome (GGS) consists of ectodermal and mesodermal abnormalities. In this case report we will investigate lower extremity lesions of GGS. A 52-year-old man with GGS underwent skull and lower extremity computer tomography. Radiographic findings included cervical spondylosis, transparent areas with slurred margins, and cerebral falx calcification. Tibial and fibular specific cortical lesions (thin cortical and subcortical cystic lesions) were seen on the radiography, which was confirmed by computer tomography. To our knowledge, this is the first report of such a long lesion of the tibia and fibula. Specific lower extremity cortical lesions (thin cortical and subcortical cystic lesions) may occur and these abnormalities can be found on radiography or CT, which are most probably attributed to retinoid treatment

  1. Bone morphology of the hind limbs in two caviomorph rodents.

    Science.gov (United States)

    de Araújo, F A P; Sesoko, N F; Rahal, S C; Teixeira, C R; Müller, T R; Machado, M R F

    2013-04-01

    In order to evaluate the hind limbs of caviomorph rodents a descriptive analysis of the Cuniculus paca (Linnaeus, 1766) and Hydrochoerus hydrochaeris (Linnaeus, 1766) was performed using anatomical specimens, radiography, computed tomography (CT) and full-coloured prototype models to generate bone anatomy data. The appendicular skeleton of the two largest rodents of Neotropical America was compared with the previously reported anatomical features of Rattus norvegicus (Berkenhout, 1769) and domestic Cavia porcellus (Linnaeus, 1758). The structures were analyzed macroscopically and particular findings of each species reported. Features including the presence of articular fibular projection and lunulae were observed in the stifle joint of all rodents. Imaging aided in anatomical description and, specifically in the identification of bone structures in Cuniculus paca and Hydrochoerus hydrochaeris. The imaging findings were correlated with the anatomical structures observed. The data may be used in future studies comparing these animals to other rodents and mammalian species. © 2012 Blackwell Verlag GmbH.

  2. Oral and masticatory rehabilitation using osseointegrated dental implants after resective treatment of multicystic ameloblastoma in the lower jaw with a fibula graft

    Directory of Open Access Journals (Sweden)

    João Ricardo Almeida Grossi

    2018-01-01

    Full Text Available Ameloblastoma is an aggressive odontogenic tumor which typically occurs between third and fourth decade of life that often needs resective approach. Immediate reconstruction may show better results. The treatment of multicystic ameloblastoma in the mandible being a rare case that occurred in the late second decade of life, which was surgically removed along with the affected teeth with safety margins, and the region was immediately reconstructed using a vascularized graft, removed from the fibula. Its integration, in combination with osseointegrated dental implants and fixed implant-supported prostheses, restored chewing function and esthetics. After 6 years from fibular graft and 24 months of dental implants, an excellent outcome was observed, with oral health and normal functions properly restored, and the immediate reconstruction of the mandible in resective cases, associated with oral rehabilitation with dental implants, may be considered a suitable treatment option.

  3. Hip Dislocation and Dystocia in Early Medieval Times: Possible Evidence of Labor Maneuver.

    Science.gov (United States)

    Malgosa, Assumpció; Carrascal, Susana; Piga, Giampaolo; Isidro, Albert

    2016-12-01

    In ancient times, maternal mortality would occur frequently, particularly during labor. Evidence of dystocia resulting in the death of a pregnant woman is very infrequent in paleopathologic literature, with only a few cases being demonstrated. In the early medieval site of Casserres, the skeleton of a young woman with a fetus in the pelvic region was found. Some abnormal findings of the maternal skeleton were evaluated, including a sacral anomaly, femoral head wound, the rare position of the lower left limb with the femoral head dislodged anteriorly and cephalad from the socket, and a fibular fracture. Examining the anomalies all together, a case of anterior hip dislocation related to a McRoberts-like maneuver performed during labor is a plausible explanation of the findings.

  4. Case Report: Gollop-Wolfgang Complex in a 5 month old baby [v3; ref status: indexed, http://f1000r.es/53y

    Directory of Open Access Journals (Sweden)

    Ihtesham A. Qureshi

    2015-02-01

    Full Text Available Skeletal dysplasias are disorders associated with a generalized abnormality in the skeleton. The Gollop-Wolfgang complex (GWC is a limb deficiency disorder and an unusual limb malformation with highly variable manifestations. Here we report an interesting case of a 5-month old male baby from India with Gollop-Wolfgang Complex showing bifurcation of the right femur, ectrodactyly of both feet, ectrodactyly of left hand, syndactyly of right hand and unusual presentation of bilateral fibular agenesis and caudal (Sacrococcygeal agenesis. The etiology of GWC in this 5 month old male baby could possibly be attributed to spontaneous gene mutation. The clinical, radiographic findings and the unusual presentation are presented in detail.

  5. [Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker].

    Science.gov (United States)

    Bucur, A; Dincă, O; Totan, C; Ghită, V

    2007-01-01

    The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

  6. Nucleolar organizer regions in Sittasomus griseicapillus and Lepidocolaptes angustirostris (Aves, Dendrocolaptidae): Evidence of a chromosome inversion.

    Science.gov (United States)

    de Oliveira Barbosa, Marcelo; da Silva, Rubens Rodrigues; de Sena Correia, Vanessa Carolina; Dos Santos, Luana Pereira; Garnero, Analía Del Valle; Gunski, Ricardo José

    2013-03-01

    Cytogenetic studies in birds are still scarce compared to other vertebrates. Woodcreepers (Dendrocolaptidae) are part of a highly specialized group within the Suboscines of the New World. They are forest birds exclusive to the Neotropical region and similar to woodpeckers, at a comparable evolutionary stage. This paper describes for the first time the karyotypes of the Olivaceous and the Narrow-billed Woodcreeper using conventional staining with Giemsa and silver nitrate staining of the nucleolar organizer regions (Ag-NORs). Metaphases were obtained by fibular bone marrow culture. The chromosome number of the Olivaceous Woodcreeper was 2n = 82 and of the Narrow-billed Woodcreeper, 2n = 82. Ag-NORs in the largest macrochromosome pair and evidence of a chromosome inversion are described herein for the first time for this group.

  7. Angles measuring on radiographic images as a tool for the diagnosis of Blount disease

    International Nuclear Information System (INIS)

    Mora Rojas, Raul

    2010-01-01

    The etiology of Blount disease has followed unknown at the present; although are described factors that could be related to the appearance of the same. Even, to make the diagnosis of this disease remains a challenge, due to it difficult to predict the behavior of the tibia varus in young children. Some measures were described in the radiographs of patients with tibia vara (the most currently used has been the Tibial Proximal Diaphyseal Goal Angle) to try to provide another tool in the diagnosis, but without be able to establish a free relationship between disruption of these measures with the pathological development of tibial varus. A new measurement (Tibial Proximal Fibular Mechanic Angle) established in the radiographs has been the purpose, taking into account the structures and concepts that are altered in patients with Blount diseases. The proximal tibial physis and the mechanical axis of the tibia are performed without to take into account in some of the measurements described above. (author) [es

  8. Imaging features of lower limb malformations above the foot.

    Science.gov (United States)

    Bergère, A; Amzallag-Bellenger, E; Lefebvre, G; Dieux-Coeslier, A; Mezel, A; Herbaux, B; Boutry, N

    2015-09-01

    Lower limb malformations are generally isolated or sporadic events. However, they are sometimes associated with other anomalies of the bones and/or viscera in patients with constitutional syndromes or disorders of the skeleton. This paper reviews the main imaging features of these abnormalities, which generally exhibit a broad spectrum. This paper focuses on several different bone malformations: proximal focal femoral deficiency, congenital short femur and femoral duplication for the femur, tibial hemimelia (aplasia/hypoplasia of the tibia) and congenital bowing for the tibia, fibular hemimelia (aplasia/hypoplasia) for the fibula, and aplasia, hypoplasia and congenital dislocation for the patella. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  9. Reconstruction of bilateral tibial aplasia and split hand-foot syndrome in a father and daughter.

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    Al Kaissi, Ali; Ganger, Rudolf; Klaushofer, Klaus; Grill, Franz

    2014-01-01

    Tibial aplasia is of heterogeneous aetiology, the majority of reports are sporadic. We describe the reconstruction procedures in two subjects - a daughter and father manifested autosomal dominant (AD) inheritance of the bilateral tibial aplasia and split hand-foot syndrome. Reconstruction of these patients required multiple surgical procedures and orthoprosthesis was mandatory. The main goal of treatment was to achieve walking. Stabilization of the ankle joint by fibular-talar-chondrodesis on both sides, followed by bilateral Brown-procedure at the knee joint level has been applied accordingly. The outcome was with improved function of the deformed limbs and walking was achieved with simultaneous designation of orthotic fitting. This is the first study encompassing the diagnosis and management of a father and daughter with bilateral tibial aplasia associated with variable split hand/foot deformity without foot ablation. Our patients showed the typical AD pattern of inheritance of split-hand/foot and tibial aplasia.

  10. New sonographic measures of peripheral nerves: a tool for the diagnosis of peripheral nerve involvement in leprosy

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    Marco Andrey Cipriani Frade

    2013-05-01

    Full Text Available To evaluate ultrasonographic (US cross-sectional areas (CSAs of peripheral nerves, indexes of the differences between CSAs at the same point (∆CSAs and between tunnel (T and pre-tunnel (PT ulnar CSAs (∆TPTs in leprosy patients (LPs and healthy volunteers (HVs. Seventy-seven LPs and 49 HVs underwent bilateral US at PT and T ulnar points, as well as along the median (M and common fibular (CF nerves, to calculate the CSAs, ∆CSAs and ∆TPTs. The CSA values in HVs were lower than those in LPs (p 80% and ∆TPT had the highest specificity (> 90%. New sonographic peripheral nerve measurements (∆CSAs and ∆TPT provide an important methodological improvement in the detection of leprosy neuropathy.

  11. Paxillin localisation in osteocytes-Is it determined by the direction of loading?

    International Nuclear Information System (INIS)

    Vatsa, A.; Semeins, C.M.; Smit, T.H.; Klein-Nulend, J.

    2008-01-01

    External mechanical loading of cells aligns cytoskeletal stress fibres in the direction of principle strains and localises paxillin to the mechanosensing region. If the osteocyte cell body can indeed directly sense matrix strains, then cytoskeletal alignment and distribution of paxillin in osteocytes in situ will bear alignment to the different mechanical loading patterns in fibulae and calvariae. We used confocal microscopy to visualise the immunofluorescence-labelled actin cytoskeleton in viable osteocytes and paxillin distribution in fixated osteocytes in situ. In fibular osteocyte cell bodies, actin cytoskeleton and nuclei were elongated and aligned parallel to the principal (longitudinal) mechanical loading direction. Paxillin was localised to the 'poles' of elongated osteocyte cell bodies. In calvarial osteocyte cell bodies, actin cytoskeleton and nuclei were relatively more round. Paxillin was distributed evenly in the osteocyte cell bodies. Thus in osteocyte cell bodies in situ, the external mechanical loading pattern likely determines the orientation of the actin cytoskeleton, and focal adhesions mediate direct mechanosensation of matrix strains.

  12. Nucleolar organizer regions in Sittasomus griseicapillus and Lepidocolaptes angustirostris (Aves, Dendrocolaptidae: evidence of a chromosome inversion

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    Marcelo de Oliveira Barbosa

    2013-01-01

    Full Text Available Cytogenetic studies in birds are still scarce compared to other vertebrates. Woodcreepers (Dendrocolaptidae are part of a highly specialized group within the Suboscines of the New World. They are forest birds exclusive to the Neotropical region and similar to woodpeckers, at a comparable evolutionary stage. This paper describes for the first time the karyotypes of the Olivaceous and the Narrow-billed Woodcreeper using conventional staining with Giemsa and silver nitrate staining of the nucleolar organizer regions (Ag-NORs. Metaphases were obtained by fibular bone marrow culture. The chromosome number of the Olivaceous Woodcreeper was 2n = 82 and of the Narrow-billed Woodcreeper, 2n = 82. Ag-NORs in the largest macrochromosome pair and evidence of a chromosome inversion are described herein for the first time for this group.

  13. A delayed presentation of ameloblastic fibrosarcoma in an African patient.

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    Chauke, Nkhensani Yvonne; Sofianos, Chrysis; Liakos, Dimitri; Ndobe, Elias

    2017-08-01

    A 24-year-old womanpresented with ameloblastic fibrosarcoma arising from ameloblastic fibroma. The delayed presentation accounted for the extensive destruction of the mandible and complete occlusion of her oral cavity. This resulted in an inability to eat and maintain oral hygiene. A multidisciplinary team management approach involved nutritional optimisation, segmental mandibulectomy, reconstruction with a reconstructive plate and a free anterolateral thigh flap to line the the floor of mouth. Functional and aesthetic outcome was acceptable, and the patient is planned for secondary free fibular flap bony reconstruction. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Saving a Child’s Elbow Joint: A Novel Reconstruction for a Tumour of the Distal Humerus

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    Calogero Graci

    2015-01-01

    Full Text Available Reconstruction after wide resection of a malignant bone tumor can be obtained using several techniques such as the use of prostheses, allograft, autograft, or combined procedure. We describe a 12-year-old girl with parosteal osteosarcoma of the distal right humerus treated by en bloc resection, intraoperative extracorporeal irradiation, and implantation. We inserted a nonvascularised fibular autograft through the middle of irradiated graft to obtain a greater stability. We have not recorded any complication associated with this technique such as nonunion, pathological fracture, infection, and bone necrosis and we obtained an excellent functional result. 10 years after surgery, the patient had no recurrence. Extracorporeal irradiation and reimplantation is a valid and inexpensive technique for the treatment of bone tumors when there is reasonable residual bone stock. With this procedure we have a precise fit being the patient’s own bone. In this way we avoid all the problems related to the adaptation of the shape and size.

  15. Primary Ankle Arthrodesis for Severely Comminuted Tibial Pilon Fractures.

    Science.gov (United States)

    Al-Ashhab, Mohamed E

    2017-03-01

    Management of severely comminuted, complete articular tibial pilon fractures (Rüedi and Allgöwer type III) remains a challenge, with few treatment options providing good clinical outcomes. Twenty patients with severely comminuted tibial pilon fractures underwent primary ankle arthrodesis with a retrograde calcaneal nail and autogenous fibular bone graft. The fusion rate was 100% and the varus malunion rate was 10%. Fracture union occurred at a mean of 16 weeks (range, 13-18 weeks) postoperatively. Primary ankle arthrodesis is a successful method for treating highly comminuted tibial pilon fractures, having a low complication rate and a high satisfaction score. [Orthopedics. 2017; 40(2):e378-e381.]. Copyright 2016, SLACK Incorporated.

  16. Bioabsorbable metal screws in traumatology: A promising innovation

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    Roland Biber

    2017-04-01

    Full Text Available MAGNEZIX® CS (Syntellix AG, Hanover, Germany is a bioabsorbable compression screw made of a magnesium alloy (MgYREZr. Currently there are only two clinical studies reporting on a limited number of elective patients who received this screw in a hallux valgus operation. We applied MAGNEZIX® CS for fixation of distal fibular fracture in a trauma patient who had sustained a bimalleolar fracture type AO 44-B2.3. Clinical course was uneventful, fracture healing occurred within three months. Follow-up X-rays showed a radiolucent area around the implant for some months, yet this radiolucent area had disappeared in the 17-months follow-up X-ray. Keywords: Magnesium, Bioabsorbable, Compression screw, Osteosynthesis, Ankle fracture

  17. 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.

  18. Global Reconstruction for Extensive Destruction in Tuberculosis of the Lumbar Spine and Lumbosacral Junction: A Case Report

    Science.gov (United States)

    Uvaraj, Nalli R.; Bosco, Aju; Gopinath, Nalli R.

    2014-01-01

    Study Design Case report. Objective To analyze the surgical difficulties in restoring global spinal stability and to describe an effective surgical option for tuberculosis with extensive destruction of the lumbosacral spine. Advanced tuberculosis with destruction of the lumbosacral spine can result in a kyphosis or hypolordosis, leading to back pain, spinal instability, and neurological deficits. The conventional treatment goals of lumbosacral tuberculosis are to correct and prevent a lumbar kyphosis, treat or prevent a neurological deficit, and restore global spinal stability. Instrumentation at the lumbosacral junction is technically demanding due to the complex local anatomy, the unique biomechanics, and the difficult fixation in the surrounding diseased bone. Methods We report a 21-year-old woman with tuberculosis from L1 to S2 with back pain and spinal instability. The radiographs showed a kyphosis of the lumbar spine. The magnetic resonance imaging and computed tomography scans revealed extensive destruction of the lumbar and lumbosacral spine. Spinopelvic stabilization combined with anterior debridement and reconstruction with free fibular strut graft was performed. Results The radiographs at follow-up showed a good correction of the kyphosis and excellent graft incorporation and fusion. Conclusions Anterior column reconstruction with a fibular strut graft helps restore and maintain the vertebral height. Posterior stabilization with spinopelvic fixation can be an effective surgical option for reconstructing the spine in extensive lumbosacral tuberculosis with sacral body destruction, requiring long fusions to the sacrum. It augments spinal stability, prevents graft-related complications, and accelerates the graft incorporation and fusion, thereby permitting early mobilization and rehabilitation. In spinal tuberculosis, antitubercular therapy may have to be prolonged in cases with large disease load, based on the clinicoradiographic and laboratory

  19. 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.)

  20. 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.)

  1. A new approach to assess the gastrocnemius muscle volume in rodents using ultrasound; comparison with the gastrocnemius muscle index.

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    Tim H J Nijhuis

    Full Text Available INTRODUCTION: The purpose of this study was to determine the reliability and validity of a new non-invasive ultrasound technique to measure gastrocnemius muscle atrophy after nerve denervation in an animal model. METHODS: In sixteen rodents an eight mm sciatic nerve gap was created. In the following 8 weeks, each week, two rodents were euthanized and the gastrocnemius muscle was examined using two different ultrasound systems and two investigators. The standardized ultrasound measurement protocol consisted of identifying pre-defined anatomical landmarks: 1 the fibula, 2 the fibular nerve, and 3 the junction between the most distal point of the semitendinosus muscle and gastrocnemius muscle. Consequently, we measured the muscle thickness as the length of the line between the fibula and the junction between the two muscles, perpendicular to the fibular nerve. After the ultrasound recording, the muscle mass was determined. RESULTS: A steep decline of muscle weight of 24% was observed after one week. In the following weeks, the weight further decreased and then remained stable from 6 weeks onwards, resulting in a maximal muscle weight decrease of 82%. The correlation coefficient was >0.96 between muscle diameter and weight using both ultrasound systems. The inter-rater reliability was excellent for both devices on the operated side (ICC of 0.99 for both ultrasound systems and good for the non-operated site (ICC's: 0.84 & 0.89. The difference between the muscle mass ratio and the muscle thickness ratio was not more than 5% with two outliers of approximately 13%. DISCUSSION: We have developed an innovative, highly reliable technique for quantifying muscle atrophy after nerve injury. This technique allows serial measurements in the same animal over time. This is a significant advantage compared to the conventional technique for quantifying muscle atrophy, which requires sacrificing the animal.

  2. 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.

  3. Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

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    James C. Anderson

    2017-07-01

    Full Text Available IntroductionRestless legs syndrome (RLS is a prevalent sleep disorder affecting quality of life and is often comorbid with other neurological diseases, including peripheral neuropathy. The mechanisms related to RLS symptoms remain unclear, and treatment options are often aimed at symptom relief rather than etiology. RLS may present in distinct phenotypes often described as “primary” vs. “secondary” RLS. Secondary RLS is often associated with peripheral neuropathy. Nerve decompression surgery of the common and superficial fibular nerves is used to treat peripheral neuropathy. Anecdotally, surgeons sometimes report improved RLS symptoms following nerve decompression for peripheral neuropathy. The purpose of this retrospective analysis was to quantify the change in symptoms commonly associated with RLS using visual analog scales (VAS.MethodsForty-two patients completed VAS scales (0–10 for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression.ResultsSubjects reported significant improvement among all VAS categories, except for “pulling” (P = 0.14. The change in VAS following surgery was negatively correlated with the pre-surgery VAS for both the summed VAS (r = −0.58, P < 0.001 and the individual VAS scores (all P < 0.01, such that patients who reported the worst symptoms before surgery exhibited relatively greater reductions in symptoms after surgery.ConclusionThis is the first study to suggest improvement in RLS symptoms following surgical decompression of the common and superficial fibular nerves. Further investigation is needed to quantify improvement using RLS-specific metrics and sleep quality assessments.

  4. Estudo das relações anatômicas e suas variações entre o nervo ciático e o músculo piriforme Study on anatomical relationships and variations between the sciatic nerve and piriform muscle

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    EJD Vicente

    2007-06-01

    Full Text Available CONTEXTO: A síndrome do músculo piriforme pode ter como causa a passagem anormal do nervo ciático ou de uma de suas partes pelo ventre do músculo piriforme. OBJETIVO: Analisar as relações anatômicas e métricas entre o músculo piriforme e o nervo ciático, contribuindo com o conhecimento anátomo-clínico da região glútea. MÉTODO: Foram utilizados 20 cadáveres adultos de ambos os sexos. O nervo ciático e o músculo piriforme foram dissecados, medidos e fotodocumentados. RESULTADOS: Observou-se que 85% das 40 regiões glúteas apresentaram o nervo como tronco único, passando pela borda inferior do músculo piriforme, e 15% mostraram uma variação bilateral, caracterizada pela passagem do nervo fibular comum através do músculo piriforme. Os dados obtidos não revelaram diferenças estatisticamente significantes.CONTEXT: Piriform muscle syndrome can be caused by abnormal passage of the sciatic nerve or one of its parts through the belly of the piriform muscle. OBJECTIVE: To analyze the anatomical and measurement relationships between the piriform muscle and the sciatic nerve in order to contribute towards better anatomoclinical understanding of the gluteal region. METHOD: Twenty adult cadavers of both sexes were used. The sciatic nerve and piriform muscle were dissected, measured and photodocumented. RESULTS: The sciatic nerve was seen to be a single trunk passing through the lower margin of the piriform muscle in 85% of the 40 gluteal regions, and 15% showed bilateral variation characterized by the passage of the common fibular nerve through the piriform muscle. The data obtained did not show any statistically significant differences.

  5. Ipsilateral stress fracture of the proximal fibula after total knee arthroplasty in a patient with severe valgus knee deformity on a background of Rheumatoid arthritis

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    Hirokazu Takai

    Full Text Available Introduction: Previous studies have reported a lower extremity stress fracture after total knee arthroplasty (TKA. However, a fibular fracture after TKA is quite rare. We report a case of proximal fibula fracture after TKA in a patient with rheumatoid arthritis (RA. Presentation of case: A 45 year old woman with RA had severe knee and foot pain with an antalgic gait disturbance. There was a significant joint deformity in many of lower limb joints. Interval bilateral TKAs were performed two weeks apart. Right TKA was performed using a constraint-type prosthesis, through lateral parapatellar approach. Left TKA was performed using a posterior-stabilized (PS prosthesis through the more commonly employed, medial parapatellar approach. Seven weeks after the right TKA, the patient was found to have an atraumatic proximal fibular fracture. The fracture went on to heal conservatively. Discussion: The fracture was considered to have occurred after the TKA. The callus appeared eleven weeks after the TKA. The factors that contributed to the fracture were thought to be overload of the fragile bone secondarily to disuse osteopaenia, RA or potentially the significant valgus malalignment correction. The surgical approach, the implant or implantation or the persisting joint deformity, were thought to be contributing factors to the aetiology of the stress fracture. The resultant change in clinical outcome/course is outlined in this case report. Conclusion: A stress fracture of the proximal fibula has the potential in the aetiology of may cause other stress fractures, joint other instability, and/or malalignment of the total lower extremity. Keywords: Stress fracture, Insufficiency fracture, Total knee arthroplasty, Fibula fracture, Valgus deformity, Rheumatoid arthritis

  6. Detection of radiographically occult-ankle fractures. Positive predictive value of post-traumatic soft-tissue swelling

    International Nuclear Information System (INIS)

    Kumar, M.; Caruana, E.

    2000-01-01

    The objective of this study was to assess the value of soft-tissue swelling on plain radiographs as a predictor of radiographically occult fracture, after acute ankle injury (trauma). Patients with acute ankle trauma and plain radiographic evidence of soft-tissue swelling were included in this study. Patients were excluded if ankle trauma was sustained more than 48 hours previously or if fracture was visible on plain radiographs. All subjects (n=25) underwent computed tomography (CT) of the ankle in sagittal and coronal planes. Size of soft-tissue swelling was measured from initial Antero-posterior (AP) radiographs. The subjects in the study were placed into two groups according to whether a fracture was identified on CT or not. The results identified that those subjects without a fracture demonstrated by CT, had a soft-tissue swelling of less than 12.6 mm, while those with over 17.1mm swelling, showed a fracture on CT. Twelve patients (48 per cent) had radiographically occult fractures identified with CT. Fracture sites included: Talus/Talar Dome (n=9), posterior or lateral malleolos (n=2), distal tibia/fibula (n=1). CT detected significant soft-tissue injuries in six patients (24 per cent), composed of damaged anterior talo-fibular ligament (n=4), torn flexor tendons (n=1), and damaged fibular calcaneal ligament (n=1). One patient also showed gas in the talar dome. This study concludes that presence of a large soft-tissue swelling on plain radiographs after acute ankle trauma suggests an underlying fracture. A soft-tissue swelling of >15 mm is a reasonable threshold to prompt further imaging. Helical computed tomography provides good visualisation of subtle bone injuries and may detect clinically important soft-tissue injuries. While the study has a small sample, there is clear evidence that there is a trend worth investigating. Future research will seek to investigate a larger sample. Copyright (1999) Australian Institute of Radiography

  7. Analysis of limb function after various reconstruction methods according to tumor location following resection of pediatric malignant bone tumors

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    Tokuhashi Yasuaki

    2010-05-01

    Full Text Available Abstract Background In the reconstruction of the affected limb in pediatric malignant bone tumors, since the loss of joint function affects limb-length discrepancy expected in the future, reconstruction methods that not only maximally preserve the joint function but also maintain good limb function are necessary. We analysis limb function of reconstruction methods by tumor location following resection of pediatric malignant bone tumors. Patients and methods We classified the tumors according to their location into 3 types by preoperative MRI, and evaluated reconstruction methods after wide resection, paying attention to whether the joint function could be preserved. The mean age of the patients was 10.6 years, Osteosarcoma was observed in 26 patients, Ewing's sarcoma in 3, and PNET(primitive neuroectodermal tumor and chondrosarcoma (grade 1 in 1 each. Results Type I were those located in the diaphysis, and reconstruction was performed using a vascularized fibular graft(vascularized fibular graft. Type 2 were those located in contact with the epiphyseal line or within 1 cm from this line, and VFG was performed in 1, and distraction osteogenesis in 1. Type III were those extending from the diaphysis to the epiphysis beyond the epiphyseal line, and a Growing Kotz was mainly used in 10 patients. The mean functional assessment score was the highest for Type I (96%: n = 4 according to the type and for VFG (99% according to the reconstruction method. Conclusion The final functional results were the most satisfactory for Types I and II according to tumor location. Biological reconstruction such as VFG and distraction osteogenesis without a prosthesis are so high score in the MSTS rating system. Therefore, considering the function of the affected limb, a limb reconstruction method allowing the maximal preservation of joint function should be selected after careful evaluation of the effects of chemotherapy and the location of the tumor.

  8. Analyse des facteurs prédictifs de malignité des goitres nodulaires : à propos de 500 cas

    Science.gov (United States)

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

    2016-01-01

    Les nodules thyroïdiens sont très fréquents et moins de 10% d'entre eux sont malin. Ils posent un véritable problème diagnostique et thérapeutique surtout par rapport à leur nature bénigne ou maligne. L’étude de certains facteurs cliniques et paracliniques de présomption de malignité permet de bien codifier la stratégie thérapeutique. Le but de ce travail est d’étudier les facteurs prédictifs de malignité des goitres nodulaires et comparer nos résultats à ceux de la littérature. Il s'agit d'une étude rétrospective à propos de 500 cas de goitres nodulaires opérés au service d'Oto-rhino-laryngologie (ORL) et Chirurgie cervico-faciale (CCF) de l'hôpital militaire Avicenne de Marrakech entre 2006 et 2012. Le pourcentage de cancers a été de 6,8%. L’âge moyen de nos patients était de 46 ans, avec une sex-ratio de 5 (F/H). A la palpation cervicale; le caractère dure du nodule a été constaté dans 94,4% des cas de cancer, avec des limites irrégulières dans 64,70% des cas de cancer. Trois nodules étaient fixes et ils étaient tous malins. Les adénopathies cervicales ont été constatées chez 8 malades dont 7 présentaient des cancers. A l’échographie, 61,8% des nodules malins présentaient un aspect hypoéchogène, avec des contours flous dans 88,24% des cas. La vascularisation intra nodulaire était présente dans 35,3% de ces cas des cancers avec des microcalcifications chez 55,9% d'entre eux. Le halo hypoéchogene périnodulaire était incomplet dans 73,5% des cas de cancer. Nos patients étaient en euthyroïdie dans 84,6% des cas. Les facteurs prédictifs de malignité d'un goitre nodulaire, étaient donc dans notre étude d'abord cliniques: l’âge supérieur à 60 ans, la consistance dure du nodule, sa fixité, son caractère irrégulier et mal limité à la palpation, ainsi que la présence d'adénopathie(s) cervicale(s) à l'examen; et échographiques: le caractère hypoéchogène, les limites floues, la présence de

  9. Morfologia do Mycobacterium leprae hominis e do M. leprae muris: estudo baseado na microscopia electrônica e de contraste de fases Morphology of Mycobacterium leprae hominis and M. leprae muris based on electron and phases contrast microscopy

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    H. C. de Souza-Araújo

    1955-12-01

    Full Text Available Hansen's Bacillus: By electron microscopy this bacillus shows membrane and halo, this being more visible when sorrounding the globi or bundles of bacilli; shows, also, free granules of various sizes which were before considered as dust of the dyes; shows external granules bound with the membrane and some times branching. By phases contrast microscopy examining leproma suspensions and subcataneous lymph at 400 x we saw many free granules with intense rotatory movement; granulated bacilli with screw, skip or stroke motion, producing slow progressive motion. All such elementes are surrounded by a halo, corresponding to the classical gloea. By a patient and delayed examination we were able to see that the internal granules are motile and help the progression of the bacilli, giving the impression that the cytoplasm is liquid. By a lasting observation we could see the larger granules form prolapse, like a pseudopode and abandon the bacilli and going in very rapid rotatory movement. There are branched bacilli; there are pedunculated fred granules like comets. The addition of a drop of formol at the preparation stops all movements. Stefansky's Bacillus: Repeated examination by RCA electron microscope, type EMU-25 of fresh suspensions of rat lepromas, led us to confirm the close relationship between human and murine leprosy agents. We examined also material from carabo (Lepra bubalorum from Java, but due to fixation, the material was unsuitable for comparative studies. The Stefansky's bacilli showed also emmbranes and halos, internal or external granules (smaller than those of Hansen's bacillus. The bacilli shaded by chromium look thicker and shorter than those of Hansen. Due to electron bombardment both, Hansen's and Stefansky's baccilli suffer considerable alterations in their structure, showing black barrs of chromatin condensation at their extremities as also in their centers. By phase microscopy the Stefansky's bacilli showed elements with 1, 2

  10. Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State: A Human Cadaveric Study.

    Science.gov (United States)

    Domnick, Christoph; Frosch, Karl-Heinz; Raschke, Michael J; Vogel, Nils; Schulze, Martin; von Glahn, Mathias; Drenck, Tobias C; Herbort, Mirco

    2017-10-01

    To determine the static stabilizing effects of different anatomical structures of the posterolateral corner (PLC) of the knee in the lateral collateral ligament (LCL)-intact state. Thirteen fresh-frozen human cadaveric knees were dissected and tested using an industrial robot with an optical tracking system. Kinematics were determined for 134 N anterior/posterior loads, 10 N m valgus/varus loads, and 5 N m internal/external rotatory loads in 0°, 20°, 30°, 60°, and 90° of knee flexion. The PLC structures were dissected and consecutively released: (I) intact knee joint, (II) with released posterior cruciate ligament (PCL), (III) popliteomeniscal fibers, (IV) popliteofibular ligament, (V) arcuat and popliteotibial fibers, (VI) popliteus tendon (PLT), and (VII) LCL. Repeated-measures analysis of variance was performed with significance set at P < .05. After releasing the PCL, posterior tibial translation increased by 5.2 mm at 20° to 9.4 mm at 90° of joint flexion (P < .0001). A mild 1.8° varus instability was measured in 0° of flexion (P = .0017). After releasing the PLC structures, posterior tibial translation further increased by 2.9 mm at 20° to 5.9 mm at 90° of flexion (P < .05) and external rotation angle increased by 2.6° at 0° to 7.9° at 90° of flexion (P < .05, vs II). Varus stability did not decrease. Mild differences between states V and VI were found in 60° and 90° external rotation tests (2.1° and 3.1°; P < .05). The connecting ligaments/fibers to the PLT act as a primary static stabilizer against external rotatory loads and a secondary stabilizer against posterior tibial loads (when PCL is injured). After releasing these structures, most static stabilizing function of the intact PLT is lost. The PLC has no varus-stabilizing function in the LCL-intact knee. Anatomy and function of these structures for primary and secondary joint stability should be considered for clinical diagnostics and when performing surgery in

  11. Uso de la reología en la evaluación de la jalea dentífrica fluida

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    Nilia de la Paz Martín-Viaña

    2002-04-01

    Full Text Available Se estudió el comportamiento reológico de la jalea dentífrica fluida mediante el empleo de un rotoviscosímetro digital HAAKE y se determinó la viscosidad aparente con la utilización de un viscosímetro rotatorio Brookfield modelo RVF. La preparación se almacenó a diferentes condiciones térmicas. Se analizaron los resultados estadísticamente a través de un análisis de varianza para contrastar si existen diferencias significativas entre las medias de las poblaciones. Tras el estudio reológico se pudo llegar al criterio de que corresponde su comportamiento a un cuerpo con flujo no newtoniano pseudoplástico, con un buen grado de recuperación estructural. No se encontraron diferencias estadísticamente significativas con un nivel de confiabilidad del 95 % entre los valores de las medias de la viscosidad aparente de la preparación almacenada a diferentes temperaturas durante 48 semanas después de elaborada. La formulación diseñada resultó estable físicamente, al menos, bajo las condiciones y circunstancias experimentales en que se ha ensayado.The rheologic behavior of the fluid tooth gel was studied by using a HAAKE digital rotatory viscosimeter. The apparent viscosity was determined by a Brookfield RVF rotatory viscosimeter. The preparation was stored under different thermal conditions. The results were statistically analyzed through a variance analysis to know if there were significant differences among the means of the population. According to the rheologic study, it was concluded that its behavior corresponded to a body with non Newtonian pseudoplastic flow, with a good degree of structural recovery. Statistically significant differences were not found. A reliability level of 95 % was attained among the values of the means of the apparent viscosity of the preparation stored at different temperatures during 48 weeks after being made. The designed formulation proved to be physically stable, at least under the experimental

  12. Factores de riesgo y protectores del bullying escolar en estudiantes con bajo rendimiento de cinco instituciones educativas de Santa Marta, Colombia

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    F. Robert Ferrel Ortega

    2015-01-01

    Full Text Available El presente artículo de investigación tiene como objetivo caracterizar factores del bullying escolar en estudiantes de 10° con bajo rendimiento, de cinco colegios del Núcleo Educativo N° 5 del Distrito de Santa Marta. El tipo de investigación es descriptiva, con diseño transversal y se trabajó con una población de 582 estudiantes y una muestra de 186, a quienes se les aplicó la Escala MESSY (The Matson Evaluation of Social Skills in Youngsters, de Matson, Rotatori y Helsel, 1983, previa validación en población escolar para este estudio. Los datos fueron procesados mediante el SPSS 17.0v. Se halló una concentración de altos porcentajes en el rango medio de los seis factores que mide la Escala: habilidades sociales adecuadas (59 %, asertividad inadecuada (77 %, impulsividad (75 %, sobreconfianza (49 %, celos/soledad (81 %, y Varios (83 %. Se concluyó que no existe bullying en esta población, pero se hallaron dos factores de riesgo: impulsividad (19 % y soledad (16 %; y, un factor protector (habilidades sociales adecuadas, 31 %. Se recomienda aplicar programas de prevención centrados en estos tres últimos factores. Abstract To characterize factors related to bullying in tenth grade students with low performance, taken as reference 5 from schools district No. 5 in Santa Marta. A cross-sectional study is conducted; 582 students and 186 students sampled, to whom a MESSY (Matson Evaluation of Social Skills in Youngsters de Matson Rotatori y Helsel 1983. Scale was applied, previous validity in school population for this research. Data was processed using SPSS 17.0v a highest percentages of 6 factors measured by Adequate Social Skills Scale in average level (59 %, inadequate assertiveness (77 %, impulsivity (75 %, overconfidence (49 %, jealousy/loneliness and others (83 %: As a conclusion, there is no bullying in this population, but two risk factors were found: impulsivity (19 % and loneliness (16 %; and protective factor (adequate

  13. Store-operated Ca2+ entry is remodelled and controls in vitro angiogenesis in endothelial progenitor cells isolated from tumoral patients.

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    Francesco Lodola

    Full Text Available Endothelial progenitor cells (EPCs may be recruited from bone marrow to sustain tumor vascularisation and promote the metastatic switch. Understanding the molecular mechanisms driving EPC proliferation and tubulogenesis could outline novel targets for alternative anti-angiogenic treatments. Store-operated Ca(2+ entry (SOCE, which is activated by a depletion of the intracellular Ca(2+ pool, regulates the growth of human EPCs, where is mediated by the interaction between the endoplasmic reticulum Ca(2+-sensor, Stim1, and the plasmalemmal Ca(2+ channel, Orai1. As oncogenesis may be associated to the capability of tumor cells to grow independently on Ca(2+ influx, it is important to assess whether SOCE regulates EPC-dependent angiogenesis also in tumor patients.The present study employed Ca(2+ imaging, recombinant sub-membranal and mitochondrial aequorin, real-time polymerase chain reaction, gene silencing techniques and western blot analysis to investigate the expression and the role of SOCE in EPCs isolated from peripheral blood of patients affected by renal cellular carcinoma (RCC; RCC-EPCs as compared to control EPCs (N-EPCs. SOCE, activated by either pharmacological (i.e. cyclopiazonic acid or physiological (i.e. ATP stimulation, was significantly higher in RCC-EPCs and was selectively sensitive to BTP-2, and to the trivalent cations, La(3+ and Gd(3+. Furthermore, 2-APB enhanced thapsigargin-evoked SOCE at low concentrations, whereas higher doses caused SOCE inhibition. Conversely, the anti-angiogenic drug, carboxyamidotriazole (CAI, blocked both SOCE and the intracellular Ca(2+ release. SOCE was associated to the over-expression of Orai1, Stim1, and transient receptor potential channel 1 (TRPC1 at both mRNA and protein level The intracellular Ca(2+ buffer, BAPTA, BTP-2, and CAI inhibited RCC-EPC proliferation and tubulogenesis. The genetic suppression of Stim1, Orai1, and TRPC1 blocked CPA-evoked SOCE in RCC-EPCs.SOCE is remodelled in EPCs

  14. The pleiotropic effects of simvastatin on retinal microvascular endothelium has important implications for ischaemic retinopathies.

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    Reinhold J Medina

    Full Text Available BACKGROUND: Current guidelines encourage the use of statins to reduce the risk of cardiovascular disease in diabetic patients; however the impact of these drugs on diabetic retinopathy is not well defined. Moreover, pleiotropic effects of statins on the highly specialised retinal microvascular endothelium remain largely unknown. The objective of this study was to investigate the effects of clinically relevant concentrations of simvastatin on retinal endothelium in vitro and in vivo. METHODS AND FINDINGS: Retinal microvascular endothelial cells (RMECs were treated with 0.01-10 microM simvastatin and a biphasic dose-related response was observed. Low concentrations enhanced microvascular repair with 0.1 microM simvastatin significantly increasing proliferation (p<0.05, and 0.01 microM simvastatin significantly promoting migration (p<0.05, sprouting (p<0.001, and tubulogenesis (p<0.001. High concentration of simvastatin (10 microM had the opposite effect, significantly inhibiting proliferation (p<0.01, migration (p<0.01, sprouting (p<0.001, and tubulogenesis (p<0.05. Furthermore, simvastatin concentrations higher than 1 microM induced cell death. The mouse model of oxygen-induced retinopathy was used to investigate the possible effects of simvastatin treatment on ischaemic retinopathy. Low dose simvastatin (0.2 mg/Kg promoted retinal microvascular repair in response to ischaemia by promoting intra-retinal re-vascularisation (p<0.01. By contrast, high dose simvastatin(20 mg/Kg significantly prevented re-vascularisation (p<0.01 and concomitantly increased pathological neovascularisation (p<0.01. We also demonstrated that the pro-vascular repair mechanism of simvastatin involves VEGF stimulation, Akt phosphorylation, and nitric oxide production; and the anti-vascular repair mechanism is driven by marked intracellular cholesterol depletion and related disorganisation of key intracellular structures. CONCLUSIONS: A beneficial effect of low

  15. A histological and micro-CT investigation in to the effect of NGF and EGF on the periodontal, alveolar bone, root and pulpal healing of replanted molars in a rat model - a pilot study.

    Science.gov (United States)

    Furfaro, Francesco; Ang, Estabelle S M; Lareu, Ricky R; Murray, Kevin; Goonewardene, Mithran

    2014-01-06

    This study aims to investigate, utilising micro-computed tomography (micro-CT) and histology, whether the topical application of nerve growth factor (NGF) and/or epidermal growth factor (EGF) can enhance periodontal, alveolar bone, root and pulpal tissue regeneration while minimising the risk of pulpal necrosis, root resorption and ankylosis of replanted molars in a rat model. Twelve four-week-old male Sprague-Dawley rats were divided into four groups: sham, collagen, EGF and NGF. The maxillary right first molar was elevated and replanted with or without a collagen membrane impregnated with either the growth factors EGF or NGF, or a saline solution. Four weeks after replantation, the animals were sacrificed and the posterior maxilla was assessed using histological and micro-CT analysis. The maxillary left first molar served as the control for the corresponding right first molar. Micro-CT analysis revealed a tendency for all replanted molars to have reduced root length, root volume, alveolar bone height and inter-radicular alveolar bone volume. It appears that the use of the collagen membrane had a negative effect while no positive effect was noted with the incorporation of EGF or NGF. Histologically, the incorporation of the collagen membrane was found to negatively affect pulpal, root, periodontal and alveolar bone healing with pulpal inflammation and hard tissue formation, extensive root resorption and alveolar bone fragmentation. The incorporation of EGF and NGF did not improve root, periodontal or alveolar bone healing. However, EGF was found to improve pulp vascularisation while NGF-improved pulpal architecture and cell organisation, although not to the level of the control group. Results indicate a possible benefit on pulpal vascularisation and pulpal cell organisation following the incorporation of EGF and NGF, respectively, into the alveolar socket of replanted molars in the rat model. No potential benefit of EGF and NGF was detected in periodontal or root

  16. Choroidal melanoma

    International Nuclear Information System (INIS)

    Hernandez Quesada, Flora

    2013-01-01

    A useful and practical guide is developed to better track to the uveal melanoma, due to its highly malignant character. Melanoma of the uveal tract (choroid, iris, ciliary body) has been the intraocular tumor most frequent in adults. The biopsy has been inaccessible, due to its location; therefore, the diagnostic should be based on clinical examination and the correct utilization of the diagnostic procedures (ultrasound, fluorescent angiography, computed axial tomography and magnetic resonance). The cases are diagnosed in the histological examination of the operatory piece post-enucleation for other causes. Epidemiological research has been key to determine the associated factors and better to understand the mechanisms of onset of the disease. Anatomopathological studies of choroidal melanoma have permitted to know the natural history of the disease. The decrease of the visual acuity, pain or inflammation are presented as a defect in the visual field. Different techniques to diagnose the disease are explained. Ultrasound in mode A and B, computed axial tomography and magnetic resonance are the diagnostic method of election. Ultrasound has been the primary method of diagnostic, giving the size and vascularisation, useful in tracking, when they are treated in shape conservatively, showing changes in echogenicity and less vascularisation as good response to treatment. The treatments of choroidal melanoma are specified. The correct interpretation of the clinical symptoms and early utilization of diagnostic imaging methods, have permitted to establish the adequate therapeutic and to avoid local and distant metastasis. The uveal melanoma, depending on their size and location, traditionally has been treated by enucleation. Data from the literature and authors, have promoted the conservation of the ocular globe, depending on the size of the tumor. Transpupillary thermotherapy has been an available alternative for small tumors in Costa Rica and level of social security

  17. Quantitative analysis of vascular colonisation and angio-conduction in porous silicon-substituted hydroxyapatite with various pore shapes in a chick chorioallantoic membrane (CAM) model.

    Science.gov (United States)

    Magnaudeix, Amandine; Usseglio, Julie; Lasgorceix, Marie; Lalloue, Fabrice; Damia, Chantal; Brie, Joël; Pascaud-Mathieu, Patricia; Champion, Eric

    2016-07-01

    The development of scaffolds for bone filling of large defects requires an understanding of angiogenesis and vascular guidance, which are crucial processes for bone formation and healing. There are few investigations on the ability of a scaffold to support blood vessel guidance and it this is of great importance because it relates to the quality and dispersion of the blood vessel network. This work reports an analysis of vascularisation of porous silicon-substituted hydroxyapatite (SiHA) bioceramics and the effects of pore shape on vascular guidance using an expedient ex ovo model, the chick embryo chorioallantoic membrane (CAM) assay. Image analysis of vascularised implants assessed the vascular density, fractal dimension and diameter of blood vessels at two different scales (the whole ceramic and pores alone) and was performed on model SiHA ceramics harbouring pores of various cross-sectional geometries (circles, square, rhombus, triangles and stars). SiHA is a biocompatible material which allows the conduction of blood vessels on its surface. The presence of pores did not influence angiogenesis related-parameters (arborisation, fractal dimension) but pore geometry affected the blood vessel guidance and angio-conductive potential (diameter and number of the blood vessels converging toward the pores). The measured angles of pore cross-section modulated the number and diameter of blood vessels converging to pores, with triangular pores appearing of particular interest. This result will be used for shaping ceramic scaffolds with specific porous architecture to promote vascular colonisation and osteointegration. An expedient and efficient method, using chick embryo chorioallantoic membrane (CAM) assays, has been set up to characterise quantitatively the angiogenesis and the vascular conduction in scaffolds. This approach complements the usual cell culture assays and could replace to a certain extent in vivo experiments. It was applied to silicon

  18. Avaliação de centrifugado osteogênico de medula óssea na consolidação de fratura em coelhos Evaluation of centrifuged osteogenic bone marrow in fracture consolidation in rabbits

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    Carlos Eduardo Sanches Vaz

    2010-01-01

    Full Text Available OBJETIVO: Avaliar a eficácia de um centrifugado osteogênico de medula óssea em estimular a consolidação de osteotomias da fíbula em coelhos. MÉTODOS: Foram utilizados dez coelhos machos adultos da raça Nova Zelândia albino. Realizou-se uma osteotomia transversa médio-diafisária da fíbula direita, seguida da adição local de uma esponja de colágeno absorvível embebida em um centrifugado osteogênico, obtido pela centrifugação de aspirado de medula óssea do osso ilíaco ipsilateral. A fíbula esquerda foi utilizada como controle, sendo feita a mesma osteotomia, porém neste caso adicionando-se somente a esponja de colágeno absorvível. Após quatro semanas os animais foram sacrificados para estudo dos calos ósseos formados. Os critérios de avaliação foram a mensuração da densidade mineral utilizando-se a densitometria óssea com DEXA, do volume do calo com tomografia computadorizada multi-slice e dos tecidos formados por meio de histomorfometria. RESULTADOS: A utilização do centrifugado osteogênico resultou em um aumento médio na densidade mineral óssea dos calos de 40,3% e da quantidade relativa de tecido ósseo de 9,4%, sem aumento significativo nas quantidades relativas de cartilagem ou fibrose nem no volume do calo ósseo. CONCLUSÃO: A administração do centrifugado osteogênico de medula óssea utilizado neste estudo favoreceu a consolidação óssea de osteotomias experimentais em coelhos.OBJECTIVE: The purpose of this study was to evaluate the efficacy of a centrifuged osteogenic bone marrow aspirate to stimulate healing in rabbit fibular osteotomies. METHODS: Ten white New Zealand rabbits were used. A transverse medial diaphyseal fibular osteotomy was performed on the right fibula, where an absorbable collagen sponge embedded in osteogenic centrifuged bone marrow aspirate, obtained from the ipsilateral iliac bone, was inserted. The left fibula was used as the control group, where the collagen absorbable

  19. Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing.

    Science.gov (United States)

    Liu, Yun-feng; Xu, Liang-wei; Zhu, Hui-yong; Liu, Sean Shih-Yao

    2014-05-23

    The occurrence of mandibular defects caused by tumors has been continuously increasing in China in recent years. Conversely, results of the repair of mandibular defects affect the recovery of oral function and patient appearance, and the requirements for accuracy and high surgical quality must be more stringent. Digital techniques--including model reconstruction based on medical images, computer-aided design, and additive manufacturing--have been widely used in modern medicine to improve the accuracy and quality of diagnosis and surgery. However, some special software platforms and services from international companies are not always available for most of researchers and surgeons because they are expensive and time-consuming. Here, a new technical solution for guided surgery for the repair of mandibular defects is proposed, based on general popular tools in medical image processing, 3D (3 dimension) model reconstruction, digital design, and fabrication via 3D printing. First, CT (computerized tomography) images are processed to reconstruct the 3D model of the mandible and fibular bone. The defect area is then replaced by healthy contralateral bone to create the repair model. With the repair model as reference, the graft shape and cutline are designed on fibular bone, as is the guide for cutting and shaping. The physical model, fabricated via 3D printing, including surgical guide, the original model, and the repair model, can be used to preform a titanium locking plate, as well as to design and verify the surgical plan and guide. In clinics, surgeons can operate with the help of the surgical guide and preformed plate to realize the predesigned surgical plan. With sufficient communication between engineers and surgeons, an optimal surgical plan can be designed via some common software platforms but needs to be translated to the clinic. Based on customized models and tools, including three surgical guides, preformed titanium plate for fixation, and physical models of

  20. Origem e distribuição do nervo isquiático no veado-catingueiro (Mazama gouazoubira

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    Tracy Martina M. Martins

    2013-02-01

    Full Text Available Este estudo teve como objetivo descrever a origem e a distribuição do nervo isquiático no veado-catingueiro (Mazama gouazoubira. Dois animais da espécie, obtidos post mortem por atropelamento em rodovia, foram utilizados para o estudo, obedecendo aos critérios da Lei Vigente (Lei 1.153/95. Através da dissecação, a pele foi completamente removida e os animais foram fixados em solução aquosa de formaldeído a 10%. Através de um acesso dorso-lateral, os músculos glúteo superficial, bíceps femoral e glúteo médio foram seccionados no seu local de inserção e rebatidos. Desta forma foi possível visualizar a origem e a distribuição do nervo isquiático, em ambos os antímeros dos animais. As imagens foram registradas com câmera fotográfica digital (Câmera Sony a200, 10.2mpx e os resultados foram descritos com base na Nomina Anatômica Veterinária. Os dados da origem do nervo isquiático nos dois espécimes estudados mostraram que esta ocorre a partir dos ramos ventrais de L6 e S1, podendo ter contribuição de S2. Após a sua emergência pelo forame isquiático maior, em ambos os antímeros, o nervo isquiático fornece ramos para suprir os músculos glúteo médio, glúteo profundo, glúteo superficial, gluteobíceps, bíceps da coxa, semimembranoso, semitendinoso e gastrocnêmio. Próximo ao meio da coxa o nervo isquiático divide-se em nervo tibial e nervo fibular comum os quais inervam os músculos da região distal do membro pélvico. Além disso, o nervo cutâneo caudal da sura pode se originar dos nervos fibular comum ou do nervo tibial. Em conclusão, nos espécimes de Mazama gouazoubira estudados, o nervo isquiático teve sua origem a partir dos ramos ventrais espinais de L6 e S1, podendo ou não ter a contribuição de S2. Na sua distribuição originam-se o nervo glúteo caudal, o nervo cutâneo femoral caudal e ramos musculares, que, conjuntamente inervam os músculos glúteo médio, glúteo profundo, gl