Science.gov

Sample records for lateral humeral condyle

  1. Posterolateral approach for humeral lateral condyle fractures in children.

    PubMed

    Liu, Chang-Heng; Kao, Hsuan-Kai; Lee, Wei-Chun; Yang, Wen-E; Chang, Chia-Hsieh

    2016-03-01

    We proposed a simple posterolateral approach to the articular surface of the trochlea for fresh and late fractures of the humeral lateral condyle. Twenty consecutive cases, 16 fresh and four old fractures, were approached between triceps and anconeus before the age of 15 years. All fractures achieved union in 3 months. Nineteen cases were classified as excellent or good by the Hardacre score after 31.3 months of follow-up. One late fracture with elbow subluxation showed radiographic fragmentation of the capitellum and a fair clinical result. This simple optional approach offers good exposure of intra-articular fracture at the trochlea, especially for late fractures. PMID:26523535

  2. Screw osteosynthesis of displaced lateral humeral condyle fractures in children: a mid-term review.

    PubMed

    Loke, W P; Shukur, M H; Yeap, J K

    2006-02-01

    Displaced humeral condyle fractures in children are traditionally fixed with smooth Kirschner wire at the expense of a risk of secondary displacement following removal of wire. Screw fixation of such fractures has recently been advocated as it provides stable fixation. We have been using screw osteosynthesis for treatment of displaced lateral humeral condyle fractures in children in our institution since the turn of this century. This study provides a midterm review of treatment of such injuries with special regards to growth disturbances after screw osteosynthesis and to assess rate of union with a view to formulate guidelines for screw removal. We review the outcomes of screw osteosynthesis for displaced lateral condyle fracture of the humerus (19 Milch type-1 and 15 Milch type-II) in 34 children treated in our institution from January 2000 to March 2004. The average age of the patients was 6.1 years. The average follow up was 24.5 months. Screw osteosynthesis led to union (average 6.9 weeks) in all patients with excellent results in 28 patients. Growth disturbances in the form of lateral condyle overgrowth (2 patients), valgus deformity secondary to lateral condyle avascular necrosis (2 patients) and fishtail deformity ((3 patients) were recognized. The implants should not be removed until fracture union is established. Screw osteosynthesis of the lateral humeral condyle fracture prevents secondary fracture redisplacement and lateral condyle overgrowth is probably related to hyperemic response to metaphyseal fixation and early removal of implant before radiological union. PMID:17042228

  3. Osteochondritis dissecans of the lateral humeral condyle in a table tennis player.

    PubMed

    Pintore, E; Maffulli, N

    1991-08-01

    The case of a table tennis player suffering from intra-articular loose bodies of the elbow is reported. The patient developed the first signs of osteochondritis dissecans of the right lateral humeral condyle at age 16 but underwent surgery only 6 yr later. He has now resumed training and competition, despite some residual stiffness due to early osteoarthritis. This is the first case of osteochondritis dissecans of the elbow ascribed to this sport. It was probably due to repetitive valgus compressive stresses at the radiocapitellar joint during the forced movements imposed by high-level table tennis in a young athlete. PMID:1956260

  4. Toxic shock syndrome post open reduction and Kirschner wire fixation of a humeral lateral condyle fracture.

    PubMed

    Chan, Yuen; Selvaratnam, Veenesh; Garg, Neeraj

    2015-01-01

    Use of Kirschner wires (K-wires) is the most common method of fracture stabilisation in lateral condyle fracture fixation in children. We report a case of toxic shock syndrome (TSS) following an open reduction and internal fixation using K-wires for a humeral lateral condyle fracture in a 5-year-old girl. TSS is a toxin-mediated multisystem illness. It typically presents with shock and it is most often attributed to toxin-producing strains of Staphylococcus aureus and Streptococcus pyogenes. It can lead to multiorgan failure and, ultimately, death. It is important to be aware of TSS, as it can present within any setting. Patients often have non-specific symptoms and their condition can worsen rapidly. TSS postorthopaedic surgery is rare; however, due to the serious nature of this disease, it is important to promptly recognise and diagnose TSS, and to ensure appropriate treatment is started without delay. PMID:26264942

  5. [Analysis of treatment results of humeral lateral condyle fractures in children].

    PubMed

    Lipczyk, Zbigniew; Flont, Paweł; Golański, Grzegorz; Niedzielski, Kryspin Ryszard

    2011-01-01

    On the basis of 60 cases authors analyze treatment results of the humeral lateral condyle fractures in children. This type of fracture is a second most common elbow fracture in children after supracondylar fracture of the humerus. Authors consider this fracture to be the most difficult to diagnose among all elbow injuries. Analyzed cohort of patients consists of 54 at age between 1.5 to 10 years and 6 patients between 12 to 17 years of age. In 75% of cases operative treatment was delayed due to late referral from other hospitals. According to appearance of the fracture line on X-rays there were 53 cases of type II and 7 cases of type 1 according to Milch classification system. The amount of displacement was evaluated according to Jakob scale and there were 35 cases of III degree, 17 cases of II degree and 8 cases of I degree of displacement. All patients were evaluated with antero-posterior and lateral distal humerus x-rays. In some cases other diagnostic techniques were used. In older children computerized tomography and in younger children ultrasound examination was performed. The treatment results were evaluated according to Hardacre scale. Follow-up time was 1 to 13 years. There were 27 very good and 27 good results in a 54 cases group of patients who underwent surgery within 15 days since injury. In other group which consists of 6 patients who underwent surgery more than 5 weeks after injury there were 2 cases of very good, 2 cases of good; and 2 cases of bad results. Authors believe that putting a proper diagnosis of humeral lateral condyle fracture in children and performing an operative treatment results in a good and a very good outcomes. Basing on the analysis of treatment results of authors cohort of patients, they claim that precise diagnosis and proper determining of degree of displacement increases the number of patients qualified to operative treatment. PMID:22708319

  6. Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution.

    PubMed

    Leonidou, Andreas; Chettiar, Krissen; Graham, Simon; Akhbari, Pouya; Antonis, Konstantinos; Tsiridis, Eleftherios; Leonidou, Omiros

    2014-08-01

    Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF of lateral humeral condyle fractures at a single institution over a period of 13 years. All cases were identified through the trauma register. Case notes and radiographs were retrieved. Fracture classification, mode of fixation, time to union, and final outcomes at the latest follow-up were reviewed. One hundred and five lateral condyle fractures were identified in 76 male and 29 female patients. Average age was 6.2 years. Ninety-two were Milch type II and 13 Milch type I. According to the Jacob's classification, 38 were type II and 67 type III. All fractures were treated with open reduction and fixation with K-wires. Average time to radiological union was 33 days. Follow-up ranged between 2 and 8 years (average 3.2 years). Radiological hypertrophy of the lateral condyle was present in 45 cases (42 %). Three patients developed a pseudo-cubitus varus deformity. Further four patients developed a true cubitus varus. There was one case of superficial infection of the K-wires and one case of delayed union. At the latest follow-up, 96 % of the patients achieved an excellent final result and 4 % a good final result. Our results demonstrate that fracture union and excellent final outcomes can be expected in all patients using our protocol, whereby all patients with a displaced fracture are managed by ORIF with K-wire fixation, with the wires only being removed after there is evidence of radiological union. Compared to recent reports of closed reduction internal fixation, this series demonstrates good results with no complications directly relating to the open reduction technique. Level of evidence Case series, Level IV. PMID:25022896

  7. Propagation of a partial incomplete ossification of the humeral condyle in an American cocker spaniel.

    PubMed

    Witte, P G; Bush, M A; Scott, H W

    2010-11-01

    A hypoattenuating lesion in the left humeral condyle of an American cocker spaniel consistent with partial incomplete ossification of the humeral condyle was observed on computed tomography. Left forelimb lameness developed over the following three weeks at which time repeat computed tomography examination confirmed propagation of the lesion. Lameness resolved following placement of a transcondylar positional screw, suggesting that lameness was secondary to condylar instability. To the authors' knowledge this is the first report of propagation of an intracondylar lesion in a dog. PMID:20973787

  8. Buried or unburied K-wires for lateral condyle elbow fractures

    PubMed Central

    McGonagle, L; Elamin, S; Wright, DM

    2012-01-01

    INTRODUCTION Lateral humeral condyle fractures typically require a longer period of internal fixation than other distal humeral fractures due to the increased risk of non-union. K-wires can be buried and left in situ until union or they can be left unburied and require removal after four weeks, with plaster immobilisation until union. There is no consensus as to whether wire burial is preferable or not. The aim of this study was to determine whether K-wire burial is associated with more complications than non-buried wires in treating lateral condyle fractures of the elbow. METHODS All patients with lateral humeral condyle fractures treated with K-wire fixation at our institution from May 2008 to August 2011 were included in the study. Fracture configuration, mode of reduction, wire burial and complications were assessed. RESULTS Sixty-seven patients (19 girls and 48 boys, mean age: 6.5 years, range: 1–17 years) were included in the study. All had closed injuries and were treated with open reduction and K-wire fixation. K-wires were buried in 55 patients. Thirteen cases of buried wires eroded through skin and were removed on average 45 days (range: 30–58 days) post-operatively. Of the wire erosion cases, three developed microbiologically proven infections, one of which was a deep infection. There were a further three superficial wound infections in the absence of wire erosion through the skin. There were complications in 2 of the 12 cases in the unburied wires group: 1 microbiologically proven superficial wire site infection and 1 wire backed out after 11 days, requiring refixation. CONCLUSIONS Wire erosion through the skin is the most common complication of K-wire burial. This may be due to the decrease in swelling after fracture fixation, making the wires more prominent under the skin. Skin integrity should be monitored closely if wires are buried. PMID:23031772

  9. Bilateral osteochondritis dissecans of the lateral femoral condyle following bilateral total removal of lateral discoid meniscus: a case report.

    PubMed

    Hashimoto, Yusuke; Yoshida, Gen; Tomihara, Tomohiro; Matsuura, Takeshi; Satake, Shinji; Kaneda, Kunikazu; Shimada, Nagakazu

    2008-11-01

    Osteochondritis dissecans (OCD) of the lateral femoral condyle sometimes occurs with a discoid lateral meniscus. Recently, it was reported that OCD of the lateral femoral condyle occurred after total removal of the lateral meniscus. We report the case of a 12-year-old boy with bilateral OCD of the lateral femoral condyle following bilateral total removal for discoid lateral meniscus. Valgus deviation of the knee after total removal and increased sporting activity might have concentrated excessive stress on the lateral condyles in the standing position. As a result, bilateral OCD might have occurred. Drilling of the areas of OCD on the bilateral lateral femoral condyles was done and the patient wore inner wedge arch supports postoperatively. After 2 years, neither knee pain nor arthrosis has occurred so far, but long-term follow-up of this patient is considered to be necessary. PMID:17985146

  10. Posteromedial dislocation of the elbow with lateral condyle fracture in children.

    PubMed

    Cheng, Pen-Gang; Chang, Wei-Ning; Wang, Matthew N

    2009-02-01

    Posteromedial dislocation of the elbow with lateral condyle fracture is a rare injury, and only a few cases have been reported in the literature. We report 3 children who had posteromedial dislocation of the elbow with Milch type II lateral condylar fracture of the distal humerus. Major complications included malunion, nonunion of the fracture, heterotophic calcification and elbow subluxation. From our experience and a review of the literature, open anatomical reduction and internal fixation of the lateral condyle fracture is the mainstay of treatment for these children. Poor reduction of the lateral condyle fracture results in incongruity of the joint surface and leads to poor results. PMID:19251541

  11. Buried versus unburied Kirschner wires in the management of paediatric lateral condyle elbow fractures: a comparative study from a tertiary centre.

    PubMed

    Ormsby, Neal M; Walton, Roger D M; Robinson, Simon; Brookes-Fazakerly, Stephen; Chang, Fernando Yuen; McGonagle, Lorcan; Wright, David

    2016-01-01

    There is little consensus on whether Kirschner wire (K-wire) burial is preferable in the management of paediatric lateral humeral condyle fractures. We identified 124 patients from May 2008 to August 2014. Sixty received buried K-wires and 64 received unburied wires. We found no significant difference in the infection rates between groups, but a high rate of skin erosion (23%) in the buried group, with a subsequent high rate of infection in this subgroup (40%). We found a strong association of wire erosion following early surgery. There is a considerable cost saving associated with using unburied wires. We therefore recommend the routine use of unburied wires. PMID:26352103

  12. Arthroscopic Microfracture Technique for Cartilage Damage to the Lateral Condyle of the Tibia

    PubMed Central

    Kan, Hiroyuki; Arai, Yuji; Nakagawa, Shuji; Inoue, Hiroaki; Minami, Ginjiro; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Kubo, Toshikazu

    2015-01-01

    This report describes the use of arthroscopic microfracture to treat a 10-year-old female patient with extensive damage to the cartilage of the lateral condyle of the tibia before epiphyseal closure, resulting in good cartilage recovery. Magnetic resonance imaging showed a defect in part of the load-bearing surface of the articular cartilage of the condyle articular of the tibia. The patient was diagnosed with damage to the lateral condyle cartilage of the tibia following meniscectomy, and arthroscopic surgery was performed. The cartilage defect measured approximately 20 × 20 mm, and microfracture was performed. Arthroscopy performed four months postoperatively showed that the cartilage defect was completely covered with fibrous cartilage, and the patient was allowed to resume sports activities. Four years postoperatively, she has had no recurrence of pain or hydrarthrosis. PMID:26345523

  13. Unusual presentation of a type 1 Monteggia equivalent lesion: simultaneous medial humeral condyle fracture with ipsilateral anterior dislocation of the radial head and acute plastic bowing of the ulna.

    PubMed

    Kim, Young Sung; Lee, Ho Min; Kim, Jong Pil; Lim, Chang Rack

    2014-07-01

    The authors describe a case of simultaneous anterior dislocation of the radial head with plastic deformation of the ulna and an ipsilateral medial humeral condyle fracture in a 6-year-old boy after a fall on an outstretched hand. This rare combination of injuries has not been described previously in the literature. Closed reduction of the dislocated radial head and percutaneous K-wire fixation of the medial humeral condyle fracture achieved an excellent result with full function. This rare combination of injuries is considered to be an unusual subtype of the Bado type I Monteggia equivalent lesion. The case emphasizes that when a fracture is detected around an elbow, other injuries in the region should be suspected. PMID:24769777

  14. Two Patients with Osteochondral Injury of the Weight-Bearing Portion of the Lateral Femoral Condyle Associated with Lateral Dislocation of the Patella

    PubMed Central

    Inoue, Hiroaki; Atsumi, Satoru; Ichimaru, Shohei; Fujiwara, Hiroyoshi; Kubo, Toshikazu

    2014-01-01

    Complications of patellar dislocation include osteochondral injury of the lateral femoral condyle and patella. Most cases of osteochondral injury occur in the anterior region, which is the non-weight-bearing portion of the lateral femoral condyle. We describe two patients with osteochondral injury of the weight-bearing surface of the lateral femoral condyle associated with lateral dislocation of the patella. The patients were 18- and 11-year-old females. Osteochondral injury occurred on the weight-bearing surface distal to the lateral femoral condyle. The presence of a free osteochondral fragment and osteochondral injury of the lateral femoral condyle was confirmed on MRI and reconstruction CT scan. Treatment consisted of osteochondral fragment fixation or microfracture, as well as patellar stabilization. Osteochondral injury was present in the weight-bearing portion of the lateral femoral condyle in both patients, suggesting that the injury was caused by friction between the patella and lateral femoral condyle when the patella was dislocated or reduced at about 90 flexion of the knee joint. These findings indicate that patellar dislocation may occur and osteochondral injury may extend to the weight-bearing portion of the femur even in deep flexion, when the patella is stabilized on the bones of the femoral groove. PMID:25506015

  15. A case of an unusual Monteggia equivalent type II with lateral condyle fracture.

    PubMed

    Gundavda, Manit K; Chinoy, Rajveer K

    2015-12-01

    Monteggia fracture dislocations are uncommon in childhood. Since the term 'Monteggia equivaents' was termed, various equivalents of this entity have been described. However, these fractures with concomitant elbow injuries are exceedingly rare in young children. We present a case of an 18 month-old girl who sustained a fracture of lateral condyle of right distal end of humerus with posterior dislocation of the elbow. We suggest that the fracture pattern can be included under type II Monteggia equivalent on the basis of its characteristics, biomechanics and the mode of injury with supporting literature review for the same. PMID:26566329

  16. Quantitative proteomics reveals regulatory differences in the chondrocyte secretome from human medial and lateral femoral condyles in osteoarthritic patients

    PubMed Central

    2013-01-01

    Background Osteoarthritis (OA) is a destructive joint disease and there are no known biomarkers available for an early diagnosis. To identify potential disease biomarkers and gain further insight into the disease mechanisms of OA we applied quantitative proteomics with SILAC technology on the secretomes from chondrocytes of OA knees, designated as high Mankin (HM) scored secretome. A quantitative comparison was made between the secretomes of the medial and lateral femur condyle chondrocytes in the same knee since the medial femur condyle is usually more affected in OA than the lateral condyle, which was confirmed by Mankin scoring. The medial/lateral comparison was also made on the secretomes from chondrocytes taken from one individual with no clinically apparent joint-disease, designated as low Mankin (LM) scored secretome. Results We identified 825 proteins in the HM secretome and 69 of these showed differential expression when comparing the medial and lateral femoral compartment. The LM scored femoral condyle showed early signs of OA in the medial compartment as assessed by Mankin score. We here report the identification and relative quantification of several proteins of interest for the OA disease mechanism e.g. CYTL1, DMD and STAB1 together with putative early disease markers e.g. TIMP1, PPP2CA and B2M. Conclusions The present study reveals differences in protein abundance between medial/lateral femur condyles in OA patients. These regulatory differences expand the knowledge regarding OA disease markers and mechanisms. PMID:24090399

  17. Selective lateral muscle activation in moderate medial knee osteoarthritis subjects does not unload medial knee condyle.

    PubMed

    Brandon, Scott C E; Miller, Ross H; Thelen, Darryl G; Deluzio, Kevin J

    2014-04-11

    There is some debate in the literature regarding the role of quadriceps-hamstrings co-contraction in the onset and progression of knee osteoarthritis. Does co-contraction during walking increase knee contact loads, thereby causing knee osteoarthritis, or might it be a compensatory mechanism to unload the medial tibial condyle? We used a detailed musculoskeletal model of the lower limb to test the hypothesis that selective activation of lateral hamstrings and quadriceps, in conjunction with inhibited medial gastrocnemius, can actually reduce the joint contact force on the medial compartment of the knee, independent of changes in kinematics or external forces. "Baseline" joint loads were computed for eight subjects with moderate medial knee osteoarthritis (OA) during level walking, using static optimization to resolve the system of muscle forces for each subject's scaled model. Holding all external loads and kinematics constant, each subject's model was then perturbed to represent non-optimal "OA-type" activation based on mean differences detected between electromyograms (EMG) of control and osteoarthritis subjects. Knee joint contact forces were greater for the "OA-type" than the "Baseline" distribution of muscle forces, particularly during early stance. The early-stance increase in medial contact load due to the "OA-type" perturbation could implicate this selective activation strategy as a cause of knee osteoarthritis. However, the largest increase in the contact load was found at the lateral condyle, and the "OA-type" lateral activation strategy did not increase the overall (greater of the first or second) medial peak contact load. While "OA-type" selective activation of lateral muscles does not appear to reduce the medial knee contact load, it could allow subjects to increase knee joint stiffness without any further increase to the peak medial contact load. PMID:24581816

  18. Screw versus pin fixation with open reduction of pediatric lateral condyle fractures.

    PubMed

    Gilbert, Shawn R; MacLennan, Paul A; Schlitz, Ryne S; Estes, Ashley R

    2016-03-01

    Good results have been described for lateral condyle fractures treated by open reduction and fixation using Kirschner wires or screws. We, in our level III retrospective comparison clinical research study, retrospectively reviewed 84 patients (43 K-wire, 41 screw fixation; average age 5.6 years, average follow-up 6.8 months). With K-wires there were three nonunions (average time to union 9.6 weeks). With screws, all fractures healed (average of 7.8 weeks). Screw fixation patients spent fewer days in a cast and had a greater range of motion at the last follow-up. Screw fixation is associated with fewer nonunions and faster time to union, but a secondary procedure for removal is required. PMID:26583930

  19. Osteochondritis dissecans of the lateral femoral condyle in a patient affected by osteogenesis imperfecta: a case report.

    PubMed

    Persiani, Pietro; Di Domenica, Marica; Martini, Lorena; Ranaldi, Filippo M; Zambrano, Anna; Celli, Mauro; Villani, Ciro

    2015-11-01

    Osteochondritis dissecans is a very uncommon phenomenon in osteogenesis imperfecta (OI). A 14-year-old boy, affected by OI and followed in our Center for Congenital Osteodystrophies, had a knee trauma and MRI indicated a hollowed area of 2.51.5?cm in the lateral femoral condyle, which was classified as grade III. The patient underwent surgery, performed as a one-step surgical treatment: the osteochondral fragment was removed, curettage of lesion's bottom was performed, and a biphasic scaffold was used to fill the defect, implanted with a press-fit technique. MRI at 12 and 24 months after surgery showed scaffold integration. At the final follow-up, the patient did not feel any pain or articular limitations. It is difficult to provide a guideline on osteochondritis dissecans in patients affected by OI because of the lack of literature reports on this rare disorder in a rare disease. According to our experience, in these patients, osteosynthesis of the bone fragment and the use of autograft are not recommended because of the patient's bone weakness and osteoporosis. Moreover, compared with two-step surgery, one-step surgery is preferred to reduce the risk related to anesthesia, often observed to be higher in these patients. PMID:25919806

  20. Humeral Lateral Epicondylitis Complicated by Hydroxyapatite Dihydrite Deposition Disease: A Case Report

    PubMed Central

    Marchand, Andrée-Anne; O’Shaughnessy, Julie; Descarreaux, Martin

    2014-01-01

    Objective The aim of this case report is to differentiate the recovery timeline expected for patients with simple lateral epicondylitis from an abnormal recovery period, in which case an underlying condition should be suspected. Clinical features A 49-year-old woman presented to a chiropractic clinic with posterolateral right elbow pain. The history included chronic recurrent lateral elbow pain, followed by a traumatic event leading to sustained pain and disability. Intervention and outcomes Following a trial of conservative therapy including activity restrictions, soft tissue therapy, joint mobilizations, and therapeutic ultrasonography that led to no significant improvement, the patient was referred for diagnostic imaging that revealed hydroxyapatite dihydrite deposition disease. Conclusion This report describes a case for which lateral epicondylitis symptoms failed to resolve because of an underlying condition (hydroxyapatite dihydrite deposition disease). This case emphasizes that primary care practitioners treating lateral epicondylitis should consider referral for further investigations when positive results are not achieved. PMID:24711788

  1. RISKS AND CONSEQUENCES OF USING THE TRANSPORTAL TECHNIQUE IN RECONSTRUCTING THE ANTERIOR CRUCIATE LIGAMENT: RELATIONSHIPS BETWEEN THE FEMORAL TUNNEL, LATERAL SUPERIOR GENICULAR ARTERY AND LATERAL EPICONDYLE OF THE FEMORAL CONDYLE

    PubMed Central

    Astur, Diego Costa; Aleluia, Vinicius; Santos, Ciro Veronese; Arliani, Gustavo Gonçalves; Badra, Ricardo; Oliveira, Saulo Gomes; Kaleka, Camila Cohen; Cohen, Moisés

    2015-01-01

    Objective: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. Methods: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. Results: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. Conclusion: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and insertion of the lateral collateral ligament, promoting post-surgical complications such as instability of the knee, osteonecrosis of the femoral condyle and ligamentização graft.

  2. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    PubMed Central

    Zheng, Zhan-Le; Yu, Xian; Chen, Wei; Liu, Yue-Ju; Yu, Kun-Lun; Wu, Tao; Zhang, Ying-Ze

    2015-01-01

    Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures. Distal locking screw prominence is one of the causes for soft tissue irritation. This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P) view in detecting distal locking screw penetrations during retrograde femoral nailing. Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT) images. After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure. The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur. A-P view, lateral condyle tangential view and medial condyle tangential view were obtained. All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not. Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°. In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw) and 25.0% (medial condyle screw) at 4 mm, and 41.7% (lateral condyle screw) and 58.3% (medial condyle screw) at 6 mm. In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm. In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm. The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm) compared with the A-P view (P < 0.05). Conclusions: The femoral condyles tangential views increased the accuracy of detecting screw penetrations on the medial and lateral condyles. Routine clinical use of the femoral condyles tangential views has the potential to increase accuracy in detecting distal locking screw penetration during retrograde femoral nailing. PMID:26668151

  3. Results of treatment of displaced supracondylar humeral fractures in children by percutaneous lateral cross-wiring technique

    PubMed Central

    El-Adl, Wael A.; El-Said, Mohammed A.; Ali, Al-Sayed M.

    2008-01-01

    Seventy children with displaced type II and III supracondylar fractures of the humerus were managed with percutaneous lateral cross-wiring technique from January 2006 to January 2007. There were 54 boys and 16 girls with a mean age of 6.1 ± 3.07 years. All patients were operated within 24 h after trauma using the Dorgans percutaneous lateral cross-wiring technique. Patients were followed up for a mean period of 6.1 ± 2.6 months and assessed both radiologically for union; and functionally and cosmetically according to Flynn’s criteria. All patients achieved solid union. Functionally, all patients achieved satisfactory results, while cosmetically, 91.4% of patients had satisfactory results and 8.6% had unsatisfactory results. The most frequently occurring complications were minor pin tract infection in six patients, deep infection in two patients, and 32 patients suffered excessive granulation tissue formation mostly around the proximal pin. There was no iatrogenic neurological injury either for the ulnar or for the radial nerves. The obtained results and minor complications reported signify this technique as a viable treatment method for displaced type II and III supracondylar fractures in children. PMID:18427917

  4. Hypoplastic occipital condyle and third occipital condyle: review of their dysembryology.

    PubMed

    Tubbs, R Shane; Lingo, Patrick Ryan; Mortazavi, Martin M; Cohen-Gadol, Aaron A

    2013-11-01

    Disruption or embryologic derailment of the normal bony architecture of the craniovertebral junction (CVJ) may result in symptoms. As studies of the embryology and pathology of hypoplasia of the occipital condyles and third occipital condyles are lacking in the literature, the present review was performed. Standard search engines were accessed and queried for publications regarding hypoplastic occipital condyles and third occipital condyles. The literature supports the notion that occipital condyle hypoplasia and a third occipital condyle are due to malformation or persistence of the proatlas, respectively. The Pax-1 gene is most likely involved in this process. Clinically, condylar hypoplasia may narrow the foramen magnum and lead to lateral medullary compression. Additionally, this maldevelopment can result in transient vertebral artery compression secondary to posterior subluxation of the occiput. Third occipital condyles have been associated with cervical canal stenosis, hypoplasia of the dens, transverse ligament laxity, and atlanto-axial instability causing acute and chronic spinal cord compression. Treatment goals are focused on craniovertebral stability. A better understanding of the embryology and pathology related to CVJ anomalies is useful to the clinician treating patients presenting with these entities. PMID:23338989

  5. Radial nerve safety in Dorgan's lateral cross-pinning of the supracondylar humeral fracture in children: a case report and cadaveric study.

    PubMed

    Gangadharan, Sangeet; Rathinam, Bertha; Madhuri, Vrisha

    2014-11-01

    We encountered an iatrogenic radial nerve injury following Dorgan's lateral cross-pinning in a 5-year-old girl with a supracondylar fracture of the humerus. This prompted a cadaveric study to define a safe entry point for the proximal lateral Kirschner -wire. A child's cadaveric humerus was pinned laterally in three coronal planes, simulating the proximal entry pin. The radial nerve lay farthest from the wire in the posterolateral plane, 1 and 2 cm proximal to the lateral epicondyle. We report the first incidence of radial nerve injury with lateral cross-pinning and suggest that the wire should be placed posterolaterally within 2 cm from the lateral epicondyle. PMID:25238330

  6. Management of distal humeral coronal shear fractures

    PubMed Central

    Yari, Shahram S; Bowers, Nathan L; Craig, Miguel A; Reichel, Lee M

    2015-01-01

    Coronal shear fractures of the distal humerus are rare, complex fractures that can be technically challenging to manage. They usually result from a low-energy fall and direct compression of the distal humerus by the radial head in a hyper-extended or semi-flexed elbow or from spontaneous reduction of a posterolateral subluxation or dislocation. Due to the small number of soft tissue attachments at this site, almost all of these fractures are displaced. The incidence of distal humeral coronal shear fractures is higher among women because of the higher rate of osteoporosis in women and the difference in carrying angle between men and women. Distal humeral coronal shear fractures may occur in isolation, may be part of a complex elbow injury, or may be associated with injuries proximal or distal to the elbow. An associated lateral collateral ligament injury is seen in up to 40% and an associated radial head fracture is seen in up to 30% of these fractures. Given the complex nature of distal humeral coronal shear fractures, there is preference for operative management. Operative fixation leads to stable anatomic reduction, restores articular congruity, and allows initiation of early range-of-motion movements in the majority of cases. Several surgical exposure and fixation techniques are available to reconstruct the articular surface following distal humeral coronal shear fractures. The lateral extensile approach and fixation with countersunk headless compression screws placed in an anterior-to-posterior fashion are commonly used. We have found a two-incision approach (direct anterior and lateral) that results in less soft tissue dissection and better outcomes than the lateral extensile approach in our experience. Stiffness, pain, articular incongruity, arthritis, and ulnohumeral instability may result if reduction is non-anatomic or if fixation fails. PMID:25984515

  7. Management of distal humeral coronal shear fractures.

    PubMed

    Yari, Shahram S; Bowers, Nathan L; Craig, Miguel A; Reichel, Lee M

    2015-05-16

    Coronal shear fractures of the distal humerus are rare, complex fractures that can be technically challenging to manage. They usually result from a low-energy fall and direct compression of the distal humerus by the radial head in a hyper-extended or semi-flexed elbow or from spontaneous reduction of a posterolateral subluxation or dislocation. Due to the small number of soft tissue attachments at this site, almost all of these fractures are displaced. The incidence of distal humeral coronal shear fractures is higher among women because of the higher rate of osteoporosis in women and the difference in carrying angle between men and women. Distal humeral coronal shear fractures may occur in isolation, may be part of a complex elbow injury, or may be associated with injuries proximal or distal to the elbow. An associated lateral collateral ligament injury is seen in up to 40% and an associated radial head fracture is seen in up to 30% of these fractures. Given the complex nature of distal humeral coronal shear fractures, there is preference for operative management. Operative fixation leads to stable anatomic reduction, restores articular congruity, and allows initiation of early range-of-motion movements in the majority of cases. Several surgical exposure and fixation techniques are available to reconstruct the articular surface following distal humeral coronal shear fractures. The lateral extensile approach and fixation with countersunk headless compression screws placed in an anterior-to-posterior fashion are commonly used. We have found a two-incision approach (direct anterior and lateral) that results in less soft tissue dissection and better outcomes than the lateral extensile approach in our experience. Stiffness, pain, articular incongruity, arthritis, and ulnohumeral instability may result if reduction is non-anatomic or if fixation fails. PMID:25984515

  8. HUMERAL SHAFT FRACTURES

    PubMed Central

    Benegas, Eduardo; Ferreira Neto, Arnaldo Amado; Neto, Raul Bolliger; Santis Prada, Flavia de; Malavolta, Eduardo Angeli; Marchitto, Gustavo Oliveira

    2015-01-01

    Humeral shaft fractures (HSFs) represent 3% of the fractures of the locomotor apparatus, and the middle third of the shaft is the section most affected. In the majority of cases, it is treated using nonsurgical methods, but surgical indications in HSF cases are increasingly being adopted. The diversity of opinions makes it difficult to reach a consensus regarding the types of osteosynthesis, surgical technique and quantity and quality of synthesis materials that should be used. It would appear that specialists are far from reaching a consensus regarding the best method for surgical treatment of HSFs. We believe that less invasive methods, which favor relative stability, are the most appropriate methods, since the most feared complications are less frequent. PMID:27019833

  9. Archaic and modern human distal humeral morphology.

    PubMed

    Yokley, Todd R; Churchill, Steven E

    2006-12-01

    The morphology of the proximal ulna has been shown to effectively differentiate archaic or premodern humans (such as Homo heidelbergensis and H. neanderthalensis) from modern humans (H. sapiens). Accordingly, the morphology of adjacent, articulating elements should be able to distinguish these two broad groups as well. Here we test the taxonomic utility of another portion of the elbow, the distal humerus, as a discriminator of archaic and modern humans. Principal components analysis was employed on a suite of log-raw and log-shape distal humeral measures to examine differences between Neandertal and modern human distal humeri. In addition, the morphological affinities of Broken Hill (Kabwe) E.898, an archaic human distal humeral fragment from the middle Pleistocene of Zambia, and five Pliocene and early Pleistocene australopith humeri were assessed. The morphometric analyses effectively differentiated the Neandertals from the other groups, while the Broken Hill humerus appears morphologically similar to modern human distal humeri. Thus, an archaic/modern human dichotomy-as previously reported for proximal ulnar morphology-is not supported with respect to distal humeral morphology. Relative to australopiths and modern humans, Neandertal humeri are characterized by large olecranon fossae and small distodorsal medial and lateral pillars. The seeming disparity in morphological affinities of proximal ulnae (in which all archaic human groups appear distinct from modern humans) and distal humeri (in which Neandertals appear distinct from modern humans, but other archaic humans do not) is probably indicative of a highly variable, possibly transitional population of which our knowledge is hampered by sample-size limitations imposed by the scarcity of middle-to-late Pleistocene premodern human fossils outside of Europe. PMID:16959299

  10. Posterior minimally invasive plate osteosynthesis for humeral shaft fractures.

    PubMed

    Gallucci, Gerardo; Boretto, Jorge; Vujovich, Andrea; Alfie, Verónica; Donndorff, Agustín; De Carli, Pablo

    2014-03-01

    Fractures of the humeral shaft are common. Most of them can be successfully treated without surgery. In some cases, an operative intervention may offer faster and better functional results. One of the major problems with the open plating osteosynthesis is the extensive soft tissue stripping and disruption of periosteal circulation, caused by extensive surgical exposure, resulting in a relatively high rate of nonunion. Minimally invasive plate osteosynthesis (MIPO) techniques were developed to achieve a biologic fixation, although minimizing the complications of an open reduction. The incisions are small and remote from the fracture site to avoid direct fracture exposure. Thereby, MIPO technique obtains, theoretically, higher rates of union, lower infection risk, and decreases the need for bone graft. In the last years, MIPO has gained popularity with satisfactory clinical outcomes in the treatment of long bone fractures, especially in lower extremity. MIPO for humeral shaft fractures, however, could be a surgically dangerous procedure because of the risk of radial nerve injury. It was described by anterior and lateral approach. Humeral middle shaft fractures are possible to treat with a MIPO technique through an anterior, lateral, or a posterior approach. However, when the fracture is near the olecranon fossa, anterior approach is not possible as there is not enough space in the distal fragment to insert the amount of screws required to achieve stability. In this case, the posterior approach may be a good option for treatment. This article describes the MIPO technique through a posterior approach for the treatment of humeral shaft fractures. PMID:24458002

  11. Giant osteochondroma of the mandibular condyle

    PubMed Central

    Sekhar, MR Muthu; Loganathan, S

    2015-01-01

    Osteochondroma or osteocartilaginous exostosis is an exophytic lesion that arises from the cortex of the bone and is cartilage-capped. Osteochondroma of the mandibular condyle is extremely rare. The following is a case report of an osteochondroma of the mandibular condyle removed via extended preauricular approach to the temporomandibular joint. PMID:26980978

  12. Tuberculous osteomyelitis of mandibular condyle: a diagnostic dilemma

    PubMed Central

    Sheikh, S; Pallagatti, S; Gupta, D; Mittal, A

    2012-01-01

    The incidence of tuberculosis (TB) is increasing worldwide and so are its consequences. Its oral manifestations are infrequent, occurring in approximately 3% of all cases. Although the primary lesion occurs as a pulmonary infection, the extrapulmonary infections have also shown an increase over the past few years. These infections generally involve the head and neck through haematogenous or lymphatic routes. The clinical presentation may be as an ulcer, granuloma, orofacial TB, TB of the salivary glands or tuberculous lymphadenitis. Rarely, secondary oral manifestations associated with pulmonary infection are seen, which can appear as lesions on the gingiva, palate, lips, tongue, buccal mucosa, frenulum and in the jaw bones. Owing to the rarity of orofacial TB, it seldom arouses clinical suspicion, especially when a positive history of a systemic infection or therapy is denied. Tuberculous involvement of the mandibular condyle is even rarer, and only two such cases are reported so far, both in English-language literature. Further, the diagnosis of such a case is extremely difficult as there are no specific signs pathogonomic of infection. The only manifestation may be a localized painful swelling of the jaw. The presented case is of osteomyelitis of the mandibular condyle in a 20-year-old male patient in whom TB was later suspected. In this case report the role of diagnostic techniques is emphasized as the osteomyelitis of the condyle has the risk of being easily missed owing to its atypical signs and symptoms and atypical radiographic appearance. PMID:22074872

  13. History of femoral head fracture and coronal fracture of the femoral condyles.

    PubMed

    Bartoníček, Jan; Rammelt, Stefan

    2015-06-01

    The first known description of the coronal fracture of the lateral femoral condyle was published by Busch in 1869. Hoffa used Busch's drawing in the first edition of his book in 1888 and accompanied it only with one sentence. A full case history of this fracture pattern was described by Braun in 1891. However, Braun's article fell into oblivion and so the fracture was popularized only in the fourth edition of Hoffa's textbook, particularly thanks to the drawing, rather than the brief description. Therefore, a fracture of the posterior femoral condyle, or more specifically, of the lateral condyle, could properly be called "Busch-Hoffa fracture". Femoral head fracture was initially described by Birkett in 1869. Of essential importance in this respect were the publications by Christopher in 1924 and, particularly, Pipkin's study of 1957, including his classification that is still in use today. A historically correct eponym for a femoral head fracture would therefore be "Birkitt-Pipkin fracture". PMID:25787681

  14. Arthroscopic Management of a Posterior Femoral Condyle (Hoffa) Fracture: Surgical Technique

    PubMed Central

    Wagih, Ahmad M.

    2015-01-01

    Unicondylar fractures of the lower end of the femur are uncommon injuries that usually occur in the sagittal plane. A coronal (tangential) plane fracture, first described by Hoffa in 1904, is unusual. It is an intrinsically unstable type of intra-articular fracture that warrants operative fixation, usually by an open technique. A simple method for the treatment of lateral femoral condyle coronal fractures with arthroscopic-assisted reduction and internal fixation by cannulated screws is reported. Managing fractures of the posterior femoral condyle with arthroscopic reduction and fixation with cannulated screws is simple and effective and could be reproducible with good results and a good prognosis. PMID:26759766

  15. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  16. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  17. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  18. Radial and humeral fractures as predictors of subsequent hip, radial or humeral fractures in women, and their seasonal variation.

    PubMed

    Lauritzen, J B; Schwarz, P; McNair, P; Lund, B; Transbøl, I

    1993-05-01

    Hip fractures are common in elderly women, and early risk assessment of future hip fractures is relevant in relation to prevention. We studied the predictive value of radial and humeral fractures in women. The influence of weather conditions on the risk was also studied. Women aged 20-99 years with a fracture of the distal radius (n = 1162) or proximal humerus (n = 406) were followed for 0 to 9 years. The relative risk (RR) and 95% confidence limits (CL) of subsequent fracture among women suffering radial or humeral fractures compared with the background population were calculated. Women 60-79 years of age who had suffered a fracture of the distal radius or proximal humerus had relative risks of sustaining a hip fracture of 1.9 (1.3-2.6, 95% CL) and 2.5 (1.3-3.6, 95% CL) respectively. The relative risk of hip fracture was highest within the first years following a fracture of the radius or the humerus. Women suffering an upper extremity fracture (radius or humerus) in snowy or icy weather had a marginally increased risk (RR = 1.3, 0.4-2.3, 95% CL and RR = 1.8, 0.3-3.4, 95% CL) for a later hip fracture. A woman 50 years old with a radial or a humeral fracture had an estimated residual lifetime risk of sustaining a subsequent hip fracture of 17% and 16% respectively compared with 11% for the background population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8481589

  19. Arthroscopic treatment of bilateral humeral head osteonecrosis.

    PubMed

    Hardy, P; Decrette, E; Jeanrot, C; Colom, A; Lortat-Jacob, A; Benoit, J

    2000-04-01

    A 37-year-old woman with a renal transplant was treated by arthroscopic debridement for bilateral steroid-induced humeral head osteonecrosis. Radiologically, the right shoulder had been categorized as stage III and the left as stage IV according to Arlet and Ficat. Relief of pain and improved range of motion were obtained especially on the right shoulder. Arthroscopy is an efficient procedure for treatment of humeral head osteonecrosis in the renal transplant recipient including radiological stages III with episodes of locking. PMID:10750016

  20. Necrosis of the femoral condyles in a four-week-old foal: clinical, imaging and histopathological features.

    PubMed

    Haggett, E F; Foote, A K; Head, M J; McGladdery, A J; Powell, S E

    2012-02-01

    A 4-week-old Thoroughbred filly foal with a history of sepsis was evaluated for right hindlimb lameness. Bilateral femoropatellar and femorotibial joint effusions were detected. Ultrasonography and radiography of the right stifle revealed signs of joint collapse and periarticular swelling. Computed tomography revealed abnormalities in the bone density of the medial femoral condyle of the right hindlimb and lateral femoral condyle of the left hindlimb. Euthanasia was recommended based on the severity of the lesions. Gross and microscopic examinations revealed extensive separation of the articular-epiphyseal cartilage complex from the subchondral bone of the femoral condyles. The histological features suggest an ischaemic aetiology; comparisons are made with lesions of osteochondrosis and avascular necrosis of bone. PMID:22594034

  1. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular condyle prosthesis. 872.3960 Section 872.3960 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis....

  2. Subchondral Impaction Fractures of the Medial Femoral Condyle in Weightlifters: A Report of 5 Cases.

    PubMed

    Grzelak, Piotr; Podgrski, Micha? Tomasz; Stefa?czyk, Ludomir; Krochmalski, Marek; Dom?alski, Marcin

    2016-01-01

    Although subchondral impaction fractures have already been reported in the non-weight-bearing portion of the lateral femoral condyle, this study reveals the presence of an intra-articular impaction fracture of the postero-superior region of the non-weight-bearing portion of the medial femoral condyle recognized in 5 of a group of 22 representatives of the Polish national Olympic weightlifting team, who underwent 1.5T magnetic resonance imaging examination. Articular cartilage lesions varied with regard to the type of injury and its severity ranging from healed or subchronic injuries to acute trauma. All described individuals had no clinical history of acute knee trauma and only 3 of them had minor pain symptoms. The accumulation of microtraumas occurring during participation in particular activities associated with weightlifting training seems to be responsible for the development of this type of contusion. This is the first description of impaction fracture observed in this location in professional weightlifters. PMID:25881566

  3. Is scapular endoprosthesis functionally superior to humeral suspension?

    PubMed

    Pritsch, Tamir; Bickels, Jacob; Wu, Chia Chun; Squires, Malcolm H; Malawer, Martin M

    2007-03-01

    Humeral suspension was the most popular reconstructive procedure after total scapulectomy until the early 1990s. Since 1992 the senior author has been performing scapular endoprosthetic reconstruction after total scapulectomy whenever the rhomboids, latissimus dorsi, deltoid, and trapezius were preserved. We hypothesized that scapular endoprosthetic reconstruction resulted in better functional and cosmetic results than humeral suspension. From 1979 to 2003, 32 consecutive patients had total scapulectomies. Reconstructions included humeral suspensions in 16 patients and scapular endoprostheses in 16 patients. Functional and cosmetic results were compared retrospectively between the two groups. Patients with scapular endoprostheses had better functional results and superior cosmesis as compared with patients with humeral suspension. The mean Musculoskeletal Tumor Society scores for patients with scapular endoprostheses and humeral suspensions were 78.5% and 58.5% respectively. Seven patients with scapular endoprostheses had greater than 40 degrees abduction and 11 patients with humeral suspensions could not abduct the shoulder greater than 20 degrees. Twelve patients with humeral suspensions and none with scapular endoprostheses wore shoulder pads or customized orthoses for cosmetic purposes. After total scapulectomy, scapular endoprosthetic reconstruction led to better functional and cosmetic results than humeral suspension and therefore we recommend performing this reconstructive procedure whenever the rhomboids, latissimus dorsi, deltoid, and trapezius are preserved. PMID:17006374

  4. Outcome of humeral shaft fractures treated by functional cast brace

    PubMed Central

    Pal, Jitendra Nath; Biswas, Prahas; Roy, Avik; Hazra, Sunit; Mahato, Somnath

    2015-01-01

    Background: Functional brace application for isolated humeral shaft fracture persistently yields good results. Nonunion though uncommon involves usually the proximal third shaft fractures. Instead of polyethylene bivalve functional brace four plaster sleeves wrapped and molded with little more proximal extension expected to prevent nonunion of proximal third fractures. Periodic compressibility of the cast is likely to yield a better result. This can be applied on the 1st day of the presentation as an outpatient basis. Comprehensive objective scoring system befitting for fracture humeral shaft is a need. Materials and Methods: Sixty six (male = 40, female = 26) unilateral humeral shaft fractures of mean age 34.4 years (range 11–75 years) involving 38 left and 28 right hands were included in this study during April 2008 to December 2012. Fractures involved proximal (n = 18), mid (n = 35) and distal (n = 13) of humerus. Transverse, oblique, comminuted and spiral orientations in 18, 35 and 13 patients respectively. One had segmental fracture and three had a pathological fracture with cystic bone lesion. Mechanisms of injuries as identified in this study were road traffic accidents 57.6% (n = 38), fall 37.9% (n = 25). 12.1% (n = 8) had radial nerve palsy 7.6% (n = 5) had Type I open fracture. Four plaster strips of 12 layers and 5–7.5 cm broad depending on the girth of arm were prepared. Arm was then wrapped with single layer compressed cotton. Lateral and medial strips were applied and then after molding anterior and posterior strips were applied in such a way that permits full elbow range of motion and partial abduction of the shoulder. Care was taken to prevent adherence of one strip with other except in the proximal end. Limb was then put in loose collar and cuff sling intermittently allowing active motion of the elbow ROM and pendular movement of the shoulder. Weekly tightening of the cast by fresh layers of bandage over the existing cast brace continued. Results: The results were assessed using 100 point scoring system where union allotted 30 points and 60 points allotted for angulations (10), elbow motion (10), shoulder abduction (10), shortening (5), rotation (5), absence of infection (10), absence of nerve palsy during treatment (10). Remaining 10 points were allotted for five items with two points each. They were the absence of skin sore, absence of vascular problem, absence of reflex sympathetic dystrophy (RSD), recovery of paralyzed nerve during injury and recovery of paralyzed nerve during treatment. Results were considered excellent with 90 and above, good with 80–89, fair with 70–79 and poor below 70 point. Results at 6 months were excellent in 43.94% (n = 29), good in 42.42% (n = 28), fair in 9.1% (n = 6), poor in 4.55% (n = 3). Union took place in 98.48% (n = 65) with an average of 10.3 weeks (range 6–16 weeks). 87.5% (n = 7) paralyzed radial nerve recovered. All wounds healed. Four patients had transient skin problem. One patient with mid shaft fracture had nonunion due to the muscle interposition. Conclusion: Modified functional cast brace is one of the options in treatment for humeral shaft fractures as it can be applied on the 1st day of the presentation in most of the situations. Simple objective scoring system was useful particularly in uneducated patients. PMID:26229161

  5. [Observation of a distinct humeral spur formation].

    PubMed

    Neff, G; Schonert, J

    1976-01-01

    A 23 year old male with a mirror right hand, duplicated ulna and aplasia of the radius is presented. A large deformity of the distal and anterior surface of the humerus was also noted. Based on clinical documentation and X-rays it was felt that this unusual bony formation probably represented a minimal rudiment of the radius and that the bone deformity at the distal end of the humerus did not represent a supracondylar humeral spur which is occasionally seen in humerus without any concommittent congenital deformities, as is nearly always seen in mammals. PMID:971866

  6. Humeral shaft fractures secondary to throwing.

    PubMed

    Pehlivan, Ozcan; Kiral, Ahmet; Akmaz, Ibrahim; Solakoglu, Can; Arpacioglu, Omer; Kaplan, Haluk

    2003-11-01

    Twenty-seven male military recruits with humeral shaft fractures that occurred during throwing of a hand grenade were analyzed to determine the causes and contributing factors of this fracture in recreational pitchers. Average patient age was 22 years (range: 19-27 years). Objective criteria included type and fracture site on radiographs. Subjective data such as throwing style, previous pitching experience, and prodromal arm pain were obtained. The recruits' throwing style was deemed faulty. Analysis of the fracture configurations indicated an external rotation mechanism. PMID:14627112

  7. Ewing's sarcoma of proximal humeral epiphysis.

    PubMed

    Esmaili, Heydar Ali; Niknejad, Mohammad Taghi; Mohajeri, Shiva

    2015-02-01

    Ewing's sarcoma is one of the most common primary bone tumors of childhood. The tumor is almost always metaphyseal or diaphyseal, within long bones. In children, lesions of the epiphysis are often benign, with the most common diagnosis being chondroblastoma. Rarely, 1%-2% of Ewing sarcomas may involve epiphysis. We present a case of Ewing's sarcoma of the proximal humeral epiphysis in a 13-year-old boy. This case adds to previously reported cases of epiphyseal Ewing sarcoma and suggests that the diagnosis should be considered for pediatric epiphyseal lesions. PMID:25644805

  8. [Tumors of the mandibular condyle (author's transl)].

    PubMed

    Freidel, M; Beziat, J L; Bertoin, P; Bouvier, R; Dumas, P

    1981-01-01

    Three cases of tumors of the mandibular condyle are reported. One patient had metastases from a cutaneous melanoblastoma, another a benign osteochondroma, and the third a plasmocytosarcoma revealing the presence of Kahler disease. The authors emphasize the rare nature of these lesions, in spite of the technical advances made in the radiological and surgical exploration of the temporomandibular joint, and also the large variety of histological types reported in the literature. They discuss the main diagnostic features, especially in isolated lesions in patients with no relevant past history, and stress the importance of surgical biopsy. Therapy varies from surgical treatment in benign tumors, the prognosis being excellent, to usually palliative therapy in malignant lesions. PMID:6939076

  9. Alloplasty of the humeral joint.

    PubMed

    Górecki, Andrzej; Struzik, Sławomir

    2003-02-28

    Background. Since 1980's, shoulder arthroplasty has become more oftenly performed procedure, and for severe comminuted fractures of proximal humerus (fou r- fragmented fractures, according to Neer's classification) has become first - line therapeutic option. At the beginnig of 90's, contemporary prinicples of shoulder arthroplasty were introduced. It is assumed that 4 mechanical parameters, i.e. range of motion, joint stability, strengh and smoothness of prosthesis components contribute to shoulder function, and we sholud reach toward their reconstruction during surgical procedure. Material and Methods. In our Department from 1995 to1999 we performed 14 shoulder hemiarthroplasties using Bio-Modular prosthesis (12 women and 2 men). Patients' age ranged from 41 to 75 years (average 61.8 years). Indications included: acute comminuted proximal humerus fractures, proximal humerus malunions, and either degenerative arthritis or rheumatoid arthrits of the shoulder. Aftertreatment consisted of passive motions introduced on the first day after an operation, followed by assisted active excercises 4- 6 weeks later, and motions against resistance, allowed 2 months postoperatively. Results. The outcomes were evaluated three years after surgery, and were measured as the score in the Constant scale and as subjective patients' assesments. Improvement was seen as an increase from average 28.3 preoperative Constant score, to 60.3 postoperatively. Subjectively, excellent outcome was reported by 4 patients, good - by 7, and fair by 2 patients. Conclusions. Our experience shows that whereas indications to shoulder artrhroplasty are not frequent in cases of fractures or orthopedic conditions of the affected region, in properly selected group of patients this procedure is effective treatment option, alleviating pain and allowing for regaining well - functioning joint, but long-lasting, at leats one-year long rehabilitation programm after surgery is mandatory. PMID:17679856

  10. Humeral head translation decreases with muscle loading.

    PubMed

    Kedgley, Angela E; Mackenzie, Geoffrey A; Ferreira, Louis M; Drosdowech, Darren S; King, Graham J W; Faber, Kenneth J; Johnson, James A

    2008-01-01

    This study was conducted to determine the effect of in vitro passive and active loading on humeral head translation during glenohumeral abduction. A shoulder simulator produced unconstrained active abduction of the humerus in 8 specimens. Loading of the supraspinatus, subscapularis, infraspinatus/teres minor, and anterior, middle, and posterior deltoid muscles was simulated by use of 4 different sets of loading ratios. Significantly greater translations of the humeral head occurred both in 3 dimensions (P < .001) and in the sagittal plane (P < .005) during passive motion when compared with active motion from 30 degrees to 70 degrees of abduction. In the sagittal plane, passive abduction experienced a resultant translation of 3.8 +/- 1.0 mm whereas the active loading ratios averaged 2.3 +/- 1.0 mm. There were no significant differences in the translations that were produced by the 4 sets of muscle-loading ratios used to achieve active motions. This study emphasizes the importance of the musculature in maintaining normal ball-and-socket kinematics of the shoulder. PMID:18036848

  11. TMJ in facial class III deformity. Condyle/fossa relations.

    PubMed

    Muñoz, Gonzalo; Olate, Sergio; Cantín, Mario; Vásquez, Bélgica; Del Sol, Mariano; Fariña, Rodrigo

    2014-01-01

    The aim of this study was to ascertain the joint space present in the TMJ of subjects diagnosed with Class III dentofacial deformity with an indication for orthognathic surgery. Fourteen subjects were recruited from the Division of Oral and Maxillofacial Surgery at the Universidad de La Frontera, Chile. All subjects were admitted to the study after signing an informed consent and undergoing cephalometric analyses to define the severity of the deformity. Then, the joint space was analyzed, studying a cone beam CT image of the TMJ, which was evaluated in the coronal and sagittal views, defining the most anterior, median and posterior joint space (sagittal view), as well as the lateral, median and medial joint space (coronal view). The data were recorded in millimeters by an observer and data were analyzed after measuring the same parameter at three different times. A student's t-test was used for the analyses. Differences observed in both joints were not greater than 0.2 mm with spaces between 2 mm and 1.5 mm, thereby establishing the homogeneity of the sample, which presented no significant differences between the two joint spaces (right and left). It can be concluded that the joint space is symmetrical in both condyles and that no important changes are present compared to the results indicated in the international literature. PMID:25356133

  12. TMJ in facial class III deformity. Condyle/fossa relations

    PubMed Central

    Muñoz, Gonzalo; Olate, Sergio; Cantín, Mario; Vásquez, Bélgica; del Sol, Mariano; Fariña, Rodrigo

    2014-01-01

    The aim of this study was to ascertain the joint space present in the TMJ of subjects diagnosed with Class III dentofacial deformity with an indication for orthognathic surgery. Fourteen subjects were recruited from the Division of Oral and Maxillofacial Surgery at the Universidad de La Frontera, Chile. All subjects were admitted to the study after signing an informed consent and undergoing cephalometric analyses to define the severity of the deformity. Then, the joint space was analyzed, studying a cone beam CT image of the TMJ, which was evaluated in the coronal and sagittal views, defining the most anterior, median and posterior joint space (sagittal view), as well as the lateral, median and medial joint space (coronal view). The data were recorded in millimeters by an observer and data were analyzed after measuring the same parameter at three different times. A student’s t-test was used for the analyses. Differences observed in both joints were not greater than 0.2 mm with spaces between 2 mm and 1.5 mm, thereby establishing the homogeneity of the sample, which presented no significant differences between the two joint spaces (right and left). It can be concluded that the joint space is symmetrical in both condyles and that no important changes are present compared to the results indicated in the international literature. PMID:25356133

  13. 21 CFR 872.4770 - Temporary mandibular condyle reconstruction plate.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... device that is intended to stabilize mandibular bone and provide for temporary reconstruction of the... surgical procedures requiring removal of the mandibular condyle and mandibular bone. This device is...

  14. Intrathoracic displacement of the humeral head in a trauma patient

    PubMed Central

    Jun-song, Wu; Jing-Yu, Du; Zhi-Qiang, Wen; Fang, Guo; Xiang-Jin, Lin

    2012-01-01

    Fracture and intrathoracic displacement of the humeral head is the result of severe high energy trauma and are extremely rare. Because of the exceedingly limited number of cases, appropriate treatment modality remains unclear. Hitherto, we describe a unique case of thoracic aorta injury caused by fragmented humeral head. Purposeful medical examination and fast locating of the humeral head fragment are crucial for the selection of appropriate treatment modality. Early aggressive intervention, e.g., emergency thoracoscopy exploring, can be performed to treat potential thoracic complications. PMID:23162158

  15. Humeral bone fragility in patients with shoulder prosthesis: a case of humeral periprosthetic refracture

    PubMed Central

    Giannotti, Stefano; Bottai, Vanna; DellOsso, Giacomo; Donati, Daniela; Bugelli, Giulia; De Paola, Gaia; Guido, Giulio

    2012-01-01

    Summary In recent decades there has been an increase in upper limb prosthetic surgery, primarily for the shoulder, for osteoarthritis disease and for traumatic pathology. It is occurring in parallel an increase in periprosthetic fractures of the humerus, although with less impact than other anatomical districts such as the hip. We report a case of humeral periprosthetic refracture in a 66-years-old female patient. The humerus bone quality is worse than in other districts in patient of the same age. The fragility humerus fracture are increasing, affecting relatively younger individuals than those with femoral neck fractures and represent an independent risk factor for the occurrence of subsequent fractures. Actually humeral BMD is underestimated by traditional densitometric evaluation techniques. PMID:22783338

  16. Strain induced in the condyle by self-tapping screws in the Biomet alloplastic temporomandibular joint: a preliminary experimental study.

    PubMed

    Ramos, A; Duarte, R J; Mesnard, M

    2015-11-01

    The main aim of this study was to analyze how screws affect the strain concentration induced on the mandibular condyle during implantation, screwing, and drilling, as well as after condylar loading. A clean cadaveric mandible was analyzed experimentally in the intact state and was then implanted with a Biomet/Lorenz Microfixation temporomandibular joint (TMJ) implant with seven bicortical self-tapping screws. The external surface of the mandible was instrumented with three strain gauges. A load of 500N on the TMJ was applied to the condyle before and after implantation. The results showed a strain concentration of -1500μɛ near the screws due to their implantation on the external surface of the mandible. The drilling process induced up to 80μɛ near the hole. The strain concentration did not change when there were more than six screws. Loading on the TMJ before and after implantation presented only a 10% difference in maximum principal strain. This study demonstrates the importance of the strain concentration induced by the screws. The process of implanting screws shows the importance of lateral surface preparation for a good fit in the condyle. Strain distribution after implantation and loading of the Biomet implant was found to be similar to that in the intact condyle. PMID:26194773

  17. Revision of failed humeral head resurfacing arthroplasty

    PubMed Central

    Streubel, Philipp N.; Simone, Juan P.; Cofield, Robert H.; Sperling, John W.

    2016-01-01

    Purpose: The purpose of this study is to assess the outcomes of a consecutive series of patients who underwent revision surgery after humeral head resurfacing (HHR). Our joint registry was queried for all patients who underwent revision arthroplasty for failed HHR at our institution from 2005 to 2010. Eleven consecutive patients (average age 54 years; range 38-69 years) that underwent revision of 11 resurfacing arthroplasties were identified. The primary indication for resurfacing had been osteoarthritis in six, glenoid dysplasia in two, a chondral lesion in two, and postinstability arthropathy in one patient. The indication for revision was pain in 10 and infection in one patient. Seven patients had undergone an average of 1.9 surgeries prior to resurfacing (range 1-3). Materials and Methods: All patients were revised to stemmed arthroplasties, including one hemiarthroplasty, two reverse, and eight anatomic total shoulder arthroplasties at a mean 33 months after primary resurfacing (range 10-131 months). A deltopectoral approach was used in seven patients; four patients required an anteromedial approach due to severe scarring. Subscapularis attenuation was found in four cases, two of which required reverse total shoulder arthroplasty. Bone grafting was required in one glenoid and three humeri. Results: At a mean follow-up of 3.5 years (range 1.6-6.9 years), modified Neer score was rated as satisfactory in five patients and unsatisfactory in six. Abduction and external rotation improved from 73° to 88° (P = 0.32) and from 23° to 32° (P = 0.28) respectively. Reoperation was required in two patients, including one hematoma and one revision for instability. Conclusion: Outcomes of revision of HHR arthroplasty in this cohort did not improve upon those reported for revision of stemmed humeral implants. A comparative study would be required to allow for definitive conclusions to be made. PMID:26980986

  18. Age-associated cartilage degeneration of the canine humeral head.

    PubMed

    Craig, L E; Reed, A

    2013-03-01

    The goal of this study was to determine if cartilage lesions of the humeral head in adult dogs are the consequence of osteochondrosis dissecans or degenerative joint disease. A gross and histologic survey was performed of humeral head cartilage lesions of 155 dogs ranging in age from 1 week to 19 years. The humeral head and cartilage lesion size were measured for each dog. Cartilage lesions were classified as fibrillation, fissures, erosion, and/or eburnation. The area of each lesion was multiplied by a severity score (fibrillation and fissures 1, erosion 2, and eburnation 3) to create a combined score for each humeral head. Correlations between this combined lesion score and age, humeral head size, body weight, and body condition score were assessed using a Bonferroni-corrected alpha of .01. Twenty-six humeral heads were also evaluated histologically. Of the 155 dogs, 80 (52%) had gross lesions of the articular cartilage. The presence and severity of the articular cartilage lesions were positively correlated with age, humeral head size, body weight, and body condition score. The average age of dogs with cartilage lesions was 8.8 years, and 77/105 (74%) of adult dogs had cartilage lesions. Fifty dogs were 3 years of age or younger; 3 of those had cartilage lesions, 1 of which was osteochondrosis. These data indicate that cartilage erosion of the caudal humeral head in dogs is a common degenerative lesion acquired in adult large breed dogs; osteochondrosis dissecans does not precede the lesion in the vast majority of cases. PMID:22773468

  19. Application of Additional Medial Plate in Treatment of Proximal Humeral Fractures With Unstable Medial Column

    PubMed Central

    He, Yu; He, Jiliang; Wang, Fu; Zhou, Dongsheng; Wang, Yan; Wang, Bomin; Xu, Shihong

    2015-01-01

    Abstract The purpose of this study was to use finite element analysis to compare the biomechanical characteristics after lateral locking plate (LLP) or LLP with a medial anatomical locking plate (LLP-MLP) fixation of proximal humeral fractures with an unstable medial column. First, a 3-dimensional, finite element analysis model was developed. Next, LLP and LLP-MLP implants were instrumented into the proximal humeral fracture models. Compressive and rotational loads were then applied to the humerus model to determine the biomechanical characteristics. Both normal and osteoporotic proximal humerus fractures were simulated using 2 internal fixation methods each under 7 loading conditions. To assess the biomechanical characteristics, the construct stiffness, fracture micromotion, and stress distribution on the implants were recorded and compared. The LLP-MLP method provided both lateral and medial support that reduced the stress on the LLP and the amount of displacement in the fracture region. In contrast, the LLP method resulted in more instability in the medial column and larger magnitudes of stress. In osteoporotic bone, the LLP was more inclined to fail than LLP-MLP. The LLP-MLP method provides a strong support for the medial column and increases the stability of the region surrounding the fracture. PMID:26469918

  20. Orthopaedic approaches to proximal humeral fractures following trauma.

    PubMed

    Mafi, Reza; Khan, Wasim; Mafi, Pouya; Hindocha, Sandip

    2014-01-01

    Proximal humeral fractures have been a topic of discussion in medical literature dating back as far as 3rd century BC. Today, these fractures are the most common type of humeral fractures and account for about 5-6% of all fractures in adults with the incidence rising rapidly with age. In broad terms the management of proximal humeral fractures can be divided into two categories: conservative versus surgical intervention. The aim of treatment is to stabilize the fracture, aid better union and reduce pain during the healing process. Failure to achieve this can result in impairment of function, and significantly weaken the muscles inserting onto the proximal humerus. With the rising incidence of proximal humeral fractures, especially among the elderly, the short and long term burden for patients as well as the wider society is increasing. Furthermore, there is a lack of consistency in the definitive treatment and management of displaced fractures. This systematic review of literature compares the surgical treatment of proximal humeral fractures with their conservative management, by evaluating the available randomised controlled trials on this topic. PMID:25408786

  1. A Review of Management Options for Proximal Humeral Fractures

    PubMed Central

    Jordan, Robert W; Modi, Chetan S

    2014-01-01

    Proximal humeral fractures are common and although the majority can be managed non-operatively, the optimal treatment of displaced or complex fractures remains controversial. Non-operative treatment is typically selected for minimally displaced fractures where union rates are high and good or excellent outcomes can be expected in approximately 80% of cases. The aims of surgical fixation are to restore articular surface congruency, alignment and the relationship between the tuberosities and the humeral head. Hemiarthroplasty provides patients with reliable pain relief and its indications include fracture dislocations, humeral head splitting fractures and some three- and four- part fractures. The key areas of surgical technique that influence functional outcome include correctly restoring the humeral height, humeral version and tuberosity position. Function, however, is poor if the tuberosities either fail to unite or mal-unite. The interest in reverse shoulder arthroplasty as an alternative option has therefore recently increased, particularly in older patients with poor bone quality and tuberosity comminution. The evidence supporting this, however, is currently limited to multiple case series with higher level studies currently underway. PMID:25067968

  2. Total Humeral Endoprosthetic Replacement following Excision of Malignant Bone Tumors

    PubMed Central

    Kotwal, Suhel; Moon, Bryan; Lin, Patrick; Satcher, Robert; Lewis, Valerae

    2016-01-01

    Humerus is a common site for malignant tumors. Advances in adjuvant therapies and reconstructive methods provide salvage of the upper limb with improved outcomes. Reports of limb salvage with total humeral replacement in extensive humeral tumors are sparse. We undertook a retrospective study of 20 patients who underwent total humeral endoprosthetic replacement as limb salvage following excision of extensile malignant tumor from 1990 to 2011. With an average followup of 42.9, functional and oncological outcomes were analyzed. Ten patients were still alive at the time of review. Mean estimated blood loss was 1131 mL and duration of surgery was 314 minutes. Deep infection was encountered in one patient requiring debridement while mechanical loosening of ulnar component was identified in one patient. Subluxation of prosthetic humeral head was noted in 3 patients. Mean active shoulder abduction was 12.5° and active flexion was 15°. Incompetence of abduction mechanism was the major determinant of poor active functional outcome. Mean elbow flexion was 103.5° with 30.5° flexion contracture in 10 patients with good and useful hand function. Average MSTS score was 71.5%. Total humeral replacement is a reliable treatment option in restoring mechanical stability and reasonable functional results without compromising patient survival, with low complication rate. PMID:27042158

  3. Total Humeral Endoprosthetic Replacement following Excision of Malignant Bone Tumors.

    PubMed

    Kotwal, Suhel; Moon, Bryan; Lin, Patrick; Satcher, Robert; Lewis, Valerae

    2016-01-01

    Humerus is a common site for malignant tumors. Advances in adjuvant therapies and reconstructive methods provide salvage of the upper limb with improved outcomes. Reports of limb salvage with total humeral replacement in extensive humeral tumors are sparse. We undertook a retrospective study of 20 patients who underwent total humeral endoprosthetic replacement as limb salvage following excision of extensile malignant tumor from 1990 to 2011. With an average followup of 42.9, functional and oncological outcomes were analyzed. Ten patients were still alive at the time of review. Mean estimated blood loss was 1131 mL and duration of surgery was 314 minutes. Deep infection was encountered in one patient requiring debridement while mechanical loosening of ulnar component was identified in one patient. Subluxation of prosthetic humeral head was noted in 3 patients. Mean active shoulder abduction was 12.5° and active flexion was 15°. Incompetence of abduction mechanism was the major determinant of poor active functional outcome. Mean elbow flexion was 103.5° with 30.5° flexion contracture in 10 patients with good and useful hand function. Average MSTS score was 71.5%. Total humeral replacement is a reliable treatment option in restoring mechanical stability and reasonable functional results without compromising patient survival, with low complication rate. PMID:27042158

  4. Orthopaedic Approaches to Proximal Humeral Fractures Following Trauma

    PubMed Central

    Mafi, Reza; Khan, Wasim; Mafi, Pouya; Hindocha, Sandip

    2014-01-01

    Proximal humeral fractures have been a topic of discussion in medical literature dating back as far as 3rd century BC. Today, these fractures are the most common type of humeral fractures and account for about 5-6% of all fractures in adults with the incidence rising rapidly with age. In broad terms the management of proximal humeral fractures can be divided into two categories: conservative versus surgical intervention. The aim of treatment is to stabilize the fracture, aid better union and reduce pain during the healing process. Failure to achieve this can result in impairment of function, and significantly weaken the muscles inserting onto the proximal humerus. With the rising incidence of proximal humeral fractures, especially among the elderly, the short and long term burden for patients as well as the wider society is increasing. Furthermore, there is a lack of consistency in the definitive treatment and management of displaced fractures. This systematic review of literature compares the surgical treatment of proximal humeral fractures with their conservative management, by evaluating the available randomised controlled trials on this topic. PMID:25408786

  5. Condyle-fossa modifications and muscle interactions during Herbst treatment, Part 2. Results and conclusions.

    PubMed

    Voudouris, John C; Woodside, Donald G; Altuna, Gurkan; Angelopoulos, Gerassimos; Bourque, Paul J; Lacouture, Camilo Yamin; Kuftinec, Mladen M

    2003-07-01

    Herbst appliances were activated progressively in growing nonhuman primates, and the results were compared with primate and human controls. The methods and materials of this research are explained in Part 1 of this study. The results are discussed here in Part 2. All experimental subjects developed large super Class I malocclusions, the result of many factors including posterior movement of the maxilla and the maxillary teeth, an increased horizontal component of condylar growth, and anterior displacement of the mandible and the mandibular teeth. The growth modification measured in the glenoid fossa was in an inferior and anterior direction. Restriction of the downward and backward growth of the fossa observed in the control subjects might additionally contribute to the overall super Class I malocclusion. Clinically, these combined effects could be significant at the fossa. The restriction of local temporal bone (fossa) growth cannot be observed clinically; thus, these results might also clarify some Class II correction effects that cannot be explained with functional appliances. Differences in the area and maximum thickness of new bone formation in the glenoid fossa and in condylar growth were statistically significant. The bony changes in the condyle and the glenoid fossa were correlated with decreased postural electromyographic activity during the experimental period. Results from permanently implanted electromyographic sensors demonstrated that lateral pterygoid muscle hyperactivity was not associated with condyle-glenoid fossa growth modification with functional appliances, and that other factors, such as reciprocal stretch forces and subsequent transduction along the fibrocartilage between the displaced condyle and fossa, might play a more significant role in new bone formation. These results support the growth relativity concept. PMID:12867894

  6. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Elbow joint humeral (hemi-elbow) metallic... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint humeral (hemi-elbow) metallic uncemented prosthesis is a device intended to be implanted made of...

  7. Thermal damage during humeral reaming in total shoulder resurfacing

    PubMed Central

    McCann, Philip A.; Sarangi, Partha P.; Baker, Richard P.; Blom, Ashley W.; Amirfeyz, Rouin

    2013-01-01

    Introduction: Total shoulder resurfacing (TSR) provides a reliable solution for the treatment of glenohumeral arthritis. It confers a number of advantages over traditional joint replacement with stemmed humeral components, in terms of bone preservation and improved joint kinematics. This study aimed to determine if humeral reaming instruments produce a thermal insult to subchondral bone during TSR. Patients and Methods: This was tested in vivo on 13 patients (8 with rheumatoid arthritis and 5 with osteoarthritis) with a single reaming system and in vitro with three different humeral reaming systems on saw bone models. Real-time infrared thermal video imaging was used to assess the temperatures generated. Results: Synthes (Epoca) instruments generated average temperatures of 40.7°C (SD 0.9°C) in the rheumatoid group and 56.5°C (SD 0.87°C) in the osteoarthritis group (P = 0.001). Irrigation with room temperature saline cooled the humeral head to 30°C (SD 1.2°C). Saw bone analysis generated temperatures of 58.2°C (SD 0.79°C) in the Synthes (Epoca) 59.9°C (SD 0.81°C) in Biomet (Copeland) and 58.4°C (SD 0.88°C) in the Depuy Conservative Anatomic Prosthesis (CAP) reamers (P = 0.12). Conclusion: Humeral reaming with power driven instruments generates considerable temperatures both in vivo and in vitro. This paper demonstrates that a significant thermal effect beyond the 47°C threshold needed to induce osteonecrosis is observed with humeral reamers, with little variation seen between manufacturers. Irrigation with room temperature saline cools the reamed bone to physiological levels and should be performed regularly during this step in TSR. PMID:24167401

  8. Management of Humeral Shaft Fractures; Non-Operative Versus Operative

    PubMed Central

    Clement, Nicholas D.

    2015-01-01

    Context: Functional humeral bracing remains the gold standard for treatment of humeral shaft fractures. There is an increasing trend in the literature to perform operative fixation of these fractures. Evidence Acquisition: The aim of this systematic review was to compare the level one evidence for the outcome of non-operative with operative management of humeral shaft fractures in adults. A comprehensive electronic literature search of Medline and PubMed was performed with specific inclusion criteria to identify randomized controlled trials. Results: In total, seventeen different studies were identified from the search terms and combinations used. Only one study met the inclusion criteria; however, this was a published study protocol of an ongoing trial currently being conducted. One additional published protocol for an ongoing trial was also identified, but this was for a prospective comparative observational study. Although this latter study may not be level one evidence, it would offer great insight into the functional outcome of humeral shaft fractures and economic implications of operative management, which is currently not addressed in the literature. Two retrospective comparative studies were also identified, one of which demonstrated a significantly lower rate of nonunion and malunion in those patients undergoing operative management. Conclusions: This systematic review demonstrated a deficiency in the current literature of level one evidence available for the management of humeral shaft fractures. The current ongoing randomized control trail would offer a greater insight into the management of humeral shaft fractures and help confirm or refute the current literature. If this randomized control trial affirms the reduction in the rate of nonunion with operative fixation, a cost economic analysis is essential. As it would seem to offer operative management to all patients may be over treatment and not to offer this at all would undertreat. PMID:26401493

  9. Soft tissue artefact assessment in humeral axial rotation.

    PubMed

    Cutti, Andrea Giovanni; Paolini, Gabriele; Troncossi, Marco; Cappello, Angelo; Davalli, Angelo

    2005-04-01

    The accuracy of upper-limb kinematic data acquired from optoelectronic systems with retro-reflective markers is poor, mainly due to soft tissue artefact (STA). For the upper-arm, humeral internal/external rotation (HIER) is the movement most affected by STA, which is measured as a percentile fraction (K) of the effective humeral axial rotation performed. The aim of this work was to quantify STA during HIERs, with independently varying attitude of the humerus and elbow flexion, and to test the possibility of estimating its mean value over the tested upper-limb orientations using one simple trial. Six able-bodied subjects performed a series of HIERs in combination with elbow flexion for different humeral planes and degrees of elevation. During the trials the instantaneous attitudes of two humeral anatomical frames were compared, one being affected by the STA to be measured, and the other assumed as the gold standard. K was found to range from 20% to 48% of the effective humeral axial rotation performed, depending on the subject, humeral attitude and elbow flexion. These last two factors comparably affect STA and resulted in mean K coefficients of variation among the subjects of about 9% and 7%, respectively. Common patterns of K with elbow flexion and humerus elevation are discussed. The data also show that the mean of K of a subject is very close to the value assessed in a specific upper-limb configuration consistent among the subjects. This result from this study could be used to build up a time-saving STA compensation procedure suitable for clinical applications. PMID:15760751

  10. Evaluation of mandibular condyles in children with unilateral posterior crossbite.

    PubMed

    Illipronti-Filho, Edson; Fantini, Solange Mongelli de; Chilvarquer, Israel

    2015-01-01

    The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB) has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in the sagittal and coronal planes, using cone-beam computed tomography (CBCT). Twenty CBCT images of 40 temporo mandibular joints (TMJs) in individuals in mixed dentition phase, which included 9 males (mean 7.9 years) and 11 females (mean 8.2 years), with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (< 40 mm), congenital or genetic anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane. PMID:25760067

  11. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Date PMA or notice of completion of a PDP is required. (1) Except as described in paragraph (c)(2) of this section, a PMA or a notice of completion of a PDP is required to be filed with the Food and Drug... other mandibular condyle prosthesis shall have an approved PMA or a declared completed PDP in...

  12. Complaints related to mandibular function impairment after closed treatment of fractures of the mandibular condyle.

    PubMed

    Niezen, E T; Bos, R R M; de Bont, L G M; Stegenga, B; Dijkstra, P U

    2010-07-01

    This study analysed the relationship between complaints and mandibular function after closed treatment of fractures of the mandibular condyle in a prospective study. In a 1-year follow-up, complaints were assessed during physical examination and function was assessed using the mandibular function impairment questionnaire (MFIQ), scoring range 0-68. Data from 114 patients (41 women, 73 men), mean age 28.1 years (SD 13.3), were available. On average the MFIQ scores were low 3.4 (SD 7.3). Ten patients (9%) experienced pain and 45 (39%) patients had a MFIQ score > 0. Mean mouth opening was 51.9 mm (SD 8.4). Occlusion was perceived as moderate or poor by 24% of the patients. In the logistic regression analysis mandibular function impairment (MFIQ score > 0) was entered as a dependent variable. Risk factors for mandibular function impairment were: pain, perceived occlusion (moderate or poor), absolute difference between left and right horizontal movements and age. A protective factor was mouth opening. The results of this study show that complaints (i.e. pain, perceived occlusion, reduced mouth opening, difference between left and right lateral movements and increased age) are predictors of mandibular function impairment after closed treatment of fractures of the mandibular condyle. PMID:20430584

  13. A novel approach to neoplasms medial to the condyle: a condylectomy with anterior displacement of the condyle.

    PubMed

    Ye, Z-X; Yang, C; Chen, M-J; Abdelrehem, A

    2016-04-01

    Resecting neoplasms involving the infratemporal space has a high risk of damaging critical nerves and vessels, in addition to joint form and function. The purpose of this study was to introduce a novel approach to lesions medial to the condyle, which comprises a condylectomy with anterior displacement of the condyle. The indications evaluated using digital surgical simulation, the critical surgical technique, and the preliminary clinical effects are presented here. Five cases underwent this approach between January 2006 and December 2014. The common characteristics of the five masses were (1) that they were non-malignant neoplasms involving the posterior-medial region of the condyle; (2) the upper and lower borders were between the skull base and the lingula, while the anterior border did not exceed the coronoid process. All masses were resected successfully with no damage to any critical nerves or vessels. The average follow-up period was 29.8 months (range 6-56 months). There was no recurrence, secondary deformity, or facial paralysis. The average mouth opening improved from an original 27mm to 34mm after surgery. The condyles were well fixed, with no resorption, as shown on computed tomography scans. PMID:26748864

  14. Management of a humeral shaft non-union after a Gustilo III C fracture.

    PubMed

    Conserva, Vito; Vicenti, Giovanni; Abate, Antonella; Pesce, Vito; Moretti, Biagio

    2015-12-01

    A 25-year-old man was admitted to our Department with an open humeral shaft fracture (Gustilo III C); two large wounds were noticed with ulnar artery and median nerve completely dissected. Initial primary treatment included irrigation, debridement and fracture stabilization with a monolateral external fixator followed by vascular and nerve repair and wound closure. At 6 months follow up the patient was able to use his arm without any painful stimuli and a CT scan showed the presence of postero-medial callus formation. Consequently, the external fixator was removed and the patient was discharged to physiotherapy. After 7 months, the patient presented with severe pain and functional impairment with no history of trauma. X rays showed recent re-fracture on a background of oligotrophic nonunion. Revision surgery included debridement of the non-union bone edges, reaming of the medullary canal and insertion of a humeral nail. Six months later osseous healing was noted with complete restoration of shoulder and elbow movement and partial recovery of the median nerve. PMID:26738452

  15. Humeral lengthening by distraction osteogenesis: a safe procedure?

    PubMed

    Ruette, Peter; Lammens, Johan

    2013-12-01

    This study was conducted to assess the safety of humeral lengthening using an Ilizarov frame. We retrospectively reviewed 26 humeral segments in 17 patients that were lengthened at our department between 1993 and 2011. There were varying aetiologies including achondroplasia, epiphyseal dysplasia, Oilier disease, trauma or infection of the proximal humeral growth-plate, unicameral bone cyst and brachial plexus injury. Mean age at start of surgery was 17.05 years (range : 5-40). The mean lengthening achieved was 8.85 (3-13) cm. Mean lengthening percentage was 353% (range : 10-48). Average healing index was 30.56 days/cm (range : 17.46-4232). There was a significant difference in healing index between achondroplasia patients (28.79 days/cm) compared to others (33.41 days/cm). Minor problems included pin tract infection (14 segments). More important obstacles were temporary elbow flexion contracture (7 segments), premature consolidation (6 segments), radial nerve dysaesthesia (6 segments) and loosening of a Schanz screw (1 segment). Complications included one fracture and one progressive bowing after frame removal. One planned lengthening was not completely achieved. Despite a lot of obstacles, humeral lengthening using an Ilizarov frame provided a reliable method to treat the functional or cosmetic problems of upper limb shortening. PMID:24563967

  16. Osteochondritis dissecans on the medial aspect of the humeral head

    PubMed Central

    Mima, Yuichiro; Matsumura, Noboru; Ogawa, Kiyohisa; Iwamoto, Takuji; Ochi, Kensuke; Sato, Kazuki; Toyama, Yoshiaki

    2016-01-01

    The case of a 29-year-old man who had osteochondritis dissecans on the medial aspect of the humeral head is reported. Repetitive micro-trauma at a low elevated arm position was thought to have induced the osteochondral lesion.

  17. Occipital condyle to cervical spine fixation in the pediatric population.

    PubMed

    Kosnik-Infinger, Libby; Glazier, Steven S; Frankel, Bruce M

    2014-01-01

    Fixation at the craniovertebral junction (CVJ) is necessary in a variety of pediatric clinical scenarios. Traditionally an occipital bone to cervical fusion is preformed, which requires a large amount of hardware to be placed on the occiput of a child. If a patient has previously undergone a posterior fossa decompression or requires a decompression at the time of the fusion procedure, it can be difficult to anchor a plate to the occipital bone. The authors propose a technique that can be used when faced with this difficult challenge by using the occipital condyle as a point of fixation for the construct. Adult cadaveric and a limited number of case studies have been published using occipital condyle (C-0) fixation. This work was adapted for the pediatric population. Between 2009 and 2012, 4 children underwent occipital condyle to axial or subaxial spine fixation. One patient had previously undergone posterior fossa surgery for tumor resection, and 1 required decompression at the time of operation. Two patients underwent preoperative deformity reduction using traction. One child had a Chiari malformation Type I. Each procedure was performed using polyaxial screw-rod constructs with intraoperative neuronavigation supplemented by a custom navigational drill guide. Smooth-shanked 3.5-mm polyaxial screws, ranging in length from 26 to 32 mm, were placed into the occipital condyles. All patients successfully underwent occipital condyle to cervical spine fixation. In 3 patients the construct extended from C-0 to C-2, and in 1 from C-0 to T-2. Patients with preoperative halo stabilization were placed in a cervical collar postoperatively. There were no new postoperative neurological deficits or vascular injuries. Each patient underwent postoperative CT, demonstrating excellent screw placement and evidence of solid fusion. Occipital condyle fixation is an effective option in pediatric patients requiring occipitocervical fusion for treatment of deformity and/or instability at the CVJ. The use of intraoperative neuronavigation allows for safe placement of screws into C-0, especially when faced with a challenging patient in whom fixation to the occipital bone is not possible or is less than ideal. PMID:24206344

  18. Assessing the mobility of the mandibular condyle by sonography

    PubMed Central

    Chen, Han-Yu; Wu, Shyi-Kuen; Lu, Chuan-Chin; You, Jia-Yuan; Lai, Chung-Liang

    2014-01-01

    Purpose Traditionally, the measurement of the maximal mouth opening was regarded as the mobility of the temporomandibular joint. The information, however, was not reliable. Sonography was often used to diagnose disc displacement in the temporomandibular joint and its validity was well established. The tool was also appropriate for measuring the outcome of temporomandibular disorders management. Therefore, the purpose of the study was to examine completely the reliability and error for evaluating the mobility of the mandibular condyle by sonography. In addition, the existing methods were modified to improve the repeatability. Patients and methods The reliability examinations included between-image and within-image explorations to represent the reliabilities of the image capturing and the mobility measuring, respectively. Sixty-two subjects were recruited to receive ultrasonic examination for condylar mobility. The images of the condyle in mouth closing and opening were captured and the horizontal displacement of the condyles was measured as the anterior translation of the condyle. To confirm that the probe did not move during mouth opening, a marker was placed between the skin and the ultrasonic probe as the landmark. Results The results demonstrated that the intrarater and interrater reliabilities in the within-image test were 0.986 and 0.970 and the reliabilities in the between-image test were 0.904 and 0.857, respectively. The standard errors of measurement in the within-image and between-image tests were 0.04 cm and 0.09 cm, respectively. Conclusion Sonography is a reliable tool to assess condylar mobility and can be used to measure the treatment outcome for temporomandibular disorders. PMID:25342888

  19. Management of humeral and glenoid bone loss in recurrent glenohumeral instability.

    PubMed

    Mascarenhas, Randy; Rusen, Jamie; Saltzman, Bryan M; Leiter, Jeff; Chahal, Jaskarndip; Romeo, Anthony A; MacDonald, Peter

    2014-01-01

    Recurrent shoulder instability and resultant glenoid and humeral head bone loss are not infrequently encountered in the population today, specifically in young, athletic patients. This review on the management of bone loss in recurrent glenohumeral instability discusses the relevant shoulder anatomy that provides stability to the shoulder joint, relevant history and physical examination findings pertinent to recurrent shoulder instability, and the proper radiological imaging choices in its workup. Operative treatments that can be used to treat both glenoid and humeral head bone loss are outlined. These include coracoid transfer procedures and allograft/autograft reconstruction at the glenoid, as well as humeral head disimpaction/humeroplasty, remplissage, humeral osseous allograft reconstruction, rotational osteotomy, partial humeral head arthroplasty, and hemiarthroplasty on the humeral side. Clinical outcomes studies reporting general results of these techniques are highlighted. PMID:25136461

  20. Management of Humeral and Glenoid Bone Loss in Recurrent Glenohumeral Instability

    PubMed Central

    Rusen, Jamie; Leiter, Jeff; Chahal, Jaskarndip; MacDonald, Peter

    2014-01-01

    Recurrent shoulder instability and resultant glenoid and humeral head bone loss are not infrequently encountered in the population today, specifically in young, athletic patients. This review on the management of bone loss in recurrent glenohumeral instability discusses the relevant shoulder anatomy that provides stability to the shoulder joint, relevant history and physical examination findings pertinent to recurrent shoulder instability, and the proper radiological imaging choices in its workup. Operative treatments that can be used to treat both glenoid and humeral head bone loss are outlined. These include coracoid transfer procedures and allograft/autograft reconstruction at the glenoid, as well as humeral head disimpaction/humeroplasty, remplissage, humeral osseous allograft reconstruction, rotational osteotomy, partial humeral head arthroplasty, and hemiarthroplasty on the humeral side. Clinical outcomes studies reporting general results of these techniques are highlighted. PMID:25136461

  1. A Rare Case Report of an Unusual Dislocation of Fractured Mandibular Condyle.

    PubMed

    Mishra, Madan; Singh, Gaurav

    2016-06-01

    Several cases have been reported regarding superolateral, posterior, or superior dislocation of mandibular condyle. The anteromedial dislocation of fractured condyle is the most common among all. This article reports an unusual and unique case of dislocated fractured mandibular condyle wherein the fractured left condylar head was dislocated to the left anatomic angle of mandible. We have not found a single such case in the world English literature published till date. The presented case falls in the rarest of the rare category that will add to our previous knowledge about the types and extent of fracture dislocation of mandibular condyle. PMID:27162576

  2. Outpatient Treatment for Humeral Fractures in Five Calves

    PubMed Central

    YAMAGISHI, Norio; DEVKOTA, Bhuminand; TAKAHASHI, Masahiro

    2014-01-01

    ABSTRACT Humeral fractures were treated in 5 calves using unilateral external fixation with epoxy putty fixator (type I). The surgeries were performed under sedation and analgesia, and it involved application of ultrasound-guided brachial plexus block. The surgical procedures were completed in 60 to 90 min, and each calf was returned to the farm on the same day. The fixation allowed each calf to remain with the dam and suckle without strict stall rest and was removed 11 to 62 days post-surgery. The clinical sign of diminished radial nerve function disappeared 40 days to 4 months post-surgery. These observations suggest that this repair technique represents a feasible outpatient treatment for humeral fractures in calves. PMID:25056675

  3. Outpatient treatment for humeral fractures in five calves.

    PubMed

    Yamagishi, Norio; Devkota, Bhuminand; Takahashi, Masahiro

    2014-11-01

    Humeral fractures were treated in 5 calves using unilateral external fixation with epoxy putty fixator (type I). The surgeries were performed under sedation and analgesia, and it involved application of ultrasound-guided brachial plexus block. The surgical procedures were completed in 60 to 90 min, and each calf was returned to the farm on the same day. The fixation allowed each calf to remain with the dam and suckle without strict stall rest and was removed 11 to 62 days post-surgery. The clinical sign of diminished radial nerve function disappeared 40 days to 4 months post-surgery. These observations suggest that this repair technique represents a feasible outpatient treatment for humeral fractures in calves. PMID:25056675

  4. Posterior elbow release and humeral osteotomy for patients with arthrogryposis.

    PubMed

    Zlotolow, Dan A; Kozin, Scott H

    2012-05-01

    Children with arthrogryposis often lack the ability to feed themselves, largely due to limited shoulder external rotation and elbow flexion. Patients who can achieve passive elbow flexion through a surgical release but who cannot externally rotate their shoulders are still unable to reach their mouths with their hands. Combining a posterior elbow capsular release with a simultaneous humeral osteotomy in these patients places the forearm and hand in a much better position for function with minimal additional surgical exposure. PMID:22483178

  5. Motion of the Shoulder Complex During Multiplanar Humeral Elevation

    PubMed Central

    Ludewig, Paula M.; Phadke, Vandana; Braman, Jonathan P.; Hassett, Daniel R.; Cieminski, Cort J.; LaPrade, Robert F.

    2009-01-01

    Background: Many prior studies have evaluated shoulder motion, yet no three-dimensional analysis comparing the combined clavicular, scapular, and humeral motion during arm elevation has been done. We aimed to describe and compare dynamic three-dimensional motion of the shoulder complex during raising and lowering the arm across three distinct elevation planes (flexion, scapular plane abduction, and coronal plane abduction). Methods: Twelve subjects without a shoulder abnormality were enrolled. Transcortical pin placement into the clavicle, scapula, and humerus allowed electromagnetic motion sensors to be rigidly fixed. The subjects completed two repetitions of raising and lowering the arm in flexion, scapular, and abduction planes. Three-dimensional angles were calculated for sternoclavicular, acromioclavicular, scapulothoracic, and glenohumeral joint motions. Joint angles between humeral elevation planes and between raising and lowering of the arm were compared. Results: General patterns of shoulder motion observed during humeral elevation were clavicular elevation, retraction, and posterior axial rotation; scapular internal rotation, upward rotation, and posterior tilting relative to the clavicle; and glenohumeral elevation and external rotation. Clavicular posterior rotation predominated at the sternoclavicular joint (average, 31°). Scapular posterior tilting predominated at the acromioclavicular joint (average, 19°). Differences between flexion and abduction planes of humerothoracic elevation were largest for the glenohumeral joint plane of elevation (average, 46°). Conclusions: Overall shoulder motion consists of substantial angular rotations at each of the four shoulder joints, enabling the multiple-joint interaction required to elevate the arm overhead. Clinical Relevance: Improved knowledge of the normal motion of the shoulder during humeral elevation will improve the assessment of patients with shoulder motion abnormalities, planning for rehabilitation programs, and performance of stabilization procedures. PMID:19181982

  6. Steroid-induced osteonecrosis of the humeral head.

    PubMed

    Usher, B W; Friedman, R J

    1995-01-01

    Steroid-induced osteonecrosis is a disease of modern medicine. Prevention remains the hallmark of management; however, as long as there are medical conditions requiring steroid therapy, osteonecrosis will remain a problem. An understanding of the pathophysiology, in addition to the clinical and radiographic manifestations of this disease process, will aid the physician in the unique challenge of diagnosing and treating osteonecrosis of the humeral head. PMID:7899168

  7. Humeral Shaft Fractures Secondary to Hand Grenade Throwing

    PubMed Central

    Akmese, Ramazan; Agar, Mustafa

    2013-01-01

    A series of five cases were presented in which similar fractures of the shaft of the humerus occurred during the hand grenade throwing activity during the military education. All the fractures were in the 1/3 distal humeral shaft, and butterfly fragments were accompanying in two soldiers. All the fractures healed without any clinical complications with conservative treatment. The mechanism of the fracture is discussed with reference to the recent literature. PMID:24967121

  8. Humeral shaft fractures secondary to hand grenade throwing.

    PubMed

    Aydin, Bahattin Kerem; Akmese, Ramazan; Agar, Mustafa

    2013-01-01

    A series of five cases were presented in which similar fractures of the shaft of the humerus occurred during the hand grenade throwing activity during the military education. All the fractures were in the 1/3 distal humeral shaft, and butterfly fragments were accompanying in two soldiers. All the fractures healed without any clinical complications with conservative treatment. The mechanism of the fracture is discussed with reference to the recent literature. PMID:24967121

  9. Proximal median neuropathy secondary to humeral neck fracture.

    PubMed

    Veilleux, M; Richardson, P

    2000-03-01

    Median neuropathies proximal to the wrist are uncommon and usually result from penetrating injuries, fracture dislocation of the distal humerus, or compression by fibrous bands. A 66-year-old man suffered a comminuted fracture of the proximal humerus after a fall. Electrodiagnostic studies revealed a severe proximal median neuropathy and a mild distal radial mononeuropathy. Proximal median neuropathy rarely occurs in humeral neck fracture, mostly because the median nerve is not in close contact with the humerus proximally. PMID:10679720

  10. Computerized Virtual Surgery Planning for ORIF of Proximal Humeral Fractures.

    PubMed

    Xia, Shengli; Zhang, Yusheng; Wang, Xiuhui; Wang, Ziping; Wang, Wei; Ma, Xiaohui; Tian, Shengjie

    2015-05-01

    The authors evaluated the effectiveness of computerized virtual planning for open reduction and internal fixation (ORIF) of proximal humeral fractures. Between June 2011 and July 2013, a total of 46 patients with proximal humeral fractures were included in the current study. Preoperatively, fracture data were obtained via computed tomography (CT) reconstruction. Based on the dataset obtained from CT scanning, the 3-dimensional model of fractures was constructed and virtual segmentation, restoration, and internal fixation were performed. All eligible cases were treated by ORIF with locking plates. Intraoperatively, operative time, blood loss, and fluoroscope frequency were recorded. Postoperatively, the curative effect was evaluated by quality of fracture restoration reconstruction and plate position. In addition, fracture healing time and complications were recorded in the follow-up period. Average operative time was 85.6 minutes, and intraoperative blood loss ranged from 60 to 150 mL. Postoperatively, 1 patient experienced avascular necrosis, and no cases of screw penetration or screw loosening were observed. The coincidence rate of plate position was 91.3% according to height and 95.7% based on the position of the intertubercular sulcus and greater tuberosity. At the end of the follow-up period, mean shoulder function score was 83.9 (range, 58-96). Eighty-seven percent of patients had an excellent or good outcome. Computerized virtual planning facilitated ORIF and showed good results for patients with complex proximal humeral fractures. It may be a favorable option for treating fractures of the proximal humerus. PMID:25970372

  11. Autograft Transfer from the Ipsilateral Femoral Condyle in Depressed Tibial Plateau Fractures

    PubMed Central

    Sferopoulos, N.K

    2014-01-01

    Introduction : The rationale for operative treatment of depressed tibial plateau fractures is anatomic reduction, stable fixation and grafting. Grafting options include autogenous bone graft or bone substitutes. Methods : The autograft group included 18 patients with depressed tibial plateau fractures treated with autogenous bone grafting from the ipsilateral femoral condyle following open reduction and internal fixation. According to Schatzker classification, there were 9 type II, 4 type III, 2 type IV and 3 type V lesions. The average time to union and the hospital charges were compared with the bone substitute group. The latter included 17 patients who had an excellent outcome following treatment of split and/or depressed lateral plateau fractures, using a similar surgical technique but grafting with bone substitutes (allografts). Results : Excellent clinical and radiological results were detected in the autograft group after an average follow-up of 28 months (range 12-37). The average time to union in the autograft group was 14 weeks (range 12-16), while in the bone substitute group it was 18 weeks (range 16-20). The mean total cost was 1276 Euros for the autograft group and 2978 Euros for the bone substitute group. Discussion : The use of autogenous graft from the ipsilateral femoral condyle following open reduction and internal fixation of depressed tibial plateau fractures provided enough bone to maintain the height of the tibial plateau and was not associated with any donor site morbidity. Using this method, the surgical time was not significantly elongated and the rehabilitation was not affected. It also exhibited faster fracture healing without postoperative loss of reduction and it was less expensive than the use of bone substitutes. PMID:25317215

  12. The application of the Risdon approach for mandibular condyle fractures

    PubMed Central

    2013-01-01

    Background Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. Methods A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 subcondylar fractures. Results All of the cases were reduced using the Risdon approach. For subcondylar fractures, reduction and fixation with plates was done under direct vision. For condylar neck fractures, reduction and fixation was done with the aid of a trochar in adults and a percutaneous threaded Kirschner wire in children. There were no malunions or nonunions revealed in follow-up care. Mild transient neuropraxia of the marginal mandibular nerve was seen in 4 patients, which was resolved within 1–2 months. Conclusions The Risdon approach is a technique for reducing the condylar neck and subcondylar fractures that is easy to perform and easy to learn. Its value in the reduction of mandibular condyle fractures should be emphasized. PMID:23829537

  13. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... uncemented prosthesis. 888.3180 Section 888.3180 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint humeral (hemi-elbow) metallic uncemented prosthesis is a device intended to be implanted made of...

  14. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  15. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  16. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... uncemented prosthesis. 888.3180 Section 888.3180 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint humeral (hemi-elbow) metallic uncemented prosthesis is a device intended to be implanted made of...

  17. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... uncemented prosthesis. 888.3180 Section 888.3180 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint humeral (hemi-elbow) metallic uncemented prosthesis is a device intended to be implanted made of...

  18. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  19. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  20. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  1. Outcome of locking compression plates in humeral shaft nonunions

    PubMed Central

    Kumar, Malhar N; Ravindranath, V Pratap; Ravishankar, MR

    2013-01-01

    Background: Nonunion of diaphyseal fractures of the humerus are frequently seen in clinical practice (incidence of up to 15% in certain studies) and osteosynthesis using dynamic compression plates, intra medullary nails and Ilizarov fixators have been reported previously. Locking compression plates (LCP) are useful in the presence of disuse osteoporosis, segmental bone loss and cortical defects that preclude strong fixation. We report a prospective followup study of the outcome of the use of LCP for humeral nonunion following failed internal fixation in which implants other than LCP had been used. Materials and Methods: Twenty four patients with nonunion of humeral shaft fractures following failed internal fixation were included in the study. The mean followup period was 3.4 years (range: 2.4 to 5.7 years) and the minimum followup period was 2 years. Mean age of the patients was 41.04 years (range: 24 to 57 years). All 24 patients underwent osteosynthesis using LCP and autologous bone grafting (cortico-cancellous iliac crest graft combined with or without fibular strut graft). Main outcome measurements included radiographic assessment of fracture union and pre and postoperative functional evaluation using the modified Constant and Murley scoring system. Results: 23 out of 24 fractures united following osteosynthesis. Average time to union was 16 weeks (range: 10 to 28 weeks). Complications included delayed union (n = 2), transient radial nerve palsy (n = 2) and persistent nonunion (n = 1). Functional evaluation using the Constant and Murley score showed excellent results in 11, good in 10, fair in two and poor outcome in one patient. Conclusions: Locking compression plating and cancellous bone grafting is a reliable option for achieving union in humeral diaphyseal nonunion with failed previous internal fixation and results in good functional outcome in patients with higher physiological demands. PMID:23682176

  2. [Periprosthetic humeral fractures : Strategies and techniques of revision arthroplasty].

    PubMed

    Kirchhoff, C; Beirer, M; Brunner, U

    2016-04-01

    The primary aims when performing revision arthroplasty of periprosthetic humeral fractures (PHF) are preservation of bone stock, achieving fracture healing and preserving a stable prosthesis with the focus on regaining the preoperative shoulder-arm function. The indications for revision arthroplasty are given in PHF in combination with loosening of the stem. In addition, further factors must be independently clarified in the case of an anatomical arthroplasty. In this context secondary glenoid erosion as well as rotator cuff insufficiency are potential factors for an extended revision procedure. For the performance of revision surgery modular revision sets including long stems, revision glenoid and metaglene components as well as plate and cerclage systems are obligatory besides the explantation instrumentation. Despite a loosened prosthesis, a transhumeral removal of the stem along with a subpectoral fenestration are often required. Length as well as bracing of revision stems need to bridge the fracture by at least twice the humeral diameter. Moreover, in many cases a combined procedure using an additional distal open reduction and internal fixation (ORIF) plus cable cerclages as well as biological augmentation might be needed. Assuming an adequate preparation, the experienced surgeon is able to achieve a high fracture union rate along with an acceptable or even good shoulder function and to avoid further complications. PMID:26992713

  3. Application of 3-Dimensional Printing Technology to Kirschner Wire Fixation of Adolescent Condyle Fracture.

    PubMed

    Dong, Zhiwei; Li, Qihong; Bai, Shizhu; Zhang, Li

    2015-10-01

    Condyle fractures are common in children and are increasingly treated with open reduction. Three-dimensional printing has developed into an important method of assisting surgical treatment. This report describes the case of a 14-year-old patient treated for a right condyle fracture at the authors' hospital. Preoperatively, the authors designed a surgical guide using 3-dimensional printing and virtual surgery. The 3-dimensional surgical guide allowed accurate alignment of the fracture using Kirschner wire without additional dissection and tissue injury. Kirschner wire fixation augmented by 3-dimensional printing technology produced a good outcome in this adolescent condyle fracture. PMID:25930960

  4. Bone properties of the humeral head and resistance to screw cutout

    PubMed Central

    Frich, Lars Henrik; Jensen, Niels Christian

    2014-01-01

    Surgical treatment of fractures involving the proximal humeral head is hampered by complications. Screw cutout is the major pitfall seen in connection with rigid plating. We have exploited a bony explanation for this phenomenon. Materials and Methods: We examined the convex surface of the humeral head looking at the density and the topographical strength of the subchondral bone using mechanical testing of bone cylinders harvested from the humeral head. We also studied the osseous architecture of the subchondral bone and thickness of the boneplate of the humeral head using a 3-dimensional serial sectioning technique. Results: The bone strength and bone density correlated well and revealed large regional variations across the humeral head. Bone strength and stiffness of the trabecular bone came to a maximum in the most medial anterior and central parts of the humeral head, where strong textural anisotropy was also found. We found in particular a lower bone strength and density in the posterior and inferior regions of the humeral head. A rapid decline in bone strength within a few mm below a relatively thin subchondral plate was also reported. Clinical Relevance: We have in this paper explored some of the most important factors connected with screw stability at the cancellous bone level. We discovered large variations in bone density and bone strength across the joint surface rendering certain areas of the humeral head less suitable for screw placement. The use of rigid plate constructs with divergent screw directions will predictably place screws in areas of the humeral head comprising low density and low strength cancellous bone. New concepts of plates and plating techniques for the surgical treatment of complex fractures of the proximal humerus should take bone distribution, strength, and architecture into account. PMID:24926160

  5. Mosaic arthroplasty of the medial femoral condyle in horses - An experimental study.

    PubMed

    Bodó, Gábor; Vásárhelyi, Gábor; Hangody, László; Módis, László

    2014-06-01

    One Arabian and 5 Hungarian half-bred horses were used to study the macroscopic and microscopic survival of autologous osteochondral grafts in the weight-bearing surface of the medial femoral condyle (MFC). Grafts were harvested from the cranial surface of the medial femoral trochlea (MFT) under arthroscopic control. Three of them were transplanted into the weight-bearing surface of the contralateral MFC using an arthrotomy approach. Three months later this transplantation procedure was repeated on the opposite stifle joints in the same animals, but at that time transplantation was performed arthroscopically. Follow-up arthroscopy was carried out 12 months after the first operations, and biopsies were taken from both the recipient and the donor sites for histological examination. During follow-up arthroscopy, the transplanted areas looked congruent and smooth. Microscopically, the characteristics of hyaline cartilage were present in 5 out of the 10 biopsies examined; however, in the other half of biopsies glycosaminoglycan (GAG) loss and change in the architecture of the transplanted cartilage was observed. In a 16-year-old horse, all grafts broke during harvesting, and thus transplantation was not performed. No radiological signs of osteoarthritic changes were detected 9 to 12 months after the operations in the donor and recipient joints. Clinically, no lameness or effusion was present three months after the transplantations. PMID:24334083

  6. Relationship between mandibular condyle and angle fractures and the presence of mandibular third molars

    PubMed Central

    Mah, Deuk-Hyun; Moon, Seong-Yong; Oh, Ji-Su; You, Jae-Seek

    2015-01-01

    Objectives We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures. Materials and Methods This was a retrospective investigation using patient records and radiographs. The sample set consisted of 440 patients with mandibular fractures. Eruption space, depth and angulation of the third molar were measured. Results Of the 144 angle fracture patients, 130 patients had third molars and 14 patients did not. The ratio of angle fractures when a third molar was present (1.26 : 1) was greater than when no third molar was present (0.19 : 1; odds ratio, 6.58; P<0.001). Of the 141 condyle fractures patients, the third molar was present in 84 patients and absent in 57 patients. The ratio of condyle fractures when a third molar was present (0.56 : 1) was lower than when no third molar was present (1.90 : 1; odds ratio, 0.30; P<0.001). Conclusion The increased ratio of angle fractures with third molars and the ratio of condyle fractures without a third molar were statistically significant. The occurrence of angle and condyle fractures was more affected by the continuity of the cortical bone at the angle than by the depth of a third molar. These results demonstrate that a third molar can be a determining factor in angle and condyle fractures. PMID:25741462

  7. Influences of implant condyle geometry on bone and screw strains in a temporomandibular implant.

    PubMed

    Mesnard, M; Ramos, A; Simões, J A

    2014-04-01

    A 3D finite element model of an in vitro implanted mandible was analysed. The load point was placed on the condyle in three positions (inside the mouth, centred and outside) to simulate different contact points between the mandible condyle and the temporal bone. The strain fields in the condyle were assessed and detailed around the surgical screws. The temporomandibular implant studied here was modelled on a commercial device that uses four screws to fix it in vivo in a very similar position. The boundary conditions of the numerical model simulated a load on the incisors with a 15 mm mouth aperture. The same contact loads were applied to the two condyles. Numerical results were successfully obtained for the three different contact points: the inside contact produced lower strains on the condyle. The first screw created a critical strain distribution in the bone, just under the screw. The study shows that centred and inside contact induces lower strain distributions. This suggests that spherical condyle geometry should be applied in order to reduce the strains in fixation. As the top screw was observed to play the most critical role, the third screw is in fact unnecessary, since the lower strain distribution suggests that it will be loosened. PMID:23726645

  8. [Surgical treatment of children with consequences of acute hematogenic osteomyelitis of the humeral bone].

    PubMed

    Pozdeev, A P; Bazarov, R A

    2003-01-01

    The authors are making an analysis of the strategy and results of operative treatment of 42 patients. A differentiated approach to treatment is proposed depending on the variant of injury of the humeral bone. PMID:14606147

  9. Drifting Diaphyses: Asymmetry in Diametric Growth and Adaptation Along the Humeral and Femoral Length.

    PubMed

    Maggiano, Isabel S; Maggiano, Corey M; Tiesler, Vera G; Chi-Keb, Julio R; Stout, Sam D

    2015-10-01

    This study quantifies regional histomorphological variation along the human humeral and femoral diaphysis in order to gain information on diaphyseal growth and modeling drift patterns. Three thin sections at 40, 50, and 60% bone length were prepared from a modern Mexican skeletal sample with known age and sex to give a longitudinal perspective on the drifting cortex (12 adults and juveniles total, 7 male and 5 female). Point-count techniques were applied across eight cross-sectional regions of interest using the starburst sampling pattern to quantify percent periosteal and endosteal primary lamellar bone at each diaphyseal level. The results of this study show a posterio-medial drift pattern in the humerus with a posterior rotational trend along the diaphysis. In the femur, we observed a consistent lateral to anteriolateral drift and an increase in primary lamellar bone area of both, periosteal and endosteal origin, towards the distal part of the diaphysis. These observations characterize drifting diaphyses in greater detail, raising important questions about how to resolve microscopic and macroscopic cross-sectional analysis towards a more complete understanding of bone growth and mechanical adaptation. Accounting for modeling drift has the potential to positively impact age and physical activity estimation, and explain some of the significant regional variation in bone histomorphology seen within (and between) bone cross-sections due to differing ages of tissue formation. More study is necessary, however, to discern between possible drift scenarios and characterize populational variation. PMID:26224448

  10. [Potentialities of blocking osteosynthesis for metaphyseal fractures of the humeral bone].

    PubMed

    Neverov, V A; Khromov, A A; Cherniaev, S N; Egorov, K S

    2008-01-01

    A method of blocking intramedullary osteosynthesis of metaphyseal fractures of the humeral bone is proposed. Its special features are: retrograde implantation of a nail from the antecubital fossa of the humeral bone, blocking the nail with distal blocking screws and proximal blocking screws which are fixed in the nail at the expense of threaded connection. This method gives exact reposition, absolute stability of fixation, possibility of early load and rehabilitation. PMID:19241817

  11. Injectable Biocomposites for Bone Healing in Rabbit Femoral Condyle Defects

    PubMed Central

    Liu, Zhengsheng; Wang, Xiumei; Cui, Fuzhai; Guo, Wenguang; Mao, Keya; Yang, Shuying

    2013-01-01

    A novel biomimetic bone scaffold was successfully prepared in this study, which was composed of calcium sulfate hemihydrate (CSH), collagen and nano-hydroxyapatite (nHAC). CSH/nHAC was prepared and observed with scanning electron microscope and rhBMP-2 was introduced into CSH/nHAC. The released protein content from the scaffold was detected using high performance liquid chromatography at predetermined time interval. In vivo bone formation capacity was investigated by means of implanting the scaffolds with rhBMP-2 or without rhBMP-2 respectively into a critical size defect model in the femoral condyle of rabbit. The releasing character of rhBMP-2 was that an initial burst release (37.5%) was observed in the first day, followed by a sustained release and reached 100% at the end of day 20. The CSH/nHAC showed a gradual decrease in degradation with the content of nHAC increase. The results of X-rays, Micro CT and histological observation indicated that more new bone was formed in rhBMP-2 group. The results implied that this new injectable bone scaffold should be very promising for bone repair and has a great potential in bone tissue engineering. PMID:24146770

  12. Occipital Condyle Fracture With Isolated Unilateral Hypoglossal Nerve Palsy

    PubMed Central

    Yoon, Jin Won; Lim, Oh Kyung; Park, Ki Deok

    2014-01-01

    Occipital condyle fractures (OCFs) with selective involvement of the hypoglossal canal are rare. OCFs usually occur after major trauma and combine multiple fractures. We describe a 38-year-old man who presented with neck pain and a tongue deviation to the right side after a traffic accident. Severe limitations were detected during active and passive range of neck motion in all directions. A physical examination revealed a normal gag reflex and normal mobility of the palate, larynx, and shoulder girdle. He had normal taste and general sensation in his tongue. However, he presented with a tongue deviation to the right side on protrusion. A videofluoroscopic swallowing study revealed piecemeal deglutition due to decreased tongue mobility but no aspiration of food. Plain X-ray film findings were negative, but a computed tomography study with coronal reconstruction demonstrated a right OCF involving the hypoglossal canal. An electrodiagnostic study revealed evidence of right hypoglossal nerve palsy. We report a rare case of isolated hypoglossal nerve palsy caused by an OCF. PMID:25379499

  13. Application of Additional Medial Plate in Treatment of Proximal Humeral Fractures With Unstable Medial Column: A Finite Element Study and Clinical Practice.

    PubMed

    He, Yu; He, Jiliang; Wang, Fu; Zhou, Dongsheng; Wang, Yan; Wang, Bomin; Xu, Shihong

    2015-10-01

    The purpose of this study was to use finite element analysis to compare the biomechanical characteristics after lateral locking plate (LLP) or LLP with a medial anatomical locking plate (LLP-MLP) fixation of proximal humeral fractures with an unstable medial column.First, a 3-dimensional, finite element analysis model was developed. Next, LLP and LLP-MLP implants were instrumented into the proximal humeral fracture models. Compressive and rotational loads were then applied to the humerus model to determine the biomechanical characteristics. Both normal and osteoporotic proximal humerus fractures were simulated using 2 internal fixation methods each under 7 loading conditions. To assess the biomechanical characteristics, the construct stiffness, fracture micromotion, and stress distribution on the implants were recorded and compared.The LLP-MLP method provided both lateral and medial support that reduced the stress on the LLP and the amount of displacement in the fracture region. In contrast, the LLP method resulted in more instability in the medial column and larger magnitudes of stress. In osteoporotic bone, the LLP was more inclined to fail than LLP-MLP.The LLP-MLP method provides a strong support for the medial column and increases the stability of the region surrounding the fracture. PMID:26469918

  14. Humeral retroversion and shoulder rotational mobility in young handball practitioners

    PubMed Central

    Quadros, Gustavo Aguiar; Döhnert, Marcelo Baptista

    2015-01-01

    ABSTRACT OBJECTIVE : To evaluate the prevalence of humeral retroversion and rotational mobility (RHH) in young handball practitioners and non-practitioners. METHODS : This is a cross-sectional study performed with two groups: the handball group, with 14 female students practicing handball and the control group, with 13 young participants non-practicing pitch sports. RESULTS : The handball group presented full rotational movement (FRM) hi-gher than the control group in both the dominant shoulder (p=0.001) and the non-dominant shoulder (p=0.0001). The mobility of active and passive internal rotation was significantly higher in handball players in both shoulders. The handball group presented lower internal rotation range of motion for the dominant shoulder as compared to the non-dominant shoul-der (p=0.001). CONCLUSION : Young handball practitioners, des-pite skeletally immature, showed a higher MRT than the control group. The handball group showed loss of internal rotation (medial) on the dominant shoulder as compared to the non--dominant shoulder. Level of Evidence II, Prospective Study. PMID:27057141

  15. Fracture Union in Closed Interlocking Nail in Humeral Shaft Fractures

    PubMed Central

    Sahu, Ramji Lal; Ranjan, Rajni; Lal, Ajay

    2015-01-01

    Background: Fracture shaft humerus is a major cause of morbidity in patients with upper extremity injuries. The aim of this study was to evaluate the outcome of interlocking nail in humeral shaft fractures. Methods: This study was conducted in the Department of Orthopedic Surgery in SMS and R Sharda University from January 2010 to November 2013. Seventy-eight patients were recruited from emergency and out-patient department having a close fracture of humerus shaft. All patients were operated under general anesthesia and closed reamed interlocking nailing was done. All patients were followed for 9 months. Results: Out of 78 patients, 69 patients underwent union in 90–150 days with a mean of 110.68 days. Complications found in four patients who had nonunion, and five patients had delayed union, which was treated with bone grafting. All the patients were assessed clinically and radiologically for fracture healing, joint movements and implant failure. The results were excellent in 88.46% and good in 6.41% patients. Complete subjective, functional, and clinical recovery had occurred in almost 100% of the patients. Conclusions: The results of the present study indicates that in the presence of proper indications, reamed antegrade intramedullary interlocked nailing appears to be a method of choice for internal fixation of osteoporotic and pathologic fractures. PMID:26021495

  16. Validity of measuring humeral torsion using palpation of bicipital tuberosities

    PubMed Central

    Dashottar, Amitabh; Borstad, John D.

    2012-01-01

    The magnitude of humeral torsion (HT) affects the internal and external rotation range of motion at the shoulder. Currently imaging is required to quantify the HT angle, however, factors such as cost and non-availability of imaging to musculoskeletal clinicians limits its use. The aim of this study was to examine the validity of palpation of the bicipital tuberosities as an alternative to imaging for quantifying HT angles. The bicipital-forearm angle, an indirect measure of HT, was measured using palpation and real-time ultrasound imaging in 25 subjects. The agreement among the two methods was excellent with the Intraclass Correlation Coefficient (3,k) = 0.92, and the mean difference between the two methods was −0.2° (SD 4.1°) with 95% limits of agreement of −8.3° to 7.9°. Pearson’s correlation coefficient (r) among the two methods was 0.85. In a clinical setting, palpation appears to be a practical alternative to US imaging for measuring HT. PMID:22489871

  17. [Periprosthetic humeral fractures : Strategies and techniques for osteosynthesis].

    PubMed

    Kirchhoff, C; Brunner, U; Biberthaler, P

    2016-04-01

    The prevalence of periprosthetic humeral fractures (PHF) is currently low and accounts for 0.6-2.4 %. Due to an increase in the rate of primary implantations a quantitative increase of PHF is to be expected in the near future. The majority of PHF occur intraoperatively during implantation with an increased risk for cementless stems and when performing total arthroplasty. Additional risk factors are in particular female gender and the severity of comorbidities. In contrast, postoperative PHF mostly due to low-energy falls, have a prevalence between 0.6 % and 0.9 % and are significantly less common. The prognosis and functional outcome following revision by open reduction internal fixation (ORIF) essentially depend on a thorough assessment of the indications for revision surgery, the operative treatment and the pretraumatic functional condition of the affected shoulder. In the armamentarium of periprosthetic ORIF of the humerus cerclage systems and locking implants as well as a combination of both play a central role. In comminuted fractures with extensive defect zones, severely thinned cortex or extensive osteolysis a biological augmentation of the ORIF should be considered. In this context when the indications are correctly interpreted, especially in the case of a stable anchored stem, various groups have reported that a high bony union rate can be achieved. As the treatment of PHF is complex it should be performed in dedicated centers in order to adequately address potential comorbidities, especially in the elderly population. PMID:27008215

  18. The impact of subsistence changes on humeral bilateral asymmetry in Terminal Pleistocene and Holocene Europe.

    PubMed

    Sládek, Vladimír; Ruff, Christopher B; Berner, Margit; Holt, Brigitte; Niskanen, Markku; Schuplerová, Eliška; Hora, Martin

    2016-03-01

    Analyses of upper limb bone bilateral asymmetry can shed light on manipulative behavior, sexual division of labor, and the effects of economic transitions on skeletal morphology. We compared the maximum (absolute) and directional asymmetry in humeral length, articular breadth, and cross-sectional diaphyseal geometry (CSG) in a large (n > 1200) European sample distributed among 11 archaeological periods from the Early Upper Paleolithic through the 20(th) century. Asymmetry in length and articular breadth is right-biased, but relatively small and fairly constant between temporal periods. Females show more asymmetry in length than males. This suggests a low impact of behavioral changes on asymmetry in length and breadth, but strong genetic control with probable sex linkage of asymmetry in length. Asymmetry in CSG properties is much more marked than in length and articular breadth, with sex-specific variation. In males, a major decline in asymmetry occurs between the Upper Paleolithic and Mesolithic. There is no further decline in asymmetry between the Mesolithic and Neolithic in males and only limited variation during the Holocene. In females, a major decline occurs between the Mesolithic and Neolithic, with resulting average directional asymmetry close to zero. Asymmetry among females continues to be very low in the subsequent Copper and Bronze Ages, but increases again in the Iron Age. Changes in female asymmetry result in an increase of sexual dimorphism during the early agricultural periods, followed by a decrease in the Iron Age. Sexual dimorphism again slightly declines after the Late Medieval. Our results indicate that changes in manipulative behavior were sex-specific with a probable higher impact of changes in hunting behavior on male asymmetry (e.g., shift from unimanual throwing to use of the bow-and-arrow) and food grain processing in females, specifically, use of two-handed saddle querns in the early agricultural periods and one-handed rotary querns in later agricultural periods. PMID:26989015

  19. Humeral Shaft Fracture Treatment in the Elite Throwing Athlete: A Unique Application of Flexible Intramedullary Nailing

    PubMed Central

    Lee, Christopher S.; Davis, Shane M.; Fronek, Jan

    2013-01-01

    Humeral shaft stress fractures are being increasingly recognized as injuries that can significantly impact throwing mechanics if residual malalignment exists. While minimally displaced and angulated injuries are treated nonoperatively in a fracture brace, the management of significantly displaced humeral shaft fractures in the throwing athlete is less clear. Currently described techniques such as open reduction and internal fixation with plate osteosynthesis and rigid antegrade/retrograde locked intramedullary nailing have significant morbidity due to soft tissue dissection and damage. We present a case report of a high-level baseball pitcher whose significantly displaced humeral shaft stress fracture failed to be nonoperatively managed and was subsequently treated successfully with unlocked, retrograde flexible intramedullary nailing. The athlete was able to return to pitching baseball in one year and is currently pitching in Major League Baseball. We were able to recently collect 10-year follow-up data. PMID:24369515

  20. Percutaneous humeral derotational osteotomy in obstetrical brachial plexus palsy: a new technique.

    PubMed

    Aly, A; Bahm, J; Schuind, F

    2014-06-01

    Thirty three per cent of children with obstetrical brachial plexus palsy with incomplete neurological recovery develop shoulder internal contracture associated with osseous deformity. Some of the older children are treated by humeral derotational osteotomy. The classical technique of open approach to the humeral diaphysis and plate fixation imposes a longitudinal scar and carries significant risks (nonunion, nerve palsy); a secondary procedure for plate removal is necessary in a significant proportion of patients. The authors report a new technique of percutaneous humeral osteotomy with osteosynthesis by Hoffmann external fixator. In six cases bone healing was obtained at an average of 45 days, without adverse complication. The postoperative results showed improved shoulder function. This new technique is simple and safe; it represents a new option for the treatment of sequelae of obstetrical brachial plexus palsy. PMID:23748411

  1. Taxonomic identification of Lower Pleistocene fossil hominins based on distal humeral diaphyseal cross-sectional shape.

    PubMed

    Lague, Michael R

    2015-01-01

    The coexistence of multiple hominin species during the Lower Pleistocene has long presented a challenge for taxonomic attribution of isolated postcrania. Although fossil humeri are well-suited for studies of hominin postcranial variation due to their relative abundance, humeral articular morphology has thus far been of limited value for differentiating Paranthropus from Homo. On the other hand, distal humeral diaphyseal shape has been used to justify such generic distinctions at Swartkrans. The potential utility of humeral diaphyseal shape merits larger-scale quantitative analysis, particularly as it permits the inclusion of fragmentary specimens lacking articular morphology. This study analyzes shape variation of the distal humeral diaphysis among fossil hominins (c. 2-1 Ma) to test the hypothesis that specimens can be divided into distinct morphotypes. Coordinate landmarks were placed on 3D laser scans to quantify cross-sectional shape at a standardized location of the humeral diaphysis (proximal to the olecranon fossa) for a variety of fossil hominins and extant hominids. The fossil sample includes specimens attributed to species based on associated craniodental remains. Mantel tests of matrix correlation were used to assess hypotheses about morphometric relationships among the fossils by comparing empirically-derived Procrustes distance matrices to hypothetical model matrices. Diaphyseal shape variation is consistent with the hypothesis of three distinct morphotypes (Paranthropus, Homo erectus, non-erectus early Homo) in both eastern and southern Africa during the observed time period. Specimens attributed to non-erectus early Homo are unique among hominids with respect to the degree of relative anteroposterior flattening, while H. erectus humeri exhibit morphology more similar to that of modern humans. In both geographic regions, Paranthropus is characterized by a morphology that is intermediate with respect to those morphological features that differentiate the two forms of early Homo. This study demonstrates the utility of the humeral diaphysis for taxonomic identification of isolated postcranial remains and further documents a high degree of postcranial diversity in early Homo. PMID:26213653

  2. Taxonomic identification of Lower Pleistocene fossil hominins based on distal humeral diaphyseal cross-sectional shape

    PubMed Central

    2015-01-01

    The coexistence of multiple hominin species during the Lower Pleistocene has long presented a challenge for taxonomic attribution of isolated postcrania. Although fossil humeri are well-suited for studies of hominin postcranial variation due to their relative abundance, humeral articular morphology has thus far been of limited value for differentiating Paranthropus from Homo. On the other hand, distal humeral diaphyseal shape has been used to justify such generic distinctions at Swartkrans. The potential utility of humeral diaphyseal shape merits larger-scale quantitative analysis, particularly as it permits the inclusion of fragmentary specimens lacking articular morphology. This study analyzes shape variation of the distal humeral diaphysis among fossil hominins (c. 2-1 Ma) to test the hypothesis that specimens can be divided into distinct morphotypes. Coordinate landmarks were placed on 3D laser scans to quantify cross-sectional shape at a standardized location of the humeral diaphysis (proximal to the olecranon fossa) for a variety of fossil hominins and extant hominids. The fossil sample includes specimens attributed to species based on associated craniodental remains. Mantel tests of matrix correlation were used to assess hypotheses about morphometric relationships among the fossils by comparing empirically-derived Procrustes distance matrices to hypothetical model matrices. Diaphyseal shape variation is consistent with the hypothesis of three distinct morphotypes (Paranthropus, Homo erectus, non-erectus early Homo) in both eastern and southern Africa during the observed time period. Specimens attributed to non-erectus early Homo are unique among hominids with respect to the degree of relative anteroposterior flattening, while H. erectus humeri exhibit morphology more similar to that of modern humans. In both geographic regions, Paranthropus is characterized by a morphology that is intermediate with respect to those morphological features that differentiate the two forms of early Homo. This study demonstrates the utility of the humeral diaphysis for taxonomic identification of isolated postcranial remains and further documents a high degree of postcranial diversity in early Homo. PMID:26213653

  3. Segmentation of humeral head from axial proton density weighted shoulder MR images

    NASA Astrophysics Data System (ADS)

    Sezer, Aysun; Sezer, Hasan Basri; Albayrak, Songul

    2015-01-01

    The purpose of this study is to determine the effectiveness of segmentation of axial MR proton density (PD) images of bony humeral head. PD sequence images which are included in standard shoulder MRI protocol are used instead of T1 MR images. Bony structures were reported to be successfully segmented in the literature from T1 MR images. T1 MR images give more sharp determination of bone and soft tissue border but cannot address the pathological process which takes place in the bone. In the clinical settings PD images of shoulder are used to investigate soft tissue alterations which can cause shoulder instability and are better in demonstrating edema and the pathology but have a higher noise ratio than other modalities. Moreover the alteration of humeral head intensity in patients and soft tissues in contact with the humeral head which have the very similar intensities with bone makes the humeral head segmentation a challenging problem in PD images. However segmentation of the bony humeral head is required initially to facilitate the segmentation of the soft tissues of shoulder. In this study shoulder MRI of 33 randomly selected patients were included. Speckle reducing anisotropic diffusion (SRAD) method was used to decrease noise and then Active Contour Without Edge (ACWE) and Signed Pressure Force (SPF) models were applied on our data set. Success of these methods is determined by comparing our results with manually segmented images by an expert. Applications of these methods on PD images provide highly successful results for segmentation of bony humeral head. This is the first study to determine bone contours in PD images in literature.

  4. Double Tension Band Osteosynthesis in Inter-Condylar Humeral Fractures

    PubMed Central

    Munde, Santosh Lakshmanrao; Bhatti, Mohmmed Javed; Siwach, R.C.; Gulia, Anil; Kundu, Z.S.; Bansal, Sanjeev; Middha, Sanjay

    2015-01-01

    Introduction Intercondylar humerus fractures are uncommon in orthopaedic practice. The treatment for the same has been described in the literature and include paragonal and orthogonal fixation by using plates. Tension band wiring as a treatment for the same is sparsely described in the literature. Aim To evaluate the effectiveness of "Double Tension Band wiring" method for the treatment of intercondylar fractures of humerus and compare the results with studies involving treatment with locked plates. Materials and Methods Twenty patients, all presenting with fresh fractures of the distal humerus, treated with double tension band wiring were retrospectively evaluated over a period of three years. Fractures were classified according to Jupiter classification of distal humeral fractures. There were 5 high T fractures, 13 low T fractures and 2 Y fractures. According to AO classification, all were C1 fractures. Average age of the patients was 56.20 years (32-70 years). There were 13 males and 07 females. Results Out of 20 cases treated with this method, rigid fixation and union was achieved in all of them. The average tourniquet time was 69 minutes with minimum of 50 minutes and maximum of 120 minutes. Radiological union was achieved at an average of 10.8 weeks (8-14weeks). Average range of motion was 104.5 degrees with maximum range of motion 120 degrees (10-130) and minimum of 70 degrees (30-100). Excellent or good results were obtained in 80% of the patients in our study. Conclusion Double tension band is a reliable, less demanding and cost effective method of fixation of intercondylar fractures of humerus. PMID:26816955

  5. Humeral cross-sectional shape in suspensory primates and sloths.

    PubMed

    Patel, Biren A; Ruff, Christopher B; Simons, Erin L R; Organ, Jason M

    2013-04-01

    Studies on the cross-sectional geometry of long bones in African apes have documented that shape ratios derived from second moments of area about principle axes (e.g., Imax /Imin ) are often correlated with habitual locomotor behaviors. For example, humeral cross-sections tend to appear more circular in more arboreal and forelimb suspensory chimpanzees compared with terrestrial quadrupedal gorillas. These data support the hypothesis that cross-sections that are more circular in shape are adapted for multidirectional loading regimes and bending moments encountered when using acrobatic locomotor behaviors. Whether a more circular humerus reflects greater use of forelimb suspension in other primates and nonprimate mammals is unknown. In this study, cross-sections at or near midshaft of the humerus were obtained from anthropoid primates that differ in their use of forelimb suspension, as well as from two genera of suspensory sloths. Imax /Imin ratios were compared within and between groups, and correlations were made with behavioral data. In broad comparisons, observed differences in morphology follow predicted patterns. Humeri of suspensory sloths are circular. Humeri of the more suspensory hominoids tend to be more circular than those of quadrupedal taxa. Humeri of the suspensory atelines are similar to hominoids, while those of Cebus are more like nonsuspensory cercopithecoids. There is, however, considerable overlap between taxa and within finer comparisons variation between species are not in the predicted direction. Thus, although Imax /Imin ratios of the humerus are informative for characterizing generalized locomotor modes (i.e., forelimb suspensory vs. quadrupedal), additional structural information is needed for more fine-grained assessments of locomotion. PMID:23408647

  6. Improving Distal Fixation with Total Shoulder Arthroplasty in Cases of Severe Humeral Bone Loss.

    PubMed

    Jacobson, Amanda; Stroud, Nick; Roche, Christopher P

    2015-12-01

    The usage of and indications for total shoulder arthroplasty have grown in recent years. Certain aspects of these arthro - plasty procedures can be very complex, especially in revi - sion and fracture cases, often leading to proximal humerus bone loss. For cases with significant bone loss, there is a need for improved devices with additional options to treat a wider range of deformities while also mitigating existing complications and rates, such as poor distal fixation, inad - equate soft tissue reattachment options, and joint instability. To that end, a fatigue and torsional test was conducted on two different devices to assess the ability of each to survive an extreme fatigue and torsional load when assembled in worst-case configurations. Evaluation of the Equinoxe ® humeral reconstruction prosthesis demonstrated superior fixation in both the fatigue loading scenario and also the torsional loading scenario as compared to the 8 mm x 215 mm cemented humeral long stem, where each had only 80 mm of cemented fixation. The results of the fatigue test demonstrated that despite the humeral reconstruction pros - thesis being subjected to a 960 N force and 45 Nm bending moment (which was significantly more challenging than the 576 N force and 24.2 Nm bending moment subjected to the cemented humeral long stem), the humeral reconstruction prosthesis completed 1 M cycles without fracture or failure. Additionally, the Equinoxe ® humeral reconstruction pros - thesis was associated with a significantly greater torsional resistance in both the torque to initial slip (29.4 Nm versus 8.2 Nm; p = 0.0002) and also the maximum torque to failure (44.3 Nm versus 12.1 Nm; p < 0.0001). These significant improvements in fixation are at least partially attributed to the application of a novel distal fixation ring, which is press fit around the diaphysis of the humerus to supplement the cemented fixation of the distal stem. These fatigue and torsional test results paired with several novel features of - fer the potential for the Equinoxe ® humeral reconstruction prosthesis to be an improved treatment option for patients with proximal humeral bone loss, though clinical follow-up is necessary to confirm these positive biomechanical results. PMID:26631195

  7. 78 FR 9010 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-07

    ..., 1993 (59 FR 65475; December 20, 1994). In response to a petition dated April 30, 1996 (FDA-1996-P-0253... malignant and benign tumors (63 FR 71743). In 2009, FDA published an order for the submission of information on mandibular condyle prostheses indicated for temporary reconstruction (74 FR 16214; April 9,...

  8. Occipital Condyle Syndrome in a Young Male: A Rare Presentation of Cranio-Vertebral Tuberculosis

    PubMed Central

    Yogesh, Patidar; Vinod, Puri; A, Khwaja Geeta

    2014-01-01

    Occipital condyle syndrome (OCS) is a rare syndrome characterized by severe, unilateral, occipital headache and ipsilateral 12th nerve palsy. Tumors are a common cause of OCS. Inflammatory lesions causing OCS is however rare. We describe a young male with OCS as the only manifestation of cranio-vertebral tuberculosis. PMID:25664279

  9. An Unusual Metallic Foreign Body inside the Knee Medial Femoral Condyle

    PubMed Central

    Helito, Camilo Partezani; Faria, Carlos Eduardo Nunes; Bonadio, Marcelo Batista; Pecora, Jose Ricardo; Camanho, Gilberto Luis; Demange, Marco Kawamura

    2014-01-01

    Foreign bodies in the knee joint are uncommon, particularly those not related to surgical procedures. In this paper, we present a case of an intraosseous metallic foreign body situated in the medial femoral condyle for one year, causing pain, which was removed with complete resolution of the symptoms. PMID:25506452

  10. Ectopic third molar in the mandibular condyle: A review of the literature

    PubMed Central

    Iglesias-Martin, Fernando; Torres-Carranza, Eusebio; Prats-Golczer, Victoria-Eugenia; Garcia-Perla-Garcia, Alberto

    2012-01-01

    Objectives: To evaluate the etiopathogenesis, clinical features, therapeutic options, and surgical approaches for removal of ectopic third molars in the mandibular condyle. Study design: MEDLINE search of articles published on ectopic third molars in the mandibular condyle from 1980 to 2011. 14 well-documented clinical cases from the literature were evaluated together with a new clinical case provided by the authors, representing a sample of 15 patients. Results: We found a mean age at diagnosis of 48.6 years and a higher prevalence in women. In 14 patients, associated radiolucent lesions were diagnosed on radiographic studies and confirmed histopathologically as odontogenic cysts. Clinical symptoms were pain and swelling in the jaw or preauricular region, trismus, difficulty chewing, cutaneous fistula and temporomandibular joint dysfunction. Treatment included conservative management in one case and in the other cases, surgical removal by intra- or extraoral approaches, the latter being the most common approach carried out. In most reported cases, serious complications were not outlined. Conclusions: The etiopathogenic theory involving odontogenic cysts in the displacement of third molars to the mandibular condyle seems to be the most relevant. They must be removed if they cause symptoms or are associated with cystic pathology. The surgical route must be planned according to the location and position of the ectopic third molar, and the possible morbidity associated with surgery. Key words:Third molar, ectopic tooth, condyle, mandible. PMID:22926463

  11. Management of Humeral Shaft Fractures With Intramedullary Interlocking Nail Versus Locking Compression Plate.

    PubMed

    Fan, Yu; Li, Yue-Wang; Zhang, Hong-Bo; Liu, Jian-Fei; Han, Xiang-Min; Chang, Xiao; Weng, Xi-Sheng; Lin, Jin; Zhang, Bao-Zhong

    2015-09-01

    Surgical fixation of humeral shaft fractures generally involves plating or nailing. It is unclear whether one method is more effective than the other. The aim of this study was to compare the results of the intramedullary nail and locking compression plate for the treatment of humeral shaft fractures. A total of 60 patients with humeral shaft fractures were randomized to undergo surgery with an intramedullary interlocking nail (n=30) or locking compression plate (n=30). The outcome was assessed in terms of intraoperative blood loss, operative time, hospital stay, union time, union rate, functional outcome, and incidence of complications. Functional outcome was assessed using the Constant score and the American Shoulder and Elbow Surgeons (ASES) score. Intraoperative blood loss, operative time, and hospital stay in group A (intramedullary interlocking nail) were significantly lower than those in group B (locking compression plate). No statistically significant difference was found regarding the union rate, mean Constant score, and mean ASES score between the groups. The average union time was found to be significantly lower for the intramedullary interlocking nail compared with the locking compression plate. The incidence of complications such as radial nerve palsy was found to be higher with the locking compression plate compared with the intramedullary interlocking nail. The intramedullary interlocking nail can be considered a better surgical option for the management of humeral shaft fractures because it offers decreased intraoperative blood loss; shorter operative times, hospital stays, and union times; and a lower incidence of serious complications such as radial nerve palsy. PMID:26375542

  12. Radial nerve injury associated with humeral shaft fracture: a retrospective study

    PubMed Central

    Ricci, Flávia Pessoni Faleiros Macêdo; Barbosa, Rafael Inácio; Elui, Valéria Meirelles Carril; Barbieri, Cláudio Henrique; Mazzer, Nilton; Fonseca, Marisa de Cássia Registro

    2015-01-01

    Objective: To determine the profile of patients with humeral diaphyseal fractures in a tertiary hospital. Methods: We conducted a survey from January 2010 to July 2012, including data from patients classified under humeral diaphyseal fracture (S42.3) according to the International Classification of Diseases (ICD-10). The variables analyzed were: age, gender, presence of radial nerve injury, causal agent and the type of treatment carried out. Results: The main causes of trauma were car accidents. The radial nerve lesion was present in some cases and was caused by the same trauma that caused the fracture or iatrogenic injury. Most of these fractures occurred in the middle third of humeral diaphysis and was treated conservatively. Conclusion: The profile of patients with fracture of humeral shaft, in this specific sample, was composed mainly of adult men involved in traffic accidents; the associated radial nerve lesion was present in most of these fractures and its cause was strongly related to the trauma mechanism. Level of Evidence II, Retrospective Study. PMID:26327789

  13. Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation

    PubMed Central

    Esmailiejah, Ali Akbar; Abbasian, Mohammad Reza; Safdari, Farshad; Ashoori, Keyqobad

    2015-01-01

    Background: The optimal technique for operative fixation of humeral shaft fractures remains controversial and warrants research. Objectives: The purpose of the current study was to compare the functional and clinical outcomes of conventional open reduction and internal fixation (ORIF) with minimally invasive plate osteosynthesis (MIPO) in patients with fractures in two-third distal humeral shaft. Patients and Methods: In the current prospective case-control study, 65 patients with humeral shaft fractures were treated using ORIF (33 patients) or MIPO (32 patients). Time of surgery, time of union, incidence of varus deformity and complications were compared between the two groups. Also, the university of California-Los Angeles (UCLA) shoulder rating scale and Mayo Elbow performance score (MEPS) were used to compare the functional outcomes between the two groups. Results: The median of union time was shorter in the MIPO group (4 months versus 5 months). The time of surgery and functional outcomes based on the UCLA and MEPS scores were the same. The incidence of varus deformity was more than 5° and was higher and the incidence of nonunion, infection and iatrogenic radial nerve injury were lower in the MIPO group; however, the differences were not significant. Conclusions: Due to the shorter union time, to some extent less complication rate and comparable functional and clinical results, the authors recommend to use the MIPO technique in treating the mid-distal humeral shaft fracture. PMID:26543844

  14. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... use without bone cement (§ 888.3027). (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the... joint humeral (hemi-elbow) metallic uncemented prosthesis shall have an approved PMA or a...

  15. Humeral Fractures in South-Eastern Australia: Epidemiology and Risk Factors.

    PubMed

    Holloway, Kara L; Bucki-Smith, Gosia; Morse, Amelia G; Brennan-Olsen, Sharon L; Kotowicz, Mark A; Moloney, David J; Sanders, Kerrie M; Korn, Sam; Timney, Elizabeth N; Dobbins, Amelia G; Pasco, Julie A

    2015-11-01

    In this study, we report the epidemiology and risk factors for humeral fractures (proximal humerus and shaft) among men and women residing in south-eastern Australia. Incident fractures during 2006 and 2007 were identified using X-ray reports (Geelong Osteoporosis Study Fracture Grid). Risk factors were identified using data from case-control studies conducted as part of the Geelong Osteoporosis Study. Median age of fracture was lower in males than females for proximal humerus (33.0 vs 71.2 years), but not for humeral shaft (8.9 vs 8.5 years). For females, proximal humerus fractures occurred mainly in the 70-79 and 80+ years age groups, whereas humeral shaft fractures followed a U-shaped pattern. Males showed a U-shaped pattern for both proximal humerus and humeral shaft fractures. Overall age-standardised incidence rates for proximal humerus fractures in males and females were 40.6 (95% CI 32.7, 48.5) and 73.2 (95% CI 62.2, 84.1) per 100,000 person years, respectively. For humeral shaft fractures, the age-standardised rate was 69.3 (95% CI 59.0, 79.6) for males and 61.5 (95% CI 51.9, 71.0) for females. There was an increase in risk of proximal humerus fractures in men with a lower femoral neck BMD, younger age, prior fracture and higher milk consumption. In pre-menopausal women, increased height and falls were both risk factors for proximal humerus fractures. For post-menopausal women, risk factors associated with proximal humerus fractures included a lower non-milk dairy consumption and sustaining a prior fracture. Humeral shaft fractures in both sexes were sustained mainly in childhood, while proximal humerus fractures were sustained in older adulthood. The overall age-standardised rates of proximal humerus fractures were nearly twice as high in females compared to males, whereas the incidence rates of humeral shaft fractures were similar. PMID:26169198

  16. Osteochondroma (OC) of the Condyle of Left Mandible: A Rare Case

    PubMed Central

    Manjunatha, Bhari Sharanesha; Kumar, Anoop N.; Alavi, Yasin A.

    2015-01-01

    Osteochondroma (OC) is one of the most common benign condylar tumours having both chondroma and osteoma. However, this tumour is most frequently found on the metaphyses of long bones and is unusual on the skull. When it affects the mandibular condyle, the cause could be due to trauma to the tempero mandibular joint (TMJ). Here, in this report we present a rare case of osteochondroma of left condyle region in a 36-year-old man. The patient had noticed pain in the left TMJ for six months. The lesion is surgically removed and histologically evaluated which composed of chondrocytes dispersed in hyaline matrix along with a rim of calcified bone at one end. PMID:25859534

  17. Medial femoral condyle fracture following traumatic allogenic bone transfer – A case report

    PubMed Central

    Kondreddi, Vamsi; Roy, Kishore; Yalamanchili, Ranjith Kumar

    2015-01-01

    Open fractures can cause an “out-in” injury, wherein a foreign body can penetrate the skin causing fracture. There are few reports of allogenic bone getting embedded in soft tissue, but one causing fracture to the host bone has not been reported till date. We present a case, wherein a large cortical bony fragment from one individual penetrated the thigh of another person causing fracture of medial femoral condyle during a head-on collision involving two motorbikes. PMID:26155058

  18. Medial femoral condyle fracture following traumatic allogenic bone transfer - A case report.

    PubMed

    Kondreddi, Vamsi; Roy, Kishore; Yalamanchili, Ranjith Kumar

    2015-09-01

    Open fractures can cause an "out-in" injury, wherein a foreign body can penetrate the skin causing fracture. There are few reports of allogenic bone getting embedded in soft tissue, but one causing fracture to the host bone has not been reported till date. We present a case, wherein a large cortical bony fragment from one individual penetrated the thigh of another person causing fracture of medial femoral condyle during a head-on collision involving two motorbikes. PMID:26155058

  19. [Current diagnosis and therapy of anterior mandibular fracture associated with condyle fractures].

    PubMed

    Xu, Xiaofeng; Xu, Bing

    2014-04-01

    Anterior mandibular fracture, which includes symphyseal and parasymphyseal mandibular fractures, is one of the most common types of fracture in clinical work, and is usually associated with condyle fracture. This type of fracture predisposes the patients to facial widening, malocclusion, and ankylosis when not properly and timely treated because of the influence of its anatomic structure. This article reviews the characteristics, complication, diagnosis, and therapy of this type of fracture. PMID:24881222

  20. Effect of alendronate on endochondral ossification in mandibular condyles of growing rats.

    PubMed

    Bradaschia-Correa, V; Barrence, F A C; Ferreira, L B; Massa, L F; Arana-Chavez, V E

    2012-01-01

    The replacement of the calcified cartilage by bone tissue during the endochondral ossification of the mandibular condyle is dependent of the resorbing activity of osteoclats. After partial resorption, calcified cartilage septa are covered by a primary bone matrix secreted by osteoblasts. Osteoadherin (OSAD) is a small proteoglycan present in bone matrix but absent in cartilage during the endochondral ossification. The aim of this study was to analyze the effect of alendronate, a drug known to inhibit bone resorption by osteoclasts, on the endochondral ossification of the mandibular condyle of young rats, by evaluating the distribution of osteoclasts and the presence of OSAD in the bone matrix deposited. Wistar newborn rats (n=45) received daily injections of alendronate (n=27) or sterile saline solution as control (n=18) from the day of birth until the ages of 4, 14 and 30 days. At the days mentioned, the mandibular condyles were collected and processed for transmission electron microscopy analysis. Specimens were also submitted to tartrate resistant acid phosphatase (TRAP) histochemistry and ultrastructural immunodetection of OSAD. Alendronate treatment did not impede the recruitment and fusion of osteoclasts at the ossification zone during condyle growth, but they presented inactivated phenotype. The trabeculae at the ossification area consisted of cartilage matrix covered by a layer of primary bone matrix that was immunopositive to OSAD at all time points studied. Apparently, alendronate impeded the removal of calcified cartilage and maturation of bone trabeculae in the mandibular ramus, while in controls they occurred normally. These findings highlight for giving attention to the potential side-effects of bisphosphonates administered to young patients once it may represent a risk of disturbing maxillofacial development. PMID:22688305

  1. Proliferative periostitis of the mandibular ramus and condyle: a case report.

    PubMed

    Seok, Hyun; Kim, Seong-Gon; Song, Ji-Young

    2015-08-01

    Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment. PMID:26339579

  2. Proliferative periostitis of the mandibular ramus and condyle: a case report

    PubMed Central

    Seok, Hyun; Kim, Seong-Gon

    2015-01-01

    Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment. PMID:26339579

  3. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    PubMed Central

    Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

  4. Current concepts in the mandibular condyle fracture management part I: overview of condylar fracture.

    PubMed

    Choi, Kang-Young; Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-07-01

    The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

  5. Femoral condyle curvature is correlated with knee walking kinematics in ungulates.

    PubMed

    Sylvester, Adam D

    2015-12-01

    The knee has been the focus of many studies linking mammalian postcranial form with locomotor behaviors and animal ecology. A more difficult task has been linking joint morphology with joint kinematics during locomotor tasks. Joint curvature represents one opportunity to link postcranial morphology with walking kinematics because joint curvature develops in response to mechanical loading. As an initial examination of mammalian knee joint curvature, the curvature of the medial femoral condyle was measured on femora representing 11 ungulate species. The position of a region of low curvature was measured using a metric termed the "angle to low curvature". This low-curvature region is important because it provides the greatest contact area between femoral and tibial condyles. Kinematic knee angles during walking were derived from the literature and kinematic knee angles across the gait cycle were correlated with angle to low curvature values. The highest correlation between kinematic knee angle and the angle to low curvature metric occurred at 20% of the walking gait cycle. This early portion of the walking gait cycle is associated with a peak in the vertical ground reaction force for some mammals. The chondral modeling theory predicts that frequent and heavy loading of particular regions of a joint surface during ontogeny will result in these regions being flatter than the surrounding joint surface. The locations of flatter regions of the femoral condyles of ungulates, and their association with knee angles used during the early stance phase of walking provides support for the chondral modeling theory. PMID:26414648

  6. Facilitation of bone resorption activities in synovial lavage fluid patients with mandibular condyle fractures.

    PubMed

    Takano, H; Takahashi, T; Nakata, A; Nogami, S; Yusa, K; Kuwajima, S; Yamazaki, M; Fukuda, M

    2016-05-01

    The aim of this study was to investigate the bone resorption effect of the mediators delivered in joint cavity of patients with mandibular condyle fractures by detecting osteoclast markers using cellular biochemistry methods, and by analysing bone resorption activities via inducing osteoclast differentiation of the infiltrated cells from arthrocentesis. Sixteen joints in 10 patients with mandibular condyle fractures were evaluated. The control group consisted of synovial fluid (SF) samples from seven joints of four volunteers who had no clinical signs or symptoms involving the temporomandibular joint (TMJ) or disc displacement. We collected SF cells from all patients during therapeutic arthrocentesis. The infiltrating cells from TMJ SF were cultured, differentiated into tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells and examined bone resorption activities. We also investigated factors related to osteoclast induction of SF, using ELISA procedures. Osteoclast-like cells were induced from the SF cells obtained from all patients with condylar fractures. These multinucleated giant cells were positive for TRAP and actin, and had the ability to absorb dentin slices. The levels of macrophage colony-stimulating factor (M-CSF), prostaglandin E2 (PGE2), soluble form of receptor activator of nuclear factor kappa-B ligand (sRANKL) and osteoprotegerin (OPG), in SF samples from the patients, were significantly higher than in the controls. These findings indicate that bone resorption activities in SF from patients with mandibular condyle fractures were upregulated and may participate in the pathogenesis and wound healing. PMID:26946239

  7. CAD-CAM-generated hydroxyapatite scaffold to replace the mandibular condyle in sheep: preliminary results.

    PubMed

    Ciocca, Leonardo; Donati, Davide; Fantini, Massimiliano; Landi, Elena; Piattelli, Adriano; Iezzi, Giovanna; Tampieri, Anna; Spadari, Alessandro; Romagnoli, Noemi; Scotti, Roberto

    2013-08-01

    In this study, rapid CAD-CAM prototyping of pure hydroxyapatite to replace temporomandibular joint condyles was tested in sheep. Three adult animals were implanted with CAD-CAM-designed porous hydroxyapatite scaffolds as condyle substitutes. The desired scaffold shape was achieved by subtractive automated milling machining (block reduction). Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Using the same technique, fixation plates were created and applied to the scaffold pre-operatively to firmly secure the condyles to the bone and to assure primary stability of the hydroxyapatite scaffolds during masticatory function. Four months post-surgery, the sheep were sacrificed. The hydroxyapatite scaffolds were explanted, and histological specimens were prepared. Different histological tissues penetrating the scaffold macropores, the sequence of bone remodeling, new apposition of bone and/or cartilage as a consequence of the different functional anatomic role, and osseointegration at the interface between the scaffold and bone were documented. This animal model was found to be appropriate for testing CAD-CAM customization and the biomechanical properties of porous, pure hydroxyapatite scaffolds used as joint prostheses. PMID:22492196

  8. Proximal humeral fractures: a biomechanical comparison of locking plate constructs in a cadaveric 3-part fracture model.

    PubMed

    Rose, David M; Sutter, Edward G; Mears, Simon C; Gupta, Rohit R; Belkoff, Stephen M

    2010-11-01

    The purpose of our study was to biomechanically compare, under cyclic loading conditions, fracture site motion, humeral head collapse, and intra-articular hardware penetration in simulated 3-part osteoporotic proximal humeral fractures stabilized with 1 of 2 locking-plate constructs. We performed fixation on simulated 3-part proximal humeral fractures in 10 pairs of cadaveric osteoporotic humeri with a Hand Innovations S3 Proximal Humerus Plate (S3 plate) or an LCP Proximal Humerus Plate (LCP plate; 1 each for each pair). The specimens were potted, mounted on a materials testing machine, and subjected to 5000 cycles of abduction in the scapular plane, loading through the supraspinatus tendon. Interfragmentary displacement at 2 virtual points (the most medial aspect of the calcar and the most superior aspect of the osteotomy line between the greater tuberosity and humeral head) was measured using an optical tracking system. Humeral head rotation was also measured. We used a generalized linear latent and mixed model to check for an effect of cyclic loading and treatment on the parameters of interest (significance, P < .05). After cyclic loading, the S3 plate humeri showed significantly greater displacement of the greater tuberosity fragment and rotation of the humeral head and a trend (not a significant difference) toward greater displacement at the calcar. No hardware penetration was noted for either repair. Although the S3 plate repairs resulted in significantly more fracture site motion, it is unknown whether the magnitude of the motion is clinically significant. PMID:23569665

  9. Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: A cadaveric study.

    PubMed

    Kim, Hyun-Min Mike; Chacon, Alexander C; Andrews, Seth H; Roush, Evan P; Cho, Edward; Conaway, William K; Kunselman, Allen R; Lewis, Gregory S

    2016-04-01

    Restoration of joint stability during total shoulder arthroplasty can be challenging in the face of severe glenoid retroversion. A novel technique of humeral head component anterior-offsetting has been proposed to address posterior instability. We evaluated the biomechanical benefits of this technique in cadaveric specimens. Total shoulder arthroplasty was performed in 14 cadaveric shoulders from 7 donors. Complementary shoulders were assigned to either 10° or 20° glenoid retroversion, with retroversion created by eccentric reaming. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. The force and energy required to displace the humeral head posteriorly increased significantly with the anterior offset position compared to the anatomic offset position. The joint contact pressures were significantly shifted anteriorly, and the joint contact area significantly increased with the anterior offset position. Anterior offsetting of the humeral head component increased the resistance to posterior humeral head translation, shifted joint contact pressures anteriorly, and increased joint contact area, thus, potentially increasing the joint stability in total shoulder arthroplasty with simulated glenoid retroversion. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:666-674, 2016. PMID:26356804

  10. Marchetti Vicenzi elastic retrograde nail in the treatment of humeral shaft fractures: review of the current literature.

    PubMed

    Ruffilli, A; Traina, F; Pilla, F; Fenga, D; Faldini, C

    2015-12-01

    Shoulder impairment following anterograde intramedullary nailing for humeral shaft fractures represents a challenging problem for the orthopedic surgeon. Traditional retrograde nailing lowers the rates of shoulder impairment although exposing the surgeons to severe technical issues related to the proximal interlocking. The Marchetti Vicenzi nail (MVN) permits a retrograde insertion along with a self-locking mechanism that lowers the risk of iatrogenic damage during proximal interlocking. Aim of this literature review was to evaluate all the case series dealing with MVN and the obtained results in terms of union rates, complications, and functional outcomes in order to evaluate evidence that would substantiate the adoption of MVN in the treatment of humeral shaft fractures. A search was performed using the keywords "humeral shaft fracture nail," "humeral retrograde nail," "humeral elastic nail," "Marchetti Vicenzi nail," "Marchetti nail," "Vicenzi nail." After accurate revision 13 articles found to be relevant with a total of 532 humeral fractures (traumatic and pathologic) and non-unions treated with MVN. The cumulative healing rate reported is 93.7 % with 6.3 % of non-unions. Despite the fact that obtained results compare favorably to the published data on the outcome of anterograde nailing, the evaluated studies presented a huge number of methodological flaws, thus making it difficult to recommend the adoption of MVN in preference of other better-validated forms of treatment. PMID:26559733

  11. Treatment Outcome of Intramedullary Fixation with a Locked Rigid Nail in Humeral Shaft Fractures

    PubMed Central

    Kivi, Mohsen Mardani; Soleymanha, Mehran; Haghparast-Ghadim-Limudahi, Zahra

    2016-01-01

    Background: The aim of this study was to determine the treatment outcome of humeral shaft fractures with a locked rigid intramedullary nail in patients indicated for surgical treatment. Methods: In this descriptive-cross sectional study, all patients were followed up for one, six, and 18 months post operatively. The Short Form Questionnaire (SF-36) and Constant Shoulder Score were applied. Results: Of 78 included patients (mean age: 35), one patient had a soft tissue infection, one had secondary radial nerve palsy, eight had non-union, one had elbow limited range of motion in extension, and three patients had decreased shoulder range of motion. The Constant Shoulder Score and Short Form Questionnaire Score (SF-36) increased in all patients, although aged women showed lower improvement. Conclusion: Intramedullary nail fixation in the humeral shaft fracture may be associated with high rates of non-union. PMID:26894218

  12. Results of non-union of humerus treated with retrograde humeral nail.

    PubMed

    Bhatt, Hinesh; Varghese, Bobin; Phillips, Hannah; Rambani, Rohit; Halder, Subhash

    2015-05-01

    Treating non-union of humerus fracture is a surgical challenge with variable outcome. We report series of 51 adult patients of aseptic non-union of humerus from 1998 to 2010 treated retrograde humeral nail. The mean age of patient was 54 years with 33 females and 18 males. The mean duration of non-union was 8 months. In 48 out of 51 cases (94 %), union was achieved at mean duration of 10.1 months. Thirty-two out of 51 patients needed bone grafting. Three patients had post-operative radial nerve neuropraxia which fully recovered. At last visit, mean Constant score for shoulder was 83 and mean Mayo score for elbow 78. Our series with this implant shows excellent union rates for extra articular humeral non-unions in adults. PMID:25427782

  13. Flexible Intramedullary Nailing of Pediatric Humeral Fractures: Indications, Techniques, and Tips.

    PubMed

    Kelly, Derek M

    2016-06-01

    Most proximal and diaphyseal pediatric humeral fractures can be treated successfully by closed means; however, certain patient factors or fracture characteristics may make surgical stabilization with flexible intramedullary nails (FIN) a better choice. Common indications for FIN of pediatric humeral fractures include unstable proximal-third fractures in children nearing skeletal maturity, unstable distal metaphyseal-diaphyseal junction fractures, shaft fractures in polytraumatized patients or patients with ipsilateral both-bone forearm fractures (floating elbow), and prophylactic stabilization of benign diaphyseal bone cysts or surgical stabilization of pathologic fractures. FIN can be safely inserted in an antegrade or retrograde manner depending on the fracture location and configuration. Careful dissection at the location of rod insertion can prevent iatrogenic nerve injuries. Rapid fracture union and return to full function can be expected in most cases. Implant prominence is the most common complication. PMID:27152902

  14. Acute Operative Management of Humeral Shaft Fractures: Analysis of the National Trauma Data Bank.

    PubMed

    Matuszewski, Paul E; Kim, Tae Won; Gay, Andre N; Mehta, Samir

    2015-06-01

    Advances in surgical techniques have increased the role of early surgical intervention for isolated diaphyseal humerus fractures. The goal of this study was to investigate the following: (1) the current trend of operative treatment; (2) factors that affect surgical treatment; and (3) the effect of surgical fixation on length of stay, complication rates, and hospital disposition. The National Trauma Data Bank from 2004 to 2006 was analyzed. All patients with multiple injuries that included closed humeral shaft fractures and all patients with isolated humeral shaft fractures were included. Of 2312 total closed humeral shaft fractures, 1662 had a documented procedure code. A total of 47% of patients underwent surgical treatment. Surgically treated patients were on average 3.5 years older than those treated nonoperatively (P=.007). A total of 49% of white patients underwent early surgery vs 39% of nonwhite patients (P<.001). The operative group had a mean Injury Severity Score of 8.33 vs 9.0 in the nonoperative group (P=.04). Treatment at a Level I trauma center decreased the likelihood of surgery compared with treatment at a non-Level I trauma center (45% vs 57%, P<.001). Mean length of stay was 4.6 days for operative treatment vs 3.9 days for nonoperative treatment (P=.02). Of patients who underwent surgery, 78% were discharged to home compared with 69% of those managed nonoperatively (P<.001). Acute operative management of humeral shaft fractures correlated with a lower Injury Severity Score, a decreased length of stay, and less rehabilitation placement. Furthermore, older patients, white patients, and patients treated at a non-Level I trauma center were more likely to undergo acute surgical management. The reasons for these disparities are unclear and warrant further investigation. PMID:26091221

  15. Stress fracture of the proximal humeral epiphysis in an elite junior badminton player.

    PubMed

    Boyd, K T; Batt, M E

    1997-09-01

    An elite junior badminton player presented with a chronic painful dominant shoulder after an intense training course. An acute stress fracture to the proximal humeral epiphysis was found. Two-plane radiography will identify abnormalities of the growth plate but comparative films of the unaffected side may also be required to differentiate subtle changes. Rest with subsequent rehabilitation is the appropriate management of these injuries although ideally they should be subjected to primary prevention. PMID:9298564

  16. Stress fracture of the proximal humeral epiphysis in an elite junior badminton player.

    PubMed Central

    Boyd, K T; Batt, M E

    1997-01-01

    An elite junior badminton player presented with a chronic painful dominant shoulder after an intense training course. An acute stress fracture to the proximal humeral epiphysis was found. Two-plane radiography will identify abnormalities of the growth plate but comparative films of the unaffected side may also be required to differentiate subtle changes. Rest with subsequent rehabilitation is the appropriate management of these injuries although ideally they should be subjected to primary prevention. Images Figure 1 Figure 2 PMID:9298564

  17. Glenohumeral Internal Rotation Deficit in the Asymptomatic Professional Pitcher and its Relationship to Humeral Retroversion

    PubMed Central

    Tokish, John M.; Curtin, Michael S.; Kim, Young-Kyu; Hawkins, Richard J.; Torry, Michael R.

    2008-01-01

    The purpose of this study was to determine if glenohumeral internal rotation deficits (GIRD) exist in an asymptomatic population of professional pitchers, and to assess whether these changes are primarily a bony or soft tissue adaptation. Twenty three, active, asymptomatic professional (Major League Baseball) pitchers volunteered for the study. Clinical measures of glenohumeral ranges of motion, laxity, GIRD, as well as radiographic measures of humeral retroversion were taken by two independent orthopaedic surgeons. Data comparing side to side differences in range of motion, laxity, and humeral retroversion were analyzed for statistical significance using a paired t-test for continuous data and a Chi-squared test for ordinal data, with a significance set at 0.05. Evaluations of statistical correlations between different measurement parameters were accomplished using a Pearson product moment correlation. We hypothesized GIRD will be positively correlated with humeral retroversion (HR) in the pitching arm. All clinical and radiographic measures were made in the field, at spring training, by physicians of both private and institutional based sports medicine practices. For the entire group, significant differences were exhibited for HR, external rotation at 90 and internal rotation at 90, for dominant vs. non-dominant arms. GIRD of greater than 25 was noted in 10/23 of pitchers. In this group, HR was significantly increased and correlated to GIRD. No such increase or correlation was noted for the non-GIRD group. GIRD is a common finding in asymptomatic professional pitchers, and is related to humeral retroversion. Thus internal rotation deficits should not be used as the sole screening tool to diagnose the disabled throwing shoulder. Key pointsGIRD is relatively common in asymptomatic baseball pitchers (35-43%).Large ranges (-45 to 5) and a large standard deviation (16) were noted suggesting that GIRD is quite variable in this population.GIRD is a variable measure in the asymptomatic population, and therefore should not be used as sole proof for the disabled throwing shoulder. PMID:24150137

  18. Recession wedge osteotomy of the greater tuberosity for proximal humeral varus.

    PubMed

    Aoki, Stephen K; Anderson, Lucas A; Marchese, Joseph W

    2011-05-01

    Proximal humeral varus has multiple etiologies and may lead to impingement and reduced shoulder range of motion, particularly abduction and forward elevation. Valgus osteotomies have been described at the level of the surgical neck yielding acceptable results. This article describes a case of a male electrician who was treated for symptoms associated with proximal humeral varus of the right shoulder. He underwent an osteotomy of the greater tuberosity designed to reduce impingement and improve range of motion. The patient had previously undergone two separate surgical procedures for a simple bone cyst, but continued to have reduced shoulder function secondary to a prominent greater tuberosity. Preoperative and follow-up radiographs, physical examinations, and shoulder function were retrospectively reviewed for 32 months. Following treatment, active forward elevation improved from 130° preoperatively to 170°, abduction from 90° to 170°, external rotation from 45° to 70°, and internal rotation from T10 to T7. The patient reported relief of pain, impingement-free range of motion, and full symmetric function equal to that of his contralateral shoulder. Radiographs demonstrated osteotomy union, improved greater tuberosity/acromial clearance, and no impingement with abduction. Postoperative stiffness was the only complication noted for which a shoulder manipulation was performed under anesthesia. Thus, recession wedge osteotomy of the prominent greater tuberosity may serve as a viable surgical approach to reducing impingement and improving clinical function in proximal humeral varus. PMID:21598883

  19. UPPER LIMB TRACTION DEVICE FOR ANTEROGRADE INTRAMEDULLARY LOCKED NAIL OF HUMERAL SHAFT FRACTURES

    PubMed Central

    Corrêa, Mário Chaves; Gomes, Felipe Antônio; Linhares, Daniel Campos; Gonçalves, Lucas Braga Jacques; Vilela, José Carlos Souza; de Andrade, Ronaldo Percopi

    2015-01-01

    Diaphyseal fractures of the femur and tibia in adults are mostly treated surgically, usually by means of intramedullary locked-nail osteosynthesis. Some comminuted and/or highly deviated shaft fractures may present a veritable technical challenge. Fracture (or orthopedic) tables, which enable vertical, horizontal and rotational instrumental stabilization of the limb, greatly facilitate reduction and implant placement maneuvers and are widely used by orthopedic surgeons. Humeral shaft fractures are mostly treated nonsurgically. However, some cases with indications that are well defined in the literature require surgical treatment. They can be fixed by means of plates or intramedullary nails, using anterograde or retrograde routes. In the humerus, fracture reduction and limb stabilization maneuvers for implantation of intramedullary nails are done manually, usually by two assistants. Because muscle fatigue may occur, this option may be less efficient. The aim of this paper is to present an external upper-limb traction device for use in anterograde intramedullary locked-nail osteosynthesis of humeral shaft fractures that enables vertical, horizontal and rotational stabilization of the upper limb, in a manner similar to the device used for the lower limbs. The device is portable, of simple construction, and can be installed on any operating table equipped with side rails. It was used for surgical treatment of 29 humeral shaft fractures using an anterograde locked intramedullary nail. Our experience was extremely positive. We did not have any complications relating to its use and we believe that it notably facilitated the surgical procedures. PMID:27022560

  20. Early asymptomatic intrathoracic migration of a threaded pin after proximal humeral osteosynthesis

    PubMed Central

    Cerruti, Paola; Mangano, Tony; Giovale, Marcello; Repetto, Ilaria

    2016-01-01

    Pinning with metallic wires is a suitable therapeutic option for proximal humeral fractures. Loosening and migration of such devices from this site is uncommon. Despite infrequently occurring, however, the literature reports dramatic and potentially lethal complications related to wires dislocation. A 69-year-old woman underwent closed reduction and fixation of a proximal 3-part humeral fracture by mean of two retrograde Kirschner wires and one anterograde threaded pin. One month after surgery, during a routine follow-up control, it was diagnosed the migration of the threaded pin in the left lung parenchyma. In the meantime, the only symptom the patient complained was an episodic intercostal pain of mild intensity, with referred onset 1 week after surgery. The migrated pin was removed through thoracoscopic approach in the emergency setting, without intra- or post-operative complications. Only a few authors reported similar complications after fixation of proximal humeral fractures. Immediate surgical removal of the device is always mandatory. When considering pinning fixation for shoulder girdle's fractures, orthopedic surgeons should take into account the risk for wire dislocation, and take up adequate precautions during surgery and follow-up control visits. PMID:26980989

  1. A comparison of proximal humeral cancellous bone of great apes and humans.

    PubMed

    Scherf, H; Harvati, K; Hublin, J-J

    2013-07-01

    The shoulder is the most mobile joint in the primate body, and is involved in both locomotor and manipulative activities. The presumed functional sensibility of trabecular bone can offer a way of decoding the activities to which the forelimbs of fossil primates were subjected. We examine the proximal humeral trabecular architecture in a relatively closely related group of similarly sized hominids (Pongo pygmaeus, Pan troglodytes, and Homo sapiens), in order to evaluate the effect of diverging habitual motion behaviors of the shoulder complex in a coherent phylogenetic group. In order to characterize and compare the humeral trabecular architectures of the three species, we imaged a large sample by high-resolution computed tomography (HrCT) and quantified their trabecular architectures by standard bone 3D morphometric parameters. Univariate statistical analysis was performed, showing significant differences among the species. However, univariate statistics could not highlight the structural particularity in the cancellous bone of each species. A principal component analysis also showed clear separation of the three taxa and enabled a structural characterization of the humeral trabecular bone of each species. We conclude that the differences in the architectural setup of the three hominids likely reflect multiple differences in their habitual activity patterns of their shoulder joint, although individual structural features are difficult to relate to specific loading conditions. PMID:23680068

  2. Bone Graft Substitute Provides Metaphyseal Fixation for a Stemless Humeral Implant.

    PubMed

    Kim, Myung-Sun; Kovacevic, David; Milks, Ryan A; Jun, Bong-Jae; Rodriguez, Eric; DeLozier, Katherine R; Derwin, Kathleen A; Iannotti, Joseph P

    2015-07-01

    Stemless humeral fixation has become an alternative to traditional total shoulder arthroplasty, but metaphyseal fixation may be compromised by the quality of the trabecular bone that diminishes with age and disease, and augmentation of the fixation may be desirable. The authors hypothesized that a bone graft substitute (BGS) could achieve initial fixation comparable to polymethylmethacrylate (PMMA) bone cement. Fifteen fresh-frozen human male humerii were randomly implanted using a stemless humeral prosthesis, and metaphyseal fixation was augmented with either high-viscosity PMMA bone cement (PMMA group) or a magnesium-based injectable BGS (OsteoCrete; Bone Solutions Inc, Dallas, Texas) (OC group). Both groups were compared with a control group with no augmentation. Initial stiffness, failure load, failure displacement, failure cycle, and total work were compared among groups. The PMMA and OC groups showed markedly higher failure loads, failure displacements, and failure cycles than the control group (P<.01). There were no statistically significant differences in initial stiffness, failure load, failure displacement, failure cycle, or total work between the PMMA and OC groups. The biomechanical properties of magnesium-based BGS fixation compared favorably with PMMA bone cement in the fixation of stemless humeral prostheses and may provide sufficient initial fixation for this clinical application. Future work will investigate the long-term remodeling characteristics and bone quality at the prosthetic-bone interface in an in vivo model to evaluate the clinical efficacy of this approach. PMID:26186322

  3. Pullulan/dextran/nHA Macroporous Composite Beads for Bone Repair in a Femoral Condyle Defect in Rats

    PubMed Central

    Schlaubitz, Silke; Derkaoui, Sidi Mohammed; Marosa, Lydia; Miraux, Sylvain; Renard, Martine; Catros, Sylvain; Le Visage, Catherine; Letourneur, Didier; Amédée, Joëlle; Fricain, Jean-Christophe

    2014-01-01

    The repair of bone defects is of particular interest for orthopedic, oral, maxillofacial, and dental surgery. Bone loss requiring reconstruction is conventionally addressed through bone grafting. Depending on the size and the location of the defect, this method has limits and risks. Biomaterials can offer an alternative and have features supporting bone repair. Here, we propose to evaluate the cellular penetration and bone formation of new macroporous beads based on pullulan/dextran that has been supplemented with nanocrystalline hydroxyapatite in a rat model. Cross-linked beads of 300–500 µm diameters were used in a lateral femoral condyle defect and analyzed by magnetic resonance imaging, micro-computed tomography, and histology in comparison to the empty defects 15, 30, and 70 days after implantation. Inflammation was absent for both conditions. For empty defects, cellularisation and mineralization started from the periphery of the defect. For the defects containing beads, cellular structures filling out the spaces between the scaffolds with increasing interconnectivity and trabecular-like organization were observed over time. The analysis of calcified sections showed increased mineralization over time for both conditions, but was more pronounced for the samples containing beads. Bone Mineral Density and Bone Mineral Content were both significantly higher at day 70 for the beads in comparison to empty defects as well as compared with earlier time points. Analysis of newly formed tissue around the beads showed an increase of osteoid tissue, measured as percentage of the defect surface. This study suggests that the use of beads for the repair of small size defects in bone may be expanded on to meet the clinical need for a ready-to-use fill-up material that can favor bone formation and mineralization, as well as promote vessel ingrowth into the defect site. PMID:25330002

  4. Osteochondroma of the mandibular condyle – Report of an atypical case and the importance of computed tomography

    PubMed Central

    Andrade, Neelam N.; Gandhewar, Trupti M.; Kapoor, Prathmesh; Thomas, Roy

    2014-01-01

    Osteochondroma is a rare tumor of the mandibular condyle. Much confusion seems to exist in the literature in differentiating these tumors from chondromas as well as condylar hyperplasias. Due to considerable overlapping features between chondromas and condylar hyperplasia, it is likely to get misdiagnosed, thereby resulting in inadvertent errors in the treatment. A case report of a 35 year old male patient with mandibular deviation and malocclusion is presented here. He initially went unnoticed for features of an osteochondroma of the mandibular condyle but was subsequently treated for the same. PMID:25737946

  5. Shape and Site Dependent in Vivo Degradation of Mg-Zn Pins in Rabbit Femoral Condyle

    PubMed Central

    Han, Pei; Tan, Moyan; Zhang, Shaoxiang; Ji, Weiping; Li, Jianan; Zhang, Xiaonong; Zhao, Changli; Zheng, Yufeng; Chai, Yimin

    2014-01-01

    A type of specially designed pin model of Mg-Zn alloy was implanted into the full thickness of lesions of New Zealand rabbits’ femoral condyles. The recovery progress, outer surface healing and in vivo degradation were characterized by various methods including radiographs, Micro-CT scan with surface rendering, SEM (scanning electron microscope) with EDX (Energy Dispersive X-ray analysis) and so on. The in vivo results suggested that a few but not sufficient bridges for holding force were formed between the bone and the implant if there was a preexisting gap between them. The rapid degradation of the implantation in the condyle would result in the appearance of cavities. Morphological evaluation of the specially designed pins indicated that the cusp was the most vulnerable part during degradation. Furthermore, different implantation sites with distinct components and biological functions can lead to different degradation rates of Mg-Zn alloy. The rate of Mg-Zn alloy decreases in the following order: implantation into soft tissue, less trabecular bone, more trabecular bone, and cortical bone. Because of the complexities of in vivo degradation, it is necessary for the design of biomedical Mg-Zn devices to take into consideration the implantation sites used in clinics. PMID:24566138

  6. Treatment of a Femur Nonunion with Microsurgical Corticoperiosteal Pedicled Flap from the Medial Femoral Condyle

    PubMed Central

    Guzzini, Matteo; Guidi, Marco; Civitenga, Carolina; Ferri, Germano; Ferretti, Andrea

    2016-01-01

    Introduction. The vascularized corticoperiosteal flap is harvested from the medial femoral condyle and it is nourished by the articular branch of the descending genicular artery and the superomedial genicular artery. This flap is usually harvested as a free flap for the reconstruction of bone defects at forearm, distal radius, carpus, hand, and recently at lower limb too. Case Report. A 50-year-old Caucasian man referred to our department for hypertrophic nonunion of the distal femur, refractory to the conservative treatments. The first surgical choice was the revision of the nail and the bone reconstruction with a corticoperiosteal pedicled flap from the medial femoral condyle. We considered union to have occurred 3.5 months after surgery when radiographs showed bridging of at least three of the four bony cortices and clinically the patient was able to walk with full weight bearing without any pain. At the last follow-up (25 months), the patient was completely satisfied with the procedure. Discussion. The corticoperiosteal flap allows a faster healing of fractures with a minimal morbidity at the donor site. We suggest that the corticoperiosteal pedicled flap graft is a reliable and effective treatment for distal femur nonunion. PMID:27064589

  7. Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study.

    PubMed

    Zrounba, Hugues; Lutz, Jean-Christophe; Zink, Simone; Wilk, Astrid

    2014-09-01

    Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral. PMID:24485271

  8. Dislocation of the mandibular condyle into the middle cranial fossa causing an epidural haematoma.

    PubMed

    Struewer, Johannes; Kiriazidis, Ilias; Figiel, Jens; Dukatz, Thomas; Frangen, Thomas; Ziring, Ewgeni

    2012-07-01

    Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma due to anatomical and biomechanical factors. Owing to the proximity of the temporal glenoid fossa to the middle meningeal artery, there is the risk of serious sequelae in case of trauma. The authors report the case of a 36-year-old male patient, who was beaten up in a family dispute and presented with complex mandibular and maxillofacial fractures, including mandibular condyle intrusion into the middle cranial fossa causing extensive meningeal bleeding. The patient underwent immediate surgery, with evacuation of the epidural haematoma via a temporal approach. In addition open reduction and reconstruction of the temporal glenoid fossa via anatomic reduction of the fragments was performed. A functional occlusion was re-established via miniplate reconstruction of the complex mandibular body and ramus fractures. Prompt diagnosis and a multidisciplinary approach are essential to minimize the complications. Advanced imaging modalities of computed tomography are indicated. Treatment options should be individualized in particular in case of suspected neurological injury. PMID:21862340

  9. ANALYSIS ON THE VARIATION OF MEDIAL ROTATION VALUES ACCORDING TO THE POSITION OF THE HUMERAL DIAPHYSIS

    PubMed Central

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Cohen, Carina; Busin Giora, Taís Stedile; Checchia, Sergio Luiz; Raia, Fabio; Pekelman, Hélio; Cymrot, Raquel

    2015-01-01

    Objective: To analyze the validity of measurements of medial rotation (MR) of the shoulder, using vertebral levels, according to the variation in the position of the humeral diaphysis, and to test the bi-goniometer as a new measuring instrument. Methods: 140 shoulders (70 patients) were prospectively evaluated in cases presenting unilateral shoulder MR limitation. The vertebral level was evaluated by means of a visual scale and was correlated with the angle obtained according to the position of the humeral diaphysis, using the bi-goniometer developed with the Department of Mechanical Engineering of Mackenzie University. Results: The maximum vertebral level reached through MR on the unaffected side ranged from T3 to T12, and on the affected side, from T6 to the trochanter. Repositioning of the affected limb in MR according to the angular values on the normal side showed that 57.13% of the patients reached lower levels, between the sacrum, gluteus and trochanter. From analysis on the maximum vertebral level attained and the variation between the affected angle x (frontal plane: abduction and MR of the shoulder) and the unaffected angle x in MR, we observed that the greater the angle of the diaphyseal axis was, the lower the variation in the vertebral level attained was. From evaluating the linear correlation between the variables of difference in maximum vertebral level reached and variation in the affected angle y (extension and abduction of the shoulder) and the unaffected angle y in MR, we observed that there was no well-established linear relationship between these variables. Conclusion: Measurement of MR using vertebral levels does not correspond to the real values, since it varies according to the positioning of the humeral diaphysis. PMID:27047845

  10. Dominant-Limb Range-of-Motion and Humeral-Retrotorsion Adaptation in Collegiate Baseball and Softball Position Players

    PubMed Central

    Hibberd, Elizabeth E.; Oyama, Sakiko; Tatman, Justin; Myers, Joseph B.

    2014-01-01

    Context: Biomechanically, the motions used by baseball and softball pitchers differ greatly; however, the throwing motions of position players in both sports are strikingly similar. Although the adaptations to the dominant limb from overhead throwing have been well documented in baseball athletes, these adaptations have not been clearly identified in softball players. This information is important in order to develop and implement injury-prevention programs specific to decreasing the risk of upper extremity injury in softball athletes. Objective: To compare range-of-motion and humeral-retrotorsion characteristics of collegiate baseball and softball position players and of baseball and softball players to sex-matched controls. Design: Cross-sectional study. Setting: Research laboratories and athletic training rooms at the University of North Carolina at Chapel Hill. Patients or Other Participants: Fifty-three collegiate baseball players, 35 collegiate softball players, 25 male controls (nonoverhead athletes), and 19 female controls (nonoverhead athletes). Intervention(s): Range of motion and humeral retrotorsion were measured using a digital inclinometer and diagnostic ultrasound. Main Outcome Measure(s): Glenohumeral internal-rotation deficit, external-rotation gain, total glenohumeral range of motion, and humeral retrotorsion. Results: Baseball players had greater glenohumeral internal-rotation deficit, total–range-of-motion, and humeral-retrotorsion difference than softball players and male controls. There were no differences between glenohumeral internal-rotation deficit, total–range-of-motion, and humeral-retrotorsion difference in softball players and female controls. Conclusions: Few differences were evident between softball players and female control participants, although range-of-motion and humeral-retrotorsion adaptations were significantly different than baseball players. The throwing motions are similar between softball and baseball, but the athletes adapt to the demands of the sport differently; thus, stretching/strengthening programs designed for baseball may not be the most effective programs for softball athletes. PMID:25098655

  11. Dicondylar humeral fracture stabilisation in a dog using a transilial rod and external fixation.

    PubMed

    Au, K; Mattern, K L; Lewis, D D

    2008-03-01

    Repair of a Salter-Harris type IV dicondylar humeral fracture was performed on a 15-week-old pitbull terrier. Interfragmentary compression of the intracondylar component of the fracture was achieved with a transilial rod and locking nuts (Trans-ilial Rod; IMEX Veterinary, Inc.). The transilial rod was articulated with a modified type I external fixator which functioned as adjunctive stabilisation for the supracondylar component of the fracture. Fracture healing was confirmed radiographically five weeks following surgery. The dog had no appreciable lameness when examined 12 months after fracture repair. PMID:17725586

  12. Zoledronate Therapy for the Pathological Humeral Fracture in Polyostotic Fibrous Dysplasia: A Case Report

    PubMed Central

    Ohno, Ikko; Higuchi, Chikahisa

    2015-01-01

    Fibrous dysplasia (FD) of bone is a rare skeletal disease often associated with bone pain, deformities and fractures. The bisphosphonate therapies are reported to be useful for bone pain, but seem to be not suitable for fracture repairs of extremities. This is the first report of zoledronate-induced radiological improvement and long bone fracture union in polyostotic FD. A 30-year-old Japanese female had bilateral shepherds crook deformities typical to FD and right pathological femoral fracture and left humeral fracture nonunion. These fractures occurred without major traumas and the humeral fracture was not united for 1 year with conservative therapy. Laboratory blood test results were notable for elevated serum alkaline phosphatase and urine N-terminal cross-linking telopeptide of type I collagen. Her subtrochanteric femoral fracture was percutaneously fixed using Kirschner wires. After surgery, a hip spica cast was applied for 2 months and the orthosis for the next 2 months. Bony union of the femoral fracture was observed 5 months after surgery. Increased bone turnover and typical radiological features suggested that the constant elbow pain was due to both FD itself and humeral nonunion. Considering the possible side effects of zoledronate delaying acute fracture healing, we initiated zoledronate (Zometa; Novartis, Tokyo, Japan) therapy after femoral fracture union. Intravenous zoledronate acid was administered at a dose of 2 mg, along with supplementation of calcium (600 mg/day) and vitamin D (alfacalcidol 0.5 ?g/day) to limit the risk of osteomalacia and improve the efficacy of bisphosphonate therapy. The patients elbow pain rapidly resolved 1 week after treatment. Second therapy with same dose was performed after 6 months. No recurrence of elbow pain was reported and bony union was diagnosed after 1 year from the first administration. This patient is currently doing well without recurrence of bone pain. She can also walk for a short distance with crutches. We presented the case of an FD patient with persistent elbow pain due to FD itself and nonunion of humeral fracture, which was ameliorated promptly by intravenous zoledronate therapies. This case illustrated the benefit of zoledronate treatment in patients with extensive polyostotic FD and pathological fractures of extremities. PMID:26491505

  13. Forequarter Amputation and Immediate Reconstruction with a Free Extended Humeral-Radial Forearm Flap

    PubMed Central

    Espinoza, Absalon; Sanchez, Jair; Gonzalez, Carlos; Martinez, Eliseo; Tamez, Juan Carlos; Rangel, Jesus María

    2015-01-01

    A forequarter amputation is a radical ablative surgical procedure that includes the entire upper extremity with its shoulder girdle. We present a 53-year-old woman with a solid slow growing tumor in her right shoulder of 15 x 20 cm in diameter. Resection and immediate reconstruction with a free radial forearm flap extended from the distal third of the arm to the midpalmar region, taking the humeral artery and the cephalic vein as a main peddicle. The final outcome is shown at six weeks after the surgery. PMID:26893993

  14. Zoledronate Therapy for the Pathological Humeral Fracture in Polyostotic Fibrous Dysplasia: A Case Report.

    PubMed

    Ohno, Ikko; Higuchi, Chikahisa

    2015-11-01

    Fibrous dysplasia (FD) of bone is a rare skeletal disease often associated with bone pain, deformities and fractures. The bisphosphonate therapies are reported to be useful for bone pain, but seem to be not suitable for fracture repairs of extremities. This is the first report of zoledronate-induced radiological improvement and long bone fracture union in polyostotic FD. A 30-year-old Japanese female had bilateral shepherd's crook deformities typical to FD and right pathological femoral fracture and left humeral fracture nonunion. These fractures occurred without major traumas and the humeral fracture was not united for 1 year with conservative therapy. Laboratory blood test results were notable for elevated serum alkaline phosphatase and urine N-terminal cross-linking telopeptide of type I collagen. Her subtrochanteric femoral fracture was percutaneously fixed using Kirschner wires. After surgery, a hip spica cast was applied for 2 months and the orthosis for the next 2 months. Bony union of the femoral fracture was observed 5 months after surgery. Increased bone turnover and typical radiological features suggested that the constant elbow pain was due to both FD itself and humeral nonunion. Considering the possible side effects of zoledronate delaying acute fracture healing, we initiated zoledronate (Zometa(®); Novartis, Tokyo, Japan) therapy after femoral fracture union. Intravenous zoledronate acid was administered at a dose of 2 mg, along with supplementation of calcium (600 mg/day) and vitamin D (alfacalcidol 0.5 μg/day) to limit the risk of osteomalacia and improve the efficacy of bisphosphonate therapy. The patient's elbow pain rapidly resolved 1 week after treatment. Second therapy with same dose was performed after 6 months. No recurrence of elbow pain was reported and bony union was diagnosed after 1 year from the first administration. This patient is currently doing well without recurrence of bone pain. She can also walk for a short distance with crutches. We presented the case of an FD patient with persistent elbow pain due to FD itself and nonunion of humeral fracture, which was ameliorated promptly by intravenous zoledronate therapies. This case illustrated the benefit of zoledronate treatment in patients with extensive polyostotic FD and pathological fractures of extremities. PMID:26491505

  15. Reflected light microscopy of the human mandibular condyle--a study of a post-mortem material.

    PubMed

    Jagger, R G

    1991-01-01

    The surface characteristics of the articulating surfaces of 11 human mandibular condyles removed post-mortem were determined by the use of reflected light dark-field microscopy. Good agreement was obtained between macroscopical grading of degenerative change and appearance as observed by microscopy. Microscopical appearances believed to correspond to normal surface, fibrillation and degenerative changes are described. PMID:1711116

  16. Hemiarthroplasty for irreparable distal humeral fractures: medium-term follow-up of 42 patients.

    PubMed

    Nestorson, J; Ekholm, C; Etzner, M; Adolfsson, L

    2015-10-01

    We report our experience of performing an elbow hemiarthroplasty in the treatment of comminuted distal humeral fractures in the elderly patients. A cohort of 42 patients (three men and 39 women, mean age 72; 56 to 84) were reviewed at a mean of 34.3 months (24 to 61) after surgery. Functional outcome was measured with the Mayo Elbow Performance Score (MEPS) and range of movement. The disabilities of the arm, shoulder and hand questionnaire (DASH) was used as a patient rated evaluation. Complications and ulnar nerve function were recorded. Plain radiographs were obtained to assess prosthetic loosening, olecranon wear and heterotopic bone formation. The mean extension deficit was 23.5° (0° to 60°) and mean flexion was 126.8° (90° to 145°) giving a mean arc of 105.5° (60° to 145°). The mean MEPS was 90 (50 to 100) and a mean DASH score of 20 (0 to 63). Four patients had additional surgery for limited range of movement and one for partial instability. One elbow was revised due to loosening, two patients had sensory ulnar nerve symptoms, and radiographic signs of mild olecranon wear was noted in five patients. Elbow hemiarthroplasty for comminuted intra-articular distal humeral fractures produces reliable medium-term results with functional outcome and complication rates, comparable with open reduction and internal fixation and total elbow arthroplasty. PMID:26430013

  17. The outcome of proximal humeral fractures in the elderly: predictors of mortality and function.

    PubMed

    Clement, N D; Duckworth, A D; McQueen, M M; Court-Brown, C M

    2014-07-01

    This study describes the epidemiology and outcome of 637 proximal humeral fractures in 629 elderly (≥ 65 years old) patients. Most were either minimally displaced (n = 278, 44%) or two-part fractures (n = 250, 39%) that predominantly occurred in women (n = 525, 82%) after a simple fall (n = 604, 95%), who lived independently in their own home (n = 560, 88%), and one in ten sustained a concomitant fracture (n = 76, 11.9%). The rate of mortality at one year was 10%, with the only independent predictor of survival being whether the patient lived in their own home (p = 0.025). Many factors associated with the patient's social independence significantly influenced the age and gender adjusted Constant score one year after the fracture. More than a quarter of the patients had a poor functional outcome, with those patients not living in their own home (p = 0.04), participating in recreational activities (p = 0.01), able to perform their own shopping (p < 0.001), or able to dress themselves (p = 0.02) being at a significantly increased risk of a poor outcome, which was independent of the severity of the fracture (p = 0.001). A poor functional outcome after a proximal humeral fracture is not independently influenced by age in the elderly, and factors associated with social independence are more predictive of outcome. PMID:24986953

  18. Comparison of surgical and nonsurgical treatment of humeral fractures in horses: 22 cases (1980-1989).

    PubMed

    Zamos, D T; Parks, A H

    1992-07-01

    Medical records of 22 horses with humeral fractures were reviewed. The horses were from 2 to 144 months old (mean, 25.8 +/- 37.3 months). Ten horses were treated with stall confinement, 3 were treated surgically, and 9 were euthanatized at the time of diagnosis. Seven of 10 horses treated nonsurgically (stall confinement) were able to be ridden 5 to 12 months after the diagnosis was made (mean, 7.5 +/- 2.6 months). One horse treated nonsurgically was euthanatized 6 months after diagnosis because of laminitis in the contralateral limb. Two horses treated nonsurgically were lost to follow-up evaluation. Two of the 3 horses treated surgically had fractures repaired with Rush pins. The fractured humerus of the third horse was repaired with lag screws. Of the 3 surgically treated horses, 1 was pasture sound 10 months after surgery, but developed varus deviation in the contralateral carpus 6 weeks after repair; 1 horse was euthanatized 2 weeks after surgery because of failure of the implant; and the other horse was sound for riding 10 months after surgery. On the basis of these findings, young horses with humeral fractures that are treated nonsurgically can become sound for riding. PMID:1644630

  19. Effect of calcium triphosphate cement on proximal humeral fracture osteosynthesis: a finite element analysis.

    PubMed

    Kennedy, Jim; Feerick, Emer; McGarry, Patrick; FitzPatrick, David; Mullett, Hannan

    2013-08-01

    PURPOSE. To measure the effect of void-filling calcium triphosphate cement on the loads at the implant-bone interface of a proximal humeral fracture osteosynthesis using a finite element analysis. METHODS. Finite element models of a 3-part proximal humeral fracture fixed with a plate with and without calcium triphosphate cement augmentation were generated from a quantitative computed tomography dataset of an intact proximal humerus. Material properties were assigned to bone fragments using published expressions relating Young's modulus to local Hounsfield number. Boundary conditions were then applied to the model to replicate the physiological loads. The effect of void-filling calcium triphosphate cement was analysed. RESULTS. When the void was filled with calcium triphosphate cement, the pressure gradient of the bone surrounding the screws in the medial fracture fragment decreased 97% from up to 21.41 to 0.66 MPa. Peak pressure of the fracture planes decreased 95% from 6.10 to 0.30 MPa and occurred along the medial aspect. The mean stress in the screw locking mechanisms decreased 78% from 71.23 to 15.92 MPa. The angled proximal metaphyseal screw had the highest stress. CONCLUSION. Augmentation with calcium triphosphate cement improves initial stability and reduces stress on the implant-bone interface. PMID:24014777

  20. Intraosseous ganglion cyst of the humeral head in a competitive flat water paddler: case report

    PubMed Central

    Muir, Brad; Kissel, Jaclyn A.; Yedon, Dominique Forand

    2011-01-01

    Objective To present the diagnostic and clinical features of an intraosseous ganglion cyst of the humeral head of a female flat water canoe athlete. Clinical Features An 18-year old female flat water canoeist complaining of right shoulder pain following a strenuous paddling training camp. Intervention and outcome A trial of passive care was conducted, including soft tissue therapy, spinal manipulative therapy, acupuncture, and rehabilitation. The patient seemed to be responding with treatment, but pain would always resume with paddling. A diagnostic ultrasound displayed mild thickening and effusion in the subacromial/subdeltoid bursae. Continued passive care was not able to resolve the symptoms and she underwent an MRI which revealed an intraosseus ganglion cyst subjacent to the lesser tuberosity and floor of the intertubercular groove. A subsequent MRA was ordered to assess the labrum, which was intact, but the cyst had progressed in size. She was referred to an orthopedic surgeon who performed surgery. Conclusion An IOG cyst within the humeral head is a rare, potentially painful condition that can mimic other pathologies including impingement and labral tear. It is important to be aware of the clinical features to obtain a prompt diagnosis and appropriate treatment of this condition. PMID:22131566

  1. Dependency between treatment outcome in pseudarthrosis of the humeral shaft and the surgical technique applied.

    PubMed

    Piotrowski, Maciej; Baczkowski, Bogusław; Markowicz, Agnieszka; Pankowski, Rafał; Luczkiewicz, Piotr

    2005-08-30

    Background. Treatment of non-union has always been one of the most difficult problems in bone pathology. In the present study we compare outcomes using 9 different methods of non-union treatment. Material and methods. From 1976 to 2003, 70 patients with 85 cases of pseudoarthrosis in the humeral shaft were operated. During that period, 103 operations using 9 different methods were performed. The study group consisted of 17 females, 36 males and 17 children, ranging in age from 3 to 85 years. The operation techniques were compared based on the achievement of bone union and recovery of limb functional efficiency. Nonunion type was also taken into account. Results. A high percentage of bone union was obtained by using a perforated block of corticocancellous graft taken from the iliac crest. The most complete limb function recovery was achieved using this method, as well as Judet's decortication with cancellous grafting and firm osteosynthesis. Conclusions. In oligotrophic and non-viable humeral shaft non-union, the most effective method is pseudarthrosis excision, using a perforated block of corticocancellous graft from the iliac crest to fill the gap, and firm osteosynthesis. Judet's decortication with cancellous grafting and firm osteosynthesis secured good outcome in hypertrophic pseudarthrosis. PMID:17611455

  2. Aequalis Humeral Head Resurfacing in Glenohumeral Arthritis at a Minimum Followup of 2 Years

    PubMed Central

    Dwyer, Amitabh J.; Chambler, Andrew F. W.

    2013-01-01

    Aim. To evaluate results of Aequalis humeral head resurfacing in patients with end-stage glenohumeral arthritis at a minimum followup of two years. Patients and Methods. Twenty-one consecutive patients underwent humeral head resurfacing hemiarthroplasty between 2007 and 2009. Three patients did not fulfill the inclusion criteria. 18 patients with mean age of 75.1 years (range 5891 years) and a mean duration of preoperative symptoms of 33.6 months (range 6120 months) were analyzed. Patients' self-reported Oxford shoulder score (OSS) was collected prospectively and was used as an assessment tool to measure final outcome. Results. The mean initial OSS was 15 (range 329). The score improved by an average of 19.5 points at a mean followup of 36.3 months (range 2454 months) to reach a mean final OSS of 34.5 (range 647). The improvement of OSS was highly significant with a two-tailed P value less than 0.0001. The overall patient satisfaction was 94%. Conclusion. This study demonstrates Aequalis shoulder resurfacing hemiarthroplasty as a reliable procedure, away from its originating center, for improvement of shoulder function as shown by the patients' self-reported outcome score (OSS) in end-stage glenohumeral arthritis at a minimum followup of 2 years. PMID:24967109

  3. Biomechanics of four techniques for fixation of the four-part humeral head fracture

    PubMed Central

    da Graça, Elpídio; Okubo, Rodrigo; Shimano, Antônio Carlos; Mazzer, Nilton; Barbieri, Cláudio Henrique

    2013-01-01

    OBJECTIVE: To carry out a biomechanical study of four techniques for fixation of four-part humeral head fractures. METHODS: The fracture was reproduced in 40 plastic humeri, divided into groups of ten according to the fixation technique, each one employing different fixation resources, in different configurations. The humeral models were mounted on an aluminum scapula, with leather straps simulating the rotator cuff tendons, and submitted to bending and torsion tests in a universal testing machine, using relative stiffness as an evaluation parameter. Assemblies with intact humeri were analyzed for comparison. RESULTS: The biomechanical behavior of the fixation techniques varied within a wide range, where the assemblies including the DCP plate and the 4.5mm diameter screws were significantly more rigid than the assemblies with the Kirschner wires and the 3.5mm diameter screws. CONCLUSION: The four fixation techniques were able to bear loads compatible with the physiological demand, but those with higher relative stiffness should be preferred for clinical application. Laboratory investigation . PMID:24453641

  4. Giant Prolactinoma Presenting with Neck Pain and Structural Compromise of the Occipital Condyles

    PubMed Central

    Yecies, Derek; Ajlan, Abdulrazag; Ratliff, John; Ziskin, Jennifer; Hwang, Peter; Vogel, Hannes; Katznelson, Laurence; Harsh, Griffith

    2015-01-01

    Prolactinomas are the most common form of endocrinologically active pituitary adenoma; they account for ∼ 45% of pituitary adenomas encountered in clinical practice. Giant adenomas are those > 4 cm in diameter. Less than 0.5% of pituitary adenomas encountered in neurosurgical practice are giant prolactinomas. Patients with giant prolactinomas typically present with highly elevated prolactin levels, endocrinologic disturbances, and neurologic symptoms from mass-induced pressure. Described here is an unusual case of a giant prolactinoma presenting with neck pain and structural compromise of the occipital condyles. Transnasal biopsy of the nasopharyngeal portion of the mass obtained tissue consistent with an atypical prolactinoma with p53 reactivity and a high Ki-67 index of 5%. Despite the size and invasiveness of the tumor, the patient had resolution of his clinical symptoms, dramatic reduction of his hyperprolactinemia, and near-complete disappearance of his tumor following medical treatment. PMID:26623246

  5. Bilateral condyle fracture of tibial insert in mobile bearing total knee arthroplasty.

    PubMed

    Yoon, Jung-Ro; Jeong, Hyeon-Il; Oh, Kwang-Jun; Yang, Jae-Hyuk

    2014-01-01

    We report a case of polyethylene insert breakage in a 45-year-old man after 3.5 years of cruciate retaining type mobile bearing total knee arthroplasty (TKA). Interstingly, both condyles of the polyethylene insert have fractured. The visual assessment done by stereoscopic microscope in the investigation report suggested that the fracture propagation was a result of cyclic loading and that the fracture was from the articular surface as a result of tibio-femoral and anteroposterior shear loading. The initial flexion-extension gap mismatch and/or specific Asian habits like kneeling or deep knee bending could have been the possible factors for over-stress for the insert causing this complication. After replacement of the broken insert and modification for daily activity preventing deep knee flexion, the patient obtained complete relief of previous symptoms. It remains unclear whether insert breakage was secondary to polyethylene insufficient design or to the polyethylene material fracture propagation. PMID:23340095

  6. Giant Prolactinoma Presenting with Neck Pain and Structural Compromise of the Occipital Condyles.

    PubMed

    Yecies, Derek; Ajlan, Abdulrazag; Ratliff, John; Ziskin, Jennifer; Hwang, Peter; Vogel, Hannes; Katznelson, Laurence; Harsh, Griffith

    2015-11-01

    Prolactinomas are the most common form of endocrinologically active pituitary adenoma; they account for ∼ 45% of pituitary adenomas encountered in clinical practice. Giant adenomas are those > 4 cm in diameter. Less than 0.5% of pituitary adenomas encountered in neurosurgical practice are giant prolactinomas. Patients with giant prolactinomas typically present with highly elevated prolactin levels, endocrinologic disturbances, and neurologic symptoms from mass-induced pressure. Described here is an unusual case of a giant prolactinoma presenting with neck pain and structural compromise of the occipital condyles. Transnasal biopsy of the nasopharyngeal portion of the mass obtained tissue consistent with an atypical prolactinoma with p53 reactivity and a high Ki-67 index of 5%. Despite the size and invasiveness of the tumor, the patient had resolution of his clinical symptoms, dramatic reduction of his hyperprolactinemia, and near-complete disappearance of his tumor following medical treatment. PMID:26623246

  7. Finite element analysis of patient-specific condyle fracture plates: a preliminary study.

    PubMed

    Aquilina, Peter; Parr, William C H; Chamoli, Uphar; Wroe, Stephen

    2015-06-01

    Various patterns of internal fixation of mandibular condyle fractures have been proposed in the literature. This study investigates the stability of two patient-specific implants (PSIs) for the open reduction and internal fixation of a subcondylar fracture of the mandible. A subcondylar fracture of a mandible was simulated by a series of finite element models. These models contained approximately 1.2 million elements, were heterogeneous in bone material properties, and also modeled the muscles of mastication. Models were run assuming linear elasticity and isotropic material properties for bone. The stability and von Mises stresses of the simulated condylar fracture reduced with each of the PSIs were compared. The most stable of the plate configurations examined was PSI 1, which had comparable mechanical performance to a single 2.0 mm straight four-hole plate. PMID:26000081

  8. Ectopic Bone Formation after Medial Femoral Condyle Graft to Scaphoid Nonunion

    PubMed Central

    Vedung, Torbjörn; Vinnars, Bertil

    2014-01-01

    Free vascularized bone graft from the medial femoral condyle has been described as a superior method for treatment of recalcitrant scaphoid nonunion with proximal pole avascularity and humpback deformity. Few complications and high union rates have been reported. In a series of three patients we describe an undesired volar ossification as a potential complication of the method. The risk of developing the ectopic bone formation can be minimized if the surgeon is aware of the strong osteogenic capacity of the periosteum. Meticulous dissection of the vascular bundle to the graft is mandatory to avoid the complication. Caution is warranted so as not to leave a periosteal sleeve under the vessels at the margin of the graft. PMID:24533246

  9. Ectopic bone formation after medial femoral condyle graft to scaphoid nonunion.

    PubMed

    Vedung, Torbjörn; Vinnars, Bertil

    2014-02-01

    Free vascularized bone graft from the medial femoral condyle has been described as a superior method for treatment of recalcitrant scaphoid nonunion with proximal pole avascularity and humpback deformity. Few complications and high union rates have been reported. In a series of three patients we describe an undesired volar ossification as a potential complication of the method. The risk of developing the ectopic bone formation can be minimized if the surgeon is aware of the strong osteogenic capacity of the periosteum. Meticulous dissection of the vascular bundle to the graft is mandatory to avoid the complication. Caution is warranted so as not to leave a periosteal sleeve under the vessels at the margin of the graft. PMID:24533246

  10. Free Vascularized Medial Femoral Condyle Structural Flaps for Septic Terminal Digital Bone Loss.

    PubMed

    Henry, Mark

    2015-12-01

    A unique clinical problem exists when the majority of distal bone stock in a digit is destroyed by osteomyelitis, leaving a residual soft tissue envelope with tenuous, random perfusion surrounding a nidus of scar tissue. Pulp pinch is lost in the absence of bony support, and limited options exist. Apart from toe transfer or revision amputation with shortening, non-vascularized bone grafting inside the residual soft tissue envelope risks graft resorption and reactivation of infection. The purpose of this investigation was to evaluate the clinical outcomes of free vascularized medial femoral condyle structural bone flaps to restore lost pulp pinch in such cases. Nine patients (8 males, 1 female) with a mean age of 43 years sustained extensive terminal bone loss near digital tips following osteomyelitis. The mean length of bone defect was 28 mm (± 8.4). The patients were reconstructed at a mean of 12 weeks from initial trauma/infection, having undergone a mean of two prior surgeries. A structural block of vascularized bone from the medial femoral condyle replaced the missing bone at the digital tip defect, temporarily fixed with K-wires. The bone flap was encased by the residual soft tissue envelope after removing scar tissue from the prior trauma and infection. All bone flaps incorporated fully, restoring pulp pinch function to the respective digits with a mean time to union of 8.6 (± 2.1) weeks; range 6-11 weeks. With few alternative solutions able to address this unique and difficult problem, the structural block of vascularized bone proved able to resist resorption, nonunion, and reactivation of infection; the problems normally encountered under this scenario. PMID:26578834

  11. Effect of Field of View on Detection of Condyle Bone Defects Using Cone Beam Computed Tomography.

    PubMed

    Salemi, Fatemeh; Shokri, Abbas; Maleki, Fatemeh Hafez; Farhadian, Maryam; Dashti, Gholamreza; Ostovarrad, Farzane; Ranjzad, Hadi

    2016-05-01

    In maxillofacial imaging, cone beam computed tomography (CBCT) is currently the modality of choice for assessment of bony structures of the temporomandibular joint (TMJ). Factors affecting the quality of CBCT images can change its diagnostic accuracy. This study aimed to assess the effect of field of view (FOV) and defect size on the accuracy of CBCT scans for detection of bone defects of the TMJs. This study was conducted on 12 sound TMJs of 6 human dry skulls. Erosions and osteophytes were artificially induced in 0.5, 1, and 1.5-mm sizes on the anterior-superior part of the condyle; CBCT scans were obtained with 6, 9, and 12-inch FOVs by NewTom 3G CBCT system. Two maxillofacial radiologists evaluated the presence/absence and type of defects on CBCT scans. The Cohen kappa was calculated to assess intra- and interobserver reliability. The Mann-Whitney U test was applied to compare the diagnostic accuracy of different FOVs.In comparison of 6- and 12-inch, 9- and 12-inch FOVs in detection of different sizes of erosive lesions, difference was significant (P <0.05), whereas difference between 6- and 9 inch just in 0.5-mm erosive lesion was significant (P = 0.04). In comparison of 6- and 12-inch FOVs in detection of different sizes of osteophyte lesion, difference was significant (P < 0.05), whereas between 6- and 9-inch FOVs statistically significant difference was not observed (P > 0.05). The highest and the lowest diagnostic accuracy of CBCT scans for condyle defects were obtained with 6-inch and 12-inch FOVs, respectively. Diagnostic accuracy of CBCT scans increased with an increase in size of bone defects. PMID:27092920

  12. CONTRIBUTION TO THE ANATOMICAL STUDY OF THE CORTICOPERIOSTEAL FLAP OF THE MEDIAL FEMORAL CONDYLE

    PubMed Central

    Andrade, Rômulo Guimarães; Bufáiçal, Henrique Gubert; Oliveira, Leandro Alves de; Souza, Fabiano Inácio de; Kuwae, Mário Yoshihide; Teixeira da Silva, João Alírio

    2015-01-01

    Objective: to perform the anatomical study, in cadavers, of the corticoperiosteal flap of the medial femoral condyle, based on the medial genicular artery, evaluating challenges in dissection and the topographic patterns. Materials and methods: fifteen limbs from eight cadavers were studied, ages ranging from 19 to 74 years old. They were placed at supine position, and a longitudinal incision on the medial face of the lower part of the thigh was performed, exposing medial vastus and sartorius muscles, with descendent genicular vessels being also exposed. The distance between the descendent genicular artery and the medial articular line of the knee, the diameter of the vessel, the length of the pedicle, and the presence of the fasciocutaneous branch and its location were analyzed. Results: the distance between the origin of the descendent genicular artery and the medial articular line of the knee ranged from 11.2cm to 14.5cm, with an average of 12.63cm. The mean artery diameter was 2.5mm (from 2.25mm to 2.75mm). The distance between the descendent genicular artery and the fasciocutaneous branch ranged from 1.0 to 1.5cm. The mean length of the vascular pedicle was 7.01cm, ranging from 5.6cm to 8.6cm. Conclusion: the corticoperiosteal flap of the medial femoral condyle of the knee is easy to dissect, presents a constant vascular pedicle, with average length of 7.0cm and diameter of 2.5mm, enabling it to be indicated for microsurgical transplants. PMID:27004187

  13. A Case of Spontaneous Osteonecrosis of the Knee with Early and Simultaneous Involvement of the Medial Femoral Condyle and Medial Tibial Plateau

    PubMed Central

    Fujita, Shinya; Arai, Yuji; Honjo, Kuniaki; Nakagawa, Shuji; Kubo, Toshikazu

    2016-01-01

    Spontaneous osteonecrosis of the knee (SPONK) usually involves a single condyle, most often the medial femoral condyle (MFC). Involvement of the medial tibial plateau (MTP) is less common, occurring in about 2% of knees with SPONK. Early onset SPONK on the ipsilateral side of the medial compartment is very rare, with, to our knowledge, only four cases reported to date. We describe a very rare case of SPONK with early simultaneous development in the MFC and MTP. Serial plain radiographs and magnetic resonance imaging showed that SPONK in both condyles followed a similar progressive course. The pathological findings in these lesions were similar to those observed in subchondral insufficiency fractures.

  14. Intramedullary Nail versus Dynamic Compression Plate Fixation in Treating Humeral Shaft Fractures: Grading the Evidence through a Meta-Analysis

    PubMed Central

    Ma, XinLong; Gao, Feng; Wei, Qiang; Jia, HaoBo; Feng, Rui; Yu, JingTao; Wang, Jie

    2013-01-01

    There is a debate regarding the choice of operative intervention in humeral shaft fractures that require surgical intervention. The choices for operative interventions include intramedullary nailing (IMN) and dynamic compression plate (DCP). This meta-analysis was performed to compare fracture union, functional outcomes, and complication rates in patients treated with IMN or DCP for humeral shaft fractures and to develop GRADE (Grading of Recommendations, Assessment, Development, and Evaluation)-based recommendations for using the procedures to treat humeral shaft fractures. A systematic search of all the studies published through December 2012 was conducted using the Medline, Embase, Sciencedirect, OVID and Cochrane Central databases. The randomized controlled trials (RCTs) and quasi-RCTs that compared IMN with DCP in treating adult patients with humeral shaft fractures and provided data regarding the safety and clinical effects were identified. The demographic characteristics, adverse events and clinical outcomes were manually extracted from all of the selected studies. Ten studies that included a total of 448 patients met the inclusion criteria. The results of a meta-analysis indicated that both IMN and DCP can achieve similar fracture union with a similar incidence of radial nerve injury and infection. IMN was associated with an increased risk of shoulder impingement, more restriction of shoulder movement, an increased risk of intraoperative fracture comminution, a higher incidence of implant failure, and an increased risk of re-operation. The overall GRADE system evidence quality was very low, which reduces our confidence in the recommendations of this system. DCP may be superior to IMN in the treatment of humeral shaft fractures. Because of the low quality evidence currently available, high-quality RCTs are required. PMID:24358141

  15. Medialized Versus Lateralized Center of Rotation in Reverse Shoulder Arthroplasty.

    PubMed

    Streit, Jonathan J; Shishani, Yousef; Gobezie, Reuben

    2015-12-01

    Reverse shoulder arthroplasty may be performed using components that medialize or lateralize the center of rotation. The purpose of this prospective study was to directly compare 2 reverse shoulder arthroplasty designs. Two treatment groups and 1 control group were identified. Group I comprised 9 patients using a medialized Grammont-style (GRM) prosthesis with a neck-shaft angle of 155. Group II comprised 9 patients using a lateralized (LAT) prosthesis with a neck-shaft angle of 135. Pre- and postoperative assessment of range of motion, American Shoulder and Elbow Surgeons score, and visual analog scale pain score were performed. Radiographic measurements of lateral humeral offset and acromiohumeral distance were compared. The GRM prosthesis achieved greater forward flexion (143.9 vs 115.6; P=.05), whereas the LAT achieved greater external rotation (35.0 vs 28.3; P=.07). The lateral humeral offset was greater for the LAT prosthesis compared with the GRM prosthesis, but this distance was not significantly different from that found in the control group. The acromiohumeral distance was significantly greater in the GRM prosthesis group compared with both the LAT and the control groups. The results of this study confirm that different reverse shoulder arthroplasty designs produce radiographically different anatomy. Whereas the GRM prosthesis significantly alters the anatomy of the shoulder, the LAT design can preserve some anatomic relationships found in the normal shoulder. The clinical outcomes indicate that this may have an effect on range of motion, with traditional designs achieving greater forward flexion and lateralized designs achieving greater external rotation. [Orthopedics. 2015; 38(12):e1098-e1103.]. PMID:26652330

  16. Presentation of a Humeral Shaft Fracture Treated by Locked Intramedullary Nailing With Unlocked Technique

    PubMed Central

    Inal, Sermet; Inal, Canan; Taspinar, Betul

    2015-01-01

    Introduction: Although intramedullary nailing (IMN) is used in a reamed or unreamed fashion for treatment of long bone fractures, the locked nails may also be used in the unlocked form if so decided by the orthopedic surgeon. Case Presentation: We describe a 50-year-old man who had a shaft fracture of his right humerus. The fracture was treated with a reamed, locked IMN using unlocked technique. Conclusions: The functional outcome 22 months post injury showed that although primary treatment method uses locked IMN in humeral shaft fractures, unlocked IMN can be used in appropriate cases. Less injury risk to the axillary and radial nerve, short period of surgery, and less radiation can be considered as advantages of this technique. PMID:26543840

  17. Humeral cortical thickness in female Bantu - its relationship to the incidence of femoral neck fracture

    SciTech Connect

    Bloom, R.A.; Pogrund, H.

    1982-03-01

    Measurements of the humeral cortical thickness demonstrate that generalised osteoporosis in female Bantu commences in the fifth decade and gradually increases until, in the ninth decade, all subjects are osteoporotic. The combined cortical thickness (CCT) of the humerus in young adults is very similar to that found previously in a white London population and the loss of cortex with age is very similar. It is concluded that the known low incidence of femoral neck fracture in Bantu is not due to a lower incidence of generalised osteoporosis but to environmental factors. The chief environmental factor postulated is the greater amount of physical work performed by the Bantu. A more careful mode of walking is suggested as a subsidiary cause.

  18. Anterior humeral circumflex artery avulsion with brachial plexus injury following an isolated traumatic anterior shoulder dislocation.

    PubMed

    Shah, Rohi; Koris, Jacob; Wazir, Akhlaq; Srinivasan, Shyamsundar S

    2016-01-01

    A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay. PMID:26969353

  19. Use of a Proximal Humeral Locking Plate for Complex Ankle and Hindfoot Fusion.

    PubMed

    Shearman, Alexander D; Eleftheriou, Kyriacos Iordanis; Patel, Akash; Pradhan, Rajib; Rosenfeld, Peter Francis

    2016-01-01

    Arthrodesis of the ankle and hindfoot in the setting of major deformity is challenging and associated with substantial risks. Patients often have significant comorbidities that lead to unforgiving soft tissues, poor vascularity, and poor bone quality. This creates the high-risk scenario of poor wound healing and poor implant fixation. Complications can be devastating, leading to loss of the limb and sepsis. The use of locking plate technology might provide biomechanical and operative technique advantages in such patients. We retrospectively assessed the results of the modified use of the PHILOS(™) (Synthes(®), Zuchwil, Switzerland) proximal humeral locking plate in 21 patients (11 males, 10 females; mean age 56.1 years, range 25 to 74 years) who had undergone complex fusions, including tibiotalar (n = 4), tibiocalcaneal (n = 7), or tibiotalocalcaneal (n =10) fusions. The average follow-up period was 14.6 (median 10, range 6 to 49) months. Of the 21 fusions, 18 achieved union (85.7%) at an average period of 4.8 (median 4.3, range 3 to 12) months. The overall deep infection rate was 14.3%. Overall, 17 of the 21 patients (81%) were satisfied with the result (good to excellent), 1 reported the result was fair (4.8%), and 3 patients developed nonunion and were dissatisfied with the procedure (14.3%). The present study is the largest series to date of patients undergoing complex ankle and hindfoot arthrodesis with the use of a proximal humeral locking plate and confirms previous findings that the technique is reliable with union, satisfaction, and complication rates comparable to those of other techniques. PMID:26875767

  20. Surface Replacement Arthroplasty of the Humeral Head in Young, Active Patients

    PubMed Central

    Iagulli, Nicholas D.; Field, Larry D.; Hobgood, E. Rhett; Hurt, James A.; Charles, Ryan; O’Brien, Michael J.; Savoie, Felix H.

    2014-01-01

    Background: The treatment of glenohumeral arthritis in young, active patients remains controversial. Standard total shoulder arthroplasty in this patient group has not obtained the same satisfaction rate as in older patients. One surgical option that has emerged is humeral resurfacing. Hypothesis: Humeral head surface replacement arthroplasty (SRA) would provide satisfactory clinical outcomes in active patients, allowing them to maintain their normal lifestyle without activity restrictions. Study Design: Case series; Level of evidence, 4. Methods: From 2004 to 2007, all consecutive surface replacement arthroplasties of the humerus performed at the authors’ institution were identified and retrospectively reviewed, and 118 patients who underwent SRA during this time were identified. This study included patients younger than 60 years who wished to maintain an active lifestyle; 52 of the 118 patients met the inclusion criteria. University of California at Los Angeles (UCLA) shoulder scores and subjective shoulder value (SSV) scores were used to measure clinical outcomes at an average follow-up of 6 years (range, 4-8 years). Of the 52 patients meeting the inclusion criteria, 48 were contacted and examined for the study, with 4 patients lost to follow-up. Results: The mean postoperative UCLA score was 28.03, with 1 patient requiring revision because of pain and glenoid wear. The mean SSV was 92% (range, 0%-100%), with 3 patients restricting their activity because of the shoulder. Forty-seven of the 48 contacted patients stated that, given the option, they would have the same surgery again. One patient required revision surgery because of pain. Conclusion: Surface replacement arthroplasty provided reasonable results in patients younger than 60 years with high activity demands with a low rate of revision at midterm follow-up. PMID:26535268

  1. Periosteal versus true cross-sectional geometry: a comparison along humeral, femoral, and tibial diaphyses.

    PubMed

    Macintosh, Alison A; Davies, Thomas G; Ryan, Timothy M; Shaw, Colin N; Stock, Jay T

    2013-03-01

    Cross-sectional geometric (CSG) properties of human long bone diaphyses are typically calculated from both periosteal and endosteal contours. Though quantification of both is desirable, periosteal contours alone have provided accurate predictions of CSG properties at the midshaft in previous studies. The relationship between CSG properties calculated from external contours and "true" (endosteal and periosteal) CSG properties, however, has yet to be examined along the whole diaphysis. Cross-sectional computed tomography scans were taken from 21 locations along humeral, femoral, and tibial diaphyses in 20 adults from a late prehistoric central Illinois Valley cemetery. Mechanical properties calculated from images with (a) artificially filled medullary cavities ("solid") and (b) true unaltered cross-sections were compared at each section location using least squares regression. Results indicate that, in this sample, polar second moments of area (J), polar section moduli (Z(p) ), and cross-sectional shape (I(max) /I(min) ) calculated from periosteal contours correspond strongly with those calculated from cross-sections that include the medullary cavity. Correlations are high throughout most of the humeral diaphysis and throughout large portions of femoral and tibial diaphyses (R(2) = 0.855-0.998, all P < 0.001, %SEE ? 8.0, %PE ? 5.0), the major exception being the proximal quarter of the tibial diaphysis for J and Z(p). The main source of error was identified as variation in %CA. Results reveal that CSG properties quantified from periosteal contours provide comparable results to (and are likely to detect the same differences among individuals as) true CSG properties along large portions of long bone diaphyses. PMID:23359138

  2. A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

    PubMed Central

    Konarik, Marek; Kachlik, David; Baca, Vaclav

    2014-01-01

    A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the “radial artery with high origin”). Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus. PMID:25428677

  3. Mesenchymal Stem Cells and Platelet Gel Improve Bone Deposition within CAD-CAM Custom-Made Ceramic HA Scaffolds for Condyle Substitution

    PubMed Central

    Ciocca, L.; Donati, D.; Ragazzini, S.; Dozza, B.; Rossi, F.; Fantini, M.; Spadari, A.; Romagnoli, N.; Landi, E.; Tampieri, A.; Piattelli, A.; Iezzi, G.; Scotti, R.

    2013-01-01

    Purpose. This study evaluated the efficacy of a regenerative approach using mesenchymal stem cells (MSCs) and CAD-CAM customized pure and porous hydroxyapatite (HA) scaffolds to replace the temporomandibular joint (TMJ) condyle. Methods. Pure HA scaffolds with a 70% total porosity volume were prototyped using CAD-CAM technology to replace the two temporomandibular condyles (left and right) of the same animal. MSCs were derived from the aspirated iliac crest bone marrow, and platelets were obtained from the venous blood of the sheep. Custom-made surgical guides were created by direct metal laser sintering and were used to export the virtual planning of the bone cut lines into the surgical environment. Sheep were sacrificed 4 months postoperatively. The HA scaffolds were explanted, histological specimens were prepared, and histomorphometric analysis was performed. Results. Analysis of the porosity reduction for apposition of newly formed bone showed a statistically significant difference in bone formation between condyles loaded with MSC and condyles without (P < 0.05). The bone ingrowth (BI) relative values of split-mouth comparison (right versus left side) showed a significant difference between condyles with and without MSCs (P < 0.05). Analysis of the test and control sides in the same animal using a split-mouth study design was performed; the condyle with MSCs showed greater bone formation. Conclusion. The split-mouth design confirmed an increment of bone regeneration into the HA scaffold of up to 797% upon application of MSCs. PMID:24073409

  4. OSTEOCHONDRAL INTERFACE REGENERATION OF THE RABBIT MANDIBULAR CONDYLE WITH BIOACTIVE SIGNAL GRADIENTS

    PubMed Central

    Dormer, Nathan H.; Busaidy, Kamal; Berkland, Cory J.; Detamore, Michael S.

    2011-01-01

    PURPOSE Tissue engineering solutions focused on the temporomandibular joint (TMJ) have expanded in number and variety over the past decade to address the treatment of TMJ disorders. The existing literature on approaches for healing small defects in the TMJ condylar cartilage and subchondral bone, however, is sparse. The purpose of this study was thus to evaluate the performance of a novel gradient-based scaffolding approach to regenerate osteochondral defects in the rabbit mandibular condyle. MATERIALS AND METHODS Miniature bioactive plugs for regeneration of small mandibular condylar defects in New Zealand White rabbits were fabricated. The plugs were constructed from poly(D,L-lactic-co-glycolic acid) (PLGA) microspheres with a gradient transition between cartilage-promoting and bone-promoting growth factors. RESULTS At six weeks of healing, results suggested that the implants provided support for the neo-synthesized tissue as evidenced by histology and 9.4T magnetic resonance imaging. CONCLUSION The inclusion of bioactive factors in a gradient-based scaffolding design is a promising new treatment strategy for focal defect repair in the TMJ. PMID:21470747

  5. Arthroscopic repair of "peel-off" lesion of the posterior cruciate ligament at the femoral condyle.

    PubMed

    Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

    2014-02-01

    Posterior cruciate ligament (PCL) injuries are uncommon, and most occur in association with other lesions. The treatment of PCL injuries remains controversial; in addition, PCL injuries have been documented to have a propensity to heal. In the literature several different patterns of PCL injury have been described including midsubstance tears/injuries, tibial bony avulsions, femoral bony avulsions, and femoral "peel-off" injuries. A peel-off injury is a complete or incomplete soft-tissue disruption of the PCL at its femoral attachment site without associated bony avulsion. In recent years arthroscopic repair of femoral avulsion and peel-off lesions of the PCL has been reported. In most of these articles, a transosseous repair with sutures passed through 2 bone tunnels into the medial femoral condyle has been described. We present a case of a femoral PCL avulsion in a 20-year-old collegiate football player with an associated medial collateral ligament injury, and we report about a novel technique for PCL repair using 2 No. 2 FiberWire sutures and two 2.9-mm PushLock anchors (Arthrex) to secure tensioning the ligament at its footprint. PMID:24749037

  6. Dental panoramic image analysis for enhancement biomarker of mandibular condyle for osteoporosis early detection

    NASA Astrophysics Data System (ADS)

    Suprijanto; Azhari; Juliastuti, E.; Septyvergy, A.; Setyagar, N. P. P.

    2016-03-01

    Osteoporosis is a degenerative disease characterized by low Bone Mineral Density (BMD). Currently, a BMD level is determined by Dual Energy X-ray Absorptiometry (DXA) at the lumbar vertebrae and femur. Previous studies reported that dental panoramic radiography image has potential information for early osteoporosis detection. This work reported alternative scheme, that consists of the determination of the Region of Interest (ROI) the condyle mandibular in the image as biomarker and feature extraction from ROI and classification of bone conditions. The minimum value of intensity in the cavity area is used to compensate an offset on the ROI. For feature extraction, the fraction of intensity values in the ROI that represent high bone density and the ROI total area is perfomed. The classification will be evaluated from the ability of each feature and its combinations for the BMD detection in 2 classes (normal and abnormal), with the artificial neural network method. The evaluation system used 105 panoramic image data from menopause women which consist of 36 training data and 69 test data that were divided into 2 classes. The 2 classes of classification obtained 88.0% accuracy rate and 88.0% sensitivity rate.

  7. Bilateral humeral lengthening in achondroplasia with unilateral external fixators: is it safe and does it improve daily life?

    PubMed

    Balci, H I; Kocaoglu, M; Sen, C; Eralp, L; Batibay, S G; Bilsel, K

    2015-11-01

    A retrospective study was performed in 18 patients with achondroplasia, who underwent bilateral humeral lengthening between 2001 and 2013, using monorail external fixators. The mean age was ten years (six to 15) and the mean follow-up was 40 months (12 to 104). The mean disabilities of the arm, shoulder and hand (DASH) score fell from 32.3 (20 to 40) pre-operatively to 9.4 (6 to 14) post-operatively (p = 0.037). A mean lengthening of 60% (40% to 95%) was required to reach the goal of independent perineal hygiene. One patient developed early consolidation, and fractures occurred in the regenerate bone of four humeri in three patients. There were three transient radial nerve palsies. Humeral lengthening increases the independence of people with achondroplasia and is not just a cosmetic procedure. PMID:26530664

  8. [Results of the provision of unstable proximal humeral fractures in geriatric patients with a new angle stabilizing antegrade nail system].

    PubMed

    Mathews, J; Lobenhoffer, P

    2004-05-01

    Treating unstable proximal humeral fractures in elderly patients with osteoporosis and limited compliance is still demanding for trauma surgeons. The failure rate of operative treatment is high. We studied the use of a new antegrade intramedullary humeral nail with special locking bolts for head fixation. The first 41 procedures in 39 patients with a mean age of 81 years (61-102) were analyzed. Half of the patients were mentally deranged. There were 16 two-part, 22 three-part, and 3 four-part fractures of the humeral head treated. After closed or partial open reduction, antegrade nailing was performed via a delta split and limited incision of the rotator cuff. Greater and lesser tuberosities were fixed with screws through threaded holes of the proximal nail leading to high stability. Early functional active treatment was performed avoiding maximal rotation. Follow-up was 13 months (7-21 months). Clinical examination was performed in 32 cases. Four patients were questioned by phone. Three patients died (mean age: 92 years) before follow-up. The mean Constant score was 57+/-12. The mean age-related and side-related Constant scores were 86+/-17% and 90+/-7%. All fractures healed. Activities of daily life were possible in every case. There was only one loss of reduction after a fall out of bed. After hemiarthroplasty the patient was excluded from the study. One shaft fissure occurred during distal interlocking and healed uneventfully. Because of stable fixation, rehabilitation without immobilization was possible and led to good functional results. In comparison to common implants, the new antegrade intramedullary nail allowed a stable osteosynthesis in unstable proximal humeral fractures in old and very old patients with limited compliance without the usual implant-related complications. PMID:15221072

  9. TREATMENT OF POST-TRAUMATIC HUMERAL FRACTURES AND COMPLICATIONS USING THE OSTEOLINE® EXTERNAL FIXATOR: A TREATMENT OPTION

    PubMed Central

    de Azevedo, Marcos Coelho; de Azevedo, Gualter Maldonado; Hayashi, Alexandre Yoshio; Dourado Nascimento, Paulo Emilio

    2015-01-01

    To evaluate the results obtained from treatment of humeral shaft fractures and their complications using the Osteoline® uniplanar external fixator. Methods: The radiographic and functional results from 78 patients with humeral shaft fractures treated using the uniplanar external fixation technique were retrospectively assessed. The patients' ages ranged from 23 to 71 years, with a mean of 47 years. Male patients predominated (79%). Out of the 78 patients, 45 presented open fractures, 14 presented pseudarthrosis and six presented synthesis failure. There were no losses during the follow-up and all the patients were discharged after fracture consolidation and functional recovery. The results were evaluated based on the studies by Catagni, as good, fair or poor. Results: Fracture consolidation was observed in 98% of the cases treated with uniplanar external fixation. Only one pseudarthrosis case required conversion to rigid internal fixation and autologous bone grafting. At the end of the treatment, all the patients were discharged with consolidated fractures, without pain, and good limb function. Conclusion: The external fixation described in this paper was shown to be an efficient and safe method for treating humeral shaft fractures and their complications. It preserved the local biological status and enabled passive and active movement immediately after surgery. PMID:27027026

  10. Migration of the humeral component of the Souter-Strathclyde elbow prosthesis: a long-term RSA study.

    PubMed

    van der Lugt, J C T; Valstar, E R; Witvoet-Braam, S W; Nelissen, R G H H

    2010-02-01

    Mechanical loosening which begins with early-onset migration of the prosthesis is the major reason for failure of the Souter-Strathclyde elbow replacement. In a prospective study of 18 Souter-Strathclyde replacements we evaluated the patterns of migration using roentgen stereophotogrammetric analysis. We had previously reported the short-term results after a follow-up of two years which we have now extended to a mean follow-up of 8.2 years (1 to 11.3). Migration was assessed along the co-ordinal axes and overall micromovement was expressed as the maximum total point movement. The alignment of the prosthesis and the presence of radiolucent lines were examined on conventional standardised radiographs. All the humeral components showed increased and variable patterns of migration at the extended follow-up and four humeral components were revised. The maximum total point movement at two years in the revised prostheses was 1.8 mm (sd 1.0) and in the non-revised 0.7 mm (sd 0.5, p = 0.01). Most humeral components migrated into external rotation resulting in an anterior and varus tilt. The ulnar components remained stable. PMID:20130315

  11. Developed Design for Humeral Head Replacement Using 3D Surface Mapping

    NASA Astrophysics Data System (ADS)

    Salah, H. R.

    2014-12-01

    Assessment of dimensional and geometrical data on the humeral head replacement (HHR) objects is essential for solving the relevant designing problems in the physics of reverse engineering (RE). In this work, 2D-assessment for human humerus was performed using the computed tomography (CT) technique within the RE plan, after which the 2D images of humeral objects were converted into 3D images. The conversion was successful and indicated a clear difference in the 2D and 3D estimates of sizes and geometry of the humerus. The authors have analyzed and confirmed experimentally the statistical information on the relevant anatomical objects. The results of finite-element simulation of the compressive stresses affecting the geometry of 3D surface mapping were analyzed using SolidWorks software. For developing the biomechanical design of an HHR object suitable biomaterials were selected, and different metal-based biomaterials are discussed as applied at various loads. New methodology is presented for the size estimation of humeral head - both anatomical and artificial - in 3D-shape. A detailed interpretation is given for the results of CT D-measurements. Izmēru un ģeometrisko datu novērtējums, kas attiecas uz pleca kaula galviņas nomaiņas (PKGN) objektiem, nepieciešams, lai risinātu virkni reversīvās inženierijas (RI) problēmu. Šajā darbā cilvēka pleca kaula galviņas divdimensiju novērtējums tika veikts ar datortomogrāfijas palīdzību (RI) ietvaros, un pēc tam objekta divdimensiju attēlojums tika pārveidots trīsdimensiju. Pārveidojums bija sekmīgs, parādot pleca kaula galviņas izmēru un ģeometrijas atšķirības starp 2D un 3D novērtējumiem. Autori izanalizēja un eksperimentāli apstiprināja statistisko informāciju pēc dotā veida anatomiskiem objektiem. Saspiešanas sasprindzinājumi, kuri ietekmē trīsdimensiju virsmas attēlojuma ģeometriju, tika analizēti ar gala-elementu simulācijas metodi, lietojot programmu SolidWorks. Biomehaniskajam PKGN dizainam tika atlasīti piemēroti materiāli. Apspriesta dažādu biomateriālu ar metālisko pamatu reakcija uz mainīgām slodzēm. Tiek piedāvāta pleca kaula galviņas - kā anatomiskas, tā mākslīgas - trīs dimensijas mērīšanas metodoloģijas. Dota datortomogrāfisko precīzo mērījumu rezultātu detalizēta interpretācija.

  12. Treatment of the humeral shaft fractures - minimally invasive osteosynthesis with bridge plate versus conservative treatment with functional brace: study protocol for a randomised controlled trial

    PubMed Central

    2013-01-01

    Background Humeral shaft fractures account for 1 to 3% of all fractures in adults and for 20% of all humeral fractures. Non-operative treatment is still the standard treatment of isolated humeral shaft fractures, although this method can present unsatisfactory results. Surgical treatment is reserved for specific conditions. Modern concepts of internal fixation of long bone shaft fractures advocate relative stabilisation techniques with no harm to fracture zone. Recently described, minimally invasive bridge plate osteosynthesis has been shown to be a secure technique with good results for treating humeral shaft fractures. There is no good quality evidence advocating which method is more effective. This randomised controlled trial will be performed to investigate the effectiveness of surgical treatment of humeral shaft fractures with bridge plating in comparison with conservative treatment with functional brace. Methods/Design This randomised clinical trial aims to include 110 patients with humeral shaft fractures who will be allocated after randomisation to one of the two groups: bridge plate or functional brace. Surgical treatment will be performed according to technique described by Livani and Belangero using a narrow DCP plate. Non-operative management will consist of a functional brace for 6 weeks or until fracture consolidation. All patients will be included in the same rehabilitation program and will be followed up for 1 year after intervention. The primary outcome will be the DASH score after 6 months of intervention. As secondary outcomes, we will assess SF-36 questionnaire, treatment complications, Constant score, pain (Visual Analogue Scale) and radiographs. Discussion According to current evidence shown in a recent systematic review, this study is one of the first randomised controlled trials designed to compare two methods to treat humeral shaft fractures (functional brace and bridge plate surgery). Trial registration Current Controlled Trials: ISRCTN24835397 PMID:23924198

  13. Ramus hinges for excessive movements of the condyles: a new dimension in mandibular tripodal subperiosteal implants.

    PubMed

    Linkow, L I; Ghalili, R

    1999-01-01

    Some subperiosteal mandibular implants of the earlier designs failed because of bone resorption beneath the posterior portions of the implant. Conversely, bone loss was observed rarely in the anterior region. The resorption was more profound posteriorly because there can be as much as 250 lb. of biting force per square inch and the bone is more porous than in the symphyseal region, which receives about 25 lb. per square inch. The independent movements of the condyles and the inferior border of the mandible at the gonial angles have dictated the success or failure of conventional mandibular subperiosteal implants in many of the earlier designs. Often, the rigidity of the implant framework prevents its posterior portion from moving in unison with the flexion and flexibility of the condyles upon the opening and closing of the mouth. Flexure usually is 2-4 mm in range and varies according to the quality of bone, age, sex, and musculature of the patient. Approximately 2% of these patients demonstrate movements of up to 4 mm. This has influenced an altered approach to posterior design-especially with tripodal mandibular subperiosteal implants. A brief history of the contributions of the earlier pioneers and their important contributions to the subperiosteal implant follows: G. Dahl inserted the first mandibular subperiosteal implant and was awarded his patent in 1941. Gershkoff and Goldberg, were the first to report clinical cases with mandibular subperiosteal implants in the United States. N. Berman reported on a direct bone impression of the mandible and transosseous wiring of the implant to the bone for stabilization. I. Lew introduced his own surgical bone impression technique for the mandibular subperiosteal implant and had published case histories on maxillary and mandibular implants. B. D. Weinberg reported an early unilateral subperiosteal implant consisting of a latticework portion that seated over the bone connected to the protruding post by four uprights. Leonard I. Linkow reported on the posterior unilateral mandibular subperiosteal implant. He followed up with a 5-year report, an 8-year follow-up report, and a 12-year report. R. L. Bodine reported his experiences with mandibular subperiosteal implants. A. N. Cranin and P. Schnitman introduced the Brookdale bar for an improved support of an overdenture for the mandibular subperiosteal implants. L. I. Linkow made some significant changes in the mandibular subperiosteal implant. D. D'Alise reported on the O-ring design for retention of implant dentures. R. A. James reported on the support system and perigingival mechanism surrounding oral implants and changed the subperiosteal based on peri-implant tissue behavior. L. I. Linkow reported on an entirely new mandibular tripodal design concept as well as a distinct change in the surgical protocol for obtaining the bone impressions without exposing those parts of the body of the mandible from the mental nerves to the ascending rami. PMID:10483422

  14. Modification of condyle anatomy following a monolateral bite rise: a histological study in rat.

    PubMed

    D'Attilio, M; Scarano, A; Quaranta, A; Festa, F; Caputi, S; Piattelli, A

    2007-01-01

    The aim of this study is to evaluate the histologic modifications of rat articular capsules, after compression and strain. Fifty adults Sprague Dawley rats were used in this study. The rats were divided into 3 groups: a dysfunction group, treatment group and a Control group. In the rats in the first two groups an occlusion hump, made of composite and less than 0.5 mm high, was applied to the upper right molar. The rats were anesthetized with an intraperitoneal injection of benzodiazepine (0.5-1 mg for 100 g. of body weight). The composite used consisted of a hollow, plastic cylinder 0.5 mm high, spread over the whole occlusal surface of the right upper molar. The dysfunction group therapy wore the occlusion hump for a week, at the end of which the animals in this group were killed and their temporomandibular joint removed. In the treatment group a second occlusion hump was applied to the left upper molar, in order to obtain a distraction of the previously compressed temporomandibular joint. The rats of the second group wore the second occlusion hump for one week. The rats were then killed with an intraperitoneal injection of Tanax, and the block sections, containing the temporo-mandibolar joint, were retrieved with a diamond disk, and surrounding tissues were washed in saline solution and immediately fixed in 4 percent formalin for 4 days. In the control group, no treatment was applied. In the first group, bone resorption was observed in the left temporomandibular joint; no osteoclast were, however, present. No other tissue alterations were present. Newly formed bone undergoing remodelling was intensely stained with acid fuchsin. In the second and third groups, no bone remodelling areas were observed. In conclusion, the compression of the temporomandibular joint determined a remodelling of the bone structure of the condyle. PMID:17897501

  15. Endoscopic Excision of Supracondylar Humeral Spur for Decompression of the Median Nerve and Brachial Artery

    PubMed Central

    Bain, Gregory; Gupta, Prince; Phadnis, Joideep; Singhi, Prahalad K.

    2016-01-01

    The humeral supracondylar process and Struthers ligament comprise a relatively rare but well-known anatomic variant. They are usually asymptomatic but may produce clinical symptoms related to compression of the median nerve or brachial artery below the ligament. Previously, surgery has been performed with an open ligament release and supracondylar process excision. This article reports on the use of endoscopic findings and the method of ligament release and process excision. Endoscopy is a minimally invasive technique that provides excellent visualization and enables the surgeon to perform dissection with magnification and precision. It allows the surgeon to introduce open surgical techniques into the depths of the wound in a controlled manner. Because of the dead space created, there is a risk of hematoma formation. Many of the concepts used in open surgery are now being used for endoscopic surgery, and vice versa. The barriers and differences among endoscopic, arthroscopic, and open procedures are being broken down. We report another endoscopic technique, which is part of the ongoing evolution of musculoskeletal surgery.

  16. Minimal invasive ostheosintesis for treatment of diaphiseal transverse humeral shaft fractures

    PubMed Central

    Zogaib, Rodrigo Kallás; Morgan, Steven; Belangero, Paulo Santoro; Fernandes, Hélio Jorge Alvachian; Belangero, William Dias; Livani, Bruno

    2014-01-01

    OBJECTIVE: To evaluate patients with transverse fractures of the shaft of the humerus treated with indirect reduction and internal fixation with plate and screws through minimally invasive technique. METHODS: Inclusion criteria were adult patients with transverse diaphyseal fractures of the humerus closed, isolated or not occurring within 15 days of the initial trauma. Exclusion criteria were patients with compound fractures. RESULTS: In two patients, proximal screw loosening occurred, however, the fractures consolidated in the same mean time as the rest of the series. Consolidation with up to 5 degrees of varus occurred in five cases and extension deficit was observed in the patient with olecranon fracture treated with tension band, which was not considered as a complication. There was no recurrence of infection or iatrogenic radial nerve injury. CONCLUSION: It can be concluded that minimally invasive osteosynthesis with bridge plate can be considered a safe and effective option for the treatment of transverse fractures of the humeral shaft. Level of Evidence III, Therapeutic Study. PMID:24868188

  17. Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases.

    PubMed

    Kim, Dong Sung; Kim, Jae-Young; Jeong, Chan-Woo; Park, Kwang-Ho; Huh, Jong-Ki

    2015-10-01

    We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma. PMID:26568928

  18. Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases

    PubMed Central

    Kim, Dong Sung; Kim, Jae-Young; Jeong, Chan-Woo; Park, Kwang-Ho

    2015-01-01

    We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma. PMID:26568928

  19. Three-dimensional quantitative analysis of the bone density of mandibular condyle in dentulous and edentulous jaws: an in vivo study.

    PubMed

    Aggarwal, Himanshi; Singh, Raghuwar D; Kumar, Manoj; Singh, Ragini; Siddhartha, Ramashanker; Jurel, Sunit Kumar; Agrawal, Kaushal K; Kumar, Pradeep

    2015-01-01

    Studies have reported that masticatory function and occlusal force are low in edentulous patients, which brings about a change in the density, thickness, and alignment of bony trabeculae. However, studies that have quantitatively measured the differential cortical and medullary bone densities of the mandibular condyle in vivo remain rare. This study determined and compared the cortical and medullary bone density of the mandibular condyle in dentulous and edentulous jaws, using multidetector computed tomography (CT). Forty mandibular condyles with no clinical signs of temporomandibular disorders were investigated in 2 groups with 10 subjects (aged 50-80 yr) in each group (group I: dentulous subjects with maintained occlusion; group II: completely edentulous patients) with multidetector CT. The density of condylar cortical and medullary bone was determined by using bone density analysis algorithms available within the proprietary software. Data were analyzed statistically with the 1-way analysis of variance test (p<0.05). The mean cortical bone density of the right and left condyles of group I was 686.11±102.78 Hounsfield unit (HU) and 775.91±89.62 HU, respectively and that of group II was 531.33±289.73 HU and 648.53±294.39 HU, respectively. The mean medullary bone density of the right and left condyles was maximum in group I subjects (429.69±102.62 HU and 486.62±108.60 HU, respectively) than in group II subjects (214.89±104.37 HU and 205.36±90.91 HU, respectively) with a statistically significant decrease in the mean scores (p<0.001). Within the limitations of this study, it can be concluded that the cortical and medullary densities of the mandibular condyle are more in dentulous than the edentulous jaws. PMID:25439457

  20. An Anatomical Study of the Nutrient Foramina of the Human Humeral Diaphysis.

    PubMed

    Xue, Zichao; Ding, Haoliang; Hu, Chuanzhen; Xu, Haitao; An, Zhiquan

    2016-01-01

    BACKGROUND Understanding the nutrient foramina is critical to clinical practice. An insult to the nutrient foramina can be caused by trauma and/or surgical dissection and lead to devascularization and bad outcomes. Few studies have looked at the humerus, and no studies have described relative information of humeral nutrient foramen related to anatomical structures that might be located by palpable landmarks. In this study, we analyzed the anatomical features of the nutrient foramina of the diaphyseal humerus and provide a discussion of clinical relevance. MATERIAL AND METHODS We dissected 19 cadavers and analyzed the relative positions of the foramina and surrounding muscles, and the number, direction, diameter, and location of the nutrient foramina. Foramina index and a new landmark index were used to calculate the location. We compared the data from both sides and the relationships between transverse and longitudinal locations, diameter and total length, and foramina index and landmark index were also analyzed. RESULTS The humeri had one or two main nutrient foramina located in a small area between the coracobrachialis and brachial muscles and oriented toward the elbow. The mean diameter was 1.11±0.32 mm. The mean index and landmark index were 43.76±4.94% and 42.26±5.35%, respectively. There were no differences between sides in terms of diameter, length, or nutrient foramina index. There were no significant correlations between transverse and longitudinal locations or diameter and total length. The foramina index and landmark index showed strong positive correlation (r=0.994, p<0.0001). CONCLUSIONS Our study provides details about the nutrient foramina that will benefit clinicians who treat injuries and diseases of the humerus. Surgeons should be mindful of soft tissue in the foraminal area during surgical procedures. PMID:27180828

  1. Plating osteosynthesis of mid-distal humeral shaft fractures: minimally invasive versus conventional open reduction technique

    PubMed Central

    Zeng, Bingfang; He, Xiaojian; Chen, Qi; Hu, Shundong

    2009-01-01

    Results of two methods, conventional open reduction–internal plating and minimally invasive plating osteosynthesis (MIPO), in the treatment of mid-distal humeral shaft fractures were compared. Thirty-three patients were retrospectively analysed and divided into two groups. Group A (n = 17) patients were treated by MIPO and group B (n = 16) by conventional plating. The mean operation time in group A was 92.35 ± 57.68 minutes and 103.12 ± 31.08 minutes in group B (P = 0.513). Iatrogenic radial nerve palsy in group A was 0% (0/17) and 31.3% in group B (5/16 (P = 0.012). The mean fracture union time in group A was 15.29 ± 4.01 weeks (range 8–24 weeks), and 21.25 ± 13.67 weeks (range 10–58 weeks) in group B (P = 0.095). The mean UCLA end-result score in group A was 34.76 ± 0.56 points (range 33–35), and 34.38 ± 1.41 points (range 30–35) in group B (P = 0.299). The mean MEPI in group A was 99.41 ± 2.43 points (range 90–100) and 99.69 ± 1.25 points (range 95–100) in group B (P = 0.687). When compared to the conventional plating techniques, MIPO offers advantages in terms of reduced incidence of iatrogenic radial nerve palsies and accelerated fracture union and a similar functional outcome with respect to shoulder and elbow function. PMID:19301000

  2. Posterior Capsular Plication Constrains the Glenohumeral Joint by Drawing the Humeral Head Closer to the Glenoid and Resisting Abduction

    PubMed Central

    DeAngelis, Joseph P.; Hertz, Benjamin; Wexler, Michael T.; Patel, Nehal; Walley, Kempland C.; Harlow, Ethan R.; Manoukian, Ohan S.; Masoudi, Aidin; Vaziri, Ashkan; Ramappa, Arun J.; Nazarian, Ara

    2015-01-01

    Background: Shoulder pain is a common problem, with 30% to 50% of the American population affected annually. While the majority of these shoulder problems improve, there is a high rate of recurrence, as 54% of patients experience persistent symptoms 3 years after onset. Purpose: Posterior shoulder tightness has been shown to alter glenohumeral (GH) kinematics. Clinically, posterior shoulder contractures result in a significant loss of internal rotation and abduction (ABD). In this study, the effect of a posterior capsular contracture on GH kinematics was investigated using an intact cadaveric shoulder without violating the joint capsule or the rotator cuff. Study Design: Controlled laboratory study. Methods: Glenohumeral motion, humeral load, and subacromial contact pressure were measured in 6 fresh-frozen left shoulders during passive ABD from 60° to 100° using an automated robotic upper extremity testing system. Baseline values were compared with the experimental condition in which the full thickness of posterior tissues was plicated without decompressing the joint capsule. Results: Posterior soft tissue plication resulted in increased compression between the humeral head and the glenoid (axial load) at 90° of ABD. Throughout ABD, the posterior contracture increased the anterior and superior moment on the humeral head, but it did not change the GH kinematics in this intact model. As a result, there was no increase in the subacromial contact pressure during ABD with posterior plication. Conclusion: In an intact cadaveric shoulder, posterior contracture does not alter GH motion or subacromial contact pressure during passive ABD. By tightening the soft tissue envelope posteriorly, there is an increase in compressive load on the articular cartilage and anterior/superior force on the humeral head. These findings suggest that subacromial impingement in the setting of a posterior soft tissue contracture may result from alterations in scapulothoracic motion, not changes in GH kinematics. Clinical Relevance: This investigation demonstrates that posterior capsular plication increases the axial load on the shoulder joint during ABD. While a significant difference from baseline was observed in the plicated condition, posterior capsular plication did not change GH motion or subacromial contact pressure significantly. PMID:26535390

  3. CASE REPORT AND LITERATURE REVIEW ANTERIOR SHOULDER DISLOCATION WITH THREE-PART PROXIMAL HUMERUS FRACTURE AND HUMERAL SHAFT FRACTURE

    PubMed Central

    Flint, John H.; Carlyle, Laura M.; Christiansen, Cory C.; Nepola, James V.

    2009-01-01

    Dislocation of the shoulder and proximal humerus fracture with coexistent humeral shaft fracture is a rare injury reported in literature. There have been a total of 20 cases reported in the literature since 19401-13 (see Table 1). These injuries often occur as a result of high velocity trauma and most have been treated, at least partially, with invasive or operative management. We present the case of a woman with an anterior dislocation, three-part proximal humerus fracture and concomitant humerus shaft fracture and discuss her non-invasive treatment. PMID:19742096

  4. Two-dimensional strain fields on the cross-section of the bovine humeral head under contact loading.

    PubMed

    Canal, Clare E; Hung, Clark T; Ateshian, Gerard A

    2008-11-14

    The objective of this study was to provide a detailed experimental assessment of the two-dimensional cartilage strain distribution on the cross-section of immature and mature bovine humeral heads subjected to contact loading at a relatively rapid physiological loading rate. Six immature and six mature humeral head specimens were loaded against glass and strains were measured at the end of a 5s loading ramp on the textured articular cross-section using digital image correlation analysis. The primary findings indicate that elevated tensile and compressive strains occur near the articular surface, around the center of the contact region. Few qualitative or quantitative differences were observed between mature and immature joints. Under an average contact stress of approximately 1.7 MPa, the peak compressive strains averaged -0.131+/-0.048, which was significantly less than the relative change in cartilage thickness, -0.104+/-0.032 (p<0.05). The peak tensile strains were significantly smaller in magnitude, at 0.0325+/-0.013. These experimental findings differ from a previous finite element analysis of articular contact, which predicted peak strains at the cartilage-bone interface even when accounting for the porous-hydrated nature of the tissue, its depth-dependent inhomogeneity, and the disparity between its tensile and compressive properties. These experimental results yield new insights into the local mechanical environment of the tissue and cells, and suggest that further refinements are needed in the modeling of contacting articular layers. PMID:18952212

  5. Seasonal Temperature and Pin Site Care Regimen Affect the Incidence of Pin Site Infection in Pediatric Supracondylar Humeral Fractures

    PubMed Central

    Chen, Mei-Chuan; Lee, Wei-Chun; Yang, Wen-E; Chang, Chia-Hsieh

    2015-01-01

    Pin site infection is a common complication after fracture fixation and bone lengthening, and daily pin site care is recommended. Weather is a strong environmental factor of infection, but few articles studied the issue of weather and pin site infection. We performed a prospective comparative study of 61 children with supracondylar humeral fractures treated by closed reduction and percutaneous pinning. The patients were divided into high-temperature season or low-temperature season by the months they received surgery. The patients within each season were further allocated to 2 groups by the different postoperative pin site care methods of daily care or noncare. The infection rate per patient was significantly higher in the high-temperature season compared to low-temperature season (45% versus 19%, P = 0.045). In the high-temperature season, the infection rate per patient was significantly higher in the daily care group versus the noncare group (70% versus 20%, P = 0.001). In the low-temperature season, the infection rate per patient was not significantly different in the daily care group versus the noncare group (10% versus 27.3%, P = 0.33). We recommend that careful monitoring of infection signs, rather than pin site cleaning, would be appropriate in the treatment of pediatric supracondylar humeral fractures, especially during the summer months. PMID:26064957

  6. Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature

    PubMed Central

    Keyhani, Sohrab; Vaziri, Arash Sharafat; shafiei, Hossein; Mardani-Kivi, Mohsen

    2015-01-01

    A rare and devastating complication following anterior cruciate ligament (ACL) revision reconstruction is femoral fracture. A 35-year old male soccer player with a history of ACL tear from one year ago, who underwent arthroscopic ACL reconstruction and functioned well until another similar injury caused ACL re-rupture. Revision of ACL reconstruction was performed and after failure of graft tension during the pumping, a fluoroscopic assessment showed a femoral condyle fracture. The patient referred to our knee clinic and was operated on in two stages first fixation of the fracture and then ACL re-revision after fracture healing was complete. Not inserting multiple guide pins, keeping a safe distance from the posterior cortex and giving more attention during graft tensioning, especially in revision surgeries, are all small points that can reduce the risk of fracture during the revision of ACL reconstruction. PMID:26110183

  7. Focal anatomic resurfacing implantation for bilateral humeral and femoral heads’ avascular necrosis in a patient with Hodgkin’s lymphoma and literature review

    PubMed Central

    Bilge, Onur; Doral, Mahmut Nedim; Miniaci, Anthony

    2015-01-01

    Introduction The femoral and humeral heads are among the most common sites of osteonecrosis. The aims of this case report was to report three years’ results for sequential treatment of bilateral, concomitant involvement of humeral and femoral heads with focal anatomic resurfacing implantation in a single patient with Hodgkin’s lymphoma and to review the relevant literature, which is relatively scarce. Presentation of case We present a 48-year-old male patient with concomitant, bilateral femoral and humeral head avascular necrosis. He was diagnosed as Hodgkin’s lymphoma in 1984. He had bilateral groin and shoulder pain, lasting for three years and aggravated by joint motions. Radiological evaluations demonstrated bilateral focal osteonecrosis of femoral heads and humeral heads, respectively. Despite conservative treatment, he did not obtain any symptomatic relief. Following the common decision, he was treated with sequential implantations with the HemiCAP® device for both bilateral pathologies, by a single surgeon and standard surgical approaches. Neither intraoperative nor postoperative complication was encountered. After the follow-up period of 36 months after the last surgery, he was symptomless and with normal range of motion for all four joints. Discussion The bilateral, concomitant involvement of humeral and femoral head in the setting of avascular necrosis is relatively rare. Moreover, the optimal treatment method at earlier stages, in young patients has not been established yet. Conclusion This study is the first report to present the three-years’ clinical result of a single, relevant case, who was treated with sequential focal anatomic resurfacing implantations (HemiCAP®) in four aforementioned joints. PMID:26624502

  8. Lateral Ulnar Collateral Ligament Reconstruction: An Analysis of Ulnar Tunnel Locations.

    PubMed

    Anakwenze, Oke A; Khanna, Krishn; Levine, William N; Ahmad, Christopher S

    2016-02-01

    We conducted a study to determine precise ulnar tunnel location during lateral ulnar collateral ligament reconstruction to maximize bony bridge and graft construct perpendicularity. Three-dimensional computer models of 15 adult elbows were constructed. These elbow models were manipulated for simulated 4-mm tunnel drilling. The proximal ulna tunnels were placed at the radial head-neck junction and sequentially 0, 5, and 10 mm posterior to the supinator crest. The bony bridges created by these tunnels were measured. Location of the humeral isometric point was determined and marked as the humeral tunnel location. Graft configuration was simulated. Using all the simulated ulna tunnels, we measured the proximal and distal limbs of the graft. In addition, we measured the degree of perpendicularity of the graft limbs. The ulnar tunnel bony bridge was significantly longer with more posterior placement of the proximal tunnel relative to the supinator crest. An increase in degree of perpendicularity of graft to ulnar tunnels was noted with posterior shifts in proximal tunnel location. Posterior placement of the proximal ulna tunnel allows for a larger bony bridge and a more geometrically favorable reconstruction. PMID:26866312

  9. OSTEOSYNTHESIS OF PROXIMAL HUMERAL END FRACTURES WITH FIXED-ANGLE PLATE AND LOCKING SCREWS: TECHNIQUE AND RESULTS

    PubMed Central

    Cohen, Marcio; Amaral, Marcus Vinicius; Monteiro, Martim; Brandão, Bruno Lobo; Motta Filho, Geraldo Rocha

    2015-01-01

    Describe the results of proximal humeral fractures surgically treated with the Philos locking plate system. Method: Between March 2003 and October 2004 we prospectively reviewed 24 of 26 patients with proximal humerus fractures treated with a Philos plate. The mean follow-up time was 12 months and the mean age of patients was 57 years. Six patients had four-part proximal humerus fractures, 11 patients had three-part proximal humerus fractures, and nine patients had two-part proximal humerus fractures. Clinical evaluation was performed using the University of California at Los Angeles (UCLA) criteria. Results: The mean UCLA score was 30 points (17-34). All fractures showed union. Three patients showed fracture union at varus position. The mean UCLA score for these patients was 27 points. Conclusion: Osteosynthesis with Philos plate provides a stable fixation method with good functional outcome. PMID:26998460

  10. The classification of complex 4-part humeral fractures revisited: the missing fifth fragment and indications for surgery.

    PubMed

    Russo, Raffaele; Cautiero, Fabio; Della Rotonda, Giuseppe

    2012-05-01

    We describe a new classification of complex 4-part proximal humeral fractures (PHF). Its novelty lies in the involvement of fractures of the calcar area (i.e., the missing fifth fragment) in relation to fragments of the head, tuberosities and shaft. The classification consists of 6 groups (divided into 15 subgroups) of calcar fracture patterns. We hypothesized that this classification could aid surgical decision making in terms of osteosynthesis versus prothesis. To test this hypothesis, two shoulder surgeons, trained in the classification, re-examined the X-rays and CT scans of 100 cases of 4-part PHF to codify each calcar fracture pattern. CT scans proved to be essential for this process. We then theoretically assigned the most appropriate treatment to each subgroup. Subsequent verification of clinical records confirmed our hypothesis that this classification could help the surgeon to decide the best approach to complex 4-part PHF. PMID:22528850

  11. Efficacy of dynamic humeral centering according to Neer test results: a stratified analysis of a randomized-controlled trial.

    PubMed

    Beaudreuil, Johann; Ostertag, Agnès; Lasbleiz, Sandra; Vicaut, Eric; Yelnik, Alain; Bardin, Thomas; Orcel, Philippe

    2015-03-01

    The aim of this study was to assess the efficacy of dynamic humeral centering (DHC) according to Neer test results. The study was a stratified analysis of a previously reported randomized trial. The patients included had shoulder pain with impingement syndrome. Interventions were DHC or nonspecific mobilization for control. The primary outcome was the Constant score including subscores for pain, activity, mobility, and strength at 3 months. All patients improved at follow-up, with better results after DHC. There was no interaction between Neer test results, treatments, and time. However, a trend toward higher effect sizes was observed after DHC in patients with a positive Neer test in comparison with negative patients. Patients with a positive Neer test showed improvement after DHC for rotator cuff disease compared with nonspecific mobilization. PMID:25185788

  12. Scapular Resting Position and Gleno-Humeral Movement Dysfunction in Asymptomatic Racquet Players: A Case-Control Study

    PubMed Central

    Shimpi, Apurv P.; Bhakti, Shah; Roshni, Karnik; Rairikar, Savita A.; Shyam, Ashok; Sancheti, Parag K.

    2015-01-01

    Background: Racquet sports, especially lawn tennis and badminton have been gaining popularity in Asian countries like India. With this increase in popularity, the injury rate in the sport has also increased. Objectives: The study will help detect the presence of gleno-humeral movement dysfunction and scapular resting position abnormality in asymptomatic racquet players, thus providing basis for screening the players and allow the clinician to determine if the asymmetry is a normal adaptation in the player or an abnormal change associated with injury. Materials and Methods: 46 asymptomatic professional players were divided into a study group of 23 players (16 tennis and 7 badminton) and control group of 23 football players. Assessment of passive gleno-humeral range of motion and distance of spine and inferior angle of scapula from corresponding spinous process were measured bilaterally and between groups. Results: There was statistically significant reduction in range of internal rotation (62.17 ± 8.09), extension (39.78 ± 4.12) and an increase in the external rotation (106.95 ± 7.49) of dominant compared to non-dominant arm of racquet players and a statistically significant decrease in internal rotation (78.69 ± 10.24), extension (44.78 ± 3.19), adduction (37.39 ± 6.54) and an increase in external rotation (102.6 ± 5.19) of dominant arm of racquet players compared to football players. Study also showed statistically significant increase in the spino-scapular distance at the level of inferior angle of scapula (10.23 ± 1.43) on dominant side compared to non-dominant. Conclusions: The dominant side scapula of asymptomatic racquet players showed increased external rotation and elevation as compared to the non-dominant side. Also, reduced shoulder internal rotation, extension and adduction and gain in shoulder external rotation was observed on the dominant side of racquet players when compared to the control group. PMID:26715968

  13. EVALUATION OF PATIENTS UNDERGOING FIXATION OF DIAPHYSEAL HUMERAL FRACTURES USING THE MINIMALLY INVASIVE BRIDGE-PLATE TECHNIQUE

    PubMed Central

    Superti, Mauro José; Martynetz, Fábio; Falavinha, Ricardo Sprenger; Fávaro, Rodrigo Caldonazzo; Boas, Luis Felipe Villas; Filho, Salim Mussi; Martynetz, Juliano; Ribas, Bruno

    2015-01-01

    Objective: The aim was to describe the experience of our group in treating humeral shaft fractures using the bridge–plate technique via an anterior approach. Methods: Seventeen patients with acute diaphyseal humeral fractures with an indication for surgical treatment who were operated in 2006–2010 were evaluated. The AO and Gustilo & Anderson classifications were used. All the patients were operated using the anterior bridge-plate technique and completed a follow–up period of at least twelve months. Results: Sixteen men and one woman were treated. Their mean age was 31.8 years (18–52). Among the injury mechanisms found were: five motorcycle accidents, four car accidents, three fractures due to firearm projectiles, two falls to the ground and finally, with one case each, assault, crushing and being run over. Eight patients had open fractures: two grade I, one grade II, four grade IIIa and one grade IIIb, according to the Gustilo-Anderson classification. In relation to the AO classification, we found: one 12A1, three 12A2, four 12A3, one 12B1, four 12 B2, three 12B3 and one 12C2. The mean postoperative follow-up was 25 months (12–48). As complications, two patients had pain in the elbow and a ROM deficit and one had deep infection. The mean time taken to achieve consolidation was 17.5 weeks. There was no loss of reduction, pseudarthrosis or malunion in this series of patients. Conclusion: The authors believe that the technique described has low rates of complications and morbidity, with good initial results, although the series is limited by the small sample. PMID:27042639

  14. Stemless humeral component in reverse shoulder prosthesis in patient with Parkinsons disease: a case report

    PubMed Central

    Giannotti, Stefano; Bottai, Vanna; DellOsso, Giacomo; Bugelli, Giulia; Guido, Giulio

    2015-01-01

    Summary Introduction In patients with Parkinsons disease falling is very common and for this reason, the prosthetic surgical indication in shoulder is reserved for special cases. PD has been linked to several interrelated factors that may contribute to failure of shoulder arthroplasty. Case presentation A 65-year-old woman with PD, severe pain, recurrent bursitis, swelling and functional limitation to all movements in left shoulder presented to our attention. Radiographic and CT exams show cuff-tear arthropathy. The patient was submitted to implantation of a Reverse Shoulder Comprehensive Nano cementless modular system (Biomet, Warsaw, IN, USA) with anterosuperior surgical approach. We chose this kind of solution of stemless humeral component after bone mineral consideration. Discussion Reverse shoulder arthroplasty represents an option in the management of glenohumeral arthritis. Poor functional results of RTSA in patients with PD have been attributed to increased muscle tone, severity of tremor and an increased mortality rate. In general, post operative complications related to the humeral component are dominated by fractures (between 1 and 3%): in patients with PD this percentage is higher because of falls often occur. With a stemless implant revisions can be performed easily. Overall, the anterosuperior surgical exposure gives a low risk of postoperative instability. Conclusion In selected cases of patients with PD, after carefully analysis of bone quality, the use of a stemless component is of benefit in the possible revision cases for periprosthetic fractures and the use of an anterosuperior exposure reduces the percentage of instability. The results obtained about the pain relief are excellent in contrast with functional outcomes that remain poor. PMID:26136798

  15. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl

    PubMed Central

    Wiktor, Łukasz; Tomaszewski, Ryszard

    2015-01-01

    The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of “halo-vest” system. We established that clinical effect after completed treatment is very good. Control MRI evaluation was performed 12 months after removal of “halo-vest” traction, and clinically silent extradural meningeal spinal cysts were detected at the ventral side of the spinal cord in the cervical segment of the spine. Due to clinically silent course of the disease, we decided to use the conservative treatment. The patient remains under control of our department. PMID:26543656

  16. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl.

    PubMed

    Wiktor, Łukasz; Tomaszewski, Ryszard

    2015-01-01

    The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of "halo-vest" system. We established that clinical effect after completed treatment is very good. Control MRI evaluation was performed 12 months after removal of "halo-vest" traction, and clinically silent extradural meningeal spinal cysts were detected at the ventral side of the spinal cord in the cervical segment of the spine. Due to clinically silent course of the disease, we decided to use the conservative treatment. The patient remains under control of our department. PMID:26543656

  17. [Treatment of fractures of the mandibular condyle. Experiences at the Department of Oral Medicine and Maxillofacial Surgery at Toulon-La-Seyne/Mer].

    PubMed

    Ribault, J Y; Lestage, F; Gacon, J; Vittel, P; Roubaudi, G; Pernice, L; Jeannenot, J; Laroche, D; Fourestier, J

    1997-11-01

    The fractures of the gnathic condyle are constantly increasing due to the violent impact on the chine. The functional treatment is essential for good results whereas the restitution of a functional joint, i.e. teeth that engage into one another, is satisfactory for the patient as it can also justify a possible surgical reduction in such cases when significant shifts of fragments resulting from the fractures are present. PMID:9471694

  18. Migration of calcium deposits into subacromial-subdeltoid bursa and into humeral head as a rare complication of calcifying tendinitis: sonography and imaging.

    PubMed

    Della Valle, Valeria; Bassi, Emilio Maria; Calliada, Fabrizio

    2015-09-01

    Calcifying tendinitis of the shoulder is a common condition characterized by the deposition of calcium, predominantly hydroxyapatite crystals, in the rotator cuff. A rare complication of this condition is the migration of calcium deposits from tendons, usually the supraspinatus, into the subacromial-subdeltoid bursa or into the humeral greater tuberosity. These complications are responsible for intense acute shoulder pain and functional disability. Patient anamnesis and clinical symptoms must be considered to make the diagnosis, but imaging, particularly sonography, is often necessary, showing a typical presentation related to the locations of calcium deposits. We present sonographic and other imaging features of subacromial-subdeltoid bursitis and humeral osteitis related to the migration of calcium. PMID:26261476

  19. Pulsed radiofrequency on radial nerve under ultrasound guidance for treatment of intractable lateral epicondylitis.

    PubMed

    Oh, Dae Seok; Kang, Tae Hyung; Kim, Hyae Jin

    2016-06-01

    Lateral epicondylitis is a painful and functionally limiting disorder. Although lateral elbow pain is generally self-limiting, in a minority of people symptoms persist for a long time. When various conservative treatments fail, surgical approach is recommended. Surgical denervation of several nerves that innervate the lateral humeral epicondyle could be considered in patients with refractory pain because it denervates the region of pain. Pulsed radiofrequency is a minimally invasive procedure that improves chronic pain when applied to various neural tissues without causing any significant destruction and painful complication. This procedure is safe, minimally invasive, and has less risk of complications relatively compared to the surgical approach. The radial nerve can be identified as a target for pulsed radiofrequency lesioning in lateral epicondylitis. This innovative method of pulsed radiofrequency applied to the radial nerve has not been reported before. We reported on two patients with intractable lateral epicondylitis suffering from elbow pain who did not respond to nonoperative treatments, but in whom the ultrasound-guided pulsed radiofrequency neuromodulation of the radial nerve induced symptom improvement. After a successful diagnostic nerve block, radiofrequency probe adjustment around the radial nerve was performed on the lateral aspect of the distal upper arm under ultrasound guidance and multiple pulsed treatments were applied. A significant reduction in pain was reported over the follow-up period of 12 weeks. PMID:26896944

  20. Regional and temporal changes in the synthesis of matrix metalloproteinases and TIMP-1 during development of the rabbit mandibular condyle.

    PubMed Central

    Breckon, J J; Hembry, R M; Reynolds, J J; Meikle, M C

    1994-01-01

    Connective tissues synthesise and secrete a family of matrix metalloproteinases (MMPs; collagenases, gelatinases and stromelysins) capable of degrading all the components of connective tissue matrices at physiological pH. We document the patterns of synthesis and distribution of MMPs and the tissue inhibitor of metalloproteinases-1 (TIMP-1) within the developing rabbit mandibular condyle using immunofluorescence microscopy. MMPs and TIMP-1 were detected both as bright intracellular accumulations within Golgi vesicles and also as diffuse matrix-bound extracellular deposits. Cells in the articular zone, proliferative zone, condylar cartilage and bone of the mandibular ramus were shown to produce all 3 classes of MMPs and TIMP-1 with the exception of stromelysin, which was not synthesised by cells of the bone of spongiosum. Temporal synthesis of MMPs and TIMP-1 within these regions varied during the period 18 d postcoitum to 14 d postnatum. Our results document unique patterns of MMP and TIMP-1 synthesis during embryonic and early postnatal development of condylar cartilage and support the concept that cells synthesise and secrete MMPs and TIMP-1 before undergoing proliferation and hypertrophy. A comparison of these results with data in the rabbit growth plate show many similarities, but some differences exist that probably reflect differences in the modes of growth of the 2 cartilages. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:8157496

  1. [Experimental histological study of the articular cartilage of the external femoral condyle in tibial elongation in dogs].

    PubMed

    Shchudlo, M M; Stupina, T A; Erofeev, S A

    2005-01-01

    The tibia was elongated in 18 adult mongrel dogs with the rate of 1 mm per day produced with 60 increments (1st series, autodistraction) or 8 increments (2nd series, manual distraction). On completion of 28 days of distraction, followed by 30 days of fixation and 30 days without the fixator, the articular cartilage of the external femoral condyle was studied in the experimental and 3 intact animals using the methods of light and scanning electron microscopy, computer morphometry and stereometry. It was established that the structural changes in the cartilage during the experiment included destruction of the superficial area. The degree of destruction severity was directly related to the duration of the stage when the fixator was on. In a month after the fixator removal the return to the motor stereotype resulted in restoration of the cartilage surface in the 1st series, whereas in the second one the changes persisted. The studies performed revealed general features of the morpho-functional state of the articular cartilage in tibial lengthening in both experimental series, and showed that the autodistraction mode was less traumatic for the articular cartilage. PMID:16669250

  2. Morphological characteristics of subchondral bone cysts in medial femoral condyles of adult horses as determined by computed tomography.

    PubMed

    Walker, Wade T; Silverberg, Jesse L; Kawcak, Christopher E; Nelson, Bradley B; Fortier, Lisa A

    2016-03-01

    OBJECTIVE To determine morphological characteristics of subchondral bone cysts (SBCs) in medial femoral condyles (MFCs) of adult horses with orthopedic disease. SAMPLE CT scans of 7 MFCs with SBCs from 6 adult horses. PROCEDURES CT was used to determine the volume, surface area, and centers of the articular cyst opening and SBC in each MFC. Cysts were ordered from smallest to largest on the basis of volume. Osseous pathological characteristics of the MFC were assessed in the frontal plane. Three-dimensional distance of displacement between the center of the articular cyst opening and center of the cyst was determined for each SBC. Cyst surface area-to-volume ratio was evaluated and compared with that of a true sphere. RESULTS All SBCs had a defect in the subchondral bone plate at the cranial 15% to 20% of the MFC. Cyst center was located in a caudal, proximal, and abaxial direction with respect to the center of the articular cyst opening for each horse. Small- and intermediate-volume SBCs were irregular and multilobulated, whereas large-volume SBCs were smooth and discrete with a surface area-to-volume ratio approaching that of a sphere. CONCLUSIONS AND CLINICAL RELEVANCE Consistency in morphological characteristics suggested a common etiopathogenesis for SBCs in MFCs of adult horses. Cyst enlargement may have been attributable to a biomechanical predisposition to decrease the surface area-to-volume ratio, resulting in a spherical cyst. PMID:26919597

  3. Lateral flow strip assay

    DOEpatents

    Miles, Robin R.; Benett, William J.; Coleman, Matthew A.; Pearson, Francesca S.; Nasarabadi, Shanavaz L.

    2011-03-08

    A lateral flow strip assay apparatus comprising a housing; a lateral flow strip in the housing, the lateral flow strip having a receiving portion; a sample collection unit; and a reagent reservoir. Saliva and/or buccal cells are collected from an individual using the sample collection unit. The sample collection unit is immersed in the reagent reservoir. The tip of the lateral flow strip is immersed in the reservoir and the reagent/sample mixture wicks up into the lateral flow strip to perform the assay.

  4. PSEUDARTHROSIS OF THE HUMERAL NECK: ANALYSIS OF THE RESULTS WHEN USING THE TECHNIQUE DESCRIBED BY WALCH ET AL

    PubMed Central

    Checchia, Sérgio Luis; Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; Nascimento, Luís Gustavo Prata

    2015-01-01

    Objective: To evaluate bone healing and the patient's outcome after open reduction and internal fixation, when using the technique described by Walch et al, in 1996, which uses conventional intramedullary corticocancellous bone graft and internal fixation with plate and screws added by a tricortical intramedullary bone graft, also autologous. Methods: From July 1997 to May 2005, 14 patients were treated by this technique, 14 of these diagnosed with pseudoarthrosis of the humeral proximal end. One died at the early postoperative period due to pulmonary thromboembolism; therefore, 13 patients were re-evaluated. Results: The mean follow-up time was 51.4 months (ranging from 12 to 130 months). Four patients evolved with excellent results, four good and five fair results. Therefore, there were 61.5% of satisfactory results according to UCLA functional scale and no poor result. Twelve cases (92%) healed within 3.5 months in average. Conclusion: the surgical treatment of the nonunion of the surgical neck of the humerus using this technique showed an effective outcome with 92% of healing; excellent and good results in 61.5% of the cases, as well as satisfaction of all patients with their final results; nonunion resulting from two-part fractures had better results when compared with three-part fractures. PMID:27004178

  5. Uncommon Variant of Type II Monteggia Fracture with Concomitant Distal Humeral Fracture

    PubMed Central

    Matta, Jihad F.; El Rassi, George S.; Abd El Nour, Hicham G.; El Asmar, Rachel

    2015-01-01

    Monteggia fracture-dislocation, a common injury sustained by pediatric population, is a rare entity in adults. It was first observed by Giovanni Battista Monteggia and later classified by Bado into 4 groups. The term “Monteggia equivalent or variant” was introduced to describe certain injuries with similar radiographic pattern and biomechanism of injury. Since then various types and their variants have been described in the literature. We present a complex fracture pattern in a 55-year-old male not previously described in the literature along with its treatment modality and favorable outcome. PMID:26550509

  6. Diagnostic accuracy of cone beam computed tomography and conventional multislice spiral tomography in sheep mandibular condyle fractures

    PubMed Central

    Sirin, Y; Guven, K; Horasan, S; Sencan, S

    2010-01-01

    Objectives The aim of this study was to compare diagnostic accuracy of cone beam CT (CBCT) and multislice CT in artificially created fractures of the sheep mandibular condyle. Methods 63 full-thickness sheep heads were used in this study. Two surgeons created the fractures, which were either displaced or non-displaced. CBCT images were acquired by the NewTom 3G® CBCT scanner (NIM, Verona, Italy) and CT imaging was performed using the Toshiba Aquillon® multislice CT scanner (Toshiba Medical Systems, Otawara, Japan). Two-dimensional (2D) cross-sectional images and three-dimensional (3D) reconstructions were evaluated by two observers who were asked to determine the presence or absence of fracture and displacement, the type of fracture, anatomical localization and type of displacement. The naked-eye inspection during surgery served as the gold standard. Inter- and intra-observer agreements were calculated with weighted kappa statistics. The receiver operating characteristics (ROC) curve analyses were used to compare statistically the area under the curve (AUC) of both imaging modalities. Results Kappa coefficients of intra- and interobserver agreement scores varied between 0.56 – 0.98, which were classified as moderate and excellent, respectively. There was no statistically significant difference between the imaging modalities, which were both sensitive and specific for the diagnosis of sheep condylar fractures. Conclusions This study confirms that CBCT is similar to CT in the diagnosis of different types of experimentally created sheep condylar fractures and can provide a cost- and dose-effective diagnostic option. PMID:20729182

  7. Reading Disability and Laterality.

    ERIC Educational Resources Information Center

    Sparrow, Sara S.

    The purpose of this study was to determine how retarded readers differed from normal readers in the various ways laterality is manifested. An additional purpose was to investigate the development of laterality as seen across several age levels. Subjects were 80 white male 9-, 10-, 11-, and 12-year-olds from regular classrooms in suburban

  8. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients

    PubMed Central

    2014-01-01

    Background During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures. Methods We used 2 types of surgical approaches, the retromandibular retroparotid or preauricular approach. Three kinds of rigid internal fixation plates were used—single plate, double plate, and trapezoidal plate. The following post-operative clinical parameters were evaluated: dental occlusion, facial nerve functionality, skin scarring, and temporomandibular joint functionality. All patients underwent post-operative orthopanoramic radiography and computed tomography. The patients were also monitored for complications such as Frey’s syndrome, infection, salivary fistula, plate fracture, and permanent paralysis of the facial nerve; the patient’s satisfaction was also recorded. Results Of the 25 patients, 80% showed occlusion recovery, 88% had no facial nerve injury, and 88% presented good surgical skin scarring. The patients showed early complete recovery of temporomandibular joint functionality and 72% of them were found to be asymptomatic. The postoperative radiographs of all patients indicated good recovery of the anatomical condylar region, and 80% of them had no postoperative complications. The average degree of patient satisfaction was 8.32 out of 10. Our results confirm that the technique of open reduction and internal fixation in association with postoperative functional rehabilitation therapy should be considered for treating patients with extracapsular condylar fractures. Conclusion The topic of condylar injury has generated more discussion and controversy than any other topic in the field of maxillofacial trauma. We confirm that open reduction and internal fixation is the treatment of choice for patients with neck and sub-condylar mandibular fractures. PMID:25196114

  9. Lateral epicondylosis and calcific tendonitis in a golfer: a case report and literature review

    PubMed Central

    Yuill, Erik A.; Lum, Grant

    2011-01-01

    Objective To detail the progress of a young female amateur golfer who developed chronic left arm pain while playing golf 8 months prior to her first treatment visit. Clinical Features Findings included pain slightly distal to the lateral epicondyle of the elbow, decreased grip strength, and positive orthopedic testing. Diagnostic ultrasound showed thickening of the common extensor tendon origin indicating lateral epicondylosis. Radiographs revealed an oval shaped calcified density in the soft tissue adjacent to the lateral humeral epicondyle, indicating calcific tendonitis of the common extensor tendon origin. Intervention and Outcome Conventional care was aimed at decreasing the repetitive load on the common extensor tendon, specifically the extensor carpi radialis brevis. Soft tissue techniques, exercises and stretches, and an elbow brace helped to reduce repetitive strain. Outcome measures included subjective pain ratings, and follow up imaging 10 weeks after treatment began. Conclusion A young female amateur golfer with chronic arm pain diagnosed as lateral epicondylosis and calcific tendonitis was relieved of her pain after 7 treatments over 10 weeks of soft tissue and physical therapy focusing specifically on optimal healing and decreasing the repetitive load on the extensor carpi radialis brevis. PMID:22131570

  10. Primary Lateral Sclerosis

    MedlinePlus

    ... When symptoms begin, PLS may be mistaken for amyotrophic lateral sclerosis (ALS) or spastic paraplegia. Most neurologists follow an affected ... www.sp-foundation.org Tel: 877-773-4483 ALS Association 1275 K Street, N.W. Suite 250 ...

  11. Amyotrophic Lateral Sclerosis

    MedlinePlus

    Amyotrophic lateral sclerosis (ALS) is a nervous system disease that attacks nerve cells called neurons in your ... people with ALS die from respiratory failure. The disease usually strikes between age 40 and 60. More ...

  12. Hemiarthroplasty of the shoulder joint using a custom-designed high-density nano-hydroxyapatite/polyamide prosthesis with a polyvinyl alcohol hydrogel humeral head surface in rabbits.

    PubMed

    Guo, Yongwen; Guo, Jun; Bai, Ding; Wang, Hang; Zheng, Xiaohui; Guo, Weihua; Tian, Weidong

    2014-07-01

    In this study, a novel custom-designed high-density nano-hydroxyapatite/polyamide (n-HA/PA) prosthesis with a polyvinyl alcohol (PVA) hydrogel humeral head surface was employed to repair the shoulder joint head for hemiarthroplasty in rabbits. The prosthesis was fabricated using three-dimensional computed tomography and computer-aided design and computer-aided manufacturing systems for perfect fitting. Sixteen New Zealand white rabbits underwent humeral head excision, and received the composite prostheses for hemiarthroplasty. The implant sites were free from suppuration and necrosis at all periods. The X-ray results showed that there was a clear space between the prosthesis head and the glenoid surface, and the joint capsules and surfaces of the glenoid and PVA were well preserved without any damage during the whole inspection period. A high density of bone was observed around the firmware part of the prosthesis. Histological results revealed that significant osteogenesis was surrounding the firmware part, and the joint space was clear and the cartilage of the upper joint surface was basically intact. There was no visible absorption of the joint surfaces even after 3 months of continuous functional motions. The maximum tensile strength between the prosthesis and host bone reached 2.63 MPa at the 12th week postimplantation. In conclusion, the customized prosthesis by combination of PVA and high-density n-HA/PA has excellent biocompatibility and biological fixation, and offers a promising substitute for both the cartilage and the bone of the humeral head in a rabbit model as level V evidence. PMID:24404998

  13. Refixation stability in shoulder hemiarthroplasty in case of four-part proximal humeral fracture.

    PubMed

    Baumgartner, Daniel; Lorenzetti, Silvio René; Mathys, Robert; Gasser, Beat; Stüssi, Edgar

    2009-05-01

    Primary stability of refixated fractures in case of shoulder hemiarthroplasty is a prerequisite to restore physiological glenohumeral joint function. Clinical observations often show a secondary dislocation and subsequent resorption of the bony anchor points like the greater and lesser tuberosity at the rotator cuff tendons. This failed integration leads to impaired glenohumeral load transmission and subsequent reduction of mobility. As a consequence, the optimisation of refixation methods is crucial for a better clinical outcome. To prove the stability of refixation techniques, a Finite Element fracture model was built. Resulting stresses at the bone surface and fragment migration relative to the prosthesis shaft were studied. The results of the calculations show that the isolated tuberosities show unstressed bone regions compared to the intact model. This circumstance may explain the clinically detected bone resorption due to the absence of mechanical stimuli. Furthermore, a cable guidance through lateral holes in the middle part of the proximal prosthesis results in a lower fragment displacement than a circumferential fixation method surrounding the entire proximal bone. PMID:19408030

  14. Resurfacing of the humeral head: An analysis of the bone stock and osseous integration under the implant.

    PubMed

    Schmidutz, Florian; Sprecher, Christoph M; Milz, Stefan; Gohlke, Frank; Hertel, Ralph; Braunstein, Volker

    2015-09-01

    Cementless-surface-replacement-arthroplasty (CSRA) of the shoulder aims for functional joint restoration with minimal bone loss. Good clinical results have been reported, but due to the radiopaque metal shell no data is available on the structure, osseous integration, and bone stock under the implant. 14 hemi-CSRAs (4 manufacturers) with two geometries (crown [n = 7]/ stem [n = 7] fixation) were retrieved from patients undergoing revision due to glenoidal erosion. Histological sections cutting through the implant centre and bone were analysed. Quantitative histomorphometry evaluated the bone-implant-contact and compared the bone-area to native humeral retrievals (n = 7). The bone-implant-interface was further assessed by scanning-electron-microscopy (SEM) and energy-dispersive-x-ray (EDX). Qualitative histology revealed a reduced and inhomogeneous bone stock. Obvious signs of stress shielding were observed with bone predominantly visible at the stem and implant rim. Quantitative histomorphometry confirmed the significantly reduced bone-area (9.2 ± 3.9% [crown 9.9 ± 4.3%, stem 8.6 ± 3.6%]) compared to native humeri (21.2 ± 9.1%; p < 0.05). Bone-implant-contact was 20.5 ± 5.8% (crown 21.8 ± 6.2%, stem 19.2 ± 5.6%) which was confirmed by SEM and EDX. Altogether, CRSA shows satisfactory bone ingrowth at the interface suggesting sufficient primary stability to allow osseous integration. However, clear signs of stress shielding with an inhomogeneous and reduced bone stock were observed. The impact on the long-term-results is unclear requiring further investigation. PMID:25808101

  15. Analysis of Range of Motion and Isokinetic Strength of Internal and External Rotation According to Humeral Retroversion of the Dominant Shoulder in Youth Baseball Players: A Pilot Study

    PubMed Central

    RHI, Soung-Yob; SO, Wi-Young

    2014-01-01

    Abstract Background We aimed to analyze the range of motion (ROM) and internal rotation (IR) and external rotation (ER) isokinetic strength according to humeral retroversion of the dominant shoulder. Methods We included 40 elite baseball players in Korea (OBP group: n=20 players with careers spanning >10 years, age: 19.37±2.21 years, height: 181.00±5.41 cm, weight: 84.58±7.85 kg; BBP group: n=20 players with careers spanning <10 years, age: 16.55±1.36 years, height: 177.27±7.57 cm, weight: 77.27±8.14 kg). Radiography was performed to examine humeral retroversion, a goniometer was used to measure IROM and EROM, and a dynamometer was used to measure IR and ER isokinetic strength (speed set at 180°/s or 300°/s). Results The BBP and OBP groups had significantly different IR and ER isokinetic strength (180°/s and 300°/s) (P<0.001) and dominant shoulder retroversion (P=0.009). In the BBP group, retroversion had no correlation with ROM and with IR or ER isokinetic strength (180°/s and 300°/s). In the OBP group, retroversion had no correlation with ROM and with ER isokinetic strength at 180°/s, but had significant correlation with IR isokinetic strength at both 180°/s (r=0.483, P=0.007) and 300°/s (r=0.373, P=0.043) and ER isokinetic strength at 300°/s (r=0.366, P=0.046). Conclusion Thus, youth players with careers spanning >10 years had significantly higher humeral retroversion, IROM, EROM, and IR and ER isokinetic strength of the dominant shoulder than youth players with careers spanning <10 years. Furthermore, humeral retroversion and ROM were not significantly related, but IR and ER isokinetic strength were significantly positively related with retroversion in both groups. PMID:26060741

  16. Laterally bendable belt conveyor

    DOEpatents

    Peterson, William J.

    1985-01-01

    An endless, laterally flexible and bendable belt conveyor particularly adapted for coal mining applications in facilitating the transport of the extracted coal up- or downslope and around corners in a continuous manner is disclosed. The conveying means includes a flat rubber belt reinforced along the middle portion thereof along which the major portion of the belt tension is directed so as to cause rotation of the tubular shaped belt when trammed around lateral turns thus preventing excessive belt bulging distortion between adjacent belt supports which would inhibit belt transport. Pretension induced into the fabric reinforced flat rubber belt by conventional belt take-up means supports the load conveyed when the belt conveyor is making lateral turns. The carrying and return portions of the belt are supported and formed into a tubular shape by a plurality of shapers positioned along its length. Each shaper is supported from above by a monorail and includes clusters of idler rollers which support the belt. Additional cluster rollers in each shaper permit the belt supporting roller clusters to rotate in response to the belt's operating tension imposed upon the cluster rollers by induced lateral belt friction forces. The freely rotating roller clusters thus permit the belt to twist on lateral curves without damage to itself while precluding escape of the conveyed material by effectively enclosing it in the tube-shaped, inner belt transport length.

  17. Infrared lateral shearing interferometers

    NASA Astrophysics Data System (ADS)

    Kwon, O.

    1980-04-01

    Recently IR interferometry has received much attention for its special capabilities of testing IR materials, diamond-turned metal mirrors, deep aspherics, unpolished rough surface optics, and other unconventional optics. A CW CO2 laser is used as a coherent light source at 10.6 microns, and germanium and zinc selenide optics are used for lenses and beam splitters. A pyroelectric vidicon (PEV) detects the modulated interference pattern through a TV monitor and video recorder-player. This paper presents three methods of IR lateral shear interferometry using (1) a germanium plane-parallel plate, (2) a Ronchi ruling, and (3) a double-grating lateral shear interferometer.

  18. Lateral Thinking of Prospective Teachers

    ERIC Educational Resources Information Center

    Lawrence, A. S. Arul; Xavier, S. Amaladoss

    2013-01-01

    Edward de Bono who invented the term "lateral thinking" in 1967 is the pioneer of lateral thinking. Lateral thinking is concerned with the generation of new ideas. Liberation from old ideas and the stimulation of new ones are twin aspects of lateral thinking. Lateral thinking is a creative skills from which all people can benefit…

  19. Operative versus non-operative treatment in complex proximal humeral fractures: a meta-analysis of randomized controlled trials.

    PubMed

    Xie, Lin; Ding, Fan; Zhao, Zhigang; Chen, Yan; Xing, Danmou

    2015-01-01

    Whether operative treatment for complex proximal humeral fractures (CPHFs) has a greater benefit over non-operative treatment remains controversial. There is no consensus on the optimal treatment in elderly patients with CPHFs. This updated meta-analysis of randomized controlled trials (RCTs) aims to investigate whether operative treatment is superior to non-operative treatment in CPHFs. The authors searched RCTs in the electronic databases (Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Embase, Springer Link, Web of Knowledge, OVID and Google Scholar) from their establishment to July 2015. Researches on operative and non-operative treatment for CPHFs were selected in this meta-analysis. The quality of all studies was assessed and effective data was pooled for this meta-analysis. Outcome measurements were functional status include constant scores (CS scores) and disabilities of the arm, shoulder and hand scores (DASH scores), total complication rates and healthy-related quality of life. The meta-analysis was performed with software revman 5.3. Nine articles with a total 518 patients (average age 70.93) met inclusion criteria. Patients were followed up for at least 1 year in all the studies. No statistical differences were found between operative and non-operative treatment in CS scores at 12 mo (months) [MD 1.06 95 % CI (-3.51, 5.62)] and 24 mo [MD -0.61 95 % CI (-5.87, 4.65)]. There are also no statistical differences between operative and non-operative treatment in DASH scores at 12 mo [MD -4.51 95 % CI (-13.49, 4.47)] and 24 mo [MD -7.43 95 % CI (-16.14, 1.27)]. Statistical differences were found between operative and non-operative treatment in total complication rates [RR 1.55, 95 % CI (1.24, 1.94)]. Statistical differences in EQ-5D at 24 mo [MD 0.15, 95 % CI (0.05, 0.24)] were found between operative and non-operative treatment but no statistical differences were found in ED-5D at 12 mo [MD 0.08, 95 % CI (-0.01, 0.17)], 15D at 12 mo [MD 0.02, 95 % CI (-0.68, 0.73)] and 15D at 24 mo [MD 0.02, 95 % CI (-0.07, 0.83)]. Operative treatments did not significantly improve the functional outcome and healthy-related quality of life in elderly patients. Instead, Operative treatment for CPHFs led to higher incidence of postoperative complications. PMID:26636016

  20. Editorial Commentary: Results of Biplanar Fluoroscopy With 3-Dimensional Analysis in Patients With Rotator Cuff Tears Challenge the Concept of Superior Translation of the Humeral Head and Must Be Interpreted With Caution.

    PubMed

    Rossi, Michael J

    2016-03-01

    Kinematic analysis of patients with rotator cuff tears shows unexpected inferior, rather than superior, translation of the humeral head. This paradox challenges conventional thought, but limitations addressed by the authors temper the results and leave the question open for future study. PMID:26945951

  1. Conjugal amyotrophic lateral sclerosis

    PubMed Central

    Dewitt, John D.; Kwon, Julia; Burton, Rebecca

    2012-01-01

    Amyotrophic lateral sclerosis (ALS) is a disease characterized by progressive degeneration of motor neurons in the motor cortex, brainstem, and spinal cord. The incidence of sporadic ALS is 1.5 to 2.7 in 100,000, and the prevalence is 5.2 to 6.0 in 100,000. Conjugal ALS is even rarer than sporadic ALS. We report a case of conjugal ALS encountered in our outpatient neurology clinic. PMID:22275781

  2. Amyotrophic lateral sclerosis.

    PubMed

    Malik, Rabia; Lui, Andrew; Lomen-Hoerth, Catherine

    2014-11-01

    Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder affecting 20,000 to 30,000 people in the United States. The mainstay of care of patients affected by this disease is supportive and given the multifaceted nature of their needs is provided most efficiently through multidisciplinary clinics that have shown to prolong survival and improve quality of life. The authors discuss in detail evidence-based management of individuals affected by this condition. PMID:25520025

  3. Treatment of Spontaneous Osteonecrosis of the Tarsal Navicular With a Free Medial Femoral Condyle Vascularized Bone Graft: A New Approach to Managing a Difficult Problem.

    PubMed

    Levinson, Howard; Miller, Kyle J; Adams, Samuel B; Parekh, Selene G

    2013-12-23

    Adult-onset spontaneous osteonecrosis of the tarsal navicular joint, or Mueller-Weiss syndrome (MWS), is an uncommon debilitating disease characterized by a painful clinical course with progressive midfoot deformity. Treatment options include nonoperative management and/or operative intervention, including percutaneous decompression of the navicular bone, stabilization of existing structures, and cancellous bone grafting from the tibia or iliac crest. To our knowledge, there have been no reported cases of treatment of MWS with a vascularized bone graft. We report an unusual case of unilateral MWS in a 25-year-old male who failed nonoperative therapy and was successfully treated with a novel operative approach using debridement followed by a free medial femoral condyle vascularized bone graft. At 18-month follow-up, the patient demonstrated an excellent outcome with return to previous level of function, including work-related and recreational activities. PMID:24368773

  4. Hemispheric lateralization in reasoning.

    PubMed

    Turner, Benjamin O; Marinsek, Nicole; Ryhal, Emily; Miller, Michael B

    2015-11-01

    A growing body of evidence suggests that reasoning in humans relies on a number of related processes whose neural loci are largely lateralized to one hemisphere or the other. A recent review of this evidence concluded that the patterns of lateralization observed are organized according to two complementary tendencies. The left hemisphere attempts to reduce uncertainty by drawing inferences or creating explanations, even at the cost of ignoring conflicting evidence or generating implausible explanations. Conversely, the right hemisphere aims to reduce conflict by rejecting or refining explanations that are no longer tenable in the face of new evidence. In healthy adults, the hemispheres work together to achieve a balance between certainty and consistency, and a wealth of neuropsychological research supports the notion that upsetting this balance results in various failures in reasoning, including delusions. However, support for this model from the neuroimaging literature is mixed. Here, we examine the evidence for this framework from multiple research domains, including an activation likelihood estimation analysis of functional magnetic resonance imaging studies of reasoning. Our results suggest a need to either revise this model as it applies to healthy adults or to develop better tools for assessing lateralization in these individuals. PMID:26426534

  5. Amyotrophic lateral sclerosis

    PubMed Central

    Shoesmith, Christen L.; Strong, Michael J.

    2006-01-01

    OBJECTIVE To discuss the epidemiology, pathogenesis, diagnosis, expected course, prognosis, and treatment of amyotrophic lateral sclerosis (ALS), a degenerative disorder of the nervous system associated with progressive weakness. QUALITY OF EVIDENCE PubMed and the Cochrane Database of Systematic Reviews were searched using the MeSH headings “amyotrophic lateral sclerosis,” “therapy,” “epidemiology,” and “etiology.” Articles containing the best available evidence were reviewed. Most provided level II and III evidence. There were some level I drug trials. MAIN MESSAGE Amyotrophic lateral sclerosis is associated with progressive dysarthria, dysphagia, and weakness in the extremities. Diagnosis is based on physical examination, electrophysiology, and excluding other confounding conditions. There is no cure for this devastating disorder. Certain treatments, however, can improve survival and quality of life. CONCLUSION Because ALS is a complex disease, care of ALS patients is best provided at multidisciplinary clinics that specialize in managing patients with this disorder. PMID:17279237

  6. Treatment of extended osteochondral lesions of the talus with a free vascularised bone graft from the medial condyle of the femur.

    PubMed

    Hintermann, B; Wagener, J; Knupp, M; Schweizer, C; J Schaefer, D

    2015-09-01

    Large osteochondral lesions (OCLs) of the shoulder of the talus cannot always be treated by traditional osteochondral autograft techniques because of their size, articular geometry and loss of an articular buttress. We hypothesised that they could be treated by transplantation of a vascularised corticoperiosteal graft from the ipsilateral medial femoral condyle. Between 2004 and 2011, we carried out a prospective study of a consecutive series of 14 patients (five women, nine men; mean age 34.8 years, 20 to 54) who were treated for an OCL with a vascularised bone graft. Clinical outcome was assessed using a visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. Radiological follow-up used plain radiographs and CT scans to assess graft incorporation and joint deterioration. At a mean follow-up of 4.1 years (2 to 7), the mean VAS for pain had decreased from 5.8 (5 to 8) to 1.8 (0 to 4) (p = 0.001) and the mean AOFAS hindfoot score had increased from 65 (41 to 70) to 81 (54 to 92) (p = 0.003). Radiologically, the talar contour had been successfully reconstructed with stable incorporation of the vascularised corticoperiosteal graft in all patients. Joint degeneration was only seen in one ankle. Treatment of a large OCL of the shoulder of the talus with a vascularised corticoperiosteal graft taken from the medial condyle of the femur was found to be a safe, reliable method of restoring the contour of the talus in the early to mid-term. PMID:26330592

  7. Familial Amyotrophic Lateral Sclerosis.

    PubMed

    Boylan, Kevin

    2015-11-01

    Genes linked to amyotrophic lateral sclerosis (ALS) susceptibility are being identified at an increasing rate owing to advances in molecular genetic technology. Genetic mechanisms in ALS pathogenesis seem to exert major effects in about 10% of patients, but genetic factors at some level may be important components of disease risk in most patients with ALS. Identification of gene variants associated with ALS has informed concepts of the pathogenesis of ALS, aided the identification of therapeutic targets, facilitated research to develop new ALS biomarkers, and supported the establishment of clinical diagnostic tests for ALS-linked genes. PMID:26515623

  8. Functional topography and ultrastructure of periarticular mechanoreceptors in the lateral elbow region of the rat.

    PubMed

    Strasmann, T; van der Wal, J C; Halata, Z; Drukker, J

    1990-01-01

    The distribution and ultrastructure of sensory nerve endings were investigated in the deep lateral elbow region of the rat. Three zones of distribution of mechanoreceptors were distinguished, each in relation to the functional architecture of the connective and muscular tissue in that area: (1) a zone with muscle spindles, Golgi tendon organs, free nerve endings and single small lamellated corpuscles ('muscle-tendon spectrum'), situated in the middle third of the supinator muscle and its superficial aponeurosis; (2) a zone with small lamellated corpuscles and free nerve endings, situated pericapsularly to the humeroradial joint capsule ('shearing spectrum'): this moderately dense, irregular connective tissue is covered by the proximal continuation of the supinator's aponeurosis, and muscle fibers insert from beneath this aponeurosis, which displays, as a part of the joint capsule, a strong collagenous tissue plate; (3) a zone with only free nerve endings within the tendon-like, most proximal part of the supinator's aponeurosis, inserting into the periosteal layer of the lateral humeral epicondyle ('endotenonial spectrum'): it is part of the joint capsule. The ultrastructure of these sensory endings is described and the distribution pattern of the mechanoreceptors observed is discussed in relation to the classification into 'muscle receptors' and 'joint receptors'. PMID:2368595

  9. B-Mode Sonographic Assessment of the Posterior Circumflex Humeral Artery: The SPI-US Protocol-A Technical Procedure in 4 Steps.

    PubMed

    van de Pol, Daan; Maas, Mario; Terpstra, Aart; Pannekoek-Hekman, Marja; Kuijer, P Paul F M; Planken, R Nils

    2016-05-01

    Elite overhead athletes are at risk of vascular injury due to repetitive abduction and external rotation of the dominant arm. The posterior circumflex humeral artery (PCHA) is prone to degeneration, aneurysm formation, and thrombosis in elite volleyball players and baseball pitchers. The prevalence of PCHA-related thromboembolic complications is unknown in this population. However, the prevalence of symptoms associated with digital ischemia is 31% in elite volleyball players. A standardized noninvasive imaging tool will aid in early detection of PCHA injury, prevention of thromboembolic complications, and measurement reproducibility. A standardized vascular sonographic protocol for assessment of the proximal PCHA (SPI-US protocol [Shoulder PCHA Pathology and Digital Ischemia-Ultrasound protocol]) is presented. PMID:27072158

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

    PubMed Central

    Kim, Moon-Hwan; Oh, Jae-Seop

    2015-01-01

    [Purpose] The purpose of this study was to examine the effects of humeral head compression taping (HHCT) on the strength of the shoulder external rotator muscle in patients with rotator cuff tendinitis. [Subjects and Methods] Twenty patients with rotator cuff tendinitis were recruited. The shoulder external rotator strength was measured using a Biodex isokinetic dynamometer system. A paired t-test was performed to evaluate within-group differences in the strength of the shoulder external rotator muscle. [Results] Significantly higher shoulder external rotator peak torque and peak torque per body weight were found in the HHCT condition than in the no-taping condition. [Conclusion] HHCT may effectively increase the shoulder external rotator muscle strength in patients with rotator cuff tendinitis. PMID:25642053

  11. Lateral Lumbar Interbody Fusion.

    PubMed

    Pawar, Abhijit; Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-12-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  12. Creativity in later life.

    PubMed

    Price, K A; Tinker, A M

    2014-08-01

    The ageing population presents significant challenges for the provision of social and health services. Strategies are needed to enable older people to cope within a society ill prepared for the impacts of these demographic changes. The ability to be creative may be one such strategy. This review outlines the relevant literature and examines current public health policy related to creativity in old age with the aim of highlighting some important issues. As well as looking at the benefits and negative aspects of creative activity in later life they are considered in the context of the theory of "successful ageing". Creative activity plays an important role in the lives of older people promoting social interaction, providing cognitive stimulation and giving a sense of self-worth. Furthermore, it is shown to be useful as a tool in the multi-disciplinary treatment of health problems common in later life such as depression and dementia. There are a number of initiatives to encourage older people to participate in creative activities such as arts-based projects which may range from visual arts to dance to music to intergenerational initiatives. However, participation shows geographical variation and often the responsibility of provision falls to voluntary organisations. Overall, the literature presented suggests that creative activity could be a useful tool for individuals and society. However, further research is needed to establish the key factors which contribute to patterns of improved health and well-being, as well as to explore ways to improve access to services. PMID:24974278

  13. Lateral Lumbar Interbody Fusion

    PubMed Central

    Hughes, Alexander; Girardi, Federico; Sama, Andrew; Lebl, Darren; Cammisa, Frank

    2015-01-01

    The lateral lumbar interbody fusion (LLIF) is a relatively new technique that allows the surgeon to access the intervertebral space from a direct lateral approach either anterior to or through the psoas muscle. This approach provides an alternative to anterior lumbar interbody fusion with instrumentation, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion for anterior column support. LLIF is minimally invasive, safe, better structural support from the apophyseal ring, potential for coronal plane deformity correction, and indirect decompression, which have has made this technique popular. LLIF is currently being utilized for a variety of pathologies including but not limited to adult de novo lumbar scoliosis, central and foraminal stenosis, spondylolisthesis, and adjacent segment degeneration. Although early clinical outcomes have been good, the potential for significant neurological and vascular vertebral endplate complications exists. Nevertheless, LLIF is a promising technique with the potential to more effectively treat complex adult de novo scoliosis and achieve predictable fusion while avoiding the complications of traditional anterior surgery and posterior interbody techniques. PMID:26713134

  14. Effects of humeral intraosseous versus intravenous epinephrine on pharmacokinetics and return of spontaneous circulation in a porcine cardiac arrest model: A randomized control trial.

    PubMed

    Johnson, Don; Garcia-Blanco, Jose; Burgert, James; Fulton, Lawrence; Kadilak, Patrick; Perry, Katherine; Burke, Jeffrey

    2015-09-01

    Cardiopulmonary Resuscitation (CPR), defibrillation, and epinephrine administration are pillars of advanced cardiac life support (ACLS). Intraosseous (IO) access is an alternative route for epinephrine administration when intravenous (IV) access is unobtainable. Previous studies indicate the pharmacokinetics of epinephrine administration via IO and IV routes differ, but it is not known if the difference influences return of spontaneous circulation (ROSC). The purpose of this prospective, experimental study was to determine the effects of humeral IO (HIO) and IV epinephrine administration during cardiac arrest on pharmacokinetics, ROSC, and odds of survival. Swine (N = 21) were randomized into 3 groups: humeral IO (HIO), peripheral IV (IV) and CPR/defibrillation control. Cardiac arrest was induced under general anesthesia. The swine remained in arrest for 2 min without intervention. Chest compressions were initiated and continued for 2 min. Epinephrine was administered and serial blood samples collected for pharmacokinetic analysis over 4 min. Defibrillation and epinephrine administration proceeded according to ACLS guidelines continuing for 20 min or until ROSC. Seven HIO swine, 4 IV swine, and no control swine had ROSC. There were no significant differences in ROSC, maximum concentration; except at 30 s, and time-to-concentration-maximum between the HIO and IV groups. Significant differences existed between the experimental groups and the control. The HIO delivers a higher concentration of epinephrine than the IV route at 30 s which may be a survival advantage. Clinicians may consider using the IO route to administer epinephrine during CA when there is no preexisting IV access or when IV access is unobtainable. PMID:26468375

  15. Effects of humeral intraosseous versus intravenous epinephrine on pharmacokinetics and return of spontaneous circulation in a porcine cardiac arrest model: A randomized control trial

    PubMed Central

    Johnson, Don; Garcia-Blanco, Jose; Burgert, James; Fulton, Lawrence; Kadilak, Patrick; Perry, Katherine; Burke, Jeffrey

    2015-01-01

    Cardiopulmonary Resuscitation (CPR), defibrillation, and epinephrine administration are pillars of advanced cardiac life support (ACLS). Intraosseous (IO) access is an alternative route for epinephrine administration when intravenous (IV) access is unobtainable. Previous studies indicate the pharmacokinetics of epinephrine administration via IO and IV routes differ, but it is not known if the difference influences return of spontaneous circulation (ROSC). The purpose of this prospective, experimental study was to determine the effects of humeral IO (HIO) and IV epinephrine administration during cardiac arrest on pharmacokinetics, ROSC, and odds of survival. Swine (N = 21) were randomized into 3 groups: humeral IO (HIO), peripheral IV (IV) and CPR/defibrillation control. Cardiac arrest was induced under general anesthesia. The swine remained in arrest for 2 min without intervention. Chest compressions were initiated and continued for 2 min. Epinephrine was administered and serial blood samples collected for pharmacokinetic analysis over 4 min. Defibrillation and epinephrine administration proceeded according to ACLS guidelines continuing for 20 min or until ROSC. Seven HIO swine, 4 IV swine, and no control swine had ROSC. There were no significant differences in ROSC, maximum concentration; except at 30 s, and time-to-concentration-maximum between the HIO and IV groups. Significant differences existed between the experimental groups and the control. The HIO delivers a higher concentration of epinephrine than the IV route at 30 s which may be a survival advantage. Clinicians may consider using the IO route to administer epinephrine during CA when there is no preexisting IV access or when IV access is unobtainable. PMID:26468375

  16. Improved clinical use of Twin-block and Herbst as a result of radiating viscoelastic tissue forces on the condyle and fossa in treatment and long-term retention: growth relativity.

    PubMed

    Voudouris, J C; Kuftinec, M M

    2000-03-01

    Understanding mechanisms of action for orthopedic appliances is critical for orthodontists who hope to treat and retain the achieved corrections in patients with initial Class II mandibular retrognathism. That knowledge can help orthodontists produce clinically significant bone formation and avoid compression at the condyle-glenoid fossa region. It also assists us to understand the differences between short-term and long-term treatment results. It was previously thought that increased activity in the postural masticatory muscles was the key to promoting condyle-glenoid fossa growth. By analyzing results from several studies, we postulate that growth modification is associated with decreased activity, which leads to our nonmuscular hypothesis. This premise has its foundation on 3 key specific findings: significant glenoid fossa bone formation occurs during treatment that includes mandibular displacement; glenoid fossa modification is a result of the stretch forces of the retrodiskal tissues, capsule, and altered flow of viscous synovium; observations that glenoid fossa bone formation takes place a distance from the soft tissue attachment. The latter observation is explained by transduction or referral of forces. Evidence is presented, therefore, that the 3 trigger switches for glenoid fossa growth can similarly initiate short-term condylar growth modifications because the 2 structures are contiguous. These are displacement, several direct viscoelastic connections, and transduction of forces. Histologic evidence further shows that stretched retrodiskal tissues also insert directly into the condylar head's fibrocartilaginous layer. The impact of the viscoelastic tissues may be highly significant and should be considered along with the standard skeletal, dental, neuromuscular, and age factors that influence condyle-glenoid fossa growth with orthopedic advancement. These biodynamic factors are also capable of reversing effects of treatment on mandibular growth direction, size, and morphology. Relapse occurs as a result of release of the condyle and ensuing compression against the newly proliferated retrodiskal tissues together with the reactivation of muscle activity. To describe condyle-glenoid fossa growth modification, an analogy is made to a light bulb on a dimmer switch. The condyle illuminates in treatment, dims down in the retention period, to near base levels over the long-term. PMID:10715086

  17. Lateral conduction infrared photodetector

    DOEpatents

    Kim, Jin K.; Carroll, Malcolm S.

    2011-09-20

    A photodetector for detecting infrared light in a wavelength range of 3-25 .mu.m is disclosed. The photodetector has a mesa structure formed from semiconductor layers which include a type-II superlattice formed of alternating layers of InAs and In.sub.xGa.sub.1-xSb with 0.ltoreq.x.ltoreq.0.5. Impurity doped regions are formed on sidewalls of the mesa structure to provide for a lateral conduction of photo-generated carriers which can provide an increased carrier mobility and a reduced surface recombination. An optional bias electrode can be used in the photodetector to control and vary a cut-off wavelength or a depletion width therein. The photodetector can be formed as a single-color or multi-color device, and can also be used to form a focal plane array which is compatible with conventional read-out integrated circuits.

  18. Lateral Flow Immunoassay.

    PubMed

    Ching, Kathryn H

    2015-01-01

    Lateral flow immunoassays (LFIAs) are a staple in the field of rapid diagnostics. These small handheld devices require no specialized training or equipment to operate, and generate a result within minutes of sample application. They are an ideal format for many types of home test kits, for emergency responders and for food manufacturers and producers looking for a quick evaluation of a given sample. LFIAs rely on high quality monoclonal antibodies that recognize the analyte of interest. As monoclonal antibody technology becomes more accessible to smaller laboratories, there has been increased interest in developing LFIA prototypes for potential commercial manufacture. In this chapter, the basics of designing and building an LFIA prototype are described. PMID:26160571

  19. Lateral asymmetry of the Hoffmann reflex: relation to cortical laterality.

    PubMed Central

    Goode, D J; Glenn, S; Manning, A A; Middleton, J F

    1980-01-01

    Lateral asymmetry of the Hoffmann reflex (H-reflex) recovery curve was found in seven subjects with no personal or family history of neurological or psychiatric disorder. Differences between recovery curves from the right and left leg were larger than differences in the same leg on two successive test days. In a group of 27 psychiatric inpatients, lateral asymmetry of the later portion of the recovery curve was correlated with cortical laterality, as measured by selective identification of differing verbal stimuli presented simultaneously to both ears (DL) and to total laterality scores, a sum of visual half-field, DL, and motor laterality scores. Asymmetry of the recovery curve is related in part to cortical laterality, possibly through selective activation of cortical motor centres on the preferred side. PMID:7420106

  20. Reflexive Planning for Later Life

    ERIC Educational Resources Information Center

    Denton, Margaret A.; Kemp, Candace L.; French, Susan; Gafni, Amiram; Joshi, Anju; Rosenthal, Carolyn J.; Davies, Sharon

    2004-01-01

    Informed by Giddens' (1991) concept of "reflexive life" planning and the notion of later life as a time of increasing social and financial risk, this research explores the idea of "reflexive planning for later life". We utilize a conceptual model that incorporates three types of planning for later life: public protection, self-insurance, and…

  1. Quantitative Anatomical Study of Tailored Far-Lateral Approach for the VA-PICA Regions

    PubMed Central

    Kim, Young-Don; Mendes, George A.C.; Seoane, Pablo; Agrawal, Abhishek; Maramreddy, Naveen; Nakaji, Peter; Spetzler, Robert F.; Preul, Mark C.

    2014-01-01

    Objective?The extent of the far-lateral approach (FLA) has not yet been quantified for the region of the vertebral and posterior inferior cerebellar arteries (VA-PICA). We quantitatively analyzed six main sequential steps of the FLA. Methods?A modified small FLA (msFLA) and a classic large FLA (clFLA) were performed sequentially on both sides of five cadaveric heads. A frameless navigational system was used to quantify the angle of attack for the origin (T1) and lateral medullary segment (T2) of the PICA and the surgical area of exposure above and below the vagus nerve (cranial nerve [CN] X). Results?The total area of exposure above CN X increased significantly (p??0.05). C1 hemilaminectomy increased (p?condyle increased (p?

  2. The Lateral Skull Base

    PubMed Central

    Gadre, Arun K.; O'Leary, Michael J.; Zakhary, Rizkalla; Linthicum, Fred H.; House, William F.

    1991-01-01

    The growing number of options in the surgical management of skull base disease has renewed interest in the microvascular anatomy of the lateral temporal region. We studied this anatomy by injecting colored solutions of methyl methacrylate into the major blood vessels of six human cadaver heads or selectively into their major branches. We used several techniques to see the vascular anatomy and to study its relationship to the layers of the scalp. Results revealed that every anatomically named blood vessel was accompanied by a finer, deeper blood vessel supplying the periosteum and outer table of the skull. These vessels arborized into a network of capillaries in the periosteum adherent to the outer bony cortex, from which we saw tiny perforators entering bone. This layered blood supply has direct implications for both ablative and reconstructive surgery for skull base disease. We also saw a previously undescribed arterial plexus accompanying the commonly described venous plexus in the infratemporal fossa. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7 PMID:17170831

  3. Amyotrophic Lateral Sclerosis: Review.

    PubMed

    Salameh, Johnny S; Brown, Robert H; Berry, James D

    2015-08-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease primarily affecting the upper and lower motor neurons. The lifetime risk of developing ALS is estimated at 1:350 for men and 1:500 for women, higher for those who have served in the military. The diagnosis remains clinical with electrodiagnostic support. Alternative diagnoses can usually be ruled out by the use of neuroimaging studies and laboratory evaluation. Perhaps because ALS is a diagnosis of exclusion, there is a substantial delay in diagnosis, upward of 12 months after the onset of symptoms, and most patients see three or more providers in the course of the diagnostic process. Once diagnosed, patients are best medically managed in a multidisciplinary care setting, an approach that has been shown to prolong survival and improve quality of life. Riluzole is the only disease-modifying therapy approved by the Food and Drug Administration, but numerous symptomatic therapies exist. In the past 20 years, ALS has become the focus of intense investigation by a worldwide community of basic scientists, and for clinical investigators the disease is an active area of research, with stem cell therapies, gene therapies, and a host of small molecule agents under investigation at various stages of clinical and preclinical development. PMID:26502769

  4. Diamond heteroepitaxial lateral overgrowth

    NASA Astrophysics Data System (ADS)

    Tang, Yung-Hsiu

    This dissertation describes improvements in the growth of single crystal diamond by microwave plasma-assisted chemical vapor deposition (CVD). Heteroepitaxial (001) diamond was grown on 1 cm. 2 a-plane sapphiresubstrates using an epitaxial (001) Ir thin-film as a buffer layer. Low-energy ion bombardment of the Ir layer, a process known as bias-enhanced nucleation, is a key step in achieving a high density of diamond nuclei. Bias conditions were optimized to form uniformly-high nucleation densities across the substrates, which led to well-coalesced diamond thin films after short growth times. Epitaxial lateral overgrowth (ELO) was used as a means of decreasing diamond internal stress by impeding the propagation of threading dislocations into the growing material. Its use in diamond growth requires adaptation to the aggressive chemical and thermal environment of the hydrogen plasma in a CVD reactor. Three ELO variants were developed. The most successful utilized a gold (Au) mask prepared by vacuum evaporation onto the surface of a thin heteroepitaxial diamond layer. The Au mask pattern, a series of parallel stripes on the micrometer scale, was produced by standard lift-off photolithography. When diamond overgrows the mask, dislocations are largely confined to the substrate. Differing degrees of confinement were studied by varying the stripe geometry and orientation. Significant improvement in diamond quality was found in the overgrown regions, as evidenced by reduction of the Raman scattering linewidth. The Au layer was found to remain intact during diamond overgrowth and did not chemically bond with the diamond surface. Besides impeding the propagation of threading dislocations, it was discovered that the thermally-induced stress in the CVD diamond was significantly reduced as a result of the ductile Au layer. Cracking and delamination of the diamond from the substrate was mostly eliminated. When diamond was grown to thicknesses above 0.1 mm it was found that crystallographic perfection continuously improved, leading to a diamond surface nearly free of stress.

  5. The influence of various resistance loads on the ratio of activity of the external rotator muscles of the shoulder and the anterior gliding of the humeral head during external rotation exercise

    PubMed Central

    Jo, Marg-Eun; Lee, Seung-Min; Jang, Jun-Hyeok; Lee, Sang-Yeol

    2015-01-01

    [Purpose] To quantify the ratio of activation of the infraspinatus and posterior deltoid muscles and the anterior gliding motion of the humeral head during external rotation (ER) motions of the shoulder performed in prone position against different external resistance loads. [Subjects] Twenty healthy women between the ages of 20 and 30?years. [Methods] Activity ratio was quantified as the difference in the root mean square of the smoothed electromyography signal (EMG) of the posterior deltoid to the infraspinatus muscle, and anterior gliding pressure of the humeral head using a pressure biofeedback unit (PBU), for three resistance loads: 0, 1 and 2?kg. [Results] There was a significant correlation among all three variables (load, ratio, and pressure). Anterior gliding pressure correlated with the activity ratio, with activity of the posterior deltoid increasing with the magnitude of the resistance load. [Conclusion] There was a positive association between the magnitude of resistance load, activity of the posterior deltoid and anterior gliding pressure of the humeral head. The PBU could be used to facilitate the recruitment of the infraspinatus muscle at higher loads to improve glenohumeral joint stability during ER exercise against higher resistance. PMID:26644683

  6. The influence of various resistance loads on the ratio of activity of the external rotator muscles of the shoulder and the anterior gliding of the humeral head during external rotation exercise.

    PubMed

    Jo, Marg-Eun; Lee, Seung-Min; Jang, Jun-Hyeok; Lee, Sang-Yeol

    2015-10-01

    [Purpose] To quantify the ratio of activation of the infraspinatus and posterior deltoid muscles and the anterior gliding motion of the humeral head during external rotation (ER) motions of the shoulder performed in prone position against different external resistance loads. [Subjects] Twenty healthy women between the ages of 20 and 30 years. [Methods] Activity ratio was quantified as the difference in the root mean square of the smoothed electromyography signal (EMG) of the posterior deltoid to the infraspinatus muscle, and anterior gliding pressure of the humeral head using a pressure biofeedback unit (PBU), for three resistance loads: 0, 1 and 2 kg. [Results] There was a significant correlation among all three variables (load, ratio, and pressure). Anterior gliding pressure correlated with the activity ratio, with activity of the posterior deltoid increasing with the magnitude of the resistance load. [Conclusion] There was a positive association between the magnitude of resistance load, activity of the posterior deltoid and anterior gliding pressure of the humeral head. The PBU could be used to facilitate the recruitment of the infraspinatus muscle at higher loads to improve glenohumeral joint stability during ER exercise against higher resistance. PMID:26644683

  7. Diminished Cartilage Creep Properties and Increased Trabecular Bone Density Following a Single, Sub-Fracture Impact of the Rabbit Femoral Condyle

    PubMed Central

    Borrelli, Joseph; Zaegel, Melissa A.; Martinez, Mario D.; Silva, Matthew J.

    2013-01-01

    Traumatic injury to articular cartilage can lead to post-traumatic arthritis. We used a custom pendulum device to deliver a single, near-fracture impact to the medial femoral condyles of rabbits. Impact was localized to a region ~3 mm in diameter, and impact stress averaged ~100 MPa. Animals were euthanized at 0, 1 and 6 months after impact. Cartilage mechanical properties from impacted and sham knees were evaluated by creep-indentation testing and periarticular trabecular bone was evaluated by microCT and histomorphometry. Impact caused immediate and statistically significant loss of cartilage thickness (-40% vs. sham) and led to a greater than two-fold increase in creep strain. From 0 to 6 months after impact, the ability of cartilage to recover from creep deformation became significantly impaired (percent recovery different from control at 1 and 6 months). At 1 month, there was a 33% increase in the trabecular bone volume fraction of the epiphysis beneath the site of impact compared to control, and increased bone formation was observed histologically. Taken together, these findings demonstrate that a single, high-energy impact below the fracture threshold leads to acute deleterious changes in the viscoelastic properties of articular cartilage that worsen with time, while at the same time stimulating increased bone formation beneath the impact site. PMID:20225288

  8. Evaluation of injectable strontium-containing borate bioactive glass cement with enhanced osteogenic capacity in a critical-sized rabbit femoral condyle defect model.

    PubMed

    Zhang, Yadong; Cui, Xu; Zhao, Shichang; Wang, Hui; Rahaman, Mohamed N; Liu, Zhongtang; Huang, Wenhai; Zhang, Changqing

    2015-02-01

    The development of a new generation of injectable bone cements that are bioactive and have enhanced osteogenic capacity for rapid osseointegration is receiving considerable interest. In this study, a novel injectable cement (designated Sr-BBG) composed of strontium-doped borate bioactive glass particles and a chitosan-based bonding phase was prepared and evaluated in vitro and in vivo. The bioactive glass provided the benefits of bioactivity, conversion to hydroxyapatite, and the ability to stimulate osteogenesis, while the chitosan provided a cohesive biocompatible and biodegradable bonding phase. The Sr-BBG cement showed the ability to set in situ (initial setting time = 11.6 ± 1.2 min) and a compressive strength of 19 ± 1 MPa. The Sr-BBG cement enhanced the proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stem cells in vitro when compared to a similar cement (BBG) composed of chitosan-bonded borate bioactive glass particles without Sr. Microcomputed tomography and histology of critical-sized rabbit femoral condyle defects implanted with the cements showed the osteogenic capacity of the Sr-BBG cement. New bone was observed at different distances from the Sr-BBG implants within eight weeks. The bone-implant contact index was significantly higher for the Sr-BBG implant than it was for the BBG implant. Together, the results indicate that this Sr-BBG cement is a promising implant for healing irregularly shaped bone defects using minimally invasive surgery. PMID:25591177

  9. Amyotrophic lateral sclerosis

    PubMed Central

    Wijesekera, Lokesh C; Leigh, P Nigel

    2009-01-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterised by progressive muscular paralysis reflecting degeneration of motor neurones in the primary motor cortex, corticospinal tracts, brainstem and spinal cord. Incidence (average 1.89 per 100,000/year) and prevalence (average 5.2 per100,000) are relatively uniform in Western countries, although foci of higher frequency occur in the Western Pacific. The mean age of onset for sporadic ALS is about 60 years. Overall, there is a slight male prevalence (M:F ratio~1.5:1). Approximately two thirds of patients with typical ALS have a spinal form of the disease (limb onset) and present with symptoms related to focal muscle weakness and wasting, where the symptoms may start either distally or proximally in the upper and lower limbs. Gradually, spasticity may develop in the weakened atrophic limbs, affecting manual dexterity and gait. Patients with bulbar onset ALS usually present with dysarthria and dysphagia for solid or liquids, and limbs symptoms can develop almost simultaneously with bulbar symptoms, and in the vast majority of cases will occur within 1–2 years. Paralysis is progressive and leads to death due to respiratory failure within 2–3 years for bulbar onset cases and 3–5 years for limb onset ALS cases. Most ALS cases are sporadic but 5–10% of cases are familial, and of these 20% have a mutation of the SOD1 gene and about 2–5% have mutations of the TARDBP (TDP-43) gene. Two percent of apparently sporadic patients have SOD1 mutations, and TARDBP mutations also occur in sporadic cases. The diagnosis is based on clinical history, examination, electromyography, and exclusion of 'ALS-mimics' (e.g. cervical spondylotic myelopathies, multifocal motor neuropathy, Kennedy's disease) by appropriate investigations. The pathological hallmarks comprise loss of motor neurones with intraneuronal ubiquitin-immunoreactive inclusions in upper motor neurones and TDP-43 immunoreactive inclusions in degenerating lower motor neurones. Signs of upper motor neurone and lower motor neurone damage not explained by any other disease process are suggestive of ALS. The management of ALS is supportive, palliative, and multidisciplinary. Non-invasive ventilation prolongs survival and improves quality of life. Riluzole is the only drug that has been shown to extend survival. PMID:19192301

  10. The Efficacy of Intra-Articular Injections for Pain Control Following the Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures

    PubMed Central

    Georgopoulos, Gaia; Carry, Patrick; Pan, Zhaoxing; Chang, Frank; Heare, Travis; Rhodes, Jason; Hotchkiss, Mark; Miller, Nancy H.; Erickson, Mark

    2012-01-01

    Background: The purpose of this single-blinded, randomized, controlled trial was to compare the analgesic efficacy of intra-articular injections of bupivacaine or ropivacaine with that of no injection for postoperative pain control after the operative treatment of supracondylar humeral fractures in a pediatric population. Methods: Subjects (n = 124) were randomized to treatment with 0.25% bupivacaine (Group B) (n = 42), 0.20% ropivacaine (Group R) (n = 39), or no injection (Group C) (n = 43). The opioid doses and the times of administration as well as child-reported pain severity (Faces Pain Scale-Revised) and parent-reported pain severity (Total Quality Pain Management survey) were recorded. Results: The proportion of subjects who required morphine and/or fentanyl injections was significantly (p = 0.004) lower in Group B (10%) as compared with Group R (36%) and Group C (44%). On the basis of the log-rank test, the opioid-free survival rates were significantly greater in Group B as compared to Groups C and R. Total opioid consumption (morphine equivalent mg/kg) in the first seventy-two hours postoperatively was significantly less in Group B as compared with Group C (mean difference, 0.225; [95% confidence interval (CI), 0.0152 to 0.435]; p = 0.036). Parent-reported pain scores were also significantly lower in Group B as compared with both Group C (mean difference, 1.81 [95% CI, 0.38 to 3.25]; p = 0.014) and Group R (mean difference, 1.66; 95% CI, 0.20 to 3.12; p = 0.027). There were no significant differences across the three groups in terms of self-reported pain. Differences between Groups R and C were not significant for any of the outcome variables. Conclusions: The intra-articular injection of 0.25% bupivacaine significantly improves postoperative pain control following the closed reduction and percutaneous pinning of supracondylar humeral fractures in pediatric patients. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. PMID:22878686

  11. The significance of laterality effects.

    PubMed Central

    Warrington, E K; Pratt, R T

    1981-01-01

    Language laterality can be unequivocally ascertained by comparing the effects of unilateral ECT to the right and the left hemisphere. It has been shown in right-handed depressed patients that a unilateral treatment to the left hemisphere resulted in transient dysphasia whereas unilateral ECT to the right hemisphere did not. The language laterality in a small group of left-handed depressed patients has been ascertained. Evidence is presented to show that neither dichotic listening nor hand position for writing provide satisfactory indices of language laterality. The ear advantage was more closely related to strength of sinistrality than to language laterality--that is sidedness appears to overide brainedness. The results favour a spatial attention hypothesis rather than a structural hypothesis as the main determinant of laterality effects. PMID:7229640

  12. A review of the evolution of intraosseous access in tactical settings and a feasibility study of a human cadaver model for a humeral head approach.

    PubMed

    Rush, Stephen; D'Amore, Jason; Boccio, Eric

    2014-08-01

    In the tactical setting, intraosseous (IO) access has become popular to treat hemorrhagic shock when peripheral intravenous access is difficult or impractical. The traditional sites most commonly used by combat medics, corpsmen, and Pararescuemen (PJs) include the sternum and tibial tuberosity. Recent studies have shown that the humeral head (HH) is an appropriate and effective access site for IO infusion and fluid resuscitation in the clinical setting. In this procedural feasibility study, we assessed the ability of 26 U.S. Air Force PJs to perform HH IO placement on fresh, unfixed human cadavers over two consecutive cadaver lab training sessions. Following a formal didactic session, which highlighted proper patient positioning and technique, the PJs were instructed to attempt to place an IO needle using both a drill and manual driver. Once performed, correct placement was reviewed by a physician and confirmed by aspiration of bone marrow. Rates of success were calculated on first and second pass. First pass success rates were 96% and 90.5% for the drill and driver, respectively. Both devices achieved 100% success by the second pass. Military field personnel would benefit from a HH approach, especially in the care and management of patients of explosive injuries. PMID:25102545

  13. Complications of Lateral Epicondylar Release.

    PubMed

    Pomerantz, Michael Lucius

    2016-04-01

    Reported complication rates are low for lateral epicondylitis management, but the anatomic complexity of the elbow allows for possible catastrophic complication. This review documents complications associated with lateral epicondylar release: 67 studies reporting outcomes of lateral epicondylar release with open, percutaneous, or arthroscopic methods were reviewed and 6 case reports on specific complications associated with the procedure are included. Overall complication rate was 3.3%. For open procedures it was 4.3%, percutaneous procedures 1.9%, and arthroscopic procedures 1.1%. In higher-level studies directly comparing modalities, the complication rates were 1.3%, 0%, and 1.2%, respectively. PMID:26772953

  14. Lateral Dominance and Reading Disability.

    ERIC Educational Resources Information Center

    Harris, Albert J.

    1979-01-01

    Theory and research on the relation of lateral dominance to the causation of reading disability are reviewed. Both direct and indirect measures of cerebral hemisphere functioning are considered. (SBH)

  15. Lateral collateral ligament (LCL) injury

    MedlinePlus

    LCL injury; Knee injury - lateral collateral ligament (LCL) ... ligament helps keep the outer side of the knee joint stable. ... by pressure or an injury that pushes the knee joint from the inside, which results in stress ...

  16. Advantage of Minimally Invasive Lateral Approach Relative to Conventional Deltopectoral Approach for Treatment of Proximal Humerus Fractures

    PubMed Central

    Liu, Kuan; Liu, Peng-cheng; Liu, Run; Wu, Xing

    2015-01-01

    Background Despite the wide application of open reduction and internal fixation with locking plates for the treatment of proximal humeral fractures, the surgical invasive approach remains controversial. This study aimed to evaluate the pros and cons of the minimally invasive lateral approach for the treatment of proximal humeral fracture (PHF) in comparison with the deltopectoral approach. Material/Methods All patients who sustained a PHF and received open reduction and internal fixation (ORIF) surgery with locking plate through either minimally invasive subacromial approach or conventional deltopectoral approach between January 2008 and February 2012 were retrospectively analyzed. Patients were divided into the conventional group and min-group according to the surgical incision. Surgery-related information, postoperative radiography, complications, and shoulder functional measurement scores in a 2-year follow-up were collected and evaluated. Results Ninety-one patients meeting the inclusion criteria were included in this study. We observed a significant difference in both surgery time (81.818.3 vs. 91.018.4) (p=0.021) and blood loss (17254.2 vs. 20573.6) (p=0.016) between the min-group and conventional group. Compared to the conventional group, the min-group had significantly better Constant-Murley score and DASH score at early follow-up (p<0.05) and higher patients satisfaction rate (8.11.1 vs. 7.61.2) (p= 0.019). The multiple linear regression analysis indicated that age, PHF types, surgical groups, surgery time, and blood loss have significant effect on the activity of affected shoulder in both abduction and forward flexion (p<0.05) except for gender factor. While larger range of movement of the affected shoulder, mainly in the 2-part and 3-part fractures, was observed in the min-group, the conventional group obtained better movement in the 4-part fractures. Conclusions The minimally invasive lateral approach is the optimal alternative for the treatment of Neers type 2 and 3 proximal humerus fractures. PMID:25682320

  17. [Multivariate prediction of breeding values for canine hip and elbow dysplasia as well as humeral osteochondrosis in the Bernese mountain dog].

    PubMed

    Hartmann, Peter; Stock, Kathrin-Friederike; Distl, Ottmar

    2012-01-01

    The aim of this study was the multivariate prediction of breeding values for canine hip dysplasia (CHD), elbow dysplasia (ED) and humeral osteochondrosis (OCD) for Bernese mountain dogs of the Schweizer Sennenhund-Verein für Deutschland e. V. (SSV). For the analysis the pedigrees of eight generations and radiographic screening results of the birth cohorts from 1995-2008 were used. The number of dogs with scores for CHD was 5513, for ED 5175 and OCD 1240. Breeding values were multivariately predicted using a mixed linear model for CHD, ED and OCD as well as for the occurrence of a fragmented coronoid process of the medial ulna (FCP) and the ED-score without FCP. The pedigree breeding value (eRZWp) which is used as the selection criterion reached a reliability to predict the phenotype of the offspring at 2.8-2.9% for CHD, 2.9% for ED, 1.1% for ED without FCP, 1.8% for FCP and 0.8-1.3% for OCD. The reason for the low predictive value of the eRZW(P) is caused by the very high influence of the own performance of the animal and the very uniform distribution of contributions of the breeding values of the relatives.These results indicate that even a multivariate prediction of breeding values does not lead to a faster progress in breeding against CHD and ED, however, does allow breeding against OCD in the Bernese mountain dog. In comparison to phenotypic selection, there is some improvement in the selection response when using breeding values. Due to the general low predictive power of breeding values better approaches for selection of future breeding animals are urgently warranted to achieve improvements in breeding Bernese mountain dogs. PMID:23045807

  18. Investigation of the mechanical behavior of kangaroo humeral head cartilage tissue by a porohyperelastic model based on the strain-rate-dependent permeability.

    PubMed

    Thibbotuwawa, Namal; Oloyede, Adekunle; Senadeera, Wijitha; Li, Tong; Gu, YuanTong

    2015-11-01

    Solid-interstitial fluid interaction, which depends on tissue permeability, is significant to the strain-rate-dependent mechanical behavior of humeral head (shoulder) cartilage. Due to anatomical and biomechanical similarities to that of the human shoulder, kangaroos present a suitable animal model. Therefore, indentation experiments were conducted on kangaroo shoulder cartilage tissues from low (10(-4)/s) to moderately high (10(-2)/s) strain-rates. A porohyperelastic model was developed based on the experimental characterization; and a permeability function that takes into account the effect of strain-rate on permeability (strain-rate-dependent permeability) was introduced into the model to investigate the effect of rate-dependent fluid flow on tissue response. The prediction of the model with the strain-rate-dependent permeability was compared with those of the models using constant permeability and strain-dependent permeability. Compared to the model with constant permeability, the models with strain-dependent and strain-rate-dependent permeability were able to better capture the experimental variation at all strain-rates (p < 0.05). Significant differences were not identified between models with strain-dependent and strain-rate-dependent permeability at strain-rate of 5 × 10(-3)/s (p = 0.179). However, at strain-rate of 10(-2)/s, the model with strain-rate-dependent permeability was significantly better at capturing the experimental results (p < 0.005). The findings thus revealed the significance of rate-dependent fluid flow on tissue behavior at large strain-rates, which provides insights into the mechanical deformation mechanisms of cartilage tissues. PMID:26275487

  19. Borehole optical lateral displacement sensor

    DOEpatents

    Lewis, R.E.

    1998-10-20

    There is provided by this invention an optical displacement sensor that utilizes a reflective target connected to a surface to be monitored to reflect light from a light source such that the reflected light is received by a photoelectric transducer. The electric signal from the photoelectric transducer is then imputed into electronic circuitry to generate an electronic image of the target. The target`s image is monitored to determine the quantity and direction of any lateral displacement in the target`s image which represents lateral displacement in the surface being monitored. 4 figs.

  20. The Effect of Emboss Enhancement on Reliability of Landmark Identification in Digital Lateral Cephalometric Images

    PubMed Central

    Nikneshan, Sima; Mohseni, Sudeh; Nouri, Mahtab; Hadian, Hoora; Kharazifard, Mohammad Javad

    2015-01-01

    Background: Evaluation of the craniofacial bones is the oldest method to measure the facial proportion ratio in orthodontics. Objectives: The purpose of this study was to evaluate the effect of emboss enhancement on the reliability of landmark identification in digital lateral cephalometric images. Materials and Methods: Ten digital lateral cephalograms were selected from the archive of an oral and maxillofacial radiology center. Using DIGORA software, these images were saved in two formats; common images and 3D emboss images. On these images, 32 skeletal, dental, and soft tissue landmarks were marked at least twice with a 2-week interval by four observers (two radiologists and two orthodontists). In order to determine the position of the marked landmarks (in x and y coordinates), a software was designed. The statistical analysis was performed in SPSS software and the reliability of each observer was obtained by means of intraclass correlation coefficient (ICC). Results: In three skeletal landmarks [Orbit (Or), condyl top (Cond), and pogonion (Pog)], the enhancement caused significant reduction in the reliability, and in four skeletal [Anterior Nasal Spine (ANS), B, A, and Basion (Ba)], two dental (U1 root, L1 incisal), and one soft tissue landmark (Menton soft tissue), the enhancement increased the reliability of landmark detection between the two phases of the study. Totally, ICC of embossed images in both x and y coordinates were greater than the typical images, but the difference was not statistically significant. However, the effect of enhancement on the improvement of the reliability of landmark identification was higher in the x-axis than the y-axis. Conclusions: Using embossed images is only effective in increasing the reliability of detection in a few numbers of cephalometric landmarks. PMID:26060555

  1. Laterality effects for tactile patterns.

    PubMed

    Minami, K; Kay, V; Bryden, M P; Free, T

    1994-01-01

    A series of studies was carried out to investigate laterality effects in the discrimination of tactile patterns presented to the fingertips of right-handed subjects. When both hands were stimulated simultaneously, a small right-hand advantage (RHA) was observed for a sequential task and a small left-hand advantage (LHA) was found for a spatial task, but only in women and only when there was a delay or mask between presentation and response. This may indicate different attentional strategies for men and women, or better shielding against interhemispheric interference in women. When only one hand was stimulated at a time (unimanual tasks), no laterality effects were found with sequential tasks, but a substantial RHA for a spatial task was observed. Because the unimanual spatial task involves more possible alternatives than the unimanual sequential ones, this RHA may be a consequence of increased information load rather than a the spatial/sequential distinction. While laterality effects in tactile laterality studies are relatively inconsistent, there are clear differences between bimanual and unimanual presentation. Effects related to hemispheric specialization are much more evident with bilateral presentation. PMID:7928115

  2. Living Arrangements in Later Life.

    ERIC Educational Resources Information Center

    Frazier, Billie H.

    This document contains a brief bibliography of peer-reviewed literature, with abstracts, on living arrangements in later life. It is one of 12 bibliographies on aging prepared by the National Agricultural Library for its "Pathfinders" series of publications. Topics covered by the other 11 bibliographies include aging parents, adult children,…

  3. [Cochlear implantation by lateral petrosectomy].

    PubMed

    Niemczyk, Kazimierz; Bruzgielewicz, Antoni; Maniecka-Aleksandrowicz, Barbara; Mikołajewska, Lidia; Piotrowski, Juliusz; Mazur, Agata; Stykowska, Małgorzata; Kilijańska, Irena

    2003-01-01

    Cochlear implantation by facial recess is nowadays the approach of choice in normal anatomical conditions in the middle and inner ear. When deafness is coincident with chronic otitis media or partial obliteration of the cochlea, others approaches can be applied. Authors presented lateral petrosectomy as an approach for cochlear implantation in two cases. In both patients all the electrodes were inserted. There were any complications in postoperative period. Lateral petrosectomy is nowadays well codified technique. It is possible to apply this approach for cochlear implantation in cases with chronic otitis media. Good access to the cochlea especially to its basal turn allows for good insertion even in partial obliteration of the scala tympani. PMID:15049189

  4. [Fractures of the lateral clavicle].

    PubMed

    Koppe, D; Reilmann, H

    2010-01-01

    Fractures of the lateral clavicle end account for 12-15 percent of all clavicle fractures. In contrast to the clear treatment of midshaft fractures the therapy of the distal third is still open to controversy. The high non-union rate up to 40 percent that occurs with the lateral end fractures shows the special biomechanical mechanisms. The role of the coracoclavicular ligaments is comparable to the acromioclavicular joint disruption. To make a clear decision about the therapy we need a treatment based classification such as the one by Jäger and Breitner, which distinguishes four different fracture types. The treatment options reach from conservative therapy up to numerous different operative techniques. The aim of this article is to demonstrate a simple and save way for the diagnosis and therapy of that special kind of fracture. PMID:20020094

  5. Lateral dampers for thrust bearings

    NASA Technical Reports Server (NTRS)

    Hibner, D. H.; Szafir, D. R.

    1985-01-01

    The development of lateral damping schemes for thrust bearings was examined, ranking their applicability to various engine classes, selecting the best concept for each engine class and performing an in-depth evaluation. Five major engine classes were considered: large transport, military, small general aviation, turboshaft, and non-manrated. Damper concepts developed for evaluation were: curved beam, constrained and unconstrained elastomer, hybrid boost bearing, hydraulic thrust piston, conical squeeze film, and rolling element thrust face.

  6. Management of amyotrophic lateral sclerosis.

    PubMed

    Bali, Taha; Miller, Timothy M

    2013-01-01

    Motor Neuron Diseases (MNDs) are neurological disorders characterized by the selective and progressive degeneration of motor neurons. Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig's disease, is the most common. ALS causes diffuse muscle weakness and death secondary to respiratory failure. The diagnosis is made clinically, supported by electrodiagnostic testing. Although medications are limited, careful attention to breathing, nutrition, and patient mobility can have a major, positive impact on the course of the disease. PMID:24279194

  7. Subcortical Laterality of Speech Encoding

    PubMed Central

    Hornickel, Jane; Skoe, Erika; Kraus, Nina

    2009-01-01

    It is well established that in the majority of the population language processing is lateralized to the left hemisphere. Evidence suggests that lateralization is also present in the brainstem. In the current study, the syllable /da/ was presented monaurally to the right and left ears and electrophysiological responses from the brainstem were recorded in adults with symmetrical interaural click-evoked responses. Responses to the right-ear presentation occurred earlier than those to left-ear presentation in two peaks of the frequency following response (FFR) and approached significance for the third peak of the FFR and the offset peak. Interestingly, there were no differences in interpeak latencies indicating the response to right-ear presentation simply occurred earlier over this region. Analyses also showed more robust frequency encoding when stimuli were presented to the right ear than the left ear. The effect was found for the harmonics of the fundamental that correspond to the first formant of the stimulus, but was not seen in the fundamental frequency range. The results suggest that left lateralization of processing acoustic elements important for discriminating speech extends to the auditory brainstem and that these effects are speech specific. PMID:19122453

  8. 49 CFR 229.63 - Lateral motion.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Lateral motion. 229.63 Section 229.63....63 Lateral motion. (a) Except as provided in paragraph (b), the total uncontrolled lateral motion... powered axles. (b) The total uncontrolled lateral motion may not exceed 11/4 inches on the center axle...

  9. Manual lateralization in macaques: handedness, target laterality and task complexity.

    PubMed

    Regaiolli, Barbara; Spiezio, Caterina; Vallortigara, Giorgio

    2016-01-01

    Non-human primates represent models to understand the evolution of handedness in humans. Despite several researches have been investigating non-human primates handedness, few studies examined the relationship between target position, hand preference and task complexity. This study aimed at investigating macaque handedness in relation to target laterality and tastiness, as well as task complexity. Seven pig-tailed macaques (Macaca nemestrina) were involved in three different "two alternative choice" tests: one low-level task and two high-level tasks (HLTs). During the first and the third tests macaques could select a preferred food and a non-preferred food, whereas by modifying the design of the second test, macaques were presented with no-difference alternative per trial. Furthermore, a simple-reaching test was administered to assess hand preference in a social context. Macaques showed hand preference at individual level both in simple and complex tasks, but not in the simple-reaching test. Moreover, target position seemed to affect hand preference in retrieving an object in the low-level task, but not in the HLT. Additionally, individual hand preference seemed to be affected from the tastiness of the item to be retrieved. The results suggest that both target laterality and individual motivation might influence hand preference of macaques, especially in simple tasks. PMID:26292019

  10. Direct lateral maneuvers in hawkmoths.

    PubMed

    Greeter, Jeremy S M; Hedrick, Tyson L

    2016-01-01

    We used videography to investigate direct lateral maneuvers, i.e. 'sideslips', of the hawkmoth Manduca sexta. M. sexta sideslip by rolling their entire body and wings to reorient their net force vector. During sideslip they increase net aerodynamic force by flapping with greater amplitude, (in both wing elevation and sweep), allowing them to continue to support body weight while rolled. To execute the roll maneuver we observed in sideslips, they use an asymmetric wing stroke; increasing the pitch of the roll-contralateral wing pair, while decreasing that of the roll-ipsilateral pair. They also increase the wing sweep amplitude of, and decrease the elevation amplitude of, the contralateral wing pair relative to the ipsilateral pair. The roll maneuver unfolds in a stairstep manner, with orientation changing more during downstroke than upstroke. This is due to smaller upstroke wing pitch angle asymmetries as well as increased upstroke flapping counter-torque from left-right differences in global reference frame wing velocity about the moth's roll axis. Rolls are also opposed by stabilizing aerodynamic moments from lateral motion, such that rightward roll velocity will be opposed by rightward motion. Computational modeling using blade-element approaches confirm the plausibility of a causal linkage between the previously mentioned wing kinematics and roll/sideslip. Model results also predict high degrees of axial and lateral damping. On the time scale of whole and half wing strokes, left-right wing pair asymmetries directly relate to the first, but not second, derivative of roll. Collectively, these results strongly support a roll-based sideslip with a high degree of roll damping in M. sexta. PMID:26740573

  11. Direct lateral maneuvers in hawkmoths

    PubMed Central

    Greeter, Jeremy S. M.; Hedrick, Tyson L.

    2016-01-01

    ABSTRACT We used videography to investigate direct lateral maneuvers, i.e. ‘sideslips’, of the hawkmoth Manduca sexta. M. sexta sideslip by rolling their entire body and wings to reorient their net force vector. During sideslip they increase net aerodynamic force by flapping with greater amplitude, (in both wing elevation and sweep), allowing them to continue to support body weight while rolled. To execute the roll maneuver we observed in sideslips, they use an asymmetric wing stroke; increasing the pitch of the roll-contralateral wing pair, while decreasing that of the roll-ipsilateral pair. They also increase the wing sweep amplitude of, and decrease the elevation amplitude of, the contralateral wing pair relative to the ipsilateral pair. The roll maneuver unfolds in a stairstep manner, with orientation changing more during downstroke than upstroke. This is due to smaller upstroke wing pitch angle asymmetries as well as increased upstroke flapping counter-torque from left-right differences in global reference frame wing velocity about the moth's roll axis. Rolls are also opposed by stabilizing aerodynamic moments from lateral motion, such that rightward roll velocity will be opposed by rightward motion. Computational modeling using blade-element approaches confirm the plausibility of a causal linkage between the previously mentioned wing kinematics and roll/sideslip. Model results also predict high degrees of axial and lateral damping. On the time scale of whole and half wing strokes, left-right wing pair asymmetries directly relate to the first, but not second, derivative of roll. Collectively, these results strongly support a roll-based sideslip with a high degree of roll damping in M. sexta. PMID:26740573

  12. Vision assisted aircraft lateral navigation

    NASA Astrophysics Data System (ADS)

    Mohideen, Mohamed Ibrahim; Ramegowda, Dinesh; Seiler, Peter

    2013-05-01

    Surface operation is currently one of the least technologically equipped phases of aircraft operation. The increased air traffic congestion necessitates more aircraft operations in degraded weather and at night. The traditional surface procedures worked well in most cases as airport surfaces have not been congested and airport layouts were less complex. Despite the best efforts of FAA and other safety agencies, runway incursions continue to occur frequently due to incorrect surface operation. Several studies conducted by FAA suggest that pilot induced error contributes significantly to runway incursions. Further, the report attributes pilot's lack of situational awareness - local (e.g., minimizing lateral deviation), global (e.g., traffic in the vicinity) and route (e.g., distance to next turn) - to the problem. An Enhanced Vision System (EVS) is one concept that is being considered to resolve these issues. These systems use on-board sensors to provide situational awareness under poor visibility conditions. In this paper, we propose the use of an Image processing based system to estimate the aircraft position and orientation relative to taxiway markings to use as lateral guidance aid. We estimate aircraft yaw angle and lateral offset from slope of the taxiway centerline and horizontal position of vanishing line. Unlike automotive applications, several cues such as aircraft maneuvers along assigned route with minimal deviations, clear ground markings, even taxiway surface, limited aircraft speed are available and enable us to implement significant algorithm optimizations. We present experimental results to show high precision navigation accuracy with sensitivity analysis with respect to camera mount, optics, and image processing error.

  13. Clinical Neurogenetics: Amyotrophic Lateral Sclerosis

    PubMed Central

    Harms, Matthew B.; Baloh, Robert H.

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, about which our understanding is expanding rapidly as its genetic causes are uncovered. The pace of new gene discovery over the last 5 years has accelerated, providing new insights into the pathogenesis of disease and highlighting biological pathways for target for therapeutic development. This article reviews our current understanding of the heritability of ALS, provides an overview of each of the major ALS genes, highlighting their phenotypic characteristics and frequencies as a guide for clinicians evaluating patients with ALS. PMID:24176417

  14. Clinical neurogenetics: amyotrophic lateral sclerosis.

    PubMed

    Harms, Matthew B; Baloh, Robert H

    2013-11-01

    Our understanding of amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disease, is expanding rapidly as its genetic causes are uncovered. The pace of new gene discovery over the last 5 years has accelerated, providing new insights into the pathogenesis of disease and highlighting biological pathways as targets for therapeutic development. This article reviews our current understanding of the heritability of ALS and provides an overview of each of the major ALS genes, highlighting their phenotypic characteristics and frequencies as a guide for clinicians evaluating patients with ALS. PMID:24176417

  15. Lateral genetic transfer: open issues

    PubMed Central

    Ragan, Mark A.; Beiko, Robert G.

    2009-01-01

    Lateral genetic transfer (LGT) is an important adaptive force in evolution, contributing to metabolic, physiological and ecological innovation in most prokaryotes and some eukaryotes. Genomic sequences and other data have begun to illuminate the processes, mechanisms, quantitative extent and impact of LGT in diverse organisms, populations, taxa and environments; deep questions are being posed, and the provisional answers sometimes challenge existing paradigms. At the same time, there is an enhanced appreciation of the imperfections, biases and blind spots in the data and in analytical approaches. Here we identify and consider significant open questions concerning the role of LGT in genome evolution. PMID:19571244

  16. Lateralization of aggression in fish.

    PubMed

    Bisazza, Angelo; de Santi, Andrea

    2003-05-15

    Recent research has suggested that lateralization of aggressive behaviors could follow an homogeneous pattern among all vertebrates. A left eye/right hemisphere dominance in eliciting aggressive responses has been demonstrated for all groups of tetrapods but teleost fish for which data is lacking. Here we studied differential eye use during aggressive interactions in three species of teleosts: Gambusia holbrooki, Xenotoca eiseni and Betta splendens. In the first experiment we checked for lateralization in the use of the eyes while the subject was attacking its own mirror image. In order to confirm the results, other tests were performed on two species and eye preference was scored during attacks or displays directed toward a live rival. All three species showed a marked preference for using the right eye when attacking a mirror image or a live rival. Thus, the direction of asymmetry in fish appears the opposite to that shown by all the other groups of vertebrates. Hypotheses on the origin of the difference are discussed. PMID:12742249

  17. LATERAL EPICONDYLITIS OF THE ELBOW

    PubMed Central

    Cohen, Marcio; da Rocha Motta Filho, Geraldo

    2015-01-01

    Lateral epicondylitis, also known as tennis elbow, is a common condition that is estimated to affect 1% to 3% of the population. The word epicondylitis suggests inflammation, although histological analysis on the tissue fails to show any inflammatory process. The structure most commonly affected is the origin of the tendon of the extensor carpi radialis brevis and the mechanism of injury is associated with overloading. Nonsurgical treatment is the preferred method, and this includes rest, physiotherapy, cortisone infiltration, platelet-rich plasma injections and use of specific immobilization. Surgical treatment is recommended when functional disability and pain persist. Both the open and the arthroscopic surgical technique with resection of the degenerated tendon tissue present good results in the literature. PMID:27047843

  18. The developmental origins of laterality: fetal handedness.

    PubMed

    Hepper, Peter G

    2013-09-01

    This paper reviews the evidence for lateralized motor behavior in the fetus around a number of key questions: does the fetus exhibit signs of laterality? when does lateralized motor behavior begin? is the lateralized preference consistently displayed? does prenatal handedness relate to postnatal handedness? and, does prenatal handedness relate to brain functioning? The evidence indicates that the fetus exhibits lateralized behavior from 10 weeks gestation, as soon as it independently moves its arms, and this is the precursor of lateralized motor behavior observed post-natally. Data is presented suggesting that the strength of laterality decreases with advancing gestation and this correlates with more efficient information processing as assessed by habituation. However extreme caution is warranted in attempting to link asymmetric motor behavior and brain function prenatally. The paper concludes that the initial developmental emergence of lateralized behavior is under genetic control and is a fundamental feature of prenatal human development. PMID:23765736

  19. Managing Complications of Diabetes in Later Life

    MedlinePlus

    ... Related Documents PDF Living with Diabetes Download PDF Managing Complications of Diabetes in Later Life Download Join our e-newsletter! Resources Managing Complications of Diabetes in Later Life Tools and Tips Printer-friendly ...

  20. Hemispheric Laterality in Music and Math

    ERIC Educational Resources Information Center

    Szirony, Gary Michael; Burgin, John S.; Pearson, L. Carolyn

    2008-01-01

    Hemispheric laterality may be a useful concept in teaching, learning, training, and in understanding more about human development. To address this issue, a measure of hemispheric laterality was compared to musical and mathematical ability. The Human Information Processing Survey (HIPS) instrument, designed to measure hemispheric laterality, was…

  1. The multifunctional lateral geniculate nucleus.

    PubMed

    Weyand, Theodore G

    2016-02-01

    Providing the critical link between the retina and visual cortex, the well-studied lateral geniculate nucleus (LGN) has stood out as a structure in search of a function exceeding the mundane 'relay'. For many mammals, it is structurally impressive: Exquisite lamination, sophisticated microcircuits, and blending of multiple inputs suggest some fundamental transform. This impression is bolstered by the fact that numerically, the retina accounts for a small fraction of its input. Despite such promise, the extent to which an LGN neuron separates itself from its retinal brethren has proven difficult to appreciate. Here, I argue that whereas retinogeniculate coupling is strong, what occurs in the LGN is judicious pruning of a retinal drive by nonretinal inputs. These nonretinal inputs reshape a receptive field that under the right conditions departs significantly from its retinal drive, even if transiently. I first review design features of the LGN and follow with evidence for 10 putative functions. Only two of these tend to surface in textbooks: parsing retinal axons by eye and functional group and gating by state. Among the remaining putative functions, implementation of the principle of graceful degradation and temporal decorrelation are at least as interesting but much less promoted. The retina solves formidable problems imposed by physics to yield multiple efficient and sensitive representations of the world. The LGN applies context, increasing content, and gates several of these representations. Even if the basic concentric receptive field remains, information transmitted for each LGN spike relative to each retinal spike is measurably increased. PMID:26479339

  2. [Biomarkers for amyotrophic lateral sclerosis].

    PubMed

    Tokuda, Takahiko

    2012-05-01

    Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive neurodegenerative disorder. Modern technology has brought new insights in the underlying pathophysiology of ALS through examination of genomic, proteomic and physiological changes in patients. However, the diagnosis of this disorder is still based on clinical findings, and there is a pronounced delay between the onset of symptoms and diagnosis. Functional rating scales, forced vital capacity, and patient survival have been used as measures of therapeutic response so far. Although effective treatments for ALS are lacking, the discovery of biomarkers for this disease offers clinicians the tools for rapid diagnosis, improved ways to monitor disease progression, and insights into the pathophysiology of sporadic ALS. Potential biomarkers that are useful in the diagnosis of ALS and sensitive to the progression of disease, which might enhance the diagnostic algorithm and provide new drug targets, are now being eagerly investigated through blood and cerebrospinal fluid analyses, as well as physiological and neuroimaging studies. These biomarkers, when used in combination, might be sensitive to early therapeutic effects. Such biomarkers might also resolve complexities of phenotypic heterogeneity in clinical trials. In this review article, I have discussed the development of biochemical, physiological and neuroimaging biomarkers for ALS including our recent results on CSF TDP-43 (TAR DNA-binding protein 43 kDa), and have considered the potential future directions for research. We should ultimately aim to broaden the available therapeutic options for patients with this disease. PMID:22570065

  3. [Epidemiology of amyotrophic lateral sclerosis].

    PubMed

    Soriani, M-H; Desnuelle, C

    2009-01-01

    Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. Loss of pyramidal and anterior horn motor neurons leads to progressive limb weakness, disability, dysarthria, dysphagia and respiratory insufficiency with a progressive fatal course. The incidence of ALS ranges between 1.5 to 2.5 for 100,000 per year. Although there are familial cases of ALS, about 90% are sporadic and of unknown etiology. Several exogenous risk factors have been documented. However, no convincing evidence has demonstrated in a reproducible manner an association between an environmental or lifestyle risk factor and ALS. Disease duration varies considerably, ranging from a few months to 10-15 years with a mean survival of about 36 months. Prognostic factors such as age, site of disease onset, nutritional, functional and respiratory status at the diagnosis or delay between beginning of the disease and diagnosis have been reported but they appear to be insufficient to explain prognostic variability. These last 15 years, development of supportive care for ALS patients and management in ALS centers may have contributed to improve survival. Finally, ALS centres, and particularly French ALS centres, have developed databases to improve our knowledge of ALS, phenotypic characterization, more accurate phenotype-genotype correlations and thus contribute to new therapeutics developments. PMID:19524991

  4. [Genetics of amyotrophic lateral sclerosis].

    PubMed

    Corcia, Philippe; Blasco, Hélène; Camu, William

    2014-05-01

    Although the pathophysiology of amyotrophic lateral sclerosis remains currently unknown, involvement of genetic factors is worldwide accepted as a key clue in the motor neuron death. Since 1993 and the discovery of mutation in the SOD1 gene, number of genes linked to or promoting ALS had always growing. Among them, only four (SOD1, TARDBP, FUS and C9ORF72 genes) are unanimously recognized as convincing causative genetic factors for more than 60% of familial and probably 10% of sporadic ALS cases. Geographic origin of the studied populations tends to become one of the major items in the gene-ALS relationship: this was extremely stressed for C9ORF72. Concerning susceptibility genes factors, an increase of the risk of ALS is clearly shown for SMN1 and ATXN2 genes and accepted for some VEGF haplotypes. Finally, some modulating effects might also exist as underline for the relationships between ApoE and ALS that differ between European and North American studies. In inherited ALS, The European Federation of Neurological Societies (EFNS) edited rules that gave a legal frame to situations for which research of mutations were justified. Progress in the field of genetic raises major questions concerning the relevance of genetic studies from asymptomatic relatives. This first implies that the mutation identified in the proband case is perfectly characterized as a pathogenic mutation. PMID:24703222

  5. Lateral violence in the perioperative setting.

    PubMed

    Bigony, Lorraine; Lipke, Tammy G; Lundberg, Ashley; McGraw, Carrie A; Pagac, Gretchen L; Rogers, Anne

    2009-04-01

    Lateral violence is disruptive, bullying, intimidating, or unsettling behavior that occurs between nurses in the workplace. The perioperative setting fosters lateral violence because of the inherent stress of performing surgery; high patient acuity; a shortage of experienced personnel; work demands; and the restriction and isolation of the OR, which allows negative behaviors to be concealed more easily. Lateral violence affects nurses' health and well-being and their ability to care for patients. Interventions to reduce lateral violence include empowerment of staff members and zero tolerance for lateral violence. PMID:19434948

  6. Human olfactory lateralization requires trigeminal activation.

    PubMed

    Croy, Ilona; Schulz, Max; Blumrich, Anna; Hummel, Cornelia; Gerber, Johannes; Hummel, Thomas

    2014-09-01

    Rats are able to lateralize odors. This ability involves specialized neurons in the orbitofrontal cortex which are able to process the left, right and bilateral presentation of stimuli. However, it is not clear whether this function is preserved in humans. Humans are in general not able to differentiate whether a selective olfactory stimulant has been applied to the left or right nostril; however exceptions have been reported. Following a screening of 152 individuals with an olfactory lateralization test, we identified 19 who could lateralize odors above chance level. 15 of these "lateralizers" underwent olfactory fMRI scanning in a block design and were compared to 15 controls matched for age and sex distribution. As a result, both groups showed comparable activation of olfactory eloquent brain areas. However, subjects with lateralization ability had a significantly enhanced activation of cerebral trigeminal processing areas (somatosensory cortex, intraparietal sulcus). In contrast to controls, lateralizers furthermore exhibited no suppression in the area of the trigeminal principal sensory nucleus. An exploratory study with an olfactory change detection paradigm furthermore showed that lateralizers oriented faster towards changes in the olfactory environment. Taken together, our study suggests that the trigeminal system is activated to a higher degree by the odorous stimuli in the group of "lateralizers". We conclude that humans are not able to lateralize odors based on the olfactory input alone, but vary in the degree to which the trigeminal system is recruited. PMID:24825502

  7. Vannevar Bush: Fifty Years Later

    NASA Astrophysics Data System (ADS)

    Lagowski, J. J.

    1995-12-01

    It is ironic that the 50th anniversary year of Vannevar Bush's Report to President Truman entitled "Science the Endless Frontier", which put into motion the eminently successful current system of education of scientists in this country occurs at a time when serious questions are being asked about the usefulness of that very system. Bush viewed his proposal to establish a national research foundation (later to be called the National Science Foundation) as a "social compact." Judgment of scientific merit would be delegated to expert peers in return for scientific progress, which would ultimately benefit the nation in terms of scientific needs--military security, economic productivity, and enhanced quality of life. Bush wanted the funding of basic research intertwined with training, and preferred to use universities for this purpose rather than industrial or national labs. Bush viewed college and university scientists as teachers and investigators. He believed university-based research would uniquely encourage and engage the next generation of scientists as no other institutional arrangement could. Bush did not trust industry's commitment to basic research, an instinct that proved prophetic. The academic reserve of scientists (PhD's in training and postdoctoral students) that existed before World War II, and upon which the United States could draw for its needs, which were primarily associated with defense efforts, was probably one of the defining factors in Bush's suggested strategy. Currently, that reserve of talent has gotten so large that it is the obvious throttle in the pipeline slowing the continued development of the university research enterprise. Since 1977, the rate at which we have trained new scientists exceeds an average of 4% annually. Since 1987, the "science work force"--PhD's--has grown at three times the rate of the general labor supply. Temporary positions for postdoctoral scientists have grown even faster (over 5% per year since 1989). To compound the problem, the 1990 Immigration Reform Act resulted in a tripling of job-based visas, with scientists representing nearly one-third of the total. In 1979, two of every three postdoctoral scientists were U.S.-born; in 1992, the ratio was about one to one. Over that period, the cohort of postdoctoral scientists grew from 18,000 to 33,000. Adding to the coincidence of events that have compounded one another is the admission of 20,000 Chinese scientists in a ten-year period, the sudden and unexpected availability of Russian scientists, the elimination of many industrial laboratories as a result of downsizing, changes in the mandatory retirement age for faculty, and the disappearance of the Cold War, which all but eliminated the need for scientists for national security purposes. Is it any wonder that postdoctoral scientists have been called the migrant workers of today's high-tech society? What once was a reservoir of enthusiastic talent is becoming a dumping ground for credentialed and capable scientists exiled from the main stream of their disciplines. From a broader point of view, the problems facing U.S. science are those of our society: an imposing deficit that is shrinking discretionary funding; the end of the Cold War, which has refocused spending for national security; and a robust science work force that can no longer expand. The business world's response to these societal problems is, basically, downsizing, which often means the elimination of large segments of the work force, usually at the middle-management level. The initial academic response to these same problems is either to insist on more resources being made available, usually through federal agencies, in an attempt to maintain the status quo, or to engage in some form of "academic birth control." The former strategy is unrealistic because it just perpetuates the problem; there will never be enough research professorships in the academic world for every aspiring PhD produced in a discipline. The latter strategy will invariably decrease the flow of truly new knowledge in a discipline, a process that will eventually affect the viability of our technology base. Some argue for a third view, namely, expanding the career options for PhD's by altering the details of the training process. If there was a flaw in the Bush plan, it was to be found in the implicit premise that an ever-growing supply of scientists would stimulate new demand for scientific expertise, not just in government and universities, but in industry and the professional venues. Bush probably never expected that, because of federal funding, university scientists would in 50 years produce not just the national reserve of scientists he sought to develop, but a growing number of young PhD's, many of whom wanted nothing more--and nothing less--than to be university scientists themselves. Bush probably never guessed at the efficiency of the process for the education of scientists he set into motion. The absence of a plan to complement supply with demand is one source of the inherent structural problem in American science today. Young PhD's do not receive a sufficiently versatile training to do anything other than academic scientific research. Science as a way of knowing is clearly a sound foundation for a variety of careers. Numerous opportunities exist that can use the skills of the scientist while rewarding creativity, autonomy, problem-solving, industriousness, and the yearning for knowledge--all the characteristics associated with well-trained scientists. The challenge for academe is to refine or adapt Vannevar Bush's original "social contract" into a new one, more appropriate for the 21st century.

  8. Unusual external resorption of a maxillary lateral.

    PubMed

    Giunta, J L; Kaplan, M A

    1994-01-01

    This article defines an unusual previously unreported entity afflicting a maxillary lateral incisor. Labial idiopathic external root resorption just apical to the cemento-enamel presented as a gingival (periodontal) problem and was misinterpreted as cervical dental caries. This report defines a new possibility for a radicular defect in a maxillary lateral incisor that may cause periodontal problems. PMID:8054293

  9. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Lateral marks. 62.25 Section 62.25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.25 Lateral marks....

  10. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Lateral marks. 62.25 Section 62.25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.25 Lateral marks....

  11. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Lateral marks. 62.25 Section 62.25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.25 Lateral marks....

  12. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Lateral marks. 62.25 Section 62.25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.25 Lateral marks....

  13. 33 CFR 62.25 - Lateral marks.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Lateral marks. 62.25 Section 62.25 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY AIDS TO NAVIGATION UNITED STATES AIDS TO NAVIGATION SYSTEM The U.S. Aids to Navigation System § 62.25 Lateral marks....

  14. Factors Affecting Lateral Stability and Controllability

    NASA Technical Reports Server (NTRS)

    Campbell, John P; Toll, Thomas A

    1948-01-01

    The effects on dynamic lateral stability and controllability of some of the important aerodynamic and mass characteristics are discussed and methods are presented for estimating the various stability parameters to be used in the calculation of the dynamic lateral stability of airplanes with swept and low-aspect-ratio wings.

  15. Laterality and Dyslexia: A Critical View.

    ERIC Educational Resources Information Center

    Hiscock, Merrill; Kinsbourne, Marcel

    1982-01-01

    Research is reviewed concerning the current state of knowledge about normal hemispheric specialization; distinctions among such terms as dominance, laterality, and lateralization; and models of abnormal cerebral organization in dyslexic children. The question of dyslexic subtypes is undertaken along such dimensions as handedness, eyedness, and…

  16. Aeromonas hydrophila Lateral Flagellar Gene Transcriptional Hierarchy

    PubMed Central

    Wilhelms, Markus; Gonzalez, Victor; Merino, Susana

    2013-01-01

    Aeromonas hydrophila AH-3 lateral flagella are not assembled when bacteria grow in liquid media; however, lateral flagellar genes are transcribed. Our results indicate that A. hydrophila lateral flagellar genes are transcribed at three levels (class I to III genes) and share some similarities with, but have many important differences from, genes of Vibrio parahaemolyticus. A. hydrophila lateral flagellum class I gene transcription is σ70 dependent, which is consistent with the fact that lateral flagellum is constitutively transcribed, in contrast to the characteristics of V. parahaemolyticus. The fact that multiple genes are included in class I highlights that lateral flagellar genes are less hierarchically transcribed than polar flagellum genes. The A. hydrophila lafK-fliEJL gene cluster (where the subscript L distinguishes genes for lateral flagella from those for polar flagella) is exclusively from class I and is in V. parahaemolyticus class I and II. Furthermore, the A. hydrophila flgAMNL cluster is not transcribed from the σ54/LafK-dependent promoter and does not contain class II genes. Here, we propose a gene transcriptional hierarchy for the A. hydrophila lateral flagella. PMID:23335410

  17. Laterality and Reading Proficiency in Children.

    ERIC Educational Resources Information Center

    Leong, Che Kan

    1980-01-01

    Discusses some current concepts of the laterality/reading relationship. An overview of Samuel T. Orton's hypotheses of cerebral dominance and "strephosymbolia" is provided, and both visual half-field and dichotic listening studies as direct, empirical tests of laterality are discussed. (MKM)

  18. 49 CFR 230.105 - Lateral motion.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Lateral motion. 230.105 Section 230.105 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Steam Locomotives and Tenders Running Gear § 230.105 Lateral motion....

  19. Gender and Marital Happiness in Later Life

    ERIC Educational Resources Information Center

    Kaufman, Gayle; Taniguchi, Hiromi

    2006-01-01

    In this study, the authors examine the effect of gender ideology on marital happiness in later life. Studies of marital satisfaction in later life have tended to neglect such attitudes, although they have received increasing attention in the literature on younger marriages. The authors use data from married individuals who range in age from 51 to…

  20. Lateral displacement and rotational displacement sensor

    DOEpatents

    Duden, Thomas

    2014-04-22

    A position measuring sensor formed from opposing sets of capacitor plates measures both rotational displacement and lateral displacement from the changes in capacitances as overlapping areas of capacitors change. Capacitances are measured by a measuring circuit. The measured capacitances are provided to a calculating circuit that performs calculations to obtain angular and lateral displacement from the capacitances measured by the measuring circuit.

  1. Usefulness of a Lateral Thoracodorsal Flap after Breast Conserving Surgery in Laterally Located Breast Cancer

    PubMed Central

    Ryu, Dong Wan; Lee, Jeong Woo; Choi, Kang Young; Chung, Ho Yun; Cho, Byung Chae; Park, Ho Yong; Byun, Jin Suk

    2013-01-01

    Background Breast-conserving surgery is widely accepted as an appropriate method in breast cancer, and the lateral thoracodorsal flap provides a simple, reliable technique, especially when a mass is located in the lateral breast. This study describes the usefulness of a lateral thoracodorsal flap after breast conserving surgery in laterally located breast cancer. Methods From September 2008 to February 2013, a lateral thoracodorsal flap was used in 20 patients with laterally located breast cancer treated at our institution. The technique involves a local medially based, wedge shaped, fasciocutaneous transposition flap from the lateral region of the thoracic area. Overall satisfaction and aesthetic satisfaction surveys were conducted with the patients during a 6-month postoperative follow-up period. Aesthetic results in terms of breast shape and symmetry were evaluated by plastic surgeons. Results The average specimen weight was 76.8 g. The locations of the masses were the upper lateral quadrant (n=15), the lower lateral quadrant (n=2), and the central lateral area (n=3). Complications developed in four of the cases, partial flap necrosis in one, wound dehiscence in one, and fat necrosis in two. The majority of the patients were satisfied with their cosmetic outcomes. Conclusions Partial breast reconstruction using a lateral thoracodorsal flap is well matched with breast color and texture, and the surgery is less aggressive than other techniques with few complications. Therefore, the lateral thoracodorsal flap can be a useful, reliable technique in correcting breast deformity after breast conserving surgery, especially in laterally located breast cancer. PMID:23898433

  2. Model to Design Drip Hose Lateral Line

    NASA Astrophysics Data System (ADS)

    Ludwig, Rafael; Cury Saad, João Carlos

    2014-05-01

    Introduction The design criterion for non-pressure compensating drip hose is normally to have 10% of flow variation (Δq) in the lateral line, corresponding to 20% of head pressure variation (ΔH). Longer lateral lines in drip irrigation systems using conventional drippers provide cost reduction, but it is necessary to obtain to the uniformity of irrigation [1]. The use of Δq higher levels can provide longer lateral lines. [4] proposes the use of a 30% Δq and he found that this value resulted in distribution uniformity over 80%. [1] considered it is possible to extend the lateral line length using two emitters spacing in different section. He assumed that the spacing changing point would be at 40% of the total length, because this is approximately the location of the average flow according with [2]. [3] found that, for practical purposes, the average pressure is located at 40% of the length of the lateral line and that until this point it has already consumed 75% of total pressure head loss (hf ). In this case, the challenge for designers is getting longer lateral lines with high values of uniformity. Objective The objective of this study was to develop a model to design longer lateral lines using non-pressure compensating drip hose. Using the developed model, the hypotheses to be evaluated were: a) the use of two different spacing between emitters in the same lateral line allows longer length; b) it is possible to get longer lateral lines using high values of pressure variation in the lateral lines since the distribution uniformity stays below allowable limits. Methodology A computer program was developed in Delphi® based on the model developed and it is able to design lateral lines in level using non-pressure compensating drip hose. The input data are: desired distribution uniformity (DU); initial and final pressure in the lateral line; coefficients of relationship between emitter discharge and pressure head; hose internal diameter; pipe cross-sectional area with the dripper; and roughness coefficient for the Hazen-Williams equation. The program allows calculate the lateral line length with three possibilities: selecting two spacing between emitters and defining the exchange point; using two pre-established spacing between emitters and calculating the length of each section with different spacing; using one emitter spacing. Results Results showed that the use of two sections with different spacing between drippers in the lateral line didn't allow longer length but got better uniformity when compared with lateral line with one spacing between emitters. The adoption of two spacing increased the flow rate per meter in the final section which represented approximately 80% of the lateral line total length and this justifies their use. The software allowed DU above 90% with pressure head variation of 40% and the use of two spacing between emitters. Conclusions The developed model/software showed to be accurate, easy to handle and useful for lateral line design using non-pressure compensating drip hose. References [1] ANDRADE, L. A. D. Estudo de uniformidade de emissão de água utilizando diferentes espaçamentos entre gotejadores na linha lateral. 2009. 87 f. Tese (Doutorado em Agronomia/Irigação e Drenagem) - Faculdade de Ciências Agronômicas, Universidade Estadual Paulista 'Julio de Mesquita Filho', Botucatu, (2009). [2] KELLER, J.; BLIESNER, R. D. Sprinkle and trickle irrigation. Caldwell: Blackburn Press, (1990). 652 p. [3] TALENS, J. A. M. Riego localizado y fertirrigacion. Madrid: Mundi-Prensa, (2002). 533 p. [4] WU, I. P. An assessment of hydraulic design of micro-irrigation systems. Agricultural Water Management, Amsterdan, v. 32, n. 3

  3. A lateral electrophoretic flow diagnostic assay

    PubMed Central

    Lin, Robert; Skandarajah, Arunan; Gerver, Rachel E.; Neira, Hector D.; Fletcher, Daniel A.

    2015-01-01

    Immunochromatographic assays are a cornerstone tool in disease screening. To complement existing lateral flow assays (based on wicking flow) we introduce a lateral flow format that employs directed electrophoretic transport. The format is termed a “lateral e-flow assay” and is designed to support multiplexed detection using immobilized reaction volumes of capture antigen. To fabricate the lateral e-flow device, we employ mask-based UV photopatterning to selectively immobilize unmodified capture antigen along the microchannel in a barcode-like pattern. The channel-filling polyacrylamide hydrogel incorporates a photoactive moiety (benzophenone) to immobilize capture antigen to the hydrogel without a priori antigen modification. We report a heterogeneous sandwich assay using low-power electrophoresis to drive biospecimen through the capture antigen barcode. Fluorescence barcode readout is collected via a low-resource appropriate imaging system (CellScope). We characterize lateral e-flow assay performance and demonstrate a serum assay for antibodies to the hepatitis C virus (HCV). In a pilot study, the lateral e-flow assay positively identifies HCV+ human sera in 60 min. The lateral e-flow assay provides a flexible format for conducting multiplexed immunoassays relevant to confirmatory diagnosis in near-patient settings. PMID:25608872

  4. Olfactory coding in the honeybee lateral horn.

    PubMed

    Roussel, Edith; Carcaud, Julie; Combe, Maud; Giurfa, Martin; Sandoz, Jean-Christophe

    2014-03-01

    Olfactory systems dynamically encode odor information in the nervous system. Insects constitute a well-established model for the study of the neural processes underlying olfactory perception. In insects, odors are detected by sensory neurons located in the antennae, whose axons project to a primary processing center, the antennal lobe. There, the olfactory message is reshaped and further conveyed to higher-order centers, the mushroom bodies and the lateral horn. Previous work has intensively analyzed the principles of olfactory processing in the antennal lobe and in the mushroom bodies. However, how the lateral horn participates in olfactory coding remains comparatively more enigmatic. We studied odor representation at the input to the lateral horn of the honeybee, a social insect that relies on both floral odors for foraging and pheromones for social communication. Using in vivo calcium imaging, we show consistent neural activity in the honeybee lateral horn upon stimulation with both floral volatiles and social pheromones. Recordings reveal odor-specific maps in this brain region as stimulations with the same odorant elicit more similar spatial activity patterns than stimulations with different odorants. Odor-similarity relationships are mostly conserved between antennal lobe and lateral horn, so that odor maps recorded in the lateral horn allow predicting bees' behavioral responses to floral odorants. In addition, a clear segregation of odorants based on pheromone type is found in both structures. The lateral horn thus contains an odor-specific map with distinct representations for the different bee pheromones, a prerequisite for eliciting specific behaviors. PMID:24560579

  5. Fracture of the proximal humerus with disruption of the tendon of the pectoralis major

    PubMed Central

    Berghs, Bart M.; Tongel, Alexander Van; Bo, Thomas De; De Wilde, Lieven F.

    2016-01-01

    Combined pectoralis major disruption and proximal humeral fractures are uncommon. A simple radiologic diagnostic tool which consists of the measurement of the displacement from the humeral shaft to the lateral side of the humeral head (lateral to the outer proximal cortex) can help to diagnose this combined lesion.

  6. Lateral Meningomyelocele in a Neonate: A Case Report

    PubMed Central

    Prasad, G Raghavendra; Rashmi, TM

    2016-01-01

    Lateral presentation of meningocele and meningomyelocele is extremely rare. Most of the lateral meningocele described are associated with other syndromes. Isolated lateral meningomyelocele cases are rarer still. We herein report a neonate with isolated lateral gluteal meningomyelocele. PMID:26793596

  7. Experiments and analysis of lateral piezoresistance gauges

    SciTech Connect

    Wong, M.K.W.

    1993-07-01

    The response of lateral piezoresistance gauges to shock wave uniaxial strain loading has been examined in a combined experimental and calculational effort. Plate impact experiments provided lateral gauge data which were analyzed using quasi-static and dynamic inclusion analyses. Experimental data showed that the response of the lateral gauge output depended upon the matrix material and gauge emplacement method. The calculations indicated that these differences were due to complex gauge-matrix interactions. These interactions were influenced by the stress and strain distributions in and around the gauge, plasticity effects, properties of the gauge and matrix materials, and emplacement conditions.

  8. Lateral Hindfoot Impingement After Nonunion of Fracture of the Lateral Process of the Talus.

    PubMed

    Wang, Ping-Hui; Su, Wei-Ren; Jou, I-Ming

    2016-01-01

    Fracture of the lateral process of the talus is a relatively uncommon ankle injury, and the diagnosis is easily delayed. Lateral hindfoot impingement is characteristically related to chronic hindfoot valgus malalignment, with lateral ankle pain localized to the subtalar region. In a review of the published data, lateral hindfoot impingement after nonunion of fracture of the lateral process of the talus was not found. We present the case of a patient with such an injury. The patient was treated operatively and was followed for 18 months. PMID:25998474

  9. Transplant Problems That May Show Up Later

    MedlinePlus

    ... soon after transplant Next Topic Other transplant issues Transplant problems that may show up later The type ... called Second Cancers Caused by Cancer Treatment . Post-transplant lymphoproliferative disorder Post-transplant lymphoproliferative ( lim -fo-pruh- ...

  10. Lateral Transpsoas Fusion: Indications and Outcomes

    PubMed Central

    Patel, Vishal C.; Park, Daniel K.; Herkowitz, Harry N.

    2012-01-01

    Spinal fusion historically has been used extensively, and, recently, the lateral transpsoas approach to the thoracic and lumbar spine has become an increasingly common method to achieve fusion. Recent literature on this approach has elucidated its advantage over more traditional anterior and posterior approaches, which include a smaller tissue dissection, potentially lower blood loss, no need for an access surgeon, and a shorter hospital stay. Indications for the procedure have now expanded to include degenerative disc disease, spinal stenosis, degenerative scoliosis, nonunion, trauma, infection, and low-grade spondylolisthesis. Lateral interbody fusion has a similar if not lower rate of complications compared to traditional anterior and posterior approaches to interbody fusion. However, lateral interbody fusion has unique complications that include transient neurologic symptoms, motor deficits, and neural injuries that range from 1 to 60% in the literature. Additional studies are required to further evaluate and monitor the short- and long-term safety, efficacy, outcomes, and complications of lateral transpsoas procedures. PMID:23213303

  11. Laterally Coupled Distributed-Feedback Lasers

    NASA Technical Reports Server (NTRS)

    Lang, Robert J.; Forouhar, Siamak; Tiberio, Richard C.; Porkolab, George

    1992-01-01

    Distributed-feedback semiconductor lasers of proposed design called "laterally coupled" features Bragg gratings located on top surfaces next to sides of ridge waveguides overlying gain regions of laser resonators.

  12. Lateralized courtship in a parasitic wasp.

    PubMed

    Romano, Donato; Donati, Elisa; Canale, Angelo; Messing, Russell H; Benelli, Giovanni; Stefanini, Cesare

    2016-05-01

    Lateralization (i.e. left-right asymmetries in the brain and behaviour) of courtship displays has been examined in a growing number vertebrate species, while evidence for invertebrates is limited. In this study, we investigated lateralization of courtship and mating displays in the parasitic wasp Leptomastidea abnormis. Results showed a population-level lateralization of male courtship displays. Male antennal tapping on the female's head was right-biased. However, right-biased male courtship acts were not characterized by higher male antennal tapping frequencies, nor success in mating although antennal tapping frequency was higher in males with mating success with respect to unsuccessful males. Overall, our results add basic knowledge to the behavioural ecology of insect parasitoids. To the best of our knowledge, this is the first report of behavioural lateralization in parasitic Hymenoptera. PMID:26932864

  13. Cooling Therapy Helps Newborns Years Later

    MedlinePlus

    ... please review our exit disclaimer . Subscribe Cooling Therapy Helps Newborns Years Later A cooling treatment for infants ... that a cooling therapy called hypothermia treatment could help these babies. The treatment involves placing newborns on ...

  14. Genetics Home Reference: amyotrophic lateral sclerosis

    MedlinePlus

    ... DW. Converging mechanisms in ALS and FTD: disrupted RNA and protein homeostasis. Neuron. 2013 Aug 7;79( ... Miller CC, Shaw CE. Mutations in FUS, an RNA processing protein, cause familial amyotrophic lateral sclerosis type ...

  15. Assessment of Phosphorus Retention in Irrigation Laterals

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Irrigation laterals transport irrigation return flow, including water, sediment, and nutrients, back to surface water bodies. Phosphorus transformations during transport can affect both phosphorus bioavailability and the best management practices selected to minimize phosphorus inputs to waters of ...

  16. Management of horizontally impacted dilacerated lateral incisor

    PubMed Central

    Katta, Anil Kumar; Peddu, Revathi; Vannala, Venkataramana; Dasari, Vaishnavi

    2015-01-01

    Impaction of maxillary lateral incisor with odontome and retained deciduous tooth is not often seen in regular dental practice. Impaction of anterior teeth cause generalized spacing which affects the esthetics of the face. Here we report a case of an 18-year-old patient with horizontally impacted dilacerated lateral incisor, which was bought into occlusion with the help of orthodontic tooth movement within a span of 18 months. PMID:26538954

  17. Discovery from a lateral oblique radiograph.

    PubMed

    Hong, Bosun

    2016-01-01

    In many oral and maxillofacial surgery units and emergency departments, lateral oblique radiographs are not routinely included in radiological investigations for suspected mandibular fractures because orthopanoramic and posteroanterior mandible views usually suffice. This paper reports a case where a lateral oblique radiograph proved to be very useful in managing a fractured atrophic mandible. This case report highlights the importance of considering the use of alternative radiographs for suspected fracture(s) of an atrophic mandible to exclude the unexpected. PMID:26791125

  18. Brain and behavioral lateralization in invertebrates

    PubMed Central

    Frasnelli, Elisa

    2013-01-01

    Traditionally, only humans were thought to exhibit brain and behavioral asymmetries, but several studies have revealed that most vertebrates are also lateralized. Recently, evidence of left–right asymmetries in invertebrates has begun to emerge, suggesting that lateralization of the nervous system may be a feature of simpler brains as well as more complex ones. Here I present some examples in invertebrates of sensory and motor asymmetries, as well as asymmetries in the nervous system. I illustrate two cases where an asymmetric brain is crucial for the development of some cognitive abilities. The first case is the nematode Caenorhabditis elegans, which has asymmetric odor sensory neurons and taste perception neurons. In this worm left/right asymmetries are responsible for the sensing of a substantial number of salt ions, and lateralized responses to salt allow the worm to discriminate between distinct salt ions. The second case is the fruit fly Drosophila melanogaster, where the presence of asymmetry in a particular structure of the brain is important in the formation or retrieval of long-term memory. Moreover, I distinguish two distinct patterns of lateralization that occur in both vertebrates and invertebrates: individual-level and population-level lateralization. Theoretical models on the evolution of lateralization suggest that the alignment of lateralization at the population level may have evolved as an evolutionary stable strategy in which individually asymmetrical organisms must coordinate their behavior with that of other asymmetrical organisms. This implies that lateralization at the population-level is more likely to have evolved in social rather than in solitary species. I evaluate this new hypothesis with a specific focus on insects showing different level of sociality. In particular, I present a series of studies on antennal asymmetries in honeybees and other related species of bees, showing how insects may be extremely useful to test the evolutionary hypothesis. PMID:24376433

  19. Brain and behavioral lateralization in invertebrates.

    PubMed

    Frasnelli, Elisa

    2013-01-01

    Traditionally, only humans were thought to exhibit brain and behavioral asymmetries, but several studies have revealed that most vertebrates are also lateralized. Recently, evidence of left-right asymmetries in invertebrates has begun to emerge, suggesting that lateralization of the nervous system may be a feature of simpler brains as well as more complex ones. Here I present some examples in invertebrates of sensory and motor asymmetries, as well as asymmetries in the nervous system. I illustrate two cases where an asymmetric brain is crucial for the development of some cognitive abilities. The first case is the nematode Caenorhabditis elegans, which has asymmetric odor sensory neurons and taste perception neurons. In this worm left/right asymmetries are responsible for the sensing of a substantial number of salt ions, and lateralized responses to salt allow the worm to discriminate between distinct salt ions. The second case is the fruit fly Drosophila melanogaster, where the presence of asymmetry in a particular structure of the brain is important in the formation or retrieval of long-term memory. Moreover, I distinguish two distinct patterns of lateralization that occur in both vertebrates and invertebrates: individual-level and population-level lateralization. Theoretical models on the evolution of lateralization suggest that the alignment of lateralization at the population level may have evolved as an evolutionary stable strategy in which individually asymmetrical organisms must coordinate their behavior with that of other asymmetrical organisms. This implies that lateralization at the population-level is more likely to have evolved in social rather than in solitary species. I evaluate this new hypothesis with a specific focus on insects showing different level of sociality. In particular, I present a series of studies on antennal asymmetries in honeybees and other related species of bees, showing how insects may be extremely useful to test the evolutionary hypothesis. PMID:24376433

  20. Laterality enhances cognition in Australian parrots.

    PubMed

    Magat, Maria; Brown, Culum

    2009-12-01

    Cerebral lateralization refers to the division of information processing in either hemisphere of the brain and is a ubiquitous trait among vertebrates and invertebrates. Given its widespread occurrence, it is likely that cerebral lateralization confers a fitness advantage. It has been hypothesized that this advantage takes the form of enhanced cognitive function, potentially via a dual processing mechanism whereby each hemisphere can be used to process specific types of information without contralateral interference. Here, we examined the influence of lateralization on problem solving by Australian parrots. The first task, a pebble-seed discrimination test, was designed for small parrot species that feed predominately on small seeds, which do not require any significant manipulation with the foot prior to ingestion. The second task, a string-pull problem, was designed for larger bodied species that regularly use their feet to manipulate food objects. In both cases, strongly lateralized individuals (those showing significant foot and eye biases) outperformed less strongly lateralized individuals, and this relationship was substantially stronger in the more demanding task. These results suggest that cerebral lateralization is a ubiquitous trait among Australian parrots and conveys a significant foraging advantage. Our results provide strong support for the enhanced cognitive function hypothesis. PMID:19726480

  1. Laterality enhances cognition in Australian parrots

    PubMed Central

    Magat, Maria; Brown, Culum

    2009-01-01

    Cerebral lateralization refers to the division of information processing in either hemisphere of the brain and is a ubiquitous trait among vertebrates and invertebrates. Given its widespread occurrence, it is likely that cerebral lateralization confers a fitness advantage. It has been hypothesized that this advantage takes the form of enhanced cognitive function, potentially via a dual processing mechanism whereby each hemisphere can be used to process specific types of information without contralateral interference. Here, we examined the influence of lateralization on problem solving by Australian parrots. The first task, a pebble-seed discrimination test, was designed for small parrot species that feed predominately on small seeds, which do not require any significant manipulation with the foot prior to ingestion. The second task, a string-pull problem, was designed for larger bodied species that regularly use their feet to manipulate food objects. In both cases, strongly lateralized individuals (those showing significant foot and eye biases) outperformed less strongly lateralized individuals, and this relationship was substantially stronger in the more demanding task. These results suggest that cerebral lateralization is a ubiquitous trait among Australian parrots and conveys a significant foraging advantage. Our results provide strong support for the enhanced cognitive function hypothesis. PMID:19726480

  2. The lateral suprasylvian corticotectal projection in cats.

    PubMed

    Segal, R L; Beckstead, R M

    1984-05-10

    The projection from the lateral suprasylvian visual areas to the superior colliculus was investigated in cats using both anterograde and retrograde tracing techniques. The retrograde transport of horseradish peroxidase (HRP) or wheat germ agglutinin-HRP (WGA-HRP) from their site of deposit in the superior colliculus indicates that all divisions of the lateral suprasylvian visual areas project to both the superficial and deep layers of the superior colliculus. However, following tracer deposits in the superior colliculus that are confined to the layers below the stratum opticum (deep layers), more neurons are labeled along the lateral bank than along the medial bank of the middle suprasylvian sulcus. Conversely, tracer deposits in the superior colliculus dorsal to and including the stratum opticum label more cells in the medial than the lateral bank. These retrograde experiments also confirm that the visual cortex along the lateral gyrus (areas 17 and 18) projects to the superficial, but apparently not to the deep layers. The visual area in the cortex surrounding the caudal two-thirds of the anterior ectosylvian sulcus projects to the deep, but not to the superficial layers. The laminar and areal patterns of anterograde axon labeling in the superior colliculus were examined after single deposits of 3H-amino acids (autoradiography), HRP, or WGA-HRP in the lateral suprasylvian cortical regions, or combined isotope and WGA-HRP deposits. Axon labeling in the superior colliculus is generally densest in the stratum opticum and extends either dorsally into the superficial layers or ventrally into the intermediate gray layer. Specifically, the anterior divisions of the lateral suprasylvian cortex project primarily to the lateral portion of the superior colliculus, with the projection from the medial bank biased toward the superficial layers and axons from the lateral bank aimed mainly at the intermediate gray layer with some axons even reaching the deepest gray layer of the superior colliculus. Both the posteromedial and posterolateral divisions of the lateral suprasylvian cortex project to more extensive portions of the mediolateral and rostrocaudal dimensions of the superior colliculus than the anterior divisions. However, the posterolateral division projects more heavily to the intermediate gray layer than the posteromedial division; from the latter, axons distribute more superficially in the superior colliculus. Finally, the cortex surrounding the posterior suprasylvian sulcus projects primarily to the medial part of the superficial layers of the superior colliculus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:6725646

  3. Lateral restraint assembly for reactor core

    DOEpatents

    Gorholt, Wilhelm; Luci, Raymond K.

    1986-01-01

    A restraint assembly for use in restraining lateral movement of a reactor core relative to a reactor vessel wherein a plurality of restraint assemblies are interposed between the reactor core and the reactor vessel in circumferentially spaced relation about the core. Each lateral restraint assembly includes a face plate urged against the outer periphery of the core by a plurality of compression springs which enable radial preloading of outer reflector blocks about the core and resist low-level lateral motion of the core. A fixed radial key member cooperates with each face plate in a manner enabling vertical movement of the face plate relative to the key member but restraining movement of the face plate transverse to the key member in a plane transverse to the center axis of the core. In this manner, the key members which have their axes transverse to or subtending acute angles with the direction of a high energy force tending to move the core laterally relative to the reactor vessel restrain such lateral movement.

  4. LOB Domain Proteins: Beyond Lateral Organ Boundaries.

    PubMed

    Xu, Changzheng; Luo, Feng; Hochholdinger, Frank

    2016-02-01

    LATERAL ORGAN BOUNDARIES DOMAIN (LBD) proteins defined by a conserved LATERAL ORGAN BOUNDARIES (LOB) domain are key regulators of plant organ development. Recent studies have expanded their functional diversity beyond the definition of lateral organ boundaries to pollen development, plant regeneration, photomorphogenesis, pathogen response, and specific developmental functions in non-model plants, such as poplar and legumes. The identification of a range of upstream regulators, protein partners, and downstream targets of LBD family members has unraveled the molecular networks of LBD-dependent processes. Moreover, it has been demonstrated that LBD proteins have essential roles in integrating developmental changes in response to phytohormone signaling or environmental cues. As we discuss here, these novel discoveries of LBD functions and their molecular contexts promote a better understanding of this plant-specific transcription factor family. PMID:26616195

  5. The Lateral Instability of Deep Rectangular Beams

    NASA Technical Reports Server (NTRS)

    Dumont, C; Hill, H N

    1937-01-01

    Experimental and analytical studies were made of solid and hollow deep rectangular beams to study their lateral instability under various conditions of loading and restraint. The tests were made on bars and tubes of 17ST aluminum alloy. Failure by lateral buckling occurred only in tests on the solid beams. It was found that, within the elastic range, the test results were in agreement with the classical theory for the lateral buckling of deep beams as given by Prandtl, Mitchell, and Timoshenko. The tests were extended to the inelastic range, where it was found that the substitution for Young's modulus of an average modulus of elasticity derived from the stress-strain curve made it possible to predict instability at high stresses.

  6. Lateral step initiation behavior in older adults

    PubMed Central

    Sparto, Patrick J; Jennings, J Richard; Furman, Joseph M; Redfern, Mark S

    2013-01-01

    Older adults have varied postural responses during induced and voluntary lateral stepping. The purpose of the research was to quantify the occurrence of different stepping strategies during lateral step initiation in older adults and to relate the stepping responses to retrospective history of falls. Seventy community-ambulating older adults (mean age 76 y, range 70–94 y) performed voluntary lateral steps as quickly as possible to the right or left in response to a visual cue, in a blocked design. Vertical ground reaction forces were measured using a forceplate, and the number and latency of postural adjustments were quantified. Subjects were assigned to groups based on their stepping strategy. The frequency of trials with one or two postural adjustments was compared with data from 20 younger adults (mean age 38 y, range 21–58 y). Logistic regression was used to relate presence of a fall in the previous year with the number and latency of postural adjustments. In comparison with younger adults, who almost always demonstrated one postural adjustment when stepping laterally, older adults constituted a continuous distribution in the percentage of step trials made with one postural adjustment (from 0% to 100% of trials). Latencies of the initial postural adjustment and foot liftoff varied depending on the number of postural adjustments made. A history of falls was associated a larger percentage of two postural adjustments, and a longer latency of foot liftoff. In conclusion, the number and latency of postural adjustments made during voluntary lateral stepping provides additional evidence that lateral control of posture may be a critical indicator of aging. PMID:24295896

  7. Lateral force microscopy profiles for amorphous potentials.

    PubMed

    Rivas, A M F; Zamora, R R M; Prioli, R

    2003-01-01

    In this work, the lateral force profiles of the scanning force microscope tip on an amorphous surface were simulated with the use of an independent oscillator model. The correlation between the lateral force profiles and the surface potential were studied as a function of the tip-surface normal force and relative scanning velocity. It is shown that the microscope resolution is governed by the quotient between the average potential interaction energy and the average elastic energy stored before the jumps. We show that there is an optimal velocity with which the scanning tip better senses the surface potential and we present its scaling laws. PMID:12801685

  8. Mitek Suspension of the Lateral Nasal Wall.

    PubMed

    White, James R; Hamilton, Grant S

    2016-02-01

    The nasal valve has long been described as the anatomical boundary most likely to inhibit nasal airflow and lead to subsequent nasal obstruction. Although many procedures can address this area to improve the nasal airway, for over 20 years, suture lateralization of the external nasal valve has been described as a minimally invasive technique that can improve nasal breathing. We report our modification of the standard technique in which we lateralize the placement of the bone-anchored suture and incorporate Gore-Tex within the nasal vestibular incision to prevent tissue migration. PMID:26862966

  9. Plasmonic lateral forces on chiral spheres

    NASA Astrophysics Data System (ADS)

    Canaguier-Durand, Antoine; Genet, Cyriaque

    2016-01-01

    We show that the optical force exerted on a finite size chiral sphere by a surface plasmon mode has a component along a direction perpendicular to the plasmon linear momentum. We reveal how this chiral lateral force, pointing in opposite directions for opposite enantiomers, stems from an angular-to-linear crossed momentum transfer involving the plasmon transverse spin angular momentum density and mediated by the chirality of the sphere. Our multipolar approach allows us discussing the inclusion of the recoil term in the force on a small sphere taken in the dipolar limit and observing sign inversions of the lateral chiral force when the size of the sphere increases.

  10. Amyotrophic Lateral Sclerosis: A Historical Perspective.

    PubMed

    Katz, Jonathan S; Dimachkie, Mazen M; Barohn, Richard J

    2015-11-01

    This article looks back in time to see where the foundational basis for the understanding of amyotrophic lateral sclerosis originated. This foundation was created primarily in France by Jean-Martin Charcot and his fellow countrymen and disciples, along with key contributions from early clinicians in England and Germany. The early work on amyotrophic lateral sclerosis provides a useful foundation for today's clinicians with respect to tying together genetic and biologic aspects of the disorder that have been discovered over the past few decades. PMID:26515617

  11. Lateral jet injection into swirling combustor flowfields

    NASA Technical Reports Server (NTRS)

    Lilley, David G.

    1988-01-01

    An experimental program has been conducted to ascertain the effects of the number of lateral jets, the jet velocity ratio, and the crossflow swirl strength, on the isothermal flowfield patterns in jets injected normally to a round-section crossflow. Attention has been given to the trajectory, penetration, and mixing efficiency of the lateral injection, using flow visualization, pitot-probe and hot-wire methods. In addition, such predictive techniques as a simple, explicit, fully three-dimensional turbulent computer code have been employed.

  12. [The lateral abdominal island flap--the lateral intercostal neurovascular island flap].

    PubMed

    Yu, G; Lao, Z; Liu, J

    1996-11-01

    This work studied the lateral abdominal island flap, its clinical value, transposition range and the practicability of a modified operative method. Five lateral abdominal island flaps were used in 5 patients. Four of them were for axillary radiation ulcers after radical mastectomy. One was for a sacral defect after resection of a recurrent fibrosarcoma. All the flaps obtained satisfactory results. Clinical applications revealed that the blood supply of the lateral abdominal skin was mainly from the lateral cutaneous branches of the 9th, 10th and 11th intercostal arteries, among which there were numerous anastomoses. The lateral abdominal island flap can be pedicled with any of these lateral cutaneous branches. The long pedicle of the flap provides a wide range of trnasposition from the axilla to the sacrum. As the pedicle of the flap contains the lateral cutaneous branch of the intercostal nerve, the flap can bring sensation function to the recipient area. The modified operative method of the lateral abdominal island flap is introduced. PMID:9387425

  13. The Assessment of Cerebral Laterality: The Sherman-Kulhavy Laterality Assessment Inventory. Technical Report No. 4.

    ERIC Educational Resources Information Center

    Sherman, Jay L.; Kulhavy, Raymond W.

    The Sherman-Kulhavy Laterality Assessment Inventory (LAI), an instrument for determining cerebral laterality, was administered to 1,000 undergraduates to determine the ability of the LAI to discriminate between right- and left-dominant groups. Each S was administered the LAI, a 45-item verbal report instrument which assesses both fine and gross…

  14. Cerebral Lateralities and Individualized Instruction. Final Report.

    ERIC Educational Resources Information Center

    Federico, Pat-Anthony

    To ascertain whether cerebral lateralities can be considered aptitudes or individual difference measures within an aptitude-treatment-interaction (ATI) framework, hemispheric asymmetries and cognitive psychometric tests were administered to 50 right-handed, Caucasian, male Navy recruits. Principal factor analysis with varimax rotation was computed

  15. Profiling 1366 Technologies: One Year Later

    ScienceCinema

    Van Mierlo, Frank; Sachs, Ely;

    2013-05-29

    Last January, we took a look at how ARPA-E performer, 1366 Technologies is working to dramatically reduce the cost of solar energy. A year later, we revisited their headquarters in Lexington, MA to see the progress they've made.

  16. New lateral stabilizing device for airplanes

    NASA Technical Reports Server (NTRS)

    Constantin, Louis

    1923-01-01

    The proposed device tends to render the lateral stabilization of airplanes easier and more efficacious. The proposed solution is to mount the ailerons independently, in such a manner that they can turn freely, under the action of the relative wind, about an axis located in front of the extreme position of the center of the lift.

  17. Lateralized Temporal Order Judgement in Dyslexia

    ERIC Educational Resources Information Center

    Liddle, Elizabeth B.; Jackson, Georgina M.; Rorden, Chris; Jackson, Stephen R.

    2009-01-01

    Temporal and spatial attentional deficits in dyslexia were investigated using a lateralized visual temporal order judgment (TOJ) paradigm that allowed both sensitivity to temporal order and spatial attentional bias to be measured. Findings indicate that adult participants with a positive screen for dyslexia were significantly less sensitive to the…

  18. Active Children: Healthy Now And Later

    ERIC Educational Resources Information Center

    Campbell, Linley; Musumeci, Josephine

    2005-01-01

    Current research is revealing that physical activity can protect against a range of lifestyle diseases and illnesses. Consequently, early childhood practitioners and parents need to adopt guidelines and practices which encourage children of all ages to be physically active. In "Active children: Healthy Now and Later," authors Linley Campbell and…

  19. Control augmentation for lateral control wheel steering

    NASA Technical Reports Server (NTRS)

    Foulkes, R. H., Jr.

    1981-01-01

    Flight control system design for lateral control wheel steering is discussed. Two alternate designs are presented. The first design is a roll-rate command, bank-angle hold system with a wings-level track-hold submode. The second is a curved-track-hold system. Design details and real-time flight simulator results are included.

  20. Early Classroom Behavior and Later Misconduct.

    ERIC Educational Resources Information Center

    Spivack, George; And Others

    1986-01-01

    Longitudinally examines the relationship between teacher-rated behaviors in kindergarten through grade three with police contact as a measure of delinquency and school misconduct throughout adolescence. Urban minority ("high risk") males and females participated. Consistent relationships between early classroom behavior and later misconduct

  1. Lateral Hip Pain in an Athletic Population

    PubMed Central

    Grumet, Robert C.; Frank, Rachel M.; Slabaugh, Mark A.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Context: Historically, the term greater trochanteric pain syndrome has been used to describe a spectrum of conditions that cause lateral-sided hip pain, including greater trochanteric bursitis, snapping iliotibial band, and/or strains or tendinopathy of the abductor mechanism. Diagnosis of these conditions may be difficult because clinical presentations are variable and sometimes inconclusive. Especially difficult is differentiating intrinsic pain from pain referred to the greater trochanteric region. The purposes of this article are to review the relevant anatomy and pathophysiology of the lateral hip. Evidence Acquisition: Data were collected through a thorough review of the literature conducted through a MEDLINE search of all relevant papers between 1980 and January 2010. Results: Recent advances in imaging and an improved understanding of pathomechanics have helped to guide the evaluation, diagnosis, and appropriate treatment for patients presenting with lateral hip pain. Conclusion: Various diagnostic tools and treatment modalities can be used to effectively manage the athletic patient presenting with lateral hip pain. PMID:23015937

  2. The Columbine Tragedy Ten Years Later

    ERIC Educational Resources Information Center

    Hammond, Jane

    2009-01-01

    Some tragedies are so emblazoned in people's minds that years later they can recall where they were when they first heard the news. The assassinations of John F. Kennedy and Martin Luther King Jr., the Challenger explosion, and the Sept. 11 terrorist attacks are among these events. So also is the Columbine High School tragedy of April 20, 1999.…

  3. Religious Attendance and Loneliness in Later Life

    ERIC Educational Resources Information Center

    Rote, Sunshine; Hill, Terrence D.; Ellison, Christopher G.

    2013-01-01

    Purpose of the Study: Studies show that loneliness is a major risk factor for health issues in later life. Although research suggests that religious involvement can protect against loneliness, explanations for this general pattern are underdeveloped and undertested. In this paper, we propose and test a theoretical model, which suggests that social…

  4. Lateral capacity of helical piles in clays

    SciTech Connect

    Prasad, Y.V.S.N.

    1996-11-01

    Helical piles, also known as screw anchors, consist of one or more helical-shaped circular plates welded to a central steel shaft at a specified spacing. Currently, helical piles are being used as tower foundations on land and in offshore areas to secure moorings, cables, and sea-bed pipelines to the sea bed. In this paper, the behavior of helical piles under lateral loads in clayey soils is examined through an experimental investigation on model piles. Tests were conducted on rigid helical piles with different numbers of plates. Model anchors were made of 13.8 mm diameter mild steel shafts to which mild steel plates of 33 mm diameter were welded. For comparison, a single straight shaft with a diameter of 13.8 mm was also tested. Test results revealed that the lateral capacity of helical piles is greater than that of straight shaft piles. A simple theoretical model is suggested to estimate the lateral capacity of rigid helical piles. The theoretical model suggested incorporates lateral resistance of the soil on the shaft, bearing resistance on the bottom of the helical plate, uplift resistance on the top of the helical plate, and frictional resistance on the surface of the helical plate. The validity of this model is examined.

  5. Amyotrophic lateral sclerosis: the role of exercise.

    PubMed

    Lisle, Stuart; Tennison, Matthew

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a chronic progressive neurodegenerative disease affecting both the upper and lower motor neurons. Given the deterioration of skeletal muscle function, historically there has been concern regarding exercise and its affect on ALS. This article reviews and explains current research, helping patients, caregivers, and providers be equipped better to make decisions regarding the treatment of ALS with exercise. PMID:25574882

  6. Lateral prefrontal cortex: architectonic and functional organization

    PubMed Central

    Petrides, Michael

    2005-01-01

    A comparison of the architecture of the human prefrontal cortex with that of the macaque monkey showed a very similar architectonic organization in these two primate species. There is no doubt that the prefrontal cortical areas of the human brain have undergone considerable development, but it is equally clear that the basic architectonic organization is the same in the two species. Thus, a comparative approach to the study of the functional organization of the primate prefrontal cortex is more likely to reveal the essential aspects of the various complex control processes that are the domain of frontal function. The lateral frontal cortex appears to be functionally organized along both a rostral–caudal axis and a dorsal–ventral axis. The most caudal frontal region, the motor region on the precentral gyrus, is involved in fine motor control and direct sensorimotor mappings, whereas the caudal lateral prefrontal region is involved in higher order control processes that regulate the selection among multiple competing responses and stimuli based on conditional operations. Further rostrally, the mid-lateral prefrontal region plays an even more abstract role in cognitive control. The mid-lateral prefrontal region is itself organized along a dorsal–ventral axis of organization, with the mid-dorsolateral prefrontal cortex being involved in the monitoring of information in working memory and the mid-ventrolateral prefrontal region being involved in active judgments on information held in posterior cortical association regions that are necessary for active retrieval and encoding of information. PMID:15937012

  7. Quantifying lateral tissue heterogeneities in hadron therapy

    SciTech Connect

    Pflugfelder, D.; Wilkens, J. J.; Szymanowski, H.; Oelfke, U.

    2007-04-15

    In radiotherapy with scanned particle beams, tissue heterogeneities lateral to the beam direction are problematic in two ways: they pose a challenge to dose calculation algorithms, and they lead to a high sensitivity to setup errors. In order to quantify and avoid these problems, a heterogeneity number H{sub i} as a method to quantify lateral tissue heterogeneities of single beam spot i is introduced. To evaluate this new concept, two kinds of potential errors were investigated for single beam spots: First, the dose calculation error has been obtained by comparing the dose distribution computed by a simple pencil beam algorithm to more accurate Monte Carlo simulations. The resulting error is clearly correlated with H{sub i}. Second, the analysis of the sensitivity to setup errors of single beam spots also showed a dependence on H{sub i}. From this data it is concluded that H{sub i} can be used as a criterion to assess the risks of a compromised delivered dose due to lateral tissue heterogeneities. Furthermore, a method how to incorporate this information into the inverse planning process for intensity modulated proton therapy is presented. By suppressing beam spots with a high value of H{sub i}, the unfavorable impact of lateral tissue heterogeneities can be reduced, leading to treatment plans which are more robust to dose calculation errors of the pencil beam algorithm. Additional possibilities to use the information of H{sub i} are outlined in the discussion.

  8. Quantifying lateral tissue heterogeneities in hadron therapy.

    PubMed

    Pflugfelder, D; Wilkens, J J; Szymanowski, H; Oelfke, U

    2007-04-01

    In radiotherapy with scanned particle beams, tissue heterogeneities lateral to the beam direction are problematic in two ways: they pose a challenge to dose calculation algorithms, and they lead to a high sensitivity to setup errors. In order to quantify and avoid these problems, a heterogeneity number H(i) as a method to quantify lateral tissue heterogeneities of single beam spot i is introduced. To evaluate this new concept, two kinds of potential errors were investigated for single beam spots: First, the dose calculation error has been obtained by comparing the dose distribution computed by a simple pencil beam algorithm to more accurate Monte Carlo simulations. The resulting error is clearly correlated with H(i). Second, the analysis of the sensitivity to setup errors of single beam spots also showed a dependence on H(i). From this data it is concluded that H(i) can be used as a criterion to assess the risks of a compromised delivered dose due to lateral tissue heterogeneities. Furthermore, a method how to incorporate this information into the inverse planning process for intensity modulated proton therapy is presented. By suppressing beam spots with a high value of H(i), the unfavorable impact of lateral tissue heterogeneities can be reduced, leading to treatment plans which are more robust to dose calculation errors of the pencil beam algorithm. Additional possibilities to use the information of H(i) are outlined in the discussion. PMID:17500481

  9. Profiling 1366 Technologies: One Year Later

    SciTech Connect

    Van Mierlo, Frank; Sachs, Ely

    2011-01-01

    Last January, we took a look at how ARPA-E performer, 1366 Technologies is working to dramatically reduce the cost of solar energy. A year later, we revisited their headquarters in Lexington, MA to see the progress they've made.

  10. Lateral drug diffusion in human nails.

    PubMed

    Palliyil, Biji B; Li, Cong; Owaisat, Suzan; Lebo, David B

    2014-12-01

    The main objective of the current work is to demonstrate the process of passive lateral diffusion in the human nail plate and its effect on the passive transungual permeation of antifungal drug ciclopirox olamine (CPO). A water soluble dye, methyl red sodium salt (MR) was used to visualize the process of lateral diffusion using a novel suspended nail experiment. The decline in concentration of CPO correlates with that of concentration of MR from the proximal to the distal end of the nail in suspended nail study. Three toenails each were trimmed to 5 mm × 5 mm (25 mm(2)), 7 mm × 7 mm (49 mm(2)), and 9 mm × 9 mm (81 mm(2)) to study the extent and effect of lateral diffusion of the CPO on its in vitro transungual permeation. The permeation flux of CPO decreased as the surface area of the toenail increased. There was a positive correlation between the concentrations of CPO and MR in the area of application and in the peripheral area of the toenails of the three surface areas, confirming the findings in the suspended nail experiment. Profound lateral diffusion of CPO was demonstrated and shown to reduce the in vitro passive transungual drug permeation and prolong the lag-time in human toenails. The study data implies that during passive in vitro transungual permeation experiments, the peripheral nail around the area of drug application has to be kept to a minimum, in order to get reliable data which mimics the in vivo situation. PMID:24970585

  11. Cerebral Lateralization and Its Effect on Drawing.

    ERIC Educational Resources Information Center

    Thomas, Yvonne A.; Thomas, Stephen B.

    1983-01-01

    Discusses the importance of both sides of the brain for the development of drawing skills but notes that the left brain can inhibit the action of the right brain. Provides a discussion of cerebral lateralization and child development. Suggests five drawing exercises to help develop hemispheric cooperation. (SB)

  12. One hand clapping: lateralization of motor control

    PubMed Central

    Welniarz, Quentin; Dusart, Isabelle; Gallea, Cécile; Roze, Emmanuel

    2015-01-01

    Lateralization of motor control refers to the ability to produce pure unilateral or asymmetric movements. It is required for a variety of coordinated activities, including skilled bimanual tasks and locomotion. Here we discuss the neuroanatomical substrates and pathophysiological underpinnings of lateralized motor outputs. Significant breakthroughs have been made in the past few years by studying the two known conditions characterized by the inability to properly produce unilateral or asymmetric movements, namely human patients with congenital “mirror movements” and model rodents with a “hopping gait”. Whereas mirror movements are associated with altered interhemispheric connectivity and abnormal corticospinal projections, abnormal spinal cord interneurons trajectory is responsible for the “hopping gait”. Proper commissural axon guidance is a critical requirement for these mechanisms. Interestingly, the analysis of these two conditions reveals that the production of asymmetric movements involves similar anatomical and functional requirements but in two different structures: (i) lateralized activation of the brain or spinal cord through contralateral silencing by cross-midline inhibition; and (ii) unilateral transmission of this activation, resulting in lateralized motor output. PMID:26082690

  13. Sequential streaming, binaural cues and lateralization.

    PubMed

    David, Marion; Lavandier, Mathieu; Grimault, Nicolas

    2015-12-01

    Interaural time differences (ITDs) and interaural level differences (ILDs) associated with monaural spectral differences (coloration) enable the localization of sound sources. The influence of these spatial cues as well as their relative importance on obligatory stream segregation were assessed in experiment 1. A temporal discrimination task favored by integration was used to measure obligatory stream segregation for sequences of speech-shaped noises. Binaural and monaural differences associated with different spatial positions increased discrimination thresholds, indicating that spatial cues can induce stream segregation. The results also demonstrated that ITDs and coloration were relatively more important cues compared to ILDs. Experiment 2 questioned whether sound segregation takes place at the level of acoustic cue extraction (ITD per se) or at the level of object formation (perceived azimuth). A difference in ITDs between stimuli was introduced either consistently or inconsistently across frequencies, leading to clearly lateralized sounds or blurred lateralization, respectively. Conditions with ITDs and clearly perceived azimuths induced significantly more segregation than the condition with ITDs but reduced lateralization. The results suggested that segregation was mainly based on a difference in lateralization, although the extraction of ITDs might have also helped segregation up to a ceiling magnitude. PMID:26723307

  14. Biphasic cell responses on laterally mobile films

    NASA Astrophysics Data System (ADS)

    Kourouklis, Andreas; Lerum, Ronald; Bermudez, Harry

    2013-03-01

    The engineering of polymer surfaces or matrices that are capable of controlling cell adhesion has been widely explored. In nearly all of these works, the polymer chains (and ligands) are chemically attached to the underlying substrate, and therefore these systems are inherently static. By contrast, cellular environments such as the extracellular matrix (ECM) are dynamic and remodeled by biochemical reactions and biophysical forces. Borrowing this concept from Nature, we created polymer films by an interfacial self-assembly process, whereby individual chains can exhibit lateral mobility (in-plane diffusive motion). NIH 3T3 fibroblasts seeded on such RGD-presenting polymer films show biphasic responses in spreading and adhesion strength to lateral mobility, with a minimal response for intermediate mobility values. Futhermore, preliminary immuno-staining experiments reveal that the total area of focal adhesions demonstrates a similar biphasic trend to the cellular-scale behaviors. In contrast, actin filaments or stress fibers appear to be unaffected by the substrate lateral mobility. These results show that lateral mobility is an important, although not fully explored aspect of mechano-sensing by cells, and can potentially give new perspectives on cell-ECM interactions. National Science Foundation

  15. Depression in Later Life: Recognition and Treatment.

    ERIC Educational Resources Information Center

    Schmall, Vicki L.; And Others

    This guide is designed to help readers understand depression and factors related to its onset in later life; recognize signs of depression and potential suicide; and know actions they can take if they suspect an older family member or friend may be depressed or contemplating suicide. Following a brief introduction, a chapter on depression…

  16. Simulation of lateral flow with SWAT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Calibration of the SWAT model for the Goodwater Creek Experimental Watershed (GCEW) showed that percolation through the restrictive claypan layer, lateral flow above that layer, and redistribution of excess moisture up to the ground surface were not correctly simulated. In addition, surface runoff a...

  17. Preparing Future Faculty: Ten Years Later

    ERIC Educational Resources Information Center

    Murphy, Sean P.; Aiossa, Elizabeth; Winter, Mary Mugica

    2010-01-01

    When Sean Murphy designed the Graduate Student Internship Program at the College of Lake County (CLC), his 2001 TETYC article about the then two-year-old program detailed his programmatic response to the job market. Ten years later, the CLC-DePaul University partnership remains the strongest of the original dozen cross-sector relationships CLC…

  18. Lateral root development in the maize (Zea mays) lateral rootless1 mutant

    PubMed Central

    Husakova, Eva; Hochholdinger, Frank; Soukup, Ales

    2013-01-01

    Background and Aims The maize lrt1 (lateral rootless1) mutant is impaired in its development of lateral roots during early post-embryonic development. The aim of this study was to characterize, in detail, the influences that the mutation exerts on lateral root initiation and the subsequent developments, as well as to describe the behaviour of the entire plant under variable environmental conditions. Methods Mutant lrt1 plants were cultivated under different conditions of hydroponics, and in between sheets of moist paper. Cleared whole mounts and anatomical sections were used in combination with both selected staining procedures and histochemical tests to follow root development. Root surface permeability tests and the biochemical quantification of lignin were performed to complement the structural data. Key Results The data presented suggest a redefinition of lrt1 function in lateral roots as a promoter of later development; however, neither the complete absence of lateral roots nor the frequency of their initiation is linked to lrt1 function. The developmental effects of lrt1 are under strong environmental influences. Mutant primordia are affected in structure, growth and emergence; and the majority of primordia terminate their growth during this last step, or shortly thereafter. The lateral roots are impaired in the maintenance of the root apical meristem. The primary root shows disturbances in the organization of both epidermal and subepidermal layers. The lrt1-related cell-wall modifications include: lignification in peripheral layers, the deposition of polyphenolic substances and a higher activity of peroxidase. Conclusions The present study provides novel insights into the function of the lrt1 gene in root system development. The lrt1 gene participates in the spatial distribution of initiation, but not in its frequency. Later, the development of lateral roots is strongly affected. The effect of the lrt1 mutation is not as obvious in the primary root, with no influences observed on the root apical meristem structure and maintenance; however, development of the epidermis and cortex are impaired. PMID:23456690

  19. White matter alterations differ in primary lateral sclerosis and amyotrophic lateral sclerosis

    PubMed Central

    Iwata, Nobue K.; Kwan, Justin Y.; Danielian, Laura E.; Butman, John A.; Tovar-Moll, Fernanda; Bayat, Elham

    2011-01-01

    Primary lateral sclerosis is a sporadic disorder characterized by slowly progressive corticospinal dysfunction. Primary lateral sclerosis differs from amyotrophic lateral sclerosis by its lack of lower motor neuron signs and long survival. Few pathological studies have been carried out on patients with primary lateral sclerosis, and the relationship between primary lateral sclerosis and amyotrophic lateral sclerosis remains uncertain. To detect in vivo structural differences between the two disorders, diffusion tensor imaging of white matter tracts was carried out in 19 patients with primary lateral sclerosis, 18 patients with amyotrophic lateral sclerosis and 19 age-matched controls. Fibre tracking was used to reconstruct the intracranial portion of the corticospinal tract and three regions of the corpus callosum: the genu, splenium and callosal fibres connecting the motor cortices. Both patient groups had reduced fractional anisotropy, a measure associated with axonal organization, and increased mean diffusivity of the reconstructed corticospinal and callosal motor fibres compared with controls, without changes in the genu or splenium. Voxelwise comparison of the whole brain white matter using tract-based spatial statistics confirmed the differences between patients and controls in the diffusion properties of the corticospinal tracts and motor fibres of the callosum. This analysis further revealed differences in the regional distribution of white matter alterations between the patient groups. In patients with amyotrophic lateral sclerosis, the greatest reduction in fractional anisotropy occurred in the distal portions of the intracranial corticospinal tract, consistent with a distal axonal degeneration. In patients with primary lateral sclerosis, the greatest loss of fractional anisotropy and mean diffusivity occurred in the subcortical white matter underlying the motor cortex, with reduced volume, suggesting tissue loss. Clinical measures of upper motor neuron dysfunction correlated with reductions in fractional anisotropy in the corticospinal tract in patients with amyotrophic lateral sclerosis and increased mean diffusivity and volume loss of the corticospinal tract in patients with primary lateral sclerosis. Changes in the diffusion properties of the motor fibres of the corpus callosum were strongly correlated with changes in corticospinal fibres in patients, but not in controls. These findings indicate that degeneration is not selective for corticospinal neurons, but affects callosal neurons within the motor cortex in motor neuron disorders. PMID:21798965

  20. Robust lateral control of highway vehicles

    SciTech Connect

    Byrne, R.H.; Abdallah, C.

    1994-08-01

    Vehicle lateral dynamics are affected by vehicle mass, longitudinal velocity, vehicle inertia, and the cornering stiffness of the tires. All of these parameters are subject to variation, even over the course of a single trip. Therefore, a practical lateral control system must guarantee stability, and hopefully ride comfort, over a wide range of parameter changes. This paper describes a robust controller which theoretically guarantees stability over a wide range of parameter changes. The robust controller is designed using a frequency domain transfer function approach. An uncertainty band in the frequency domain is determined using simulations over the range of expected parameter variations. Based on this bound, a robust controller is designed by solving the Nevanlinna-Pick interpolation problem. The performance of the robust controller is then evaluated over the range of parameter variations through simulations.

  1. Resonant cavity LEDs by lateral epitaxy

    NASA Astrophysics Data System (ADS)

    Mauk, Michael G.; Burch, P. A.; Johnson, Scott W.; Shellenbarger, Zane A.; McNeely, James B.; Goodwin, Thomas A.; Feyock, Bryan W.

    1997-04-01

    Optical cavity light-emitting diode structures with 'buried' mirrors, and their fabrication by lateral epitaxy are described. Single-crystal, high-quality epitaxial layers are formed over substrates coated with patterned, reflective masks using liquid-phase or vapor-phase epitaxial lateral overgrowth processes. The reflecting mask acts as a backside mirror and forms an optical cavity leading to enhanced external quantum efficiencies. An AlGaAs optical cavity LED incorporating a refractory metal 'buried' mirror is assessed: a greater than 3-fold increase in output optical power is measured compared to control devices with no buried mirror. Application of the epitaxial overgrowth techniques to LED structures utilizing electron-beam deposited dielectric/semiconductor 'buried' mirrors and to other semiconductor materials, such as InGaAsSb, SiC, and ZnSe is described.

  2. Thrust vectoring for lateral-directional stability

    NASA Technical Reports Server (NTRS)

    Peron, Lee R.; Carpenter, Thomas

    1992-01-01

    The advantages and disadvantages of using thrust vectoring for lateral-directional control and the effects of reducing the tail size of a single-engine aircraft were investigated. The aerodynamic characteristics of the F-16 aircraft were generated by using the Aerodynamic Preliminary Analysis System II panel code. The resulting lateral-directional linear perturbation analysis of a modified F-16 aircraft with various tail sizes and yaw vectoring was performed at several speeds and altitudes to determine the stability and control trends for the aircraft compared to these trends for a baseline aircraft. A study of the paddle-type turning vane thrust vectoring control system as used on the National Aeronautics and Space Administration F/A-18 High Alpha Research Vehicle is also presented.

  3. Lateral view of facial fractures: new observations

    SciTech Connect

    Daffner, R.H.; Apple, J.S.; Gehweiler, J.A.

    1983-09-01

    Traditional plain film evaluation of facial fractures includes a lateral view of the face. This projection is often not exploited to its full potential because the many overlapping shadows are perceived to detract from its usefulness. To assess the value of this view, the authors reviewed the lateral facial films of 50 patients with a variety of fractures including 25 orbital blow-out fractures, 27 zygomaticomaxillary complex fractures, and 17 maxillary (including Le Fort) fractures. Three observations were encountered: orbital floor displacement in 60% of orbital fractures; malar strut displacement in 41% of zygomaticomaxillary complex fractures; and maxillary wall displacement in 76% of maxillary fractures. The presence of any of these structural displacements, either alone or in combination, provides further direct evidence of skeletal disruption and should serve to augment the findings observed on frontal views.

  4. Nanoparticle-based lateral flow biosensors.

    PubMed

    Quesada-González, Daniel; Merkoçi, Arben

    2015-11-15

    Lateral flow biosensors (LFBs) are paper-based devices which permit the performance of low-cost and fast diagnostics with good robustness, specificity, sensitivity and low limits of detection. The use of nanoparticles (NPs) as labels play an important role in the design and fabrication of a lateral flow strip (LFS). The choice of NPs and the corresponding detection method directly affect the performance of these devices. This review discusses aspects related to the application of different nanomaterials (e.g. gold nanoparticles, carbon nanotubes, quantum dots, up-converting phosphor technologies, and latex beads, between others) in LFBs. Moreover, different detection methods (colorimetric, fluorescent, electrochemical, magnetic, etc.) and signal enhancement strategies (affording secondary reactions or modifying the architecture of the LFS) as well as the use of devices such as smartphones to mediate the response of LFSs will be analyzed. PMID:26043315

  5. Tonoplast Aquaporins Facilitate Lateral Root Emergence.

    PubMed

    Reinhardt, Hagen; Hachez, Charles; Bienert, Manuela Désirée; Beebo, Azeez; Swarup, Kamal; Voß, Ute; Bouhidel, Karim; Frigerio, Lorenzo; Schjoerring, Jan K; Bennett, Malcolm J; Chaumont, Francois

    2016-03-01

    Aquaporins (AQPs) are water channels allowing fast and passive diffusion of water across cell membranes. It was hypothesized that AQPs contribute to cell elongation processes by allowing water influx across the plasma membrane and the tonoplast to maintain adequate turgor pressure. Here, we report that, in Arabidopsis (Arabidopsis thaliana), the highly abundant tonoplast AQP isoforms AtTIP1;1, AtTIP1;2, and AtTIP2;1 facilitate the emergence of new lateral root primordia (LRPs). The number of lateral roots was strongly reduced in the triple tip mutant, whereas the single, double, and triple tip mutants showed no or minor reduction in growth of the main root. This phenotype was due to the retardation of LRP emergence. Live cell imaging revealed that tight spatiotemporal control of TIP abundance in the tonoplast of the different LRP cells is pivotal to mediating this developmental process. While lateral root emergence is correlated to a reduction of AtTIP1;1 and AtTIP1;2 protein levels in LRPs, expression of AtTIP2;1 is specifically needed in a restricted cell population at the base, then later at the flanks, of developing LRPs. Interestingly, the LRP emergence phenotype of the triple tip mutants could be fully rescued by expressing AtTIP2;1 under its native promoter. We conclude that TIP isoforms allow the spatial and temporal fine-tuning of cellular water transport, which is critically required during the highly regulated process of LRP morphogenesis and emergence. PMID:26802038

  6. Quantifiable Lateral Flow Assay Test Strips

    NASA Technical Reports Server (NTRS)

    2003-01-01

    As easy to read as a home pregnancy test, three Quantifiable Lateral Flow Assay (QLFA) strips used to test water for E. coli show different results. The brightly glowing control line on the far right of each strip indicates that all three tests ran successfully. But the glowing test line on the middle left and bottom strips reveal their samples were contaminated with E. coli bacteria at two different concentrations. The color intensity correlates with concentration of contamination.

  7. Lateral distribution of electrons of air showers

    NASA Technical Reports Server (NTRS)

    Asakimori, K.; Maeda, T.; Kameda, T.; Mizushima, K.; Misaki, Y.

    1985-01-01

    The lateral distribution of electrons (LDE) of the air showers of size 10 to the 5th power to 10 to the 6th power was studied within one MU. It was found that the LDE of the air showers observed is well represented by NKG function except for vicinity of the core. It was also found that LDE measured by thin scintillators does not differ from that measured by thick ones of 50mm thickness.

  8. Paraoxonase Gene Mutations in Amyotrophic Lateral Sclerosis

    PubMed Central

    Ticozzi, Nicola; LeClerc, Ashley Lyn; Keagle, Pamela; Glass, Jonathan D.; Wills, Anne-Marie; van Blitterswijk, Marka; Bosco, Daryl A.; Rodriguez-Leyva, Ildefonso; Gellera, Cinzia; Ratti, Antonia; Taroni, Franco; McKenna-Yasek, Diane M.; Sapp, Peter C.; Silani, Vincenzo; Furlong, Clement E.; Brown, Robert H.; Landers, John E.

    2010-01-01

    Three clustered, homologous paraoxonase genes (PON1, PON2 and PON3) have roles in preventing lipid oxidation and detoxifying organophosphates. Recent reports describe a genetic association between the PON genes and sporadic amyotrophic lateral sclerosis (ALS). We now report that in genomic DNA from individuals with familial and sporadic ALS we have identified at least seven PON gene mutations that are predicted to alter PON function. PMID:20582942

  9. Efferent pathways of the mouse lateral habenula

    PubMed Central

    Quina, Lely A.; Tempest, Lynne; Ng, Lydia; Harris, Julie; Ferguson, Susan; Jhou, Thomas; Turner, Eric E.

    2014-01-01

    The lateral habenula (LHb) is part of the habenula complex of the dorsal thalamus. Recent studies of the LHb have focused on its projections to the ventral tegmental area (VTA) and rostromedial tegmental nucleus (RMTg), which contain GABAergic neurons that mediate reward prediction error via inhibition of dopaminergic activity. However, older studies in the rat have also identified LHb outputs to the lateral and posterior hypothalamus, median raphe, dorsal raphe, and dorsal tegmentum. Although these studies have shown that the medial and lateral divisions of the LHb have somewhat distinct projections, the topographic specificity of LHb efferents is not completely understood, and the relative extent of these projections to brainstem targets is unknown. Here we have used anterograde tracing with adeno-associated virus mediated expression of green fluorescent protein, combined with serial two-photon tomography, to map the efferents of the LHb on a standard coordinate system for the entire mouse brain, and reconstruct the efferent pathways of the LHb in three dimensions. Using automated quantitation of fiber density, we show that in addition to the RMTg, the median raphe, caudal dorsal raphe, and pontine central gray are major recipients of LHb efferents. Using retrograde tract tracing with cholera toxin subunit B, we show that LHb neurons projecting to the hypothalamus, VTA, median raphe, and caudal dorsal raphe, and pontine central gray reside in characteristic, but sometimes overlapping regions of the LHb. Together these results provide the anatomical basis for systematic studies of LHb function in neural circuits and behavior in mice. PMID:25099741

  10. Lateral flow immunoassay using magnetoresistive sensors

    NASA Astrophysics Data System (ADS)

    Taton, Kristin; Johnson, Diane; Guire, Patrick; Lange, Erik; Tondra, Mark

    2009-05-01

    Magnetic particles have been adapted for use as labels in biochemical lateral flow strip tests. Standard gold particle lateral flow assays are generally qualitative; however, with magnetic particles, quantitative results can be obtained by using electronic detection systems with giant magnetoresistive (GMR) sensors. As described here, these small integrated sensor chips can detect the presence of magnetic labels in capture spots whose volume is approximately 150 μm×150 μm×150 μm. The range of linear detection is better than two orders of magnitude; the total range is up to four orders of magnitude. The system was demonstrated with both indirect and sandwich enzyme-linked immunosorbent assays (ELISAs) for protein detection of rabbit IgG and interferon-γ, respectively, achieving detection of 12 pg/ml protein. Ultimately, the goal is for the detector to be fully integrated into the lateral flow strip backing to form a single consumable item that is interrogated by a handheld electronic reader.

  11. High performance amorphous selenium lateral photodetector

    NASA Astrophysics Data System (ADS)

    Abbaszadeh, Shiva; Allec, Nicholas; Karim, Karim S.

    2012-03-01

    Lateral amorphous selenium (a-Se) detectors based on the metal-semiconductor-metal (MSM) device structure have been studied for indirect detector medical imaging applications. These detectors have raised interest due to their simple structure, ease of fabrication, high-speed, low dark current, low capacitance per unit area and better light utilization. The lateral device structure has a benefit that the electrode spacing may be easily controlled to reduce the required bias for a given desired electric field. In indirect conversion x-ray imaging, the scintillator is coupled to the top of the a-Se MSM photodetector, which itself is integrated on top of the thin-film-transistor (TFT) array. The carriers generated at the top surface of the a-Se layer experience a field that is parallel to the surface, and does not initially sweep them away from the surface. Therefore these carriers may recombine or get trapped in surface states and change the field at the surface, which may degrade the performance of the photodetector. In addition, due to the finite width of the electrodes, the fill factor of the device is less than unity. In this study we examine the effect of lateral drift of carriers and the fill factor on the photodetector performance. The impact of field magnitude on the performance is also investigated.

  12. Lateral jet injection into typical combustor flowfields

    NASA Technical Reports Server (NTRS)

    Lilley, D. G.

    1986-01-01

    The experimental problem of lateral jet injection into typical flow fields in the absence of combustion was studied. All flow fields being investigated have no expansion of the crossflow (the test section to swirler diameter ratio D/d = 1), after its passage through an optional swirler (with swirl vane angle phi = 0 (swirler removed), 45, and 70 degree). The lateral jet(s) is(are) located one test-section diameter downstream of the test-section inlet (x/D = 1). The lateral jets have round-sectioned nozzles, each of which has an area of 1/100th of the cross sectional area of the crossflow (A sub j/A sub c = 1/100). Jet-to-crossflow velocity ratios of R = v sub j/u sub o = 2, 4, and 6 were investigated. Helium-bubble low visualization, five-hole pitot probe time-mean velocity measurements, and single-wire time-mean velocity and normal and shear stress turbulence data were obtained in the research program.

  13. Arthroscopic approaches and intraarticular anatomy of the equine elbow.

    PubMed

    Nixon, A J

    1990-01-01

    Periarticular anatomy and techniques for arthroscopic access to the equine elbow were studied in six joints from cadavers. Caudomedial and craniolateral approaches were evaluated subsequently in 11 anesthetized horses. The caudomedial approach was made between the flexor carpi radialis and flexor carpi ulnaris muscle bellies. Most of the caudal articular surfaces of the humeral condyles, the caudal perimeter of the radius, and the trochlear notch and portions of the anconeal process of the ulna could be identified. The voluminous caudal joint capsule cul-de-sac proximal to the anconeal process was readily entered. A 70 degree arthroscope allowed examination of more of the joint recesses and articular surfaces of the olecranon fossa than a 25 degree arthroscope. A second portal for intraarticular instrument manipulation was made caudal and slightly proximal to the arthroscope entry. Entry more proximal than the level of the radiohumeral articulation carried significant risk of damage to the ulnar nerve and collateral ulnar artery and vein. For examination of the cranial regions of the elbow, a craniolateral portal was established cranial to the lateral collateral ligament. An instrument portal was made through the muscle bellies of the extensor carpi radialis or common digital extensor muscles. The cranial articular surfaces of the humeral condyles were readily exposed by extension of the elbow. The weight-bearing articular surface of the radius could not be seen. Eight horses were euthanatized without recovery from anesthesia and the elbows were dissected for examination. Three horses were allowed to recover from anesthesia and were euthanatized on days 3, 30, and 60.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2333691

  14. Lateral Programmable Metallization Cell Devices And Applications

    NASA Astrophysics Data System (ADS)

    Ren, Minghan

    2011-12-01

    Programmable Metallization Cell (PMC) is a technology platform which utilizes mass transport in solid or liquid electrolyte coupled with electrochemical (redox) reactions to form or remove nanoscale metallic electrodeposits on or in the electrolyte. The ability to redistribute metal mass and form metallic nanostructure in or on a structure in situ, via the application of a bias on laterally placed electrodes, creates a large number of promising applications. A novel PMC-based lateral microwave switch was fabricated and characterized for use in microwave systems. It has demonstrated low insertion loss, high isolation, low voltage operation, low power and low energy consumption, and excellent linearity. Due to its non-volatile nature the switch operates with fewer biases and its simple planar geometry makes possible innovative device structures which can be potentially integrated into microwave power distribution circuits. PMC technology is also used to develop lateral dendritic metal electrodes. A lateral metallic dendritic network can be grown in a solid electrolyte (GeSe) or electrodeposited on SiO2 or Si using a water-mediated method. These dendritic electrodes grown in a solid electrolyte (GeSe) can be used to lower resistances for applications like self-healing interconnects despite its relatively low light transparency; while the dendritic electrodes grown using water-mediated method can be potentially integrated into solar cell applications, like replacing conventional Ag screen-printed top electrodes as they not only reduce resistances but also are highly transparent. This research effort also laid a solid foundation for developing dendritic plasmonic structures. A PMC-based lateral dendritic plasmonic structure is a device that has metallic dendritic networks grown electrochemically on SiO2 with a thin layer of surface metal nanoparticles in liquid electrolyte. These structures increase the distribution of particle sizes by connecting pre-deposited Ag nanoparticles into fractal structures and result in three significant effects, resonance red-shift, resonance broadening and resonance enhancement, on surface plasmon resonance for light trapping simultaneously, which can potentially enhance thin film solar cells' performance at longer wavelengths.

  15. Efferent pathways of the mouse lateral habenula.

    PubMed

    Quina, Lely A; Tempest, Lynne; Ng, Lydia; Harris, Julie A; Ferguson, Susan; Jhou, Thomas C; Turner, Eric E

    2015-01-01

    The lateral habenula (LHb) is part of the habenula complex of the dorsal thalamus. Recent studies of the LHb have focused on its projections to the ventral tegmental area (VTA) and rostromedial tegmental nucleus (RMTg), which contain γ-aminobutyric acid (GABA)ergic neurons that mediate reward prediction error via inhibition of dopaminergic activity. However, older studies in the rat have also identified LHb outputs to the lateral and posterior hypothalamus, median raphe, dorsal raphe, and dorsal tegmentum. Although these studies have shown that the medial and lateral divisions of the LHb have somewhat distinct projections, the topographic specificity of LHb efferents is not completely understood, and the relative extent of these projections to brainstem targets is unknown. Here we have used anterograde tracing with adeno-associated virus-mediated expression of green fluorescent protein, combined with serial two-photon tomography, to map the efferents of the LHb on a standard coordinate system for the entire mouse brain, and reconstruct the efferent pathways of the LHb in three dimensions. Using automated quantitation of fiber density, we show that in addition to the RMTg, the median raphe, caudal dorsal raphe, and pontine central gray are major recipients of LHb efferents. By using retrograde tract tracing with cholera toxin subunit B, we show that LHb neurons projecting to the hypothalamus, VTA, median raphe, caudal dorsal raphe, and pontine central gray reside in characteristic, but sometimes overlapping regions of the LHb. Together these results provide the anatomical basis for systematic studies of LHb function in neural circuits and behavior in mice. J. Comp. Neurol. 523:32-60, 2015. © 2014 Wiley Periodicals, Inc. PMID:25099741

  16. Involvements of the lateral hypothalamic area in gastric motility and its regulation by the lateral septum.

    PubMed

    Gong, Yanling; Xu, Luo; Wang, Hongbo; Guo, Feifei; Sun, Xiangrong; Gao, Shengli

    2013-12-01

    Ghrelin is an endogenous ligand for the growth hormone secretagogue receptor (GHS-R) pre-dominantly produced in the stomach. Recent studies have shown that it may promote food intake and gastric motility. We aim to explore effects of ghrelin on the gastric distension (GD) sensitive neurons and gastric motility in the lateral hypothalamic area (LHA), and the possible regulation by the lateral septum. Extracellular single unit discharges were recorded and the gastric motility was monitored by administration of ghrelin into LHA and electrical stimulation of lateral septum. Expression of GHS-R was determined by polymerase chain reaction (PCR), western blot and immunohistochemistry staining. Projection of nerve fiber and expression of ghrelin were observed by retrograde tracer and fluo-immunohistochemistry staining. Results revealed that there were GD neurons in the LHA, and administration of ghrelin could excite both GD-excitatory (GD-E) and GD-inhibited (GD-I) neurons in the LHA. The gastric motility was significantly promoted by administration of ghrelin into LHA with a dose dependent manner, which could be completely abolished by treatment with ghrelin receptor antagonist [D-Lys-3]-GHRP-6 or BIM-28163. c-Fos expression was significantly increased after ghrelin administration to the LHA. Electrical stimulation of the lateral septum could significantly excite GD neurons responsive to ghrelin in the LHA as well as promote gastric motility. However, those effects could be absorbed by pre-treatment of [D-Lys-3]-GHRP-6. GHSR-1a expression in the LHA had no change after ghrelin administration to the LHA or electrical stimulating lateral septum. Electrical lesion of the LHA resulted in the decrease of gastric motility. GHS-R and Ghrelin/FG-double labeled neurons were observed in the LHA and lateral septum, respectively. It is suggested that the LHA may involve in promoting gastric motility via ghrelin. The Lateral septum projects to the LHA and exerts some regulating function on the LHA. PMID:24100167

  17. UPRC completes first quad-lateral well

    SciTech Connect

    Califf, B. ); Kerr, D. )

    1993-09-01

    This paper describes the Union Pacific Resources Company's first large diameter quad-lateral well in the Austin Chalk of Texas. The Austin Chalk has at least two producing zones which are separated by either a shale zone or a volcanic ash zone. The UPRC well was designed to penetrate two horizontal drainage wells into each of these zones. This paper reviews the design, cost, and success of this project and the applicability of the technology to other horizontal drilling projects worldwide. The main thrust of the article was that multiple horizontal wells drilled from the same drill site reduces the cost for all wells to a level making horizontal drilling more attractive.

  18. Lateral chirality-sorting optical forces.

    PubMed

    Hayat, Amaury; Mueller, J P Balthasar; Capasso, Federico

    2015-10-27

    The transverse component of the spin angular momentum of evanescent waves gives rise to lateral optical forces on chiral particles, which have the unusual property of acting in a direction in which there is neither a field gradient nor wave propagation. Because their direction and strength depends on the chiral polarizability of the particle, they act as chirality-sorting and may offer a mechanism for passive chirality spectroscopy. The absolute strength of the forces also substantially exceeds that of other recently predicted sideways optical forces. PMID:26453555

  19. Trigemino-abducens synkinesis after lateral orbitotomy.

    PubMed

    Park, Kyung-Ah; Oh, Sei Yeul

    2013-01-01

    A 30-year-old man underwent lateral orbitotomy with removal of dermoid cyst in the right orbit. One month after operation, the patient started to experience double vision. He had 25 prism diopters of esotropia in primary gaze with marked limitation of abduction in the right eye. Seven months after the operation, he developed synkinetic movement of the eye when clenching his teeth. He could abduct his right eye while gritting his teeth. This is the fourth reported case of trigemino-abducens synkinesis and the first reported case without brain trauma. PMID:23128534

  20. Quantifying Disease Progression in Amyotrophic Lateral Sclerosis

    PubMed Central

    Simon, Neil G; Turner, Martin R; Vucic, Steve; Al-Chalabi, Ammar; Shefner, Jeremy; Lomen-Hoerth, Catherine; Kiernan, Matthew C

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) exhibits characteristic variability of onset and rate of disease progression, with inherent clinical heterogeneity making disease quantitation difficult. Recent advances in understanding pathogenic mechanisms linked to the development of ALS impose an increasing need to develop strategies to predict and more objectively measure disease progression. This review explores phenotypic and genetic determinants of disease progression in ALS, and examines established and evolving biomarkers that may contribute to robust measurement in longitudinal clinical studies. With targeted neuroprotective strategies on the horizon, developing efficiencies in clinical trial design may facilitate timely entry of novel treatments into the clinic. PMID:25223628

  1. Energy metabolism in amyotrophic lateral sclerosis.

    PubMed

    Dupuis, Luc; Pradat, Pierre-Franois; Ludolph, Albert C; Loeffler, Jean-Philippe

    2011-01-01

    Amyotrophic lateral sclerosis (ALS) is characterised by the progressive degeneration of upper and lower motor neurons. Besides motor neuron degeneration, ALS is associated with several defects in energy metabolism, including weight loss, hypermetabolism, and hyperlipidaemia. Most of these abnormalities correlate with duration of survival, and available clinical evidence supports a negative contribution of defective energy metabolism to the overall pathogenic process. Findings from animal models of ALS support this view and provide insights into the underlying mechanisms. Altogether, these results have clinical consequences for the management of defective energy metabolism in patients with ALS and pave the way for future therapeutic interventions. PMID:21035400

  2. Lateral chirality-sorting optical forces

    PubMed Central

    Hayat, Amaury; Mueller, J. P. Balthasar; Capasso, Federico

    2015-01-01

    The transverse component of the spin angular momentum of evanescent waves gives rise to lateral optical forces on chiral particles, which have the unusual property of acting in a direction in which there is neither a field gradient nor wave propagation. Because their direction and strength depends on the chiral polarizability of the particle, they act as chirality-sorting and may offer a mechanism for passive chirality spectroscopy. The absolute strength of the forces also substantially exceeds that of other recently predicted sideways optical forces. PMID:26453555

  3. Potential Environmental Factors in Amyotrophic Lateral Sclerosis.

    PubMed

    Oskarsson, Björn; Horton, D Kevin; Mitsumoto, Hiroshi

    2015-11-01

    The causes of amyotrophic lateral sclerosis (ALS) are largely unknown, and may always be multiple, including environmental factors. Monogenetic determinants of ALS are involved in roughly 20% of all cases (including 10% familial cases). Less well understood multigenetic causes may contribute to another 20% to 80%. Environmental factors likely play a role in the development of ALS in susceptible individuals, but proved causation remains elusive. This article discusses the possible factors of male gender (males are selectively exposed to different influences, or genetically predisposed to be susceptible), smoking, military service, exercise, electrical exposure, heavy metals, agricultural chemicals, and geographic clusters. PMID:26515627

  4. Lateral stress evolution in Chromium Sulfide

    NASA Astrophysics Data System (ADS)

    Petel, O. E.; Appleby-Thomas, G. J.; Hameed, A.; Capozzi, A.; Goroshin, S.; Frost, D. L.; Hazell, P. J.

    2014-05-01

    In this paper the shock response of CrS, a cermet of potential interest as a matrix material for ballistic applications, has been investigated. Compacts with a Chromium: Sulfur ratio of 1.15:1 were investigated via the plate-impact technique. These experiments allowed the material to be loaded under a one-dimensional state of strain. Embedded manganin stress gauges were employed to monitor the temporal evolution of longitudinal and lateral components of stress. Comparison of these two components has allowed assessment of the variation of material shear strength both with impact pressure/strain-rate and time.

  5. Towards reproducible, scalable lateral molecular electronic devices

    SciTech Connect

    Durkan, Colm Zhang, Qian

    2014-08-25

    An approach to reproducibly fabricate molecular electronic devices is presented. Lateral nanometer-scale gaps with high yield are formed in Au/Pd nanowires by a combination of electromigration and Joule-heating-induced thermomechanical stress. The resulting nanogap devices are used to measure the electrical properties of small numbers of two different molecular species with different end-groups, namely 1,4-butane dithiol and 1,5-diamino-2-methylpentane. Fluctuations in the current reveal that in the case of the dithiol molecule devices, individual molecules conduct intermittently, with the fluctuations becoming more pronounced at larger biases.

  6. Uniform lateral load capacity of infilled frames

    SciTech Connect

    Flanagan, R.D.; Bennett, R.M.

    1993-11-11

    Three tests were conducted on 2.4 meter by 2.4 meter steel frames infilled with structural clay tile to determine the behavior and capacity when subjected to uniform lateral loads. An air bag was used to apply the out-of-plane loads. The walls were subjected to increasing load-unload cycles until virtual destruction of the infill. Cracking in the mortar joints occurred early in the tests, and then the primary load resisting mechanism was arching of the infilled panel. Typically, vertical arching occurred until failure of the top and bottom course tiles. Following failure of these courses, horizontal arching developed enabling the walls to maintain stability.

  7. Auditory lateralization: an effect of rhythm.

    PubMed

    Buxton, H

    1983-03-01

    Recall of monaurally presented semantically anomalous sentences, which had either neutral or rhythmic timing, was tested at the right ear, at the left ear, and on transfer from one ear to the other. The component words, being computer stored digitized waveforms, had identical acoustic structure in the two conditions. In the rhythmic condition there was not only an overall advantage in the second half of the experiment but also an asymmetric transfer effect such that this advantage did not appear when the left ear was tested after the right. It is proposed that functional lateralization be viewed as an adaptive, dynamic, organizational factor. PMID:6839142

  8. Lateral root initiation in Marsilea quadrifolia. I. Origin and histogensis of lateral roots

    NASA Technical Reports Server (NTRS)

    Lin, B. L.; Raghavan, V.

    1991-01-01

    In Marsilea quadrifolia, lateral roots arise from modified single cells of the endodermis located opposite the protoxylem poles within the meristematic region of the parent root. The initial cell divides in four specific planes to establish a five-celled lateral root primordium, with a tetrahedral apical cell in the centre and the oldest merophytes and the root cap along the sides. The cells of the merophyte divide in a precise pattern to give rise to the cells of the cortex, endodermis, pericycle, and vascular tissues of the emerging lateral root. Although the construction of the parent root is more complicated than that of lateral roots, patterns of cell division and tissue formation are similar in both types of roots, with the various tissues being arranged in similar positions in relation to the central axis. Vascular connection between the lateral root primordium and the parent root is derived from the pericycle cells lying between the former and the protoxylem members of the latter. It is proposed that the central axis of the root is not only a geometric centre, but also a physiological centre which determines the fate of the different cell types.

  9. Balance problems after unilateral lateral ankle sprains.

    PubMed

    Akbari, Mohammad; Karimi, Hossein; Farahini, Hossein; Faghihzadeh, Soghrat

    2006-01-01

    Abstract-Ankle ligament injury is the most common injury in athletic activities. This study examined balance problems in athletes with acute lateral ankle sprains. Thirty male athletes aged 20 to 35 years with right dominant side and traumatic ankle sprain were recruited through simple nonprobability sampling. We measured the sway index and limits of stability with the Biodex Balance System under different conditions. Functional balance was evaluated with two clinical tests: the Functional Reach Test and the Star-Excursion Balance Test. The results showed that balance ability in patients with acute lateral ankle sprain was significantly weaker under closed- versus open-eye conditions. Symmetry of weight-bearing on involved and sound limb in bilateral standing was not significantly different, but weight-bearing on the nondominant limb was significantly higher than on the dominant limb. We can conclude that balance problems occur after acute ankle sprains because of proprioception deficits and that the unconscious (reflexive) aspect of proprioception is more severely affected than the conscious (voluntary) aspect. PMID:17436168

  10. Lateral vision in horses: a behavioral investigation.

    PubMed

    Hanggi, Evelyn B; Ingersoll, Jerry F

    2012-09-01

    This study investigated lateral vision in horses (Equus caballus) for the first time from a behavioral point of view. Three horses were tested using a novel experimental design to determine the range of their lateral and caudolateral vision with respect to stimulus detection and discrimination. Real-life stimuli were presented along a curvilinear wall in one of four different positions (A, B, C, D) and one of two height locations (Top, Bottom) on both sides of the horse. To test for stimulus detection, the correct stimulus was paired against a control; for stimulus discrimination, the correct stimulus was paired against another object. To indicate that the correct stimulus was detected or discriminated, the horses pushed one of two paddles. All horses scored significantly above chance on stimulus detection trials regardless of stimulus position or location. They also accurately discriminated between stimuli when objects appeared in positions A, B, and C for the top or bottom locations; however, they failed to discriminate these stimuli at position D. This study supports physiological descriptions of the equine eye and provides new behavioral data showing that horses can detect the appearance of objects within an almost fully encompassing circle and are able to identify objects within most but not all of their panoramic field of view. PMID:22698758

  11. Lateral regulation of synaptic transmission by astrocytes.

    PubMed

    Covelo, A; Araque, A

    2016-05-26

    Fifteen years ago the concept of the "tripartite synapse" was proposed to conceptualize the functional view that astrocytes are integral elements of synapses. The signaling exchange between astrocytes and neurons within the tripartite synapse results in the synaptic regulation of synaptic transmission and plasticity through an autocrine form of communication. However, recent evidence indicates that the astrocyte synaptic regulation is not restricted to the active tripartite synapse but can be manifested through astrocyte signaling at synapses relatively distant from active synapses, a process termed lateral astrocyte synaptic regulation. This phenomenon resembles the classical heterosynaptic modulation but is mechanistically different because it involves astrocytes and its properties critically depend on the morphological and functional features of astrocytes. Therefore, the functional concept of the tripartite synapse as a fundamental unit must be expanded to include the interaction between tripartite synapses. Through lateral synaptic regulation, astrocytes serve as an active processing bridge for synaptic interaction and crosstalk between synapses with no direct neuronal connectivity, supporting the idea that neural network function results from the coordinated activity of astrocytes and neurons. PMID:25732135

  12. Lateral Gene Transfer from the Dead

    PubMed Central

    Szöllősi, Gergely J.; Tannier, Eric; Lartillot, Nicolas; Daubin, Vincent

    2013-01-01

    In phylogenetic studies, the evolution of molecular sequences is assumed to have taken place along the phylogeny traced by the ancestors of extant species. In the presence of lateral gene transfer, however, this may not be the case, because the species lineage from which a gene was transferred may have gone extinct or not have been sampled. Because it is not feasible to specify or reconstruct the complete phylogeny of all species, we must describe the evolution of genes outside the represented phylogeny by modeling the speciation dynamics that gave rise to the complete phylogeny. We demonstrate that if the number of sampled species is small compared with the total number of existing species, the overwhelming majority of gene transfers involve speciation to and evolution along extinct or unsampled lineages. We show that the evolution of genes along extinct or unsampled lineages can to good approximation be treated as those of independently evolving lineages described by a few global parameters. Using this result, we derive an algorithm to calculate the probability of a gene tree and recover the maximum-likelihood reconciliation given the phylogeny of the sampled species. Examining 473 near-universal gene families from 36 cyanobacteria, we find that nearly a third of transfer events (28%) appear to have topological signatures of evolution along extinct species, but only approximately 6% of transfers trace their ancestry to before the common ancestor of the sampled cyanobacteria. [Gene tree reconciliation; lateral gene transfer; macroevolution; phylogeny.] PMID:23355531

  13. Prototype cantilevers for quantitative lateral force microscopy

    SciTech Connect

    Reitsma, Mark G.; Gates, Richard S.; Friedman, Lawrence H.; Cook, Robert F.

    2011-09-15

    Prototype cantilevers are presented that enable quantitative surface force measurements using contact-mode atomic force microscopy (AFM). The ''hammerhead'' cantilevers facilitate precise optical lever system calibrations for cantilever flexure and torsion, enabling quantifiable adhesion measurements and friction measurements by lateral force microscopy (LFM). Critically, a single hammerhead cantilever of known flexural stiffness and probe length dimension can be used to perform both a system calibration as well as surface force measurements in situ, which greatly increases force measurement precision and accuracy. During LFM calibration mode, a hammerhead cantilever allows an optical lever ''torque sensitivity'' to be generated for the quantification of LFM friction forces. Precise calibrations were performed on two different AFM instruments, in which torque sensitivity values were specified with sub-percent relative uncertainty. To examine the potential for accurate lateral force measurements using the prototype cantilevers, finite element analysis predicted measurement errors of a few percent or less, which could be reduced via refinement of calibration methodology or cantilever design. The cantilevers are compatible with commercial AFM instrumentation and can be used for other AFM techniques such as contact imaging and dynamic mode measurements.

  14. Prototype cantilevers for quantitative lateral force microscopy

    NASA Astrophysics Data System (ADS)

    Reitsma, Mark G.; Gates, Richard S.; Friedman, Lawrence H.; Cook, Robert F.

    2011-09-01

    Prototype cantilevers are presented that enable quantitative surface force measurements using contact-mode atomic force microscopy (AFM). The "hammerhead" cantilevers facilitate precise optical lever system calibrations for cantilever flexure and torsion, enabling quantifiable adhesion measurements and friction measurements by lateral force microscopy (LFM). Critically, a single hammerhead cantilever of known flexural stiffness and probe length dimension can be used to perform both a system calibration as well as surface force measurements in situ, which greatly increases force measurement precision and accuracy. During LFM calibration mode, a hammerhead cantilever allows an optical lever "torque sensitivity" to be generated for the quantification of LFM friction forces. Precise calibrations were performed on two different AFM instruments, in which torque sensitivity values were specified with sub-percent relative uncertainty. To examine the potential for accurate lateral force measurements using the prototype cantilevers, finite element analysis predicted measurement errors of a few percent or less, which could be reduced via refinement of calibration methodology or cantilever design. The cantilevers are compatible with commercial AFM instrumentation and can be used for other AFM techniques such as contact imaging and dynamic mode measurements

  15. Lateral Pectoral Nerve Injury Mimicking Cervical Radiculopathy.

    PubMed

    Aktas, Ilknur; Palamar, Deniz; Akgun, Kenan

    2015-07-01

    The lateral pectoral nerve (LPN) is commonly injured along with the brachial plexus, but its isolated lesions are rare. Here, we present a case of an isolated LPN lesion confused with cervical radiculopathy. A 41-year-old man was admitted to our clinic because of weakness in his right arm. Previous magnetic resonance imaging (MRI) examination revealed right posterolateral protrusion at the C6-7 level. At the initial assessment, atrophy of the right pectoralis major muscle was evident, and mild weakness of the right shoulder adductor, internal rotator, and flexor muscles was observed. Therefore, electrodiagnostic evaluation was performed, and a diagnosis of isolated LPN injury was made. Nerve injury was thought to have been caused by weightlifting exercises and traction injury. Lateral pectoral nerve injury can mimic cervical radiculopathy, and MRI examination alone may lead to misdiagnosis. Repeated physical examinations during the evaluation and treatment phase will identify the muscle atrophy that occurs 1 or more months after the injury. PMID:25290103

  16. Semantic deficits in amyotrophic lateral sclerosis.

    PubMed

    Leslie, Felicity V C; Hsieh, Sharpley; Caga, Jashelle; Savage, Sharon A; Mioshi, Eneida; Hornberger, Michael; Kiernan, Matthew C; Hodges, John R; Burrell, James R

    2015-03-01

    Our objective was to investigate, and establish neuroanatomical correlates of, semantic deficits in amyotrophic lateral sclerosis (ALS) and amyotrophic lateral sclerosis-frontotemporal dementia (ALS-FTD), compared to semantic dementia (SD) and controls. Semantic deficits were evaluated using a naming and semantic knowledge composite score, comprising verbal and non-verbal neuropsychological measures of single-word processing (confrontational naming, comprehension, and semantic association) from the Sydney Language Battery (SYDBAT) and Addenbrooke's Cognitive Examination - Revised (ACE-R). Voxel based morphometry (VBM) analysis was conducted using the region of interest approach. In total, 84 participants were recruited from a multidisciplinary research clinic in Sydney. Participants included 17 patients with ALS, 19 with ALS-FTD, 22 with SD and 26 age- and education-matched healthy controls. Significant semantic deficits were observed in ALS and ALS-FTD compared to controls. The severity of semantic deficits varied across the clinical phenotypes: ALS patients were less impaired than ALS-FTD patients, who in turn were not as impaired as SD patients. Anterior temporal lobe atrophy significantly correlated with semantic deficits. In conclusion, semantic impairment is a feature of ALS and ALS-FTD, and reflects the severity of temporal lobe pathology. PMID:25544644

  17. Nappe emplacement under lateral pressure gradient

    NASA Astrophysics Data System (ADS)

    Podladchikov, Yury; Schmalholz, Stefan

    2014-05-01

    New thin viscous approximation is under development specifically targeted to model spontaneous initiation and tens of kilometers horizontal displacement of tectonic nappes. Nappes are few kilometers thing and tens of kilometers long rock units trusted towards foreland often preserving internal lithological consistency and laying at near horizontal position at the end of the emplacement. Significant shear stresses and deviation of principal stresses from vertical is required to explain this very peculiar strain localization style from mechanical point of view. There is also a need for the explanation of their common appearances in most collisional settings. Both pure shear thin sheet and flexural models kinematically eliminate nappes formation. Spreading viscous sheet models, such as used to model glaciers, are also not applicable as the direction of motion is upward, against gravity. The reason for this discrepancy is the hydrostatic pressure approximation of the gravity-driven spreading models. Actually, the thin sheet approximation is not sensitive to the assumptions made on pressure profile. Lateral non-lithostatic pressure gradient-driven viscous sheet model is appropriate for modeling of nappes. In turn, significant non-lithostatic pressure must be supported by flexural rigidity of overlying and underlying units. Lateral gradients of this non-lithostatic pressure are responsible for the significant shear stress and, therefore, deviation of principal stress from vertical.

  18. Dual-domain lateral shearing interferometer

    DOEpatents

    Naulleau, Patrick P.; Goldberg, Kenneth Alan

    2004-03-16

    The phase-shifting point diffraction interferometer (PS/PDI) was developed to address the problem of at-wavelength metrology of extreme ultraviolet (EUV) optical systems. Although extremely accurate, the fact that the PS/PDI is limited to use with coherent EUV sources, such as undulator radiation, is a drawback for its widespread use. An alternative to the PS/PDI, with relaxed coherence requirements, is lateral shearing interferometry (LSI). The use of a cross-grating, carrier-frequency configuration to characterize a large-field 4.times.-reduction EUV lithography optic is demonstrated. The results obtained are directly compared with PS/PDI measurements. A defocused implementation of the lateral shearing interferometer in which an image-plane filter allows both phase-shifting and Fourier wavefront recovery. The two wavefront recovery methods can be combined in a dual-domain technique providing suppression of noise added by self-interference of high-frequency components in the test-optic wavefront.

  19. Amyotrophic lateral sclerosis: one or multiple causes?

    PubMed Central

    Bastos, Aline Furtado; Orsini, Marco; Machado, Dionis; Mello, Mariana Pimentel; Nader, Sergio; Silva, Júlio Guilherme; da Silva Catharino, Antonio M.; de Freitas, Marcos R.G.; Pereira, Alessandra; Pessoa, Luciane Lacerda; Sztajnbok, Flavio R.; Leite, Marco Araújo; Nascimento, Osvaldo J.M.; Bastos, Victor Hugo

    2011-01-01

    The Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease in the adulthood, and it is characterized by rapid and progressive compromise of the upper and lower motor neurons. The majority of the cases of ALS are classified as sporadic and, until now, a specific cause for these cases still is unknown. To present the different hypotheses on the etiology of ALS. It was carried out a search in the databases: Bireme, Scielo and Pubmed, in the period of 1987 to 2011, using the following keywords: Amyotrophic lateral sclerosis, motor neuron disease, etiology, causes and epidemiology and its similar in Portuguese and Spanish. It did not have consensus as regards the etiology of ALS. Researches demonstrates evidences as regards intoxication by heavy metals, environmental and occupational causes, genetic mutations (superoxide dismutase 1), certain viral infections and the accomplishment of vigorous physical activity for the development of the disease. There is still no consensus regarding the involved factors in the etiology of ALS. In this way, new research about these etiologies are necessary, for a better approach of the patients, promoting preventive programs for the disease and improving the quality of life of the patients. PMID:21785676

  20. Confronting the Material Convoy in Later Life

    PubMed Central

    Smith, Gabriella V.; Ekerdt, David J.

    2011-01-01

    We adapt a metaphor from life course studies to designate the whole of one’s possessions, across time, as a convoy of material support. This dynamic collection of things supports daily life and the self, but it can also present difficulty in later life. To alleviate the purported burdens of the material convoy, a discourse has arisen that urges elders and their family members to reduce the volume of possessions. An analysis of 11 such possession management texts shows authors addressing two distinct audiences about elders’ need to downsize: family members and elders themselves. Authors who speak to family members do so with an urgent, unsentimental tone that echoes mainstream clutter-control advice about disorderly, overfull households. In texts for elders, the standard critique about consumption and unruly lives is gentler, more sensitive to the meaning of things, and underplays the emotions of divestment. There is stress on the responsibility to spare the next generation and control one’s legacy. These latter texts seem to respect that downsizing in later life symbolizes a narrowing of the life world. PMID:21822336

  1. Restoration deterioration related to later failure.

    PubMed

    Smales, R J; Webster, D A

    1993-01-01

    The purpose of this study was to determine the relationship between the deterioration and the later failure of a very large number of amalgams and anterior resin composites examined over periods of up to 16 years. Assessments were made of the deterioration of various clinical factors or characteristics of the restorative materials that were thought to predict later failures. True failures, which were directly related to the restorative materials, accounted for 7.5% of the amalgam and 30.4% of the composite restorations. For the amalgams, there was a significant association found between the failures and surface tarnishing. Marginal fracture and marginal staining were not associated significantly with any of the three different failure modes. For the composites there were significant associations found between the failures and surface roughness, marginal fracture, and color mismatch. Surface staining and marginal staining were not associated significantly with any of the three different failure modes. Many restorations assessed as being unsatisfactory continued to function for a further 2.5 to 3.5 years on average before being replaced, often for unrelated reasons. There is a need to define unsatisfactory restorations more clearly in terms of actual adverse effects on dental health, rather than merely in terms of restoration deterioration. PMID:8152980

  2. [Outcome of surgically treated lateral clavicle fractures].

    PubMed

    Krüger-Franke, M; Köhne, G; Rosemeyer, B

    2000-07-01

    This retrospective study presents the results of 41 patients with a lateral clavicle fracture eight years after the treatment at the Staatliche Orthopädische Klinik of the LMU München in the time between 31.10.1979 and 31.10.1994. It could be shown that the lateral clavicle fractures, due to their variety, hold a special position among the clavicle fractures and thus need a differentiated therapeutic procedure. Among the operation methods the K-wire stabilisation with cerclage was the most often chosen operation technique i.e. in 24 cases. The K-wire without cerclage was used in two cases. Twelve fractures were treated with AO-plate-osteosynthesis. Three fractures had to be treated by resection, as they produced two pseudarthrosis and one serious AC-arthrosis during the conservative therapy. 92.7% of the subjective results of the 41 checked up patients were good and very good. The clinical follow-up of 36 and the radiological follow-up of 33 patients revealed in 97% a good and very good outcome in the Boenisch-Score. PMID:10969540

  3. Strath Terraces, Lateral Planation, and Sediment Supply

    NASA Astrophysics Data System (ADS)

    Finnegan, N. J.; Dietrich, W. E.

    2008-12-01

    Abandoned fluvially eroded bedrock surfaces (strath terraces) are used ubiquitously as indicators of past river elevation. However, little is known about how, why and over what time period they form. Consequently, dates of strath surfaces, or overlying gravels, can be difficult to interpret without a more mechanistic understanding of strath genesis. We mapped strath terraces in detail in the field along the South Fork Eel River and its tributaries in the California Coast Ranges to illuminate the process(es) of lateral bedrock planation. We document two straths along the South Fork Eel: a high strath terrace with a bedrock surface at 9-12 m above the modern low water line and a low strath terrace with a bedrock elevation 2-5 m above modern low water line. Straths are capped with up to 6 meters of gravel, and are locally as much as 3 times the width of the modern river channel. The South Fork Eel incises interbedded sandstone and mudstone of the Franciscan Complex. Straths are usually, but not always, formed in the weaker mudstone. This is consistent with observations in the active river channel indicating mudstone is readily planed down to the low water line by weathering processes and abrasion, whereas sandstone forms resistant ribs that locally constrict the flow. Our observations suggest at least two primary mechanisms drive the lateral planation essential to preserving straths. First, many strath terraces along the South Fork Eel are exposed at the toe of inactive debris fans that entered the channel from tributaries and graded to the higher strath elevation. In these settings, the river has almost always cut vertically through the strath between the outside edge of the fan and a bedrock wall. We interpret this as evidence that when the debris fan was active and the river occupied the high strath, the river was pinned by the debris fan against a bedrock valley wall. This, in turn, suggests lateral sediment input from fans may be important in driving lateral motion of the river. Second, where there is no significant lateral sediment input, straths appear to form at channel meanders. Observations in the active channel suggest that mudstone bedrock will erode much more readily than bars or fans, which are both comprised almost entirely of resistant sandstone boulders. We hypothesize that deposition of point bars, island bars, and debris fans therefore provides a mechanism to preferentially armor one bank of an active channel, leading to erosion of the other bank where mudstone is present. Importantly, along the South Fork Eel the majority of straths appear to form unidirectionally, that is via one continuous sweep of the channel across the strath. Recent dating of strath terraces along the South Fork Eel by others (and additional samples awaiting dating) will be used to evaluate this hypothesis. We assess recent proposals that strath terrace formation on the South Fork Eel is associated with a doubling of hillslope erosion by running HEC- RAS on a LiDAR DEM of the South Fork Eel to model bed sediment transport and bed evolution under different sediment supply scenarios. A primary goal is to explore how up to 6 m of aggradation could be associated with strath terrace formation.

  4. Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later.

    PubMed

    Griffin, Martha; Clark, Cynthia M

    2014-12-01

    Ten years ago, Griffin wrote an article on the use of cognitive rehearsal as a shield for lateral violence. Since then, cognitive rehearsal has been used successfully in several studies as an evidence-based strategy to address uncivil and bullying behaviors in nursing. In the original study, 26 newly licensed nurses learned about lateral violence and used cognitive rehearsal techniques as an intervention for nurse-to-nurse incivility. The newly licensed nurses described using the rehearsed strategies as difficult, yet successful in reducing or eliminating incivility and lateral violence. This article updates the literature on cognitive rehearsal and reviews the use of cognitive rehearsal as an evidence-based strategy to address incivility and bullvina behaviors in nursing. PMID:25406637

  5. Lateralized differences in olfactory bulb volume relate to lateralized differences in olfactory function.

    PubMed

    Hummel, T; Haehner, A; Hummel, C; Croy, I; Iannilli, E

    2013-05-01

    The present study aimed to investigate whether side differences in olfactory bulb (OB) volume correlate to respective differences in olfactory function. In a total of 164 healthy volunteers volumetric measures of the OBs were performed plus lateralized measurements of odor thresholds and odor discrimination. Side differences were defined as 10% difference between the left and right OB. In 39 cases volumes on the right side were larger than on the left side, whereas in 29 cases it was the other way around. Subjects with larger right-sided OB volumes were found to be more sensitive to odorous stimulation of the right as compared to the left nostril in terms of odor thresholds and odor detection; higher sensitivity of the left nostrils (decreased odor threshold) was observed in individuals with larger OB volumes on the left side. These data appear to suggest that OB volume may be partly dependent on lateralized influences on the olfactory system, reflecting its lateralized organization. PMID:23376116

  6. Summary of Methods for Calculating Dynamic Lateral Stability and Response and for Estimating Lateral Stability Derivatives

    NASA Technical Reports Server (NTRS)

    Campbell, John P; Mckinney, Marion O

    1951-01-01

    A summary of methods for making dynamic lateral stability and response calculations and for estimating the aerodynamic stability derivatives required for use in these calculations is presented. The processes of performing calculations of the time histories of lateral motions, of the period and damping of these motions, and of the lateral stability boundaries are presented as a series of simple straightforward steps. Existing methods for estimating the stability derivatives are summarized and, in some cases, simple new empirical formulas are presented. Reference is also made to reports presenting experimental data that should be useful in making estimates of the derivatives. Detailed estimating methods are presented for low-subsonic-speed conditions but only a brief discussion and a list of references are given for transonic- and supersonic-speed conditions.

  7. Radiographic Comparison between Cervical Spine Lateral and Whole-Spine Lateral Standing Radiographs

    PubMed Central

    Park, Moon Soo; Moon, Seong-Hwan; Kim, Tae-Hwan; Oh, Jae Keun; Kang, Hwa Jun; Riew, K. Daniel

    2015-01-01

    Study Design?Retrospective radiologic study. Objective?The sagittal alignment of the cervical spine can be evaluated using either a lateral cervical radiograph or a whole-spine lateral view on which the cervical spine is included. To our knowledge, however, no report has compared the two. The purpose of this work is to identify the difference in radiographic parameters between the cervical spine lateral view and the whole-spine lateral view. Methods?We retrospectively analyzed 59 adult patients suffering from neck pain with cervical spine lateral radiographs and whole-spine lateral radiographs from November 2007 to December 2011. The radiographs were measured using standard techniques to obtain the following parameters from the two different radiographs: occipitalC2 angle, C2C7 angle, C7sternal angle, sternal slope, T1 slope, C2 central offset distance, the distance between C2 and C7 plumb lines, C4 anteroposterior (AP) diameter, the ratio of C2 central off distance to C4 AP diameter, the ratio of plumb lines' distance to C4 AP diameter. Results?We found that the occipitalC2 angle, sternal slope, and C4 AP diameter were similar, but the C2C7 angle, C7sternal angle, T1 slope, C2 central offset distance, distance between C2 and C7 plumb lines, ratio of C2 central off distance to C4 AP diameter, and ratio of plumb lines' distance to C4 AP diameter were different. However, the error of measurement was greater than the small angular and linear differences between the two views. Conclusions?Most numerical values of the measured radiographic parameters appear to be different between the two views. However, the two views are comparable because the numerical differences were smaller than the errors of measurement.

  8. Bioenergetic markers in skin fibroblasts of sporadic amyotrophic lateral sclerosis and progressive lateral sclerosis patients.

    PubMed

    Kirk, Kathryne; Gennings, Chris; Hupf, Jonathan C; Tadesse, Saba; D'Aurelio, Marilena; Kawamata, Hibiki; Valsecchi, Federica; Mitsumoto, Hiroshi; Manfredi, Giovanni

    2014-10-01

    Energy metabolism could influence amyotrophic lateral sclerosis (ALS) and progressive lateral sclerosis (PLS) pathogenesis and the response to therapy. We developed a novel assay to simultaneously assess mitochondrial content and membrane potential in patients' skin fibroblasts. In ALS and PLS fibroblasts, membrane potential was increased and mitochondrial content decreased, relative to healthy controls. In ALS higher mitochondrial membrane potential correlated with age at diagnosis, and in PLS it correlated with disease severity. These unprecedented findings in ALS and PLS fibroblasts could shed new light onto disease pathogenesis and help in developing biomarkers to predict disease evolution and the individual response to therapy in motor neuron diseases. PMID:25090982

  9. Macroscopic lateral heterogeneity observed in a laterally mobile immiscible mixed polyelectrolyte-neutral polymer brush

    SciTech Connect

    Lee, Hoyoung; Tsouris, Vasilios; Lim, Yunho; Mustafa, Rafid; Choi, Je; Choi, Yun Hwa; Park, Hae-Woong; Meron, Mati; Lin, Binhua; Won, You-Yeon

    2014-07-11

    We studied mixed poly(ethylene oxide) (PEO) and poly(2-(dimethylamino)ethyl methacrylate) (PDMAEMA) brushes. The question we attempted to answer was: when the chain grafting points are laterally mobile, how will this lateral mobility influence the structure and phase behavior of the mixed brush? Three different model mixed PEO/PDMAEMA brush systems were prepared: (1) a laterally mobile mixed brush by spreading onto the air–water interface a mixture of poly(ethylene oxide)–poly(n-butyl acrylate) (PEO–PnBA) and poly(2-(dimethylamino)ethyl methacrylate)–poly(n-butyl acrylate) (PDMAEMA–PnBA) diblock copolymers (the specific diblock copolymers used will be denoted as PEO113–PnBA100 and PDMAEMA118–PnBA100, where the subscripts refer to the number-average degrees of polymerization of the individual blocks), (2) a mobility-restricted (inseparable) version of the above mixed brush prepared using a PEO–PnBA–PDMAEMA triblock copolymer (denoted as PEO113–PnBA89–PDMAEMA120) having respective brush molecular weights matched with those of the diblock copolymers, and (3) a different laterally mobile mixed PEO and PDMAEMA brush prepared from a PEO113–PnBA100 and PDMAEMA200–PnBA103 diblock copolymer combination, which represents a further more height-mismatched mixed brush situation than described in (1). These three mixed brush systems were investigated by surface pressure–area isotherm and X-ray (XR) reflectivity measurements. These experimental data were analyzed within the theoretical framework of a continuum self-consistent field (SCF) polymer brush model. The combined experimental and theoretical results suggest that the mobile mixed brush derived using the PEO113–PnBA100 and PDMAEMA118–PnBA100 combination (i.e., mixed brush System #1) undergoes a lateral macroscopic phase separation at high chain grafting densities, whereas the more height-mismatched system (System #3) is only microscopically phase separated under comparable brush density conditions even though the lateral mobility of the grafted chains is unrestricted. The macroscopic phase separation observed in the laterally mobile mixed brush system is in contrast with the microphase separation behavior commonly observed in two-dimensional laterally mobile charged small molecule mixtures. Further study is needed to determine the detailed morphologies of the macro- and microphase-separated mixed PEO/PDMAEMA brushes.

  10. Electrophysiological correlates of suppressive lateral interactions.

    PubMed

    Ellemberg, Dave; Brault, Olivier; Masson, Myriame

    2015-01-01

    The visibility of image elements can be reduced by other elements in their vicinity. This is usually explained by inhibitory lateral interactions among neurons in the primary visual cortex, although there is little evidence for the involvement of intracortical inhibition. Further, the mechanisms underlying these interactions remain unknown. We investigated the neural bases of suppressive lateral interactions by recording visual evoked potentials together with psychophysical measures for visual targets in the presence of flanking stimuli. High-density EEG's were recorded in eight observers with normal or corrected-to-normal vision in response to a foveally viewed Gabor as a function of the spacing of horizontally adjacent Gabors. Inter-element spacing ranged from 1.5 to 6 cycles from the centre of the target to the centre of either of its adjacent flankers. The central target had the same or a different orientation (0 º, ±15º, ±30º, and ±60º) and spatial frequency as the flankers (0, ±.5, and ±1 octave). Each stimulus configuration was repeated 80 times and stimuli were interleaved. We analyzed the power density and spectral coherence over the time-frequency plane (in the central occipito-parietal region). Power density (p = 0.015) as well as short- (p = 0.005) and long-range (p = 0.005) spectral coherence decreases as inter-element spacing decreased to reach conditions under which the psychophysical test produced the greatest suppression in the apparent contrast of the central Gabor. A similar pattern of results was found when the spatial frequency and orientation of the flankers were systematically varied. These findings support the cortical origin of suppressive lateral interactions through short- and long-range functional connectivity. Further, synaptic inhibition likely causes a breakdown of synchronisation in the network response, consistent with the proposition that a function of surround suppression is to remove the statistical redundancies by increasing the sparseness or selectivity of sensory responses. Meeting abstract presented at VSS 2015. PMID:26325797

  11. Lateral Quantum Dots for Quantum Information Processing

    NASA Astrophysics Data System (ADS)

    House, Matthew Gregory

    The possibility of building a computer that takes advantage of the most subtle nature of quantum physics has been driving a lot of research in atomic and solid state physics for some time. It is still not clear what physical system or systems can be used for this purpose. One possibility that has been attracting significant attention from researchers is to use the spin state of an electron confined in a semiconductor quantum dot. The electron spin is magnetic in nature, so it naturally is well isolated from electrical fluctuations that can a loss of quantum coherence. It can also be manipulated electrically, by taking advantage of the exchange interaction. In this work we describe several experiments we have done to study the electron spin properties of lateral quantum dots. We have developed lateral quantum dot devices based on the silicon metal-oxide-semiconductor transistor, and studied the physics of electrons confined in these quantum dots. We measured the electron spin excited state lifetime, which was found to be as long as 30 ms at the lowest magnetic fields that we could measure. We fabricated and characterized a silicon double quantum dot. Using this double quantum dot design, we fabricated devices which combined a silicon double quantum dot with a superconducting microwave resonator. The microwave resonator was found to be sensitive to two-dimensional electrons in the transistor channel, which we measured and characterized. We developed a new method for extracting information from random telegraph signals, which are produced when we observe thermal fluctuations of electrons in quantum dots. The new statistical method, based on the hidden Markov model, allows us to detect spin-dependent effects in such fluctuations even though we are not able to directly observe the electron spin. We use this analysis technique on data from two experiments involving gallium arsenide quantum dots and use it to measure spin-dependent tunneling rates. Our results advance the understanding of electron spin physics in lateral quantum dots, in silicon and in gallium arsenide.

  12. Genetics of amyotrophic lateral sclerosis: an update

    PubMed Central

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder involving both upper motor neurons (UMN) and lower motor neurons (LMN). Enormous research has been done in the past few decades in unveiling the genetics of ALS, successfully identifying at least fifteen candidate genes associated with familial and sporadic ALS. Numerous studies attempting to define the pathogenesis of ALS have identified several plausible determinants and molecular pathways leading to motor neuron degeneration, which include oxidative stress, glutamate excitotoxicity, apoptosis, abnormal neurofilament function, protein misfolding and subsequent aggregation, impairment of RNA processing, defects in axonal transport, changes in endosomal trafficking, increased inflammation, and mitochondrial dysfunction. This review is to update the recent discoveries in genetics of ALS, which may provide insight information to help us better understanding of the disease neuropathogenesis. PMID:23941283

  13. A comprehensive review of amyotrophic lateral sclerosis

    PubMed Central

    Zarei, Sara; Carr, Karen; Reiley, Luz; Diaz, Kelvin; Guerra, Orleiquis; Altamirano, Pablo Fernandez; Pagani, Wilfredo; Lodin, Daud; Orozco, Gloria; Chinea, Angel

    2015-01-01

    Amyotrophic lateral sclerosis (ALS) is a late-onset fatal neurodegenerative disease affecting motor neurons with an incidence of about 1/100,000. Most ALS cases are sporadic, but 5–10% of the cases are familial ALS. Both sporadic and familial ALS (FALS) are associated with degeneration of cortical and spinal motor neurons. The etiology of ALS remains unknown. However, mutations of superoxide dismutase 1 have been known as the most common cause of FALS. In this study, we provide a comprehensive review of ALS. We cover all aspects of the disease including epidemiology, comorbidities, environmental risk factor, molecular mechanism, genetic factors, symptoms, diagnostic, treatment, and even the available supplement and management of ALS. This will provide the reader with an advantage of receiving a broad range of information about the disease. PMID:26629397

  14. Electrodiagnosis in persons with amyotrophic lateral sclerosis.

    PubMed

    Joyce, Nanette C; Carter, Gregory T

    2013-05-01

    Electrophysiology remains an important tool in the evaluation of patients presenting with signs and symptoms of motor neuron disease. The electrodiagnostic study should include peripheral nerve conduction studies and needle electromyography to both exclude treatable disease and gather evidence regarding a diagnosis of amyotrophic lateral sclerosis (ALS). The recent changes in the revised El Escorial criteria, recommended by the Awaji-shima consensus group, have increased the diagnostic significance of fasciculation potentials to equal that of fibrillation and positive sharp-wave potentials in the needle electromyography examination of patients suspected of having ALS. In addition, electrophysiologic evidence is now considered equivalent to clinical signs and symptoms in reaching a diagnostic certainty of ALS. These changes, strategies for the design, and implementation of an effective electrodiagnostic evaluation, in addition to electrophysiologic techniques and their relationship to the evaluation of a patient with ALS, are reviewed and discussed. PMID:23523708

  15. On lateral competition in dynamic neural networks

    SciTech Connect

    Bellyustin, N.S.

    1995-02-01

    Artificial neural networks connected homogeneously, which use retinal image processing methods, are considered. We point out that there are probably two different types of lateral inhibition for each neural element by the neighboring ones-due to the negative connection coefficients between elements and due to the decreasing neuron`s response to a too high input signal. The first case characterized by stable dynamics, which is given by the Lyapunov function, while in the second case, stability is absent and two-dimensional dynamic chaos occurs if the time step in the integration of model equations is large enough. The continuous neural medium approximation is used for analytical estimation in both cases. The result is the partition of the parameter space into domains with qualitatively different dynamic modes. Computer simulations confirm the estimates and show that joining two-dimensional chaos with symmetries provided by the initial and boundary conditions may produce patterns which are genuine pieces of art.

  16. Amyotrophic lateral sclerosis associated with pregnancy.

    PubMed

    Tyagi, A; Sweeney, B J; Connolly, S

    2001-12-01

    Amyotrophic lateral sclerosis (ALS) is the most common, progressive motor neurone disease but is rare in the obstetric population. Only 4 cases have been described in the English literature since 1975. We describe a 29 year old woman who presented with ataxia, lower limb weakness and dysarthria 4 weeks after the birth of her first child. The symptoms had onset during the pregnancy but had not been considered remarkable. There were clinical features of upper and lower motor neurone involvement without any sensory loss. MRI of brain and spine was normal. CSF analysis was negative. EMG studies confirmed the presence of widespread anterior horn cell dysfunction compatible with ALS. The patient was commenced on Riluzole and has progressed clinically, at 12 months post diagnosis. PMID:11799421

  17. Amyotrophic lateral sclerosis and environmental factors

    PubMed Central

    Bozzoni, Virginia; Pansarasa, Orietta; Diamanti, Luca; Nosari, Guido; Cereda, Cristina; Ceroni, Mauro

    2016-01-01

    Summary Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder that affects central and peripheral motor neuron cells. Its etiology is unknown, although a relationship between genetic background and environmental factors may play a major role in triggering the neurodegeneration. In this review, we analyze the role of environmental factors in ALS: heavy metals, electromagnetic fields and electric shocks, pesticides, β-N-methylamino-L-alanine, physical activity and the controversial role of sports. The literature on the single issues is analyzed in an attempt to clarify, as clearly as possible, whether each risk factor significantly contributes to the disease pathogenesis. After summarizing conflicting observations and data, the authors provide a final synthetic statement. PMID:27027889

  18. Optical fiber head for providing lateral viewing

    DOEpatents

    Everett, Matthew J.; Colston, Billy W.; James, Dale L.; Brown, Steve; Da Silva, Luiz

    2002-01-01

    The head of an optical fiber comprising the sensing probe of an optical heterodyne sensing device includes a planar surface that intersects the perpendicular to axial centerline of the fiber at a polishing angle .theta.. The planar surface is coated with a reflective material so that light traveling axially through the fiber is reflected transverse to the fiber's axial centerline, and is emitted laterally through the side of the fiber. Alternatively, the planar surface can be left uncoated. The polishing angle .theta. must be no greater than 39.degree. or must be at least 51.degree.. The emitted light is reflected from adjacent biological tissue, collected by the head, and then processed to provide real-time images of the tissue. The method for forming the planar surface includes shearing the end of the optical fiber and applying the reflective material before removing the buffer that circumscribes the cladding and the core.

  19. EAS-BUAP: Lateral Distribution and Performance

    NASA Astrophysics Data System (ADS)

    Salazar, H.; Martinez, O.; Cotzomi, J.; Moreno, E.; Aguilar, S.; Villaseñor, L.

    2003-07-01

    We describe the operation and performance of the first stage of the EAS-UAP extensive air shower array, as a detector of very high energy cosmic rays (Eo > 1014eV) after one year of operation. The array is located at the Campus of Puebla University, 2200 m above sea level. It consists of 10 liquid scintillator detectors, each with an active surface of 1 m2 and a detector spacing of 20 m in a square grid. One Auger Water Cherenkov detector is also included as part of the array. In this report we discuss the stability, the calibration and lateral distribution function reconstruction capabilities of the detector array. We also present the analysis of the shower size spectrum. In addition, the main characteristics of this array allow us to use it as an educational and training facility.

  20. Autophagy dysregulation in amyotrophic lateral sclerosis.

    PubMed

    Chen, Sheng; Zhang, Xiaojie; Song, Lin; Le, Weidong

    2012-01-01

    Autophagy is an intracellular lysosomal degradation process, which plays an important role in cell growth and development, and keeping cellular homeostasis in all eukaryotes. Autophagy has multiple physiological functions, including protein degradation, organelle turnover and response to stress. Emerging evidences support the notion that dysregulation of autophagy might be critical for pathogenesis of amyotrophic lateral sclerosis (ALS). The autophagy dysregulation in motor neurons of ALS may occur in different steps of the autophagic process. Recent studies have shown that two ALS associated proteins, TDP-43 and superoxide dismutase 1 (SOD1), are involved in the abnormal autophagy regulation. Furthermore, it is reported that several genetic mutations in ALS disturb the autophagic process in the motor neurons. This review will provide new evidence of autophagy dysregulation as a critical pathogenic process leading to ALS, and will discuss the prospect of future therapeutic targets using autophagic regulation to treat this disease. PMID:22150926

  1. Amyotrophic lateral sclerosis from bench to bedside.

    PubMed

    Lomen-Hoerth, Catherine

    2008-04-01

    Amyotrophic lateral sclerosis (ALS) is a progressive disease for which there are currently no significant treatments to alter the fatal outcome. The cause of the disease is still elusive, except in familial cases where significant advances have been made in identifying new genetic causes. ALS is a relatively rare disease affecting approximately 1 in 100,000 people equally across geographic and ethnic distributions. It is a difficult disease to diagnose, and there are many mimics of ALS. Overlap with dementia may provide new clues to the etiology and treatment. There have been many advances in symptomatic treatments and improvements in the quality of life for ALS patients due to technological advancements. PMID:18351522

  2. [Lateral clavicular fractures in children and adolescents].

    PubMed

    Wilfinger, C; Höllwarth, M

    2002-07-01

    From 1996 to 1999, 572 fractures of the clavicle were treated in our department, 26 of which were located at the lateral end of the clavicle. Two children were operated: in one a closed reduction of the fracture under general anesthesia was performed, and in the other the fracture required open reduction with internal fixation. All other fractures were treated conservatively with a figure-of-eight clavicle strap for 3 weeks. A follow-up study was performed in autumn 2000. Sixteen patients came to our outpatient department for clinical and radiological control, and three patients informed us by phone. All patients including the two treated under general anesthesia were fully recovered and had no problems doing their job and engaging in different sports. The radiological controls showed a good ossification without visible deformity of the clavicle. PMID:12219645

  3. Analysis of flexible structures under lateral impact

    SciTech Connect

    Ramirez, D. F.; Razavi, H.

    2012-07-01

    Three methods for analysis of flexible structures under lateral impact are presented. The first proposed method (Method A) consists of: (1) modifying an available deceleration on a rigid target with conservation principles to account for structural flexibility; and (2) transient nonlinear analysis of the structure with the corrected forcing function. The second proposed method (Method B) is similar to Method A in obtaining the forcing function but it solves the equations of motion of an idealized two-degree-of-freedom system instead of directly using conservation principles. The last method simply provides the maximum force in the structure using the conservation of energy and linear momentum. A coupled simulation is also performed in LS-DYNA and compared against the proposed methods. A case study is presented to illustrate the applicability of all three methods and the LS-DYNA simulation. (authors)

  4. [Symptomatic management in amyotrophic lateral sclerosis (ALS)].

    PubMed

    Czaplinski, A; Schweikert, K; Strobel, W; Steck, A J; Weber, M

    2006-02-22

    Although disease-specific treatment of amyotrophic lateral sclerosis is still unsatisfactory, a number of advances have been made in the symptomatic therapy of ALS patients within the last decade. Current data suggest that active and aggressive multidisciplinary management of ALS patients improve their quality of life and prolong their survival. Patient and caregiver communications and decisions are increasingly recognized to be a relevant part of this management. A wide range of supportive and palliative measures, in particular the widely use of symptomatic drugs for pseudobulbar affect, sialorrhea, and sleep disorders is available to relieve patients symptomatology. In addition, patients quality of life has been profoundly improved by the introduction of enteral nutrition and non-invasive ventilation. PMID:16523990

  5. [Amyotrophic lateral sclerosis--diagnosis and treatment].

    PubMed

    Jung, H H; Neumann, M; Bloch, K E

    2012-07-01

    Amyotrophic lateral sclerosis (ALS) represents the most common motoneuron disorder in adulthood. It is characterized by selective degeneration of the motoneurons. About 10% of patients have a genetically determined ALS. Clinically, ALS is characterized by coexistence of signs of the first motoneuron, such as spasticity and hyperreflexia, as well as the second motoneuron, such as muscular atrophy and fasciculations. If such signs are present in at least three regions and if other possible causes have been excluded, a definite diagnosis of ALS can be made based on the revised El-Escorial criteria. Initial manifestations are often focalized and generalization develops during the course. The glutamate antagonist riluzole is worldwide the only approved ALS treatment. However, symptomatic treatments to ameliorate spasticity, drooling, speech and swallowing problems, and assisted ventilation to treat respiratory failure are essential. PMID:22763933

  6. Therapeutic neuroprotective agents for amyotrophic lateral sclerosis

    PubMed Central

    Pandya, Rachna S.; Zhu, Haining; Li, Wei; Bowser, Robert; Friedlander, Robert M.

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) is a fatal chronic neurodegenerative disease whose hallmark is proteinaceous, ubiquitinated, cytoplasmic inclusions in motor neurons and surrounding cells. Multiple mechanisms proposed as responsible for ALS pathogenesis include dysfunction of protein degradation, glutamate excitotoxicity, mitochondrial dysfunction, apoptosis, oxidative stress, and inflammation. It is therefore essential to gain a better understanding of the underlying disease etiology and search for neuroprotective agents that might delay disease onset, slow progression, prolong survival, and ultimately reduce the burden of disease. Because riluzole, the only Food and Drug Administration (FDA)-approved treatment, prolongs the ALS patient’s life by only 3 months, new therapeutic agents are urgently needed. In this review, we focus on studies of various small pharmacological compounds targeting the proposed pathogenic mechanisms of ALS and discuss their impact on disease progression. PMID:23864030

  7. Toward precision medicine in amyotrophic lateral sclerosis

    PubMed Central

    Liu, Chang-Yun; Che, Chun-Hui

    2016-01-01

    Precision medicine is an innovative approach that uses emerging biomedical technologies to deliver optimally targeted and timed interventions, customized to the molecular drivers of an individual’s disease. This approach is only just beginning to be considered for treating amyotrophic lateral sclerosis (ALS). The clinical and biological complexities of ALS have hindered development of effective therapeutic strategies. In this review we consider applying the key elements of precision medicine to ALS: phenotypic classification, comprehensive risk assessment, presymptomatic period detection, potential molecular pathways, disease model development, biomarker discovery and molecularly tailored interventions. Together, these would embody a precision medicine approach, which may provide strategies for optimal targeting and timing of efforts to prevent, stop or slow progression of ALS. PMID:26889480

  8. Lateral hypothalamic circuits for feeding and reward.

    PubMed

    Stuber, Garret D; Wise, Roy A

    2016-01-27

    In experiments conducted over 60 years ago, the lateral hypothalamic area (LHA) was identified as a critical neuroanatomical substrate for motivated behavior. Electrical stimulation of the LHA induces voracious feeding even in well-fed animals. In the absence of food, animals will work tirelessly, often lever-pressing thousands of times per hour, for electrical stimulation at the same site that provokes feeding, drinking and other species-typical motivated behaviors. Here we review the classic findings from electrical stimulation studies and integrate them with more recent work that has used contemporary circuit-based approaches to study the LHA. We identify specific anatomically and molecularly defined LHA elements that integrate diverse information arising from cortical, extended amygdala and basal forebrain networks to ultimately generate a highly specified and invigorated behavioral state conveyed via LHA projections to downstream reward and feeding-specific circuits. PMID:26814589

  9. Motoneuron firing in amyotrophic lateral sclerosis (ALS)

    PubMed Central

    de Carvalho, Mamede; Eisen, Andrew; Krieger, Charles; Swash, Michael

    2014-01-01

    Amyotrophic lateral sclerosis is an inexorably progressive neurodegenerative disorder involving the classical motor system and the frontal effector brain, causing muscular weakness and atrophy, with variable upper motor neuron signs and often an associated fronto-temporal dementia. The physiological disturbance consequent on the motor system degeneration is beginning to be well understood. In this review we describe aspects of the motor cortical, neuronal, and lower motor neuron dysfunction. We show how studies of the changes in the pattern of motor unit firing help delineate the underlying pathophysiological disturbance as the disease progresses. Such studies are beginning to illuminate the underlying disordered pathophysiological processes in the disease, and are important in designing new approaches to therapy and especially for clinical trials. PMID:25294995

  10. Large-scale lateral nanowire arrays nanogenerators

    DOEpatents

    Wang, Zhong L; Xu, Chen; Qin, Yong; Zhu, Guang; Yang, Rusen; Hu, Youfan; Zhang, Yan

    2014-01-07

    In a method of making a generating device, a plurality of spaced apart elongated seen members are deposited onto a surface of a flexible non-conductive substrate. An elongated conductive layer is applied to a top surface and a first side of each seed member, thereby leaving an exposed second side opposite the first side. A plurality of elongated piezoelectric nanostructures is grown laterally from the second side of each seed layer. A second conductive material is deposited onto the substrate adjacent each elongated first conductive layer so as to be soupled the distal end of each of the plurality of elongated piezoelectric nanostructures. The second conductive material is selected so as to form a Schottky barrier between the second conductive material and the distal end of each of the plurality of elongated piezoelectric nanostructures and so as to form an electrical contact with the first conductive layer.

  11. Lateral habenular influence on dorsal raphe neurons.

    PubMed

    Ferraro, G; Montalbano, M E; Sardo, P; La Grutta, V

    1996-01-01

    Previously, we have demonstrated that lateral habenula (LH) modulates the bioelectric activity of the hippocampus through the dorsal raphe nucleus functional involvement. In this study we have, preliminarily, electrophysiologically identified two types of raphe neurons: "slow" (S cells, serotonergic in nature); and "fast" (F cells, presumably GABAergic in nature). Then, we have shown that LH electrical stimulation at lower frequency induced an excitation of S and F neurons. LH stimulation at higher frequency inhibited only S neurons. Furthermore, iontophoretic NMDA excited S and F neurons. The excitatory effects of LH stimulation were antagonized by the iontophoretic 2-APV (NMDA antagonist). Iontophoretic GABA inhibited only S neurons. Iontophoretic bicuculline antagonized the LH-induced inhibition os S neurons. The data suggested a direct (NMDA-mediated) and indirect (through the F GABAergic inhibitory interneuron) influence of the LH on the serotonergic efferent neuron. PMID:8883915

  12. Amyotrophic lateral sclerosis: a hormonal condition?

    PubMed

    Blasco, Helene; Guennoc, Anne-Marie; Veyrat-Durebex, Charlotte; Gordon, Paul H; Andres, Christian R; Camu, William; Corcia, Philippe

    2012-10-01

    Amyotrophic lateral sclerosis (ALS) is the most frequent motor neuron disorder in adults. This fatal condition, due to degeneration of upper and lower motor neurons in spinal and bulbar myotomes, leads to death from respiratory failure after median disease duration of 36 months. ALS is sporadic in more than 90% of cases and familial in the remaining cases. Most studies show male predominance with a gender ratio of 3:2, but gender differences are age related. The phenotype of ALS is also different in males and females with a predominance of limb onset in males and bulbar onset in females. While age and site of onset impact survival rate, and are both related to gender, gender by itself has not clearly been shown to have an effect on survival. Given this complex relationship between gender and ALS, we developed a hypothesis about hormone involvement in ALS aetiology by suggesting protective effect of oestrogens and adverse effect of androgens. PMID:22873563

  13. TIBIOTALOCALCANEAL ARTHRODESIS WITH LATERAL COMPRESSION PLATE

    PubMed Central

    Coughlin, Michael J.; Nery, Caio; Baumfeld, Daniel; Jastifer, James

    2015-01-01

    Objective: The objective of this study was to evaluate the short-term clinical and radiographic results from a TTC fusion procedure using a lateral locking plate specifically designed for this purpose. Methods: All the fourteen patients were evaluated using a variety of methods, including a visual analogue scale (VAS), the AOFAS hindfoot score and a subjective satisfaction scale. The average follow-up was 10 months. Results: The average AOFAS score improved from 41 points preoperatively to 63 points postoperatively. The VAS pain score decreased from 7 to 3 points. Four patients reported excellent results, eight good, one fair and one poor. Conclusion: Our study provides support for using a specially designed plate for TTC fusion in hindfoot salvage surgery. RESUMO Objetivo: O propósito deste estudo é avaliar os resultados clínicos e radiológicos a curto prazo do procedimento de fusão tíbio-talo-calcaneana (TTC) com o uso de uma placa lateral bloqueada específicamente concebida para este fim. Métodos: Todos os 14 pacientes foram avaliados usando uma variedade de métodos, incluindo a escala analógico visual da dor (EAV), escore da AOFAS para o retropé e escala subjetiva de satisfação. O acompanhamento médio foi de 10 meses. Resultados: O escore AOFAS médio melhorou de 41 pontos no período pré-operatório para 63 pontos no período pós-operatório. O escore da dor (EAV) caiu de 7 para 3 pontos. Quatro pacientesforam classificados como excelentes resultados, oito bons, um moderado e um ruim. Conclusão: Nosso estudo dá suporte ao uso da placa especialmente desenhada para a fusão tibio-talo-calcaneana (TTC) nas cirurgias de salvamento do retropé. PMID:27047852

  14. Costa Rica's Chain of laterally collapsed volcanoes.

    NASA Astrophysics Data System (ADS)

    Duarte, E.; Fernandez, E.

    2007-05-01

    From the NW extreme to the SW end of Costa Rica's volcanic backbone, a number of laterally collapsed volcanoes can be observed. Due to several factors, attention has been given to active volcanoes disregarding the importance of collapsed features in terms of assessing volcanic hazards for future generations around inhabited volcanoes. In several cases the typical horseshoe shape amphitheater-like depression can be easily observed. In other cases due to erosion, vegetation, topography, seismic activity or drastic weather such characteristics are not easily recognized. In the order mentioned above appear: Orosi-Cacao, Miravalles, Platanar, Congo, Von Frantzius, Cacho Negro and Turrialba volcanoes. Due to limited studies on these structures it is unknown if sector collapse occurred in one or several phases. Furthermore, in the few studied cases no evidence has been found to relate collapses to actual eruptive episodes. Detailed studies on the deposits and materials composing dome-like shapes will shed light on unsolved questions about petrological and chemical composition. Volume, form and distance traveled by deposits are part of the questions surrounding most of these collapsed volcanoes. Although most of these mentioned structures are extinct, at least Irazú volcano (active volcano) has faced partial lateral collapses recently. It did presented strombolian activity in the early 60s. Collapse scars show on the NW flank show important mass removal in historic and prehistoric times. Moreover, in 1994 a minor hydrothermal explosion provoked the weakening of a deeply altered wall that holds a crater lake (150m diameter, 2.6x106 ). A poster will depict images of the collapsed volcanoes named above with mayor descriptive characteristics. It will also focus on the importance of deeper studies to assess the collapse potential of Irazú volcano with related consequences. Finally, this initiative will invite researchers interested in such topic to join future studies in these Costarrican volcanoes.

  15. Suicide among patients with amyotrophic lateral sclerosis.

    PubMed

    Fang, Fang; Valdimarsdóttir, Unnur; Fürst, Carl Johan; Hultman, Christina; Fall, Katja; Sparén, Pär; Ye, Weimin

    2008-10-01

    Studies on the suicide risk among patients with amyotrophic lateral sclerosis (ALS) in countries without legalized euthanasia or assisted suicide are important additions to data on the wish to die of these patients. We conducted a population-based cohort study in Sweden between 1965 and 2004, which comprised of 6,642 patients with incident ALS identified from the Swedish Inpatient Register. We calculated the standardized mortality ratios (SMRs) of suicide among the patients using the suicide rates of the general Swedish population as a reference. In total, 21 patients committed suicide during follow-up, compared to the predicted 3.6 suicides. Thus, we noted an almost 6-fold increased risk for suicide among ALS patients [SMR 5.8, 95% confidence interval (CI) 3.6-8.8]. Patients who committed suicide were, on average, around 7 years younger at the time of their first period of hospitalization than patients who did not commit suicide. The highest relative risk for suicide was observed within the first year after the patient's first period of hospitalization (SMR 11.2, 95% CI 5.8-19.6). After that, the relative risks decreased with time after hospitalization (P-value for trend = 0.006), but remained elevated 3 years later. The relative risks of suicide among ALS patients did not show a clear trend over time in contrast to the decreasing trend of relative risks for suicide among patients with cancer during the same period. Patients with ALS are at excess risk of suicide in Sweden and the relative risk is higher during the earlier stage of the disease. PMID:18669498

  16. Lateral interactions in the outer retina

    PubMed Central

    Thoreson, Wallace B.; Mangel, Stuart C.

    2012-01-01

    Lateral interactions in the outer retina, particularly negative feedback from horizontal cells to cones and direct feed-forward input from horizontal cells to bipolar cells, play a number of important roles in early visual processing, such as generating center-surround receptive fields that enhance spatial discrimination. These circuits may also contribute to post-receptoral light adaptation and the generation of color opponency. In this review, we examine the contributions of horizontal cell feedback and feed-forward pathways to early visual processing. We begin by reviewing the properties of bipolar cell receptive fields, especially with respect to modulation of the bipolar receptive field surround by the ambient light level and to the contribution of horizontal cells to the surround. We then review evidence for and against three proposed mechanisms for negative feedback from horizontal cells to cones: 1) GABA release by horizontal cells, 2) ephaptic modulation of the cone pedicle membrane potential generated by currents flowing through hemigap junctions in horizontal cell dendrites, and 3) modulation of cone calcium currents (ICa) by changes in synaptic cleft proton levels. We also consider evidence for the presence of direct horizontal cell feed-forward input to bipolar cells and discuss a possible role for GABA at this synapse. We summarize proposed functions of horizontal cell feedback and feed-forward pathways. Finally, we examine the mechanisms and functions of two other forms of lateral interaction in the outer retina: negative feedback from horizontal cells to rods and positive feedback from horizontal cells to cones. PMID:22580106

  17. Coverage of Exposed Bone of the Lateral Malleolus With a Proximally Based Lateral Malleolar Perforator Flap.

    PubMed

    van der Zee, Caroline W; Moerman, Esther; Haverlag, Robert; Schepers, Tim

    2015-01-01

    The treatment of soft tissue defects of the ankle, combined with an implant-related infection, remains a challenge. The present case report illustrates the use of a pedicled perforator flap for soft tissue reconstruction to cover a postoperative defect at the lateral malleolus after an ankle fracture. PMID:25154652

  18. Side of Limb-Onset Predicts Laterality of Gray Matter Loss in Amyotrophic Lateral Sclerosis

    PubMed Central

    Mao, Cuiping; Jin, Jiaoting; Niu, Chen; Dang, Jingxia

    2014-01-01

    Conflicting findings have been reported regarding the lateralized brain abnormality in patients with amyotrophic lateral sclerosis (ALS). In this study, we aimed to investigate the probable lateralization of gray matter (GM) atrophy in ALS patients. We focused on the relationship between the asymmetry in decreased GM volume and the side of disease onset in patients with limb-onset. Structural imaging evaluation of normalized atrophy (SIENAX) and voxel-based morphometry (VBM) were used to assess differences in global and local brain regions in patients with heterogeneous body onset and subgroups with different side of limb-onset. We found global brain atrophy and GM losses in the frontal and parietal areas in each patient group as well as left predominant GM losses in the total cohort. The intriguing findings in subgroup analyses demonstrated that the motor cortex in the contralateral hemisphere of the initially involved limb was most affected. We also found that regional brain atrophy was related to disease progression rate. Our observations suggested that side of limb-onset can predict laterality of GM loss in ALS patients and disease progression correlates with the extent of cortical abnormality. PMID:25093168

  19. Pay Me Now or Pay Me Later: 10 Years Later and Have We Seen Any Change?

    ERIC Educational Resources Information Center

    Cone, Stephen L.

    2004-01-01

    It has been nearly a decade since the 1996 Surgeon General?s Report (SGR) on "Physical Activity and Health" (United States Department of Health and Human Services [USDHHS], 1996). It is time that people stop and reflect on this historic report and begin the assessment process--are people paying now or will they continue to pay later? This…

  20. Can Early Menopause Trigger Depression Later in Life?

    MedlinePlus

    ... news/fullstory_156556.html Can Early Menopause Trigger Depression Later in Life? Research suggests longer estrogen exposure ... menopause may increase a woman's later risk of depression, a new review suggests. If further studies confirm ...

  1. Sex Differences in Cerebral Laterality of Language and Visuospatial Processing

    ERIC Educational Resources Information Center

    Clements, A. M.; Rimrodt, S. L.; Abel, J. R.; Blankner, J. G.; Mostofsky, S. H.; Pekar, J. J.; Denckla, M. B.; Cutting, L. E.

    2006-01-01

    Sex differences on language and visuospatial tasks are of great interest, with differences in hemispheric laterality hypothesized to exist between males and females. Some functional imaging studies examining sex differences have shown that males are more left lateralized on language tasks and females are more right lateralized on visuospatial…

  2. Predicting Later-Life Outcomes of Early-Life Exposures

    EPA Science Inventory

    Background: In utero exposure of the fetus to a stressor can lead to disease in later life. Epigenetic mechanisms are likely mediators of later-life expression of early-life events.Objectives: We examined the current state of understanding of later-life diseases resulting from ea...

  3. Dynamic cortical lateralization during olfactory discrimination learning

    PubMed Central

    Cohen, Yaniv; Putrino, David; Wilson, Donald A

    2015-01-01

    Key points Odour discrimination and memory involve changes in the primary olfactory (piriform) cortex. The results obtained in the present study suggest that there is an asymmetry in piriform cortical change, with learning-related changes in cortical oscillations emerging with different time courses over the course of multiday training in the left and right piriform cortices in rats. There is an initial decrease in coherence between the left and right piriform cortices during the early stages of the odour discrimination task, which recovers as the animals approach criterion performance. This decreased coherence is expressed when the animals are performing the task relative to when they are in their home cage. The results suggest a transient cortical asymmetry during learning and raise new questions about the functions and mechanisms of cerebral lateralization. Abstract Bilateral cortical circuits are not necessarily symmetrical. Asymmetry, or cerebral lateralization, allows functional specialization of bilateral brain regions and has been described in humans for such diverse functions as perception, memory and emotion. There is also evidence for asymmetry in the human olfactory system, although evidence in non-human animal models is lacking. In the present study, we took advantage of the known changes in olfactory cortical local field potentials that occur over the course of odour discrimination training to test for functional asymmetry in piriform cortical activity during learning. Both right and left piriform cortex local field potential activities were recorded. The results obtained demonstrate a robust interhemispheric asymmetry in anterior piriform cortex activity that emerges during specific stages of odour discrimination learning, with a transient bias toward the left hemisphere. This asymmetry is not apparent during error trials. Furthermore, functional connectivity (coherence) between the bilateral anterior piriform cortices is learning- and context-dependent. Steady-state interhemispheric anterior piriform cortex coherence is reduced during the initial stages of learning and then recovers as animals acquire competent performance. The decrease in coherence is seen relative to bilateral coherence expressed in the home cage, which remains stable across conditioning days. Similarly, transient, trial-related interhemispheric coherence increases with task competence. Taken together, the results demonstrate transient asymmetry in piriform cortical function during odour discrimination learning until mastery, suggesting that each piriform cortex may contribute something unique to odour memory. PMID:25604039

  4. Genetic Rodent Models of Amyotrophic Lateral Sclerosis

    PubMed Central

    Van Den Bosch, L.

    2011-01-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by the selective death of motor neurons in the motor cortex, brainstem, and spinal cord. A large number of rodent models are available that show motor neuron death and a progressive motor phenotype that is more or less reminiscent of what occurs in patients. These rodent models contain genes with spontaneous or induced mutations or (over) express different (mutant) genes. Some of these models have been of great value to delineate potential pathogenic mechanisms that cause and/or modulate selective motor neuron degeneration. In addition, these genetic rodent models play a crucial role in testing and selecting potential therapeutics that can be used to treat ALS and/or other motor neuron disorders. In this paper, we give a systematic overview of the most important genetic rodent models that show motor neuron degeneration and/or develop a motor phenotype. In addition, we discuss the value and limitations of the different models and conclude that it remains a challenge to find more and better rodent models based on mutations in new genes causing ALS. PMID:21274268

  5. Molecular Motor Proteins and Amyotrophic Lateral Sclerosis

    PubMed Central

    Soo, Kai Y; Farg, Manal; Atkin, Julie D.

    2011-01-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting motor neurons in the brain, brainstem and spinal cord, which is characterized by motor dysfunction, muscle dystrophy and progressive paralysis. Both inherited and sporadic forms of ALS share common pathological features, however, the initial trigger of neurodegeneration remains unknown. Motor neurons are uniquely targeted by ubiquitously expressed proteins in ALS but the reason for this selectively vulnerability is unclear. However motor neurons have unique characteristics such as very long axons, large cell bodies and high energetic metabolism, therefore placing high demands on cellular transport processes. Defects in cellular trafficking are now widely reported in ALS, including dysfunction to the molecular motors dynein and kinesin. Abnormalities to dynein in particular are linked to ALS, and defects in dynein-mediated axonal transport processes have been reported as one of the earliest pathologies in transgenic SOD1 mice. Furthermore, dynein is very highly expressed in neurons and neurons are particularly sensitive to dynein dysfunction. Hence, unravelling cellular transport processes mediated by molecular motor proteins may help shed light on motor neuron loss in ALS. PMID:22272119

  6. Alcoholic Marriage: Later Start, Sooner End

    PubMed Central

    Waldron, Mary; Heath, Andrew C.; Lynskey, Michael T.; Bucholz, Kathleen K.; Madden, Pamela A. F.; Martin, Nicholas G.

    2010-01-01

    Background Although associations between drinking behavior and marital status are well documented, timing of marital transitions as a function of alcohol use or disorder has received limited empirical attention. Methods We examine the relationship between lifetime history of alcohol dependence (AD) and timing and survival of first marriages in a sample of 3575 female and 1845 male adult Australian twins born mostly between 1940 and 1964. Survival analyses were conducted using Cox proportional hazards regression models. Results Results indicate moderate delays in marriage associated with AD for both women and men. Among ever married respondents, AD was strongly predictive of early separation, with similar effects observed for women and men. Heritable sources of covariation were also documented. For women, genetic influences shared between early-onset AD and marital timing were found. Genetic influences shared between AD and marital survival were observed for women without regard to onset and for men with later-onset AD. Conclusions Results confirm the importance of AD as a predictor of both timing and survival of first marriages, with genetic influences contributing to observed associations. PMID:21244438

  7. Controversies and priorities in amyotrophic lateral sclerosis.

    PubMed

    Turner, Martin R; Hardiman, Orla; Benatar, Michael; Brooks, Benjamin R; Chio, Adriano; de Carvalho, Mamede; Ince, Paul G; Lin, Cindy; Miller, Robert G; Mitsumoto, Hiroshi; Nicholson, Garth; Ravits, John; Shaw, Pamela J; Swash, Michael; Talbot, Kevin; Traynor, Bryan J; Van den Berg, Leonard H; Veldink, Jan H; Vucic, Steve; Kiernan, Matthew C

    2013-03-01

    Two decades after the discovery that 20% of familial amyotrophic lateral sclerosis (ALS) cases were linked to mutations in the superoxide dismutase-1 (SOD1) gene, a substantial proportion of the remainder of cases of familial ALS have now been traced to an expansion of the intronic hexanucleotide repeat sequence in C9orf72. This breakthrough provides an opportunity to re-evaluate longstanding concepts regarding the cause and natural history of ALS, coming soon after the pathological unification of ALS with frontotemporal dementia through a shared pathological signature of cytoplasmic inclusions of the ubiquitinated protein TDP-43. However, with profound clinical, prognostic, neuropathological, and now genetic heterogeneity, the concept of ALS as one disease appears increasingly untenable. This background calls for the development of a more sophisticated taxonomy, and an appreciation of ALS as the breakdown of a wider network rather than a discrete vulnerable population of specialised motor neurons. Identification of C9orf72 repeat expansions in patients without a family history of ALS challenges the traditional division between familial and sporadic disease. By contrast, the 90% of apparently sporadic cases and incomplete penetrance of several genes linked to familial cases suggest that at least some forms of ALS arise from the interplay of multiple genes, poorly understood developmental, environmental, and age-related factors, as well as stochastic events. PMID:23415570

  8. Characteristics of pain in amyotrophic lateral sclerosis

    PubMed Central

    Hanisch, Frank; Skudlarek, Anika; Berndt, Janine; Kornhuber, Malte E

    2015-01-01

    Background Pain is an often underestimated and neglected symptom in amyotrophic lateral sclerosis (ALS). Methods In a cross-sectional survey, 46 patients with ALS, 46 age- and gender matched population-based controls, and 23 diseased controls with myotonic dystrophy type 2 (DM2) were screened for occurrence, type, distribution, and treatment of pain and cramps. Data were collected with the use of the short form brief pain inventory (BPI). Results Pain was reported in 78% of ALS patients,79% of DM2 patients, and 54% of controls (P < 0.05). More ALS patients than controls reported moderate to severe pain (42% vs. 20%). Pain in ALS patients interfered significantly more with daily activities than in controls (median pain interference score: 3.0 vs. 1.2, P < 0.05), especially enjoyment of life (5.0 vs. 1.0) and mood (3.0 vs. 1.0). There was no correlation between the duration of the disease and the severity of pain. Movement-induced cramps were reported in 63% of ALS patients, mostly in the distal extremities. There was no difference in the duration of ALS disease between patients reporting cramps and those who did not. Discussion Our study showed that pain was a relatively frequent symptom which had an important impact on the quality of life. Pain that requires treatment can occur at every stage of ALS. PMID:25642388

  9. Epidemiologic correlates of sporadic amyotrophic lateral sclerosis

    SciTech Connect

    Armon, C.; Kurland, L.T.; Daube, J.R.; O'Brien, P.C. )

    1991-07-01

    The authors evaluated 74 selected patients with amyotrophic lateral sclerosis (ALS) and 201 matched controls for risk factors for ALS by a case-control design and a sequential questionnaire/interview technique to quantitate biographic data. They analyzed occupational and recreational data only for 47 male patients and 47 corresponding patient controls; data for women were insufficient. They used nonparametric analyses to evaluate five primary comparisons of ALS patients with controls: (1) more hard physical labor, p not significant (NS); (2) greater frequency of neurodegenerative disease in family members, p NS; (3) greater exposure to lead, p less than 0.05; (4) more years lived in a rural community, p NS; and (5) more trauma or major surgery, p NS. Men with ALS had worked more frequently at blue-collar jobs (although not a statistically significant difference, p = 0.10) and at welding or soldering (p less than 0.01). These results suggest that there may be an association between ALS in men and exposure to lead vapor. The limited nature of the association favors a multifactorial etiologic mechanism of ALS.

  10. Miro1 deficiency in amyotrophic lateral sclerosis

    PubMed Central

    Zhang, Fan; Wang, Wenzhang; Siedlak, Sandra L.; Liu, Yingchao; Liu, Jun; Jiang, Keji; Perry, George; Zhu, Xiongwei; Wang, Xinglong

    2015-01-01

    Proper transportation of mitochondria to sites with high energy demands is critical for neuronal function and survival. Impaired mitochondrial movement has been repeatedly reported in motor neurons of amyotrophic lateral sclerosis (ALS) patients and indicated as an important mechanism contributing to motor neuron degeneration in ALS. Miro1, a RhoGTPase also referred to as Rhot1, is a key regulator of mitochondrial movement linking mitochondria and motor proteins. In this study, we investigated whether the expression of Miro1 was altered in ALS patients and ALS animal models. Immunoblot analysis revealed that Miro1 was significantly reduced in the spinal cord tissue of ALS patients. Consistently, the decreased expression of Miro1 was also noted only in the spinal cord, and not in the brain tissue of transgenic mice expressing ALS-associated SOD1 G93A or TDP-43 M337V. Glutamate excitotoxicity is one of the major pathophysiological mechanisms implicated in the pathogenesis of ALS, and we found that excessive glutamate challenge lead to significant reduction of Miro1 expression in spinal cord motor neurons both in vitro and in mice. Taken together, these findings show Miro1 deficiency in ALS patients and ALS animal models and suggest glutamate excitotoxicity as a likely cause of Miro1 deficiency. PMID:26074815

  11. Mitochondrial Dysfunction in Amyotrophic Lateral Sclerosis

    PubMed Central

    Shi, Ping; Gal, Jozsef; Kwinter, David M.; Liu, Xiaoyan; Zhu, Haining

    2009-01-01

    The etiology of motor neuron degeneration in amyotrophic lateral sclerosis (ALS) remains to be better understood. Based on the studies from ALS patients and transgenic animal models, it is believed that ALS is likely to be a multifactorial and multisystem disease. Many mechanisms have been postulated to be involved in the pathology of ALS, such as oxidative stress, glutamate excitotoxicity, mitochondrial damage, defective axonal transport, glia cell pathology and aberrant RNA metabolism. Mitochondria, which play crucial roles in excitotoxicity, apoptosis and cell survival, have shown to be an early target in ALS pathogenesis and contribute to the disease progression. Morphological and functional defects in mitochondria were found in both human patients and ALS mice overexpressing mutant SOD1. Mutant SOD1 was found to be preferentially associated with mitochondria and subsequently impair mitochondrial function. Recent studies suggest that axonal transport of mitochondria along microtubules and mitochondrial dynamics may also be disrupted in ALS. These results also illustrate the critical importance of maintaining proper mitochondrial function in axons and neuromuscular junctions, supporting the emerging “dying-back” axonopathy model of ALS. In this review, we will discuss how mitochondrial dysfunction has been linked to the ALS variants of SOD1 and the mechanisms by which mitochondrial damage contributes to the disease etiology. PMID:19715760

  12. Treatment algorithm for chronic lateral ankle instability

    PubMed Central

    Giannini, Sandro; Ruffilli, Alberto; Pagliazzi, Gherardo; Mazzotti, Antonio; Evangelisti, Giulia; Buda, Roberto; Faldini, Cesare

    2014-01-01

    Summary Introduction: ankle sprains are a common sports-related injury. A 20% of acute ankle sprains results in chronic ankle instability, requiring surgery. Aim of this paper is to report the results of a series of 38 patients treated for chronic lateral ankle instability with anatomic reconstruction. Materials and methods: thirty-eight patients were enrolled in the study. Seventeen patients underwent a surgical repair using the Brostrom-modified technique, while the remaining underwent anatomic reconstruction with autologous or allogenic graft. Results: at a mean follow-up of 5 years the AOFAS score improved from 66.1 ± 5.3 to 92.2 ± 5.6. Discussion: the findings of this study confirm that anatomic reconstruction is an effective procedure with satisfactory subjective and objective results which persist at long-term follow-up along with a low complication rate. No differences, in term of clinical and functional outcomes, were observed between the Brostrom-modified repair and the anatomic reconstruction technique. Level of evidence: level IV. PMID:25767783

  13. Lateral gene transfer in the subsurface

    SciTech Connect

    Barkay, Tamar; Sobecky, Patricia

    2007-08-27

    Lateral gene transfer (LGT) is an important adaptive mechanism among prokaryotic organisms. This mechanism is particularly important for the response of microorganisms to changing environmental conditions because it facilitates the transfer of a large number of genes and their rapid expression. Together the transferred genes promote rapid genetic and metabolic changes that may enhance survival to newly established and sometimes hostile environmental conditions. The goal of our project was to examine if and how LGT enhances microbial adaptation to toxic heavy metals in subsurface environments that had been contaminated by mixed wastes due to activities associated with the production of nuclear energy and weapons. This task has been accomplished by dividing the project to several sub-tasks. Thus, we: (1) Determined the level of resistance of subsurface bacterial isolates to several toxic metals, all identified as pollutants of concern in subsurface environments; (2) Designed, tested, and applied, a molecular approach that determined whether metal resistance genes had evolved by LGT among subsurface bacteria; and (3) Developed a DNA hybridization array for the identification of broad host range plasmids and of metal resistance plasmids. The results are briefly summarized below with references to published papers and manuscripts in preparation where details about our research can be found. Additional information may be found in copies of our published manuscripts and conference proceedings, and our yearly reports that were submitted through the RIMS system.

  14. Redox Regulation in Amyotrophic Lateral Sclerosis

    PubMed Central

    Parakh, Sonam; Spencer, Damian M.; Halloran, Mark A.; Soo, Kai Y.; Atkin, Julie D.

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that results from the death of upper and lower motor neurons. Due to a lack of effective treatment, it is imperative to understand the underlying mechanisms and processes involved in disease progression. Regulations in cellular reduction/oxidation (redox) processes are being increasingly implicated in disease. Here we discuss the possible involvement of redox dysregulation in the pathophysiology of ALS, either as a cause of cellular abnormalities or a consequence. We focus on its possible role in oxidative stress, protein misfolding, glutamate excitotoxicity, lipid peroxidation and cholesterol esterification, mitochondrial dysfunction, impaired axonal transport and neurofilament aggregation, autophagic stress, and endoplasmic reticulum (ER) stress. We also speculate that an ER chaperone protein disulphide isomerase (PDI) could play a key role in this dysregulation. PDI is essential for normal protein folding by oxidation and reduction of disulphide bonds, and hence any disruption to this process may have consequences for motor neurons. Addressing the mechanism underlying redox regulation and dysregulation may therefore help to unravel the molecular mechanism involved in ALS. PMID:23533690

  15. Possession divestment by sales in later life.

    PubMed

    Ekerdt, David J; Addington, Aislinn

    2015-08-01

    Residential relocation in later life is almost always a downsizing, with many possessions to be divested in a short period of time. This article examines older movers' capacities for selling things, and ways that selling attenuates people's ties to those things, thus accomplishing the human dis-possession of the material convoy. In qualitative interviews in 79 households in the Midwestern United States, older adults reported their experience with possession sales associated with residential relocation. Among this group, three-quarters of the households downsized by selling some belongings. Informal sales seemed the least fraught of all strategies, estate sales had mixed reviews, and garage sales were recalled as laborious. Sellers' efforts were eased by social relations and social networks as helpers and buyers came forward. As selling proceeded, sentiment about possessions waned as their materiality and economic value came to the fore, easing their detachment from the household. Possession selling is challenging because older adults are limited in the knowledge, skills, and efforts that they can apply to the recommodification of their belongings. Selling can nonetheless be encouraged as a divestment strategy as long as the frustrations and drawbacks are transparent, and the goal of ridding is kept in view. PMID:26162722

  16. Selective attention impairment in amyotrophic lateral sclerosis.

    PubMed

    Volpato, Chiara; Prats Sedano, Maria Angeles; Silvoni, Stefano; Segato, Nicoletta; Cavinato, Marianna; Merico, Antonio; Piccione, Francesco; Palmieri, Arianna; Birbaumer, Niels

    2016-01-01

    Objective of this study was to evaluate attentional control mechanisms in amyotrophic lateral sclerosis (ALS) using an auditory event-related potentials (ERPs) paradigm. Fifteen mild to moderate ALS patients and 15 healthy controls were administered a brief neuropsychological test battery and an ERPs paradigm assessing selective attention. Four types of auditory stimuli were presented in random order: short standard (200 Hz, 200 ms), long standard (200 Hz, 500 ms), short deviant (1000 Hz, 200 ms) and long deviant (1000 Hz, 500 ms). Participants had to respond to the long deviant stimuli only. During the task the electroencephalogram (EEG) was recorded. The N200, P300 and re-orienting negativity (RON) ERP components were analysed. Compared to controls ALS patients showed reduced amplitudes and delayed latencies of N200, P300 and RON. These results could be attributable to both an alteration in change detection resulting in a reduction of the allocation and re-orientation of attentional resources or a general slowing or reduction of neural processing efficiency in the same system. The ERPs results support the hypothesis that ALS involves extramotor cognitive functions including auditory attentional processing at all processing stages, early (200 ms) and late (300-600 ms). These data prove the usefulness and sensitivity of the auditory ERPs in detection of cognitive functions in ALS patients. PMID:26889872

  17. Rodent Models of Amyotrophic Lateral Sclerosis.

    PubMed

    Philips, Thomas; Rothstein, Jeffrey D

    2015-01-01

    Amyotrophic Lateral Sclerosis (ALS) is a motor neuron disease affecting upper and lower motor neurons in the central nervous system. Patients with ALS develop extensive muscle wasting and atrophy leading to paralysis and death 3 to 5 years after disease onset. The condition may be familial (fALS 10%) or sporadic ALS (sALS, 90%). The large majority of fALS cases are due to genetic mutations in the Superoxide dismutase 1 gene (SOD1, 15% of fALS) and repeat nucleotide expansions in the gene encoding C9ORF72 (∼ 40% to 50% of fALS and ∼ 10% of sALS). Studies suggest that ALS is mediated through aberrant protein homeostasis (i.e., ER stress and autophagy) and/or changes in RNA processing (as in all non-SOD1-mediated ALS). In all of these cases, animal models suggest that the disorder is mediated non-cell autonomously, i.e., not only motor neurons are involved, but glial cells including microglia, astrocytes, and oligodendrocytes, and other neuronal subpopulations are also implicated in the pathogenesis. Provided in this unit is a review of ALS rodent models, including discussion of their relative advantages and disadvantages. Emphasis is placed on correlating the model phenotype with the human condition and the utility of the model for defining the disease process. Information is also presented on RNA processing studies in ALS research, with particular emphasis on the newest ALS rodent models. PMID:26344214

  18. Nutrition management of amyotrophic lateral sclerosis.

    PubMed

    Greenwood, Daniel I

    2013-06-01

    Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease with high risk of malnutrition. Symptoms of dysphagia, depression, cognitive impairment, difficulty with self-feeding and meal preparation, hypermetabolism, anxiety, respiratory insufficiency, and fatigue with meals increase the risk of malnutrition. Malnutrition negatively affects prognosis and quality of life, making early and frequent nutrition assessment and intervention essential. Implementation of an adequate calorie diet, dietary texture modification, use of adaptive eating utensils, and placement of a feeding tube aid in preventing malnutrition. When nutrition status is compromised by dysphagia and weight loss (5%-10% of usual body weight) or body mass index <20 kg/m(2) without weight loss and when forced vital capacity is >50%, a percutaneous endoscopic gastrostomy placement is indicated. When forced vital capacity is <50%, a radiologically inserted gastrostomy is the preferred means of enteral placement due to lessened aspiration and respiratory risk. Parenteral nutrition (PN) is indicated only when enteral nutrition (EN) is contraindicated or impossible. This article reviews the background of ALS, nutrition implications and risk of malnutrition, treatment strategies to prevent malnutrition, the role of EN and PN, and feeding tube placement methods according to disease stage. PMID:23466470

  19. Amyotrophic Lateral Sclerosis: New Perpectives and Update.

    PubMed

    Orsini, Marco; Oliveira, Acary Bulle; Nascimento, Osvaldo J M; Reis, Carlos Henrique Melo; Leite, Marco Antonio Araujo; de Souza, Jano Alves; Pupe, Camila; de Souza, Olivia Gameiro; Bastos, Victor Hugo; de Freitas, Marcos R G; Teixeira, Silmar; Bruno, Carlos; Davidovich, Eduardo; Smidt, Benny

    2015-09-24

    Amyotrophic lateral sclerosis (ALS), Charcot's disease or Lou Gehrig's disease, is a term used to cover the spetrum of syndromes caracterized by progressive degeneration of motor neurons, a paralytic disorder caused by motor neuron degeneration. Currently, there are approximately 25,000 patients with ALS in the USA, with an average age of onset of 55 years. The incidence and prevalence of ALS are 1-2 and 4-6 per 100,000 each year, respectively, with a lifetime ALS risk of 1/600 to 1/1000. It causes progressive and cumulative physical disabilities, and leads to eventual death due to respiratory muscle failure. ALS is diverse in its presentation, course, and progression. We do not yet fully understand the causes of the disease, nor the mechanisms for its progression; thus, we lack effective means for treating this disease. In this chapter, we will discuss the diagnosis, treatment, and how to cope with impaired function and end of life based on of our experience, guidelines, and clinical trials. Nowadays ALS seems to be a more complex disease than it did two decades - or even one decade - ago, but new insights have been plentiful. Clinical trials should be seen more as experiments on pathogenic mechanisms. A medication or combination of medications that targets more than one pathogenic pathway may slow disease progression in an additive or synergistic fashion. PMID:26487927

  20. Impaired Sacculocollic Reflex in Lateral Medullary Infarction

    PubMed Central

    Kim, Seonhye; Kim, Hyo-Jung; Kim, Ji Soo

    2011-01-01

    Objective: The aim of this study was to determine saccular dysfunction by measuring cervical vestibular-evoked myogenic potentials (cVEMP) and to correlate abnormality of cVEMP with results of other vestibular function tests in lateral medullary infarction (LMI). Methods: We recorded cVEMP in 21 patients with LMI documented on MRI. cVEMP was induced by a short tone burst and was recorded in contracting sternocleidomastoid muscle while patients turned their heads forcefully to the contralateral side against resistance. Patients also underwent video-oculographic recording of spontaneous, gaze-evoked and head shaking nystagmus (HSN), evaluation of ocular tilt reaction (OTR), measurement of the subjective visual vertical (SVV) tilt, bithermal caloric tests, and audiometry. Results: Nine patients (43%) showed abnormal cVEMP, unilateral in seven and bilateral in two. The cVEMP abnormalities included decreased p13–n23 amplitude in four, delayed p13/n23 responses in five, and both decreased and delayed responses in two. The abnormal cVEMP was ipsilesional in five, contralesional in two, and bilateral in two. The prevalence of OTR/SVV tilt, spontaneous nystagmus, and HSN did not differ between the patients with normal and abnormal cVEMP. Conclusion: cVEMP was abnormal in approximately half of the patients with LMI. The abnormal cVEMP indicates damage to the descending sacculocollic reflex pathway or disruption of commissural modulation between the vestibular nuclei. PMID:21415908