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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. Fractures of the lateral humeral condyle in children.

    PubMed

    Rutherford, A

    1985-07-01

    I conducted a clinical review of thirty-nine fractures of the lateral condyle of the humerus in children and drew the following conclusions: (1) epiphyseal arrest is rare (it occurred in only one patient, despite malreduction in ten), and (2) fishtail deformity of the distal part of the humerus occurs commonly when malreduction is present. Only two poor results were encountered, both in patients in whom the reduction was grossly inadequate. PMID:4019532

  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. A modified surgical technique for neglected fracture of lateral humeral condyle in children.

    PubMed

    Sulaiman, Abdul Razak; Munajat, Ismail; Mohd, Emil Fazliq

    2011-11-01

    Operative treatment for neglected fracture of lateral humeral condyle (LHC) is difficult because of contracted muscle, fibrous tissue formation, and indistinct bony edges. Its success depends on the ability to preserve blood supply during the surgery. We retrospectively reviewed eight cases of neglected fracture of LHC in children treated with open reduction with selected multiple 'V' lengthening of common extensor muscle and internal fixation. The patients were between 3 and 8 years of age. The period of neglect was between 3 and 20 weeks. Four patients with displacement of more than 10 mm and neglect for 5 weeks or more required lengthening of common extensor muscle aponeurosis. The follow-up assessments were between 1 and 6.3 years with a mean of 4.4 years. All patients had union by 2 months. They gained improvement of flexion range of motion between 60 and 120 with a mean of 86.3. Loss of final range of motion compared with the normal side was between 5 and 35 with a mean of 10. No patient had limitation of activities or pain. Six cases had excellent and two cases had good Dillon functional score. All patients had lateral condyle prominent with different severities. There was one mild avascular necrosis and one fishtail deformity. Both of them had almost full range of motion. All patients had early physeal closure, except one, who had only 1 year follow-up. There was no case of progressive valgus deformity. Children with neglected fracture of LHC would benefit from anatomical reduction and internal fixation through a proper exposure and if indicated combined with multiple 'V' lengthening of common extensor muscle aponeurosis. This is a level IV study. PMID:21716140

  7. 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

  8. Unusual humeral medial condyle fracture in an adolescent because of a previous post-traumatic fishtail deformity: a case report.

    PubMed

    Otsuka, Junko; Horii, Emiko; Koh, Shukuki; Hiroishi, Masayuki

    2015-09-01

    A fishtail deformity is a well-known complication following pediatric lateral condyle fracture of the humerus. We report a rare case of a medial humeral condyle fracture in a 12-year-old boy who had had a fishtail deformity because of a lateral condyle fracture in childhood. Radiographs showed a longitudinal fracture plane of the medial condyle extending to the articular surface, which is different from the three types of medial condyle fracture classified by Kilfoyle. We present our case and reviewed the literature to clarify the difference in the mechanism of medial humeral condyle fracture after a fishtail deformity. PMID:25919805

  9. Medial humeral condyle fractures in adolescents: treatment and complications.

    PubMed

    Sa?lam, Necdet; Saka, Grsel; Kurtulmu?, Tuhan; Cem Co?kun, Avc?; Trker, Mehmet

    2014-10-01

    The very rare isolated medial humeral condyle fractures in children and adolescents pose significant problems to orthopedic surgeons such as ulnar nerve injury, trochlear irregularities, fishtail deformity and motion loss. Six adolescent boys with displaced medial humeral condyle fractures with an average age of 14.8 (range 12-17) were included in this study. Patients were followed-up with a mean of 39.8 months (range 21-72). In three patients, there were clinical signs of ulnar nerve dysfunction at initial presentation. Of these, two had only mild hypoesthesia on the ulnar side. The other patient had sensory and motor loss of ulnar nerve at initial presentation complicated by hypothenar atrophy and anhydrosis during follow-up. Complete recovery was seen in this patient only at 2 years. One patient without a neurologic compliant at initial presentation developed mild hypoesthesia on the ulnarly innervated areas postoperatively with complete resolution. Medial skin incision was used for open reduction and internal fixation. No signs of gross morphologic damage were seen on the nerve. The symptoms resolved postoperatively in 3 months time in three of the patients, but in the remaining one, it took 2 years for complete resolution of the symptoms. Also, trochlear irregularity and fishtail deformity were seen on radiographs of two different patients. In all but one patients, motion loss ranging from 10 to 20 was evident on physical examination. The most important finding of this study revealed that transient ulnar nerve dysfunction was seen two-thirds of the patients in this series than any other series reported previously. In three series, only one case of ulnar nerve injury was reported from a total of 19 patients. A possible explanation for such a difference may be the older age in this series. PMID:23934502

  10. 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

  11. Late open reduction internal fixation of lateral condyle fractures.

    PubMed

    Wattenbarger, J Michael; Gerardi, J; Johnston, C E

    2002-01-01

    To study the effects of late open reduction of lateral condyle fracture (LCF) on avascular necrosis (AVN), amount of displacement, and improvement, the records of 11 children with an open capitellar physis and a malunion or a nonunion treated >3 weeks after injury were reviewed. Preoperative and postoperative displacement amounts were recorded. Radiographs were reviewed for AVN, lateral overgrowth, or fishtail deformity. There were no cases of AVN. Three patients had occasional pain. Four patients had displacement of >10 mm before surgery. In fractures with >1 cm of displacement, fragment position was minimally improved surgically, but final alignment and range of motion were good. These fractures showed more radiographic deformities at the time of late open reduction. The risk of AVN with late open reduction of LCF at >3 weeks is reduced if no tissue is stripped off the fracture fragment posteriorly. Even children without anatomic reduction had functional arms with little or no pain. PMID:11961463

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. The lateral pterygoid muscle affects reconstruction of the condyle in the sagittal fracture healing process: a histological study.

    PubMed

    Wu, D; Yang, X-J; Cheng, P; Deng, T-G; Jiang, X; Liu, P; Liu, C-K; Meng, F-W; Hu, K-J

    2015-08-01

    The purpose of this study was to verify the role of the lateral pterygoid muscle in the reconstruction of the condyle shape during the sagittal fracture healing process by histological methods. Twenty-four adult sheep underwent an osteotomy to create a sagittal fracture of the left condyle; the sheep were then divided randomly into two groups. The lateral pterygoid muscles of the sheep in the experimental group were maintained on the internal poles of the condyles, and their functions remained stable. The lateral pterygoid muscles of the sheep in the control group were cut, and their functions were blocked. The shape, erosion, and calcification of the condyles were observed and measured after 4, 12, and 24 weeks of healing (n=4 from each group). The condyles were then submitted to haematoxylin and eosin, Ponceau S, and Sirius red studies. The results of the histology studies showed increased bone formation in the experimental group in which the functions of the lateral pterygoid muscle remained the same. The results of this study suggest that the lateral pterygoid muscle affects the reconstruction of the condylar shape during the healing process of a sagittal fracture of the mandibular condyle, and may even be involved in the formation of ankylosis. PMID:25752241

  19. Management of lateral humeral condylar fracture in children.

    PubMed

    Tejwani, Nirmal; Phillips, Donna; Goldstein, Rachel Y

    2011-06-01

    Lateral condylar fractures constitute 12% to 20% of all pediatric distal humerus fractures. These fractures are easily missed and when not managed appropriately can displace. Missed fracture is a common cause of nonunion and deformity; thus, a high index of suspicion and adequate clinical and radiographic evaluation are required. Displaced fractures are associated with a high rate of nonunion. Nondisplaced fractures or those displaced ?2 mm are managed with cast immobilization and frequent radiographic follow-up. Fractures displaced >2 mm are managed with surgical fixation. Successful outcomes have been reported with closed reduction, open reduction, and arthroscopically assisted techniques. Complications associated with pediatric lateral condylar fracture include cubitus varus, cubitus valgus, fishtail deformity, and tardy ulnar nerve palsy. PMID:21628646

  20. Chondral fracture of the lateral femoral condyle in children with different treatment methods.

    PubMed

    Song, Kwang Soon; Min, Byung Woo; Bae, Ki Cheor; Cho, Chul Hyun; Lee, Si Wook

    2016-01-01

    Adolescents are predisposed to chondral injuries of the knee; however, the incidence of traumatic chondral and osteochondral fractures and their role in the development of joint degeneration are not fully elucidated. Several methods are described for the treatment of chondral or osteochondral fractures of the knee. In our literature review, we could not find any report on the management of chondral fractures with autologous bone pegs or headless screws. We report three cases of traumatic cartilage fractures of the lateral femoral condyle in adolescents who were treated with three different methods. We also present their follow-up outcomes. PMID:26439672

  1. 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

  2. A ganglion of the patellar tendon in patellar tendon-lateral femoral condyle friction syndrome.

    PubMed

    Touraine, Sbastien; Lagadec, Matthieu; Petrover, David; Genah, Idan; Parlier-Cuau, Caroline; Bousson, Valrie; Laredo, Jean-Denis

    2013-09-01

    Intratendinous ganglia are rare. We report the case of a sedentary woman with chronic mechanical anterolateral pain of the knee and an extensive ganglion of the patellar tendon as indicated on magnetic resonance (MR) and ultrasound (US) examinations. There was evidence of a high-riding patella, patellar malalignment and patellar tendon-lateral femoral condyle friction syndrome with significantly close contact between the patellar tendon and the lateral facet of the femoral trochlea. The ultrasound-guided aspiration of the ganglion enabled a localized injection of an anti-inflammatory drug (cortivazol) and the cytopathological examination of the fluid, which confirmed the diagnosis. Clinical improvement was maintained with knee rehabilitation and was satisfactory at follow-up after 1year. To our knowledge, we report the first case of a ganglion of the patellar tendon subsequent to patellar tendon-lateral femoral condyle friction syndrome. We found that this case was illustrative of mucoid degeneration in connective tissue due to chronic repetitive microtraumas. Additionally, this case provided the opportunity to discuss the management of this condition in a sedentary individual with a high-riding patella and patellar malalignment. PMID:23657611

  3. 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

  4. Late presentation of fractures of the lateral condyle of the humerus in children

    PubMed Central

    Saraf, Shyam K; Khare, Ghanshyam N

    2011-01-01

    Background: The current controversy regarding the management of fractures of the lateral condyle of the humerus presenting between 3 to 12 weeks prompted us to evaluate our results of open reduction and internal fixation of such fractures. Patients and Methods: Twenty-one patients operated between March 1995 and February 2001 qualified for this study. Five patients presented between 34 weeks, nine between 58 weeks and seven between 912 weeks post injury. Ten fractures were classified as stage II and eleven as stage III (Jacob et al. criteria). The mean age was 8 years (range: 414 years). All patients underwent surgery (open reduction and internal fixation with K-wires/screw, with or without bone grafting). The results were assessed by the modified criteria of Agarwal et al. after an average follow-up of 2.3 years. Results: Excellent to good results were observed in all the five patients presenting at 34 weeks post injury. In the patients presenting at 58 weeks, the results were excellent in one, good in four, fair in three, and poor in one patient. The fracture united in all cases; however, malunion was observed in four patients. The fractures that were operated at 912 weeks showed good results in one case, fair result in three cases, and poor result in three cases. Avascular necrosis of the lateral condyle in one patient, premature fusion in two patients, pin tract infection in three patients, and gross restriction of elbow movements in three patients were the major complications in this group. Accurate reduction was difficult as a result of new bone formation and remodeling at the fracture surfaces. Multiple incisions over the common extensor aponeurosis and bone graft supplementation were helpful for achieving acceptable reduction. Conclusion: Open reduction and internal fixation is recommended in all cases of displaced fractures of the lateral condyle of the humerus presenting at up to 12 weeks post injury. However, the results become poorer with increase in duration after injury and the grade of displacement. To avoid complications it is important to carry out careful dissection of the soft tissue attachments and to mobilize the fragment without the use of force. PMID:21221222

  5. 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

  6. 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

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

    PubMed Central

    Marchand, Andre-Anne; OShaughnessy, 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

  8. [Treatment of fractures of the radial condyle of the humerus in children].

    PubMed

    Amgwerd, M; Sacher, P

    1990-01-01

    A retrospective study of treatment of 46 children with fracture of the lateral humeral condyle is presented. The minimal follow-up of 45 patients was 18 months. 15 children had been treated conservatively while 31 have been operated on with two crossed Kirschner wires. 4 patients presented with varus or valgus deformities of maximal 15 degrees at follow-up. 2 with cubitus varus including one with "fishtail" phenomenon and with cubitus valgus and isolated "fishtail" phenomenon one each. Minimally displaced fractures (less than 2 mm) may be treated conservatively with good results. Dislocated fractures must be treated by open reduction and osteosynthesis to avoid complications (non-union, cubitus valgus, "fishtail" phenomenon and tardy ulnar nerve palsy). Fixation with Kirschner wires is our preferred surgical method. The degree of articular injury has an important influence on the late result. PMID:2346704

  9. Incomplete humeral condylar fracture in two English Pointer dogs.

    PubMed

    Gnudi, G; Martini, F M; Zanichelli, S; Volta, A; Bertoni, G; Del Bue, M; Borghetti, P

    2005-01-01

    Incomplete humeral condylar fracture was diagnosed by means of radiology, CT, scintigraphy, arthroscopy and bone biopsy in two English Pointer dogs. In both cases an acute thoracic limb lameness, unrelated to a known episode of major trauma, was observed. Incomplete humeral condylar fracture, mainly described in the Spaniel breeds, has been recently diagnosed in Labrador retrievers, Rottweiler, German Wachtel and other breeds. The pathogenesis of the condition is still unknown, but incomplete ossification of the humeral condyle and mechanical stress, alone or associated, have to be considered. However, our clinical and histopathological data lead us to believe that in Pointers, high performance dogs, the mechanical stress can assume a critical ethiopathogenetic role. PMID:16594393

  10. 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

  11. Bifid mandibular condyle

    PubMed Central

    Katti, Girish; Najmuddin, Mohammed; Fatima, Syeda; Unnithan, Jayesh

    2012-01-01

    A 20-year-old young male patient presented with limited mouth opening and cosmetic disfigurement since childhood. On examination, marked mandibular hypoplasia resulting in a convex facial profile was noted. Further radiographic investigation using orthopantomograph and CT scan with three-dimensional reconstruction revealed bifid mandibular condyle of the right side. PMID:23131544

  12. Bifid mandibular condyle.

    PubMed

    Katti, Girish; Najmuddin, Mohammed; Fatima, Syeda; Unnithan, Jayesh

    2012-01-01

    A 20-year-old young male patient presented with limited mouth opening and cosmetic disfigurement since childhood. On examination, marked mandibular hypoplasia resulting in a convex facial profile was noted. Further radiographic investigation using orthopantomograph and CT scan with three-dimensional reconstruction revealed bifid mandibular condyle of the right side. PMID:23131544

  13. Medial condyle fracture of the distal humerus in an adolescent with pre-existing fishtail deformity. A case report.

    PubMed

    Namba, Jiro; Tsujimoto, Takashi; Temporin, Ko; Yamamoto, Koji

    2011-12-01

    Medial condyle fractures of the humerus are rare in any age group. We report a unique case of a humeral medial condyle fracture in a 15-year-old boy with posttraumatic fishtail deformity. The fracture line extended up from the top of the sharp trochlear wedge to the incomplete medial supracondylar cortical aperture. The appearance of the upward displacement and computed tomography imaging with three-dimensional reconstruction at the two different elbow positions suggested that an edge of the semilunar notch of the olecranon acted as a wedge to break and split the trochlea directly. This is the first visualized case of a wedge type injury and may provide evidence that humeral medial condyle fractures can be produced by the wedge force besides the valgus avulsion one. PMID:21935682

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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

  19. [Aseptic osteonecrosis of the femoral condyle after meniscectomy by the arthroscopic approach].

    PubMed

    al-Kaar, M; Garcia, J; Fritschy, D; Bonvin, J C

    1997-04-01

    Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prothesis, the other 7 patients were treated medically. PMID:9239362

  20. 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.

  1. 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

  2. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  3. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  4. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  5. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the human... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular condyle prosthesis. 872.3960...

  6. 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

  7. No differences in morphological characteristics between hyperplastic condyle and class III condyle.

    PubMed

    Goulart, D R; Muoz, P; Olate, S; de Moraes, M; Faria, R

    2015-10-01

    The aim of this research was to compare the condylar morphology of patients with unilateral condylar hyperplasia (UCH) and patients with a class III skeletal relationship using cone beam computed tomography (CBCT). A prospective study was conducted on patients with facial asymmetry attending the division of oral and maxillofacial surgery of the study university in Chile. Fifteen patients with UCH and 15 with a class III skeletal relationship were selected. Linear measurements of the condylar processes were obtained at a scale of 1:1 using the software Ez3D Viewer Plus. Analysis of variance (ANOVA) and the paired t-test were used, considering P<0.05. Patients with UCH presented statistical differences between the hyperplastic condyle and non-hyperplastic condyle for anteroposterior and mediolateral diameters, condylar neck length, and ramus height. Patients with a class III skeletal relationship showed no differences between the right and left sides; the morphology of their condyles was similar to the condyles with hyperplasia and presented statistical differences when compared with the non-hyperplastic condyles (one-way ANOVA, P<0.05). The condylar morphology of UCH patients could be related to the development of a class III skeletal relationship. These findings provide an insight into the possibility of some class III patients presenting bilateral condylar hyperplasia. PMID:26112995

  8. [The mandibular condyle. The prenatal evolutionary process].

    PubMed

    Fuentes, A

    1988-01-01

    Fourteen prenatal maxillary condyles were studied from 66 to 305 mm. vertex-coxa, making slides with different orientation and using several staining techniques. The most significative characteristics were described in the different ages. The lining connective tissue increased its thickness but not change appreciably its structure. The mesenchymal layer, generating cells, maintained its character, but its columnar invaginations observed early were getting more tense as its age increased. The cartilage without typical isogeneic groups and few intercellular substance, decreased as substituted by osteoid trabeculae observing few osteoclasts. In the subchondral area, the difference between the columnar mesenchyma and haematogenous narrow was outstanding. PMID:2464192

  9. 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

  10. 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

  11. 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 1175 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 57.5 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 8089, fair with 7079 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 616 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

  12. [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

  13. 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

  14. Updated Classification System for Proximal Humeral Fractures

    PubMed Central

    Guix, Jos M. Mora; Pedrs, Juan Sala; Serrano, Alejandro Castao

    2009-01-01

    Proximal humeral fractures can restrict daily activities and, therefore, deserve efficient diagnoses that minimize complications and sequels. For good diagnosis and treatment, patient characteristics, variability in the forms of the fractures presented, and the technical difficulties in achieving fair results with surgical treatment should all be taken into account. Current classification systems for these fractures are based on anatomical and pathological principles, and not on systematic image reading. These fractures can appear in many different forms, with many characteristics that must be identified. However, many current classification systems lack good reliability, both inter-observer and intra-observer for different image types. A new approach to image reading, following a well-designed set and sequence of variables to check, is needed. We previously reported such an image reading system. In the present study, we report a classification system based on this image reading system. Here we define 21 fracture characteristics and apply them along with classical Codman approaches to classify fractures. We base this novel classification system for classifying proximal humeral fractures on a review of scientific literature and improvements to our image reading protocol. Patient status, fracture characteristics and surgeon circumstances have been important issues in developing this system. PMID:19574487

  15. Updated classification system for proximal humeral fractures.

    PubMed

    Mora Guix, Jos M; Pedrs, Juan Sala; Serrano, Alejandro Castao

    2009-06-01

    Proximal humeral fractures can restrict daily activities and, therefore, deserve efficient diagnoses that minimize complications and sequels. For good diagnosis and treatment, patient characteristics, variability in the forms of the fractures presented, and the technical difficulties in achieving fair results with surgical treatment should all be taken into account. Current classification systems for these fractures are based on anatomical and pathological principles, and not on systematic image reading. These fractures can appear in many different forms, with many characteristics that must be identified. However, many current classification systems lack good reliability, both inter-observer and intra-observer for different image types. A new approach to image reading, following a well-designed set and sequence of variables to check, is needed. We previously reported such an image reading system. In the present study, we report a classification system based on this image reading system. Here we define 21 fracture characteristics and apply them along with classical Codman approaches to classify fractures. We base this novel classification system for classifying proximal humeral fractures on a review of scientific literature and improvements to our image reading protocol. Patient status, fracture characteristics and surgeon circumstances have been important issues in developing this system. PMID:19574487

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

    PubMed

    Muoz, Gonzalo; Olate, Sergio; Cantn, Mario; Vsquez, Blgica; Del Sol, Mariano; Faria, 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

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

    PubMed Central

    Muoz, Gonzalo; Olate, Sergio; Cantn, Mario; Vsquez, Blgica; del Sol, Mariano; Faria, 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 students 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

  18. 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

  19. 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

  20. Osteochondroma of condyle: case discussion and review of treatment modalities

    PubMed Central

    Arora, Piyush; Deora, Shakti Singh; Kiran, Shital; Bargale, Seema Dinesh

    2014-01-01

    Temporomandibular joint (TMJ) forms a synovial articulation between the condyle and the cranium. It is a complex joint and shows hinge and gliding movements. Unlike other articulating heads, condyle grows with intramembranous ossification. TMJ is subjected to excessive loads throughout life as it supports essential functions such as mastication, deglutition, speech and respiration. Traumatic, neoplastic or non-neoplastic pathologies sometimes necessitate joint replacement therapy. Osteochondroma is one such benign tumour originating from condyle which requires surgical replacement of condyle with prosthesis. Various replacement methods have been designed in the past. Alloplastic grafts have been successfully used in joint replacement surgeries like hip joint, knee joint, etc. This case discussion supports the use of titanium-made condylar prosthesis for long-term functional stability of TMJ. PMID:24496065

  1. 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...

  2. 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 -1500?? near the screws due to their implantation on the external surface of the mandible. The drilling process induced up to 80?? 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

  3. Morphology of the humeral insertion of the supraspinatus and infraspinatus tendons: Application to rotator cuff repair.

    PubMed

    Lumsdaine, William; Smith, Adam; Walker, Rowan G; Benz, Daniel; Mohammed, Khalid D; Stewart, Fiona

    2015-09-01

    In shoulder surgery, a precise understanding of anatomical relationships is required for accurate reconstruction. Reports in recent literature have challenged the traditional definitions of the humeral footprints of the supraspinatus and infraspinatus tendons. This study aims to precisely delineate these footprints. The rotator cuffs of 54 shoulders from 27 Australian Caucasoid donor cadavers were examined. The tendinous portions were dissected down to their region/footprint of attachment upon the humerus. Measurements of those footprints, upon the greater and lesser tuberosities, were made. Those measurements were statistically analyzed for any association with age, sex, height, or side. Twenty-seven cadavers had an average age at death of 74.9 ( 12.8), 56% were male, average height was 168 ( 8.6) cm. Due to premorbid fracture, or degeneration, 11 shoulders were excluded. The footprint of the supraspinatus was triangular, with a medial, anteroposterior length of 20.4 4.2 mm. Its lateral anteroposterior length was 6.3 1.6 mm and its maximal mediolateral width was 6.6 2.7 mm. Its calculated area was 122.0 66.6 mm(2). The footprint of the infraspinatus was trapezoidal, with a medial anteroposterior length 22.6 3.0 mm. Its lateral anteroposterior length was 25.4 3.3mm and its maximal mediolateral width was 12.0 2.7 mm. Its calculated area was 294.9 74.1 mm(2). There was no statistical correlation between size of the footprint and age, sex, side, or height. The humeral footprints of the supraspinatus and infraspinatus tendons upon the greater tuberosity were distinct. The lateral border of the infraspinatus' humeral attachment extended much farther anteriorly upon the highest facet of the greater tuberosity than in traditional descriptions. PMID:25914209

  4. 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

  5. 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

  6. CT Scan Method Accurately Assesses Humeral Head Retroversion

    PubMed Central

    Boileau, P.; Mazzoleni, N.; Walch, G.; Urien, J. P.

    2008-01-01

    Humeral head retroversion is not well described with the literature controversial regarding accuracy of measurement methods and ranges of normal values. We therefore determined normal humeral head retroversion and assessed the measurement methods. We measured retroversion in 65 cadaveric humeri, including 52 paired specimens, using four methods: radiographic, computed tomography (CT) scan, computer-assisted, and direct methods. We also assessed the distance between the humeral head central axis and the bicipital groove. CT scan methods accurately measure humeral head retroversion, while radiographic methods do not. The retroversion with respect to the transepicondylar axis was 17.9 and 21.5 with respect to the trochlear tangent axis. The difference between the right and left humeri was 8.9. The distance between the central axis of the humeral head and the bicipital groove was 7.0mm and was consistent between right and left humeri. Humeral head retroversion may be most accurately obtained using the patients own anatomic landmarks or, if not, identifiable retroversion as measured by those landmarks on contralateral side or the bicipital groove. PMID:18264854

  7. 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

  8. 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

  9. 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

  10. Dislocation of the mandibular condyle into the middle cranial fossa.

    PubMed

    Clauser, Luigi; Tieghi, Riccardo; Polito, Jessica; Gali, Manlio

    2006-05-01

    Dislocation of the mandibular condyle into the middle cranial fossa is an uncommon event. A case report is presented based on a patient (32-year-old female) who sustained a traumatic left condyle fracture with superior dislocation into the middle cranial fossa due to a high-speed car accident. The diagnosis was done four months after trauma. Via a preauricular approach, left condylectomy and transposition of temporal muscle flap was performed. Postoperatively, the patient stayed for two weeks with intermaxillary fixation and four months of physical therapy. PMID:16770205

  11. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Elbow joint humeral (hemi-elbow) metallic... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint... Food and Drug Administration on or before December 26, 1996 for any elbow joint humeral...

  12. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Elbow joint humeral (hemi-elbow) metallic... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint... Food and Drug Administration on or before December 26, 1996 for any elbow joint humeral...

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Elbow joint humeral (hemi-elbow) metallic... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint... Food and Drug Administration on or before December 26, 1996 for any elbow joint humeral...

  14. 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... Food and Drug Administration on or before December 26, 1996 for any elbow joint humeral...

  15. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Elbow joint humeral (hemi-elbow) metallic... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint... Food and Drug Administration on or before December 26, 1996 for any elbow joint humeral...

  16. Humeral head resurfacing for fixed anterior glenohumeral dislocation

    PubMed Central

    Aldinger, P. R.; Kasten, P.; Rickert, M.; Loew, M.

    2007-01-01

    The purpose of this prospective study was to describe cementless humeral surface replacement arthroplasty (CHSRA) as a bone preserving treatment option for patients with fixed anterior glenohumeral dislocation. Ten patients with post-traumatic fixed anterior glenohumeral dislocation underwent CHSRA with a mean follow-up of 24months. All patients were evaluated clinically using the Constant score and with radiographs in two planes. There were two reoperations: one patient developed glenoid erosion and was revised and in another case redislocation occurred. Clinical or radiographical signs of implant loosening were not found. The humeral head centred in the glenoid in nine out of ten cases radiographically. The Constant score increased from 20 points preoperatively to 61 points postoperatively (p?humeral head. Good clinical results and a moderate complication rate were found in the short term. PMID:18092162

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. Posterior condyle surface damage on retrieved femoral knee components.

    PubMed

    Burnell, Colin D C; Brandt, Jan-M; Petrak, Martin J; Bourne, Robert B

    2011-12-01

    Twenty-two retrieved femoral knee components were identified with posterior condyle surface damage on average at 99 flexion (range, 43-135 flexion). Titanium alloy material transfer and abrasive surface damage were evident on cobalt-chromium alloy femoral components that were in contact with titanium alloy tibial trays. Surface damage on the retrieved Oxinium femoral components (Smith and Nephew, Inc, Memphis, Tenn) that were in contact with titanium alloy tibial trays showed gouging, associated with the removal and cracking of the oxide and exposure of the zirconium-niobium alloy substrate. Cobalt-chromium alloy femoral components that were in contact with cobalt-chromium alloy tibial trays showed abrasive wear. Contact between the femoral component and tibial tray should be avoided to prevent surface damage to the femoral condyles, which could potentially accelerate polyethylene wear in vivo. PMID:21570806

  3. 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

  4. 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

  5. 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

  6. [Osteological interdisciplinary management : Exemplified by a bilateral proximal humeral fracture].

    PubMed

    Neuerburg, C; Pietschke, K; Stumpf, U; Sommerey, S; Schmidmaier, R; Ockert, B; Bcker, W; Haasters, F

    2015-11-01

    Following locking plate osteosynthesis of a proximal humeral fracture, a 62-year-old male patient suffered mild secondary dislocation. Subsequent bone densitometry identified an osteoporosis. Laboratory testing and sonography revealed an underlying primary hyperparathyroidism. In the short term, the patient suffered a similar proximal humeral fracture of the contralateral side. Given the knowledge about the underlying osteoporosis a cement-augmented locking plate osteosynthesis was carried out to treat the fracture. Parathyroidectomy was performed shortly thereafter and laboratory parameters returned to normal. Secondary fractures did not arise. Treatment of this patient in a certified osteoporosis center with a multimodal management led to systematic interdisciplinary diagnostics, a specific surgical therapy and ended in an excellent result. PMID:26187431

  7. Humeral Retrotorsion in Collegiate Baseball Pitchers With Throwing-Related Upper Extremity Injury History

    PubMed Central

    Myers, Joseph B.; Oyama, Sakiko; Rucinski, Terri Jo; Creighton, R. Alexander

    2011-01-01

    Background: Collegiate baseball pitchers, as well as position players, exhibit increased humeral retrotorsion compared with individuals with no history of overhead sport participation. Whether the humeral retrotorsion plays a role in the development of throwing-related injuries that are prevalent in collegiate baseball pitchers is unknown. Hypotheses: Humeral retrotorsion will be significantly different in collegiate pitchers with throwing-related shoulder or elbow injury history compared with pitchers with no injury history. Humeral retrotorsion can also discriminate participants with and without shoulder or elbow injury. Study Design: Cross-sectional study. Methods: Comparisons of ultrasonographically-obtained humeral retrotorsion were made between 40 collegiate pitchers with and without history of throwing-related shoulder or elbow injury. The ability of humeral retrotorsion to discriminate injury history was determined from the receiver operating characteristic area under the curve. Results: Participants with an elbow injury history demonstrated a greater humeral retrotorsion limb difference (mean difference = 7.2, P = 0.027) than participants with no history of upper extremity injury. Participants with shoulder injury history showed no differences in humeral torsion compared with participants with no history of injury. Humeral retrotorsion limb difference exhibited a fair ability (receiver operating characteristic area under the curve = 0.74) to discriminate elbow injury history. Conclusions: Collegiate pitchers with a history of elbow injury exhibited a greater limb difference in humeral retrotorsion compared with pitchers with no history of injury. No differences in humeral retrotorsion variables were present in participants with and without shoulder injury history. Clinical Relevance: Baseball players with a history of elbow injury demonstrated increased humeral retrotorsion, suggesting that the amount of retrotorsion and the development of elbow injury may be associated. PMID:23016031

  8. Humeral Neck Fracture after Electrocution - Case Report and Literature Review.

    PubMed

    Zbuchea, A

    2015-01-01

    A case of left humeral neck fracture following electrocution is reported in a 56-year old man, associated with partial thickness burns on his left hand. A fracture after accidental electrical shock injury represents a very unusual situation, due to muscle contractions. Surgeons involved in the management of the electrocuted patients should be aware of the possibility of musculoskeletal injuries. Neglecting these injuries can lead to delay in diagnosis and to detrimental complications. PMID:26531798

  9. 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

  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. Allografting in Locked Nailing and Interfragmentary Wiring for Humeral Nonunions

    PubMed Central

    Lin, Wei-Peng

    2009-01-01

    In this prospective study, we compared outcomes after repair of humeral nonunions when morsellized fresh-frozen allograft or autograft was used to augment repair by intramedullary nailing. Sixty-five patients with humeral shaft nonunions of greater than 6months duration and gross instability at the nonunion site were included and treated by locked nailing, interfragmentary wiring, and bone grafting. Graft type was determined by patient preference. Outcomes assessed included union rate and functional recovery of the arm. Secondary end points included operative blood loss, operation time, hospital stay, time to fracture healing, and complications. Twenty-eight patients with autografts and 36 with allografts were followed up more than 2years. The baseline conditions of the two groups were similar. The autograft group had greater blood loss and longer operative time than the allograft group. The autograft group also had a longer hospital stay. The healing rate, time to healing, and functional scores did not differ between these two groups. In the autograft group, 43% reported pain and limited mobility as a result of the donor site. We concluded that when used in association with locked nailing for humeral nonunions, allografts can achieve treatment results similar to autografts but without donor site complications. Level of Evidence: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence. Electronic supplementary material The online version of this article (doi:10.1007/s11999-009-1055-8) contains supplementary material, which is available to authorized users. PMID:19701671

  12. 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

  13. Overexpressed TGF-? in subchondral bone leads to mandibular condyle degradation.

    PubMed

    Jiao, K; Zhang, M; Niu, L; Yu, S; Zhen, G; Xian, L; Yu, B; Yang, K; Liu, P; Cao, X; Wang, M

    2014-02-01

    Emerging evidence has implied that subchondral bone plays an important role during osteoarthritis (OA) pathology. This study was undertaken to investigate whether abnormalities of the condylar subchondral bone lead to temporomandibular joint (TMJ) OA. We used an osteoblast-specific mutant TGF-?1 transgenic mouse, the CED mouse, in which high levels of active TGF-?1 occur in bone marrow, leading to abnormal bone remodeling. Subchondral bone changes in the mandibular condyles were investigated by micro-CT, and alterations in TMJ condyles were confirmed by histopathological and immunohistochemical analysis. Abnormalities in the condylar subchondral bone, characterized as fluctuant bone mineral density and microstructure and increased but uncoupled activity of osteoclasts and osteoblasts, were apparent in the 1- and 4-month CED mouse groups, while obvious cartilage degradation, in the form of cell-free regions and proteoglycan loss, was observed in the 4-month CED group. In addition, increased numbers of apoptotic chondrocytes and MMP9- and VEGF-positive chondrocytes were observed in the condylar cartilage in the 4-month CED group, but not in the 1-month CED group, compared with their respective age-matched controls. This study demonstrated that progressive degradation of mandibular condylar cartilage could be induced by the abnormal remodeling of the underlying subchondral bone during TMJOA progression. PMID:24309371

  14. An inconvenient truth: treatment of displaced paediatric supracondylar humeral fractures.

    PubMed

    Donnelly, M; Green, C; Kelly, I P

    2012-06-01

    The need for emergent management of displaced paediatric supracondylar humeral fractures is being questioned in the literature. Open reduction rates of up to 46% have been reported in the non-emergent management of these injuries. At our institution these fractures are managed as operative emergencies by senior personnel. To examine the ongoing need for this policy we reviewed our results. All patients managed over a five year period with Gartland type IIB or III paeditric supracondylar humeral fractures were identified and a comprehensive chart and radiographic review undertaken. The mean time from injury to fracture reduction and stabilization was 6.6h. Consultants performed or supervised 90% of cases. Open reduction was necessary in 5% of cases. Complications included a perioperative nerve injury rate of 6% and a superficial pin site infection rate of 3%. This study suggests that, despite the challenge to trauma on-call rostering, the emergency management of these injuries is advantageous to patients in units of our size. Based on the data presented here we continue our practice of emergent management. We suggest that units of a similar size to our own would show a benefit from an analogous policy albeit an inconvenient truth. PMID:22525415

  15. Conventional Humeral Retroversion Measurements Using Computed Tomography Slices or Ultrasound Images Are Not Correlated With the 3-Dimensional Humeral Retroversion Angle

    PubMed Central

    Saka, Masayuki; Yamauchi, Hiroki; Yoshioka, Toru; Hamada, Hidetoshi; Gamada, Kazuyoshi

    2015-01-01

    Background: Humeral retroversion angles determined by previous techniques are varied and/or biased by morphologic variations of the proximal and distal humerus, and their validity should be revisited. To overcome the limitations of previous studies associated with 2-dimensional (2D) images and the reference axes, a 3-dimensional (3D) measurement of humeral retroversion is required. However, comparisons of 2D imaging methods with the 3D computed tomography (CT) measurement as a reference standard have not been heretofore performed. Purpose: To determine whether the 3D CT humeral retroversion angle in baseball players is correlated with conventional humeral retroversion measurements. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 28 humeri from 14 male baseball players were used for measuring humeral retroversion. Participants underwent CT scans, and geometric bone models were created for measuring the 3D CT humeral retroversion angle. Using CT slices, the 2D CT humeral retroversion angle was also determined. Bicipital forearm angle was assessed using the indirect ultrasound technique. Linear regressions and Bland-Altman plots were used to determine whether there were agreements among 3 variables: the 3D CT retroversion, 2D CT retroversion, and bicipital forearm angles. Results: In linear regression analyses, the 3D humeral retroversion angle was not predicted by the 2D CT retroversion (R = 0.167, R 2 = 0.028, P = .395) or the bicipital forearm angle (R = 0.049, R 2 = 0.002, P = .805). The bias of these 2 methods was 20.9 and 15.3, respectively. Regression analysis demonstrated that the bicipital forearm angle was a significant predictor of the 2D CT retroversion angle (R = 0.632, R 2 = 0.400, P < .001). Conclusion: The 3D CT humeral retroversion angle was found to be underestimated by the 2D CT retroversion angle and overestimated by the bicipital forearm angle obtained by the indirect ultrasound, although a previously observed relationship between the 2D CT retroversion and bicipital forearm angles was confirmed. Clinical Relevance: Precise measurement of humeral retroversion angle is important because retroversion has been linked to upper extremity disorders, including throwing-related shoulder and elbow disorders in baseball players. PMID:26665028

  16. Osteochondroma of the mandibular condyle: an unusual case of dentofacial asymmetry.

    PubMed

    Power, Andrew; Carter, Lachlan

    2015-05-01

    An osteochondroma of the mandibular condyle is a rare tumour of the maxillofacial region that could first present to the general dental practitioner. This case report describes an osteochondroma of the posterio-medial mandibular condyle presenting with marked facial asymmetry and trismus over a six- month period. Appropriate referral and investigation enabled successful removal of the tumour, recontouring of the condyle and an uncomplicated, positive outcome for our patient. Clinical Relevance: Temporomandibular joint disorders can be a cause of dento-facial asymmetry. Pathology of the temporomandibular joint should be considered in the differential diagnosis when such a patient presents. PMID:26062262

  17. Application of 3-Dimensional Printing Technology to Kirschner Wire Fixation ofAdolescent 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

  18. Three-dimensional Humeral Morphological Alterations and Atrophy Associated with Obstetrical Brachial Plexus Palsy

    PubMed Central

    Sheehan, Frances T.; Brochard, Sylvain; Behnam, Abrahm J.; Alter, Katharine E.

    2014-01-01

    Background Obstetrical Brachial Plexus Palsy (OBPP) is a common birth injury, resulting in severe functional losses. Yet, little is known about how OBPP affects the 3D humeral morphology. Thus, the purpose of this study was to measure the 3D humeral architecture in children with unilateral OBPP. Methods Thirteen individuals (4F/9M, age=11.83.3 years, Mallet score=15.13.0) participated in this IRB-approved study. A three-dimensional T1-weighted gradient-recalled-echo magnet resonance image set was acquired for both upper limbs (involved/non-involved). Humeral size, version, and inclination were quantified from 3D humeral models derived from these images. Results The involved humeral head was significantly less retroverted and in declination (medial humeral head pointed anteriorly and inferiorly), relative to the non-involved side. Osseous atrophy was present in all three dimensions and affected the entire humerus. The inter-rater reliability was excellent (ICC = 0.961.00). Discussion This study demonstrated that both humeral atrophy and bone shape deformities associated with OBPP are not limited to the axial plane, but are three-dimensional phenomena. Incorporating information related to these multiplanar, 3D, humeral deformities into surgical planning could potentially improve functional outcomes following surgery. The documented reduction in retroversion is an osseous adaptation, which may help maintain glenohumeral congruency by partially compensating for the internal rotation of the arm. The humeral head declination is a novel finding and may be an important factor to consider when developing OBPP management strategies, as it has been shown to lead to significant supraspinatus inefficiencies and increased required elevation forces. Level of evidence Anatomic Study, Imaging PMID:24291045

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

    PubMed

    Bod, Gbor; Vsrhelyi, Gbor; Hangody, Lszl; Mdis, Lszl

    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

  20. Proximal humeral osteoarticular allografts: technique, pearls and pitfalls, outcomes.

    PubMed

    Farfalli, German L; Ayerza, Miguel A; Muscolo, D Luis; Aponte-Tinao, Luis A

    2015-12-01

    Allograft transplantation is a biologic reconstruction option for massive bone defects after resection of bone sarcomas. This type of reconstruction not only restores bone stock but it also allows us to reconstruct the joint anatomically. These factors are a major concern, especially in a young and active population.We are describing indications, surgical techniques, pearls and pitfalls, and outcomes of proximal humeral osteoarticular allografts, done at present time in our institution.We found that allograft fractures and articular complications, as epiphyseal resorption and subchondral fracture, are the main complications observed in proximal humerus osteoarticular allograft reconstructions. Nevertheless, only fractures need a reconstruction revision. Joint complications may adversely affect the limb function, but for this reason, an allograft revision is rarely performed. PMID:26428365

  1. Proximal humeral reconstruction after excision of a primary sarcoma.

    PubMed

    Jensen, K L; Johnston, J O

    1995-02-01

    From 1978 to 1991, 19 patients underwent wide resection of the proximal humerus for a primary bone tumor. Reconstructions included intercalary autoclaved autograft and Neer prosthesis composites in 11 patients, intercalary allograft and Neer prosthesis composites in 4 patients, and a Neer prosthesis with methylmethacrylate in 4 patients. All patients were observed for at least 2 years or until death. The functional results and complications of the 19 procedures were evaluated. Function was rated as excellent for 17 patients and good for 2 patients. There were no failures of fixation. Local recurrence occurred in 2 patients. There were 2 cases of recurrent anterior subluxation and 1 of dislocation. Two superficial wound infections were treated successfully with local debridement and antibiotics. The authors conclude that autoclaved autograft or allograft when combined with a long-stem cemented Neer prosthesis offers an excellent composite for proximal humeral reconstruction. PMID:7634572

  2. Humeral fractures by arm wrestling in adult: a biomechanical study.

    PubMed

    Pedrazzini, Alessio; Pedrazzoni, Mario; De Filippo, Massimo; Nicoletto, Gianni; Govoni, Riccardo; Ceccarelli, Francesco

    2012-08-01

    Humeral shaft fractures may occur as a result of arm wrestling. We discuss the biomechanics of this rare injury mechanism. Using Strength of materials concepts, Computerized Tomography and Bone Density Scans we studied the biomechanical and anatomical conditions that predispose to this particular fracture. An unfavorable ratio between inner-outer diameter and a low bone mineral concentration in the distal third of humerus compared to other sections of bone were seen as critical aspects. The biomechanical study observed the primary importance of these factors to explain the typical shape and location of this fracture. These results indicate that each arm wrestler should be conscious of the risks of practicing this activity. (www.actabiomedica.it). PMID:23393920

  3. 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

  4. 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

  5. Changes in growth and morphology of the condyle following mandibular distraction in minipigs: Overloading or Underloading?

    PubMed Central

    Rafferty, Katherine L.; Sun, Zongyang; Egbert, Mark; Bakko, Daniel W.; Herring, Susan W.

    2007-01-01

    Objective: Loading of temporomandibular tissues during mandibular distraction may cause changes in condylar growth and cartilage thickness. This study examines the effects of distraction on the condyle in a large animal model by explicitly measuring growth and in vivo loading. Design: Unilateral mandibular distraction was carried out on twenty growing minipigs divided into three groups. One group underwent distraction but not consolidation, whereas the other two groups were allowed a period of consolidation of either one or two weeks. Animals received fluorochrome and 5-bromo-2'-deoxyuridine (BrdU) labeling and masticatory strain was measured from the condylar neck. Condylar strain was also recorded in an age-matched sample of eight animals that received no distraction surgery. Immunohistochemical procedures were used to identify dividing prechondroblasts and histological analysis was used to measure mineral apposition rate, count dividing cells, and measure the thickness of condylar cartilage. Results: Strain magnitude, particularly compressive strain, was much larger on the non-distraction side compared to the distraction side condyle. Compared to normal loading levels, the distraction side condyle was underloaded whereas the condyle on the intact side was overloaded. Mineral apposition and cartilage thickness were greater on the distraction side condyle compared to the opposite side. Differences between the sides were most pronounced in the group with no consolidation and became progressively reduced with consolidation time. Conclusions: Increased mineralization and cartilage thickness on the distraction side condyle is associated with reduced, not increased loading, perhaps because of disruption of the distraction side masseter muscle. PMID:17573035

  6. 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

  7. Bifid mandibular condyle with ankylosis in a 3-year-old child: A rare presentation and review

    PubMed Central

    Mainali, Sneedha; Tandon, Shobha

    2010-01-01

    Bifid mandibular condyle with ankylosis is an extremely rare condition and may arise as a developmental or traumatic defect. It may be associated with ankylosis. We here report a case of unilateral bifid mandibular condyle with ankylosis in a 3-year-old child. This is the youngest patient reported with the condition making it one of its first kind in the literature. The detailed description of the case, its radiological findings, and the literature on bifid condyles are reviewed. PMID:22114377

  8. 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

  9. Characterizing occipital condyle loads under high-speed head rotation.

    PubMed

    Pintar, Frank A; Yoganandan, Narayan; Baisden, Jamie

    2005-11-01

    Because of the need to evaluate anthropomorphic test device (ATD) biofidelity under high-head angular accelerations, the purpose of the present investigation was to develop appropriate instrumentation for intact post mortem human subject (PMHS) testing, validate the instrumentation, and obtain information to characterize the response of the head-neck complex under this loading scenario. A series of rigid-arm pendulum, inertially loaded ATD tests was conducted. Head and neck ATD hydraulic piston chin pull tests were conducted. Subsequently, a series of PMHS tests was conducted to derive the response of the human head-neck under high-rate chin loading. Finally, Hybrid III and THOR-NT ATD head-neck systems were evaluated under the same scenario as the PMHS. A parametric analysis for center of gravity (CG) location and accelerometer orientation determined that even small errors (+/- 3 mm or 2 degrees), produced errors in the force and moment calculations by as much as 17 %. If the moment of inertia (MOI) term was varied by 5 %, resulting moment calculations were affected by as much as 8 %. If the 5 % error in MOI was used to compute occipital condyle moments, and results compared to upper load cell derived moments, peaks differed by as much as 24 %. The head CG and mass MOI should be directly measured for each preparation to obtain accurate results. The injury run on each specimen resulted in predominantly C1-C2 separations or partial separations. The 50(th) percentile probability of AIS=2+ neck injury using tensile force was about 2400 N; for AIS=3+ neck injury the 50(th) percentile risk was about 3180 N. When inserting extension moment as the criteria, the 50(th) percentile probability of an AIS=2+ injury was 51 Nm. The AIS=3+ extension moment at the 50(th) percentile probability was 75 Nm. The new THOR-NT ATD head-neck produced more biofidelic responses with an alternate head-neck junction design compared to the Hybrid III ATD. PMID:17096267

  10. 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

  11. Dislocation of Mandibular Condyle Into Middle Cranial Fossa: Two Alternative Methods for Two Patients.

    PubMed

    Temiz, Gkhan; akmako?lu, a?r?; Akp?nar, Ali Cem; Filinte, Gaye Taylan

    2015-08-01

    Dislocation of the mandibular condyle into the middle cranial fossa is rare, and the number of cases discussed in published studies is limited. Various treatment routes have been suggested, and the entire published data are based on the presentations of single cases. The present report presents 2 cases of dislocation of the mandibular condyle into the middle cranial fossa. The first case was treated with closed reduction in the early stage; however, the second case, which was treated in the late stage, required open reduction. Both the methods of reduction and the key aspects of diagnosis are discussed. PMID:25957877

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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

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

    PubMed

    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

  18. 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

  19. 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,...

  20. 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

  1. 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

  2. The role of external fixation in the treatment of humeral shaft fractures: a retrospective case study review on 85 humeral fractures.

    PubMed

    Scaglione, Michelangelo; Fabbri, Luca; Dell' Omo, Dario; Goffi, Andrea; Guido, Giulio

    2015-02-01

    There is no consensus among surgeons on the treatment for humeral fractures: the best it is still a matter of some debate. The aim of our work was to demonstrate that external fixation may be considered a valid method not only in emergencies but also for the definitive treatment of such fractures. We perform a retrospective case study review on 85 humeral fractures, 62 shaft fractures, and 23 extrarticular distal third fractures treated with external fixation. Clinical (Disabilities of the Arm, Shoulder and Hand (DASH) score and SF-36) and radiographic follow-up lasted on average 30 months (minimum 12 to maximum 36). Complete healing of fractures was achieved in 97.6% of cases (83 patients), with an average consolidation time of about 12 weeks (83.2 days). One case of delayed union and one case of refracture were encountered. Eighty-one patients demonstrated SF-36 scores at or above the national average and an average DASH score of 8.9. External fixation of humeral shaft fractures is considered a valid treatment method as it provides good results in terms of stability of reduction, tolerability, healing times, and functional recovery. PMID:25530408

  3. Measurement of migration of a humeral head resurfacing prosthesis using radiostereometry without implant marking

    PubMed Central

    2011-01-01

    Introduction Standard radiostereometric analysis of prosthetic migration requires that tantalum beads are inserted into the implant. For manufacturing reasons, this is not possible for humeral head resurfacing implants. We therefore used marker-free radiostereometry, developed for metal-backed acetabular cups, on a dummy model to validate the method for a humeral head resurfacing prosthesis. Material and methods 3 hemispherical resurfacing prostheses of different sizes were marked with tantalum beads and mounted in a sawbone. Standard and marker-free radiostereometry was then done repeatedly with gradual shifts of position of the prosthesis between each analysis. The marker-free algorithm was then compared to the standard to determine the accuracy. Results The accuracy for marker-free radiostereometry was 0.220.47 mm for translations and 0.921.56 degrees for rotations. Interpretation Based on our results, marker-free radiostereometry can be used to measure migration of humeral head resurfacing prostheses. This indicates that implant marking is not required when doing radiostereometry on humeral head resurfacing in clinical trials. PMID:21428847

  4. 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 HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices 888.3690 Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder...

  5. Arthroscopically assisted retrograde drilling of the humeral head with a guiding device.

    PubMed

    Kircher, Jrn; Patzer, Thilo; Ziskoven, Christoph; Bittersohl, Bernd; Hedtmann, Achim; Krauspe, Rdiger

    2015-05-01

    This manuscript describes the successful treatment of a steroid-induced avascular necrosis of the humeral head using arthroscopically assisted retrograde drilling of a stage II lesion using a guiding device. At the final follow-up 19 month post-operatively, the patient presented pain-free without functional limitations although the osteonecrosis had not been fully healed. PMID:24296988

  6. 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

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

    PubMed Central

    Ricci, Flvia Pessoni Faleiros Macdo; Barbosa, Rafael Incio; Elui, Valria Meirelles Carril; Barbieri, Cludio Henrique; Mazzer, Nilton; Fonseca, Marisa de Cssia 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

  8. 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

  9. Minimal Invasive Percutaneous Osteosynthesis for Elderly Valgus Impacted Proximal Humeral Fractures with the PHILOS

    PubMed Central

    Chen, Hang; Hu, Xiaochuan; Tang, Haochen; Yang, Guoyong; Xiang, Ming

    2015-01-01

    There is a growing concern about elderly valgus impacted proximal humeral fractures. The aim of this study was to evaluate the treatment and clinical outcomes following minimal invasive percutaneous plate osteosynthesis (MIPPO) with the proximal humeral internal locking system (PHILOS) for the treatment of elderly valgus impacted proximal humeral fracture. Between May 2008 and May 2012, 27 patients (average age 67.3, range 6174) with valgus impacted proximal humeral fractures were enrolled in the study. The patients were treated with MIPPO using PHILOS-plate through the anterolateral delta-splitting approach. Rehabilitation exercises were done gradually. The NEER score and Constant-Murley score were used to evaluate shoulder function. All the patients were followed up by routine radiological imaging and clinical examination. There were 15 cases of II-part greater tuberosity fractures, 10 cases of III-part greater tuberosity fractures, and 2 cases of IV-part fractures according to the NEER classification. The surgery was successful in all patients with an average follow-up of 20.8 (range: 1134) months. The fractures united in an average of 7.2 (614) weeks without implant loosening. According to NEER score, there were 17 excellent, 7 satisfactory, 2 unsatisfactory, and 1 poor. The mean Constant-Murley score was 89.4 4.35. No complication including axillary nerve damage, postoperative nerve or vessel damage, infections, DVT, or death was observed. In conclusion, the MIPPO technique with the PHILOS through the anterolateral delta-splitting approach seems to be a safe and easy treatment for elderly valgus impacted proximal humeral fractures. A case-control study and longer follow-up time are needed. PMID:26693491

  10. 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

  11. Use of anthropometric data from the medial tibial and femoral condyles to design unicondylar knee prostheses in the Chinese population.

    PubMed

    Cheng, Fu Bo; Ji, Xiao Feng; Zheng, Wen Xu; Lai, Ying; Cheng, Kai Liang; Feng, Jia Chun; Li, You Qiong

    2010-03-01

    Anthropometric data on medial tibial condyles and medial femoral condyles of 172 normal knees (94 male knees, 78 female knees) were obtained using three-dimensional computer tomographic measurements. In the medial tibial condyle, we measured the anteroposterior (AP) and widest dimension (WD), and compared the measurements with the similar dimensions of five tibial unicondylar knee prostheses conventionally used in China. In the femur, we used best-fit two-circular arcs to measure the morphology of the sagittal plane of the medial femoral condyle. We found that three of the prostheses showed WD overhang for all ranges of the AP dimension, while two of them showed WD underhang. We also found a progressive decrease in the condylar aspect ratio (WD/AP%) in parallel with an increase in the AP dimension in the medial tibial condyle. However, none of the conventional tibial prosthesis showed a similar change. Furthermore, males had larger values in aspect ratio than females with the same values for AP dimension. There were definite correlations between the radius of the curvature for the posterior part (R1) and distal part (R2) in the sagittal plane of medial femoral condyle. Both of these values were smaller than in the Caucasian population. Both radiuses of curvature for the posterior and distal components showed definite correlations with the AP dimension. The results of this study may provide guidelines for designing unicondylar knee prostheses suitable for the Chinese population. PMID:19629438

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

    PubMed Central

    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

  13. 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

  14. 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

  15. 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

  16. Osteomyelitis of the condyle secondary to pericoronitis of a third molar: a case and literature review.

    PubMed

    Wang, R; Cai, Y; Zhao, Y F; Zhao, J H

    2014-09-01

    In this study, we report a very unusual case of a patient with osteomyelitis of the condyle secondary to pericoronitis of an impacted third molar. The patient was treated by removal of the impacted third molar, opening of the drainage, combined with systemic application of antibiotics for two weeks. This treatment option did not lead to any functional defects or facial asymmetry. The patient fully recovered and the disease did not recur. PMID:24819410

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

    PubMed Central

    Bichsel, Ursina; Nyffeler, Richard Walter

    2015-01-01

    Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally. PMID:26558125

  3. 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

  4. 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

  5. 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

  6. Radiological and biomechanical analysis of humeral fractures occurring during arm wrestling

    PubMed Central

    Kruczy?ski, Jacek; Nowicki, Jaros?aw Jaszczur; Topoli?ski, Tomasz; Srokowski, Grzegorz; Ma?ko, Grzegorz; Chantsoulis, Marzena; Frankowska, Ma?gorzata; Frankowski, Pawe?

    2012-01-01

    Summary Background Arm wrestling has recently become one of the most popular sports among young people, mainly due to its simplicity and spectacularity. Yet, unfortunately it is also injury prone. The aim of the study was to perform a biomechanical analysis of the forces which act during arm wrestling, as well as to explain the mechanism of the occurrence of humeral fractures of a similar topology as observed on X-rays. Material/Methods During the period 2001 to 2008 nine cases of humeral fractures resulting from arm wrestling were consulted and treated at the Clinic. The assessment of the limb condition included an interview and the examination of the fractured extremity. All the patients underwent surgical treatment, using the method of open reduction and internal fixation. The virtual dynamic model of the upper limb was established on the basis of a series of computer tomography scans of the bone, and literature data. The biomechanical analysis was carried out using the Finite Elements Method (FEM). Results There were five cases of the 12-B1 type in the AO Classification with butterfly fragments in five cases, and four of the 12-A1 type without the butterfly fragment. The maximum bone stress resulting from torsional loading which occurs during arm wrestling amounted to 60 MPa and was located 115 mm above the elbow on the medial - posterior side of the humeral. Conclusions The strength analysis carried out during arm wrestling revealed that the forces of the acting muscles significantly exert stresses within the distal third of the humeral. PMID:22534710

  7. Effect of posterior offset humeral components on range of motion in reverse shoulder arthroplasty.

    PubMed

    Dedy, Nicolas J; Stangenberg, Martin; Liem, Dennis; Hurschler, Christof; Simmen, Beat; Riner, Marc; Marquardt, Bjoern; Steinbeck, Joern

    2011-04-01

    The purpose of this study was to evaluate the effect of eccentric humeral components with different degrees of posterior offset on range of glenohumeral motion in reverse shoulder arthroplasty. Uncemented PROMOS reverse shoulder prostheses were implanted in eight human cadaveric shoulder specimens. Passive range of motion was evaluated with a robot-assisted shoulder simulator. Three movements were tested: abduction, anterior elevation and external rotation. Each specimen was tested with a customary reverse humeral component and two eccentric components with 3 and 6 mm of posterior offset respectively. Mean abduction was 81 (standard deviation [SD] 12) for the customary reverse components, 81 (SD 13) for the 3 mm eccentric and 82 (SD 15) for 6-mm eccentric implants. Mean anterior elevation was 68 (SD 13) in the regular group and 66 (SD 14) and 63 (SD 14) for 3- and 6-mm eccentric groups. With all configurations, 90 of external rotation were achieved without requiring more than 2 Nm of applied rotational moment. Although there was no statistically significant difference between the conventional and the eccentric implants, anterior elevation was decreased by almost 20 in three of eight shoulders with the posterior offset configurations. This was due to a conflict between the proximal humerus and the anterior aspect of the acromion or the coracoid. Although eccentric humeral components can be useful in reverse shoulder arthroplasty to avoid anterior cortical defects in individuals with pronounced humeral head posterior offset, a potential conflict between proximal humerus and scapula may have an unfavourable effect on range of anterior elevation. However, this observation is only true for the uncemented PROMOS reverse prosthesis. Other reverse shoulder designs with posterior offset components are yet to be tested. PMID:20563805

  8. 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

  9. Treatment of complex proximal humeral fracture: plate and tension band fixation versus conservative therapy

    PubMed Central

    Sun, Yangbai; Li, Li; Dai, Jiezhi; Wang, Ting

    2015-01-01

    Background: There is no consensus on the optimal treatment for patients with complex proximal humeral fractures. A meta-analysis was performed to evaluate clinical effectiveness of plate and tension band fixation compared with conservative therapy. Methods: We systematically searched electronic databases (Pubmed, Medline, Embase, Cochrane library and Google Scholar) to identify comparative studies and randomized controlled trials in which plate and tension band fixation was compared with conservative treatment of the complex proximal humeral fractures from 1995 to 2013. The quality of the studies was assessed and effective data were pooled for meta-analysis. Results: A total of 222 patients from three RCTs and three comparative studies were included in this meta-analysis (113 fractures treated with plate and tension band and 109 with conservative treatment). The primary and secondary outcomes (Constant Score, nonunion, avascular necrosis and osteoarthritis) were compared and there was no significant difference among these different treatments of this injury. Conclusions: Compared with conservative treatment, internal fixation including plate and tension band did not find better shoulder function, higher rate avascular necrosis of humeral head, lower rate nonunion, and higher rate osteoarthritis. In further, high quality and large randomized trials should be recommended to make a choice between these treatment modalities. PMID:26221252

  10. 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

  11. 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.

  12. 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

  13. A case of delayed recurrent hemarthrosis after posterolateral reconstruction of the knee with a staple fixation at the lateral femoral epicondyle.

    PubMed

    Yoo, Jae Ho; Yi, Seung Rim; Huh, Jung Kyu

    2008-11-01

    We present a case of delayed recurrent hemarthrosis after posterolateral reconstruction of the knee with staple fixation of the tendon graft at the lateral femoral condyle. A 20-year-old man had undergone a reconstructive surgery of the knee with allogeneic Achilles tendon aimed to reinforce lateral collateral ligament and popliteofibular ligament. At 4 months after surgery, recurrent swelling of the operated knee after minor exertion developed. The radiographs showed prominent staples at the lateral side of lateral femoral condyle. The arthroscopy revealed that the staples were salient intra-articularly at lateral gutter of the knee, and the adjacent lateral capsule seemed abraded, through which the longitudinal fibers of iliotibial band were seen. Iatrogenic iliotibial band syndrome owing to the prominent staple was speculated. The staples were removed under arthroscopic guidance, and there has been no recurrence thereafter. A staple fixation over bony prominence is not advisable and the interference screw might be a better alternative method of fixation. PMID:18365223

  14. Failure of the Stem-Condyle Junction of a Modular Femoral Stem in Revision Total Knee Arthroplasty.

    PubMed

    Boe, Chelsea C; Fehring, Keith A; Trousdale, Robert T

    2015-10-01

    Newer technologies have been established in modern revision total knee arthroplasty, including modular junctions, which allow customization of the prosthesis intraoperatively. We report a case of failure of the stem-condyle junction of a modular femoral component of a revision total knee implant, despite appearing well fixed on preoperative radiographs. Intraoperatively, there was dissociation of the condylar component from the well-fixed, cemented stem, creating motion at the stem-condyle junction. To our knowledge, this failure mode has not been reported in the literature. PMID:26447420

  15. The effect of humeral torsion on rotational range of motion in the shoulder and throwing performance

    PubMed Central

    Roach, Neil Thomas; Lieberman, Daniel E; Gill, Thomas J; Palmer, William E; Gill, Thomas J

    2012-01-01

    Several recent studies have found that throwing athletes typically have lower humeral torsion (retroversion) and a greater range of external rotation at the shoulder than non-athletes. How these two parameters are related is debated. This study uses data from a sample of both throwers and non-throwers to test a new model that predicts torsion values from a range of motion data. The model proposes a series of predicted regressions which can help provide new insight into the factors affecting rotational range of motion at the shoulder. Humeral torsion angles were measured from computed tomography scans collected from 25 male subjects. These values are compared to predicted torsion values for the same subjects calculated from both kinematic and goniometric range-of-motion data. Results show that humeral torsion is negatively correlated (goniometric: r = ?0.409, P = 0.047; kinematic: r = ?0.442, P = 0.035) with external rotational range of motion and positively correlated (goniometric: r = 0.741, P < 0.001; kinematic: r = 0.559, P = 0.006) with internal rotational range of motion. The predicted torsion values are highly correlated (goniometric: r = 0.815, P < 0.001; kinematic: r = 0.617, P = 0.006) with actual torsion values. Deviations in the data away from predicted equations highlight significant differences between high torsion and low torsion individuals that may have significant functional consequences. The method described here may be useful for non-invasively assessing the degree of torsion in studies of the evolution and biomechanics of the shoulder and arm, and for testing hypotheses about the etiology of repetitive stress injuries among athletes and others who throw frequently. PMID:22257273

  16. 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

  17. Radiographic structural findings in the mandibular condyles of young individuals receiving orthodontic treatment.

    PubMed

    Peltola, J S; Nystrm, M; Knnen, M; Wolf, J

    1995-04-01

    Radiographic findings in mandibular condyles were studied from the pre- and post-treatment panoramic radiographs of 625 orthodontic patients. The subjects' mean age was 11 years at the start and 14 years at the end of active orthodontic treatment. Radiographic condylar findings were seen in 14 (2%) subjects before treatment and in 54 subjects (9%) after treatment (p < 0.001). In age-related controls (n = 783) condylar findings were seen in 3% (p < 0.001). The condylar finding was 'flattening only' in half of the patients and in one-third of the controls with condylar findings. Activator treatment was associated with condylar findings (p < 0.05). Condylar findings increased with age in the orthodontically treated subjects (p < 0.05) but not in the unselected population controls. This may mean that condyles become more sensitive with age in children. Increase with age may be partly due to the radiographic interpretation, since minor condylar findings are difficult to observe in young children, and partly due to differences in treatment modalities and the duration of treatment. PMID:7610781

  18. 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

  19. Shape and site dependent in vivo degradation of Mg-Zn pins in rabbit femoral condyle.

    PubMed

    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

  20. 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

  1. 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, totalrange-of-motion, and humeral-retrotorsion difference than softball players and male controls. There were no differences between glenohumeral internal-rotation deficit, totalrange-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

  2. Indications and limitations of the fixator TGF "Gex-Fix" in proximal end humeral fractures.

    PubMed

    Parlato, A; D'Arienzo, A; Ferruzza, M; Galvano, N; D'Arienzo, M

    2014-12-01

    The incidence of fractures of the humerus has increased exponentially in recent years. The most used classifications for humerus fracture are morphological (Neer), biological (AO/ASIF) and descriptive (Hertel). The types of surgical treatment for humerus fracture include prosthetic replacement and synthesis using different devices, including the Tension Guide Fixator (TGF), Gex-Fix. External fixation for displaced proximal humeral fractures avoids dissection and soft tissue stripping and has been reported by some authors to be associated with higher union rates, a lower incidence of avascular necrosis, less scarring of the scapulohumeral interface, and faster rehabilitation compared with open reduction and internal fixation. Other authors have reported that external fixation does not ensure acceptable reduction and fracture stability, particularly in patients with osteoporosis. The external fixation technique involves the introduction of Steinmann's pin to keep manual reduction, the introduction of two K-wires in the humeral head, the removal of the Steinmann's pin, and the introduction of two fiches on the humeral shaft. Hub connectors are mounted on the wires and on the chips to connect the outer bar and tensioning system. A total of 84 patients aged 42-84 years with proximal end humeral fractures (66% had two-part fractures) were treated with Fixator TGF in this study from December 2007 to June 2012. The postoperative recovery was earlier and the active-assisted motion was less painful than has been reported with other surgical techniques. The TGF was removed without anaesthesia at the outpatient clinic at a mean of 7 weeks (range 5-8 weeks) after surgery, and there was no loss of reduction or secondary displacement after removal. These results, after five years of experience, confirm that the best indication for this fixator is two- or three-part fractures because the device enables early active mobilisation. The limitations of this fixator are evident in fractures in which closed reduction is not possible and in three-part fractures with varus displacement because the TGF has less stability than other systems, such as the plate or cage. The short learning curve, reduced surgical time and risk, and low cost encourage the use of this technique. PMID:25457319

  3. Use of a proximal humeral plate for a paediatric peri-prosthetic femoral fracture

    PubMed Central

    Shaw, C.R.; Badhesha, J.; Ayana, G.; Abu-Rajab, R.

    2014-01-01

    In this case an 18-year-old female with cerebral palsy sustained a peri-prosthetic femoral fracture adjacent to a blade plate previously inserted for a femoral varus osteotomy. The injury was treated using a long proximal humeral locking plate. The existing blade plate was removed. The fracture was reduced and held, and a 10-hole PHILOS plate applied with near anatomical reduction. There were no post-operative complications. Radiographic union was confirmed at 11 months. To our knowledge, this is the first reported use of a PHILOS plate in the management of a femoral peri-prosthetic fracture and successfully demonstrated a straightforward method for revision fixation. PMID:24986984

  4. 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 Mara

    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.

  5. 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 ?g/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

  6. Use of a proximal humeral plate for a paediatric peri-prosthetic femoral fracture.

    PubMed

    Shaw, C R; Badhesha, J; Ayana, G; Abu-Rajab, R

    2014-01-01

    In this case an 18-year-old female with cerebral palsy sustained a peri-prosthetic femoral fracture adjacent to a blade plate previously inserted for a femoral varus osteotomy. The injury was treated using a long proximal humeral locking plate. The existing blade plate was removed. The fracture was reduced and held, and a 10-hole PHILOS plate applied with near anatomical reduction. There were no post-operative complications. Radiographic union was confirmed at 11 months. To our knowledge, this is the first reported use of a PHILOS plate in the management of a femoral peri-prosthetic fracture and successfully demonstrated a straightforward method for revision fixation. PMID:24986984

  7. 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

  8. Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study.

    PubMed

    Antic, Svetlana; Vukicevic, Arso M; Milasinovic, Marko; Saveljic, Igor; Jovicic, Gordana; Filipovic, Nenad; Rakocevic, Zoran; Djuric, Marija

    2015-07-01

    The aim of the present study was to investigate the influences of the presence and position of a lower third molar (M3) on the fragility of mandibular angle and condyle, using finite element analysis. From computed tomographic scans of a human mandible with normally erupted M3, two additional virtual models were generated: a mandibular model with partially impacted M3 and a model without M3. Two cases of impact were considered: a frontal and a lateral blow. The results are based on the chromatic analysis of the distributed von Mises and principal stresses, and calculation of their failure indices. In the frontal blow, the angle region showed the highest stress in the case with partially impacted M3, and the condylar region in the case without M3. Compressive stresses were dominant but caused no failure. Tensile stresses were recorded in the retromolar areas, but caused failure only in the case with partially impacted M3. In the lateral blow, the stress concentrated at the point of impact, in the ipsilateral and contralateral angle and condylar regions. The highest stresses were recorded in the case with partially impacted M3. Tensile stresses caused the failure on the ipsilateral side, whereas compressive stresses on the contralateral side. PMID:25939313

  9. Epicondylitis: lateral.

    PubMed

    Brummel, Jared; Baker, Champ L; Hopkins, Rob; Baker, Champ L

    2014-09-01

    Lateral epicondylitis is the most common cause of lateral elbow pain in adults. Although it is typically a self-limiting process, there are many nonsurgical and surgical treatment options available if lateral epicondylitis becomes chronic and continues to cause pain. Its common name, tennis elbow, is somewhat of a misnomer because the condition is often work-related and occurs in athletes and nonathletes alike. Acute onset of symptoms occurs more often in young athletes; chronic, recalcitrant symptoms typically occur in older patients. In this review, we describe the pathogenesis and clinical presentation and the nonsurgical and surgical treatment options currently available. PMID:25077751

  10. 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

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

    PubMed

    Piotrowski, Maciej; Baczkowski, Bogus?aw; Markowicz, Agnieszka; Pankowski, Rafa?; 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

  12. 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

  13. 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

  14. Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle.

    PubMed

    Campos, M I G; Campos, P S F; Cangussu, M C T; Guimares, R C; Line, S R P

    2008-06-01

    The aim of this study was to investigate temporomandibular joint (TMJ) pain and magnetic resonance imaging characteristics in 104 TMJs with and 58 without degenerative changes of the condyle, such as osteophytes, erosion, avascular necrosis, subcondral cyst and intra-articular loose bodies. TMJ images were also assessed for flattening, retropositioning and hypomobility of condyle and disc displacement. Comparison of the TMJ side-related data showed a significant relationship between disc displacement without reduction (DDwoR) and the presence of degenerative bony changes (p=0.00). Flattening, retropositioning and hypomobility of condyle showed no significant difference in relation to the presence or absence of degenerative bony changes. Retropositioning of the condyle was significantly associated to disc displacement with reduction (DDwR) (p=0.00), while condylar hypomobility was significantly more frequent in TMJ with DDwoR (p<0.05). Independent of the presence or type of DD, TMJ pain was more frequent in the presence of degenerative bony changes. When considering only DDwR, TMJ pain was significantly associated to a degenerative condition (p=0.03). When there were no degenerative bony changes, TMJ pain was significantly more frequent in DDwoR (p=0.04). Despite the present findings, the absence of symptoms in some patients with condylar bony changes suggests that the diagnosis of osteoarthritis should be established by evaluation of magnetic resonance images in association with clinical examination. PMID:18440778

  15. 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

  16. 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

  17. 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

  18. 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 43years sustained extensive terminal bone loss near digital tips following osteomyelitis. The mean length of bone defect was 28mm ( 8.4). The patients were reconstructed at a mean of 12weeks 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 6-11weeks. 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

  19. 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.

  20. 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

  1. Lack of Benefit of Physical Therapy on Function Following Supracondylar Humeral Fracture

    PubMed Central

    Schmale, Gregory A.; Mazor, Suzan; Mercer, Laina D.; Bompadre, Viviana

    2014-01-01

    Background: The goal of the study was to evaluate the efficacy of physical therapy in restoring function and mobility after a pediatric supracondylar humeral fracture. Methods: The study included sixty-one patients from five to twelve years of age with a supracondylar humeral fracture that was treated with casting or with closed reduction and pinning followed by casting. Patients were randomized to receive either no further treatment (no-PT group) or six sessions of a standardized hospital-based physical therapy program (PT group). The ASK-p (Activities Scale for Kids-performance version) and self-assessments of activity were used to assess function at one, nine, fifteen, and twenty-seven weeks after injury. Motion was measured at nine and fifteen weeks after injury by a blinded therapist. Anxiety was measured at one and nine weeks after injury with a self-assessment. Differences in ASK-p scores and anxiety level were analyzed with use of multivariate generalized estimating equations. Results: ASK-p scores were significantly better in the no-PT group at nine and fifteen weeks after injury (p = 0.02 and 0.01, respectively) but the difference at twenty-seven weeks was not significant. There were no differences between groups with respect to performance of activities of daily living or time to return to sports. Anxiety at nine weeks was associated with worse ASK-p scores at nine and fifteen weeks in the PT group and with better ASK-p scores in the no-PT group at these time points (p = 0.01 and 0.02, respectively). There were no differences between the groups with respect to elbow motion in the injured arm at any time. Severity of injury had no impact on function or elbow motion in either the PT or the no-PT group. Conclusions: Children undergoing closed treatment of a supracondylar humeral fracture that was limited to approximately three weeks of cast immobilization received no benefit involving either return of function or elbow motion from a short course of physical therapy. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. PMID:24897743

  2. 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

  3. 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.

  4. Shoulder dislocation in skiing: choice of surgical method depending on the degree of humeral retrotorsion.

    PubMed

    Pieper, H G

    1985-06-01

    Shoulder dislocation is one of the typical upper extremity injuries in skiing, first following a violent accident but quite frequently recurring without new trauma. This article discusses the retrotorsional angle of the humerus as an etiological factor in the occurrence of an initial dislocation and as a triggering element for its recurrence. It focuses on the consequences to be drawn for the surgical treatment of recurrent shoulder dislocation. A technique for exact determination of the humeral angle of retrotorsion by X-ray is presented. In patients with recurrent anterior dislocations of the shoulder joint, the retrotorsional angle of the humerus is pathologically reduced as compared to the control group. The method of surgical therapy is determined by the individual deviance from the average value. PMID:4030191

  5. 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; OBrien, 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

  6. 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

  7. Humeral Head Arthroplasty and Meniscal Allograft Resurfacing of the Glenoid: A Concise Follow-up of a Previous Report and Survivorship Analysis.

    PubMed

    Bois, Aaron J; Whitney, Ian J; Somerson, Jeremy S; Wirth, Michael A

    2015-10-01

    The two to five-year results of humeral head arthroplasty and lateral meniscal allograft resurfacing of the glenoid in patients fifty-five years of age or younger were previously reported by the senior author (M.A.W.). The purpose of the present study was to report the survival rate, clinical findings, and radiographic results of the original thirty shoulders (thirty patients) followed for a mean duration of 8.3 years (range, five to twelve years). The scores on the visual analog scale for pain, American Shoulder and Elbow Surgeons scoring system, and Simple Shoulder Test were significantly improved at the latest follow-up evaluation compared with the preoperative findings (p < 0.001). Radiographic indices of posterior subluxation did not significantly increase from the immediate postoperative imaging to the latest radiographs, while the glenohumeral joint space demonstrated a gradual decrease. Nine (30%) of thirty shoulders were known to have undergone a reoperation. The present study demonstrated that biological glenoid resurfacing combined with hemiarthroplasty can provide significant improvement in shoulder function and pain relief in young patients with glenohumeral arthritis; however, mid-term follow-up at a mean of over eight years demonstrated a high reoperation rate. PMID:26446964

  8. 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

  9. 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

  10. 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

  11. [A composite osteomusculocutaneous free flap from the medial femoral condyle: anatomic characteristics, clinical aspects, new applications].

    PubMed

    Rahmanian-Schwarz, A; Spetzler, V; Willkomm, L-M; Eisenschenk, A; Bernhard, H; Schaller, H-E

    2012-04-01

    Advances in plastic and reconstructive surgery allow an almost complete functional and aesthetic reconstruction after severe injuries. However, particularly the treatment of complex defects involving different tissue components is still challenging. The reconstruction requires a combined flap consisting of different tissues from an adequate donor area. In this context, we focused on anatomical and clinical aspects of transplants from the area of the medial femoral condyle. In this study, the anatomical characteristics and potentials of various flaps from the region of this region are described. Moreover, previous literature on this subject is put in context with both the results of our own anatomical study and our clinical experience. The supplying vessel is the descending genicular artery with its branches. In addition to the consistency in vessel length and diameter, the descending genicular artery has a continuous distribution in a periosteal, cutaneous and muscular branch. Due to this anatomical characteristic, this donor site offers the possibility for several customized transplants. Thus, the distal medial thigh is a versatile and reliable donor site for plastic surgical procedures. PMID:22495956

  12. A new automatic landmark extraction framework on ultrasound images of femoral condyles

    NASA Astrophysics Data System (ADS)

    Masson-Sibut, Agns; Nakib, Amir; Petit, Eric; Leitner, Franois

    2012-03-01

    In Computer Assisted Orthopaedic Surgery (CAOS), surgeons have to acquire some anatomical landmarks as inputs to the system. To do so, they use manual pointers that are localized in the Operating Room (OR) space using an infrared camera. When the needed landmark is not reachable through an opening, it is palpated directly on skin and there is a loss of precision that can vary from several millimeters to centimeters depending on the thickness of soft tissues. In this paper, we propose a new framework based on three main steps to register the bone surface and extract automatically anatomical landmarks with an ultrasound probe. This framework is based on an oriented gradient calculation, a simulated-compound and a contour closure using a graph representation. The oriented gradient allows extracting a set of pixels that probably belong to the bone surface. The simulatedcompound step allows using ultrasound images properties to define a set of small segments which may belong to the bone surface, and the graph representation allows eliminating false positive detection among remaining segments. The proposed method has been validated on a database of 230 ultrasound images of anterior femoral condyles (on the knee). The average computation time is 0.11 sec per image, and average errors are: 0.54 mm for the bone surface extraction, 0.31 mm for the condylar line, and 1.4 mm for the trochlea middle.

  13. 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

  14. Mapping the Articular Contact Area of the Long Head of the Biceps Tendon on the Humeral Head

    PubMed Central

    Morris, Brent J.; Byram, Ian R.; Lathrop, Ray A.; Dunn, Warren R.; Kuhn, John E.

    2014-01-01

    The purpose of this investigation was to calculate the contact surface area of the long head of the biceps (LHB) in neutral position and abduction. We sought to determine whether the LHB articulates with the humeral head in a consistent pattern comparing articular contact area in neutral position and abduction. Eleven fresh frozen matched cadaveric shoulders were analyzed. The path of the biceps tendon on the articular surface of the humeral head and the total articular surface were digitized using a MicronTracker 2 H3-60 three-dimensional optical tracker. Contact surface area was significantly less in abduction than in neutral position (P = 0.002) with a median ratio of 41% (36%, 47.5%). Ratios of contact area in neutral position to full articular surface area were consistent between left and right shoulders (rho = 1, P = 0.017) as were ratios of abduction area to full articular surface area (rho = 0.97, P = 0.005). The articular contact surface area is significantly greater in neutral position than abduction. The ratios of articular contact surface areas to total humeral articular surface areas have a narrow range and are consistent between left and right shoulders of the same cadaver. PMID:25210631

  15. 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.

  16. 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.

  17. 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

  18. Biomechanical comparison of different pin configurations during percutaneous pinning for the treatment of proximal humeral fractures.

    PubMed

    Jiang, Chunyan; Zhu, Yiming; Wang, Manyi; Rong, Guowei

    2007-01-01

    We investigate the influence on fracture stability of different pin configurations during percutaneous pinning for the treatment of proximal humeral fractures. We performed a matched-paired study of 18 pairs of adult fresh-frozen humeri (36 humeri), which were divided into 4 groups. A 2-part surgical neck fracture model was used in all humeri, and 4 terminal threaded pins (2.5 mm in diameter) were used for fixation. Parallel-type pinning (box type) was carried out in 2 groups, and convergent-type pinning (fan-shaped type) was used in the other 2 groups. For each specimen, both anti-shear ultimate load and anti-torsion ultimate load were measured. There was no statistical difference between the parallel pin construct and convergent construct with regard to anti-shear resistance (P = .73). However, the parallel pin construct had a significant advantage over the convergent construct regarding anti-torsion resistance. The parallel pin construct has better torsional stability when 1 cm is used for the pin-to-pin distance. We suggest that parallel pin fixation should be applied whenever possible. PMID:17275352

  19. A Pitfall in Fixation of Distal Humeral Fractures with Pre-Contoured Locking Compression Plate

    PubMed Central

    Jayakumar, Prakash; Ring, David

    2015-01-01

    Anatomically precontoured locking plates are intended to facilitate the fixation of articular fractures and particularly those associated with osteoporosis. Fractures of the distal humerus are relatively uncommon injuries where operative intervention can be exceptionally challenging. The distal humeral trochlea provides a very narrow anatomical window through which to pass a fixed-angle locking screw, which must also avoid the olecranon, coronoid, and radial fossae. We describe 3 patients (ages 27, 49, and 73 years) with a bicolumnar fracture of the distal humerus where very short distal locking screws were used. Intra-articular screw placement was avoided but loss of fixation occurred in two patients and a third was treated with a prolonged period of immobilization. We postulate that fixed-angle screw trajectories may make it difficult for the surgeon to place screws of adequate length in this anatomically confined region, and may lead to insufficient distal fixation. Surgical tactics should include placement of as many screws as possible into the distal fragment, as long as possible and that each screw passes through a plate without necessarily locking in. PMID:26110181

  20. A biomechanical comparison of Schuhli nuts or cement augmented screws for plating of humeral fractures.

    PubMed

    Jazrawi, L M; Bai, B; Simon, J A; Kummer, F J; Birdzell, L T; Koval, K J

    2000-08-01

    Schuhli locking nuts can be used in poor quality cortical bone to enhance fixation stability as an alternative to cement augmented screws. This study compared the fixation strength and stability of plate constructs using Schuhli locking nuts with standard screws and cement augmented screws for fixation of simulated humeral shaft fractures in a test model with osteoporosis. The constructs were tested in axial compression, 4-point bending, and torsion to determine fixation stability. The humeri were cycled in torsion (4.5 Nm) for 1000 cycles to simulate upper extremity use during the early postoperative period and retested for stability. The Schuhli locking nuts and cement augmented screws had significantly greater fixation stability than the standard screws before (range, 6-14 times greater) and after cycling in torsional loading (range, 3-3.6 times greater). Although cement augmented screws and Schuhli augmentation showed increased fixation stability compared with the standard screws in axial and 4-point bending before cycling (range, 1.3-1.4 times greater), this was not significant. Compared with Schuhli fixation, cement augmented screws showed no significant difference in fixation stability in all loading modes before and after cycling. Schuhli locking nuts offer the stability of cement augmentation while avoiding its potential adverse effects on fracture healing with extravasation and thermal necrosis. PMID:10943207

  1. Humeral shaft fracture sustained during arm wrestling: report on 30 cases and review of the literature.

    PubMed

    Ogawa, K; Ui, M

    1997-02-01

    Thirty cases of humeral shaft fracture sustained during arm wrestling were analyzed. Twenty eight were men and two were women. Eighteen were fractures of the right arm and 12 were of the left. The patients ranged in age from 15 to 60 years old, averaging 30 years. Although there was no prominent tendency for the injuries to occur at a certain phase of the match, they happened in all cases while full force was being exerted in an effort to win or to change the tide of the contest. All cases were spiral fractures, of which 23% presented with a medial butterfly fragment, and also 23% of which had radial nerve palsy. We infer that, through a shift in body weight and subsequent counterattack from the opponent, the shoulder internal rotator muscles suddenly changed from their maximum concentric contraction to eccentric contraction, resulting in development of an intense rotational force leading to the subsequent fracture. Therefore, this type of fracture may occur in anyone of any age engaging in this type of sport. PMID:9042875

  2. Biomechanical testing of rectangular humeral shaft prosthesis: higher torsional stability without increased fracture risk

    PubMed Central

    Schmoelz, Werner; Schreiber, Ulrich; Goldhahn, Joerg

    2010-01-01

    Background Rectangular cementless femur shaft prostheses have a higher primary stability than round shafts. A novel rectangular humeral shaft design was tested with two questions: does the rectangular design cause a higher fracture risk during implantation than round designs, and does it increase the torsional stiffness? Materials and methods Two series with six paired human humeri (total 24) were tested on one side with the rectangular shaft and on the contralateral side with a round shaft. In the first series, the shaft implantation was carried out with a constant speed of 100mm/min and the maximum force was measured when the fracture occurred. In the second series, the implants were preloaded with 50N and then rotated at 2 per second with monitoring of the torsional torque. Results The maximum force at fracture showed no significant difference for the two designs (p=0.34). Higher age and low bone density reduced the force required for fracture. The rectangular shaft showed significant higher torsional moments (p<0.05). Conclusions In biomechanical testing, the rectangular shaft had a significantly higher primary torsional stability than the round shaft without a higher risk of fracture during cementless implantation. Fracture risk and torsional stability are influenced by age and bone density. PMID:20857127

  3. Treatment of distal humeral fractures using conventional implants. Biomechanical evaluation of a new implant configuration

    PubMed Central

    2010-01-01

    Background In the face of costly fixation hardware with varying performance for treatment of distal humeral fractures, a novel technique (U-Frame) is proposed using conventional implants in a 180 plate arrangement. In this in-vitro study the biomechanical stability of this method was compared with the established technique which utilizes angular stable locking compression plates (LCP) in a 90 configuration. Methods An unstable distal 3-part fracture (AO 13-C2.3) was created in eight pairs of human cadaveric humeri. All bone pairs were operated with either the "Frame" technique, where two parallel plates are distally interconnected, or with the LCP technique. The specimens were cyclically loaded in simulated flexion and extension of the arm until failure of the construct occurred. Motion of all fragments was tracked by means of optical motion capturing. Construct stiffness and cycles to failure were identified for all specimens. Results Compared to the LCP constructs, the "Frame" technique revealed significant higher construct stiffness in extension of the arm (P = 0.01). The stiffness in flexion was not significantly different (P = 0.16). Number of cycles to failure was found significantly larger for the "Frame" technique (P = 0.01). Conclusions In an in-vitro context the proposed method offers enhanced biomechanical stability and at the same time significantly reduces implant costs. PMID:20684752

  4. Short-term effect of zoledronic acid upon fracture resistance of the mandibular condyle and femoral head in an animal model

    PubMed Central

    Lpez-Jornet, Pa; Vicente-Hernndez, Ascensin

    2013-01-01

    Objective: The aim of this study was to compare the effects in terms of resistance to fracture of the mandibular condyle and femoral head following different doses of zoledronic acid in an animal model. Study design: A total of 80 adult male Sprague-Dawley rats were included in a prospective randomized study. The animals were randomly divided into four groups of 20 rats each. Group 1 (control) received sterile saline solution, while groups 2, 3 and 4 received a accumulated dose of 0.2 mg, 0.4 mg and 0.6 mg of zoledronic acid, respectively. The animals were sacrificed 28 days after the last dose, and the right hemimandible and the right femur were removed. The fracture strength was measured (in Newtons) with a universal test machine using a 1 kN load connected to a metal rod with one end angled at 30 degrees. The cross-head speed was 1 mm/min. Later, the specimens were observed under a scanning electron microscope with backscattered electron imaging (SEM-BSE). At last, chemical analysis and elemental mapping of the mineral bone composition were generated using a microanalytical system based on energy-dispersive and X-ray spectrometry (EDX). Results: A total of 160 fracture tests were performed. The fracture resistance increased in mandible and femur with a higher accumulated dose of zoledronic acid. Statistically significant differences were recorded versus the controls with all the studies groups. The chemical analysis in mandible showed a significantly increased of calcium and phosphorous to compare the control with all of the study groups; however, in femur no statistically significant differences between the four study groups were observed. Conclusions: The administration of bisphosphonates increases the fracture resistance in mandible and femur. Key words:Zoledronic acid, bisphosphonates, animal experimentation, fracture test. PMID:23524420

  5. Reconstruction of ramus-condyle unit with transport distraction osteogenesis: Report of eight cases and review of literature

    PubMed Central

    Mehrotra, Divya; Chellappa, Arul A.L.; Gupta, Chandan; Passi, Deepak; Kumar, Sumit

    2012-01-01

    Background/Aims This report and review of literature aimed to assess the feasibility of condylar distraction in humans and its esthetic and functional outcome. Methods We present a case series of eight TMJ ankylosis patients, where after a gap arthroplasty, ramus condyle unit was reconstructed using transport distraction to analyze its feasibility, esthetic and functional outcome and success. Results All patients had satisfactory mouth opening, and minimal pain in their follow-up period. Conclusion Condylar transport distraction osteogenesis holds promise for successful TMJ reconstruction and should be the method of choice as it does not involve secondary surgery or need for an alloplast. PMID:25737856

  6. 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

  7. 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

  8. Arthroscopic Repair of a Posterior Bony Humeral Avulsion of the Glenohumeral Ligament With Associated Teres Minor Avulsion

    PubMed Central

    Smith, Patrick A.; Nuelle, Clayton W.; Bradley, James P.

    2014-01-01

    Humeral avulsion of the inferior glenohumeral ligament (HAGL) has recently gained more recognition as a cause of shoulder instability. Posterior HAGL lesions, being much more infrequent than anterior disruptions, have only recently been documented as a notable cause of posterior instability. We detail the treatment of a previously unreported case of a posterior HAGL variant lesion consisting of a bony avulsion with involvement of the teres minor tendon. Arthroscopic fixation was facilitated by use of a sheathless arthroscopic approach with a 70 arthroscope and suture anchor. PMID:24749048

  9. 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

  10. The reconstruction of large laryngeal defect with medial condyle femur corticoperiosteal free flap-a case report.

    PubMed

    Banaszewski, Jacek; Gaggl, Alexander; Buerger, Heinz; Wierzbicka, Malgorzata; Pabiszczak, Maciej; Pastusiak, Tomasz; Szyfter, Witold

    2016-02-01

    The larynx is a complicated organ with very important functions. Reconstructive operations of the larynx often result in some function reduction caused by scars and stenoses. The aim of this report is to present the results of the one-stage reconstructive operation after a large excision of the chondrosarcoma of the larynx. The patient was male, aged 48 with the history of the operation of the highly mature cartilaginous sarcoma of the thyroid on the right side with tumor recurrence. The one-stage reconstructive surgery using medial condyle femur corticoperiosteal free flap which reshaped the cartilage scaffold and restored an inner layer as the mucosa was made. The flap survived without local and systemic complications. Six months follow-up revealed no local recurrence and good breathing results. There was no restriction of movement of the lower limbs. The patient returned to work previously performed. Results were shown in endoscopic examinations and computer tomography. The medial condyle femur corticoperiosteal free flap may be an option for reconstruction of large laryngeal defect with restoring its shape and inner layers. 2015 Wiley Periodicals, Inc. Microsurgery 36:157-160, 2016. PMID:26456549

  11. Finite element analysis of the temporomandibular joint during lateral excursions of the mandible.

    PubMed

    Prez Del Palomar, A; Doblar, M

    2006-01-01

    One of the most significant characteristics of the temporomandibular joint (TMJ) is that it is in fact composed of two joints. Several finite element simulations of the TMJ have been developed but none of them analysed the different responses of its two sides during nonsymmetrical movement. In this paper, a lateral excursion of the mandible was introduced and the biomechanical behaviour of both sides was studied. A three-dimensional finite element model of the joint comprising the bone components, both articular discs, and the temporomandibular ligaments was used. A fibre-reinforced porohyperelastic model was introduced to simulate the behaviour of the articular discs, taking into account the orientation of the fibres in each zone of these cartilage components. The mandible movement during its lateral excursion was introduced as the loading condition in the analysis. As a consequence of the movement asymmetry, the discs were subjected to different load distributions. It was observed that the maximal shear stresses were located in the lateral zone of both discs and that the lateral attachment of the ipsilateral condyle-disc complex suffered a large distortion, due to the compression of this disc against the inferior surface of the temporal bone. These results may be related with possible consequences of a common disorder called bruxism. Although it would be necessary to perform an exhaustive analysis of this disorder, including the contact forces between the teeth during grinding, it could be suggested that a continuous lateral movement of the jaw may lead to perforations of both discs in their lateral part and may damage the lateral attachments of the disc to the condyle. PMID:16125714

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

    PubMed

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

    2015-04-01

    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

  13. 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

  14. Using conservative condylectomy for management of a large osteochondroma of the mandibular condyle with 6-year follow-up.

    PubMed

    Santos, George Soares; Gomes, Julio Bisinotto; de Sousa Maia, Sergio; Bermejo, Patricia Rota; Shinohara, Elio Hitoshi; Sonoda, Celso Koogi; de Melo, Willian Morais

    2014-01-01

    Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure. PMID:24469370

  15. Focal anatomic resurfacing implantation for bilateral humeral and femoral heads avascular necrosis in a patient with Hodgkins 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 Hodgkins 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 Hodgkins 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

  16. Primary Lateral Sclerosis

    MedlinePLUS

    ... Awards Enhancing Diversity Find People About NINDS NINDS Primary Lateral Sclerosis Information Page Table of Contents (click ... is being done? Clinical Trials Organizations What is Primary Lateral Sclerosis? Primary lateral sclerosis (PLS) is a ...

  17. 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

  18. The management of complex periprosthetic humeral fractures: a case series of strut allograft augmentation, and a review of the literature.

    PubMed

    Trompeter, Alex J; Gupta, Rohit R

    2013-04-01

    There is little published discussion on the management of postoperative periprosthetic humeral fractures where rotator cuff function is poor, the bone stock is dwindling or both. This is a phenomenon increasingly seen in the older, more osteoporotic population and presents an interesting challenge especially in when faced with these patients with poor bone quality. We present the treatment of three fractures with the use of long-stem reverse geometry arthroplasty and other surgical techniques more commonly reserved for periprosthetic fractures of the proximal femur such as cortical strut allograft augmentation. We believe revision to reverse geometry long-stem implant with cortical strut allograft augmentation to be safe and appropriate in the management of these complex injuries, although technically challenging, and has excellent initial and medium-term results. PMID:23457000

  19. 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.

  20. 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

  1. Humeral cross-sectional morphology from 18th century Quebec prisoners of war: Limits to activity reconstruction.

    PubMed

    Weiss, Elizabeth

    2005-03-01

    This study uses measures of cross-sectional robusticity and asymmetry (based on humeral areal and inertial cross-sectional components) to test a prediction from bone remodeling theory that a physically active 18th century Quebec prisoner of war sample (N = 25) should have more robust and asymmetrical humeri than a nonphysically active 20th century New Mexico suburbanite sample (N = 27). Narrative accounts document that prisoners of war engaged in labor-intensive activities, and these activities were confirmed by observations of osteoarthritis and other pathologies. The suburbanite sample, for the most part, did not engage in such activities. The prisoners had higher levels of pathology than the suburbanites (e.g., 80% vs. 22% osteoarthritis; F = 17.95, P < 0.01). For robusticity, the populations did not differ significantly in total area, cortical area, moment areas of inertia about the mediolateral plane, or polar moment area of inertia. The Quebec prison sample did have significantly higher values for moment areas of inertia about the anteroposterior plane. For asymmetry, the populations did not differ in any values (total area, cortical area, moment areas of inertia about the mediolateral plane, moment areas of inertia about the anteroposterior plane, or polar moment of inertia). Thus, examinations of cross-sectional robusticity and asymmetry failed to conclusively confirm the hypothesis that intensive labor leads to changes in humeral morphology. Possible explanations for the lack of differences are discussed, such as poor diet impeding bone remodeling. Nevertheless, the one significant finding suggests that cross-sectional shape is more useful in reconstructing activity patterns than amount of bone in a cross section. Results from this study join those from other recent investigations to suggest that additional controls are required before cross-sectional differences may be confidently attributed to activity patterns. PMID:15386299

  2. 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

  3. 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

  4. 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

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

    PubMed

    Wiktor, ?ukasz; 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

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

    PubMed Central

    Wiktor, ?ukasz; 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

  7. Comparison of the condyle-fossa relationship between skeletal class III malocclusion patients with and without asymmetry: a retrospective three-dimensional cone-beam computed tomograpy study

    PubMed Central

    Kim, Hyoun Oak; Lee, Won; Kook, Yoon-Ah

    2013-01-01

    Objective This study investigated whether temporomandibular joint (TMJ) condyle-fossa relationships are bilaterally symmetric in class III malocclusion patients with and without asymmetry and compared to those with normal occlusion. The hypothesis was a difference in condyle-fossa relationships exists in asymmetric patients. Methods Group 1 comprised 40 Korean normal occlusion subjects. Groups 2 and 3 comprised patients diagnosed with skeletal class III malocclusion, who were grouped according to the presence of mandibular asymmetry: Group 2 included symmetric mandibles, while group 3 included asymmetric mandibles. Pretreatment three-dimensional cone-beam computed tomography (3D CBCT) images were obtained. Right- and left-sided TMJ spaces in groups 1 and 2 or deviated and non-deviated sides in group 3 were evaluated, and the axial condylar angle was compared. Results The TMJ spaces demonstrated no significant bilateral differences in any group. Only group 3 had slightly narrower superior spaces (p < 0.001). The axial condylar angles between group 1 and 2 were not significant. However, group 3 showed a statistically significant bilateral difference (p < 0.001); toward the deviated side, the axial condylar angle was steeper. Conclusions Even in the asymmetric group, the TMJ spaces were similar between deviated and non-deviated sides, indicating a bilateral condyle-fossa relationship in patients with asymmetry that may be as symmetrical as that in patients with symmetry. However, the axial condylar angle had bilateral differences only in asymmetric groups. The mean TMJ space value and the bilateral difference may be used for evaluating condyle-fossa relationships with CBCT. PMID:24228235

  8. Application of oriented poly-L-lactide screws for experimental Salter-Harris type 4 fracture in distal femoral condyle of the dog.

    PubMed

    Hara, Y; Tagawa, M; Ejima, H; Orima, H; Fujita, M; Yamagami, T; Umeda, M; Sugiyama, M; Shikinami, Y; Ikada, Y

    1994-10-01

    The clinical usefulness of biodegradable oriented poly-L-lactide (PLLA) screws for experimental Salter-Harris type 4 fracture in the distal femoral condyle of dogs was evaluated. Bony union of the osteotomized fragment of the condyle was almost completed radiographically and histologically within 1 to 2 months after surgery, suggesting that PLLA screws maintained strength long enough to fix the fragment until bone healing. At 4 to 6 months after surgery, minute fissures were histologically confirmed on the surface of the screw thread, suggesting the early stage of biodegradation and absorption of the polymer. During the observational period, no significant difference between the treated femur and the contralateral non-treated femur in either total femoral length or maximum condyle width was observed, indicating no growth disturbance in the treated femur. From these results it was concluded that the PLLA screw might be an ideal implant for the reduction and fixation of epiphyseal plate fractures such as Salter-Harris type 3 or type 4 fractures. PMID:7865578

  9. 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

  10. Amyotrophic lateral sclerosis

    MedlinePLUS

    Amyotrophic lateral sclerosis, or ALS, is a disease of the nerve cells in the brain and spinal cord that ... PA: Elsevier Elsevier; 2012:chap 74. Shaw PJ. Amyotrophic lateral sclerosis and other motor neuron diseases. In: Goldman L, ...

  11. Tennis Elbow (Lateral Epicondylitis)

    MedlinePLUS

    .org Tennis Elbow (Lateral Epicondylitis) Page ( 1 ) Tennis elbow, or lateral epicondyliti s, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can ...

  12. 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: 19.372.21 years, height: 181.005.41 cm, weight: 84.587.85 kg; BBP group: n=20 players with careers spanning <10 years, age: 16.551.36 years, height: 177.277.57 cm, weight: 77.278.14 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

  13. 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

  14. Lateral Neck Injury Assessments in Side Impact Using Post Mortem Human Subject Tests

    PubMed Central

    Yoganandan, Narayan; Humm, John; Pintar, Frank A.; Wolfla, Christopher E.; Maiman, Dennis J.

    2011-01-01

    Current neck injury criteria are based on matching upper cervical spine injuries from piglet tests to airbag deployment loads and pairing kinematics from child dummies. These child-based scaled data together with adult human cadaver tolerances in axial loading are used to specify neck injury thresholds in axial compression and tension, and flexion and extension moment about the occipital condyles; no thresholds are specified for any other force or moment including lateral bending. The objective of this study was to develop a testing methodology and to determine the lateral bending moment injury threshold under coronal loading. Post mortem human subjects (PMHS) were used. Specimens consisted of whole body and isolated head-neck complexes with intact musculature. Intact specimen positioning included: sitting PMHS upright on a rigid seat, supporting the torso by a plate, maintaining Frankfurt plane horizontal. Isolated head-neck complexes were fixed at T1 with the occiput connected via a custom apparatus to a testing device to induce lateral bending motion. Head angular and linear accelerations and angular velocities were computed using a pyramid nine accelerometer package on the head; specimen-specific physical properties including center of gravity and moments of inertia in the three-dimensions; and equations of equilibrium. These data were used to determine neck loads at the occipital condyles. No specimens sustained injuries, identified by palpation, x-rays, CT, and autopsy. Results from 24 tests indicated that PMHS head-neck complexes can tolerate 75 Nm of coronal moment at low axial load without failure, and this level may be used as an initial estimate of the injury reference value under lateral loading to the human head-neck complex. PMID:22105394

  15. 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.

  16. [Fracture of the radial condyle of the humerus in the growth period].

    PubMed

    von Laer, L R

    1998-04-01

    In an overview the clinical and academic problems of this kind of fractures are described and their treatment is discussed. The most important problem is the pseudarthrosis that can happen in the framework of a conservative treatment of displaced fractures, rarely after operative treatment with K-wires. A rather academic problem is the obligatory growth disturbance of a partial stimulation of the lateral part of the growth plate. This leads to radial overgrowth and thus to a more or less distinct varus deformity. The extent of varus deformity is dependent on the time till consolidation, which is longest in conservatively treated fractures and shortest in those treated with compression screw osteosynthesis. An additional academic problem is the so-called fishtail deformity that becomes radiological visible at the end of growth. This deformity has no clinical significance. Pseudarthrosis, varus and fishtail deformity are a result of increasing instability of primarily or secondarily displaced fractures. All three problems can be avoided by metaphyseal compression osteosynthesis with an AO small-fragment screw with an additional axial K wire in the trochlea. Our own long-term results are shown and compared with the results of other procedures in the literature. PMID:9613212

  17. 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

  18. 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.

  19. CEREBRAL LATERALITY IN SCHIZOPHRENIA

    PubMed Central

    Gaur, R.K.; Bhat, V.K.

    1985-01-01

    SUMMARY Electro-enccphalographic (E.E.G.) pattern of 35 drug free schizophrenic patients was studied. 15 cases (42.86%) had abnormal EEG records, 9 records out of 15 abnormal records showed effect of laterality. Laterality of abnormality to left hemisphers was present in 7 cases while laterality to right hemisphere was present only in 2 cases. Cortical locations of abnormalities were also studied. The most common cortical area found to be involved was temporal lobe. PMID:21927070

  20. Laterality and reading attainment.

    PubMed

    Richardson, J T; Firlej, M D

    1979-12-01

    This investigation was concerned with measures of laterality and their usefulness as predictors of reading attainment. Previous research has suggested that retarded reading is the result of abnormal development of cerebral dominance, and that this may be indicated by left-handedness or by inconsistencies in lateral preference. A group of schoolboys carried out tests of lateral preference, reading, spelling, and experimental tasks involving dichotic listening and tachistoscopic recognition. There was no evidence that left-handedness, right cerebral dominance, or inconsistencies in laterality were correlated with reading retardation. PMID:548222

  1. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

    PubMed Central

    2011-01-01

    Purpose The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Materials and Methods Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Results Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Conclusion Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture. PMID:21977475

  2. 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

  3. 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

  4. Lateral superlattice solar cells

    SciTech Connect

    Mascarenhas, A.; Zhang, Y.; Millunchick, J.M.; Twesten, R.D.; Jones, E.D.

    1997-10-01

    A novel structure which comprises of a lateral superlattice as the active layer of a solar cell is proposed. If the alternating regions A and B of a lateral superlattice ABABAB... are chosen to have a Type-II band offset, it is shown that the performance of the active absorbing region of the solar cell is optimized. In essence, the Type-II lateral superlattice region can satisfy the material requirements for an ideal solar cells active absorbing region, i.e. simultaneously having a very high transition probability for photogeneration and a very long minority carrier recombination lifetime.

  5. 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 ...

  6. 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.

  7. Treating lateral epicondylitis.

    PubMed

    Sevier, T L; Wilson, J K

    1999-11-01

    Lateral epicondylitis is a common problem among physically active individuals. One of the most important roles of the clinician is to provide the most effective rehabilitation intervention for the injured athlete and the physically active individual. Over 40 different treatment methods for lateral epicondylitis have been reported in the literature. Initially, lateral epicondylitis can be treated with rest, ice, tennis brace and/or injections. Injections are one of the most popular methods utilised, with a high success rate. However, when the condition is chronic or not responding to initial treatment, physical therapy is initiated. Common rehabilitation modalities utilised are ultrasound, phonophoresis, electrical stimulation, manipulation, soft tissue mobilisation, neural tension, friction massage, augmented soft tissue mobilisation (ASTM) and stretching and strengthening exercise. ASTM is becoming a more popular modality due to the detection of changes in the soft tissue texture as the patient progresses through the rehabilitation process. Other new modalities include laser and acupuncture. As a last resort for chronic or resistant cases, lateral epicondylitis may undergo surgery. Scientific research has found that all these methods have been inconsistently effective in treating lateral epicondylitis. Therefore, further research efforts are needed to determine which method is more effective. PMID:10593647

  8. Bilateral lateral periodontal cyst.

    PubMed

    Govil, Somya; Gupta, Vishesh; Misra, Neeta; Misra, Pradyumna

    2013-01-01

    The bilateral lateral periodontal cyst is a rare nasological entity, which despite clinical and radiological presentation is being diagnosed by histological characteristics. It is asymptomatic in nature and is observed in routine radiography. The aim and objective of this article is to present a rare case of bilateral lateral periodontal cyst in a 14-year-old child. The clinical and radiographical findings, along with its management have been discussed. Enucleation of bilateral cyst without extraction of the adjacent tooth was performed. Lesion samples were sent for histopathological analysis. The histopathological analysis revealed a thin, non keratinised stratified squamous epithelium resembling reduced enamel epithelium. Epithelial plaques were also seen. A clinicopathological correlation incorporating the surgical, radiographical and gold standard histopathological findings was obtained to suggest the final diagnosis of the bilateral lateral periodontal cyst. PMID:23667246

  9. 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.

  10. 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…

  11. 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

  12. Components in Hemispheric Lateralization.

    ERIC Educational Resources Information Center

    Lynes, Sharon C. S. L.; And Others

    The fact that there is an imperfect correlation between the asymmetrical function of the two halves of the brain and handedness has been a source of puzzlement for many investigators. Many theories have been proposed to explain handedness and why handedness does not correlate perfectly with other measures of lateralization. To assess the

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. The lateral line microcosmos.

    PubMed

    Ghysen, Alain; Dambly-Chaudire, Christine

    2007-09-01

    The lateral-line system is a simple sensory system comprising a number of discrete sense organs, the neuromasts, distributed over the body of fish and amphibians in species-specific patterns. Its development involves fundamental biological processes such as long-range cell migration, planar cell polarity, regeneration, and post-embryonic remodeling. These aspects have been extensively studied in amphibians by experimental embryologists, but it is only recently that the genetic bases of this development have been explored in zebrafish. This review discusses progress made over the past few years in this field. PMID:17785522

  19. 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

  20. 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 2min without intervention. Chest compressions were initiated and continued for 2min. Epinephrine was administered and serial blood samples collected for pharmacokinetic analysis over 4min. Defibrillation and epinephrine administration proceeded according to ACLS guidelines continuing for 20min 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 30s, 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 30s 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

  1. 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

  2. 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

  3. 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

  4. 7. UPPER INSIDE CHORD, VERTICAL, LATERAL STRUT, UPPER LATERAL & ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. UPPER INSIDE CHORD, VERTICAL, LATERAL STRUT, UPPER LATERAL & GUSSET PLATE, TWO DIAGONAL BRACES - Enterprise Parker Truss Bridge, Spanning Smoky Hill River on K-43 Highway, Enterprise, Dickinson County, KS

  5. 8. UPPER INSIDE CHORD, VERTICAL, LATERAL STRUT, UPPER LATERAL & ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. UPPER INSIDE CHORD, VERTICAL, LATERAL STRUT, UPPER LATERAL & GUSSET PLATE, ONE DIAGONAL BRACE - Enterprise Parker Truss Bridge, Spanning Smoky Hill River on K-43 Highway, Enterprise, Dickinson County, KS

  6. 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

  7. Lateral conduction infrared photodetector

    DOEpatents

    Kim, Jin K. (Albuquerque, NM); Carroll, Malcolm S. (Albuquerque, NM)

    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.

  8. "Lazy" far-lateral approach to the anterior foramen magnum and lower clivus.

    PubMed

    Moscovici, Samuel; Umansky, Felix; Spektor, Sergey

    2015-04-01

    The far-lateral approach (FLA) has become a mainstay for skull base surgeries involving the anterior foramen magnum and lower clivus. The authors present a surgical technique using the FLA for the management of lesions of the anterior/ anterolateral foramen magnum and lower clivus. The authors consider this modification a "lazy" FLA. The vertebral artery (VA) is both a critical anatomical structure and a barrier that limits access to this region. The most important nuance of this FLA technique is the management of this critical vessel. When the lazy FLA is used, the VA is reflected laterally, encased in its periosteal sheath and wrapped in the dura, greatly minimizing the risk for vertebral injury while preserving a wide working space. To accomplish this step, drilling is performed lateral to the point where the VA pierces the dura. The dura is incised medial to the VA entry point by using a slightly curved longitudinal cut. Drilling of the condyle and the C-1 lateral mass is performed in a manner that preserves craniocervical stability. The lazy FLA is a true FLA that is based on manipulation of the VA and lateral bone removal to obtain excellent exposure ventral to the spinal cord and medulla, yet it is among the most conservative FLA techniques for management of the VA and provides a safer window for bone work and lesion management. Among 44 patients for whom this technique was used to resect 42 neoplasms and clip 2 posterior inferior cerebral artery aneurysms, there was no surgical mortality and no injury to the VA. PMID:25828490

  9. Lateral Thinking and Technology Education.

    ERIC Educational Resources Information Center

    Waks, Shlomo

    1997-01-01

    Presents an analysis of technology education and its relevance to lateral thinking. Discusses prospects for utilizing technology education as a platform and a contextual domain for nurturing lateral thinking. Argues that technology education is an appropriate environment for developing complementary incorporation of vertical and lateral thinking.

  10. Laterally oscillating nitinol engine

    SciTech Connect

    Banks, R.

    1987-09-08

    This patent describes a laterally oscillating nitinol engine comprising: a first L-shaped drive member journalled for pivoting horizontal oscillation about the juncture of the legs of the L-shaped member, a second drive member journalled for pivoting about a point proximate the outboard end of the shorter leg of the L-shaped member at a distance from the pivot journal of the L-shaped member, a bearing block secured to the end of longer leg of the L-shaped and having a guide hole. The second member extending through the guide hole and arranged to reciprocate therein, a shape memory alloy power element disposed in flexure secured at its ends to the bearing block and to the second member intermediate the sliding connection with the bearing block and the pivotal connection of the second member, means for disposing different temperature baths below the element whereby as the drive members oscillate about their journals the element alternately dips into one bath and then the other, and means for absorbing a portion of the energy developed by the engine and moving the power element from the cold bath to the hot bath.

  11. 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

  12. Custom-made lateral femoral hemiarthroplasty for traumatic bone loss: A case report.

    PubMed

    Stuyts, Bart; Peersman, Geert; Thienpont, Emmanuel; Van den Eeden, Elke; Van der Bracht, Hans

    2015-10-01

    We report the case of a 32-year-old male patient involved in a road traffic accident in which he sustained a grade II open supra- and intercondylar fracture of the left distal femur with substantial bone loss of the lateral femoral condyle and trochlea (AO classification type 33 C3). Normal knee function was no longer possible, as the patella was trapped within the bony defect. Existing reconstructive options such as unicondylar osteoarticular allograft, arthrodesis, and arthroplasty were considered. However, as all these techniques present significant disadvantages, particularly in young and active patients, a custom-made lateral hemiarthroplasty was designed and implanted as an alternative treatment. Follow-up at 24 months revealed an excellent, pain-free level of function and radiographs showed no signs of implant loosening or migration. This technique offers the most anatomical means of reconstruction with maximal preservation of the bone stock, thereby better facilitating any revisions that may be necessary in the future. This is an experimental technique reserved for rare indications, and currently has no long-term follow-up results associated with its use. Additional research is therefore needed before widespread adoption of this technique can take place. PMID:26183418

  13. 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?

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. Lateral Transorbital Neuroendoscopic Approach to the Lateral Cavernous Sinus

    PubMed Central

    Bly, Randall A.; Ramakrishna, Rohan; Ferreira, Manuel; Moe, Kris S.

    2013-01-01

    Objective?To design and assess the quality of a novel lateral retrocanthal endoscopic approach to the lateral cavernous sinus. Design?Computer modeling software was used to optimize the geometry of the surgical pathway, which was confirmed on cadaver specimens. We calculated trajectories and surgically accessible areas to the middle fossa while applying a constraint on the amount of soft tissue retraction. Setting?Virtual computer model to simulate the surgical approach and cadaver laboratory. Participants?The authors. Main Outcome Measures?Adequate surgical access to the lateral cavernous sinus and adjacent regions as determined by operations on the cadaver specimens. Additionally, geometric limitations were imposed as determined by the model so that retraction on soft tissue structures was maintained at a clinically safe distance. Results?Our calculations revealed adequate access to the lateral cavernous sinus, Meckel cave, orbital apex, and middle fossa floor. Cadaveric testing revealed sufficient access to these areas using <10?mm of orbital retraction. Conclusions?Our study validates not only the use of computer simulation to plan operative approaches but the feasibility of the lateral retrocanthal approach to the lateral cavernous sinus. PMID:24498584

  20. Dome osteotomy using the paratricipital (triceps-sparing) approach for cubitus varus deformity in children: a surgical technique to avoid lateral condylar prominence.

    PubMed

    Ali, Ayman M; Abouelnas, Bassam A; Elgohary, Hatem S A

    2016-01-01

    Twenty patients (11 males and nine females) with cubitus varus deformity were treated with corrective dome osteotomy through the paratricipital approach. Patients presented after an average 3 years of appearance of the deformity. The average age of the patients was 8.5 years (range 6-14 years). All patients had a previous history of supracondylar fracture. Preoperatively, carrying angle, lateral condylar prominent index, and range of motion were recorded. There were no intraoperative complications. Postoperatively, three patients developed a superficial skin infection. No patient had unsightly scarring or a prominent lateral condyle. No patient reported pain, motor weakness, or atrophy of the arm musculature. There was no fixation failure or loss of correction during the healing stage and no revision surgery was needed. The results were graded according to the preoperative and postoperative carrying angle, movement of flexion and extension, and lateral condylar prominence index and they were evaluated statistically. Preoperative and postoperative extension, carrying angle, and lateral condylar prominence index were statistically significant. Corrective dome osteotomy using the paratricipital approach seems to be a reliable technique for correction of cubitus varus in children. The procedure is relatively simple and enables correction of the deformity without inducing lateral condylar prominence. PMID:26340368

  1. 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

  2. Lateral pterygoid muscle: a three-dimensional analysis of neuromuscular partitioning.

    PubMed

    Davies, J C; Charles, M; Cantelmi, D; Liebgott, B; Ravichandiran, M; Ravichandiran, K; Agur, A M

    2012-07-01

    The lateral pterygoid (LP) has been implicated in temporomandibular joint (TMJ) pathology. Few studies have examined muscle architecture of the superior (SLP) and inferior (ILP) heads of LP; moreover, the pattern of intramuscular innervation is poorly defined. The purpose of this study was to determine patterns of intramuscular innervation of LP using 3D modeling. The superior and lateral aspects of LP were exposed in 10 embalmed cadaveric specimens. Nerves entering the muscle, all branches of the mandibular nerve (V(3) ), were followed intramuscularly in short segments and sequentially digitized. Muscle volume, surrounding bone, and the TMJ disc were also digitized. The data were reconstructed into 3D models (Maya) that were used to determine patterns of intramuscular innervation. It was found that the SLP had independent sources of innervation to each of the quadrants in its superior part (masseteric/posterior deep temporal/middle deep temporal/buccal) and one primary source of innervation (buccal) to the quadrants of the inferior part. This difference in innervation is significant as the superior part attaches to the TMJ disc-capsule complex, whereas the inferior part attaches to the mandibular condylar neck. Differing sites of attachment and sources of innervation for each part suggests that movement of the TMJ disc-capsule complex, independent of the condyle, may be possible. The buccal nerve supplied both the medial and lateral quadrants of the ILP, with the medial quadrants receiving additional innervation from V(3) muscular branches. Results of this study could be used to direct EMG/ultrasound studies of LP function as related to TMJ disorders. PMID:22144260

  3. Cerebral Laterality and Verbal Processes

    ERIC Educational Resources Information Center

    Sherman, Jay L.; And Others

    1976-01-01

    Research suggests that we process information by way of two distinct and functionally separate coding systems. Their location, somewhat dependent on cerebral laterality, varies in right- and left-handed persons. Tests this dual coding model. (Editor/RK)

  4. 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)

  5. 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 ...

  6. 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

  7. Dysregulation of 4q35- and muscle-specific genes in fetuses with a short D4Z4 array linked to facio-scapulo-humeral dystrophy.

    PubMed

    Broucqsault, Natacha; Morere, Julia; Gaillard, Marie-Ccile; Dumonceaux, Julie; Torrents, Julia; Salort-Campana, Emmanuelle; Maues De Paula, Andr; Bartoli, Marc; Fernandez, Carla; Chesnais, Anne Laure; Ferreboeuf, Maxime; Sarda, Laure; Dufour, Henry; Desnuelle, Claude; Attarian, Shahram; Levy, Nicolas; Nguyen, Karine; Magdinier, Frdrique; Roche, Stphane

    2013-10-15

    Facio-scapulo-humeral dystrophy (FSHD) results from deletions in the subtelomeric macrosatellite D4Z4 array on the 4q35 region. Upregulation of the DUX4 retrogene from the last D4Z4 repeated unit is thought to underlie FSHD pathophysiology. However, no one knows what triggers muscle defect and when alteration arises. To gain further insights into the molecular mechanisms of the disease, we evaluated at the molecular level, the perturbation linked to the FSHD genotype with no a priori on disease onset, severity or penetrance and prior to any infiltration by fibrotic or adipose tissue in biopsies from fetuses carrying a short pathogenic D4Z4 array (n = 6) compared with fetuses with a non-pathogenic D4Z4 array (n = 21). By measuring expression of several muscle-specific markers and 4q35 genes including the DUX4 retrogene by an RT-PCR and western blotting, we observed a global dysregulation of genes involved in myogenesis including MYOD1 in samples with <11 D4Z4. The DUX4-fl pathogenic transcript was detected in FSHD biopsies but also in controls. Importantly, in FSHD fetuses, we mainly detected the non-spliced DUX4-fl isoform. In addition, several other genes clustered at the 4q35 locus are upregulated in FSHD fetuses. Our study is the first to examine fetuses carrying an FSHD-linked genotype and reveals an extensive dysregulation of several muscle-specific and 4q35 genes at early development stage at a distance from any muscle defect. Overall, our work suggests that even if FSHD is an adult-onset muscular dystrophy, the disease might also involve early molecular defects arising during myogenesis or early differentiation. PMID:23777630

  8. [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

  9. 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

  10. Task-related laterality effects in the lateral occipital complex.

    PubMed

    Large, Mary-Ellen; Aldcroft, Adrian; Vilis, Tutis

    2007-01-12

    Using functional imaging, we investigated the effects of two different tasks on activation in the lateral occipital complex (LOC). Alternating blocks of intact and scrambled objects were presented. In one task, subjects responded when an object repeated (matching task). In a second task subjects silently named objects (naming task). Identical objects (tools, animals and letters) were presented for both tasks. A relative measure of the number of voxels activated in LOC in left and right hemispheres was calculated for each task across a range of thresholds. Also the effects of task demands on category specific areas in LOC were examined. The object matching task resulted in proportionally more activity in the right hemisphere. The object naming task resulted in proportionally more activity in the left hemisphere, most prominently in the anterior portion of LOC. Effectively, changing the task changed the lateralization of activation to intact objects in LOC. In contrast, changing the task did not change the lateralization of category-specific activations. The results suggest that there are task-related top-down influences on the activation of neural populations in LOC as a whole, but the lateralization of category-specific regions in LOC is independent of task demands and may reflect bottom-up processing. PMID:17141747

  11. 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.

  12. A laterally graded junctionless transistor

    NASA Astrophysics Data System (ADS)

    Bal, Punyasloka; Ghosh, Bahniman; Mondal, Partha; Akram, M. W.

    2014-03-01

    This paper proposes a laterally graded junctionless transistor taking peak doping concentration near the source and drain region, and a gradual decrease in doping concentration towards the center of the channel to improve the IOFF and ION/IOFF ratio. The decrease of doping concentration in the lateral direction of the channel region depletes a greater number of charge carriers compared to the uniformly doped channel in the OFF-state, which in turn suppresses the OFF state current flowing through the device without greatly affecting the ON state current.

  13. 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

  14. Anxiety and Lateral Cerebral Function

    ERIC Educational Resources Information Center

    Tucker, Don M.; And Others

    1978-01-01

    Examines the effect of stressful and nonstressful experimental situations upon the processing capacity of each cerebral hemisphere, through observing the differential performance tasks presented to right and left visual half-fields (VHFs). Also examines attentional bias and lateral eye movements. (Author/RK)

  15. Diagnosing and treating lateral epicondylitis.

    PubMed Central

    Geoffroy, P.; Yaffe, M. J.; Rohan, I.

    1994-01-01

    Lateral epicondylitis is often encountered in primary care. Although its diagnosis can be fairly straightforward, its treatment is often difficult. This review examines the epidemiology, pathophysiology, and clinical presentation of tennis elbow. Management options are discussed. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:8312757

  16. Genetics Home Reference: Juvenile primary lateral sclerosis

    MedlinePLUS

    ... Recent literature OMIM Genetic disorder catalog Conditions > Juvenile primary lateral sclerosis On this page: Description Genetic changes ... Glossary definitions Reviewed July 2013 What is juvenile primary lateral sclerosis? Juvenile primary lateral sclerosis is a ...

  17. 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

  18. 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.

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

    PubMed

    Regaiolli, Barbara; Spiezio, Caterina; Vallortigara, Giorgio

    2016-03-01

    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

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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

  6. Experimental IUGR and later diabetes.

    PubMed

    Martin-Gronert, M S; Ozanne, S E

    2007-05-01

    It is widely accepted that an association exists between the intrauterine environment in which a fetus grows and develops and the subsequent development of type 2 diabetes. Any disturbance in maternal ability to provide nutrients and oxygen to the fetus can lead to fetal intrauterine growth restriction (IUGR). Here we will review IUGR in rodent models, in which maternal metabolism has been experimentally manipulated to investigate the molecular basis of the relationship between IUGR and development of type 2 diabetes in later life, and the identification of the molecular derangements in specific metabolically - sensitive organs/tissues. PMID:17444883

  7. Normal and transplanted lateral knee menisci: evaluation of extrusion using magnetic resonance imaging and ultrasound.

    PubMed

    Verdonk, Peter; Depaepe, Yves; Desmyter, Stefan; De Muynck, Martine; Almqvist, Karl Fredrik; Verstraete, Koenraad; Verdonk, Ren

    2004-09-01

    The aim of the study is to develop a clinically useful and reproducible method for evaluating lateral meniscal extrusion in normal and transplanted knees under different axial loading conditions. Magnetic resonance imaging (MRI) and ultrasound (US) were used to assess meniscal extrusion. Both types of imaging were performed at least 6 months postoperatively (mean 23.5 months). Coronal MR images (DESS-3D sequence) of the lateral compartments of 10 normal knees and 17 transplanted lateral knees were analyzed. Extrusion was defined as the distance measured from the femoral condyle or tibial plateau to the outer edge of the meniscus. Subjects were examined in the supine position. Ultrasound print-outs of the lateral compartment of both knees of ten patients (transplanted side and contralateral normal side) were analyzed. Extrusion cross-sectional area (CSA) and distance were measured just anterior to the lateral collateral ligament: the former was defined as the CSA of the meniscus outside the knee, the latter as the greatest distance from a line connecting the femur and tibia to the outer edge of the lateral meniscus. Patients were examined in the supine position, bipodal stance and unipodal stance. The viable meniscal allograft was securely sutured to a bleeding functional meniscal rim. No bone blocks were used to fix the allograft; instead, the anterior and posterior horn were firmly sutured to their enthesis. The MRI results (tibial) show the transplanted lateral meniscus to be significantly (p<0.005) more extruded in comparison to the normal lateral meniscus. The anterior horn (mean 5.8 mm, SD=2.8) of the transplanted lateral meniscus tends to be more extruded than the posterior horn (mean 2.7 mm, SD=1.48). The posterior horn of the normal lateral meniscus does not (mean 0 mm) extrude, while the mean extrusion of the anterior horn is 0.8 mm (SD=0.92). In the US results, the transplanted lateral meniscus is significantly (p<0.005) more extruded than the normal lateral meniscus in all patient positions. Both cross-sectional surface and distance are equally good parameters to determine meniscal extrusion. There is no statistical difference between patient positions. The transplanted lateral meniscus extrudes, in the supine position, bipodal and unipodal stance 6.43 (SD=1.84), 6.01 (SD=1.93) and 6.99 mm (SD=2.7) respectively. The extrusion surface of the lateral transplanted meniscus is 50.50 mm2 (SD=15.32), 47.24 mm2 (SD=14.35) and 58.61 mm2 (SD=29.65) in the supine position, bipodal stance and unipodal stance respectively. The normal lateral meniscus extrudes in the supine position, bipodal and unipodal stance 3.77 (SD=1.76), 3.94 (SD=1.66) and 3.79 mm (SD=1.79) respectively. The extrusion surface of the normal lateral meniscus is 22.42 mm2 (SD=12.54), 23.24 mm2 (SD=12.74) and 24.79 mm2 (SD=10.18) in the supine position, bipodal stance and unipodal stance respectively. The presented data shows that the transplanted lateral meniscus, without bone block fixation but with firm fixation of the horns to the original entheses, extrudes in the lateral direction significantly more than the normal meniscus. The transplanted lateral meniscus, however, does not extrude more in the lateral direction under axial load. The anterior horn of both normal and transplanted menisci is extruded more laterally than the posterior horn. Both methods are adequate to measure laterally-directed extrusion of the normal and transplanted lateral meniscus, but have distinctive advantages and disadvantages: MRI in this series visualizes the complete-from posterior to anterior-meniscal body, but only in the supine, non-weight-bearing position. Using ultrasound one can evaluate the meniscal extrusion in different conditions of axial loading, but only from a single examination point. PMID:15146312

  8. 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

  9. [Vertical changes in the lateral teleroentgenographic image after functional orthodontic therapy].

    PubMed

    Steinhardt, J; Borchers, N; Schleiff, C

    1990-10-01

    We looked for vertical changes in lateral cephalometric X-rays of patients who had been treated with Andresen and Hupl appliances to correct distal occlusion. Thus, a therapy using functional appliances for orthodontic correction has the following effects on the vertical proportions of the visceral cranium. 1. The alveolar processes show additional vertical growth in the area of the incisors of the upper jaw and the molars of the lower jaw. 2. In conjunction with 1, increased vertical growth of the anterior facial heights compared to the posterior facial height causes an opening of the bite which, however, is not significant in terms of the Jarabak ratio. 3. Functional therapy has an effect on the spina plane, and, in addition, causes active vertical growth in the area of both upper facial heights, i.e., of the entire nasomaxillary complex. This additional growth is a little bit more pronounced anteriorly than posteriorly. Therefore the effect of functional orthodontic appliances on the nasomaxillary complex seems to be more complex than previously believed. 4. We did not observe any additional growth in the area of the ascending rami and/or condyles of the lower jaw during activator treatment. Our studies showed that the influence of functional orthodontic therapy on the vertical growth of the lower jaw is rather insignificant; the significant vertical changes were seen in the area of the mandibular molars and of the anterior facial heights. 5. Our findings thus support the assumption that the main vertical effect of the activator can be described as a relative inhibition of the development of the nasomaxillary complex with simultaneous normal progression of mandibular growth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2262182

  10. 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

  11. 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

  12. 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…

  13. 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

  14. [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

  15. [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

  16. [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

  17. 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

  18. Examining lateral violence in the nursing workforce.

    PubMed

    Stanley, Karen M; Martin, Mary M; Nemeth, Lynne S; Michel, Yvonne; Welton, John M

    2007-11-01

    The decision to examine the phenomenon of lateral violence within the nursing workforce of a Southeastern tertiary care medical center evolved from the strong response of attendees to a nursing presentation on lateral violence. This paper describes the development and testing of the Lateral Violence in Nursing Survey. This questionnaire, designed to measure perceived incidence and severity of lateral violence, was administered online to 663 nursing staff participants. Forty-six percent of the study participants reported lateral violence as a "very serious" or "somewhat serious" problem, and 65% reported frequently observing lateral violence behaviors among coworkers. Education and effective leadership were found to mediate oppressive and negative behaviors, whereas ineffective leadership was found to exacerbate lateral violence. PMID:17987480

  19. Retroviruses and amyotrophic lateral sclerosis

    PubMed Central

    Alfahad, Tariq; Nath, Avindra

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a progressive, invariably fatal neurologic disorder resulting from upper and lower motor neuron degeneration, which typically develops during the sixth or seventh decade of life, and is diagnosed based on standard clinical criteria. Its underlying cause remains undetermined. The disease may occur with increased frequency within certain families, often in association with specific genomic mutations, while some sporadic cases have been linked to environmental toxins or trauma. Another possibility, first proposed in the 1970s, is that retroviruses play a role in pathogenesis. In this paper, we review the published literature for evidence that ALS is associated either with infection by an exogenous retrovirus or with the expression of human endogenous retroviral (HERV) sequences in cells of the central nervous system. A small percentage of persons infected with the human immunodeficiency virus-1 (HIV-1) or human T cell leukemia virus-1 (HTLV-1) develop ALS-like syndromes. While HTLV-1 associated ALS-like syndrome has several features that may distinguish it from classical ALS, HIV-infected patients may develop neurological manifestations that resemble classical ALS although it occurs at a younger age and they may show a dramatic improvement following the initiation of antiretroviral therapy. However, most patients with probable or definite ALS show no evidence of HIV-1 or HTLV-1 infection. In contrast, recent reports have shown a stronger association with HERV, as analysis of serum samples, and postmortem brain tissue from a number of patients with a classical ALS has revealed significantly increased expression of HERV-K, compared to controls. These findings suggest that endogenous retroviral elements are involved in the pathophysiology of ALS, but there is no evidence that they are the primary cause of the syndrome. PMID:23707220

  20. Summary of lateral-control research

    NASA Technical Reports Server (NTRS)

    Toll, Thomas A

    1947-01-01

    A summary has been made of the available information on lateral control. A discussion is given of the criterions used in lateral-control specifications, of the factors involved in obtaining satisfactory lateral control, and of the methods employed in making lateral-control investigations in flight and in wind tunnels. The available data on conventional flap-type ailerons having various types of aerodynamic balance are presented in a form convenient for use in design. The characteristics of spoiler devices and booster mechanisms are discussed. The effects of Mach number, boundary layer, and distortion of the wing or of the lateral-control system are considered insofar as the available information permits. An example is included to illustrate the use of the design data. The limitations of the available information and some of the lateral-control problems that remain to be solved are indicated.

  1. Genetics Home Reference: Juvenile primary lateral sclerosis

    MedlinePLUS

    ... Genetic testing ClinicalTrials.gov Research studies PubMed Recent literature OMIM Genetic disorder catalog Conditions > Juvenile primary lateral sclerosis On this page: Description Genetic changes ...

  2. 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.

  3. Minimizing energy requirements for sprinkler laterals

    SciTech Connect

    Kincaid, D.C.

    1985-01-01

    A computer model was developed to utilize single sprinkler pattern tests in simulating stationary lateral sprinkler systems operating under variable wind conditions. The performance of a low pressure nozzle was compared to that of a standard high pressure round nozzle on a typical multiple set lateral system.

  4. Lateral displacement and rotational displacement sensor

    SciTech Connect

    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.

  5. NURSERY SCHOOL BEHAVIOR AND LATER SCHOOL ADJUSTMENT.

    ERIC Educational Resources Information Center

    WESTMAN, JACK C.; AND OTHERS

    THE RELATIONSHIP BETWEEN BEHAVIOR AND PERSONALITY TRAITS OBSERVED EARLY AND LATER IN LIFE IS EXPLORED IN THIS PAPER. IN PARTICULAR, THE POSSIBILITY OF IDENTIFYING CHILDREN DURING NURSERY SCHOOL YEARS WHO LATER SHOW SIGNS OF MALADJUSTMENT IS EXPLORED. A SAMPLE OF 130 CHILDREN WHO ATTENDED A PRIVATE NURSERY SCHOOL BETWEEN 1945 AND 1950 WAS SELECTED.

  6. Later Life: A Time to Learn

    ERIC Educational Resources Information Center

    Russell, Helen

    2008-01-01

    In this article, an emerging framework for investigating and interpreting the experiences of learning in later life is presented. This framework is contextualized by a study in which the lived experiences of later-life computer learners were investigated. Significant ontological and existential interpretations from the study provided insights into

  7. 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)

  8. 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…

  9. 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....

  10. 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....

  11. 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....

  12. 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....

  13. 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....

  14. Successful implementation of policies addressing lateral violence.

    PubMed

    Coursey, Joy H; Rodriguez, Ricardo E; Dieckmann, Loraine S; Austin, Paul N

    2013-01-01

    Lateral violence is a problem in nursing despite policies addressing the issue, which suggests that implementation of these policies may be ineffective. We used an evidence-based approach to locate and appraise evidence about effectively implementing lateral violence policies. Our search strategy emphasized preappraised evidence, and we found 12 sources that met our inclusion criteria. Most evidence was from low-level sources, which is not surprising due to the subjective and sensitive nature of this topic. The evidence did not indicate that there is consistent, effective implementation of lateral violence policies. The appraised evidence suggests the importance of collaboratively prepared implementation strategies. Administrator involvement and relationships with staff members and the presence of a commitment to positive behavior change before lateral violence incidents occur are factors that can lead to successful implementation of lateral violence policies. PMID:23265652

  15. Lateral orbital approach: Gateway to intraorbital lesions.

    PubMed

    Surej Kumar, L K; Vinod, Moni K; Menon, P Varun

    2014-01-01

    Several approaches to the intraorbital space have been described in the literature. Selection of a proper approach to intraorbital lesions depends on various factors including the location of the tumor, the size of the lesion, and the probable pathology anticipated. The approach should provide a good exposure of intraorbital anatomical structures, allow their functional preservation, and provide good cosmetic results. Intraconal lesions of the orbit usually necessitate transcranial approaches although some intraconal and laterally situated lesions could be removed effectively via lateral orbitotomy. Lateral orbitotomy is a well-known approach for lesions of the lateral orbital cone. In this case report, the lateral orbital approach has been used for exposure of intraorbital lesion, as it is minimally invasive compared to the transcranial approach. PMID:25937740

  16. 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

  17. Lateralized suckling in domestic horses (Equus caballus).

    PubMed

    Komrkov, Martina; Bartoov, Jitka

    2013-05-01

    Brain lateralization enables preferential processing of certain stimuli and more effective utilization of these stimuli in either the left or the right cerebral hemisphere. Horses show both motor and sensory lateralization patterns. Our aim was to determine whether a lateralized response could be detected in foals during the naturally side-biased behaviour, suckling. The foals' preferred suckling side could be the effect of either visual or motor lateralization. In the case of a visual lateralized response, foals are expected to suck more often from the mother's right side, so potential danger can be detected by the better adapted right hemisphere (i.e. left eye). Motor lateralization can be identified when a foal will suck predominantly from one side, either left or right. We found no population trend in the preferred suckling side, but we detected significant differences amongst individual foals. One-third (35.4 %) of 79 foals showed a strong, either right or left side preference which increased with age. The mothers did not influence the foals' suckling side preferences either by side-biased rejection or termination of suckling. According to our findings, a general pattern of sucking with the left eye open for better danger detection and recognition is unlikely in foals up to 7 months old. Foals of this age are probably young or fully focused on suckling and rely on their mothers' vigilance. Individual side preferences amongst foals are suggested to be based on motor lateralization. PMID:23117229

  18. 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

  19. 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

  20. Lateral Meningomyelocele in a Neonate: A Case Report.

    PubMed

    Prasad, G Raghavendra; Rashmi, T M

    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

  1. 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.

  2. 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.

  3. Rapid prototyping of lateral flow assays.

    PubMed

    Volkov, Alexander; Mauk, Michael; Corstjens, Paul; Niedbala, R Sam

    2009-01-01

    Principles and characteristics of lateral flow strip assays are reviewed. Recent technology developments permit the use of inexpensive electronic readers for interrogating lateral flow strip test results, thus avoiding the inevitable variation and subjectivity of visual inspection to assess the capture of reporter-labeled analyte on test lines of the strip. Protocols for developing lateral flow assays are described, including two specific case studies for assaying cotinine (a small-molecule metabolite of nicotine) in a competitive format, and assaying HIV antibodies in a sandwich-type assay format. PMID:19159100

  4. Lateral-deflection-controlled friction force microscopy

    NASA Astrophysics Data System (ADS)

    Fukuzawa, Kenji; Hamaoka, Satoshi; Shikida, Mitsuhiro; Itoh, Shintaro; Zhang, Hedong

    2014-08-01

    Lateral-deflection-controlled dual-axis friction force microscopy (FFM) is presented. In this method, an electrostatic force generated with a probe-incorporated micro-actuator compensates for friction force in real time during probe scanning using feedback control. This equivalently large rigidity can eliminate apparent boundary width and lateral snap-in, which are caused by lateral probe deflection. The method can evolve FFM as a method for quantifying local frictional properties on the micro/nanometer-scale by overcoming essential problems to dual-axis FFM.

  5. Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement.

    PubMed

    Bakke, Merete; Mller, Eigild; Werdelin, Lene M; Dalager, Torben; Kitai, Noriyuki; Kreiborg, Sven

    2005-12-01

    A novel treatment procedure is introduced for severe clicking of the temporomandibular joint (TMJ) associated with anterior disc displacement (ADD), using injections with botulinum toxin (BTX-A) in the lateral pterygoid muscle (LP). It has been suggested that ADD may be caused, precipitated, or maintained by LP activity, but the role of the LP in the dynamics of the TMJ clicking is uncertain. The case report includes 2 women, followed with clinical examinations, TMJ imaging, and electromyography (EMG), in whom local anesthetics in the LP could abolish the clicking for several days. BTX-A block of the LP (30 U Botox, given twice under EMG guidance with 6-month interval) temporarily reduced the action of the muscle, but the clicking was permanently eliminated and did not return during the observation period of 1 year, and a small but distinctive positional improvement in the disc-condyle relationship was obtained. However, the precise mechanisms behind the favourable treatment outcome are unclear. PMID:16301150

  6. Dynamics and lateral interactions of dipolar chains

    NASA Astrophysics Data System (ADS)

    Furst, Eric M.; Gast, Alice P.

    2000-11-01

    The dynamics and lateral interactions of dipolar chains in magnetorheological suspensions determine the long-time microscopic structure and resulting rheological response. In this paper we characterize proposed lateral interaction mechanisms and their implications for long-time coarsening of structure and compare them to direct measurements of the lateral interaction of dipolar chains using optical trap micromanipulation. We observe a long-range far-field attraction between flexible chains, while the near-field interaction can be repulsive or attractive. At high field strengths, we observe the short-range attraction of rigid chains. Chain dynamics measured with videomicroscopy and diffusing wave spectroscopy are described by a local-mode model and are consistent with fluctuation-mediated interaction theories. The subdiffusive behavior at intermediate and long times scales as t0.75, identical to semiflexible molecules. Finally, we show examples of how defects in chains can create lateral attractions or repulsions.

  7. Genetics Home Reference: Amyotrophic lateral sclerosis

    MedlinePLUS

    ... leading to their buildup in nerve cells. The accumulation of toxic substances can damage motor neurons and ... in the Handbook. What if I still have specific questions about amyotrophic lateral sclerosis? Ask the Genetic ...

  8. 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 ...

  9. 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

  10. Coping with Mood Changes Later in Life

    MedlinePLUS

    ... Research Studies Peer Support Research WeSearchTogether Coping with Mood Changes Later in Life Feeling sad? Irritable? Hopeless? ... can I find out if I have a mood disorder? Since only a health care provider can ...

  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. 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

  14. 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

  15. 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

  16. Listeners' impressions of speakers with lateral lisps.

    PubMed

    Silverman, E M

    1976-11-01

    This paper reports research conducted to determine whether the lateral lisp is a speech defect. The specific purpose of this research was to determine whether the lateral lisp calls adverse attention to the speaker. Two groups of broadcast communication students rates the concept "The Person Speaking" on a 49-scale semantic differential. One group performed the task after listening to a tape recording of a young woman reading contextual material with a simulated lateral lisp. The other group performed the task after listening to a recording of the same woman reading the material in a normal manner. Analyses of the scale values computed for the two conditions indicated that the lateral lisp called adverse attention to the speaker. A systematic replication was undertaken to assess the generality of this finding. The procedures of the original investigation were followed except that business administration students served as judges. The results replicated those of the original investigation. These data indicate that the lateral lisp is probably a speech defect and suggest that the practice of eliminating school speech services for children whose only speech difference is a lateral lisp should be reconsidered. PMID:994486

  17. 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

  18. 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

  19. Task-specific initial impact phase adjustments in lateral jumps and lateral landings.

    PubMed

    Fleischmann, Jana; Gehring, Dominic; Mornieux, Guillaume; Gollhofer, Albert

    2011-09-01

    Load-dependant adjustments in lateral jumps are thought to rely on foot placement and on upper leg's kinematic and neuromuscular adaptations. The aim of this study was to elucidate task-specific adjustments during the initial impact phase under varying stretch-loads by the comparison of lateral jumps and lateral landings. Ten subjects performed lateral jumps and landings from four distances. Electromyographic (EMG) data of five lower extremity muscles were measured, whilst lower extremity kinematics and kinetics were analysed by 3D motion analysis. Lateral jumps were characterized by increased impact forces, higher lower extremity joint moments with exception of the initial knee abduction moment, greater sagittal knee and hip joint displacements, and a further exorotated foot placement. In lateral landings frontal ankle and hip joint displacements were greater. Thigh muscle and m. tibialis anterior (TA) pre-activity as well as initial post-impact EMG were higher in lateral jumps than in lateral landings, whilst during the reflex-induced phase thigh and shank muscle EMG, except for TA, were enhanced in lateral jumps. From these findings it can be concluded that task specificity in lateral jumps in contrast to lateral landings impedes a stretch-load adequate modulation of initial impact forces which particularly affects ankle joint loading. Foot placement seems to play a decisive role for limiting lateral ankle and medial knee joint loading. Therefore, in sports containing high-impact frontal plane movements a special emphasis in training routines should be paid to foot placement strategy in those movements. Such training interventions might contribute to injury prevention in lateral movements. PMID:21336953

  20. Lateral stability in sideward cutting movements.

    PubMed

    Stacoff, A; Steger, J; Stssi, E; Reinschmidt, C

    1996-03-01

    Sideward cutting movements occur frequently in sports activities, such as basketball, soccer, and tennis. These activities show a high incidence of injuries to the lateral aspect of the ankle. Consequently, the lateral stability of sport shoes seems important. The purpose of this study was to show the effect of different shoe sole properties (hardness, thickness, torsional stiffness) and designs on the lateral stability during sideward cutting movements. A film analysis was conducted including 12 subjects performing a cutting movement barefoot and with five different pairs of shoes each filmed in the frontal plane. A standard film analysis was conducted; for the statistical analysis, various parameters such as the range of motion in inversion and the angular velocity of the rearfoot were used. The results showed a large difference between the barefoot and shod conditions with respect to the lateral stability. Two shoes performed significantly better (P < 0.05) than the others with a decreased inversion movement and less slipping inside the shoe. The two shoes differed mainly in the shoe sole design (hollow inner core) and the upper (high-cut). It is concluded that lateral stability may be improved by altering the properties and design of the shoe sole as well as the upper. PMID:8776223

  1. [Lateral asymmetry of the human pain sensitivity.].

    PubMed

    Gbel, H; Westphal, W

    1987-09-01

    In repeated clinical studies a preponderance of pain syndromes on the left side of the body has frequently been observed. Experimental studies in humans revealed a lower pain threshold on the left, nondominant side. On the other hand, some studies do not confirm this lateralization. Since pain threshold is not a very valid measure of pain sensitivity in the range beyond threshold, and since clinical studies are limited by simply counting the incidence of the pain syndromes, we investigated whether a significant lateralization of pain sensitivity exists in the entire range beyond pain threshold. Handedness and gender were included as factors. For experimental pain stimulation in 24 subjects three different methods were used: local pressure on the middle phalanxes, a modified submaximal effort tourniquet test, and submerging the hands into cold water. For pain measurement beyond threshold we used the category splitting procedure (Heller).All three methods of stimulation produced corresponding results. Lefthanded subjects showed decreased pain sensitivity on the left side, right-handed subjects on the right side. This was true for the total range of pain sensitivity. For pain induced by pressure, lateral asymmetry increased with pain intensity, for the other two methods it was constant. Lateral asymmetry was found in all subjects, but significant differences could only be demonstrated in female Ss. It is concluded that both gender and handedness contribute to lateral asymmetry of pain sensitivity in man. PMID:18415557

  2. Lateral restraint assembly for reactor core

    DOEpatents

    Gorholt, Wilhelm (San Diego, CA); Luci, Raymond K. (Del Mar, CA)

    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.

  3. Language lateralization shifts with learning by adults.

    PubMed

    Plante, Elena; Almryde, Kyle; Patterson, Dianne K; Vance, Christopher J; Asbjrnsen, Arve E

    2015-05-01

    For the majority of the population, language is a left-hemisphere lateralized function. During childhood, a pattern of increasing left lateralization for language has been described in brain imaging studies, suggesting that this trait develops. This development could reflect change due to brain maturation or change due to skill acquisition, given that children acquire and refine language skills as they mature. We test the possibility that skill acquisition, independent of age-associated maturation can result in shifts in language lateralization in classic language cortex. We imaged adults exposed to an unfamiliar language during three successive fMRI scans. Participants were then asked to identify specific words embedded in Norwegian sentences. Exposure to these sentences, relative to complex tones, resulted in consistent activation in the left and right superior temporal gyrus. Activation in this region became increasingly left-lateralized with repeated exposure to the unfamiliar language. These results demonstrate that shifts in lateralization can be produced in the short term within a learning context, independent of maturation. PMID:25285756

  4. Congenital Lateral Cleft Palate of Unknown Etiology.

    PubMed

    Kahraman, Ahmet; Yce, Serdar; Koak, mer Faruk; Canbaz, Yasin; I?ik, Da?han

    2015-06-01

    The term cleft palate (CP) refers to midline defects extending from the prealveolar ark to the uvula, and these defects present with varying degrees. CP may be complete, incomplete, unilateral, bilateral, or submucosal. It is often observed with cleft lip (CL). In various studies, the incidence of isolated CP has been reported as 1.3 to 25.3 per 1000 births. As a result of deterioration of the anatomical structure of the palate, illnesses such as regurgitation, respiratory tract infections, otitis, and speech disorders may occur. These defects are often observed in the midline and are rarely laterally localized. Cleft palates with lateral localization are outside the natural midline cleft closure line and cause clinical complaints similar to other types of CP. Two cases of laterally localized CP have previously been published in the literature. The case presented here is the third known case to be reported. PMID:26080188

  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. Recovery of Dysphagia in lateral medullary stroke.

    PubMed

    Gupta, Hitesh; Banerjee, Alakananda

    2014-01-01

    Lateral medullary stroke is typically associated with increased likelihood of occurrence of dysphagia and exhibits the most severe and persistent form. Worldwide little research exists on dysphagia in brainstem stroke. An estimated 15% of all patients admitted to stroke rehabilitation units experience a brainstem stroke out of which about 47% suffer from dysphagia. In India, a study showed that 22.3% of posterior circulation stroke patients develop dysphagia. Dearth of literature on dysphagia and its outcome in brainstem stroke particularly lateral medullary stroke motivated the author to present an actual case study of a patient who had dysphagia following a lateral medullary infarct. This paper documents the severity and management approach of dysphagia in brainstem stroke, with traditional dysphagia therapy and VitalStim therapy. Despite being diagnosed with a severe form of dysphagia followed by late treatment intervention, the patient had complete recovery of the swallowing function. PMID:25045555

  7. 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

  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. 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

  10. 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.

  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 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…

  13. 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

  14. The omega lateral approach to the hip.

    PubMed

    Learmonth, I D; Allen, P E

    1996-07-01

    We describe a modified lateral approach to the hip which exploits the function continuity of gluteus medius and vastus lateralis and their dense crescentic attachment to the greater trochanter. The gluteus medius is not incised or split, but is detached and mobilised with gluteus minimus as one unit. This facilitates reattachment of the glutei and helps to preserve abductor function. PMID:8682820

  15. Laterality, Implicit Memory, and Attention Disorder.

    ERIC Educational Resources Information Center

    Shaw, Geraldine A.; Brown, Geoffrey

    1991-01-01

    Presents study showing children with behaviors characteristic of attention disorder/hyperactivity deficit and high intelligence have more mixed laterality and allergies. Finds these children gather and use more diverse nonverbal and poorly focused information. Concludes such children use uncommon information when exhibiting novelty in nonverbal

  16. 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.

  17. Cooling Therapy Helps Newborns Years Later

    MedlinePLUS

    ... part of the U.S. Department of Health and Human Services Latest Issue This Issue Features Digging a Vegetarian Diet Massage Therapy Health Capsules Cooling Therapy Helps Newborns Years Later High Blood Pressure in Children Featured Website: Impact of NIH Research Past Issues Most Viewed July ...

  18. 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…

  19. 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...

  20. Proportioning the airplane for lateral stability

    NASA Technical Reports Server (NTRS)

    Donlan, C. J.

    1976-01-01

    Proportioning for lateral aircraft control included: (1) directional stability (slope of curve of yawing moment coefficient against sideslip), and (2) effective dihedral factor (slope of curve of rolling moment coefficient against sideslip). Basic forces influencing the directional stability of aircraft are indicated. Propeller side force, basic fuselage yaw, and vertical tail side force contributed to yaw moment about center of gravity.

  1. 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

  2. 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

  3. 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

  4. 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.

  5. Lateral root organogenesis - from cell to organ.

    PubMed

    Benkov, Eva; Bielach, Agnieszka

    2010-12-01

    Unlike locomotive organisms capable of actively approaching essential resources, sessile plants must efficiently exploit their habitat for water and nutrients. This involves root-mediated underground interactions allowing plants to adapt to soils of diverse qualities. The root system of plants is a dynamic structure that modulates primary root growth and root branching by continuous integration of environmental inputs, such as nutrition availability, soil aeration, humidity, or salinity. Root branching is an extremely flexible means to rapidly adjust the overall surface of the root system and plants have evolved efficient control mechanisms, including, firstly initiation, when and where to start lateral root formation; secondly lateral root primordia organogenesis, during which the development of primordia can be arrested for a certain time; and thirdly lateral root emergence. Our review will focus on the most recent advances in understanding the molecular mechanisms involved in the regulation of lateral root initiation and organogenesis with the main focus on root system of the model plant Arabidopsis thaliana. PMID:20934368

  6. Laterality and Directional Preferences in Preschool Children.

    ERIC Educational Resources Information Center

    Tan, Lesley E.

    1982-01-01

    Directional preference for horizontal hand movements was investigated in 49 right- and 49 left-handed four-year-olds using three drawing tests. Directionality for more complex perceptual-motor tasks has a different basis than directionality for simple tasks; such directionality is established at a later age but only for the right hand. (Author/CM)

  7. Magnetic lateral guidance sensors for automated highways

    NASA Astrophysics Data System (ADS)

    Stauffer, Donald R.; Barrett, Mike; Demma, Nick; Dahlin, Thomas J.

    1995-12-01

    Automated highway systems will need sensors both for longitudinal guidance (intelligent speed control) and for lateral guidance relative to the center of the traffic lane. A magnetic sensor combined with a practical magnetic highway marking system provides an all-weather, cost effective lateral guidance technique. A practical system must have robust performance under all weather operation, and be producible at a reasonable cost. Previous schemes have suffered from weather related performance problems, cost of the sensor portion on the vehicle, or the cost of the highway infrastructure. The subject system uses a high sensitivity magneto-resistive sensor and a magnetic marking tape which is a variant of existing traffic marking tapes. In addition to providing lateral position information, the system can encode ancillary data that can be received by the vehicle sensor. An important data item is the road curvature for the next segment of road. If the system operates with closed loop autonomous lateral control, such feedforward data is important for good performance at highway speeds. A preliminary feasibility demonstration illustrated that the system provides a high signal to noise ratio, and good accuracy.

  8. 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.

  9. 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

  10. 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…

  11. 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

  12. 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

  13. 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 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Suspension System ...

  14. 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

  15. 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…

  16. Convergent models of handedness and brain lateralization

    PubMed Central

    Sainburg, Robert L.

    2014-01-01

    The pervasive nature of handedness across human history and cultures is a salient consequence of brain lateralization. This paper presents evidence that provides a structure for understanding the motor control processes that give rise to handedness. According to the Dynamic Dominance Model, the left hemisphere (in right handers) is proficient for processes that predict the effects of body and environmental dynamics, while the right hemisphere is proficient at impedance control processes that can minimize potential errors when faced with unexpected mechanical conditions, and can achieve accurate steady-state positions. This model can be viewed as a motor component for the paradigm of brain lateralization that has been proposed by Rogers et al. (MacNeilage et al., 2009) that is based upon evidence from a wide range of behaviors across many vertebrate species. Rogers proposed a left-hemisphere specialization for well-established patterns of behavior performed in familiar environmental conditions, and a right hemisphere specialization for responding to unforeseen environmental events. The dynamic dominance hypothesis provides a framework for understanding the biology of motor lateralization that is consistent with Roger's paradigm of brain lateralization. PMID:25339923

  17. 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

  18. 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.…

  19. One hand clapping: lateralization of motor control.

    PubMed

    Welniarz, Quentin; Dusart, Isabelle; Gallea, Ccile; 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

  20. Robotic Gripper Resists Torsion And Lateral Forces

    NASA Technical Reports Server (NTRS)

    Voellmar, George M.

    1992-01-01

    Gripper for end effector of robot shaped to tolerate large initial misalignments with object gripped. Gripping surfaces contoured to prevent lateral forces from prying them apart. Ridges on handle mate with grooves in finger. Same ridge-end-slope pattern appears on opposite face of handle so two opposed fingers grip it.

  1. 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.

  2. [Upper lateral incisor with 2 canals].

    PubMed

    Fabra Campos, H

    1991-01-01

    Clinical case summary of the patient with an upper lateral incisor with two root canals. The suspicion that there might be an anatomic anomaly in the root that includes a complex root canal system was made when an advanced radicular groove was detected in the lingual surface or an excessively enlarged cingulum. PMID:1659854

  3. 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.

  4. 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.

  5. Lateral Biases in Assumptions of Lighting Position

    ERIC Educational Resources Information Center

    Elias, Lorin J.; Robinson, Brent M.

    2005-01-01

    People presume that the light source in pictures comes from above, and there is some evidence that this phenomenon also demonstrates lateral biases. When investigators present multiple ambiguous stimuli or visually complex objects, people assume that the source of light is from above, and to the left. However, when single relatively simple stimuli

  6. 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…

  7. Ultimate lateral capacity of piles in clay

    SciTech Connect

    Hamilton, J.M.; Murff, J.D.

    1995-12-01

    This paper presents the results of centrifuge tests and analyses performed to determine the influence of cyclic lateral loading on the ultimate lateral resistance of foundation piles in normally consolidated clay soil. The work was motivated by the need for an appropriate method for estimating lateral soil resistance in order to assess the foundation reserve strength ratio (RSR) of fixed offshore platforms. In the absence of test data, industry practice has been to use the fully degraded cyclic resistance from the working stress design criteria recommended in API RP2A for cyclically loaded piles. It was suspected that this working stress approach substantially underestimates the ultimate lateral soil resistance available. The data reported herein demonstrate that while the cyclic criteria are appropriate for working stress analyses, they are extremely conservative for ultimate strength analyses. It is recommended that the non-degraded, static clay criteria be used to obtain soil resistances for use in RSR calculations. Since the data were obtained in kaolin, caution should be used when dealing with highly sensitive or fissured soils; in those cases additional study may be warranted. The data reported herein show that when the pile displaces into undisturbed soil, the ultimate resistance that can be mobilized is, to a large extent, regained. The most significant implication of this finding is for platforms whose foundation reserve strength is controlled by lateral pile resistance. Platforms most favorably affected by the conclusions of this study are older, shallow water template-type jackets with unbattered piles. Using the criteria recommended herein, the computed foundation RSR of such platforms is raised about 30 percent over that computed using cyclic criteria.

  8. Laterality and mental disorders in the postgenomic age - A closer look at schizophrenia and language lateralization.

    PubMed

    Ocklenburg, Sebastian; Gntrkn, Onur; Hugdahl, Kenneth; Hirnstein, Marco

    2015-12-01

    Most people are right-handed and show left-hemispheric language lateralization, but a minority exhibits left-handedness and right-hemispheric language lateralization. This atypical laterality pattern is observed significantly more often in schizophrenia patients than in the general population, which led several authors to conclude that there is a genetic link between laterality and schizophrenia. It has even been suggested that a failure in the lateralization process, orchestrated by genes, could be the primary cause of schizophrenia. However, the molecular genetic evidence for a link between laterality and schizophrenia is weak. Recent genetic evidence indicates that schizophrenia is not a single disorder but a group of heritable disorders caused by different genotypic networks leading to distinct clinical symptoms. To uncover the link between schizophrenia and laterality we therefore suggest a paradigm shift where genetics are not mapped on schizophrenia as a whole but on discrete schizophrenia symptoms. In addition, we provide a critical evaluation of current theories on the genetic link between schizophrenia and brain asymmetry. PMID:26598216

  9. Lateral cephalometric radiograph versus lateral nasopharyngeal radiograph for quantitative evaluation of nasopharyngeal airway space

    PubMed Central

    Pereira, Suelen Cristina da Costa; Beltro, Rejane Targino Soares; Janson, Guilherme; Garib, Daniela Gamba

    2014-01-01

    Objective This study compared lateral radiographs of the nasopharynx (LN) and lateral cephalometric radiographs (LC) used to assess nasopharyngeal airway space in children. Material and Methods One examiner measured the nasopharyngeal space of 15 oral breathing patients aged between 5 and 11 years old by using LN and LC. Both assessments were made twice with a 15-day interval in between. Intergroup comparison was performed with t-tests (P < 0.05). Results Comparison between LN and LC measurements showed no significant differences. Conclusion Lateral cephalometric radiograph is an acceptable method used to assess nasopharyngeal airway space. PMID:25279526

  10. 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

  11. 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.

  12. Nanoparticle-based lateral flow biosensors.

    PubMed

    Quesada-Gonzlez, Daniel; Merkoi, 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

  13. 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.

  14. A new integrative model of lateral epicondylalgia.

    PubMed

    Coombes, B K; Bisset, L; Vicenzino, B

    2009-04-01

    Tennis elbow or lateral epicondylalgia is a diagnosis familiar to many within the general community and presents with an uncomplicated clinical picture in most cases. However, the underlying pathophysiology presents a more complex state and its management has not been conclusively determined. Research on this topic extends across anatomical, biomechanical and clinical literature; however, integration of findings is lacking. We propose that the current understanding of the underlying pathophysiology of lateral epicondylalgia can be conceptualised as encompassing three interrelated components: (i) the local tendon pathology, (ii) changes in the pain system, and (iii) motor system impairments. This paper presents a model that integrates these components on the basis of a literature review with the express aim of assisting in the targeting of specific treatments or combinations thereof to individual patients. PMID:19050004

  15. 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.

  16. Pressure behavior of laterally composite reservoirs

    SciTech Connect

    Kuchuk, F.J.; Habashy, T.

    1997-03-01

    This paper presents a new general method for solving the pressure diffusion equation in laterally composite reservoirs, where rock and fluid properties may change laterally as a function of y in the x-y plane. Composite systems can be encountered as a result of many different types of depositional and tectonic processes. For example, meandering point bar reservoirs or reservoirs with edgewater encroachment are examples of such systems. The new solution method presented is based on the reflection-transmission concept of electromagnetics to solve fluid-flow problems in 3D nonhomogeneous reservoirs, where heterogeneity is in only one (y) direction. A general Green`s function for a point source in 3D laterally composite systems is developed by using the reflection-transmission method. The solutions in the Laplace transform domain are then developed from the Green`s function for the pressure behavior of specific composite reservoirs. The solution method can also be applied to many different types of wells, such as vertical, fractured, and horizontal in composite reservoirs. The pressure behavior of a few well-known laterally composite systems are investigated. It is shown that a network of partially communicating faults and fractures in porous medium can be modeled as composite systems. It is also shown that the existing solutions for a partially communicating fault are not valid when the fault permeability is substantially larger than the formation permeability. The derivative plots are presented for selected faulted, fractured, channel, and composite reservoirs as diagnostic tools for well-test interpretation. It is also shown that if the composite system`s permeability varies moderately in the x or y direction, it exhibits a homogeneous system behavior. However, it does not yield the system`s average permeability. Furthermore, the composite systems with distributed low-permeability zones behave as if the system has many two no-flow boundaries.

  17. Dilational lateral stress in drying latex films.

    PubMed

    Knig, Alexander M; Bourgeat-Lami, Elodie; Mellon, Vronique; von der Ehe, Kerstin; Routh, Alexander F; Johannsmann, Diethelm

    2010-03-16

    Drying latex films usually experience tensile stress due to the reduction in volume. While an unconstrained film would shrink affinely in all three dimensions, a coating can only shrink along the vertical and therefore exerts tensile stress onto the substrate. Using an instrument capable of producing maps of the stress distribution, we found that dilational stress sometimes develops as well. The in-plane stress was monitored by spreading the latex dispersion on a flexible membrane. Usually, the membrane bends upward under the tensile stress exerted by the film, but it may also bend downward. Dilational stress was only found with samples showing a strong coffee stain effect, that is, samples in which there is a significant lateral flow from the center to the edge while the film dries. During drying, particles consolidate first at the edge because of the lower height in this region. Continued evaporation from the consolidated region results in a water flow toward the edge, exerting a force onto the latex particles. At the time, when the network is formed, any single sphere must be in a force-balance condition: the network must exert an elastic force onto the sphere which just compensates the viscous drag. Pictorially speaking, a spring (an elastic network) is created while an external force acts onto it. Once the flow stops, the drag force vanishes and the internal stress, which previously compensated the drag, expands the film laterally. This phenomenon can lead to buckling. Given that lateral flow of liquid while films dry is a rather common occurrence, this mode of structure formation should be widespread. It requires lateral flow in conjunction with elastic recovery of the particle network. PMID:20146486

  18. A lateralized brain network for visuospatial attention.

    PubMed

    Thiebaut de Schotten, Michel; Dell'Acqua, Flavio; Forkel, Stephanie J; Simmons, Andrew; Vergani, Francesco; Murphy, Declan G M; Catani, Marco

    2011-10-01

    Right hemisphere dominance for visuospatial attention is characteristic of most humans, but its anatomical basis remains unknown. We report the first evidence in humans for a larger parieto-frontal network in the right than left hemisphere, and a significant correlation between the degree of anatomical lateralization and asymmetry of performance on visuospatial tasks. Our results suggest that hemispheric specialization is associated with an unbalanced speed of visuospatial processing. PMID:21926985

  19. Lateral dampers for thrust bearings. Final Report

    SciTech Connect

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

    1985-08-01

    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.

  20. Arthroscopic treatment for chronic lateral epicondylitis?

    PubMed Central

    Terra, Bernardo Barcellos; Rodrigues, Leandro Marano; Filho, Anis Nahssen; de Almeida, Gustavo Dalla Bernardina; Cavatte, Jos Maria; De Nadai, Anderson

    2015-01-01

    Objective To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC) in patients with chronic lateral epicondylitis that was refractory to conservative treatment. Methods Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti-inflammatory agents, corticoid infiltration or physiotherapy) had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analog scale (VAS) for pain. Results A total of 15 patients (9 men and 6 women) were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100). The pain VAS improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used (p<0.01). No correlations were observed using the Spearman test between the results and age, gender, length of time with symptoms before the operation or injury mechanism (p>0.05). Conclusion Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure. PMID:26401498

  1. 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

  2. Lateral restraint assembly for reactor core

    SciTech Connect

    Gorholt, W.; Luci, R.K.

    1986-06-24

    In a nuclear reactor including a reactor vessel defining a shielded core cavity having a reactor core extending vertically along a longitudinal axis and being located internally of the cavity, the reactor core is described which has layers of reflector blocks defining an outer peripheral surface for the core spaced from the vessel and being supported in a manner permitting at least limited lateral movement relative to the vessel; the combination therewith comprising lateral restraint means including lateral restraint assemblies disposed in the circumferential spaced relation about the periphery of the reactor core between the core and reactor vessel. The lateral restraint elements are located circumferentially about the outer peripheral surface of the core and being located in a number of layers to engage intermediate layers of reflector blocks between the top and the bottom of the core to restrain the peripheral core surface each of the restraint assemblies including a face plate having a contact surface to contact one of the reflector blocks of the core, spring means biasing the face plate against the reflector block on the outer periphery of the core, the spring means being disposed to allow radial expansion and contraction of the core and vertical movement of the core relative to the vessel. The spring means exert forces substantially horizontally directed between the top and the bottom of the core and only in the radial direction and at locations spaced circumferentially and vertically about the entire peripheral surface of the core, and a key means to restrain core movement in a direction parallel to the contact surface of the face plate and perpendicular to the longitudinal axis relative to the vessel due to seismic loads while allowing substantial vertical movement in a direction parallel to the core axis and radial movement toward and from the core axis.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Pranayama increases grip strength without lateralized effects.

    PubMed

    Raghuraj, P; Nagarathna, R; Nagendra, H R; Telles, S

    1997-04-01

    The present study was conducted to determine whether breathing through a particular nostril has a lateralized effect on hand grip strength. 130 right hand dominant, school children between 11 and 18 yrs of age were randomly assigned to 5 groups. Each group had a specific yoga practice in addition to the regular program for a 10 day yoga camp. The practices were: (1) right-, (2) left-, (3) alternate- nostril breathing (4), breath awareness and (5) practice of mudras. Hand grip strength of both hands was assessed initially and at the end of 10 days for all 5 groups. The right-, left- and alternate-nostril breathing groups had a significant increase in grip strength of both hands, ranging from 4.1% to 6.5%, at the end of the camp though without any lateralization effect. The breath awareness and mudra groups showed no change. Hence the present results suggest that yoga breathing through a particular nostril, or through alternate nostrils increases hand grip strength of both hands without lateralization. PMID:9142556

  8. Transnational connections of later-life migrants.

    PubMed

    Heikkinen, Sari Johanna; Lumme-Sandt, Kirsi

    2013-04-01

    In this paper a transnational perspective is used to explain whether and how older migrants construct and sustain their social networks. The paper uses a transnational viewpoint on older migrants' lives by analysing their engagement with their former homeland, and the intensity and habitualness of those engagements in old age. The aim of this article is to study the transnational connections of later-life migrants'. Attention is especially paid to the features of old age while maintaining these connections. These considerations are based on analyses of transnational networks in the everyday lives of later-life migrants from the former Soviet Union residing in Finland. The data were collected from 11 later-life migrants. It is found that transnational relationships are a vital part of the everyday lives of older migrants, and that they are sustained in varied ways. These connections mean a concrete source of help, family affiliations, the sharing of emotions, and a larger social network. Economic limitations affect the frequency and type of communication, and various physical limitations may also cause inability to maintain contacts across borders. In these circumstances, family members or other close relatives or friends are needed to deliver messages on the older person's behalf. Old age and immigration status affect the amount and direction of communication across borders, thereby shaping these networks. PMID:23561285

  9. [Fractures of the mandibular condyle. Therapeutic controversies].

    PubMed

    Martins, J S; Frage, Z B

    1999-01-01

    The condylar mandibular fractures are important because its incidence, possible complications and controversial treatment. The treatment of condylar fractures has generated more controversy and discussion than any other in the field of maxillofacial trauma. The main goal of treatment is restoration of function and not anatomic restoration of parts. Despite several clinical and anatomical studies still lack consensus regarding the best method of treatment. This review article focus on the controversy that surrounds treatment of the condylar fractures, trying to supply consensus about questions like: Should condylar mandibular fractures be managed via a closed or open technique? What is the best surgical approach? Surgical timing? What is the degree and duration of mandibular immobilization? Is or not necessary to treat the ATM disc? PMID:10481324

  10. 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.

  11. Lateral Mode Control of Semiconductor Lasers

    NASA Astrophysics Data System (ADS)

    Sun, Yan

    This thesis deals with several topics related to the lateral modes of edge-emitting semiconductor lasers. The first topic is the improvement of lateral beam quality for high power operation. A thermally controlled antiguiding unstable-resonator semiconductor laser with cleaved facets is proposed. With temperature controlled by monolithically integrated micro-heaters, the beam propagation factor is improved by 8 times at 300 mW and by 6 time at 600 mW. The second issue is monolithic semiconductor laser beam steering. Two new mechanisms, thermally controlled offset gain and index guiding lasers and fan laser arrays, have been proposed and demonstrated. They both have single-lobed Gaussian intensity distributions. The fan laser array has shown a total steering angle of 80^circ with eleven resolvable spots, which surpasses the previous results by a factor of three. The third issue is the nonlinear interaction between the semiconductor gain medium and optical waves. The filamentation effect is studied with perturbation theory. Analytical spatial solitary waves have been obtained. The fourth issue is the complex Hermite-Gaussian functions and their applications. An analytical integral expression has been obtained. The generalized complex Gaussian duct is discussed. It is found that the biorthogonal mode expansion and adjoint mode coupling theory in unstable resonators need to be improved. The fifth issue is the lateral modes of stable resonator and stadium resonator semiconductor lasers which have been designed, fabricated and tested. For the stable cavity semiconductor lasers, three distinct operation regions are identified as the stable cavity region, the transition region, and the geometrically unstable region. Preliminary results on stadium resonator semiconductor lasers have also been obtained.

  12. Lateral Flagellar Gene System of Vibrio parahaemolyticus

    PubMed Central

    Stewart, Bonnie J.; McCarter, Linda L.

    2003-01-01

    Vibrio parahaemolyticus possesses dual flagellar systems adapted for movement under different circumstances. A single polar flagellum propels the bacterium in liquid (i.e., swimming) with a motor that is powered by the sodium motive force. Multiple proton-driven lateral flagella enable translocation over surfaces (i.e., swarming). The polar flagellum is produced continuously, while production of lateral flagella is induced when the organism is grown on surfaces. This work describes the isolation of mutants with insertions in the structural and regulatory laf genes. A Tn5-based lux transcriptional reporter transposon was constructed and used for mutagenesis and subsequent transcriptional analysis of the laf regulon. Twenty-nine independent insertions were distributed within 16 laf genes. DNA sequence analysis identified 38 laf genes in two loci. Among the mutants isolated, 11 contained surface-induced lux fusions. A hierarchy of laf gene expression was established following characterization of the laf::lux transcriptional fusion strains and by mutational and primer extension analyses of the laf regulon. The laf system is like many enteric systems in that it is a proton-driven, peritrichous flagellar system; however, laf regulation was different from the Salmonella-Escherichia coli paradigm. There is no apparent flhDC counterpart that encodes master regulators known to control flagellar biosynthesis and swarming in many enteric bacteria. A potential ?54-dependent regulator, LafK, was demonstrated to control expression of early genes, and a lateral-specific ?28 factor controls late flagellar gene expression. Another notable feature was the discovery of a gene encoding a MotY-like product, which previously had been associated only with the architecture of sodium-type polar flagellar motors. PMID:12867460

  13. Upper Blepharoplasty and Lateral Wound Dehiscence

    PubMed Central

    Kashkouli, Mohsen Bahmani; Jamshidian-Tehrani, Mansooreh; Sharzad, Sahab; Sanjari, Mostafa Soltan

    2015-01-01

    Purpose: To report the frequency of lateral wound dehiscence (LWD) after upper blepharoplasty (UB), a technique and its outcome to prevent LWD. Materials and Methods: A retrospective review was performed for cases of LWD after UB presenting between 2003 and 2009, and then a prospective comparative study was performed between February 2009 and March 2013. For the comparison, subjects were divided into two groups based on intraoperative assessment of lateral wound tension (same technique and surgeon). Group 1 received 1-3 orbicularis/subcutaneous buried sutures (6-0 polyglactin) before interrupted 6-0 nylon skin closure. Group 2 underwent skin closure only. Subjects, who had re-operation, skin healing disorders, and incomplete follow-up (<6 months), were excluded. P < 0.05 was considered as statistically significant. Results: There were 14 (14/678, 2%) cases with LWD with a mean age of 36.2 years in the audit (20032009). The prospective study included 68 subjects (68/293, 23.2%) in Group 1 and 225 in Group 2. Gender and simultaneous forehead and eyebrow procedures were similar between groups (P = 0.3 and P = 0.4 respectively). Group 1 was statistically significantly younger at mean age of 41.4 years, compared to Group 2 at 56.1 years (P = 0.000). The frequency of LWD significantly (P = 0.04) decreased to 0.3% (1/293). Conclusion: In the presence of wound tension on skin closure (intraoperative assessment), tension relieving buried orbicularis/subcutaneous 6-0 polyglactin suturing of the lateral UB incision could prevent LWD. PMID:26692716

  14. 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

  15. Subtle retinal pathology in amyotrophic lateral sclerosis

    PubMed Central

    Ringelstein, Marius; Albrecht, Philipp; Sdmeyer, Martin; Harmel, Jens; Mller, Ann-Kristin; Keser, Nazmiye; Finis, David; Ferrea, Stefano; Guthoff, Rainer; Schnitzler, Alfons; Hartung, Hans-Peter; Methner, Axel; Aktas, Orhan

    2014-01-01

    Amyotrophic lateral sclerosis (ALS) is characterized by neuro-ophthalmological abnormalities beyond disturbed oculomotor control such as decreased visual acuity and disturbed visual evoked potentials. Here we report retinal alterations in a cohort of 24 patients with clinically definite (n = 20) or probable (n = 4) ALS as compared to matched controls. High-resolution spectral domain optical coherence tomography with retinal segmentation revealed a subtle reduction in the macular thickness and the retinal nerve fiber layer (RNFL) as well as a marked thinning of the inner nuclear layer (INL). Our data indicate an unprecedented retinal damage pattern and suggest neurodegeneration beyond the motor system in this disease. PMID:25590041

  16. 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.

  17. Towards reproducible, scalable lateral molecular electronic devices

    NASA Astrophysics Data System (ADS)

    Durkan, Colm; Zhang, Qian

    2014-08-01

    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.

  18. 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

  19. 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

  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. Photolithography using lateral surface of nanofibers

    NASA Astrophysics Data System (ADS)

    Wei, Zhen; Bai, Jian; Wang, Chen; Hu, Neibin; Xu, Jianfeng; Yao, Yuan; Liang, Yiyong; Wang, Kaiwei; Hou, Changlun; Yang, Guoguang

    2015-05-01

    To enhance the resolution of photolithography, we demonstrate a technique that confines the exposure area by using lateral surface of nanofibers. Due to evanescent wave and optical tunneling effect, the interaction area of optical energy and the photoresist layer is confined into sub-wavelength dimension. Illuminated by a He-Cd laser device with a 442 nm wavelength, exposed lines with sub-wavelength width were obtained by using a nanofiber with a 247 nm diameter. Furthermore, curve lines and annular lines were obtained by manipulating the shape of nanofibers on the photoresist layer.

  2. Psychotherapists and the clergy: Fifty years later.

    PubMed

    Spiegelman, J M

    1984-03-01

    Jung's two powerful articles on psychotherapy and the clergy, written in 1928 and 1932. are looked at from the vantage point of fifty years later and the author's experience in conducting analysis with many people from both vocations. He notes that relatively few people achieve the kind of integration of the ego that Jung writes about-an essentially religious experience-wherein the center of their existence now gravitates about the Self. Yet Jung's work and views have had a profound effect on spiritually inclined people of all ages. The predictions of Jung's articles, regarding therapy, the dissemination of pyschology to the masses, and other issues are examined. PMID:24306937

  3. 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.

  4. Psychiatric aspects of amyotrophic lateral sclerosis (ALS).

    PubMed

    Norris, Lorenzo; Que, Guinevere; Bayat, Elham

    2010-06-01

    Amyotrophic lateral sclerosis (ALS) is a progressive disorder characterized by degeneration of motor neurons. Given the severe nature of ALS, many believed that patients would suffer from a high level of depression and a low quality of life. However, research into the psychological health of patients with ALS has shown that this is not the case. This article reviews the state of current knowledge as it pertains to the psychological health of ALS patients in four broad areas: quality of life, personality characteristics, emotional reactions, and end-of-life choices. PMID:20425287

  5. Individual differences in infancy and later IQ.

    PubMed

    Slater, A

    1995-01-01

    In recent years it has been demonstrated that cognitive development from infancy to later childhood displays some degree of (correlational) continuity. Studies that have demonstrated this continuity are reviewed, focusing on measures of visual information processing, means-ends problem-solving and other cognitive indices of infant performance. Models of continuity are described and evaluated, and the relevance of the findings and models to the Nature-Nurture issue are considered, with particular attention to the related issues of the role of experience in early life, and the extent to which infant development is canalized. Theoretical and practical applications of the research are discussed. PMID:7714030

  6. 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

  7. 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

  8. 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.

  9. Responsiveness-to-Intervention: A Decade Later

    PubMed Central

    Fuchs, Lynn S.; Vaughn, Sharon

    2012-01-01

    In this introduction to this special issue, A Decade Later, we provide an overview of the accomplishments as well as the persistent questions surrounding RTI. We organize this discussion within 3 categories: assessment, instruction, and policy. Within each of these sections, we also highlight how the articles in the present special issue expand upon the key issues. Developed initially for the early grades (kindergarten through third grade) and primarily in the area of reading, many-although not all-of these issues speak to the expansion of RTI to address a broader set of academic content areas and the full range of grade levels. PMID:22539056

  10. Cerebral lateralization of frontal lobe language processes and lateralization of the posterior visual word processing system.

    PubMed

    Cai, Qing; Lavidor, Michal; Brysbaert, Marc; Paulignan, Yves; Nazir, Tatjana A

    2008-04-01

    The brain areas involved in visual word processing rapidly become lateralized to the left cerebral hemisphere. It is often assumed this is because, in the vast majority of people, cortical structures underlying language production are lateralized to the left hemisphere. An alternative hypothesis, however, might be that the early stages of visual word processing are lateralized to the left hemisphere because of intrinsic hemispheric differences in processing low-level visual information as required for distinguishing fine-grained visual forms such as letters. If the alternative hypothesis was correct, we would expect posterior occipito-temporal processing stages still to be lateralized to the left hemisphere for participants with right hemisphere dominance for the frontal lobe processes involved in language production. By analyzing event-related potentials of native readers of French with either left hemisphere or right hemisphere dominance for language production (determined using a verb generation task), we were able to show that the posterior occipito-temporal areas involved in visual word processing are lateralized to the same hemisphere as language production. This finding could suggest top-down influences in the development of posterior visual word processing areas. PMID:18052778

  11. 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

  12. 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.

  13. 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

  14. Amyotrophic lateral sclerosis: one or multiple causes?

    PubMed

    Bastos, Aline Furtado; Orsini, Marco; Machado, Dionis; Mello, Mariana Pimentel; Nader, Sergio; Silva, Jlio Guilherme; da Silva Catharino, Antonio M; de Freitas, Marcos R G; Pereira, Alessandra; Pessoa, Luciane Lacerda; Sztajnbok, Flavio R; Leite, Marco Arajo; Nascimento, Osvaldo J M; Bastos, Victor Hugo

    2011-06-01

    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

  15. [Methodology in studying laterality in developmental neuropsychiatry].

    PubMed

    Mitrovi?, D; Nikoli?, V; Vlajkovi?, K

    1991-01-01

    The extent of literature and research dedicated to the laterality of cerebral functions and it's relation towards peripheral laterality gives the impression that this problem is precisely determined to a greater extent. The fact that can be accepted by the examination of literature is that the relation behavior (in the sense of acting)--brain (in the sense of a material determination of behavior itself) cannot be accepted as precisely determined or according to definition, not by nature nor by the mechanism of establishing this relation. From the perspective of the clinical viewpoint of the meaning of left-handedness the most acceptable is the theory of Satz Orsini and Sopper from 1986 in which they consider that non-righthanded people present a heterogenous group with a few individual sub-types: pathological lefthanded persons; ambivalent persons, in other words, ambidexters and the group of lefthanded persons by nature. On the basis of present neuropsychological research and in accordance with the psycho-neuro-vegetative approach to the semiotics of the developmental age of Popov et al., a complete battery is given which enables the neuropsychological analysis according to Orzbut's principals. PMID:1870465

  16. 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.

  17. 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

  18. 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

  19. 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

  20. Laterality of vestibular evoked myogenic potentials.

    PubMed

    Murofushi, Toshihisa; Ochiai, Atsushi; Ozeki, Hidenori; Iwasaki, Shinichi

    2004-02-01

    To clarify the laterality of acoustically evoked vestibulocollic reflexes with a short latency (vestibular evoked myogenic potentials, VEMPs). responses on the bilateral sternocleidomastoid muscles (SCMs) to unilateral acoustic stimulation were studied. Twenty-one healthy volunteers were enrolled. Surface electrodes were placed on the upper half of each SCM (active) and on the lateral end of the upper sternum (reference). Clicks and 500-Hz tone-bursts (95dB nHL) were used. All subjects showed positive-negative biphasic responses on the ipsilateral SCM by clicks and tone-bursts. Click-stimulation of 41 of the 42 ears did not evoke any response on the contralateral SCM. However, in one ear, positive-negative biphasic responses were evoked on the contralateral SCM. Recordings on the contralateral SCM by tone-bursts showed no response in 32 ears, small positive-negative biphasic responses in four ears, and small negative-positive biphasic responses in six ears. These findings show that VEMPs are ipsilateral-dominant, basically consistent with the hypothesis that they are of saccular origin. PMID:15035558

  1. Lateral epicondylalgia: midlife crisis of a tendon.

    PubMed

    Luk, James K H; Tsang, Raymond C C; Leung, H B

    2014-04-01

    The pathogenesis and management of lateral epicondylalgia, or tennis elbow, a common ailment affecting middle-aged subjects of both genders continue to provoke controversy. Currently it is thought to be due to local tendon pathology, pain system changes, and motor system impairment. Its diagnosis is usually clinical, based on a classical history, as well as symptoms and signs. In selected cases, additional imaging (X-rays, ultrasound, and magnetic resonance imaging) can help to confirm the diagnosis. Different treatment modalities have been described, including the use of orthotics, non-steroidal anti-inflammatory drugs, steroid injections, topical glyceryl trinitrate, exercise therapy, manual therapy, ultrasound therapy, laser therapy, extracorporeal shockwave therapy, acupuncture, taping, platelet-rich plasma injections, hyaluronan gel injections, botulinum toxin injections, and surgery. Nevertheless, evidence to select the best treatment is lacking and the choice of therapy depends on the experience of the management team, availability of the equipment and expertise, and patient response. This article provides a snapshot of current medical practice for lateral epicondylalgia management. PMID:24584568

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. The lateral occipitotemporal cortex in action.

    PubMed

    Lingnau, Angelika; Downing, Paul E

    2015-05-01

    Understanding and responding to other people's actions is fundamental for social interactions. Whereas many studies emphasize the importance of parietal and frontal regions for these abilities, several lines of recent research show that the human lateral occipitotemporal cortex (LOTC) represents varied aspects of action, ranging from perception of tools and bodies and the way they typically move, to understanding the meaning of actions, to performing overt actions. Here, we highlight common themes across these lines of work, which have informed theories related to high-level vision, concepts, social cognition, and apraxia. We propose that patterns of activity in LOTC form representational spaces, the dimensions of which capture perceptual, semantic, and motor knowledge of how actions change the state of the world. PMID:25843544

  10. The 'Omics' of Amyotrophic Lateral Sclerosis.

    PubMed

    Caballero-Hernandez, Diana; Toscano, Miguel G; Cejudo-Guillen, Marta; Garcia-Martin, Maria L; Lopez, Soledad; Franco, Jaime M; Quintana, Francisco J; Roodveldt, Cintia; Pozo, David

    2016-01-01

    Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease that primarily affects motor neurons and is accompanied by sustained unregulated immune responses, but without clear indications of the ultimate causative mechanisms. The identification of a diverse array of ALS phenotypes, a series of recently discovered mutations, and the links between ALS and frontotemporal degeneration have significantly increased our knowledge of the disease. In this review we discuss the main features involved in ALS pathophysiology in the context of recent advances in 'omics' approaches, including genomics, proteomics, and others. We emphasize the pressing need to combine clinical imaging with various different parameters taken from omics fields to facilitate early, accurate diagnosis and rational drug design in the treatment of ALS. PMID:26691296

  11. [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

  12. 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

  13. [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

  14. 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

  15. 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

  16. Optical fiber head for providing lateral viewing

    DOEpatents

    Everett, Matthew J. (Livermore, CA); Colston, Billy W. (Livermore, CA); James, Dale L. (Tracy, CA); Brown, Steve (Livermore, CA); Da Silva, Luiz (Danville, CA)

    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.

  17. [Late results after individualized lateral internal sphincterotomy].

    PubMed

    Blessing, H

    1993-03-01

    A total of 75 patients underwent individualized lateral internal sphincterotomy for acute and chronic anal fissure (n = 30) or high pressure hemorrhoids (n = 45) and were followed-up 3 months and 3 years (13-66 months) postoperatively. All but one patient with anal fissure (97%) and 38 out of 45 patients with hemorrhoids (84%) remained symptom free; only one patient (1.3%) occasionally had symptoms of minor incontinence. Following the operation both the maximum resting pressure and the medium anal pressure fell significantly and were completely or nearly normalized in 54 (72%) and 17 (23%) patients respectively. At medium follow-up of 3 months and 3 years postoperatively there was no significant difference in the two sets of postoperative manometric results. PMID:8473178

  18. 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

  19. 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

  20. EAS-BUAP: Lateral Distribution and Performance

    NASA Astrophysics Data System (ADS)

    Salazar, H.; Martinez, O.; Cotzomi, J.; Moreno, E.; Aguilar, S.; Villaseor, 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.

  1. Cerebrospinal fluid filtration in amyotrophic lateral sclerosis.

    PubMed

    Finsterer, J; Mamoli, B

    1999-09-01

    By means of a randomized, controlled and open study the authors wanted to find out if cerebrospinal (CSF)-filtration was of substantial benefit to patients with sporadic amyotrophic lateral sclerosis (SALS). Five SALS patients, aged 51-75 years, being treated with riluzole underwent CSF-filtration daily over five days (group A). Five other SALS patients, aged 52-70 years, were treated only with riluzole (group B). Although all five patients in the first group reported a subjective benefit following CSF- filtration, the Norris score, the Frenchay score, the vital capacity, the ulnar nerve F-wave persistence and the peak-ratio of the brachial biceps and anterior tibial muscles did not change significantly after five days of therapy, either in group A or in group B. In conclusion, filtration of 200-250 ml CSF daily, over five days, does not seem to have a substantial therapeutic effect in patients with SALS. PMID:10457394

  2. 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

  3. 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

  4. Motoneuron firing in amyotrophic lateral sclerosis (ALS).

    PubMed

    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

  5. Lateral epicondylalgia: a problem for rural workers.

    PubMed

    Silcock, J; Rivett, D

    2004-01-01

    Lateral Epicondylalgia (LE) (tennis elbow) is a problematic condition for workers in labour intensive industries. The economies of many rural communities are founded on industries such as grape growing, meat and fish processing, fruit processing and winemaking. Workers in those industries are at increased risk of developing work-related upper limb mechanical disorders, including LE. This article reviews current understanding of the aetiology and management of this common condition as an aid to rural health professionals managing this presentation. A variety of treatment options exist for the management of LE with the literature divided on which approach is most effective. However, there is evidence that exercise is a key component of a management strategy. In addition to the current practice of prescribing exercises for the wrist extensor muscles, recent research suggests that appropriate activation of the stabilising muscles of the shoulder and cervical spine also needs to be considered by the rural practitioner. PMID:15885011

  6. Amyotrophic lateral sclerosis: update and new developments

    PubMed Central

    Pratt, Ashley J; Getzoff, Elizabeth D; Perry, J Jefferson P

    2012-01-01

    Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease. It is typically characterized by adult-onset degeneration of the upper and lower motor neurons, and is usually fatal within a few years of onset. A subset of ALS patients has an inherited form of the disease, and a few of the known mutant genes identified in familial cases have also been found in sporadic forms of ALS. Precisely how the diverse ALS-linked gene products dictate the course of the disease, resulting in compromised voluntary muscular ability, is not entirely known. This review addresses the major advances that are being made in our understanding of the molecular mechanisms giving rise to the disease, which may eventually translate into new treatment options. PMID:23019386

  7. 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.

  8. 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)

  9. 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

  10. Mechanical contributions to chronic lateral ankle instability.

    PubMed

    Hubbard, Tricia J; Hertel, Jay

    2006-01-01

    Lateral ankle sprains are one of the most common athletic injuries. Even more concerning is the high recurrence rate after an initial sprain. The development of repetitive ankle sprains and persistent symptoms after injury has been termed chronic ankle instability (CAI). One of the purported causes of CAI is mechanical ankle instability (MAI).MAI results in abnormal ankle mechanics. Both hypermobility and hypomobility may change a joint's axis of rotation and result in abnormal joint mechanics. The role of hypermobility, or laxity, has been examined extensively in the literature, but more recently the role of hypomobility has also been examined. There may be a relationship between the two, with implications at the talocrural, subtalar, and inferior tibiofibular joints.Assessment and treatment should focus on both hypermobility and hypomobility and although injury may seem to be isolated to the talocrural joint, the inferior tibiofibular and subtalar joints should also be thoroughly examined. PMID:16526836

  11. 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.

  12. 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

  13. 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 Iraz 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 Iraz volcano with related consequences. Finally, this initiative will invite researchers interested in such topic to join future studies in these Costarrican volcanoes.

  14. 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

  15. Footballer's Lateral Meniscus: Anterior Horn Tears of the Lateral Meniscus with a Stable Knee

    PubMed Central

    Hagino, Tetsuo; Ochiai, Satoshi; Sato, Eiichi; Watanabe, Yoshiyuki; Senga, Shinya

    2011-01-01

    This paper aimed to identify the characteristics of isolated anterior horn tear of the lateral meniscus in footballers who underwent arthroscopic surgery. We identified 8 patients with stable knee and no ligament injury, who had only isolated anterior horn tear of the lateral meniscus between 2007 and 2009. All 8 patients were footballers, comprising 7 men and 1 woman with mean age of 18.6 years. Arthroscopy revealed multiple longitudinal tears in 2 patients, longitudinal tear in 2 patients, degenerative tear in 3 patients, and flap tear in 1 patient. Two patients were treated by repair, five by partial excision, and one by rasping only. The mean Lysholm score was 65 before surgery and recovered to 89 at the last followup, on average 12 months after surgery. Anterior horn tear of the lateral meniscus in footballers with a stable knee is characterized by pain at the anterolateral aspect of the knee during knee extension, especially when kicking a ball, and pain during weight-bearing knee extension, together with MRI finding of hyperintense signal in the anterior horn of the lateral meniscus. Preoperative diagnosis may be possible based on these findings in footballers. PMID:22084745

  16. 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 ...

  17. Variable left-hemisphere language and orthographic lateralization reduces right-hemisphere face lateralization.

    PubMed

    Dundas, Eva M; Plaut, David C; Behrmann, Marlene

    2015-05-01

    It is commonly believed that, in right-handed individuals, words and faces are processed by distinct neural systems: one in the left hemisphere (LH) for words and the other in the right hemisphere (RH) for faces. Emerging evidence suggests, however, that hemispheric selectivity for words and for faces may not be independent of each other. One recent account suggests that words become lateralized to the LH to interact more effectively with language regions, and subsequently, as a result of competition with words for representational space, faces become lateralized to the RH. On this interactive account, left-handed individuals, who as a group show greater variability with respect to hemispheric language dominance, might be expected to show greater variability in their degree of RH lateralization of faces as well. The current study uses behavioral measures and ERPs to compare the hemispheric specialization for both words and faces in right- and left-handed adult individuals. Although both right- and left-handed groups demonstrated LH over RH superiority in discrimination accuracy for words, only the right-handed group demonstrated RH over LH advantage in discrimination accuracy for faces. Consistent with this, increased right-handedness was related to an increase in RH superiority for face processing, as measured by the strength of the N170 ERP component. Interestingly, the degree of RH behavioral superiority for face processing and the amplitude of the RH N170 for faces could be predicted by the magnitude of the N170 ERP response to words in the LH. These results are discussed in terms of a theoretical account in which the typical RH face lateralization fails to emerge in individuals with atypical language lateralization because of weakened competition from the LH representation of words. PMID:25390197

  18. IQ, fetal testosterone and individual variability in children's functional lateralization.

    PubMed

    Mercure, Evelyne; Ashwin, Emma; Dick, Frederic; Halit, Hanife; Auyeung, Bonnie; Baron-Cohen, Simon; Johnson, Mark H

    2009-10-01

    Previous event-related potential (ERP) studies have revealed that faces and words show a robust difference in the lateralization of their N170. The present study investigated the development of this differential lateralization in school-age boys. We assessed the potential role of fetal testosterone (FT) level as a factor biasing the prenatal development of lateralization, and the role of reading skill and Verbal IQ as factors predicting left lateralization for words in childhood. The adult pattern of differential N170 lateralization for faces and words was not present in a group of 26 school-age boys. This suggests that N170 lateralization only appears with years of experience with these stimulus categories or with late childhood maturation. FT level measured by amniocentesis did not account for a significant part of the individual variability in lateralization. Verbal IQ correlated with the degree of left lateralization of the N170 to words, but this effect was not specific to language abilities and language lateralization. A strong correlation was observed between the degree of left lateralization for words and the degree of left lateralization for faces, and both lateralization scores correlated with Verbal and Performance IQ. Possible explanations for these results are discussed along with ERP correlates of words and faces in school-age boys. PMID:19422841

  19. The Relationship Between Lateral Dominance and Divergent Cognitive Thought.

    ERIC Educational Resources Information Center

    Williams, Barbara B.

    This study was designed to explore the relationship of lateral dominance to divergent cognitive thought. According to the screening results of the Harris Tests of Lateral Dominance, 36 subjects ranging from 9-12 years were divided equally into three groups of left, right, and mixed lateral dominance. In order to measure divergent cognitive

  20. 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...