Science.gov

Sample records for modified anterior approach

  1. Modified Supraorbital Keyhole Approach to Anterior Circulation Aneurysms

    PubMed Central

    Kim, Yuhee; Park, Cheol Wan; Kim, Myeong Jin; Choi, Dae Han; Kim, Yeon Jun; Park, Kawngwoo

    2016-01-01

    Objective To select a surgical approach for aneurysm clipping by comparing 2 approaches. Materials and Methods 204 patients diagnosed with subarachnoid hemorrhage treated by the same neurosurgeon at a single institution from November 2011 to October 2013, 109 underwent surgical clipping. Among these, 40 patients with Hunt and Hess or Fisher grades 2 or lower were selected. Patients were assigned to Group 1 (supraorbital keyhole approach) or Group 2 (modified supraorbital approach). The prognosis according to the difference between the two surgical approaches was retrospectively compared. Results Supraorbital keyhole approach (Group 1) was performed in 20 aneurysms (50%) and modified supraorbital approach (Group 2) was used in 20 aneurysms. Baseline characteristics of patients did not differ significantly between two groups. Total operative time (p = 0.226), early ambulation time (p = 0.755), length of hospital stay (p = 0.784), Glasgow Coma Scale at discharge (p = 0.325), and Glasgow Outcome Scale scores (p = 0.427) did not show statistically significant differences. The amount of intraoperative hemorrhage was significantly lower in the supraorbital keyhole approach (p < 0.05). Conclusion The present series demonstrates the safety and feasibility of the two minimal invasive surgical techniques for clipping the intracranial aneurysms. The modified supraorbital keyhole approach was associated with more hemorrhage than the previous supraorbital keyhole approach, but did not exhibit differences in clinical results, and provided a better surgical view and convenience for surgeons in patients with Hunt and Hess or Fisher grades 2 or lower. PMID:27114960

  2. Correction of anterior crossbite using modified transparent aligners: An esthetic approach

    PubMed Central

    Abraham, K. Korath; James, Arun Roy; Thenumkal, Elza; Emmatty, Tharian

    2016-01-01

    Anterior crossbite results from the abnormal axial inclination of one or more anterior teeth. It is a major esthetic and functional anomaly which has to be corrected in the primary and early mixed dentition period to allow the normal development of maxilla and mandible as well as the occlusion. Several treatment options are available to correct the problem. A unique appliance, “modified transparent tray aligners” was used to correct the anterior crossbite in an 8-year-old child. The clinical presentation, fabrication of the appliance, and the outcome are discussed.

  3. The modified lateral supraorbital approach for tumors of the petroclival junction extending into the anterior cerebellopontine area.

    PubMed

    Lim, Jaejoon; Cho, Kyunggi

    2016-05-01

    Various surgical approaches for the removal of meningioma and trigeminal schwannoma in the petroclival junction (PCJ) and anterior cerebellopontine area (CPA) have been described previously. In this study, we compared the surgical outcomes of the combined petrosal approach and a modified lateral supraorbital (MLSO) approach and evaluated the reliability and safety of the MLSO approach. Fifty patients underwent surgical treatment using the combined petrosal or MLSO approach between 1996 and 2011. We retrospectively analyzed the clinical data and compared the two approaches. Among 50 patients, 27 patients underwent operation through the combined petrosal approach and 23 underwent operation through the MLSO approach. The operation time of the MLSO approach was significantly shorter than that of the combined petrosal approach (p = 0.03). There was no significant difference in the gross total resection rate between the two approaches (p = 0.67). After the operation, the improvement in Karnofsky performance score and Mean Glasgow outcomes scales were better in the MLSO approach, but without statistical significance (p = 0.723, p = 0.20 respectively). Complications occurred more often with the combined petrosal approach than with MLSO. Facial nerve palsy was the most common complication, followed by hearing difficulty. The frequency of these two complications was higher in the combined petrosal approach. Various tumors occurring in the PCJ and anterior CPA remain a challenging problem for neurosurgeons. The new modified approach of MLSO yielded good surgical results for these tumors compared to the combined petrosal approach. Therefore, the MLSO approach might be a good option for removal of tumors in the PCJ including anterior CPA. PMID:26886578

  4. A Novel Approach to Regain Anterior Space Using Modified 2 by 3 Fixed Appliance: A Report of Two Cases.

    PubMed

    Mohammad, Ziauddin; Cheruku, Sampath Reddy; Penmetcha, Sarada; Bagalkotkar, Apeksha; Kumari, Surabhi

    2015-10-01

    Early loss of permanent anterior teeth in growing children has a psychological impact on the child. Anterior teeth are important both aesthetically and functionally. When a permanent tooth is lost, the teeth adjacent to the created space tend to migrate into the space resulting in the space loss. Management of regaining space with the removable appliance always depends on child cooperation for using the appliance as well as for the recall visits. The advantages of fixed appliances over the removable appliances are minimal discomfort, reduced need for patient cooperation and increased control of tooth movements in all three directions of space. Thus, a short course of fixed appliance like the modified 2 by 3 fixed appliance followed by fixed functional space maintainer could be an ideal treatment option for such cases. PMID:26557631

  5. A Novel Approach to Regain Anterior Space Using Modified 2 by 3 Fixed Appliance: A Report of Two Cases

    PubMed Central

    Cheruku, Sampath Reddy; Penmetcha, Sarada; Bagalkotkar, Apeksha; Kumari, Surabhi

    2015-01-01

    Early loss of permanent anterior teeth in growing children has a psychological impact on the child. Anterior teeth are important both aesthetically and functionally. When a permanent tooth is lost, the teeth adjacent to the created space tend to migrate into the space resulting in the space loss. Management of regaining space with the removable appliance always depends on child cooperation for using the appliance as well as for the recall visits. The advantages of fixed appliances over the removable appliances are minimal discomfort, reduced need for patient cooperation and increased control of tooth movements in all three directions of space. Thus, a short course of fixed appliance like the modified 2 by 3 fixed appliance followed by fixed functional space maintainer could be an ideal treatment option for such cases. PMID:26557631

  6. Hip replacement by a minimal anterior approach.

    PubMed

    Paillard, P

    2007-08-01

    The mini-incision anterior approach in total hip replacement is not new, but uses a shorter incision than the traditional Hueter approach, typically only 6-8 cm in length. Despite its size, the single anterior incision allows good exposure. It is very atraumatic, preserves muscles and tendons, and allows the patient early mobilisation and fast postoperative recovery. Although, a special table (e.g., a Judet table) and specific tools (e.g., a curved reamer) are needed to perform hip replacement via the mini-anterior approach, any kind of hip prosthesis (cemented or uncemented) can be implanted. As there is a significant learning curve in mastering the mini-incision anterior approach, surgeons are advised to start with a longer incision and then to decrease its length with increasing experience. PMID:17657491

  7. Anterior Approach Total Hip Replacement

    MedlinePlus Videos and Cool Tools

    ... this view, I mean this is the traditional Smith Meet Jeu De view of the acetabulum,. I ... re using only part of what’s called the “Smith-Peterson approach.” The true Smith- Peterson, you would ...

  8. The Anterior Approach for Total Hip Replacement.

    PubMed

    Hochfelder, Jason P; Davidovitch, Roy I

    2016-03-01

    The anterior approach for total hip replacements has recently gained popularity. Some authors report faster recoveries and decreased dislocation rated with no increased risk of complications. However others claim no difference in outcomes when compared to other approaches yet an increase in complication rates. This paper provides a brief history of the approach, discusses various indications and contraindications, preoperative considerations, surgical techniques, and postoperative protocols. PMID:26977549

  9. The Modified Mid-Anterior Portal for Hip Arthroscopy

    PubMed Central

    Matsuda, Dean K.; Villamor, Angel

    2014-01-01

    The modified mid-anterior portal is a utilitarian hip arthroscopy working portal that permits dual-portal comprehensive surgery for femoroacetabular impingement and related chondrolabral procedures without the need for interportal exchange. Its distal location facilitates labral reparative and reconstructive procedures while minimizing iatrogenic acetabular chondral damage. The relatively lateral location permits instrument navigation not only along the anterosuperior acetabular rim and anterolateral proximal femur typically required for acetabuloplasty and femoroplasty but even to the posterior regions of the hip in cases of global pincer femoroacetabular impingement and posterior extensions of cam morphology and the anteromedial proximal femur while avoiding direct injury to the lateral femoral cutaneous nerve. PMID:25276606

  10. Minimally invasive surgery of the anterior skull base: transorbital approaches

    PubMed Central

    Gassner, Holger G.; Schwan, Franziska; Schebesch, Karl-Michael

    2016-01-01

    Minimally invasive approaches are becoming increasingly popular to access the anterior skull base. With interdisciplinary cooperation, in particular endonasal endoscopic approaches have seen an impressive expansion of indications over the past decades. The more recently described transorbital approaches represent minimally invasive alternatives with a differing spectrum of access corridors. The purpose of the present paper is to discuss transorbital approaches to the anterior skull base in the light of the current literature. The transorbital approaches allow excellent exposure of areas that are difficult to reach like the anterior and posterior wall of the frontal sinus; working angles may be more favorable and the paranasal sinus system can be preserved while exposing the skull base. Because of their minimal morbidity and the cosmetically excellent results, the transorbital approaches represent an important addition to established endonasal endoscopic and open approaches to the anterior skull base. Their execution requires an interdisciplinary team approach. PMID:27453759

  11. Anterior muscle sparing approach for total hip arthroplasty

    PubMed Central

    Moskal, Joseph T; Capps, Susan G; Scanelli, John A

    2013-01-01

    The purpose of this review is to examine the validity of positive claims regarding the direct anterior approach (DAA) with a fracture table for total hip arthroplasty. Recent literature regarding the DAA was searched and specific claims investigated including improved early outcomes, speed of recovery, component placement, dislocation rates, and complication rates. Recent literature is positive regarding the effects of total hip arthroplasty with the anterior approach. While the data is not definitive at present, patients receiving the anterior approach for total hip arthroplasty tend to recover more quickly and have improved early outcomes. Component placement with the anterior approach is more often in the “safe zone” than with other approaches. Dislocation rates tend to be less than 1% with the anterior approach. Complication rates vary widely in the published literature. A possible explanation is that the variance is due to surgeon and institutional experience with the anterior approach procedure. Concerns remain regarding the “learning curve” for both surgeons and institutions. In conclusion, it is not a matter of should this approach be used, but how should it be implemented. PMID:23362470

  12. Modified intracanal post for severely mutilated primary anterior teeth

    PubMed Central

    Rallan, Mandeep; Rallan, Neelakshi Singh; Navit, Pragati; Malhotra, Garima

    2013-01-01

    Early childhood caries leads to early damage, discolouration and gross destruction of the maxillary anterior teeth. This leads to difficulty in speech, decreased masticatory efficiency, development of abnormal tongue thrust and subsequent malocclusion, psychological problems and problem with self-esteem, if aesthetics are compromised. Thus, restoration of severely mutilated primary anterior teeth is often considered as a special challenge, especially in an emotionally immature child. This case documents the restoration of severely mutilated incisors in a patient with early childhood caries. PMID:23605834

  13. Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis

    PubMed Central

    Güler, Mete; Yılmaz, Turgut

    2013-01-01

    AIM To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE). METHODS Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach. RESULTS Six of 9 patients were male. The average patients' age was (60±8.1) years. The average period between cataract extraction and onset of signs and symptoms was (3.6±1.3) weeks. The average presenting visual acuity was 0.3±0.1 and the average final post operative visual acuity was 0.7±0.2. The mean follow-up period was (28.1±8.9) weeks. In all patients, the inflammation subsided after surgery. CONCLUSION Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE. PMID:23550103

  14. Approaching the ruptured anterior cruciate ligament.

    PubMed

    Sarraf, Khaled M; Sadri, Amir; Thevendran, Gowreeson; Vedi, Vikas

    2011-08-01

    Anterior cruciate ligament (ACL) disruptions are common injuries that currently hold a fearsome reputation among athletes of all abilities and disciplines. Indeed, if the diagnosis is missed at first presentation, it is difficult to attribute ongoing instability and recurrent injury to an ACL tear. Classically, patients then often improve shortly before repeatedly reinjuring their knee. At some point, the knee may lock, necessitating an arthroscopic meniscectomy. Tragically, this then hastens the progression of joint arthrosis and the decline of the joint function. While the burden of responsibility does not lie solely with the junior doctor or the general practitioner, it is often at the first consultation that the natural history of this devastating injury is decided. The ability to recognise, institute early management and reassure patients with ACL tears about the future is an invaluable asset to the non-specialist junior doctor. Once diagnosed, the responsibility of advising and further counselling of patients with ACL injuries is best left to the orthopaedic knee specialist. Family practitioners and emergency room doctors should not feel pressured to offer advice on specialist areas such as return to sports without reconstruction or indeed the need for reconstruction. Indeed, decisions to return to sports with ACL-deficient knees have all too often led to disastrous reinjury events to the articular cartilage and/or the menisci. PMID:21097944

  15. Midline Anterior Craniofacial Approach for Malignancy

    PubMed Central

    Wellman, Bryan John; Traynelis, Vincent C.; McCulloch, Timothy M.; Funk, Gerry F.; Menezes, Arnold H.; Hoffman, Henry T.

    1999-01-01

    Thirty consecutive cases of midline anterior craniofacial procedures for the treatment of malignant neoplasms arising from the paranasal sinuses were reviewed. Posterior and lateral base craniofacial procedures were specifically excluded. This review compares the results, in terms of survival and major complication rate, between en bloc and piecemeal resections. The average follow-up was 4 years and 3 months. Sixteen patients were treated with an en bloc resection. The major complication rate was 31%. One-year survival rate was 94% for the en bloc resection group, 67% for patients with positive margins, and 100% for patients with clear margins. Three-year survival for en bloc resection dropped to 56, 33, and 67%, respectively. Fourteen patients were treated with piecemeal resections. The major complication rate was 21%. One-year survival rate was 83% for the piecemeal resection group, 60% for patients with positive margins, and 100% for patients with clear margins. Three-year survival dropped to 70, 60, and 80%, respectively. Although it is considered desirable to obtain an en bloc resection in some craniofacial procedures, we conclude that a piecemeal resection is a viable alternative in situations where an en bloc procedure is difficult to obtain safely. ImagesFigure 1p43-bFigure 2p44-b PMID:17171080

  16. Superficial temporal artery to proximal posterior cerebral artery bypass through the anterior temporal approach

    PubMed Central

    Takeuchi, Satoru; Tanikawa, Rokuya; Tsuboi, Toshiyuki; Noda, Kosumo; Oda, Junpei; Miyata, Shiro; Ota, Nakao; Yoshikane, Tsutomu; Kamiyama, Hiroyasu

    2015-01-01

    Background: The superficial temporal artery (STA) to proximal posterior cerebral artery (PCA) (P2 segment) bypass is one of the most difficult procedures to perform because the proximal PCA is located deep and high within the ambient cistern. STA to proximal PCA bypass is usually performed through a subtemporal approach or posterior transpetrosal approach, and rarely through a transsylvian approach. The aim of this study was to describe the operative technique of STA to proximal PCA bypass through a modified transsylvian approach (anterior temporal approach). Methods: STA to proximal PCA bypass was performed through an anterior temporal approach in three patients with intracranial aneurysm. We describe the details of the surgical technique. Results: The STA was successfully anastomosed to the proximal PCA in all cases. One patient suffered hemiparesis and aphasia due to infarction in the anterior thalamoperforating artery territory. Conclusions: STA to proximal PCA bypass can be performed through an anterior temporal approach in selected patients. We recommend that every precaution, including complete hemostasis, placement of cellulose sponges beneath the recipient artery to elevate the site of the anastomosis, and placement of a continuous drainage tube at the bottom of the operative field to avoid blood contamination during the anastomosis, should be taken to shorten the temporary occlusion time. PMID:26097774

  17. Combined operative technique with anterior surgical approach and video-assisted thoracoscopic surgical lobectomy for anterior superior sulcus tumours.

    PubMed

    Yokoyama, Yuhei; Chen, Fengshi; Aoyama, Akihiro; Sato, Toshihiko; Date, Hiroshi

    2014-11-01

    Video-assisted thoracoscopic surgery (VATS) has been widely used, but surgical resections of superior sulcus tumours remain challenging because of their anatomical location. For such cases, less-invasive procedures, such as the anterior transcervical-thoracic and transmanubrial approaches, have been widely performed because of their excellent visualization of the subclavian vessels. Recently, a combined operative technique with an anterior surgical approach and VATS for anterior superior sulcus tumours has been introduced. Herein, we report three cases of anterior superior sulcus tumours successfully resected by surgical approaches combined with a VATS-based lobectomy. In all cases, operability was confirmed by VATS, and upper lobectomies with hilar and mediastinal lymph node dissections were performed. Subsequently, dissections of the anterior inlet of the tumours were performed using the transmanubrial approach in two patients and the anterior trans-cervical-thoracic approach in one patient. Both approaches provided excellent access to the anterior inlet of the tumour and exposure of the subclavian vessels, resulting in radical resection of the tumour with concomitant resection of the surrounding anatomical structures, including the chest wall and vessels. In conclusion, VATS lobectomy combined with the anterior surgical approach might be an excellent procedure for the resection of anterior superior sulcus tumours. PMID:25028075

  18. Modified Occlusal Rim Design and Use of Phonetics to Determine Anterior Tooth Position and Vertical Dimension: A Clinical Report.

    PubMed

    Romero, Mario F; DeRosa, Thomas A

    2016-06-01

    Prosthetic rehabilitation of edentulous patients can sometimes pose many clinical challenges for the clinician. The importance of correct vertical and horizontal positioning of the anterior teeth so that the completed denture is esthetically pleasing while being functionally correct has been well documented in the literature. Different techniques have been proposed whereby a conventional occlusal rim is used. The wax-rim thickness of this design can interfere with the neutral zone, making normal phonetics difficult. In this report, a completely edentulous patient received treatment using a modified occlusal rim so that phonetics could be used to determine the anterior tooth position and vertical dimension, following a strict adherence to a clinical protocol. The methodology involved the use of heat-processed resin record bases and a thin segment of baseplate wax that mimics anterior teeth. This approach resulted in a more natural feeling for the patient and provided the clinician the necessary information for the laboratory, which was easily communicated. PMID:27525732

  19. A Conservative Treatment Approach to Replacing a Missing Anterior Tooth

    PubMed Central

    Singh, Kunwarjeet; Gupta, Nidhi; Unnikrishnan, Nandini; Kapoor, Vikram; Arora, Dhruv; Khinnavar, Poonam K.

    2014-01-01

    An implant-supported crown or conventionally fixed partial denture is the most common treatment modality to replace a missing anterior tooth but a more conservative approach, with a fiber reinforced composite resin FPD, can be used to replace a missing anterior tooth in young patients or when the patient does not agree for an implant, or conventional FPD or RPD therapy. It is an esthetic, conservative single sitting chairside procedure which can be used as a definitive treatment alternative in certain clinical situations for esthetic and functional replacement of a missing anterior tooth. To achieve desirable results, putty matrix was used for proper positioning of the pontic during direct fabrication of FRCFPD. PMID:25254122

  20. Zygomatic Anterior Subtemporal Approach for Lesions in the Interpeduncular Cistern

    PubMed Central

    Deda, Haluk; Ugur, Hasan Çaglar

    2001-01-01

    The interpeduncular cistern is a difficult region to approach through conventional methods due to its deep location and important adjacent neurovascular structures. Therefore, it is usually difficult to expose the region sufficiently. Technical problems associated with various surgical approaches have led to emergence of combined approaches and their modifications (i.e., the removal of the zygomatic arch). In addition, a frontotemporal craniotomy is reported to provide a wide exposure of the anterior temporal base, thus allowing oblique access to the interpeduncular cistern with minimal brain retraction. This study describes clinicians' experience and the surgical results of 24 patients who underwent a zygomatic anterior subtemporal approach. ImagesFigure 1Figure 2 PMID:17167628

  1. Anterior EEG Asymmetry and the Modifier Model of Autism

    ERIC Educational Resources Information Center

    Burnette, Courtney P.; Henderson, Heather A.; Inge, Anne Pradella; Zahka, Nicole E.; Schwartz, Caley B.; Mundy, Peter C.

    2011-01-01

    Individual differences in the expression of autism complicate research on the nature and treatment of this disorder. In the Modifier Model of Autism (Mundy et al. 2007), we proposed that individual differences in autism may result not only from syndrome specific causal processes, but also from variability in generic, non-syndrome specific…

  2. Anterior approaches for cervical spondylotic myelopathy: which? When? How?

    PubMed

    Emery, Sanford E

    2015-04-01

    Cervical spondylotic myelopathy is a degenerative disorder with an unfavorable natural history. Surgical treatment options have evolved substantially over time, with both anterior and posterior methods proving successful for certain patients with specific characteristics. Anterior decompression of the spinal canal plus fusion techniques for stabilization has several advantages and some disadvantages when compared to posterior options. Understanding the pros and cons of the approaches and techniques is critical for the surgeon to select the best operative treatment strategy for any given patient to achieve the best outcome. Multiple decision-making factors are involved, such as sagittal alignment, number of levels, shape of the pathoanatomy, age and comorbidities, instability, and pre-operative pain levels. Any or all of these factors may be relevant for a given patient, and to varying degrees of importance. Choice of operative approach will therefore be dependent on patient presentation, risks of that approach for a given patient, and to some degree surgeon experience. PMID:25652554

  3. Evaluation of functional outcomes and complications following modified Latarjet reconstruction in athletes with anterior shoulder instability

    PubMed Central

    van der Watt, Christelle; de Beer, Joe F

    2015-01-01

    Background The optimal management of anterior shoulder instability in athletes continues to be a challenge. The present study aimed to evaluate the functional outcomes of athletes with anterior shoulder instability following modified Latarjet reconstruction through assessing the timing of return to sport and complications. Methods Retrospective assessment was performed of athletes (n = 56) who presented with recurrent anterior shoulder instability and were treated with modified congruent arc Latarjet reconstruction over a 1-year period. Rugby union was the predominant sport performed. Pre-operative instability severity index scores were assessed. Postoperative complications were recorded as was the time taken for the athlete to return to sport. Results Arthroscopic evaluation revealed that 86% of patients had associated bony lesions affecting the glenohumeral joint. The overall complication rate relating to the Latarjet reconstruction was 7%. No episodes of recurrent shoulder instability were noted. Of the patients, 89% returned to competitive sport at the same level as that prior to surgery. The mean time post surgery to returning to full training was 3.2 months. Conclusions The modified congruent arc Latarjet procedure facilitates early rehabilitation and return to sport. These results support our systematic management protocol of performing modified Latarjet surgery in contact sport athletes with recurrent anterior instability.

  4. The anterior interhemispheric approach to a third ventricular cavernous malformation.

    PubMed

    Martirosyan, Nikolay L; Kalani, M Yashar S; Nakaji, Peter; Spetzler, Robert F

    2016-01-01

    The anterior interhemispheric approach is a workhorse for treatment of lesions in the third ventricle. In this case, we demonstrate the utility of this approach for resecting a complex third ventricular cavernous malformation. We discuss patient positioning, optimal location of the craniotomy, and surgical resection techniques for safe removal of these lesions. We also demonstrate the importance of gravity retraction using the falx to prevent injury to the dominant frontal lobe. The video can be found here: https://youtu.be/38woc28er7M . PMID:26722693

  5. The Transcallosal Anterior Interfoniceal Approach: A Microsurgical Anatomy Study

    PubMed Central

    Graziano, F.; Ganau, M.; Meccio, F.; Iacopino, D. G.; Ulm, A. J.

    2014-01-01

    Objectives A plethora of surgical strategies have been described to reach deep-seated lesions situated within the third ventricle including the Rosenfeld, or transcallosal anterior interfoniceal (TAIF), approach. First introduced in 2001, it consists of a small callosotomy followed by the midline transseptal dissection of fornices to enter the roof of the third ventricle. The aim of this microsurgical anatomy study is to describe and show each stage of the surgical procedure, focusing on the possible trajectories to anatomical landmarks. Participants A total of 20 adult cadaveric specimens were used in this study. Using ×3 to ×40 magnifications, the surgical dissection was performed in a stepwise fashion, and the transcallosal anterior interforniceal approach was performed, analyzed, and described. Results In 5 specimens of 10, a cavum septum pellucidum was depicted. In 5 cases of 20 after the callosotomy ,the lateral ventricular cavities were reached. Different orientation of the microscope allowed us to define three surgical trajectories to visualize the region of interest without exposing important functional areas. Conclusion The TAIF represents a minimally invasive approach to the third ventricle; its tricky surgical steps make appropriate anatomical dissection training essential to become confident and skilled in performing this approach. PMID:26225299

  6. The anterior approach to the shoulder from the lateral position.

    PubMed

    Steingard, M A

    1996-11-01

    An alternative method of operating on the anterior structures of the shoulder is presented. With the patient in the decubitus lateral position, the joint is readily accessible without cutting the conjoined tendon or performing an osteotomy of the coracoid process. The lateral decubitus positioning of the patient allows the surgeon to reinsert the arthroscope into the shoulder after open surgery to check the repair. This approach eliminates repositioning the patient to the supine position. It can be performed without a surgical assistant if the scrub technician is able to rotate the arm at certain times during the operation. PMID:8959262

  7. Anatomical reconstruction of the anterior cruciate ligament: a logical approach

    PubMed Central

    Gali, Julio Cesar

    2015-01-01

    We describe the surgical approach that we have used over the last years for anterior cruciate ligament (ACL) reconstruction, highlighting the importance of arthroscopic viewing through the anteromedial portal (AMP) and femoral tunnel drilling through an accessory anteromedial portal (AMP). The AMP allows direct view of the ACL femoral insertion site on the medial aspect of the lateral femoral condyle, does not require guides for anatomic femoral tunnel reaming, prevents an additional lateral incision in the distal third of the thigh (as would be unavoidable when the outside-in technique is used) and also can be used for double-bundle ACL reconstruction. PMID:26417571

  8. Systematic Approach for Anterior Corpectomy through a Transthoracic Exposure.

    PubMed

    Puvanesarajah, Varun; Lina, Ioan A; Liauw, Jason A; Lo, Sheng-Fu L; Elder, Benjamin D; Wolinsky, Jean-Paul; Bydon, Ali; Sciubba, Daniel M; Gokaslan, Ziya L; Witham, Timothy F

    2016-01-01

    While several approaches have been suggested for performing a transthoracic corpectomy of the thoracolumbar spine, the steep learning curve and high risk of operative morbidity often dissuades its use clinically. As a result, posterior approaches have been more frequently used, though transthoracic approaches often allow for improved access for more complete decompression of the spinal cord. Additionally, the transthoracic approach allows for more complete removal of vertebral body lesions along with better access for reconstruction of the anterior column. Here we describe a distinct nine-step thoracolumbar corpectomy technique via a transthoracic approach. We include a description of one patient with one-year follow-up to further illustrate the surgical approach and relevant surgical anatomy. We have used this technique for maximal bi-pedicular decompression afforded by the lateral approach. We discuss key anatomical considerations, perioperative techniques and potential complications of the operation. The presented nine-step transthoracic corpectomy technique is a safe method for providing adequate neurological decompression and vertebral body tumor removal. PMID:27400115

  9. Current approach in diagnosis and management of anterior uveitis

    PubMed Central

    Agrawal, Rupesh V; Murthy, Somasheila; Sangwan, Virender; Biswas, Jyotirmay

    2010-01-01

    Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated appropriately. The present article will assist ophthalmologists in accurately diagnosing anterior uveitis, improving the quality of care rendered to patients with anterior uveitis, minimizing the adverse effects of anterior uveitis, developing a decision-making strategy for management of patients at risk of permanent visual loss from anterior uveitis, informing and educating patients and other healthcare practitioners about the visual complications, risk factors, and treatment options associated with anterior uveitis. PMID:20029142

  10. Image-guided modified deep anterior lamellar keratoplasty (DALK) corneal transplant using intraoperative optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Tao, Yuankai K.; LaBarbera, Michael; Ehlers, Justis P.; Srivastava, Sunil K.; Dupps, William J.

    2015-03-01

    Deep anterior lamellar keratoplasty (DALK) is an alternative to full-thickness corneal transplant and has advantages including the absence of allograft rejection; shortened duration of topical corticosteroid treatment and reduced associated risk of glaucoma, cataract, or infection; and enables use of grafts with poor endothelial quality. DALK begins by performing a trephination of approximately 80% stromal thickness, as measured by pachymetry. After removal of the anterior stoma, a needle is inserted into the residual stroma to inject air or viscoelastic to dissect Descemet's membrane. These procedures are inherently difficult and intraoperative rates of Descemet's membrane perforation between 4-39% have been reported. Optical coherence tomography (OCT) provides high-resolution images of tissue microstructures in the cornea, including Descemet's membrane, and allows quantitation of corneal layer thicknesses. Here, we use crosssectional intraoperative OCT (iOCT) measurements of corneal thickness during surgery and a novel micrometeradjustable biopsy punch to precision-cut the stroma down to Descemet's membrane. Our prototype cutting tool allows us to establish a dissection plane at the corneal endothelium interface, mitigates variability in cut-depths as a result of tremor, reduces procedure complexity, and reduces complication rates. iOCT-guided modified DALK procedures were performed on 47 cadaveric porcine eyes by non-experts and achieved a perforation rate of ~5% with a mean corneal dissection time <18 minutes. The procedure was also successful performed on a human donor eye without perforation. Our data shows the potential for iOCT-guided precision anterior segment surgery without variability as a result of tremor and improvements to standard clinical care.

  11. Craniofacial resection: decreased complication rate with a modified subcranial approach.

    PubMed

    Ross, D A; Marentette, L J; Moore, C E; Switz, K L

    1999-01-01

    The authors have successfully utilized a modified subcranial approach to the anterior skull base, based upon the procedure first described by Joram Raveh, as an alternative to standard craniofacial resection. The complication rate of this procedure in 31 consecutive cases (28 tumors, 2 congenital malformations, and 1 mucocele) has been 19.4% with no permanent complications, no deaths, no new neurological deficits, no brain injuries, no infections, and no seizures. Minor complications without permanent sequelae included two cases of tension pnenmocephalus, a subdural hygroma, two transient cerebrospinal fluid leaks, and a case of bacterial meningitis secondary to fecal contamination of a lumbar drain in a child. Average length of hospitalization was 7.1 days (range 2 to 16 days). The overall complication rate is considerably below the complication rate for other reported craniofacial procedures. We describe the technique we have used and the results. The subcranial approach as described herein provides wide exposure of the anterior cranial base without brain retraction, does not require prolonged operating times or hospitalization, and has a potentially lower complication rate than reported for other transfrontal transbasal approaches. PMID:17171124

  12. The Transconjunctival Transorbital Approach: A Keyhole Approach to the Midline Anterior Skull Base

    PubMed Central

    Raza, Shaan M.; Quinones-Hinojosa, Alfredo; Lim, Michael; Owusu Boahene, Kofi D.

    2015-01-01

    OBJECTIVE To report an initial experience with a medial transorbital approach to the midline skull base performed via a transconjunctival incision. METHODS The authors retrospectively reviewed their clinical experience with this approach in the management of benign cranial base pathology. Preoperative imaging, intraoperative records, hospitalization charts, and postoperative records were reviewed for relevant data. RESULTS During the period 2009–2011, six patients underwent a transconjunctival craniotomy performed by a neurosurgeon and otolaryngologist–head and neck surgeon working together. The indications for surgery were esthesioneuroblastoma in one patient, juvenile angiofibroma in one patient, Paget disease in one patient, and recalcitrant cerebrospinal fluid leaks in three patients. Three patients had prior cranial base surgery (either open craniotomy or an endonasal approach) done at another institution. The mean length of stay was 3.8 days; mean follow-up was 6 months. Surgery was considered successful in all cases (negative margins or no leak recurrence); diplopia was noted in one patient postoperatively. CONCLUSIONS The transconjunctival medial orbital craniectomy provides a minimally invasive keyhole approach to lesions located anteriorly along the anterior cranial fossa that are in the midline with lateral extension over the orbital roof. Based on our initial experience with this technique, the working space afforded limits complex surgical dissection; this approach is primarily well suited for less extensive pathology. PMID:22722037

  13. Multidisciplinary treatment of anterior worn dentition: a staged approach.

    PubMed

    Wilson, Chris

    2015-03-01

    This case involving a male patient with long-standing wear on his anterior teeth demonstrates the importance of an accurate risk profile and prognosis. It also shows an example of a patient who, as is frequently the case, was aware of his problem but chose not to address it until after many years, being finally motivated by a change in marital status. Upon examination, it was determined that the severe attrition was due to the position of the teeth, and the functional diagnosis was a constricted chewing pattern. Orthodontic therapy was a central aspect of the treatment plan, followed initially by a composite trial restoration of the anterior teeth, and, finally, placement of porcelain crowns. Careful communication among the treating dentist, orthodontist, and the dental laboratory at specific phases of the treatment proved to play a pivotal role in achieving an exceptional esthetic result and stable functional bite. PMID:25822746

  14. A conservative approach toward restoration of fractured anterior tooth

    PubMed Central

    Goenka, Puneet; Sarawgi, Aditi; Dutta, Samir

    2012-01-01

    Reattachment of the fractured anterior tooth is a highly conservative and aesthetic treatment that has gained popularity in the recent past. Presented here is one such case in which a combination of external enamel bevel and internal dentinal groove has been used to enhance the bonding between the fractured fragment and the remaining tooth. The treatment was found to be successful both functionally and aesthetically at the 18-month follow-up. PMID:22629071

  15. Modified Facial Translocation Approach in a One-Month Old With a Skullbase Tumor.

    PubMed

    Klosterman, Tristan; Tatum, Sherard

    2016-05-01

    The authors present a patient of a neonate with a skull base extragonadal germ cell tumor requiring a modified facial translocation approach for resection. A 1-week-old female presented with right proptosis, eyelid edema, and nasal obstruction. Imaging revealed a 3-cm right-sided skull base mass involving the right maxillary, ethmoid, sphenoid sinuses, orbit, infratemporal fossa, and cavernous sinus via skull base erosion. The lesion was refractory to chemotherapy and required surgical excision. A modified facial translocation approach with preservation of anterior maxillary bone vascularization was used to remove the tumor, which was found to be teratoma with yolk-sac features. The patient tolerated surgery well and was noted to have minimally affected facial skeleton growth at 2-year follow-up. This modified facial translocation approach allowed safe access to this anterior skull base tumor with acceptable morbidity and mild facial growth effects so far. PMID:27092923

  16. A Guided, Conservative Approach for the Management of Localized Mandibular Anterior Tooth Wear.

    PubMed

    Mehta, Shamir B; Francis, Selar; Banerji, Subir

    2016-03-01

    The successful management of the worn mandibular anterior dentition may present an awkward challenge to the dental operator. The purpose of this article is to describe a case report illustrating the use of a guided, three-dimensional protocol for the ultra-conservative and predictable restoration of the worn lower anterior dentition using direct resin composite. This technique utilizes information based on established biomechanical and occlusal principles to fabricate a diagnostic wax-up, which is duplicated in dental stone. This is used to prepare a vacuum-formed modified stent, assisting the clinician to place directly bonded resin composite restorations to restore the worn lower anterior dentition. The technique, described in 2012 and referred to as 'injection moulding' has the potential to offer optimal form, function and an aesthetic outcome in an efficient manner. CPD/Clinical Relevance: This article aims to describe an alternative technique to simplify the processes involved with restoration of worn lower anterior teeth. PMID:27188126

  17. Clinical Features of Herniated Disc at Cervicothoracic Junction Level Treated by Anterior Approach

    PubMed Central

    Lee, Jun Gue; Kim, Hyeun Sung; Ju, Chang Il

    2016-01-01

    Objective The anterior approach for C7-T1 disc herniation may be challenging because of obstruction by the manubrium and the narrow operative field. This study aimed to investigate the clinical and neurological outcomes of anterior approach for C7-T1 disc herniation. Methods We retrospectively evaluated 13 patients who underwent the anterior approach for C7-T1 disc herniation by a single surgeon within a period of 11 years (2003-2014). The minimum follow-up duration was 6 months. We describe the clinical presentation, radiographic findings, neurological outcome, and related complications. Results Of 372 patients with single-level anterior discectomy and fusion or artificial disc replacement for cervical disc herniation, 13 (3.5%) had C7-T1 disc herniation. The main clinical presentation was unilateral motor weakness in intrinsic hand muscles (11 patients), along with numbness, pain, and tingling sensation that radiate down the arm to the little finger. Most of the patients improved after surgery via the anterior approach. Ten patients underwent successful anterior discectomy and fusion by the standard supramanubrial Smith-Robinson approach, but 2 needed additional manubriotomy and sternotomy. In 1 patient, we performed surgery at a wrong level because the correct level was difficult to identify intraoperatively. Two patients had transient vocal dysfunction, but none had major complications related to injuries of the great vessels such as the thoracic duct or esophagus. Conclusion For patients who require direct anterior decompression for C7-T1 disc herniation, the anterior approach is relatively feasible. However, care should be taken to overcome physical constraints by the manubrium and slope. PMID:27437013

  18. Anterior Ridge Extension Using Modified Kazanjian Technique in Mandible- A Clinical Study

    PubMed Central

    Kumar, Jagannadham Vijay; Chakravarthi, Pandi Srinivas; Sridhar, Meka; Devi, Kolli Naga Neelima; Lingamaneni, Krishna Prasad

    2016-01-01

    Introduction Good alveolar ridge is a prerequisite for successful conventional/ implant supported partial/complete denture. Extensively resorbed ridges with shallow vestibule and high insertion of muscles in to the ridge crest, leads to failure of prosthesis. Success of prosthesis depends on surgical repositioning of mucosa and muscle insertions, which increases the depth of vestibule and denture flange area for retention. So, the study was planned to provide good attached gingiva with adequate vestibular depth using Modified Kazanjian Vestibuloplasty (MKV). Aim To evaluate efficacy of MKV technique for increasing vestibular depth in anterior mandible so that successful prosthesis can be delivered. Efficacy of the technique was evaluated through operating time required, vestibular depth achieved, scarring or relapse and any postoperative complications associated with the healing. Materials and Methods Total of 10 patients were included in the study, who had minimum 20mm of bone height and less than 5mm of vestibular depth for MKV procedure. The results were tabulated and statistical analysis was carried out to assess vestibular depth achieved i.e. from crest of the ridge to junction of attached mucosa both pre and postoperatively. The study results were compared with existing literature. Results Healing of raw surface was uneventful with satisfactory achievement of vestibular depth. The average gain in vestibular depth was 11 mm. The patients had good satisfaction index for prosthesis. Conclusion Even in the era of implant prosthesis Modified Kazanjian technique is worth to practice to achieve good results and overcorrection is not required as that of standard Kazanjian technique. It provides adequate attached gingiva for successful prosthesis. Extension of vestibular depth enables fabrication of better denture flange with improved oral hygiene. This technique does not require hospitalization and additional surgery for grafts. PMID:27042579

  19. Constructal approach to bio-engineering: the ocular anterior chamber temperature

    PubMed Central

    Lucia, Umberto; Grisolia, Giulia; Dolcino, Daniela; Astori, Maria Rosa; Massa, Eugenio; Ponzetto, Antonio

    2016-01-01

    The aim of this work was to analyse the pressure inside the eyes anterior chamber, namedintraocular pressure (IOP), in relation to the biomechanical properties of corneas. The approach used was based on the constructal law, recently introduced in vision analysis. Results were expressed as the relation between the temperature of the ocular anterior chamber and the biomechanical properties of the cornea. The IOP, the elastic properties of the cornea, and the related refractive properties of the eye were demonstrated to be dependent on the temperature of the ocular anterior chamber. These results could lead to new perspectives for experimental analysis of the IOP in relation to the properties of the cornea. PMID:27492652

  20. Constructal approach to bio-engineering: the ocular anterior chamber temperature.

    PubMed

    Lucia, Umberto; Grisolia, Giulia; Dolcino, Daniela; Astori, Maria Rosa; Massa, Eugenio; Ponzetto, Antonio

    2016-01-01

    The aim of this work was to analyse the pressure inside the eyes anterior chamber, namedintraocular pressure (IOP), in relation to the biomechanical properties of corneas. The approach used was based on the constructal law, recently introduced in vision analysis. Results were expressed as the relation between the temperature of the ocular anterior chamber and the biomechanical properties of the cornea. The IOP, the elastic properties of the cornea, and the related refractive properties of the eye were demonstrated to be dependent on the temperature of the ocular anterior chamber. These results could lead to new perspectives for experimental analysis of the IOP in relation to the properties of the cornea. PMID:27492652

  1. Constructal approach to bio-engineering: the ocular anterior chamber temperature

    NASA Astrophysics Data System (ADS)

    Lucia, Umberto; Grisolia, Giulia; Dolcino, Daniela; Astori, Maria Rosa; Massa, Eugenio; Ponzetto, Antonio

    2016-08-01

    The aim of this work was to analyse the pressure inside the eyes anterior chamber, namedintraocular pressure (IOP), in relation to the biomechanical properties of corneas. The approach used was based on the constructal law, recently introduced in vision analysis. Results were expressed as the relation between the temperature of the ocular anterior chamber and the biomechanical properties of the cornea. The IOP, the elastic properties of the cornea, and the related refractive properties of the eye were demonstrated to be dependent on the temperature of the ocular anterior chamber. These results could lead to new perspectives for experimental analysis of the IOP in relation to the properties of the cornea.

  2. Anterior Versus Posterolateral Approach for Total Laparoscopic Splenectomy: A Comparative Study

    PubMed Central

    Ji, Bai; Wang, Yingchao; Zhang, Ping; Wang, Guangyi; Liu, Yahui

    2013-01-01

    Objective: Although the anterior approach is normally used for elective laparoscopic splenectomy (LS), the posterolateral approach may be superior. We have retrospectively compared the effectiveness and safety of these approaches in patients with non-severe splenomegaly scheduled for elective total LS. Methods: Patients with surgical spleen disorders scheduled for elective LS between March 2005 and June 2011 underwent laparoscopic splenic mobilization via the posterolateral or anterior approach. Main outcome measures included operation time, intraoperative blood loss, frequency of postoperative pancreatic leakage, and length of hospital stay. Results: During the study period, 203 patients underwent LS, 58 (28.6%) via the posterolateral and 145 (71.4%) via the anterior approach. Three patients (1.5%) required conversion to laparotomy due to extensive perisplenic adhesions. The posterolateral approach was associated with significantly shorter operation time (65.0 ± 12.3 min vs. 95.0 ± 21.3 min, P < 0.01), reduced intraoperative blood loss (200.0 ± 23.4 mL vs. 350.0 ± 45.2 mL, P < 0.01), and shorter hospital stay (5.0 ± 2.0 d vs. 9.0 ± 3.0 d, P < 0.01) than the anterior approach. The frequency of pancreatic leakage was slightly lower in patients undergoing LS via the posterolateral than the anterior approach (0.0% vs. 3.4%, P > 0.05) Conclusions: The posterolateral approach is more effective and safer than the anterior approach in patients without severe splenomegaly (< 30 cm). PMID:23372427

  3. Outcomes and Complications of the Midline Anterior Approach 3 Years after Lumbar Spine Surgery

    PubMed Central

    Braaksma, Brian; Weinreb, Jeffrey H.; Nalbandian, Matthew; Spivak, Jeffrey M.; Petrizzo, Anthony

    2014-01-01

    Objective. The purpose of this study was to evaluate a new questionnaire to assess outcomes related to the midline anterior lumbar approach and to identify risk factors for negative patient responses. Methods. A retrospective review of 58 patients who underwent anterior lumbar surgery at a single institution for either degenerative disc disease or spondylolisthesis in 2009 was performed. The outcome measures included our newly developed Anterior Lumbar Surgery Questionnaire (ALSQ), ODI, and EQ-5D. Results. There were 58 patients available for followup, 27 women and 31 men. The average age at surgery was 50.8 years, with an average followup of 2.92 years. The average change in ODI was 34.94 (22.7) and EQ-5D was 0.28 (0.29). The rate of complications with the anterior approach was 10.3% and there was one male patient (3.2%) with retrograde ejaculation. Determination of the effectiveness of the new ALSQ revealed that it significantly correlated to the EQ-5D and ODI (P < 0.05). Smoking was associated with a negative response on thirteen questions. BMP use was not associated with a negative response on any sexual function questions. Conclusions. Our new Anterior Lumbar Surgery Questionnaire determines patient perceived complications related to the midline anterior lumbar surgical approach. PMID:25610657

  4. Minimally Invasive Supraorbital Key-hole Approach for the Treatment of Anterior Cranial Fossa Meningiomas

    PubMed Central

    IACOANGELI, Maurizio; NOCCHI, Niccolò; NASI, Davide; DI RIENZO, Alessandro; DOBRAN, Mauro; GLADI, Maurizio; COLASANTI, Roberto; ALVARO, Lorenzo; POLONARA, Gabriele; SCERRATI, Massimo

    2016-01-01

    The most important target of minimally invasive surgery is to obtain the best therapeutic effect with the least iatrogenic injury. In this background, a pivotal role in contemporary neurosurgery is played by the supraorbital key-hole approach proposed by Perneczky for anterior cranial base surgery. In this article, it is presented as a possible valid alternative to the traditional craniotomies in anterior cranial fossa meningiomas removal. From January 2008 to January 2012 at our department 56 patients underwent anterior cranial base meningiomas removal. Thirty-three patients were submitted to traditional approaches while 23 to supraorbital key-hole technique. A clinical and neuroradiological pre- and postoperative evaluation were performed, with attention to eventual complications, length of surgical procedure, and hospitalization. Compared to traditional approaches the supraorbital key-hole approach was associated neither to a greater range of postoperative complications nor to a longer surgical procedure and hospitalization while permitting the same lesion control. With this technique, minimization of brain exposition and manipulation with reduction of unwanted iatrogenic injuries, neurovascular structures preservation, and a better aesthetic result are possible. The supraorbital key-hole approach according to Perneckzy could represent a valid alternative to traditional approaches in anterior cranial base meningiomas surgery. PMID:26804334

  5. Technical Note on Modified Posterior Approach to the Hip Joint

    PubMed Central

    Iyer, Krishna Mohan

    2015-01-01

    Introduction: The posterior approach is the most commonly and relatively easy to be used to expose the hip joint. Posterior approaches allow excellent visualization of the entire acetabulum and the upper femoral shaft, and thus they are popular for revision joint replacement surgery particularly in cases where only the femoral component needs to be replaced. There may be a higher dislocation rate with minimal movement as compared to anterior approaches if the posterior approach is used in fractured neck of femur surgery in demented or elderly bedridden patients who often lie crouched in bed with their hips in a flexed and adducted position. The expected purpose of this modification of the Posterior Approach to the Hip Joint is to overcome the fear of dislocation and hence combine the advantages of the Posterior route with greater stability. Technique: The author’s original paper written 30 years ago (Iyer, 1981) presented an original technique devised to confer greater stability to the hip joint posteriorly to minimize the greater incidence of dislocation which has been reported extensively in literature. The technique involves an osteotomy of the posterior overhanging part of the greater trochanter to include the insertions of the short lateral rotators along with the posterior third of the gluteus medius, which can then be turned back in one piece like the page of a book to include the capsule of the hip joint. This gives wide exposure of the posterior lip of the acetabulum and is relatively bloodless in its exposure. This approach is very useful in the elderly particularly demented patients requiring a hemiarthroplasty and also in primary and revision total hip replacement. This approach has been tested in cadavers to conclude the greater stability given as compared to the routine resuture or reattachment of the short lateral rotators. Conclusion: The modified technique provides for greater stability as compared to the Southern Approach. PMID:27299026

  6. [Low colorectal anastomosis by the anterior perineal approach. 29 cases].

    PubMed

    Bricot, R; Le Treut, Y P; Kadji, C A; Bardot, J; Rodde, J M

    1985-12-14

    Using the combined abdominoperineal approach to the rectum through the recto-genital space, very low colo-rectal anastomosis can be performed without damaging the anal sphincter. Twenty-nine patients were operated upon by this procedure for malignant or benign disease of the lower two-thirds of the rectum: there was 2 failure; 6 patients developed transient perineal fistula; 27 patients now have normal anal continence. This technique has been considerably facilitated, notably in males, by stapled anastomosis. PMID:2934722

  7. Spontaneous intracranial hypotension secondary to anterior thoracic osteophyte: Resolution after primary dural repair via posterior approach

    PubMed Central

    Veeravagu, Anand; Gupta, Gaurav; Jiang, Bowen; Berta, Scott C.; Mindea, Stefan A.; Chang, Steven D.

    2012-01-01

    INTRODUCTION Spontaneous intracranial hypotension (SIH) is an uncommon syndrome widely attributed to CSF hypovolemia, typically secondary to spontaneous CSF leak. Although commonly associated with postural headache and variable neurological symptoms, one of the most severe consequences of SIH is bilateral subdural hematomas with resultant neurological deterioration. PRESENTATION OF CASE We present the case of a patient diagnosed with SIH secondary to an anteriorly positioned thoracic osteophyte with resultant dural disruption, who after multiple attempts at nonsurgical management developed bilateral subdural hematomas necessitating emergent surgical intervention. The patient underwent a unilateral posterior repair of his osteophyte with successful anterior decompression. At 36 months follow up, the patient reported completely resolved headaches with no focal neurological deficits. DISCUSSION We outline our posterior approach to repair of the dural defect and review the management algorithm for the treatment of patients with SIH. We also examine the current hypotheses as to the origin, pathophysiology, diagnosis and treatment of this syndrome. CONCLUSION A posterior approach was utilized to repair the dural defect caused by an anterior thoracic osteophyte in a patient with severe SIH complicated by bilateral subdural hematomas. This approach minimizes morbidity compared to an anterior approach and allowed for removal of the osteophyte and repair of the dural defect. PMID:23108168

  8. Retrograde Proximal Anterior Tibial Artery Access for Treating Femoropopliteal Segment Occlusion: A Novel Approach.

    PubMed

    Affonso, Breno Boueri; Golghetto Domingos, Fernanda Uchiyama; da Motta Leal Filho, Joaquim Maurício; Maciel, Macello José Sampaio; Cavalcante, Rafael Noronha; Bortolini, Edgar; Carnevale, Francisco Cesar

    2016-05-01

    Some challenges have been detected when there are long and complex lesions of femoropopliteal arterial occlusive disease, even with descriptions of the retrograde pedal approaches. The aim of this article is to describe the retrograde proximal anterior tibial artery access for treatment of femoropopliteal segment occlusion when antegrade recanalization failed (retrograde recanalization and rearranging the system into an antegrade position). Technical and clinical success was achieved in 100% of 4 cases, with an improvement of at least 2 Rutherford classes. Minor complication, small hematoma in an anterior compartment of the limb, occurred in 1 patient. No sign of compartmental syndrome was observed. PMID:26902943

  9. Simultaneously Combined Anterior-Posterior Approaches for Subaxial Cervical Circumferential Reconstruction in a Sitting Position.

    PubMed

    Han, Yue; Xia, Qun; Hu, Yong-cheng; Zhang, Ji-dong; Lan, Jie; Ma, Xin-long

    2015-11-01

    The purpose of this article is to introduce and analyze the feasibility of simultaneously combined anterior-posterior approaches for subaxial cervical circumferential reconstruction in sitting position. A retrospective case review was performed for above surgery procedure. A 79-year-old man was confirmed subaxial cervical fracture and dislocation with facet locked by radiological examination, and the involved levels were C5-6. According to American Spinal Injury Association (ASIA) classification, the impairment scale was grade B. And the Subaxial Cervical Spine Injury and Severity Score (SLIC) were 9. The patient was restricted in sitting position with traction on a halo in extension to immobilize the head during the operation. A posterior laminectomy and pedicle screws insertion to the involved cervical spine was performed firstly. And then the anterior discectomy and strut graft were accomplished through an anterior cervical approach. The final fixation was finished by clamping the strut graft with pedicle screw system. Total blood loss was 600 ml and the total operating time was 150 min. The patient was followed up for 6 months. The symptom of neck pain improved distinctly and no evidence about implant failure was noted. Neurological status improvement was confirmed and the ASIA scale was improved to grade C. We believed that the simultaneously combined anterior-posterior approach in sitting position was safe and more advantageous for appropriate cases. PMID:26790982

  10. Evaluating online information regarding the direct anterior approach for total hip arthroplasty.

    PubMed

    Mohan, Rohith; Yi, Paul H; Hansen, Erik N

    2015-05-01

    We evaluated the quality of information available on the Internet regarding the direct anterior approach (DAA). The top 50 Web sites from three major search engines (Google, Yahoo!, and Bing) were tabulated utilizing the search term direct anterior hip replacement. Of these, only 22% were authored by a hospital/university, while 60% were by a private physician/clinic. Most Web sites presented the DAA as "better" than other surgical approaches describing benefits, such as accelerated recovery though only 35% described risks of the approach. While only 39% of sites presented patient eligibility criteria, greater than 75% had the ability to make an appointment. Web sites regarding the DAA provide patients with a limited perspective and may be focused on attracting new patients, as opposed to accurately educating them. PMID:25697892

  11. Anterior Microsurgical Approach to Ventral Lower Cervical Spine Meningiomas: Indications, Surgical Technique and Long Term Outcome.

    PubMed

    Fraioli, Mario F; Marciani, Maria G; Umana, Giuseppe E; Fraioli, Bernardo

    2015-08-01

    Ventral lower cervical spinal meningiomas with posterior displacement of the spinal cord are rare and anterior approach has been rarely reported in the literature. The authors present their experience about eight patients operated through anterior microsurgical approach. Exposure of meningiomas was achieved through one or two corpectomies, according to meningioma extension. Tumour removal was performed thanks to the aid of a dedicated ultrasonic aspirator, and intraoperative evoked potentials were employed. Particular care was taken with the materials adopted for reconstruction of the anterior dural plane, to avoid postoperative cerebrospinal fluid leak. Vertebral fusion and stabilization were achieved by tantalum cage or titanium graft in case of one or two corpectomies respectively; anterior titanium plate fixed with screws was applied in all patients. Extent of tumour removal was related to the presence of a conserved arachnoidal plane between the tumour and the spinal cord: total removal was achieved in 2 patients, while gross total removal in the other six ones. Postoperative neurological outcome, which was favourable in all patients, was related mostly to preoperative neurologic status. No recurrence after total removal and no remnant growth after gross total removal occurred during an average follow-up period of 6, 7 years. PMID:26269613

  12. Comparison of accuracy of anterior and superomedial approaches to shoulder injection: an experimental study

    PubMed Central

    Chernchujit, Bancha; Zonthichai, Nutthapon

    2016-01-01

    Introduction: We aimed to compare the accuracy between the standard anterior technique of shoulder injection and the new superomedial technique modified from Neviaser arthroscopic portal placement. Intra-articular placement, especially at the long head of biceps (LHB) tendon, and needle depth were evaluated. Methods: Fifty-eight patients (ages 57 ± 10 years) requiring shoulder arthroscopy in the beach-chair position were recruited. Needle punctures for both techniques were performed by an experienced sports medicine orthopedist. Patients were anesthetized, and the shoulder placed in the neutral position. A single needle was passed through the skin, with only one redirection allowed per trial. The superomedial technique was performed, then the anterior technique. Posterior-portal arthroscopy determined whether needle placement was inside the joint. The percentage of intra-articular needle placements for each technique defined accuracy. When inside the joint, the needle’s precise location was determined and its depth measured. A marginal χ2 test compared results between techniques. Results: The superomedial technique was significantly more accurate than the anterior technique (84% vs. 55%, p < 0.05). For superomedial versus anterior attempts, the LHB tendon was penetrated in 4% vs. 28% of patients, respectively, and the superior labrum in 35% vs. 0% of patients, respectively; the needle depth was 42 ± 7 vs. 32 ± 7 mm, respectively (all p < 0.05). Conclusions: The superomedial technique was more accurate, penetrating the LHB tendon less frequently than the standard anterior technique. A small-diameter needle was needed to minimize superior labral injury. The superomedial technique required a longer needle to access the shoulder joint. PMID:27163102

  13. Stoppa Approach for Anterior Plate Fixation in Unstable Pelvic Ring Injury

    PubMed Central

    Choo, Suk Kyu; Kim, Jung-Jae; Lee, Mark

    2016-01-01

    Background The Stoppa (intrapelvic) approach has been introduced for the treatment of pelvic-acetabular fractures; it allows easy exposure of the pelvic brim, where the bone quality is optimal for screw fixation. The purpose of our study was to investigate the surgical outcomes of unstable pelvic ring injuries treated using the Stoppa approach for stable anterior ring fixation. Methods We analyzed 22 cases of unstable pelvic ring injury treated with plate fixation of the anterior ring with the Stoppa approach. We excluded cases of nondisplaced rami fracture, simple symphyseal diastasis, and parasymphyseal fractures, which can be easily treated with other techniques. The average age of the study patients was 41 years (range, 23 to 61 years). There were 10 males and 12 females. According to the Young and Burgess classification, there were 12 lateral compression, 4 anteroposterior compression, and 6 vertical shear fracture patterns. The fracture location on the anterior ring was near the iliopectineal eminence in all cases and exposure of the pelvic brim was required for plate fixation. All patients were placed in the supine position. For anterior plate fixation, all screws were applied to the anterior ramus distally and directed above the hip joint proximally. Radiologic outcomes were assessed by union time and quality of reduction by Matta method. The Merle d'Aubigne-Postel score was used to evaluate the functional results. Results The average radiologic follow-up period was 16 months (range, 10 to 51 months). All fractures united at an average of 3.5 months (range, 3 to 5 months). According to the Matta method, the quality of reduction was classified as follows: 16 anatomical (73%) and 6 nearly anatomical (27%) reductions. There were no cases of screw or implant loosening before bone healing. The functional results were classified as 7 excellent (32%), 12 good (55%), and 3 fair (13%) by the Merle d'Aubigne-Postel score. There were no wound complications

  14. Mini Transsternal Approach to the Anterior High Thoracic Spine (T1–T4 Vertebrae)

    PubMed Central

    Thakur, Bhaskar; Tsoti, Sandra Maria; Anichini, Giulio; Vergani, Francesco; Malik, Irfan

    2016-01-01

    Purpose. The anterior high thoracic spine is one of the most complex segments to be accessed surgically due to anatomical constraints and transitional characteristics. We describe in detail the mini transsternal approach to metastatic, infective, traumatic, and degenerative pathologies of T1 to T4 vertebral bodies. We analyse our surgical series, indications, and outcomes. Methods. Over a 5-year period 18 consecutive patients with thoracic myelopathy due to metastatic, infective, traumatic, and degenerative pathologies with T1 to T4 vertebral bodies involvement received a mini transsternal approach with intraoperative monitoring. Frankel scoring system was used to grade the neurological status. Results. Mean follow-up was 40 months. 78% patients improved in Frankel grade after surgery and 22% patients remained unchanged. Average operation time was 210 minutes. There were no intraoperative complications. One patient developed postoperative pneumonia successfully treated with antibiotics. Conclusion. The mini transsternal is a safe approach for infective, metastatic, traumatic, and degenerative lesions affecting the anterior high thoracic spine and the only one allowing an early and direct visualisation of the anterior theca. This approach overcomes the anatomical constraints of this region and provides adequate room for optimal reconstruction and preservation of spinal alignment in the cervicothoracic transition zone with good functional patient outcomes. PMID:27218104

  15. Mini Transsternal Approach to the Anterior High Thoracic Spine (T1-T4 Vertebrae).

    PubMed

    Brogna, Christian; Thakur, Bhaskar; Fiengo, Leslie; Tsoti, Sandra Maria; Landi, Alessandro; Anichini, Giulio; Vergani, Francesco; Malik, Irfan

    2016-01-01

    Purpose. The anterior high thoracic spine is one of the most complex segments to be accessed surgically due to anatomical constraints and transitional characteristics. We describe in detail the mini transsternal approach to metastatic, infective, traumatic, and degenerative pathologies of T1 to T4 vertebral bodies. We analyse our surgical series, indications, and outcomes. Methods. Over a 5-year period 18 consecutive patients with thoracic myelopathy due to metastatic, infective, traumatic, and degenerative pathologies with T1 to T4 vertebral bodies involvement received a mini transsternal approach with intraoperative monitoring. Frankel scoring system was used to grade the neurological status. Results. Mean follow-up was 40 months. 78% patients improved in Frankel grade after surgery and 22% patients remained unchanged. Average operation time was 210 minutes. There were no intraoperative complications. One patient developed postoperative pneumonia successfully treated with antibiotics. Conclusion. The mini transsternal is a safe approach for infective, metastatic, traumatic, and degenerative lesions affecting the anterior high thoracic spine and the only one allowing an early and direct visualisation of the anterior theca. This approach overcomes the anatomical constraints of this region and provides adequate room for optimal reconstruction and preservation of spinal alignment in the cervicothoracic transition zone with good functional patient outcomes. PMID:27218104

  16. Combined Anterior and Posterior Approach in Total Hip Arthroplasty for Crowe IV Dysplasia or Ankylosed Hips.

    PubMed

    Lee, Young-Kyun; Kim, Ki-Choul; Ha, Yong-chan; Koo, Kyung-Hoi

    2015-05-01

    We evaluated 70 patients (71 hips) who underwent complex total hip arthroplasty (THA) through the combined anterior and posterior approach. Sixty-five patients (32 dislocated hips and 34 ankylosed hips) were followed-up at a minimum of 3 years (median, 6 years; range, 3-10 years). Seven patients (10.6%), who had transient paresthesia on the anterior thigh, recovered within 3 months. All patients had a good clinical outcome in terms of range of motion, pain and recovery of walking. At the latest follow-up, all prostheses had bone-ingrown stability without any detectable wear or osteolysis. The combined approach allows an excellent exposure of the acetabulum for accurate cup alignment, leg lengthening and mobilization of joint in complex THA without trochanteric osteotomy, excessive abductor release and femoral shortening osteotomy. PMID:25682205

  17. Axillary nerve neurotization with the anterior deltopectoral approach in brachial plexus injuries.

    PubMed

    Jerome, J Terrence Jose; Rajmohan, Bennet

    2012-09-01

    Combined neurotization of both axillary and suprascapular nerves in shoulder reanimation has been widely accepted in brachial plexus injuries, and the functional outcome is much superior to single nerve transfer. This study describes the surgical anatomy for axillary nerve relative to the available donor nerves and emphasize the salient technical aspects of anterior deltopectoral approach in brachial plexus injuries. Fifteen patients with brachial plexus injury who had axillary nerve neurotizations were evaluated. Five patients had complete avulsion, 9 patients had C5, six patients had brachial plexus injury pattern, and one patient had combined axillary and suprascapular nerve injury. The long head of triceps branch was the donor in C5,6 injuries; nerve to brachialis in combined nerve injury and intercostals for C5-T1 avulsion injuries. All these donors were identified through the anterior approach, and the nerve transfer was done. The recovery of deltoid was found excellent (M5) in C5,6 brachial plexus injuries with an average of 134.4° abduction at follow up of average 34.6 months. The shoulder recovery was good with 130° abduction in a case of combined axillary and suprascapular nerve injury. The deltoid recovery was good (M3) in C5-T1 avulsion injuries patients with an average of 64° shoulder abduction at follow up of 35 months. We believe that anterior approach is simple and easy for all axillary nerve transfers in brachial plexus injuries. PMID:22434572

  18. An aesthetic approach in the repair of anterior frontal sinus fractures.

    PubMed

    Fattahi, T; Salman, S

    2016-09-01

    The management of upper facial trauma is a common responsibility of surgeons taking care of maxillofacial injuries. Historically, the most commonly used surgical approach has been the bi-temporal (coronal) incision. As is well known, the coronal incision carries some inherent complications such as hair loss, long scars, and increased length of hospital stay. The purpose of this article is to describe an aesthetic approach, similar to an endoscopic brow lift, for the repair of anterior wall fractures of the frontal sinus without the need for long incisions or fixation devices. PMID:27157631

  19. Dorsolateral onlay urethroplasty for pan anterior urethral stricture by a unilateral urethral mobilisation approach

    PubMed Central

    Chaudhary, Ranjit; Jain, Nidhi; Singh, Kulwant; Bisoniya, Hari Singh; Chaudhary, Rahul; Biswas, Rakesh

    2011-01-01

    The preferred management of urethral strictures involving long segments of anterior urethra is dorsal onlay buccal mucosa augmentation urethroplasty. This requires circumferential mobilisation of the urethra, which might cause ischaemia of the urethra in addition to chordee. The authors managed a pan anterior urethral stricture, applying a dorsolateral free graft by unilateral urethral mobilisation through a perineal approach. This is a recently described surgical technique which preserves the lateral vascular supply on one side thereby minimising ischaemia. Since circumferential mobilisation of urethra is not carried out in this technique, there are no chances of developing a chordee. Entire procedure is carried out by a perineal incision and no incision is made on the penis except for meatotomy. The pendulous urethra is accessed by penile eversion through the perineal wound. Obviating penile incisions minimises chances of wound infection and fistula formation. PMID:22689855

  20. Function of transected or avulsed rectus muscles following recovery using an anterior orbitotomy approach

    PubMed Central

    Pineles, Stacy L.; Laursen, Jessica; Goldberg, Robert A.; Demer, Joseph L.; Velez, Federico G.

    2013-01-01

    PURPOSE To assess the function of muscles retrieved from a retrobulbar location using an anterior orbitotomy approach and to identify the prognostic factors favoring a good outcome. METHODS The records of all patients undergoing anterior orbitotomy for the retrieval of a transected or avulsed muscle in a retrobulbar location were reviewed. Ocular motility, before and after retrieval (with ductions scaled from −4 to +4), was evaluated. RESULTS Record review identified 11 patients who had suffered trauma to 12 muscles (5 inferior, 6 medial, and 1 lateral rectus muscle). Ductions improved from −4 ± 0.4 preoperatively to −2.7 ± 0.9 postoperatively (P = 0.002); mean primary position deviation improved from 34Δ ± 14Δ-15Δ ± 9Δ (P < 0.001), and mean deviation in the field of action improved from 47Δ ± 20Δ-20Δ ± 22Δ (P = 0.02). Ductions improved by at least two units in three patients, all of whom had medial rectus trauma. Single binocular vision in primary gaze was achieved in 6 patients. Patients with medial rectus muscle injury and patients injured by sinus surgery had the lowest likelihood of recovering single binocular vision. CONCLUSIONS Our results are similar to historical series in which muscles were not retrieved and transpositions performed; however, muscle retrieval avoids risks associated with transposition surgeries such as anterior segment ischemia. Muscle recovery via the anterior orbitotomy approach may be reasonable to consider in those cases with a reasonable possibility of having active force generation postoperatively. PMID:22835914

  1. Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.

    PubMed

    Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

    2014-11-01

    This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field. PMID:25377976

  2. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    PubMed Central

    Alexandrov, Tamara; Ahlmann, Elke R.; Menendez, Lawrence R.

    2014-01-01

    We present a retrospective review of the early results and complications in a series of 35 consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%), femur fracture (2%), greater trochanteric fracture (12%), postoperative periprosthetic intertrochanteric fracture (2%), femoral nerve palsy (5%), hematoma (2%), and postoperative iliopsoas avulsion (2%). Radiographic analysis revealed average cup anteversion of 19.6° ± 6.6, average cup abduction angle of 48.4° ± 7, stem varus of 0.9° ± 2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery. PMID:24715984

  3. Superciliary Keyhole Approach for Unruptured Anterior Circulation Aneurysms: Surgical Technique, Indications, and Contraindications

    PubMed Central

    2014-01-01

    Neurosurgeons have been trying to reduce surgical invasiveness by applying minimally invasive keyhole approaches. Therefore, this paper clarifies the detailed surgical technique, its limitations, proper indications, and contraindications for a superciliary keyhole approach as a minimally invasive modification of a pterional approach. Successful superciliary keyhole surgery for unruptured aneurysms requires an understanding of the limitations and the use of special surgical techniques. Essentially, this means the effective selection of surgical indications, usage of the appropriate surgical instruments with a tubular shaft, and refined surgical techniques, including straightforward access to the aneurysm, clean surgical dissection, and the application of clips with an appropriate configuration. A superciliary keyhole approach allows unruptured anterior circulation aneurysms to be clipped safely, rapidly, and less invasively on the basis of appropriate surgical indications. PMID:25535512

  4. Modified Whale's tail technique for the management of bone-defect in anterior teeth.

    PubMed

    Kuriakose, Anu; Ambooken, Majo; Jacob, Jayan; John, Priya

    2015-01-01

    The purpose of this case report is to describe the efficacy of a modified Whale's tail technique to achieve primary closure and thereby aid in regeneration of an interdental osseous defect between maxillary central incisors complicated by an aberrant frenal attachment. A healthy 32-year-old female patient reported with the complaint of spacing between her upper front teeth. Clinical examination revealed an aberrant frenum extending into the interdental papilla in relation to the central incisors. There was a 6 mm periodontal pocket in relation to the mesiopalatal aspect of maxillary left central incisor. Intraoral periapical radiograph showed vertical bone loss in relation to mesial aspect of maxillary left central incisor. A modified Whale's tail flap was employed to access the area. The defect was filled with an alloplastic graft. Six months postoperative review showed complete elimination of the pocket along with radiographic bone fill of the defect. PMID:25810604

  5. Open preperitoneal versus anterior approach for recurrent inguinal hernia: a randomized study

    PubMed Central

    2012-01-01

    Background Inguinal herniorrhaphy remains one of the most common general surgical operations, with approximately 15% performed for recurrence. The repair of the resulting recurrent hernia is a daunting task because of already weakened tissues and obscured and distorted anatomy. The aim of this study is to compare the posterior preperitoneal versus anterior tension-free approach for repair of unilateral recurrent inguinal hernia regarding complications and early recurrence. Methods 120 Patients in this study were divided randomly into 2 main groups; Group A patients were subjected to posterior preperitoneal approach and those of group B were subjected to conventional anterior tension-free repair. The primary end point was recurrence and the secondary end points were time off from work, postoperative pain, scrotal swelling and wound infections. Results The mean hospital stay was 1.2 days and 4.7, the mean time to return work was 8.2 and 11.2 days and the mean time off from work was 9.4 and 15.9 days in group A and B respectively. The maximum follow-up period was 48 months and the minimum was 14 months with a mean value as 37.11 ± 5.14 months. Only 2 recurrences (3.3%) in group A and 4 cases (6.25%) in group B were seen. The final pain score per patient and the overall complication rate were higher in group B. Conclusions The open preperitoneal repair offers the advantages of low recurrence rate and allows covering all potential defects with one piece of mesh and is far superior to the anterior approach. Trial Registration ACTRN12611000337976 PMID:23110701

  6. One-stage bilateral open reduction using the anterior iliofemoral approach in developmental dysplasia of the hip.

    PubMed

    Gem, Mehmet; Arslan, Hüseyin; Ozkul, Emin; Alemdar, Celil; Azboy, Ibrahim; Demirtaş, Abdullah

    2014-06-01

    The aim of this study was to investigate the safety of one-stage bilateral open reduction using the anterior approach in the treatment of patients with bilateral Tönnis Type III and IV Developmental Dysplasia of the Hip (DDH). Forty-six patients were retrospectively evaluated. Thirty-eight were female, eight were male. The mean age was 16.63 (11-29) months. The mean follow-up period was 27.18 (12-65) months. The mean hospitalization period after surgery was 1.91 (1-5) days. The mean pre-operative hematocrit level was 35.14% (28.1-44.1) and the mean pre-operative hemoglobin level was 11.75 g/dl (9.3-13.6). The mean post-operative hematocrit level was 32.54% (26.7-40.4) and the mean post-operative hemoglobin level was 10.80 g/dl (8.78-12.3). None of the patients required blood transfusion. The mean anesthesia duration was 133.30 (95-180) minutes, and the mean operation duration was 107.58 (70-145) minutes. According to the modified scoring system by Trevor et al, excellent results were obtained in 66 hips of 46 patients (71.8%), and good results were obtained in 26 hips (28.2%). Twenty two hips (23.91%), which developed acetabular dysplasia in the follow-up period required a secondary acetabular intervention. According to the Kalamchi and MacEwen classification, Type I avascular necrosis developed in ten hips, Type II in one hip, and Type IV in two hips. One-stage bilateral open reduction using the anterior iliofemoral approach in Tönnis Type III and IV DDH at walking age is a safe, time-saving treatment method that shortens the hospitalization and immobilization periods. PMID:25090794

  7. A Modifiable Approach To Expert Systems Development

    NASA Astrophysics Data System (ADS)

    Sanborn, James C.

    1987-05-01

    Rule based expert systems programmers experience similar difficulties in developing and maintaining large application programs: rules become instantiated when they shouldn't the execution order of rules is undesirably nondeterministic, or worse, simply incorrect; and modifications to program behavior are difficult or unwieldy. All of these problems arise from the control strategies used by the development language, their implementation, and the programmers control over (and awareness of) them. This paper explores the impact of rule based program control on overall program modifiability. We present a language designed with efficiency, modifiability, and ease of use in mind. Throughout, we discuss traditional control strategies, improvements made through our research, and directions for further study.

  8. Appraisal, Work-Up and Diagnosis of Anterior Uveitis: A Practical Approach

    PubMed Central

    Herbort, Carl P.

    2009-01-01

    This article presents a comprehensive approach of the diagnosis of anterior uveitis and appropriate investigational tests based on clinical signs. Uveitis has classically been presented by uveitis specialists as an obscure and complicated field in ophthalmology that was supposed to be restricted to the happy few who had the knowledge, which in some countries was even prevented from being diffused. The effect was that ophthalmologists turned away from uveitis or were not correctly armed when they chose to take care of uveitis patients. The consequences of this situation often fell upon the patients. Since more than 15 years our group has been represented by the Society for Ophthalmo-Immunoinfectiology in Europe (SOIE), which has been working to alter this image of uveitis and ensure that the knowledge of the basics of uveitis reaches the practicing ophthalmologist. Our firm believe is that up to 70% of uveitis cases, especially anterior uveitis, can be taken care of by the practicing ophthalmologist following a structured approach in the appraisal of the uveitis case. Judging from the attendance obtained, the response to our approach in every country (where we organise courses) has been inversely proportional to the previous disinterest since we started publicizing it. PMID:20404984

  9. Cervical nerve root decompression by lateral approach as salvage operation after failed anterior transdiscal surgery: technical case report

    PubMed Central

    George, Bernard

    2009-01-01

    Cervical nerve root compression caused by disco-osteophytic changes is classically operated by anterior transdiscal approach with disc replacement. If compression persists or recurs, reoperation via the same surgical route may be difficult, because of scar tissue and/or implants. An alternative approach may be necessary. We recommend the lateral cervical approach (retrojugular) as salvage operation in such cases. We report a patient with cervical nerve root compression operated by anterior transdiscal approach with plate and bone graft. As some compression persisted clinically and radiologically, the patient was re-operated via a lateral approach. The surgical access was free of scar tissue. The arthrodesis could be left intact and did not prevent effective nerve root decompression. The patient became asymptomatic. The lateral cervical approach (retrojugular) as reported here, is an excellent alternative pathway if reoperation after anterior transdiscal surgery with disc replacement becomes necessary. PMID:19449041

  10. Exhaustible Resource Depletion: A Modified Graphical Approach.

    ERIC Educational Resources Information Center

    Tisato, Peter

    1995-01-01

    Presents a graphical analysis of the exhaustible resource depletion problem. Applies Hotelling's "r percent rule" as a new approach that operates in an "N"-period context. Includes two figures illustrating the approach. (CFR)

  11. Identification and expression profile of multiple genes in the anterior kidney of channel catfish induced by modified live Edwardsiella ictaluri vaccination

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Using PCR-select subtractive cDNA hybridization technique, 57 expressed sequence tags (ESTs) were isolated from 240 clones of a modified live Edwardsiella ictaluri-vaccinated vs sham-vaccinated channel catfish anterior kidney subtractive library. The transcription levels of the 57 ESTs in response t...

  12. Identification and expression profile of multiple genes in the anterior kidney of channel catfish induced by modified live Edwardsiella ictaluri vaccination.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Using PCR-select subtractive cDNA hybridization technique, 57 expressed sequence tags (ESTs) were isolated from 240 clones of a modified live Edwardsiella ictaluri-vaccinated vs sham-vaccinated channel catfish anterior kidney subtractive library. The transcription levels of the 57 ESTs in response t...

  13. Transmasseteric anterior parotid approach for condylar fractures: experience of 129 cases.

    PubMed

    Narayanan, Vinod; Ramadorai, Ashok; Ravi, Poornima; Nirvikalpa, Natarajan

    2012-07-01

    We have evaluated the transmasseteric anterior parotid (TMAP) approach in the treatment of 163 condylar fractures in 129 patients. Ninety-five patients presented with unilateral, and 34 with bilateral, fractures. The inclusion criteria were patient's choice for open reduction and internal fixation, displaced unilateral condylar fractures with occlusal derangement, and displaced bilateral condylar fractures with anterior open bite. Mean (SD) maximum interincisal opening after 3 months was 44(5)mm. There were no differences in lateral movements during the reviews 6 weeks and 3 months postoperatively. Protrusive movement at the end of 3 months was 7(2)mm. All patients achieved functional occlusion identical to the pretraumatic occlusion and good reduction of the condyles. No patient developed temporary or permanent facial palsy, sialocele, salivary fistula, or Frey syndrome. The mean (SD) operating time was 46(11)min. The TMAP approach avoids the complications of incision of the parotid gland, minimises the risk of facial nerve palsy, and offers excellent access to the fractured condyle. PMID:21982159

  14. Fins into limbs: Autopod acquisition and anterior elements reduction by modifying gene networks involving 5'Hox, Gli3, and Shh.

    PubMed

    Tanaka, Mikiko

    2016-05-01

    Two major morphological changes occurred during the fin-to-limb transition: the appearance of the autopod, and the reduction of anterior skeletal elements. In the past decades, numerous approaches to the study of genetic developmental systems involved in patterning of fins/limbs among different taxa have provided clues to better understand the mechanism of the fin-to-limb transition. In this article, I discuss recent progress toward elucidating the evolutionary origin of the autopod and the mechanism through which the multiple-basal bones of ancestral fins were reduced into a single bone (humerus/femur). A particular focus of this article is the patterning mechanism of the tetrapod limb and chondrichthyan fin controlled by gene networks involving the 5'Hox genes, Gli3 and Shh. These recent data provide possible scenarios that could have led to the transformation of fins into limbs. PMID:26992366

  15. Retrospective Evaluation of Efficiency and Safety of an Anterior Percutaneous Approach for Cervical Discectomy

    PubMed Central

    Schubert, Michael

    2014-01-01

    Study Design Retrospective case series. Purpose The purpose of the study was to evaluate the efficiency and complication rate of a percutaneous anterior approach to herniated cervical disks with or without concomitant foraminal stenosis and/or spondylosis. Overview of Literature Recent publications reflect that minimally invasive procedures gain in importance in patients and spine surgeons as they are generally associated with less tissue damage and shorter recovery times. However, for anterior percutaneous cervical discectomy, very little data is available for relevant patient populations. Methods Charts from patients with herniated cervical disc confirmed by magnetic resonance imaging, mainly radicular symptoms and irresponsive to conservative treatment who underwent anterior percutaneous discectomy were evaluated retrospectively. All patients were asked to return questionnaires that included visual analogue scores (VAS), MacNab score as well as subjective satisfaction data 2 years after surgery. Results Ninety-five patients were included. There were no neurological or vascular complications; only one patient suffered from transient hoarseness. During the two years after surgery, 9 patients underwent reoperation. 90.5% of the patients returned the questionnaire at 2 years' follow-up. 87.7% of them reported excellent or good outcome, 11.1% rated results as fair and 1.2% as unsatisfactory. On average, arm and neck pain improved significantly by 6.1 points and 5.8 points respectively on a ten point VAS. 94.5% stated that they would choose the same procedure again. Conclusions This procedure has proved a safe and sufficient option for symptomatic cervical disk herniations with or without concomitant spondylosis and/or foraminal stenosis. PMID:25187857

  16. [Combined Anterior and Posterior Surgical Approaches for Resection of a 2nd-rib Chondrosarcoma Occupying the Superior Sulcus].

    PubMed

    Shinohara, Yoshikazu; Anraku, Masaki; Saito, Noriyuki; Fukumoto, Kento; Kobayashi, Hiroshi; Shinoda, Yusuke; Chikuda, Hirotaka; Nakajima, Jun

    2016-06-01

    A 77-year-old man with right chest wall chondrosarcoma invading vertebral bodies underwent resection. Computed tomography (CT) showed that the tumor occupied the right superior sulcus, and was close to mediastinal organs including the trachea and esophagus. We adopted a combined anterior and posterior approaches that made safe and curative resection possible. In the anterior approach, we dissected and mobilized the neurovascular structures and neighboring organs from the tumor. A-4 cm gutter on the ventral side of the 1st, 2nd, and 3rd thoracic vertebral bodies was created for safe resection. By the subsequent posterior approach, successful resection was achieved without violating tumor margins. PMID:27246126

  17. Mechanoreceptors in the Anterior Horn of the Equine Medial Meniscus: an Immunohistochemical Approach.

    PubMed

    Nemery, E; Gabriel, A; Grulke, S; Piret, J; Toppets, V; Antoine, N

    2016-04-01

    Lameness due to stifle and especially meniscal lesions is frequent in equine species. In humans, mechanoreceptors involved in proprioceptive function are well studied. Given the high incidence of meniscal injuries in horses, and the lack of information concerning them in equine menisci, our objective was to study these corpuscles in six healthy anterior horns of the equine medial meniscus, which is the most common localisation reported for equine meniscal injuries. Immunohistochemical stainings were performed using antibodies against high molecular weight neurofilaments and glial fibrillary acidic proteins. From a purely fundamental point of view, our work highlights for the first time the presence of Ruffini, Pacini and Golgi corpuscles in equine meniscus. They were found, isolated or in clusters and always located at the vicinity of blood vessels, at the level of the anterior horn of the equine medial meniscus. This morphological approach could serve as a basis for clinical studies, to evaluate the impact of these corpuscles on the poor sportive prognosis in equine meniscal tears. PMID:25904399

  18. [Anterior approach of cervical spine in Pott's disease. Apropos of 7 cases].

    PubMed

    Achouri, M; Hilmani, S; Lakhdar, H; Ait Ben Ali, S; Naja, A; Ouboukhlik, A; el Kamar, A; el Azhari, A; Boucetta, M

    1997-01-01

    This study reports 7 cases of cervical Pott's disease, gathered during 6 years in the department of neuro-surgery of Ibn Rochd U.H.C. 4 females and 3 males, aged between 9 and 52 years were included. All the patients complained of cervicobrachial pain and weakness of the limbs. Clinical features were: deterioration of general status, rachidian syndrome and neurological impairement with motor and sensitive deficit. Radiological analysis found a destructive and extensive lesion, cervical kyphosis from 10 degrees to 60 degrees, retropharyngeal abscess and intraspinal canal extension of infection. Diagnosis was confirmed by histological study in all cases. In addition to antituberculous therapy and preoperative cervical traction in 4 cases, all the patients had spinal fusion using an anterior approach. Post operative immobilization in a cervical collar varied from 9 to 12 months. All 7 patients had full neurological recovery, 6 patients had an excellent bony fusion and cervical kyphosis was corrected. For the remaining patient, the bone graft was mobilized without neurological disorders. This study confirms anterior arthrodesis efficiency. This procedure in conjunction with preoperative traction, allowed stabilization of the spine and healing of vertebral lesions with excellent kyphosis correction. PMID:9452797

  19. Outcome of modified Bristow-Laterjet procedure in post-traumatic recurrent anterior shoulder dislocation in young population.

    PubMed

    Sakeb, N; Islam, M A; Jannat, S N

    2015-01-01

    Anterior shoulder dislocation (ASD) is a common injury of young population which may progress to recurrent episodes. The treatment is initially conservative but surgery is indicated when it fails. Out of more than 150 techniques, modified Bristow-Latarjet procedure has become most favorable even to arthroscopic techniques. We have intended to retrospectively assess the outcome of it in post-traumatic recurrent ASD of young non-athletes, performed at our different private settings between January 2007 and July 2012; which included 15 male patients of 20-39 years with minimum 2 years follow up. Clinical, functional, radiological and overall outcome status were evaluated. There was significant improvement of shoulder stability (p<0.05, chi-square test) despite significant deterioration (p<0.05, paired t-test) of external rotation (21.67°±00.61° loss). The patient self assessed pain and instability had highly significant (p<0.001, paired t-test) and all components of activities of daily living (except above shoulder weight carrying and overhead throwing) had significant improvement (p<0.05, paired t-test). Despite of intra-operative difficulties, radiological transplant errors (33.33%) and post-operative complications (06.67%), overall satisfactory outcome (86.67%) had been significant (p<0.05, chi-square test). PMID:25725671

  20. Surgical repair of chronic rupture of the distal end of the biceps brachii. A modified anterior surgical repair technique.

    PubMed

    Sharma, Dinesh K; Goswami, Ved; Wood, Jane

    2004-06-01

    The authors have used a modified surgical technique for repair of the distal end of the biceps brachii in three patients who presented with chronic rupture, all more than 6 weeks old. All patients were males; two lesions were on the dominant right side and one was on the non-dominant left side. An anterior incision was made over the cubital fossa, a hole was drilled over the radial tuberosity and a simple pull-through technique with an Ethibond suture was used to attach the tendon to an endobutton over the posterior surface of the radius. All patients returned to their employment and preinjury activity levels by six months. There were no postoperative complications and clinically all repairs remained intact. The patients regained their normal range of movements in 3 months; all but one regained the endurance and strength of their bicep in 6 months as assessed by Cybex testing. Surgical repair of the distal end of the biceps using the technique reported has given excellent results in these three patients. PMID:15287407

  1. Giant intracranial aneurysm of the anterior communicating artery treated by direct surgical approach. Case report.

    PubMed

    Bas, M B; Guerra, N; Valsania, V; Boccardo, M

    2000-09-01

    We report the singular case of an exceptionally large giant communicating artery aneurysm successfully treated with a direct surgical approach. The clinical presentation was a relatively short history of frontal headache. In the pre- and postcontrast CT scans the lesion mimicked an intracranial tumor. At surgery the intraluminal thrombus was partially removed with an ultrasonic surgical aspirator; the decompression allowed the isolation and subsequent temporary dipping of the tracts A1 and A2 of both the anterior cerebral arteries. It was then possible to complete the thrombectomy and to dip the neck of the aneurysm. The report emphasizes the indispensable role of MRI for the accurate diagnosis of giant intracranial aneurysms and the recent improvement of the surgical results concerning this category of aneurysms (mainly related to the present wider availability of technical surgical instrumentation). PMID:11126447

  2. Plant mediated green synthesis: modified approaches

    NASA Astrophysics Data System (ADS)

    Das, Ratul Kumar; Brar, Satinder Kaur

    2013-10-01

    Plant mediated green synthesis of different metallic nanoparticles has emerged as one of the options for implementation of green chemistry principles, and successfully made an important contribution towards green nanotechnology. However, beyond the synthesis and application aspects, the science of green synthesis has carried some wrong perceptions in an unforeseen fashion. In this review, some of the key issues related to the green synthesis of metallic nanoparticles employing plants as reducing/capping agents have been addressed. Random selection of plants and its overall impact on the different aspects of green synthesis have been discussed. Emphasis is given to the setting of some standard selection criteria to be adopted for selecting a plant for use in green synthesis. How selection of a plant can positively or negatively influence both procedure and products of a green synthesis process is the prime concern of this article. In addition to selection, the key issue of biocompatibility associated with green synthesized metallic nanoparticles has been considered. Both selection of plant and biocompatibility were reconsidered for their minute details in terms of synthesis, analysis and data interpretation in the green synthesis approach. The key factors capable of fine tuning the core meaning of ``green'' in the synthesis of any metallic nanoparticles were taken into consideration. This article is an effort towards keeping the core meaning of green synthesis.

  3. Combining classical and molecular approaches elaborates on the complexity of mechanisms underpinning anterior regeneration.

    PubMed

    Evans, Deborah J; Owlarn, Suthira; Tejada Romero, Belen; Chen, Chen; Aboobaker, A Aziz

    2011-01-01

    The current model of planarian anterior regeneration evokes the establishment of low levels of Wnt signalling at anterior wounds, promoting anterior polarity and subsequent elaboration of anterior fate through the action of the TALE class homeodomain PREP. The classical observation that decapitations positioned anteriorly will regenerate heads more rapidly than posteriorly positioned decapitations was among the first to lead to the proposal of gradients along an anteroposterior (AP) axis in a developmental context. An explicit understanding of this phenomenon is not included in the current model of anterior regeneration. This raises the question what the underlying molecular and cellular basis of this temporal gradient is, whether it can be explained by current models and whether understanding the gradient will shed light on regenerative events. Differences in anterior regeneration rate are established very early after amputation and this gradient is dependent on the activity of Hedgehog (Hh) signalling. Animals induced to produce two tails by either Smed-APC-1(RNAi) or Smed-ptc(RNAi) lose anterior fate but form previously described ectopic anterior brain structures. Later these animals form peri-pharyngeal brain structures, which in Smed-ptc(RNAi) grow out of the body establishing a new A/P axis. Combining double amputation and hydroxyurea treatment with RNAi experiments indicates that early ectopic brain structures are formed by uncommitted stem cells that have progressed through S-phase of the cell cycle at the time of amputation. Our results elaborate on the current simplistic model of both AP axis and brain regeneration. We find evidence of a gradient of hedgehog signalling that promotes posterior fate and temporarily inhibits anterior regeneration. Our data supports a model for anterior brain regeneration with distinct early and later phases of regeneration. Together these insights start to delineate the interplay between discrete existing, new, and then

  4. The Sacral Hiatus Approach for Drainage of Anterior Lumbo-Sacral Epidural Abscesses

    PubMed Central

    Mathews, M.S.; Ospina, J.; Suzuki, S.

    2011-01-01

    Summary Lumbosacral epidural abscesses are managed either conservatively with IV antibiotics or with open surgery, particularly in the presence of acute neurological symptoms. Their location makes it difficult for image-guided interventional approaches either for biopsy or evacuation. We report the sacral hiatus and canal as a corridor for image-guided minimally invasive abscess of lumbosacral epidural abscess for aspiration. A 56-year-old man presented to the emergency department complaining of six weeks of worsening low back pain. MRI of the patient’s lumbosacral spine showed osteomyelitis involving his L5, S1 vertebrae, L5-S1 discitis, as well as an anterior epidural abscess extending from L4-5 disc space to the S2 vertebral level. Blood cultures grew out gram-positive cocci. For drainage, a 5-French micropuncture kit was utilized to access the hiatus. Under fluoroscopic guidance a microwire was then advanced along the sacral canal. An 18-gauge needle curved to approximate the contours of the sacral canal was then advanced over the guidewire. Once anatomic access was established 2 ml of thick purulent material was aspirated. The patient tolerated the procedure well, and no focal nerve root symptoms were noted following the procedure. Image-guided aspiration of lumbosacral epidural abscesses can thus be carried out in a safe and effective manner using a sacral hiatus approach. PMID:22192554

  5. Visible iris sign as a predictor of problems during and following anterior approach ptosis surgery

    PubMed Central

    Malhotra, R; Salam, A; Then, S-Y; Grieve, A P

    2011-01-01

    Objective To describe the pre- and postoperative features of the visible iris sign (VIS), which is the apparent visibility of iris colour through a closed upper eyelid, in patients undergoing anterior approach surgery for severe involutional aponeurotic ptosis, and to assess its effect on postoperative outcome. Design Prospective, comparative interventional case series. Methods Prospective series of all patients undergoing surgery for severe involutional aponeurotic ptosis during a 16-month period at a single centre. Inclusion criteria Severe involutional ptosis (upper eyelid margin reflex distance (MRD) ≤1 mm) treated by anterior-approach surgery. Main outcome measures Presence of VIS, type of ptosis (primary or recurrent), preoperative MRD, levator function and skin crease height, documented unusual intra-operative findings, postoperative complications, and follow-up time. Results Of 133 procedures for involutional aponeurotic ptosis, 96 procedures (56 patients) were included in the study. In total, 12 patients (21%, 12/56, 2 males, and 10 females) had been identified as having VIS preoperatively. In order to avoid any selection bias, only patients with severe degree of ptosis were included in the two groups with the two groups being alike in the preoperative lid height, levator function or the skin crease. In the VIS group, 55% (12/22) had a thinned, significantly retracted levator aponeurosis and a thin tarsus prone to full-thickness suture passes (36.3%, 8/22) during aponeurosis reattachment. Immediate persistent overcorrection during surgery was seen in three procedures, with one patient having an under corrected outcome when treated with a hang-back suture. In the non-VIS group, no patients were documented intra-operatively, as having significant retraction of the levator aponeurosis. However, 14% (10/74) of the eyelids were recorded as having a very attenuated levator and one patient (3%, 1/44) was noted to have a floppy tarsus that was difficult to

  6. Treating the initial anterior shoulder dislocation--an evidence-based medicine approach.

    PubMed

    Kuhn, John E

    2006-12-01

    This manuscript presents the best available evidence to answer questions regarding the treatment of the patient with an initial anterior shoulder dislocation. The highest levels of evidence available offer the following conclusions: (1) of the many methods to reduce the dislocated shoulder, little data exist to identify the best method. Recommendations are based on low levels of evidence (levels 4 and 5). (2) Premedication with intra-articular lidocaine has fewer complications and requires a shorter time in the emergency room than intravenous sedation with no detectable differences in reduction success rates (level 1). (3) Postreduction immobilization in external rotation may reduce recurrence (level 2), but immobilization in internal rotation does not (level 1). (4) Arthroscopic surgery significantly reduces recurrence compared to a nonoperative approach (level 1), and (5) there are limited data on features that would allow a safe return to play. Expert opinion suggests that return is allowed when motion and strength are nearly normal, and the athletes can engage in sport-specific activities, however, the athlete is at risk for recurrence while playing (levels 4 and 5). PMID:17135968

  7. A tissue engineering approach to anterior cruciate ligament regeneration using novel shaped capillary channel polymer fibers

    NASA Astrophysics Data System (ADS)

    Sinclair, Kristofer D.

    2009-12-01

    Ruptures of the anterior cruciate ligament (ACL) are the most frequent of injuries to the knee due to its role in preventing anterior translation of the tibia. It is estimated that as many as 200,000 Americans per year will suffer from a ruptured ACL, resulting in management costs on the order of 5 billion dollars. Without treatment these patients are unable to return to normal activity, as a consequence of the joint instability found within the ACL deficient knee. Over the last thirty years, a variety of non-degradable, synthetic fibers have been evaluated for their use in ACL reconstruction; however, a widely accepted prosthesis has been unattainable due to differences in mechanical properties of the synthetic graft relative to the native tissue. Tissue engineering is an interdisciplinary field charged with the task of developing therapeutic solutions for tissue and organ failure by enhancing the natural wound healing process through the use of cellular transplants, biomaterials, and the delivery of bioactive molecules. The capillary channel polymer (CC-P) fibers used in this research were fabricated by melt extrusion from polyethylene terephthalate and polybutylene terephthalate. These fibers possess aligned micrometer scale surface channels that may serve as physical templates for tissue growth and regeneration. This inherent surface topography offers a unique and industrially viable approach for cellular contact guidance on three dimensional constructs. In this fundamental research the ability of these fiber channels to support the adhesion, alignment, and organization of fibroblasts was demonstrated and found to be superior to round fiber controls. The results demonstrated greater uniformity of seeding and accelerated formation of multi-layered three-dimensional biomass for the CC-P fibers relative to those with a circular cross-section. Furthermore, the CC-P geometry induced nuclear elongation consistent with that observed in native ACL tissue. Through the

  8. Increasing orthodontic and orthognathic surgery treatment efficiency with a modified surgery-first approach.

    PubMed

    Uribe, Flavio; Agarwal, Sachin; Shafer, David; Nanda, Ravindra

    2015-11-01

    This case report describes the treatment of a 33-year-old white man who had a skeletal Class III and dental Class II subdivision malocclusion caused by a retrognathic maxilla, with severe maxillary crowding, a highly placed maxillary left canine, mild mandibular crowding, and a bilateral posterior crossbite. Treatment was performed with a modified surgery-first approach, which included a short presurgical alignment phase for the correction of the significant maxillary crowding while controlling the incisal angulation, followed by LeFort I maxillary advancement surgery. The short presurgical orthodontic phase aimed at eliminating the anterior dental interferences before the maxillary advancement, and the use of the inherent increased bone turnover in the postsurgical phase helped to reduce the total orthodontic treatment time to 12 months. Pleasing esthetic results and a good functional occlusion were achieved. PMID:26522045

  9. Accuracy of the modified Hardinge approach in acetabular positioning

    PubMed Central

    Goyal, Prateek; Lau, Adrian; McCalden, Richard; Teeter, Matthew G.; Howard, James L.; Lanting, Brent A.

    2016-01-01

    Background The surgical approach chosen for total hip arthroplasty (THA) may affect the positioning of the acetabular component. The purpose of this study was to examine the accuracy in orienting the acetabular component using the modified Hardinge approach. Methods We used our institutional arthroplasty database to identify patients with primary, press-fit, hemispherical acetabular components of a metal-on-polyethylene THA performed between 2003 and 2011. Patients with radiographs obtained 1–3 years after the index procedure were included for measurement of anteversion and inclination angles. Acceptable values of anteversion and abduction angles were defined as 15° ± 10° and 40° ± 10°, respectively. Results We identified 1241 patients from the database, and the modified Hardinge approach was used in 1010 of the patients included in our analysis. The acetabular component was anteverted in the acceptable zone in 54.1% of patients. The abduction angle was within the defined range in 79.2% of patients. Combined anteversion and abduction angles within the defined zone were present in 43.6% of patients. Conclusion Consistent with studies examining accuracy from other approaches, our study reveals that the modified Hardinge approach was only moderately accurate in positioning the acetabular component in the acceptable zone. PMID:27240130

  10. Disseminated synovial chondromatosis of the knee treated by open radical synovectomy using combined anterior and posterior approaches.

    PubMed

    Singh, Shailendra; Neelakandan, Karthik; Sood, Chetan; Krishnan, Jeganath

    2014-09-01

    Synovial chondromatosis of the knee is a rare benign neoplasm of the synovium. Likewise, uncertainty on management still prevails. Though rare, it nevertheless warrants greater emphasis than it receives in the literature to allow correct diagnosis and accurate early surgical intervention. It predominantly involves the anterior compartment of the knee and disseminated disease is extremely rare. The optimal approach for surgical treatment of such an extensive synovial chondromatosis of knee remains unclear. Herein, we describe a case of extensive generalized synovial chondromatosis of the knee extending into the Baker's cyst in a 30 years old female. A diagnosis of synovial chondromatosis was made by clinical evaluation and MR imaging and confirmed by histopathological examination. Patient was successfully treated by open radical synovectomy of knee using both anterior and posterior approaches in a single step procedure. PMID:25983490

  11. Total Hip Arthroplasty Performed Through Direct Anterior Approach Provides Superior Early Outcome: Results of a Randomized, Prospective Study.

    PubMed

    Parvizi, Javad; Restrepo, Camilo; Maltenfort, Mitchell G

    2016-07-01

    Studies suggest that total hip arthroplasty (THA) performed through direct anterior (DA) approach has better functional outcomes than other surgical approaches. The immediate to very early outcomes of DA THA are not known. A prospective, randomized study examined the very early outcome of THA performed through DA versus direct lateral approach. The functional outcomes on day 1, day 2, week 6, week 12, 6 months, and 1 year were measured. Patients receiving DA THA had significantly higher functional scores during the early period following surgery. The difference in functional scores leveled out at 6 months. PMID:27241374

  12. Conservative approach to mitral valve replacement in hypertrophic cardiomyopathy with systolic anterior motion – a case report

    PubMed Central

    Suder, Bogdan; Szymoński, Krzysztof; Wasilewski, Grzegorz; Sadowski, Jerzy; Kapelak, Boguslaw

    2015-01-01

    The authors report the case of a 60-year-old patient with hypertrophic cardiomyopathy (HCM), systolic anterior motion (SAM), and high gradient in the left ventricular outflow tract (LVOT) who underwent surgical treatment. During the surgery, myomectomy of the septum was performed using the Morrow method: despite the persisting SAM and increased LVOT gradients, the mitral valve was not replaced. The case study presents a conservative approach to mitral valve replacement during HCM surgery. PMID:26855652

  13. Single anterior tooth replacement by a cast lingual loop connector - a conservative approach.

    PubMed

    Dandekeri, Shilpa Sudesh; Dandekeri, Savita

    2014-09-01

    One of the most challenging and complex treatment modality is replacement of single anterior tooth. This can be overcome by different treatment options such as implant-supported restorations as well as conventional porcelain-fused-to-metal and resin-bonded fixed partial dentures. Drifting of teeth into the edentulous area may reduce the available pontic space; whereas a diastema existing before an extraction may result in excessive mesiodistal dimension to the pontic space. Loop connector fixed partial denture (FPD) may be the simplest and best solution to maintain the diastema and provide optimum restoration of aesthetics. This article describes the procedure for the fabrication of a loop connector FPD to restore an excessively wide anterior edentulous space in a patient with existing spacing between the maxillary anterior teeth. PMID:25386535

  14. Modified trans-oral approach for mandibular condylectomy.

    PubMed

    Deng, M; Long, X; Cheng, A H A; Cheng, Y; Cai, H

    2009-04-01

    Different approaches to the mandibular condyle have been described. In this paper, a modified trans-oral technique to access the mandibular condyle is described and illustrated. This technique was used in a small group of patients; the clinical outcomes are promising. The technique can be used in various temporomandibular joint (TMJ) operations, such as condylar resection, high condylectomy or tumor removal. It provides adequate intra-oral surgical access to the mandibular condyle and avoids complications from extra-oral approaches to the TMJ. PMID:19282151

  15. DNA enrichment approaches to identify unauthorized genetically modified organisms (GMOs).

    PubMed

    Arulandhu, Alfred J; van Dijk, Jeroen P; Dobnik, David; Holst-Jensen, Arne; Shi, Jianxin; Zel, Jana; Kok, Esther J

    2016-07-01

    With the increased global production of different genetically modified (GM) plant varieties, chances increase that unauthorized GM organisms (UGMOs) may enter the food chain. At the same time, the detection of UGMOs is a challenging task because of the limited sequence information that will generally be available. PCR-based methods are available to detect and quantify known UGMOs in specific cases. If this approach is not feasible, DNA enrichment of the unknown adjacent sequences of known GMO elements is one way to detect the presence of UGMOs in a food or feed product. These enrichment approaches are also known as chromosome walking or gene walking (GW). In recent years, enrichment approaches have been coupled with next generation sequencing (NGS) analysis and implemented in, amongst others, the medical and microbiological fields. The present review will provide an overview of these approaches and an evaluation of their applicability in the identification of UGMOs in complex food or feed samples. PMID:27086015

  16. An anatomical analysis of the mini-modified orbitozygomatic and supra-orbital approaches.

    PubMed

    Figueiredo, Eberval G; Deshmukh, Puspha; Nakaji, Peter; Shu, Edson Bor Seng; Crawford, Neil; Spetzler, Robert F; Preul, Mark C

    2012-11-01

    Seven sides of cadaver heads were used to compare the surgical exposures provided by the mini-modified orbitozygomatic (MOz) and supra-orbital (SO) approaches. The Optotrak 3020 computerized tracking system (Northern Digital, Waterloo, ON, Canada) was utilized to evaluate the area of anatomical exposure defined by six points: (1) ipsilateral sphenoid ridge; (2) most distal point of the ipsilateral middle cerebral artery (MCA); (3) most distal point of the ipsilateral posterior cerebral artery (PCA); (4) most distal point of the contralateral PCA; (5) most distal point of the contralateral MCA; and (6) contralateral sphenoid ridge. Additionally, angles of approach for the ipsilateral MCA bifurcation, ipsilateral ICA bifurcation, basilar artery tip, contralateral MCA and ICA bifurcation and anterior communicating artery (AcomA) were evaluated, first for SO and then for MOz. An image guidance system was used to evaluate the limits of surgical exposure. No differences in the area of surgical exposure were noted (p>0.05). Vertical angles were significantly wider for the ipsilateral and contralateral ICA bifurcation, AcomA, contralateral MCA and basilar tip (p<0.05) for MOz. No differences in horizontal angles were observed between the approaches for the six targets (p>0.05). There were no differences in the limits of exposure. MOz affords no additional surgical working space. However, our results demonstrate systematically that vertical exposure is improved. The MOz should be performed while planning an approach to these regions and a wider exposure in the vertical axis is needed. PMID:22989790

  17. Successful salvage surgery for failed transforaminal lumbosacral interbody fusion using the anterior transperitoneal approach.

    PubMed

    Hozumi, Takashi; Orita, Sumihisa; Inage, Kazuhide; Fujimoto, Kazuki; Sato, Jun; Shiga, Yasuhiro; Kanamoto, Hirohito; Abe, Koki; Yamauchi, Kazuyo; Aoki, Yasuchika; Nakamura, Junichi; Matsuura, Yusuke; Suzuki, Takane; Takahashi, Kazuhisa; Ohtori, Seiji; Sainoh, Takeshi

    2016-05-01

    Transforaminal lumbar interbody fusion (TLIF) is a popular posterior spinal fusion technique, but sometimes require salvage surgery when implant failure occurs, which involves possible neural damage due to postoperative adhesion. The current report deals with successful anterior transperitoneal salvage surgery for failed L5-S TLIF with less neural invasiveness. PMID:27190611

  18. The Effectiveness of Injury Prevention Programs to Modify Risk Factors for Non-Contact Anterior Cruciate Ligament and Hamstring Injuries in Uninjured Team Sports Athletes: A Systematic Review

    PubMed Central

    Monajati, Alireza; Larumbe-Zabala, Eneko; Goss-Sampson, Mark; Naclerio, Fernando

    2016-01-01

    Background Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes. Objective The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes. Data Sources PubMed, Science Direct, Web of Science, Cochrane Libraries, U.S. National Institutes of Health clinicaltrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles. Main Results Nineteen studies were included in this review. Four assessment categories: i) landing, ii) side cutting, iii) stop-jump, and iv) muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position. Conclusions Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors. PMID:27171282

  19. Applying a Modified Triad Approach to Investigate Wastewater lines

    SciTech Connect

    Pawlowicz, R.; Urizar, L.; Blanchard, S.; Jacobsen, K.; Scholfield, J.

    2006-07-01

    Approximately 20 miles of wastewater lines are below grade at an active military Base. This piping network feeds or fed domestic or industrial wastewater treatment plants on the Base. Past wastewater line investigations indicated potential contaminant releases to soil and groundwater. Further environmental assessment was recommended to characterize the lines because of possible releases. A Remedial Investigation (RI) using random sampling or use of sampling points spaced at predetermined distances along the entire length of the wastewater lines, however, would be inefficient and cost prohibitive. To accomplish RI goals efficiently and within budget, a modified Triad approach was used to design a defensible sampling and analysis plan and perform the investigation. The RI task was successfully executed and resulted in a reduced fieldwork schedule, and sampling and analytical costs. Results indicated that no major releases occurred at the biased sampling points. It was reasonably extrapolated that since releases did not occur at the most likely locations, then the entire length of a particular wastewater line segment was unlikely to have contaminated soil or groundwater and was recommended for no further action. A determination of no further action was recommended for the majority of the waste lines after completing the investigation. The modified Triad approach was successful and a similar approach could be applied to investigate wastewater lines on other United States Department of Defense or Department of Energy facilities. (authors)

  20. Class III Restoration of Anterior Primary Teeth: In Vitro Retention Comparison of Conventional, Modified and Air-abrasion Treated Preparations

    PubMed Central

    Asl Aminabadi, Naser; Najafpour, Ebrahim; Erfanparast, Leila; Samiei, Mohammad; Haghifar, Monireh; Sighari Deljavan, Alireza; Jamali, Zahra; Pournaghi Azar, Fatemeh; Shokravi, Marzieh

    2014-01-01

    Background and aims. Anterior esthetic restoration is challenging in pediatric dentistry, due to limited durability and poor retention of the restoration.This study assessed the effect of air abrasion on tensile failure load of composite class III restorations using different preparation techniques. Materials and methods. 100 extracted human anterior primary teeth were divided, based on the preparation methods, into four groups each consisting of 25 subjects : conventional (A), labial surface bevel (B), conventional + air abrasion (C), and labial surface bevel + air abrasion (D). After restoring cavities, tensile failure load of samples was measured in Newton by Universal testing machine at a crosshead speed of 1 mm per minute. The data were analyzed by Kruskal-Wallis and Mann Whitney U tests using SPSS software. Results. There were statistically significant differences between groups A and C (P = 0.003), groups A and B (P & 0.001), groups A and D (P & 0.001), groups B and C (P = 0.028), groups B and D (P = 0.027), and also groups C and D (P& 0.001). Group D demonstrated the highest mean tensile failure load. Conclusion. Labial surface bevel treated by air abrasion showed significantly more retention of composite restoration. PMID:25093052

  1. A Versatile Approach Towards Nucleobase-Modified Aptamers.

    PubMed

    Tolle, Fabian; Brändle, Gerhard M; Matzner, Daniel; Mayer, Günter

    2015-09-01

    A novel and versatile method has been developed for modular expansion of the chemical space of nucleic acid libraries, thus enabling the generation of nucleobase-modified aptamers with unprecedented recognition properties. Reintroduction of the modification after enzymatic replication gives broad access to many chemical modifications. This wide applicability, which is not limited to a single modification, will rapidly advance the application of in vitro selection approaches beyond what is currently feasible and enable the generation of aptamers to many targets that have so far not been addressable. PMID:26224087

  2. Surgical approaches for the management of idiopathic thoracic scoliosis and the indications for combined anterior-posterior technique.

    PubMed

    Rauzzino, M J; Shaffrey, C I; Wagner, J; Nockels, R; Abel, M

    1999-05-15

    The indications for surgical intervention in patients with idiopathic scoliosis have been well defined. The goals of surgery are to achieve fusion and arrest progressive curvature while restoring normal coronal and sagittal balance. As first introduced by Harrington, posterior fusion, the gold standard of treatment, has a proven record of success. More recently, anterior techniques for performing fusion procedures via either a thoracotomy or a retroperitoneal approach have been popularized in attempts to achieve better correction of curvature, preserve motion segments, and avoid some of the complications of posterior fusion such as the development of the flat-back syndrome. Anterior instrumentation alone, although effective, can be kyphogenic and has been shown to be associated with complications such as pseudarthrosis and instrumentation failure. Performing a combined approach in patients with scoliosis and other deformities has become an increasingly popular procedure to achieve superior correction of deformity and to minimize later complications. Indications for a combined approach (usually consisting of anterior release, arthrodesis with or without use of instrumentation, and posterior segmental fusion) include: prevention of crankshaft phenomenon in juvenile or skeletally immature adolescents; correction of large curves (75 degrees ) or excessively rigid curves in skeletally mature or immature patients; correction of curves with large sagittal-plane deformities such as thoracic kyphosis (> 90 degrees ) or thoracic lordosis (> 20 degrees ); and correction of thoracolumbar curves that need to be fused to the sacrum. Surgery may be performed either in a staged proceedure or, more commonly, in a single sitting. The authors discuss techniques for combined surgery and complication avoidance. PMID:17031912

  3. Microsurgical anterior cervical foraminotomy for radiculopathy: a new approach to cervical disc herniation.

    PubMed

    Jho, H D

    1996-02-01

    A new technique of microsurgical anterior foraminotomy was developed to improve the treatment of cervical radiculopathy. This technique provides direct anatomical decompression of the compressed nerve root by removing the compressive spondylotic spur or disc fragment. The nerve root is decompressed from its origin in the spinal cord to the point at which it passes behind the vertebral artery laterally. Because most of the disc within the intervertebral space is undisturbed, a functioning motion segment of the disc remains intact. This technique differs from that of Verbiest in that it does not directly transpose the vertebral artery. Unlike Hakuba's technique, the disc within the intervertebral disc space is not removed. PMID:8592215

  4. Prognosis of anterior cruciate ligament reconstruction: a data-driven approach

    PubMed Central

    Chandra, Abhijit; Kar, Oliva; Wu, Kuan-Chuen; Hall, Michelle; Gillette, Jason

    2015-01-01

    Individuals who suffer anterior cruciate ligament (ACL) injury are at higher risk of developing knee osteoarthritis (OA) and almost 50% display symptoms 10–20 years post injury. Anterior cruciate ligament reconstruction (ACLR) often does not protect against knee OA development. Accordingly, a multi-scale formulation for data-driven prognosis (DDP) of post-ACLR is developed. Unlike traditional predictive strategies that require controlled off-line measurements or ‘training’ for determination of constitutive parameters to derive the transitional statistics, the proposed DDP algorithm relies solely on in situ measurements. The proposed DDP scheme is capable of predicting onset of instabilities. As the need for off-line testing (or training) is obviated, it can be easily implemented for ACLR, where such controlled a priori testing is almost impossible to conduct. The DDP algorithm facilitates hierarchical handling of the large dataset and can assess the state of recovery in post-ACLR conditions based on data collected from stair ascent and descent exercises of subjects. The DDP algorithm identifies inefficient knee varus motion and knee rotation as primary difficulties experienced by some of the post-ACLR population. In such cases, levels of energy dissipation rate at the knee, and its fluctuation may be used as measures for assessing progress after ACL reconstruction.

  5. Comparison of different approaches to the reduction of anterior temporomandibular joint dislocation: a randomized clinical trial.

    PubMed

    Ardehali, M M; Tari, N; Bastaninejad, Sh; Amirizad, E

    2016-08-01

    This randomized clinical trial was designed to compare three different reduction methods for anterior temporomandibular joint (TMJ) dislocation. The three methods evaluated were the conventional method, wrist pivot method, and extraoral method. The study sample comprised 90 consecutive patients suffering from anterior dislocation of the TMJ, who were allocated randomly to one of the three groups. This study found success rates of 86.7% for the conventional method, 96.7% for the wrist pivot method, and 66.7% for the extraoral method. The extraoral method was more difficult for the physician and the patient than the other two methods. For the patients, the wrist pivot method was easier than the other methods. For the doctors, the extraoral method was significantly more difficult than the other methods. In conclusion, due to the absence of a biting risk with the extraoral method and the lack of a significant difference in success between this method and the conventional method, the extraoral method could be considered the appropriate first-line treatment where there is a risk of the patient biting the surgeon's hand. Given the overall benefits of the wrist pivot method, this method could be considered the first-line and gold standard treatment modality in other cases. PMID:27160610

  6. First experiences with the direct anterior approach in lateral decubitus position: learning curve and 1 year complication rate.

    PubMed

    Melman, Wietse P R; Mollen, Bas P; Kollen, Boudewijn J; Verheyen, Cees C P M

    2015-01-01

    The direct anterior approach (DAA) in supine position for hip arthroplasty has been reported to suffer from high complication rates initially. The DAA with the patient in lateral decubitus position is believed to provide better visibility and especially femoral accessibility with potential fewer complications.The first cohort of total hip prostheses, which were implanted by a single surgeon using DAA in lateral decubitus position more than 1 year ago, was analysed retrospectively.In total 182 hip prostheses (172 patients) were analysed. Three consecutive time periods based on equal number of surgical procedures were compared. The technical complication rate and operating time improved significantly between the 3 consecutive groups. The 1 year infection rate was 0.5% and survival rate of 98.9%.This is the first series of patients that were subjected to a hip replacement based on the direct anterior approach in a lateral decubitus position in which decreasing complication rates suggest the presence of a learning curve in surgeons conducting this type of surgery. Initial complication rate was high but decreased significantly in time and was acceptable certainly in the third group of our cohort. An unacceptable complication rate with the straight uncemented stem forced us to discontinue this configuration after only 7 surgical procedures. Complication, infection and revision rates were acceptable for the all cemented hip replacements using a curved anatomical stem. PMID:25684251

  7. 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

  8. Dark energy or modified gravity? An effective field theory approach

    SciTech Connect

    Bloomfield, Jolyon; Flanagan, Éanna É.; Park, Minjoon; Watson, Scott E-mail: eef3@cornell.edu E-mail: gswatson@syr.edu

    2013-08-01

    We take an Effective Field Theory (EFT) approach to unifying existing proposals for the origin of cosmic acceleration and its connection to cosmological observations. Building on earlier work where EFT methods were used with observations to constrain the background evolution, we extend this program to the level of the EFT of the cosmological perturbations — following the example from the EFT of Inflation. Within this framework, we construct the general theory around an assumed background which will typically be chosen to mimic ΛCDM, and identify the parameters of interest for constraining dark energy and modified gravity models with observations. We discuss the similarities to the EFT of Inflation, but we also identify a number of subtleties including the relationship between the scalar perturbations and the Goldstone boson of the spontaneously broken time translations. We present formulae that relate the parameters of the fundamental Lagrangian to the speed of sound, anisotropic shear stress, effective Newtonian constant, and Caldwell's varpi parameter, emphasizing the connection to observations. It is anticipated that this framework will be of use in constraining individual models, as well as for placing model-independent constraints on dark energy and modified gravity model building.

  9. Runx2-Modified Adipose-Derived Stem Cells Promote Tendon Graft Integration in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Zhang, Xin; Ma, Yong; Fu, Xin; Liu, Qiang; Shao, Zhenxing; Dai, Linghui; Pi, Yanbin; Hu, Xiaoqing; Zhang, Jiying; Duan, Xiaoning; Chen, Wenqing; Chen, Ping; Zhou, Chunyan; Ao, Yingfang

    2016-01-01

    Runx2 is a powerful osteo-inductive factor and adipose-derived stem cells (ADSCs) are multipotent. However, it is unknown whether Runx2-overexpressing ADSCs (Runx2-ADSCs) could promote anterior cruciate ligament (ACL) reconstruction. We evaluated the effect of Runx2-ADSCs on ACL reconstruction in vitro and in vivo. mRNA expressions of osteocalcin (OCN), bone sialoprotein (BSP) and collagen I (COLI) increased over time in Runx2-ADSCs. Runx2 overexpression inhibited LPL and PPARγ mRNA expressions. Runx2 induced alkaline phosphatase activity markedly. In nude mice injected with Runx2-ADSCs, promoted bone formation was detected by X-rays 8 weeks after injection. The healing of tendon-to-bone in a rabbit model of ACL reconstruction treated with Runx2-ADSCs, fibrin glue only and an RNAi targeting Runx2, was evaluated with CT 3D reconstruction, histological analysis and biomechanical methods. CT showed a greater degree of new bone formation around the bone tunnel in the group treated with Runx2-ADSCs compared with the fibrin glue group and RNAi Runx2 group. Histology showed that treatment with Runx2-ADSCs led to a rapid and significant increase at the tendon-to-bone compared with the control groups. Biomechanical tests demonstrated higher tendon pullout strength in the Runx2-ADSCs group at early time points. The healing of the attachment in ACL reconstruction was enhanced by Runx2-ADSCs. PMID:26743583

  10. A Practical Approach to Modified Condition/Decision Coverage

    NASA Technical Reports Server (NTRS)

    Hayhurst, Kelly J.; Veerhusem, Dan S.

    2001-01-01

    Testing of software intended for safety-critical applications in commercial transport aircraft must achieve modified condition/decision coverage (MC/DC) of the software structure. This requirement causes anxiety for many within the aviation software community. Results of a survey of the aviation software industry indicate that many developers believe that meeting the MC/DC requirement is difficult, and the cost is exorbitant. Some of the difficulties stem, no doubt, from the scant information available on the subject. This paper provides a practical 5-step approach for assessing MC/DC for aviation software products, and an analysis of some types of errors expected to be caught when MC/DC is achieved1.

  11. The anterior supine intermuscular approach for total hip arthroplasty: reducing the complication rate by improving the procedure.

    PubMed

    den Hartog, Yvon M; Mathijssen, Nina M C; Peters, Sebastian J; Vehmeijer, Stephan B W

    2015-01-01

    This study describes specific complications noticed during the first unselected cases operated by anterior approach for THA in our hospital and specific adjustments that were applied on the procedure to prevent these complications. We retrospectively analysed the differences between 202 patients who were operated by a standardised approach and 248 patients who were operated after adjustments were implemented with the procedure. Injury to the lateral femoral cutaneous nerve (LFCN), fractures of the greater trochanter and dislocation were specific complications that were noticed with the initial technique.Prevalence of injury to the LFCN decreased from 7.9% to 0.8% (p<0.001), fractures of the greater trochanter decreased from 5.4% to 0.8% (p = 0.004) and the incidence of dislocation decreased from 4.5% to 1.6% (p = 0.074). PMID:25198300

  12. Heat Shock Protein Beta-1 Modifies Anterior to Posterior Purkinje Cell Vulnerability in a Mouse Model of Niemann-Pick Type C Disease.

    PubMed

    Chung, Chan; Elrick, Matthew J; Dell'Orco, James M; Qin, Zhaohui S; Kalyana-Sundaram, Shanker; Chinnaiyan, Arul M; Shakkottai, Vikram G; Lieberman, Andrew P

    2016-05-01

    Selective neuronal vulnerability is characteristic of most degenerative disorders of the CNS, yet mechanisms underlying this phenomenon remain poorly characterized. Many forms of cerebellar degeneration exhibit an anterior-to-posterior gradient of Purkinje cell loss including Niemann-Pick type C1 (NPC) disease, a lysosomal storage disorder characterized by progressive neurological deficits that often begin in childhood. Here, we sought to identify candidate genes underlying vulnerability of Purkinje cells in anterior cerebellar lobules using data freely available in the Allen Brain Atlas. This approach led to the identification of 16 candidate neuroprotective or susceptibility genes. We demonstrate that one candidate gene, heat shock protein beta-1 (HSPB1), promoted neuronal survival in cellular models of NPC disease through a mechanism that involved inhibition of apoptosis. Additionally, we show that over-expression of wild type HSPB1 or a phosphomimetic mutant in NPC mice slowed the progression of motor impairment and diminished cerebellar Purkinje cell loss. We confirmed the modulatory effect of Hspb1 on Purkinje cell degeneration in vivo, as knockdown by Hspb1 shRNA significantly enhanced neuron loss. These results suggest that strategies to promote HSPB1 activity may slow the rate of cerebellar degeneration in NPC disease and highlight the use of bioinformatics tools to uncover pathways leading to neuronal protection in neurodegenerative disorders. PMID:27152617

  13. Heat Shock Protein Beta-1 Modifies Anterior to Posterior Purkinje Cell Vulnerability in a Mouse Model of Niemann-Pick Type C Disease

    PubMed Central

    Dell’Orco, James M.; Qin, Zhaohui S.; Kalyana-Sundaram, Shanker; Chinnaiyan, Arul M.; Shakkottai, Vikram G.; Lieberman, Andrew P.

    2016-01-01

    Selective neuronal vulnerability is characteristic of most degenerative disorders of the CNS, yet mechanisms underlying this phenomenon remain poorly characterized. Many forms of cerebellar degeneration exhibit an anterior-to-posterior gradient of Purkinje cell loss including Niemann-Pick type C1 (NPC) disease, a lysosomal storage disorder characterized by progressive neurological deficits that often begin in childhood. Here, we sought to identify candidate genes underlying vulnerability of Purkinje cells in anterior cerebellar lobules using data freely available in the Allen Brain Atlas. This approach led to the identification of 16 candidate neuroprotective or susceptibility genes. We demonstrate that one candidate gene, heat shock protein beta-1 (HSPB1), promoted neuronal survival in cellular models of NPC disease through a mechanism that involved inhibition of apoptosis. Additionally, we show that over-expression of wild type HSPB1 or a phosphomimetic mutant in NPC mice slowed the progression of motor impairment and diminished cerebellar Purkinje cell loss. We confirmed the modulatory effect of Hspb1 on Purkinje cell degeneration in vivo, as knockdown by Hspb1 shRNA significantly enhanced neuron loss. These results suggest that strategies to promote HSPB1 activity may slow the rate of cerebellar degeneration in NPC disease and highlight the use of bioinformatics tools to uncover pathways leading to neuronal protection in neurodegenerative disorders. PMID:27152617

  14. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    PubMed

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol. PMID:26421244

  15. Enhanced Bone-Tendon-Bone Approach for Open Anterior Cruciate Ligament Replacement With Conservation of the Joint Capsule

    PubMed Central

    Walter, Sebastian Gottfried; Thomas, Tom Sascha; Tafuro, Luca; Thomas, Wolfram

    2015-01-01

    Arthroscopic procedures for ruptured anterior cruciate ligament (ACL) tears are a common standard. However, there are strong alternatives to this standard. The purpose of this study is to present a precise, fast, and minimally invasive but open procedure for reconstruction of the ruptured ACL. The torn ACL is substituted by a widely used bone–patellar tendon–bone (BPTB) autograft. After the BPTB graft has been harvested, the Hoffa body is exposed and mobilized ventrally. The surgeon then has a free view of the remnants of the torn ACL, which are to be removed completely. Through the tibial and femoral footprints of the ACL, a tunnel is drilled under a direct view, thus ensuring optimal anatomic positioning of the BPTB graft. The described approach is simple in handling and advantageous because all steps are performed under a direct view, which improves overall precision and intraoperative functional control. PMID:26900562

  16. Anterior versus posterior approach for four-level cervical spondylotic myelopathy.

    PubMed

    Lin, Dasheng; Zhai, Wenliang; Lian, Kejian; Kang, Liangqi; Ding, Zhenqi

    2013-11-01

    The purpose of this study was to compare the results of 2 surgical strategies for 4-level cervical spondylotic myelopathy: a hybrid procedure using anterior cervical diskectomy and fusion (ACDF) combined with segmental corpectomy versus posterior laminectomy and fixation. Between 2002 and 2010, fifty-one patients with consecutive 4-level cervical spondylotic myelopathy were treated surgically, with 27 patients undergoing the hybrid procedure and 24 undergoing posterior laminectomy and fixation. Radiologic data were compared between the 2 groups, including cervical curvature and cervical range of motion (ROM) in the sagittal plane. Pre- and postoperative neurological status was evaluated using the Japanese Orthopaedic Association (JOA) scoring system and the Nurick grading system. Mean ROM at last follow-up was not significantly different between the 2 groups (P>.05). In the hybrid group, mean JOA score and Nurick grade improved from 9.6±1.4 and 2.74±0.45 respectively, preoperatively, to 13.9±1.3 and 0.86±0.38 respectively, postoperatively. In the fixation group, mean JOA score and Nurick grade improved from 9.4±1.2 and 2.81±0.42 respectively, preoperatively, to 13.1±1.5 and 1.32±0.36 respectively, postoperatively. The JOA scores and Nurick grades at last follow-up were significantly different between the 2 groups (P<.05). In patients with preoperative cervical kyphosis, preoperative JOA score and Nurick grade were not significantly different between the 2 groups (P>.05); however, JOA scores and Nurick grades at last follow-up showed better improvement in the hybrid group than in the fixation group (P<.01). In patients with preoperative cervical lordosis, the preoperative and last follow-up JOA score and Nurick grade were not significantly different between the 2 groups (P>.05). PMID:24200449

  17. Conjunctival lymphoma: Results and treatment with a single anterior electron field. A lens sparing approach

    SciTech Connect

    Dunbar, S.F.; Linggood, R.M.; Doppke, K.P.; Duby, A.; Wang, C.C. )

    1990-08-01

    Lymphoma of the conjunctiva is rare. It presents in older patients as a mass lesion and usually remains localized. Surgery is limited to biopsy, and radiation therapy is the definitive treatment of choice. The entire conjunctiva is treated. Relatively high doses (approximately 30 Gy) are required for local control, which may lead to cataract formation. Twelve patients with conjunctival lymphoma were treated at the Massachusetts General Hospital between 1979 and 1988. Ten of 12 patients presented with a unilateral lesion; 2 of 12 with bilateral lesions. Two of 12 patients were found to have systemic disease at the time of presentation. One patient developed conjunctival lymphoma 5 years after the diagnosis of generalized disease. Using electron beam, all patients were treated with a single anterior circular field to total doses ranging from 24 Gy to 30 Gy delivered in 8 to 16 fractions over 9 to 20 days. In all cases, the lens was shielded by a specially designed plastic contact lens bearing a 12 mm diameter lead shield. The lens dose was determined at varying depths beneath the shield for 6 MeV and 9 MeV electron beams and ranged from a minimum of 5% to an absolute maximum of 18% of the total dose delivered to the tumor. Local control was maintained in all patients with follow-up to 9 1/2 years. One patient relapsed distantly 3 years after treatment. One of 12 patients died of systemic disease 4 years after treatment of the ocular lesion. Two patients developed cataracts 4 and 5 years after treatment; one had bilateral cataract, although only one eye had been treated. Both patients were over 75 years old. In both cases, the cataracts were felt to be senile cataracts which are ophthalmologically and radiographically distinguishable from radiation induced lesions.

  18. Approach-Related Complications of Anterior Lumbar Interbody Fusion: Results of a Combined Spine and Vascular Surgical Team

    PubMed Central

    Mobbs, Ralph J.; Phan, Kevin; Daly, Daniel; Rao, Prashanth J.; Lennox, Andrew

    2015-01-01

    Study Design Retrospective analysis of prospectively collected cohort data. Objective Anterior lumbar interbody fusion (ALIF) is a commonly performed procedure for the treatment of degenerative diseases of the lumbar spine. Detailed and comprehensive descriptions of intra- and postoperative complications of ALIF are surprisingly limited in the literature. In this report, we describe our experience with a team model for ALIF and report all complications occurring in our patient series. Methods Patients were prospectively enrolled between January 2009 and January 2013 by a combined spine surgeon and vascular surgeon team. All patients underwent an open ALIF using an anterior approach to the lumbosacral spine. Results From the 227 ALIF cases, mean operative blood loss was 103 mL, ranging from 30 to 900 mL. Mean operative time was 78 minutes. The average length of stay was 5.2 days. Intraoperative vascular injury requiring primary repair with suturing occurred in 15 patients (6.6%). There were 2 cases of postoperative retroperitoneal hematoma. Three patients (1.3%) had incisional hernia requiring revision surgery; 7 (3.1%) patients had prolonged ileus (>7 days) managed conservatively. Four patients described retrograde ejaculation. Sympathetic dysfunction occurred in 15 (6.6%) patients. There were 5 (2.2%) cases of superficial wound infection treated with oral antibiotics, with no deep wound infections requiring reoperation or intravenous therapy. There were no mortalities in this series. Conclusions ALIF is a safe procedure when performed by a combined vascular surgeon and spine surgeon team with acceptably low complication rates. Our series confirms that the team approach results in short operative times and length of stay, with rapid control of intraoperative vessel injury and low overall blood loss. PMID:26933616

  19. Approach-Related Complications of Anterior Lumbar Interbody Fusion: Results of a Combined Spine and Vascular Surgical Team.

    PubMed

    Mobbs, Ralph J; Phan, Kevin; Daly, Daniel; Rao, Prashanth J; Lennox, Andrew

    2016-03-01

    Study Design Retrospective analysis of prospectively collected cohort data. Objective Anterior lumbar interbody fusion (ALIF) is a commonly performed procedure for the treatment of degenerative diseases of the lumbar spine. Detailed and comprehensive descriptions of intra- and postoperative complications of ALIF are surprisingly limited in the literature. In this report, we describe our experience with a team model for ALIF and report all complications occurring in our patient series. Methods Patients were prospectively enrolled between January 2009 and January 2013 by a combined spine surgeon and vascular surgeon team. All patients underwent an open ALIF using an anterior approach to the lumbosacral spine. Results From the 227 ALIF cases, mean operative blood loss was 103 mL, ranging from 30 to 900 mL. Mean operative time was 78 minutes. The average length of stay was 5.2 days. Intraoperative vascular injury requiring primary repair with suturing occurred in 15 patients (6.6%). There were 2 cases of postoperative retroperitoneal hematoma. Three patients (1.3%) had incisional hernia requiring revision surgery; 7 (3.1%) patients had prolonged ileus (>7 days) managed conservatively. Four patients described retrograde ejaculation. Sympathetic dysfunction occurred in 15 (6.6%) patients. There were 5 (2.2%) cases of superficial wound infection treated with oral antibiotics, with no deep wound infections requiring reoperation or intravenous therapy. There were no mortalities in this series. Conclusions ALIF is a safe procedure when performed by a combined vascular surgeon and spine surgeon team with acceptably low complication rates. Our series confirms that the team approach results in short operative times and length of stay, with rapid control of intraoperative vessel injury and low overall blood loss. PMID:26933616

  20. Burnei’s anterior transthoracic retropleural approach of the thoracic spine: a new operative technique in the treatment of spinal disorders

    PubMed Central

    Gavriliu, TS; Japie, EM; Ghiță, RA; Hamei, Ș; Dughilă, C; Țiripa, IL; Elnayef, T

    2015-01-01

    Background: Up to the middle of the last century, the thoracic spine, especially in its upper part, has been considered an unapproachable site, a no-man’s land, but the constant evolution of medicine imposed techniques of the spine at these levels in order to solve a large area of pathology (infectious, tumoral, traumatic, and last but not least, deformative). This way, a series of anterior approaches allowed surgeons to gain access to the anterior part of the spine and the posterior mediastinum. The approaches described by Hodgson, Mirbaha or transthoracic transpleural approach (T4-T11), are enumerated. The idea to allow a more visible and extensive approach, but to avoid respiratory issues due to the lesion of the pleura, led to the description of a new anterior approach by Burnei in 2000. Material and method: Burnei’s approach represents an anterior approach to the thoracic spine, being a transthoracic and retropleural one. This approach allows a large area of spinal pathology due to infectious, traumatic, tumoral and degenerative (idiopathic or congenital scoliosis) causes. Statistically, this approach has been performed more frequently in cases of spinal instrumentation after diskectomy, in order to perform a partial correction of severe, rigid idiopathic scoliosis with more than 70 degrees Cobb and in cases of congenital scoliosis for hemivertebra resection and somatic synthesis to correct the scoliotic curve. Results: This kind of anterior approach allows the surgeon a large visibility of the anterior thoracic spine, diskectomies of up to 5 levels to tender the curve of the deformity and to ensure somatic or/ and transpedicular synthesis of up to 6 thoracic vertebrae. By performing a thoracotomy involving the resection of the posterior arches of the ribs, a thoracoplasty is also ensured with functional and aesthetic effects, by ameliorating the thoracic hump due to the scoliotic deformity. Conclusions: Burnei’s approach joins all the other anterior

  1. Modifiability: A Dynamic Approach To Assessing Immediate Language Change.

    ERIC Educational Resources Information Center

    Gutierrez-Clellan, Vera F.; Conboy, Barbara; Brown, Sandra; Robinson-Zanartu, Carol

    1998-01-01

    This study examined the use of dynamic mediation procedures for assessing language modifiability of Spanish-speaking students with learning disabilities. Pre- and post-mediation measures included language scores and behavioral observations of language learning and modifiability during mediation. Results indicated significant improvement in…

  2. Modified deep anterior lamellar keratoplasty for the treatment of advanced keratoconus with steep corneal curvature to help in eliminating the wrinkles in the Descemet's membrane

    PubMed Central

    Khakshoor, Hamid; Eslampoor, Alireza; Rad, Saeed Shokoohi; Vejdani, Amirhossein

    2014-01-01

    Aims: To determine the clinical efficacy of modified deep anterior lamellar keratoplasty (DALK) for the treatment of advanced-stage keratoconus with steep curvature. Materials and Methods: In this interventional, non-comparative case series, 30 patients with advanced stages of keratoconus and curvature of more than 60 D underwent a modified DALK procedure. In this technique, after big-bubble formation, posterior stromal lamella was cut and removed 5 mm centrally (baring Descemet's membrane completely) with posterior stromal layer remaining peripherally. Results: The study included 30 eyes (30 patients with a mean ± SD age of 25 ± 5.4 years). The follow-up examination was performed for all participants up to 12 months after the surgery. The mean uncorrected visual acuity (UCVA) increased from 20/800 before the surgery to a subsequent 3/10 (P =0.12). Likewise, best spectacle corrected visual acuity (BSCVA) improved, reaching 6/10 postoperatively (former quantity 20/200) (P =0.18). In addition, mean keratometry and keratometric astigmatism managed to achieve considerable improvement, from 58.8 ± 5.4 D to 46.5 ± 2.1 D and 7.8 ± 2.1 to 4.54 ± 1.54 D, respectively (P =0.52). Descemet's membrane wrinkling was not seen in any patient postoperatively. Conclusions: This technique is effective in restoring acceptable vision and corneal regularity in advanced cases of keratoconus with a curvature more than 60 D who are also at risk of Descemet's membrane wrinkling after DALK. Therefore, this procedure could prevent from Descemet membrane wrinkling in such cases. PMID:24817742

  3. Enhancement of tendon-to-bone healing after anterior cruciate ligament reconstruction using bone marrow-derived mesenchymal stem cells genetically modified with bFGF/BMP2

    PubMed Central

    Chen, Biao; Li, Bin; Qi, Yong-Jian; Ni, Qu-Bo; Pan, Zheng-Qi; Wang, Hui; Chen, Liao-Bin

    2016-01-01

    Many strategies, including various growth factors and gene transfer, have been used to augment healing after anterior cruciate ligament (ACL) reconstruction. The biological environment regulated by the growth factors during the stage of tendon-bone healing was considered important in controlling the integrating process. The purpose of this study was to evaluate the effects of bone marrow-derived mesenchymal stem cells (BMSCs) genetically modified with bone morphogenetic protein 2 (BMP2) and basic fibroblast growth factor (bFGF) on healing after ACL reconstruction. BMSCs were infected with an adenoviral vector encoding BMP2 (AdBMP2) or bFGF (AdbFGF). Then, the infected BMSCs were surgically implanted into the tendon-bone interface. At 12 weeks postoperatively, the formation of abundant cartilage-like cells, smaller tibial bone tunnel and significantly higher ultimate load and stiffness levels, through histological analysis, micro-computed tomography and biomechanical testing, were observed. In addition, the AdBMP2-plus-AdbFGF group had the smallest bone tunnel and the best mechanical properties among all the groups. The addition of BMP2 or bFGF by gene transfer resulted in better cellularity, new bone formation and higher mechanical property, which contributed to the healing process after ACL reconstruction. Furthermore, the co-application of these two genes was more powerful and efficient than either single gene therapy. PMID:27173013

  4. Enhancement of tendon-to-bone healing after anterior cruciate ligament reconstruction using bone marrow-derived mesenchymal stem cells genetically modified with bFGF/BMP2.

    PubMed

    Chen, Biao; Li, Bin; Qi, Yong-Jian; Ni, Qu-Bo; Pan, Zheng-Qi; Wang, Hui; Chen, Liao-Bin

    2016-01-01

    Many strategies, including various growth factors and gene transfer, have been used to augment healing after anterior cruciate ligament (ACL) reconstruction. The biological environment regulated by the growth factors during the stage of tendon-bone healing was considered important in controlling the integrating process. The purpose of this study was to evaluate the effects of bone marrow-derived mesenchymal stem cells (BMSCs) genetically modified with bone morphogenetic protein 2 (BMP2) and basic fibroblast growth factor (bFGF) on healing after ACL reconstruction. BMSCs were infected with an adenoviral vector encoding BMP2 (AdBMP2) or bFGF (AdbFGF). Then, the infected BMSCs were surgically implanted into the tendon-bone interface. At 12 weeks postoperatively, the formation of abundant cartilage-like cells, smaller tibial bone tunnel and significantly higher ultimate load and stiffness levels, through histological analysis, micro-computed tomography and biomechanical testing, were observed. In addition, the AdBMP2-plus-AdbFGF group had the smallest bone tunnel and the best mechanical properties among all the groups. The addition of BMP2 or bFGF by gene transfer resulted in better cellularity, new bone formation and higher mechanical property, which contributed to the healing process after ACL reconstruction. Furthermore, the co-application of these two genes was more powerful and efficient than either single gene therapy. PMID:27173013

  5. A conservative treatment approach using direct composite resins for anterior teeth eroded by lemon sucking.

    PubMed

    Passos, Vanara Florencio; de Souza, Andre Mattos Brito; Rodrigues, Lidiany Karla Azevedo; Bombonatti, Juliana Campos Fraga Soares; Santiago, Sergio Lima

    2013-08-01

    An excessively acidic diet results in the progressive deterioration of dental health, with functional, esthetic, and biological consequences. Previously, rehabilitation required placing numerous full crowns and root canal treatments; however, with improved adhesive techniques, a more conservative approach may be utilized to preserve tooth structure. This article describes 2 cases that utilized conservative dental treatments (involving direct composite resins with minimal preparation of the tooth structure) to treat eroded dentition induced by lemon sucking. PMID:23928446

  6. Patient Participation Approach to Reduction of Anterior Shoulder Dislocation: P-R-I-M/O-Y-E-S.

    PubMed

    Lachance, Paul-André; Taieb-Lachance, Catherine Isabelle

    2016-07-01

    A variety of successful techniques are available for reduction of shoulder dislocation; none have been shown to be clearly superior to another. Analgesic methods vary as well from none to deep sedation-analgesia. The literature hints at the importance of optimal muscle relaxation as a factor of success. Yet, the literature describes only cursorily the means by which muscle relaxation is optimized. Patient-centered participation and relaxation methods have been used in other contexts to reduce pain, anxiety, and muscle tension. This article proposes to integrate a patient-centered participation approach to the reduction of anterior shoulder dislocation as a way to optimize muscular relaxation nonpharmacologically. It can be used in the field in combination with the practitioner's reduction technique of choice. It minimizes risks because it entails no deep pharmacological sedation. The mnemonic P-R-I-M/O-Y-E-S is used to respectively represent the four phases: Preparation, Rehearsal, Intervention, and Mobilization as well as the 4 repeated steps in each phase of the procedure: Observe, Yield control, Explain, and Support. The focus is on (1) securing optimal patient participation within a patient-centered approach and (2) achieving nonpharmacological muscular relaxation through a simple relaxation routine. More studies are needed to identify the factors that determine success and guide the practitioner's choice among available options in shoulder dislocation reductions. PMID:26584435

  7. Orbital roof craniotomy via an eyebrow incision: a simplified anterior skull base approach.

    PubMed

    Jho, H D

    1997-09-01

    Utilizing the conceptual combination of brain protective skull base surgery and minimalism, a conventional frontal craniotomy for tumors in the subfrontal and parasellar regions is modified to an orbital roof craniotomy. Through a 4 to 5 centimeter (cm) long eyebrow incision an orbital roof craniotomy (measuring 2 cm by 3 cm), including the supraorbital arch, is made as a single piece bone flap. The orbital roof is opened up to the supraorbital fissure and to the optic canal by additional removal of the bone in the orbital roof. This will expose the globe and the orbitofrontal dura mater. When the dural incision is made at the orbital portion of the dura mater, the orbital contents are retracted by tack-up sutures. The tumor is removed utilizing the orbital space rather than the intracranial space. Brain retractors are not necessary and are not used to execute the tumor resection. This technique has been used in three patients with craniopharyngiomas, seven patients with meningiomas, and one patient with a subfrontal teratoma. Gross total resection was achieved in three patients with craniopharyngiomas and in five patients with subfrontal or parasellar meningiomas. Subtotal resection of the tumor was achieved in two patients with recurrent meningiomas and in the patient with a subfrontal teratoma. The surgeon's operating space through this exposure was sufficiently ample to achieve the goals of the operation. The direct eyebrow incision provides an additional vital working space with a width of more than 1 cm at the skull base by eliminating the scalp flap which a coronal incision employs. The surgical technique is described with a report of 11 cases. PMID:9359086

  8. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    PubMed Central

    Lehman, Gregory J.; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75); t(22) = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29)) or rectus femoris length (change = −0.005 (−0.013, +0.003); t(22) = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol. PMID:26421244

  9. The Use of a Modified Semantic Features Analysis Approach in Aphasia

    ERIC Educational Resources Information Center

    Hashimoto, Naomi; Frome, Amber

    2011-01-01

    Several studies have reported improved naming using the semantic feature analysis (SFA) approach in individuals with aphasia. Whether the SFA can be modified and still produce naming improvements in aphasia is unknown. The present study was designed to address this question by using a modified version of the SFA approach. Three, rather than the…

  10. Operative surgical nuances of modified extradural temporopolar approach with mini-peeling of dura propria based on cadaveric anatomical study of lateral cavernous structures

    PubMed Central

    Otani, Naoki; Wada, Kojiro; Toyooka, Terushige; Fujii, Kazuya; Kobayashi, Yasushi; Mori, Kentaro

    2016-01-01

    Background: Extradural temporopolar approach (ETA) has been modified as less invasive manner and named as trans-superior orbital fissure (SOF) approach with mini-peeling technique. The present study discusses the operative nuances of this modified technique on the basis of cadaveric study of lateral cavernous structures. Methods: In five consecutive cadaveric specimens, we performed an extradural anterior clinoidectomy with mini-peeling of the dura propria to expose the anterior clinoid process entirely. We also investigated the histological characteristics of the lateral cavernous sinus (CS) between the dura propria and periosteal dura at the SOF, foramen rotundum (FR), and foramen ovale (FO) levels, and of each trigeminal nerve division. Results: Coronal histological examination of the lateral wall of the CS showed invagination of the dura propria and periosteal dura into the SOF. In contrast, no such invagination was observed at the levels of the FR and FO. This finding supports the technical rationale of the only skeletonization of the SOF for peeling of the dura propria but not FR. In addition, our modified ETA method needs only minimal dural incision between the SOF and FR where no cranial nerves are present. Conclusion: Our technical modification of ETA may be recommended for surgical treatment of paraclinoid lesions to reduce the risk of intraoperative neurovascular injury. PMID:27500005

  11. Modified lattice-statics approach to dislocation calculations. I - Formalism

    NASA Technical Reports Server (NTRS)

    Esterling, D. M.

    1978-01-01

    A modified lattice-statics method to calculate the atomic displacements associated with a screw dislocation is outlined. The model incorporates an anharmonic region wherein the forces are derived from a pair potential. Appropriate energy and force expressions are derived. The modifications necessary for the implementation of the conjugate-gradient function minimization method are also derived.

  12. Diversity and Choice in School Education: A Modified Libertarian Approach.

    ERIC Educational Resources Information Center

    Hargreaves, David H.

    1996-01-01

    Argues from a modified libertarian position that diversity and choice in school education are desirable unless some convincing argument and evidence can be shown that the costs greatly outweigh the benefits and any costs incurred cannot be reduced or overcome by limited state intervention. (MJP)

  13. Improving Student Group Marketing Presentations: A Modified Pecha Kucha Approach

    ERIC Educational Resources Information Center

    Oliver, Jason; Kowalczyk, Christine

    2013-01-01

    Student presentations can often seem like a formality rather than a lesson in representing oneself or group in a professional manner. To improve the quality of group presentations, the authors modified the popular presentation style of Pecha Kucha (20 slides, 20 seconds per slide) for marketing courses to help students prepare and deliver…

  14. The Third-Difference Approach to Modified Allan Variance

    NASA Technical Reports Server (NTRS)

    Greenhall, C. A.

    1995-01-01

    This study gives strategies for estimating the modified Allan variance (mvar) and formulas for computing the equivalent degrees of freedom (edf) of the estimators. A third-difference formulation of mvar leads to a tractable formula for edf in the presence of power-law phase noise. The effect of estimation stride on edf is tabulated. First-degree rational-function approximations for edf are derived.

  15. "Structured Discovery": A Modified Inquiry Approach to Teaching Social Studies.

    ERIC Educational Resources Information Center

    Lordon, John

    1981-01-01

    Describes structured discovery approach to inquiry teaching which encourages the teacher to select instructional objectives, content, and questions to be answered. The focus is on individual and group activities. A brief outline using this approach to analyze Adolf Hitler is presented. (KC)

  16. Modified lattice-statics approach to dislocation calculations. II - Application

    NASA Technical Reports Server (NTRS)

    Esterling, D. M.; Moriarty, J. A.

    1978-01-01

    The atomic structure of a screw dislocation core of the 110 line type in aluminum is calculated by the modified lattice-statics method developed in the preceding paper. The method includes anharmonic as well as harmonic forces and permits relaxation of the atoms in all three dimensions. All forces used in the present calculations were derived from a first-principles interatomic pair potential obtained via pseudopotential theory. Several significant differences from the ordinary lattice statics results are noted, including the displacement field, Peierl's energy barrier, and the equilibrium core-center location.

  17. Generation of differentially modified microtubules using in vitro enzymatic approaches.

    PubMed

    Vemu, Annapurna; Garnham, Christopher P; Lee, Duck-Yeon; Roll-Mecak, Antonina

    2014-01-01

    Tubulin, the building block of microtubules, is subject to chemically diverse and evolutionarily conserved post-translational modifications that mark microtubules for specific functions in the cell. Here we describe in vitro methods for generating homogenous acetylated, glutamylated, or tyrosinated tubulin and microtubules using recombinantly expressed and purified modification enzymes. The generation of differentially modified microtubules now enables a mechanistic dissection of the effects of tubulin post-translational modifications on the dynamics and mechanical properties of microtubules as well as the behavior of motors and microtubule-associated proteins. PMID:24630106

  18. Cervical intervertebral disc herniation treatment via radiofrequency combined with low-dose collagenase injection into the disc interior using an anterior cervical approach

    PubMed Central

    Wang, Zhi-Jian; Zhu, Meng-Ye; Liu, Xiao-Jian; Zhang, Xue-Xue; Zhang, Da-Ying; Wei, Jian-Mei

    2016-01-01

    Abstract This study aimed to determine the therapeutic effect of radiofrequency combined with low-dose collagenase injected into the disc interior via an anterior cervical approach for cervical intervertebral disc herniation. Forty-three patients (26–62-year old; male/female ratio: 31/12) with cervical intervertebral disc herniation received radiofrequency combined with 60 to 100 U of collagenase, injected via an anterior cervical approach. The degree of nerve function was assessed using the current Japanese Orthopaedic Association (JOA) scoring system at 3 and 12 months postoperation. A visual analogue scale (VAS) was used to evaluate the degree of pain preoperation and 7 days postoperation. The preoperative and 3 month postoperative protrusion areas were measured and compared via magnetic resonance imaging (MRI) and picture archiving and communication systems (PACS). Compared with the preoperative pain scores, the 7-day postoperative pain was significantly reduced (P <0.01). The excellent and good rates of nerve function amelioration were 93.0% and 90.7% at 3 and 12 months postoperation, respectively, which was not significantly different. Twenty-seven cases exhibited a significantly reduced protrusion area (P <0.01) at 3 months postoperation. No serious side effects were noted. To our knowledge, this is the first study to demonstrate that the use of radiofrequency combined with low-dose collagenase injection into the disc interior via an anterior cervical approach is effective and safe for the treatment of cervical intervertebral disc herniation. PMID:27336892

  19. a Modified Approach Based on Influence Coefficient Method for Balancing Crank-Shafts

    NASA Astrophysics Data System (ADS)

    KANG, Y.; CHANG, Y.-P.; TSENG, M.-H.; TANG, P.-H.; CHANG, Y.-F.

    2000-07-01

    The conventional balancing machines utilize two-plane separation for the determination of equivalent imbalances. However, the imbalance masses of a crank-shaft cannot be corrected at arbitrary locations of the balancing planes. This study has presented a modified method for balancing crank-shafts by using the soft-pedestal machines. The modified influence coefficient method for asymmetrical rotor-bearing systems has been applied to balance crank-shafts. Also, the decomposition method for irremovable masses has been replaced by an iteration method based on an influence coefficient approach. Furthermore, the validity and accuracy of the modified approach are verified in balancing practical crank-shafts.

  20. Modified approaches for high pressure filtration of fine clean coal

    SciTech Connect

    Yang, J.; Groppo, J.G.; Parekh, B.K.

    1995-12-31

    Removal of moisture from fine (minus 28 mesh) clean coal to 20% or lower level is difficult using the conventional vacuum dewatering technique. High pressure filtration technique provides an avenue for obtaining low moisture in fine clean coal. This paper describes a couple of novel approaches for dewatering of fine clean coal using pressure filtration which provides much lower moisture in fine clean coal than that obtained using conventional pressure filter. The approaches involve (a) split stream dewatering and (b) addition of paper pulp to the coal slurry. For Pittsburgh No. 8 coal slurry, split stream dewatering at 400 mesh provided filter cake containing 12.9% moisture compared to 24.9% obtained on the feed material. The addition of paper pulp to the slurry provided filter cake containing about 17% moisture.

  1. Synthesis of cyclic oligonucleotides by a modified phosphotriester approach.

    PubMed Central

    de Vroom, E; Broxterman, H J; Sliedregt, L A; van der Marel, G A; van Boom, J H

    1988-01-01

    Evidence will be presented to show that the allyl group is suitable for the protection of a 3'-terminal phosphodiester function. The latter will be demonstrated by the synthesis, via a phosphotriester approach, of two cyclic tetraribonucleotides [r(AAAA) and r(UAMe2UAMe2)], two cyclic hexadeoxyribonucleotides [d(CGCGCG) and d(TAAAAA)] and a cyclic octadeoxyribonucleotide [d(CGTGCGTG)]. PMID:3380690

  2. Modified FGP approach and MATLAB program for solving multi-level linear fractional programming problems

    NASA Astrophysics Data System (ADS)

    Lachhwani, Kailash; Nehra, Suresh

    2015-09-01

    In this paper, we present modified fuzzy goal programming (FGP) approach and generalized MATLAB program for solving multi-level linear fractional programming problems (ML-LFPPs) based on with some major modifications in earlier FGP algorithms. In proposed modified FGP approach, solution preferences by the decision makers at each level are not considered and fuzzy goal for the decision vectors is defined using individual best solutions. The proposed modified algorithm as well as MATLAB program simplifies the earlier algorithm on ML-LFPP by eliminating solution preferences by the decision makers at each level, thereby avoiding difficulties associate with multi-level programming problems and decision deadlock situation. The proposed modified technique is simple, efficient and requires less computational efforts in comparison of earlier FGP techniques. Also, the proposed coding of generalized MATLAB program based on this modified approach for solving ML-LFPPs is the unique programming tool toward dealing with such complex mathematical problems with MATLAB. This software based program is useful and user can directly obtain compromise optimal solution of ML-LFPPs with it. The aim of this paper is to present modified FGP technique and generalized MATLAB program to obtain compromise optimal solution of ML-LFP problems in simple and efficient manner. A comparative analysis is also carried out with numerical example in order to show efficiency of proposed modified approach and to demonstrate functionality of MATLAB program.

  3. Modified One-piece Supraorbital Approach for Orbital Tumors: Widely Preserved Orbital Roof in a Self-fitting Flap.

    PubMed

    Shimizu, Satoru; Osawa, Shigeyuki; Sekiguchi, Tomoko; Mochizuki, Takahiro; Oka, Hidehiro; Kumabe, Toshihiro

    2015-12-01

    Objectives The one-piece supraorbital approach is a rational approach for the removal of orbital tumors. However, cutting the roof through the orbit is often difficult. We modified the technique to facilitate the osteotomy and improve the cosmetic effect. Design Three burr holes are made: the first, the MacCarty keyhole (burr hole 1), exposes the anterior cranial fossa and orbit; the second is placed above the supraorbital nerve (burr hole 2); and the third on the superior temporal line. Through burr hole 2, a small hole is created on the roof, 10 mm in depth. Next the roof is rongeured through burr hole 1 toward the preexisting small hole. Seamless osteotomies using a diamond-coated threadwire saw and the preexisting four holes are performed. Lastly the flap is removed. On closure, sutures are passed through holes in the cuts made with the threadwire saw, and tied. Results We applied our technique to address orbital tumors in two adult patients. The osteotomies in the roof were easy, and most parts of the roof were repositioned. Conclusions Our modification results in orbital osteotomies with greater preservation of the roof. Because the self-fitting flap does not require the use of fixation devices, the reconstruction is cosmetically satisfactory. PMID:26682124

  4. Internal carotid artery dissection after anterior cervical disc replacement: first case report and literature review of vascular complications of the approach.

    PubMed

    Loret, Jean-Edouard; Francois, Patrick; Papagiannaki, Chrysanthi; Cottier, Jean-Philippe; Terrier, Louis-Marie; Zemmoura, Ilyess

    2013-07-01

    We report the case of a 41-year-old woman who underwent cervical total disc replacement at C4C5 and C5C6 levels and fusion at C6C7 level through an anterior right-side approach. After anesthesia recovery, the patient presented left hemiparesia and facial palsy due to large right hemispheric stroke. Diffusion-weighted magnetic resonance imaging was performed as soon as the patient developed neurologic symptoms of stroke and revealed a right internal carotid artery dissection. Digital substraction angiography, endovascular stenting, angioplasty and thrombectomy were performed. Six months after treatment, clinical examination showed mild left-arm spasticity. To the best of our knowledge, only two cases of internal carotid artery stroke without dissection or thrombosis are reported. In conclusion, although vascular complications are rare after anterior cervical spine procedure, internal carotid artery dissection can occur. Suspected risk factors are prolonged retraction of the carotid artery and neck extension. PMID:23728441

  5. Anterior Decompression and Shortening Reconstruction with a Titanium Mesh Cage through a Posterior Approach Alone for the Treatment of Lumbar Burst Fractures

    PubMed Central

    Abe, Eiji; Miyakoshi, Naohisa; Murai, Hajime; Kobayashi, Takashi; Abe, Toshiki; Kikuchi, Kazuma; Shimada, Yoichi

    2012-01-01

    Study Design A retrospective study. Purpose To examine the efficacy and safety for a posterior-approach circumferential decompression and shortening reconstruction with a titanium mesh cage for lumbar burst fractures. Overview of Literature Surgical decompression and reconstruction for severely unstable lumbar burst fractures requires an anterior or combined anteroposterior approach. Furthermore, anterior instrumentation for the lower lumbar is restricted through the presence of major vessels. Methods Three patients with an L1 burst fracture, one with an L3 and three with an L4 (5 men, 2 women; mean age, 65.0 years) who underwent circumferential decompression and shortening reconstruction with a titanium mesh cage through a posterior approach alone and a 4-year follow-up were evaluated regarding the clinical and radiological course. Results Mean operative time was 277 minutes. Mean blood loss was 471 ml. In 6 patients, the Frankel score improved more than one grade after surgery, and the remaining patient was at Frankel E both before and after surgery. Mean preoperative visual analogue scale was 7.0, improving to 0.7 postoperatively. Local kyphosis improved from 15.7° before surgery to -11.0° after surgery. In 3 cases regarding the mid to lower lumbar patients, local kyphosis increased more than 10° by 3 months following surgery, due to subsidence of the cages. One patient developed severe tilting and subsidence of the cage, requiring additional surgery. Conclusions The results concerning this small series suggest the feasibility, efficacy, and safety of this treatment for unstable lumbar burst fractures. This technique from a posterior approach alone offers several advantages over traditional anterior or combined anteroposterior approaches. PMID:22708016

  6. Probing modified gravity with atom-interferometry: A numerical approach

    NASA Astrophysics Data System (ADS)

    Schlögel, Sandrine; Clesse, Sébastien; Füzfa, André

    2016-05-01

    Refined constraints on chameleon theories are calculated for atom-interferometry experiments, using a numerical approach consisting in solving for a four-region model the static and spherically symmetric Klein-Gordon equation for the chameleon field. By modeling not only the test mass and the vacuum chamber but also its walls and the exterior environment, the method allows one to probe new effects on the scalar field profile and the induced acceleration of atoms. In the case of a weakly perturbing test mass, the effect of the wall is to enhance the field profile and to lower the acceleration inside the chamber by up to 1 order of magnitude. In the thin-shell regime, results are found to be in good agreement with the analytical estimations, when measurements are realized in the immediate vicinity of the test mass. Close to the vacuum chamber wall, the acceleration becomes negative and potentially measurable. This prediction could be used to discriminate between fifth-force effects and systematic experimental uncertainties, by doing the experiment at several key positions inside the vacuum chamber. For the chameleon potential V (ϕ )=Λ4 +α/ϕα and a coupling function A (ϕ )=exp (ϕ /M ), one finds M ≳7 ×1016 GeV , independently of the power-law index. For V (ϕ )=Λ4(1 +Λ /ϕ ), one finds M ≳1014 GeV . A sensitivity of a ˜10-11 m /s2 would probe the model up to the Planck scale. Finally, a proposal for a second experimental setup, in a vacuum room, is presented. In this case, Planckian values of M could be probed provided that a ˜10-10 m /s2 , a limit reachable by future experiments. Our method can easily be extended to constrain other models with a screening mechanism, such as symmetron, dilaton and f(R) theories.

  7. Anterior Knee Pain (Chondromalacia Patellae).

    ERIC Educational Resources Information Center

    Garrick, James G.

    1989-01-01

    This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

  8. Modified Scaled Hierarchical Equation of Motion Approach for the Study of Quantum Coherence in Photosynthetic Complexes

    SciTech Connect

    Zhu, J.; Kais, S.; Rebentrost, P.; Aspuru-Guzik, Alan

    2011-02-17

    We present a detailed theoretical study of the transfer of electronic excitation energy through the Fenna-Matthews-Olson (FMO) pigment-protein complex, using the newly developed modified scaled hierarchical approach (Shi, Q.; et al. J. Chem. Phys.2009, 130, 084105). We show that this approach is computationally more efficient than the original hierarchical approach. The modified approach reduces the truncation levels of the auxiliary density operators and the correlation function. We provide a systematic study of how the number of auxiliary density operators and the higher-order correlation functions affect the exciton dynamics. The time scales of the coherent beating are consistent with experimental observations. Furthermore, our theoretical results exhibit population beating at physiological temperature. Additionally, the method does not require a low-temperature correction to obtain the correct thermal equilibrium at long times.

  9. A Child is Not a Little Adult: Modified Approaches to Sport for Australian Children.

    ERIC Educational Resources Information Center

    Winter, Gillian; And Others

    This publication reports on competitive sports played by 6 to 12 year old children in Australia. The information in this two-part report is directed toward teachers, coaches, and parents. Part I, "Modified Approaches to Junior Sport," provides discussion of aspects of physical, social, and emotional development associated with children playing…

  10. Mathematical Understanding and Proving Abilities: Experiment with Undergraduate Student by Using Modified Moore Learning Approach

    ERIC Educational Resources Information Center

    Maya, Rippi; Sumarmo, Utari

    2011-01-01

    This paper reports findings of a post test experimental control group design conducted to investigate the role of modified Moore learning approach on improving students' mathematical understanding and proving abilities. Subjects of study were 56 undergraduate students of one state university in Bandung, who took advanced abstract algebra course.…

  11. Computer-aided analysis of Landsat-1 MSS data - A comparison of three approaches, including a 'modified clustering' approach

    NASA Technical Reports Server (NTRS)

    Fleming, M. D.; Berkebile, J. S.; Hoffer, R. M.

    1975-01-01

    Three approaches for analyzing Landsat-1 data from Ludwig Mountain in the San Juan Mountain range in Colorado are considered. In the 'supervised' approach the analyst selects areas of known spectral cover types and specifies these to the computer as training fields. Statistics are obtained for each cover type category and the data are classified. Such classifications are called 'supervised' because the analyst has defined specific areas of known cover types. The second approach uses a clustering algorithm which divides the entire training area into a number of spectrally distinct classes. Because the analyst need not define particular portions of the data for use but has only to specify the number of spectral classes into which the data is to be divided, this classification is called 'nonsupervised'. A hybrid method which selects training areas of known cover type but then uses the clustering algorithm to refine the data into a number of unimodal spectral classes is called the 'modified-supervised' approach.

  12. Results of a modified posterolateral approach for the isolated posterolateral tibial plateau fracture

    PubMed Central

    Liu, Guan-Yi; Xiao, Bai-Ping; Luo, Cong-Feng; Zhuang, Yun-Qiang; Xu, Rong-Ming; Ma, Wei-Hu

    2016-01-01

    Background: There are few posterolateral approaches that do not require the common peroneal nerve (CPN) dissection. With the nerve exposure, it would pose a great challenge and sometimes iatrogenic damage over the surgical course. The purpose was to present a case series of patients with posterolateral tibial plateau fractures treated by direct exposure and plate fixation through a modified posterolateral approach without exposing the common peroneal nerve (CPN). Materials and Methods: 9 consecutive cases of isolated posterior fractures of the posterolateral tibial plateau were operated by open reduction and plate fixation through the modified posterolateral approach without exposing the CPN between June 2009 and January 2012. Articular reduction quality was assessment according to the immediate postoperative radiographs. At 24 month followup, all patients had radiographs and were asked to complete a validated outcome measure and the modified Hospital for Special Surgery (HSS) Knee Scale. Results: All patients were followedup, with a mean period of 29 months (range 25–40 months). Bony union was achieved in all patients. In six cases, the reduction was graded as best and in three cases the reduction was graded as middle according to the immediate postoperative radiographs by the rank order system. The average range of motion arc was 127° (range 110°–134°) and the mean postoperative HSS was 93 (range 85–97) at 24 months followup. None of the patients sustained neurovascular complication. Conclusions: The modified posterolateral approach through a long skin incision without exposing the CPN could help to expand the surgical options for an optimal treatment of this kind of fracture, and plating of posterolateral tibial plateau fractures would result in restoration and maintenance of alignment. This approach demands precise knowledge of the anatomic structures of this region. PMID:27053799

  13. Concomitant Transsphenoidal Approach to the Anterior Skull Base and Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis

    PubMed Central

    Schaberg, Madeleine R.; Shah, Gopi B.; Evans, James J.; Rosen, Marc R.

    2013-01-01

    Objectives To describe outcomes of endoscopic resection of sellar tumors with concomitant endoscopic sinus surgery for patients with chronic rhinosinusitis (CRS). Design Retrospective chart review. Setting Tertiary care medical center. Participants Patients who underwent endoscopic transsphenoidal surgery for excision of anterior skull base lesions and simultaneous functional endoscopic sinus surgery (FESS) for CRS between January 2006 and January 2011 by senior authors (MRR and JJE). Main Outcomes Measured Short- and long-term postoperative complications. Results Fourteen patients were identified. Average follow-up was 27 months. All patients had preoperative symptoms consistent with CRS. No patients were treated with preoperative antibiotics. Surgical pathology revealed chronic sinusitis in all specimens. Pathology of the intracranial lesions included 11 pituitary macroadenomas, one craniopharyngioma, one chondrosarcoma, and one cholesterol granuloma. Short-term postoperative morbidities included a sphenoid polyp, one adhesion, and one case of pharyngitis. Long-term outcomes included one frontoethmoidal mucocele, one recurrence of nasal polyps, and three cases of acute sinusitis. There were no intracranial complications for the entire follow-up period. Conclusions Transsphenoidal surgery can safely be performed in the setting of CRS without increased risk of intracranial complications. PMID:24436919

  14. Three dimensional anatomy of the anterior cruciate ligament: a new approach in anatomical orthopedic studies and a literature review

    PubMed Central

    Arliani, Gustavo Gonçalves; Astur, Diego Costa; Moraes, Eduardo Ramalho; Kaleka, Camila Cohen; Jalikjian, Wahi; Golano, Pau; Cohen, Moisés

    2012-01-01

    Background The anterior cruciate ligament (ACL) is an important structure in the knee. The ACL does not heal following lesions, and surgical reconstruction is the standard treatment among athletes. Some steps of ACL reconstruction remain controversial. It is important to fully understand the anatomy of the ACL to accurately reproduce its anatomy during surgical reconstructions. The purpose of this study was to evaluate the use of anaglyphic images that produce 3D images to better visualize the anatomy of the ACL, and to highlight the anatomical features of this ligament as reported in the literature. Methods We included ten knees in this study. After dissection of the knee structures, pictures were acquired using a camera with Nikon D40, AF-S Nikkor 18–55 mm (1:3.5–5.6 G2 ED), and Micro Nikkor 105 mm (1:2.8) lenses. The pair of images was processed using Callipyan 3D Anabuilder software, which transforms the two images into one anaglyphic image. Results During the dissection of the knees, nine pictures were acquired and transformed into anaglyphic images. Conclusion This study, demonstrated that the use of 3D images is a useful tool that can improve the knowledge of the anatomy of the knee, while also facilitating knee reconstruction surgery. PMID:24198601

  15. Assessing the impact of the Indian Ocean tsunami on households: a modified domestic assets index approach.

    PubMed

    Arlikatti, Sudha; Peacock, Walter Gillis; Prater, Carla S; Grover, Himanshu; Sekar, Arul S Gnana

    2010-07-01

    This paper offers a potential measurement solution for assessing disaster impacts and subsequent recovery at the household level by using a modified domestic assets index (MDAI) approach. Assessment of the utility of the domestic assets index first proposed by Bates, Killian and Peacock (1984) has been confined to earthquake areas in the Americas and southern Europe. This paper modifies and extends the approach to the Indian sub-continent and to coastal surge hazards utilizing data collected from 1,000 households impacted by the Indian Ocean tsunami (2004) in the Nagapattinam district of south-eastern India. The analyses suggest that the MDAI scale is a reliable and valid measure of household living conditions and is useful in assessing disaster impacts and tracking recovery efforts over time. It can facilitate longitudinal studies, encourage cross-cultural, cross-national comparisons of disaster impacts and inform national and international donors of the itemized monetary losses from disasters at the household level. PMID:20298262

  16. A combined periodontal - prosthetic treatment approach to manage unusual gingival visibility in resting lip position and inversely inclined upper anterior teeth: a case report with discussion.

    PubMed

    Biniraj, K R; Janardhanan, Mahija; Sunil, M M; Sagir, Mohammed; Hariprasad, A; Paul, Tony P; Emmatty, Rishi

    2015-03-01

    Excessive gingival visibility during smile is a common esthetic complaint in dentistry, but excessive gingival visibility in resting lip position is relatively uncommon condition. Several exclusive radical to conservative surgical treatment or its combination with orthodontic therapy to treat this condition are within the reach of every patient nowadays. A case report of an excessive gingival visibility because of altered passive eruption along with inversely inclined maxillary anterior teeth is presented here. A relatively simple treatment approach combining periodontal and restorative therapy is used here to achieve the desirable aesthetic results. The gingival exposure resulting from altered passive eruption was completely managed by a gingivectomy, but the inclined appearance of teeth was still an aesthetic complaint. After complete healing of gingivectomy surgery, appropriately designed crowns were given to rectify the inversely inclined appearance. A complete rehabilitation of patient's smile could be achieved, the case was followed up for 3 years and the condition was found satisfactory. PMID:25878482

  17. Prosthetic-restorative approach for the restoration of tooth wear. Vdo increase, rehabilitation of anatomy and function and aesthetic restoration of anterior teeth. Case report

    PubMed Central

    GARGARI, M.; CERUSO, F.M.; PRETE, V.; PUJIA, A.

    2012-01-01

    SUMMARY Prosthetic-restorative approach for the restoration of tooth wear. Case report Objective This article presents a case report of combined prosthetic-adhesive rehabilitation in a patient with a generalized tooth wear. Methods A combined treatment adhesive - prosthetic was proposed to a male patient of 65 years old having a clinically significant tooth wear, with dentine exposure and with a reduction in clinical crown height. The erosive/abrasive worn dentition have been reconstructed with direct resin composite restorations on the posterior teeth and with zirconia crown on the anterior teeth. Results Direct composite restorations have a number of distinct advantages. These restorations have proved durable and aesthetic, protect tooth structure and posterior occlusal contact is predictably re-established. Conclusions. A combinations of direct and indirect restorations, based on the new vertical dimension of occlusion (VDO), can help to reestablish anatomy and function. PMID:23285409

  18. Validation of the modified Becker's split-window approach for retrieving land surface temperature from AVHRR

    NASA Astrophysics Data System (ADS)

    Quan, Weijun; Chen, Hongbin; Han, Xiuzhen; Ma, Zhiqiang

    2015-10-01

    To further verify the modified Becker's split-window approach for retrieving land surface temperature (LST) from long-term Advanced Very High Resolution Radiometer (AVHRR) data, a cross-validation and a radiance-based (R-based) validation are performed and examined in this paper. In the cross-validation, 3481 LST data pairs are extracted from the AVHRR LST product retrieved with the modified Becker's approach and compared with the Moderate Resolution Imaging Spectroradiometer (MODIS) LST product (MYD11A1) for the period 2002-2008, relative to the positions of 548 weather stations in China. The results show that in most cases, the AVHRR LST values are higher than the MYD11A1. When the AVHRR LSTs are adjusted with a linear regression, the values are close to the MYD11A1, showing a good linear relationship between the two datasets ( R 2 = 0.91). In the R-based validation, comparison is made between AVHRR LST retrieved from the modified Becker's approach and the inversed LST from the Moderate Resolution Transmittance Model (MODTRAN) consolidated with observed temperature and humidity profiles at four radiosonde stations. The results show that the retrieved AVHRR LST deviates from the MODTRAN inversed LST by-1.3 (-2.5) K when the total water vapor amount is less (larger) than 20 mm. This provides useful hints for further improvement of the LST retrieval algorithms' accuracy and consistency.

  19. Approaches for the Identification of Genetic Modifiers of Nutrient Dependent Phenotypes: Examples from Folate

    PubMed Central

    Zinck, John W. R.; MacFarlane, Amanda J.

    2014-01-01

    By combining the sciences of nutrition, bioinformatics, genomics, population genetics, and epidemiology, nutrigenomics is improving our understanding of how diet and nutrient intake can interact with or modify gene expression and disease risk. In this review, we explore various approaches to examine gene–nutrient interactions and the modifying role of nutrient consumption, as they relate to nutrient status and disease risk in human populations. Two common approaches include the use of SNPs in candidate genes to identify their association with nutritional status or disease outcomes, or genome-wide association studies to identify genetic polymorphisms associated with a given phenotype. Here, we examine the results of various gene–nutrient interaction studies, the association of genetic polymorphisms with disease expression, and the identification of nutritional factors that modify gene-dependent disease phenotypes. We have focused on specific examples from investigations of the interactions of folate, B-vitamin consumption, and polymorphisms in the genes of B-vitamin dependent enzymes and their association with disease risk, followed by an examination of the strengths and limitations of the methods employed. We also present suggestions for future studies, including an approach from an on-going large scale study, to examine the interaction of nutrient intake and genotypic variation and their impact on nutritional status. PMID:25988111

  20. A modified team approach for the evaluation of children with moderate or greater mental retardation.

    PubMed

    Adamson, J F

    1969-12-01

    A modified diagnostic team approach was tried as a solution to increased service demands, staff shortage, and imbalance at a regional state diagnostic center. Departing from their usual diagnostic roles, psychologists and pediatricians did social history taking and related tasks. In this way, 100 moderate and severely retarded children and their families received diagnostic help over a year's time. Through care and responsibility and innovation in the planning and implementation of the project, and through cooperative staff functioning, problems involving staff shortage and imbalance and assumed urgent service demands were overcome. Pending an independent follow-up evaluation, the approach is recommended. PMID:24178874

  1. Modifying Automatic Approach Action Tendencies in Individuals with Elevated Social Anxiety Symptoms

    PubMed Central

    Taylor, Charles T.; Amir, Nader

    2012-01-01

    Research suggests that social anxiety is associated with a reduced approach orientation for positive social cues. In the current study we examined the effect of experimentally manipulating automatic approach action tendencies on the social behavior of individuals with elevated social anxiety symptoms. The experimental paradigm comprised a computerized Approach Avoidance Task (AAT) in which participants responded to pictures of faces conveying positive or neutral emotional expressions by pulling a joystick toward themselves (approach) or by moving it to the right (sideways control). Participants were randomly assigned to complete an AAT designed to increase approach tendencies for positive social cues by pulling these cues toward themselves on the majority of trials, or to a control condition in which there was no contingency between the arm movement direction and picture type. Following the manipulation, participants took part in a relationship-building task with a trained confederate. Results revealed that participants trained to approach positive stimuli displayed greater social approach behaviors during the social interaction and elicited more positive reactions from their partner compared to participants in the control group. These findings suggest that modifying automatic approach tendencies may facilitate engagement in the types of social approach behaviors that are important for relationship development. PMID:22728645

  2. A targeted proteomics approach to the identification of peptides modified by reactive metabolites.

    PubMed

    Tzouros, Manuel; Pähler, Axel

    2009-05-01

    Covalent binding of reactive metabolites is generally accepted as one underlying mechanism of drug-induced toxicity. However, identification of protein targets by reactive metabolites still remains a challenge due to their low abundance. Here, we report the development of a highly selective proteomics workflow for the targeted identification of peptides modified by reactive metabolites. An equimolar mixture of non- and radiolabeled furan containing 2-amino-pyrimidine drug candidate (1 and 14C(1)-1) along with rat liver microsomes were used for the in vitro generation of reactive metabolites. Liver microsomal proteins were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, modified protein bands were highlighted by autoradiography and in-gel digested, and peptides were fractionated by strong cation exchange chromatography. Fractions enriched in modified peptides, as determined by radioactivity levels, were subjected to nanoLC-MS/MS and unambiguously detected based on their unique 12C/14C MS isotope pattern fingerprint. The peptide detection step could be automated using isotope pattern recognition software. Peptide sequencing, identification of the site of modification, and reactive metabolite characterization were achieved by MS2 and MS3 experiments using high-resolution and accurate mass detection. This approach led to the identification of four modified peptides originating from three drug-metabolizing enzymes, MGST1, FMO1, and P450 2C11. These revealed modifications by five different metabolite structures. This approach is generally suitable for the identification and characterization of modified proteins and metabolite structures involved in covalent binding and may serve as a valuable tool to link protein targets with clinically relevant toxicities. PMID:19317514

  3. Pertussis toxin modifies the characteristics of both the inhibitory GTP binding proteins and the somatostatin receptor in anterior pituitary tumor cells

    SciTech Connect

    Mahy, N.; Woolkalis, M.; Thermos, K.; Carlson, K.; Manning, D.; Reisine, T.

    1988-08-01

    The effects of pertussis toxin treatment on the characteristics of somatostatin receptors in the anterior pituitary tumor cell line AtT-20 were examined. Pertussis toxin selectively catalyzed the ADP ribosylation of the alpha subunits of the inhibitory GTP binding proteins in AtT-20 cells. Toxin treatment abolished somatostatin inhibition of forskolin-stimulated adenylyl cyclase activity and somatostatin stimulation of GTPase activity. To examine the effects of pertussis toxin treatment on the characteristics of the somatostatin receptor, the receptor was labeled by the somatostatin analog (125I)CGP 23996. (125I)CGP 23996 binding to AtT-20 cell membranes was saturable and within a limited concentration range was to a single high affinity site. Pertussis toxin treatment reduced the apparent density of the high affinity (125I)CGP 23996 binding sites in AtT-20 cell membranes. Inhibition of (125I)CGP 23996 binding by a wide concentration range of CGP 23996 revealed the presence of two binding sites. GTP predominantly reduced the level of high affinity sites in control membranes. Pertussis toxin treatment also diminished the amount of high affinity sites. GTP did not affect (125I)CGP 23996 binding in the pertussis toxin-treated membranes. The high affinity somatostatin receptors were covalently labeled with (125I) CGP 23996 and the photoactivated crosslinking agent n-hydroxysuccinimidyl-4-azidobenzoate. No high affinity somatostatin receptors, covalently bound to (125I)CGP 23996, were detected in the pertussis toxin-treated membranes. These results are most consistent with pertussis toxin uncoupling the inhibitory G proteins from the somatostatin receptor thereby converting the receptor from a mixed population of high and low affinity sites to only low affinity receptors.

  4. Neurological Complications after Lateral Transpsoas Approach to Anterior Interbody Fusion with a Novel Flat-Blade Spine-Fixed Retractor

    PubMed Central

    Nunley, Pierce; Sandhu, Faheem; Frank, Kelly; Stone, Marcus

    2016-01-01

    Introduction. The lateral lumbar interbody fusion (LLIF) surgical approach has potential advantages over other approaches but is associated with some unique neurologic risks due to the proximity of the lumbosacral plexus. The present study analyzed complications following LLIF surgical approach using a novel single flat-blade retractor system. Methods. A retrospective data collection of patients receiving LLIF using a novel single flat-blade retractor system at two institutions in the US. Inclusion criteria were all patients receiving an LLIF procedure with the RAVINE® Lateral Access System (K2M, Inc., Leesburg, VA, USA). There was no restriction on preoperative diagnosis or number of levels treated. Approach-related neurologic complications were collected and analyzed postoperatively through a minimum of one year. Results. Analysis included 253 patients with one to four treated lateral levels. Immediate postoperative neurologic complications were present in 11.1% (28/253) of patients. At one-year follow-up the approach-related neurologic complications resolved in all except 5 patients (2.0%). Conclusion. We observed an 11.1% neurologic complication rate in LLIF procedures. There was resolution of symptoms for most patients by 12-month follow-up, with only 2% of patients with residual symptoms. This supports the hypothesis that the vast majority of approach-related neurologic symptoms are transient. PMID:27294140

  5. Neurological Complications after Lateral Transpsoas Approach to Anterior Interbody Fusion with a Novel Flat-Blade Spine-Fixed Retractor.

    PubMed

    Nunley, Pierce; Sandhu, Faheem; Frank, Kelly; Stone, Marcus

    2016-01-01

    Introduction. The lateral lumbar interbody fusion (LLIF) surgical approach has potential advantages over other approaches but is associated with some unique neurologic risks due to the proximity of the lumbosacral plexus. The present study analyzed complications following LLIF surgical approach using a novel single flat-blade retractor system. Methods. A retrospective data collection of patients receiving LLIF using a novel single flat-blade retractor system at two institutions in the US. Inclusion criteria were all patients receiving an LLIF procedure with the RAVINE® Lateral Access System (K2M, Inc., Leesburg, VA, USA). There was no restriction on preoperative diagnosis or number of levels treated. Approach-related neurologic complications were collected and analyzed postoperatively through a minimum of one year. Results. Analysis included 253 patients with one to four treated lateral levels. Immediate postoperative neurologic complications were present in 11.1% (28/253) of patients. At one-year follow-up the approach-related neurologic complications resolved in all except 5 patients (2.0%). Conclusion. We observed an 11.1% neurologic complication rate in LLIF procedures. There was resolution of symptoms for most patients by 12-month follow-up, with only 2% of patients with residual symptoms. This supports the hypothesis that the vast majority of approach-related neurologic symptoms are transient. PMID:27294140

  6. Assessing Skin Blood Flow Dynamics in Older Adults Using a Modified Sample Entropy Approach

    PubMed Central

    Liao, Fuyuan; Jan, Yih-Kuen

    2015-01-01

    The aging process may result in attenuated microvascular reactivity in response to environmental stimuli, which can be evaluated by analyzing skin blood flow (SBF) signals. Among various methods for analyzing physiological signals, sample entropy (SE) is commonly used to quantify the degree of regularity of time series. However, we found that for temporally correlated data, SE value depends on the sampling rate. When data are oversampled, SE may give misleading results. To address this problem, we propose to modify the definition of SE by using time-lagged vectors in the calculation of the conditional probability that any two vectors of successive data points are within a tolerance r for m points remain within the tolerance at the next point. The lag could be chosen as the first minimum of the auto mutual information function. We tested the performance of modified SE using simulated signals and SBF data. The results showed that modified SE is able to quantify the degree of regularity of the signals regardless of sampling rate. Using this approach, we observed a more regular behavior of blood flow oscillations (BFO) during local heating-induced maximal vasodilation period compared to the baseline in young and older adults and a more regular behavior of BFO in older adults compared to young adults. These results suggest that modified SE may be useful in the study of SBF dynamics. PMID:25570060

  7. RELIABILITY AND VALIDITY OF A MODIFIED ISOMETRIC DYNAMOMETER IN THE ASSESSMENT OF MUSCULAR PERFORMANCE IN INDIVIDUALS WITH ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

    PubMed Central

    de Vasconcelos, Rodrigo Antunes; Bevilaqua-Grossi, Débora; Shimano, Antonio Carlos; Paccola, Cleber Jansen; Salvini, Tânia Fátima; Prado, Christiane Lanatovits; Junior, Wilson A. Mello

    2015-01-01

    Objectives: The aim of this study was to evaluate the reliability and validity of a modified isometric dynamometer (MID) in performance deficits of the knee extensor and flexor muscles in normal individuals and in those with ACL reconstructions. Methods: Sixty male subjects were invited to participate of the study, being divided into three groups with 20 subjects each: control group (GC), group of individuals with ACL reconstruction with patellar tendon graft (GTP, and group of individuals with ACL reconstruction with hamstrings graft (GTF). All individuals performed isometric tests in the MID, muscular strength deficits collected were subsequently compared to the tests performed on the Biodex System 3 operating in the isometric and isokinetic mode at speeds of 60°/s and 180o/s. Intraclass ICC correlation calculations were done in order to assess MID reliability, specificity, sensitivity and Kappa's consistency coefficient calculations, respectively, for assessing the MID's validity in detecting muscular deficits and intra- and intergroup comparisons when performing the four strength tests using the ANOVA method. Results: The modified isometric dynamometer (MID) showed excellent reliability and good validity in the assessment of the performance of the knee extensor and flexor muscles groups. In the comparison between groups, the GTP showed significantly greater deficits as compared to the GTF and GC groups. Conclusion: Isometric dynamometers connected to mechanotherapy equipments could be an alternative option to collect data concerning performance deficits of the extensor and flexor muscles groups of the knee in subjects with ACL reconstruction. PMID:27004175

  8. Surgical Approach for Repair of Rectovaginal Fistula by Modified Martius Flap

    PubMed Central

    Reichert, M.; Schwandner, T.; Hecker, A.; Behnk, A.; Baumgart-Vogt, E.; Wagenlehner, F.; Padberg, W.

    2014-01-01

    Rectovaginal fistulas (RVF) are rare but represent a challenge for both patients and surgeons. The most common cause of RVF is obstetric trauma, and treatment is based on fistula classification and localization of the fistula in relation to the vagina and rectum. Conventional therapy frequently fails, making surgery the most viable approach for fistula repair. One surgical procedure which offers adequate repair of lower and middle rectovaginal fistulas consists of interposition of a bulbocavernosus fat flap also called modified Martius flap. First described by Heinrich Martius in 1928, this approach has been continuously modified and adjusted over time and is used in the repair of various pelvic floor disorders. Overall success rates reported in the literature of the interposition of a Martius flap as an adjunct procedure in the surgical management of RVF are 65–100 %. We present a detailed description of the operation technique together with a discussion of the use of a dorsal-flapped modified Martius flap in the treatment of RVF. PMID:25364031

  9. Robotic sialoadenectomy of the submandibular gland via a modified face-lift approach.

    PubMed

    De Virgilio, A; Park, Y M; Kim, W S; Lee, S Y; Seol, J H; Kim, S-H

    2012-11-01

    The purpose of this study was to describe and analyse the advantages and disadvantages of submandibular gland (SMG) resection using a robotic surgical system through a modified face-lift approach. The authors performed robotic sialoadenectomy of the SMG on 5 patients using the daVinci robot system through a modified face-lift approach. Three robotic arms were inserted through a modified face-lift incision; a face-down 30-degree endoscopic arm and two operative arms. The right arm was equipped with a harmonic scalpel and the left arm with a Maryland forceps. In all patients, robotic sialoadenectomy of the SMG was completed successfully. Diagnoses were sialolithiasis in two patients, pleomophic adenoma in two patients, and ranula in one patient. The mean robotic operative time was 90.2 min (range 62-185 min) and that for setting the robotic system was 8.2 min (range 5-15 min). No significant intra-operative or postoperative complications were observed. All patients were satisfied with the outcome and especially the cosmetic results at their last follow-up visit. In the authors opinion robotic sialoadenectomy of the SMG is technically feasible and secures a better cosmetic outcome than endoscopic submandibular resection. PMID:22578632

  10. Dual stack filters and the modified difference of estimates approach to edge detection.

    PubMed

    Yoo, J; Coyle, E J; Bouman, C A

    1997-01-01

    The theory of optimal stack filtering has been used in the difference of estimates (DoE) approach to the detection of intensity edges in noisy images. The DoE approach is modified by imposing a symmetry condition on the data used to train the two stack filters. Under this condition, the stack filters obtained are duals of each other. Only one filter must therefore be trained; the other is simply its dual. This new technique is called the symmetric difference of estimates (SDoE) approach. The dual stack filters obtained under the SDoE approach are shown to be comparable. This allows the difference of these two filters to be represented by a single equivalent edge operator. This latter result suggests that an edge operator can be found by directly training a (possibly nonpositive) Boolean function to be used on each level of the threshold decomposition architecture. This approach, which is called the threshold Boolean filter (TBF) approach, requires less training time but produces operators that are less robust than those produced by the SDoE approach. This is demonstrated and interpreted via comparisons of results for natural images. PMID:18285234

  11. Phacoemulsification in anterior megalophthalmos.

    PubMed

    Lee, Graham A; Hann, Joshua V; Braga-Mele, Rosa

    2006-07-01

    This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes. PMID:16857490

  12. A modified QuEChERS approach for the screening of dioxins and furans in sediments.

    PubMed

    Haimovici, Liad; Reiner, Eric J; Besevic, Sladjana; Jobst, Karl J; Robson, Matthew; Kolic, Terry; MacPherson, Karen

    2016-06-01

    A rapid extraction and cleanup method for the screening of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans in sediments is described which combines a modified QuEChERS extraction with carbon reversed-phase solid phase extraction cleanup. This approach is compared to the classical Soxhlet extraction and multi-column cleanup method in terms of toxic equivalence quotients (TEQs), precision, instrumental chromatography, method detection limits (MDLs), recovery of (13)C-labelled quantitation standard, sample preparation time, workload capacity, and sustainability factors. TEQs of 32 sediment samples were found to be well correlated and differed by 16 ± 10 % between the two methods. Certified and standard reference sediments differed by 4.1 and 6.7 %, respectively. Precision and instrumental chromatography were comparable. While the modified QuEChERS method had higher MDLs and lower recoveries, in terms of preparation time and workload capacity, the modified QuEChERS approach can prepare approximately 30 samples per day as compared to 10-20 samples in 3 to 4 days for the classic method. The modified QuEChERS method was also found to be safer and greener. The appreciable improvement in capacity makes the modified QuEChERS approach a suitable alternative to the classical method for applications where turnaround time and the number of samples that can be analyzed are more important than minimal detection limits. Graphical Abstract Created using Microsoft Paint for Windows 7 Professional A bar graph with the structures of dioxins and furans on the x axis shows agreement between two sets of data. A legend labels the first set of data as Soxhlet. The Soxhlet set is illustrated as four days crossed off of a calendar page, a Soxhlet extractor, and several packed chromatography columns. The legend identifies the second set of data as QuEChERS. The QuEChERS set is represented by a clock face marked with twenty four hours, two centrifuge tubes containing

  13. Analysis of higher harmonic contamination with a modified approach using a grating analyser

    NASA Astrophysics Data System (ADS)

    Gupta, Rajkumar; Modi, Mohammed H.; Kumar, M.; Chakera, J. A.; Lodha, G. S.

    2014-04-01

    Soft x-ray spectra of the toroidal grating monochromator (TGM) at the reflectivity beamline of Indus-1 synchrotron source are analyzed for higher harmonic contribution. A diffraction grating of central line spacing 1200 l/mm is used to disperse the monochromatic beam received from TGM to quantify the harmonic contents in the 50-360 Å wavelength range. In order to calculate the harmonic contamination, conventionally the intensity of higher order peak is divided by first order peak intensity of the desired wavelength. This approach is found to give wrong estimate as first order peak itself is overlapped by higher order peaks. In the present study, a modified approach has been proposed to calculate harmonic contamination where the intensity contributions of overlapping orders have been removed from the first order diffraction peak of the desired wavelength. It is found that the order contamination in the TGM spectra is less than 15% in the wavelength range of 90-180 Å. The total harmonic contribution increases from 6%-60% in the wavelength range of 150-260 Å. The critical wavelength of Indus-1 is 61 Å hence the harmonic contamination below 90 Å is significantly low. The results obtained with modified approach match well with those obtained by quantitative analysis of multilayer reflectivity data. The obtained higher harmonics data are used to fit the transmission of aluminum edge filter in the 120-360 Å wavelength range.

  14. Analysis of higher harmonic contamination with a modified approach using a grating analyser.

    PubMed

    Gupta, Rajkumar; Modi, Mohammed H; Kumar, M; Chakera, J A; Lodha, G S

    2014-04-01

    Soft x-ray spectra of the toroidal grating monochromator (TGM) at the reflectivity beamline of Indus-1 synchrotron source are analyzed for higher harmonic contribution. A diffraction grating of central line spacing 1200 l/mm is used to disperse the monochromatic beam received from TGM to quantify the harmonic contents in the 50-360 Å wavelength range. In order to calculate the harmonic contamination, conventionally the intensity of higher order peak is divided by first order peak intensity of the desired wavelength. This approach is found to give wrong estimate as first order peak itself is overlapped by higher order peaks. In the present study, a modified approach has been proposed to calculate harmonic contamination where the intensity contributions of overlapping orders have been removed from the first order diffraction peak of the desired wavelength. It is found that the order contamination in the TGM spectra is less than 15% in the wavelength range of 90-180 Å. The total harmonic contribution increases from 6%-60% in the wavelength range of 150-260 Å. The critical wavelength of Indus-1 is 61 Å hence the harmonic contamination below 90 Å is significantly low. The results obtained with modified approach match well with those obtained by quantitative analysis of multilayer reflectivity data. The obtained higher harmonics data are used to fit the transmission of aluminum edge filter in the 120-360 Å wavelength range. PMID:24784593

  15. Analysis of higher harmonic contamination with a modified approach using a grating analyser

    SciTech Connect

    Gupta, Rajkumar Modi, Mohammed H.; Lodha, G. S.; Kumar, M.; Chakera, J. A.

    2014-04-15

    Soft x-ray spectra of the toroidal grating monochromator (TGM) at the reflectivity beamline of Indus-1 synchrotron source are analyzed for higher harmonic contribution. A diffraction grating of central line spacing 1200 l/mm is used to disperse the monochromatic beam received from TGM to quantify the harmonic contents in the 50–360 Å wavelength range. In order to calculate the harmonic contamination, conventionally the intensity of higher order peak is divided by first order peak intensity of the desired wavelength. This approach is found to give wrong estimate as first order peak itself is overlapped by higher order peaks. In the present study, a modified approach has been proposed to calculate harmonic contamination where the intensity contributions of overlapping orders have been removed from the first order diffraction peak of the desired wavelength. It is found that the order contamination in the TGM spectra is less than 15% in the wavelength range of 90–180 Å. The total harmonic contribution increases from 6%–60% in the wavelength range of 150–260 Å. The critical wavelength of Indus-1 is 61 Å hence the harmonic contamination below 90 Å is significantly low. The results obtained with modified approach match well with those obtained by quantitative analysis of multilayer reflectivity data. The obtained higher harmonics data are used to fit the transmission of aluminum edge filter in the 120–360 Å wavelength range.

  16. [Endoscopic removal of a dental foreign body from maxillary sinus via anterior prelacrimal recess approach: a case report].

    PubMed

    Song, Yuanyuan; Ji, Yongjin; Zhao, Changqing

    2016-03-01

    We present a rare case of dental foreign body from maxillary sinus in a 21-year woman who was hospitalized because of oral cavity and nasal sinus leak for 3 months when doing cheek-bulging action. Admission diagnosis :dental maxillary sinus"foreign body" (left); chronic maxillary sinusitis (left). Computed tomographic scan showed irregular high density shadow in the left maxillary sinus. The "foreign body" was removed via anteri- or prelacrimal recess approach, which was supposed to be the iatrogenic foreign body - alveolar bone. PMID:27382694

  17. The Preference for Anterior Approach Major Hepatectomy: Experience Over 3 Decades and a Propensity Score-Matching Analysis in Right Hepatectomy for Hepatocellular Carcinoma

    PubMed Central

    Chan, Kun-Ming; Wang, Yu-Chao; Wu, Tsung-Han; Lee, Chen-Fang; Wu, Ting-Jung; Chou, Hong-Shiue; Yu, Ming-Chin; Lee, Wei-Chen

    2015-01-01

    Abstract Surgical treatment for primary hepatocellular carcinoma (HCC) has progressed enormously over time. The aim of this study was to analyze the evolution of surgical techniques and outcomes of patients undergoing major right hepatectomy (RH) over the last few decades. A retrospective review of 557 consecutive patients who had undergone RH for HCC between January 1982 and December 2011 was performed. Patients were categorized into subgroups and analyzed according to period and surgical approach to hepatectomy. Based on a propensity score-matching model, the surgical approach in patients in the second period was also analyzed in terms of anterior approach (AA) and conventional approach (CA)-RH. Tumor factors remained the most important prognostic factors related to postoperative HCC recurrence throughout the 2 periods examined in this study. Comparison of patients selected by a propensity score-matching model showed that AA-RH led to significantly better outcomes including recurrence-free survival (RFS) (P = 0.011) and overall survival (OS) (P = 0.012) in patients with HCC as compared with CA-RH. The 5-year RFS and OS were 33.4% and 52.2% after AA-RH, and 21.0% and 36.5% after CA-RH. Major hepatectomy has evolved into a safe procedure that can be performed with confidence. RH by an AA has shown several advantages over CA-RH, and can thus be recommended as the standard procedure for liver resection in patients who require right hepatectomy. PMID:26313778

  18. Approach to the synthesis of natural and modified oligonucleotides by the phosphotriester method using O-nucleophilic intramolecular catalysis.

    PubMed

    Efimov, Vladimir A; Molchanova, Natalia S; Chakhmakhcheva, Oksana G

    2007-01-01

    An approach to the solid phase synthesis of natural and modified oligonucleotides using phosphotriester technique has been developed. Particularly, this method allows the synthesis of ribo- and deoxyribo-oligonucleotides containing various 2'-modified mononucleotides as well as stereodefined nucleotide phosphorothioate analogues. PMID:18058542

  19. Tensile-shear correlations obtained from shear punch test technique using a modified experimental approach

    NASA Astrophysics Data System (ADS)

    Karthik, V.; Visweswaran, P.; Vijayraghavan, A.; Kasiviswanathan, K. V.; Raj, Baldev

    2009-09-01

    Shear punch testing has been a very useful technique for evaluating mechanical properties of irradiated alloys using a very small volume of material. The load-displacement data is influenced by the compliance of the fixture components. This paper describes a modified experimental approach where the compliances of the punch and die components are eliminated. The analysis of the load-displacement data using the modified setup for various alloys like low carbon steel, SS316, modified 9Cr-1Mo, 2.25Cr-1Mo indicate that the shear yield strength evaluated at 0.2% offset of normalized displacement relates to the tensile YS as per the Von Mises yield relation ( σys = 1.73 τys). A universal correlation of type UTS = mτmax where m is a function of strain hardening exponent, is seen to be obeyed for all the materials in this study. The use of analytical models developed for blanking process are explored for evaluating strain hardening exponent from the load-displacement data. This study is directed towards rationalizing the tensile-shear empirical correlations for a more reliable prediction of tensile properties from shear punch tests.

  20. Correction of geometric distortion in Propeller echo planar imaging using a modified reversed gradient approach

    PubMed Central

    Chang, Hing-Chiu; Chuang, Tzu-Chao; Wang, Fu-Nien; Huang, Teng-Yi; Chung, Hsiao-Wen

    2013-01-01

    Objective This study investigates the application of a modified reversed gradient algorithm to the Propeller-EPI imaging method (periodically rotated overlapping parallel lines with enhanced reconstruction based on echo-planar imaging readout) for corrections of geometric distortions due to the EPI readout. Materials and methods Propeller-EPI acquisition was executed with 360-degree rotational coverage of the k-space, from which the image pairs with opposite phase-encoding gradient polarities were extracted for reversed gradient geometric and intensity corrections. The spatial displacements obtained on a pixel-by-pixel basis were fitted using a two-dimensional polynomial followed by low-pass filtering to assure correction reliability in low-signal regions. Single-shot EPI images were obtained on a phantom, whereas high spatial resolution T2-weighted and diffusion tensor Propeller-EPI data were acquired in vivo from healthy subjects at 3.0 Tesla, to demonstrate the effectiveness of the proposed algorithm. Results Phantom images show success of the smoothed displacement map concept in providing improvements of the geometric corrections at low-signal regions. Human brain images demonstrate prominently superior reconstruction quality of Propeller-EPI images with modified reversed gradient corrections as compared with those obtained without corrections, as evidenced from verification against the distortion-free fast spin-echo images at the same level. Conclusions The modified reversed gradient method is an effective approach to obtain high-resolution Propeller-EPI images with substantially reduced artifacts. PMID:23630654

  1. Experimental and Numerical Analysis of Triaxially Braided Composites Utilizing a Modified Subcell Modeling Approach

    NASA Technical Reports Server (NTRS)

    Cater, Christopher; Xiao, Xinran; Goldberg, Robert K.; Kohlman, Lee W.

    2015-01-01

    A combined experimental and analytical approach was performed for characterizing and modeling triaxially braided composites with a modified subcell modeling strategy. Tensile coupon tests were conducted on a [0deg/60deg/-60deg] braided composite at angles [0deg, 30deg, 45deg, 60deg and 90deg] relative to the axial tow of the braid. It was found that measured coupon strength varied significantly with the angle of the applied load and each coupon direction exhibited unique final failures. The subcell modeling approach implemented into the finite element software LS-DYNA was used to simulate the various tensile coupon test angles. The modeling approach was successful in predicting both the coupon strength and reported failure mode for the 0deg, 30deg and 60deg loading directions. The model over-predicted the strength in the 90deg direction; however, the experimental results show a strong influence of free edge effects on damage initiation and failure. In the absence of these local free edge effects, the subcell modeling approach showed promise as a viable and computationally efficient analysis tool for triaxially braided composite structures. Future work will focus on validation of the approach for predicting the impact response of the braided composite against flat panel impact tests.

  2. Experimental and Numerical Analysis of Triaxially Braided Composites Utilizing a Modified Subcell Modeling Approach

    NASA Technical Reports Server (NTRS)

    Cater, Christopher; Xiao, Xinran; Goldberg, Robert K.; Kohlman, Lee W.

    2015-01-01

    A combined experimental and analytical approach was performed for characterizing and modeling triaxially braided composites with a modified subcell modeling strategy. Tensile coupon tests were conducted on a [0deg/60deg/-60deg] braided composite at angles of 0deg, 30deg, 45deg, 60deg and 90deg relative to the axial tow of the braid. It was found that measured coupon strength varied significantly with the angle of the applied load and each coupon direction exhibited unique final failures. The subcell modeling approach implemented into the finite element software LS-DYNA was used to simulate the various tensile coupon test angles. The modeling approach was successful in predicting both the coupon strength and reported failure mode for the 0deg, 30deg and 60deg loading directions. The model over-predicted the strength in the 90deg direction; however, the experimental results show a strong influence of free edge effects on damage initiation and failure. In the absence of these local free edge effects, the subcell modeling approach showed promise as a viable and computationally efficient analysis tool for triaxially braided composite structures. Future work will focus on validation of the approach for predicting the impact response of the braided composite against flat panel impact tests.

  3. The effectiveness of different approaches to media literacy in modifying adolescents' responses to alcohol.

    PubMed

    Chen, Yi-Chun Yvonnes

    2013-01-01

    Fearing the negative effect that alcohol advertising might have on adolescents' receptiveness to the consumption of alcohol, health educators have used media literacy as an effective strategy to mitigate the effect of these messages in the media. The present study applied parental mediation to the design and evaluations of a media literacy curriculum that targets alcohol decision-making processes illustrated in the message interpretation process model. The authors conducted a pretest-posttest quasi-experiment of 171 adolescents to examine the effect of a negative evaluative approach and a balanced evaluative approach (a combination of negative and positive evaluative strategies) to media literacy on modifying adolescents' responses to alcohol messages. Results showed that different media literacy approaches had varying degrees of effectiveness on adolescent boys and girls. After receiving a negative media literacy lesson, adolescent boys regarded television characters as less realistic and believed that drinking alcohol had negative consequences. In contrast, adolescent girls benefited more from a balanced evaluative approach as their media skepticism attitude was enhanced. Results suggest that health educators should choose tailored pedagogical approaches that are based on gender to improve decision making regarding alcohol consumption. PMID:23496333

  4. Fast SAR Image Change Detection Using Bayesian Approach Based Difference Image and Modified Statistical Region Merging

    PubMed Central

    Ni, Weiping; Yan, Weidong; Bian, Hui; Wu, Junzheng

    2014-01-01

    A novel fast SAR image change detection method is presented in this paper. Based on a Bayesian approach, the prior information that speckles follow the Nakagami distribution is incorporated into the difference image (DI) generation process. The new DI performs much better than the familiar log ratio (LR) DI as well as the cumulant based Kullback-Leibler divergence (CKLD) DI. The statistical region merging (SRM) approach is first introduced to change detection context. A new clustering procedure with the region variance as the statistical inference variable is exhibited to tailor SAR image change detection purposes, with only two classes in the final map, the unchanged and changed classes. The most prominent advantages of the proposed modified SRM (MSRM) method are the ability to cope with noise corruption and the quick implementation. Experimental results show that the proposed method is superior in both the change detection accuracy and the operation efficiency. PMID:25258740

  5. 20 Years of hypertension research using genetically modified animals: no clinically promising approaches in sight.

    PubMed

    Stingl, Lavinia; Völkel, Manfred; Lindl, Toni

    2009-01-01

    The incidence of essential or primary hypertension is increasing, especially in the northern hemisphere, but although the disease displays clear symptoms, its aetiology appears very complex, and thus no causal treatment is available yet. In the 1990's, genetically modified animals (GMO) were considered to be the key to solving this problem of high complexity. However, until now, although a few approaches have shown that old, well-known drugs have a positive effect (decrease of blood pressure) on such animal models of hypertension, no approach has appeared in the literature of this area of research which might indicate a direct connection between GMO and a therapeutic strategy to treat or prevent this type of hypertension in humans. Instead, criticism of the GMO approach has accumulated in the last years, arguing that it is misleading as this disease does not have a monogenic cause and so complementary regulatory mechanisms could prevent the true identification of the function of the modified genes. Furthermore, the technology is best developed in mice, whose physiology of blood pressure is different from that of humans. Because of species specificity, it is not easy to extrapolate the results from animal models of hypertension to human hypertension. Also, in the years 2000 to 2004 a reorientation of the technology and the aims of this kind of research took place. Therefore, although these approaches are without exception deemed "very promising" in the literature, it cannot be expected that research on GMO will make any contribution to a new therapeutic strategy in the near future. PMID:19326032

  6. Segmental Alveolar Osteotomy by Palatal Approach to Correct Excessive Angulated Dental Implants in Anterior and Posterior Maxilla

    PubMed Central

    Akkas, Ismail; Akpinar, Yusuf Ziya; Ozan, Fatih

    2015-01-01

    Dental implants have been used for a long time to achieve better prosthetic and health conditions in the mouth. With the increase in their usage, more complications have occurred, and methods of solving these problems have been developed. One complication is insertion of the implant in the wrong direction. The aim of this case report is to describe an osteotomy technique to reposition a malpositioned dental implant. A female patient, aged 38 years, and a male patient aged 48 years, were referred complaining of the malpositioned osseointegrated implants, which had been placed in the region of the left maxillary first premolar and molar tooth, and in the region of the left maxillary lateral incisor. Due to severe buccal positioning of the implant fixtures, acceptable prosthetic treatment was not possible. Alveolar osteotomy procedure was used to reposition the implants. Satisfactory results were obtained by osteotomy for 18-month of follow up. We conclude that inadequately axially inclined implants can be successfully treated by alveolar osteotomy. The preservation of marginal gingiva permits obtaining better prosthetic results. To avoid the recession of attached gingiva, palatal approach technique may help the clinicians. PMID:26023650

  7. A modified approach for change detection using change vector analysis in posterior probability space

    NASA Astrophysics Data System (ADS)

    Azzouzi, S. A.; Vidal, A.; Bentounes, H. A.

    2015-04-01

    The multispectral and multitemporal data coming from satellites allow us to extract valuable spatiotemporal change. Consequently, Earth surface change detection analysis has been used in the past to monitor land cover changes caused by different reasons. Several techniques have been used for that purpose and change vector analysis (CVA) has been frequently employed to carry out automatic spatiotemporal information extraction. This work describes a modified methodology based on Supervised Change Vector Analysis in Posterior probability Space (SCVAPS) with the final aim of obtaining a change detection map in Blida, Algeria. The proposed technique is a Modified version of Supervised Change Vector Analysis Posterior probability Space (MSCVAPS) and it is applied at the same region that the original technique studied in the literature. The classical Maximum Likelihood classifier is the selected method for supervised classification since it provides good properties in the posterior probability map. An improved method for threshold determination based on Double Flexible Pace Search (DFPS) is proposed in this work and it is employed to obtain the most adequate threshold value. Then, the MSCVAPS approach is evaluated by two cases study of the land cover change detection in the region of Blida, Algeria, and in the region of Shunyi District, Beijing, China, using a pair of Landsat Thematic Mapper images and pair of Landsat Enhanced Thematic Mapper images, respectively. The final evaluation is given by the overall accuracy of changed and unchanged pixels and the kappa coefficient. The results show that the modified approach gives excellent results using the same area of study that was selected in the literature.

  8. Percutaneous bypass creation between hollow organs by modified gun-sight approach.

    PubMed

    Kariya, Shuji; Tanigawa, Noboru; Komemushi, Atsushi; Nakatani, Miyuki; Yagi, Rie; Suzuki, Satoshi; Sawada, Satoshi

    2012-03-01

    This animal study investigated the feasibility of creating a bypass between two hollow organs, using a modified gun-sight approach with a pull-through string and pull-through tow wire. Ten procedures (femoral arteriovenous shunt, n = 4; portacaval shunt, n = 4; cholangiogastrostomy, n = 2) were performed in six adult swine. Snares were inserted into the two hollow organs through the sheath and deployed at the site of bypass creation. When snares overlapped on fluoroscopy, a needle was inserted to pass through both snares. The string was inserted through the needle, with only the needle then withdrawn. The snare furthest from the skin was closed to capture the string and was then withdrawn. The other snare was withdrawn without closing. The string thus served as a pull-through string penetrating both hollow organs. This string was then attached to a pull-through tow wire, withdrawn, and exchanged for the pull-through tow wire. By withdrawing the pull-through tow wire, the delivery sheath connected to the pull-through tow wire was towed through the site of the bypass, and the stent was placed. In all cases, bypass creation was achieved. Percutaneous bypass creation using a modified gun-sight approach with a pull-through string and pull-through tow wire is feasible between two hollow organs. PMID:21395456

  9. Frontal Sinus Surgery Anterior to the Ethmoid Bulla

    PubMed Central

    Ji, Junfeng; Zhou, Mei; Li, Zeqing; Wang, Tianyou; Cheng, You; Wang, Qiuping

    2013-01-01

    The frontal sinus surgery is difficult to perform but the ethmoid bulla is a relative, constant landmark in the middle turbinate that can improve the surgery. The purpose of this study was to evaluate the validity, security, and predominance of approaches to the frontal sinus via the route anterior to the ethmoid bulla. The data from 370 endoscopic frontal sinus surgery cases from our center were integrated and retrospectively analyzed. Three hundred twenty-nine patients underwent frontal sinus surgery via the route anterior to the ethmoid bulla. An additional 27 patients underwent frontal sinus surgery with mini-trephination, 13 patients with the Draf II procedure, and 1 patient had applied MELP (modified endoscopic Lothrop procedure). No serious complications occurred; however, there were 3 cases of eyelid ecchymosis and 1 case of anterior ethmoid artery bleeding. In all, 319 patients (86.2%) were cured, an improvement was noted in 36 of the patients (9.7%), and there was no improvement in 15 patients (4.1%). Frontal sinus surgery via the route anterior to the ethmoid bulla is valid, relatively safe, and can be applied in most cases involving frontal disease. PMID:23701151

  10. The value of early intervention and a multidisciplinary approach in the management of necrotizing fasciitis of the neck and anterior mediastinum of odontogenic origin.

    PubMed

    Muhammad, Joseph Kamal; Almadani, Hana; Al Hashemi, Bader A; Liaqat, Muneezeh

    2015-05-01

    Necrotizing fasciitis (NF) is a serious clinical condition, which, if diagnosed late, invariably leads to a fatal outcome. A high index of suspicion of the presenting clinical signs and symptoms, supported by knowledge of the clinicopathologic processes that underlie its aggressive nature, should prompt early surgical intervention. Ultimately, the success of treatment requires a robust clinical pathway in which all members of the health care team are aligned by their skill sets and competencies to manage NF. This report describes the management of a case of a young man with aggressive NF of odontogenic origin affecting the neck and anterior mediastinum. A multidisciplinary approach brought about early recognition of the disease and surgical intervention, the use of frozen section biopsies to determine the extent of fascial spread, and aggressive debridement of the affected tissue. Teamwork, critical thinking, and situational awareness ensured that the patient received optimum care in a timely manner. The psychological, clinical, radiologic, pathologic, and microbiological aspects of the patient's care are presented with a literature review. PMID:25795188

  11. Giant Cavernous Haemangioma of the Anterior Mediastinum

    PubMed Central

    Kaya, Seyda Ors; Samancılar, Ozgur; Usluer, Ozan; Acar, Tuba; Yener, Ali Galip

    2015-01-01

    Cavernous hemangiomas of the anterior mediastinum is rare. We present a case of a 56-year-old male patient with a giant cavernous hemangioma of the anterior mediastinum, 18 cm in diameters, approached by left posterolateral thoracotomy. To the best of our knowledge, such a unique case has not been previously presented in the literature. PMID:26644773

  12. Anterior vaginal wall repair

    MedlinePlus

    ... Cystocele Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series References Lentz GM. Anatomic defects of the ... 72. Read More Anterior Inflatable artificial sphincter Stress urinary incontinence Urinary catheters Urinary incontinence - injectable implant Urinary incontinence - ...

  13. How I do it: Anterior pull-through tympanoplasty for anterior eardrum perforations.

    PubMed

    Harris, Jeffrey P; Wong, Yu-Tung; Yang, Tzong-Hann; Miller, Mia

    2016-04-01

    Conclusions This technique is offered as a convenient and reliable method for cases with anterior TM perforation and inadequate anterior remnant. Objectives Chronic otitis media surgery is one of the most common procedures in otology. Anterior tympanic membrane (TM) perforation with inadequate anterior remnant is associated with higher rates of graft failure. It was the goal of this series to evaluate the anatomical and functional outcomes of a modified underlay myringoplasty technique-the anterior pull-through method. Materials and methods In a retrospective clinical study, 13 patients with anterior TM perforations with inadequate anterior remnants underwent tympanoplasty with anterior pull-through technique. The anterior tip of the temporalis fascia was pulled through and secured in a short incision lateral to the anterior part of the annulus. Data on graft take rate, pre-operative, and post-operative hearing status were analyzed. Results A graft success rate of 84.6% (11 out of 13) was achieved, without lateralization, blunting, atelectasia, or epithelial pearls. The air-bone gap was 21.5 ± 6.8 dB before intervention and 11.75 ± 5.7 dB after surgery (p = 0.003). PMID:26988908

  14. Bioengineered anterior cruciate ligament

    NASA Technical Reports Server (NTRS)

    Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor); Martin, Ivan (Inventor)

    2001-01-01

    The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

  15. A modified CAS-CI approach for an efficient calculation of magnetic exchange coupling constants

    NASA Astrophysics Data System (ADS)

    Fink, Karin; Staemmler, Volker

    2013-09-01

    A modification of the conventional wavefunction-based CAS-CI method for the calculation of magnetic exchange coupling constants J in small molecules and transition metal complexes is presented. In general, CAS-CI approaches yield much too small values for J since the energies of the important charge transfer configurations are calculated with the ground state orbitals and are therefore much too high. In the present approach we improve these energies by accounting for the relaxation of the orbitals in the charge transfer configurations. The necessary relaxation energies R can be obtained in separate calculations using mononuclear or binuclear model systems. The method is applied to a few examples, small molecules, binuclear transition metal complexes, and bulk NiO. It allows to obtaining fairly reliable estimates for J at costs that are not higher than those of conventional CAS-CI calculations. Therefore, extended and very time-consuming perturbation theory (PT2), configuration interaction (CI), or coupled cluster (CC) schemes on top of the CAS-CI calculation can be avoided and the modified CAS-CI (MCAS-CI) approach can be applied to rather large systems.

  16. A modified dynamic evolving neural-fuzzy approach to modeling customer satisfaction for affective design.

    PubMed

    Kwong, C K; Fung, K Y; Jiang, Huimin; Chan, K Y; Siu, Kin Wai Michael

    2013-01-01

    Affective design is an important aspect of product development to achieve a competitive edge in the marketplace. A neural-fuzzy network approach has been attempted recently to model customer satisfaction for affective design and it has been proved to be an effective one to deal with the fuzziness and non-linearity of the modeling as well as generate explicit customer satisfaction models. However, such an approach to modeling customer satisfaction has two limitations. First, it is not suitable for the modeling problems which involve a large number of inputs. Second, it cannot adapt to new data sets, given that its structure is fixed once it has been developed. In this paper, a modified dynamic evolving neural-fuzzy approach is proposed to address the above mentioned limitations. A case study on the affective design of mobile phones was conducted to illustrate the effectiveness of the proposed methodology. Validation tests were conducted and the test results indicated that: (1) the conventional Adaptive Neuro-Fuzzy Inference System (ANFIS) failed to run due to a large number of inputs; (2) the proposed dynamic neural-fuzzy model outperforms the subtractive clustering-based ANFIS model and fuzzy c-means clustering-based ANFIS model in terms of their modeling accuracy and computational effort. PMID:24385884

  17. A Modified Dynamic Evolving Neural-Fuzzy Approach to Modeling Customer Satisfaction for Affective Design

    PubMed Central

    Kwong, C. K.; Fung, K. Y.; Jiang, Huimin; Chan, K. Y.

    2013-01-01

    Affective design is an important aspect of product development to achieve a competitive edge in the marketplace. A neural-fuzzy network approach has been attempted recently to model customer satisfaction for affective design and it has been proved to be an effective one to deal with the fuzziness and non-linearity of the modeling as well as generate explicit customer satisfaction models. However, such an approach to modeling customer satisfaction has two limitations. First, it is not suitable for the modeling problems which involve a large number of inputs. Second, it cannot adapt to new data sets, given that its structure is fixed once it has been developed. In this paper, a modified dynamic evolving neural-fuzzy approach is proposed to address the above mentioned limitations. A case study on the affective design of mobile phones was conducted to illustrate the effectiveness of the proposed methodology. Validation tests were conducted and the test results indicated that: (1) the conventional Adaptive Neuro-Fuzzy Inference System (ANFIS) failed to run due to a large number of inputs; (2) the proposed dynamic neural-fuzzy model outperforms the subtractive clustering-based ANFIS model and fuzzy c-means clustering-based ANFIS model in terms of their modeling accuracy and computational effort. PMID:24385884

  18. Modified tragus edge approach for mid-level or low condylar fractures.

    PubMed

    Li, Z; Zhao, W; Liu, C; Liu, J

    2016-09-01

    The aim of this study was to evaluate and report a modified tragus edge approach (MTEA) for surgical access to mid-level or low condylar fractures. The MTEA was used on 45 patients (59 sides). All of the patients were reviewed for scarring, parotid fistula, facial nerve function, occlusion, deviation, and limitation of mouth opening (MO). Forty-one patients (64 sides) with middle or low level condylar fractures who underwent surgery by retromandibular approach during the same period were selected for comparison. In the MTEA group, scars were not obvious and there was no parotid fistula. The occlusion of four cases (8.9%) was not ideal, but returned to normal after 2 weeks of intermaxillary traction. Temporary facial nerve damage was present on two sides (3.4%). MO was not deviated in any patient, but was limited in the first 2 weeks after operation in three cases (6.7%). The risks of facial nerve dysfunction and parotid fistula were much higher in the retromandibular approach group than in the MTEA group, while the risks of malocclusion and limitation of MO were similar. MTEA is safe and has good aesthetic outcomes. MTEA represents an appropriate surgical access to mid-level and low condylar fractures. PMID:27256012

  19. Co-Crystals: A Novel Approach to Modify Physicochemical Properties of Active Pharmaceutical Ingredients

    PubMed Central

    Yadav, A. V.; Shete, A. S.; Dabke, A. P.; Kulkarni, P. V.; Sakhare, S. S.

    2009-01-01

    Crystal form can be crucial to the performance of a dosage form. This is especially true for compounds that have intrinsic barriers to drug delivery, such as low aqueous solubility, slow dissolution in gastrointestinal media, low permeability and first-pass metabolism. The nature of the physical form and formulation tends to exhibit the greatest effect on bioavailability parameters of water insoluble compounds that need to be given orally in high doses. An alternative approach available for the enhancement of drug solubility, dissolution and bioavailability is through the application of crystal engineering of co-crystals. The physicochemical properties of the active pharmaceutical ingredients and the bulk material properties can be modified, whilst maintaining the intrinsic activity of the drug molecule. This article covers the advantages of co-crystals over salts, solvates (hydrates), solid dispersions and polymorphs, mechanism of formation of co-crystals, methods of preparation of co-crystals and application of co-crystals to modify physicochemical characteristics of active pharmaceutical ingredients along with the case studies. The intellectual property implications of creating co-crystals are also highly relevant. PMID:20502540

  20. Modified neural dynamic surface approach to output feedback of MIMO nonlinear systems.

    PubMed

    Sun, Guofa; Li, Dongwu; Ren, Xuemei

    2015-02-01

    We report an adaptive output feedback dynamic surface control (DSC), maintaining the prescribed performance, for a class of uncertain nonlinear systems with multiinput and multioutput. Designing neural network observers and modifying the DSC method achieves several control objectives. First, to achieve output feedback control, the finite-time echo state networks (ESN) observer with fast convergence is designed to obtain the online system states. Thus, the immeasurable states in traditional state feedback control are estimated and the unknown functions are approximated by ESN. Then, a modified DSC approach is developed by introducing a high-order sliding mode differentiator to replace the first-order filter in each step. Thus, the effect of filter performance on closed-loop stability is reduced. Furthermore, the input to state stability guarantees that all signals of the whole closed-loop system are semiglobally uniformly ultimately bounded. Specifically, the performance functions make the tracking errors converge to a compact set around equilibrium. Two numerical examples illustrated the proposed control scheme with satisfactory results. PMID:25608286

  1. Finite-element blunt-crack propagation: a modified J-integral approach. [LMFBR

    SciTech Connect

    Pan, Y.C.; Marchertas, A.H.; Kennedy, J.M.

    1983-01-01

    In assessing the safety of a liquid metal fast breeder reactor (LMFBR), a major concern is the behavior of concrete structures subjected to high temperatures. The potential of concrete cracking is an important parameter which could significantly influence the safety assessment of thermally attacked concrete. A new modified J-integral approach for the blunt crack model has been derived to provide a general procedure to accurately predict the direction of crack growth. This formulation has been incorporated into the coupled heat transfer-stress analysis finite element code TEMP-STRESS. A description of the formulation is presented in this paper. Results for the problems of a Mode I and mixed mode crack in a plate using regular and slanted meshes subjected to uniaxial and shear loading are presented.

  2. The CAP Approach to Modifying Vocational Programs for Handicapped Students. Vol. 1: Agriculture with an Example in Horticulture.

    ERIC Educational Resources Information Center

    Tindall, Lloyd W.; Morehouse, Nancy

    This combination teaching guide and student workbook, the first in a five-volume series (see note), presents an approach to teaching horticulture for handicapped students. The guide discusses a functional approach to modifying agriculture programs to accomodate cognitive, affective, and psychomotor (CAP) domain handicaps. The discussion centers on…

  3. Approaches to the treatment of early rheumatoid arthritis with disease-modifying antirheumatic drugs.

    PubMed

    Sizova, Lyudmila

    2008-08-01

    This paper reviews recent approaches to treatment of early rheumatoid arthritis (RA) with disease-modifying antirheumatic drugs (DMARDs). The literature on treatment the early RA published between 1995 and 2007 was accessed through the PubMed database from the National Library of Medicine. Keywords were 'early rheumatoid arthritis', 'disease-modifying antirheumatic drugs', 'biologic agents' and 'combination therapy'. Only results of trials on human subjects that directly measured the effects of DMARDs or biological agents on clinical, laboratory parameters and radiological progression of early RA were selected. Combination therapy suppresses RA activity and radiological progression more effectively than monotherapy. If better control of RA is evident after 3-6 months of treatment with the combination of DMARDs, one must still decide whether to stop the first DMARD, stop the second, or continue with the combination. Combination therapy biological agents (infliximab, adalimumab) with methotrexate and etanercept therapy alone may induce remission in many patients with early RA. It is a method of choice in patients with an adverse prognosis. The main indications for combination therapy 'standard' DMARDs or combination 1 DMARDs with a biological agent are such variables as detection of a shared epitope, increase of concentration of anticyclic citrullinated peptide antibodies, rheumatoid factor, C-reactive protein, 28-joint disease activity score, Sharp score and presence of erosion in joints. The majority of rheumatologists believe that patients with RA should be treated with DMARDs earlier rather than later in the disease process. Further trials should establish the optimal approaches to early RA therapy. PMID:18537958

  4. Anterior Cervical Spine Surgery for Degenerative Disease: A Review

    PubMed Central

    SUGAWARA, Taku

    Anterior cervical spine surgery is an established surgical intervention for cervical degenerative disease and high success rate with excellent long-term outcomes have been reported. However, indications of surgical procedures for certain conditions are still controversial and severe complications to cause neurological dysfunction or deaths may occur. This review is focused mainly on five widely performed procedures by anterior approach for cervical degenerative disease; anterior cervical discectomy, anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, anterior cervical foraminotomy, and arthroplasty. Indications, procedures, outcomes, and complications of these surgeries are discussed. PMID:26119899

  5. Quantum harmonic Brownian motion in a general environment: A modified phase-space approach

    NASA Astrophysics Data System (ADS)

    Yeh, L.

    1993-06-01

    After extensive investigations over three decades, the linear-coupling model and its equivalents have become the standard microscopic models for quantum harmonic Brownian motion, in which a harmonically bound Brownian particle is coupled to a quantum dissipative heat bath of general type modeled by infinitely many harmonic oscillators. The dynamics of these models have been studied by many authors using the quantum Langevin equation, the path-integral approach, quasi-probability distribution functions (e.g., the Wigner function), etc. However, the quantum Langevin equation is only applicable to some special problems, while other approaches all involve complicated calculations due to the inevitable reduction (i.e., contraction) operation for ignoring/eliminating the degrees of freedom of the heat bath. In this dissertation, the author proposes an improved methodology via a modified phase-space approach which employs the characteristic function (the symplectic Fourier transform of the Wigner function) as the representative of the density operator. This representative is claimed to be the most natural one for performing the reduction, not only because of its simplicity but also because of its manifestation of geometric meaning. Accordingly, it is particularly convenient for studying the time evolution of the Brownian particle with an arbitrary initial state. The power of this characteristic function is illuminated through a detailed study of several physically interesting problems, including the environment-induced damping of quantum interference, the exact quantum Fokker-Planck equations, and the relaxation of non-factorizable initial states. All derivations and calculations are shown to be much simplified in comparison with other approaches. In addition to dynamical problems, a novel derivation of the fluctuation-dissipation theorem which is valid for all quantum linear systems is presented.

  6. Quantum Harmonic Brownian Motion in a General Environment: a Modified Phase-Space Approach.

    NASA Astrophysics Data System (ADS)

    Yeh, Leehwa

    After extensive investigations over three decades, the linear-coupling model and its equivalents have become the standard microscopic models for quantum harmonic Brownian motion, in which a harmonically bound Brownian particle is coupled to a quantum dissipative heat bath of general type modeled by infinitely many harmonic oscillators. The dynamics of these models have been studied by many authors using the quantum Langevin equation, the path-integral approach, quasi-probability distribution functions (e.g., the Wigner function), etc. However, the quantum Langevin equation is only applicable to some special problems, while other approaches all involve complicated calculations due to the inevitable reduction (i.e., contraction) operation for ignoring/eliminating the degrees of freedom of the heat bath. In this dissertation, I propose an improved methodology via a modified phase-space approach which employs the characteristic function (the symplectic Fourier transform of the Wigner function) as the representative of the density operator. This representative is claimed to be the most natural one for performing the reduction, not only because of its simplicity but also because of its manifestation of geometric meaning. Accordingly, it is particularly convenient for studying the time evolution of the Brownian particle with an arbitrary initial state. The power of this characteristic function is illuminated through a detailed study of several physically interesting problems, including the environment-induced damping of quantum interference, the exact quantum Fokker-Planck equations, and the relaxation of non-factorizable initial states. All derivations and calculations are shown to be much simplified in comparison with other approaches. In addition to dynamical problems, a novel derivation of the fluctuation-dissipation theorem which is valid for all quantum linear systems is presented. With the help of this theorem, the mechanism of this model is examined and the

  7. Quantum harmonic Brownian motion in a general environment: A modified phase-space approach

    SciTech Connect

    Yeh, L. |

    1993-06-23

    After extensive investigations over three decades, the linear-coupling model and its equivalents have become the standard microscopic models for quantum harmonic Brownian motion, in which a harmonically bound Brownian particle is coupled to a quantum dissipative heat bath of general type modeled by infinitely many harmonic oscillators. The dynamics of these models have been studied by many authors using the quantum Langevin equation, the path-integral approach, quasi-probability distribution functions (e.g., the Wigner function), etc. However, the quantum Langevin equation is only applicable to some special problems, while other approaches all involve complicated calculations due to the inevitable reduction (i.e., contraction) operation for ignoring/eliminating the degrees of freedom of the heat bath. In this dissertation, the author proposes an improved methodology via a modified phase-space approach which employs the characteristic function (the symplectic Fourier transform of the Wigner function) as the representative of the density operator. This representative is claimed to be the most natural one for performing the reduction, not only because of its simplicity but also because of its manifestation of geometric meaning. Accordingly, it is particularly convenient for studying the time evolution of the Brownian particle with an arbitrary initial state. The power of this characteristic function is illuminated through a detailed study of several physically interesting problems, including the environment-induced damping of quantum interference, the exact quantum Fokker-Planck equations, and the relaxation of non-factorizable initial states. All derivations and calculations axe shown to be much simplified in comparison with other approaches. In addition to dynamical problems, a novel derivation of the fluctuation-dissipation theorem which is valid for all quantum linear systems is presented.

  8. Artificial Cervical Vertebra and Intervertebral Complex Replacement through the Anterior Approach in Animal Model: A Biomechanical and In Vivo Evaluation of a Successful Goat Model

    PubMed Central

    Qin, Jie; He, Xijing; Wang, Dong; Qi, Peng; Guo, Lei; Huang, Sihua; Cai, Xuan; Li, Haopeng; Wang, Rui

    2012-01-01

    This was an in vitro and in vivo study to develop a novel artificial cervical vertebra and intervertebral complex (ACVC) joint in a goat model to provide a new method for treating degenerative disc disease in the cervical spine. The objectives of this study were to test the safety, validity, and effectiveness of ACVC by goat model and to provide preclinical data for a clinical trial in humans in future. We designed the ACVC based on the radiological and anatomical data on goat and human cervical spines, established an animal model by implanting the ACVC into goat cervical spines in vitro prior to in vivo implantation through the anterior approach, and evaluated clinical, radiological, biomechanical parameters after implantation. The X-ray radiological data revealed similarities between goat and human intervertebral angles at the levels of C2-3, C3-4, and C4-5, and between goat and human lordosis angles at the levels of C3-4 and C4-5. In the in vivo implantation, the goats successfully endured the entire experimental procedure and recovered well after the surgery. The radiological results showed that there was no dislocation of the ACVC and that the ACVC successfully restored the intervertebral disc height after the surgery. The biomechanical data showed that there was no significant difference in range of motion (ROM) or neural zone (NZ) between the control group and the ACVC group in flexion-extension and lateral bending before or after the fatigue test. The ROM and NZ of the ACVC group were greater than those of the control group for rotation. In conclusion, the goat provides an excellent animal model for the biomechanical study of the cervical spine. The ACVC is able to provide instant stability after surgery and to preserve normal motion in the cervical spine. PMID:23300816

  9. A numerical simulation approach to studying anterior cruciate ligament strains and internal forces among young recreational women performing valgus inducing stop-jump activities.

    PubMed

    Kar, Julia; Quesada, Peter M

    2012-08-01

    Anterior cruciate ligament (ACL) injuries are commonly incurred by recreational and professional women athletes during non-contact jumping maneuvers in sports like basketball and volleyball, where incidences of ACL injury is more frequent to females compared to males. What remains a numerical challenge is in vivo calculation of ACL strain and internal force. This study investigated effects of increasing stop-jump height on neuromuscular and bio-mechanical properties of knee and ACL, when performed by young female recreational athletes. The underlying hypothesis is increasing stop-jump (platform) height increases knee valgus angles and external moments which also increases ACL strain and internal force. Using numerical analysis tools comprised of Inverse Kinematics, Computed Muscle Control and Forward Dynamics, a novel approach is presented for computing ACL strain and internal force based on (1) knee joint kinematics and (2) optimization of muscle activation, with ACL insertion into musculoskeletal model. Results showed increases in knee valgus external moments and angles with increasing stop-jump height. Increase in stop-jump height from 30 to 50 cm lead to increase in average peak valgus external moment from 40.5 ± 3.2 to 43.2 ± 3.7 Nm which was co-incidental with increase in average peak ACL strain, from 9.3 ± 3.1 to 13.7 ± 1.1%, and average peak ACL internal force, from 1056.1 ± 71.4 to 1165.4 ± 123.8 N for the right side with comparable increases in the left. In effect this study demonstrates a technique for estimating dynamic changes to knee and ACL variables by conducting musculoskeletal simulation on motion analysis data, collected from actual stop-jump tasks performed by young recreational women athletes. PMID:22527014

  10. Postoperative changes in the tensor fascia lata muscle after using the modified anterolateral approach for total hip arthroplasty.

    PubMed

    Unis, Douglas B; Hawkins, Evan J; Alapatt, Michael F; Benitez, Carlos L

    2013-04-01

    The modified Watson-Jones approach to the hip has been described as a minimally invasive approach with the potential for fewer postoperative complications than the traditional approach. Because the approach relies on an intermuscular rather than an internervous plane, there is potential for injury to the superior gluteal nerve. The aim of this study was to evaluate incidence of tensor fascia lata (TFL) denervation in patients undergoing this approach. Twenty-six patients underwent total hip arthroplasty (THA) using a modified anterolateral approach. Postoperative MRIs were analyzed for signs of muscle denervation including atrophy, hypertrophy and fat replacement. At a median follow-up of 9.3months, 74% of patients exhibited either atrophy or hypertrophy of the TFL and 42% exhibited fat replacement on MRI. PMID:23253300

  11. An adaptive optics approach for laser beam correction in turbulence utilizing a modified plenoptic camera

    NASA Astrophysics Data System (ADS)

    Ko, Jonathan; Wu, Chensheng; Davis, Christopher C.

    2015-09-01

    Adaptive optics has been widely used in the field of astronomy to correct for atmospheric turbulence while viewing images of celestial bodies. The slightly distorted incoming wavefronts are typically sensed with a Shack-Hartmann sensor and then corrected with a deformable mirror. Although this approach has proven to be effective for astronomical purposes, a new approach must be developed when correcting for the deep turbulence experienced in ground to ground based optical systems. We propose the use of a modified plenoptic camera as a wavefront sensor capable of accurately representing an incoming wavefront that has been significantly distorted by strong turbulence conditions (C2n <10-13 m- 2/3). An intelligent correction algorithm can then be developed to reconstruct the perturbed wavefront and use this information to drive a deformable mirror capable of correcting the major distortions. After the large distortions have been corrected, a secondary mode utilizing more traditional adaptive optics algorithms can take over to fine tune the wavefront correction. This two-stage algorithm can find use in free space optical communication systems, in directed energy applications, as well as for image correction purposes.

  12. Development of Modified MOD-TFA Approach for YBCO Film Growth

    SciTech Connect

    Bhuiyan, Md S; Paranthaman, Mariappan Parans; Sathyamurthy, Srivatsan; Hunt, Rodney Dale; List III, Frederick Alyious; Duckworth, Robert C

    2007-01-01

    Low-cost coated-conductor fabrication methods are essential for various electric-power applications. Metal-organic-deposition (MOD) approach to grow both YBa{sub 2}Cu{sub 3}O{sub 7-{delta}} (YBCO) and buffer layers on textured metal substrates is very promising towards fabrication of lower-cost second generation wires. YBCO coated conductors (CC) are being developed with high critical currents that should be sufficient for their extensive use in power applications. However, the present CC has high energy losses in ac magnetic field that are unacceptable. We have developed a modified MOD precursor route to deposit {approx} 0.8 {micro}m thick YBCO films in a single coat that requires less than one-fifth of the pyrolysis time compared to the traditional MOD approach. We have also developed a filamentization technique of CC using ink-jet printing to reduce ac losses due to applied ac fields. The preliminary results of YBCO films deposited on standard RABiTS template yielded an of 140 A/cm at 77 K and self- field. A modest reduction of ac loss was observed for the solution ink-jet printed filamentary conductor.

  13. Band gaps from the Tran-Blaha modified Becke-Johnson approach: A systematic investigation

    NASA Astrophysics Data System (ADS)

    Jiang, Hong

    2013-04-01

    The semi-local Becke-Johnson (BJ) exchange-correlation potential and its modified form proposed by Tran and Blaha (TB-mBJ) have attracted a lot of interest recently because of the surprisingly accurate band gaps they can deliver for many semiconductors and insulators. In this work, we have investigated the performance of the TB-mBJ potential for the description of electronic band structures in a comprehensive set of semiconductors and insulators. We point out that a perturbative use of the TB-mBJ potential can give overall better results. By investigating a set of IIB-VI and III-V semiconductors, we point out that although the TB-mBJ approach can describe the band gap of these materials quite well, the binding energies of semi-core d-states in these materials deviate strongly from experiment. The difficulty of the TB-mBJ potential to describe the localized states is likely the cause for the fact that the electronic band structures of Cu2O and La2O3 are still poorly described. Based on these observations, we propose to combine the TB-mBJ approach with the Hubbard U correction for localized d/f states, which is able to provide overall good descriptions for both the band gaps and semi-core states binding energies. We further apply the approach to calculate the band gaps of a set of Ti(IV)-oxides, many of which have complicated structures so that the more advanced methods like GW are expensive to treat directly. An overall good agreement with experiment is obtained, which is remarkable considering its little computational efforts compared to GW.

  14. The use of a modified Delphi approach to engage stakeholders in zoonotic disease research priority setting

    PubMed Central

    2014-01-01

    Background After the 2011 cluster of Hendra virus cases in horses in Australia, public health targeted education initiatives at people in the equine industry to reduce human exposure to potentially infected horses. ‘Horse owners and Hendra Virus: A Longitudinal cohort study To Evaluate Risk’ aims to enhance public health measures through improved understanding of Hendra virus risk perception and risk mitigation strategies among horse owners and horse care providers. This paper describes the stakeholder consultation that was undertaken to ensure the cohort study outcomes were relevant to diverse groups who play a role in Hendra virus policy development and implementation. Methods A two-round modified Delphi study with online questionnaires was conducted. In round one, stakeholders identified priority research areas. In round two, stakeholders rated and ranked topics that emerged from thematic analysis of the round one responses. Round two data were analysed using logistic regression. Results Of the 255 stakeholders contacted, 101 responded to round one. Over 450 topics were proposed. These were organized into 18 themes. Approximately two thirds of the round one respondents participated in round two. ‘Hendra virus-related risk awareness and perception’, ‘personal health and safety’, ‘emergency preparedness’, ‘risk prevention, mitigation, and biosecurity’, and ‘Hendra virus vaccination in horses – attitudes/uptake’ were the top five areas identified according to probability of being ranked extremely important. Conclusions In this study, a modified Delphi approach was effective in guiding research into Hendra virus, a zoonotic disease of animal and human health significance. The findings support the notion that stakeholders should be engaged in zoonotic disease research priority setting. Such consultation will help to ensure that research initiatives are relevant and useful to stakeholders in the position to make use of new findings. PMID

  15. Simulation of emotional contagion using modified SIR model: A cellular automaton approach

    NASA Astrophysics Data System (ADS)

    Fu, Libi; Song, Weiguo; Lv, Wei; Lo, Siuming

    2014-07-01

    Emotion plays an important role in the decision-making of individuals in some emergency situations. The contagion of emotion may induce either normal or abnormal consolidated crowd behavior. This paper aims to simulate the dynamics of emotional contagion among crowds by modifying the epidemiological SIR model to a cellular automaton approach. This new cellular automaton model, entitled the “CA-SIRS model”, captures the dynamic process ‘susceptible-infected-recovered-susceptible', which is based on SIRS contagion in epidemiological theory. Moreover, in this new model, the process is integrated with individual movement. The simulation results of this model show that multiple waves and dynamical stability around a mean value will appear during emotion spreading. It was found that the proportion of initial infected individuals had little influence on the final stable proportion of infected population in a given system, and that infection frequency increased with an increase in the average crowd density. Our results further suggest that individual movement accelerates the spread speed of emotion and increases the stable proportion of infected population. Furthermore, decreasing the duration of an infection and the probability of reinfection can markedly reduce the number of infected individuals. It is hoped that this study will be helpful in crowd management and evacuation organization.

  16. Modified approach to use of DOE-STD-3009 example risk matrices.

    SciTech Connect

    Atwood, Ginger A.

    2008-04-01

    DOE-STD-3009, Preparation Guide for US Department of Energy Non-reactor Nuclear Facilities Documented Safety Analyses, identifies a methodology for selection of high risk accidents and hazard scenarios for Hazard Category 1, 2, and 3 Nuclear Facilities and their controls. It provides examples of risk matrices which can be used as a part of this methodology. It also states, 'There is no one correct approach or presentation'. Sandia has used a modified version of these examples to focus control selection on controls that provide the highest risk to the public and the workers. Sandia's matrix assigns a lower risk level to high probability, low consequence events that are covered by institutional safety programs. The objective of this paper is to serve as a point of discussion on the benefits of using this modification to the DOE-STD-3009 examples. The paper relates to the workshop subtopic of Lessons Learned and Hazards Analysis since it provides lessons learned in hazard analysis process at SNL.

  17. GRACE L1b inversion through a self-consistent modified radial basis function approach

    NASA Astrophysics Data System (ADS)

    Yang, Fan; Kusche, Juergen; Rietbroek, Roelof; Eicker, Annette

    2016-04-01

    Implementing a regional geopotential representation such as mascons or, more general, RBFs (radial basis functions) has been widely accepted as an efficient and flexible approach to recover the gravity field from GRACE (Gravity Recovery and Climate Experiment), especially at higher latitude region like Greenland. This is since RBFs allow for regionally specific regularizations over areas which have sufficient and dense GRACE observations. Although existing RBF solutions show a better resolution than classical spherical harmonic solutions, the applied regularizations cause spatial leakage which should be carefully dealt with. It has been shown that leakage is a main error source which leads to an evident underestimation of yearly trend of ice-melting over Greenland. Unlike some popular post-processing techniques to mitigate leakage signals, this study, for the first time, attempts to reduce the leakage directly in the GRACE L1b inversion by constructing an innovative modified (MRBF) basis in place of the standard RBFs to retrieve a more realistic temporal gravity signal along the coastline. Our point of departure is that the surface mass loading associated with standard RBF is smooth but disregards physical consistency between continental mass and passive ocean response. In this contribution, based on earlier work by Clarke et al.(2007), a physically self-consistent MRBF representation is constructed from standard RBFs, with the help of the sea level equation: for a given standard RBF basis, the corresponding MRBF basis is first obtained by keeping the surface load over the continent unchanged, but imposing global mass conservation and equilibrium response of the oceans. Then, the updated set of MRBFs as well as standard RBFs are individually employed as the basis function to determine the temporal gravity field from GRACE L1b data. In this way, in the MRBF GRACE solution, the passive (e.g. ice melting and land hydrology response) sea level is automatically

  18. A modified TILLING approach to detect induced mutations in tetraploid and hexaploid wheat

    PubMed Central

    Uauy, Cristobal; Paraiso, Francine; Colasuonno, Pasqualina; Tran, Robert K; Tsai, Helen; Berardi, Steve; Comai, Luca; Dubcovsky, Jorge

    2009-01-01

    Background Wheat (Triticum ssp.) is an important food source for humans in many regions around the world. However, the ability to understand and modify gene function for crop improvement is hindered by the lack of available genomic resources. TILLING is a powerful reverse genetics approach that combines chemical mutagenesis with a high-throughput screen for mutations. Wheat is specially well-suited for TILLING due to the high mutation densities tolerated by polyploids, which allow for very efficient screens. Despite this, few TILLING populations are currently available. In addition, current TILLING screening protocols require high-throughput genotyping platforms, limiting their use. Results We developed mutant populations of pasta and common wheat and organized them for TILLING. To simplify and decrease costs, we developed a non-denaturing polyacrylamide gel set-up that uses ethidium bromide to detect fragments generated by crude celery juice extract digestion of heteroduplexes. This detection method had similar sensitivity as traditional LI-COR screens, suggesting that it represents a valid alternative. We developed genome-specific primers to circumvent the presence of multiple homoeologous copies of our target genes. Each mutant library was characterized by TILLING multiple genes, revealing high mutation densities in both the hexaploid (~1/38 kb) and tetraploid (~1/51 kb) populations for 50% GC targets. These mutation frequencies predict that screening 1,536 lines for an effective target region of 1.3 kb with 50% GC content will result in ~52 hexaploid and ~39 tetraploid mutant alleles. This implies a high probability of obtaining knock-out alleles (P = 0.91 for hexaploid, P = 0.84 for tetraploid), in addition to multiple missense mutations. In total, we identified over 275 novel alleles in eleven targeted gene/genome combinations in hexaploid and tetraploid wheat and have validated the presence of a subset of them in our seed stock. Conclusion We have generated

  19. Mini-open anterior lumbar interbody fusion.

    PubMed

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ . PMID:27364424

  20. A modified regionalization weighting approach for climate change impact assessment at watershed scale

    NASA Astrophysics Data System (ADS)

    Zareian, Mohammad Javad; Eslamian, Saeid; Safavi, Hamid Reza

    2015-11-01

    This study is conducted to investigate the regional effects of climate change on Zayandeh-Rud River Basin located in the central part of Iran for the both near and far future scenarios. A combination of various general circulation models (GCMs) is used through a weighting approach to generate different climate change patterns including the ideal, medium, and critical patterns. Each of the GCMs has different ability to simulate the baseline climatic parameters in various months and regions of the basin. A new method, namely "modified weighting method based on the actual values" (MWM-AV), also is applied to convert the local effects of climate change to the regional effects. The results showed that the annual temperature of Zayandeh-Rud River Basin would increase by 0.59-1.34 and 1.02-2.53 °C, respectively, in the near and far futures in which maximum increase in seasonal temperature is expected to happen in the summer. Annual precipitation would change by +1.78 to -20.78 % in the near future and -14.35 to -32.82 % in the far future. The maximum decrease in precipitation is observed to be in the winter. The results of temperature and precipitation regionalization showed that the applied method has a good precision in estimating temperature and precipitation in different regions of the desired basin. The eastern part of the basin would have the maximum increase in temperature, while the western part would experience the maximum decrease in precipitation. Overall, the results demonstrated that due to the centralization of the main water uses in the east and the water resources in the west, the Zayandeh-Rud River Basin will face an intensive water shortage under climate change.

  1. A modified Delphi approach to standardize low back pain recurrence terminology.

    PubMed

    Stanton, Tasha R; Latimer, Jane; Maher, Chris G; Hancock, Mark J

    2011-05-01

    Lack of standardization of terminology in low back pain (LBP) research has significantly impeded progress in this area. The diversity in existing definitions for a 'recurrence of an episode of LBP' and 'recurrent LBP' is an important example. The variety of definitions used by researchers working in this area has prevented comparison of results between trials and made meta-analyses of this data unfeasible. The aim of this study was to use a modified Delphi approach to gain consensus on definitions for a 'recurrence of an episode of LBP' (e.g. outcome event) and for 'recurrent LBP' (e.g. patient population). Existing definitions for both constructs were classified into the main features comprising the definition (e.g. 'duration of pain') and the items that defined each feature (e.g. 'pain lasting at least 24 h'). In each round, participants were asked to rate the importance of each feature to a definition of a 'recurrence of an episode of LBP', and a definition of 'recurrent LBP' and rank the items (defining each feature) in order of decreasing importance. Forty-six experts in LBP research, from nine different countries, participated in this study. Four rounds were completed with responses rates of 94, 91, 83, and 97% in rounds 1, 2, 3, and 4, respectively. Consensus definitions were reached in both areas with 95% of panel members supporting the definition of a 'recurrence of an episode of LBP' and 92% of panel members supporting the definition of 'recurrent LBP'. Future research is necessary to evaluate these definitions. PMID:21193932

  2. Atomic-layer electroless deposition: a scalable approach to surface-modified metal powders.

    PubMed

    Cappillino, Patrick J; Sugar, Joshua D; El Gabaly, Farid; Cai, Trevor Y; Liu, Zhi; Stickney, John L; Robinson, David B

    2014-04-29

    Palladium has a number of important applications in energy and catalysis in which there is evidence that surface modification leads to enhanced properties. A strategy for preparing such materials is needed that combines the properties of (i) scalability (especially on high-surface-area substrates, e.g. powders); (ii) uniform deposition, even on substrates with complex, three-dimensional features; and (iii) low-temperature processing conditions that preserve nanopores and other nanostructures. Presented herein is a method that exhibits these properties and makes use of benign reagents without the use of specialized equipment. By exposing Pd powder to dilute hydrogen in nitrogen gas, sacrificial surface PdH is formed along with a controlled amount of dilute interstitial hydride. The lattice expansion that occurs in Pd under higher H2 partial pressures is avoided. Once the flow of reagent gas is terminated, addition of metal salts facilitates controlled, electroless deposition of an overlayer of subnanometer thickness. This process can be cycled to create thicker layers. The approach is carried out under ambient processing conditions, which is an advantage over some forms of atomic layer deposition. The hydride-mediated reaction is electroless in that it has no need for connection to an external source of electrical current and is thus amenable to deposition on high-surface-area substrates having rich, nanoscale topography as well as on insulator-supported catalyst particles. STEM-EDS measurements show that conformal Rh and Pt surface layers can be formed on Pd powder with this method. A growth model based on energy-resolved XPS depth profiling of Rh-modified Pd powder is in general agreement. After two cycles, deposits are consistent with 70-80% coverage and a surface layer with a thickness from 4 to 8 Å. PMID:24738575

  3. Survivorship of standard versus modified posterior surgical approaches in metal-on-metal hip resurfacing

    PubMed Central

    M. Takamura, K.; Maher, P.; Nath, T.; Su, E. P.

    2014-01-01

    Objectives Metal-on-metal hip resurfacing (MOMHR) is available as an alternative option for younger, more active patients. There are failure modes that are unique to MOMHR, which include loosening of the femoral head and fractures of the femoral neck. Previous studies have speculated that changes in the vascularity of the femoral head may contribute to these failure modes. This study compares the survivorship between the standard posterior approach (SPA) and modified posterior approach (MPA) in MOMHR. Methods A retrospective clinical outcomes study was performed examining 351 hips (279 male, 72 female) replaced with Birmingham Hip Resurfacing (BHR, Smith and Nephew, Memphis, Tennessee) in 313 patients with a pre-operative diagnosis of osteoarthritis. The mean follow-up period for the SPA group was 2.8 years (0.1 to 6.1) and for the MPA, 2.2 years (0.03 to 5.2); this difference in follow-up period was statistically significant (p < 0.01). Survival analysis was completed using the Kaplan–Meier method. Results At four years, the Kaplan–Meier survival curve for the SPA was 97.2% and 99.4% for the MPA; this was statistically significant (log-rank; p = 0.036). There were eight failures in the SPA and two in the MPA. There was a 3.5% incidence of femoral head collapse or loosening in the SPA and 0.4% in the MPA, which represented a significant difference (p = 0.041). There was a 1.7% incidence of fractures of the femoral neck in the SPA and none in the MPA (p = 0.108). Conclusion This study found a significant difference in survivorship at four years between the SPA and the MPA (p = 0.036). The clinical outcomes of this study suggest that preserving the vascularity of the femoral neck by using the MPA results in fewer vascular-related failures in MOMHRs. Cite this article: Bone Joint Res 2014;3:150–4 PMID:24842931

  4. USE OF MODELING APPROACHES TO UNDERSTAND POTENTIAL IMPACTS OF GENETICALLY MODIFIED PLANTS ON PLANT COMMUNITIES

    EPA Science Inventory

    Model development is of interest to ecologists, regulators and developers, since it may assist theoretical understanding, decision making in experimental design, product development and risk assessment. In order to predict the potential impacts of genetically modified (GM) plants...

  5. [Isolated anterior cervical hypertrichosis].

    PubMed

    Monteagudo, B; Cabanillas, M; de las Heras, C; Cacharrón, J M

    2009-01-01

    Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair disorders, facial dysmorphism, or sensory and motor peripheral neuropathy. We report the case of a 27-year-old woman who presented with this condition as an isolated finding. PMID:19268113

  6. Approaches in the risk assessment of genetically modified foods by the Hellenic Food Safety Authority.

    PubMed

    Varzakas, Theodoros H; Chryssochoidis, G; Argyropoulos, D

    2007-04-01

    Risk analysis has become important to assess conditions and take decisions on control procedures. In this context it is considered a prerequisite in the evaluation of GM food. Many consumers worldwide worry that food derived from genetically modified organisms (GMOs) may be unhealthy and hence regulations on GMO authorisations and labelling have become more stringent. Nowadays there is a higher demand for non-GM products and these products could be differentiated from GM products using the identity preservation system (IP) that could apply throughout the grain processing system. IP is the creation of a transparent communication system that encompasses HACCP, traceability and related systems in the supply chain. This process guarantees that certain characteristics of the lots of food (non-GM origin) are maintained "from farm to fork". This article examines the steps taken by the Hellenic Food Safety Authority to examine the presence of GMOs in foods. The whole integrated European legislation framework currently in place still needs to be implemented in Greece. Penalties should be enforced to those who import, process GMOs without special licence and do not label those products. Similar penalties should be enforced to those companies that issue false certificates beyond the liabilities taken by the food enterprises for farmers' compensation. We argue that Greece has no serious reasons to choose the use of GMOs due to the fact that the structural and pedologic characteristics of the Greek agriculture favour the biological and integrated cultivation more. Greece is not in favour of the politics behind coexistence of conventional and GM plants and objects to the use of GMOs in the food and the environment because the processor has a big burden in terms of money, time and will suffer a great deal in order to prove that their products are GMO free or that any contamination is adventitious or technically unavoidable. Moreover, Greece owns a large variety of genetic

  7. Nutrient fluxes in the Changjiang River estuary and adjacent waters — a modified box model approach

    NASA Astrophysics Data System (ADS)

    Wang, Xiaohong; Yu, Zhiming; Fan, Wei; Song, Xiuxian; Cao, Xihua; Yuan, Yongquan

    2015-01-01

    one in estimating nutrient fluxes in a complicated hydrodynamic current system and provides a modified box model approach to material flux research.

  8. On the validity of the modified equation approach to the stability analysis of finite-difference methods

    NASA Technical Reports Server (NTRS)

    Chang, Sin-Chung

    1987-01-01

    The validity of the modified equation stability analysis introduced by Warming and Hyett was investigated. It is shown that the procedure used in the derivation of the modified equation is flawed and generally leads to invalid results. Moreover, the interpretation of the modified equation as the exact partial differential equation solved by a finite-difference method generally cannot be justified even if spatial periodicity is assumed. For a two-level scheme, due to a series of mathematical quirks, the connection between the modified equation approach and the von Neuman method established by Warming and Hyett turns out to be correct despite its questionable original derivation. However, this connection is only partially valid for a scheme involving more than two time levels. In the von Neumann analysis, the complex error multiplication factor associated with a wave number generally has (L-1) roots for an L-level scheme. It is shown that the modified equation provides information about only one of these roots.

  9. Seasonal rationalization of river water quality sampling locations: a comparative study of the modified Sanders and multivariate statistical approaches.

    PubMed

    Varekar, Vikas; Karmakar, Subhankar; Jha, Ramakar

    2016-02-01

    The design of surface water quality sampling location is a crucial decision-making process for rationalization of monitoring network. The quantity, quality, and types of available dataset (watershed characteristics and water quality data) may affect the selection of appropriate design methodology. The modified Sanders approach and multivariate statistical techniques [particularly factor analysis (FA)/principal component analysis (PCA)] are well-accepted and widely used techniques for design of sampling locations. However, their performance may vary significantly with quantity, quality, and types of available dataset. In this paper, an attempt has been made to evaluate performance of these techniques by accounting the effect of seasonal variation, under a situation of limited water quality data but extensive watershed characteristics information, as continuous and consistent river water quality data is usually difficult to obtain, whereas watershed information may be made available through application of geospatial techniques. A case study of Kali River, Western Uttar Pradesh, India, is selected for the analysis. The monitoring was carried out at 16 sampling locations. The discrete and diffuse pollution loads at different sampling sites were estimated and accounted using modified Sanders approach, whereas the monitored physical and chemical water quality parameters were utilized as inputs for FA/PCA. The designed optimum number of sampling locations for monsoon and non-monsoon seasons by modified Sanders approach are eight and seven while that for FA/PCA are eleven and nine, respectively. Less variation in the number and locations of designed sampling sites were obtained by both techniques, which shows stability of results. A geospatial analysis has also been carried out to check the significance of designed sampling location with respect to river basin characteristics and land use of the study area. Both methods are equally efficient; however, modified Sanders

  10. New approach of maxillary protraction using modified C-palatal plates in Class III patients

    PubMed Central

    Bayome, Mohamed; Park, Jae Hyun; Kim, Ki Beom; Kim, Seong-Hun; Chung, Kyu-Rhim

    2015-01-01

    Maxillary protraction is the conventional treatment for growing Class III patients with maxillary deficiency, but it has undesirable dental effects. The purpose of this report is to introduce an alternative modality of maxillary protraction in patients with dentoskeletal Class III malocclusion using a modified C-palatal plate connected with elastics to a face mask. This method improved skeletal measurements, corrected overjet, and slightly improved the profile. The patients may require definitive treatment in adolescence or adulthood. The modified C-palatal plate enables nonsurgical maxillary advancement with maximal skeletal effects and minimal dental side effects. PMID:26258067

  11. A modified coupled pair functional approach. [for dipole moment calculation of metal hydride ground states

    NASA Technical Reports Server (NTRS)

    Chong, D. P.; Langhoff, S. R.

    1986-01-01

    A modified coupled pair functional (CPF) method is presented for the configuration interaction problem that dramatically improves properties for cases where the Hartree-Fock reference configuration is not a good zeroth-order wave function description. It is shown that the tendency for CPF to overestimate the effect of higher excitations arises from the choice of the geometric mean for the partial normalization denominator. The modified method is demonstrated for ground state dipole moment calculations of the NiH, CuH, and ZnH transition metal hydrides, and compared to singles-plus-doubles configuration interaction and the Ahlrichs et al. (1984) CPF method.

  12. BILATERAL ANTERIOR GLENOHUMERAL DISLOCATION: CLINICAL CASE

    PubMed Central

    Silva, Luís Pires; Sousa, Cristina Varino; Rodrigues, Elisa; Alpoim, Bruno; Leal, Miguel

    2015-01-01

    Bilateral anterior glenohumeral dislocation is a rare occurrence. We present a case of bilateral anterior glenohumeral dislocation caused by a fall. The interest in publishing this case is that this is a clinical rarity with few cases reported in the literature. An 89-year-old female patient was brought to the emergency department after a fall, complaining of intense pain in both shoulders and inability to move them. Objective examination showed clinical signs giving the suspicion of bilateral anterior glenohumeral dislocation, which was confirmed by x-ray imaging. Both dislocations were successfully reduced in the emergency department using the modified Milch technique. When a synchronous and symmetrical force has acted on both shoulders and these are painful with significant functional limitation, the suspicion of bilateral glenohumeral dislocation is a differential diagnosis to be considered, even though it is rare. PMID:27047826

  13. Identification of Core Competencies for an Undergraduate Food Safety Curriculum Using a Modified Delphi Approach

    ERIC Educational Resources Information Center

    Johnston, Lynette M.; Wiedmann, Martin; Orta-Ramirez, Alicia; Oliver, Haley F.; Nightingale, Kendra K.; Moore, Christina M.; Stevenson, Clinton D.; Jaykus, Lee-Ann

    2014-01-01

    Identification of core competencies for undergraduates in food safety is critical to assure courses and curricula are appropriate in maintaining a well-qualified food safety workforce. The purpose of this study was to identify and refine core competencies relevant to postsecondary food safety education using a modified Delphi method. Twenty-nine…

  14. Modifying Racial Attitudes of Second Graders in a Multicultural Setting Using a Curriculum Approach.

    ERIC Educational Resources Information Center

    Ruiz, Andres Julian

    An interdisciplinary unit designed to modify racial attitudes of primary school students was implemented in a multicultural setting. The target group was a class of 27 second-grade students representing nine countries: the United States, Haiti, Cuba, Puerto Rico, Nicaragua, Mexico, Ecuador, Pakistan, and China. Classroom problems included…

  15. Inquiry Based Learning: A Modified Moore Method Approach To Encourage Student Research

    ERIC Educational Resources Information Center

    McLoughlin, M. Padraig M. M.

    2008-01-01

    The author of this paper submits that a mathematics student needs to learn to conjecture and prove or disprove said conjecture. Ergo, the purpose of the paper is to submit the thesis that learning requires doing; only through inquiry is learning achieved, and hence this paper proposes a programme of use of a modified Moore method (MMM) across the…

  16. Malpositioned implants in the anterior maxilla: a novel restorative approach to reestablish peri-implant tissue health and acceptable esthetics. Part II: Case report and discussion.

    PubMed

    Moráguez, Osvaldo D; Vailati, Francesca; Belser, Urs C

    2015-01-01

    This two-part case presentation describes the prosthetic challenge of managing complications in a 50-year-old female patient after inadequate esthetic risk assessment, treatment planning, and implant placement in the anterior maxilla. In Part I, the clinical situation was described, and different restorative solutions were proposed to correct the extreme facial inclination of the implants, excluding major surgical procedures, namely implant removal. In Part II, different prosthetic options are discussed, and the final treatment is revealed. A noninvasive treatment protocol was applied to transform a severely compromised postsurgical situation into an esthetically acceptable result. An unconventional prosthesis design was implemented, including the use of ceramic veneers bonded to the CAD/CAM-generated screw-retained zirconia- based fixed dental prosthesis (FDP), to correct major axis-related problems and spatial discrepancies. PMID:26794049

  17. Malpositioned implants in the anterior maxilla: a novel restorative approach to reestablish peri-implant tissue health and acceptable esthetics. Part I. Case presentation and treatment options.

    PubMed

    Moráguez, Osvaldo D; Vailati, Francesca; Belser, Urs C

    2015-01-01

    This two-part case presentation describes the prosthetic challenge of managing complications after inadequate esthetic risk assessment, treatment planning, and implant positioning in the anterior maxilla. Here, the case report of a 50-year-old woman, referred after inappropriate execution of immediate implant placement, is presented. Different restorative treatment alternatives are proposed, excluding major surgical procedures. In the next part of the article, the advantages and shortcomings of the various prosthetic options will be discussed and the selected treatment revealed. The aim of this part of the article is to illustrate the importance of treatment planning, emphasizing that the correction of esthetic implant failures consistently leads to compromised results when compared to what could have been achieved first time round. PMID:26171441

  18. A modified fluorescent microsphere-based approach for determining resting and hyperemic blood flows in individual murine skeletal muscles

    PubMed Central

    Cardinal, Trevor R.; Hoying, James B.

    2007-01-01

    The goal of this study was to develop a modified fluorescent microsphere-based approach for measuring resting and hyperemic blood flows in individual mouse skeletal muscles. Absolute resting blood flow in the left gracilis posterior was 1.04±0.12 ml·min−1·g−1, while functional hyperemia following muscle activity was 5.94±1.33 ml·min−1·g−1. Measuring absolute blood flow requires sampling arterial blood that serves as a flow-rate and concentration reference to the fluorescent microsphere (FMS) content in the tissue-of-interest for calculating the flow value. Because sampling arterial blood can impair cardiovascular function in the mouse, we also modified our FMS approach to determine relative blood flows in the left gracilis posterior by using the contralateral muscle as our reference in blood flow calculations. Absolute and relative hyperemia measurements detect similar increases in blood flow — 521.93±216.76% and 555.24±213.82%, respectively. However, sampling arterial blood during absolute blood flow measurements significantly decreased mean arterial pressure from the beginning to the end of our experiments, from 102.7±2.18 to 75.5±9.71 mm Hg. This decrease was not seen when measuring relative blood flows. This approach provides critical advantages over contemporary blood flow measurement approaches by allowing blood flow measurements in small and non-superficial tissues. PMID:17500044

  19. Intrinsic optical fiber sensor for sensing organophosphate nerve agent using the modified cladding approach

    NASA Astrophysics Data System (ADS)

    Bansal, Lalitkumar; El-Sherif, Mahmoud

    2004-03-01

    The concept of modified cladding based sensors represents the largest class of intrinsic fiber optic chemical sensors. In this design, the passive cladding of the optical fiber is replaced by an active coating, called modified cladding. The analyte in this case diffuses into the coating and induces changes in the absorbance, fluorescence, or some other spectroscopic property of the modified cladding, the coating acts as a chemo-chromic transducer and sensing takes place by intensity modulation. This design i.e. of the coating based sensors, has found enormous applicability in the realm of chemical and biochemical sensing which also includes environmental monitoring and detection of chemical warfare agents. In this paper, the development of an intrinsic fiber optic sensor for detection of organophosphate dimethyl-methyl phoshopnate (DMMP) is presented. DMMP is a chemical precursor to the nerve agent sarin. The chemo-chromic transducer material used as a modified coating on the fiber core is NDSA (Naphthalene disulphonic acid) doped polypyrrole. This coating material shows conductivity and absorbance change when exposed to DMMP. The fabrication of the sensor device is a three step process which involves (a) etching a small section of the optical fiber to expose the core, (b) coating the etched section of the optical fiber with the polymer, (c) integration of sensor components and testing. Thin film characterization is done using the UV-Vis spectrophotometer on in-situ coated films of polypyrrole on a glass substrate to check for absorbance change upon exposure to DMMP. The development procedure is presented next and encouraging results are discussed.

  20. Comparative Study of Modified Posterior Operation to Treat Kümmell's Disease

    PubMed Central

    Wang, Feng; Wang, Dachuan; Tan, Bingyi; Dong, Jun; Feng, Rongjie; Yuan, Zenong; Wang, Naiguo

    2015-01-01

    Abstract The present study aimed at examining the curative effect of modified posterior operation on treatment of Kümmell's disease. About 30 patients of Kümmell's disease with complete image and clinical data treated during June 2004 to July 2013 were conducted with anterior and posterior approaches, respectively. Kyphotic Cobb angle, fractured vertebra wedge angle, and the anterior and posterior heights of fractured vertebra were all measured through x-ray before and after operation, and the pain visual analog scale (VAS) was determined for evaluating the effect of operations. The injury and restoration of neurological function were assessed using Frankel classification. Patients in group A were treated with anterior operation, whereas group B was posterior operation. Postoperatively, VAS score, kyphotic Cobb angle, anterior vertebra height, and pathologic vertebra wedge angle were all significantly improved in patients with Kümmell's disease receiving modified posterior operation (group B). Similar results were also observed in patients with anterior operation. The improvement of VAS and correction rate of kyphotic Cobb angle indicated equivalent effects of posterior and anterior operations. Meanwhile, alleviated neurological function damage was observed in 2 groups. Relevant factor analysis illustrated that there was no significant correlation of the severity and improvement rate of pain symptoms with age, medical history, anterior and posterior vertebra heights, kyphotic Cobb angle, and pathological vertebra wedge angle. Compared with traditional anterior approach, modified posterior operation, adopting transpedicular vertebral body grafting combined with vertebral pedicle screw fixation, could produce equivalent effects on kyphosis correction, pain relief, and improvement of neurological function in patients with Kümmell's disease. PMID:26426639

  1. Comparative Study of Modified Posterior Operation to Treat Kümmell's Disease.

    PubMed

    Wang, Feng; Wang, Dachuan; Tan, Bingyi; Dong, Jun; Feng, Rongjie; Yuan, Zenong; Wang, Naiguo

    2015-09-01

    The present study aimed at examining the curative effect of modified posterior operation on treatment of Kümmell's disease. About 30 patients of Kümmell's disease with complete image and clinical data treated during June 2004 to July 2013 were conducted with anterior and posterior approaches, respectively. Kyphotic Cobb angle, fractured vertebra wedge angle, and the anterior and posterior heights of fractured vertebra were all measured through x-ray before and after operation, and the pain visual analog scale (VAS) was determined for evaluating the effect of operations. The injury and restoration of neurological function were assessed using Frankel classification. Patients in group A were treated with anterior operation, whereas group B was posterior operation. Postoperatively, VAS score, kyphotic Cobb angle, anterior vertebra height, and pathologic vertebra wedge angle were all significantly improved in patients with Kümmell's disease receiving modified posterior operation (group B). Similar results were also observed in patients with anterior operation. The improvement of VAS and correction rate of kyphotic Cobb angle indicated equivalent effects of posterior and anterior operations. Meanwhile, alleviated neurological function damage was observed in 2 groups. Relevant factor analysis illustrated that there was no significant correlation of the severity and improvement rate of pain symptoms with age, medical history, anterior and posterior vertebra heights, kyphotic Cobb angle, and pathological vertebra wedge angle. Compared with traditional anterior approach, modified posterior operation, adopting transpedicular vertebral body grafting combined with vertebral pedicle screw fixation, could produce equivalent effects on kyphosis correction, pain relief, and improvement of neurological function in patients with Kümmell's disease. PMID:26426639

  2. Two-directional two-dimensional modified Fisher principal component analysis: an efficient approach for thermal face verification

    NASA Astrophysics Data System (ADS)

    Wang, Ning; Li, Qiong; El-Latif, Ahmed A. Abd; Peng, Jialiang; Niu, Xiamu

    2013-04-01

    In recent years, verification based on thermal face images has been extensively studied because of its invariance to illumination and immunity to forgery. However, most of them have not given full consideration to high-verification performance and singular within-class scatter matrix problems. We propose a novel thermal face verification algorithm, which is named two-directional two-dimensional modified Fisher principal component analysis. First, two-dimensional principal component analysis (2-DPCA) is utilized to extract the optimal projective vector in the row direction. Then, 2-D modified Fisher linear discriminant analysis is implemented to overcome the singular within-class scatter matrix problem of the 2-DPCA space in the column direction. Comparative experiments on the natural visible and infrared facial expression thermal face subdatabase demonstrate that the proposed approach outperforms state-of-the-art methods in terms of verification performance.

  3. Congenital anterior urethral diverticulum.

    PubMed

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  4. Employing a Modified Positive Peer Culture Treatment Approach in a State Youth Center.

    ERIC Educational Resources Information Center

    Tannehill, Ronald L.

    1987-01-01

    Presents concepts and philosophies of positive peer culture (PPC) treatment approach and describes implementation of PPC approach in state youth center. Notes PPC can be effective behavior management tool. Considers PPC not easy to implement and develop, yet sees implementation as worthwhile for both students and staff. (NB)

  5. Approaches to Modifying the Behavior of Clinicians Who Are Noncompliant With Antimicrobial Stewardship Program Guidelines.

    PubMed

    Goldstein, Ellie J C; Goff, Debra A; Reeve, William; Naumovski, Snezana; Epson, Erin; Zenilman, Jonathan; Kaye, Keith S; File, Thomas M

    2016-08-15

    Antimicrobial stewardship programs (ASPs) are a key national initiative to promote appropriate use of antibiotics and to reduce the burden of resistance. The dilemma of managing the outlier physician is especially complex. We outline strategies to establish a successful ASP that reviews appropriate efforts to achieve the goal of modifying outlier physicians' behavior. One must try to differentiate deviation from ASP norms from all other issues of outliers. Essential elements include identifying and understanding the local problems, planning, and achieving hospital administration and medical staff support. A successful ASP includes effective communication and acceptance of evidence-based recommendations, so that patient clinical outcomes will be optimized. PMID:27098167

  6. [Toxic anterior segment syndrome].

    PubMed

    Cornut, P-L; Chiquet, C

    2011-01-01

    Toxic anterior segment syndrome (TASS) is a general term used to describe acute, sterile postoperative inflammation due to a non-infectious substance that accidentally enters the anterior segment at the time of surgery and mimics infectious endophthalmitis. TASS most commonly occurs acutely following anterior segment surgery, typically 12-72h after cataract extraction. Anterior segment inflammation is usually quite severe with hypopyon. Endothelial cell damage is common, resulting in diffuse corneal edema. No bacterium is isolated from ocular samples. The causes of TASS are numerous and difficult to isolate. Any device or substance used during the surgery or in the immediate postoperative period may be implicated. The major known causes include: preservatives in ophthalmic solutions, denatured ophthalmic viscosurgical devices, bacterial endotoxin, and intraocular lens-induced inflammation. Clinical features of infectious and non-infectious inflammation are initially indistinguishable and TASS is usually diagnosed and treated as acute endophthalmitis. It usually improves with local steroid treatment but may result in chronic elevation of intraocular pressure or irreversible corneal edema due to permanent damage of trabecular meshwork or endothelial cells. PMID:21176994

  7. A soft computing based approach using modified selection strategy for feature reduction of medical systems.

    PubMed

    Zuhtuogullari, Kursat; Allahverdi, Novruz; Arikan, Nihat

    2013-01-01

    The systems consisting high input spaces require high processing times and memory usage. Most of the attribute selection algorithms have the problems of input dimensions limits and information storage problems. These problems are eliminated by means of developed feature reduction software using new modified selection mechanism with middle region solution candidates adding. The hybrid system software is constructed for reducing the input attributes of the systems with large number of input variables. The designed software also supports the roulette wheel selection mechanism. Linear order crossover is used as the recombination operator. In the genetic algorithm based soft computing methods, locking to the local solutions is also a problem which is eliminated by using developed software. Faster and effective results are obtained in the test procedures. Twelve input variables of the urological system have been reduced to the reducts (reduced input attributes) with seven, six, and five elements. It can be seen from the obtained results that the developed software with modified selection has the advantages in the fields of memory allocation, execution time, classification accuracy, sensitivity, and specificity values when compared with the other reduction algorithms by using the urological test data. PMID:23573172

  8. Evaluating Potential Response-Modifying Factors for Associations between Ozone and Health Outcomes: A Weight-of-Evidence Approach

    PubMed Central

    Owens, Elizabeth O.; Nichols, Jennifer L.; Ross, Mary; Brown, James S.; Sacks, Jason D.

    2014-01-01

    Background: Epidemiologic and experimental studies have reported a variety of health effects in response to ozone (O3) exposure, and some have indicated that certain populations may be at increased or decreased risk of O3-related health effects. Objectives: We sought to identify potential response-modifying factors to determine whether specific groups of the population or life stages are at increased or decreased risk of O3-related health effects using a weight-of-evidence approach. Methods: Epidemiologic, experimental, and exposure science studies of potential factors that may modify the relationship between O3 and health effects were identified in U.S. Environmental Protection Agency’s 2013 Integrated Science Assessment for Ozone and Related Photochemical Oxidants. Scientific evidence from studies that examined factors that may influence risk were integrated across disciplines to evaluate consistency, coherence, and biological plausibility of effects. The factors identified were then classified using a weight-of-evidence approach to conclude whether a specific factor modified the response of a population or life stage, resulting in an increased or decreased risk of O3-related health effects. Discussion: We found “adequate” evidence that populations with certain genotypes, preexisting asthma, or reduced intake of certain nutrients, as well as different life stages or outdoor workers, are at increased risk of O3-related health effects. In addition, we identified other factors (i.e., sex, socioeconomic status, and obesity) for which there was “suggestive” evidence that they may increase the risk of O3-related health effects. Conclusions: Using a weight-of-evidence approach, we identified a diverse group of factors that should be considered when characterizing the overall risk of health effects associated with exposures to ambient O3. Citation: Vinikoor-Imler LC, Owens EO, Nichols JL, Ross M, Brown JS, Sacks JD. 2014. Evaluating potential response-modifying

  9. Bedside placement of a retrievable inferior vena cava filter in a morbidly obese patient guided by modified IVUS approach.

    PubMed

    Patel, Nishit; Saucedo, Jorge

    2012-12-01

    Deep vein thrombosis and pulmonary embolism are major causes of morbidity and mortality in trauma patients. Anticoagulation therapy is often contraindicated in these patient populations. The retrievable inferior vena cava (IVC) filter provides a good option for preventing pulmonary embolism in the immediate injury and postoperative periods. Bedside IVC filter placement by guidance of intravascular ultrasound eliminates the risk of transportation; it is safe, efficient, and cost effective. We hereby present a case of bedside IVC filter placement in a morbidly obese patient with modified intravascular ultrasound approach. PMID:23220991

  10. A modified cryo-maze procedure via the superior transseptal approach.

    PubMed

    Higuchi, Kazuhiko

    2015-01-01

    The superior transseptal approach provides excellent exposure for mitral valve reconstruction. For atrial fibrillation, cryoablation is less invasive, simpler, and safer than the Cox maze operation. Combining the superior transseptal approach and cryoablation for mitral valve procedures yields a high recovery rate from atrial fibrillation, similar to that of radiofrequency ablation. Cryoablation-related complications such as thromboembolic events or requirement for a permanent pacemaker were not observed in our consecutive series. Cryoablation is also cost-effective. PMID:24585282

  11. A combined approach for the enhancement and segmentation of mammograms using modified fuzzy C-means method in wavelet domain.

    PubMed

    Srivastava, Subodh; Sharma, Neeraj; Singh, S K; Srivastava, R

    2014-07-01

    In this paper, a combined approach for enhancement and segmentation of mammograms is proposed. In preprocessing stage, a contrast limited adaptive histogram equalization (CLAHE) method is applied to obtain the better contrast mammograms. After this, the proposed combined methods are applied. In the first step of the proposed approach, a two dimensional (2D) discrete wavelet transform (DWT) is applied to all the input images. In the second step, a proposed nonlinear complex diffusion based unsharp masking and crispening method is applied on the approximation coefficients of the wavelet transformed images to further highlight the abnormalities such as micro-calcifications, tumours, etc., to reduce the false positives (FPs). Thirdly, a modified fuzzy c-means (FCM) segmentation method is applied on the output of the second step. In the modified FCM method, the mutual information is proposed as a similarity measure in place of conventional Euclidian distance based dissimilarity measure for FCM segmentation. Finally, the inverse 2D-DWT is applied. The efficacy of the proposed unsharp masking and crispening method for image enhancement is evaluated in terms of signal-to-noise ratio (SNR) and that of the proposed segmentation method is evaluated in terms of random index (RI), global consistency error (GCE), and variation of information (VoI). The performance of the proposed segmentation approach is compared with the other commonly used segmentation approaches such as Otsu's thresholding, texture based, k-means, and FCM clustering as well as thresholding. From the obtained results, it is observed that the proposed segmentation approach performs better and takes lesser processing time in comparison to the standard FCM and other segmentation methods in consideration. PMID:25190996

  12. A novel approach to delayed-start analyses for demonstrating disease-modifying effects in Alzheimer's disease.

    PubMed

    Liu-Seifert, Hong; Andersen, Scott W; Lipkovich, Ilya; Holdridge, Karen C; Siemers, Eric

    2015-01-01

    One method for demonstrating disease modification is a delayed-start design, consisting of a placebo-controlled period followed by a delayed-start period wherein all patients receive active treatment. To address methodological issues in previous delayed-start approaches, we propose a new method that is robust across conditions of drug effect, discontinuation rates, and missing data mechanisms. We propose a modeling approach and test procedure to test the hypothesis of noninferiority, comparing the treatment difference at the end of the delayed-start period with that at the end of the placebo-controlled period. We conducted simulations to identify the optimal noninferiority testing procedure to ensure the method was robust across scenarios and assumptions, and to evaluate the appropriate modeling approach for analyzing the delayed-start period. We then applied this methodology to Phase 3 solanezumab clinical trial data for mild Alzheimer's disease patients. Simulation results showed a testing procedure using a proportional noninferiority margin was robust for detecting disease-modifying effects; conditions of high and moderate discontinuations; and with various missing data mechanisms. Using all data from all randomized patients in a single model over both the placebo-controlled and delayed-start study periods demonstrated good statistical performance. In analysis of solanezumab data using this methodology, the noninferiority criterion was met, indicating the treatment difference at the end of the placebo-controlled studies was preserved at the end of the delayed-start period within a pre-defined margin. The proposed noninferiority method for delayed-start analysis controls Type I error rate well and addresses many challenges posed by previous approaches. Delayed-start studies employing the proposed analysis approach could be used to provide evidence of a disease-modifying effect. This method has been communicated with FDA and has been successfully applied to actual

  13. A Novel Approach to Delayed-Start Analyses for Demonstrating Disease-Modifying Effects in Alzheimer’s Disease

    PubMed Central

    Liu-Seifert, Hong; Andersen, Scott W.; Lipkovich, Ilya; Holdridge, Karen C.; Siemers, Eric

    2015-01-01

    One method for demonstrating disease modification is a delayed-start design, consisting of a placebo-controlled period followed by a delayed-start period wherein all patients receive active treatment. To address methodological issues in previous delayed-start approaches, we propose a new method that is robust across conditions of drug effect, discontinuation rates, and missing data mechanisms. We propose a modeling approach and test procedure to test the hypothesis of noninferiority, comparing the treatment difference at the end of the delayed-start period with that at the end of the placebo-controlled period. We conducted simulations to identify the optimal noninferiority testing procedure to ensure the method was robust across scenarios and assumptions, and to evaluate the appropriate modeling approach for analyzing the delayed-start period. We then applied this methodology to Phase 3 solanezumab clinical trial data for mild Alzheimer’s disease patients. Simulation results showed a testing procedure using a proportional noninferiority margin was robust for detecting disease-modifying effects; conditions of high and moderate discontinuations; and with various missing data mechanisms. Using all data from all randomized patients in a single model over both the placebo-controlled and delayed-start study periods demonstrated good statistical performance. In analysis of solanezumab data using this methodology, the noninferiority criterion was met, indicating the treatment difference at the end of the placebo-controlled studies was preserved at the end of the delayed-start period within a pre-defined margin. The proposed noninferiority method for delayed-start analysis controls Type I error rate well and addresses many challenges posed by previous approaches. Delayed-start studies employing the proposed analysis approach could be used to provide evidence of a disease-modifying effect. This method has been communicated with FDA and has been successfully applied to

  14. Microanatomy of the perforators of the anterior communicating artery complex.

    PubMed

    Camuscu, H; Dujovny, M; Abd el-Bary, T; Beristain, X; Viñas, F C

    1997-12-01

    We describe the microanatomy of the perforating arteries arising from the anterior communicating artery complex (5 mm distal of the anterior cerebral artery, the anterior communicating artery, and 5 mm proximal of the distal anterior cerebral artery). Thirteen unfixed human brains were used in this study. The origin and number of perforators are described, as is the site of brain penetration, and results are correlated with previous studies. The hemodynamics of blood flow in relation to the formation of an anterior communicating artery aneurysm and different surgical approaches are mentioned. The neuropsychological outcome after aneurysm clipping with regards to the pattern of blood supply from the anterior cerebral artery complex is also discussed. PMID:9427956

  15. Modified lip repositioning: A surgical approach to treat the gummy smile.

    PubMed

    Rao, Aditya Gopinath; Koganti, Vijay Prasad; Prabhakar, Ashok Kodangala; Soni, Sweta

    2015-01-01

    Gummy smile has been an esthetic concern for many patients. This clinical report describes a successful surgical coverage obtained by modified lip repositioning, thus surgically treating the gummy smile. The technique was performed to limit the retraction of elevator muscles (e.g., zygomaticus minor, orbicularis oris, leviator anguli oris and levator labi oris.) The technique is fulfilled by removing two strips of mucosa from maxillary buccal vestibule on both the sides leaving the frenum untouched and creating a partial thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display. This technique is different from the conventional surgical lip repositioning as labial frenum is left untouched over here as it helps in maintain Litton the midline for lip repositioning and reduces the morbidity associated with it. PMID:26229285

  16. Modified Wilson’s Osteotomy for Hallux Valgus Deformity. A New Approach

    PubMed Central

    Xarchas, Konstantinos C; Mavrolias, Dimitrios; Kyriakopoulos, Georgios

    2014-01-01

    We introduce a new set of modifications and present the results from 48 patients (a total of 60 feet operated), who underwent this modified Wilson’s osteotomy for the correction of Hallux Valgus. Patients were of an average age of 52 years old (from 21 to 75 years of age) and were followed up for a mean of 12 months post-operatively. Patient evaluation was made with the symptom scoring system as presented by Kataraglis et al., with the final outcome being satisfactory in all of the cases. This set of modifications introduced to the original Wilson’s osteotomy, proved to offer a stable, predictable and satisfactory outcome in all cases and we strongly recommend it. PMID:25352929

  17. An empirical analysis of online gamers' perceptions of game items: modified theory of consumption values approach.

    PubMed

    Park, Bong-Won; Lee, Kun Chang

    2011-01-01

    The aims of this article are (1) to propose a modified theory of consumption values (MTCV) for investigation of online gamer perceptions of the value of purchasable game items and (2) to apply the developed MTCV to multiple game genres and player age groups. To address these aims, 327 valid questionnaires were obtained and analyzed. The original theory of consumption values (TCV) was modified to apply to the specific characteristics of online games. The original TCV specifies five types of consumption values: functional value, social value, emotional value, conditional value, and epistemic value. After revising the TCV to apply to the examination of online games, we proposed that the MTCV be composed of character competency value, enjoyment value, visual authority value, and monetary value. The validity of the MTCV was proven by statistically analyzing the responses provided by the 327 valid questionnaires. To examine the second aim, experiments were conducted to examine the MTCV in three online game genres-massive multiplayer online role-playing games, first-person shooters games, and casual games. The second aim was also studied via questionnaires that examined the ages of online gamers. It was determined that massive multiplayer online role-playing games players regard visual authority value and monetary value as more important than do casual gamers. It was also determined that younger gamers tend to be more interested in visual authority, whereas older gamers tend to be more interested in character competency. This research provides a foundation for future studies to extend the MTCV to consider other user factors, such as cultural effects. PMID:21288134

  18. Modeling resilience to schizophrenia in genetically modified mice: a novel approach to drug discovery

    PubMed Central

    Mihali, Andra; Subramani, Shreya; Kaunitz, Genevieve; Rayport, Stephen; Gaisler-Salomon, Inna

    2012-01-01

    Complex psychiatric disorders, such as schizophrenia, arise from a combination of genetic, developmental, environmental and social factors. These vulnerabilities can be mitigated by adaptive factors in each of these domains engendering resilience. Modeling resilience in mice using transgenic approaches offers a direct path to intervention, as resilience mutations point directly to therapeutic targets. As prototypes for this approach, we discuss the three mouse models of schizophrenia resilience, all based on modulating glutamatergic synaptic transmission. This motivates the broader development of schizophrenia resilience mouse models independent of specific pathophysiological hypotheses as a strategy for drug discovery. Three guiding validation criteria are presented. A resilience-oriented approach should identify pharmacologically tractable targets and in turn offer new insights into pathophysiological mechanisms. PMID:22853787

  19. Novel therapeutic approaches for various cancer types using a modified sleeping beauty-based gene delivery system.

    PubMed

    Hong, In-Sun; Lee, Hwa-Yong; Kim, Hyun-Pyo

    2014-01-01

    Successful gene therapy largely depends on the selective introduction of therapeutic genes into the appropriate target cancer cells. One of the most effective and promising approaches for targeting tumor tissue during gene delivery is the use of viral vectors, which allow for high efficiency gene delivery. However, the use of viral vectors is not without risks and safety concerns, such as toxicities, a host immune response towards the viral antigens or potential viral recombination into the host's chromosome; these risks limit the clinical application of viral vectors. The Sleeping Beauty (SB) transposon-based system is an attractive, non-viral alternative to viral delivery systems. SB may be less immunogenic than the viral vector system due to its lack of viral sequences. The SB-based gene delivery system can stably integrate into the host cell genome to produce the therapeutic gene product over the lifetime of a cell. However, when compared to viral vectors, the non-viral SB-based gene delivery system still has limited therapeutic efficacy due to the lack of long-lasting gene expression potential and tumor cell specific gene transfer ability. These limitations could be overcome by modifying the SB system through the introduction of the hTERT promoter and the SV40 enhancer. In this study, a modified SB delivery system, under control of the hTERT promoter in conjunction with the SV40 enhancer, was able to successfully transfer the suicide gene (HSV-TK) into multiple types of cancer cells. The modified SB transfected cancer cells exhibited a significantly increased cancer cell specific death rate. These data suggest that our modified SB-based gene delivery system can be used as a safe and efficient tool for cancer cell specific therapeutic gene transfer and stable long-term expression. PMID:24466025

  20. Novel Therapeutic Approaches for Various Cancer Types Using a Modified Sleeping Beauty-Based Gene Delivery System

    PubMed Central

    Kim, Hyun-Pyo

    2014-01-01

    Successful gene therapy largely depends on the selective introduction of therapeutic genes into the appropriate target cancer cells. One of the most effective and promising approaches for targeting tumor tissue during gene delivery is the use of viral vectors, which allow for high efficiency gene delivery. However, the use of viral vectors is not without risks and safety concerns, such as toxicities, a host immune response towards the viral antigens or potential viral recombination into the host's chromosome; these risks limit the clinical application of viral vectors. The Sleeping Beauty (SB) transposon-based system is an attractive, non-viral alternative to viral delivery systems. SB may be less immunogenic than the viral vector system due to its lack of viral sequences. The SB-based gene delivery system can stably integrate into the host cell genome to produce the therapeutic gene product over the lifetime of a cell. However, when compared to viral vectors, the non-viral SB-based gene delivery system still has limited therapeutic efficacy due to the lack of long-lasting gene expression potential and tumor cell specific gene transfer ability. These limitations could be overcome by modifying the SB system through the introduction of the hTERT promoter and the SV40 enhancer. In this study, a modified SB delivery system, under control of the hTERT promoter in conjunction with the SV40 enhancer, was able to successfully transfer the suicide gene (HSV-TK) into multiple types of cancer cells. The modified SB transfected cancer cells exhibited a significantly increased cancer cell specific death rate. These data suggest that our modified SB-based gene delivery system can be used as a safe and efficient tool for cancer cell specific therapeutic gene transfer and stable long-term expression. PMID:24466025

  1. Optical tracking of organically modified silica nanoparticles as DNA carriers: A nonviral, nanomedicine approach for gene delivery

    NASA Astrophysics Data System (ADS)

    Roy, Indrajit; Ohulchanskyy, Tymish Y.; Bharali, Dhruba J.; Pudavar, Haridas E.; Mistretta, Ruth A.; Kaur, Navjot; Prasad, Paras N.

    2005-01-01

    This article reports a multidisciplinary approach to produce fluorescently labeled organically modified silica nanoparticles as a nonviral vector for gene delivery and biophotonics methods to optically monitor intracellular trafficking and gene transfection. Highly monodispersed, stable aqueous suspensions of organically modified silica nanoparticles, encapsulating fluorescent dyes and surface functionalized by cationic-amino groups, are produced by micellar nanochemistry. Gel-electrophoresis studies reveal that the particles efficiently complex with DNA and protect it from enzymatic digestion of DNase 1. The electrostatic binding of DNA onto the surface of the nanoparticles, due to positively charged amino groups, is also shown by intercalating an appropriate dye into the DNA and observing the Förster (fluorescence) resonance energy transfer between the dye (energy donor) intercalated in DNA on the surface of nanoparticles and a second dye (energy acceptor) inside the nanoparticles. Imaging by fluorescence confocal microscopy shows that cells efficiently take up the nanoparticles in vitro in the cytoplasm, and the nanoparticles deliver DNA to the nucleus. The use of plasmid encoding enhanced GFP allowed us to demonstrate the process of gene transfection in cultured cells. Our work shows that the nanomedicine approach, with nanoparticles acting as a drug-delivery platform combining multiple optical and other types of probes, provides a promising direction for targeted therapy with enhanced efficacy as well as for real-time monitoring of drug action. nonviral vector | ORMOSIL nanoparticles | confocal microscopy

  2. Percutaneous CT-Guided Biopsy of C3 Vertebral Body: Modified Approach for an Old Procedure

    SciTech Connect

    Pua, Uei; Chan, Stephen Yung-Wei

    2013-06-15

    Percutaneous biopsy of upper cervical vertebrae is challenging due to the various critical structures in the location and often requires difficult trajectory such as transoral or paramaxillary approaches. The purpose of this manuscript is to illustrate the utility of head rotation in creating a potential space for direct percutaneous access to C3 vertebral body for safe biopsy.

  3. Cysteine-modifying agents: a possible approach for effective anticancer and antiviral drugs.

    PubMed Central

    Casini, Angela; Scozzafava, Andrea; Supuran, Claudiu T

    2002-01-01

    Modification of cysteine residues in proteins, due to a) the participation of the thiol moiety of this amino acid in oxido-reduction reactions, b) its ability to strongly coordinate transition metal ions, or c) its nucleophilic nature and facile reaction with electrophiles, may be critically important for the design of novel types of pharmacological agents. Application of such procedures recently led to the design of novel antivirals, mainly based on the reaction of zinc finger proteins with disulfides and related derivatives. This approach was particularly successful for developing novel antiviral agents for human immunodeficiency virus and human papilloma virus. Several new anticancer therapeutic approaches, mainly targeting tubulin, have also been reported. Thus, this unique amino acid offers very interesting possibilities for developing particularly useful pharmacological agents, which generally possess a completely different mechanism of action compared with classic agents in clinical use, thus avoiding major problems such as multidrug resistance (for antiviral and anticancer agents) or high toxicity. PMID:12426135

  4. A modified technique for real time ultrasound guided pediatric percutaneous renal biopsy: the angled tangential approach

    PubMed Central

    Caliskan, Kosti Can; Turkoglu, Ozlem Kolcak; Cakmakci, Selma; Ozcelik, Gul; Yilmaz, Engin; Turk, Sebnem; Ozagari, Aysim; Ucan, Berna

    2014-01-01

    Aim Pediatric renal biopsy may result in serious hemorrhagic complications, requiring additional diagnostic procedures, blood transfusion, vascular interventions, and prolongation of hospitalization. The aim of the present study was to propose the angled tangential approach technique for real-time ultrasound-guided pediatric percutaneous renal biopsy. Methods A retrospective analysis of 166 percutaneous biopsies from June 2004 to May 2009 was performed. Patients’ medical records, pathology results, and complications were reviewed. Results No major complications were seen in the study group. The most frequently occurring minor complication was macroscopic hematuria, which occurred at the rate of 9.6%. Hematoma was detected in three cases and regressed spontaneously in all cases. Conclusions The angled tangential approach is a safe technique and an alternative option in pediatric percutaneous renal biopsies. PMID:24914420

  5. A novel approach to assess the population health impact of introducing a Modified Risk Tobacco Product.

    PubMed

    Weitkunat, Rolf; Lee, Peter N; Baker, Gizelle; Sponsiello-Wang, Zheng; González-Zuloeta Ladd, Angela M; Lüdicke, Frank

    2015-06-01

    Based on the Food and Drug Administration's Modified Risk Tobacco Product (MRTP) Application draft guideline, Philip Morris International (PMI) has developed a Population Health Impact Model to estimate the reduction in the number of deaths over a period following the introduction of an MRTP. Such a model is necessary to assess the effect that its introduction would have on population health, given the lack of epidemiological data available prior to marketing authorization on any risks from MRTPs. The model is based on publicly available data on smoking prevalence and on the relationships between smoking-related disease-specific mortality and various aspects of the smoking of conventional cigarettes (CCs), together with an estimate of exposure from the MRTP relative to that from CCs, and allows the exploration of possible scenarios regarding the effect of MRTP introduction on the prevalence of CC and MRTP use, individually and in combination. By comparing mortality attributable in a scenario where the MRTP is introduced with one where it is not, the model can estimate the mortality attributable to CCs and the MRTP, as well as the reduction in the deaths attributable to the introduction of the MRTP. PMID:25819932

  6. Early fibrillin-1 assembly monitored through a modifiable recombinant cell approach

    PubMed Central

    Hubmacher, Dirk; Bergeron, Eric; Fagotto-Kaufmann, Christine; Sakai, Lynn Y.; Reinhardt, Dieter P.

    2016-01-01

    Fibrillin proteins constitute the backbone of extracellular macromolecular microfibrils. Mutations in fibrillins cause heritable connective tissue disorders, including Marfan syndrome, dominant Weill-Marchesani syndrome, and stiff skin syndrome. Fibronectin provides a critical scaffold for microfibril assembly in cell culture models. Full length recombinant fibrillin-1 was expressed by HEK 293 cells, which deposited the secreted protein in a punctate pattern on the cell surface. Co-cultured fibroblasts consistently triggered assembly of recombinant fibrillin-1, which was dependent on a fibronectin network formed by the fibroblasts. Deposition of recombinant fibrillin-1 on fibronectin fibers occurred first in discrete packages that subsequently extended along fibronectin fibers. Mutant fibrillin-1 harboring either a cysteine 204 to serine mutation or a RGD to RGA mutation which prevents integrin binding, did not affect fibrillin-1 assembly. In conclusion, we developed a modifiable recombinant full-length fibrillin-1 assembly system that allows for rapid analysis of critical roles in fibrillin assembly and functionality. This system can be used to study the contributions of specific residues, domains or regions of fibrillin-1 to the biogenesis and functionality of microfibrils. It provides also a method to evaluate disease-causing mutations, and to produce microfibril-containing matrices for tissue engineering applications for example in designing novel vascular grafts or stents. PMID:24559401

  7. Effects of modified pharmacologic stress approaches on hyperemic myocardial blood flow

    SciTech Connect

    Czernin, J.; Auerbach, M.; Sun, K.T.

    1995-04-01

    Pharmacologic stress testing with 0.56 mg/kg of intravenous dipyridamole is frequently used to noninvasively detect coronary artery disease (CAD). However, high-dose dipyridamole (0.80 mg/kg) or the combination of standard-dose dipyridamole (0.56 mg/kg) with the isometric handgrip maneuver might evoke a greater coronary hyperemic response. To evaluate the effect of modified pharmacologic stress tests, myocardial blood flow was quantified in 11 male subjects (mean age: 27 {plus_minus} 7 yr) during standard-dose dipyridamole (0.56 mg/kg), high-dose dipyridamole (0.80 mg/kg) and standard-dose dipyridamole combined with the isometric handgrip exercise using dynamic PET and a two-compartment model for {sup 13}N-ammonia. Systolic blood pressure, heart rate and rate pressure product remained unchanged from standard to high-dose dipyridamole but increased with the addition of the isometric handgrip. Myocardial blood flow was unchanged from standard to high-dose dipyridamole but was lower with the addition of the isometric handgrip. The hyperemic response induced by standard-dose dipyridamole cannot be further enhanced by high-dose dipyridamole. The addition of the isometric handgrip exercise results in a modest, but significant decline in hyperemic blood flow possibly due to increased extravascular resistive forces or an increase in a mediated coronary vasoconstriction associated with exercise. 31 refs., 2 figs., 1 tab.

  8. Anterior mandibular ameloblastoma

    PubMed Central

    Bhandarwar, Ajay H.; Bakhshi, Girish D.; Borisa, Ashok D.; Wagh, Amol; Kapoor, Rajat; Kori, Channabasappa G.

    2012-01-01

    Ameloblastoma is a benign odontogenic tumor. These are usually asymptomatic until a large size is attained. Ameloblastoma has tendency to spread locally and has a high recurrence rate. Majority of ameloblastomas (80%) arise from the mandible. Ameloblastoma arising from anterior mandibular region (symphysis-menti) is rare. Very few cases of midline anterior ameloblastomas are reported in the literature. They often require wide local excision. Reconstruction of mandible in these cases is challenging. We present a case of mandibular ameloblastoma arising from symphysis-menti. Patient underwent wide surgical excision of the tumor followed by immediate reconstruction using free fibular vascular flap, stabilized with titanium reconstructive plates. A brief case report ands review of literature is presented. PMID:24765429

  9. Anterior urethral stricture review

    PubMed Central

    Stein, Marshall J.

    2013-01-01

    Male anterior urethral stricture disease is a commonly encountered condition that presents to many urologists. According to a National Practice Survey of Board Certified Urologist in the United States most urologists treat on average 6-20 urethral strictures yearly. Many of those same urologists surveyed treat with repeated dilation or internal urethrotomy, despite continual recurrence of the urethral stricture. In point of fact, the urethroplasty despite its high success rate, is underutilized by many practicing urologists. Roughly half of practicing urologist do not perform urethroplasty in the United States. Clearly, the reconstructive ladder for urethral stricture management that was previously described in the literature may no longer apply in the modern era. The following article reviews the etiology, diagnosis, management and comparisons of treatment options for anterior urethral strictures. PMID:26816721

  10. New approaches for tracking earth orbiters using modified GPS ground receivers

    NASA Technical Reports Server (NTRS)

    Lichten, S. M.; Young, L. E.; Nandi, S.; Haines, B. J.; Dunn, C. E.; Edwards, C. D.

    1993-01-01

    A Global Positioning System (GPS) flight receiver provides a means to precisely determine orbits for satellites in low to moderate altitude orbits. Above a 5000-km altitude, however, relatively few GPS satellites are visible. New approaches to orbit determination for satellites at higher altitudes could reduce DSN antenna time needed to provide navigation and orbit determination support to future missions. Modification of GPS ground receivers enables a beacon from the orbiter to be tracked simultaneously with GPS data. The orbit accuracy expected from this GPS-like tracking (GLT) technique is expected to be in the range of a few meters or better for altitudes up to 100,000 km with a global ground network. For geosynchronous satellites, however, there are unique challenges due to geometrical limitations and to the lack of strong dynamical signature in tracking data. We examine two approaches for tracking the Tracking and Data Relay Satellite System (TDRSS) geostationary orbiters. One uses GLT with a global network; the other relies on a small 'connected element' ground network with a distributed clock for short-baseline differential carrier phase (SB Delta Phi). We describe an experiment planned for late 1993, which will combine aspects of both GLT and SB Delta Phi, to demonstrate a new approach for tracking the Tracking and Data Relay Satellites (TDRSs) that offers a number of operationally convenient and attractive features. The TDRS demonstration will be in effect a proof-of-concept experiment for a new approach to tracking spacecraft which could be applied more generally to deep-space as well as near-Earth regimes.

  11. Surgical Excision of Carotid Body Tumor Through Modified Approach-A Case Report.

    PubMed

    Prabakaran, Sureshkannan; Subburayulu, Anand Shankar; Ravikumar, P T

    2016-06-01

    Paragangliomas arising from the carotid body in the carotid bifurcation are termed as carotid body tumors. They are usually slow growing and asymptomatic. Considering the anatomical location, invasion or pressure on the adjacent vascular and neural tissues, the importance of early diagnosis and management is critical. In this article a case of carotid body tumor excised through transverse neck skin crease incision is presented along with literature review on the diagnosis, grading and different surgical approaches. PMID:27298550

  12. Comparison Between Posterior Short-segment Instrumentation Combined With Lateral-approach Interbody Fusion and Traditional Wide-open Anterior-Posterior Surgery for the Treatment of Thoracolumbar Fractures

    PubMed Central

    Li, Xiang; Zhang, Junwei; Tang, Hehu; Lu, Zhen; Liu, Shujia; Chen, Shizheng; Hong, Yi

    2015-01-01

    Abstract The aim of the study was to compare the radiographic and clinical outcomes between posterior short-segment pedicle instrumentation combined with lateral-approach interbody fusion and traditional anterior-posterior (AP) surgery for the treatment of thoracolumbar fractures. Lateral-approach interbody fusion has achieved satisfactory results for thoracic and lumbar degenerative disease. However, few studies have focused on the use of this technique for the treatment of thoracolumbar fractures. Inclusion and exclusion criteria were established. All patients who meet the above criteria were prospectively treated by posterior short-segment instrumentation and secondary-staged minimally invasive lateral-approach interbody fusion, and classified as group A. A historical group of patients who were treated by traditional wide-open AP approach was used as a control group and classified as group B. The radiological and clinical outcomes were compared between the 2 groups. There were 12 patients in group A and 18 patients in group B. The mean operative time and intraoperative blood loss of anterior reconstruction were significantly higher in group B than those in group A (127.1 ± 21.7 vs 197.5 ± 47.7 min, P < 0.01; 185.8 ± 62.3 vs 495 ± 347.4 mL, P < 0.01). Two of the 12 (16.7%) patients in group A experienced 2 surgical complications: 1 (8.3%) major and 1 (8.3%) minor. Six of the 18 (33%) patients in group B experienced 9 surgical complications: 3 (16.7%) major and 6 (33.3%) minor. There was no significant difference between the 2 groups regarding loss of correction (4.3 ± 2.1 vs 4.2 ± 2.4, P = 0.89) and neurological function at final follow-up (P = 0.77). In both groups, no case of instrumentation failure, pseudarthrosis, or nonunion was noted. Compared with the wide-open AP surgery, posterior short-segment pedicle instrumentation, combined with minimally invasive lateral-approach interbody fusion, can achieve similar

  13. Development of sampling approaches for the determination of the presence of genetically modified organisms at the field level.

    PubMed

    Sustar-Vozlic, Jelka; Rostohar, Katja; Blejec, Andrej; Kozjak, Petra; Cergan, Zoran; Meglic, Vladimir

    2010-03-01

    In order to comply with the European Union regulatory threshold for the adventitious presence of genetically modified organisms (GMOs) in food and feed, it is important to trace GMOs from the field. Appropriate sampling methods are needed to accurately predict the presence of GMOs at the field level. A 2-year field experiment with two maize varieties differing in kernel colour was conducted in Slovenia. Based on the results of data mining analyses and modelling, it was concluded that spatial relations between the donor and receptor field were the most important factors influencing the distribution of outcrossing rate (OCR) in the field. The approach for estimation fitting function parameters in the receptor (non-GM) field at two distances from the donor (GM) field (10 and 25 m) for estimation of the OCR (GMO content) in the whole receptor field was developed. Different sampling schemes were tested; a systematic random scheme in rows was proposed to be applied for sampling at the two distances for the estimation of fitting function parameters for determination of OCR. The sampling approach had already been validated with some other OCR data and was practically applied in the 2009 harvest in Poland. The developed approach can be used for determination of the GMO presence at the field level and for making appropriate labelling decisions. The importance of this approach lies in its possibility to also address other threshold levels beside the currently prescribed labelling threshold of 0.9% for food and feed. PMID:20069281

  14. Anterior perineal sinus.

    PubMed

    Oliver, G C; Rubin, R J; Salvati, E P; Eisenstat, T E; Lott, J

    1991-09-01

    Each year we treat several patients with an anterior perineal sinus tract. They do not conform to commonly encountered perineal problems such as pilonidal disease, epidermal cysts, hidradenitis, fistulous abscess, or inflammatory bowel disease. In an effort to improve understanding of the problem and its clinical significance, we reviewed our practice records for the period from 1968 through 1988. Fifty-six patients underwent surgery for an anterior perineal sinus tract. In 31 patients, the clinical and pathologic condition defied classical diagnostic categorization. We have termed these lesions "anterior perineal sinuses." Their clinical characteristics, treatment, and pathologic assessment from the body of this report. Male predominance (87 percent) and midlife presentation (average age, 44 years) characterized this group. Local symptoms were present from several weeks to several years prior to treatment. Local anesthesia (74 percent) and limited surgery (100 percent) resulted in complete healing in all patients (average, 7 weeks). A 15 percent recurrence rate was noted. The pathologic evaluation demonstrated acute and chronic dermal and subcutaneous inflammation. The etiology of this process remains uncertain. Its predominance along the median raphe suggests a congenital midline inclusion disorder. PMID:1914743

  15. Monthly gravity field models derived from GRACE Level 1B data using a modified short-arc approach

    NASA Astrophysics Data System (ADS)

    Chen, Qiujie; Shen, Yunzhong; Zhang, Xingfu; Hsu, Houze; Chen, Wu; Ju, Xiaolei; Lou, Lizhi

    2015-03-01

    In this study, a new time series of Gravity Recovery and Climate Experiment (GRACE) monthly solutions, complete to degree and order 60 spanning from January 2003 to August 2011, has been derived based on a modified short-arc approach. Our models entitled Tongji-GRACE01 are available on the website of International Centre for Global Earth Models http://icgem.gfz-potsdam.de/ICGEM/. The traditional short-arc approach, with no more than 1 h arcs, requires the gradient corrections of satellite orbits in order to reduce the impact of orbit errors on the final solution. Here the modified short-arc approach has been proposed, which has three major differences compared to the traditional one: (1) All the corrections of orbits and range rate measurements are solved together with the geopotential coefficients and the accelerometer biases using a weighted least squares adjustment; (2) the boundary position parameters are not required; and (3) the arc length can be extended to 2 h. The comparisons of geoid degree powers and the mass change signals in the Amazon basin, the Antarctic, and Antarctic Peninsula demonstrate that our model is comparable with the other existing models, i.e., the Centre for Space Research RL05, Jet Propulsion Laboratory RL05, and GeoForschungsZentrum RL05a models. The correlation coefficients of the mass change time series between our model and the other models are better than 0.9 in the Antarctic and Antarctic Peninsula. The mass change rates in the Antarctic and Antarctic Peninsula derived from our model are -92.7 ± 38.0 Gt/yr and -23.9 ± 12.4 Gt/yr, respectively, which are very close to those from other three models and with similar spatial patterns of signals.

  16. "The children's feedback game": an approach for modifying disruptive group behavior.

    PubMed

    Epstein, Y M; Borduin, C M

    1984-01-01

    Adult leaders of groups for children are almost invariably confronted with the problem of disruptive child behavior. Although these adults are usually able to effect at least some level of child compliance, the achievement of such compliance often demands a considerable expenditure of time and forces the leader and children into an adversary relationship. An alternative approach toward disruptive group behavior avoids some of these difficulties by engaging the children themselves as agents of change. The "Children's Feedback Game" provides a mechanism for implementing peer-group modification of undesirable behavior. The game uses an incentive system to teach the children to give and to receive both positive and negative feedback. As these interpersonal skills are developed, group supportiveness and cooperation are enhanced and other group goals are more easily met. The game can be readily adapted to a variety of clinical and teaching situations that involve a group of children. PMID:6711711

  17. Modified Redundancy based Technique—a New Approach to Combat Error Propagation Effect of AES

    NASA Astrophysics Data System (ADS)

    Sarkar, B.; Bhunia, C. T.; Maulik, U.

    2012-06-01

    Advanced encryption standard (AES) is a great research challenge. It has been developed to replace the data encryption standard (DES). AES suffers from a major limitation of error propagation effect. To tackle this limitation, two methods are available. One is redundancy based technique and the other one is bite based parity technique. The first one has a significant advantage of correcting any error on definite term over the second one but at the cost of higher level of overhead and hence lowering the processing speed. In this paper, a new approach based on the redundancy based technique is proposed that would certainly speed up the process of reliable encryption and hence the secured communication.

  18. Grey-Turner's sign after modified Kugel herniorrhaphy.

    PubMed

    Fan, Zhe; Tian, Xiaofeng; Zhang, Yingyi; Jing, Huirong; Pan, Jiyong; Wang, Shuang

    2014-01-01

    Tension-free hernia repairing techniques is a popular herniorrhaphy for open inguinal hernioplasty and the modified Kugel herniorrhaphy (MKH) is a kind of tension-free hernia repairing technique. The modified Kugel herniorrhaphy (MKH) is a minimally invasive, non-laparoscopic, conventional anterior approach, preperitoneal and sutureless technique. It is well accepted by most people because of few complications and low recurrence rate. A case of an 82-year-old man underwent MKH. After the third day of postoperation, a strange symptom of Grey-Turner's sign appeared and maintained for 10 days. PMID:25664136

  19. Fatigue of pseudoelastic NiTi within the stress-induced transformation regime: a modified Coffin-Manson approach

    NASA Astrophysics Data System (ADS)

    Maletta, C.; Sgambitterra, E.; Furgiuele, F.; Casati, R.; Tuissi, A.

    2012-11-01

    Strain controlled fatigue tests of a pseudoelastic nickel-titanium (NiTi) shape memory alloy (SMA) have been carried out in this investigation. In particular, flat dog-bone shaped specimens, obtained from commercial NiTi sheets, have been analyzed, under pull-pull loading conditions, in two subsequent steps: (i) material stabilization and (ii) fatigue life estimation. The first step was carried out to obtain a stable pseudoelastic response of the SMA, i.e. with no residual deformations upon unloading, and it can be regarded as a preliminary processing condition of the alloy. Results on functional fatigue, i.e. in terms of stabilized pseudoelastic response, and on structural fatigue, in terms of cycles to failure, are reported and discussed. Furthermore, a modified Coffin-Manson approach for fatigue life estimation of SMAs is proposed, which takes into account the strain mechanisms involved during repeated stress-induced martensitic transformations.

  20. Harmonic analysis approach to the 'TunneLadder' - A modified Karp circuit for millimeter-wave TWTA's

    NASA Technical Reports Server (NTRS)

    Kosmahl, H. G.; Palmer, R. W.

    1982-01-01

    A field approach to the summed harmonic analysis of the TunneLadder structure, or modified forward-wave Karp circuit, is developed by combining TM(01) and TE(11) modes. Results suggest the suitability of this structure as a high-impedance, about 1-% bandwidth circuit, millimeter-wave forward-wave-type amplifier that is voltage tunable over about a 5-% frequency range and has excellent power handling ability. Theory gives good agreement with experimental results obtained by Karp in omega-beta dispersion and predicts qualitatively the appearances of the antisymmetric mode discussed and of the so called Hightron mode that was discussed earlier in White, Enderby and Birdsall (1964), and Enderby (1964), in addition to the desired symmetric mode.

  1. Harmonic analysis approach to the 'TunneLadder' - A modified Karp circuit for millimeter-wave TWTA's

    NASA Astrophysics Data System (ADS)

    Kosmahl, H. G.; Palmer, R. W.

    1982-05-01

    A field approach to the summed harmonic analysis of the TunneLadder structure, or modified forward-wave Karp circuit, is developed by combining TM(01) and TE(11) modes. Results suggest the suitability of this structure as a high-impedance, about 1-% bandwidth circuit, millimeter-wave forward-wave-type amplifier that is voltage tunable over about a 5-% frequency range and has excellent power handling ability. Theory gives good agreement with experimental results obtained by Karp in omega-beta dispersion and predicts qualitatively the appearances of the antisymmetric mode discussed and of the so called Hightron mode that was discussed earlier in White, Enderby and Birdsall (1964), and Enderby (1964), in addition to the desired symmetric mode.

  2. A systems approach to designing next generation vaccines: combining α-galactose modified antigens with nanoparticle platforms

    NASA Astrophysics Data System (ADS)

    Phanse, Yashdeep; Carrillo-Conde, Brenda R.; Ramer-Tait, Amanda E.; Broderick, Scott; Kong, Chang Sun; Rajan, Krishna; Flick, Ramon; Mandell, Robert B.; Narasimhan, Balaji; Wannemuehler, Michael J.

    2014-01-01

    Innovative vaccine platforms are needed to develop effective countermeasures against emerging and re-emerging diseases. These platforms should direct antigen internalization by antigen presenting cells and promote immunogenic responses. This work describes an innovative systems approach combining two novel platforms, αGalactose (αGal)-modification of antigens and amphiphilic polyanhydride nanoparticles as vaccine delivery vehicles, to rationally design vaccine formulations. Regimens comprising soluble αGal-modified antigen and nanoparticle-encapsulated unmodified antigen induced a high titer, high avidity antibody response with broader epitope recognition of antigenic peptides than other regimen. Proliferation of antigen-specific CD4+ T cells was also enhanced compared to a traditional adjuvant. Combining the technology platforms and augmenting immune response studies with peptide arrays and informatics analysis provides a new paradigm for rational, systems-based design of next generation vaccine platforms against emerging and re-emerging pathogens.

  3. A systems approach to designing next generation vaccines: combining α-galactose modified antigens with nanoparticle platforms

    PubMed Central

    Phanse, Yashdeep; Carrillo-Conde, Brenda R.; Ramer-Tait, Amanda E.; Broderick, Scott; Kong, Chang Sun; Rajan, Krishna; Flick, Ramon; Mandell, Robert B.; Narasimhan, Balaji; Wannemuehler, Michael J.

    2014-01-01

    Innovative vaccine platforms are needed to develop effective countermeasures against emerging and re-emerging diseases. These platforms should direct antigen internalization by antigen presenting cells and promote immunogenic responses. This work describes an innovative systems approach combining two novel platforms, αGalactose (αGal)-modification of antigens and amphiphilic polyanhydride nanoparticles as vaccine delivery vehicles, to rationally design vaccine formulations. Regimens comprising soluble αGal-modified antigen and nanoparticle-encapsulated unmodified antigen induced a high titer, high avidity antibody response with broader epitope recognition of antigenic peptides than other regimen. Proliferation of antigen-specific CD4+ T cells was also enhanced compared to a traditional adjuvant. Combining the technology platforms and augmenting immune response studies with peptide arrays and informatics analysis provides a new paradigm for rational, systems-based design of next generation vaccine platforms against emerging and re-emerging pathogens. PMID:24441019

  4. Calculation of measurement uncertainty in quantitative analysis of genetically modified organisms using intermediate precision--a practical approach.

    PubMed

    Zel, Jana; Gruden, Kristina; Cankar, Katarina; Stebih, Dejan; Blejec, Andrej

    2007-01-01

    Quantitative characterization of nucleic acids is becoming a frequently used method in routine analysis of biological samples, one use being the detection of genetically modified organisms (GMOs). Measurement uncertainty is an important factor to be considered in these analyses, especially where precise thresholds are set in regulations. Intermediate precision, defined as a measure between repeatability and reproducibility, is a parameter describing the real situation in laboratories dealing with quantitative aspects of molecular biology methods. In this paper, we describe the top-down approach to calculating measurement uncertainty, using intermediate precision, in routine GMO testing of food and feed samples. We illustrate its practicability in defining compliance of results with regulations. The method described is also applicable to other molecular methods for a variety of laboratory diagnostics where quantitative characterization of nucleic acids is needed. PMID:17474528

  5. Insight into sorption mechanism of phenanthrene onto gemini modified palygorskite through a multi-level fuzzy-factorial inference approach.

    PubMed

    Zhao, Shan; Huang, Gordon; Wang, Shuo; Wang, Xiuquan; Huang, Wendy

    2016-07-28

    A multi-level fuzzy-factorial inference approach was proposed to examine the sorption behavior of phenanthrene on palygorskite modified with a gemini surfactant. Fuzzy set theory was used to determine five experimentally controlled environmental factors with triangular membership functions, including initial concentration, added humid acid dose, ionic strength, temperature, and pH. The statistical significance of factors and their interactions affecting the sorption process was revealed through a multi-level factorial experiment. Initial concentration, ionic strength, and pH were identified as the most significant factors based on the multi-way ANOVA results. Examination of curvature effects of factors revealed the nonlinear complexity inherent in the sorption process. The potential interactions among experimental factors were detected, which is meaningful for providing a deep insight into the sorption mechanisms under the influences of factors at different levels. PMID:27163726

  6. Direct anterior total hip arthroplasty: Comparative outcomes and contemporary results

    PubMed Central

    Connolly, Keith P; Kamath, Atul F

    2016-01-01

    Direct anterior total hip arthroplasty has become increasingly more popular among arthroplasty surgeons, in large part due to the use of an intramuscular interval and desire to reduce soft tissue damage. Several studies have now been published comparing the anterior intramuscular to other commonly used approaches, and many studies have published complication rates on large series of patients. Review of comparative studies indicates direct anterior hips tend towards shorter hospital stays and high rates of patients discharged to home. Although some studies show evidence of early benefit in functional outcomes, there is no strong evidence that the anterior approach provides any long term functional improvements compared to other approaches. Additionally, evidence to support reduced damage to soft tissue may not translate to certain clinical significance. Rates of intra-operative femur fracture, operative time and blood loss rates are notably higher for those developing familiarity with this approach. However, when surgeons have performed a modest number of procedures, the complication rates tend to markedly decrease in most studies to levels comparable to other approaches. Accuracy of component positioning also favors the anterior approach in some studies. This review summarizes the available literature comparing the direct anterior to other approaches for total hip arthroplasty and provides a comprehensive summary of common complications. PMID:26925380

  7. Benchmark of a modified iterated perturbation theory approach on the fcc lattice at strong coupling

    NASA Astrophysics Data System (ADS)

    Arsenault, Louis-François; Sémon, Patrick; Tremblay, A.-M. S.

    2012-08-01

    The dynamical mean-field theory approach to the Hubbard model requires a method to solve the problem of a quantum impurity in a bath of noninteracting electrons. Iterated perturbation theory (IPT) has proven its effectiveness as a solver in many cases of interest. Based on general principles and on comparisons with an essentially exact continuous-time quantum Monte Carlo (CTQMC) solver, here we show that the standard implementation of IPT fails away from half-filling when the interaction strength is much larger than the bandwidth. We propose a slight modification to the IPT algorithm that replaces one of the equations by the requirement that double occupancy calculated with IPT gives the correct value. We call this method IPT-D. We recover the Fermi liquid ground state away from half-filling. The Fermi liquid parameters, density of states, chemical potential, energy, and specific heat on the fcc lattice are calculated with both IPT-D and CTQMC as benchmark examples. We also calculated the resistivity and the optical conductivity within IPT-D. Particle-hole asymmetry persists even at coupling twice the bandwidth. A generalization to the multiorbital case is suggested. Several algorithms that speed up the calculations are described in appendixes.

  8. Tibialis Anterior Tendon Transfer.

    PubMed

    Mulhern, Jennifer L; Protzman, Nicole M; Brigido, Stephen A

    2016-01-01

    Tendon transfer procedures are used commonly for the correction of soft tissue imbalances and instabilities. The complete transfer and the split transfer of the tibialis anterior tendon are well-accepted methods for the treatment of idiopathic equinovarus deformity in children and adults. Throughout the literature, complete and split transfer have been shown to yield significant improvements in ankle and foot range of motion and muscle function. At present, there is insufficient evidence to recommend one procedure over the other, although the split procedure has been advocated for consistently achieving inversion to eversion muscle balance without overcorrection. PMID:26590723

  9. Qualitative mathematical modelling of coupled coast and estuary morphodynamics: a modified Boolean network approach

    NASA Astrophysics Data System (ADS)

    French, J.; Burningham, H.

    2011-12-01

    A major challenge in coastal geomorphology is the prediction of morphological change at a meso-scale (10 to 100 km; 10 to 100 yr). This scale sits awkwardly between understanding of geomorphological processes at the micro-scale, and broader aspects of coastal evolution informed by the Holocene stratigraphic record. In this paper, we explore the potential of a new kind of qualitative mathematical model implemented at a system level. Qualitative models derive predictions from the structure of the system rather from the detailed physics of the underlying processes. Although systems thinking is well established in geomorphology methodologies for converting system diagrams into simulation tools have not been widely investigated. In a recent Defra-funded project in the UK, a Boolean network approach was piloted and applied to the simulation of generic aspects of estuary response to environmental and anthropogenic forcing. We build on this to present a generic approach to the construction of system diagrams for estuaries and adjacent open coasts and their conversion into a network graph. In a Boolean model, each node of this graph is assigned a binary value, the state of which is determined by a logical function that specifies the combined influence of other nodes to which it is connected. System evolution is simulated by specifying a set of initial conditions and repeatedly evaluating the logical functions until an equilibrium condition is reached (either a steady state or a cyclical sequence between two end states). In our enhanced Boolean scheme, changes in morphology are allowed to feed back into intrinsic process variables (e.g. estuary waves or tidal prism), although some processes are externally imposed (e.g. sea-level rise). Arbitrary time lags condition the response of morphology to a change in process, such that some landforms adjust more rapidly than others. We also present a simulator architecture based around a solver and externally specified model components

  10. Two matrix approaches for aerial image formation obtained by extending and modifying the transmission cross coefficients.

    PubMed

    Yamazoe, Kenji

    2010-06-01

    This paper physically compares two different matrix representations of partially coherent imaging with the introduction of matrices E and Z, containing the source, object, and pupil. The matrix E is obtained by extending the Hopkins transmission cross coefficient (TCC) approach such that the pupil function is shifted while the matrix Z is obtained by shifting the object spectrum. The aerial image I can be written as a convex quadratic form I = = , where |phi> is a column vector representing plane waves. It is shown that rank(Z) < or = rank(E) = rank(T) = N, where T is the TCC matrix and N is the number of the point sources for a given unpolarized illumination. Therefore, the matrix Z requires fewer than N eigenfunctions for a complete aerial image formation, while the matrix E or T always requires N eigenfunctions. More importantly, rank(Z) varies depending on the degree of coherence determined by the von Neumann entropy, which is shown to relate to the mutual intensity. For an ideal pinhole as an object, emitting spatially coherent light, only one eigenfunction--i.e., the pupil function--is enough to describe the coherent imaging. In this case, we obtain rank(Z) = 1 and the pupil function as the only eigenfunction regardless of the illumination. However, rank(E) = rank(T) = N even when the object is an ideal pinhole. In this sense, aerial image formation with the matrix Z is physically more meaningful than with the matrix E. The matrix Z is decomposed as B(dagger)B, where B is a singular matrix, suggesting that the matrix B as well as Z is a principal operator characterizing the degree of coherence of the partially coherent imaging. PMID:20508699

  11. Sutureless clear corneal DSAEK with a modified approach for preventing pupillary block and graft dislocation: case series with retrospective comparative analysis.

    PubMed

    Titiyal, Jeewan S; Tinwala, Sana I; Shekhar, Himanshu; Sinha, Rajesh

    2015-04-01

    The purpose of this study was to describe a modified technique of sutureless DSAEK with continuous pressurized internal air tamponade. This was a prospective interventional case series, single-center, institutional study. Twenty-seven patients with corneal decompensation without scarring were included. Aphakic patients and patients with cataractous lens requiring IOL implantation surgery were excluded. Following preparation of the donor tissue, a corneal tunnel was made nasally with two side ports. All incisions were kept long enough to be overlapped by the peripheral part of the donor tissue. Descemet membrane scoring was done using a reverse Sinskey hook, following which it was removed with the same instrument or by forceps. The donor lenticule was then inserted using Busin's glide. Continuous pressurized internal air tamponade was achieved by means of a 30-gauge needle, inserted through the posterior limbus, for 12-14 min. At the end of the surgery, air was partially replaced with BSS, leaving a moderate-sized mobile air bubble in the anterior chamber. At the 6 month's follow-up, CDVA improved from counting fingers at half meter-6/24 preoperatively to 6/9-6/18 postoperatively, and the mean endothelial cell count decreased: to 1,800 from 2,200 cell/mm(2) preoperatively (18.19 % endothelial cell loss). Donor lenticule thickness as documented on AS-OCT was 70-110 µ on Day 1 and 50-80 µ at 6 months postoperative. None of the cases had flat AC or peripheral anterior synechiae formation. None of the patients required a second intervention. There were no cases of primary graft failure, pupillary block glaucomax or donor lenticule dislocation postoperatively. Our modified technique is simple and effective with reduction in postoperative complications associated with DSAEK, thereby maximizing anatomic and functional outcomes associated. PMID:24728534

  12. Anterior Cervical Discectomy and Fusion (ACDF): Comparison Between Zero Profile Implants and Anterior Cervical Plate and Spacer

    PubMed Central

    Alimi, Marjan; Njoku, Innocent; Hofstetter, Christoph P; Tsiouris, Apostolos J; Kesavabhotla, Kartik; Boockvar, John; Härtl, Roger

    2016-01-01

    Introduction: Interposition grafts combined with anterior plating currently remain the gold standard for anterior cervical discectomy and fusion. The use of anterior plates increases fusion rates but may be associated with higher rates of postoperative dysphagia. The aim of the current study was to determine the clinical and radiological outcomes following anterior cervical discectomy and fusion (ACDF) using zero-profile anchored spacers versus standard interposition grafts with anterior plating. Methods: This was a retrospective case series. A total of 53 male and 51 female consecutive patients (164 total operated levels) who underwent ACDF between 2007 and 2011 were included. The mean clinical follow-up was 15.7 ± 1.2 (SEM) months for patients with zero-profile implants and 14.8 ± 2.1 months for patients with conventional ACDF with anterior plating. Patient demographics, operative details, clinical outcomes, complications, and radiographic imaging were reviewed. Dysphagia was determined using the Bazaz criteria. Results: Clinical outcome scores improved in both groups as measured by the modified Japanese Orthopedic Association and Nurick scores. Zero-profile constructs gave rise to significantly less prevertebral soft tissue swelling compared to constructs with anterior plates postoperatively (15.74 ± 0.52 as compared to 20.48 ± 0.85 mm, p < 0.001) and at the latest follow-up (10.88 ± 0.39 mm vs. 13.72 ± 0.67 mm, p < 0.001). There was a significant difference in the incidence of dysphagia at the latest follow-up (1.5% vs. 20%, p=0.001, zero-profile vs. anterior plate, respectively). Conclusion: Zero-profile implants lead to functional outcomes similar to standard anterior plate constructs. Avoiding the use of an anterior locking plate may decrease the risk of persistent postoperative dysphagia. PMID:27200226

  13. Uveitis (acute anterior)

    PubMed Central

    2010-01-01

    Introduction Anterior uveitis is rare, with an annual incidence of 12/100,000 population, although it is more common in Finland (annual incidence of 23/100,000), probably because of genetic factors, such as high frequency of HLA–B27 in the population. It is often self-limiting, but can, in some cases, lead to complications such as posterior synechiae, cataract, glaucoma, and chronic uveitis. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of anti-inflammatory eye drops on acute anterior uveitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found six systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: corticosteroids, mydriatics, and non-steroidal anti-inflammatory drug eye drops. PMID:21736765

  14. ENVIRONMENTAL AUDITING: An Aquifer Vulnerability Assessment of the Paluxy Aquifer, Central Texas, USA, Using GIS and a Modified DRASTIC Approach.

    PubMed

    Fritch; McKnight; Yelderman; Arnold

    2000-03-01

    / The Paluxy aquifer in north-central Texas is composed primarily of Lower Cretaceous clastics. This aquifer provides water for both domestic and agricultural purposes in the region. The study area for this investigation incorporates the outcrop and recharge areas, as well as the confined and unconfined portions of the aquifer. The purpose of this investigation is to perform a groundwater vulnerability assessment on the Paluxy aquifer using the GRASS 4.1 geographic information system combined with a modified DRASTIC approach. DRASTIC is an acronym for the variables that control the groundwater pollution potential (Depth to water, net Recharge, Aquifer media, Soil media,Topography, Impact of the vadose zone, andConductivity of the aquifer). Using such an approach allows one to investigate the potential for groundwater contamination on a regional, rather than site-specific, scale. Based upon data from variables such as soil permeability, depth to water, aquifer hydraulic conductivity, and topography, subjective numerical weightings have been assigned according to the variable's relative importance in regional groundwater quality. The weights for each variable comprise a GIS map layer. These map layers are combined to formulate the final groundwater pollution potential map. Using this method of investigation, the pollution potential map for the study area classifies 47% of the area as having low pollution potential, 26% as having moderate pollution potential, 22% as having high pollution potential, and 5% as having very high pollution potential. PMID:10629314

  15. An aquifer vulnerability assessment of the Paluxy Aquifer, central Texas, USA, using GIS and a modified DRASTIC approach

    SciTech Connect

    Fritch, T.G.; McKnight, C.L.; Yelderman, J.C. Jr.; Arnold, J.G.

    2000-03-01

    The Paluxy aquifer in north-central Texas is composed primarily of Lower Cretaceous clastics. This aquifer provides water for both domestic and agricultural purposes in the region. The study area for this investigation incorporates the outcrop and recharge areas, as well as the confined and unconfined portions of the aquifer. The purpose of this investigation is to perform a groundwater vulnerability assessment on the Paluxy aquifer using the GRASS 4.1 geographic information system combined with a modified DRASTIC approach. DRASTIC is an acronym for the variables that control the groundwater pollution potential (Depth to water, net Recharge, Aquifer media, Soil media, Topography, Impact of the vadose zone, and Conductivity of the aquifer). Using such an approach allows one to investigate the potential for groundwater contamination on a regional, rather than site-specific, scale. Based upon data from variables such as soil permeability, depth to water, aquifer hydraulic conductivity, and topography, subjective numerical weightings have been assigned according to the variable's relative importance in regional groundwater quality. The weights for each variable comprise a GIS map layer. These map layers are combined to formulate the final groundwater pollution potential map. Using this method of investigation, the pollution potential map for the study area classified 47% of the area as having low pollution potential, 26% as having moderate pollution potential, 22% as having high pollution potential, and 5% as having very high pollution potential.

  16. Quantitative assessment of hyperspectral imaging in detection of plasmonic nanoparticles: a modified contrast-detail analysis approach

    NASA Astrophysics Data System (ADS)

    Wang, Jianting; Chen, Yu; Pfefer, T. Joshua

    2016-03-01

    Hyperspectral reflectance imaging (HRI) is an emerging imaging modality being applied for clinical indications such as tissue oximetry, and cancer detection based on endogenous biological constituents including plasmonic nanoparticles. However, there is currently a lack of standardized test methods for objective, quantitative evaluation of HRI system performance. Contrast-detail analysis (CDA) is a phantom-based test method commonly used to evaluate medical imaging devices (e.g., mammography systems) in terms of their lower detection limit. We investigated a modified CDA (mCDA) method to quantify the detectability of gold nanoparticles by HRI systems. Silicone-based turbid phantoms containing micro-fluidic channels were developed for the mCDA tests. Polydimethylsiloxane (PDMS) phantom materials were doped with chromophores and scatterers to achieve biologically relevant optical properties (OPs). Molds were used to produce cylindrical channels of diameters 0.3 to 1.65 mm and depths of 0.2 mm inside the phantoms. Channels were filled with a mixture of hemoglobin and concentrations of gold nanorods (GNR) and measured with our HRI system. The contrast of GNRs was solved with a spectral unmixing algorithm from the reflectance spectra. The lowest detectable concentration was determined as a function of inclusion size and depth and plotted as modified contrast detail curve (mCDC). mCDCs were used to compare the detectabilities of the HRI system with different data processing algorithms. It is demonstrated that our mCDA test method involving turbid microchannel phantoms can help to elucidate the combined performance of imaging devices and plasmonic nanoparticle contrast agents. This approach may be useful for performing clinical trial standardization and device re-calibration, thus ensuring quality control and clinical performance.

  17. Anterior hip pain.

    PubMed

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  18. Anterior segment parameters and eyelids in systemic sclerosis.

    PubMed

    Sahin Atik, Sevinc; Koc, Feray; Akin Sari, Sirin; Sefi Yurdakul, Nazife; Ozmen, Mustafa; Akar, Servet

    2016-08-01

    To evaluate main numerical parameters of anterior segment and the effects of eyelid skin changes on these parameters in patients with systemic sclerosis (SSc). Thirty-four patients with SSc and 34 healthy individuals were enrolled. Besides full eye examination, anterior segment measurements including anterior chamber depth (ACD), anterior chamber volume, anterior chamber angle width, central corneal thickness, pupil size, corneal volume and keratometry were obtained using a Sirius Scheimpflug/Placido photography-based topography system. Eyelid thickness was evaluated using the scala of the modified Rodnan skin score and the patients were subgrouped with respect to these scores to evaluate the effect of eyelid thickening on the anterior segment parameters. Age and sex distributions of the groups were similar (p > 0.05). SSc patients had steeper and thinner corneas, smaller corneal volumes, narrower, shallower and smaller anterior segments but only the mean ACD value of right eyes was found significantly less than those of the controls (p = 0.047). The mean ACD values of SSc subgroup patients with moderate to severe eyelid thickening (50 %) had lower ACD measurements compared to those of control group. (p = 0.043 for the right eyes, p = 0.070 for the left eyes). However, SSc subgroup patients with none to mild eyelid thickening (50 %) had similar anterior segment parameters with control subjects (p > 0.05). Anterior chamber parameters of the SSc patients could show significant differences. These differences occur parallel to the eyelid changes but not secondary to it. PMID:26694912

  19. A Modified Approach of Percutaneous Endoscopic Lumbar Discectomy (PELD) for Far Lateral Disc Herniation at L5-S1 with Foot Drop.

    PubMed

    Chun, Eun Hee; Park, Hahck Soo

    2016-01-01

    Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy. PMID:26839673

  20. [Anterior cervical hypertrichosis: case report].

    PubMed

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years. PMID:27606653

  1. Reactivation of organophosphate-inhibited human, Cynomolgus monkey, swine and guinea pig acetylcholinesterase by MMB-4: A modified kinetic approach

    SciTech Connect

    Worek, Franz; Wille, Timo; Aurbek, Nadine; Eyer, Peter; Thiermann, Horst

    2010-12-15

    Treatment of poisoning by highly toxic organophosphorus compounds (OP, nerve agents) is a continuous challenge. Standard treatment with atropine and a clinically used oxime, obidoxime or pralidoxime is inadequate against various nerve agents. For ethical reasons testing of oxime efficacy has to be performed in animals. Now, it was tempting to investigate the reactivation kinetics of MMB-4, a candidate oxime to replace pralidoxime, with nerve agent-inhibited acetylcholinesterase (AChE) from human and animal origin in order to provide a kinetic basis for the proper assessment of in vivo data. By applying a modified kinetic approach, allowing the use of necessary high MMB-4 concentrations, it was possible to determine the reactivation constants with sarin-, cyclosarin-, VX-, VR- and tabun-inhibited AChE. MMB-4 exhibited a high reactivity and low affinity towards OP-inhibited AChE, except of tabun-inhibited enzyme where MMB-4 had an extremely low reactivity. Species differences between human and animal AChE were low (Cynomolgus) to moderate (swine, guinea pig). Due to the high reactivity of MMB-4 a rapid reactivation of inhibited AChE can be anticipated at adequate oxime concentrations which are substantially higher compared to HI-6. Additional studies are necessary to determine the in vivo toxicity, tolerability and pharmacokinetics of MMB-4 in humans in order to enable a proper assessment of the value of this oxime as an antidote against nerve agent poisoning.

  2. Modifying the photoelectric behavior of bacteriorhodopsin by site-directed mutagenesis: electrochemical and genetic engineering approaches to molecular devices

    NASA Astrophysics Data System (ADS)

    Hong, F. T.; Hong, F. H.; Needleman, R. B.; Ni, B.; Chang, M.

    1992-07-01

    Bacteriorhodopsins (bR's) modified by substitution of the chromophore with synthetic vitamin A analogues or by spontaneous mutation have been reported as successful examples of using biomaterials to construct molecular optoelectronic devices. The operation of these devices depends on desirable optical properties derived from molecular engineering. This report examines the effect of site-directed mutagenesis on the photoelectric behavior of bR thin films with an emphasis on their application to the construction of molecular devices based on their unique photoelectric behavior. We examine the photoelectric signals induced by a microsecond light pulse in thin films which contain reconstituted oriented purple membrane sheets isolated from several mutant strains of Halobacterium halobium. A recently developed expression system is used to synthesize mutant bR's in their natural host, H. halobium. We then use a unique analytical method (tunable voltage clamp method) to investigate the effect of pH on the relaxation of two components of the photoelectric signals, B1 and B2. We found that for the four mutant bR's examined, the pH dependence of the B2 component varies significantly. Our results suggest that genetic engineering approaches can produce mutant bR's with altered photoelectric characteristics that can be exploited in the construction of devices.

  3. [Concept extraction of graduate research by modified grounded theory approach and creating of rubric oriented to performance evaluation].

    PubMed

    Yasuhara, Tomohisa; Sone, Tomomichi; Kohno, Takeyuki; Ogita, Kiyokazu

    2015-01-01

      A revised core curriculum model for pharmaceutical education, developed on the basis of the principles of outcome-based education, will be introduced in 2015. Inevitably, appropriate assessments of students' academic achievements will be required. Although evaluations of the cognitive domain can be carried out by paper tests, evaluation methods for the attitude domain and problem-solving abilities need to be established. From the viewpoint of quality assurance for graduates, pharmaceutical education reforms have become vital to evaluation as well as learning strategies. To evaluate student academic achievements on problem-solving abilities, authentic assessment is required. Authentic assessment is the evaluation that mimics the context tried in work and life. Specifically, direct evaluation of performances, demonstration or the learners' own work with integrated variety knowledge and skills, is required. To clarify the process of graduate research, we obtained qualitative data through focus group interviews with six teachers and analyzed the data using the modified grounded theory approach. Based on the results, we clarify the performance students should show in graduate research and create a rubric for evaluation of performance in graduate research. PMID:25743905

  4. Elevator Muscle Anterior Resection: A New Technique for Blepharoptosis.

    PubMed

    Zigiotti, Gian Luigi; Delia, Gabriele; Grenga, Pierluigi; Pichi, Francesco; Rechichi, Miguel; Jaroudi, Mahmoud O; d'Alcontres, Francesco Stagno; Lupo, Flavia; Meduri, Alessandro

    2016-01-01

    Blepharoptosis is a condition of inadequate upper eyelid position, with a downward displacement of the upper eyelid margin resulting in obstruction of the superior visual field. Levator resection is an effective technique that is routinely used to correct aponeurotic ptosis. The anterior levator resection is the procedure of choice in moderate blepharoptosis when there is moderate to good levator muscle function, furthermore, with an anterior approach, a greater resection can be achieved than by a conjunctival approach. The authors describe a modification in the Putterman technique with a resection done over a plicated elevator, plication that was suggested by Mustardè. The technique has been named as elevator muscle anterior resection. The elevator muscle anterior resection inspires from the Fasanella-Servat operation by the use of a clamp, making the operation simple and predictable. PMID:26703054

  5. Flap Coverage of Anterior Abdominal Wall Defects

    PubMed Central

    Sacks, Justin M.; Broyles, Justin M.; Baumann, Donald P.

    2012-01-01

    Reconstruction of complex defects of the anterior abdomen is both challenging and technically demanding for reconstructive surgeons. Advancements in the use of pedicle and free tissue transfer along with the use of bioprosthetic and synthetic meshes have provided for novel approaches to these complex defects. Accordingly, detailed knowledge of abdominal wall and lower extremity anatomy in combination with insight into the design, implementation, and limitations of various flaps is essential to solve these complex clinical problems. Although these defects can be attributed to a myriad of etiologic factors, the objectives in abdominal wall reconstruction are consistent and include the restoration of abdominal wall integrity, protection of intraabdominal viscera, and the prevention of herniation. In this article, the authors review pertinent anatomy and the various local, regional, and distant flaps that can be utilized in the reconstruction of these complex clinical cases of the anterior abdomen. PMID:23372457

  6. Cataract Surgery in Anterior Megalophthalmos: A Review

    PubMed Central

    GALVIS, Virgilio; TELLO, Alejandro; M. RANGEL, Carlos

    2015-01-01

    Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also called X-linked megalocornea. It is accompanied by early development of cataracts, zonular anomalies, and, rarely, vitreoretinal disorders. Subluxation of a cataract can occur in cataract surgery because of zonular weakness. In addition, in most patients, standard intraocular lens (IOL) decentration is a risk because of the enlarged sulcus and capsular bag. These unique circumstances make cataract surgery challenging. To date, several approaches have been developed. Implantation of a retropupillary iris-claw aphakic intraocular lens may be a good option because it is easier than suturing the IOL and can have better and more stable anatomic and visual outcomes, compared to other techniques. PMID:27350950

  7. Anterior radical debridement and anterior instrumentation in tuberculosis spondylitis.

    PubMed

    Benli, I Teoman; Acaroğlu, Emre; Akalin, Serdar; Kiş, Mahmut; Duman, Evrim; Un, Ahmet

    2003-04-01

    The conventional procedure in the treatment of vertebral tuberculosis is drainage of the abscess, curettage of the devitalized vertebra and application of an antituberculous chemotherapy regimen. Posterior instrumentation results are encouraging in the prevention or treatment of late kyphosis; however, a second-stage operation is needed. Recently, posterolateral or transpedicular drainage without anterior drainage or posterior instrumentation following anterior drainage in the same session has become the preferred treatment, in order that kyphotic deformity can be avoided. Information on the use of anterior instrumentation along with radical debridement and fusion is scarce. This study reports on the surgical results of 63 patients with Pott's disease who underwent anterior radical debridement with anterior fusion and anterior instrumentation (23 patients with Z-plate and 40 patients with CDH system). Average age at the time of operation was 46.8+/-13.4 years. Average duration of follow-up was 50.9+/-12.9 months. Local kyphosis was measured preoperatively, postoperatively and at the last follow-up visit as the angle between the upper and lower end plates of the collapsed vertebrae. Vertebral collapse, destruction, cold abscess, and canal compromise were assessed on magnetic resonance (MR) images. It was observed that the addition of anterior instrumentation increased the rate of correction of the kyphotic deformity (79.7+/-20.1%), and was effective in maintaining it, with an average loss of 1.1 degrees +/-1.7 degrees. Of the 25 patients (39.7%) with neurological symptoms, 20 (80%) had full and 4 (16%) partial recoveries. There were very few intraoperative and postoperative complications (major vessel complication: 3.2%; secondary non-specific infection: 3.2%). Disease reactivation was not seen with the employment of an aggressive chemotherapy regimen. It was concluded that anterior instrumentation is a safe and effective method in the treatment of tuberculosis

  8. Towards Tailored Patient's Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire

    PubMed Central

    El Miedany, Yasser; El Gaafary, Maha; Youssef, Sally; Ahmed, Ihab

    2016-01-01

    Objectives. To assess the validity, reliability, and responsiveness to change of a patient self-reported questionnaire combining the Widespread Pain Index and the Symptom Severity Score as well as construct outcome measures and comorbidities assessment in fibromyalgia patients. Methods. The PROMs-FM was conceptualized based on frameworks used by the WHO Quality of Life tool and the PROMIS. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction were achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. The questionnaire included the modified ACR criteria main items (Symptom Severity Score and Widespread Pain Index), in addition to assessment of functional disability, quality of life (QoL), review of the systems, and comorbidities. Every patient completed HAQ and EQ-5D questionnaires. Results. A total of 146 fibromyalgia patients completed the questionnaire. The PROMs-FM questionnaire was reliable as demonstrated by a high standardized alpha (0.886–0.982). Content construct assessment of the functional disability and QoL revealed significant correlation (p < 0.01) with both HAQ and EQ-5D. Changes in functional disability and QoL showed significant (p < 0.01) variation with diseases activity status in response to therapy. There was higher prevalence of autonomic symptoms, CVS risk, sexual dysfunction, and falling. Conclusions. The developed PROMs-FM questionnaire is a reliable and valid instrument for assessment of fibromyalgia patients. A phased treatment regimen depending on the severity of FMS as well as preferences and comorbidities of the patient is the best approach to tailored patient management. PMID:27190648

  9. The Modified Ampullar Approach for Vestibular Implant Surgery: Feasibility and Its First Application in a Human with a Long-Term Vestibular Loss

    PubMed Central

    van de Berg, Raymond; Guinand, Nils; Guyot, Jean-Philippe; Kingma, Herman; Stokroos, Robert J.

    2012-01-01

    Objective: To assess, for the first time in a human with a long-term vestibular loss, a modified approach to the ampullae and the feasibility of evoking a VOR by ampullar stimulation. Materials and methods: Peroperative stimulation of the ampullae, using the ampullar approach, was performed under full anesthesia during cochlear implantation in a 21-year-old female patient, who had experienced bilateral vestibular areflexia and sensorineural hearing loss for almost 20 years. Results: The modified ampullar approach was performed successfully with as minimally invasive surgery as possible. Ampullar stimulation evoked eye movements containing vectors congruent with the stimulated canal. As expected, the preliminary electrophysiological data were influenced by the general anesthesia, which resulted in current spread and reduced maximum amplitudes of eye movement. Nevertheless, they confirm the feasibility of ampullar stimulation. Conclusion: The modified ampullar approach provides safe access to the ampullae using as minimally invasive surgery as possible. For the first time in a human with long-term bilateral vestibular areflexia, it is shown that the VOR can be evoked by ampullar stimulation, even when there has been no vestibular function for almost 20 years. This approach should be considered in vestibular surgery, as it provides safe access to one of the most favorable stimulus locations for development of a vestibular implant. PMID:22363317

  10. Comparatively studying the ultrasound present in a mild two-stage approach on the content of functional groups in modified MWCNT

    NASA Astrophysics Data System (ADS)

    Tian, Run; Liang, Shaolei; Li, Guangfen; Zhang, Yanxia; Shi, Le

    2016-04-01

    A two-stage approach assisted with ultrasound for oxidation of multiwalled carbon nanotubes (MWCNT) with ultra-high content of functional groups was utilized. The effect of ultrasound on the content of functional groups of the modified MWCNTs from different stages was analyzed by FE-SEM, HR-TEM, FTIR, Raman, TGA, XPS and triple double-backward titration method. The results confirm that more oxygen-containing functional groups were grafted on MWCNT with little damage to the structure integrity of nanotubes. The particle size distribution and the dispersion photography of MWCNTs in water and in ethanol further show a better dispersion of modified MWCNTs in polar solvent.

  11. Revision Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Wilde, Jeffrey; Bedi, Asheesh; Altchek, David W.

    2014-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is one of the most common surgical procedures, with more than 200,000 ACL tears occurring annually. Although primary ACL reconstruction is a successful operation, success rates still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database (1988-2013) as well as from textbook chapters and surgical technique papers. Study Design: Clinical review. Level of Evidence: Level 4. Results: The clinical outcomes after revision ACL reconstruction are largely based on level IV case series. Much of the existing literature is heterogenous with regard to patient populations, primary and revision surgical techniques, concomitant ligamentous injuries, and additional procedures performed at the time of the revision, which limits generalizability. Nevertheless, there is a general consensus that the outcomes for revision ACL reconstruction are inferior to primary reconstruction. Conclusion: Excellent results can be achieved with regard to graft stability, return to play, and functional knee instability but are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal graft selection, tunnel position, graft fixation, or biological milieu for tendon-bone healing. Strength-of-Recommendation Taxonomy (SORT): Good results may still be achieved with regard to graft stability, return to play, and functional knee instability, but results are generally inferior to primary ACL reconstruction: Level B. PMID:25364483

  12. Anterior Repair with Processed Dermis

    MedlinePlus Videos and Cool Tools

    Anterior Repair with Axis® Tutoplast® Processed Dermis and Digitex® - Performed by Dr. Manish Patel Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2016 BroadcastMed, Inc. ...

  13. Evaluation of the bioconversion of genetically modified switchgrass using simultaneous saccharification and fermentation and a consolidated bioprocessing approach

    PubMed Central

    2012-01-01

    Background The inherent recalcitrance of lignocellulosic biomass is one of the major economic hurdles for the production of fuels and chemicals from biomass. Additionally, lignin is recognized as having a negative impact on enzymatic hydrolysis of biomass, and as a result much interest has been placed on modifying the lignin pathway to improve bioconversion of lignocellulosic feedstocks. Results Down-regulation of the caffeic acid 3-O-methyltransferase (COMT) gene in the lignin pathway yielded switchgrass (Panicum virgatum) that was more susceptible to bioconversion after dilute acid pretreatment. Here we examined the response of these plant lines to milder pretreatment conditions with yeast-based simultaneous saccharification and fermentation and a consolidated bioprocessing approach using Clostridium thermocellum, Caldicellulosiruptor bescii and Caldicellulosiruptor obsidiansis. Unlike the S. cerevisiae SSF conversions, fermentations of pretreated transgenic switchgrass with C. thermocellum showed an apparent inhibition of fermentation not observed in the wild-type switchgrass. This inhibition can be eliminated by hot water extraction of the pretreated biomass, which resulted in superior conversion yield with transgenic versus wild-type switchgrass for C. thermocellum, exceeding the yeast-based SSF yield. Further fermentation evaluation of the transgenic switchgrass indicated differential inhibition for the Caldicellulosiruptor sp. strains, which could not be rectified by additional processing conditions. Gas chromatography–mass spectrometry (GC-MS) metabolite profiling was used to examine the fermentation broth to elucidate the relative abundance of lignin derived aromatic compounds. The types and abundance of fermentation-derived-lignin constituents varied between C. thermocellum and each of the Caldicellulosiruptor sp. strains. Conclusions The down-regulation of the COMT gene improves the bioconversion of switchgrass relative to the wild-type regardless of

  14. Restoring primary anterior teeth.

    PubMed

    Waggoner, William F

    2002-01-01

    A variety of esthetic restorative materials are available for restoring primary incisors. Knowledge of the specific strengths, weakness, and properties of each material will enhance the clinician's ability to make the best choice of selection for each individual situation. Intracoronal restorations of primary teeth may utilize resin composites, glass ionomer cements, resin-modified ionomers, or polyacid-modified resins. Each has distinct advantages and disadvantages and the clinical conditions of placement may be a strong determining factor as to which material is utilized. Full coronal restoration of primary incisors may be indicated for a number of reasons. Crowns available for restoration of primary incisors include those that are directly bonded onto the tooth, which generally are a resin material, and those crowns that are luted onto the tooth and are some type of stainless steel crown. However, due to lack of supporting clinical data, none of the crowns can be said to be superior to the others under all circumstances. Though caries in the mandibular region is rare, restorative solutions for mandibular incisors are needed. Neither stainless steel crowns nor celluloid crown forms are made specifically for mandibular incisors. Many options exist to repair carious primary incisors, but there is insufficient controlled, clinical data to suggest that one type of restoration is superior to another. This does not discount the fact that dentists have been using many of these crowns for years with much success. Operator preferences, esthetic demands by parents, the child's behavior, and moisture and hemorrhage control are all variables which affect the decision and ultimate outcome of whatever restorative treatment is chosen. PMID:12412967

  15. Fabrication of BaTiO3-Based Dielectrics for Ultrathin-Layer Multilayer Ceramic Capacitor Application by a Modified Coating Approach

    NASA Astrophysics Data System (ADS)

    Tian, Zhibin; Wang, Xiaohui; Zhang, Yichi; Song, Tae-Ho; Hur, Kang Heon; Li, Longtu

    2011-02-01

    The development of multilayer ceramic capacitor (MLCC) with base metal electrode (BME) requires precise controlling of the microstructure in a very thin dielectric layer (<1 µm). In this paper, a modified coating approach for high coverage of BaTiO3 powder for further MLCC application has been developed. The well dispersed and coated BaTiO3 powders are prepared and the relative mechanism has been discussed. Furthermore, the ultrafine grained X7R dielectric ceramics were produced by both conventional mixing and modified coating methods. Compared with the conventional mixing method, the ceramics prepared by the coating approach exhibited better TCC (the temperature coefficient of capacitance) performance, with dielectric constant over 2000 and grain size below 150 nm. In addition, it is found through the coating method the content of additives can be reduced to a relatively smaller amount than that required in conventional mixing method.

  16. The orbitozygomatic stich: A technical modification of the lateral supraorbital approach

    PubMed Central

    Lazukova, Miroslava; Andrade-Barazarte, Hugo; Makhamov, Mahkham; Kivelev, Juri; Goehre, Felix; Jahromi, Behnam Rezai; Ibrahim, Tarik F.; Araujo, Ricardo; Lehto, Hanna; Hernesniemi, Juha A.

    2016-01-01

    Background: The lateral supraorbital approach (LSO) provides access to a variety of pathologies including anterior and some posterior circulation aneurysms, sellar and suprasellar lesions, and anterior fossa tumors. Technical modifications of LSO improve the surgical exposure of the skull base. Methods: We retrospectively analyzed 73 consecutive patients treated by the senior author (Juha A. Hernesniemi), at the Department of Neurosurgery, Helsinki University Hospital in Helsinki, Finland from May 2013 to October 2013. This study cohort underwent a modified LSO to access anterior circulation aneurysms, sellar and suprasellar tumors, and anterior fossa tumors. The studied population comprised 30 men and 43 women, with a mean age at treatment of 54 years (9–83 years). Results: LSO was successfully used to access anterior circulation aneurysms in 59 (81%) patients, 10 (14%) patients with anterior cranial fossa tumors, and 4 (5%) patients with suprasellar tumors. The skull base drilling provided a mean of 6.8 mm (1.7–22 mm) in increased exposure. Conclusion: LSO provides adequate access to vascular and neoplastic lesions of the anterior cranial fossa, by drilling approximately 6.8 mm (1.7–22 mm) of the lateral orbital wall and sphenoid wing. This enhances surgical exposure and trajectory. An additional trick while performing an LSO is to place a single or multiple stiches (orbitozygomatic stich) at the base of the dura once opened, eliminating the dead space between the dura and anterior skull base. PMID:27168949

  17. Mitral paravalvular leak closure by antegrade percutaneous approach: three-dimensional transesophageal echocardiographic guided multiple Amplatzer implantation by a modified sequential anchoring-based technique.

    PubMed

    Tarantini, Giuseppe; Mojoli, Marco; Napodano, Massimo

    2013-10-01

    We describe the technical aspects and the possible advantages of a modified anchoring-based technique for the implantation of multiple Amplatzer devices, in a case of large anteroseptal mitral paravalvular leak causing massive regurgitation, which was manaed by antegrade transseptal, single-stage, percutaneous approach. Real-time three-dimensional transesophageal echocardiographic guidance was crucial to ensure successful recrossings of the target defect and the optimal anatomical closure. PMID:23613380

  18. A New Modified-Rate Approach For Gas-Grain Chemistry: Comparison with a Unified Large-Scale Monte Carlo Simulation

    NASA Astrophysics Data System (ADS)

    Garrod, R. T.; Vasyunin, A. I.; Semenov, D. A.; Wiebe, D. S.; Henning, Th.

    2009-07-01

    We compare the results of the unified Monte Carlo chemical model with the new modified-rate equation (MRE) method under a wide range of interstellar conditions, using a full gas-grain chemical network. In most of the explored parameter space, the new MRE method reproduces very well the results of the exact approach. Small disagreements between the methods may be remedied by the use of a more complete surface chemistry network, appropriate to the full range of temperatures employed here.

  19. A NEW MODIFIED-RATE APPROACH FOR GAS-GRAIN CHEMISTRY: COMPARISON WITH A UNIFIED LARGE-SCALE MONTE CARLO SIMULATION

    SciTech Connect

    Garrod, R. T.; Vasyunin, A. I.; Semenov, D. A.; Henning, Th.; Wiebe, D. S. E-mail: vasyunin@mpia.de E-mail: henning@mpia.de

    2009-07-20

    We compare the results of the unified Monte Carlo chemical model with the new modified-rate equation (MRE) method under a wide range of interstellar conditions, using a full gas-grain chemical network. In most of the explored parameter space, the new MRE method reproduces very well the results of the exact approach. Small disagreements between the methods may be remedied by the use of a more complete surface chemistry network, appropriate to the full range of temperatures employed here.

  20. Ultrasound of the male anterior urethra

    PubMed Central

    Shaida, N; Berman, L H

    2012-01-01

    Imaging of the anterior male urethra has traditionally been performed by fluoroscopic contrast urethrography. While providing easily interpretable images, this technique has a number of disadvantages associated with it. An alternative approach is to use ultrasound to assess the lumen of the urethra and the periurethral tissues. Here we describe the development of urethral ultrasound and the ascending and descending urethral ultrasound techniques employed in our institution with reference to commonly and uncommonly encountered pathologies. We also identify common pitfalls and how to avoid them. PMID:22674713

  1. Anterior Orbit and Adnexal Amyloidosis

    PubMed Central

    Al Hussain, Hailah; Edward, Deepak P.

    2013-01-01

    Purpose: To describe six cases of anterior orbital and adnexal amyloidosis and to report on proteomic analysis to characterize the nature of amyloid in archived biopsies in two cases. Materials and Methods: The clinical features, radiological findings, pathology, and outcome of six patients with anterior orbit and adnexal amyloidosis were retrieved from the medical records. The biochemical nature of the amyloid was determined using liquid chromatography/mass spectroscopy archived paraffin-embedded tissue in two cases. Results: Of the six cases, three had unilateral localized anterior orbit and lacrimal gland involvement. Four of the six patients were female with an average duration of 12.8 years from the time of onset to presentation eyelid infiltration by amyloid caused ptosis in five cases. CT scan in patients with lacrimal gland involvement (n = 3) demonstrated calcified deformable anterior orbital masses and on pathological exmaintionamyloid and calcific deposits replaced the lacrimal gland acini. Ptosis repair was performed in three patients with good outcomes. One patient required repeated debulking of the mass and one patient had recurrenct disease. Proteomic analysis revealed polyclonal IgG-associated amyloid deposition in one patient and AL kappa amyloid in the second patient. Conclusion: Amyloidosis of the anterior orbit and lacrimal gland can present with a wide spectrum of findings with good outcomes after surgical excision. The nature of amyloid material can be precisely determined in archival pathology blocks using diagnostic proteomic analysis. PMID:24014979

  2. Predictor's analysis of anterior circulation cerebral infarction after the endovascular treatment of anterior communicating artery aneurysms

    PubMed Central

    Sun, Liqian; Jing, Xiaobin; Cui, Changmeng; Cui, Jianzhong

    2014-01-01

    Background: Despite increasing acceptance of endovascular coiling for treating anterior communicating artery (ACoA) aneurysms, anterior circulation cerebral infarction (ACI) after embolization remains a limitation. With higher incidence, higher morbidity and higher mortality, it is one of the main factors influencing the ACoA aneurysms prognosis. Determining the risk factors leading to ACI after embolization will have clinical significance. Through retrospective case analysis, this study investigated the risk factors related to ACI after embolization in order to provide information to serve the clinical practice. Materials and Methods: A retrospective review was performed of patients who had undergone coiling of ACoA aneurysms from 2008 to 2012. All patients had ruptured prior to the completion of embolization. Cases with acute stroke symptoms without alternative diagnoses after embolization were diagnosed as ACI. A total of 32 risk factors such as age, sex, hypertension, diabetes mellitus, modified Fisher grade, Hunt-Hess grade, ventricular hemorrhage, etc. were analyzed using univariate and logistic regression analysis. Results: Univariate analysis showed that negative fluid volume balance (P = 0.041 <0.05) and modified Fisher grade (P = 0.049 <0.05) reached statistical significance, suggesting that they might be risk factors for ACI after embolization. Multiple logistic regression analysis showed that modified Fisher grade was significantly associated with ACI after embolization, suggesting that it was an independent risk factor (odds ratios (OR): 4.968, 95% confidence intervals (CI): 1.013-24.360, P = 0.048). Conclusion: Modified Fisher grade is an independent risk factor for ACI after embolization. PMID:25097601

  3. Crossing the Bridge to Higher Mathematics: Using a Modified Moore Approach to Assist Students Transitioning to Higher Mathematics

    ERIC Educational Resources Information Center

    McLoughlin, M. Padraig M. M.

    2008-01-01

    The author of this paper submits that a mathematics student needs to learn to conjecture and prove or disprove said conjecture. Ergo, the purpose of the paper is to submit the thesis that learning requires doing; only through inquiry is learning achieved, and hence this paper proposes a programme of use of a modified Moore method in a Bridge to…

  4. A Modified Moore Approach to Teaching Mathematical Statistics: An Inquiry Based Learning Technique to Teaching Mathematical Statistics

    ERIC Educational Resources Information Center

    McLoughlin, M. Padraig M. M.

    2008-01-01

    The author of this paper submits the thesis that learning requires doing; only through inquiry is learning achieved, and hence this paper proposes a programme of use of a modified Moore method in a Probability and Mathematical Statistics (PAMS) course sequence to teach students PAMS. Furthermore, the author of this paper opines that set theory…

  5. Anterior callosal section is useful for the removal of large tumors invading the dorsal part of the anterior third ventricle: operative technique and results.

    PubMed

    Shiramizu, Hideki; Hori, Tomokatsu; Matsuo, Seigo; Niimura, Kaku; Yoshimoto, Haruko; Ishida, Atsushi; Asakuno, Keizoh; Yuzawa, Miki; Moriyama, Takashi

    2013-07-01

    Large tumors invading the dorsal part of the anterior third ventricle are difficult to manage. The anterior transcallosal approach is usually used to manage these tumors. In our clinic, anterior callosal section was combined with the anterior interhemispheric (AIH) translamina terminalis approach for these tumors with excellent results. The AIH approach is useful for removing tumors in and around the anterior part of the third ventricle. However, AIH alone is insufficient for large tumors invading the dorsal part of the anterior third ventricle. In such situations, simple anterior callosal section enables the neurosurgeon to extirpate the caudal part of the tumors deeply hidden from operative field, sparing the foramen of Monro, fornix, etc. We treated four large tumors (malignant teratoma, recurrent chordoid glioma, recurrent papillary tumor of pineal region occupying the third ventricle, and paraventricular meningioma) without major complications. The malignant teratoma case exhibited no recurrence with >10 years follow-up. The chordoid glioma and papillary tumor of pineal region were totally removed. The meningioma was subtotally removed except only a small tumor around the bilateral anterior cerebral artery. This simple technique is a new way to manage difficult large lesions in and around the third ventricle. PMID:23568695

  6. Reliability and Validity of the Anterior Knee Pain Scale: Applications for Use as an Epidemiologic Screener

    PubMed Central

    2016-01-01

    A screening instrument’s ability to provide clinicians with consistent and reproducible information is crucial to intervention. Despite widespread acceptance and clinical use of the Kujala Anterior Knee Pain Scale (AKPS) in orthopedics and sports medicine, few studies have reported on its reliability and no such studies have concentrated on child or adolescent samples exclusively, segments of the population for which this instrument is often used. The purpose of the current study was to describe and report on the reliability and validity of the AKPS for use with high school female athletes participating in interscholastic athletics. The study was a secondary analysis of prospective epidemiologic data using established scale validation methods. The records of 414 female athletes 11.0 to 18.1 years of age (Mean 13.9 yrs, SD = 1.7 yrs) were used for analysis. Four different approaches to scoring and scale reduction of the AKPS were evaluated, including the original, ordinal 13-item form, a modified, ordinal 6-item form, a modified, dichotomous 13-item form, and a modified, dichotomous 6-item form. Three different types of reliability (internal consistency, equivalence across forms, standard error of measurement) and one type of validity (criterion-related) were estimated for the AKPS in the current sample. The four scoring formats of the AKPS scale were found to have high internal consistency (αcoef = 0.83 to 0.91), equivalence across the short and long forms (r = 0.98), acceptable standard errors of measurement (0.82 to 3.00), and moderate to high criterion related validity—as determined by physican’s diagnosis: 0.92 (13-item form), 0.90 (6-item form). The Kujala AKPS is a valid and reliable measure of anterior knee pain and appropriate for use as an epidemiologic screening tool with adolescent female athletes. PMID:27441381

  7. Reliability and Validity of the Anterior Knee Pain Scale: Applications for Use as an Epidemiologic Screener.

    PubMed

    Ittenbach, Richard F; Huang, Guixia; Barber Foss, Kim D; Hewett, Timothy E; Myer, Gregory D

    2016-01-01

    A screening instrument's ability to provide clinicians with consistent and reproducible information is crucial to intervention. Despite widespread acceptance and clinical use of the Kujala Anterior Knee Pain Scale (AKPS) in orthopedics and sports medicine, few studies have reported on its reliability and no such studies have concentrated on child or adolescent samples exclusively, segments of the population for which this instrument is often used. The purpose of the current study was to describe and report on the reliability and validity of the AKPS for use with high school female athletes participating in interscholastic athletics. The study was a secondary analysis of prospective epidemiologic data using established scale validation methods. The records of 414 female athletes 11.0 to 18.1 years of age (Mean 13.9 yrs, SD = 1.7 yrs) were used for analysis. Four different approaches to scoring and scale reduction of the AKPS were evaluated, including the original, ordinal 13-item form, a modified, ordinal 6-item form, a modified, dichotomous 13-item form, and a modified, dichotomous 6-item form. Three different types of reliability (internal consistency, equivalence across forms, standard error of measurement) and one type of validity (criterion-related) were estimated for the AKPS in the current sample. The four scoring formats of the AKPS scale were found to have high internal consistency (αcoef = 0.83 to 0.91), equivalence across the short and long forms (r = 0.98), acceptable standard errors of measurement (0.82 to 3.00), and moderate to high criterion related validity-as determined by physican's diagnosis: 0.92 (13-item form), 0.90 (6-item form). The Kujala AKPS is a valid and reliable measure of anterior knee pain and appropriate for use as an epidemiologic screening tool with adolescent female athletes. PMID:27441381

  8. Microwave-Assisted Esterification of N-Acetyl-L-Phenylalanine Using Modified Mukaiyama's Reagents: A New Approach Involving Ionic Liquids

    PubMed Central

    Zhao, Hua; Song, Zhiyan; Cowins, Janet V.; Olubajo, Olarongbe

    2008-01-01

    Inspired by the concept of ionic liquids (ILs), this study modified the original Mukaiyama's reagent, 2-chloro-1-methylpyridinium iodide (m.p. 200-dec), from ionic solid into liquids by changing its anion. The esterification of N-acetyl-L-phenylalanine was investigated as a model reaction. The microwave irradiation was more effective in esterifying N-acetyl-L-phenylalanine than the conventional reflux method. The original Mukaiyama's reagent was modified into ILs through manipulating its anion. However, only non-nucleophilic anions (such as EtSO4– and Tf2N–) were favorable since nucleophilic ones (such as CF3COO– and CH3COO–) could exchange with chlorine resulting in non-reactive coupling reagents. Two modified Mukaiyama's compounds (i.e. hydrophilic [2-ClMePy][EtSO4] and hydrophobic [2-ClMePy][Tf2N]) have been identified as the best ILtype coupling reagents. The esterification reaction was greatly enhanced by using 1- methylimidazole as the base instead of conventional toxic tertiary amines, and by using excess amount of alcohols as solvents instead of dichloromethane. Overall, the method reported is effective and ‘greener’. PMID:19325717

  9. Anterior colporrhaphy reinforced with Marlex mesh for the treatment of cystoceles.

    PubMed

    Flood, C G; Drutz, H P; Waja, L

    1998-01-01

    This study assesses the use of Marlex mesh in conjunction with anterior colporrhaphy for the correction of cystocele with or without urinary stress incontinence. A retrospective review was carried out of 12 years' experience with 142 patients undergoing a modified anterior colporrhaphy reinforced with Marlex mesh. All patients had preoperative urodynamics. Pre- and postoperative symptoms were compared and patients were examined for recurrent prolapse and mesh complications. Mean follow-up time was 3.2 years. No patients experienced recurrent anterior vaginal wall prolapse. Three patients developed mesh erosions into the vagina. There was a 74% success rate in the treatment of urinary stress incontinence. Marlex mesh used as a reinforcement for anterior colporrhaphy is effective in preventing recurrent anterior wall descent, with minimal complications. PMID:9795824

  10. The Development and Implementation of a Modified Language Experience Approach to a Reading Program for the Pre-Operational Child.

    ERIC Educational Resources Information Center

    Long, Diane D.

    A Piagetian, language-experience approach to the early teaching of reading to normal young and older developmentally delayed preoperational children was developed. The approach was discussed in a specially-developed manual which was field tested by 42 teachers among 390 children in 16 school systems in several states and in Canada. Subjects were…

  11. The CAP Approach to Modifying Vocational Programs for Handicapped Students. Vol. 5: Trades and Industry with an Example in Welding.

    ERIC Educational Resources Information Center

    Fessenden, Patricia K.; Mendini, Daniel

    This combination teaching guide and student workbook, fifth in a five-volume series (see note), presents an approach to teaching basic welding and welding terms for handicapped students. The teaching guide discusses a functional approach to teaching that can accomodate or alleviate the effects of disabilities. Discussion centers on categories to…

  12. Ankle Joint Fusion With an Anatomically Preshaped Anterior Locking Plate.

    PubMed

    Wiewiorski, Martin; Barg, Alexej; Schlemmer, Thomas; Valderrabano, Victor

    2016-01-01

    We present a novel fixation plate for primary ankle joint fusion. A single anatomically preshaped angular stable plate was used with an anterior approach. An excellent result with good bone consolidation was present at the 1-year follow-up examination. PMID:25998475

  13. Development of a Modified Version of the Spinal Function Sort (M-SFS): A Mixed Method Approach.

    PubMed

    Janssen, Svenja; Trippolini, Maurizio A; Hilfiker, Roger; Oesch, Peter

    2016-09-01

    Purpose To develop a modified version of the spinal function sort (M-SFS) by measuring work-related self-efficacy beliefs in patients with chronic low back pain. Methods A mixed method design consisting of three different methods (M1-3) was performed. In semi-structured interviews participants were asked how often they performed the activities of the 50 SFS items in 1 week, and which spinal postures and movements were associated with their back pain (M1). Quantitative analysis of previously obtained SFS data investigated internal consistency, unidimensionality, item response, and floor and ceiling effect (M2). Experts rated the SFS items based on their relevance (M3). The findings from these methods were used within a final scoring system for item reduction. Results From semi-structured interviews with 17 participants, eight new items emerged (M1). Quantitative analysis of 565 data sets (M2) revealed very high internal consistency of all items (Cronbach's alpha = 0.98) indicating item redundancy; unidimensionality of the SFS was supported by principal component analysis; good item response was confirmed by Rasch analysis; and a floor effect of four items depicting very heavy material handling was found. Experts agreed on 8 out of the 50 SFS as relevant (M3). From the original SFS, 12 items met the predefined summary score of 9. Conclusions A modified version of the SFS with 20 items has been developed. Feasibility, reliability and validity of this modified version must be tested before it can be used in clinical practice. PMID:26499967

  14. Serotype 1 viruses modified by backpassage or insertional mutagenesis: approaching the threshold of vaccine efficacy in Marek's disease.

    PubMed

    Witter, R L; Kreager, K S

    2004-12-01

    Improved vaccines to control Marek's disease (MD) in chickens are desired by the poultry industry but have been difficult to develop. Studies were conducted to evaluate strategies for deriving MD vaccines of high protective efficacy, irrespective of virulence. Candidate viruses from parent strains representing v and vv+ pathotypes were modified by cell culture passage, backpassage in chickens, or insertional mutagenesis following cocultivation with retroviruses. Ten strains considered most likely to exhibit high protective efficacy were selected for further study. The ability of these modified viruses to protect commercial or maternal antibody-positive (ab+) chickens against virulent MD virus (MDV) challenge was compared with that of strain CVI988, the standard commercial MD vaccine. Modified strains were also evaluated for the ability to induce lymphomas or other pathologic changes in ab+ and antibody-negative (ab-) chickens. Two of the 10 modified viruses, strains RM1 and CVI988/BP5, provided high levels of protection against highly virulent MDV challenge. The magnitude of protection was greater than that of one laboratory and two commercial preparations of CV1988, but was approximately equal to that of two other commercial preparations of CVI988 in laboratory and field tests. Three of the strains, including RMI and CVI988/BP5, induced lymphoid organ atrophy in ab-chicks but not in ab+ commercial chicks, a property designated here as L phenotype. Seven strains, including two L+ strains, were mildly oncogenic for ab- chicks, a property designated here as O phenotype. Five of these strains caused no tumors in ab+ chickens. The two fully attenuated strains induced neither lymphomas nor lymphoid organ atrophy. The L and O phenotypes appeared not to be linked, and both (especially the L phenotype) appeared associated with high levels of protection. These studies also illustrated differences in the protective efficacy of different preparations of CVI988 vaccine

  15. [Large distal anterior cerebral artery aneurysm associated with azygos anterior cerebral artery: case report].

    PubMed

    Suzuki, Y; Kawamata, T; Matsumoto, H; Kunii, N; Matsumoto, K

    1998-10-01

    A 51-year-old woman presented with a distal anterior cerebral artery aneurysm (DACAA) manifesting as severe headache and monoparesis of the left lower limb. Computed tomography revealed subarachnoid hemorrhage in the interhemispheric fissure, bilateral sylvian fissures, and basal cistern, and a hematoma in the supracallosal region. Angiography showed a large aneurysm (23 x 18 mm) located on the distal end of the azygos anterior cerebral artery (azygos ACA) at the supracallosal portion. T2-weighted magnetic resonance imaging demonstrated the hematoma as a mixed intensity mass, compressing the corpus callosum downward, and the aneurysm as a flow void anterior to the hematoma. Unilateral frontoparietal parasagittal craniotomy was performed with a horse-shoe shaped incision. The aneurysm was clipped via the interhemispheric approach, and the hematoma was aspirated. Postoperative angiography showed disappearance of the aneurysm and intact azygos ACA. The patient was discharged with mild monoparesis, paresthesia of the left lower limb and diagnostic dyspraxia. DACAA almost always arises at or near the genu of the corpus callosum and is often associated with vascular anomaly. In the literature, 22 of 26 cases of large and giant DACAA were located at or near the genu, but only 3 cases, including ours, in the supracallosal area. 11 cases were associated with azygos ACA. Therefore, hemodynamic stress caused by vascular anomaly may be involved in the formation of large or giant DACAA in contrast with cases of normal DACAA. PMID:9789300

  16. Right upper lobe lung cancer: Resection through left anterior mediastinotomy.

    PubMed

    Sirois, Marco; Abu Arab, Walid; Turcotte, Eric; Poulin, Yannick

    2016-01-01

    There is sparse information concerning approaches to metachronous lung cancer in patients who had a previous pneumonectomy for lung carcinoma. We describe the case of a 55-year-old woman who underwent a left pneumonectomy for lung carcinoma. Four years later, a radiological examination revealed a hypermetabolic nodule in the right upper lobe, which was located in the left hemithorax because of right lung hyperinflation and a mediastinal shift to the left. Wedge resection was carried out through a left anterior mediastinotomy. We believe that an anterior mediastinotomy represents a valuable option for the management of recurrent lung cancer after previous surgery. PMID:26124429

  17. Anterior spinal cord syndrome of unknown etiology

    PubMed Central

    Klakeel, Merrine; Thompson, Justin; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome. PMID:25552812

  18. 38 CFR 3.379 - Anterior poliomyelitis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it...

  19. Anterior Hepatic Transection for Caudate Lobectomy

    PubMed Central

    Chaib, Eleazar; Ribeiro, Marcelo A F; de Souza, Yngrid Ellyn Dias Maciel; D’Albuquerque, Luiz Augusto C

    2009-01-01

    Resection of the caudate lobe (segment I- dorsal sector, segment IX- right paracaval region, or both) is often technically difficult due to the lobe’s location deep in the hepatic parenchyma and because it is adjacent to the major hepatic vessels (e.g., the left and middle hepatic veins). A literature search was conducted using Ovid MEDLINE for the terms “caudate lobectomy” and “anterior hepatic transection” (AHT) covering 1992 to 2007. AHT was used in 110 caudate lobectomies that are discussed in this review. Isolated caudate lobectomy was performed on 28 (25.4%) patients, with 11 case (11%) associated with hepatectomy, while 1 (0.9%) was associated with anterior segmentectomy. Complete caudate lobectomy was performed on 82 (74.5%) patients. Hepatocellular carcinoma was observed in 106 (96.3%) patients, while 1 (0.9%) had hemangioma and 3 (2.7%) had metastatic caudate tumors. AHT was used in 108 (98.1%) caudate resections, while AHT associated with a right-sided approach was performed in 2 (1.8%) cases. AHT is recommended for tumors located in the paracaval portion of the caudate lobe (segment IX). AHT is usually a safe and potentially curative surgical option. PMID:19936187

  20. Anterior vaginal wall prolapse and voiding dysfunction in urogynecology patients.

    PubMed

    Schimpf, Megan O; O'Sullivan, David M; LaSala, Christine A; Tulikangas, Paul K

    2007-07-01

    We investigated whether women with and without anterior vaginal wall prolapse have voiding differences. Women (n=109) who presented to a urogynecology practice were categorized into two groups based on anterior vaginal wall prolapse: stages 0 and 1 and stages 2, 3, and 4. Women with prolapse were older than the women without prolapse but the groups were otherwise similar demographically. There was a higher rate of activity-related urine loss and use of wetness protection amongst women without prolapse. There was no significant difference for urgency symptoms or urge incontinence. Urodynamic testing found no significant differences for maximal flow rate or maximal urethral closing pressures. Postvoid residual volume and detrusor overactivity were not different but approached significance. Anterior vaginal wall prolapse of stage 2 or greater was not associated with urge incontinence or voiding function in this population. Women without prolapse were more likely to report stress incontinence. PMID:17031486

  1. Cytotoxicity of ZnO Nanoparticles Can Be Tailored by Modifying Their Surface Structure: A Green Chemistry Approach for Safer Nanomaterials.

    PubMed

    Punnoose, Alex; Dodge, Kelsey; Rasmussen, John W; Chess, Jordan; Wingett, Denise; Anders, Catherine

    2014-07-01

    ZnO nanoparticles (NP) are extensively used in numerous nanotechnology applications; however, they also happen to be one of the most toxic nanomaterials. This raises significant environmental and health concerns and calls for the need to develop new synthetic approaches to produce safer ZnO NP, while preserving their attractive optical, electronic, and structural properties. In this work, we demonstrate that the cytotoxicity of ZnO NP can be tailored by modifying their surface-bound chemical groups, while maintaining the core ZnO structure and related properties. Two equally sized (9.26 ± 0.11 nm) ZnO NP samples were synthesized from the same zinc acetate precursor using a forced hydrolysis process, and their surface chemical structures were modified by using different reaction solvents. X-ray diffraction and optical studies showed that the lattice parameters, optical properties, and band gap (3.44 eV) of the two ZnO NP samples were similar. However, FTIR spectroscopy showed significant differences in the surface structures and surface-bound chemical groups. This led to major differences in the zeta potential, hydrodynamic size, photocatalytic rate constant, and more importantly, their cytotoxic effects on Hut-78 cancer cells. The ZnO NP sample with the higher zeta potential and catalytic activity displayed a 1.5-fold stronger cytotoxic effect on cancer cells. These results suggest that by modifying the synthesis parameters/conditions and the surface chemical structures of the nanocrystals, their surface charge density, catalytic activity, and cytotoxicity can be tailored. This provides a green chemistry approach to produce safer ZnO NP. PMID:25068096

  2. Cytotoxicity of ZnO Nanoparticles Can Be Tailored by Modifying Their Surface Structure: A Green Chemistry Approach for Safer Nanomaterials

    PubMed Central

    2015-01-01

    ZnO nanoparticles (NP) are extensively used in numerous nanotechnology applications; however, they also happen to be one of the most toxic nanomaterials. This raises significant environmental and health concerns and calls for the need to develop new synthetic approaches to produce safer ZnO NP, while preserving their attractive optical, electronic, and structural properties. In this work, we demonstrate that the cytotoxicity of ZnO NP can be tailored by modifying their surface-bound chemical groups, while maintaining the core ZnO structure and related properties. Two equally sized (9.26 ± 0.11 nm) ZnO NP samples were synthesized from the same zinc acetate precursor using a forced hydrolysis process, and their surface chemical structures were modified by using different reaction solvents. X-ray diffraction and optical studies showed that the lattice parameters, optical properties, and band gap (3.44 eV) of the two ZnO NP samples were similar. However, FTIR spectroscopy showed significant differences in the surface structures and surface-bound chemical groups. This led to major differences in the zeta potential, hydrodynamic size, photocatalytic rate constant, and more importantly, their cytotoxic effects on Hut-78 cancer cells. The ZnO NP sample with the higher zeta potential and catalytic activity displayed a 1.5-fold stronger cytotoxic effect on cancer cells. These results suggest that by modifying the synthesis parameters/conditions and the surface chemical structures of the nanocrystals, their surface charge density, catalytic activity, and cytotoxicity can be tailored. This provides a green chemistry approach to produce safer ZnO NP. PMID:25068096

  3. A theoretical introduction to "combinatory SYBRGreen qPCR screening", a matrix-based approach for the detection of materials derived from genetically modified plants.

    PubMed

    Van den Bulcke, Marc; Lievens, Antoon; Barbau-Piednoir, Elodie; MbongoloMbella, Guillaume; Roosens, Nancy; Sneyers, Myriam; Casi, Amaya Leunda

    2010-03-01

    The detection of genetically modified (GM) materials in food and feed products is a complex multi-step analytical process invoking screening, identification, and often quantification of the genetically modified organisms (GMO) present in a sample. "Combinatory qPCR SYBRGreen screening" (CoSYPS) is a matrix-based approach for determining the presence of GM plant materials in products. The CoSYPS decision-support system (DSS) interprets the analytical results of SYBRGREEN qPCR analysis based on four values: the C(t)- and T(m) values and the LOD and LOQ for each method. A theoretical explanation of the different concepts applied in CoSYPS analysis is given (GMO Universe, "Prime number tracing", matrix/combinatory approach) and documented using the RoundUp Ready soy GTS40-3-2 as an example. By applying a limited set of SYBRGREEN qPCR methods and through application of a newly developed "prime number"-based algorithm, the nature of subsets of corresponding GMO in a sample can be determined. Together, these analyses provide guidance for semi-quantitative estimation of GMO presence in a food and feed product. PMID:19960341

  4. Fine-Needle Aspiration Followed by Core-Needle Biopsy in the Same Setting: Modifying Our Approach.

    PubMed

    Joudeh, Amani A; Shareef, Sameera Q; Al-Abbadi, Mousa A

    2016-01-01

    Fine-needle aspiration biopsy (FNAB) is a well-established initial diagnostic tool. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis. Consequently, patients have to undergo another diagnostic procedure. The second procedure is either repeat FNAB, core-needle or open biopsy, and can be inconvenient and costly. In some centers, the FNAB is immediately followed by core-needle biopsy (CNB) in the same setting after assuring adequacy on the initial FNAB utilizing rapid on-site specimen evaluation (ROSE). It is argued that implementing such an approach will eventually have additional critical advantages that include the following: (a) it is more convenient to patients to have both procedures in one visit, (b) the tissue procured by both procedures will be more adequate, enabling cytopathologists to reach an accurate diagnosis, and (c) it is ultimately a cost-effective approach if we take into consideration the avoidance of a potential second more invasive diagnostic procedure. Since we are living in an era of patient-centered medicine coupled with cost-cutting strategies, we present here a brief review of the topic with analysis of this alternative approach, review of the pertinent literature and shed light on a few scenarios that justify this approach. PMID:26963594

  5. Robotic Anterior and Midline Skull Base Surgery: Preclinical Investigations

    SciTech Connect

    O'Malley, Bert W. Weinstein, Gregory S.

    2007-10-01

    Purpose: To develop a minimally invasive surgical technique to access the midline and anterior skull base using the optical and technical advantages of robotic surgical instrumentation. Methods and Materials: Ten experimental procedures focusing on approaches to the nasopharynx, clivus, sphenoid, pituitary sella, and suprasellar regions were performed on one cadaver and one live mongrel dog. Both the cadaver and canine procedures were performed in an approved training facility using the da Vinci Surgical Robot. For the canine experiments, a transoral robotic surgery (TORS) approach was used, and for the cadaver a newly developed combined cervical-transoral robotic surgery (C-TORS) approach was investigated and compared with standard TORS. The ability to access and dissect tissues within the various areas of the midline and anterior skull base were evaluated, and techniques to enhance visualization and instrumentation were developed. Results: Standard TORS approaches did not provide adequate access to the midline and anterior skull base; however, the newly developed C-TORS approach was successful in providing the surgical access to these regions of the skull base. Conclusion: Robotic surgery is an exciting minimally invasive approach to the skull base that warrants continued preclinical investigation and development.

  6. Electronic structure engineering of ZnO with the modified Becke-Johnson exchange versus the classical correlation potential approaches

    NASA Astrophysics Data System (ADS)

    Haq, Bakhtiar Ul; Ahmed, R.; Goumri-Said, Souraya; Shaari, A.; Afaq, A.

    2013-12-01

    In this study, we report investigations of structural and electronic properties of ZnO in wurtzite (WZ), rock salt (RS) and zinc-blende (ZB) phases. Calculations have been done with full-potential linearized augmented plane wave plus local orbital method developed within the frame work of Density Functional Theory (DFT). For structural properties investigations, Perdew and Wang proposed local density approximations (LDA) and Perdew et al. proposed generalized gradient approximations (GGA) have been applied. Where for electronic properties in addition to these, Tran-Blaha modified Becke-Johnson (mBJ) potential has been used. Our computed band gap values of ZnO in WZ and ZB phases with mBJ potential are significantly improved compared to those with LDA and GGA; however, in RS phase, energy gap is significantly overestimated compared to experimental measurements. The Zn-d band was found to be more narrower with mBJ potential than that of LDA and GGA. On the other hand, our evaluated crystal field splitting energy values overestimate the experimental values.

  7. Foreign body embedded in anterior chamber angle.

    PubMed

    Graffi, Shmuel; Tiosano, Beatrice; Ben Cnaan, Ran; Bahir, Jonathan; Naftali, Modi

    2012-01-01

    Introduction. We present a case of a metallic foreign body embedded in the anterior chamber angle. After standing in close proximity to a construction worker breaking a tile, a 26-year-old woman using soft contact lens for the correction of mild myopia presented to emergency department for evaluation of a foreign body sensation of her right eye. Methods and Results. Diagnosis was confirmed by gonioscopic examination and a noncontrast CT scan of head and orbits. The foreign body was removed by an external approach without utilizing a magnet. The patient's final outcome was favorable. Discussion. The above is a rare clinical situation, which is impossible to detect on slit-lamp examination without a gonioscopic view. Proper imaging and a specific management are mandatory in order to achieve favorable outcome. PMID:23091762

  8. A new approach to gene therapy using Sleeping Beauty to genetically modify clinical-grade T cells to target CD19

    PubMed Central

    Singh, Harjeet; Huls, Helen; Cooper, Laurence JN

    2014-01-01

    Summary The advent of efficient approaches to the genetic modification of T cells has provided investigators with clinically appealing approaches to improve the potency of tumor-specific clinical grade T cells. For example, gene therapy has been successfully used to enforce expression of chimeric antigen receptors (CAR) that provide T cells with ability to directly recognize tumor-associated antigens without the need for presentation by human leukocyte antigen. Gene transfer of CARs can be undertaken using viral-based and non-viral approaches. We have advanced DNA vectors derived from the Sleeping Beauty (SB) system to avoid the expense and manufacturing difficulty associated with transducing T cells with recombinant viral vectors. After electroporation, the transposon/transposase system improves the efficiency of integration of plasmids used to express CAR and other transgenes in T cells. The SB system combined with artificial antigen-presenting cells (aAPC) can selectively propagate and thus retrieve CAR+ T cells suitable for human application. This review describes the translation of the SB system and aAPC for use in clinical trials and highlights how a nimble and cost-effective approach to developing genetically modified T cells can be used to implement clinical trials infusing next-generation T cells with improved therapeutic potential. PMID:24329797

  9. Transabdominal Robot-Assisted Laparoscopic Urethral Diverticulectomy of a Complex Anterior Horseshoe Diverticulum of the Proximal Urethra

    PubMed Central

    Sivarajan, Ganesh; Glickman, Leonard; Faber, Kenneth; Kim, Michelle; Fromer, Debra

    2015-01-01

    Abstract Complex, proximal, anteriorly located urethral diverticula present the reconstructive urologist with a uniquely challenging task for repair through a conventional transvaginal approach. Herein, we present the first report of urethral diverticulectomy to excise a large, anterior, horseshoe-shaped urethral diverticulum that resulted in bladder outlet obstruction, using a transabdominal robot-assisted laparoscopic approach.

  10. Troubleshooting thoracoscopic anterior mediastinal surgery: lessons learned from thoracoscopic lobectomy

    PubMed Central

    Hirji, Sameer A.; Balderson, Scott S.; Berry, Mark F.

    2015-01-01

    Video-assisted thoracoscopic surgery (VATS) lobectomy is safe, oncologically effective, and increasingly utilized for lung cancer resection. Lessons from VATS lobectomy experience can guide the use of a VATS approach to resect mediastinal masses. Exposure and dissection when using VATS to resect anterior mediastinal masses has unique challenges. Several maneuvers acquired from experience with VATS lobectomy can reduce the technical difficulty and often prevent conversion to an open approach. In this troubleshooting guide, we offer ‘tips’ to both avoid and manage numerous intra-operative technical difficulties that commonly arise during VATS anterior mediastinal procedures. Avoiding an open approach may improve outcomes, although conversion for safety or complete resection can be necessary. Techniques and experiences derived from VATS lobectomy can facilitate VATS resection of mediastinal masses. PMID:26693151

  11. A Novel Approach to Decrease Sialic Acid Expression in Cells by a C-3-modified N-Acetylmannosamine*

    PubMed Central

    Wratil, Paul R.; Rigol, Stephan; Solecka, Barbara; Kohla, Guido; Kannicht, Christoph; Reutter, Werner; Giannis, Athanassios; Nguyen, Long D.

    2014-01-01

    Due to its position at the outermost of glycans, sialic acid is involved in a myriad of physiological and pathophysiological cell functions such as host-pathogen interactions, immune regulation, and tumor evasion. Inhibitors of cell surface sialylation could be a useful tool in cancer, immune, antibiotic, or antiviral therapy. In this work, four different C-3 modified N-acetylmannosamine analogs were tested as potential inhibitors of cell surface sialylation. Peracetylated 2-acetylamino-2-deoxy-3-O-methyl-d-mannose decreases cell surface sialylation in Jurkat cells in a dose-dependent manner up to 80%, quantified by flow cytometry and enzyme-linked lectin assays. High-performance liquid chromatography experiments revealed that not only the concentration of membrane bound but also of cytosolic sialic acid is reduced in treated cells. We have strong evidence that the observed reduction of sialic acid expression in cells is caused by the inhibition of the bifunctional enzyme UDP-GlcNAc-2-epimerase/ManNAc kinase. 2-Acetylamino-2-deoxy-3-O-methyl-d-mannose inhibits the human ManNAc kinase domain of the UDP-GlcNAc-2-epimerase/ManNAc kinase. Binding kinetics of the inhibitor and human N-acetylmannosamine kinase were evaluated using surface plasmon resonance. Specificity studies with human N-acetylglucosamine kinase and hexokinase IV indicated a high specificity of 2-acetylamino-2-deoxy-3-O-methyl-d-mannose for MNK. This substance represents a novel class of inhibitors of sialic acid expression in cells, targeting the key enzyme of sialic acid de novo biosynthesis. PMID:25278018

  12. A novel approach to decrease sialic acid expression in cells by a C-3-modified N-acetylmannosamine.

    PubMed

    Wratil, Paul R; Rigol, Stephan; Solecka, Barbara; Kohla, Guido; Kannicht, Christoph; Reutter, Werner; Giannis, Athanassios; Nguyen, Long D

    2014-11-14

    Due to its position at the outermost of glycans, sialic acid is involved in a myriad of physiological and pathophysiological cell functions such as host-pathogen interactions, immune regulation, and tumor evasion. Inhibitors of cell surface sialylation could be a useful tool in cancer, immune, antibiotic, or antiviral therapy. In this work, four different C-3 modified N-acetylmannosamine analogs were tested as potential inhibitors of cell surface sialylation. Peracetylated 2-acetylamino-2-deoxy-3-O-methyl-D-mannose decreases cell surface sialylation in Jurkat cells in a dose-dependent manner up to 80%, quantified by flow cytometry and enzyme-linked lectin assays. High-performance liquid chromatography experiments revealed that not only the concentration of membrane bound but also of cytosolic sialic acid is reduced in treated cells. We have strong evidence that the observed reduction of sialic acid expression in cells is caused by the inhibition of the bifunctional enzyme UDP-GlcNAc-2-epimerase/ManNAc kinase. 2-Acetylamino-2-deoxy-3-O-methyl-D-mannose inhibits the human ManNAc kinase domain of the UDP-GlcNAc-2-epimerase/ManNAc kinase. Binding kinetics of the inhibitor and human N-acetylmannosamine kinase were evaluated using surface plasmon resonance. Specificity studies with human N-acetylglucosamine kinase and hexokinase IV indicated a high specificity of 2-acetylamino-2-deoxy-3-O-methyl-D-mannose for MNK. This substance represents a novel class of inhibitors of sialic acid expression in cells, targeting the key enzyme of sialic acid de novo biosynthesis. PMID:25278018

  13. evaluation of the bioconversion of genetically modified switchgrass using simultaneous saccharification and fermentation ans a consolidated bioprocessing approach

    SciTech Connect

    Yee, Kelsey L; Rodriguez, Jr., Miguel; Tschaplinski, Timothy J; Engle, Nancy L; Martin, Madhavi Z; Fu, Chunxiang; Wang, Zeng-Yu; Hamilton-Brehm, Scott; Mielenz, Jonathan R

    2012-01-01

    Abstract Background: The inherent recalcitrance of lignocellulosic biomass is one of the major economic hurdles for the production of fuels and chemicals from biomass. Additionally, lignin is recognized as having a negative impact on enzymatic hydrolysis of biomass, and as a result much interest has been placed on modifying the lignin pathway to improve bioconversion of lignocellulosic feedstocks. Results: Previous results showed down-regulation of the caffeic acid 3-O-methyl transferase (COMT) gene in the lignin pathway yielded switchgrass (Panicum virgatum) that was more susceptible to bioconversion after dilute acid pretreatment. Here we examined the response of these plant lines to milder pretreatment conditions with yeast-based SSF, CBP with Clostridium thermocellum, and fermentations with the cellulolytic extreme thermophiles, Caldicellulosiruptor bescii and Caldicellulosiruptor obsidiansis. Unlike the S. cerevisiae SSF conversions, fermentations of pretreated down-regulated COMT transgenic switchgrass with C. thermocellum showed an apparent inhibition of fermentation not observed in the wild-type switchgrass. This inhibition can be eliminated by hot water extraction of the pretreated biomass which resulted in superior conversion yield with transgenic versus wild-type switchgrass for C. thermocellum, also exceeding the yeast-based SSF yield. Further fermentation evaluation of the transgenic switchgrass indicated differential inhibition for the Caldicellulosiruptor strains, which could not be rectified by additional processing conditions. Gas chromatography-mass spectrometry metabolite profiling was used to examine the fermentation broth to elucidate the relative abundance of lignin derived aromatic compounds. The types and abundance of fermentation-derived lignin constituents varied between C. thermocellum and each of the Caldicellulosiruptor strains. Conclusions: The down-regulation of the COMT gene improves the bioconversion of switchgrass relative to the

  14. Combined posterior flap and anterior suspended flap dacryocystorhinostomy: A modification of external dacryocystorhinostomy

    PubMed Central

    Deka, Amarendra; Saikia, S. P.; Bhuyan, S. K.

    2010-01-01

    Background: External dacryocystorhinostomy (DCR) remains a reliable surgical technique for the treatment of obstruction of lacrimal drainage system beyond the common canalicular opening. Aim: To describe a simple modified double flap external DCR technique. Materials and Methods: Ninety six consecutive cases of chronic dacryocystitis with or without mucocele were selected irrespective of age and sex. In a modification to routine external DCR, a modified technique was followed, where both anterior and posterior flaps of lacrimal sac and nasal mucosa are created and sutured. Two double armed sutures were used to join the edges of anterior flaps, and elevate them anteriorly to avoid adhesion or apposition with underlying sutured posterior flaps, and to approximate the deep plane of the wound. Results: At the end of average follow-up period of 13 months, we observed 98.9% objective and 96.8% subjective success rates. The average operation time was 45 minutes. No significant intraoperative or postoperative complications were noticed. Conclusion: We believe that combined posterior flap and anterior suspended flap DCR technique is simple to perform and has the advantage of both double flap DCR and anterior suspension of anterior flaps. The results of the study showed the efficacy of this simple modification. PMID:20606867

  15. De Novo Proteome Analysis of Genetically Modified Tumor Cells By a Metabolic Labeling/Azide-alkyne Cycloaddition Approach*

    PubMed Central

    Ballikaya, Seda; Lee, Jennifer; Warnken, Uwe; Schnölzer, Martina; Gebert, Johannes; Kopitz, Jürgen

    2014-01-01

    Activin receptor type II (ACVR2) is a member of the transforming growth factor type II receptor family and controls cell growth and differentiation, thereby acting as a tumor suppressor. ACVR2 inactivation is known to drive colorectal tumorigenesis. We used an ACVR2-deficient microsatellite unstable colon cancer cell line (HCT116) to set up a novel experimental design for comprehensive analysis of proteomic changes associated with such functional loss of a tumor suppressor. To this end we combined two existing technologies. First, the ACVR2 gene was reconstituted in an ACVR2-deficient colorectal cancer (CRC) cell line by means of recombinase-mediated cassette exchange, resulting in the generation of an inducible expression system that allowed the regulation of ACVR2 gene expression in a doxycycline-dependent manner. Functional expression in the induced cells was explicitly proven. Second, we used the methionine analog azidohomoalanine for metabolic labeling of newly synthesized proteins in our cell line model. Labeled proteins were tagged with biotin via a Click-iT chemistry approach enabling specific extraction of labeled proteins by streptavidin-coated beads. Tryptic on-bead digestion of captured proteins and subsequent ultra-high-performance LC coupled to LTQ Orbitrap XL mass spectrometry identified 513 proteins, with 25 of them differentially expressed between ACVR2-deficient and -proficient cells. Among these, several candidates that had already been linked to colorectal cancer or were known to play a key role in cell growth or apoptosis control were identified, proving the utility of the presented experimental approach. In principle, this strategy can be adapted to analyze any gene of interest and its effect on the cellular de novo proteome. PMID:25225355

  16. Fault diagnosis of nonlinear and large-scale processes using novel modified kernel Fisher discriminant analysis approach

    NASA Astrophysics Data System (ADS)

    Shi, Huaitao; Liu, Jianchang; Wu, Yuhou; Zhang, Ke; Zhang, Lixiu; Xue, Peng

    2016-04-01

    It is pretty significant for fault diagnosis timely and accurately to improve the dependability of industrial processes. In this study, fault diagnosis of nonlinear and large-scale processes by variable-weighted kernel Fisher discriminant analysis (KFDA) based on improved biogeography-based optimisation (IBBO) is proposed, referred to as IBBO-KFDA, where IBBO is used to determine the parameters of variable-weighted KFDA, and variable-weighted KFDA is used to solve the multi-classification overlapping problem. The main contributions of this work are four-fold to further improve the performance of KFDA for fault diagnosis. First, a nonlinear fault diagnosis approach with variable-weighted KFDA is developed for maximising separation between the overlapping fault samples. Second, kernel parameters and features selection of variable-weighted KFDA are simultaneously optimised using IBBO. Finally, a single fitness function that combines erroneous diagnosis rate with feature cost is created, a novel mixed kernel function is introduced to improve the classification capability in the feature space and diagnosis accuracy of the IBBO-KFDA, and serves as the target function in the optimisation problem. Moreover, an IBBO approach is developed to obtain the better quality of solution and faster convergence speed. On the one hand, the proposed IBBO-KFDA method is first used on Tennessee Eastman process benchmark data sets to validate the feasibility and efficiency. On the other hand, IBBO-KFDA is applied to diagnose faults of automation gauge control system. Simulation results demonstrate that IBBO-KFDA can obtain better kernel parameters and feature vectors with a lower computing cost, higher diagnosis accuracy and a better real-time capacity.

  17. SAAFEC: Predicting the Effect of Single Point Mutations on Protein Folding Free Energy Using a Knowledge-Modified MM/PBSA Approach

    PubMed Central

    Getov, Ivan; Petukh, Marharyta; Alexov, Emil

    2016-01-01

    Folding free energy is an important biophysical characteristic of proteins that reflects the overall stability of the 3D structure of macromolecules. Changes in the amino acid sequence, naturally occurring or made in vitro, may affect the stability of the corresponding protein and thus could be associated with disease. Several approaches that predict the changes of the folding free energy caused by mutations have been proposed, but there is no method that is clearly superior to the others. The optimal goal is not only to accurately predict the folding free energy changes, but also to characterize the structural changes induced by mutations and the physical nature of the predicted folding free energy changes. Here we report a new method to predict the Single Amino Acid Folding free Energy Changes (SAAFEC) based on a knowledge-modified Molecular Mechanics Poisson-Boltzmann (MM/PBSA) approach. The method is comprised of two main components: a MM/PBSA component and a set of knowledge based terms delivered from a statistical study of the biophysical characteristics of proteins. The predictor utilizes a multiple linear regression model with weighted coefficients of various terms optimized against a set of experimental data. The aforementioned approach yields a correlation coefficient of 0.65 when benchmarked against 983 cases from 42 proteins in the ProTherm database. Availability: the webserver can be accessed via http://compbio.clemson.edu/SAAFEC/. PMID:27070572

  18. A modified vaginal wall patch sling technique as a first-line surgical approach for genuine stress incontinence with urethral hypermobility: long-term follow up.

    PubMed

    Mikhail, Magdy S; Rosa, Hector; Packer, Paul; Palan, Prabhudas; Lazarou, George

    2004-01-01

    We describe our long-term outcome for patients with genuine stress incontinence (GSI) and urethral hypermobility using a modified vaginal wall patch sling technique. Fifty-three patients were studied. Preoperatively, all patients had a positive standing stress test and urethral hypermobility on Q-tip testing. On urodynamics, all patients had absence of detrusor contractions on subtracted cystometry. The mean age of the patients was 45+10.2 years. Forty-four patients demonstrated complete symptomatic and urodynamic improvement. Five patients had a noticeable failure observed within the first 12 months of follow up and four patients developed later recurrence despite initial success. The overall success rate after 5 years of follow up was 83% (n=44/53). The modified vaginal wall patch sling technique appears to have a good long-term success rate with low operative morbidity and minimal postoperative voiding dysfunction. The patch sling can be used as a first-line surgical approach for GSI with urethral hypermobility and be combined with other vaginal surgery. PMID:15014942

  19. Stereopsis after anterior temporal lobectomy.

    PubMed

    Verhoef, Bram-Ernst; Decramer, Thomas; van Loon, Johannes; Goffin, Jan; Van Paesschen, Wim; Janssen, Peter; Theys, Tom

    2016-09-01

    Brain areas critical for stereopsis have been investigated in non-human primates but are largely unknown in the human brain. Microelectrode recordings and functional MRI (fMRI) studies in monkeys have shown that in monkeys the inferior temporal cortex is critically involved in 3D shape categorization. Furthermore, some human fMRI studies similarly suggest an involvement of visual areas in the temporal lobe in depth perception. We aimed to investigate the role of the human anterior temporal neocortex in stereopsis by assessing stereoscopic depth perception before and after anterior temporal lobectomy. Eighteen epilepsy surgery patients were tested, pre- and postoperatively, in 3 different depth discrimination tasks. Sensitivity for local and global disparity was tested in a near-far discrimination task and sensitivity for 3D curvature was assessed in a convex-concave discrimination task, where 3D shapes were presented at different positions in depth. We found no evidence that temporal lobe epilepsy surgery has a significant effect on stereopsis. In contrast with earlier findings, we conclude that local as well as global stereopsis is maintained after unilateral resection of the temporal pole in epilepsy surgery patients. Our findings, together with previous studies, suggest that in humans more posterior visual regions underlie depth perception. PMID:27344239

  20. Synthesis, characterization and optical properties of in situ ZnFe2O4 functionalized rGO nano hybrids through modified solvothermal approach

    NASA Astrophysics Data System (ADS)

    Ameer, Shahid; Gul, Iftikhar Hussain; Mahmood, Nasir; Mujahid, Muhammad

    2015-07-01

    Graphene, honeycomb structure of carbon having exceptional characteristics have attracted researcher's interest and is now being studied and used in numerous technological areas and next generation nano devices. In this research work, reduced graphene oxide was functionalized with magnetic nano crystals, i.e. ZnFe2O4 via modified solvothermal approach. X-ray diffraction and Micro Raman spectroscopy was used to confirm structural aspects of synthesized graphene oxide and ZnFe2O4 pristine magnetic nano crystals and the functionalized rGO-ZnFe2O4 nano hybrid. Morphology were analyzed through SEM showing that the particles sizes were in between 24 and 27 nm range attached to reduced graphene oxide sheets while composition and valence state of functional groups were analyzed through XPS. UV-Vis spectroscopy was carried out for analyzing their optical absorption behavior. Their optical characteristics were explained in depth in relation with their structural aspects and functionalization behavior.

  1. Surgical Treatment of Synovial Osteochondromatosis of the Hip Using a Modified-Hardinge Approach with a Z-Shaped Capsular Incision

    PubMed Central

    Fukunishi, Shigeo; Nishio, Shoji; Fujihara, Yuki; Fukui, Tomokazu; Okahisa, Shohei; Yoshiya, Shinichi

    2015-01-01

    Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip. PMID:26793291

  2. Surgical Treatment of Synovial Osteochondromatosis of the Hip Using a Modified-Hardinge Approach with a Z-Shaped Capsular Incision.

    PubMed

    Takeda, Yu; Fukunishi, Shigeo; Nishio, Shoji; Fujihara, Yuki; Fukui, Tomokazu; Okahisa, Shohei; Yoshiya, Shinichi

    2015-12-28

    Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip. PMID:26793291

  3. Incidental Anterior Cruciate Ligament Calcification: Case Report

    PubMed Central

    Hayashi, Hisami; Fischer, Hans

    2016-01-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding. PMID:27200163

  4. Anterior Cingulate epilepsy: mechanisms and modulation

    PubMed Central

    Chang, Wei-Pang; Shyu, Bai-Chuang

    2014-01-01

    Epilepsy is a common neurological disorder, about 1% population worldwide suffered from this disease. In 1989, the International League Against Epilepsy (ILAE) classified anterior cingulate epilepsy as a form of frontal lobe epilepsy (FLE). FLE is the second most common type of epilepsy. Previous clinical studies showed that FLE account an important cause in refractory epilepsy, therefore to find alternative approach to modulate FLE is very important. Basic research using animal models and brain slice have revealed some insights on the epileptogenesis and modulation of seizure in anterior cingulate cortex (ACC). Interneurons play an important role in the synchronization of cingulate epilepsy. Research has shown that the epileptogenesis of seizure originated from mesial frontal lobe might be caused by a selective increase in nicotine-evoked γ-aminobutyric acid (GABA) inhibition, because the application of the GABAA receptor antagonist picrotoxin inhibited epileptic discharges. Gap junctions are also involved in the regulation of cingulate epilepsy. Previous studies have shown that the application of gap junction blockers could attenuate ACC seizures, while gap junction opener could enhance them in an in vitro preparation. μ-Opioid receptors have been shown to be involved in the epileptic synchronization mechanism in ACC seizures in a brain slice preparation. Application of the μ-opioid agonist DAMGO significantly abolished the ictal discharges in a 4-aminopyridine induced electrographic seizure model in ACC. Basic research has also found that thalamic modulation has an inhibitory effect on ACC seizures. Studies have shown that the medial thalamus may be a target for deep brain stimulation to cure ACC seizures. PMID:24427123

  5. Novel in vivo targets of ΔNp63 in keratinocytes identified by a modified chromatin immunoprecipitation approach

    PubMed Central

    Birkaya, Barbara; Ortt, Kori; Sinha, Satrajit

    2007-01-01

    Background p63 is a transcription factor that plays an important role in skin epidermal development and differentiation. The p63 gene encodes for two major protein isoforms, those containing an amino-terminal trans-activation domain (TAp63) and those lacking this domain (ΔNp63). Both the TA and ΔN transcripts are also alternatively spliced at the 3' end producing proteins with unique C-termini that are designated as α, β and γ isoforms. Recent research has suggested that ΔNp63 is the predominant isoform expressed and active in keratinocytes. Results To better elucidate the biological role of p63 in regulating gene expression in keratinocytes we performed chromatin immunoprecipitation (ChIP) experiments with ΔNp63-specific antibodies. We included an additional step in the ChIP procedure to enrich for ΔNp63 targets by screening the library of immunoprecipitated DNA for its ability to bind recombinant GST-ΔNp63. Cloning of ΔNp63-ChIP-derived DNA fragments identified more than 60 potential ΔNp63 target loci that were located close to or embedded within known or predicted genes. Identity of these target genes suggests that they may participate in a myriad of cellular processes including transcriptional regulation, signaling and metabolism. Here we confirm the binding of ΔNp63 to several of these genomic loci both by EMSA and replicate ChIP assays. Finally we show that the expression of many of these target genes is altered when ΔNp63 levels in keratinocytes are reduced by siRNA, further confirming that these are bona fide targets. Conclusion This unbiased genomic approach has allowed us to uncover functional targets of ΔNp63 and serves as the initial step in further analysis of the transcriptional regulatory mechanisms that are governed by p63 in keratinocytes. PMID:17521434

  6. Anterior insula reactivity during certain decisions is associated with neuroticism

    PubMed Central

    Feinstein, Justin S.; Stein, Murray B.; Paulus, Martin P.

    2006-01-01

    Neuroticism is a core personality trait that profoundly affects how individuals interpret and interact with their environment. Understanding neuroticism at a neurobiological level will be an important step toward identifying novel vulnerability factors for psychiatric illnesses such as depression and anxiety. Along these lines, recent work has identified neural activation patterns within the right anterior insula that correlates with an individual's degree of neuroticism. The present study aims to further characterize the circumstances under which neuroticism modulates insular activity. Sixteen healthy participants underwent functional magnetic resonance imaging while playing a card game with varying degrees of outcome uncertainty. Activation within the bilateral anterior insula was found during all decisions, irrespective of uncertainty. However, a significant positive correlation between neuroticism and anterior insula activity was found only during ‘certain decisions’ (i.e. situations where the most probable outcome was clearly evident). Moreover, an increase in the right anterior insula activity during certain decisions was related to a behavioral mirroring effect such that the response latency for certain decisions approached the response latency for uncertain decisions. These findings suggest that increasing levels of neuroticism modulate neural activation in such a way that the brain interprets certainty as uncertain. PMID:18985124

  7. Endoscopic fetal urethrotomy for anterior urethral valves: a preliminary report.

    PubMed

    Sago, Haruhiko; Hayashi, Satoshi; Chiba, Toshio; Ueoka, Katsuhiko; Matsuoka, Kentaro; Nakagawa, Atsuko; Kitagawa, Michihiro

    2008-01-01

    Anterior urethral valves are a rare congenital anomaly associated with distal urethral obstruction, which can result in a poor prognosis. We report on the endoscopic creation of a fetal urethrotomy for obstructive uropathy resulting from anterior urethral valves. A 33-year-old woman was evaluated at 17 weeks gestation due to fetal megacystis. The diagnosis of anterior urethral valves was confirmed by the characteristic sonographic feature of a dilated membranous penile urethra. Oligohydramnios with normal-appearing kidneys and favorable urinary electrolytes led to fetal intervention. Ablation on the ventral site of the fetal penis for a cutaneous urethrotomy was performed using a YAG laser under a 1-mm fetoscope at 19 weeks gestation. Urine was drained from the incision and the dilated penis and the distended bladder shrunk with an increase in amniotic fluid. However, the fetus died unexpectedly on postoperative day 3, and chorioamnionitis was suspected as the etiology. While the outcome was unfavorable, our preliminary experience shows that fetal urethrotomy for obstructive uropathy can be achieved in utero using an endoscopic laser approach. Further experience will be required to evaluate the therapeutic value of this new procedure in the management of fetal anterior urethral valves. PMID:18648205

  8. Novel Strategies for Anterior Segment Ocular Drug Delivery

    PubMed Central

    Cholkar, Kishore; Patel, Sulabh P.; Vadlapudi, Aswani Dutt

    2013-01-01

    Abstract Research advancements in pharmaceutical sciences have led to the development of new strategies in drug delivery to anterior segment. Designing a new delivery system that can efficiently target the diseased anterior ocular tissue, generate high drug levels, and maintain prolonged and effective concentrations with no or minimal side effects is the major focus of current research. Drug delivery by traditional method of administration via topical dosing is impeded by ocular static and dynamic barriers. Various products have been introduced into the market that prolong drug retention in the precorneal pocket and to improve bioavailability. However, there is a need of a delivery system that can provide controlled release to treat chronic ocular diseases with a reduced dosing frequency without causing any visual disturbances. This review provides an overview of anterior ocular barriers along with strategies to overcome these ocular barriers and deliver therapeutic agents to the affected anterior ocular tissue with a special emphasis on nanotechnology-based drug delivery approaches. PMID:23215539

  9. Modified cyanobacteria

    DOEpatents

    Vermaas, Willem F J.

    2014-06-17

    Disclosed is a modified photoautotrophic bacterium comprising genes of interest that are modified in terms of their expression and/or coding region sequence, wherein modification of the genes of interest increases production of a desired product in the bacterium relative to the amount of the desired product production in a photoautotrophic bacterium that is not modified with respect to the genes of interest.

  10. Anatomic Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Murawski, Christopher D.; Wolf, Megan R.; Araki, Daisuke; Muller, Bart; Tashman, Scott

    2013-01-01

    Anatomic anterior cruciate ligament (ACL) reconstruction is common procedure performed by orthopedic surgeons, particularly in association with sports-related injuries. Whereas traditional reconstruction techniques used a single bundle graft that was typically placed in a non-anatomic position, a renewed interest in anatomy has facilitated the popularization of anatomic reconstruction techniques. Recently, a focus has been placed on individualizing ACL surgery based on each patient’s native anatomical characteristics (e.g., insertion site size, notch size, and shape), thereby dictating the ultimate procedure of choice. As subjective outcome measurements have demonstrated varying outcomes with respect to single- versus double-bundle ACL reconstruction, investigators have turned to more objective techniques, such as in vivo kinematics, as a means of evaluating joint motion and cartilage contact mechanics. Further investigation in this area may yield important information with regard to the potential progression to osteoarthritis after ACL reconstruction, including factors affecting or preventing it. PMID:26069663

  11. Anteriorly Based Partial Thickness Sternocleidomastoid Muscle Flap Following Parotidectomy.

    PubMed

    Dalmia, Deepak; Behera, Sanjaya Kumar; Bhatia, Jas Simran Singh

    2016-03-01

    The anteriorly based partial thickness sternocleidomastoid (SCM) muscle flap is among the various methods described to correct parotidectomy defects, but its indications and limitations are not clearly demonstrated in several reports. This study was done to test the aesthetic outcome of this method, its indications and limitations. At Dr. Babasaheb Ambedkar Memorial hospital, Mumbai, 20 patients presenting with benign parotid tumors underwent parotidectomy. 16 underwent superficial parotidectomy and 3 underwent adequate parotidectomy, 1 had total parotidectomy. The anteriorly based partial thickness SCM muscle flap was used to correct the contour deformity and to prevent Frey syndrome. The aesthetic result was evaluated by assessing and scoring the overall appearance of the scar, the degree of symmetry of the reconstructed parotid region and the site of the donor muscle in comparison to their contralateral normal sides. The overall aesthetic appearance was good in 17 patients, and moderate in 3 patients. 17/20 patients had an overall deep satisfaction with the result. The residual hollowness following total parotidectomy defect and the poor quality of scars were the main reasons affecting the aesthetic outcome. Superficial parotidectomy through modified Blair's incision with immediate reconstruction with anteriorly based partial thickness SCM flap allows a satisfactory aesthetic outcome and minimal donor site morbidity. Scores of the above two parameters were accessed. Patients' satisfaction was assessed by patients questionnaire. PMID:27066413

  12. Lower incisor retraction with a modified corticotomy.

    PubMed

    Germeç, Derya; Giray, Bahadir; Kocadereli, Ilken; Enacar, Ayhan

    2006-09-01

    This case report demonstrates the orthodontic treatment facilitated with a new conservative corticotomy technique to shorten the treatment time during lower incisor retraction. The patient was a 22-year-old woman with protrusive profile, severe anterior crowding, an anterior crossbite, and Class III dental relationship. Orthodontic treatment consisted of the extraction of four first premolars with maximum anchorage. A modified corticotomy technique, in which the lingual vertical and subapical horizontal cuts were eliminated, was combined with orthodontic therapy for the retraction of the lower anterior teeth. Corticotomy-facilitated orthodontics dramatically reduced the treatment time without any adverse effects on the periodontium and the vitality of the teeth. The main advantages of this modified corticotomy technique were the elimination of the lingual cuts and flap, the reduction of surgery time, and minimum discomfort to the patient. At the end of active orthodontic therapy, balanced occlusion and facial esthetics were achieved. PMID:17029527

  13. Reconstruction of the anterior cruciate ligament.

    PubMed

    Seedhom, B B

    1992-01-01

    Ligaments are strong collagenous structures that act as constraints on joint motion, thus confining the articular surfaces to more or less the same paths. In so doing they prevent arbitrary apposition of these surfaces from occurring and resulting in abnormal stresses which may damage the joint surfaces. Ligaments rupture due to excessive loads, particularly those resulting from trauma occurring during sporting events or motor vehicle accidents. Knee and ankle joints have the highest frequency of ligamentous injuries. This paper is a brief review of the current approaches to the reconstruction of the knee ligaments with specific reference to the anterior cruciate ligament (ACL) being the most frequently reconstructed. This is not only because it is frequently injured but also because of the debilitating consequences of such an injury. Approaches ranging from the conservative to those that advocate the use of frank prosthetic replacement have been adopted by surgeons at both ends of the spectrum. Following a discussion of the rationale for reconstruction of the ACL, the mechanical and biological considerations of the reconstructive procedure are discussed. The different methods of ACL reconstruction are reviewed. These include: (a) primary repair, (b) reconstruction with different tissues, including autogenous allografts and xenografts, (c) reconstruction employing different synthetic devices. A brief discussion of the procedures used for reconstruction with different types of tissue and of the surviving examples of the synthetic devices will follow. PMID:1418190

  14. Implementation of Open and Closed Kinetic Chain Quadriceps Strengthening Exercises after Anterior Cruciate Ligament Reconstruction.

    ERIC Educational Resources Information Center

    Ross, Michael D.; Denegar, Craig R.; Winzenried, Jay A.

    2001-01-01

    Reviews the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) exercise on anterior cruciate ligament (ACL) strain and patellofemoral joint stress, suggesting a combination of the two for quadriceps strengthening after ACL reconstruction. Both OKC and CKC exercises may be modified and implemented for quadriceps strengthening after…

  15. Bioplasty for vertebral fractures: preliminary results of a pre-clinical study on goats using autologous modified skin fibroblasts

    PubMed Central

    Pola, Enrico; Nasto, Luigi A.; Tampieri, Anna; Lattanzi, W.; Di Giacomo, G.; Colangelo, D.; Ciriello, V.; Pagano, E.; Spinelli, S.; Robbins, P.D.; Logroscino, G.

    2012-01-01

    Summary The debate is still ongoing about the long term effects of the mininvasive vertebral augmentation techniques and their usefulness in treating more complex cases where a bone inducing effect more than a merely bone substitution would be suitable, such as the vertebral fractures in young patients. We previously developed a clinically relevant gene therapy approach using modified dermal fibroblasts for inducing bone healing and bone formation in different animal models. The aim of this study is to show the feasibility of a minimally invasive percutaneous intrasomatic ex vivo gene therapy approach to treat thoracolumbar vertebral fractures and anterior column bone defects in a goat model. PMID:21669153

  16. Anterior cervical hypertrichosis: a sporadic case

    PubMed Central

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-01-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  17. Anterior cervical hypertrichosis: a sporadic case.

    PubMed

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  18. Mismatch repair genes Mlh1 and Mlh3 modify CAG instability in Huntington's disease mice: genome-wide and candidate approaches.

    PubMed

    Pinto, Ricardo Mouro; Dragileva, Ella; Kirby, Andrew; Lloret, Alejandro; Lopez, Edith; St Claire, Jason; Panigrahi, Gagan B; Hou, Caixia; Holloway, Kim; Gillis, Tammy; Guide, Jolene R; Cohen, Paula E; Li, Guo-Min; Pearson, Christopher E; Daly, Mark J; Wheeler, Vanessa C

    2013-10-01

    The Huntington's disease gene (HTT) CAG repeat mutation undergoes somatic expansion that correlates with pathogenesis. Modifiers of somatic expansion may therefore provide routes for therapies targeting the underlying mutation, an approach that is likely applicable to other trinucleotide repeat diseases. Huntington's disease Hdh(Q111) mice exhibit higher levels of somatic HTT CAG expansion on a C57BL/6 genetic background (B6.Hdh(Q111) ) than on a 129 background (129.Hdh(Q111) ). Linkage mapping in (B6x129).Hdh(Q111) F2 intercross animals identified a single quantitative trait locus underlying the strain-specific difference in expansion in the striatum, implicating mismatch repair (MMR) gene Mlh1 as the most likely candidate modifier. Crossing B6.Hdh(Q111) mice onto an Mlh1 null background demonstrated that Mlh1 is essential for somatic CAG expansions and that it is an enhancer of nuclear huntingtin accumulation in striatal neurons. Hdh(Q111) somatic expansion was also abolished in mice deficient in the Mlh3 gene, implicating MutLγ (MLH1-MLH3) complex as a key driver of somatic expansion. Strikingly, Mlh1 and Mlh3 genes encoding MMR effector proteins were as critical to somatic expansion as Msh2 and Msh3 genes encoding DNA mismatch recognition complex MutSβ (MSH2-MSH3). The Mlh1 locus is highly polymorphic between B6 and 129 strains. While we were unable to detect any difference in base-base mismatch or short slipped-repeat repair activity between B6 and 129 MLH1 variants, repair efficiency was MLH1 dose-dependent. MLH1 mRNA and protein levels were significantly decreased in 129 mice compared to B6 mice, consistent with a dose-sensitive MLH1-dependent DNA repair mechanism underlying the somatic expansion difference between these strains. Together, these data identify Mlh1 and Mlh3 as novel critical genetic modifiers of HTT CAG instability, point to Mlh1 genetic variation as the likely source of the instability difference in B6 and 129 strains and suggest that MLH1

  19. Choice of Approach Does Not Affect Clinical and Radiologic Outcomes: A Comparative Cohort of Patients Having Anterior Lumbar Interbody Fusion and Patients Having Lateral Lumbar Interbody Fusion at 24 Months

    PubMed Central

    Malham, Gregory M.; Parker, Rhiannon M.; Blecher, Carl M.; Chow, Fiona Y.; Seex, Kevin A.

    2015-01-01

    Study Design  Retrospective analysis of prospectively collected registry data. Objective  This study aimed to compare the clinical and radiologic outcomes between comparative cohorts of patients having anterior lumbar interbody fusion (ALIF) and patients having lateral lumbar interbody fusion (LLIF). Methods  Ninety consecutive patients were treated by a single surgeon with either ALIF (n = 50) or LLIF (n = 40). Inclusion criteria were patients age 45 to 70 years with degenerative disk disease or grade 1 to 2 spondylolisthesis and single-level pathology from L1 to S1. Patient-reported outcome measures included pain (visual analog scale), disability (Oswestry Disability Index [ODI]), and quality of life (Short Form 36 physical component score [PCS] and mental component scores [MCS]). Assessment of fusion and measurement of lordosis and posterior disk height were performed on computed tomography scans. Results  At 24 months, patients having ALIF had significant improvements in back (64%) and leg (65%) pain and ODI (60%), PCS (44%), and MCS (26%; p < 0.05) scores. Patients having LLIF had significant improvements in back (56%) and leg (57%) pain and ODI (52%), PCS (48%), and MCS (12%; p < 0.05) scores. Fourteen complications occurred in the ALIF group, and in the LLIF group, there were 17 complications (p > 0.05). The fusion rate was 100% for ALIF and 95% for LLIF (p = 0.1948). ALIF added ∼6 degrees of lordosis and 3 mm of height, primarily measured at L5–S1, and LLIF added ∼3 degrees of lordosis and 2 mm of height between L1 to L5. Mean follow-up was 34.1 months. Conclusions  In comparative cohorts of patients having ALIF and patients having LLIF at 24 months postoperatively, there were no significant differences in clinical outcomes, complication rates, or fusion rates. PMID:27433432

  20. Anterior capsulotomy using the CO2 laser

    NASA Astrophysics Data System (ADS)

    Barak, Adiel; Ma-Naim, Tova; Rosner, Mordechai; Eyal, Ophir; Belkin, Michael

    1998-06-01

    Continuous circular capsulorhexis (CCC) is the preferred technique for removal of the anterior capsule during cataract surgery due to this technique assuring accurate centration of the intraocular lens. During modern cataract surgery, especially with small or foldable intra ocular lenses, centration of the lens is obligatory. Radial tears at the margin of an anterior capsulotomy may be associated with the exit of at least one loop of an intraocular lens out of the capsular bag ('pea pod' effect) and its subsequent decentration. The anterior capsule is more likely to ream intact if the continuous circular capsulorhexis (CCC) technique is used. Although manual capsulorhexis is an ideal anterior capsulectomy technique for adults, many ophthalmologists are still uncomfortable with it and find it difficult to perform, especially in complicated cases such as these done behind small pupil, cataract extraction in children and pseudoexfoliation syndrome. We have developed a technique using a CO2 laser system for safe anterior capsulotomy and tested it in animal eyes.

  1. Atraumatic Anterior Dislocation of the Hip Joint

    PubMed Central

    Ohtsuru, Tadahiko; Morita, Yasuyuki; Murata, Yasuaki; Itou, Junya; Morita, Yuji; Munakata, Yutaro; Kato, Yoshiharu

    2015-01-01

    Dislocation of the hip joint in adults is usually caused by high-energy trauma such as road traffic accidents or falls from heights. Posterior dislocation is observed in most cases. However, atraumatic anterior dislocation of the hip joint is extremely rare. We present a case of atraumatic anterior dislocation of the hip joint that was induced by an activity of daily living. The possible causes of this dislocation were anterior capsule insufficiency due to developmental dysplasia of the hip, posterior pelvic tilt following thoracolumbar kyphosis due to vertebral fracture, and acetabular anterior coverage changes by postural factor. Acetabular anterior coverage changes in the sagittal plane were measured using a tomosynthesis imaging system. This system was useful for elucidation of the dislocation mechanism in the present case. PMID:26819791

  2. Craniofacial access to the anterior and middle cranial fossae and skull base.

    PubMed

    Lello, G; Statham, P; Steers, J; McGurk, M

    1997-12-01

    A profusion of surgical approaches to gain access to the anterior and middle cranial fossa and skull base have been described. An attempt has been made to simplify the position by suggesting a classification of surgical approaches and to describe a standard approach (of at most 4 defined osteotomies, or at least 2) to give a craniofacial approach to the anterior and middle cranial fossae, the infratemporal fossa, the orbit and the superior nasal cavity. The full extent of the osteotomies have been likened to an ancient Corinthian face mask, or to the stylized face-mask worn by the comic book hero, Batman. PMID:9504303

  3. Morphometric Analysis of Bone Resection in Anterior Petrosectomies.

    PubMed

    Ahmed, Osama; Walther, Jonathan; Theriot, Krystle; Manuel, Morganne; Guthikonda, Bharat

    2016-06-01

    Introduction The anterior petrosectomy is a well-defined skull base approach to lesions such as petroclival meningiomas, posterior circulation aneurysms, petrous apex lesions (chondrosarcomas, cholesteatomas), ventrolateral brainstem lesions, clival chordomas, trigeminal neurinomas, and access to cranial nerves III, IV, V, and VII. Methods and Materials Fourteen anterior petrosectomies on eight cadaveric heads were performed in a skull base dissection laboratory. Predissection and postdissection thin-cut computed tomography scans were obtained to compare the bone resection. A computer program was used (InVivo5, Anatomage, San Jose, California, United States) to measure the bone resection and the improved viewing angle. Results The average bone removed in each plane was as follows: anterior to posterior plane was 10.57 mm ± 2.00 mm, superior to inferior was 9.39 mm ± 1.67 mm, and lateral to medial was 17.46 mm ± 4.64 mm. The average increased angle of view was 13.01 ± 2.35 degrees (Table 1). The average volume was 1786.94 ± 827.40 mm(3). Conclusions Anterior petrosectomy is a useful approach to access the ventrolateral brainstem region. We present a cadaveric study quantitating the volume of bone resection and improvement in the viewing angle. These data provide useful preoperative information on the utility of this skull base approach and the gain in the viewing angle after bony removal. PMID:27175319

  4. Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

    PubMed Central

    Durban, Claire Marie C.; Kim, Je Kyun; Kim, Sae Hoon

    2016-01-01

    Background The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed. PMID:27247742

  5. Anterior Cruciate Ligament Reconstruction Rehabilitation

    PubMed Central

    Wright, Rick W.; Haas, Amanda K.; Anderson, Joy; Calabrese, Gary; Cavanaugh, John; Hewett, Timothy E.; Lorring, Dawn; McKenzie, Christopher; Preston, Emily; Williams, Glenn; Amendola, Annunziato

    2015-01-01

    Context: Anterior cruciate ligament (ACL) reconstruction rehabilitation has evolved over the past 20 years. This evolution has been driven by a variety of level 1 and level 2 studies. Evidence Acquisition: The MOON Group is a collection of orthopaedic surgeons who have developed a prospective longitudinal cohort of the ACL reconstruction patients. To standardize the management of these patients, we developed, in conjunction with our physical therapy committee, an evidence-based rehabilitation guideline. Study Design: Clinical review. Level of Evidence: Level 2. Results: This review was based on 2 systematic reviews of level 1 and level 2 studies. Recently, the guideline was updated by a new review. Continuous passive motion did not improve ultimate motion. Early weightbearing decreases patellofemoral pain. Postoperative rehabilitative bracing did not improve swelling, pain range of motion, or safety. Open chain quadriceps activity can begin at 6 weeks. Conclusion: High-level evidence exists to determine appropriate ACL rehabilitation guidelines. Utilizing this protocol follows the best available evidence. PMID:26131301

  6. Invisible Cost Effective Mechanics for Anterior Space Closure.

    PubMed

    Jumle, Aatish Vinod; Bagrecha, Saurabh; Gharat, Ninad; Misal, Abhijit; Toshniwal, N G

    2015-01-01

    The shifting paradigm towards invisible orthodontic treatment and also awareness in patients has allured their focus towards the most esthetic treatment approach. Also the lingual treatment is proved successful and is very well accepted by the patients. The problem that persist is its high expenses, which is not affordable by all patients. This article is a effort to treat a simple Class I malocclusion with anterior spacing using a simple, esthetic, Cost effective approach with acceptable results when esthetics plays a priority role. PMID:26349282

  7. Moving forward through consensus: protocol for a modified Delphi approach to determine the top research priorities in the field of orthopaedic oncology

    PubMed Central

    Evaniew, Nathan; Rendon, Juan Sebastian; McKay, Paula; Randall, R Lor; Turcotte, Robert; Vélez, Roberto; Bhandari, Mohit; Ghert, Michelle

    2016-01-01

    Introduction Orthopaedic oncology researchers face several obstacles in the design and execution of randomised controlled trials, including finite fiscal resources to support the rising costs of clinical research and insufficient patient volume at individual sites. As a result, high-quality research to guide clinical practice has lagged behind other surgical subspecialties. A focused approach is imperative to design a research programme that is economical, streamlined and addresses clinically relevant endpoints. The primary objective of this study will be to use a consensus-based approach to identify research priorities for international clinical trials in orthopaedic oncology. Methods and analysis We will conduct a 3-phase modified Delphi method consisting of 2 sequential rounds of anonymous web-based questionnaires (phases I and II), and an in-person consensus meeting (phase III). Participants will suggest research questions that they believe are of particular importance to the field (phase I), and individually rate each proposed question on 5 criteria (phase II). Research questions that meet predetermined consensus thresholds will be brought forward to the consensus meeting (phase III) for discussion by an expert panel. Following these discussions, the expert panel will be asked to assign scores for each research question, and research questions meeting predetermined criteria will be brought forward for final ranking. The expert panel will then be asked to rank the top 3 research questions, and these 3 research questions will be distributed to the initial group of participants for validation. Ethics and dissemination An ethics application is currently under review with the Hamilton Integrated Research Ethics Board in Hamilton, Ontario, Canada. The results of this initiative will be disseminated through peer-reviewed publications and conference presentations. PMID:27221129

  8. Modified superficial circumflex iliac artery perforator flap and supermicrosurgery technique for lower extremity reconstruction: a new approach for moderate-sized defects.

    PubMed

    Hong, Joon Pio; Sun, Sang Hoon; Ben-Nakhi, Muneera

    2013-10-01

    The superficial circumflex iliac artery perforator (SCIP) flap is an evolved form of groin flap. It overcomes the inherent disadvantages of the groin flap by preserving the deep fascia but still requires challenging skills because of short pedicles and small caliber of vessels. The use of SCIP flap was evaluated for lower extremity use.From June of 2009 to August of 2011, a total of 79 cases were performed (age range, 4-80 years) on the lower extremity using supermicrosurgical approach. All flaps were harvested above the deep fat and the pedicles were taken above or just below the deep fascia to reconstruct the defects throughout the lower extremity.Supermicrosurgery technique was used in 71 cases. A total of 75 cases were performed successfully; 1 case underwent revision but failed and 2 cases were lost within 2 days of surgery. Average size of the flap was 75.5 cm, thickness 7 mm, average length of pedicle was 5 cm, and the average caliber of artery was 0.7 mm. Donor sites were all closed primarily but complications were noted with 1 dehiscence and prolong drainage of lymphatics. Flaps provided good functional coverage and appearance. The average follow-up was 12 months.With the modification of elevating the flap on the superficial fascia, we can harvest a thin flap without additional debulking and avoid complications such as lymphorrhea. Furthermore, with the perforator to perforator or perforator to small distal vessel approach, we can apply this flap on all regions of the lower extremity overcoming the difficulties with short pedicle and small vessel caliber. In our hands, the modified SCIP flap is the flap of choice for small to moderate size defects in the lower extremity. PMID:23187712

  9. A Retrospective Study of Survivors of Endovascular Coiling for Posterior and Anterior Aneurysms

    PubMed Central

    Wilson, Sarah J.; Drackford, Ruth; Holt, Michael

    2015-01-01

    Abstract This article documents the longer-term medical and psychosocial outcomes of patients referred for endovascular coiling. There is limited research investigating outcome following endovascular coiling for posterior compared to anterior circulation aneurysms, and minimal understanding of how medical outcomes relate to patient experiences of treatment and quality of life. We studied a consecutive cohort of 80 patients referred Australia wide for endovascular coiling between 1995 and 2003 (49% posterior; 76% ruptured; 69% women, mean age 51.5 years). We used a mixed methods approach, assessing medical outcome with the Modified Rankin Scale (MRS) in 61 patients (76%), and health-related quality of life and psychosocial functioning using the EuroQol questionnaire and a qualitative semistructured interview in 49 patients (61%). Despite the high proportion of posterior aneurysms, the majority of patients (80%) showed good medical outcomes as indicated by regained independence of activities of daily living (MRS score ≤3). Patients with unruptured aneurysms were significantly more likely to show good outcomes (P < 0.04), whereas aneurysm location (posterior, anterior, or mixed) showed no significant effect. In patients with good medical outcomes, greater functional disability was associated with neurological complications surrounding treatment (P < 0.05). Good outcomes correlated with higher EuroQol ratings (P < 0.001) and the experience of less change after treatment (P < 0.001), although psychosocial adjustment issues were reported by most of the patients, including those with no medical symptoms. These results support the long-term efficacy of endovascular coiling, particularly for posterior circulation aneurysms. They have implications for guiding clinicians and patients in their choice of treatment, as well as the provision of psychological counseling for patient adjustment issues posttreatment. PMID:26266373

  10. A new kinetic-mechanistic approach to elucidate electrooxidation of doxorubicin hydrochloride in unprocessed human fluids using magnetic graphene based nanocomposite modified glassy carbon electrode.

    PubMed

    Soleymani, Jafar; Hasanzadeh, Mohammad; Shadjou, Nasrin; Khoubnasab Jafari, Maryam; Gharamaleki, Jalil Vaez; Yadollahi, Mehdi; Jouyban, Abolghasem

    2016-04-01

    A novel magnetic nanocomposite was synthesized in one step using polymerization of magnetic graph oxide grafted with chlorosulfonic acid (Fe3O4-GO-SO3H) in the presence of polystyrene. The prepared magnetic nanocomposite was characterized using transmission electron microscopy (TEM), dynamic differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), (Thermo-gravimetric/differential thermal analysis (DTA)), Fourier transform infrared (FTIR), and UV-Vis techniques. Magnetic nanocomposite was casted on the surface of the glassy carbon electrode (PS/Fe3O4-GO-SO3H/GCE) and used for the detection and determination of doxorubicin hydrochloride (DOX) in human biological fluids. The cyclic voltammograms (CVs) of the modified electrode in aqueous solution displayed a pair of well-defined, stable and irreversible reductive/oxidation redox systems. CV study indicated that the oxidation process is irreversible and adsorption controlled. In addition, CV results indicated that DOX is oxidized via two electrons and three protons which is an unusual approach for the oxidation of DOX. A sensitive and time-saving procedure was developed for the analysis of DOX in plasma, cerebrospinal fluid, and urine with detection limit of 4.9 nM, 14 nM and 4.3 nM, respectively. PMID:26838892

  11. Effect of Thermal Aging on Ductile-Brittle Transition Temperature of Modified 9Cr-1Mo Steel Evaluated with Reference Temperature Approach Under Dynamic Loading Condition

    NASA Astrophysics Data System (ADS)

    Sathyanarayanan, S.; Basu, Joysurya; Moitra, A.; Sasikala, G.; Singh, V.

    2013-05-01

    The effect of thermal aging on the ductile-brittle transition behavior has been assessed for a modified 9Cr-1Mo steel (P91) using the reference temperature approach under dynamic loading condition ( T {0/dy}). The steel in normalized and tempered (NT) condition and in different levels of subsequent cold work (CW) was subjected to thermal aging at temperatures of 873 K and 923 K (600 °C and 650 °C) for 5000 and 10,000 hours. For the NT and all the cold work conditions of the starting material, a drastic increase in T {0/dy} has been noticed after aging at 923 K (650 °C) for 10,000 h. A moderate increase was observed for the NT steel aged at 873 K (600 °C) for 5000 hours and for the 10 pct CW steel aged at 873 K (600 °C) for 10,000 h. A detailed transmission electron microscope (TEM) study of the embrittled materials aged at 923 K (650 °C)/10,000 hours and 873 K (600 °C)/10,000 hours has indicated presence of hexagonal Laves phase of Fe2(Mo,Nb) type with different size and spatial distributions. The increase in the T {0/dy} is attributed to the embrittling effect of a network of Laves phase precipitates along the grain boundaries.

  12. Transfection of pseudouridine-modified mRNA encoding CPD-photolyase leads to repair of DNA damage in human keratinocytes: a new approach with future therapeutic potential

    PubMed Central

    Boros, Gábor; Miko, Edit; Muramatsu, Hiromi; Weissman, Drew; Emri, Eszter; Rózsa, Dávid; Nagy, Georgina; Juhász, Attila; Juhász, István; van der Horst, Gijsbertus; Horkay, Irén; Remenyik, Éva; Karikó, Katalin; Emri, Gabriella

    2013-01-01

    UVB irradiation induces harmful photochemical reactions, including formation of cyclobutane pyrimidine dimers (CPDs) in DNA. Accumulation of unrepaired CPD lesions causes inflammation, premature ageing and skin cancer. Photolyases are DNA repair enzymes that can rapidly restore DNA integrity in a light-dependent process called photoreactivation, but these enzymes are absent in humans. Here, we present a novel mRNA-based gene therapy method that directs synthesis of a marsupial, Potorous tridactylus, CPD-photolyase in cultured human keratinocytes. Pseudouridine was incorporated during in vitro transcription to make the mRNA non-immunogenic and highly translatable. Keratinocytes transfected with lipofectamine-complexed mRNA expressed photolyase in the nuclei for at least 2 days. Exposing photolyase mRNA-transfected cells to UVB irradiation resulted in significantly less CPD in those cells that were also treated with photoreactivating light, which is required for photolyase activity. The functional photolyase also diminished other UVB-mediated effects, including induction of IL-6 and inhibition of cell proliferation. These results demonstrate that pseudouridine-containing photolyase mRNA is a powerful tool to repair UVB-induced DNA lesions. The pseudouridine-modified mRNA approach has a strong potential to discern cellular effects of CPD in UV-related cell biological studies. The mRNA-based transient expression of proteins offers a number of opportunities for future application in medicine. PMID:24211294

  13. Transfection of pseudouridine-modified mRNA encoding CPD-photolyase leads to repair of DNA damage in human keratinocytes: a new approach with future therapeutic potential.

    PubMed

    Boros, Gábor; Miko, Edit; Muramatsu, Hiromi; Weissman, Drew; Emri, Eszter; Rózsa, Dávid; Nagy, Georgina; Juhász, Attila; Juhász, István; van der Horst, Gijsbertus; Horkay, Irén; Remenyik, Éva; Karikó, Katalin; Emri, Gabriella

    2013-12-01

    UVB irradiation induces harmful photochemical reactions, including formation of Cyclobutane Pyrimidine Dimers (CPDs) in DNA. Accumulation of unrepaired CPD lesions causes inflammation, premature ageing and skin cancer. Photolyases are DNA repair enzymes that can rapidly restore DNA integrity in a light-dependent process called photoreactivation, but these enzymes are absent in humans. Here, we present a novel mRNA-based gene therapy method that directs synthesis of a marsupial, Potorous tridactylus, CPD-photolyase in cultured human keratinocytes. Pseudouridine was incorporated during in vitro transcription to make the mRNA non-immunogenic and highly translatable. Keratinocytes transfected with lipofectamine-complexed mRNA expressed photolyase in the nuclei for at least 2days. Exposing photolyase mRNA-transfected cells to UVB irradiation resulted in significantly less CPD in those cells that were also treated with photoreactivating light, which is required for photolyase activity. The functional photolyase also diminished other UVB-mediated effects, including induction of IL-6 and inhibition of cell proliferation. These results demonstrate that pseudouridine-containing photolyase mRNA is a powerful tool to repair UVB-induced DNA lesions. The pseudouridine-modified mRNA approach has a strong potential to discern cellular effects of CPD in UV-related cell biological studies. The mRNA-based transient expression of proteins offers a number of opportunities for future application in medicine. PMID:24211294

  14. Molecular phylogeny and a modified approach of character-based barcoding refining the taxonomy of New Caledonian freshwater gastropods (Caenogastropoda, Truncatelloidea, Tateidae).

    PubMed

    Zielske, Susan; Haase, Martin

    2015-08-01

    The islands of New Caledonia represent one of the world's biodiversity hotspots with many endemic species including freshwater gastropods of the family Tateidae. A phylogenetic analysis based on the mitochondrial COI and 16S rRNA and the nuclear ITS2 genes revealed two cryptic genera, Crosseana gen. n. and Novacaledonia gen. n. In order to provide character-based diagnoses we modified a DNA barcoding approach identifying strings of pairwise diagnostic characters, i.e. alignment positions, at which two genera are alternatively fixed for different nucleotides. The combination or string of all pairwise diagnostic characters was unique for each genus. Inconsistent mitochondrial and nuclear topologies suggest that Hemistomia cockerelli Haase and Bouchet, 1998 and H. fabrorum Haase and Bouchet, 1998, two morphologically well-defined species, hybridize. The age of the most recent common ancestor of the New Caledonian radiation of Tateidae was estimated at 24.6±9.5 MY. These findings are in line with the notion that New Caledonia is rather a Darwinian island that was colonized after an extended phase of submergence - in case of the tateids probably from Australia - despite being a fragment of Gondwanaland. PMID:25929789

  15. A modified EK method with an I-/I2 lixiviant assisted and approaching cathodes to remedy mercury contaminated field soils

    NASA Astrophysics Data System (ADS)

    Shen, Zhemin; Zhang, Jianda; Qu, Liya; Dong, Zeqin; Zheng, Shenshen; Wang, Wenhua

    2009-05-01

    Wanshan mercury mine is the largest cinnabar deposit in Guizhou, China. Few effective methods had been achieved to remedy Hg heavily contaminated field soils. In this paper, a modified EK method with approaching cathodes (AC-EK) and an I-/I2 lixiviant was described to remedy mercury-contaminated field soils near Wanshan mercury mine. Paddy Soil I and Paddy Soil II were sampled and contained 576.73 ± 45.50 and 491.35 ± 4.73 mg/kg Hg, respectively. Although they contained 6.9 and 9.4% organic matter respectively, more than 92 and 89% Hg were removed by AC-EK within 5 days. Removal ratio increased by 0.21 and 0.68 times using EK process with ACs over that with one single cathode (SC-EK). AC-EK method saved nearly 26.4-28.1% electric power as compared to SC-EK method. As an I-/I2 lixiviant solution was used to solubilize HgS(HgO) during EK process, the bonding of Hg to organic functional S groups should be less important than the binding to inner sites of organic matter in soil. The relationship between EK remediation effect and soil organic matter content was fitted to a linear model. It turned out that when soil OM increased by 1.0%, EK removal ratio (%) of Hg would decrease by 2.63%.

  16. Chemical improvement of chitosan-modified beads for the immobilization of Enterococcus faecium DBFIQ E36 L-arabinose isomerase through multipoint covalent attachment approach.

    PubMed

    Manzo, Ricardo M; de Sousa, Marylane; Fenoglio, Cecilia L; Gonçalves, Luciana Rocha Barro; Mammarella, Enrique J

    2015-10-01

    D-tagatose is produced from D-galactose by the enzyme L-arabinose isomerase (L-AI) in a commercially viable bioprocess. An active and stable biocatalyst was obtained by modifying chitosan gel structure through reaction with TNBS, D-fructose or DMF, among others. This led to a significant improvement in L-AI immobilization via multipoint covalent attachment approach. Synthetized derivatives were compared with commercial supports such as Eupergit(®) C250L and glyoxal-agarose. The best chitosan derivative for L-AI immobilization was achieved by reacting 4 % (w/v) D-fructose with 3 % (w/v) chitosan at 50 °C for 4 h. When compared to the free enzyme, the glutaraldehyde-activated chitosan biocatalyst showed an apparent activity of 88.4 U g (gel) (-1) with a 211-fold stabilization factor while the glyoxal-agarose biocatalyst gave an apparent activity of 161.8 U g (gel) (-1) with an 85-fold stabilization factor. Hence, chitosan derivatives were comparable to commercial resins, thus becoming a viable low-cost strategy to obtain high active L-AI insolubilized derivatives. PMID:26254040

  17. Tongji-GRACE01: A GRACE-only static gravity field model recovered from GRACE Level-1B data using modified short arc approach

    NASA Astrophysics Data System (ADS)

    Chen, Qiujie; Shen, Yunzhong; Zhang, Xingfu; Chen, Wu; Hsu, Houze

    2015-09-01

    The modified short arc approach, where the position vector in force model are regarded as pseudo observation, is implemented in the SAtellite Gravimetry Analysis Software (SAGAS) developed by Tongji university. Based on the SAGAS platform, a static gravity field model (namely Tongji-GRACE01) complete to degree and order 160 is computed from 49 months of real GRACE Level-1B data spanning the period 2003-2007 (including the observations of K-band range-rate, reduced dynamic orbits, non-conservative accelerations and altitudes). The Tongji-GRACE01 model is compared with the recent GRACE-only models (such as GGM05S, AIUB-GRACE03S, ITG-GRACE03, ITG-GRACE2010S, and ITSG-GRACE2014S) and validated with GPS-leveling data sets in different countries. The results show that the Tongji-GRACE01 model has a considered quality as GGM05S, AIUB-GRACE03S and ITG-GRACE03. The Tongji-GRACE01 model is available at the International Centre for Global Earth Models (ICGEM) web page (http://icgem.gfz-potsdam.de/ICGEM/).

  18. Development of surface modified biodegradable polymeric nanoparticles to deliver GSE24.2 peptide to cells: a promising approach for the treatment of defective telomerase disorders.

    PubMed

    Egusquiaguirre, Susana P; Manguán-García, Cristina; Pintado-Berninches, Laura; Iarriccio, Laura; Carbajo, Daniel; Albericio, Fernando; Royo, Miriam; Pedraz, José Luís; Hernández, Rosa M; Perona, Rosario; Igartua, Manuela

    2015-04-01

    The aim of the present study was to develop a novel strategy to deliver intracellularly the peptide GSE24.2 for the treatment of Dyskeratosis congenita (DC) and other defective telomerase disorders. For this purpose, biodegradable polymeric nanoparticles using poly(lactic-co-glycolic acid) (PLGA NPs) or poly(lactic-co-glycolic acid)-poly ethylene glycol (PLGA-PEG NPs) attached to either polycations or cell-penetrating peptides (CPPs) were prepared in order to increase their cellular uptake. The particles exhibited an adequate size and zeta potential, with good peptide loading and a biphasic pattern obtained in the in vitro release assay, showing an initial burst release and a later sustained release. GSE24.2 structural integrity after encapsulation was assessed using SDS-PAGE, revealing an unaltered peptide after the NPs elaboration. According to the cytotoxicity results, cell viability was not affected by uncoated polymeric NPs, but the incorporation of surface modifiers slightly decreased the viability of cells. The intracellular uptake exhibited a remarkable improvement of the internalization, when the NPs were conjugated to the CPPs. Finally, the bioactivity, addressed by measuring DNA damage rescue and telomerase reactivation, showed that some formulations had the lowest cytotoxicity and highest biological activity. These results proved that GSE24.2-loaded NPs could be delivered to cells, and therefore, become an effective approach for the treatment of DC and other defective telomerase syndromes. PMID:25660910

  19. Anterior Inferior Iliac Spine Avulsion Fracture

    PubMed Central

    Serbest, Sancar; Tosun, Hacı Bayram; Tiftikçi, Uğur; Oktas, Birhan; Kesgin, Engin

    2015-01-01

    Abstract Avulsion fractures of the pelvic apophyses rarely occur in adolescent athletes in the course of sudden strong contraction of muscle attached to growth cartilage. This injury may usually be misdiagnosed for tendon or muscle strain. Patient's history, physical examination, and radiologic studies are important for diagnosis. The literature includes only a few case reports but no case series as yet. The aim of this study was to present the results of 5 cases of anterior inferior iliac spine (AIIS) avulsion fractures treated conservatively. The study included 5 patients (4 male, 1 female, mean age 13.6 years) who underwent conservative treatment for AIIS avulsion fractures and had an adequate follow-up. All patients were admitted to the emergency department and misdiagnosed as muscle strain. Three of them were football player, 1 skier, and 1 fighter. Each patient was treated with immobilization and nonsteroidal anti-inflammatory drugs. At follow-up, all patients showed relief from their pain and mechanical symptoms and regained full range of motion and returned to their previous levels of activity. Diagnosis requires careful attention to the physical examination and imaging. In this series, all pelvic avulsion fractures (100%) were managed successfully with a conservative approach. Good results and return to previous levels of activity can be achieved with conservative treatment. PMID:25700329

  20. 3D spectral imaging system for anterior chamber metrology

    NASA Astrophysics Data System (ADS)

    Anderson, Trevor; Segref, Armin; Frisken, Grant; Frisken, Steven

    2015-03-01

    Accurate metrology of the anterior chamber of the eye is useful for a number of diagnostic and clinical applications. In particular, accurate corneal topography and corneal thickness data is desirable for fitting contact lenses, screening for diseases and monitoring corneal changes. Anterior OCT systems can be used to measure anterior chamber surfaces, however accurate curvature measurements for single point scanning systems are known to be very sensitive to patient movement. To overcome this problem we have developed a parallel 3D spectral metrology system that captures simultaneous A-scans on a 2D lateral grid. This approach enables estimates of the elevation and curvature of anterior and posterior corneal surfaces that are robust to sample movement. Furthermore, multiple simultaneous surface measurements greatly improve the ability to register consecutive frames and enable aggregate measurements over a finer lateral grid. A key element of our approach has been to exploit standard low cost optical components including lenslet arrays and a 2D sensor to provide a path towards low cost implementation. We demonstrate first prototypes based on 6 Mpixel sensor using a 250 μm pitch lenslet array with 300 sample beams to achieve an RMS elevation accuracy of 1μm with 95 dB sensitivity and a 7.0 mm range. Initial tests on Porcine eyes, model eyes and calibration spheres demonstrate the validity of the concept. With the next iteration of designs we expect to be able to achieve over 1000 simultaneous A-scans in excess of 75 frames per second.

  1. Pupil Tracking for Real-Time Motion Corrected Anterior Segment Optical Coherence Tomography.

    PubMed

    Carrasco-Zevallos, Oscar M; Nankivil, Derek; Viehland, Christian; Keller, Brenton; Izatt, Joseph A

    2016-01-01

    Volumetric acquisition with anterior segment optical coherence tomography (ASOCT) is necessary to obtain accurate representations of the tissue structure and to account for asymmetries of the anterior eye anatomy. Additionally, recent interest in imaging of anterior segment vasculature and aqueous humor flow resulted in application of OCT angiography techniques to generate en face and 3D micro-vasculature maps of the anterior segment. Unfortunately, ASOCT structural and vasculature imaging systems do not capture volumes instantaneously and are subject to motion artifacts due to involuntary eye motion that may hinder their accuracy and repeatability. Several groups have demonstrated real-time tracking for motion-compensated in vivo OCT retinal imaging, but these techniques are not applicable in the anterior segment. In this work, we demonstrate a simple and low-cost pupil tracking system integrated into a custom swept-source OCT system for real-time motion-compensated anterior segment volumetric imaging. Pupil oculography hardware coaxial with the swept-source OCT system enabled fast detection and tracking of the pupil centroid. The pupil tracking ASOCT system with a field of view of 15 x 15 mm achieved diffraction-limited imaging over a lateral tracking range of +/- 2.5 mm and was able to correct eye motion at up to 22 Hz. Pupil tracking ASOCT offers a novel real-time motion compensation approach that may facilitate accurate and reproducible anterior segment imaging. PMID:27574800

  2. Pupil Tracking for Real-Time Motion Corrected Anterior Segment Optical Coherence Tomography

    PubMed Central

    Carrasco-Zevallos, Oscar M.; Nankivil, Derek; Viehland, Christian; Keller, Brenton; Izatt, Joseph A.

    2016-01-01

    Volumetric acquisition with anterior segment optical coherence tomography (ASOCT) is necessary to obtain accurate representations of the tissue structure and to account for asymmetries of the anterior eye anatomy. Additionally, recent interest in imaging of anterior segment vasculature and aqueous humor flow resulted in application of OCT angiography techniques to generate en face and 3D micro-vasculature maps of the anterior segment. Unfortunately, ASOCT structural and vasculature imaging systems do not capture volumes instantaneously and are subject to motion artifacts due to involuntary eye motion that may hinder their accuracy and repeatability. Several groups have demonstrated real-time tracking for motion-compensated in vivo OCT retinal imaging, but these techniques are not applicable in the anterior segment. In this work, we demonstrate a simple and low-cost pupil tracking system integrated into a custom swept-source OCT system for real-time motion-compensated anterior segment volumetric imaging. Pupil oculography hardware coaxial with the swept-source OCT system enabled fast detection and tracking of the pupil centroid. The pupil tracking ASOCT system with a field of view of 15 x 15 mm achieved diffraction-limited imaging over a lateral tracking range of +/- 2.5 mm and was able to correct eye motion at up to 22 Hz. Pupil tracking ASOCT offers a novel real-time motion compensation approach that may facilitate accurate and reproducible anterior segment imaging. PMID:27574800

  3. Treatment strategies for frontal sinus anterior table fractures and contour deformities.

    PubMed

    Delaney, Sean W

    2016-08-01

    Anterior table frontal sinus fractures can result in aesthetically displeasing contour deformities. Acute anterior table frontal sinus fractures that are depressed may be reduced with an open, closed, or endoscope-assisted approach. Delayed contour deformity camouflage can be achieved using bone grafts, titanium meshes, methyl methacrylate, hydroxyapatite cement, and polyether ether ketone implants. The selection of surgical approach to repair a frontal sinus contour deformity depends on the fracture severity, chronicity, complexity, patient comorbidities, and surgeon preference and experience. Advancement in endoscopic technology and expertise has created a paradigm shift toward a less invasive approach to the frontal region, with considerably less morbidity than conventional open techniques. PMID:27345471

  4. Anterior Cervical Discectomy and Fusion with Plating

    MedlinePlus Videos and Cool Tools

    Anterior Cervical Discectomy and Fusion with Plating Broward Health Medical Center Fort Lauderdale, FL November 17, 2011 I'm Dr. Matthew Moore, head of the Spine Care Center here at North Broward Medical Center. And ...

  5. Secondary anterior crocodile shagreen of Vogt.

    PubMed Central

    Tripathi, R C; Bron, A J

    1975-01-01

    The clincopathological features and pathogenesis of secondary mosaic degeneration of the cornea (anterior crocodile shagreen of Vogt) are described. The structural basis for the normal anterior corneal mosaic pattern seems to lie in the particular arrangement of many prominent collagen lamellae of the anterior stroma that thake an oblique course to gain insertion into Bowman's layer. Since, at normal intraocular pressure, Bowman's layer is under tension, when viewed from the anterior surface the cornea appears smooth. By releasing the tension, however, a reproducible polygonal ridge pattern becomes manifest. It is suggested that a prolonged phthisical state of the eye is one condition wherein the mosaic pattern may become permanent and that, as a secondary event, this is followed by irregular calcification of Bowman's layer which particularly involves the ridges projecting into the epithelium. Biomicroscopically these ridges corresponded to the branching reticular arrangement of the mosaic opacities. Images PMID:1079137

  6. Inverted liver with suprahepatic, anteriorly displaced gallbladder.

    PubMed

    Hibbs, Harold; Ahmad, Usman

    2010-01-01

    A suprahepatic, anteriorly displaced gallbladder in association with an inverted liver is an extremely rare congenital anomaly. We report the clinical and radiologic findings associated with a 78-year-old woman presenting with shortness of breath, desaturation, hypercapnia and hypoxemia. An abnormal chest radiograph demonstrated right hemi-diaphragmatic elevation consistent with a possible eventration. Subsequent imaging by computed tomography (CT) demonstrated an inverted liver with an anteriorly displaced, suprahepatic gallbladder. PMID:20666167

  7. Erlotinib-related bilateral anterior uveitis

    PubMed Central

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterior uveitis. PMID:22694887

  8. Anterior capsular defect with acute anterior subcapsular cataract in herpetic keratouveitis

    PubMed Central

    Arora, Tarun; Sharma, Namrata; Arora, Supriya; Titiyal, Jeewan S

    2014-01-01

    A 20-year-old man presented with a recurrent episode of herpetic keratouveitis in his right eye. The patient was treated with oral acyclovir and topical steroids. One week later the patient reported a sudden diminution of vision. Slitlamp biomicroscopy revealed the presence of a central anterior capsular defect and anterior subcapsular cataract. Dosage of steroids was temporarily increased and progression of cataract monitored. Subsequently, the anterior chamber reaction decreased and steroids were tapered. PMID:25228677

  9. Anterior-posterior treatment localization in pelvic radiotherapy: tattoos or fixed couch-to-isocentre distance.

    PubMed

    Greer, P B; Mortensen, T M

    1997-01-01

    The methods of determining the anterior-posterior isocentre location in pelvic radiotherapy are either by aligning lateral localization lasers to tattoo marks on skin, or by setting a constant daily couch-to-isocentre distance. While using the former method the day-to-day vertical couch movement was recorded and combined with measurements of day-to-day anterior-posterior patient movement made with an electronic portal imaging device to determine whether couch vertical movement contributes to anterior-posterior setup variation. Seven unimmobilized patients were studied, four supine prostate and three prone rectum patients. The two motions were found to be highly correlated (correlation coefficient = 0.82) which supports the constant couch-to-isocentre distance approach. When the day-to-day couch vertical movement was subtracted from the anterior-posterior movement results the setup variation was reduced in six of the seven patients. PMID:9136107

  10. Eye contact reveals a relationship between Neuroticism and anterior EEG asymmetry.

    PubMed

    Uusberg, Helen; Allik, Jüri; Hietanen, Jari K

    2015-07-01

    Although anterior functional brain asymmetry has been linked to individual differences in affect and motivation, its relations with the Five Factor Model personality traits remain unclear. We investigated anterior EEG alpha-activity asymmetry in response to variable degrees of social contact induced by different gaze directions of a "live" model. Neuroticism was negatively related to the anterior EEG asymmetry scores in response to direct gaze, indicating that higher levels of Neuroticism were associated with avoidance-related, relative right-sided functional brain asymmetry. Neuroticism was also related to behavioral direct gaze avoidance and subjective averted gaze preference. These relationships arose primarily from the Withdrawal aspect factor, suggesting that two subdomains of Neuroticism may be differentially related to approach-avoidance tendencies. These findings demonstrate that experimental manipulations of social contact can reveal personality related differences in anterior EEG asymmetry responsiveness, offering a motivationally salient alternative to resting state measures. PMID:25980386

  11. Successful Treatment of Severe Sympathetically Maintained Pain Following Anterior Spine Surgery

    PubMed Central

    Woo, Jae Hee

    2014-01-01

    Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity of approach side used in anterior cervical discectomy and fusion, and underwent a stellate ganglion block with a significant relief of his pain. The second patient complained of a cold sensation and severe unexpected pain in the lower extremity of the contralateral side after anterior lumbar interbody fusion and was treated with lumbar sympathetic block. We aimed to describe sympathetically maintained pain as one of the important causes of early postoperative pain and the treatment option chosen for these cases in detail. PMID:25289130

  12. Anterior Eye Imaging with Optical Coherence Tomography

    NASA Astrophysics Data System (ADS)

    Huang, David; Li, Yan; Tang, Maolong

    The development of corneal and anterior segment optical coherence tomography (OCT) technology has advanced rapidly in recently years. The scan geometry and imaging wavelength are both important choices to make in designing anterior segment OCT systems. Rectangular scan geometry offers the least image distortion and is now used in most anterior OCT systems. The wavelength of OCT light source affects resolution and penetration. An optimal choice of the OCT imaging wavelength (840, 1,050, or 1,310 nm) depends on the application of interest. Newer generation Fourier-domain OCT technology can provide scan speed 100-1000 times faster than the time-domain technology. Various commercial anterior OCT systems are available on the market. A wide spectrum of diagnostic and surgical applications using anterior segment OCT had been investigated, including mapping of corneal and epithelial thicknesses, keratoconus screening, measuring corneal refractive power, corneal surgery planning and evaluation in LASIK, intracorneal ring implantation, assessment of angle closure glaucoma, anterior chamber biometry and intraocular lens implants, intraocular lens power calculation, and eye bank donor cornea screening.

  13. Treating mannitol in a saturated solution of mannitol: a novel approach to modify mannitol crystals for improved drug delivery to the lungs.

    PubMed

    Kaialy, Waseem; Nokhodchi, Ali

    2013-05-01

    The aim of this study was to evaluate the influence of treatment of a promising dry powder aerosol carrier (mannitol) on the aerosolization performance of salbutamol sulphate (SS) using a novel approach: treating excess commercial carrier particles in a saturated solution of the same carrier. Commercial mannitol (CM) particles were treated with aqueous mannitol supersaturated solutions (20% and 25% w/v), under stirring, (300 rpm) for either 24h or 48 h. The results showed that particle treatment did not alter the polymorphic form of mannitol (β-mannitol); however, all treated mannitol particles demonstrated smoother surface topography and improved aerosolization performance compared to CM in dry powder inhalations. Unlike the concentration of mannitol solution used during treatment, the time of treatment to collect mannitol crystals was an essential key to modify the physical properties of mannitol and its effect on the aerosolization performance. In comparison to mannitol particles treated for 48 h, mannitol particles treated for 24h demonstrated larger size, more elongated-less regular shape, and smoother surfaces. No apparent relationship was obtained between in vitro aerosolisation behavior of SS with either mannitol particle size or shape descriptors. However, despite their larger size and more irregular-less uniformed shape, treated mannitol particles with smoother surfaces generated drug particles with smaller aerodynamic size and are expected to deliver higher amounts of drug to lower airways. The results demonstrated the potential of treating mannitol particles in aqueous solutions of the same material under controlled conditions to produce mannitol particles promising for dry powder inhaler systems. The results suggested that mannitol particle surface texture properties dominate over both particle size and particle shape of mannitol in terms of determining the aerosolization performance of mannitol. PMID:23500603

  14. Polarimetric glucose sensing in an artificial eye anterior chamber

    NASA Astrophysics Data System (ADS)

    Malik, Bilal H.; Pirnstill, Casey W.; Coté, Gerard L.

    2012-03-01

    The application of optical polarimetry to glucose sensing in the anterior chamber of the eye has emerged as a potential technique to noninvasively ascertain blood glucose levels. One of the major limiting factors preventing the realization of such a device is the time varying corneal birefringence due to motion artifact in the eye. The varying birefringence confounds the optical activity of glucose, and thus, needs to be taken into account in order to successfully predict the glucose concentration in the aqueous humor of the eye. Our group has developed a multi-spectral optical polarimetric approach which can minimize the effect of corneal birefringence coupled with motion artifact by treating it as common mode noise to multiple wavelengths. Here, we present the application of a real-time closed-loop dual wavelength polarimeter to ex vivo glucose sensing in excised New Zealand White rabbits' corneas mounted on an artificial anterior chamber. Our PID control system can reach stability in less than 100 ms which is fast enough to overcome motion artifact due to heart beat and respiration. The system can predict the glucose concentration with a standard error of less than 26 mg/dL in the physiologic glucose range of 0 - 500 mg/dL. Our results indicate that dualwavelength polarimetry has the potential to noninvasively probe glucose through the anterior chamber of the eye.

  15. Robot-assisted Anterior Odontoid Screw Fixation: A Case Report.

    PubMed

    Tian, Wei; Wang, Han; Liu, Ya-Jun

    2016-08-01

    Anterior odontoid screw fixation has been proved to be effective but technically challenging because the difficult approach is associated with high risks of screw malposition and damage to surrounding vital structures. Navigation techniques are therefore increasingly being used to improve safety and accuracy. However, no robot-assisted odontoid screw fixation has yet been reported. We here report a 61-year-old woman with a type II dens fracture on whom anterior odontoid screw fixation was performed under the guidance of a newly developed robotic system (TiRobot, co-designed by Beijing Jishuitan Hospital and TINAVI Medical Technologies). One odontoid screw was safely and accurately placed, the calculated deviation between the planned and actual positions being 0.9 mm. No intraoperative complications were identified and the patient was discharged on Day 5. Follow-up studies after 2 weeks showed good clinical and radiological results. We believe this is the first reported case of robot-assisted anterior odontoid screw fixation. We consider that complicated procedures can become feasible, safe and accurate using TiRobot systems. PMID:27627725

  16. Craniotomy for anterior cranial fossa meningiomas: historical overview.

    PubMed

    Morales-Valero, Saul F; Van Gompel, Jamie J; Loumiotis, Ioannis; Lanzino, Giuseppe

    2014-04-01

    The surgical treatment of meningiomas located at the base of the anterior cranial fossa is often challenging, and the evolution of the surgical strategy to resect these tumors parallels the development of craniotomy, and neurosurgery in general, over the past century. Early successful operations to treat these tumors were pioneered by prominent figures such as Sir William Macewen and Francesco Durante. Following these early reports, Harvey Cushing made significant contributions, allowing a better understanding and treatment of meningiomas in general, but particularly those involving the anterior cranial base. Initially, large-sized unilateral or bilateral craniotomies were necessary to approach these deep-seated lesions. Technical advances such as the introduction of electrosurgery, the operating microscope, and refined microsurgical instruments allowed neurosurgeons to perform less invasive surgical procedures with better results. Today, a wide variety of surgical strategies, including endoscopic surgery and radiosurgery, are used to treat these tumors. In this review, the authors trace the evolution of craniotomy for anterior cranial fossa meningiomas. PMID:24684326

  17. Anterior Cruciate Ligament Injuries in Wakeboarding

    PubMed Central

    Starr, Harlan M.; Sanders, Brett

    2012-01-01

    Background: Wakeboarding is an increasingly popular sport that involves aggressive stunts with high risk for lower extremity injury, including anterior cruciate ligament (ACL) rupture. Little has been reported on prevalence or mechanism of ACL injury while wakeboarding. Hypothesis: The prevalence of ACL injury in wakeboarding approaches that of other high-risk sports. Analyzing the mechanism of ACL injury may aid in future efforts of prevention. Study Design: Descriptive epidemiology study. Methods: In sum, 1580 surveys were sent internationally to professional and amateur wakeboarders. The survey questioned the participants on their history of an ACL tear while wakeboarding and asked them to describe the mechanism of injury and treatment. Results: A total of 123 surveys were returned. Of this group, 52 (42.3%) acknowledged having had an ACL tear while wakeboarding. The majority described feeling a pop or buckle after attempting to land a high jump. Only 5 participants (13.5%) described a rotational mechanism created by catching the board edge in the water. Thirty-seven participants (71.15%) said that the injury ruined their ability to wakeboard before reconstruction, and 41 (78.85%) had the injury repaired surgically. Conclusion: The prevalence of ACL tears in this data set, 42.3%, is the highest reported in the literature for wakeboarding and one of the highest for any sport. The main mechanism of injury appears to involve axial compression while one lands in a provocative position; it is not related to a rotational force created by fixed bindings. The injury should be surgically repaired to effectively continue the sport. Further study is needed to determine if wakeboarding represents a high-risk sport for ACL injury. Clinical Significance: Wakeboarding may be a high-risk sport for ACL injury. Noncontact axial compression appears to be the main mechanism of injury. PMID:23016104

  18. Vaginal myomectomy for a thirteen-centimeter anterior myoma.

    PubMed

    Deval, Bruno; Rousset, Pascal; Kayani, Salma

    2013-01-01

    Vaginal myomectomy is an uncommon but advantageous approach for large interstitial uterine fibroids. Myomectomy is performed via laparotomy and laparoscopy; however, in selected cases, vaginal myomectomy has been proven to be a safe and an effective surgical procedure. We report the case of a 38-year-old para one woman with complaints of chronic lower abdominal pain. Preoperative workup revealed a thirteen-centimeter interstitial uterine myoma in the anterior wall. Successful myomectomy was performed via the vaginal route. We will share the preoperative images, operative technique, and postoperative images. PMID:23662225

  19. Vaginal Myomectomy for a Thirteen-Centimeter Anterior Myoma

    PubMed Central

    Deval, Bruno; Rousset, Pascal

    2013-01-01

    Vaginal myomectomy is an uncommon but advantageous approach for large interstitial uterine fibroids. Myomectomy is performed via laparotomy and laparoscopy; however, in selected cases, vaginal myomectomy has been proven to be a safe and an effective surgical procedure. We report the case of a 38-year-old para one woman with complaints of chronic lower abdominal pain. Preoperative workup revealed a thirteen-centimeter interstitial uterine myoma in the anterior wall. Successful myomectomy was performed via the vaginal route. We will share the preoperative images, operative technique, and postoperative images. PMID:23662225

  20. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    PubMed

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed. PMID:26545750

  1. Changes in Gait with Anteriorly Added Mass: A Pregnancy Simulation Study.

    PubMed

    Ogamba, Maureen I; Loverro, Kari L; Laudicina, Natalie M; Gill, Simone V; Lewis, Cara L

    2016-08-01

    During pregnancy, the female body experiences structural changes, such as weight gain. As pregnancy advances, most of the additional mass is concentrated anteriorly on the lower trunk. The purpose of this study is to analyze kinematic and kinetic changes when load is added anteriorly to the trunk, simulating a physical change experienced during pregnancy. Twenty healthy females walked on a treadmill while wearing a custom made pseudo-pregnancy sac (1 kg) under 3 load conditions: sac-only condition, 10-lb condition (4.535 kg added anteriorly), and 20-lb condition (9.07 kg added anteriorly), used to simulate pregnancy in the second trimester and at full-term pregnancy, respectively. The increase in anterior mass resulted in kinematic changes at the knee, hip, pelvis, and trunk in the sagittal and frontal planes. In addition, ankle, knee, and hip joint moments normalized to baseline mass increased with increased load; however, these moments decreased when normalized to total mass. These kinematic and kinetic changes may suggest that women modify gait biomechanics to reduce the effect of added load. Furthermore, the increase in joint moments increases stress on the musculoskeletal system and may contribute to musculoskeletal pain. PMID:26958743

  2. Warfare-related secondary anterior cranioplasty

    PubMed Central

    Ebrahimi, Ali; Nejadsarvari, Nasrin; Rasouli, Hamid Reza; Ebrahimi, Azin

    2016-01-01

    Background: Anterior cranial bone defects secondary to global war cranial defects pose a unique reconstructive challenge. The objective of this study was to evaluate the outcomes of alloplastic reconstructions of cranial bone with titanium mesh and fat graft after warfare-related cranial trauma. Patients and Methods: Thirty-five patients at the plastic and reconstructive surgery ward of our hospital underwent anterior cranioplasty with titanium mesh with or without fat grafts from lower abdominal wall. Inclusion criteria were anterior cranial bone defect due to warfare injuries, the mean age of these patients was 31 years (range, 23–48 years). Ninety-five percent were male, and 5% were female. Average follow-up was 12 months. Fat grafts were used to help obliterate endocranial dead spaces. Results: Twenty-five patients (71%) had more than 0.5 cm dead space under cranial defects, and we used fat graft under the titanium mesh. The majority groups of patients (80%) were injured as a result of previous explosive device blasts with or without neurosurgical procedures in the past. The average patient age was 31 years, and 95% of patients were male. The mean anterior cranial defect size was 6 cm × 8 cm, and there were no wound infection or flap necrosis after operations. Conclusion: We recommend this procedure (titanium mesh with or without fat graft) for warfare injured cranial defects in secondary anterior cranial reconstructions. Fat grafts eliminates dead space and reduce secondary complications. PMID:27563609

  3. En bloc resection of a thoracic chordoma is possible using minimally invasive anterior access: An 8-year follow-up.

    PubMed

    Goomany, Anand; Timothy, Jake; Robson, Craig; Rao, Abhay

    2016-01-01

    Thoracic spine chordomas are a rare clinical entity and present several diagnostic and management challenges. Posterior debulking techniques are the traditional approach for the resection of thoracic tumors involving the vertebral body. Anterior approaches to the thoracic spine enable complete tumor resection and interbody fusion. However, this approach has previously required a thoracotomy incision, which is associated with significant perioperative morbidity, pain, and the potential for compromised ventilation and subsequent respiratory sequelae. The extreme lateral approach to the anterior spine has been used to treat degenerative disorders of the lower thoracic and lumbar spine, and reduces the potential complications compared with the anterior transperitoneal/transpleural approach. However, such an approach has not been utilized in the treatment of thoracic chordomas. We describe the first case of an en bloc resection of a thoracic chordoma via a minimally invasive eXtreme lateral interbody fusion approach. PMID:26933363

  4. En bloc resection of a thoracic chordoma is possible using minimally invasive anterior access: An 8-year follow-up

    PubMed Central

    Goomany, Anand; Timothy, Jake; Robson, Craig; Rao, Abhay

    2016-01-01

    Thoracic spine chordomas are a rare clinical entity and present several diagnostic and management challenges. Posterior debulking techniques are the traditional approach for the resection of thoracic tumors involving the vertebral body. Anterior approaches to the thoracic spine enable complete tumor resection and interbody fusion. However, this approach has previously required a thoracotomy incision, which is associated with significant perioperative morbidity, pain, and the potential for compromised ventilation and subsequent respiratory sequelae. The extreme lateral approach to the anterior spine has been used to treat degenerative disorders of the lower thoracic and lumbar spine, and reduces the potential complications compared with the anterior transperitoneal/transpleural approach. However, such an approach has not been utilized in the treatment of thoracic chordomas. We describe the first case of an en bloc resection of a thoracic chordoma via a minimally invasive eXtreme lateral interbody fusion approach. PMID:26933363

  5. Trading experience modulates anterior insula to reduce the endowment effect.

    PubMed

    Tong, Lester C P; Ye, Karen J; Asai, Kentaro; Ertac, Seda; List, John A; Nusbaum, Howard C; Hortaçsu, Ali

    2016-08-16

    People often demand a greater price when selling goods that they own than they would pay to purchase the same goods-a well-known economic bias called the endowment effect. The endowment effect has been found to be muted among experienced traders, but little is known about how trading experience reduces the endowment effect. We show that when selling, experienced traders exhibit lower right anterior insula activity, but no differences in nucleus accumbens or orbitofrontal activation, compared with inexperienced traders. Furthermore, insula activation mediates the effect of experience on the endowment effect. Similar results are obtained for inexperienced traders who are incentivized to gain trading experience. This finding indicates that frequent trading likely mitigates the endowment effect indirectly by modifying negative affective responses in the context of selling. PMID:27482098

  6. Restoration of complex sensorimotor behavior and skilled forelimb use by a modified nigral cell suspension transplantation approach in the rat Parkinson model.

    PubMed

    Nikkhah, G; Duan, W M; Knappe, U; Jödicke, A; Björklund, A

    1993-09-01

    While intrastriatal transplants of dopamine-rich ventral mesencephalic tissue are effective in reversing a variety of drug-induced behaviors in the rat Parkinson model, previous studies have failed to obtain significant graft-induced effects on deficits in certain aspects of complex sensorimotor behaviors. In the present study we have applied a modified cell suspension transplantation procedure, which allows more reproducible and consistent ventral mesencephalic transplants of large size, as well as more wide-spread distribution of the ventral mesencephalic tissue over multiple graft sites within the denervated caudate-putamen. Using this approach it has for the first time been possible to obtain significant amelioration of the lesion-induced deficits in skilled forelimb use and in the rats ability to switch from one behavior (eating) to another (orientation towards tactile stimuli), so-called disengage behavior. Rats with unilateral 6-hydroxydopamine lesions of the mesostriatal dopamine pathway received a total of 450,000 fetal ventral mesencephalic cells, implanted either as two large deposits along a single injection tract ("Macro" grafts), or as 18 small deposits along six injection tracts in the head of the denervated caudate-putamen ("Micro" grafts) and the behavioral changes were studied up to three months after transplantation. On the drug-induced tests, both types of transplants reversed amphetamine- and D1-receptor agonist-induced turning, and produced a partial (50-75%) reduction in apomorphine-induced and D2-receptor agonist-induced turning. On the spontaneous sensorimotor tests, both types of grafts reversed the deficit in simple sensorimotor orientation. In addition, the Micro-grafted animals (which produced the most extensive reinnervation of the denervated striatum) showed a significant improvement in skilled forelimb use and in response latency in the disengage behavior test. Although the large sized Macro-grafted animals showed a similar trend, it

  7. Early adversity and combat exposure interact to influence anterior cingulate cortex volume in combat veterans☆

    PubMed Central

    Woodward, Steven H.; Kuo, Janice R.; Schaer, Marie; Kaloupek, Danny G.; Eliez, Stephan

    2013-01-01

    Objective Childhood and combat trauma have been observed to interact to influence amygdala volume in a sample of U.S. military veterans with and without PTSD. This interaction was assessed in a second, functionally-related fear system component, the pregenual and dorsal anterior cingulate cortex, using the same sample and modeling approach. Method Anterior cingulate cortical tissues (gray + white matter) were manually-delineated in 1.5 T MR images in 87 U.S. military veterans of the Vietnam and Persian Gulf wars. Hierarchical multiple regression modeling was used to assess associations between anterior cingulate volume and the following predictors, trauma prior to age 13, combat exposure, the interaction of early trauma and combat exposure, and PTSD diagnosis. Results As previously observed in the amygdala, unique variance in anterior cingulate cortical volume was associated with both the diagnosis of PTSD and with the interaction of childhood and combat trauma. The pattern of the latter interaction indicated that veterans with childhood trauma exhibited a significant inverse linear relationship between combat trauma and anterior cingulate volume while those without childhood trauma did not. Such associations were not observed in hippocampal or total cerebral tissue volumes. Conclusions In the dorsal anterior cingulate cortex, as in the amygdala, early trauma may confer excess sensitivity to later combat trauma. PMID:24179818

  8. Selective importance of the rat anterior thalamic nuclei for configural learning involving distal spatial cues.

    PubMed

    Dumont, Julie R; Amin, Eman; Aggleton, John P

    2014-01-01

    To test potential parallels between hippocampal and anterior thalamic function, rats with anterior thalamic lesions were trained on a series of biconditional learning tasks. The anterior thalamic lesions did not disrupt learning two biconditional associations in operant chambers where a specific auditory stimulus (tone or click) had a differential outcome depending on whether it was paired with a particular visual context (spot or checkered wall-paper) or a particular thermal context (warm or cool). Likewise, rats with anterior thalamic lesions successfully learnt a biconditional task when they were reinforced for digging in one of two distinct cups (containing either beads or shredded paper), depending on the particular appearance of the local context on which the cup was placed (one of two textured floors). In contrast, the same rats were severely impaired at learning the biconditional rule to select a specific cup when in a particular location within the test room. Place learning was then tested with a series of go/no-go discriminations. Rats with anterior thalamic nuclei lesions could learn to discriminate between two locations when they were approached from a constant direction. They could not, however, use this acquired location information to solve a subsequent spatial biconditional task where those same places dictated the correct choice of digging cup. Anterior thalamic lesions produced a selective, but severe, biconditional learning deficit when the task incorporated distal spatial cues. This deficit mirrors that seen in rats with hippocampal lesions, so extending potential interdependencies between the two sites. PMID:24215178

  9. 131Cs myocardial scintigraphy. Application to assessment of anterior myocardial infarction.

    PubMed Central

    Burguet, W; Merchie, G; Kulbertus, H

    1975-01-01

    Earlier studies have indicated that caesium-131 is a good myocardial scanning agent for the demonstration of anterior infarcts. One hundred and ten patients with documented anterior myocardial infarction were studied by 131Cs myocardial scintigraphy. An anterior area of decreased uptake of caesium was noted in all but 3 subjects whose necrotic zone was likely to be of small dimensions. In 20 cases, the scintigram showed a definite, sometimes very large, cold area whereas the electrocardiogram failed to display any diagnostic feature of myocardial necrosis. In most of the latter instances, the electrocardiographic diagnosis was obscured by the presence of intraventricular conduction disturbances. In order to visualize the intracardiac cavities, the 131Cs investigation was usually completed by a 113mIn scintigram, which allowed recognition of a parietal aneurysm in 12 of the 18 patients with extensive anterior lesions. In each case, an index of necrosis was computed from planimetric measurements of the infarcted area as compared to the total left ventricular surfact in both the anteroposterior and left anterior oblique projections. This index was shown to correlate with the incidence of major complications developing after the acute episode of coronary occlusion. The sensitivity, specificity, and accuracy of the method are briefly discussed. It is felt that myocardial scintigraphy represents a sound approach to the semiquantitative assessment of anterior myocardial infarction; the clinical usefulness of the technique seems sufficiently demonstrated to prompt further research in this field. Images PMID:1191417

  10. Selective importance of the rat anterior thalamic nuclei for configural learning involving distal spatial cues

    PubMed Central

    Dumont, Julie R; Amin, Eman; Aggleton, John P

    2013-01-01

    To test potential parallels between hippocampal and anterior thalamic function, rats with anterior thalamic lesions were trained on a series of biconditional learning tasks. The anterior thalamic lesions did not disrupt learning two biconditional associations in operant chambers where a specific auditory stimulus (tone or click) had a differential outcome depending on whether it was paired with a particular visual context (spot or checkered wall-paper) or a particular thermal context (warm or cool). Likewise, rats with anterior thalamic lesions successfully learnt a biconditional task when they were reinforced for digging in one of two distinct cups (containing either beads or shredded paper), depending on the particular appearance of the local context on which the cup was placed (one of two textured floors). In contrast, the same rats were severely impaired at learning the biconditional rule to select a specific cup when in a particular location within the test room. Place learning was then tested with a series of go/no-go discriminations. Rats with anterior thalamic nuclei lesions could learn to discriminate between two locations when they were approached from a constant direction. They could not, however, use this acquired location information to solve a subsequent spatial biconditional task where those same places dictated the correct choice of digging cup. Anterior thalamic lesions produced a selective, but severe, biconditional learning deficit when the task incorporated distal spatial cues. This deficit mirrors that seen in rats with hippocampal lesions, so extending potential interdependencies between the two sites. PMID:24215178

  11. Traumatic graft dehiscence after anterior lamellar keratoplasty.

    PubMed

    Prasher, Pawan; Muftuoglu, Orkun; Mootha, V Vinod

    2009-02-01

    A 64-year-old man underwent anterior lamellar keratoplasty using the Melles technique for corneal scar secondary to healed bacterial keratitis in the left eye. Two months postoperatively, the patient presented with blurry vision in the left eye after a fall in the bathroom. The uncorrected visual acuity was 20/400 in the left eye, and the external examination showed periorbital swelling with ecchymosis. Slit-lamp examination revealed an absent graft, a circular crater in the center, and a fragment of suture on the temporal edge of the crater. The Seidel test was negative, and there was no sign of infection. The anterior segment optical coherence tomography showed intact residual stroma with slight forward protrusion. The patient underwent repeat anterior lamellar corneal transplantation with improvement in uncorrected visual acuity of 20/100 and best spectacle-corrected visual acuity of 20/70 in the left eye 3 months postoperatively. PMID:19158577

  12. Anterior eye development and ocular mesenchyme

    PubMed Central

    Cvekl, Aleš; Tamm, Ernst R.

    2007-01-01

    Summary During development of the anterior eye segment, cells that originate from the surface epithelium or the neuroepithelium need to interact with mesenchymal cells, which predominantly originate from the neural crest. Failures of proper interaction result in a complex of developmental disorders such Peters’ anomaly, Axenfeld-Rieger’s syndrome or aniridia. Here we review the role of transcription factors that have been identified to be involved in the coordination of anterior eye development. Among these factors is PAX6, which is active in both epithelial and mesenchymal cells during ocular development, albeit at different doses and times. We propose that PAX6 is a key element that synchronizes the complex interaction of cell types of different origin, which are all needed for proper morphogenesis of the anterior eye. We discuss several molecular mechanisms that might explain the effects of haploinsufficiency of PAX6 and other transcription factors, and the broad variation of the resulting phenotypes. PMID:15057935

  13. [Arthroscopic tightening of the anterior cruciate ligament].

    PubMed

    Charrois, O; Cheyrou, E; Remi, J; Panarella, L; Jouve, F; Beaufils, P

    2008-02-01

    We present here the preliminary results obtained with arthroscopic tightening of the anterior cruciate ligament. Six patients underwent the technique. Four had had prior ligamentoplasty, two had sequelae of tibial spine fractures. Laxity persisted in all cases. The transplant or the ligament were continuous and insertion points were well-positioned. The procedure consisted in using a trephine to bore the tibial bone at the "foot" of the ligament or transplant in order to tighten the ligament. There was no evidence of instability after the arthroscopic tightening procedure. Mean pre- and postoperative differential anterior drawer values were successively 9.2 and 3.9 mm. For native or reconstructed anterior cruciate ligaments, which are continuous and well-positioned but not loose, arthroscopic tightening spares the need for ligament transplant and appears to be free of specific morbidity. PMID:18342033

  14. Biological response modifiers

    SciTech Connect

    Weller, R.E.

    1988-10-01

    Much of what used to be called immunotherapy is now included in the term biological response modifiers. Biological response modifiers (BRMs) are those agents or approaches that modify the relationship between the tumor and host by modifying the host's biological response to tumor cells with resultant therapeutic effects. Most of the early work with BRMs centered around observations of spontaneous tumor regression and the association of tumor regression with concurrent bacterial infections. The BRM can modify the host response by increasing the host's antitumor responses through augmentation and/or restoration of effector mechanisms or mediators of the host's defense or decrease the deleterious component by the host's reaction, increasing the host's defenses by the administration of natural biologics (or the synthetic derivatives thereof) as effectors or mediators of an antitumor response, augmenting the host's response to modified tumor cells or vaccines, which might stimulate a greater response by the host or increase tumor-cell sensitivity to an existing response, decreasing the transformation and/or increase differentiation (maturation) of tumor cells, or increasing the ability of the host to tolerate damage by cytotoxic modalities of cancer treatment.

  15. Biological response modifiers

    SciTech Connect

    Weller, R.E.

    1991-10-01

    Much of what used to be called immunotherapy is now included in the term biological response modifiers. Biological response modifiers (BRMs) are defined as those agents or approaches that modify the relationship between the tumor and host by modifying the host's biological response to tumor cells with resultant therapeutic effects.'' Most of the early work with BRMs centered around observations of spontaneous tumor regression and the association of tumor regression with concurrent bacterial infections. The BRM can modify the host response in the following ways: Increase the host's antitumor responses through augmentation and/or restoration of effector mechanisms or mediators of the host's defense or decrease the deleterious component by the host's reaction; Increase the host's defenses by the administration of natural biologics (or the synthetic derivatives thereof) as effectors or mediators of an antitumor response; Augment the host's response to modified tumor cells or vaccines, which might stimulate a greater response by the host or increase tumor-cell sensitivity to an existing response; Decrease the transformation and/or increase differentiation (maturation) of tumor cells; or Increase the ability of the host to tolerate damage by cytotoxic modalities of cancer treatment.

  16. Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

    PubMed Central

    Narang, Priya; Agarwal, Amar

    2015-01-01

    Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV) were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA), early and late postoperative complications and intraocular pressure (IOP). Ultrasound biomicroscopic (UBM) evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT) was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR]) and CDVA (logMAR) was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061) and the mean CMT at 2 years was 192.5 ± 5.54 μm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8%) case and postoperative uveitis was seen in 2 (5.7%) cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate. PMID:26632124

  17. Surgical experience of minipterional craniotomy with 102 ruptured and unruptured anterior circulation aneurysms.

    PubMed

    Figueiredo, Eberval Gadelha; Welling, Leonardo C; Preul, Mark C; Sakaya, Gabriel Reis; Neville, Iuri; Spetzler, Robert F; Teixeira, Manoel Jacobsen

    2016-05-01

    The pterional approach was described in the 1970s and has become the most utilized cranial approach with many variations described, including the minipterional technique. Although described recently as an alternative to the pterional approach for anterior circulation aneurysms, to our knowledge a large series of cases using the minipterional approach in both ruptured and unruptured aneurysms has not been described. We present our clinical experience with the minipterional craniotomy in more than 100 ruptured and unruptured anterior circulation aneurysms. The results of 86 consecutive patients with 102 ruptured non-giant, anterior circulation aneurysms treated with early surgery utilizing the minipterional craniotomy were analyzed. Postoperative angiography was carried out in all cases. Outcome results were classified as excellent in 67 (77.9%), and good in seven (8.1%), while 16 (13.9%) patients died. The minipterional technique provides adequate surgical exposure and excellent outcomes for both ruptured and unruptured anterior circulation aneurysm clipping. It constitutes a safe and effective alternative to the pterional approach, with equivalent or potentially better aesthetic and functional outcomes. PMID:26924181

  18. Identification of overexpressed immune-related genes in the anterior kidney of channel catfish induced by Edwardsiella ictaluri vaccination.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Using PCR-select subtractive cDNA hybridization technique, 57 expressed sequence tags (ESTs) were isolated from 240 clones of a modified live Edwardsiella ictaluri-vaccinated vs sham-vaccinated channel catfish anterior kidney subtractive library. The transcription levels of the 57 ESTs in response t...

  19. Anterior subtalar dislocation with comminuted fracture of the anterior calcaneal process.

    PubMed

    Hui, Siu Hung Kenneth; Lui, Tun Hing

    2016-01-01

    Anterior subtalar dislocation is a very rare injury. We report a case of an 81-year-old woman who had her right foot injured during a motor vehicle accident. Radiographs showed anterior subtalar dislocation with comminuted fracture of the anterior calcaneal process. The dislocation was closely reduced and protected by a short leg cast. One year postinjury, the patient had only mild pain when walking on uneven ground. There was mild tenderness over the lateral heel. Subtalar motion was mildly painful. There was no pain with ankle motion. PMID:26887882

  20. Surgical techniques of anterior decompression and fusion for spinal cord injuries.

    PubMed

    Bohlman, H H; Eismont, F J

    1981-01-01

    Many patients who have static or only slowly improving neurologic deficits and significant compression of the spinal cord and nerve roots can benefit from anterior decompression. The improvement ranges from partial root recovery to very dramatic improvement in upper as well as lower extremities in the patient with quadriparesis. Intrinsic damage or contusion of the spinal cord cannot be reversed by decompression. Patients with motor sparing preoperatively attain a better functional improvement than those patients who have only slight distal sensory function initially. The same can be said of patients with spinal cord injuries treated with surgery, but we believe the ultimate degree of functional recovery of incomplete cord injuries is greater following anterior than posterior decompression when the operation is indicated. An early accurate diagnosis must be made concerning whether a patient has a complete or an incomplete spinal cord injury. The mechanical compressive lesion must be well documented by myelography, laminography, or CAT scan. The patient should not be neurologically harmed by a posterior laminectomy approach to anterior pathology which additionally removes all posterior stability. An anterior compressive block is best removed through an anterior approach. PMID:7471590

  1. Modifying Achievement Test Items: A Theory-Guided and Data-Based Approach for Better Measurement of What Students with Disabilities Know

    ERIC Educational Resources Information Center

    Kettler, Ryan J.; Elliott, Stephen N.; Beddow, Peter A.

    2009-01-01

    Federal regulations allow up to 2% of the student population of a state to achieve proficiency for adequate yearly progress by taking an alternate assessment based on modified academic achievement standards (AA-MAS). Such tests are likely to be easier, but as long as a test is considered a valid measure of grade level content, it is allowable as…

  2. Balanitis xerotica obliterans involving anterior urethra.

    PubMed

    Herschorn, S; Colapinto, V

    1979-12-01

    Balanitis xerotica obliterans (BXO) is known to affect the urethral meatus, glans, and prepuce. We describe a case of biopsy-proved BXO that involves not only the usual areas but the anterior urethra as well. Of added interest is the subsequent development of squamous cell carcinoma in the fossa navicularis. The literature is reviewed. PMID:516213

  3. Performing an Anterior Cervical Discectomy and Fusion.

    PubMed

    Schroeder, Gregory D; Kurd, Mark F; Millhouse, Paul W; Vaccaro, Alexander R; Hilibrand, Alan S

    2016-06-01

    An anterior cervical discectomy and fusion is one of the most common procedures performed in spine surgery. It allows for a direct decompression of the spinal cord and the neural foramen. When performed properly, the results of this procedure are some of the best in spine surgery. PMID:27187618

  4. A rare case of anterior chamber dirofilariasis

    PubMed Central

    Das, Dipankar; Das, Kalyan; Islam, Saidul; Bhattacharjee, Kasturi; Bhattacharjee, Harsha; Das, Shrutanjoy Mohan; Deka, Apurba

    2015-01-01

    We report a rare case of anterior chamber live dirofilariasis presenting as anterior uveitis. A 60-year-old man presented with dimness of vision in the right eye for 1 month. Vision recorded was 6/18 P, N 18 in the right eye. Slit lamp examination of the right eye revealed anterior uveitis with a moving nemathelminthes. The worm was removed live from the anterior chamber under local anesthesia with assisted methyl cellulose delivery and post-operatively, the worm was examined directly under light microscope. Morphometric measurement showed length of the worm was 6.061 mm. A thin, pale, slender worm was diagnosed as immature female Dirofilaria repens and was documented completely. Patient had made an excellent recovery of vision and intraocular inflammation after the surgical removal of the worm. Intraocular infection of dirofilaria is a rare presentation and successful surgical removal of the worm resulted in complete recovery of uveitis and visual status in the affected eye. PMID:25709276

  5. Two cases of isolated anterior cervical hypertrichosis.

    PubMed

    Reddy, Swapna; Antaya, Richard J

    2010-01-01

    Two unrelated Hispanic females, ages 4 and 3 years, respectively, each presented with a solitary patch of excessive terminal hair growth in the midline of the neck. This rare form of congenital localized hypertrichosis, known as anterior cervical hypertrichosis, is reported here as an isolated defect with no other underlying abnormalities. PMID:20796240

  6. Anterior Chamber Live Loa loa: Case Report.

    PubMed

    Kagmeni, G; Cheuteu, R; Bilong, Y; Wiedemann, P

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  7. Anterior Chamber Live Loa loa: Case Report

    PubMed Central

    Kagmeni, G.; Cheuteu, R.; Bilong, Y.; Wiedemann, P.

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  8. Cytological organization of the alpha component of the anterior olfactory nucleus and olfactory limbus

    PubMed Central

    Larriva-Sahd, Jorge

    2012-01-01

    This study describes the microscopic organization of a wedge-shaped area at the intersection of the main (MOB) and accessory olfactory bulbs (AOBs), or olfactory limbus (OL), and an additional component of the anterior olfactory nucleus or alpha AON that lies underneath of the AOB. The OL consists of a modified bulbar cortex bounded anteriorly by the MOB and posteriorly by the AOB. In Nissl-stained specimens the OL differs from the MOB by a progressive, antero-posterior decrease in thickness or absence of the external plexiform, mitral/tufted cell, and granule cell layers. On cytoarchitectual grounds the OL is divided from rostral to caudal into three distinct components: a stripe of glomerular-free cortex or preolfactory area (PA), a second or necklace glomerular area, and a wedge-shaped or interstitial area (INA) crowned by the so-called modified glomeruli that appear to belong to the anterior AOB. The strategic location and interactions with the main and AOBs, together with the previously noted functional and connectional evidence, suggest that the OL may be related to both sensory modalities. The alpha component of the anterior olfactory nucleus, a slender cellular cluster (i.e., 650 × 150 μm) paralleling the base of the AOB, contains two neuron types: a pyramidal-like neuron and an interneuron. Dendrites of pyramidal-like cells (P-L) organize into a single bundle that ascends avoiding the AOB to resolve in a trigone bounded by the edge of the OL, the AOB and the dorsal part of the anterior olfactory nucleus. Utrastructurally, the neuropil of the alpha component contains three types of synaptic terminals; one of them immunoreactive to the enzyme glutamate decarboxylase, isoform 67. PMID:22754506

  9. Oblique septal crossbar graft for anterior septal angle reconstruction.

    PubMed

    Aziz, Zeeshan S; Brenner, Michael J; Putman, Harrison C

    2010-01-01

    Nasal septal deformity is a central feature of the crooked nose, contributing to functional and aesthetic problems. Straightening of the septum often requires resection, scoring, or incision of the septum--maneuvers that inevitably weaken the cartilaginous dorsal and caudal L-shaped struts, which together are known as the L-strut. Compromise of this L-strut predisposes to septal buckling, recurrent deviation, and saddle nose deformity. We describe our experience with the oblique septal crossbar, a structural graft that allows biomechanically sound anterior septal angle reconstruction during septorhinoplasty. The technique improves dorsal septal support and facilitates correction of the crooked nose. The open septorhinoplasty approach and swinging door maneuver are followed by placement of a diagonally oriented crossbar graft, obtained from cartilage or the perpendicular plate. The approach allows consistent midline correction and buttressing of the nasal dorsum, with no complications to date. PMID:21079121

  10. Aneurysm of azygos anterior cerebral artery: A report of two cases

    PubMed Central

    Ghanta, Rajesh Kumar; Kesanakurthy, Murthy V. S. N.; Vemuri, Varaprasad N.

    2016-01-01

    Aneurysms of azygos anterior cerebral artery (ACA) are rare with very few cases reported in medical literature. We report here two cases of aneurysm of azygos ACA among 105 patients with subarachnoid hemorrhage. The two aneurysms were successfully clipped by using the bifrontal basal interhemispheric approach. PMID:27366270

  11. Cervical Cord Decompression Using Extended Anterior Cervical Foraminotomy Technique

    PubMed Central

    Kim, Sung-Duk; Lee, Cheol-Young; Kim, Hyun-Woo; Jung, Chul-Ku; Kim, Jong Hyun

    2014-01-01

    Objective At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. Methods Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. Results In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was 9.77 mm2 (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. Conclusions Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed. PMID:25328648

  12. Differential pulse anodic stripping voltammetry for detection of As (III) by Chitosan-Fe(OH)3 modified glassy carbon electrode: A new approach towards speciation of arsenic.

    PubMed

    Saha, Suparna; Sarkar, Priyabrata

    2016-09-01

    An efficient electrochemical sensor for As(III) was developed based on adsorption of arsenic on a specially modified electrodes at some applied potential and subsequent i) stripping at a fixed potential by anodic stripping voltammetry ii) analysis by generating surface plasmon resonance (SPR). The working glassy carbon electrode was modified by Chitosan-Fe(OH)3 composite and a reducing agent L-cysteine. The composite enhanced adsorption of As(III) and subsequent reduction to As(O) moieties and measurement by anodic stripping. The surface property of modified electrode was characterized by SEM, AFM, FTIR, XPS and electrochemistry was analyzed by impedance spectroscopy (EIS). Surface Plasmon resonance (SPR) was also employed to investigate the As(III) binding capability of polymer matrix. Several optimum voltammetric parameters e.g supporting electrolyte; 0.1M acetate buffer (pH 5.2) deposition potential, -0.9V; deposition time, 100s were established for anodic stripping voltammetry (ASV). A linear correlation was obtained in the range of 2-100ppb for ASV (R(2) 0.974) with limit of detection 0.072ppb. A variety of common coexistent ions such as Mn, Zn, Pb, Cu, Cd in water samples showed no interferences on the As (III) determination. The method was applied successfully to real samples collected from arsenic affected areas of West Bengal, India. PMID:27343601

  13. Symmetric limb overgrowth following anterior cruciate ligament reconstruction in a skeletally immature patient.

    PubMed

    Zimmerman, Lance J; Jauregui, Julio J; Riis, Jacob F; Tuten, Hans Robert

    2015-11-01

    This report describes a case of symmetric femoral and tibial overgrowth of 2.8 cm in a 13-year-old patient after undergoing reconstruction surgery for his torn right anterior cruciate ligament. A literature review of previous cases is also provided. Following a pediatric anterior cruciate ligament tear, delaying surgery until the patient approaches skeletal maturity may avoid long-term growth disturbances, however, delaying this procedure may increase the probability of further joint damage. This growth disturbance was managed with a percutaneous epiphysiodesis that corrected the limb length deformity. PMID:25919804

  14. Multiparametric MRI of the anterior prostate gland: clinical-radiological-histopathological correlation.

    PubMed

    Moosavi, B; Flood, T A; Al-Dandan, O; Breau, R H; Cagiannos, I; Morash, C; Malone, S C; Schieda, N

    2016-05-01

    Anterior prostate cancer (APC) is defined as a tumour in which more than half of malignant tissue is located anterior to the urethra. APCs are increasingly recognized as clinically important, particularly in patients undergoing active surveillance and for patients with negative non-targeted systematic transrectal ultrasound (TRUS)-guided biopsies but with persistent clinical suspicion of cancer. Multiparametric (mp) MRI has a crucial role for the diagnosis of anterior tumours, eventual histological sampling of suspicious lesions using image-guided targeted biopsy techniques, and potentially, to improve local staging of disease. mpMRI is accurate for the detection of APC and for differentiation of tumour from other anterior prostatic structures including benign prostatic hyperplasia (BPH) and the anterior fibromuscular stroma (AFMS). Characterization and reporting of APC should rely on the recently revised Prostate Imaging and Data Reporting System (PI-RADS) version 2.0 document. T2-weighted (T2W) imaging is emphasized as the determining sequence for assessment of the anterior prostate and specific features for APC on T2W imaging include: ill-defined/spiculated margin, lenticular shape, anterior/inferior location, and growth pattern (invasion of urethra or AFMS and crossing midline). Functional imaging, mainly with diffusion-weighted imaging, is also contributory and improves the sensitivity for detection of APC compared to T2W imaging alone. APCs commonly show positive surgical margins after radical prostatectomy and staging of disease extent using conventional clinical parameters is limited. mpMRI may have a future role to improve local staging of APC. This review illustrates the importance of mpMRI in APC using a clinical-radiological-histopathological approach. PMID:26888762

  15. A Retrospective Study of Survivors of Endovascular Coiling for Posterior and Anterior Aneurysms: Medical and Patient Perspectives.

    PubMed

    Wilson, Sarah J; Drackford, Ruth; Holt, Michael

    2015-08-01

    This article documents the longer-term medical and psychosocial outcomes of patients referred for endovascular coiling.There is limited research investigating outcome following endovascular coiling for posterior compared to anterior circulation aneurysms, and minimal understanding of how medical outcomes relate to patient experiences of treatment and quality of life.We studied a consecutive cohort of 80 patients referred Australia wide for endovascular coiling between 1995 and 2003 (49% posterior; 76% ruptured; 69% women, mean age 51.5 years). We used a mixed methods approach, assessing medical outcome with the Modified Rankin Scale (MRS) in 61 patients (76%), and health-related quality of life and psychosocial functioning using the EuroQol questionnaire and a qualitative semistructured interview in 49 patients (61%).Despite the high proportion of posterior aneurysms, the majority of patients (80%) showed good medical outcomes as indicated by regained independence of activities of daily living (MRS score ≤3). Patients with unruptured aneurysms were significantly more likely to show good outcomes (P < 0.04), whereas aneurysm location (posterior, anterior, or mixed) showed no significant effect. In patients with good medical outcomes, greater functional disability was associated with neurological complications surrounding treatment (P < 0.05). Good outcomes correlated with higher EuroQol ratings (P < 0.001) and the experience of less change after treatment (P < 0.001), although psychosocial adjustment issues were reported by most of the patients, including those with no medical symptoms.These results support the long-term efficacy of endovascular coiling, particularly for posterior circulation aneurysms. They have implications for guiding clinicians and patients in their choice of treatment, as well as the provision of psychological counseling for patient adjustment issues posttreatment. PMID:26266373

  16. A checklist for endonasal transsphenoidal anterior skull base surgery.

    PubMed

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  17. An Experiential Learning Approach to Teaching Social Entrepreneurship, Triple Bottom Line, and Sustainability: Modifying and Extending Practical Organizational Behavior Education (PROBE)

    ERIC Educational Resources Information Center

    Gundlach, Michael J.; Zivnuska, Suzanne

    2010-01-01

    When teaching social entrepreneurship and sustainability, using an experiential learning approach can be more effective than a traditional lecture approach. Social and environmental entrepreneurs often have a deep passion for their work that is important for students to develop early in their careers. Experiential learning enables students to…

  18. Quantitative anatomical labeling of the anterior abdominal wall

    NASA Astrophysics Data System (ADS)

    Allen, Wade M.; Xu, Zhoubing; Asman, Andrew J.; Poulose, Benjamin K.; Landman, Bennett A.

    2013-03-01

    Ventral hernias (VHs) are abnormal openings in the anterior abdominal wall that are common side effects of surgical intervention. Repair of VHs is the most commonly performed procedure by general surgeons worldwide, but VH repair outcomes are not particularly encouraging (with recurrence rates up to 43%). A variety of open and laparoscopic techniques are available for hernia repair, and the specific technique used is ultimately driven by surgeon preference and experience. Despite routine acquisition of computed tomography (CT) for VH patients, little quantitative information is available on which to guide selection of a particular approach and/or optimize patient-specific treatment. From anecdotal interviews, the success of VH repair procedures correlates with hernia size, location, and involvement of secondary structures. Herein, we propose an image labeling protocol to segment the anterior abdominal area to provide a geometric basis with which to derive biomarkers and evaluate treatment efficacy. Based on routine clinical CT data, we are able to identify inner and outer surfaces of the abdominal walls and the herniated volume. This is the first formal presentation of a protocol to quantify these structures on abdominal CT. The intra- and inter rater reproducibilities of this protocol are evaluated on 4 patients with suspected VH (3 patients were ultimately diagnosed with VH while 1 was not). Mean surfaces distances of less than 2mm were achieved for all structures.

  19. Lacrimal sac compression by an anterior ethmoidal mucocele presenting as a late complication of dacryocystorhinostomy

    PubMed Central

    Olaleye, Oladejo; Salleh, Shizalia; David, Don; Bickerton, Richard

    2013-01-01

    This was an unusual case of lacrimal sac compression by an anterior ethmoidal mucocele presenting as a late complication of a dacryocystorhinostomy (DCR) that was jointly managed by ophthalmic and ENT surgeons via an endoscopic approach. A 22-year-old lady presented with a 12-month history of a painless lump in her left medial canthus area and a 6-month history of left intermittent epiphora. She had a DCR when she was 15 years old with initial symptom control until recent recurrence. There were no nasal or other eye symptoms. The rest of the eye and nasendoscopic examinations were unremarkable. An MRI scan suggested a dacryocystocele; however, a further CT scan revealed a 1.6 cm cystic lesion consistent with an anterior ethmoidal mucocele compressing the lacrimal sac. An endoscopic left anterior ethmoidectomy with marsupialisation of the mucocele was performed in combination with an endoscopic DCR. She made good post-operative recovery. PMID:24964413

  20. Amelogenesis imperfecta and anterior open bite: Etiological, classification, clinical and management interrelationships

    PubMed Central

    Alachioti, Xanthippi Sofia; Dimopoulou, Eleni; Vlasakidou, Anatoli; Athanasiou, Athanasios E

    2014-01-01

    Although amelogenesis imperfecta is not a common dental pathological condition, its etiological, classification, clinical and management aspects have been addressed extensively in the scientific literature. Of special clinical consideration is the frequent co-existence of amelogenesis imperfecta with the anterior open bite. This paper provides an updated review on amelogenesis imperfecta as well as anterior open bite, in general, and documents the association of these two separate entities, in particular. Diagnosis and treatment of amelogenesis imperfecta patients presenting also with anterior open bite require a lengthy, comprehensive and multidisciplinary approach, which should aim to successfully address all dental, occlusal, developmental, skeletal and soft tissue problems associated with these two serious clinical conditions. PMID:24987656

  1. Chloroquine-induced bilateral anterior shoulder dislocation: a unique aetiology for a rare clinical problem.

    PubMed

    Martin, Alexander Nicholas; Tsekes, Dimitris; White, William James; Rossouw, Dan

    2016-01-01

    Bilateral anterior shoulder dislocation is a rare clinical entity with few case reports and limited series published in the literature. Bilateral shoulder dislocations are rare and of them, most are posterior. We present a highly unusual case of bilateral, atraumatic, anterior shoulder dislocation with concomitant comminuted greater tuberosity fracture on the right side, secondary to seizure, in a patient without known epilepsy, induced by oral chloroquine medication. We demonstrate the treatment approach that led to a satisfactory clinical outcome, evidenced by radiological union, clinical assessment and Patient Reported Outcome Measure data, following non-operative management of both shoulders. The unusual mechanism for anterior shoulder dislocation, the asymmetric dislocation pattern and peculiar precipitant for the causative seizure all provide interesting learning points from this case. PMID:27005796

  2. Neurosurgical management of anterior meningo-encephaloceles about 60 cases

    PubMed Central

    Rifi, Loubna; Barkat, Amina; El Khamlichi, Abdeslam; Boulaadas, Malek; El Ouahabi, Abdessamad

    2015-01-01

    Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature. All patients beneficed of neuro-radiological investigations including Plan X rays, Spiral Three dimensional CT scan and MRI. Ophthalmologic and maxillo-facial evaluations were done in all the cases. MEA are surgically approached in various ways, mainly on the basis of its location and type, by cranio-facial approach in one-step, or in two stages by intracranial approach followed by facial approach, only by cranial approach or facial approach. The surgical results were evaluated in the follow up on the basis of disappearance of cranio-facial tumefaction with correction of hypertelorism. 60 children with AME were treated in our department between January 1992 and December 2012. The mean age at time of surgery was 14 months (20 days to 18 years) with slight men predominance (28 females/32 males). Cranio-facial team operated 21 patients, 16 were operated in two stages by intracranial approach followed by facial approach, 20 cases beneficed the neurosurgical approach and three only the facial approach Some post operative complications were observed: 2 cases of post operative hydrocephalus underwent shunt; CSF fistulas in three cases cured by spinal drainage, one death due to per operative hypothermia, 3 cases of recurrence how needed second surgery. After mean follow up for 80 months (1 year to 19 years) theses techniques permitted a good cosmetics results in 42 cases, average cosmetics

  3. Anterior Insular Cortex and Emotional Awareness

    PubMed Central

    Gu, Xiaosi; Hof, Patrick R.; Friston, Karl J.; Fan, Jin

    2014-01-01

    This paper reviews the foundation for a role of the human anterior insular cortex (AIC) in emotional awareness, defined as the conscious experience of emotions. We first introduce the neuroanatomical features of AIC and existing findings on emotional awareness. Using empathy, the awareness and understanding of other people’s emotional states, as a test case, we then present evidence to demonstrate: 1) AIC and anterior cingulate cortex (ACC) are commonly coactivated as revealed by a meta-analysis, 2) AIC is functionally dissociable from ACC, 3) AIC integrates stimulus-driven and top-down information, and 4) AIC is necessary for emotional awareness. We propose a model in which AIC serves two major functions: integrating bottom-up interoceptive signals with top-down predictions to generate a current awareness state and providing descending predictions to visceral systems that provide a point of reference for autonomic reflexes. We argue that AIC is critical and necessary for emotional awareness. PMID:23749500

  4. Anterior insular cortex and emotional awareness.

    PubMed

    Gu, Xiaosi; Hof, Patrick R; Friston, Karl J; Fan, Jin

    2013-10-15

    This paper reviews the foundation for a role of the human anterior insular cortex (AIC) in emotional awareness, defined as the conscious experience of emotions. We first introduce the neuroanatomical features of AIC and existing findings on emotional awareness. Using empathy, the awareness and understanding of other people's emotional states, as a test case, we then present evidence to demonstrate: 1) AIC and anterior cingulate cortex (ACC) are commonly coactivated as revealed by a meta-analysis, 2) AIC is functionally dissociable from ACC, 3) AIC integrates stimulus-driven and top-down information, and 4) AIC is necessary for emotional awareness. We propose a model in which AIC serves two major functions: integrating bottom-up interoceptive signals with top-down predictions to generate a current awareness state and providing descending predictions to visceral systems that provide a point of reference for autonomic reflexes. We argue that AIC is critical and necessary for emotional awareness. PMID:23749500

  5. Anterior mediastinal presentation of a giant angiomyolipoma.

    PubMed

    Amir, Afzal M I; Zeebregts, Clark J; Mulder, H Jan

    2004-12-01

    Angiomyolipomas are benign, solitary, noninvasive lesions that most often arise in the kidney. Extrarenal manifestations of these tumors include the skin, oropharynx, the abdominal wall, retroperitoneum, gastrointestinal tract, heart, lung, liver, uterus, penis, and spinal cord. We report a patient with a giant angiomyolipoma located in the anterior mediastinum. We believe this is the seventh reported case of mediastinal angiomyolipoma and the largest reported by size. It is the second reported lesion to arise in the anterior mediastinum. Distinction from other pulmonary or thoracic masses relies on the appreciation of the unique and characteristic histologic features of these mediastinal angiomyolipomas. We conclude that, although rare, angiomyolipoma should be considered in the differential diagnosis of a mediastinal tumor. PMID:15561061

  6. Inferior vena cava injury caused by an anteriorly migrated cage resulting in ligation: case report.

    PubMed

    Ariyoshi, Dai; Sano, Shigeo; Kawamura, Naohiro

    2016-03-01

    Anterior dislodgement of the transforaminal lumbar interbody fusion (TLIF) cage is one of the severe complications seen in this procedure, which may cause an intraoperative major vessel injury. The objective of this report is to present a rare case of inferior vena cava (IVC) injury during revision surgery for removal of the anteriorly migrated cage. The authors describe a case of 74-year-old woman with lumbar spinal canal stenosis and degenerative scoliosis. During the TLIF surgery, an inserted titanium cage at the L4-5 level dislodged anteriorly to the retroperitoneal space without massive bleeding from the disc space. In the second surgery, which was performed via an anterior retroperitoneal approach to remove the migrated cage, massive torrential bleeding occurred because of IVC injury. The laceration in the posterior wall of the IVC necessitated ligation of this vessel and both common iliac veins by a vascular surgeon. Postoperative edema of the lower extremities after ligation of the vessels was well tolerated, and the patient showed almost full recovery. For removal surgery of an anteriorly migrated cage, the surgeon should be well prepared for the risk of IVC injury, including requesting the attendance of a vascular surgeon. Ligation of the infrarenal IVC is an acceptable solution in irreparable IVC injury. PMID:26637062

  7. Anorgasmia in anterior spinal cord syndrome.

    PubMed Central

    Berić, A; Light, J K

    1993-01-01

    Three male and two female patients with anorgasmia and dissociated sensory loss due to an anterior spinal cord syndrome are described. Clinical, neurophysiological and quantitative sensory evaluation revealed preservation of the large fibre dorsal column functions from the lumbosacral segments with concomitant severe dysfunction or absence of the small fibre neospinothalamic mediated functions. These findings indicate a role for the spinothalamic system in orgasm. PMID:8505649

  8. Anorgasmia in anterior spinal cord syndrome.

    PubMed

    Berić, A; Light, J K

    1993-05-01

    Three male and two female patients with anorgasmia and dissociated sensory loss due to an anterior spinal cord syndrome are described. Clinical, neurophysiological and quantitative sensory evaluation revealed preservation of the large fibre dorsal column functions from the lumbosacral segments with concomitant severe dysfunction or absence of the small fibre neospinothalamic mediated functions. These findings indicate a role for the spinothalamic system in orgasm. PMID:8505649

  9. Anterior cervical hypertrichosis and mental retardation.

    PubMed

    Thienpont, Bernard; Vermeesch, Joris; Devriendt, Koen

    2006-07-01

    Anterior cervical hypertrichosis or hairy throat is a rare dysmorphic sign described in a total of 19 patients so far. The association with a number of additional features has been reported, including mental retardation. We report on another patient with this condition who also had moderate mental retardation, mildly dysmorphic facial features, obesity, hypermetropia and additional hair anomalies (low dorsal hair line on the neck, lumbosacral hypertrichosis). Karyotype and array comparative genomic hybridization analysis at 1 Mb resolution were normal. PMID:16760744

  10. Glandular Odontogenic Cyst of the Anterior Mandible

    PubMed Central

    Raju, Srinivasa Pathapati; Reddy, Sridhar Padala; Ananthnag, Jakkula

    2015-01-01

    Context: Glandular odontogenic cyst (GOC) is a rare cyst occurring in the middle-age people with mandibular anterior as the common site of occurrence. Case Report: We report a case of massive GOC in a 65-year-old female with an emphasis on its clinical course, histological features, and treatment modalities. Conclusion: The aggressiveness and recurrences of GOC warrants clinicians for the careful examination, treatment, and long-term follow-up. PMID:25789251

  11. Cervical vertebral fusion with anterior meningocele

    PubMed Central

    Chavredakis, Emmanuel; Carter, David; Bhojak, Manesh; Jenkinson, Michael D; Clark, Simon R

    2015-01-01

    We present the first described case of cervical vertebral fusion associated with anterior meningocele and syringomyelia. A 45-year-old woman presented with minor trauma, and plain cervical spine radiographs highlighted a congenital deformity of the cervical vertebral bodies. She had a normal neurological examination; however, further imaging revealed a meningocele and syringomyelia. This case highlights the importance of thorough imaging investigation when presented with a congenital deformity in order to detect and prevent development of degenerative spinal cord pathologies. PMID:25923673

  12. Anterior segment dysgenesis in mosaic Turner syndrome

    PubMed Central

    Lloyd, I; Haigh, P; Clayton-Smith, J; Clayton, P; Price, D; Ridgway, A; Donnai, D

    1997-01-01

    AIMS/BACKGROUND—Females with Turner syndrome commonly exhibit ophthalmological abnormalities, although there is little information in the literature documenting findings specific to Turner syndrome mosaics. Ophthalmic findings are described in four patients with mosaic Turner syndrome. All had anterior chamber abnormalities and all four had karyotypic abnormalities with a 45, X cell line. The possible relation between the karyotypic and the phenotypic findings in these patients is discussed.
METHODS—Four girls with mosaic Turner syndrome underwent a full ophthalmological assessment, including examination under anaesthesia where indicated.
RESULTS—Three of the four patients presented with congenital glaucoma. Two had the karyotype 45, X/46, X, idic(Y) and one a 45, X/47, XXX karyotype. The remaining child had a Rieger malformation of the iris and the karyotype 45, X/46, X, r(X).
CONCLUSIONS—These findings suggest that Turner syndrome mosaicism (where there are two abnormal cell lines) is associated with anterior segment dysgenesis. The findings in these four patients are compared with those seen in other mosaic phenotypes and it is postulated that the presence of two or more genetically different cell lines may have an adverse effect on anterior segment development.

 PMID:9349149

  13. The thoracic anterior spinal cord adhesion syndrome

    PubMed Central

    Taylor, T R; Dineen, R; White, B; Jaspan, T

    2012-01-01

    Objectives This study included a series of middle-aged male and female patients who presented with chronic anterior hemicord dysfunction progressing to paraplegia. Imaging of anterior thoracic cord displacement by either a dural adhesion or a dural defect with associated cord herniation is presented. Methods This is a retrospective review of cases referred to a tertiary neuroscience centre over a 19-year period. Imaging series were classified by two experienced neuroradiologists against several criteria and correlated with clinical examination and/or findings at surgery. Results 16 cases were available for full review. Nine were considered to represent adhesions (four confirmed surgically) and four to represent true herniation (three confirmed surgically). In the three remaining cases the diagnosis was radiologically uncertain. Conclusion The authors propose “thoracic anterior spinal cord adhesion syndrome” as a novel term to describe this patient cohort and suggest appropriate clinicoradiological features for diagnosis. Several possible aetiologies are also suggested, with disc rupture and inflammation followed by disc resorption and dural pocket formation being a possible mechanism predisposing to herniation at the extreme end of a clinicopathological spectrum. PMID:22665931

  14. Functional Outcomes of Primary Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Allograft

    PubMed Central

    Başar, Selda; Büyükafşar, Enes; Hazar, Zeynep; Ataoğlu, Baybars; Kanatlı, Ulunay

    2014-01-01

    Objectives: Allografts have potential advantages in primary anterior cruciate ligament reconstruction (ACLR), including the absence of donor site morbidity, shorter operative times, improved cosmesis, and easier rehabilitation. There is limited and conflicting outcome data for ACLR with tibialis anterior allograft. The purpose of this study was to evaluate the functional outcomes of ACLR with tibialis anterior allograft. Methods: We retrospectively evaluated patients underwent ACLR using with tibialis anterior allograft between 2005 and 2013. Totally 12 patients who were performed suspensory fixation technique were included in this study (range: 25-43 years). Exclusion criteria included double bundle, bone tendon bone technique and revision surgery. Clinical outcomes were measured by subject part of International Knee Documentation Committee (IKDC) and Lysholm scores. Results: A significant increase was reported in all the clinical scores. In particular, the IKDC-subjective score increased from a basal value of 45.5±12.7 to 84.3±5.50 at the 12 months' evaluation (p<0.05). The Lysholm score revealed a significant improvement from 49.7±14.2 to 83.5±20.5 at the 12 months' evaluation (p<0.05). Conclusion: ACLR with tibialis anterior allograft is an effective treatment for correcting loss of function and increasing quality of life.

  15. Modified maxillomandibular advancement for obstructive sleep apnoea: towards a better outcome for Asians.

    PubMed

    Liao, Y-F; Chiu, Y-T; Lin, C-H; Chen, Y-A; Chen, N-H; Chen, Y-R

    2015-02-01

    Excluding tracheostomy, maxillomandibular advancement (MMA) is the most effective surgical treatment for obstructive sleep apnoea (OSA). However, the anticipated facial changes may prevent acceptance of this procedure by patients with bimaxillary protrusion, a common feature of Asian faces. We therefore developed a modified MMA technique for such cases, consisting of anterior segmental osteotomies together with standard Le Fort I and bilateral sagittal split osteotomies. A prospective study of 20 consecutive Taiwanese adults with moderate-to-severe OSA who underwent modified MMA and postsurgical orthodontics was undertaken to evaluate the efficacy with regard to OSA and the postoperative facial appearance and dental occlusion. After modified MMA, the mean apnoea-hypopnoea index decreased from 41.6±19.2 n/h to 5.3±4.0 n/h (P<0.001). All patients had a successful outcome. No patient was dissatisfied with their postoperative facial appearance. The mean Peer Assessment Rating score decreased from 21.9±14.3 to 1.7±1.6 (P=0.001). The data suggest that the modified MMA is effective in treating patients with moderate-to-severe OSA without negatively affecting facial appearance or dental occlusion. To achieve a better outcome, surgical-orthodontic integration is warranted. The surgery-first approach can achieve early improvement. PMID:25305697

  16. Natural Orifice Translumenal Endoscopic Surgery for Anterior Spinal Procedures

    PubMed Central

    Magno, Priscilla; Khashab, Mouen A.; Mas, Manuel; Giday, Samuel A.; Buscaglia, Jonathan M.; Shin, Eun Ji; Dray, Xavier; Kalloo, Anthony N.

    2012-01-01

    Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae. Methods. Nonsurvival experiments on four 50-kg porcine animals were performed. Transesophageal access to the mediastinum was attained using submucosal tunneling technique. Results. The posterior mediastinum was successfully accessed and navigated in all animals. Vertebral bodies and intervertebral spaces were easily approached while avoiding damage to adjacent vessels. Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples. Conclusions. Peroral transesophageal access into the posterior mediastinum and thoracic vertebral bone biopsy was feasible and safe. The proximity of the esophagus to the vertebral column provides close and direct access to the thoracic spine and opens up new ground for the performance of multilevel anterior spine procedures using NOTES techniques. PMID:22693665

  17. Bilateral anterior cerebral artery aneurysm due to mucormycosis.

    PubMed

    Kasliwal, Manish K; Reddy, Vemuru Sunil K; Sinha, Sumit; Sharma, Bhawani S; Das, Prasenjit; Suri, Vaishali

    2009-01-01

    True mycotic aneurysms are extremely rare cerebrovascular lesions with a dismal prognosis. They mostly follow fungal meningitis or septicaemia and herald their presence with the development of subarachnoid haemorrhage. The authors report an extremely rare occurrence of bilateral anterior cerebral artery aneurysms caused by mucormycosis. The infection was diagnosed after investigation of prolonged fever following transsphenoidal surgery. The aneurysm was diagnosed after a subarachnoid haemorrhage and the patient finally died. The present case highlights an atypical presentation of fungal infection that can perplex the best of clinicians and thus delay diagnosis. As subarachnoid haemorrhage due to true mycotic aneurysmal rupture is uniformly associated with a fatal outcome, the authors speculate that a high index of suspicion should be maintained when a neurosurgical patient is predisposed to fungal infection. This approach, combined with the empirical institution of antifungal drugs, provides the only chance of survival. PMID:19013802

  18. Medical restraints to anterior-posterior motion of the knee.

    PubMed

    Sullivan, D; Levy, I M; Sheskier, S; Torzilli, P A; Warren, R F

    1984-07-01

    We investigated the motion of cadaver knees before and after section of the medial structures and anterior cruciate ligament. The knees were tested using a 5-degrees-of-freedom in vitro knee-testing apparatus that measured anterior-posterior, medial-lateral, and axial displacement as well as internal-external and valgus-varus rotation. The flexion angle could be varied but was fixed for each individual test. A 125-newton anterior-posterior force was applied perpendicular to the tibial shaft and the resulting motion of the knee was measured. In five knees the anterior cruciate ligament was cut first, followed by progressive cuts of the structures on the medial side (superficial medial collateral ligament, deep medial ligament, oblique fibers of the superficial medial ligament, and the posteromedial part of the capsule). Conversely, in five knees the medial structures were progressively cut first, followed by section of the anterior cruciate ligament. Tests were performed after each cut. With an intact anterior cruciate ligament, progressive cutting of the medial side had no effect on anterior and posterior displacements. When section of the medial structures followed cutting of the anterior cruciate ligament, anterior displacement exceeded that seen after isolated section of the anterior cruciate ligament. The anterior and posterior load-tests were repeated with the tibia fixed in 5 degrees of internal and 5 degrees of external rotation. Fixed external rotation had no effect on anterior and posterior displacements. Fixed internal rotation significantly decreased anterior displacement only when both the anterior cruciate ligament and the medial structures were cut.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6736094

  19. Thermodynamics properties study of diatomic molecules with q-deformed modified Poschl-Teller plus Manning Rosen non-central potential in D dimensions using SUSYQM approach

    NASA Astrophysics Data System (ADS)

    Suparmi, A.; Cari, C.; Pratiwi, B. N.

    2016-04-01

    D-dimensional Dirac equation of q-deformed modified Poschl-Teller plus Manning Rosen non-central potential was solved using supersymmetric quantum mechanics (SUSY QM). The relativistic energy spectra were analyzed by using SUSY QM and shape invariant properties from radial part of D dimensional Dirac equation and the angular quantum numbers were obtained from angular part of D dimensional Dirac equation. The SUSY operators was used to generate the D dimensional relativistic wave functions both for radial and angular parts. In the non-relativistic limit, the relativistic energy equation was reduced to the non-relativistic energy. In the classical limit, the partition function of vibrational, the specific heat of vibrational, and the mean energy of vibrational of some diatomic molecules were calculated from the equation of non-relativistic energy with the help of error function and Mat-lab 2011.

  20. A new approach to the study of intramolecular electron-transfer reactions of metalloproteins: Pulse radiolysis of NO[sub 2]-modified tyrosine derivatives of plastocyanin

    SciTech Connect

    Govindaraju, K.; Christensen, H.E.M.; Lloyd, E.; Tomkinson, N.P.; Sykes, A.G. ); Olsen, M. ); Salmon, G.A. )

    1993-01-06

    Single NO[sub 2]-modified derivatives of plastocyanin, with modifications at Tyr83 (spinach) and Tyr83/Tyr62 (parsley, deletions at 57 and 58), have been prepared and characterized by peptide mapping. All three products give a TyrNO[sub 2] UV-vis absorbance band at 355 nm ([epsilon] = 3,900 M[sup [minus]1] cm[sup [minus]1]) at pH < 7.5, assigned to NO[sub 2], which shifts to 428 nm on increasing the pH to > 9.0 due to acid dissociation of the phenolic group. Pulse radiolysis experiments in which the reductant CO[sub 2][sup [sm bullet][minus

  1. Closed-form expressions for state-to-state charge-transfer differential cross sections in a modified Faddeev three-body approach

    SciTech Connect

    Adivi, E. Ghanbari; Brunger, M. J.; Campbell, L.; Bolorizadeh, M. A.

    2007-02-15

    The second-order Faddeev-Watson-Lovelace approximation in a modified form is applied to charge transfer from hydrogenlike target atoms by a fully stripped energetic projectile ion. The state-to-state, nlm{yields}n{sup '}l{sup '}m{sup '}, partial transition amplitudes are calculated analytically. The method is specifically applied to the collision of protons with hydrogen atoms, where differential cross sections of different transitions are calculated for incident energies of 2.8 and 5.0 MeV. It is shown that the Thomas peak is present in all transition cross sections. The partial cross sections are then summed and compared with the available forward-angle experimental data, showing good agreement.

  2. Demonstrating approaches to chemically modify the surface of Ag nanoparticles in order to influence their cytotoxicity and biodistribution after single dose acute intravenous administration.

    PubMed

    Pang, Chengfang; Brunelli, Andrea; Zhu, Conghui; Hristozov, Danail; Liu, Ying; Semenzin, Elena; Wang, Wenwen; Tao, Wuqun; Liang, Jingnan; Marcomini, Antonio; Chen, Chunying; Zhao, Bin

    2016-03-01

    With the advance in material science and the need to diversify market applications, silver nanoparticles (AgNPs) are modified by different surface coatings. However, how these surface modifications influence the effects of AgNPs on human health is still largely unknown. We have evaluated the uptake, toxicity and pharmacokinetics of AgNPs coated with citrate, polyethylene glycol, polyvinyl pyrolidone and branched polyethyleneimine (Citrate AgNPs, PEG AgNPs, PVP AgNPs and BPEI AgNPs, respectively). Our results demonstrated that the toxicity of AgNPs depends on the intracellular localization that was highly dependent on the surface charge. BPEI AgNPs (ζ potential = +46.5 mV) induced the highest cytotoxicity and DNA fragmentation in Hepa1c1c7. In addition, it showed the highest damage to the nucleus of liver cells in the exposed mice, which is associated with a high accumulation in liver tissues. The PEG AgNPs (ζ potential = -16.2 mV) showed the cytotoxicity, a long blood circulation, as well as bioaccumulation in spleen (34.33 µg/g), which suggest better biocompatibility compared to the other chemically modified AgNPs. Moreover, the adsorption ability with bovine serum albumin revealed that the PEG surface of AgNPs has an optimal biological inertia and can effectively resist opsonization or non-specific binding to protein in mice. The overall results indicated that the biodistribution of AgNPs was significantly dependent on surface chemistry: BPEI AgNPs > Citrate AgNPs = PVP AgNPs > PEG AgNPs. This toxicological data could be useful in supporting the development of safe AgNPs for consumer products and drug delivery applications. PMID:25962681

  3. Innovative non-surgical management of pelvic and anterior vaginal wall abscess following vaginal surgery.

    PubMed

    Singh, Nisha; Negi, Neha; Kumar, Namrata

    2016-01-01

    Surgical site infections remain a common cause of morbidity following gynaecological surgery. The widespread implementation of antibiotic prophylaxis prior to surgery, as well as cognizance of modifiable risk factors for postoperative infection, has led to a significant reduction in postoperative infection rates. However, in low resource settings where sepsis and infections are common, surgical site infections following vaginal hysterectomy are sometimes encountered. It is a challenge to treat these infections with minimal intervention avoiding repeat surgery. We report here a unique situation following vaginal hysterectomy and then laparotomy; where a pelvic abscess communicated with the vesicovaginal space and drained through an opening into the anterior vaginal wall. An innovative technique was used to drain this anterior vaginal wall abscess connecting to pelvic cavity using a 40 cm long disposable urinary catheter (made of polyvinyl chloride), which was inserted into the vaginal opening under ultrasound guidance. PMID:27571911

  4. Single-leg postural stability deficits following anterior cruciate ligament reconstruction in pediatric and adolescent athletes.

    PubMed

    Sugimoto, Dai; Howell, David R; Micheli, Lyle J; Meehan, William P

    2016-07-01

    The objective of this study was to compare the postural stability of pediatric and adolescent athletes without anterior cruciate ligament injury with those who underwent anterior cruciate reconstruction (ACLR). Postural stability ratings derived from a video-force plate system during the three stances of the modified Balance Error Scoring System were collected from pediatric and adolescent athletes who underwent ACLR (N=24; mean 1.2 years after surgery) and from uninjured controls (N=479). The postural control rating was calculated as the mean of the displacement and variance of the torso and center of pressure data, normalized on a scale from 0 to 100. A higher rating indicates greater postural stability. Participants who underwent ACLR showed lower postural stability ratings during single-leg stance compared with uninjured controls (40.0 vs. 48.7; P=0.037). ACLR is associated with deficits in postural stability. PMID:26863483

  5. An anterior signaling center patterns and sizes the anterior neuroectoderm of the sea urchin embryo.

    PubMed

    Range, Ryan C; Wei, Zheng

    2016-05-01

    Anterior signaling centers help specify and pattern the early anterior neuroectoderm (ANE) in many deuterostomes. In sea urchin the ANE is restricted to the anterior of the late blastula stage embryo, where it forms a simple neural territory comprising several types of neurons as well as the apical tuft. Here, we show that during early development, the sea urchin ANE territory separates into inner and outer regulatory domains that express the cardinal ANE transcriptional regulators FoxQ2 and Six3, respectively. FoxQ2 drives this patterning process, which is required to eliminate six3 expression from the inner domain and activate the expression of Dkk3 and sFRP1/5, two secreted Wnt modulators. Dkk3 and low expression levels of sFRP1/5 act additively to potentiate the Wnt/JNK signaling pathway governing the positioning of the ANE territory around the anterior pole, whereas high expression levels of sFRP1/5 antagonize Wnt/JNK signaling. sFRP1/5 and Dkk3 levels are rigidly maintained via autorepressive and cross-repressive interactions with Wnt signaling components and additional ANE transcription factors. Together, these data support a model in which FoxQ2 initiates an anterior patterning center that implements correct size and positions of ANE structures. Comparisons of functional and expression studies in sea urchin, hemichordate and chordate embryos reveal striking similarities among deuterostome ANE regulatory networks and the molecular mechanism that positions and defines ANE borders. These data strongly support the idea that the sea urchin embryo uses an ancient anterior patterning system that was present in the common ambulacrarian/chordate ancestor. PMID:26952978

  6. C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: A case report

    PubMed Central

    Zenga, Francesco; Marengo, Nicola; Pacca, Paolo; Pecorari, Giancarlo; Ducati, Alessandro

    2015-01-01

    Background: The transoral ventral corridor is the most common approach used to reach the craniovertebral junction (CVJ). Over the last decade, many case reports have demonstrated the transnasal corridor to the odontoid peg represents a practicable route to remove the tip of the odontoid process. The biomechanical consequences of the traditional odontoidectomy led to the necessity of a cervical spine stabilization. Preserving the inferior portion of the C1 anterior arch should prevent instability. Case Description: This is the first report in which the technique to remove the tip of the odontoid while preserving the C1 anterior arch is described by means of a three-dimensional (3D) endoscope. A 53-year-old man underwent a transnasal 3D endoscopic approach because of a complex CVJ malformation. The upper-medial portion of the C1 anterior arch was removed preserving its continuity, and the odontoidectomy was performed. After surgery, a dynamic X-ray scan showed no difference in CVJ motility in comparison with the preoperative one. Conclusions: The stereoscopic perception augmented the precision of the surgical gesture in the deep field. The importance of a 3D view relates to the depth of field, which a two-dimensional endoscopy cannot provide. This affects the preservation of the C1 anterior arch because of the presence of critical structures that are exposed to potential damage if not displayed. PMID:26759737

  7. Injury to the Anterior Tibial Artery during Bicortical Tibial Drilling in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Kim, Sang Bum; Lim, Jin Woo; Seo, Jeong Gook

    2016-01-01

    Many complications have been reported during or after anterior cruciate ligament (ACL) reconstruction, including infection, bleeding, tibial tunnel widening, arthrofibrosis, and graft failure. However, arterial injury has been rarely reported. This paper reports a case of an anterior tibial arterial injury during bicortical tibial drilling in arthroscopic ACL reconstruction, associated with an asymptomatic occlusion of the popliteal artery. The patient had a vague pain which led to delayed diagnosis of compartment syndrome and delayed treatment with fasciotomy. All surgeons should be aware of these rare but critical complications because the results may be disastrous like muscle necrosis as in this case. PMID:26929808

  8. Injury to the Anterior Tibial Artery during Bicortical Tibial Drilling in Anterior Cruciate Ligament Reconstruction.

    PubMed

    Kim, Sang Bum; Lim, Jin Woo; Seo, Jeong Gook; Ha, Jeong Ku

    2016-03-01

    Many complications have been reported during or after anterior cruciate ligament (ACL) reconstruction, including infection, bleeding, tibial tunnel widening, arthrofibrosis, and graft failure. However, arterial injury has been rarely reported. This paper reports a case of an anterior tibial arterial injury during bicortical tibial drilling in arthroscopic ACL reconstruction, associated with an asymptomatic occlusion of the popliteal artery. The patient had a vague pain which led to delayed diagnosis of compartment syndrome and delayed treatment with fasciotomy. All surgeons should be aware of these rare but critical complications because the results may be disastrous like muscle necrosis as in this case. PMID:26929808

  9. Is a Theory of Elementary Counseling Per Se Passe for the 70's? (An Integrated Approach to Modifying Behavior: Individual and System Change).

    ERIC Educational Resources Information Center

    Witmer, J. Melvin

    Five models for the behavior change process at both the individual and the systemic level are proposed. The author sees them as comprising an integrated or eclectic approach, which he defines as using that which is most appropriate for achieving goals. The five models, which are central in the author's program of counselor education, are: (1) the…

  10. Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature.

    PubMed

    Halani, Sameer H; Baum, Griffin R; Riley, Jonathan P; Pradilla, Gustavo; Refai, Daniel; Rodts, Gerald E; Ahmad, Faiz U

    2016-09-01

    OBJECTIVE Esophageal perforation is a rare but well-known complication of anterior cervical spine surgery. The authors performed a systematic review of the literature to evaluate symptomatology, direct causes, repair methods, and associated complications of esophageal injury. METHODS A PubMed search that adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included relevant clinical studies and case reports (articles written in the English language that included humans as subjects) that reported patients who underwent anterior spinal surgery and sustained some form of esophageal perforation. Available data on clinical presentation, the surgical procedure performed, outcome measures, and other individual variables were abstracted from 1980 through 2015. RESULTS The PubMed search yielded 65 articles with 153 patients (mean age 44.7 years; range 14-85 years) who underwent anterior spinal surgery and sustained esophageal perforation, either during surgery or in a delayed fashion. The most common indications for initial anterior cervical spine surgery in these cases were vertebral fracture/dislocation (n = 77), spondylotic myelopathy (n = 15), and nucleus pulposus herniation (n = 10). The most commonly involved spinal levels were C5-6 (n = 51) and C6-7 (n = 39). The most common presenting symptoms included dysphagia (n =63), fever (n = 24), neck swelling (n = 23), and wound leakage (n = 18). The etiology of esophageal perforation included hardware failure (n = 31), hardware erosion (n = 23), and intraoperative injury (n = 14). The imaging modalities used to identify the esophageal perforations included modified contrast dye swallow studies, CT, endoscopy, plain radiography, and MRI. Esophageal repair was most commonly achieved using a modified muscle flap, as well as with primary closure. Outcomes measured in the literature were often defined by the time to oral intake following esophageal repair. Complications included

  11. Quality-of-Life after Anterior Skull Base Surgery: A Systematic Review.

    PubMed

    Kirkman, Matthew A; Borg, Anouk; Al-Mousa, Alaa; Haliasos, Nikolaos; Choi, David

    2014-04-01

    Background Improved treatment and survival of patients with skull base tumors has made the assessment of quality-of-life (QoL) in this population increasingly important. This article provides a comprehensive systematic review pertaining to QoL assessment in adults undergoing anterior skull base surgery. Methods We performed a literature search using the electronic databases of Ovid Medline and Embase. Additional articles were identified through a search using the phrase anterior skull base. Further articles were sought through hand-searching relevant journals and reference lists of identified articles. Results Our search strategy identified 29 articles for inclusion in our systematic review, with considerable variation between studies in population characteristics, methodological design and quality, follow-up length, and outcome assessment. The most commonly used QoL tools were the Karnofsky Performance Status and the Anterior Skull Base Questionnaire. QoL following anterior skull base surgery appears to improve beyond preoperative levels in the months after surgery. For patients undergoing endoscopic skull base surgery, the gain in QoL appears to be greater and may manifest earlier, with no clear long-term deleterious effect on sinonasal outcomes compared with open surgery. Conclusions QoL after anterior skull base surgery in adults appears to improve within several months of surgery, but earlier and to a larger extent if the endoscopic approach is used. Given the relative paucity and heterogeneity of anterior skull base tumors, large-scale prospective multicentre studies utilizing valid and reliable multidimensional QoL tools are required. This may result in improved patient care, by understanding patients' needs better and facilitating the provision of reliable outcome data for clinical trials. PMID:24719794

  12. Knee imaging after anterior cruciate ligament reconstruction.

    PubMed

    Rodrigues, M B; Silva, J J; Homsi, C; Stump, X M; Lecouvet, F E

    2001-01-01

    An increasing number of reconstructions of the anterior cruciate ligament (ACL) are performed every year, due to both the increasing occurrence of sport related injuries and the development of diagnostic and surgical techniques. The most used surgical procedure for the torn ACL reconstruction is the use of autogenous material, most often the patellar and semitendinosus tendons. Magnetic resonance (MR) imaging and spiral-CT performed after arthrography with multiplanar reconstructions are the imaging methods of choice for post-operative evaluation of ACL ligamentoplasty. This paper provides a brief bibliographic and more extensive pictorial review of the normal evolution and possible complications after ACL repair. PMID:11817479

  13. [Perineal urethrostomy in complex anterior urethral stricture].

    PubMed

    Barbagli, G

    2010-06-01

    Staged urethroplasty is a well-known procedure for urethral reconstruction that had already been described by Russell in 1914 and was later popularized by Johanson, Turner-Warwick, Blandy, and Schreiter. It lends itself to the treatment of complex anterior urethral stricture in combination with lichen sclerosus, failed correction of hypospadias, fistula, via falsa, abscess, carcinoma, or previously unsuccessful urethroplasty. Perineal urethrostomy can be performed as a temporary or definitive measure. Some patients even decline further urethral reconstruction because they perceive subjective satisfaction after perineal urethrostomy that was originally intended to be temporary. PMID:20544335

  14. Evaluation of Different Wastewater Treatment Processes and Development of a Modified Attached Growth Bioreactor as a Decentralized Approach for Small Communities

    PubMed Central

    Valipour, Alireza; Sithebe, Thami

    2013-01-01

    This study was undertaken to evaluate the potential future use of three biological processes in order to designate the most desired solution for on-site treatment of wastewater from residential complexes, that is, conventional activated sludge process (CASP), moving-bed biofilm reactor (MBBR), and packed-bed biofilm reactor (PBBR). Hydraulic retention time (HRT) of 6, 3, and 2 h can be achieved in CASP, MBBR, and PBBR, respectively. The PBBR dealt with a particular arrangement to prevent the restriction of oxygen transfer efficiency into the thick biofilms. The laboratory scale result revealed that the overall reduction of 87% COD, 92% BOD5, 82% TSS, 79% NH3-N, 43% PO4-P, 95% MPN, and 97% TVC at a HRT of 2 h was achieved in PBBR. The microflora present in the system was also estimated through the isolation, identification, and immobilization of the microorganisms with an index of COD elimination. The number of bacterial species examined on the nutrient agar medium was 22 and five bacterial species were documented to degrade the organic pollutants by reducing COD by more than 43%. This study illustrated that the present PBBR with a specific modified internal arrangement could be an ideal practice for promoting sustainable decentralization and therefore providing a low wastage sludge biomass concentration. PMID:24327802

  15. Evaluation of different wastewater treatment processes and development of a modified attached growth bioreactor as a decentralized approach for small communities.

    PubMed

    Azizi, Shohreh; Valipour, Alireza; Sithebe, Thami

    2013-01-01

    This study was undertaken to evaluate the potential future use of three biological processes in order to designate the most desired solution for on-site treatment of wastewater from residential complexes, that is, conventional activated sludge process (CASP), moving-bed biofilm reactor (MBBR), and packed-bed biofilm reactor (PBBR). Hydraulic retention time (HRT) of 6, 3, and 2 h can be achieved in CASP, MBBR, and PBBR, respectively. The PBBR dealt with a particular arrangement to prevent the restriction of oxygen transfer efficiency into the thick biofilms. The laboratory scale result revealed that the overall reduction of 87% COD, 92% BOD₅, 82% TSS, 79% NH₃-N, 43% PO₄-P, 95% MPN, and 97% TVC at a HRT of 2 h was achieved in PBBR. The microflora present in the system was also estimated through the isolation, identification, and immobilization of the microorganisms with an index of COD elimination. The number of bacterial species examined on the nutrient agar medium was 22 and five bacterial species were documented to degrade the organic pollutants by reducing COD by more than 43%. This study illustrated that the present PBBR with a specific modified internal arrangement could be an ideal practice for promoting sustainable decentralization and therefore providing a low wastage sludge biomass concentration. PMID:24327802

  16. Evaluation of the interfacial shear strength and residual stress of TiAlN coating on ZIRLO™ fuel cladding using a modified shear-lag model approach

    NASA Astrophysics Data System (ADS)

    Liu, Y.; Bhamji, I.; Withers, P. J.; Wolfe, D. E.; Motta, A. T.; Preuss, M.

    2015-11-01

    This paper investigates the residual stresses and interfacial shear strength of a TiAlN coating on Zr-Nb-Sn-Fe alloy (ZIRLO™) substrate designed to improve corrosion resistance of fuel cladding used in water-cooled nuclear reactors, both during normal and exceptional conditions, e.g. a loss of coolant event (LOCA). The distribution and maximum value of the interfacial shear strength has been estimated using a modified shear-lag model. The parameters critical to this analysis were determined experimentally. From these input parameters the interfacial shear strength between the TiAlN coating and ZIRLO™ substrate was inferred to be around 120 MPa. It is worth noting that the apparent strength of the coating is high (∼3.4 GPa). However, this is predominantly due to the large compressive residuals stress (3 GPa in compression), which must be overcome for the coating to fail in tension, which happens at a load just 150 MPa in excess of this.

  17. A novel approach for preparation of modified-biochar derived from marine macroalgae: Dual purpose electro-modification for improvement of surface area and metal impregnation.

    PubMed

    Jung, Kyung-Won; Hwang, Min-Jin; Jeong, Tae-Un; Ahn, Kyu-Hong

    2015-09-01

    In the present study, an aluminum electrode-based electrochemical process was newly adopted as a modification method for fabricating physically and chemically modified biochar derived from marine macroalgae. Specifically, a current density of 93.96 mA cm(-2) was applied for 5 min at pH 3.0. Subsequently, the mixture was stirred continuously for 30 min without electric field, and the dried sample was then pyrolyzed at 450 °C under a N2 environment for 2 h. SEM-EDS and XRD analyses clearly indicated that nano-sized aluminum crystals (beohemite, AlOOH) were uniformly present on the EM-biochar surface. Adsorption equilibrium tests showed that the phosphate adsorption onto EM-biochar agreed well with the Langmuir-Freundlich adsorption isotherm model, with a maximum adsorption capacity of 31.28 mg-P g(-1). These findings suggest that this novel and simple electro-modification method is a reasonable and effective option for simultaneously upgrading both the surface area and chemical properties of biochar. PMID:26008889

  18. Using a Modified Intervention Mapping Approach to Develop and Refine a Single-Session Motivational Intervention for Methamphetamine-Using Men Who Have Sex With Men

    PubMed Central

    Zule, William A; Coomes, Curtis M; Karg, Rhonda; Harris, Jennie L; Orr, Alex; Wechsberg, Wendee M

    2010-01-01

    There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical. PMID:20657716

  19. The Dorsal Anterior Cingulate Cortex Modulates Dialectical Self-Thinking

    PubMed Central

    Wang, Fei; Peng, Kaiping; Bai, Yang; Li, Rui; Zhu, Ying; Sun, Pei; Guo, Hua; Yuan, Chun; Rotshtein, Pia; Sui, Jie

    2016-01-01

    Dialectical self-thinking involves holding the view that one can possess contradictory traits such as extraverted and introverted. Prior work has demonstrated that the dorsal part of anterior cingulate cortex (dACC) plays a crucial role in conflict monitoring as well as self-related processing. Here, we tested the function of dACC in dialectical self-thinking using a modified classical self-referential paradigm (self- vs. other-referential thinking), in which participants had to make a judgment whether a simultaneously presented pair of contradictory or non-contradictory traits properly described them while brain activity was recording using functional magnetic resonance imaging (fMRI). The data showed that activity in the dACC during the processing of self-relevant conflicting information was positively correlated with participants’ dispositional level of naïve dialecticism (measured with the Dialectical Self Scale). Psychophysiological interaction (PPI) analyses further revealed increased functional connectivity between the dACC and the caudate, middle temporal gyrus and hippocampus during the processing of self-relevant conflicting information for dialectical thinkers. These results support the hypothesis that the dACC has a key role in dialectical self-thinking. PMID:26903940

  20. Psychosocial Effects of Fractured Anterior Teeth among Rural Children

    PubMed Central

    Naveen, Mohan; Teja, Ravi; Paulindraraj, Shankar; Vallabhaneni, Sai K; Arumugam, Selva B

    2016-01-01

    ABSTRACT Aim: The aim of the study is to determine how rural children view children with visible incisor fracture. Materials and methods: Class 7 (aged 11-12 years) and class 10 (aged 14-15 years) schoolchildren (the participants) were invited to make a social judgment about the color photograph of two children (the subjects). Participants were randomly allocated either (i) pictures of children without incisor fracture or (ii) pictures of the same children whose photographs had been digitally modified to visible incisor fracture. Using a child-centered questionnaire, participants rated subjects using a four-point Likert scale for three negative and six positive attributes. Total attribute scores were tested for significant differences, according to whether the subject had visible incisor fracture or not, using multivariate analysis of variance (p < 0.05). Results: Both class 7 and 10 children rated subjects with visible incisor fracture more negatively than the subjects without incisor fracture. Female participants of class 10 have rated the male subject with incisor fracture significantly negatively (p < 0.01) than male subject without incisor fracture. How to cite this article: Venkatesan R, Naveen M, Teja R, Paulindraraj S, Vallabhaneni SK, Arumugam SB. Psychosocial Effects of Fractured Anterior Teeth among Rural Children. Int J Clin Pediatr Dent 2016;9(2):128-130. PMID:27365933