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Sample records for unilateral zmc fractures

  1. Unilateral Mydriasis After Mandibular Fracture Fixation Surgery

    PubMed Central

    Nesioonpour, Sholeh; Khiabani, Kazem; Hassanijirdehi, Marzieh

    2014-01-01

    Introduction: Unilateral mydriasis is a seriously significant finding in neurologic examinations indicating life-threatening conditions such as cerebral vascular injuries. Case Presentation: A 24 year old woman with mandibular trauma was referred to our center after five days for a reduction of the right mandibular angle fracture. The patient had no history of any loss of consciousness after the accident. Her physical examination showed no abnormalities, except those related to her mandibular fracture. The laboratory results were normal as well. At 8:30 am a general anesthesia was induced. The patients eyes were kept shut throughout the surgical procedure. The operation included an intraoral open reduction and fixation using two miniplates without any complications. After the operation, it was noticed that the left eye was completely dilated with no reaction to light, while the right eye was normal. The management and outcomes in this patient were described in the present case report. Conclusions: Evaluating the size of the patients pupils before, during and after the operation, careful history, consult, CT scan and MRI would help to diagnosis. Although no probable cause was found to explain the transient mydriasis in our patient. PMID:24829881

  2. Three-Dimensional Analysis of Zygomatic-Maxillary Complex Fracture Patterns

    PubMed Central

    Pau, Candace Y.; Barrera, Jose E.; Kwon, Jaehwan; Most, Sam P.

    2010-01-01

    Zygomatic-maxillary (ZMC) complex fractures are a common consequence of facial trauma. In this retrospective study, we present a novel method of ZMC fracture pattern analysis, utilizing three-dimensional visualization of computed tomography (CT) images to record displacement of the malar eminence in a three-dimensional coordinate plane. The pattern of fracture was then correlated with treatment outcome. Facial CT scans were obtained from 29 patients with unilateral ZMC fractures and 30 subjects without fractures and analyzed. Briefly, displacement of the malar eminence (ME) on the fractured side was measured in medial-lateral (x), superior-inferior (y), and anterior-posterior (z) dimensions, as well as Euclidean distance, by comparison to ME location on the unfractured side. Baseline natural variance in asymmetry was accounted for by comparing ME location on the left and right sides in subjects without fractures. Patients who required open reduction and internal fixation (ORIF) to repair the ZMC fracture alone had significantly greater cumulative ME displacements than patients who did not require ORIF (p = 0.02). Additionally, patients with a high fracture score of 3, 4, or 5 (assigned based on severity displacement in each dimension) had significantly higher rates of ORIF than patients with a low fracture score of 0, 1, or 2 (p = 0.05). Severe displacement in one or more dimensions was associated with higher rates of ORIF than seen in patients with only neutral or mild displacements in all dimensions (p = 0.05). Severe x displacement was most strongly correlated with surgical intervention (p = 0.02). Overall, orbital floor repair was less strongly associated with most displacement measures than ZMC repair alone; however, patients requiring orbital floor repair had greater Euclidean ME displacements than patients who did not require orbital floor repair (p = 0.02). Fracture severity, as determined by multiple parameters in this novel evaluation system, is associated with higher rates of ORIF in patients with unilateral ZMC fractures. Determination of ZMC fracture pattern may thus be informative when considering treatment options. PMID:22110833

  3. Unilateral Pedicle Stress Fracture in a Long-Term Hemodialysis Patient with Isthmic Spondylolisthesis

    PubMed Central

    Maruo, Keishi; Tachibana, Toshiya; Inoue, Shinichi; Arizumi, Fumihiro; Yoshiya, Shinichi

    2015-01-01

    Most unilateral pedicle stress fractures occur on the contralateral side of patients with unilateral spondylolysis. However, there are few reports of unilateral pedicle stress fractures in patients with bilateral spondylolysis and spondylolisthesis. We report a unique case of unilateral pedicle stress fracture in a long-term hemodialysis patient with isthmic spondylolisthesis. A 65-year-old man who had undergone hemodialysis presented with lower back pain that had persisted for several years. The patient experienced severe right lower extremity pain with no history of trauma. Computed tomography revealed unilateral pedicle fracture with bilateral L5 spondylolysis and spondylolisthesis with progression of scoliosis. The patient underwent Gill laminectomy of L5 with pedicle screw fixation at L4-S1 and interbody fusion at L5-S1. The patient's leg pain ceased immediately, and he began walking without leg pain. In our present patient, development of scoliosis caused by destructive spondyloarthropathy may have contributed to a unilateral pedicle fracture. PMID:25737789

  4. Bilateral scaphoid stress fracture in a platform diver presenting with unilateral symptoms.

    PubMed

    Mohamed Haflah, Nor Hazla; Mat Nor, Noreen Fazlina; Abdullah, Shalimar; Sapuan, Jamari

    2014-10-01

    Scaphoid stress fracture is rare and occurs mainly in gymnasts. The current literature has only two reported cases: unilateral scaphoid stress fracture in a platform diver and bilateral scaphoid stress fracture in a gymnast. We herein report bilateral stress fracture of the scaphoid in a platform diver who presented with only one symptomatic side. Our patient was a 16-year-old competitive platform diver with an 18-month history of pain in the right wrist. Radiography revealed fracture of the right scaphoid at the waist. As part of our preoperative plan of measuring the scaphoid length to determine the appropriate screw, radiography of the contralateral side was performed, revealing an unexpected fracture of the left scaphoid. Due to the frequency of stress fractures in competitive sports, especially gymnastics, we recommend that bilateral scaphoid radiography be performed for athletes presenting with a unilateral scaphoid fracture, to avoid missing a fracture in the contralateral side. PMID:25631904

  5. Bilateral scaphoid stress fracture in a platform diver presenting with unilateral symptoms

    PubMed Central

    Mohamed Haflah, Nor Hazla; Mat Nor, Noreen Fazlina; Abdullah, Shalimar; Sapuan, Jamari

    2014-01-01

    Scaphoid stress fracture is rare and occurs mainly in gymnasts. The current literature has only two reported cases: unilateral scaphoid stress fracture in a platform diver and bilateral scaphoid stress fracture in a gymnast. We herein report bilateral stress fracture of the scaphoid in a platform diver who presented with only one symptomatic side. Our patient was a 16-year-old competitive platform diver with an 18-month history of pain in the right wrist. Radiography revealed fracture of the right scaphoid at the waist. As part of our preoperativezh to determine the appropriate screw, radiography of the contralateral side was performed, revealing an unexpected fracture of the left scaphoid. Due to the frequency of stress fractures in competitive sports, especially gymnastics, we recommend that bilateral scaphoid radiography be performed for athletes presenting with a unilateral scaphoid fracture, to avoid missing a fracture in the contralateral side. PMID:25631904

  6. Occipital Condyle Fracture With Isolated Unilateral Hypoglossal Nerve Palsy

    PubMed Central

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

    2014-01-01

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

  7. Unilateral versus bilateral balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures.

    PubMed

    Chen, Hua; Tang, Peifu; Zhao, Yanpeng; Gao, Yuan; Wang, Yan

    2014-09-01

    Bilateral and unilateral approaches are the main methods for balloon kyphoplasty. However, controversy exists about which leads to superior outcomes. The goal of this study was to compare the clinical effects and safety of unilateral vs bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures. Five databases (PubMed, Cochrane Library, EMBASE, Web of Science, and Chinese Biomedical Database) were searched without language, publication, or date restrictions. Randomized controlled trials involving a total of 876 patients and comparing the efficacy of unilateral vs bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures were identified. Meta-analysis revealed no significant differences in visual analog scale pain score up to 2-year follow-up (mean difference at 1 week, 0.17 [95% confidence interval (CI), -0.11 to 0.44]; mean difference at 1 year, 0.01 [95% CI, -0.29 to 0.32]; mean difference at 2 years, 0.28 [95% CI, -0.13 to 0.70]), Oswestry Disability Index pain score up to 1-year follow-up (mean difference at 1 week, 1.28 [95% CI, -2.62 to 5.17]; mean difference at 1 year, 1.87 (95% CI, -5.33 to 9.06]), anterior and middle vertebral height (mean difference anterior, -0.13 [95% CI, -0.32 to 0.06]; mean difference middle, -0.16 [95% CI, -0.36 to 0.03]), or kyphotic angle (mean difference, -0.02 [95% CI, -0.65 to 0.61]); however, the unilateral approach resulted in a shorter operative time (mean difference, -19.33 [95% CI, -4.42 to -14.24]), smaller amount of cement injected (mean difference, -2.07 [95% CI, -2.42 to -1.71]), and lower risk of cement leakage (mean difference, 0.47 [95% CI, 0.24-0.92]) than the bilateral approach. The unilateral approach resulted in pain relief and vertebral height and kyphotic angle restoration comparable with that of bilateral kyphoplasty. The unilateral approach should be considered an effective option for the treatment of osteoporotic vertebral compression fractures. PMID:25350627

  8. Severe injury of bilateral elbow joints with unilateral terrible triad of the elbow and unilateral suspected terrible triad of the elbow complicated with olecranon fracture: one case report

    PubMed Central

    Zha, Guoqing; Niu, Xiaofeng; Yu, Weiguang; Xiao, Liangbao

    2015-01-01

    Terrible triad of the elbow is characterized as posterior dislocation of the elbow joint accompanied by the fractures of the radial head and coronoid process of the ulna, which is rarely seen in clinical practice, especially because the mild fracture is barely detected by imaging method In this study, we reported one case of serious complex bilateral elbow injury, presenting with unilateral typical terrible triad of the elbow and suspected terrible triad of the elbow complicated with olecranon fracture on the other side. Clinical experience was obtained during the diagnosis and treatment procedures. PMID:26550399

  9. Severe injury of bilateral elbow joints with unilateral terrible triad of the elbow and unilateral suspected terrible triad of the elbow complicated with olecranon fracture: one case report.

    PubMed

    Zha, Guoqing; Niu, Xiaofeng; Yu, Weiguang; Xiao, Liangbao

    2015-01-01

    Terrible triad of the elbow is characterized as posterior dislocation of the elbow joint accompanied by the fractures of the radial head and coronoid process of the ulna, which is rarely seen in clinical practice, especially because the mild fracture is barely detected by imaging method In this study, we reported one case of serious complex bilateral elbow injury, presenting with unilateral typical terrible triad of the elbow and suspected terrible triad of the elbow complicated with olecranon fracture on the other side. Clinical experience was obtained during the diagnosis and treatment procedures. PMID:26550399

  10. Unilateral versus bilateral percutaneous kyphoplasty for osteoporotic vertebral compression fractures: A systematic review and meta-analysis of RCTs.

    PubMed

    Feng, Hui; Huang, Peng; Zhang, Xuesong; Zheng, Guoquan; Wang, Yan

    2015-11-01

    The purpose of this research was to compare the efficacy and safety of unilateral versus bilateral PKP for osteoporotic vertebral compression fractures (OVCFs). Six databases (Cochrane, PubMed, MEDLINE, EMBASE, SinoMed, and CNKI) were searched without language restrictions. Twelve randomized controlled trials involving a total of 1,030 patients were identified. The results indicate that unilateral PKP had a better degree of pain relief (visual analog scale) than bilateral PKP (p = 0.04; 95%CI =?-0.36 to -0.00) with short-term follow-up (within 4 weeks) after operation. The radiological outcome assessment with short-term follow-up after operation indicates bilateral PKP had a better degree of anterior vertebral height restoration (p = 0.03; 95%CI =?-2.58 to -0.14). Operation time and cement dosage were less for unilateral PKP (p < 0.05). There were no differences in complications such as cement leakage and adjacent vertebral fractures between two approaches (p = 0.06 and p = 0.97, respectively). Life quality assessment (SF-36) indicates unilateral PKP had a better result of bodily pain relief (p < 0.05; 95%CI = 3.93 to 7.48) and general health benefit (p < 0.05; 95%CI = 0.02 to 2.93) with short-term follow-up after operation. We suggest that a unilateral PKP is advantageous. PMID:26123667

  11. Unilateral atlanto-axial fractures in near side impact collisions: An under recognized entity in cervical trauma

    PubMed Central

    Lozen, Andrew M.; Pace, Jonathan; Yoganandan, Narayan; Pintar, Frank A.; Cusick, Joseph F.

    2014-01-01

    Objective: Nearside impact collisions presenting with lateral mass fractures of atlanto-axial vertebrae contralateral to the impact site represents a rare fracture pattern that does not correlate with previously described injury mechanism. We describe our clinical experience with such fractures and propose a novel description of biomechanical forces involved in this unique injury pattern. The findings serve to alert clinicians to potentially serious consequences of associated unrecognized and untreated vertebral artery injury. Material and Methods: In addition to describing our clinical experience with three of these fractures, a review of Crash Injury Research and Engineering Network (CIREN) database was conducted to further characterize such fractures. A descriptive analysis of three recent lateral mass fractures of the atlanto-axial segment is coupled with a review of the CIREN database. A total of 4047 collisions were screened for unilateral fractures of atlas or axis. Information was screened for side of impact and data regarding impact velocity, occupant injuries and use of restraints. Results: Following screening of unilateral fractures of atlas and axis for direct side impacts, 41 fractures were identified. Cross referencing these cases for occurrence contralateral to side of impact identified four such fractures. Including our recent clinical experience, seven injuries were identified: Five C1 and two C2 fractures. Velocity ranged from 14 to 43 km/h. Two associated vertebral artery injuries were identified. Conclusions: Complexity of the atlanto-axial complex is responsible for a sequence of events that define load application in side impacts. This study demonstrates the vulnerability of vertebral artery to injury under unique translational forces and supports the use or routine screening for vascular injury. Diminished sensitivity of plain radiography in identifying these injuries suggests that computerized tomography should be used in all patients wherein a similar pattern of injury is suspected. PMID:25013345

  12. Monte Carlo Modeling of Diffuse Scattering from Single Crystals: The Program ZMC

    SciTech Connect

    Goossens, D.J.; Heerdegen, A.P.; Chan, E.J.; Welberry, T.R.

    2012-04-30

    Diffuse scattering probes the local ordering in a crystal, whereas Bragg peaks are descriptive of the average long-range ordering. The population of local configurations can be explored by modeling the three-dimensional distribution of diffuse scattering. Local configurations are not constrained by the average crystallographic symmetry, so one way of modeling diffuse scattering is by modeling a disordered (short-range-ordered) structure and then calculating its diffuse scattering. The structure must contain enough unit cells to give a statistically valid model of the populations of local configurations, and so requirements for a program to model this ordering are very different from programs that model average crystal structures (used to fit the Bragg diffraction). ZMC is a program that has been developed to model diffuse scattering, particularly from molecular crystals. The strategies used to tackle the problem and the way in which they are implemented will be discussed.

  13. Continuous paravertebral infusion of ropivacaine with or without fentanyl for pain relief in unilateral multiple fractured ribs

    PubMed Central

    Mohta, Medha; Ophrii, Emeni L; Sethi, Ashok Kumar; Agarwal, Deepti; Jain, Bhupendra Kumar

    2013-01-01

    Background: Continuous thoracic paravertebral block (TPVB) provides effective analgesia for unilateral multiple fractured ribs (MFR). However, prolonged infusion of local anaesthetic (LA) in high doses can predispose to risk of LA toxicity, which may be reduced by using safer drugs or drug combinations. This study was conducted to assess efficacy and safety of paravertebral infusion of ropivacaine and adrenaline with or without fentanyl to provide analgesia to patients with unilateral MFR. Methods: Thirty adults, having ?3 unilateral MFR, with no significant trauma outside chest wall, were studied. All received bolus of 0.5% ropivacaine 0.3 ml/kg through paravertebral catheter, followed by either 0.1-0.2 ml/kg/hr infusion of ropivacaine 0.375% with adrenaline 5 ?g/ml in group RA or ropivacaine 0.2% with adrenaline 5 ?g/ml and fentanyl 2 ?g/ml in group RAF. Rescue analgesia was provided by IV morphine. Results: Statistical analysis was performed using unpaired Student t-test, Chi-square test and repeated measures ANOVA. After TPVB, VAS scores, respiratory rate and PEFR improved in both groups with no significant inter-group differences. Duration of ropivacaine infusion, morphine requirements, length of ICU and hospital stay, incidence of pulmonary complications and opioid-related side-effects were similar in both groups. Ropivacaine requirement was higher in group RA than group RAF. No patient showed signs of LA toxicity. Conclusion: Continuous paravertebral infusion of ropivacaine 0.375% with adrenaline 5 ?g/ml at 0.1-0.2 ml/kg/hr provided effective and safe analgesia to patients with unilateral MFR. Addition of fentanyl 2 ?g/ml allowed reduction of ropivacaine concentration to 0.2% without decreasing efficacy or increasing opioid-related side-effects. PMID:24403614

  14. Synthetic metallochaperone ZMC1 rescues mutant p53 conformation by transporting zinc into cells as an ionophore.

    PubMed

    Blanden, Adam R; Yu, Xin; Wolfe, Aaron J; Gilleran, John A; Augeri, David J; O'Dell, Ryan S; Olson, Eric C; Kimball, S David; Emge, Thomas J; Movileanu, Liviu; Carpizo, Darren R; Loh, Stewart N

    2015-05-01

    p53 is a Zn(2+)-dependent tumor suppressor inactivated in >50% of human cancers. The most common mutation, R175H, inactivates p53 by reducing its affinity for the essential zinc ion, leaving the mutant protein unable to bind the metal in the low [Zn(2+)]free environment of the cell. The exploratory cancer drug zinc metallochaperone-1 (ZMC1) was previously demonstrated to reactivate this and other Zn(2+)-binding mutants by binding Zn(2+) and buffering it to a level such that Zn(2+) can repopulate the defective binding site, but how it accomplishes this in the context of living cells and organisms is unclear. In this study, we demonstrated that ZMC1 increases intracellular [Zn(2+)]free by functioning as a Zn(2+) ionophore, binding Zn(2+) in the extracellular environment, diffusing across the plasma membrane, and releasing it intracellularly. It raises intracellular [Zn(2+)]free in cancer (TOV112D) and noncancer human embryonic kidney cell line 293 to 15.8 and 18.1 nM, respectively, with half-times of 2-3 minutes. These [Zn(2+)]free levels are predicted to result in ∼90% saturation of p53-R175H, thus accounting for its observed reactivation. This mechanism is supported by the X-ray crystal structure of the [Zn(ZMC1)2] complex, which demonstrates structural and chemical features consistent with those of known metal ionophores. These findings provide a physical mechanism linking zinc metallochaperone-1 in both in vitro and in vivo activities and define the remaining critical parameter necessary for developing synthetic metallochaperones for clinical use. PMID:25710967

  15. Unilateral posterior vertebral column resection for severe thoracolumbar kyphotic deformity caused by old compressive vertebrae fracture: a technical improvement

    PubMed Central

    Wang, Hui; Zhang, Di; Sun, Ya-Peng; Ma, Lei; Ding, Wen-Yuan; Shen, Yong; Zhang, Ying-Ze

    2015-01-01

    Severe thoracolumbar kyphotic deformity caused by old compressive vertebrae fracture remains a big challenge for spine surgeons. When symptoms related to significant deformities cannot be adequately managed conservatively, posterior vertebral column resection (PVCR) is required, but with long operating time and severe blood loss. We develop a UPVCR technique, which is done through a unilateral approach instead of a bilateral approach, vertebral body resection advancing to cross the midline in an abrasive way from an extreme oblique orientation enable the resection of most contralateral vertebral body. In the present study, the effects of UPVCR for severe thoracolumbar kyphotic deformity were investigated. We did find that satisfactory correction of sagittal deformity, functional improvement and pain relief can be achieved by UPVCR, and it has the advantage of shortening surgery time, reducing blood loss and incidence of nerve root impingement over PVCR. PMID:26064252

  16. Management of tripod fractures (zygomaticomaxillary complex) 1 point and 2 point fixations: A 5-year review

    PubMed Central

    Balakrishnan, K.; Ebenezer, Vijay; Dakir, Abu; Kumar, Saravana; Prakash, D.

    2015-01-01

    The zygomaticomaxillary complex (ZMC) plays a key role in the structure, function, and esthetic appearance of the facial skeleton. They can account for approximately 40% of mid-face fractures. They are the second most common facial bone fracture after nasal bone injuries. The fracture complex results from a direct blow to the malar eminence and results in three distinct fracture components that disrupt the anchoring of the zygoma. In addition, the fracture components may result in impingement of the temporalis muscle, trismus (difficulty with mastication) and may compromise the infraorbital foramen/nerve resulting in hypesthesia within its sensory distribution. A 4-year retrospective review of all patients treated with ZMC fractures at oral and maxillofacial surgery department, sree balaji dental college and hospital was performed. Computed tomography scans were reviewed. Demographics, treatment protocols, outcomes, complications, reoperations, and length of follow-up were identified. A total of 245 patients was identified by the Current Procedural Terminology codes for ZMC fractures. Closed or open reduction methods were performed with the goal of treatment being preservation of normal facial structure, sensory function, globe position, and mastication functionality. Unacceptably poor surgical outcomes are uncommon. Significant facial asymmetry requiring surgical revision occurs in 3-4% of patients. Postoperative infection rates are extremely low, and these infections nearly always resolve with oral antibiotics. In general, the long-term prognosis after repair of ZMC fractures is very good. PMID:26015723

  17. Bilateral atypical insufficiency fractures of the proximal tibia and a unilateral distal femoral fracture associated with long-term intravenous bisphosphonate therapy: a case report

    PubMed Central

    2012-01-01

    Introduction Atypical insufficiency fractures of the femur in patients on long-term bisphosphonate therapy have been well described in recent literature. The majority of cases are associated with minimal or no trauma and occur in the subtrochanteric or diaphyseal region. Case presentation We describe the case of a 76-year-old British Caucasian woman who presented initially to an emergency department and then to her primary care physician with a long-standing history of bilateral knee pain after minor trauma. Plain radiographs showed subtle linear areas of sclerosis bilaterally in her proximal tibiae. Magnetic resonance imaging confirmed the presence of insufficiency fractures in these areas along with her left distal femur. There are very few reports of atypical insufficiency fractures involving the tibia in patients on long-term bisphosphonate therapy and this appears to be the only documented bilateral case involving the metaphyseal regions of the proximal tibia and distal femur. Conclusion In addition to existing literature describing atypical fractures in the proximal femur and femoral shaft, there is a need for increased awareness that these fractures can also occur in other weight-bearing areas of the skeleton. All clinicians involved in the care of patients taking long-term bisphosphonates need to be aware of the growing association between new onset lower limb pain and atypical insufficiency fractures. PMID:22309438

  18. Unilateral perseveration.

    PubMed

    Acosta, Lealani Mae Y; Goodman, Ira J; Heilman, Kenneth M

    2013-12-01

    The brain's action-intentional ("when") programming system helps to control when to and when not to initiate an action, when to persist at an action, and when to terminate an action. Motor perseveration is a failure to terminate an action. This disengagement disorder most often results from dysfunction of the executive frontal-subcortical networks that control the action-intentional programming system. Reports of unilateral perseveration are unusual. Here we describe a patient with a form of progressive supranuclear palsy (PSP) who exhibited continuous right-hand motor perseveration. This 68-year-old right-handed man had impaired walking and vertical gaze, consistent with PSP. He often repeated words, and on many motor tasks he showed continuous perseveration of his right but not his left hand. Unilateral motor perseveration may be a sign of PSP, the corticobasal syndrome, or a subtype of these disorders. Future studies of patients with both disorders should use tasks that assess for asymmetric hand perseveration. The mechanism of the unilateral perseveration must also be determined. Bilateral perseveration is found most often in patients with unilateral right frontal-subcortical (basal ganglia) or insula dysfunction. Because patients with PSP or corticobasal syndrome have callosal degeneration, their unilateral perseveration might result from a callosal disconnection of the right frontal lobe from the left hemisphere's premotor and motor as well as speech areas. PMID:24366105

  19. Fractures

    PubMed Central

    Hall, Michael C.

    1963-01-01

    Recent studies on the epidemiology and repair of fractures are reviewed. The type and severity of the fracture bears a relation to the age, sex and occupation of the patient. Bone tissue after fracture shows a process of inflammation and repair common to all members of the connective tissue family, but it repairs with specific tissue. Cartilage forms when the oxygen supply is outgrown. After a fracture, the vascular bed enlarges. The major blood supply to healing tissue is from medullary vessels and destruction of them will cause necrosis of the inner two-thirds of the cortex. Callus rapidly mineralizes, but full mineralization is achieved slowly; increased mineral metabolism lasts several years after fracture. PMID:13952119

  20. Fractures

    MedlinePLUS

    A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open ... falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the ...

  1. Mechanics in the Production of Mandibular Fractures: A Clinical, Retrospective Case-Control Study

    PubMed Central

    Yang, Rongtao; Li, Zhi; Li, Zubing

    2016-01-01

    As the mandible is susceptible to fracture, the aim of this study was to use multivariate logistic regression analysis to identify and distinguish various internal factors that may influence the location of mandibular fractures. The study included 1131 patients with maxillofacial fractures during the period from January 2000 to December 2009 to evaluate the association of mandibular fracture location (unilateral symphysis, body, angle, condylar, or bilateral condylar fractures) with various internal factors. Among the 1131 patients, 869 had mandibular fractures. Data on age, sex, soft tissue injuries, dental trauma, and maxillofacial fracture type were collected and analyzed using multivariate logistic regression. In total, 387, 210, 139, 319, and 172 patients were diagnosed with unilateral symphysis, body, angle, unilateral, or bilateral condylar fractures, respectively. The dental trauma in patients with bilateral condylar fractures differed from that in patients with unilateral condylar fractures. Patients with mandibular fracture (unilateral symphysis, body, unilateral or bilateral condylar) possessed an approximately equal risk of soft tissue injuries in the mandible. Patients with either unilateral or bilateral condylar fractures were associated with a low risk of mandibular angle fracture (OR < 1). Similarly, patients with mandibular angle fracture were associated with a low risk of unilateral or bilateral condylar fractures (OR < 1). Moreover, patients with symphysis fracture were associated with a low risk of bilateral condylar fractures (90 of 387 [23.3%], OR 0.899). By contrast, patients with bilateral condylar fractures were associated with a high risk of symphysis fracture (90 of 172 [52.3%], OR 17.38). Patients with condylar fractures, particularly those with bilateral condylar fractures, were infrequently associated with secondary mandibular fractures. Mandibular fractures tended to have less of an association with midfacial fractures. The occurrence of mandibular fractures is strongly correlated with age, sex, soft tissue injuries, dental trauma, and the pattern and position of the maxillofacial fractures in patients. PMID:26900699

  2. Unilateral watershed cerebral infarcts.

    PubMed

    Bogousslavsky, J; Regli, F

    1986-03-01

    We studied 51 patients with symptomatic unilateral watershed (WS) cerebral infarct on CT. In 22 patients, the infarct was between the superficial territory of the anterior and middle cerebral arteries, 20 had an infarct between the superficial territory of the middle and posterior cerebral arteries, and 9 had an infarct between the superficial and deep territory of the middle cerebral arteries. Each type had a characteristic neurologic picture. Syncope at onset (37%) and focal limb shaking (12%) were frequent. Thirty-eight patients (75%) had internal carotid artery occlusion or tight stenosis associated with a hemodynamically significant cardiopathy, increased hematocrit, or acute hypotension. Embolic infarction was probable in only two patients (4%) who had only atrial fibrillation. PMID:3951705

  3. Nose fracture

    MedlinePLUS

    Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It ... with other fractures of the face. Sometimes a blunt injury can ...

  4. Skull fracture

    MedlinePLUS

    Basilar skull fracture; Depressed skull fracture; Linear skull fracture ... Skull fractures may occur with head injuries . The skull provides good protection for the brain. However, a severe impact ...

  5. Noncompliance unilateral maxillary molar distalization:.

    PubMed

    Mavropoulos, Anestis; Sayinsu, Korkmaz; Allaf, Ferdi; Kiliaridis, Stavros; Papadopoulos, Moschos A; Keles, Ahmet Ozlem

    2006-05-01

    The aim of this prospective study was the three-dimensional (3-D) analysis of tooth movements after unilateral upper molar distalization by means of a noncompliance intraoral appliance, the Keles slider. This appliance exerts a distalizing force of 150 g at approximately the level of the center of resistance of the upper first molar. Twelve patients (six girls and six boys with a mean age of 13.1 years) with a unilateral Class II molar relationship participated in the study. Dental casts were taken immediately before placement and after removal of the appliance. The casts were digitized using a 3-D surface laser scanner and superimposed on a predefined area of the palate. The average unilateral upper first molar distal movement was 3.1 mm (range: 2.4 to 5.3 mm). Anchorage loss was expressed by a 2.1 mm (range: 0.8 to 3.8 mm) proclination of the central incisors and a 6.1 degrees mesial inclination of the ipsilateral first premolar (range: 1.7 degrees to 12.3 degrees ). There was approximately 1 mm of midline deviation toward the contralateral side and a 1.6 mm (range: 0.8 to 2.3 mm) buccal displacement of the contralateral first premolar. A substantial variation was observed among patients. Noncompliance unilateral upper molar distalization was an efficient treatment approach. There was, however, a substantial anchorage loss. Case selection is strongly recommended because significant anterior crowding, ectopic canines, or spacing can lead to significant anchorage loss. PMID:16637715

  6. Unifocal versus multifocal mandibular fractures and injury location.

    PubMed

    Buch, Karen; Mottalib, Adham; Nadgir, Rohini N; Fujita, Akifumi; Sekiya, Kotaro; Ozonoff, Al; Sakai, Osamu

    2016-04-01

    Mandibular fractures are frequently encountered in the trauma setting and comprise a significant number of facial injuries. The purpose of this study was to evaluate the prevalence and injury patterns of unifocal and multifocal mandibular fractures using thin-section imaging. Following IRB approval, 220 patients with mandibular fractures identified on maxillofacial CT scans performed between October 2008 and February 2011 were retrospectively reviewed. Examinations were performed on 64-multidetector row CT scanners with axial images acquired at 1.25-mm slice thickness. The location and number of fractures as well as causative mechanisms were recorded. Fractures were unifocal in 108/220 (49 %) and multifocal in 112/220 (51 %) patients. The mandibular angle was the most common fracture site in both unifocal and multifocal mandible fractures. In cases with multifocal mandibular fractures, bilateral fractures were more common (83 %) than unilateral multifocal mandibular fractures (17 %). Fractures involving the parasymphysis, the mandibular body, or ramus were significantly associated with the presence of additional mandibular fractures (p < 0.0001). While multifocal and unifocal fractures occurred in near equal frequency, bilateral multifocal fractures were much more common than unilateral multifocal mandibular fractures. Alveolar ridge fractures were exclusively seen in unifocal mandibular fractures. PMID:26797024

  7. Bilateral pneumothorax after unilateral transthoracic puncture.

    PubMed

    Yamaura, Hidekazu; Inaba, Yoshitaka; Sato, Yozo; Najima, Mina; Shimamoto, Hiroshi; Nishiofuku, Hideyuki

    2007-06-01

    Pneumothorax is a common complication following transthoracic interventional procedures. Most often, this occurs unilaterally on the side of the intervention. Bilateral pneumothorax following unilateral puncture is rare, but may mandate emergent chest tube insertion. We describe two cases in which bilateral pneumothorax occurred after unilateral thoracic puncture. One patient had a history of esophageal resection, while the other had no history of thoracic surgery. PMID:17538145

  8. Unilateral ptosis and eye dominance.

    PubMed

    Lyon, D B; Gonnering, R S; Dortzbach, R K; Lemke, B N

    1993-12-01

    We studied the relationship between eye dominance (Scobee test) and upper lid level (MRD) in 54 patients with unilateral ptosis or asymmetric bilateral ptosis (> or = 2 mm difference in MRD) using the phenylephrine test. A contralateral lid drop was measured in 12/54 patients after instillation of 2.5% phenylephrine in the more ptotic eye and occurred in both congenital (3) and acquired (9) ptosis cases. A contralateral lid drop was seen in 7/14 (50%) patients whose ptosis was greater in the dominant eye and in 5/40 (12.5%) patients whose ptosis was greater in the nondominant eye (p = .01). Contralateral lid drops > or = 1 mm were present in 7/54 patients, and 6/14 (43%) of them had greater ptosis on the dominant side and 1/40 (2.5%) on the non-dominant side (p = .001). There was no association between contralateral pseudoretraction and either visual acuity or severity of ptosis. These results suggest that levator muscle tone is influenced by eye dominance when ptosis is present. The preoperative evaluation of unilateral or asymmetrical bilateral ptosis cases should include the Scobee and phenylephrine tests to unmask contralateral upper lid pseudoretraction. PMID:8305369

  9. Unilateral acute idiopathic maculopathy. 1991.

    PubMed

    Yannuzzi, Lawrence A; Jampol, Lee M; Rabb, Maurice F; Sorenson, John A; Beyrer, Charles; Wilcox, Lloyd M

    2012-02-01

    This is a report of nine patients who experienced sudden, severe, unilateral central vision loss following a flulike illness. Each patient had an exudative detachment of the macula. All patients experienced a spontaneous resolution of the acute macular manifestations with near-complete recovery of vision. A characteristic "bull's-eye" appearance in the macula persisted. The acute manifestations of the disorder did not recur in any of the patients during the period of follow-up. The constellation of findings was suggestive of an inflammatory disease of the retinal pigment epithelium, but a specific causative agent could not be identified. The acute clinical and angiographic features, the natural course, and the residual pigment epithelial derangement were not consistent with any previously described disorder. PMID:22451959

  10. Acute unilateral facial nerve palsy.

    PubMed

    Yeong, Siew Swan; Tassone, Peter

    2011-05-01

    Mrs PS, 78 years of age, presented with acute left-sided otalgia, ear swelling and subsequent unilateral facial paralysis (Figure 1). She denied any otorrhoea or hearing loss. Past medical history relevant to the presenting complaint included: * Bell palsy diagnosed 20 years ago with no residual effect * biopsy confirmed benign parotid lump (diagnosed 3 years previously). Histopathology revealed a pleomorphic adenoma. Mrs PS declined surgical intervention at the time * chicken pox as a child * normal fasting blood glucose 1 month previously and no known immune compromise. Examination revealed yellow crusts and small vesicles on the external acoustic meatus (Figure 2). A 10 mm well defined firm and nontender nodule was palpable at the ramus of the mandible. PMID:21597548

  11. Delayed Unilateral Adrenal Hemorrhage Complicating Pneumococcal Septic Shock.

    PubMed

    Wharton, Jeff; Cohen, David

    2015-10-01

    An 80-year-old male presented to the hospital after being found unresponsive at home. He was found to have pneumococcal pneumonia complicated by septic shock. He was treated in the medical ICU briefly with vasopressors and received intravenous antibiotics. He achieved a full recovery and was discharged after 10 days. He returned within 24 hours with vague abdominal and chest pain. His complaints of pain were difficult to localize--radiating from back to chest and abdomen. He received an extensive work-up to exclude acute coronary syndrome, pulmonary embolism, pancreatitis, cholecystitis, and rib fracture. He was ultimately found to have a symptomatic unilateral adrenal hemorrhage, likely secondary to the acute stress of septic shock. PMID:26638422

  12. Unilateral Lumbosacral Dislocation: Case Report and a Comprehensive Review

    PubMed Central

    Grivas, Theodoros B; Papadakis, Stamatios A; Katsiva, Vassiliki; Koufopoulos, George; Mouzakis, Vassilios

    2012-01-01

    Lumbosacral fracture-dislocation is a rare occurrence. There are more than 73 cases reported in the English literature. We report on the imaging findings and surgical treatment in a patient suffered of unilateral traumatic L5-S1 dislocation associated with severe disruption of the posterior ligamentous complex. The patient underwent open reduction and stabilization of L4-S1 vertebrae with posterior instrumentation system. Open reduction and internal fixation was mandatory as post-traumatic ligamentous insufficiency would lead to abnormal motion. Operative treatment managed to produce a solid arthrodesis and restore stability of the lumbosacral junction. Follow-up revealed excellent results. This study reports a rare injury of the lumbosacral junction, and the literature concerning this unusual condition is extensively reviewed. PMID:23166575

  13. 48 CFR 30.603-2 - Unilateral and desirable changes.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... contractor is initiating management actions directly associated with the change that will result in cost... Unilateral and desirable changes. (a) Unilateral changes. (1) The contractor may unilaterally change its... the aggregate, as a result of the unilateral change. (2) Prior to making any contract price or...

  14. 48 CFR 30.603-2 - Unilateral and desirable changes.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... contractor is initiating management actions directly associated with the change that will result in cost... Unilateral and desirable changes. (a) Unilateral changes. (1) The contractor may unilaterally change its... the aggregate, as a result of the unilateral change. (2) Prior to making any contract price or...

  15. Hand Fractures

    MedlinePLUS

    ... are set, they are held together with pins, plates, or screws (see Figure 2). Fractures that disrupt ... of fractures in fingers. Figure 2: Examples of plates, pins, and screws used to join fractures while ...

  16. Shoulder Fractures

    MedlinePLUS

    ... Hand Therapist? Media Find a Hand Surgeon Shoulder Fractures Email to a friend * required fields From * To * ... create difficulty with its function. Types of Shoulder Fractures The type of fracture varies by age. Most ...

  17. Trilateral retinoblastoma with unilateral eye involvement.

    PubMed

    Andrade, Gabriel Costa de; Pinto, Neviçolino Pereira de Carvalho; Motono, Márcia; Chojniak, Martha Motono; Chojniak, Rubens; Bezerra, Stephania Martins

    2015-08-01

    Retinoblastomas (RB) are the main forms of intraocular tumor in childhood, with a worldwide incidence of 1 case per 15,000 to 20,000 live births. Trilateral RB (RBT) is a rare combination of unilateral or bilateral RB with a midline intracranial neoplasm of neuroblastic origin, usually found in the pineal region or the suprasellar region, presenting variable incidence of 0.5% up to 6% among patients with RB. The article reports a case of unilateral RBT in a patient treated at Hospital A.C.Camargo. PMID:26466209

  18. Pregnancy in a unilaterally ovariohysterectomised queen.

    PubMed

    Jurka, Piotr; Kacprzak, Kamil J; Degórska, Beata

    2015-04-01

    A 4-year-old female Russian Blue cat presented with signs of right-sided abdominal distension, anorexia and a mucoid vaginal discharge. On the basis of clinical and ultrasonographical findings a tentative diagnosis of uterine torsion was made. Exploratory coeliotomy revealed a 900º right uterine torsion along the longitudinal axis. Unilateral ovariohysterectomy was performed. Subsequently, the cat had two successful and uneventful pregnancies. To our knowledge this is the first case report of pregnancy in a unilaterally ovariohysterectomised queen. PMID:25414240

  19. Analysis of the Biomechanical Properties of the Mandible After Unilateral Distraction Osteogenesis

    PubMed Central

    Schwarz, Daniel A.; Arman, Krikor G.; Kakwan, Mehreen S.; Jamali, Ameen M.; Buchman, Steven R.

    2012-01-01

    Background The purpose of this study was to establish biomechanical outcomes measures to evaluate how mandibular distraction osteogenesis affects the overall quality of bone healing in the mandible. Strength and functional integrity of the regenerate was quantitatively determined after unilateral mandibular distraction osteogenesis in comparison to the contralateral mandible, and a partially reduced fracture. We hypothesized that the breaking load, yield and stiffness of mandibular distraction osteogenesis would be significantly reduced in comparison to both the contralateral mandible and a partially reduced fracture. Methods Sprague-Dawley rats underwent mandibular distraction osteogenesis (n=8) or a partially reduced fracture (n=6). External fixators were secured, unilateral osteotomies created behind the 3rd molar, followed by either mandibular distraction osteogenesis: 4days latency then 0.3mm Q12hrs 8days (5.1mm) or a partially reduced mandibular fracture: fixed gap post-operatively (2.1mm). Both groups underwent 4 weeks consolidation. The contralateral mandibles were used as controls (n = 14). Mandibles were tension tested at 0.5mm/s to failure and then breaking load, yield and stiffness were determined. Results mandibular distraction osteogenesis had significantly lower breaking load, yield and stiffness when compared to the contralateral mandible, by 40%, 30% and 60%, respectively. Breaking load was reduced in partially reduced mandibular fractures by 40% when compared to mandibular distraction osteogenesis. Conclusion Utilizing a standard Ilizarov protocol, the strength and durability of the regenerate, as measured by breaking load, yield and stiffness in mandibular distraction osteogenesis was significantly lower than contralateral mandibles. Surprisingly, the breaking load of mandibular distraction osteogenesis was significantly greater than partially reduced mandibular fracture. These verifiable metrics of regenerate integrity can be utilized to discern optimal outcomes of mandibular distraction osteogenesis, and to extrapolate the data from the bench and bring it to the bedside, enhancing the clinical applications of this powerful technique. PMID:20375764

  20. Obstetric fractures.

    PubMed

    Nadas, S; Reinberg, O

    1992-06-01

    The purpose of this study was to determine the risk factors predisposing to an obstetric fracture, and their long-term outcome. We reviewed 28 obstetric fractures treated in the County of Vaud, Switzerland, between 1976 and 1989. There were 12 fractures of long bones, 10 clavicles and 6 depressed skull fractures. The belief that obstetric fractures occur in large babies or after breech deliveries is no longer valid. The common risk factors of these fractures are obstetric maneuvers during delivery (75% of cases), especially Cesarean sections (35%), prolonged labor (33%), and prematurity (25%). Cephalic presentation (64.2% of cases) is more frequent than breech position (32.1%). Weight, size, age of gestation, age of the mother, parity, gestity, and time of delivery cannot be considered as risk factors for obstetric fractures. For each type of fracture some specific risk factors are pointed out: maneuvers at birth for depressed skull fracture, Cesarean section, breech delivery with assistance and low birth weight for the fractures of long bones. All fractures were treated conservatively, except for skull fractures with a depression of more than 2 cm. Early consolidation is achieved within 2 weeks. Long-term prognosis for obstetric fractures is good without sequelae. PMID:1498109

  1. Transient visual loss after right unilateral ECT.

    PubMed

    Kurani, Amit P; Kellner, Charles H; Turbin, Roger E; Serodio, Paulo; Sheren, Lorne B; Tannen, Brad

    2005-09-01

    We report a case of transient bilateral visual loss in a 27-year-old patient with a diagnosis of bipolar disorder after right unilateral electroconvulsive therapy that occurred immediately after her first session and resolved within 24 hours. We discuss possible mechanisms for this adverse effect. PMID:16127312

  2. Motor cortex excitability during unilateral muscle activity.

    PubMed

    Christova, M I; Pondev, N G; Christova, L G; Wolf, W; Dengler, R; Kossev, A R

    2006-10-01

    The effect of unilateral tonic muscle activity with and without co-activation of the antagonists on motor cortex excitability has been studied. Motor evoked potentials (MEPs) were recorded from the first dorsal interosseus muscles of both hands in response to transcranial magnetic stimulation (TMS) during relax, isometric index finger abduction and antagonistic co-activation. The intracortical inhibition (ICI) and intracortical facilitation (ICF) were investigated by paired-pulse TMS with interstimulus intervals of 3 and 13 ms. The unilateral tonic activation of the right hand facilitated contralateral and ipsilateral responses (cMEP and iMEP) recorded from both hands with an exception of iMEPs recorded from the left hand. During paired-pulse TMS ICI for cMEPs was not influenced by the unilateral tonic activity in both hands, while ICF was suppressed when MEPs were recorded from the active right hand. The effect of unilateral tonic activity on iMEP in response to paired-pulse TMS was essentially different: generally, ICI was greater for iMEPs and ICF was completely abolished with an exception of iMEPs recorded from the left hand during right finger isometric abduction when a strong ICF was evident. The decreased ICF and/or increased ICI are assumed to reflect mechanisms underlying the co-activation of antagonists. PMID:16275014

  3. Unilateral vestibular loss impairs external space representation.

    PubMed

    Borel, Liliane; Redon-Zouiteni, Christine; Cauvin, Pierre; Dumitrescu, Michel; Devze, Arnaud; Magnan, Jacques; Pruch, Patrick

    2014-01-01

    The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menire's disease and healthy participants were instructed to point to memorized targets in near (peripersonal) and far (extrapersonal) spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menire's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation), and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss. PMID:24523916

  4. Fracture Management

    MedlinePLUS

    Fracture Management 804 W. Diamond Ave., Ste. 210 Gaithersburg, MD 20878 (800) 981-2663 (301) 947-0083 ... a disorder that is characterized by frequent bone fractures. As a result, people with this disorder may ...

  5. Unilateral scrotal angiomas: An expression of underlying varicocele.

    PubMed

    Tromp, Elise E; Kouwenhoven, Stijn T P; Quint, Koen D; Gmelig Meijling, Kevin A; Genders, Roel E

    2016-02-01

    The current casereport describes a 35-year-old man who presented with unilateral scrotal angiomas. The presence of unilateral scrotal angiomas was associated with an underlying varicocele on the ipsilateral side due to increased venous pressure. In case of unilateral scrotal angiomas further examination for underlying pathology is necessary. PMID:26175040

  6. Modification of unilateral otolith responses following spaceflight.

    PubMed

    Clarke, Andrew H; Schnfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing. PMID:26358122

  7. Facial fractures.

    PubMed Central

    Carr, M. M.; Freiberg, A.; Martin, R. D.

    1994-01-01

    Emergency room physicians frequently see facial fractures that can have serious consequences for patients if mismanaged. This article reviews the signs, symptoms, imaging techniques, and general modes of treatment of common facial fractures. It focuses on fractures of the mandible, zygomaticomaxillary region, orbital floor, and nose. Images p520-a p522-a PMID:8199509

  8. Ankle Fractures

    MedlinePLUS

    .org Ankle Fractures (Broken Ankle) Page ( 1 ) A broken ankle is also known as an ankle “fracture.” This means that one or more of the ... may not stop you from walking, to several fractures, which forces your ankle out of place and ...

  9. Scaphoid fractures.

    PubMed

    Ramponi, Denise R

    2012-01-01

    The scaphoid is the most commonly fractured of the eight carpal wrist bones. The mechanism of injury is usually from a fall on the outstretched hand. Initial radiographs may not identify a scaphoid fracture. A high index of suspicion given to these biomechanics and the physical findings will assist in the identification of this fracture. Certain fractures of the scaphoid are at high risk of avascular necrosis and nonunion requiring splinting and orthopedic referral of suspected fractures to assist in preventing such complications. PMID:23111304

  10. Rapidly fluctuating anosmia: A clinical sign for unilateral smell impairment.

    PubMed

    Negoias, Simona; Friedrich, Hergen; Caversaccio, Marco D; Landis, Basile N

    2016-02-01

    Reports about fluctuating olfactory deficits are rare, as are reports of unilateral olfactory loss. We present a case of unilateral anosmia with contralateral normosmia, presenting as rapidly fluctuating anosmia. The olfactory fluctuation occurred in sync with the average nasal cycle duration. Examination after nasal decongestion, formal smell testing, and imaging revealed unilateral, left-sided anosmia of sinonasal cause, with right-sided normosmia. We hypothesize that the nasal cycle induced transient anosmia when blocking the normosmic side. Fluctuating olfactory deficits might hide a unilateral olfactory loss and require additional unilateral testing and thorough workup. Laryngoscope, 126:E57-E59, 2016. PMID:26153195

  11. Mandibulectomy for treatment of fractures associated with severe periodontal disease.

    PubMed

    Carvalho, Carina Marchiori; Rahal, Sheila Canevese; Dos Reis Mesquita, Luciane; Castilho, Mara Sales; Kano, Washington Takashi; Mamprim, Maria Jaqueline

    2015-03-01

    Six cases of mandibular fractures associated with severe periodontal disease that had been treated by mandibulectomy, due to intense bone loss, were evaluated retrospectively. The dogs were mainly older, small breed dogs that had suffered a traumatic event. Four dogs had a bilateral mandibulectomy and 2 a unilateral mandibulectomy. PMID:25750452

  12. [Unilateral retinal pseudoarteritis after eyeball contusion].

    PubMed

    Arend, N; Thurau, S

    2012-12-01

    This article reports an unusual case of unilateral frosted branch angiitis. Three major groups of this disease are known: secondary frosted branch angiitis due to viral infection or autoimmune diseases, frosted branch-like angiitis related to malignant diseases and the rare entity of idiopathic frosted branch angiitis. A 58-year-old patient presented with strictly unilateral sheathing and partly occluded retinal arteries, vitritis and macular edema and 4 months prior to presentation he suffered a contusion of the eye with traumatic cataract and vitreous hemorrhage followed by cataract extraction and vitrectomy. The general medical history revealed that the contralateral eye and biochemical analyses were unremarkable despite slightly elevated antinuclear antibody (ANA) levels. Under high dose steroid therapy the patient showed slow improvement in all clinical findings. This case does not fit into any of the known groups and can therefore be defined as pseudoarteritis. PMID:22736263

  13. Unilateral Blaschkoid lichen planus in successive pregnancies

    PubMed Central

    Kumar, Shiva; Okade, Rajendra; Rahman, Yasmin Abdul

    2011-01-01

    A number of genetic, congenital and acquired dermatoses have been known to follow Blaschko's lines. A common disorder like lichen planus can very rarely present with pruritic lesions in atypical patterns such as unilateral distribution, painful eruptions and along Blaschko's lines. Various triggering factors varying from viral infections and vaccinations to trauma have been implicated in lichen planus. We describe a female patient in the second trimester of her second pregnancy who developed unilateral lichen planus along Blaschko's lines during both pregnancies. No case of lichen planus along Blaschko's lines recurring during pregnancy is reported so far. Could pregnancy itself be a contributory factor towards onset of lichen planus in this case? PMID:25386287

  14. Paramedian unilateral Le Fort I osteotomy

    PubMed Central

    Tauro, David P.; Uppada, Uday Kiran

    2015-01-01

    A novel maxillary osteotomy is designed which is a technical modification of the standard Le Fort I osteotomy, termed the paramedian unilateral Le Fort I osteotomy. This technique has been used to correct an anterior open bite in a given patient based on the current clinical scenario as described, secondary to post ankylosis surgery. Its use may be extrapolated to various clinical situations to correct occlusal discrepancies including distraction osteogenesis. PMID:26389040

  15. Functioning unilateral adrenocortical carcinoma in a dog

    PubMed Central

    Gójska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech

    2012-01-01

    An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery. PMID:23204580

  16. Functioning unilateral adrenocortical carcinoma in a dog.

    PubMed

    Gójska-Zygner, Olga; Lechowski, Roman; Zygner, Wojciech

    2012-06-01

    An 11-year-old, 24-kg, intact female Siberian husky dog in anestrus had a 2-month history of polyuria and polydipsia. The dog had signs of mineralocorticoid excess such as hypertension and hypokalemia refractory to potassium supplementation. Abdominal ultrasound revealed an irregular mass in the left adrenal gland. The ACTH stimulation test for aldosterone concentration did not reveal hyperaldosteronism. Unilateral adrenalectomy was performed and histopathology identified adrenal cortical carcinoma. All clinical signs of mineralocorticoid excess ceased after surgery. PMID:23204580

  17. Accommodative Performance of Children With Unilateral Amblyopia

    PubMed Central

    Manh, Vivian; Chen, Angela M.; Tarczy-Hornoch, Kristina; Cotter, Susan A.; Candy, T. Rowan

    2015-01-01

    Purpose. The purpose of this study was to compare the accommodative performance of the amblyopic eye of children with unilateral amblyopia to that of their nonamblyopic eye, and also to that of children without amblyopia, during both monocular and binocular viewing. Methods. Modified Nott retinoscopy was used to measure accommodative performance of 38 subjects with unilateral amblyopia and 25 subjects with typical vision from 3 to 13 years of age during monocular and binocular viewing at target distances of 50, 33, and 25 cm. The relationship between accommodative demand and interocular difference (IOD) in accommodative error was assessed in each group. Results. The mean IOD in monocular accommodative error for amblyopic subjects across all three viewing distances was 0.49 diopters (D) (95% confidence interval [CI], 1.12 D) in the 180 meridian and 0.54 D (95% CI, 1.27 D) in the 90 meridian, with the amblyopic eye exhibiting greater accommodative errors on average. Interocular difference in monocular accommodative error increased significantly with increasing accommodative demand; 5%, 47%, and 58% of amblyopic subjects had monocular errors in the amblyopic eye that fell outside the upper 95% confidence limit for the better eye of control subjects at viewing distances of 50, 33, and 25 cm, respectively. Conclusions. When viewing monocularly, children with unilateral amblyopia had greater mean accommodative errors in their amblyopic eyes than in their nonamblyopic eyes, and when compared with control subjects. This could lead to unintended retinal image defocus during patching therapy for amblyopia. PMID:25626970

  18. Hip fracture - discharge

    MedlinePLUS

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - ...

  19. Simultaneous Bilateral or Unilateral Carpal Tunnel Release?

    PubMed Central

    Osei, Daniel A.; Calfee, Ryan P.; Stepan, Jeffrey G.; Boyer, Martin I.; Goldfarb, Charles A.; Gelberman, Richard H.

    2014-01-01

    Background: Over 60% of patients with carpal tunnel syndrome present with symptoms and findings of nerve compression in both hands. Our goal was to compare patient-rated difficulties in performing activities of daily living in the early postoperative period between those undergoing bilateral carpal tunnel release and those undergoing unilateral carpal tunnel release. Methods: This prospective cohort study enrolled consecutive patients with bilateral carpal tunnel syndrome undergoing bilateral carpal tunnel release (n = 47) or unilateral carpal tunnel release (n = 41). Patient function and disease severity were measured by an abbreviated form of the Disabilities of the Arm, Shoulder and Hand questionnaire, QuickDASH, and the Boston Carpal Tunnel Questionnaire at baseline, at postoperative visit 1 at a mean time (and standard deviation) of 10 3 days, and at postoperative visit 2 at a mean time (and standard deviation) of 30 6 days. Patients rated their difficulty in completing fifteen activities of daily living each day for the first postoperative week. Patients reported the factors that influenced their choice of surgery. Results: There was no difference in baseline function or disease severity between the two groups with regard to QuickDASH and the Boston Carpal Tunnel Questionnaire. Patients in both groups improved after carpal tunnel release with no difference between groups either at postoperative visit 1 for QuickDASH (p = 0.97) and the Boston Carpal Tunnel Questionnaire (p = 0.86) or at postoperative visit 2 for QuickDASH (p = 0.43) and the Boston Carpal Tunnel Questionnaire (p = 0.34). Patients undergoing bilateral carpal tunnel release had more difficulty only during postoperative days 1 to 2 in opening jars (p = 0.03), cooking (p = 0.008), and doing household chores (p = 0.02). Patients in the two groups did not differ (p > 0.05) in their abilities to perform activities of daily living necessary for personal hygiene or independence on any day during the first seven days following surgery with regard to using the bathroom, bathing, dressing, or eating. Although the most common reason why patients chose bilateral carpal tunnel release was to avoid two surgical procedures (42%), the most common reason why patients chose unilateral carpal tunnel release was concern for self-care (36%). Conclusions: Patients with bilateral carpal tunnel syndrome can anticipate more severe functional impairment during the first few postoperative days with bilateral carpal tunnel release compared with unilateral carpal tunnel release, but limitations beyond postoperative day 2 or 3 are similar for bilateral and unilateral carpal tunnel release. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. PMID:24897736

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

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

    2012-07-01

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

  2. Acetabular Central Fracture Dislocation after Generalized Seizure during Lumbar Myelography with Iohexol

    PubMed Central

    Park, Kyung-Soon; Moon, Jae-Young; Oh, Chang-Seon; Yoon, Taek-Rim

    2013-01-01

    Fracture is a less common complication in seizure patients, and fractures as a consequence of convulsive seizures without direct trauma occur in 0.3% of cases. Acetabular fractures after convulsions are even more rare, and only a few cases of acetabular fracture dislocations, purely caused by convulsive activity, have been reported. Therefore, we report a case of unilateral acetabular central fracture dislocation after a seizure episode, with relevant literature review. The seizure attack occurred after contrast media (Iohexol) injection for checking the myelography. PMID:23607018

  3. Elbow Fractures

    MedlinePLUS

    ... and in the elderly. Nerve and/or artery injuries can be associated with these types of fractures and must be carefully evaluated by your doctor. These fractures usually require surgical repair with plates and/or screw, unless they are stable. SIGNS ...

  4. Ocular Tuberculosis with Progressive Unilateral Corneal Melting

    PubMed Central

    Bayraktutar, Betl N.; Uakhan-Gndz, mr

    2015-01-01

    Objectives In this case report, we present a patient with ocular tuberculosis presenting with progressive unilateral corneal melting. Patient A 47-year-old female was admitted with melting at the inferior half of the peripheral cornea and inferior subconjunctival nodules. Biopsy material of the nodules was negative for tuberculosis bacillus. However, polymerase chain reaction of the biopsy sample revealed the DNA of the bacillus, and the diagnosis was confirmed. Conclusion In endemic areas, ocular tuberculosis should be kept in mind in the differential diagnosis of patients with chronic and atypical corneal involvement. PMID:26483670

  5. Neurological asymmetries immediately after unilateral ECT.

    PubMed Central

    Kriss, A; Blumhardt, L D; Halliday, A M; Pratt, R T

    1978-01-01

    Twenty-nine right handed patients were examined neurologically before and immediately after each of 62 unilateral ECTs to the dominant and non-dominant hemispheres. Most convulsions were followed by signs of transitory neurological dysfunction referable to the treated hemisphere. These signs included deep tendon reflex asymmetry, hemiparesis, tactile and visual inattention, and homonymous hemianopia. After treatment to the right hemisphere some patients had left visuospatial neglect, while all patients who had dominant hemisphere ECT were transiently dysphasic. All neurological abnormalities tested resolved within 20 minutes of treatment. PMID:731257

  6. Unilateral Molar Distalization: A Nonextraction Therapy

    PubMed Central

    Prasad, M. Bhanu; Sreevalli, S.

    2012-01-01

    In the recent years, nonextraction treatment approaches and noncompliance therapies have become more popular in the correction of space discrepancies. One of the conventional approaches for space gaining in the arches without patient compliance is done by using certain extra oral appliances or intraoral appliance. The greatest advantage of certain appliances like fixed functional and molar distalization appliances is that they minimize the dependence on patient cooperation. Molar distalization appliances like pendulum appliance which distalizes the molar rapidly without the need of head gear can be used in patients as a unilateral space gaining procedure due to buccal segment crowding. PMID:23320203

  7. Management of Children with Unilateral Hearing Loss.

    PubMed

    Lieu, Judith E C

    2015-12-01

    Children with impaired hearing in one ear (unilateral hearing loss [UHL]) and normal hearing in the other ear experience challenges in understanding speech in noisy backgrounds and localizing the source of sounds in 3-dimensional space. They are at a high risk for speech and language delay and need educational help in school. However, definitive evidence of benefit from amplification is currently lacking to recommend placement of hearing aids or cochlear implants in all young children with UHL. Management of UHL in children should be guided by the child's development, performance in school, and personal/family values and preferences. PMID:26443488

  8. External fixation as a primary and definitive treatment for tibial diaphyseal fractures.

    PubMed

    Beltsios, Michail; Savvidou, Olga; Kovanis, John; Alexandropoulos, Panagiotis; Papagelopoulos, Panagiotis

    2009-10-01

    The aim of this study was to evaluate the effectiveness of unilateral external fixator as primary and definitive treatment for open tibial fractures, fractures with severe soft tissues injuries, threatened compartment syndrome, and in multiply injured patients. Two hundred and twenty-three tibial shaft fractures (212 patients) were treated. In open fractures, union was achieved in 25weeks, while in closed in 21. There were 18 nonunions, 21 delayed unions, 4 malunions, 58 pin infections and 3 osteomyelitis. A reoperation was performed in 42 patients. Fat embolism was diagnosed in three patients, pulmonary embolism in five and deep venous thrombosis in 14. The external fixator was definitive treatment in 87.27%. Unilateral external fixators can be used as primary and definitive treatment for complicated tibia shaft fractures. Re-operation or change of the method must be performed only when there is a delay in callus formation. PMID:19714440

  9. Multifractal fracture

    SciTech Connect

    Williford, R.E.

    1988-11-01

    This paper discusses the relationship between fracture energies and the fractal dimensions (D/sub s/) of fracture surfaces. Fractal dimensions provide a means to describe complicated geometries in terms of transitions between the integer-valued Euclidean dimensions. For fracture surfaces, D/sub s/ is between 2 and 3 because the surface features (i.e., the roughness R) extend from the two-dimensional mean plane of the surface into the third dimension. It has generally been found that a greater R results in greater D/sub s/. Only single dimensions have been used in previous applications of fractals to fracture problems. The purpose of this paper is to propose an explanation for this negative correlation based on the above spectrum of dimensions. This spectrum is part of a recent extension of the fractal concept: multifractals. In the following, a brief description of the multifractal concept provides a new understanding of the correlation (ordering) between the energetics of various fracture mechanisms and the complicated geometries of material damage. This ordering is quantified by a multifractal fracture model that is based on a partitioning of fracture mechanisms into two basic types: ductile (shear) or brittle (tensile). Interactive mechanisms in heterogeneous materials (composites) are implicitely included in the model, and a method for model verification by comparison to measured values of D/sub s/ is demonstrated.

  10. Clinical verification of a unilateral otolith test

    NASA Astrophysics Data System (ADS)

    Wetzig, J.; Hofstetter-Degen, K.; Maurer, J.; von Baumgarten, R. J.

    In a previous study 13 we reported promising results for a new test to differentiate in vivo unilateral otolith functions. That study pointed to a need for further validation on known pathological cases. In this presentation we will detail the results gathered on a group of clinically verified vestibular defectives (verum) and a normal (control) group. The subjects in the verum group were former patients of the ENT clinic of the university hospital. These subjects had usually suffered from neurinoma of the VIIth cranial nerve or inner ear infections. All had required surgical intervention including removal of the vestibular system. The patients were contacted usually two or more years postoperatively. A group of students from the pre- and clinical phase of medical training served as control. Both groups were subjected to standardized clinical tests. These tests served to reconfirm the intra- or postoperative diagnosis of unilateral vestibular loss in the verum group. In the control group they had to establish the normalcy of the responses of the vestibular system. Both groups then underwent testing on our exccentric rotary chair in the manner described before 13. Preliminary results of the trials indicate that this test may indeed for the first time offer a chance to look at isolated otolith apparati in vivo.

  11. [Unilateral spatial and motor neglect in children].

    PubMed

    Laurent-Vannier, A; Pradat-Diehl, P; Chevignard, M; Abada, G

    2001-04-01

    Although unilateral spatial neglect is well documented in adults after a cerebral damage, the description in children is rare and no motor neglect has yet been reported. We report four children age range from three to thirteen years old, in patients in a rehabilitation department. A cancellation task "the Teddy bear test" was used to assess spatial neglect in children. The children were presented a page containing line drawings of usual objects, including fifteen Teddy bears. The children were asked to cross out each Teddy bear. These four children omitted five to eleven teddy bears located on the left space, whereas children of the controlled group never omitted more than one Teddy bear. The four children also exhibited neglect in drawings, and during daily life activities. Moreover, one of them had a motor neglect with no more defects of strength and an under-utilization of his left side. Spatial unilateral neglect and motor neglect should be systematically investigated in children after a cerebral damage, and should be considered during rehabilitation. PMID:11398014

  12. [Spontaneous unilateral adrenal hematomas. 10 cases].

    PubMed

    Hoeffel, C; Legmann, P; Luton, J P; Chapuis, Y; Bonnin, A

    1994-06-11

    Spontaneous unilateral adrenal haematoma is a very rare condition. We report 10 such cases in which the pathological examination confirmed the diagnosis and for which computed tomography (CT) (n = 10) and magnetic resonance imaging (MRI) (n = 5) were performed. The diagnosis of this condition was difficult because there was no specific clinical setting nor any specific functional disorder. CT most often revealed a large mass (> 4 cm) of one of the adrenal glands, most often displaying soft-tissue attenuation and thus not specific. However, MRI suggested the diagnosis, showing foci of hypersignal on T1-weighted images and heterogeneous masses on T2-weighted images, predominantly displaying hypersignal and not enhancing, after Gd-DTPA dynamic perfusion study. Pathologic examination of the surgical specimen confirmed either idiopathic haematoma (n = 5) or haematoma possibly associated with a small benign tumour (n = 5). The diagnosis of adrenal haematoma must be considered when an unilateral isolated large adrenal mass is discovered in an asymptomatic patient. MRI with Gd-DTPA dynamic perfusion study has to be performed and one may suggest waiting and repeat imaging (so as to follow decrease in size or signal changes) in order to avoid surgery. PMID:7971805

  13. Wrist Fractures

    MedlinePLUS

    ... may be fixed with many devices. Pins, screws, plates, rods or external fixation can all be used ( ... Radius fracture shown stabilized with external fixation and plate and screws. © 2015 American Society for Surgery of ...

  14. Regenerate Healing Outcomes in Unilateral Mandibular Distraction Osteogenesis Using Quantitative Histomorphometry

    PubMed Central

    Schwarz, Daniel A.; Arman, Krikor G.; Kakwan, Mehreen S.; Jamali, Ameen M.; Elmeligy, Ayman A.; Buchman, Steven R.

    2015-01-01

    Background The authors goal was to ascertain regenerate bone-healing metrics using quantitative histomorphometry at a single consolidation period. Methods Rats underwent either mandibular distraction osteogenesis (n=7) or partially reduced fractures (n=7); their contralateral mandibles were used as controls (n=11). External fixators were secured and unilateral osteotomies performed, followed by either mandibular distraction osteogenesis (4 days latency, then 0.3 mm every 12 hours for 8 days; 5.1 mm) or partially reduced fractures (fixed immediately postoperatively; 2.1 mm); both groups underwent 4 weeks of consolidation. After tissue processing, bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, and osteocyte count per high-power field were analyzed by means of quantitative histomorphometry. Results Contralateral mandibles had statistically greater bone volume/tissue volume ratio and osteocyte count per high-power field compared with both mandibular distraction osteogenesis and partially reduced fractures by almost 50 percent, whereas osteoid volume/tissue volume ratio was statistically greater in both mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles. No statistical difference in bone volume/tissue volume ratio, osteoid volume/tissue volume ratio, or osteocyte count per high-power field was found between mandibular distraction osteogenesis specimens and partially reduced fractures. Conclusions The authors findings demonstrate significantly decreased bone quantity and maturity in mandibular distraction osteogenesis specimens and partially reduced fractures compared with contralateral mandibles using the clinically analogous protocols. If these results are extrapolated clinically, treatment strategies may require modification to ensure reliable, predictable, and improved outcomes. PMID:20463629

  15. Delayed unilateral traumatic brain swelling in a child

    PubMed Central

    Paiva, Wellingson S.; Beer-Furlan, André; Soares, Matheus S.; Teixeira, Manoel J.

    2014-01-01

    Traumatic brain injury is a leading cause of morbidity and death in the pediatric population. In this study, we report a delayed unilateral traumatic brain swelling in a child with initial favorable evolution and sudden neurological deterioration after 4 days; highlighting clinical, physiopathological and radiological aspects of delayed unilateral brain swelling. PMID:25250079

  16. Unilateral external ophthalmoplegia in Miller Fisher syndrome: case report

    PubMed Central

    Smith, Jonathan; Clarke, Lucy; Severn, Philip; Boyce, Robert

    2007-01-01

    Background A description of the diagnostic features of Miller Fisher syndrome. Case presentation The clinical presentation, investigation, and subsequent progress of our patient with clinical unilateral external ophthalmoplegia. Conclusion Our case demonstrates the presentation of clinical unilateral external ophthalmoplegia as part of the full triad of Miller Fisher syndrome. PMID:17439660

  17. Reproducibility of Tactile Assessments for Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Auld, Megan Louise; Ware, Robert S.; Boyd, Roslyn Nancy; Moseley, G. Lorimer; Johnston, Leanne Marie

    2012-01-01

    A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were

  18. Reproducibility of Tactile Assessments for Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Auld, Megan Louise; Ware, Robert S.; Boyd, Roslyn Nancy; Moseley, G. Lorimer; Johnston, Leanne Marie

    2012-01-01

    A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were…

  19. Fractures of the articular processes of the cervical spine

    SciTech Connect

    Woodring, J.H.; Goldstein, S.J.

    1982-08-01

    Fractures of the articular processes occurred in 16 (20.8%) of 77 patients with cervical spine fractures as demonstrated by multidirectional tomography. Plain films demonstrated the fractures in only two patients. Acute cervical radiculopathy occurred in five of the patients with articular process fractures (superior process, two cases; inferior process, three cases). Persistent neck pain occurred in one other patient without radiculopathy. Three patients suffered spinal cord damage at the time of injury, which was not the result of the articular process fracture itself. In the other seven cases, no definite sequelae occurred. However, disruption of the facet joint may predispose to early degenerative joint disease and chronic pain; unilateral or bilateral facet dislocation was present in five patients. In patients with cervical trauma who develop cervical radiculopathy, tomography should be performed to evaluate the articular processes.

  20. Temporal Bone Fracture Causing Superior Semicircular Canal Dehiscence

    PubMed Central

    Peng, Kevin A.; Yang, Isaac; Gopen, Quinton

    2014-01-01

    Importance. Superior semicircular canal dehiscence (SCD) is a third window lesion of the inner ear causing symptoms of vertigo, autophony, tinnitus, and hearing loss. A “two-hit” hypothesis has traditionally been proposed, whereby thinly developed bone overlying the superior canal is disrupted by a sudden change in intracranial pressure. Although the symptoms of SCD may be precipitated by head injury, no previous reports have described a temporal bone fracture directly causing SCD. Observations. Two patients sustained temporal bone fractures after closed head trauma, and developed unilateral otologic symptoms consistent with SCD. In each instance, computed tomography imaging revealed fractures extending through the bony roof of the superior semicircular canal. Conclusions and Relevance. Temporal bone fractures, which are largely treated nonoperatively, have not previously been reported to cause SCD. As it is a potentially treatable entity, SCD resulting from temporal bone fracture must be recognized as a possibility and diagnosed promptly if present. PMID:25295207

  1. Bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis

    PubMed Central

    Kocak, Nilufer; Ozturk, Taylan A; Kaynak, Suleyman

    2014-01-01

    X-linked juvenile retinoschisis is a rare hereditary retinal disease characterized by a tangential splitting of the neurosensory retina which may cause early-onset visual impairment. Existence of the retinal neurosensory layer splitting on cross-sectional images of optical coherance tomography (OCT) and the absence of leakage on fluorescein angiography (FA) help confirming the diagnosis. Such diagnostic tests are also helpful in determining the management of the disease. However, most of the retinoschisis cavities remain stable and rarely extend to the posterior pole, many authors suggest laser prophylaxis to avoid the potential risk of retinal detachment due to holes in the outer retinal layer. Herein, we report a case with bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis who was evaluated with detailed ophthalmologic examination. Visual acuity, fundoscopy, OCT, and FA remained stable in the second year of follow-up after prophylactic argon laser treatment. PMID:23571248

  2. [Unilateral to bilateral pleurisy: Pleural tuberculosis?].

    PubMed

    Ben Ameur, S; Smaoui, S; Kamoun, F; Chabchoub, I; Kamoun, T; Messaadi, F; Aloulou, H; Hachicha, M

    2016-04-01

    Pleural tuberculosis is the first or second most common form of extrapulmonary tuberculosis as well as the main cause of pleural effusion in many countries. It is rare in young infants and is more common in children over 10 years of age. We report the case of a 19-month-old girl admitted for prolonged fever with unilateral pleural effusion. The mother reported a history of lymph node tuberculosis 6 years previously. Intravenous antibiotics with cefotaxime and vancomycin were started. Thoracocentesis yielded a serosanguinous exudate fluid with a lymphocyte predominance. The tuberculin skin test and PCR GeneXpert(©) on pleural fluid were negative. The initial outcome was favorable, but the chest X-rays 10 days after discharge showed bilateral pleural effusion. Pleural biopsy was proposed but the culture of pleural fluid was positive for Mycobacterium tuberculosis. The child was put under standard treatment for tuberculosis. The outcome was favorable. PMID:26922570

  3. Unilateral condylar hyperplasia: a treatment strategy.

    PubMed

    Ferreira, Sabrina; da Silva Fabris, Andr Luis; Ferreira, Gabriel Ramalho; Faverani, Leonardo Perez; Francisconi, Giovanna Barbosa; Souza, Francisley Avila; Garcia, Idelmo Rangel

    2014-05-01

    Condylar hyperplasia (CH) is a pathologic condition that causes overdevelopment of the condylar head and neck as well as the mandible. Slowly progressive unilateral enlargement of the head and the neck of the condyle causes crossbite malocclusion, facial asymmetry, and shifting of the midpoint of the chin to the unaffected side. The etiology and the pathogenesis of CH remain uncertain. The diagnosis is made by clinical and radiologic examinations and bone scintigraph. A difference in uptake of 10% or more between condyles is regarded as indicative of CH, and the affected condyles had a relative uptake of 55% or more. When the diagnosis of active CH is established, the treatment consists of removal of the growth center by a partial condylectomy. The authors present the case of a 46-year-old male patient with right active type II CH or hemimandibular hyperplasia who underwent a high condylectomy. PMID:24820728

  4. Distraction osteogenesis of a unilateral hypoplastic mandible.

    PubMed

    Liaqat, Sahrish; Baig, Amir Mushtaq; Bukhari, Syed Gulzar Ali; Ahmed, Waseem

    2011-01-01

    Distraction osteogenesis (DO) is a surgical process in which two bony segments are gradually separated so new soft tissue and bone will form between them by applying tension through a fixation device. There are three phases to this process: latency phase, distraction phase, and consolidation phase. The technique was originally applied to long bones but in recent years the method has been adapted for use in maxillofacial surgery. Distraction osteogenesis is a new variation of more traditional; orthognathic surgical procedures which can be applied for the correction of dento-facial deformities and syndromes of the jaws, treating upper airway obstruction in paediatric patients with mandibualr retrognathia, due to tongue collapse and physical obstruction in the hypopharangeal region. It is an effective and powerful reconstructive surgical technique, which can be performed safely without the need of bone graft or blood transfusion. We present treatment of a child with severe facial asymmetry after unilateral TMJ ankylosis corrected bydistraction osteogenesis. PMID:24800374

  5. Unilateral corneal leukoplakia without limbal involvement

    PubMed Central

    Hirano, Koji; Koide, Mihoko; Mizoguchi, Yoshikazu; Osakabe, Yasuhiro; Sasaki, Kaoru-Araki

    2015-01-01

    Purpose Leukoplakia is the term given to a white patch or plaque that is found mainly on the oral mucus membrane. It can occasionally be seen on the corneal surface. We report our clinical and histopathological findings in a case of unilateral corneal leukoplakia. Methods A 26-year-old woman was referred to our hospital because of a white patch on her right cornea that continued to expand. She first noticed the white patch when she was 20 years old, and the white patch had expanded to cover the pupillary area affecting her vision. After plastic surgery on both eyelids for bilateral entropion to alleviate the pain caused by the eyelashes rubbing the cornea, the white corneal patch decreased in size. Because of this reduction, we performed surgery to remove the patch with microforceps under topical anesthesia. The plaque was removed easily and completely, and submitted for histopathological examination. Results Histopathological examination showed that the specimen had characteristics of epidermis with a basal cell layer, spinous cell layer, granular cell layer, and horny layer with hyperkeratosis. She was diagnosed with leukoplakia of the corneal surface. The basic structure of the squamous cell layer was preserved, and there were no signs of metaplasia. Six months after the removal of the leukoplakia, no recurrence was seen and her corrected decimal visual acuity recovered to 1.0. Conclusion Our case of unilateral corneal leukoplakia without limbal involvement was most likely caused by chronic irritation of the cornea by the eyelashes. Although it was totally removed with good recovery of vision, we continue to follow the patient because of the potential of malignant transformation. PMID:26056494

  6. Generalization of Visuomotor Learning Between Bilateral and Unilateral Conditions

    PubMed Central

    Sainburg, Robert L.

    2009-01-01

    A long history of behavioral and physiological research has suggested that bilateral coordination invokes unique neural processes that are not involved in unilateral movements. This hypothesis predicts that motor learning should show limited transfer between unilateral and bilateral conditions, which is consistent with a recent finding that indicated partial, but not complete, transfer of learning between the two conditions. However, during learning of new motor skills, transformations must also be made between visual and proprioceptive coordinate systems, a process that may occur upstream to the processes that differentiate bilateral from unilateral movements. We now investigate whether visuomotor adaptations are shared between unilateral and bilateral movement conditions. Our results indicate substantial transfer from bilateral to subsequent unilateral conditions for both arms. Interestingly, whereas the nondominant arm never showed complete adaptation to visual rotation under bilateral conditions, this interference, or lack of improvement, in bilateral performance did not disturb the visuomotor adaptation process or transfer, as reflected by superb unilateral performances immediately following the bilateral conditions. These findings unambiguously indicate that visuomotor adaptation can extensively generalize between bilateral and unilateral conditions, thus suggesting a substantial overlap in the neural processes underlying visuomotor transformations between the two movement conditions. Our findings provide support for a two-stage model of motor planning, in which the visuomotor transformation process precedes the processes that convert the visuomotor plan into effector-specific commands that incorporate bilateral synergies and that result in the forces that determine motion. PMID:19759325

  7. Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review

    PubMed Central

    Molinari, Robert W.; Saleh, Ahmed; Molinari, Robert; Hermsmeyer, Jeff; Dettori, Joseph R.

    2015-01-01

    Study Design Systematic review. Clinical Questions (1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrumentation in spine surgery. Studies including recombinant human bone morphogenetic protein 2 as adjunct therapy and those with follow-up of less than 2 years were excluded. Results Ten randomized controlled trials met the inclusion criteria: five compared unilateral with bilateral instrumentation using open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF), one used open posterolateral fusion, and four used minimally invasive TLIF/PLIF. There were no significant differences between unilateral and bilateral screw instrumentation with respect to nonunion, low back or leg pain scores, Oswestry Disability Index, reoperation, or complications. Conclusions The existing literature does not identify significant differences in clinical outcomes, union rates, and complications when unilateral instrumentation is used for degenerative pathologic conditions in the lumbar spine. The majority of published reports involve single-level lumbar unilateral instrumentation. PMID:26131385

  8. Expanding upon the unilateral hyperlucent hemithorax in children.

    PubMed

    Dillman, Jonathan R; Sanchez, Ramon; Ladino-Torres, Maria F; Yarram, Sai G; Strouse, Peter J; Lucaya, Javier

    2011-01-01

    Unilateral hyperlucent hemithorax is a common pediatric chest radiographic finding that may also be seen at computed tomography. It may result from congenital or acquired conditions involving the pulmonary parenchyma, airway, pulmonary vasculature, pleural space, and chest wall, as well as from technical factors such as patient rotation. Unilateral hyperlucent hemithorax has a broad differential diagnosis that includes unilateral emphysematous or bullous disease, pneumatocele, foreign body aspiration, Swyer-James syndrome, congenital lobar emphysema, endobronchial mass, unilateral pulmonary agenesis, proximal interruption of the pulmonary artery, scimitar syndrome, diaphragmatic hernia, and Poland syndrome. Although certain causes of unilateral hyperlucent hemithorax are clinically significant and potentially life threatening, others are of minimal or no clinical significance. When evaluating a patient with this finding, it is important to establish whether the apparent unilateral hyperlucent hemithorax is truly too lucent (hypoattenuating) or if the contralateral hemithorax is too opaque (hyperattenuating). It is imperative that radiologists be aware of the various causes of unilateral hyperlucent hemithorax so that they may diagnose the underlying condition and appropriately guide patient management. PMID:21571653

  9. Hydraulic fracturing-1

    SciTech Connect

    Not Available

    1990-01-01

    This book contains papers on hydraulic fracturing. Topics covered include: An overview of recent advances in hydraulic fracturing technology; Containment of massive hydraulic fracture; and Fracturing with a high-strength proppant.

  10. Nonprogressive Unilateral Intracranial Arteriopathy in Children with Arterial Ischemic Stroke

    PubMed Central

    Yeon, Je Young

    2015-01-01

    The nonprogressive unilateral intracranial arteriopathy known as transient (focal) cerebral arteriopathy is not a well-recognized arteriopathy among practitioners of Korea and Japan, although it cannot be easily differentiated from early moyamoya disease. This review summarizes the nomenclature, pathophysiology, diagnostic evaluation, clinico-radiological features, and management of nonprogressive (reversible or stable) unilateral arteriopathy based on the relevant literature and our own experiences. Nonprogressive unilateral arteriopathy should be strongly suspected in children presenting with basal ganglia infarction and arterial beading. The early identification of patients likely to have nonprogressive or progressive arteriopathy would ensure proper management and guide further research for secondary stroke prevention. PMID:26180606

  11. Burned unilateral half-cheek resurfacing techniques.

    PubMed

    Grishkevich, Viktor M

    2012-01-01

    Postburn cheek deformities are a tragedy for patients and pose a great challenge to surgeons due to a limited number of well-matching donor sites. In cases of unilateral half-cheek deformity, the flap's skin should match the contralateral cheek and the residual skin of the deformed cheek. The skin of a distant flap does not match the facial skin and resembles a patch. The most suitable skin type is the neck's skin and residual cheek's skin transposed on the defect with special techniques. Seventy-six patients with unilateral cheek scars covering nearly half of cheek's surface (total cheek deformities are not included in this series) were personally operated. The deformities were divided into four types or forms: lower cheek, lateral, medial, and upper. The flaps and techniques were designed for each type. The cervical skin, residual cheek skin, and periauricular skin (most matching the cheek's skin) was used in form of different flaps, depending on the scar location on the cheek. The basic flap used was the cervical split flap which could include A) a thoracic adipose-cutaneous layer (cervico-thoracic flap); B) periauricular fasciocutaneous layer (cervico-periauricular and cervico-thoraco-periauricular flaps); C) residual healthy facial adipocutaneous layer (cervico-facial, cervico-facio-periauricular, and cervico-thoraco-facioperiauricular flaps). Cervical flap has axial circulation and is elevated without platysma; it is transposed on the cheek with some tension. The lower and lateral cheek deformities were eliminated most successfully with the cervico-thoraco-periauricular flap by one-stage procedure. Medial and upper cheek deformities were eliminated with the cervico-facio-thoraco-periauricular flap. The facial segment can be expanded (usually in cases of upper cheek reconstruction); in such cases, the thoracic region is not included in the flap (cervico-facio-periauricular flap). The cheeks were reconstructed in all patients without serious complications. The flap's skin matched the contralateral cheek and surrounding healthy skin; the donor site's damage was minimal; operation scars' line was maximally shortened. The use of cervical split flap in combination with thoracic, facial, and periauricular adipose-cutaneous layer opens, in author's opinion, a reliable and most successful way for postburn half-cheek resurfacing. PMID:22210070

  12. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    PubMed Central

    Guven, Yeliz; Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case. PMID:26339511

  13. Influence of unilateral weight on bilateral cyclograms

    NASA Astrophysics Data System (ADS)

    Pellicer Costa, Juan José; Dusza, Jacek J.

    2014-11-01

    The paper presents the results of gait parameters as a function of unilateral weight. The object of the research was a woman walking on a stationary surface and carrying in his hand weights from 0 to 15 kg. Her movement was recorded by 6 cameras recording the location of 34 markers placed at appropriate points in the body. 3D reconstruction was performed for each of the reflecting markers. Tested signals were changes in the value the joint angles of ankle, knee and hip. On the basis of about 6 cycles of movement of each load, a model for the average gait cycle was developed. The result of the experiments are graphs of changes the joint angles as a function of time, bilateral cyclograms, synchronized bilateral cyclograms and regression lines. The conclusion of the study is to determine how one-sided load affects gait asymmetry. Simple and easy to interpret method of presentation of results were also shown. Studies were conducted using VICON system.

  14. Isolated, unilateral, reversible palsy of the hypoglossal nerve.

    PubMed

    Giuffrida, S; Lo Bartolo, M L; Nicoletti, A; Reggio, E; Lo Fermo, S; Restivo, D A; Domina, E; Reggio, A

    2000-05-01

    We report three patients with isolated unilateral hypoglossal nerve palsy who experienced an excellent outcome. In two patients no cause was found. Our study seems to confirm that the occurrence of benign and idiopathic isolated unilateral palsy of the hypoglossal nerve is more frequent than previously reported. We would like to stress that neuroimaging studies remain mandatory in order to exclude other common causes, such as tumour and spontaneous or traumatic vascular lesions, in which a specific treatment is necessary. PMID:10886321

  15. Unilateral Vogt-Koyanagi-Harada Disease: Report of Two Cases

    PubMed Central

    Agrawal, Alok; Biswas, Jyotirmay

    2011-01-01

    In this retrospective report, we present two cases of unilateral Vogt-Koyanagi-Harada (VKH) disease. These patients were evaluated with clinical, ophthalmological and laboratory examinations. Their response following corticosteroid administration was evaluated. Both patients had the characteristic clinical features of VKH involving only one eye, including disc edema, choroidal striae, multiple sub retinal yellow lesions and exudative retinal detachment. These cases indicate that the clinical and angiographic features were typical of VKH disease despite the unilateral involvement. PMID:21572744

  16. Grip Force Coordination during Bimanual Tasks in Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Islam, Mominul; Gordon, Andrew M.; Skold, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2011-01-01

    Aim: The aim of the study was to investigate coordination of fingertip forces during an asymmetrical bimanual task in children with unilateral cerebral palsy (CP). Method: Twelve participants (six males, six females; mean age 14y 4mo, SD 3.3y; range 9-20y;) with unilateral CP (eight right-sided, four left-sided) and 15 age-matched typically

  17. Major haemorrhage in pubic rami fractures.

    PubMed

    Tang, Chun Hong; Shivji, Faiz; Forward, Daren

    2015-01-01

    A 62-year-old man presented to the emergency department, having fallen 6?ft from a ladder, with pain over his left hip and shoulder. He was managed according to the Advanced Trauma Life Support (ATLS) protocol, and his primary survey showed no haemodynamic compromise. Initial radiographs showed a unilateral left superior and inferior pubic rami fracture, which was treated conservatively. Forty-eight hours post-admission, the patient became tachycardic and hypotensive and was found to have dropped his haemoglobin from 125 to 89?g/L. After resuscitation, a repeat contrast CT scan revealed an enlarging haematoma in his pelvis. This was treated with urgent angioembolisation and the patient was further stabilised in the intensive care unit. This report shows the need for a low threshold in suspecting intrapelvic bleeds in patients with pubic rami fractures, and the need for prompt treatment of such patients, either surgically or radiologically. PMID:25739798

  18. Controlling fracture growth

    SciTech Connect

    Lord, D.L.; McDaniel, B.W.; Harris, L.E.; Manrique, J.E.

    1989-12-19

    This patent describes a fire extinguisher apparatus. It comprises: fire extinguisher medium storing means for storing a fire extinguishing medium; into at least one fracture formed therein. The first fracturing fluid having a known density and containing a diverting agent; introducing a second fracturing fluid into the fracture having a known density different from density of the first fracturing fluid whereby the second fracturing fluid selectably the overrides or underrides the first fracturing fluid and forces the first fracturing fluid to the bottom or top of the fracture whereby the diverting agent contained therein is caused to screen out along the bottom or top of the fracture and to thereby impede further downward or upward growth of the fracture; and continuing the introduction of the second fracturing fluid into the fracture until the fracture is extended a desired amount.

  19. [Fracture of macroporous hydroxyapatite prosthesis].

    PubMed

    Adetchessi, A T; Pech-Gourg, G; Metellus, P; Fuentes, S

    2012-12-01

    Different prosthesis implants are offered to perform a cranioplasty after a decompressive craniectomy when autologous bone graft cannot be used. The authors report the case of a 25-year-old man who benefited a unilateral decompressive craniectomy after a severe head trauma. Seven months later, a cranioplasty using custom macroporous hydroxyapatite prosthesis was performed. The postoperative course was marked by a generalized seizure leading to a traumatic head injury. The CT-scan showed a comminutive fracture of the prosthesis and an extradural hematoma. The patient underwent a removal of the fractured prosthesis and an evacuation of the extradural clot. The postoperative course was uneventful with a Glasgow outcome scale score at 5. A second cranioplasty using a polyether ether ketone (PEEK) implant was performed. Among cranioplasty prosthesis solutions, hydroxyapatite implants seem to have similar property to the bone. However, its weak mechanic resistance is an actual problem in patients susceptible to present generalized seizures with consecutive head impact. Hence, in patients with decompressive craniectomy who are exposed to potential brain injury, we favor the use of more resistant implant as PEEK prosthesis. PMID:22898300

  20. The impacts of Unilateral Stratospheric Geoengineering

    NASA Astrophysics Data System (ADS)

    Jones, A.; Haywood, J. M.; Bellouin, N.; Stephenson, D.

    2013-12-01

    Stratospheric geoengineering proposals have been suggested on the premise that the cooling impacts of volcanic eruptions could be deliberately mimicked to offset the impacts of increased greenhouse gas concentrations in the future by counterbalance global warming. Here, we examine both the impacts of hemispherically asymmetric volcanoes in the observational record and the impact of prolonged deliberate injection of stratospheric aerosol into either the northern or southern hemisphere stratosphere or into both hemispheres equally to assess the impacts on Sahelian rainfall and agriculture (Haywood et al., 2013). While the frequency of volcanic eruptions during the past 100 years is too sparse for definitive attribution, there is a suggestion that volcanic eruptions that preferentially load the northern hemisphere are the harbinger of Sahelian drought. Simulations are then performed with the HadGEM2 couple atmospheric-ocean model to assess the impacts of these volcanic eruptions and deliberate unilateral stratospheric geoengineering. Figure 1 shows the impacts of the geoengineering simulations which show that stratospheric injection into the northern hemisphere induces a severe and prolonged Sahelian drought with undoubted detrimental consequences for the local population. Conversely injection into the southern hemisphere causes a significant greening of the Sahel with vegetation productivity enhanced by over 100%. On the face of it, this suggests potential advocacy of injection into the southern hemisphere: we will investigate potential other side-effects from such a strategy...... Haywood, J.M., A. Jones, N. Bellouin, and D.B. Stephenson, Asymmetric forcing from stratospheric aerosols impacts Sahelian drought, Nature Climate Change, Vol 3, No 7, 660-665, doi: 10.1038/NCLIMATE1857, 2013.

  1. Saccadic eye movement programming in unilateral neglect.

    PubMed

    Walker, R; Findlay, J M

    1996-06-01

    The present study examined the eye movements made by patients with unilateral neglect under fixation gap and overlap conditions. The prior offset of fixation in a + 100 msec gap condition did not produce an increase in the numbers of contralesional saccades made by 3 out of 4 patients. This finding is incompatible with the view that the deficit in producing contralesional saccades reflects an inability to disengage visual attention from fixation. A significant reduction in saccade latency was, however, obtained in the gap condition ('gap effect'). The latency reduction in the gap condition is consistent with models which attribute the gap effect to warning signal effects and the release of an ocular rather than an attentional disengagement mechanism. Saccade latency was not increased when two targets were presented bilaterally and simultaneously in both hemifields (in contrast to the increase in latency shown by normal subjects). The lack of a normal 'bilateral target effect' in neglect is attributed to an imbalance in the level of activity in the saccadic system. Three patients showed visual 'extinction' and did not make saccades to the contralesional bilateral targets. In contrast R.R. who shows object-based neglect did not show extinction and made saccades to the contralesional bilateral targets. This suggests that visual extinction may be influenced by the form of neglect shown by the patient. The effects on saccade amplitude of presenting two targets in the same hemifield were also examined in a global effect task. One patient showed a much greater global effect than normal when pairs of targets were presented in his ipsilesional hemifield. In contrast R.R. showed a normal magnitude global effect. It appears that the form of neglect shown by a patient is a factor that influences their eye movement behaviour on simple saccade tasks and these eye movement abnormalities cannot be accounted for by a deficit of attentional disengagement. PMID:8736563

  2. Postural Compensation for Unilateral Vestibular Loss

    PubMed Central

    Peterka, Robert J.; Statler, Kennyn D.; Wrisley, Diane M.; Horak, Fay B.

    2011-01-01

    Postural control of upright stance was investigated in well-compensated, unilateral vestibular loss (UVL) subjects compared to age-matched control subjects. The goal was to determine how sensory weighting for postural control in UVL subjects differed from control subjects, and how sensory weighting related to UVL subjects’ functional compensation, as assessed by standardized balance and dizziness questionnaires. Postural control mechanisms were identified using a model-based interpretation of medial–lateral center-of-mass body-sway evoked by support-surface rotational stimuli during eyes-closed stance. The surface-tilt stimuli consisted of continuous pseudorandom rotations presented at four different amplitudes. Parameters of a feedback control model were obtained that accounted for each subject’s sway response to the surface-tilt stimuli. Sensory weighting factors quantified the relative contributions to stance control of vestibular sensory information, signaling body-sway relative to earth-vertical, and proprioceptive information, signaling body-sway relative to the surface. Results showed that UVL subjects made significantly greater use of proprioceptive, and therefore less use of vestibular, orientation information on all tests. There was relatively little overlap in the distributions of sensory weights measured in UVL and control subjects, although UVL subjects varied widely in the amount they could use their remaining vestibular function. Increased reliance on proprioceptive information by UVL subjects was associated with their balance being more disturbed by the surface-tilt perturbations than control subjects, thus indicating a deficiency of balance control even in well-compensated UVL subjects. Furthermore, there was some tendency for UVL subjects who were less able to utilize remaining vestibular information to also indicate worse functional compensation on questionnaires. PMID:21922014

  3. Pediatric depressed skull fractures: analysis of 530 cases.

    PubMed

    Er?ahin, Y; Mutluer, S; Mirzai, H; Palali, I

    1996-06-01

    Depressed skull fractures (DSFs) account for 7-10% of children admitted to hospital with a head injury and 15-25% of children with skull fractures. We reviewed the records of 530 patients operated on for DSF from January 1, 1973, to December 31, 1993. This group was made up of 357 boys (67%) and 173 girls (33%) whose ages ranged from 1 day to 16 years (mean age 6.1 years). Fall was the most common cause of injury. Of the 530 patients with DSF, 66% had compound fractures. The incidence of compound fractures increased with age. Compound fractures caused more brain lacerations (29%) than simple fractures (15.5%) did. We also classified DSFs radiologically as true, flat, or ping-pong ball fractures. Associated intracranial lesions were found to be a bad prognostic factor. There were 13 deaths (2.5%) in this series. Satisfactory results were achieved in over 95% of the patients. Compound fractures are associated with a worse outcome and a higher incidence of intracranial lesions and cortical laceration. Unilateral pupillary dilatation and an admission GCS score of 8 or less are ominous signs in regard to mortality. We also found that the deeper the depressed bone, the higher the risk of both dural tear and cortical laceration and the worse the prognosis. A conservative approach should be followed in cases of simple DSF without associated intracranial hematoma and in cases in which the bone depression is not deeper than 1 cm. PMID:8816297

  4. Unilateral carpal tunnel syndrome caused by an occult palmar lipoma.

    PubMed

    Bagatur, A Erdem; Yalcinkaya, Merter

    2009-10-01

    Carpal tunnel syndrome usually presents bilaterally and space-occupying lesions should be suspected in patients with unilateral symptoms, especially with a long history and when the symptomatic hand shows severe neurophysiologic impairment, while the contralateral hand is neurophysiologically intact. Approximately half of patients with unilateral symptoms have positive electrodiagnostic test results in the asymptomatic, contralateral hand. Space-occupying lesions are known to cause carpal tunnel syndrome and the incidence of space-occupying lesions in unilateral carpal tunnel syndrome is higher than that of bilateral carpal tunnel syndrome. It is easy to detect a mass when it is palpable, but occult lesions may be overlooked easily. Whenever a patient presents with unilateral symptoms and unilateral neurophysiologic impairment, the possibility of a space-occupying lesion compressing the median nerve should be kept in mind in the differential diagnosis. This article presents 2 cases of patients with occult deep palmar lipomas compressing the median nerve and causing unilateral symptoms of carpal tunnel syndrome. We stress the importance of imaging studies in patients with unilateral symptoms that are usually not used in carpal tunnel syndrome. While both patients' symptomatic hands showed severe neurophysiologic impairment, the contralateral hands were totally intact, which is contradictory with a long history. The reported patients were evaluated and magnetic resonance images revealed intra-tunnel lesions. Although lipomas are the most common soft tissue tumor in the body, <5% of the benign tumors of the hand are lipomas. Since the thick palmar fascia is strong, a deep lipoma may not be recognized although nerve compression symptoms may be gross. PMID:19824610

  5. Controlled pulse fracturing

    SciTech Connect

    Not Available

    1985-10-22

    A method for extending fractures in underground formations obtained by controlled pulse fracturing through the use of stabilized hydrogen peroxide solution. Controlled pulse fracturing causes radial fracturing near the wellbore. In order to extend these radial fractures further into the formation or reservoir, stabilized hydrogen peroxide is forced into the radial fractures. Stabilizing agents in the hydrogen peroxide react with metals in the formation causing the hydrogen peroxide to breakdown and form gas pressure sufficient to extend the radial fractures. Hydrocarbonaceous fluids are then obtained from the formation via the extended fractures which contact natural fractures in the wellbore.

  6. The clinical application and efficacy of percutaneous kyphoplasty via unilateral pedicular approach guided by CT image measurement

    PubMed Central

    Zhai, Weifeng; Jia, Yongwei; Wang, Jianjie; Cheng, Liming

    2015-01-01

    This study aimed to investigate the clinical application and efficacy of percutaneous kyphoplasty via unilateral pedicular approach with the reference of preoperative CT image data. 73 cases (a total of 112 vertebrae) with thoracic and lumbar osteoporotic vertebral compression fractures (OVCF) received in our department were collected in this study and underwent percutaneous kyphoplasty via unilateral pedicular approach directed by CT image measurement with the operative time and fluoroscopic times recorded. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess the pain status and functional activity before and after operation and at the last follow-up, while X-ray and CT image were used to measure the height of the injured spinal middle column and kyphotic Cobb angle before and after operation. 73 cases (112 vertebrae) underwent percutaneous kyphoplasty successfully. Cement leakage occurred in 7 cases without obvious neurological symptoms, and they were followed up for 10 to 60 months with the average of 23 months; adjacent vertebral refractures occurred in 3 cases during the follow-up, and their symptoms were relieved after the second surgery. There was significant difference in the height of the injured spinal middle column and kyphotic Cobb angle before and after operation (P<0.05); there was significant difference in preoperative and postoperative VAS score and ODI values (P<0.05). Postoperative CT image data showed that puncture paths of the 110 vertebrae were consistent with preoperative ones sketched using the CT image, and the consistent rate of preoperative and postoperative measurement data was 98%. All patients could ambulate with brace within 2 days after operation without serious complications. In conclusion, percutaneous kyphoplasty via unilateral pedicular approach guided by preoperative CT image data is effective in treatment of osteoporotic vertebral compression fractures, and it is convenient and safe with high puncture accuracy, shorter operative time and less radiation exposure for patients and operators. PMID:26885011

  7. Clinical and surgical management of unilateral prepubertal gynecomastia

    PubMed Central

    Ferraro, Giuseppe Andrea; De Francesco, Francesco; Romano, Tiziana; Grandone, Anna; DAndrea, Francesco; Miraglia Del Giudice, Emanuele; Perrone, Laura; Nicoletti, Gianfranco

    2014-01-01

    INTRODUCTION Gynecomastia is the benign proliferation of the glandular tissue in the male breast. This condition is thought to be caused by the imbalance between estrogen action relative to androgen action at the breast tissue level. Bilateral gynecomastia is frequently found in the neonatal period, early in puberty, and with increasing age. Prepubertal unilateral gynecomastia in the absence of endocrine abnormalities is extremely rare, with only a few cases in literature. PRESENTATION OF CASE We present an otherwise healthy boy of 12 years old with unilateral breast masses. No abnormalities were found on ultrasonography and on all endocrine parameters. Treatment consisted in a new modified Webster technique. DISCUSSION The results confirmed validity of this technique in terms of esthetic and functional results, and patient satisfaction. Atypical presentations of gynecomastia are often not recognized. The main pathophysiology of gynecomastia is alteration in the balance between the stimulatory effect of estrogen and the inhibitory effects of androgens on the development of the breast. If there is no causal treatment, surgical resection is the therapy of first choice. CONCLUSION The exact mechanism of unilateral gynecomastia formation in our case is unclear. The evaluation of unilateral gynecomastia can therefore be complex. In conclusion, the surgical treatment of unilateral gynecomastia requires an individual approach, based on an appropriate diagnostic algorithm. PMID:25437663

  8. Determinants of diaphragm motion in unilateral diaphragmatic paralysis.

    PubMed

    Scillia, Pierre; Cappello, Matteo; De Troyer, Andr

    2004-01-01

    Cranial displacement of a hemidiaphragm during sniffs is a cardinal sign of unilateral diaphragmatic paralysis in clinical practice. However, we have recently observed that isolated stimulation of one phrenic nerve in dogs causes the contralateral (inactive) hemidiaphragm to move caudally. In the present study, therefore, we tested the idea that, in unilateral diaphragmatic paralysis, the pattern of inspiratory muscle contraction plays a major role in determining the motion of the inactive hemidiaphragm. We induced a hemidiaphragmatic paralysis in six anesthetized dogs and assessed the contour of the diaphragm during isolated unilateral phrenic nerve stimulation and during spontaneous inspiratory efforts. Whereas the inactive hemidiaphragm moved caudally in the first instance, it moved cranially in the second. The parasternal intercostal muscles were then severed to reduce the contribution of the rib cage muscles to inspiratory efforts and to enhance the force generated by the intact hemidiaphragm. Although the change in pleural pressure (DeltaPpl) was unaltered, the cranial displacement of the paralyzed hemidiaphragm was consistently reduced. A pneumothorax was finally induced to eliminate DeltaPpl during unilateral phrenic nerve stimulation, and this enhanced the caudal displacement of the inactive hemidiaphragm. These observations indicate that, in unilateral diaphragmatic paralysis, the motion of the inactive hemidiaphragm is largely determined by the balance between the force related to DeltaPpl and the force generated by the intact hemidiaphragm. PMID:12949010

  9. Fractured Surface

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03084 Fractured Surface

    These fractures and graben are part of Gordii Fossae, a large region that has undergone stresses which have cracked the surface.

    Image information: VIS instrument. Latitude 16.6S, Longitude 234.3E. 18 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  10. Radial head fracture - aftercare

    MedlinePLUS

    Elbow fracture - radial head - aftercare ... the radius bone, just below your elbow. A fracture is a break in your bone. The most common cause of a radial head fracture is falling with an outstretched arm.

  11. Recovery from Fractures

    PubMed Central

    Ailsby, Ronald L.

    1980-01-01

    Rehabilitation for fracture patients begins immediately after the fracture is diagnosed, not once it has healed. Rehabilitation is based on sound basic fracture management principles. The patient's confidence and firm physician guidance are required to promote recovery. PMID:20469323

  12. [Fractures in children].

    PubMed

    Marti, R K; Besselaar, P P

    1988-12-01

    Children's fractures can be divided into shaft fractures, epiphysiolysis and epiphyseal fractures. Shaft fractures always heal with conservative methods. Slight axis deviations and shortening will correct spontaneously, while fracture disease and pseudarthrosis are extremely rare. Nevertheless, acute complications such as compartment syndromes deserve special attention. Epiphyseal fractures call for anatomical reduction and foolproof fixation to prevent growth disturbance through partial or complete closure of the growth plate. Such growth disturbance is not to be expected in case of epiphysiolysis. PMID:3238680

  13. Prepubertal unilateral gynecomastia in the absence of endocrine abnormalities

    PubMed Central

    Kang, Min; Lee, Chan Jae; Hwang, Il Tae; Lee, Kwanseop

    2014-01-01

    Gynecomastia is defined as the excessive development of breast tissue in males, which can occur as unilateral or bilateral. Although the overall prevalence of gynecomastia is 40%-65%, the prepubertal unilateral gynecomastia in the absence of endocrine abnormalities is unusual, with only a few case reports in literature. Idiopathic gynecomastia in prepuberty is benign but a diagnosis of exclusion. We here report two cases of healthy prepubertal boys aged 8.8 and 9.6 years old, respectively, presented with painful palpable mass in their unilateral breast. Breast tissue with glandular proliferation was confirmed on ultrasonography. Serum levels of estradiol, testosterone, and other laboratory findings were within normal range. They seem to have the prepubertal idiopathic gynecomastia but further follow-up to see their progression is needed. PMID:25346921

  14. Unilateral versus bilateral clubfoot: an analysis of severity and correlation.

    PubMed

    Gray, Kelly; Barnes, Elizabeth; Gibbons, Paul; Little, David; Burns, Joshua

    2014-09-01

    This study compares the severity of unilateral and bilateral clubfoot, and the correlation between right and left feet of bilateral cases. Sixty-six unilateral and 75 bilateral clubfoot patients were assessed for severity using the Pirani score at an average age of 12.9 days (SD 9 days). In bilateral cases, the severity of right and left feet was highly correlated (r=0.68). The odds of being very severe were 2.6 (95% confidence interval 1.3-5.1) times higher in bilateral cases (P=0.007). Bilateral and unilateral clubfeet present with differing severity. Right and left feet from bilateral cases are highly correlated. Researchers need to address these issues during study design and analysis. PMID:24869905

  15. [Unilateral and bilateral shock therapy: mechanism of action (author's transl)].

    PubMed

    Ottosson, J O

    1979-01-01

    The unilateral and bilateral therapy differ in psycho-organic effects but have the same antidepressive efficiency. This is due to the facts that the organic effects are mainly caused by the electrical current whereas the antidepressive effect is dependent on the seizure activity. Compared to the bilateral treatment, unilateral gives reduced confusion, anterograde and retrograde amnesia as well as reduced experience of memory impairment. The difference is explained by a lower density of current in the brain. The unilateral treatment should be the treatment to be chosen. The antidepressive action of ECT fits the amine hypothesis, ECT causes a sustained increase of the synthesis of norepinephrine and of the sensitivity of amine receptors and creates conditions for alleviating both "low-output" and "low-sensitivity" depression. The antidepressive action is probably mediated by release of hypothalamic neurohormones. PMID:44867

  16. Minimally invasive unilateral arytenoid lateralization in dogs: A cadaveric study.

    PubMed

    Shipov, A; Israeli, I; Weiser, M; Kelmer, E; Klainbart, S; Milgram, J

    2015-10-01

    The aim of this study was to develop a minimally invasive thyroarytenoid lateralization technique (MITAL). Eleven unilateral MITAL procedures were performed on 11 canine cadavers. Two hypodermic needles were passed through the skin into the lumen of the larynx, penetrating the thyroid and arytenoid cartilages. Suture material was passed through the needles to lateralize the arytenoid cartilage. A rigid endoscope was used to visualize needle insertion and suture material placement. A key-hole approach to the larynx was performed and the suture material was knotted on the lateral aspect of the thyroid cartilage. The change in the rima glottidis area was recorded as were the duration of the procedure and complications encountered. The landmarks for needle insertion were easily palpated, and a significant increase in the area of the rima glottidis was documented after performing unilateral MITAL. In conclusion, unilateral MITAL is a quick, minimally invasive procedure which increases the area of the rima glottidis in cadaveric dogs. PMID:26412529

  17. Unilateral Breast Reconstruction Using Bilateral Inferior Gluteal Artery Perforator Flaps

    PubMed Central

    Muto, Mayu; Ogawa, Marina; Shibuya, Mai; Yasumura, Kazunori; Kobayashi, Shinji; Ishikawa, Takashi; Maegawa, Jiro

    2015-01-01

    Background: For reconstructing moderate-to-high projection breasts in nulliparous patients with insufficient abdominal tissue or prior abdominal surgeries, a unilateral inferior gluteal artery perforator (IGAP) flap is an alternative procedure. In patients with slim hips, however, unilateral gluteal tissue is insufficient and inferior gluteal crease displacement may develop postoperatively. Donor-site asymmetry is also a major disadvantage. In these circumstances, bilateral IGAP flaps provide sufficient tissue without significant gluteal deformity. Methods: We retrospectively reviewed 20 patients who underwent unilateral breast reconstruction using bilateral IGAP flaps by a single surgeon between November 2007 and December 2012. A quantitative outcome assessment was performed and compared with that of 22 unilateral IGAP flap patients operated on by the same surgeon. Results: Twenty patients underwent reconstruction with 40 IGAP flaps. Of the 40 flaps, 39 survived and 1 developed total necrosis due to repeated venous thrombosis. In 15 of 20 patients, the size of reconstructed breast was comparable to that of the contralateral breast. Final inset flap weight was 462.3 g for bilateral flaps and 244.3 g for unilateral flaps. Total operating time was 671.1 minutes (bilateral flaps) and 486.8 minutes (unilateral flaps). Conclusions: Use of bilateral IGAP flaps for breast reconstruction helps to avoid asymmetry of the inferior buttock volume and shape. Bilateral flaps provide sufficient tissue volume and allow for reconstruction of a breast comparable to the unaffected side. In patients with moderate-to-high projection breast whose abdominal tissue cannot be used for reconstruction, IGAP flaps may be a suitable alternative. PMID:25878925

  18. Unilateral Augmented Pedicle Screw Fixation for Foraminal Stenosis

    PubMed Central

    Kim, Jeong-Gyun; Jin, Yong-Jun; Kim, Ki-Jeong; Kim, Hyun-Jib

    2009-01-01

    Objective The purpose of this study is to evaluate the effectiveness of unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis. Methods The study group comprises consecutive 16 patients who underwent unilateral decompression and bone cement augmented pedicle screw fixation from May 2003 to January 2006. The patients were evaluated by visual analog scale (VAS) for pain and the scoring system of the Japanese Orthopedic Association (JOA) for low back pain. The result of surgery was also evaluated with McNab's classification. Excellent or good outcome was considered as successful. The patients were followed at postoperative 1 month, 3 month, 6 month, and 1 year with standing AP and lateral films. Results The average VAS and JOA score of the 16 patients were 7.8 (range, 6-9) and 5.8 (range, 3 - 10) before surgery and 2.2 (range, 0 - 5) and 12.3 (range, 9 - 15) at the time of last follow up. Both VAS and JOA score improved significantly after the surgery (p < 0.05, t-test). All patients improved after the operation and no revision surgery was required. No metal failure or pseudoarthrosis was observed during the follow-up. The success rate was 87.5%. Conclusion Our data suggest that unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis is an effect method for obtaining satisfactory clinical outcome. Its possible advantage is shorter operation time and reduced surgical extent. We believe that the reduced stiffness of unilateral fixation was compensated by pedicle screw augmentation and interbody fusion. PMID:19707487

  19. Unilateral Direct Carotid Cavernous Fistula Causing Bilateral Ocular Manifestation

    PubMed Central

    Demartini Jr., Zeferino; Liebert, Fernando; Gatto, Luana Antunes Maranha; Jung, Thiago Simiano; Rocha Jr., Carlos; Santos, Alex Marques Borges; Koppe, Gelson Luis

    2015-01-01

    Unilateral carotid cavernous fistula presents with ipsilateral ocular findings. Bilateral presentation is only seen in bilateral fistulas, usually associated with indirect (dural) carotid cavernous fistulas. Direct carotid cavernous fistulas are an abnormal communication between the internal carotid artery and the cavernous sinus. They typically begin with a traumatic disruption in the artery wall into the cavernous sinus, presenting with a classic triad of unilateral pulsatile exophthalmos, cranial bruit and episcleral venous engorgement. We report the case of a 38-year-old male with traumatic right carotid cavernous sinus fistula and bilateral ocular presentation successfully treated by interventional neuroradiology.

  20. Cold shivering activity after unilateral destruction of the vestibular apparatus

    NASA Technical Reports Server (NTRS)

    Kuzmina, G. I.

    1980-01-01

    The bioelectric activity of muscles (flexors and extensors of the forelimbs and hindlimbs) during cold shivering after unilateral destruction of the vestibular apparatus. It was found, that unilateral delabyrinthing produces bilateral facilitation of cold shivering in the flexor extremities more pronounced on the ipsilateral side. In the extensor muscles there was an absence of bioelectric activity both before and after delabyrinthing. Enhancement of cold shivering in the flexor extremities following intervention was evidently conditioned by removal of the inhibiting effect of the vestibulary apparatus on the function of special centers.

  1. Unilateral Crystalline Vitreoretinopathy: A Rare Entity Associated with Intraocular Inflammation

    PubMed Central

    Harshey, Kaustubh B.; Srinivasan, Karthik; Rengappa, Ramakrishnan; Ramasamy, Kim

    2015-01-01

    A 31-year-old Indian male presented with floaters and diminution of vision in the right eye. Ocular examination showed features of old anterior uveitis with posterior subcapsular cataract and fine, refractile crystals in the vitreous cavity and on the retinal surface. A thorough workup for all known causes of crystalline retinopathy was inconclusive. Unilateral crystalline retinopathy has been sparingly reported. This is the first report of unilateral, crystalline vitreoretinopathy in the absence of any demonstrable and known cause for intraocular crystals. PMID:26688764

  2. Unilateral Hypoglossal Nerve Injury in a Collegiate Wrestler: A Case Report

    PubMed Central

    Loro, William A.; Owens, Brett

    2009-01-01

    Abstract Objective: To introduce the case of a collegiate wrestler who suffered a traumatic unilateral hypoglossal nerve injury. This case presents the opportunity to discuss the diagnosis and treatment of a 20-year-old man with an injury to his right hypoglossal nerve. Background: Injuries to the hypoglossal nerve (cranial nerve XII) are rare. Most reported cases are the result of malignancy, with traumatic causes less common. In this case, a collegiate wrestler struck his head on the wrestling mat during practice. No loss of consciousness occurred. The wrestler initially demonstrated signs and symptoms of a mild concussion, with dizziness and a headache. These concussion symptoms cleared quickly, but the athlete complained of difficulty swallowing (dysphagia) and demonstrated slurred speech (dysarthria). Also, his tongue deviated toward the right. No other neurologic deficits were observed. Differential Diagnosis: Occipital-cervical junction fracture, syringomyelia, malignancy, iatrogenic causes, cranial nerve injury. Treatment: After initial injury recognition, the athletic trainer placed the patient in a cervical collar and transported him to the emergency department. The patient received prednisone, and the emergency medicine physician ordered cervical spine plain radiographs, brain computed tomography, and brain and internal auditory canal magnetic resonance imaging. The physician consulted a neurologist, who managed the patient conservatively, with rest and no contact activity. The neurologist allowed the patient to participate in wrestling 7 months after injury. Uniqueness: To our knowledge, no other reports of unilateral hypoglossal nerve injury from relatively low-energy trauma (including athletics) exist. Conclusions: Hypoglossal nerve injury should be considered in individuals with head injury who experience dysphagia and dysarthria. Athletes with head injuries require cranial nerve assessments. PMID:19771294

  3. Effect of Natural Fractures on Hydraulic Fracturing

    NASA Astrophysics Data System (ADS)

    Ben, Y.; Wang, Y.; Shi, G.

    2012-12-01

    Hydraulic Fracturing has been used successfully in the oil and gas industry to enhance oil and gas production in the past few decades. Recent years have seen the great development of tight gas, coal bed methane and shale gas. Natural fractures are believed to play an important role in the hydraulic fracturing of such formations. Whether natural fractures can benefit the fracture propagation and enhance final production needs to be studied. Various methods have been used to study the effect of natural fractures on hydraulic fracturing. Discontinuous Deformation Analysis (DDA) is a numerical method which belongs to the family of discrete element methods. In this paper, DDA is coupled with a fluid pipe network model to simulate the pressure response in the formation during hydraulic fracturing. The focus is to study the effect of natural fractures on hydraulic fracturing. In particular, the effect of rock joint properties, joint orientations and rock properties on fracture initiation and propagation will be analyzed. The result shows that DDA is a promising tool to study such complex behavior of rocks. Finally, the advantages of disadvantages of our current model and future research directions will be discussed.

  4. Bimanual Force Coordination in Children with Spastic Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Smits-Engelsman, B. C. M.; Klingels, K.; Feys, H.

    2011-01-01

    In this study bimanual grip-force coordination was quantified using a novel "Gripper" system that records grip forces produced while holding a lower and upper unit, in combination with the lift force necessary to separate these units. Children with unilateral cerebral palsy (CP) (aged 5-14 years, n = 12) were compared to age matched typically…

  5. Unilateral Family Therapy for Alcohol Abuse: A Working Conception.

    ERIC Educational Resources Information Center

    Thomas, Edwin J.; Santa, Cathleen A.

    1982-01-01

    Presents unilateral family therapy in which intervention is directed toward changing the behavior of an uncooperative family member through working with a cooperative member as mediator. Applies the approach to the problem of endeavoring to reach and change an uncooperative alcohol abuser. (Author)

  6. The Shoulder Gradient in Patients with Unilateral Shoulder Impingement Syndrome

    PubMed Central

    Kim, Hee-Sang; Lee, Jong Ha; Yun, Dong Hwan; Yun, Jee-Sang; Shin, Yong Won; Chon, Jinmann

    2011-01-01

    Objective To investigate the relationship between the shoulder gradient and acromiohumeral interval of both shoulders in patients with unilateral shoulder impingement syndrome. Method Using the angulometer, we measured the shoulder gradient in patients with unilateral shoulder impingement syndrome in a standing position. Using the radiography, we measured the acromiohumeral interval and the angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapula. Results In patients with unilateral shoulder impingement syndrome, the frequency of shoulder impingement syndrome was 76.2% (16 of 21) on the side of the relatively lower shoulder. The mean acromiohumeral interval on the side of the lower shoulder was 10.031.28 mm, compared with 10.461.50 mm for the higher shoulder. The angle between a vertical line and a line connecting a superior angle with an inferior angle of the scapular of the side of the lower shoulder was -0.313.73 degrees, compared with 3.854.42 degrees for the higher shoulder. Conclusion The frequency of shoulder impingement syndrome was significantly higher on the side of the relatively lower shoulder, and there is no significant difference in the acromiohumeral interval between the side of the lower shoulder and that of the higher shoulder. In patients with unilateral shoulder impingement syndrome, the scapular on the side of lower shoulder was more rotated downward than on the side of the higher shoulder. PMID:22506196

  7. IQ Decline Following Early Unilateral Brain Injury: A Longitudinal Study

    ERIC Educational Resources Information Center

    Levine, Susan C.; Kraus, Ruth; Alexander, Erin; Suriyakham, Linda Whealton; Huttenlocher, Peter R.

    2005-01-01

    We examine whether children with early unilateral brain injury show an IQ decline over the course of development. Fifteen brain injured children were administered an IQ test once before age 7 and again several years later. Post-7 IQ scores were significantly lower than pre-7 IQ scores. In addition, pre-7 IQ scores were lower for children with

  8. Unilateral radiation pneumonitis in sheep: Physiological changes and bronchoalveolar lavage

    SciTech Connect

    Tillman, B.F.; Loyd, J.E.; Malcolm, A.W.; Holm, B.A.; Brigham, K.L. )

    1989-03-01

    Radiation pneumonitis is a life-threatening result of therapeutic thoracic irradiation, yet its mechanisms are poorly understood. We studied the effects of unilateral lung irradiation (3,000 rad) in sheep from the immediate response to the later development of radiation pneumonitis. We defined radiation pneumonitis by its diagnostic clinical feature, radiographic infiltration of the irradiated zone with a straight margin corresponding to the radiation port. The immediate response in the few hours after irradiation was characterized by cough, labored respiration, hypoxemia (arterial PO{sub 2} decreased 19 Torr), mild pulmonary hypertension (pulmonary arterial pressure increased 20%), and lymphopenia. Hemodynamics and gas exchange returned to normal by day 2 but became abnormal again before or during radiation pneumonitis at 32 +/- 2 days. Respiratory distress, hypoxemia, and pulmonary hypertension recurred during radiation pneumonitis. Bronchoalveolar lavage during radiation pneumonitis contained increased neutrophils (19 +/- 4%, control = 7%), increased protein (0.27 +/- 0.1 g/dl, control = 0.12 +/- 0.03), and severely impaired ability to lower surface tension. Alveolar macrophages from both lungs during unilateral radiation pneumonitis exhibited impaired generation of superoxide after phorbol myristate (only a 30% increase). Normal control alveolar macrophages increased superoxide production after stimulation greater than 400%. We conclude that unilateral lung irradiation in sheep causes a mild immediate response followed by radiation pneumonitis at 1 mo. Unilateral radiation pneumonitis in this model is associated with ipsilateral neutrophilic alveolitis, increased bronchoalveolar lavage protein, and impaired surfactant function, as well as bilateral functional abnormalities of alveolar macrophages.

  9. Unilateral nevoid acanthosis nigricans: Uncommon variant of a common disease

    PubMed Central

    Das, Anupam; Bhattacharya, Sabari; Kumar, Piyush; Gayen, Tirthankar; Roy, Kunal; Das, Nilay K.; Gharami, Ramesh C.

    2014-01-01

    Acanthosis nigricans (AN) is a fairly common dermatosis characterized by hyperpigmented velvety plaques, having a predilection for the intertriginous areas. We herein present a case of unilateral nevoid acanthosis nigricans over the left lateral chest, in an adult male. The rarity of documentation of this entity in the world literature prompted us to report the case. PMID:25506563

  10. Unilateral maxillary molar distalization with zygoma-gear appliance.

    PubMed

    Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

    2012-08-01

    The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. PMID:22858341

  11. Unilateral congenital elbow luxation in a Cavalier King Charles Spaniel

    PubMed Central

    2004-01-01

    Abstract A 7-week-old, intact female, Cavalier King Charles Spaniel was evaluated for nonweight bearing lameness of the right forelimb. Type III unilateral congenital elbow luxation was diagnosed radiographically. After surgical reduction, temporary placement of a transarticular pin, and external splinting of the joint, full weight bearing was achieved. Radial head subluxation persisted. PMID:15600161

  12. Unilateral alpha rhythm and Cheyne-Stokes respirations.

    PubMed

    Nowack, W J; Baker, Y; Janati, A

    1988-01-01

    A case of unilateral basal ganglion hemorrhage with Cheyne-Stokes respirations is presented. During the hyperpneic periods there was rhythmic alpha activity in the hemisphere contralateral to the basal ganglion hemorrhage. We postulate that the hemorrhage interrupted the thalamocortical fibers on the involved side. The implications of this clinical evidence are discussed in the light of the theory of cerebral autorhythmicity. PMID:3396202

  13. Bimanual Force Coordination in Children with Spastic Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Smits-Engelsman, B. C. M.; Klingels, K.; Feys, H.

    2011-01-01

    In this study bimanual grip-force coordination was quantified using a novel "Gripper" system that records grip forces produced while holding a lower and upper unit, in combination with the lift force necessary to separate these units. Children with unilateral cerebral palsy (CP) (aged 5-14 years, n = 12) were compared to age matched typically

  14. Coupling of FM Systems to Individuals with Unilateral Hearing Loss.

    ERIC Educational Resources Information Center

    Kopun, Judy G.; And Others

    1992-01-01

    This study examined the attenuation characteristics of 5 Frequency Modulation system sound delivery options for 25 adults and children (ages 5-13). Degree of ear canal occlusion was a major factor in degree of attenuation. For children with unilateral hearing impairments, the most acoustically appropriate option was the tube-fitting. (Author/JDD)

  15. Traumatic glaucoma with features of unilateral pigment dispersion

    PubMed Central

    Bowler, Gordon; Ellul, Antony; Gouws, Pieter

    2014-01-01

    Summary We report a patient with traumatic glaucoma with features of unilateral pigment dispersion. This rare form of secondary glaucoma has only been reported twice previously, with both patients demonstrating angle recession, indicating associated damage to the trabecular meshwork. To our knowledge, this is the first such case reported in which angle recession was absent. PMID:25097455

  16. Management of Young Children with Unilateral Hearing Loss

    ERIC Educational Resources Information Center

    McKay, Sarah

    2006-01-01

    Children with unilateral hearing loss (UHL) are at risk for academic, speech and language and social-emotional difficulties. To date, most of the evidence documented in the literature has been obtained from school-age children, most of whom were diagnosed with UHL after enrollment in school. Following the widespread institution of universal

  17. Fracture channel waves

    SciTech Connect

    Nihei, K.T.; Yi, W.; Myer, L.R.; Cook, N.G.; Schoenberg, M.

    1999-03-01

    The properties of guided waves which propagate between two parallel fractures are examined. Plane wave analysis is used to obtain a dispersion equation for the velocities of fracture channel waves. Analysis of this equation demonstrates that parallel fractures form an elastic waveguide that supports two symmetric and two antisymmetric dispersive Rayleigh channel waves, each with particle motions and velocities that are sensitive to the normal and tangential stiffnesses of the fractures. These fracture channel waves degenerate to shear waves when the fracture stiffnesses are large, to Rayleigh waves and Rayleigh-Lamb plate waves when the fracture stiffnesses are low, and to fracture interface waves when the fractures are either very closely spaced or widely separated. For intermediate fracture stiffnesses typical of fractured rock masses, fracture channel waves are dispersive and exhibit moderate to strong localization of guided wave energy between the fractures. The existence of these waves is examined using laboratory acoustic measurements on a fractured marble plate. This experiment confirms the distinct particle motion of the fundamental antisymmetric fracture channel wave (A{sub 0} mode) and demonstrates the ease with which a fracture channel wave can be generated and detected. {copyright} 1999 American Geophysical Union

  18. Ankle fracture - aftercare

    MedlinePLUS

    An ankle fracture is a break in 1 or more ankle bones. These fractures may: Be partial (the bone is only partially ... Severe ankle fractures may require surgery. Fractures that may need surgery if: The ends of the bone are out of line ...

  19. An analytical methodology for magnetic field control in unilateral NMR.

    PubMed

    Marble, Andrew E; Mastikhin, Igor V; Colpitts, Bruce G; Balcom, Bruce J

    2005-05-01

    Traditionally, unilateral NMR systems such as the NMR-MOUSE have used the fringe field between two bar magnets joined with a yoke in a 'U' geometry. This allows NMR signals to be acquired from a sensitive volume displaced from the magnets, permitting large samples to be investigated. The drawback of this approach is that the static field (B0) generated in this configuration is inhomogeneous, and has a large, nonlinear, gradient. As a consequence, the sensitive volume of the instrument is both small and ill defined. Empirical redesign of the permanent magnet array producing the B0 field has yielded instruments with magnetic field topologies acceptable for varying applications. The drawback of current approaches is the lack of formalism in the control of B0. Rather than tailoring the magnet geometry to NMR investigations, measurements must be tailored to the available magnet geometry. In this work, we present a design procedure whereby the size, shape, field strength, homogeneity, and gradients in the sensitive spot of a unilateral NMR sensor can be controlled. Our design uses high permeability pole pieces, shaped according to the contours of an analytical expression, to control B0, allowing unilateral NMR instruments to be designed to generate a controlled static field topology. We discuss the approach in the context of previously published design techniques, and explain the advantages inherent in our strategy as compared to other optimization methods. We detail the design, simulation, and construction of a unilateral magnet array using our approach. It is shown that the fabricated array exhibits a B0 topology consistent with the design. The utility of the design is demonstrated in a sample nondestructive testing application. Our design methodology is general, and defines a class of unilateral permanent magnet arrays in which the strength and shape of B0 within the sensitive volume can be controlled. PMID:15809175

  20. Circling behavior following unilateral kainic acid injections into rat striatum.

    PubMed

    Taylor, R J; Reavill, C; Jenner, P; Marsden, C D

    1981-12-01

    Unilateral injection of kainic acid (2.5-25 nmol) into rat anterior caudate putamen induced dose-related circling behaviour. Kainic acid (10 nmol) consistently caused initial weak ipsiversive circling lasting 1 h followed by prolonged strong contraversive rotation lasting in excess of 10 h. Unilateral intrastriatal administration of L-glutamic acid, or of monosodium L-glutamate, to normal rats, or administration of monosodium L-glutamate to rats with extensive decortication, did not induce circling behaviour. The simultaneous unilateral injection of monosodium L-glutamate (1 mumol) with kainic acid (10 nmol) did not modify circling behaviour induced by kainic acid. However, extensive decortication greatly reduced circling induced by unilateral intrastriatal kainic acid (10 nmol), and effect not reversed by the simultaneous administration of monosodium L-glutamate (1 mumol). Unilateral 6-hydroxydopamine lesions of the left nigrostriatal pathway abolished the initial ipsiversive rotation and potentiated the subsequent contraversive rotation for up to 4 h after intrastriatal injection of kainic acid (10 nmol). Peripheral administration of haloperidol (1 mg/kg i.p.) also abolished initial ipsiversive rotation and decreased the subsequent contraversive rotation. Electro-coagulation of the ipsilateral strio-nigral pathway prolonged the initial ipsiversive rotation produced by kainic acid, but markedly attenuated contraversive rotation. These findings suggest that circling induced by intrastriatal administration of kainic acid depends on intact corticostriate pathways, but it cannot be reproduced or modified by intrastriatal administration of glutamate. Kainic acid circling appears to be mediated via strio-nigral pathways, and to be modulated by dopaminergic function. PMID:7333356

  1. Unilateral Incompatibility in Capsicum (Solanaceae): Occurrence and Taxonomic Distribution

    PubMed Central

    ONUS, A. NACI; PICKERSGILL, BARBARA

    2004-01-01

    Background and aims Unilateral incompatibility (UI) occurs when pollinations between species are successful in one direction but not in the other. Self-incompatible (SI) species frequently show UI with genetically related, self-compatible (SC) species, as pollen of SI species is compatible on the SC pistil, but not vice versa. Many examples of unilateral incompatibility, and all those which have been studied most intensively, are found in the Solanaceae, particularly Lycopersicon, Solanum, Nicotiana and Petunia. The genus Capsicum is evolutionarily somewhat distant from Lycopersicon and Solanum and even further removed from Nicotiana and Petunia. Unilateral incompatibility has also been reported in Capsicum; however, this is the first comprehensive study of crosses between all readily available species in the genus. Methods All readily available (wild and domesticated) species in the genus are used as plant material, including the three genera from the Capsicum pubescens complex plus eight other species. Pollinations were made on pot-grown plants in a glasshouse. The number of pistils pollinated per cross varied (from five to 40 pistils per plant), depending on the numbers of flowers available. Pistils were collected 24 h after pollination and fixed for 324 h. After staining, pistils were mounted in a drop of stain, squashed gently under a cover slip and examined microscopically under ultra-violet light for pollen tube growth. Key results Unilateral incompatibility is confirmed in the C. pubescens complex. Its direction conforms to that predominant in the Solanaceae and other families, i.e. pistils of self-incompatible species, or self-compatible taxa closely related to self-incompatible species, inhibit pollen tubes of self-compatible species. Conclusions Unilateral incompatibility in Capsicum does not seem to have arisen to prevent introgression of self-compatibility into self-incompatible taxa, but as a by-product of divergence of the C. pubescens complex from the remainder of the genus. PMID:15229125

  2. Outcomes After Unilateral Uterine Artery Embolization: A Retrospective Review

    SciTech Connect

    Bratby, M. J.; Hussain, F. F.; Walker, W. J.

    2008-03-15

    Purpose. Bilateral uterine artery embolization (UAE) is considered necessary to provide effective treatment for symptomatic uterine fibroids. Occasionally, only unilateral embolization is performed, and this study evaluates these outcomes. Materials and Methods. As part of a prospective observational study of more than 1600 patients treated with UAE since 1996, there have been 48 patients in whom unilateral embolization has been performed. This study retrospectively reviews clinical response as assessed by our standard questionnaire and radiological response assessed by either magnetic resonance imaging or ultrasound. Results. Two principal groups emerged: the largest, where only the dominant unilateral arterial supply was electively embolized (30 patients); and the second, where there was technical failure to catheterize the second uterine artery as a result of anatomical constraints (12 patients). Favorable clinical response with a reduction in menorrhagia at 1 year was seen in 85.7% (18/21) of those patients with a dominant arterial supply to the fibroid(s). In contrast, in those patients where there was technical failure to embolize one uterine artery, there was a high rate of clinical failure requiring further intervention in 58.3% (7/12). Comparison of the technical failure group with the dominant uterine artery group demonstrated a statistically significant (Fisher's exact test) difference in the proportion of patients with evidence of persistent fibroid vascularity (p < 0.001) and requiring repeat intervention (p < 0.01). Conclusion. We conclude that unilateral UAE can achieve a positive clinical result in the group of patients where there is a dominant unilateral artery supplying the fibroid(s), in contrast to the poor results seen following technical failure.

  3. Identifying osteoporotic vertebral fracture

    PubMed Central

    2015-01-01

    Osteoporosis per se is not a harmful disease. It is the sequela of osteoporosis and most particularly the occurrence of osteoporotic fracture that makes osteoporosis a serious medical condition. All of the preventative measures, investigations, treatment and research into osteoporosis have one primary goal and that is to prevent the occurrence of osteoporotic fracture. Vertebral fracture is by far and away the most prevalent osteoporotic fracture. The significance and diagnosis of vertebral fracture are discussed in this article. PMID:26435923

  4. Fractures of angle of mandible – A retrospective study

    PubMed Central

    Singh, Sourav; Fry, Ramesh R.; Joshi, Ajit; Sharma, Geeta; Singh, Smita

    2012-01-01

    Aims This retrospective study was done to evaluate the efficacy of single miniplate osteosynthesis at superior border of angle of mandible. Material and methods In this study 50 patients were treated by single miniplate osteosynthesis according to Champy's principle. Bite force generated was used as a parameter for judging the efficacy of internal fixation. In this article we present our experience over the years in the management of the fractures of angle of mandible based on this model. Results Most patients were of 21–30 yrs of age with unilateral angle fracture of mandible except one patient who had isolated bilateral angle fracture. The patients were treated successfully according to Champy's principle of osteosynthesis. There was a progressive improvement in the bite force generated after osteosynthesis. Conclusions The angle of the mandible is an anatomically weak and an area susceptible to fracture. The presence of an impacted or partially erupted third molar tooth further weakens it. Angle of mandible is the most common site for fracture however, bilateral angle fracture is very rare and uncommon. Osteosynthesis according to Champy's model led to an early functional improvement as demonstrated by the bite force generated. PMID:25737858

  5. Paratrooper's Ankle Fracture: Posterior Malleolar Fracture

    PubMed Central

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

    2015-01-01

    Background We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Methods Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. Results The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Conclusions Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to undergo surgical repairs. PMID:25729514

  6. Topology of Fracture Networks

    NASA Astrophysics Data System (ADS)

    Andresen, Christian Andr; Hansen, Alex; Le Goc, Romain; Davy, Philippe; Hope, Sigmund Mongstad

    2013-08-01

    We propose a mapping from fracture systems consisting of intersecting fracture sheets in three dimensions to an abstract network consisting of nodes and links. This makes it possible to analyze fracture systems with the methods developed within modern network theory. We test the mapping for two-dimensional geological fracture outcrops and find that the equivalent networks show small-world characteristics and are dissasortative. By analyzing the Discrete Fracture Network model, which is used to generate artificial fracture outcrop networks, we also find small world networks. However, the networks turn out to be assortative.

  7. Bilateral distal radius fractures in a 12-year-old boy after household electrical shock: case report and literature summary.

    PubMed

    Stone, Norman; Karamitopoulos, Mara; Edelstein, David; Hashem, Jenifer; Tucci, James

    2014-01-01

    Background. Fracture resulting from household electric shock is uncommon. When it occurs, it is usually the result of a fall; however, electricity itself can cause sufficient tetany to produce a fracture. We present the case of bilateral fractures of the distal radii of a 12-year-old boy which were sustained after accidental shock. The literature regarding fractures after domestic electric shock is also reviewed. Methods. An Ovid-Medline search was conducted. The resultant articles and their bibliographies were surveyed for cases describing fractures resulting from a typical household-level voltage (110-220?V, 50-60?Hertz) and not a fall after the shock. Twenty-one articles describing 22 patients were identified. Results. Twenty-two cases were identified. Thirteen were unilateral injuries; 9 were bilateral. Proximal humerus fractures were most frequent (8 cases), followed by scapula fractures (7 cases), forearm fractures (4 cases), femoral neck fractures (2 cases), and vertebral body fracture (1 case). Eight of the 22 cases were diagnosed days to weeks after the injury. Conclusions. Fracture after electric shock is uncommon. It should be suspected in patients with persistent pain, particularly in the shoulder or forearm area. Distal radius fractures that occur during electrocution are likely due to tetany. PMID:24511315

  8. Bilateral Distal Radius Fractures in a 12-Year-Old Boy after Household Electrical Shock: Case Report and Literature Summary

    PubMed Central

    Stone, Norman; Karamitopoulos, Mara; Edelstein, David; Tucci, James

    2014-01-01

    Background. Fracture resulting from household electric shock is uncommon. When it occurs, it is usually the result of a fall; however, electricity itself can cause sufficient tetany to produce a fracture. We present the case of bilateral fractures of the distal radii of a 12-year-old boy which were sustained after accidental shock. The literature regarding fractures after domestic electric shock is also reviewed. Methods. An Ovid-Medline search was conducted. The resultant articles and their bibliographies were surveyed for cases describing fractures resulting from a typical household-level voltage (110220?V, 5060?Hertz) and not a fall after the shock. Twenty-one articles describing 22 patients were identified. Results. Twenty-two cases were identified. Thirteen were unilateral injuries; 9 were bilateral. Proximal humerus fractures were most frequent (8 cases), followed by scapula fractures (7 cases), forearm fractures (4 cases), femoral neck fractures (2 cases), and vertebral body fracture (1 case). Eight of the 22 cases were diagnosed days to weeks after the injury. Conclusions. Fracture after electric shock is uncommon. It should be suspected in patients with persistent pain, particularly in the shoulder or forearm area. Distal radius fractures that occur during electrocution are likely due to tetany. PMID:24511315

  9. Congenital unilateral perisylvian syndrome: radiological basis and clinical correlations.

    PubMed Central

    Sbire, G; Husson, B; Dusser, A; Navelet, Y; Tardieu, M; Landrieu, P

    1996-01-01

    DESIGN--Advances in neuroimaging have allowed correlations between radiological patterns and clinical features of brain malformations. This paper reports clinical, prognosis, and electroencephalographic features of six children with a previously unrecognised neuroimaging picture of unilateral widening and verticalisation of the sylvian fossa associated with an abnormal ipsilateral perisylvian cortex. RESULTS--All children had reduced hemisphere size and thalamostriatal hypoplasia ipsilateral to the cleft and hemiplegia. Cognitive development was mostly impaired. Epilepsy occurred in two patients and was mainly characterised by partial seizures. Studies with EEG showed hemispheric slowing of background activity homolateral to the perisylvian dysplasia. Occurrence of the malformation among their siblings was not found. CONCLUSION--Similar brain malformations occasionally reported in older patients confirm the clinical picture, sporadic occurrence, and prognosis found, allowing the validation of a unilateral perisylvian syndrome. Images PMID:8676160

  10. Unilateral Stance Strategies of Athletes With ACL Deficiency

    PubMed Central

    Di Stasi, Stephanie L.; Hartigan, Erin H.; Snyder-Mackler, Lynn

    2013-01-01

    Aberrant movement strategies are characteristic of ACL-deficient athletes with recurrent knee instability (non-copers), and may instigate premature or accelerate joint degradation. Biomechanical evaluation of kinematic changes over time may elucidate noncopers responses to neuromuscular intervention and ACL reconstruction (ACLR). Forty noncopers were randomized into a perturbation group or a strength training only group. We evaluated the effects of perturbation training, and then gender on knee angle and tibial position during a unilateral standing task before and after ACLR. No statistically significant interactions were found. Before surgery, the strength training only group demonstrated knee angle asymmetry, but 6 months after ACLR, both groups presented with similar knee flexion between limbs. Aberrant and asymmetrical tibial position was found only in females following injury and ACLR. Neither treatment group showed distinct unilateral standing strategies following intervention; however, males and female noncopers appear to respond uniquely to physical therapy and surgery. PMID:22983931

  11. Framework Surgery for Treatment of Unilateral Vocal Fold Paralysis

    PubMed Central

    Daniero, James J.; Garrett, C. Gaelyn; Francis, David O.

    2014-01-01

    Laryngeal framework surgery is the current gold standard treatment for unilateral vocal fold paralysis. It provides a permanent solution to glottic insufficiency caused by injury to the recurrent laryngeal nerve. Various modifications to the original Isshiki type I laryngoplasty procedure have been described to improve voice and swallowing outcomes. The success of this procedure is highly dependent on the experience of the surgeon as it epitomizes the intersection of art and science in the field. The following article reviews the evidence, controversies, and complications related to laryngoplasty for unilateral vocal fold paralysis. It also provides a detailed analysis of how and when arytenoid-positioning procedures should be considered, and summarizes the literature on postoperative outcomes. PMID:24883239

  12. Congenital Unilateral Deafness Affects Cerebral Organization of Reading

    PubMed Central

    Adorni, Roberta; Manfredi, Mirella; Proverbio, Alice Mado

    2013-01-01

    It is known that early sensory deprivation modifies brain functional structure and connectivity. The aim of the present study was to investigate the neuro-functional organization of reading in a patient with profound congenital unilateral deafness. Using event-related potentials (ERPs), we compared cortical networks supporting the processing of written words in patient RA (completely deaf in the right ear since birth) and in a group of control volunteers. We found that congenital unilateral hearing deprivation modifies neural mechanisms of word reading. Indeed, while written word processing was left-lateralized in controls, we found a strong right lateralization of the fusiform and inferior occipital gyri activation in RA. This finding goes in the same direction of recent proposals that the ventral occipito-temporal activity in word reading seem to lateralize to the same hemisphere as the one involved in spoken language processing. PMID:24961430

  13. Early-onset unilateral electric cataract: a rare clinical entity.

    PubMed

    Mutlu, Fatih Mehmet; Duman, Haluk; Cil, Yakup

    2004-01-01

    Electrical injury may result in cataracts, which usually occur bilaterally. In this report, we present a rare complication of such an injury presenting as a unilateral cataract in a 33-year-old woman with a painless but gradual worsening of vision in her left eye 3 weeks after sustaining a high-voltage electrical injury. A cataract did not develop in the right eye during 26 months of follow-up. The patient underwent successful cataract surgery with an excellent return of vision. Electrical injuries may result in the formation of a unilateral cataract and therefore an ophthalmic examination should be performed regularly in the early recovery period of such injuries. Cataract surgery with intraocular lens implantation results in an excellent return of vision in patients with electrical cataract who do not have any other ocular damage. PMID:15247836

  14. Offspring of patients treated for unilateral Wilms' tumor in childhood

    SciTech Connect

    Green, D.M.; Fine, W.E.; Li, F.P.

    1982-01-01

    Twenty-seven women and the wives of nine men who survived unilateral Wilms' tumor in childhood had a total of 59 live born offspring. Among the 33 infants born to women who had received orthovoltage abdominal irradiation, ten weighed less than 2500 g at birth and three died during the perinatal period. In addition, one term infant of normal weight died of complications of a breech delivery. Only one of 26 infants born to the wives of Wilms' tumor patients and unirradiated female patients weighed less than 2500 g at birth and none died. The frequency of congenital malformations and spontaneous abortions in this series was not increased, and no offspring has developed cancer. The findings suggest that the risk of Wilms' tumor is low among progeny of survivors of nonfamilial, unilateral lesions. Damage from abdominal irradiation given to girls with Wilms' tumor may predispose them to the subsequent delivery of low birthweight children.

  15. Unilateral Loss of Spontaneous Venous Pulsations in an Astronaut

    NASA Technical Reports Server (NTRS)

    Mader, Thomas H.; Gibson, C. Robert; Lee, Andrew G.; Patel, Nimesh; Hart, Steven; Pettit, Donald R.

    2014-01-01

    Spontaneous venous pulsations seen on the optic nerve head (optic disc) are presumed to be caused by fluctuations in the pressure gradient between the intraocular and retrolaminar venous systems. The disappearance of previously documented spontaneous venous pulsations is a well-recognized clinical sign usually associated with a rise in intracranial pressure and a concomitant bilateral elevation of pressure in the subarachnoid space surrounding the optic nerves. In this correspondence we report the unilateral loss of spontaneous venous pulsations in an astronaut 5 months into a long duration space flight. We documented a normal lumbar puncture opening pressure 8 days post mission. The spontaneous venous pulsations were also documented to be absent 21 months following return to Earth.. We hypothesize that these changes may have resulted from a chronic unilateral rise in optic nerve sheath pressure caused by a microgravity-induced optic nerve sheath compartment syndrome.

  16. Isolated Unilateral Frontosphenoidal Craniosynostosis: A Rare Cause of Anterior Plagiocephaly.

    PubMed

    Pickrell, Brent B; Lam, Sandi K; Monson, Laura A

    2015-09-01

    Isolated unilateral frontosphenoidal synostosis is a rare and often misdiagnosed cause of synostotic frontal plagiocephaly. It is important to distinguish the various synostotic causes of frontal plagiocephaly from deformational frontal plagiocephaly because operative intervention is required in synostotic plagiocephaly to avoid progressive deformity, whereas deformational plagiocephaly typically improves without surgery. This study reports a patient with a unique case of anterior plagiocephaly caused by left-sided frontosphenoidal craniosynostosis. The workup should include a thorough history and clinical examination followed by computed tomography scan with three-dimensional reconstruction. Frontosphenoidal synostosis should be suspected in the absence of a coronal synostosis in a child with anterior unilateral plagiocephaly and treated surgically. Good aesthetic and functional results occur with prompt diagnosis and early surgical correction. PMID:26267563

  17. Repair of unilateral cleft lip: a comparison of five techniques.

    PubMed

    Lazarus, D D; Hudson, D A; van Zyl, J E; Fleming, A N; Fernandes, D

    1998-12-01

    Repair of unilateral cleft lip is a challenging procedure with no single technique satisfactory for all types of unilateral cleft deformity. This study compares retrospectively five techniques of unilateral cleft lip repair in 72 children (45 boys, 27 girls). Twenty-two children had a Millard rotation-advancement repair, 5 children had a Davies Z-plasty, 22 had a modified Z-plasty, 10 had a Tennison-Randall triangular flap repair, and 13 had a Nakajima-Yoshimura straight-line repair. Assessment was performed clinically by a plastic surgeon not involved in the original surgery. Repairs were assessed objectively by measurement of the vertical length of both the repaired and normal sides of the lip with calipers. Subjective criteria used to evaluate the repair were the symmetry of Cupid's bow, the quality of scar, the alignment of white roll, the evenness of the vermilion, and the lip pout. The mean follow-up period was 5.4 years (range, 9 months-29 years). Sixty-five of the 72 repairs measured (90%) were within two standard deviations (SDs) of normal and thus were considered to be of "acceptable" length. Seven repairs were unacceptably short (>2 SDs) on measurement, six of which included a rotation-advancement repair for a complete cleft lip. Subjective results paralleled the objective results. The outcome following repair of unilateral cleft lip was similar for all five surgical methods assessed except for complete cleft lips repaired by the rotation-advancement technique, which tended to result in an unacceptably short lip as measured on the repaired side. PMID:9869130

  18. Mirror Therapy in Unilateral Neglect After Stroke (MUST trial)

    PubMed Central

    Arora, Rajni; Kaur, Paramdeep; Sharma, Deepika; Vishwambaran, Dheeraj K.; Arima, Hisatomi

    2014-01-01

    Objective: We explored the effectiveness of mirror therapy (MT) in the treatment of unilateral neglect in stroke patients. Methods: This is an open, blinded endpoint, randomized controlled trial carried out from January 2011 to August 2013. We included stroke patients with thalamic and parietal lobe lesions with unilateral neglect 48 hours after stroke. Patients were randomized to the MT group or the control group (sham MT), and both the groups received limb activation. Patients received treatment for 1–2 hours a day 5 days a week for 4 weeks. The primary outcome was unilateral neglect assessed by a blinded assessor using the star cancellation test, the line bisection test, and a picture identification task at 1, 3, and 6 months. This study was registered at http://clinicaltrials.gov (NCT 01735877). Results: Forty-eight patients were randomized to MT (n = 27) or the control group (n = 21). Improvement in scores on the star cancellation test over 6 months was greater in the MT group (mean difference 23, 95% confidence interval [CI] 19–28; p < 0.0001). Similarly, improvement in the MT group was observed in the scores on the picture identification task (mean difference 3.2, 95% CI 2.4–4.0; p < 0.0001) and line bisection test (mean difference 8.6, 95% CI 2.7–14.6; p = 0.006). Conclusions: In patients with stroke, MT is a simple treatment that improves unilateral neglect. Classification of evidence: This study provides Class I evidence that for patients with neglect from thalamic and parietal lobe strokes, MT improves neglect. PMID:25107877

  19. Unilateral hearing during development: hemispheric specificity in plastic reorganizations

    PubMed Central

    Kral, Andrej; Heid, Silvia; Hubka, Peter; Tillein, Jochen

    2013-01-01

    The present study investigates the hemispheric contributions of neuronal reorganization following early single-sided hearing (unilateral deafness). The experiments were performed on ten cats from our colony of deaf white cats. Two were identified in early hearing screening as unilaterally congenitally deaf. The remaining eight were bilaterally congenitally deaf, unilaterally implanted at different ages with a cochlear implant. Implanted animals were chronically stimulated using a single-channel portable signal processor for two to five months. Microelectrode recordings were performed at the primary auditory cortex under stimulation at the hearing and deaf ear with bilateral cochlear implants. Local field potentials (LFPs) were compared at the cortex ipsilateral and contralateral to the hearing ear. The focus of the study was on the morphology and the onset latency of the LFPs. With respect to morphology of LFPs, pronounced hemisphere-specific effects were observed. Morphology of amplitude-normalized LFPs for stimulation of the deaf and the hearing ear was similar for responses recorded at the same hemisphere. However, when comparisons were performed between the hemispheres, the morphology was more dissimilar even though the same ear was stimulated. This demonstrates hemispheric specificity of some cortical adaptations irrespective of the ear stimulated. The results suggest a specific adaptation process at the hemisphere ipsilateral to the hearing ear, involving specific (down-regulated inhibitory) mechanisms not found in the contralateral hemisphere. Finally, onset latencies revealed that the sensitive period for the cortex ipsilateral to the hearing ear is shorter than that for the contralateral cortex. Unilateral hearing experience leads to a functionally-asymmetric brain with different neuronal reorganizations and different sensitive periods involved. PMID:24348345

  20. Acute Contralateral Radiculopathy after Unilateral Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Jang, Kyoung-Min; Kim, Young-Baeg; Park, Yong-Sook; Nam, Taek-Kyun; Lee, Young-Seok

    2015-01-01

    Objective Cases of contralateral radiculopathy after a transforaminal lumbar interbody fusion with a single cage (unilateral TLIF) had been reported, but the phenomenon has not been explained satisfactorily. The purpose of this study was to determine its incidence, causes, and risk factors. Methods We did retrospective study with 546 patients who underwent a unilateral TLIF, and used CT and MRI to study the causes of contralateral radicular symptoms that appeared within a week postoperatively. Clinical and radiological results were compared by dividing the patients into the symptomatic group and asymptomatic group. Results Contralateral symptoms occurred in 32 (5.9%) of the patients underwent unilateral TLIF. The most common cause of contralateral symptoms was a contralateral foraminal stenosis in 22 (68.8%), screw malposition in 4 (12.5%), newly developed herniated nucleus pulposus in 3 (9.3%), hematoma in 1 (3.1%), and unknown origin in 2 patients (6.3%). 16 (50.0%) of the 32 patients received revision surgery. There was no difference in visual analogue scale and Oswestry disability index between the two groups at discharge. Both preoperative and postoperative contralateral foraminal areas were significantly smaller, and postoperative segmental angle was significantly greater in the symptomatic group comparing to those of the asymptomatic group (p<0.05). Conclusion The incidence rate is not likely to be small (5.9%). If unilateral TLIF is performed for cases when preoperative contralateral foraminal stenosis already exists or when a large restoration of segmental lordosis is required, the probability of developing contralateral radiculopathy is increased and caution from the surgeon is needed. PMID:26587189

  1. Early surgical treatment in unilateral coronoid hyperplasia and facial asymmetry.

    PubMed

    Gali, Manlio; Consorti, Giuseppe; Tieghi, Riccardo; Denes, Stefano Andrea; Fainardi, Enrico; Schmid, Judith Louisa; Neuschl, Matthias; Clauser, Luigi

    2010-01-01

    Unilateral coronoid hyperplasia is a rare condition in the pediatric age. It may be an unrecognized cause of restricted mouth opening in children.The limited jaw movement is due to the enlargement of the coronoid process of the mandible that impinges on the zygomatic arch during mouth opening. This pathologic condition is still unknown and often misdiagnosed.Although in the past the term osteochondroma has been used to describe most of the unilateral and a few of the bilateral cases, there is no histologic evidence that the process has a neoplastic origin.Microscopic examination of the removed coronoid process has revealed hyperplastic compact bone covered with a thin layer of normal cartilage.There are multiple causes of mandibular hypomobility, each of them associated with different anatomic structures and etiologies, and a large number of cases, mostly bilateral, are idiopathic in nature.Several theories of pathogenesis have been proposed: temporomandibular joint dysfunctions, mandibular hypomobility, temporalis hyperactivity, hormonal stimulus, persistent cartilage growth center, genetic inheritance, and family factors.Unilateral coronoid hyperplasia is usually due to a trauma or a pathologic condition and is associated with facial asymmetry, being more frequently seen in women with histologic chondromatous or neoplastic changes. A thorough clinical history should include information about the onset and progression of pain and other subjective symptoms.In this study, we present a case of unilateral hyperplasia of the coronoid process in a 3 year-old female who, to the best of our knowledge, is the youngest patient so far reported with such anomaly.Our findings support the recommendation that early surgical treatment and aggressive postoperative physical therapy should be taken into account to allow for recovery of morphology and growth function in children. PMID:20072021

  2. Perioperative outcomes after unilateral and bilateral total knee arthroplasty

    PubMed Central

    Memtsoudis, Stavros G.; Ma, Yan; González Della Valle, Alejandro; Mazumdar, Madhu; Gaber-Baylis, Licia K.; MacKenzie, C. Ronald; Sculco, Thomas P.

    2009-01-01

    Background The safety of bilateral total knee arthroplasties (BTKA) during the same hospitalization remains controversial. We sought to study differences in perioperative outcomes between unilateral and BTKA, and further compare BTKAs performed during the same versus different operations during the same hospitalization. Methods Nationwide Inpatient Sample data from 1998 to 2006 were analyzed. Entries for unilateral and BTKA procedures performed on the same day (simultaneous) and separate days (staged) during the same hospitalization were identified. Patient and health-care system related demographics were determined. The incidence of in-hospital mortality and procedure related complications was estimated and compared between groups. Multivariate regression was used to identify independent risk factors for morbidity and mortality. Results Despite younger average age and lower comorbidity burden, procedure related complications and in-hospital mortality were more frequent after BTKA than after unilateral procedures (9.45% vs. 7.07% and 0.30% vs. 0.14%, P<0.0001 each). An increased rate of complications was associated with a staged versus simultaneous approach with no difference in mortality (10.30% vs. 9.15% (P<0.0001) and 0.29% vs. 0.26% (P=0.2875)). Independent predictors for in-hospital mortality included: BTKA (simultaneous: OR 2.23, CI=[1.69; 2.95], P<0.0001; staged: OR 2.01, CI=[1.28; 3.41], P=0.0031), male gender (OR 2.02, CI=[1.75, 2.34], P<0.0001), age above 75 years (OR 3.96 CI=[2.77, 5.66], P<0.0001), and the presence of a number of comorbidities and complications. Conclusion BTKAs carry increased risk of perioperative morbidity and mortality compared to unilateral procedures. Staging BTKA procedures during the same hospitalization offers no mortality benefit, and may even expose patients to increased morbidity. PMID:19934863

  3. Adolescent femoral shaft fractures: rigid versus flexible nails.

    PubMed

    Gregory, P; Sullivan, J A; Herndon, W A

    1995-07-01

    Twenty-one skeletally immature patients between 11 and 16 years of age were treated operatively for a unilateral femoral shaft fracture. Eleven patients underwent fixation with flexible nails and 10 with rigid nails. The patients were studied retrospectively to determine the similarity of the groups. Each method of fixation was then compared to determine the technical ease and final outcome. Both methods gave excellent final radiographic alignment with minimal complications. Flexible nailing required much less operative time and less fluoroscopy time. Estimated cost of using Ender nails is much less than using Russell-Taylor interlocking nails. PMID:7479403

  4. Choroidal Thickness in Eyes with Unilateral Ocular Ischemic Syndrome

    PubMed Central

    Kim, Dong Yoon; Joe, Soo Geun; Lee, Joo Yong; Kim, June-Gone; Yang, Sung Jae

    2015-01-01

    Aim. To analyze the subfoveal choroid thickness and choroidal volume in unilateral ocular ischemic syndrome (OIS). Methods. A retrospective review was conducted for all patients with unilateral OIS from October 2010 through June 2014. The subfoveal choroidal thickness (SFChT) and choroidal volume of both eyes were compared. Results. 19 unilateral OIS patients were included in this study. The mean SFChT of OIS eyes was significantly lower than that of fellow eyes (OIS eyes: 208.89 82.62??m and fellow eyes: 265.31 82.77??m, P < 0.001). The choroidal volume of OIS eyes was significantly smaller than that of fellow eyes (OIS eyes: 0.16 0.05?mm3 and fellow eyes: 0.21 0.05?mm3, P < 0.001). Conclusion. The choroidal thickness and volume of OIS eyes were smaller than those of unaffected fellow eyes. Decreased choroidal circulation caused by carotid artery stenosis might affect the discordance of choroidal thickness and choroidal volume. PMID:26504596

  5. Percutaneous nephrolithotomy: Effect of unilateral procedure on contralateral kidney function

    PubMed Central

    Sichani, Mehrdad Mohammadi; Behnamfar, Amir; Khorami, Mohammad Hatef; Nourimahdavi, Kia; Alizadeh, Farshid; Izadpanahi, Mohammad Hossein

    2014-01-01

    Background: Although long-term effects of percutaneous nephrolithotomy (PCNL) on renal function and structure have been evaluated, knowledge regarding the immediate effects of surgery on renal function is limited. We conducted this study to evaluate the impact of unilateral PCNL on bilateral renal function during immediate post-operative period. Materials and Methods: From April to September 2012, 40 eligible patients were enrolled in this study and underwent unilateral PCNL. During the post-operative period, creatinine clearances (CrCl) of treated and untreated sides were estimated separately and pattern of changes in bilateral renal function following this procedure was evaluated. Results: Following the operation, CrCl of both kidneys showed a similar pattern of changes, of course more dramatic on treated side. We observed progressive decline in CrCl of both sides followed by bilateral improvement in renal function toward pre-operative values. Conclusions: During the early post-operative period following unilateral PCNL, both kidneys experienced a temporary drop in function warranting more intensive post-operative care. PMID:25538913

  6. Intracordal auricular cartilage injection for unilateral vocal fold paralysis.

    PubMed

    Lim, Yun-Sung; Lee, Yoon Se; Lee, Jin-Choon; Lee, Byung-Joo; Wang, Soo-Geun; Park, Hee-June; Nam, Su-Bong; Bae, Yong-Chan

    2015-01-01

    We evaluated the efficacy and outcome of intracordal auricular cartilage injection in patients with unilateral vocal fold paralysis. Our interest developed from findings of a canine model study that reported that histologic characteristics of cartilage were preserved 2 and 3 years after intracordal autologous cartilage injection. Between May 2002 and July 2010, 29 patients with breathy dysphonia caused by unilateral vocal fold paralysis underwent intracordal auricular cartilage injection. Each subject underwent preoperative and postoperative perceptual assessments, acoustical voice analysis, and videostroboscopy. Fourteen patients were male, and the mean age was 52-years old. Patients were tracked for a mean duration of 257 days. Injections were performed through a transoral approach under general anesthesia. Perceptual assessments by GRBAS scale, acoustic parameters of jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time significantly improved at 3, 6, and 12 months after cartilage injection (p?unilateral vocal fold paralysis. Autologous auricular cartilage can be a safe, effective, and alternative material for vocal fold medialization, and can be a long lasting one. PMID:24764320

  7. Reliability of the Melbourne assessment of unilateral upper limb function.

    PubMed

    Randall, M; Carlin, J B; Chondros, P; Reddihough, D

    2001-11-01

    This study examines the reliability of the Melbourne Assessment of Unilateral Upper Limb Function: a quantitative test of quality of movement in children with neurological impairment. The assessment was administered to 20 children aged from 5 to 16 years (mean age 9 years 10 months, SD 2 years 10 months) who had various types and degrees of cerebral palsy (CP). The performances of the 20 children during assessment were videotaped for subsequent scoring by 15 occupational therapists. Scores were analyzed for internal consistency of test items, inter- and intrarater reliability of scorings of the same videotapes, and test-retest reliability using repeat videotaping. Results revealed very high internal consistency of test items (alpha=0.96), moderate to high agreement both within and between raters for all test items (intraclass correlations of at least 0.7) apart from item 16 (hand to mouth and down), and high interrater reliability (0.95) and intrarater reliability (0.97) for total test scores. Test-retest results revealed moderate to high intrarater reliability for item totals (mean of 0.83 and 0.79) for each rater and high reliability for test totals (0.98 and 0.97). These findings indicate that the Melbourne Assessment of Unilateral Upper Limb Function is a reliable tool for measuring the quality of unilateral upper-limb movement in children with CP. PMID:11730151

  8. Fractures of the Fifth Metatarsal

    MedlinePLUS

    ... type of fracture is the result of an injury in which the ankle rolls. Avulsion fractures are often overlooked when they occur with an ankle sprain. Jones fracture . Jones fractures occur in a small ...

  9. Preventing Falls and Related Fractures

    MedlinePLUS

    ... Basics Falls and Fractures Preventing Falls and Related Fractures Publication available in: PDF (79 KB) Related Resources ... and reduce fracture risk. Prevention of Falls and Fractures Safety first to prevent falls: At any age, ...

  10. Sprains, Strains and Fractures

    MedlinePLUS

    ... Sprains, Strains & Fractures What is a Foot or Ankle Sprain or Fracture? The feet and ankles work together to provide support and mobility to the body. A foot or ankle sprain is a soft tissue injury. Most often, ...

  11. Nasal fracture (image)

    MedlinePLUS

    A nasal fracture is a break in the bone over the ridge of the nose. It usually results from a blunt ... and is one of the most common facial fracture. Symptoms of a broken nose include pain, blood ...

  12. Lisfranc (Midfoot) Fractures

    MedlinePLUS

    ... that disrupts multiple different joints and includes multiple fractures. Lisfranc injuries tend to damage the cartilage of ... include ligament strains and tears, as well as fractures and dislocations of bone (far right). (Le ) This ...

  13. Forearm Fractures in Children

    MedlinePLUS

    .org Forearm Fractures in Children The forearm is the part of the arm between the wrist and the elbow. It is ... two bones: the radius and the ulna. Forearm fractures are common in childhood, accounting for more than ...

  14. Infant skull fracture (image)

    MedlinePLUS

    Skull fractures may occur with head injuries. Although the skull is both tough and resilient and provides excellent protection ... a severe impact or blow can result in fracture of the skull and may be accompanied by ...

  15. Pediatric Thighbone (Femur) Fracture

    MedlinePLUS

    .org Thighbone (Femur) Fractures In Children Page ( 1 ) The thighbone (femur) is the largest and strongest bone in the body. It can break ... Cause Statistics The most common cause of thighbone fractures in infants under 1 year old is child ...

  16. Femur fracture repair - discharge

    MedlinePLUS

    You had a fracture (break) in the femur, also called the thigh bone, in your leg. You may have needed surgery to repair ... surgeon will make a cut to open your fracture. Your surgeon will then use special metal devices ...

  17. Growth Plate Fractures

    MedlinePLUS

    .org Growth Plate Fractures Page ( 1 ) The bones of children and adults share many of the same risks for injury. But because they ... to a unique injury called a growth plate fracture. Growth plates are areas of cartilage located near ...

  18. Fractures in anisotropic media

    NASA Astrophysics Data System (ADS)

    Shao, Siyi

    Rocks may be composed of layers and contain fracture sets that cause the hydraulic, mechanical and seismic properties of a rock to be anisotropic. Coexisting fractures and layers in rock give rise to competing mechanisms of anisotropy. For example: (1) at low fracture stiffness, apparent shear-wave anisotropy induced by matrix layering can be masked or enhanced by the presence of a fracture, depending on the fracture orientation with respect to layering, and (2) compressional-wave guided modes generated by parallel fractures can also mask the presence of matrix layerings for particular fracture orientations and fracture specific stiffness. This report focuses on two anisotropic sources that are widely encountered in rock engineering: fractures (mechanical discontinuity) and matrix layering (impedance discontinuity), by investigating: (1) matrix property characterization, i.e., to determine elastic constants in anisotropic solids, (2) interface wave behavior in single-fractured anisotropic media, (3) compressional wave guided modes in parallel-fractured anisotropic media (single fracture orientation) and (4) the elastic response of orthogonal fracture networks. Elastic constants of a medium are required to understand and quantify wave propagation in anisotropic media but are affected by fractures and matrix properties. Experimental observations and analytical analysis demonstrate that behaviors of both fracture interface waves and compressional-wave guided modes for fractures in anisotropic media, are affected by fracture specific stiffness (controlled by external stresses), signal frequency and relative orientation between layerings in the matrix and fractures. A fractured layered medium exhibits: (1) fracture-dominated anisotropy when the fractures are weakly coupled; (2) isotropic behavior when fractures delay waves that are usually fast in a layered medium; and (3) matrix-dominated anisotropy when the fractures are closed and no longer delay the signal. The theory and experimental results in this report demonstrate that the presence of fractures in anisotropic material can be unambiguously interpreted if experimental measurements are made as a function of stress, which eliminates many fracture-generated discrete modes (e.g., interface waves, and leaky guided-modes). Orthogonal fracture networks that are often encountered in field exploration bring in additional challenges for seismic/acoustic data interpretation. An innovative wavefront imaging system with a bi-axial load frame was designed and implemented on orthogonally-fractured samples to determine the effect of fracture networks on elastic wave propagation. The effects of central wave guiding and extra time delays along a fracture intersection were observed in experiments and was analyzed. Interpreting data from media with intersecting fracture sets must account for fracture intersections and the non-uniformity of fracture properties caused by local tectonic conditions or other physical process such as non-uniform fluid distributions within a network and/or chemical alterations.

  19. Hydraulic Fracturing Sand

    USGS Multimedia Gallery

    Fine-grained silica sand is mixed with chemicals and water before being pumped into rock formations to prevent the newly created artificial fractures from closing after hydraulic fracturing is completed....

  20. [Fractures of the talus].

    PubMed

    Thordarson, D B

    2011-10-01

    Fractures of the neck of the talus are a relatively uncommon fracture of the foot but they have potentially serious complications. This article details the Hawkins classification, operative treatment and indications, and complications of fractures of the neck of the talus. It also discusses the treatment of fractures of the body of the talus and talar head. An English full text version of this article is available at SpringerLink as supplemental. PMID:21979888

  1. Pediatric hand fractures.

    PubMed

    Nellans, Kate W; Chung, Kevin C

    2013-11-01

    Pediatric hand fractures are common childhood injuries. Identification of the fractures in the emergency room setting can be challenging owing to the physes and incomplete ossification of the carpus that are not revealed in the radiographs. Most simple fractures can be treated with appropriate immobilization through buddy taping, finger splints, or casting. If correctly diagnosed, reduced, and immobilized, these fractures usually result in excellent clinical outcomes. PMID:24209954

  2. Hydraulic fracture design optimization

    SciTech Connect

    Lee, Tae-Soo; Advani, S.H.

    1992-01-01

    This research and development investigation, sponsored by US DOE and the oil and gas industry, extends previously developed hydraulic fracture geometry models and applied energy related characteristic time concepts towards the optimal design and control of hydraulic fracture geometries. The primary objective of this program is to develop rational criteria, by examining the associated energy rate components during the hydraulic fracture evolution, for the formulation of stimulation treatment design along with real-time fracture configuration interpretation and control.

  3. Hydraulic fracture design optimization

    SciTech Connect

    Lee, Tae-Soo; Advani, S.H.

    1992-06-01

    This research and development investigation, sponsored by US DOE and the oil and gas industry, extends previously developed hydraulic fracture geometry models and applied energy related characteristic time concepts towards the optimal design and control of hydraulic fracture geometries. The primary objective of this program is to develop rational criteria, by examining the associated energy rate components during the hydraulic fracture evolution, for the formulation of stimulation treatment design along with real-time fracture configuration interpretation and control.

  4. Recent advances in hydraulic fracturing

    SciTech Connect

    Gidley, J.L.

    1989-01-01

    This book is a reference to the application of significant technological advances in hydraulic fracturing. It features illustrative problems to demonstrate specific applications of advanced technologies. Chapters examine pretreatment formation evaluation, rock mechanics and fracture geometry, 2D and 3D fracture-propagation models, propping agents and fracture conductivity, fracturing fluids and additives, fluid leakoff, flow behavior, proppant transport, treatment design, well completions, field implementation, fracturing-pressure analysis, postfracture formation evaluation, fracture azimuth and geometry determination, and economics of fracturing.

  5. Assessment of fracture risk.

    PubMed

    Baim, Sanford; Leslie, William D

    2012-03-01

    Osteoporosis-related fractures (low-trauma, fragility fractures) are associated with significant morbidity, mortality, and health care expenditure worldwide. In the absence of a defining fracture, the diagnosis of osteoporosis is based on the World Health Organization's T-score criteria using central dual-energy x-ray absorptiometry (DXA). Paradoxically, the majority of those patients who will sustain a low-trauma fracture do not meet the T-score definition of osteoporosis. Conversely, younger individuals with bone density in the osteoporotic range but no other risk factors have relatively low fracture rates and yet are frequently considered candidates for osteoporosis therapies. The limited accuracy of bone density testing alone to predict fractures has led to the development of a variety of fracture assessment tools that utilize the combination of bone density and clinical risk factors to improve the prediction of low-trauma fractures. These fracture assessment tools quantitatively predict the 10-year fracture probability of hip and major osteoporosis-related fractures, and can be used to define cost-effective intervention strategies for primary and secondary fracture prevention. PMID:22274642

  6. Tibia (Shinbone) Shaft Fractures

    MedlinePLUS

    .org Tibia (Shinbone) Sha Fractures Page ( 1 ) The tibia, or shinbone, is the most common fractured long bone in your body. The long bones include ... femur, humerus, tibia, and fibula. A tibial sha fracture occurs along the length of the bone, below ...

  7. Fracture Education in Engineering.

    ERIC Educational Resources Information Center

    Sidey, D.; And Others

    Fracture mechanics is a multidisciplinary topic which is being introduced to undergraduate engineering students in such courses as materials engineering. At a recent Conference on Fracture held at the University of Waterloo, a session was devoted to fracture education. Some of the ideas presented at that session are included and discussed here.

  8. Fractured tooth (image)

    MedlinePLUS

    A tooth can be chipped or fractured during an accident or a bad fall. A tooth that is chipped or not badly fractured can usually be handled on a nonemergency basis. A tooth that is badly fractured may have exposed nerve ...

  9. Locking compression plate osteosynthesis of complicated mandibular fractures in six horses.

    PubMed

    Kuemmerle, J M; Kummer, M; Auer, J A; Nitzl, D; Frst, A E

    2009-01-01

    Complicated mandibular fractures were recognised in one foal, one pony and four horses. The foal was two months old while the adult animals ranged in age from 12 to 24 years. Three horses had a unilateral horizontal ramus fracture. Two fractures were open and one was closed. Comminution was present in one of these patients while the other two horses had marked displacement of the fragments. Two suffered from comminuted fractures of the horizontal and vertical ramus of the mandible. One of these patients had open and infected fractures. One foal had a bilateral horizontal ramus fracture with marked periosteal 'new bone' formation and malalignement which required corrective osteotomy. Each horse underwent locking compression plate (LCP) osteosynthesis consisting of open fracture reduction and application of one to three 4.5/5.0 mm LCP at the ventral, lateral or caudal aspect of the mandible under fluoroscopic control. Two 3.5 mm LCP were used in the foal. Plate fixation was supported by application of a cerclage wire construct between the incisor and premolar teeth in most patients. Complete fracture healing, with an excellent functional and cosmetic outcome, was achieved in all of the patients. Complications encountered included seroma formation, screw and wire breakage, as well as implant and apical tooth root infections. The LCP was removed after fracture healing had occurred in four patients. PMID:19151871

  10. Multi-scale finite element modelling at the posterior lumbar vertebra: analysis of pedicle stresses due to pars fracture.

    PubMed

    Inceo?lu, Serkan; Mageswaran, Prasath

    2014-05-01

    Multi-scale finite element (FE) model is a cost-effective way to analyse stress response of micro-level structures to the changes in loading at macro-level. This study deals with the development of a multi-scale model of a human vertebra and stress changes in the pedicle at high resolution after a gross fracture at the posterior neural arch. Spondylolysis (pars fracture) is a painful condition occurring in the vertebral neural arch and common especially among the athletic young population. The fracture of the pars significantly alters load distribution and load transfer characteristics at the neural arch. Structural changes in the posterior vertebra due to the new loading patterns can trigger secondary complications. Clinical reports have shown the association of pedicle hypertrophy or pedicle fracture with unilateral pars fractures. However, the biomechanical consequences of pars fracture and its effect on the pedicle have never been studied in detail. Therefore, we prepared a multi-scale model of posterior vertebra with continuum laminar complex model combined with micro-FE model of a pedicle section. The results showed that stress at the contralateral pars and pedicle increased after unilateral pars fracture simulation. High-stress regions were found around the outer boundaries of the pedicle. This model and information are helpful in understanding the stress changes in the pedicle and can be used for adaptive remodelling studies. PMID:22963179

  11. Observations of Fractures Induced by Hydraulic Fracturing in Anisotropic Granite

    NASA Astrophysics Data System (ADS)

    Chen, Youqing; Nagaya, Yuya; Ishida, Tsuyoshi

    2015-07-01

    To investigate how the viscosity of the fracturing fluid affects fracture propagation, hydraulic fracturing experiments using three fluids with different viscosities (supercritical CO2, water, and viscous oil) under the true tri-axial condition were conducted on anisotropic granite specimens, and then the induced fractures were microscopically observed via a fluorescent method. Fractures induced by hydraulic fracturing are considerably tortuous from a microscopic view. A higher viscosity creates a smoother fracture pattern. The tortuosity, which is defined as the total fracture length along a pathway divided by the direct length of the two ends of a fracture, ranges from 1.05 to 1.13, demonstrating that the viscosity of fracturing fluid influences the fracture propagation pattern due to the different pathways of fracture propagation. In addition, hydraulic fracturing can induce many derivative pathways around the main fracture. Hydraulic fracturing with a lower viscosity fluid forms a more complex fracture network in rocks; the fracture induced by supercritical CO2 has the most branches along the main fracture. From these observations, fracture propagation by hydraulic fracturing sometimes develops by the shear fracture mode. This shear fracturing is often observed for a low-viscosity supercritical CO2 injection, which agrees with our results from AE monitoring and waveform analysis.

  12. Subsurface fracture spacing

    SciTech Connect

    Lorenz, J.C. ); Hill, R.E. )

    1991-01-01

    This study was undertaken in order to document and analyze the unique set of data on subsurface fracture characteristics, especially spacing, provided by the US Department of Energy's Slant Hole Completion Test well (SHCT-1) in the Piceance Basin, Colorado. Two hundred thirty-six (236) ft (71.9 m) of slant core and 115 ft (35.1 m) of horizontal core show irregular, but remarkably close, spacings for 72 natural fractures cored in sandstone reservoirs of the Mesaverde Group. Over 4200 ft (1280 m) of vertical core (containing 275 fractures) from the vertical Multiwell Experiment wells at the same location provide valuable information on fracture orientation, termination, and height, but only data from the SHCT-1 core allow calculations of relative fracture spacing. Within the 162-ft (49-m) thick zone of overlapping core from the vertical and deviated wellbores, only one fracture is present in vertical core whereas 52 fractures occur in the equivalent SHCT-1 core. The irregular distribution of regional-type fractures in these heterogeneous reservoirs suggests that measurements of average fracture spacing'' are of questionable value as direct input parameters into reservoir engineering models. Rather, deviated core provides data on the relative degree of fracturing, and confirms that cross fractures can be rare in the subsurface. 13 refs., 11 figs.

  13. Mechanics of Hydraulic Fractures

    NASA Astrophysics Data System (ADS)

    Detournay, Emmanuel

    2016-01-01

    Hydraulic fractures represent a particular class of tensile fractures that propagate in solid media under pre-existing compressive stresses as a result of internal pressurization by an injected viscous fluid. The main application of engineered hydraulic fractures is the stimulation of oil and gas wells to increase production. Several physical processes affect the propagation of these fractures, including the flow of viscous fluid, creation of solid surfaces, and leak-off of fracturing fluid. The interplay and the competition between these processes lead to multiple length scales and timescales in the system, which reveal the shifting influence of the far-field stress, viscous dissipation, fracture energy, and leak-off as the fracture propagates.

  14. Outpatient Treatment for Humeral Fractures in Five Calves

    PubMed Central

    YAMAGISHI, Norio; DEVKOTA, Bhuminand; TAKAHASHI, Masahiro

    2014-01-01

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

  15. [Nasal sequels of unilateral clefts: analysis and management].

    PubMed

    Talmant, J-C; Talmant, J-Ch; Lumineau, J-P

    2007-09-01

    Usually, the nasal sequels of unilateral cleft patient are just considered as an esthetic problem to be addressed after the growth spurt of adolescence. This very narrow vision has led the cleft lip and palate treatment to a deadend. Actually, nasal sequels are the worst in terms of consequence on facial growth. 75% of complete unilateral cleft children are more oral than nasal breathers. Today, we know about the bad consequences of oral breathing on facial growth. It is not surprising to observe a high rate of small maxilla with cleft maxilla scars. In the fetus, the unilateral cleft nose deformities are well explained by the rupture of the facial envelope and the ventilatory dynamics of the amniotic fluid. Every step of the primary treatment threatens the nasal air way patency, whether when repairing lip and nose, suturing the hard palate that is the floor of the nose, or closing the alveolar cleft which controls the width of the piriform aperture. The functional and esthetic nasal sequels reflect the initial deformity, but are also the surgeon's skill and protocol choice. Before undertaking treatment, we must analyze the deformity at every level. Usually, the best option is to reopen the cleft completely to perform a combined revision of the lip, nose, and alveolar cleft after an adequate anterior maxillary expansion. If nasal breathing is necessary for an adequate facial growth, 25 years of experience showed us that it was very difficult to erase the cortical imprint of an early oral breathing pattern. So it is essential to establish a normal nasal breathing mode at the initial surgery. When the initial surgery is efficient and/or the secondary repair is successful, the final esthetic rhinoplasty, when indicated, is just performed for the sake of harmonization, with a classic internal approach and a few refinements. PMID:17688895

  16. Unilateral Radiotherapy for the Treatment of Tonsil Cancer

    SciTech Connect

    Chronowski, Gregory M.; Garden, Adam S.; Morrison, William H.; Frank, Steven J.; Schwartz, David L.; Shah, Shalin J.; Beadle, Beth M.; Gunn, G. Brandon; Kupferman, Michael E.; Ang, Kian K.; Rosenthal, David I.

    2012-05-01

    Purpose: To assess, through a retrospective review, clinical outcomes of patients with squamous cell carcinoma of the tonsil treated at the M. D. Anderson Cancer Center with unilateral radiotherapy techniques that irradiate the involved tonsil region and ipsilateral neck only. Methods and Materials: Of 901 patients with newly diagnosed squamous cell carcinoma of the tonsil treated with radiotherapy at our institution, we identified 102 that were treated using unilateral radiotherapy techniques. All patients had their primary site of disease restricted to the tonsillar fossa or anterior pillar, with <1 cm involvement of the soft palate. Patients had TX (n = 17 patients), T1 (n = 52), or T2 (n = 33) disease, with Nx (n = 3), N0 (n = 33), N1 (n = 23), N2a (n = 21), or N2b (n = 22) neck disease. Results: Sixty-one patients (60%) underwent diagnostic tonsillectomy before radiotherapy. Twenty-seven patients (26%) underwent excision of a cervical lymph node or neck dissection before radiotherapy. Median follow-up for surviving patients was 38 months. Locoregional control at the primary site and ipsilateral neck was 100%. Two patients experienced contralateral nodal recurrence (2%). The 5-year overall survival and disease-free survival rates were 95% and 96%, respectively. The 5-year freedom from contralateral nodal recurrence rate was 96%. Nine patients required feeding tubes during therapy. Of the 2 patients with contralateral recurrence, 1 experienced an isolated neck recurrence and was salvaged with contralateral neck dissection only and remains alive and free of disease. The other patient presented with a contralateral base of tongue tumor and involved cervical lymph node, which may have represented a second primary tumor, and died of disease. Conclusions: Unilateral radiotherapy for patients with TX-T2, N0-N2b primary tonsil carcinoma results in high rates of disease control, with low rates of contralateral nodal failure and a low incidence of acute toxicity requiring gastrostomy.

  17. Unilateral cerebellar hypoplasia and mesencephalic malformation in a Hanoverian foal.

    PubMed

    Schröder, S; Schmidt, M J; Preis, S; Klumpp, S; Köhler, K; Kuchelmeister, K; Herden, C

    2013-01-01

    Neurological cases, especially in foals, are rare in the daily practical work. The most common causes are traumata and infectious diseases of the central nervous system (CNS). This case report provides further insights into the wide spectrum of possible neuropathological lesions by detailing a complex malformation with unilateral neurological signs that occurred later post natum. Thus, clinicians should also be aware of malformations in case of respective neurological patients. A Hanoverian foal was presented with progressive ataxia. General and blood examination revealed no further alterations. By neurologic examination, a unilateral hypermetria was diagnosed and a cysternography of the head was performed. A cerebellar malformation was assumed and the foal was euthanized due to poor prognosis. At necropsy, a unilateral absence of a cerebellar hemisphere and vermis accompanied by contralateral malformation of the mesencephalon was diagnosed. The missing areas of the right cerebellar hemisphere were replaced by a cystic formation. The left part of the mesencephalic lamina quadrigemina was reduced in size and the corpus callosum was hypoplastic. Additional microscopical findings were most obvious near the cyst formation and included angiofibrosis in remaining cerebellar and mesencephalic parenchyma and leptomeninges, heterotopia of cerebellar neurons, sclerosis in cerebellar cortex, focal proliferation of meningeal cells and mild mononuclear perivascular infiltrates. Occassional irregular neuronal arrangement in the mesencephalon was also present. Infectious agents such as Borna disease virus, rabies virus, and equine herpesvirus were not detected. Therefore, the complex malformation in this foal might have been caused by a destructive, possibly ischemic event, or could represent a sequel of a primary retrocerebellar cyst with accompanying compression of adjacent parenchyma. PMID:23608891

  18. Refractive State in Children with Unilateral Congenital Nasolacrimal Duct Obstruction

    PubMed Central

    Bagheri, Abbas; Safapoor, Sharareh; Yazdani, Shahin; Yaseri, Mehdi

    2012-01-01

    Purpose To evaluate refractive state in children with unilateral congenital nasolacrimal duct obstruction (NLDO). Methods This descriptive cross-sectional study includes consecutive children with unilateral congenital NLDO. Examination under anesthesia was performed to perform cycloplegic refraction and was followed by appropriate intervention in each patient. Refractive errors of the involved and sound fellow eyes were compared. Results Ninety-four children with mean age of 25.420.4 months (range, 6 months to 10 years) were enrolled from May 2007 to January 2010. Based on spherical equivalent refractive error, hyperopia was more common in the affected eyes, however this difference failed to reach statistical significance (P=0.5). Anisometropia more and less than 0.5 diopters (D) was present in 25% and 43% of patients respectively. Interocular difference was significant in terms of spherical refractive error and spherical equivalent (P=0.003) but not cylindrical refractive error. When the comparison was limited to hyperopic eyes, the interocular difference became more significant in terms of spherical refractive error and spherical equivalent (P<0.001). Each month of increase in age was associated with an interocular difference of 0.007D in spherical refractive error (r=0.242, P=0.02). Older age at the time of intervention was associated with more procedures (r=0.297, P=0.004). Conclusion Unilateral congenital NLDO is associated with anisometropia especially anisohyperopia which may predispose affected children to amblyopia. With increasing age, the degree of anisometropia and the number of required procedures increase. It is prudent to perform refraction and initiate proper intervention at a younger age. PMID:23503710

  19. Modeling of Interaction of Hydraulic Fractures in Complex Fracture Networks

    NASA Astrophysics Data System (ADS)

    Kresse, O. 2; Wu, R.; Weng, X.; Gu, H.; Cohen, C.

    2011-12-01

    A recently developed unconventional fracture model (UFM) is able to simulate complex fracture network propagation in a formation with pre-existing natural fractures. Multiple fracture branches can propagate at the same time and intersect/cross each other. Each open fracture exerts additional stresses on the surrounding rock and adjacent fractures, which is often referred to as "stress shadow" effect. The stress shadow can cause significant restriction of fracture width, leading to greater risk of proppant screenout. It can also alter the fracture propagation path and drastically affect fracture network patterns. It is hence critical to properly model the fracture interaction in a complex fracture model. A method for computing the stress shadow in a complex hydraulic fracture network is presented. The method is based on an enhanced 2D Displacement Discontinuity Method (DDM) with correction for finite fracture height. The computed stress field is compared to 3D numerical simulation in a few simple examples and shows the method provides a good approximation for the 3D fracture problem. This stress shadow calculation is incorporated in the UFM. The results for simple cases of two fractures are presented that show the fractures can either attract or expel each other depending on their initial relative positions, and compares favorably with an independent 2D non-planar hydraulic fracture model. Additional examples of both planar and complex fractures propagating from multiple perforation clusters are presented, showing that fracture interaction controls the fracture dimension and propagation pattern. In a formation with no or small stress anisotropy, fracture interaction can lead to dramatic divergence of the fractures as they tend to repel each other. However, when stress anisotropy is large, the fracture propagation direction is dominated by the stress field and fracture turning due to fracture interaction is limited. However, stress shadowing still has a strong effect on fracture width, which affects the injection rate distribution into multiple perforation clusters, and hence overall fracture network geometry and proppant placement.

  20. Fracture corridors in carbonates

    NASA Astrophysics Data System (ADS)

    Chatelée, Sébastien; Lamarche, Juliette; Gauthier, Bertrand D. M.

    2015-04-01

    Among fractures, Fracture Corridors (FC) are anomalous structures made of highly persistent fracture clusters having a strong effect on multi-phase fluid flow in the subsurface. While mechanical and geological conditions for diffuse fracture systems are well constrained, FC genetic conditions remain a matter of questioning. FC can be localized in larger structures such as folds and fault zones but recent studies suggest that a large amount of fractures and FC also arise as distributed in the host rock and formed in tabular layers during burial with early rock mechanical differentiation. In addition, while the mechanical stratigraphy is of prime importance for fracture stratigraphy, it is still unknown which factor prevails on FC genesis among the local versus regional stress-state, the host rock mechanical stratigraphy or the sedimentary facies. We present a study of fractures in a 400×300 m wide quarry (Calvisson, SE France) dug in homogeneous marly limestones of Hauterivian age. The quarry exhibits diffuse fractures as well as 16 FC. The aim of this study is to reveal the genetics factor for FC development, their global geometry and internal morphologic variations, but also to clear the impact of fracture corridors on diffuse fracture. For that, we measured >2500 fractures (strike, dip, spacing, filling, aperture, etc.) and studied microstructures in 80 thin sections. We calculated fracture density and acquired LiDAR data with >90 million points with a resolution of 4 to 15mm. Diffuse fractures are organized as two perpendicular sets, a main set NE-SW-trending and minor set NW-SE-trending. The FC have the same trend, but the NW-SE trend prevail on the NE-SW one. The LiDAR acquisition allows to visualize the 3D lateral continuity with corridors with a minimal extension of 30m. We distinguish 4 internal morphologic types in FC, depending on fracture morphology, occurrence of breccia and number of zones. The types may occur in a single FC with a lateral transition from one type to another. Fracture density study shows that diffuse fracture increase around FC. FC growth and variability was not dependent on facies variations, as they are inexistent in the quarry. The result of this study allows to interpret geomechanical behaviors and geological history of fractures and fracture corridors in carbonates.

  1. Graves’ disease presenting as unilateral anterior ischaemic optic neuropathy

    PubMed Central

    Monigari, Naresh; Deshpande, Anirudda; Nalabothu, Murali; Rao, Shilpa

    2014-01-01

    We report a case of a 28-year-old man who presented with 1-day history of sudden diminution of vision in the right eye. Examination showed unilateral exophthalmos with restricted eyeball movement on upward gaze in the right eye. MRI of the orbit showed no evidence of compression of the optic nerve on the right side. Visual-evoked potential showed prolonged P100 in the right eye. Fundus examination revealed swollen optic disc and para papillary nerve fibre layer splinter haemorrhages with corresponding altitudinal field defect on perimetry suggestive of anterior ischaemic optic neuropathy. PMID:24648476

  2. Extensive unilateral atrophoderma vermiculatum associated with ipsilateral congenital cataract.

    PubMed

    Bhoyrul, B; Jones, H; Blackford, S

    2016-03-01

    Atrophoderma vermiculatum (AV) is a rare follicular dermatosis presenting with 'wormeaten' or 'honeycomb' atrophy, usually on the cheeks and sometimes extending to the preauricular areas and forehead. It predominantly affects children and follows a slowly progressive course. The treatment of AV is challenging. We describe a rare case of unilateral AV in a young boy. The scarring in AV is characteristically limited to the face, but our patient had lesions extending to the concha auriculae and the neck. He also had an ipsilateral congenital cataract. Such an association has only been reported once before in the literature. PMID:26179135

  3. MRI and unilateral NMR study of reindeer skin tanning processes.

    PubMed

    Zhu, Lizheng; Del Federico, Eleonora; Ilott, Andrew J; Klokkernes, Torunn; Kehlet, Cindie; Jerschow, Alexej

    2015-04-01

    The study of arctic or subarctic indigenous skin clothing material, known for its design and ability to keep the body warm, provides information about the tanning materials and techniques. The study also provides clues about the culture that created it, since tanning processes are often specific to certain indigenous groups. Untreated skin samples and samples treated with willow (Salix sp) bark extract and cod liver oil are compared in this study using both MRI and unilateral NMR techniques. The two types of samples show different proton spatial distributions and different relaxation times, which may also provide information about the tanning technique and aging behavior. PMID:25719858

  4. Unilateral sudden hearing loss: a rare symptom of Moyamoya disease.

    PubMed

    Gl, Fatih; Berin, Sami; Mderris, Togay; Yal?ner, Gkhan; nal, zkan; K?r??, Muzaffer

    2016-01-01

    A 38-year-old female patient experienced a sudden onset of unilateral sensorineural hearing loss due to Moyamoya disease. A detailed summary of audiological and neurological findings indicated that the sudden hearing loss might be due to Moyamoya disease resulting in occlusion of posterior and middle cerebral arteries. Intravenous prednisolone and trimetazidine dihydrochloride may improve hearing thresholds and speech understanding. To our knowledge, this is the first article in the literature reporting a case of sudden hearing loss as the first manifestation of Moyamoya disease in a young adult. PMID:26890714

  5. Unilateral Hydronephrosis and Renal Damage after Acute Leukemia

    PubMed Central

    Simanauskiene, Egle; Daugelaviciene, Valentina; Laurinavicius, Arvydas; Mickys, Ugnius; Simonyte, Vaida; Vaitkeviciene, Goda; Verkauskas, Gilvydas

    2012-01-01

    A 14-year-old boy presented with asymptomatic right hydronephrosis detected on routine yearly ultrasound examination. Previously, he had at least two normal renal ultrasonograms, 4 years after remission of acute myeloblastic leukemia, treated by AML-BFM-93 protocol. A function of the right kidney and no damage on the left was confirmed by a DMSA scan. Right retroperitoneoscopic nephrectomy revealed 3 renal arteries with the lower pole artery lying on the pelviureteric junction. Histologically chronic tubulointerstitial nephritis was detected. In the pathogenesis of this severe unilateral renal damage, we suspect the exacerbation of deleterious effects of cytostatic therapy on kidneys with intermittent hydronephrosis. PMID:22548083

  6. Unilateral retinitis pigmentosa: 30?years follow-up

    PubMed Central

    Weller, Julia M; Michelson, Georg; Juenemann, Anselm G

    2014-01-01

    This case report depicts the clinical course of a female patient with unilateral retinitis pigmentosa (RP), who presented first in 1984 at the age of 43?years. At the beginning, there were cells in the vitreous leading to the diagnosis of uveitis with vasculitis. Within 30?years, the complete clinical manifestation of RP developed with bone spicule-shaped pigment deposits, pale optic disc, narrowed arterioles, cystoid macular oedema, posterior subcapsular cataract, concentric narrowing of the visual field and undetectable electroretinogram signal. At the age of 72?years, there are still no signs of retinal dystrophy in the other eye. PMID:24515232

  7. Surgical correction of unilateral and bilateral facial palsy

    PubMed Central

    Harrison, D

    2005-01-01

    Unilateral and bilateral facial palsies are debilitating and depressing conditions for the patient. For the past 30 years attempts have been made to improve the reanimation of these patients. The ability to transfer axons over significant distances with nerve grafts and the transfer of muscle that can be revascularised by microvascular surgery greatly improves results of this surgery. The revascularisation of muscle has been the important step forward but the re-focusing of interest in this condition has brought about a number of peripheral advances. PMID:16143684

  8. Finite element analysis of three commonly used external fixation devices for treating Type III pilon fractures.

    PubMed

    Ramlee, Muhammad Hanif; Kadir, Mohammed Rafiq Abdul; Murali, Malliga Raman; Kamarul, Tunku

    2014-10-01

    Pilon fractures are commonly caused by high energy trauma and can result in long-term immobilization of patients. The use of an external fixator i.e. the (1) Delta, (2) Mitkovic or (3) Unilateral frame for treating type III pilon fractures is generally recommended by many experts owing to the stability provided by these constructs. This allows this type of fracture to heal quickly whilst permitting early mobilization. However, the stability of one fixator over the other has not been previously demonstrated. This study was conducted to determine the biomechanical stability of these external fixators in type III pilon fractures using finite element modelling. Three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones were reconstructed from previously obtained CT datasets. Bones were assigned with isotropic material properties, while the cartilage was assigned as hyperelastic springs with Mooney-Rivlin properties. Axial loads of 350 N and 70 N were applied at the tibia to simulate the stance and the swing phase of a gait cycle. To prevent rigid body motion, the calcaneus and metatarsals were fixed distally in all degrees of freedom. The results indicate that the model with the Delta frame produced the lowest relative micromovement (0.03 mm) compared to the Mitkovic (0.05 mm) and Unilateral (0.42 mm) fixators during the stance phase. The highest stress concentrations were found at the pin of the Unilateral external fixator (509.2 MPa) compared to the Mitkovic (286.0 MPa) and the Delta (266.7 MPa) frames. In conclusion, the Delta external fixator was found to be the most stable external fixator for treating type III pilon fractures. PMID:25127377

  9. Subtrochanteric femoral fractures.

    PubMed

    Lundy, Douglas W

    2007-11-01

    Subtrochanteric femoral fractures are complicated injuries that may be associated with other life-threatening conditions. Patients should be carefully evaluated and appropriately treated for hypovolemic shock. These fractures can be effectively stabilized with 95 degrees plates, femoral reconstruction nails, or trochanteric femoral nails with interlocking options. Nails produce very stable constructs and consistently can be placed with the patient in the lateral position on the radiolucent table or in the supine position on the fracture table. Standard antegrade femoral nails may be indicated in certain fracture patterns. The 135 degrees hip screw-plate is not suitable in the treatment of subtrochanteric femoral fractures; use of these implants may result in loss of fixation and fracture displacement. Chemical and mechanical prophylaxis for deep vein thrombosis should be initiated unless contraindicated by other medical comorbidities. An accurate reduction and excellent surgical technique with minimal soft-tissue dissection can routinely produce good results without the need for secondary procedures. PMID:17989417

  10. Acute Unilateral Vestibular Failure Does Not Cause Spatial Hemineglect

    PubMed Central

    Conrad, Julian; Habs, Maximilian; Brandt, Thomas; Dieterich, Marianne

    2015-01-01

    Objectives Visuo-spatial neglect and vestibular disorders have common clinical findings and involve the same cortical areas. We questioned (1) whether visuo-spatial hemineglect is not only a disorder of spatial attention but may also reflect a disorder of higher cortical vestibular function and (2) whether a vestibular tone imbalance due to an acute peripheral dysfunction can also cause symptoms of neglect or extinction. Therefore, patients with an acute unilateral peripheral vestibular failure (VF) were tested for symptoms of hemineglect. Methods Twenty-eight patients with acute VF were assessed for signs of vestibular deficits and spatial neglect using clinical measures and various common standardized paper-pencil tests. Neglect severity was evaluated further with the Center of Cancellation method. Pathological neglect test scores were correlated with the degree of vestibular dysfunction determined by the subjective visual vertical and caloric testing. Results Three patients showed isolated pathological scores in one or the other neglect test, either ipsilesionally or contralesionally to the VF. None of the patients fulfilled the diagnostic criteria of spatial hemineglect or extinction. Conclusions A vestibular tone imbalance due to unilateral failure of the vestibular endorgan does not cause spatial hemineglect, but evidence indicates it causes mild attentional deficits in both visual hemifields. PMID:26247469

  11. Eccentric Strength and Endurance in Patients with Unilateral Intermittent Claudication

    PubMed Central

    Basyches, Mrcio; Wolosker, Nelson; Ritti-Dias, Raphael Mendes; Cmara, Lucas Caseri; Puech-Leo, Pedro; Battistella, Linamara Rizzo

    2009-01-01

    OBJECTIVE: To analyze concentric and eccentric strength and endurance in patients with unilateral intermittent claudication. INTRODUCTION: Basic motor tasks are composed of concentric, isometric, and eccentric actions, which are related and contribute to physical performance. In previous studies of patients with intermittent claudication, the disease-related reduction in concentric and isometric muscular strength and endurance resulted in poorer walking performance. To date, no study has evaluated eccentric muscle action in patients with intermittent claudication. METHODS: Eleven patients with unilateral intermittent claudication performed isokinetic concentric and eccentric actions at the ankle joints to assess peak torque and total work in both symptomatic and asymptomatic legs. RESULTS: Concentric peak torque and total work were lower in the symptomatic than in the asymptomatic leg (80 32 vs. 95 41 N/m, P = 0.01; 1479 667 vs. 1709 879 J, P = 0.03, respectively). There were no differences in eccentric peak torque and total work between symptomatic and asymptomatic legs (96 30 vs. 108 48 N/m; 1852 879 vs. 1891 755 J, respectively). CONCLUSION: Strength and endurance in the symptomatic leg were lower during concentric compared to eccentric action. Future studies are recommended to investigate the mechanisms underlying these responses and to analyze the effects of interventions to improve concentric strength and endurance on functional limitations in patients with intermittent claudication. PMID:19488589

  12. Bilateral masseteric contractile activity in unilateral gum chewing: differential calculus.

    PubMed

    Christensen, L V; Mohamed, S E

    1996-09-01

    Twelve healthy subjects performed 10 s, 15 s, 20 s, and 25 s of right-sided and, subsequently, left-sided gum chewing. The contractile activities of the ipsilateral (chewing side) and contralateral (non-chewing side) masseter muscles, mainly the concentric contractions of the phase of jaw closing and the isometric contractions of the phase of dental occlusion, were recorded through cumulative surface electromyography (EMG). A linear function (y = ax + b) described the association between an increase in the duration (x) of unilateral gum chewing and the cumulative EMG (y) of both the ipsilateral and the contralateral masseter muscle, and because of different slopes (a) of the two straight lines a geometric function (y = aqx) described the progressively larger differences between the paired and straight lines. When differential calculus was applied to the exponential functions, it became evident that the chewing forces generated by the ipsilateral masseter muscle continually exceeded those generated by the contralateral masseter muscle, and that the positive work (force x distance) produced by the concentric contractions of the ipsilateral masseter muscle continually exceeded that produced by the concentric contractions of the contralateral masseter muscle. It was inferred that mechano-physical work plays a major role if clinical muscle fatigue develops during prolonged unilateral gum chewing. PMID:8890066

  13. Autologous blood transfusion after primary unilateral total knee replacement surgery.

    PubMed

    Dramis, Asterios; Plewes, Jeremy

    2006-01-01

    A prospective study was undertaken to assess the efficacy and financial cost of the use of an autologous blood transfusion device in the reduction of allogeneic blood requirements of patients undergoing primary unilateral total knee arthroplasty. Forty-nine consecutive patients received either the CellTrans blood salvage device (group A of 32 patients) or the Redivac high vacuum drainage system (group B of 17 patients). The preoperative and postoperative haemoglobin levels were recorded at 72 or 96 hours. Nine percent of group A patients received an allogeneic blood transfusion compared to 59% in group B. There was an average saving of 1.1 unit of allogeneic blood per patient in group A (p<0.001). The total cost per patient was about Euro 111 less for the group A patients. Autologous re-infusion was found in this study to be an effective method of reducing allogeneic blood requirements and to afford significant cost savings in primary unilateral knee arthroplasty. PMID:16570888

  14. The Computerized Table Setting Test for Detecting Unilateral Neglect

    PubMed Central

    Ye, Byoung Seok; Lee, Hye Sun; Chang, Hyuk-Jae; Song, Dongbeom; Kim, Young Dae; Heo, Ji Hoe; Nam, Hyo Suk

    2016-01-01

    Background Patients with unilateral neglect fail to respond normally to stimuli on the left side. To facilitate the evaluation of unilateral spatial neglect, we developed a new application that runs on a tablet device and investigated its feasibility in stroke patients. Methods We made the computerized table setting test (CTST) to run on the tablet computer. Forty acute ischemic stroke patients (20 patients with right hemispheric infarction with neglect, 10 patients with right hemispheric infarction without neglect, and 10 patients with left hemispheric infarction) and 10 healthy controls were prospectively enrolled to validate the CTST. The test requires subjects to set a table by dragging 12 dishes located below the table on the tablet screen. The horizontal deviation of the 12 dishes from the midline of the table, the selection tendency measured by the sequence of the dish selection, and the elapsed time for table setting were calculated automatically. Results Parameters measured by the CTST were correlated with the results of conventional neglect tests. The horizontal deviation was significantly higher in patients with right hemispheric infarction with neglect compared with the other groups. The selection tendency and elapsed time also were significantly different in patients with right hemispheric infarction with neglect compared with the left hemispheric infarction and control groups, but were similar to those with right hemispheric infarction without neglect. Conclusions The CTST is feasible to administer and comparable with conventional neglect tests. This new application may be useful for the initial diagnosis and follow-up of neglect patients. PMID:26771512

  15. Partial lumbosacral transitional vertebrae: 2 cases of unilateral sacralization

    PubMed Central

    Muir, Jeffrey M.

    2012-01-01

    Objective Lumbosacral transitional vertebrae (LSTV) are relatively common skeletal anomalies with a debated role in low back pain. There are few documented cases of conservative care being used to address LSTV-associated symptomatology. The current report discusses chiropractic management of 2 patients with unilateral sacralization. Clinical Features Two patients with LSTV involving unilateral sacralization of L5, a Castellvi type IIIa variant, presented with back pain to a chiropractic clinic. Each case presented with symptomatology similar to piriformis syndrome. Intervention and Outcome Manual therapy, including spinal manipulation soft tissue therapies and exercise/stretching, was used to address the presenting symptoms. Approximately 2 weeks after initial treatment, the first patient subjectively reported a 70% improvement in symptoms, with lumbar extension increased to full in active range of motion at the lumbar spine but with continued tenderness and hypertonicity at the left piriformis and gluteus medius. After 4 weeks of treatment, the second patient reported improvement in pain and perceived mobility, although prolonged standing remained an aggravating factor. Although both showed improvement, neither case resulted in complete resolution of symptoms. Conclusion The presenting cases demonstrated partial resolution of symptoms after chiropractic management. It is proposed that sacralization is a possible cause of back pain in these cases. PMID:23204950

  16. Unilateral Agenesis of the Lung: A Rare Entity

    PubMed Central

    Singh, Urvinderpal; Jhim, Daksh; Kumar, Sunil; Mittal, Vidhu; Singh, Navdeep; Gour, Hitesh; Ramaraj, Muralidharan

    2015-01-01

    Patient: Female, 15 Final Diagnosis: Unilateral agenesis of the lung Symptoms: Sore throat with dry cough Medication: Clinical Procedure: Cect of the chest and bronchoscopy Specialty: Pulmonology Objective: Congenital defects/diseases Background: Agenesis of the lung, a rare congenital anomaly, arises or develops when there is disruption of evolution of the primitive lung bud, leading to complete absence of the lung, bronchi, and the main pulmonary artery. With right-sided agenesis, a variety of cardiac and other congenital malformations are more commonly seen, leading to a poor prognosis. Case Report: A young female, aged 15 years, presented with complaints of sore throat and cough. Her x-ray of the chest showed a homogeneous opacity in the middle and lower zones on the right side with marked shift of the mediastinum to the right side. Upon investigation, she was diagnosed with agenesis of the right lung with scoliosis, without any other congenital anomaly. Conclusions: Especially in adults, it requires a high level of good clinical judgement to identify and diagnose this congenital aberration, as they are often wrongly diagnosed as more common diseases associated with unilateral opaque hemithorax on x-ray. Hence, when confronted with an opaque hemithorax with shift of the mediastinum to the affected side in a young person, agenesis of the lung should be an important differential diagnosis while investigating the case. PMID:25659613

  17. Follow-up of prenatally diagnosed unilateral hydronephrosis.

    PubMed

    Thorup, J; Lenz, K; Rabol, A; Passalides, A; Nielsen, O H

    1996-12-01

    Based on previous experience with prenatally diagnosed unilateral hydronephrosis, we found that the primary indications for surgical intervention should be symptoms or functional impairment of the hydronephrotic kidney. Nonoperative management of neonates without symptoms and with normal function of the affected kidney was proposed. However, the strategy of treatment after prenatally diagnosed hydronephrosis is still controversial. We studied 28 consecutive children with suspected unilateral pelviureteral junction obstruction and a normal contralateral kidney. The overall follow-up period varied between 2.5 months and 6 years (median 2 years). Eleven children had normal function of the hydronephrotic kidney and were managed nonoperatively throughout the follow-up period. None of these demonstrated any symptoms and the renal function remained normal. A further 4 children with normal function of the affected kidney were managed nonoperatively, but later had a pyeloplasty performed because of either symptoms or deterioration of renal function. Eleven children had a pyeloplasty performed after the first renography showed that the hydronephrotic kidney provided less than 40% of total renal function. The age at pyeloplasty was 3 weeks- 7 months (median 6 weeks). In all cases but 1 the function of the affected kidney improved. Two patients with impaired hydronephrotic renal function were not operated upon. Our results indicate no need to change the strategy of treatment. PMID:24057464

  18. Fracturing-fluid additives

    SciTech Connect

    Harris, P.C. )

    1988-10-01

    Fracturing-fluid additives serve two purposes: to enhance fracture creation and proppant-carrying capacity and to minimize formation damage. Additives that assist fracture creation include viscosifiers, temperature stabilizers, pH-control agents, and fluid-loss-control materials. Those used to minimize formation damage are gel breakers, biocides, surfactants, clay stabilizers, and gases. This paper discusses the qualities and applications of each of these additives.

  19. Altered Contralateral Auditory Cortical Morphology in Unilateral Sudden Sensorineural Hearing Loss

    PubMed Central

    Fan, Wenliang; Zhang, Wenjuan; Li, Jing; Zhao, Xueyan; Mella, Grace; Lei, Ping; Liu, Yuan; Wang, Haha; Cheng, Huamao; Shi, Hong; Xu, Haibo

    2015-01-01

    Objective: To investigate the cerebral gray matter volume alterations in unilateral sudden sensorineural hearing loss patients within the acute period by the voxel-based morphometry method, and to determine if hearing impairment is associated with regional gray matter alterations in unilateral sudden sensorineural hearing loss patients. Study Design: Prospective case study. Setting: Tertiary class A teaching hospital. Patients: Thirty-nine patients with left-side unilateral sudden sensorineural hearing loss and 47 patients with right-side unilateral sudden sensorineural hearing loss. Intervention: Diagnostic. Main Outcome Measure: To compare the regional gray matter of unilateral sudden sensorineural hearing loss patients and healthy control participants. Results: Compared with control groups, patients with left side unilateral sudden sensorineural hearing loss had significant gray matter reductions in the right middle temporal gyrus and right superior temporal gyrus, whereas patients with right side unilateral sudden sensorineural hearing loss showed gray matter decreases in the left superior temporal gyrus and left middle temporal gyrus. A significant negative correlation with the duration of the sudden sensorineural hearing loss (R = −0.427, p = 0.012 for left-side unilateral SSNHL and R = −0.412, p = 0.013 for right-side unilateral SSNHL) was also found in these brain areas. There was no region with increased gray matter found in both groups of unilateral sudden sensorineural hearing loss patients. Conclusions: This study confirms that detectable decreased contralateral auditory cortical morphological changes have occurred in unilateral SSNHL patients within the acute period by voxel-based morphometry methods. The gray matter volumes of these brain areas also perform a negative correlation with the duration of the disease, which suggests a gradual brain structural impairment after the progression of the disease. PMID:26595717

  20. Assessment of Fracture Repair.

    PubMed

    Cook, Gillian E; Bates, Brent D; Tornetta, Paul; McKee, Michael D; Morshed, Saam; Slobogean, Gerard P; Schemitsch, Emil H

    2015-12-01

    Assessment of fracture union is a critical concept in clinical orthopaedics; however, there is no established "gold standard" for fracture healing. This review provides an overview of the problems related to the assessment of fracture healing, examines currently available tools to determine union, discusses the role of functional outcomes in the assessment of fracture healing, and finally evaluates healing outcome measures as they pertain to fracture trials. Because there is no universally accepted method to determine fracture healing, orthopaedic surgeons must rely on a range of tools that can include: radiographic assessment, mechanical assessment, serologic markers, and clinical evaluation (including functional outcomes). When used in conjunction, these tools can help to improve the sensitivity and specificity of determining fracture union. This is furthermore relevant when conducting fracture healing trials, for which there is little consensus between surgeons or the Food and Drug Administration as to optimal study endpoints. Such studies should therefore include a composite outcome measure consisting of radiographic and functional assessments to increase the quality and consistency of fracture healing trials. PMID:26584269

  1. Natural fracture systems studies

    SciTech Connect

    Lorenz, J.C.; Warpinski, N.R.

    1992-09-01

    The objectives of this program are (1) to develop a basinal-analysis methodology for natural fracture exploration and exploitation, and (2) to determine the important characteristics of natural fracture systems for use in completion, stimulation, and production operations. Natural-fracture basinal analysis begins with studies of fractures in outcrop, core and logs in order to determine the type of fracturing and the relationship of the fractures to the lithologic environment. Of particular interest are the regional fracture systems that are pervasive in western US tight sand basins. A Methodology for applying this analysis is being developed, with the goal of providing a structure for rationally characterizing natural fracture systems basin-wide. Such basin-wide characterizations can then be expanded and supplemented locally, at sites where production may be favorable. Initial application of this analysis is to the Piceance basin where there is a wealth of data from the Multiwell Experiment (MWX), DOE cooperative wells, and other basin studies conducted by Sandia, CER Corporation, and the USGS (Lorenz and Finley, 1989, Lorenz et aI., 1989, and Spencer and Keighin, 1984). Such a basinal approach has been capable of explaining the fracture characteristics found throughout the southern part of the Piceance basin and along the Grand Hogback.

  2. Pterygoid Plate Fractures: Not Limited to Le Fort Fractures.

    PubMed

    Garg, Ravi K; Alsheik, Nila H; Afifi, Ahmed M; Gentry, Lindell R

    2015-09-01

    Pterygoid plate fractures are often described in the setting of Le Fort fractures. The goal of this study was to define other craniofacial fracture patterns causing injury to the pterygoid plates. A retrospective review of computed tomography (CT) scans obtained on craniofacial trauma patients over a 5-year period revealed 209 patients with pterygoid plate fractures. Pterygoid plate fractures in 78 patients (37.3%) were unrelated to Le Fort fractures. Common causes included sphenotemporal buttress fractures in 26 patients (33.3%), temporal bone fractures in 18 patients (23.1%), zygomaticomaxillary complex fractures in 17 patients (21.8%), and displaced mandible fractures in 14 patients (17.9%). These findings indicate that approximately one third of pterygoid plate fractures do not result from Le Fort pattern injuries and that the craniofacial surgeon should have a broad differential for causes of pterygoid plate fractures when reviewing trauma imaging. PMID:26147022

  3. Boot top fractures.

    PubMed

    Höflin, F; van der Linden, W

    1976-01-01

    Low transverse fractures of the tibiofibular complex due to ski injuries were formerly virtually unknown but are now met in ever increasing numbers. A series of 126 such fractures occurring in patients 13 years or older was analyzed. The sex and age distributions of these patients were found to differ significantly from those in skiers with other tibial shaft fractures. Among boot top fractures cases, boys younger than 20 years predominated much more than among patients with other fractures of the tibial shaft. In the boot top fracture there is characteristically a backward angulation, which may be combined with a forward displacement of the distal fragment. A simple technique for reduction of this typical deformity is described. According to this technique the surgeon should take a steady grip on the foot held in extreme plantar flexion. By applying strong traction, disimpaction is achieved after which the distal fragment is forced back into position and the fracture is immobilized with the foot in full equinus. This technique was successfully applied in the majority of our cases (112 of 126). Patients with boot top fractures were hospitalized for shorter periods than were skiers with other tibial fractures, and they were able to resume their normal activities much sooner. This held true even when allowance was made for differences in age. During the last few years a new type of boot top fracture has been observed. In this type there is a forward instead of a backward angulation. Its occurrence is most probably related to the new "scoot foot" or "sitting back" technique in downhill skiing. The appearance of this new type of boot top fracture implies that successful prevention can be achieved only with safety bindings that release not only at rotation but also when the skier falls backward. PMID:1256788

  4. Children with Mild Bilateral and Unilateral Hearing Loss: Parents' Reflections on Experiences and Outcomes

    ERIC Educational Resources Information Center

    Fitzpatrick, Elizabeth; Grandpierre, Viviane; Durieux-Smith, Andrée; Gaboury, Isabelle; Coyle, Doug; Na, Eunjung; Sallam, Nusaiba

    2016-01-01

    Children with mild bilateral and unilateral hearing loss are now commonly identified early through newborn hearing screening initiatives. There remains considerable uncertainty about how to support parents and about which services to provide for children with mild bilateral and unilateral hearing loss. The goal of this study was to learn about…

  5. Song Recognition by Young Children with Cochlear Implants: Comparison between Unilateral, Bilateral, and Bimodal Users

    ERIC Educational Resources Information Center

    Bartov, Tamar; Most, Tova

    2014-01-01

    Purpose: To examine song identification by preschoolers with normal hearing (NH) versus preschoolers with cochlear implants (CIs). Method: Participants included 45 children ages 3;8-7;3 (years;months): 12 with NH and 33 with CIs, including 10 with unilateral CI, 14 with bilateral CIs, and 9 bimodal users (CI-HA) with unilateral CI and

  6. Motor Learning of a Bimanual Task in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Hung, Ya-Ching; Gordon, Andrew M.

    2013-01-01

    Children with unilateral cerebral palsy (CP) have been shown to improve their motor performance with sufficient practice. However, little is known about how they learn goal-oriented tasks. In the current study, 21 children with unilateral CP (age 4-10 years old) and 21 age-matched typically developed children (TDC) practiced a simple bimanual

  7. Bilateral Input Protects the Cortex from Unilaterally-Driven Reorganization in Children Who Are Deaf

    ERIC Educational Resources Information Center

    Gordon, Karen A.; Wong, Daniel D. E.; Papsin, Blake C.

    2013-01-01

    Unilateral hearing in childhood restricts input along the bilateral auditory pathways, possibly causing permanent reorganization. In this study we asked: (i) do the auditory pathways develop abnormally in children who are bilaterally deaf and hear with a unilateral cochlear implant? and (ii) can such differences be reversed by restoring input to…

  8. Bilateral Input Protects the Cortex from Unilaterally-Driven Reorganization in Children Who Are Deaf

    ERIC Educational Resources Information Center

    Gordon, Karen A.; Wong, Daniel D. E.; Papsin, Blake C.

    2013-01-01

    Unilateral hearing in childhood restricts input along the bilateral auditory pathways, possibly causing permanent reorganization. In this study we asked: (i) do the auditory pathways develop abnormally in children who are bilaterally deaf and hear with a unilateral cochlear implant? and (ii) can such differences be reversed by restoring input to

  9. Children with Mild Bilateral and Unilateral Hearing Loss: Parents' Reflections on Experiences and Outcomes

    ERIC Educational Resources Information Center

    Fitzpatrick, Elizabeth; Grandpierre, Viviane; Durieux-Smith, Andre; Gaboury, Isabelle; Coyle, Doug; Na, Eunjung; Sallam, Nusaiba

    2016-01-01

    Children with mild bilateral and unilateral hearing loss are now commonly identified early through newborn hearing screening initiatives. There remains considerable uncertainty about how to support parents and about which services to provide for children with mild bilateral and unilateral hearing loss. The goal of this study was to learn about

  10. Longitudinal Development of Hand Function in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Holmefur, Marie; Krumlinde-Sundholm, Lena; Bergstrom, Jakob; Eliasson, Ann-Christin

    2010-01-01

    Aim: The aim of this study was to describe how the usefulness of the hemiplegic hand develops in children with unilateral cerebral palsy (CP) aged between 18 months and 8 years. Method: A prospective longitudinal study of 43 children (22 males, 21 females) with unilateral CP was conducted. Inclusion age was 18 months to 5 years 4 months (mean 2y

  11. A Magnetoencephalographic Study of Sensorimotor Activity Differences during Unilateral and Bilateral Forearm Movements

    ERIC Educational Resources Information Center

    Nakagawa, Kei

    2010-01-01

    This study compared activation of the sensorimotor area using magnetoencephalography after unilateral and bilateral movements. Thirteen healthy individuals and a patient with mild hemiplegia performed unilateral and bilateral forearm pronation movements. Among healthy participants, there were no significant differences in motor-evoked field during

  12. Motor Learning of a Bimanual Task in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Hung, Ya-Ching; Gordon, Andrew M.

    2013-01-01

    Children with unilateral cerebral palsy (CP) have been shown to improve their motor performance with sufficient practice. However, little is known about how they learn goal-oriented tasks. In the current study, 21 children with unilateral CP (age 4-10 years old) and 21 age-matched typically developed children (TDC) practiced a simple bimanual…

  13. 12 CFR 950.11 - Capital stock requirements; unilateral redemption of excess stock.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Capital stock requirements; unilateral redemption of excess stock. 950.11 Section 950.11 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL... Housing Associates 950.11 Capital stock requirements; unilateral redemption of excess stock. (a)...

  14. Substantial Generalization of Sensorimotor Learning from Bilateral to Unilateral Movement Conditions

    PubMed Central

    Wang, Jinsung; Lei, Yuming; Xiong, Khongchee; Marek, Katie

    2013-01-01

    Controversy exists regarding whether bimanual skill learning can generalize to unimanual performance. For example, some investigators showed that dynamic adaptation could only partially generalize between bilateral and unilateral movement conditions, while others demonstrated complete generalization of visuomotor adaptation. Here, we identified three potential factors that might have contributed to the discrepancy between the two sets of findings. In our first experiment, subjects performed reaching movements toward eight targets bilaterally with a novel force field applied to both arms, then unilaterally with the force field applied to one arm. Results showed that the dynamic adaptation generalized completely from bilateral to unilateral movements. In our second experiment, the same force field was only applied to one arm during both bilateral and unilateral movements. Results indicated complete transfer again. Finally, our subjects performed reaching movements toward a single target with the force field or a novel visuomotor rotation applied only to one arm during both bilateral and unilateral movements. The reduced breadth of experience obtained during bilateral movements resulted in incomplete transfer, which explains previous findings of limited generalization. These findings collectively suggest a substantial overlap between the neural processes underlying bilateral and unilateral movements, supporting the idea that bilateral training, often employed in stroke rehabilitation, is a valid method for improving unilateral performance. However, our findings also suggest that while the neural representations developed during bilateral training can generalize to facilitate unilateral performance, the extent of generalization may depend on the breadth of experience obtained during bilateral training. PMID:23505519

  15. Biomechanical comparison of unilateral semi-rigid and dynamic stabilization on ovine vertebrae.

    PubMed

    Karakoyun, Dursun O; zkaya, Mustafa; Okutan, Volkan C; Dalg?, Ali; Belen, Deniz; Demir, Teyfik

    2015-11-01

    Using the unilateral pedicle screw fixation was thought to decrease the stiffness of the fixed segments. Various prospective, randomized studies were performed to determine whether unilateral pedicle screw fixation provides the necessities of bilateral fixation in one- or two-segment lumbar spinal fusion. In this study, four different unilateral pedicle screw fixation systems were evaluated to determine which one best approximated an intact spine with respect to biomechanics and kinematics. The four groups included an intact group, a unilateral facetectomy group with no fixation, a unilateral semi-rigid pedicle screw fixation group with a poly-ether-ether-ketone rod, and a unilateral dynamic pedicle screw fixation group. The bone mineral densities of all specimens were measured and specimens were matched with groups randomly. Flexion, lateral bending, and axial rotation tests were performed to compare the groups. For the flexion, lateral bending, and axial rotation tests, the best biomechanical outcomes were in the control group. The unilateral facetectomy group had the poorest performance and was not stable enough, compared with the control group. The dynamic and semi-rigid groups showed performance closer to that of the control group. The biomechanical responses of these two groups were also in good agreement, showing no significant statistical differences. Based on these test results, it is concluded that the unilateral dynamic and semi-rigid pedicle screw fixations can be used to provide stability to the vertebrae. PMID:26503839

  16. Induced fractures: well stimulation through fracturing

    SciTech Connect

    Hanold, R.J.

    1982-01-01

    Seven fracture stimulation treatments were planned and executed under the Department of Energy-funded Geothermal Well Stimulation Program. The objective of this program is to demonstrate that geothermal well stimulation offers a technical alternative to additional well drilling and redrilling for productivity enhancement which can substantially reduce development costs. Well stimulation treatments have been performed at Raft River, Idaho; East Mesa, California; The Geysers, California; and the Baca Project Area in New Mexico. Six of the seven stimulation experiments were technically successful in stimulating the wells. The two fracture treatments in East Mesa more than doubled the production rate of the previously marginal producer. The two fracture treatments at Raft River and the two at Baca were all successful in obtaining significant production from previously nonproductive intervals. The acid etching treatment in the well at the Geysers did not have any material effect on production rate.

  17. Contaminated fractures of the tibia: a comparison of treatment modalities in an animal model.

    PubMed

    Curtis, M J; Brown, P R; Dick, J D; Jinnah, R H

    1995-03-01

    External fixation is the current standard treatment for skeletal stabilization of open tibial fractures, but intramedullary fixation techniques have become increasingly popular. The aim of this study was to compare, in an animal model, the susceptibility to infection of contaminated fractures stabilized with external fixation with that of contaminated fractures fixed with intramedullary locking nails with or without reaming. A unilateral osteotomy of the tibia was performed in 15 goats under general anesthesia. Each osteotomy was stabilized with either (a) a unilateral biplanar external fixator, (b) an 8 mm diameter intramedullary rod inserted without reaming of the medullary cavity, or (c) a 10 mm diameter rod inserted after reaming. A standardized inoculum of Staphylococcus aureus, 10(3) colony forming units per milliliter, was placed at each osteotomy site on a piece of absorbable gelatin sponge, to simulate contamination of an open fracture. Antibiotics were not administered. The animals were allowed full activity after the procedure. Fourteen days postoperatively, the animals were killed, radiographs of the tibiae were taken, and the tibiae were harvested in a sterile manner. Multiple specimens for quantitative microbiological analysis were taken from the fracture site and from sites 3 cm distal and 6 cm proximal to the fracture. Additional specimens of bone were taken for histological study. Clinical, radiographic, and microbiological analysis demonstrated that, in this animal model, there were significantly fewer and less severe infections in fractures fixed with external fixation than in those fixed with an intramedullary nail with or without reaming. There was marked cortical necrosis in tibiae that had been fixed with nailing and reaming. PMID:7722766

  18. Compression fractures of the back

    MedlinePLUS

    Vertebral compression fractures ... the most common cause of this type of fracture. Osteoporosis is a disease in which bones become ... the spine, such as multiple myeloma Having many fractures of the vertebrae can lead to kyphosis . This ...

  19. Hip Fractures among Older Adults

    MedlinePLUS

    ... training for health care providers. Learn More Hip Fractures Among Older Adults Recommend on Facebook Tweet Share ... older. What You Can Do to Prevent Hip Fractures You can prevent hip fractures by taking steps ...

  20. Vertebroplasty for Spine Fracture Pain

    MedlinePLUS

    MENU Return to Web version Vertebroplasty for Spine Fracture Pain Vertebroplasty for Spine Fracture Pain More than 40 million people in the ... bones that puts them at risk for spine fractures (broken bones). Thinning of the bones can occur ...

  1. Look over there! Unilateral gaze increases geographical memory of the 50 United States.

    PubMed

    Propper, Ruth E; Bruny, Tad T; Christman, Stephen D; Januszewskia, Ashley

    2012-02-01

    Based on their specialized processing abilities, the left and right hemispheres of the brain may not contribute equally to recall of general world knowledge. US college students recalled the verbal names and spatial locations of the 50 US states while sustaining leftward or rightward unilateral gaze, a procedure that selectively activates the contralateral hemisphere. Compared to a no-unilateral gaze control, right gaze/left hemisphere activation resulted in better recall, demonstrating left hemisphere superiority in recall of general world knowledge and offering equivocal support for the hemispheric encoding asymmetry model of memory. Unilateral gaze- regardless of direction- improved recall of spatial, but not verbal, information. Future research could investigate the conditions under which unilateral gaze increases recall. Sustained unilateral gaze can be used as a simple, inexpensive, means for testing theories of hemispheric specialization of cognitive functions. Results support an overall deficit in US geographical knowledge in undergraduate college students. PMID:22061174

  2. Virtual environment training system for rehabilitation of stroke patients with unilateral neglect: crossing the virtual street.

    PubMed

    Kim, Jaehun; Kim, Kwanguk; Kim, Deog Young; Chang, Won Hyek; Park, Chang-Il; Ohn, Suk Hoon; Han, Kiwan; Ku, Jeonghun; Nam, Sang Won; Kim, In Young; Kim, Sun I

    2007-02-01

    In this paper, we propose a system for training of stroke patients with unilateral neglect by using technology of virtual reality (VR). The proposed system is designed to compensate for unilateral neglect. This system contains the calibration of unilateral neglect and the training of this disease. The calibration procedure is implemented by aligning the virtual object at a subjective middle line. The training procedure is implemented by completing the missions that are used to keep the virtual avatar safe during crossing the street in a virtual environment. The results of this study show that the proposed system is effective to train unilateral neglect. The left to right ratio scores extracted from this system gradually decrease as the sessions of training are repeated. To validate the VR system parameters, the parameters are analyzed by correlation with those of traditional unilateral neglect assessment methods (such as the line bisection test and the cancellation test). PMID:17305443

  3. Unilateral cross bite treated by corticotomy-assisted expansion: two case reports

    PubMed Central

    2010-01-01

    Background True unilateral posterior crossbite in adults is a challenging malocclusion to treat. Conventional expansion methods are expected to have some shortcomings. The aim of this paper is to introduce a new technique for treating unilateral posterior crossbite in adults, namely, corticotomy-assisted expansion (CAE) applied on two adult patients: one with a true unilateral crossbite and the other with an asymmetrical bilateral crossbite, both treated via modified corticotomy techniques and fixed orthodontic appliances. Methods Two cases with asymmetric maxillary constriction were treated using CAE. Results In both cases, effective asymmetrical expansion was achieved using CAE, and functional occlusion was established as well. Conclusions Unilateral CAE presents an effective and reliable technique to treat true unilateral crossbite. PMID:20482859

  4. Biomechanics and biology of fracture repair under external fixation.

    PubMed

    Aro, H T; Chao, E Y

    1993-11-01

    The major factors determining the mechanical milieu of a healing fracture under external fixation, and thereby the mechanism of union, are the rigidity of the selected fixation device, the fracture configuration, the accuracy of fracture reduction, and the amount of physiologic stresses dictated by functional activity and loading. Bone healing problems encountered in fractures stabilized externally merely reflect the severity of the local soft-tissue and periosteal injury and should not be attributed to the inherent features of the fixation modality. Although some surgeons have had reservations concerning the use of external fixation for fracture treatment, based mainly on concerns of pin-tract infection and fracture nonunion, much of the clinical experience and basic science research results have proven the reverse. Many of the potential benefits of external fixation, such as the change of fixation stiffness, are not yet fully appreciated. Additional research and well-organized clinical trials must be performed. Pin-tract problems can be controlled, but the surgeon using such a device must be familiar with the techniques and follow the established regimens during postoperative care. One common mistake is to assume that external fixators, especially those of the simpler unilateral configuration, are easy to use and do not require learning or mastering the surgical techniques until the time of application. Periodic examination and radiographic evaluations are also essential to adjust conditions of the fracture site. The importance of balancing the biomechanical properties and the biologic consequences of different external fixation modalities has been demonstrated. Understanding this knowledge and the techniques of application associated with external fixation is the prerequisite to successful treatment. Some of the basic biomechanical information related to external fixation and bone fracture union is still unknown. This lack should provide the impetus for surgeons, bioengineers, and medical scientists to continue collaborative basic and applied research. Furthermore, by recognizing the proper cell mediators and the physical means to stimulate these cellular elements, the bone fracture healing process may be modulated, regardless of the fixation technique. The result of such effort should provide new modalities to improve fracture management. PMID:8300724

  5. Fracture of synthetic diamond

    SciTech Connect

    Drory, M.D.; Dauskardt, R.H.; Kant, A.; Ritchie, R.O.

    1995-09-01

    The fracture behavior of synthetic diamond has been investigated using indentation methods and by the tensile testing of pre-notched fracture-mechanics type samples. Specifically, the fracture toughness of free-standing diamond plates, grown by chemically-vapor deposited (CVD) methods, was measured using Vickers indentations and by the use of disk-shaped compact-tension specimens; the latter method provides an evaluation of the through-thickness fracture properties, whereas the indentation method was performed on the nucleation surface of the sample. Measured fracture toughness ({ital K}{sub c}) values were found to be approximately 5--6 MPa{radical}m by both methods, indicating that the fracture resistance of CVD diamond does not vary appreciably with grain size (within the certainty of the testing procedures). Complications, however, arose with the fracture-mechanics testing regarding crack initiation from a relatively blunt notch; further work is needed to develop pre-cracking methods to permit more reliable fracture toughness testing of diamond. {copyright} {ital 1995} {ital American} {ital Institute} {ital of} {ital Physics}.

  6. Fractures in myelomeningocele

    PubMed Central

    Bresch, Bjoern; Raiss, Patric; Frstenberg, Carl Hans; Bruckner, Thomas; Seyler, Thorsten; Carstens, Claus; Abel, Rainer

    2010-01-01

    Background In patients with myelomeningocele (MMC), a high number of fractures occur in the paralyzed extremities, affecting mobility and independence. The aims of this retrospective cross-sectional study are to determine the frequency of fractures in our patient cohort and to identify trends and risk factors relevant for such fractures. Materials and methods Between March 1988 and June 2005, 862 patients with MMC were treated at our hospital. The medical records, surgery reports, and X-rays from these patients were evaluated. Results During the study period, 11% of the patients (n=92) suffered one or more fractures. Risk analysis showed that patients with MMC and thoracic-level paralysis had a sixfold higher risk of fracture compared with those with sacral-level paralysis. Femoral-neck z-scores measured by dual-energy X-ray absorptiometry (DEXA) differed significantly according to the level of neurological impairment, with lower z-scores in children with a higher level of lesion. Furthermore, the rate of epiphyseal separation increased noticeably after cast immobilization. Mainly patients who could walk relatively well were affected. Conclusions Patients with thoracic-level paralysis represent a group with high fracture risk. According to these results, fracture and epiphyseal injury in patients with MMC should be treated by plaster immobilization. The duration of immobilization should be kept to a minimum (<4weeks) because of increased risk of secondary fractures. Alternatively, patients with refractures can be treated by surgery, when nonoperative treatment has failed. PMID:20721596

  7. TIBIAL SHAFT FRACTURES

    PubMed Central

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2015-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures.

  8. Rib fracture - aftercare

    MedlinePLUS

    A rib fracture is a crack or break in one or more of your rib bones. Your ribs are the round, ... A rib fracture can be very painful because your ribs move when you breathe, cough, and move your upper body. The ...

  9. Obesity and fracture risk

    PubMed Central

    Gonnelli, Stefano; Caffarelli, Carla; Nuti, Ranuccio

    2014-01-01

    Summary Obesity and osteoporosis are two common diseases with an increasing prevalence and a high impact on morbidity and mortality. Obese women have always been considered protected against osteoporosis and osteoporotic fractures. However, several recent studies have challenged the widespread belief that obesity is protective against fracture and have suggested that obesity is a risk factor for certain fractures. Fat and bone are linked by many pathways, which ultimately serve the function of providing a skeleton appropriate to the mass of adipose tissue it is carrying. Leptin, adiponectin, adipocytic estrogens and insulin/amylin are involved in this connection. However, excessive body fat, and particularly abdominal fat, produces inflammatory cytokines which may stimulate bone resorption and reduce bone strength. This review aimed to examine the literature data on the relationships of BMI and fat mass with factures in adult and elderly subjects. Even though the more recent studies have shown conflicting results, there is growing evidence that obesity, and particularly severe obesity, may be related to an increased risk of fracture at different skeletal sites which is partially independent from BMD. Moreover, the relationship between obesity and fracture appears to be markedly influenced by ethnicity, gender and fat distribution. Even though the incidence and the pathogenesis of fracture in obese individuals has not yet been clearly defined, the growing evidence that obesity may be related to an increased risk of fracture has important public health implications and emphasizes the need to develop effective strategies to reduce fracture risk in obese subjects. PMID:25002873

  10. Method for performing fracturing operations

    SciTech Connect

    Soliman, M.Y.

    1989-05-09

    A method is described of establishing a proppant distribution within an earth fracture to be created by a fracturing operation, the fracture to intersect a wellbore, comprising: determining desired conductivities at a plurality of locations within the proposed fracture, the conductivities varying as function of distance in the fracture from the wellbore; and establishing a proppant distribution within the fracture in response to the determined conductivities.

  11. Dynamic fracture mechanics

    NASA Technical Reports Server (NTRS)

    Kobayashi, A. S.; Ramulu, M.

    1985-01-01

    Dynamic fracture and crack propagation concepts for ductile materials are reviewed. The equations for calculating dynamic stress integrity and the dynamic energy release rate in order to study dynamic crack propagation are provided. The stress intensity factor versus crack velocity relation is investigated. The uses of optical experimental techniques and finite element methods for fracture analyses are described. The fracture criteria for a rapidly propagating crack under mixed mode conditions are discussed; crack extension and fracture criteria under combined tension and shear loading are based on maximum circumferential stress or energy criteria such as strain energy density. The development and use of a Dugdale model and finite element models to represent crack and fracture dynamics are examined.

  12. Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis

    PubMed Central

    Burakgazi, Ahmet Z.; Henderson, Carl S.

    2016-01-01

    Optic neuritis (ON) is one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme ON is an exceedingly rare ocular manifestation of Lyme disease (LD) and only a few cases have been published in the literature. Lyme ON is very rare but should be included in the differential diagnosis in unexplained cases, particularly in Lyme endemic areas. Careful and detailed examination and investigation are warranted to make the diagnosis. We report this case to increase awareness of clinicians to include Lyme disease in differential diagnosis of ON for unexplained cases of ON. Herein we present a unique case with a unilateral ON caused by LD along with pre- and posttreatment findings and literature review. PMID:26953086

  13. Unilateral shunt formation with thoracic aortic dissection in a whippet.

    PubMed

    Cornelis, I; Bosmans, T; Doom, M; Binst, D; Van der Vekens, E; Kromhout, K; Cornillie, P; Van Ham, L

    2014-06-01

    A three-year-old neutered male whippet was presented with intermittent, exercise-induced paraparesis. Femoral pulses were bilaterally absent. Neurologic examination was suggestive of a thoracolumbar myelopathy. Blood pressure measurements revealed hypotension in both pelvic limbs, hypertension in the right thoracic limb and it was immeasurable in the left thoracic limb. Echocardiography was within reference limits. A clear vascular pulsation was palpable on the right ventral abdominal wall. Computed tomographic angiography revealed a dissection of the aortic wall between the left subclavian artery and the brachiocephalic trunk with subsequent thrombus formation. A shunt between the right internal thoracic, cranial and caudal epigastric arteries to preserve blood flow to the pelvic limbs was visualized. Necropsy was declined by the owner. This is the first case report describing the formation of a unilateral vascular shunt following a thoracic aortic occlusion, which presented as exercise-induced paraparesis. PMID:24602076

  14. [Differential diagnosis of unilateral paresis and paralysis of the larynx].

    PubMed

    Chernobel'ski?, S I

    1996-01-01

    Differential diagnosis of laryngeal paresis and paralysis using electron glottography (EGG) was tried in 57 patients and 30 healthy controls. Measurements were made of speed quotient (SQ) and open quotient (OQ) at piano and forte. It was found that in patients and controls SQ and OQ were not similar. SQ and OQ differed also in paralysis and paresis. Tonicity of the inner laryngeal muscles seems to decline more in paralysis than in paresis. Aerodynamic properties of the larynx are damaged more in paralysis and remain unchanged in paresis. Reduced SQ and high OQ at forte indicate unilateral laryngeal paralysis. OQ should be measured both at piano and forte. Thus, EGG is an effective procedure for differential diagnosis of laryngeal paralysis and paresis. It is especially convenient when laryngostroboscopy is problematic. PMID:8711839

  15. Adaptations to unilateral lower limb suspension in humans

    NASA Technical Reports Server (NTRS)

    Dudley, Gary A.; Duvoisin, Marc R.; Adams, Gregory R.; Meyer, Ronald A.; Belew, Anne H.; Buchanan, Paul

    1992-01-01

    The effect of unilateral lower limb suspension (ULLS) on neuromuscular function in humans is analyzed. All ambulatory activity on crutches was performed by eight subjects for 6 weeks who wear a shoe with a 10 cm sole on the right foot to unweight the left lower limb. Results show that average muscle cross sectional area (CSA) of the left knee extensor (KE) decreased 16 percent whereas the KE of the nonsuspended right limb showed no changes. Maximal integrated electromyography of vastus lateralis and overall mean power frequency of gastrocnemius medialis and soleus for submaximal isometric actions were both decreased post-ULLS. It is concluded that six weeks of ULLS induces adaptations in the neuromuscular system of humans which are comparable to those induced by bed rest and spaceflight.

  16. Unilateral sagittal split mandibular ramus osteotomy: indications and geometry.

    PubMed

    Beukes, Jacques; Reyneke, Johan P; Damstra, Janalt

    2016-02-01

    Small mandibular asymmetries may be corrected by unilateral sagittal split ramus osteotomy (USSO). This study had two objectives: first to define the geometric changes in the mandibular condyle and the lower incisor teeth that result from the rotation of the major segment (n=26), and secondly to examine in a clinical study the temporomandibular joints (TMJ) of 23 patients after correction of mandibular asymmetry by USSO to find out if there were any long-term adverse effects. Small mandibular asymmetries (<5mm) can be corrected by USSO. Secondary anteroposterior changes as a result of setback or advancement on the operated side should be taken into account during the planning of treatment. The small rotational changes of the condyle did not adversely affect the TMJ. PMID:26774360

  17. [TRANSIENT PSEUDOBULBAR SYNDROME IN UNILATERAL FRONTAL OPERCULAR INFARCTS].

    PubMed

    Rzsa, Anik; Tork Gyongyi; Nagy, va; Kovcs, Krisztina; Gcs, Gyula

    2015-09-30

    The classic anterior (frontal) opercular syndrome (Foix-Chavany-Marie sy.) is a cortical pseudobulbar palsy mainly due to bilateral lesions of anterior brain operculum. In 2000 the authors had a 70-year old female patient with acute onset of swallowing and speaking difficulty. Neurological examination established a left facial central palsy, the palsy of the tongue and the soft palate, dysarthry, difficulty in chewing with left side hemiparesis. The CT scan showed a right side (one-sided) frontal opercular ischemic lesion. This event switched their attention especially to this group of cases and subsequently the authors collected 12 patients with these symptoms. Authors discuss the patomechanism of transient pseudobulbar palsy that occurs due to unilateral opercular lesion that the diaschisis effect might explain. PMID:26665496

  18. Micronucleus formation causes perpetual unilateral chromosome inheritance in mouse embryos.

    PubMed

    Vzquez-Diez, Cayetana; Yamagata, Kazuo; Trivedi, Shardul; Haverfield, Jenna; FitzHarris, Greg

    2016-01-19

    Chromosome segregation defects in cancer cells lead to encapsulation of chromosomes in micronuclei (MN), small nucleus-like structures within which dangerous DNA rearrangements termed chromothripsis can occur. Here we uncover a strikingly different consequence of MN formation in preimplantation development. We find that chromosomes from within MN become damaged and fail to support a functional kinetochore. MN are therefore not segregated, but are instead inherited by one of the two daughter cells. We find that the same MN can be inherited several times without rejoining the principal nucleus and without altering the kinetics of cell divisions. MN motion is passive, resulting in an even distribution of MN across the first two cell lineages. We propose that perpetual unilateral MN inheritance constitutes an unexpected mode of chromosome missegregation, which could contribute to the high frequency of aneuploid cells in mammalian embryos, but simultaneously may serve to insulate the early embryonic genome from chromothripsis. PMID:26729872

  19. Unusual unilateral presentation of pachydermodactyly: a case report.

    PubMed

    Ulusoy, Hasan; Tas, Nevsun Pihtili; Akgol, Gurkan; Gulkesen, Arif; Kamanli, Ayhan

    2012-06-01

    Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule, clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with inflammatory rheumatic diseases, especially with juvenile chronic arthritis. A prompt clinical diagnosis of the disease would prevent inappropriate treatment with immunosuppressive agents or steroids and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Once diagnosed, patients should be advised in order to avoid repetitive traumas of the hands, rubbing and cracking of the fingers, obsessive-compulsive use of computer and video games. The joint outcome is always benign. Here, we report a case of pachydermodactyly differs from the typical clinical picture of pachydermodactyly in the unilateral distribution of the lesions. PMID:21442169

  20. A structured approach to processing clients' unilateral termination decisions.

    PubMed

    Schaeffer, Judith A; Kaiser, Erika M

    2013-01-01

    Research over several decades reveals that close to half of clients in the United States terminate psychotherapy before finishing their work, sometimes without discussing the matter with their therapist. As a result, therapists may experience significant distress, both because they had no input into the termination decision, and because they wonder if they were unhelpful, unskillful or even harmful to their clients. This article proposes a structured approach to enable therapists to process unilateral termination experiences. Its six steps are designed to help therapists honor their initial reaction response to the termination; appraise possible causes of the termination; determine most probable causes of the termination, and take commensurate responsibility; mourn; perform reparative tasks for the benefit of current and future clients; evaluate their subsequent well-being and sense of self-efficacy; and take a broader perspective. Designed as pantheoretical, the proposed structured approach is based on empirical data as well as commonly held theory. PMID:23909058

  1. Listening to classical music ameliorates unilateral neglect after stroke.

    PubMed

    Tsai, Pei-Luen; Chen, Mei-Ching; Huang, Yu-Ting; Lin, Keh-Chung; Chen, Kuan-Lin; Hsu, Yung-Wen

    2013-01-01

    OBJECTIVE. We determined whether listening to excerpts of classical music ameliorates unilateral neglect (UN) in stroke patients. METHOD. In this within-subject study, we recruited and separately tested 16 UN patients with a right-hemisphere stroke under three conditions within 1 wk. In each condition, participants were asked to complete three subtests of the Behavioral Inattention Test while listening to classical music, white noise, or nothing. All conditions and the presentation of the tests were counterbalanced across participants. Visual analog scales were used to provide self-reported ratings of arousal and mood. RESULTS. Participants generally had the highest scores under the classical music condition and the lowest scores under the silence condition. In addition, most participants rated their arousal as highest after listening to classical music. CONCLUSION. Listening to classical music may improve visual attention in stroke patients with UN. Future research with larger study populations is necessary to validate these findings. PMID:23597691

  2. Overexpanded viscous supersonic jet interacting with a unilateral barrier

    NASA Astrophysics Data System (ADS)

    Dobrynin, B. M.; Maslennikov, V. G.; Sakharov, V. A.; Serova, E. V.

    1986-07-01

    The interaction of a two-dimensional supersonic jet with a unilateral barrier parallel to the flow symmetry plane was studied to account for effects due to gas viscosity and backgound-gas ejection from the region into which the jet expands. In the present experiments, the incident shock wave was reflected at the end of a shock tube equipped with a nozzle. The jet emerged into a pressure chamber 6 cu m in volume and the environmental pressure ratio of the flow in the quasi-stationary phase remained constant. The light source was an OGM-20 laser operating in the giant-pulse mode. Due to background-gas ejection, the gas density in the vicinity of the barrier is much less than on the unconfined side of the jet. The resulting flow is characterized by two distinct environmental pressure ratios: the flow is underexpanded near the barrier, while on the other side it is overexpanded.

  3. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, E.; Rath, A.R.; Roeder, S.B.W.

    1984-05-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coils in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  4. Apparatus for unilateral generation of a homogeneous magnetic field

    DOEpatents

    Fukushima, Eiichi (Los Alamos, NM); Rath, Alan R. (San Diego, CA); Roeder, Stephen B. W. (La Mesa, CA)

    1988-01-01

    An apparatus for unilaterally producing a substantially homogeneous magnetic field. The apparatus includes two circular electromagnet coils, a small coil and a large coil, which are coaxial with one another and which are separated by a distance equal to one-half the difference in the radius of the two coils. By appropriate selection of electrical currents, which are passed through the coil in opposite directions, a region of homogeneous magnetic field is formed. This region is centered on the common axis of the two coils, at a point on the axis which is at a distance from the small coil equal to one-half the radius of the small coil, and which is on the opposite side of the small coil from the large coil. The apparatus has particular application in the field of diagnostic medical NMR and other NMR applications.

  5. Non Functional Unilateral Adrenal Myelolipoma, A Case Report

    PubMed Central

    Athanikar, Vidisha S.; Dinesh, U S; Nanjappa, Bhuvnesh; Patil, Preetam B.

    2015-01-01

    Adrenal myelolipoma is characterized by presence within the adrenal gland of mature adipose tissue and active bone marrow elements. Owing to their non functional nature most cases are incidental, either at autopsy or through computer tomography scan. Occasionally the lesions attain a large size to become clinically apparent. We present a case of a 58-year-old female with mass per abdomen. Preoperative computer tomography scan of abdomen, hormonal and urine analysis showed features of non functional adrenal myelolipoma. Gross specimen consists of unilateral ovoid mass, external surface having capsule with adherent fat and areas of congestion. Microscopic examination showed well encapsulated tumour tissue composed of mature adipose tissue with major blood forming elements like myeloid, erythroid and megakaryocytic series. The diagnosis was confirmed by histopathological examination of right sided adrenalectomy specimen. PMID:26266130

  6. Plate versus titanium elastic nail in treatment of displaced midshaft clavicle fractures

    PubMed Central

    Saha, Partha; Datta, Prasenjit; Ayan, Saankritya; Garg, Anant Kumar; Bandyopadhyay, Utpal; Kundu, Srikanta

    2014-01-01

    Background: With changing trends in treatment of displaced midshaft clavicle fractures (DMCF), plating remains the standard procedure for fixation. An attracting alternative method of fixation is the titanium elastic nailing (TEN). However, prospective randomized studies comparing the two methods of fixation are lacking. We assessed the effectiveness of minimally invasive antegrade TEN and plating technique for the treatment of DMCF. Materials and Methods: 80 unilateral displaced midclavicular fractures operated between October 2010 and May 2013 were included in study. This prospective comparative study was approved by the local ethical committee. Followups were at 2nd and 6th weeks and subsequently at 3, 6, 12, 18 and 24 months postoperatively. Primary outcome was measured by the Constant score, union rate and difference in clavicular length after fracture union. Secondary outcome was measured by operative time, intraoperative blood loss, wound size, cosmetic results and complications. Results: During analysis, we had 37 patients in the plate group and 34 patients in the TEN group. There was no significant difference in Constant scores between the two groups. However, faster fracture union, lesser operative time, lesser blood loss, easier implant removal and fewer complications were noted in the TEN group. Conclusion: The use of minimally invasive antegrade TEN for fixation of displaced midshaft clavicle fractures is recommended in view of faster fracture union, lesser morbidity, better cosmetic results, easier implant removal and fewer complications; although for comminuted fractures plating remains the procedure of choice. PMID:25404771

  7. Anti-DKK1 antibody promotes bone fracture healing through activation of ?-catenin signaling

    PubMed Central

    Jin, Hongting; Wang, Baoli; Li, Jia; Xie, Wanqing; Mao, Qiang; Li, Shan; Dong, Fuqiang; Sun, Yan; Ke, Hua-Zhu; Babij, Philip; Tong, Peijian; Chen, Di

    2015-01-01

    In this study we investigated if Wnt/?-catenin signaling in mesenchymal progenitor cells plays a role in bone fracture repair and if DKK1-Ab promotes fracture healing through activation of ?-catenin signaling. Unilateral open transverse tibial fractures were created in CD1 mice and in ?-cateninPrx1ER conditional knockout (KO) and Cre-negative control mice (C57BL/6 background). Bone fracture callus tissues were collected and analyzed by radiography, micro-CT (?CT), histology, biomechanical testing and gene expression analysis. The results demonstrated that treatment with DKK1-Ab promoted bone callus formation and increased mechanical strength during the fracture healing processinCD1 mice. DKK1-Ab enhanced fracture repair by activation of endochondral ossification. The normal rate of bone repair was delayed when the ?-catenin gene was conditionally deleted in mesenchymal progenitor cells during the early stages of fracture healing. DKK1-Ab appeared to act through ?-catenin signaling to enhance bone repair since the beneficial effect of DKK1-Ab was abrogated in ?-cateninPrx1ER conditional KO mice. Further understanding of the signaling mechanism of DKK1-Ab in bone formation and bone regeneration may facilitate the clinical translation of this anabolic agent into therapeutic intervention. PMID:25263522

  8. Radioimmunoassay of inhibin: serum responses to unilateral and bilateral orchidectomy

    SciTech Connect

    Schanbacher, B.

    1988-11-01

    An overnight double antibody RIA using a rabbit antiserum to porcine inhibin alpha-chain (Tyr30) (1-30) NH2 (pI alpha(1-30)), radioiodinated pI alpha(1-30), and a preprecipitated second antibody complex has been developed to measure inhibin concentrations in sera and other biological fluids. The assay is accurate, precise (intraassay coefficient of variation, 4.8%), sensitive (25 pM; 2.5 fmol/tube), and specific for inhibin. The synthetic reference standard pI alpha(1-30) produced a displacement curve that paralleled intact male ovine and bovine sera, crude bovine follicular fluid, and a partially purified porcine follicular fluid reference preparation (WHO/NIH 86/690). Bilateral castration of prepubertal and postpubertal ram lambs resulted in a rapid decrease in serum inhibin concentrations and a subsequent increase in serum FSH. Inhibin levels were high in prepubertal lambs (approximately 375 pM), but these levels were not sustained near the time of puberty (approximately 180 pM). Intensive sampling by jugular venipuncture after castration indicated a 50% drop in circulating inhibin levels within 2 h of testes removal with chronic castrate levels (approximately 75 pM) achieved by 6 h postcastration. A rapid fall in circulating levels of inhibin was also observed after unilateral castration, but these values stabilized within hours to levels intermediate (i.e. approximately 200 pM) to those of intact and bilateral castrate rams. Hemicastrates exhibited a more subtle rise in serum FSH after testis removal, with FSH and inhibin levels of prepubertal hemicastrates returning to mature intact ram values by 15 weeks of age. Serum inhibin levels remained low and FSH levels high at 14 days in unilateral castrate postpubertal rams. Inhibin immunoreactivity increased abruptly in castrate ewes and rams injected iv with 5 ml bovine follicular fluid.

  9. Emotional Perception of Music in Children with Unilateral Cochlear Implants

    PubMed Central

    Shirvani, Sareh; Jafari, Zahra; Sheibanizadeh, Abdolreza; Motasaddi Zarandy, Masoud; Jalaie, Shohre

    2014-01-01

    Introduction: Cochlear implantation (CI) improves language skills among children with hearing loss. However, children with CIs still fall short of fulfilling some other needs, including musical perception. This is often attributed to the biological, technological, and acoustic limitations of CIs. Emotions play a key role in the understanding and enjoyment of music. The present study aimed to investigate the emotional perception of music in children with bilaterally severe-to-profound hearing loss and unilateral CIs. Materials and Methods: Twenty-five children with congenital severe-to-profound hearing loss and unilateral CIs and 30 children with normal hearing participated in the study. The children’s emotional perceptions of music, as defined by Peretz (1998), were measured. Children were instructed to indicate happy or sad feelings fostered in them by the music by pointing to pictures of faces showing these emotions. Results: Children with CI obtained significantly lower scores than children with normal hearing, for both happy and sad items of music as well as in overall test scores (P<0.001). Furthermore, both in CI group (P=0.49) and the control one (P<0.001), the happy items were more often recognized correctly than the sad items. Conclusion: Hearing-impaired children with CIs had poorer emotional perception of music than their normal peers. Due to the importance of music in the development of language, cognitive and social interaction skills, aural rehabilitation programs for children with CIs should focus particularly on music. Furthermore, it is essential to enhance the quality of musical perception by improving the quality of implant prostheses. PMID:25320700

  10. Biomechanical evaluation of four different posterior screw and rod fixation techniques for the treatment of the odontoid fractures.

    PubMed

    Li, Lei; Liu, Wen-Fei; Jiang, Hong-Kun; Li, Yun-Peng

    2015-01-01

    Problems that screw cannot be inserted may occur in screw-rod fixation techniques such as Harms technique. We compared the biomechanical stability imparted to the C-2 vertebrae by four designed posterior screw and rod fixation techniques for the management of odontoid fractures. A three-dimensional finite element model of the odontoid fracture was established by subtracting several unit structures from the normal model from a healthy male volunteer. 4 different fixation techniques, shown as follows: ? C-1 lateral mass and C-2 pedicle screw fixation (Harms technique); ? C-1 lateral mass and unilateral C-2 pedicle screw fixation combined with ipsilateral laminar screw fixation; ? Unilateral C-1lateral mass combined with ipsilateral C-1 posterior arch, and C-2 pedicle screw fixation; and ? Unilateral C1 lateral mass screw connected with bilateral C2 pedicle screw fixation was performed on the odontoid fracture model. The model was validated for axial rotation, flexion, extension, lateral bending, and tension for 1.5 Nm. Changes in motion in flexion-extension, lateral bending, and axial rotation were calculated. The finite element model of the odontoid fracture was established in this paper. All of the four screw-rod techniques significantly decreased motion in flexion-extension, lateral bending, and axial rotation, as compared with the destabilized odontoid fracture complex (P<0.05). There was no statistically significant difference in stability among the four screw techniques. We concluded that the first three fixation techniques are recommended to be used as surgical intervention for odontoid fracture, while the last can be used as supplementary for the former three methods. PMID:26309508

  11. Biomechanical evaluation of four different posterior screw and rod fixation techniques for the treatment of the odontoid fractures

    PubMed Central

    Li, Lei; Liu, Wen-Fei; Jiang, Hong-Kun; Li, Yun-Peng

    2015-01-01

    Problems that screw cannot be inserted may occur in screw-rod fixation techniques such as Harms technique. We compared the biomechanical stability imparted to the C-2 vertebrae by four designed posterior screw and rod fixation techniques for the management of odontoid fractures. A three-dimensional finite element model of the odontoid fracture was established by subtracting several unit structures from the normal model from a healthy male volunteer. 4 different fixation techniques, shown as follows: ? C-1 lateral mass and C-2 pedicle screw fixation (Harms technique); ? C-1 lateral mass and unilateral C-2 pedicle screw fixation combined with ipsilateral laminar screw fixation; ? Unilateral C-1lateral mass combined with ipsilateral C-1 posterior arch, and C-2 pedicle screw fixation; and ? Unilateral C1 lateral mass screw connected with bilateral C2 pedicle screw fixation was performed on the odontoid fracture model. The model was validated for axial rotation, flexion, extension, lateral bending, and tension for 1.5 Nm. Changes in motion in flexion-extension, lateral bending, and axial rotation were calculated. The finite element model of the odontoid fracture was established in this paper. All of the four screw-rod techniques significantly decreased motion in flexion-extension, lateral bending, and axial rotation, as compared with the destabilized odontoid fracture complex (P<0.05). There was no statistically significant difference in stability among the four screw techniques. We concluded that the first three fixation techniques are recommended to be used as surgical intervention for odontoid fracture, while the last can be used as supplementary for the former three methods. PMID:26309508

  12. Fracture of silicon wafers

    NASA Astrophysics Data System (ADS)

    McLaughlin, J. C.; Willoughby, A. F. W.

    1987-11-01

    In spite of the increasing use of silicon in applications where mechanical stresses are deliberately applied to the material, such as in transducers, and the fatal nature of cracking in silicon devices, there is very limited characterisation and understanding of the fracture behaviour of silicon wafers at room temperature. This understanding is of increasing importance with the use of larger diameter wafers in modern technology. This paper examines the fracture strength of a wide range of silicon material both as-grown and after processing. The wafers tested were from crystals grwon by float-zone and Czochralski techniques and the effects of oxidation, ion-implantation and annealing in various environments have been studied. The technique used to measure the fracture stress involved simply supporting the wafer on an aluminium ring concentric to the load axis. The load was gradually increased until the wafer fractured. This method was chosen to avoid edge effects, and has proved to have adequate reproducibility. Typical values of the fracture stress obtained by this method, for different crystals, vary between 2 and 3.5 GPa. In the first part of the study, the role of the surface on the fracture behaviour has been investigated in detail. While the surface perfection of the tensile surface has a major effect on the fracture stress (as shown in previous studies), some of the results were found to be sensitive to the compressive surface as well. In the case where the results are sensitive to the compressive surface finish the fracture stress rose from 3.7 to 8.8 GPa as the surface finish was improved while in the cases where they were not sensitive the fracture stress remained at about 3.5-4.6 GPa. Only in the float-zone material were fracture stresses approaching 8.8 GPa observed. At this level of fracture stress, the behaviour is believed to be sensitive to surface defects less than 0.01 ?m in size. These results can be analyzed in terms of surface controlled defects under conditions where surface defects are dominant and bulk controlled defects where these defects are dominant. In this manner bulk effects can be isolated from surface ones. This gives the opportunity to study the effects of specific defects on the fracture stress and the results in this paper are discussed in terms of the role of surface and internal defects on the fracture stress.

  13. Limited Unilateral Decompression and Pedicle Screw Fixation with Fusion for Lumbar Spinal Stenosis with Unilateral Radiculopathy: A Retrospective Analysis of 25 Cases

    PubMed Central

    Zhang, Li; Miao, Hai-xiong; Wang, Yong; Chen, An-fu; Zhang, Tao

    2015-01-01

    Objective Lumbar spinal stenosis is conventionally treated with surgical decompression. However, bilateral decompression and laminectomy is more invasive and may not be necessary for lumbar stenosis patients with unilateral radiculopathy. We aimed to report the outcomes of unilateral laminectomy and bilateral pedicle screw fixation with fusion for patients with lumbar spinal stenosis and unilateral radiculopathy. Methods Patients with lumbar spinal stenosis with unilateral lower extremity radiculopathy who received limited unilateral decompression and bilateral pedicle screw fixation were included and evaluated using visual analog scale (VAS) pain and the Oswestry Disability Index (ODI) scores preoperatively and at follow-up visits. Ligamentum flavum thickness of the involved segments was measured on axial magnetic resonance images. Results Twenty-five patients were included. The mean preoperative VAS score was 6.6±1.6 and 4.6±3.1 for leg and back pain, respectively. Ligamentum flavum thickness was comparable between the symptomatic and asymptomatic side (p=0.554). The mean follow-up duration was 29.2 months. The pain in the symptomatic side lower extremity (VAS score, 1.32±1.2) and the back (VAS score, 1.75±1.73) significantly improved (p=0.000 vs. baseline for both). The ODI improved significantly postoperatively (6.60±6.5; p=0.000 vs. baseline). Significant improvement in VAS pain and ODI scores were observed in patients receiving single or multi-segment decompression fusion with fixation (p<0.01). Conclusion Limited laminectomy and unilateral spinal decompression followed by bilateral pedicle screw fixation with fusion achieves satisfactory outcomes in patients with spinal stenosis and unilateral radiculopathy. This procedure is less damaging to structures that are important for maintaining posterior stability of the spine. PMID:26279816

  14. Evaluation of the relationship between fracture conductivity, fracture fluid production, and effective fracture length

    NASA Astrophysics Data System (ADS)

    Lolon, Elyezer P.

    Low-permeability gas wells often produce less than predicted after a fracture treatment. One of the reasons for this is that fracture lengths calculated after stimulation are often less than designed lengths. While actual fracture lengths may be shorter due to fracture growth out of zone, improper proppant settling, or proppant flowback, short calculated fracture lengths can also result from incorrect analysis techniques. It is known that fracturing fluid that remains in the fracture and formation after a hydraulic fracture treatment can decrease the productivity of a gas well by reducing the relative permeability to gas in the region invaded by this fluid. However, the relationships between fracture fluid cleanup, effective fracture length, and well productivity are not fully understood. In this work I used reservoir simulation to determine the relationship between fracture conductivity, fracture fluid production, effective fracture length, and well productivity. I simulated water saturation and pressure profiles around a propped fracture, tracked gas production along the length of the propped fracture, and quantified the effective fracture length (i.e., the fracture length under single-phase flow conditions that gives similar performance as for multiphase flow conditions), the "cleanup" fracture length (i.e., the fracture length corresponding to 90% cumulative gas flow rate into the fracture), and the "apparent" fracture length (i.e., the fracture length where the ratio of multiphase to single-phase gas entry rate profiles is unity). This study shows that the proppant pack is generally cleaned up and the cleanup lengths are close to designed lengths in relatively short times. Although gas is entering along entire fracture, fracturing fluid remains in the formation near the fracture. The water saturation distribution affects the gas entry rate profile, which determines the effective fracture length. Subtle changes in the gas rate entry profile can result in significant changes in effective fracture length. The results I derived from this work are consistent with prior work, namely that greater fracture conductivity results in more effective well cleanup and longer effective fracture lengths versus time. This study provides better explanation of mechanisms that affect fracturing fluid cleanup, effective fracture length, and well productivity than previous work.

  15. Periprosthetic patellar fractures.

    PubMed

    Adigweme, Obinna O; Sassoon, Adam A; Langford, Joshua; Haidukewych, George J

    2013-10-01

    Periprosthetic patellar fractures represent a spectrum of injuries to a patient with a total knee arthroplasty. They range in severity from an inconsequential injury, which does not compromise function, to a severely debilitating injury that may require advanced reconstructive measures. This article will outline the epidemiology and risk factors associated with periprosthetic patellar fractures. Treatment options as they relate to injury mechanism, fracture severity, patellar component stability, and remaining bone stock will also be discussed. Finally, a review of the current literature regarding the results of treatment will be presented. PMID:23975335

  16. The Effect of Performing Bi- and Unilateral Row Exercises on Core Muscle Activation.

    PubMed

    Saeterbakken, A; Andersen, V; Brudeseth, A; Lund, H; Fimland, M S

    2015-11-01

    The purpose of the study was to compare core muscle activation in 3 different row exercises (free-weight bent-over row, seated cable row and machine row) performed unilaterally and bilaterally, at matched effort levels. 15 resistance-trained men (26.0±4.4 years, 81.0±9.5 kg, 1.81±0.07 m) performed the exercises in randomized order. For erector spinae and multifidus, EMG activities in unilateral machine- and cable row were 60-63% and 74-78% of the bilateral performance (P≤0.036). For external oblique, the EMG activities recorded during bilateral exercises were 37-41% of the unilateral performance (P≤0.010). In unilateral cable- and machine rows, the EMG activities in external oblique and multifidus were 50-57% and 70-73% of the free-weight row (P≤0.002). In bilateral free-weight row, EMG activity in erector spinae was greater than bilateral machine- (+34%, P=0.004) and unilateral free-weight rows (+12%, P=0.016). For rectus abdominis there were no significant differences between conditions. In conclusion, 1) free-weight row provided greater EMG activity in erector spinae (bilaterally and unilaterally) and multifidus (unilaterally) than machine row; 2) unilateral performance of exercises activated the external oblique more than bilateral performance, regardless of exercise; and 3) generally bilateral performance of exercises provided higher erector spinae and multifidus EMG activity compared to unilateral performance. PMID:26134664

  17. Mechanical Coal-Face Fracturer

    NASA Technical Reports Server (NTRS)

    Collins, E. R., Jr.

    1984-01-01

    Radial points on proposed drill bit take advantage of natural fracture planes of coal. Radial fracture points retracted during drilling and impacted by piston to fracture coal once drilling halts. Group of bits attached to array of pneumatic drivers to fracture large areas of coal face.

  18. Evidence for less improvement in depression in patients taking benzodiazepines during unilateral ECT.

    PubMed

    Pettinati, H M; Stephens, S M; Willis, K M; Robin, S E

    1990-08-01

    Among 48 patients with diagnoses of depression according to DSM-III, there was a significant relation between therapeutic failure of unilateral ECT, as measured by scores on the Hamilton Rating Scale for Depression, and the concomitant use of a benzodiazepine. Of the 34 patients who showed a good therapeutic response to unilateral ECT, those taking benzodiazepines had smaller changes in their Hamilton depression ratings from before treatment to after treatment and were more symptomatic at the end of the course of ECT. Thus, when patients take benzodiazepines during a course of unilateral ECT, the maximum therapeutic response may be compromised. PMID:2375437

  19. Postpartum sacral insufficiency fractures.

    PubMed

    Yan, Charles Xiao Bo; Vautour, Line; Martin, Marie-Hlne

    2016-03-01

    Postpartum sacral insufficiency fracture is an uncommon occurrence that is often under-diagnosed because its symptoms of low back, buttock and groin pains may initially be attributed to physiologic biomechanical changes caused by pregnancy or to intervertebral disc disease. We present a case of bilateral sacral insufficiency fractures in a 37-year-old postpartum woman with osteopenic bone mineral density confirmed by dual energy X-ray absorptiometry. The symptoms were initially suspected to be of discogenic cause, and the fractures were incidentally appreciated at the edge of a lumbar spine magnetic resonance image. Therefore, it is important to keep in mind this potential diagnosis when examining imaging studies of postpartum patients. For women who present other risk factors of osteoporosis, imaging of the entire sacrum should be part of the imaging studies. If sacral stress fractures are diagnosed, further evaluation for bone mineral density and underlying metabolic bone disease is recommended. PMID:26554948

  20. Hay balers' fractures.

    PubMed

    Mayba, I I

    1984-03-01

    Two cases of fractures of the sternum and T12 vertebra are presented, which appear to be a characteristic combination of injuries to farmers when hay bales fall on them. The mechanism of injury proposed is a severe forward flexion, producing vertebral collapse at the dorsolumbar junction, and fracture of the sternum from direct trauma against the steering wheel. These fractures should always be suspected in persons injured while baling hay. It is proposed to call this complex of injuries hay balers' fractures. Preventive measures suggested are: operator caution when hay bales are lifted; addition of locks to the loader forks; increasing the size of the loader, or placing a screen or cage over the operators to keep hay bales from falling on them. PMID:6708148

  1. Vertebral Compression Fractures

    MedlinePLUS

    ... OI: Information on Vertebral Compression Fractures 804 W. Diamond Ave., Ste. 210 Gaithersburg, MD 20878 (800) 981- ... osteogenesis imperfecta contact : Osteogenesis Imperfecta Foundation 804 W. Diamond Avenue, Suite 210, Gaithersburg, MD 20878 Tel: 800- ...

  2. Colles wrist fracture aftercare

    MedlinePLUS

    ... This may occur due to: Car accident Contact sports Falling while skiing, riding a bike, or other activity Falling on an outstretched arm (most common cause) Having osteoporosis is a major risk factor for wrist fractures. Osteoporosis makes bones brittle, ...

  3. Fracture Characterization of Meteorites

    NASA Astrophysics Data System (ADS)

    Bryson, K. L.; Agrawal, P.; Ostrowski, D. R.; Sears, D. W. G.

    2015-07-01

    NASA ARC has been tasked with understanding the behavior of ~100m asteroids entering the atmosphere and quantifying the impact hazard. As part of this task, we report the initial results of a survey of the fracture properties of meteorites.

  4. Clavicle Fracture (Broken Collarbone)

    MedlinePLUS

    ... are held in place by a combination of plates and screws. Reproduced with permission from Bahk MS, Kuhn JE, Galatz LM, Connor PM, Williams GR: Acromioclavicular and sternoclavicular injuries and cla- vicular, glenoid, and scapular fractures. Instructional ...

  5. Metatarsal stress fractures - aftercare

    MedlinePLUS

    ... McCormack RG, Lopez CA. Commonly encountered fractures in sports medicine. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Saunders Elsevier; 2014:chap. ...

  6. Suspensions in hydraulic fracturing

    SciTech Connect

    Shah, S.N.

    1996-12-31

    Suspensions or slurries are widely used in well stimulation and hydraulic fracturing processes to enhance the production of oil and gas from the underground hydrocarbon-bearing formation. The success of these processes depends significantly upon having a thorough understanding of the behavior of suspensions used. Therefore, the characterization of suspensions under realistic conditions, for their rheological and hydraulic properties, is very important. This chapter deals with the state-of-the-art hydraulic fracturing suspension technology. Specifically it deals with various types of suspensions used in well stimulation and fracturing processes, their rheological characterization and hydraulic properties, behavior of suspensions in horizontal wells, review of proppant settling velocity and proppant transport in the fracture, and presently available measurement techniques for suspensions and their merits. Future industry needs for better understanding of the complex behavior of suspensions are also addressed. 74 refs., 21 figs., 1 tab.

  7. Fracturing fluids -- then and now

    SciTech Connect

    Jennings, A.R. Jr.

    1996-07-01

    Fracturing fluid provides the means by which the hydraulic fracturing process can take place. All applications of well stimulation by fracturing must include selection of fracturing fluid in the initial phases of fracture design and treatment planning. Fracturing fluid has two important purposes: (1) to provide sufficient viscosity to suspend and transport proppant deep into the created fracture system and (2) to decompose, or break, chemically to a low viscosity to allow flowback of a major part of the fluid to the surface for fracture cleanup after the treatment is completed. Because of the importance of its rheological properties and behavior in the fracture under reservoir conditions during (and immediately after) the treatment, service company research laboratories have spent millions of dollars on R and D of fracturing fluids.

  8. [Sonographic fracture diagnosis in children].

    PubMed

    Eckert, K; Ackermann, O

    2014-04-01

    X-rays are the standard imaging procedure for the diagnosis of pediatric long bone fractures. Recent studies show that ultrasound (US) imaging is also qualified to diagnose pediatric long bones fractures. Thus, the diagnosis and decision-making for the treatment of metaphyseal forearm fractures in children can be performed by solely using US. The sonographic fat pad sign has been proven to be a useful primary screening tool for pediatric elbow injuries. If there is a negative fat pad sign, a fracture is unlikely and taking additional radiographs is dispensable at this time. If there is a positive fat pad sign, a fracture is likely and radiographs should be taken. US is also useful to exclude subcapital humeral fractures and to estimate fracture displacement. If a fracture of the subcapital humerus is present, additional radiographs are necessary to avoid overlooking of pathologic fractures. For reliable sonographic fracture diagnosis in childhood, a detailed history und exact clinical examination are required. PMID:24700086

  9. Atomistic simulations of fracture

    SciTech Connect

    Farkas, D.

    1997-12-31

    Embedded atom interaction potentials are used to simulate the atomistic aspects of the fracture process. Simulations are presented for the behavior of cracks in pure metals and intermetallics, near the Griffith condition. The materials considered include Fe, Cu, Ni as well as Fe, Ni, Co, and Ti aluminides. The work focuses on the comparative study of fracture behavior in the different materials. The role of the atomic relaxation at the crack tip and of lattice trapping phenomena is analyzed.

  10. The mechanism of fracture

    SciTech Connect

    Goel, V.S.

    1985-01-01

    This book presents the papers given at a conference on the fracture mechanics of metals. Topics considered at the conference included microcrack mechanics, pressurized thermal shock behavior of LWR pressure vessels, stress intensity factors, submerged arc welding, weldments in power plants, pipeline weld quality, natural gas tanks, cast iron for spent nuclear fuel shipping casks, pipe ruptures, physical radiation effects, pressure tubes, hydrogen embrittlement, critical flaw size curves, and the fracture mechanics of steels in turbines of power stations.

  11. Dynamic fracture toughness

    NASA Technical Reports Server (NTRS)

    Kobayashi, A. S.; Ramulu, M.; Dadkhah, M. S.; Yang, K.-H.; Kang, B. S. J.

    1986-01-01

    Dynamic fracture toughness versus crack velocity relations of Homalite-100, polycarbonate, hardened 4340 steel and reaction bonded silicon nitride are reviewed and discrepancies with published data and their probable causes are discussed. Data scatter in published data are attributed in part to the observed fluctuations in crack velocities. The results reaffirmed our previous conclusion that the dynamic fracture toughness versus crack velocity relation is specimen dependent and that the dynamic arrest stress intensity factor is not a unique material property.

  12. Interlaminar fracture of composites

    NASA Technical Reports Server (NTRS)

    Obrien, T. K.

    1984-01-01

    Fracture mechanics has been found to be a useful tool for understanding composite delamination. Analyses for calculating strain energy release rates associated with delamination growth have been developed. These analyses successfully characterized delamination onset and growth for particular sources of delamination. Low velocity impact has been found to be the most severe source of composite delamination. A variety of test methods for measuring interlaminar fracture toughness are being developed to identify new composite materials with enhanced delamination resistance.

  13. Relative permeability through fractures

    SciTech Connect

    Diomampo, Gracel, P.

    2001-08-01

    The mechanism of two-phase flow through fractures is of importance in understanding many geologic processes. Currently, two-phase flow through fractures is still poorly understood. In this study, nitrogen-water experiments were done on both smooth and rough parallel plates to determine the governing flow mechanism for fractures and the appropriate methodology for data analysis. The experiments were done using a glass plate to allow visualization of flow. Digital video recording allowed instantaneous measurement of pressure, flow rate and saturation. Saturation was computed using image analysis techniques. The experiments showed that gas and liquid phases flow through fractures in nonuniform separate channels. The localized channels change with time as each phase path undergoes continues breaking and reforming due to invasion of the other phase. The stability of the phase paths is dependent on liquid and gas flow rate ratio. This mechanism holds true for over a range of saturation for both smooth and rough fractures. In imbibition for rough-walled fractures, another mechanism similar to wave-like flow in pipes was also observed. The data from the experiments were analyzed using Darcy's law and using the concept of friction factor and equivalent Reynold's number for two-phase flow. For both smooth- and rough-walled fractures a clear relationship between relative permeability and saturation was seen. The calculated relative permeability curves follow Corey-type behavior and can be modeled using Honarpour expressions. The sum of the relative permeabilities is not equal one, indicating phase interference. The equivalent homogeneous single-phase approach did not give satisfactory representation of flow through fractures. The graphs of experimentally derived friction factor with the modified Reynolds number do not reveal a distinctive linear relationship.

  14. Clinical experience in treatment of diffuse unilateral subretinal neuroretinitis

    PubMed Central

    Relhan, Nidhi; Pathengay, Avinash; Raval, Vishal; Nayak, Sameera; Choudhury, Himadri; Flynn, Harry W

    2015-01-01

    Purpose To describe the clinical features, management, and outcomes of patients with diffuse unilateral subacute neuroretinitis (DUSN). Methods A noncomparative, consecutive analysis of case series from two tertiary care campuses of LV Prasad Eye Institute, India, between January 2011 and April 2014 was performed. Medical records of the patients presenting with DUSN (early or late stage) were reviewed. Results The current study included 13 patients. The majority (10/13, 76.92%) of the patients were aged 20 years or less. All patients had unilateral eye involvement. Visual acuity at presentation was 20/200 or worse in 9/13 (69.23%) patients. A delay in diagnosis occurred in 6/13 patients, and initial diagnosis in these patients included retinitis pigmentosa (4 patients) and posterior uveitis (2 patients). Clinical features included early presentation (prominent vitritis, localized retinitis, and vasculitis) in 7/13 (53.85%) patients and late presentation (attenuation of vessels, retinal pigment epithelium atrophic changes, and optic atrophy) in 6/13 (46.15%) patients. Worm could not be identified in any of the cases. All the patients received laser photocoagulation of retina and oral albendazole treatment for a period of 30 days. With treatment, visual acuity improved in seven patients (six early stage, one late stage) and remained unchanged in six patients. Mean follow-up period was 8.69 months (range, 121 months). The mean central foveal thickness in the affected eye, done by optical coherence tomography, during the late stage of the disease was 188.2040 m (range, 111242 m), which was significantly thinner than the fellow eye, 238.7036.90 m (range, 186319 m), P=0.008. Conclusion DUSN is a serious vision threatening disease, which may progress to profound vision loss in the later stage of the disease. Visualization of subretinal worm is usually not possible. Treatment with high-dose albendazole therapy and laser photocoagulation may alter the bloodretinal barrier and may be useful in achieving visual recovery. PMID:26491239

  15. FRACTURING FLUID CHARACTERIZATION FACILITY

    SciTech Connect

    Subhash Shah

    2000-08-01

    Hydraulic fracturing technology has been successfully applied for well stimulation of low and high permeability reservoirs for numerous years. Treatment optimization and improved economics have always been the key to the success and it is more so when the reservoirs under consideration are marginal. Fluids are widely used for the stimulation of wells. The Fracturing Fluid Characterization Facility (FFCF) has been established to provide the accurate prediction of the behavior of complex fracturing fluids under downhole conditions. The primary focus of the facility is to provide valuable insight into the various mechanisms that govern the flow of fracturing fluids and slurries through hydraulically created fractures. During the time between September 30, 1992, and March 31, 2000, the research efforts were devoted to the areas of fluid rheology, proppant transport, proppant flowback, dynamic fluid loss, perforation pressure losses, and frictional pressure losses. In this regard, a unique above-the-ground fracture simulator was designed and constructed at the FFCF, labeled ''The High Pressure Simulator'' (HPS). The FFCF is now available to industry for characterizing and understanding the behavior of complex fluid systems. To better reflect and encompass the broad spectrum of the petroleum industry, the FFCF now operates under a new name of ''The Well Construction Technology Center'' (WCTC). This report documents the summary of the activities performed during 1992-2000 at the FFCF.

  16. Treatment of Thoracolumbar Fracture

    PubMed Central

    Kim, Byung-Guk; Shin, Dong-Eun

    2015-01-01

    The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity. PMID:25705347

  17. Fracture toughness of graphene

    NASA Astrophysics Data System (ADS)

    Zhang, Peng; Ma, Lulu; Fan, Feifei; Zeng, Zhi; Peng, Cheng; Loya, Phillip E.; Liu, Zheng; Gong, Yongji; Zhang, Jiangnan; Zhang, Xingxiang; Ajayan, Pulickel M.; Zhu, Ting; Lou, Jun

    2014-04-01

    Perfect graphene is believed to be the strongest material. However, the useful strength of large-area graphene with engineering relevance is usually determined by its fracture toughness, rather than the intrinsic strength that governs a uniform breaking of atomic bonds in perfect graphene. To date, the fracture toughness of graphene has not been measured. Here we report an in situ tensile testing of suspended graphene using a nanomechanical device in a scanning electron microscope. During tensile loading, the pre-cracked graphene sample fractures in a brittle manner with sharp edges, at a breaking stress substantially lower than the intrinsic strength of graphene. Our combined experiment and modelling verify the applicability of the classic Griffith theory of brittle fracture to graphene. The fracture toughness of graphene is measured as the critical stress intensity factor of and the equivalent critical strain energy release rate of 15.9?J?m-2. Our work quantifies the essential fracture properties of graphene and provides mechanistic insights into the mechanical failure of graphene.

  18. Effects of unilateral selective hypergravity stimulation on gait

    NASA Astrophysics Data System (ADS)

    Lazerges, M.; Bessou, P.

    The purpose of this work is to analyse the neural mechanisms of human motor perturbations induced by dynamic changes in gravity. A unilateral selective hypergravity stimulation (USHS) was produced by stretching an elastic band between the right shoulder and foot. The consequences of the extensor muscle tone change due to the positioning (increased muscular loading) and to its removal (decreased muscular loading) by the elastic band were observed on motor gait skill. Gait spatio-temporal parameters (horizontal displacement of both feet) and lower limb functional length variations (efficiency of flexion and extension movements of the lower limbs) were measured. The latter measure was performed using a device specially designed for that purpose. The main results were: (1) during and after USHS, gait perturbations appeared on the leftthe body side not directly stimulated, (2) just after the end of USHS, perturbations were present on the right (homolateral) side evidencing a post treatment effect which caused a decrease in functional shortening of the lower limb during extension and an increase of functional shortening of the lower limb during stance (opposite in sense to the modification observed during swing). Such results afford evidence that, in addition to vestibular receptors, the mechanoreceptors of extensor muscles are involved in determining the changes in motor skills observed at the beginning and at the end of space flights.

  19. Primate translational vestibuloocular reflexes. IV. Changes after unilateral labyrinthectomy

    NASA Technical Reports Server (NTRS)

    Angelaki, D. E.; Newlands, S. D.; Dickman, J. D.

    2000-01-01

    The effects of unilateral labyrinthectomy on the properties of the translational vestibuloocular reflexes (trVORs) were investigated in rhesus monkeys trained to fixate near targets. Translational motion stimuli consisted of either steady-state lateral and fore-aft sinusoidal oscillations or short-lasting transient displacements. During small-amplitude, steady-state sinusoidal lateral oscillations, a small decrease in the horizontal trVOR sensitivity and its dependence on viewing distance was observed during the first week after labyrinthectomy. These deficits gradually recovered over time. In addition, the vertical response component increased, causing a tilt of the eye velocity vector toward the lesioned side. During large, transient lateral displacements, the deficits were larger and longer lasting. Responses after labyrinthectomy were asymmetric, with eye velocity during movements toward the side of the lesion being more compromised. The most profound effect of the lesions was observed during fore-aft motion. Whereas responses were kinematically appropriate for fixation away from the side of the lesion (e.g., to the left after right labyrinthectomy), horizontal responses were anticompensatory during fixation at targets located ipsilateral to the side of the lesion (e.g., for targets to the right after right labyrinthectomy). This deficit showed little recovery during the 3-mo post-labyrinthectomy testing period. These results suggest that inputs from both labyrinths are important for the proper function of the trVORs, although the details of how bilateral signals are processed and integrated remain unknown.

  20. Dental maturation of unilateral cleft lip and palate

    PubMed Central

    Tan, Elaine Li Yen; Yow, Mimi; Kuek, Meaw Charm; Wong, Hung Chew

    2012-01-01

    Cleft lip and palate (CLP) is the most common craniofacial abnormality and the fourth most common birth defect in Singapore. Many reports suggest that CLP children have delayed dental development and asymmetrical timing of tooth-pair formation. The aim of this study was to investigate the timing of development of permanent teeth in unilateral CLP (UCLP) children and to compare the findings with non-CLP children in Singapore. A total of 60 UCLP children aged between 5 and 9 years (mean 6.64 ± 0.90 years) and a non-CLP control group matched for age, gender, and race were investigated and compared. Dental records and radiographs were studied and the dental maturation was determined using the Demirjian's method (1973). The dental maturation of UCLP children were delayed compared with non-CLP children by a mean of 0.55 ± 0.75 years and the delay was statistically significant (P < 0.001). The UCLP group also had significantly higher risk of asymmetrically developing tooth pairs than the control group (P < 0.001). The most commonly delayed tooth in development was the maxillary cleft-sided lateral incisor. In conclusion, the UCLP children in Singapore demonstrated delayed dental maturation and a higher occurrence of asymmetrical tooth-pair formation than the non-CLP children. PMID:23483778

  1. Rehabilitation and neuroplasticity in children with unilateral cerebral palsy.

    PubMed

    Reid, Lee B; Rose, Stephen E; Boyd, Roslyn N

    2015-07-01

    Cerebral palsy is a childhood-onset, lifelong neurological disorder that primarily impairs motor function. Unilateral cerebral palsy (UCP), which impairs use of one hand and perturbs bimanual co-ordination, is the most common form of the condition. The main contemporary upper limb rehabilitation strategies for UCP are constraint-induced movement therapy and bimanual intensive therapy. In this Review, we outline the factors that are crucial to the success of motor rehabilitation in children with UCP, including the dose of training, the relevance of training to daily life, the suitability of training to the age and goals of the child, and the ability of the child to maintain close attention to the tasks. Emerging evidence suggests that the first 2 years of life are a critical period during which interventions for UCP could be more effective than in later life. Abnormal brain organization in UCP, and the effects of development on rehabilitation, must also be understood to develop new effective interventions. Therefore, we also consider neuroimaging methods that can provide insight into the neurobiology of UCP and how the condition responds to existing therapies. We discuss how these methods could shape future rehabilitative strategies based on the neurobiology of UCP and the therapy-induced changes seen in the brain. PMID:26077839

  2. Subtotal Petrosectomy and Cerebrospinal Fluid Leakage in Unilateral Anacusis

    PubMed Central

    Magliulo, Giuseppe; Iannella, Giannicola; Appiani, Mario Ciniglio; Re, Massimo

    2014-01-01

    Objective This study presents a group of patients experiencing recurrent cerebrospinal fluid (CSF) leakage associated with ipsilateral anacusis who underwent subtotal petrosectomies with the goal of stopping the CSF leak and preventing meningitis. Materials and Methods Eight patients with CSF leakage were enrolled: three patients with giant vestibular schwannomas had CSF leakage after gamma knife failure and subsequent removal via a retrosigmoid approach; two patients had malformations at the level of the inner ear with consequent translabyrinthine fistulas; two had posttraumatic CSF leakages; and one had a CSF leakage coexisting with an encephalocele. Two patients developed meningitis that resolved with antibiotic therapy. Each patient had preoperative anacusis and vestibular nerve areflexia on the affected side. Results The patients with congenital or posttraumatic CSF leaks had undergone at least one unsuccessful endaural approach to treat the fistula. All eight patients were treated successfully with a subtotal petrosectomy. The symptoms disappeared within 2 months postoperatively. No meningitis, signs of fistula, or other symptoms occurred during the follow-up. Conclusion A subtotal petrosectomy should be the first choice of treatment in patients with recurrent CSF leakage whenever there is associated unilateral anacusis. PMID:25452896

  3. Vocal improvement after voice therapy in unilateral vocal fold paralysis.

    PubMed

    Schindler, Antonio; Bottero, Alessandro; Capaccio, Pasquale; Ginocchio, Daniela; Adorni, Fulvio; Ottaviani, Francesco

    2008-01-01

    Unilateral vocal fold paralysis (UVFP) is associated with changes in acoustic and aerodynamic voice measurements and can have a significant impact on a patient's quality of life. Few objective data regarding the efficacy of voice therapy for UVFP exist. The aim of this study was to retrospectively analyze voice modifications in a group of patients with UVFP before and after voice therapy. Forty patients with UVFP of different etiology were included in the study. Each subject had voice therapy with an experienced speech/language pathologist twice a week; the mean number of sessions was 12.6. A multidimensional assessment protocol was used; it included videoendoscopy, the maximum phonation time (MPT), the GIRBAS scale, spectrograms and a perturbation analysis, and the Voice Handicap Index (VHI). Pre- and posttreatment data were compared by means of the Wilcoxon and Student's t tests. A complete glottal closure was seen in 8 patients before voice therapy and in 14 afterward. Mean MPT increased significantly. In the perceptual assessment, the difference was significant for five out of six parameters. A significant improvement was found on spectrographic analysis; as for perturbation analysis, the differences in jitter, shimmer, and noise-to-harmonic ratio values were significant. VHI values showed a clear and significant improvement. A significant improvement of voice quality and quality of life after voice therapy is an often reached and reasonable goal in patients with UVFP. PMID:17014987

  4. Bimanual force coordination in children with spastic unilateral cerebral palsy.

    PubMed

    Smits-Engelsman, B C M; Klingels, K; Feys, H

    2011-01-01

    In this study bimanual grip-force coordination was quantified using a novel "Gripper" system that records grip forces produced while holding a lower and upper unit, in combination with the lift force necessary to separate these units. Children with unilateral cerebral palsy (CP) (aged 5-14 years, n=12) were compared to age matched typically developing (TD) children (n=23). Compared to TD, the CP-group is much slower and takes 50% more time to generate grip and lift forces with more fixating force before lifting the upper unit. In addition the coordination between forces in both hands is reduced. The CP-group increases the lift force in the upper hand 2.5 times more than the holding force when pulling the two units apart, while this is only 1.5 times in TD. Moreover, the correlation between forces generated in both hands in the CP-group is lower. The lack of fine tuning of the forces, measured by the linearity error is increased, especially when the magnet load keeping the unit together is low. The results indicate an impaired pull-hold synergy between upper and lower hand and the lift force. Bimanual tasks evaluating bimanual grip and lift forces in children with CP and can give us new insights in the underlying force control mechanisms of the spastic hand. PMID:21592724

  5. Three-Magnet Arrays for Unilateral Magnetic Resonance

    NASA Astrophysics Data System (ADS)

    Garcia Naranjo, Juan Carlos

    Unilateral Magnetic Resonance (UMR) has become, in different research areas, a powerful tool to interrogate samples of arbitrary size. The three-magnet array developed by the MRI Centre of the University of New Brunswick has features that make it a simple and robust approach for UMR. This thesis introduces a group of solutions to broaden the range of application of this design. Practical applications for non-destructive testing and reservoir core plug characterization are presented. We have shown that it is also possible to monitor the curing process of an epoxy/polyamidoamine system by employing a three-magnet array. A new version of the three-magnet array which features extended constant magnetic field gradients is also introduced. Constant gradients of more than 3 cm extent can be achieved in a very simple, compact and safe design. The application of the three-magnet array in combination with a solenoid as the RF probe for analysis of long core plugs has been presented. Core plugs of different diameter can be analyzed by simply changing the diameter of the RF probe employed for the measurement. Results of an initial survey of selective excitation in UMR are presented. The low SNR and inhomogeneities in the selective spot reduce the effectiveness of selective excitation for UMR.

  6. Accidental Unilateral Mydriasis from Hyoscine Patch in a Care Provider.

    PubMed

    Ng, Jia; Li Yim, James

    2015-12-01

    The hyoscine patch is effective and is frequently used in motion sickness treatment. Not uncommonly, it is used to control excessive respiratory secretions in palliative patients. Patients, healthcare workers, and caregivers who administer these may experience a benign, although worrying, mydriasis should they inadvertently rub their eye after handling the patch. A 46-year-old staff nurse working in a stroke ward presented with sudden-onset unilateral enlarged pupil. To rule out any intracranial pathology, the stroke team requested an urgent head computed tomography (CT) scan, which showed no abnormality. Upon ophthalmology review, nonreactive dilated left pupil was noted. Examination was otherwise unremarkable with no focal neurology findings. Following further history, she recalled applying a hyoscine patch to a patient in the morning. Two days later, her left pupil returned to normal size. This unique presentation of pharmacological mydriasis reinforces the importance of a detailed targeted history to avoid unnecessary investigations and anxiety, as well as the importance of informing patients, healthcare workers, and caregivers of this peculiar side-effect. PMID:24460454

  7. Consideration of vocal fold position in unilateral vocal fold paralyses.

    PubMed

    Olthoff, Arno; Steinle, Julia; Asendorf, Thomas; Kruse, Eberhard

    2015-04-01

    The objective of this study was to improve the evaluation of unilateral vocal fold paralyses (uVFP) by means of an area measurement of the glottic plane, which describes the position of the paralysed vocal fold. The area measurements were related to electromyographic findings and clinical outcome (recovery, voice quality). In 56 patients (33 women and 23 men), uVFP were confirmed by endolaryngeal electromyography (EMG) of the paralysed vocal fold and cricothyroid muscles (CT). The EMG response was classified on a 4-point scale (from 0 to 3). Vocal fold position was divided into 'paramedian' and 'intermediate' and additionally quantified by measurement of the glottic area. An 'area quotient' (AQ) was calculated and related to the EMG findings and clinical outcome. Voice qualities were objectified regarding their additive noise (breathiness) and irregularity (roughness) using the 'Gttingen Hoarseness Diagram'. The majority of uVFP was due to iatrogenic lesions. The AQ of classically graduated 'paramedian' and 'intermediate' vocal fold positions was significantly different but did not correlate with objective voice quality values. There were no significant correlations regarding EMG findings, duration or recovery from paralyses. Laryngeal EMG remains the gold standard for verifying uVFP. But EMG did not correlate significantly with AQ or functional outcome of uVFP. The measurement of an AQ is suitable for obtaining continuous data describing the position of paralysed vocal folds beyond the terms 'paramedian' or 'intermediate' and provides the basis for clinical evaluations of diagnostic tools and therapeutic interventions. PMID:25519473

  8. Hearing and music in unilateral spatial neglect neuro-rehabilitation

    PubMed Central

    Guilbert, Alma; Sylvain Clément; Moroni, Christine

    2014-01-01

    Unilateral spatial neglect (USN) is an attention deficit in the contralesional side of space which occurs after a cerebral stroke, mainly located in the right hemisphere. USN patients are disabled in all daily activities. USN is an important negative prognostic factor of functional recovery and of socio-professional reinsertion. Thus, patient rehabilitation is a major challenge. As this deficit has been described in many sensory modalities (including hearing), many sensory and poly-sensory rehabilitation methods have been proposed to USN patients. They are mainly based on visual, tactile modalities and on motor abilities. However, these methods appear to be quite task-specific and difficult to transfer to functional activities. Very few studies have focused on the hearing modality and even fewer studies have been conducted in music as a way of improving spatial attention. Therefore, more research on such retraining needs is neccessary in order to make reliable conclusions on its efficiency in long-term rehabilitation. Nevertheless, some evidence suggests that music could be a promising tool to enhance spatial attention and to rehabilitate USN patients. In fact, music is a material closely linked to space, involving common anatomical and functional networks. The present paper aims firstly at briefly reviewing the different procedures of sensory retraining proposed in USN, including auditory retraining, and their limits. Secondly, it aims to present the recent scientific evidence that makes music a good candidate for USN patients’ neuro-rehabilitation. PMID:25566165

  9. SUNCT Headache (Short-Lasting, Unilateral, Neuralgiform with Conjunctival Injection and Tearing)

    MedlinePLUS

    ... Enhancing Diversity Find People About NINDS NINDS SUNCT Headache Information Page Table of Contents (click to jump ... Related NINDS Publications and Information What is SUNCT Headache? SUNCT-Short-lasting, Unilateral, Neuralgiform headache attacks with ...

  10. Triplane fracture associated with a proximal third fibula fracture.

    PubMed

    Healy, W A; Starkweather, K D; Meyer, J; Teplitz, G A

    1996-06-01

    The case of a Maisonneuve fracture occurring in association with a triplane fracture in an adolescent wrestler is presented. In this combination of injuries, the deltoid ligament may be ruptured, and/or the medial malleolus fractured. If the proximal fibula fracture is not discovered, and the syndesmosis rupture is not treated, the resulting chronic talocrural instability may lead to chronic ankle pain and degenerative arthritis. The orthopedist should be aware of the possibility of a Maisonneuve fracture occurring in association with a triplane fracture, and should treat both injuries appropriately. PMID:8798988

  11. Laryngeal fracture after coughing.

    PubMed

    Fenig, Mark; Strasberg, Stephen; Cohen, Justin C; Almadi, Rami; Gold, Menachem

    2013-09-01

    Nontraumatic laryngeal fractures are exceedingly rare disease entities. Only 3 prior instances have been described in the medical literature (Br Med J 1950;1:1052; Acta Otorrinolaringol Esp 2007;58:73-4; Otolaryngol Head Neck Surg 2012;147:801-2). We present a case of thyroid cartilage fracture and associated phlegmon formation after a vigorous coughing spell in a 47-year-old man. On presentation, the patient's symptoms included the triad of odynophagia, dysphagia, and dysphonia as well as diffuse swelling and tenderness over the thyroid cartilage. Computed tomography and magnetic resonance imaging revealed a mildly displaced anterior thyroid cartilage fracture as well as a phlegmon in the strap muscle compartment adjacent to the fracture (Figs. 1 and 2). Intravenous dexamethasone and antibiotics were initiated, and the patient was admitted to the medical intensive care unit. On fiberoptic examination with the flexible laryngoscope, the patient was found to have slightto-moderate watery edema of the right aryepiglottic fold and right greater than left arytenoid cartilages. After 48 hours, the patient's neck swelling and pain significantly improved. On hospital day 4, the patient was discharged with a course of oral antibiotics. One week later, the patient reported only mild odynophagia and persistent dysphonia. He otherwise felt well and was tolerating fluids and soft food without difficulty. A preexisting, congenital abnormality resulting in a focal weakness in the thyroid cartilage might predispose patients to nontraumatic fractures (Otolaryngol Head Neck Surg 2012;147:801-2). Patients in prior case reports of nontraumatic laryngeal fractures presented with similar symptoms (Table). The triad of odynophagia, dysphagia, and dysphonia after a severe coughing or sneezing episode should raise the clinician's suspicion of a thyroid cartilage fracture. PMID:23806730

  12. Early Swept-Source Optical Coherence Tomography Angiography Findings in Unilateral Acute Idiopathic Maculopathy.

    PubMed

    Nicolo, Massimo; Rosa, Raffaella; Musetti, Donatella; Musolino, Maria; Traverso, Carlo Enrico

    2016-02-01

    Unilateral acute idiopathic maculopathy (UAIM) is a rare disorder presenting in young people with an acute onset of unilateral central visual loss often associated with a prodromal flu-like illness. The authors present the early anatomical findings of a 35-year-old man clinically diagnosed with UAIM using swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:180-182.]. PMID:26878453

  13. Unilateral facial palsy in Guillain-Barre syndrome (GBS): a rare occurrence

    PubMed Central

    Verma, Rajesh; Chaudhari, Tejendra S; Giri, Prithvi

    2012-01-01

    Guillain-Barre syndrome (GBS) is a postinfectious, autoimmune disorder which, apart from limb weakness, is characterised by cranial nerve involvement. Bilateral facial nerve palsy is the most common pattern of cranial nerve involvement in GBS. However, unilateral facial palsy, although uncommon, can be seen in GBS. We report a rare case of unilateral facial palsy in GBS and importance of electrophysiological tests including blink study in such cases has been emphasised. PMID:23087283

  14. Stress fractures in ballet dancers.

    PubMed

    Kadel, N J; Teitz, C C; Kronmal, R A

    1992-01-01

    We surveyed 54 female dancers in two professional ballet companies. A total of 27 fractures were reported in 17 dancers. Metatarsal fractures were the most common (63%), followed by fractures of the tibia (22%) and spine (7%). Dancers who danced greater than 5 hours per day were significantly more likely to have a stress fracture than those dancing less than 5 hours per day. Dancers in the stress fracture group also had a significantly longer duration of amenorrhea than those in the group with no stress fractures. No significant difference was found between the dancers who had stress fractures and those who did not with regard to any of the other variables examined. These data suggest that prolonged amenorrheic intervals and heavy training schedules may predispose ballet dancers to stress fractures. Of the 17 dancers with stress fractures, only 1 had neither of these risk factors. PMID:1357994

  15. Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

    PubMed Central

    Upile, Tahwinder; Elmiyeh, Behrad; Jerjes, Waseem; Prasad, Vyas; Kafas, Panagiotis; Abiola, Jesuloba; Youl, Bryan; Epstein, Ruth; Hopper, Colin; Sudhoff, Holger; Rubin, John

    2009-01-01

    Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport) in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral) and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS) system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale), length of response and duration of complications (breathiness, cough, dysphagia and total voice loss). Injections were performed under electromyography (EMG) guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS) and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia. PMID:19852852

  16. Optimal dose of hyperbaric bupivacaine 0.5% for unilateral spinal anesthesia during diagnostic knee arthroscopy

    PubMed Central

    Atef, HM; El-Kasaby, AM; Omera, MA; Badr, MD

    2010-01-01

    Objective To determine the dose of hyperbaric bupivacaine 0.5% required for unilateral spinal anesthesia during diagnostic knee arthroscopy. Patients and methods This prospective, randomized, clinical study was performed in 80 patients who were assigned to four groups to receive different doses of intrathecal hyperbaric bupivacaine (5 mg, 7.5 mg, 10 mg and 12.5 mg in Groups 1, 2, 3, and 4 respectively). Onset of sensory and motor block, hemodynamic changes, regression of motor block, and incidence of complications were recorded. Results Unilateral sensory block was reported in 90% and 85% of patients in Group 1 and Group 2, respectively, but not in any patient in Group 3 and Group 4. Unilateral motor block (modified Bromage scale 0) was reported in 95% of patients in Group 1, 90% in Group 2, and only 5% in Group 3, while no patient in Group 4 showed unilateral motor block. The time required for regression of motor block (Bromage scale 0) was prolonged with higher doses. The incidence of nausea, vomiting, and urine retention was similar in the study groups. Conclusion Unilateral sensory and motor block can be achieved with doses of 5 mg and 7.5 mg hyperbaric bupivacaine 0.5% with a stable hemodynamic state. However, 7.5 mg of hyperbaric bupivacaine 0.5% was the dose required for adequate unilateral spinal anesthesia. PMID:22915874

  17. Fracture behavior across interfaces

    NASA Astrophysics Data System (ADS)

    Petrie, E. S.; Evans, J. P.; Jeppson, T. N.

    2011-12-01

    Faults and fracture networks at depth are important fluid pathways, especially in fine-grained, low permeability seal lithologies. Discontinues in sealing lithologies can create seal bypass systems, leading to the failure of CO2 geosequestration sites or hydrocarbon traps. We characterize the occurrence of and changes in discontinuity patterns and the associated changes in elastic moduli across sedimentologic interfaces to document the importance of these discontinuities for fluid management in the subsurface and potential for re-activation in high-pressure injection scenarios. We evaluate well-exposed, fine-grained, low-permeability Mesozoic and Paleozoic units that are seals of potential CO2 repositories on the Colorado Plateau and show evidence for open fractures and fluid flow in the subsurface. Field observations document changes in fracture distributions across lithologic boundaries allowing us to identify mechano-stratigraphic units and focus on the effect of lithologic interfaces on fracture distribution. An interface marks the boundary between facies in a seal and in this study the fractures are shown to deflect or arrest at the interface. In outcrop fracture intensity varies in from 1 to 18 fractures per meter and fracture apertures range from mm to cm. The mineralized fractures often have associated alteration halos along their boundaries; their general orientation follows that of discontinuities within the underlying reservoir facies or adjacent faults. The recognition of these changes in fracture distribution is important for forward modeling of fluid flow and risk management. Studying the occurrence of and changes in fracture patterns from outcrops and scaling it up for use in modeling at a field scale is difficult due to the lack of direct correlation between outcrop observations and subsurface data. Due to the size and amount of data needed to model fluid flow at the field scale the meso-scale (cm to m) variability of rock properties is often neglected. We evaluate this meso-scale variability in elastic moduli, where possible. We combine mechano-stratigraphic outcrop observations with elastic moduli calculated from publically available wire line log data to evaluate the variability in rock strength within the heterolithic top seal. Relationships between changes in Young's modulus to resulting fracture distribution can then be observed. The outcome of this analysis can be used for modeling the effectiveness of seal for storage of CO2 in the underlying reservoirs. Digitized publically available wire line well log data were used to calculate Poisson's ratio and Young's modulus over the Carmel Formation and upper most 3 m of the underlying Navajo Sandstone. Our calculations show that Young's Modulus can range between 15 to 34 GPa across 60 cm of the intra-seal interfaces, and an average difference of 5 GPa across the reservoir seal interface. These variations will affect fracture distributions and fluid behavior in the subsurface. These data provide a means to closely tie outcrop observations to derived estimates of subsurface rock strength. The characterization of rock strength variability is especially important for modeling the response of seals to increased pressure, due to CO2 injection, and will allow for better site screening and fluid management once injection projects are underway.

  18. An accessory skull suture mimicking a skull fracture.

    PubMed

    Wiedijk, J E F; Soerdjbalie-Maikoe, V; Maat, G J R; Maes, A; van Rijn, R R; de Boer, H H

    2016-03-01

    This paper describes an investigation of the sudden and unexpected death of a five-and-a-half-month-old boy. As in every Dutch case of sudden unexpected death in infancy (SUDI), a multidisciplinary diagnostic approach was used. This included post-mortem radiography, showing a linear discontinuity of the parietal bone. Originally this was interpreted as a skull fracture, but autopsy indicated no signs of mechanical trauma. Instead the defect was defined as a unilateral accessory suture of the parietal bone. The initial erroneous diagnosis had severe adverse consequences and thus every health care professional or forensic specialist dealing with paediatric mechanical traumas should be cautious of this rare anomaly. PMID:26860068

  19. Circumferential Stent Fracture

    PubMed Central

    Ramegowda, Raghu T.; Chikkaswamy, Srinivas B.; Bharatha, Ashalatha; Radhakrishna, Jayashree; Krishnanaik, Geetha B.; Nanjappa, Manjunath C.; Panneerselvam, Arunkumar

    2012-01-01

    Circumferential stent fracture is extremely uncommon, and in rare cases, it can cause stent thrombosis. Recognizing stent fracture can be difficult on conventional fluoroscopy because of poor stent radiopacity. We found that StentBoost image acquisition yields improved visibility of stent struts, enabling the identification of stent fracture and the precise positioning of new stents over previously stented segments. We report the case of a 50-year-old man who presented with acute myocardial infarction and subacute stent thrombosis a week after percutaneous transluminal coronary angioplasty and placement of a bare-metal stent. The new lesion was crossed with a guidewire, but multiple attempts to advance a balloon catheter were unsuccessful. Live StentBoost image acquisition revealed circumferential stent fracture into 2 separate sections, with abnormal angulation between the proximal and distal portions of the stent. With StentBoost guidance, the wire and balloon catheter were both easily manipulated to cross the lesion, and angioplasty and restenting were completed with good results. StentBoost can be a useful adjunctive tool for the cardiac interventionist during complex percutaneous transluminal coronary angioplasty, and it was invaluable in this challenging situation. We discuss stent fracture and the benefits of using StentBoost in such situations. PMID:22719162

  20. Pelvic Insufficiency Fractures

    PubMed Central

    OConnor, Timothy J.

    2014-01-01

    Pelvic insufficiency fractures may occur in the absence of trauma or as a result of low-energy trauma in osteoporotic bone. With a growing geriatric population, the incidence of pelvic insufficiency fracture has increased over the last 3 decades and will continue to do so. These fractures can cause considerable pain, loss of independence, and economic burden to both the patient and the health care system. While many of these injuries are identified and treated based on plain radiographs, some remain difficult to diagnose. The role of advanced imaging in these cases is discussed. In addition to treating the fracture, medical comorbidities contributing to osteoporosis should be identified and corrected. Specific attention has been given to 25-OH serum vitamin D screening and repletion. Treatment generally consists of providing pain control and assisting patients with mobilization while allowing weight bearing as tolerated. In those unable to do so, invasive techniques such as sacroplasty as well as internal fixation may be beneficial. The role of operative fixation in insufficiency fractures is also discussed. PMID:26246940

  1. Pediatric calcaneal fractures

    PubMed Central

    Summers, Hobie; Ann Kramer, Patricia; Benirschke, Stephen K.

    2009-01-01

    Although operative treatment of displaced, intra-articular fractures of the calcaneus in adults is generally accepted as standard practice, operative treatment for the same fractures in the skeletally immature remains controversial, potentially because the outcome for fracture types (intra- vs. extra-articular) and severity (displaced vs. nondisplaced) have been confounded in studies of children. We review herein the results of 21 displaced, intra-articular fractures in 18 skeletally immature patients, who were treated with open reduction and internal fixation using a standard surgical approach and protocol developed for adults. The average pre-operative Bhler's angle on the injured side was ?5 (range: ?35 +35) compared to 31 (range: +22 +47) on the uninjured side, indicating substantial displacement. There were no post-operative infections or wound healing problems, and all but one patient was followed to union (average follow-up: 1.5 years; range: 0.304.3 years). Maintenance of reduction was confirmed on follow-up radiographs with an average Bhler's angle of 31 (range: +22 +49). We demonstrate that results for operative fixation of displaced, intra-articular calcaneal fractures in the skeletally immature are comparable to those in adults when the treatment protocol is the same. PMID:21808673

  2. Sacroiliitis or insufficiency fracture?

    PubMed

    Memeto?lu, O G; Ozkan, F U; Boy, N S; Aktas, I; Kulcu, D G; Taraktas, A

    2016-03-01

    Sacral stress fracture and sacroiliitis are two conditions that present with pain. Sacral stress fractures are a rare cause of lumbar and hip pain. Sacral insufficiency fractures are a type of sacral stress fractures. Sacroiliitis represents inflammation of the sacroiliac joints. Coexistence of sacroiliitis and sacral insufficiency fracture(SIF) has not been reported before. Case 1: A 39-year-old woman reporting inflammatory back pain. Imaging revealed bilateral chronic sacroiliitis and bilateral SIF. Case 2: A 31-year-old woman presenting with left hip and inguinal pain. Imaging revealed left sacroiliitis and ipsilateral SIF. Calcium and vitamin D supplementation together with nonsteroidal anti-inflammatory drug (NSAID) treatment were given. Sulfasalazine was added to the treatment of the second patient who developed peripheral arthritis during follow-ups. Early diagnosis is best made with magnetic resonance imaging (MRI) since roentgenograms may be negative initially. Furthermore, MRI findings of both entities share common features leading to a diagnostic dilemma. Interpretation of radiological findings assisted by detailed history and clinical findings is crucial for diagnosis and treatment. PMID:26501559

  3. Surgical treatment of talus fractures.

    PubMed

    Shakked, Rachel J; Tejwani, Nirmal C

    2013-10-01

    Talus fractures result from high-energy mechanisms and usually occur at the neck. Functional outcome after talar neck fracture worsens with increasing Hawkins grade. The mainstay of treatment for talar neck fractures is anatomic reduction and internal fixation. Prompt reduction of dislocations should be performed. Patients should be taken to the operating room as soon as stabilized. Dual incisions and a combination of minifragment plates and screws should be used. Talar body fractures have a high rate of ankle and subtalar arthritis. Lateral process fractures are frequently missed on radiographs. Complications after talus fractures include osteonecrosis, malunion, post-traumatic arthritis, and infection. PMID:24095068

  4. Fracture-Flow-Enhanced Solute Diffusion into Fractured Rock

    SciTech Connect

    Wu, Yu-Shu; Ye, Ming; Sudicky, E.A.

    2007-12-15

    We propose a new conceptual model of fracture-flow-enhanced matrix diffusion, which correlates with fracture-flow velocity, i.e., matrix diffusion enhancement induced by rapid fluid flow within fractures. According to the boundary-layer or film theory, fracture flow enhanced matrix diffusion may dominate mass-transfer processes at fracture-matrix interfaces, because rapid flow along fractures results in large velocity and concentration gradients at and near fracture-matrix interfaces, enhancing matrix diffusion at matrix surfaces. In this paper, we present a new formulation of the conceptual model for enhanced fracture-matrix diffusion, and its implementation is discussed using existing analytical solutions and numerical models. In addition, we use the enhanced matrix diffusion concept to analyze laboratory experimental results from nonreactive and reactive tracer breakthrough tests, in an effort to validate the new conceptual model.

  5. Treatment of Clavicle Fractures

    PubMed Central

    Paladini, P; Pellegrini, A; Merolla, G; Campi, F; Porcellini, G

    2012-01-01

    Summary Clavicle fractures are very common injuries in adults (2–5%) and children (10–15%) (1) and represent the 44–66% of all shoulder fractures (2). Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. With this review we wants to focus the attention on the basic epidemiology, anatomy, classification, evaluation and management of surgical treatments in relationship with the gravity of injuries. Both conservative and surgical management are possible, and surgeons must choose the most appropriate management modality according to the biologic age, functional demands, and type of lesion. We performed a review of the English literature thought PubMed to produce an evidence-based review of current concept and management of clavicle fracture. We finished taking a comparison with our survey in order to underline our direct experience. PMID:23905044

  6. Geometrically Frustrated Fracture Mechanics

    NASA Astrophysics Data System (ADS)

    Mitchell, Noah; Koning, Vinzenz; Vitelli, Vincenzo; Irvine, William T. M.

    2015-03-01

    When a flat elastic sheet is forced to conform to a surface with Gaussian curvature, stresses arise in the sheet. The mismatch between initial and final metrics gives rise to new fracture behavior which cannot be achieved by boundary loading alone. Using experiments of PDMS sheets frustrated on 3D-printed surfaces and a linearized analytical model, we demonstrate the ability of curvature to govern the sheets' fracture phenomenology. In this talk, we first show that curvature can both stimulate and suppress fracture initiation, depending on the position and orientation of the initial slit. Secondly, we show that curvature can steer the path of a crack as it propagates through the material. Lastly, the curvature can arrest cracks which would otherwise continue to propagate.

  7. Semiautomatic fracture zone tracking

    NASA Astrophysics Data System (ADS)

    Wessel, Paul; Matthews, Kara J.; Müller, R. Dietmar; Mazzoni, Aline; Whittaker, Joanne M.; Myhill, Robert; Chandler, Michael T.

    2015-07-01

    Oceanic fracture zone traces are widely used in studies of seafloor morphology and plate kinematics. Satellite altimetry missions have resulted in high-resolution gravity maps in which all major fracture zones and other tectonic fabric can be identified, and numerous scientists have digitized such lineaments. We have initiated a community effort to maintain low-cost infrastructure that allows seafloor fabric lineaments to be stored, accessed, and updated. A key improvement over past efforts is our processing software (released as a GMT5 supplement) that allows for semiautomatic corrections to previously digitized fracture zone traces given improved gridded data sets. Here we report on our seafloor fabric processing tools, which complement our database of seafloor fabric lineations, magnetic anomaly identifications, and plate kinematic models.

  8. DEM Particle Fracture Model

    SciTech Connect

    Zhang, Boning; Herbold, Eric B.; Homel, Michael A.; Regueiro, Richard A.

    2015-12-01

    An adaptive particle fracture model in poly-ellipsoidal Discrete Element Method is developed. The poly-ellipsoidal particle will break into several sub-poly-ellipsoids by Hoek-Brown fracture criterion based on continuum stress and the maximum tensile stress in contacts. Also Weibull theory is introduced to consider the statistics and size effects on particle strength. Finally, high strain-rate split Hopkinson pressure bar experiment of silica sand is simulated using this newly developed model. Comparisons with experiments show that our particle fracture model can capture the mechanical behavior of this experiment very well, both in stress-strain response and particle size redistribution. The effects of density and packings o the samples are also studied in numerical examples.

  9. Fracking, fracture, and permeability

    NASA Astrophysics Data System (ADS)

    Turcotte, D. L.; Norris, J.; Rundle, J. B.

    2013-12-01

    Injections of large volumes of water into tight shale reservoirs allows the extraction of oil and gas not previously accessible. This large volume 'super' fracking induces damage that allows the oil and/or gas to flow to an extraction well. The purpose of this paper is to provide a model for understanding super fracking. We assume that water is injected from a small spherical cavity into a homogeneous elastic medium. The high pressure of the injected water generates hoop stresses that reactivate natural fractures in the tight shales. These fractures migrate outward as water is added creating a spherical shell of damaged rock. The porosity associated with these fractures is equal to the water volume injected. We obtain an analytic expression for this volume. We apply our model to a typical tight shale reservoir and show that the predicted water volumes are in good agreement with the volumes used in super fracking.

  10. Bilateral cerebellar activation in unilaterally challenged essential tremor

    PubMed Central

    Broersma, Marja; van der Stouwe, Anna M.M.; Buijink, Arthur W.G.; de Jong, Bauke M.; Groot, Paul F.C.; Speelman, Johannes D.; Tijssen, Marina A.J.; van Rootselaar, Anne-Fleur; Maurits, Natasha M.

    2015-01-01

    Background Essential tremor (ET) is one of the most common hyperkinetic movement disorders. Previous research into the pathophysiology of ET suggested underlying cerebellar abnormalities. Objective In this study, we added electromyography as an index of tremor intensity to functional Magnetic Resonance Imaging (EMG-fMRI) to study a group of ET patients selected according to strict criteria to achieve maximal homogeneity. With this approach we expected to improve upon the localization of the bilateral cerebellar abnormalities found in earlier fMRI studies. Methods We included 21 propranolol sensitive patients, who were not using other tremor medication, with a definite diagnosis of ET defined by the Tremor Investigation Group. Simultaneous EMG-fMRI recordings were performed while patients were off tremor medication. Patients performed unilateral right hand and arm extension, inducing tremor, alternated with relaxation (rest). Twenty-one healthy, age- and sex-matched participants mimicked tremor during right arm extension. EMG power variability at the individual tremor frequency as a measure of tremor intensity variability was used as a regressor, mathematically independent of the block regressor, in the general linear model used for fMRI analysis, to find specific tremor-related activations. Results Block-related activations were found in the classical upper-limb motor network, both for ET patients and healthy participants in motor, premotor and supplementary motor areas. In ET patients, we found tremor-related activations bilaterally in the cerebellum: in left lobules V, VI, VIIb and IX and in right lobules V, VI, VIIIa and b, and in the brainstem. In healthy controls we found simulated tremor-related activations in right cerebellar lobule V. Conclusions Our results expand on previous findings of bilateral cerebellar involvement in ET. We have identified specific areas in the bilateral somatomotor regions of the cerebellum: lobules V, VI and VIII. PMID:26909321

  11. In-vivo corneal biomechanical analysis of unilateral keratoconus

    PubMed Central

    Ayar, Orhan; Ozmen, Mehmet Cuneyt; Muftuoglu, Orkun; Akdemir, Mehmet Orcun; Koc, Mustafa; Ozulken, Kemal

    2015-01-01

    AIM To evaluate and compare corneal biomechanical findings measured by ocular response analyzer, topographic and pachymetric findings in patients with unilateral keratoconus patients and healthy controls. METHODS This is an observational, case-control study. Patients with keratoconus in one eye and forme fruste keratoconus in the fellow eye were compared with sex and age matched with controls healthy subjects. All subjects were evaluated with rotating scheimpflug imaging system. The receiver-operating-characteristic curves were analyzed to evaluate the sensitivity and specificity of the parameters. RESULTS Twenty-seven patients with keratoconus in one eye and forme fruste keratoconus in the fellow eye were compared with 40 eyes of 40 normal subjects. Corneal hysteresis (CH) was 8.01.7 mm Hg in keratoconus group, 8.31.6 mm Hg in forme fruste keratoconus group, and 9.81.6 mm Hg in control groups (P=0.54 between keratoconus and forme fruste keratoconus groups, P<0.01 between control group and other groups). Corneal resistance factor (CRF) was 7.12.2 mm Hg in keratoconus group, 7.81.2 mm Hg in forme fruste keratoconus group and 9.91.5 mm Hg in control group (P<0.001 between control group and other groups). Using receiver-operating-characteristic analysis, the area under curve values of the parameters to distinguish forme fruste keratoconus from control subjects were: CH (0.768), CRF (0.866). Best cut-off points were 9.3 mm Hg and 8.8 mm Hg for CH and CRF respectively. CONCLUSION Ocular response analyzer parameters (CH and CRF) are found to be significantly lower in forme fruste keratoconus patients compared to normal control subjects. PMID:26682162

  12. Aggravated Cardiac Remodeling post Aortocaval Fistula in Unilateral Nephrectomized Rats

    PubMed Central

    Gu, Ye; Zou, Wusong; Zhang, Mingjing; Zhu, Pengfei; Hu, Shao

    2015-01-01

    Background Aortocaval fistula (AV) in rat is a unique model of volume-overload congestive heart failure and cardiac hypertrophy. Living donor kidney transplantation is regarded as beneficial to allograft recipients and not particularly detrimental to the donors. Impact of AV on animals with mild renal dysfunction is not fully understood. In this study, we explored the effects of AV in unilateral nephrectomized (UNX) rats. Methods Adult male Sprague-Dawley (SD) rats were divided into Sham (n = 10), UNX (right kidney remove, n = 10), AV (AV established between the levels of renal arteries and iliac bifurcation, n = 18) and UNX+AV (AV at one week after UNX, n = 22), respectively. Renal outcome was measured by glomerular filtration rate, effective renal plasma flow, fractional excretion of sodium, albuminuria, plasma creatinine, and cystatin C. Focal glomerulosclerosis (FGS) incidence was evaluated by renal histology. Cardiac function was measured by echocardiography and hemodynamic measurements. Results UNX alone induced compensatory left kidney enlargement, increased plasma creatinine and cystatin C levels, and slightly reduced glomerular filtration rate and increased FGS. AV induced significant cardiac enlargement and hypertrophy and reduced cardiac function and increased FGS, these changes were aggravated in UNX+AV rats. Conclusions Although UNX only induces minor renal dysfunction, additional chronic volume overload placement during the adaptation phase of the remaining kidney is associated with aggravated cardiac dysfunction and remodeling in UNX rats, suggesting special medical care is required for UNX or congenital monokidney subjects in case of chronic volume overload as in the case of pregnancy and hyperthyroidism to prevent further adverse cardiorenal events in these individuals. PMID:26252578

  13. Unilateral Vogt-Koyanagi-Harada Disease: A Clinical Case Report

    PubMed Central

    Neves, Arminda; Cardoso, Ana; Almeida, Mariana; Campos, Joana; Campos, Antnio; Castro Sousa, Joo Paulo

    2015-01-01

    Purpose To report a case of a 20-year-old female with decreased visual acuity (VA) in the left eye (LE). Methods This is a retrospective and descriptive case report based on data from clinical records, patient observation and analysis of diagnostic tests. Results A 20-year-old female presented with decreased VA in the LE for 3 days. Best-corrected visual acuity (BCVA) was 20/20 in the right eye (RE) and 20/40 in the LE. Pupillary function, intraocular pressure, results of external segment examinations and slit-lamp biomicroscopy were normal, bilaterally. RE fundoscopy was normal, and in the LE it revealed papillitis and posterior pole exudative retinal detachment. Optical coherence tomography (OCT) confirmed the macular serous retinal detachment and showed thickening of the posterior choroid also revealed by orbital ultrasound and magnetic resonance imaging (MRI). Fluorescein angiography showed angiographic features typical of Vogt-Koyanagi-Harada (VKH) disease: disseminated spotted choroidal hyperfluorescence and choroidal multifocal hypofluorescence, multifocal profuse leakage in the retina with pooling, serous retinal detachment and optic disc hyperfluorescence. Serological testing for the diagnosis of infectious pathologies was negative, and the review of systems was normal. The patient received systemic steroids and cyclosporine. LE BCVA improved up to 20/20 at 18 months after the diagnosis, with complete reabsorption of subretinal fluid and normal retinal and choroidal thickness by OCT. Conclusion Despite the unilateral involvement, the clinical and angiographic features were typical of VKH disease, and ophthalmologists should be aware to recognize this rare clinical variant of the disease. PMID:26600790

  14. Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy.

    PubMed

    Batuecas-Caletrío, Angel; Yañez-Gonzalez, Raquel; Sanchez-Blanco, Carmen; Pérez, Pedro Blanco; González-Sanchez, Enrique; Sanchez, Luis Alberto Guardado; Kaski, Diego

    2015-11-01

    Acute unilateral vestibulopathy (AUV) is characterized by acute vertigo, nausea, and imbalance without neurological deficits or auditory symptomatology. Here, we explore the effect of glucocorticoid treatment on the degree of canal paresis in patients with AUV, and critically, establish its relationship with dizziness symptom recovery. We recruited consecutive patients who were retrospectively assigned to one of the two groups according to whether they received glucocorticoid treatment (n = 32) or not (n = 44). All patients underwent pure-tone audiometry, bithermal caloric testing, MRI brain imaging, and were asked to complete a dizziness handicap inventory on admission to hospital and just prior to hospital discharge. In the treatment group, the canal paresis at discharge was significantly lower than in the control group (mean ± SD % 38.04 ± 21.57 versus 82.79 ± 21.51, p < 0.001). We also observed a significant reduction in the intensity of nystagmus in patients receiving glucocorticoid treatment compared to the non-treatment group (p = 0.03). DHI test score was significantly lower at discharge in the treatment group (mean ± SD % 23.15 ± 12.40 versus 64.07 ± 12.87, p < 0.001), as was the length of hospital stay (2.18 ± 1.5 days versus 3.6 ± 1.7 days, p = 0.002). Glucocorticoid treatment leads to acute symptomatic improvement, with a reduced hospital stay and reduction in the intensity of acute nystagmus. Our findings suggest that glucocorticoids may accelerate vestibular compensation via a restoration of peripheral vestibular function, and therefore has important clinical implications for the treatment of AUV. PMID:26459091

  15. The Unilateral, Self-Deregulation of AT&T

    NASA Astrophysics Data System (ADS)

    Maloff, Joel H.

    1990-01-01

    The provision of telecommunications products and services in the United States has been dominated by AT&T and the Bell System for more than one hundred years. From the early days of telephones, it was clear that some framework of logic was required to provide "universal" telephone services to the vast majority of American citizens. The concept was known as "natural monopoly", and for the most part, has served us well. We are all aware of statements concerning absolute power corrupting absolutely, and AT&T has not been immune to this law of human nature. Several times during the past century, action has been required by the Federal Government to regulate and constrain AT&T and the Bell System from anti-competitive and predatory actions. These have been called consent decrees, Computer Inquiry II, Computer Inquiry III, and the Modified Final Judgment. The regulations and constraints imposed upon AT&T, with good reason, are now becoming eroded. The perception of a more highly competitive marketplace capable of accommodating an unrestrained AT&T, the impact of uncoordinated national and regional government policies, and unilateral actions by AT&T themselves are bringing us to the edge of an abyss. There are substantial reasons to believe that AT&T will use its considerable might to eliminate its competitors, once free to do so. Must we be doomed to repeat history with still another antitrust case against AT&T some years from now? Logic demands that we learn from the past, and that telecommunications policies be based upon that knowledge.

  16. Transstyloid, transscaphoid, transcapitate fracture: a variant of scaphocapitate fractures

    PubMed Central

    Burke, Neil G; Cosgrave, Ciaran H; O'Neill, Barry James; Kelly, Eamonn P

    2014-01-01

    Transstyloid, transscaphoid, transcapitate fractures are uncommon. We report the case of a 28-year-old man who sustained this fracture following direct trauma. The patient was successfully treated by open reduction internal fixation of the scaphoid and proximal capitate fragment, with a good clinical outcome at 1-year follow-up. This pattern is a new variant of scaphocapitate fracture as involves a fracture of the radial styloid as well. PMID:24686808

  17. [Bilateral pelvic stress fracture].

    PubMed

    Palenzuela Paniagua, S M; Maldonado Alconada, J; Prez Galn, R J

    2013-04-01

    A stress fracture is defined as that which occurs as a consequence of many low intensity traumas. These were originally described in the metatarsals of soldiers, and later on in athletes, and now we should consider them in general population subjected to excessive stress. Statistically, it generally occurs in women and in weight-bearing bones, such as the tibia, fibula and metatarsals. This case is of interest due to the diagnosis a double fracture in a woman without risk factors or increase in physical activity, and in an unusual location such as the pelvis. A detailed clinical history and examination are essential for the diagnosis. PMID:23540991

  18. Fractured Petroleum Reservoirs

    SciTech Connect

    Firoozabadi, Dr. Abbas

    2000-01-18

    In this report the results of experiments of water injection in fractured porous media comprising a number of water-wet matrix blocks are reported for the first time. The blocks experience an advancing fracture-water level (FWL). Immersion-type experiments are performed for comparison; the dominant recovery mechanism changed from co-current to counter-current imbibition when the boundary conditions changed from advancing FWL to immersion-type. Single block experiments of co-current and counter-current imbibition was performed and co-current imbibition leads to more efficient recovery was found.

  19. Pediatric Orbital Fractures

    PubMed Central

    Oppenheimer, Adam J.; Monson, Laura A.; Buchman, Steven R.

    2013-01-01

    It is wise to recall the dictum “children are not small adults” when managing pediatric orbital fractures. In a child, the craniofacial skeleton undergoes significant changes in size, shape, and proportion as it grows into maturity. Accordingly, the craniomaxillofacial surgeon must select an appropriate treatment strategy that considers both the nature of the injury and the child's stage of growth. The following review will discuss the management of pediatric orbital fractures, with an emphasis on clinically oriented anatomy and development. PMID:24436730

  20. Multiple mandibular fractures. Treatment outlines.

    PubMed

    Elia, Giovanni; Franco, Elena; Clauser, Luigi C

    2016-02-01

    Multiple mandibular comminuted fractures usually occur in high energy traumas. The authors describe the management and treatment of multiple mandibular fractures in a young patient after a suicide attempt. PMID:26862697

  1. Fracture surfaces of granular pastes.

    PubMed

    Mohamed Abdelhaye, Y O; Chaouche, M; Van Damme, H

    2013-11-01

    Granular pastes are dense dispersions of non-colloidal grains in a simple or a complex fluid. Typical examples are the coating, gluing or sealing mortars used in building applications. We study the cohesive rupture of thick mortar layers in a simple pulling test where the paste is initially confined between two flat surfaces. After hardening, the morphology of the fracture surfaces was investigated, using either the box counting method to analyze fracture profiles perpendicular to the mean fracture plane, or the slit-island method to analyze the islands obtained by cutting the fracture surfaces at different heights, parallel to the mean fracture plane. The fracture surfaces were shown to exhibit scaling properties over several decades. However, contrary to what has been observed in the brittle or ductile fracture of solid materials, the islands were shown to be mass fractals. This was related to the extensive plastic flow involved in the fracture process. PMID:24241751

  2. Fracture characterization of multilayered reservoirs

    SciTech Connect

    Britt, L.K.; Larsen, M.J.

    1986-01-01

    Fracture treatment optimization techniques have been developed using Long-Spaced-Digital-Sonic (LSDS) log, pumpin-flowback, mini-frac, and downhole treating pressure data. These analysis techniques have been successfully applied in massive hydraulic fracturing (MHF) of ''tight gas'' wells. Massive hydraulic fracture stimulations have been used to make many tight gas reservoirs commercially attractive. However, studies have shown that short highly conductive fractures are optimum for the successful stimulation of wells in moderate permeability reservoirs. As a result, the ability to design and place optimal fractures in these reservoirs is critical. This paper illustrates the application of fracture analysis techniques to a moderate permeability multi-layered reservoir. These techniques were used to identify large zonal variations in rock properties and pore pressure which result from the complex geology. The inclusion of geologic factors in fracture treatment design allowed the placement of short highly conductive fractures which were used to improve injectivity and vertical sweep, and therefore, ultimate recovery.

  3. Femur Shaft Fractures (Broken Thighbone)

    MedlinePLUS

    .org Femur Sha Fractures (Broken Thighbone) Page ( 1 ) Your thighbone (femur) is the longest and strongest bone in your body. Because the femur ... example, are the number one cause of femur fractures. The long, straight part of the femur is ...

  4. Ankle Fractures Often Not Diagnosed

    MedlinePLUS

    ... Videos & Podcasts » Articles » Text Size Print Bookmark Ankle Fractures Often Not Diagnosed Long-term Complications Result from Poor Recovery Mistaking an ankle fracture for an ankle sprain has serious consequences when ...

  5. Distal Radius Fracture (Broken Wrist)

    MedlinePLUS

    .org Distal Radius Fracture (Broken Wrist) Page ( 1 ) The radius is the larger of the two bones of the forearm. The end toward the wrist is called the distal end. A fracture of the distal radius occurs when the area ...

  6. Progressive Fracture of Composite Structures

    NASA Technical Reports Server (NTRS)

    Chamis, Christos C.; Minnetyan, Levon

    2008-01-01

    A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells and the built-up composite structure global fracture are enhanced when internal pressure is combined with shear loads.

  7. Scaphoid Fracture of the Wrist

    MedlinePLUS

    .org Scaphoid Fracture of the Wrist Page ( 1 ) The scaphoid is one of the small bones in the wrist. It is ... that the scaphoid is injured. Cause A scaphoid fracture is usually caused by a fall on an ...

  8. Unilateral Subthalamic Nucleus Stimulation Has a Measurable Ipsilateral Effect on Rigidity And Bradykinesia in Parkinson Disease

    PubMed Central

    Tabbal, Samer D.; Ushe, Mwiza; Mink, Jonathan W.; Revilla, Fredy J.; Wernle, Angie R.; Hong, Minna; Karimi, Morvarid; Perlmutter, Joel S.

    2008-01-01

    Background Bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor function in Parkinson disease (PD). However, little is known about the quantitative effects on motor behavior of unilateral STN DBS. Methods In 52 PD subjects with STN DBS, we quantified in a double-blinded manner rigidity (n= 42), bradykinesia (n= 38), and gait speed (n= 45). Subjects were tested in four DBS conditions: both on, left on, right on and both off. A force transducer was used to measure rigidity across the elbow, and gyroscopes were used to measure angular velocity of hand rotations for bradykinesia. About half of the subjects were rated using the Unified Parkinson Disease Rating Scale (part III) motor scores for arm rigidity and repetitive hand rotation simultaneously during the kinematic measurements. Subjects were timed walking 25 feet. Results All subjects had significant improvement with bilateral STN DBS. Contralateral, ipsilateral and bilateral stimulation significantly reduced rigidity and bradykinesia. Bilateral stimulation improved rigidity more than unilateral stimulation of either side, but there was no significant difference between ipsilateral and contralateral stimulation. Although bilateral stimulation also increased hand rotation velocity more than unilateral stimulation of either side, contralateral stimulation increased hand rotation significantly more than ipsilateral stimulation. All stimulation conditions improved walking time but bilateral stimulation provided the greatest improvement. Conclusions Unilateral STN DBS decreased rigidity and bradykinesia contralaterally as well ipsilaterally. As expected, bilateral DBS improved gait more than unilateral DBS. These findings suggest that unilateral STN DBS alters pathways that affect rigidity and bradykinesia bilaterally but do not support the clinical use of unilateral STN DBS since bilateral DBS clearly provides greater benefit. PMID:18329019

  9. Predictive Factors Affecting Long-Term Outcome of Unilateral Lateral Rectus Recession

    PubMed Central

    Yang, Hee Kyung; Kim, Mi-Jin; Hwang, Jeong-Min

    2015-01-01

    Background There are few long-term outcome reports of unilateral lateral rectus (LR) recession for exotropia including a large number of subjects. Previous reports on unilateral LR recession commonly show extremely low rates of initial overcorrection and large exodrifts after surgery suggesting that the surgical dose may be increased. However, little is known of the long-term outcome of a large unilateral LR recession for exotropia. Objectives To determine long-term outcomes and predictive factors of recurrence after a large unilateral LR recession in patients with exotropia. Data Extraction Retrospective analysis was performed on 92 patients aged 3 to 17 years who underwent 10 mm unilateral LR recession for exotropia of ≤ 25 prism diopters (Δ) with prism and alternate cover testing and were followed up for more than 2 years after surgery. Final success rates within 10Δ of exophoria/tropia and 5Δ of esophoria/tropia at distance in the primary position, improvement in stereopsis and the predictive factors for recurrence were evaluated. Results At 24 months after surgery, 54% of patients had ocular alignment meeting the defined criteria of success, 45% had recurrence and 1% had overcorrection. After a mean follow-up of 39 months, 36% showed success, 63% showed recurrence and 1% resulted in overcorrection. The average time of recurrence was 23.4±14.7 months (range, 1–60 months) and the rate of recurrence per person-year was 23% after unilateral LR recession. Predictive factors of recurrence were a larger preoperative near angle of deviation (>16Δ) and larger initial postoperative exodeviation (>5Δ) at distance. Conclusions Long-term outcome of unilateral LR recession for exotropia showed low success rates with high recurrence, thus should be reserved for patients with a small preoperative near angle of exodeviation. PMID:26418819

  10. Correlation of Hip Fracture with Other Fracture Types: Toward a Rational Composite Hip Fracture Endpoint

    PubMed Central

    Coln-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.

    2016-01-01

    Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123

  11. Statistics and thermodynamics of fracture

    NASA Technical Reports Server (NTRS)

    Chudnovsky, A.

    1984-01-01

    A probabilistic model of the fracture processes unifying the phenomenological study of long term strength of materials, fracture mechanics and statistical approaches to fracture is briefly outlined. The general framework of irreversible thermodynamics is employed to model the deterministic side of the failure phenomenon. The stochastic calculus is used to account for thg failure mechanisms controlled by chance; particularly, the random roughness of fracture surfaces.

  12. Managing the Pediatric Facial Fracture

    PubMed Central

    Cole, Patrick; Kaufman, Yoav; Hollier, Larry H.

    2009-01-01

    Facial fracture management is often complex and demanding, particularly within the pediatric population. Although facial fractures in this group are uncommon relative to their incidence in adult counterparts, a thorough understanding of issues relevant to pediatric facial fracture management is critical to optimal long-term success. Here, we discuss several issues germane to pediatric facial fractures and review significant factors in their evaluation, diagnosis, and management. PMID:22110800

  13. Temporomandibular joint ankylosis caused by condylar fractures: a retrospective analysis of cases at an urban teaching hospital in Nigeria.

    PubMed

    Anyanechi, C E

    2015-08-01

    Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. This study aimed to analyze cases of mandibular condylar fracture complicated by TMJ ankylosis after treatment. A 16-year retrospective analysis was performed at the dental and maxillofacial surgery clinic of the study institution; patient data were collected from the hospital records and entered into a pro-forma questionnaire. It was found that 56/3596 (1.6%) fractures resulted in TMJ ankylosis. The age of patients with ankylosis ranged from 12 to 47 years. The age (P=0.03) and gender (P=0.01) distributions were significant, with most cases of ankylosis occurring in those aged 11-30 years (n=43/56, 76.8%). Fractures complicated by ankylosis were intracapsular (n=22/56, 39.3%) and extracapsular (n=34/56, 60.7%). Ankylosis increased significantly with the increase in time lag between injury and fracture treatment (P=0.001). Ankylosis was associated with concomitant mandibular (85.7%) and middle third (66.1%) fractures. Treatment methods were not significantly related to ankylosis (P=0.32). All cases of ankylosis were unilateral, and complete (n=36, 64.3%) and incomplete ankylosis (n=20, 35.7%) were diagnosed clinically. The incorporation of computed tomography scans and rigid internal fixation in the management of condylar fractures will reduce ankylosis. PMID:26008733

  14. [Fracture of the tibial head].

    PubMed

    Petersen, W; Zantop, T; Raschke, M

    2006-03-01

    Fractures of the tibial head are severe injuries, characterized by enormous variety. Fractures can be classified into fractures of the tibial plateau, luxation fractures, and comminuted fractures. Due to the mechanism of injury luxation fractures are frequently associated with lesions of the menisci and intra- and extra-articular ligaments. Multiple factors can be etiologic for post-traumatic gonarthrosis: nonanatomic reduction of the joint surface, malalignment, and unaddressed associated injuries. Therefore in addition to diagnostic steps such as X-ray, CT scan, and MRI a sophisticated therapeutic regime is necessary. In cases with severely damaged soft tissue or unstable patients, the fracture should initially be reduced and fixed with an external fixator and the definite fixation should be performed in a second setting. Arthroscopically assisted treatment is reserved for fractures of the tibial eminence, crack fractures, and impression fractures. Comminuted and bilateral fractures can be addressed via different incisions. New locking plates with angular stability allow avoidance of bilateral plating in most situations. In specific cases such as compound fractures and for patients with low compliance, a hybrid fixator may be a well-chosen alternative. PMID:16523282

  15. Hydraulic fracturing propping agent

    SciTech Connect

    Lunghofer, E. P.

    1985-06-11

    A high strength propping agent for use in hydraulic fracturing of subterranean formations comprising solid, spherical particles having an alumina content of between 40 and 60%, a density of less than 3.0 gm/cc and an ambient temperature permeability of 100,000 or more millidarcies at 10,000 psi.

  16. Statistical Physics of Fracture

    SciTech Connect

    Alava, Mikko; Nukala, Phani K; Zapperi, Stefano

    2006-05-01

    Disorder and long-range interactions are two of the key components that make material failure an interesting playfield for the application of statistical mechanics. The cornerstone in this respect has been lattice models of the fracture in which a network of elastic beams, bonds, or electrical fuses with random failure thresholds are subject to an increasing external load. These models describe on a qualitative level the failure processes of real, brittle, or quasi-brittle materials. This has been particularly important in solving the classical engineering problems of material strength: the size dependence of maximum stress and its sample-to-sample statistical fluctuations. At the same time, lattice models pose many new fundamental questions in statistical physics, such as the relation between fracture and phase transitions. Experimental results point out to the existence of an intriguing crackling noise in the acoustic emission and of self-affine fractals in the crack surface morphology. Recent advances in computer power have enabled considerable progress in the understanding of such models. Among these partly still controversial issues, are the scaling and size-effects in material strength and accumulated damage, the statistics of avalanches or bursts of microfailures, and the morphology of the crack surface. Here we present an overview of the results obtained with lattice models for fracture, highlighting the relations with statistical physics theories and more conventional fracture mechanics approaches.

  17. Neglected hangman fracture.

    PubMed

    Srivastava, Sudhir Kumar; Aggarwal, Rishi Anil; Nemade, Pradip Sharad; Bhoale, Sunil Krishna

    2015-01-01

    Acute management of hangman fracture is well described; however the surgical management of neglected hangman fracture has not been described in literature. We report the surgical management of an untreated hangman's fracture. A 30-year-old male had fallen from a tree 12 weeks back. Patient presented with cervical myelopathy and restricted neck movements. Radiographs and computed tomography (CT) scan revealed fracture of pars interarticularis of axis with Grade III C2-C3 spondylolisthesis with localized kyphosis of 33. Gentle reduction under general anesthesia (GA) failed to improve the alignment. Patient was operated in three stages in a single setting. In Stage I, release of contracted anterior structures and C2-C3 discectomy was done in supine position followed by C2-C3 posterior fixation and fusion in Stage II. C2-C3 interbody bone grafting and anterior plating completed the third stage. C2-C3 interbody fusion was seen at 5 months and a CT scan at 18 months postoperative confirmed fusion and maintenance of alignment. The satisfactory outcome in our patient leads us to believe that anterior-posterior-anterior is the appropriate surgical approach for treatment of such patients. PMID:26692701

  18. Infiltration into Fractured Bedrock

    SciTech Connect

    Salve, Rohit; Ghezzehei, Teamrat A.; Jones, Robert

    2007-09-01

    One potential consequence of global climate change and rapid changes in land use is an increased risk of flooding. Proper understanding of floodwater infiltration thus becomes a crucial component of our preparedness to meet the environmental challenges of projected climate change. In this paper, we present the results of a long-term infiltration experiment performed on fractured ash flow tuff. Water was released from a 3 x 4 m{sup 2} infiltration plot (divided into 12 square subplots) with a head of {approx}0.04 m, over a period of {approx}800 days. This experiment revealed peculiar infiltration patterns not amenable to current infiltration models, which were originally developed for infiltration into soils over a short duration. In particular, we observed that in part of the infiltration plot, the infiltration rate abruptly increased a few weeks into the infiltration tests. We suggest that these anomalies result from increases in fracture permeability during infiltration, which may be caused by swelling of clay fillings and/or erosion of infill debris. Interaction of the infiltration water with subsurface natural cavities (lithophysal cavities) could also contribute to such anomalies. This paper provides a conceptual model that partly describes the observed infiltration patterns in fractured rock and highlights some of the pitfalls associated with direct extension of soil infiltration models to fractured rock over a long period.

  19. Fracturing products and additives

    SciTech Connect

    1996-08-01

    This paper provides a consumer guide for the various propping and fracturing fluids available to the oil and gas industry. Products are subdivided into groups that have similar function and performance within each functional category. Where applicable, performance groups have been subdivided to reflect significant differences in additive or proppant chemical nature to emphasize uniqueness in company product lines.

  20. Injection through fractures

    SciTech Connect

    Johns, R.A.

    1987-05-01

    Tracer tests are conducted in geothermal reservoirs as an aid in forecasting thermal breakthrough of reinjection water. To interpret tracer tests, mathematical models have been developed based on the various transport mechanisms in these highly fractured reservoirs. These tracer flow models have been applied to interpret field tests. The resulting matches between the model and field data were excellent and the model parameters were used to estimate reservoir properties. However, model fitting is an indirect process and the model's ability to estimate reservoir properties cannot be judged solely on the quality of the match between field data and model predictions. The model's accuracy in determining reservoir characteristics must be independently verified in a closely controlled environment. In this study, the closely controlled laboratory environment was chosen to test the validity and accuracy of tracer flow models developed specifically for flow in fractured rocks. The laboratory tracer tests were performed by flowing potassium iodide (KI) through artificially fractured core samples. The tracer test results were then analyzed with several models to determine which best fit the measured data. A Matrix Diffusion model was found to provide the best match of the tracer experiments. The core properties, as estimated by the Matrix Diffusion model parameters generated from the indirect matching process, were then determined. These calculated core parameters were compared to the measured core properties and were found to be in agreement. This verifies the use of the Matrix Diffusion flow model in estimating fracture widths from tracer tests.

  1. Proximal femural fractures: epidemiology

    PubMed Central

    Innocenti, Massimo; Civinini, Roberto; Carulli, Christian; Matassi, Fabrizio

    2009-01-01

    The Authors report briefly about epidemiology and prognosis of proximal femoral fractures in elderly people worldwide. Focusing particurarly on Italian population, the Authors report on the impact that this pathologic phenomenon has on the quality of life of patients and on general population, also from a social and economical point of view. A concise overview of the options treatment is also presented. PMID:22461159

  2. Fragility fractures requiring special consideration: pelvic insufficiency fractures.

    PubMed

    Humphrey, Catherine A; Maceroli, Michael A

    2014-05-01

    Fractures of the pelvis and acetabulum in osteoporotic bone represent an important subset of fragility fractures. Pelvic fractures in the elderly patient carry a significant 1-year mortality risk, comparable to that of hip fractures. Patients often lose their ability to function independently in the community. In this group, treatment of their bone density is essential to reducing their risk of further fractures. A thorough discussion of the likely course of recovery, the prolonged need for pain medications, and the risks and benefits of intervention can help patients and their families cope with the disability. PMID:24721375

  3. Resident Rounds: Part III - Case Report: A Non-Syndromic Case of Multiple Unilateral Nodular and Pigmented Basal Cell Carcinomas.

    PubMed

    Weiss, Jonathan; Van Driessche, Freya; Wei, Erin X; Shabbir, Arsalan

    2015-06-01

    Although basal cell carcinomas (BCC) are relatively common, particularly in older individuals, the development of multiple BCCs at a young age can indicate an associated genetic disorder. Several cases of unilateral or segmental BCCs have been described in the literature. Some cases have demonstrated concomitant syndromic findings while others had unilateral BCCs as the only finding. Herein we present a non-syndromic case of multiple unilateral nodular and pigmented BCCs in a 61-year-old Hispanic man. PMID:26292374

  4. Emotional processing and its impact on unilateral neglect and extinction.

    PubMed

    Domnguez-Borrs, Judith; Saj, Arnaud; Armony, Jorge L; Vuilleumier, Patrik

    2012-05-01

    Unilateral spatial neglect is a neurological disorder characterized by impaired orienting of attention to stimuli located in the contralesional space, typically following right-hemisphere damage. Neuropsychological investigations in the past two decades have demonstrated that neglect is caused by deficits affecting a widespread cortico-subcortical fronto-parietal network controlling spatial attention, but usually sparing early sensory pathways. As a consequence, certain residual abilities in sensory processing remain intact and still take place for stimuli in the neglected space, such as the extraction and organization of coherent or meaningful object features. Moreover, these residual abilities can alleviate inattention symptoms when contralesional stimuli are perceptually or biologically salient. Here we review recent studies suggesting that the emotional content of stimuli may also be processed despite impaired attention towards contralesional space, and that such processing may act to enhance attention and partly reduce neglect for these stimuli, relative to similar but emotionally neutral stimuli. For example, faces with emotional expressions, voices with emotional prosody, as well as pictures of scenes or even spiders have been found to be less severely extinguished from awareness in conditions of bilateral stimulations, and/or lead to fewer omissions in search tasks with multiple distracters. Gaze cues and reward learning might also produce similar effects. Altogether, these findings suggest that emotionally significant information is not only extracted from stimuli at neglected locations through spared pathways, but can also induce emotional biases in attention that partly counteract the abnormal spatial biases caused by fronto-parietal damage. We discuss results from neuropsychology and neuroimaging research suggesting that specific mechanisms for emotional attention might exist, centered on the amygdala and other limbic regions, and that these mechanisms can operate partly independent from other circuits controlling spatial and object-based attention. Although we are only beginning to understand these interactive effects of emotion and attention and to identify their neuroanatomical substrates, we believe that a deeper knowledge of such mechanisms and their conditions of optimal operation will help develop or improve therapeutic strategies in neglect patients. PMID:22406694

  5. Executive functioning in children with unilateral cerebral palsy: protocol for a cross-sectional study

    PubMed Central

    Bodimeade, Harriet L; Whittingham, Koa; Lloyd, Owen; Boyd, Roslyn N

    2013-01-01

    Introduction Early brain injury, as found in children with unilateral cerebral palsy (CP), may cause deficits in higher-order cognitive tasks known as executive functions (EF). EF has been conceptualised as comprised of four distinct yet inter-related components: (1) attentional control, (2) cognitive flexibility, (3) goal setting and (4) information processing. The aim of this study was to examine EF in children with unilateral CP and compare their performance with a typically developing reference group (TDC). The potential laterality effects of unilateral CP on EF will be explored, as will the relationship between the cognitive measures of EF, behavioural manifestations of EF, psychological functioning and clinical features of unilateral CP. Methods and analysis This cross-sectional study aims to recruit a total of 42 children with unilateral CP (21 right unilateral CP and 21 left unilateral CP) and 21 TDC aged between 8 and 16?years. Clinical severity will be described for gross motor function and manual ability. Outcomes for cognitive EF measureswill include subtests from the Wechsler Intelligence Scale for ChildrenFourth Edition, Delis-Kaplan Executive Function System, Rey Complex Figure Test and the Test of Everyday Attention for Children. Behavioural manifestations of EF will be assessed using the Behaviour Rating Inventory of Executive Function, Parent and Teacher versions. Psychological functioning will be examined using the Strengths and Difficulties Questionnaire. Between-groups differences will be examined in a series of one-way analyses of covariance and followed up using linear comparisons. An overall composite of cognitive EF measures will be created. Bivariate correlations between the EF composite and psychological measures will be calculated. Ethics and dissemination This protocol describes a study that, to our knowledge, is the first to examine multiple components of EF using a cohort of children with unilateral CP. Exploration of potential laterality effects of EF among children with a congenital, unilateral brain injury is also novel. Possible relationships between EF and psychological functioning will also be investigated. Ethics have been obtained through the University of Queensland School of Psychology Ethics Committee and the Queensland Children's Health Services Human Research Ethics Committee. Results will be disseminated in peer reviewed publications and presentations at national and international conferences. This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611000263998). PMID:23558736

  6. [The open femoral fracture in war--173 external fixators applied to the femur (Afghanistan war)].

    PubMed

    Oberli, H; Frick, T

    1992-03-01

    During the three years 1988 through 1990, more than 700 external skeletal fixations (AO/ASIF Tubular System) were utilized at the ICRC Hospital for Afghan War Wounded in Peshawar, Pakistan, 173 of which were for femoral fractures. 13% of the fractures were open grade II, and 71% open grade III, mostly due to high velocity gunshot or shrapnel injuries. Usually, the external fixator was left in place until consolidation of the fracture. The average time of external fixation was 128 days. Three major groups of complications have been observed: fracture complications, implant complications, and residual loss of function of the knee joint, probably the most significant permanent complication to the patient. In order to improve the functional results in treating open fractures of the femur, three measures are recommended: unilateral frame with posterolateral insertion of Schanz screws, postoperative positioning of the patient with 90 degrees of flexion of hip and knee joints and mobilization of the patient as soon as possible (on the first or second postoperative day). PMID:1592638

  7. Bite Force Measurement in Mandibular Parasymphyseal Fractures: A Preliminary Clinical Study

    PubMed Central

    Kshirsagar, Rajesh; Jaggi, Nitin; Halli, Rajshekhar

    2011-01-01

    We measured the amount of bite force generated by patients treated for parasymphyseal fractures of the mandible by open reduction and internal fixation at various predetermined time intervals. Sixty volunteers ranging from 18 to 60 years old were selected as the control group. All measurements were made on a bite force measurement device with the head in an upright position and in an unsupported natural position. Bite forces were measured at the incisor and right and left molar regions. These bite forces were compared with six patients with isolated mandibular unilateral parasymphyseal fractures. All patients were operated using open reduction and internal fixation using two miniplates at the fracture site. In the volunteer group, bite forces ranged from 22 to 50 kg in the molar region and 3 to 27 kg in the incisor region. Mean adult healthy values (male and female) in the molar region were 36 kg and in the incisor region, 15 kg. In mandibular parasymphyseal fractures, incisor bite forces were reduced significantly when compared with the control group in the first 2 postoperative weeks and regained significantly thereafter till 4 to 6 weeks. Bite forces in the molar region took ~6 to 12 weeks to regain maximum bite forces when compared with the volunteer group. Restoration of functional bite forces was evident by 6 to 8 weeks. However, the restoration of maximum bite forces may require up to 12 weeks in parasymphyseal fractures. PMID:23205177

  8. Unilateral Outer Bow Expanded Cervical Headgear Force System: 3D Analysis Using Finite Element Method

    PubMed Central

    Mortezai, Omid; Esmaily, Masomeh; Darvishpour, Hojat

    2015-01-01

    Objectives: Headgears are among the effective orthodontic appliances to achieve treatment goals. Unilateral molar distal movement is sometimes needed during an orthodontic treatment, which can be achieved by an asymmetric headgear. Different unilateral headgears have been introduced. The main goal of this study was to analyze the force system of unilateral expanded outer bow asymmetric headgears by the finite element method (FEM). Materials and Methods: Six 3D finite element models of a mesiodistal slice of the maxilla containing upper first molars, their periodontal ligaments (PDLs), cancellous bone, cortical bone, and a cervical headgear with expanded outer bow attached to maxillary first molars were designed in SolidWorks 2010 and meshed in ANSYS Workbench ver. 12.1. The models were the same except for the degree of outer bow expansion. The outer bow ends were loaded with 2 N force. The distal driving force and the net moment were evaluated. Results: A decrease in the distalizing force in the normal side molar from 1.69 N to 1.37 N was shown by increasing the degree of unilateral expansion. At the same time, the force increased from 2.19 N to 2.49 N in the expanded side molar. A net moment increasing from 2.26 N.mm to 4.64 N.mm was also shown. Conclusion: Unilateral outer bow expansion can produce different distalizing forces in molars, which increase by increasing the expansion. PMID:26622282

  9. [Unilateral acute pulmonary edema and ischemic myocardial process: a case report].

    PubMed

    Bentaleb, A; Tagu, P; Vascaut, L

    2008-08-01

    Unilateral acute pulmonary oedema (APO) is a rare radioclinical finding. It occurs secondary to multiple specific and rare pathological processes. Functional ischemic mitral regurgitation (FIMR) secondary to myocardial necrosis is one of the rare aetiologies involved in its pathogenesis. This concerns a 94-year-old male patient with a history of myocardial infarction who presented with a clinical picture of unilateral APO secondary to functional mitral regurgitation as a complication of myocardial necrosis. In addition to the clinical presentation and unilateral radiological findings, the diagnosis was based essentially on the electrocardiographic tracing, as well as changes in cardiac enzyme levels and transthoracic echocardiogram coupled with Doppler tissue imaging. This resulted after ruling out many differential diagnoses. Unilateral APO secondary to functional mitral regurgitation often presents diagnostic challenges and problems of initial management for the clinician. There are multiple aetiologies of acute unilateral pulmonary oedema, namely mechanical (re-expansion), lesional, vascular, bronchial obstructions, as well as iatrogenic causes, as is the case with some lung transplantations. As with all cases of APO, the treatment is based mainly on diuretics with high-flow oxygen therapy in association with an anticoagulant, which is usually effectively combined with a platelet aggregation inhibiting drug and sometimes with vasodilators and beta-blockers. Surgical treatment with valvuloplasty or valvular replacement appears to be the most effective means for preventing relapse. PMID:19019285

  10. Unilateral versus bilateral endoscopic biliary stenting for malignant hilar biliary strictures.

    PubMed

    Yasuda, Ichiro; Mukai, Tsuyoshi; Moriwaki, Hisataka

    2013-05-01

    The present review compared unilateral versus bilateral stenting in order to determine the optimal stenting strategy for malignant hilar biliary strictures based on the previous literature. The role of preoperative biliary drainage prior to liver resection for hilar cholangiocarcinoma remains under discussion. However, in Japan, endoscopic placement of single nasobiliary drainage in the future remnant hepatic lobe is currently considered the most suitable method. In most unresectable cases, unilateral stenting appears to be adequate for ameliorating jaundice. It is technically easier and less expensive than bilateral stenting, with reintervention for stent dysfunction also being considerably easier. However, contrast medium injection into undrained bile ducts is associated with uncontrolled cholangitis and poor prognosis. To prevent this complication, bilateral stenting may be preferred to unilateral stenting. Additionally, previous studies have demonstrated bilateral stenting to be associated with longer stent patency as compared to unilateral stenting. We consider that further large-scale studies are required to clarify whether unilateral or bilateral stenting is a better therapeutic technique for malignant hilar biliary stricture. PMID:23617655

  11. Midterm outcome after unilateral approach for bilateral decompression of lumbar spinal stenosis: 5-year prospective study

    PubMed Central

    Kaya, Ramazan Alper; Trkmenoglu, Osman Nuri; Tuncer, Cengiz; olak, ?brahim; Ayd?n, Yunus

    2007-01-01

    The aim of our study is to evaluate the results and effectiveness of bilateral decompression via a unilateral approach in the treatment of degenerative lumbar spinal stenosis. We have conducted a prospective study to compare the midterm outcome of unilateral laminotomy with unilateral laminectomy. One hundred patients with 269 levels of lumbar stenosis without instability were randomized to two treatment groups: unilateral laminectomy (Group 1), and laminotomy (Group 2). Clinical outcomes were assessed with the Oswestry Disability Index (ODI) and Short Form36 Health Survey (SF-36). Spinal canal size was measured pre- and postoperatively. The spinal canal was increased to 46.1-fold (mean 5.1SD 0.8-fold) the preoperative size in Group 1, and 3.35.9-fold (mean 4.7SD 1.1-fold) the preoperative size in Group 2. The mean follow-up time was 5.4years (range 47 years). The ODI scores decreased significantly in both early and late follow-up evaluations and the SF-36 scores demonstrated significant improvement in late follow-up results in our series. Analysis of clinical outcome showed no statistical differences between two groups. For degenerative lumbar spinal stenosis unilateral approaches allowed sufficient and safe decompression of the neural structures and adequate preservation of vertebral stability, resulted in a highly significant reduction of symptoms and disability, and improved health-related quality of life. PMID:17712577

  12. Phalangeal fractures: displaced/nondisplaced.

    PubMed

    Gaston, R Glenn; Chadderdon, Christopher

    2012-08-01

    Nonsurgical management is the preferred treatment of stable, extra-articular fractures of the proximal and middle phalanx, most distal phalanx fractures, and, rarely, nondisplaced intraarticular fractures in elite athletes. Techniques that afford maximal strength with minimal dissection, thus allowing earlier return to play, are ideal. Open reduction with internal fixation with plate fixation is most often chosen for unstable phalangeal shaft fractures in high-demand athletes to provide rigid internal fixation and allow immediate range of motion and more rapid return to sport. It is our practice to routinely treat unicondylar fractures with surgery with percutaneous headless compression screws in elite athletes. PMID:22883890

  13. [Fracture of the tibial head].

    PubMed

    Raschke, M; Zantop, T; Petersen, W

    2007-12-01

    Fractures of the tibial head are marked by huge variety. They can be classified into fractures of the tibial plateau, luxation fractures, and comminuted fractures. Luxation fractures are commonly associated with lesions of the menisci and intra- and extra-articular ligaments. Several factors may be responsible for the development of post-traumatic OA: anatomically nonreduced joint surface, malalignment, and unaddressed associated injuries. Therefore a sophisticated therapeutic regime is necessary. In case of severely damaged soft tissue or unstable patients, the fracture should first be reduced and fixed with an external fixateur and the osteosynthesis should be performed in a second setting. Arthroscopically assisted reduction and osteosynthesis are indicated for fractures of the tibial eminence, crack fractures, and impression fractures. Comminuted fractures can be addressed via several different incisions. Due to locking plates, the bilateral use of large plates can be avoided. In specific cases such as compound fractures and for patients with low compliance, hybrid fixateurs may be an alternative. PMID:18026913

  14. Biomechanical Concepts for Fracture Fixation.

    PubMed

    Bottlang, Michael; Schemitsch, Christine E; Nauth, Aaron; Routt, Milton; Egol, Kenneth A; Cook, Gillian E; Schemitsch, Emil H

    2015-12-01

    Application of the correct fixation construct is critical for fracture healing and long-term stability; however, it is a complex issue with numerous significant factors. This review describes a number of common fracture types and evaluates their currently available fracture fixation constructs. In the setting of complex elbow instability, stable fixation or radial head replacement with an appropriately sized implant in conjunction with ligamentous repair is required to restore stability. For unstable sacral fractures with vertical or multiplanar instabilities, "standard" iliosacral screw fixation is not sufficient. Periprosthetic femur fractures, in particular Vancouver B1 fractures, have increased stability when using 90/90 fixation versus a single locking plate. Far cortical locking combines the concept of dynamization with locked plating to achieve superior healing of a distal femur fracture. Finally, there is no ideal construct for syndesmotic fracture stabilization; however, these fractures should be fixed using a device that allows for sufficient motion in the syndesmosis. In general, orthopaedic surgeons should select a fracture fixation construct that restores stability and promotes healing at the fracture site, while reducing the potential for fixation failure. PMID:26584263

  15. Linear elastic fracture mechanics primer

    NASA Technical Reports Server (NTRS)

    Wilson, Christopher D.

    1992-01-01

    This primer is intended to remove the blackbox perception of fracture mechanics computer software by structural engineers. The fundamental concepts of linear elastic fracture mechanics are presented with emphasis on the practical application of fracture mechanics to real problems. Numerous rules of thumb are provided. Recommended texts for additional reading, and a discussion of the significance of fracture mechanics in structural design are given. Griffith's criterion for crack extension, Irwin's elastic stress field near the crack tip, and the influence of small-scale plasticity are discussed. Common stress intensities factor solutions and methods for determining them are included. Fracture toughness and subcritical crack growth are discussed. The application of fracture mechanics to damage tolerance and fracture control is discussed. Several example problems and a practice set of problems are given.

  16. Vascular calcification and fracture risk.

    PubMed

    Szulc, Pawel

    2015-01-01

    Osteoporosis and cardiovascular diseases are public health problems. Fragility fractures are associated with high risk of cardiovascular event and patients with cardiovascular diseases have higher risk of fracture. Severe abdominal aortic calcification (AAC) is associated with higher cardiovascular mortality and morbidity. Severe AAC is associated with higher risk of fracture. In cross-sectional studies severe AAC was associated with greater prevalence, higher number and greater severity of vertebral fractures after adjustment for confounders including bone mineral density (BMD). Prospective studies confirm the association between baseline AAC severity and prospectively assessed fracture risk in both sexes. Data on the link between AAC and BMD are discordant. Age, smoking, hypertension, diabetes mellitus, and low grade systemic inflammation are possible risk factors of severe AAC and fracture risk. However, in clinical studies, the link between AAC and fracture was significant after adjustment for these factors. Data on the association between calcification in other vascular beds and BMD are limited and discordant. PMID:26604939

  17. Vascular calcification and fracture risk

    PubMed Central

    Szulc, Pawel

    2015-01-01

    Summary Osteoporosis and cardiovascular diseases are public health problems. Fragility fractures are associated with high risk of cardiovascular event and patients with cardiovascular diseases have higher risk of fracture. Severe abdominal aortic calcification (AAC) is associated with higher cardiovascular mortality and morbidity. Severe AAC is associated with higher risk of fracture. In cross-sectional studies severe AAC was associated with greater prevalence, higher number and greater severity of vertebral fractures after adjustment for confounders including bone mineral density (BMD). Prospective studies confirm the association between baseline AAC severity and prospectively assessed fracture risk in both sexes. Data on the link between AAC and BMD are discordant. Age, smoking, hypertension, diabetes mellitus, and low grade systemic inflammation are possible risk factors of severe AAC and fracture risk. However, in clinical studies, the link between AAC and fracture was significant after adjustment for these factors. Data on the association between calcification in other vascular beds and BMD are limited and discordant. PMID:26604939

  18. Fracture mechanics validity limits

    NASA Technical Reports Server (NTRS)

    Lambert, Dennis M.; Ernst, Hugo A.

    1994-01-01

    Fracture behavior is characteristics of a dramatic loss of strength compared to elastic deformation behavior. Fracture parameters have been developed and exhibit a range within which each is valid for predicting growth. Each is limited by the assumptions made in its development: all are defined within a specific context. For example, the stress intensity parameters, K, and the crack driving force, G, are derived using an assumption of linear elasticity. To use K or G, the zone of plasticity must be small as compared to the physical dimensions of the object being loaded. This insures an elastic response, and in this context, K and G will work well. Rice's J-integral has been used beyond the limits imposed on K and G. J requires an assumption of nonlinear elasticity, which is not characteristic of real material behavior, but is thought to be a reasonable approximation if unloading is kept to a minimum. As well, the constraint cannot change dramatically (typically, the crack extension is limited to ten-percent of the initial remaining ligament length). Rice, et al investigated the properties required of J-type parameters, J(sub x), and showed that the time rate, dJ(sub x)/dt, must not be a function of the crack extension rate, da/dt. Ernst devised the modified-J parameter, J(sub M), that meets this criterion. J(sub M) correlates fracture data to much higher crack growth than does J. Ultimately, a limit of the validity of J(sub M) is anticipated, and this has been estimated to be at a crack extension of about 40-percent of the initial remaining ligament length. None of the various parameters can be expected to describe fracture in an environment of gross plasticity, in which case the process is better described by deformation parameters, e.g., stress and strain. In the current study, various schemes to identify the onset of the plasticity-dominated behavior, i.e., the end of fracture mechanics validity, are presented. Each validity limit parameter is developed in detail, and then data is presented and the various schemes for establishing a limit of the validity are compared. The selected limiting parameter is applied to a set of fracture data showing the improvement of correlation gained.

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

    PubMed Central

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

    2015-01-01

    Background: Functional brace application for isolated humeral shaft fracture persistently yields good results. Nonunion though uncommon involves usually the proximal third shaft fractures. Instead of polyethylene bivalve functional brace four plaster sleeves wrapped and molded with little more proximal extension expected to prevent nonunion of proximal third fractures. Periodic compressibility of the cast is likely to yield a better result. This can be applied on the 1st day of the presentation as an outpatient basis. Comprehensive objective scoring system befitting for fracture humeral shaft is a need. Materials and Methods: Sixty six (male = 40, female = 26) unilateral humeral shaft fractures of mean age 34.4 years (range 1175 years) involving 38 left and 28 right hands were included in this study during April 2008 to December 2012. Fractures involved proximal (n = 18), mid (n = 35) and distal (n = 13) of humerus. Transverse, oblique, comminuted and spiral orientations in 18, 35 and 13 patients respectively. One had segmental fracture and three had a pathological fracture with cystic bone lesion. Mechanisms of injuries as identified in this study were road traffic accidents 57.6% (n = 38), fall 37.9% (n = 25). 12.1% (n = 8) had radial nerve palsy 7.6% (n = 5) had Type I open fracture. Four plaster strips of 12 layers and 57.5 cm broad depending on the girth of arm were prepared. Arm was then wrapped with single layer compressed cotton. Lateral and medial strips were applied and then after molding anterior and posterior strips were applied in such a way that permits full elbow range of motion and partial abduction of the shoulder. Care was taken to prevent adherence of one strip with other except in the proximal end. Limb was then put in loose collar and cuff sling intermittently allowing active motion of the elbow ROM and pendular movement of the shoulder. Weekly tightening of the cast by fresh layers of bandage over the existing cast brace continued. Results: The results were assessed using 100 point scoring system where union allotted 30 points and 60 points allotted for angulations (10), elbow motion (10), shoulder abduction (10), shortening (5), rotation (5), absence of infection (10), absence of nerve palsy during treatment (10). Remaining 10 points were allotted for five items with two points each. They were the absence of skin sore, absence of vascular problem, absence of reflex sympathetic dystrophy (RSD), recovery of paralyzed nerve during injury and recovery of paralyzed nerve during treatment. Results were considered excellent with 90 and above, good with 8089, fair with 7079 and poor below 70 point. Results at 6 months were excellent in 43.94% (n = 29), good in 42.42% (n = 28), fair in 9.1% (n = 6), poor in 4.55% (n = 3). Union took place in 98.48% (n = 65) with an average of 10.3 weeks (range 616 weeks). 87.5% (n = 7) paralyzed radial nerve recovered. All wounds healed. Four patients had transient skin problem. One patient with mid shaft fracture had nonunion due to the muscle interposition. Conclusion: Modified functional cast brace is one of the options in treatment for humeral shaft fractures as it can be applied on the 1st day of the presentation in most of the situations. Simple objective scoring system was useful particularly in uneducated patients. PMID:26229161

  20. Coracoid fractures in wild birds: a comparison of surgical repair versus conservative treatment.

    PubMed

    Scheelings, T Franciscus

    2014-12-01

    Medical records of wild bird admissions to the Australian Wildlife Health Centre at Healesville Sanctuary were analyzed for cases of unilateral coracoid fractures with known final outcomes. Forty-seven birds, comprising 13 species, fit these criteria. Of those birds, 18 were treated conservatively with analgesia and cage rest without coaptation bandaging, and 29 were treated with surgical correction of the fracture. Of the conservatively managed birds, 89% (16 of 18) were released back into the wild. Conversely, 34% (10 of 29) of the surgically managed birds were released. Treatment success for release differed significantly between treatment groups (P < .001). Intraoperative death from concurrent trauma was the major reason that surgically treated birds were not released. Given the high risks associated with surgical treatment and the high success rate of conservative management, cage rest without surgery appears prudent when managing coracoid injuries in birds. PMID:25843468

  1. Treatment of unilateral posterior crossbite with facial asymmetry in a female patient with transverse discrepancy.

    PubMed

    Jung, Seok-Ki; Kim, Tae-Woo

    2015-07-01

    A unilateral posterior crossbite with facial asymmetry is difficult to correct with orthodontic treatment alone. This case report describes the orthodontic treatment and additional plasty without orthognathic surgery for a 19-year-old woman with a transverse discrepancy. The posterior crossbite was resolved by expansion of the narrow maxillary arch and space closure in the mandibular arch. This accelerated the correction of the functional shift of the mandible. After resolution of the unilateral posterior crossbite, the problems of the anteroposterior molar relationship were treated using orthodontic mini-implants. Mandibular angle reduction plasty was performed for the asymmetric mandibular border to improve the facial appearance. After treatment, the patient had a more symmetrical facial appearance, normal overjet and overbite, and midline coincidence. The treatment results remained stable 1 year after treatment. This case report demonstrates that a minimally invasive treatment can successfully correct a unilateral posterior crossbite with a transverse discrepancy. PMID:26124038

  2. Treatment of holocord spinal epidural abscess via alternating side unilateral approach for bilateral laminectomy.

    PubMed

    Hwang, Roy; Yung, Brian H; Sedney, Cara; Miele, Vincent J

    2015-01-01

    To date, this is the first reported case of the surgical management of a holocord epidural abscess done through level-skipping laminectomies. It is also the first reported case of these laminectomies being performed via an alternating side unilateral approach for this condition. A 51-year-old patient presenting with progressive lower extremity weakness secondary to a spinal epidural abscess extending from C4 to S1. A minimally disruptive method of relieving the spinal cord compression via evacuation of the abscess was employed successfully. This report demonstrates the efficacy of level skipping laminectomies via a unilateral approach for holocord epidural abscesses (extending 20 vertebral levels). Performing the laminectomies via a unilateral approach as well as alternating the side of the approach minimized iatrogenic instability risk. Both strategies were designed to minimize incision size, tissue disruption, and the amount of muscular weakness/imbalance postoperatively. PMID:26050292

  3. Hyperventilation-induced nystagmus in vestibular schwannoma and unilateral sensorineural hearing loss.

    PubMed

    Mandalà, Marco; Giannuzzi, Annalisa; Astore, Serena; Trabalzini, Franco; Nuti, Daniele

    2013-07-01

    We evaluated the incidence and characteristics of hyperventilation-induced nystagmus (HVN) in 49 patients with gadolinium-enhanced magnetic resonance imaging evidence of vestibular schwannoma and 53 patients with idiopathic unilateral sensorineural hearing loss and normal radiological findings. The sensitivity and specificity of the hyperventilation test were compared with other audio-vestibular diagnostic tests (bedside examination of eye movements, caloric test, auditory brainstem responses) in the two groups of patients. The hyperventilation test scored the highest diagnostic efficiency (sensitivity 65.3 %; specificity 98.1 %) of the four tests in the differential diagnosis of vestibular schwannoma and idiopathic unilateral sensorineural hearing loss. Small tumors with a normal caloric response or caloric paresis were associated with ipsilateral HVN and larger tumors and severe caloric deficits with contralateral HVN. These results confirm that the hyperventilation test is a useful diagnostic test for predicting vestibular schwannoma in patients with unilateral sensorineural hearing loss. PMID:23108420

  4. Unilateral lower extremity swelling as a rare presentation of non-Hodgkin's lymphoma

    PubMed Central

    Elgendy, Islam Y; Lo, Margaret C

    2014-01-01

    Lower extremity oedema is frequently encountered in clinical practice. The challenge is to correctly identify the aetiology of oedema, and hence correctly manage the cause. Oedema can be classified as venous oedema and lymphoedema. Lymphoedema of the lower extremities is usually bilateral. Unilateral leg lymphoedema may occur secondary to radiation, surgery, compression by a tumour or early filariasis infection. Unilateral lower extremity lymphoedema has been reported as a rare initial presentation for lymphoma, mostly in women, usually without B-symptoms, and often with inguinal lymphadenopathies or abdominal masses. In this paper, we report a rare case of unilateral lower extremity oedema in a healthy male presenting to the outpatient clinic following trauma; further work-up revealed non-Hodgkin's lymphoma with bulky inguinal lymphadenopathy compressing the iliac veins. PMID:24431414

  5. Cardiogenic unilateral pulmonary edema: an unreported complication of a digestive endoscopic procedure.

    PubMed

    Baldessari, Enrique M; Mendez-Villarroel, Andres; Maurio, Eduardo; Nachman, Fabio D; Veltri, Ignacio A

    2009-01-01

    Unilateral pulmonary edema is an uncommon clinical situation that may be difficult to distinguish from other conditions that cause lung infiltrates. Most cases occur in the right lung, and there are no reports about cardiogenic unilateral pulmonary edema as a complication of an endoscopic procedure of gastrointestinal tract. The authors describe a case of a 79-year-old woman with acute cardiac heart failure that developed soon after a diagnostic upper and lower digestive endoscopy. Continuous positive airway pressure, intravenous nitroglycerin, and furosemide treatment resulted in rapid improvement of symptoms and the progressive resolution of left-sided infiltrates on chest radiography. This case is of particular importance because of the rarity of cardiogenic unilateral edema in the left lung. This clinical finding was associated with the prolonged rest on the left side during the gastrointestinal endoscopic procedure. PMID:19751430

  6. Ventilation-perfusion scan in the acutely ill patient with unilateral hyperlucent lung

    SciTech Connect

    Miller, M.B.; Caride, V.J.

    1988-01-01

    A patient with a unilateral hyperlucent lung with acute respiratory complaints is presented. A ventilation-perfusion scan was performed to rule out pulmonary embolism. The perfusion scan ( (/sup 99m/TC)MAA) showed peripheral perfusion defects in the hyperlucent lung. The ventilation study (/sup 133/Xe) demonstrated peripheral ventilatory defects on the single breath image in the hyperlucent lung, the filling in of these on the equilibrium view, and diffusely delayed washout in the affected lung. These findings were suggestive of the Swyer-James syndrome and critical in excluding the numerous other causes of unilateral hyperlucent lung, which are discussed. The importance of the ventilation-perfusion study (and particularly the ventilation scan) in the patient with unilateral hyperlucent lung and acute respiratory symptoms is stressed. In addition, a discussion of the Swyer-James syndrome is included.

  7. HUMERAL SHAFT FRACTURES

    PubMed Central

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

    2015-01-01

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

  8. Computational fracture mechanics

    NASA Technical Reports Server (NTRS)

    Rice, J. R.; Tracey, D. M.

    1973-01-01

    Numerical procedures for accurate determination of elastic stress intensity factors for the general two-dimensional crack problem are reviewed. The elastic perfectly plastic state of crack tip deformation is studied by a finite element procedure. Elastic-plastic fields in the immediate vicinity of a crack tip are determined numerically by finite element procedures based on asymptotic studies of crack tip singularities in plastic materials. The small-scale yielding problem is modeled, and expressions for crack tip opening displacement, shear singularity amplitude, and plastic zone extent are derived. A finite element solution to the large-scale yielding of a circumferentially cracked round tension bar is obtained. The three-dimensional aspects of flawed structures and numerical methods of treating them are studied. Ductile fracture mechanisms, in particular crack tip fracture on the microscale, are discussed.

  9. Unilateral pediatric "do not attempt resuscitation" orders: the pros, the cons, and a proposed approach.

    PubMed

    Mercurio, Mark R; Murray, Peter D; Gross, Ian

    2014-02-01

    A unilateral do not attempt resuscitation (DNAR) order is written by a physician without permission or assent from the patient or the patient's surrogate decision-maker. Potential justifications for the use of DNAR orders in pediatrics include the belief that attempted resuscitation offers no benefit to the patient or that the burdens would far outweigh the potential benefits. Another consideration is the patient's right to mercy, not to be made to undergo potentially painful interventions very unlikely to benefit the patient, and the physician's parallel obligation not to perform such interventions. Unilateral DNAR orders might be motivated in part by the moral distress caregivers sometimes experience when feeling forced by parents to participate in interventions that they believe are useless or cruel. Furthermore, some physicians believe that making these decisions without parental approval could spare parents needless additional emotional pain or a sense of guilt from making such a decision, particularly when imminent death is unavoidable. There are, however, several risks inherent in unilateral DNAR orders, such as overestimating one's ability to prognosticate or giving undue weight to the physician's values over those of parents, particularly with regard to predicted disability and quality of life. The law on the question of unilateral DNAR varies among states, and readers are encouraged to learn the law where they practice. Arguments in favor of, and opposed to, the use of unilateral DNAR orders are presented. In some settings, particularly when death is imminent regardless of whether resuscitation is attempted, unilateral DNAR orders should be viewed as an ethically permissible approach. PMID:24488539

  10. Compensatory renal growth after unilateral nephrectomy in the new-born rat

    PubMed Central

    Dicker, S. E.; Shirley, D. G.

    1973-01-01

    1. The right kidney in a series of control rats aged between 5 days and 115 days was weighed. The kidney weight/body weight ratio was greater in young than in older rats, but decreased linearly with increasing age. 2. After unilateral nephrectomy of rats 5 days old, the remaining kidney underwent compensatory growth. The rate and extent of this growth were greater than in adult rats. 3. The concentrations of RNA and DNA in the renal cortex and medulla of rats 5 days old were higher than in adult animals. The concentrations of the two nucleic acids fell with age, and reached adult levels after approximately 6 weeks. 4. After unilateral nephrectomy of rats 5 days old, the concentrations of RNA and DNA in the medulla were not significantly different from those in control animals. In the cortex, however, there was a delayed increase in the RNA/DNA ratio, which reached a level some 12% higher than that in control rats. This increase was smaller than that observed in unilaterally nephrectomized adult rats. 5. The cortical QO2 of the remaining kidney of unilaterally nephrectomized new-born rats was elevated by some 20% within 1 day of unilateral nephrectomy. Cortical QO2's remained higher than those of control animals for 3-4 weeks. 6. Since after unilateral nephrectomy, the increase in renal mass in new-borns was greater than that in adults, whereas the degree of cortical cellular hypertrophy (as estimated by the RNA/DNA ratio) was smaller than in adults, it is likely that in new-born animals a significant contribution to compensatory growth comes from cellular hyperplasia. PMID:4686024

  11. Could we prevent unilateral cleft lip/palate in the future?

    PubMed

    Mladina, Ranko; Skitareli?, Neven B; Skitareli?, Natasa P

    2009-10-01

    Surveillance studies have shown that cleft lip and palate is one of the commonest craniofacial anomalies, occurring in approximately 1 in 500 live births. Previous studies on craniofacial form in unilateral cleft lip/palate subjects have been carried out, but most attention has been focused on the deformity of the bony septum whereas the deformities of the nasal spine and cartilaginous component of the septum had received little attention. Our recent study was based on monitoring a very specific type of nasal septal deformity, type 6, and its relation to the unilateral cleft lip/palate disease. This type is very anteriorly located and refers to the cartilaginous part of the nasal septum and the inter-maxillary bone itself. Rhinoscopic view shows a typical, almost horizontal, unilateral groove at the nasal septum located very anteriorly. At the opposite septal side, but corresponding location, there is so called basal crest. The results of our study showed that the incidence of type 6 septal deformity was very high not only in unilateral cleft lip/palate children (80.6%) but also in their parents (58% in at least one of them). In contrast, in our previous study this type of septal deformity was seen in only 3.7% of non-unilateral cleft lip/palate children before puberty, rising to 7.4% in students and 9.4% in adults. In other words, perhaps we can expect the onset of unilateral cleft lip/palate in the offspring of parents who both have a type 6 septal deformity. Perhaps there is a gene responsible for the onset of both type 6 septal deformity and the cleft. If these clinical entities belong to the same gene, the cleft per se could perhaps disappear from the Earth in a near future owing to the gene therapy which will be able to eliminate it before the baby is born or even conceived. PMID:19559541

  12. Unilateral vs bilateral symptomatic knee osteoarthritis: associations between pain intensity and function

    PubMed Central

    Stratford, Paul W.

    2013-01-01

    Objective. The objective of this study was to determine if associations between pain distribution (unilateral vs bilateral) and measures of function (self-report vs performance-based) were influenced by knee pain intensity of the painful knee(s) in persons with moderate to severe symptomatic knee OA. Methods. Data from persons in the Osteoarthritis Initiative (OAI) dataset (n = 852) with symptomatic knee OA were studied. Key dependent variables were the WOMAC physical function, Knee Injury and Osteoarthritis Outcome Score (KOOS) quality of life, the repeated chair stand test and the 20-m walk test. In addition to covariates, the independent variables were the presence of unilateral or bilateral OA involvement (either Kellgren and Lawrence grade 3 or 4 or a grade <3) and pain category (mild, moderate or severe). Results. WOMAC physical function scores consistently showed the strongest association with pain intensity for persons with unilateral vs bilateral knee pain. For example, in persons with unilateral severe knee pain, WOMAC scores averaged 19.9 (s.d. = 12.0) points while persons with bilateral knee pain with at least one knee rated as severe had WOMAC scores ranging from 25.3 to 28.9, depending on pain severity of the contralateral knee. These differences were statistically significant (P < 0.001) as was the test for trend (P = 0.001). Self-report measures generally showed larger effect sizes than performance-based measures. Conclusion. Knee pain intensity influences self-report and performance-based tests differently depending on whether knee pain is unilateral or bilateral. WOMAC scores are most strongly associated with pain intensity in persons with unilateral vs bilateral pain while walking tests are least influenced by pain intensity. PMID:24026250

  13. Effects on Contralateral Muscles after Unilateral Electrical Muscle Stimulation and Exercise

    PubMed Central

    Song, Yafeng; Forsgren, Sture; Yu, Jiguo; Lorentzon, Ronny; Stål, Per S.

    2012-01-01

    It is well established that unilateral exercise can produce contralateral effects. However, it is unclear whether unilateral exercise that leads to muscle injury and inflammation also affects the homologous contralateral muscles. To test the hypothesis that unilateral muscle injury causes contralateral muscle changes, an experimental rabbit model with unilateral muscle overuse caused by a combination of electrical muscle stimulation and exercise (EMS/E) was used. The soleus and gastrocnemius muscles of both exercised and non-exercised legs were analyzed with enzyme- and immunohistochemical methods after 1, 3 and 6 weeks of repeated EMS/E. After 1 w of unilateral EMS/E there were structural muscle changes such as increased variability in fiber size, fiber splitting, internal myonuclei, necrotic fibers, expression of developmental MyHCs, fibrosis and inflammation in the exercised soleus muscle. Only limited changes were found in the exercised gastrocnemius muscle and in both non-exercised contralateral muscles. After 3 w of EMS/E, muscle fiber changes, presence of developmental MyHCs, inflammation, fibrosis and affections of nerve axons and AChE production were observed bilaterally in both the soleus and gastrocnemius muscles. At 6 w of EMS/E, the severity of these changes significantly increased in the soleus muscles and infiltration of fat was observed bilaterally in both the soleus and the gastrocnemius muscles. The affections of the muscles were in all three experimental groups restricted to focal regions of the muscle samples. We conclude that repetitive unilateral muscle overuse caused by EMS/E overtime leads to both degenerative and regenerative tissue changes and myositis not only in the exercised muscles, but also in the homologous non-exercised muscles of the contralateral leg. Although the mechanism behind the contralateral changes is unclear, we suggest that the nervous system is involved in the cross-transfer effects. PMID:23284946

  14. Phase Field Fracture Mechanics.

    SciTech Connect

    Robertson, Brett Anthony

    2015-11-01

    For this assignment, a newer technique of fracture mechanics using a phase field approach, will be examined and compared with experimental data for a bend test and a tension test. The software being used is Sierra Solid Mechanics, an implicit/explicit finite element code developed at Sandia National Labs in Albuquerque, New Mexico. The bend test experimental data was also obtained at Sandia Labs while the tension test data was found in a report online from Purdue University.

  15. Melt fracture revisited

    SciTech Connect

    Greenberg, J. M.

    2003-07-16

    In a previous paper the author and Demay advanced a model to explain the melt fracture instability observed when molten linear polymer melts are extruded in a capillary rheometer operating under the controlled condition that the inlet flow rate was held constant. The model postulated that the melts were a slightly compressible viscous fluid and allowed for slipping of the melt at the wall. The novel feature of that model was the use of an empirical switch law which governed the amount of wall slip. The model successfully accounted for the oscillatory behavior of the exit flow rate, typically referred to as the melt fracture instability, but did not simultaneously yield the fine scale spatial oscillations in the melt typically referred to as shark skin. In this note a new model is advanced which simultaneously explains the melt fracture instability and shark skin phenomena. The model postulates that the polymer is a slightly compressible linearly viscous fluid but assumes no slip boundary conditions at the capillary wall. In simple shear the shear stress {tau}and strain rate d are assumed to be related by d = F{tau} where F ranges between F{sub 2} and F{sub 1} > F{sub 2}. A strain rate dependent yield function is introduced and this function governs whether F evolves towards F{sub 2} or F{sub 1}. This model accounts for the empirical observation that at high shears polymers align and slide more easily than at low shears and explains both the melt fracture and shark skin phenomena.

  16. Relative Dating Via Fractures

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site]

    This VIS image of the eastern part of the Tharsis region illustrates how fractures can be used in relative dating of a surface. The fractured materials on the right side of the image are embayed by younger volcanic flows originating to the west of the image. Note how the younger flows cover the ends of the fractures, and are not at all fractured themselves.

    Image information: VIS instrument. Latitude 43.2, Longitude 269.4 East (90.6 West). 19 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  17. Fractured Craters on Ganymede

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Two highly fractured craters are visible in this high resolution image of Jupiter's moon, Ganymede. NASA's Galileo spacecraft imaged this region as it passed Ganymede during its second orbit through the Jovian system. North is to the top of the picture and the sun illuminates the surface from the southeast. The two craters in the center of the image lie in the ancient dark terrain of Marius Regio, at 40 degrees latitude and 201 degrees longitude, at the border of a region of bright grooved terrain known as Byblus Sulcus (the eastern portion of which is visible on the left of this image). Pervasive fracturing has occurred in this area that has completely disrupted these craters and destroyed their southern and western walls. Such intense fracturing has occurred over much of Ganymede's surface and has commonly destroyed older features. The image covers an area approximately 26 kilometers (16 miles) by 18 kilometers (11 miles) across at a resolution of 86 meters (287 feet) per picture element. The image was taken on September 6, 1996 by the solid state imaging (CCD) system on NASA's Galileo spacecraft.

    The Jet Propulsion Laboratory, Pasadena, CA manages the Galileo mission for NASA's Office of Space Science, Washington, DC. JPL is an operating division of California Institute of Technology (Caltech).

    This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page at URL http://galileo.jpl.nasa.gov.

  18. [Unilateral Creutzfeld-Jakob disease: report of a probable case on electroclinical, MRI and biological criteria].

    PubMed

    Moisset, X; Vitello, N; Cornut-Chauvinc, C; Taithe, F; Dionet, E; Lauxerois, M; Guy, N; Clavelou, P

    2013-02-01

    We report the case of a 70-year-old man who developed probable unilateral Creutzfeldt-Jakob disease. Clinically, he presented with right hemiparesis, progressive aphasia, temporospatial disorientation and cerebellar ataxia and later on, myoclonia. The MRI showed a hypersignal from the left caudate in DWI with decreased ADC. Repeated electroencephalograms showed a slow background rhythm in the left hemisphere with superimposed periodic, biphasic and triphasic sharp-wave complexes in the left temporal region. Death occurred after 5weeks. Although exceptional, unilateral Creutzfeldt-Jakob disease was retained as possible. PMID:23079855

  19. A New Classification System for Unilateral Cleft Lip and Palate Infants to assist Presurgical Infant Orthopedics.

    PubMed

    Daigavane, P S; Hazarey, P V; Niranjane, P; Vasudevan, S D; Thombare, B R; Daigavane, S

    2015-01-01

    The proposed advantages of pre-surgical naso-alveolar moulding (PNAM) are easy primary lip repair which heals under minimum tension reducing the scar formation and improving the aesthetic results in addition to reshaping of alar cartilage and improvement of nasal symmetry.However, the anatomy and alveolar morphology varies for each cleft child; the procedure for PNAM differs accordingly. In an attempt to categorize unilateral cleft lip and palate cases as per anatomical variations, a new classification system has been proposed. This classification aims to give an insight in unilateral cleft morphology based on which modification in PNAM procedure could be done. PMID:26208067

  20. Unilateral Heliotrope Rash in Juvenile Dermatomyositis: An Unusual Presentation of an Underlying Serious Disease

    PubMed Central

    Al-Janobi, Ghada; Alkhalidi, Hisham; Omair, Mohammed A.

    2014-01-01

    Background. Heliotrope rash is one of the characteristic skin manifestations of juvenile dermatomyositis. It is a reddish-purple rash on the upper eyelids that is usually bilateral. Case Presentation. We report a boy who presented with unilateral heliotrope rash, Gottron's papules, and muscle weakness. Muscle biopsy was consistent with inflammatory myositis. Patient was started on prednisolone and methotrexate with an excellent response in both the skin and muscles. Conclusion. Unilateral heliotrope rash can occur in patients with juvenile dermatomyositis. Being a paraneoplastic condition caution should be taken not to miss any underlying malignancy. PMID:25587479

  1. Management of Unilateral Masseter Hypertrophy and Hypertrophic ScarA Case Report

    PubMed Central

    Shetty, Naresh; Malaviya, Rajanikanth K.; Gupta, M. K.

    2012-01-01

    Masseter muscle hypertrophy is a rare condition of idiopathic cause. It clinically presents as an enlargement of one or both masseter muscles. Most patients complain of facial asymmetry; however, symptoms such as trismus, protrusion, and bruxism may also occur. Several treatment options reported for masseter hypertrophy are present, which range from simple pharmacotherapy to more invasive surgical reduction. Keloid scar with unilateral masseter hypertrophy is a rarely seen in clinical practice. This paper reports a case of unilateral masseter hypertrophy with keloid scar in the angle of the mandible for which surgical treatment was rendered to the patient by using a single approach. PMID:22844620

  2. Rare encounter of unilateral facial nerve palsy in an adolescent with Guillain-Barré syndrome.

    PubMed

    Iqbal, Mehtab; Sharma, Parnika; Charadva, Creana; Prasad, Manish

    2016-01-01

    Unilateral facial nerve palsy is rarely encountered in Guillain-Barré syndrome (GBS). We report a case of an adolescent girl who presented with peripheral ascending weakness, preceded by Campylobacter jejuni infection. After treatment with intravenous immunoglobulin, the peripheral weakness improved. Electro-diagnostic testing confirmed axonal dysfunction and the patient was positive for antiganglioside antibodies. However, the patient developed unilateral left-sided facial weakness. She was managed with further intravenous immunoglobulin and intensive physiotherapy. The outcome for facial palsy was very good, with almost complete resolution after 2 weeks. PMID:26823357

  3. Unilateral, Linear Blue Rubber Bleb Nevus Syndrome (Bean's syndrome): An Unfamiliar Presentation: First Case from India

    PubMed Central

    Sancheti, Karan; Podder, Indrashis; Das, Anupam; Choudhury, Sourav; Chandra, Somodyuti; Gharami, Ramesh Chandra

    2015-01-01

    Blue rubber bleb nevus syndrome (BRBNS) also called Bean's syndrome is a rare disorder characterized by multiple cutaneous venous malformations in association with visceral lesions, most commonly affecting the gastrointestinal tract. We report here, a 21-year-old woman patient, who presented with unilateral, blaschkoid distribution of cutaneous venous malformations along with blue rubber bleb nevus and recurrent episodes of hematochezia due to vascular lesions in the sigmoid colon; likely to be a case of BRBNS. The unusual unilateral, blaschkoid distribution of BRBNS prompted this present report. PMID:26677281

  4. Renography with captopril. Changes in a patient with hypertension and unilateral renal artery stenosis.

    PubMed

    Geyskes, G G; Oei, H Y; Puylaert, C B; Dorhout Mees, E J

    1986-09-01

    In a 56-year-old man with severe familial hypertension and unilateral renal artery stenosis, captopril induced striking changes in the renograms of the affected kidney. After injection of orthoiodohippurate sodium I 131, the uptake phase was unchanged but the later curve showed continuous accumulation. In contrast, the uptake of technetium Tc 99m diethylenetriamine pentracetic acid was abolished. These changes are compatible with a cessation of filtration and maintenance of renal blood flow. After balloon dilatation of the stenosis, the blood pressure became lower, and these changes could no longer be demonstrated. The captopril renogram may provide useful information on the dependency of hypertension on unilateral renal artery stenosis. PMID:3530163

  5. Renography with captopril. Changes in a patient with hypertension and unilateral renal artery stenosis

    SciTech Connect

    Geyskes, G.G.; Oei, H.Y.; Puylaert, C.B.; Dorhout Mees, E.J.

    1986-09-01

    In a 56-year-old man with severe familial hypertension and unilateral renal artery stenosis, captopril induced striking changes in the renograms of the affected kidney. After injection of orthoiodohippurate sodium I 131, the uptake phase was unchanged but the later curve showed continuous accumulation. In contrast, the uptake of technetium Tc 99m diethylenetriamine pentracetic acid was abolished. These changes are compatible with a cessation of filtration and maintenance of renal blood flow. After balloon dilatation of the stenosis, the blood pressure became lower, and these changes could no longer be demonstrated. The captopril renogram may provide useful information on the dependency of hypertension on unilateral renal artery stenosis.

  6. On fracture toughness evaluation for semi-brittle fracture

    NASA Technical Reports Server (NTRS)

    Eftis, J.; Liebowitz, H.

    1975-01-01

    The existing methods of assessing the fracture toughness of materials exhibiting semi-brittle fracture are critically reviewed. The methods concern the Crack Growth Resistance (R-curve), the Crack Opening Displacement (COD), and the J-integral. An analysis of the shortcomings of the methods described makes it possible to formulate a new definition of fracture toughness appropriate to semi-brittle fracture. An improved simple experimental method for measuring fracture toughness for semi-brittle fracture is proposed which takes into account both crack growth and plastic nonlinear effects at crack front. The proposed method is shown to be free of the theoretical and experimental discrepancies encountered in the R-curve, COD, and J-integral methods.

  7. Correlation of fractural reservoir productivity with fracture intersection quadrants

    SciTech Connect

    Trost, P.B.

    1983-09-01

    Higher success rates for discovery of gas and oil in naturally fractured reservoirs can be achieved by correlating discoveries and productivities with fracture intersection quadrants. These fracture intersection quadrants are formed by the intersection of the two predominant fracture directions. Higher success rates in a particular quadrant appear to be related to greater fracture density resulting from the downdip extensions of the fractures in the stratigraphic zone of interest. Plunge of the intersection should be considered to insure that the drill hole penetrates the projected intersection within the stratigraphic zone of interest. Observations in Kentucky have shown success rates can be improved three-fold when drilling in the most favorable quadrant as opposed to the least favorable quadrant, and when the drill hole is located a proper distance from the fault intersection to allow for the downdip projection to the zone of interest.

  8. Fracture Networks in Sea Ice

    NASA Astrophysics Data System (ADS)

    Vevatne, Jonas; Rimstad, Eivind; Hansen, Alex; Korsnes, Reinert; Hope, Sigmund

    2014-04-01

    Fracturing and refreezing of sea ice in the Kara sea are investigated using complex networkanalysis. By going to the dual network, where the fractures are nodes and their intersectionslinks, we gain access to topological features which are easy to measure and hence comparewith modeled networks. Resulting network reveal statistical properties of the fracturing process.The dual networks have a broad degree distribution, with a scale-free tail, high clusteringand efficiency. The degree-degree correlation profile shows disassortative behavior, indicatingpreferential growth. This implies that long, dominating fractures appear earlier than shorterfractures, and that the short fractures which are created later tend to connect to the longfractures.The knowledge of the fracturing process is used to construct growing fracture network (GFN)model which provides insight into the generation of fracture networks. The GFN model isprimarily based on the observation that fractures in sea ice are likely to end when hitting existingfractures. Based on an investigation of which fractures survive over time, a simple model forrefreezing is also added to the GFN model, and the model is analyzed and compared to the realnetworks.

  9. Diagnosing vertebral fractures: missed opportunities.

    PubMed

    Borges, João Lindolfo Cunha; Maia, Julianne Lira; Silva, Renata Faria; Lewiecki, Edward Michael

    2015-01-01

    Vertebral fractures are the single most common type of osteoporotic fracture. Postmenopausal women are at increased risk for osteoporotic vertebral fractures compared with women of childbearing age. Vertebral fractures are associated with an increase in morbidity, mortality, and high risk of a subsequent vertebral fracture, regardless of bone mineral density. Despite the common occurrence and serious consequences of vertebral fractures, they are often unrecognized or misdiagnosed by radiologists. Moreover, vertebral fractures may be described by variable terminology that can confuse rather than enlighten referring physicians. We conducted a survey of spine X-ray reports from a group of postmenopausal women screened for participation in a study of osteoporosis at Centro de Pesquisa Clínica do Brasil. A descriptive analysis evaluated the variability of reports in 7 patients. Four independent general radiologists issued reports assessing vertebral fractures through a blinded analysis. The objective of this study was to evaluate for consistency in these reports. The analysis found marked variability in the diagnosis of vertebral fractures and the terminology used to describe them. In community medical practices, such variability could lead to differences in the management of patients with osteoporosis, with the potential for undertreatment or overtreatment depending on clinical circumstances. Accurate and unambiguous reporting of vertebral fractures is likely to be associated with improved clinical outcomes. PMID:25772659

  10. Fractures of the cervical spine

    PubMed Central

    Marcon, Raphael Martus; Cristante, Alexandre Fogaa; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcsio Eloy Pessoa

    2013-01-01

    OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

  11. Procedure for estimating fracture energy from fracture surface roughness

    DOEpatents

    Williford, Ralph E.

    1989-01-01

    The fracture energy of a material is determined by first measuring the length of a profile of a section through a fractured surface of the material taken on a plane perpendicular to the mean plane of that surface, then determining the fractal dimensionality of the surface. From this, the yield strength of the material, and the Young's Modulus of that material, the fracture energy is calculated.

  12. Prediction of Composite Laminate Fracture: Micromechanics and Progressive Fracture

    NASA Technical Reports Server (NTRS)

    Gotsis, P. K.; Chamis, C. C.; Minnetyan, L.

    1998-01-01

    An investigation is described on the prediction of first-ply failure and fracture in selected composite laminates. The laminates are made from glass fibers and graphite fibers in epoxy matrices. Failure envelopes are generated for combined loading of these laminates on the basis of first-ply failure and laminate fracture. The evaluation is performed by a micromechanics-based theory and progressive fracture.

  13. Visual Field Function in School-Aged Children with Spastic Unilateral Cerebral Palsy Related to Different Patterns of Brain Damage

    ERIC Educational Resources Information Center

    Jacobson, Lena; Rydberg, Agneta; Eliasson, Ann-Christin; Kits, Annika; Flodmark, Olof

    2010-01-01

    Aim: To relate visual field function to brain morphology in children with unilateral cerebral palsy (CP). Method: Visual field function was assessed using the confrontation technique and Goldmann perimetry in 29 children (15 males, 14 females; age range 7-17y, median age 11y) with unilateral CP classified at Gross Motor Function Classification

  14. Hand Function in Relation to Brain Lesions and Corticomotor-Projection Pattern in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Holmstrom, Linda; Vollmer, Brigitte; Tedroff, Kristina; Islam, Mominul; Persson, Jonas Ke; Kits, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2010-01-01

    Aim: To investigate relationships between hand function, brain lesions, and corticomotor projections in children with unilateral cerebral palsy (CP). Method: The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4] range 7-16y), with unilateral CP at Gross Motor Function Classification System level I and Manual Ability

  15. Effect of unilateral, bilateral, and combined plyometric training on explosive and endurance performance of young soccer players.

    PubMed

    Ramírez-Campillo, Rodrigo; Burgos, Carlos H; Henríquez-Olguín, Carlos; Andrade, David C; Martínez, Cristian; Álvarez, Cristian; Castro-Sepúlveda, Mauricio; Marques, Mário C; Izquierdo, Mikel

    2015-05-01

    The aim of the study was to compare the effects of bilateral, unilateral, or combined bilateral and unilateral plyometric training (PT) on muscle power output, endurance, and balance performance adaptations in young soccer players. Four groups of young soccer players (age 11.4 ± 2.2 years) were divided into control group (CG; n = 14), bilateral group (BG; n = 12), unilateral group (UG; n = 16), and bilateral + unilateral group (B + UG; n = 12). Players were measured in unilateral and bilateral countermovement jump with arms, 5 multiple bounds test, 20-cm drop jump reactive strength index, maximal kicking velocity, sprint and agility test time, endurance, and balance performance. The PT was applied during 6 weeks, 2 sessions per week, for a total of 2,160 jumps. After intervention, all PT groups showed a statistically significant (p ≤ 0.05) change in all performance measures, with no statistically significant differences between treatments. Among the 21 performance measures, the B + UG showed a significantly (p ≤ 0.05) higher performance change in 13 of them vs. the CG, whereas the UG and BG showed only 6 and 3, respectively. The current study showed that bilateral, unilateral, and combined bilateral and unilateral PT ensured significant improvement in several muscular power and endurance performance measures in young soccer players. However, the combination of unilateral and bilateral drills seems more advantageous to induce superior performance improvements. PMID:25474338

  16. Hand Function in Relation to Brain Lesions and Corticomotor-Projection Pattern in Children with Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    Holmstrom, Linda; Vollmer, Brigitte; Tedroff, Kristina; Islam, Mominul; Persson, Jonas Ke; Kits, Annika; Forssberg, Hans; Eliasson, Ann-Christin

    2010-01-01

    Aim: To investigate relationships between hand function, brain lesions, and corticomotor projections in children with unilateral cerebral palsy (CP). Method: The study included 17 children (nine males, eight females; mean age 11.4 [SD 2.4] range 7-16y), with unilateral CP at Gross Motor Function Classification System level I and Manual Ability…

  17. The use of a laser-level paralleling device for the fabrication of a unilateral auricular prosthesis.

    PubMed

    Piper, James M; Sutton, Alan J; Hansen, Nancy A

    2014-05-01

    This article describes the use of a laser-level paralleling device for the fabrication of a unilateral auricular prosthesis. Traditional methods require use of calipers to obtain orientation of contralateral auricular anatomy, which in turn can be difficult to replicate on the patient. The purpose of this clinical report is to describe a simple means to record unilateral auricular anatomy. PMID:24445026

  18. FRACTURED PETROLEUM RESERVOIRS

    SciTech Connect

    Abbas Firoozabadi

    1999-06-11

    The four chapters that are described in this report cover a variety of subjects that not only give insight into the understanding of multiphase flow in fractured porous media, but they provide also major contribution towards the understanding of flow processes with in-situ phase formation. In the following, a summary of all the chapters will be provided. Chapter I addresses issues related to water injection in water-wet fractured porous media. There are two parts in this chapter. Part I covers extensive set of measurements for water injection in water-wet fractured porous media. Both single matrix block and multiple matrix blocks tests are covered. There are two major findings from these experiments: (1) co-current imbibition can be more efficient than counter-current imbibition due to lower residual oil saturation and higher oil mobility, and (2) tight fractured porous media can be more efficient than a permeable porous media when subjected to water injection. These findings are directly related to the type of tests one can perform in the laboratory and to decide on the fate of water injection in fractured reservoirs. Part II of Chapter I presents modeling of water injection in water-wet fractured media by modifying the Buckley-Leverett Theory. A major element of the new model is the multiplication of the transfer flux by the fractured saturation with a power of 1/2. This simple model can account for both co-current and counter-current imbibition and computationally it is very efficient. It can be orders of magnitude faster than a conventional dual-porosity model. Part II also presents the results of water injection tests in very tight rocks of some 0.01 md permeability. Oil recovery from water imbibition tests from such at tight rock can be as high as 25 percent. Chapter II discusses solution gas-drive for cold production from heavy-oil reservoirs. The impetus for this work is the study of new gas phase formation from in-situ process which can be significantly different from that of gas displacement processes. The work is of experimental nature and clarifies several misconceptions in the literature. Based on experimental results, it is established that the main reason for high efficiency of solution gas drive from heavy oil reservoirs is due to low gas mobility. Chapter III presents the concept of the alteration of porous media wettability from liquid-wetting to intermediate gas-wetting. The idea is novel and has not been introduced in the petroleum literature before. There are significant implications from such as proposal. The most direct application of intermediate gas wetting is wettability alteration around the wellbore. Such an alteration can significantly improve well deliverability in gas condensate reservoirs where gas well deliverability decreases below dewpoint pressure. Part I of Chapter III studies the effect of gravity, viscous forces, interfacial tension, and wettability on the critical condensate saturation and relative permeability of gas condensate systems. A simple phenomenological network model is used for this study, The theoretical results reveal that wettability significantly affects both the critical gas saturation and gas relative permeability. Gas relative permeability may increase ten times as contact angle is altered from 0{sup o} (strongly liquid wet) to 85{sup o} (intermediate gas-wetting). The results from the theoretical study motivated the experimental investigation described in Part II. In Part II we demonstrate that the wettability of porous media can be altered from liquid-wetting to gas-wetting. This part describes our attempt to find appropriate chemicals for wettability alteration of various substrates including rock matrix. Chapter IV provides a comprehensive treatment of molecular, pressure, and thermal diffusion and convection in porous media Basic theoretical analysis is presented using irreversible thermodynamics.

  19. Mortality after hip fracture with vertebral compression fracture is poor.

    PubMed

    Imai, Norio; Endo, Naoto; Hoshino, Tadashi; Suda, Ken; Miyasaka, Dai; Ito, Tomoyuki

    2016-01-01

    Due to the increasing elderly population, the prevalence of osteoporotic hip fractures in Japanese patients continues to rise. It is well established that patients with either hip fracture or both symptomatic and asymptomatic morphometric vertebral compression fracture (VCF) have a poor health prognosis compared with the general population. The purpose of this study was to retrospectively investigate vertebral fracture rates among patients with hip fracture and their influence on mortality. We examined 182 cases of osteoporotic hip fracture in patients admitted to our institution between January 2009 and May 2011. The average age at the time of fracture was 85years. Radiographs of the lumbar spine were obtained from all of the participants and the lateral spinal radiographs were examined for evidence of VCF. The patients were classified into two groups, those with VCF and those without. A VCF was identified in approximately 78% of the patients. The mortality rate 1year after the hip fracture was approximately 22% and it was significantly higher in patients with VCF. Through multivariate statistics we found that VCF, post-operative complication, loss of ambulation after operation and medication for osteoporosis were statistically significant. In other words, VCF, post-operative complication and loss of ambulation were considered to be poor prognostic factors and medication for osteoporosis was likely to improve the prognosis. We concluded that the risk of mortality after hip fracture is significantly greater in patients who also have VCF compared to patients without VCF, and that medication for osteoporosis is likely to improve prognosis. PMID:25501699

  20. Prediction of Composite Laminate Fracture: Micromechanics and Progressive Fracture

    NASA Technical Reports Server (NTRS)

    Gotsis, P. K.; Chamis, C. C.; Minnetyan, L.

    1996-01-01

    This report describes an investigation to predict first-ply failure and final fracture in selected composite laminates subjected to inplane loads. The laminates were composed of glass fiber and graphite fibers in epoxy matrices. Failure envelopes based on first-ply failure and laminate fracture were generated for combined loading of these laminates. Predictions were evaluated by micromechanics-based theory and progressive fracture. The results show that, for most cases, combined tensile loading significantly enhanced the laminate fracture stress in comparison to the uniaxial loading.

  1. Resistivity logging of fractured basalt

    SciTech Connect

    Stefansson, V.; Axelsson, G.; Sigurdsson, O.

    1982-01-01

    A lumped double porosity model was studied in order to estimate the effect of fractures on resistivity - porosity relations. It is found that the relationship between resistivity and porosity for fractured rock is in general not simple and depends both on the amounts of matrix porosity as well as the fracture orientation. However, when fractures dominate over matrix porosity the exponent is close to 1.0. Resistivity-porosity relations have been determined for large amounts of basaltic formations in Iceland. An exponent close to 1.0 is found in all cases investigated. This is interpreted as fractures constitute a considerable part of the porosity of the basalts. In the IRDP-hole in Eastern Iceland it is found that the ratio of fracture porosity to total porosity decreases with depth.

  2. Assessment of compromised fracture healing.

    PubMed

    Bishop, Julius A; Palanca, Ariel A; Bellino, Michael J; Lowenberg, David W

    2012-05-01

    No standard criteria exist for diagnosing fracture nonunion, and studies suggest that assessment of fracture healing varies among orthopaedic surgeons. This variability can be problematic in both clinical and orthopaedic trauma research settings. An understanding of risk factors for nonunion and of diagnostic tests used to assess fracture healing can facilitate a systematic approach to evaluation and management. Risk factors for nonunion include medical comorbidities, age, and the characteristics of the injury. The method of fracture management also influences healing. Comprehensive evaluation includes an assessment of the patient's symptoms, signs, and immune and endocrine status as well as the biologic capacity of the fracture, presence of infection, and quality of reduction and fixation. Diagnostic tests include plain radiography, CT, ultrasonography, fluoroscopy, bone scan, MRI, and several laboratory tests, including assays for bone turnover markers in the peripheral circulation. A systematic approach to evaluating fracture union can help surgeons determine the timing and nature of interventions. PMID:22553099

  3. Fracture healing: mechanisms and interventions.

    PubMed

    Einhorn, Thomas A; Gerstenfeld, Louis C

    2015-01-01

    Fractures are the most common large-organ, traumatic injuries to humans. The repair of bone fractures is a postnatal regenerative process that recapitulates many of the ontological events of embryonic skeletal development. Although fracture repair usually restores the damaged skeletal organ to its pre-injury cellular composition, structure and biomechanical function, about 10% of fractures will not heal normally. This article reviews the developmental progression of fracture healing at the tissue, cellular and molecular levels. Innate and adaptive immune processes are discussed as a component of the injury response, as are environmental factors, such as the extent of injury to the bone and surrounding tissue, fixation and the contribution of vascular tissues. We also present strategies for fracture treatment that have been tested in animal models and in clinical trials or case series. The biophysical and biological basis of the molecular actions of various therapeutic approaches, including recombinant human bone morphogenetic proteins and parathyroid hormone therapy, are also discussed. PMID:25266456

  4. Fracture healing: mechanisms and interventions

    PubMed Central

    Einhorn, Thomas A.; Gerstenfeld, Louis C.

    2015-01-01

    Fractures are the most common large-organ, traumatic injuries to humans. The repair of bone fractures is a postnatal regenerative process that recapitulates many of the ontological events of embryonic skeletal development. Although fracture repair usually restores the damaged skeletal organ to its pre-injury cellular composition, structure and biomechanical function, about 10% of fractures will not heal normally. This article reviews the developmental progression of fracture healing at the tissue, cellular and molecular levels. Innate and adaptive immune processes are discussed as a component of the injury response, as are environmental factors, such as the extent of injury to the bone and surrounding tissue, fixation and the contribution of vascular tissues. We also present strategies for fracture treatment that have been tested in animal models and in clinical trials or case series. The biophysical and biological basis of the molecular actions of various therapeutic approaches, including recombinant human bone morphogenetic proteins and parathyroid hormone therapy, are also discussed. PMID:25266456

  5. Rock fracture image acquisition and analysis

    NASA Astrophysics Data System (ADS)

    Wang, W.; Zongpu, Jia; Chen, Liwan

    2007-12-01

    As a cooperation project between Sweden and China, this paper presents: rock fracture image acquisition and analysis. Rock fracture images are acquired by using UV light illumination and visible optical illumination. To present fracture network reasonable, we set up some models to characterize the network, based on the models, we used Best fit Ferret method to auto-determine fracture zone, then, through skeleton fractures to obtain endpoints, junctions, holes, particles, and branches. Based on the new parameters and a part of common parameters, the fracture network density, porosity, connectivity and complexities can be obtained, and the fracture network is characterized. In the following, we first present a basic consideration and basic parameters for fractures (Primary study of characteristics of rock fractures), then, set up a model for fracture network analysis (Fracture network analysis), consequently to use the model to analyze fracture network with different images (Two dimensional fracture network analysis based on slices), and finally give conclusions and suggestions.

  6. Carpal fractures other than scaphoid.

    PubMed

    Urch, Ekaterina Y; Lee, Steve K

    2015-01-01

    Carpal fractures are uncommon, but if missed, can lead to morbidity and loss of function, especially in an athlete. Early diagnosis through physical examination, plain radiographs, and possibly advanced imaging is paramount. Treatment is specific to each fracture type, and return to play varies with each clinical scenario. This article organizes current knowledge of these potentially difficult fractures with a table of diagnoses and treatment guidelines. PMID:25455396

  7. Fracture analysis of optical fibers

    SciTech Connect

    Mecholsky, J.J.

    1980-01-01

    The fracture markings on glass optical fiber surfaces are quantitatively related to the strength and time under load. Knowledge of the fracture-initiating defects and the surrounding topography pinpoints the source of failure, aids in troubleshooting, and improves production procedures. It is shown that the techniques of fracture surface analysis help analyze in-service failures as well as improve fiber optic production control.

  8. Method for fracturing subterranean formations

    SciTech Connect

    Almond, S. W.; Conway, M. W.

    1985-11-19

    The present invention relates to a thermally stable crosslinked gel fracturing fluid for use in the treatment of subterranean formations penetrated by a well bore. The fracturing fluid comprises an aqueous liquid, a gelling agent comprising a selected modified cellulose ether, a crosslinking agent and any additional additives that may be present. The fracturing fluid is thermally stable under shear at temperatures in excess of about 200/sup 0/ F.

  9. [Cervical fractures in autopsy records].

    PubMed

    Pankowski, Rafa?; Wilmanowska, Anita; Gos, Tomasz; Smoczy?ski, Andrzej

    2003-01-01

    We reviewed the autopsy records of 1872 cases of death because of politrauma, gunshot wounds and suicidal hanging. The analysis included causes and frequency of cervical spine fractures, their most common localisation, architecture of bone destruction and their influence on cervical cord. The most common cause of cervical spine injury was motor vehicle accidents. We examined 82 specimens with traumatic fractures of cervical spine obtained from accident victims. About half of the injuries occurred in upper cervical spine. The most common fracture localisation was C2 with dens fracture as the most frequent injury. The most common spinal cord lesion was complete rupture mainly at the upper cervical spine level. PMID:14564791

  10. Fracture Mechanics of Ice Shelves

    NASA Astrophysics Data System (ADS)

    Sammonds, P.; Rist, M.

    2003-12-01

    The importance of large-scale fracture processes has recently been emphasized by the break-up of ice shelves on the Antarctic Peninsula and underlines the need for incorporation of fracture mechanics into models of ice sheet dynamics. Key components for fracture mechanics models include qualitative models of the brittle processes in ice shelf fracture and experimental measurements of fundamental fracture parameters. We have adopted an integrated experimental and theoretical approach which is validated against field and satellite measurements. Our procedure has been first to quantify experimentally and physical behaviour of Antarctic ice core, then to use these measurements in fracture criteria describing the spatial distribution of crevasses, the depth and height of top and bottom crevasse penetration and the effect of tidal flexure. Up to now these have been crack initiation criteria. Here we discuss two extensions to our work: 1) to describe the statistical nature of ice fracture; 2) to describe crack propagation in ice. We find there that the statistical nature of ice shelf fracture can arise from the inhomogeneous size distribution of initiation cracks. We infer that crack propagation in ice can have strong environmental controls. We describe how these aspects of ice fracture can be incorporated into ice shelf models.

  11. BTEX biodegradation in fractured shale

    SciTech Connect

    O`Cleirigh, D.; Coryea, H.; Christopher, M.; Vaughn, C.

    1997-12-31

    A petroleum hydrocarbon groundwater plume was identified at a Federal Aviation Administration (FAA) facility in Oklahoma. The affected area had an average BTEX concentration of 3.8 mg/L. Previous aquifer tests indicated preferential groundwater flow paths resulting from natural fractures present in the aquifer formation (primarily shale). A pneumatic fracturing pilot study was performed to evaluate the technology`s effectiveness in creating a more isotropic aquifer. As part of the study, pre-fracture/post-fracture pump tests were performed. Pre-fracture and post-fracture graphs confirmed the study`s hypothesis that pneumatic fracturing would eliminate preferential flow paths and increase groundwater yield. Based on the successful pneumatic fracturing test, an area within the petroleum hydrocarbon plume was fractured and a pilot-scale biodegradation system was operated for four months. The remediation system provided groundwater circulation amended with nutrients and oxygen. Results of the study indicated a significant decrease in BTEX concentrations between the injection well and the observation wells. By Day 113, the benzene concentration (0.044 mg/L) at one of the observation wells was less than the desired state cleanup goal of 0.05 mg/L.

  12. Endotine Midface for Soft Tissue Suspension in Zygoma Fracture.

    PubMed

    Shim, Hyung-Sup; Seo, Bommie F; Rha, Eun-Young; Byeon, Jun Hee

    2015-09-01

    Treatment of zygomatic fractures necessitates dissection beneath the soft tissues of the cheek. Inadequate resuspension may lead to deformities, including cheek ptosis, lower lid ectropion, and lateral canthal dystopia. The authors present their experience using a biodegradable suspension device for cheek flap resuspension. Patients who received open reduction for unilateral zygomatic fracture between January, 2006 and December, 2013 at a single center were included in the study. Patients could choose whether or not to have Endotine midface inserted. Patients rated satisfaction on facial symmetry. Computed tomography (CT) at 15 months was assessed for soft tissue thickness at the level of the midpoint of the nasolabial fold on each side. Photographs at 15 months were viewed by 3 blinded plastic surgeons and rated for cheek drooping. The results for all 3 parameters were compared between the Endotine group and the control group. A total of 83 patients were included (43 in the Endotine group and 39 in the control group). Patient satisfaction scores were statistically higher (P?=?0.03) in the Endotine group (3.70??0.76) than the control group (2.85??0.96). Computed tomography soft tissue thickness score ratio between affected and unaffected side was significantly lower (P?fracture patients. PMID:26267573

  13. The Course and Outcome of Unilateral Intracranial Arteriopathy in 79 Children with Ischaemic Stroke

    ERIC Educational Resources Information Center

    Braun, K. P. J.; Bulder, M. M. M.; Chabrier, S.; Kirkham, F. J.; Uiterwaal, C. S. P.; Tardieu, M.; Sebire, G.

    2009-01-01

    Arteriopathies are the commonest cause of arterial ischaemic stroke (AIS) in children. Repeated vascular imaging in children with AIS demonstrated the existence of a "transient cerebral arteriopathy" (TCA), characterized by lenticulostriate infarction due to non-progressive unilateral arterial disease affecting the supraclinoid internal carotid

  14. Unilateral medial frontal cortex lesions cause a cognitive decision-making deficit in rats

    PubMed Central

    Croxson, Paula L; Walton, Mark E; Boorman, Erie D; Rushworth, Matthew F S; Bannerman, David M

    2014-01-01

    The medial frontal cortex (MFC) is critical for costbenefit decision-making. Generally, cognitive and reward-based behaviour in rodents is not thought to be lateralised within the brain. In this study, however, we demonstrate that rats with unilateral MFC lesions show a profound change in decision-making on an effort-based decision-making task. Furthermore, unilateral MFC lesions have a greater effect when the rat has to choose to put in more effort for a higher reward when it is on the contralateral side of space to the lesion. Importantly, this could not be explained by motor impairments as these animals did not show a turning bias in separate experiments. In contrast, rats with unilateral dopaminergic midbrain lesions did exhibit a motoric turning bias, but were unimpaired on the effort-based decision-making task. This rare example of a cognitive deficit caused by a unilateral cortical lesion in the rat brain indicates that the MFC may have a specialised and lateralised role in evaluating the costs and benefits of actions directed to specific spatial locations. PMID:25348059

  15. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  16. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  17. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  18. Polymerase chain reaction in unilateral cases of presumed viral anterior uveitis

    PubMed Central

    Shoughy, Samir S; Alkatan, Hind M; Al-Abdullah, Abdulelah A; El-Khani, Albarah; de Groot-Mijnes, Jolanda DF; Tabbara, Khalid F

    2015-01-01

    Background and objectives Anterior uveitis is the most common form of intraocular inflammation. The main aim of this study was to determine the viral etiology in patients with unilateral cases of anterior uveitis. Patients and methods A total of 12 consecutive patients with the diagnosis of idiopathic unilateral anterior uveitis were included prospectively. Aqueous specimens were obtained from each patient by anterior chamber paracentesis and subjected to the detection of viral DNA/RNA genome by polymerase chain reaction assay for herpes simplex virus, varicella zoster virus, cytomegalovirus, EpsteinBarr virus, and rubella virus. Results There were six male and six female patients. The mean age was 43 years, with an age range of 1182 years. All 12 cases presented with unilateral anterior uveitis. In four (33%) patients, polymerase chain reaction was positive for viral genome. Two patients were positive for herpes simplex virus type 1, one patient was positive for cytomegalovirus and one for EpsteinBarr virus. Conclusion Recent molecular diagnostic assays would help in the identification of the causative agent in patients with unilateral anterior uveitis. PMID:26715836

  19. Consistency of Intermanual Discrepancies in Normal and Unilateral Brain Lesion Patients.

    ERIC Educational Resources Information Center

    Bornstein, R. A.

    1986-01-01

    The distribution of intermanual discrepancies on three motor tests (Grooved Pegboard, Finger Tapping and Dynamometer) were examined in normal and unilateral brain lesion samples. Considerable variability in the intermanual discrepancies was observed in all three samples. Therefore, the consistency of discrepancies across tasks was examined. The

  20. The Course and Outcome of Unilateral Intracranial Arteriopathy in 79 Children with Ischaemic Stroke

    ERIC Educational Resources Information Center

    Braun, K. P. J.; Bulder, M. M. M.; Chabrier, S.; Kirkham, F. J.; Uiterwaal, C. S. P.; Tardieu, M.; Sebire, G.

    2009-01-01

    Arteriopathies are the commonest cause of arterial ischaemic stroke (AIS) in children. Repeated vascular imaging in children with AIS demonstrated the existence of a "transient cerebral arteriopathy" (TCA), characterized by lenticulostriate infarction due to non-progressive unilateral arterial disease affecting the supraclinoid internal carotid…

  1. Action Planning in Typically and Atypically Developing Children (Unilateral Cerebral Palsy)

    ERIC Educational Resources Information Center

    Craje, Celine; Aarts, Pauline; Nijhuis-van der Sanden, Maria; Steenbergen, Bert

    2010-01-01

    In the present study, we investigated the development of action planning in children with unilateral Cerebral Palsy (CP, aged 3-6 years, n = 24) and an age matched control group. To investigate action planning, participants performed a sequential movement task. They had to grasp an object (a wooden play sword) and place the sword in a hole in a

  2. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL...

  3. Single-Sided Deafness Leads to Unilateral Aural Preference within an Early Sensitive Period

    ERIC Educational Resources Information Center

    Kral, Andrej; Hubka, Peter; Heid, Silvia; Tillein, Jochen

    2013-01-01

    Unilateral deafness has a high incidence in children. In addition to children who are born without hearing in one ear, children with bilateral deafness are frequently equipped only with one cochlear implant, leaving the other ear deaf. The present study investigates the effects of such single-sided deafness during development in the congenitally…

  4. Atypical presentation of a unilateral septic thrombosis of the cavernous sinus.

    PubMed

    Baidya, Krishnapada; Bhaduri, Gautam; Mondal, L K; Mukherjee, Rajarshi; Singh, Maneesh

    2005-08-01

    A 7 year-old boy with unilateral septic cavernous sinus thrombosis following a pyoderma in the eyebrow is described. Problems in diagnosis and the role of magnetic resonance imaging (MRI) in the management are highlighted. Patient recovered with mild residual sequelae. The unique feature of this case was absence of chemosis and non-toxic presentation of the patient. PMID:16363201

  5. Single-Sided Deafness Leads to Unilateral Aural Preference within an Early Sensitive Period

    ERIC Educational Resources Information Center

    Kral, Andrej; Hubka, Peter; Heid, Silvia; Tillein, Jochen

    2013-01-01

    Unilateral deafness has a high incidence in children. In addition to children who are born without hearing in one ear, children with bilateral deafness are frequently equipped only with one cochlear implant, leaving the other ear deaf. The present study investigates the effects of such single-sided deafness during development in the congenitally

  6. "No-Show": Therapist Racial/Ethnic Disparities in Client Unilateral Termination

    ERIC Educational Resources Information Center

    Owen, Jesse; Imel, Zac; Adelson, Jill; Rodolfa, Emil

    2012-01-01

    In the present study, the authors examined the source of racial/ethnic minority (REM) disparities in unilateral termination (i.e., the client ending therapy without informing the therapist)--a form of dropout that is associated with poor alliance and outcome. First, the authors tested whether some therapists were more likely to have clients who

  7. Unilateral canine crossbite correction in adults using the Invisalign method: a case report.

    PubMed

    Giancotti, Aldo; Mampieri, Gianluca

    2012-01-01

    The aim of this paper is to present and debate the treatment of a unilateral canine crossbite using clear aligners (Invisalign). The possibility of combining partial fixed appliances with removable elastics to optimize the final outcome is also described. The advantages of protected movement, due to the presence of the aligners, to jump the occlusion during crossbite correction is also highlighted. PMID:22567623

  8. Unilateral Molariform Macrodont Mandibular Second Premolar: An Unusual Case Report in A Nonsyndromic Patient

    PubMed Central

    Chaurasia, Vishwajit Rampratap; Masamatti, Vinay Kumar; Tiwari, Samarth; Malik, Sidharath

    2014-01-01

    Macrodontia is a rare dental anomaly that refers to teeth appears larger than normal. It can be generalized or isolated macrodontia. Isolated macrodontia involving premolar is very rare. This case report presents an unusual unilateral molarifrom macrodontia of mandibular second premolar. PMID:25177648

  9. Perceptual Ratings of Vocal Characteristics and Voicing Features in Untreated Patients with Unilateral Vocal Fold Paralysis

    ERIC Educational Resources Information Center

    Leydon, Ciara; Bielamowicz, Steven; Stager, Sheila V.

    2005-01-01

    This study used visual analog scales to obtain perceptual ratings of features of voice production in subjects with unilateral vocal fold paralysis (UVFP), including clarity of laryngeal articulation, consistency of loudness across the utterance and the voiced/voiceless distinction. Recordings of repeated /i/, /isi/, and /izi/ from subjects

  10. Levels of Processing with Free and Cued Recall and Unilateral Temporal Lobe Epilepsy

    ERIC Educational Resources Information Center

    Lespinet-Najib, Veronique; N'Kaoua, Bernard; Sauzeon, Helene; Bresson, Christel; Rougier, Alain; Claverie, Bernard

    2004-01-01

    This study investigates the role of the temporal lobes in levels-of-processing tasks (phonetic and semantic encoding) according to the nature of recall tasks (free and cued recall). These tasks were administered to 48 patients with unilateral temporal epilepsy (right ''RTLE''=24; left ''LTLE''=24) and a normal group (n=24). The results indicated

  11. Comparison of the Electromyographic Activation Level and Unilateral Selectivity of Erector Spinae during Different Selected Movements

    ERIC Educational Resources Information Center

    Guo, Lan-Yuen; Wang, Yu-Lin; Huang, Yu-Han; Yang, Chich-Haung; Hou, Yi-You; Harn, Hans I-Chen; You, Yu-Lin

    2012-01-01

    For patients with scoliosis, core stabilization exercises may be beneficial in improving muscle strength and trunk dynamic control. However, few studies have examined whether the erector spinae (ES) activation status during unilateral spinal extensor strengthening meets the guideline for patients with spinal scoliosis. To determine ES activation

  12. Reliability of a Unilateral Horizontal Leg Power Test to Assess Stretch Load Tolerance

    ERIC Educational Resources Information Center

    Simpson, Rhianna Parker; Cronin, John

    2006-01-01

    Drop jumping has previously been used to measure fast stretch shorten cycle (SSC) ability and stretch load tolerance. To the knowledge of these authors a test does not exist to achieve this in the horizontal direction. The purpose of this study therefore was to estimate the reliability of a new unilateral horizontal leg power test to assess these

  13. Sex Differences in the Effects of Unilateral Brain Damage on Intelligence.

    ERIC Educational Resources Information Center

    Inglis, James; Lawson, J. S.

    1981-01-01

    A sexual dimorphism in the functional asymmetry of the damaged human brain is reflected in a test-specific laterality effect in male patients, explaining some contradictions concerning the effects of unilateral brain damage on intelligence in studies in which the influence of sex was overlooked. (Author/SK)

  14. Sex Differences in the Effects of Unilateral Brain Damage on Intelligence

    NASA Astrophysics Data System (ADS)

    Inglis, James; Lawson, J. S.

    1981-05-01

    A sexual dimorphism in the functional asymmetry of the damaged human brain is reflected in a test-specific laterality effect in male but not in female patients. This sex difference explains some contradictions concerning the effects of unilateral brain damage on intelligence in studies in which the influence of sex was overlooked.

  15. Gaze Behaviour during Interception in Children with Spastic Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    van Kampen, P. M.; Ledebt, A.; Smorenburg, A. R. P.; Vermeulen, R. J.; Kelder, M. E.; van der Kamp, J.; Savelsbergh, G. J. P.

    2012-01-01

    Anticipatory gaze behaviour during interceptive movements was investigated in children with Spastic Unilateral Cerebral Palsy (SUCP), and related to the side of the intracerebral lesion. Five children with lesions of the right hemisphere (RHL) and five children with lesions of the left hemisphere (LHL) had to walk towards and intercept a ball that

  16. Amnesia for the McCollough effect following unilateral electroconvulsive therapy: implications for laterality.

    PubMed

    Ringo, J L; Guttmacher, L B

    1988-08-01

    The hemispheric lateralization of retrograde amnesia following unilateral electroconvulsive therapy (ECT) was measured by a novel nonverbal probe, the McCollough effect, which allowed equal and exclusive access to each hemisphere. Alternating exposure to perpendicular gratings of complementary colors (e.g., red vertical stripes alternated with green horizontal stripes) will cause subsequently presented black and white gratings to appear colored hours or even days later (the McCollough effect). Three of the patients examined (3 of 10) lost the effect in just the half visual field contralateral to the treatment side when unilateral nondominant ECT was interposed between the induction of the effect and the its test. Six patients lost the effect bilaterally following unilateral ECT. One patient retained a bilateral aftereffect. This patient had by far the shortest seizure (18 sec). Nine of 10 comparison patients, also suffering from major depression but without ECT intervening between induction and test, showed good bilateral retention of the McCollough effect. The remaining comparison patients showed no retention. These results imply that despite bilateral cortical spread of seizure activity, unilateral nondominant ECT has effects that are most pronounced over the stimulated hemisphere. PMID:3408756

  17. An anterior tooth size comparison in unilateral and bilateral congenitally absent maxillary lateral incisors.

    PubMed

    Baidas, Laila; Hashim, Hayder

    2005-02-15

    The purpose of this study is to compare the anterior tooth size width in patients with congenitally missing maxillary lateral incisors using the Bolton Index and divine proportion. The study sample consisted of thirty pairs of orthodontic models with unilateral (twelve patients; 7 females, 5 males) and bilateral (eighteen patients; 13 females, 5 males) absence of maxillary lateral incisors. The mean ages of the selected cases were 17.7 and 17.5 years, respectively. Descriptive statistics were used for the data analysis. The result showed the mean of the Bolton Index in cases with bilateral absence was closer to the Bolton mean than in cases with unilateral absence. In the unilateral absence cases the width of the existing lateral incisor (5.5 mm) was an average of 1.00 mm less compared to the standard mean (6.5 mm). The divine proportion showed the maxillary central incisors were small in width as indicated by the adjusted value or they were slightly larger in width than the mandibular central incisors. In cases with unilateral and bilateral absence the Bolton Index exhibited maxillary insufficiency, which was confirmed by evaluating the divine proportion of the maxillary and mandibular incisors. The result of the present study will be of great help to both the orthodontist, whether to open or close the space, and to the prosthodontist to restore the missing teeth of patients having missing maxillary lateral incisors. PMID:15719077

  18. Informational Masking and Spatial Hearing in Listeners with and without Unilateral Hearing Loss

    ERIC Educational Resources Information Center

    Rothpletz, Ann M.; Wightman, Frederic L.; Kistler, Doris J.

    2012-01-01

    Purpose: This study assessed selective listening for speech in individuals with and without unilateral hearing loss (UHL) and the potential relationship between spatial release from informational masking and localization ability in listeners with UHL. Method: Twelve adults with UHL and 12 normal-hearing controls completed a series of monaural and

  19. Results of exploratory tympanotomy following sudden unilateral deafness and its effects on hearing restoration.

    PubMed

    Maier, Wolfgang; Fradis, Milo; Kimpel, Susanne; Schipper, Jrg; Laszig, Roland

    2008-08-01

    In cases of acute unilateral deafness, no consensus exists as to whether tympanotomy and sealing of the round window should be performed routinely. To further address this issue, we conducted a retrospective study of pre-, intra-, and postoperative findings in 97 patients who had undergone exploratory tympanotomy (EXT) after the onset of sudden and severe unilateral deafness. Our goal was to ascertain, if we could, whether the benefits of EXT outweigh the risks. We also took into account the effects of perilymph fistula (PLF) on the etiology of sudden hearing loss and postoperative outcomes. We found that routine EXT was indeed beneficial for these patients. It was associated with a very low surgical complication rate, and its effects on hearing as assessed by objective measures were beneficial. The greatest benefits were seen in patients who underwent EXT within 7 days after the onset of their hearing loss. With respect to PLF, we found that the presence or absence of the "typical history" of PLF (i.e., a sudden unilateral hearing loss within 48 hours after a precipitating trauma or physical exertion) had no bearing on whether a PLF was actually present in our group; nor was vertigo a reliable predictor of PLF. We recommend that EXT be performed on all patients with new-onset acute unilateral deafness, barring any contraindications, of course. The absence of a typical history of PLF should not dissuade the surgeon from proceeding with EXT. PMID:18712692

  20. The unilateral occipital transtentorial approach for pineal region meningiomas: a report of 15 cases.

    PubMed

    Qiu, Bo; Wang, Yong; Ou, Shaowu; Guo, Zongze; Wang, Yunjie

    2014-10-01

    In the current study, we reviewed and re-evaluated the experiences of microsurgical management for pineal region meningiomas via the unilateral occipital transtentorial approach (Poppen's approach). Clinical data were obtained on 15 meningiomas of the pineal region, which underwent microsurgery via unilateral Poppen's approach from March 2009 to June 2012. These patients were hospitalized in our department; their data were collected and analyzed retrospectively. The tumors were removed via the right Poppen's approach in 12 cases and left Poppen's approach in 3 cases, and intraoperative external ventricular drainage was performed for hydrocephalus in 3 cases. As a result, gross total resection was achieved in 11 cases, near total resection in 3 cases and subtotal resection in 1 case. All resected tumors were pathologically confirmed. The postoperative complications included two cases of homonymous hemianopia, and deteriorated Parinaud syndrome and diplopia in one case. Ten cases were followed up (range 1-4 years) and no death occurred. On the basis of the existing literature and our experiences, the unilateral Poppen's approach is appropriate for most meningiomas of the pineal region that are small or intermediate in size. However, gross total resection might be difficult via the unilateral Poppen's approach for large-sized meningiomas with much contralateral infratentorial extension due to limited exposure. For these cases, combined supra-infratentorial or bilateral Poppen's approaches are recommended. Preoperative or intraoperative external ventricular drainage can increase tumor exposure and improve microsurgical effects. PMID:24397496

  1. Action Planning in Typically and Atypically Developing Children (Unilateral Cerebral Palsy)

    ERIC Educational Resources Information Center

    Craje, Celine; Aarts, Pauline; Nijhuis-van der Sanden, Maria; Steenbergen, Bert

    2010-01-01

    In the present study, we investigated the development of action planning in children with unilateral Cerebral Palsy (CP, aged 3-6 years, n = 24) and an age matched control group. To investigate action planning, participants performed a sequential movement task. They had to grasp an object (a wooden play sword) and place the sword in a hole in a…

  2. Gaze Behaviour during Interception in Children with Spastic Unilateral Cerebral Palsy

    ERIC Educational Resources Information Center

    van Kampen, P. M.; Ledebt, A.; Smorenburg, A. R. P.; Vermeulen, R. J.; Kelder, M. E.; van der Kamp, J.; Savelsbergh, G. J. P.

    2012-01-01

    Anticipatory gaze behaviour during interceptive movements was investigated in children with Spastic Unilateral Cerebral Palsy (SUCP), and related to the side of the intracerebral lesion. Five children with lesions of the right hemisphere (RHL) and five children with lesions of the left hemisphere (LHL) had to walk towards and intercept a ball that…

  3. 12 CFR 950.11 - Capital stock requirements; unilateral redemption of excess stock.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Capital stock requirements; unilateral redemption of excess stock. 950.11 Section 950.11 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK ASSETS AND OFF-BALANCE SHEET ITEMS ADVANCES Advances to Members 950.11 Capital...

  4. TRPV1 channel-mediated bilateral allodynia induced by unilateral masseter muscle inflammation in rats.

    PubMed

    Simonic-Kocijan, Suncana; Zhao, Xuehong; Liu, Wen; Wu, Yuwei; Uhac, Ivone; Wang, KeWei

    2013-01-01

    Pain in masticatory muscles is among the most prominent symptoms of temperomandibular disorders (TMDs) that have diverse and complex etiology. A common complaint of TMD is that unilateral pain of craniofacial muscle can cause a widespread of bilateral pain sensation, although the underlying mechanism remains unknown. To investigate whether unilateral inflammation of masseter muscle can cause a bilateral allodynia, we generated masseter muscle inflammation induced by unilateral injection of complete Freund's adjuvant (CFA) in rats, and measured the bilateral head withdrawal threshold at different time points using a von Frey anesthesiometer. After behavioral assessment, both right and left trigeminal ganglia (TRG) were dissected and examined for histopathology and transient receptor potential vanilloid 1 (TRPV1) mRNA expression using quantitative real-time PCR analysis. A significant increase in TRPV1 mRNA expression occurred in TRG ipsilateral to CFA injected masseter muscle, whereas no significant alteration in TRPV1 occurred in the contralateral TRG. Interestingly, central injection of TRPV1 antagonist 5-iodoresiniferatoxin into the hippocampus significantly attenuated the head withdrawal response of both CFA injected and non-CFA injected contralateral masseter muscle. Our findings show that unilateral inflammation of masseter muscle is capable of inducing bilateral allodynia in rats. Upregulation of TRPV1 at the TRG level is due to nociception caused by inflammation, whereas contralateral nocifensive behavior in masticatory muscle nociception is likely mediated by central TRPV1, pointing to the involvement of altered information processing in higher centers. PMID:24377488

  5. Look over There! Unilateral Gaze Increases Geographical Memory of the 50 United States

    ERIC Educational Resources Information Center

    Propper, Ruth E.; Brunye, Tad T.; Christman, Stephen D.; Januszewskia, Ashley

    2012-01-01

    Based on their specialized processing abilities, the left and right hemispheres of the brain may not contribute equally to recall of general world knowledge. US college students recalled the verbal names and spatial locations of the 50 US states while sustaining leftward or rightward unilateral gaze, a procedure that selectively activates the

  6. 36 CFR 223.235 - Unilateral delay, suspension, or modification of contracts, permits, or other instruments...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Unilateral delay, suspension, or modification of contracts, permits, or other instruments authorizing the sale of special forest products. 223.235 Section 223.235 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT...

  7. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    ERIC Educational Resources Information Center

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  8. Perceptual Ratings of Vocal Characteristics and Voicing Features in Untreated Patients with Unilateral Vocal Fold Paralysis

    ERIC Educational Resources Information Center

    Leydon, Ciara; Bielamowicz, Steven; Stager, Sheila V.

    2005-01-01

    This study used visual analog scales to obtain perceptual ratings of features of voice production in subjects with unilateral vocal fold paralysis (UVFP), including clarity of laryngeal articulation, consistency of loudness across the utterance and the voiced/voiceless distinction. Recordings of repeated /i/, /isi/, and /izi/ from subjects…

  9. Synchronous unilateral triple breast cancers composed of invasive ductal carcinoma, invasive lobular carcinoma, and Paget's disease.

    PubMed

    Onoe, Shunsuke; Tsuda, Hitoshi; Akashi-Tanaka, Sadako; Hasebe, Takahiro; Iwamoto, Eriko; Hojo, Takashi; Kinoshita, Takayuki

    2014-03-01

    We report a case of synchronous unilateral triple breast cancers comprising invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), and Paget's disease. A 57-year-old woman with a left breast mass was referred to our hospital. Mammography revealed only an isodense area with foci of microcalcification in the lateral area of the left breast. Ultrasonography revealed 2 hypoechoic masses in the outer lower and inner upper areas, and these 2 lesions were diagnosed by core needle biopsy as ILC and IDC, respectively. Left total mastectomy with sentinel lymph node biopsies was performed. In addition to the ILC and IDC, histological examination also identified Paget's disease. Breast cancer often manifests as multiple unilateral lesions; however, it is sometimes difficult to determine whether these tumors have developed multicentrically or have multifocally invaded from an intraductal carcinoma. This case was clearly diagnosed to have occurred multicentrically because of the absence of continuity among the 3 tumors, the presence of a non-invasive component in all 3 tumors, and different histopathological findings. The synchronous unilateral development of ILCs is well known. Cases of synchronous unilateral triple or more breast cancers were reviewed, and their histopathological characteristics, including the incidence of Paget's disease, is discussed. PMID:21140247

  10. Mechanisms of Gait Asymmetry Due to Push-Off Deficiency in Unilateral Amputees.

    PubMed

    Adamczyk, Peter Gabriel; Kuo, Arthur D

    2015-09-01

    Unilateral lower-limb amputees exhibit asymmetry in many gait features, such as ground force, step time, step length, and joint mechanics. Although these asymmetries result from weak prosthetic-side push-off, there is no proven mechanistic explanation of how that impairment propagates to the rest of the body. We used a simple dynamic walking model to explore possible consequences of a unilateral impairment similar to that of a transtibial amputee. The model compensates for reduced push-off work from one leg by performing more work elsewhere, for example during the middle of stance by either or both legs. The model predicts several gait abnormalities, including slower forward velocity of the body center-of-mass during intact-side stance, greater energy dissipation in the intact side, and more positive work overall. We tested these predictions with data from unilateral transtibial amputees (N = 11) and nonamputee control subjects (N = 10) walking on an instrumented treadmill. We observed several predicted asymmetries, including forward velocity during stance phases and energy dissipation from the two limbs, as well as greater work overall. Secondary adaptations, such as to reduce discomfort, may exacerbate asymmetry, but these simple principles suggest that some asymmetry may be unavoidable in cases of unilateral limb loss. PMID:25222950

  11. Transient right-to-left shunting through a patent foramen ovale secondary to unilateral diaphragmatic paralysis.

    PubMed Central

    Cordero, P. J.; Morales, P.; Mora, V.; Cebrian, J.; Vallterra, J.; Gudin, J.; Benlloch, E.; Marco, V.

    1994-01-01

    A 57 year old patient presented with unilateral diaphragmatic paralysis and severe hypoxaemia secondary to transient right-to-left interatrial shunting through a patent foramen ovale. The final diagnosis was made because of the initial detection of a shunt while the patient was breathing 100% oxygen. Images PMID:7940438

  12. Unilateral hypoplastic kidney and ureter associated with diverse mesonephric remnant hyperplasia

    PubMed Central

    Xiao, Guang-Qian; Jerome, Jean-Gilles; Wu, Guan

    2015-01-01

    Mesonephric remnants have been rarely reported in the genitourinary system and sometimes impose a diagnostic challenge both clinically and pathologically. We reported a case of mesonephric remnant hyperplasia with mixed acinar/tubular and epididymis/vas deferens-like morphologies occurring in the renal parenchyma of a unilateral hypoplastic kidney, which has not been previously described. PMID:26309900

  13. Perceptual Asymmetry for Chimeric Stimuli in Children with Early Unilateral Brain Damage

    ERIC Educational Resources Information Center

    Bava, Sunita; Ballantyne, Angela O.; May, Susanne J.; Trauner, Doris A.

    2005-01-01

    The present study used a chimeric stimuli task to assess the magnitude of the left-hemispace bias in children with congenital unilateral brain damage (n=46) as compared to typically developing matched controls (n=46). As would be expected, controls exhibited a significant left-hemispace bias. In the presence of left hemisphere (LH) damage, the

  14. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    ERIC Educational Resources Information Center

    Klint, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate

  15. Gender Differences in Unilateral Spatial Neglect within 24 Hours of Ischemic Stroke

    ERIC Educational Resources Information Center

    Kleinman, Jonathan T.; Gottesman, Rebecca F.; Davis, Cameron; Newhart, Melissa; Heidler-Gary, Jennifer; Hillis, Argye E.

    2008-01-01

    Hemispatial neglect is a common and disabling consequence of stroke. Previous reports examining the relationship between gender and the incidence of unilateral spatial neglect (USN) have included either a large numbers of patients with few neglect tests or small numbers of patients with multiple tests. To determine if USN was more common and/or

  16. A Comparative Study to Evaluate the Functional Effect of Unilateral Uvuloplasty after Primary Palatoplasty

    PubMed Central

    Olivencia-Flores, Claudia; Gavino-Gutierrez, Arquímedes M.; Caceres-Nano, Evelyn; Cotrina-Rabanal, Omar

    2015-01-01

    Background: The conventional method for uvular repair suturing the 2 hemi-uvulas of the palatal cleft together in the midline does not allow us to obtain a proper anatomical repair. In our hands, the midline straight closure frequently causes retraction of the uvular tissues with the consequent abnormal appearance of the uvula. We described before a method for uvular repair in patients with cleft palate. The technique consists in preserving one of the hemi-uvulas, which is moved to the midline to form the definitive uvula. The purpose of this study was to evaluate the functional effects of the unilateral uvuloplasty for uvular repair in a group of patients with bilateral cleft palate. Methods: This is a retrospective, single-blinded cohort study between 2 groups of 90 patients with bilateral cleft palate who were operated on using the conventional and unilateral uvuloplasty methods of uvular repair from 2000 to 2009. Data collection was accomplished by physical examination to evaluate the presence of postoperative fistulas and hypernasal speech determined at 6 months to 5 years after surgery. In addition, postoperative dimensions of the velopharynx were measured by a single-blind examiner using a computed tomography scan. Results: Our comparative study found statistically significant differences between the 2 groups in favor of the unilateral uvuloplasty group. Conclusions: We observed that the use of unilateral uvuloplasty for uvular reconstruction reduces the velopharyngeal space and the frequency of hypernasality in patients with bilateral cleft palate. PMID:26180716

  17. Comparison of the Electromyographic Activation Level and Unilateral Selectivity of Erector Spinae during Different Selected Movements

    ERIC Educational Resources Information Center

    Guo, Lan-Yuen; Wang, Yu-Lin; Huang, Yu-Han; Yang, Chich-Haung; Hou, Yi-You; Harn, Hans I-Chen; You, Yu-Lin

    2012-01-01

    For patients with scoliosis, core stabilization exercises may be beneficial in improving muscle strength and trunk dynamic control. However, few studies have examined whether the erector spinae (ES) activation status during unilateral spinal extensor strengthening meets the guideline for patients with spinal scoliosis. To determine ES activation…

  18. Unilateral Left-Hand Contractions Produce Widespread Depression of Cortical Activity after Their Execution

    PubMed Central

    Cross-Villasana, Fernando; Gröpel, Peter; Doppelmayr, Michael; Beckmann, Jürgen

    2015-01-01

    The execution of unilateral hand contractions before performance has been reported to produce behavioral aftereffects in various tasks. These effects have been regularly attributed to an induced shift in activation asymmetry to the contralateral hemisphere produced by the contractions. An alternative explanation proposes a generalized state of reduced bilateral cortical activity following unilateral hand contractions. The current experiment contrasted the above explanation models and tested the state of cortical activity after the termination of unilateral hand contractions. Twenty right-handed participants performed hand contractions in two blocks, one for each hand. Using electroencephalogram (EEG), the broad alpha band and its asymmetry between hemispheres before, during, and after hand contractions were analyzed. During contractions, significant bilateral decrease in alpha amplitudes (indicating cortical activation) emerged for both hands around sensory-motor regions. After contractions, alpha amplitudes increased significantly over the whole scalp when compared to baseline, but only for the left hand. No modulation of hemispheric asymmetry was observed at any phase. The results suggest that unilateral hand contractions produce a state of reduced cortical activity after their termination, which is more pronounced if the left hand was used. Consequently, we propose that the reduced cortical activity (and not the persistent activation asymmetry) may facilitate engagement in subsequent behavior, probably due to preventing interference from other, nonessential cortical regions. PMID:26709832

  19. Instability in dynamic fracture

    NASA Astrophysics Data System (ADS)

    Fineberg, J.; Marder, M.

    1999-05-01

    The fracture of brittle amorphous materials is an especially challenging problem, because the way a large object shatters is intimately tied to details of cohesion at microscopic scales. This subject has been plagued by conceptual puzzles, and to make matters worse, experiments seemed to contradict the most firmly established theories. In this review, we will show that the theory and experiments fit within a coherent picture where dynamic instabilities of a crack tip play a crucial role. To accomplish this task, we first summarize the central results of linear elastic dynamic fracture mechanics, an elegant and powerful description of crack motion from the continuum perspective. We point out that this theory is unable to make predictions without additional input, information that must come either from experiment, or from other types of theories. We then proceed to discuss some of the most important experimental observations, and the methods that were used to obtain the them. Once the flux of energy to a crack tip passes a critical value, the crack becomes unstable, and it propagates in increasingly complicated ways. As a result, the crack cannot travel as quickly as theory had supposed, fracture surfaces become rough, it begins to branch and radiate sound, and the energy cost for crack motion increases considerably. All these phenomena are perfectly consistent with the continuum theory, but are not described by it. Therefore, we close the review with an account of theoretical and numerical work that attempts to explain the instabilities. Currently, the experimental understanding of crack tip instabilities in brittle amorphous materials is fairly detailed. We also have a detailed theoretical understanding of crack tip instabilities in crystals, reproducing qualitatively many features of the experiments, while numerical work is beginning to make the missing connections between experiment and theory.

  20. [Rehabilitation after periprosthetic fractures].

    PubMed

    Schmitt-Sody, M; Valle, C

    2016-03-01

    Periprosthetic fractures of the upper and lower extremities not only represent a challenge for surgeons but also for the rehabilitation team. The sometimes multimorbid patients have often undergone several surgical operations and need special planning and cooperation between an interdisciplinary team in order to achieve the best possible functional result and social reintegration. A structured rehabilitation planning after surgical treatment is a prerequisite for the patient to return to life as normal as possible. The aim is always rapid mobilization to achieve independence in activities of daily living. Special attention should be paid to postoperative immobilization and weight bearing. PMID:26923872

  1. Permeability damage to natural fractures caused by fracturing fluid polymers

    SciTech Connect

    Gall, B.L.; Sattler, A.R.; Maloney, D.R.; Raible, C.J.

    1988-04-01

    Formation damage studies using artificially fractured, low-permeability sandstone cores indicate that viscosified fracturing fluids can severely restrict gas flow through these types of narrow fractures. These studies were performed in support of the Department of Energy's Multiwell Experiment (MWX). Extensive geological and production evaluations at the MWX site indicate that the presence of a natural fracture system is largely responsible for unstimulated gas production. The laboratory formation damage studies were designed to examine changes in cracked core permeability to gas caused by fracturing fluid residues introduced into such narrow fractures during fluid leakoff. Polysaccharide polymers caused significant reduction (up to 95%) to gas flow through cracked cores. Polymer fracturing fluid gels used in this study included hydroxypropyl guar, hydroxyethyl cellulose, and xanthan gum. In contrast, polyacrylamide gels caused little or no reduction in gas flow through cracked cores after liquid cleanup. Other components of fracturing fluids (surfactants, breakers, etc.) caused less damage to gas flows. Other factors affecting gas flow through cracked cores were investigated, including the effects of net confining stress and non-Darcy flow parameters. Results are related to some of the problems observed during the stimulation program conducted for the MWX. 24 refs., 4 figs., 7 tabs.

  2. Comparison of two-transsacral-screw fixation versus triangular osteosynthesis for transforaminal sacral fractures.

    PubMed

    Min, Kyong S; Zamorano, David P; Wahba, George M; Garcia, Ivan; Bhatia, Nitin; Lee, Thay Q

    2014-09-01

    Transforaminal pelvic fractures are high-energy injuries that are translationally and rotationally unstable. This study compared the biomechanical stability of triangular osteosynthesis vs 2-transsacral-screw fixation in the repair of a transforaminal pelvic fracture model. A transforaminal fracture model was created in 10 cadaveric lumbopelvic specimens. Five of the specimens were stabilized with triangular osteosynthesis, which consisted of unilateral L5-to-ilium lumbopelvic fixation and ipsilateral iliosacral screw fixation. The remaining 5 were stabilized with a 2-transsacral-screw fixation technique that consisted of 2 transsacral screws inserted across S1. All specimens were loaded cyclically and then loaded to failure. Translation and rotation were measured using the MicroScribe 3D digitizing system (Revware Inc, Raleigh, North Carolina). The 2-transsacral-screw group showed significantly greater stiffness than the triangular osteosynthesis group (2-transsacral-screw group, 248.7 N/mm [standard deviation, 73.9]; triangular osteosynthesis group, 125.0 N/mm [standard deviation, 66.9]; P=.02); however, ultimate load and rotational stiffness were not statistically significant. Compared with triangular osteosynthesis fixation, the use of 2 transsacral screws provides a comparable biomechanical stability profile in both translation and rotation. This newly revised 2-transsacral-screw construct offers the traumatologist an alternative method of repair for vertical shear fractures that provides biplanar stability. It also offers the advantage of percutaneous placement in either the prone or supine position. PMID:25350616

  3. Mechanical Models of Bed-Perpendicular Fractures in Layered Rocks Subjected to Extensional Strain

    NASA Astrophysics Data System (ADS)

    Sanz, P.; Pollard, D. D.; Borja, R. I.

    2010-12-01

    Natural fractures (joints) enhance permeability and therefore are important for the economical production of low-permeability hydrocarbon reservoirs and aquifers. In this work we investigate the formation of bed-perpendicular joints during extension in a stiff brittle layer surrounded by thick softer layers. The quasi-static finite element models consist of three elasto-plastic layers with frictional bedding interfaces and the middle layer contains layer-perpendicular fractures that can accommodate opening at the bedding surface accompanied by interface sliding. The upper and lower boundaries are subject to normal tractions appropriate for the depth of burial. Lateral boundaries are displaced horizontally to represent the extensional tectonic regime. We use an interface model that captures the most important mechanical features during sliding of bedding interfaces and opening of joints: unilateral contact, elastic and plastic relative deformation, tensile strength, cohesion, frictional sliding, and non-associative plastic flow. The constitutive law extends the Coulomb slip criterion to the tensile regime to capture opening of fractures in a quasi-brittle manner. The finite element implementation employs a penalty scheme to impose the contact constraints along the interfaces. The numerical simulations show the effects of mechanical properties of layers and interfaces in the development and spacing of bed-perpendicular joints. We evaluate the concepts of fracture saturation and sequential infilling, and the relationship between joint spacing and layer thickness in the context of the new modeling capabilities.

  4. PERPENDICULAR DOUBLE-PLATE FIXATION WITH LOCKING SYSTEM FOR ACROMION PEDICLE FRACTURE

    PubMed Central

    Zhu, Junkun; Pan, Zhijun; Zheng, Rongzong; Lan, Shuhua

    2016-01-01

    Objective : To describe the surgical technique and preliminary clinical outcomes in a series of open reduction internal fixation of basal acromion process fractures applying a double-plating technique. Methods : Nine consecutive patients, mean age 33.4 years old (range, 23-61 years old) with unilateral acromion fracture (Type 3 AO/OTA) with more than 1cm displacement who underwent fixation utilizing a locked double-plating technique, were evaluated on average at 7.8 months (range, 3-15 months) for outcomes related to pain, shoulder function, and surgical complications. Results : Eight patients recovered with complete radiographic union and favorable shoulder function. One case failed to be fully evaluated for more than 3 months follow-up. The overall scores of Constant, Shoulder Pain and Disability Index (SPADI) and DASH for the eight patients reviewed were 91.9± 6.31, 3.11± 3.79 and 5.2± 6.35, respectively. No post-operative infection or surgical hardware irritation was identified at final follow-up of these eight patients. Conclusion : While more evidence is needed to justify its advantages over traditional implants, perpendicular double-plate with a locking system may be indicated for acromion pedicle fracture treatment, since it performed well for fracture healing and joint function rehabilitation. Level of Evidence IV, Therapeutic Study. PMID:26981047

  5. Unilateral Versus Bilateral Prostatic Arterial Embolization for Lower Urinary Tract Symptoms in Patients with Prostate Enlargement

    SciTech Connect

    Bilhim, Tiago; Pisco, Joao; Rio Tinto, Hugo; Fernandes, Lucia; Campos Pinheiro, Luis; Duarte, Marisa; Pereira, Jose A.; Oliveira, Antonio G.; O'Neill, Joao

    2013-04-15

    This study was designed to compare baseline data and clinical outcome between patients with prostate enlargement/benign prostatic hyperplasia (PE/BPH) who underwent unilateral and bilateral prostatic arterial embolization (PAE) for the relief of lower urinary tract symptoms (LUTS). This single-center, ambispective cohort study compared 122 consecutive patients (mean age 66.7 years) with unilateral versus bilateral PAE from March 2009 to December 2011. Selective PAE was performed with 100- and 200-{mu}m nonspherical polyvinyl alcohol (PVA) particles by a unilateral femoral approach. Bilateral PAE was performed in 103 (84.4 %) patients (group A). The remaining 19 (15.6 %) patients underwent unilateral PAE (group B). Mean follow-up time was 6.7 months in group A and 7.3 months in group B. Mean prostate volume, PSA, International prostate symptom score/quality of life (IPSS/QoL) and post-void residual volume (PVR) reduction, and peak flow rate (Qmax) improvement were 19.4 mL, 1.68 ng/mL, 11.8/2.0 points, 32.9 mL, and 3.9 mL/s in group A and 11.5 mL, 1.98 ng/mL, 8.9/1.4 points, 53.8 mL, and 4.58 mL/s in group B. Poor clinical outcome was observed in 24.3 % of patients from group A and 47.4 % from group B (p = 0.04). PAE is a safe and effective technique that can induce 48 % improvement in the IPSS score and a prostate volume reduction of 19 %, with good clinical outcome in up to 75 % of treated patients. Bilateral PAE seems to lead to better clinical results; however, up to 50 % of patients after unilateral PAE may have a good clinical outcome.

  6. Unilateral versus bilateral pedicle screw instrumentation for single-level minimally invasive transforaminal lumbar interbody fusion.

    PubMed

    Shen, Xiaolong; Zhang, Hailong; Gu, Xin; Gu, Guangfei; Zhou, Xu; He, Shisheng

    2014-09-01

    Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) has become an increasingly popular method of lumbar arthrodesis. However, there are few published studies comparing the clinical outcomes between unilateral and bilateral instrumented MIS TLIF. Sixty-five patients with degenerative lumbar spine disease were enrolled in this study. Thirty-one patients were randomized to the unilateral group and 34 to the bilateral group. Recorded demographic data included sex, age, preoperative diagnosis, and degenerated segment. Operative time, blood loss, hospital stay length, complication rates, and fusion rates were also evaluated. The Oswestry Disability Index (ODI) score and Visual Analog Scale (VAS) pain score data were obtained. All patients were asked to follow-up at 3 and 6 months after surgery, and once every 6 months thereafter. The mean follow-up was 26.6 months (range 18-36 months). The two groups were similar in sex, age, preoperative diagnosis, and operated level. The unilateral group had significantly shorter operative time, lower blood loss, and shorter hospital time than the bilateral group. The average postoperative ODI and VAS scores improved significantly in each group. No significant differences were found between the two groups in relation to ODI and VAS. All patients showed evidence of fusion at 12 months postoperatively. The total fusion rate, screw failure, and general complication rate were not significantly different. Results showed that single-level MIS TLIF with unilateral pedicle screw fixation would be sufficient in the management of preoperatively stable patients with lumbar degenerative disease. It seems that MIS TLIF with unilateral pedicle screw instrumentation is a better choice for single-level degenerative lumbar spine disease. PMID:24814852

  7. Usefulness of Contralateral Indirect Decompression through Minimally Invasive Unilateral Transforaminal Lumbar Interbody Fusion

    PubMed Central

    Yoo, Jae-Sung; Lee, Jun-Yeul

    2014-01-01

    Study Design Retrospective study. Purpose This study aims to investigate the clinical and radiological results of contralateral indirect decompression through minimally invasive unilateral transforaminal lumbar interbody fusion (MI-TLIF). Overview of Literature Several studies have proposed that blood loss and operation time could be reduced through a unilateral approach, although many surgeons have forecast that satisfactory foraminal decompression is difficult to achieve through a unilateral approach. Methods The study included 30 subjects who had undergone single-level MI-TLIF. Visual analogue scale (VAS) and Oswestry disability index (ODI) were analyzed for clinical assessment. Disc height, segmental lordosis, and lumbar lordosis angle were examined for radiological assessment. The degree of contralateral indirect decompression was evaluated through a comparative analysis, with a magnetic resonance imaging (MRI) performed preoperatively and at one year postoperatively. Results Intraoperative blood loss volume was 308.75 mL in the unilateral approach group (UAP), and 575.00 mL in the bilateral approach group (BAP), showing a statistically significant difference. Operation time was 139.50 minutes in the UAP group, and 189.00 minutes in the BAP group, exhibiting a statistically significant difference (p<0.05). On the other hand, no significant difference was found in VAS, ODI, disc height, lordosis angles and the degree of nerve decompression in the vertebral foramen, using MRI, between the two groups (p>0.05). Conclusions Satisfactory results were acquired with MI-TLIF conducted through the unilateral approach of contralateral indirect decompression, in alignment with the bilateral approach. Therefore, contralateral indirect decompression is thought to be a useful procedure in reducing the operation time and volume of blood loss. PMID:25187862

  8. Changes in auditory perceptions and cortex resulting from hearing recovery after extended congenital unilateral hearing loss

    PubMed Central

    Firszt, Jill B.; Reeder, Ruth M.; Holden, Timothy A.; Burton, Harold; Chole, Richard A.

    2013-01-01

    Monaural hearing induces auditory system reorganization. Imbalanced input also degrades time-intensity cues for sound localization and signal segregation for listening in noise. While there have been studies of bilateral auditory deprivation and later hearing restoration (e.g., cochlear implants), less is known about unilateral auditory deprivation and subsequent hearing improvement. We investigated effects of long-term congenital unilateral hearing loss on localization, speech understanding, and cortical organization following hearing recovery. Hearing in the congenitally affected ear of a 41 year old female improved significantly after stapedotomy and reconstruction. Pre-operative hearing threshold levels showed unilateral, mixed, moderately-severe to profound hearing loss. The contralateral ear had hearing threshold levels within normal limits. Testing was completed prior to, and 3 and 9 months after surgery. Measurements were of sound localization with intensity-roved stimuli and speech recognition in various noise conditions. We also evoked magnetic resonance signals with monaural stimulation to the unaffected ear. Activation magnitudes were determined in core, belt, and parabelt auditory cortex regions via an interrupted single event design. Hearing improvement following 40 years of congenital unilateral hearing loss resulted in substantially improved sound localization and speech recognition in noise. Auditory cortex also reorganized. Contralateral auditory cortex responses were increased after hearing recovery and the extent of activated cortex was bilateral, including a greater portion of the posterior superior temporal plane. Thus, prolonged predominant monaural stimulation did not prevent auditory system changes consequent to restored binaural hearing. Results support future research of unilateral auditory deprivation effects and plasticity, with consideration for length of deprivation, age at hearing correction and degree and type of hearing loss. PMID:24379761

  9. Unilateral Prostate Cancer Cannot be Accurately Predicted in Low-Risk Patients

    SciTech Connect

    Isbarn, Hendrik; Karakiewicz, Pierre I.; Vogel, Susanne

    2010-07-01

    Purpose: Hemiablative therapy (HAT) is increasing in popularity for treatment of patients with low-risk prostate cancer (PCa). The validity of this therapeutic modality, which exclusively treats PCa within a single prostate lobe, rests on accurate staging. We tested the accuracy of unilaterally unremarkable biopsy findings in cases of low-risk PCa patients who are potential candidates for HAT. Methods and Materials: The study population consisted of 243 men with clinical stage {<=}T2a, a prostate-specific antigen (PSA) concentration of <10 ng/ml, a biopsy-proven Gleason sum of {<=}6, and a maximum of 2 ipsilateral positive biopsy results out of 10 or more cores. All men underwent a radical prostatectomy, and pathology stage was used as the gold standard. Univariable and multivariable logistic regression models were tested for significant predictors of unilateral, organ-confined PCa. These predictors consisted of PSA, %fPSA (defined as the quotient of free [uncomplexed] PSA divided by the total PSA), clinical stage (T2a vs. T1c), gland volume, and number of positive biopsy cores (2 vs. 1). Results: Despite unilateral stage at biopsy, bilateral or even non-organ-confined PCa was reported in 64% of all patients. In multivariable analyses, no variable could clearly and independently predict the presence of unilateral PCa. This was reflected in an overall accuracy of 58% (95% confidence interval, 50.6-65.8%). Conclusions: Two-thirds of patients with unilateral low-risk PCa, confirmed by clinical stage and biopsy findings, have bilateral or non-organ-confined PCa at radical prostatectomy. This alarming finding questions the safety and validity of HAT.

  10. Lesion Activity on Brain MRI in a Chinese Population with Unilateral Optic Neuritis

    PubMed Central

    Lai, Chuntao; Chang, Qinglin; Tian, Guohong; Wang, Jiawei; Yin, Hongxia; Liu, Wu

    2015-01-01

    Longitudinal studies have shown that brain white matter lesions are strong predictors of the conversion of unilateral optic neuritis to multiple sclerosis (MS) in Caucasian populations. Consequently brain MRI criteria have been developed to improve the prediction of the development of clinically definite multiple sclerosis (CDMS). In Asian populations, optic neuritis may be the first sign of classical or optic-spinal MS. These signs add to the uncertainty regarding brain MRI changes with respect to the course of unilateral optic neuritis. The aim of this study was to examine the association between brain lesion activity and conversion to CDMS in Chinese patients with unilateral optic neuritis. A small prospective cohort study of 40 consecutive Chinese patients who presented with unilateral optic neuritis was conducted. Brain lesion activity was recorded as the incidence of Gd-enhanced lesions and new T2 lesions. Brain lesions on MRI that were characteristic of MS were defined according to the 2010 revisions of the McDonald criteria. The primary endpoint was the development of CDMS. We found that nineteen patients (48%) had brain lesions that were characteristic of MS on the initial scan. One of these patients (3%) had Gd-enhanced brain lesions. A significantly lower percentage of the patients (10%, p<0.001) presented with new T2 brain lesions on the second scan. During a median of 5 years of follow-up, seven patients (18%) developed CDMS. There was no significant difference in the conversion rate to CDMS between patients with and without brain lesions that were characteristic of MS (4/19 and 3/21, respectively; Fisher exact test, one-sided, p = 0.44). We conclude that brain lesions characteristic of MS are common in Chinese patients with unilateral optic neuritis; however, these patients exhibit low lesion activity. The predictive value of brain lesion activity for CDMS requires investigation in additional patients. PMID:26485719

  11. Gravity-Driven Hydraulic Fractures

    NASA Astrophysics Data System (ADS)

    Germanovich, L. N.; Garagash, D.; Murdoch, L. C.; Robinowitz, M.

    2014-12-01

    This study is motived by a new method for disposing of nuclear waste by injecting it as a dense slurry into a hydraulic fracture that grows downward to great enough depth to permanently isolate the waste. Disposing of nuclear waste using gravity-driven hydraulic fractures is mechanically similar to the upward growth of dikes filled with low density magma. A fundamental question in both applications is how the injected fluid controls the propagation dynamics and fracture geometry (depth and breadth) in three dimensions. Analog experiments in gelatin [e.g., Heimpel and Olson, 1994; Taisne and Tait, 2009] show that fracture breadth (the short horizontal dimension) remains nearly stationary when the process in the fracture "head" (where breadth is controlled) is dominated by solid toughness, whereas viscous fluid dissipation is dominant in the fracture tail. We model propagation of the resulting gravity-driven (buoyant or sinking), finger-like fracture of stationary breadth with slowly varying opening along the crack length. The elastic response to fluid loading in a horizontal cross-section is local and can be treated similar to the classical Perkins-Kern-Nordgren (PKN) model of hydraulic fracturing. The propagation condition for a finger-like crack is based on balancing the global energy release rate due to a unit crack extension with the rock fracture toughness. It allows us to relate the net fluid pressure at the tip to the fracture breadth and rock toughness. Unlike the PKN fracture, where breadth is known a priori, the final breadth of a finger-like fracture is a result of processes in the fracture head. Because the head is much more open than the tail, viscous pressure drop in the head can be neglected leading to a 3D analog of Weertman's hydrostatic pulse. This requires relaxing the local elasticity assumption of the PKN model in the fracture head. As a result, we resolve the breadth, and then match the viscosity-dominated tail with the 3-D, toughness-dominated head to obtain a complete closed-form solution. We then analyze the gravity fracture propagation in conditions of either continuous injection or finite volume release for sets of parameters representative of dense waste injection technique and low viscosity magma diking.

  12. Fracture Detection and Mapping

    SciTech Connect

    Goldstein, Norman E.; Iovenitti, Joseph L.

    1986-01-21

    Because the costs of drilling, completing, and testing a well can be extremely high, it is important to develop better tools and methods for locating high permeability zones prior to drilling, and to develop better tools and methods for identifying and characterizing major fracture zones during the drilling and well testing stages. At the recommendation of the LBL Industry Review Panel on Geothermal Reservoir Technology, we organized and convened a one-day workshop this past July to discuss various aspects of DOE's current and planned activities in fracture detection, to review the geothermal industry's near-term and long-term research needs, to determine the priority of those needs, to disseminate to industry the status of research in progress, and to discuss the possibility of future joint research between industry and DOE. In this paper we present a brief overview of the workshop from the perspective of those who participated in it and provided us with written comments to a questionnaire that was distributed.

  13. Fracture detection and mapping

    SciTech Connect

    Goldstein, N.E.; Iovenitti, J.L.

    1986-03-01

    Because the costs of drilling, completing, and testing a well can be extremely high, it is important to develop better tools and methods for locating high permeability zones prior to drilling, and to develop better tools and methods for identifying and characterizing major fracture zones during the drilling and well testing stages. At the recommendation of the LBL Industry Review Panel on Geothermal Reservoir Technology, we organized and convened a one-day workshop this past July to discuss various aspects of DOE's current and planned activities in fracture detection, to review the geothermal industry's near-term and long-term research needs, to determine the priority of those needs, to disseminate to industry the status of research in progress, and to discuss the possibility of future joint research between industry and DOE. In this paper we present a brief overview of the workshop from the perspective of those who participated in it and provided us with written comments to a questionnaire that was distributed.

  14. Thoracolumbar Spine Fractures in the Geriatric Fracture Center

    PubMed Central

    Folbert, E. C.; Kraai, M.; Smit, R. S.; Hegeman, J. H.; van der Velde, D.

    2014-01-01

    Introduction: Thoracolumbar spine fractures are common osteoporotic fractures among elderly patients. Several studies suggest that these fractures can be treated successfully with a nonoperative management. The aim of this study is to evaluate the conservative treatment of elderly patients with a vertebral fracture. Methods: This study is a retrospective cohort study, which included all patients with an age of 65 years and older, who were diagnosed with a vertebral fracture and where therefore admitted to the Geriatric Fracture Center over a period of 2 years. Primary outcome was the level of functioning 6 weeks and 3 months after admission. Results: We included 106 patients with 143 vertebral fractures, of which 61 patients were evaluated after 3 months. In our population, 53% of the patients had a fracture involving both middle and anterior columns. The majority of the patients functioned sufficiently 6 weeks and 3 months after admission. Analysis showed that age <80 years is an independent predictor of a sufficient level of functioning after 6 weeks. Discussion: The nonoperative treatment of elderly patients with a vertebral fracture leads to a sufficient level of functioning 6 weeks and 3 months after admission. In our population, only age <80 years is an independent predictor for a sufficient level of functioning 6 weeks after admission. The level of functioning at 6 weeks predicts the level of functioning 3 months after admission. On comparison, the level of functioning after early ambulation is equal to the level of functioning after immobilization. Where immobilization may lead to complications, early ambulation was not associated with new complications or neurological damage. Based on these advantages, the treatment of elderly patients with a fracture involving both middle and anterior columns may be altered from immobilization to mobilization in the future. PMID:25360330

  15. Closed reduction of a fractured bone

    MedlinePLUS

    Fracture reduction - closed ... pain medicine you receive. There may be new fractures that occur with the reduction. If the reduction ... Wood GW. General Principles of Fracture Treatment. In: Canale ST, Beaty JH, ... PA: Mosby Elsevier; 2012:chap 53. General principles ...

  16. Toe and Metatarsal Fractures (Broken Toes)

    MedlinePLUS

    ... toes) Text Size Print Bookmark Toe and Metatarsal Fractures (Broken toes) The structure of the foot is ... received in an emergency room. What Is a Fracture? A fracture is a break in the bone. ...

  17. Femoral fracture repair and postoperative management in new zealand white rabbits.

    PubMed

    Reuter, Jon D; Ovadia, Shira; Howell, Paula; Jaskwich, David H

    2002-07-01

    Low bone density and large muscle mass predispose rabbits to femoral fractures. However, there are few reports describing treatment and prognosis. Two New Zealand White rabbits presented with unilateral left rear limb abduction and lateral rotation of the distal left rear limb 2 and 17 days after experimental surgery to create a "stair step" in the patellar groove of the left medial femoral chondyle. This procedure was performed after approval by the Institutional Animal Care and Use Committee. Radiography revealed a spiral oblique mid-shaft fracture of the left femur in both rabbits. Open fracture reduction was undertaken. Because of the presence of screws and Kirschner-wires in the medial femoral condyle, a lateral approach to surgical correction was chosen. Intramedullary fixation was used to reduce and stabilize the fractures. A 0.062" Kirschner wire was selected for the intramedullary device, because it was sufficiently flexible to allow easy passage into the femoral canal while being sufficiently stiff to promote reduction of the fracture. In addition, the ends of the fracture were secured with a 0.032" Kirschner cerclage wire to provide additional control of rotation and angulation. Then we assessed the range of motion of the knee joint to determine fracture stability and ensure that the hardware did not impinge on soft-tissue elements. After closure and application of sterile dressing, the hind legs were hobbled proximal to the hock by using elastic veterinary wrap in a figure-eight pattern to maintain limb alignment and prevent formation of pressure ulcers. Intraoperative fluoroscopic evaluation and postoperative radiographs confirmed fracture reduction. Bruising and seroma formation occurred at the surgical site, and transient anorexia developed. Rabbits were treated with fluids, analgesics, antibiotics, and fitted with Elizabethan collars. They were housed in isolation to limit excessive environmental stimulation, which could alarm them and provoke "thumping" of the rear legs. Muscular weakness and atrophy developed in the affected legs, but the fractures remained immobilized. Radiographs obtained 21 days after surgery confirmed marked callus formation and integrity of the implanted hardware. Four weeks after surgical fixation, both rabbits showed increased muscle development in the repaired leg and were ambulating normally. The long-term prognosis was excellent. These cases demonstrate that repair of femoral fractures in rabbits can be achieved by using basic orthopedic techniques and diligent post-operative management. PMID:12109898

  18. Fracturing experiments: Nevada Test Site

    SciTech Connect

    Warpinski, N.R.; Chu, T.Y.

    1987-01-01

    The purpose of this program is to develop techniques for efficient and economic recovery of natural gas from low permeability reservoirs in both Western US basins and the Eastern Appalachian area. Experiments have been conducted at G-tunnel to improve this conventional technology and to develop novel techniques for improved recovery. These experiments offer a unique opportunity to perform fracturing research under conditions combining the best aspects of field tests and laboratory experiments; they are conducted under realistic in situ conditions, yet mining allows for direct observation. The development of controlled-pulse fracturing technology has been the major focus of the program the last two years. We find that explosive fracturing can often have detrimental results such as crushing, a stress cage, and reduced permeability. Hydraulic fracturing produces a single fracture which may not adequately drain a naturally fractured reservoir. A controlled-pulse-fracturing stimulation can result in multiple fratures extending in all directions. This is attractive for draining naturally fractured reservoirs. 11 refs.

  19. Formation stability after hydraulic fracturing

    NASA Astrophysics Data System (ADS)

    Papanastasiou, Panos

    1999-12-01

    This paper investigates stress changes resulting from fracturing in a weak formation and estimates the reduced risk of formation failure. The analysis is based on fracture propagation and closure of a plane strain elasto-plastic fracture. It is shown that during fracture propagation the area near the fracture tip undergoes plastic deformation, with the result that the in situ stresses there are significantly reduced from the original compressive state. The stress relief is driven by the reduction of the minimum in situ stress and the consistency condition which requires the stress state to remain on the yield or failure envelope. After fracture closure, due to permanent deformation the stress state does not return to its original state, as in the case of elastic material. The risk of formation failure, which is quantified with the introduction of a yield factor, is significantly reduced after fracturing and closure. The residual width from plastic deformation results in a non-uniform closure stress on proppant with higher values near the tip and lower value near the wellbore which is detrimental to the stability of proppant. The closure stress becomes more uniform with increasing fracture length.

  20. Epidemiological study on talus fractures???

    PubMed Central

    Sakaki, Marcos Hideyo; Saito, Guilherme Honda; de Oliveira, Rafael Garcia; Ortiz, Rafael Trevisan; Silva, Jorge dos Santos; Fernandes, Tlio Diniz; dos Santos, Alexandre Leme Godoy

    2014-01-01

    Objective to analyze the characteristics of patients with talus fractures and the injuries that they present. Methods retrospective analysis on patients hospitalized in the Institute of Orthopedics and Traumatology, Hospital das Clnicas, School of Medicine of the University of So Paulo, between 2006 and 2011, with talus fractures. Patient profile parameters, risk factors, fracture characteristics, treatment data and acute complications were analyzed. Results analysis on 23 cases showed that men were more affected than women, with a ratio of 4.8:1. The most frequent trauma mechanism was traffic accidents, followed by falls from a height. The most frequent type of fracture was at the neck of the talus, with 17 cases. Among the 23 cases, seven had peritalar dislocation at the time of presentation, four had exposed fractures and 11 presented other associated fractures. The mean length of time between the trauma and the definitive treatment was six days, while the mean length of hospital stay was 11 days. Three patients presented acute postoperative complications. Conclusion talus fractures occurred most commonly in the region of the talar neck and most frequently in young males who suffered high-energy trauma. In almost half of the cases, there were other associated fractures. The length of hospital stay was 11 days. PMID:26229823