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Sample records for 12th intercostal space

  1. NASA Spitzer 12th Anniversary Space Calendar

    NASA Image and Video Library

    2015-08-20

    NASA Spitzer Space Telescope celebrated its 12th anniversary with a new digital calendar showcasing some of the mission most notable discoveries and popular cosmic eye candy. The digital calendar is online at http://www.jpl.nasa.gov/images/spitzer/20150820/Spitzer12thAnniversaryCalendar.pdf The calendar follows the life of the mission, with each month highlighting top infrared images and discoveries from successive years -- everything from a dying star resembling the eye of a monster to a star-studded, swirling galaxy. The final month includes a brand new image of the glittery star-making factory known as the Monkey Head nebula. Spitzer, which launched into space on August 25, 2003, from Cape Canaveral, Florida, is still going strong. It continues to use its ultra-sensitive infrared vision to probe asteroids, comets, exoplanets (planets outside our solar system) and some of the farthest known galaxies. Recently, Spitzer helped discover the closest known rocky exoplanet to us, named HD219134b, at 21 light-years away. In fact, Spitzer's exoplanet studies continue to surprise the astronomy community. The telescope wasn't originally designed to study exoplanets, but as luck -- and some creative engineering -- would have it, Spitzer has turned out to be a critical tool in the field, probing the climates and compositions of these exotic worlds. This pioneering work began in 2005, when Spitzer became the first telescope to detect light from an exoplanet. http://photojournal.jpl.nasa.gov/catalog/PIA19872

  2. 12th Man in Space Symposium: The Future of Humans in Space. Abstract Volume

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The National Aeronautics and Space Administration (NASA) is pleased to host the 12th IAA Man in Space Symposium. A truly international forum, this symposium brings together scientists, engineers, and managers interested in all aspects of human space flight to share the most recent research results and space agency planning related to the future of humans in space. As we look out at the universe from our own uniquely human perspective, we see a world that we affect at the same time that it affects us. Our tomorrows are highlighted by the possibilities generated by our knowledge, our drive, and our dreams. This symposium will examine our future in space from the springboard of our achievements.

  3. Additional circular intercostal space created by bifurcation of the left 3rd rib and its costal cartilage: a case report.

    PubMed

    Kumar, Naveen; Guru, Anitha; Patil, Jyothsna; Ravindra, Swamy; Badagabettu, Satheesha Nayak

    2013-01-08

    In the thorax there are normally 11 pairs of intercostal spaces: the spaces between adjacent ribs. The intercostal spaces contain intercostal muscles, intercostal nerves and vessels. During a routine dissection for undergraduate medical students, we observed a variation involving the left 3rd rib and 3rd costal cartilage in the cadaver of a man of Indian ethnicity aged about 65 years. The left 3rd rib and its costal cartilage were bifurcated at their costochondral junction enclosing a small circular additional intercostal space. Muscle tissue covered by deep fascia was present in this circular intercostal space. The muscle in the circular intercostal space received its nerve supply from a branch of the 2nd intercostal nerve. Knowledge of such variations is helpful to surgeons operating on the anterior thoracic wall involving ribs and intercostal spaces. Knowing the possibility of the presence of an additional space between normal intercostal spaces can guide a surgeon through to a successful surgery.

  4. Immune targeting of the pleural space by intercostal approach.

    PubMed

    Weber, Georg F

    2015-02-18

    Infectious diseases of the airways are a major health care problem world wide. New treatment strategies focus on employing the body's immune system to enhance its protective capacities during airway disease. One source for immune-competent cells is the pleural space, however, its immune-physiological function remains poorly understood. The aim of this study was to develop an experimental technique in rodents that allows for an in vivo analysis of pleural space immune cells participating in the host defense during airway disease. I developed an easy and reliable technique that I named the "InterCostal Approach of the Pleural Space" (ICAPS) model that allows for in vivo analysis of pleural space immune cells in rodents. By injection of immune cell altering fluids into or flushing of the pleural space the immune response to airway infections can be manipulated. The results reveal that (i) the pleural space cellular environment can be altered partially or completely as well as temporarily or permanently, (ii) depletion of pleural space cells leads to increased airway inflammation during pulmonary infection, (iii) the pleural space contributes immune competent B cells during airway inflammation and (iv) inhibition of B cell function results in reduced bacterial clearance during pneumonia. As the importance for in-depth knowledge of participating immune cells during health and disease evolves, the presented technique opens new possibilities to experimentally elucidate immune cell function, trafficking and contribution of pleural space cells during airway diseases.

  5. Finding the fifth intercostal space for chest drain insertion: guidelines and ultrasound.

    PubMed

    Bowness, J S; Nicholls, K; Kilgour, P M; Ferris, J; Whiten, S; Parkin, I; Mooney, J; Driscoll, P

    2015-12-01

    International guidelines exist for chest drain insertion and recommend identifying the fifth intercostal space or above, around the midaxillary line. In a recent study, applying these guidelines in cadavers risked insertion in the 6th intercostal space or below in 80% of cases. However, there are limitations of cadaveric studies and this investigation uses ultrasound to determine the intercostal space identified when applying these guidelines in healthy adult volunteers. On each side of the chest wall in 31 volunteers, the position for drain insertion was identified using the European Trauma Course method, Advanced Trauma Life Support (ATLS) method, British Thoracic Society's 'safe triangle' and the 'traditional' method of palpation. Ultrasound imaging was used to determine the relationship of the skin marks with the underlying intercostal spaces. Five methods were assessed on 60 sides. In contrast to the cadaveric study, 94% of skin marks lay over a safe intercostal space. However, the range of intercostal spaces found spanned the second to the seventh space. In 44% of women, the inferior boundary of the 'safe triangle' and the ATLS guidelines located the sixth intercostal space or below. Current guidelines often identify a safe site for chest drain insertion, although the same site is not reproducibly found. In addition, women appear to be at risk of subdiaphragmatic drain insertion when the nipple is used to identify the fifth intercostal space. Real-time ultrasonography can be used to confirm the intercostal space during this procedure, although a safe guideline is still needed for circumstances in which ultrasound is not possible. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Additional circular intercostal space created by bifurcation of the left 3rd rib and its costal cartilage: a case report

    PubMed Central

    2013-01-01

    Introduction In the thorax there are normally 11 pairs of intercostal spaces: the spaces between adjacent ribs. The intercostal spaces contain intercostal muscles, intercostal nerves and vessels. Case presentation During a routine dissection for undergraduate medical students, we observed a variation involving the left 3rd rib and 3rd costal cartilage in the cadaver of a man of Indian ethnicity aged about 65 years. The left 3rd rib and its costal cartilage were bifurcated at their costochondral junction enclosing a small circular additional intercostal space. Muscle tissue covered by deep fascia was present in this circular intercostal space. The muscle in the circular intercostal space received its nerve supply from a branch of the 2nd intercostal nerve. Conclusions Knowledge of such variations is helpful to surgeons operating on the anterior thoracic wall involving ribs and intercostal spaces. Knowing the possibility of the presence of an additional space between normal intercostal spaces can guide a surgeon through to a successful surgery. PMID:23298541

  7. Clinical location of the fourth and fifth intercostal spaces as a percent of the length of the sternum.

    PubMed

    Marcus, Frank; Hughes, Trina; Barrios, Phillip; Borgstrom, Mark

    2017-05-18

    To verify accurate placement of the precordial ECG leads by identifying the 4th and 5th intercostal spaces as a function of the length of the sternum. This should decrease the percentage of lead misplacement leading to misdiagnoses. The population consisted of patients and healthy volunteers. The proposed method compared palpation of the 4th and 5th intercostal spaces to a percentile of the sternal length. Location of the 4th and 5th intercostal space using a simple device was evaluated to assist in proper placement of the precordial leads to obtain accurate diagnosis. The location of the 4th and 5th intercostal space is related to the length of the sternum. It is 77% of the sternal length that measures 15cm for the 4th intercostal space. The position of the V1 and V2 electrodes decreases to 57% when the sternal length is 26cm. Similar data was obtained to locate the 5th intercostal space with proper position of V4-V6 electrodes. Tables are provided to facilitate this process. An instrument was designed to measure the 4th and 5th intercostal space as a function of the sternal length. The location of the 4th and 5th intercostal space is identified based on the length of the sternum. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Identification of 4th intercostal space using sternal notch to xiphoid length for accurate electrocardiogram lead placement.

    PubMed

    Day, Kevin; Oliva, Isabel; Krupinski, Elizabeth; Marcus, Frank

    2015-01-01

    Precordial ECG lead placement is difficult in obese patients with increased chest wall soft tissues due to inaccurate palpation of the intercostal spaces. We investigated whether the length of the sternum (distance between the sternal notch and xiphoid process) can accurately predict the location of the 4th intercostal space, which is the traditional location for V1 lead position. Fifty-five consecutive adult chest computed tomography examinations were reviewed for measurements. The sternal notch to right 4th intercostal space distance was 67% of the sternal notch to xiphoid process length with an overall correlation of r=0.600 (p<0.001). The above measurement may be utilized to locate the 4th intercostal space for accurate placement of the precordial electrodes in adults in whom the 4th intercostal space cannot be found by physical exam. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Proceedings of the 12th Space Photovoltaic Research and Technology Conference (SPRAT 12)

    NASA Technical Reports Server (NTRS)

    1993-01-01

    The Twelfth Space Photovoltaic Research and Technology conference was held at the NASA Lewis Research Center from 20 to 22 Oct. 1992. The papers and workshops presented in this volume report substantial progress in a variety of areas in space photovoltaics. Topics covered include: high efficiency GaAs and InP solar cells, GaAs/Ge cells as commercial items, flexible amorphous and thin film solar cells (in the early stages of pilot production), high efficiency multiple bandgap cells, laser power converters, solar cell and array technology, heteroepitaxial cells, betavoltaic energy conversion, and space radiation effects in InP cells. Space flight data on a variety of cells were also presented.

  10. Aplastic articular facets in a dog with intervertebral disk rupture of the 12th to 13th thoracic vertebral space.

    PubMed

    Werner, Thorsten; McNicholas, W Thomas; Kim, Jongmin; Baird, Debra K; Breur, Gert J

    2004-01-01

    A 6-year-old, female spayed Pomeranian was presented with acute hind-limb paraplegia with the presence of deep pain perception and urinary incontinence. Myelography showed a Hansen type I herniation of the12th to 13th thoracic intervertebral space (T(12-13)). Articular facets of the T(12-13) and T(13) to first lumbar vertebra (L(1)) were absent. The spinal cord was decompressed using a bilateral T(12-13) modified lateral hemilaminectomy (pediculectomy). The aplastic sites were associated with minimal instability of the vertebral column, and stabilization of the vertebral column was not required. Familiarity with this condition is important, because articular facet aplasia may cause vertebral instability and may require an adjusted surgical approach or vertebral reduction and fusion following decompression.

  11. Sonographic analysis of the intercostal spaces for the application of high-intensity focused ultrasound therapy to the liver.

    PubMed

    Kim, Young-Sun; Park, Min Jung; Rhim, Hyunchul; Lee, Min Woo; Lim, Hyo Keun

    2014-07-01

    The purposes of this study were to assess the widths of the intercostal spaces of the right inferior human rib cage through which high-intensity focused ultrasound therapy would be applied for treating liver cancer and to elucidate the demographic factors associated with intercostal space width. From March 2013 to June 2013, the widths of the intercostal spaces and the ribs at six areas of the right inferior rib cage (area 1, lowest intercostal space on anterior axillary line and the adjacent upper rib; area 2, second-lowest intercostal space on anterior axillary line and the adjacent upper rib; areas 3 and 4, lowest and second-lowest spaces on midaxillary line; areas 5 and 6, lowest and second-lowest spaces on posterior axillary line) were sonographically measured in 466 patients (214 men, 252 women; mean age, 53.0 years) after an abdominal sonographic examination. Demographic factors and the presence or absence of chronic liver disease were evaluated by multivariate analysis to investigate which factors influence intercostal width. The width of the intercostal space was 19.7 ± 3.7 mm (range, 9-33 mm) at area 1, 18.3 ± 3.4 mm (range, 9-33 mm) at area 2, 17.4 ± 4.0 mm (range, 7-33 mm) at area 3, 15.4 ± 3.5 mm (range, 5-26 mm) at area 4, 17.2 ± 3.7 mm (range, 7-28 mm) at area 5, and 14.5 ± 3.6 mm (range, 4-26 mm) at area 6. The corresponding widths of the ribs were 15.2 ± 2.3 mm (range, 8-22 mm), 14.5 ± 2.3 mm (range, 9-22 mm), 13.2 ± 2.0 mm (range, 9-20), 14.3 ± 2.2 mm (range, 9-20 mm), 15.0 ± 2.2 mm (range, 10-22 mm), and 15.1 ± 2.3 mm (range, 8-21 mm). Only female sex was significantly associated with the narrower intercostal width at areas 1, 2, 3, and 5 (regression coefficient, 1.124-1.885; p = 0.01-0.04). There was substantial variation in the widths of the intercostal spaces of the right inferior rib cage such that the anterior and inferior aspects of the intercostal space were relatively wider. Women had significantly narrower intercostal spaces

  12. Surgical technique: The intercostal space approach to the internal mammary vessels in 463 microvascular breast reconstructions.

    PubMed

    Darcy, Catharine M; Smit, Jeroen M; Audolfsson, Thorir; Acosta, Rafael

    2011-01-01

    The internal mammary vessels are one of the most frequently used recipient sites for microsurgical free-flap breast reconstruction, and an accepted technique to expose these vessels involves removal of a segment of costal cartilage of the rib. However, in some patients, cartilage removal may result in a visible medial chest-wall depression that requires corrective procedures. We, therefore, use an intercostal space approach to the internal mammary vessels, as there is minimal disturbance of the costal cartilage with this technique. We have developed and performed our technique over an 8-year period in 463 microvascular breast reconstructions, and present it here as it contains modifications not previously described that may be of interest to other surgeons. There was no serious morbidity associated with the intercostal space approach, the internal mammary vessels were reliably and safely exposed in all these cases and the flap success rate was 95.8%. Copyright © 2010. Published by Elsevier Ltd.

  13. A Single Intercostal Space Thoracoscopic Approach for Minimally Invasive Ivor Lewis Esophagectomy.

    PubMed

    Pan, Saibo; Wang, Lian; Wu, Ming; Wang, Qi; Shen, Gang; Chen, Gang

    2017-05-15

    We present a laparoscopic and single intercostal space thoracoscopic approach (SICS group) for Ivor Lewis minimally invasive esophagectomy (MIE) and provide postoperative analgesia with a continuous multiple intercostal nerve blocking technique. The characters of this technique are evaluated. From October 2015 to April 2016, 18 consecutive patients with esophageal cancer were treated with Ivor Lewis MIE by a SICS group. Moreover, from July 2014 to September 2015, 48 patients with esophageal cancer received Ivor Lewis MIE by four-port video-assisted thoracic surgery (VATS) approach. Among those patients, by using propensity-score matching, 18 matched patients who underwent four-port VATS MIE (four-port group) were retrospectively selected for further statistical analysis. Patient demographics, short-term postoperative outcomes were recorded. None of the patients in the SICS group required conversion to an open procedure. No failure of the intrathoracic esophagogastrostomy occurred. No perioperative mortality or readmission was observed in this series. No patient suffered from anastomotic leak or complained remarkable dysphasia during follow-up. SICS group had a shorter duration of both docking procedure and closure of chest incisions compared with four-port group. The visual analog scale (VAS) pain scores on 24 hours after surgery was significantly lower in SICS group than in four-port group, while the values on 6 hours were comparable. The level of creatine kinase on postoperative day (POD) 1 was significantly lower in SICS group than in four-port group. Single intercostal space thoracoscopic procedure is safe and technically feasible and can therefore be viewed as an attractive alternative approach for performing Ivor Lewis MIE.

  14. Is the 10th and 11th Intercostal Space a Safe Approach for Percutaneous Nephrostomy and Nephrolithotomy?

    SciTech Connect

    Muzrakchi, Ahmed Al; Szmigielski, W. Omar, Ahmed J.S.; Younes, Nagy M.

    2004-09-15

    The aim of this study was to determine the rate of complications in percutaneous nephrostomy (PCN) and nephrolithotomy (PCNL) performed through the 11th and 10th intercostal spaces using our monitoring technique and to discuss the safety of the procedure. Out of 398 PCNs and PCNLs carried out during a 3-year period, 56 patients had 57 such procedures performed using an intercostal approach. The 11th intercostal route was used in 42 and the 10th in 15 cases. One patient had two separate nephrostomies performed through the 10th and 11th intercostal spaces. The technique utilizes bi-planar fluoroscopy with a combination of a conventional angiographic machine to provide anterior-posterior fluoroscopy and a C-arm mobile fluoroscopy machine to give a lateral view, displayed on two separate monitors. None of the patients had clinically significant thoracic or abdominal complications. Two patients had minor chest complications. Only one developed changes (plate atelectasis, elevation of the hemi-diaphragm) directly related to the nephrostomy (2%). The second patient had bilateral plate atelectasis and unilateral congestive lung changes after PCNL. These changes were not necessarily related to the procedure but rather to general anesthesia during nephrolithotomy. The authors consider PCN or PCNL through the intercostal approach a safe procedure with a negligible complication rate, provided that it is performed under bi-planar fluoroscopy, which allows determination of the skin entry point just below the level of pleural reflection and provides three-dimensional monitoring of advancement of the puncturing needle toward the target entry point.

  15. Surgical anatomy of the 10th and 11th intercostal, and subcostal nerves: prevention of damage during lumbotomy.

    PubMed

    van der Graaf, Teunette; Verhagen, Paul C M S; Kerver, Anton L A; Kleinrensink, Gert-Jan

    2011-08-01

    In a descriptive, inventorial anatomical study we mapped the course of the 10th and 11th intercostal nerves, and the subcostal nerve in the abdominal wall to determine a safe zone for lumbotomy. We dissected 11 embalmed cadavers, of which 10 were analyzed. The 10th and 11th intercostal nerves, and the subcostal nerve were dissected from the intercostal space to the rectus sheath. Analysis was done using computer assisted surgical anatomy mapping. A safe zone and an incision line with a minimum of nerve crossings were determined. The 10th and 11th intercostal nerves were invariably positioned subcostally. The subcostal nerve lay subcostally but caudal to the rib in 4 specimens. The main branches were located between the internal oblique and transverse abdominal muscles. The nerves branched and extensively varied in the abdominal wall. A straight line extended from the superior surface of the 11th and 12th ribs indicated a zone with lower nerve density. In 5 specimens the 10th and 11th intercostal nerves crossed this line from the superior surface of the 11th rib. In 5 specimens neither the 11th intercostal nerve nor the subcostal nerve crossed this extended line from the superior surface of the 12th rib up to 15 cm from the tip of the rib. Damage is inevitable to branches of the 10th or 11th intercostal nerve, or the subcostal nerve during lumbotomy. However, an incision extending from the superior surface of the 11th or 12th rib is less prone to damage these nerves. Closing the abdominal wall in 3 layers with the transverse abdominal muscle separately might prevent damage to neighboring nerves. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Evaluating Earth and Space Sciences STEM Research Communication in 7th-12th Grade Rural Mississippi Classrooms and Resulting Student Attitudinal Impacts

    NASA Astrophysics Data System (ADS)

    Radencic, S.; McNeal, K. S.

    2013-05-01

    Observation and evaluation of STEM graduate students from Mississippi State University communicating their research of the Earth and Space Sciences in rural 7th-12th grade classrooms participating in the Initiating New Science Partnerships in Rural Education (INSPIRE) NSF GK-12 project. The methods they utilize to communicate their STEM research includes introducing new technologies and inquiry based learning experiences. These communication experiences have been observed and evaluated using two observational systems, the Mathematics Science Classroom Observational Profile System (M-SCOPS) and the Presentation Skills Protocol (PSP). M-SCOPS has been used over the first three years of the project to evaluate what Earth and Space research the STEM graduate students communicate in classroom activities along with how they are introducing STEM research through a variety of communication methods and levels of understanding. PSP, which INSPIRE began using this year, evaluates and provides feedback to the STEM graduate students on their communication during these classroom experiences using a rubric covering a range of skills for successful communication. PSP also allows the participating INSPIRE teacher partners to provide feedback to the STEM graduate students about development of their communication skills over the course of the year. In addition to feedback from the INSPIRE project and participating teachers, the STEM graduate students have the opportunity to evaluate their personal communication skills through video documentation to determine specific skills they would like to improve. Another area of research to be discussed is how the STEM graduate students communicating Earth and Space sciences research in the participating classrooms is impacting student attitudes about science and mathematics over the last three years. Student Attitudinal Surveys (SAS) are administered as a pre-evaluation tool in the fall when the STEM graduate students first enter into their

  17. Usefulness of multichannel Holter ECG recording in the third intercostal space for detecting type 1 Brugada ECG: comparison with repeated 12-lead ECGs.

    PubMed

    Shimeno, Kenji; Takagi, Masahiko; Maeda, Keiko; Tatsumi, Hiroaki; Doi, Atsushi; Yoshiyama, Minoru

    2009-09-01

    Type 1 Brugada ECG is essential for the diagnosis of Brugada syndrome. We aimed to evaluate the usefulness of multichannel Holter ECG recording in the third intercostal space for detecting type 1 Brugada ECG. We enrolled 60 consecutive individuals with type 1 Brugada ECG and 31 individuals with type 2 or 3 Brugada ECG, in the presence or absence of Na+ channel blockers. All individuals underwent 12-lead ECGs recorded in the standard position and the third intercostal space at least 5 times every 3 months (4L-ECGs, 3L-ECGs, respectively) and multichannel Holter ECG. On multichannel Holter ECG, the precordial electrodes were attached at standard positions (4L-Holter) and the third intercostal space (3L-Holter) for leads V1 and V2. Among the 60 individuals, type 1 Brugada ECG in 4L-ECGs, 3L-ECGs, 4L-Holter, and 3L-Holter was detected in 15 (25%), 26 (43.3%), 23 (38.3%), and 33 individuals (55%), respectively, whereas detected in none of the 31 individuals. The documented duration of type 1 Brugada ECG on 3L-Holter was significantly longer than that on 4L-Holter (700 +/- 467 vs 372 +/- 422 min; P = 0.01, 3L-Holter vs 4L-Holter, respectively), and type 1 Brugada ECG was most frequently observed between 6 pm and 12 pm. Neither the presence nor the duration of the appearance of type 1 Brugada ECG differed significantly between symptomatic and asymptomatic individuals. Multichannel Holter ECG recording in the third intercostal space is more sensitive and useful for the diagnosis of type 1 Brugada ECG than repeated 12-lead ECGs or multichannel Holter ECG in the standard position.

  18. Bedside thoracic ultrasonography of the fourth intercostal space reliably determines safe removal of tube thoracostomy after traumatic injury.

    PubMed

    Kwan, Rita O; Miraflor, Emily; Yeung, Louise; Strumwasser, Aaron; Victorino, Gregory P

    2012-12-01

    Thoracic ultrasonography is more sensitive than chest radiography (CXR) in detecting pneumothorax; however, the role of ultrasonography to determine resolution of pneumothorax after thoracostomy tube placement for traumatic injury remains unclear. We hypothesized that ultrasonography can be used to determine pneumothorax resolution and facilitate efficient thoracostomy tube removal. We sought to compare the ability of thoracic ultrasonography at the second through fifth intercostal space (ICS) to detect pneumothorax with that of CXR and determine which ICS maximizes the positive and negative predictive value of thoracic ultrasonography for detecting clinically relevant pneumothorax resolution. A prospective, blinded clinical study of trauma patients requiring tube thoracostomy placement was performed at a university-based urban trauma center. A surgeon performed daily thoracic ultrasonographies consisting of midclavicular lung evaluation for pleural sliding in ICS 2 through 5. Ultrasonography findings were compared with findings on concurrently obtained portable CXR. Of the patients, 33 underwent 119 ultrasonographies, 109 of which had concomitant portable CXR results for comparison. Ultrasonography of ICS 4 or 5 was better than ICS 2 and 3 at detecting a pneumothorax, with a positive predictive value of 100% and a negative predictive value of 92%. The positive and negative predictive values for ICS 2 were 46% and 93% and for ICS 3 were 63% and 92%, respectively. Bedside, surgeon-performed, thoracic ultrasonography of ICS 4 for pneumothorax can safely and efficiently determine clinical resolution of traumatic pneumothorax and aid in the timely removal of thoracostomy tubes. Diagnostic study, level II.

  19. Suture techniques of the intercostal space in thoracotomy and their relationship with post-thoracotomy pain: a systematic review.

    PubMed

    García-Tirado, Javier; Rieger-Reyes, Cristina

    2012-01-01

    Post-thoracotomy pain is a symptom of high incidence among patients who have undergone thoracotomy and is a major risk factor in the pathogenesis of several postoperative complications. Chronic pain after thoracotomy reaches a high prevalence. Since the earliest studies, this pain has been seen to be related with intercostal nerve injury, thus the need to avoid these lesions during thoracotomy has been recommended. This review aims to establish the appropriate surgical procedure for closure of the thoracotomy through a systematic review of the literature and analysis of levels of evidence provided by the studies found. After an exhaustive search in MEDLINE, EMBASE, IME, IBECS and Cochrane Library, few studies were found. Each focuses on different aspects of thoracotomy surgical techniques, with a common denominator focused on the preservation of the intercostal nerves, and conclusions with different levels of evidence.

  20. The transduction properties of intercostal muscle mechanoreceptors

    PubMed Central

    Holt, Gregory A; Johnson, Richard D; Davenport, Paul W

    2002-01-01

    Background Intercostal muscles are richly innervated by mechanoreceptors. In vivo studies of cat intercostal muscle have shown that there are 3 populations of intercostal muscle mechanoreceptors: primary muscle spindles (1°), secondary muscle spindles (2°) and Golgi tendon organs (GTO). The purpose of this study was to determine the mechanical transduction properties of intercostal muscle mechanoreceptors in response to controlled length and velocity displacements of the intercostal space. Mechanoreceptors, recorded from dorsal root fibers, were localized within an isolated intercostal muscle space (ICS). Changes in ICS displacement and the velocity of ICS displacement were independently controlled with an electromagnetic motor. ICS velocity (0.5 – 100 μm/msec to a displacement of 2,000 μm) and displacement (50–2,000 μm at a constant velocity of 10 μm/msec) parameters encompassed the full range of rib motion. Results Both 1° and 2° muscle spindles were found evenly distributed within the ICS. GTOs were localized along the rib borders. The 1° spindles had the greatest discharge frequency in response to displacement amplitude followed by the 2° afferents and GTOs. The 1° muscle spindles also possessed the greatest discharge frequency in response to graded velocity changes, 3.0 spikes·sec-1/μm·msec-1. GTOs had a velocity response of 2.4 spikes·sec-1/μm·msec-1 followed by 2° muscle spindles at 0.6 spikes·sec-1/μm·msec-1. Conclusion The results of this study provide a systematic description of the mechanosenitivity of the 3 types of intercostal muscle mechanoreceptors. These mechanoreceptors have discharge properties that transduce the magnitude and velocity of intercostal muscle length. PMID:12392601

  1. Respiratory pattern changes produced by intercostal muscle/rib vibration.

    PubMed

    Bolser, D C; Lindsey, B G; Shannon, R

    1988-06-01

    Large-amplitude vibration of the intercostal muscles/ribs has an inhibitory effect on inspiratory motor output. This effect has been attributed, in part, to the stimulation of intercostal muscle tendon organs. Intercostal muscle/rib vibration can also produce a decrease or increase in respiratory frequency. Studies were conducted 1) to determine whether, in addition to intercostal tendon organs, costovertebral joint mechanoreceptors (CVJR's) contribute to the inspiratory inhibitory effect of intercostal muscle/rib vibration (IMV) and 2) to explain the different respiratory frequency responses to IMV previously reported. Phrenic (C5) activity was monitored in paralyzed thoracotomized, artificially ventilated cats. Vibration (125 Hz) at amplitudes greater than 1,200 micron of one T6 intercostal space in decerebrated vagotomized rats reduced phrenic activity. This response was still present but weaker in some animals after denervation of the T6 intercostal muscles. Subsequent denervation of the T6 CVJR's by dorsal root sections eliminated this effect. Respiratory frequency decreased during simultaneous vibration (greater than 1,200 micron) of the T5 and T7 intercostal spaces in vagotomized cats. Respiratory frequency increased during IMV of two intercostal spaces (greater than 1,300 micron) in vagal intact cats. The use of different anesthetics (pentobarbital, allobarbital) did not alter these results. We conclude that CVJR's may contribute to the inhibitory effect of IMV on medullary inspiratory activity. The presence or absence of pulmonary vagal afferents can account for the different respiratory frequency responses to IMV, and different anesthetics did not influence these results.

  2. Does a Multimodal No-Compression Suture Technique of the Intercostal Space Reduce Chronic Postthoracotomy Pain? A Prospective Randomized Study.

    PubMed

    Ibrahim, Mohsen; Menna, Cecilia; Andreetti, Claudio; Puyo, Carlos; Maurizi, Giulio; D'Andrilli, Antonio; Ciccone, Anna Maria; Massullo, Domenico; Vanni, Camilla; Berardi, Giammauro; Baldini, Rossella; Rendina, Erino Angelo

    2016-09-01

    Chronic postthoracotomy pain is a significant adverse outcome of thoracic surgery. We evaluated with a prospective randomized trial the effect of a multimodal no-compression suture technique of the intercostal space on postoperative pain occurrence in patients undergoing minithoracotomy. Patients undergoing a muscle-sparing lateral minithoracotomy for different thoracic diseases were randomly divided into two groups: 146 patients received intercostal muscle flap harvesting and pericostal no-compression "edge" suture (the IMF group), and 151 patients received a standard suture technique associated with an intrapleural intercostal nerve block (the IINB group). Pain scores and interference of pain with daily activities were assessed by using the Italian version of the Brief Pain Inventory on day 1, and at 1 to 6 months postoperatively. The results of pulmonary function tests (spirometry and the 6-minute walking test ) were evaluated preoperatively and at 1 and 6 months postoperatively. Postthoracotomy pain scores throughout the first postoperative day were significantly lower in the IMF group. After 1 and 6 months, patients in the IMF group had a significantly lower average pain score (p = 0.001). There were no significant differences in pain interference scores at each evaluation time point in either group. However, differences were shown in lung function test results at 1 and 6 months postoperatively (the forced expiratory volume in 1 second in the IINB group averaged 68.8 ± 17.4% of predicted value and 72.8 ± 10.5%, respectively, and in the IMF group it averaged 83.1 ± 7.4% and 86.4 ± 12.8%, respectively [p = 0.023 and 0.013, respectively]; the 6-minute walking test results in the IINB group averaged 311.1 ± 51.0 and 329.9 ± 54.8 m, respectively, and those in the IMF group averaged 371.2 ± 54.8 and 395.7 ± 56.4 m, respectively [p = 0.0001]). The multimodal no-compression suture technique is a rapid and feasible procedure that reduces the intensity of

  3. 12th Central Hardwood Forest Conference

    Treesearch

    Jeffrey W. Stringer; David L. Loftis; Michael Lacki; Thomas Barnes; Robert A. Muller

    1999-01-01

    There were 32 oral presentations, 11 abstracts, and 22 poster presentations presented at the 12th Central Hardwood Forest Conference. Presentation topics included wildlife management, nutrient dynamics, stand structure, reforestation/reclamation, timber harvesting, modeling and inventory, silviculture, disturbance effects, and genetics/tree improvement.

  4. Course and variation of the intercostal artery by CT scan.

    PubMed

    Helm, Emma J; Rahman, Najib M; Talakoub, Omid; Fox, Danial L; Gleeson, Fergus V

    2013-03-01

    It is conventionally taught that the intercostal artery is shielded in the intercostal groove of the superior rib. The continuous course and variability of the intercostal artery, and factors that may influence them, have not been described in a large number of arteries in vivo. Maximal intensity projection reformats in the coronal plane were produced from CT scan pulmonary angiograms to identify the posterolateral course of the intercostal artery (seventh to 11th rib spaces). A novel semiautomated computer segmentation algorithm was used to measure distances between the lower border of the superior rib, the upper border of the inferior rib, and the position of the intercostal artery when exposed in the intercostal space. The position and variability of the artery were analyzed for association with clinical factors. Two hundred ninety-eight arteries from 47 patients were analyzed. The mean lateral distance from the spine over which the artery was exposed within the intercostal space was 39 mm, with wide variability (SD, 10 mm; 10th-90th centile, 28-51 mm). At 3 cm lateral distance from the spine, 17% of arteries were shielded by the superior rib, compared with 97% at 6 cm. Exposed artery length was not associated with age, sex, rib space, or side. The variability of arterial position was significantly associated with age (coefficient, 0.91; P < .001) and rib space number (coefficient, - 2.60; P < .001). The intercostal artery is exposed within the intercostal space in the first 6 cm lateral to the spine. The variability of its vertical position is greater in older patients and in more cephalad rib spaces.

  5. Pre-expanded Intercostal Perforator Super-Thin Skin Flap.

    PubMed

    Liao, Yunjun; Luo, Yong; Lu, Feng; Hyakusoku, Hiko; Gao, Jianhua; Jiang, Ping

    2017-01-01

    This article introduces pre-expanded super-thin intercostal perforator flaps, particularly the flap that has a perforator from the first to second intercostal spaces. The key techniques, advantages and disadvantages, and complications and management of this flap are described. At present, the thinnest possible flap is achieved by thinning the pre-expanded flap that has a perforator from the first to second intercostal spaces. It is used to reconstruct large defects on the face and neck, thus restoring function and cosmetic appearance. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Angiographic analysis of the lateral intercostal artery perforator of the posterior intercostal artery: anatomic variation and clinical significance

    PubMed Central

    Jeon, Eui-Yong; Cho, Young Kwon; Yoon, Dae Young; Seo, Young Lan; Lim, Kyoung Ja; Yun, Eun Joo

    2015-01-01

    PURPOSE Knowledge of the anatomic variations of the posterior intercostal artery (PICA) and its major branches is important during transthoracic procedures and surgery. We aimed to identify the anatomic features and variations of the lateral intercostal artery perforator (LICAP) of the PICA with selective PICA arteriography. METHODS We retrospectively evaluated 353 PICAs in 75 patients with selective PICA arteriography for the following characteristics: incidence, length (as number of traversed intercostal spaces), distribution at the hemithorax (medial half vs. lateral half), and size as compared to the collateral intercostal artery of the PICA. RESULTS The incidence of LICAPs was 35.9% (127/353). LICAPs were most commonly observed in the right 8th–11th intercostal spaces (33%, 42/127) and in the medial half of the hemithorax (85%, 108/127). Most LICAPs were as long as two (35.4%, 45/127) or three intercostal spaces (60.6%, 77/127). Compared to the collateral intercostal artery, 42.5% of LICAPs were larger (54/127), with most of these observed in the right 4th–7th intercostal spaces (48.8%, 22/54). CONCLUSION We propose the clinical significance of the LICAP as a potential risk factor for iatrogenic injury during posterior transthoracic intervention and thoracic surgery. For example, skin incisions must be as superficial as possible and directed vertically at the right 4th–7th intercostal spaces and the medial half of the thorax. Awareness of the anatomical variations of the LICAPs of the PICA will allow surgeons and interventional radiologists to avoid iatrogenic arterial injuries during posterior transthoracic procedures and surgery. PMID:26268302

  7. Angiographic analysis of the lateral intercostal artery perforator of the posterior intercostal artery: anatomic variation and clinical significance.

    PubMed

    Jeon, Eui Yong; Cho, Young Kwon; Yoon, Dae Young; Seo, Young Lan; Lim, Kyoung Ja; Yun, Eun Joo

    2015-01-01

    Knowledge of the anatomic variations of the posterior intercostal artery (PICA) and its major branches is important during transthoracic procedures and surgery. We aimed to identify the anatomic features and variations of the lateral intercostal artery perforator (LICAP) of the PICA with selective PICA arteriography. We retrospectively evaluated 353 PICAs in 75 patients with selective PICA arteriography for the following characteristics: incidence, length (as number of traversed intercostal spaces), distribution at the hemithorax (medial half vs. lateral half), and size as compared to the collateral intercostal artery of the PICA. The incidence of LICAPs was 35.9% (127/353). LICAPs were most commonly observed in the right 8th-11th intercostal spaces (33%, 42/127) and in the medial half of the hemithorax (85%, 108/127). Most LICAPs were as long as two (35.4%, 45/127) or three intercostal spaces (60.6%, 77/127). Compared to the collateral intercostal artery, 42.5% of LICAPs were larger (54/127), with most of these observed in the right 4th-7th intercostal spaces (48.8%, 22/54). We propose the clinical significance of the LICAP as a potential risk factor for iatrogenic injury during posterior transthoracic intervention and thoracic surgery. For example, skin incisions must be as superficial as possible and directed vertically at the right 4th-7th intercostal spaces and the medial half of the thorax. Awareness of the anatomical variations of the LICAPs of the PICA will allow surgeons and interventional radiologists to avoid iatrogenic arterial injuries during posterior transthoracic procedures and surgery.

  8. Posterior intercostal artery tortuosity and collateral branch points: a cadaveric study.

    PubMed

    Shurtleff, E; Olinger, A

    2012-11-01

    Publications report observing tortuosity in the posterior intercostal arteries of elderly patients. Studies also describe the size and course of the collateral intercostal arteries. This information is clinically significant when performing thoracentesis and video-assisted thorascopic surgery. To the best of our knowledge, no studies have examined arterial tortuosity or described collateral artery origins relative to bony landmarks. The purpose of this study was to define a safe surgical zone for thoracic access using palpable external bony landmarks. A total of 348 intercostal spaces (3rd-8th) of 29 male and female embalmed cadavers were dissected from the vertebral body to the mid-axillary line to observe the posterior intercostal artery and its collateral branch. The origins of the collateral intercostal arteries relative to the midline of thoracic spinous processes were measured. Mild to moderate tortuosity (arterial curves covering 25- -50% of the intercostal space) was observed in at least one posterior intercostal artery in the majority of cadavers. The origins of the collateral intercostal arteries were variable relative to the midline. Additional collateral intercostal arteries distal to the primary collateral branch were observed, most commonly in the 5th intercostal space, which is used in video-assisted thorascopic surgery and thoracentesis. Tortuosity is common in the 3rd to the 8th posterior intercostal arteries, especially in individuals over the age of 60 years. Given the findings of this study, we recommend that any procedure involving placement of a surgical instrument into these intercostal spaces does so at least 120 mm lateral to the midline of the spinous processes. We also recommend pre-procedure ultrasound (intercostal scan) of the posterior and collateral intercostal arteries when performing non-emergent thoracentesis and video-assisted thorascopic surgery, particularly in patients over 60 years of age.

  9. Dorsolateral musculocutaneous perforators of posterior intercostal artery: an anatomical study.

    PubMed

    Prasad, Vani; Almutairi, Khalid; Kimble, Frank W; Stewart, Fiona; Morris, Steven F

    2012-11-01

    The posterior intercostal artery (PICA) is divided into four segments, vertebral, costal, intermuscular, and rectus, based on the neurovascular branching pattern. Dorsal branches arise from the vertebral segment. Several musculocutaneous perforators and a lateral branch originate from the costal segment. Musculocutaneous branches arise from the intermuscular and rectus segments. The purpose of this study is to describe in detail the musculocutaneous perforators of the costal segment of the posterior intercostal artery. Fresh cadavers were injected with a modified lead oxide-gelatin mixture. Intercostal spaces (8-11) were dissected in twelve cadavers (six preserved cadavers and six fresh cadavers). Angiograms were assembled with Adobe Photoshop. Two fresh cadavers underwent CT angiography and three dimensional reconstructions of the intercostal perforators were performed using Materialise's Interactive Medical Image Control System (MIMICS). In twelve cadavers, a total of 356 perforators (size > 0.5 mm) were found to arise from the posterior intercostal arteries in 96 intercostal (IC) spaces. 154 perforators (>0.5 mm) were found in the costal segment of the PICA. An average of 6.4 perforators was found in each hemithorax. All perforators were found within 2 cm of the midscapular line. At least one perforator was found in all intercostal spaces. Two or more perforators were found in 40% of the 8th and 9th IC spaces and 60% of the 10th and 11th IC spaces. Perforators were oriented perpendicular to the direction of the muscle fibres of the latissimus dorsi and were usually present one or two intercostal spaces below their origin from the PICA. Perforators of the costal segment of the PICA are described in detail. We propose to call these currently unnamed musculocutaneous perforators "dorsolateral" branches of the PICA, as they are located between dorsal and lateral branches of PICA. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons

  10. Recovery of inspiratory intercostal muscle activity following high cervical hemisection.

    PubMed

    Dougherty, B J; Lee, K Z; Gonzalez-Rothi, E J; Lane, M A; Reier, P J; Fuller, D D

    2012-09-30

    Anatomical and neurophysiological evidence indicates that thoracic interneurons can serve a commissural function and activate contralateral motoneurons. Accordingly, we hypothesized that respiratory-related intercostal (IC) muscle electromyogram (EMG) activity would be only modestly impaired by a unilateral cervical spinal cord injury. Inspiratory tidal volume (VT) was recorded using pneumotachography and EMG activity was recorded bilaterally from the 1st to 2nd intercostal space in anesthetized, spontaneously breathing rats. Studies were conducted at 1-3 days, 2 wks or 8 wks following C2 spinal cord hemisection (C2HS). Data were collected during baseline breathing and a brief respiratory challenge (7% CO(2)). A substantial reduction in inspiratory intercostal EMG bursting ipsilateral to the lesion was observed at 1-3 days post-C2HS. However, a time-dependent return of activity occurred such that by 2 wks post-injury inspiratory intercostal EMG bursts ipsilateral to the lesion were similar to age-matched, uninjured controls. The increases in ipsilateral intercostal EMG activity occurred in parallel with increases in VT following the injury (R=0.55; P<0.001). We conclude that plasticity occurring within a "crossed-intercostal" circuitry enables a robust, spontaneous recovery of ipsilateral intercostal activity following C2HS in rats. Copyright © 2012. Published by Elsevier B.V.

  11. 12th International CHARGE syndrome conference proceedings.

    PubMed

    Martin, Donna M; Salem-Hartshorne, Nancy; Hartshorne, Timothy S; Scacheri, Peter C; Hefner, Margaret A

    2016-04-01

    The CHARGE Syndrome Foundation holds an International conference for families and professionals every other summer. In July, 2015, the 12th meeting was held in Schaumburg, Illinois, at the Renaissance Schaumburg Hotel. Day one of the 4-day conference was dedicated to professionals caring for and researching various aspects of CHARGE, including education, medical management, animal models, and stem cell-based approaches to understanding and treating individuals with CHARGE. Here, we summarize presentations from the meeting, including a synopsis of each of the three different breakout sessions (Medical/Clinical, Basic Science/CHD7, and Education), followed by a list of abstracts and authors for both platform and poster presentations. © 2016 Wiley Periodicals, Inc.

  12. Ipsilateral inspiratory intercostal muscle activity after C2 spinal cord hemisection in rats.

    PubMed

    Beth Zimmer, M; Grant, Joshua S; Ayar, Angelo E; Goshgarian, Harry G

    2015-03-01

    Upper cervical spinal cord hemisection causes paralysis of the ipsilateral hemidiaphragm; however, the effect of C2 hemisection on the function of the intercostal muscles is not clear. We hypothesized that C2 hemisection would eliminate inspiratory intercostal activity ipsilateral to the injury and that some activity would return in a time-dependent manner. Female Sprague Dawley rats were anesthetized with urethane and inspiratory intercostal electromyogram (EMG) activity was recorded in control rats, acutely injured C2 hemisected rats, and at 1 and 16 weeks post C2 hemisection. Bilateral recordings of intercostal EMG activity showed that inspiratory activity was reduced immediately after injury and increased over time. EMG activity was observed first in rostral spaces followed by recovery occurring in caudal spaces. Theophylline increased respiratory drive and increased intercostal activity, inducing activity that was previously absent. These results suggest that there are crossed, initially latent, respiratory connections to neurons innervating the intercostal muscles similar to those innervating phrenic motor neurons.

  13. Congenital Intercostal Lung Herniation Combined with an Unusual Morgagni's Hernia

    PubMed Central

    Lee, Sang-Kwon

    2011-01-01

    A 70-year-old male visited urgent care due to coughing for 1 month and left chest pain. He had no history of trauma. The initial chest computed tomography (CT) showed the 7th left intercostal lung herniation. A follow-up CT showed an intercostal lung herniation combined with a bowl herniation, which had developed due to a Morgagni's hernia. An emergency operation was performed due to the incarceration of the bowl and lung. The primary repair of the diaphragm was performed and the direct approximation of the 7th intercostal space was determined. We concluded that the defect of the diaphragm and the intercostal muscle was a congenital lesion, and the recurrent coughing was the aggravating factor of herniation. PMID:22324036

  14. Determination of the chest wall thicknesses and needle thoracostomy success rates at second and fifth intercostal spaces: a cadaver-based study.

    PubMed

    Ozen, Can; Akoglu, Haldun; Ozdemirel, Rifat Ozgur; Omeroglu, Elif; Ozpolat, Cigdem Ulubay; Onur, Ozge; Buyuk, Yalcin; Denizbasi, Arzu

    2016-12-01

    The purposes of this study were to measure the chest wall thicknesses (CWTs) at second intercostal space (ICS) mid-clavicular line (MCL) and fifth ICS MAL directly, and compare the actual success rates of needle thoracostomies (NTs) by inserting a 5-cm-long syringe needle. Predictive values of weight, body mass index (BMI) and CWT were also analyzed. This study included 199 measurements of 50 adult fresh cadavers from both hemithoraces. Five-centimeter-long syringe needles were inserted and secured. Penetration into the pleural cavity was assessed, and CWTs at 4 locations were measured. Achieved power of this study for the primary aim of CWT comparison from 2(nd) and 5(th) ICSs was .94. Overall mean CWTs at 2(nd) ICS MCL and 5(th) ICS MAL were measured as 2.46 ± 0.78 and 2.89 ± 1.09, respectively, and 5(th) ICS MAL was found to be statistically thicker (P = .002). The success rate of NT at 2(nd) ICS MCL was 87% (95% CI, 80-94), and that at 5(th) ICS MAL was 78% (95% CI, 70-86; P = .3570). Only 6 (17.1%) of 35 failed NTs had a CWT greater than 5-cm. Needle thoracostomy has failed in 29 (14.9%) of 194 locations, despite a CWT less than 5-cm. Below a weight of 72 kg, BMI of 23 kg/m(2), or CWT of 2.4 cm, all NTs were successful. In this report, we present the largest cadaver-based cohort to date to the best of our knowledge, and we observed a statistically nonsignificant 9% more NT success rate at 2(nd) ICS at a power of 88% and statistically significant more success rate in males at 5(th) ICS was (47.7%). We also observed thinner CWTs and higher success rates than previous imaging-based studies. A BMI of 23 kg/m(2) or less and weight of 72 kg or less seem to accurately rule-out NT failure in cadavers, and they seem to be better predictors at the bedside. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Recovery of inspiratory intercostal muscle activity following high cervical hemisection

    PubMed Central

    Dougherty, B.J.; Lee, K.Z.; Gonzalez-Rothi, E.J.; Lane, M.A.; Reier, P.J.; Fuller, D.D.

    2014-01-01

    Anatomical and neurophysiological evidence indicates that thoracic interneurons can serve a commissural function and activate contralateral motoneurons. Accordingly, we hypothesized that respiratory-related intercostal (IC) muscle electromyogram (EMG) activity would be only modestly impaired by a unilateral cervical spinal cord injury. Inspiratory tidal volume (VT) was recorded using pneumotachography and EMG activity was recorded bilaterally from the 1st to 2nd intercostal space in anesthetized, spontaneously breathing rats. Studies were conducted at 1–3 days, 2 wks or 8 wks following C2 spinal cord hemisection (C2HS). Data were collected during baseline breathing and a brief respiratory challenge (7% CO2). A substantial reduction in inspiratory intercostal EMG bursting ipsilateral to the lesion was observed at 1–3 days post-C2HS. However, a time-dependent return of activity occurred such that by 2 wks post-injury inspiratory intercostal EMG bursts ipsilateral to the lesion were similar to age-matched, uninjured controls. The increases in ipsilateral intercostal EMG activity occurred in parallel with increases in VT following the injury (R = 0.55; P < 0.001). We conclude that plasticity occurring within a “crossed-intercostal” circuitry enables a robust, spontaneous recovery of ipsilateral intercostal activity following C2HS in rats. PMID:22705013

  16. The anterior to midaxillary line between the 4th or 5th intercostal space (Buelau position) is safe for the use of thoracostomy tubes in preterm and term infants.

    PubMed

    Eifinger, Frank; Lenze, Miriam; Brisken, Katrin; Welzing, Lars; Roth, Bernhard; Koebke, Jürgen

    2009-06-01

    Thoracostomy tubes are widely used in neonatology. Complications occurred significantly more frequently in infants, especially neonates, than in adults. Principally, the access is the modified Buelau position which takes place in the anterior axillary line at the 4th or 5th intercostal space above the margin of the ribs. This study seeks to determine the characteristics and topographic conditions of the anatomical structures at the ventral and lateral thoracic wall in the preterm and term neonate. Fifteen formalin-fixed stillborns were prepared (nine male, six female, 28-43 weeks gestational age). The anatomical preparation involved the complete thoracic wall region. In all preparations, a venous vessel was detected at the lateral wall and was identified as v. thoracoepigastrica without accompanying artery. Arteria (a.) and vena (v.) thoracica interna were regularly found close to the sternal plate on both sides between rib and fascia. With increasing gestational ages the course of the v. thoracoepigastrica varied significantly between the left and right thoracic wall. It was demonstrated that the v. thoracoepigastrica regularly arose within the abdominal or thoracic subcutaneous fat and drained into the v. subclavia. The variance between its course was almost 5-12 mm to the lateral or medial side. At both thoracic sides, no other organs or organ structures except lung parenchyma could be detected when using the Buelau position. The anterior to midaxillary line between the 4th or 5th intercostal space (Buelau position) is safe for the use of thoracostomy tubes in preterm and term infants.

  17. Panel Recommends State-Level NAEP for 12th Graders

    ERIC Educational Resources Information Center

    Olson, Lynn

    2004-01-01

    A national commission formed to review the future of the 12th grade National Assessment of Educational Progress (NAEP) has recommended that the nation's primary barometer of student performance should expand dramatically to provide mandatory state results on the achievement of 12th graders and to measure their readiness for college, employment,…

  18. Panel Recommends State-Level NAEP for 12th Graders

    ERIC Educational Resources Information Center

    Olson, Lynn

    2004-01-01

    A national commission formed to review the future of the 12th grade National Assessment of Educational Progress (NAEP) has recommended that the nation's primary barometer of student performance should expand dramatically to provide mandatory state results on the achievement of 12th graders and to measure their readiness for college, employment,…

  19. The 12th Aerospace Mechanisms Symposium

    NASA Technical Reports Server (NTRS)

    1979-01-01

    Mechanisms developed for various aerospace applications are discussed. Specific topics covered include: boom release mechanisms, separation on space shuttle orbiter/Boeing 747 aircraft, payload handling, spaceborne platform support, and deployment of spaceborne antennas and telescopes.

  20. Use of intercostal trocars for laparoscopic resection of subphrenic hepatic tumors.

    PubMed

    Ichida, Hirofumi; Ishizawa, Takeaki; Tanaka, Masayuki; Terasawa, Muga; Watanabe, Genki; Takeda, Yoshinori; Matsuki, Ryota; Matsumura, Masaru; Hata, Taigo; Mise, Yoshinori; Inoue, Yosuke; Takahashi, Yu; Saiura, Akio

    2017-03-01

    The aim of this study was to demonstrate the detailed surgical techniques of laparoscopic hepatectomy using intercostal transthoracic trocars for subcapsular tumors located in segment VII or VIII. Intercostal transthoracic trocars were used in patients undergoing laparoscopic hepatectomy for tumors located in segment VII or VIII. Following establishment of pneumoperitoneum and placement of abdominal trocars, balloon-tipped trocars were inserted into the abdominal cavity from the intercostal space and through the pleural space and diaphragm. Upon placement of the intercostal trocars, the lung edge was confirmed by ultrasonography and laparoscopic examination. Following minimal mobilization of the right liver, hemispherical wedge resection of segment VII or VIII was performed using the intercostal trocars as a camera port or for the forceps of the surgeon's left hand. After the hepatectomy, the holes in the diaphragm were sutured closed. Among the 79 patients who underwent laparoscopic hepatectomy, intercostal trocars were used in 14 patients for resection of tumors located in segment VII (4 nodules) or VIII (10 nodules). The median (range) operation time and amount of blood loss for hepatectomy were 225 (109-477) min and 60 (20-310) mL, respectively. No postoperative complications associated with hepatectomy or the use of intercostal trocars occurred. Use of intercostal transthoracic trocars is safe and effective not only for complicated laparoscopic hepatectomy but also for hemispherical wedge resections of subcapsular hepatic tumors located in segment VII or VIII.

  1. Acquired Abdominal Intercostal Hernia: A Case Report and Literature Review

    PubMed Central

    Tripodi, Giuseppe

    2014-01-01

    Acquired abdominal intercostal hernia (AAIH) is a rare disease phenomenon where intra-abdominal contents reach the intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. We discuss a case of a 51-year-old obese female who arrived to the emergency room with a painful swelling between her left 10th rib and 11th rib. She gave a history of a stab wound to the area 15 years earlier. A CT scan revealed a fat containing intercostal hernia with no diaphragmatic defect. An open operative approach with a hernia patch was used to repair this hernia. These hernias are difficult to diagnose, so a high clinical suspicion and thorough history and physical exam are important. This review discusses pathogenesis, clinical presentation, complications, and appropriate treatment strategies of AAIH. PMID:25197605

  2. Human intersegmental reflexes from intercostal afferents to scalene muscles.

    PubMed

    McBain, Rachel A; Taylor, Janet L; Gorman, Robert B; Gandevia, Simon C; Butler, Jane E

    2016-10-01

    What is the central question of this study? The aim was to determine whether specific reflex connections operate between intercostal afferents and the scalene muscles in humans, and whether these connections operate after a clinically complete cervical spinal cord injury. What is the main finding and its importance? This is the first description of a short-latency inhibitory reflex connection between intercostal afferents from intercostal spaces to the scalene muscles in able-bodied participants. We suggest that this reflex is mediated by large-diameter afferents. This intercostal-to-scalene inhibitory reflex is absent after cervical spinal cord injury and may provide a way to monitor the progress of the injury. Short-latency intersegmental reflexes have been described for various respiratory muscles in animals. In humans, however, only short-latency reflex responses to phrenic nerve stimulation have been described. Here, we examined the reflex connections between intercostal afferents and scalene muscles in humans. Surface EMG recordings were made from scalene muscles bilaterally, in seven able-bodied participants and seven participants with motor- and sensory-complete cervical spinal cord injury (median 32 years postinjury, range 5 months to 44 years). We recorded the reflex responses produced by stimulation of the eighth or tenth left intercostal nerve. A short-latency (∼38 ms) inhibitory reflex was evident in able-bodied participants, in ipsilateral and contralateral scalene muscles. This bilateral intersegmental inhibitory reflex occurred in 46% of recordings at low stimulus intensities (at three times motor threshold). It was more frequent (in 75-85% of recordings) at higher stimulus intensities (six and nine times motor threshold), but onset latency (38 ± 9 ms, mean ± SD) and the size of inhibition (23 ± 10%) did not change with stimulus intensity. The reflex was absent in all participants with spinal cord injury. As the intercostal

  3. Electro-physiological evidence of intercostal nerve injury after thoracotomy: an experimental study in a sheep model

    PubMed Central

    Schwabe, Kerstin; Krüger, Marcus; Haverich, Axel; Krauss, Joachim K.; Alam, Mesbah

    2017-01-01

    Background Although intercostal nerve injury is one of the major causes for post-thoracotomy pain, the exact mechanisms are still unclear. We sought to evaluate the electro-physiological changes of intercostal nerve injury after thoracotomy in a sheep model. Methods Adult sheep underwent thoracotomy in the sixth intercostal space by employing diathermy to superior border of the seventh rib. In two sheep, ribs were then spread using retractor spreading for a distance of 7 cm for 30 minutes. In the third sheep, thoracotomy was followed by harvesting intercostal muscles including the neurovascular bundle adjacent to inferior edge of the sixth rib. Thereafter, ribs were spread in the same way, but with the muscle flap dangled between the blades for intercostal nerve protection (dangling muscle flap technique). The nerve conduction velocity of the intercostal nerve was recorded before and after incision of intercostal muscles, immediately and 30 minutes after retractor placement and 30 minutes after removal of the retractor. Results In the sheep undergoing conventional thoracotomy, the physiological conductivity of intercostal nerve was completely blocked immediately after retractor placement using the same stimulation intensity or even the supra-threshold intensity. The conduction block persisted for 30 minutes during the retractor placement and further 30 minutes after removal of the retractor. In contrast, intercostal nerve conduction was not impaired throughout the experiment with the dangling muscle flap technique. Conclusions Our experiment provides electro-physiological evidence for intercostal nerve injury after thoracotomy. The injury is primarily attributed to mechanical compression caused by the rib retractor.

  4. The Mars 6 Landing, 12th March 1974

    NASA Astrophysics Data System (ADS)

    Harvey, B.

    The Soviet Union sent five landers to Mars: 2MV3 in 1962; Mars 2 and 3 in 1971 and Mars 6 and 7 in 1973. Influenced by astrobiologist Gavril Tikhov, early Soviet designers believed that it would be possible to reach the surface of Mars using large parachutes. When the atmosphere was found to be much thinner than anticipated, the landers were redesigned to incorporate rockets. The Mars 2 and 3 missions were impeded by a poor level of navigational knowledge, making it difficult to achieve precise entry trajectories for the subsequent touchdowns. Despite that, Mars 3 achieved the first soft landing on Mars in 1971 and a brief surface transmission. Two years later, the Soviet Union achieved the first temperature and pressure profile of the atmosphere of Mars down to the surface when Mars 6 landed in the Mare Erythraeum on 12th March 1974. Because of internal debates within the Soviet space programme and the nature of news management at the time, the achievement of Mars 6 has been obscured.

  5. The canine phrenic-to-intercostal reflex

    PubMed Central

    De Troyer, André

    1998-01-01

    Paralysis of the diaphragm in the dog causes a non-vagal, non-chemical increase in the activity of the inspiratory intercostal muscles. In the present studies, the hypothesis was tested that phrenic afferent fibres may elicit a reflex inhibition of inspiratory intercostal activity. The electrical activity of the three groups of inspiratory intercostal muscles (parasternal intercostals, external intercostals, levator costae) was recorded in twenty vagotomized, spontaneously breathing dogs, and the proximal end of one or both C5 phrenic nerve roots was stimulated during inspiration. Stimulation of the ipsilateral and contralateral C5 phrenic roots caused an immediate reduction in inspiratory intercostal activity. This reduction was abolished when phrenic stimulation was repeated after section of the C5 dorsal roots. The reduction in external intercostal and levator costae activity during bilateral C5 afferent stimulation appeared when the stimulus strength was 3 times the motor threshold and it increased in magnitude when stimulus intensity was increased further. In contrast, the reduction in parasternal intercostal activity occurred only when the stimulus strength was 12 times the motor threshold. These observations confirm the hypothesis that diaphragmatic receptors may reflexly inhibit efferent activity to the inspiratory intercostal muscles, in particular the external intercostals and levator costae. This inhibition appears to be primarily mediated by small myelinated fibres. PMID:9518742

  6. 12th European VLBI Network Symposium and Users Meeting

    NASA Astrophysics Data System (ADS)

    Tarchi, Andrea; Giroletti, Marcello; Feretti, Luigina

    The Istituto di Radioastronomia (IRA) di Bologna and the Osservatorio Astronomico di Cagliari (OAC), on behalf of the European VLBI Consortium, hosted the 12th European VLBI Network (EVN) Symposium and Users Meeting. The Conference was held from 7th to 10th of October at the Hotel Regina Margherita, in the center of Cagliari. The latest scientific results and technical developments from VLBI, and, in particular, e-VLBI and space-VLBI (RadioAstron) outcomes were reported. The timing of this meeting coincided with the first successful observational tests of the Sardinia Radio Telescopes within the EVN, and with a number of results from new and upgraded radio facilities around the globe, such as e-MERLIN, ALMA, and the SKA pathfinders. The symposium was attended by 133 participants from all over the world, with the Asian community represented by more than 20 colleagues. The program of the meeting consisted of 70 oral contributions (including 8 invited speakers) and 50 poster that covered a very wide range of VLBI topics both in galactic and extragalactic astrophysics (e.g., AGN, stellar evolution from birth to death, astrometry, and planetary science) as well as technological developments and future international collaborations. The scientific program also included a visit to the 64-m Sardinia Radio Telescope (SRT) and the EVN Users Meeting, where astronomers have provided useful feedback on various matters regarding EVN operations. The research leading to these results has received funding from the European Commission Seventh Framework Programme (FP/2007-2013) under grant agreement No 283393 (RadioNet3). EDITORIAL BOARD: Andrea Tarchi, Marcello Giroletti, Luigina Feretti

  7. The 12th Annual Pharmacogenetics in Psychiatry meeting report.

    PubMed

    Zhang, Jian-Ping; Aitchison, Katherine J; Malhotra, Anil K

    2014-10-01

    The 12th Annual Pharmacogenetics in Psychiatry meeting was held in Hollywood, Florida, from 31 May to 1 June 2013, in conjunction with the NCDEU meeting. It included a series of oral presentations as well as a poster session. This report summarizes the presentations at the conference.

  8. Reflections on the 12th International Transformative Learning Conference

    ERIC Educational Resources Information Center

    Schapiro, Steven A.; Gallegos, Placida V.; Stashower, Keren; Clark, Donna F.

    2017-01-01

    This article is a reflective essay that explores the question: What can the content and experience of the conference tell us about the state of theory and practice in the field of TL; where is it today and where it may be going in the future? The 12th International Transformative Learning Conference (ITLC) held October 19-23 at Pacific Lutheran…

  9. Reflections on the 12th International Transformative Learning Conference

    ERIC Educational Resources Information Center

    Schapiro, Steven A.; Gallegos, Placida V.; Stashower, Keren; Clark, Donna F.

    2017-01-01

    This article is a reflective essay that explores the question: What can the content and experience of the conference tell us about the state of theory and practice in the field of TL; where is it today and where it may be going in the future? The 12th International Transformative Learning Conference (ITLC) held October 19-23 at Pacific Lutheran…

  10. Intercostal lung herniation - The role of imaging

    PubMed Central

    Detorakis, Efstathios E.; Androulidakis, Emmanuel

    2014-01-01

    Extrathoracic lung hernias can be congenital or acquired. Acquired hernias may be classified by etiology into traumatic, spontaneous, and pathologic. We present a case of a 40-year-old male with a history of bronchial asthma and a blunt chest trauma who presented complaining of sharp chest pain of acute onset that began after five consecutive days of vigorous coughing. Upon physical examination a well-demarcated deformity overlying the third intercostal space of the left upper anterior hemithorax was revealed. Thoracic CT scan showed that a portion of the anterior bronchopulmonary segment of the left upper lobe had herniated through a chest wall defect. The role of imaging, especially chest computed tomography with multiplanar image reconstructions and maximum (MIP) and minimum intensity projection (MinIP) reformats can clearly confirm the presence of the herniated lung, the hernial sac, the hernial orifice in the chest wall, and exclude possible complications such as lung tissue strangulation. PMID:24967031

  11. Recurrent inhibition of intercostal motoneurones in the cat.

    PubMed Central

    Kirkwood, P A; Sears, T A; Westgaard, R H

    1981-01-01

    1. The external and internal intercostal nerves of a single intercostal space were stimulated in anaesthetized paralysed cats with dorsal roots cut in the corresponding spinal cord segment. 2. Extracellular recording in the ventral horn revealed single units which fired short high frequency bursts of spikes at short latency to stimulation of either or both of the two nerves at stimulus strengths appropriate to the activation of alpha motor axons. These units were deduced to be Renshaw cells. 3. Small (0.1-0.2 mV) hyperpolarizing potentials of duration up to 50 msec were recorded intracellularly in both inspiratory and expiratory motoneurones of the same segment. Latencies and thresholds were appropriate for disynaptic i.p.s.p.s evoked by collaterals of alpha motor axons. 4. The changes in probability of firing following the stimuli were examined for inspiratory alpha motoneurones by constructing post-stimulus histograms of efferent discharges recorded from filaments of the external intercostal nerve of the segment stimulated and from other segments. 5. A period of reduced probability of firing of up to 24 msec duration, corresponding in all respects to disynaptic inhibition from alpha motor axon collaterals, was seen in the segment stimulated and up to three segments distant, though declining in intensity with distance. Either nerve could evoke such inhibition although that evoked from the internal intercostal nerve was stronger, as were the intensities of the Renshaw cell discharges. 6. We conclude that recurrent inhibition, via Renshaw cells which have axons up to 30 mm in length, is present for intercostal motoneurones. Arguments are adduced to show that although the effects from stimulating any one segmental nerve may be relatively weak, the over-all effect resulting from the widely spread projections of the Renshaw cells concerned is an inhibition comparable intensity with that seen in many hind limb motor nuclei. PMID:7320908

  12. Making New Links, 12th Grade and beyond: Technical Panel on 12th Grade Preparedness Research. Final Report

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2009

    2009-01-01

    The Technical Panel on 12th Grade Preparedness Research, convened by the Governing Board, consists of seven members with expertise in a variety of measurement and policy areas related to preparedness. The purpose of the Panel was to assist the National Assessment Governing Board (NAGB) in planning research and validity studies that will enable the…

  13. Intercostal Nerve Block and Neurolysis for Intractable Cancer Pain.

    PubMed

    Matchett, Gerald

    2016-06-01

    Management of intractable cancer-associated chest wall pain is difficult once patients have reached dose-limiting side effects of opioids and coanalgesic medications. This case series describes 11 patients with intractable cancer-associated chest wall pain who were treated with a diagnostic intercostal nerve block. Six patients subsequently received chemical neurolysis with phenol using the same approach. No serious adverse events were observed. Radiopaque contrast dye spread into the paravertebral space in all 11 patients, and in 1 patient contrast dye spread into the epidural space. Seven of 11 patients experienced pain relief from the diagnostic blockade. Four of six patients experienced pain relief from the neurolytic blockade. The principal reportable finding from this case series is the observation that contrast dye spread liberally from the intercostal space into other anatomic spaces, even though very small volumes of injectate (less than 5 mL) were used. Definitive evidence of safety and efficacy of intercostal nerve block and neurolysis for cancer pain will require a prospective randomized clinical trial.

  14. Ipsilateral inspiratory intercostal muscle activity after C2 spinal cord hemisection in rats

    PubMed Central

    Beth Zimmer, M.; Grant, Joshua S.; Ayar, Angelo E.; Goshgarian, Harry G.

    2015-01-01

    Background Upper cervical spinal cord hemisection causes paralysis of the ipsilateral hemidiaphragm; however, the effect of C2 hemisection on the function of the intercostal muscles is not clear. We hypothesized that C2 hemisection would eliminate inspiratory intercostal activity ipsilateral to the injury and that some activity would return in a time-dependent manner. Methods Female Sprague Dawley rats were anesthetized with urethane and inspiratory intercostal electromyogram (EMG) activity was recorded in control rats, acutely injured C2 hemisected rats, and at 1 and 16 weeks post C2 hemisection. Results Bilateral recordings of intercostal EMG activity showed that inspiratory activity was reduced immediately after injury and increased over time. EMG activity was observed first in rostral spaces followed by recovery occurring in caudal spaces. Theophylline increased respiratory drive and increased intercostal activity, inducing activity that was previously absent. Conclusion These results suggest that there are crossed, initially latent, respiratory connections to neurons innervating the intercostal muscles similar to those innervating phrenic motor neurons. PMID:24969369

  15. Face reconstruction using lateral intercostal artery perforator-based adipofascial free flap.

    PubMed

    Jeong, Jae Hoon; Hong, Jin Myung; Imanishi, Nobuaki; Lee, Yoonho; Chang, Hak

    2014-01-01

    The aim of this study was to determine the efficacy of lateral intercostal artery perforator-based adipofascial free flaps for facial reconstruction in patients with facial soft tissue deficiency. We conducted a retrospective study of five consecutive patients diagnosed with facial soft tissue deficiency who underwent operations between July 2006 and November 2011. Flap design included the area containing the perforators. A linear incision was made along the rib, which had the main intercostal pedicle. First, we dissected below Scarpa's fascia as the dorsal limit of the flap. Then, the adipofascial flap was elevated from the medial to the lateral side, including the perforator that pierces the serratus anterior muscle after emerging from the lateral intercostal artery. After confirming the location of the perforator, pedicle dissection was performed dorsally. Dominant perforators were located on the sixth to eighth intercostal space, and more than four perforators were found in fresh-cadaver angiography. In the clinical case series, the seventh or eighth intercostal artery perforators were used for the free flaps. The mean diameter of the pedicle artery was 1.36 mm, and the mean pedicle length was 61.4 mm. There was one case of partial fat necrosis. No severe complications occurred. This is the first study of facial contour reconstruction using lateral intercostal artery perforator-based adipofascial free flaps. The use of this type of flap was effective and can be considered a good alternative for restoring facial symmetry in patients with severe facial soft tissue deficiency.

  16. Postural and ventilatory functions of intercostal muscles.

    PubMed

    Duron, B

    1973-01-01

    During spontaneous breathing, the interchondral muscles present a pattern of activity similar to that of the diaphragm. The external intercostals and most of the internal intercostals generally show electrical discharges not related to ventilatory rhythm. Studies of the electrical responses of these muscles in experimental variations of their length show that the external and internal intercostals are readily activated by this category of reflexes while the diaphragm and the interchondrals are not. Bilateral multisegmental sections of spinal dorsal roots do not affect the respiratory activity of the diaphragm and of the interchondral muscles; on the contrary, all types of activity - spontaneous or reflex - disappear from the intercostals. Electrical stimulation of appropriate points in the bulbar pyramids in decerebrate cats can activate at the same time different intercostals and leg muscles without modifying the rhythmic inspiratory activity of the diaphragm and the interchondrals. In preparations with chronically implanted electrodes, the intercostals muscles are chiefly involved in posture. These results fit very well with our histological findings which disclose a much greater density of muscle spindles in external intercostals than in the diaphragm or in the interchondral muscles.

  17. Energy education resources: Kindergarten through 12th grade

    SciTech Connect

    1998-09-01

    Energy Education Resources: Kindergarten Through 12th Grade is published by the National Energy Information Center (NEIC) a service of the Energy Information Administration (EIA), to provide students, educators, and other information users, a list of generally available free or low-cost energy-related educational materials. Each entry includes the address, telephone number, and description of the organization and the energy-related materials available. Most of the entries also include Internet (Web) and electronic mail (E-Mail) addresses. Each entry is followed by a number, which is referenced in the subject index in the back of this book.

  18. [Capillary density and respiratory function in the external intercostal muscle].

    PubMed

    Jiménez-Fuentes, M A; Gea, J; Aguar, M C; Minguella, J; Lloreta, J; Félez, M; Broquetas, J

    1999-11-01

    Changes in lung function have been related to adaptive structural modifications in respiratory muscles. To evaluate the capillary density (Dcap) of the external intercostal muscle in patients with chronic obstructive pulmonary disease (COPD), and its possible relation to respiratory function. Forty-two individuals (61 +/- 9 years old) underwent conventional lung function testing and evaluation of respiratory muscles (maximum pressures at rest and a tolerance test using Martyn's technique). The sample included 10 subjects with normal lung function and 32 COPD patients (FEV1 between 13 and 78% of reference), in stable phase and with no respiratory insufficiency (PaO2 > 60 mmHg). A local biopsy of the external intercostal muscle was taken from all subjects at the fifth intercostal space (anterior axillary [correction of axile]) on the non-dominant side. The sample was processed for morphometry and fiber typing with ATPase staining and for quantifying capillarity with Gomori's trichrome staining. The mean diameter was 61 +/- 10 micrograms, with type I fibers predominating (56 +/- 11%). Dcap was 2.8 +/- 0.6 capillaries/fiber (equivalent to 1.02 +/- 0.37 capillaries/mm2 of fibrillary surface). The number of capillaries/fiber was significantly higher in patients with severe COPD (FEV1 < 50% ref) than in controls (3.0 +/- 0.6 versus 2.3 +/- 0.5, p < 0.01) and was inversely related to FEV1 (r = -0.395, p < 0.01). Muscle capillarity was unrelated to other function variables, including markers of respiratory muscle function and gas exchange. The structural remodelling of external intercostal muscles in COPD patients also includes an increase in density of interfibrillary capillaries. This increase is proportional to the severity of obstruction and probably reflects an adaptive phenomenon.

  19. International Geomagnetic Reference Field: the 12th generation

    NASA Astrophysics Data System (ADS)

    Thébault, Erwan; Finlay, Christopher C.; Beggan, Ciarán D.; Alken, Patrick; Aubert, Julien; Barrois, Olivier; Bertrand, Francois; Bondar, Tatiana; Boness, Axel; Brocco, Laura; Canet, Elisabeth; Chambodut, Aude; Chulliat, Arnaud; Coïsson, Pierdavide; Civet, François; Du, Aimin; Fournier, Alexandre; Fratter, Isabelle; Gillet, Nicolas; Hamilton, Brian; Hamoudi, Mohamed; Hulot, Gauthier; Jager, Thomas; Korte, Monika; Kuang, Weijia; Lalanne, Xavier; Langlais, Benoit; Léger, Jean-Michel; Lesur, Vincent; Lowes, Frank J.; Macmillan, Susan; Mandea, Mioara; Manoj, Chandrasekharan; Maus, Stefan; Olsen, Nils; Petrov, Valeriy; Ridley, Victoria; Rother, Martin; Sabaka, Terence J.; Saturnino, Diana; Schachtschneider, Reyko; Sirol, Olivier; Tangborn, Andrew; Thomson, Alan; Tøffner-Clausen, Lars; Vigneron, Pierre; Wardinski, Ingo; Zvereva, Tatiana

    2015-05-01

    The 12th generation of the International Geomagnetic Reference Field (IGRF) was adopted in December 2014 by the Working Group V-MOD appointed by the International Association of Geomagnetism and Aeronomy (IAGA). It updates the previous IGRF generation with a definitive main field model for epoch 2010.0, a main field model for epoch 2015.0, and a linear annual predictive secular variation model for 2015.0-2020.0. Here, we present the equations defining the IGRF model, provide the spherical harmonic coefficients, and provide maps of the magnetic declination, inclination, and total intensity for epoch 2015.0 and their predicted rates of change for 2015.0-2020.0. We also update the magnetic pole positions and discuss briefly the latest changes and possible future trends of the Earth's magnetic field.

  20. 12th Anglo-French Physical Acoustics Conference (AFPAC2013)

    NASA Astrophysics Data System (ADS)

    2014-04-01

    The Anglo-French Physical Acoustics Conference (AFPAC) had its 12th annual meeting in Villa Clythia, Fréjus, France, from 16th to 18th January 2013. This series of meetings is a collaboration between the Physical Acoustics Group (PAG) of the Institute of Physics and the Groupe d'Acoustique Physique, Sous-marine et UltraSonore (GAPSUS) of the Société Française d'Acoustique. This year, attendees got the opportunity to see the French Riviera with its Mediterranean vegetation covered by a nice thick snow layer. The participants heard 34 excellent oral presentations and saw 3 posters covering an exciting and diverse range of subjects and of frequencies, from ultrasonic wave propagation in chocolate to metamaterials applied to seismic waves for protecting buildings. Among them, invited talks were given by Pr F A Duck ( Enhanced healing by ultrasound: clinical effects and mechanisms), Pr. J-C Valiére, who actually gave two invited talks ( 1. Measurement of audible acoustic particle velocity using laser: Principles, signal processing and applications, 2. Acoustic pots in ancient and medieval buildings: Literary analysis of ancient texts and comparison with recent observations in French churches), Dr P Huthwaite ( Ultrasonic imaging through the resolution of inverse problems), Dr X Lurton ( Underwater acoustic systems on oceanographic research vessels: principles and applications), Dr S Guenneau ( From platonics to seismic metamaterials). For the fifth consecutive year AFPAC is followed by the publication of its proceedings with 12 peer-reviewed papers which cover the most recent research developments in the field of Physical Acoustics in the UK and France. Alain Lhémery (CEA, France) and Nader Saffari (UCL, United Kingdom) French Riviera 12th AFPAC — Villa Clythia, Fréjus (French Riviera), the 17th of January 2013

  1. Non-traumatic trans-diaphragmatic intercostal hernia and cor pulmonale in a patient with poorly controlled obstructive sleep apnoea.

    PubMed

    Mehdi, Syed Basharath; Madi, Salem; Sudworth, Jordan

    2016-10-28

    Trans-diaphragmatic intercostal hernia is a rare entity. Patient with multiple medical comorbidities, including obstructive sleep apnoea, presents with shortness of breath, leg oedema and a bulging swelling through the right chest wall. CT shows partial herniation of the right lung and liver through intercostal space and an echocardiogram reveals right heart failure. He was treated initially with continuous positive airway pressure with poor response and subsequently treated with adaptive servo ventilation with much better symptomatic relief and treatment tolerance.

  2. Effects of unilateral airway occlusion on rib motion and inspiratory intercostal activity in dogs.

    PubMed

    Leduc, Dimitri; Marechal, Sarah; Taton, Olivier; Blairon, Bernard; Legrand, Alexandre

    2017-04-01

    Unilateral bronchial occlusion, a complication of many lung diseases, causes dyspnea but the mechanism of this symptom is uncertain. In this study, electromyographic (EMG) activity in the parasternal and external intercostal muscles in the third intercostal space and inspiratory motion of the third rib on both sides of the thorax were assessed during occlusion of a main bronchus for a single breath in anesthetized dogs. Occlusion produced a 65% increase in external intercostal EMG activity in both hemithoraces without altering parasternal EMG activity. Concomitantly, the inspiratory cranial rib motion showed a 50% decrease on both sides of the thorax. These changes were unaffected by bilateral vagotomy. However, when an external, caudally oriented force was applied to the third rib on the right or left side so that its inspiratory cranial displacement was abolished, activity in the adjacent external intercostals showed a twofold increase, but rib motion and external activity in the contralateral hemithorax remained unchanged. It is concluded that during occlusion of a main bronchus, the increase in external intercostal activity is induced by the decrease in inspiratory cranial rib displacement in both hemithoraces, and that this decrease is determined by the increase in pleural pressure swings on both sides of the mediastinum. This mechanism, combined with the decrease in PaO2, induces similar alterations when unilateral bronchial occlusion is maintained for a series of consecutive breaths. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  3. Special Issue the 12th International Conference on Substorms

    NASA Technical Reports Server (NTRS)

    Shiokawa, Kazuo; Fok, Mei-Ching; Fujimoto, Masaki

    2016-01-01

    The 12th International Conference on Substorms (ICS-12) was held at the Ise-Shima Royal Hotel in Shima, Japan, on November 10-14, 2014. There were 125 attendees including 68 from foreign countries. The ICS has been held every 2 years since 1992 to discuss substorms, which are fundamental global-scale disturbances in the Earth's magnetosphere. The year 2014 marked the 50th anniversary of the first publication about substorms (Akasofu 1964). The conference included three tutorial lecturers (Profs. S.-I. Akasofu, V. Angelopoulous, and D. Baker), as well as many international scientists, to discuss substorm processes in the tail, their Interactions with the inner magnetosphere and the ionosphere, substorm currents and their dynamics and energetics, the role of MagnetoHydroDynamics (MHD) and kinetic instabilities, storm-substorm relationships, ULFELFVLF waves, and non-Earth substorm-like features. Prof. Akasofu also gave an evening talk about the history of auroral research since the nineteenth century with photographs that inspired and intrigued the young scientists and students in attendance.

  4. The 12th International Workshops on Opportunistic Protists (IWOP-12)

    PubMed Central

    Weiss, Louis M.; Cushion, Melanie T.; Didier, Elizabeth; Xiao, Lihua; Marciano-Cabral, Francine; Sinai, Anthony P.; Matos, Olga; Calderon, Enrique J.; Kaneshiro, Edna S.

    2013-01-01

    The 12th International Workshops on Opportunistic Protists (IWOP-12) was held in August 2012 in Tarrytown, New York. The objectives of the IWOP meetings are to: (1) serve as a forum for exchange of new information among active researchers concerning the basic biology, molecular genetics, immunology, biochemistry, pathogenesis, drug development, therapy, and epidemiology of these immunodeficiency-associated pathogenic eukaryotic microorganisms that are seen in patients with AIDS and (2) foster the entry of new and young investigators into these underserved research areas. The IWOP meeting focuses on opportunistic protists, e.g. the free-living amoebae, Pneumocystis, Cryptosporidium, Toxoplasma, the Microsporidia, and kinetoplastid flagellates. This conference represents the major conference that brings together research groups working on these opportunistic pathogens. Slow but steady progress is being achieved on understanding the biology of these pathogenic organisms, their involvement in disease causation in both immune-deficient and immune-competent hosts, and is providing critical insights into these emerging and reemerging pathogens. This IWOP meeting demonstrated the importance of newly developed genomic level information for many of these pathogens and how analysis of such large data sets is providing key insights into the basic biology of these organisms. A great concern is the loss of scientific expertise and diversity in the research community due to the ongoing decline in research funding. This loss of researchers is due to the small size of many of these research communities and a lack of appreciation by the larger scientific community concerning the state of art and challenges faced by researchers working on these organisms. PMID:23560871

  5. Expiratory muscle loading increases intercostal muscle blood flow during leg exercise in healthy humans.

    PubMed

    Athanasopoulos, Dimitris; Louvaris, Zafeiris; Cherouveim, Evgenia; Andrianopoulos, Vasilis; Roussos, Charis; Zakynthinos, Spyros; Vogiatzis, Ioannis

    2010-08-01

    We investigated whether expiratory muscle loading induced by the application of expiratory flow limitation (EFL) during exercise in healthy subjects causes a reduction in quadriceps muscle blood flow in favor of the blood flow to the intercostal muscles. We hypothesized that, during exercise with EFL quadriceps muscle blood flow would be reduced, whereas intercostal muscle blood flow would be increased compared with exercise without EFL. We initially performed an incremental exercise test on eight healthy male subjects with a Starling resistor in the expiratory line limiting expiratory flow to approximately 1 l/s to determine peak EFL exercise workload. On a different day, two constant-load exercise trials were performed in a balanced ordering sequence, during which subjects exercised with or without EFL at peak EFL exercise workload for 6 min. Intercostal (probe over the 7th intercostal space) and vastus lateralis muscle blood flow index (BFI) was calculated by near-infrared spectroscopy using indocyanine green, whereas cardiac output (CO) was measured by an impedance cardiography technique. At exercise termination, CO and stroke volume were not significantly different during exercise, with or without EFL (CO: 16.5 vs. 15.2 l/min, stroke volume: 104 vs. 107 ml/beat). Quadriceps muscle BFI during exercise with EFL (5.4 nM/s) was significantly (P = 0.043) lower compared with exercise without EFL (7.6 nM/s), whereas intercostal muscle BFI during exercise with EFL (3.5 nM/s) was significantly (P = 0.021) greater compared with that recorded during control exercise (0.4 nM/s). In conclusion, increased respiratory muscle loading during exercise in healthy humans causes an increase in blood flow to the intercostal muscles and a concomitant decrease in quadriceps muscle blood flow.

  6. Expiratory muscle loading increases intercostal muscle blood flow during leg exercise in healthy humans

    PubMed Central

    Athanasopoulos, Dimitris; Louvaris, Zafeiris; Cherouveim, Evgenia; Andrianopoulos, Vasilis; Roussos, Charis; Zakynthinos, Spyros

    2010-01-01

    We investigated whether expiratory muscle loading induced by the application of expiratory flow limitation (EFL) during exercise in healthy subjects causes a reduction in quadriceps muscle blood flow in favor of the blood flow to the intercostal muscles. We hypothesized that, during exercise with EFL quadriceps muscle blood flow would be reduced, whereas intercostal muscle blood flow would be increased compared with exercise without EFL. We initially performed an incremental exercise test on eight healthy male subjects with a Starling resistor in the expiratory line limiting expiratory flow to ∼ 1 l/s to determine peak EFL exercise workload. On a different day, two constant-load exercise trials were performed in a balanced ordering sequence, during which subjects exercised with or without EFL at peak EFL exercise workload for 6 min. Intercostal (probe over the 7th intercostal space) and vastus lateralis muscle blood flow index (BFI) was calculated by near-infrared spectroscopy using indocyanine green, whereas cardiac output (CO) was measured by an impedance cardiography technique. At exercise termination, CO and stroke volume were not significantly different during exercise, with or without EFL (CO: 16.5 vs. 15.2 l/min, stroke volume: 104 vs. 107 ml/beat). Quadriceps muscle BFI during exercise with EFL (5.4 nM/s) was significantly (P = 0.043) lower compared with exercise without EFL (7.6 nM/s), whereas intercostal muscle BFI during exercise with EFL (3.5 nM/s) was significantly (P = 0.021) greater compared with that recorded during control exercise (0.4 nM/s). In conclusion, increased respiratory muscle loading during exercise in healthy humans causes an increase in blood flow to the intercostal muscles and a concomitant decrease in quadriceps muscle blood flow. PMID:20507965

  7. Face Reconstruction Using Lateral Intercostal Artery Perforator-Based Adipofascial Free Flap

    PubMed Central

    Jeong, Jae Hoon; Hong, Jin Myung; Imanishi, Nobuaki; Lee, Yoonho

    2014-01-01

    Background The aim of this study was to determine the efficacy of lateral intercostal artery perforator-based adipofascial free flaps for facial reconstruction in patients with facial soft tissue deficiency. Methods We conducted a retrospective study of five consecutive patients diagnosed with facial soft tissue deficiency who underwent operations between July 2006 and November 2011. Flap design included the area containing the perforators. A linear incision was made along the rib, which had the main intercostal pedicle. First, we dissected below Scarpa's fascia as the dorsal limit of the flap. Then, the adipofascial flap was elevated from the medial to the lateral side, including the perforator that pierces the serratus anterior muscle after emerging from the lateral intercostal artery. After confirming the location of the perforator, pedicle dissection was performed dorsally. Results Dominant perforators were located on the sixth to eighth intercostal space, and more than four perforators were found in fresh-cadaver angiography. In the clinical case series, the seventh or eighth intercostal artery perforators were used for the free flaps. The mean diameter of the pedicle artery was 1.36 mm, and the mean pedicle length was 61.4 mm. There was one case of partial fat necrosis. No severe complications occurred. Conclusions This is the first study of facial contour reconstruction using lateral intercostal artery perforator-based adipofascial free flaps. The use of this type of flap was effective and can be considered a good alternative for restoring facial symmetry in patients with severe facial soft tissue deficiency. PMID:24511495

  8. Intercostal Trocars Enable Easier Laparoscopic Resection of Liver Tumors in Segments 7 and 8.

    PubMed

    Hirokawa, Fumitoshi; Hayashi, Michihiro; Asakuma, Mitsuhiro; Shimizu, Tetsunosuke; Inoue, Yoshihiro; Uchiyama, Kazuhisa

    2017-05-01

    Laparoscopic resection of posterosuperior (PS) tumors of the liver is more difficult than that of anterolateral (AL) tumors, owing to the narrow surgical field in the PS location. In this retrospective cohort study, our aim was to determine if port insertion through the intercostal space would lead to improved outcomes for laparoscopic resection of tumors in PS liver segments 7 and 8. Between January 2006 and December 2015, 153 patients underwent laparoscopic resection of solitary liver tumors at Osaka Medical College Hospital. Of these, 107 patients had AL lesions, and 46 had PS lesions. Of the 46 patients with a PS lesion, 23 underwent an abdominal-only approach, and 23 underwent the intercostal trocar approach. Multivariate analyses were performed to investigate outcomes. Conventional abdominal-only laparoscopic resection of PS liver tumors resulted in prolonged surgical time (P = 0.031), increased bleeding (P = 0.012), and a higher open conversion rate (P = 0.022) compared with AL tumors. Among patients with PS tumors, the open conversion rate was significantly higher for those treated with the abdominal-only approach than with the intercostal trocar approach (P = 0.047). Appropriate surgical margins were obtained equally using the intercostal trocar approach (P = 0.648). There was no significant difference in occurrence of complications between the abdominal-only group and the intercostal trocar group. Using the intercostal trocar approach for PS liver lesions is a safe and effective method, which significantly reduced the open conversion rate compared with the conventional abdominal-only approach.

  9. PREFACE: 12th Conference on ''Theoretical Nuclear Physics in Italy''

    NASA Astrophysics Data System (ADS)

    Bombaci, I.; Covello, A.; Marcucci, L. E.; Rosati, S.

    2009-07-01

    These Proceedings contain the invited and contributed papers presented at the 12th Conference on Theoretical Nuclear Physics in Italy held in Cortona, Italy, from 8-10 October 2008. As usual, the meeting was held at il Palazzone, a 16th century castle owned by the Scuola Normale Superiore di Pisa. The aim of this biennal conference is to bring together Italian theorists working in various fields of Nuclear Physics to discuss their latest results and confront their points of view in a lively and informal way. This offers the opportunity to promote collaborations between different groups. There were about 50 participants at the conference, coming from 14 Italian Universities (Cagliari, Catania, Ferrara, Firenze, Genova, Lecce, Milano, Napoli, Padova, Pavia, Pisa, Roma, Trento, Trieste). The program of the conference, prepared by the Organizing Committee (Ignazio Bombaci, Aldo Covello, Laura Elisa Marcucci and Sergio Rosati) focused on six main topics: Few-Nucleon Systems, Nuclear Matter and Nuclear Dynamics, Nuclear Astrophysics, Structure of Hadrons and Hadronic Matter, Nuclear Structure, Nuclear Physics with Electroweak Probes. Winfried Leidemann, Maria Colonna, Marcello Lissia, Elena Santopinto, Silvia Lenzi and Omar Benhar took the burden of giving general talks on these topics and reviewing the research activities of the various Italian groups. In addition, 19 contributed papers were presented, most of them by young participants. In the last session of the Conference there were two invited talks related to experimental activities of great current interest. Gianfranco Prete from the Laboratori Nazionali di Legnaro spoke about the Italian radioactive ion beam facility SPES and the status of the European project EURISOL, while Nicola Colonna from the INFN, Bari, gave an overview of the perspectives of development of fourth-generation nuclear reactors. We would like to thank the authors of the general reports for their hard work in reviewing the main achievements in

  10. PREFACE 12th International Workshop on Slow Positron Beam Techniques

    NASA Astrophysics Data System (ADS)

    Buckman, Stephen; Sullivan, James; White, Ronald

    2011-01-01

    Preface These proceedings arose from the 12th International Workshop on Slow Positron Beam Techniques (SLOPOS12), which was held on Magnetic Island, North Queensland, Australia, between 1-6th August 2010. Meetings in the SLOPOS series are held (roughly) every three years and have now been held on (almost) all continents, indicating the truly international nature of the field. SLOPOS12 marked the second time that the Workshop had been held in the southern hemisphere, and the first time in Australia. SLOPOS12 attracted 122 delegates from 16 countries. Most encouraging was the attendance of 28 student delegates, and that about half of the overall delegates were early career researchers - a good sign for the future of our field. We also enjoyed the company of more than a dozen partners and families of delegates. In a slight departure from previous SLOPOS meetings, the International Advisory Committee approved a broader scope of scientific topics for inclusion in the program for the 2010 Workshop. This broader scope was intended to capture the applications of positrons in atomic, molecular and biomedical areas and was encapsulated in the byeline for SLOPOS-12: The 12th International Workshop on Slow Positron Beam Techniques for Solids, Surfaces, Atoms and Molecules. The scientific and social program for the meeting ran over 6 days with delegates gathering on Sunday August 1st and departing on August 6th. The scientific program included plenary, invited, contributed and student lectures, the latter being the subject of a student prize. In all there were 53 oral presentations during the week. There were also two poster sessions, with 63 posters exhibited, and a prize was awarded for the best poster by a student delegate. The standard of the student presentations, both oral and posters, was outstanding, so much so that the judging panel recommended an additional number of prizes be awarded. Topics that were the focus of invited presentations and contributed papers at

  11. Right intercostal insertion of a Veress needle for laparoscopy in dogs.

    PubMed

    Fiorbianco, Valentina; Skalicky, Monika; Doerner, Judith; Findik, Murat; Dupré, Gilles

    2012-04-01

    To evaluate right intercostal Veress needle (VN) insertion for laparoscopy in dogs. Longitudinal cohort study. Female dogs (n = 56). The VN was inserted in the last palpable right intercostal space, either 1/3 (Group T; 28 dogs) or mid distance (Group H; 28 dogs) from the xiphoid cartilage to the most caudal extent of the costal arch. Problems encountered during VN insertion and injuries were recorded, graded, and compared between groups, and also between the first and last 20 insertions. Pneumoperitoneum was successfully achieved by VN insertion in 49 (88%) dogs after a single (45 dogs) or 2nd attempt (4 dogs). Frequency of complications was as follows: 20 grade 1 (subcutaneous emphysema, omentum, or falciform injuries); 6 grade 2 (liver or spleen injury), and 1 grade 3 complication (pneumothorax occurred). No significant difference was found between the 2 groups or between the first and last 20 dogs. Right intercostal VN insertion facilitates pneumoperitoneum in dogs with few consequential complications. No significant difference was found between entry sites; however, the mid distance insertion site in the last palpable intercostal space with dog positioned in dorsal recumbency is likely to result in less complications. © Copyright 2012 by The American College of Veterinary Surgeons.

  12. Seven Destructive Seismic Crises in 12th Century Syria

    NASA Astrophysics Data System (ADS)

    Guidoboni, E.; Bernardini, F.

    2002-12-01

    the region bridging the present-day Syro-Turkish border. The long and devastating series of shakes in 1156-59 and the great earthquake of June 1170, affected a huge area within the current territories of north-western Syria, northern Lebanon and the region of inter Antioch (modern Antakya, in southern Turkey). The effects of the earthquakes in August 1110 and June 1117 have been attested to in southern Lebanon and Palestine. On the grounds of the detailed seismic scenarios of the 5 most documented earthquakes we have also been able to advance some hypotheses as to the seismogenic structures involved. In the first half of the 12th century the most intense seismicity seems to be concentrated in the zones bordering south-eastern Turkey and north-western Syria, suggesting a likely involvement both of the northernmost portion of the Dead Sea Fault System (DSFS), and the south-western segment of the East-Anatolian Fault System (EAFS), as well as, perhaps, also the convergence structures present in south-eastern Turkey (Bitlis suture zone?). Beginning from around mid-1150 the greatest seismic activity seems to migrate more southwards, along the structures of the DSFS that cross western Syria (Ghab and Missyaf faults) and northern Lebanon (Akkar fault?). Lastly, for the great event of 1170, the sources we have retrieved and analysed contain information concerning damage or felt effects in slightly fewer than 30 Crusader and Arab locations, 15 of which new and never before identified. The detailed macroseismic picture that has been reconstructed has thus also allowed us to propose an estimate of the main shock parameters for this earthquake.

  13. Hepatocellular carcinomas smaller than 4 cm supplied by the intercostal artery: can we predict which intercostal artery supplies the tumor?

    PubMed

    Hur, Saebeom; Kim, Hyo-Cheol; Chung, Jin Wook; Kim, Min-Uk; Kim, Ji Dae; Kim, Gyoung Min; Lee, In Joon; Kim, Young Il; Jae, Hwan Jun; Park, Jae Hyung

    2011-01-01

    To predict which intercostal artery supplies a tumor by examining the spatial relationship between hepatocellular carcinoma (HCC) and the intercostal artery feeding the tumor on transverse computed tomography (CT) images. Between January 2000 and September 2009, 46 intercostal arteries supplying HCCs smaller than 4 cm were noted in 44 patients, and CT scans and angiograms of these patients were retrospectively reviewed. The intercostal artery feeding the tumor was marked on the CT scan showing the center of the tumor. In addition, its spatial relationship with the tumor center was examined. The angle of the tumor location was measured on the transverse CT scan in the clockwise direction from the sagittal line on the virtual circle centered in the right hemithorax. Correlations between the angle of the tumor location and the level of the tumor-feeding intercostal artery were assessed with the Spearman rank coefficient. Of 46 intercostal arteries feeding HCC, 39 (85%) were the first ones observed from the tumor center in a counterclockwise direction on the transverse CT image containing the tumor center. The level of the tumor-feeding intercostal artery was significantly correlated with the angle of the tumor, as the posteriorly located tumor tends to be supplied by lower intercostal arteries, while the laterally located tumor by upper intercostal arteries (Spearman coefficient = -0.537; p < 0.001). We can predict the tumor feeder with an accuracy of 85% as the first intercostal artery encountered from the tumor center in a counterclockwise direction on a transverse CT image.

  14. Acquired abdominal intercostal hernia: case report and systematic review of the literature.

    PubMed

    Erdas, E; Licheri, S; Calò, P G; Pomata, M

    2014-10-01

    The protrusion of abdominal viscera through an intercostal space under an intact diaphragm is a very rare condition. The aim of this study is to elucidate the etiology, clinical features, and therapeutic options on what several authors call "abdominal intercostal hernia" (AIH). A typical case of AIH of the 9th left intercostal space in a 48-year-old man is presented. A literature search was conducted on the Medline and Scopus databases. Only acquired AIHs (AAIHs) were considered, while lung, transdiaphragmatic, and congenital intercostal hernias were excluded. Eighteen studies met selection criteria and a total of 20 patients were useful for analysis. Etiology was related mainly to traumatism (65 %) or to previous surgery (20 %). The intercostal defects were mostly located under the 9th rib without significant differences as to side. The main symptom was chest swelling (85 %), often associated with discomfort or pain (76 %). Acute complications such as incarceration and strangulation occurred in three patients. CT was the most employed diagnostic tool (80 %). Early diagnosis was made in 25 % of cases. Seventeen patients underwent hernia repair with either open (73 %) or laparoscopic approach (28 %), and various techniques with and without prosthesis were described. Recurrence occurred in 28.6 % of patients, during a mean follow-up of 8.6 months. AAIH should be always suspected when chest swelling occurs after a minor or major trauma, and CT must be promptly performed to rule out diaphragmatic or abdominal viscera injury. This condition requires surgery to prevent serious complications, the first-choice technique should be mesh tension-free repair.

  15. Spatial distribution of external and internal intercostal activity in dogs

    PubMed Central

    Legrand, Alexandre; De Troyer, André

    1999-01-01

    The observation that the external and internal interosseous intercostal muscles in the dog show marked regional differences in mechanical advantage has prompted us to re-examine the topographic distribution of electrical activity among these muscles during spontaneous breathing. Inspiratory activity was recorded only from the areas of the external intercostals with an inspiratory mechanical advantage, and expiratory activity was recorded only from the areas of the internal intercostals with an expiratory mechanical advantage. The expiratory discharges previously recorded from the caudal external intercostals and the inspiratory discharges recorded from the rostral internal intercostals were probably due to cross-contamination. Activity in each muscle area was also quantified relative to the activity measured during tetanic, supramaximal nerve stimulation (maximal activity). External intercostal inspiratory activity was consistently greater in the areas with a greater inspiratory advantage (i.e. the dorsal aspect of the rostral segments) than in the areas with a smaller inspiratory advantage, and internal intercostal expiratory activity was invariably greatest in the areas with the greatest expiratory advantage (i.e. the dorsal aspect of the caudal segments). This topographic distribution of neural drive confers to the external intercostal muscles an inspiratory action on the lung during breathing and to the internal interosseous intercostals an expiratory action. PMID:10373710

  16. An Intercostal Muscular Hernia as a Consequence of Intercostal Nerve Root Compromise After Trauma to the Thoracic Spine.

    PubMed

    LaBan, Myron M

    2017-04-01

    'True' intercostal hernias, that is, those containing both pleura and lung components, occur infrequently. Only 300 cases have been reported since Rolland's initial description in 1499. Rarer still are intercostal muscle hernias, which occur without containing pulmonary components. In both instances, males predominate, usually a consequence of direct blunt chest trauma. In many instances, recognition of the intercostal muscle hernia may be delayed from weeks to months, its diagnosis masked by more obvious evidence of physical trauma.

  17. Feasibility of intercostal blood flow measurement by echo-Doppler technique in healthy subjects.

    PubMed

    de Bisschop, Claire; Montaudon, Michel; Glénet, Stéphane; Guénard, Hervé

    2015-10-02

    Intercostal artery blood flow supplies the external and internal intercostal muscles, which are inspiratory and expiratory muscles. Intercostal blood flow measured by the echo-Doppler (ED) technique has not previously been reported in humans. This study describes the feasibility of this measurement during free and loaded breathing in healthy subjects. Systolic, diastolic and mean blood flows were measured in the eighth dorsal intercostal space during free and loaded breathing using the ED technique. Flows were calculated as the product of the artery intraluminal surface and blood velocity. Ten healthy subjects (42 ± 13·6 years) were included. Integrated electromyogram (iEMG), arterial pressure, cardiac frequency and breathing pattern were also recorded. Mean blood flows were 3·5 ± 1·2 ml min(-1) at rest, 6 ± 2·6 ml min(-1) while breathing through a combined inspiratory and expiratory resistance and 4·0 ± 1·3 ml min(-1) 1 min after unloading. Diastolic blood flow was about one-third the systolic blood flow. The changes in blood flows were consistent with those in iEMG. No change in mean blood flow was observed between inspiration and expiration, suggesting a balance in the perfusion of external and internal muscles during breathing. In conclusion, ED is a feasible technique for non-invasive, real-time measurement of intercostal blood flow in humans. In healthy subjects, mean blood flow appeared tightly matched to iEMG activity. This technique may provide a way to assess the vascular adaptations induced by diseases in which respiratory work is increased or cardiac blood flow altered.

  18. Intercostal Artery Supplying Hepatocellular Carcinoma: Demonstration of a Tumor Feeder by C-arm CT and Multidetector Row CT

    SciTech Connect

    Kim, Hyo-Cheol Chung, Jin Wook; Lee, In Joon; An, Sangbu; Seong, Nak Jong; Son, Kyu Ri; Jae, Hwan Jun; Park, Jae Hyung

    2011-02-15

    This study was designed to describe tumor feeders from the intercostal artery supplying hepatocellular carcinoma (HCC) on C-arm CT and multidetector row CT. From March 2008 to May 2009, C-arm CT of the intercostal artery was prospectively performed in 24 HCC patients. Two interventional radiologists, who performed C-arm CT, evaluated tumor feeders on C-arm CT and multidetector row CT scans by consensus. In total, 35 intercostal arteries were examined by C-arm CT. All tumor feeders except one showed a sharp upward turn at or near the costochondral junction. On axial C-arm CT images, all tumor feeders were observed as an enhancing dot in the upper intercostal space along the diaphragm. On multidetector CT scans, 17 tumor feeders were observed and 18 were not. Tumor feeders from the intercostal artery are observed as an enhancing dot along the diaphragm on C-arm CT and can be seen on multidetector row CT in approximately half of patients.

  19. Minutes of the 12th Joint NASA/DARA-DLR Life Sciences Program Working Group Meeting

    SciTech Connect

    White, R.J.

    1994-12-31

    This report contains the final minutes of the 12th Joint NASA/DARA-DLR Life Sciences Program Working Group Meeting and includes the presentations made by participants. Separate abstracts have been submitted for articles from this report.

  20. 75 FR 10483 - Filing Dates for the Pennsylvania Special Election in the 12th Congressional District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... From the Federal Register Online via the Government Publishing Office FEDERAL ELECTION COMMISSION Filing Dates for the Pennsylvania Special Election in the 12th Congressional District AGENCY: Federal Election Commission. ACTION: Notice of filing dates for special election. SUMMARY: Pennsylvania...

  1. The BGS magnetic field candidate models for the 12th generation IGRF

    NASA Astrophysics Data System (ADS)

    Hamilton, Brian; Ridley, Victoria A.; Beggan, Ciarán D.; Macmillan, Susan

    2015-05-01

    We describe the candidate models submitted by the British Geological Survey for the 12th generation International Geomagnetic Reference Field. These models are extracted from a spherical harmonic `parent model' derived from vector and scalar magnetic field data from satellite and observatory sources. These data cover the period 2009.0 to 2014.7 and include measurements from the recently launched European Space Agency (ESA) Swarm satellite constellation. The parent model's internal field time dependence for degrees 1 to 13 is represented by order 6 B-splines with knots at yearly intervals. The parent model's degree 1 external field time dependence is described by periodic functions for the annual and semi-annual signals and by dependence on the 20-min Vector Magnetic Disturbance index. Signals induced by these external fields are also parameterized. Satellite data are weighted by spatial density and by two different noise estimators: (a) by standard deviation along segments of the satellite track and (b) a larger-scale noise estimator defined in terms of a measure of vector activity at the geographically closest magnetic observatories to the sample point. Forecasting of the magnetic field secular variation beyond the span of data is by advection of the main field using core surface flows.

  2. Transdiaphragmatic intercostal hernia: imaging aspects in three cases.

    PubMed

    Macedo, Ana Carolina Sandoval; Kay, Fernando Uliana; Terra, Ricardo Mingarini; Campos, José Ribas Milanez de; Aranha, André Galante Alencar; Funari, Marcelo Buarque de Gusmão

    2013-01-01

    Transdiaphragmatic intercostal hernia is uncommon and mostly related to blunt or penetrating trauma. We report three similar cases of cough-induced transdiaphragmatic intercostal hernia, highlighting the anatomic findings obtained with different imaging modalities (radiography, ultrasonography, CT, and magnetic resonance) in each of the cases.

  3. 3D Image Fusion to Localise Intercostal Arteries During TEVAR.

    PubMed

    Koutouzi, G; Sandström, C; Skoog, P; Roos, H; Falkenberg, M

    2017-01-01

    Preservation of intercostal arteries during thoracic aortic procedures reduces the risk of post-operative paraparesis. The origins of the intercostal arteries are visible on pre-operative computed tomography angiography (CTA), but rarely on intra-operative angiography. The purpose of this report is to suggest an image fusion technique for intra-operative localisation of the intercostal arteries during thoracic endovascular repair (TEVAR). The ostia of the intercostal arteries are identified and manually marked with rings on the pre-operative CTA. The optimal distal landing site in the descending aorta is determined and marked, allowing enough length for an adequate seal and attachment without covering more intercostal arteries than necessary. After 3D/3D fusion of the pre-operative CTA with an intra-operative cone-beam CT (CBCT), the markings are overlaid on the live fluoroscopy screen for guidance. The accuracy of the overlay is confirmed with digital subtraction angiography (DSA) and the overlay is adjusted when needed. Stent graft deployment is guided by the markings. The initial experience of this technique in seven patients is presented. 3D image fusion was feasible in all cases. Follow-up CTA after 1 month revealed that all intercostal arteries planned for preservation, were patent. None of the patients developed signs of spinal cord ischaemia. 3D image fusion can be used to localise the intercostal arteries during TEVAR. This may preserve some intercostal arteries and reduce the risk of post-operative spinal cord ischaemia.

  4. Transdiaphragmatic intercostal hernia: imaging aspects in three cases*

    PubMed Central

    Macedo, Ana Carolina Sandoval; Kay, Fernando Uliana; Terra, Ricardo Mingarini; de Campos, José Ribas Milanez; Aranha, André Galante Alencar; Funari, Marcelo Buarque de Gusmão

    2013-01-01

    Transdiaphragmatic intercostal hernia is uncommon and mostly related to blunt or penetrating trauma. We report three similar cases of cough-induced transdiaphragmatic intercostal hernia, highlighting the anatomic findings obtained with different imaging modalities (radiography, ultrasonography, CT, and magnetic resonance) in each of the cases. PMID:24068274

  5. Improving the Odds: Intercostal Metal Coils Mark Area to Resect in Rib Lesions.

    PubMed

    Riggs, Kyle W; Zeltsman, David; Gu, Bo; Sung, Chris C; Lobko, Igor

    Precise localization of a rib lesion for its resection remains a challenge because of multiple factors including nonpalpable pathology, unfavorable body habitus, inaccurate clinical examination, and unreliable rib count on physical examination, unfavorable lesion location within a rib (its posterior aspect), and resection of sclerotic lesions with grossly intact rib cortex. We describe a novel rib localization technique that eliminates potential mistakes and avoids resection of an inappropriate rib. Our method of rib localization includes placement of metallic coils by interventional radiologists under computed tomography guidance where two coils are deployed within the intercostal spaces, one superior and one inferior to the rib lesion. Intraoperative use of fluoroscopy results in precise localization of rib lesions even in cases where the pathology is not grossly apparent. We implemented this approach in 2014 and have since performed it in five patients for both lytic and sclerotic lesions. Placement of markers superficial to the intercostal spaces resulted in their displacement in one case. Successfully, we removed the correct ribs in each patient without technical difficulties or complications. Our series demonstrates a novel strategy for a highly accurate and relatively easy way to identify the exact portion of the rib for surgical resection. Intercostal space positioning of the coil markers superior and inferior to the lesion prevents their dislodgement during patient transport and positioning on the operating room table, which improves rib identification accuracy and reliability. When combined with intraoperative fluoroscopy, it will greatly eliminate resection of incorrect ribs.

  6. [Anatomic study on intercostal nerve transfer to suprascapular nerve].

    PubMed

    Chu, Bin; Hu, Shaonan; Chen, Liang; Song, Jie

    2012-09-01

    To investigate the feasibility of the 3rd-6th intercostal nerve transfer to the suprascapular nerve for reconstruction of shoulder abduction. Fifteen thoracic walls (30 sides) were collected from cadavers. The 3rd-6th intercostal nerve length which can be dissected between the midaxillary line and midclavicular the transfer distance between the midaxillary line and midpoint of the clavicular bone (prepared point for neurotization) measured. In 30 sides of specimens, the 3rd and 4th intercostal nerves could be obtained between the midaxillary and midclavicular line, the available length of which was significantly greater than the transfer distance (P < 0.01). Six 5th intercostal nerve and 16 sides of 6th intercostal nerve were covered by the costal cartilage before reaching the midclavicular line. The available length of the 5th intercostal nerve was similar to the transfer distance (P > 0.01), while the available the 6th intercostal nerve was significantly less than transfer distance (P < 0.01). The suprascapular nerve could be dissociated turned to the clavicular bone of more than 2 cm. The whole length of the available 5th intercostal nerve length and length (2 cm) of suprascapular nerve was significantly greater than the transfer distance (P < 0.01), but for the 6th nerve, the whole length was still less than transfer distance (P < 0.01). It could be an alternative method the 3rd, 4th, and 5th intercostal nerve transfer to the suprascapular nerve for reconstruction of shoulder abduction. And 6th intercostal nerve, longer dissociated length may be required for direct coaptation or using a graft for nerve repair.

  7. [Clinical evaluation of in-plane ultrasound-guided thoracic paravertebral block using laterally intercostal approach].

    PubMed

    Xu, T; Li, M; Tian, Y; Song, J T; Ni, C; Guo, X Y

    2017-02-18

    To evaluate the feasibility and success rate of in-plane ultrasound-guided paravertebral block using laterally intercostal approach. In the study, 27 patients undergoing elective thoracic surgery were selected to do paravertebral block preoperatively. The fifth intercostal space was scanned by ultrasound probe which was placed along the long axis of the rib and 8 cm lateral to the midline of the spine. The needle was advanced in increments aiming at the space between the internal and innermost intercostal muscles. Once the space between the muscles was achieved, 20 mL of 0.5% (mass fraction) ropivacaine was injected and a catheter was inserted. Whether the tip of catheter was in right place was evaluated by ultrasound image. The block dermatomes of cold sensation were recorded 10, 20 and 30 min after the bolus drug was given. Then 0.2% ropivacaine was infused with 6 mL/h via the catheter by an analgesia pump postoperatively. The block dermatomes of cold sensation and pain score were recorded 1, 6, 24 and 48 h postoperatively. The first attempt success rate of catheteration was 81.48% (22/27); the tips of catheter were proved in right places after the second or third attempt in 5 patients. The median numbers of the block dermatomes 10, 20 and 30 min after the bolus drug was given were 2, 3, 4; the median numbers of block dermatomes were 5, 5, 5, 4, and of pain score were 1, 1, 2, 2 at 1, 6, 24, 48 h postoperatively; no case of bilateral block, pneumothorax or vessel puncture occurred. Thoracic paravertebral block using laterally intercostal approach is feasible, which has high success rate of block and low rate of complications.

  8. Environmental Education in High School 9th-12th Biology Course Curricula Started to Be Implemented in 2007

    ERIC Educational Resources Information Center

    Erdogan, Mehmet; Bahar, Mehmet; Usak, Muhammet

    2012-01-01

    The aim of this study is to analyze 9th-12th grade Biology Course Curricula started to be implemented in 2007 with regard to concepts and attainments addressing to environmental education. In this regard, 9th-12th grade Biology Course Curricula were analyzed using content-analysis technique, one of the qualitative research methods. 9th-12th grade…

  9. Hepatocellular Carcinomas Smaller Than 4 cm Supplied by the Intercostal Artery: Can We Predict Which Intercostal Artery Supplies the Tumor?

    PubMed Central

    Hur, Saebeom; Chung, Jin Wook; Kim, Min-Uk; Kim, Ji Dae; Kim, Gyoung Min; Lee, In Joon; Kim, Young Il; Jae, Hwan Jun; Park, Jae Hyung

    2011-01-01

    Objective To predict which intercostal artery supplies a tumor by examining the spatial relationship between hepatocellular carcinoma (HCC) and the intercostal artery feeding the tumor on transverse computed tomography (CT) images. Materials and Methods Between January 2000 and September 2009, 46 intercostal arteries supplying HCCs smaller than 4 cm were noted in 44 patients, and CT scans and angiograms of these patients were retrospectively reviewed. The intercostal artery feeding the tumor was marked on the CT scan showing the center of the tumor. In addition, its spatial relationship with the tumor center was examined. The angle of the tumor location was measured on the transverse CT scan in the clockwise direction from the sagittal line on the virtual circle centered in the right hemithorax. Correlations between the angle of the tumor location and the level of the tumor-feeding intercostal artery were assessed with the Spearman rank coefficient. Results Of 46 intercostal arteries feeding HCC, 39 (85%) were the first ones observed from the tumor center in a counterclockwise direction on the transverse CT image containing the tumor center. The level of the tumor-feeding intercostal artery was significantly correlated with the angle of the tumor, as the posteriorly located tumor tends to be supplied by lower intercostal arteries, while the laterally located tumor by upper intercostal arteries (Spearman coefficient = -0.537; p < 0.001). Conclusion We can predict the tumor feeder with an accuracy of 85% as the first intercostal artery encountered from the tumor center in a counterclockwise direction on a transverse CT image. PMID:22043151

  10. Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn.

    PubMed

    Bruschettini, Matteo; Romantsik, Olga; Ramenghi, Luca Antonio; Zappettini, Simona; O'Donnell, Colm P F; Calevo, Maria Grazia

    2016-01-11

    Pneumothorax occurs more frequently in the neonatal period than at any other time of life and is associated with increased mortality and morbidity. It may be treated with either needle aspiration or insertion of a chest tube. The former consists of aspiration of air with a syringe through a needle or an angiocatheter, usually through the second or third intercostal space in the midclavicular line. The chest tube is usually placed in the anterior pleural space passing through the sixth intercostal space into the pleural opening, turned anteriorly and directed to the location of the pneumothorax, and then connected to a Heimlich valve or an underwater seal with continuous suction. To compare the efficacy and safety of needle aspiration and intercostal tube drainage in the management of neonatal pneumothorax. We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 11), MEDLINE via PubMed (1966 to 30 November 2015), EMBASE (1980 to 30 November 2015), and CINAHL (1982 to 30 November 2015). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. Randomised controlled trials, quasi-randomised controlled trials and cluster trials comparing needle aspiration (either with the needle or angiocatheter left in situ or removed immediately after aspiration) to intercostal tube drainage in newborn infants with pneumothorax. For each of the included trial, two authors independently extracted data (e.g. number of participants, birth weight, gestational age, kind of needle and chest tube, choice of intercostal space, pressure and device for drainage) and assessed the risk of bias (e.g. adequacy of randomisation, blinding, completeness of follow-up). The primary outcomes considered in this review are mortality during the neonatal period and during hospitalisation. One

  11. Rare case of a strangulated intercostal flank hernia following open nephrectomy: A case report and review of literature

    PubMed Central

    Akinduro, Oluwaseun O.; Jones, Frank; Turner, Jacquelyn; Cason, Frederick; Clark, Clarence

    2015-01-01

    Introduction Flank incisions may be associated with incisional flank hernias, which may progress to incarceration and strangulation. Compromised integrity of the abdominal and intercostal musculature due to previous surgery may be associated with herniation of abdominal contents into the intercostal space. There have been six previously reported cases of herniation into the intercostal space after a flank incision for a surgical procedure. This case highlights the clinical picture associated with an emergent strangulated hernia and highlights the critical steps in its management. Presentation of case We present a case of a 79-year-old adult man with multiple comorbidities presenting with a strangulated flank hernia secondary to an intercostal incision for a right-sided open nephrectomy. The strangulated hernia required emergent intervention including right-sided hemi-colectomy with ileostomy and mucous fistula. Discussion Abdominal incisional hernias are rare and therefore easily overlooked, but may result in significant morbidity or even death in the patient.. The diagnosis can be made with a thorough clinical examination and ultrasound or computed topographical investigation. Once a hernia has become incarcerated, emergent surgical management is necessary to avoid strangulation and small bowel obstruction. Conclusion Urgent diagnosis and treatment of this extremely rare hernia is paramount especially in the setting of strangulation. PMID:26629848

  12. Rare case of a strangulated intercostal flank hernia following open nephrectomy: A case report and review of literature.

    PubMed

    Akinduro, Oluwaseun O; Jones, Frank; Turner, Jacquelyn; Cason, Frederick; Clark, Clarence

    2015-01-01

    Flank incisions may be associated with incisional flank hernias, which may progress to incarceration and strangulation. Compromised integrity of the abdominal and intercostal musculature due to previous surgery may be associated with herniation of abdominal contents into the intercostal space. There have been six previously reported cases of herniation into the intercostal space after a flank incision for a surgical procedure. This case highlights the clinical picture associated with an emergent strangulated hernia and highlights the critical steps in its management. We present a case of a 79-year-old adult man with multiple comorbidities presenting with a strangulated flank hernia secondary to an intercostal incision for a right-sided open nephrectomy. The strangulated hernia required emergent intervention including right-sided hemi-colectomy with ileostomy and mucous fistula. Abdominal incisional hernias are rare and therefore easily overlooked, but may result in significant morbidity or even death in the patient.. The diagnosis can be made with a thorough clinical examination and ultrasound or computed topographical investigation. Once a hernia has become incarcerated, emergent surgical management is necessary to avoid strangulation and small bowel obstruction. Urgent diagnosis and treatment of this extremely rare hernia is paramount especially in the setting of strangulation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Strangulation of chronic transdiaphragmatic intercostal hernia.

    PubMed

    Kao, Peiyu; Fang, Hsin-Yuan; Lu, Ting-Yu; Hsu, Shih-Chao; Chen, Chien-Kuang; Chen, Pin-Ru

    2014-06-01

    Transdiaphragmatic intercostal hernia (TIH) caused by violent coughing is a rare clinical diagnosis. Most patients diagnosed with TIH have a chronic condition consisting of a hernia that can be reduced completely by surgical intervention. Our patient presented with acute abdomen resulting from mechanical bowel obstruction secondary to an incarcerated hernia. Acute TIH presents a diagnostic challenge because of its rarity and lack of specific signs or symptoms in the differential diagnosis of acute abdomen. We recommend performing diagnostic computed tomography (CT) early if there is suspicion of TIH. Surgical intervention is always needed. Surgical intervention was complicated in this case, necessitating both transthoracic and abdominal exposure to resect the ischemic bowel segment. Nonetheless, the patient recovered uneventfully.

  14. THE HISTOGENESIS OF RAT INTERCOSTAL MUSCLE

    PubMed Central

    Kelly, A. M.; Zacks, S. I.

    1969-01-01

    Intercostal muscle from fetal and newborn rats was examined with the electron microscope. At 16 days' gestation, the developing muscle was composed of primary generations of myotubes, many of which were clustered together in groups. Within these groups, the membranes of neighboring myotubes were interconnected by specialized junctions, including tight junctions. Morphologically undifferentiated cells surrounded the muscle groups, frequently extended pseudopodia along the interspace between adjacent myotubes, and appeared to separate neighboring myotubes from one another. At 18 and 20 days' gestation, the muscle was also composed of groups of cells but the structure of the groups differed from that of the groups observed at 16 days. Single, well differentiated myotubes containing much central glycogen and peripheral myofibrils dominated each group. These large cells were interpreted as primary myotubes. Small, less differentiated muscle cells and undifferentiated cells clustered around their walls. Each cluster was ensheated by a basal lamina. The small cells were interpreted as primordia of new generations of muscle cells which differentiated by appositional growth along the walls of the large primary myotubes. All generations of rat intercostal muscle cells matured to myofibers between 20 days' gestation and birth. Coincidentally, large and small myofibers diverged from each other, leading to disintegration of the groups of muscle cells. Undifferentiated cells frequently occurred in the interspaces between neighboring muscle cells at the time of separation. Myofibers arising at different stages of muscle histogenesis intermingled in a checkerboard fashion as a result of this asynchronous mode of development. The possibility of fusion between neighboring muscle cells in this developing system is discussed. PMID:5786979

  15. Spatial distribution of inspiratory drive to the parasternal intercostal muscles in humans

    PubMed Central

    Gandevia, Simon C; Hudson, Anna L; Gorman, Robert B; Butler, Jane E; De Troyer, André

    2006-01-01

    The human parasternal intercostal muscles are obligatory inspiratory muscles with a diminishing mechanical advantage from cranial to caudal interspaces. This study determined whether inspiratory neural drive to these muscles is graded, and whether this distribution matches regional differences in inspiratory mechanical advantage. To determine the neural drive, intramuscular EMG was recorded from the first to the fifth parasternal intercostals during resting breathing in six subjects. All interspaces showed phasic inspiratory activity but the onset of activity relative to inspiratory flow in the fourth and fifth spaces was delayed compared with that in cranial interspaces. Activity in the first, second and third interspaces commenced, on average, within the first 10% of inspiratory time, and sometimes preceded inspiratory airflow. In contrast, activity in the fourth and fifth interspaces began after an average 33% of inspiratory time. The peak inspiratory discharge frequency of motor units in the first interspace averaged 13.4 ± 1.0 Hz (mean ± s.e.m.) and was significantly greater than in all other interspaces, in particular in the fifth space (8.0 ± 1.0 Hz). Phasic inspiratory activity was sometimes superimposed on tonic activity. In the first interspace, only 3% of units had tonic firing, but this proportion increased to 34% in the fifth space. In five subjects, recordings were also made from the medial and lateral extent of the second parasternal intercostal. Both portions showed phasic inspiratory activity which began within the first 6% of inspiratory time. Motor units from the lateral and medial portions fired at the same peak discharge rate (10.4 ± 0.7 versus 10.7 ± 0.6 Hz). These observations indicate that the distribution of neural drive to the parasternal intercostals in humans has a rostrocaudal gradient, but that the drive is uniform along the mediolateral extent of the second interspace. The distribution of inspiratory neural drive to the

  16. Incidental Finding of Intercostal Artery Aneurysm During Coarctation Surgery.

    PubMed

    Sabzi, Feridoun; Ghasemi, Fahime

    2017-06-01

    Intercostal artery aneurysms (ICAA) are very rare vascular complication of coarctation. The most cases are asymptomatic and could be found incidentally during thoracotomy for others vascular pathology or may present with fatal problems such as rupture that is leading to bleeding and hypovolemic shock. Intercostal artery aneurysm most commonly accompanies with neurofibromatosis, aortic coarctation, or in chest trauma. We report a 10-year-old girl who complained of lower extremities pain and hypertension for a few months. His final diagnosis was coarctation of the aorta. She was scheduled for thoracotomy and coarctation repair by resection and end to end anastomosis. During thoracotomy at lateral side of coarctation, an ICAA distal to coarctation site was seen that by a collateral artery connects to its upper intercostals artery. The patient was treated by ligation and resection of the affected intercostal artery and subsequent coarctation repair. The postoperative course was uneventful and, she was discharged on 7th postoperative day.

  17. Asian Studies: Experimental Course of Study, 11th or 12th Year Elective.

    ERIC Educational Resources Information Center

    Fryberg, Carl

    This experimental course of study has a twofold purpose. Primarily, it is intended to serve as basis for an elective for the 11th or 12th year student. Openended in organization, it encourages teachers and students to add new dimensions. It provides a comprehensive bibliography and detailed information with which to develop an elective in the area…

  18. Why 12th Grade Must Be Redesigned Now--and How

    ERIC Educational Resources Information Center

    Vargas, Joel

    2015-01-01

    This first report in a new series by Jobs For the Future (JFF) provides the rationale for restructuring 12th grade and tying it more tightly to the first year of college through new high school and college partnerships. The paper proposes a new common benchmark of readiness that high schools and colleges can work together to meet to ensure…

  19. Crime and the Law: A 12th Grade Social Studies Course.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Education, Madison.

    The document outlines a semester-long 12th grade study of criminal law which is accomplished through an examination of Wisconsin and constitutional law. Six sections comprise the teaching outline. Section I, The Legislative Process, considers the legislature, various statutes and terminologies, revision of legislation, and penalties. Section II,…

  20. Within-District Effects of Catholic Schooling on 12th-Grade Math Achievement

    ERIC Educational Resources Information Center

    Chen, Vivien W.; Pong, Suet-Ling

    2014-01-01

    Using a propensity score matching method, and regression modeling based on the 2002 Education Longitudinal Study, this study found a significant Catholic school, mathematics achievement effect among those 12th graders who were least likely to attend Catholic school. This result is evident within districts after we used the School District…

  1. Crime and the Law: A 12th Grade Social Studies Course.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Education, Madison.

    The document outlines a semester-long 12th grade study of criminal law which is accomplished through an examination of Wisconsin and constitutional law. Six sections comprise the teaching outline. Section I, The Legislative Process, considers the legislature, various statutes and terminologies, revision of legislation, and penalties. Section II,…

  2. Relationships between Grade Levels, Personal Factors, and Instructional Variation among 4th-12th Grade Teachers

    ERIC Educational Resources Information Center

    White, Jacquelyn M.

    2011-01-01

    The purpose of this quantitative correlational study was to investigate relationships between grade levels, personal factors of teachers, and instructional variety used by 4th-12th grade teachers in Kern County, California. The population under investigation included 2,844 teachers. 235 elementary, middle school/junior high, and secondary teachers…

  3. Seagrass science is growing: A report on the 12th International Seagrass Biology Workshop.

    PubMed

    Hind-Ozan, Edward J; Jones, Benjamin L

    2017-08-11

    This conference report describes the programme of the 12th International Seagrass Biology Workshop, its highlights, areas of growth for the workshop, and potential future directions for the workshop series. The report is written with an eye toward where it fits within the field of seagrass research. Copyright © 2017. Published by Elsevier Ltd.

  4. Within-District Effects of Catholic Schooling on 12th-Grade Math Achievement

    ERIC Educational Resources Information Center

    Chen, Vivien W.; Pong, Suet-Ling

    2014-01-01

    Using a propensity score matching method, and regression modeling based on the 2002 Education Longitudinal Study, this study found a significant Catholic school, mathematics achievement effect among those 12th graders who were least likely to attend Catholic school. This result is evident within districts after we used the School District…

  5. Engaging the Learner. Annual Instructional Technology Conference (12th, Murfreesboro, Tennessee, April 1-3, 2007)

    ERIC Educational Resources Information Center

    Smith, Carter F.; Schneider, Gary F.; Kontos, George; Kuzat, Hanan; Janossy, James; Thurmond, Karen; Moore, Beth; Whitledge, Lynn; Speer, Priscilla; Harber, Annette; Bailey, Kathrine; Penney, Samantha

    2007-01-01

    The following is a collection of papers presented at the 12th annual Instructional Technology Conference at Middle Tennessee State University in Murfreesboro, Tennessee. This conference is an opportunity for higher-education professionals from across the country to discuss opportunities and challenges presented by instructional technology. The…

  6. A Positive Move: 12th Annual College M&O Cost Study

    ERIC Educational Resources Information Center

    Agron, Joe

    2006-01-01

    Colleges placed more of an emphasis on maintenance and operations (M&O) this school year by increasing the amount spent on M&O as a percentage of total budget. According to "American School & University's" 12th annual College Maintenance and Operations Cost Study, spending on M&O as a percentage of total college budget increased to 11 percent from…

  7. Serratus anterior intercostal nerve graft: a new vascularized nerve graft.

    PubMed

    Gailliot, R V; Core, G B

    1995-07-01

    We present our investigative and clinical experience with a new vascularized nerve graft: the serratus anterior intercostal nerve graft. The serratus branch of the thoracodorsal arterial system was injected with silicone rubber injection compound in seven fresh cadavers (N = 11 injected specimens) after the composite serratus-intercostal structures were harvested. Microdissection of selected vascular territories was then performed. Our findings reconfirmed the previously described vascular connections between the thoracodorsal system and the intercostal vessels via periosteal vessels. We also newly discovered vascular anastomoses between the serratus anterior muscle and the intercostal artery running within a mesentery. This mesentery is lateral to and distinct from the serratus-periosteal-intercostal network. The nerve graft was applied clinically in the reconstruction of a complex soft-tissue, 13-cm ulnar nerve defect of the volar forearm after an electrical injury. The clinical application was successful with limb salvage and return of protective sensation at 4 months. Our clinical and investigative results support the feasibility of the serratus anterior intercostal nerve graft, a unique and versatile new vascularized nerve graft.

  8. "Loops and Legs in Quantum Field Theory", 12th DESY Workshop on Elementary Particle Physics

    NASA Astrophysics Data System (ADS)

    The bi-annual international conference "Loops and Legs in Quantum Field Theory" has been held at Weimar, Germany, from April 27 to May 02, 2014. It has been the 12th conference of this series, started in 1992. The main focus of the conference are precision calculations of multi- loop and multi-leg processes in elementary particle physics for processes at present and future high-energy facilities within and beyond the Standard Model. At present many physics questions studied deal with processes at the LHC and future facilities like the ILC. A growing number of contributions deals with important developments in the field of computational technologies and algorithmic methods, including large-scale computer algebra, efficient methods to compute large numbers of Feynman diagrams, analytic summation and integration methods of various kinds, new related function spaces, precise numerical methods and Monte Carlo simulations. The present conference has been attended by more than 110 participants from all over the world, presenting more than 75 contributions, most of which have been written up for these pro- ceedings. The present volume demonstrates in an impressive way the enormous development of the field during the last few years, reaching the level of 5-loop calculations in QCD and a like- wise impressive development in massive next-to-leading order and next-to-next-to-leading order processes. Computer algebraic and numerical calculations require terabyte storage and many CPU years, even after intense parallelization, to obtain state-of-the-art theoretical predictions. The city of Weimar gave a suitable frame to the conference, with its rich history, especially in literature, music, arts, and architecture. Goethe, Schiller, Wieland, Herder, Bach and Liszt lived there and created many of their masterpieces. The many young participants signal that our field is prosperous and faces an exciting future. The conference hotel "Kaiserin Augusta" offered a warm hospitality and

  9. Rib motion modulates inspiratory intercostal activity in dogs.

    PubMed Central

    De Troyer, A

    1996-01-01

    1. A test was performed of the hypothesis that the motion of the ribs during inspiration modulates, via changes in spindle afferent activity, the activation of the inspiratory intercostal muscles. The electrical activity of the parasternal intercostal, external intercostal, and levator costae muscles in anaesthetized spontaneously breathing dogs was thus recorded during manipulation of the inspiratory displacement of the ribs over a wide range of rib motion. 2. In agreement with the hypothesis, the external intercostal and levator costae muscles lengthened and showed increased inspiratory activities when the normal inspiratory cranial motion of the lower rib was reduced or reversed into an inspiratory caudal motion. Conversely, the inspiratory activities decreased when the inspiratory cranial motion of the rib and the inspiratory shortening of the muscles was augmented. The inspiratory activity of the parasternal intercostal remained unchanged throughout. 3. However, when the two ribs making up the interspace were linked together so that the external intercostal muscle was constant in length, the relationship of muscle activity to rib motion was maintained. 4. In addition, when the upper rather than the lower rib of the interspace was manipulated, the relationship between the change in muscle length and inspiratory activity was reversed, so that activity decreased when the muscle was lengthened and increased when the muscle was shortened. The relationship of muscle activity to lower rib motion, however, was still maintained. 5. These observations thus indicate that rib motion triggers proprioceptive reflexes which, regardless of the changes in length of the individual muscles, make the external intercostal inspiratory activity exquisitely sensitive to the direction of rib displacement. PMID:8730601

  10. Intercostal neuroma pain after laparoscopic cholecystectomy: diagnosis and treatment.

    PubMed

    Dellon, A Lee

    2014-03-01

    Chest wall or abdominal pain after laparoscopic cholecystectomy is perceived as residual gastrointestinal problems. Some patients will have tenderness at the laparoscopic portal site(s), representing injury to one or more intercostal nerves. The author describes this patient population for the first time, outlining a diagnostic and therapeutic algorithm. Inclusion criteria included (1) right chest wall or abdominal pain persisting more than 1 year after laparoscopic cholecystectomy, (2) relief of that pain with intercostal nerve block, (3) resection of intercostal nerves identified by nerve block, and (4) at least a 6-month postoperative follow-up by telephone. Review from 2009 through 2011 identified one man and seven women meeting these criteria. Mean age was 44 years (range, 18 to 74 years). Mean interval between cholecystectomy and intercostal neurectomy was 44.3 months (range, 13 to 72 months). Two intercostal nerves were resected in two patients, three in four patients, four in one patient, and five in one patient, most commonly intercostal nerves T6, T7, and T8. Proximal nerves were implanted into the serratus or latissimus dorsi. At a mean period of 18.3 months after surgery, the preoperative mean visual analogue score of 8.9 (range, 7 to 10) decreased to 3.6 (range, 0 to 6) (p < 0.01). Overall results were excellent in five (63 percent) and good in two (25 percent), with one failure (12 percent). Pain following laparoscopic cholecystectomy may represent intercostal nerve injury. Diagnostic blocks are essential to confirm diagnosis. Nerve resection and implantation of the proximal ends into muscle can give good to excellent results in most patients. Therapeutic, IV.

  11. Intercostal and forearm muscle deoxygenation during respiratory fatigue in patients with heart failure: potential role of a respiratory muscle metaboreflex.

    PubMed

    Moreno, A M; Castro, R R T; Silva, B M; Villacorta, H; Sant'Anna Junior, M; Nóbrega, A C L

    2014-11-01

    The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66 ± 12 years; left ventricle ejection fraction, 34 ± 3%) and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenation were continuously monitored by near-infrared spectroscopy with transducers placed on the seventh left intercostal space and the left forearm. Data were compared by two-way ANOVA and Bonferroni correction. Respiratory fatigue occurred at 5.1 ± 1.3 min in heart failure patients and at 9.3 ± 1.4 min in controls (P<0.05), but perceived effort, changes in heart rate, and in systolic blood pressure were similar between groups (P>0.05). Respiratory fatigue in heart failure reduced intercostal and forearm muscle blood volume (P<0.05) along with decreased tissue oxygenation both in intercostal (heart failure, -2.6 ± 1.6%; controls, +1.6 ± 0.5%; P<0.05) and in forearm muscles (heart failure, -4.5 ± 0.5%; controls, +0.5 ± 0.8%; P<0.05). These results suggest that respiratory fatigue in patients with heart failure causes an oxygen demand/delivery mismatch in respiratory muscles, probably leading to a reflex reduction in peripheral limb muscle perfusion, featuring a respiratory metaboreflex.

  12. Target Allocation Methodology for China's Provinces: Energy Intensity in the 12th FIve-Year Plan

    SciTech Connect

    Ohshita, Stephanie; Price, Lynn

    2011-03-21

    Experience with China's 20% energy intensity improvement target during the 11th Five-Year Plan (FYP) (2006-2010) has shown the challenges of rapidly setting targets and implementing measures to meet them. For the 12th FYP (2011-2015), there is an urgent need for a more scientific methodology to allocate targets among the provinces and to track physical and economic indicators of energy and carbon saving progress. This report provides a sectoral methodology for allocating a national energy intensity target - expressed as percent change in energy per unit gross domestic product (GDP) - among China's provinces in the 12th FYP. Drawing on international experience - especially the European Union (EU) Triptych approach for allocating Kyoto carbon targets among EU member states - the methodology here makes important modifications to the EU approach to address an energy intensity rather than a CO{sub 2} emissions target, and for the wider variation in provincial energy and economic structure in China. The methodology combines top-down national target projections and bottom-up provincial and sectoral projections of energy and GDP to determine target allocation of energy intensity targets. Total primary energy consumption is separated into three end-use sectors - industrial, residential, and other energy. Sectoral indicators are used to differentiate the potential for energy saving among the provinces. This sectoral methodology is utilized to allocate provincial-level targets for a national target of 20% energy intensity improvement during the 12th FYP; the official target is determined by the National Development and Reform Commission. Energy and GDP projections used in the allocations were compared with other models, and several allocation scenarios were run to test sensitivity. The resulting allocations for the 12th FYP offer insight on past performance and offer somewhat different distributions of provincial targets compared to the 11th FYP. Recommendations for reporting

  13. Reflex inhibition of canine inspiratory intercostals by diaphragmatic tension receptors

    PubMed Central

    De Troyer, André; Brunko, Eric; Leduc, Dimitri; Jammes, Yves

    1999-01-01

    Electrical stimulation of phrenic afferent fibres in the dog elicits a reflex inhibition of efferent activity to the inspiratory intercostal muscles. However, electrical stimulation has a poor selectivity, so the sensory receptors responsible for this inhibition were not identified.In the present studies, cranial forces were applied during spontaneous inspiration to the abdominal surface of the central, tendinous portion of the canine diaphragm to activate tension mechanoreceptors in the muscle. Vagal afferent inputs were eliminated by vagotomy.The application of force to the central tendon caused a graded, reflex reduction in inspiratory intercostal activity, especially in external intercostal activity. This reduction was commonly associated with a decrease in inspiratory duration and was invariably attenuated after section of the cervical dorsal roots.In contrast, no change in inspiratory intercostal activity was seen when high frequency mechanical vibration was applied to the central tendon to stimulate diaphragmatic muscle spindles.These observations provide strong evidence that tension receptors in the diaphragm, but not muscle spindles, induce reflex inhibition of inspiratory intercostal activity. The expression of this reflex probably involves supraspinal structures. PMID:9831731

  14. Clinicoradiological diagnosis of cough-induced intercostal hernia.

    PubMed

    Dobradin, Andrew; Bello, Jessica

    2013-07-01

    Cough-induced intercostal hernias without any type of external trauma are very uncommon. There have been less than 10 cases documented in literature. This clinical report describes a 66-year-old male who developed an intercostal hernia induced by a severe cough due to bilateral pneumonia and a subsequent rib fracture. It took almost a full year to diagnose this patient's chest wall mass. Only after taking careful history and reviewing all the images, the diagnosis of intercostal hernia was made. He was referred to a cardiothoracic surgeon for treatment. Intercostal hernias can be caused by the sheer exertion of coughing without any prior history of trauma to the chest wall or abdomen. Early diagnosis is difficult and had to be based on clinical signs and symptoms. The imaging studies might help to establish diagnosis, but cannot replace a diligent examination and clinical interview. The treatment of the chest wall defect is case dependent. Surgical repair reinforcement of the intercostal muscles might be required with prosthetic nonabsorbable (polypropylene) mesh.

  15. Tandem intercostal thoracic schwannomas resected using a thoracoscopic nerve-sparing technique: case report.

    PubMed

    Gantwerker, Brian R; Dickman, Curtis A

    2011-07-01

    To describe a novel nerve-sparing technique for the resection of intercostal nerve schwannomas. This case demonstrates that intercostal neuralgia can be caused by intercostal schwannomas and that it can be relieved by their removal. A young woman with schwannomatosis had progressively worsening intercostal neuralgia caused by compression of the intercostal nerve against the rib by tandem intercostal schwannomas. After the tumors were removed, her symptoms were completely relieved. A thoracoscopic technique was used to define the involved fascicles and to facilitate removal of the tumors while sparing the uninvolved nerve. The patient's radicular pain was relieved completely by the tumor resection. Thoracoscopic surgery offers a safe and minimally invasive technique for removal of intercostal schwannomas and is a valid alternative to open thoracotomy. Removal of thoracic schwannomas can relieve intercostal neuralgia.

  16. The Impact of Gerontology Inclusion on 12th Grade Student Perceptions of Aging, Older Adults and Working with Elders

    ERIC Educational Resources Information Center

    Krout, John A.; McKernan, Peggy

    2007-01-01

    The present study examines the impact of including lessons on aging in a 12th grade social studies course on student perceptions of aging and older adults, working with older persons, and knowledge of "facts" on aging. Pre/post-test data were collected from approximately 650 upstate New York 12th grade students enrolled in a government…

  17. Intercostal muscle compensation for parasternal paralysis in the dog: central and proprioceptive mechanisms.

    PubMed Central

    De Troyer, A; Yuehua, C

    1994-01-01

    1. Denervation of the parasternal intercostal muscles in the dog is known to cause a substantial reduction in the inspiratory cranial displacement of the ribs and a compensatory increase in the activation of the other inspiratory intercostal muscles, namely the external intercostals and the levator costae. The present studies were designed to assess the mechanism(s) of that compensation. 2. Denervating the parasternal intercostals bilaterally caused a reduction in tidal volume and an increase in arterial PCO2 (Pa, CO2). Severing the parasternal intercostals selectively produced similar changes. The concomitant increases in external intercostal and levator costae activity, however, were much greater than predicted on the basis of the increased Pa, CO2. 3. Denervating the parasternal intercostals on one side of the chest produced large increases in ipsilateral, but not contralateral external intercostal activity. 4. Manipulating the ribs after the parasternal intercostals were inactivated so as to reproduce the normal inspiratory cranial displacement of the ribs elicited immediate, clear-cut reductions in external intercostal and levator costae activities. 5. The increases in external intercostal and levator costae activities that occur after inactivation of the parasternal intercostals thus result partly from the increased hypercapnic drive but mostly from proprioceptive reflexes, presumably muscle spindle reflexes. PMID:7990031

  18. Symptomatic intercostal lung hernia secondary to sternal dehiscence surgery.

    PubMed

    Celik, Sezai; Aydemir, Cüneyt; Gürer, Onur; Işık, Omer

    2013-01-01

    Patient: Male, 60Final Diagnosis: Iatrogenic intercostal lung herniaSymptoms: -Medication: No medicationClinical Procedure: Surgically cerrectedSpecialty: Thoracic surgery. Unusual clinical course. Iatrogenic intercostal lung hernia is a rare thoracic pathology. Injury of intercostal muscles and costocondral separation during median sternotomy and sternal dehiscence surgery are important factors in the development of hernia. We report for the first time a case of a 60-year-old man with acquired lung hernia after sternal dehiscence surgery, presenting as chest pain and exertional dyspnea. A 60-year-old man presented with a 6-week history of progressive exertional dyspnea, particularly following vigorous coughing. Past medical history included slight chronic obstructive pulmonary disease and coronary artery bypass grafting surgery 8 weeks previously, using the left internal mammary artery for the left anterior descending artery via median sternotomy and sternal dehiscence by the Robicsek method. A chest X-ray showed intact sternal and parasternal wires, but the bilateral lung parenchyma appeared normal. A spiral computed tomography scan of the chest found intercostal herniation of the anterior segment of the left upper lobe. The lung hernia was repaired surgically to relieve exertional dyspnea and incarceration, and to improve respiratory function. The postoperative course was uneventful and the patient recovered well. Intercostal lung hernia after median sternotomy and sternal dehiscence surgery is rare, and it has been previously reported on. Preventive techniques include gentle manipulation of the sternal retractor, avoidance of rib fractures, and using a protective method of intercostal arteries and nerves such as Sharma technique. Thoracic surgeons should be aware of this rare complication in sternal dehiscence surgery.

  19. [Interventional Radiological Treatment of Intercostal Artery Bleedings - a Retrospective Analysis].

    PubMed

    Kupczyk, Patrick; Meyer, Carsten; Thomas, Daniel; Schild, Hans Heinz; Pieper, Claus Christian

    2017-08-01

    Background Intercostal artery bleedings are potentially fatal injuries. Apart from conservative and surgical treatment options, emergency interventional radiological treatment can also be performed. We report our experience with emergency intercostal artery embolisation. Materials and Methods Patients with acute arterial bleedings from the intercostal artery who were treated interventionally over a period of 7 years were identified retrospectively. Technical and clinical success, clinical and procedural parameters as well as overall survival were analysed. Results Between 2010 and 2017, a total of 27 embolisation procedures was performed in 24 patients (14 male, mean age 65.7 ± 13.9 years). The majority of patients suffered from iatrogenic intercostal artery bleedings (n = 17; 70.1%; especially after thoracocentesis). In five cases, thoracoscopic surgery was attempted prior to intervention but was unsuccessful. Primary technical success was obtained in 25/27 interventions. In two cases, there was re-bleeding via collateral arteries so that re-intervention became necessary (secondary technical success). In 15 cases, secondary surgery after successful interventional treatment was necessary to evacuate the haematoma/haemothorax. Intercostal artery embolisation was clinically successful in 23/24 patients. One patient died despite technically successful embolisation, due to extensive haemothorax. One case of spinal ischaemia was observed as a major complication. Conclusion Intercostal artery embolisation is an effective interventional radiological emergency measure in patients with acute bleeding and is an alternative to surgical treatment even after attempted, unsuccessful surgery. Because of potentially severe complications, the interventional procedure should be performed by an experienced interventionalist. Georg Thieme Verlag KG Stuttgart · New York.

  20. [Thermoregulatory activity of the intercostal muscles under a hypercapnic load].

    PubMed

    Burachevskaia, L E

    1983-02-01

    In experiments on anesthetized cats, the reactions elicited by CO2 inhalation were studied in single motor units of the intercostal muscles activated during shivering. The excitation of the bulbar respiratory center during shivering was found to modify the activity of the respiratory and tonic motor units. Most of the respiratory motor units in a hypercapnic state increased the mean firing rate by 1.5/sec. The tonic motor units both diminished the mean firing rate and changed the pattern of activity: they began to produce bursts of spikes synchronous with the respiratory rhythm. The problems of supraspinal regulation of activity of the intercostal muscles motoneuron pool are discussed.

  1. Poland syndrome with extracorporeal intercostal liver herniation and thoracic myelomeningocele.

    PubMed

    Seifarth, Federico G; Cruz Pico, Christian X; Stromberg, Jeffrey; Recinos, Violette M; Burdjalov, Vladimir F; Karakas, S Pinar

    2012-01-01

    Poland syndrome is characterized by hypoplastic unilateral chest wall structures. These chest wall deformities may be associated with upper extremity anomalies. The association of Poland syndrome with either intercostal liver herniation or a spinocerebral deformity has been described, but there is no report of both findings encountered simultaneously. This is the first report of a newborn child with Poland syndrome associated with an intercostal liver segment herniation and thoracic myelomeningocele with features of an Arnold-Chiari II cerebral malformation. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Constancy and characteristics of the anterior cutaneous branch of the first intercostal nerve: correcting the descriptions in human anatomy texts.

    PubMed

    Miyawaki, Makoto

    2006-12-01

    Human anatomy texts state that the anterior cutaneous branch of the first intercostal nerve (Rca-Th1) does not exist or that, even if it does, it is poorly developed. However, an anterior cutaneous branch in the first intercostal space (Rca-1) was observed in 74.8% of cases examined (104/139 sides) and was not poorly developed at all. Some of the observed Rca-I were even larger than the anterior cutaneous branches in the second intercostal space (Rca-ll). The segment of origin of the Rca-I was analyzed in 37 sides and 66.2% (49/74 branches) were confirmed to be from Th1. As a result, in contrast with traditional beliefs, it was shown that Rca-Th1 exists. The Rca-I was classified into two types according to the course and distribution: (i) an anterior cutaneous branch that appeared at the anterior end of the first intercostal space (ICS), ran through the pectoralis major muscle and extended in the first ICS (Rca-1); and (ii) another branch that appeared at the same place but ran downward along the anterior surface of the second costal cartilage, deep to the pectoralis major muscle, to reach the inferior edge of the second costal cartilage or the second ICS, passed through the pectoralis major muscle and extended to the second rib or the second ICS (pseudo Rca-2). It was found that 77.8% (35/45 branches) of Rca-1 and 48.3% (14/29 branches) of pseudo Rca-2 were derived from Th1. Accordingly, the author suggests that the description in human anatomy texts should be revised to read, '... the Rca-Th1 exists quite constantly and some of appear at a position resembling Rca-Th2'.

  3. Comparison of anatomic landmarks and ultrasound guidance for intercostal nerve injections in cadavers.

    PubMed

    Bhatia, Anuj; Gofeld, Michael; Ganapathy, Sugantha; Hanlon, John; Johnson, Marjorie

    2013-01-01

    Intercostal nerve (ICN) injections are routinely performed under anatomic landmark or fluoroscopic guidance for acute and chronic pain indications. Ultrasound (US) is being used increasingly to perform ICN injections, but there is lack of evidence to support categorically the benefits of US over conventional techniques. We compared guidance with US versus anatomic landmarks for accuracy and safety of ICN injections in cadavers in a 2-phase study that included evaluation of deposition of injected dye by dissection and spread of contrast on fluoroscopy. A cadaver experiment was performed to validate US as an imaging modality for ICN blocks. In the first phase of the study, 12 ICN injections with 2 different volumes of dye were performed in 1 cadaver using anatomic landmarks on one side and US-guidance on the other (6 injections on each side). The cadaver was then dissected to evaluate spread of the dye. The second phase of the study consisted of 74 ICN injections (37 US-guided and 37 using anatomic landmarks) of contrast dye in 6 non-embalmed cadavers followed by fluoroscopy to evaluate spread of the contrast dye. In the first phase of the study, the intercostal space was identified with US at all levels. Injection of 2 mL of dye was sufficient to ensure compete staining of the ICN for 5 of 6 US-guided injections but anatomic landmark guidance resulted in correct injection at only 2 of 6 intercostal spaces. No intravascular injection was found on dissection with either of the guidance techniques. In the second phase of the study, US-guidance was associated with a higher rate of intercostal spread of 1 mL of contrast dye on fluoroscopy compared with anatomic landmarks guidance (97% vs 70%; P = 0.017). Ultrasound confers higher accuracy and allows use of lower volumes of injectate compared with anatomic landmarks as a guidance method for ICN injections in cadavers. Ultrasound may be a viable alternative to anatomic landmarks as a guidance method for ICN injections.

  4. PREFACE: 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM 2012)

    NASA Astrophysics Data System (ADS)

    Zhou, Zhangjian; Li, Jingfeng; Zhang, Lianmeng; Ge, Changchun

    2013-03-01

    The 12th International Symposium on Multiscale, Multifunctional and Functionally Graded Materials (FGM-2012) was held in Beijing, China, from 22-36 October 2012. This was part of a series of conferences organized every two years endorsed by International Advisory Committee for FGM's, which serves as a forum for scientists, educators, engineers and young students interested in the development of functionally graded materials (FGM). The series continues from the previous international symposium on FGM held in Sendai, Japan (1990), San Francisco, USA (1992), Lausanne, Switzerland (1994), Tsukuba, Japan (1996), Dresden, Germany (1998), Estes Park, USA (2000), Beijing, China (2002), Leuven, Belgium (2004), Hawaii, USA (2006), Sendai, Japan (2008) and Guimaraes, Portugal (2010). Functionally graded materials are non-uniform materials which are designed with embodied continuous spatial variations in composition and microstructure for the specific purpose of adjusting their thermal, structural, mechanical, biological or functional response to specific application conditions. Such multi-phase materials cover a range of space and time scales, and are best understood by means of a comprehensive multiscale, multiphysics approach. These kinds of materials are presently in the forefront of materials research, receiving worldwide attention. They have a broad range of applications including for example, biomedical, biomechanical, automotive, aerospace, mechanical, civil, nuclear, and naval engineering. New applications are continuously being discovered and developed. The objective of the FGM-2012 intends to provide opportunities for exchanging ideas and discussing state-of-the-art theories, techniques and applications in the fields of multiscale, multifunctional and FGM, through invited lectures, oral and poster presentations. FGM-2012 was organized and hosted by University of Science and Technology Beijing, China, together with Tsing-hua University and Wuhan University of

  5. PREFACE: EMAS 2011: 12th European Workshop on Modern Developments in Microbeam Analysis

    NASA Astrophysics Data System (ADS)

    Brisset, François; Dugne, Olivier; Robaut, Florence; Lábár, János L.; Walker, Clive T.

    2012-03-01

    This volume of IOP Conference Series: Materials Science and Engineering contains papers from the 12th Workshop of the European Microbeam Analysis Society (EMAS) on Modern Developments and Applications in Microbeam Analysis, which took place from the 15-19 May 2011 in the Angers Congress Centre, Angers, France. The primary aim of this series of workshops is to assess the state-of-the-art and reliability of microbeam analysis techniques. The workshops also provide a forum where students and young scientists starting out on a career in microbeam analysis can meet and discuss with the established experts. The workshops have a very specific format comprising invited plenary lectures by internationally recognized experts, poster presentations by the participants and round table discussions on the key topics led by specialists in the field. This workshop was organized in collaboration with GN-MEBA - Groupement National de Microscopie Electronique à Balayage et de microAnalysis, France. The technical programme included the following topics: the limits of EPMA, new techniques, developments and concepts in microanalysis, microanalysis in the SEM, and new and less common applications of micro- and nanoanalysis. As at previous workshops there was also a special oral session for young scientists. The best presentation by a young scientist was awarded with an invitation to attend the 2012 Microscopy and Microanalysis meeting at Phoenix, Arizona. The prize went to Pierre Burdet, of the Federal Institute of Technology of Lausanne (EPFL), for his talk entitled '3D EDS microanalysis by FIB-SEM: enhancement of elemental quantification'. The continuing relevance of the EMAS workshops and the high regard in which they are held internationally can be seen from the fact that 74 posters from 18 countries were on display at the meeting, and that the participants came from as far away as Japan, Canada and the USA. A selection of participants with posters were invited to give a short oral

  6. 12th European Conference on Accelerators in Applied Research and Technology

    NASA Astrophysics Data System (ADS)

    Sajavaara, Timo; Tarvainen, Olli; Javanainen, Arto; Räisänen, Jyrki

    2017-09-01

    The 12th European Conference on Accelerators in Applied Research and Technology was organized by Department of Physics on the 3rd -8th July 2016 in the Agora building of the University of Jyväskylä in Finland. This was the first time ECAART was held in Nordic countries. There were in total 141 participants from 31 countries and six industrial exhibitors. The largest foreign delegation was from Japan with 25 participants. The scientific programme included 13 invited lectures, 29 oral and 112 poster presentations. There were altogether 14 exhibitors and sponsors.

  7. Conference report: 12th Annual University of Wisconsin Land O'Lakes Bioanalytical Conference.

    PubMed

    DeMuth, James E; Briscoe, Chad; Amaravadi, Lakshmi; Arnold, Mark E; Clement, Robert P; Fluhler, Eric N; Ji, Qin C; Stubbs, R John

    2011-10-01

    This University of Wisconsin School of Pharmacy bioanalytical conference is presented each year by the Extension Services in Pharmacy, the professional development department within the school. The purpose of this 4-day conference is to provide an educational forum to discuss issues and applications associated with the analysis of xenobiotics, metabolites, biologics and biomarkers in biological matrices. The conference is designed to include and encourage an open exchange of scientific and methodological applications for bioanalysis. To increase the interactive nature of the conference, the program was a mixture of lectures, poster sessions, round table discussions and workshops. This article summarizes the presentations at the 12th Annual Conference.

  8. Within-District Effects of Catholic Schooling on 12th Grad Math Achievement

    PubMed Central

    Chen, Vivien W.; Pong, Suet-Ling

    2015-01-01

    Using a propensity score matching method and regression modeling based on the 2002 Education Longitudinal Study, this study found a significant Catholic school effect on mathematics achievement among those 12th graders who were least likely to attend Catholic school. This result is evident within-districts after we used the School District Demographics System map data to locate Catholic schools within school district boundaries. Furthermore, the Catholic school effects were statistically significant for students in districts that allowed publicly funded private education. PMID:25606028

  9. Extended locoregional use of intercostal artery perforator propeller flaps.

    PubMed

    Baghaki, Semih; Diyarbakirlioglu, Murat; Sahin, Ugur; Kucuksucu, Muge Anil; Turna, Akif; Baca, Bilgi; Aydın, Yağmur

    2017-05-01

    Besides conventional flaps, intercostal artery perforator flaps have been reported to cover trunk defects. In this report the use of anterior intercostal artery perforator (AICAP) flap, lateral intercostal artery perforator (LICAP) flap and dorsal intercostal artery perforator (DICAP) flap for thoracic, abdominal, cervical, lumbar and sacral defects with larger dimensions and extended indications beyond the reported literature were reevaluated. Thirty-nine patients underwent surgery between August 2012 and August 2014. The age of the patients ranged between 16 and 79 with a mean of 49 years. The distribution of defects were as follows; 12 thoracic, 8 parascapular, 3 cervical, 8 abdominal, 4 sacral and 4 lumbar. AICAP, LICAP and DICAP flaps were used for reconstruction. Fifty-two ICAP flaps were performed on 39 patients. Flap dimensions ranged between 6 × 9 cm and 14 × 35 cm. Twenty-six patients had single flap coverage and 13 patients had double flap coverage. Forty-six flaps have been transferred as propeller flaps and 6 flaps have been transferred as perforator plus flap. Forty flaps (75%) went through transient venous congestion. In one DICAP flap, 30% of flap was lost. No infection, hematoma or seroma were observed in any patient. Follow-up period ranged between 3 and 32 months with a mean of 9 months. The ICAP flaps provide reliable and versatile options in reconstructive surgery and can be used for challenging defects in trunk. © 2016 Wiley Periodicals, Inc.

  10. The Anterior Intercostal Artery Flap: Anatomical and Radiologic Study.

    PubMed

    Carrasco-López, Cristian; Julian Ibañez, Juan Francisco; Vilà, Jordi; Rodriguez-Baeza, Alfonso; Carrera-Burgaya, Anna; Reina-de-la-Torre, Francisco; Damaso-Margelí-Cervera, Victor; Fernandez-Llamazares-Rodriguez, Jaime; Higueras-Suñe, Carmen

    2017-03-01

    Reconstruction of the anterior thorax is complex because of the presence of aesthetically important areas such as the breast, sternum, and upper abdomen. For this reason, a wide variety of pedicled perforator flaps have been described. The anterior intercostal perforator flap is one of these perforators flaps and is valuable for use in breast reconstruction surgery. The location and characteristics of the anterior intercostal perforators were evaluated both anatomically and radiologically. The anatomical study was conducted in a set of 14 hemitrunk cadavers, and the radiologic study was performed retrospectively from a randomly selected set of images obtained from 30 female patients who underwent thoracic computed tomographic angiography for other health problems at the authors' institution during the year 2015. The findings were then compared. A total of 60 perforators in 14 hemitrunks were identified and mapped. Perforators were found in all hemithoraces. The lateral third donor location was the most reliable zone, containing larger and more numerous perforators compared with the other donor regions. According to the radiologic study, a total of 164 perforators in 30 computed tomographic angiographs were identified and mapped. Perforators were found in all thoraxes. The authors found that the intercostal perforator flap has a consistent vascularization. Computed tomographic angiography is less reliable than dissection in identifying the number of perforators. The authors' findings suggest that intercostal perforator flaps are reliable and consistent flaps for reconstruction of the upper trunk.

  11. Mechanical Action of the Intercostal Muscles on the Ribs

    NASA Astrophysics Data System (ADS)

    de Troyer, Andre; Kelly, Suzanne; Zin, Walter A.

    1983-04-01

    The external and internal interosseous intercostal muscles were separately stimulated at end-expiratory lung volume in anesthetized dogs. These muscles were all found to elevate the ribs into which they insert. By attaching weights to the ribs, it was determined that the nonlinear compliance of the ribs was responsible for this phenomenon.

  12. Hemoperitoneum secondary to intercostal arterial bleeding in a trauma patient

    PubMed Central

    Laeeq, K.; Cheung, S.; Phillips, B.

    2017-01-01

    Blunt trauma resulting in rib fractures can be associated with hemothorax, pneumothorax, pulmonary contusions or less frequently chest and abdominal wall hematomas. Our case describes the first report of hemoperitoneum secondary to intercostal arterial bleeding from blunt trauma in a patient on anticoagulation. PMID:28108633

  13. 12th international conference on human retrovirology: HTLV and related retroviruses

    PubMed Central

    Lairmore, Michael D; Fujii, Masahiro

    2005-01-01

    The 12th International Conference on Human Retrovirology: HTLV and Related Retroviruses, was held at the Half Moon Hotel in Montego Bay, Jamaica, from June 22nd to June 25th 2005. The scientific conference, sponsored by the International Retrovirology Association, is held biennially at rotating international venues around the world. The meeting brings together basic scientists, epidemiologists and clinical researchers to discuss findings to prevent HTLV infection or develop new therapies against HTLV-mediated diseases. The Association fosters the education and training of young scientists to bring new approaches to the complex problems of HTLV research, such as translational research to bring findings from the laboratory into clinical trials that benefit HTLV-infected patients. The breadth and quality of research presentations and workshops at the 12th International Conference indicate that these goals are being accomplished. As HTLV research enters its third decade a new generation of scientists face many challenges. However, HTLV scientists and clinicians displayed exciting new approaches and discoveries during plenary talks and poster sessions. The conference encouraged research in HTLV infections and disease, fostered collaborations, and stimulated new partnerships between clinicians and scientists to encourage clinical trials and novel therapeutic interventions. PMID:16202161

  14. Subxiphoid versus intercostal chest tubes: comparison of postoperative pain and pulmonary morbidities after coronary artery bypass grafting.

    PubMed

    Guden, Mustafa; Korkmaz, Askin Ali; Onan, Burak; Onan, Ismihan Selen; Tarakci, Sevim Indelen; Fidan, Fatma

    2012-01-01

    Chest tubes are one cause of pain after cardiac surgery. In a prospective, randomized study, we investigated the effects of the position of chest tubes on acute postoperative pain and pulmonary morbidities in patients who underwent coronary artery bypass grafting. From June through December 2010, 40 patients who underwent elective coronary artery bypass grafting were enrolled in the study. We investigated 2 randomized groups of patients: Group 1 (n-20) had a left chest tube inserted through the midline inferior to the xiphoid process (subxiphoid approach), and Group 2 (n-20) had a left chest tube inserted through the 6th intercostal space along the anterior axillary line (intercostal approach). We compared the results with respect to postoperative pain, the need for analgesic agents, chest-tube drainage, pulmonary morbidities, and duration of hospitalization. The intensity of postoperative pain was similar between the groups. The cumulative doses of analgesic agents, incidence of pulmonary morbidities, and duration of hospitalization were also similar. Pleural effusion and atelectasis were each diagnosed in 3 patients in Group 1 (15%) and 1 patient in Group 2 (5%) (both P=0.68). Two of the patients in Group 1 required drainage of the pleural effusion. In our study, we found that the subxiphoid and intercostal approaches for chest-tube placement yielded similar clinical outcomes.

  15. Highlights of the 12th International Conference on Nuclear Cardiology and Cardiac CT.

    PubMed

    Kitsiou, Anastasia; Dorbala, Sharmila; Scholte, Arthur J H A

    2015-09-01

    The 12th International Conference on Nuclear Cardiology and Cardiac CT was held from 3 to 5 May 2015 in Madrid, Spain. In this article, the three Congress Program Committee Chairs summarize selected highlights of the presented abstracts. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com. This article is being published concurrently in the Journal of Nuclear Cardiology (10.1007/s12350-015-0260-y) and European Heart Journal – Cardiovascular Imaging (10.1093/ehjci/jev179). The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article.

  16. 12th Update in Gastroenterology and Hepatology for the Primary Care Practitioner.

    PubMed

    Stephen, F Otis; Rossaro, Lorenzo

    2008-10-01

    The 12th Update in Gastroenterology and Hepatology for the Primary Care Practitioner is an annual course organized by the Division of Gastroenterology and Hepatology at the University of California, Davis, and held in beautiful Monterey, California. The course was geared towards primary care physicians, nurse practitioners and other allied health professionals. The goals of this symposium were to provide current information regarding the diagnosis and management of digestive diseases commonly seen in the primary care setting and to provide practical guidelines for disease management. Topics covered during this symposium included viral hepatitis, alcoholic liver disease, hepatocellular carcinoma, dysphagia, gastroesophageal reflux disease, chronic diarrhea, inflammatory bowel disease, irritable bowel syndrome, dyspepsia, gastroparesis and bariatric surgery. The course was organized into two sessions each morning, over 2 days, with three or four 30-min lectures. A brief question-and-answer session followed each lecture.

  17. Spinal cord injury from fluoroscopically guided intercostal blocks with phenol.

    PubMed

    Kissoon, Narayan R; Graff-Radford, Jonathan; Watson, James C; Laughin, Ruple S

    2014-01-01

    Image guided intercostal blocks are commonly performed and considered relatively safe. Chemical denervation is commonly used in clinical practice for treatment of chronic non-cancer associated pain. To report a case of spinal cord injury resulting from fluoroscopically guided intercostal blocks with phenol. Case report. Inpatient hospital service. RESULTS/CASE REPORTS: A 53 year-old women was transferred from her local facility for acute onset of lower extremity paresis beginning shortly after right intercostal nerve injections of 2 mL of preservative-free phenol at the T7, 8, 9 levels. She had previous intercostal blocks for chronic right-sided mid thoracic/abdominal pain every 3 months for at least one year without sequelae. Within 20 minutes of the injection, she developed a sensation of right leg weakness and heaviness. Over several hours she developed worsening right leg weakness, and then left leg weakness, followed by urinary retention. Admission examination revealed severe right greater than left leg weakness, right lower extremity hyperesthesia to T10, absent lower extremity reflexes, and bilateral extensor plantar responses. Magnetic resonance imaging (MRI) of the entire spine demonstrated extensive T2/DWI hyperintensity in the central spinal cord from T1 to L1 with mild cord enlargement and enhancement at T7-9 (sites of injection). Extensive serum and cerebrospinal fluid (CSF) evaluation did not show any evidence of an infectious, inflammatory, or metabolic cause to her myelopathy. Repeat MRI of the entire spine demonstrated near complete resolution of the T2 signal abnormality. One month after presentation, despite radiographic improvement, the patient showed some clinical improvement, but remained walker dependent and with neurogenic bowel and bladder. This report describes a single case report. This case offers several lessons for a pain specialist including 1) the potential for a neurologic catastrophe (spinal cord injury) from aqueous neurolytic

  18. The Manchester Microlensing Conference: The 12th International Conference and ANGLES Microlensing Workshop

    NASA Astrophysics Data System (ADS)

    Kerins, E.; Mao, S.; Rattenbury, N.; Wyrzykowski, L.

    The Manchester Microlensing Conference (M2C) was held at the Jodrell Bank Centre for Astrophysics at Manchester University in the UK from 21st-25th January 2008. M2C comprised two elements: the ANGLES Microlensing Workshop and the 12th International Conference on gravitational microlensing. M2C began with the two-day Workshop, providing interactive Master Classes to around 60 researchers on selected hot topics in microlensing. The Master Classes were delivered by world-leading experts on each of the topics. The topics reflected the diverse techniques and applications of microlensing, such as crowded-field photometry, modelling of extra-solar planetary systems, and the use of microlensing in cosmology. The 12th International Conference on microlensing followed immediately after the Workshop and was attended by around 90 researchers. The Conference covered all aspects of current research in microlensing, including: Microlensing towards the Magellanic Clouds; Cosmological Microlensing; Stellar and Galactic Microlensing; Galactic Microlensing Surveys; Follow-up Programmes and Planetary Microlensing; M31 Microlensing; and Future Directions. The M2C Proceedings serve three functions. Through the expert master classes the M2C Proceedings provide a great starting point for those who wish to enter the field or who just wish to learn more about microlensing at a depth beyond that usually covered by a single review article. The M2C proceedings also provide a snapshot of the state-of-the art in microlensing observations and theory as of January 2008, in what is a rapidly developing field. Lastly, the M2C meeting and its Proceedings are dedicated to the memory of the late Bohdan Paczynski, a towering figure and founding father of modern day microlensing research.

  19. Alleviating Thoracotomy Pain With Intercostal Liposomal Bupivacaine: A Case Report.

    PubMed

    Saby, Adam; Swaminathan, Kavitha; Pangarkar, Sanjog; Tribuzio, Bianca

    2016-11-01

    Thoracotomy pain is common after chest surgery and may result from injury to the lung pleura, intercostal muscles, costovertebral joint, or intercostal nerves. Inappropriately controlled postoperative pain can hinder recovery and increase the risk of complications such as infection, atelectasis, blood clots, and development of post-thoracotomy pain syndrome. A number of treatment options for acute pain are available, most of which require systemic medications or indwelling catheters that may be contraindicated in patients on anticoagulants. We present the case of a patient with post-thoracotomy pain that effectively was treated with an ultrasound-guided nerve block with liposomal bupivacaine. The patient experienced pain relief without adverse event. Liposomal bupivacaine may be considered a potential treatment option for patients with severe acute post-thoracotomy pain in whom other modalities have not worked or are contraindicated. N/A. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  20. Incisional Intercostal Hernia With Prolapse of the Colon After Right Partial Nephrectomy

    PubMed Central

    Yamamoto, Takatsugu; Kurashima, Yukiko; Watanabe, Chie; Ohata, Kazunori; Hashiba, Ryoya; Tanaka, Shogo; Uenishi, Takahiro; Ohno, Koichi

    2013-01-01

    A 75-year-old woman with a history of myocardial infarction, gallstones, and right renal cancer was referred to our department because of right flank pain. She had a surgical scar on the right abdomen between the 10th and 11th ribs; computed tomography demonstrated intercostal herniation of the colon. Recognizing the possibility of adhesions of the hernia and colon, we used a median skin incision and patched a polyester mesh coated with absorbent collagen. The patient had an uneventful postoperative course, with no pain for 6 months postoperatively. Transdiaphragmatic intercostal hernias with abdominal contents commonly develop after trauma or thoracic surgery. Incisional intercostal hernias seldom develop after nephrectomy; the present case is only the fourth report. We conjecture that a costochondral incision can induce subluxation of the costotransverse joint, intercostal nerve injury, and atrophy of the intercostal and abdominal oblique muscles. Surgeons must therefore recognize the potential, albeit rare, for intercostal hernia after nephrectomy. PMID:24229033

  1. Incisional intercostal hernia with prolapse of the colon after right partial nephrectomy.

    PubMed

    Yamamoto, Takatsugu; Kurashima, Yukiko; Watanabe, Chie; Ohata, Kazunori; Hashiba, Ryoya; Tanaka, Shogo; Uenishi, Takahiro; Ohno, Koichi

    2013-01-01

    A 75-year-old woman with a history of myocardial infarction, gallstones, and right renal cancer was referred to our department because of right flank pain. She had a surgical scar on the right abdomen between the 10th and 11th ribs; computed tomography demonstrated intercostal herniation of the colon. Recognizing the possibility of adhesions of the hernia and colon, we used a median skin incision and patched a polyester mesh coated with absorbent collagen. The patient had an uneventful postoperative course, with no pain for 6 months postoperatively. Transdiaphragmatic intercostal hernias with abdominal contents commonly develop after trauma or thoracic surgery. Incisional intercostal hernias seldom develop after nephrectomy; the present case is only the fourth report. We conjecture that a costochondral incision can induce subluxation of the costotransverse joint, intercostal nerve injury, and atrophy of the intercostal and abdominal oblique muscles. Surgeons must therefore recognize the potential, albeit rare, for intercostal hernia after nephrectomy.

  2. The intercostal nerve as a target for diagnostic biopsy.

    PubMed

    Nguyen, Khoi D; Choudhri, Haroon F; Macomson, Samuel D

    2017-05-12

    OBJECTIVE Peripheral nerve biopsy is a useful tool in diagnosing peripheral neuropathies. Sural and gracilis nerves have become the most common targets for nerve biopsy. However, the yield of sural nerve biopsy is limited in patients who have motor neuropathies, and gracilis nerve biopsy presents technical challenges and increased complications. The authors propose the intercostal nerve as an alternative motor nerve target for biopsy. METHODS A total of 4 patients with suspected peripheral neuropathies underwent intercostal nerve biopsy at the authors' institution. A rib interspace that is inferior to the pectoralis muscle and anterior to the anterior axillary line is selected for the procedure. Generally the lower intercostal nerves (i.e., T7-11) are targeted. An incision is made over the inferior aspect of the superior rib at the chosen interspace. Blunt dissection is carried down to the neurovascular bundle and the nerve is isolated, ligated, and cut to send for pathological examination. RESULTS The average operative time for all cases was 73 minutes, with average blood loss of 8 ml. Biopsy results from 1 patient exhibited axonopathy, and the other 3 patients demonstrated axonopathy with demyelination. There were no short- or long-term postoperative complications. None of the patients reported sensory or motor deficits related to the biopsy at 6 weeks postoperatively. CONCLUSIONS The intercostal nerve can be an alternative target for biopsy, especially in patients with predominantly motor neuropathies, due to its mixed sensory and motor fibers, straightforward anatomy, minimal risk of serious sensory deficits, and no risk of motor impairment.

  3. Intercostal nerve blockade for evaluation of local anaesthetic agents.

    PubMed

    Bridenbaugh, P O

    1975-02-01

    Bilateral intercostal nerve block provides the opportunity to subject as many as 16 separate peripheral nerves in a single subject to known or unknown local anaesthetic agents in a variety of concentrations, volumes, and additives. It permits the observation of local (e.g., neuritis), clinical (e.g., onset and duration), and systemic (e.g., toxicity and blood concentration) effects of these variables. In double-blind studies, bilateral intercostal nerve block allows the use of each side of the trunk for comparison of two experimental drugs, a new drug against a standard, or two new drugs. Subtle differences in clinical properties as well as simultaneous blood concentrations may be detected in these studies. The advantages of this technique in evaluating local anaesthetic agents are primarily the use of a single subject as his own control while studying may separate peripheral nerves. This aids appreciably in limiting the variable of age, temperature, and perfusion, as well as techniques of administration and evaluation. The constancy of the anatomy of the intercostal nerve provides a highly reliable and reproducible block technique.

  4. Intercostal artery perforator propeller flap for reconstruction of trunk defects following sarcoma resection.

    PubMed

    Zang, Mengqing; Yu, Shengji; Xu, Libin; Zhao, Zhenguo; Zhu, Shan; Ding, Qiang; Liu, Yuanbo

    2015-06-01

    Trunk defects following soft tissue sarcoma resection are usually managed by myocutaneous flaps or free flaps. However, harvesting muscle will cause functional morbidities and some trunk regions lack reliable recipient vessels. The intercostal arteries give off multiple perforators, which distribute widely over the trunk and can supply various pedicle flaps. Our purpose is to use various intercostal artery perforator propeller flaps for trunk oncologic reconstruction. Between November 2013 and July 2014, nine intercostal artery perforator propeller flaps were performed in seven patients to reconstruct the defects following sarcoma resection in different regions of the trunk, including the back, lumbar, chest, and abdomen. Two perforators from intercostal arteries were identified for each flap using Doppler ultrasound probe adjacent to the defect. The perforator with visible pulsation was chosen as the pedicle vessel. An elliptical flap was raised and rotated in a propeller fashion to repair the defects. There were one dorsal intercostal artery perforator flap, four dorsolateral intercostal artery perforator flaps, three lateral intercostal artery perforator flaps, and one anterior intercostal artery perforator flap. The mean skin paddle dimension was 9.38 cm in width (range 6-14 cm) and 21.22 cm in length (range 13-28 cm). All intercostal artery perforator flaps survived completely, except for marginal necrosis in one flap harvested close to the previous flap donor site. The intercostal artery perforator propeller flap provides various and valuable options in our reconstructive armamentarium for trunk oncologic reconstruction. To our knowledge, this is the first case series of using intercostal artery perforator propeller flaps for trunk oncologic reconstruction and clinical application of dorsolateral intercostal artery perforator flaps. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All

  5. Response of the canine inspiratory intercostal muscles to chest wall vibration.

    PubMed

    Leduc, D; Brunko, E; De Troyer, A

    2000-02-01

    High-frequency mechanical vibration of the rib cage reduces dyspnea, but the effect of this procedure on the respiratory muscles is largely unknown. In the present studies, we have initially assessed the electrical and mechanical response to vibration (40 Hz) of the canine parasternal and external intercostal muscles (third interspace) during hyperventilation-induced apnea. When the vibrator was applied to the segment investigated, prominent external intercostal activity was recorded in the seven animals studied, whereas low-amplitude parasternal intercostal activity was recorded in only four animals. Similarly, when the vibrator was applied to more rostral and more caudal interspaces, activity was recorded commonly from the external intercostal but only occasionally from the parasternal. The two muscles, however, showed similar changes in length. We next examined the response to vibration of the muscles in seven spontaneously breathing animals. Vibrating the rib cage during inspiration (in-phase) had no effect on parasternal intercostal inspiratory activity but induced a marked increase in neural drive to the external intercostals. For the animal group, peak external intercostal activity during the control, nonvibrated breaths averaged (mean +/- SE) 43.1 +/- 3.7% of the activity recorded during the vibrated breaths (p < 0.001). External intercostal activity during vibration also occurred earlier at the onset of inspiration and commonly carried on after the cessation of parasternal intercostal activity. Yet tidal volume was unchanged. Vibrating the rib cage during expiration (out-of-phase) did not elicit any parasternal or external intercostal activity in six animals. These observations thus indicate that the external intercostals, with their larger spindle density, are much more sensitive to chest wall vibration than the parasternal intercostals. They also suggest that the impact of this procedure on the mechanical behavior of the respiratory system is relatively

  6. Mechanical effect of muscle spindles in the canine external intercostal muscles

    PubMed Central

    Leduc, Dimitri; Troyer, André De

    2003-01-01

    High-frequency mechanical vibration of the ribcage increases afferent activity from external intercostal muscle spindles, but the effect of this procedure on the mechanical behaviour of the respiratory system is unknown. In the present study, we have measured the changes in external intercostal muscle length and the craniocaudal displacement of the ribs during ribcage vibration (40 Hz) in anaesthetized dogs. With vibration, external intercostal inspiratory activity increased by ∼50 %, but the respiratory changes in muscle length and rib displacement were unaltered. A similar response was obtained after the muscles in the caudal segments of the ribcage were sectioned and the caudally oriented force exerted by these muscles on the rib was removed, thus suggesting that activation of external intercostal muscle spindles by vibration generates little tension. Prompted by this observation, we also examined the role played by the external intercostal muscle spindles in determining the respiratory displacement of the ribs during breathing against high inspiratory airflow resistances. Although resistances consistently elicited prominent reflex increases in external intercostal inspiratory activity, the normal inspiratory cranial displacement of the ribs was reversed into an inspiratory caudal displacement. Also, this caudal rib displacement was essentially unchanged after section of the external intercostal muscles, whereas it was clearly enhanced after denervation of the parasternal intercostals. These findings indicate that stretch reflexes in external intercostal muscles confer insufficient tension on the muscles to significantly modify the mechanical behaviour of the respiratory system. PMID:12626677

  7. Giant congenital intercostal arteriovenous malformation with extensive involvement of chest wall and ribs: surgical experience.

    PubMed

    Parashi, Hrishikesh Sukhadeo; Bhosle, Krishnarao Narayan; Thakare, Nitin Dashrath; Sharma, Ajay; Potwar, Sushrut Suhas

    2013-06-01

    Intercostal arteriovenous malformations (AVMs) are rare lesions. Review of literature shows that most reported cases are secondary to trauma or iatrogenic in origin. Congenital intercostal AVMs are extremely rare. We believe that only 1 case report of congenital intercostal arteriovenous malformation has been reported previously in the literature. We present an exceedingly rare case of giant congenital intercostal AVM in a young patient diagnosed on contrast-enhanced computed tomography of the thorax and treated by surgical resection of the involved chest wall and ribs with reconstruction of the surgical defect. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Utility of intercostal nerve conventional thermal radiofrequency ablations in the injured worker after blunt trauma.

    PubMed

    Engel, Andrew J

    2012-01-01

    Intercostal nerve blocks offer short-term therapeutic relief and serve as a diagnostic test for intercostal neuralgia. This original case report demonstrates the efficacy of radiofrequency ablations for long-term pain relief of intercostal neuralgia. To date, there have been no studies that demonstrate the efficacy of thermal conventional intercostal nerve radiofrequency ablations for intercostal neuralgia. Describe the use of conventional thermal radiofrequency ablations of the intercostal nerves to treat blunt chest wall trauma. Case report. Clinical practice. Six patients suffering from work-related injuries to the chest wall whose treatment focused on conventional thermal radiofrequency ablations of the intercostal nerves. Four of the 6 patients were pain free by their final visit. The remaining 2 patients experienced pain relief until one began wearing a brace after an L5-S1 fusion; the other required repeat treatment after 5.5 months. Case series. There was limited follow-up as patients were either discharged after receiving potentially curative care or were lost to follow-up. Following conventional thermal radiofrequency ablations of the intercostal nerves, 5 of the 6 patients experienced either long-term pain relief or required no additional care. The treatment has potential efficacy for injuries, including rib fractures or intercostal neuralgia, stemming from blunt trauma to the chest wall. In addition, there may be a potential for this treatment to help patients suffering from postthoracotomy pain.

  9. Hybrid Thoracic Endovascular Aortic Repair for Intercostal Patch Aneurysm after Thoracoabdominal Aortic Replacement.

    PubMed

    Kitahara, Hiroto; Yoshitake, Akihiro; Hachiya, Takashi; Okamoto, Kazuma; Hirano, Akinori; Kasai, Mio; Akamatsu, Yuta; Oka, Hidetoshi; Shimizu, Hideyuki

    2015-01-01

    We report a case of hybrid thoracic endovascular aortic repair for intercostal patch aneurysm after thoracoabdominal aortic replacement. Eighteen years ago, a 63-year-old woman with Marfan syndrome had undergone thoracoabdominal aortic replacement with reimplantation of the intercostal artery in an island fashion. Follow-up computed tomography (CT) revealed a remaining intercostal patch aneurysm of diameter 60 mm 17 years after the last operation. Hybrid thoracic endovascular aortic repair for exclusion of this intercostal patch aneurysm was successfully performed, with visceral artery bypasses. Postoperative CT showed no anastomotic stenosis or endoleak.

  10. Associations among physical activity, health indicators, and employment in 12th grade girls.

    PubMed

    Dowda, Marsha; Pfeiffer, Karin A; Dishman, Rod K; Pate, Russell R

    2007-11-01

    This study compared physical activity, sedentary behaviors, and other health indicators between 1381 employed and nonemployed 12th grade girls. The girls were from 22 high schools in South Carolina (2002-2003); 56% of the girls were African American, and the mean age was 17.7 (0.6) years. Physical activity and sedentary behaviors were measured using the 3-Day Physical Activity Recall (3DPAR). Fitness, depressive symptoms, and smoking behavior were assessed. Fifty percent of the girls were employed, and on average, employed girls worked 9.6 30-minute blocks per day. Girls who worked reported significantly (p < or = 0.001) higher average total metabolic equivalents (METs) (mean [M] 66.4, SE 0.5) than girls who did not work (M 59.5, SE 0.5). Also, a higher percent of girls who worked reported 2+ blocks of moderate to vigorous physical activity (MVPA) (89.3%), and fewer (20.2%) reported 4+ blocks of electronic media (EM) compared with girls who did not work (MVPA 62.7%, EM 41.7%). After on-the-job activity was subtracted, total METs for girls who worked was reduced to 48.0 (SE 0.4), and only 48.5% reported 2 or more blocks on average of MVPA. No significant differences (p > 0.05) were found between girls who reported working (W) and those who did not (NW) for body mass index (BMI) (W: M 25.2, SE 0.2; NW: M 24.6, SE 0.2), depression scores (W: M 14.4, SE 0.5; NW: M 14.4, SE 0.5), fitness (W: M 11.3 kg . m/min/kg, SE 0.2; NW: M 11.7 kg . m/min/kg, SE 0.2), or smoking during the past 30 days (W: 18.5%; NW: 17.4%). Nearly one third of employed high school girls' total physical activity occurred while they were at work. Employed girls also spent less time using electronic media. Employment was not associated with fitness, smoking, or depressive symptoms in 12th grade girls.

  11. Intercostal myositis ossificans misdiagnosed as osteosarcoma in a 10-year-old child.

    PubMed

    Koob, Mériam; Durckel, Jean; Dosch, Jean-Claude; Entz-Werle, Natacha; Dietemann, Jean-Louis

    2010-12-01

    Myositis ossificans (MO) is a rare benign cause of heterotopic bone formation within soft tissue. It most commonly affects adolescents and young adults, typically in the limbs and following trauma. Very few cases have been reported in children. We report here a case of nontraumatic MO occurring in a 10-year-old girl with an uncommon location in the 5th right intercostal space; it was initially misdiagnosed and treated as osteosarcoma. Imaging findings including plain radiographs, CT, MRI, bone scintigraphy and PET-CT are described. This case highlights the central role played by imaging in diagnosis, thus avoiding biopsy that can erroneously suggest osteosarcoma as the diagnosis, as occurred in this case.

  12. Study of Three Homologous Solar Flares Observed from Active Region NOAA 9033 on 12th June 2000

    NASA Astrophysics Data System (ADS)

    Verma, V. K.; Vats, Hari Om

    2003-03-01

    In the paper, we present a study of three homologous H flares observed on 12th June 2000 in active region (AR) NOAA 9033. During the observation of AR NOAA 9033 on 12th June 2000, we observed 1st solar flare between 0135-0155 UT, 2nd flare between 0236-0253 UT and 3rd flare between 0259-0323 UT. The present study supports the quadrapolar reconnection scenario presented by Machado et al. (1983) and also shows the presence of 26.7 min periodicity in intensity data estimated from the site of the homologous flares.

  13. Proceedings of the 12th Biennial Conference of research on the Colorado Plateau

    USGS Publications Warehouse

    Ralston, Barbara E.

    2016-05-20

    The 12th Biennial Conference held in Flagstaff, Arizona, from September 16 to 19, 2013, covered a range of topics in the physical, biological, and socio-cultural sciences. The conference was organized and hosted by Northern Arizona University’s (NAU) Merriam-Powell Center for Environmental Research, the Colorado Plateau Cooperative Ecosystem Studies Unit, and the U.S. Geological Survey Southwest Biological Science Center. Financial and in-kind support was provided by a wide range of organizations including the U.S. Forest Service, National Park Service, Bureau of Land Management, Grand Canyon Trust, Colorado Plateau Research Station, and various NAU entities. NAU sponsors include the Landscape Conservation Initiative, School of Forestry, School of Earth Science and Environmental Sustainability, Office of the Provost, and Office of the Vice President of Research. Contributors to these proceedings include researchers and managers from Federal, State, and Tribal governments, universities, private entities, and non-profit organizations. In this regard, this conference has wide-ranging support and participation among private and public entities involved in the science and management of natural resources on the Colorado Plateau.

  14. [Recent history: 12th International Conference on Cancer, Buenos Aires, Argentina, 1978].

    PubMed

    Spinelli, Hugo

    2014-04-01

    Using the approaches of history of the present, this article recovers the discussions surrounding the 12th International Conference on Cancer carried out in Buenos Aires in 1978, in reaction to which Georges Périès organized a "counter-conference" in Paris. In order to understand this discussion, the political situation of the time is described, as is the state of human rights at the time in Argentina, the role of the media - in particular the newspapers La Nación and Clarín and the magazine Gente - and the institutional position adopted by the National Academy of Medicine, as expressed in a letter sent to the presidents of the primary scientific societies of the world. The letter is reprinted in this text as a documentary source, taken from Memoria: Año 1978 (Presidencia de Dr. José E. Rivarola) [Acta: Year 1978 (Presidency of Dr. José E. Rivarola)]. The framework of the discussion makes reference to science's social policy versus science's supposed neutrality and the role of scientific societies.

  15. PREFACE: 12th Europhysical Conference on Defects in Insulating Materials (EURODIM 2014)

    NASA Astrophysics Data System (ADS)

    Alfredsson, M. L.; Chadwick, A. V.; Jackson, R. A.; McCabe, E. E.

    2015-04-01

    The 12th Europhysical Conference on Defects in Insulating Materials (EURODIM14) was held at the University of Kent, UK, from 13-18 July 2014. It was attended by about 120 delegates from around the world, and featured 56 oral presentations and 77 posters. EURODIM14 followed other conferences in the series, held in Pecs (2010), Milan (2006) and Wroclaw (2002), as well as the related ICDIM conferences held in Santa Fe (2012), Aracaju (2008) and Riga (2004). These conferences all have the aim of bringing together scientists to discuss the chemistry and physics of defects in solids, and their role in determining material properties. We would like to thank the International Advisory Committee for suggesting invited speakers, and the Local and Programme Committee for their hard work in planning and running the conference. Finally we would like to thank the authors and referees for their contributions to the proceedings. M L Alfredsson (Conference Chair) A V Chadwick R A Jackson E E McCabe

  16. [Ultrasound-assisted approach to blocking the intercostal nerves in the mid-axillary line for non-reconstructive breast and axilla surgery].

    PubMed

    Diéguez García, P; Fajardo Pérez, M; López Álvarez, S; Alfaro de la Torre, P; Pensado Castiñeiras, A P

    2013-01-01

    Several nerve blocks have recently been used for pain treatment in breast surgery. The main objective of our study was to determine the efficacy and safety of ultrasound-assisted blocking of the anterior and lateral cutaneous branches of the intercostal nerves in the mid-axillary line for non-reconstructive breast and axilla surgery. A prospective observational study was conducted on 30 patients scheduled for non-reconstructive breast and axilla surgery. An intercostal branches block was performed in the mid-axillary line with 0,5% levobupivacaine (3ml in each intercostal space). Clinical efficacy was assessed by standard intraoperative hemodynamic response to surgical stimulus and the need for opioids, and in the postoperative period, by assessing pain intensity as a verbal numerical scale and the need for rescue treatment. We also evaluated the quality of sleep the first night after surgery, any adverse events that occurred, and the satisfaction of patients and surgeons with the anesthetic technique. The intercostal branches block in the mid-axillary line was effective in most cases, with only 2 patients requiring intraoperative opioids, and in one case analgesic rescue was necessary in the postoperative period. The duration of postoperative analgesia was 19±4h. There were no notable adverse events or complications. The satisfaction with the chosen technique was assessed as "very good" in all patients, and by 97% of the surgeons. Intercostal branches block in the mid-axillary line provides adequate intraoperative and postoperative analgesia for non-reconstructive breast and axilla surgery. It is a simple, reproducible technique in most patients of this study, with an easy to understand ultrasound anatomy, in which adequate analgesia could be provided through a single puncture, and may be an alternative to neuroaxial blocks. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights

  17. Design Document for 12th Grade NAEP Preparedness Research Judgmental Standard Setting Studies: Setting Standards on the National Assessment of Educational Progress in Reading and Mathematics for 12th Grade Preparedness

    ERIC Educational Resources Information Center

    National Assessment Governing Board, 2010

    2010-01-01

    The National Assessment Governing Board adopted a Program of Preparedness Research in March 2009. Several categories of research studies were recommended to produce results for reporting 12th grade preparedness for the 2009 grade 12 National Assessment of Educational Progress (NAEP) in reading and mathematics. The categories included content…

  18. EDITORIAL: Proceedings of the 12th Gravitational Wave Data Analysis Workshop (GWDAW 12), Cambridge, MA, USA, 13 16 December 2007

    NASA Astrophysics Data System (ADS)

    Hughes, S.; Katsavounidis, E.

    2008-09-01

    It was a great pleasure and an honor for us to host the 12th Gravitational Wave Data Analysis Workshop (GWDAW) at MIT and the LIGO Laboratory in Cambridge, Massachusetts, the place where this workshop series started in 1996. This time the conference was held at the conference facilities of the Royal Sonesta Hotel in Cambridge from 13 16 December, 2007. This 12th GWDAW found us with the ground interferometers having just completed their most sensitive search for gravitational waves and as they were starting their preparation to bring online and/or propose more sensitive instruments. Resonant mass detectors continued to observe the gravitational wave sky with instruments that have been operating now for many years. LISA, the Laser Interferometer Space Antenna, was recently reviewed by NASA's Beyond Einstein Program Assessment Committee (BEPAC) convened by the National Research Council (NRC) and found that 'on purely scientific grounds LISA is the mission that is the most promising and least scientifically risky…thus, the committee gave LISA its highest scientific ranking'. Even so, JDEM, the Joint Dark Energy Mission, was identified to go first, with LISA following a few years after. New methods, analysis ideas, results from the analysis of data collected by the instruments, as well as Mock Data Challenges for LISA were reported in this conference. While data from the most recent runs of the instruments are still being analyzed, the first upper limit results show how even non-detection statements can be interesting astrophysics. Beyond these traditional aspects of GWDAW though, for the first time in this workshop we tried to bring the non-gravitational wave physics and astronomy community on board in order to present, discuss and propose ways to work together as we pursue the first detection of gravitational waves and as we hope to transition to gravitational wave astronomy in the near future. Overview talks by colleagues leading observations in the electromagnetic

  19. Proceedings of the International Academy for Information Management Annual Conference (12th, Atlanta, Georgia, December 12-14, 1997).

    ERIC Educational Resources Information Center

    Rogers, Camille, Ed.

    This proceedings includes 62 papers presented at the 12th annual International Academy for Information Management (IAIM) conference. Topics of papers include: electronic undergraduate courses; software for teaching change management; cooperative projects; experiential learning; World Wide Web applications; internationalization of the information…

  20. 12th Annual Comparative Analysis of the Racine Unified School District: Demographics, Attendance, Finances, Student Engagement, and Achievement

    ERIC Educational Resources Information Center

    Henken, Rob; Dickman, Anneliese; Schmidt, Jeff; Kramer, Renee

    2009-01-01

    This is the 12th annual report on conditions affecting the Racine Unified School District (RUSD). This year, the analysis again focuses on the long-term historical trends in RUSD. The analysis compares RUSD data to data of nine peer school districts as well as statewide data. The peer districts are defined as those Wisconsin districts with…

  1. Campus Computing, 2001: The 12th National Survey of Computing and Information Technology in American Higher Education.

    ERIC Educational Resources Information Center

    Green, Kenneth C.

    The 2001 Campus Computing Survey, the 12th such survey, is the largest continuing study of the role of computing and information technology in U.S. higher education today. The survey results in this report summarize data from 590 two- and four-year, public and private colleges across the United States, representing a 38.4% response rate. The focus…

  2. Project Based Learning for Life Skill Building in 12th Grade Social Studies Classrooms: A Case Study

    ERIC Educational Resources Information Center

    Zimmerman, Daniele C.

    2010-01-01

    Based on the assumption that project based learning (PBL) in 12th grade social studies classrooms contributes to the development of life skills for high school seniors in this advanced and globalized time, this research will investigate student experiences with PBL methods for helping them acquire skills along with a case study of a successful PBL…

  3. Observation in a School without Walls: Peer Observation of Teaching in a 2nd-12th Grade Independent School

    ERIC Educational Resources Information Center

    Salvador, Josephine

    2012-01-01

    What happens when teachers start to observe each other's classes? How do teachers make meaning of observing and being observed? What effects, if any, does requiring peer observation have on the teaching community? This research explores these questions in a qualitative study of peer observation of teaching (POT) in the 2nd-12th grades of an…

  4. A Content Analysis of Kindergarten-12th Grade School-Based Nutrition Interventions: Taking Advantage of Past Learning

    ERIC Educational Resources Information Center

    Roseman, Mary G.; Riddell, Martha C.; Haynes, Jessica N.

    2011-01-01

    Objective: To review the literature, identifying proposed recommendations for school-based nutrition interventions, and evaluate kindergarten through 12th grade school-based nutrition interventions conducted from 2000-2008. Design: Proposed recommendations from school-based intervention reviews were developed and used in conducting a content…

  5. A Content Analysis of Kindergarten-12th Grade School-Based Nutrition Interventions: Taking Advantage of Past Learning

    ERIC Educational Resources Information Center

    Roseman, Mary G.; Riddell, Martha C.; Haynes, Jessica N.

    2011-01-01

    Objective: To review the literature, identifying proposed recommendations for school-based nutrition interventions, and evaluate kindergarten through 12th grade school-based nutrition interventions conducted from 2000-2008. Design: Proposed recommendations from school-based intervention reviews were developed and used in conducting a content…

  6. The 12th I. E. Melhus Graduate Student Symposium: host plant resistance and disease management, current status and future outlook

    USDA-ARS?s Scientific Manuscript database

    The 12th I. E. Melhus Graduate Student Symposium was held on 6 August 2012 during the Annual meeting of the American Phytopathological Society (APS) in Providence, RI. The theme for this symposium was “Host Plant Resistance and Disease Management: Current Status and Future Outlook”. The APS Host R...

  7. Observation in a School without Walls: Peer Observation of Teaching in a 2nd-12th Grade Independent School

    ERIC Educational Resources Information Center

    Salvador, Josephine

    2012-01-01

    What happens when teachers start to observe each other's classes? How do teachers make meaning of observing and being observed? What effects, if any, does requiring peer observation have on the teaching community? This research explores these questions in a qualitative study of peer observation of teaching (POT) in the 2nd-12th grades of an…

  8. PREFACE: 12th European Workshop on Advanced Control and Diagnosis (ACD 2015)

    NASA Astrophysics Data System (ADS)

    Straka, Ondřej; Punčochář, Ivo; Duník, Jindřich

    2015-11-01

    The 12th European Workshop on Advanced Control and Diagnosis (ACD 2015) took place at the Research Centre NTIS - New Technologies for the Information Society, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic, on November 19 - 20, 2015. The annual European Workshop on Advanced Control and Diagnosis has been organized since 2003 by Control Engineering departments of several European universities in Germany, France, the UK, Poland, Italy, Hungary, and Denmark to bring together senior and junior academics and engineers from diverse fields of automatic control, fault detection, and signal processing. The workshop provides an opportunity for researchers and developers to present their recent theoretical developments, practical applications, or even open problems. It also offers a great opportunity for industrial partners to express their needs and priorities and to review the current activities in the fields. A total of 74 papers have been submitted for ACD 2015. Based on the peer reviews 48 papers were accepted for the oral presentation and 10 papers for the poster presentation. The accepted papers covered areas of control theory and applications, identification, estimation, signal processing, and fault detection. In addition, four excellent plenary lectures were delivered by Prof. Fredrik Gustafsson (Automotive Sensor Mining for Tire Pressure Monitoring), Prof. Vladimír Havlena (Advanced Process Control for Energy Efficiency), Prof. Silvio Simani (Advanced Issues on Wind Turbine Modelling and Control), and Prof. Robert Babuška (Learning Control in Robotics). The ACD 2015 was for the first time in the workshop history co-sponsored by the International Federation of Automatic Control (IFAC). On behalf of the ACD 2015 organising committee, we would like to thank all those who prepared and submitted papers, participated in the peer review process, supported, and attended the workshop.

  9. Cardiorespiratory Fitness and Proximity to Commercial Physical Activity Facilities Among 12th Grade Girls

    PubMed Central

    Dowda, Marsha; Pfeiffer, Karin A.; Lobelo, Felipe; Porter, Dwayne E.; Pate, Russell R.

    2011-01-01

    Purpose To investigate the relationship between proximity to commercial physical activity facilities and cardiorespiratory fitness of 12th grade girls. Methods Adolescent girls (N=786, 60% African American, mean age=17.6 ± 0.6 years) performed a submaximal fitness test (PWC170). Commercial physical activity facilities were mapped and counted within a 0.75-mile street-network buffer around girls’ homes using Geographic Information Systems (GIS). Sedentary activities and vigorous physical activity (VPA, greater or equal to 6 METs) were determined by the average number of 30-minute blocks reported per day on the 3-Day Physical Activity Recall (3DPAR). Mixed model regressions were calculated using school as a random variable. Results Girls had higher weight-relative PWC170 scores if there was a commercial physical activity facility (n=186, 12.4±4.2 kg·m/min/kg) within 0.75-mile street-network buffer of home as compared to girls without a nearby facility (n=600, 11.2±3.6 kg·m/min/kg). After adjusting for demographic variables, sports participation, sedentary behaviors and VPA, having one or more commercial physical activity facilities within a 0.75-mile street-network buffer of homes was significantly related to cardiorespiratory fitness. Conclusions Both with and without adjustment for covariates, the presence of a commercial physical activity facility within a 0.75-mile street-network buffer of a girl’s home was associated with higher cardiorespiratory fitness. PMID:22525114

  10. Ruptured Aneurysm of Intercostal Arteriovenous Malformation Associated With Neurofibromatosis Type 1: A Case Report

    SciTech Connect

    Kim, Hyung Jun; Seon, Hyun Ju Choi, Song; Jang, Nam Kyu

    2011-02-15

    Intercostal arteriovenous malformations (AVM) are rare, with most being secondary to trauma or iatrogenic therapeutic procedures. Only one case of presumably congenital AVM has been reported. Here we report the first case of a ruptured aneurysm of intercostal AVM associated with neurofibromatosis type 1 in a 32-year-old woman who experienced hypovolemic shock caused by massive hemothorax.

  11. Scoliosis development in identical twins after intercostal thoracotomy for pulmonary artery sling correction.

    PubMed

    Kaila, Rajiv; Blackman, Mark; Lehovsky, Jan

    2006-10-01

    We present a report on two monozygotic female twins who underwent a left-sided intercostal thoracotomy in the second month of life for pulmonary artery sling correction. Twenty-four years later, in adulthood, the identical twins had both developed right-sided thoracic scoliosis. No previous accounts of scoliosis development after intercostal thoracotomy for pulmonary artery sling correction have been reported.

  12. Hepatocellular carcinoma: prediction of blood supply from an intercostal artery with multidetector row computed tomography.

    PubMed

    Kim, Min-Uk; Kim, Hyo-Cheol; Chung, Jin Wook; An, Sangbu; Seong, Nak Jong; Jae, Hwan Jun; Park, Jae Hyung

    2011-10-01

    To evaluate the ability of multidetector row computed tomography (CT) to detect blood supply from the intercostal artery in patients with hepatocellular carcinoma (HCC). Between January 2003 and December 2007, angiography of the intercostal artery was performed in 93 patients (76 men and 17 women, mean age 58 years) with HCC who had also undergone multidetector row CT. CT scans and digital subtraction angiograms of these patients were retrospectively reviewed by two investigators in consensus to evaluate tumor feeding vessels. Multiple logistic regression analysis was used to identify factors that predict the presence of an HCC blood supply from an intercostal artery. Tumor staining fed by an intercostal artery was noted in 65 patients (70%; 112 tumor feeding vessels) by intercostal angiography. Readers interpreted that tumor feeding vessels were evident by CT in 35 (54%) of these 65 patients with tumor staining supplied by an intercostal artery by angiography. Multiple logistic regression analysis showed that a visible tumor feeding vessel by CT (P = .003) and hepatic artery attenuation by angiography (P = .014) were significantly related to the presence of a blood supply from an intercostal artery. Visualization of a tumor feeding vessel from the intercostal artery by multidetector row CT is an important sign of parasitic supply to an HCC. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  13. Short-term synchronization of intercostal motoneurone activity.

    PubMed

    Sears, T A; Stagg, D

    1976-12-01

    1. The hypothesis is advanced that the joint occurrence of unitary excitatory post-synaptic potentials e.p.s.p.s) evoked in motoneurones by branches of common stem pre-synaptic fibres causes short-term synchronization of their discharge during the rising phases of the unitary e.p.s.p.s. 2. This hypothesis was tested using the pre- and post-stimulus time (PPST) histogram to detect synchronized firing among groups of intercostal motoneurones discharging in response to their natural synaptic drives. 3. Motor nerve action potentials were recorded monophasically from nerve filaments of the external intercostal muscles of anaesthetized, paralysed cats maintained on artificial ventilation. 4. Computer methods were used to measure peak spike amplitude, spike amplitude, spike interval and filament identification for simultaneous recordings from four filaments. The spike amplitude histograms were derived for each filament and groups of spikes were selected for analysis. 5. With spikes of one group designated as 'stimuli' (occurring at zero time) and those of a second as 'response' the PPST histogram was computed with different time bin widths. 6. With bin widths of 100 and 10 msec the central respiratory periodicity was apparent in the PPST histogram. With 1.0 msec bins the PPST histogram showed a narrow central peak extending to +/- 3.0 msec at its base. This 'short-term synchronization' supports the hypothesis of joint firing due to common presynaptic connectivity. 7. It was shown that detection of short-term synchronization was critically dependent on a sufficient quantity of data but that provided a simple criterion of adequate counts per bin in the PPST histogram was met, short-term synchronization could be detected between intercostal motoneurones of the same and adjacent segments.

  14. Abdominal pain of spinal origin. Value of intercostal block.

    PubMed Central

    Ashby, E. C.

    1977-01-01

    A prospective study was made of 73 patients presenting in one year with abdominal pain provisionally diagnosed as of spinal origin. The criteria for audit of diagnosis and treatment are defined. The diagnosis was confirmed in 53 patients, 49 of whom had been treated with a lignocaine intercostal block in the relevant segment. Thirty-three of these (67.3%) had both complete and prolonged relief. It is suggested that the block causes interruption of a vicious circle of pain and muscle spasm in a 'spinal reflex pain syndrome'. PMID:860866

  15. TT2014 meeting report on the 12th Transgenic Technology meeting in Edinburgh: new era of transgenic technologies with programmable nucleases in the foreground.

    PubMed

    Beck, Inken M; Sedlacek, Radislav

    2015-02-01

    The 12th Transgenic Technology meeting was held in Edinburgh on 6th-8th October 2014 and interest to participate in the meeting overcame all expectations. The TT2014 was the largest meeting ever with more than 540 scientists, technicians, and students from all over the world. The meeting had an excellent scientific program that brought information on the latest ground-breaking technologies for gene targeting and genome editing using programmable nucleases into the foreground. These presentations were well balanced with several highlights over viewing topics in embryonic stem cell research, embryogenesis, disease models, and animals in agriculture. Ample space was reserved also for short talks presenting technical development and for highlighting posters contributions. A highlight of the meeting was the award of the 10th International Society of Transgenic Technologies Prize to Janet Rossant for her outstanding contributions in the field of mouse embryogenesis.

  16. Intercostal thoracotomy closure: transcostal sutures as a less painful alternative to circumcostal suture placement.

    PubMed

    Rooney, Matthew B; Mehl, Margo; Monnet, Eric

    2004-01-01

    To determine if transcostal thoracotomy closure resulted in less pain than circumcostal closure. Experimental cadaver and prospective clinical study. Two canine cadavers and 13 adult, 22-29 kg dogs. Phase 1: In 2 cadavers, 4 suture passage techniques were evaluated to determine the incidence of nerve entrapment in circumcostal intercostal thoracotomy closure. Phase 2: Pain after circumcostal closure (7 dogs) or transcostal closure (6 dogs) of a 4th intercostal space thoracotomy was evaluated by use of pain threshold scores, fentanyl administration rates, heart and respiratory rates, and numerical ratings for behavior. Arterial blood gas analyses were obtained 4 hours postoperatively. Transcostal closure was accomplished by drilling 5-6 small holes in the 5th rib and passing sutures through the holes and around the 4th rib to achieve closure. Pain threshold scores (PTS) were measured by an observer unaware of closure assignment, at 2, 4, 12, and 24 hours after closure by applying slowly increasing pressure to the incision line using a load cell. Rates of fentanyl administration were adjusted based on subjective impressions of dog comfort by a second observer unaware of closure assignment. A 70-100% incidence of nerve entrapment was found for all circumcostal techniques. PTS was higher (P=.045) and fentanyl infusion rates were lower (P=.001) for the transcostal group at 2, 4, 12, and 24 hour postoperatively compared with the circumcostal group. There is a high incidence of nerve entrapment using circumcostal closure techniques. A transcostal technique appears to be associated with less pain during the first 24 hours postoperatively. Based on lower pain scores, transcostal thoracotomy closure may be preferable to circumcostal closure techniques.

  17. Robotic intercostal nerve harvest: a feasibility study in a pig model.

    PubMed

    Miyamoto, Hideaki; Serradori, Thomas; Mikami, Yoji; Selber, Jesse; Santelmo, Nicola; Facca, Sybille; Liverneaux, Philippe

    2016-01-01

    The aim of this study was to report the feasibility of robotic intercostal nerve harvest in a pig model. A surgical robot, the da Vinci Model S system, was installed after the creation of 3 ports in the pig's left chest. The posterior edges of the fourth, fifth, and sixth intercostal nerves were isolated at the level of the anterior axillary line. The anterior edges of the nerves were transected at the rib cartilage zone. Three intercostal nerve harvesting procedures, requiring an average of 33 minutes, were successfully performed in 3 pigs without major complications. The advantages of robotic microsurgery for intercostal nerve harvest include elimination of physiological tremor, free movement of joint-equipped robotic arms, and amplification of the surgeon's hand motion by as much as 5 times. Robot-assisted neurolysis may be clinically useful for intercostal nerve harvest for brachial plexus reconstruction.

  18. Robotic repair of a large abdominal intercostal hernia: a case report and review of literature.

    PubMed

    Wang, Stephani C; Singh, Tejinder P

    2017-06-01

    Abdominal intercostal hernia is an uncommon phenomenon, reported in few case reports and small case series. If left untreated, it can lead to strangulation and visceral ischemia. Prompt diagnosis and appropriate surgical intervention are thus critical to prevent resulting morbidity. We present a 50-year-old woman with a large abdominal intercostal hernia after an open nephrectomy. She underwent a successful robotic repair of the hernia with mesh placement. Through the presentation, we would like to raise awareness of intercostal hernia as a complication of open nephrectomy and significance of early diagnosis in avoiding potential morbidity. We also performed a review of literature especially focusing on acquired abdominal intercostal hernia secondary to prior surgery. Although intercostal hernias can be difficult to repair secondary to the size and location, adequate visualization and surgical planning are critical to successful repair.

  19. PREFACE: 12th Conference on Recent Developments in Gravity (NEB XII)

    NASA Astrophysics Data System (ADS)

    Christodoulakis, Theodosios; Vagenas, Elias C.

    2007-06-01

    Continuing the 24 year old tradition, one of the Greek relativistic groups, this time the Relativity Group of the Physics Department of the University of Athens, organized the 12th Conference of the series "Recent Developments in Gravity" (NEB XII). This time NEB took place at Nafplio, Greece, from Thursday 29 June to Sunday 2 July, 2006. The Conference was attended by more than 100 participants, more than 50% of whom were relativists from abroad (both Greek and other nationalities). This signifies a tendency of the last few Conferences to open up the Greek Relativity Conference to the international scientific community. Actually, many notable members of the relativistic community all over the globe showed particular interest in coming to Nafplio, and spend four relaxed days in a nice sunny and historical place, presenting the results of their more recent work and discussing it with colleagues and students from Greece. The NEB XII Conference covered various aspects of gravitational physics: Relativistic Astrophysics, Mathematical Relativity, Quantum Gravity, and Cosmology. Although the program was rather heavy and for the first time we had parallel sessions running in the afternoons, the wonderful weather (apart from the last afternoon when it rained heavily) and the beauty of Nafplio helped the organizers offer the participants a warm, pleasant, and creative time. According to most attendees, their impression was more than good, not only with respect to the hospitable environment, but with respect to the high level of talks as well. We hope the next Conference, which will be organized by the Relativity Group of the Aristotle University of Thessaloniki in the summer of 2008, will raise the standards of the Conference even higher, thus further establishing our Conference as a notable Conference in the Relativistic community all over the world. Finally, we would like to thank the Gravitational Physics Section of the European Physical Society (GPS/EPS), ILIAS

  20. PREFACE: 12th High-Tech Plasma Processes Conference (HTPP-12)

    NASA Astrophysics Data System (ADS)

    Gleizes, Alain; Ghedini, Emanuele; Gherardi, Matteo; Sanibondi, Paolo; Dilecce, Giorgio

    2012-12-01

    The High-Tech Plasma Processes - 12th European Plasma Conference (HTPP-12) was held in Bologna (Italy) on 24-29 June 2012. The conference series started in 1990 as a thermal plasma conference and gradually expanded to include other topic fields as well. Now the High-Tech Plasma Processes - European Plasma Conference (HTPP) is a bi-annual international conference based in Europe with topics encompassing the whole area of plasma processing science. The aim of the conference is to bring different scientific communities together, facilitate the contacts between science, technology and industry and provide a platform for the exploration of both fundamental topics and new applications of plasmas. Thanks to the efforts of the conference chairman, Professor Vittorio Colombo and of the co-chair, Professor Piero Favia, a well balanced participation from both the communities of thermal and nonthermal plasma researchers was achieved; this resulted in just about 196 attendees from 39 countries, with 8 plenary and 15 invited talks, plus 50 oral and 140 poster contributions. This volume of Journal of Physics: Conference Series gathers papers from regular contributions of HTPP-12; each contribution submitted for publication has been peer reviewed and the Editors are very grateful to the referees for their careful support in improving the original manuscripts. In the end, 39 manuscripts were accepted for publication, covering different topics of plasma processing science: from plasma fundamentals and modelling to source design and process diagnostics, from nanomaterial synthesis to surface modification, from waste treatment to plasma applications in a liquid environment. It is an honour to present this volume of Journal of Physics: Conference Series and we deeply thank the authors for their enthusiastic and high-grade contribution. Finally, we would like to thank the conference chairmen, the members of the steering committee, the international scientific committee, the local

  1. Impact of intercostal paravertebral neurectomy on post thoracotomy pain syndrome after thoracotomy in lung cancer patients: a randomized controlled trial

    PubMed Central

    Althaus, Astrid; Poels, Marcel; Joppich, Robin; Lefering, Rolf; Wappler, Frank; Windisch, Wolfram; Ludwig, Corinna; Stoelben, Erich

    2016-01-01

    Background Thoracotomy leads to chronic neuropathic pain in up to 50% of patients and is responsible for an impaired quality of life. Intercostal nerve injury has been suggested to be responsible for this pain. In the present study the impact of paravertebral intercostal neurectomy on post thoracotomy pain was assessed. Methods In this single center parallel-group randomized controlled trial patients underwent muscle sparing anterolateral thoracotomy and anatomical lung resection for lung cancer. A subcostal approach was used for thoracotomy with single paravertebral neurectomy being performed at the beginning of the procedure at the level of the retracted intercostal space. For documentation of neuropathic pain the Leeds Assessment Score for Neuropathic Symptoms and Signs (LANSS) was used postoperatively. The primary endpoint was defined as LANSS ≥12 points on day 120. In addition, the numeric pain rating scale (NRS) was used to score pain intensity. Results Out of 172 patients initially randomized 161 patients were investigated following intraoperative and postoperative drop-out criteria. All patients required anatomical lung resection via thoracotomy. Five patients were lost for follow up. For the remaining 156 patients there was no difference between the two groups with regard to LANSS ≥12: 26.6% in patients with neurectomy and 28.8% in control-subjects (P=0.78). In addition, the NSR score at day 120 did not differ significantly at rest and during activity between the two groups (at rest: 21.7% vs. 15.8% P=0.439; activity: 24.5% vs. 21.9% P=0.735). Conclusions Neurectomy was not shown to reduce the post thoracotomy pain syndrome in patients with anatomical lung resection following anterolateral muscle sparing thoracotomy. PMID:27746994

  2. Contribution of spindle reflexes to post-inspiratory activity in the canine external intercostal muscles

    PubMed Central

    Berdah, Stéphane V; De Troyer, André

    2001-01-01

    The external intercostal muscles have greater post-inspiratory activity than the parasternal intercostal muscles and are more abundantly supplied with muscle spindles. In the present study, the hypothesis was tested that spindle afferent inputs play a major role in determining this activity. The electrical activity of the external and parasternal intercostal muscles in the rostral interspaces was recorded in anaesthetized spontaneously breathing dogs, and the ribs were manipulated so as to alter their normal caudal displacement and the normal lengthening of the muscles in early expiration. Post-inspiratory activity in the external intercostal muscles showed a reflex decrease when the caudal motion of the ribs and the lengthening of the muscles was impeded, and it showed a reflex increase when the rate of caudal rib motion and muscle lengthening was increased. In contrast, the small post-inspiratory activity in the parasternal intercostal muscles remained unchanged. When the two ribs making up the interspace investigated were locked to keep muscle length constant, post-inspiratory activity in the external intercostal muscles was reduced and no longer responded to cranial rib manipulation. These observations confirm that afferent inputs from muscle receptors, presumably muscle spindles, are a primary determinant of post-inspiratory activity in the canine external intercostal muscles. In anaesthetized animals, the contribution of central control mechanisms to this activity is small. PMID:11483716

  3. On the intercostal muscle compensation for diaphragmatic paralysis in the dog.

    PubMed Central

    Brichant, J F; De Troyer, A

    1997-01-01

    1. Paralysis of the diaphragm in the dog is known to cause a compensatory increase in activation of the inspiratory intercostal muscles (parasternal intercostals, external intercostals, and levator costae). The present studies were designed to assess the mechanism(s) of that compensation. 2. Complete, selective diaphragmatic paralysis was induced by injecting local anaesthetic into small silicone cuffs placed around the phrenic nerve roots in the neck. 3. Paralysis produced a decrease in tidal volume and an increase in arterial P(CO2) (P(a,CO2)). The increased hypercapnic drive was a primary determinant of the increased inspiratory intercostal activity. 4. However, paralysis also produced an increased inspiratory cranial displacement of the ribs. When this increased rib displacement was reduced to that seen before paralysis, it appeared that the increase in external intercostal and levator costae inspiratory activity was commonly greater than anticipated on the basis of the increased P(a,CO2). 5. Diaphragmatic paralysis after bilateral vagotomy also elicited disproportionate increases in inspiratory intercostal activity, thus indicating that these increases are not caused by vagal afferent inputs. 6. These observations are consistent with the idea that the intercostal muscle compensation for diaphragmatic paralysis is, in part, due to the release of an inhibition originating from the contracting diaphragm. This inhibition might arise in the diaphragmatic tendon organs. PMID:9097948

  4. Superbugs and Superdrugs-SMi's 12th annual conference--Overcoming resistance. 17-18 March 2010, London, UK.

    PubMed

    Oni, Adekemi

    2010-05-01

    The 12th Annual Superbugs and Superdrugs conference, held in London, included topics covering new therapeutic developments in the field of antimicrobial research. This conference report highlights selected presentations on antimicrobial peptides, addressing bacterial resistance, and new treatments for bacterial infections. Investigational drugs discussed include DPK-060 (DermaGen AB), DAV-132 (Da Volterra), PF-4287881, PNU-100480 and PF-02538084 (all Pfizer Inc), BAL-30072 (Basilea Pharmaceutica International Ltd) and lanbiotics from Novacta.

  5. [From bioinformatics to systems biology: account of the 12th international conference on intelligent systems in molecular biology].

    PubMed

    Ivakhno, S S

    2004-01-01

    The paper reviews the 12th International Conference on Intelligent Systems for Molecular Biology/Third European Conference on Computational Biology 2004 that was held in Glasgow, UK, during July 31-August 4. A number of talks, papers and software demos from the conference in bioinformatics, genomics, proteomics, transcriptomics and systems biology are described. Recent applications of liquid chromatography - tandem mass spectrometry, comparative genomics and DNA microarrays are given along with the discussion of bioinformatics curricular in higher education.

  6. 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems

    SciTech Connect

    Berk, Herbert L.; Breizman, Boris N.

    2014-02-21

    The 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems took place in Austin, Texas (7–11 September 2011). This meeting was organized jointly with the 5th IAEA Technical Meeting on Theory of Plasma Instabilities (5–7 September 2011). The two meetings shared one day (7 September 2011) with presentations relevant to both groups. Some of the work reported at these meetings was then published in a special issue of Nuclear Fusion [Nucl. Fusion 52 (2012)]. Summaries of the Energetic Particle Conference presentations were given by Kazuo Toi and Boris Breizman. They respectively discussed the experimental and theoretical progress presented at the meeting. Highlights of this meeting include the tremendous progress that has been achieved in the development of diagnostics that enables the ‘viewing’ of internal fluctuations and allows comparison with theoretical predictions, as demonstrated, for example, in the talks of P. Lauber and M. Osakabe. The need and development of hardened diagnostics in the severe radiation environment, such as those that will exist in ITER, was discussed in the talks of V. Kiptily and V.A. Kazakhov. In theoretical studies, much of the effort is focused on nonlinear phenomena. For example, detailed comparison of theory and experiment on D-III-D on the n = 0 geodesic mode was reported in separate papers by R. Nazikian and G. Fu. A large number of theoretical papers were presented on wave chirping including a paper by B.N. Breizman, which notes that wave chirping from a single frequency may emanate continuously once marginal stability conditions have been established. Another area of wide interest was the detailed study of alpha orbits in a burning plasma, where losses can come from symmetry breaking due to finite coil number or magnetic field imperfections introduced by diagnostic or test modules. An important area of development, covered by M.A. Hole and D.A. Spong, is concerned with the self

  7. Prospective Associations of 12th-Grade Drinking Intensity and Age 19/20 Driving-Related Consequences.

    PubMed

    Evans-Polce, Rebecca J; Patrick, Megan E; O'Malley, Patrick M

    2017-09-01

    The purpose of this study is to examine driving-related consequences associated with levels of drinking intensity among a national sample of young adult drinkers. Data come from a nationally representative sample of 12th graders sampled annually in 2005-2014 with subsamples surveyed at age 19/20 years. Multivariable logistic regressions examined associations of 12th-grade drinking intensity (0-4, 5-9, 10-14, and 15+ drinks in a row) with driving consequences at age 19/20 years. Twelfth-grade binge drinkers (compared with nonbinge drinkers) were more likely to experience negative driving consequences at age 19/20 years. Among binge drinkers, 15+ drinkers (compared with 5-9 drinkers) in 12th grade had increased the risk of negative drinking consequences at age 19/20 years. These results suggest that while underage binge drinkers are at an increased risk for having driving consequences, those who engage in higher intensity drinking are at even greater risk for these consequences. High-intensity drinkers may require additional screening or intervention to reduce future driving-related consequences. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Respiratory effects of the external and internal intercostal muscles in humans

    PubMed Central

    Wilson, Theodore A; Legrand, Alexandre; Gevenois, Pierre-Alain; De Troyer, André

    2001-01-01

    The current conventional view of intercostal muscle actions is based on the theory of Hamberger (1749) and maintains that as a result of the orientation of the muscle fibres, the external intercostals have an inspiratory action on the lung and the internal interosseous intercostals have an expiratory action. Recent studies in dogs, however, have shown that this notion is only approximate. In the present studies, the respiratory actions of the human external and internal intercostal muscles were evaluated by applying the Maxwell reciprocity theorem. Thus the orientation of the muscle fibres relative to the ribs and the masses of the muscles were first assessed in cadavers. Five healthy individuals were then placed in a computed tomographic scanner to determine the geometry of the ribs and their precise transformation during passive inflation to total lung capacity. The fractional changes in length of lines with the orientation of the muscle fibres were then computed to obtain the mechanical advantages of the muscles. These values were finally multiplied by muscle mass and maximum active stress (3.0 kg cm−2) to evaluate the potential effects of the muscles on the lung. The external intercostal in the dorsal half of the second interspace was found to have a large inspiratory effect. However, this effect decreases rapidly in the caudal direction, in particular in the ventral portion of the ribcage. As a result, it is reversed into an expiratory effect in the ventral half of the sixth and eighth interspaces. The internal intercostals in the ventral half of the sixth and eighth interspaces have a large expiratory effect, but this effect decreases dorsally and cranially. The total pressure generated by all the external intercostals during a maximum contraction would be -15 cmH2O, and that generated by all the internal interosseous intercostals would be +40 cmH2O. These pressure changes are substantially greater than those induced by the parasternal intercostal and

  9. Safety of an intercostal approach for imaging-guided percutaneous drainage of subdiaphragmatic abscesses.

    PubMed

    Preece, Stephen R; Nelson, Rendon C; Bashir, Mustafa R; Jaffe, Tracy A; Kim, Charles Y; Haystead, Clare M

    2014-06-01

    The objective of our study was to test the hypothesis that an intercostal approach to imaging-guided percutaneous subdiaphragmatic abscess drainage is as safe as a subcostal approach. A cohort of 258 consecutive patients with one or more subdiaphragmatic abscesses referred for imaging-guided (CT or ultrasound) percutaneous drainage was identified. Demographic characteristics and clinical outcomes were compared between patients who underwent drainage catheter placement via an intercostal approach versus those who underwent drainage catheter placement via a subcostal approach. Percutaneous drainage was performed for 441 abscesses in 258 patients in 409 separate procedures (214 via an intercostal approach, 186 by a subcostal approach, and nine by a combined approach). The total number of pleural complications was significantly higher in the intercostal group (56/214 [26.2%]) than the subcostal group (15/186 [8.1%]; p < 0.001). These complications included a significantly higher pneumothorax rate in the intercostal group than the subcostal group (15/214 [7.0%] vs 0/186 [0%], respectively; p < 0.01) and a higher incidence of new or increased pleural effusions (38/214 [17.8%] vs 14/186 [7.5%]; p < 0.01). The incidence of empyema was low and similar between the two groups (intercostal vs subcostal, 3/214 [1.4%] vs 1/186 [0.5%]; p = 0.63). A few of the complications in the patients who underwent an intercostal-approach drainage were clinically significant. Four of the 15 pneumothoraces required thoracostomy tubes and eight of 38 (21.1%) pleural effusions required thoracentesis, none of which was considered infected. An intercostal approach for imaging-guided percutaneous drainage is associated with a higher risk of pleural complications; however, most of these complications are minor and should not preclude use of the intercostal approach.

  10. Endovascular exclusion of patch aneurysms of intercostal arteries after thoracoabdominal aortic aneurysm repair.

    PubMed

    Juthier, Francis; Rousse, Natacha; Banfi, Carlo; Beregi, Jean-Paul; Vincentelli, André; Prat, Alain; Bachet, Jean

    2013-02-01

    Reimplantation of the largest patent intercostal arteries is usually performed during thoracoabdominal aortic aneurysm repair. This may lead to aneurysmal evolution of the intercostal arteries patch. We report the successful percutaneous endovascular repair in 4 Marfan patients of aneurysms of the intercostal arteries patch that developed after thoracoabdominal aortic aneurysm repair (Crawford type II) during a mean delay of 70 months (range, 48 to 91 months). All patients had previously undergone one or several aortic surgical procedures and had patent subclavian and hypogastric arterial networks. No in-hospital deaths or spinal cord ischemic injuries occurred, which emphasizes the importance of the vascular collateral network.

  11. Ultrasound-guided paravertebral block using an intercostal approach.

    PubMed

    Ben-Ari, Alon; Moreno, Milena; Chelly, Jacques E; Bigeleisen, Paul E

    2009-11-01

    We describe an ultrasound-guided technique of continuous bilateral paravertebral block using an intercostal approach in 12 patients undergoing elective abdominal surgery. Postoperatively, each of the patient's paravertebral catheters was bolused with 10 mL lidocaine (15 mg/mL), and each of the patient's catheters was infused with 0.2% ropivacaine at 10 mL/h. Using a pinprick test, the median number of dermatomes blocked after the initial bolus was 5 (interquartile range, 4-6), and 23 of 24 catheters produced a local anesthetic block. The median verbal pain score on postoperative day 1 was 5.5 (interquartile range, 3.5-6), and median dose of IV hydromorphone consumed during the first 24 h after surgery was 1.9 mg (interquartile range, 0.7-5.05). All catheters were removed within 72 h after surgery.

  12. Breast Reinnervation: DIEP Neurotization Using the Third Anterior Intercostal Nerve

    PubMed Central

    Menn, Zachary K.; Eldor, Liron; Kaufman, Yoav; Dellon, A. Lee

    2013-01-01

    Background: The purpose of this article is to evaluate a new method of DIEP flap neurotization using a reliably located recipient nerve. We hypothesize that neurotization by this method (with either nerve conduit or direct nerve coaptation) will have a positive effect on sensory recovery. Methods: Fifty-seven deep inferior epigastric perforator (DIEP) flaps were performed on 35 patients. Neurotizations were performed to the third anterior intercostal nerve by directly coapting the flap donor nerve or coapting with a nerve conduit. Nine nonneurotized DIEP flaps served as controls and received no attempted neurotization. All patients were tested for breast sensibility in 9 areas of the flap skin-island and adjacent postmastectomy skin. Testing occurred at an average of 111 weeks (23–309) postoperatively. Results: At a mean of 111 weeks after breast reconstruction, neurotization of the DIEP flap resulted in recovery of sensibility that was statistically significantly better (lower threshold) in the flap skin (P < 0.01) and statistically significantly better than in the native mastectomy skin into which the DIEP flap was inserted (P < 0.01). Sensibility recovered in DIEP flaps neurotized using the nerve conduit was significantly better (lower threshold) than that in the corresponding areas of the DIEP flaps neurotized by direct coaptation (P < 0.01). Conclusion: DIEP flap neurotization using the third anterior intercostal nerve is an effective technique to provide a significant increase in sensory recovery for breast reconstruction patients, while adding minimal surgical time. Additionally, the use of a nerve conduit produces increased sensory recovery when compared direct coaptation. PMID:25289267

  13. Factors influencing the diameter of human anterior and posterior intercostal arteries.

    PubMed

    Kuhlman, David R; Khuder, Sadik A; Lane, Richard D

    2015-03-01

    At present, there have not been any detailed studies examining the size relationships of the intercostal arteries. This study was carried out to investigate the relationship between the vessel lumenal diameter of ipsilateral, paired anterior and posterior IC arteries, as well as with the length of the IC space supplied by each artery. Samples were collected from the second-sixth anterior and posterior IC arteries near their site of origin, and the lengths of the corresponding IC spaces were measured in 42 cadavers. Lumenal diameters of both the anterior and posterior IC arteries at consecutive IC space closely followed second degree polynomial regression models (R(2) = 0.9655, and R(2) = 0.9741, respectively), and reached maximum size at the fifth IC space, which was found to be the longest of the IC spaces. No direct relationship was observed between diameters of the paired anterior and posterior IC arteries, although there was a trend for the larger anterior IC arteries to be paired with the larger posterior IC arteries. The calculated rate of blood flow at each IC artery was approximately two-fold greater in males than in females. These results suggest that the length of the IC space, and hence the extent of the thoracic wall supplied, is a major factor in determining the diameter of both anterior and posterior IC arteries. Since COPD is such a prevalent disease, this study also examined its influence on the IC arteries, and found that the posterior IC arteries are significantly larger among afflicted subjects.

  14. Effect of spaceflight on oxidative and antioxidant enzyme activity in rat diaphragm and intercostal muscles

    NASA Technical Reports Server (NTRS)

    Lee, Mona D.; Tuttle, Ronald; Girten, Beverly

    1995-01-01

    There are limited data regarding changes in oxidative and antioxidant enzymes induced by simulated or actual weightlessness, and any additional information would provide insight into potential mechanisms involving other changes observed in muscles from animals previously flown in space. Thus, the NASA Biospecimen Sharing Program was an opportunity to collect valuable information. Oxidative and antioxidant enzyme levels, as well as lipid peroxidation, were measured in respiratory muscles from rates flown on board Space Shuttle mission STS-54. The results indicated that there was an increasing trend in citrate synthase activity in the flight diaphragm when compared to ground based controls, and there were no significant changes observed in the intercostal muscles for any of the parameters. However, the lipid peroxidation was significantly (p less than 0.05) decreased in the flight diaphragm. These results indicate that 6 day exposure to microgravity may have a different effect on oxidative and antioxidant activity in rat respiratory muscles when compared to data from previous 14 day hindlimb suspension studies.

  15. Effect of spaceflight on oxidative and antioxidant enzyme activity in rat diaphragm and intercostal muscles

    NASA Technical Reports Server (NTRS)

    Lee, Mona D.; Tuttle, Ronald; Girten, Beverly

    1995-01-01

    There are limited data regarding changes in oxidative and antioxidant enzymes induced by simulated or actual weightlessness, and any additional information would provide insight into potential mechanisms involving other changes observed in muscles from animals previously flown in space. Thus, the NASA Biospecimen Sharing Program was an opportunity to collect valuable information. Oxidative and antioxidant enzyme levels, as well as lipid peroxidation, were measured in respiratory muscles from rates flown on board Space Shuttle mission STS-54. The results indicated that there was an increasing trend in citrate synthase activity in the flight diaphragm when compared to ground based controls, and there were no significant changes observed in the intercostal muscles for any of the parameters. However, the lipid peroxidation was significantly (p less than 0.05) decreased in the flight diaphragm. These results indicate that 6 day exposure to microgravity may have a different effect on oxidative and antioxidant activity in rat respiratory muscles when compared to data from previous 14 day hindlimb suspension studies.

  16. [Effectiveness of intercostal nerve block with ropivacaine in analgesia of patients undergoing emergency open cholecystectomy under general anesthesia].

    PubMed

    Vizcarra-Román, M A; Bahena-Aponte, J A; Cruz-Jarquín, A; Vázquez-García, Ja C; Cárdenas-Lailson, L E

    2012-01-01

    Postoperative pain after open cholecystectomy is associated with reduced respiratory function, longer recovery period before deambulation and oral food intake, and prolonged hospital stay. Intercostal nerve block provides satisfactory analgesia and ropivacaine is the most widely used local anesthetic agent in intercostal nerve block due to its excellent effectiveness, lower cardiovascular toxicity, and longer half-life. To evaluate intercostal nerve block effectiveness with ropivacaine in patients undergoing emergency open cholecystectomy under general anesthesia compared with conventional management. A controlled clinical trial was carried out on 50 patients undergoing open cholecystectomy, 25 patients without intercostal nerve block versus 25 patients with intercostal nerve block using ropivacaine at 0.5% combined with epinephrine. Intraoperative minimum alveolar concentration and inhalation anesthetic use were evaluated. Tramadol as rescue analgesic agent and pain were evaluated during immediate postoperative period by means of the Visual Analog Scale at 8, 16, and 24 hours. Mean inhalation anesthetic use was lower in the intercostal nerve block group with 13% vs 37% in the group without intercostal nerve block (p= 0.01). Rescue tramadol requirement was lower in the intercostal nerve block group than in the group without intercostal nerve block at 8 hours (8% vs 67%), 16 hours (0% vs 83%), and 24 hours (12% vs 79%) (p<0.0001). Visual Analog Scale for Pain results were similar in both groups. Intercostal nerve block reduces intraoperative inhalation anesthetic use, immediate postoperative pain, and tramadol intake as rescue analgesic agent in patients undergoing open cholecystectomy.

  17. Proceedings of the Space Surveillance Workshop (12th) Held in Lexington, Massachusetts on 5-7 April 1994. Volume 2

    DTIC Science & Technology

    1994-04-07

    Plane Unit Focal Plane Unit Filtr Wheel WFOV Ultraviolet Primary Mirror Tertiary Mirror SunshadeF•4 -A FocalPlnI Secondary Unit Filktr Wheel Mirror I...from UVISI pixel coordinates to spacecraft coordinates and passes them to the MSX flight processor, which performs Kalman filtering of other...to follow the target through extended data dropouts. A second method, the extended Kalman filter, bases its state propagation on underlying equations

  18. Posttraumatic Transdiaphragmatic Intercostal Hernia: Report of a Case and Review of the Literature

    PubMed Central

    Kalles, Vasileios; Dasiou, Maria; Doga, Georgia; Papapanagiotou, Ioannis; Konstantinou, Evangelos A; Mekras, Alexandros; Mariolis-Sapsakos, Theodoros; Anastasiou, Nikolaos

    2015-01-01

    Intercostal hernias are rare, and usually occur following injuries of the thoracic wall. The scope of this report is to present a case of a 53-year-old obese patient that developed a transdiaphragmatic intercostal hernia. The patient presented with a palpable, sizeable, reducible mass in the right lateral thoracic wall, with evident bowel sounds in the area, 6 months after a motor-vehicle accident. On computed tomography (CT), the hernia sac contained part of the liver and part of the ascending colon. A surgical repair of the defect was performed, using a prosthetic patch. The patient's postoperative course was uneventful and she remains recurrence free at 12 months after surgery. Intercostal hernias should be suspected following high-impact injuries of the thoracic wall, and CT scans will facilitate the diagnosis of intercostal hernia. We consider the surgical repair of the defect, with placement of a prosthetic mesh, as the treatment of choice to ensure a favorable outcome. PMID:25785325

  19. Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine

    PubMed Central

    Kobayashi, Hiroshi; Shinoda, Yusuke; Ohki, Takahiro; Kawano, Hirotaka

    2015-01-01

    An osteoblastoma is a benign bone lesion most commonly affecting the spine; it is frequently found in the posterior elements of the vertebra. When an osteoblastoma originates in the spine, it usually causes dull and localised dorsal pain, but the period between symptom development and diagnosis can be long. MRI shows intense peritumoural oedema accompanying the osteoblastoma. We present a case of a 15-year-old boy with osteoblastoma at the level of the T8–9 left laminae causing intercostal neuralgia without direct invasion to the intercostal nerve. Immediately after surgery, intercostal neuralgia was diminished. To our knowledge, this is the first case of an osteoblastoma with intercostal neuralgia, which is possibly the key symptom for diagnosing an osteoblastoma in the thoracic spine. PMID:26139654

  20. Use of intercostal nerves for different target neurotization in brachial plexus reconstruction

    PubMed Central

    Lykissas, Marios G; Kostas-Agnantis, Ioannis P; Korompilias, Ananstasios V; Vekris, Marios D; Beris, Alexandros E

    2013-01-01

    Intercostal nerve transfer is a valuable procedure in devastating plexopathies. Intercostal nerves are a very good choice for elbow flexion or extension and shoulder abduction when the intraplexus donor nerves are not available. The best results are obtained in obstetric brachial plexus palsy patients, when direct nerve transfer is performed within six months from the injury. Unlike the adult posttraumatic patients after median and ulnar nerve neurotization with intercostal nerves, almost all obstetric brachial plexus palsy patients achieve protective sensation in the hand and some of them achieve active wrist and finger flexion. Use in combination with proper muscles, intercostal nerve transfer can yield adequate power to the paretic upper limb. Reinnervation of native muscles (i.e., latissimus dorsi) should always be sought as they can successfully be transferred later on for further functional restoration. PMID:23878776

  1. Pain relief from preganglionic injury to the brachial plexus by late intercostal nerve transfer.

    PubMed

    Berman, J; Anand, P; Chen, L; Taggart, M; Birch, R

    1996-09-01

    We performed intercostal nerve transfer in 19 patients to relieve pain from preganglionic injury to the brachial plexus. The procedure was successful in 16 patients at a mean of 28.6 months (12 to 68) after the injury.

  2. Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine.

    PubMed

    Kobayashi, Hiroshi; Shinoda, Yusuke; Ohki, Takahiro; Kawano, Hirotaka

    2015-07-02

    An osteoblastoma is a benign bone lesion most commonly affecting the spine; it is frequently found in the posterior elements of the vertebra. When an osteoblastoma originates in the spine, it usually causes dull and localised dorsal pain, but the period between symptom development and diagnosis can be long. MRI shows intense peritumoural oedema accompanying the osteoblastoma. We present a case of a 15-year-old boy with osteoblastoma at the level of the T8-9 left laminae causing intercostal neuralgia without direct invasion to the intercostal nerve. Immediately after surgery, intercostal neuralgia was diminished. To our knowledge, this is the first case of an osteoblastoma with intercostal neuralgia, which is possibly the key symptom for diagnosing an osteoblastoma in the thoracic spine.

  3. Concomitant percutaneous treatment of aortic coarctation and associated intercostal aneurysms: pre-procedural recognition is key.

    PubMed

    Batlivala, Sarosh P; Rome, Jonathan J

    2016-02-01

    Intercostal aneurysms are associated with aortic coarctation. Their aetiology is not well-understood but may be related to intrinsic vascular pathology and altered flow dynamics through the intercostal artery. We present the cases of two patients with coarctation and intercostal aneurysms. The aneurysms were recognised on pre-catheterisation imaging studies and were selectively occluded during the same procedure to treat the coarctation. There were no complications; both the patients have no residual coarctation at the most recent follow-up. Intercostal aneurysms associated with coarctation can have significant consequences including late rupture, paralysis, and even death. These aneurysms are common with an incidence of up to 40% with adult-diagnosed coarctation; one treatment plan is to treat both the coarctation and aneurysm during a single catheterisation. Pre-catheterisation CT or MRI may play a role in this strategy.

  4. Posttraumatic transdiaphragmatic intercostal hernia: report of a case and review of the literature.

    PubMed

    Kalles, Vasileios; Dasiou, Maria; Doga, Georgia; Papapanagiotou, Ioannis; Konstantinou, Evangelos A; Mekras, Alexandros; Mariolis-Sapsakos, Theodoros; Anastasiou, Nikolaos

    2015-03-01

    Intercostal hernias are rare, and usually occur following injuries of the thoracic wall. The scope of this report is to present a case of a 53-year-old obese patient that developed a transdiaphragmatic intercostal hernia. The patient presented with a palpable, sizeable, reducible mass in the right lateral thoracic wall, with evident bowel sounds in the area, 6 months after a motor-vehicle accident. On computed tomography (CT), the hernia sac contained part of the liver and part of the ascending colon. A surgical repair of the defect was performed, using a prosthetic patch. The patient's postoperative course was uneventful and she remains recurrence free at 12 months after surgery. Intercostal hernias should be suspected following high-impact injuries of the thoracic wall, and CT scans will facilitate the diagnosis of intercostal hernia. We consider the surgical repair of the defect, with placement of a prosthetic mesh, as the treatment of choice to ensure a favorable outcome.

  5. 12th Annual Science and Engineering Technology Conference/DoD TECH Exposition

    DTIC Science & Technology

    2011-06-23

    SPAWAR CDR Will Hesse , USN (Ret) Scott Health & Safety Dr. Ed Hibsman SPAWAR Mr. Larry Hill CAS, Inc. Mrs. Cheryl Holbrook U.S. Army Space and Missile... Herman Rediess Science & Technology Directorate, DHS CAPT Brett Reissener, USN (Ret) Concurrent Technologies Corporation Ms. Denise Rhea-McKenzie Mission

  6. Comparative study of phrenic and intercostal nerve transfers for elbow flexion after global brachial plexus injury.

    PubMed

    Liu, Yuzhou; Lao, Jie; Zhao, Xin

    2015-04-01

    Global brachial plexus injuries (BPIs) are devastating events frequently resulting in severe functional impairment. The widely used nerve transfer sources for elbow flexion in patients with global BPIs include intercostal and phrenic nerves. The aim of this study was to compare phrenic and intercostal nerve transfers for elbow flexion after global BPI. A retrospective review of 33 patients treated with phrenic and intercostal nerve transfer for elbow flexion in posttraumatic global root avulsion BPI was carried out. In the phrenic nerve transfer group, the phrenic nerve was transferred to the anterolateral bundle of the anterior division of the upper trunk (23 patients); in the intercostal nerve transfer group, three intercostal nerves were coapted to the anterolateral bundles of the musculocutaneous nerve. The British Medical Research Council (MRC) grading system, angle of elbow flexion, and electromyography (EMG) were used to evaluate the recovery of elbow flexion at least 3 years postoperatively. The efficiency of motor function in the phrenic nerve transfer group was 83%, while it was 70% in the intercostal nerve transfer group. The two groups were not statistically different in terms of the MRC grade (p=0.646) and EMG results (p=0.646). The outstanding rates of angle of elbow flexion were 48% and 40% in the phrenic and intercostal nerve transfer groups, respectively. There was no significant difference of outstanding rates in the angle of elbow flexion between the two groups. Phrenic nerve transfer had a higher proportion of good prognosis for elbow flexion than intercostal nerve transfer, but the effective and outstanding rate had no significant difference for biceps reinnervation between the two groups according to MRC grading, angle of elbow flexion, and EMG. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Scoliosis Development in Identical Twins After Intercostal Thoracotomy for Pulmonary Artery Sling Correction

    PubMed Central

    Kaila, Rajiv; Blackman, Mark; Lehovsky, Jan

    2006-01-01

    We present a report on two monozygotic female twins who underwent a left-sided intercostal thoracotomy in the second month of life for pulmonary artery sling correction. Twenty-four years later, in adulthood, the identical twins had both developed right-sided thoracic scoliosis. No previous accounts of scoliosis development after intercostal thoracotomy for pulmonary artery sling correction have been reported. PMID:17059704

  8. Laparoscopic Liver Resection Using the Lateral Approach from Intercostal Ports in Segments VI, VII, and VIII.

    PubMed

    Inoue, Yoshihiro; Suzuki, Yusuke; Fujii, Kensuke; Kawaguchi, Nao; Ishii, Masatsugu; Masubuchi, Shinsuke; Yamamoto, Masashi; Hirokawa, Fumitoshi; Hayashi, Michihiro; Uchiyama, Kazuhisa

    2017-07-31

    Laparoscopic liver resection (LLR) has been developed as a minimally invasive surgery. However, challenges such as difficulty securing visibility and limited control of forceps make it difficult to complete LLR in hepatic segments VI, VII, and VIII. To overcome these challenges, we devised a surgical technique using intercostal ports. We termed this approach the lateral approach. This work describes our experience performing LLR using this approach and discusses the safety and effectiveness of this approach. Between April 2011 and December 2016, data from 91 patients who underwent LLR with or without the intercostal port at a single institution were retrospectively analyzed regarding surgical outcomes, safety, and utility. LLR was performed for 32 patients with the intercostal port and for 59 patients without the intercostal port. The conversion rates to open surgery with and without intercostal ports were 3.1 and 25.4% (P = 0.008). In hepatic segments VII and VIII, the rates of conversion to open surgery were significantly lower for cases involving intercostal ports (6.7 vs. 42.9 and 0 vs. 38.9%; P = 0.035 and 0026, respectively); however, there were no differences in hepatic segment VI (0 vs. 7.4%; P = 0.563). There were no differences in operative time, blood loss volume, surgical margin, curative resection rate, or postoperative complication rate for LLR in all segments (VI, VII, and VIII). No adverse events due to placement of the intercostal port were observed in this set of patients. LLR using the lateral approach and intercostal ports for hepatic segments VII and VIII resulted in a significant decrease in conversion rates to open surgery.

  9. Emergency embolization for the treatment of acute hemorrhage from intercostal arteries.

    PubMed

    Stampfl, Ulrike; Sommer, Christof-Matthias; Bellemann, Nadine; Kortes, Nikolas; Gnutzmann, Daniel; Mokry, Theresa; Gockner, Theresa; Schmitz, Anne; Ott, Katja; Kauczor, Hans-Ulrich; Radeleff, Boris

    2014-12-01

    To evaluate embolotherapy for the emergency management of acute bleeding from intercostal arteries. Between October 2003 and August 2012, 19 consecutive patients with hemorrhage from intercostal arteries were scheduled for emergency embolization. The primary study endpoints were technical and clinical success, which were defined as angiographic cessation of bleeding, and cessation of clinical signs of hemorrhage. The secondary study endpoints were periprocedural complications and 30-day mortality rate. In most patients (74 %), hemorrhage was caused by iatrogenic procedures with subsequent intercostal artery laceration. One of the patients was treated twice for recurrent hemothorax caused by a new intercostal artery pseudoaneurysm 7.5 years after the initial procedure. Thus, 20 procedures were performed in these 19 patients. Overall technical success was 85 %. In six patients, no embolization of the "backdoor" was feasible, and in two of these patients additional embolization of other intercostal arteries was necessary to prevent hemorrhage via collateral vessels. Clinical signs of hemorrhage ceased after embolotherapy in 16 of 20 procedures (clinical success 80 %). The mean follow-up was 358.7 ± 637.1 days. One minor procedure-related complication occurred. The 30-day mortality rate was 21 %, however, this was unrelated to intercostal artery hemorrhage. Embolotherapy is an effective emergency therapy for patients with acute hemorrhage from intercostal arteries. Especially if embolization of the backdoor is not feasible, collateral supply via other intercostal arteries should be either ruled out or embolized to prevent ongoing hemorrhage. Despite successful embolotherapy, a majority of patients underwent surgery during follow-up to remove the symptomatic hematoma.

  10. The posterior intercostal vein: a thermoregulatory gateway to the internal vertebral venous plexus.

    PubMed

    Hoogland, P V; Wessels, Q; Vorster, W; Groen, R J M; Wettstein, R; Greyling, L M; Kotzé, S H

    2013-09-01

    The internal vertebral venous plexus (IVVP) plays a putative role in thermoregulation of the spinal cord. Cold cutaneous venous blood may cool, while warm venous blood from muscles and brown fat areas may warm the spinal cord. The regulating mechanisms for both cooling and warming are still unknown. Warm venous blood mainly enters the IVVP via the intervertebral veins. In the thoracic area these veins are connected to the posterior intercostal veins. In this study, anatomical structures were investigated that might support the mechanisms by which warmed venous blood from the intercostal muscles and the recently described paravertebral patches of brown adipose tissue are able to drain into the vertebral venous plexus. Therefore, tissue samples from human cadavers (n = 21) containing the posterior intercostal vein and its connections to the IVVP and the azygos veins were removed and processed for histology. Serial sections revealed that the proximal parts of the posterior intercostal veins contained abundant smooth muscle fibers at their opening into the azygos vein. Furthermore, the walls of the proximal parts of the posterior intercostal veins contain plicae that allow the vessel to dilate, thereby allowing it to serve as a pressure chamber. It is suggested that a cold induced closure of the intercostal/azygos opening can result in retrograde blood flow from the proximal posterior intercostal vein towards the IVVP. This blood flow would be composed of warm blood from the paravertebral brown adipose tissue and blood containing metabolic heat from the muscles draining into the intercostal veins. Copyright © 2013 Wiley Periodicals, Inc.

  11. Early patency rate and fate of reattached intercostal arteries after repair of thoracoabdominal aortic aneurysms.

    PubMed

    Omura, Atsushi; Yamanaka, Katsuhiro; Miyahara, Shunsuke; Sakamoto, Toshihito; Inoue, Takeshi; Okada, Kenji; Okita, Yutaka

    2014-06-01

    The present study analyzes the early patency of intercostal artery reconstruction, using graft interposition and aortic patch anastomosis, and determines the fate of reattached intercostal arteries after repair of thoracoabdominal aortic aneurysms. We selected 115 patients (mean age, 63 ± 15 years; range, 19-83 years; male, n = 83) treated by thoracoabdominal aortic aneurysm repair with 1 or more reconstructed intercostal arteries at the Kobe University Graduate School of Medicine between October 1999 and December 2012. The intercostal arteries were reconstructed using graft interposition (n = 66), aortic patch anastomosis (n = 42), or both (n = 7). The hospital mortality rate was 7.8% (n = 9). Eleven patients (9.6%) developed spinal cord ischemic injury (permanent, n = 6, transient, n = 5). The average number of reconstructed intercostal arteries per patient was 3.0 ± 1.5 (1-7), and 345 intercostal arteries were reattached. The overall patency rate was 74.2% (256/345) and that of aortic patch anastomosis was significantly better than that of graft interposition (90.8% [109/120] vs 65.3% [147/225], P < .01), but significantly worse for patients with than without spinal cord ischemic injury (51.9% [14/27] vs 76.1% [242/318], P = .01). There was no patch aneurysm in graft interposition during a mean of 49 ± 38 (range, 2-147) postoperative months, but aortic patch anastomosis including 4 intercostal arteries became dilated in 2 patients. Aortic patch anastomosis might offer better patency rates and prevent spinal cord ischemic injury compared with graft interposition. Although aneurysmal changes in intercostal artery reconstructions are rare, large blocks of aortic wall reconstruction should be closely monitored. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  12. STEM development: A study of 6th--12th grade girls' interest and confidence in mathematics and science

    NASA Astrophysics Data System (ADS)

    Heaverlo, Carol Ann

    Researchers, policymakers, business, and industry have indicated that the United States will experience a shortage of professionals in the Science, Technology, Engineering, and Mathematics (STEM) fields. Several strategies have been suggested to address this shortage, one of which includes increasing the representation of girls and women in the STEM fields. In order to increase the representation of women in the STEM fields, it is important to understand the developmental factors that impact girls' interest and confidence in STEM academics and extracurricular programs. Research indicates that greater confidence leads to greater interest and vice versa (Denissen et al., 2007). This study identifies factors that impact girls' interest and confidence in mathematics and science, defined as girls' STEM development. Using Bronfenbrenner's (2005) bioecological model of human development, several factors were hypothesized as having an impact on girls' STEM development; specifically, the macrosystems of region of residence and race/ethnicity, and the microsystems of extracurricular STEM activities, family STEM influence, and math/science teacher influence. Hierarchical regression analysis results indicated that extracurricular STEM involvement and math teacher influence were statistically significant predictors for 6--12th grade girls' interest and confidence in mathematics. Furthermore, hierarchical regression analysis results indicated that the only significant predictor for 6--12th grade girls' interest and confidence in science was science teacher influence. This study provides new knowledge about the factors that impact girls' STEM development. Results can be used to inform and guide educators, administrators, and policy makers in developing programs and policy that support and encourage the STEM development of 6--12th grade girls.

  13. The canine parasternal and external intercostal muscles drive the ribs differently

    PubMed Central

    Troyer, André De; Wilson, Theodore A

    2000-01-01

    In the dog, the elevation of the ribs during inspiration results from the combined actions of the parasternal and external intercostal muscles. In the present studies, the hypothesis was tested that co-ordinated activity among these two sets of muscles reduces the distortion of the rib cage. During spontaneous inspiration before or after section of the phrenic nerves, the ribs moved cranially and outward in the same way as they did during passive inflation. However, whereas the sternum moved cranially during passive inflation, it was displaced caudally during spontaneous inspiration. When the parasternal intercostal muscles were selectively denervated, both the sternum and the ribs moved cranially, but the rib outward displacement was markedly reduced. In contrast, when the external intercostals were excised and the parasternal intercostals were left intact, the sternum continued to move caudally and the outward displacement of the ribs was augmented relative to their cranial displacement. These observations establish that the external intercostal muscles drive the ribs primarily in the cranial direction, whereas the parasternal intercostals drive the ribs both cranially and outward. They also indicate, in agreement with the hypothesis, that co-ordinated activity among these two sets of muscles displaces the ribs on their relaxation curve. However, this co-ordinated activity also displaces the sternum caudally. Although this distortion requires an additional energy expenditure, it enhances the outward component of rib displacement which is more effective with respect to lung expansion. PMID:10718756

  14. The Role of a Relative Age Effect in the 12th Winter European Youth Olympic Festival in 2015.

    PubMed

    Müller, Lisa; Hildebrandt, Carolin; Schnitzer, Martin; Raschner, Christian

    2016-04-01

    The aim of this study was to define the role of the relative age effect in the 12th Winter European Youth Olympic Festival 2015. The birth dates of all 899 participants and anthropometric data of 655 participants were analyzed. A significant relative age effect was present in the total sample and among the male athletes but not in the female athletes. Additionally, a significant relative age effect was present in strength- and endurance-related sports but not in technique-related sports. Statistically significantly more older athletes won medals. Relative age had a strong influence on participation in strength- and endurance-related sports as well as on performance.

  15. Texas Symposium on Relativistic Astrophysics, 12th, Jerusalem, Israel, December 17-21, 1984, Proceedings

    NASA Astrophysics Data System (ADS)

    Livio, M.; Shaviv, G.

    Papers are presented on cosmology, the early universe, particle physics, active galactic nuclei and jets, large-scale structures, general relativity, satellites, cosmic and gamma rays, numerical astrophysics, and the late stages of stellar evolution. Particular emphasis is given to the Hubble Space Telescope, strong pulsar waves, spinors and their symmetries, vacuum energy in cosmic dynamics, quantized magnetic Bremsstrahlung and gamma-ray bursts, image separation statistics for multiply imaged quasars, tensor manipulation, and Kaluza-Klein cosmologies. Also discussed are the distribution of gravitational energy and the microwave measurement of the galactic helium-3 abundance.

  16. The synaptic connexions to intercostal motoneurones as revealed by the average common excitation potential.

    PubMed

    Kirkwood, P A; Sears, T A

    1978-02-01

    1. The hypothesis is advanced that the joint occurrence of unitary e.p.s.p.s evoked in motoneurones by branches of common stem presynaptic fibres causes, on average, transient depolarization in one motoneurone at the time of discharge in another motoneurone of the same pool. 2. The hypothesis was tested in anaesthetized, paralysed cats by averaging the naturally occurring synpatic noise of thoracic inspiratory motoneurones with an averager triggered by spikes from other inspiratory motoneurones. These spikes were obtained as efferent discharges in nerve filaments supplying the proximal regions of the external intercostal muscles. 3. A transient depolarization centred around the time of the trigger spikes was consistently observed and was designated the average common excitation (a.c.e.) potential. 4. The peak depolarization lay between -1.0 and +4.6 msec (mean +0.7 msec) with respect to the trigger spikes and the rise times of its most prominent component ranged from 4 to 16 msec (mean 8.4 msec). 5. The amplitudes of the a.c.e. potentials ranged from 6 to 104 muV (mean 32 muV) when the trigger spikes were derived from a filament in the same segment as the relevant motoneurones, and from 3 to 42 muV (mean 19 muV) when the filament was two segments rostral to the motoneurone. 6. Cells innervating the proximal region of the intercostal space gave larger a.c.e. potentials than those innervating more distal regions and also showed larger central respiratory drive potentials. 7. A.c.e. potentials were observed for either alpha or gamma spikes as triggers. The potentials were usually smaller for the gamma than for the alpha spikes, the mean ration being about 0.6. The presence of the a.c.e. potentials from the gamma spikes was taken as evidence for alpha-gamma coactivation by common presynaptic axons. 8. A theory is developed which quantitatively accounts for the main features of both the a.c.e. potential and the short term synchrony observed by Sears & Stagg (1976). 9

  17. Measurement of neural respiratory drive via parasternal intercostal electromyography in healthy adult subjects.

    PubMed

    MacBean, V; Hughes, C; Nicol, G; Reilly, C C; Rafferty, G F

    2016-11-01

    Neural respiratory drive, quantified by the parasternal intercostal muscle electromyogram (EMGpara), provides a sensitive measure of respiratory system load-capacity balance. Reference values for EMGpara-based measures are lacking and the influence of individual anthropometric characteristics is not known. EMGpara is conventionally expressed as a percentage of that obtained during a maximal inspiratory effort (EMGpara%max), leading to difficulty in applying the technique in subjects unable to reliably perform such manoeuvres. To measure EMGpara in a large, unselected cohort of healthy adult subjects in order to evaluate relevant technical and anthropometric factors. Surface second intercostal space EMGpara was measured during resting breathing and maximal inspiratory efforts in 63 healthy adult subjects, median (IQR) age 31.0 (25.0-47.0) years, 28 males. Detailed anthropometry, spirometry and respiratory muscle strength were also recorded. Median (IQR EMGpara was 4.95 (3.35-6.93) µV, EMGpara%max 4.95 (3.39-8.65)% and neural respiratory drive index (NRDI, the product of EMGpara%max and respiratory rate) was 73.62 (46.41-143.92) %.breath/min. EMGpara increased significantly to 6.28 (4.26-9.93) µV (p  <  0.001) with a mouthpiece, noseclip and pneumotachograph in situ. Median (IQR) EMGpara was higher in female subjects (5.79 (4.42-7.98) µV versus 3.56 (2.81-5.35) µV, p  =  0.003); after controlling for sex neither EMGpara, EMGpara%max or NRDI were significantly related to anthropometrics, age or respiratory muscle strength. In subjects undergoing repeat measurements within the same testing session (n  =  48) or on a separate occasion (n  =  19) similar repeatability was observed for both EMGpara and EMGpara%max. EMGpara is higher in female subjects than males, without influence of other anthropometric characteristics. Reference values are provided for EMGpara-derived measures. Expressing EMGpara as a percentage of maximum confers no

  18. Molecular typing for HLA class I using ARMS-PCR: further developments following the 12th International Histocompatibility Workshop.

    PubMed

    Tonks, S; Marsh, S G; Bunce, M; Bodmer, J G

    1999-02-01

    Molecular typing for HLA class I was introduced in the 12th International Histocompatibility Workshop. Following a pilot study using three methods, sequence specific oligotyping (SSO), reverse dot blot and amplification refractory mutation system (ARMS)-PCR, the ARMS-PCR method was selected for use. A great advantage of an ARMS-PCR method is that, unlike the other two methods, it can determine whether sequence motifs are in cis or in trans, as ARMS-PCR detects two cis located motifs per reaction using forward and reverse sequence specific primers. Resolution was designed to be low to medium level for HLA-A, -B and -C alleles. Two hundred and fifty class I kits and 83 HLA-A2 subtyping kits were distributed. The A2 subtyping kit used a two round nested PCR system to identify all of the A2 alleles known at the time. Typing results on control DNA samples distributed with both the kits showed a very satisfactory performance. Since the 12th Workshop, the kits have been developed with the addition of new primers and primer mixes to increase the resolution of the test.

  19. The impact of home computers on 12th grade students' achievement in the computer science curriculum in Riyadh, Saudi Arabia

    NASA Astrophysics Data System (ADS)

    Aljuwaiber, Mohammed A.

    Technology has improved many educational issues. This is a very exciting time for technology and education. The primary purpose of this study was aimed at understanding the impact of home computer use on academic achievement in the computer curriculum of the 12th grade students in Riyadh, Kingdom of Saudi Arabia. In particular, the study attempted to determine if the use of home computers would be an effective manner for increasing students' academic achievement. The participants of the study were 240 male and female students as a random sample from 12th grade from eight random high schools in Riyadh, Saudi Arabia. An achievement exam and survey were developed by the researcher based on the computer science curriculum topics, the quantitative data was collected in both a single achievement exam and a single survey from a sample of 240 Saudi high school students. Both the survey and an achievement exam were split equally between male and female students. The study sought the answer to 10 questions. Analysis of variance (ANOVA), followed by tests of simple main effects and post hoc comparisons using Scheffe, as well as Pearson Correlation were conducted to answer the research questions. The study results pointed out that home computers were important to support the students in their academic achievement in the computer science curriculum. Therefore, more attention must be given to the use of home computers for all students. Moreover, we should attempt to treat the difficulties which students face for getting computers in their homes.

  20. A randomized, double-blinded, placebo-controlled trial of intercostal nerve block after percutaneous nephrolithotomy.

    PubMed

    Honey, R John D'A; Ghiculete, Daniela; Ray, A Andrew; Pace, Kenneth T

    2013-04-01

    The optimal method of pain control after percutaneous nephrolithotomy (PCNL) remains controversial. We sought to determine whether intercostal nerve block with bupivicaine provided superior pain control, when compared with placebo, with a lower need for narcotics and improved health-related quality of life (HRQL) in the immediate postoperative period. Sixty-three patients were randomized to receive intercostal blockade with either 20 mL of 0.5% bupivacaine with epinephrine or 20 mL physiologic saline. All patients received intravenous narcotic patient-controlled analgesia (PCA) postoperatively. Data were collected on stone parameters, demographics, analgesic usage, length of stay, and HRQL as assessed by the Postoperative Recovery Scale. The mean age was 47.7±1.2 years; mean body mass index was 28.0±5.0 kg/m(2); mean stone diameter was 29.2±15.8 mm. Within the first 3 to 6 hours after surgery, there was a significant reduction in narcotic use for the group receiving intercostal nerve blockade with bupivacaine compared with placebo. At 3 hours, narcotic use was 2.4±3.1 mg vs 4.3±3.8 mg morphine equivalents (P=0.034), and within 6 hours of surgery, narcotic use was 5.9±6.1 mg vs 8.8±7.4 mg (P=0.096). Durable improvement in HRQL was also observed in patients receiving intercostal nerve blockade with bupivacaine compared with placebo (P=0.034). No complications were attributable to the intercostal nerve blocks in either group. Intercostal blockade with bupivacaine significantly improves both pain control and HRQL in the early postoperative period. The effectiveness of bupivacaine disappears within 6 hours of surgery, after which narcotic use becomes indistinguishable. Intercostal nerve blockade is an easy, safe, and inexpensive method that can be used to optimize pain control after PCNL.

  1. Extreme Binge Drinking among 12th-Grade Students in the U.S.: Prevalence and Predictors

    PubMed Central

    Patrick, Megan E.; Schulenberg, John E.; Martz, Meghan E.; Maggs, Jennifer L.; O’Malley, Patrick M.; Johnston, Lloyd

    2013-01-01

    Importance The prevalence of underage alcohol use has been studied extensively but binge drinking among youth in the U.S. is not yet well understood. In particular, adolescents may drink much larger amounts than the threshold (5 drinks) often used in definitions of binge drinking. Delineating various levels of binge drinking, including extreme levels, and understanding predictors of such extreme binge drinking among adolescents will benefit public health efforts. Objective To examine the prevalence and predictors of 5+ binge drinking and of 10+ and 15+ extreme binge drinking among 12th graders in the U.S. Design A non-clinical nationally representative sample. Setting High school seniors in the annual Monitoring the Future study between 2005 and 2011. Participants The sample included 16,332 12th graders (modal age 18) in the U.S. Response rates were 79–85%. Main Outcome Measures Prevalence of consuming 5+, 10+, and 15+ drinks in a row in the past two weeks. Results Between 2005 and 2011, 20.2% of high school seniors reported 5+ binge drinking, 10.5% reported 10+ extreme binge drinking, and 5.6% reported 15+ extreme binge drinking in the past 2 weeks. Rates of 5+ binge drinking and 10+ extreme binge drinking have declined since 2005, but rates of 15+ extreme binge drinking have not. Students with college-educated parents were more likely to consume 5+ drinks but less likely to consume 15+ drinks than students whose parents were not college educated. Students from more rural areas were more likely than students from large metropolitan areas to drink 15+ drinks. Socializing with substance-using peers, number of evenings out with friends, substance-related attitudes, and other substance use (cigarettes, marijuana) predicted all three levels of binge and extreme binge drinking. Conclusions Binge drinking at the traditionally defined 5+ drinking level was common among high school seniors representative of all 12th graders in the contiguous U.S. A significant segment of

  2. Mass and fat infiltration of intercostal muscles measured by CT histogram analysis and their correlations with COPD severity.

    PubMed

    Park, Mi Jung; Cho, Jae Min; Jeon, Kyung Nyeo; Bae, Kyung Soo; Kim, Ho Cheol; Choi, Dae Seob; Na, Jae Boem; Choi, Ho Cheol; Choi, Hye Young; Kim, Ji Eun; Shin, Hwa Seon

    2014-06-01

    Chronic obstructive pulmonary disease (COPD) is characterized by progressive respiratory function impairment and respiratory muscle dysfunction. We hypothesized that the mass and fat infiltration of respiratory muscles correlates with COPD severity and emphysema extent. Ninety-eight male patients with COPD underwent chest computed tomography (CT) and spirometry. The mass and fat infiltrations of intercostal and latissimus muscles were quantified as the cross-sectional area (CSA) and attenuation of these muscles using CT histogram analysis. Intercostal index and latissimus index were defined as intercostal CSAs and latissimus CSAs divided by body mass index. The emphysema extent was measured as the ratio of the emphysematous lung volume to the total lung volume using a density-mask technique. Pearson correlation analyses were performed to evaluate the relationships between these parameters. Multiple regression analysis was performed using forced expiratory volume in 1 second (FEV1) as the dependent parameter and the clinical and CT data as the independent parameters. FEV1 was significantly correlated with intercostal index (r = 0.57), latissimus index (r = 0.34), intercostal attenuation (r = 0.62), and latissimus attenuation (r = 0.38). Emphysema extent was significantly correlated with intercostal index (r = -0.36) and intercostal attenuation (r = -0.50). Multiple regression analysis showed that FEV1 was predicted by intercostal attenuation (B = 0.40), intercostal CSA (B = 0.23), emphysema extent (B = -0.23), and age (B = -0.21, R(2) = 0.64, P < .001). A decrease in intercostal mass and an increase in intercostal fat are associated with worsening of COPD severity. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  3. Simultaneous intercostal nerve transfers to deltoid and triceps muscle through the posterior approach.

    PubMed

    Malungpaishrope, Kanchai; Leechavengvongs, Somsak; Witoonchart, Kiat; Uerpairojkit, Chairoj; Boonyalapa, Artit; Janesaksrisakul, Disorn

    2012-04-01

    This study reports the results of restoring the deltoid and triceps functions in patients with C5, C6, and C7 root avulsion injuries by simultaneously transferring 4 intercostal nerves to the anterior axillary nerve and the nerve to the long head of the triceps through the posterior approach. Nine patients with C5, C6, and C7 root avulsion injuries underwent spinal accessory nerve transfer to the suprascapular nerve combined with transfer of the third and fourth intercostal nerves to the anterior axillary nerve for shoulder reconstruction. Simultaneous transfer of the fifth and sixth intercostal nerves to the radial nerve branch of the triceps was done to restore elbow extension. For shoulder function, 8 patients had M4 recovery and 1 patient had M2 recovery. Average shoulder abduction and external rotation were 69° and 42°, respectively. For elbow extension, 3 patients achieved M3 recovery, 5 patients had M2 recovery, and 1 patient had M1 recovery. Reconstruction of 2 muscles with intercostal nerves is possible when both muscles act synergistically, such as shoulder abduction and elbow extension. Two intercostal nerves are adequate to transfer for deltoid reconstruction but not enough for elbow extension against gravity. Therapeutic IV. Copyright © 2012. Published by Elsevier Inc.

  4. Rib Composite Flap With Intercostal Nerve and Internal Thoracic Vessels for Mandibular Reconstruction

    PubMed Central

    Zhang, Bin; Li, Ke-Yi; Jiang, Li-Cheng; Meng, Zhen; Wang, Xiu-Mei; Cui, Fu-Zhai; Zhu, Ying-Nan; Wu, Ya-Ping

    2016-01-01

    Purpose: The purpose of this study was to present the outcome and discuss the feasibility of rib composite flap with intercostal nerve and internal thoracic vessels for reconstructing mandibular defect. Methods: Rib composite flaps have been used in 82 patients for reconstructing benign tumor-caused large mandibular defects: 66 of the 82 patients were reconstructed using rib composite flap with intercostal nerve and internal thoracic vessels, whereas the other 16 patients were reconstructed using rib composite flap with internal thoracic vessels, without intercostal nerve. After operation, clinical observation, imageological examination, and sensory detection were used to evaluate the effect of reconstruction. Results: All rib composite flaps with intercostal nerve and internal thoracic vessels were successfully harvested and transplanted. Both immediate and long-term examination showed good appearance reconstruction. All followed-up patients conveyed good satisfaction degree with function and appearance reconstruction. Postoperative panoramic x-ray examination showed new bone formation between the transplanted rib and mandibular stump. Good recoveries of mandibular nerve sensory were observed when followed up after reconstruction surgery. Conclusions: Rib composite flap with intercostal nerve and internal thoracic vessels could be a promising method for reconstruction of mandibular defects. PMID:27564074

  5. Rib Composite Flap With Intercostal Nerve and Internal Thoracic Vessels for Mandibular Reconstruction.

    PubMed

    Zhang, Bin; Li, Ke-Yi; Jiang, Li-Cheng; Meng, Zhen; Wang, Xiu-Mei; Cui, Fu-Zhai; Zhu, Ying-Nan; Wu, Ya-Ping

    2016-10-01

    The purpose of this study was to present the outcome and discuss the feasibility of rib composite flap with intercostal nerve and internal thoracic vessels for reconstructing mandibular defect. Rib composite flaps have been used in 82 patients for reconstructing benign tumor-caused large mandibular defects: 66 of the 82 patients were reconstructed using rib composite flap with intercostal nerve and internal thoracic vessels, whereas the other 16 patients were reconstructed using rib composite flap with internal thoracic vessels, without intercostal nerve. After operation, clinical observation, imageological examination, and sensory detection were used to evaluate the effect of reconstruction. All rib composite flaps with intercostal nerve and internal thoracic vessels were successfully harvested and transplanted. Both immediate and long-term examination showed good appearance reconstruction. All followed-up patients conveyed good satisfaction degree with function and appearance reconstruction. Postoperative panoramic x-ray examination showed new bone formation between the transplanted rib and mandibular stump. Good recoveries of mandibular nerve sensory were observed when followed up after reconstruction surgery. Rib composite flap with intercostal nerve and internal thoracic vessels could be a promising method for reconstruction of mandibular defects.

  6. Chest tube insertion is one important factor leading to intercostal nerve impairment in thoracic surgery.

    PubMed

    Miyazaki, Takuro; Sakai, Tetsuya; Yamasaki, Naoya; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Tagawa, Tsutomu; Hatachi, Go; Tomoshige, Koichi; Mine, Mariko; Nagayasu, Takeshi

    2014-01-01

    Chest tube insertion seems to be one important factor leading to intercostal nerve impairment. The purpose of this prospective study was to objectively evaluate intercostal nerve damage using current perception threshold testing in association with chest tube insertion. Sixteen patients were enrolled in this study. Intercostal nerve function was assessed with a series of 2000-Hz (Aβ fiber), 250-Hz (Aδ fiber), and 5-Hz (C fiber) stimuli using current perception threshold testing (Neurometer CPT/C(®)). Current perception threshold values at chest tube insertion were measured before surgery, during chest tube insertion and after removal of the chest tube. Intensities of ongoing pain were also assessed using a numeric rating scale (0-10). Current perception thresholds at each frequency after surgery were significantly higher than before surgery. Numeric rating scale scores for pain were significantly reduced from 3.3 to 1.9 after removal of the chest tube (p = 0.004). The correlation between current perception threshold value at 2000 Hz and intensity of ongoing pain was marginally significant (p = 0.058). This is the first study to objectively evaluate intercostal nerve damage at chest tube insertion. The results confirmed that chest tube insertion has clearly deleterious effects on intercostal nerve function.

  7. Family support for physical activity in girls from 8th to 12th grade in South Carolina

    PubMed Central

    Dowda, Marsha; Dishman, Rod K.; Pfeiffer, Karin A.; Pate, Russell R.

    2007-01-01

    Objective To examine the relationship between perceived family support and other selected correlates of physical activity (PA) with changes in PA over time. Methods A total of 421 girls in South Carolina completed questionnaires at 8th, 9th and 12th grades (1998–2003). Family support for PA, PA self-efficacy, perceived behavioral control, attitudes, availability of equipment, and PA were measured. Results Growth curve analysis showed that family support, perceived behavioral control, and self-efficacy were independently related to age-related changes in PA as reflected by total METs. Girls who reported lower family support at the 8th grade measure had more rapid declines in PA, and a unit change in family support was related to approximately 1/3 of a standard deviation change in total METs. Conclusions Maintenance of support from family members may reduce the decline in PA independent of girl’s self-efficacy and perceived behavioral control. PMID:17157371

  8. 12th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals: susceptibility to environmental hazards.

    PubMed Central

    Barrett, J C; Vainio, H; Peakall, D; Goldstein, B D

    1997-01-01

    The 12th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC) considered the topic of methodologies for determining human and ecosystem susceptibility to environmental hazards. The report prepared at the meeting describes measurement of susceptibility through the use of biological markers of exposure, biological markers of effect, and biomarkers directly indicative of susceptibility of humans or of ecosystems. The utility and validity of these biological markers for the study of susceptibility are evaluated, as are opportunities for developing newer approaches for the study of humans or of ecosystems. For the first time a SGOMSEC workshop also formally considered the issue of ethics in relation to methodology, an issue of particular concern for studies of susceptibility. PMID:9255554

  9. The effect of trade books on the environmental literacy of 11th and 12th graders in aquatic science

    NASA Astrophysics Data System (ADS)

    Lewis, Ann S.

    The purpose of this study was to compare the environmental literacy of 11th and 12th graders who participated in an eighteen-week environmental education program using trade books versus 11 th- and 12th-graders who participated in an eighteen-week, traditional environmental education program without the use of trade books. This study was conducted using a quasi-experimental research technique. Four high school aquatic science classes at two suburban high schools were used in the research. One teacher at each high school taught one control class and one experimental class of aquatic science. In the experimental classes, four trade books were read to the classes during the eighteen-week semester. These four books were selected by the participating teachers before the semester began. The books used were A Home by the Sea, Sea Otter Rescue, There's a Hair in My Dirt, and The Missing Gator of Gumbo Limbo. The instrument used to measure environmental literacy was the Children's Environmental Attitude and Knowledge Scale. This test was given at the beginning of the semester and at the end of the semester. The scores at the end of the semester were analyzed by 2 x 2 mixed model ANOVA with the teacher as the random effect and the condition (trade books) as the fixed effect. The statistical analysis of this study showed that the students in the experimental classes did not score higher than the control classes on the Children's Environmental Attitude and Knowledge Scale or on a subset of "water" questions. Several limitations were placed on this research. These limitations included the following: (1) a small number of classes and a small number of teachers, (2) change from the original plan of using environmental science classes to aquatic science classes, (3) possible indifference of the students, and (4) restrictive teaching strategies of the teachers.

  10. Topography of four different endodontic rotary systems, before and after being used for the 12th time.

    PubMed

    Yamazaki-Arasaki, Andréa; Cabrales, Ricardo; Santos, Marcelo dos; Kleine, Brígida; Prokopowitsch, Igor

    2012-01-01

    Root canal preparation may damage NiTi instruments resulting in wear and deformation. The aim of this study was to make a comparative evaluation of the surface topography of the cervical third of four different rotary systems, before and after being used twelve times, in 1.440 resin blocks with simulated root canals with standardized 45° curvatures, and analyzed by atomic force microscopy AFM. The blocks were divided into four groups and prepared according to the manufacturers recommendations: Group 1--K3®; Group 2--Protaper Universal®; Group 3--Twisted Files® and Group 4--Biorace®. After each preparation, the instruments were washed and autoclaved. A total of 240 instruments were selected, being 30 new instruments and 30 after having been used for the 12th time, from each group. These instruments were analyzed by AFM and for quantitative evaluation, the mean RMS (Root mean square) values of the cervical third of the specimens from the four groups were used. The result showed that all the rotary files used for the 12th time suffered wear with change in the topography of the cervical region of the active portion of the file (ANOVA p < 0.01). Classifying the specimens in increasing order, from the least to the greatest wear suffered, Group 3 (2.8993 nm) presented the least wear, followed by Group 4 (12.2520 nm), Group 1 (36.0043 nm) and lastly, Group 2 (59.8750 nm) with the largest amount of cervical surface wear.

  11. A spontaneous intercostal artery hemorrhage in systemic lupus erythematosus.

    PubMed

    Lu, Chun-Chi; Chen, Chen-Hung; Yeh, Song-Feng; Lai, Jenn-Haung; Chang, Deh-Ming

    2012-03-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that can lead to damage to several vital organs. Antiphospholipid syndrome (APS), manifesting as vascular thromboembolic events and morbidities of pregnancy in the presence of antiphospholipid antibodies (aPL), has been described in patients with SLE. Catastrophic antiphospholipid syndrome (CAPS), in contradistinction to APS, is defined as three or more organs affected by thrombotic microangiopathy in patients demonstrating aPL and can result in mortality up to 50%. We describe a unique SLE patient who was diagnosed with recurrent APS presented with axillary venous thrombosis and subsequent superficial edema and compartment syndrome. The CAPS followed and revealed thromboses over liver, spleen, and acute pancreatitis. The spontaneous hemorrhage of left fourth intercostal artery (ICA) and left axillary artery occured at the same time without vasculitis or severe trauma. Though emergency transcatheter arterial embolization (TAE) of the left fourth ICA was successfully accomplished by the radiologist. The repeated computed tomography angiogram of chest demonstrated remission of ruptured ICA. Nevertheless, the patient died of diffuse alveolar hemorrhage and respiratory failure and shock. Both disseminated intravascular coagulation (DIC) and CAPS share similar characteristics encompassing thrombotic microangiopathy, bleeding, thromboembolism, and multiple organ dysfunction. It is difficult to distinguish between them, especially in cases such as our uremic SLE patient with a calamitous disease progression. The emphasis of treatment for DIC is on platelet and fresh plasma transfusion, in contrast with anti-coagulant for CAPS. To the best of our knowledge, this is the first report describing ICA hemorrhage in an SLE patient without vasculitis or aneurysm. The lupus flare initiated a pathological immunological cascade and resulted in the CAPS and the vascular damage.

  12. Dissection of intercostal nerves by means of assisted video thoracoscopy: experimental study

    PubMed Central

    2013-01-01

    In total brachial plexus preganglionic lesions (C5-C6-C7-C8 and T1) different extraplexual neurotizations are indicated for partial motor function restitution. Mostly for the flexion of the elbow. Neurotization with intercostal nerves (ICN) to musculocutaneous nerve has been known and accepted during many years with different results 2 - 5. The customary technique as described by various authors is carried out by means of a large submammary incision to harvest three or four intercostal nerves (Figure 1). Then are connected by direct suture or grafts to the musculocutaneous nerve or its motor branches 6 - 7. In this article the authors described the possibility of dissection intercostal nerves by means of assisted video thoracoscopy. (VATS-videdo assisted thoracic surgery). PMID:23406448

  13. Demonstration of the course of the posterior intercostal artery on CT angiography: relevance to interventional radiology procedures in the chest.

    PubMed

    Dewhurst, Catherine; O'Neill, Siobhan; O'Regan, Kevin; Maher, Michael

    2012-01-01

    To document the course of the posterior intercostal artery (PIA) within the intercostal space (IS) in vivo using computed tomography angiography (CTA). A review of 428 IS from CTA of the chest was performed. Using multiplanar reconstruction (MPR) algorithms, the course of the PIA within the IS and the maximum distance of the PIA from the undersurface of the rib were determined in the 4th to 8th IS at three clinically relevant points: the posterior paravertebral area (PPV), angle of the rib (AR), and 25 mm lateral to the angle of the rib (LAR). Tortuosity of the vessels was graded from coronal three-dimensional images. The mean maximum distances of the PIA within the IS from the undersurface of the rib were as follows: PPV, 7.2±0.512 mm (P = 0.0027); AR, 5.5±0.535 mm (P = 0.0487); and LAR, 2.3±0.366 mm (P = 0.0052). At the PPV, the PIA lies halfway between the two ribs within the IS and lies one third of the way from the undersurface of the rib at the AR and comes to lie within the subcostal groove toward the mid-axillary line. The tortuosity of the vessel was highly variable and was independent of both age and gender. Considerable variability in vessel position was noted within the IS, with the PIA lying furthest from the undersurface of the rib in the PPV. To avoid injury, our data support the dictum "choose a site above the rib below," and additional caution should be taken to avoid the posterior paravertebral area.

  14. A new intercostal artery management strategy for thoracoabdominal aortic aneurysm repair.

    PubMed

    Mell, Matthew W; Wynn, Martha M; Reeder, Scott B; Tefera, Girma; Hoch, John R; Acher, Charles W

    2009-06-01

    The purpose of this study is to describe a new approach for addressing the intraoperative management of intercostal arteries during thoracoabdominal aortic aneurysm (TAAA) repair, using preoperative spinal MRA for detection of intercostal arteries supplying the anterior spinal artery. Patients undergoing TAAA repair from August 2005 to September 2007 were included. Spinal artery MRA was performed to identify the anterior spinal artery, the artery of Adamkiewicz, and its major intercostal source artery (SA-AAK). Intraoperative spinal cord protection was carried out using standard techniques. Important intercostal arteries were either preserved or reimplanted as a button patch after removing aortic clamps. Demographic and perioperative data were collected for review. Analysis was performed with Fisher's exact test or Student's t-test, where applicable, using SAS ver. 8.0 (Cary, NC). Spinal artery MRA was performed in 27 patients. The SA-AAK was identified in 85% of preoperative studies. Open or endovascular repair was performed in 74% and 26% of patients, respectively. The SA-AAK was preserved or reimplanted in 13 (65%) of patients who underwent open repair. A mean of 1.67 (range 1-3) intercostal arteries were reimplanted. All patients undergoing endovascular repair necessitated coverage of the SA-AAK. No patient developed immediate or delayed paraplegia. Longer mean operative times in the reimplanted cohort were not statistically significant (330 versus 245 min, P = 0.1). The SA-AAK identified by MRA can be preserved or safely reimplanted after TAAA repair. Further study is warranted to determine if selective intercostal reimplantation can reduce the risk of immediate or delayed paraplegia.

  15. Correlation and interventional embolization therapy of posterior intercostal arteries-induced hemoptysis.

    PubMed

    Chen, Y P; Chen, Y G; Jiang, F; Chen, J M

    2014-06-09

    The incidence of posterior intercostal arteries-induced hemoptysis, its correlation with primary diseases, and the value of interventional embolization therapy were investigated. Clinical data, multislice spiral computed tomography (MSCT), digital subtraction angiography (DSA), and other imaging data of 143 cases of hemoptysis were retrospectively analyzed. After the offending vessels were subjected to interventional embolization therapy, patients were followed-up for observations of clinical efficacies and complications. Thirty-one patients (21.7%) showed 65 branches of posterior intercostal arteries as the non-bronchial systemic arteries involved in hemoptysis; pleural thickening was evident in 25 (80.6%) cases. Posterior intercostal arteries-induced hemoptysis was observed in 16 of the 27 (59.3%) patients with pulmonary tuberculosis, and in 9 of the 10 (90.0%) patients with pulmonary tuberculosis and pulmonary damage. Posterior intercostal arteries-induced hemoptysis was correlated to pleural thickening (P<0.05), which differed significantly among different underlying diseases (P<0.05). Twenty-eight cases of 58 branches of posterior intercostal arteries were found to be involved in hemoptysis by preoperative chest CT angiogram (CTA); the intraoperative matching rates were 90.3% (28/31) and 89.2% (58/65), respectively. Thirty-one patients received transcatheter arterial embolization (TAE), of which 29 (93.5%) showed immediate hemostasis; 1 case had surgical treatment for ineffectuality, and 2 cases showed recurrence without serious complications. The posterior intercostal arteries were commonly involved in hemoptysis, and were closely associated with pleural thickening and pulmonary tuberculosis, especially when accompanied by pulmonary damage. Complete TAE could improve the treatment effect of hemoptysis and preoperative chest CTA was helpful for interventional embolization therapy.

  16. The use of a multi-method approach to identify the pigments in the 12th century manuscript Liber Floridus

    NASA Astrophysics Data System (ADS)

    Deneckere, A.; De Reu, M.; Martens, M. P. J.; De Coene, K.; Vekemans, B.; Vincze, L.; De Maeyer, Ph.; Vandenabeele, P.; Moens, L.

    2011-10-01

    A selection of illuminations of the 12th century manuscript Liber Floridus was analysed with Raman spectroscopy (in situ and laboratory measurements), X-ray fluorescence spectroscopy, UV-fluorescence photography and infrared reflectography (IRR). The aim of this study is to determine the pigments used, in order to search for anachronisms. Using a combination of Raman spectroscopy (molecular information) and X-ray fluorescence spectroscopy (elemental information) following pigments could be identified: ultramarine (Na 8-10Al 6Si 6O 24S 2-4), azurite (2CuCO 3·Cu(OH) 2), caput mortuum (Fe 2O 3), vermilion (HgS), orpiment (As 2S 3) and lead white (2PbCO 3·Pb(OH) 2). Moreover, two synthetic red pigments, PR4 and PR176, and a degradation product, gypsum (CaSO 4·2H 2O), were present in the manuscript. To establish the origin of the modern materials UV-fluorescence photography was used. Infrared reflectography (IRR) was applied to visualise the underdrawing of the investigated folios.

  17. In Japanese, there is no word for abstinence. Report from the 12th World Congress of Sexology.

    PubMed

    Haffner, D W

    1995-01-01

    The 12th World Congress of Sexology took place in August 1995 in Japan under the sponsorship of the World Association for Sexology, a conglomerate of 60 member organizations representing 25 countries. The conference focused on sexuality education, and participants from around the world recounted how sexuality education and sexual rights are being politicalized in their countries. Sexuality professionals world-wide look to US professionals for information about effective programs, resources, and research, but the US has a great deal to learn from countries such as those in Scandinavia which have extremely low levels of unplanned pregnancy or sexually transmitted diseases as a result of their commitment to sexuality education and services for young people. During the Congress, debates centered around whether the nature of sexuality is a social construct or is innate and universal. The biological nature of sexuality was explored, and reports of sexuality surveys from around the world revealed surprisingly similar patterns of behavior. Homosexuality emerged as the issue most shaped by culture. In some countries, male same-sex behavior is recognized without being categorized into a separate identity. Terminology for sex behavior also differs across cultures. For example, there is no word for "abstinence" in Japanese or in Swedish. Conference participants were urged to exchange information, expand their work in sex education to "sexuality" education, evaluate their efforts, educate themselves and others, and encourage reforms to assure sexuality education and sexual rights.

  18. "Explosive volcanic activity at Mt. Yasur: A characterization of the acoustic events (9-12th July 2011)"

    NASA Astrophysics Data System (ADS)

    Spina, Laura; Taddeucci, Jacopo; Cannata, Andrea; Gresta, Stefano; Lodato, Luigi; Privitera, Eugenio; Scarlato, Piergiorgio; Gaeta, Mario; Gaudin, Damien; Palladino, Danilo Mauro

    2016-08-01

    Volcanic processes occur in a wide range of temporal and spatial scales. However, a key step of magma ascent is recognizable in the dynamics of gas and magma in the shallow plumbing system, where volatiles play a fundamental role in controlling the eruptive style. With the aim of investigating shallow degassing processes, an experimental setup was deployed at Mt. Yasur, an active volcano located in Tanna Island (Vanuatu arc), from 9th to 12th July 2011. The setup comprised high-speed and thermal cameras, as well as a microphone, capable of recording both in the infrasonic and audible range. The analysis of acoustic signals, validated by observing images from the high-speed and thermal cameras, has enabled characterizing the explosive activity during the investigated period. Two types of explosions, distinct for spectral features and waveforms, were observed: (i) minor events, corresponding to small overpressurized bursts, occurring almost continuously; (ii) major events, characterizing the Strombolian activity at Mt. Yasur. By investigating variation in the occurrence rate of the minor events, we found that, on a short timescale, the dynamics responsible for the two types of explosions are decoupled. These results, together with previous literature data, bring additional evidence of the existence of distinct sources of degassing. Finally, major events can be distinguished as emergent events, i.e. long-lasting signals, corresponding to ash-rich explosions, and impulsive events, featuring shorter duration and larger amplitude.

  19. The use of a multi-method approach to identify the pigments in the 12th century manuscript Liber Floridus.

    PubMed

    Deneckere, A; De Reu, M; Martens, M P J; De Coene, K; Vekemans, B; Vincze, L; De Maeyer, Ph; Vandenabeele, P; Moens, L

    2011-10-01

    A selection of illuminations of the 12th century manuscript Liber Floridus was analysed with Raman spectroscopy (in situ and laboratory measurements), X-ray fluorescence spectroscopy, UV-fluorescence photography and infrared reflectography (IRR). The aim of this study is to determine the pigments used, in order to search for anachronisms. Using a combination of Raman spectroscopy (molecular information) and X-ray fluorescence spectroscopy (elemental information) following pigments could be identified: ultramarine (Na(8-10)Al(6)Si(6)O(24)S(2-4)), azurite (2CuCO(3)·Cu(OH)(2)), caput mortuum (Fe(2)O(3)), vermilion (HgS), orpiment (As(2)S(3)) and lead white (2PbCO(3)·Pb(OH)(2)). Moreover, two synthetic red pigments, PR4 and PR176, and a degradation product, gypsum (CaSO(4)·2H(2)O), were present in the manuscript. To establish the origin of the modern materials UV-fluorescence photography was used. Infrared reflectography (IRR) was applied to visualise the underdrawing of the investigated folios. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Three centuries of geomagnetic field intensity changes in Spain (from the 9th to the 12th centuries)

    NASA Astrophysics Data System (ADS)

    Gomez-Paccard, M.; Osete, M. L.; Chauvin, A.; Jimenez-Castillo, P.; Perez-Asensio, M.

    2013-12-01

    Available European data indicate that during the past 2500 years there have been periods of rapid intensity geomagnetic fluctuations (at least of ~20 μT/century) interspersed with periods of little change. The challenge now is to precisely describe these rapid changes by the acquisition of well-dated high-quality archeomagnetic data. In this study we report the archeomagnetic study of Spanish ceramic fragments. The collected fragments belong to 14 superposed stratigraphic levels corresponding to a surface no bigger than 3 m by 7 m. The pottery fragments dates back to the 9th and 11th centuries. The dating was established by 4 radiocarbon dates and by archeological/historical constraints including typological comparisons and well-controlled stratigraphic constrains between the different stratigraphic units. From classical Thellier experiments including TRM anisotropy and cooling rate corrections upon archeointensity estimates and conducted on 79 fragments, twelve new high-quality mean intensities have been obtained. Together with previously published high-quality data from Western Europe, the new data provide an improved description of the intensity changes that took place in Spain between the 9th and the 12th centuries. The results confirm that rapid intensity changes took place in Western Europe during the recent history of the Earth.

  1. An analysis of action of intercostal muscles in human upper rib cage.

    PubMed

    Saumarez, R C

    1986-02-01

    The actions of the intercostal and paraspinal muscles in stabilizing the human upper rib cage have been analyzed using a geometrically realistic mathematical model of the first six ribs, vertebrae, and associated musculature. The model suggests roles of the deep layers of erector spinae in stabilizing the vertebral column so that it can support the loads placed upon it by the ribs under physiological load. If we assume that the tension exerted by an intercostal muscle is proportional to its local thickness, the model predicts that the observed distribution of intercostal thickness is close to that which minimizes the stresses in ribs when the model is subjected to peak physiological load. The observed shape of the ribs are optimal to withstand the calculated pattern of loading along their length. These calculations raise the hypothesis that the arrangement of intercostal musculature and rib geometry result in an optimally light rib cage, which is capable of withstanding the loads placed upon it. The analysis of the mechanics of the entire model indicates that the geometrical simplifications made in Hamberger's model are not valid when applied to the rib cage.

  2. Reanimation of elbow extension with intercostal nerves transfers in total brachial plexus palsies.

    PubMed

    Goubier, Jean-Noël; Teboul, Frédéric; Khalifa, Heba

    2011-01-01

    Restoration of flexion in the elbow is the priority in the management of brachial plexus injuries. Current techniques of reconstructions, combining both nerve grafting and nerve transfer, allow more extensive repair, with additional targets: shoulder, elbow extension, hand. The transfer of intercostal nerves onto the nerve of the triceps long head is used to restore elbow extension. The aim of this retrospective study is to evaluate the results of this procedure, in total brachial plexus palsies with uninjured C5 and C6 roots. Eleven patients with total brachial plexus injury were reviewed 24 months in average after intercostal nerves transfer. The average age of the patients was twenty-nine years. The average time to surgery after occurrence of the injury was 5 months. Triceps re-innervation and strength of elbow extension were evaluated. The averaged time required for triceps re-innervation after intercostal nerve transfer was 9 months. Seven patients achieved M4 elbow extension according to the Medical Research Council grading system. Two patients achieved M3 elbow extension. Two patients had poor results (M2 and M0). Transfer of intercostal nerves onto the nerve of the triceps long head is a reliable procedure for the restoration of elbow extension in total brachial plexus palsy. Copyright © 2010 Wiley-Liss, Inc.

  3. Role of joint receptors in modulation of inspiratory intercostal activity by rib motion in dogs.

    PubMed Central

    De Troyer, A

    1997-01-01

    1. Inspiratory activity in the canine external intercostal muscles is exquisitely sensitive to the direction and amplitude of the inspiratory displacement of the ribs. This study was designed to investigate the role of muscle receptors, in particular the muscle spindles, in mediating this phenomenon. 2. External intercostal inspiratory activity showed a reflex increase when the normal cranial motion of the ribs and the normal shortening of the muscles was reduced, and showed a reflex decrease when the cranial motion of the ribs and the shortening of the muscles was augmented. However, clamping the two ribs making up the interspace and maintaining muscle length constant only moderately attenuated these responses. 3. These persistent responses remained unchanged after section of the levator costae muscles. 4. The responses were attenuated but still present after section of the external intercostals in the contiguous segments and denervation of the internal intercostals. 5. These reflex responses are therefore mediated in part by non-muscular receptors, which most likely lie within the costovertebral joints. These joint receptors might be a primary determinant of the load-compensating reflex. PMID:9306285

  4. Role of joint receptors in modulation of inspiratory intercostal activity by rib motion in dogs.

    PubMed

    De Troyer, A

    1997-09-01

    1. Inspiratory activity in the canine external intercostal muscles is exquisitely sensitive to the direction and amplitude of the inspiratory displacement of the ribs. This study was designed to investigate the role of muscle receptors, in particular the muscle spindles, in mediating this phenomenon. 2. External intercostal inspiratory activity showed a reflex increase when the normal cranial motion of the ribs and the normal shortening of the muscles was reduced, and showed a reflex decrease when the cranial motion of the ribs and the shortening of the muscles was augmented. However, clamping the two ribs making up the interspace and maintaining muscle length constant only moderately attenuated these responses. 3. These persistent responses remained unchanged after section of the levator costae muscles. 4. The responses were attenuated but still present after section of the external intercostals in the contiguous segments and denervation of the internal intercostals. 5. These reflex responses are therefore mediated in part by non-muscular receptors, which most likely lie within the costovertebral joints. These joint receptors might be a primary determinant of the load-compensating reflex.

  5. Phrenic nerve transfer for elbow flexion and intercostal nerve transfer for elbow extension.

    PubMed

    Zheng, Mou-Xiong; Xu, Wen-Dong; Qiu, Yan-Qun; Xu, Jian-Guang; Gu, Yu-Dong

    2010-08-01

    To explore long-term recovery of elbow flexion and extension after transferring the phrenic nerve and intercostal nerves, respectively, in adults with global brachial plexus avulsion injuries. Seven adults with global brachial plexus avulsion injuries had the phrenic nerve transferred to the musculocutaneous nerve (or to the anterior division of upper trunk) and intercostal nerves transferred to the triceps branch of the radial nerve at our hospital 7 to 12 years ago. The results of elbow motor strength testing using the Medical Research Council grading scale, and electrodiagnostic findings using electromyogram examinations, were studied retrospectively. Pulmonary function tests were also performed at final visits. Functional elbow flexion was obtained in most of the 7 cases (M2, 1; M3, 3; M4, 2; and M5, 1) but elbow extension was absent or insufficient in all subjects (M0, 1; M1, 3; and M2, 3). Electrical results showed successful biceps reinnervation in 6 patients and successful triceps reinnervation in 5. No patient experienced breathing problems, and pulmonary function results were within normal range. In the long term, after brachial plexus avulsion injury in most patients who underwent both phrenic nerve and intercostal nerve transfer to achieve elbow flexion and extension eventually obtained satisfactory elbow flexion but poor elbow extension. We recommend against transferring the intercostal nerves to the triceps branch of radial nerve in conjunction with primary phrenic to musculocutaneous nerve transfer. Therapeutic IV. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. Diaphragmatic and intercostal muscle tear after an episode of violent sneezing: spontaneous diaphragmatic injury.

    PubMed

    Karangizi, Alvin H K; Renaud, Steven J; Rao, Jagan N; Chetty, Govind

    2013-07-01

    Spontaneous diaphragmatic injuries are rare, accounting for approximately 1% of all diaphragmatic injuries. We report a case of a 69-year-old male with a concurrent lower respiratory tract infection who sustained diaphragmatic and intercostal muscle injuries after an episode of violent sneezing. To our knowledge, this is the first reported case of spontaneous diaphragmatic injury after sneezing.

  7. Anatomic study of the intercostal nerve transfer to the suprascapular nerve and a case report.

    PubMed

    Hu, S; Chu, B; Song, J; Chen, L

    2014-02-01

    The purpose of this study was to investigate the anatomical basis of intercostal nerve transfer to the suprascapular nerve and provide a case report. Thoracic walls of 30 embalmed human cadavers were used to investigate the anatomical feasibility for neurotization of the suprascapular nerve with intercostal nerves in brachial plexus root avulsions. We found that the 3rd and 4th intercostal nerves could be transferred to the suprascapular nerve without a nerve graft. Based on the anatomical study, the 3rd and 4th intercostal nerves were transferred to the suprascapular nerve via the deltopectoral approach in a 42-year-old man who had had C5-7 root avulsions and partial injury of C8, T1 of the right brachial plexus. Thirty-two months postoperatively, the patient gained 30° of shoulder abduction and 45° of external rotation. This procedure provided us with a reliable and convenient method for shoulder function reconstruction after brachial plexus root avulsion accompanied with spinal accessory nerve injury. It can also be used when the accessory nerve is intact but needs to be preserved for better shoulder stability or possible future trapezius transfer.

  8. Rehabilitation, Using Guided Cerebral Plasticity, of a Brachial Plexus Injury Treated with Intercostal and Phrenic Nerve Transfers

    PubMed Central

    Dahlin, Lars B.; Andersson, Gert; Backman, Clas; Svensson, Hampus; Björkman, Anders

    2017-01-01

    Recovery after surgical reconstruction of a brachial plexus injury using nerve grafting and nerve transfer procedures is a function of peripheral nerve regeneration and cerebral reorganization. A 15-year-old boy, with traumatic avulsion of nerve roots C5–C7 and a non-rupture of C8–T1, was operated 3 weeks after the injury with nerve transfers: (a) terminal part of the accessory nerve to the suprascapular nerve, (b) the second and third intercostal nerves to the axillary nerve, and (c) the fourth to sixth intercostal nerves to the musculocutaneous nerve. A second operation—free contralateral gracilis muscle transfer directly innervated by the phrenic nerve—was done after 2 years due to insufficient recovery of the biceps muscle function. One year later, electromyography showed activation of the biceps muscle essentially with coughing through the intercostal nerves, and of the transferred gracilis muscle by deep breathing through the phrenic nerve. Voluntary flexion of the elbow elicited clear activity in the biceps/gracilis muscles with decreasing activity in intercostal muscles distal to the transferred intercostal nerves (i.e., corresponding to eighth intercostal), indicating cerebral plasticity, where neural control of elbow flexion is gradually separated from control of breathing. To restore voluntary elbow function after nerve transfers, the rehabilitation of patients operated with intercostal nerve transfers should concentrate on transferring coughing function, while patients with phrenic nerve transfers should focus on transferring deep breathing function. PMID:28316590

  9. Rehabilitation, Using Guided Cerebral Plasticity, of a Brachial Plexus Injury Treated with Intercostal and Phrenic Nerve Transfers.

    PubMed

    Dahlin, Lars B; Andersson, Gert; Backman, Clas; Svensson, Hampus; Björkman, Anders

    2017-01-01

    Recovery after surgical reconstruction of a brachial plexus injury using nerve grafting and nerve transfer procedures is a function of peripheral nerve regeneration and cerebral reorganization. A 15-year-old boy, with traumatic avulsion of nerve roots C5-C7 and a non-rupture of C8-T1, was operated 3 weeks after the injury with nerve transfers: (a) terminal part of the accessory nerve to the suprascapular nerve, (b) the second and third intercostal nerves to the axillary nerve, and (c) the fourth to sixth intercostal nerves to the musculocutaneous nerve. A second operation-free contralateral gracilis muscle transfer directly innervated by the phrenic nerve-was done after 2 years due to insufficient recovery of the biceps muscle function. One year later, electromyography showed activation of the biceps muscle essentially with coughing through the intercostal nerves, and of the transferred gracilis muscle by deep breathing through the phrenic nerve. Voluntary flexion of the elbow elicited clear activity in the biceps/gracilis muscles with decreasing activity in intercostal muscles distal to the transferred intercostal nerves (i.e., corresponding to eighth intercostal), indicating cerebral plasticity, where neural control of elbow flexion is gradually separated from control of breathing. To restore voluntary elbow function after nerve transfers, the rehabilitation of patients operated with intercostal nerve transfers should concentrate on transferring coughing function, while patients with phrenic nerve transfers should focus on transferring deep breathing function.

  10. Rib approximation without intercostal nerve compression reduces post-thoracotomy pain: a prospective randomized study.

    PubMed

    Bayram, Ahmet Sami; Ozcan, Metin; Kaya, Fatma Nur; Gebitekin, Cengiz

    2011-04-01

    One of the most important considerations in the care of thoracic surgery patients is the control of pain, which leads to increased morbidity and relevant mortality. Between February and May 2009, 60 patients undergoing full muscle-sparing posterior minithoracotomy were prospectively randomized into two groups, according to the thoracotomy closure techniques. In the first group (group A), two holes were drilled into the sixth rib using a hand perforator, and sutures were passed through the holes in the sixth rib and were circled from the upper edge of the fifth rib, thereby compressing the intercostal nerve underneath the fifth rib. In the second group (group B), the intercostal muscle underneath the fifth rib was partially dissected along with the intercostal nerve, corresponding to the holes on the sixth rib. Two 1/0 polyglactin (Vicyrl) sutures were passed through the holes in the sixth rib and above the intercostal nerve. There were 30 patients in each group. The visual analog score, observer verbal ranking scale (OVRS) scores for pain, and Ramsay sedation scores were used to follow-up on postoperative analgesia and sedation. The von Frey hair test was used to evaluate hyperalgesia of the patients. The patients in group B had lower visual analog scores at rest and during coughing. The patients in group B had lower OVRS scores than group A patients. The groups were not statistically different in terms of the Ramsay sedation scores and von Frey hair tests. Thoracotomy closure by a technique that avoids intercostal nerve compression significantly decreases post-thoracotomy pain. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  11. Posterior Intercostal Nerve Block With Liposomal Bupivacaine: An Alternative to Thoracic Epidural Analgesia.

    PubMed

    Rice, David C; Cata, Juan P; Mena, Gabriel E; Rodriguez-Restrepo, Andrea; Correa, Arlene M; Mehran, Reza J

    2015-06-01

    Pain relief using regional neuroaxial blockade is standard care for patients undergoing major thoracic surgery. Thoracic epidural analgesia (TEA) provides effective postoperative analgesia but has unwanted side effects, including hypotension, urinary retention, nausea, and vomiting, and is highly operator dependent. Single-shot intercostal nerve and paravertebral blockade have not been widely used because of the short duration of action of most local anesthetics; however, the recent availability of liposomal bupivacaine (LipoB) offers the potential to provide prolonged blockade of intercostal nerves (72 to 96 hours). We hypothesized that a five-level unilateral posterior intercostal nerve block using LipoB would provide effective analgesia for patients undergoing thoracic surgery. We identified patients who underwent lung resection using intraoperative LipoB posterior intercostal nerve blockade and retrospectively compared them with a group of patients who had TEA and who were matched for age, sex, type of surgery, and surgical approach. We analyzed perioperative morbidity, pain scores and narcotic requirements. There were 54 patients in each group. Mean hospital stay was 3.5 days and 4.5 days (p = 0.004) for LipoB group and TEA group, respectively. There were no significant differences in perioperative complications, postoperative pain scores, or in narcotic utilization between LipoB group and TEA group. No acute toxicity related to LipoB was observed. Posterior intercostal nerve blockade using LipoB is safe and provides effective analgesia for patients undergoing thoracic surgery. It may be considered as a suitable alternative to TEA. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Diaphragm and intercostal muscle activity following mid-cervical spinal cord contusion in the rat.

    PubMed

    Wen, Ming-Han; Lee, Kun-Ze

    2017-08-26

    The present study was designed to investigate the diaphragm and intercostal muscle activity following unilateral mid-cervical spinal cord contusion in rats. Electromyogram (EMG) activity of the bilateral diaphragm and T2 intercostal muscle was measured in anesthetized and spontaneously breathing rats. Unilateral mid-cervical contusion caused an immediate reduction in inspiratory bursting in the bilateral diaphragm and intercostal muscles. From 3 days to 8 weeks post-contusion, the contused animals displayed significantly lower tidal volume than uninjured animals, regardless of the time point after injury. The burst amplitude of the contralateral diaphragm EMG was augmented in contused animals at 3 days post-injury. When the data were normalized by the maximal response during hypoxic-hypercapnic challenge (12-13 % O2, 3-4 % CO2), the ipsilateral diaphragm EMG of contused animals was greater than that of uninjured animals at 3 days and 2 weeks post-injury. Moreover, hypoxia-hypercapnia induced increases in ipsilateral diaphragm EMG activity were blunted in contused animals at 2 weeks post-injury but recovered at 8 weeks post-injury. Bilateral diaphragm EMG activity in contused animals was comparable to uninjured animals at 8 weeks post-injury. Notably, intercostal muscle activity was not substantially changed by mid-cervical spinal cord contusion from 3 days to 8 weeks post-contusion. These results suggest that mid-cervical spinal contusion induces a compensatory increase in contralateral diaphragmatic activity and greater utilization of a percentage of maximal inspiratory activity in the ipsilateral diaphragm. The maintenance of intercostal muscle activity may enable the animal to sustain essential breathing capacity following cervical spinal cord injury.

  13. Foreword: The 12th International Conference on Vibrations at Surfaces (VAS 12) (Erice, 20 26 July 2007)

    NASA Astrophysics Data System (ADS)

    Benedek, Giorgio; Vattuone, Luca

    2008-06-01

    The 12th International Conference on Vibrations at Surfaces (VAS 12) took place from 20 26 July 2007 as an event of the International School of Solid State Physics at the Ettore Majorana Foundation and Centre for Scientific Culture, Erice (Italy). The format and special environment of the conference have contributed to its transition from a traditional, medium-size conference into a more effective workshop, with a series of lectures reporting the most recent developments in the field, two poster sessions presenting recent results and even works in progress being discussed. The papers collected in this issue cover the highlights of the conference very thoroughly. Quite a few novel aspects concerning vibrations at surfaces are represented here, for example: new aspects in surface phonon spectroscopy, such as the very recent progress in inelastic x-ray scattering, the first observation of the boson peak in disordered surfaces, progress in the theory of atom scattering inelastic resonances, the action spectroscopy, the study of polycrystalline surfaces with electron energy-loss spectroscopy etc; parallel developments in experimental vibrational studies of adsorbed phases, either inorganic or organic, with those in ab initio theoretical simulations; the theory of enhanced electron--phonon interaction in low dimensions (2D and 1D); the extension from the traditional realm of surface vibrations and spectroscopy to other aspects of surface dynamics, like friction and various nonlinear effects, and to relevant dynamical phenomena occurring at interfaces. Other novelties presented at the conference, but already published in recent issues of the Journal of Physics: Condensed Matter, are also worth mentioning: the spin-echo spectroscopy with 3He allowing for slow-dynamics spectroscopy at very high, unprecedented resolutions (2007 J. Phys.: Cond. Matter 19 300301 and 305010; the first demonstration of dissociative surface trapping of molecules (2007 J. Phys.: Cond. Matter 19

  14. The Advanced Program of Vocational Agriculture in Louisiana. Ag III and Ag IV (11th and 12th Grades). Volume II. Bulletin No. 1725.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This curriculum guide consists of materials for use in teaching an advanced course in agricultural mechanics designed for 11th and 12th grade students. Addressed in the individual units of the guide are arc welding; oxy-acetylene welding; soldering; electricity; tractor maintenance, operation, and safety; small engines; farm structures; and cold…

  15. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Mobile Learning (12th, Vilamoura, Algarve, Portugal, April 9-11, 2016)

    ERIC Educational Resources Information Center

    Sánchez, Inmaculada Arnedillo, Ed.; Isaías, Pedro, Ed.

    2016-01-01

    These proceedings contain the papers of the 12th International Conference on Mobile Learning 2016, which was organized by the International Association for Development of the Information Society, in Vilamoura, Algarve, Portugal, April 9-11, 2016. The Mobile Learning 2016 Conference seeks to provide a forum for the presentation and discussion of…

  16. Cooperative Learning, Motivational Effects, and Student Characteristics: An Experimental Study Comparing Cooperative Learning and Direct Instruction in 12th Grade Physics Classes

    ERIC Educational Resources Information Center

    Hanze, Martin; Berger, Roland

    2007-01-01

    One hundred thirty-seven students in 12th grade physics classes participated in a quasi-experimental study comparing the jigsaw classroom method of cooperative instruction with traditional direct instruction. While no differences were found between the two conditions for physics achievement gains, the results revealed differences in students'…

  17. Alcohol, Tobacco, & Other Drug Use by 9th-12th Grade Students: Results from the 1993 North Carolina Youth Risk Behavior Survey.

    ERIC Educational Resources Information Center

    Mikow, Victoria A.

    This survey examined the behaviors associated with the six leading causes of death or disability in one state's high school youth. Participants were 2,439 9th-12th grade students. Results identified alcohol as the drug most frequently used by high school students, with over half of students having used alcohol by their senior year and almost half…

  18. Legal Implications of Personnel Management. Proceedings of the Annual Summer Workshop, Southeastern Community College Leadership Program (12th, Tallahassee, Florida, July 18-20, 1973).

    ERIC Educational Resources Information Center

    Clampitt, Joyce, Ed.

    The 12th Annual Summer Workshop, Southeastern Community College Leadership Program, focused on "first-level managers" and on the increasing role of the courts in the day-to-day operation of the college. The first session of the workshop was a video-tape presentation entitled "Legal Implications of Personnel Management." These proceedings provide…

  19. Influence of Skip Patterns on Item Non-Response in a Substance Use Survey of 7th to 12th Grade Students

    ERIC Educational Resources Information Center

    Ding, Kele; Olds, R. Scott; Thombs, Dennis L.

    2009-01-01

    This retrospective case study assessed the influence of item non-response error on subsequent response to questionnaire items assessing adolescent alcohol and marijuana use. Post-hoc analyses were conducted on survey results obtained from 4,371 7th to 12th grade students in Ohio in 2005. A skip pattern design in a conventional questionnaire…

  20. Gender and Ethnic Differences in Smoking, Drinking and Illicit Drug Use among American 8th, 10th and 12th Grade Students, 1976-2000.

    ERIC Educational Resources Information Center

    Wallace, John M., Jr.; Bachman, Jerald G.; O'Malley, Patrick M.; Schulenberg, John E.; Cooper, Shauna M.; Johnston, Lloyd D.

    2003-01-01

    Paper examines ethnic differences in licit and illicit drug use among American 8th, 10th, and 12th grade students, with a particular focus on girls. Across ethnic groups, drug use is highest among Native American girls and lowest among black and Asian American girls. Trend data suggest that girls' and boys' drug use patterns are converging.…

  1. The Advanced Program of Vocational Agriculture in Louisiana. Ag III and Ag IV (11th and 12th Grades). Volume I. Bulletin No. 1725.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This curriculum guide consists of materials for use in teaching an advanced course in vocational agriculture designed for 11th and 12th grade students. Addressed in the individual units of the guide are the following topics: farm and agribusiness planning, employment-seeking skills, agricultural chemicals, and conservation. Each unit includes a…

  2. Making the Grade: Do Nebraska Teachers and Administrators Working in Public Schools in 7th-12th Grade Settings Agree about What Constitutes Sound Grading Practice?

    ERIC Educational Resources Information Center

    Olson, Mark E.

    2013-01-01

    In this study, the researcher sought to determine whether Nebraska teachers and administrators agreed about what constitutes sound grading practice. The results of this study indicated that Nebraska teachers and administrators working in public schools in 7th-12th grade settings did not always agree about what constituted sound grading practice.…

  3. Fixitup Faucet Company's Overseas Move. 12th Grade Lesson. Schools of California Online Resources for Education (SCORE): Connecting California's Classrooms to the World.

    ERIC Educational Resources Information Center

    Harris, Judy; Jacobson, Edy

    This lesson asks 12th grade students to imagine that they are special assistants to the Undersecretary of Commerce for a foreign country who must answer a letter from a U.S. company planning to move its manufacturing operations overseas. The lesson also asks them to design a business brochure that will convince the company to come to their…

  4. Influence of Skip Patterns on Item Non-Response in a Substance Use Survey of 7th to 12th Grade Students

    ERIC Educational Resources Information Center

    Ding, Kele; Olds, R. Scott; Thombs, Dennis L.

    2009-01-01

    This retrospective case study assessed the influence of item non-response error on subsequent response to questionnaire items assessing adolescent alcohol and marijuana use. Post-hoc analyses were conducted on survey results obtained from 4,371 7th to 12th grade students in Ohio in 2005. A skip pattern design in a conventional questionnaire…

  5. Making the Grade: Do Nebraska Teachers and Administrators Working in Public Schools in 7th-12th Grade Settings Agree about What Constitutes Sound Grading Practice?

    ERIC Educational Resources Information Center

    Olson, Mark E.

    2013-01-01

    In this study, the researcher sought to determine whether Nebraska teachers and administrators agreed about what constitutes sound grading practice. The results of this study indicated that Nebraska teachers and administrators working in public schools in 7th-12th grade settings did not always agree about what constituted sound grading practice.…

  6. [Induced abortion after the 12th week of pregnancy in the county of Arhus 1993-1994. Psychological consequences].

    PubMed

    Meyer, L; Petersson, B H

    1996-07-29

    The records of all women applying for permission to have an abortion performed after the 12th week of pregnancy during a one-year period in the County of Aarhus were continuously reviewed, and the women who had the abortion performed due to psychosocial reasons were interviewed with a questionnaire at the time of the abortion and again four months later. Of the 76 women who applied for permission for a late abortion the following were excluded from the study: 31 who had the abortion because a malformed child was suspected, six women who did not have the abortion although permission had been given, five women who did not receive permission, four who were under 18 years of age, one who had a miscarriage, 10 who were from another country of origin and did not understand Danish and finally four women who were allowed an abortion on a medical indication and who were either in hospital or in jail. Fifteen women were questioned concerning their age, length of pregnancy and psychological and social histories and were asked to fill out a depression scale. The data showed that none of them had planned their pregnancy and they had had no symptoms of pregnancy until the time at which they applied for the abortion. None of them regretted the abortion afterwards; half of the women were under psychological strain at the time of application, and a few of them had even more psychological symptoms four months after the abortion. Although they had many social problems, physical complications and psychological problems only a few of the women had seen a doctor in the four month period between the abortion and the follow-up.

  7. Multiple and substitute addictions involving prescription drugs misuse among 12th graders: gateway theory revisited with Market Basket Analysis.

    PubMed

    Jayawardene, Wasantha Parakrama; YoussefAgha, Ahmed Hassan

    2014-01-01

    This study aimed to identify the sequential patterns of drug use initiation, which included prescription drugs misuse (PDM), among 12th-grade students in Indiana. The study also tested the suitability of the data mining method Market Basket Analysis (MBA) to detect common drug use initiation sequences in large-scale surveys. Data from 2007 to 2009 Annual Surveys of Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents were used for this study. A close-ended, self-administered questionnaire was used to ask adolescents about the use of 21 substance categories and the age of first use. "Support%" and "confidence%" statistics of Market Basket Analysis detected multiple and substitute addictions, respectively. The lifetime prevalence of using any addictive substance was 73.3%, and it has been decreasing during past few years. Although the lifetime prevalence of PDM was 19.2%, it has been increasing. Males and whites were more likely to use drugs and engage in multiple addictions. Market Basket Analysis identified common drug use initiation sequences that involved 11 drugs. High levels of support existed for associations among alcohol, cigarettes, and marijuana, whereas associations that included prescription drugs had medium levels of support. Market Basket Analysis is useful for the detection of common substance use initiation sequences in large-scale surveys. Before initiation of prescription drugs, physicians should consider the adolescents' risk of addiction. Prevention programs should address multiple addictions, substitute addictions, common sequences in drug use initiation, sex and racial differences in PDM, and normative beliefs of parents and adolescents in relation to PDM.

  8. [The 12th amendment to the German Drug Law. Chances and obstacles for investigator-initiated clinical trials].

    PubMed

    Dreier, G; Marx, C; Schmoor, C; Maier-Lenz, H

    2005-04-01

    The European Union's so called Clinical Trials Directive 2001/20/EC was implemented in national law in Germany in August 2004, leading to the 12th amendment of the German Drug Law (Arzneimittelgesetz). The directive is intended to harmonize the clinical trial's regulatory environment across the European Union and to improve protection of human subjects. It lays down the principles and guidelines of Good Clinical Practice (GCP). As the regulation applies to all clinical trials on medicinal products for human use, and as only non-interventional studies are excluded, academic, investigator-initiated clinical trials will also have to comply with the EU clinical trials directive implemented in the German Drug Law. In an investigator-initiated trial in which the investigator takes the responsibility of a sponsor, the investigator-sponsor must take total legal and financial responsibility for the clinical trial. Since publicly funded clinical trials make a large contribution to improved care, concern has been expressed that non-commercial research projects will be reduced and the vital medical research conducted at academic institutions curtailed. Nonetheless GCP ensures a valid study design, qualified data management, analysis and monitoring of the trial and thereby promotes more valid data and protection of study participants. The trials are more likely to lead to reliable results leading to new therapies, strategies or a better understanding of diseases. What is needed, therefore, is an increase in public funding and the establishment of clinical trial units/organizations associated with the universities or hospitals where independent researchers have the possibility to obtain theoretical advice and practical help, professional training and support. In the end, the directive may serve as a stimulus to build a better national research environment and to promote public funding, and may lead to fewer but more valid clinical trials.

  9. Trends in weight management goals and behaviors among 9th-12th grade students: United States, 1999-2009.

    PubMed

    Demissie, Zewditu; Lowry, Richard; Eaton, Danice K; Nihiser, Allison J

    2015-01-01

    To examine trends in weight management goals and behaviors among U.S. high school students during 1999-2009. Data from six biennial cycles (1999-2009) of the national Youth Risk Behavior Survey were analyzed. Cross-sectional, nationally representative samples of 9th-12th grade students (approximately 14,000 students/cycle) completed self-administered questionnaires. Logistic regression models adjusted for grade, race/ethnicity, and obesity were used to test for trends in weight management goals and behaviors among subgroups of students. Combined prevalences and trends differed by sex and by race/ethnicity and weight status within sex. During 1999-2009, the prevalence of female students trying to gain weight decreased (7.6-5.7 %). Among female students trying to lose or stay the same weight, prevalences decreased for eating less (69.6-63.2 %); fasting (23.3-17.6 %); using diet pills/powders/liquids (13.7-7.8 %); and vomiting/laxatives (9.5-6.6 %) for weight control. During 1999-2009, the prevalence of male students trying to lose weight increased (26.1-30.5 %). Among male students trying to lose or stay the same weight, the prevalence of exercising to control weight did not change during 1999-2003 and then increased (74.0-79.1 %) while the prevalence of taking diet pills/powders/liquids for weight control decreased (6.9-5.1 %) during 1999-2009. Weight management goals and behaviors changed during 1999-2009 and differed by subgroup. To combat the use of unhealthy weight control behaviors, efforts may be needed to teach adolescents about recommended weight management strategies and avoiding the risks associated with unhealthy methods.

  10. SPACE: Enhancing Life on Earth. Proceedings Report

    NASA Technical Reports Server (NTRS)

    Hobden, Alan (Editor); Hobden, Beverly (Editor); Bagley, Larry E. (Editor); Bolton, Ed (Editor); Campaigne, Len O. (Editor); Cole, Ron (Editor); France, Marty (Editor); Hand, Rich (Editor); McKinley, Cynthia (Editor); Zimkas, Chuck (Editor)

    1996-01-01

    The proceedings of the 12th National Space Symposium on Enhancing Life on Earth is presented. Technological areas discussed include: Space applications and cooperation; Earth sensing, communication, and navigation applications; Global security interests in space; and International space station and space launch capabilities. An appendices that include featured speakers, program participants, and abbreviation & acronyms glossary is also attached.

  11. EDITORIAL: Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers Special issue containing papers presented at the 12th International Workshop on H-mode Physics and Transport Barriers

    NASA Astrophysics Data System (ADS)

    Hahm, T. S.

    2010-06-01

    The 12th International Workshop on H-mode Physics and Transport Barriers was held at the Princeton Plasma Physics Laboratory, Princeton, New Jersey, USA between September 30 and October 2, 2009. This meeting was the continuation of a series of previous meetings which was initiated in 1987 and has been held bi-annually since then. Following the recent tradition at the last few meetings, the program was sub- divided into six sessions. At each session, an overview talk was presented, followed by two or three shorter oral presentations which supplemented the coverage of important issues. These talks were followed by discussion periods and poster sessions of contributed papers. The sessions were: Physics of Transition to/from Enhanced Confinement Regimes, Pedestal and Edge Localized Mode Dynamics, Plasma Rotation and Momentum Transport, Role of 3D Physics in Transport Barriers, Transport Barriers: Theory and Simulations and High Priority ITER Issues on Transport Barriers. The diversity of the 90 registered participants was remarkable, with 22 different nationalities. US participants were in the majority (36), followed by Japan (14), South Korea (7), and China (6). This special issue of Nuclear Fusion consists of a cluster of 18 accepted papers from submitted manuscripts based on overview talks and poster presentations. The paper selection procedure followed the guidelines of Nuclear Fusion which are essentially the same as for regular articles with an additional requirement on timeliness of submission, review and revision. One overview paper and five contributed papers report on the H-mode pedestal related results which reflect the importance of this issue concerning the successful operation of ITER. Four papers address the rotation and momentum transport which play a crucial role in transport barrier physics. The transport barrier transition condition is the main focus of other four papers. Finally, four additional papers are devoted to the behaviour and control of

  12. Transfer of the first intercostal nerve to supra- and infraspinatus muscles: an anatomical study and report of the first case.

    PubMed

    Durand, S; Oberlin, C; Fox, M; Diverrez, J P; Dauge, M C

    2009-04-01

    We have assessed the anatomical feasibility of a transfer of the first intercostal nerve to the supra- and infraspinatus muscles and report on the first clinical application. Ten fresh cadavers were dissected for this study. Histomorphometric analysis showed the fascicular surface area of the first intercostal nerve at its origin (0.38 mm(2)) to be comparable to the suprascapular nerve (0.81 mm(2)). The first intercostal nerve is usually a pure motor nerve. Preservation of the spinal accessory nerve, lack of donor site morbidity and direct suture without nerve graft are the other advantages of this transfer. Its principal indication is in lesions of the upper brachial plexus, used in association with neurotisation of two other intercostal nerves to the anterior branch of the axillary nerve. At 21 months follow-up there was useful motor reinnervation in the first clinical case.

  13. Mechanical advantage of the human parasternal intercostal and triangularis sterni muscles

    PubMed Central

    De Troyer, André; Legrand, Alexandre; Gevenois, Pierre-Alain; Wilson, Theodore A

    1998-01-01

    Previous studies in dogs have demonstrated that the maximum change in airway pressure (ΔPao) produced by a particular respiratory muscle is the product of three factors, namely the mass of the muscle, the maximal active muscle tension per unit cross-sectional area (∼3.0 kg cm−2), and the fractional change in muscle length per unit volume increase of the relaxed chest wall (i.e. the muscle's mechanical advantage). In the present studies, we have used this principle to infer the ΔPao values generated by the parasternal intercostal and triangularis sterni muscles in man. The mass of the muscles and the direction of the muscle fibres relative to the sternum were first assessed in six cadavers. Seven healthy individuals were then placed in a computed tomographic scanner to determine the orientation of the costal cartilages relative to the sternum and their rotation during passive inflation to total lung capacity. The fractional changes in length of the muscles during inflation, their mechanical advantages, and their ΔPao values were then calculated. Passive inflation induced shortening of the parasternal intercostals in all interspaces and lengthening of the triangularis sterni. The fractional shortening of the parasternal intercostals decreased gradually from 7.7% in the second interspace to 2.0% in the fifth, whereas the fractional lengthening of the triangularis sterni increased progressively from 5.9 to 13.8%. These rostrocaudal gradients were well accounted for by the more caudal orientation of the cartilages of the lower ribs. Since these fractional changes in length corresponded to a maximal inflation, the inspiratory mechanical advantage of the parasternal intercostals was only 2.2–0.6% l−1, and the expiratory mechanical advantage of the triangularis sterni was only 1.6–3.8% l−1. In addition, whatever the interspace, parasternal and triangularis muscle mass was 3–5 and 1–3 g, respectively. As a result, the magnitude of the ΔPao values

  14. Mechanical advantage of the human parasternal intercostal and triangularis sterni muscles.

    PubMed

    De Troyer, A; Legrand, A; Gevenois, P A; Wilson, T A

    1998-12-15

    1. Previous studies in dogs have demonstrated that the maximum change in airway pressure (DeltaPao) produced by a particular respiratory muscle is the product of three factors, namely the mass of the muscle, the maximal active muscle tension per unit cross-sectional area ( approximately 3.0 kg cm-2), and the fractional change in muscle length per unit volume increase of the relaxed chest wall (i.e. the muscle's mechanical advantage). In the present studies, we have used this principle to infer the DeltaPao values generated by the parasternal intercostal and triangularis sterni muscles in man. 2. The mass of the muscles and the direction of the muscle fibres relative to the sternum were first assessed in six cadavers. Seven healthy individuals were then placed in a computed tomographic scanner to determine the orientation of the costal cartilages relative to the sternum and their rotation during passive inflation to total lung capacity. The fractional changes in length of the muscles during inflation, their mechanical advantages, and their DeltaPao values were then calculated. 3. Passive inflation induced shortening of the parasternal intercostals in all interspaces and lengthening of the triangularis sterni. The fractional shortening of the parasternal intercostals decreased gradually from 7.7 % in the second interspace to 2.0 % in the fifth, whereas the fractional lengthening of the triangularis sterni increased progressively from 5.9 to 13.8 %. These rostrocaudal gradients were well accounted for by the more caudal orientation of the cartilages of the lower ribs. 4. Since these fractional changes in length corresponded to a maximal inflation, the inspiratory mechanical advantage of the parasternal intercostals was only 2.2-0. 6 % l-1, and the expiratory mechanical advantage of the triangularis sterni was only 1.6-3.8 % l-1. In addition, whatever the interspace, parasternal and triangularis muscle mass was 3-5 and 1-3 g, respectively. As a result, the magnitude of

  15. The proprioceptive reflex control of the intercostal muscles during their voluntary activation

    PubMed Central

    Davis, J. Newsom; Sears, T. A.

    1970-01-01

    1. A quantitative study has been made of the reflex effects of sudden changes in mechanical load on contracting human intercostal muscles during willed breathing movements involving the chest wall. Averaging techniques were applied to recordings of electromyogram (EMG) and lung volume, and to other parameters of breathing. 2. Load changes were effected for brief periods (10-150 msec) at any predetermined lung volume by sudden connexion of the airway to a pressure source variable between ± 80 cm H2O so that respiratory movement could be either assisted or opposed. In some experiments airway resistance was suddenly reduced by porting from a high to a low resistance external airway. 3. Contracting inspiratory and expiratory intercostal muscles showed a `silent period' with unloading which is attributed to the sudden withdrawal from intercostal motoneurones of monosynaptic excitation of muscle spindle origin. 4. For both inspiratory and expiratory intercostal muscles the typical immediate effect of an increase in load was an inhibitory response (IR) with a latency of about 22 msec followed by an excitatory response (ER) with a latency of 50-60 msec. 5. It was established using brief duration stimuli (< 40 msec) that the IR depended on mechanical events associated with the onset of stimulation, whereas stimuli greater than 40 msec in duration were required to evoke the ER. 6. For constant expiratory flow rate and a constant load, the ER of expiratory intercostal muscles increased as lung volume decreased within the limits set by maximal activation of the motoneurone pool as residual volume was approached. 7. The ER to a constant load increased directly with the expiratory flow rate at which the load applied, also within limits set by maximal activation of the motoneurone pool. 8. For a given load, the ER during phonation was greater than that occurring at a similar expiratory flow rate without phonation when the resistance of the phonating larynx was mimicked by an

  16. Non-Angled Intercostal Percutaneous Access Under Full Expiration: Safety Is Not an Issue Anymore.

    PubMed

    Ajib, Khaled M; Matta, Imad F; Zgheib, Joseph T; Jabbour, Michel E

    2017-08-01

    Percutaneous nephrolithotomy (PCNL) is a well-established procedure for the management of urinary calculi and can be performed intercostally or subcostally. Favoring one approach vs the other is still debatable, and literature has been inconclusive regarding the efficacy and safety of both approaches. Hence, this study aims to assess the safety and efficacy of direct non-angled intercostal technique performed under full expiration and to compare it to the subcostal approach. PCNL was conducted among 361 patients during 2010-2015 at Saint George Hospital University Medical Center in Beirut, Lebanon. PCNL was done by one operator and by following a standard technique. After reviewing the medical records, 304 patients were included. Data analysis was conducted using Stata/IC 10.0. Bivariate analysis was conducted using Pearson's Chi-square, and logistic regression model was run. Alpha level was set at 0.05. Of the total patients, 54.6% and 45.4% underwent intercostal (Group I) and subcostal (Group II) access, respectively. Mean drop in hemoglobin in Group II was 1.9 g/dL vs 1.48 g/dL in Group I (p-value = 0.0040). The mean difference in operation time between group I (88.61 minutes) and group II (102.58 minutes) was statistically significant (p-value = 0.0064). Patients were stone free in 88.05% of the intercostal cases and 78.52% of the subcostal cases. Group II patients were twice more likely to have residual stones compared to Group I (p-value = 0.029). No statistical significance was observed in postoperative complications among both groups. In addition, no cases of pneumothorax were reported. Compared to subcostal access, intercostal approach under full expiration is a safe technique that provides optimal approach to the intrarenal collecting system and allows less angulation, less bleeding, and yields higher stone clearance with minimal complications. When performed by a well-trained urologist, intercostal access should be advocated in PCNL to

  17. [Postmastectomy syndrome after the radical treatment of the breast cancer with the preservation of the intercostal nerve].

    PubMed

    Iarygin, M L; Obmanov, I V; Iarygin, L M; Khokhlov, A A; Shmyrev, V I

    2013-01-01

    Postmastectomy syndrome often follows the radical surgery oа the breast cancer. The intersection of the branches of the intercostal nerve is an infrequent cause of the postmastectomy syndrome development. We studied the long-term follow up results in 30 patients after radical mastectomy by Madden with preservation of the branches of the intercostal nerve on the level of Th1-Th3. The method demonstrated the decrease of the postmastectomy syndrome and the improvement of quality of life.

  18. Novel use of noninvasive high-intensity focused ultrasonography for intercostal nerve neurolysis in a swine model.

    PubMed

    Gulati, Amitabh; Loh, Jeffrey; Gutta, Narendra B; Ezell, Paula C; Monette, Sébastien; Erinjeri, Joseph P; Maybody, Majid; Solomon, Stephen

    2014-01-01

    High-intensity focused ultrasound (HIFU) is a noninvasive thermal ablation technique. High-intensity focused ultrasound has been used in small-animal models to lesion neural tissue selectively. This study aimed to evaluate the efficacy of HIFU in a large-animal model for ablation of nerves similar in size to human nerves. Twelve acute magnetic resonance-guided HIFU ablation lesions were created in intercostal nerves in a swine model. In a second pig, as a control, 4 radiofrequency ablation and 4 alcohol lesions were performed on intercostal nerves under ultrasound guidance. Preprocedural and postprocedural magnetic resonance imaging was then performed to evaluate radiologically the lesion size created by HIFU. Animals were euthanized 1 hour postprocedure, and necropsy was performed to collect tissue samples for histopathologic analysis. On gross and histological examination of the intercostal nerve, acute HIFU nerve lesions showed evidence of well-demarcated, acute, focally extensive thermal necrosis. Four intercostal nerves ablated with HIFU were sent for histopathologic analysis, with 2 of 4 lesions showing pathologic damage to the intercostal nerve. Similar results were shown with radiofrequency ablation technique, whereas the intercostal nerves appeared histologically intact with alcohol ablation. High-intensity focused ultrasound may be used as a noninvasive neurolytic technique in swine. High-intensity focused ultrasound may have potential as a neuroablation technique for patients with chronic and cancer pain.

  19. Electromyographic comparison of various exercises to improve elbow flexion following intercostal nerve transfer.

    PubMed

    Chalidapong, P; Sananpanich, K; Klaphajone, J

    2006-05-01

    We compared the quantitative electromyographic activity of the elbow flexors during four exercises (forced inspiration, forced expiration, trunk flexion and attempted elbow flexion), following intercostal nerve transfer to the musculocutaneous nerve in 32 patients who had sustained root avulsion brachial plexus injuries. Quantitative electromyographic evaluation of the mean and maximum amplitude was repeated three times for each exercise. We found that mean and maximum elbow flexor activity was highest during trunk flexion, followed by attempted elbow flexion, forced inspiration and finally forced expiration. The difference between each group was significant (p < 0.001), with the exception of the difference between trunk flexion and attempted elbow flexion. Consequently, we recommend trunk flexion exercises to aid rehabilitation following intercostal nerve transfer.

  20. Intercostal nerves block for mastectomy in two patients with advanced breast malignancy.

    PubMed

    Kolawole, Israel K; Adesina, Michael D; Olaoye, Iyiade O

    2006-03-01

    Regional anesthesia is recognized as an alternative to general anesthesia for modern breast cancer surgery. Various techniques of block have been described. Each has its unique problems. Regional anesthesia was chosen for simple mastectomy in two patients with advanced breast malignancy, due to compromised pulmonary status resulting from widespread malignant infiltration of both lungs. We used intercostal nerves block. The block was supplemented with an infraclavicular infiltration to interrupt the branches of the superficial cervical plexus that provide sensation to the upper chest wall and subcutaneous infiltration in the midline to block the nerve supply from the contralateral side. Anesthesia was generally effective and the operations were uneventful. Both patients and surgeons expressed satisfaction. We conclude that where patients have significant comorbidities that make general anesthesia undesirable, the use of intercostal nerves block remains a safe and reliable anesthetic option that allows the patient access to surgery for simple mastectomy.

  1. Intercostal nerves block for mastectomy in two patients with advanced breast malignancy.

    PubMed Central

    Kolawole, Israel K.; Adesina, Michael D.; Olaoye, Iyiade O.

    2006-01-01

    Regional anesthesia is recognized as an alternative to general anesthesia for modern breast cancer surgery. Various techniques of block have been described. Each has its unique problems. Regional anesthesia was chosen for simple mastectomy in two patients with advanced breast malignancy, due to compromised pulmonary status resulting from widespread malignant infiltration of both lungs. We used intercostal nerves block. The block was supplemented with an infraclavicular infiltration to interrupt the branches of the superficial cervical plexus that provide sensation to the upper chest wall and subcutaneous infiltration in the midline to block the nerve supply from the contralateral side. Anesthesia was generally effective and the operations were uneventful. Both patients and surgeons expressed satisfaction. We conclude that where patients have significant comorbidities that make general anesthesia undesirable, the use of intercostal nerves block remains a safe and reliable anesthetic option that allows the patient access to surgery for simple mastectomy. Images Figure 1 Figure 2 Figure 3 PMID:16573313

  2. Effect of intercostal muscle and costovertebral joint material properties on human ribcage stiffness and kinematics.

    PubMed

    Kindig, Matthew; Li, Zuoping; Kent, Richard; Subit, Damien

    2015-01-01

    Current finite element (FE) models of the human thorax are limited by the lack of local-level validation, especially in the ribcage. This study exercised an existing FE ribcage model for a 50th percentile male under quasi-static point loading and dynamic sternal loading. Both force-displacement and kinematic responses of the ribcage were compared against experimental data. The sensitivity of the model response to changes in the material properties of the costovertebral (CV) joints and intercostal muscles was assessed. The simulations found that adjustments to the CV joints tended to change the amount of rib rotation in the sagittal plane, while changes to the elastic modulus and thickness of the intercostal muscles tended to alter both the stiffness and the direction and magnitude of rib motions. This study can lend insight into the role that the material properties of these two thoracic structures play in the dynamics of the ribcage during a frontal loading condition.

  3. A Case of Spontaneous Transdiaphragmatic Intercostal Hernia with Contralateral Injury, and Review of the Literature

    PubMed Central

    Duff, Steven B.

    2017-01-01

    This case report discusses the diagnosis and management of a 67-year-old male presenting with a spontaneous transdiaphragmatic intercostal hernia with contralateral intercostal hernia. The patient had a history of chronic obstructive pulmonary disease (COPD) exacerbations requiring multiple prolonged courses of steroids. The patient was ultimately diagnosed with computed tomography (CT) and underwent surgical repair via thoracotomy with primary repair of the diaphragmatic defect. The patient's postoperative course was uncomplicated. A review of the literature since the first similar case in 1977 recognizes the propensity of this injury to be found in patients with COPD and chronic steroid usage, as well as its diagnosis and management. The case reviewed is the second documented case of a concurrent abdominal wall herniation and the first one with a contralateral injury. It is important for clinicians to be aware of this pathology when evaluating patients with COPD and chronic steroid usage. PMID:28326219

  4. Rostrocaudal gradient of mechanical advantage in the parasternal intercostal muscles of the dog.

    PubMed Central

    De Troyer, A; Legrand, A; Wilson, T A

    1996-01-01

    1. Previous theoretical studies have led to the predictions that, in the dog, the parasternal intercostal muscles in the rostral interspaces shorten more during passive inflation than those in the caudal interspaces and have, therefore, a greater inspiratory mechanical advantage. The present studies were undertaken to test these predictions. 2. The effects of passive inflation on the length of the parasternal intercostals interspaces 1 to 7 were evaluated with markers implanted in the costal cartilages. Although the muscles in all interspaces shortened with passive inflation, the fractional shortening increased from the first to the second and third interspaces and then decreased continuously to the seventh interspace. 3. To understand this peculiar distribution, a geometric model of the parasternal area was then developed and a relation was obtained between muscle shortening and the angles that describe the orientation of the muscle and costal cartilage relative to the sternum. Measurement of these angles indicated that the rostrocaudal gradient of parasternal shortening resulted from the different orientations of the costal cartilages and their different rotations during passive inflation. 4. The changes in airway pressure generated by the parasternal intercostals in interspaces 3, 5 and 7 were finally measured during selective, maximal stimulation. The fall in pressure was invariably greatest during contraction of the third interspace and smallest during contraction of the seventh. 5. These observations indicate that, in the dog, the rostrocaudal gradient in rib rotation induces a rostrocaudal gradient of mechanical advantage in the parasternal intercostals, which has its climax in the second and third interspaces. These observations also support the concept that the respiratory effect of a given respiratory muscle can be computed from its behaviour during passive inflation. PMID:8866366

  5. Rostrocaudal gradient of mechanical advantage in the parasternal intercostal muscles of the dog.

    PubMed

    De Troyer, A; Legrand, A; Wilson, T A

    1996-08-15

    1. Previous theoretical studies have led to the predictions that, in the dog, the parasternal intercostal muscles in the rostral interspaces shorten more during passive inflation than those in the caudal interspaces and have, therefore, a greater inspiratory mechanical advantage. The present studies were undertaken to test these predictions. 2. The effects of passive inflation on the length of the parasternal intercostals interspaces 1 to 7 were evaluated with markers implanted in the costal cartilages. Although the muscles in all interspaces shortened with passive inflation, the fractional shortening increased from the first to the second and third interspaces and then decreased continuously to the seventh interspace. 3. To understand this peculiar distribution, a geometric model of the parasternal area was then developed and a relation was obtained between muscle shortening and the angles that describe the orientation of the muscle and costal cartilage relative to the sternum. Measurement of these angles indicated that the rostrocaudal gradient of parasternal shortening resulted from the different orientations of the costal cartilages and their different rotations during passive inflation. 4. The changes in airway pressure generated by the parasternal intercostals in interspaces 3, 5 and 7 were finally measured during selective, maximal stimulation. The fall in pressure was invariably greatest during contraction of the third interspace and smallest during contraction of the seventh. 5. These observations indicate that, in the dog, the rostrocaudal gradient in rib rotation induces a rostrocaudal gradient of mechanical advantage in the parasternal intercostals, which has its climax in the second and third interspaces. These observations also support the concept that the respiratory effect of a given respiratory muscle can be computed from its behaviour during passive inflation.

  6. Absence of synergy for monosynaptic Group I inputs between abdominal and internal intercostal motoneurons

    PubMed Central

    Ford, T. W.; Meehan, C. F.

    2014-01-01

    Internal intercostal and abdominal motoneurons are strongly coactivated during expiration. We investigated whether that synergy was paralleled by synergistic Group I reflex excitation. Intracellular recordings were made from motoneurons of the internal intercostal nerve of T8 in anesthetized cats, and the specificity of the monosynaptic connections from afferents in each of the two main branches of this nerve was investigated. Motoneurons were shown by antidromic excitation to innervate three muscle groups: external abdominal oblique [EO; innervated by the lateral branch (Lat)], the region of the internal intercostal muscle proximal to the branch point (IIm), and muscles innervated from the distal remainder (Dist). Strong specificity was observed, only 2 of 54 motoneurons showing excitatory postsynaptic potentials (EPSPs) from both Lat and Dist. No EO motoneurons showed an EPSP from Dist, and no IIm motoneurons showed one from Lat. Expiratory Dist motoneurons fell into two groups. Those with Dist EPSPs and none from Lat (group A) were assumed to innervate distal internal intercostal muscle. Those with Lat EPSPs (group B) were assumed to innervate abdominal muscle (transversus abdominis or rectus abdominis). Inspiratory Dist motoneurons (assumed to innervate interchondral muscle) showed Dist EPSPs. Stimulation of dorsal ramus nerves gave EPSPs in 12 instances, 9 being in group B Dist motoneurons. The complete absence of heteronymous monosynaptic Group I reflex excitation between muscles that are synergistically activated in expiration leads us to conclude that such connections from muscle spindle afferents of the thoracic nerves have little role in controlling expiratory movements but, where present, support other motor acts. PMID:24920027

  7. Synchronization of presynaptic input to motor units of tongue, inspiratory intercostal, and diaphragm muscles.

    PubMed

    Rice, Amber; Fuglevand, Andrew J; Laine, Christopher M; Fregosi, Ralph F

    2011-05-01

    The respiratory central pattern generator distributes rhythmic excitatory input to phrenic, intercostal, and hypoglossal premotor neurons. The degree to which this input shapes motor neuron activity can vary across respiratory muscles and motor neuron pools. We evaluated the extent to which respiratory drive synchronizes the activation of motor unit pairs in tongue (genioglossus, hyoglossus) and chest-wall (diaphragm, external intercostals) muscles using coherence analysis. This is a frequency domain technique, which characterizes the frequency and relative strength of neural inputs that are common to each of the recorded motor units. We also examined coherence across the two tongue muscles, as our previous work shows that, despite being antagonists, they are strongly coactivated during the inspiratory phase, suggesting that excitatory input from the premotor neurons is distributed broadly throughout the hypoglossal motoneuron pool. All motor unit pairs showed highly correlated activity in the low-frequency range (1-8 Hz), reflecting the fundamental respiratory frequency and its harmonics. Coherence of motor unit pairs recorded either within or across the tongue muscles was similar, consistent with broadly distributed premotor input to the hypoglossal motoneuron pool. Interestingly, motor units from diaphragm and external intercostal muscles showed significantly higher coherence across the 10-20-Hz bandwidth than tongue-muscle units. We propose that the lower coherence in tongue-muscle motor units over this range reflects a larger constellation of presynaptic inputs, which collectively lead to a reduction in the coherence between hypoglossal motoneurons in this frequency band. This, in turn, may reflect the relative simplicity of the respiratory drive to the diaphragm and intercostal muscles, compared with the greater diversity of functions fulfilled by muscles of the tongue.

  8. Intercostal muscles and purring in the cat: the influence of afferent inputs.

    PubMed

    Kirkwood, P A; Sears, T A; Stagg, D; Westgaard, R H

    1987-03-03

    Feline purring has previously been reported as originating in a central oscillator, independent of afferent inputs, and also as not involving expiratory muscles. Here we show, via electromyographic recordings from intercostal muscles, quantified by cross-correlation, that expiratory muscles can be involved and that even if the oscillator is central, reflex components nevertheless play a considerable part in the production of the periodic pattern of muscle activation seen during purring.

  9. Synchronization of presynaptic input to motor units of tongue, inspiratory intercostal, and diaphragm muscles

    PubMed Central

    Rice, Amber; Fuglevand, Andrew J.; Laine, Christopher M.

    2011-01-01

    The respiratory central pattern generator distributes rhythmic excitatory input to phrenic, intercostal, and hypoglossal premotor neurons. The degree to which this input shapes motor neuron activity can vary across respiratory muscles and motor neuron pools. We evaluated the extent to which respiratory drive synchronizes the activation of motor unit pairs in tongue (genioglossus, hyoglossus) and chest-wall (diaphragm, external intercostals) muscles using coherence analysis. This is a frequency domain technique, which characterizes the frequency and relative strength of neural inputs that are common to each of the recorded motor units. We also examined coherence across the two tongue muscles, as our previous work shows that, despite being antagonists, they are strongly coactivated during the inspiratory phase, suggesting that excitatory input from the premotor neurons is distributed broadly throughout the hypoglossal motoneuron pool. All motor unit pairs showed highly correlated activity in the low-frequency range (1–8 Hz), reflecting the fundamental respiratory frequency and its harmonics. Coherence of motor unit pairs recorded either within or across the tongue muscles was similar, consistent with broadly distributed premotor input to the hypoglossal motoneuron pool. Interestingly, motor units from diaphragm and external intercostal muscles showed significantly higher coherence across the 10–20-Hz bandwidth than tongue-muscle units. We propose that the lower coherence in tongue-muscle motor units over this range reflects a larger constellation of presynaptic inputs, which collectively lead to a reduction in the coherence between hypoglossal motoneurons in this frequency band. This, in turn, may reflect the relative simplicity of the respiratory drive to the diaphragm and intercostal muscles, compared with the greater diversity of functions fulfilled by muscles of the tongue. PMID:21307319

  10. Absence of synergy for monosynaptic Group I inputs between abdominal and internal intercostal motoneurons.

    PubMed

    Ford, T W; Meehan, C F; Kirkwood, P A

    2014-09-01

    Internal intercostal and abdominal motoneurons are strongly coactivated during expiration. We investigated whether that synergy was paralleled by synergistic Group I reflex excitation. Intracellular recordings were made from motoneurons of the internal intercostal nerve of T8 in anesthetized cats, and the specificity of the monosynaptic connections from afferents in each of the two main branches of this nerve was investigated. Motoneurons were shown by antidromic excitation to innervate three muscle groups: external abdominal oblique [EO; innervated by the lateral branch (Lat)], the region of the internal intercostal muscle proximal to the branch point (IIm), and muscles innervated from the distal remainder (Dist). Strong specificity was observed, only 2 of 54 motoneurons showing excitatory postsynaptic potentials (EPSPs) from both Lat and Dist. No EO motoneurons showed an EPSP from Dist, and no IIm motoneurons showed one from Lat. Expiratory Dist motoneurons fell into two groups. Those with Dist EPSPs and none from Lat (group A) were assumed to innervate distal internal intercostal muscle. Those with Lat EPSPs (group B) were assumed to innervate abdominal muscle (transversus abdominis or rectus abdominis). Inspiratory Dist motoneurons (assumed to innervate interchondral muscle) showed Dist EPSPs. Stimulation of dorsal ramus nerves gave EPSPs in 12 instances, 9 being in group B Dist motoneurons. The complete absence of heteronymous monosynaptic Group I reflex excitation between muscles that are synergistically activated in expiration leads us to conclude that such connections from muscle spindle afferents of the thoracic nerves have little role in controlling expiratory movements but, where present, support other motor acts. Copyright © 2014 the American Physiological Society.

  11. Non-intubated thoracoscopic surgery using internal intercostal nerve block, vagal block and targeted sedation.

    PubMed

    Hung, Ming-Hui; Hsu, Hsao-Hsun; Chan, Kuang-Cheng; Chen, Ke-Cheng; Yie, Jr-Chi; Cheng, Ya-Jung; Chen, Jin-Shing

    2014-10-01

    Thoracoscopic surgery using internal intercostal nerve block, vagal block and targeted sedation without endotracheal intubation is a promising technique for selected patients, but little is known about its feasibility and safety. We evaluated 109 patients with lung (105), mediastinal (3) or pleural (1) tumours treated using non-intubated thoracoscopic surgery. Internal, intercostal nerve block was performed at the T3-T8 intercostal level and vagal block was performed adjacent to the vagus nerve at the level of the lower trachea for right-sided operations and at the level of the aortopulmonary window for left-sided operations. Sedation was performed with propofol infusion to achieve a bispectral index value between 40 and 60. Thoracoscopic lobectomy was performed in 43 patients, wedge resection in 50, segmentectomy in 12 and mediastinal or pleural tumour excision in 4. Three patients (2.8%) required conversion to intubated one-lung ventilation because of vigorous mediastinal movement and dense diaphragmatic adhesions. Anaesthetic induction and operation had a median duration of 10.0 and 127.0 min, respectively. Operative complications developed in 13 patients with air leaks for more than 3 days and 1 patient required transfusion of blood products. The median postoperative chest drainage and hospital stay were 2.0 and 4.0 days, respectively. Non-intubated thoracoscopic surgery using internal intercostal nerve block, vagal block and targeted sedation is technically feasible and safe in surgical treatment of lung, mediastinal and pleural tumours in selected patients. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  12. Curative effect research on curing intercostal neuralgia through paravertebral nerve block combined with pregabalin.

    PubMed

    Xiao, Peng; Zhu, Xu; Wu, Xuejian

    2014-09-01

    This paper aimed to discuss the curative effect and safety of curing intercostal neuralgia through paravertebral nerve block combined with pregabalin. 90 cases of patients diagnosed as intercostal neuralgia were taken as research object. Random number method was used to divide the patients that is conforming to the inclusion criteria and exclusion criteria into 3 groups. 30 cases was in group A (oral lyrica), 30 cases was in group B (paravertebral block only) and 30 cases was in group C (paravertebral block combined with pregabalin). The clinical effect and safety of three groups was compared. The result showed that: visual analogue scale (VAS) and quality of sleep (QS) of three groups of patients after treatment all decreased obviously; group A had slow work, large amount of dosage and many adverse effects; group B had quick work, but the improvement on pain and sleep was not satisfactory; the curative effect of group C was higher than group A and B (p<0.05); 3 groups all had adverse effect, among which group C had the least adverse effect. It can be concluded that paravertebral nerve block combined with pregabalin for curing intercostal neuralgia was superior than single use of pregabalin or paravertebral block and that is worth to promote.

  13. Intercostal nerve transfer to the biceps motor branch in complete traumatic brachial plexus injuries.

    PubMed

    Cho, Alvaro Baik; Iamaguchi, Raquel Bernardelli; Silva, Gustavo Bersani; Paulos, Renata Gregorio; Kiyohara, Leandro Yoshinobu; Sorrenti, Luiz; de Menezes, Klícia de Oliveira Costa Riker Teles; de Rezende, Marcelo Rosa; Wei, Teng Hsiang; Mattar Júnior, Rames

    2015-09-01

    The purpose of this report is to critically evaluate our results of two intercostal nerve transfers directly to the biceps motor branch in complete traumatic brachial plexus injuries. From January 2007 to November 2012, 19 patients were submitted to this type of surgery, but only 15 of them had a follow-up for ≥2 years and were included in this report. The mean interval from trauma to surgery was 6.88 months (ranging from 3 to 9 months). Two intercostals nerves were dissected and transferred directly to the biceps motor branch. The mean follow-up was 38.06 months (ranging from 24 to 62 months). Ten patients (66.6%) recovered an elbow flexion strength ≥M3. Four of them (26.66%) recovered a stronger elbow flexion ≥M4. One patient (6.25%) recovered an M2 elbow flexion and four patients (26.66%) did not regain any movement. We concluded that two intercostal nerve transfers to the biceps motor branch is a procedure with moderate results regarding elbow flexion recovery, but it is still one of the few options available in complete brachial plexus injuries, especially in five roots avulsion scenario. © 2015 Wiley Periodicals, Inc.

  14. Subcapsular hematoma of the liver due to intercostal anesthesic blockage after cholecystectomy: case report.

    PubMed

    Santos Rodrigues, A L; Silva Santana, A C; Crociati Meguins, L; Felgueiras Rolo, D; Lobato Ferreira, M; Ribeiro Braga, C A

    2009-01-01

    The subcapsular hematoma of the liver (SHL) are the results of injuries such as liver needle biopsy, liver trauma, pregnancy illnesses, parasitic diseases and others. The approach of these lesions depends on the various clinical presentations of subcapsular hematoma of the liver because it may be small with minimal clinical repercussion, managed only by ultrasound observation. In some situations the SHL may present large dimensions with hemodinamic instability. A case of subcapsular hematoma of the liver secondary to anesthetic intercostal blockade to control the postoperative pain after cholecystectomy is reported. A 34-year-old woman was submitted to intercostal anesthetic blockade after cholecystectomy for treatment of cholelithiasis. The blockade evolved with pain in right flank followed of mucocutaneous pallor and fall of the haematocrit and hemoglobin levels. At relaparotomy, subcapsular hematoma of the liver was proven and tamponed with compresses. The patient had good postoperative evolution being discharged from hospital, after removing the compresses. In conclusion, the intercostal anesthesic blockade, as any other medical procedure, is not exempt of complications. Therefore, it must be carried through in well selected cases; Anyway nowadays, there are efficient drugs for the control of postoperative pain.

  15. Intercostal thoracotomy in 20 dogs: muscle-sparing versus traditional techniques

    PubMed Central

    Lee, Suhwon; Jeong, Soon-wuk

    2015-01-01

    The levels of pain, duration of approaching and closure, and surgical exposure associated with intercostal thoracotomy were compared between muscle-sparing and traditional techniques in 20 dogs. Postoperative pain was assessed based on numerical pain scores using behavioral observation, heart rate, respiratory rate, and wound palpation. Time for approaching and closure were measured, and the extent of intrathoracic organ exposure for the surgical procedures was described for each technique. There were significant differences in numerical pain scores at 2 h as well as 1, 2, 3, 4, 5, 6, and 7 days after surgery between the two groups (p < 0.0001). There was no significant (p = 0.725) difference in times for approaching and closure between the two groups. Compared to the traditional method, the muscle-sparing technique also achieved the desired exposure without compromising exposure of the target organs. Our results suggest that the muscle-sparing technique is more effective than the traditional method for providing a less painful recovery during the first 7 days after intercostal thoracotomy. Additionally, the muscle-sparing technique is as effective as the traditional modality for providing an appropriate time for approaching and closure during intercostal thoracotomy as well as adequate organ exposure for the surgical procedures. PMID:25798045

  16. Correlation between ATLS training and junior doctors' anatomical knowledge of intercostal chest drain insertion.

    PubMed

    Kong, Victor Y; Oosthuizen, George V; Sartorius, Benn; Keene, Claire M; Clarke, Damian L

    2015-01-01

    To review the ability of junior doctors (JDs) in identifying the correct anatomical site for intercostal chest drain insertion and whether prior Advanced Trauma Life Support (ATLS) training influences this. We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact preferred site for intercostal chest drain insertion. This study was conducted in a large metropolitan university hospital in South Africa. A total of 152 JDs participated in the study. Among them, 63 (41%) were men, and the mean age was 24 years. There were 90 (59%) PGY1 doctors and 62 (41%) PGY2 doctors. Overall, 28% (42/152) of all JDs correctly identified the site that was located within the accepted safe triangle. A significantly higher proportion of PGY2 doctors selected the correct site when compared with PGY1 doctors (39% vs 20%, p = 0.026). Those who had prior ATLS provider training were 6.8 times more likely to be able to identify the correct site (RR = 6.8, 95% CI: 3.7-12.5). Most of the JDs do not have sufficient anatomical knowledge to identify the safe insertion site for intercostal chest drain. Those who had undergone ATLS training were more likely to be able to identify the safe insertion site. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Review of the Local Organizing Committee (LOC) medical services during the 12th FINA World Swimming Championships (25 m) in Doha, Qatar.

    PubMed

    Dijkstra, H Paul; Geertsema, Liesel; Benzarti, Nejib; van Dorssen, Elsbeth A L; van den Hoogenband, Cees-Rein; Mountjoy, Margo

    2016-05-01

    One of the primary roles of Fédération Internationale de Natation (FINA) is to promote athlete health. The planning and delivery of major international event medical services is carried out in collaboration with the Local Organizing Committee Medical Commission (LOCMC). Aspetar Orthopaedic and Sports Medicine Hospital provided the medical services to the 12th FINA World Swimming Championships (25 m) creating a unique opportunity for collaboration with FINA. The purpose of this paper is to review the planning and delivery of medical services and athlete health promotion projects during the 12th FINA World Swimming Championships (25 m) to facilitate the planning of future sporting events of this size and scope. The 12th FINA World Swimming Championships (25 m) hosted 974 athletes from 166 countries. The LOC medical team recorded all medical encounters-newly incurred (or acute exacerbations of chronic) injuries and illnesses as well as follow-up consultations. More than 90% of teams did not travel with a team physician and relied on the LOCMC for diagnosis and treatment of injuries and illnesses in athletes and accredited team officials. The LOC medical team had a total of 554 medical encounters: 385 therapy, 34 athlete injury, 65 athlete illness and 70 non-athlete encounters. The LOCMC in collaboration with FINA delivered comprehensive medical services to athletes, officials and spectators attending the 12th FINA World Swimming Championships (25 m). This review paper provides information relevant to the planning and delivery of LOCMC medical services for future international swimming events contributing to the FINA objective of promoting athlete health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Earthquake relocations and InSAR analysis following the June 12th 2011 eruption of Nabro volcano, Afar

    NASA Astrophysics Data System (ADS)

    Hamlyn, Joanna; Wright, Tim; Keir, Derek; Neuberg, Jurgen; Grandin, Raphael; Goitom, Berhe; Hammond, James; Kibreab, Alem; Ogubazghi, Ghebrebrhan; Pagli, Carolina; Sansosti, Eugenio

    2014-05-01

    Nabro volcano sits on the southern part of Danakil block to the east of the Afar depression, on the Arabian plate. On the 12th June 2011, Nabro volcano suddenly erupted after being inactive for 10,000 years. The eruption caused a 17-km-long lava flow, a 15-km-high ash cloud, and ranks as one of the largest emissions of SO2 since the Mt. Pinatubo (1991) event. This eruption creates an important opportunity to use seismicity and surface deformation measurements to understand the subsurface magmatic system and deformation of a hazardous, off axis caldera during continental rupture. We installed a network of 8 seismometers around Nabro caldera which began recording on the 31st August and tasked SAR acquisitions from TerraSAR-X (TSX) and Cosmo-SkyMed (CSK) satellites. The SAR images used for this study post date the eruption. We used TSX stripmap mode images from ascending and descending orbits. Using a small baseline approach, we used 25 images acquired between the 1st July 2011 to the 5th October 2012 on descending orbit 046, to create 34 interferograms. We complemented these with 19 images from ascending orbit 130 spanning the 6th July 2011 to the 10th October 2012 from ascending orbit 130, which we used to create 21 interferograms. We produced a velocity ratemap and timeseries using π-RATE showing subsidence of up to 25cm/yr centred on Nabro. We used a Monte-Carlo hybrid downhill simplex technique to invert the dataset and found the best fitting solution as a mogi source at 6.9 ±1.1 km depth, and located at a 13.35 (lat) and 41.69 (long). The time dependence observed is consistent with a viscoelastic relaxation around the magma chamber, following depletion. Concurrent with the TSX acquisitions, CSK imaged the volcano on a descending track between 26th June 2011 and 18th July 2012 within the ASI project SAR4Volcanoes, and 64 images were used to produce 171 interferograms which were inverted to form a timeseries using a SBAS approach. This dataset has an overall

  19. High-Risk Driving Behaviors Among 12th Grade Students: Differences Between Alcohol-Only and Alcohol Mixed With Energy Drink Users.

    PubMed

    Williams, Ronald D; Housman, Jeff M; Woolsey, Conrad L; Sather, Thomas E

    2017-08-04

    About 30% of high school students use energy drinks. Alcohol mixed with energy drinks (AmED) has been associated with higher rates of risky driving among college students. The purpose of this study was to: (a) examine AmED-use in a sample of high school students and (b) to specifically investigate differences in risky driving behaviors between 12th grade students who engaged in AmED-use and those who consumed alcohol only. Differences in risky driving behaviors were investigated by utilizing secondary data analyses of nationally representative data from the Monitoring the Future Study (N = 1305). 12th grade AmED users were significantly more likely to be in a motor vehicle accident (p <.001) and receive a ticket for a traffic violation (p <.05). Additionally, 12th grade AmED users were significantly less likely to wear a seatbelt as a driver or passenger (p <.001). Conclusions/Importance: Although this study does not link risky driving behaviors to specific drinking events, it does indicate a relationship between AmED-use and high-risk driving. Because traffic accidents are the highest cause of mortality among U.S. teenagers, drug education efforts to reduce high-risk driving behaviors should include information on the decision-making and synergistic effects of energy drinks when mixed with alcohol.

  20. The Association of Employment and Physical Activity among Black and White 10th and 12th Grade Students in the United States

    PubMed Central

    2010-01-01

    Background Evidence of an association between employment and physical activity (PA) in youth has been mixed, with studies suggesting both positive and negative associations. We examined the association between employment and PA among U.S. high school students as measured by self-reported overall PA, vigorous exercise, and participation in school athletic teams. Methods We employed a secondary analysis using weighted linear regression to a sample of black and white 10th grade (n=12073) and 12th grade students (n=5500) drawn from the nationally representative cross-sectional 2004 Monitoring the Future Study. Results Overall, 36.5% of 10th and 74.6% of 12th grade students were employed. In multivariable analyses, 10th graders working >10 hours a week reported less overall PA and exercise and those working >20 hours a week reported less participation in team sports. Among 12th graders, any level of employment was associated with lower rates of team sports; those working >10 hours a week reported less overall PA; and those working >20 hours reported less exercise. Conclusions Employment at and above 10 hours per week is negatively associated with PA. Increasing work intensity may shed light on the decline of PA as adolescents grow older and merits further attention in research. PMID:20231752

  1. Intercostal Artery Reconstruction: The Simple and Effective Technique on Spinal Cord Protection during Thoracoabdominal Aortic Replacement.

    PubMed

    Zhang, Liang; Sun, Xiao-Gang; Yu, Cun-Tao; Chang, Qian; Qian, Xiang-Yang

    2016-07-01

    To retrospectively analyze the role of intercostal artery reconstruction in the spinal cord protection for patients undergoing extensive thoracoabdominal aortic aneurysm repair. From August 2007 to 2014, thoracoabdominal aortas (Crawford II) of 81 consecutive patients with mean age 39.4 ± 10.32 years were repaired. Seventy-three of these patients (90.12%) were diagnosed with aortic dissection in our group, 25 (30.86%) with Stanford type A dissection and 48 (59.26%) with Stanford B aortic dissection. All 25 patients with type A dissection have previously undergone surgical procedures which include Bentall's procedures in 11 cases, ascending aortic replacement in 6 cases, and total aortic arch replacement in 8 cases. All procedures were performed under profound hypothermia with interval cardiac arrest after making a thoracoabdominal incision. Extracorporeal circulation was instituted with 2 arterial cannulae and a single venous cannula in the right atrium. T6-T12 intercostal arteries and L1 and L2 lumbar arteries were formed to a neo-intercostal artery in place and were connected to an 8 mm branch for maintaining spinal cord blood perfusion. Visceral arteries were joined into a patch and anastomosed to the end of the main graft. The left renal artery was anastomosed to an 8 mm branch or joined to the patch. The other 10 mm branches were anastomosed to iliac arteries. With 100% follow-up, early mortality was 7.4%. Six deaths were recorded; 1 patient died of cerebral hemorrhage, 3 of renal failure, 1 of heart failure because of myocardial infarction, and the last one died from the rupture of celiac artery dissection. The rate of postoperative spinal cord deficits was 3.7%, 2 patients with paraplegia and 1 patient with paraparesis. None had bladder or rectum dysfunction. Neo-intercostal arteries were clogged in 12 patients within follow-up period and formed pseudoaneurysm in 2 patients with Marfan syndrome. The mean survival time in this group was 54.22 ± 3.03

  2. A Man for All Reason: General Larry D. Welch, 12th Chief of Staff, US Air Force

    DTIC Science & Technology

    2012-06-01

    Carl Dolman, Pure Strategy: Power and Principle in the Space and Information Age (New York: Frank Cass, 2005), 1. 4 Gen Larry D. Welch, interview...strategy as expressed in Everett Carl Dolman, Pure Strategy: Power and Principle in the Space and Information Age (New York: Frank Cass, 2005), 14...Outcomes, ed. James M. Smith and Gwendolyn Hall (Maxwell AFB, AL: Air University Press, September 2002), 143. 4 Everett Carl Dolman, Pure Strategy

  3. FOREWORD: 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications

    NASA Astrophysics Data System (ADS)

    Kreter, Arkadi; Linke, Jochen; Rubel, Marek

    2009-12-01

    The 12th International Workshop on Plasma-Facing Materials and Components for Fusion Applications (PFMC-12) was held in Forschungszentrum Jülich (FZJ) in Germany in May 2009. This symposium is the successor to the International Workshop on Carbon Materials for Fusion Applications series. Between 1985 and 2003, 10 'Carbon Workshops' were organized in Jülich, Stockholm and Hohenkammer. After this time, the scope of the symposium was redefined to reflect the new requirements of ITER and the ongoing evolution of the field. The workshop was first organized under its new name in 2006 in Greifswald, Germany. The main objective of this conference series is to provide a discussion forum for experts from research institutions and industry dealing with materials for plasma-facing components in present and future controlled fusion devices. The operation of ASDEX-Upgrade with tungsten-coated wall, the fast progress of the ITER-Like Wall Project at JET, the plans for the EAST tokamak to install tungsten, the start of ITER construction and a discussion about the wall material for DEMO all emphasize the importance of plasma-wall interactions and component behaviour, and give much momentum to the field. In this context, the properties and behaviour of beryllium, carbon and tungsten under plasma impact are research topics of foremost relevance and importance. Our community realizes both the enormous advantages and serious drawbacks of all the candidate materials. As a result, discussion is in progress as to whether to use carbon in ITER during the initial phase of operation or to abandon this element and use only metal components from the start. There is broad knowledge about carbon, both in terms of its excellent power-handling capabilities and the drawbacks related to chemical reactivity with fuel species and, as a consequence, about problems arising from fuel inventory and dust formation. We are learning continuously about beryllium and tungsten under fusion conditions, but our

  4. Discrimination of DPRK M5.1 February 12th, 2013 Earthquake as Nuclear Test Using Analysis of Magnitude, Rupture Duration and Ratio of Seismic Energy and Moment

    NASA Astrophysics Data System (ADS)

    Salomo Sianipar, Dimas; Subakti, Hendri; Pribadi, Sugeng

    2015-04-01

    On February 12th, 2013 morning at 02:57 UTC, there had been an earthquake with its epicenter in the region of North Korea precisely around Sungjibaegam Mountains. Monitoring stations of the Preparatory Commission for the Comprehensive Nuclear Test-Ban Treaty Organization (CTBTO) and some other seismic network detected this shallow seismic event. Analyzing seismograms recorded after this event can discriminate between a natural earthquake or an explosion. Zhao et. al. (2014) have been successfully discriminate this seismic event of North Korea nuclear test 2013 from ordinary earthquakes based on network P/S spectral ratios using broadband regional seismic data recorded in China, South Korea and Japan. The P/S-type spectral ratios were powerful discriminants to separate explosions from earthquake (Zhao et. al., 2014). Pribadi et. al. (2014) have characterized 27 earthquake-generated tsunamis (tsunamigenic earthquake or tsunami earthquake) from 1991 to 2012 in Indonesia using W-phase inversion analysis, the ratio between the seismic energy (E) and the seismic moment (Mo), the moment magnitude (Mw), the rupture duration (To) and the distance of the hypocenter to the trench. Some of this method was also used by us to characterize the nuclear test earthquake. We discriminate this DPRK M5.1 February 12th, 2013 earthquake from a natural earthquake using analysis magnitude mb, ms and mw, ratio of seismic energy and moment and rupture duration. We used the waveform data of the seismicity on the scope region in radius 5 degrees from the DPRK M5.1 February 12th, 2013 epicenter 41.29, 129.07 (Zhang and Wen, 2013) from 2006 to 2014 with magnitude M ≥ 4.0. We conclude that this earthquake was a shallow seismic event with explosion characteristics and can be discriminate from a natural or tectonic earthquake. Keywords: North Korean nuclear test, magnitude mb, ms, mw, ratio between seismic energy and moment, ruptures duration

  5. A comparison of intercostal and partial ulnar nerve transfers in restoring elbow flexion following upper brachial plexus injury (C5-C6+/-C7).

    PubMed

    Coulet, Bertrand; Boretto, Jorge G; Lazerges, Cyril; Chammas, Michel

    2010-08-01

    Restoring active elbow flexion is essential in the surgical management of C5-C6 +/- C7 brachial plexus palsies. This study compares the clinical results of 2 techniques to restore elbow flexion: the partial ulnar nerve transfer and the intercostal nerve transfer. Partial ulnar nerve transfer was performed in 23 patients, and intercostal nerve transfer was performed in 17 patients. For both techniques, the transfer to the musculocutaneous nerve was made at the same anatomical point. Age and preoperative delay were comparable between groups of patients. Biceps reinnervation time was significantly earlier (p = .001) in the ulnar nerve technique (mean, 5.1 mo) than the intercostal nerve technique (mean 9.9 mo). Ten of 17 patients recovered useful elbow flexion force (British Medical Research Council grade >M3) in the intercostal nerve transfer group, compared with 20 of 23 patients in the ulnar nerve transfer group. No patient who had surgery more than 6 months after the injury recovered useful elbow flexion force in the intercostal nerve transfer. Elbow flexion strength was better in patients less than 30 years old in the intercostal nerve group. No complications were observed in either group. This study shows that transferring fascicles of the ulnar nerve yields better results than intercostals nerve transfer for restoring elbow flexion. Moreover, preoperative delay and age are important preoperative prognostic factors for the intercostal nerves transfers. Therapeutic III. Copyright 2010. Published by Elsevier Inc.

  6. International Space Station (ISS)

    NASA Image and Video Library

    2001-12-15

    As seen through a window on the Space Shuttle Endeavor's aft flight deck, the International Space Station (ISS), with its newly-staffed crew of three, Expedition Four, is contrasted against a patch of the blue and white Earth. The Destiny laboratory is partially covered with shadows in the foreground. The photo was taken during the departure of the Earth-bound Endeavor, bringing to a close the STS-108 mission, the 12th Shuttle mission to visit the ISS.

  7. Primary proton and helium spectra in the energy range 10 to the 12th to 10 to the 14th eV

    NASA Technical Reports Server (NTRS)

    Gregory, J. C.; Ogata, T.; Saito, T.; Holynski, R.; Jurak, A.; Wolter, W.; Wosiek, B.; Dake, S.; Fuki, M.; Parnell, T. A.; hide

    1982-01-01

    Measurements of proton and helium spectra have been made in the energy range 10 to the 12th to 10 to the 14th eV. Large area thin emulsion calorimeters were used in the Japanese American Cooperative Emulsion Experiment balloon flight series. Power indices of the integral spectra for both nuclei are consistent with published data at lower energies. Absolute intensities are also consistent for helium and proton fluxes with extrapolations of previous data. No steepening of the proton spectrum is indicated.

  8. An estimation of the primary proton spectrum between 10 to the 12th and 10 to the 14th eV

    NASA Technical Reports Server (NTRS)

    Gaisser, T. K.; Siohan, F.; Yodh, G. B.

    1978-01-01

    Based on measurements of unaccompanied charged hadron flux from 10 to the 11th to 10 to the 14th eV at mountain altitudes, the primary proton flux is estimated using recently determined proton-proton total cross sections from new measurements of the real part of the forward scattering amplitude at ISR, and Glauber theory to calculate proton-air inelastic cross section. The derived spectrum agrees well with extrapolation of the direct measurements below 2 times 10 to the 12th eV without change of slope.

  9. Primary proton and helium spectra in the energy range 10 to the 12th to 10 to the 14th eV

    NASA Technical Reports Server (NTRS)

    Gregory, J. C.; Ogata, T.; Saito, T.; Holynski, R.; Jurak, A.; Wolter, W.; Wosiek, B.; Dake, S.; Fuki, M.; Parnell, T. A.; Jones, W. V.

    1982-01-01

    Measurements of proton and helium spectra have been made in the energy range 10 to the 12th to 10 to the 14th eV. Large area thin emulsion calorimeters were used in the Japanese American Cooperative Emulsion Experiment balloon flight series. Power indices of the integral spectra for both nuclei are consistent with published data at lower energies. Absolute intensities are also consistent for helium and proton fluxes with extrapolations of previous data. No steepening of the proton spectrum is indicated.

  10. Distribution of inspiratory drive to the external intercostal muscles in humans

    PubMed Central

    De Troyer, André; Gorman, Robert B; Gandevia, Simon C

    2003-01-01

    The external intercostal muscles in humans show marked regional differences in respiratory effect, and this implies that their action on the lung during breathing is primarily determined by the spatial distribution of neural drive among them. To assess this distribution, monopolar electrodes were implanted under ultrasound guidance in different muscle areas in six healthy individuals and electromyographic recordings were made during resting breathing. The muscles in the dorsal portion of the third and fifth interspace showed phasic inspiratory activity with each breath in every subject. However, the muscle in the ventral portion of the third interspace showed inspiratory activity in only three subjects, and the muscle in the dorsal portion of the seventh interspace was almost invariably silent. Also, activity in the ventral portion of the third interspace, when present, and activity in the dorsal portion of the fifth interspace were delayed relative to the onset of activity in the dorsal portion of the third interspace. In addition, the discharge frequency of the motor units identified in the dorsal portion of the third interspace averaged (mean ± s.e.m.) 11.9 ± 0.3 Hz and was significantly greater than the discharge frequency of the motor units in both the ventral portion of the third interspace (6.0 ± 0.5 Hz) and the dorsal portion of the fifth interspace (6.7 ± 0.4 Hz). The muscle in the dorsal portion of the third interspace started firing simultaneously with the parasternal intercostal in the same interspace, and the discharge frequency of its motor units was even significantly greater (11.4 ± 0.3 vs. 8.9 ± 0.2 Hz). These observations indicate that the distribution of neural inspiratory drive to the external intercostals in humans takes place along dorsoventral and rostrocaudal gradients and mirrors the spatial distribution of inspiratory mechanical advantage. PMID:12563017

  11. Oxidative stress in the external intercostal muscles of patients with obstructive sleep apnoea.

    PubMed

    Barreiro, Esther; Nowinski, Adam; Gea, Joaquim; Sliwinski, Pawel

    2007-12-01

    The external intercostal muscles are chronically exposed to increased inspiratory loading and to continuous hypoxia-reoxygenation cycles in patients with obstructive sleep apnoea syndrome (OSAS). It was therefore hypothesised that oxidative stress levels would be increased in these muscles, and that treatment with continuous positive airway pressure (CPAP) would modify the oxidative stress levels and improve muscle dysfunction. A case-control study and a case-case study were conducted on the external intercostal muscles of 12 patients with severe OSAS (before and after 6 months of treatment with CPAP) and 6 control subjects. Reactive carbonyl groups, malondialdehyde (MDA)-protein and hydroxynonenal (HNE)-protein adducts, antioxidant enzyme levels, 3-nitrotyrosine and fibre type proportions were measured using immunoblotting and immunohistochemistry. Compared with controls, the intercostal muscles of patients with OSAS had higher levels of protein carbonylation (median values 3.06 and 2.45, respectively, p = 0.042), nitration (median values 1.64 and 1.05, respectively, p = 0.019) and proportions of type I fibres (median values 57% and 48%, respectively, p = 0.035) and reduced respiratory muscle endurance (median values 3.2 and 9.5 min, respectively, p = 0.001). Positive correlations were found between MDA-protein and HNE-protein adducts (r = 0.641, p = 0.02 and r = 0.594, p = 0.05, respectively) and 3-nitrotyrosine (r = 0.625, p = 0.03) and the apnoea-hypopnoea index (AHI) in all the patients with OSAS. Although treatment with CPAP significantly improved the AHI and oxygen desaturation, muscle oxidative stress levels and respiratory muscle endurance were not affected. This study suggests that inspiratory muscle performance is not completely restored after long-term treatment with CPAP.

  12. Effect of a combined thoracic and backward lifting exercise on the thoracic kyphosis angle and intercostal muscle pain.

    PubMed

    Yoo, Won-Gyu

    2017-08-01

    [Purpose] This study developed a combined thoracic and backward lifting exercise for thoracic kyphosis angle and intercostal muscle pain. [Subject and Methods] The subject was a 41-year-old man who complained of upper thoracic and intercostal pain. He performed the combined thoracic and backward lifting exercise for 15 days. [Results] The initial VAS score for the intercostal area was 4/10. The VAS score decreased to 1/10 after the thoracic exercise combined with backward lifting. The initial thoracic kyphosis angle was 38° and it decreased to 32° after the exercise period. [Conclusion] Therefore, backward lifting and thoracic extension is a good posture for activating the different layers of muscle that are attached to the ribs. The kyphosis angle is also reduced by providing sufficient resistance during the thoracic exercise.

  13. [Ultrasound-guided cutaneous intercostal branches nerves block: A good analgesic alternative for gallbladder open surgery].

    PubMed

    Fernández Martín, M T; López Álvarez, S; Mozo Herrera, G; Platero Burgos, J J

    2015-12-01

    Laparoscopic cholecystectomy has become the standard treatment for gallbladder diseases. However, there are still some patients for whom conversion to open surgery is required. This surgery can produce significant post-operative pain. Opioids drugs have traditionally been used to treat this pain, but side effects have led to seeking alternatives (plexus, nerve or fascia blocks or wound). The cases are presented of 4 patients subjected to ultrasound-guided intercostal branches blocks in the mid-axillary line from T6 to T12 with levobupivacaine as an analgesic alternative in open surgery of gallbladder, with satisfactory results.

  14. The inframammary extending lateral intercostal artery perforator flap for reconstruction of axillary contractures: a case report.

    PubMed

    Stillaert, F B; Casaer, B; Roche, N; Van Landuyt, K; Hamdi, M; Blondeel, P N; Monstrey, S

    2008-12-01

    Release and reconstruction of axillary scar contractures can be challenging due to the specific anatomic site and contouring of the axillary region. Pliable and unscarred skin coverage of resulting defects after scar release is needed which enhances the postoperative recovery and revalidation. When traditional donor regions of fasciocutaneous flaps are involved in the scarred area, options are few. We describe the design and versatility of an inframammary extended lateral intercostal artery perforator (LICAP) flap to reconstruct an axillary defect after wide scar release and debridement. The postoperative recovery was uneventful with restoration of the range of motion of the shoulder joint.

  15. Relationship between parasternal and external intercostal muscle length and load compensatory responses in dogs.

    PubMed Central

    Romaniuk, J R; Supinski, G; DiMarco, A F

    1992-01-01

    1. The effects of tracheal occlusion on peak parasternal (PA) and external intercostal (EI) (3rd interspace) EMG activities were examined at different end-expiratory lung volumes both above and below functional reserve capacity (FCR) in anaesthetized, vagotomized and spontaneously breathing dogs. 2. Parasternal (PA) and external intercostal (EI) muscle lengths were monitored in situ. The difference in peak EMG activity between free and occluded breaths (test breaths) was related to the coincident peak change in intercostal muscle length (delta L) for each muscle, respectively. 3. At FRC, tracheal occlusion resulted in compensatory augmentation of peak EI, but little change in peak PA EMG activities. At lung volumes below FRC, airway occlusion resulted in augmentation of both PA and EI activities. Responses to airway occlusion at lung volumes above FRC were variable. The magnitude and duration of these changes in EMG, however, could be linearly related to the value of delta L. With delta L = 0, there was no change in peak EI or PA EMG; for values of delta L less than 0, there was attenuation of EI and PA EMG; for delta L greater than 0, there was enhancement of EI and PA EMG activation. 4. The magnitude of the changes in EMG activity in response to tracheal occlusion was more prominent for the EI muscle compared to the PA, the latter of which are known to have much fewer muscle spindles than EI muscle. 5. Our results suggest that a difference in end-inspiratory muscle length between the control and occluded breaths is a stimulus for the intercostal response to applied loads implicating muscle spindles as the predominant receptor moderating these responses. We hypothesize that when delta L = 0, no change in EMG occurs since the spindles sense no change in muscle length. When delta L less than 0 (i.e. peak muscle length during the occluded breath is shorter than control) muscle spindles would be disengaged, resulting in a disfacilitation of EMG activity. Where delta L

  16. Thoracic Intercostal Nerve Blocks Reduce Opioid Consumption and Length of Stay in Patients Undergoing Implant-Based Breast Reconstruction.

    PubMed

    Shah, Ajul; Rowlands, Megan; Krishnan, Naveen; Patel, Anup; Ott-Young, Anke

    2015-11-01

    Traditionally, narcotics have been used for analgesia after breast surgery. However, these agents have unpleasant side effects. Intercostal nerve blockade is an alternative technique to improve postoperative pain. In this study, the authors investigate outcomes in patients who receive thoracic intercostal nerve blocks for implant-based breast reconstruction. A retrospective chart review was performed. The operative technique for breast reconstruction and administration of nerve blocks is detailed. Demographic factors, length of stay, and complications were recorded. The consumption of morphine, Valium, Zofran, and oxycodone was recorded. Data sets for patients receiving thoracic intercostal nerve blocks were compared against those that did not. One hundred thirty-two patients were included. For patients undergoing bilateral reconstruction with nerve blocks, there was a significant reduction in length of stay (1.87 days versus 2.32 days; p = 0.001), consumption of intravenous morphine (5.15 mg versus 12.68 mg; p = 0.041) and Valium (22.24 mg versus 31.13 mg; p = 0.026). For patients undergoing unilateral reconstruction with nerve blocks, there was a significant reduction in consumption of intravenous morphine (2.80 mg versus 8.17 mg; p = 0.007). For bilateral reconstruction with intercostal nerve block, cost savings equaled $2873.14 per patient. For unilateral reconstruction with intercostal nerve block, cost savings equaled $1532.34 per patient. The authors' data demonstrate a reduction in the consumption of pain medication, in the hospital length of stay, and in hospital costs for patients receiving intercostal nerve blocks at the time of pectoralis elevation for implant-based breast reconstruction. Therapeutic, III.

  17. Systematic review and meta-analysis of initial management of pneumothorax in adults: Intercostal tube drainage versus other invasive methods.

    PubMed

    Kim, Min Joung; Park, Incheol; Park, Joon Min; Kim, Kyung Hwan; Park, Junseok; Shin, Dong Wun

    2017-01-01

    The ideal invasive management as initial approach for pneumothorax (PTX) is still under debate. The purpose of this systematic review and meta-analysis was to examine the evidence for the effectiveness of intercostal tube drainage and other various invasive methods as the initial approach to all subtypes of PTX in adults. Three databases were searched from inception to May 29, 2016: MEDLINE, EMBASE, and the Cochrane CENTRAL. Randomised controlled trials that evaluated intercostal tube drainage as the control and various invasive methods as the intervention for the initial approach to PTX in adults were included. The primary outcome was the early success rate of each method, and the risk ratios (RRs) were used for an effect size measure. The secondary outcomes were recurrence rate, hospitalization rate, hospital stay, and complications. Seven studies met our inclusion criteria. Interventions were aspiration in six studies and catheterization connected to a one-way valve in one study. Meta-analyses were conducted for early success rate, recurrence rate, hospitalization rate, and hospital stay. Aspiration was inferior to intercostal tube drainage in terms of early success rate (RR = 0.82, confidence interval [CI] = 0.72 to 0.95, I2 = 0%). While aspiration and intercostal tube drainage showed no significant difference in the recurrence rate (RR = 0.84, CI = 0.57 to 1.23, I2 = 0%), aspiration had shorter hospital stay than intercostal tube drainage (mean difference = -1.73, CI = -2.33 to -1.13, I2 = 0%). Aspiration had lower hospitalization rate than intercostal tube drainage, but marked heterogeneity was present (RR = 0.38, CI = 0.19 to 0.76, I2 = 85%). Aspiration was inferior to intercostal tube drainage in terms of early resolution, but it had shorter hospital stay. The recurrence rate of aspiration and intercostal tube drainage did not differ significantly. The efficacy of catheterization connected to a one-way valve was inconclusive because of the small number of

  18. Nonintubated thoracoscopic lobectomy for lung cancer using epidural anesthesia and intercostal blockade: a retrospective cohort study of 238 cases.

    PubMed

    Hung, Ming-Hui; Chan, Kuang-Cheng; Liu, Ying-Ju; Hsu, Hsao-Hsun; Chen, Ke-Cheng; Cheng, Ya-Jung; Chen, Jin-Shing

    2015-04-01

    Intubated general anesthesia with single-lung ventilation has been considered mandatory for thoracoscopic lobectomy for nonsmall cell lung cancer. Few reports of thoracoscopic lobectomy without tracheal intubation are published, using either thoracic epidural anesthesia (TEA) or intercostal blockade. The comparisons of perioperative outcomes of nonintubated thoracoscopic lobectomy using epidural anesthesia and intercostal blockade are not reported previously. From September 2009 to August 2014, a total of 238 patients with lung cancer who underwent nonintubated thoracoscopic lobectomy were recruited from our prospectively maintained database of all patients undergoing nonintubated thoracoscopic surgery using TEA or intercostal blockade. A multiple regression analysis, adjusting for preoperative variables, was performed to compare the perioperative outcomes of the 2 anesthesia methods. Overall, 130 patients underwent nonintubated thoracoscopic lobectomy using epidural anesthesia whereas 108 had intercostal blockade. The 2 groups were similar in demographic data, except for sex, preoperative lung function, physical status classification, and history of smoking. After adjustment for the preoperative variables, nonintubated thoracoscopic lobectomy using intercostal blockade was associated with shorter durations of anesthetic induction and surgery (P < 0.001). Furthermore, hemodynamics were more stable with less use of vasoactive drugs (odds ratio: 0.53; 95% confidence interval [CI], 0.27 to 1.04; P = 0.064) and less blood loss (mean difference: -55.2 mL; 95% CI, -93 to -17.3; P = 0.004). Postoperatively, the 2 groups had comparable incidences of complications. Patients in the intercostal blockade group had a shorter average duration of chest tube drainage (P = 0.064) but a similar average length of hospital stay (P = 0.569). Conversion to tracheal intubation was required in 13 patients (5.5%), and no in-hospital mortality occurred in either group

  19. International Space Station (ISS)

    NASA Image and Video Library

    2001-10-01

    This is a crew portrait of the International Space Station (ISS) Expedition Four. Left to right are Astronaut Daniel W. Bursch, flight engineer; Cosmonaut Yuri I. Onufrienko, mission commander; and Astronaut Carl E. Walz, flight engineer. The crew was launched on December 5, 2001 aboard the STS-108 mission Space Shuttle Orbiter Endeavour, the 12th Shuttle mission to visit the ISS. The crew returned to Earth on June 19th, 2002 aboard the STS-111 mission Space Shuttle Orbiter Endeavour, replaced by Expedition Five. The Expedition Four crew spent 196 days in space, which gives flight engineers Walz and Bursh the U.S. space flight endurance record.

  20. Characterization of Intercostal Muscle Pathology in Canine Degenerative Myelopathy: A Disease Model for Amyotrophic Lateral Sclerosis

    PubMed Central

    Morgan, Brandie R.; Coates, Joan R.; Johnson, Gayle C.; Bujnak, Alyssa C.; Katz, Martin L.

    2014-01-01

    Dogs homozygous for missense mutations in the SOD1 gene develop a late-onset neuromuscular disorder called degenerative myelopathy (DM) that has many similarities to amyotrophic lateral sclerosis (ALS). Both disorders are characterized by widespread progressive declines in motor functions accompanied by atrophic changes in the descending spinal cord tracts , and some forms of ALS are also associated with SOD1 mutations. In end-stage ALS, death usually occurs as a result of respiratory failure due to severe functional impairment of respiratory muscles. The mechanisms that lead to this loss of function are not known. Dogs with DM are euthanized at all stages of disease progression providing an opportunity to characterize the onset and progression of any pathological changes in the respiratory muscles that may precede respiratory failure. To characterize such potential disease-related pathology we evaluated intercostal muscles from Boxer and Pembroke Welsh Corgi dogs that were euthanized at various stages of DM disease progression. DM was found to result in intercostal muscle atrophy, fibrosis, increased variability in muscle fiber size and shape, and an alteration in muscle fiber type composition. This pathology was not accompanied by retraction of the motor neuron terminals from the muscle acetylcholine receptor complexes, suggesting that the muscle atrophy did not result from physical denervation. These findings provide a better understanding of the mechanisms that likely lead to respiratory failure in at least some forms of ALS and will be useful in the development and evaluation of potential therapeutic interventions using the DM model. PMID:24043596

  1. The role of intercostal nerve preservation in acute pain control after thoracotomy.

    PubMed

    Marchetti-Filho, Marco Aurélio; Leão, Luiz Eduardo Villaça; Costa-Junior, Altair da Silva

    2014-01-01

    To evaluate whether the acute pain experienced during in-hospital recovery from thoracotomy can be effectively reduced by the use of intraoperative measures (dissection of the neurovascular bundle prior to the positioning of the Finochietto retractor and preservation of the intercostal nerve during closure). We selected 40 patients who were candidates for elective thoracotomy in the Thoracic Surgery Department of the Federal University of São Paulo/Paulista School of Medicine, in the city of São Paulo, Brazil. The patients were randomized into two groups: conventional thoracotomy (CT, n = 20) and neurovascular bundle preservation (NBP, n = 20). All of the patients underwent thoracic epidural anesthesia and muscle-sparing thoracotomy. Pain intensity was assessed with a visual analog scale on postoperative days 1, 3, and 5, as well as by monitoring patient requests for/consumption of analgesics. On postoperative day 5, the self-reported pain intensity was significantly lower in the NBP group than in the CT group (visual analog scale score, 1.50 vs. 3.29; p = 0.04). No significant differences were found between the groups regarding the number of requests for/consumption of analgesics. In patients undergoing thoracotomy, protecting the neurovascular bundle prior to positioning the retractor and preserving the intercostal nerve during closure can minimize pain during in-hospital recovery.

  2. The role of intercostal nerve preservation in acute pain control after thoracotomy*

    PubMed Central

    Marchetti-Filho, Marco Aurélio; Leão, Luiz Eduardo Villaça; Costa-Junior, Altair da Silva

    2014-01-01

    OBJECTIVE: To evaluate whether the acute pain experienced during in-hospital recovery from thoracotomy can be effectively reduced by the use of intraoperative measures (dissection of the neurovascular bundle prior to the positioning of the Finochietto retractor and preservation of the intercostal nerve during closure). METHODS: We selected 40 patients who were candidates for elective thoracotomy in the Thoracic Surgery Department of the Federal University of São Paulo/Paulista School of Medicine, in the city of São Paulo, Brazil. The patients were randomized into two groups: conventional thoracotomy (CT, n = 20) and neurovascular bundle preservation (NBP, n = 20). All of the patients underwent thoracic epidural anesthesia and muscle-sparing thoracotomy. Pain intensity was assessed with a visual analog scale on postoperative days 1, 3, and 5, as well as by monitoring patient requests for/consumption of analgesics. RESULTS: On postoperative day 5, the self-reported pain intensity was significantly lower in the NBP group than in the CT group (visual analog scale score, 1.50 vs. 3.29; p = 0.04). No significant differences were found between the groups regarding the number of requests for/consumption of analgesics. CONCLUSIONS: In patients undergoing thoracotomy, protecting the neurovascular bundle prior to positioning the retractor and preserving the intercostal nerve during closure can minimize pain during in-hospital recovery. PMID:24831401

  3. Upregulation of pro-inflammatory cytokines in the intercostal muscles of COPD patients.

    PubMed

    Casadevall, C; Coronell, C; Ramírez-Sarmiento, A L; Martínez-Llorens, J; Barreiro, E; Orozco-Levi, M; Gea, J

    2007-10-01

    Muscle dysfunction is a characteristic feature of chronic obstructive pulmonary disease (COPD). Recent studies suggest that cytokines may operate as local regulators of both muscle function and regeneration. The aim of the present study was to characterise the expression of different cytokines in the external intercostal muscle of COPD. Muscle biopsies were obtained from 25 stable COPD patients and eight healthy controls. Local tumour necrosis factor (TNF)-alpha, interleukin (IL)-1beta, -6 and -10 expressions (real-time PCR and ELISA), sarcolemmal damage (immunohistochemistry), and the transcript levels of CD18 were assessed. Muscle TNF-alpha and IL-6 transcripts were significantly higher in COPD patients compared with controls, and IL-1beta and sarcolemmal damage showed a strong tendency in the same direction. Similar results were observed at protein level. The CD18 panleukocyte marker was similar in COPD and controls. Respiratory muscle function was impaired in COPD patients and it correlated to both the severity of lung function impairment and TNF-alpha muscle expression. Chronic obstructive pulmonary disease is associated with the upregulation of pro-inflammatory cytokines in the intercostal muscles. This phenomenon might be involved in respiratory muscle dysfunction.

  4. TMS-evoked silent periods in scalene and parasternal intercostal muscles during voluntary breathing.

    PubMed

    Luu, Billy L; Saboisky, Julian P; Taylor, Janet L; Gandevia, Simon C; Butler, Jane E

    2015-09-15

    Transcranial magnetic stimulation (TMS) during voluntary muscle contraction causes a period of reduced electromyographic (EMG) activity (EMG). This is attributed to cortical inhibition and is known as the 'silent period'. Silent periods were compared in inspiratory muscles following TMS during voluntary inspiratory efforts during normocapnia, hypercapnia, and hypocapnia. TMS was delivered during isometric and dynamic contractions of scalenes and parasternal intercostals at 25% maximum inspiratory pressure. Changing end-tidal CO2 did not affect the duration of the silent period nor suppression of EMG activity during the silent period. In scalenes, silent periods were shorter for dynamic compared to isometric contractions (p<0.05); but contraction type did not alter the degree of suppression of EMG during the silent period. In parasternal intercostal, no significant differences in silent period parameters occurred for the different contraction types. The lack of effect of end-tidal CO2 suggests that descending drive from the medullary respiratory centres does not independently activate the inspiratory muscles during voluntary inspiratory efforts.

  5. Intercostal Muscle Pacing with High Frequency Spinal Cord Stimulation in Dogs

    PubMed Central

    DiMarco, Anthony F.; Kowalski, Krzysztof E.

    2010-01-01

    High frequency spinal cord stimulation (HF-SCS) is a novel and more physiologic method of inspiratory muscle activation which involves stimulation of spinal cord pathways. In the present study, we determined if activation of the inspiratory intercostal muscles alone by this technique could be utilized to maintain artificial ventilation. In 7 anesthetized dogs, following C2 spinal cord section and bilateral phrenicotomy, trains of electrical stimulation (12 times/min) were applied at the T2 level. Eucapnea was maintained during an initial 5.5 hour period of continuous stimulation. During a subsequent 0.5 hour period, stimulus parameters were increased to induce hyperventilation resulting in a sustained fall in end-tidal PCO2 to 29.3 ± 0.4 mmHg. Single motor unit peak firing frequencies of the intercostal muscles during HF-SCS were similar to those occurring during spontaneous breathing. This technique holds promise as a method to restore ventilation in ventilator-dependent tetraplegics who do not have adequate phrenic nerve function for diaphragm pacing. PMID:20338266

  6. Pneumomediastinum and the aortic nipple: the clinical relevance of the left superior intercostal vein.

    PubMed

    Walters, Andy; Cassidy, Lindsey; Muhleman, Mitchel; Peterson, Ashley; Blaak, Christa; Loukas, Marios

    2014-07-01

    This article discusses the appearance of the "aortic nipple" in chest radiography, and reviews the embryology and anatomy of the left superior intercostal vein which causes the appearance of an "aortic nipple." This radiological sign is useful in differentiating certain thoracic pathologies, such as pneumomediastinum, pneumopericardium, and medial pneumothorax. Pneumomediastinum is an encompassing term describing the presence of air in the mediastinum, and may arise from a wide range of pathological conditions. Despite the well-described imaging of pneumomediastinum, it is sometimes difficult to differentiate from other conditions such as pneumopericardium and medial pneumothorax. A separate finding, "aortic nipple" is the radiographic term used to describe the lateral nipple-like projection from the aortic knob present in a small number of individuals. The aortic nipple corresponds to the end-on appearance of the left superior intercostal vein coursing around the aortic knob, and may be mistaken radiologically for lymphadenopathy or a neoplasm. Despite their relative independence, the aortic nipple is defined by new contours in cases of pneumomediastinum, taking on an "inverted aortic nipple" appearance. In this position, the inverted aortic nipple may facilitate radiographic discrimination of pneumomediastinum from similar conditions. This study aims to review the common clinical and radiographic features of both pneumomediastinum and the aortic nipple. The radiologic appearance of the aortic nipple occurring in unison with pneumomediastinum, and its potential role as a tool in the differentiation of pneumomediastinum from similarly presenting conditions will also be described. Copyright © 2013 Wiley Periodicals, Inc.

  7. Characterization of intercostal muscle pathology in canine degenerative myelopathy: a disease model for amyotrophic lateral sclerosis.

    PubMed

    Morgan, Brandie R; Coates, Joan R; Johnson, Gayle C; Bujnak, Alyssa C; Katz, Martin L

    2013-12-01

    Dogs homozygous for missense mutations in the SOD1 gene develop a late-onset neuromuscular disorder called degenerative myelopathy (DM) that has many similarities to amyotrophic lateral sclerosis (ALS). Both disorders are characterized by widespread progressive declines in motor functions, accompanied by atrophic changes in the descending spinal cord tracts. Some forms of ALS are also associated with SOD1 mutations. In end-stage ALS, death usually occurs as a result of respiratory failure from severe functional impairment of respiratory muscles. The mechanisms that lead to this loss of function are not known. Dogs with DM are euthanized at all stages of disease progression, providing an opportunity to characterize the onset and progression of any pathological changes in the respiratory muscles that may precede respiratory failure. To characterize such potential disease-related pathology, we evaluated intercostal muscles from Boxer and Pembroke Welsh Corgi dogs that were euthanized at various stages of DM disease progression. DM was found to result in intercostal muscle atrophy, fibrosis, increased variability in muscle fiber size and shape, and alteration in muscle fiber type composition. This pathology was not accompanied by retraction of the motor neuron terminals from the muscle acetylcholine receptor complexes, suggesting that the muscle atrophy did not result from physical denervation. These findings provide a better understanding of the mechanisms that likely lead to respiratory failure in at least some forms of ALS and will be useful in the development and evaluation of potential therapeutic interventions using the DM model.

  8. Fine structures around the orifice of the intercostal artery of the rabbit thoracic aorta.

    PubMed

    Emura, S; Masuko, S; Sunaga, T

    1992-03-01

    In hypercholesterolemic rabbits, atherosclerotic lesions easily occur in the thoracic aorta, especially at the distal and lateral sides of the walls around the orifices of the dorsal intercostal arteries. In order to examine whether some special structures that lead to atherosclerotic lesions are present even in normal conditions, the authors investigated the morphologic features around the orifice of the intercostal artery of 20 normal rabbit aortae under electron microscopy. The endothelial cells were generally fusiform but tended to be round and have a cobblestone-like appearance at the lateral side. There was intimal protrusion at the distal and lateral sides of the orifice, where the distribution and arrangement of elastic fibers and smooth muscle cells were different from those at the proximal side. At the proximal edge of the orifice, elastic fibers formed a thick plate-like internal elastic lamina beneath the endothelial cells. On the other hand, at the distal and lateral sides, elastic fibers formed close-meshed structures over the proper plate-like internal elastic lamina. These results indicate that the aortic walls at the distal and lateral sides of the orifice are structurally different from those at other regions even in normal conditions and suggest the involvement of special structures at the distal and lateral sides of the orifice in atherogenesis.

  9. Proceedings of the Annual Space Surveillance Workshop (12th) Held in Lexington, Massachusetts on 5-7 April 1994. Volume 1

    DTIC Science & Technology

    1994-04-07

    The primary mirror is a Zerodur pseudo meniscus substrate produced by Schott, Germany, and provided as Government furnished equipment. The pseudo...and mirrored in up to three ways. A journaling file system is employed to ensure data integrity in the event of a system crash or power outage. The...design the pointing jitter amplitude should be less than 7 g~radian rms to avoid loss of signal. 72 VLS Telescope-3- mirror , f/4, off axis design

  10. Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults.

    PubMed

    Carson-Chahhoud, Kristin V; Wakai, Abel; van Agteren, Joseph Em; Smith, Brian J; McCabe, Grainne; Brinn, Malcolm P; O'Sullivan, Ronan

    2017-09-07

    For management of pneumothorax that occurs without underlying lung disease, also referred to as primary spontaneous pneumothorax, simple aspiration is technically easier to perform than intercostal tube drainage. In this systematic review, we seek to compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax. This review was first published in 2007 and was updated in 2017. To compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 1) in the Cochrane Library; MEDLINE (1966 to January 2017); and Embase (1980 to January 2017). We searched the World Health Organization (WHO) International Clinical Trials Registry for ongoing trials (August 2017). We checked the reference lists of included trials and contacted trial authors. We imposed no language restrictions. We included randomized controlled trials (RCTs) of adults 18 years of age and older with primary spontaneous pneumothorax that compared simple aspiration versus intercostal tube drainage. Two review authors independently selected studies for inclusion, assessed trial quality, and extracted data. We combined studies using the random-effects model. Of 2332 publications obtained through the search strategy, seven studies met the inclusion criteria; one study was ongoing and six studies of 435 participants were eligible for inclusion in the updated review. Data show a significant difference in immediate success rates of procedures favouring tube drainage over simple aspiration for management of primary spontaneous pneumothorax (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.69 to 0.89; 435 participants, 6 studies; moderate-quality evidence). Duration of hospitalization however was significantly less for patients treated by simple aspiration (mean

  11. [Hemothorax caused by injury of the 1st intercostal artery following trial puncture of the subclavian vein].

    PubMed

    Bergmann, J; Gök, Y; Smague, E

    1984-12-01

    This article reports the case of a patient who sustained an injury of the intercostal artery after a vena subclavia aspiration with extensive haemothorax. After thoracotomy, haemostatic treatment, respiratory therapy, intensive care and a prolonged hospital stay the female patient was discharged with a clean bill of health.

  12. Costal and crural diaphragm, and intercostal and genioglossal electromyogram activities during spontaneous augmented breaths (sighs) in kittens.

    PubMed

    Watchko, J F; Brozanski, B S; O'Day, T L; Klesh, K W; Guthrie, R D

    1989-01-01

    Spontaneously occurring augmented breaths (sighs) are common in infants. The pattern of electrical activity of the inspiratory muscles of the thorax and upper airway during augmented breaths, however, has not been fully characterized in this less than fully mature age group. We therefore examined costal and crural diaphragm and external intercostal and genioglossal EMG activities during spontaneous augmented breaths (n = 46) in 10 anesthetized (1.35% halothane) 1-month-old kittens breathing room air. EMG responses were assessed by comparing the spontaneous augmented breaths (AB) to the five immediately preceding breaths (control). The peak moving time average EMG activity observed during the AB was 240 +/- 32% (mean +/- SD) of control for the costal diaphragm, 279 +/- 66% of control for the crural diaphragm, and 274 +/- 68% of control for the external intercostal muscle. The mean increase in EMG activity during the AB was not significantly different among these three muscle groups (P greater than 0.25). Genioglossal EMG activity during AB was observed in only 1 of 10 study animals. These results document that during AB in anesthetized kittens, activity of the thoracic inspiratory muscles (costal/crural diaphragm and external intercostal muscles) increase in parallel, suggesting that they are modulated in a uniform manner. The infrequent observance of genioglossal activity during AB suggests that either 1) halothane anesthesia depresses genioglossal activity more than diaphragmatic and intercostal activity during AB or 2) that genioglossal recruitment is not necessary to maintain upper airway patency during this period of heightened respiratory drive.

  13. Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial

    PubMed Central

    Ahmed, Zulfiqar; Samad, Khalid; Ullah, Hameed

    2017-01-01

    Background: The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS. Materials and Methods: Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward. Results: The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours. Conclusion: Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period. PMID:28217054

  14. Successful Reinnervation of the Diaphragm After Intercostal to Phrenic Nerve Neurotization in Patients With High Spinal Cord Injury.

    PubMed

    Nandra, Kulvir S; Harari, Martin; Price, Thea P; Greaney, Patrick J; Weinstein, Michael S

    2017-08-01

    Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing. Our study aimed to evaluate early outcomes and efficacy of intercostal nerve transfer in diaphragmatic pacing. Four ventilator-dependent patients with high cervical spinal cord injuries were selected for this study. Each patient demonstrated absence of phrenic nerve function via external neck stimulation and laparoscopic diaphragm mapping. Each patient underwent intercostal to phrenic nerve grafting with implantation of a phrenic nerve pacer. The patients were followed, and ventilator dependence was reassessed at 1 year postoperatively. Our primary outcome was measured by the amount of time our patients tolerated off the ventilator per day. We found that all 4 patients have tolerated paced breathing independent of mechanical ventilation, with 1 patient achieving 24 hours of tracheostomy collar. From this study, intercostal to phrenic nerve transfer seems to be a promising approach in reducing or eliminating ventilator support in patients with C3 to C5 high spinal cord injury.

  15. Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial.

    PubMed

    Ahmed, Zulfiqar; Samad, Khalid; Ullah, Hameed

    2017-01-01

    The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS. Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward. The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours. Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.

  16. Reflex and cerebellar influences on α and on `rhythmic' and `tonic' γ activity in the intercostal muscle

    PubMed Central

    Corda, M.; von Euler, C.; Lennerstrand, G.

    1966-01-01

    1. Efferent intercostal α and γ activity and afferent intercostal muscle spindle activity were studied in decerebrate cats in response to stimulation of the anterior lobe of the cerebellum and to postural and other reflexes. 2. Low threshold intercostal responses were elicited from lobuli IV and V of the anterior lobe of the cerebellum. 3. The existence of two functionally different types of intercostal γ neurones has been confirmed. These are the `rhythmic' or `specifically respiratory' γ neurones, and the `tonic' γ neurones. 4. In response to cerebellar stimulation, facilitatory, inhibitory and diphasic tetanic and post-tetanic effects were obtained from α and the two types of γ fibres in both external and internal intercostal nerve branches. 5. Generally both inspiratory and expiratory α and γ activity was facilitated in response to tetanic stimulation at contralateral stimulus sites, and inhibited in response to stimulation of ipsilateral sites. 6. `Rhythmic' γ activity appeared to be rather closely linked to the respiratory α activity but the balance between `rhythmic' γ and α was often changed in response to cerebellar stimulation, as indicated by the responses of primary muscle spindle afferents. 7. The `tonic' γ neurones were as a rule more responsive to cerebellar stimulation than were the α and `rhythmic' γ neurones. Long-lasting post-tetanic effects were much more prominent in the `tonic' γ fibres than in the α or `rhythmic' γ fibres. 8. `Rhythmic' γ activity was abolished after cervical transections of the cord. `Tonic' γ activity remained in the spinal preparations although usually at a different discharge rate. 9. `Tonic' γ neurones were more responsive than the `rhythmic' γ neurones to the proprioceptive γ reflex elicited by passive movements of the chest wall as well as to other spinal and supraspinal reflexes. 10. Both `dynamic' and `static' γ fibres seem to be represented in the group of `tonic' intercostal γ neurones. 11

  17. Climate Change and the Water Cycle: A New Southwest Regional Climate Hub Curriculum Unit for 6th-12th Grade Students

    NASA Astrophysics Data System (ADS)

    Elias, E.; Steele, C. M.; Bestelmeyer, S.; Haan-Amato, S.; Deswood, H.; Rango, A.; Havstad, K.

    2015-12-01

    As climate change intensifies, increased temperatures and altered precipitation will make water, a limited resource in the arid southwestern United States, even scarcer in many locations. The USDA Southwest Regional Climate Hub (SWRCH) developed Climate Change and the Water Cycle, an engaging and scientifically rigorous education unit for 6th -12th grade students. The unit is aligned with Common Core State Standards and Next Generation Science Standards. Nine activities can be conducted over 10 instruction hours. Each activity can also stand alone. In partnership with SWRCH, the Asombro Institute for Science Education developed the unit. Each activity was reviewed by an educator for educational practices and by a scientist for scientific accuracy. The unit was pilot tested with 524 students in 2014, and pre- and post-tests were administered. Ninety-one percent of students were able to name a greenhouse gas on the post-test, compared to only 48% on the pre-test. On the post-test, 86% of students identified the relationship between average global temperature and carbon dioxide levels in the atmosphere, compared to only 52% on the pre-test. A student commented: "I loved all of the activities! They are fun and help us understand about what goes on in the world." Educators who participated in pilot testing said: "the entire curriculum is great, but I was particularly impressed with the progression of ideas and the variety of lessons," and "students could see the relevance and importance of these real life issues." Anyone interested in using the unit to host workshops for teachers in southwestern states should contact Asombro for more information (information@asombro.org). The Climate Change and the Water Cycle 6th-12th grade curriculum unit is available online: www.swclimatehub.info/education/climate-change-and-water-cycle

  18. Alcohol mixed with energy drink use among u.s. 12th-grade students: prevalence, correlates, and associations with unsafe driving.

    PubMed

    Martz, Meghan E; Patrick, Megan E; Schulenberg, John E

    2015-05-01

    The consumption of alcohol mixed with energy drinks (AmED) is a risky drinking behavior, most commonly studied using college samples. We know little about rates of AmED use and its associations with other risk behaviors, including unsafe driving, among high school students. This study examined the prevalence and correlates of AmED use among high school seniors in the United States. Nationally representative analytic samples included 6,498 12th-grade students who completed Monitoring the Future surveys in 2012 and 2013. Focal measures included AmED use, sociodemographic characteristics, academic and social factors, other substance use, and unsafe driving (i.e., tickets/warnings and accidents) after alcohol consumption. Approximately one in four students (24.8%) reported AmED use during the past 12 months. Rates of AmED use were highest among males and white students. Using multivariable logistic regression models controlling for sociodemographic characteristics, results indicate that students who cut class, spent more evenings out for fun and recreation, and reported binge drinking, marijuana use, and illicit drug use had a greater likelihood of AmED use. AmED use was also associated with greater odds of alcohol-related unsafe driving, even after controlling for sociodemographic, academic, and social factors and other substance use. AmED use among 12th-grade students is common and associated with certain sociodemographic, academic, social, and substance use factors. AmED use is also related to alcohol-related unsafe driving, which is a serious public health concern. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Alcohol mixed with energy drink use among U.S. 12th-grade students: Prevalence, correlates, and associations with unsafe driving

    PubMed Central

    Martz, Meghan E.; Patrick, Megan E.; Schulenberg, John E.

    2015-01-01

    Purpose The consumption of alcohol mixed with energy drinks (AmED) is a risky drinking behavior, most commonly studied using college samples. We know little about rates of AmED use and its associations with other risk behaviors, including unsafe driving, among high school students. This study examined the prevalence and correlates of AmED use among high school seniors in the United States. Methods Nationally representative analytic samples included 6,498 12th-grade students who completed Monitoring the Future surveys in 2012 and 2013. Focal measures included AmED use, sociodemographic characteristics, academic and social factors, other substance use, and unsafe driving (i.e., tickets/warnings and accidents) following alcohol consumption. Results Approximately one in four students (24.8%) reported AmED use during the past 12 months. Rates of AmED use were highest among males and White students. Using multivariable logistic regression models controlling for sociodemographic characteristics, results indicate that students who cut class, spent more evenings out for fun and recreation, and reported binge drinking, marijuana use, and illicit drug use had a greater likelihood of AmED use. AmED use was also associated with greater odds of alcohol-related unsafe driving, even after controlling for sociodemographic, academic, and social factors, and other substance use. Conclusions AmED use among 12th-grade students is common and associated with certain sociodemographic, academic, social, and substance use factors. AmED use is also related to alcohol-related unsafe driving, which is a serious public health concern. PMID:25907654

  20. Current status and future trends of SO2 and NOx pollution during the 12th FYP period in Guiyang city of China

    NASA Astrophysics Data System (ADS)

    Tian, Hezhong; Qiu, Peipei; Cheng, Ke; Gao, Jiajia; Lu, Long; Liu, Kaiyun; Liu, Xingang

    2013-04-01

    In order to investigate the future trends of SO2 and NOx pollution in Guiyang city of China, the MM5/CALMET/CALPUFF modeling system is applied to assess the effects of air pollution improvement that would result from reduction targets for SO2 and NOx emissions during the 12th Five-Year Plan (2011-2015). Three scenarios are established for the objective year 2015 based on the reference emissions in base year 2010. Scenario analysis and modeling results show that emissions are projected to increase by 26.5% for SO2 and 138.0% for NOx in 2015 Business-As-Usual (BAU) relative to base year 2010, respectively, which will lead to a substantial worsening tendency of SO2 and NOx pollution. In comparison, both the 2015 Policy Reduction (PR) and 2015 Intensive Policy Reduction (IPR) scenarios would contribute to improve the urban air quality. Under 2015 PR scenario, the maximum annual average concentration of SO2 and NOx will reduce by 54.9% and 31.7%, respectively, relative to the year 2010, with only 2.1% of all individual gridded receptors exceed the national air quality standard limits; while the maximum annual average concentrations of SO2 and NOx can reduce further under 2015 IPR scenario and comply well with standards limits. In view of the technical feasibility and cost-effectiveness, the emission reduction targets set in the 2015 PR scenario are regarded as more reasonable in order to further improve the air quality in Guiyang during the 12th FYP period and a series of comprehensive countermeasures should be effectively implemented.

  1. [The effect of maternal dexamethasone treatment after the 12th week of pregnancy on fetal genital development in adrenogenital syndrome with 21-hydroxylase deficiency].

    PubMed

    Schwab, K O; Kruse, K; Dörr, H G; Horwitz, A E; Spingler, H

    1989-05-01

    Prenatal treatment with dexamethasone starting with gestation week 5 has been proposed to prevent virilization of female fetuses with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. We report dexamethasone treatment in a mother during her third pregnancy; this treatment could not be started before the 12th week of gestation. The second child (index case) had a simple virilizing 21-hydroxylase deficiency CAH and Prader IV genitalia. Because after amniocentesis a normal female karyotype and HLA identity with the index case were found, the dexamethasone treatment (3 x 0.5 mg/die) was continued until delivery.-In contrast to patients with salt-wasting CAH, the 17-alpha-hydroxyprogesterone level in the amniotic fluid was within the normal range. Decreased maternal plasma and urine estriol concentrations, as well as the plasma cortisol values, demonstrated adequate suppression of the fetal and maternal adrenal gland. No side effects were found in the mother as a result of the dexamethasone treatment. The newborn had virilization of the external genitalia according to Prader III but without hypertrophy of the clitoris. The degree of rugated scrotum was less marked in relation to the index case and the sinus urogenitalis was more distally shifted. Thus, surgery on the clitoris could be avoided. The conditions for further surgery (vaginoplasty) could probably be improved. Therefore, dexamethasone treatment of a mother with a female CAH fetus due to 21-hydroxylase deficiency seems to be justified starting at the 12th week of gestation. However, the optimal beginning of therapy is in early pregnancy.

  2. Postoperative pain management in pediatric patients undergoing minimally invasive repair of pectus excavatum: the role of intercostal block.

    PubMed

    Lukosiene, Laura; Rugyte, Danguole Ceslava; Macas, Andrius; Kalibatiene, Lina; Malcius, Dalius; Barauskas, Vidmantas

    2013-12-01

    There are no published data regarding value of intercostal block following pectus excavatum repair. Our aim was to evaluate the efficacy of intercostal block in children following minimally invasive repair of pectus excavatum (MIRPE). Forty-five patients given patient-controlled analgesia (PCA) with morphine postoperatively were studied. Twenty-six patients were given bilateral intercostal blocks after induction of anesthesia (PCA-IB group), and nineteen patients were retrospective controls without regional blockade (PCA group). All patients were followed up 24 h postoperatively. A loading dose of morphine (0,1±0,49 mg/kg) before starting PCA was used in seventeen patients in PCA group vs. no patient in PCA-IB group. Cumulative used morphine doses were lower up to 12 h after surgery in PCA-IB group (0,29±0,08 μg/kg) than in the PCA group (0,46±0,18 μg/kg), p<0,01. There were no differences in pain scores, oxygen saturation values, sedation scores, and the incidence of pulmonary adverse events between the two groups. There was a tendency towards less morphine-related adverse effects in PCA-IB group compared to PCA group (p<0,05). No complications related to the intercostal blocks were observed. Bilateral intercostal blocks following MIRPE are safe and easy to perform and can diminish postoperative opioid requirement. Double-blind randomized study is required to confirm the potential to diminish opioid related side effects. © 2013 Elsevier Inc. All rights reserved.

  3. Intercostal retractions

    MedlinePlus

    ... ed. Philadelphia, PA: Elsevier; 2016:chap 385. Sarnaik AP, Clark JA, Sarnaik AA. Respiratory distress and failure. ... Support Get email updates Subscribe to RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players ...

  4. Electrical activation to the parasternal intercostal muscles during high-frequency spinal cord stimulation in dogs

    PubMed Central

    Kowalski, Krzysztof E.

    2014-01-01

    High-frequency spinal cord stimulation (HF-SCS) is a novel technique of inspiratory muscle activation involving stimulation of spinal cord pathways, which may have application as a method to provide inspiratory muscle pacing in ventilator-dependent patients with spinal cord injury. The purpose of the present study was to compare the spatial distribution of motor drive to the parasternal intercostal muscles during spontaneous breathing with that occurring during HF-SCS. In nine anesthetized dogs, HF-SCS was applied at the T2 spinal level. Fine-wire recording electrodes were used to assess single motor unit (SMU) pattern of activation in the medial bundles of the 2nd and 4th and lateral bundles of the 2nd interspaces during spontaneous breathing and HF-SCS following C1 spinal section. Stimulus amplitude during HF-SCS was adjusted such that inspired volumes matched that occurring during spontaneous breathing (protocol 1). During HF-SCS mean peak SMU firing frequency was highest in the medial bundles of the 2nd interspace (17.1 ± 0.6 Hz) and significantly lower in the lateral bundles of the 2nd interspace (13.5 ± 0.5 Hz) and medial bundles of the 4th (15.2 ± 0.7 Hz) (P < 0.05 for each comparison). Similar rostrocaudal and mediolateral gradients of activity were observed during spontaneous breathing prior to C1 section. Since rib cage movement was greater and peak discharge frequencies of the SMUs higher during HF-SCS compared with spontaneous breathing, stimulus amplitude during HF-SCS was adjusted such that rib cage movement matched that occurring during spontaneous breathing (protocol 2). Under this protocol, mean peak SMU frequencies and rostrocaudal and mediolateral gradients of activity during HF-SCS were not significantly different compared with spontaneous breathing. This study demonstrates that 1) the topographic pattern of electrical activation of the parasternal intercostal muscles during HF-SCS is similar to that occurring during spontaneous breathing

  5. Effectiveness of intercostal nerve block for management of pain in rib fracture patients.

    PubMed

    Hwang, Eun Gu; Lee, Yunjung

    2014-08-01

    Controlling pain in patients with fractured ribs is essential for preventing secondary complications. Conventional medications that are administered orally or by using injections are sufficient for the treatment of most patients. However, additional aggressive pain control measures are needed for patients whose pain cannot be controlled effectively as well as for those in whom complications or a transition to chronic pain needs to be prevented. In this study, we retrospectively analyzed the medical records of patients in our hospital to identify the efficacy and characteristics of intercostal nerve block (ICNB), as a pain control method for rib fractures. Although ICNB, compared to conventional methods, showed dramatic pain reduction immediately after the procedure, the pain control effects decreased over time. These findings suggest that the use of additional pain control methods (e.g. intravenous patient-controlled analgesia and/or a fentanyl patch) is recommended for patients in who the pain level increases as the ICNB efficacy decreases.

  6. Adherent Primary Cultures of Mouse Intercostal Muscle Fibers for Isolated Fiber Studies

    PubMed Central

    Robison, Patrick; Hernández-Ochoa, Erick O.; Schneider, Martin F.

    2011-01-01

    Primary culture models of single adult skeletal muscle fibers dissociated from locomotor muscles adhered to glass coverslips are routine and allow monitoring of functional processes in living cultured fibers. To date, such isolated fiber cultures have not been established for respiratory muscles, despite the fact that dysfunction of core respiratory muscles leading to respiratory arrest is the most common cause of death in many muscular diseases. Here we present the first description of an adherent culture system for single adult intercostal muscle fibers from the adult mouse. This system allows for monitoring functional properties of these living muscle fibers in culture with or without electrical field stimulation to drive muscle fiber contraction at physiological or pathological respiratory firing patterns. We also provide initial characterization of these fibers, demonstrating several common techniques in this new model system in the context of the established Flexor Digitorum Brevis muscle primary culture model. PMID:21869860

  7. Prostaglandin E₂ induced contraction of human intercostal arteries is mediated by the EP₃ receptor.

    PubMed

    Longrois, Dan; Gomez, Ingrid; Foudi, Nabil; Topal, Gokce; Dhaouadi, Malek; Kotelevets, Larissa; Chastre, Eric; Norel, Xavier

    2012-04-15

    Arterial vascularization of the spinal cord may be mechanically or functionally altered during thoraco-abdominal surgery/intravascular procedures. Increased arterial pressure has been shown to restore spinal perfusion and function probably by increasing the blood flow through the intercostal arteries. The regulation of human intercostal artery (HICA) vascular tone is not well documented. Prostaglandin (PG)E(2) concentration is increased during inflammatory conditions and has been shown to regulate vascular tone in many preparations. In this context, the pharmacological response of HICA to PGE(2) and the characterization of the PGE(2) receptor subtypes (EP(1), EP(2), EP(3) or EP(4)) involved are of importance and that is the aim of this study. Rings of HICA were prepared from 29 patients and suspended in organ baths for isometric recording of tension. Cumulative concentration-response curves were performed in these preparations with various EP receptor agonists in the absence or presence of different receptor antagonists or inhibitors. PGE(2) induced the contraction of HICA (E(max)=7.28 ± 0.16 g; pEC(50) value=0.79 ± 0.18; n=17); contractions were also observed with the EP(3) receptor agonists, sulprostone, 17-phenyl-PGE(2), misoprostol or ONO-AE-248. In conclusion, PGE(2) induced vasoconstriction of HICA via EP(3) receptor subtypes and this result was confirmed by the use of selective EP receptor antagonists (L-826266, ONO-8713, SC-51322) and by a strong detection of EP(3) mRNA. These observations suggest that in the context of perioperative inflammation, increased PGE(2) concentrations could trigger vasoconstriction of HICA and possibly alter spinal vascularization. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. SpaceX CRS-12 Liftoff

    NASA Image and Video Library

    2017-08-14

    The two-stage SpaceX Falcon 9 launch vehicle lifts off Launch Complex 39A at NASA's Kenney Space Center carrying the Dragon resupply spacecraft to the International Space Station. Liftoff was at 12:31 p.m. EDT. On its 12th commercial resupply services mission to the International Space Station, Dragon will bring up more than 6,400 pounds of supplies and new science experiments and equipment for technology research.

  9. SpaceX CRS-12 Liftoff

    NASA Image and Video Library

    2017-08-14

    The two-stage SpaceX Falcon 9 launch vehicle lifts off Launch Complex 39A at NASA's Kennedy Space Center carrying the Dragon resupply spacecraft to the International Space Station. Liftoff was at 12:31 p.m. EDT. On its 12th commercial resupply services mission to the International Space Station, Dragon will bring up more than 6,400 pounds of supplies and new science experiments and equipment for technology research.

  10. Space Shuttle Project

    NASA Image and Video Library

    1997-12-05

    With Commander Kevin R. Kregel and Pilot Steven W. Lindsey at the controls, the orbiter Columbia (STS-87) touched down its main gear on Runway 33 at Kennedy Space Center's (KSC) Shuttle Landing Facility to complete a 15-day, 16-hour and 34-minute-long mission of 6.5 million miles. During the 88th Space Shuttle mission, the crew performed experiments on the United States Microgravity Payload-4 and pollinated plants as part of the Collaborative Ukrainian Experiment. This was the 12th landing for Columbia at KSC and the 41st KSC landing in the history of the Space Shuttle program.

  11. Movement related cortical source for elbow flexion in patients with branchial plexus injury after intercostal-musculocutaneous nerve crossing.

    PubMed

    Kanamaru, A; Homma, I; Hara, T

    1999-10-29

    Nine patients with brachial plexus injury whose transected musculo-cutaneous nerves had been sutured with intercostal nerves were examined and the relationship between flexion of the operated elbow and the respiratory movement were shown. Three out of nine patients showed independent control of movement from respiration after regeneration. The primary motor cortex for either flexion of the elbow to the operated side or brisk voluntary inspiration was estimated in the medial vertex region of the frontal cortex by the dipole-tracing method in these three patients. The present results suggest that patients contract the biceps muscle reinnervated by the intercostal nerve independently from respiratory movements using the same primary motor cortex with trunk movements. Functional plasticity may occur in the patients using the primary trunk motor cortex for elbow flexion.

  12. Control of abdominal and expiratory intercostal muscle activity during vomiting - Role of ventral respiratory group expiratory neurons

    NASA Technical Reports Server (NTRS)

    Miller, Alan D.; Tan, L. K.; Suzuki, Ichiro

    1987-01-01

    The role of ventral respiratory group (VRG) expiratory (E) neurons in the control of abdominal and internal intercostal muscle activity during vomiting was investigated in cats. Two series of experiments were performed: in one, the activity of VRG E neurons was recorded during fictive vomiting in cats that were decerebrated, paralyzed, and artificially ventilated; in the second, the abdominal muscle activity during vomiting was compared before and after sectioning the axons of descending VRG E neurons in decerebrate spontaneously breathing cats. The results show that about two-thirds of VRG E neurons that project at least as far caudally as the lower thoracic cord contribute to internal intercostal muscle activity during vomiting. The remaining VRG E neurons contribute to abdominal muscle activation. As shown by severing the axons of the VRG E neurons, other, as yet unidenified, inputs (either descending from the brain stem or arising from spinal reflexes) can also produce abdominal muscle activation.

  13. [Embolization of life-threatening intercostal hemorrhaging in a severely injured patient: a rarity in trauma care].

    PubMed

    Hussmann, B; Taeger, G; Wanke, I; Waydhas, C; Schoch, B; Nast-Kolb, D; Lendemans, S

    2009-12-01

    Transarterial embolization of ruptured intercostal arteries due to massive bleeding represents an infrequent indication in severely injured patients. The current literature shows isolated case descriptions but no clinical trials exist. In the case depicted here embolization is represented as a form of therapy after haemorrhagic shock caused by a ruptured intercostal artery. The embolization carried out led to an immediate cessation of bleeding. The vital signs returned to normal immediately after the procedure and surgical intervention could be avoided. The course of the disease represented in the following shows the effectiveness of this type of treatment not only for bleeding due to pelvic fractures and abdominal injuries, but also for isolated arterial bleeding in other body regions.

  14. Spinal cord bypass surgery with intercostal and spinal accessory nerves: an anatomical feasibility study in human cadavers.

    PubMed

    Haque, Raqeeb M; Malone, Hani R; Bauknight, Martin W; Kellner, Michael A; Ogden, Alfred T; Martin, John H; Tanji, Kurenai; Winfree, Christopher J

    2012-02-01

    Despite extensive study, no meaningful progress has been made in encouraging healing and recovery across the site of spinal cord injury (SCI) in humans. Spinal cord bypass surgery is an unconventional strategy in which intact peripheral nerves rostral to the level of injury are transferred into the spinal cord below the injury. This report details the feasibility of using spinal accessory nerves to bypass cervical SCI and intercostal nerves to bypass thoracolumbar SCI in human cadavers. Twenty-three human cadavers underwent cervical and/or lumbar laminectomy and dural opening to expose the cervical cord and/or conus medullaris. Spinal accessory nerves were harvested from the Erb point to the origin of the nerve's first major branch into the trapezius. Intercostal nerves from the T6-12 levels were dissected from the lateral border of paraspinal muscles to the posterior axillary line. The distal ends of dissected nerves were then transferred medially and sequentially inserted 4 mm deep into the ipsilateral cervical cord (spinal accessory nerve) or conus medullaris (intercostals). The length of each transferred nerve was measured, and representative distal and proximal cross-sections were preserved for axonal counting. Spinal accessory nerves were consistently of sufficient length to be transferred to caudal cervical spinal cord levels (C4-8). Similarly, intercostal nerves (from T-7 to T-12) were of sufficient length to be transferred in a tension-free manner to the conus medullaris. Spinal accessory data revealed an average harvested nerve length of 15.85 cm with the average length needed to reach C4-8 of 4.7, 5.9, 6.5, 7.1, and 7.8 cm. The average length of available intercostal nerve from each thoracic level compared with the average length required to reach the conus medullaris in a tension-free manner was determined to be as follows (available, required in cm): T-7 (18.0, 14.5), T-8 (18.7, 11.7), T-9 (18.8, 9.0), T-10 (19.6, 7.0), T-11 (18.8, 4.6), and T-12 (15

  15. Control of abdominal and expiratory intercostal muscle activity during vomiting - Role of ventral respiratory group expiratory neurons

    NASA Technical Reports Server (NTRS)

    Miller, Alan D.; Tan, L. K.; Suzuki, Ichiro

    1987-01-01

    The role of ventral respiratory group (VRG) expiratory (E) neurons in the control of abdominal and internal intercostal muscle activity during vomiting was investigated in cats. Two series of experiments were performed: in one, the activity of VRG E neurons was recorded during fictive vomiting in cats that were decerebrated, paralyzed, and artificially ventilated; in the second, the abdominal muscle activity during vomiting was compared before and after sectioning the axons of descending VRG E neurons in decerebrate spontaneously breathing cats. The results show that about two-thirds of VRG E neurons that project at least as far caudally as the lower thoracic cord contribute to internal intercostal muscle activity during vomiting. The remaining VRG E neurons contribute to abdominal muscle activation. As shown by severing the axons of the VRG E neurons, other, as yet unidenified, inputs (either descending from the brain stem or arising from spinal reflexes) can also produce abdominal muscle activation.

  16. Slow-release carbohydrates: growing evidence on metabolic responses and public health interest. Summary of the symposium held at the 12th European Nutrition Conference (FENS 2015).

    PubMed

    Vinoy, Sophie; Laville, Martine; Feskens, Edith J M

    2016-01-01

    To draw attention to the necessity of considering differences in the digestibility of carbohydrates, and more specifically of starch, a symposium was held at the 12th European Nutrition Conference (FENS), which took place in Berlin from October 20 to 23, 2015. The purpose of this session was to present the consolidated knowledge and recent advances regarding the relationship between slow-release carbohydrates, metabolic responses, and public health issues. Three main topics were presented: 1) the definition of, sources of, and recognised interest in the glycaemic response to slowly digestible starch (SDS); 2) clinical evidence regarding the physiological effects of slow-release carbohydrates from cereal foods; and 3) interest in reducing the postprandial glycaemic response to help prevent metabolic diseases. Foods with the highest SDS content induce the lowest glycaemic responses, as the starch is protected from gelatinisation during processing. In humans, high-SDS food consumption induces slower glucose release, lower postprandial insulinaemia, and stimulation of gut hormones. Moreover, postprandial hyperglycaemia is an independent risk factor for type two diabetes mellitus (T2DM) and cardiovascular disease (CVD). Therefore, given the plausible aetiologic mechanisms, we argue that postprandial glucose levels are relevant for health and disease and represent a meaningful target for intervention, for example, through dietary factors. This symposium was organised by Mondelez International R&D.

  17. Absence of point mutation in the 12th codon of transformed c-Ha-rasl genes of human cancer of the breast, stomach, melanoma, and neuroblastoma

    SciTech Connect

    Knyazev, P.G.; Schafer, R.; Willecke, K.V.; Seitz, I.F.

    1985-11-01

    In the authors' previous investigations, they established that the tumorous cell lines SK-BR-3 (breast cancer), LAN-1 (neuroblastoma), and a heterotransplant of malignant melanoma Jal contain transforming genes of Ha-ras type. Now, the authors report their results using restriction endonucleases of MspI and HpaII restriction to study nucleotide sequences 5'-CCGGC-3' and 3'GGCCG-5', which contain the 12th codon of GGC for the amino acid glycine in the normal allele of c-Ha-rasl in the three tumors listed above, in addition to human adenocarcinoma of the stomach (CaVSt) and normal cells corresponding to them. For hybridization of MspI/HpaII, fragments of chromosomal DNA isolated from cell lines SK-BR-3, and LAN-1, Ja-1 heterotransplant, and stomach adenocarcinoma CaVSt, the XmaI section of EJ oncogene, c-Ha-rasl (plasmid pEJ 6.6), labeled with /sup 32/P was used in down-translation reaction. Hybridization was performed in 3 x SSC buffer containing 5x Deinhardt's reagent and 10% dextran sulfate at 68/sup 0/C for 16-18 h. Washing of filters was conducted under rigid conditions. For autoradiography, Kodak XR-5 x-ray film in cartridges with reinforcing shields was used at -70/sup 0/C, exposure time of four to six days.

  18. Possible impacts of early-11th-, middle-12th-, and late-13th-century droughts on western Native Americans and the Mississippian Cahokians

    NASA Astrophysics Data System (ADS)

    Benson, Larry V.; Berry, Michael S.; Jolie, Edward A.; Spangler, Jerry D.; Stahle, David W.; Hattori, Eugene M.

    2007-02-01

    One or more of three intense and persistent droughts impacted some Native American cultures in the early-11th, middle-12th and late-13th centuries, including the Anasazi, Fremont, Lovelock, and Mississippian (Cahokian) prehistorical cultures. Tree-ring-based reconstructions of precipitation and temperature indicate that warm drought periods occurred between AD 990 and 1060, AD 1135 and 1170, and AD 1276 and 1297. These droughts occurred during minima in the Pacific Decadal Oscillation and may have been associated with positive values of the Atlantic Multidecadal Oscillation. Each of the Native American cultures was supported, to a greater or lesser degree, by precipitation-dependent resources. Both the Four Corners region and Cahokia were sites of intense growth between about AD 1050 and 1130, and by AD 1150, cultures in both regions were undergoing stress. By AD 1300 the Anasazi and Fremont cultures had collapsed and their residual populations had either left their homelands or withered. In the case of Fremont populations, the AD 990-1060 drought may have had the greatest impact. This drought also may have affected the Anasazi, for it was at the end of this drought that some people from Chaco migrated to the San Juan River valley and founded the Salmon Ruin great house. Detailed data do not exist on the number of Lovelock habitation sites or populations over time; however, Lovelock populations appear to have retreated from the western Great Basin to California by AD 1300 or shortly thereafter.

  19. Slow-release carbohydrates: growing evidence on metabolic responses and public health interest. Summary of the symposium held at the 12th European Nutrition Conference (FENS 2015)

    PubMed Central

    Vinoy, Sophie; Laville, Martine; Feskens, Edith J M

    2016-01-01

    To draw attention to the necessity of considering differences in the digestibility of carbohydrates, and more specifically of starch, a symposium was held at the 12th European Nutrition Conference (FENS), which took place in Berlin from October 20 to 23, 2015. The purpose of this session was to present the consolidated knowledge and recent advances regarding the relationship between slow-release carbohydrates, metabolic responses, and public health issues. Three main topics were presented: 1) the definition of, sources of, and recognised interest in the glycaemic response to slowly digestible starch (SDS); 2) clinical evidence regarding the physiological effects of slow-release carbohydrates from cereal foods; and 3) interest in reducing the postprandial glycaemic response to help prevent metabolic diseases. Foods with the highest SDS content induce the lowest glycaemic responses, as the starch is protected from gelatinisation during processing. In humans, high-SDS food consumption induces slower glucose release, lower postprandial insulinaemia, and stimulation of gut hormones. Moreover, postprandial hyperglycaemia is an independent risk factor for type two diabetes mellitus (T2DM) and cardiovascular disease (CVD). Therefore, given the plausible aetiologic mechanisms, we argue that postprandial glucose levels are relevant for health and disease and represent a meaningful target for intervention, for example, through dietary factors. This symposium was organised by Mondelez International R&D. PMID:27388153

  20. Longitudinal Study of Career Cluster Persistence from 8th Grade to 12th Grade with a Focus on the Science, Technology, Engineering, & Math Career Cluster

    NASA Astrophysics Data System (ADS)

    Wagner, Judson

    Today's technology driven global economy has put pressure on the American education system to produce more students who are prepared for careers in Science, Technology, Engineering, and Math (STEM). Adding to this pressure is the demand for a more diverse workforce that can stimulate the development of new ideas and innovation. This in turn requires more female and under represented minority groups to pursue future careers in STEM. Though STEM careers include many of the highest paid professionals, school systems are dealing with exceptionally high numbers of students, especially female and under represented minorities, who begin but do not persist to STEM degree completion. Using the Expectancy-Value Theory (EVT) framework that attributes student motivation to a combination of intrinsic, utility, and attainment values, this study analyzed readily available survey data to gauge students' career related values. These values were indirectly investigated through a longitudinal approach, spanning five years, on the predictive nature of 8 th grade survey-derived recommendations for students to pursue a future in a particular career cluster. Using logistic regression analysis, it was determined that this 8 th grade data, particularly in STEM, provides significantly high probabilities of a 12th grader's average grade, SAT-Math score, the math and science elective courses they take, and most importantly, interest in the same career cluster.

  1. Possible impacts of early-11th-, middle-12th-, and late-13th-century droughts on western Native Americans and the Mississippian Cahokians

    USGS Publications Warehouse

    Benson, L.V.; Berry, M.S.; Jolie, E.A.; Spangler, J.D.; Stahle, D.W.; Hattori, E.M.

    2007-01-01

    One or more of three intense and persistent droughts impacted some Native American cultures in the early-11th, middle-12th and late-13th centuries, including the Anasazi, Fremont, Lovelock, and Mississippian (Cahokian) prehistorical cultures. Tree-ring-based reconstructions of precipitation and temperature indicate that warm drought periods occurred between AD 990 and 1060, AD 1135 and 1170, and AD 1276 and 1297. These droughts occurred during minima in the Pacific Decadal Oscillation and may have been associated with positive values of the Atlantic Multidecadal Oscillation. Each of the Native American cultures was supported, to a greater or lesser degree, by precipitation-dependent resources. Both the Four Corners region and Cahokia were sites of intense growth between about AD 1050 and 1130, and by AD 1150, cultures in both regions were undergoing stress. By AD 1300 the Anasazi and Fremont cultures had collapsed and their residual populations had either left their homelands or withered. In the case of Fremont populations, the AD 990-1060 drought may have had the greatest impact. This drought also may have affected the Anasazi, for it was at the end of this drought that some people from Chaco migrated to the San Juan River valley and founded the Salmon Ruin great house. Detailed data do not exist on the number of Lovelock habitation sites or populations over time; however, Lovelock populations appear to have retreated from the western Great Basin to California by AD 1300 or shortly thereafter.

  2. Gas chromatography-mass spectrometry assay for the simultaneous quantification of drugs of abuse in human placenta at 12th week of gestation.

    PubMed

    Joya, Xavier; Pujadas, Mitona; Falcón, María; Civit, Ester; Garcia-Algar, Oscar; Vall, Oriol; Pichini, Simona; Luna, Aurelio; de la Torre, Rafael

    2010-03-20

    We describe the development and validation of a method for the quantification of drugs of abuse, using gas chromatography-mass spectrometry (GC/MS), in human placenta. Concentration ranges covered were 5-500 ng/g for amphetamine, methamphetamine, MDMA, methadone, cocaine, benzoylecgonine, cocaethylene, morphine, 11-nor-9-carboxy-delta-9-tetrahydrocannabinol, nicotine, and cotinine. Intra-assay and inter-assay imprecisions were less than 15.7% for lower quality control samples and less than 14.9% for medium and high quality control samples. Recovery range was 36.2-83.7%. Placenta samples were kept at -80 degrees C until analysis; analytes were stable after three freeze-thaw cycles (samples stored at -20 degrees C). This accurate and precise assay has sufficient sensitivity and specificity for the analysis of specimens collected from women who voluntarily terminated their pregnancy at 12th week of gestation. The method has proven to be robust and accurate for the quantification of the principal recreational drugs of abuse in this period of the prenatal life. This is the first report that highlights the presence of drugs of abuse during the first trimester of gestation.

  3. Effect of intercostal nerve blockade during operation on lung function and the relief of pain following thoracotomy.

    PubMed

    Galway, J E; Caves, P K; Dundee, J W

    1975-06-01

    The use, during operation, of intercostal nerve blocks with lignocaine and bupivacaine for the relief of pain following thoracotomy was assessed in 138 patients. Irrespective of the method used to evaluate efficacy, it was not possible to demonstrate a lasting effect of clinical significance favouring either local anaesthetic agent. This form of treatment, although free from serious side effects, had no beneficial effects on lung function and is not recommended for the relief of pain following surgery.

  4. Intercostal Neuralgia Occurring as a Complication of Splanchnic Nerve Radiofrequency Ablation in a Patient with Chronic Pancreatitis.

    PubMed

    Tewari, Saipriya; Agarwal, Anil; Gautam, Sujeet K; Madabushi, Rajashree

    2017-07-01

    Our intent is to report a case of intercostal neuralgia occuring as a complication of splanchnic radiofreqency ablation (RFA), due to a breach in the integrity of the insulating sheath of the RFA needle.A 48-year-old man presented to our pain clinic with upper abdominal pain due to chronic pancreatitis, recalcitrant to medical management. We decided to perform bilateral splanchnic nerve RFA in this patient. After confirmation of bilateral correct needle placement under fluoroscopic guidance and sensorimotor testing, RFA was performed on the right side uneventfully. However, during RFA on the left side, the patient experienced severe pain in the epigastric region. A bolus of fentanyl 50 µg was given intravenously in order to minimise discomfort, and RFA was performed. In the post-procedure period, the patient described severe pain in the left subcostal and epigastric region, with features suggestive of intercostal neuralgia of the left 11th intercostal nerve. We went back and analysed all the fluoroscopic images again. Convinced of correct needle placement, we examined the RFA needles which had been used for ablation in this patient. One of the needles was discovered to have a fine breach in its insulating sheath, at a distance of approximately 30 mm from the active tip. It is of utmost importance for all interventional pain physicians to perform a thorough pre-use check of the equipment prior to any RFA procedure, with special emphasis on ensuring the integrity of the insulating sheath of the needles which are to be used, in order to prevent injury of non target nerves. Splanchnic nerve block, radiofrequency ablation, intercostal neuralgia, radiofrequency ablation complications, radiofrequency equipment check, radiofrequency needle.

  5. Diaphragmatic rupture precipitated by intercostal chest tube drainage in a patient of blunt thoraco-abdominal trauma

    PubMed Central

    Mehrotra, Ashok Kumar; Feroz, Asif; Dawar, Sachet; Kumar, Prem; Singh, Anupam; Khublani, Trilok Kumar

    2016-01-01

    Blunt thoraco-abdominal trauma in collision injuries in road traffic accident (RTA) occasionally results in diaphragmatic injury and rupture besides other serious multisystem injuries. These diaphragmatic injuries (DI) frequently go undetected specially when occur on the right side. DI associated with hemothorax need insertion of intercostal tube drainage (ICTD). ICTD has never been reported to precipitate diaphragmatic rupture and hernia. We are reporting such a rare case for the first time in medical literature. PMID:26933316

  6. Restoration of elbow flexion in brachial plexus avulsion injury: comparing spinal accessory nerve transfer with intercostal nerve transfer.

    PubMed

    Waikakul, S; Wongtragul, S; Vanadurongwan, V

    1999-05-01

    This study was performed to compare the clinical outcome of 2 types of commonly used nerve transfers, the spinal accessory nerve transfer and the intercostal nerve transfer. This study was a prospective randomized parallel trial involving 205 patients presenting between 1989 and 1994. All patients were males ranging in age from 16 to 43 years. All patients underwent surgery within 6 months of injury. Spinal accessory nerve transfer was performed in 130 patients; better results were obtained in terms of less operative time, fewer blood transfusions, fewer immediate complications, and better motor function (very good and good power in 83% of patients). Intercostal nerve transfer was performed in 75 patients; better results were observed in terms of earlier electromyographic evidence of motor reinnervation, improvement in protective sensation, and reduction of pain. However, very good and good motor recovery was observed in only 64% of patients. There was no significant difference with regard to tidal volume, vital capacity, and the FEV1 to FEV ratio before and after surgery in either group. Smoking adversely affected the rate of recovery. Spinal accessory nerve transfer should be used when motor function of the elbow flexors is the major concern. Intercostal nerve transfer should be performed in patients who need both motor and sensory reconstruction and in those who have chronic pain syndrome after brachial plexus injury.

  7. Comparison thoracic epidural and intercostal block to improve ventilation parameters and reduce pain in patients with multiple rib fractures.

    PubMed

    Hashemzadeh, Shahryar; Hashemzadeh, Khosrov; Hosseinzadeh, Hamzeh; Aligholipour Maleki, Raheleh; Golzari, Samad E J; Golzari, Samad

    2011-01-01

    Chest wall blunt trauma causes multiple rib fractures and will often be associated with significant pain and may compromise ventilator mechanics. Analgesia has great roll in rib fracture therapies, opioid are useful, but when used as sole agent may require such high dose that they produce respiratory depression, especially in elderly .the best analgesia for a severe chest wall injury is a continuous epidural infusion of local anesthetic. This provides complete analgesia allowing inspiration and coughing without of the risk of respiratory depression. sixty adult patients who with multiple rib fractures were enrolled in this study. They were divided into Group A or thoracic epidural with bupivacaine 0.125 % +1mg/5ml morphine and group B or intercostal block with 0.25% bupivacaine. The patients were assessed through ICU and hospital stay length, ventilation function tests. Pain score among the patients was measured with verbal rating scale, before and after administration of the analgesia. We found a significant improvement in ventilatory function tests during the 1st, 2nd, and 3rd days after epidural analgesia compared with the intercostal block (P < 0.004). Changes in the visual Analogue Scale were associated with marked improvement regarding pain at rest and pain caused by coughing and deep breathing in group A compared group B... ICU and hospital stay markedly reduced in Group A. thoracic epidural analgesia is superior to intercostals block regarding pain relief of rib fractures. Patients who received epidural analgesia had significantly lower pain scores at all studied times.

  8. Analysis of activity of motor units in the biceps brachii muscle after intercostal-musculocutaneous nerve transfer.

    PubMed

    Sakuta, Naoki; Sasaki, Sei-Ichi; Ochiai, Naoyuki

    2005-04-01

    We examined respiratory activity of motor units (MUs) in the internal intercostal nerves (IICNs)-transferred biceps brachii muscle (IC-biceps) in cats. MUs of IC-biceps showed respiratory discharges in inspiratory and expiratory phases, and these were enhanced by CO2 inhalation. Narrowing the airway also enhanced inspiratory and expiratory MUs activity. A mechanical load to the thorax immediately enhanced inspiratory MUs activity and weakened expiratory MUs activity. We analyzed the cross-correlation of MUs activity in interchondral muscle and IC-biceps to characterize the respiratory spinal descending inputs to motoneurons. We confirmed the short-term synchronization from interchondral muscles indicating divergence of a single respiratory presynaptic axon to thoracic motoneurons, but could not find synchronization from IC-biceps. The motor axonal conduction velocity (axonal CV) of IC-biceps MUs was lower than that of interchondral muscles. There was no correlation between the respiratory recruitment order of IC-biceps MUs and their axonal CV. These results indicate that IC-biceps shows the respiratory activities and afferent inputs from intercostal muscle spindles in the neighboring segments remain influential on activity of IC-biceps. In addition, the short-term synchronization from IC-biceps could not be found, suggesting that the intercostal nerve transfer alters the respiratory spinal descending inputs to thoracic motoneurons.

  9. Ultrasound-Guided Radiofrequency Treatment of Intercostal Nerves for the Prevention of Incidental Pain Arising Due to Rib Metastasis.

    PubMed

    Ahmed, Arif; Bhatnagar, Sushma; Khurana, Deepa; Joshi, Saurabh; Thulkar, Sanjay

    2017-03-01

    Breakthrough pain (BTP) arising due to rib metastasis is very distressing and often very difficult to manage by titration of traditional analgesics. This study is undertaken to determine the efficacy of radiofrequency (RF) treatment of intercostal nerves for the prevention of BTP. The RF treatment of the intercostal nerves was carried out in 25 patients with uncontrolled BTP arising out of the rib metastasis. The intensity and episode of BTP, background pain, opioid dose, functional status (Karnofky score), and quality of life (Short-Form Health Survey [SF-36]) were noted at baseline visit and subsequently after the RF treatment. After the RF treatment, there was more than 50% decrease in both intensity and frequency of BTP in more than 50% of patients for 3 months, and there was more than 50% decrease in BTP opioid dose in more than 50% of patients throughout the study period. There was also significant improvement in background pain, functional status, and the quality of life after the RF. Interestingly, pain relief, lowering of opioid dose, and functional status improvement were found mostly in patients with mixed and neuropathic type of pain and in patients in whom the metastasis were confined to the ribs only. RF of the intercostal nerves is effective in preventing and deceasing the severity of BTP arising due to rib metastasis in selected group of patients with mixed and neuropathic type of pain and with the metastasis involving the ribs only.

  10. Building on Family Strengths: Research and Services in Support of Children and Their Families. Proceedings of the Building on Family Strengths Annual Conference (12th, Portland, Oregon, June 23-25, 2005)

    ERIC Educational Resources Information Center

    Gordon, Lyn, Ed.; Bradley, Jennifer, Ed.; Aue, Nicole, Ed.; Holman, Ariel, Ed.

    2006-01-01

    The 12th Annual Building on Family Strengths Conference was held from June 23rd through June 25th 2005 in Portland, Oregon. Highlights included: (1) An information-packed keynote address by Dr. Richard M. Lerner on promoting positive youth development through enhancing the assets of communities; (2) An exciting research plenary panel session that…

  11. Homestead and Gardening Skills. A Guide for Providing Instruction for 11th and 12th Grade Students Enrolled in North Carolina's Secondary Schools [and] Vocational Education Competency Test-Item Bank. Agricultural Education.

    ERIC Educational Resources Information Center

    Robinson, Ward R.

    This document consists of a teacher's guide for a competency-based course on homestead and gardening skills designed for North Carolina's 11th- and 12th-grade students, and a list of competency test items applicable to the course. The teacher's guide contains course specifications, a list of competency statements, a sheet describing each unit of…

  12. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Cognition and Exploratory Learning in the Digital Age (CELDA) (12th, Maynooth, Greater Dublin, Ireland, October 24-26, 2015)

    ERIC Educational Resources Information Center

    Sampson, Demetrios G., Ed.; Spector, J. Michael, Ed.; Ifenthaler, Dirk, Ed.; Isaias, Pedro, Ed.

    2015-01-01

    These proceedings contain the papers of the 12th International Conference on Cognition and Exploratory Learning in the Digital Age (CELDA 2015), October 24-26, 2015, which has been organized by the International Association for Development of the Information Society (IADIS), co-organized by Maynooth University, Ireland, and endorsed by the…

  13. Report of the Two-Day National Seminar on New Directions in Higher Education, Organized by the Kerala State Higher Education Council on 12th and 13th July 2010

    ERIC Educational Resources Information Center

    Praveen, C.

    2010-01-01

    This is a report of the Two-Day National Seminar on New Directions in Higher Education, organized by the Kerala State Higher Education Council on 12th and 13th July 2010. The objective of the seminar was to deliberate upon the reforms being undertaken by the Government of India in Higher Education. Reputed scholars from within and outside the…

  14. Building on Family Strengths: Research and Services in Support of Children and Their Families. Proceedings of the Building on Family Strengths Annual Conference (12th, Portland, Oregon, June 23-25, 2005)

    ERIC Educational Resources Information Center

    Gordon, Lyn, Ed.; Bradley, Jennifer, Ed.; Aue, Nicole, Ed.; Holman, Ariel, Ed.

    2006-01-01

    The 12th Annual Building on Family Strengths Conference was held from June 23rd through June 25th 2005 in Portland, Oregon. Highlights included: (1) An information-packed keynote address by Dr. Richard M. Lerner on promoting positive youth development through enhancing the assets of communities; (2) An exciting research plenary panel session that…

  15. Integrated Analysis of the 12th January 2010, Mw 7.0, Haiti Earthquake Using InSAR, MAI, GPS, and Seismic Data

    NASA Astrophysics Data System (ADS)

    Weston, J. M.; Jung, H.; Funning, G. J.; Ferreira, A. M.

    2012-12-01

    The Haiti earthquake, Mw 7.0, 12th January 2010, caused widespread destruction and resulted in more than 230,000 deaths. It is believed to have occurred on previously unknown fault(s), raising many questions concerning the tectonics and seismic hazard in this region. While accurate source models are key for robust seismic hazard assessments, existing source models for the Haiti earthquake from various datasets - geodetic (Calais et al., 2010), seismic (Nettles and Hjorjleifsdottir, 2010) and a combination of the two (Hayes et al., 2010) - show discrepancies, particularly concerning the fault geometry. We investigate these discrepancies using multiple aperture InSAR (MAI) data, along with seismo-geodetic analyses based on a new joint earthquake source inversion approach. Similar to previous geodetic models of this event, this study includes measurements of horizontal and line of sight displacement from GPS and InSAR data, respectively. However, we also extract further horizontal (along-track) measurements from the InSAR data using an updated MAI processing flow, incorporating flat-Earth and topographic phase corrections (Jung et al., 2009) . Despite the additional geodetic measurements, part of the signal is underwater, and thus seismic data (teleseismic long-period body and surface waves) are also included to further constrain the source parameters. We carry out geodetic and seismic-only inversions, as well as novel joint inversions taking, for the first time, realistic 3D Earth structure into account when modelling the seismic data. Initial results suggest that the addition of MAI and GPS data to the source inversions helps better constrain the strike and dip angle. However, the dip of our model is shallower (52°) than existing source models (60° - 70°) and the best fitting fault is buried ~ 4 km deeper than previously reported. We explore and discuss the implications of these findings in terms of earthquake slip distribution, mechanism and its tectonic context.

  16. Impact of alcohol and alcohol mixed with energy drinks on non-medical prescription stimulant use in a nationally representative sample of 12th-grade students.

    PubMed

    Housman, Jeff M; Williams, Ronald D; Woolsey, Conrad L

    2016-08-01

    Approximately 30% of high school students use energy drinks. Alcohol use and alcohol mixed with energy drink use (AmED) is associated with risky behavior, including non-medical prescription stimulant use. We assessed alcohol-only, AmED and non-medical prescription stimulant use among 12th grade students in the U.S. using a nationally representative secondary data from the 2012 Monitoring the Future Study. Wilcoxon-Mann-Whitney tests and logistic regression analyses were used to determine differences in non-medical prescription stimulant use by students who used alcohol-only versus AmED and to identify covariates of non-medical prescription stimulant use. Pearson-product moment coefficients were used to determine strength of variable relationships. Significant differences were found in frequency of Ritalin (p < .001, Cohen's d = .23) and Adderall (p < .001, Cohen's d = .32) use between alcohol-only students and AmED students. Greater frequency of AmED use was also associated with greater frequency of Ritalin use (r = .293, p < .001) and Adderall use (r = .353, p < .001). Males (b = .138, OR = 1.148) were more likely to use prescription stimulants non-medically than females. This study highlights the need to better understand influences on non-medical prescription stimulant, energy drink and AmED use, as the combined effects of stimulants contained in energy drinks and the depressant effects of alcohol appear to be associated with increased non-medical prescription stimulant use. Research on the influential factors related to energy drinks, alcohol, and non-medical prescription stimulants will help practitioners to more appropriately design prevention and intervention strategies addressing these high-risk behaviors. (Am J Addict 2016;25:378-384). © 2016 American Academy of Addiction Psychiatry.

  17. An analysis of 12th-grade students' reasoning styles and competencies when presented with an environmental problem in a social and scientific context

    NASA Astrophysics Data System (ADS)

    Yang, Fang-Ying

    This study examined reasoning and problem solving by 182 12th grade students in Taiwan when considering a socio-scientific issue regarding the use of nuclear energy. Students' information preferences, background characteristics, and eleven everyday scientific thinking skills were scrutinized. It was found most participants displayed a willingness to take into account both scientific and social information in reasoning the merits of a proposed construction of a nuclear power plant. Students' reasoning scores obtained from the "information reasoning style" test ranged from -0.5 to 1.917. And, the distribution was approximately normal with mean and median at around 0.5. For the purpose of categorization, students whose scores were within one standard deviation from the mean were characterized as having a "equally disposed" reasoning style. One hundred and twenty-five subjects, about 69%, belonged to this category. Students with scores locating at the two tails of the distribution were assigned to either the "scientifically oriented" or the "socially oriented" reasoning category. Among 23 background characteristics investigated using questionnaire data and ANOVA statistical analysis, only students' science performance and knowledge about nuclear energy were statistically significantly related to their information reasoning styles (p < 0.05). The assessed background characteristics addressed dimensions such as gender, academic performances, class difference, future education, career expectation, commitment to study, assessment to educational enrichment, family conditions, epistemological views about science, religion, and the political party preference. For everyday scientific thinking skills, interview data showed that both "scientifically oriented" students and those who were categorized as "equally disposed to using scientific and social scientific sources of data" displayed higher frequencies than "socially oriented" ones in using these skills, except in the use of

  18. Effect of intercostal stretch on pulmonary function parameters among healthy males

    PubMed Central

    Mohan, Vikram; Aziz, Ku Badlisyah Ku; Kamaruddin, Kamaria; Leonard, Joseph H.; Das, Srijit; Jagannathan, Madhana Gopal

    2012-01-01

    The use of manual stretching procedures has become more prevalent in cardiorespiratory physiotherapy to improve pulmonary functions. However, limited evidence exists regarding evaluation of their effectiveness. The study aimed to determine the impact of Intercostal (IC) stretch in improving the dynamic pulmonary function parameters (Forced Expiratory Volume in the first second (FEV1), Forced Vital Capacity (FVC) and FEV1/FVC % and respiratory rate among healthy adults. Thirty healthy male subjects were recruited based on inclusion and exclusion criteria. Subjects were assigned to the experimental group and the control group through random sampling method. In the experimental group, subjects underwent IC stretch for ten breaths on the inspiratory phase of the respiratory cycle with breathing control exercises in semi recumbent position, while in the control group, breathing control exercises alone were performed in the semi recumbent position. The results of the study showed, FEV1/FVC % in the experimental group significantly improved with P=0.017 (p<0.05) than the control group, which means IC stretch increased lung volume and lead to improved lung function. This study suggested the IC stretching with breathing control may be more effective in improving dynamic lung parameters especially FEV1/FVC % than breathing control alone. PMID:27418905

  19. Human pulmonary dirofilariasis coexisting with intercostal neurilemmoma: a case report and literature review.

    PubMed

    Li, Chia-Ying; Chang, Yih-Leong; Lee, Yung-Chie

    2013-10-01

    Human pulmonary dirofilariasis (HPD) is a rare zoonotic infection caused by Dirofilaria immitis. Dogs are the definite hosts and humans are infected occasionally via a vector, generally a mosquito. Most thoracic neurilemmoma arise in the mediastinum and fewer tumors originate peripherally from the intercostal nerves. Most patients with HPD or thoracic neurilemmoma are asymptomatic and these diseases are often discovered incidentally. We present a 53-year-old female who was found to have a pulmonary nodule and a chest wall nodule during a routine health examination. She underwent a video-assisted thoracoscopic surgery (VATS) with partial lung resection and local excision of the chest wall. The pathological examination revealed a coiled, degenerating Dirofilariasis immitis worm surrounded by granulomatous inflammation with caseous necrosis and a neurilemmoma composed of S-100 protein immunoreactive but smooth muscle actin negative spindle cells. Because these diseases are self-limiting and make further treatment unnecessary, video-assisted thoracoscopic surgery (VATS) is considered preferable and less invasive for definitive diagnosis and management.

  20. Na+ current densities and voltage dependence in human intercostal muscle fibres.

    PubMed Central

    Ruff, R L; Whittlesey, D

    1992-01-01

    1. Voltage-clamp Na+ currents (INa) were studied in human intercostal muscle fibres using the loose-patch-clamp technique. 2. The fibres could be divided into two groups based upon the properties of INa. The two groups of fibres were called type 1 and type 2. 3. Both type 1 and type 2 fibres demonstrated fast and slow inactivation of INa. 4. Type 1 fibres had lower INa on the endplate border and extrajunctional membrane than type 2 fibres and required larger membrane depolarizations to inactivate Na+ channels by fast or slow inactivation of INa. 5. Type 2 fibres had a higher ratio of INa at the endplate border compared to extrajunctional membrane than Type 1 fibres. 6. Measurement of membrane capacitance suggested that the increase in INa at the endplate border was due to increased Na+ channel density. 7. Histochemical staining of some fibres suggested that type 1 fibres were slow twitch and type 2 fibres were fast twitch. 8. Differences in the properties of Na+ channels between fast- and slow-twitch fibres may contribute to the ability of fast-twitch fibres to operate at high firing frequencies and slow-twitch fibres to be tonically active. PMID:1338797

  1. Versatility of lateral cutaneous branches of intercostal vessels and nerves: anatomical study and clinical application.

    PubMed

    Iida, Takuya; Narushima, Mitsunaga; Yoshimatsu, Hidehiko; Mihara, Makoto; Kikuchi, Kazuki; Hara, Hisako; Yamamoto, Takumi; Araki, Jun; Koshima, Isao

    2013-11-01

    The use of the intercostal artery perforator (ICAP) flap has recently become popular in reconstructions of the breast, upper arm and trunk. Lateral cutaneous branches (LCBs) are a group of the ICAPs that penetrate the fascia near the middle axillary line. However, reports on its precise anatomy and clinical applications are quite limited. We performed an anatomical study of LCBs using cadavers. Based on the findings, we developed novel clinical application methods as follows: (1) sensate superficial circumflex iliac perforator (SCIP) flap, (2) supercharged SCIP flap, (3) ICAP-based propeller flap (IBPF) and (4) free ICAP flap based on LCB. LCBs have the following advantages: (1) Long pedicles can be obtained in the supine position without risk of pneumothorax. (2) The neurovascular bundle is consistently available, allowing elevation of sensate flaps. (3) Donor-site morbidity is low. Therefore, we believe that LCBs offer a versatile option in reconstructive surgery. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Intrinsic Transient Tracheal Occlusion Training and Myogenic Remodeling of Rodent Parasternal Intercostal Fibers

    PubMed Central

    Smith, Barbara K.; Mathur, Sunita; Ye, Fan; Martin, A. Daniel; Truelson, Sara Attia; Vandenborne, Krista; Davenport, Paul W.

    2014-01-01

    It is recognized that diaphragm muscle plasticity occurs with mechanical overloads, yet less is known regarding synergistic parasternal intercostal muscle fiber remodeling. We conducted overload training with intrinsic transient tracheal occlusion (ITTO) exercises in conscious animals. We hypothesized ITTO would yield significant fiber hypertrophy and myogenic activation that would parallel diaphragm fiber remodeling. Sprague-Dawley rats underwent placement of a tracheal cuff and were randomly assigned to receive daily ten-minute sessions of conscious ITTO or observation (SHAM) over two weeks. After training, fiber morphology, myosin heavy chain isoform composition, cross-sectional area, proportion of Pax7-positive nuclei, and presence of embryonic myosin (eMHC) were quantified. Type IIx/b fibers were 20% larger after ITTO training than with SHAM training (ITTO: 4431±676 μm2, SHAM: 3689±400 μm2, p<0.05), and type I fibers were more prevalent after ITTO (p<0.01). Expression of Pax7 was increased in ITTO parasternals and diaphragm (p<0.05). In contrast, the proportion of eMHC-positive fibers was increased only in ITTO parasternals (1.2 (3.4-0.6)%, SHAM: 0 (0.6-0%, p<0.05). Although diaphragm and parasternal type II fibers hypertrophy to a similar degree, myogenic remodeling appears to differ between the two muscles. PMID:25509059

  3. SpaceX CRS-12 Liftoff

    NASA Image and Video Library

    2017-08-14

    The two-stage Falcon 9 launch vehicle lifts off Launch Complex 39A at NASA's Kenney Space Center carrying the Dragon resupply spacecraft to the International Space Station. Liftoff was at 12:31 p.m. EDT. On its 12th commercial resupply services mission to the International Space Station, Dragon will bring up more than 6,400 pounds of supplies and new science experiments and equipment for technology research.

  4. SpaceX CRS-12 Liftoff

    NASA Image and Video Library

    2017-08-14

    The two-stage Falcon 9 launch vehicle lifts off Launch Complex 39A at NASA's Kennedy Space Center carrying the Dragon resupply spacecraft to the International Space Station. Liftoff was at 12:31 p.m. EDT. On its 12th commercial resupply services mission to the International Space Station, Dragon will bring up more than 6,400 pounds of supplies and new science experiments and equipment for technology research.

  5. Postoperative pain control by preventive intercostal nerve block under direct vision followed by catheter-based infusion of local analgesics in rib cartilage harvest for auricular reconstruction in children with microtia: A randomized controlled trial.

    PubMed

    Woo, Kyong-Je; Kang, Bo Young; Min, Jeong Jin; Park, Jin-Woo; Kim, Ara; Oh, Kap Sung

    2016-09-01

    Children with microtia complain of severe postoperative pain during early postoperative days after rib cartilage harvest for auricular reconstruction. The purpose of this study was to evaluate the effects of preventive donor site wound analgesia by intercostal nerve block (ICNB) and catheter-based infusion of local analgesics on postoperative pain after rib cartilage graft for auricular reconstruction in children with microtia. In this prospective randomized study, 66 children underwent postoperative pain control using either preventive ICNB followed by catheter-based infusion (33 patients, study group) or intravenous (IV) analgesia alone (33 patients, control group). ICNB was performed under direct vision by the surgeon by injecting 0.5% bupivacaine into each of the three intercostal spaces before perichondrial dissection. Catheters were placed in three subchondral spaces before wound closure, and 0.5% bupivacaine was infused every 12 h for 48 h postoperatively. Pain degrees were recorded every 4 h during the first 48 postoperative hours using a visual analogue scale. The study group showed significantly lower mean pain scores of the chest at rest (3.7 vs. 5.1, p = 0.001), the chest during coughing (4.3 vs. 5.8, p = 0.006), and the ear (3.0 vs. 4.1, p = 0.001) than the control group. The amount of use of rescue IV ketorolac was smaller in the study group (p = 0.026) than in the control group. No side effects related to the intervention were noted. Preventive ICNB followed by catheter-based infusion is effective and safe in postoperative pain relief in rib cartilage graft for auricular reconstruction. (The clinical trial registration number: WHO ICTRP, apps.who.int/trialsearch (KCT0001668)). Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. The reins of the soul: the centrality of the intercostal nerves to the neurology of Thomas Willis and to Samuel Parker's theology.

    PubMed

    Knoeff, Rina

    2004-07-01

    Thomas Willis's description of the intercostal nerves has not received much attention by historians of medicine. Yet the intercostal nerves are of paramount importance for his neurology. Willis explained that via these nerves, which connect the brain to the heart and lower viscera, the brain controls the passions and instincts of the lower body. In other words, Willis believed that the intercostal nerves mediate a kind of rationality and that therefore they make a human a rational being. Willis's theory, I argue, must be seen in the context of the early modern mind-body problem. In the second part of the article I discuss how Oxford theologian Samuel Parker took up Willis's argument while stating that the intercostal nerves are the most important instruments (reins) of the soul. They control the bodily passions so that humans can transform into more virtuous beings. The explanation of the intercostal nerves offered by Willis and Parker fits the Anglican optimism about the abilities of human reason as well as about the moral potential of humankind.

  7. PREFACE: 12th Russia/CIS/Baltic/Japan Symposium on Ferroelectricity and 9th International Conference on Functional Materials and Nanotechnologies (RCBJSF-2014-FM&NT)

    NASA Astrophysics Data System (ADS)

    Sternberg, Andris; Grinberga, Liga; Sarakovskis, Anatolijs; Rutkis, Martins

    2015-03-01

    The joint International Symposium RCBJSF-2014-FM&NT successfully has united two international events - 12th Russia/CIS/Baltic/Japan Symposium on Ferroelectricity (RCBJSF-12) and 9th International Conference Functional Materials and Nanotechnologies (FM&NT-2014). The RCBJSF symposium is a continuation of series of meetings on ferroelectricity, the first of which took place in Novosibirsk (USSR) in 1976. FM&NT conferences started in 2006 and have been organized by Institute of Solid State Physics, University of Latvia in Riga. In 2012 the International program committee decided to transform this conference into a traveling Baltic State conference and the FM&NT-2013 was organized by the Institute of Physics, University of Tartu, Estonia. In 2014 the joint international symposium RCBJSF-2014-FM&NT was organized by the Institute of Solid State Physics, University of Latvia and was part of Riga - 2014, the European Capital of Culture event. The purpose of the joint Symposium was to bring together scientists, students and high-level experts in solid state physics, materials science, engineering and related disciplines. The number of the registered participants from 26 countries was over 350. During the Symposium 128 high quality scientific talks (5 plenary, 42 invited, 81 oral) and over 215 posters were presented. All presentations were divided into 4 parallel sessions according to 4 main topics of the Symposium: Ferroelectricity, including ferroelectrics and multiferroics, pyroelectrics, piezoelectrics and actuators, integrated ferroelectrics, relaxors, phase transitions and critical phenomena. Multifunctional Materials, including theory, multiscale and multiphenomenal material modeling and simulation, advanced inorganic, organic and hybrid materials. Nanotechnologies, including progressive methods, technologies and design for production, investigation of nano- particles, composites, structures, thin films and coatings. Energy, including perspective materials and

  8. Zipingpu Concrete Face Rockfill Dam Failures caused by the 8.0R Earthquake on the 12th May 2008 (Chengdu, China)

    NASA Astrophysics Data System (ADS)

    Lekkas, E.

    2009-04-01

    The 8.0R earthquake that struck Sichuan on the 12th of May 2008, in the district of Chengdu of Southern China resulted in tenths of thousands casualties, the complete destruction of many towns and extended damages to public works. The earthquake was triggered by a reverse fault of NE-SW trend, more than 100 km long, that divides morphologically the affected area in two sections, the eastern one with mild low topography and the western one with intense relief representing the boundary of Tibet Mountains. This mountainous section is characterized by a rich drainage network that drains the greater region of the Tibet plateau. Along the trace of this high-stand for thousands of years numerous hydraulic works have been attempted in order to manage the water supply. Especially during the past decades, 400 small and large dams have been constructed. The main dam is the Zipingpu dam. It is a Concrete Face Rockfill Dam (CFRD) that has a height of 150m, a capacity of 1.2 billion m3 and includes a hydroelectric plant of 3.4 billion Kwh power. The Zipingpu dam is located 10km east of the earthquake epicenter and after the earthquake of 8.0R, the following failures were recorded: (i) Subsidence of the crown in the central part of the dam, of the order of 50cm in relation to the side survey control points, (ii) Deformation of the lower face of the dam, an area of approximately 1000 m2, (iii) Deviations and deformations of the construction elements throughout the face of the dam, (iv) Widening of construction joints (approximately 15 cm on the upper face), (v) Extended massive landslides throughout the reservoir, and (vi) Landslides on both left and right abutments of the dam causing further damages to secondary constructions. After the evaluation of the dam damages, the discharge of the reservoir was ordered through the emergency spillway in order to minimize the risk of a potential disaster for the nearby towns and especially Dujiangyan. Finally, the causes of the failures are

  9. Mini-flank supra-12th rib incision for open partial nephrectomy for renal tumor with RENAL nephrometry score ≥10: an innovation of traditional open surgery.

    PubMed

    Wang, Hang; Sun, Li-an; Wang, Yiwei; Xiang, Zhuoyi; Zhou, Lin; Guo, Jianming; Wang, Guomin

    2015-04-01

    The skill of supra-12th rib mini-flank approach for open partial nephrectomy (MI-OPN) provides an advanced operative method for renal tumor. Compared with laparoscopic and robotic surgery, it may be a feasible selection for the complex renal tumors. We describe our techniques and results of MI-OPN in complex renal tumors with high RENAL nephrometry score (RENAL nephrometry score ≥10). Fifty-five patients diagnosed with renal tumors between January 2009 and July 2013 were included in this study. Eligibility criteria comprised of patients with complex renal tumor (RENAL score ≥10) being candidates for partial nephrectomy (PN). All patients received MI-OPN and all surgeries were performed by a single urologist. The preoperative workup comprised of medical history, physical examination, and routine laboratory tests. Serum creatinine was recorded preoperatively and 2 to 3 months after operation. Operative time, ischemia time, blood loss, operative and postoperative complications, renal function, and pathology parameters were recorded. MI-OPN was successfully performed in all cases. Mean tumor size was 4.7 cm (range: 2.5-8.1). Mean warm ischemia time was 28.1 minutes (range: 21-39), mean operative time was 105 minutes (range: 70-150) and mean estimated blood loss was 68 mL (range: 10-400). Mean postoperative hospital stay was 6.5 days (range: 5-12). Postoperative complications were found in 3 patients (5.5%). The mean pre- and postoperative serum creatinine levels were 76.2 μmol/L (range: 47-132) and 87.1 μmol/L (range: 61-189) with significant difference (P = 0.004). The mean pre- and postoperative estimated glomerular filtration rate (eGFR) were 91.5 (range: 34-133) and 82.5 (range: 22-126.5), respectively with significant difference (P = 0.024). In an average follow-up of 19.9 months (range: 8-50), no local recurrence or systemic progression occurred. In conclusion, MI-OPN can combine the benefits of both minimal invasive and traditional open

  10. Initiating New Science Partnerships in Rural Education: STEM Graduate Students Bring Current Research into 7th-12th Grade Science Classrooms

    NASA Astrophysics Data System (ADS)

    Radencic, S.; Dawkins, K. S.; Jackson, B. S.; Walker, R. M.; Schmitz, D.; Pierce, D.; Funderburk, W. K.; McNeal, K.

    2014-12-01

    Initiating New Science Partnerships in Rural Education (INSPIRE), a NSF Graduate K-12 (GK-12) program at Mississippi State University, pairs STEM graduate students with local K-12 teachers to bring new inquiry and technology experiences to the classroom (www.gk12.msstate.edu). The graduate fellows prepare lessons for the students incorporating different facets of their research. The lessons vary in degree of difficulty according to the content covered in the classroom and the grade level of the students. The focus of each lesson is directed toward the individual research of the STEM graduate student using inquiry based designed activities. Scientific instruments that are used in STEM research (e.g. SkyMaster weather stations, GPS, portable SEM, Inclinometer, Soil Moisture Probe, Google Earth, ArcGIS Explorer) are also utilized by K-12 students in the activities developed by the graduate students. Creativity and problem solving skills are sparked by curiosity which leads to the discovery of new information. The graduate students work to enhance their ability to effectively communicate their research to members of society through the creation of research linked classroom activities, enabling the 7-12th grade students to connect basic processes used in STEM research with the required state and national science standards. The graduate students become respected role models for the high school students because of their STEM knowledge base and their passion for their research. Sharing enthusiasm for their chosen STEM field, as well as the application techniques to discover new ideas, the graduate students stimulate the interests of the classroom students and model authentic science process skills while highlighting the relevance of STEM research to K-12 student lives. The measurement of the student attitudes about science is gathered from pre and post interest surveys for the past four years. This partnership allows students, teachers, graduate students, and the public to

  11. Intercostal muscle motor behavior during tracheal occlusion conditioning in conscious rats

    PubMed Central

    Jaiswal, Poonam B.

    2016-01-01

    A respiratory load compensation response is characterized by increases in activation of primary respiratory muscles and/or recruitment of accessory respiratory muscles. The contribution of the external intercostal (EI) muscles, which are a primary respiratory muscle group, during normal and loaded breathing remains poorly understood in conscious animals. Consciousness has a significant role on modulation of respiratory activity, as it is required for the integration of behavioral respiratory responses and voluntary control of breathing. Studies of respiratory load compensation have been predominantly focused in anesthetized animals, which make their comparison to conscious load compensation responses challenging. Using our established model of intrinsic transient tracheal occlusions (ITTO), our aim was to evaluate the motor behavior of EI muscles during normal and loaded breathing in conscious rats. We hypothesized that 1) conscious rats exposed to ITTO will recruit the EI muscles with an increased electromyogram (EMG) activation and 2) repeated ITTO for 10 days would potentiate the baseline EMG activity of this muscle in conscious rats. Our results demonstrate that conscious rats exposed to ITTO respond by recruiting the EI muscle with a significantly increased EMG activation. This response to occlusion remained consistent over the 10-day experimental period with little or no effect of repeated ITTO exposure on the baseline ∫EI EMG amplitude activity. The pattern of activation of the EI muscle in response to an ITTO is discussed in detail. The results from the present study demonstrate the importance of EI muscles during unloaded breathing and respiratory load compensation in conscious rats. PMID:26823339

  12. Multimodal analgesic treatment in video-assisted thoracic surgery lobectomy using an intraoperative intercostal catheter.

    PubMed

    Wildgaard, Kim; Petersen, Rene H; Hansen, Henrik J; Møller-Sørensen, Hasse; Ringsted, Thomas K; Kehlet, Henrik

    2012-05-01

    No golden standard for analgesia in video-assisted thoracic surgery (VATS) lobectomy exists. A simple multimodal approach using an intercostal catheter (ICC) may be of benefit since acute post-operative pain following VATS lobectomy primarily originates from the chest drain area. Prospective observational cohort. Forty-eight consecutive patients received a standardized regimen consisting of paracetamol, non-steroidal anti-inflammatory drug and gabapentin. Further, surgeons performed a single-shot paravertebral block (PVB) at five levels (15 ml of 0.5% bupivacaine) and inserted an ICC at the drain site level for continuous delivery of 6 ml of 0.25% bupivacaine h(-1). Pain scores at rest, mobilization and with the extended arms were followed until discharge or for 4 days. Forty-eight patients, mean age 64 years (CI: 61-68), were included. The mean time for the PVB and ICC placement was 5 min (CI: 4.7-5.9). The mean pain score at rest using a numerical rating scale (NRS, 0-10) was <3 for 1-16 h and decreased from 4.7 to 1.7 (NRS day 1-4, getting out of bed). The ICC was removed with the drain in 48/73/92% on day 1/2/3 after surgery. The median day of discharge was 3 (interquartile range 2-4) with >85% of patients reporting satisfactory or very satisfactory pain treatment all days. Acute pain after VATS lobectomy may be adequately controlled using a multimodal non-opioid regime including PVB and an ICC. The low pain scores and reduced time used inserting the ICC may present an alternative to continuous epidural analgesia or conventional PVB.

  13. Preexpanded distant "super-thin" intercostal perforator flaps for facial reconstruction without the need for microsurgery.

    PubMed

    Lu, F; Gao, J H; Ogawa, R; Hykusoku, H

    2006-01-01

    Concept of the 'super-thin perforator flap' was introduced in 1994 by authors. Since then, various types of 'super-thin perforator flaps' were applied successfully especially for contour sensitive reconstruction such as face and neck. Eleven patients requiring large flaps who presented with extensive disfiguring facial scar (male: seven cases, female: four cases). On the consideration of flaps' colour, texture and thickness requirements, the authors selected 'super-thin' anterior intercostal perforator flaps (AICP, range from 4 x 14 cm to 25 cm x 9 cm) for reconstruction purpose. First, tissue expanders (volume range from 800 cc to 1200 cc) were carefully inserted under the AICP. After the flaps were expanded for 2 months, distant scars were removed and the covering super-thinned flaps were transferred into recipient site. Two weeks later, pedicles in the anterior chest were cut down and flaps were transferred to replace all the left scars. Flap were survived without any complications. The colour, texture and thickness of the transferred flap were satisfactory, shrink of flaps were not observed after long term follow-up. The authors present a method of facial reconstruction that has the advantages of creating a large amount of thin tissue of both good colour and texture, without the need of microsurgery and few disadvantages of donor-site morbidity. The disadvantages are three-staged procedures, complications of tissue expansion and uncomfortable compulsory posture for patients. In our opinion, this is an alternative method of choice for reconstructing all large defects in the lower two-thirds of the face.

  14. Recruitment and plasticity in diaphragm, intercostal, and abdominal muscles in unanesthetized rats.

    PubMed

    Navarrete-Opazo, A; Mitchell, G S

    2014-07-15

    Although rats are a frequent model for studies of plasticity in respiratory motor control, the relative capacity of rat accessory respiratory muscles to express plasticity is not well known, particularly in unanesthetized animals. Here, we characterized external intercostal (T2, T4, T5, T6, T7, T8, T9 EIC) and abdominal muscle (external oblique and rectus abdominis) electromyogram (EMG) activity in unanesthetized rats via radiotelemetry during normoxia (Nx: 21% O2) and following acute intermittent hypoxia (AIH: 10 × 5-min, 10.5% O2; 5-min intervals). Diaphragm and T2-T5 EIC EMG activity, and ventilation were also assessed during maximal chemoreceptor stimulation ( 7% CO2, 10.5% O2) and sustained hypoxia (SH: 10.5% O2). In Nx, T2 EIC exhibits prominent inspiratory activity, whereas T4, T5, T6, and T7 EIC inspiratory activity decreases in a caudal direction. T8 and T9 EIC and abdominal muscles show only tonic or sporadic activity, without consistent respiratory activity. MCS increases diaphragm and T2 EIC EMG amplitude and tidal volume more than SH (0.94 ± 0.10 vs. 0.68 ± 0.05 ml/100 g; P < 0.001). Following AIH, T2 EIC EMG amplitude remained above baseline for more than 60 min post-AIH (i.e., EIC long-term facilitation, LTF), and was greater than diaphragm LTF (41.5 ± 1.3% vs. 19.1 ± 2.0% baseline; P < 0.001). We conclude that 1) diaphragm and rostral T2-T5 EIC muscles exhibit inspiratory activity during Nx; 2) MCS elicits greater ventilatory, diaphragm, and rostral T2-T5 EIC muscle activity vs. SH; and 3) AIH induces greater rostral EIC LTF than diaphragm LTF. Copyright © 2014 the American Physiological Society.

  15. Recruitment and plasticity in diaphragm, intercostal, and abdominal muscles in unanesthetized rats

    PubMed Central

    Navarrete-Opazo, A.

    2014-01-01

    Although rats are a frequent model for studies of plasticity in respiratory motor control, the relative capacity of rat accessory respiratory muscles to express plasticity is not well known, particularly in unanesthetized animals. Here, we characterized external intercostal (T2, T4, T5, T6, T7, T8, T9 EIC) and abdominal muscle (external oblique and rectus abdominis) electromyogram (EMG) activity in unanesthetized rats via radiotelemetry during normoxia (Nx: 21% O2) and following acute intermittent hypoxia (AIH: 10 × 5-min, 10.5% O2; 5-min intervals). Diaphragm and T2–T5 EIC EMG activity, and ventilation were also assessed during maximal chemoreceptor stimulation (MCS: 7% CO2, 10.5% O2) and sustained hypoxia (SH: 10.5% O2). In Nx, T2 EIC exhibits prominent inspiratory activity, whereas T4, T5, T6, and T7 EIC inspiratory activity decreases in a caudal direction. T8 and T9 EIC and abdominal muscles show only tonic or sporadic activity, without consistent respiratory activity. MCS increases diaphragm and T2 EIC EMG amplitude and tidal volume more than SH (0.94 ± 0.10 vs. 0.68 ± 0.05 ml/100 g; P < 0.001). Following AIH, T2 EIC EMG amplitude remained above baseline for more than 60 min post-AIH (i.e., EIC long-term facilitation, LTF), and was greater than diaphragm LTF (41.5 ± 1.3% vs. 19.1 ± 2.0% baseline; P < 0.001). We conclude that 1) diaphragm and rostral T2–T5 EIC muscles exhibit inspiratory activity during Nx; 2) MCS elicits greater ventilatory, diaphragm, and rostral T2–T5 EIC muscle activity vs. SH; and 3) AIH induces greater rostral EIC LTF than diaphragm LTF. PMID:24833779

  16. Comparative study of continuous extrapleural intercostal nerve block and lumbar epidural morphine in post-thoracotomy pain

    PubMed Central

    Dauphin, Alezandre; Lubanska-Hubert, Elizabeth; Young, J. Edward M.; Miller, John D.; Bennett, W. Frederick; Fuller, Hugh D.

    1997-01-01

    Objectives To compare the efficacy of continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200 000 epinephrine and continuous lumbar epidural block with morphine in controlling post-thoracotomy pain and to measure serum bupivacaine concentrations during extrapleural infusion. Design A prospective, randomized, controlled trial. Setting St. Joseph’s Hospital, Hamilton, Ont., a tertiary care teaching centre. Patients Sixty-one patients booked for elective thoracotomy were randomized by sealed envelope to two groups. Interventions Group A received a continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200 000 epinephrine as a bolus of 0.3 mL/kg followed by an infusion of 0.1 mL/kg every hour for 72 hours. Group B received a continuous lumbar epidural block with morphine as a bolus of 70 g/kg followed by an infusion of 7 g/kg every hour for 72 hours. Main outcome measures Pain was assessed by a linear visual analogue scale (VAS) pain score. The cumulative amount of “rescue” intravenous morphine used, and serum bupivacaine concentrations were measured as secondary outcomes. Results Pain control was the same in both groups as assessed by linear VAS score (p = 0.33). The cumulative dose of intravenous morphine for supplemental analgesia was statistically significant between the groups: group A patients used more morphine than group B (p < 0.05). Accumulation of serum bupivacaine was present with no clinical toxicity. Conclusions There is no significant difference in the degree of post-thoracotomy pain control measured by the VAS score when analgesia is provided by continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200 000 epinephrine or lumbar epidural block with morphine. Larger amounts of rescue analgesia were used by patients in the continuous extrapleural group with bupivacaine than those in the continuous lumbar epidural block with morphine. Serum bupivacaine concentrations rise without clinical

  17. Thoracic skeletal defects in myogenin- and MRF4-deficient mice correlate with early defects in myotome and intercostal musculature.

    PubMed

    Vivian, J L; Olson, E N; Klein, W H

    2000-08-01

    Myogenin and MRF4 are skeletal muscle-specific bHLH transcription factors critical for muscle development. In addition to a variety of skeletal muscle defects, embryos homozygous for mutations in myogenin or MRF4 display phenotypes in the thoracic skeleton, including rib fusions and sternal defects. These skeletal defects are likely to be secondary because myogenin and MRF4 are not expressed in the rib cartilage or sternum. In this study, the requirement for myogenin and MRF4 in thoracic skeletal development was further examined. When a hypomorphic allele of myogenin and an MRF4-null mutation were placed together, the severity of the thoracic skeletal defects was greatly increased and included extensive rib cartilage fusion and fused sternebrae. Additionally, new rib defects were observed in myogenin/MRF4 compound mutants, including a failure of the rib cartilage to contact the sternum. These results suggested that myogenin and MRF4 share overlapping functions in thoracic skeletal formation. Spatial expression patterns of skeletal muscle-specific markers in myogenin- and MRF4-mutant embryos revealed early skeletal muscle defects not previously reported. MRF4-/- mice displayed abnormal intercostal muscle morphology, including bifurcation and fusion of adjacent intercostals. myogenin/MRF4-mutant combinations displayed ventral myotome defects, including a failure to express normal levels of myf5. The results suggested that the early muscle defects observed in myogenin and MRF4 mutants may cause subsequent thoracic skeletal defects, and that myogenin and MRF4 have overlapping functions in ventral myotome differentiation and intercostal muscle morphogenesis. Copyright 2000 Academic Press.

  18. Comparison Thoracic Epidural and Intercostal Block to Improve Ventilation Parameters and Reduce Pain in Patients with Multiple Rib Fractures

    PubMed Central

    Hashemzadeh, Shahryar; Hashemzadeh, Khosrov; Hosseinzadeh, Hamzeh; Aligholipour Maleki, Raheleh; Golzari, Samad

    2011-01-01

    Introduction Chest wall blunt trauma causes multiple rib fractures and will often be associated with significant pain and may compromise ventilator mechanics. Analgesia has great roll in rib fracture therapies, opioid are useful, but when used as sole agent may require such high dose that they produce respiratory depression, especially in elderly .the best analgesia for a severe chest wall injury is a continuous epidural infusion of local anesthetic. This provides complete analgesia allowing inspiration and coughing without of the risk of respiratory depression. Methods sixty adult patients who with multiple rib fractures were enrolled in this study. They were divided into Group A or thoracic epidural with bupivacaine 0.125 % +1mg/5ml morphine and group B or intercostal block with 0.25% bupivacaine. The patients were assessed through ICU and hospital stay length, ventilation function tests. Pain score among the patients was measured with verbal rating scale, before and after administration of the analgesia. Results We found a significant improvement in ventilatory function tests during the 1st, 2nd, and 3rd days after epidural analgesia compared with the intercostal block (P < 0.004). Changes in the visual Analogue Scale were associated with marked improvement regarding pain at rest and pain caused by coughing and deep breathing in group A compared group B... ICU and hospital stay markedly reduced in Group A. Conclusion thoracic epidural analgesia is superior to intercostals block regarding pain relief of rib fractures. Patients who received epidural analgesia had significantly lower pain scores at all studied times. PMID:24250961

  19. Comparison of postoperative pain relief by intercostal block between pre-rib harvest and post-rib harvest groups.

    PubMed

    Bashir, Muhammad Mustehsan; Shahzad, Muhammad Ateeq; Yousaf, Muhammad Nadeem; Khan, Bilal Ahmad; Khan, Farid Ahmad

    2014-01-01

    To compare intercostal nerve block before and after rib harvest in terms of mean postoperative pain score and mean postoperative tramadol usage. Randomized controlled trial. Department of Plastic Surgery, Mayo Hospital, KEMU, Lahore, from January 2011 to July 2012. Patients (n = 120) of either gender with ASA class-I and II requiring autogenous costal cartilage graft were inducted. Patients having history of local anaesthetic hypersensitivity and age < 15 years or > 60 years were excluded. Subjects were randomly assigned to pre-rib harvest (group-1) and post-rib harvest (group-2). Local anaesthetic mixture was prepared by adding 10 milliliters 2% lidocaine to 10 milliliters 0.5% bupivacaine to obtain a total 20 ml solution. Group-1 received local anaesthetic infiltration along the proposed incision lines and intercostals block before the rib harvest. Group-2 received the infiltration and block after rib harvest. Postoperative consumption of tramadol and pain scores were measured at 6 and 12 hours postoperatively using VAS. Mean age was 31.43 ± 10.78 years. The mean pain scores at 6 hours postoperatively were 1.033 ± 0.609 and 2.4667 ± 0.812 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean pain scores at 12 hours postoperatively were 1.45 ± 0.565 and 3.65 ± 0.633 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean tramadol used postoperatively in first 24 hours was 169 ± 29.24 mg and 255 ± 17.70 mg in prerib harvest and post-rib harvest groups respectively (p < 0.0001). Intercostal block administered before rib harvest as preemptive strategy result in decreased postoperative pain scores and narcotic use.

  20. Quality of postoperative recovery after breast surgery. General anaesthesia combined with paravertebral versus serratus-intercostal block.

    PubMed

    Pérez Herrero, M A; López Álvarez, S; Fadrique Fuentes, A; Manzano Lorefice, F; Bartolomé Bartolomé, C; González de Zárate, J

    2016-12-01

    The quality of postoperative recovery is one of the most important among all the quality indicators used in clinical situations. This is even more important after cancer surgery. Our aim was to evaluate this after non-reconstructive breast surgery under general anesthesia and paravertebral blockade or serratus-intercostal plane blockade, in the early and late post-operative period. A prospective observational study was conducted on 60 patients (25 paravertebral blockade group and 35 serratus-intercostal plane blockade group) scheduled for non-reconstructive breast surgery during a 6 month period. Every patient received general anaesthesia and were randomised to receive either paravertebral blockade or serratus-intercostal plane blockade. The quality of post-anaesthetic recovery was quantified by Postoperative Quality Recovery Scale, which is used to assess physiological, nociceptive, emotional, autonomy, cognitive and general state domains at different times: baseline (before surgery), 15min after the end of surgery, at discharge to home, and one month after surgery. A total recovery of 95.93% was achieved in the early postoperative period (15min PACU), 99.07% at discharge to home, and 99.25% at one month after the intervention. No significant differences were found between groups in total score or in each evaluated area. A progressive improvement was observed in the scores assessed with the Postoperative Quality Recovery Scale, reaching values that would allow the discharge to home and early return to usual active life from the immediate postoperative period, with no significant differences between the 2 analgesic techniques. Savings in opioid use and the excellent recovery were observed in all measured domains observed. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Different sensitivity of miniature endplate currents in rat external and internal intercostal muscles to the acetylcholinesterase inhibitor C-547 as compared with diaphragm and extensor digitorum longus.

    PubMed

    Petrov, K; Kovyazina, I; Zobov, V; Bukharaeva, E; Nikolsky, E E; Vyskocil, F

    2009-01-01

    Derivative of 6-methyluracil, selective cholinesterase inhibitor C-547 potentiates miniature endplate currents (MEPCs) in rat external intercostal muscles (external ICM) more effectively than in internal intercostal muscles (internal ICM). Effect of the C-547 on intercostal muscles was compared with those on extensor digitorum longus (EDL) and diaphragm muscles. Half-effective concentrations for tau of MEPC decay arranged in increasing order were as follows: EDL, locomotor muscle, most sensitive = 1.3 nM, external ICM, inspiration muscle = 6.8 nM, diaphragm, main inspiration muscle = 28 nM, internal ICM, expiration muscle = 71 nM. External ICM might therefore be inhibited, similarly as the limb muscles, by nanomolar concentrations of the drug and do not participate in inspiration in the presence of the C-547. Moreover, internal ICM inhibition can hinder the expiration during exercise-induced fast breathing of C-547- treated experimental animals.

  2. Intercostal high intensity focused ultrasound for liver ablation: The influence of beam shaping on sonication efficacy and near-field risks

    SciTech Connect

    Greef, M. de Wijlemans, J. W.; Bartels, L. W.; Moonen, C. T. W.; Ries, M.; Schubert, G.; Koskela, J.

    2015-08-15

    Purpose: One of the major issues in high intensity focused ultrasound ablation of abdominal lesions is obstruction of the ultrasound beam by the thoracic cage. Beam shaping strategies have been shown by several authors to increase focal point intensity while limiting rib exposure. However, as rib obstruction leaves only part of the aperture available for energy transmission, conserving total emitted acoustic power, the intensity in the near-field tissues inherently increases after beam shaping. Despite of effective rib sparing, those tissues are therefore subjected to increased risk of thermal damage. In this study, for a number of clinically representative intercostal sonication geometries, modeling clinically available hardware, the effect of beam shaping on both the exposure of the ribs and near-field to acoustic energy was evaluated and the implications for the volumetric ablation rate were addressed. Methods: A relationship between rib temperature rise and acoustic energy density was established by means of in vivo MR thermometry and simulations of the incident acoustic energy for the corresponding anatomies. This relationship was used for interpretation of rib exposure in subsequent numerical simulations in which rib spacing, focal point placement, and the focal point trajectory were varied. The time required to heat a targeted region to 65 °C was determined without and with the application of beam shaping. The required sonication time was used to calculate the acoustic energy density at the fat–muscle interface and at the surface of the ribs. At the fat–muscle interface, exposure was compared to available literature data and rib exposure was interpreted based on the earlier obtained relation between measured temperature rise and simulated acoustic energy density. To estimate the volumetric ablation rate, the cool-down time between periods of energy exposure was estimated using a time-averaged power limit of 100 kJ/h. Results: At the level of the ribs

  3. Indocyanine green fluorescence in the assessment of the quality of the pedicled intercostal muscle flap: a pilot study.

    PubMed

    Piwkowski, Cezary; Gabryel, Piotr; Gąsiorowskia, Łukasz; Zieliński, Paweł; Murawa, Dawid; Roszak, Magdalena; Dyszkiewicz, Wojciech

    2013-07-01

    The pedicled intercostal muscle flap (IMF) is a high quality vascularized tissue commonly used to buttress the bronchial stump after pneumonectomy or bronchial anastomosis after sleeve lobectomy in order to prevent bronchopleural fistula formation. The evaluation of the viability of the muscle flap is difficult. The aim of this study was the assessment of the application of indicyanine green fluorescence for the evaluation of IMF perfusion. The study included 27 patients (10 males and 17 females), mean age 62.6 years (47-77 years). Indocyanine green fluorescence (ICG) was used for objective assessment of the IMF quality by a near-infrared camera system (Photodynamic Eye(®), Hamamatsu Photonics, Japan). The following factors that may have an impact on the quality of the IMF were assessed: age, gender, body mass index, comorbidities, IMF length and thickness and timing of the harvesting during the procedure. The following surgical pulmonary resections with IMF harvesting were performed: 12 pneumonectomies, 2 sleeve lobectomies and 13 lobectomies. Intercostal muscle flap (IMF) was harvested before rib spreader insertion in 23 patients (85%) and at the end of the surgery in 4 patients (15%). The mean length and thickness of the harvested intercostal muscle were 19.9 ± 2.9 cm (range 13-24 cm) and 2.4 cm ± 0.7 cm (range 1.0-3.5 cm), respectively. Indocyanine green angiography showed ischaemia in the distal part of the muscle in all cases, despite the lack of obvious macroscopic signs. Median length of the ischaemic part was 4 cm (range 0.5-20 cm). The IMF length and thickness had a significant impact on the length of the ischaemic segment. In 24 patients, the ischaemic part of the muscle flap was severed. In 3 patients with the longest ischaemic segment (11, 13 and 20 cm), an alternative tissue was used to cover the bronchial stump. No major complications occurred. Our preliminary results confirmed the simplicity and high efficacy of ICG in the assessment of

  4. The Combination of IV and Perineural Dexamethasone Prolongs the Analgesic Duration of Intercostal Nerve Blocks Compared with IV Dexamethasone Alone.

    PubMed

    Maher, Dermot P; Serna-Gallegos, Derek; Mardirosian, Rodney; Thomas, Otto J; Zhang, Xiao; McKenna, Robert; Yumul, Roya; Zhang, Vida

    2017-06-01

     The use of multiple-level, single-injection intercostal nerve blocks for pain control following video-assisted thorascopic surgery (VATS) is limited by the analgesic duration of local anesthetics. This study examines whether the combination of perineural and intravenous (IV) dexamethasone will prolong the duration of intraoperatively placed intercostal nerve blocks following VATS compared with IV dexamethasone and a perineural saline placebo.  Prospective, double-blind, randomized placebo-controlled trial.  Single level-1 academic trauma center.  Forty patients undergoing a unilateral VATS under the care of a single surgeon.  Patients were randomly assigned to two groups and received an intercostal nerve block containing 1) 0.5% bupivacaine with epinephrine and 1 ml of 0.9% saline or 2) 0.5% bupivacaine with epinephrine and 1 ml of a 4 mg/ml dexamethasone solution. All patients received 8 mg of IV dexamethasone.  Group 2 had lower NRS-11 scores at post-operative hours 8 (5.05, SD = 2.13 vs 3.50, SD = 2.50; p  = 0.04), 20 (4.30, SD = 2.96 vs 2.26, SD = 2.31; p  = 0.02), and 24 (4.53, SD = 1.95 vs 2.26, SD = 2.31; p  = 0.02). Equianalgesic opioid requirement was decreased in group 2 at 32 hours (5.78 mg, SD = 5.77 vs 1.67 mg, SD = 3.49; p  = 0.02). Group 2 also had greater FEV1 measured at 8, 12, 24, and 44 hours; greater FVC at 24 hours; greater PEF at 28 through 48 hours; and greater FEV1/FVC at 8 and 36 hours.  The combination of IV and perineural dexamethasone prolonged the duration of a single-injection bupivacaine intercostal nerve block as measured by NRS-11 compared with IV dexamethasone alone at 24 hours. Reduced NRS-11 at other times, reduced opioid requirements, and increased PFTs were observed in group 2.

  5. FOREWORD: The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) (Pine Mountain, Georgia, USA, 19-23 April 2009) The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) (Pine Mountain, Georgia, USA, 19-23 April 2009)

    NASA Astrophysics Data System (ADS)

    Orlando, Thomas M.; Diebold, Ulrike

    2010-03-01

    The 12th International Workshop on Desorption Induced by Electronic Transitions (DIET XII) took place from 19-23 April 2009 in Pine Mountain, Georgia, USA. This was the 12th conference in a strong and vibrant series, which dates back to the early 1980s. DIET XII continued the tradition of exceptional interdisciplinary science and focused on the study of desorption and dynamics induced by electronic excitations of surfaces and interfaces. The format involved invited lectures, contributed talks and a poster session on the most recent developments and advances in this area of surface physics. The Workshop International Steering Committee and attendees wish to dedicate DIET XII to the memory of the late Professor Theodore (Ted) Madey. Ted was one of the main pioneers of this field and was one of the primary individuals working to keep this area of science exciting and adventurous. His overall contributions to surface science were countless and his contributions to the DIET field and community were enormous. He is missed and remembered by many friends and colleagues throughout the world. The papers collected in this issue cover many of the highlights of DIET XII. Topics include ultrafast electron transfer at surfaces and interfaces, quantum and spatially resolved mapping of surface dynamics and desorption, photon-, electron- and ion-beam induced processes at complex interfaces, the role of non-thermal desorption in astrochemistry and astrophysics and laser-/ion-based methods of examining soft matter and biological media. Although the workshop attracted many scientists active in the general area of non-thermal surface processes, DIET XII also attracted many younger scientists (i.e., postdoctoral fellows, advanced graduate students, and a select number of advanced undergraduate students). This field has had an impact in a number of areas including nanoscience, device physics, astrophysics, and now biophysics. We believe that this special issue of Journal of Physics

  6. Free Functioning Gracilis Muscle Transfer versus Intercostal Nerve Transfer to Musculocutaneous Nerve for Restoration of Elbow Flexion after Traumatic Adult Brachial Pan-Plexus Injury.

    PubMed

    Maldonado, Andrés A; Kircher, Michelle F; Spinner, Robert J; Bishop, Allen T; Shin, Alexander Y

    2016-09-01

    After complete five-level root brachial plexus injury, free functional muscle transfer and intercostal nerve transfer to the musculocutaneous nerve are two potential reconstructive options for elbow flexion. The aim of this study was to determine the outcomes of free functional muscle transfer versus intercostal nerve-to-musculocutaneous nerve transfers with respect to strength. Sixty-two patients who underwent free functional muscle transfer reconstruction or intercostal nerve-to-musculocutaneous nerve transfer for elbow flexion following a pan-plexus injury were included. The two groups were compared with respect to postoperative elbow flexion strength according to the British Medical Research Council grading system; preoperative and postoperative Disabilities of the Arm, Shoulder, and Hand questionnaire scores. In the free functional muscle transfer group, 67.7 percent of patients achieved M3 or M4 elbow flexion. In the intercostal nerve-to-musculocutaneous nerve transfer group, 41.9 percent of patients achieved M3 or M4 elbow flexion. The difference was statistically significant (p < 0.05). Changes in Disabilities of the Arm, Shoulder, and Hand questionnaire scores were not statistically significant. Average time from injury to surgery was significantly different (p < 0.01) in both groups. The number of intercostal nerves used for the musculocutaneous nerve transfer did not correlate with better elbow flexion grade. Based on this study, gracilis free functional muscle transfer reconstruction achieves better elbow flexion strength than intercostal nerve-to-musculocutaneous nerve transfer for elbow flexion after pan-plexus injury. The role of gracilis free functional muscle transfer should be carefully considered in acute reconstruction. Therapeutic, III.

  7. VATS biopsy for undetermined interstitial lung disease under non-general anesthesia: comparison between uniportal approach under intercostal block vs. three-ports in epidural anesthesia.

    PubMed

    Ambrogi, Vincenzo; Mineo, Tommaso Claudio

    2014-07-01

    Video-assisted thoracoscopic (VATS) biopsy is the gold standard to achieve diagnosis in undetermined interstitial lung disease (ILD). VATS lung biopsy can be performed under thoracic epidural anesthesia (TEA), or more recently under simple intercostal block. Comparative merits of the two procedures were analyzed. From January 2002 onwards, a total of 40 consecutive patients with undetermined ILD underwent VATS biopsy under non-general anesthesia. In the first 20 patients, the procedures were performed under TEA and in the last 20 with intercostal block through a unique access. Intraoperative and postoperative variables were retrospectively matched. Two patients, one from each group, required shift to general anesthesia. There was no 30-day postoperative mortality and two cases of major morbidity, one for each group. Global operative time was shorter for operations performed under intercostal block (P=0.041). End-operation parameters significantly diverged between groups with better values in intercostal block group: one-second forced expiratory flow (P=0.026), forced vital capacity (P=0.017), oxygenation (P=0.038), PaCO2 (P=0.041) and central venous pressure (P=0.045). Intraoperative pain coverage was similar. Significant differences with better values in intercostal block group were also experienced in 24-hour postoperative quality of recovery-40 questionnaire (P=0.038), hospital stay (P=0.033) and economic expenses (P=0.038). Histology was concordant with radiologic diagnosis in 82.5% (33/40) of patients. Therapy was adjusted or modified in 21 patients (52.5%). Uniportal VATS biopsies under intercostal block can provide better intraoperative and postoperative outcomes compared to TEA. They allow the indications for VATS biopsy in patients with undetermined ILD to be extended.

  8. VATS biopsy for undetermined interstitial lung disease under non-general anesthesia: comparison between uniportal approach under intercostal block vs. three-ports in epidural anesthesia

    PubMed Central

    Mineo, Tommaso Claudio

    2014-01-01

    Objective Video-assisted thoracoscopic (VATS) biopsy is the gold standard to achieve diagnosis in undetermined interstitial lung disease (ILD). VATS lung biopsy can be performed under thoracic epidural anesthesia (TEA), or more recently under simple intercostal block. Comparative merits of the two procedures were analyzed. Methods From January 2002 onwards, a total of 40 consecutive patients with undetermined ILD underwent VATS biopsy under non-general anesthesia. In the first 20 patients, the procedures were performed under TEA and in the last 20 with intercostal block through a unique access. Intraoperative and postoperative variables were retrospectively matched. Results Two patients, one from each group, required shift to general anesthesia. There was no 30-day postoperative mortality and two cases of major morbidity, one for each group. Global operative time was shorter for operations performed under intercostal block (P=0.041). End-operation parameters significantly diverged between groups with better values in intercostal block group: one-second forced expiratory flow (P=0.026), forced vital capacity (P=0.017), oxygenation (P=0.038), PaCO2 (P=0.041) and central venous pressure (P=0.045). Intraoperative pain coverage was similar. Significant differences with better values in intercostal block group were also experienced in 24-hour postoperative quality of recovery-40 questionnaire (P=0.038), hospital stay (P=0.033) and economic expenses (P=0.038). Histology was concordant with radiologic diagnosis in 82.5% (33/40) of patients. Therapy was adjusted or modified in 21 patients (52.5%). Conclusions Uniportal VATS biopsies under intercostal block can provide better intraoperative and postoperative outcomes compared to TEA. They allow the indications for VATS biopsy in patients with undetermined ILD to be extended. PMID:25093084

  9. National Society of Black Physicists XXV Annual Day of Scientific Lectures and 21st Annual Meeting - NSBP '98: The Next Generation/12th Annual National Conference of Black Physics Students - NCPBS '98: Physics/Life in Motion

    SciTech Connect

    MacKellar, Alan

    1999-02-28

    The 12th Annual National Conference of Black Physics Students (NCBPS) was held jointly with the Annual Meeting of the National Society of Black Physicists (NSBP) March 4-8, 1998 in Lexington, Ky. The Proceedings consists of scientific talks and abstracts given by NSBP members and students attending the NCBPS meeting. One joint session of general scientific interest was held, with NCBPS students, NSBP members, and about 75 high school students from the state of Kentucky present. NCBPS session included ''How to get into Graduate School'', ''How to Survive in Graduate School'', and a Panel on ''Opportunities for Physics Graduates.'' The report by AIP: ''Survey of Participants of the 12th Annual NCBPS'' is included in the Proceedings.

  10. SpaceX/Dragon CRS-12 What's on Board Science Briefing

    NASA Image and Video Library

    2017-08-13

    The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  11. Preceedings of the International Congress (12th), Corrosion Control for Low-Cost Reliability, Held in Houston, Texas on September 19 -24, 1993. Volume 4. Oil/Gas/Pipeline

    DTIC Science & Technology

    1993-09-24

    CONTROL FOR Low -CosT RELIABILITY 12thIntlrnaional Corrosion IuCongwos PRECEEDIN6S OIL/GA S/PIPELINE 93-29516 IilnE liN511111 Ill 9 3 )% 210 3 The...Plenary I Blends V. Verkholantsev and M. Flavian ..................................... 99 Low -Cost Corrosion Engineering and Risk Potential, Operational...Atmospheric Corrosion R. Johnson and V. Agarwala ............................................... 370 of Low Carbon Steel, Zinc, Copper, and Aluminum A

  12. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    In the Kennedy Space Center’s Press Site auditorium, members of social media listen to a briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  13. SpaceX CRS-12 Live Launch Coverage

    NASA Image and Video Library

    2017-08-14

    Live Launch Coverage of the SpaceX Falcon 9 launch vehicle lift off from Launch Complex 39A at NASA's Kennedy Space Center carrying the Dragon resupply spacecraft to the International Space Station. Liftoff was at 12:31 p.m. EDT. On its 12th commercial resupply services mission to the International Space Station, Dragon will bring up more than 6,400 pounds of supplies and new science experiments and equipment for technology research.

  14. Continuous wound infiltration with 0.2% ropivacaine versus a single intercostal nerve block with 0.75% ropivacaine for postoperative pain management after reconstructive surgery for microtia.

    PubMed

    Niiyama, Yukitoshi; Yotsuyanagi, Takatoshi; Yamakage, Michiaki

    2016-10-01

    In reconstructive surgery for microtia during childhood, costal cartilage is used for pinna formation. Postoperative pain in the region from which the costal cartilage is taken is severe, which delays recovery after surgery. We evaluated prospectively whether continuous wound infiltration (CWI) of a local anesthetic (LA) reduces pain and enables rapid recovery compared with a single intercostal nerve block (ICNB). Forty-eight patients were randomly divided into two groups. In Group I, a single ICNB with 10 ml of 0.75% ropivacaine was performed at the end of surgery. In Group C, a catheter was inserted into the space between the abdominal external oblique muscle and the rectus abdominis muscle. Then, a 0.4-ml/kg bolus of 0.2% ropivacaine was administered, followed by continuous infusion at 2-4 ml/h for 48 h. Postoperative pain intensity evaluated using the Face Scale, dose of supplemental analgesics, and time until mobilization were evaluated. In Group C, the plasma concentrations of ropivacaine were analyzed. The pain intensity at rest was significantly lower in Group C than in Group I, but the values during coughing were comparable. The number of patients receiving a supplemental analgesic and the median number of doses were significantly larger in Group I than in Group C (P = 0.029, P = 0.0007, respectively). The plasma concentrations of ropivacaine were within the safe range over 48 h. The times until mobilization were comparable. CWI of 0.2% ropivacaine is a better and safe technique for postoperative pain management after costal cartilage graft harvest in children. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Use of intercostal nerves for neurotization of the musculocutaneous nerve in infants with birth-related brachial plexus palsy.

    PubMed

    Kawabata, H; Shibata, T; Matsui, Y; Yasui, N

    2001-03-01

    The use of intercostal nerves (ICNs) for the neurotization of the musculocutaneous nerve (MCN) in adult patients with traumatic brachial plexus palsy has been well described. However, its use for brachial plexus palsy in infants has rarely been reported. The authors surgically created 31 ICN-MCN communications for birth-related brachial plexus palsy and present the surgical results. Thirty-one neurotizations of the MCN, performed using ICNs, were conducted in 30 patients with birth-related brachial plexus palsy. In most cases other procedures were combined to reconstruct all upper-extremity function. The mean patient age at surgery was 5.8 months and the mean follow-up period was 5.2 years. Intercostal nerves were transected 1 cm distal to the mammary line and their stumps were transferred to the axilla, where they were coapted directly to the MCN. Two ICNs were used in 26 cases and three ICNs in five cases. The power of the biceps muscle of the arm was rated Grade M4 in 26 (84%) of 31 patients. In the 12 patients who underwent surgery when they were younger than 5 months of age, all exhibited a grade of M4 (100%) in their biceps muscle power. These results are better than those previously reported in adults. Neurotization of the MCN by surgically connecting ICNs is a safe, reliable, and effective procedure for reconstruction of the brachial plexus in patients suffering from birth-related palsy.

  16. Early-weaning and postweaning nutritional management affect feedlot performance, carcass merit, and the relationship of 12th-rib fat, marbling score, and feed efficiency among Angus and Wagyu heifers.

    PubMed

    Wertz, A E; Berger, L L; Walker, P M; Faulkner, D B; McKeith, F K; Rodriguez-Zas, S L

    2002-01-01

    Twelve 3/4 Angus (Angus) and 12 Wagyu-cross (1/2 Wagyu x 1/2 Angus) (Wagyu) heifers were weaned at 180 d of age and grazed on endophyte-infected tall fescue for 16 mo before entering the feedlot as 2-yr-olds. Twelve 3/4 Angus heifer calves and 12 Wagyu-cross heifer calves from the following year's calf crop were weaned at 142 +/- 4.1 d of age, immediately adjusted to an 80% concentrate diet, and finished as calves. All heifers were fed a common finishing diet until an estimated 50% of their respective group would grade USDA low Prime or better based on ultrasound predictions. Ultrasound measurements of s.c. and i.m. fat depots were recorded at 60-d intervals throughout the finishing period. Heifers finished as calves had higher (P = 0.02) marbling scores at any given fat thickness and gained more efficiently (P < or = 0.01) at any given marbling score than heifers finished as 2-yr-olds. Gain:feed decreased quadratically (P < or = 0.05) as 12th-rib fat thickness increased for Angus and Wagyu heifers. Gain:feed decreased linearly (P < or = 0.01) for Wagyu calves and quadratically (P < or = 0.01) for Angus calves as 12th-rib fat thickness increased. However, these differences in slope were not different (P = 0.34) as a result of breed among heifers finished as calves. Marbling score increased linearly (P < or = 0.01) as 12th-rib fat thickness increased for Angus and Wagyu heifers finished as 2-yrolds or as calves. However, Wagyu heifers, regardless of age at feedlot entry, had a higher marbling score (P < or = 0.05) at any given 12th-rib fat thickness than Angus heifers. Finishing early-weaned heifers as calves as opposed to 2-yr-olds results in i.m. fat deposition during a period of more efficient growth. Additionally, including Wagyu genetics into the breeding of early-weaned heifers finished as calves or as 2-yr-olds results in higher marbling scores at any 12th-rib fat thickness.

  17. Selected papers from the 12th International Workshop on Micro and Nanotechnology for Power Generation and Energy Conversion Applications (PowerMEMS 2012) (Atlanta, GA, USA, 2-5 December 2012)

    NASA Astrophysics Data System (ADS)

    Allen, Mark G.; Lang, Jeffrey

    2013-11-01

    Welcome to this special section of the Journal of Micromechanics and Microengineering (JMM). This section, co-edited by myself and by Professor Jeffrey Lang of the Massachusetts Institute of Technology, contains expanded versions of selected papers presented at the Power MEMS meeting held in Atlanta, GA, USA, in December of 2012. Professor Lang and I had the privilege of co-chairing Power MEMS 2012, the 12th International Workshop on Micro and Nanotechnology for Power Generation and Energy Conversion Applications. The scope of the PowerMEMS series of workshops ranges from basic principles, to materials and fabrication, to devices and systems, to applications. The many applications of power MEMS (microelectromehcanical systems) range from MEMS-enabled energy harvesting, storage, conversion and conditioning, to integrated systems that manage these processes. Why is the power MEMS field growing in importance? Smaller-scale power and power supplies (microwatts to tens of watts) are gaining in prominence due to many factors, including the ubiquity of low power portable electronic equipment and the proliferation of wireless sensor nodes that require extraction of energy from their embedding environment in order to function. MEMS manufacturing methods can be utilized to improve the performance of traditional power supply elements, such as allowing batteries to charge faster or shrinking the physical size of passive elements in small-scale power supplies. MEMS technologies can be used to fabricate energy harvesters that extract energy from an embedding environment to power wireless sensor nodes, in-body medical implants and other devices, in which the harvesters are on the small scales that are appropriately matched to the overall size of these microsystems. MEMS can enable the manufacturing of energy storage elements from nontraditional materials by bringing appropriate structure and surface morphology to these materials as well as fabricating the electrical interfaces

  18. Magnetic stimulation of biceps after intercostal cross-innervation for brachial plexus palsy. A study of motor evoked potentials in 25 patients.

    PubMed

    Kawai, H; Murase, T; Shibuya, R; Kawabata, H; Yonenobu, K; Masatomi, T; Ono, K

    1994-07-01

    We studied the motor evoked potentials (MEP) in the biceps of 25 patients with traumatic brachial plexus palsy from root avulsion after cross-innervation by intercostal nerves. We used transcranial, transcervical and transthoracic magnetic stimulation at 8 to 235 months (mean 51) after transfer of intercostal nerves to the musculocutaneous nerve. Biceps strength recovered to MRC grade 2 in eight patients, grade 3 in three and grade 4 in 14. The mean latency of the MEP in the normal biceps on transcranial stimulation was 12.5 +/- 1.3 ms and on transcervical stimulation 6.3 +/- 1.1 ms. After intercostal reinnervation the mean latency on transcranial stimulation was 21.7 +/- 4.5 ms and on transthoracic stimulation 11.6 +/- 3.8 ms. The latency of the biceps MEP after reinnervation by intercostal nerves on transcranial and transthoracic magnetic stimulation correlated well with the duration of follow-up and the latency of the MEP on transthoracic magnetic stimulation correlated significantly with muscle power.

  19. Intercostal nerve cryoablation versus thoracic epidural catheters for postoperative analgesia following pectus excavatum repair: Preliminary outcomes in twenty-six cryoablation patients.

    PubMed

    Keller, Benjamin A; Kabagambe, Sandra K; Becker, James C; Chen, Y Julia; Goodman, Laura F; Clark-Wronski, Julianna M; Furukawa, Kenneth; Stark, Rebecca A; Rahm, Amy L; Hirose, Shinjiro; Raff, Gary W

    2016-12-01

    Multimodal pain management strategies are used for analgesia following pectus excavatum repair. However, the optimal regimen has not been identified. We describe our early experience with intercostal cryoablation for pain management in children undergoing the Nuss procedure and compare early cryoablation outcomes to our prior outcomes using thoracic epidural analgesia. A multi-institutional, retrospective review of fifty-two patients undergoing Nuss bar placement with either intercostal cryoablation (n=26) or thoracic epidural analgesia (n=26) from March 2013 to January 2016 was conducted. The primary outcome was hospital length of stay. Secondary outcomes included telemetry unit monitoring time, total intravenous narcotic use, duration of intravenous narcotic use, and postoperative complications. Patients who underwent intercostal cryoablation had a significant reduction in the mean hospital length of stay, time in a monitored telemetry bed, total use of intravenous narcotics, and the duration of intravenous narcotic administration when compared to thoracic epidural patients. Cryoablation patients had a slightly higher rate of postoperative complications. Intercostal cryoablation is a promising technique for postoperative pain management in children undergoing repair of pectus excavatum. This therapy results in reduced time to hospital discharge, decreased intravenous narcotic utilization, and has eliminated epidurals from our practice. Retrospective study - level III. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011) Special issue containing papers presented at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems (7-11 September 2011)

    NASA Astrophysics Data System (ADS)

    Berk, H. L.

    2012-09-01

    The topic of the behaviour of energetic alpha particles in magnetic fusion confined plasmas is perhaps the ultimate frontier plasma physics issue that needs to be understood in the quest to achieve controlled power from the fusion reaction in magnetically confined plasmas. The partial pressure of alpha particles in a burning plasma will be ~5-10% of the total pressure and under these conditions the alpha particles may be prone to develop instability through Alfvénic interaction. This may lead, even with moderate alpha particle loss, to a burn quench or severe wall damage. Alternatively, benign Alfvénic signals may allow the vital information to control a fusion burn. The significance of this issue has led to extensive international investigations and a biannual meeting that began in Kyiv in 1989, followed by subsequent meetings in Aspenäs (1991), Trieste (1993), Princeton (1995), JET/Abingdon (1997), Naka (1999), Gothenburg (2001), San Diego (2003), Takayama (2005), Kloster Seeon (2007) and Kyiv (2009). The meeting was initially entitled 'Alpha Particles in Fusion Research' and then was changed during the 1997 meeting to 'Energetic Particles in Magnetic Confinement Systems' in appreciation of the need to study the significance of the electron runaway, which can lead to the production of energetic electrons with energies that can even exceed the energy produced by fusion products. This special issue presents some of the mature interesting work that was reported at the 12th IAEA Technical Meeting on Energetic Particles in Magnetic Confinement Systems, which was held in Austin, Texas, USA (7-11 September 2011). This meeting immediately followed a related meeting, the 5th IAEA Technical Meeting on Theory of Plasma Wave Instabilities (5-7 September 2011). The meetings shared one day (7 September 2011) with presentations relevant to both groups. The presentations from most of the participants, as well as some preliminary versions of papers, are available at the

  1. Management of post-operative pain by placement of an intraoperative intercostal catheter after single port video-assisted thoracoscopic surgery: a propensity-score matched study

    PubMed Central

    Wu, Ching-Feng; Hsieh, Ming-Ju; Liu, Hung-Pin; Gonzalez-Rivas, Diego; Liu, Yun-Hen; Wu, Yi-Cheng; Chao, Yin-Kai

    2016-01-01

    Background The establishment of a golden standard for post-operative analgesia after thoracic surgery remains an unresolved issue. Benefiting from the rapid development of single port video-assisted thoracoscopic surgery (VATS), a good candidate for the alleviation of patients’ pain is the placement of an intercostal catheter (ICC) safely after uniport VATS. We hypothesized that continual infusion through ICC could provide effective analgesia for patients with only one wound and we evaluate its postoperative analgesic function in uniport VATS patients with or without intercostal nerve blockade. Methods Since March 2014, 235 patients received various kinds of single port VATS. We identified 50 patients who received single port VATS with intercostal nerve blockade and retrospectively compared them with a group of patients who had received single port VATS without intercostal nerve blockade. The operative time, post operation day 0, 1, 2, 3 and discharge day pain score, narcotic requirements, drainage duration and post-operative hospital stay were collected. In order to establish a well-balanced cohort study, we also used propensity scores matching (1:1) to compare the short term clinical outcome in two groups. Results No operative deaths occurred in this study. The uniport VATS with intercostal nerve blockade group was associated with less post operation day 0 and day 1 pain score, and narcotic requirements in our cohort study (P<0.001, <0.001, and 0.003). After propensity scores matching, there were 50 patients in each group. Mean day 0 and day 1, day 2, day 3 pain score, drainage duration, post-operative hospital stay, and narcotic requirements were smaller in uniport VATS with intercostal nerve blockade (P<0.001, <0.001, 0.038, 0.007, 0.02, 0.042, and 0.003). Conclusions In conclusion, in patients post single port VATS, continual intercostal nerve block with levobupivacaine infusion appears to be a safe, effective and promising technique in our study, associated

  2. Management of post-operative pain by placement of an intraoperative intercostal catheter after single port video-assisted thoracoscopic surgery: a propensity-score matched study.

    PubMed

    Wu, Ching-Feng; Hsieh, Ming-Ju; Liu, Hung-Pin; Gonzalez-Rivas, Diego; Liu, Yun-Hen; Wu, Yi-Cheng; Chao, Yin-Kai; Wu, Ching-Yang

    2016-06-01

    The establishment of a golden standard for post-operative analgesia after thoracic surgery remains an unresolved issue. Benefiting from the rapid development of single port video-assisted thoracoscopic surgery (VATS), a good candidate for the alleviation of patients' pain is the placement of an intercostal catheter (ICC) safely after uniport VATS. We hypothesized that continual infusion through ICC could provide effective analgesia for patients with only one wound and we evaluate its postoperative analgesic function in uniport VATS patients with or without intercostal nerve blockade. Since March 2014, 235 patients received various kinds of single port VATS. We identified 50 patients who received single port VATS with intercostal nerve blockade and retrospectively compared them with a group of patients who had received single port VATS without intercostal nerve blockade. The operative time, post operation day 0, 1, 2, 3 and discharge day pain score, narcotic requirements, drainage duration and post-operative hospital stay were collected. In order to establish a well-balanced cohort study, we also used propensity scores matching (1:1) to compare the short term clinical outcome in two groups. No operative deaths occurred in this study. The uniport VATS with intercostal nerve blockade group was associated with less post operation day 0 and day 1 pain score, and narcotic requirements in our cohort study (P<0.001, <0.001, and 0.003). After propensity scores matching, there were 50 patients in each group. Mean day 0 and day 1, day 2, day 3 pain score, drainage duration, post-operative hospital stay, and narcotic requirements were smaller in uniport VATS with intercostal nerve blockade (P<0.001, <0.001, 0.038, 0.007, 0.02, 0.042, and 0.003). In conclusion, in patients post single port VATS, continual intercostal nerve block with levobupivacaine infusion appears to be a safe, effective and promising technique in our study, associated with a shorter hospital stay and less

  3. Nuclear Science Symposium, 27th, and Symposium on Nuclear Power Systems, 12th, Orlando, Fla., November 5-7, 1980, Proceedings

    NASA Technical Reports Server (NTRS)

    Martini, M.

    1981-01-01

    Advances in instrumentation for use in nuclear-science studies are described. Consideration is given to medical instrumentation, computerized fluoroscopy, environmental instrumentation, data acquisition techniques, semiconductor detectors, microchannel plates and photomultiplier tubes, reactor instrumentation, neutron detectors and proportional counters, and space instrumentation.

  4. Nuclear Science Symposium, 27th, and Symposium on Nuclear Power Systems, 12th, Orlando, Fla., November 5-7, 1980, Proceedings

    NASA Technical Reports Server (NTRS)

    Martini, M.

    1981-01-01

    Advances in instrumentation for use in nuclear-science studies are described. Consideration is given to medical instrumentation, computerized fluoroscopy, environmental instrumentation, data acquisition techniques, semiconductor detectors, microchannel plates and photomultiplier tubes, reactor instrumentation, neutron detectors and proportional counters, and space instrumentation.

  5. Distribution of electrical activation to the external intercostal muscles during high frequency spinal cord stimulation in dogs

    PubMed Central

    DiMarco, Anthony F; Kowalski, Krzysztof E

    2011-01-01

    Abstract In contrast to previous methods of electrical stimulation of the inspiratory muscles, high frequency spinal cord stimulation (HF-SCS) results in more physiological activation of these muscles. The spatial distribution of activation to the external intercostal muscles by this method is unknown. In anaesthetized dogs, multiunit and single motor unit (SMU) EMG activity was monitored in the dorsal portion of the 3rd, 5th and 7th interspaces and ventral portion of the 3rd interspace during spontaneous breathing and HF-SCS following C2 spinal section. Stimulus amplitude during HF-SCS was adjusted such that inspired volumes matched spontaneous breathing (Protocol 1). During HF-SCS, mean peak SMU firing frequency was highest in the 3rd interspace (dorsal) (18.8 ± 0.3 Hz) and significantly lower in the 3rd interspace (ventral) (12.2 ± 0.2 Hz) and 5th interspace (dorsal) (15.3 ± 0.3 Hz) (P < 0.05 for each comparison). Similar rostrocaudal and dorsoventral gradients of activity were observed during spontaneous breathing prior to C2 section. No significant activity was observed in the 7th interspace during either spontaneous breathing or HF-SCS. Since peak discharge frequencies of the SMUs were higher and rib cage movement greater during HF-SCS compared to spontaneous breathing, stimulus amplitude during HF-SCS was adjusted such that rib cage movement matched (Protocol 2). Under these conditions, mean peak SMU frequencies and rostrocaudal and dorsoventral gradients of activity during HF-SCS were not significantly different compared to spontaneous breathing. These results indicate that (a) the topographic pattern of electrical activation of the external intercostal muscles during HF-SCS is similar to that occurring during spontaneous breathing and (b) differential descending synaptic input from supraspinal centres is not a required component of the differential spatial distribution of external intercostal muscle activation. HF-SCS may provide a more physiological

  6. International Conference on Atomic Physics: Abstracts of Contributed Papers (12th) Held in Ann Arbor, Michigan on 29 July-3 August 1990

    DTIC Science & Technology

    1990-09-26

    1935 Fock5 showed how to cast the momentum-space form of the Schrodinger integral equation into the equation for 0(4) hyperspherical harmonics. The...linear equations, which may be easily numerically integrated . By adopting the same techniques, based on the Heisenberg equations, equations are obtained...for the motion of each atom, which are then integrated in conjunction with the equations for the internal degrees of freedom. In the limit of no

  7. Studies on conversion of motor function in intercostal nerves crossing for complete brachial plexus injuries of root avulsion type.

    PubMed

    Takahashi, M

    1983-11-01

    The progress of the functional conversion in cases where the 3rd and 4th intercostal nerves were crossed to the musculocutaneous nerve to regain elbow flexion after a total avulsion type of brachial plexus injury was followed up by means of the electromyogram, goniogram and spirogram in 25 patients. The joint position sense was further studied. It was found that in the early stage of reinnervation, spontaneous activity which synchronized with respiration was found in the biceps brachii muscles, but this involuntary element disappeared gradually and followed this the volitional control and endurance improved and became quite satisfactory within several years. It was observed that skin sensation played an important role in judging joint position.

  8. Dynamic and static contributions to the rhythmic γ activation of primary and secondary spindle endings in external intercostal muscle

    PubMed Central

    von Euler, C.; Peretti, G.

    1966-01-01

    1. In cats anaesthetized with sodium pentobarbital 160 external intercostal muscle spindle afferents were identified by their pause in response to ventral root stimulation; the internal intercostal muscle was denervated. 2. In order to assignate the afferents to either primary or secondary endings they were tested for their responsiveness to vibration (Bianconi & Van Der Meulen, 1963). The maximal frequency which they were able to follow regularly for at least four cycles, termed `critical frequency', was determined. 3. The endings fell into two groups: low-f (frequency) sensitive endings with critical frequencies below 400 c/s and high-f sensitive endings with critical frequencies above 400 c/s. The latter were regarded as primary endings and the former as secondary ones. 4. The manner in which the spindle endings resumed activity after a pause produced by shocks to the ventral root, i.e. whether `phasic' or `tonic' (Granit & Van Der Meulen, 1962) was studied in all the spindle afferents. 5. All the secondary (low-f sensitive) endings were `tonic' except three for which the determination of critical frequency was questionable. Both `tonic' and `phasic' properties were found among the primary (high-f sensitive) endings. 6. The majority of the secondary endings (74%) showed inspiratory rhythmic fusimotor activation in parallel with the skeletomotor contraction as did the primary endings (79%). 7. Fifty-seven spindle endings which all showed marked rhythmic inspiratory γ activation were tested for respiratory variations in their dynamic responses to steady stretch and length changes introduced at low repetition rates. 8. The results indicate that both `dynamic' and `static' γ fibres are represented among the rhythmic γ fibres controlling primary muscle spindle endings, whereas rhythmic activation of secondary endings seems to be mediated only by `static' fibres. PMID:16783909

  9. Excitatory post-synaptic potentials from single muscle spindle afferents in external intercostal motoneurones of the cat.

    PubMed Central

    Kirkwood, P A; Sears, T A

    1982-01-01

    1. The discharges of muscle spindle afferents from the external intercostal muscles of anaesthetized, paralysed cats were recorded from dorsal roots in continuity. The dynamic responses, regularities of firing and conduction velocities of the afferents were measured and used to characterize the afferents as primary-like or secondary-like. 2. The synchronization of afferent discharges was investigated by the construction of cross-correlation histograms from the simultaneously recorded discharges of pairs of afferents. The discharges of primary-like afferents with high dynamic responses were found to be synchronized within a few msec. The cardiac pulse was a strong contributary factor in this synchronization. 3. Intracellular recordings were made from external intercostal motoneurones, and spike-triggered averaging was used to reveal unitary e.p.s.p.s evoked by muscle spindle afferents which were from the same spinal cord segment. Dorsal roots other than the rootlet containing the afferent were cut to prevent the synchronization of afferent discharges from affecting the averaged e.p.s.p.s. 4. For primary-like afferents the mean amplitude of the e.p.s.p.s was 171 microV and the mean connectivity (the proportion of motoneurones connected by one afferent) was between 42 and 48%. 5. The amplitudes and shapes of the e.p.s.p.s varied with the respiratory phase, usually being larger in inspiration than in expiration and sometimes also having a longer time course. In particular some e.p.s.p.s showed that components, only represent in inspiration, which were interpreted as indicating polysynaptic connexions gated by the respiratory cycle. 6. The results are discussed in comparison with the connexions of individual muscle spindle afferents from other muscles, with particular reference to the conduction velocities of the afferents. PMID:6461757

  10. Management of acute postoperative pain with continuous intercostal nerve block after single port video-assisted thoracoscopic anatomic resection

    PubMed Central

    Hsieh, Ming-Ju; Wang, Kuo-Cheng; Liu, Hung-Pin; Gonzalez-Rivas, Diego; Wu, Ching-Yang; Liu, Yun-Hen; Wu, Yi-Cheng; Chao, Yin-Kai

    2016-01-01

    Background Effective postoperative pain control for thoracic surgery is very important, not only because it reduces pulmonary complications but also because it accelerates the pace of recovery. Moreover, it increases patients’ satisfaction with the surgery. In this study, we present a simple approach involving the safe placement of intercostal catheter (ICC) after single port video-assisted thoracoscopic surgery (VATS) anatomic resection and we evaluate postoperative analgesic function with and without it. Methods We identified patients who underwent single port anatomic resection with ICC placed intraoperatively as a route for continuous postoperative levobupivacaine (0.5%) administration and retrospectively compared them with a group of single port anatomic resection patients without ICC. The operation time, postoperative day 0, 1, 2, 3 and discharge day pain score, triflow numbers, narcotic requirements, drainage duration and post-operative hospital stay were compared. Results In total, 78 patients were enrolled in the final analysis (39 patients with ICC and 39 without). We found patients with ICC had less pain sensation numerical rating scale (NRS) on postoperative day 0, 1 (P=0.023, <0.001) and better triflow performance on postoperative day 1 and 2 (P=0.015, 0.032). In addition, lower IV form morphine usage frequency and dosage (P=0.009, 0.017), shorter chest tube drainage duration (P=0.001) and postoperative stay (P=0.005) were observed in the ICC group. Conclusions Continuous intercostal nerve blockade by placing an ICC intraoperatively provides effective analgesia for patients undergoing single port VATS anatomic resection. This may be considered a viable alternative for postoperative pain management. PMID:28149550

  11. Diaphragmatic and intercostal electromyographic activity during neostigmine, sugammadex and neostigmine-sugammadex-enhanced recovery after neuromuscular blockade: A randomised controlled volunteer study.

    PubMed

    Cammu, Guy; Schepens, Tom; De Neve, Nikolaas; Wildemeersch, Davina; Foubert, Luc; Jorens, Philippe G

    2017-01-01

    Electromyographic activity of the diaphragm (EMGdi) during weaning from mechanical ventilation is increased after sugammadex compared with neostigmine. To determine the effect of neostigmine on EMGdi and surface EMG (sEMG) of the intercostal muscles during antagonism of rocuronium block with neostigmine, sugammadex and neostigmine followed by sugammadex. Randomised, controlled, double-blind study. Intensive care research unit. Eighteen male volunteers. A transoesophageal EMGdi recorder was inserted into three groups of six anaesthetised study participants, and sEMG was recorded on their intercostal muscles. To reverse rocuronium, volunteers received 50 μg kg neostigmine, 2 mg kg sugammadex or 50 μg kg neostigmine, followed 3 min later by 2 mg kg sugammadex. We examined the EMGdi and sEMG at the intercostal muscles during recovery enhanced by neostigmine or sugammadex or neostigmine-sugammadex as primary outcomes. Secondary objectives were the tidal volume, PaO2 recorded between the onset of spontaneous breathing and extubation of the trachea and SpO2 during and after anaesthesia. During weaning, median peak EMGdi was 0.76 (95% confidence interval: 1.20 to 1.80) μV in the neostigmine group, 1.00 (1.23 to 1.82) μV in the sugammadex group and 0.70 (0.91 to 1.21) μV in the neostigmine-sugammadex group (P < 0.0001 with EMGdi increased after sugammadex vs. neostigmine and neostigmine-sugammadex). The median peak intercostal sEMG for the neostigmine group was 0.39 (0.65 to 0.93) μV vs. 0.77 (1.15 to 1.51) μV in the sugammadex group and 0.82 (1.28 to 2.38) μV in the neostigmine-sugammadex group (P < 0.0001 with sEMG higher after sugammadex and after neostigmine-sugammadex vs. neostigmine). EMGdi and sEMG on the intercostal muscles were increased after sugammadex alone compared with neostigmine. Adding sugammadex after neostigmine reduced the EMGdi compared with sugammadex alone. Unlike the diaphragm, intercostal EMG was preserved with neostigmine

  12. A histochemical study of the biceps brachii muscle cross-innervated by intercostal nerves. 6 cases of brachial plexus injuries operated with nerve-crossing.

    PubMed

    Kawai, H; Murase, T; Kawabata, H; Ohta, I; Masatomi, T; Ono, K; Nonaka, I

    1994-04-01

    Direct nerve-crossing of intercostal nerves from the lateral thorax to the musculocutaneous nerve was performed in 6 patients after spinal nerve root avulsion with brachial plexus palsy. Elbow flexion power was regained well enough to move against gravity and some resistance in all cases. The muscles were examined histochemically 4 (1-9) years after the operation. The intercostally-innervated biceps brachii muscle showed motor predominance of slow-twitch Type 1 fiber regeneration much more than that of fast-twitch Type 2 fiber in 5 of our patients. Our study suggests that the motor nerves of slow-twitch fibers may have priority in peripheral nerve regeneration over those of fast-twitch fibers.

  13. Satisfactory elbow flexion in complete (preganglionic) brachial plexus injuries: produced by suture of third and fourth intercostal nerves to musculocutaneous nerve.

    PubMed

    Minami, M; Ishii, S

    1987-11-01

    The third and fourth intercostal nerves were sutured to the musculocutaneous nerve to restore flexion of the elbow joint in complete (preganglionic) brachial plexus injuries. Seventeen patients were followed on the average for 5 years and 7 months after surgery. The results were evaluated by means of manual muscle tests and electrical diagnostic tests. Good (grade IV), or better, flexion of the elbow joint occurred in 12 patients over 3 years after the operation.

  14. External rib structure can be predicted using mathematical models: An anatomical study with application to understanding fractures and intercostal muscle function.

    PubMed

    Casha, Aaron R; Camilleri, Liberato; Manché, Alexander; Gatt, Ruben; Attard, Daphne; Gauci, Marilyn; Camilleri-Podesta, Marie-Therese; Grima, Joseph N

    2015-05-01

    As ribs adapt to stress like all bones, and the chest behaves as a pressure vessel, the effect of stress on the ribs can be determined by measuring rib height and thickness. Rib height and thickness (depth) were measured using CT scans of seven rib cages from anonymized cadavers. A Finite Element Analysis (FEA) model of a rib cage was constructed using a validated approach and used to calculate intramuscular forces as the vectors of both circumferential and axial chest wall forces at right angles to the ribs. Nonlinear quadratic models were used to relate rib height and rib thickness to rib level, and intercostal muscle force to vector stress. Intercostal muscle force was also related to vector stress using Pearson correlation. For comparison, rib height and thickness were measured on CT scans of children. Rib height increased with rib level, increasing by 13% between the 3rd and 7th rib levels, where the 7th/8th rib was the widest part or "equator" of the rib cage, P < 0.001 (t-test). Rib thickness showed a statistically significant 23% increase between the 3rd and 7th ribs, P = 0.004 (t-test). Intercostal muscle force was significantly related to vector stress, Pearson correlation r = 0.944, P = 0.005. The three nonlinear quadratic models developed all had statistically significant parameter estimates with P < 0.03. External rib morphology, in particular rib height and thickness, can be predicted using statistical mathematical models. Rib height is significantly related to the calculated intercostal muscle force, showing that environmental factors affect external rib morphology. © 2015 Wiley Periodicals, Inc.

  15. SpaceX CRS-12 Prelaunch News Conference

    NASA Image and Video Library

    2017-08-13

    In the Kennedy Space Center’s Press Site auditorium, Dan Hartman, NASA deputy manager of the International Space Station Program, speaks to members of the media during a prelaunch news conference for the SpaceX CRS-12 commercial resupply services mission to the International Space Station. A Dragon spacecraft is scheduled to be launched from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  16. SpaceX CRS-12 Prelaunch News Conference

    NASA Image and Video Library

    2017-08-13

    In the Kennedy Space Center’s Press Site auditorium, Pete Hasbrook, associate program scientist for the International Space Station Program, speaks to members of the media during a prelaunch news conference for the SpaceX CRS-12 commercial resupply services mission to the International Space Station. A Dragon spacecraft is scheduled to be launched from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  17. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    John London, an engineer for the U.S. Army Space and Missile Defense Command, left, and Chip Hardy, Kestrel Eye program manager for the U.S. Army Space and Missile Defense Command, speak to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  18. SpaceX CRS-12 Prelaunch News Conference

    NASA Image and Video Library

    2017-08-13

    In the Kennedy Space Center’s Press Site auditorium, Hans Koenigsmann, vice president of Build and Flight Reliability for SpaceX, speaks to members of the media during a prelaunch news conference for the SpaceX CRS-12 commercial resupply services mission to the International Space Station. A Dragon spacecraft is scheduled to be launched from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  19. Improved intercostal HIFU ablation using a phased array transducer based on Fermat's spiral and Voronoi tessellation: A numerical evaluation.

    PubMed

    Ramaekers, Pascal; Ries, Mario; Moonen, Chrit T W; de Greef, Martijn

    2017-03-01

    A major complication for abdominal High Intensity Focused Ultrasound (HIFU) applications is the obstruction of the acoustic beam path by the thoracic cage, which absorbs and reflects the ultrasonic energy leading to undesired overheating of healthy tissues in the pre-focal area. Prior work has investigated the determination of optimized transducer apodization laws, which allow for a reduced rib exposure whilst (partially) restoring focal point intensity through power compensation. Although such methods provide an excellent means of reducing rib exposure, they generally increase the local energy density in the pre-focal area, which similarly can lead to undesired overheating. Therefore, this numerical study aimed at evaluating whether a novel transducer design could provide improvement for intercostal HIFU applications, in particular with respect to the pre-focal area. A combination of acoustic and thermal simulations was used to evaluate 2 mono-element transducers, 2 clinical phased array transducers, and 4 novel transducers based on Fermat's Spiral (FS), two of which were Voronoi-tessellated (VTFS). Binary apodizations were determined for the phased array transducers using a collision detection algorithm. A tissue geometry was modeled to represent an intercostal HIFU sonication in the liver at 30 and 50 mm behind the ribs, including subsequent layers of gel pad, skin, subcutaneous fat, muscle, and liver tissue. Acoustic simulations were then conducted using propagation of the angular spectrum of plane waves (ASPW). The results of these simulations were used to evaluate pre-focal intensity levels. Subsequently, a finite difference scheme based on the Pennes bioheat equation was used for thermal simulations. The results of these simulations were used to calculate both the energy density in the pre-focal skin, fat, and muscle layers, as well as the energy exposure of the ribs. The acoustic simulations showed that for a sonication in a single point without

  20. Restoration of elbow flexion and wrist extension in brachial plexus paralyses by means of free muscle transplantation innervated by intercostal nerve.

    PubMed

    Akasaka, Y; Hara, T; Takahashi, M

    1990-01-01

    Traumatic lesions of the brachial plexus with nerve root avulsion pose extremely complex therapeutic problems. Since 1965, the authors have performed neurotization of the musculocutaneous nerve by intercostal nerves in order to restore elbow flexion. The results of this operation are considerably poorer when the interval between the trauma and the neurotization exceeds 6 months. In these late cases, the authors have used, since 1978, a free muscle transfer reinnervated by a transposed intercostal nerve. 17 patients have been operated by means of this technique; 8 of the 11 patients with a follow-up exceeding one year recovered elbow flexion force evaluated to be M3 or more. Encouraged by these results, the authors have extended this procedure to restoration of wrist extension by free musculocutaneous transfer of the gracilis muscle innervated by intercostal nerves. 17 of the 29 patients operated have a follow-up of more than one year and 9 these cases have regained wrist extension with a score of M3 or more.

  1. Bronchoesophageal Fistula Repair with Intercostal Muscle Flap Followed by Occlusion of Residual Diverticula with N-butyl Cyanoacrylate (NBCA) Glue: A Case Report

    PubMed Central

    Saikia, Manuj Kumar; Handique, Akash; Topno, Noor; Sarma, Kalyan

    2016-01-01

    The incidence of bronchoesophageal fistula in presence of benign pathology of tracheal tree or oesophagus is rare. It is encountered in thoracic diseases like tuberculosis, syphilis or histoplasmosis due to erosion by infected lymph node or abscess to adjoining structures. The source of primary pathology has to be eliminated followed by appropriate steps of fistula tract closure is essential for optimal result. We report a 25-year-old patient with left sided bronchoesophageal fistula. He had a past history of pulmonary tuberculosis. A left lower lobectomy followed by repair of oesophageal fistula opening was performed by primary closure and reinforcement with an intercostal muscle flap based on posterior intercostal artery. Postoperative oesophagogram showed short diverticula, which was occluded with n-butyl cyanoacrylate (NBCA) glue under radiological guidance. Feeding was started one week after application of glue without further complication. Reports on intercostals muscle flap repair and intervention of residual oesophageal diverticula with n-butyl cyanoacrylate (NBCA) glue under radiological guidance are scanty. PMID:27656500

  2. Combination of subxiphoid and intercostal uniportal video-assisted thoracoscopic surgery for bilateral lung lesions: report of two cases and review of the literature.

    PubMed

    Wang, Linlin; Ge, Lihui; Yang, Xueying

    2017-06-01

    Uniportal video-assisted thoracic surgery (VATS) is carried out to reduce postoperative pain after treatment of thoracic diseases. Here, we report a novel method that combines a subxiphoid and intercostal uniportal VATS approach that can be used to treat bilateral pulmonary lesions simultaneously. The first case is a 50-year-old female with bilateral pulmonary lesions who received left lower lobectomy associated with right middle lobe wedge resection synchronously; the other case is a 14-year-old male who was admitted for resection of bilateral lung metastases as a result of previous osteosarcoma. We combined a subxiphoid approach with intercostal uniportal surgical procedure for bilateral pulmonary lesions. Less postoperative pain, faster postoperative recovery, and a better aesthetic effect are possible superiorities of this method if patients are selected carefully. Our results show that the combining of a subxiphoid approach with intercostal uniportal VATS is a feasible and efficient surgical procedure for bilateral pulmonary lesions, with good outcomes. Moreover, this procedure is more suitable for patients with bilateral pulmonary lesions.

  3. Initiating New Science Partnerships in Rural Education (INSPIRE) Brining STEM Research to 7th-12th Grade Science and Math Classrooms

    NASA Astrophysics Data System (ADS)

    Radencic, S.; McNeal, K. S.; Pierce, D.

    2012-12-01

    The Initiating New Science Partnerships in Rural Education (INSPIRE) program at Mississippi State University (MSU), funded by the NSF Graduate STEM Fellows in K-12 Education (GK12) program, focuses on the advancement of Earth and Space science education in K-12 classrooms. INSPIRE currently in its third year of partnering ten graduate students each year from the STEM fields of Geosciences, Engineering, Physics and Chemistry at MSU with five teachers from local, rural school districts. The five year project serves to enhance graduate student's communication skills as they create interactive lessons linking their STEM research focus to the state and national standards covered in science and math classrooms for grades 7-12 through inquiry experiences. Each graduate student is responsible for the development of two lessons each month of the school year that include an aspect of their STEM research, including the technologies that they may utilize to conduct their STEM research. The plans are then published on the INSPIRE project webpage, www.gk12.msstate.edu, where they are a free resource for any K-12 classroom teacher seeking innovative activities for their classrooms and total over 300 lesson activities to date. Many of the participating teachers and graduate students share activities developed with non-participating teachers, expanding INSPIRE's outreach of incorporating STEM research into activities for K-12 students throughout the local community. Examples of STEM research connections to classroom topics related to earth and ocean science include activities using GPS with GIS for triangulation and measurement of area in geometry; biogeochemical response to oil spills compared to organism digestive system; hydrogeology water quality monitoring and GIS images used as a determinant for habitat suitability in area water; interactions of acids and bases in the Earth's environments and surfaces; and the importance of electrical circuitry in an electrode used in

  4. Management of Implant Exposure in One-Stage Breast Reconstruction Using Titanium-Coated Polypropylene Mesh: Sub-Mammary Intercostal Perforator Flap.

    PubMed

    De Riggi, Michele Antonio; Rocco, Nicola; Gherardini, Giulio; Esposito, Emanuela; D'Aiuto, Massimiliano

    2016-12-01

    One-stage implant-based breast reconstruction using titanium-coated polypropylene mesh is a novel approach widely used in Europe. Complication rates in breast reconstruction with the use of titanium-coated meshes seem to be comparable to those in patients with implant-based breast reconstruction alone. However, the use of synthetic meshes in implant-based breast reconstructive surgery leads to new clinical scenarios with the need for the breast surgeon to face new complications. We present an innovative treatment of implant exposure in the absence of infection in patients who underwent nipple-sparing mastectomy and immediate breast reconstruction with silicone implants and titanium-coated polypropylene mesh by using a pedicled sub-mammary intercostal perforator flap. Four patients who experienced implant exposure without infection have been treated with the use of a sub-mammary intercostal perforator flap. Whole coverage of the exposed implant/mesh with a sub-mammary intercostal perforator flap was obtained in all cases. No post-operative complications have been observed, whereas a pleasant aesthetic result has been achieved. Patients' post-operative quality of life and satisfaction levels were measured by the European Organisation for Research and Treatment of Cancer breast cancer-specific quality of life QLQ-BR23 questionnaire and showed an average good satisfaction with the post-operative outcomes (mean QLQ-BR23 score 1.9). For the first time, a sub-mammary intercostal perforator flap has been used with the aim of treating implant exposures without removing the prosthesis even in the presence of synthetic meshes, when wound infection was excluded. Although tested on a small series, the sub-mammary intercostal perforator flap might represent a simple, versatile and cost-effective procedure for the management of implant exposure following nipple-sparing mastectomy and immediate reconstruction with silicone implants and synthetic meshes. It should be considered to

  5. Boundaries of the thoracic paravertebral space: potential risks and benefits of the thoracic paravertebral block from an anatomical perspective.

    PubMed

    Bouman, Esther A C; Sieben, Judith M; Balthasar, Andrea J R; Joosten, Elbert A; Gramke, Hans-Fritz; van Kleef, Maarten; Lataster, Arno

    2017-04-25

    Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed. In a third unembalmed specimen, ultrasound-guided posterolateral injections at several levels of the TPVS were performed with different fluids. TPVS communicated with all surrounding spaces including the segmental dorsal intercostal compartments (SDICs) and the prevertebral space. TPVS transitions to the SDICs were wide, whereas the SDICs showed narrowed transitions to the lateral intercostal spaces at the costal angle. Internal subdivision of the TPVS in a subendothoracic and an extra-pleural compartment by the endothoracic fascia was not observed. Caudally injected fluids spread posteriorly to the costodiaphragmatic recess, showing segmental intercostal and slight prevertebral spread. Our detailed anatomical study shows that TPVS is a potential space continuous with the SDICs. The separation of the TPVS in a subendothoracic and an extra-pleural compartment by the endothoracic fascia was not observed. Based on the ultrasound-guided liquid spread we conclude that the use of a more lateral approach might increase the probability of intravascular puncture or catheter position.

  6. [Nerve transfer between the intercostal nerves and the motor component of the musculocutaneous nerve. Anatomical study of feasibility].

    PubMed

    Fleury, M; Lepage, D; Pluvy, I; Pauchot, J

    2017-06-01

    The intercostal nerves (ICN) transfer to the musculocutaneous nerve (MCN) can restore elbow flexion in complete brachial plexus palsy. The last cases our service dealt with, allowed our staff to observe two different situations. In the 2 first patients, we were able to proceed with an intraneurodissection of the MCN motor component up to the axillary cavity level, while on the third case such dissection could not be performed as high. The aim of this work is to assess the feasibility of a transfer on the MCN's motor component. We conducted a series of 5 cadaver dissections of the MCN and ICN on the anatomy laboratory. Using magnifying loupes to perform an intraneurodissection, we were able to split the motor and sensory fibers as they stood out. It would help motor recuperation avoiding directional error on sensitive component. The ICN can be sutured on the motor component of the MCN, provided the dissection is very minutious. The intraneurodissection of the MCN up to the axillary cavity level is possible as the interfascicular exchanges are scarce there. Publications already refer to the possibility of a nerve transfer between the ICN and the motor component of the MCN. Therefore, our researches suggest that such a procedure can be considered for routine procedures. The neurotization is one of the latest breakthroughs in terms of brachial plexus surgery. We are hopeful that anatomical researches could lead to optimization possibilities. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Spatiotemporal distribution of heparan sulfate epitopes during myogenesis and synaptogenesis: a study in developing mouse intercostal muscle.

    PubMed

    Jenniskens, Guido J; Hafmans, Theo; Veerkamp, Jacques H; van Kuppevelt, Toin H

    2002-09-01

    Formation of a basal lamina (BL) ensheathing developing skeletal muscle cells is one of the earliest events in mammalian skeletal muscle myogenesis. BL-resident heparan sulfate proteoglycans have been implicated in various processes during myogenesis, including synaptic differentiation. However, attention has focused on the proteoglycan protein core, ignoring the glycosaminoglycan moiety mainly because of a lack of appropriate tools. Recently, we selected a panel of anti-heparan sulfate antibodies applied here to study the spatiotemporal distribution of specific heparan sulfate (HS) epitopes during myogenesis. In mouse intercostal muscle at embryonic day (E14), formation of acetylcholine receptor clusters at synaptic sites coincides with HS deposition. Although some HS epitopes show a general appearance throughout the BL, one epitope preferably clusters at synaptic sites but does so only from E16 onward. During elongation and maturation of primary myotubes, a process preceding secondary myotube development, significant changes in the HS epitope constitution of both synaptic and extrasynaptic BL were observed. As a whole, the data presented here strengthen previous observations on developmental regulation by BL components, and add to the putative roles of specific HS epitopes in myogenesis and synaptogenesis. Copyright 2002 Wiley-Liss, Inc.

  8. Inter-costal Liver Ablation Under Real Time MR-Thermometry With Partial Activation Of A HIFU Phased Array Transducer

    NASA Astrophysics Data System (ADS)

    Quesson, Bruno; Merle, Mathilde; Köhler, Max; Mougenot, Charles; Roujol, Sebastien; de Senneville, Baudouin Denis; Moonen, Chrit

    2010-03-01

    HIFU ablation of tumours located inside the liver is hampered by the rib cage, which partially obstructs the beam path and may create adverse effects such as skin burns. This study presents a method for selectively deactivating the transducer elements causing undesired temperature increases near the bones. A manual segmentation of the bones visualized on 3D anatomical MR images acquired prior to sonication was performed to identify the beam obstruction. The resulting mask was projected (ray tracing starting from the focal point) on the transducer and elements with more than 50% obstruction of their active surface were deactivated. The effectiveness of the method for HIFU ablations is demonstrated ex vivo and in vivo in the liver of pigs with real-time MR thermometry, using the proton resonant frequency (PRF) method. For both ex vivo and in vivo experiments, the temperature increase near the bones was significantly reduced when the elements located in front of the ribs were deactivated. The temperature evolution at the focal point were similar, indicative of the absence of loss of heating efficacy when the elements were deactivated. This method is simple, rapid and reliable and allows to perform intercostal MRgHIFU ablation of the liver while sparing the ribs.

  9. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Chip Hardy, Kestrel Eye program manager for the U.S. Army Space and Missile Defense Command, speaks to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  10. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Ken Shields, director of Operations for Center for the Advancement of Science in Space/ISS National Lab, speaks to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  11. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Pete Hasbrook, associate program scientist for the International Space Station Program, speaks to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  12. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Jacob Smith of the University of Maryland speaks to members of social media in the Kennedy Space Center’s Press Site auditorium. He is operations lead for the International Space Station Cosmic Ray Energetics and Mass, or ISS-CREAM, investigation. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  13. 12th Annual School Construction Report, 2007

    ERIC Educational Resources Information Center

    Abramson, Paul

    2007-01-01

    School construction completed in 2006 totaled just more than $20 billion, a drop of seven percent from the record $21.6 billion put in place in 2005. Even so, it was the sixth year in the last seven that annual construction exceeded $20 billion. During the seven years of the present century, school districts have completed construction projects…

  14. 12th International Congress of Neuroethology

    DTIC Science & Technology

    2016-10-14

    attendees Amphibian Brains Behavior and Evolution March 29, 2016 Presidencia de Ia Republica , Montevideo, Uruguay Organizers: Kim Hoke, USA; Lauren...attendees Neuroethology of Disease Vector Insects March 29, 2016 Facultad de Quimica, Universidad de Ia Republica , Montevideo, Uruguay Organizers: Claudio...29, 2016 Facultad de Quimica, Universidad de Ia Republica , Montevideo, Uruguay Organizers: Walter Farina, Argentina; Jean Marc Devaud, France LOC

  15. 12th Annual School Construction Report, 2007

    ERIC Educational Resources Information Center

    Abramson, Paul

    2007-01-01

    School construction completed in 2006 totaled just more than $20 billion, a drop of seven percent from the record $21.6 billion put in place in 2005. Even so, it was the sixth year in the last seven that annual construction exceeded $20 billion. During the seven years of the present century, school districts have completed construction projects…

  16. 12th Annual Small Business Conference

    DTIC Science & Technology

    2008-11-13

    BUSINESSES MUST: Synchronous Manufacturing JIT USE TIME TO COMPETE MANAGE THE SUPPLY CHAIN FORM ALLIANCES/ PARTNERSHIPS Quick Response VMI ...Holdings, Inc. PANEL: “ASSISTANCE AND OPPORTUNITIES” “FUTURE COMBAT SYSTEMS (FCS)” Mr. Steve Marion, Senior Program, Supplier Management and...VETERANS AVAILABLE Mr. Rodney Borba, Program Manager , Always A Soldier Program, HQ AMC BREAKOUT SESSIONS – SPECIAL INTEREST TOPICS: PREPARING YOUR

  17. 12th Annual ALS Users' Association Meeting

    SciTech Connect

    Robinson, Arthur L.

    1999-12-17

    Science took the front seat as 219 Advanced Light Source (ALS) users and staff gathered on Monday and Tuesday, October 18 and 19 for the twelfth annual users' meeting. The bulk of the meeting was dedicated to reports on science at the ALS. Packed into two busy days were 31 invited oral presentations and 80 submitted poster presentations, as well as time to visit 24 vendor booths. The oral sessions were dedicated to environmental science, chemical dynamics, biosciences, magnetic materials, and atomic and molecular science. In addition, there was an ALS highlights session that emphasized new results and a session comprising highlights from the young scientists who will carry the ALS into the future.

  18. 12th Annual Systems Engineering Conference

    DTIC Science & Technology

    2009-10-29

    COA 1e COA 1c COA 3 COA 2 JCR key leaders SFF-S MPCommon to all COAs: EPLRS for FCS NIKs PRC-117G for FCS NIKs ASA (AL&T) UNCLASSIFIED SO B-Kit ICS...cost/SWAP approach for vehicles that only require one SRW channel as an advanced waveform - For key leader JCR vehicles l As alternative to HMS

  19. 2007 Expeditionary Warfare Conference (12th)

    DTIC Science & Technology

    2007-10-25

    NORTHCOM requirements (1 per year) • MIREM funding restored by CPF for FY08 – Provide timely unit, system and TTP assessment and analysis that is useful to...the Battle in the Littorals Personal Exoskeleton : Integrated Power, Armor, Comms, and Combat Systems Unmanned Land Transport, Sensor, and Combat...Work The Problem Thus, We Were Lucky….. And…. We Focused On Exploiting Our Good Fortune “TACAMO” OUR STRATEGY Restore The Fleet- “The 600 Ship Navy

  20. Transport of aminoisobutyric acid (AIB) and methylamino-isobutyric acid (MeAIB) in sheep external intercostal muscle

    SciTech Connect

    Forsberg, N.E.; Kaneps, A.J.; Riebold, T.W.

    1986-03-05

    External intercostal muscle bundles (EIC) from growing sheep (35-45 kg) were used to assess transport of AIB and MeAIB. EIC (20-30 mg, with tendons attached) were incubated free of support in sodium (Na) and choline-based KHB media containing 2 mM glucose, 1 mM acetate and variable AIB or MeAIB concentrations (.15 ..mu..Ci each). Inulin-/sup 14/C was used in replicate incubations to correct for extracellular /sup 14/C. At 7.5, 15, 30, 60 and 120 min rates of transport for AIB and MeAIB (1 mM each) were .115 +/- 0.47, .331 +/- .127, .563 +/- .197, 1.07 +/- .178, 1.81 +/- .48 and .052 +/- .052, .101 +/- .064, .215 +/- .079, .307 +/- .130, .461 +/- .196 respectively. Rates of transport (30 min) for AIB at 1, 2.5, 5, 12.5, 25 and 50 mM were .188 +/- .015, .553 +/- .101, .803 +/- .104, 2.05 +/- .32, 2.78 +/- .28, 3.82 +/- 1.15 in Na-containing media and 0, .209 +/- .074, .467 +/- .092, 1.15 +/- .24, 1.32 +/- .62, 2.71 +/- .105 in choline media, respectively. The difference in AIB transport between Na and choline media showed Michaelis-Menten Kinetics (Vmax = 1.16/sup 1/, Km = 5.8 mM) and may be analogous to cumulative activities of Systems A and ASC-like carriers. The Na-independent component for AIB uptake was large; however, saturation kinetics were evident. Other Na-independent carriers (possibly System L-like) may have activity for AIB as a substrate.

  1. Intercostal chest drain insertion by general physicians: attitudes, experience and implications for training, service and patient safety.

    PubMed

    Corcoran, John P; Hallifax, Robert J; Talwar, Ambika; Psallidas, Ioannis; Sykes, Annemarie; Rahman, Najib M

    2015-05-01

    Intercostal chest drain (ICD) insertion is considered a core skill for the general physician. Recent guidelines have highlighted the risks of this procedure, while UK medical trainees have reported a concurrent decline in training opportunities and confidence in their procedural skills. We explored clinicians' attitudes, experience and knowledge relating to pleural interventions and ICD insertion in order to determine what changes might be needed to maintain patient safety and quality of training. Consultants and trainees delivering general medical services across five hospitals in England were invited to complete a questionnaire survey over a 5-week period in July and August 2014. 117 general physicians (32.4% of potential participants; comprising 31 consultants, 48 higher specialty trainees, 38 core trainees) responded. Respondents of all grades regarded ICD insertion as a core procedural skill. Respondents were asked to set a minimum requirement for achieving and maintaining independence at ICD insertion; however, only 25% of higher specialty trainees reported being able to attain this self-imposed standard. A knowledge gap was also revealed, with trainees managing clinical scenarios correctly in only 51% of cases. Given the disparity between clinical reality and what is expected of the physician-in-training, it is unclear whether ICD insertion can remain a core procedural skill for general physicians. Consideration should be given to how healthcare providers and training programmes might address issues relating to clinical experience and knowledge given the implications for patient safety and service provision. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. An audit of the complications of intercostal chest drain insertion in a high volume trauma service in South Africa

    PubMed Central

    Oosthuizen, GV; Sartorius, B; Keene, C; Clarke, DL

    2014-01-01

    Introduction Intercostal chest drain (ICD) insertion is a commonly performed procedure in trauma and may be associated with significant morbidity. Methods This was a retrospective review of ICD complications in a major trauma service in South Africa over a four-year period from January 2010 to December 2013. Results A total of 1,050 ICDs were inserted in 1,006 patients, of which 91% were male. The median patient age was 24 years (interquartile range [IQR]: 20–29 years). There were 962 patients with unilateral ICDs and 44 with bilateral ICDs. Seventy-five per cent (758/1,006) sustained penetrating trauma and the remaining 25% (248/1006) sustained blunt trauma. Indications for ICD insertion were: haemopneumothorax (n=338), haemothorax (n=314), simple pneumothorax (n=265), tension pneumothorax (n=79) and open pneumothorax (n=54). Overall, 203 ICDs (19%) were associated with complications: 18% (36/203) were kinked, 18% (36/203) were inserted subcutaneously, 13% (27/203) were too shallow and in 7% (14/203) there was inadequate fixation resulting in dislodgement. Four patients (2%) sustained visceral injuries and two sustained vascular injuries. Forty-one per cent (83/203) were inserted outside the ‘triangle of safety’ but without visceral or vascular injuries. One patient had the ICD inserted on the wrong side. Junior doctors inserted 798 ICDs (76%) while senior doctors inserted 252 (24%). Junior doctors had a significantly higher complication rate (24%) compared with senior doctors (5%) (p<0.001). There was no mortality as a direct result of ICD insertion. Conclusions ICD insertion is associated with a high rate of complications. These complications are significantly higher when junior doctors perform the procedure. A multifaceted quality improvement programme is needed to improve the situation. PMID:25350185

  3. The Texas Earth and Space Science (TXESS) Revolution: A Model for the Delivery of Earth Science Professional Development to Minority-Serving Teachers

    ERIC Educational Resources Information Center

    Ellins, K. K.; Snow, E.; Olson, H. C.; Stocks, E.; Willis, M.; Olson, J.; Odell, M. R.

    2013-01-01

    The Texas Earth and Space Science (TXESS) Revolution was a 5-y teacher professional development project that aimed to increase teachers' content knowledge in Earth science and preparing them to teach a 12th-grade capstone Earth and Space Science course, which is new to the Texas curriculum. The National Science Foundation-supported project was…

  4. Atypical findings of perineural cysts on postmyelographic computed tomography: a case report of intermittent intercostal neuralgia caused by thoracic perineural cysts.

    PubMed

    Iwamuro, Hirokazu; Yanagawa, Taro; Takamizawa, Sachiko; Taniguchi, Makoto

    2017-06-13

    Perineural cysts are sometimes found incidentally with magnetic resonance imaging, and clinical symptoms requiring treatment are rare. Perineural cysts typically exhibit delayed filling with contrast medium on myelography, which is one of the criteria used by Tarlov to distinguish perineural cysts from meningeal diverticula. We present a case of multiple thoracolumbar perineural cysts, one of which was considered the cause of intermittent intercostal neuralgia with atypical findings on postmyelographic computed tomography seen as selective filling of contrast medium. A 61-year-old woman presented with intermittent pain on her left chest wall with distribution of the pain corresponding to the T10 dermatome. Magnetic resonance imaging showed multiple thoracolumbar perineural cysts with the largest located at the left T10 nerve root. On postmyelographic computed tomography immediately after contrast medium injection, the largest cyst and another at left T9 showed selective filling of contrast medium, suggesting that inflow of cerebrospinal fluid to the cyst exceeded outflow. Three hours after the injection, the intensity of the cysts was similar to the intensity of the thecal sac, and by the next day, contrast enhancement was undetectable. The patient was treated with an intercostal nerve block at T10, and the pain subsided. However, after 9 months of observation, the neuralgia recurred, and the nerve block was repeated with good effect. There was no recurrence 22 months after the last nerve block. We concluded that intermittent elevation of cerebrospinal fluid pressure in the cyst caused the neuralgia because of an imbalance between cerebrospinal fluid inflow and outflow, and repeated intercostal nerve blocks resolved the neuralgia. Our case demonstrates the mechanism of cyst expansion.

  5. SpaceX CRS-12 at Pad 39A

    NASA Image and Video Library

    2017-08-14

    As a Falcon 9 rocket stands ready for liftoff at the Kennedy Space Center's Launch Complex 39A. The rocket will boost a Dragon resupply spacecraft to the International Space Station. Liftoff is scheduled for 12:31 p.m. EDT. On its 12th commercial resupply services mission to the space station, Dragon will bring up more than 6,400 pounds of supplies. The historic launch site now is operated by SpaceX under a property agreement signed with NASA.

  6. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Boy Scouts of America Troop 209 members Andrew Frank, left, and Elliot Lee speak to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  7. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Sebastian Mathea of the University of Oxford in England, speaks to members of social media in the Kennedy Space Center’s Press Site auditorium. Mathea is principal investigator for the Crystallization of LRRK2 Under Microgravity Conditions experiment. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  8. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Michael Delp of Florida State University in Tallahassee, speaks to members of social media in the Kennedy Space Center’s Press Site auditorium. He is principal investigator for the Rodent Research-9 experiment. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  9. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Boy Scouts of America Troop 209 members Andrew Frank, left, Elliot Lee center, and team leader Norman McFarland speak to members of social media in the Kennedy Space Center’s Press Site auditorium. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  10. SpaceX CRS-12 "What's on Board?" Science Briefing

    NASA Image and Video Library

    2017-08-13

    Marco Baptista, director of Research Programs for the Michael J. Fox Foundation, speaks to members of social media in the Kennedy Space Center’s Press Site auditorium about the Crystallization of LRRK2 Under Microgravity Conditions experiment. The briefing focused on research planned for launch to the International Space Station. The scientific materials and supplies will be aboard a Dragon spacecraft scheduled for launch from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  11. NASA - Human Space Flight

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2006-01-01

    The presentation covers five main topical areas. The first is a description of how things work in the microgravity environment such as convection and sedimentation. The second part describes the effects of microgravity on human physiology. This is followed by a description of the hazards of space flight including the environment, the space craft, and the mission. An overview of biomedical research in space, both on shuttle and ISS is the fourth section of the presentation. The presentation concludes with a history of space flight from Ham to ISS. At CART students (11th and 12th graders from Fresno Unified and Clovis Unified) are actively involved in their education. They work in teams to research real world problems and discover original solutions. Students work on projects guided by academic instructors and business partners. They will have access to the latest technology and will be expected to expand their learning environment to include the community. They will focus their studies around a career area (Professional Sciences, Advanced Communications, Engineering and Product Development, or Global Issues).

  12. Transfer of the intercostal nerves to the nerve of the long head of the triceps to recover elbow extension in brachial plexus palsy.

    PubMed

    Goubier, Jean-Noel; Teboul, Frédéric

    2007-06-01

    Restoration of elbow flexion is the first goal in brachial plexus injuries. The current procedures using nerve grafts and nerve transfers authorize more extensive repairs, with different possible targets: shoulder, elbow extension, and hand. Elbow extension is important to stabilize the elbow without the contralateral hand and allows achieving a useful grasp. The transfer of the intercostal nerves to the nerve of the long head of the triceps may restore this function in brachial plexus palsies. Furthermore, in case of C5 to C7 palsy, this transfer spares the radial nerve and gives a chance to spontaneous triceps recovery by the reinnervation from C8 root. Moreover, in case of absence or insufficient (M0 to M2 according to Medical Research Council scoring) recovery of elbow flexion strength by nerve surgery, the reinnervated triceps can be transferred. We present the technique of intercostal nerve transfer to the long head of the triceps branch to restore elbow extension in brachial plexus palsy. Results concerning 10 patients are presented.

  13. Comparison between partial ulnar and intercostal nerve transfers for reconstructing elbow flexion in patients with upper brachial plexus injuries.

    PubMed

    Kakinoki, Ryosuke; Ikeguchi, Ryosuke; Dunkan, Scott Fm; Nakayama, Ken; Matsumoto, Taiichi; Ohta, Soichi; Nakamura, Takashi

    2010-01-26

    There have been several reports that partial ulnar transfer (PUNT) is preferable for reconstructing elbow flexion in patients with upper brachial plexus injuries (BPIs) compared with intercostal nerve transfer (ICNT). The purpose of this study was to compare the recovery of elbow flexion between patients subjected to PUNT and patients subjected to ICNT. Sixteen patients (13 men and three women) with BPIs for whom PUNT (eight patients) or ICNT (eight patients) had been performed to restore elbow flexion function were studied. The time required in obtaining M1, M3 (Medical Research Council scale grades recovery) for elbow flexion and a full range of elbow joint movement against gravity with the wrist and fingers extended maximally and the outcomes of a manual muscle test (MMT) for elbow flexion were examined in both groups. There were no significant differences between the PUNT and ICNT groups in terms of the age of patients at the time of surgery or the interval between injury and surgery. There were significantly more injured nerve roots in the ICNT group (mean 3.6) than in the PUNT group (mean 2.1) (P = 0.0006). The times required to obtain grades M1 and M3 in elbow flexion were significantly shorter in the PUNT group than in the ICNT group (P = 0.04 for M1 and P = 0.002 for M3). However, there was no significant difference between the two groups in the time required to obtain full flexion of the elbow joint with maximally extended fingers and wrist or in the final MMT scores for elbow flexion. PUNT is technically easy, not associated with significant complications, and provides rapid recovery of the elbow flexion. However, separation of elbow flexion from finger and wrist motions needed more time in the PUNT group than in the ICNT group. Although the final mean MMT score for elbow flexion in the PUNT group was greater than in the ICNT group, no statistically significant difference was found between the two groups.

  14. Comparison between partial ulnar and intercostal nerve transfers for reconstructing elbow flexion in patients with upper brachial plexus injuries

    PubMed Central

    2010-01-01

    Background There have been several reports that partial ulnar transfer (PUNT) is preferable for reconstructing elbow flexion in patients with upper brachial plexus injuries (BPIs) compared with intercostal nerve transfer (ICNT). The purpose of this study was to compare the recovery of elbow flexion between patients subjected to PUNT and patients subjected to ICNT. Methods Sixteen patients (13 men and three women) with BPIs for whom PUNT (eight patients) or ICNT (eight patients) had been performed to restore elbow flexion function were studied. The time required in obtaining M1, M3 (Medical Research Council scale grades recovery) for elbow flexion and a full range of elbow joint movement against gravity with the wrist and fingers extended maximally and the outcomes of a manual muscle test (MMT) for elbow flexion were examined in both groups. Results There were no significant differences between the PUNT and ICNT groups in terms of the age of patients at the time of surgery or the interval between injury and surgery. There were significantly more injured nerve roots in the ICNT group (mean 3.6) than in the PUNT group (mean 2.1) (P = 0.0006). The times required to obtain grades M1 and M3 in elbow flexion were significantly shorter in the PUNT group than in the ICNT group (P = 0.04 for M1 and P = 0.002 for M3). However, there was no significant difference between the two groups in the time required to obtain full flexion of the elbow joint with maximally extended fingers and wrist or in the final MMT scores for elbow flexion. Conclusions PUNT is technically easy, not associated with significant complications, and provides rapid recovery of the elbow flexion. However, separation of elbow flexion from finger and wrist motions needed more time in the PUNT group than in the ICNT group. Although the final mean MMT score for elbow flexion in the PUNT group was greater than in the ICNT group, no statistically significant difference was found between the two groups. PMID

  15. Daily acute intermittent hypoxia elicits functional recovery of diaphragm and inspiratory intercostal muscle activity after acute cervical spinal injury.

    PubMed

    Navarrete-Opazo, A; Vinit, S; Dougherty, B J; Mitchell, G S

    2015-04-01

    A major cause of mortality after spinal cord injury is respiratory failure. In normal rats, acute intermittent hypoxia (AIH) induces respiratory motor plasticity, expressed as diaphragm (Dia) and second external intercostal (T2 EIC) long-term facilitation (LTF). Dia (not T2 EIC) LTF is enhanced by systemic adenosine 2A (A2A) receptor inhibition in normal rats. We investigated the respective contributions of Dia and T2 EIC to daily AIH-induced functional recovery of breathing capacity with/without A2A receptor antagonist (KW6002, i.p.) following C2 hemisection (C2HS). Rats received daily AIH (dAIH: 10, 5-min episodes, 10.5% O2; 5-min normoxic intervals; 7 successive days beginning 7days post-C2HS) or daily normoxia (dNx) with/without KW6002, followed by weekly (reminder) presentations for 8weeks. Ventilation and EMGs from bilateral diaphragm and T2 EIC muscles were measured with room air breathing (21% O2) and maximum chemoreceptor stimulation ( 7% CO2, 10.5% O2). dAIH increased tidal volume (VT) in C2HS rats breathing room air (dAIH+vehicle: 0.47±0.02, dNx+vehicle: 0.40±0.01ml/100g; p<0.05) and MCS (dAIH+vehicle: 0.83±0.01, dNx+vehicle: 0.73±0.01ml/100g; p<0.001); KW6002 had no significant effect. dAIH enhanced contralateral (uninjured) diaphragm EMG activity, an effect attenuated by KW6002, during room air breathing and MCS (p<0.05). Although dAIH enhanced contralateral T2 EIC EMG activity during room air breathing, KW6002 had no effect. dAIH had no statistically significant effects on diaphragm or T2 EIC EMG activity ipsilateral to injury. Thus, two weeks post-C2HS: 1) dAIH enhances breathing capacity by effects on contralateral diaphragm and T2 EIC activity; and 2) dAIH-induced recovery is A2A dependent in diaphragm, but not T2 EIC. Daily AIH may be a useful in promoting functional recovery of breathing capacity after cervical spinal injury, but A2A receptor antagonists (e.g. caffeine) may undermine its effectiveness shortly after injury. Copyright © 2015

  16. Daily acute intermittent hypoxia elicits functional recovery of diaphragm and inspiratory intercostal muscle activity after acute cervical spinal injury

    PubMed Central

    Navarrete-Opazo, A.; Vinit, S; Dougherty, B.J.; Mitchell, G.S.

    2015-01-01

    A major cause of mortality after spinal cord injury is respiratory failure. In normal rats, acute intermittent hypoxia (AIH) induces respiratory motor plasticity, expressed as diaphragm (Dia) and second external intercostal (T2 EIC) long-term facilitation (LTF). Dia (not T2 EIC) LTF is enhanced by systemic adenosine 2A (A2a) receptor inhibition in normal rats. We investigated the respective contributions of Dia and T2 EIC to daily AIH-induced functional recovery of breathing capacity with/without A2a receptor antagonist (KW6002, i.p.) following C2 hemisection (C2HS). Rats received daily AIH (dAIH: 10, 5-min episodes, 10.5% O2; 5-min normoxic intervals; 7 successive days beginning 7 days post-C2HS) or daily normoxia (dNx) with/without KW6002, followed by weekly (reminder) presentations for 8 weeks. Ventilation and EMGs from bilateral diaphragm and T2 EIC muscles were measured with room air breathing (21% O2) and maximum chemoreceptor stimulation (MCS: 7% CO2, 10.5% O2). dAIH increased tidal volume (Vt) in C2HS rats breathing room air (dAIH + vehicle: 0.47 ± 0.02, dNx + vehicle: 0.40 ± 0.01ml/100 g; p<0.05) and MCS (dAIH + vehicle: 0.83 ± 0.01, dNx + vehicle: 0.73 ± 0.01ml/100g; p<0.001); KW6002 had no significant effect. dAIH enhanced contralateral (uninjured) diaphragm EMG activity, an effect attenuated by KW6002, during room air breathing and MCS (p<0.05). Although dAIH enhanced contralateral T2 EIC EMG activity during room air breathing, KW6002 had no effect. dAIH had no statistically significant effects on diaphragm or T2 EIC EMG activity ipsilateral to injury. Thus, two weeks post-C2HS: 1) dAIH enhances breathing capacity by effects on contralateral diaphragm and T2 EIC activity; and 2) dAIH-induced recovery is A2a dependent in diaphragm, but not T2 EIC. Daily AIH may be a useful in promoting functional recovery of breathing capacity after cervical spinal injury, but A2a receptor antagonists (eg. caffeine) may undermine its effectiveness shortly after

  17. Racial/ethnic differences in the relationship between parental education and substance use among U.S. 8th-, 10th-, and 12th-grade students: findings from the Monitoring the Future project.

    PubMed

    Bachman, Jerald G; O'Malley, Patrick M; Johnston, Lloyd D; Schulenberg, John E; Wallace, John M

    2011-03-01

    Secondary school students' rates of substance use vary significantly by race/ethnicity and by their parents' level of education (a proxy for socioeconomic status). The relationship between students' substance use and race/ethnicity is, however, potentially confounded because parental education also differs substantially by race/ethnicity. This report disentangles the confounding by examining White, African American, and Hispanic students separately, showing how parental education relates to cigarette smoking, heavy drinking, and illicit drug use. Data are from the 1999-2008 Monitoring the Future nationally representative in-school surveys of more than 360,000 students in Grades 8, 10, and 12. (a) High proportions of Hispanic students have parents with the lowest level of education, and the relatively low levels of substance use by these students complicates total sample data linking parental education and substance use. (b) There are clear interactions: Compared with White students, substance use rates among African American and Hispanic students are less strongly linked with parental education (and are lower overall). (c) Among White students, 8th and 10th graders show strong negative relations between parental education and substance use, whereas by 12th grade their heavy drinking and marijuana use are not correlated with parental education. Low parental education appears to be much more of a risk factor for White students than for Hispanic or African American students. Therefore, in studies of substance use epidemiology, findings based on predominantly White samples are not equally applicable to other racial/ethnic subgroups. Conversely, the large proportions of minority students in the lowest parental education category can mask or weaken findings that are clearer among White students alone.

  18. SpaceX CRS-12 Prelaunch News Conference

    NASA Image and Video Library

    2017-08-13

    In the Kennedy Space Center’s Press Site auditorium, agency and industry leaders speak to members of the media during a prelaunch news conference for the SpaceX CRS-12 commercial resupply services mission to the International Space Station. From left are: Josh Finch of NASA Communications; Dan Hartman, NASA deputy manager of the International Space Station Program, Hans Koenigsmann, vice president of Build and Flight Reliability for SpaceX, and Pete Hasbrook, associate program scientist for the International Space Station Program. A Dragon spacecraft is scheduled to be launched from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  19. SpaceX CRS-12 Prelaunch News Conference

    NASA Image and Video Library

    2017-08-13

    In the Kennedy Space Center’s Press Site auditorium, agency and industry leaders speak to members of the media during a prelaunch news conference for the SpaceX CRS-12 commercial resupply services mission to the International Space Station. Josh Finch of NASA Communications; Dan Hartman, NASA deputy manager of the International Space Station Program, Hans Koenigsmann, vice president of Build and Flight Reliability for SpaceX, and Pete Hasbrook, associate program scientist for the International Space Station Program. A Dragon spacecraft is scheduled to be launched from Kennedy’s Launch Complex 39A on Aug. 14 atop a SpaceX Falcon 9 rocket on the company's 12th Commercial Resupply Services mission to the space station.

  20. Surgical excision of the breast giant fibroadenoma under regional anesthesia by Pecs II and internal intercostal plane block: a case report and brief technical description: a case report.

    PubMed

    Kim, Hyungtae; Shim, Junho; Kim, Ikthae

    2017-02-01

    A 22-years-old female patient at 171 cm and 67 kg visited the Department of Breast Surgery of the hospital with a mass accompanied with pain on the left side breast as chief complaints. Since physical examination revealed a suspected huge mass, breast surgeon decided to perform surgical excision and requested anesthesia to our department. Surgery of breast tumor is often under local anesthesia. However, in case of big size tumor, surgery is usually performed under general anesthesia. The patient feared general anesthesia. Unlike abdominal surgery, there is no need to control visceral pain for breast and anterior thoracic wall surgery. Therefore, we decided to perform resection under regional anesthesia. Herein, we report a successful anesthetic and pain management of the patient undergoing excision of a huge breast fibroadenoma under regional anesthesia using Pecs II and internal intercostal plane block.

  1. Surgical excision of the breast giant fibroadenoma under regional anesthesia by Pecs II and internal intercostal plane block: a case report and brief technical description: a case report

    PubMed Central

    Shim, Junho; Kim, Ikthae

    2017-01-01

    A 22-years-old female patient at 171 cm and 67 kg visited the Department of Breast Surgery of the hospital with a mass accompanied with pain on the left side breast as chief complaints. Since physical examination revealed a suspected huge mass, breast surgeon decided to perform surgical excision and requested anesthesia to our department. Surgery of breast tumor is often under local anesthesia. However, in case of big size tumor, surgery is usually performed under general anesthesia. The patient feared general anesthesia. Unlike abdominal surgery, there is no need to control visceral pain for breast and anterior thoracic wall surgery. Therefore, we decided to perform resection under regional anesthesia. Herein, we report a successful anesthetic and pain management of the patient undergoing excision of a huge breast fibroadenoma under regional anesthesia using Pecs II and internal intercostal plane block. PMID:28184271

  2. Intercostal nerve crossing to restore elbow flexion and sensibility of the hand for a root avulsion type of brachial plexus injury.

    PubMed

    Ogino, T; Naito, T

    1995-01-01

    Ten patients with a root avulsion type of brachial plexus injury were treated with simultaneous intercostal nerve crossing to the musculocutaneous and median nerves, and nine cases were followed for more than 40 months. The average interval from injury to surgery was 2.7 months. The average age at operation was 18.6 years. The elbow flexor was M4 in six patients, M3 in two patients, and M1 in one patient. The wrist flexor was more than M3 in six patients and less than M2 in four patients. The finger flexor was more than M3 in four patients and less than M2 in five patients. Protective sensation in the areas innervated by the musculocutaneous and median nerves was restored in all cases.

  3. Latissimus dorsi/rib intercostal perforator myo-osseocutaneous free flap reconstruction in composite defects of the scalp: case series and review of literature.

    PubMed

    Seitz, Iris A; Adler, Neta; Odessey, Eric; Reid, Russell R; Gottlieb, Lawrence J

    2009-11-01

    Adequate coverage of complex, composite scalp defects in previously radiated, infected, or otherwise compromised tissue represents a challenge in reconstructive surgery. To provide wound closure with bony protection to the brain, improve cranial contour, and prevent or seal cerebrospinal fluid (CSF) leaks, composite free tissue transfer is a reliable and safe option. We report our experience with the latissimus dorsi/rib intercostal perforator myo-osseocutaneous free flap in the reconstruction of bony and soft tissue defects of the cranium and overlying scalp. The surgical technique, design, and outcomes of the latissimus dorsi/rib intercostal perforator myo-osseocutaneous free flap reconstruction in five patients with cranial defects between 2003 and 2007 were retrospectively evaluated. Patient characteristics, defect size, underlying cause, reconstructive details, and complications were analyzed. All patients (age 43 to 81) had composite defects ranging from 36 to 750 cm2 (mean size 230 cm2) for the bony component and from 16 to 400 cm2 (mean size 170 cm2) for the soft tissue defect. All patients had a history of prior or current infection of the affected area, and two patients had a CSF leak. Defects were due to malignancy and infection (n = 2), infiltrative cutaneous mucormycosis with osteomyelitis (n = 1), and hemorrhagic stroke requiring craniectomy (n = 2), complicated by infection and failed cranioplasty in one patient and continuous CSF leak in the other. The latissimus dorsi composite free flap consisting of skin, muscle, and vascularized rib can successfully cover large complex cranial defects, provide skeletal support, improve contour, and significantly enhance functional outcome with limited donor site morbidity. Copyright Thieme Medical Publishers.

  4. Ultrasonography of the spleen, liver, gallbladder, caudal vena cava and portal vein in healthy calves from birth to 104 days of age

    PubMed Central

    2013-01-01

    Background Many of the ultrasonographic abdominal findings of adult cattle probably also apply to calves. However, significant changes associated with ruminal growth and transition from a milk to a roughage diet occur in young calves during the first few months, and it can be expected that ultrasonographic features of organs adjacent to the rumen such as spleen and liver also undergo significant changes. These have not been investigated to date and therefore the goal of this study was to describe ultrasonographic findings of the spleen, liver, gallbladder, caudal vena cava and portal vein in six healthy calves from birth to 104 days of age. Standing calves were examined ultrasonographically six times at three-week intervals starting on the first or second day of life using a 5.0-MHz transducer and techniques described previously. Results The spleen was imaged on the left at the 5th to 12th intercostal spaces. The dorsal and ventral visible limits ran from cranioventral to caudodorsal because of superimposition of the lungs. The size of the spleen was largest at the 7th and 8th intercostal spaces and the maximum thickness was measured at the 9th to 12th intercostal spaces. The liver was seen in all calves on the right and could be imaged at the 5th to 12th intercostal