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Sample records for abdominal sagittal diameter

  1. Sagittal Abdominal Diameter and Visceral Adiposity

    PubMed Central

    Kahn, Henry S.; Gasevic, Danijela; Liang, Zhe; Frediani, Jennifer K.; Torres, William E.; Ziegler, Thomas R.; Phillips, Lawrence S.; Lin, Edward

    2013-01-01

    Background In the context of increasing obesity prevalence, the relationship between large visceral adipose tissue (VAT) volumes and type 2 diabetes mellitus (T2DM) is unclear. In a clinical sample of severely obese women (mean body mass index [BMI], 46 kg/m2) with fasting normoglycemia (n=40) or dysglycemia (impaired fasting glucose+diabetes; n=20), we sought to determine the usefulness of anthropometric correlates of VAT and associations with dysglycemia. Methods VAT volume was estimated using multi-slice computer tomography; anthropometric surrogates included sagittal abdominal diameter (SAD), waist circumference (WC) and BMI. Insulin sensitivity (Si), and beta-cell dysfunction, measured by insulin secretion (AIRg) and the disposition index (DI), were determined by frequently sampled intravenous glucose tolerance test. Results Compared to fasting normoglycemic women, individuals with dysglycemia had greater VAT (P<0.001) and SAD (P=0.04), but BMI, total adiposity and Si were similar. VAT was inversely associated with AIRg and DI after controlling for ancestry, Si, and total adiposity (standardized beta, −0.32 and −0.34, both P<0.05). In addition, SAD (beta=0.41, P=0.02) was found to be a better estimate of VAT volume than WC (beta=0.32, P=0.08) after controlling for covariates. Receiver operating characteristic analysis showed that VAT volume, followed by SAD, outperformed WC and BMI in identifying dysglycemic participants. Conclusions Increasing VAT is associated with beta-cell dysfunction and dysglycemia in very obese women. In the presence of severe obesity, SAD is a simple surrogate of VAT, and an indicator of glucose dysregulation. PMID:23408092

  2. Sagittal abdominal diameter shows better correlation with cardiovascular risk factors than waist circumference and BMI

    PubMed Central

    2013-01-01

    Background Obesity (abdominal adiposity) is a risk factor for cardiovascular diseases and the most used methods to measure the adiposity are body mass index (BMI), waist circumference (WC), and sagittal abdominal diameter (SAD). Objective To correlate BMI, WC, and SAD with biochemical parameters and blood pressure in adults. Methods A non-experimental exploratory/descriptive and cross sectional study was developed and it was assessed 133 subjects (59 men and 74 women) aging between 18 and 87 years. It was registered the patients’ weight (kg), height (m), BMI (kg/m2), WC (cm) and SAD (cm), and these parameters were correlated with glycemia, triglycerides, total cholesterol, HDL-c, LDL-c and blood pressure. Results After adjustment for gender and age, it was observed a positive correlation between SAD and systolic arterial blood pressure (r = 0.20), glycemia (r = 0.20), triglycerides (r = 0.32), LDL (r = 0.26), total cholesterol (TC) (r = 0.33), and a negative correlation with HDL-c (r = −0.21) (p < 0.05). It was observed a positive correlation between WC and systolic arterial blood pressure (r = 0.14), triglycerides (r = 0.31), total cholesterol (r = 0.21), and a negative correlation with HDL-c (r = −0.24) (p < 0.05). BMI showed a positive correlation with systolic arterial blood pressure (r = 0.22), total cholesterol (r = 0.20), and triglycerides (r = 0.23) (p < 0.05). Conclusion SAD correlated with almost all the cardiovascular risk factors analyzed and it might be considered the best predictor of abdominal fat and cardiovascular risk. PMID:23856008

  3. Sagittal Abdominal Diameter to Measure Visceral Adipose Tissue in Overweight or Obese Adolescent Children and Its Role as A Marker of Insulin Resistance

    PubMed Central

    Yashoda, H.T.; Boraiah, Ganga; Vishwa, Suma

    2015-01-01

    Background Measurement of sagittal abdominal diameter using a revalidated caliper is simple, inexpensive, non-invasive method. It strongly correlates with insulin resistance and can be used as a surrogate marker to predict risk for Type II Diabetes Mellitus. Aim To assess visceral abdominal fat by measuring sagittal abdominal diameter using sliding calipers and to predict insulin resistance in obese or overweight adolescent children. Study design Explorative study for Paediatric age group among over weight and obese children aged 10-18 years in urban population in a Tertiary Care Centre. Materials and Methods Paediatric population satisfying ADA guidelines for diagnosis of prediabetes were included in the study. Anthropometric measurements with SAD were recorded. Blood was collected to investigate for prediabetes and insulin resistance using HOMA-IR. Results Out of 924 subjects who gave assent to participate in study 108 fulfilled ADA criteria. 33 subjects who didn’t come for the follow up were excluded. Out of 75 subjects 12 were detected to have insulin resistance (16%) and 63 were normal (84%). Pearson’s partial correlation of HOMA-IR and OGTT with SAD has demonstrated it to be better correlation with Insulin Resistance (IR) than other anthropometric measurements. Fasting Glucose correlated better with Waist Hip Circumference. Conclusion Insulin Resistance was diagnosed in 16% of the population and these had high levels of insulin resistance. SAD in relation to glucose metabolism, had a better correlation with OGTT followed by HOMA-IR and fasting Insulin. SAD with anthropometric measurements had better correlation all the parameters other than Waist Circumference, which had negative correlation. SAD can be used in evaluation of obese or overweight children for evaluation. PMID:26673888

  4. Genetic and Environmental Effects on the Abdominal Aortic Diameter Development

    PubMed Central

    Tarnoki, Adam Domonkos; Tarnoki, David Laszlo; Littvay, Levente; Garami, Zsolt; Karlinger, Kinga; Berczi, Viktor

    2016-01-01

    Background Configuration of the abdominal aorta is related to healthy aging and a variety of disorders. Objectives We aimed to assess heritable and environmental effects on the abdominal aortic diameter. Methods 114 adult (69 monozygotic, 45 same-sex dizygotic) twin pairs (mean age 43.6 ± 16.3 years) underwent abdominal ultrasound with Esaote MyLab 70X ultrasound machine to visualize the abdominal aorta below the level of the origin of the renal arteries and 1-3 cm above the bifurcation. Results Age- and sex-adjusted heritability of the abdominal aortic diameter below the level of the origin of the renal arteries was 40% [95% confidence interval (CI), 14 to 67%] and 55% above the aortic bifurcation (95% CI, 45 to 70%). None of the aortic diameters showed common environmental effects, but unshared environmental effects were responsible for 60% and 45% of the traits, respectively. Conclusions Our analysis documents the moderate heritability and its segment-specific difference of the abdominal aortic diameter. The moderate part of variance was explained by unshared environmental components, emphasizing the importance of lifestyle factors in primary prevention. Further studies in this field may guide future gene-mapping efforts and investigate specific lifestyle factors to prevent abdominal aortic dilatation and its complications. PMID:26559855

  5. Reproducibility of Abdominal Aortic Aneurysm Diameter Measurement and Growth Evaluation on Axial and Multiplanar Computed Tomography Reformations

    SciTech Connect

    Dugas, Alexandre; Therasse, Eric; Kauffmann, Claude; Tang, An; Elkouri, Stephane; Nozza, Anna; Giroux, Marie-France; Oliva, Vincent L.; Soulez, Gilles

    2012-08-15

    Purpose: To compare different methods measuring abdominal aortic aneurysm (AAA) maximal diameter (Dmax) and its progression on multidetector computed tomography (MDCT) scan. Materials and Methods: Forty AAA patients with two MDCT scans acquired at different times (baseline and follow-up) were included. Three observers measured AAA diameters by seven different methods: on axial images (anteroposterior, transverse, maximal, and short-axis views) and on multiplanar reformation (MPR) images (coronal, sagittal, and orthogonal views). Diameter measurement and progression were compared over time for the seven methods. Reproducibility of measurement methods was assessed by intraclass correlation coefficient (ICC) and Bland-Altman analysis. Results: Dmax, as measured on axial slices at baseline and follow-up (FU) MDCTs, was greater than that measured using the orthogonal method (p = 0.046 for baseline and 0.028 for FU), whereas Dmax measured with the orthogonal method was greater those using all other measurement methods (p-value range: <0.0001-0.03) but anteroposterior diameter (p = 0.18 baseline and 0.10 FU). The greatest interobserver ICCs were obtained for the orthogonal and transverse methods (0.972) at baseline and for the orthogonal and sagittal MPR images at FU (0.973 and 0.977). Interobserver ICC of the orthogonal method to document AAA progression was greater (ICC = 0.833) than measurements taken on axial images (ICC = 0.662-0.780) and single-plane MPR images (0.772-0.817). Conclusion: AAA Dmax measured on MDCT axial slices overestimates aneurysm size. Diameter as measured by the orthogonal method is more reproducible, especially to document AAA progression.

  6. Maximum Diameter of Native Abdominal Aortic Aneurysm Measured by Angio-Computed Tomography

    PubMed Central

    Mora, Caroline E.; Marcus, Claude D.; Barbe, Coralie M.; Ecarnot, Fiona B.; Long, Anne L.

    2015-01-01

    Background: Computed tomography angiography (CTA) is the reference technique for the measurement of native maximum abdominal aortic aneurysm (AAA) diameter when surgery is being considered. However, there is a wide choice available for the methodology of maximum AAA diameter measurement on CTA, and to date, no consensus has been reached on which method is best. We analyzed clinical decisions based on these various measures of native maximum AAA diameter with CTA, then analyzed their reproducibility and identified the method of measurement yielding the highest agreement in terms of patient management. Materials and Methods: Three sets of measures in 46 native AAA were obtained, double-blind by three radiologists (J, S, V) on orthogonal planes, curved multiplanar reconstructions, and semi-automated-software, based on the AAA-lumen centerline. From each set, the clinical decision was recorded as follows: "Follow-up" (if all diameters <50 mm), "ambiguous" (if at least one diameter <50 mm AND at least one ≥50 mm) or "Surgery " (if all diameters ≥50 mm). Intra- and interobserver agreements in clinical decisions were compared using the weighted Kappa coefficient. Results: Clinical decisions varied according to the measurement sets used by each observer, and according to intra and interobserver (lecture#1) reproducibility. Based on the first reading of each observer, the number of AAA proposed for surgery ranged from 11 to 24 for J, 5 to 20 for S, and 15 to 23 for V. The rate of AAAs classified as "ambiguous" varied from 11% (5/46) to 37% (17/46). The semi-automated method yielded very good intraand interobserver agreements in clinical decisions in all comparisons (Kappa range 0.83–1.00). Conclusion: The semi-automated method seems to be appropriate for native AAA maximum diameter measurement on CTA. In the absence of AAA outer-wallbased software more robust for complex AAA, clinical decisions might best be made with diameter values obtained using this technique

  7. Efficacy of Transcerebellar Diameter/Abdominal Circumference Versus Head Circumference/Abdominal Circumference in Predicting Asymmetric Intrauterine Growth Retardation

    PubMed Central

    Bhimarao; Bhat, Venkataramana; Gowda, Puttanna VN

    2015-01-01

    Background The high incidence of IUGR and its low recognition lead to increasing perinatal morbidity and mortality for which prediction of IUGR with timely management decisions is of paramount importance. Many studies have compared the efficacy of several gestational age independent parameters and found that TCD/AC is a better predictor of asymmetric IUGR. Aim To compare the accuracy of transcerebellar diameter/abdominal circumference with head circumference/abdominal circumference in predicting asymmetric intrauterine growth retardation after 20 weeks of gestation. Materials and Methods The prospective study was conducted over a period of one year on 50 clinically suspected IUGR pregnancies who were evaluated with 3.5 MHz frequency ultrasound scanner by a single sonologist. BPD, HC, AC and FL along with TCD were measured for assessing the sonological gestational age. Two morphometric ratios- TCD/AC and HC/AC were calculated. Estimated fetal weight was calculated for all these pregnancies and its percentile was determined. Statistical Methods The TCD/AC and HC/AC ratios were correlated with advancing gestational age to know if these were related to GA. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) for TCD/AC and HC/AC ratios in evaluating IUGR fetuses were calculated. Results In the present study, linear relation of TCD and HC in IUGR fetuses with gestation was noted. The sensitivity, specificity, PPV, NPV & DA were 88%, 93.5%, 77.1%, 96.3% & 92.4% respectively for TCD/AC ratio versus 84%, 92%, 72.4%, 95.8% & 90.4% respectively for HC/AC ratio in predicting IUGR. Conclusion Both ratios were gestational age independent and can be used in detecting IUGR with good diagnostic accuracy. However, TCD/AC ratio had a better diagnostic validity and accuracy compared to HC/AC ratio in predicting asymmetric IUGR. PMID:26557588

  8. [Diameter decrement of abdominal aorta and redistribution of systemic blood flow in non-ambulant Duchenne muscular dystrophy patients].

    PubMed

    Shinoe, T; Kawai, M

    1996-10-01

    Cardiomyopathy is a major life-threatening complication in Duchenne muscular dystrophy (DMD). Cardiac output is always low in advanced stage patients. Impaired muscles presumably require extremely low circulation, while blood flow to brain and internal organs is probably maintained. Therefore, the redistribution of systemic circulation must be another important factor which determines whether or not the cardiomyopathy results in fatal heart failure. Although great efforts have been focused on the cardiac function, this problem has seldom attracted attentions. Assuming that diameter of blood vessels reflects blood flow, we measured the diameter of abdominal aorta on CT at four levels: 1) beginning of the abdominal aorta, 2) before and 3) after the branching of renal arteries, 4) before bifurcation of the common iliac arteries. Six bed-ridden DMD patients were compared with 10 ambulant patients suffering from other neurological and non-neurological diseases. We obtained following results. First, the diameter of abdominal aorta is significantly smaller in DMD patients. Second, the decrement is most prominent between before and after the branching of the renal arteries. These results clearly showed predilection of renointestinal circulation at the sacrifice of lower extremities. This narrowing of distal aorta was also observed in Kugelberg-Welander disease and understood as a sequelae of longstanding abolition of lower extremity functions. PMID:8997143

  9. Fixed sagittal plane imbalance.

    PubMed

    Savage, Jason W; Patel, Alpesh A

    2014-12-01

    Study Design Literature review. Objective To discuss the evaluation and management of fixed sagittal plane imbalance. Methods A comprehensive literature review was performed on the preoperative evaluation of patients with sagittal plane malalignment, as well as the surgical strategies to address sagittal plane deformity. Results Sagittal plane imbalance is often caused by de novo scoliosis or iatrogenic flat back deformity. Understanding the etiology and magnitude of sagittal malalignment is crucial in realignment planning. Objective parameters have been developed to guide surgeons in determining how much correction is needed to achieve favorable outcomes. Currently, the goals of surgery are to restore a sagittal vertical axis < 5 cm, pelvic tilt < 20 degrees, and lumbar lordosis equal to pelvic incidence ± 9 degrees. Conclusion Sagittal plane malalignment is an increasingly recognized cause of pain and disability. Treatment of sagittal plane imbalance varies according to the etiology, location, and severity of the deformity. Fixed sagittal malalignment often requires complex reconstructive procedures that include osteotomy correction. Reestablishing harmonious spinopelvic alignment is associated with significant improvement in health-related quality-of-life outcome measures and patient satisfaction.

  10. Size-specific Dose Estimates for Chest, Abdominal, and Pelvic CT: Effect of Intrapatient Variability in Water-equivalent Diameter

    PubMed Central

    Shiung, Maria; Duan, Xinhui; Yu, Lifeng; Zhang, Yi; McCollough, Cynthia H.

    2015-01-01

    Purpose To develop software to automatically calculate size-specific dose estimates (SSDEs) and to assess the effect of variations in water-equivalent diameter (Dw) along the z-axis on SSDE for computed tomographic (CT) examinations of the torso. Materials and Methods In this institutional review board–approved, HIPAA-compliant, retrospective study, a software program was used to calculate Dw at each image position in 102 consecutive CT examinations of the combined chest, abdomen, and pelvis. SSDE was calculated by multiplying the size-dependent conversion factor and volume CT dose index (CTDIvol) at each image position. The variations in Dw along the z-axis were determined for six hypothetical scanning ranges: chest alone; abdomen alone; pelvis alone; chest and abdomen; abdomen and pelvis; and chest, abdomen, and pelvis. Mean SSDE was calculated in two ways: (a) from the SSDE at each position and (b) from the mean CTDIvol over each scan range and the conversion factor corresponding to Dw at the middle of the scan range. Linear regression analysis was performed to determine the correlation between SSDE values calculated in these two ways. Results Across patients, for scan ranges 1–6, the mean of the difference between maximal and minimal Dw within a given patient was 5.2, 4.9, 2.5, 6.0, 5.6, and 6.5 cm, respectively. The mean SSDE values calculated by using the two methods were in close agreement, with root mean square differences of 0.9, 0.5, 0.5, 1.4, 1.0, and 1.1 mGy or 6%, 3%, 2%, 9%, 4%, and 6%, for the scan ranges of chest; abdomen; pelvis; chest and abdomen; abdomen and pelvis; and chest, abdomen, and pelvis, respectively. Conclusion Using the mean CTDIvol from the whole scan range and Dw from the image at the center of the scan range provided an easily obtained estimate of SSDE for the whole scan range that agreed well with values from an image-by-image approach, with a root mean square difference less than 1.4 mGy (9%). © RSNA, 2015 Online

  11. [Short sagittal osteotomy].

    PubMed

    Paulus, Christian; Kater, Wolfgang

    2015-12-01

    Bilateral sagittal split osteotomy has become the standard mandibular surgery for the treatment of dento-facial deformities. Even patients with less important deformities may undergo surgery. The morbidity must be as low as possible. We describe a technique with reduced split surfaces. The osseous section follows an oblique line since the thorn of Spix below and outside towards the supra-angular region. This section is completed by an osteotomy of the posterior border of the mandible. This split never reaches the inferior alveolar nerf tunnel. The protection of the alveolar nerve is increased what decreases considerably the risk of nervous complications of this intervention. The majority of the mandibular movements are possible by this technique with the exception of the important advancements and the increase of the height of the ramus. PMID:26655415

  12. Poor sleep quality potentiates stress-induced cytokine reactivity in postmenopausal women with high visceral abdominal adiposity.

    PubMed

    Prather, Aric A; Puterman, Eli; Epel, Elissa S; Dhabhar, Firdaus S

    2014-01-01

    Sleep disturbance is a key behavioral risk factor for chronic medical conditions observed at high rates among overweight and obese individuals. Systemic inflammation, including that induced by stress, may serve as a common biological mechanism linking sleep, adiposity, and disease risk. To investigate these relationships, 48 postmenopausal women (mean age=61.8) completed a standardized laboratory stress task during which time blood was collected at baseline and 30, 50 and 90+ min after stressor onset to assess circulating levels of interleukin (IL)-6, IL-10, and IL-6/IL-10 ratio. Self-reported global sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) while adiposity was estimated by body mass index. Sagittal diameter was obtained in clinic to estimate visceral abdominal adiposity. Multi-level growth curve models revealed that poorer self-reported sleep quality was associated with greater stress-induced increases in IL-6/IL-10 ratio. In terms of adiposity, higher sagittal diameter, but not BMI, was associated with greater IL-6 reactivity (p's<0.05). Further, associations between sleep quality and cytokine reactivity varied as a function of sagittal diameter. Among poor sleepers (1 SD above mean of PSQI score), stress-induced increases in IL-6 and IL-6/IL-10 ratio were significantly steeper in those with high visceral adiposity (1 SD above the mean of sagittal diameter) compared to those with low visceral adiposity (1 SD below the mean of sagittal diameter). In sum, poorer sleep quality and greater visceral adiposity, separately and especially in combination, are associated with greater stress-related increases in systemic inflammation. This research may help elucidate the complex link between sleep, obesity and inflammatory disease risk. PMID:24060585

  13. Solar diameter/s/

    NASA Astrophysics Data System (ADS)

    Rosch, J.; Yerle, R.

    1983-01-01

    Two definitions are possible for the solar diameter: astrophysical, relating to a specific physical parameter, or observational, relating to a given quantity that is to be measured. Since only the latter is directly accessible, astrophysical definitions should be linked to these quantities. All current solar diameter programs refer to the point of the limb where the brightness gradient is maximum, or to a higher order approximation of the profile shape. Two such programs, the Pic-du-Midi experiment which uses fast scans of the limb to define the injection point after a correction for atmospheric blurring, and the SCLERA experiment, employing an algorithm to obviate this correction, are compared. The advantage of a fast scan is noted.

  14. Abdominal tap

    MedlinePlus

    Peritoneal tap; Paracentesis; Ascites - abdominal tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap ... abdominal cavity ( most often cancer of the ovaries ) Cirrhosis of the liver Damaged bowel Heart disease Infection ...

  15. Effect of changes in intra-abdominal pressure on diameter, cross-sectional area, and distensibility of the lower esophageal sphincter of healthy dogs as determined by use of an endoscopic functional luminal imaging probe.

    PubMed

    Mayhew, Philipp D; Pitt, Kathryn A; Steffey, Michele A; Culp, William T N; Kass, Philip H; Marks, Stanley L

    2016-08-01

    OBJECTIVE To evaluate the effect of intra-abdominal pressure (IAP) on morphology and compliance of the lower esophageal sphincter (LES) by use of impedance planimetry in healthy dogs and to quantify the effect of changes in IAP. ANIMALS 7 healthy, purpose-bred sexually intact male hound-cross dogs. PROCEDURES Dogs were anesthetized, and cross-sectional area (CSA), minimal diameter (MD), LES length, LES volume, and distensibility index (DI) of the LES were evaluated by use of an endoscopic functional luminal imaging probe. For each dog, measurements were obtained before (baseline) and after creation of a pneumoperitoneum at an IAP of 4, 8, and 15 mm Hg. Order of the IAPs was determined by use of a randomization software program. RESULTS CSA and MD at 4 and 8 mm Hg were not significantly different from baseline measurements; however, CSA and MD at 15 mm Hg were both significantly greater than baseline measurements. The LES length and LES volume did not differ significantly from baseline measurements at any IAP. The DI differed inconsistently from the baseline measurement but was not substantially affected by IAP. CONCLUSIONS AND CLINICAL RELEVANCE Pneumoperitoneum created with an IAP of 4 or 8 mm Hg did not significantly alter LES morphology in healthy dogs. Pneumoperitoneum at an IAP of 15 mm Hg caused a significant increase in CSA and MD of the LES. Compliance of the LES as measured by the DI was not greatly altered by pneumoperitoneum at an IAP of up to 15 mm Hg. PMID:27463542

  16. Continence after posterior sagittal anorectoplasty.

    PubMed

    Langemeijer, R A; Molenaar, J C

    1991-05-01

    Posterior sagittal anorectoplasty (PSARP) was introduced in 1982 by Peña and De Vries as a new operation for patients with a high anorectal malformation. The degree of postoperative continence is reported to be high. During the past decade, too, new insights have been gained into the embryology of anorectal malformations. Evaluation of PSARP in relation to current understanding of the development and anatomy of the anorectum and the pelvic floor has led us to conclude that optimal continence cannot be expected. Fifty patients with a high anorectal malformation underwent PSARP between June 1983 and May 1990. Postoperative follow-up consisted of anamnesis (subjective) and electrostimulation, defecography, and anorectal manometry (objective). All patients are alive, and all but one are being evaluated regularly. Subjectively, the majority of patients were more or less incontinent, with soiling of pants at least once a day. On the basis of objective criteria, virtually all patients appeared to be incontinent, and in only one patient was the mechanism of defecation almost unimpaired after PSARP. From this study, we conclude that although PSARP provides a good aesthetic result, patients will never acquire normal continence.

  17. Leaking mycotic abdominal aortic aneurysm.

    PubMed

    Sing, T M; Young, N; O'Rourke, I C; Tomlinson, P

    1994-11-01

    A case of leaking mycotic abdominal aortic aneurysm is reported, with a brief review of the literature. A 58 year old female presented with shoulder and abdominal pain associated with diarrhoea, vomiting and fever with leucocytosis. Computed tomography of the abdomen showed pooling of contrast in the retroperitoneum anterior to a non-dilated abdominal aorta. There was considerable retroperitoneal blood accumulating in a mass-like lesion in the right lower abdomen and pelvis obstructing the right renal collecting system. Laparotomy revealed a 4 cm diameter saccular aneurysm of the abdominal aorta, with a 1 cm diameter neck. Culture of the thrombus grew Streptococcus pyogenes. PMID:7993259

  18. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  19. Relationship Between Juncturae Tendinum and Sagittal Bands.

    PubMed

    Chinchalkar, Shrikant J; Barker, Chelsea A; Owsley, Bobbi

    2015-06-01

    The juncturae tendinum and sagittal bands transmit precise forces through the dorsum of the hand. Both structures are integral in the mechanics of normal digital extension and in stabilization of the metacarpophalangeal (MCP) joints. Extensor tendon injury, or rupture/attenuation of sagittal bands and/or juncturae tendinum, may disrupt the kinematic chain and lead to a number of abnormal hand postures and motions. Early treatment of extensor tendon and/or sagittal band injury is dependent upon proper recognition of primary pathology. Proper evaluation and the use of special clinical tests should be implemented to rule out other pathologies. Once diagnosed, treatment may consist of relative motion splinting and standard pain/edema control measures to increase joint motion, tendon excursion, and functional use of the hand. PMID:26078512

  20. Wavefront reconstruction from tangential and sagittal curvature.

    PubMed

    Canales, Javier; Barbero, Sergio; Portilla, Javier; López-Alonso, José Manuel

    2014-12-10

    In a previous contribution [Appl. Opt.51, 8599 (2012)], a coauthor of this work presented a method for reconstructing the wavefront aberration from tangential refractive power data measured using dynamic skiascopy. Here we propose a new regularized least squares method where the wavefront is reconstructed not only using tangential but also sagittal curvature data. We prove that our new method provides improved quality reconstruction for typical and also for highly aberrated wavefronts, under a wide range of experimental error levels. Our method may be applied to any type of wavefront sensor (not only dynamic skiascopy) able to measure either just tangential or tangential plus sagittal curvature data.

  1. Sagittal Balance in Adolescent Idiopathic Scoliosis

    PubMed Central

    Xu, Xi-Ming; Wang, Fei; Zhou, Xiao-Yi; Liu, Zi-Xuan; Wei, Xian-Zhao; Bai, Yu-Shu; Li, Ming

    2015-01-01

    Abstract The relationship between spinal sagittal alignment and pelvic parameters is well known in adolescent idiopathic scoliosis. However, few studies have reported the sagittal spinopelvic relationship after selective posterior fusion of thoracolumbar/lumbar (TL/L) curves. We evaluated the relationship between spinal sagittal alignment and the pelvis, and analyzed how the pelvic sagittal state is adjusted in Lenke type 5C patients. We conducted a retrospective study of 36 patients with Lenke type 5C curves who received selective posterior TL/L curve fusion. Coronal and spinopelvic sagittal parameters were pre and postoperatively compared. Pearson coefficients were used to analyze the correlation between all spinopelvic sagittal parameters before and after surgery. We also evaluated 3 pelvic morphologies (anteverted, normal, and retroverted) before and after surgery. Preoperatively, the mean pelvic incidence was 46.0°, with a pelvic tilt and sacral slope (SS) of 8.2° and 37.8°, respectively, and 25% (9/36) of patients had an anteverted pelvis, whereas the other 75% had a normal pelvis. Postoperatively, 42% (15/36) of patients had a retroverted pelvis, 53% (19/36) had a normal pelvis, and 2 patients had an anteverted pelvis. Logistic regression analyses yielded 2 factors that were significantly associated with the risk for a postoperative unrecovered anteverted pelvis, including increased lumbar lordosis (LL) (odds ratio [OR] 4.8, P = 0.029) and increased SS (OR 5.6, P = 0.018). Four factors were significantly associated with the risk of a postoperative newly anteverted pelvis, including LL at the final follow-up (OR 6.9, P = 0.009), increased LL (OR 8.9, P = 0.003), LL below fusion (OR 9.4, P = 0.002), and increased SS (OR 11.5, P = 0.001). The pelvic state may be adjusted after selective posterior TL/L curve fusion in Lenke 5C adolescent idiopathic scoliosis patients. It is difficult to improve an anteverted pelvis in patients who have

  2. Ellis-van Creveld Syndrome with Sagittal Craniosynostosis.

    PubMed

    Fischer, Andrew S; Weathers, William M; Wolfswinkel, Erik M; Bollo, Robert J; Hollier, Larry H; Buchanan, Edward P

    2015-06-01

    Ellis-van Creveld syndrome (EVC) is a rare disorder (the incidence is estimated at around 7/1,000,000) characterized by the clinical tetrad of chondrodystrophy, polydactyly, ectodermal dysplasia, and cardiac anomalies. Sagittal synostosis is characterized by a dolichocephalic head shape resulting from premature fusion of the sagittal suture. Both are rare disorders, which have never been reported together. We present a case of EVC and sagittal synostosis. We report the clinical features of a Hispanic boy with EVC and sagittal craniosynostosis who underwent cranial vault remodeling. The presentation of this patient is gone over in detail. A never before reported case of EVC and sagittal synostosis is presented in detail.

  3. The Relationship between T1 Sagittal Angle and Sagittal Balance: A Retrospective Study of 119 Healthy Volunteers

    PubMed Central

    Li, Ming

    2016-01-01

    T1 sagittal angle has been reported to be used as a parameter for assessing sagittal balance and cervical lordosis. However, no study has been performed to explore the relationship between T1 sagittal angle and sagittal balance, and whether T1 sagittal angle could be used for osteotomy guidelines remains unknown. The aim of our study is to explore the relationship between T1 sagittal angle and sagittal balance, determine the predictors for T1 sagittal angle, and determine whether T1 sagittal angle could be used for osteotomy guidelines to restore sagittal balance. Medical records of healthy volunteers in our outpatient clinic from January 2014 to August 2015 were reviewed, and their standing full-spine lateral radiographs were evaluated. Demographic and radiological parameters were collected and analyzed, including age, gender, T1 sagittal angle, maxTK, maxLL, SS, PT, and PI. Correlation coefficients between T1 sagittal angle and other spinopelvic parameters were determined. In addition, multiple regression analysis was performed to establish predictive radiographic parameters for T1 sagittal angle as the primary contributors. A total of 119 healthy volunteers were recruited in our study with a mean age of 34.7 years. It was found that T1 sagittal angle was correlated with maxTK with very good significance (r = 0.697, P<0.001), maxLL with weak significance (r = 0.206, P = 0.024), SS with weak significance (r = 0.237, P = 0.009), PI with very weak significance (r = 0.189, P = 0.039), SVA with moderate significance (r = 0.445, P<0.001), TPA with weak significance (r = 0.207, P = 0.023), and T1SPI with weak significance (r = 0.309, P = 0.001). The result of multiple regression analysis showed that T1 sagittal angle could be predicted by using the following regression equation: T1 sagittal angle = 0.6 * maxTK—0.2 * maxLL + 8. In the healthy population, T1 sagittal angle could be considered as a useful parameter for sagittal balance; however, it could not be

  4. Posterior Sagittal Mesh Rectopexy (PSMR) and Anal Encirclement with Polypropylene Mesh for Correction of Complete Rectal Prolapse-a New Application.

    PubMed

    Maiti, Sukumar

    2015-06-01

    The posterior sagittal route is utilized as an alternative to the abdominal and perineal routes for the operation of a complete rectal prolapse (syn. procidentia). A mesh is interposed between the rectum and sacrum. The mesh also acts as a sling suspended from the sacrum. The levator muscle is repaired from behind. Anal encirclement is made to correct a patulous anus.

  5. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  6. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  7. The posterior sagittal trans-sphincteric approach.

    PubMed

    Peña, A; Hong, A

    2004-01-01

    The posterior sagittal, transphincteric approach to treat different pelvic problems has been known since last century. Although some surgeons have embraced it and have enthusiastically advocated it s use, it has never become an overly popular technique. The purpose of this study is to evaluate the advantages and disadvantages of the approach, both from an historical perspective and from the authors experience. The international literature on the subject was reviewed since 1877 up to the present date. A retrospective evaluation of the authors experience was conducted, and the results reviewed. Specific attention was paid to the final result obtained in the treatment of the original condition, surgical complications and the effect of the surgical approach on bowel and urinary control. The experiential review included 114 cases. They were divided into two groups. A included 85 patients who underwent a posterior sagittal transphincteric approach that included 49 cases of Hirschsprung s disease (primary 21, secondary 28), 15 presacral masses; 10 rectaltumors; 7 acquired recto-genito-urinary fistulae; and 4 cases of idiopathic rectal prolapse. Group B included 29 patients who underwent a posterior sagittal trans-anorectal approach, in which the anterior wall of the rectum and the sphincter was divided as well.. This group included 12 cases of urogenital sinuses; 8 acquired urethral stricture or atresia after trauma; and 9 posterior urethral masses. Post-operative bowel control was normal all cases except in those patients whose basic condition had resulted in fecal incontinence, or who had sustained an irreversible injury prior tothe operation. Urinary control was normal except in cases with pre-operative incontinence. Complications included recurrence of recto-genitourinary fistulae in 3 cases, recto-cutaneous fistula in 3 Hirschsprung s patients and 2 partial wound dehisences. The posterior sagittal trans-sphincteric approach represents a useful technical alternative

  8. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  9. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  10. The primal sagittal plane of the head: a new concept.

    PubMed

    Gateno, J; Jajoo, A; Nicol, M; Xia, J J

    2016-03-01

    To assess facial form, one has to determine the size, position, orientation, shape, and symmetry of the different facial units. Many of these assessments require a frame of reference. The customary coordinate system used for these assessments is the 'standard anatomical frame of reference', a three-dimensional Cartesian system made by three planes: the sagittal, the axial, and the coronal. Constructing the sagittal plane seems simple, but because of universal facial asymmetry, it is complicated. Depending on the method one selects, one can build hundreds of different planes, never knowing which one is correct. This conundrum can be solved by estimating the sagittal plane a patient would have had if his or her face had developed symmetrically. We call this the 'primal sagittal plane'. To estimate this plane we have developed a mathematical algorithm called LAGER (Landmark Geometric Routine). In this paper, we explain the concept of the primal sagittal plane and present the structure of the LAGER algorithm.

  11. [ENDOVASCULAR ABDOMINAL AORTIC ANEURISM REPAIR].

    PubMed

    Maĭstrenko, D N; Generalov, M I; Tarazov, P G; Zherebtsov, F K; Osovskikh, V V; Ivanov, A S; Oleshchuk, A N; Granov, D A

    2015-01-01

    The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stent-grafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn't necessary to use a conversion to open surgery. The follow-up period consisted of 44,6?2,1 months. Control ultrasound and computer tomography studies hadn't revealed an increase of aneurism sack sizes or "eakages". A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stent-graft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group. PMID:26234059

  12. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  13. Monitoring the Foetal Phase of Gestation in the Queen With a 12.5-MHz Ultrasound Probe and Prediction of the Parturition by Combining the Measurements of Head and Abdominal Diameters.

    PubMed

    Topie, E; Bencharif, D; Briand, L; Tainturier, D

    2015-08-01

    Ten gestations in six domestic shorthair cats (Europeans) were monitored daily during the foetal phase of gestation, from the 28th day after the first mating until parturition, using ultrasound with a 12.5-MHz probe. The development of the various organs over this period was recorded. The diameters of the head (HD) and abdomen (AD) were measured. Skeletal calcification visible on ultrasound occurred in a defined order between the 34th and 40th day of gestation. During the last 30 days of gestation, there was a significant correlation between HD and days before parturition (DBP) (r(2)  = 0.99) and between AD and DBP (r(2)  = 0.98). The following equations were obtained: DBP = -2.10*HD (mm) + 50.74; DBP = -1.01*AD (mm) + 42.19. The confidence intervals were stable over the last 30 days of gestation. For the HD, the confidence interval was ±1 day in 53% of cases and ±2 days in 85% of cases. For the AD, the confidence interval was ±1 day in 45% of cases and ±2 days in 77% of cases. A table obtained by combining the HD and AD measurements made it possible to estimate the date of parturition within 2 days with a reliability of over 85%.

  14. Sagittal Balance Correction in Lateral Interbody Fusion for Degenerative Scoliosis

    PubMed Central

    Gallizzi, Michael A.; Sheets, Charles; Smith, Benjamin T.; Isaacs, Robert E.; Eure, Megan; Brown, Christopher R.

    2016-01-01

    Background Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population. The objective of this study is to evaluate the ability of LIF to restore sagittal balance in degenerative lumbar scoliosis. Methods Thirty-five patients who underwent LIF for degenerative thoracolumbar scoliosis from July 2013 to March 2014 by a single surgeon were included. Outcome measures included sagittal balance, lumbar lordosis, Cobb Angle, and segmental lordosis. Measures were evaluated pre-operative, immediately post-operatively, and at their last clinical follow-up. Repeated measures ANOVAs were used to assess the differences between pre-operative, first postoperative, and a follow-up visit. Results The average sagittal balance correction was not significantly different: 1.06cm from 5.79cm to 4.74cm forward. The average Cobb angle correction was 14.1 degrees from 21.6 to 5.5 degrees. The average change in global lumbar lordosis was found to be significantly different: 6.3 degrees from 28.9 to 35.2 degrees. Conclusions This study demonstrates that LIF reliably restores lordosis, but does not significantly improve sagittal balance. Despite this, patients had reliable improvement in pain and functionality suggesting that sagittal balance correction may not be as critical in scoliosis correction as previous studies have indicated. Clinical Relevance LIF does not significantly change sagittal balance; however, clinical improvement does not seem to be contingent upon sagittal balance correction in the degenerative scoliosis population. The DUHS IRB has determined this

  15. Sagittal Balance Correction in Lateral Interbody Fusion for Degenerative Scoliosis

    PubMed Central

    Gallizzi, Michael A.; Sheets, Charles; Smith, Benjamin T.; Isaacs, Robert E.; Eure, Megan; Brown, Christopher R.

    2016-01-01

    Background Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population. The objective of this study is to evaluate the ability of LIF to restore sagittal balance in degenerative lumbar scoliosis. Methods Thirty-five patients who underwent LIF for degenerative thoracolumbar scoliosis from July 2013 to March 2014 by a single surgeon were included. Outcome measures included sagittal balance, lumbar lordosis, Cobb Angle, and segmental lordosis. Measures were evaluated pre-operative, immediately post-operatively, and at their last clinical follow-up. Repeated measures ANOVAs were used to assess the differences between pre-operative, first postoperative, and a follow-up visit. Results The average sagittal balance correction was not significantly different: 1.06cm from 5.79cm to 4.74cm forward. The average Cobb angle correction was 14.1 degrees from 21.6 to 5.5 degrees. The average change in global lumbar lordosis was found to be significantly different: 6.3 degrees from 28.9 to 35.2 degrees. Conclusions This study demonstrates that LIF reliably restores lordosis, but does not significantly improve sagittal balance. Despite this, patients had reliable improvement in pain and functionality suggesting that sagittal balance correction may not be as critical in scoliosis correction as previous studies have indicated. Clinical Relevance LIF does not significantly change sagittal balance; however, clinical improvement does not seem to be contingent upon sagittal balance correction in the degenerative scoliosis population. The DUHS IRB has determined this

  16. Early proximal junctional failure in patients with preoperative sagittal imbalance.

    PubMed

    Smith, Micah W; Annis, Prokopis; Lawrence, Brandon D; Daubs, Michael D; Brodke, Darrel S

    2013-10-01

    Study Type Retrospective review. Introduction Sagittal imbalance has been associated with lower health-related quality of life outcomes, and restoration of imbalance is associated with improved outcomes.123 The long constructs used in adult spinal deformity have potential consequences such as proximal junctional kyphosis (PJK). Clinically, the development of PJK may not be as important as failure of the construct or vertebrae at the proximal end. As PJK does not lead to worse clinical outcomes,45 we define the term early proximal junctional failure (EPJF) as fracture, implant failure, or myelopathy due to stenosis at the upper instrumental vertebra (UIV) or UIV + 1 within 6 months of surgery. Objective The purpose of this study is to report the incidence of EPJF in patients who are sagittally imbalanced preoperatively and to identify risk factors postoperatively that correlate with EPJF using commonly reported sagittal balance parameters. Methods We reviewed 197 patients with preoperative sagittal imbalance by at least one of the following: sagittal vertical axis more than 5 cm, global sagittal alignment more than 45 degrees, pelvic incidence-lumbar lordosis more than 10 degrees, or spine-sacral angle less than 120 degrees. Radiographic measurements also included proximal junctional angle, thoracic kyphosis, lumbar lordosis, pelvic parameters, and sagittal balance parameters/formulas, as well as UIV angle, UIV spinosacral angle, and UIV plumb line to assess as potential risk factors. EPJF incidence was calculated postoperatively for each of the accepted sagittal balance parameters/formulas. Results EPJF was observed in 49 of 197 patients (25%) with preoperative sagittal imbalance and was more common in fusions with UIV in the lower thoracic spine (TS) (35%) than in those with UIV in the upper TS (10%) or lumbar (25%) (p = 0.007). Of the 49 EPJF patients, 16 patients (33%) required revision surgery within the first year, for an overall early revision

  17. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  18. Contributions of individual muscles to the sagittal- and frontal-plane angular accelerations of the trunk in walking.

    PubMed

    Klemetti, Rudolf; Steele, Katherine M; Moilanen, Petro; Avela, Janne; Timonen, Jussi

    2014-07-18

    This study was conducted to analyze the unimpaired control of the trunk during walking. Studying the unimpaired control of the trunk reveals characteristics of good control. These characteristics can be pursued in the rehabilitation of impaired control. Impaired control of the trunk during walking is associated with aging and many movement disorders. This is a concern as it is considered to increase fall risk. Muscles that contribute to the trunk control in normal walking may also contribute to it under perturbation circumstances, attempting to prevent an impending fall. Knowledge of such muscles can be used to rehabilitate impaired control of the trunk. Here, angular accelerations of the trunk induced by individual muscles, in the sagittal and frontal planes, were calculated using 3D muscle-driven simulations of seven young healthy subjects walking at free speed. Analysis of the simulations demonstrated that the abdominal and back muscles displayed large contributions throughout the gait cycle both in the sagittal and frontal planes. Proximal lower-limb muscles contributed more than distal muscles in the sagittal plane, while both proximal and distal muscles showed large contributions in the frontal plane. Along with the stance-limb muscles, the swing-limb muscles also exhibited considerable contribution. The gluteus medius was found to be an important individual frontal-plane control muscle; enhancing its function in pathologies could ameliorate gait by attenuating trunk sway. In addition, since gravity appreciably accelerated the trunk in the frontal plane, it may engender excessive trunk sway in pathologies.

  19. Sagittal plane balancing in the total knee arthroplasty.

    PubMed

    Manson, Theodore T; Khanuja, Harpal S; Jacobs, Michael A; Hungerford, Marc W

    2009-01-01

    Postoperative stiffness or instability may result from a total knee arthroplasty imbalanced in the sagittal plane. Total knee arthroplasty instrumentation systems differ in the basic strategies used to assure this balance. In an anterior referencing system, changes in femoral size affect flexion gap tightness, and femoral size selection is paramount to assure sagittal plane balance. Conversely, in posterior referencing systems, femoral size changes do not affect the flexion gap but, rather, influence femoral component-patella articulation. Flexion/extension gap systems use calibrated spacer blocks to ensure gap balance but do not guarantee midrange stability; if used incorrectly, they may cause component malposition and joint line elevation. The authors reviewed the strengths and weaknesses of system types and provided system-specific troubleshooting guidelines for clinicians addressing intraoperative sagittal plane imbalance.

  20. Mid-sagittal plane and mid-sagittal surface optimization in brain MRI using a local symmetry measure

    NASA Astrophysics Data System (ADS)

    Stegmann, Mikkel B.; Skoglund, Karl; Ryberg, Charlotte

    2005-04-01

    This paper describes methods for automatic localization of the mid-sagittal plane (MSP) and mid-sagittal surface (MSS). The data used is a subset of the Leukoaraiosis And DISability (LADIS) study consisting of three-dimensional magnetic resonance brain data from 62 elderly subjects (age 66 to 84 years). Traditionally, the mid-sagittal plane is localized by global measures. However, this approach fails when the partitioning plane between the brain hemispheres does not coincide with the symmetry plane of the head. We instead propose to use a sparse set of profiles in the plane normal direction and maximize the local symmetry around these using a general-purpose optimizer. The plane is parameterized by azimuth and elevation angles along with the distance to the origin in the normal direction. This approach leads to solutions confirmed as the optimal MSP in 98 percent of the subjects. Despite the name, the mid-sagittal plane is not always planar, but a curved surface resulting in poor partitioning of the brain hemispheres. To account for this, this paper also investigates an optimization strategy which fits a thin-plate spline surface to the brain data using a robust least median of squares estimator. Albeit computationally more expensive, mid-sagittal surface fitting demonstrated convincingly better partitioning of curved brains into cerebral hemispheres.

  1. Establishing abdominal height cut-offs and their association with conventional indices of obesity among Arab children and adolescents

    PubMed Central

    Al-Daghri, Nasser; Alokail, Majed; Al-Attas, Omar; Sabico, Shaun; Kumar, Sudhesh

    2010-01-01

    BACKGROUND AND OBJECTIVES: Obesity, particularly childhood obesity is common in the Middle East, but no studies have examined the relationship of sagittal abdominal diameter (SAD) or abdominal height to conventional markers of obesity in this region. This is the first study to document the association of SAD with measures of obesity among Arab children and adolescents. METHODS: Nine hundred sixty-four Saudi children aged 5-17 years (365 prepubertal, including 146 boys and 219 girls; 249 pubertal, including 125 boys and 124 girls; and 350 postpubertal, including 198 boys and 152 girls) were included in this cross-sectional study. RESULTS: SAD was significantly correlated with indices of obesity regardless of gender, but was strongest among pubertal boys. The cut-off values were as follows: for prepubertal children, 14 cm (equivalent to 50th percentile among girls and 60th percentile among boys); for pubertal children, 15 cm for girls (30th percentile) and 16 cm for boys (50th percentile), and for postpubertal, 21.5 cm for girls (70th percentile) and 22 cm for boys (80th percentile). CONCLUSION: SAD is a reliable indicator of visceral obesity among Arab children and adolescents in particular. Prospective studies should be done to determine whether such an association translates to a promising risk factor for hard endpoints such as diabetes mellitus and coronary heart disease. PMID:20427937

  2. Overjet as a predictor of sagittal skeletal relationships.

    PubMed

    Zupancic, S; Pohar, M; Farcnik, F; Ovsenik, Maja

    2008-06-01

    Skeletal relationships in the sagittal plane do not always correspond with dental relationships. The aim of this study was to determine in which type of malocclusion the correlation between overjet and skeletal sagittal parameters assessed by lateral cephalogram analysis is the highest. The extent to which overjet can predict skeletal relationships in the sagittal plane was also assessed. Eighty-three subjects fulfilled the inclusion criteria (40 males and 43 females, mean age 16.3 +/- 4.3 years). Overjet was measured on study casts and sagittal skeletal relationships were analysed on lateral cephalograms. ANB angle, Wits appraisal, and convexity at point A were determined. Mean values and standard deviations of measured parameters were calculated for Class I, Class II division 1, and Class III malocclusion subjects. Correlation between overjet measured on study casts and sagittal skeletal parameters measured on lateral cephalogram was calculated. Overjet as a predictor of skeletal relationships was assessed by means of linear regression analysis. A statistically significant positive correlation (P < 0.01) was found between the values of overjet and ANB (r = 0.690), overjet and Wits appraisal (r = 0.750), and overjet and convexity at point A (r = 0.608) when assessing the whole sample. When linear regression between overjet and cephalometric parameters was assessed separately in Class I, Class II division 1, and Class III malocclusion subjects, the percentage of variability was statistically significant in just four pairs. The findings show that overjet is a good predictor of sagittal relationship only in subjects with a Class II division 1 malocclusion.

  3. Diffraction crystals for sagittally focusing x-rays

    DOEpatents

    Ice, G.E.; Sparks, C.J. Jr.

    1982-06-07

    The invention is a new type of diffraction crystal designed for sagittally focusing photons of various energies. The invention is based on the discovery that such focusing is not obtainable with conventional crystals because of distortion resulting from anticlastic curvature. The new crystal comprises a monocrystalline base having a front face contoured for sagittally focusing photons and a back face provided with rigid, upstanding, stiffening ribs restricting anticlastic curvature. When mounted in a suitable bending device, the reflecting face of the crystal can be adjusted to focus photons having any one of a range of energies.

  4. Diffraction crystal for sagittally focusing x-rays

    DOEpatents

    Ice, Gene E.; Sparks, Jr., Cullie J.

    1984-01-01

    The invention is a new type of diffraction crystal designed for sagittally focusing photons of various energies. The invention is based on the discovery that such focusing is not obtainable with conventional crystals because of distortion resulting from anticlastic curvature. The new crystal comprises a monocrystalline base having a front face contoured for sagittally focusing photons and a back face provided with rigid, upstanding, stiffening ribs restricting anticlastic curvature. When mounted in a suitable bending device, the reflecting face of the crystal can be adjusted to focus photons having any one of a range of energies.

  5. Compression of superior sagittal sinus by neonatal calvarial molding.

    PubMed

    Newton, T H; Gooding, C A

    1975-06-01

    Compression of the superior sagittal sinus may result from overlapping of the parietal and occipital bones in the newborn infant. Such compression has been documented angiographically and the resultant decreased blood flow confirmed with a Doppler ultrasound probe. This compression may increase intracerebral venous pressures and thereby contribute to the high incidence of intracerebral hemorrhage in premature infants with respiratory distress syndrome.

  6. ARTICULATOR-RELATED REGISTRATION AND ANALYSIS OF SAGITTAL CONDYLAR INCLINATION.

    PubMed

    Cimić, Samir; Simunković, Sonja Kraljević; Suncana Simonić Kocijan; Matijević, Jurica; Dulcić, Niksa; Catić, Amir

    2015-12-01

    The purpose of this investigation was to study sagittal condylar inclination values within a uniform sample (Angle class I occlusion) using 'articulator-related registration' and Camper's plane as a reference plane. The study was performed on a sample of 58 Angle class I subjects (mean age 25.1, SD 3.1). Measurements were performed with an ultrasonic jaw tracking device with six degrees of freedom. After a paraocclusal tray was fixed in the mouth, each subject had to make three protrusive movements and three right and left laterotrusive movements. From protrusive movements the software of the device automatically calculated the left and the right sagittal condylar inclination values used for setting of the articulator. The mean sagittal condylar inclinationvalue was 41.0° (SD 10.5) for the right joint and 40.7° (SD 9.8) for the left joint. The maximum value was 65.0° for the right and 68.6° for the left joint, and the minimum value was 13.7° for the right and 21.7° for the left joint. The results of this study suggested the average articulator setting for sagittal condylar inclination for fully dentate adult subjects to be 40° in relation to Camper's plane. This is especially important for the articulators that are set up in relation to Camper's plane.

  7. Influence of metopic suture fusion associated with sagittal synostosis.

    PubMed

    Domeshek, Leahthan F; Das, Rajesh R; Van Aalst, John A; Mukundan, Srinivasan; Marcus, Jeffrey R

    2011-01-01

    Some patients with sagittal synostosis present with a fused metopic suture. We hypothesize that premature metopic suture fusion consistently and identifiably alters form associated with sagittal synostosis. We previously validated three-dimensional vector analysis as a tool for the study of cranial morphology and used it herein to distinguish between dysmorphologies of isolated sagittal synostosis (ISS) and combined sagittal-metopic synostosis (CSM). Preoperative computed tomographic scans for patients with ISS and CSM were compared with matched normative counterparts. Premature metopic suture fusion was defined by established radiographic criteria. Color-coded point clouds were created for each scan, with color gradient based on patient deviation from normal across the dysmorphic skull. Standard deviation data were evaluated in 7 cranial regions and compared between ISS and CSM. Mean ISS and CSM point clouds were evaluated. Using three-dimensional vector analysis, standard anthropometric data/indices were determined and compared between the 2 groups. Differences in ISS and CSM regional deviations and index measurements were not statistically significant. Mean ISS and CSM representations depicted similar overall morphology. Using accepted criteria for identification of metopic synostosis in CSM, only subtle differences appear between the 2 populations on average. Expected morphologic changes associated with metopic synostosis are present in only a small number of patients with CSM, arguing against our hypothesis, and calling into question the criteria used to identify premature metopic suture fusion. Normal metopic suture fusion occurs for a continuum of time. Our findings suggest that the normal continuum may begin earlier than the literature suggests. In the setting of sagittal synostosis, the influence of metopic suture fusion and treatment is best determined by individual morphologic analysis.

  8. Congenital lateral abdominal wall hernia.

    PubMed

    Montes-Tapia, Fernando; Cura-Esquivel, Idalia; Gutiérrez, Susana; Rodríguez-Balderrama, Isaías; de la O-Cavazos, Manuel

    2016-08-01

    Congenital abdominal wall defects that are located outside of the anterior wall are extremely rare and difficult to classify because there are no well accepted guidelines. There are two regions outside of the anterior wall: the flank or lateral wall; and the lumbar region. We report the case of a patient with an oval 3 cm-diameter hernia defect located above the anterior axillary line, which affects all layers of the muscular wall. An anorectal malformation consisting of a recto-vestibular fistula was also identified, and chest X-ray showed dextrocardia. The suggested treatment is repair of the defect before 1 year of age. Given that the anomalies described may accompany lateral abdominal wall hernia, it is important to diagnose and treat the associated defects.

  9. Interpreting stem diameter changes

    NASA Astrophysics Data System (ADS)

    Hölttä, T.; Sevanto, S.; Nikinmaa, E.

    2009-12-01

    Detecting phloem transport in stem diameter changes Teemu Hölttä1, Sanna Sevanto2, Eero Nikinmaa1 1Department of Forest Ecology, P.O. Box 27, FIN-00014 University of Helsinki, Finland 2Department of Physics, P.O. Box 48, FIN-00014 University of Helsinki, Finland Introduction The volume of living cells and xylem conduits vary according to pressures they are subjected to. Our proposition is that the behavior of the inner bark diameter variation which cannot be explained by changes in xylem water status arise from changes in the osmotic concentration of the phloem and cambial growth. Materials and methods Simultaneous xylem and stem diameter measurements were conducted between June 28th to October 4th 2006 in Southern Finland on a 47-year old, 15 meter tall, Scots pine tree (DBH 15 cm) at heights of 1.5 and 10 meters. The difference between the measured inner bark diameter and the inner bark diameter predicted from xylem diameter change with a simple model (assuming there was no change in the osmotic concentration of the phloem) is hypothesized to give the changes in the osmotic concentration of the inner bark. The simple model calculates the radial water exchange between the xylem and phloem driven by the water potential changes in the xylem. Results and Discussion The major signal in the inner bark diameter was the transpiration rate as assumed, but also a signal arising from the change in the osmotic concentration (Fig 1a). The predicted osmotic concentration of the phloem typically increased during the afternoon due to the loading of photosynthesized sugars to the phloem. Inner bark osmotic concentration followed the photosynthesis rate with a 3 and 4 hour time-lag at the top and base, respectively (Fig 1b). The connection between photosynthesis and the predicted change in phloem osmotic concentration was stronger in the upper part of the tree compared to lower part. The changes in the predicted osmotic concentration were not similar every day, indicating that

  10. Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients.

    PubMed

    Hyun, Seung-Jae; Kim, Yongjung J; Rhim, Seung-Chul

    2013-11-16

    In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The long-term overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided.

  11. Congenital muscular torticollis concurrent with sagittal synostosis: a case report.

    PubMed

    Kim, Seung-Hyun; Ahn, Ah-Reum; Yim, Shin-Young

    2014-10-01

    Congenital muscular torticollis (CMT) and craniosynostosis are diseases that cause plagiocephaly and craniofacial asymmetry in children. In our literature review, we did not find any report of concurrent manifestation of CMT and craniosynostosis. A 41-month-old boy visited our hospital with left torticollis, right laterocollis, and craniofacial asymmetry as the main findings. During clinical examination, prominent right sternocleidomastoid muscle and limited range of motion of the neck were noted, and right CMT was confirmed by magnetic resonance imaging of the neck. Three-dimensional computed tomography of the skull, which was conducted due to the unusual appearance of the skull with a large head circumference, mild brachycephaly, as well as left plagiocephaly, revealed premature closure of the sagittal suture. Thus, we report the first case that showed concurrence of CMT and sagittal synostosis. We recommend that concurrently manifested craniosynostosis needs to be examined if the subject with CMT displays unusual craniofacial asymmetry to a greater extent than deformational plagiocephaly.

  12. Force-Induced Craniosynostosis in the Murine Sagittal Suture

    PubMed Central

    Oppenheimer, Adam J.; Rhee, Samuel T.; Goldstein, Steven A.; Buchman, Steven R.

    2010-01-01

    BACKGROUND The etiology of non-syndromic craniosynostosis remains elusive. While compressive forces have been implicated in premature suture fusion, conclusive evidence of force-induced craniosynostosis is lacking. The purpose of this study was to determine if cyclical loading of the murine calvarium could induce suture fusion. METHODS Calvarial coupons from post-natal day 21, B6CBA wild-type mice (n = 18) were harvested and cultured. A custom appliance capable of delivering controlled, cyclical, compressive loads was applied perpendicular to the sagittal suture within the coupon in vitro. Nine coupons were subjected to 0.3g of force for 30 minutes each day for a total of 14 days. A control group of nine coupons was clamped in the appliance without loading. Analysis of suture phenotype was performed using alkaline phosphatase and H&E staining techniques, as well as in situ hybridization analysis using Bone Sialoprotein (BSP). RESULTS Control group sagittal sutures—which normally remain patent in mice—showed their customary histological appearance. In contradistinction, sagittal sutures subjected to cyclic loading showed histological evidence of premature fusion (craniosynostosis). In addition, alkaline phosphatase activity and BSP expression was observed to be increased in the experimental group when compared to matched controls. CONCLUSIONS An in vitro model of forced-induced craniosynostosis has been devised. Premature fusion of the murine sagittal suture was induced with the application of controlled, cyclical, compressive loads. These results implicate abnormal forces in the development of non-syndromic craniosynostosis, which supports our global hypothesis that epigenetic phenomena have a crucial role in the pathogenesis of craniosynostosis. PMID:19952640

  13. Abdominal cerebrospinal fluid pseudocysts.

    PubMed

    Erşahin, Y; Mutluer, S; Tekeli, G

    1996-12-01

    Abdominal cerebrospinal fluid pseudocyst in an infrequent complication of ventriculoperitoneal (VP) shunts. We reviewed ten patients with abdominal pseudocyst. There were five girls and five boys, aged between 4 months and 14 years. The number of shunt procedures prior to the presentation varied between one and five. Only one patient had had a previous shunt infection. No patients had undergone prior abdominal surgery other than VP shunting. The time from the last shunting procedure to the development of abdominal pseudocyst ranged from 3 weeks to 5 years. Presenting symptoms and signs were mainly related to abdominal complaints in all patients. Three patients also had signs of shunt malfunction. The diagnosis was made by ultrasound in all patients. Shunt infection was determined in six patients. Repositioning if the peritoneal catheter seemed to have a higher rate of recurrence. The diagnosis of abdominal pseudocyst should be considered in VP-shunted patients presenting with abdominal complaints.

  14. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  15. Fetal weight estimation by ultrasonic measurement of abdominal circumference.

    PubMed

    Kearney, K; Vigneron, N; Frischman, P; Johnson, J W

    1978-02-01

    The purpose of this study was to compare ultrasonic measurements of fetal abdominal circumference to ultrasonic measurements of fetal biparietal diameter, as a means of estimating fetal body weight. Of 58 fetuses who had abdominal circumferences measured, 48 (82%) of the predicted weights were within 15% of the actual birth weights. Forty-four of the same 58 fetuses had satisfactory biparietal diameter measurements, but only 21 (48%) of the predicted weights were within 15% of the actual birthweights. Ultrasonic measurement of abdominal circumference appears to be a more reliable index of fetal body weight than other currently available techniques.

  16. Sagittal back contour and craniofacial morphology in preadolescents

    PubMed Central

    Lippold, Carsten; Végh, András; Drerup, Burkhard; Moiseenko, Tatjana; Danesh, Gholamreza

    2009-01-01

    The aim of this study was to analyze the correlation ratios between the sagittal back contour (flèche cervicale and lombaire, trunk inclination) and selected parameters of craniofacial morphology in children. The patient sample consisted of 66 healthy children with a mean age of 11.2 years (SD 1.6 years), of which 34 were male (mean age 11.5 years, SD 1.3 years) and 32 were females (mean age 10.9 years, SD 1.9 years). The children were recruited during the preparation of the initial orthodontic treatment records. Craniofacial morphology was analyzed by six angular measurements: facial axis, mandibular plane angle, inner gonial angle, lower facial height, facial depth and maxilla position. Rasterstereography was used for reconstruction of the spinal back sagittal profile. From the profile flèche cervicale, flèche lombaire and trunk inclination were determined and the correlations with the craniofacial morphology were calculated (Pearson and Mann–Whitney U test). Significant correlations were found with respect to the inner gonial angle and the flèche cervicale, the mandibular plane angle and the flèche lombaire, the inner gonial angle and the flèche lombaire, and the angular lower facial height and the flèche lombaire, as well as the inner gonial angle and the trunk inclination. The craniofacial vertical growth pattern, presented by mandibular plane angle, inner gonial angle and the angular lower facial height, and the correlation to flèche cervicale and lombaire as well as trunk inclination reveal correlations between growth pattern and sagittal back contour. PMID:19946733

  17. Bilambdoid and posterior sagittal synostosis: the Mercedes Benz syndrome.

    PubMed

    Moore, M H; Abbott, A H; Netherway, D J; Menard, R; Hanieh, A

    1998-09-01

    A consistent pattern of craniosynostosis in the sagittal and bilateral lambdoid sutures is described in three patients. The external cranial ridging associated with fusion of these sutures produces a characteristic triradiate, or "Mercedes Benz," appearance to the posterior skull. Locally marked growth restriction is evident in the posterior fossa with compensatory secondary expansion of the anterior fossa manifesting a degree of frontal bossing which mimics bicoronal synostosis. Although this appearance could lead to inadvertent surgery in the frontal region, attention to the occipital region with wide early suture excision and vault shaping is indicated.

  18. Rondeau Seminars amalgamated mid-sagittal (lateral) cephalometric analysis.

    PubMed

    Palencar, Adrian J

    2014-01-01

    The author presents a comprehensive International Association for Orthodontics--Rondeau Seminars Amalgamated Mid-sagittal (Lateral) Cephalometric Analysis. Norms on the Cephalometric Data Sheet are age and gender specific for the Caucasian population and the postings are color coded for visual attraction. If the patient is ofa different ethnic group, the Norms should be adjusted accordingly. This Cephalometric Analysis is comprised often Sections, in alphabetical order and twenty nine Factors. The author expanded Rondeau Seminars Cephalometric Analysis by only six Factors, thus fulfilling the requirement for the case presentation for the Fellow of the IAO and the Diplomate ofthe IBO.

  19. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    PubMed

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months.

  20. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    PubMed

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months. PMID:23891013

  1. Automatic recognition of corpus callosum from sagittal brain MR images

    NASA Astrophysics Data System (ADS)

    Lee, Chulhee; Unser, Michael A.; Ketter, Terence A.

    1995-08-01

    We propose a new method to find the corpus callosum from sagittal brain MR images automatically. First, we calculate the statistical characteristics of the corpus callosum and obtain shape information. The recognition algorithm consists of two stages: extracting regions satisfying the statistical characteristics (gray level distribtuions) of the corpus callosum, and finding a region matching the shape information. An innovative feature of the algorithm is that we adaptively relax the statistical requirement until we find a region matching the shape information. In order to match the shape information, we propose a new directed window region growing algorithm instead of using conventional contour matching. Experiments show promising results.

  2. Bilambdoid and posterior sagittal synostosis: the Mercedes Benz syndrome.

    PubMed

    Moore, M H; Abbott, A H; Netherway, D J; Menard, R; Hanieh, A

    1998-09-01

    A consistent pattern of craniosynostosis in the sagittal and bilateral lambdoid sutures is described in three patients. The external cranial ridging associated with fusion of these sutures produces a characteristic triradiate, or "Mercedes Benz," appearance to the posterior skull. Locally marked growth restriction is evident in the posterior fossa with compensatory secondary expansion of the anterior fossa manifesting a degree of frontal bossing which mimics bicoronal synostosis. Although this appearance could lead to inadvertent surgery in the frontal region, attention to the occipital region with wide early suture excision and vault shaping is indicated. PMID:9780908

  3. Sagittal Spinal Morphology in Highly Trained Adolescent Tennis Players

    PubMed Central

    Muyor, José M.; Sánchez-Sánchez, Estefanía; Sanz-Rivas, David; López-Miñarro, Pedro A.

    2013-01-01

    Sports with a predominance of forward-bending and extension postures have been associated with alterations in the sagittal spinal curvatures and greater risk of spinal injury. Because, the tennis players adopt these postures, the aims of this study were: 1) to describe spinal curvatures and pelvic tilt in male and female highly trained adolescent tennis players during relaxed standing posture and with thoracic spine corrected (in prone lying on the floor); and 2) to determine the frequency of thoracic hyperkyphosis and lumbar hypo/hyper lordosis in these postures. Forty adolescent tennis players (24 male and 16 female) aged 13-18 years, participated voluntarily in this study. The Spinal Mouse system was used to measure sagittal spinal curvatures and pelvic tilt. The mean values in the relaxed standing posture were 43.83° ± 7.87° (thoracic kyphosis), - 27.58° ± 7.01° (lumbar lordosis), and 13.38° ± 5.57° (pelvic tilt) for male tennis players, respectively; and 36.13° ± 6.69° (thoracic kyphosis), - 32.69° ± 5.06° (lumbar lordosis), 20.94° ± 5.36° (pelvic tilt) for female tennis players (p < 0.05 between genders in all spinal parameters). The male and female tennis players showed a frequency of 62.5% and 93.8% (p = 0.032) for neutral thoracic kyphosis, and 83.3% and 93.8% (p = 0.062) in neutral lumbar lordosis, respectively. In conclusion, due to the high percentage of neutral spinal curvatures in both male and female tennis players, to practice tennis in these levels does not alter sagittal spinal morphology in the relaxed standing posture in adolescent highly trained tennis players. Key Points This study evaluated thoracic and lumbar spinal curvatures and pelvic tilt during several postures in young highly trained tennis players. Female tennis players showed statistically significant greater anterior pelvic tilt, lumbar lordosis and lower thoracic kyphosis than male tennis players. The high percentage of neutral thoracic kyphosis and lumbar

  4. Modification of sagittal split ramus osteotomy to avoid unfavorable fracture around impacted third molars.

    PubMed

    Marquez, I M; Stella, J P

    1998-01-01

    The dental literature recognizes that performing sagittal ramus osteotomy when impacted third molars are present significantly increases the risk of unfavorable fractures of both the proximal and distal segments. Many articles have described how to repair unfavorable fractures of sagittal split segments, but few to date specifically address how to modify the osteotomy design to reduce the potential for unfavorable fractures. Moreover, techniques for removal of impacted third molars after the completion of a sagittal split ramus osteotomy have received little attention in the literature, yet it is obviously a common occurrence. This paper describes a modification of the sagittal split ramus osteotomy when a fully formed impacted third molar is present at the time of the sagittal ramus osteotomy. A technique is also described for removing the impacted third molar after the sagittal split is completed. Clinical experience has demonstrated these techniques to have several advantages.

  5. [Sagittal Balance of the Spine--Clinical Importance and Radiographic Assessment].

    PubMed

    Decker, S; Müller, C W; Omar, M; Krettek, C; Schwab, F; Trobisch, P D

    2016-04-01

    Sagittal deformities of the spine frequently result in back pain, as patients have to expend much energy in compensation. The sagittal alignment of the spine is defined by its curvatures (lordosis and kyphosis) relative to the position of the pelvis. Diagnostic assessment is based on full spine a. p. and lateral X-rays. The sagittal balance is primarily described by different angles that can be measured, e.g. lumbar lordosis, pelvic incidence, pelvic tilt and thoracic kyphosis. The quality of life can best be estimated by subtracting lumbar lordosis from the pelvic incidence. However, initial evaluation of the sagittal balance can also be based on the sagittal vertical axis. The severity of imbalance can be described by the sagittal vertical axis and the pelvic tilt, but surgical therapy necessitates a more profound analysis, which can be based on the SRS-Schwab classification.

  6. Distribution of sagittal occlusal relationships in different stages of dentition.

    PubMed

    Emine, Kaygisiz; Lale, Taner; Kahraman, Gungor

    2015-01-01

    The aim of this study was to assess the distribution of sagittal occlusal relationships in different dentition periods in a Turkish sample group. In total, 1,110 patients (561 females, 549 males) aged 4.6-23 years were randomly chosen after intraoral clinical examination. The subjects were classified according to their sagittal occlusal relationships and four dentition stages -deciduous, early mixed, late mixed, and permanent dentition. The statistical significance of the occurrence of malocclusion types in dentition stages was evaluated by Chi-square and Fischer's exact tests. Class I malocclusion was observed at the highest rate in all dentition stages. Class III malocclusion was observed at the highest rate in the permanent dentition, whereas Class II malocclusion was observed at the highest rate in the late mixed dentition. The rates of Class I, II, and III malocclusions were similar in males and females. Our study reveals that the prevalence of malocclusion and need for orthodontic treatment has increased in the population towards the permanent dentition.

  7. [Abdominal compartment syndrome].

    PubMed

    Pottecher, T; Segura, P; Launoy, A

    2001-04-01

    French physicians dealing with abdominal emergencies are not very familiar with the abdominal compartment syndrome (ACS). Increased abdominal pressure has deleterious consequences on local (intestine, liver, kidney) circulation, leading to death in the absence of correct treatment. Abdominal trauma and ruptured aortic aneurism are the main causes of ACS. Clinical presentation may be misleading: respiratory failure, oliguria or circulatory symptoms are often predominant. Abdominal palpation is inefficient for evaluating intra-abdominal pressure (IAP); only measurement of cystic pressure allows precise evaluation of IAP. Abdominal decompression is the treatment of choice. It must be performed as soon as IAP exceeds 25 mmHg. The procedure may be risky with a high incidence of severe complications when ischaemic territories are reperfused. Recent data underline the importance of compensation of hypovolemia before decompression. Abdominal closure may necessitate various techniques (aponevrotomy, Bogota bags, etc.). At any rate, IAP must remain low at the end of the procedure. In case of suspicion of ACS, early measurement of IAP is mandatory. If pressure is over 25 mmHg, a decompressive procedure must be initiated. PMID:11340703

  8. [Semeiotics of abdominal tuberculosis].

    PubMed

    Guseĭnov, G K; Ramazanova, A M; Guseĭnov, A G

    1984-01-01

    Examination of 119 patients with abdominal tuberculosis permitted the description of the characteristic semiotics of the illness. Today the patients with abdominal tuberculosis are mainly women of child-bearing age with a long-term tuberculosis catamnesis and intoxication, with a history of tuberculosis of different sites, those suffering from tuberculosis or its sequels at present (64%), those with pains (94%), discomfort or swelling of the abdomen (79%), malfunction of the gastrointestinal tract (65%), weight loss (86%), malnutrition (72%), anemia (63%), not infrequently with inflammatory induration (43%) or ascites in the abdominal cavity (39%). In addition to this characteristic semiotics, the patients with abdominal tuberculosis may demonstrate the most different and unexpected symptoms up to acute abdomen (23%). To make differential diagnosis of abdominal tuberculosis, one has often to resort to diagnostic laparotomy, laparoscopy, Koch's test and to trial therapy.

  9. Double diameter boring tool

    DOEpatents

    Ashbaugh, Fred N.; Murry, Kenneth R.

    1988-12-27

    A boring tool and a method of operation are provided for boring two concentric holes of precision diameters and depths in a single operation. The boring tool includes an elongated tool body, a shank for attachment to a standard adjustable boring head which is used on a manual or numerical control milling machine and first and second diametrically opposed cutting edges formed for cutting in opposite directions. The diameter of the elongated tool body is substantially equal to the distance from the first cutting edge tip to the axis of rotation plus the distance from the second cutting edge tip to the axis of rotation. The axis of rotation of the tool is spaced from the tool centerline a distance substantially equal to one-half the distance from the second cutting edge tip to the axis of rotation minus one-half the distance from the first cutting edge tip to the axis of rotation. The method includes the step of inserting the boring tool into the boring head, adjusting the distance between the tool centerline and the tool axis of rotation as described above and boring the two concentric holes.

  10. Double diameter boring tool

    DOEpatents

    Ashbaugh, F.A.; Murry, K.R.

    1986-02-10

    A boring tool and a method of operation are provided for boring two concentric holes of precision diameters and depths in a single operation. The boring tool includes an elongated tool body, a shank for attachment to a standard adjustable boring head which is used on a manual or numerical control milling machine and first and second diametrically opposed cutting flutes formed for cutting in opposite directions. The diameter of the elongated tool body is substantially equal to the distance from the first flute tip to the axis of rotation plus the distance from the second flute tip to the axis of rotation. The axis of rotation of the tool is spaced from the tool centerline a distance substantially equal to one-half the distance from the second flute tip to the axis of rotation minus one-half the distance from the first flute tip to the axis of rotation. The method includes the step of inserting the boring tool into the boring head, adjusting the distance between the tool centerline and the tool axis of rotation as described above and boring the two concentric holes.

  11. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  12. Surrogate Markers of Abdominal Aortic Aneurysm Progression.

    PubMed

    Wanhainen, Anders; Mani, Kevin; Golledge, Jonathan

    2016-02-01

    The natural course of many abdominal aortic aneurysms (AAA) is to gradually expand and eventually rupture and monitoring the disease progression is essential to their management. In this publication, we review surrogate markers of AAA progression. AAA diameter remains the most widely used and important marker of AAA growth. Standardized reporting of reproducible methods of measuring AAA diameter is essential. Newer imaging assessments, such as volume measurements, biomechanical analyses, and functional and molecular imaging, as well as circulating biomarkers, have potential to add important information about AAA progression. Currently, however, there is insufficient evidence to recommend their routine use in clinical practice. PMID:26715680

  13. Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy.

    PubMed

    Cansiz, Erol; Isler, Sabri Cemil; Gultekin, B Alper

    2016-01-01

    Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth.

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

    PubMed

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

    2016-02-01

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

  15. [Mandibular advancement: bilateral sagittal split versus -distraction osteogenesis].

    PubMed

    Akkerman, V; Ho, J P; Baas, E M; de Lange, J de

    2015-11-01

    In the 1990s intra-oral distraction osteogenesis (DO) became available as an alternative for bilateral sagittal splitosteotomy (BSSO) for advancement of the mandible. It was thought that DO would lead to more stability in the results and fewer neurosensory disturbances of the inferior alveolar nerve. However, there was no scientific evidence for this assumption. This article describes a number of recently published, prospective studies that demonstrate that BSSO is not inferior to DO with respect to stability and neurosensory disturbances of the inferior alveolar nerve. They also demonstrate that BSSO leads to less pain in patients and to lower total costs. It can be concluded that BSSO should be considered the standard therapy for mandibular advancement up to 10 mm in non-syndromal patients. PMID:26569001

  16. [The 3D printed drilling template for bilateral sagittal osteotomy].

    PubMed

    Wes, J T; Houppermans, P N W J; Verweij, J P; Mensink, G; Liberton, N; van Merkesteyn, J P R

    2016-09-01

    The bilateral sagittal osteotomy (BSSO) is a widely used surgical technique within orthognatic surgery. The specific osteotomy design may vary from clinic to clinic. The best position of the bone cuts in a BSSO continues to be a point of discussion and probably differs from patient to patient. In addition, standardisation in, for example, research may be desirable. Pre-operative planning using a drilling template in order to position the planned individual saw cuts during BSSO can be of value. To achieve this goal, a pre-operative 3D printed biocompatible drilling template was manufactured for 1 patient on the basis of pre-operative planning. The difference between the pre-operatively determined bone cuts with the assistance of the drilling template and the actual bone cuts was still large. PMID:27643492

  17. Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy

    PubMed Central

    Isler, Sabri Cemil

    2016-01-01

    Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth. PMID:27429810

  18. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot

    PubMed Central

    Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  19. Laparoscopic Bullet Removal in a Penetrating Abdominal Gunshot.

    PubMed

    Stefanou, Christos; Zikos, Nicolaos; Pappas-Gogos, George; Koulas, Spyridon; Tsimoyiannis, Ioannis

    2016-01-01

    Penetrating abdominal trauma has been traditionally treated by exploratory laparotomy. Nowadays laparoscopy has become an accepted practice in hemodynamically stable patient without signs of peritonitis. We report a case of a lower anterior abdominal gunshot patient treated laparoscopically. A 32-year-old male presented to the Emergency Department with complaint of gunshot penetrating injury at left lower anterior abdominal wall. The patient had no symptoms or obvious bleeding and was vitally stable. On examination we identified 1 cm diameter entry wound at the left lower abdominal wall. The imaging studies showed the bullet in the peritoneal cavity but no injured intraperitoneal and retroperitoneal viscera. We decided to remove the bullet laparoscopically. Twenty-four hours after the intervention the patient was discharged. The decision for managing gunshot patients should be based on clinical and diagnostic findings. Anterior abdominal injuries in a stable patient without other health problems can be managed laparoscopically. PMID:27525150

  20. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  1. Small diameter carbon nanopipettes

    NASA Astrophysics Data System (ADS)

    Singhal, Riju; Bhattacharyya, Sayan; Orynbayeva, Zulfiya; Vitol, Elina; Friedman, Gary; Gogotsi, Yury

    2010-01-01

    Nanoscale multifunctional carbon probes facilitate cellular studies due to their small size, which makes it possible to interrogate organelles within living cells in a minimally invasive fashion. However, connecting nanotubes to macroscopic devices and constructing an integrated system for the purpose of fluid and electrical signal transfer is challenging, as is often the case with nanoscale components. We describe a non-catalytic chemical vapor deposition based method for batch fabrication of integrated multifunctional carbon nanopipettes (CNPs) with tip diameters much smaller (10-30 nm) than previously reported (200 nm and above) and approaching those observed for multiwalled carbon nanotubes. This eliminates the need for complicated attachment/assembly of nanotubes into nanofluidic devices. Variable tip geometries and structures were obtained by controlled deposition of carbon inside and outside quartz pipettes. We have shown that the capillary length and gas flow rate have a marked effect on the carbon deposition. This gives us a flexible protocol, useful for growing carbon layers of different thicknesses at selective locations on a glass pipette to yield a large variety of cellular probes in bulk quantities. The CNPs possess an open channel for fluid transfer with the carbon deposited inside at 875 °C behaving like an amorphous semiconductor. Vacuum annealing of the CNP tips at temperatures up to 2000 °C yields graphitic carbon structures with an increase in conductivity of two orders of magnitude. Penetration of the integrated carbon nanoprobes into cells was shown to produce minimal Ca2+ signals, fast recovery of basal Ca2+ levels and no adverse activation of the cellular metabolism during interrogation times as long as 0.5-1 h.

  2. Association between CYP19A1 genotype and pubertal sagittal jaw growth

    PubMed Central

    He, Shushu; Hartsfield, James K.; Guo, Yujiao; Cao, Yang; Wang, Si; Chen, Song

    2016-01-01

    Introduction Sagittal jaw growth is influenced during puberty by a ratio of androgens and estrogens. The CYP19A1 (formerly CYP19) gene encodes the cytochrome P450 enzyme aromatase (estrogen synthetase), which converts testosterone to estrogen. Genetic variations including single nucleotide polymorphisms might regulate CYP19A1 gene expression or the function of the aromatase protein and thus influence sagittal jaw growth. Methods The annual sagittal jaw growth in 92 pubertal orthodontic patients was determined by using pretreatment and posttreatment cephalometric radiographs. Single nucleotide polymorphisms rs2470144 and rs2445761 were genotyped and haplotypes constructed. Associations between genotypes or haplotypes and the annual sagittal growth were estimated by using JMP (version 9.0; SAS Institute, Cary, NC). Results Two single nucleotide polymorphisms were significantly associated with average differences in annual sagittal jaw growth in boys. Haplotype analysis demonstrated that haplotypes Trs2470144Trs2445761 and Crs2470144Trs2445761 had significant effects on annual sagittal maxillary growth and on mandibular growth in boys. No association was found in girls. Conclusions A quantitative trait locus that influences male pubertal sagittal jaw growth might exist in the CYP19A1 gene, and single nucleotide polymorphisms rs2470144 and rs2445761 might be inside this quantitative trait locus or be linked to it. PMID:23116507

  3. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  4. New insights into the relationship between suture closure and craniofacial dysmorphology in sagittal nonsyndromic craniosynostosis

    PubMed Central

    Heuzé, Yann; Boyadjiev, Simeon A; Marsh, Jeffrey L; Kane, Alex A; Cherkez, Elijah; Boggan, James E; Richtsmeier, Joan T

    2010-01-01

    Premature closure of the sagittal suture occurs as an isolated (nonsyndromic) birth defect or as a syndromic anomaly in combination with other congenital dysmorphologies. The genetic causes of sagittal nonsyndromic craniosynostosis (NSC) remain unknown. Although variation of the dysmorphic (scaphocephaly) skull shape of sagittal NSC cases has been acknowledged, this variation has not been quantitatively studied three-dimensionally (3D). We have analyzed the computed tomography skull images of 43 infants (aged 0.9–9 months) with sagittal NSC using anatomical landmarks and semilandmarks to quantify and characterize the within-sample phenotypic variation. Suture closure patterns were defined by dividing the sagittal suture into three sections (anterior, central, posterior) and coding each section as ‘closed’ or ‘fused’. Principal components analysis of the Procrustes shape coordinates representing the skull shape of 43 cases of NSC did not separate individuals by sex, chronological age, or dental stages of the deciduous maxillary first molar. However, analysis of suture closure pattern allowed separation of these data. The central section of the sagittal suture appears to be the first to fuse. Then, at least two different developmental paths towards complete fusion of the sagittal suture exist; either the anterior section or the posterior section is the second to fuse. Results indicate that according to the sequence of sagittal suture closure patterns, different craniofacial complex shapes are observed. The relationship between craniofacial shape and suture closure indicates not only which suture fused prematurely (in our case the sagittal suture), but also the pattern of the suture closure. Whether these patterns indicate differences in etiology cannot be determined with our data and requires analysis of longitudinal data, most appropriately of animal models where prenatal conditions can be monitored. PMID:20572900

  5. The DIAMET campaign

    NASA Astrophysics Data System (ADS)

    Vaughan, G.

    2012-04-01

    DIAMET (DIAbatic influences on Mesoscale structures in ExTratropical storms) is a joint project between the UK academic community and the Met Office. Its focus is on understanding and predicting mesoscale structures in synoptic-scale storms, and in particular on the role of diabatic processes in generating and maintaining them. Such structures include fronts, rain bands, secondary cyclones, sting jets etc, and are important because much of the extreme weather we experience (e.g. strong winds, heavy rain) comes from such regions. The project conducted two field campaigns in the autumn of 2011, from September 14 - 30 and November 24 - December 14, based around the FAAM BAe146 aircraft with support from ground-based radar and radiosonde measurements. Detailed modelling, mainly using the Met Office Unified model, supported the planning and interpretation of these campaigns. This presentation will give a brief overview of the campaigns. Both in September and November-December the weather regime was westerly, with a strong jet stream directed across the Atlantic. Three IOPs were conducted in September, to observe a convective band ahead of an upper-level trough, waves on a long trailing cold front, and a warm conveyor belt associated with a secondary cyclone. In November-December six IOPs were conducted, to observe frontal passages and high winds. This period was notable for a number of very strong windstorms passing across the north of the UK, and gave us an opportunity to examine bent-back warm fronts in the southern quadrant of these storms where the strongest winds are found. The case studies fell into two basic patterns. In the majority of cases, dropsonde legs at high level were used to obtain a cross-section of winds and thermodynamic structure (e.g. across a front), followed by in situ legs at lower levels (generally where the temperature was between 0 and -10°) to examine microphysical processes, especially ice multiplication and the extent of supercooled water

  6. Reconstruction of small diameter arteries using decellularized vascular scaffolds.

    PubMed

    Nagaoka, Yuki; Yamada, Hiroshi; Kimura, Tsuyoshi; Kishida, Akio; Fujisato, Toshia; Takakuda, Kazuo

    2014-03-19

    Although artificial vessels are available for large diameter arteries, there are no artificial vessels for small diameter arteries of < 4 mm. We created a decellularized vascular scaffold (length, 10 mm; outer diameter, 1.5 mm; inner diameter, 1.3 mm) from rat abdominal arteries. We measured the biomechanical characteristics of the scaffolds, implanted them to defects made in rat carotid arteries, and evaluated their patency and the endothelial cell linings. Silastic grafts were implanted as controls. The decellularized scaffolds demonstrated similar mechanical characteristics to normal arteries. All of the control grafts were occluded. Fibroblast-like cells were discovered in the thrombus, and fibrous organization was apparent. In contrast, patency of the grafts in 10 of 12 animals was observed 4 weeks after implantation. The internal cavity of the patent scaffold was completely lined by endotheliallike cells. Thus, the possibility of small artery reconstruction using decellularized scaffolds was demonstrated.

  7. Importance of sagittal kick symmetry for underwater dolphin kick performance.

    PubMed

    Atkison, Ryan R; Dickey, James P; Dragunas, Andrew; Nolte, Volker

    2014-02-01

    The purpose of this study was to determine how sagittal kick symmetry in the underwater dolphin kick (UDK) between the downkick and upkick phases is related to UDK performance. Fifteen adult male competitive swimmers ranging from provincial to international level were filmed performing three trials each of maximum effort UDK over 15m using an underwater video camera. Video frames were manually digitized and each subjects' single fastest trial was evaluated for between-subject comparisons. Kinematic variables were calculated for each individual and Pearson product-moment correlations between the average horizontal centre of mass velocity (Vx) and all kinematic variables were calculated. Horizontal velocity during the downkick, horizontal velocity during the upkick, relative time spent in each phase, maximum chest flexion angle, maximum knee and ankle extension angles, the ratio of flexion/extension for chest, knee and ankle angles, and maximum vertical toe velocity during the upkick phase correlated significantly with Vx (p<0.05). The ratio of downkick vertical toe velocity/upkick vertical toe velocity was significantly negatively correlated with Vx (p<0.05). These results indicate the importance of kick symmetry for UDK performance, and indicate that performing the upkick phase well appears to be most important for UDK performance.

  8. [Abdominal actinomycosis: four cases].

    PubMed

    Ghannouchi Jaafoura, N; Kaabia, N; Khalifa, M; Ben Jazia, I; Hachfi, W; Braham, A; Letaief, A; Bahri, F

    2008-12-01

    The abdominal actinomycosis (AA) is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic Gram positive bacteria, Actinomyces israelii. Abdominal actinomycosis is responsible for pseudotumoral syndrome often leading, to a large and mutilating surgery whereas a prolonged treatment by antibiotics would have permitted to cure the disease. The diagnosis is obtained generally from anatomopathologic exam. We report four cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis was only made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had a relapse of the infectious process. These four observations confirm the diagnostic and therapeutic difficulties previously reported by other authors.

  9. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  10. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  11. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  12. Wheel Diameter and Speedometer Reading

    ERIC Educational Resources Information Center

    Murray, Clifton

    2010-01-01

    Most introductory physics students have seen vehicles with nonstandard wheel diameters; some may themselves drive "low-rider" cars or "big-wheel" pickup trucks. But how does changing wheel diameter affect speedometer readout for a given speed? Deriving the answer can be followed readily by students who have been introduced to rotation, and it…

  13. Normalization of brain morphology after surgery in sagittal craniosynostosis.

    PubMed

    Brooks, Eric D; Yang, Jenny; Beckett, Joel S; Lacadie, Cheryl; Scheinost, Dustin; Persing, Sarah; Zellner, Elizabeth G; Oosting, Devon; Keifer, Cara; Friedman, Hannah E; Wyk, Brent Vander; Jou, Roger J; Sun, Haosi; Gary, Cyril; Duncan, Charles C; Constable, R Todd; Pelphrey, Kevin A; Persing, John A

    2016-04-01

    OBJECT Nonsyndromic craniosynostosis (NSC) is associated with significant learning disability later in life. Surgical reconstruction is typically performed before 1 year of age to correct the cranial vault morphology and to allow for normalized brain growth with the goal of improving cognitive function. Yet, no studies have assessed to what extent normalized brain growth is actually achieved. Recent advances in MRI have allowed for automated methods of objectively assessing subtle and pronounced brain morphological differences. The authors used one such technique, deformation-based morphometry (DBM) Jacobian mapping, to determine how previously treated adolescents with sagittal NSC (sNSC) significantly differ in brain anatomy compared with healthy matched controls up to 11.5 years after surgery. METHODS Eight adolescent patients with sNSC, previously treated via whole-vault cranioplasty at a mean age of 7 months, and 8 age- and IQ-matched control subjects without craniosynostosis (mean age for both groups = 12.3 years), underwent functional 3-T MRI. Statistically significant group tissue-volume differences were assessed using DBM, a whole-brain technique that estimates morphological differences between 2 groups at each voxel (p < 0.01). Group-wise Jacobian volume maps were generated using a spacing of 1.5 mm and a resolution of 1.05 × 1.05 × 1.05 mm(3). RESULTS There were no significant areas of volume reduction or expansion in any brain areas in adolescents with sNSC compared with controls at a significance level of p < 0.01. At the more liberal threshold of p < 0.05, two areas of brain expansion extending anteroposteriorly in the right temporooccipital and left frontoparietal regions appeared in patients with sNSC compared with controls. CONCLUSIONS Compared with previous reports on untreated infants with sNSC, adolescents with sNSC in this cohort had few areas of brain dysmorphology many years after surgery. This result suggests that comprehensive cranioplasty

  14. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  15. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  16. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  17. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  18. Stellar diameters and temperatures. IV. Predicting stellar angular diameters

    SciTech Connect

    Boyajian, Tabetha S.; Van Belle, Gerard; Von Braun, Kaspar

    2014-03-01

    The number of stellar angular diameter measurements has greatly increased over the past few years due to innovations and developments in the field of long baseline optical interferometry. We use a collection of high-precision angular diameter measurements for nearby, main-sequence stars to develop empirical relations that allow the prediction of stellar angular sizes as a function of observed photometric color. These relations are presented for a combination of 48 broadband color indices. We empirically show for the first time a dependence on metallicity of these relations using Johnson (B – V) and Sloan (g – r) colors. Our relations are capable of predicting diameters with a random error of less than 5% and represent the most robust and empirical determinations of stellar angular sizes to date.

  19. Bad splits in bilateral sagittal split osteotomy: systematic review of fracture patterns.

    PubMed

    Steenen, S A; Becking, A G

    2016-07-01

    An unfavourable and unanticipated pattern of the mandibular sagittal split osteotomy is generally referred to as a 'bad split'. Few restorative techniques to manage the situation have been described. In this article, a classification of reported bad split pattern types is proposed and appropriate salvage procedures to manage the different types of undesired fracture are presented. A systematic review was undertaken, yielding a total of 33 studies published between 1971 and 2015. These reported a total of 458 cases of bad splits among 19,527 sagittal ramus osteotomies in 10,271 patients. The total reported incidence of bad split was 2.3% of sagittal splits. The most frequently encountered were buccal plate fractures of the proximal segment (types 1A-F) and lingual fractures of the distal segment (types 2A and 2B). Coronoid fractures (type 3) and condylar neck fractures (type 4) have seldom been reported. The various types of bad split may require different salvage approaches.

  20. Design and testing of a new, simple continuous bent sagittally focusing monochromator

    SciTech Connect

    Kycia, S.; Inoue, K.; Shen, Q.

    1996-09-01

    A continuous bent sagittally focusing monochromator has been designed and built. The monochromator is compatible with the present single-point bender apparatus designed for polygonal (ribbed) triangular sagittally focusing monochromators. This monochromator implements a new design concept taking advantage of a tapered rectangular wafer to allow for sagittal bending while simultaneously minimizing anticlastic bending. The monochromator was optimized to operate at x-ray energies in the range of 5 to 25 keV. The design was derived from finite element analysis using ANSYS. The monochromator performance was tested by means of an apparatus implementing an x-ray tube source and a double-crystal configuration. This method yields precise contour maps of the entire monochromator surface. Details of the monochromator design, test apparatus, and corresponding results will be presented. {copyright} {ital 1996 American Institute of Physics.}

  1. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  2. Outcome and Efficacy of Height Gain and Sagittal Alignment after Kyphoplasty of Osteoporotic Vertebral Compression Fractures

    PubMed Central

    Lee, Tae-One; Jo, Dae-Jean

    2007-01-01

    Objective Although a significant correction of local kyphosis has been reported previously, only a few studies have investigated whether this correction leads to an improved overall sagittal alignment. The study objective was to determine whether an improvement in the local kyphotic angle improves the overall sagittal alignment. We examined and compared the effects of thoracic and lumbar level kyphoplasty procedures on local versus overall sagittal alignment of the spine. Methods Thirty-eight patients with osteoporotic vertebral compression fractures who showed poor response to conventional, palliative medical therapy underwent single-level kyphoplasty. The pertinent clinical data of these patients, from June 2006 to November 2006, were reviewed retrospectively. We measured preoperative and postoperative vertebral body heights, which were classified as anterior, middle, or posterior fractured vertebral body heights. Furthermore, the local and overall sagittal angles after polymethylmethacrylate deposition were measured. Results More height was gained at the thoracic level, and the middle vertebral height regained the most. A significant local kyphosis correction was observed at the fractured level, and the correction at larger spanning segments decreased with the distance from the fractured level. Conclusion The inflatable balloon kyphoplasty procedure was the most effective in regaining the height of the thoracic fractured vertebra in the middle vertebral body. The kyphosis correction by kyphoplasty was mainly achieved in the fractured vertebral body. Sagittal angular correction decreased with an increase in the distance from the fractured vertebra. No significant improvement was observed in the overall sagittal alignment after kyphoplasty. Further studies in a larger population are required to clarify this issue. PMID:19096555

  3. Correlation Between Dental Arch Width and Sagittal Dento-Skeletal Morphology in Untreated Adults

    PubMed Central

    Shahroudi, Atefe Saffar; Etezadi, Tahura

    2013-01-01

    Objective: Dental arch form is one of the most important characteristics of dentition. However, this dimension usually receives less attention in diagnosis or treatment planning and orthodontic patients are traditionally classified with regard to their sagittal characteristics. The objectives of this study were to investigate if a relationship exists between the dental arch width (transverse dimension) and sagittal skeletal and dental parameters in orthodontic patients. Materials and Methods: Dental casts and lateral cephalograms of 108 consecutive untreated Iranian patients (47 males and 61 females) between 16 and 31 years of age were evaluated. Arch width (AW) parameters including upper and lower inter-molar width (UIMW and LIMW) and upper and lower inter-canine width (UICW and LICW) were measured by a digital caliper. Sagittal parameters included SNA and SNB angle and Wits’ appraisal obtained from lateral cephalograms in addition to upper and lower arch length (UAL and LAL) obtained from dental casts. The correlation between the aforementioned parameters was evaluated applying Pearson correlation coefficients. Molar and canine relationship according to Angle’s classification was also recorded and the means of all parameters were compared between three occlusal relationship classes and two gender groups by means of two-way ANOVA. Results: According to statistical analysis a significant positive correlation between sagittal parameters and arch width measures exists between SNA and UICW and between LICW and LAL. Upper and lower ICW were significantly correlated, the relationship between upper and lower IMW and between UAL and LAL were significant. Among sagittal measures, both UAL and LAL were correlated with the ANB angle. The means of arch width parameters in three occlusal classes were not significantly different. Conclusion: The only significant correlation between arch width and sagittal parameters existed between UICW and SNA angle and between LICW and

  4. Effect of alignment changes on sagittal and coronal socket reaction moment interactions in transtibial prostheses.

    PubMed

    Kobayashi, Toshiki; Orendurff, Michael S; Zhang, Ming; Boone, David A

    2013-04-26

    Alignment is important for comfortable and stable gait of lower-limb prosthesis users. The magnitude of socket reaction moments in the multiple planes acting simultaneously upon the residual limb may be related to perception of comfort in individuals using prostheses through socket interface pressures. The aim of this study was to investigate the effect of prosthetic alignment changes on sagittal and coronal socket reaction moment interactions (moment-moment curves) and to characterize the curves in 11 individuals with transtibial amputation using novel moment-moment interaction parameters measured by plotting sagittal socket reaction moments versus coronal ones under various alignment conditions. A custom instrumented prosthesis alignment component was used to measure socket reaction moments during walking. Prosthetic alignment was tuned to a nominally aligned condition by a prosthetist, and from this position, angular (3° and 6° of flexion, extension, abduction or adduction of the socket) and translational (5mm and 10mm of anterior, posterior, medial or lateral translation of the socket) alignment changes were performed in either the sagittal or the coronal plane in a randomized manner. A total of 17 alignment conditions were tested. Coronal angulation and translation alignment changes demonstrated similar consistent changes in the moment-moment curves. Sagittal alignment changes demonstrated more complex changes compared to the coronal alignment changes. Effect of sagittal angulations and translations on the moment-moment curves was different during 2nd rocker (mid-stance) with extension malalignment appearing to cause medio-lateral instability. Presentation of coronal and sagittal socket reaction moment interactions may provide useful visual information for prosthetists to understand the biomechanical effects of malalignment of transtibial prostheses.

  5. A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging

    PubMed Central

    Randall, David; Fenner, John; Gillott, Richard; ten Broek, Richard; Strik, Chema; Spencer, Paul; Bardhan, Karna Dev

    2016-01-01

    Introduction. Abdominal adhesions can cause serious morbidity and complicate subsequent operations. Their diagnosis is often one of exclusion due to a lack of a reliable, non-invasive diagnostic technique. Development and testing of a candidate technique are described below. Method. During respiration, smooth visceral sliding motion occurs between the abdominal contents and the walls of the abdominal cavity. We describe a technique involving image segmentation and registration to calculate shear as an analogue for visceral slide based on the tracking of structures throughout the respiratory cycle. The presence of an adhesion is attributed to a resistance to visceral slide resulting in a discernible reduction in shear. The abdominal movement due to respiration is captured in sagittal dynamic MR images. Results. Clinical images were selected for analysis, including a patient with a surgically confirmed adhesion. Discernible reduction in shear was observed at the location of the adhesion while a consistent, gradually changing shear was observed in the healthy volunteers. Conclusion. The technique and its validation show encouraging results for adhesion detection but a larger study is now required to confirm its potential. PMID:26880884

  6. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  7. Volumetric analysis of abdominal aortic aneurysm

    NASA Astrophysics Data System (ADS)

    Baskin, Kevin M.; Kusnick, Catherine A.; Shamsolkottabi, Susanne; Lang, Elvira V.; Corson, J. D.; Stanford, William; Thompson, Brad H.; Hoffman, Eric A.

    1996-04-01

    The purpose of this study was to develop a valid, reliable and accurate system of measurement of abdominal aortic aneurysms, using volumetric analysis of x-ray computed tomographic data. This study evaluates illustrative cases, and compares measurements of AAA phantoms, using standard 2D versus volumetric methods. To validate the volumetric analysis, four phantom aneurysms were constructed in a range of diameters (4.5 - 7.0 cm) which presents the greatest management challenge to the clinician. These phantoms were imaged using a Toshiba Xpress SX helical CT. Separate scans were obtained at conventional (10 mm X 10 mm) and thin slice (5 mm X 5 mm) collimations. The thin slices were reconstructed at 2 mm intervals. Data from each of the 96 scans were interpreted using a standard 2D approach, then analyzed using task-oriented volumetric software. We evaluate patient assessments, and compare greatest outer diameters of phantoms, by standard versus volumetric methods. Qualitative differences between solutions based on standard versus volumetric analysis of illustrative patient cases are substantial. Expert radiologists' standard measurements of phantom aneurysms are highly reliable (r2 equals 0.901 - 0.958; p < 0.001), but biased toward significant overestimation of aneurysm diameters in the range of clinical interest. For the same phantoms, volumetric analysis was both more reliable (r2 equals 0.986 - 0.996; p < 0.001), and more accurate, with no significant bias in the range of interest. Volumetric analysis promotes selection of more valid management strategies, by providing vital information not otherwise available, and allowing more reliable and accurate assessment of abdominal aortic aneurysms. It is particularly valuable in the presence of aortic tortuosity, vessel eccentricity, and uncertain involvement of critical vessels.

  8. High voltage variable diameter insulator

    DOEpatents

    Vanacek, D.L.; Pike, C.D.

    1982-07-13

    A high voltage feedthrough assembly having a tubular insulator extending between the ground plane ring and the high voltage ring. The insulator is made of Pyrex and decreases in diameter from the ground plane ring to the high voltage ring, producing equipotential lines almost perpendicular to the wall of the insulator to optimize the voltage-holding capability of the feedthrough assembly.

  9. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  10. [The abdominal drop flap].

    PubMed

    Bodin, F; Liverneaux, P; Seigle-Murandi, F; Facca, S; Bruant-Rodier, C; Dissaux, C; Chaput, B

    2015-08-01

    The skin between the mastectomy scar and the future infra-mammary fold may be managed in different ways in delayed breast reconstruction using a DIEP (deep inferior epigastric perforator). Conserving this skin and positioning the flap skin paddle in the middle of the breast usually highlights skin color disparity because of two visible transition zones. Resection of the entire skin under the scar may be more aesthetic but limits direct closure possibility in case of flap failure. In order to benefit from both aesthetic result and safe surgical method, we propose the abdominal drop flap. The inferior thoracic skin flap is detached from the thoracic wall beyond the future infra-mammary fold, preserved and pushed under the breast.

  11. Skin movement errors in measurement of sagittal lumbar and hip angles in young and elderly subjects.

    PubMed

    Kuo, Yi-Liang; Tully, Elizabeth A; Galea, Mary P

    2008-02-01

    Errors in measurement of sagittal lumbar and hip angles due to skin movement on the pelvis and/or lateral thigh were measured in young (n = 21, age = 18.6 +/- 2.1 years) and older (n = 23, age = 70.9 +/- 6.4 years) age groups. Skin reference markers were attached over specific landmarks of healthy young and elderly subjects, who were videotaped in three static positions of hip flexion using the 2D PEAK Motus video analysis system. Sagittal lumbar and hip angles were calculated from skin reference markers and manually palpated landmarks. The elderly subjects demonstrated greater errors in lumbar angle due to skin movement on the pelvis only in the maximal hip flexion position. The traditional model (ASIS-PSIS-GT-LFE) underestimated sagittal hip angle and the revised model (ASIS-PSIS-2/3Th-1/4Th) provided more accurate measurement of sagittal hip angle throughout the full available range of hip flexion. Skin movement on the pelvis had a small counterbalancing effect on the larger errors from lateral thigh markers (GT-LFE), thereby decreasing hip angle error.

  12. Gravitational forces and sagittal shape of the spine. Clinical estimation of their relations.

    PubMed

    Legaye, J; Duval-Beaupere, G

    2008-12-01

    The sagittal morphology of the pelvis determines the amount of lordosis needed for each individual. The proper harmony of the sagittal spinal curves allows a stable balance, economical in terms of mechanical effects and muscular energy. A previous barycentremetrical laboratory study allowed us to demonstrate that the axis of gravity of the upper body segment was located behind the lumbar vertebrae and the femoral heads, thus ensuring economy and stability. The determination of the anatomical connection of the individual gravity is thus of primary importance for the evaluation of sagittal balance. Data for 42 patients without spinal pathology, previously evaluated by barycentremetry, were used to establish a predictive equation for the application point of the gravity at the level of the third lumbar vertebra (L3). This equation, using anthropometric and radiographic pelvic and spinal parameters, was integrated into a software program called Similibary. It was applied to the same 42 subjects. These results were compared in order to validate the method. No significant difference was observed between the two techniques. This easy-to-use tool allows a personalised evaluation of the sagittal balance of the spine, both through the evaluation of the harmonious relationship between the spinal curves and the pelvis, and through the location of gravity supported by the vertebral structures in L3.

  13. Walking in simulated Martian gravity: Influence of added weight on sagittal dynamic stability

    NASA Astrophysics Data System (ADS)

    Scott-Pandorf, Melissa M.; O'Connor, Daniel P.; Layne, Charles S.; Josić, Krešimir; Kurz, Max J.

    2010-05-01

    With human exploration of the Moon and Mars on the horizon, research considerations for space suit redesign have surfaced. Review of Apollo mission videos revealed repeated instance of falling during extravehicular activities. A better understanding of how suit weight influences the sagittal dynamic stability of the gait pattern may provide insight for new suit design such that space missions may have more productive extravehicular activities and smaller risk of falls that may cause injuries and damage equipment. Participants walked for 4 min in simulated Martian gravity with additional loads of 0%, 15%, 30% and 45% of their body weight. Floquet and Lyapunov analysis techniques were used to quantify the dynamic stability of the sagittal plane gait pattern. Additionally, sagittal plane joint kinematics were evaluated to determine if any modification occurred. Results indicated that weight (i.e., added load) had little effect on the sagittal dynamic stability or joint kinematics while in simulated Martian gravity. Potentially, suit weight may not be a priority for space suit redesign.

  14. Sagittal alignment of the spine-pelvis-lower extremity axis in patients with severe knee osteoarthritis

    PubMed Central

    Wang, W. J.; Liu, F.; Zhu, Y.W.; Sun, M.H.; Qiu, Y.

    2016-01-01

    Objectives Normal sagittal spine-pelvis-lower extremity alignment is crucial in humans for maintaining an ergonomic upright standing posture, and pathogenesis in any segment leads to poor balance. The present study aimed to investigate how this sagittal alignment can be affected by severe knee osteoarthritis (KOA), and whether associated changes corresponded with symptoms of lower back pain (LBP) in this patient population. Methods Lateral radiograph films in an upright standing position were obtained from 59 patients with severe KOA and 58 asymptomatic controls free from KOA. Sagittal alignment of the spine, pelvis, hip and proximal femur was quantified by measuring several radiographic parameters. Global balance was accessed according to the relative position of the C7 plumb line to the sacrum and femoral heads. The presence of chronic LBP was documented. Comparisons between the two groups were carried by independent samples t-tests or chi-squared test. Results Patients with severe KOA showed significant backward femoral inclination (FI), hip flexion, forward spinal inclination, and higher prevalence of global imbalance (27.1% versus 3.4%, p < 0.001) compared with controls. In addition, patients with FI of 10° (n = 23) showed reduced lumbar lordosis and significant forward spinal inclination compared with controls, whereas those with FI > 10° (n = 36) presented with significant pelvic anteversion and hip flexion. A total of 39 patients with KOA (66.1%) suffered from LBP. There was no significant difference in sagittal alignment between KOA patients with and without LBP. Conclusions The sagittal alignment of spine-pelvis-lower extremity axis was significantly influenced by severe KOA. The lumbar spine served as the primary source of compensation, while hip flexion and pelvic anteversion increased for further compensation. Changes in sagittal alignment may not be involved in the pathogenesis of LBP in this patient population. Cite this article: W. J. Wang, F. Liu

  15. High voltage variable diameter insulator

    DOEpatents

    Vanecek, David L.; Pike, Chester D.

    1984-01-01

    A high voltage feedthrough assembly (10) having a tubular insulator (15) extending between the ground plane ring (16) and the high voltage ring (30). The insulator (15) is made of Pyrex and decreases in diameter from the ground plane ring (16) to the high voltage ring (30), producing equipotential lines almost perpendicular to the wall (27) of the insulator (15) to optimize the voltage-holding capability of the feedthrough assembly (10).

  16. Comparison of Accuracy of Uncorrected and Corrected Sagittal Tomography in Detection of Mandibular Condyle Erosions: an Exvivo Study

    PubMed Central

    Naser, Asieh Zamani; Shirani, Amir Mansour; Hekmatian, Ehsan; Valiani, Ali; Ardestani, Pegah; Vali, Ava

    2010-01-01

    Background: Radiographic examination of TMJ is indicated when there are clinical signs of pathological conditions, mainly bone changes that may influence the diagnosis and treatment planning. The purpose of this study was to evaluate and to compare the validity and diagnostic accuracy of uncorrected and corrected sagittal tomographic images in the detection of simulated mandibular condyle erosions. Methods Simulated lesions were created in 10 dry mandibles using a dental round bur. Using uncorrected and corrected sagittal tomography techniques, mandibular condyles were imaged by a Cranex Tome X-ray unit before and after creating the lesions. The uncorrected and corrected tomography images were examined by two independent observers for absence or presence of a lesion. The accuracy for detecting mandibular condyle lesions was expressed as sensitivity, specificity, and validity values. Differences between the two radiographic modalities were tested by Wilcoxon for paired data tests. Inter-observer agreement was determined by Cohen's Kappa. Results: The sensitivity, specificity and validity were 45%, 85% and 30% in uncorrected sagittal tomographic images, respectively, and 70%, 92.5% and 60% in corrected sagittal tomographic images, respectively. There was a significant statistical difference between the accuracy of uncorrected and corrected sagittal tomography in detection of mandibular condyle erosions (P = 0.016). The inter-observer agreement was slight for uncorrected sagittal tomography and moderate for corrected sagittal tomography. Conclusion: The accuracy of corrected sagittal tomography is significantly higher than that of uncorrected sagittal tomography. Therefore, corrected sagittal tomography seems to be a better modality in detection of mandibular condyle erosions. PMID:22013461

  17. THE RELATIONSHIP BETWEEN LOWER EXTREMITY CLOSED KINETIC CHAIN STRENGTH & SAGITTAL PLANE LANDING KINEMATICS IN FEMALE ATHLETES

    PubMed Central

    Kivlan, Ben; Scibek, Jason S.

    2011-01-01

    Background: Female athletes continue to injure their anterior cruciate ligaments at a greater rate than males in comparable sports. During landing activities, females exhibit several different kinematic and kinetic traits when compared to their male counterparts including decreased knee flexion angles as well as decreased lower extremity (LE) strength. While open kinetic chain strength measures have not been related to landing kinematics, given the closer replication of movement patterns that occur during closed kinetic chain (CKC) activity, it is possible that lower extremity strength if measured in this fashion will be related to landing kinematics. Purpose: To determine if unilateral isometric CKC lower extremity (LE) strength was related to sagittal plane tibiofemoral kinematics during a single leg landing task in competitive female athletes. We hypothesized females who demonstrated lesser CKC LE strength would exhibit decreased sagittal plane angles during landing. Methods: 20 competitive female athletes (age = 16.0 ± 1.8 yrs; height = 166.5 ± 8.3 cm; weight = 59.7 ± 10.2 kg) completed CKC LE strength testing followed by 5 unilateral drop landings on the dominant LE during one test session at an outpatient physical therapy clinic. Closed kinetic chain LE strength was measured on a computerized leg press with an integrated load cell while sagittal plane tibiofemoral kinematics were quantified with an electrogoniometer. Results: No significant relationships between absolute or normalized isometric CKC strength and sagittal plane landing kinematics were identified. Conclusions: Closed kinetic chain lower extremity isometric strength tested at 25 degrees of knee flexion is not related to sagittal plane landing kinematics in adolescent competitive female athletes. Levels of Evidence: Analytic, Observational PMID:21655453

  18. Enhanced Lapidus arthrodesis: crossed screw technique with middle cuneiform fixation further reduces sagittal mobility.

    PubMed

    Galli, Melissa M; McAlister, Jeffrey E; Berlet, Gregory C; Hyer, Christopher F

    2015-01-01

    Persistent medial column sagittal mobility can be encountered despite successful first tarsometatarsal stabilization if fixation has been limited to the first tarsometatarsal joint. The purpose of the present cadaveric research was to quantify the effect of a third point of fixation from the base of the first metatarsal to the middle cuneiform compared with the traditional isolated first tarsometatarsal fixation. Ten matched pairs of below-the-knee specimens, with a known cause of death, sex, ethnicity, and age, height, weight, and body mass index at death, were used for our examination. Portable fluoroscopy aided with the accurate placement of all points of fixation. Measurements of movement were obtained using the validated Klaue device. The 20 matched below-the-knee specimens were from 10 cadavers (2 female and 8 male donors, aged 72.8 ± 9.3 years, body mass index 21.1 ± 4.2 kg/m(2)). The sagittal plane motion of the first ray was 7.45 ± 1.82 mm before fixation. With isolated first tarsometatarsal fixation, the sagittal motion decreased to 4.41 ± 1.51 mm and decreased further to 3.12 ± 1.06 mm, with the addition of middle cuneiform fixation. Statistically significant enhancement of the stability of sagittal first ray motion was noted with the addition of the first metatarsal to middle cuneiform pin, even after simulated Lapidus fixation. Our findings suggest that first metatarsal to middle cuneiform fixation can be beneficial if excessive sagittal motion is present after standard 2-point fixation and can play a role in the prevention of recurrence and complications. PMID:25456344

  19. Sagittal gait patterns in cerebral palsy: the plantarflexor-knee extension couple index.

    PubMed

    Sangeux, Morgan; Rodda, Jill; Graham, H Kerr

    2015-02-01

    The identification of gait patterns in cerebral palsy offers a common language for clinicians and contributes to management algorithms. We describe a quantitative classification of sagittal gait patterns based on the plantarflexor-knee extension couple index. This consists of a scatter plot based on ankle and knee scores, and allows objective identification of the sagittal gait pattern. Sagittal kinematic data from 200 limbs of 100 patients with bilateral spastic cerebral palsy were utilized to validate the algorithm against the assessment of a clinician with expertise in gait pattern identification. A dataset of 776 cerebral palsy patients, 1552 limbs, was used to compare the sagittal gait patterns against k-means statistical clustering. The classification was further explored with respect to the knee kinetics during the middle of stance and physical examination measurements of the gastrocnemius-soleus complex. Two supplementary materials (Appendices 2 and 3) provide in-depth discussion about statistical properties of the plantarflexor-knee extension couple index as well as its relationship with statistical clustering. The plantarflexor-knee extension index achieved 98% accuracy and may be suitable for the computational classification of large patient cohorts and multicentre studies. The sagittal gait patterns were strongly related to k-means statistical clustering and physical examination of the gastrocnemius-soleus complex. Patients in crouch gait had normal soleus and gastrocnemius lengths but spasticity in the gastrocnemius. Patients in jump gait exhibited a short gastrocnemius and soleus and gastrocnemius spasticity. Patients in true equinus presented with a moderately contracted soleus and gastrocnemius and gastrocnemius spasticity. Patients in apparent equinus did not show abnormal physical examination measurements for the gastrocnemius-soleus complex.

  20. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  1. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  2. 7 CFR 51.2934 - Diameter.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Standards for Grades of Apricots Definitions § 51.2934 Diameter. Diameter means the greatest diameter, measured through the center of the apricot, at right angles to a line running from the stem to the...

  3. 7 CFR 51.2934 - Diameter.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apricots Definitions § 51.2934 Diameter. Diameter means the greatest diameter, measured through the center of the apricot, at right angles to a...

  4. 7 CFR 51.2934 - Diameter.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apricots Definitions § 51.2934 Diameter. Diameter means the greatest diameter, measured through the center of the apricot, at right angles to a...

  5. 7 CFR 51.2934 - Diameter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Standards for Grades of Apricots Definitions § 51.2934 Diameter. Diameter means the greatest diameter, measured through the center of the apricot, at right angles to a line running from the stem to the...

  6. 7 CFR 51.2934 - Diameter.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Standards for Grades of Apricots Definitions § 51.2934 Diameter. Diameter means the greatest diameter, measured through the center of the apricot, at right angles to a line running from the stem to the...

  7. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  8. Virtual preoperative measurement and surgical manipulation of sagittal spinal alignment using a novel research and educational software program.

    PubMed

    Pettigrew, David B; Morgan, Chad J; Anderson, R Brian; Wilsey, Philip A; Kuntz, Charles

    2010-03-01

    Understanding regional as well as global spinal alignment is increasingly recognized as important for the spine surgeon. A novel software program for virtual preoperative measurement and surgical manipulation of sagittal spinal alignment was developed to provide a research and educational tool for spine surgeons. This first-generation software program provides tools to measure sagittal spinal alignment from the occiput to the pelvis, and to allow for virtual surgical manipulation of sagittal spinal alignment. The software was developed in conjunction with Clifton Labs, Inc. Photographs and radiographs were imported into the software program, and a 2D virtual spine was constructed from the images. The software then measured regional and global sagittal spinal alignment from the virtual spine construct, showing the user how to perform the measurements. After measuring alignment, the program allowed for virtual surgical manipulation, simulating surgical procedures such as interbody fusion, facet osteotomy, pedicle subtraction osteotomy, and reduction of spondylolisthesis, as well as allowing for rotation of the pelvis on the hip axis. Following virtual manipulation, the program remeasured regional and global sagittal spinal alignment. Computer software can be used to measure and manipulate sagittal spinal alignment virtually, providing a new research and educational tool. In the future, more comprehensive programs may allow for measurement and interaction in the coronal, axial, and sagittal planes. PMID:20192663

  9. Functional Abdominal Pain in Children

    MedlinePlus

    ... At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain ...

  10. Radiographic Parameters in Adult Degenerative Scoliosis and Different Parameters Between Sagittal Balanced and Imbalanced ADS Patients.

    PubMed

    Yang, Changwei; Yang, Mingyuan; Chen, Yuanyuan; Wei, Xianzhao; Ni, Haijian; Chen, Ziqiang; Li, Jingfeng; Bai, Yushu; Zhu, Xiaodong; Li, Ming

    2015-07-01

    A retrospective study. To summarize and describe the radiographic parameters of adult degenerative scoliosis (ADS) and explore the radiological parameters which are significantly different in sagittal balanced and imbalanced ADS patients. ADS is the most common type of adult spinal deformity. However, no comprehensive description of radiographic parameters in ADS patients has been made, and few studies have been performed to explore which radiological parameters are significantly different between sagittal balanced and imbalanced ADS patients. Medical records of ADS patients in our outpatient clinic from January 2012 to January 2014 were reviewed. Demographic data including age and sex, and radiographic data including the coronal Cobb angle, location of apical vertebra/disc, convexity of the curve, degree of apical vertebra rotation, curve segments, thoracic kyphosis (TK), lumbar lordosis (LL), thoracolumbar kyphosis (TL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), sagittal vertical axis (SVA), and PI minus LL (PI-LL) were reviewed to make comprehensive description of radiographic parameters of ADS. Furthermore, patients were divided into 2 groups according to whether the patients' sagittal plane was balanced: Group A (imbalanced, SVA > 5 cm) and Group B (balanced, SVA  ≤ 5 cm). Demographic and radiological parameters were compared between these 2 groups. A total of 99 patients were included in this study (Group A = 33 and Group B = 66; female = 83 and male = 16; sex ratio = 5:1). The median of age were 67 years (range: 41-92 years). The median of coronal Cobb angle and length of curve was 23 (range: 10-75°) and 5 segments (range: 3-7), respectively. The most common location of apical vertebra was at L2 to L3 (81%) and the median of degree of apical vertebra rotation was 2° (range: 1-3). Our study also showed significant correlations between coronal Cobb angle and curve segments (r = 0.23, P < 0.005) and degree of apical vertebra rotation (r

  11. Abdominal ultrasonography, 2nd Ed

    SciTech Connect

    Goldberg, B.B.

    1984-01-01

    This volume is a new and updated edition of an extensively illustrated text and reference on the capabilities and imaging of gray scale ultrasonography for each major abdominal organ. Each major organ system is treated separately, including liver, gallbladder and bile ducts, pancreas, kidney, retroperitoneum, abdominal vasculature, and more. There are over 500 illustrations and ten pages of full color plates for cross sectional anatomy.

  12. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  13. Scanogram for sagittal imbalance of the spine: low dose alternative for a safer diagnosis.

    PubMed

    Weisz, George M; Albury, W R; Houang, M D; Matucci-Cerinic, Marco

    2014-01-01

    The diagnosis of Fixed Sagittal Imbalance (FSI), previously known as Flat Back Syndrome, requires the measurement of spinal curvatures on a lateral radiograph in the standing position (C7-S1). It can be difficult to position a spastic patient, sometimes repeated exposure are required, at separate thoracic and lumbar levels, increasing the radiation dosage. CT Scanography is suggested as an alternative radiological diagnostic method since it is rapid to perform. The patient is comfortably positioned (horizontal) and it combines both prone and supine positions, therefore acting as a functional examination. This test was performed on 34 consecutive patients with fractured vertebrae (lumbar, dorsal) and with back pain persisting beyond the bone healing period. The functional scanogram was found to be accurate in diagnosing sagittal imbalances, but more importantly it offered reduction in radiation: in Entrance dose; in Effective dose and Absorption dose. Scanogram is therefore proposed as an alternative method for the diagnosis of FSI.

  14. High-resolution sagittal and coronal reformatted CT images of the larynx

    SciTech Connect

    Silverman, P.M.; Johnson, G.A.; Korobkin, M.

    1983-04-01

    Computed tomography has become the major technique for evaluation of patients with laryngeal corcinoma and trauma to the larynx. The routine examination usually consists of 5 mm contiguous selection through the larynx in quiet respiration. Reformatted images obtained from these sections have not been of clinical value, in part because of the poor resolution of these images. In the past, thin-section scanning (1.5 mm collimation) has been impractical because of the significant time required to scan the entire larynx. By using the technique of rapid sequential scanning with automated table incrementation this logistic difficulty can be overcome, and the total thin-section examination may be performed in less than 9 min. Sophisticated computer software allows rapid reformatting of transaxial images in sagittal and coronal planes. This report illustates the normal and abnormal appearance of the larynx on coronal and sagittal reformatted images and compares reformatted images using the routine technique to those using the thin-section technique.

  15. Differences of Sagittal Lumbosacral Parameters between Patients with Lumbar Spondylolysis and Normal Adults

    PubMed Central

    Yin, Jin; Peng, Bao-Gan; Li, Yong-Chao; Zhang, Nai-Yang; Yang, Liang; Li, Duan-Ming

    2016-01-01

    Background: Recent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Han Chinese people concerning the normal range of spinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases. The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population. Methods: A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force (Beijing, China) were identified as the spondylolysis group. All the 52 patients were divided into two subgroups, Subgroup A: 36 patients with simple lumbar spondylolysis, and Subgroup B: 16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis (slip percentage <30%). Altogether 207 healthy adults were chosen as the control group. All patients and the control group took lumbosacral lateral radiographs. Seven sagittal lumbosacral parameters, including PI, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), L5 incidence, L5 slope, and sacral table angle (STA), were measured in the lateral radiographs. All the parameters aforementioned were compared between the two subgroups and between the spondylolysis group and the control group with independent-sample t-test. Results: There were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B. PI, PT, SS, and LL were higher (P < 0.05) in the spondylolysis group than those in the control group, but STA was lower (P < 0.001) in the spondylolysis group. Conclusions: Current study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population. PMID:27174324

  16. Clinical Impact of Sagittal Spinopelvic Parameters on Disc Degeneration in Young Adults

    PubMed Central

    Oh, Young-Min; Eun, Jong-Pil

    2015-01-01

    Abstract The sagittal balance plays an important role in the determination of shear and compressive forces applied on the anterior (vertebral bodies and intervertebral discs) and posterior (facet joints) elements of the lumbar vertebral column. Many studies have also examined the effect of structural changes in the disc on the biomechanical characteristics of the spinal segment. Nevertheless, the relationship between sagittal balance and the degree of disc degeneration has not been extensively explored. Thus, here we investigated the relationships between various sagittal spinopelvic parameters and the degree of disc degeneration in young adults. A total of 278 young adult male patients were included in this study (age range: 18–24 years old). Multiple sagittal spinopelvic parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), sacral inclination (SI), lumbosacral angle (LSA), and sacral table angle (STA), were measured from standing lateral lumbosacral radiographs. The degree of intervertebral disc degeneration was classified using a modified Pfirrmann scale. To assess the pain intensity of each patient, the visual analogue scale (VAS) score for low back pain (LBP) was obtained from all the patients. Finally, the relationships between these spinopelvic parameters and the degree of disc degeneration in young adults were analyzed. Also, we performed multiple logistic regression study. Out of all the spinopelvic parameters measured in this study, a low STA and a low SI were the only significant risk factors that were associated with disc degeneration in young adults. It means that patients with disc degeneration tend to have more severe sacral kyphosis and vertical sacrum. We found that patients with disc degeneration showed a lower SI and lower STA compared with patients without disc degeneration in young adults. Therefore, we suggest that the patients with disc degeneration tend to have more vertical sacrum, more

  17. Management of superior sagittal sinus injury encountered in traumatic head injury patients: Analysis of 15 cases

    PubMed Central

    Behera, Sanjay K.; Senapati, Satya Bhusan; Mishra, Sudhansu Sekhar; Das, Srikant

    2015-01-01

    Background: Significant dural sinus injury occurs in 1.5- 5% of all head injuries and injury to superior sagittal sinus accounts for 70-80% of these. Its management is also a challenging issue to every neurosurgeon. Materials and Methods: In a period of one year (Aug 2011 to july2012) out of 549 cases of head injuries operated in our department analysis of 15 cases (2.73%) shown to have superior sagittal sinus injury. Three dimensional reconstruction of skull bone during CT scan helped us to diagnose possible dural sinus injury pre-operatively. Results: SSS injury was due to direct impact of fracture segment (5 cases), extension of fracture line over sinus area (4 cases) or due to coronal suture diastases (6 cases). Injury to anterior third of sagittal sinus occurred in 12 cases (80%) and injury to middle third occurred in 3 cases (20%). Small tear over superior sagittal sinus was found in 7 cases (46.66%) and was managed with Gelfoam® compression only and in two cases (13.33%) were large tear, which was managed with sinoraphy. In four cases (36.34%) hitch stitches over Gelfoam® to adjacent bone given and in rest two cases (13.33%) a strip of bone was left over the sinus area and bilateral hitch stitches were applied. Conclusion: Injury to SSS in traumatic head injury patient though rarely encountered during surgery, the management is challenging to every neurosurgeon. Preoperative suspicion and combination of surgical techniques rather than one single technique may be effective in decreasing the sinus related mortality rate. PMID:25767570

  18. Assessment of methods to extract the mid-sagittal plane from brain MR images

    NASA Astrophysics Data System (ADS)

    Kuijf, Hugo J.; Leemans, Alexander; Viergever, Max A.; Vincken, Koen L.

    2013-03-01

    Automatic detection of the mid-sagittal plane, separating both hemispheres of the brain, is useful in various applications. Several methods have been developed in the past years, applying different techniques to estimate the position of the mid-sagittal plane. These methods can be classified into three distinct classes: feature-based, global symmetry based, and local symmetry based methods. Feature-based methods use the shape or intensity of the interhemispheric fissure to extract the mid-sagittal plane. Global symmetry based methods reflect the entire image with respect to the sagittal axes and perform a rigid registration. Local symmetry based methods try to optimize a symmetry-measure in a small band covering the interhemispheric fissure. From each class, one leading method has been implemented. The methods have been evaluated on the same datasets to allow a fair comparison. Manual delineations were made by two experienced human observers. The results show that the examined methods perform similar to human observers. No significant differences were found between errors (defined as the angle and volume between planes) made by the methods and the inter-observer differences. Feature-based and local symmetry based methods have a low computation time of 1.8 and 0.5 seconds, respectively. The global symmetry based method has a higher computation time of 33.6 seconds, caused by the full 3D rigid registration. The largest errors, both by the methods and observers, are made in participants with cerebral atrophy. These participants have a widened interhemispheric fissure, allowing many plane orientations and positions to result in a valid division of the hemispheres.

  19. Cheiloscopy: A new role as a marker of sagittal jaw relation

    PubMed Central

    Kulkarni, Narayan; Vasudevan, SD; Shah, Romil; Rao, Parikshit; Balappanavar, Aswini Y

    2012-01-01

    Context: It has been proved that lip prints are analogous to thumb prints. A correlation between thumb prints and sagittal dental malocclusion has already been established. Soft tissue is gaining more importance in judgement of deformity or identity of a patient. Aim: To find a correlation between sagittal skeletal jaw relation and lip prints. Settings and Design: Descriptive, cross-sectional, comparative, single-blind, hospital-based study. Materials and Methods: A total of 90 patients were categorized into skeletal class I, class II, and class III, comprising 30 patients in each group with equal gender distribution. Dolphin imaging (10.5) software was used for analyzing sagittal jaw relation. Lip prints obtained from these 90 patients were analyzed. Statistical Analyses Used: Karl Pearson's correlation coefficient, Chi-square test, t-test, Spearman's co-efficient, analysis of variance (ANOVA). Results: It was observed that angle ANB (Angle formed between points nasion[N] to Subnasal[A] and nasion[N] to supramental [B]) and beta angle were statistically significant, revealing a strong negative correlation (-0.9060) with different classes of jaw relation. Significant difference was observed between genders in all the three classes. Significant difference was observed in relation to lip print and the quadrants of upper and lower lips. A statistical significance was noted on the right side of both upper and lower arches. Conclusion: This study shows that lip prints can be employed for sagittal jaw relation recognition. A further study on various ethnic backgrounds with a larger sample size in individual group is necessary for comparing lip prints and malocclusion. PMID:23087575

  20. Sagittal jaw position in relation to body posture in adult humans – a rasterstereographic study

    PubMed Central

    Lippold, Carsten; Danesh, Gholamreza; Schilgen, Markus; Drerup, Burkhard; Hackenberg, Lars

    2006-01-01

    Background The correlations between the sagittal jaw position and the cranio – cervical inclination are described in literature. Only few studies focus on the sagittal jaw position and the body posture using valid and objective orthopaedic examination methods. The aim of this study was to test the hypothesis that patients with malocclusions reveal significant differences in body posture compared to those without (upper thoracic inclination, kyphotic angle, lordotic angle and lower lumbar inclination). Methods Eighty-four healthy adult patients (with a mean age = 25.6 years and ranging from 16.1 to 55.8 years) were examined with informed consent. The orthodontic examination horizontal overjet (distance between upper and lower incisors) was determined by using an orthodontic digital sliding calliper. The subjects were subdivided in respect of the overjet with the following results: 18 revealed a normal overjet (Class I), 38 had an increased overjet (Class II) and 28 had an reversed overjet (Class III). Rasterstereography was used to carry out a three – dimensional back shape analysis. This method is based on photogrammetry. A three-dimensional shape was produced by analysing the distortion of parallel horizontal white light lines projected on the patient's back, followed by mathematical modelling. On the basis of the sagittal profile the upper thoracic inclination, the thoracic angle, the lordotic angle and the pelvic inclination were determined with a reported accuracy of 2.8° and the correlations to the sagittal jaw position were calculated by means of ANOVA, Scheffé and Kruskal-Wallis procedures. Results Between the different overjet groups, no statistically significant differences or correlations regarding the analysed back shape parameters could be obtained. However, comparing males and females there were statistically significant differences in view of the parameters 'lordotic angle' and 'pelvic inclination'. Conclusion No correlations between overjet and

  1. Automatic extraction of the mid-sagittal plane using an ICP variant

    NASA Astrophysics Data System (ADS)

    Fieten, Lorenz; Eschweiler, Jörg; de la Fuente, Matías; Gravius, Sascha; Radermacher, Klaus

    2008-03-01

    Precise knowledge of the mid-sagittal plane is important for the assessment and correction of several deformities. Furthermore, the mid-sagittal plane can be used for the definition of standardized coordinate systems such as pelvis or skull coordinate systems. A popular approach for mid-sagittal plane computation is based on the selection of anatomical landmarks located either directly on the plane or symmetrically to it. However, the manual selection of landmarks is a tedious, time-consuming and error-prone task, which requires great care. In order to overcome this drawback, previously it was suggested to use the iterative closest point (ICP) algorithm: After an initial mirroring of the data points on a default mirror plane, the mirrored data points should be registered iteratively to the model points using rigid transforms. Finally, a reflection transform approximating the cumulative transform could be extracted. In this work, we present an ICP variant for the iterative optimization of the reflection parameters. It is based on a closed-form solution to the least-squares problem of matching data points to model points using a reflection. In experiments on CT pelvis and skull datasets our method showed a better ability to match homologous areas.

  2. Knee joint passive stiffness and moment in sagittal and frontal planes markedly increase with compression.

    PubMed

    Marouane, H; Shirazi-Adl, A; Adouni, M

    2015-01-01

    Knee joints are subject to large compression forces in daily activities. Due to artefact moments and instability under large compression loads, biomechanical studies impose additional constraints to circumvent the compression position-dependency in response. To quantify the effect of compression on passive knee moment resistance and stiffness, two validated finite element models of the tibiofemoral (TF) joint, one refined with depth-dependent fibril-reinforced cartilage and the other less refined with homogeneous isotropic cartilage, are used. The unconstrained TF joint response in sagittal and frontal planes is investigated at different flexion angles (0°, 15°, 30° and 45°) up to 1800 N compression preloads. The compression is applied at a novel joint mechanical balance point (MBP) identified as a point at which the compression does not cause any coupled rotations in sagittal and frontal planes. The MBP of the unconstrained joint is located at the lateral plateau in small compressions and shifts medially towards the inter-compartmental area at larger compression forces. The compression force substantially increases the joint moment-bearing capacities and instantaneous angular rigidities in both frontal and sagittal planes. The varus-valgus laxities diminish with compression preloads despite concomitant substantial reductions in collateral ligament forces. While the angular rigidity would enhance the joint stability, the augmented passive moment resistance under compression preloads plays a role in supporting external moments and should as such be considered in the knee joint musculoskeletal models.

  3. Sagittal rotational stiffness and damping increase in a porcine lumbar spine with increased or prolonged loading.

    PubMed

    Zondervan, Robert L; Popovich, John M; Radcliffe, Clark J; Pathak, Pramod K; Reeves, N Peter

    2016-02-29

    While the impact of load magnitude on spine dynamic parameters (stiffness and damping) has been reported, it is unclear how load history (exposure to prolonged loading) affects spine dynamic parameters in sagittal rotation. Furthermore, it is unknown if both spine stiffness and damping are equally affected to prolonged loading. Using a pendulum testing apparatus, the effect of load magnitude and load history on spine sagittal rotational stiffness and damping was assessed. Nine porcine lumbar functional spine units (FSUs) were tested in an increasing compressive load phase (ICP: 44.85, 68.55, 91.75, 114.6kg) and then a decreasing compressive load phase (DCP: 91.75, 68.55, and 44.85kg). Each trial consisted of flexing the FSU 5° and allowing it to oscillate unconstrained. During the ICP, both stiffness and damping linearly increased with load. However, in the DCP, stiffness and damping values were significantly higher than the identical load collected during the ICP, suggesting load history affects sagittal rotational dynamic parameters. In addition, spine damping was more affected by load history than spine stiffness. These results highlight the importance of controlling load magnitude and history when assessing spine dynamic parameters. PMID:26892899

  4. Conservative management of abdominal injuries

    PubMed Central

    Okuş, Ahmet; Sevinç, Barış; Ay, Serden; Arslan, Kemal; Karahan, Ömer; Eryılmaz, Mehmet Ali

    2013-01-01

    Objective: Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt penetrating) is discussed. Material and Methods: All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. Results: The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. Conclusion: Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring. PMID:25931868

  5. Monitoring the biological activity of abdominal aortic aneurysms Beyond Ultrasound

    PubMed Central

    Forsythe, Rachael O; Newby, David E; Robson, Jennifer M J

    2016-01-01

    Abdominal aortic aneurysms (AAAs) are an important cause of morbidity and, when ruptured, are associated with >80% mortality. Current management decisions are based on assessment of aneurysm diameter by abdominal ultrasound. However, AAA growth is non-linear and rupture can occur at small diameters or may never occur in those with large AAAs. There is a need to develop better imaging biomarkers that can identify the potential risk of rupture independent of the aneurysm diameter. Key pathobiological processes of AAA progression and rupture include neovascularisation, necrotic inflammation, microcalcification and proteolytic degradation of the extracellular matrix. These processes represent key targets for emerging imaging techniques and may confer an increased risk of expansion or rupture over and above the known patient-related risk factors. Magnetic resonance imaging, using ultrasmall superparamagnetic particles of iron oxide, can identify and track hotspots of macrophage activity. Positron emission tomography, using a variety of targeted tracers, can detect areas of inflammation, angiogenesis, hypoxia and microcalcification. By going beyond the simple monitoring of diameter expansion using ultrasound, these cellular and molecular imaging techniques may have the potential to allow improved prediction of expansion or rupture and to better guide elective surgical intervention. PMID:26879242

  6. Abdominal aortic grafting for spontaneous infrarenal abdominal aortic dissection.

    PubMed

    Iwasaki, Hiroto; Shibuya, Takashi; Shintani, Takashi; Uenaka, Hisazumi; Suehiro, Shigefumi; Satoh, Hisashi

    2010-02-01

    This case report concerns a 62-year-old woman with spontaneous infrarenal abdominal aortic dissection, which developed into claudication and rest pain in the lower extremity. Multi-row detector computed tomography showed the entry site of the abdominal aortic dissection at the second lumbar artery, while the reentry site was found intraoperatively at the median sacral artery, indicating that the false lumen had progressed and compressed the true lumen. A direct approach involving grafting appears to be an effective procedure for resolving mesenteric and lower extremity hypoperfusion due to aortic dissection with a dilated false channel, even during the acute period. PMID:19879731

  7. Internal morphology of the nonsyndromic prematurely fused sagittal suture in the human skull--A preliminary micro-CT study.

    PubMed

    Nowaczewska, W; Ziółkowski, G; Dybała, B

    2015-10-01

    Although nonsyndromic craniosynostosis (NSC) of the sagittal suture is a well-known type of craniosynostosis, little is currently known about the internal morphology of this prematurely fused suture in modern humans. Recently, micro-computed tomography (micro-CT) has been applied as a new tool for the quantitative evaluation of cranial suture morphology. However, so far there are only a small number of reports concerning studies of the internal morphology of prematurely fused sagittal suture in humans using micro-CT. The primary aim of this study was to examine the internal morphology of a completely obliterated sagittal suture in NSC. Two modern human skulls were used in this study: a skull of a child (aged 10 ± 2.5 years) displaying NSC of the sagittal suture and a skull of an adult showing non-prematurely completely obliterated sagittal suture. Quantitative variables of the sagittal sutures were assessed using method proposed by the authors. Porosity, and relative thickness of three bone layers in two examined skulls (inner cortical, diploë and outer cortical) were analysed using micro-CT in three equal sections of the sagittal suture. In the case of the prematurely fused suture, there were statistically significant differences mainly in the mean values of the porosity, thickness and relative thickness of the diploë between the anterior part and the two other parts (central and posterior) of this suture. Significant differences were also observed in some of the analysed variables between the sections of the sagittal suture of the skull with NSC and the normal skull. PMID:26122169

  8. Abdominal actinomycosis mimicking acute appendicitis.

    PubMed

    Conrad, Robert Joseph; Riela, Steven; Patel, Ravi; Misra, Subhasis

    2015-01-01

    A 52-year-old Hispanic woman presented to the emergency department, reporting worsening sharp lower right quadrant abdominal pain for 3 days. CT of the abdomen and pelvis showed evidence of inflammation in the peritoneal soft tissues adjacent to an enlarged and thick-walled appendix, an appendicolith, no abscess formation and a slightly thickened caecum consistent with acute appendicitis. During laparoscopic appendectomy, the caecum was noted to be firm, raising suspicion of malignancy. Surgical oncology team was consulted and open laparotomy with right hemicolectomy was performed. Pathology reported that the ileocaecal mass was not a malignancy but was, rather, actinomycosis. The patient was discharged after 10 days of intravenous antibiotics in the hospital, with the diagnosis of abdominal actinomycosis. Although the original clinical and radiological findings in this case were highly suggestive of acute appendicitis, abdominal actinomycosis should be in the differential for right lower quadrant pain as it may be treated non-operatively.

  9. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  10. Ultrasonographic evaluation of visceral and subcutaneous abdominal fat tissue before and after bariatric surgery.

    PubMed

    Djurić-Stefanović, A; Vasin, D; Jovanović, S; Lazić, Lj; Kovac, J; Popović, I; Bajec, Dj; Saranović, Dj

    2013-01-01

    Visceral fat is considered a key factor in the development of metabolic syndrome and other pathological conditions and diseases associated with obesity. Therefore, analysis of the dynamics of reducing the amount of abdominal visceral fat is important for evaluating the therapeutic effects of different modalities of obesity treatment, including bariatric surgery. In 53 obese patients visceral and subcutaneous abdominal adipose tissue was measured by ultrasonography (US) before and after bariatric surgery, in the period of 1, 3, 6 months. At the same time, standard anthropometric parameters were assessed: body mass (m), BMI, waist circumference (WC), and hip circumference (HC). Five diameters of the visceral abdominal fat (VAF) were measured: IAFT (Intraabdominal Fat Thickness), LV (Lienal Vein), VF (Visceral Fat), MES sum (Mesenterial leafs) and Max PFT (Maximal Preperitoneal Fat Thickness), and three diameters of the subcutaneous abdominal adipose tissue (SCAF): Min SFT (Minimal Subcutaneous Fat), and MaxSFTa and MaxSFTb (Maximal Subcutaneous Fat Thickness a and b). Statistically significant decrease in all anthropometric parameters, except HC was registered 1, 3 and 6 months after the surgery. We registered the decline of almost all US diameters of abdominal adipose tissue in the follow-up period, but statistically significant decrease were found only in the diameters of visceral adipose tissue: IAFT after 1 and 3 months (p = 0.031 and p = 0.027); VF after 1 month (p = 0.031), LV after 6 months (p = 0.011), and MESsum after 3 and 6 months (p = 0.001 and p = 0.028), as well as MaxSFTb, at 1 month follow-up (p = 0.015). In the short-term follow-up period after the bariatric surgery, there was a significant decrease in body mass, BMI and WC, and ultrasonography revealed a significant reduction in the diameters of the visceral abdominal fat.

  11. Abdominal aortic aneurysms: case report

    PubMed Central

    Hadida, Camille; Rajwani, Moez

    1998-01-01

    A 71-year-old male presented to a chiropractic clinic with subacute low back pain. While the pain appeared to be mechanical in nature, radiographic evaluation revealed an abdominal aortic aneurysm, which required the patient to have vascular surgery. This case report illustrates the importance of the history and physical examination in addition to a thorough knowledge of the features of abdominal aortic aneurysms. The application of spinal manipulative therapy in patients with (AAA) is also discussed. ImagesFigure 1Figure 2Figure 3

  12. Recurrent abdominal pain during childhood.

    PubMed Central

    Scott, R. B.

    1994-01-01

    Recurrent abdominal pain is a common presenting complaint among children. A thorough history and physical examination and limited laboratory investigation should enable a physician to make a positive diagnosis of "functional" recurrent abdominal pain in 90% to 95% of cases; an organic cause is identified in only 5% to 10%. The care and thoroughness of the history and physical examination establish the physician's credibility; explaining the clinical basis for the diagnosis and educating the child and parents on what is known about the condition reassures the parents. PMID:8199511

  13. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  14. Radiological management of abdominal abscess.

    PubMed Central

    Mac Erlean, D P; Gibney, R G

    1983-01-01

    Forty-two abdominal and retroperitoneal abscesses were drained percutaneously under ultrasound guidance. A success rate of 85.7% was achieved. Subsequent surgery was required in only 5 patients. Postoperative and spontaneous abscesses did equally well. Most intra-abdominal and retroperitoneal abscesses are amenable to this form of percutaneous drainage. The procedure requires only local anaesthesia and is well tolerated. Surgical management should probably now be reserved for those cases which are considered unsuitable for percutaneous drainage or which fail to resolve following this procedure. PMID:6842496

  15. Laparoscopic excision of intra-abdominal paragonimiasis.

    PubMed

    Kim, Jun-Young; Kang, Chang-Moo; Choi, Gi-Hong; Yang, Woo-Ick; Sim, Seo-Bo; Kwon, Ji-Eun; Kim, Kyung-Sik; Choi, Jin-Sub; Lee, Woo-Jung; Kim, Byong-Ro

    2007-12-01

    Lung fluke, Paragonimus westermani of Paragonimus species usually are accompanied by a persistent cough, hemoptysis, and chest pain. Extrapulmonary paragonimiasis caused by ectopic parasites in aberrant locations such as the abdominal wall, abdominal organs, and brain has been reported and the most commonly involved extrapulmonary organ is the brain. We present a case of 56-year-old male patient with intra-abdominal paragonimiasis who underwent laparoscopic excision of abdominal granuloma caused by parasite infection. An intra-abdominal mass associated with eosinophilia might be related to parasite infection. A laparoscopic approach is the most appropriate treatment modality in such benign abdominal pathology.

  16. Medical management of small abdominal aortic aneurysms.

    PubMed

    Baxter, B Timothy; Terrin, Michael C; Dalman, Ronald L

    2008-04-01

    Abdominal aortic aneurysm is a common condition that may be lethal when it is unrecognized. Current guidelines suggest repair as the aneurysm diameter reaches 5.0 to 5.5 cm. Most aortic aneurysms are detected incidentally when imaging is done for other purposes or through screening programs. Ninety percent of these aneurysms are below the threshold for intervention at the time of detection. A number of studies have sought to determine factors that lead to progression of aneurysmal disease that might be amenable to intervention during this period of observation. We review these studies and make recommendations for the medical management of small abdominal aortic aneurysms. On the basis of our current knowledge of the causes of aneurysm, a number of approaches have been proposed to prevent progression of aneurysmal disease. These include hemodynamic management, inhibition of inflammation, and protease inhibition. The American College of Cardiology/American Heart Association clinical practice guidelines rules of evidence have helped to define strength of evidence to support these approaches. Level A evidence (from large randomized trials) is available to indicate that observation of small aneurysms in men is safe up to a size of 5.5 cm and that propranolol does not inhibit aneurysm expansion. Level B evidence (from small randomized trials) suggests that roxithromycin or doxycycline will decrease the rate of aneurysm expansion. A number of studies agree that tobacco use is associated with an increased rate of aneurysm expansion. Level B and C evidence is available to suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) may inhibit aneurysm expansion. There are animal data but no human data demonstrating that angiotensin-converting enzyme inhibitors or losartan, an angiotensin receptor blocker, will decrease the rate of AAA expansion. A pharmacological agent without important side effects that inhibited aneurysm expansion could change

  17. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe ... kinds of pain: Generalized pain or pain over more than half ...

  18. [The influence of proprioceptive insoles (Bourdiol) on the sagittal curvature and inclination of the trunk].

    PubMed

    Müller-Gliemann, C; Drerup, B; Osada, N; Wetz, H H

    2006-11-01

    Proprioceptive insoles rely on the concept of Réné-Jaques Bourdiol, a French neurologist. The aim is to modulate plantar surface sensibility and to influence posture and statics of patients: it is hypothesized that the effect of modified afferent sensory input through proprioceptive stimulation of terminal muscle chains will have either a relaxing or stimulating effect on the whole body, which may be realized by affecting the posture. Small pads with a thickness of typically 1-3 mm are embedded into the insole to provide a specific stimulation. In fitting the insoles selectively to the individual patient the effect of the insoles on the trunk posture is taken as a feedback. This study investigates the influence of proprioceptive insoles on the sagittal curve in 20 selected patients. The protocol used a repeated measures research design. The measures of the sagittal curve were obtained using raster stereography. The four different conditions were: (1) barefoot, (2) convenient shoes without the insoles, (3) the same shoes with a placebo insole, and (4) the same shoes with neurological insoles. Evaluation of raster stereographs provided the kyphotic angle between T4 and T12 and lordotic angle between T12 and S1. Statistical evaluation was performed with the t-test for paired measurements. No significant differences were found in the sagittal profile. Only trunk inclination in normal posture was found to yield a significant difference (0.38 degrees) between placebo and neurological insoles. However, no clear statement on the efficiency of neurological insoles can be made.

  19. Biomechanical Comparison of Single- and Double-Leg Jump Landings in the Sagittal and Frontal Plane

    PubMed Central

    Taylor, Jeffrey B.; Ford, Kevin R.; Nguyen, Anh-Dung; Shultz, Sandra J.

    2016-01-01

    Background: Double-leg forward or drop-jump landing activities are typically used to screen for high-risk movement strategies and to determine the success of neuromuscular injury prevention programs. However, research suggests that these tasks that occur primarily in the sagittal plane may not adequately represent the lower extremity biomechanics that occur during unilateral foot contact or non–sagittal plane movements that are characteristic of many multidirectional sports. Purpose: To examine the extent to which lower extremity biomechanics measured during a jump landing on a double leg (DL) after a sagittal plane (SAG) movement is representative of biomechanics measured during single-leg (SL) or frontal plane (FRONT) jump landing tasks. Study Design: Controlled laboratory study. Methods: Lower extremity biomechanics were measured in 15 recreationally active females (mean age [±SD], 19.4 ± 2.1 years; mean height, 163.3 ± 5.9 cm; mean weight, 61.1 ± 7.1 kg) while performing SAGDL, SAGSL, FRONTDL, and FRONTSL jump landing tasks. Repeated-measures analyses of variance examined differences in lower extremity biomechanics between the 4 tasks, and linear regressions examined the extent to which an individual’s biomechanics during SAGDL were representative of their biomechanics during SAGSL, FRONTDL, and FRONTSL. Results: Lower extremity kinematics and kinetics differed by condition, with the SAGDL task generally eliciting greater hip and knee flexion angles and lower hip and knee forces than the other tasks (P < .05). Although biomechanics during the SAGDL task were strongly associated with those during the FRONTDL task (R 2, 0.41-0.82), weaker associations were observed between SAGDL and single-leg tasks for hip kinematics (R 2, 0.03-0.25) and kinetics (R 2, 0.05-0.20) and knee abduction moments (R 2, 0.06-0.18) (P < .05). Conclusion: Standard double-leg sagittal plane jump landing tasks used to screen for ACL injury risk and the effectiveness of ACL injury

  20. Bilateral optic disc swelling as a presenting sign of superior sagittal sinus thrombosis

    PubMed Central

    Pakter, Grant Jason

    2012-01-01

    The case of a 59-year-old Caucasian man who presented with a 6-week history of intermittent blurring of vision and diplopia is reported. Fundoscopy revealed asymmetrical, bilateral optic disc swelling with peripapillary haemorrhages. An initial CT scan and D-dimer level were reported as normal. A subsequent MRI revealed a recanalising superior sagittal sinus thrombosis. Cerebral venous sinus thrombosis is a rare and potentially fatal condition. The author suggests that it should be part of the differential diagnosis of bilateral optic disc swelling and that a normal unenhanced CT scan and D-dimer would not rule out this potentially devastating condition. PMID:22987907

  1. A practical MRI grading system for cervical foraminal stenosis based on oblique sagittal images

    PubMed Central

    Park, H-J; Kim, S S; Lee, S-Y; Chung, E-C; Rho, M-H; Kwon, H-J; Kook, S-H

    2013-01-01

    Objective: To propose a new and practical MRI grading method for cervical neural foraminal stenosis and to evaluate its reproducibility. Methods: We evaluated 50 patients (37 males and 13 females, mean age 49 years) who visited our institution and underwent oblique sagittal MRI of the cervical spine. A total of 300 foramina and corresponding nerve roots in 50 patients were qualitatively analysed from C4–5 to C6–7. We assessed the grade of cervical foraminal stenosis at the maximal narrowing point according to the new grading system based on T2 weighted oblique sagittal images. The incidence of each of the neural foraminal stenosis grades according to the cervical level was analysed by χ2 tests. Intra- and interobserver agreements between two radiologists were analysed using kappa statistics. Kappa value interpretations were poor (κ<0.1), slight (0.1≤κ≤0.2), fair (0.2<κ≤0.4), moderate (0.4<κ≤0.6), substantial (0.6<κ≤0.8) and almost perfect (0.8<κ≤1.0). Results: Significant stenoses (Grades 2 and 3) were rarely found at the C4–5 level. The incidence of Grade 3 at the C5–6 level was higher than that at other levels, a difference that was statistically significant. The overall intra-observer agreement according to the cervical level was almost perfect. The agreement at each level was almost perfect, except for only substantial agreement at the right C6–7 by Reader 2. No statistically significant differences were seen according to the cervical level. Overall kappa values of interobserver agreement according to the cervical level were almost perfect. In addition, the agreement of each level was almost perfect. Overall intra- and interobserver agreement for the presence of foraminal stenosis (Grade 0 vs Grades 1, 2 and 3) and for significant stenosis (Grades 0 and 1 vs Grades 2 and 3) showed similar results and were almost perfect. However, only substantial agreement was seen in the right C6–7. Conclusion: A new grading system for cervical

  2. Abdominal cocoon secondary to disseminated tuberculosis

    PubMed Central

    Puppala, Radha; Sripathi, Smiti; Kadavigere, Rajagopal; Koteshwar, Prakashini; Singh, Jyoti

    2014-01-01

    Abdominal cocoon, also known as sclerosing encapsulating peritonitis, represents a rare entity where a variable length of the small bowel is enveloped by a fibrocollagenous membrane giving the appearance of a cocoon. It may be asymptomatic and is often diagnosed incidentally at laparotomy. We present a rare case of abdominal cocoon due to abdominal tuberculosis. PMID:25239980

  3. Effects of frontal and sagittal thorax attitudes in gait on trunk and pelvis three-dimensional kinematics.

    PubMed

    Begon, Mickaël; Leardini, Alberto; Belvedere, Claudio; Farahpour, Nader; Allard, Paul

    2015-10-01

    While sagittal trunk inclinations alter upper body biomechanics, little is known about the extent of frontal trunk bending on upper body and pelvis kinematics in adults during gait and its relation to sagittal trunk inclinations. The objective was to determine the effect of the mean lateral trunk attitude on upper body and pelvis three-dimensional kinematics during gait in asymptomatic subjects. Three gait cycles were collected in 30 subjects using a motion analysis system (Vicon 612) and an established protocol. Sub-groups were formed based on the mean thorax lateral bending angle, bending side, and also sagittal tilt. These were compared based on 38 peak angles identified on pelvis, thorax and shoulder kinematics using MANOVAs. A main effect for bending side (p = 0.038) was found, especially for thorax peak angles. Statistics revealed also a significant interaction (p = 0.04993) between bending side and tilt for the thorax sagittal inclination during body-weight transfer. These results reinforce the existence of different gait patterns, which correlate upper body and pelvis motion measures. The results also suggest that frontal and sagittal trunk attitude should be considered carefully when treating a patient with impaired gait.

  4. Towards higher sensitivity and stability of axon diameter estimation with diffusion‐weighted MRI

    PubMed Central

    Alexander, Daniel C.; Kurniawan, Nyoman D.; Reutens, David C.; Yang, Zhengyi

    2016-01-01

    Diffusion‐weighted MRI is an important tool for in vivo and non‐invasive axon morphometry. The ActiveAx technique utilises an optimised acquisition protocol to infer orientationally invariant indices of axon diameter and density by fitting a model of white matter to the acquired data. In this study, we investigated the factors that influence the sensitivity to small‐diameter axons, namely the gradient strength of the acquisition protocol and the model fitting routine. Diffusion‐weighted ex. vivo images of the mouse brain were acquired using 16.4‐T MRI with high (G max of 300 mT/m) and ultra‐high (G max of 1350 mT/m) gradient strength acquisitions. The estimated axon diameter indices of the mid‐sagittal corpus callosum were validated using electron microscopy. In addition, a dictionary‐based fitting routine was employed and evaluated. Axon diameter indices were closer to electron microscopy measures when higher gradient strengths were employed. Despite the improvement, estimated axon diameter indices (a lower bound of ~ 1.8 μm) remained higher than the measurements obtained using electron microscopy (~1.2 μm). We further observed that limitations of pulsed gradient spin echo (PGSE) acquisition sequences and axonal dispersion could also influence the sensitivity with which axon diameter indices could be estimated. Our results highlight the influence of acquisition protocol, tissue model and model fitting, in addition to gradient strength, on advanced microstructural diffusion‐weighted imaging techniques. © 2016 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd. PMID:26748471

  5. Treatment of the Superior Sagittal Sinus Thrombosis with the Mechanical Thrombectomy Using Stent-Retriever Device.

    PubMed

    Kim, Hoon; Kim, Seong Rim; Park, Ik Seong; Kim, Young Woo

    2016-09-01

    Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device (4×20 mm) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR (6×20 mm). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences.

  6. Concomitant Third Molar Removal During Sagittal Split Osteotomy of the Mandible.

    PubMed

    Sasaki, Ryo; Yao, Chuan-Fong; Chen, Ying-An; Lin, Cheng-Hui; Chen, Yu-Ray

    2016-01-01

    It is described in textbook about management of third molar in orthognathic surgery that "ideally, the third molars should be removed 9 to 12 months before sagittal split osteotomy (SSO)." At the Chang Gung Craniofacial Center, the authors always remove mandibular third molars during SSO, because: removal of third molars at the same time of SSO could reduce psychological stress on patients by saving 1 surgical procedure under local anesthesia, better exposure of impacted third molars could be facilitated by sagittal split of buccal cortical plate, rigid fixation could be performed without difficulty by our fixation method using plates and screws crossover anterior oblique line. Strong force during the elevation of third molars, however, may result in the fracture of distal segment of SSO, where the buccal cortical plate is relatively thin because of the presence of third molar. Therefore, more care needs to be taken in the surgical technique, which is different from ordinary tooth extraction. In this paper, the details of surgical procedure of third molar removal during SSO were reported.

  7. Anterior column realignment following lateral interbody fusion for sagittal deformity correction.

    PubMed

    Pimenta, Luiz; Fortti, Fernanda; Oliveira, Leonardo; Marchi, Luis; Jensen, Rubens; Coutinho, Etevaldo; Amaral, Rodrigo

    2015-07-01

    Degenerative and iatrogenic diseases may lead to loss of lordosis or even kyphotic thoracolumbar deformity and sagittal misalignment. Traditional surgery with three-column osteotomies is associated with important neurologic risks and postoperative morbidity. In a novel technique, the lateral transpsoas interbody fusion (LTIF) is complemented with the sacrifice of the anterior longitudinal ligament and anterior portion of the annulus followed by the insertion of a hyperlordotic interbody cage. This is a less invasive lateral technique named anterior column realignment (ACR) and aims to correct sagittal misalignment in adult spinal deformity (ASD), with or without the addition of minor posterior osteotomies. In this article, we provide an account of the evolution to the ACR technique, the literature, and the Brazilian experience in the treatment of adult spinal deformity with this novel advanced application of LTIF. In the presence of ASD, the risk-to-benefit ratio of a surgical correction must be evaluated. Less invasive surgical strategies can be alternatives to treat the deformity and provide better quality of life to the patient. ACR is an advanced application of lateral transpsoas approach, up to date has shown to be reliable and effective when used for ASD, and may minimize complications and morbidity from traditional surgical procedures. Long-term follow-up and comparative studies are needed to evaluate real benefit.

  8. Bilateral lambdoid and sagittal synostosis (BLSS): a unique craniosynostosis syndrome or predictable craniofacial phenotype?

    PubMed

    Hing, Anne V; Click, Eleanor S; Holder, Ursula; Seto, Marianne L; Vessey, Kyle; Gruss, Joseph; Hopper, Richard; Cunningham, Michael L

    2009-05-01

    Multisutural craniosynostosis that includes bilateral lambdoid and sagittal synostosis (BLSS) results in a very characteristic head shape with frontal bossing, turribrachycephaly, biparietal narrowing, occipital concavity, and inferior displacement of the ears. This entity has been reported both in the genetics literature as craniofacial dyssynostosis and in the surgical literature as "Mercedes Benz" syndrome. Craniofacial dyssynostosis was first described in 1976 by Dr. Neuhauser when he presented a series of seven patients with synostosis of the sagittal and lambdoid sutures, short stature, and developmental delay. Over the past 30 years nine additional patients with craniofacial dyssynostosis have been reported in the literature adding to the growing evidence for a distinct craniosynostosis syndrome. The term "Mercedes Benz" syndrome was coined by Moore et al. in 1998 due to the characteristic appearance of the fused sutures on three-dimensional CT imaging. In contrast to the aforementioned reported cases of craniofacial dyssynostosis, all three patients had normal development. Recently, there have been several case reports of patients with BLSS and distinct chromosomal anomalies. These findings suggest that BLSS is a heterogeneous disorder perhaps with syndromic, chromosomal, and isolated forms. In this manuscript we will present the largest series of patients with BLSS and review clinical, CT, and molecular findings.

  9. Treatment of the Superior Sagittal Sinus Thrombosis with the Mechanical Thrombectomy Using Stent-Retriever Device

    PubMed Central

    Kim, Hoon; Kim, Seong Rim; Park, Ik Seong

    2016-01-01

    Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device (4×20 mm) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR (6×20 mm). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences. PMID:27651872

  10. Current concepts on the sagittal balance and classification of spondylolysis and spondylolisthesis☆☆☆

    PubMed Central

    Tebet, Marcos Antonio

    2014-01-01

    Treatment of spondylolysis and spondylolisthesis remains a challenge for orthopaedic surgeons, neurosurgeons and paediatrics. In spondylolisthesis, it has been clearly demonstrated over the past decade that spino-pelvic morphology is abnormal and that it can be associated to an abnormal sacro-pelvic orientation as well as to a disturbed global sagittal balance of spine. This article presents the SDSG (Spinal Deformity Study Group) classification of lumbosacral spondylolisthesis. The proper treatment of spondylolisthesis is dependent on recognizing the type of slip, sacro-pelvic balance and overall sagittal balance and its natural history. Although a number of clinical radiographic features have been identified as risk factors, their role as primary causative factors or secondary adaptative changes is not clear. The conservative treatment of adult isthmic spondylolisthesis results in good outcome in the majority of cases. Of those patients who fail conservative treatment, success with surgery is quite good, with significant improvement in neurologic function in those patients with deficits, as well as improvement in patients with back pain. PMID:26229765

  11. Current concepts on the sagittal balance and classification of spondylolysis and spondylolisthesis.

    PubMed

    Tebet, Marcos Antonio

    2014-01-01

    Treatment of spondylolysis and spondylolisthesis remains a challenge for orthopaedic surgeons, neurosurgeons and paediatrics. In spondylolisthesis, it has been clearly demonstrated over the past decade that spino-pelvic morphology is abnormal and that it can be associated to an abnormal sacro-pelvic orientation as well as to a disturbed global sagittal balance of spine. This article presents the SDSG (Spinal Deformity Study Group) classification of lumbosacral spondylolisthesis. The proper treatment of spondylolisthesis is dependent on recognizing the type of slip, sacro-pelvic balance and overall sagittal balance and its natural history. Although a number of clinical radiographic features have been identified as risk factors, their role as primary causative factors or secondary adaptative changes is not clear. The conservative treatment of adult isthmic spondylolisthesis results in good outcome in the majority of cases. Of those patients who fail conservative treatment, success with surgery is quite good, with significant improvement in neurologic function in those patients with deficits, as well as improvement in patients with back pain.

  12. Effects of increased muscle mass on mouse sagittal suture morphology and mechanics.

    PubMed

    Byron, Craig D; Borke, James; Yu, Jack; Pashley, David; Wingard, Christopher J; Hamrick, Mark

    2004-07-01

    The purpose of this study is to test predicted form-function relationships between cranial suture complexity and masticatory muscle mass and biomechanics in a mouse model. Specifically, to test the hypothesis that increased masticatory muscle mass increases sagittal suture complexity, we measured the fractal dimension (FD), temporalis mass, and temporalis bite force in myostatin-deficient (GDF8(-/-)) mice and wild-type CD-1 mice (all male, 6 months old). Myostatin is a negative regulator of muscle mass, and myostatin-deficient mice show a marked increase in muscle mass compared to normal mice. We predicted that increased sagittal suture complexity would decrease suture stiffness. The data presented here demonstrate that increased suture complexity (measured as FD) was observed in a hypermuscular mouse model (GDF8(-/-)) with significantly increased temporalis muscle mass and bite forces. Hypermuscular mice were also found to possess suture connective tissue that was less stiff (i.e., underwent more displacement before failure occurred) when loaded in tension. By decreasing stiffness, suture complexity apparently helps to dissipate mechanical loads within the cranium that are related to chewing. These results suggest that cranial suture connective tissue locally adapts to functional demands of the biomechanical suture environment. As such, cranial sutures provide a novel model for studies in connective tissue mechanotransduction.

  13. Treatment of the Superior Sagittal Sinus Thrombosis with the Mechanical Thrombectomy Using Stent-Retriever Device

    PubMed Central

    Kim, Hoon; Kim, Seong Rim; Park, Ik Seong

    2016-01-01

    Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device (4×20 mm) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR (6×20 mm). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences.

  14. Risk factors for breakage of biodegradable plate systems after bilateral sagittal split mandibular setback surgery.

    PubMed

    Yoshioka, Izumi; Igawa, Kaori; Nagata, Jyunko; Yoshida, Maho; Baba, Takashi; Ichiki, Takeshi; Kondoh, Yudai; Takamori, Koichi; Kashima, Koji; Sakoda, Sumio

    2013-06-01

    The aim of this retrospective study was to evaluate the risk factors associated with breakage of biodegradable plate systems after bilateral sagittal split mandibular setback. We studied 169 Japanese adults (62 men, 107 women; age range 16-53 years) with deformities of the jaw diagnosed as mandibular prognathism. All patients were treated by bilateral sagittal split osteotomy (BSSO) with 2 biodegradable fixation plates and screws at the anterior mandibular ramus. We collected the following data from the medical records and radiological findings: sex; age; degree of setback; presence of asymmetry; presence of open bite; operation; design of the plate; operating time; and blood loss. Multiple logistic regression analysis was used to find the factors that were independently associated with the dependent variable: breakage of the biodegradable plate system. In 10 of the 169 patients (6%) the biodegradable plate system for the BSSO broke. Factors that influenced whether or not the biodegradable plate system fractured were if they were asymmetrical (odds ratio (OR) 5.35; P=0.02) and had an open bite (OR 5.20; P=0.02). Asymmetry or open bite was significantly associated with breaks in the biodegradable plate system. Biodegradable plates should be used only when loading is minimal.

  15. Treatment of the Superior Sagittal Sinus Thrombosis with the Mechanical Thrombectomy Using Stent-Retriever Device.

    PubMed

    Kim, Hoon; Kim, Seong Rim; Park, Ik Seong; Kim, Young Woo

    2016-09-01

    Cerebral venous sinus thrombosisis an uncommon entity and its clinical presentations are highly variable. We present the case of superior sagittal sinus thrombosis. Although it was medical refractory, successfully treated with mechanical thrombectomy using the Solitaire FR device. A 27-year-old man who presented with venous infarction accompanied by petechial hemorrhage secondary to the superior sagittal sinus (SSS) thrombosis. Due to rapid deterioration despite of anticoagulation therapy, the patient was taken for endovascular treatment. We deployed the Solitaire FR device (4×20 mm) in the anterior portion of the thrombosed SSS, and it was left for ten minutes before the retraction. Thus, we removed a small amount of thrombus. But the sinus remained occluded. We therefore performed the thrombectomy using the same methods using the Solitaire FR (6×20 mm). Thus, we were successful in removing larger clots. Our case highlights not only that the mechanical thrombectomy using the Solitaire FR is effective in achieving revascularization both rapidly and efficiently available, but also that it might be another option in patients with cerebral venous sinus thrombosis who concurrently had rapid clinical deterioration with devastating consequences. PMID:27651872

  16. Relationship of brain and skull in pre- and postoperative sagittal synostosis

    PubMed Central

    Aldridge, Kristina; Kane, Alex A; Marsh, Jeffrey L; Yan, Peng; Govier, Daniel; Richtsmeier, Joan T

    2005-01-01

    Models of vertebrate skull evolution stress the coordinated developmental relationship between the skull and the brain that it houses. This study investigates the relationship between altered skull morphology and brain morphology in premature fusion of the cranial sagittal suture (isolated sagittal synostosis; ISS), a condition associated with dysmorphology of both neurocranium and brain. Although the skull displays a more normal shape following reconstructive cranial vault surgery, effects of this surgery on the brain have not been investigated. Landmark coordinate data were collected from three-dimensional magnetic resonance imaging reconstructions of the brain in a sample of ISS patients and an age-matched unaffected cohort. These data were analysed using Euclidean distance matrix analysis (EDMA). Results show that the brain in ISS is dysmorphic preoperatively, displaying a posteriorly directed neural expansion that does not ‘worsen’ with growth. Postoperatively, the brain in ISS displays a more globular shape overall as compared with the preoperative morphology, but differs from normal in its subcortical morphology. These results show that the ISS brain is altered following neurocranial surgery, but does not more closely approximate that of unaffected individuals. This suggests that although the brain is affected by manipulation of the skull, it retains a growth pattern that is, at least in part, independent of the skull. PMID:15817105

  17. The Role of Hyperthyroidism as the Predisposing Factor for Superior Sagittal Sinus Thrombosis

    PubMed Central

    Hwang, Jong-Uk; Hur, Jin-Woo; Lee, Jong-Won; Lee, Hyun-Koo

    2012-01-01

    Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who developed seizure and mental deterioration. Findings on brain computed tomography (CT) showed multiple hemorrhages in the subcortical area of both middle frontal gyrus and cerebral digital subtraction angiography (DSA) showed irregular intra-luminal filling defects of the superior sagittal sinus. These findings were consistent with hemorrhagic transformation of SSST. Findings on clinical laboratory tests were consistent with hyperthyroidism. In addition, our patient also showed high activity of factors IX and XI. The patient received treatment with oral anticoagulant and prophylthiouracil. His symptoms showed complete improvement. A follow-up cerebral angiography four weeks after treatment showed a recanalization of the SSS. In conclusion, findings of our case indicate that hypercoagulability may contribute to development of SSST in a patient with hyperthyroidism. PMID:23210057

  18. Evaluation of facial morphology and sagittal relationship between dental arches in primary and mixed dentition

    PubMed Central

    Traldi, Aline; Valdrighi, Heloísa Cristina; de Souza, Luciane Zanin; Vedovello, Silvia Amélia Scudeler

    2015-01-01

    OBJECTIVE: To assess facial morphology (Pattern) and sagittal relationship between dental arches (Class), and establish a potential association between them and the variables sex, age and ethnicity, among schoolchildren aged between 4 and 9 years old (mean age of 6.7 years) in primary and mixed dentitions. METHODS: The sample comprised 875 children (457 males and 418 females) attending schools in Descalvado, São Paulo, Brazil. An attempt was made with a view to establish a potential association between children's morphological features with sex, age and ethnicity. RESULTS: Descriptive analysis revealed a predominance of facial Pattern I (69.9 %) and Class I (67.4 %). Statistical tests (p < 0.001) showed that Class I was more frequent among Pattern I children, whereas Class II prevailed among Pattern II, and Class III was frequent among Pattern I and III children. Ethnicity was the only variable associated with facial pattern. CONCLUSIONS: Results suggest that facial pattern and sagittal relationship between dental arches tend to be correlated. Ethnicity was associated with facial pattern, with Pattern I being the most recurrent among Caucasians and facial Pattern II being recurrent among Afro-descendant subjects. PMID:26352847

  19. The role of hyperthyroidism as the predisposing factor for superior sagittal sinus thrombosis.

    PubMed

    Hwang, Jong-Uk; Kwon, Ki-Young; Hur, Jin-Woo; Lee, Jong-Won; Lee, Hyun-Koo

    2012-09-01

    Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who developed seizure and mental deterioration. Findings on brain computed tomography (CT) showed multiple hemorrhages in the subcortical area of both middle frontal gyrus and cerebral digital subtraction angiography (DSA) showed irregular intra-luminal filling defects of the superior sagittal sinus. These findings were consistent with hemorrhagic transformation of SSST. Findings on clinical laboratory tests were consistent with hyperthyroidism. In addition, our patient also showed high activity of factors IX and XI. The patient received treatment with oral anticoagulant and prophylthiouracil. His symptoms showed complete improvement. A follow-up cerebral angiography four weeks after treatment showed a recanalization of the SSS. In conclusion, findings of our case indicate that hypercoagulability may contribute to development of SSST in a patient with hyperthyroidism. PMID:23210057

  20. Bilateral lambdoid and sagittal synostosis (BLSS): a unique craniosynostosis syndrome or predictable craniofacial phenotype?

    PubMed

    Hing, Anne V; Click, Eleanor S; Holder, Ursula; Seto, Marianne L; Vessey, Kyle; Gruss, Joseph; Hopper, Richard; Cunningham, Michael L

    2009-05-01

    Multisutural craniosynostosis that includes bilateral lambdoid and sagittal synostosis (BLSS) results in a very characteristic head shape with frontal bossing, turribrachycephaly, biparietal narrowing, occipital concavity, and inferior displacement of the ears. This entity has been reported both in the genetics literature as craniofacial dyssynostosis and in the surgical literature as "Mercedes Benz" syndrome. Craniofacial dyssynostosis was first described in 1976 by Dr. Neuhauser when he presented a series of seven patients with synostosis of the sagittal and lambdoid sutures, short stature, and developmental delay. Over the past 30 years nine additional patients with craniofacial dyssynostosis have been reported in the literature adding to the growing evidence for a distinct craniosynostosis syndrome. The term "Mercedes Benz" syndrome was coined by Moore et al. in 1998 due to the characteristic appearance of the fused sutures on three-dimensional CT imaging. In contrast to the aforementioned reported cases of craniofacial dyssynostosis, all three patients had normal development. Recently, there have been several case reports of patients with BLSS and distinct chromosomal anomalies. These findings suggest that BLSS is a heterogeneous disorder perhaps with syndromic, chromosomal, and isolated forms. In this manuscript we will present the largest series of patients with BLSS and review clinical, CT, and molecular findings. PMID:19396832

  1. On growth measurements of abdominal aortic aneurysms using maximally inscribed spheres.

    PubMed

    Gharahi, H; Zambrano, B A; Lim, C; Choi, J; Lee, W; Baek, S

    2015-07-01

    The maximum diameter, total volume of the abdominal aorta, and its growth rate are usually regarded as key factors for making a decision on the therapeutic operation time for an abdominal aortic aneurysm (AAA) patient. There is, however, a debate on what is the best standard method to measure the diameter. Currently, two dominant methods for measuring the maximum diameter are used. One is measured on the planes perpendicular to the aneurism's central line (orthogonal diameter) and the other one is measured on the axial planes (axial diameter). In this paper, another method called 'inscribed-spherical diameter' is proposed to measure the diameter. The main idea is to find the diameter of the largest sphere that fits within the aorta. An algorithm is employed to establish a centerline for the AAA geometries obtained from a set of longitudinal scans obtained from South Korea. This centerline, besides being the base of the inscribed spherical method, is used for the determination of orthogonal and axial diameter. The growth rate parameters are calculated in different diameters and the total volume and the correlations between them are studied. Furthermore, an exponential growth pattern is sought for the maximum diameters over time to examine a nonlinear growth pattern of AAA expansion both globally and locally. The results present the similarities and discrepancies of these three methods. We report the shortcomings and the advantages of each method and its performance in the quantification of expansion rates. While the orthogonal diameter measurement has an ability of capturing a realistic diameter, it fluctuated. On the other hand, the inscribed sphere diameter method tends to underestimate the diameter measurement but the growth rate can be bounded in a narrow region for aiding prediction capability. Moreover, expansion rate parameters derived from this measurement exhibit good correlation with each other and with growth rate of volume. In conclusion, although the

  2. Abdominal Distension and Vascular Collapse.

    PubMed

    Cosentino, Gina; Uwaifo, Gabriel I

    2016-04-01

    We present the case of a 43-year-old gentleman who presented to the emergency room with acute abdominal distension, confusion and vascular collapse. The emergent radiologic imaging obtained showed massive bilateral adrenal enlargement, but despite the initial clinical suspicion of possible overwhelming sepsis and/or massive abdominal/intralesional hemorrhage, lab tests based obtained rapidly confirmed the diagnosis of acute Addisonian crisis which responded dramatically to adrenocorticoid hormone replacement therapy and aggressive fluid resuscitation. The patient's established history of metastatic lung cancer confirmed this as a case of metastatic massive bilateral adrenal metastases with an initial presentation of acute adrenal insufficiency which is uncommon in the setting of metastatic carcinomatosis but more typically associated with lymphomas. Recognition of this clinical possibility is vital to enable rapid diagnosis and consequent life saving therapy. PMID:27328473

  3. [Abdominal bruit associated with hypertension].

    PubMed

    Fontseré, N; Bonet, J; Bonal, J; Romero, R

    2004-01-01

    First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated.

  4. [Abdominal cystic tumor revealing lymphangioleiomyomatosis].

    PubMed

    Barbier, L; Ebbo, M; Andrac-Meyer, L; Schneilitz, N; Le Treut, Y-P; Reynaud-Gaubert, M; Hardwigsen, J

    2009-02-01

    We report the case of a 39 year-old woman with many years of intermittent abdominal pain who was found to have cystic masses evocative of cystic lymphangioma involving the posterior mediastinal and retroperitoneum. Worsening abdominal pain led to a recommendation for laparoscopic unroofing and decompression of the cysts. During the postoperative period, hemorrhagic shock required reintervention with excision of the tumoral mass. Pathologic examination revealed lymphangioleiomyomatosis (LAM). On the 15th postoperative day, the patient developed a chylopneumothorax which required prolonged chest tube drainage. The presence of multiple polycystic lesions in the pulmonary parenchyma supported the diagnosis of diffuse LAM with primary extrapulmonary presentation. This diagnosis should be considered preoperatively since it modifies the treatment: a complete excision of the cystic lesions seems to be necessary in order to prevent bleeding and lymphatic extravasation.

  5. Management of voluminous abdominal incisional hernia.

    PubMed

    Bouillot, J-L; Poghosyan, T; Pogoshian, T; Corigliano, N; Canard, G; Veyrie, N

    2012-10-01

    Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference. PMID:23137643

  6. [Endovascular treatment of abdominal aortic aneurysms].

    PubMed

    Hatlinghus, S; Dale, L G; Nordby, A; Aadahl, P; Lundbom, J; Saether, O D; Myhre, H O

    1996-02-28

    Eight patients, six men and two women (mean age 67.3 years) were treated for infrarenal abdominal aortic aneurysm by endovascular technique. A bifurcated graft (Mialhe Stentor, Min Tec, France) was used in all cases. The introducing system, with an 18 French diameter, is inserted through an arteriotomy in the common femoral artery. The proximal end of the main part of the graft is placed just distal to the renal arteries, and includes one graft limb, which is placed in the iliac artery on the ipsilateral side. The contralateral graft limb is introduced into a short limb of the main graft through a 10 French introducer, using Seldinger-technique, from the contralateral common femoral artery. All the implantations were successful from both a technical and a clinical point of view. All patients except one were mobilized on the first day after operation and received a normal diet. A thorough preoperative evaluation of the patient with regard to selection of the right size of the implant is necessary, and the implantation must be performed with great attention to technical details. PMID:8644071

  7. Osteoprotegerin Prevents Development of Abdominal Aortic Aneurysms

    PubMed Central

    Fujii, Masayuki; Yoshimura, Koichi; Aoki, Hiroki; Orita, Yuichi; Ishida, Takafumi; Ohtaki, Megu; Nagao, Masataka; Ishida, Mari; Yoshizumi, Masao

    2016-01-01

    Abdominal aortic aneurysms (AAAs), which commonly occur among elderly individuals, are accompanied by a risk of rupture and subsequent high mortality. Establishment of medical therapies for the prevention of AAAs requires further understanding of the molecular pathogenesis of this condition. This report details the possible involvement of Osteoprotegerin (OPG) in the prevention of AAAs through inhibition of Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). In CaCl2-induced AAA models, both internal and external diameters were significantly increased with destruction of elastic fibers in the media in Opg knockout (KO) mice, as compared to wild-type mice. Moreover, up-regulation of TRAIL expression was observed in the media by immunohistochemical analyses. Using a culture system, both the TRAIL-induced expression of matrix metalloproteinase-9 in smooth muscle cells (SMCs) and the chemoattractive effect of TRAIL on SMCs were inhibited by OPG. These data suggest that Opg may play a preventive role in the development of AAA through its antagonistic effect on Trail. PMID:26783750

  8. Pupil Diameter Tracks Lapses of Attention

    PubMed Central

    Murphy, Peter R.; Nieuwenhuis, Sander

    2016-01-01

    Our ability to sustain attention for prolonged periods of time is limited. Studies on the relationship between lapses of attention and psychophysiological markers of attentional state, such as pupil diameter, have yielded contradicting results. Here, we investigated the relationship between tonic fluctuations in pupil diameter and performance on a demanding sustained attention task. We found robust linear relationships between baseline pupil diameter and several measures of task performance, suggesting that attentional lapses tended to occur when pupil diameter was small. However, these observations were primarily driven by the joint effects of time-on-task on baseline pupil diameter and task performance. The linear relationships disappeared when we statistically controlled for time-on-task effects and were replaced by consistent inverted U-shaped relationships between baseline pupil diameter and each of the task performance measures, such that most false alarms and the longest and most variable response times occurred when pupil diameter was both relatively small and large. Finally, we observed strong linear relationships between the temporal derivative of pupil diameter and task performance measures, which were largely independent of time-on-task. Our results help to reconcile contradicting findings in the literature on pupil-linked changes in attentional state, and are consistent with the adaptive gain theory of locus coeruleus-norepinephrine function. Moreover, they suggest that the derivative of baseline pupil diameter is a potentially useful psychophysiological marker that could be used in the on-line prediction and prevention of attentional lapses. PMID:27768778

  9. Diameter Effect In Initiating Explosives, Numerical Simulations

    SciTech Connect

    Lefrancois, A.; Benterou, J.; Roeske, F.; Roos, E.

    2006-02-10

    The ability to safely machine small pieces of HE with the femtosecond laser allows diameter effect experiments to be performed in initiating explosives in order to study the failure diameter, the reduction of the detonation velocity and curvature versus the diameter. The reduced diameter configuration needs to be optimized, so that the detonation products of the first cylinder will not affect the measurement of the detonation velocity of the second cylinder with a streak camera. Different 2D axi-symmetrical configurations have been calculated to identify the best solution using the Ignition and Growth reactive flow model for LX16 Pellet with Ls-Dyna.

  10. Acute Abdominal Pain in Children.

    PubMed

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  11. Roles of Sagittal Anatomical Parameters of the Pelvis in Primary Total Hip Replacement for Patients with Ankylosing Spondylitis.

    PubMed

    Gu, Minghui; Zhang, Zhiqi; Kang, Yan; Sheng, Puyi; Yang, Zibo; Zhang, Ziji; Liao, Weiming

    2015-12-01

    We examined the correlation between acetabular prostheses and sagittal anatomical parameters of the pelvis for the preoperative evaluation of total hip arthroplasty in 29 patients with ankylosing spondylitis between April 2004 and November 2011. No implant dislocation or subsidence was observed at 4.18 years. The relationship between sagittal parameters conformed to the equation Pelvic incidence (PI)=Pelvic tilt (PT)+Sacral slope (SS). Better outcomes were achieved in the SS>PT group, postoperative function was positively correlated with SS/PI. Functional abduction and anteversion were positively correlated with PT but negatively correlated with SS. Due to the compensatory changes in the pelvis and spine of patients with AS, the preoperative assessment of sagittal parameters plays pivotal roles in placing acetabular prostheses in optimal positions and preventing postoperative impingement and dislocation.

  12. Propofol-remifentanil is More Effective than Propofol-fentanyl in Decreasing Intraoperative Blood Loss during Sagittal Split Ramus Osteotomy.

    PubMed

    Handa, Toshiyuki; Onodera, Takaaki; Honda, Yoshifumi; Koukita, Yoshihiko; Ichinohe, Tatsuya

    2016-01-01

    This study retrospectively compared blood loss during sagittal split ramus osteotomy in patients receiving propofol-remifentanil (R group) and those receiving propofol-fentanyl (F group). All patients underwent sagittal split ramus osteotomy under general anesthesia during the 3-year 4-month period between October 2007 and February 2011 in an operating room at Tokyo Dental College Suidobashi Hospital. Blood loss in the R group was significantly less than that in the F group. Mean arterial pressure and heart rate, measured at 20 and 15 min after tracheal intubation, respectively, were both lower in the R group. No marked change was observed in blood pressure in the R group under general anesthesia, however. Volume of urine was also larger in the R group. The results of this study suggest that remifentanil is effective in reducing intraoperative blood loss during sagittal split ramus osteotomy. PMID:27665694

  13. Graft Diameter matters in Hamstring ACL reconstruction

    PubMed Central

    Clatworthy, Mark

    2016-01-01

    Objective: Recently techniques have been developed to increase graft diameter in hamstring ACL reconstruction with the hope to decrease graft failure. To date there is limited evidence to show that a smaller graft diameter results in a higher ACL failure rate. Method: The factors for failure in 1480 consecutive single surgeon hamstring ACL reconstructions were evaluated prospectively. Patients were followed for 2-15 years. A multivariate analysis was performed which looked at graft size, age, sex, time to surgery, meniscal integrity, meniscal repair and ACL graft placement to determine whether graft diameter matters in determining the failure of hamstring ACL reconstruction. Results: Graft diameters ranged from 6-10 mm. The mean graft diameter for all patients was 7.75 mm. 83 ACL reconstructions failed. The mean size of graft failures was 7.55 mm ACL reconstructions that failed had a significantly smaller hamstring graft diameter p=0.001. The Hazard Ratio for a smaller diameter graft is 0.517 p=<0.0001. For every 1 mm decrease in graft diameter there is a 48.3% higher chance of failure. The multivariate analysis showed a hazard ratio of 0.543 p=0.002. For every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure. Conclusion: Smaller diameter hamstring grafts do have a higher failure rate. Grafts ≤ 7.5 mm had twice the failure rate of grafts ≥8 mm using a multivariate analysis for every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure.

  14. The outcome of abdominal aortic aneurysm repair in northern Malaysia.

    PubMed

    Lakhwani, M N; Yeoh, K C; Gooi, B H; Lim, S K

    2003-08-01

    A prospective study of all infrarenal abdominal aortic aneurysm (AAA) repairs both as electives and emergencies in Penang between January 1997 to December 2000 is presented. The objectives of the study were to determine the age, gender, racial distribution of the patients, the incidence, and risk factors and to summarize treatments undertaken and discuss the outcome. Among the races, the Malays were the most common presenting with infrarenal AAA. The mean age of patients operated was 68.5 years. Males were more commonly affected compared to females (12:1). Most infrarenal AAA repairs were performed as emergency operations, 33 cases (61.1%) compared to electives, 21 cases (38.9%). Total survival was 70.3% (elective 85.7%; emergency 57.6%). Mortality rate was 31.5% and the primary reason is the lack of operating time available for urgent operation and for treatment of concurrent disease states. Mycotic aneurysm with its triad of abdominal pain, fever and abdominal mass resulted in a significantly higher mortality (46.6%). Ninety six percent of the infrarenal AAA had transverse diameter greater than 6 cm. Morphologically 90.7% were fusiform AAA rather than saccular aneurysm (9.3%). Pulmonary complications (35.2%) were more common than cardiac complications (11.1%) possibly related to the urgent nature of the operation, smoking or history of pulmonary tuberculosis. Bleeding (14.8%) was the most common cause of mortality in ruptured mycotic infrarenal AAA.

  15. 7 CFR 51.2850 - Diameter.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... Diameter. Diameter means the greatest dimension measured at right angles to a straight line running...

  16. 7 CFR 51.651 - Diameter.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946...) Definitions § 51.651 Diameter. Diameter means the greatest dimension measured at right angles to a line...

  17. 7 CFR 51.712 - Diameter.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... § 51.712 Diameter. Diameter means the greatest dimension measured at right angles to a line from...

  18. Shrinking plastic tubing and nonstandard diameters

    NASA Technical Reports Server (NTRS)

    Ruiz, W. V.; Thatcher, C. S.

    1980-01-01

    Process allows larger-than-normal postshrink diameters without splitting. Tetrafluoroethylene tubing on mandrel is supported within hot steel pipe by several small diameter coil sections. Rising temperature of mandrel is measured via thermocouple so assembly can be removed without overshrinking (and splitting) of tubing.

  19. 7 CFR 51.2850 - Diameter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... Diameter. Diameter means the greatest dimension measured at right angles to a straight line running...

  20. 7 CFR 51.651 - Diameter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946...) Definitions § 51.651 Diameter. Diameter means the greatest dimension measured at right angles to a line...

  1. 7 CFR 51.712 - Diameter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946... § 51.712 Diameter. Diameter means the greatest dimension measured at right angles to a line from...

  2. Reliability of the Radiographic Sagittal and Frontal Tibiotalar Alignment after Ankle Arthrodesis

    PubMed Central

    Willegger, Madeleine; Holinka, Johannes; Nemecek, Elena; Bock, Peter; Wanivenhaus, Axel Hugo; Windhager, Reinhard; Schuh, Reinhard

    2016-01-01

    Background Accurate measurement of the tibiotalar alignment is important in radiographic outcome assessment of ankle arthrodesis (AA). In studies, various radiological methods have been used to measure the tibiotalar alignment leading to facultative misinterpretation of results. However, to our knowledge, no previous study has investigated the reliability of tibiotalar alignment measurement in AA. We aimed to investigate the reliability of four different methods of measurement of the frontal and sagittal tibiotalar alignment after AA, and to further clarify the most reliable method for determining the longitudinal axis of the tibia. Methods Thirty-eight weight bearing anterior to posterior and lateral ankle radiographs of thirty-seven patients who had undergone AA with a two screw fixation technique were selected. Three observers measured the frontal tibiotalar angle (FTTA) and the sagittal tibiotalar angle (STTA) using four different methods. The methods differed by the definition of the longitudinal tibial axis. Method A was defined by a line drawn along the lateral tibial border in anterior to posterior radiographs and along the posterior tibial border in lateral radiographs. Method B was defined by a line connecting two points in the middle of the proximal and the distal tibial shaft. Method C was drawn „freestyle”along the longitudinal axis of the tibia, and method D was defined by a line connecting the center of the tibial articular surface and a point in the middle of the proximal tibial shaft. Intra- and interobserver correlation coefficients (ICC) and repeated measurement ANOVA were calculated to assess measurement reliability and accuracy. Results All four methods showed excellent inter- and intraobserver reliability for the FTTA and the STTA. When the longitudinal tibial axis is defined by connecting two points in the middle of the proximal and the distal tibial shaft, the highest interobserver reliability for the FTTA (ICC: 0.980; CI 95%: 0.966–0

  3. Agreement between fiber optic and optoelectronic systems for quantifying sagittal plane spinal curvature in sitting.

    PubMed

    Cloud, Beth A; Zhao, Kristin D; Breighner, Ryan; Giambini, Hugo; An, Kai-Nan

    2014-07-01

    Spinal posture affects how individuals function from a manual wheelchair. There is a need to directly quantify spinal posture in this population to ultimately improve function. A fiber optic system, comprised of an attached series of sensors, is promising for measuring large regions of the spine in individuals sitting in a wheelchair. The purpose of this study was to determine the agreement between fiber optic and optoelectronic systems for measuring spinal curvature, and describe the range of sagittal plane spinal curvatures in natural sitting. Able-bodied adults (n = 26, 13 male) participated. Each participant assumed three sitting postures: natural, slouched (accentuated kyphosis), and extension (accentuated lordosis) sitting. Fiber optic (ShapeTape) and optoelectronic (Optotrak) systems were applied to the skin over spinous processes from S1 to C7 and used to measure sagittal plane spinal curvature. Regions of kyphosis and lordosis were identified. A Cobb angle-like method was used to quantify lordosis and kyphosis. Generalized linear model and Bland-Altman analyses were used to assess agreement. A strong correlation exists between curvature values obtained with Optotrak and ShapeTape (R(2) = 0.98). The mean difference between Optotrak and ShapeTape for kyphosis in natural, extension, and slouched postures was 4.30° (95% LOA: -3.43 to 12.04°), 3.64° (95% LOA: -1.07 to 8.36°), and 4.02° (95% LOA: -2.80 to 10.84°), respectively. The mean difference for lordosis, when present, in natural and extension postures was 2.86° (95% LOA: -1.18 to 6.90°) and 2.55° (95% LOA: -3.38 to 8.48°), respectively. In natural sitting, the mean ± SD of kyphosis values was 35.07 ± 6.75°. Lordosis was detected in 8/26 participants: 11.72 ± 7.32°. The fiber optic and optoelectronic systems demonstrate acceptable agreement for measuring sagittal plane thoracolumbar spinal curvature.

  4. Office-based ultrasound screening for abdominal aortic aneurysm

    PubMed Central

    Blois, Beau

    2012-01-01

    Abstract Objective To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA). Design A prospective observational study. Consecutive patients were approached by nonphysician staff. Setting Rural family physician offices in Grand Forks and Revelstoke, BC. Participants The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA. Main outcome measures A focused “quick screen,” which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (ie, a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded. Results Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds). Conclusion Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point

  5. Serial Measurements of Splanchnic Vein Diameters in Rats Using High-Frequency Ultrasound

    PubMed Central

    Seitz, Bridget M.; Krieger-Burke, Teresa; Fink, Gregory D.; Watts, Stephanie W.

    2016-01-01

    The purpose of this study was to investigate serial ultrasound imaging in rats as a fully non-invasive method to (1) quantify the diameters of splanchnic veins in real time as an indirect surrogate for the capacitance function of those veins, and (2) assess the effects of drugs on venous dimensions. A 21 MHz probe was used on anesthetized male Sprague–Dawley rats to collect images containing the portal vein (PV), superior mesenteric vein (SMV), abdominal inferior vena cava (IVC), and splenic vein (SpV; used as a landmark in timed studies) and the abdominal aorta (AA). Stable landmarks were established that allowed reproducible quantification of cross-sectional diameters within an animal. The average diameters of vessels measured every 5 min over 45 min remained within 0.75 ± 0.15% (PV), 0.2 ± 0.09% (SMV), 0.5 ± 0.12% (IVC), and 0.38 ± 0.06% (AA) of baseline (PV: 2.0 ± 0.12 mm; SMV: 1.7 ± 0.04 mm; IVC: 3.2 ± 0.1 mm; AA: 2.3 ± 0.14 mm). The maximal effects of the vasodilator sodium nitroprusside (SNP; 2 mg/kg, i.v. bolus) on venous diameters were determined 5 min post SNP bolus; the diameters of all noted veins were significantly increased by SNP, while mean arterial pressure (MAP) decreased 29 ± 4 mmHg. By contrast, administration of the venoconstrictor sarafotoxin (S6c; 5 ng/kg, i.v. bolus) significantly decreased PV and SpV, but not IVC, SMV, or AA, diameters 5 min post S6c bolus; MAP increased by 6 ± 2 mmHg. In order to determine if resting splanchnic vein diameters were stable over much longer periods of time, vessel diameters were measured every 2 weeks for 8 weeks. Measurements were found to be highly reproducible within animals over this time period. Finally, to evaluate the utility of vein imaging in a chronic condition, images were acquired from 4-week deoxycorticosterone acetate salt (DOCA-salt) hypertensive and normotensive (SHAM) control rats. All vessel diameters increased from baseline while MAP increased (67 ± 4 mmHg) in DOCA-salt rats

  6. Percutaneous Transhepatic Drainage of Inaccessible Abdominal Abscesses Following Abdominal Surgery Under Real-Time CT-Fluoroscopic Guidance

    SciTech Connect

    Yamakado, Koichiro Takaki, Haruyuki; Nakatsuka, Atsuhiro; Kashima, Masataka; Uraki, Junji; Yamanaka, Takashi; Takeda, Kan

    2010-02-15

    This study evaluated the safety, feasibility, and clinical utility of transhepatic drainage of inaccessible abdominal abscesses retrospectively under real-time computed tomographic (CT) guidance. For abdominal abscesses, 12 consecutive patients received percutaneous transhepatic drainage. Abscesses were considered inaccessible using the usual access route because they were surrounded by the liver and other organs. The maximum diameters of abscesses were 4.6-9.5 cm (mean, 6.7 {+-} 1.4 cm). An 8-Fr catheter was advanced into the abscess cavity through the liver parenchyma using real-time CT fluoroscopic guidance. Safety, feasibility, procedure time, and clinical utility were evaluated. Drainage catheters were placed with no complications in abscess cavities through the liver parenchyma in all patients. The mean procedure time was 18.8 {+-} 9.2 min (range, 12-41 min). All abscesses were drained. They shrank immediately after catheter placement. In conclusions, this transhepatic approach under real-time CT fluoroscopic guidance is a safe, feasible, and useful technique for use of drainage of inaccessible abdominal abscesses.

  7. Influence of neck pain on cervical movement in the sagittal plane during smartphone use

    PubMed Central

    Kim, Man-Sig

    2015-01-01

    [Purpose] Smartphone use reportedly changes posture. However, how neck posture is altered in smartphone users with neck pain is unknown. This study examined changes in the posture of young adults with and without mild neck pain (MNP) when using a smartphone. [Subjects] Thirteen control subjects and 14 subjects with MNP who used smartphones were recruited. [Methods] The upper cervical (UC) and lower cervical (LC) angles in the sagittal plane were measured using an ultrasound-based motion analysis system while the seated subjects used a smartphone for 5 min. [Results] During smartphone use, the MNP group exhibited greater UC and LC flexion angles than the control group. [Conclusion] These findings suggest that young adults with MNP are more careful and more frequently utilize a neutral neck posture than young adults without MNP when using a smartphone while sitting. PMID:25642027

  8. Antegrade rheolytic thrombectomy and thrombolysis for superior sagittal sinus thrombosis using burr hole access

    PubMed Central

    Lee, Darrin J; Latchaw, Richard E; Dahlin, Brian C; Dong, Paul R; Verro, Piero; Muizelaar, J Paul; Shahlaie, Kiarash

    2014-01-01

    Superior sagittal sinus (SSS) thrombosis has high morbidity and mortality, and urgent recanalization is critical for severe cases. Standard endovascular techniques for thrombolysis and thrombectomy use retrograde venous access, an approach that may be unsuccessful in cases with extensive firm clot burden involving the dural sinuses distal to the SSS. An anterior open transcranial approach to the SSS for catheter sheath placement to facilitate antegrade mechanical thrombectomy and thrombolysis of the SSS and more distal sinuses has not been previously described. Here we describe a case in which multiple unsuccessful attempts at retrograde endovascular access were attempted. Thus, a burr hole over the anterior SSS was performed for daily endovascular antegrade procedures using the Angiojet rheolytic catheter device and chemical thrombolysis. Near-complete recanalization of the SSS was achieved with venous outflow via dilated left transverse and left sigmoid sinuses, along with significant collateral flow in multiple cerebral veins. PMID:24692369

  9. Influence of neck pain on cervical movement in the sagittal plane during smartphone use.

    PubMed

    Kim, Man-Sig

    2015-01-01

    [Purpose] Smartphone use reportedly changes posture. However, how neck posture is altered in smartphone users with neck pain is unknown. This study examined changes in the posture of young adults with and without mild neck pain (MNP) when using a smartphone. [Subjects] Thirteen control subjects and 14 subjects with MNP who used smartphones were recruited. [Methods] The upper cervical (UC) and lower cervical (LC) angles in the sagittal plane were measured using an ultrasound-based motion analysis system while the seated subjects used a smartphone for 5 min. [Results] During smartphone use, the MNP group exhibited greater UC and LC flexion angles than the control group. [Conclusion] These findings suggest that young adults with MNP are more careful and more frequently utilize a neutral neck posture than young adults without MNP when using a smartphone while sitting. PMID:25642027

  10. Macrocephaly-capillary malformation syndrome in a newborn with tetralogy of fallot and sagittal sinus thrombosis.

    PubMed

    Ercan, Tugba Erener; Oztunc, Funda; Celkan, Tiraje; Bor, Meltem; Kizilkilic, Osman; Vural, Mehmet; Perk, Yildiz; Islak, Civan; Tuysuz, Beyhan

    2013-01-01

    Macrocephaly-capillary malformation syndrome is characterized by cutaneous vascular malformations with associated anomalies as macrocephaly, macrosomia, hemihypertrophy, hypotonia, developmental delay, lax joints, loose skin, polysyndactyly, and neuroimaging abnormalities. We present a newborn with a prenatal diagnosis of macrosomia and tetralogy of Fallot. He also had macrocephaly; a high forehead; capillary hemangioma on the forehead, upper lip, and philtrum; generalized loose skin; postaxial polydactyly of both hands and feet, with neuroimaging findings of polymicrogyria and thrombosis in sagittal sinus and sinus rectus. His condition was diagnosed as macrocephaly-capillary malformation syndrome in the neonatal period and he died suddenly during sleep at 6 months of age. The clinical course in this syndrome is not as benign as was previously thought. Careful follow-up of these patients with particular emphasis on neuroradiologic and cardiologic evaluation might help decrease the risk of sudden death and to improve long-term outcome. PMID:22451530

  11. Sagittal focusing of synchrotron radiation X-rays using a winged crystal.

    PubMed

    Nisawa, A; Yoneda, Y; Ueno, G; Murakami, H; Okajima, Y; Yamamoto, K; Senba, Y; Uesugi, K; Tanaka, Y; Yamamoto, M; Goto, S; Ishikawa, T

    2013-03-01

    A Si(111) winged crystal has been designed to minimize anticlastic bending and improve sagittal focusing efficiency. The crystal was thin with wide stiffening wings. The length-to-width ratio of the crystal was optimized by finite element analysis, and the optimal value was larger than the `golden value'. The analysis showed that the slope error owing to anticlastic bending is less than the Darwin width. The X-rays were focused two-dimensionally using the crystal and a tangentially bent mirror. The observed profiles of the focal spot agreed well with the results of a ray-tracing calculation in the energy range from 8 to 17.5 keV. X-ray diffraction measurements with a high signal-to-noise ratio using this focusing system were demonstrated for a small protein crystal.

  12. Sagittal wrist motion of carpal bones following intraarticular fractures of the distal radius.

    PubMed

    Lutz, M; Rudisch, A; Kralinger, F; Smekal, V; Goebel, G; Gabl, M; Pechlaner, S

    2005-06-01

    Forty patients (mean age, 37 years) with intraarticular C2 and C3 Colles fractures were treated by open reduction, internal fixation and bone grafting. At a mean follow-up of 8 years radiocarpal and midcarpal motion was evaluated, the depth of the articular surface of the distal radius in the sagittal plane was measured and the presence of arthritis was noted. The fractures healed with a mean palmar tilt of 6 degrees , a mean ulnar tilt of 18 degrees and ulna variance within 1 mm of the contralateral side. The depth of the articular surface of the distal radius was 1.3 mm greater than the uninvolved side. Measurement of carpal bone angles relative to the radius in maximum flexion and extension revealed lunate extension of 23 degrees , lunate flexion of 15 degrees , capitate extension of 62 degrees , capitate flexion of 40 degrees . There was a significant correlation between articular surface depth and radiocarpal motion.

  13. A Dynamic Finite Element Analysis of Human Foot Complex in the Sagittal Plane during Level Walking

    PubMed Central

    Qian, Zhihui; Ren, Lei; Ding, Yun; Hutchinson, John R.; Ren, Luquan

    2013-01-01

    The objective of this study is to develop a computational framework for investigating the dynamic behavior and the internal loading conditions of the human foot complex during locomotion. A subject-specific dynamic finite element model in the sagittal plane was constructed based on anatomical structures segmented from medical CT scan images. Three-dimensional gait measurements were conducted to support and validate the model. Ankle joint forces and moment derived from gait measurements were used to drive the model. Explicit finite element simulations were conducted, covering the entire stance phase from heel-strike impact to toe-off. The predicted ground reaction forces, center of pressure, foot bone motions and plantar surface pressure showed reasonably good agreement with the gait measurement data over most of the stance phase. The prediction discrepancies can be explained by the assumptions and limitations of the model. Our analysis showed that a dynamic FE simulation can improve the prediction accuracy in the peak plantar pressures at some parts of the foot complex by 10%–33% compared to a quasi-static FE simulation. However, to simplify the costly explicit FE simulation, the proposed model is confined only to the sagittal plane and has a simplified representation of foot structure. The dynamic finite element foot model proposed in this study would provide a useful tool for future extension to a fully muscle-driven dynamic three-dimensional model with detailed representation of all major anatomical structures, in order to investigate the structural dynamics of the human foot musculoskeletal system during normal or even pathological functioning. PMID:24244500

  14. Ability of Sagittal Kinematic Variables to Estimate Ground Reaction Forces and Joint Kinetics in Running

    PubMed Central

    Wille, Christa; Lenhart, Rachel; Wang, Sijian; Thelen, Darryl; Heiderscheit, Bryan

    2015-01-01

    Study Design Controlled laboratory study, cross sectional design. Objective To determine if sagittal kinematic variables can be used to estimate select running kinetics. Background Excessive loading during running has been implicated in a variety of injuries, yet this information is typically not assessed during a standard clinical examination. Developing a clinically feasible strategy to estimate ground reaction forces and joint kinetics may improve the ability to identify those at an increased risk of injury. Methods Three-dimensional kinematics and ground reaction forces of 45 participants were recorded during treadmill running at self-selected speed. Kinematic variables used to estimate specific kinetic metrics included: vertical excursion of the center of mass, foot inclination angle at initial contact, horizontal distance between the center of mass and heel at initial contact, knee flexion angle at initial contact, and peak knee flexion angle during stance. Linear mixed effects models were fitted to explore the association between the kinetic and kinematic measures, including step rate and gender, with final models created using backward variable selection. Results Models were developed to estimate peak knee extensor moment (R2=0.43), energy absorbed at the knee during loading response (R2=0.58), peak patellofemoral joint reaction force (R2=0.55), peak vertical ground reaction force (R2=0.48), braking impulse (R2=0.50), and average vertical loading rate (R2=0.04). Conclusions Our findings suggest that insights into important running kinetics can be obtained from a subset of sagittal plane kinematics common to a clinical running analysis. Of note, the limb posture at initial contact influenced subsequent loading patterns in stance. PMID:25156183

  15. An in vitro comparison between two different designs of sagittal split ramus osteotomy

    PubMed Central

    Andrade, Valdir Cabral; Luthi, Leonardo Flores; Sato, Fabio Loureiro; Pozzer, Leandro; Albergaria-Barbosa, Jose Ricardo

    2015-01-01

    Objectives To evaluate the influence of the type of osteotomy in the inferior aspect of the mandible on the mechanical performance. Materials and Methods The study was performed on 20 polyurethane hemimandibles. A sagittal split ramus osteotomy (SSRO) was designed in 10 hemimandibles (group 1) with a vertical osteotomy in the buccal side (second molar level) and final osteotomy was performed horizontally on the lingual aspect, while the mandible body osteotomy was finalized as a straight osteotomy in the basilar area, perpendicular to the body. For group 2, the same osteotomy technique was used, but an oblique osteotomy was done in the basilar aspect of the mandibular body, forming continuity with the sagittal cut in the basilar area. Using a surgical guide, osteosynthesis was performed with bicortical screws using an inverted L scheme. In both groups vertical compression tests were performed with a linear load of 1 mm/min on the central fossa of the first molar and tests were done with models made from photoelastic resin. Data were analyzed using Student's t-test, establishing a statistical significance when P <0.05. Results A statistical difference was not observed in the maximum displacements obtained in the two osteotomies (P <0.05). In the extensiometric analysis, statistically significant differences were identified only in the middle screw of the fixation. The photoelastic resin models showed force dissipation towards the inferior aspect of the mandible in both SSRO models. Conclusion We found that osteotomy of the inferior aspect did not influence the mechanical performance for osteosynthesis with an inverted L system. PMID:26131430

  16. Biomechanical Comparison of 3 Ankle Braces With and Without Free Rotation in the Sagittal Plane

    PubMed Central

    Alfuth, Martin; Klein, Dieter; Koch, Raphael; Rosenbaum, Dieter

    2014-01-01

    Context: Various designs of braces including hinged and nonhinged models are used to provide external support of the ankle. Hinged ankle braces supposedly allow almost free dorsiflexion and plantar flexion of the foot in the sagittal plane. It is unclear, however, whether this additional degree of freedom affects the stabilizing effect of the brace in the other planes of motion. Objective: To investigate the dynamic and passive stabilizing effects of 3 ankle braces, 2 hinged models that provide free plantar flexion–dorsiflexion in the sagittal plane and 1 ankle brace without a hinge. Design: Crossover study. Setting: University Movement Analysis Laboratory. Patients or Other Participants: Seventeen healthy volunteers (5 women, 12 men; age = 25.4 ± 4.8 years; height = 180.3 ± 6.5 cm; body mass = 75.5 ± 10.4 kg). Intervention(s): We dynamically induced foot inversion on a tilting platform and passively induced foot movements in 6 directions via a custom-built apparatus in 3 brace conditions and a control condition (no brace). Main Outcome Measure(s): Maximum inversion was determined dynamically using an in-shoe electrogoniometer. Passively induced maximal joint angles were measured using a torque and angle sensor. We analyzed differences among the 4 ankle-brace conditions (3 braces, 1 control) for each of the dependent variables with Friedman and post hoc tests (P < .05). Results: Each ankle brace restricted dynamic foot-inversion movements on the tilting platform as compared with the control condition, whereas only the 2 hinged ankle braces differed from each other, with greater movement restriction caused by the Ankle X model. Passive foot inversion was reduced with all ankle braces. Passive plantar flexion was greater in the hinged models as compared with the nonhinged brace. Conclusions: All ankle braces showed stabilizing effects against dynamic and passive foot inversion. Differences between the hinged braces and the nonhinged brace did not appear to be

  17. Quantitative measures of sagittal plane head-neck control: a test-retest reliability study.

    PubMed

    Popovich, John M; Reeves, N Peter; Priess, M Cody; Cholewicki, Jacek; Choi, Jongeun; Radcliffe, Clark J

    2015-02-01

    Determining the reliability of measurements used to quantify head-neck motor control is necessary before they can be used to study the effects of injury or treatment interventions. Thus, the purpose of this study was to determine the within- and between-day reliability of position tracking, position stabilization and force tracking tasks to quantify head-neck motor control. Ten asymptomatic subjects performed these tasks on two separate days. Position and force tracking tasks required subjects to track a pseudorandom square wave input signal by controlling their head-neck angular position (position tracking) or the magnitude of isometric force generated against a force sensor by the neck musculature (force tracking) in the sagittal plane. Position stabilization required subjects to maintain an upright head position while pseudorandom perturbations were applied to the upper body using a robotic platform. Within-day and between-day reliability of the frequency response curves were assessed using coefficients of multiple correlations (CMC). Root mean square error (RMSE) and mean bandpass signal energy, were computed for each task and between-day reliability was calculated using intra-class correlation coefficients (ICC). Within- and between-day CMCs for the position and force tracking tasks were all ≥0.96, while CMCs for position stabilization ranged from 0.72 to 0.82. ICCs for the position and force tracking tasks were all ≥0.93. For position stabilization, ICCs for RMSE and mean bandpass signal energy were 0.66 and 0.72, respectively. Measures of sagittal plane head-neck motor control using position tracking, position stabilization and force tracking tasks were demonstrated to be reliable.

  18. Quantitative measures of sagittal plane head-neck control: a test-retest reliability study

    PubMed Central

    Popovich, John M.; Reeves, N. Peter; Priess, M. Cody; Cholewicki, Jacek; Choi, Jongeun; Radcliffe, Clark J.

    2015-01-01

    Determining the reliability of measurements used to quantify head-neck motor control is necessary before they can be used to study the effects of injury or treatment interventions. Thus, the purpose of this study was to determine the within- and between-day reliability of position tracking, position stabilization and force tracking tasks to quantify head-neck motor control. Ten asymptomatic subjects performed these tasks on two separate days. Position and force tracking tasks required subjects to track a pseudorandom square wave input signal by controlling their head-neck angular position (position tracking) or the magnitude of isometric force generated against a force sensor by the neck musculature (force tracking) in the sagittal plane. Position stabilization required subjects to maintain an upright head position while pseudorandom perturbations were applied to the upper body using a robotic platform. Within-day and between-day reliability of the frequency response curves were assessed using coefficients of multiple correlations (CMC). Root mean square error (RMSE) and mean bandpass signal energy, were computed for each task and between-day reliability was calculated using intra-class correlation coefficients (ICC). Within- and between-day CMCs for the position and force tracking tasks were all 0.96, while CMCs for position stabilization ranged from 0.72-0.82. ICCs for the position and force tracking tasks were all 0.93. For position stabilization, ICCs for RMSE and mean bandpass signal energy were 0.66 and 0.72, respectively. Measures of sagittal plane head-neck motor control using position tracking, position stabilization and force tracking tasks were demonstrated to be reliable. PMID:25553673

  19. Analysis of Cervical Sagittal Balance Parameters in MRIs of Patients with Disc-Degenerative Disease

    PubMed Central

    Wang, Zhao-Lin; Xiao, Jian-Lin; Mou, Jian-Hui; Qin, Ting-Zheng; Liu, Peng

    2015-01-01

    Background The aim of this study was to explore the correlations between the different parameters of the cervical sagittal balance in magnetic resonance images (MRI) and evaluate the criteria for their clinical application in disc-degenerative diseases. Material/Methods We conducted a retrospective review of the MRIs of 125 adult outpatients with disc-degenerative diseases of the cervical spine; the images were obtained between May and July 2014 at our institute. The control group comprised 50 volunteers whose MRIs were also obtained. The parameters measured in the MRIs were: neck tilt (NT), T1 slope (T1S), thoracic inlet angle (TIA), and Cobb’s angle (C2–7). The correlation between the various parameters was analyzed using the Pearson correlation coefficient. Results The outpatients group showed moderate correlation between TIA and T1S, a significant correlation between TIA and NT, a weak correlation between T1S and Cobb’s angle, and a weakly negative correlation between T1S and NT. Further, the TIA showed no significant difference between the outpatient group and the control group, as per the sample t test. Conclusions Our findings indicate that TIA, T1S, and NT could be used as indices for the evaluation of cervical sagittal balance and that the TIA could be used as a reference to assess the cervical compensation. Restoration of the NT and T1S should be considered as a goal of surgical treatment during the preoperative planning in patients with disc-degenerative diseases. PMID:26486162

  20. The Effects of Molding Helmet Therapy on Spring-Mediated Cranial Vault Remodeling for Sagittal Craniosynostosis.

    PubMed

    Swanson, Jordan W; Haas, Jacqueline A; Mitchell, Brianne T; Storm, Philip B; Bartlett, Scott P; Heuer, Gregory G; Taylor, Jesse A

    2016-09-01

    There is no clear consensus for the optimal treatment of sagittal craniosynostosis; however, recent studies suggest that improved neurocognitive outcomes may be obtained when surgical intervention imparts active cranial expansion or remodeling and is performed before 6 months of age. The authors consider spring-mediated cranioplasty (SMC) to optimally address these imperatives, and this is an investigation of how helmet orthoses before or after SMC affect aesthetic outcomes.The authors retrospectively evaluated patients treated with SMC and adjunct helmeting for sagittal synostosis. Patients were stratified into 4 cohorts based on helmet usage: preop, postop, both, and neither. The cephalic index (CI) was used to assess head shape changes and outcomes. Twenty-six patients met inclusion criteria: 6 (23%) had preop, 11 (42%) had postop, 4 (15%) had preop and postop, and 5 (19%) had no helmeting. Average age at surgery was 3.6 months. Overall, CI improved from a mean 69.8 to 77.9 during an average 7-month course of care. Mean preoperative change in CI showed greater improvement with preop helmet (1.3) versus not (0.0), (P = 0.029), despite similar initial CI in these cohorts (70.4 and 69.6 respectively, P = 0.69). Nonetheless, all patient cohorts regardless of helmeting status achieved similar final CIs (range 76.4-80.4; P = 0.72).In summary, preoperative molding helmet therapy leads to improved CI at the time of spring-mediated cranioplasty. However, this benefit does not necessarily translate into overall improved CI after surgery and in follow-up, calling into question the benefits of molding helmet therapy in this setting. PMID:27607110

  1. Improving the Efficiency of Abdominal Aortic Aneurysm Wall Stress Computations

    PubMed Central

    Zelaya, Jaime E.; Goenezen, Sevan; Dargon, Phong T.; Azarbal, Amir-Farzin; Rugonyi, Sandra

    2014-01-01

    An abdominal aortic aneurysm is a pathological dilation of the abdominal aorta, which carries a high mortality rate if ruptured. The most commonly used surrogate marker of rupture risk is the maximal transverse diameter of the aneurysm. More recent studies suggest that wall stress from models of patient-specific aneurysm geometries extracted, for instance, from computed tomography images may be a more accurate predictor of rupture risk and an important factor in AAA size progression. However, quantification of wall stress is typically computationally intensive and time-consuming, mainly due to the nonlinear mechanical behavior of the abdominal aortic aneurysm walls. These difficulties have limited the potential of computational models in clinical practice. To facilitate computation of wall stresses, we propose to use a linear approach that ensures equilibrium of wall stresses in the aneurysms. This proposed linear model approach is easy to implement and eliminates the burden of nonlinear computations. To assess the accuracy of our proposed approach to compute wall stresses, results from idealized and patient-specific model simulations were compared to those obtained using conventional approaches and to those of a hypothetical, reference abdominal aortic aneurysm model. For the reference model, wall mechanical properties and the initial unloaded and unstressed configuration were assumed to be known, and the resulting wall stresses were used as reference for comparison. Our proposed linear approach accurately approximates wall stresses for varying model geometries and wall material properties. Our findings suggest that the proposed linear approach could be used as an effective, efficient, easy-to-use clinical tool to estimate patient-specific wall stresses. PMID:25007052

  2. Intraoperative Sac Pressure Measurement During Endovascular Abdominal Aortic Aneurysm Repair

    SciTech Connect

    Ishibashi, Hiroyuki; Ishiguchi, Tsuneo; Ohta, Takashi; Sugimoto, Ikuo; Iwata, Hirohide; Yamada, Tetsuya; Tadakoshi, Masao; Hida, Noriyuki; Orimoto, Yuki; Kamei, Seiji

    2010-10-15

    PurposeIntraoperative sac pressure was measured during endovascular abdominal aortic aneurysm repair (EVAR) to evaluate the clinical significance of sac pressure measurement.MethodsA microcatheter was placed in an aneurysm sac from the contralateral femoral artery, and sac pressure was measured during EVAR procedures in 47 patients. Aortic blood pressure was measured as a control by a catheter from the left brachial artery.ResultsThe systolic sac pressure index (SPI) was 0.87 {+-} 0.10 after main-body deployment, 0.63 {+-} 0.12 after leg deployment (P < 0.01), and 0.56 {+-} 0.12 after completion of the procedure (P < 0.01). Pulse pressure was 55 {+-} 21 mmHg, 23 {+-} 15 mmHg (P < 0.01), and 16 {+-} 12 mmHg (P < 0.01), respectively. SPI showed no significant differences between the Zenith and Excluder stent grafts (0.56 {+-} 0.13 vs. 0.54 {+-} 0.10, NS). Type I endoleak was found in seven patients (15%), and the SPI decreased from 0.62 {+-} 0.10 to 0.55 {+-} 0.10 (P = 0.10) after fixing procedures. Type II endoleak was found in 12 patients (26%) by completion angiography. The SPI showed no difference between type II endoleak positive and negative (0.58 {+-} 0.12 vs. 0.55 {+-} 0.12, NS). There were no significant differences between the final SPI of abdominal aortic aneurysms in which the diameter decreased in the follow-up and that of abdominal aortic aneurysms in which the diameter did not change (0.53 {+-} 0.12 vs. 0.57 {+-} 0.12, NS).ConclusionsSac pressure measurement was useful for instant hemodynamic evaluation of the EVAR procedure, especially in type I endoleaks. However, on the basis of this small study, the SPI cannot be used to reliably predict sac growth or regression.

  3. Is there a reliable and invariant set of muscle synergy during isometric biaxial trunk exertion in the sagittal and transverse planes by healthy subjects?

    PubMed

    Sedaghat-Nejad, Ehsan; Mousavi, Seyed Javad; Hadizadeh, Maliheh; Narimani, Roya; Khalaf, Kinda; Campbell-Kyureghyan, Naira; Parnianpour, Mohamad

    2015-09-18

    It has been suggested that the central nervous system simplifies muscle control through basic units, called synergies. In this study, we have developed a novel target-matching protocol and used non-negative matrix factorization (NMF) technique to extract trunk muscle synergies and corresponding torque synergies. Isometric torque data at the L5/S1 level and electromyographic patterns of twelve abdominal and back muscles from twelve healthy participants (five females) were simultaneously recorded. Each participant performed a total number of 24 isometric target-matching tasks using 12 different angular directions and 2 levels of uniaxial and biaxial exertions. Within- and between-subject similarities were assessed by considering both the data of different pairs of participants, where the activation coefficients of one participant were used in the NMF analysis of another participant, and the Pearson's correlation coefficients (R) between muscle synergy vectors. The results showed that, for a healthy person, a set of four muscles (overall variance accounted for (VAF) of 97.9 ± 0.53%) and four corresponding torque synergies (overall VAF of 92.2 ± 3.03%) could efficiently decompose the sagittal and transverse torque planes into their main directions. Furthermore, the correlation coefficients were 0.77 ± 0.12, 0.86 ± 0.08, 0.78 ± 0.12, and 0.93 ± 0.04, for all synergies, reflecting the consistency of muscle synergies across participants. Overall, our results suggest that by taking advantage of muscle synergies we could potentially overcome the redundancy inherent to control strategies of the trunk neuromuscular system. In future studies, the synergies identified in patients with low back pain could be compared with those extracted from healthy participants towards various clinical and rehabilitation applications.

  4. Endovascular abdominal aortic aneurysm repair

    PubMed Central

    Norwood, M G A; Lloyd, G M; Bown, M J; Fishwick, G; London, N J; Sayers, R D

    2007-01-01

    The operative mortality following conventional abdominal aortic aneurysm (AAA) repair has not fallen significantly over the past two decades. Since its inception in 1991, endovascular aneurysm repair (EVAR) has provided an alternative to open AAA repair and perhaps an opportunity to improve operative mortality. Two recent large randomised trials have demonstrated the short and medium term benefit of EVAR over open AAA repair, although data on the long term efficacy of the technique are still lacking. This review aimed at providing an overview of EVAR and a discussion of the potential benefits and current limitations of the technique. PMID:17267674

  5. [Dirofilaria in the abdominal cavity].

    PubMed

    Révész, Erzsébet; Markovics, Gabriella; Darabos, Zoltán; Tóth, Ildikó; Fok, Eva

    2008-10-01

    Number of cases of filariasis have been recently reported in the Hungarian medical literature, most of them caused by Dirofilaria repens . Dirofilaria repens is a mosquito-transmitted filarioid worm in the subcutaneous tissue of dogs and cats. Human infection manifests as either subcutaneous nodules or lung parenchymal disease, which may even be asymptomatic. The authors report a human Dirofilaria repens infection of the abdominal cavity in a 61-year-old man,who underwent laparotomy for acute abdomen. Intraoperatively, local peritonitis was detected caused by a white nemathhelminth, measured 8 cm in size. Histocytology confirmed that the infection was caused by Dirofilaria repens.

  6. [Abdominal pain, constipation and anemia].

    PubMed

    Barresi, Fabio; Kunz Caflish, Isabel; Bayly-Schinzel, Leena; Dressel, Holger

    2016-03-30

    We present the case of a 42-year old man who went to the emergency department because of spasmodic abdominal pain. The abdomen was soft. A gastroscopy and a colonoscopy were without pathological findings. The laboratory analyses indicated anemia. The differential blood count showed basophilic granules in the red blood cells. The blood lead level was elevated. A lead poisoning was diagnosed. The cause was the oral intake of an ayurvedic medication which the patient had received in Bangladesh to treat his vitiligo. PMID:27005735

  7. Treatment of neonatal abdominal cysts.

    PubMed

    Dénes, J; Lukäcs, F V; Léb, J; Bognár, M

    1974-01-01

    Intraperitoneal or retroperitoneal cystic structures in the newborn appear with a variable clinical picture and in the case of intra-abdominal cysts, surgery is performed mostly on an emergency basis. In such cases the exact preoperative diagnosis is difficult and is seldom made. With early laparotomy, extensive small bowel resection can usually be avoided. Retroperitoneal lesions are mostly of renal origin; in such cases, preoperative diagnosis is easy, being based on specific examinations. In the year 1973, 5 newborns with an intraperitoneal or retroperitoneal cyst have been treated surgically. In this series, one infant died after resection of 90% of the small bowel.

  8. [Internationalization and innovation of abdominal acupuncture].

    PubMed

    Wang, Yong-Zhou

    2013-09-01

    Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture.

  9. [FUNCTIONAL PLASTIC OF ANTERIOR ABDOMINAL WALL HERNIAS].

    PubMed

    Grubnik, V V; Parfentyeva, N D; Parfentyev, R S

    2015-07-01

    In order to improve the treatment efficacy of postoperative anterior abdominal wall hernias the method of plastic with restoration of anatomical and physiological properties of the muscles of the anterior abdominal wall was used. After the intervention by the improved method, regardless of the location of the hernia defect yielded promising results for the conservation of anterior abdominal wall muscle function in 75% of cases completely restored functional ability of muscles recti abdomini. PMID:26591212

  10. Correlations between sagittal plane kinematics and landing impact force during single-leg lateral jump-landings

    PubMed Central

    Aizawa, Junya; Ohji, Shunsuke; Koga, Hideyuki; Masuda, Tadashi; Yagishita, Kazuyoshi

    2016-01-01

    [Purpose] The correlations of peak vertical ground reaction force and sagittal angles during single-leg lateral jump-landing with noncontact anterior cruciate ligament injury remain unknown. This study aimed to clarify the correlations between kinematics and impact force during lateral jump-landing. [Subjects and Methods] Twenty active males were included in the analysis. A sagittal-view movie camera and force plate were time synchronized. Trunk and lower extremity sagittal angles were measured 100 ms before initial contact and at peak vertical ground reaction force. Peak vertical ground reaction force, time between initial contact and peak vertical ground reaction force, and loading rate were calculated. [Results] The mean sagittal angle was 40.7° ± 7.7° for knee flexion during the flight phase and 16.4° ± 6.3° for pelvic anterior inclination during the landing phase. The mean peak vertical ground reaction force was four times the body weight. The median time to peak vertical ground reaction force was 63.8 ms. The knee flexion during the flight phase and pelvic anterior inclination angles during the landing phase were related to the peak vertical ground reaction force. [Conclusion] Increasing knee flexion and decreasing pelvic anterior inclination might reduce the impact during single-leg lateral jump-landing.

  11. Transpalatal screw traction: a simple technique for the management of sagittal fractures of the maxilla and palate.

    PubMed

    Ma, D; Guo, X; Yao, H; Chen, J

    2014-12-01

    Sagittal fractures of the maxilla and palate are uncommon in clinical practice. Current methods for the management of such fractures have advantages and limitations. The authors present the simple and practical technique of bilateral transpalatal screw traction to manage this fracture type.

  12. Correlations between sagittal plane kinematics and landing impact force during single-leg lateral jump-landings.

    PubMed

    Aizawa, Junya; Ohji, Shunsuke; Koga, Hideyuki; Masuda, Tadashi; Yagishita, Kazuyoshi

    2016-08-01

    [Purpose] The correlations of peak vertical ground reaction force and sagittal angles during single-leg lateral jump-landing with noncontact anterior cruciate ligament injury remain unknown. This study aimed to clarify the correlations between kinematics and impact force during lateral jump-landing. [Subjects and Methods] Twenty active males were included in the analysis. A sagittal-view movie camera and force plate were time synchronized. Trunk and lower extremity sagittal angles were measured 100 ms before initial contact and at peak vertical ground reaction force. Peak vertical ground reaction force, time between initial contact and peak vertical ground reaction force, and loading rate were calculated. [Results] The mean sagittal angle was 40.7° ± 7.7° for knee flexion during the flight phase and 16.4° ± 6.3° for pelvic anterior inclination during the landing phase. The mean peak vertical ground reaction force was four times the body weight. The median time to peak vertical ground reaction force was 63.8 ms. The knee flexion during the flight phase and pelvic anterior inclination angles during the landing phase were related to the peak vertical ground reaction force. [Conclusion] Increasing knee flexion and decreasing pelvic anterior inclination might reduce the impact during single-leg lateral jump-landing.

  13. Analysis of sagittal balance using spinopelvic parameters in ankylosing spondylitis patients treated with vertebral column decancellation surgery.

    PubMed

    Lin, Bin; Zhang, Wen-Bin; Cai, Tao-yi; Lu, Cheng-Wu; Zhou, Qin; Huang, Zhuanzhi; Yu, Hui

    2015-09-01

    This study was designed to explore the change of spinopelvic parameters after vertebral column decancellation (VCD) for the management of thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). Forty-two AS patients including thirty-six males and six females with thoracolumbar kyphosis, who underwent VCD from April 2005 to June 2012 in our hospital, were retrospectively reviewed. A series of spinopelvic parameters including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and sagittal vertical axis (SVA) measured on preoperative and postoperative free-standing radiographs were obtained and analyzed. Also clinical assessments were performed with the Oswestry disability index (ODI) and the Bath Ankylosing Spondylitis Activity and Function Index (BASDAI and BASFI) so as to seek correlations between radiological parameters and symptoms. Except for pelvic incidence (PI), significant difference was found in all radiological spinopelvic parameters between the preoperative and follow-up values. Furthermore, there was significant improvement in the clinical assessment parameters ODI, BASDAI and BASFI, which all correlated significantly with the postoperative pelvic tilt (PT). The results of this study show that posterior VCD is an effective option to manage sagittal imbalance in AS. In the current series, patients improving LL and PT were found to achieve good clinical outcomes. Overall, our findings show that it is important to quantify sagittal spinopelvic parameters and promote sagittal balance in the surgery for AS. PMID:26435251

  14. Correlations between sagittal plane kinematics and landing impact force during single-leg lateral jump-landings.

    PubMed

    Aizawa, Junya; Ohji, Shunsuke; Koga, Hideyuki; Masuda, Tadashi; Yagishita, Kazuyoshi

    2016-08-01

    [Purpose] The correlations of peak vertical ground reaction force and sagittal angles during single-leg lateral jump-landing with noncontact anterior cruciate ligament injury remain unknown. This study aimed to clarify the correlations between kinematics and impact force during lateral jump-landing. [Subjects and Methods] Twenty active males were included in the analysis. A sagittal-view movie camera and force plate were time synchronized. Trunk and lower extremity sagittal angles were measured 100 ms before initial contact and at peak vertical ground reaction force. Peak vertical ground reaction force, time between initial contact and peak vertical ground reaction force, and loading rate were calculated. [Results] The mean sagittal angle was 40.7° ± 7.7° for knee flexion during the flight phase and 16.4° ± 6.3° for pelvic anterior inclination during the landing phase. The mean peak vertical ground reaction force was four times the body weight. The median time to peak vertical ground reaction force was 63.8 ms. The knee flexion during the flight phase and pelvic anterior inclination angles during the landing phase were related to the peak vertical ground reaction force. [Conclusion] Increasing knee flexion and decreasing pelvic anterior inclination might reduce the impact during single-leg lateral jump-landing. PMID:27630422

  15. Correlations between sagittal plane kinematics and landing impact force during single-leg lateral jump-landings

    PubMed Central

    Aizawa, Junya; Ohji, Shunsuke; Koga, Hideyuki; Masuda, Tadashi; Yagishita, Kazuyoshi

    2016-01-01

    [Purpose] The correlations of peak vertical ground reaction force and sagittal angles during single-leg lateral jump-landing with noncontact anterior cruciate ligament injury remain unknown. This study aimed to clarify the correlations between kinematics and impact force during lateral jump-landing. [Subjects and Methods] Twenty active males were included in the analysis. A sagittal-view movie camera and force plate were time synchronized. Trunk and lower extremity sagittal angles were measured 100 ms before initial contact and at peak vertical ground reaction force. Peak vertical ground reaction force, time between initial contact and peak vertical ground reaction force, and loading rate were calculated. [Results] The mean sagittal angle was 40.7° ± 7.7° for knee flexion during the flight phase and 16.4° ± 6.3° for pelvic anterior inclination during the landing phase. The mean peak vertical ground reaction force was four times the body weight. The median time to peak vertical ground reaction force was 63.8 ms. The knee flexion during the flight phase and pelvic anterior inclination angles during the landing phase were related to the peak vertical ground reaction force. [Conclusion] Increasing knee flexion and decreasing pelvic anterior inclination might reduce the impact during single-leg lateral jump-landing. PMID:27630422

  16. Occlusion of the pig superior sagittal sinus, bridging and cortical veins: multistep evolution of sinus-vein thrombosis.

    PubMed

    Fries, G; Wallenfang, T; Hennen, J; Velthaus, M; Heimann, A; Schild, H; Perneczky, A; Kempski, O

    1992-07-01

    Cerebral sinus-vein thrombosis may lead to severe hemodynamic changes, elevated intracranial pressure (ICP), and brain edema. It is supposed that progression of the thrombus from the sinus into bridging and cortical veins plays a key role in the development of these pathophysiological changes, but this hypothesis lacks experimental proof. The aim of this study, using a novel animal model of sinus-vein thrombosis, was to evaluate the effects of a standardized occlusion of the superior sagittal sinus and its bridging and cortical veins on hemodynamic alterations, on brain water content, and on ICP in domestic pigs. In 10 animals, the middle third of the superior sagittal sinus was occluded with a catheter-guided balloon. Five of these pigs received an additional injection of 1 ml fibrin glue into the superior sagittal sinus anterior to the inflated balloon, leading to an obstruction of bridging and cortical veins. In five control animals the balloon was inserted but not inflated. Five pigs underwent cerebral angiography. Four hours after occlusion, the brains were frozen in liquid nitrogen, and coronal slices were examined for Evans blue dye extravasation, regional water content, and histological changes. Occlusion of the superior sagittal sinus alone did not affect ICP or cerebral perfusion pressure (CPP). The additional injection of fibrin glue caused an obstruction of cortical and bridging veins as well as severe increases in mean (+/- standard deviation) ICP to 49.4 +/- 14.3 mm Hg, compared with 8.3 +/- 4.5 mm Hg in sham-treated controls and 7.1 +/- 3.9 mm Hg in animals with occlusion of the superior sagittal sinus alone. There was also a steep fall in the mean CPP to 34.2 +/- 19.6 mm Hg compared with 96.4 +/- 13.8 mm Hg in the control group. White-matter water content anterior to the occlusion site was elevated to 81.9 +/- 3.7 gm/100 gm frozen weight in the fibrin group as compared to 70.7 +/- 2.2 gm/100 gm in controls. Posterior to the occlusion site, water

  17. Advanced techniques in abdominal surgery.

    PubMed Central

    Monson, J R

    1993-01-01

    Almost every abdominal organ is now amenable to laparoscopic surgery. Laparoscopic appendicectomy is a routine procedure which also permits identification of other conditions initially confused with an inflamed appendix. However, assessment of appendiceal inflammation is more difficult. Almost all colonic procedures can be performed laparoscopically, at least partly, though resection for colonic cancer is still controversial. For simple patch repair of perforated duodenal ulcers laparoscopy is ideal, and inguinal groin hernia can be repaired satisfactorily with a patch of synthetic mesh. Many upper abdominal procedures, however, still take more time than the open operations. These techniques reduce postoperative pain and the incidence of wound infections and allow a much earlier return to normal activity compared with open surgery. They have also brought new disciplines: surgeons must learn different hand-eye coordination, meticulous haemostasis is needed to maintain picture quality, and delivery of specimens may be problematic. The widespread introduction of laparoscopic techniques has emphasised the need for adequate training (operations that were straight-forward open procedures may require considerable laparoscopic expertise) and has raised questions about trainee surgeons acquiring adequate experience of open procedures. Images FIG 9 p1347-a p1347-b p1349-a p1350-a p1350-b PMID:8257893

  18. Mechanical ventilation in abdominal surgery.

    PubMed

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery.

  19. Growth of nanostructures with controlled diameter

    DOEpatents

    Pfefferle, Lisa; Haller, Gary; Ciuparu, Dragos

    2009-02-03

    Transition metal-substituted MCM-41 framework structures with a high degree of structural order and a narrow pore diameter distribution were reproducibly synthesized by a hydrothermal method using a surfactant and an anti-foaming agent. The pore size and the mesoporous volume depend linearly on the surfactant chain length. The transition metals, such as cobalt, are incorporated substitutionally and highly dispersed in the silica framework. Single wall carbon nanotubes with a narrow diameter distribution that correlates with the pore diameter of the catalytic framework structure were prepared by a Boudouard reaction. Nanostructures with a specified diameter or cross-sectional area can therefore be predictably prepared by selecting a suitable pore size of the framework structure.

  20. Gene Tree Diameter for Deep Coalescence.

    PubMed

    Górecki, Paweł; Eulenstein, Oliver

    2015-01-01

    The deep coalescence cost accounts for discord caused by deep coalescence between a gene tree and a species tree. It is a major concern that the diameter of a gene tree (the tree's maximum deep coalescence cost across all species trees) depends on its topology, which can largely obfuscate phylogenetic studies. While this bias can be compensated by normalizing the deep coalescence cost using diameters, obtaining them efficiently has been posed as an open problem by Than and Rosenberg. Here, we resolve this problem by describing a linear time algorithm to compute the diameter of a gene tree. In addition, we provide a complete classification of the species trees yielding this diameter to guide phylogenetic analyses.

  1. Postural- and respiratory-related activities of abdominal muscles during post-exercise hyperventilation.

    PubMed

    David, Pascal; Terrien, Jérémy; Petitjean, Michel

    2015-05-01

    The present study focuses on the role of superficial abdominal muscles revealed by electromyographic recordings during the maintenance of a bipedal stance perturbed by post-exercise hyperventilation. Twelve healthy subjects performed six 30-s postural tests: one pre-exercise test while breathing quietly, then one test every minute for the 5 min immediately following a maximum-intensity, incremental cycling exercise test. Displacement of the centre of pressure in the sagittal plane was monitored over time. Myoelectric activities of the obliquus externus (OE), obliquus internus (OI) and rectus abdominis (RA) muscles were recorded by surface electromyography (EMG). Metabolic parameters were measured with a portable telemetric device. The change in ventilatory drive induced by exercise was accompanied by a significant increase in both postural sway parameters and EMG activities. For OE and OI, the increased EMG activities were prominent during expiration, whereas OI was silent during inspiration. OE and RA were activated during both expiration and inspiration. It is concluded that the compensation of respiratory disturbances of the erect posture appears to be less effective when minute ventilation increases. The patterns of muscle activity suggest that abdominal muscles are controlled differentially and that their functional coordination is dependent on the respiratory demand.

  2. Large diameter carbon-boron fiber

    NASA Technical Reports Server (NTRS)

    Veltri, R. D.; Jacob, B. A.; Galasso, F. S.

    1975-01-01

    Investigations concerned with a development of large-diameter carbon fibers are considered, taking into account the employment of vapor deposition techniques. In the experiments a carbon monofilament substrate is used together with reacting gases which consist of combinations of hydrogen, methane, and boron trichloride. It is found that the described approach can be used to obtain a large-diameter carbon filament containing boron. The filament has reasonable strength and modulus properties.

  3. Precision wire feeder for small diameter wire

    DOEpatents

    Brandon, Eldon D.; Hooper, Frederick M.; Reichenbach, Marvin L.

    1992-01-01

    A device for feeding small diameter wire having a diameter less than 0.04 mm (16 mil) to a welding station includes a driving wheel for controllably applying a non-deforming driving force to the wire to move the free end of the wire towards the welding station; and a tension device such as a torque motor for constantly applying a reverse force to the wire in opposition to the driving force to keep the wire taut.

  4. Precision wire feeder for small diameter wire

    DOEpatents

    Brandon, E.D.; Hooper, F.M.; Reichenbach, M.L.

    1992-08-11

    A device for feeding small diameter wire having a diameter less than 0.04 mm (16 mil) to a welding station includes a driving wheel for controllably applying a non-deforming driving force to the wire to move the free end of the wire towards the welding station; and a tension device such as a torque motor for constantly applying a reverse force to the wire in opposition to the driving force to keep the wire taut. 1 figure.

  5. Gender differences in sagittal standing alignment before pubertal peak growth: the importance of subclassification and implications for spinopelvic loading

    PubMed Central

    Dolphens, Mieke; Cagnie, Barbara; Vleeming, Andry; Vanderstraeten, Guy; Danneels, Lieven

    2013-01-01

    The aim of this study was to analyze gender differences in sagittal standing alignment at pre-peak height velocity age thereby applying a scientifically sound and practically oriented classification scheme for overall standing balance. The study population consisted of healthy boys (n = 639) and girls (n = 557) before pubertal peak growth. During subjects' habitual standing, sagittal plane measures of the spine, pelvis and lower limbs were collected using a clinical screening protocol. With each subject classified as one of three postural types (neutral, sway-back, or leaning-forward), differences in sagittal plane alignment were analyzed between sexes. The results revealed clear differences between genders in each of the postural types. Within the neutral and sway-back postural subgroups, boys presented more forward inclination of the trunk, more thoracic kyphosis and more pelvis backtilt compared with girls. Within the leaning-forward category, girls displayed more forward trunk lean, less thoracic kyphosis and more pelvic anteversion. A state of lumbar segmental hyperextension appeared to exist in female leaning-forward subjects. Our results reveal for the first time that sagittal standing alignment is different between prepubescent boys and girls when subjects are appropriately subclassified, and conversely represent a ‘wash-out effect’ when pooled. When the classification system is applied, gender-specificity in gravity line position is suggested, implying gender-related differences in lever arms and thus load. Present findings may add to our understanding of gender-specific biomechanical challenges posed by habitual posture, and may shed new light on sagittal standing alignment as a possible contributory factor in developmental spinal-pelvic disorders. PMID:24107185

  6. How is sagittal balance acquired during bipedal gait acquisition? Comparison of neonatal and adult pelves in three dimensions. Evolutionary implications.

    PubMed

    Tardieu, Christine; Bonneau, Noémie; Hecquet, Jérôme; Boulay, Christophe; Marty, Catherine; Legaye, Jean; Duval-Beaupère, Geneviève

    2013-08-01

    We compare adult and intact neonatal pelves, using a pelvic sagittal variable, the angle of sacral incidence, which presents significant correlations with vertebral curvature in adults and plays an important role in sagittal balance of the trunk on the lower limbs. Since the lumbar curvature develops in the child in association with gait acquisition, we expect a change in this angle during growth which could contribute to the acquisition of sagittal balance. To understand the mechanisms underlying the sagittal balance in the evolution of human bipedalism, we also measure the angle of incidence of hominid fossils. Fourty-seven landmarks were digitized on 50 adult and 19 intact neonatal pelves. We used a three-dimensional model of the pelvis (DE-VISU program) which calculates the angle of sacral incidence and related functional variables. Cross-sectional data from newborns and adults show that the angle of sacral incidence increases and becomes negatively correlated with the sacro-acetabular distance. During ontogeny the sacrum becomes curved, tends to sink down between the iliac blades as a wedge and moves backward in the sagittal plane relative to the acetabula, thus contributing to the backwards displacement of the center of gravity of the trunk. A chain of correlations links the degree of the sacral slope and of the angle of incidence, which is tightly linked with the lumbar lordosis. We sketch a model showing the coordinated changes occurring in the pelvis and vertebral column during the acquisition of bipedalism in infancy. In the australopithecine pelves, Sts 14 and AL 288-1, and in the Homo erectus Gona pelvis the angle of sacral incidence reaches the mean values of humans. Discussing the incomplete pelves of Ardipithecus ramidus, Australopithecus sediba and the Nariokotome Boy, we suggest how the functional linkage between pelvis and spine, observed in humans, could have emerged during hominid evolution. PMID:23838060

  7. How is sagittal balance acquired during bipedal gait acquisition? Comparison of neonatal and adult pelves in three dimensions. Evolutionary implications.

    PubMed

    Tardieu, Christine; Bonneau, Noémie; Hecquet, Jérôme; Boulay, Christophe; Marty, Catherine; Legaye, Jean; Duval-Beaupère, Geneviève

    2013-08-01

    We compare adult and intact neonatal pelves, using a pelvic sagittal variable, the angle of sacral incidence, which presents significant correlations with vertebral curvature in adults and plays an important role in sagittal balance of the trunk on the lower limbs. Since the lumbar curvature develops in the child in association with gait acquisition, we expect a change in this angle during growth which could contribute to the acquisition of sagittal balance. To understand the mechanisms underlying the sagittal balance in the evolution of human bipedalism, we also measure the angle of incidence of hominid fossils. Fourty-seven landmarks were digitized on 50 adult and 19 intact neonatal pelves. We used a three-dimensional model of the pelvis (DE-VISU program) which calculates the angle of sacral incidence and related functional variables. Cross-sectional data from newborns and adults show that the angle of sacral incidence increases and becomes negatively correlated with the sacro-acetabular distance. During ontogeny the sacrum becomes curved, tends to sink down between the iliac blades as a wedge and moves backward in the sagittal plane relative to the acetabula, thus contributing to the backwards displacement of the center of gravity of the trunk. A chain of correlations links the degree of the sacral slope and of the angle of incidence, which is tightly linked with the lumbar lordosis. We sketch a model showing the coordinated changes occurring in the pelvis and vertebral column during the acquisition of bipedalism in infancy. In the australopithecine pelves, Sts 14 and AL 288-1, and in the Homo erectus Gona pelvis the angle of sacral incidence reaches the mean values of humans. Discussing the incomplete pelves of Ardipithecus ramidus, Australopithecus sediba and the Nariokotome Boy, we suggest how the functional linkage between pelvis and spine, observed in humans, could have emerged during hominid evolution.

  8. Comparison Between Interactive Closest Point and Procrustes Analysis for Determining the Median Sagittal Plane of Three-Dimensional Facial Data

    PubMed Central

    Xiong, Yuxue; Zhao, Yijiao; Yang, Huifang; Sun, Yucun; Wang, Yong

    2016-01-01

    Objective: To compare 2 digital methods to determine median sagittal plane of three-dimensional facial data—the interactive closest point algorithm and Procrustes analysis. Methods: The three-dimensional facial data of the 30 volunteers were got by the Face Scan 3D optical sensor (3D-Shape GmbH, Erlangen, Germany), and then were input to the reverse engineering software Imageware 13.0 (Siemens, Plano, TX) and Geomagic 2012 (Cary, NC). Their mirrored data were acquired and superimposed with the original data by the methods of interactive closest points and Procrustes analysis. The median sagittal planes of the 2 methods were extracted from the original and mirrored facial data respectively, 3 asymmetry indices were measured for comparison. Differences between the facial asymmetry indices of the 2 methods were evaluated using the paired sample t-test. Results: In terms of the 3 asymmetry indices, there were no significant differences between interactive closest points and Procrustes analysis for extracting median sagittal plane from three-dimensional facial data.(t = 0.0.060, P = 0.953 for asymmetry index (AI) 1, t = −0.926, P = 0.362 for AI 2, t = 1.1172, P = 0.0.251 for AI 3). Conclusions: In this evaluation of 30 subjects, the Procrustes analysis and the interactive closest point median-sagittal planes were similar in terms of the 3 asymmetry indices. Thus, Procrustes analysis and interactive closest point can both be used to abstract median sagittal plane from three-dimensional facial data. PMID:26825747

  9. Non-invasive ultrasonic measurement of the elastic properties of the human abdominal aorta.

    PubMed

    Imura, T; Yamamoto, K; Kanamori, K; Mikami, T; Yasuda, H

    1986-03-01

    A new echo tracking device linked to real time ultrasonic B mode equipment was developed to measure non-invasively the elastic properties of the human abdominal aorta. Pulsatile diameter change and mean diameter of the abdominal aorta were measured in 61 subjects with this ultrasonic device. Strain and pressure-strain elastic modulus Ep were calculated from pulsatile diameter change, diameter, and pulse pressure obtained by the auscultatory method. Strain significantly decreased with age; 0.076(0.024) (mean(SD)) in group 1 (20 young adults below the age of 35 years); 0.048(0.024) in group 2 (21 middle aged subjects between the ages of 35 and 60 years); and 0.030(0.010) in group 3 (20 elderly subjects over the age of 60 years). Ep values were 0.99(0.34) X 10(5), 1.55(0.68) X 10(5), and 3.80(2.05) X 10(5) N X m-2 in groups 1, 2, and 3 respectively. Ep in group 3 was significantly higher than in groups 1 and 2. The regression equation relating Ep to age was Ep = (-0.72 + 0.058 X age) X 10(5) N X m-2 (r = 0.73). The Ep value and its age related increase agreed with the findings in postmortem arteries. The elastic properties of the abdominal aorta could, therefore, be determined non-invasively by this ultrasonic method.

  10. Ultra-efficient Engine Diameter Study

    NASA Technical Reports Server (NTRS)

    Daggett, David L.; Brown, Stephen T.; Kawai, Ron T.

    2003-01-01

    Engine fan diameter and Bypass Ratio (BPR) optimization studies have been conducted since the beginning of the turbofan age with the recognition that reducing the engine core jet velocity and increasing fan mass flow rate generally increases propulsive efficiency. However, performance tradeoffs limit the amount of fan flow achievable without reducing airplane efficiency. This study identifies the optimum engine fan diameter and BPR, given the advanced Ultra-Efficient Engine Technology (UEET) powerplant efficiencies, for use on an advanced subsonic airframe. Engine diameter studies have historically focused on specific engine size options, and were limited by existing technology and transportation infrastructure (e.g., ability to fit bare engines through aircraft doors and into cargo holds). This study is unique in defining the optimum fan diameter and drivers for future 2015 (UEET) powerplants while not limiting engine fan diameter by external constraints. This report follows on to a study identifying the system integration issues of UEET engines. This Engine Diameter study was managed by Boeing Phantom Works, Seattle, Washington through the NASA Glenn Revolutionary Aero Space Engine Research (RASER) contract under task order 10. Boeing Phantom Works, Huntington Beach, completed the engine/airplane sizing optimization, while the Boeing Commercial Airplane group (BCA) provided design oversight. A separate subcontract to support the overall project was issued to Tuskegee University.

  11. Center of Mass Compensation during Gait in Hip Arthroplasty Patients: Comparison between Large Diameter Head Total Hip Arthroplasty and Hip Resurfacing.

    PubMed

    Bouffard, Vicky; Nantel, Julie; Therrien, Marc; Vendittoli, Pascal-André; Lavigne, Martin; Prince, François

    2011-01-01

    Objective. To compare center of mass (COM) compensation in the frontal and sagittal plane during gait in patients with large diameter head total hip arthroplasty (LDH-THA) and hip resurfacing (HR). Design. Observational study. Setting. Outpatient biomechanical laboratory. Participants. Two groups of 12 patients with LDH-THA and HR recruited from a larger randomized study and 11 healthy controls. Interventions. Not applicable. Main Outcome Measures. To compare the distance between the hip prosthetic joint center (HPJC) and the COM. The ratio (R(HPJC-COM)) and the variability (CV(HPJC-COM)) were compared between groups. Hip flexor, abductor, and adductor muscle strength was also correlated between groups while radiographic measurements were correlated with the outcome measures. Results. In the frontal plane, HR shows less variability than healthy controls at push-off and toe-off and R(HPJC-COM) is correlated with the muscle strength ratios (FR(ABD)) at heel contact, maximal weight acceptance, and mid stance. In the sagittal plane, LDH-THA has a higher R(HPJC-COM) than healthy controls at push-off, and CV(HPJC-COM) is significantly correlated with FR(FLEX). Conclusions. One year after surgery, both groups of patients, LDH-THA and HR, demonstrate minor compensations at some specific instant of the gait cycle, in both frontal and sagittal planes. However, their locomotion pattern is similar to the healthy controls. PMID:22110976

  12. Facial and abdominal hair growth in hirsutism: a computerized evaluation.

    PubMed

    Hines, G; Moran, C; Huerta, R; Folgman, K; Azziz, R

    2001-12-01

    Methods of objectively assessing the growth rate of hairs in hirsute women have generally required some form of shaving and have focused on studying hairs affecting the face, which has reduced the number of patients willing or able to participate in such studies. A possible solution is to assess the terminal hairs on the lower abdomen (ie, the male escutcheon) because these two body areas are the most frequently affected with excess hair growth in hirsute patients. Nonetheless, it is unclear how the growth characteristics (density, diameter, and growth rate) of the hairs on the abdomen and face differ in these patients. We hypothesize that the growth characteristics of terminal hairs on the abdomen and face are similar and that evaluation of either area may be sufficient in assessing the hair growth rate of these patients. To objectively evaluate hair growth in the face and abdomen in hirsute patients, we developed a computer-aided image analysis system capable of measuring several growth parameters. Twenty hirsute women (12 white and 8 black), aged 31.2 +/- 6.1 years, were studied. Facial and abdominal skin areas were shaved, and 3 to 5 days later the areas were photographed through a calibrated glass plate and 5 terminal hairs were plucked from each area. The daily hair growth rate (assessed by photography and by direct measurement of the plucked hair), the density of hairs (number of hairs per surface area assessed by photography), and hair diameter (of the plucked hairs) were determined. The extent of hirsutism was also measured, albeit subjectively, by a modification of the Ferriman-Gallwey method, with each area given a score of 0 (no terminal hairs seen) to 4 (terminal hairs in a pattern similar to that of a very hirsute man). Facial, abdominal, and total Ferriman-Gallwey scores were 1.3 +/- 0.6, 1.8 +/- 0.9, and 12.5 +/- 5.4, respectively. Our results indicated that facial hairs were distributed in greater density and had a greater diameter than abdominal

  13. Dioctophyma renale (Goeze, 1782) in the abdominal cavity of a capuchin monkey (Cebus apella), Brazil.

    PubMed

    Ishizaki, Mirian Naomi; Imbeloni, Aline Amaral; Muniz, José Augusto Pereira Carneiro; Scalercio, Sarah Raphaella Rocha de Azevedo; Benigno, Raimundo Nonato Moraes; Pereira, Washington Luiz Assunção; Cunha Lacreta Junior, Antonio Carlos

    2010-10-29

    This study reports a case of parasitism by Dioctophyma renale (Goeze, 1762) encysted in the abdominal cavity of a capuchin monkey (Cebus apella) coming from the Centro Nacional de Primatas, Brazil. The animal was sent to the Veterinary Clinic sector with an increase in abdominal volume and no occurrence of any other clinical signs. Upon palpation, a movable circular mass with a diameter of approximately 10 cm was found. Urinalysis, complete blood count and serum biochemistry were performed without revealing any alterations. The animal was then submitted to an abdominal ultrasound exam. The cyst was punctured and a surgical removal procedure was performed, revealing a brownish-colored cylindrical structure that was already deteriorated, making it impossible to perform morphological analysis and classification. In the sediment of the liquid found, eggs were encountered that had morphological characteristics compatible with D. renale. The objective of this paper is to report the first case of parasitism by D. renale in C. apella (Linnaeus, 1758).

  14. Puerperal endometritis after abdominal twin delivery.

    PubMed

    Suonio, S; Huttunen, M

    1994-04-01

    The infectious complications of 122 consecutive abdominal twin deliveries over the period 1984-1989 were analyzed in a prospective clinical study, comparing them with 761 singleton abdominal deliveries over the period 1984-1986. The incidence of endometritis was nearly three-fold after twin deliveries and the incidence of abdominal wound infections nearly two-fold compared with singleton abdominal pregnancies (13.1/4.7% and 5.6/3.0%). The risk of amnionitis was increased ten-fold, 6 hours after rupture of the membranes in abdominal twin delivery, but no connection was found between amnionitis and endometritis, as in singleton abdominal deliveries. Multiple regression analysis indicated only two risk factors as regards puerperal endometritis after abdominal twin delivery: age under 25 years (odds ratio 6.9, 95% confidence limits 1.9-24.8), an association also seen in singleton abdominal deliveries, and a period of more than 6 hours from rupture of membranes to delivery (odds ratio 7.8, 95% confidence limits 2.1-28.5). Multiple pregnancy appears to be associated with an increased risk of endometritis. The etiological factors remain unknown, but a large placental bed and/or immunological factors may be implicated. PMID:8160537

  15. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

    PubMed

    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

  16. Collagen fibril diameter and leather strength.

    PubMed

    Wells, Hannah C; Edmonds, Richard L; Kirby, Nigel; Hawley, Adrian; Mudie, Stephen T; Haverkamp, Richard G

    2013-11-27

    The main structural component of leather and skin is type I collagen in the form of strong fibrils. Strength is an important property of leather, and the way in which collagen contributes to the strength is not fully understood. Synchrotron-based small angle X-ray scattering (SAXS) is used to measure the collagen fibril diameter of leather from a range of animals, including sheep and cattle, that had a range of tear strengths. SAXS data were fit to a cylinder model. The collagen fibril diameter and tear strength were found to be correlated in bovine leather (r(2) = 0.59; P = 0.009), with stronger leather having thicker fibrils. There was no correlation between orientation index, i.e., fibril alignment, and fibril diameter for this data set. Ovine leather showed no correlation between tear strength and fibril diameter, nor was there a correlation across a selection of other animal leathers. The findings presented here suggest that there may be a different structural motif in skin compared with tendon, particularly ovine skin or leather, in which the diameter of the individual fibrils contributes less to strength than fibril alignment does.

  17. Abdominal tuberculosis of the gastrointestinal tract: Revisited

    PubMed Central

    Debi, Uma; Ravisankar, Vasudevan; Prasad, Kaushal Kishor; Sinha, Saroj Kant; Sharma, Arun Kumar

    2014-01-01

    Abdominal tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of abdominal tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of abdominal tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease. PMID:25356043

  18. A fibromatosis case mimicking abdominal aorta aneurysm.

    PubMed

    Tasdemir, Arzu; Kahraman, Cemal; Tasdemir, Kutay; Mavili, Ertugrul

    2013-01-01

    Retroperitoneal fibrosis is a rare fibrosing reactive process that may be confused with mesenteric fibromatosis. Abdominal aorta aneurysm is rare too and mostly develops secondary to Behcet's disease, trauma, and infection or connective tissue diseases. Incidence of aneurysms occurring as a result of atherosclerotic changes increases in postmenopausal period. Diagnosis can be established with arteriography, tomography, or magnetic resonance imaging associated with clinical findings. Tumors and cysts should be considered in differential diagnosis. Abdominal ultrasound and contrast-enhanced computerized tomography revealed an infrarenal abdominal aorta aneurysm in a 41-year-old woman, but, on surgery, retroperitoneal fibrosis surrounding the aorta was detected. We present this interesting case because retroperitoneal fibrosis encircling the abdominal aorta can mimic abdominal aorta aneurysm radiologically.

  19. Male and female runners demonstrate different sagittal plane mechanics as a function of static hamstring flexibility

    PubMed Central

    Williams III, D. S. Blaise; Welch, Lee M.

    2015-01-01

    ABSTRACT Background: Injuries to runners are common. However, there are many potential contributing factors to injury. While lack of flexibility alone is commonly related to injury, there are clear differences in hamstring flexibility between males and females. Objective: To compare the effect of static hamstring length on sagittal plane mechanics between male and female runners. Method: Forty subjects (30.0±6.4 years) participated and were placed in one of 4 groups: flexible males (n=10), inflexible males (n=10), flexible females (n=10), and inflexible females (n=10). All subjects were free of injury at the time of data collection. Three-dimensional kinematics and kinetics were collected while subjects ran over ground across 2 force platforms. Sagittal plane joint angles and moments were calculated at the knee and hip and compared with a 2-way (sex X flexibility) ANOVA (α=0.05). Results: Males exhibited greater peak knee extension moment than females (M=2.80±0.47, F=2.48±0.52 Nm/kg*m, p=0.05) and inflexible runners exhibited greater peak knee extension moment than flexible runners (In=2.83±0.56, Fl=2.44±0.51 Nm/kg*m, p=0.01). For hip flexion at initial contact, a significant interaction existed (p<0.05). Flexible females (36.7±7.4º) exhibited more hip flexion than inflexible females (27.9±4.6º, p<0.01) and flexible males (30.1±9.5º, p<0.05). No differences existed for knee angle at initial contact, peak knee angle, peak hip angle, or peak hip moment. Conclusion: Hamstring flexibility results in different mechanical profiles in males and females. Flexibility in the hamstrings may result in decreased moments via active or passive tension. These differences may have implications for performance and injury in flexible female runners. PMID:26537812

  20. DiameterJ: A Validated Open Source Nanofiber Diameter Measurement Tool

    PubMed Central

    Hotaling, Nathan A.; Bharti, Kapil; Kriel, Haydn; Simon, Carl G.

    2015-01-01

    Despite the growing use of nanofiber scaffolds for tissue engineering applications, there is not a validated, readily available, free solution for rapid, automated analysis of nanofiber diameter from scanning electron microscope (SEM) micrographs. Thus, the goal of this study was to create a user friendly ImageJ/FIJI plugin that would analyze SEM micrographs of nanofibers to determine nanofiber diameter on a desktop computer within 60 seconds. Additional design goals included 1) compatibility with a variety of existing segmentation algorithms, and 2) an open source code to enable further improvement of the plugin. Using existing algorithms for centerline determination, Euclidean distance transforms and a novel pixel transformation technique, a plugin called “DiameterJ” was created for ImageJ/FIJI. The plugin was validated using 1) digital synthetic images of white lines on a black background and 2) SEM images of nominally monodispersed steel wires of known diameters. DiameterJ analyzed SEM micrographs in 20 seconds, produced diameters not statistically different from known values, was over 10-times closer to known diameter values than other open source software, provided hundreds of times the sampling of manual measurement, and was hundreds of times faster than manual assessment of nanofiber diameter. DiameterJ enables users to rapidly and thoroughly determine the structural features of nanofiber scaffolds and could potentially allow new insights to be formed into fiber diameter distribution and cell response. PMID:26043061

  1. DiameterJ: A validated open source nanofiber diameter measurement tool.

    PubMed

    Hotaling, Nathan A; Bharti, Kapil; Kriel, Haydn; Simon, Carl G

    2015-08-01

    Despite the growing use of nanofiber scaffolds for tissue engineering applications, there is not a validated, readily available, free solution for rapid, automated analysis of nanofiber diameter from scanning electron microscope (SEM) micrographs. Thus, the goal of this study was to create a user friendly ImageJ/FIJI plugin that would analyze SEM micrographs of nanofibers to determine nanofiber diameter on a desktop computer within 60 s. Additional design goals included 1) compatibility with a variety of existing segmentation algorithms, and 2) an open source code to enable further improvement of the plugin. Using existing algorithms for centerline determination, Euclidean distance transforms and a novel pixel transformation technique, a plugin called "DiameterJ" was created for ImageJ/FIJI. The plugin was validated using 1) digital synthetic images of white lines on a black background and 2) SEM images of nominally monodispersed steel wires of known diameters. DiameterJ analyzed SEM micrographs in 20 s, produced diameters not statistically different from known values, was over 10-times closer to known diameter values than other open source software, provided hundreds of times the sampling of manual measurement, and was hundreds of times faster than manual assessment of nanofiber diameter. DiameterJ enables users to rapidly and thoroughly determine the structural features of nanofiber scaffolds and could potentially allow new insights to be formed into fiber diameter distribution and cell response.

  2. DiameterJ: A validated open source nanofiber diameter measurement tool.

    PubMed

    Hotaling, Nathan A; Bharti, Kapil; Kriel, Haydn; Simon, Carl G

    2015-08-01

    Despite the growing use of nanofiber scaffolds for tissue engineering applications, there is not a validated, readily available, free solution for rapid, automated analysis of nanofiber diameter from scanning electron microscope (SEM) micrographs. Thus, the goal of this study was to create a user friendly ImageJ/FIJI plugin that would analyze SEM micrographs of nanofibers to determine nanofiber diameter on a desktop computer within 60 s. Additional design goals included 1) compatibility with a variety of existing segmentation algorithms, and 2) an open source code to enable further improvement of the plugin. Using existing algorithms for centerline determination, Euclidean distance transforms and a novel pixel transformation technique, a plugin called "DiameterJ" was created for ImageJ/FIJI. The plugin was validated using 1) digital synthetic images of white lines on a black background and 2) SEM images of nominally monodispersed steel wires of known diameters. DiameterJ analyzed SEM micrographs in 20 s, produced diameters not statistically different from known values, was over 10-times closer to known diameter values than other open source software, provided hundreds of times the sampling of manual measurement, and was hundreds of times faster than manual assessment of nanofiber diameter. DiameterJ enables users to rapidly and thoroughly determine the structural features of nanofiber scaffolds and could potentially allow new insights to be formed into fiber diameter distribution and cell response. PMID:26043061

  3. New pre-arrival instructions can avoid abdominal hand placement for chest compressions

    PubMed Central

    2013-01-01

    Objective To investigate if modified pre-arrival instructions using patient’s arm and nipple line as landmarks could avoid abdominal hand placements for chest compressions. Method Volunteers were randomized to one of two telephone instructions: “Kneel down beside the chest. Place one hand in the centre of the victim’s chest and the other on top” (control) or “Lay the patient’s arm which is closest to you, straight out from the body. Kneel down by the patient and place one knee on each side of the arm. Find the midpoint between the nipples and place your hands on top of each other” (intervention). Hand placement was conducted on an adult male and documented by laser measurements. Hand placement, quantified as the centre of the compressing hands in the mid-sagittal plane, was compared to the inter-nipple line (INL) for reference and classified as above or below. Fisher’s exact test was used for comparison of proportions. Results Thirty-six lay people, age range 16–60, were included. None in the intervention group placed their hands in the abdominal region, compared to 5/18 in the control group (p = 0.045). Using INL as a reference, the new instructions resulted in less caudal hand placement, and the difference in mean hand position was 47 mm [95% CI 21,73], p = 0.001. Conclusion New pre-arrival instructions where the patient’s arm and nipple line were used as landmarks resulted in less caudal hand placements and none in the abdominal region. PMID:23799963

  4. Submicron diameter single crystal sapphire optical fiber

    SciTech Connect

    Hill, Cary; Homa, Daniel; Liu, Bo; Yu, Zhihao; Wang, Anbo; Pickrell, Gary

    2014-10-02

    In this work, a submicron-diameter single crystal sapphire optical fiber was demonstrated via wet acid etching at elevated temperatures. Etch rates on the order 2.3 µm/hr were achievable with a 3:1 molar ratio sulfuric-phosphoric acid solution maintained at a temperature of 343°C. A sapphire fiber with an approximate diameter of 800 nm was successfully fabricated from a commercially available fiber with an original diameter of 50 µm. The simple and controllable etching technique provides a feasible approach to the fabrication of unique waveguide structures via traditional silica masking techniques. The ability to tailor the geometry of sapphire optical fibers is the first step in achieving optical and sensing performance on par with its fused silica counterpart.

  5. Submicron diameter single crystal sapphire optical fiber

    DOE PAGES

    Hill, Cary; Homa, Daniel; Liu, Bo; Yu, Zhihao; Wang, Anbo; Pickrell, Gary

    2014-10-02

    In this work, a submicron-diameter single crystal sapphire optical fiber was demonstrated via wet acid etching at elevated temperatures. Etch rates on the order 2.3 µm/hr were achievable with a 3:1 molar ratio sulfuric-phosphoric acid solution maintained at a temperature of 343°C. A sapphire fiber with an approximate diameter of 800 nm was successfully fabricated from a commercially available fiber with an original diameter of 50 µm. The simple and controllable etching technique provides a feasible approach to the fabrication of unique waveguide structures via traditional silica masking techniques. The ability to tailor the geometry of sapphire optical fibers ismore » the first step in achieving optical and sensing performance on par with its fused silica counterpart.« less

  6. Role of T1 Pelvic Angle in Assessing Sagittal Balance in Outpatients With Unspecific Low Back Pain.

    PubMed

    Yang, Mingyuan; Yang, Changwei; Xu, Zhengfang; Chen, Ziqiang; Wei, Xianzhao; Zhao, Jian; Shao, Jie; Zhang, Guoyou; Zhao, Yingchuan; Ni, Haijian; Bai, Yushu; Zhu, Xiaodong; Li, Ming

    2016-03-01

    The aim of the study was to explore the significance of T1 pelvic angle (TPA) for assessment of sagittal balance in a cohort of Chinese patients with unspecific low back pain. TPA has been commonly used to assess sagittal balance in adult spinal deformity. However, whether TPA could be used to assess sagittal balance in patients with unspecific low back pain effectively remains unanswered. Medical records of outpatients with unspecific low back pain who received treatment in our outpatient clinic between September 2013 and November 2014 were reviewed. Demographic data and radiographic data were collected. Correlation coefficients between TPA and other sagittal parameters were analyzed, and the intraclass correlation coefficient (ICC) analysis was performed to assess the inter- and intra-observer reliability of TPA. Patients were divided into 2 groups according to whether they were well-aligned (TPA ≤ 20°) or poorly aligned (TPA > 20°), and then demographic and sagittal parameters were compared between the 2 groups of patients. A total of 97 patients with unspecific low back pain were included in this study. The inter- and intraobserver reliability of the TPA measure had excellent agreement (ICC = 0.985 and 0.919, respectively). There were significant correlations between TPA and age, LL, PT, PI, T1SPI, SVA, and NRS (all P < 0.05). Of the 38 well-aligned patients in Group A, SVA was ≤5 cm in 33 (86.84%) patients and >5 cm in the other 5 (13.16%) patients, and of the 59 poorly aligned patients in Group B, SVA was >5 cm in 42 (71.19%) patients and ≤5 cm in the other 17 (28.81%) patients. There were significant differences in age, LL, SS, PT, PI, T1SPI, SVA, and NRS between the 2 groups of patients, but no significant difference was observed in TK and TL. TPA could be used to assess sagittal balance in outpatients with unspecific low back pain effectively.

  7. Shaft Diameter Measurement Using Structured Light Vision

    PubMed Central

    Liu, Siyuan; Tan, Qingchang; Zhang, Yachao

    2015-01-01

    A method for measuring shaft diameters is presented using structured light vision measurement. After calibrating a model of the structured light measurement, a virtual plane is established perpendicular to the measured shaft axis and the image of the light stripe on the shaft is projected to the virtual plane. On the virtual plane, the center of the measured shaft is determined by fitting the projected image under the geometrical constraints of the light stripe, and the shaft diameter is measured by the determined center and the projected image. Experiments evaluated the measuring accuracy of the method and the effects of some factors on the measurement are analyzed. PMID:26274963

  8. Fabrication of 10nm diameter carbon nanopores

    SciTech Connect

    Radenovic, Aleksandra; Trepagnier, Eliane; Csencsits, Roseann; Downing, Kenneth H; Liphardt, Jan

    2008-09-25

    The addition of carbon to samples, during imaging, presents a barrier to accurate TEM analysis, the controlled deposition of hydrocarbons by a focused electron beam can be a useful technique for local nanometer-scale sculpting of material. Here we use hydrocarbon deposition to form nanopores from larger focused ion beam (FIB) holes in silicon nitride membranes. Using this method, we close 100-200nm diameter holes to diameters of 10nm and below, with deposition rates of 0.6nm per minute. I-V characteristics of electrolytic flow through these nanopores agree quantitatively with a one dimensional model at all examined salt concentrations.

  9. Hypoperfusion of the Adventitial Vasa Vasorum Develops an Abdominal Aortic Aneurysm

    PubMed Central

    Sasaki, Takeshi; Sano, Masaki; Yamamoto, Naoto; Saito, Takaaki; Inuzuka, Kazunori; Hayasaka, Takahiro; Goto-Inoue, Naoko; Sugiura, Yuki; Sato, Kohji; Kugo, Hirona; Moriyama, Tatsuya; Konno, Hiroyuki; Setou, Mitsutoshi; Unno, Naoki

    2015-01-01

    The aortic wall is perfused by the adventitial vasa vasorum (VV). Tissue hypoxia has previously been observed as a manifestation of enlarged abdominal aortic aneurysms (AAAs). We sought to determine whether hypoperfusion of the adventitial VV could develop AAAs. We created a novel animal model of adventitial VV hypoperfusion with a combination of a polyurethane catheter insertion and a suture ligation of the infrarenal abdominal aorta in rats. VV hypoperfusion caused tissue hypoxia and developed infrarenal AAA, which had similar morphological and pathological characteristics to human AAA. In human AAA tissue, the adventitial VV were stenotic in both small AAAs (30–49 mm in diameter) and in large AAAs (> 50 mm in diameter), with the sac tissue in these AAAs being ischemic and hypoxic. These results indicate that hypoperfusion of adventitial VV has critical effects on the development of infrarenal AAA. PMID:26308526

  10. Clinical and radiographic evaluation of a computer-generated guiding device in bilateral sagittal split osteotomies.

    PubMed

    Abdel-Moniem Barakat, Ahmed; Abou-ElFetouh, Adel; Hakam, Maha Mohammed; El-Hawary, Hesham; Abdel-Ghany, Khaled Mahmoud

    2014-07-01

    The bilateral sagittal split osteotomy (BSSO) is one of the main orthognathic surgery procedures used for managing skeletal mandibular excess, deficiency or asymmetry. It is known to be a technique-sensitive procedure with high reported incidences of inferior alveolar nerve injury, bad splits and post-surgical relapse. With the increasing use of computer-assisted techniques in orthognathic surgery, the accurate transfer of the virtual plan to the operating room is currently a subject of research. This study evaluated the efficacy of computer-generated device at maintaining the planned condylar position and minimizing inferior alveolar nerve injury during BSSO. The device was used in 6 patients who required isolated mandibular surgery for correction of their skeletal deformities. Clinical evaluation showed good recovery of the maximal incisal opening and a reproducible occlusion in 5 of the 6 patients. Radiographic evaluation showed better control of the condyle position in both the vertical and anteroposterior directions than in the mediolateral direction. The degree of accuracy between the planned and achieved screw positions were judged as good to excellent in all cases. Within the limitations of this study and the small sample size, the proposed device design allowed for good transfer of the virtual surgical plan to the operating room.

  11. High prevalence of vaterite in sagittal otoliths causes hearing impairment in farmed fish

    PubMed Central

    Reimer, T.; Dempster, T.; Warren-Myers, F.; Jensen, A. J.; Swearer, S. E.

    2016-01-01

    The rapid growth of aquaculture raises questions about the welfare status of mass-produced species. Sagittal otoliths are primary hearing structures in the inner ear of all teleost (bony) fishes and are normally composed of aragonite, though abnormal vaterite replacement is sometimes seen in the wild. We provide the first widespread evaluation of the prevalence of vaterite in otoliths, showing that farmed fish have levels of vaterite replacement over 10 times higher than wild fish, regardless of species. We confirm this observation with extensive sampling of wild and farmed Atlantic salmon in Norway, the world’s largest producer, and verify that vateritic otoliths are common in farmed salmon worldwide. Using a mechanistic model of otolith oscillation in response to sound, we demonstrate that average levels of vaterite replacement result in a 28–50% loss of otolith functionality across most of a salmonid’s known hearing range and throughout its life cycle. The underlying cause(s) of vaterite formation remain unknown, but the prevalence of hearing impairment in farmed fish has important implications for animal welfare, the survival of escapees and their effects on wild populations, and the efficacy of restocking programs based on captive-bred fish. PMID:27121086

  12. Bone healing of an unfixed bone fragment of the distal segment in sagittal split ramus osteotomy.

    PubMed

    Park, Won-Jong; Hwang, Soon Jung

    2014-03-01

    In bilateral sagittal split ramus osteotomy for the correction of asymmetry of the mandible, yawing movement of the distal segment can displace the proximal segment. This displacement can be minimized through osteotomy of the posterior part of the distal segment (ie, distal cutting). This free bone fragment is usually removed because of the difficulty of fixation. No previous studies have examined whether union of the bone fragment after distal cutting could join and consequently strengthen the thinned mandibular posterior border. This study used CT imaging to evaluate bone union of the unfixed bone fragment at 3 months postoperatively. The location of the bone fragment and the morphology of bone healing were evaluated in 2D and 3D. The amount of cancellous bone healing between the free bone segment and the proximal segment averaged 63.69%. There was no correlation between the size of the bone gap and the degree of bone union. In most cases, the free bone fragment was located between the distal and proximal segments and tended to dislocate in an anterior-superior direction. Because the postoperative follow-up period was only 3 months, a longer-term study of the changes in bone volume after remodeling is necessary.

  13. Head and brain response to blast using sagittal and transverse finite element models.

    PubMed

    Singh, Dilaver; Cronin, Duane S; Haladuick, Tyler N

    2014-04-01

    Mild traumatic brain injury caused by blast exposure from Improvised Explosive Devices has become increasingly prevalent in modern conflicts. To investigate head kinematics and brain tissue response in blast scenarios, two solid hexahedral blast-head models were developed in the sagittal and transverse planes. The models were coupled to an Arbitrary Lagrangian-Eulerian model of the surrounding air to model blast-head interaction, for three blast load cases (5 kg C4 at 3, 3.5 and 4 m). The models were validated using experimental kinematic data, where predicted accelerations were in good agreement with experimental tests, and intracranial pressure traces at four locations in the brain, where the models provided good predictions for frontal, temporal and parietal, but underpredicted pressures at the occipital location. Brain tissue response was investigated for the wide range of constitutive properties available. The models predicted relatively low peak principal brain tissue strains from 0.035 to 0.087; however, strain rates ranged from 225 to 571 s-1. Importantly, these models have allowed us to quantify expected strains and strain rates experienced in brain tissue, which can be used to guide future material characterization. These computationally efficient and predictive models can be used to evaluate protection and mitigation strategies in future analysis.

  14. Onyx removal after embolization of a superior sagittal sinus dural arteriovenous fistula involving scalp artery

    PubMed Central

    Watanabe, Jun; Maruya, Jun; Nishimaki, Keiichi; Ito, Yasushi

    2016-01-01

    Background: Most dural arteriovenous fistula (DAVF) in superior sagittal sinus (SSS) requires multimodal treatment. Onyx embolization is useful for DAVF; however, scalp artery embolization has cast extrusion risk. Case Description: A 59-year-old male presented with involuntary movements of both legs and progressive dementia. Cerebral angiography demonstrated the DAVF in the SSS fed by bilateral superficial temporal, occipital, and middle meningeal arteries. The posterior SSS was thrombosed, and the main drainers were cortical veins. Combined treatment with transarterial embolization using Onyx and transvenous embolization using coils was performed. Although symptoms were improved, a small DAVF remained. Two months later, Onyx cast extrusion through the scalp was observed, requiring removal and debridement because of infection at the extrusion sites. Surgery for the residual DAVF would be difficult because of scalp condition; therefore, an additional endovascular treatment was conducted, completely occluding DAVF. Conclusion: Onyx embolization is useful for DAVF; however, scalp artery embolization has cast extrusion risk. Therefore, scalp infection should be considered because it may preclude additional surgical procedures. PMID:27313969

  15. An interesting radiological picture of post traumatic TMJ ankylosis due to sagittal condylar fracture

    PubMed Central

    Kumar L.K., Surej; Manuel, Suvy; Kurien, Nikhil M.; Khalam, Sherin A.; P. Menon, Varun

    2015-01-01

    Introduction In a condylar fracture whether to intervene or to go for conservative management still remains a dilemma. Studies and hypothesis suggests that it's medially dislocated condylar fracture segment that is more likely to ankylose, moreover no consensus have been put forth as to whether to remove the medially displaced fracture segment. Presentation of case The current article describes a case of unilateral temporomandibular joint (TMJ) ankylosis, which resulted as a sequlae from conservative management of a bilateral condylar fracture of which, the ankylosed side had a sagittal fracture of condyle. In our case the post trauma CT shows the lateral segment abutting with the arch and that the area has become ankylotic in a span of 2 years. Here we report a case of posttraumatic unilateral TMJ ankylosis resulting from closed reduction of a bilateral condylar fracture with interesting radiological findings. Discussion We have tried to discuss a rather interesting radiological picture of posttraumatic TMJ ankylosis which resulted as a sequlae from conservative management of a bilateral condylar fracture. Conclusion The dilemma for a clinician as to whether to intervene in a condylar fracture or to go for conservative management still remains at large. As in this case the medial fracture segment was intact and the lateral segment was resulting in ankylosis. PMID:25985295

  16. A midline sagittal brain view depicted in Da Vinci's "Saint Jerome in the wilderness".

    PubMed

    Valença, M M; Aragão, M de F V Vasco; Castillo, M

    2013-01-01

    It is estimated that around the year 1480 Leonardo da Vinci painted Saint Jerome in the Wilderness, representing the saint during his years of retreat in the Syrian dessert where he lived the life of a hermit. One may interpret Leonardo's Saint Jerome in the Wilderness as St. Jerome practicing self-chastisement with a stone in his right hand, seemingly punching his chest repeatedly. The stone, the lion and a cardinal's hat are conventionally linked to the saint. A skull was also almost always present with the image of the saint symbolically representing penance. With careful analysis of the painting one can identify the skull which is hidden in an arc represented as a lion's tail. The image is of a hemicranium (midline sagittal view) showing the intracranial dura, including the falx and tentorium, and venous system with the sinuses and major deep veins. This may have been the first time when the intracranial sinuses and the major deep venous vessels were illustrated.

  17. High prevalence of vaterite in sagittal otoliths causes hearing impairment in farmed fish.

    PubMed

    Reimer, T; Dempster, T; Warren-Myers, F; Jensen, A J; Swearer, S E

    2016-01-01

    The rapid growth of aquaculture raises questions about the welfare status of mass-produced species. Sagittal otoliths are primary hearing structures in the inner ear of all teleost (bony) fishes and are normally composed of aragonite, though abnormal vaterite replacement is sometimes seen in the wild. We provide the first widespread evaluation of the prevalence of vaterite in otoliths, showing that farmed fish have levels of vaterite replacement over 10 times higher than wild fish, regardless of species. We confirm this observation with extensive sampling of wild and farmed Atlantic salmon in Norway, the world's largest producer, and verify that vateritic otoliths are common in farmed salmon worldwide. Using a mechanistic model of otolith oscillation in response to sound, we demonstrate that average levels of vaterite replacement result in a 28-50% loss of otolith functionality across most of a salmonid's known hearing range and throughout its life cycle. The underlying cause(s) of vaterite formation remain unknown, but the prevalence of hearing impairment in farmed fish has important implications for animal welfare, the survival of escapees and their effects on wild populations, and the efficacy of restocking programs based on captive-bred fish. PMID:27121086

  18. In vitro biomechanical comparison of six different fixation methods following 5-mm sagittal split advancement osteotomies.

    PubMed

    Oguz, Y; Watanabe, E R; Reis, J M; Spin-Neto, R; Gabrielli, M A; Pereira-Filho, V A

    2015-08-01

    The sagittal split ramus osteotomy (SSRO) is a surgical technique used widely to treat many congenital and acquired mandibular discrepancies. Stabilization of the osteotomy site and the potential for skeletal relapse after the procedure are still major problems. The aim of this study was to compare the mechanical stability of six methods of rigid fixation in SSRO using a biomechanical test model. Sixty polyurethane replicas of human hemimandibles were divided into six groups. In group I, the osteotomies were fixed with two four-hole titanium miniplates; in group II, with one four-hole miniplate; in group III, with one four-hole miniplate+a bicortical screw; in group IV, with a grid miniplate; in group V, with a four-hole locking miniplate; and in group VI, with a six-hole miniplate. A linear load in the premolar region was applied to the hemimandibles. The resistance forces (N) needed to displace the distal segment by 1, 3, and 5mm were recorded and the data transmitted from the load cell to a computer. One-way analysis of variance with Tukey's post hoc test was performed to compare the means between groups. For the three displacement conditions, there was a strong tendency for the 2.0-mm plate+screw and the grid plate to have higher values.

  19. High prevalence of vaterite in sagittal otoliths causes hearing impairment in farmed fish.

    PubMed

    Reimer, T; Dempster, T; Warren-Myers, F; Jensen, A J; Swearer, S E

    2016-01-01

    The rapid growth of aquaculture raises questions about the welfare status of mass-produced species. Sagittal otoliths are primary hearing structures in the inner ear of all teleost (bony) fishes and are normally composed of aragonite, though abnormal vaterite replacement is sometimes seen in the wild. We provide the first widespread evaluation of the prevalence of vaterite in otoliths, showing that farmed fish have levels of vaterite replacement over 10 times higher than wild fish, regardless of species. We confirm this observation with extensive sampling of wild and farmed Atlantic salmon in Norway, the world's largest producer, and verify that vateritic otoliths are common in farmed salmon worldwide. Using a mechanistic model of otolith oscillation in response to sound, we demonstrate that average levels of vaterite replacement result in a 28-50% loss of otolith functionality across most of a salmonid's known hearing range and throughout its life cycle. The underlying cause(s) of vaterite formation remain unknown, but the prevalence of hearing impairment in farmed fish has important implications for animal welfare, the survival of escapees and their effects on wild populations, and the efficacy of restocking programs based on captive-bred fish.

  20. A Systematic Approach to Predicting Spring Force for Sagittal Craniosynostosis Surgery.

    PubMed

    Zhang, Guangming; Tan, Hua; Qian, Xiaohua; Zhang, Jian; Li, King; David, Lisa R; Zhou, Xiaobo

    2016-05-01

    Spring-assisted surgery (SAS) can effectively treat scaphocephaly by reshaping crania with the appropriate spring force. However, it is difficult to accurately estimate spring force without considering biomechanical properties of tissues. This study presents and validates a reliable system to accurately predict the spring force for sagittal craniosynostosis surgery. The authors randomly chose 23 patients who underwent SAS and had been followed for at least 2 years. An elastic model was designed to characterize the biomechanical behavior of calvarial bone tissue for each individual. After simulating the contact force on accurate position of the skull strip with the springs, the finite element method was applied to calculating the stress of each tissue node based on the elastic model. A support vector regression approach was then used to model the relationships between biomechanical properties generated from spring force, bone thickness, and the change of cephalic index after surgery. Therefore, for a new patient, the optimal spring force can be predicted based on the learned model with virtual spring simulation and dynamic programming approach prior to SAS. Leave-one-out cross-validation was implemented to assess the accuracy of our prediction. As a result, the mean prediction accuracy of this model was 93.35%, demonstrating the great potential of this model as a useful adjunct for preoperative planning tool.

  1. Automatic spinal canal detection in lumbar MR images in the sagittal view using dynamic programming.

    PubMed

    Koh, Jaehan; Chaudhary, Vipin; Jeon, Eun Kyung; Dhillon, Gurmeet

    2014-10-01

    As there is an increasing need for the computer-aided effective management of pathology in lumbar spine, we have developed a computer-aided diagnosis and characterization framework using lumbar spine MRI that provides radiologists a second opinion. In this paper, we propose a left spinal canal boundary extraction method, based on dynamic programming in lumbar spine MRI. Our method fuses the absolute intensity difference of T1-weighted and T2-weighted sagittal images and the inverted gradient of the difference image into a dynamic programming scheme and works in a fully automatic fashion. The boundaries generated by our method are compared against reference boundaries in terms of the Euclidean distance and the Chebyshev distance. The experimental results from 85 clinical data show that our methods find the boundary with a mean Euclidean distance of 3mm, achieving a speedup factor of 167 compared with manual landmark extraction. The proposed method successfully extracts landmarks automatically and fits well with our framework for computer-aided diagnosis in lumbar spine.

  2. Comparing inclined locomotion in a ground-living and a climbing ant species: sagittal plane kinematics.

    PubMed

    Weihmann, Tom; Blickhan, Reinhard

    2009-11-01

    Formicine ants are able to detect slopes in the substrates they crawl on. It was assumed that hair fields between the main segments of the body and between the proximal leg segments contribute to graviception which triggers a change of posture in response to substrate slopes. The sagittal kinematics of two ant species were investigated and compared on different slopes. Cataglyphis fortis, a North African desert ant, is well known for its extraordinary sense of orientation in texturally almost uniform habitats, while Formica pratensis, a common central-European species, primarily uses landmarks and pheromone traces for orientation. A comparison of these two species reveals differences in postural adaptations during inclined locomotion. Only minor slope-dependent angular adjustments were observed. The largest is a 25 degrees head rotation for Cataglyphis, even if the slope is changed by 150 degrees, suggesting dramatic changes in the field of vision. The trunk's pitch adjustment towards the increasing slope is low in both species. On all slopes Cataglyphis achieves higher running speeds than Formica and displays greater slope-dependent variation in body height. This indicates different strategies for coping with changing slopes. These specific aspects have to be reflected in the ants' respective mode of slope perception.

  3. Accuracy of experimental mandibular osteotomy using the image-guided sagittal saw.

    PubMed

    Pietruski, P; Majak, M; Swiatek-Najwer, E; Popek, M; Szram, D; Zuk, M; Jaworowski, J

    2016-06-01

    The aim of this study was to perform an objective assessment of the accuracy of mandibular osteotomy simulations performed using an image-guided sagittal saw. A total of 16 image-guided mandibular osteotomies were performed on four prefabricated anatomical models according to the virtual plan. Postoperative computed tomography (CT) image data were fused with the preoperative CT scan allowing an objective comparison of the results of the osteotomy executed with the virtual plan. For each operation, the following parameters were analyzed and compared independently twice by two observers: resected bone volume, osteotomy trajectory angle, and marginal point positions. The mean target registration error was 0.95±0.19mm. For all osteotomies performed, the mean difference between the planned and actual bone resection volumes was 8.55±5.51%, the mean angular deviation between planned and actual osteotomy trajectory was 8.08±5.50°, and the mean difference between the preoperative and the postoperative marginal point positions was 2.63±1.27mm. In conclusion, despite the initial stages of the research, encouraging results were obtained. The current limitations of the navigated saw are discussed, as well as the improvements in technology that should increase its predictability and efficiency, making it a reliable method for improving the surgical outcomes of maxillofacial operations. PMID:26780924

  4. Conical geometry for sagittal focusing as applied to X rays from synchrotrons

    SciTech Connect

    Ice, G.E.; Sparks, C.J.

    1993-06-01

    The authors describe a method for simultaneously focusing and monochromatization of X rays from a fan of radiation having up to 15 mrad divergence in one dimension. This geometry is well suited to synchrotron radiation sources at magnifications of one-fifth to two and is efficient for X-ray energies between 3 and 40 keV (0.48 and 6.4 fJ). The method uses crystals bent to part of a cone for sagittal focusing and allows for the collection of a larger divergence with less mixing of the horizontal into the vertical divergence than is possible with X-ray mirrors. They describe the geometry required to achieve the highest efficiency when a conical crystal follows a flat crystal in a nondispersive two-crystal monochromator. At a magnification of one-third, the geometry is identical to a cylindrical focusing design described previously. A simple theoretical calculation is shown to agree well with ray-tracing results. Minimum aberrations are observed at magnifications near one. Applications of the conical focusing geometry to existing and future synchrotron radiation facilities are discussed.

  5. Influence of tube's diameter on boiling heat transfer performance in small diameter tubes

    NASA Astrophysics Data System (ADS)

    Gan, Chengjun; Wang, Weicheng; Zhang, Lining

    1998-03-01

    This paper reports the experiments of evaporation study in 6 mm inner copper diameter tubes using HFC-134a, HCFC-22 and CFC-12 as working fluid. The results show that the evaporation heat transfer coefficient increases with the decreasing of inner diameter of tubes. A new concept of non-dimensional tube diameter U is proposed in this paper for correction of the influence of the tube diameter on the evaporation heat transfer coefficient. And further, a convenient empirical correction method is presented.

  6. Can outer-to-outer diameter be used alone in diagnosing appendicitis on 128-slice MDCT?

    PubMed Central

    Yaqoob, Jamal; Idris, Muhammad; Alam, Muhammad Shahbaz; Kashif, Nazia

    2014-01-01

    AIM: To assess the frequency of visualization, position and diameter of normal appendix on 128-slice multidetector computed tomography (MDCT) in adult population. METHODS: Retrospective cross sectional study conducted at Radiology Department, Dallah Hospital, Riyadh, Saudi Arabia from March 2013 to October 2013. Non-enhanced computed tomography scans of abdomen and pelvis of 98 patients presenting with hematuria (not associated with abdominal pain, fever or colonic disease) were reviewed by two radiologists, blinded to patient history. The study group included 55 females and 43 males with overall mean age of 54.7 years (range 21 to 94 years). The coronal reformatted images were reviewed in addition to the axial images. The frequency of visualization of appendix was recorded with assessment of position, diameter and luminal contents. RESULTS: The appendix was recorded as definitely visualized in 99% of patients and mean outer-to-outer diameter of the appendix was 5.6 ± 1.3 mm (range 3.0-11.0 mm). CONCLUSION: MDCT with its multiplanar reformation display is extremely useful for visualization of normal appendix. The normal appendix is very variable in its position and diameter. In the absence of other signs, the diagnosis of acute appendix should not be made solely on outer-to-outer appendiceal diameter. PMID:25550996

  7. A Pancreatic Solid Pseudo-Papillary Tumor Detected After Abdominal Injury

    PubMed Central

    Ishii, Atsushi; Yoshimura, Kazuko; Ideguchi, Hiroshi; Hirose, Shinichi

    2013-01-01

    Solid pseudo-papillary tumor (SPT) of the pancreas is a relatively benign tumor that is more frequently reported in females. Most patients usually present with abdominal pain or mass. We experienced the girl who identified SPT with the injury. We diagnosed SPT in a previously healthy 14-year-old Asian girl after abdominal injury. She experienced upper abdominal pain and vomiting after being hit by a basketball. Blood examination revealed a high serum amylase level. Abdominal radiography indicated abnormal bowel gases. Contrast-enhanced computed tomography revealed a smooth, peripheral and unilocular mass approximately 55 mm in diameter in the pancreatic tail. Based on these observations, acute pancreatitis complicated by a pancreatic mass was initially diagnosed. Therapy for acute pancreatitis was instituted, while we simultaneously investigated the mass. Levels of tumor markers were not profoundly elevated in serum. Dynamic contrast-enhanced magnetic resonance imaging (MRI) revealed moderate and gradual increase in contrast-enhanced imaging, consistent with findings of SPT of the pancreas. We thus elected surgical resection for her. Pathological examination of the surgical specimen confirmed our diagnosis of SPT. SPT of the pancreas should be considered as a differential diagnosis of acute abdomen disorders, especially in instances after minor abdominal injuries in young women, and diagnoses must be confirmed with MRIs.

  8. Intra-abdominal pressure during swimming.

    PubMed

    Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

    2014-02-01

    The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P < 0.05). However, there was no significant difference in stroke length by velocity. Significant within-subject correlations between intra-abdominal pressure and stroke rate or stroke length (P < 0.01) were observed, although there were no significant correlations between intra-abdominal pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure. PMID:23868677

  9. Intra-abdominal pressure during swimming.

    PubMed

    Moriyama, S; Ogita, F; Huang, Z; Kurobe, K; Nagira, A; Tanaka, T; Takahashi, H; Hirano, Y

    2014-02-01

    The present study aimed to determine the intra-abdominal pressure during front crawl swimming at different velocities in competitive swimmers and to clarify the relationships between stroke indices and changes in intra-abdominal pressure. The subjects were 7 highly trained competitive collegiate male swimmers. Intra-abdominal pressure was measured during front crawl swimming at 1.0, 1.2 and 1.4 m · s(-1) and during the Valsalva maneuver. Intra-abdominal pressure was taken as the difference between minimum and maximum values, and the mean of 6 stable front crawl stroke cycles was used. Stroke rate and stroke length were also measured as stroke indices. There were significant differences in stroke rate among all velocities (P < 0.05). However, there was no significant difference in stroke length by velocity. Significant within-subject correlations between intra-abdominal pressure and stroke rate or stroke length (P < 0.01) were observed, although there were no significant correlations between intra-abdominal pressure and stroke indices when controlling for swimming velocity. These findings do not appear to support the effectiveness of trunk training performed by competitive swimmers aimed at increasing intra-abdominal pressure.

  10. Precision distances with spiral galaxy apparent diameters

    NASA Astrophysics Data System (ADS)

    Steer, Ian

    2016-01-01

    Spiral galaxy diameters offer the oldest extragalactic distance indicator known. Although outdated and hitherto imprecise, two spiral diameter-based distance indicators applied in the 1980s can be tested, calibrated, and re-established for precision era use, based on abundant redshift-independent distances data available in NED-D. Indicator one employs the largest Giant Spiral Galaxies, which have an absolute isophotal major diameter of ~70 +/- 10 kpc, offering standard ruler-based distances with <10% precision. Indicator two employs the diameter-magnitude relation for spirals in general, as a secondary indicator, offering ~20% precision. The ruler-based indicator is the only indicator with <10% precision able to independently calibrate type Ia supernovae-based distances at cosmological distances. The secondary-based indicator is the only indicator with 20% precision applicable to more galaxies than in current Tully-Fisher surveys. The primary indicator gives researchers a new tool to confirm or refute if, as currently believed, universal expansion is accelerating. The secondary indicator gives researchers a new path toward acquiring a more complete 3D picture of the local universe and potentially, because the majority of galaxies in the universe are spirals, the distant universe.

  11. 7 CFR 51.587 - Diameter.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Diameter. 51.587 Section 51.587 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF...

  12. 7 CFR 51.587 - Diameter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Diameter. 51.587 Section 51.587 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF...

  13. 7 CFR 51.320 - Diameter.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Standards for Grades of Apples Definitions § 51.320 Diameter. When measuring for minimum size, “diameter” means the greatest dimension of the apple measured at right angles to a line from stem to blossom end. When measuring for maximum size, “diameter” means the smallest dimension of the apple determined...

  14. 7 CFR 51.320 - Diameter.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Definitions § 51.320 Diameter. When measuring for minimum size, “diameter” means the greatest dimension of the apple measured at right angles to... dimension of the apple determined by passing the apple through a round opening in any position....

  15. 7 CFR 51.320 - Diameter.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Standards for Grades of Apples Definitions § 51.320 Diameter. When measuring for minimum size, “diameter” means the greatest dimension of the apple measured at right angles to a line from stem to blossom end. When measuring for maximum size, “diameter” means the smallest dimension of the apple determined...

  16. 7 CFR 51.320 - Diameter.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Definitions § 51.320 Diameter. When measuring for minimum size, “diameter” means the greatest dimension of the apple measured at right angles to... dimension of the apple determined by passing the apple through a round opening in any position....

  17. Slug flow in a large diameter pipe

    SciTech Connect

    Crowley, C.J.; Sam, R.G.; Wallis, G.B.; Mehta, D.C.

    1985-01-01

    Experimental and anlytical results are presented for two-phase slug flow in a transparent, large diameter pipe (6.75 inches ID) at high gas density. Slug characteristics of velocity, length, frequency, carpet profile and carpet velocity, as well as pressure drop, have been measured and compared with correlations and mechanistic models.

  18. Changing the Diameter of a Viewing Tube

    ERIC Educational Resources Information Center

    Obara, Samuel

    2009-01-01

    This article is about the students' investigation about the relationship between the diameter of the view tubes (x) of constant lengths and the viewable vertical distance (y) on the wall while keeping the perpendicular distance from the eyeball to the wall constant. The students collected data and used and represented it in tabular and graphical…

  19. Reducing the diameters of computer networks

    NASA Technical Reports Server (NTRS)

    Bokhari, S. H.; Raza, A. D.

    1986-01-01

    Three methods of reducing the diameters of computer networks by adding additional processor to processor links under the constraint that no more than one I/O port be added to each processor are discussed. This is equivalent to adding edges to a given graph under the constraint that the degree of any node be increased, at most, by one.

  20. Exploration of the validity of the two-dimensional sagittal plane assumption in modeling the standing long jump.

    PubMed

    Hickox, Lauren J; Ashby, Blake M; Alderink, Gordon J

    2016-05-01

    Most previous standing long jump studies have been based on the assumption of two-dimensional sagittal plane motion with bilateral symmetry. The purpose of this study was to investigate the validity of this assumption. Standing long jump trials were collected using six adult male participants. Each participant stood with a foot on each of two force plates and performed eight standing long jumps for maximal distance. Inverse dynamics analyses were performed for two-dimensional (2D) and three-dimensional (3D) models, and joint moments, powers, and work values were compared. The differences between these models with respect to the validity of the common planar jumping assumption were analyzed. Good agreement was observed between 2D and 3D methods for the lower body, with minimal differences in sagittal plane moments, power, and work for the ankle, knee, and lower back. There were significant, but relatively small differences in the sagittal plane kinematics and kinetics at the hip. For the upper body, the results contradicted the sagittal plane assumption in that significant moments and power were generated about the abduction/adduction axis of the shoulder and a similar amount of work was performed about both abduction/adduction and flexion/extension axes of the shoulder. The elbow also showed significant differences in power and work. These results indicate that an assumption of planar motion should be sufficient for many studies of the standing long jump that only examine lower body movement. However, for studies that include upper body motion, diagnosing injury risk, or investigating gender differences, a 3D model may be more appropriate. PMID:26949101

  1. Laparoscopic repair of abdominal incisional hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Abdominal incisional hernia is a common complication after open abdominal operations. Laparoscopic procedures have obvious mini-invasive advantages for surgical treatment of abdominal incisional hernia, especially to cases with big hernia defect. Laparoscopic repair of incisional hernia has routine mode but the actual operations will be various according to the condition of every hernia. Key points of these operations include design of the position of trocars, closure of defects and fixation of meshes. The details of these issues and experiences of perioperative evaluation and treatment will be talked about in this article. PMID:27761446

  2. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    PubMed

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  3. [Internationalization and innovation of abdominal acupuncture].

    PubMed

    Wang, Yong-Zhou

    2013-09-01

    Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture. PMID:24298780

  4. Isolate abdominal bronchogenic cyst: a case report.

    PubMed

    Cetinkurşun, S; Oztürk, H; Celasun, B; Sakarya, M T; Sürer, I

    1997-04-01

    Isolated abdominal bronchogenic cysts are rare abnormalities. They are usually asymptomatic unless secondarily infected or large enough to cause compression of other vital structures. The authors report on a 20-month-old girl who had an abdominal bronchogenic cyst and presented with a history of recurrent urinary tract infections. The evaluation and treatment of this patient is presented as well as a review of the ten previously reported cases. A literature review showed only four cases in the pediatric age group. Excision is recommended to establish diagnosis and alleviate any symptoms. Abdominal bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal masses.

  5. Simulation of bifurcated stent grafts to treat abdominal aortic aneurysms (AAA)

    NASA Astrophysics Data System (ADS)

    Egger, J.; Großkopf, S.; Freisleben, B.

    2007-03-01

    In this paper a method is introduced, to visualize bifurcated stent grafts in CT-Data. The aim is to improve therapy planning for minimal invasive treatment of abdominal aortic aneurysms (AAA). Due to precise measurement of the abdominal aortic aneurysm and exact simulation of the bifurcated stent graft, physicians are supported in choosing a suitable stent prior to an intervention. The presented method can be used to measure the dimensions of the abdominal aortic aneurysm as well as simulate a bifurcated stent graft. Both of these procedures are based on a preceding segmentation and skeletonization of the aortic, right and left iliac. Using these centerlines (aortic, right and left iliac) a bifurcated initial stent is constructed. Through the implementation of an ACM method the initial stent is fit iteratively to the vessel walls - due to the influence of external forces (distance- as well as balloonforce). Following the fitting process, the crucial values for choosing a bifurcated stent graft are measured, e.g. aortic diameter, right and left common iliac diameter, minimum diameter of distal neck. The selected stent is then simulated to the CT-Data - starting with the initial stent. It hereby becomes apparent if the dimensions of the bifurcated stent graft are exact, i.e. the fitting to the arteries was done properly and no ostium was covered.

  6. The effects of changes in the sagittal plane alignment of running-specific transtibial prostheses on ground reaction forces

    PubMed Central

    Tominaga, Shuichi; Sakuraba, Keisyoku; Usui, Fumio

    2015-01-01

    [Purpose] To verify the effects of sagittal plane alignment changes in running-specific transtibial prostheses on ground reaction forces (GRFs). [Subjects and Methods] Eight transtibial amputees who used running-specific prostheses during sprinting participated. The sprint movements were recorded using a Vicon-MX system and GRF measuring devices. The experiment levels were set as regularly recommended alignment (REG; the normal alignment for the subjects) and dorsiflexion or plantar flexion from the REG. [Results] The subjects were classified into fast (100-m personal best < 12.50 s) and slow (100-m personal best ≥ 12.50 s) groups. In both groups, there were no significant differences in the center of gravity speed; further, the difference in the stance time was significant in the slow group but not in the fast group. Significant differences were observed in the step length for the fast group, whereas the stance time and step rate significantly differed in the slow group. The GRF impulse showed significant differences in the vertical and braking directions in both groups. [Conclusion] The GRFs are affected by sagittal plane alignment changes in running-specific prostheses. Moreover, our results suggest that the change in GRFs along with the altered sagittal plane alignment influenced the step length and step rate. PMID:26157216

  7. Magnetic resonance imaging-verified temporomandibular joint disk displacement in relation to sagittal and vertical jaw deformities.

    PubMed

    Jung, W-S; Kim, H; Jeon, D-M; Mah, S-J; Ahn, S-J

    2013-09-01

    This retrospective study was designed to analyze the relationships between temporomandibular joint (TMJ) disk displacement and skeletal deformities in orthodontic patients. Subjects consisted of 460 adult patients. Before treatment, lateral cephalograms and TMJ magnetic resonance imaging (MRI) were recorded. Subjects were divided into six groups based on TMJ MRI according to increasing severity of TMJ disk displacement, in the following order: bilateral normal TMJs, unilateral disk displacement with reduction (DDR) and contralateral normal, bilateral DDR, unilateral disk displacement without reduction (DDNR) and contralateral normal, unilateral DDR and contralateral DDNR, and bilateral DDNR. Subjects were subdivided sagittally into skeletal Class I, II, and III deformities based on the ANB (point A, nasion, point B) angle and subdivided vertically into hypodivergent, normodivergent, and hyperdivergent deformities based on the facial height ratio. Linear trends between severity of TMJ disk displacement and sagittal or vertical deformities were analyzed by Cochran-Mantel-Haenszel test. The severity of TMJ disk displacement increased as the sagittal skeletal classification changed from skeletal Class III to skeletal Class II and the vertical skeletal classification changed from hypodivergent to hyperdivergent. There were no significant differences in the linear trend of TMJ disk displacement severity between the sexes according to the skeletal deformities. This study suggests that subjects with skeletal Class II and/or hyperdivergent deformities have a high possibility of severe TMJ disk displacement, regardless of sex.

  8. Mechanical properties of rat thoracic and abdominal aortas.

    PubMed

    Assoul, N; Flaud, P; Chaouat, M; Letourneur, D; Bataille, I

    2008-07-19

    Mechanical properties of abdominal and thoracic arteries of 2mm in diameter were determined from adults Wistar rats. A tensile testing instrument was used to obtain stress/strain curves with arteries immersed in physiological buffer at 37 degrees C. A displacement was applied on all arteries with various frequencies (1-7.5Hz) and strains (5-60%). From each curve a Young modulus was obtained using a mathematical model based on a nonlinear soft tissue model. No influence of frequency on modulus was evidenced in the tested range. Abdominal aortas, which were found slightly thicker than thoracic aortas, were characterized by a higher modulus. Due to the interest of decellularized biological materials, we also used SDS/Triton treated arteries, and found that the chemical treatment increased modulus of thoracic arteries. Tensile tests were also performed on thoracic aortas in the longitudinal and transversal directions. Longitudinal moduli were found higher than transversal moduli and the difference could be related to the longitudinal orientation of collagen fibers. These data and mathematical model seem useful in the design of new vascular synthetic or biological prostheses for the field of tissue engineering.

  9. Early and late results of resection of abdominal aortic aneurysms.

    PubMed Central

    Scobie, K.; McPhail, N.; Hubbard, C.

    1977-01-01

    Resection of the abdominal aortic aneurysm is being performed with decreasing operative mortality and morbidity. Among 190 patients undergoing this procedure at the Ottawa Civic Hospital between 1970 and 1975, 53 (28%) had a ruptured aneurysm and 137 (72%), a nonruptured aneurysm. Mean age of the patients was 66.2 years. Concomitant disease was frequent, 73% of patients having two or more associated diseases; the average number of associated diseases per patient was 2.25. Operative mortality in the group with ruptured aneurysms was 51%, and in the group with nonruptured aneurysms, 4%. Postoperative morbidity was 85% among those with a ruptured aneurysm, 67% among those with imminent rupture before operation and 34% among the others with a nonruptured aneurysm. Graft complications occurred in 15% of those with a ruptured aneurysm and 9% of those with a nonruptured aneurysm. Among survivors of the operation 73% and 81% of those with a ruptured and a nonruptured aneurysm, respectively, are known to be alive. In both groups causes of late death included infection or thrombosis of the graft and mesenteric thrombosis, as well as causes unrelated to the operation. Surgical management of the abdominal aortic aneurysm is advocated in all but patients at poor risk for operation who have asymptomatic aneurysms less than 6 cm in diameter. PMID:872011

  10. In vivo strain assessment of the abdominal aortic aneurysm.

    PubMed

    Satriano, Alessandro; Rivolo, Simone; Martufi, Giampaolo; Finol, Ender A; Di Martino, Elena S

    2015-01-21

    The only criteria currently used to inform surgical decision for abdominal aortic aneurysms are maximum diameter (>5.5 cm) and rate of growth, even though several studies have identified the need for more specific indicators of risk. Patient-specific biomechanical variables likely to affect rupture risk would be a valuable addition to the science of understanding rupture risk and prove to be a life saving benefit for patients. Local deformability of the aorta is related to the local mechanical properties of the wall and may provide indication on the state of weakening of the wall tissue. We propose a 3D image-based approach to compute aortic wall strain maps in vivo. The method is applicable to a variety of imaging modalities that provide sequential images at different phases in the cardiac cycle. We applied the method to a series of abdominal aneurysms imaged using cine-MRI obtaining strain maps at different phases in the cardiac cycle. These maps could be used to evaluate the distensibility of an aneurysm at baseline and at different follow-up times and provide an additional index to clinicians to facilitate decisions on the best course of action for a specific patient. PMID:25497379

  11. The MRI of extraadrenal pheochromocytoma in the abdominal cavity.

    PubMed

    Qiao, Huang Sui; Feng, Xu Lin; Yong, Li; Yong, Zhang; Lian, Zhong Jing; Ling, Liang Bi

    2007-06-01

    The purpose of this study was to summarize the MR appearances of extraadrenal pheochromocytoma in the abdominal cavity and evaluate the capabilities of MRI in diagnosis of the tumor. Eleven consecutive patients with an extraadrenal pheochromocytoma in abdominal cavity who underwent preoperative 0.5 T (n=5) or 1.5 T (n=6) superconductor MRI and had a surgical resection were enrolled in the study. The MR scanning protocol included axial T(2)-weighted imaging with or without fat-suppressed sequences, axial and coronal uncontrast and contrast T(1)-weighted sequences with or without fat suppression. The extraadrenal pheochromocytomas were found in retroperitoneum (n=5), the urinary bladder (n=1), the pelvis (n=1), the right prerenal area (n=1), the renal hilus (n=1), the left paramusculus psoas major (n=1) and liver (n=1). The mean maximal diameter of tumors was 55.9 mm (range 17.8-162.2 mm). The high signal intensity was seen on T(2)-weighted imaging in all tumors compared to muscle or liver, especially with fat suppression. The intratumoral septa and capsules were shown in 63.6% and 72.7% of cases, respectively, which had low signal intensity on T(2)-weighted imaging. These relative characteristics may be helpful for qualitative diagnosis of extraadrenal pheochromocytomas with MRI. Other usefulness of MRI was to locate the position, to decide the range of tumors and to show well the relationship between the tumor and near structures.

  12. Adult Mansonella perstans in the abdominal cavity in nine Africans.

    PubMed

    Baird, J K; Neafie, R C; Lanoie, L; Connor, D H

    1987-11-01

    Adult Mansonella perstans infected the abdominal cavity of nine patients seen at Karawa Hospital in the Ubangi territory of Zaire. In four patients the worms were removed at laparotomy, and in the other five they were removed at autopsy. Twelve adult worms were identified in the nine patients. None of the worms caused symptoms or contributed to the patient's death. Worms were in the hernial sac in three patients, and one each was in connective tissue beside a reactive mesenteric lymph node, in peripancreatic connective tissue, in perirenal connective tissue, in hepatic portal connective tissue, on the serosal surface of the small intestine, and in connective tissue adjacent to rectum. The diameter of male worms was 45 microns to 60 microns and of female worms, 80 microns to 125 microns. One female worm was removed intact. It was 6 cm long and had a bifurcated tail characteristic of M. perstans. PMID:3688309

  13. Anesthetic considerations for endovascular abdominal aortic aneurysm repair

    PubMed Central

    Kothandan, Harikrishnan; Haw Chieh, Geoffrey Liew; Khan, Shariq Ali; Karthekeyan, Ranjith Baskar; Sharad, Shah Shitalkumar

    2016-01-01

    Aneurysm is defined as a localized and permanent dilatation with an increase in normal diameter by more than 50%. It is more common in males and can affect up to 8% of elderly men. Smoking is the greatest risk factor for abdominal aortic aneurysm (AAA) and other risk factors include hypertension, hyperlipidemia, family history of aneurysms, inflammatory vasculitis, and trauma. Endovascular Aneurysm Repair [EVAR] is a common procedure performed for AAA, because of its minimal invasiveness as compared with open surgical repair. Patients undergoing EVAR have a greater incidence of major co-morbidities and should undergo comprehensive preoperative assessment and optimization within the multidisciplinary settings. In majority of cases, EVAR is extremely well-tolerated. The aim of this article is to outline the Anesthetic considerations related to EVAR. PMID:26750684

  14. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  15. The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex

    NASA Technical Reports Server (NTRS)

    Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

    1993-01-01

    The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

  16. Spontaneous rupture of the abdominal aorta.

    PubMed Central

    Williams, T. G.

    1977-01-01

    Fatal spontaneous rupture of the lower abdominal aorta in a previously healthy 61-year-old woman is reported; the possibility that she had the Ehlers-Danlos syndrome is discussed. Images Fig. 1 PMID:870895

  17. Genetics Home Reference: abdominal wall defect

    MedlinePlus

    ... size and can usually be diagnosed early in fetal development, typically between the tenth and fourteenth weeks of ... organs at the abdominal wall opening late in fetal development may also contribute to organ injury. Intestinal damage ...

  18. Understanding noninguinal abdominal hernias in the athlete.

    PubMed

    Cabry, Robert J; Thorell, Erik; Heck, Keith; Hong, Eugene; Berkson, David

    2014-01-01

    Abdominal hernias are common with over 20 million hernia repairs performed worldwide. Inguinal hernias are the most common type of hernia. Inguinal and sports hernia have been discussed at length in recent literature, and therefore, they will not be addressed in this article. The noninguinal hernias are much less common but do occur, and knowledge of these hernias is important when assessing the athlete with abdominal pain. Approximately 25% of abdominal wall hernias are noninguinal, and new data show the order of frequency as umbilical, epigastric, incisional, femoral, and all others (i.e., Spigelian, obturator, traumatic). Return-to-play guidelines need to be tailored to the athlete and the needs of their sport. Using guidelines similar to abdominal strain injuries can be a starting point for the treatment plan. Laparoscopic repair is becoming more popular because of safety and efficacy, and it may lead to a more rapid return to play. PMID:24614421

  19. Magnetic Surgical Instruments for Robotic Abdominal Surgery.

    PubMed

    Leong, Florence; Garbin, Nicolo; Natali, Christian Di; Mohammadi, Alireza; Thiruchelvam, Dhan; Oetomo, Denny; Valdastri, Pietro

    2016-01-01

    This review looks at the implementation of magnetic-based approaches in surgical instruments for abdominal surgeries. As abdominal surgical techniques advance toward minimizing surgical trauma, surgical instruments are enhanced to support such an objective through the exploration of magnetic-based systems. With this design approach, surgical devices are given the capabilities to be fully inserted intraabdominally to achieve access to all abdominal quadrants, without the conventional rigid link connection with the external unit. The variety of intraabdominal surgical devices are anchored, guided, and actuated by external units, with power and torque transmitted across the abdominal wall through magnetic linkage. This addresses many constraints encountered by conventional laparoscopic tools, such as loss of triangulation, fulcrum effect, and loss/lack of dexterity for surgical tasks. Design requirements of clinical considerations to aid the successful development of magnetic surgical instruments, are also discussed.

  20. Coke from small-diameter tubes analyzed

    SciTech Connect

    Albright, L.F.

    1988-08-29

    The mechanism for coke deposit formation and the nature of the coke itself can vary with the design of the ethylene furnace tube bank. In this article, coke deposits from furnaces with small-diameter pyrolysis tubes are examined. The samples were taken from four furnaces of identical design (Plant B). As in both the first and second installments of the series, the coke deposits were examined using a scanning electron microscope (SEM) and an energy dispersive X-ray analyzer (EDAX). The deposits from the small-diameter tubes are compared with the coke deposits from the furnace discussed in earlier articles. Analysis of the coke in both sets of samples are then used to offer recommendations for improved decoking procedures, operating procedures, better feed selection, and better selection of the metallurgy used in furnace tubes, to extend the operating time of the furnace tubes by reducing the amount and type of coke build up.

  1. Small diameter, deep bore optical inspection system

    DOEpatents

    Lord, D.E.; Petrini, R.R.; Carter, G.W.

    An improved rod optic system for inspecting small diameter, deep bores is described. The system consists of a rod optic system utilizing a curved mirror at the end of the rod lens such that the optical path through the system is bent 90/sup 0/ to minimize optical distortion in examing the sides of a curved bore. The system is particularly useful in the examination of small bores for corrosion, and is capable if examing 1/16 inch diameter and up to 4-inch deep drill holes, for example. The positioning of the curved mirror allows simultaneous viewing from shallow and righ angle points of observation of the same artifact (such as corrosion) in the bore hole. The improved rod optic system may be used for direct eye sighting, or in combination with a still camera or a low-light television monitor; particularly low-light color television.

  2. Small diameter, deep bore optical inspection system

    DOEpatents

    Lord, David E.; Petrini, Richard R.; Carter, Gary W.

    1981-01-01

    An improved rod optic system for inspecting small diameter, deep bores. The system consists of a rod optic system utilizing a curved mirror at the end of the rod lens such that the optical path through the system is bent 90.degree. to minimize optical distortion in examining the sides of a curved bore. The system is particularly useful in the examination of small bores for corrosion, and is capable of examining 1/16 inch diameter and up to 4 inch deep drill holes, for example. The positioning of the curved mirror allows simultaneous viewing from shallow and right angle points of observation of the same artifact (such as corrosion) in the bore hole. The improved rod optic system may be used for direct eye sighting, or in combination with a still camera or a low-light television monitor; particularly low-light color television.

  3. On finding minimum-diameter clique trees

    SciTech Connect

    Blair, J.R.S. . Dept. of Computer Science); Peyton, B.W. )

    1991-08-01

    It is well-known that any chordal graph can be represented as a clique tree (acyclic hypergraph, join tree). Since some chordal graphs have many distinct clique tree representations, it is interesting to consider which one is most desirable under various circumstances. A clique tree of minimum diameter (or height) is sometimes a natural candidate when choosing clique trees to be processed in a parallel computing environment. This paper introduces a linear time algorithm for computing a minimum-diameter clique tree. The new algorithm is an analogue of the natural greedy algorithm for rooting an ordinary tree in order to minimize its height. It has potential application in the development of parallel algorithms for both knowledge-based systems and the solution of sparse linear systems of equations. 31 refs., 7 figs.

  4. Muscle contributions to whole-body sagittal plane angular momentum during walking.

    PubMed

    Neptune, R R; McGowan, C P

    2011-01-01

    Walking is a complex dynamic task that requires the regulation of whole-body angular momentum to maintain dynamic balance while performing walking subtasks such as propelling the body forward and accelerating the leg into swing. In human walking, the primary mechanism to regulate angular momentum is muscle force generation. Muscles accelerate body segments and generate ground reaction forces that alter angular momentum about the body's center-of-mass to restore and maintain dynamic stability. In addition, gravity contributes to whole-body angular momentum through its contribution to the ground reaction forces. The purpose of this study was to generate a muscle-actuated forward dynamics simulation of normal walking to quantify how individual muscles and gravity contribute to whole-body angular momentum in the sagittal plane. In early stance, the uniarticular hip and knee extensors (GMAX and VAS), biarticular hamstrings (HAM) and ankle dorsiflexors (TA) generated backward angular momentum while the ankle plantar flexors (SOL and GAS) generated forward momentum. In late stance, SOL and GAS were the primary contributors and generated angular momentum in opposite directions. SOL generated primarily forward angular momentum while GAS generated backward angular momentum. The difference between muscles was due to their relative contributions to the horizontal and vertical ground reaction forces. Gravity contributed to the body's angular momentum in early stance and to a lesser extent in late stance, which was counteracted primarily by the plantar flexors. These results may provide insight into balance and movement disorders and provide a basis for developing locomotor therapies that target specific muscle groups.

  5. A New Model to Produce Sagittal Plane Rotational Induced Diffuse Axonal Injuries

    PubMed Central

    Davidsson, Johan; Risling, Marten

    2011-01-01

    A new in vivo animal model that produces diffuse brain injuries in sagittal plane rearward rotational acceleration has been developed. In this model, the skull of an anesthetized adult rat is tightly secured to a rotating bar. During trauma, the bar is impacted by a striker that causes the bar and the animal head to rotate rearward; the acceleration phase last 0.4 ms and is followed by a rotation at constant speed and a gentle deceleration when the bar makes contact with a padded stop. The total head angle change is less than 30°. By adjusting the air pressure in the rifle used to accelerate the striker, resulting rotational acceleration between 0.3 and 2.1 Mrad/s2 can be produced. Numerous combinations of trauma levels, post-trauma survival times, brain and serum retrieval, and tissue preparation techniques were adopted to characterize this new model. The trauma caused subdural bleedings in animals exposed to severe trauma. Staining brain tissue with β-Amyloid Precursor Protein antibodies and FD Neurosilver that detect degenerating axons revealed wide spread axonal injuries (AI) in the corpus callosum, the border between the corpus callosum and cortex and in tracts in the brain stem. The observed AIs were apparent only when the rotational acceleration level was moderate and above. On the contrary, only limited signs of contusion injuries were observed following trauma. Macrophage invasions, glial fibrillary acidic protein redistribution or hypertrophy, and blood brain barrier (BBB) changes were unusual. S100 serum analyses indicate that blood vessel and glia cell injuries occur following moderate levels of trauma despite the absence of obvious BBB injuries. We conclude that this rotational trauma model is capable of producing graded axonal injury, is repeatable and produces limited other types of traumatic brain injuries and as such is useful in the study of injury biomechanics, diagnostics, and treatment strategies following diffuse axonal injury. PMID

  6. Establishment of norms of the beta angle to assess the sagittal discrepancy for Nellore district population

    PubMed Central

    Prasad, Mandava; Reddy, Karnati Praveen Kumar; Talapaneni, Ashok Kumar; Chaitanya, Nellore; Bhaskar Reddy, Myla Vijay; Patil, Rajendra

    2013-01-01

    Background and Objectives: In orthodontic diagnosis and treatment planning, assessment of anteroposterior discrepancy is of importance to the orthodontist. Both angular and linear measurements have been incorporated into various cephalometric analyses to help the clinician diagnose anteroposterior discrepancies and establish the most appropriate treatment plan. Hence the present study is designed to establish the norms of Beta angle to assess the sagittal discrepancy for Nellore district population. Materials and Methods: The sample was screened from the old records of the Orthodontic department of Narayana Dental College and Hospital. One hundred and fifty pretreatment cephalometric radiographs (50 each of Class I, II, and III) were subdivided based on ANB, Wits appraisal, and Beta angle into skeletal Class I, II, III. The same cephalograms were again classified into skeletal Class I, II, and III based purely on Beta angle. Each group was again divided into 2 subgroups consisting of 25 male and 25 female subjects with a mean age limit between 15 and 45 years old. Results: The Newman-keuls post hoc test and ANOVA showed that the 3 groups were significantly different (P ≤ 0.001). The Newman-keuls post hoc test also found the groups to be significantly different. Conclusions: There was statistically significant difference for, the mean values and the standard deviation for Beta angle within the three skeletal patterns (Class I, Class II and Class III skeletal patterns). There was no statistically significant difference among the mean values of beta angle between Nellore district population and Caucasian norms and between male and female sex groups. PMID:24082742

  7. [Intestinal occlusion and abdominal compartment syndrome (ACS)].

    PubMed

    Stagnitti, Franco

    2009-01-01

    Intestinal occlusion is defined as an independent predictive factor of intra-abdominal hypertension (IAH) which represents an independent predictor of mortality. Baggot in 1951 classified patients operated with intestinal occlusion as being at risk for IAH ("abdominal blow-out"), recommending them for open abdomen surgery proposed by Ogilvie. Abdominal surgery provokes IAH in 44.7% of cases with mortality which, in emergency, triples with respect to elective surgery (21.9% vs 6.8%). In particular, IAH is present in 61.2% of ileus and bowel distension and is responsible for 52% of mortality (54.8% in cases with intra-abdominal infection). These patients present with an increasing intra-abdominal pressure (IAP) which, over 20-25 mmHg, triggers an Abdominal Compartment Syndrome (ACS) with altered functions in some organs arriving at Multiple Organ Dysfunction Syndrome (MODS). The intestine normally covers 58% of abdominal volume but when there is ileus distension, intestinal pneumatosis develops (third space) which can occupy up to 90% of the entire cavity. At this moment, Gastro Intestinal Failure (GIF) can appear, which is a specific independent risk factor of mortality, motor of "Organ Failure". The pathophysiological evolution has many factors in 45% of cases: intestinal pneumatosis is associated with mucosal and serous edema, capillary leakage with an increase in extra-cellular volume and peritoneal fluid collections (fourth space). The successive loss of the mucous barrier permits a bacterial translocation which includes bacteria, toxins, pro-inflammatory factors and oxygen free radicals facilitating the passage from an intra-abdominal to inter-systemic vicious cyrcle. IAH provokes the raising of the diaphragm, and vascular and visceral compressions which induce hypertension in the various spaces with compartmental characteristics. These trigger hypertension in the renal, hepatic, pelvic, thoracic, cardiac, intracranial, orbital and lower extremity areas, giving

  8. Lasing in microdisks of ultrasmall diameter

    SciTech Connect

    Zhukov, A. E. Kryzhanovskaya, N. V.; Maximov, M. V.; Lipovskii, A. A.; Savelyev, A. V.; Bogdanov, A. A.; Shostak, I. I.; Moiseev, E. I.; Karpov, D. V.; Laukkanen, J.; Tommila, J.

    2014-12-15

    It is demonstrated by calculations and experimental results that room-temperature lasing can be obtained at the ground-state optical transition of InAs/InGaAs/GaAs quantum dots in optical microcavities with a record-small diameter of 1.5 μm. In 1-μm cavities, lasing occurs at the wavelength of one of the whispering-gallery modes within the band corresponding to the first excited-state optical transition.

  9. Cadaveric dissection identifying the left superior anastomotic vein of Trolard communicating indirectly with the superior sagittal sinus via a lateral lacuna.

    PubMed

    Thuy, Matthew N T; Ramesh, Rajalakshmi; Soh, Bob; Drummond, Katharine J

    2012-02-01

    A cadaveric dissection of the calvarium of a 90 year old woman demonstrated a left superior anastomotic vein of Trolard communicating indirectly with the superior sagittal sinus via a left lateral lacunae. This is an anatomical variant contrary to the textbook description of a direct communication between the vein of Trolard and the superior sagittal sinus. A literature search failed to identify a previous description of this variation. Possible clinical implications of this finding will be discussed. PMID:22079142

  10. Management of abdominal contusion in polytraumatized children.

    PubMed

    Canarelli, J P; Boboyono, J M; Ricard, J; Doidy, L; Collet, L M; Postel, J P

    1991-01-01

    Management of abdominal contusion in polytraumatized children is based on the conservative treatment of spleen and liver lesions when it is possible. Ultrasonography and CTScan can give a good evaluation of splenic, liver, pancreas or kidney lesions. In some cases, if the haemodynamic conditions are good, a non-operative treatment may be proposed. We report our experience of conservative management of intra abdominal lesions in children, about 91 cases in ten years. PMID:1869385

  11. Abdominal Aortic Aneurysmectomy in Renal Transplant Patients

    PubMed Central

    Jebara, Victor A.; Fabiani, Jean-Noël; Moulonguet-Deloris, L.; Acar, Christophe; Debauchez, Mathieu; Chachques, J.C.; Glotz, Denis; Duboust, Alain; Langanay, Thierry; Carpentier, Alain

    1990-01-01

    Because renal transplantation is allowing an increased number of patients to survive for prolonged periods, abdominal aortic aneurysms can be expected to occur with growing frequency in these patients. Surgical management of such cases involves the provision of allograft protection. To date, the literature contains 15 reports of abdominal aortic aneurysms in renal allograft recipients. We describe a 16th case and discuss the management of these patients. (Texas Heart Institute Journal 1990;17:240-4) Images PMID:15227179

  12. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death. PMID:27695177

  13. Computed tomography of the postoperative abdominal aorta

    SciTech Connect

    Hilton, S.; Megibow, A.J.; Naidich, D.P.; Bosniak, M.A.

    1982-11-01

    Computed tomography (CT) of the abdomen was performed on 46 patients who had undergone graft replacement of abdominal aortic aneurysms. Twelve post-operative complications were found in nine patients. They included hemorrhage, infection, anastomotic pseudoaneurysms, major vessel occlusion, postoperative pancreatitis, and others. The varied apperance of the normal postoperative graft is also presented. It is concluded that CT is a rapid, sensitive, and noninvasive method for detecting or excluding postoperative complications of abdominal aortic surgery.

  14. A focus on intra-abdominal infections

    PubMed Central

    2010-01-01

    Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as

  15. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  16. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death.

  17. [Late primary abdominal pregnancy. Case report].

    PubMed

    Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández

    2008-09-01

    Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.

  18. Diameter-dependent hydrophobicity in carbon nanotubes

    NASA Astrophysics Data System (ADS)

    Kyakuno, Haruka; Fukasawa, Mamoru; Ichimura, Ryota; Matsuda, Kazuyuki; Nakai, Yusuke; Miyata, Yasumitsu; Saito, Takeshi; Maniwa, Yutaka

    2016-08-01

    Single-wall carbon nanotubes (SWCNTs) are a good model system that provides atomically smooth nanocavities. It has been reported that water-SWCNTs exhibit hydrophobicity depending on the temperature T and the SWCNT diameter D. SWCNTs adsorb water molecules spontaneously in their cylindrical pores around room temperature, whereas they exhibit a hydrophilic-hydrophobic transition or wet-dry transition (WDT) at a critical temperature Twd ≈ 220-230 K and above a critical diameter Dc ≈ 1.4-1.6 nm. However, details of the WDT phenomenon and its mechanism remain unknown. Here, we report a systematic experimental study involving X-ray diffraction, optical microscopy, and differential scanning calorimetry. It is found that water molecules inside thick SWCNTs (D > Dc) evaporate and condense into ice Ih outside the SWCNTs at Twd upon cooling, and the ice Ih evaporates and condenses inside the SWCNTs upon heating. On the other hand, residual water trapped inside the SWCNTs below Twd freezes. Molecular dynamics simulations indicate that upon lowering T, the hydrophobicity of thick SWCNTs increases without any structural transition, while the water inside thin SWCNTs (D < Dc) exhibits a structural transition, forming an ordered ice. This ice has a well-developed hydrogen bonding network adapting to the cylindrical pores of the SWCNTs. Thus, the unusual diameter dependence of the WDT is attributed to the adaptability of the structure of water to the pore dimension and shape.

  19. Management of small asymptomatic abdominal aortic aneurysms – a review

    PubMed Central

    Silaghi, H; Branchereau, A; Malikov, S; Andercou, Aurel

    2007-01-01

    The approach for abdominal aortic aneurysms (AAAs) larger than 55 mm is well defined due to the risk of rupture being higher than 10% per year, and a 30-day perioperative mortality rate between 2.5% and 5%. However, the approach for small asymptomatic AAAs is less well defined. There are different definitions given to describe a small AAA. The one the authors accepted and applied is “a localized, permanent and irreversible dilation of the aorta of at least 50% in relation to the normal adjacent infrarenal or suprarenal aorta, with a maximum diameter between 30–55 mm”. The investigators of the largest study on small AAAs (United Kingdom Small Aneurysm Trial [UK-SAT]) concluded, in brief, that ultrasound monitoring is the most appropriate solution because the results do not support a policy of surgical restoration for AAAs with a diameter of between 40 mm and 55 mm. The aim of the present review article is to highlight several challenges that could change the limits or create a more flexible deciding factor in the management of AAAs. There are multiple factors that influence surgical decision-making, and the limit on aneurysm diameter that indicates surgery should depend on the patient’s age, life expectancy, general status, associated diseases, diameter in relation to body mass, risk factors, sex, anxiety and compliance during the follow-up period. Monitoring is an acceptable alternative for AAAs between 40 mm and 55 mm, and is probably the best solution for high-risk patients. Surgery is the most reasonable solution for patients who are at moderate risk, have a significant life expectancy, are less than 70 to 75 years of age, and/or have aortic aneurysms larger than 50 mm. PMID:22477326

  20. Precision measurement of disc height, vertebral height and sagittal plane displacement from lateral radiographic views of the lumbar spine.

    PubMed

    Frobin, W.; Brinckmann, P.; Biggemann, M.; Tillotson, M.; Burton, K.

    1997-01-01

    OBJECTIVE.: To compile a database of disc height, vertebral height and sagittal plane displacement from lateral radiographic views of the lumbar spine, valid for male and female subjects in the age range 16-57 years. The protocols used to measure these parameters compensate for distortion in central projection, off-centre position, axial rotation and lateral tilt of the spine as well as for variation in radiographic magnification and stature. STUDY DESIGN.: The study comprised designing and testing of measurement protocols, together with subsequent data collection from archive radiographs. BACKGROUND.: Attempts to quantify primary mechanical damage to lumbar vertebrae and discs have been limited due to imprecision when measuring disc height, vertebral height and sagittal plane displacement. Age-related, normative values for these parameters were not previously available. Consequently, important issues like the effectiveness of past and present guidelines for safe manual handling with respect to prevention of overload injuries could not be resolved and judgement on pathological alterations in the morphology of the individual lumbar spine could only be performed in a qualitative, subjective manner. METHODS.: Based on the analysis of vertebral contours in the lateral radiographic image of the lumbar spine, new protocols for measuring disc height, vertebral height and sagittal plane displacement were developed. The measured data are virtually independent of distortion, axial rotation and lateral tilt. Furthermore, description of height and displacement using dimensionless parameters guarantees independence of radiographic magnification and stature. Subjective influence in the measurement procedure was minimized by automatic computation of contour-landmarks and derived parameters. Measurement errors were assessed from sets of radiographs of spine specimens and serial flexion-extension radiographs; interobserver and intraobserver errors were assessed from repeated

  1. Treatment of chronic low back pain in patients with spinal deformities using a sagittal re-alignment brace

    PubMed Central

    Weiss, Hans-Rudolf; Werkmann, Mario

    2009-01-01

    Background For adult scoliosis patients with chronic low back pain bracing is initially indicated before spinal surgery is considered. Until recently there has been a lack of research into the effect upon pain reductions in the mid and long-term. Promising results have been documented in short-term studies for the application of a sagittal re-alignment brace in patients with spinal deformities and along with pain; however mid-term and long-term results are not yet available. The purpose of this study is to investigate the mid-term effects of this brace with respect to pain control. Materials and methods 67 patients (58 females and 9 males) with chronic low back pain (> 24 months) and the diagnosis of scoliosis or hyperkyphosis were treated with a sagittal re-alignment brace (physio-logic brace™) between January 2006 and July 2007. The indication for this kind of brace treatment was derived from a positive sagittal re-alignment test (SRT) and the exclusion of successful conservative treatment during the last 24 months. The aim of this type of conservative intervention was to avoid surgery for chronic low back pain. Results The average pain intensity was measured on the Roland and Morris VRS (5 steps) before treatment. This was 3.3 (t1), at the time of brace adjustment it was 2.7 (t2) and after at an average observation time of 18 months it was 2.0 (t3). The differences were highly significant in the Wilcoxon test. Discussion Short-term measurements showed that a significant pain reduction is possible in chronic postural low back pain using a sagittal re-alignment brace inducing lumbar re-lordosation. In a preliminary report at adjustment (t2), highly significant improvements of pain intensity have also been demonstrated. At 6 months of treatment however, no improvement was measured. The improvement of the mid-term effects (18 months) found in this study compared to the preliminary report may be due to the changed approach to compliance: whilst the bracing standard

  2. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  3. Genes and Abdominal Aortic Aneurysm

    PubMed Central

    Hinterseher, Irene; Tromp, Gerard; Kuivaniemi, Helena

    2010-01-01

    Abdominal aortic aneurysm (AAA) is a multifactorial disease with a strong genetic component. Since first candidate gene studies were published 20 years ago, nearly 100 genetic association studies using single nucleotide polymorphisms (SNPs) in biologically relevant genes have been reported on AAA. The studies investigated SNPs in genes of the extracellular matrix, the cardiovascular system, the immune system, and signaling pathways. Very few studies were large enough to draw firm conclusions and very few results could be replicated in another sample set. The more recent unbiased approaches are family-based DNA linkage studies and genome-wide genetic association studies, which have the potential of identifying the genetic basis for AAA, if appropriately powered and well-characterized large AAA cohorts are used. SNPs associated with AAA have already been identified in these large multicenter studies. One significant association was of a variant in a gene called CNTN3 which is located on chromosome 3p12.3. Two follow-up studies, however, could not replicate the association. Two other SNPs, which are located on chromosome 9p21 and 9q33 were replicated in other samples. The two genes with the strongest supporting evidence of contribution to the genetic risk for AAA are the CDKN2BAS gene, also known as ANRIL, which encodes an antisense RNA that regulates expression of the cyclin-dependent kinase inhibitors CDKN2A and CDKN2B, and DAB2IP, which encodes an inhibitor of cell growth and survival. Functional studies are now needed to establish the mechanisms by which these genes contribute to AAA pathogenesis. PMID:21146954

  4. Relationship between intra-abdominal pressure and vaginal wall movements during Valsalva in women with and without pelvic organ prolapse: technique development and early observations

    PubMed Central

    Spahlinger, D. M.; Newcomb, L.; Ashton-Miller, J. A.; DeLancey, J. O. L.; Chen, Luyun

    2014-01-01

    Objectives To develop and test a method for measuring the relationship between the rise in intra-abdominal pressure and sagittal plane movements of the anterior and posterior vaginal walls during Valsalva in a pilot sample of women with and without prolapse. Methods Mid-sagittal MRI images were obtained during Valsalva while changes in intra-abdominal pressure were measured via a bladder catheter in 5 women with cystocele, 5 women with rectocele, and 5 controls. The regional compliance of the anterior and posterior vagina wall support systems were estimated from the ratio of displacement (mm) of equidistant points along the anterior and posterior vaginal walls to intra-abdominal pressure rise (mmHg). Results The compliance of both anterior and posterior vaginal wall support systems varied along different regions of vaginal wall for all three groups, with the highest compliance found near the vaginal apex and the lowest near the introitus. Women with cystocele had more compliant anterior and posterior vaginal wall support systems than women with rectocele. The movement direction differs between cystocele and rectocele. In cystocele, the anterior vaginal wall moves mostly toward the vaginal orifice in the upper vagina, but in a ventral direction in the lower vagina. In rectocele, the direction of the posterior vaginal wall movement is generally toward the vaginal orifice. Conclusions Movement of the vaginal wall and compliance of its support is quantifiable and was found to vary along the length of the vagina. Compliance was greatest in the upper vagina of all groups. Women with cystocele demonstrated the most compliant vaginal wall support. PMID:24474605

  5. A deployable .015 inch diameter wire antenna

    NASA Technical Reports Server (NTRS)

    Dibiasi, L.

    1979-01-01

    This mechanism was developed to dispense a small diameter wire which serves as a receiving antenna for electric field measurements on an Earth orbiting satellite. The antenna is deployed radially from a spinning satellite. A brushless dc motor drives a storage spool to dispense the wire at a controlled rate. Centrifugal force, acting on a mass attached to the end of the wire, keeps the wire in the radial position. The mechanism design, testing, and performance characteristics are discussed. Finally, operational data of the mechanism while in orbit are presented.

  6. Thread gauge for measuring thread pitch diameters

    DOEpatents

    Brewster, A.L.

    1985-11-19

    A thread gauge which attaches to a vernier caliper to measure the thread pitch diameter of both externally threaded and internally threaded parts is disclosed. A pair of anvils are externally threaded with threads having the same pitch as those of the threaded part. Each anvil is mounted on a stem having a ball on which the anvil can rotate to properly mate with the parts to which the anvils are applied. The stems are detachably secured to the caliper blades by attachment collars having keyhole openings for receiving the stems and caliper blades. A set screw is used to secure each collar on its caliper blade. 2 figs.

  7. Variable diameter wind turbine rotor blades

    DOEpatents

    Jamieson, Peter McKeich; Hornzee-Jones, Chris; Moroz, Emilian M.; Blakemore, Ralph W.

    2005-12-06

    A system and method for changing wind turbine rotor diameters to meet changing wind speeds and control system loads is disclosed. The rotor blades on the wind turbine are able to adjust length by extensions nested within or containing the base blade. The blades can have more than one extension in a variety of configurations. A cable winching system, a hydraulic system, a pneumatic system, inflatable or elastic extensions, and a spring-loaded jack knife deployment are some of the methods of adjustment. The extension is also protected from lightning by a grounding system.

  8. Thread gauge for measuring thread pitch diameters

    DOEpatents

    Brewster, Albert L.

    1985-01-01

    A thread gauge which attaches to a vernier caliper to measure the thread pitch diameter of both externally threaded and internally threaded parts. A pair of anvils are externally threaded with threads having the same pitch as those of the threaded part. Each anvil is mounted on a stem having a ball on which the anvil can rotate to properly mate with the parts to which the anvils are applied. The stems are detachably secured to the caliper blades by attachment collars having keyhole openings for receiving the stems and caliper blades. A set screw is used to secure each collar on its caliper blade.

  9. Large Diameter Limbs for Dilated Common Iliac Arteries in Endovascular Aneurysm Repair. Is It Safe?

    SciTech Connect

    Malagari, Katerina Brountzos, Elias; Gougoulakis, Alexandros; Papathanasiou, Matilda; Alexopoulou, Efthymia; Mastorakou, Renata; Kelekis, Dimitris

    2004-09-15

    In this prospective study we examined whether dilated common iliac arteries (CIAs) can provide a safe distal seal in endovascular aneurysm repair (EVAR) with the use of bifurcated stent grafts with large diameter limbs. Sixteen patients with 26 dilated CIAs with a diameter of {>=}6 mm who were offered EVAR using stent grafts with large diameter limbs were included in the study (Group A). Forty-two patients who also underwent EVAR without iliac dilatation, matched for age, sex and surgical risk were used for comparison (controls-Group B). In group A mean CIA diameter was 18.2 mm (16-28) and mean abdominal aortic aneurysm (AAA) diameter was 6.87 {+-} 1.05 cm; mean age was 77.2 {+-} 4.8 yrs (67-81). Mean follow-up was 33.6 months (2.8 yrs). CIA diameter changes and development of endoleaks were assessed by CT angiography (CTA). Overall iliac dilatation was present in 16/58 of our patients (27.6%). In 10 patients dilatation was bilateral (17.3%). Partial or complete flow to the internal iliac artery (IIA) territories was preserved in all patients post-EVAR. On follow-up, stable caliber of the dilated CIAs was observed in 21 patients (84%), enlargement of 1mm in 3 (16%), and failure of the distal attachment in 1 (6.2%). Compared to the control group there was no statistical significance in the incidence of complications. Dilated common iliac arteries provide a safe distal seal in patients who have undergone EVAR, thus obviating the need for additional endovascular procedures and sparing flow in the IIA vascular bed.

  10. Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis

    PubMed Central

    Makirov, Serik K.; Jahaf, Mohammed T.; Nikulina, Anastasia A.

    2015-01-01

    Goal of the study This study intends to develop a method of quantitative sagittal balance parameters assessment, based on a geometrical model of lumbar spine and sacrum. Methods One hundred eight patients were divided into 2 groups. In the experimental group have been included 59 patients with lumbar spinal stenosis on L1-5 level. Forty-nine healthy volunteers without history of any lumbar spine pathlogy were included in the control group. All patients have been examined with supine MRI. Lumbar lordosis has been adopted as circular arc and described either anatomical (lumbar lordosis angle), or geometrical (chord length, circle segment height, the central angle, circle radius) parameters. Moreover, 2 sacral parameters have been assessed for all patients: sacral slope and sacral deviation angle. Both parameters characterize sacrum disposition in horizontal and vertical axis respectively. Results Significant correlation was observed between anatomical and geometrical lumbo-sacral parameters. Significant differences between stenosis group and control group were observed in the value of the “central angle” and “sacral deviation” parameters. We propose additional parameters: lumbar coefficient, as ratio of the lordosis angle to the segmental angle (Kl); sacral coefficient, as ratio of the sacral tilt (ST) to the sacral deviation (SD) angle (Ks); and assessment modulus of the mathematical difference between sacral and lumbar coefficients has been used for determining lumbosacral balance (LSB). Statistically significant differences between main and control group have been obtained for all described coefficients (p = 0.006, p = 0.0001, p = 0.0001, accordingly). Median of LSB value of was 0.18 and 0.34 for stenosis and control groups, accordingly. Conclusion Based on these results we believe that that spinal stenosis is associated with an acquired deformity that is measureable by the described parameters. It's possible that spinal stenosis occurs in patients with an

  11. Evaluation of nasal morphology in predicting vertical and sagittal maxillary skeletal discrepancies’

    PubMed Central

    Prasad, Mandava; Chaitanya, Nellore; Reddy, Karnati Praveen Kumar; Talapaneni, Ashok Kumar; Myla, Vijaya Bhaskar; Shetty, Sharath Kumar

    2014-01-01

    Objective: The purpose of this prospective observational study was to evaluate the relationship between nasal morphology and maxillary skeletal pattern. The clinical significance was to emphasize the importance of role of nasal pattern in diagnosis and treatment planning. Materials and Methods: The sample included the pre-treatment lateral cephalometric radiographs of 180 South Indian adults (94 women, 86 men), aged 18 to 28 years. Six maxillary and six nasal soft tissue parameters were measured. Pearson correlation coefficients and Analysis of variance were used for statistical analyses. Results: There were significant correlations between maxillary vertical and sagittal, skeletal and soft tissue parameters. The Mean and standard deviations were correlated between low insignificant range to high significant levels with nasal length, nasal depth and columella convexity. Nasal length also showed significant correlation with inclination of palatal plane. Significant influence of gender was seen on nasal length, nasal depth, columella convexity and nasal tip angle. A statistically significant difference was seen regarding nasal length between males and females, with nasal length being more in males (50.26 ± 4.18) than in females (48.86 ± 3.45), nasal depth being more in males (18.64 ± 2.56) than in females (16.63 ± 2.16), columella convexity being greater in males (4.31 ± 1.26) than in females (3.41 ± 1.13), nasolabial angle decreased in males (87.26° ±13.79°) than in females (89.38° ±15.72°) and nasal tip angle being more in females (80.18° ±9.44°) than in males (73.60° ±10.24°). There was no statistically significant difference in nasal hump between males (-2.01 ± 1.76) and females (-2.02 ± 1.62). Conclusion: Long nose with increased nasal prominence were seen with increase in the anteroposterior length and vertical height of maxilla. Male and female genders had a varied amount of nasal length, nasal depth and columella convexity along with nasal

  12. Measurement of Diameter Changes during Irradiation Testing

    SciTech Connect

    Davis, K. L.; Knudson, D. L.; Crepeau, J. C.; Solstad, S.

    2015-03-01

    New materials are being considered for fuel, cladding, and structures in advanced and existing nuclear reactors. Such materials can experience significant dimensional and physical changes during irradiation. Currently in the US, such changes are measured by repeatedly irradiating a specimen for a specified period of time and then removing it from the reactor for evaluation. The time and labor to remove, examine, and return irradiated samples for each measurement makes this approach very expensive. In addition, such techniques provide limited data and handling may disturb the phenomena of interest. In-pile detection of changes in geometry is sorely needed to understand real-time behavior during irradiation testing of fuels and materials in high flux US Material and Test Reactors (MTRs). This paper presents development results of an advanced Linear Variable Differential Transformer-based test rig capable of detecting real-time changes in diameter of fuel rods or material samples during irradiation in US MTRs. This test rig is being developed at the Idaho National Laboratory and will provide experimenters with a unique capability to measure diameter changes associated with fuel and cladding swelling, pellet-clad interaction, and crud buildup.

  13. Abdominal sarcoidosis: cross-sectional imaging findings

    PubMed Central

    Gezer, Naciye Sinem; Başara, Işıl; Altay, Canan; Harman, Mustafa; Rocher, Laurence; Karabulut, Nevzat; Seçil, Mustafa

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%–70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis. PMID:25512071

  14. Functional bowel disorders and functional abdominal pain

    PubMed Central

    Thompson, W; Longstreth, G; Drossman, D; Heaton, K; Irvine, E; Muller-Lissner, S

    1999-01-01

    The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms for at least 12 weeks during the preceding 12 months in the absence of a structural or biochemical explanation. The irritable bowel syndrome, functional abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and laboratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relation to gut function and loss of daily activities, or unspecified FAP, which lacks criteria for the FAP syndrome. An organic cause for the pain must be excluded, but aspects of the patient's pain behavior are of primary importance. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features.


Keywords: functional bowel disorder; functional constipation; functional diarrhea; irritable bowel syndrome; functional abdominal pain; functional abdominal bloating; Rome II PMID:10457044

  15. Methods of Patient Warming during Abdominal Surgery

    PubMed Central

    Shao, Li; Zheng, Hong; Jia, Feng-Ju; Wang, Hui-Qin; Liu, Li; Sun, Qi; An, Meng-Ying; Zhang, Xiu-Hua; Wen, Hao

    2012-01-01

    Background Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. Methods Patients (n = 160) scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients’ nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. Results When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. Discussion The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed. PMID:22808045

  16. Hydatidemesis: a bizarre presentation of abdominal hydatidosis.

    PubMed

    Thomas, S; Mishra, M C; Kriplani, A K; Kapur, B M

    1993-06-01

    A 31 year old male presented with high grade fever and abdominal pain of 20 days duration. At the age of 9 he had been operated on for a solitary retroperitoneal hydatid cyst and had been asymptomatic until the age of 21 when he sustained a blunt injury to the abdomen. An exploratory laparotomy for splenic rupture revealed multiple intra-abdominal hydatid cysts, which were removed. The patient remained well until the present episode. An ultrasound examination revealed multiple intra-abdominal hydatid cysts. Seven days after admission, the patient developed hydatidemesis (hydatid cysts and membranes in the vomitus) and hydatidenteria (passage of hydatid membranes in the stools), and his pain and fever subsided. A Gastrografin study and a computerized tomography (CT) scan revealed hydatid cysts communicating with the stomach and duodenum. In view of his disseminated recurrent abdominal hydatidosis, he was treated with high dose, long-term albendazole along with regular follow up. This is the first documented case of disseminated abdominal hydatidosis presenting with a cystogastric fistula and hydatidemesis.

  17. Gait stability improvement after fusion surgery for adolescent idiopathic scoliosis is influenced by corrective measures in coronal and sagittal planes.

    PubMed

    Paul, Justin C; Patel, Ashish; Bianco, Kristina; Godwin, Ellen; Naziri, Qais; Maier, Stephen; Lafage, Virginie; Paulino, Carl; Errico, Thomas J

    2014-09-01

    To achieve optimal results after fusion for adolescent idiopathic scoliosis (AIS), radiographic parameters must be aligned with motion and performance. The effects of fusion on balance are poorly understood. Center of mass (COM) excursion and instantaneous interaction with center of pressure (COP) provides information about patients' balancing ability during gait. This study investigates the interaction between COM and COP (COM-COP) in AIS patients before and one year after spine fusion and determines what radiographic goals predict restoration of harmonious COM-COP. This was a prospective study that investigated sixteen adolescents with AIS curvature >30˚ requiring surgical correction. Clinical outcomes measures, X-rays, and 3D motion-capture gait analysis were collected. Sagittal and coronal COM and COP offsets and inclination angles were calculated from positional data. COM excursion was calculated as peak COM displacement based on mediolateral and vertical deviation from a line fitted to the patient's path. Radiographic parameters were measured to determine variables predictive of change in COM excursion. Post-operatively, average COM peak displacement decreased (42.6 to 13.1 mm, p=0.001) and COM peak vertical displacement remained unchanged (17.0 to 16.3 mm, p=0.472). COM-COP inclination angles reduced in the coronal, but not sagittal plane. Coronal lower extremity peak inclination angles reduced (8.8˚ to 7.5˚, p=0.025), correlating with C7 plumb-line offset (R=0.581, p=0.018). Thoracic Cobb, thoracic kyphosis, and C7 plumb-line were predictors of change in COM excursion. Mediolateral COM excursion post-surgery may reflect an attempt to reduce kinetic demands with improved spinal alignment. Although AIS correction has historically focused on the coronal plane, sagittal parameters may be more important for motion than previously theorized.

  18. Skeletal Stability after Large Mandibular Advancement (> 10 mm) with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

    PubMed Central

    Rodrigo-Domingo, Maria; Jensen, Thomas

    2016-01-01

    ABSTRACT Objectives The aim of the present study was to assess the skeletal stability after large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation and to correlate the skeletal stability with the vertical facial type. Material and Methods A total of 33 consecutive patients underwent bimaxillary surgery to correct skeletal Class II malocclusion with a mandibular advancement (> 10 mm) measured at B-point and postoperative skeletal elastic intermaxillary fixation for 16 weeks. Skeletal stability was evaluated using lateral cephalometric radiographs obtained preoperative (T1), 8 weeks postoperatively (T2), and 18 month postoperatively (T3). B-point and pogonion (Pog) was used to measure the skeletal relapse and the mandibular plane angle (MP-angle) was used to determine the vertical facial type. Results The mean advancement from T1 to T2 were 11.6 mm and 13.5 mm at B-point and Pog, respectively. The mean skeletal relapse from T2 to T3 was -1.3 mm at B-point and -1.6 mm at Pog. The nineteen patients characterized as long facial types, showed the highest amount of skeletal relapse (-1.5 mm at B-point and -1.9 mm at Pog). Conclusions The present study showed a limited amount of skeletal relapse in large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation. Bilateral sagittal split osteotomy in combination with skeletal intermaxillary fixation can therefore be an alternative to distraction osteogenesis in large mandibular advancements. PMID:27489609

  19. The significance of faint visualization of the superior sagittal sinus in brain scintigraphy for the diagnosis of brain death

    SciTech Connect

    Bisset, R.; Sfakianakis, G.; Ihmedian, I.; Holzman, B.; Curless, R.; Serafini, A.

    1985-05-01

    Brain death is associated with cessation of blood flow to the brain. Tc-99m brain flow studies are used as a laboratory confirmatory test for the establishment of the diagnosis of brain death. Criteria for the diagnosis of cessation of blood flow to the brain are 1) visualization of carotid artery activity in the neck of the patient and 2) no visualization of activity in the distribution of the anterior and middle cerebral arteries. The authors noticed that in a significant number of patients, although there was no visualization of arterial blood flow to the brain the static images demonstrated faint accumulation of activity in the region of the superior sagittal sinus (SSS). In a four year period 212 brain flow studies were performed in 154 patients for diagnosis of brain death; of them 137 studies (65%) showed no evidence of arterial flow. In 103 out of the 137 studies (75%) there was no visualization of the SSS; in the remaining 34 studies (3l patients) however three patterns of faint activity attributed to partial and or faint visualization of the SSS could be recognized at the midline of the immediate anterior static view: a) linear from the cranial vault floor up b) disk shaped at the apex of the vault and c) disk shaped at the apex tailing caudad. All of the 3l patients in this group satisfied brain death criteria within four days of the last study which showed faint visualization of the superior sagittal sinus. The authors conclude that even in the presence of a faint visualization of the superior sagittal sinus on static post brain flow scintigraphy, the diagnosis of cessation of blood flow to the brain can be made if there is no evidence of arterial blood flow.

  20. Acoustic and non-acoustic factors in modeling listener-specific performance of sagittal-plane sound localization

    PubMed Central

    Majdak, Piotr; Baumgartner, Robert; Laback, Bernhard

    2014-01-01

    The ability of sound-source localization in sagittal planes (along the top-down and front-back dimension) varies considerably across listeners. The directional acoustic spectral features, described by head-related transfer functions (HRTFs), also vary considerably across listeners, a consequence of the listener-specific shape of the ears. It is not clear whether the differences in localization ability result from differences in the encoding of directional information provided by the HRTFs, i.e., an acoustic factor, or from differences in auditory processing of those cues (e.g., spectral-shape sensitivity), i.e., non-acoustic factors. We addressed this issue by analyzing the listener-specific localization ability in terms of localization performance. Directional responses to spatially distributed broadband stimuli from 18 listeners were used. A model of sagittal-plane localization was fit individually for each listener by considering the actual localization performance, the listener-specific HRTFs representing the acoustic factor, and an uncertainty parameter representing the non-acoustic factors. The model was configured to simulate the condition of complete calibration of the listener to the tested HRTFs. Listener-specifically calibrated model predictions yielded correlations of, on average, 0.93 with the actual localization performance. Then, the model parameters representing the acoustic and non-acoustic factors were systematically permuted across the listener group. While the permutation of HRTFs affected the localization performance, the permutation of listener-specific uncertainty had a substantially larger impact. Our findings suggest that across-listener variability in sagittal-plane localization ability is only marginally determined by the acoustic factor, i.e., the quality of directional cues found in typical human HRTFs. Rather, the non-acoustic factors, supposed to represent the listeners' efficiency in processing directional cues, appear to be

  1. Effect of the hip motion on the body kinematics in the sagittal plane during human quiet standing.

    PubMed

    Sasagawa, Shun; Ushiyama, Junichi; Kouzaki, Motoki; Kanehisa, Hiroaki

    2009-01-23

    Human quiet stance is often modeled as a single-link inverted pendulum pivoting only around the ankle joints in the sagittal plane. However, several recent studies have shown that movement around the hip joint cannot be negligible, and the body behaves like a double-link inverted pendulum. The purpose of this study was to examine how the hip motion affects the body kinematics in the sagittal plane during quiet standing. Ten healthy subjects were requested to keep a quiet stance for 30s on a force platform. The angular displacements of the ankle and hip joints were measured using two highly sensitive CCD laser sensors. By taking the second derivative of the angular displacements, the angular accelerations of both joints were obtained. As for the angular displacements, there was no clear correlation between the ankle and hip joints. On the other hand, the angular accelerations of both joints were found to be modulated in a consistent anti-phase pattern. Then we estimated the anterior-posterior (A-P) acceleration of the center of mass (CoM) as a linear summation of the angular acceleration data. Simultaneously, we derived the actual CoM acceleration by dividing A-P share force by body mass. When we estimated CoM acceleration using only the angular acceleration of the ankle joint under the assumption that movement of the CoM is merely a scaled reflection of the motion of the ankle, it was largely overestimated as compared to the actual CoM acceleration. Whereas, when we take the angular acceleration of the hip joint into the calculation, it showed good coincidence with the actual CoM acceleration. These results indicate that the movement around the hip joint has a substantial effect on the body kinematics in the sagittal plane even during quiet standing. PMID:19027828

  2. Interceptive orthopedics for the correction of maxillary transverse and sagittal deficiency in the early mixed dentition period

    PubMed Central

    Talapaneni, Ashok Kumar; Kumar, Karnati Praveen; Kommi, Pradeep Babu; Nuvvula, Sivakumar

    2011-01-01

    Dentofacial Orthopedics directed to a hypoplastic maxilla in the prepubertal period redirects growth of the maxilla in the vertical, transverse and sagittal planes of space. The orthopedic correction of maxillary hypoplasia in the early mixed dentition period thus intercepts the establishment of permanent structural asymmetry in the mandible and helps in the achievement of optimal dentofacial esthetics. This paper presents the growth redirection in a hypoplastic maxilla of an 8-year-old girl with simultaneous rapid maxillary expansion and protraction headgear therapy for a period of 11 months which corrected the posterior unilateral cross-bite, the positional asymmetry of the mandible and established an orthognathic profile in the individual. PMID:22346162

  3. Access to the Mandibular Angle Using a Sagittal Split to Address Pathologic Displacement of a Mandibular Third Molar.

    PubMed

    Kontaxis, Katrina L; Steinbacher, Derek M

    2015-12-01

    Access to the mandibular angle for removal of pathology poses a unique challenge to surgeons. Intraoral approaches result in considerable bone removal and potential damage to the inferior alveolar nerve (IAN). Extraoral approaches are associated with a cutaneous scar and the potential for facial nerve damage. This report describes the case of a 53-year-old man with a deeply impacted third molar associated with a cystic lesion that was treated by enucleation using an intraoral sagittal split osteotomy. This approach allowed for complete access and visualization of the cyst and displaced third molar and protection of the IAN with minimal surgical morbidity. PMID:26408844

  4. Endovascular treatment of a traumatic dural arteriovenous fistula of the superior sagittal sinus using dual lumen balloon microcatheter.

    PubMed

    Tao, Yihao; Niu, Yin; Zhu, Gang; Chen, Zhi

    2016-04-01

    Dural arteriovenous fistula (DAVFs) induced by trauma in the superior sagittal sinus (SSS) are rare and difficult to treat because of their unique midline location, multiplicity of arterial feeders, and critical venous drainage. We report a case of an endovascular treatment using dual lumen balloon microcatheter on a patient with post-traumatic SSS DAVF. By the use of dual lumen Scepter balloon microcatheter, proximal Onyx reflux was prevented. In this case, complete embolization of the DAVFs was achieved and the outcome of the patient was fairly good. PMID:27094527

  5. Scar due to skin incision for screw fixation through the transbuccal approach after sagittal split ramus osteotomy.

    PubMed

    Muto, Toshitaka

    2012-05-01

    Most rigid fixation techniques after sagittal split ramus osteotomies of the mandible involve the transbuccal approach. A skin incision in the cheek carries with it possible undesirable sequelae, such as noticeable scarring. The aim of this study was to investigate whether there is scarring in the face after this technique. For screw insertion, a 5-mm stab incision was performed on 40 Japanese patients (20 men and 20 women) with class III occlusion. After surgery, gross examination (via the naked eyes) of the skin incision was performed monthly for 1 year by the same oral surgeon. In all cases, the skin incision had disappeared by 1 year after the surgery. PMID:22627425

  6. The Role of Geometric and Biomechanical Factors in Abdominal Aortic Aneurysm Rupture Risk Assessment

    PubMed Central

    Raut, Samarth S.; Chandra, Santanu; Shum, Judy; Finol, Ender A.

    2013-01-01

    The current clinical management of abdominal aortic aneurysm (AAA) disease is based to a great extent on measuring the aneurysm maximum diameter to decide when timely intervention is required. Decades of clinical evidence show that aneurysm diameter is positively associated with the risk of rupture, but other parameters may also play a role in causing or predisposing the AAA to rupture. Geometric factors such as vessel tortuosity, intraluminal thrombus volume, and wall surface area are implicated in the differentiation of ruptured and unruptured AAAs. Biomechanical factors identified by means of computational modeling techniques, such as peak wall stress, have been positively correlated with rupture risk with a higher accuracy and sensitivity than maximum diameter alone. The objective of this review is to examine these factors, which are found to influence AAA disease progression, clinical management and rupture potential, as well as to highlight on-going research by our group in aneurysm modeling and rupture risk assessment. PMID:23508633

  7. [A case of tuberculous lymphadenitis found as an abdominal mass penetrating the duodenum].

    PubMed

    Tokiwa, Kayoko; Hozawa, Shigenari; Kojima, Seiichirou; Kobayashi, Keinji; Watanabe, Kenichi; Mine, Tetsuya; Kijima, Hiroshi; Imai, Yutaka; Miyachi, Hayato

    2006-08-01

    A 42-year-old woman who complained of epigastralgia was referred to our hospital because of an abdominal mass found by ultrasonography. CT and MRI scans revealed that the abdominal mass, 4 cm in diameter, located on the left side of the right kidney. Gastroduodenoscopy detected a deep ulcerative lesion covered with a yellowish coat in the second portion of duodenum. A sonolucent area at the bottom of the ulcerative lesion seemed to expand to the abdominal mass on ultrasonic endoscopy. Tuberculosis was one possible differential diagnosis. Pathological examination including Ziehl-Neelsen staining using biopsy specimens taken from the bottom of the ulcerative lesion did not show tuberculosis infection. However, polymerase chain reaction analysis using the biopsy specimens revealed that gene expression of tuberculosis was positive. We determined that tuberculous lymphadenitis penetrated the duodenum forming an ulcerative lesion in the duodenum. The administration of anti-tubercular medicine for 6 months male the abdominal mass disappeared and the duodenal ulcerative lesion formed an ulcer scar. We report here a case of tuberculous lymphadenitis penetrating the duodenum which was successfully treated by conservative therapy without surgical treatment.

  8. [A Case of Intra-Abdominal Desmoid Tumor with Abacterial Peritonitis].

    PubMed

    Sumiyama, Fusao; Inada, Ryo; Nakamura, Fumiko; Ryota, Hironori; Miki, Hirokazu; Oishi, Masaharu; Matsumoto, Tomoko; Iwamoto, Shigeyoshi; Mukaide, Yumi; Ozaki, Takeshi; Michiura, Taku; Inoue, Kentaro; Kon, Masanori; Miyasaka, Chika; Uemura, Yoshiko; Hamada, Madoka

    2016-03-01

    A woman in her 50s visited our hospital in February 2015 with a complaint of dull abdominal pain in the right lower quadrant. She had a medical history of appendectomy for appendicitis in her 20s. Computed tomography(CT)revealed a tumor 90 mm in diameter near the ileocecum. Elective surgery was planned under the suspicion of gastrointestinal tumor, malignant lymphoma, or ileal cancer. She was emergently hospitalized 1 day earlier than scheduled because of high fever and severe abdominal pain. CT revealed that the tumor had increased to 120 mm in diameter without free air. Her white blood cell count was not elevated, and her symptoms improved readily with medical treatment. Thus, we performed the operation as scheduled. A tumor with a dark red recess on the surface had invaded the transverse colon intraoperatively, and a small amount of purulent ascites was present at the pouch of Douglas. We performed ileocecal resection with partial transverse colectomy. Histopathological examination led to the diagnosis of desmoid tumor in the mesentery of the terminal ileum. The surgical margins were negative for tumor cells. The tumor surface around the recess showed peritonitis, and the ascites showed no bacteria or tumor cells. The patient had been doing well without recurrence after discharge. Some cases of desmoid tumor with peritonitis have been reported, but most were caused by tumor penetration into the intestinal tract. We report herein a rare case of intra-abdominal desmoid tumor with abacterial peritonitis.

  9. Psychosocial factors and childhood recurrent abdominal pain.

    PubMed

    Boey, Christopher Chiong-Meng; Goh, Khean-Lee

    2002-12-01

    Recurrent abdominal pain in children is not a single condition but a description of a wide spectrum of clinical manifestations, some of which fit into a definite pattern, such as the irritable bowel syndrome, while others do not. Organic disorders may be present, but in the majority of children they cannot be detected. Although children with recurrent abdominal pain do not generally have psychological or psychiatric illness, there is a growing body of evidence to suggest that psychosocial stress plays an important role in this condition. This review will look into some of this evidence. The precise pathophysiology that results in abdominal pain is still not clearly understood, but the current belief is that visceral hypersensitivity or hyperalgesia and changes in the brain-gut axis linking the central and enteric nervous systems are important mechanisms. PMID:12423267

  10. Thoracic and abdominal blastomycosis in a horse.

    PubMed

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  11. [Differential diagnosis of abdominal cysts in children].

    PubMed

    Józsa, Gergő; Mohay, Gabriella; Pintér, András; Vástyán, Attila

    2015-09-13

    19 children were diagnosed with abdominal cysts of different origin in the Surgical Unit of the Department of Pediatrics, Medical University of Pécs, Hungary between 2010 and 2013. The authors discuss the details of representative cases of a parovarial cyst, an intestinal duplication, and an omental cyst with emphasis on the clinical symptoms, diagnostic tools, and surgical interventions. The authors conclude that abdominal cysts often cause mild symptoms only, and they are discovered accidentally by ultrasound imaging performed for other reasons. In some cases, the cyst can cause severe complaints or even acute abdomen requiring emergency surgery. Laporoscopy may be a valuable method both in diagnosis and surgical therapy. Abdominal CT or MRI are not required in the majority of the patients.

  12. Abdominal Sarcoidosis May Mimic Peritoneal Carcinomatosis

    PubMed Central

    Gorkem, Umit; Gungor, Tayfun; Bas, Yılmaz; Togrul, Cihan

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disorder of unknown etiology. It shows a great variety of clinical presentation, organ involvement, and disease progression. Lungs and lymphoid system are the most common sites involved with a frequency of 90% and 30%, respectively. Extrapulmonary involvement of sarcoidosis is reported in 30% of patients and abdomen is the most frequent site. Furthermore, peritoneal involvement is extremely rare in sarcoidosis. The case presented here described peritoneal manifestations of sarcoidosis without involvement of lungs. A 78-year-old woman possessing signs of malignancy on blood test and abdominal magnetic resonance imaging underwent laparatomy with a suspicion of ovarian malignancy. The macroscopic interpretation during surgery was peritoneal carcinomatosis. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal biopsies, total omentectomy, and appendectomy were performed. Final histopathological result revealed the diagnosis of sarcoidosis. Clinicians must keep in mind that peritoneal sarcoidosis can mimic intra-abdominal malignancies. PMID:26558122

  13. Development of fine diameter mullite fiber

    NASA Technical Reports Server (NTRS)

    Long, W. G.

    1974-01-01

    Results are presented of a program to develop and evaluate mullite fiber with a mean diameter under two microns. The two micron fiber is produced by a blowing process at room temperature from a low viscosity (10-25 poise) solution. The blown fiber was evaluated for dimensional stability in thermal cycling to 1371 C, and was equivalent to the 5 micron spun B and W mullite fiber. An additive study was conducted to evaluate substitutes for the boron. Three levels of chromium, lithium fluoride, and magnesium were added to the standard composition in place of boron and the fiber produced was evaluated for chemical and dimensional stability in thermal cycling to 1371 C. The magnesium was the most chemically stable, but the chrome additive imparted the best dimensional stability.

  14. Fire protection covering for small diameter missiles

    NASA Technical Reports Server (NTRS)

    Riccitiello, S. R.; Sawko, P. M. (Inventor)

    1979-01-01

    Flexible intumescent protection sheeting of unusually uniform thickness were prepared from epoxy-polysulfide compositions, containing microfibers and the ammonium salt of 1,4-nitroaniline-2-sulfonic acid, as disclosed in U.S. Pat. No. 3,663,464, except that an ammonium salt particle size in the order of 5 to 8 microns and a fiber size of about 1/128th inch in length and 3 to 5 microns in diameter were found critical to obtain the required density of 1.46 to 1.50 g/cc. The insulation sheeting was prepared by a continuous process involving vacuum mixing, calendering, and curing under very strict conditions which depend to some extent upon the thickness of the sheet produced.

  15. Granulation, Irradiance and Diameter Solar Variations

    NASA Astrophysics Data System (ADS)

    Humberto Andrei, Alexandre; Calderari Boscardin, Sergio; Lousada Penna, Jucira; Reis Neto, Eugenio

    2015-08-01

    Though granulation forms the very face of sun’s photosphere, there are no long term registers of it. Observational and computational hardships to define and follow such highly variable “face” have so far prevented the realization of those registers. However, in recent years a large, coherent body of white light images became available. We retrieved white light, full solar disk images from the BBSO, to a total of 1104 treated ones and 1245 treated and compensated for limb darkening ones. The time coverage extends from the year 2000 to 2005, thus covering the rise and fall of the solar cycle 23. For the analysis, only the central 0.35R portion of the Sun was considered. The central portion was then divided into 100 subsectors, to average and discard the deviant results. The analysis goal is to derive the long term behavior of the photosphere granulation, in broad statistical sense. Three statistics were this way calculated: the standard deviation of the counts (that answers to the grains size); the counts difference between the maximum and minimum tenths (that answers to the grains brightness); the degree of the best fit polynomial along lines and columns (that answers to the grains numbers). According to the statistics, there is no significant variation in the number of grains. The grains sizes are the largest by the solar maximum, in excellent agreement with the maximum of the measured diameter. The grains brightness, on the contrary, is minimum at the solar maximum, and again an excellent agreement is verified with the maximum of the measured diameter.

  16. Decompressive laparotomy for abdominal compartment syndrome

    PubMed Central

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  17. An abdominal extraskeletal osteosarcoma: A case report

    PubMed Central

    WU, ZHIMING; CHU, XIUFENG; MENG, XINGCHENG; XU, CHAOYANG

    2013-01-01

    Primary abdominal extraskeletal osteosarcoma (EOS) is a rare carcinoma. The present study reports a case of a primary abdominal EOS involving the greater omentum and also presents a review of the literature on the etiology, diagnosis, differential diagnosis, pathological features, treatment and prognosis of the disease. The patient in the present study underwent laparoscopic surgery. A pathological examination revealed that the tumor tissues contained malignant and primitive spindle cells with varying amounts of neoplastic osteoid and osseous or cartilaginous tissue. The post-operative follow-up appointments were scheduled at three-month intervals for two years. The tumor recurred three months after the surgery. PMID:24137451

  18. An unusual cause of abdominal pain.

    PubMed

    Terneu, S; Verhelst, D; Thys, F; Ketelslegers, E; Hantson, P; Wittebole, X

    2003-01-01

    A 36-year-old woman presented to the Emergency Room because of abdominal pain associated with hematuria and red blood blending to stool. On admission, the physical examination revealed abdominal tenderness and diffuse cutaneous hematoma. The laboratory findings showed abnormal clotting tests with high International Normalised Ratio (INR) and prolonged activated partial thromboplastin time. Hemoperitoneum and ureteral hematoma were noted on the abdomen computed tomography. The patient confessed she had ingested difenacoum for several weeks. All the symptoms resolved with fresh frozen plasma perfusion and vitamin K. PMID:14635532

  19. Acellular dermal matrix in abdominal wall reconstruction.

    PubMed

    Silverman, Ronald P

    2011-09-01

    Abdominal wall reconstruction is a complex and challenging surgical undertaking. While permanent prosthetic mesh is considered the gold standard for minimizing hernia recurrence, placement of synthetic mesh is sometimes imprudent due to contamination or risk of infection. Acellular dermal matrices (ADM) offer an exciting biologic alternative. This article provides a historical perspective on the evolution of complex ventral hernia repair leading up to and including the placement of ADM, an explanation of the biology of ADM as it relates to ventral hernia repair, and a description of the current indications, techniques, benefits, and shortcomings of its use in the abdominal wall.

  20. [Penetrating abdominal wounds. Apropos of 330 cases].

    PubMed

    Nejjar, M; Bennani, S; Zerouali, O N

    1991-01-01

    Penetrating abdominal wounds are frequent and serious. 330 cases have been treated in the Department of Emergencies and visceral Surgery at Averroes Hospital of Casablanca from 1980 to 1990. The predominance of male sex is noted, and these wounds are always the result of aggression by white arm. All patients have been operated, the white laparotomy rate is of 36%. The classic interventionist attitude is still recommended in spite of this high rate, because our present conditions can't permit us a rigorous watching. According to abdominal lesions, the different interventions are reviewed, and their indications are detailed. PMID:1960187

  1. [Abdominal migraine as a cause of chronic recurrent abdominal pain in a 9-years-old girl--case report].

    PubMed

    Kwiecień, Jarosław; Piasecki, Leszek; Kasner, Jacek; Karczewska, Krystyna

    2005-08-01

    Abdominal migraine is a rarely recognized functional intestinal disorder, manifesting as recurrent paroxysmal abdominal pain of neurogenic origin. The authors describe the 9-years old girl referred to the hospital because of chronic paroxysmal abdominal pain. She did not improve after medication used commonly in functional abdominal disorders (drotaverine, mebeverine, trimebutine). On the ground of various investigations organic causes of abdominal pain were excluded. Carefully completed anamnesis, as well as precise description of the clinical picture of abdominal pain attacks, has lead to the diagnosis of abdominal migraine. According to advice of neurologist the treatment with amitriptyline was introduced. Thereafter a significant improvement was observed. Abdominal migraine has to be taken in to account when diagnosing chronic abdominal pain in children. PMID:16245431

  2. Carotid-femoral pulse wave velocity is negatively correlated with aortic diameter.

    PubMed

    Bailey, Marc A; Davies, Jennifer M; Griffin, Kathryn J; Bridge, Katherine I; Johnson, Anne B; Sohrabi, Soroush; Baxter, Paul D; Scott, D Julian A

    2014-10-01

    Cardiovascular events pose significant morbidity and mortality burden to abdominal aortic aneurysm (AAA) patients. Arterial stiffness as measured by pulse wave velocity (PWV) is an independent predictor of cardiovascular risk. We investigated the relationship between aortic diameter and PWV. Consecutive patients with AAA were invited to participate. Patients completed a health questionnaire, received aortic ultrasound and carotid-femoral PWV (cfPWV) recordings with a Vicorder. Thirty patients were used for reproducibility assessment. A linear regression model was used to identify significant predictors of cfPWV. Observer variation was assessed using Bland and Altman analysis and the intraclass correlation coefficient. Three hundred and nine patients were included-148 with AAA and 161 controls. The mean difference for repeated cfPWV between observers was 0.11 ms(-1). cfPWV was positively correlated with age (r=0.24, P<0.001) and systolic blood pressure (r=0.29, P<0.001) and negatively correlated with aortic diameter (r=-0.15, P=0.008). There was no difference in cfPWV between AAA and control groups (9.75±2.3 ms(-1) vs. 9.55±2.3 ms(-1), P=0.43). Aortic diameter (P=0.003) and systolic blood pressure (P<0.001) were significant predictors of cfPWV independent of age, aspirin usage and a history of myocardial infarction. Patients with large AAA (>5 cm) had decreased cfPWV compared with patients with small AAA (P=0.02) or normal diameter aorta (P=0.02). Vicorder measurements of cfPWV are repeatable. cfPWV is negatively associated with infra-renal aortic diameter and reduced in large AAA. cfPWV is likely invalid for accurate arterial stiffness assessment in patients with AAA owing to the apparent confounding effect of aortic size.

  3. The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

    PubMed

    Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

    2012-06-01

    The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ.

  4. Ultrasound follow-up of posttraumatic injuries of the sagittal band of the dorsal hood treated by a conservative approach.

    PubMed

    Willekens, Inneke; Kichouh, Mimoun; Boulet, Cedric; De Maeseneer, Michel; Clarys, Jan Pieter; de Mey, Johan

    2015-02-01

    Traumatic dislocation of the extensor tendon over the metacarpophalangeal (MCP) joint is a rare problem in patients without rheumatoid disorders. The common extensor tendon is stabilized on the metacarpal head by components of the dorsal hood (DH). A tear in the sagittal bands, allows (sub)luxation of the tendon. To ensure appropriate treatment, the identification of the damaged structures is essential. Ultrasound (US) is a valuable method in the evaluation of DH injuries and in the follow-up for evaluation of healing or lack of healing of the lesions. We report three cases with partial rupture of the sagittal band of the DH: two cases in the index finger and one case in the long finger, which caused pain and swelling and was diagnosed with US. The patients were treated conservatively and the pain resolved after 9 months in case 1, 3 months in case 2 and 6 months in case 3. The follow-up at one year revealed painless full range of motion and no residual subluxation during the dynamic ultrasound.

  5. Stability of unilateral sagittal split ramus osteotomy for correction of facial asymmetry: long-term case series and literature review

    PubMed Central

    Lee, Seong-Geun; Kang, Young-Hoon; Byun, June-Ho; Kim, Uk-Kyu; Kim, Jong-Ryoul

    2015-01-01

    Bilateral sagittal split ramus osteotomy is considered a standard technique in mandibular orthognathic surgeries to reduce unexpected bilateral stress in the temporomandibular joints. Unilateral sagittal split ramus osteotomy (USSO) was recently introduced to correct facial asymmetry caused by asymmetric mandibular prognathism and has shown favorable outcomes. If unilateral surgery could guarantee long-term postoperative stability as well as favorable results, operation time and the incidence of postoperative complications could be reduced compared to those in bilateral surgery. This report highlights three consecutive cases with long-term follow-up in which USSO was used to correct asymmetric mandibular prognathism. Long-term postoperative changes in the condylar contour and ramus and condylar head length were analyzed using routine radiography and computed tomography. In addition, prior USSO studies were reviewed to outline clear criteria for applying this technique. In conclusion, patients showing functional-type asymmetry with predicted unilateral mandibular movement of less than 7 mm can be considered suitable candidates for USSO-based correction of asymmetric mandibular prognathism with or without maxillary arch surgeries. PMID:26131434

  6. Lower lumbar spine axial rotation is reduced in end-range sagittal postures when compared to a neutral spine posture.

    PubMed

    Burnett, Angus; O'Sullivan, Peter; Ankarberg, Lars; Gooding, Megan; Nelis, Rogier; Offermann, Frank; Persson, Jannike

    2008-08-01

    Sports such as rowing, gymnastics, cycling and fast bowling in cricket that combine rotation with spine flexion and extension are known to carry greater risk of low back pain (LBP). Few studies have investigated the capacity of the lumbar spine to rotate in various sagittal positions, and further, these studies have generated disparate conclusions. The purpose of this study was to determine whether the range of lower lumbar axial rotation (L3-S2) is decreased in end-range flexion and extension postures when compared to the neutral spine posture. Eighteen adolescent female rowers (mean age=14.9 years) with no history of LBP were recruited for this study. Lower lumbar axial rotation was measured by an electromagnetic tracking system (3-Space Fastrak) in end-range flexion, extension and neutral postures, in sitting and standing positions. There was a reduction in the range of lower lumbar axial rotation in both end-range extension and flexion (p<0.001) postures when compared to neutral. Further, the range of lower lumbar axial rotation measurements in flexion when sitting was reduced when compared to standing (p=0.013). These findings are likely due to the anatomical limitations of the passive structures in end-range sagittal postures. PMID:17395521

  7. Bad split during bilateral sagittal split osteotomy of the mandible with separators: a retrospective study of 427 patients.

    PubMed

    Mensink, Gertjan; Verweij, Jop P; Frank, Michael D; Eelco Bergsma, J; Richard van Merkesteyn, J P

    2013-09-01

    An unfavourable fracture, known as a bad split, is a common operative complication in bilateral sagittal split osteotomy (BSSO). The reported incidence ranges from 0.5 to 5.5%/site. Since 1994 we have used sagittal splitters and separators instead of chisels for BSSO in our clinic in an attempt to prevent postoperative hypoaesthesia. Theoretically an increased percentage of bad splits could be expected with this technique. In this retrospective study we aimed to find out the incidence of bad splits associated with BSSO done with splitters and separators. We also assessed the risk factors for bad splits. The study group comprised 427 consecutive patients among whom the incidence of bad splits was 2.0%/site, which is well within the reported range. The only predictive factor for a bad split was the removal of third molars at the same time as BSSO. There was no significant association between bad splits and age, sex, class of occlusion, or the experience of the surgeon. We think that doing a BSSO with splitters and separators instead of chisels does not increase the risk of a bad split, and is therefore safe with predictable results.

  8. Risk factors for common complications associated with bilateral sagittal split osteotomy: A literature review and meta-analysis.

    PubMed

    Verweij, Jop P; Houppermans, Pascal N W J; Gooris, Peter; Mensink, Gertjan; van Merkesteyn, J P Richard

    2016-09-01

    The most common complications that are associated with bilateral sagittal split osteotomy are: bad splits, postoperative infection, removal of osteosynthesis material, and neurosensory disturbances of the lower lip. Particularly in elective orthognathic surgery, it is important that surgeons inform their patients about the risk of these complications and attempt to minimize these risks. The purpose of this literature review and meta-analysis is to provide an overview of these common complications and their risk factors. After a systematic electronic database search, 59 studies were identified and included in this review. For each complication, a pooled mean incidence was computed. Both the pooled study group and the pooled 'complication group' were analysed. The mean incidences for bad split (2.3% per SSO), postoperative infection (9.6% per patient), removal of the osteosynthesis material (11.2% per patient), and neurosensory disturbances of the lower lip (33.9% per patient) are reported. Regularly reported risk factors for complications were the patient's age, smoking habits, presence of third molars, the surgical technique and type of osteosynthesis material. This information may help the surgeon to minimize the risk of these complications and inform the patient about the risks of complications associated with bilateral sagittal split osteotomy. PMID:27527679

  9. Relative importance of aneurysm diameter and body size for predicting AAA rupture in men and women

    PubMed Central

    Lo, Ruby C.; Lu, Bing; Fokkema, Margriet T.M.; Conrad, Mark; Patel, Virendra I.; Fillinger, Mark; Matyal, Robina; Schermerhorn, Marc L.

    2014-01-01

    Objectives Women have been shown to have up to a four-fold higher risk of abdominal aortic aneurysm (AAA) rupture at any given aneurysm diameter compared to men, leading to recommendations to offer repair to women at lower diameter thresholds. Although this higher risk of rupture may simply reflect greater relative aortic dilatation in women who have smaller aortas to begin with, this has never been quantified. Our objective was therefore to quantify the relationship between rupture and aneurysm diameter relative to body size and to determine whether a differential association between aneurysm diameter, body size, and rupture risk exists for men and women. Methods We performed a retrospective review of all patients in the Vascular Study Group of New England (VSGNE) database who underwent endovascular or open AAA repair. Using each patient’s height and weight, body mass index (BMI) and body surface area (BSA) were calculated. Next, indices of each measure of body size (height, weight, BMI, BSA) relative to aneurysm diameter were calculated for each patient. To generate these indices, we divided aneurysm diameter (in cm) by the measure of body size [e.g. aortic size index (ASI) = aneurysm diameter (cm) / BSA (m2)]. Along with other relevant clinical variables, we used these indices to construct different age-adjusted and multivariable-adjusted logistic regression models to determine predictors of ruptured repair vs. elective repair. Models for men and women were developed separately and different models were compared using the area under the curve (AUC). Results We identified 4045 patients who underwent AAA repair (78% male, 53% EVAR). Women had significantly smaller diameter aneurysms, lower BSA, and higher BSA indices than men (Table 1). For men, the variable that increased the odds of rupture the most was aneurysm diameter (AUC = 0.82). Men exhibited an increased rupture risk with increasing aneurysm diameter (<5.5cm: OR 1.0; 5.5–6.4cm: OR 0.9, 95% CI 0.5–1

  10. [Marfan's syndrome presented with dissected thoraco-abdominal aneurism and pregnancy. A case report].

    PubMed

    Mendoza-Alvarez, Sergio Alberto; Fuentes-León, Jorge; Vargas-Ayala, Germán; Hernández-González, Claudia; López-Arias, Gabriela; Vera-Lastra, Olga

    2009-01-01

    A 39-year-old patient diagnosed two years previously with Marfan Syndrome (MS) and thoraco-abdominal aneurysm, both presented with the following symptoms: occasional mild effort dyspnea and thoracic pain. The patient started her current illness at 28 weeks of pregnancy with an exacerbation of a deep, oppressive thoracic pain and orthopnea. The echocardiogram showed a 10 cm diameter aortic aneurysm with involvement of the aortic root, tho-racoabdominal and dissection. The computed tomography reported aneurysmatic dilatation of the aortic root and dissection of the thoracic and abdominal portion. Until the delivery of pregnancy the patient was treated successfully with meto-prolol, prazocin, and diuretics. A cesarean section at 29 weeks of pregnancy was practiced. PMID:20602908

  11. Ultrasonographic Measurement of Normal Common Bile Duct Diameter and its Correlation with Age, Sex and Anthropometry

    PubMed Central

    Mehra, Simmi; Lal, Vivek

    2014-01-01

    Background: Ultrasonography is the diagnostic method of choice for visualization and rational work-up of abdominal organs. The dilatation of the common bile duct helps distinguish obstructive from non-obstructive causes of jaundice. Availability of normal measurements of the common bile duct is therefore important. There exists significant variations in the anthropometric features of various populations, regions and races. Aim: Study was conducted to obtain data on sonographically measured diameters of common bile duct in a series of normal Rajasthani population and to measure its correlation with age, sex and anthropometry. Setting and Design: Cross-sectional hospital-based study conducted at Mahatma Gandhi Medical College and Hospital, Jaipur, India. Materials and Methods: Study included 200 participants with equal proportion belonging to either sex. Common bile duct was measured at three locations- at the porta hepatis, in the most distal aspect of head of pancreas and mid-way between these points. Anthropometric measurements including height, weight, chest circumference, circumference at transpyloric plane, circumference at umbilicus and circumference at hip were obtained using standard procedures. Statistical Analysis: Univariable analysis with measures of frequency and standard deviation and bivariable analysis using correlation. Results: Mean age of study subjects was 34.5 years (Range 18-85 years). Mean diameters of the common bile duct in the three locations were: proximal, 4.0 mm (SD 1.02 mm); middle, 4.1 mm (SD 1.01 mm); and distal, 4.2 mm (SD 1.01 mm) and overall mean for all measures 4.1 mm (SD 1.01 mm). Average diameter ranged from 2.0 mm to 7.9 mm, with 95 percent of the subjects having a diameter of less than 6 mm. We observed a statistically significant relation of common bile duct with age, along with a linear trend. There was no statistically significant difference in common bile duct diameter between male and female subjects. The diameter did

  12. [Albert Einstein and his abdominal aortic aneurysm].

    PubMed

    Cervantes Castro, Jorge

    2011-01-01

    The interesting case of Albert Einstein's abdominal aortic aneurysm is presented. He was operated on at age 69 and, finding that the large aneurysm could not be removed, the surgeon elected to wrap it with cellophane to prevent its growth. However, seven years later the aneurysm ruptured and caused the death of the famous scientist.

  13. Cardiopulmonary monitoring in intra-abdominal hypertension.

    PubMed

    Malbrain, Manu L N G; Ameloot, Koen; Gillebert, Carl; Cheatham, Michael L

    2011-07-01

    Cardiopulmonary dysfunction and failure are commonly encountered in the patient with intra-abdominal hypertension (IAH) or abdominal compartment syndrome. Accurate assessment and optimization of preload, contractility, and afterload in conjunction with appropriate goal-directed resuscitation and assessment of fluid responsiveness are essential to restore end-organ perfusion. In patients with IAH, the traditional "barometric" preload indicators such as pulmonary artery occlusion pressure and central venous pressure are erroneously increased. Volumetric monitoring techniques have been proven to be superior in directing the appropriate resuscitation together with targeted abdominal perfusion pressure. If such limitations are not recognized, misinterpretation of the patient's cardiac status is likely, resulting in inappropriate and potentially detrimental therapy. IAH also markedly affects the mechanical properties of the chest wall and consequently also the respiratory function. Altered mechanical properties of the chest wall may limit ventilation, influence the work of breathing, affect the interaction between the respiratory muscles, hasten the development of respiratory failure, and interfere with gas exchange. Pulmonary monitoring is important to understand the relationships between intra-abdominal pressure and chest wall mechanics and the impact of IAH on ventilator-induced lung injury, lung distention, recruitment, and lung edema. PMID:21944448

  14. Childhood functional abdominal pain: mechanisms and management.

    PubMed

    Korterink, Judith; Devanarayana, Niranga Manjuri; Rajindrajith, Shaman; Vlieger, Arine; Benninga, Marc A

    2015-03-01

    Chronic abdominal pain is one of the most common clinical syndromes encountered in day to day clinical paediatric practice. Although common, its definition is confusing, predisposing factors are poorly understood and the pathophysiological mechanisms are not clear. The prevailing viewpoint in the pathogenesis involves the inter-relationship between changes in hypersensitivity and altered motility, to which several risk factors have been linked. Making a diagnosis of functional abdominal pain can be a challenge, as it is unclear which further diagnostic tests are necessary to exclude an organic cause. Moreover, large, well-performed, high-quality clinical trials for effective agents are lacking, which undermines evidence-based treatment. This Review summarizes current knowledge regarding the epidemiology, pathophysiology, risk factors and diagnostic work-up of functional abdominal pain. Finally, management options for children with functional abdominal pain are discussed including medications, dietary interventions, probiotics and psychological and complementary therapies, to improve understanding and to maximize the quality of care for children with this condition. PMID:25666642

  15. Physical activity and abdominal obesity in youth.

    PubMed

    Kim, YoonMyung; Lee, SoJung

    2009-08-01

    Childhood obesity continues to escalate despite considerable efforts to reverse the current trends. Childhood obesity is a leading public health concern because overweight-obese youth suffer from comorbidities such as type 2 diabetes mellitus, nonalcoholic fatty liver disease, metabolic syndrome, and cardiovascular disease, conditions once considered limited to adults. This increasing prevalence of chronic health conditions in youth closely parallels the dramatic increase in obesity, in particular abdominal adiposity, in youth. Although mounting evidence in adults demonstrates the benefits of regular physical activity as a treatment strategy for abdominal obesity, the independent role of regular physical activity alone (e.g., without calorie restriction) on abdominal obesity, and in particular visceral fat, is largely unclear in youth. There is some evidence to suggest that, independent of sedentary activity levels (e.g., television watching or playing video games), engaging in higher-intensity physical activity is associated with a lower waist circumference and less visceral fat. Several randomized controlled studies have shown that aerobic types of exercise are protective against age-related increases in visceral adiposity in growing children and adolescents. However, evidence regarding the effect of resistance training alone as a strategy for the treatment of abdominal obesity is lacking and warrants further investigation.

  16. Abdominal Compartment Syndrome Secondary to Chronic Constipation

    PubMed Central

    Flageole, Helene; Ouahed, Jodie; Walton, J. Mark; Yousef, Yasmin

    2011-01-01

    Abdominal compartment syndrome (ACS) is defined as an elevated intraabdominal pressure with evidence of organ dysfunction. The majority of published reports of ACS are in neonates with abdominal wall defects and in adults following trauma or burns, but it is poorly described in children. We describe the unusual presentation of an 11-year-old boy with a long history of chronic constipation who developed acute ACS requiring resuscitative measures and emergent disimpaction. He presented with a 2-week history of increasing abdominal pain, nausea, diminished appetite and longstanding encopresis. On exam, he was emaciated with a massively distended abdomen with a palpable fecaloma. Abdominal XR confirmed these findings. Within 24 hours of presentation, he became tachycardic and oliguric with orthostatic hypotension. Following two enemas, he acutely deteriorated with severe hypotension, marked tachycardia, acute respiratory distress, and a declining mental status. Endotracheal intubation, fluid boluses, and vasopressors were commenced, followed by emergent surgical fecal disimpaction. This resulted in rapid improvement in vital signs. He has been thoroughly investigated and no other condition apart from functional constipation has been identified. Although ACS secondary to constipation is extremely unusual, this case illustrates the need to actively treat constipation and what can happen if it is not. PMID:22606517

  17. Myxoid Liposarcoma in the Abdominal Wall

    PubMed Central

    Fan, Zhe; Tian, Xiao Feng; Tang, Shun Xiong; Zhang, Ying Yi; Pan, Ji Yong; Wang, Shuang

    2014-01-01

    Abstract A liposarcoma is the most common type of soft tissue sarcoma, and most liposarcomas are malignant. The extremities are the most common site for liposarcomas. There are 5 histologic types of liposarcoma, as follows: well differentiated; myxoid; round cell; pleomorphic; and dedifferentiated. Myxoid liposarcomas (MLSs) represent a subgroup of liposarcomas. There has been no report of MLSs in the abdominal wall. We report a rare case of a MLS of a 43-year-old male who presented with tensile force on the abdominal wall. Computed tomography (CT) found a tumor in abdominal wall. There was no other abnormal symptom and the laboratory testing was also unusual. At last, the tumor was successfully excised, which was diagnosed MLSs in pathology. Following standard principles, after complete excision, the patient received radiotherapy. The patient was followed up for 8 month and no disease recurrence was identified. MLSs are rarely seen in the clinic, irrespective of the presenting signs, but also based on histologic features. The aim of this report was to present the differential diagnosis of an abdominal wall mass, and to remind us of MLSs. PMID:25526446

  18. Laparoscopic management of an abdominal pregnancy.

    PubMed

    Srinivasan, Aarthi; Millican, Suzanne

    2014-01-01

    Background. Ectopic pregnancy is one of the leading causes of significant maternal morbidity and mortality. Abdominal surgeries increase the risk of postoperative adhesions. We here present a case of omental ectopic pregnancy in a patient with a prior history of cesarean section. Case. A 20-year-old female presented with a two-day history of crampy lower abdominal pain. Patient was hemodynamically stable with a beta HCG of 1057 mI/mL. Transvaginal ultrasound did not show an intrauterine pregnancy but revealed an ill-defined mass in the midline pelvis extending to the right of the midline. Diagnostic laparoscopy revealed large clots in the pelvis with normal uterus and adnexa. Intra-abdominal survey revealed an omental adhesion close to the right adnexa with a hematoma. Partial omentectomy was completed and the portion of the omentum with the hematoma was sent to pathology for confirmation. Final pathology confirmed the presence of chorionic villi consistent with products of conception. Conclusion. Omental ectopic pregnancy is a rare diagnosis and often missed. We recommend careful intra-abdominal survey for an ectopic pregnancy in the presence of hemoperitoneum with normal uterus and adnexa. This can be safely achieved using laparoscopy in early gestational ages when the patient is hemodynamically stable. PMID:25478262

  19. [Two cases of abdominal bronchogenic cyst].

    PubMed

    Takeshita, K; Watabe, N; Sato, A; Watanabe, I; Yamaguchi, M; Tezuka, H; Abe, H; Sakamoto, K

    1990-09-01

    Two cases of abdominal bronchogenic cyst were reported. In the first case, the cyst was communicated with gastric fundus and existed as gastric abscess. In the second case, the cyst showed high CT number and chemical analysis of the contents revealed high range of Ca, Fe and Amylase levels.

  20. Large Circular Basin - 1300-km diameter

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Close-up view of one-half of a 1300-km diameter circular basin the largest observed on Mercury. The other half is hidden beyond the terminator to the left. Hills and valleys extend in a radial fashion outward from the main ring. Interior of the large basin is completely flooded by plains materials; adjacent lowlands are also partially flooded and superimposed on the plains are bowl shaped craters. Wrinkle ridges are abundant on the plains materials. The area shown is 1008 miles (1600 km) from the top to the bottom of the picture. Sun's illumination is from the right. Blurred linear lines extending across the picture near bottom are missing data lines that have been filled in by the computer. Mariner 10 encountered Mercury on Friday, March 29th, 1974, passing the planet on the darkside 431 miles (690-km) from the surface.

    The Mariner 10 mission, managed by the Jet Propulsion Laboratory for NASA's Office of Space Science, explored Venus in February 1974 on the way to three encounters with Mercury-in March and September 1974 and in March 1975. The spacecraft took more than 7,000 photos of Mercury, Venus, the Earth and the Moon.

    NOTE: This image was scanned from physical media.

  1. The 15 cm diameter ion thruster research

    NASA Technical Reports Server (NTRS)

    Wilbur, P. J.

    1974-01-01

    The startup reliability of a 15 cm diameter mercury bombardment ion thruster which employs a pulsed high voltage tickler electrode on the main and neutralizer cathodes is examined. Startup of the thruster is achieved 100% of the time on the main cathode and 98.7% of the time on the neutralizer cathode over a 3640 cycle test. The thruster was started from a 20 C initial condition and operated for an hour at a 600 mA beam current. An energy efficiency of 75% and a propellant utilization efficiency of 77% was achieved over the complete cycle. The effect of a single cusp magnetic field thruster length on its performance is discussed. Guidelines are formulated for the shaping of magnetic field lines in thrusters. A model describing double ion production in mercury discharges is presented. The production route is shown to occur through the single ionic ground state. Photographs of the interior of an operating-hollow cathode are presented. A cathode spot is shown to be present if the cathode is free of low work-function surfaces. The spot is observed if a low work-function oxide coating is applied to the cathode insert. Results show that low work-function oxide coatings tend to migrate during thruster operation.

  2. SKADS: Sub-Kilometer Asteroid Diameter Survey

    NASA Astrophysics Data System (ADS)

    Davis, D. R.; Gladman, B.; Jedicke, R.; Williams, G.

    2004-11-01

    We surveyed 8 sq deg over the course of six nights (March 21-23 and March 29-31 UT, 2001) using the mosaic camera on the KPNO 4m telescope. This survey was designed to sample the mainbelt asteroid size and orbit distribution down to mR ˜ 23 and to obtain V and R band photometry on these objects. Improved understanding of the asteroid size distribution is needed to refine our knowledge of the disruptive scaling law and the collisional evolution of asteroids. On each night, 24 fields were observed 3 times with the fields being shifted by the mean motion of mainbelt asteroids between dates. Data was taken on all six nights with 4 nights being photometric for all or most of the night. A total of 1087 asteroids were detected on 2 or more of the 6 nights while 907 asteroids were detected on at least 4 nights to allow a ``good" orbit to be determined. The 50% detection efficiency was between mR ˜ 22.9 and 23.1 for the photometric nights. Debiasing the detected asteroids will yield the asteroid diameter distribution down to sub-km sizes.

  3. Talk to Your Doctor about Abdominal Aortic Aneurysm

    MedlinePlus

    ... español Talk to Your Doctor about Abdominal Aortic Aneurysm Browse Sections The Basics Overview What is AAA? ... doctor about getting screened (tested) for abdominal aortic aneurysm (AAA). If AAA isn't found and treated ...

  4. 1975 Memorial Award Paper. Image generation and display techniques for CT scan data. Thin transverse and reconstructed coronal and sagittal planes.

    PubMed

    Glenn, W V; Johnston, R J; Morton, P E; Dwyer, S J

    1975-01-01

    The various limitations to computerized axial tomographic (CT) interpretation are due in part to the 8-13 mm standard tissue plane thickness and in part to the absence of alternative planes of view, such as coronal or sagittal images. This paper describes a method for gathering multiple overlapped 8 mm transverse sections, subjecting these data to a deconvolution process, and then displaying thin (1 mm) transverse as well as reconstructed coronal and sagittal CT images. Verification of the deconvolution technique with phantom experiments is described. Application of the phantom results to human post mortem CT scan data illustrates this method's faithful reconstruction of coronal and sagittal tissue densities when correlated with actual specimen photographs of a sectioned brain. A special CT procedure, limited basal overlap scanning, is proposed for use on current first generation CT scanners without hardware modification.

  5. Combined Gastric and Duodenal Perforation Through Blunt Abdominal Trauma

    PubMed Central

    Kaur, Adarshpal; Singla, Archan Lal; Kumar, Ashwani; Yadav, Manish

    2015-01-01

    Blunt abdominal traumas are uncommonly encountered despite their high prevalence, and injuries to the organ like duodenum are relatively uncommon (occurring in only 3%-5% of abdominal injuries) because of its retroperitoneal location. Duodenal injury combined with gastric perforation from a single abdominal trauma impact is rarely heard. The aim of this case report is to present a rare case of blunt abdominal trauma with combined gastric and duodenal injuries. PMID:25738037

  6. Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents.

    PubMed

    Linek, Pawel; Saulicz, Edward; Wolny, Tomasz; Myśliwiec, Andrzej; Kokosz, Mirosław

    2015-02-01

    Lateral abdominal wall muscles in children and adolescents have not been characterised to date. In the present report, we examined the reliability of the ultrasound measurement and thickness of the oblique external muscle (OE), oblique internal muscle (OI) and transverse abdominal muscle (TrA) at rest and during abdominal drawing-in manoeuvre (ADIM) on both sides of the body in healthy adolescents. We also determined possible differences between boys and girls and defined any factors-such as body mass, height and BMI-that may affect the thickness of the abdominal muscles. B-mode ultrasound was used to assess OE, OI and TrA on both sides of the body in the supine position. Ultrasound measurements at rest and during ADIM were reliable in this age group (ICC3,3 > 0.92). OI was always the thickest and TrA the thinnest muscle on both sides of the body. In this group, an identical pattern of the contribution of the individual muscles to the structure of the lateral abdominal wall (OI > OE > TrA) was observed. At rest and during ADIM, no statistically significant side-to-side differences were demonstrated in either gender. The body mass constitutes between 30% and <50% of the thickness differences in all muscles under examination at rest and during ADIM. The structure of lateral abdominal wall in adolescents is similar to that of adults. During ADIM, the abdominal muscles in adolescents react similarly to those in adults. This study provided extensive information regarding the structure of the lateral abdominal wall in healthy adolescents.

  7. [Approaches to the abdominal cavity and closure of the abdominal wall].

    PubMed

    Dittmar, Y; Rauchfuss, F; Ardelt, M; Settmacher, U

    2011-12-01

    Although minimally invasive approaches to the abdominal cavity are becoming increasingly more important, open surgical techniques are still of essential interest and must be mastered by general and visceral surgeons. The choice of the particular approach depends on the specificity and location of the scheduled procedure. The following article is intended to give an overview on the current literature as well as experiences in the field of open surgical approaches to the abdominal cavity.

  8. Effects of physical activity on blood pressure monitoring and morphometric parameters of the left ventricle and of the abdominal aorta in healthy elderly subjects.

    PubMed

    Macchi, Claudio; Lova, Raffaele Molino; Giannelli, Fabrizio; Papucci, Mario; Conti, Andrea A; Paternostro, Ferdinando; Contini, Massimo; Miniati, Benedetta; Gulisano, Massimo; Catini, Claudio

    2003-01-01

    To investigate the effects of physical activity not only on morphometric left ventricular parameters, but also on the abdominal aorta diameter and on blood pressure, we enrolled 100 healthy subjects, 50 males and 50 females, aged between 63 and 91 years (mean 73.3 +/- s.d. 7.7), each divided into two subgroups, sedentary and non sedentary, come to our observation for a diagnostic screening. For each subject an Echography was performed, by using an Acuson 128XP10 apparatus, equipped with a 2 MHz phased array probe, both for the study of the heart and for the study of the abdominal aorta. Then, all the subjects underwent 24 hours blood pressure monitoring by using a P6 Delmar apparatus in order to get mean systolic and diastolic blood pressure. Diastolic blood pressure was significantly related to physical activity (sedentary > non sedentary, P < 0.01), while systolic blood pressure was not; left ventricle and abdominal aorta diameters were both significantly related to sex (males > females, P < 0.001), but left ventricle diameter was significantly related to diastolic blood pressure (P < 0.01), while abdominal aorta diameter was significantly related to systolic blood pressure (P < 0.001). Our data suggest that physical activity might be strongly recommended to control blood pressure.

  9. Treatment of osteomyelitis in the rear area of the lingula of the mandible using sagittal split ramus osteotomy: a case report.

    PubMed

    Jung, Tae-Young

    2015-08-01

    Osteomyelitis is classified into three groups according to its origin: osteomyelitis that originates from the blood supply, osteomyelitis related to bone disease or vascular disease, and osteomyelitis related to a local infection of dental or non-dental origin. The present case involved osteomyelitis related to a local infection of dental origin and was located in the rear area of the lingula of the mandible. We decided to use sagittal split ramus osteotomy to access the osteomyelitis area. Under general anesthesia, we successfully performed surgical sequestrectomy and curettage via sagittal split ramus osteotomy.

  10. Can release of urinary retention trigger abdominal aortic aneurysm rupture?

    PubMed

    Luhmann, Andreas; Powell-Bowns, Matilda; Elseedawy, Emad

    2013-04-04

    Only 50% of abdominal aortic aneurysms present with the classic triad of hypotension, back pain and a pulsatile abdominal mass. This variability in symptoms can delay diagnosis and treatment. We present the case of a patient presenting with a unique combination of symptoms suggesting that decompression of urinary retention can lead to abdominal aortic aneurysm rupture.

  11. 2013 WSES guidelines for management of intra-abdominal infections

    PubMed Central

    2013-01-01

    Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections. PMID:23294512

  12. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Abdominal decompression chamber. 884.5225 Section... Devices § 884.5225 Abdominal decompression chamber. (a) Identification. An abdominal decompression chamber is a hoodlike device used to reduce pressure on the pregnant patient's abdomen for the relief...

  13. Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.

    ERIC Educational Resources Information Center

    Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.

    2001-01-01

    Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…

  14. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Abdominal pain is the most common indication for OGD in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. We conducted the current study to examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and ...

  15. Effect of age on survival between open repair and surveillance for small abdominal aortic aneurysms.

    PubMed

    Filardo, Giovanni; Lederle, Frank A; Ballard, David J; Hamilton, Cody; da Graca, Briget; Herrin, Jeph; Sass, Danielle M; Johnson, Gary R; Powell, Janet T

    2014-10-15

    Randomized controlled trials have shown no significant difference in survival between immediate open repair and surveillance with selective repair for asymptomatic abdominal aortic aneurysms of 4.0 to 5.5 cm in diameter. This lack of difference has been shown to hold true for all diameters in this range, in men and women, but the question of whether patients of different ages might obtain different benefits has remained unanswered. Using the pooled patient-level data for the 2,226 patients randomized to immediate open repair or surveillance in the United Kingdom Small Aneurysm Trial (UKSAT; September 1, 1991, to July 31, 1998; follow-up 2.6 to 6.9 years) or the Aneurysm Detection and Management (ADAM) trial (August 1, 1992, to July 31, 2000; follow-up 3.5 to 8.0 years), the adjusted effect of age on survival in the 2 treatment groups was estimated using a generalized propensity approach, accounting for a comprehensive array of clinical and nonclinical risk factors. No significant difference in survival between immediate open repair and surveillance was observed for patients of any age, overall (p = 0.606) or in men (p = 0.371) or women separately (p = 0.167). In conclusion, survival did not differ significantly between immediate open repair and surveillance for patients of any age, overall or in men or women. Combined with the previous evidence regarding diameter, and the lack of benefit of immediate endovascular in trials comparing it with surveillance repair for small abdominal aortic aneurysms, these results suggest that surveillance should be the first-line management strategy of choice for asymptomatic abdominal aortic aneurysms of 4.0 to 5.5 cm.

  16. Frontobiparietal remodeling with or without a widening bridge for sagittal synostosis: comparison of 2 cohorts for aesthetic and functional outcome.

    PubMed

    van Veelen, Marie-Lise C; Mihajlović, Dalibor; Dammers, Ruben; Lingsma, Hester; van Adrichem, Leon N A; Mathijssen, Irene M J

    2015-07-01

    OBJECT Various techniques to correct sagittal synostosis have been described. The authors of this study assess the results of 2 techniques for late complete cranial remodeling and test the hypothesis that adding a widening bridge would improve outcome. METHODS In this retrospective study, the authors evaluated patients with nonsyndromic sagittal synostosis-those who underwent frontobiparietal remodeling (FBR) and those who underwent modified FBR (MFBR) involving the introduction of a bony bridge to increase the width of the skull. Outcomes for both groups are described in terms of the aesthetic results assessed on photographs and any changes in the cranial index (CI) and head circumference over time, the presence of papilledema, and complaints of headache. The effect of the surgical technique on CI and head circumference over time was assessed using linear regression analysis, with adjustment for preoperative CI and head circumference. RESULTS Sixty-nine patients with isolated sagittal synostosis were included in this study: 35 underwent MFBR and 34 underwent the original technique of FBR. The mean follow-up period was 7 years. In the 1st year after surgery, mean CI improved by 9% in the FBR group and by 12% in the MFBR group. One year after surgery, CI in the MFBR group was on average 4.7% higher than that in the FBR group (p < 0.001). During follow-up, CI decreased in both groups; however, at all time points CI was significantly higher in the MFBR group than in the FBR group. The impact of surgical technique on CI was less important than the impact of preoperative CI (R(2)= 0.26 vs 0.54), and this applied at all time points during follow-up. Head circumference declined during follow-up in both groups. It was influenced by preoperative head circumference, but not by surgical technique. Aesthetic outcome, prevalence of headache (42%), and papilledema (7%) were comparable in both groups. CONCLUSIONS Adding a widening bridge to late complete remodeling significantly

  17. THE INFLUENCE OF HEEL HEIGHT ON SAGITTAL PLANE KNEE KINEMATICS DURING LANDING TASKS IN RECREATIONALLY ACTIVE AND ATHLETIC COLLEGIATE FEMALES

    PubMed Central

    Carcia, Christopher R.; Phelps, Amy L.; Martin, RobRoy L.; Burrows, Anne M.

    2011-01-01

    Purpose: To determine if heel height alters sagittal plane knee kinematics when landing from a forward hop or drop landing. Background: Knee angles close to extension during landing are theorized to increase ACL injury risk in female athletes. Methods: Fifty collegiate females performed two single-limb landing tasks while wearing heel lifts of three different sizes (0, 12 & 24 mm) attached to the bottom of a sneaker. Using an electrogoniometer, sagittal plane kinematics (initial contact [KAIC], peak flexion [KAPeak], and rate of excursion [RE]) were examined. Repeated measures ANOVAs were used to determine the influence of heel height on the dependent measures. Results: Forward hop task- KAIC with 0 mm, 12 mm, and 24 mm lifts were 8.88±6.5, 9.38±5.8 and 11.28±7.0, respectively. Significant differences were noted between 0 and 24 mm lift (p<.001) and 12 and 24 mm lifts (p=.003), but not between the 0 and 12 mm conditions (p=.423). KAPeak with 0 mm, 12 mm, and 24 mm lifts were 47.08±10.9, 48.18±10.3 and 48.88±9.7, respectively. A significant difference was noted between 0 and 24 mm lift (p=.004), but not between the 0 and 12 mm or 12 and 24 mm conditions (p=.071 and p=.282, respectively). The RE decreased significantly from 2128/sec±52 with the 12 mm lift to 1958/sec±55 with the 24 mm lift (p=.004). RE did not differ from 0 to 12 or 0 to 24 mm lift conditions (p=.351 and p=.086, respectively). Jump-landing task- No significant differences were found in KAIC (p=.531), KAPeak (p=.741), or the RE (p=.190) between any of the heel lift conditions. Conclusions: The addition of a 24 mm heel lift to the bottom of a sneaker significantly alters sagittal plane knee kinematics upon landing from a unilateral forward hop but not from a drop jump. PMID:21904697

  18. Comprehensive Analysis of Mandibular Residual Asymmetry after Bilateral Sagittal Split Ramus Osteotomy Correction of Menton Point Deviation

    PubMed Central

    Lin, Qiuping; Huang, Xiaoqiong; Xu, Yue; Yang, Xiaoping

    2016-01-01

    Purpose Facial asymmetry often persists even after mandibular deviation corrected by the bilateral sagittal split ramus osteotomy (BSSRO) operation, since the reference facial sagittal plane for the asymmetry analysis is usually set up before the mandibular menton (Me) point correction. Our aim is to develop a predictive and quantitative method to assess the true asymmetry of the mandible after a midline correction performed by a virtual BSSRO, and to verify its availability by evaluation of the post-surgical improvement. Patients and Methods A retrospective cohort study was conducted at the Hospital of Stomatology, Sun Yat-sen University (China) of patients with pure hemi-mandibular elongation (HE) from September 2010 through May 2014. Mandibular models were reconstructed from CBCT images of patients with pre-surgical orthodontic treatment. After mandibular de-rotation and midline alignment with virtual BSSRO, the elongation hemi-mandible was virtually mirrored along the facial sagittal plane. The residual asymmetry, defined as the superimposition and boolean operation of the mirrored elongation side on the normal side, was calculated, including the volumetric differences and the length of transversal and vertical asymmetry discrepancy. For more specific evaluation, both sides of the hemi-mandible were divided into the symphysis and parasymphysis (SP), mandibular body (MB), and mandibular angle (MA) regions. Other clinical variables include deviation of Me point, dental midline and molar relationship. The measurement of volumetric discrepancy between the two sides of post-surgical hemi-mandible were also calculated to verify the availability of virtual surgery. Paired t-tests were computed and the P value was set at .05. Results This study included 45 patients. The volume differences were 407.8±64.8 mm3, 2139.1±72.5 mm3, and 422.5±36.9 mm3; residual average transversal discrepancy, 1.9 mm, 1.0 mm, and 2.2 mm; average vertical discrepancy, 1.1 mm, 2.2 mm, and 2

  19. Instability of Reference Diameter in the Evaluation of Stenosis After Coronary Angioplasty: Percent Diameter Stenosis Overestimates Dilative Effects Due to Reference Diameter Reduction

    SciTech Connect

    Hirami, Ryouichi; Iwasaki, Kohichiro; Kusachi, Shozo; Murakami, Takashi; Hina, Kazuyoshi; Matano, Shigeru; Murakami, Masaaki; Kita, Toshimasa; Sakakibara, Noburu; Tsuji, Takao

    2000-03-15

    Purpose: To examine changes in the reference segment luminal diameter after coronary angioplasty.Methods: Sixty-one patients with stable angina pectoris or old myocardial infarction were examined. Coronary angiograms were recorded before coronary angioplasty (pre-angioplasty) and immediately after (post-angioplasty), as well as 3 months after. Artery diameters were measured on cine-film using quantitative coronary angiographic analysis.Results: The diameters of the proximal segment not involved in the balloon inflation and segments in the other artery did not change significantly after angioplasty, but the reference segment diameter significantly decreased (4.7%). More than 10% luminal reduction was observed in seven patients (11%) and more than 5% reduction was observed in 25 patients (41%). More than 5% underestimation of the stenosis was observed in 22 patients (36%) when the post-angioplasty reference diameter was used as the reference diameter, compared with when the pre-angioplasty measurement was used and more than 10% underestimation was observed in five patients (8%).Conclusion: This study indicated that evaluation by percent diameter stenosis, with the reference diameter from immediately after angioplasty, overestimates the dilative effects of coronary angioplasty, and that it is thus better to evaluate the efficacy of angioplasty using the absolute diameter in addition to percent luminal stenosis.

  20. Limitations on the Optical Tunability of Small Diameter Gold Nanoshells

    PubMed Central

    Rasch, Michael R.; Sokolov, Konstantin V.; Korgel, Brian A.

    2009-01-01

    Gold (Au) nanoshells were grown on silica nanoparticles with differing average diameters, ranging from 30 nm to 120 nm. Au nanoshells were also formed on silica spheres encapsulating 5 nm diameter magnetic iron oxide nanocrystals. The optical absorbance spectra of these Au nanoshells are reported. The plasmon resonance wavelengths of the smaller diameter nanoshells were significantly less tunable than those of the larger diameter nanoshells. This is due to a reduced range of accessible core-shell ratio—the geometric factor that determines the plasmon peak position—as the silica core diameter shrinks. The smaller diameter nanoshells were also found to be highly prone to aggregation, which broadens the plasmon absorption peak. Model calculations of dispersion stability as a function of silica core diameter reveal that smaller diameter Au shells exhibit more aggregation because of the size-dependence of the electrostatic double-layer potential. PMID:19711913

  1. Nineteen-Foot Diameter Explosively Driven Blast Simulator

    SciTech Connect

    VIGIL,MANUEL G.

    2001-07-01

    This report describes the 19-foot diameter blast tunnel at Sandia National Laboratories. The blast tunnel configuration consists of a 6 foot diameter by 200 foot long shock tube, a 6 foot diameter to 19 foot diameter conical expansion section that is 40 feet long, and a 19 foot diameter test section that is 65 feet long. Therefore, the total blast tunnel length is 305 feet. The development of this 19-foot diameter blast tunnel is presented. The small scale research test results using 4 inch by 8 inch diameter and 2 foot by 6 foot diameter shock tube facilities are included. Analytically predicted parameters are compared to experimentally measured blast tunnel parameters in this report. The blast tunnel parameters include distance, time, static, overpressure, stagnation pressure, dynamic pressure, reflected pressure, shock Mach number, flow Mach number, shock velocity, flow velocity, impulse, flow duration, etc. Shadowgraphs of the shock wave are included for the three different size blast tunnels.

  2. Intra-abdominal abscess demonstrating an unusually large intra-abdominal pattern on an indium-111 leukocyte scan

    SciTech Connect

    Black, R.R.; Fernandez-Ulloa, M.; ter Penning, B.; Yellin, J.

    1988-12-01

    Indium-111 WBC imaging of a patient with occult septicemia revealed a large focal pattern of radiopharmaceutical distribution within the abdominal cavity at 24 hours post radiopharmaceutical administration. This finding was felt to represent a large intra-abdominal abscess. A five liter peritoneal abscess was found at surgery. This case illustrates an unusual presentation of an intra-abdominal abscess.

  3. Expanding current EVAR indications to include small abdominal aortic aneurysms: a glimpse of the future.

    PubMed

    Georgakarakos, Efstratios; Ioannou, Christos V; Georgiadis, George S; Kapoulas, Konstantinos; Schoretsanitis, Nikolaos; Lazarides, Miltos

    2011-08-01

    The traditional criterion of maximum transverse diameter is not sufficient to differentiate the small abdominal aortic aneurysms (AAAs) that are either prone to rupture or prone to enlarge rapidly. Wall stress may be a more reliable indicator with respect to these tasks. We review the importance of geometric features in rupture- or growth-predictive models and stress the need for further evaluation and validation of geometric indices. This study may lead to identifying those small AAAs that could justify early endovascular intervention. PMID:21422056

  4. The diameter-dependent photoelectrochemical performance of silicon nanowires.

    PubMed

    Zhang, Bing-Chang; Wang, Hui; He, Le; Duan, Chun-Yang; Li, Fan; Ou, Xue-Mei; Sun, Bao-Quan; Zhang, Xiao-Hong

    2016-01-25

    We demonstrate the first systematic study of the diameter-dependent photoelectrochemical performance of single silicon nanowires within a broad size range from 200 to 2000 nm. SiNWs with a diameter of 1415 nm exhibit the highest solar energy conversion efficiency, which can be mainly traced to their diameter-dependent light absorption properties.

  5. Transcranial direct middle meningeal artery puncture for the onyx embolization of dural arteriovenous fistula involving the superior sagittal sinus.

    PubMed

    Oh, Jae-Sang; Yoon, Seok-Mann; Shim, Jai-Joon; Bae, Hack-Gun

    2015-01-01

    A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx.

  6. Fast, Accurate and Precise Mid-Sagittal Plane Location in 3D MR Images of the Brain

    NASA Astrophysics Data System (ADS)

    Bergo, Felipe P. G.; Falcão, Alexandre X.; Yasuda, Clarissa L.; Ruppert, Guilherme C. S.

    Extraction of the mid-sagittal plane (MSP) is a key step for brain image registration and asymmetry analysis. We present a fast MSP extraction method for 3D MR images, based on automatic segmentation of the brain and on heuristic maximization of the cerebro-spinal fluid within the MSP. The method is robust to severe anatomical asymmetries between the hemispheres, caused by surgical procedures and lesions. The method is also accurate with respect to MSP delineations done by a specialist. The method was evaluated on 64 MR images (36 pathological, 20 healthy, 8 synthetic), and it found a precise and accurate approximation of the MSP in all of them with a mean time of 60.0 seconds per image, mean angular variation within a same image (precision) of 1.26o and mean angular difference from specialist delineations (accuracy) of 1.64o.

  7. Chance fracture in an older patient with positive sagittal imbalance and previous lumbar arthrodesis: what can be done?

    PubMed

    Zwolak, Pawel; Kröber, Markus

    2016-04-01

    The Chance fracture occurs frequently in school-aged patients' population and is related to flexion-distraction injury in motor vehicle accidents. It is so called seat-belt syndrome because the seatbelt lies over the abdomen. After sudden deceleration bends the child around the lap belt causing injuries to the abdomen, and the spine (e.g., Chance fracture). The Chance fracture after a low energy fall in elderly patient's population has rarely been reported. We present an 82 years old patient who suffered unrecognized Chance fracture after a low energy fall. The management of this patient with positive sagittal imbalance and previous arthrodesis consisted of decompression, Smith-Petersen osteotomy and posterior pedicle screw instrumentation.

  8. Enucleation of large keratocystic odontogenic tumor at mandible via unilateral sagittal split osteotomy: a report of three cases

    PubMed Central

    Lee, Hyeong-Geun; Rhee, Seung-Hyun; Noh, Chung-Ah

    2015-01-01

    Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The purpose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible. PMID:26339581

  9. Simultaneous anterior vertebral column resection-distraction and posterior rod contouring for restoration of sagittal balance: report of a technique

    PubMed Central

    Bhagat, Shaishav; Rai, Am S.

    2016-01-01

    With an increasingly aging population, adult spinal deformity is becoming more common. This can be associated with increased morbidity. Results from multicentre studies of deformity surgery correction confirm complication rates as high as 40 percent. Most often a bad result is associated with inadequate restoration of the sagittal balance. Posterior vertebral body resection has been described as a method to correct significant deformity, but this is a complicated procedure. It is possible to do this in the thoracic spine where nerve roots can be sacrificed, but it is difficult in the lumbar spine due to the significant role of the lumbar nerve roots. We describe a safer technique for correction of deformity using a three stage process. This appears to be a good technique for revision surgery. PMID:27757434

  10. Antiphospholipid Antibodies Predict Progression of Abdominal Aortic Aneurysms

    PubMed Central

    Dejaco, Christian; Chemelli-Steingruber, Iris; Schennach, Harald; Klotz, Werner; Rieger, Michael; Herold, Manfred; Falkensammer, Jürgen; Fraedrich, Gustav; Schirmer, Michael

    2014-01-01

    Antiphospholipid antibodies (aPLs) frequently occur in autoimmune and cardiovascular diseases and correlate with a worse clinical outcome. In the present study, we evaluated the association between antiphospholipid antibodies (aPLs), markers of inflammation, disease progression and the presence of an intra-aneurysmal thrombus in abdominal aortic aneurysm (AAA) patients. APLs ELISAs were performed in frozen serum samples of 96 consecutive AAA patients and 48 healthy controls yielding positive test results in 13 patients (13.5%) and 3 controls (6.3%; n.s.). Nine of the 13 aPL-positive AAA patients underwent a second antibody testing >12 weeks apart revealing a positive result in 6 cases. APL-positive patients had increased levels of inflammatory markers compared to aPL-negative patients. Disease progression was defined as an increase of the AAA diameter >0.5 cm/year measured by sonography. Follow-up was performed in 69 patients identifying 41 (59.4%) patients with progressive disease. Performing multipredictor logistic regression analysis adjusting for classical AAA risk factors as confounders, the presence of aPLs at baseline revealed an odds ratio of 9.4 (95% CI 1.0–86.8, p = 0.049) to predict AAA progression. Fifty-five patients underwent a computed tomography in addition to ultrasound assessment indicating intra-aneurysmal thrombus formation in 82.3%. Median thrombus volume was 46.7 cm3 (1.9–377.5). AAA diameter correlated with the size of the intra-aneurysmal thrombus (corrcoeff = 0.721, p<0.001), however neither the presence nor the size of the intra-aneurysmal thrombus were related to the presence of aPLs. In conclusion, the presence of aPLs is associated with elevated levels of inflammatory markers and is an independent predictor of progressive disease in AAA patients. PMID:24979700

  11. Morphological comparison of cervical vertebrae in adult females with different sagittal craniofacial patterns: A cross-sectional study

    PubMed Central

    Alkan, Özer; Aydoğan, Cihan; Akkaya, Sevil

    2016-01-01

    Introduction: Cervical vertebral maturation (CVM) methods have gained popularity to assess growth and development status for orthodontic patients. Although craniofacial and craniocervical structures are known to be associated, there is no evidence in the literature if this relation might negatively affect the accuracy of CVM assessments. Therefore, this study aimed to comparatively investigate the sizes of the 2nd, 3rd, and 4th cervical vertebrae in adult females (radius union stage of skeletal maturity) who have different sagittal skeletal patterns. Materials and Methods: A cross-sectional study was conducted, and 151 lateral cephalometric radiographs of adult female patients were assessed in the study. Patients were assigned to three groups according to ANB angle. Parameters including concavity depth at the lower border of the 2nd, 3rd, and 4th cervical vertebrae and base length, upper border length, body length, posterior height, anterior height, and body height of the 3rd and 4th cervical vertebrae bodies were measured. One-way analysis of variance was used for between-group comparisons. Results: No statistically significant differences were found between groups in terms of concavity depth at the lower borders of the 2nd, 3rd, and 4th cervical vertebrae (P > 0.05). Base length, upper border length, body length, posterior height, anterior height, and body height of the 3rd and 4th cervical vertebrae were also similar between groups (P > 0.05). Conclusions: The results of this study supports that sagittal craniofacial pattern has no effect on the accuracy of using the methods assessing CVM and calculating cervical vertebral age. PMID:27630474

  12. Morphological comparison of cervical vertebrae in adult females with different sagittal craniofacial patterns: A cross-sectional study

    PubMed Central

    Alkan, Özer; Aydoğan, Cihan; Akkaya, Sevil

    2016-01-01

    Introduction: Cervical vertebral maturation (CVM) methods have gained popularity to assess growth and development status for orthodontic patients. Although craniofacial and craniocervical structures are known to be associated, there is no evidence in the literature if this relation might negatively affect the accuracy of CVM assessments. Therefore, this study aimed to comparatively investigate the sizes of the 2nd, 3rd, and 4th cervical vertebrae in adult females (radius union stage of skeletal maturity) who have different sagittal skeletal patterns. Materials and Methods: A cross-sectional study was conducted, and 151 lateral cephalometric radiographs of adult female patients were assessed in the study. Patients were assigned to three groups according to ANB angle. Parameters including concavity depth at the lower border of the 2nd, 3rd, and 4th cervical vertebrae and base length, upper border length, body length, posterior height, anterior height, and body height of the 3rd and 4th cervical vertebrae bodies were measured. One-way analysis of variance was used for between-group comparisons. Results: No statistically significant differences were found between groups in terms of concavity depth at the lower borders of the 2nd, 3rd, and 4th cervical vertebrae (P > 0.05). Base length, upper border length, body length, posterior height, anterior height, and body height of the 3rd and 4th cervical vertebrae were also similar between groups (P > 0.05). Conclusions: The results of this study supports that sagittal craniofacial pattern has no effect on the accuracy of using the methods assessing CVM and calculating cervical vertebral age.

  13. Vertebral destruction due to abdominal aortic aneurysm

    PubMed Central

    Jiménez Viseu Pinheiro, J.F.; Blanco Blanco, J.F.; Pescador Hernández, D.; García García, F.J.

    2014-01-01

    Introduction Low back pain is a common cause of medical consultation, and usually supposes a non-malignant prognostic. Presentation of case We report an atypical appearance of low back pain associated to shock and pulsatile abdominal mass that made us diagnose an abdominal aortic aneurysm as reason of vertebral lysis and pain. Discusion Surgical repair of contained AAA should be directed to secondary re-rupture prevention, with an approximate survival near to 100% at selected patients for elective surgery. Consequently, orthopedic surgery for back spine stabilization has to be elective in those cases when vertebral destruction is above 30% and clinic is directly related to spine instability. Conclusion We should consider AAA as other cause of low back pain and routinely examine the abdomen and seek complementary imaging proves when risk factors for AAA are present. PMID:25569196

  14. [Normal abdominal ultrasound anatomy. Examination procedure].

    PubMed

    Salcedo Joven, I; Segura Grau, A; Rodríguez Lorenzo, A; Segura Cabral, J M

    2014-01-01

    To carry out an abdominal ultrasound examination with the highest degree of accuracy and thoroughness, it is essential to have a good knowledge of the anatomy and the normal measurements of the different organs. In this way, we can determine their normal condition and identify the pathology and its location more easily. It is very important to adopt a correct examination procedure, systematically sweeping the scan in the same direction and not leaving any organ unexamined. We suggest a procedure consisting of longitudinal, cross-sectional and oblique scans to view all the abdominal organs, starting the examination in the epigastric region, scanning first the right upper quadrant, then the left upper quadrant, both iliac fossa, and lastly the hypogastric region.

  15. Solitary fibrous tumor of the abdominal wall.

    PubMed

    Migita, Kazuhiro; Watanabe, Akihiko; Nakagawa, Kenji; Ohyama, Takao; Sekigawa, Susumu

    2009-12-01

    Solitary fibrous tumors (SFTs) are uncommon neoplasms of mesenchymal origin that usually arise from the pleura. SFTs of the abdominal wall are extremely rare, and only 12 cases have been reported in the English language literature. This report presents a new case of SFT of the abdominal wall in a 74-year-old female. Positron emission tomography demonstrated the heterogeneous 18F-fluorodeoxyglucose uptake of the tumor (the maximum standardized uptake value was 2.8). Histologically, the mitotic count was 1 to 2/10 high-power fields. The patient is alive without recurrence at 10 months after undergoing a surgical excision. We discuss the clinicopathological features and differential diagnosis and present a review of the pertinent literature.

  16. Atrophic coarctation of the abdominal aorta.

    PubMed Central

    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  17. Color Doppler ultrasonography of the abdominal aorta

    PubMed Central

    Battaglia, S.; Danesino, G.M.; Danesino, V.; Castellani, S.

    2010-01-01

    Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations. PMID:23396814

  18. [Adrenal injury in blunt abdominal trauma].

    PubMed

    Abakumov, M M; Smoliar, A N; Barmina, T G; Boĭko, A V; Shalimova, I G

    2009-01-01

    10 patients with adrenal damage were observed during 2.5 years. It amounted 0.93% of all patients with closed abdominal injuries. The right adrenal gland was traumatized in all cases evidently due to it's compression between right lobe of liver and vertebral column. Adrenal damage is observed quite often in combination with injuries of right liver lobe, right kidney and retroperitoneal hematoma formation. 5 patients underwent laparotomy on account of intra-abdominal bleeding, but adrenal damage was never revealed. Ultrasound and tomographic semiotics of adrenal damage was worked out, which allowed ascertaining diagnosis in 80% on application of ultrasound study and in 100% at computer tomography. Injury of one adrenal gland was not accompanied by adrenal failure and did not require hormonal replacement therapy.

  19. Abdominal calcifications in infants and children.

    PubMed

    Pintér, A B; Weisenbach, J; Szemlédy, F

    1984-12-01

    Abdominal and pelvic calcifications are usually incidental findings and require further measures to determine their origin. Most laboratory investigations are of little help. Plain anteroposterior and lateral x-rays are essential. The time of appearance and localisation of a calcification is of diagnostic importance. Amorphous, granular and irregular calcification can be an early sign of malignancy. Mobility of a calcification also helps to clarify its origin. Over the past 15 years abdominal and pelvic calcifications, excluding urological radiodensities, have been found in 63 patients up to fourteen years of age at our institute. A migrating deposit in the omentum, a spontaneously amputated calcified ovary mimicking a vesical calculus and a congenital retroperitoneal xanthofibroma caused the greatest difficulty in establishing a preoperative diagnosis.

  20. Retroperitoneal lymphocele after abdominal aortic surgery.

    PubMed

    Garrett, H E; Richardson, J W; Howard, H S; Garrett, H E

    1989-09-01

    Lymphoceles may occur as a result of lymphatic injury during abdominal aortic surgery. These lymphatic collections may occur as a retroperitoneal mass or as groin lymphoceles. Four cases are presented in which persistent retroperitoneal lymphoceles were discovered 2 to 8 years after surgery. Reexploration of the groin and repeated aspirations of lymphatic fluid failed to control the drainage. Reexploration of the retroperitoneum documented lymphatic injury, which was controlled by ligation of the lymphatics with suture. A review of the literature discloses five similar reported cases of retroperitoneal lymphocele and 12 cases of chylous ascites after abdominal aortic surgery. Clearly, avoiding lymphatic injury or immediate repair of any lymphatic injuries will prevent this problem. Once a persistent lymphocele has developed, aspiration will establish the diagnosis. Our experience would suggest that reexploration of the retroperitoneum is required to control the drainage and to prevent possible graft infection.

  1. [Traumatic and iatrogenic lesions of abdominal vessels].

    PubMed

    Farah, I; Tarabula, P; Voirin, L; Magne, J L; Delannoy, P; Gattaz, F; Guidicelli, H

    1997-01-01

    Gravity of abdominal vessels traumatisms is secondary to multiple factors. It depends on the type of injured vessels, aetiology and associated lesions. Between September 1984 and March 1995, 22 abdominal vessel traumatisms in 16 patients (mean age: 39 years) were treated. At surgical exploration, 4 aortic and 2 renal vein lesions, 7 iliac artery and 3 renal artery contusions, 2 superior mesenteric artery dissections; 3 infra-renal vena cava ruptures and 1 superior mesenteric vein dilaceration were found. All lesions were caused by penetrant wounds secondary to firearm or blade injury or secondary to injuries due to ski or traffic accidents. In 5 cases, lesions were iatrogenic. There was no mortality in the post-operative period, 14 patients out of the 16 patients operated on have been followed during a period from 1 to 120 months.

  2. Abdominal obesity, muscle composition, and insulin resistance in premenopausal women.

    PubMed

    Ross, Robert; Freeman, Jennifer; Hudson, Robert; Janssen, Ian

    2002-11-01

    The independent relationships between visceral and abdominal sc adipose tissue (AT) depots, muscle composition, and insulin sensitivity were examined in 40 abdominally obese, premenopausal women. Measurements included glucose disposal by euglycemic clamp, muscle composition by computed tomography, abdominal and nonabdominal (e.g. leg) AT by magnetic resonance imaging and cardiovascular fitness. Glucose disposal rates were negatively related to visceral AT mass (r = -0.42, P < 0.01). These observations remained significant (P < 0.01) after control for nonabdominal and abdominal sc AT, muscle attenuation, and peak oxygen uptake. Total, abdominal, or leg sc AT or muscle attenuation was not significantly (P > 0.10) related to glucose disposal. Subdivision of abdominal sc AT into anterior and posterior depots did not alter the observed relationships. Further analysis matched two groups of women for abdominal sc AT but with low and high visceral AT. Women with high visceral AT had lower glucose disposal rates compared with those with low visceral AT (P < 0.05). A similar analysis performed on two groups of women matched for visceral AT but high and low abdominal sc AT revealed no statistically different values for insulin sensitivity (P > 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal, abdominal sc AT, muscle composition, and cardiovascular fitness. Subdivision of abdominal sc AT did not provide additional insight into the relationship between abdominal obesity and metabolic risk.

  3. [Vaginal hysterectomy following previous abdominal and gynecologic surgery].

    PubMed

    Draca, P; Vuleta, P; Miljković, S

    1976-01-01

    The authors analyse 125 cases of vaginal histerectomy (V.H.) preceded by vaginal and abdominal operations (15.3% of a total of 817 V.H.) There were 95 cases of previous abdominal operations and 30 cases of previous gynecological operations (19 vaginal and 11 abdominal). The most frequent previously performed vaginal operation was anterior and posterior colporrhaphy. The authors have come to the conclusion that neither previous abdominal nor previous gynecological surgical interventions make the carrying out of vaginal histerectomy more difficult. Only Doleris's operation, among abdominal ones, may represent a relative contraindication for V.H. In one case the authors had to complete the already started histerectomy abdominally owing to some technical difficulties. The authors maintain that it would be good to use vaginal histerectomy more frequently after previously applied gynecological, vaginal, and abdominal operations.

  4. Focal epilepsy with ictal abdominal pain: a case report.

    PubMed

    Cerminara, Caterina; El Malhany, Nadia; Roberto, Denis; Curatolo, Paolo

    2013-01-01

    Focal epilepsy with ictal abdominal pain is an unusual partial epilepsy characterized by paroxysmal episodes of abdominal or visceral pain, disturbance of awareness and electroencephalographic abnormalities. We describe a new case of ictal abdominal pain in which gastrointestinal complaints were the only manifestation of seizures and review the previously described pediatric patients. In our patient clinical findings, ictal EEG abnormalities, and a good response to antiepileptic drugs allowed us to make a diagnosis of focal epilepsy with ictal abdominal pain. This is a rare epileptic phenomenon that should be suspected in patients with unexplained paroxysmal abdominal pain and migraine-like symptoms. We suggest that, after the exclusion of more common etiologies, focal epilepsy with ictal abdominal pain should be considered in patients with paroxysmal abdominal pain and ictal EEG abnormalities. PMID:24321431

  5. [Role of surgery in closed abdominal trauma].

    PubMed

    Panis, Y; Charbit, L; Valleur, P

    1997-05-01

    Over the past twenty years, nonoperative management has increasingly been recommended for the care of patients with blunt abdominal trauma. Emergency laparotomy remains the rule in patients with hemodynamic instability or in those with peritonitis due to intestinal perforation. Surgical treatment of liver and splenic lesions tends to be more conservative. After assessment of the lesions by computed tomography, nonoperative management in intensive care unit is allowed in the majority of patients. PMID:9208689

  6. Diameter-selective separation of double-walled carbon nanotubes

    NASA Astrophysics Data System (ADS)

    Kim, Jin Hee; Kataoka, Masakazu; Kim, Yoong Ahm; Shimamoto, Daisuke; Muramatsu, Hiroyuki; Hayashi, Takuya; Endo, Morinobu; Terrones, Mauricio; Dresselhaus, Mildred S.

    2008-12-01

    Here, we report a simple and effective way of separating double-walled carbon nanotubes as a function of their diameter using individually dispersed nanotube solutions with the aid of long and random single-stranded DNA. The subtle pH change in nanotube solutions gives rise to the preferential coagulation of large-diameter tubes and allows the easy preparation of small-diameter tubes. The stronger van der Waals forces between large-diameter tubes, combined with the decreased solubility of DNA in water at low pH, lead to the preferential agglomeration of large-diameter tubes.

  7. Abdominal exploration in captive collared peccaries (Tayassu tajacu) by ultrasonography.

    PubMed

    Peixoto, G C X; Oliveira, I R S; Alves, N D; Oliveira, M F; Silva, A R

    2012-08-01

    This study determines the morphology and ultrasound features of the abdominal organs in male, nestling and healthy collared peccaries. The bladder wall is hyperechogenic, with a thickness of 0.2 ± 0.08 cm. The kidneys present a well-defined cortex, medulla and pelvis, and the dimensions are 2.56 ± 0.3 × 4.6 ± 0.8 cm for the left and 2.51 ± 0.4 × 4.86 ± 1.1 cm for the right kidney. The spleen has a uniform echotexture over its entire surface. The largest dimensions of the liver are 2.0 ± 0.57 cm for the left lobe and 1.42 ± 0.66 cm for the caudate lobe. The liver presents a homogeneous echotexture in the majority of cases, but sometimes some hyperechoic spots are present. The stomach wall has a thickness of 0.42 ± 0.28 cm. The bowel loops show alternate hyperechoic and hypoechoic layers with a uniform diameter and a wall thickness of 0.19 ± 0.07 cm.

  8. Abdominal aortic aneurysms: how can we improve their treatment?

    PubMed Central

    Scobie, T K

    1980-01-01

    Arteriosclerotic abdominal aortic aneurysms are present in a least 2% of the elderly population of the Western world and their number is increasing. Without treatment 30% of patients with asymptomatic aneurysms live for 5 years, although the risk of rupture becomes greater as the size of the aneurysm increases. Of those with untreated symptomatic aneurysms 80% are dead within a year. Elective repair of aneurysms has a low mortality, and 50% of the patients live for at least 5 years. Symptomatic aneurysms all cause pain and may produce other symptoms from pressure on adjacent structures, distal embolism, acute thrombosis or rupture. In 88% of cases an aneurysm can be diagnosed by physical examination alone; confirmatory tests include soft-tissue roentgenography of the abdomen, ultrasonography, computer-assisted tomography and aortography. Repair is indicated for symptomatic or ruptured aortic aneurysms and for asymptomatic aneurysms over 5 cm in diameter. Early diagnosis and referral for repair is essential for optimum treatment of this common condition. PMID:7004617

  9. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    PubMed

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta. PMID:26858185

  10. Familial abdominal aortic aneurysm: prevalence and implications for screening.

    PubMed

    Adams, D C; Tulloh, B R; Galloway, S W; Shaw, E; Tulloh, A J; Poskitt, K R

    1993-11-01

    The high prevalence of abdominal aortic aneurysm (AAA) in men over the age of 65 has led to the establishment of ultrasound screening programmes for this group. The apparent familial tendency towards AAA formation suggests that relatives of aneurysm patients may form another subpopulation in whom screening is appropriate. The first degree relatives of 100 consecutive aneurysm patients were identified. Of 110 relatives over 50 years of age, two were known to have had AAA and ultrasound scans were performed on 74, providing information on aortic size for 76 relatives (69%). No further aortic aneurysms (antero-posterior diameter > or = 4.0 cm) were found on scanning. However, nine relatives were demonstrated to have aortic dilatation (2.5-3.9 cm). Aortic dilatation was observed in 21% of male first degree relatives over 50 years of age, affecting 27% of sons and 17% of brothers. Only 4% of the sisters and none of the daughters were found to have aortic dilatation. The prevalence of aortic enlargement seems to be sufficiently high amongst male first degree relatives of AAA patients over 50 years of age to justify aortic screening.

  11. Distribution of Wall Stress in Abdominal Aortic Aneurysm (AAA)

    NASA Astrophysics Data System (ADS)

    Lasheras, Juan

    2005-11-01

    Abdominal aortic aneurysm (AAA) rupture is believed to occur when the mechanical stress acting on the wall exceeds the strength of the wall tissue. Therefore, knowledge of the AAA wall stress distribution could be useful in assessing its risk of rupture. In our research, a finite element analysis was used to determine the wall stresses both in idealized models and in a real clinical model in which the aorta was considered isotropic with nonlinear material properties and was loaded with a given pressure. In the idealized models, both maximum diameter and asymmetry were found to have substantial influence on the distribution of the wall stress. The thrombus inside the AAA was also found to help protecting the walls from high stresses. Using CT scans of the AAA, the actual geometry of the aneurysm was reconstructed and we found that wall tension increases on the flatter surface (typically corresponds to the posterior surface) and at the inflection points of the bulge. In addition to the static analysis, we also performed simulations of the effect of unsteady pressure wave propagation inside the aneurysm.

  12. Determination of dosimetric quantities in pediatric abdominal computed tomography scans*

    PubMed Central

    Jornada, Tiago da Silva; da Silva, Teógenes Augusto

    2014-01-01

    Objective Aiming at contributing to the knowledge on doses in computed tomography (CT), this study has the objective of determining dosimetric quantities associated with pediatric abdominal CT scans, comparing the data with diagnostic reference levels (DRL). Materials and methods The study was developed with a Toshiba Asteion single-slice CT scanner and a GE BrightSpeed multi-slice CT unit in two hospitals. Measurements were performed with a pencil-type ionization chamber and a 16 cm-diameter polymethylmethacrylate trunk phantom. Results No significant difference was observed in the values for weighted air kerma index (CW), but the differences were relevant in values for volumetric air kerma index (CVOL), air kerma-length product (PKL,CT) and effective dose. Conclusion Only the CW values were lower than the DRL, suggesting that dose optimization might not be necessary. However, PKL,CT and effective dose values stressed that there still is room for reducing pediatric radiation doses. The present study emphasizes the importance of determining all dosimetric quantities associated with CT scans. PMID:25741103

  13. Contemporary Applications of Ultrasound in Abdominal Aortic Aneurysm Management

    PubMed Central

    Scaife, Mark; Giannakopoulos, Triantafillos; Al-Khoury, Georges E.; Chaer, Rabih A.; Avgerinos, Efthymios D.

    2016-01-01

    Ultrasound (US) is a well-established screening tool for detection of abdominal aortic aneurysms (AAAs) and is currently recommended not only for those with a relevant family history but also for all men and high-risk women older than 65 years of age. The advent of minimally invasive endovascular techniques in the treatment of AAAs [endovascular aneurysm repair (EVAR)] has increased the need for repeat imaging, especially in the postoperative period. Nevertheless, preoperative planning, intraoperative execution, and postoperative surveillance all mandate accurate imaging. While computed tomographic angiography and angiography have dominated the field, repeatedly exposing patients to the deleterious effects of cumulative radiation and intravenous nephrotoxic contrast, US technology has significantly evolved over the past decade. In addition to standard color duplex US, 2D, 3D, or 4D contrast-enhanced US modalities are revolutionizing AAA management and postoperative surveillance. This technology can accurately measure AAA diameter and volume, and most importantly, it can detect endoleaks post-EVAR with high sensitivity and specificity. 4D contrast-enhanced US can even provide hemodynamic information about the branch vessels following fenestrated EVARs. The need for experienced US operators and accredited vascular labs is mandatory to guarantee the reliability of the results. This review article presents a comprehensive overview of the literature on the state-of-art US imaging in AAA management, including post-EVAR follow-up, techniques, and diagnostic accuracy. PMID:27303669

  14. Contemporary Applications of Ultrasound in Abdominal Aortic Aneurysm Management.

    PubMed

    Scaife, Mark; Giannakopoulos, Triantafillos; Al-Khoury, Georges E; Chaer, Rabih A; Avgerinos, Efthymios D

    2016-01-01

    Ultrasound (US) is a well-established screening tool for detection of abdominal aortic aneurysms (AAAs) and is currently recommended not only for those with a relevant family history but also for all men and high-risk women older than 65 years of age. The advent of minimally invasive endovascular techniques in the treatment of AAAs [endovascular aneurysm repair (EVAR)] has increased the need for repeat imaging, especially in the postoperative period. Nevertheless, preoperative planning, intraoperative execution, and postoperative surveillance all mandate accurate imaging. While computed tomographic angiography and angiography have dominated the field, repeatedly exposing patients to the deleterious effects of cumulative radiation and intravenous nephrotoxic contrast, US technology has significantly evolved over the past decade. In addition to standard color duplex US, 2D, 3D, or 4D contrast-enhanced US modalities are revolutionizing AAA management and postoperative surveillance. This technology can accurately measure AAA diameter and volume, and most importantly, it can detect endoleaks post-EVAR with high sensitivity and specificity. 4D contrast-enhanced US can even provide hemodynamic information about the branch vessels following fenestrated EVARs. The need for experienced US operators and accredited vascular labs is mandatory to guarantee the reliability of the results. This review article presents a comprehensive overview of the literature on the state-of-art US imaging in AAA management, including post-EVAR follow-up, techniques, and diagnostic accuracy. PMID:27303669

  15. Endovascular repair of abdominal aortic aneurysms.

    PubMed

    Arnaoutakis, Dean J; Zammert, Martin; Karthikesalingam, Alan; Belkin, Michael

    2016-09-01

    Endovascular repair of abdominal aortic aneurysms is an important technique in the vascular surgeon's armamentarium, which has created a seismic shift in the management of aortic pathology over the past two decades. In comparison to traditional open repair, the endovascular approach is associated with significantly improved perioperative morbidity and mortality. The early survival benefit of endovascular abdominal aortic aneurysm repair is sustained up to 3 years postoperatively, but longer-term life expectancy remains poor regardless of operative modality. Nonetheless, most abdominal aortic aneurysms are now repaired using endovascular stent grafts. The technology is not perfect as several postoperative complications, namely endoleak, stent-graft migration, and graft limb thrombosis, can develop and therefore lifelong imaging surveillance is required. In addition, a postoperative inflammatory response has been documented after endovascular repair of aortic aneurysms; the clinical significance of this finding has yet to be determined. Subsequently, the safety and applicability of endovascular stent grafts are likely to improve and expand with the introduction of newer-generation devices and with the simplification of fenestrated systems. PMID:27650343

  16. [Abdominal multi-organ transplantation in dogs].

    PubMed

    Kumagae, T

    1988-07-01

    Abdominal multi-organ transplantation including the liver, gallbladder, spleen, pancreas, kidneys, adrenal glands and gastrointestinal tract was attempted in 8 dogs. Each experiment was discontinued when the recipient deteriorated. Immersion hypothermia was introduced in both the donor and recipient until the esophageal temperature reached 27-30 degrees C. Whole abdominal organs of the donor were removed in an en-bloc fashion at 20 degrees C of the graft temperature after additional cooling by ice slush scattering into the abdominal cavity. Transplantation was carried out orthotopically in the following sequence: (1) the proximal aorta, (2) suprahepatic vena cava, (3) distal aorta, (4) infrahepatic vena cava. The alimentary tract was reconstructed by gastro-gastrostomy and colo-colostomy. The ureters were implanted in the bladder. Cold ischemic time of the graft was about 40 minutes. Heparin was not used throughout the procedure. Five out of eight dogs were alive for more than 24 hours and two of them survived for 60 hours with good recovery. No immunosuppressant was given. Though the result in the present study was far from satisfaction, the experiment may provide a possibility of a new experimental model for transplantation, especially regarding pathophysiology and interrelationship of the transplanted complex organs.

  17. [Abdominal aortic aneurysm: an uncommon presentation].

    PubMed

    Taborda, Lúcia; Pereira, Laurinda; Amona, Eurides; Pinto, Erique Guedes; Rodrigues, Joaquim

    2011-01-01

    Most abdominal aortic aneurysms are asymptomatic, being accidentally found on physical examination or in routinely performed imaging studies. They only require surveillance (which is variable according to the aneurism size) and medical therapy in order to achieve risk factor reduction. However, in certain situations, according to the risk of aneurism rupture, elective surgery or endovascular procedure may be necessary. About 80% of the cases of aneurism rupture occur into the retroperitoneal space, with a high mortality rate. There are uncommon presentations of aneurism rupture as the aorto-caval fistula, which also require fast diagnosis and intervention. The authors present the case of a 71-year-old man, with the previous diagnosis of hypertension, acute myocardial infarction 2 months earlier (undergone primary Percutaneous Coronary Intervention) and tabagism, who was admitted at the emergency department with intense 24-hour-evolution epigastric pain. On physical examination, the Blood Pressure values measured at the lower limbs were about half the ones measured at the upper limbs and there was an abdominal pulsatile mass, with a high-intensity murmur. As the authors suspected aortic dissection, aneurysm, coarctation or thrombosis, it was done a Computed Tomography scanning with intravenous contrast, which revealed a ruptured abdominal aorta aneurysm with a mural thrombus. The doppler ultrasound confirmed the presence of a high debit aorto-caval fistula. The patient was immediately transferred to the Vascular Surgery. However he died 2 hours later, during surgery. PMID:22525642

  18. [Hereditary angioedema: strange cause of abdominal pain].

    PubMed

    Salas-Lozano, Nereo Guillermo; Meza-Cardona, Javier; González-Fernández, Coty; Pineda-Figueroa, Laura; de Ariño-Suárez, Mauricio

    2014-01-01

    Antecedentes: el angioedema hereditario es un trastorno inflamatorio episódico, que se hereda de manera autosómica dominante y se caracteriza por episodios de edema periférico. Los pacientes pueden tener edema de la pared de cualquier víscera hueca, incluido el intestino. Caso clínico: se comunica el caso de un paciente masculino de 33 años de edad, sin antecedentes de importancia, con dolor abdominal, localizado en el epigastrio, irradiado al cuadrante inferior derecho, acompañado de 5 vómitos. La tomografía abdominal mostró engrosamiento de la pared de la segunda y tercera porción del duodeno, con infiltración de grasa y líquido libre. Los exámenes de laboratorio mostraron: concentraciones bajas del complemento C4 (5.5 mg/dL) y actividad del inhibidor de C1 del complemento de 30%. Conclusiones: el angioedema hereditario es consecuencia de la deficiencia (tipo I) o disfunción (tipo II) del inhibidor C1 del complemento. El dolor abdominal asociado con angioedema es de inicio súbito, como dolor cólico, recurrente y de intensidad moderada. En la actualidad existen dos medicamentos aprobados por la Food and Drug Administration para el tratamiento de pacientes con esta afección.

  19. Mesh Sutured Repairs of Abdominal Wall Defects

    PubMed Central

    Lanier, Steven T.; Jordan, Sumanas W.; Miller, Kyle R.; Ali, Nada A.; Stock, Stuart R.

    2016-01-01

    Background: A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. Methods: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. Results: One hundred and seven patients underwent a mesh sutured abdominal wall closure. Seventy-six patients had preoperative hernias, and the mean hernia width by CT scan for those with scans was 9.1 cm. Forty-nine surgical fields were clean-contaminated, contaminated, or dirty. Five patients had infections within the first 30 days. Only one knot was removed as an office procedure. Mean follow-up at 234 days revealed 4 recurrent hernias. Conclusions: Mesh sutured repairs reliably appose tissue under tension using concepts of force distribution and resistance to suture pull-through. The technique reduces the amount of foreign material required in comparison to sheet meshes, and avoids the shortcomings of monofilament sutures. Mesh sutured closures seem to be tolerant of bacterial contamination with low hernia recurrence rates and have replaced our routine use of mesh sheets and bioprosthetic grafts. PMID:27757361

  20. Quantification of abdominal aortic deformation after EVAR

    NASA Astrophysics Data System (ADS)

    Demirci, Stefanie; Manstad-Hulaas, Frode; Navab, Nassir

    2009-02-01

    Quantification of abdominal aortic deformation is an important requirement for the evaluation of endovascular stenting procedures and the further refinement of stent graft design. During endovascular aortic repair (EVAR) treatment, the aortic shape is subject to severe deformation that is imposed by medical instruments such as guide wires, catheters, and, the stent graft. This deformation can affect the flow characteristics and morphology of the aorta which have been shown to be elicitors for stent graft failures and be reason for reappearance of aneurysms. We present a method for quantifying the deformation of an aneurysmatic aorta imposed by an inserted stent graft device. The outline of the procedure includes initial rigid alignment of the two abdominal scans, segmentation of abdominal vessel trees, and automatic reduction of their centerline structures to one specified region of interest around the aorta. This is accomplished by preprocessing and remodeling of the pre- and postoperative aortic shapes before performing a non-rigid registration. We further narrow the resulting displacement fields to only include local non-rigid deformation and therefore, eliminate all remaining global rigid transformations. Finally, deformations for specified locations can be calculated from the resulting displacement fields. In order to evaluate our method, experiments for the extraction of aortic deformation fields are conducted on 15 patient datasets from endovascular aortic repair (EVAR) treatment. A visual assessment of the registration results and evaluation of the usage of deformation quantification were performed by two vascular surgeons and one interventional radiologist who are all experts in EVAR procedures.

  1. Influence of age and sex on lumbar vertebral morphometry determined using sagittal magnetic resonance imaging.

    PubMed

    Sevinc, Ozdemir; Barut, Cagatay; Is, Merih; Eryoruk, Nesrin; Safak, Alp Alper

    2008-01-01

    We evaluated age-related changes in the morphometric features of lumbar vertebrae in both sexes using magnetic resonance imaging (MRI). Midsagittal MRI scans of 366 individuals (156 males, 210 females; 25-82 years old) were evaluated retrospectively. The anterior height (H(a)), central height (H(c)), posterior height (H(p)), and anteroposterior diameter (D) of the body of each lumbar vertebra were measured. These measurements were used to calculate three indices, namely, the anterior wedge index (H(a)/H(p)), the biconcavity index (H(c)/H(p)), and the compression index (H(p)/D). The values of each of the three indices for the upper lumbar vertebrae of females were higher than those of the same vertebrae in males. The values of the compression index for all lumbar vertebrae decreased with age in females, whereas in males the compression index of the L1-L4 vertebrae decreased with age. No significant changes were observed in the value of the anterior wedge index in either sex. The biconcavity indices of the L1 and L5 vertebrae decreased with age in males. These results may be useful for evaluating age-related morphological changes that occur in the lumbar vertebrae.

  2. Transversus abdominal plane block as a sole anesthetic technique for abdominal wall hematoma drainage.

    PubMed

    Varela, N; Golvano, M; Monedero, P

    2016-10-01

    Transversus abdominal plane (TAP) block is a known and useful technique, widely used for postoperative pain management of abdominal wall incisions. During the past years, and following the expansion of ultrasound guided techniques, its use has even gained more adepts. It is usually used as an adjuvant technique, primarily in order to control postoperative pain and reduce opioids consumption. We report the case of an 82 years old patient admitted for drainage of a postoperative abdominal wall hematoma after correction of a McBurney incisional hernia. The corrective surgery had gone on without incident, under general anesthesia with laryngeal mask. Two weeks later, the patient came back to our emergency department with a clear hematoma of the abdominal wall. Surgery was decided. A sole local anesthetic technique was achieved, using a TAP block. The block was performed under ultrasound guidance, using a subcostal approach. The surgery went on without complications. Therefore, TAP block offers a hemodynamic stability, appropriate intra-operative anesthesia and post-surgical analgesia of the abdominal wall.

  3. Periadventitial adipose-derived stem cell treatment halts elastase-induced abdominal aortic aneurysm progression

    PubMed Central

    Blose, Kory J; Ennis, Terri L; Arif, Batool; Weinbaum, Justin S; Curci, John A; Vorp, David A

    2014-01-01

    Aim Demonstrate that periadventitial delivery of adipose-derived mesenchymal stem cells (ADMSCs) slows aneurysm progression in an established murine elastase-perfusion model of abdominal aortic aneurysm (AAA). Materials & methods AAAs were induced in C57BL/6 mice using porcine elastase. During elastase perfusion, a delivery device consisting of a subcutaneous port, tubing and porous scaffold was implanted. Five days after elastase perfusion, 100,000 ADMSCs were delivered through the port to the aorta. After sacrifice at day 14, analyzed metrics included aortic diameter and structure of aortic elastin. Results ADMSC treated aneurysms had a smaller diameter and less fragmented elastin versus saline controls. Conclusion Periadventitial stem cell delivery prevented the expansion of an established aneurysm between days 5 and 14 after elastase perfusion. PMID:25431910

  4. Epidermal growth factor receptor inhibitor protects against abdominal aortic aneurysm in a mouse model.

    PubMed

    Obama, Takashi; Tsuji, Toshiyuki; Kobayashi, Tomonori; Fukuda, Yamato; Takayanagi, Takehiko; Taro, Yoshinori; Kawai, Tatsuo; Forrester, Steven J; Elliott, Katherine J; Choi, Eric; Daugherty, Alan; Rizzo, Victor; Eguchi, Satoru

    2015-05-01

    Angiotensin II (Ang II) has been implicated in the development of abdominal aortic aneurysm (AAA). In vascular smooth muscle cells (VSMC), Ang II activates epidermal growth factor receptor (EGFR) mediating growth promotion. We hypothesized that inhibition of EGFR prevents Ang II-dependent AAA. C57BL/6 mice were co-treated with Ang II and β-aminopropionitrile (BAPN) to induce AAA with or without treatment with EGFR inhibitor, erlotinib. Without erlotinib, 64.3% of mice were dead due to aortic rupture. All surviving mice had AAA associated with EGFR activation. Erlotinib-treated mice did not die and developed far fewer AAA. The maximum diameters of abdominal aortas were significantly shorter with erlotinib treatment. In contrast, both erlotinib-treated and non-treated mice developed hypertension. The erlotinib treatment of abdominal aorta was associated with lack of EGFR activation, endoplasmic reticulum (ER) stress, oxidative stress, interleukin-6 induction and matrix deposition. EGFR activation in AAA was also observed in humans. In conclusion, EGFR inhibition appears to protect mice from AAA formation induced by Ang II plus BAPN. The mechanism seems to involve suppression of vascular EGFR and ER stress. PMID:25531554

  5. Epidermal growth factor receptor inhibitor protects against abdominal aortic aneurysm in a mouse model.

    PubMed

    Obama, Takashi; Tsuji, Toshiyuki; Kobayashi, Tomonori; Fukuda, Yamato; Takayanagi, Takehiko; Taro, Yoshinori; Kawai, Tatsuo; Forrester, Steven J; Elliott, Katherine J; Choi, Eric; Daugherty, Alan; Rizzo, Victor; Eguchi, Satoru

    2015-05-01

    Angiotensin II (Ang II) has been implicated in the development of abdominal aortic aneurysm (AAA). In vascular smooth muscle cells (VSMC), Ang II activates epidermal growth factor receptor (EGFR) mediating growth promotion. We hypothesized that inhibition of EGFR prevents Ang II-dependent AAA. C57BL/6 mice were co-treated with Ang II and β-aminopropionitrile (BAPN) to induce AAA with or without treatment with EGFR inhibitor, erlotinib. Without erlotinib, 64.3% of mice were dead due to aortic rupture. All surviving mice had AAA associated with EGFR activation. Erlotinib-treated mice did not die and developed far fewer AAA. The maximum diameters of abdominal aortas were significantly shorter with erlotinib treatment. In contrast, both erlotinib-treated and non-treated mice developed hypertension. The erlotinib treatment of abdominal aorta was associated with lack of EGFR activation, endoplasmic reticulum (ER) stress, oxidative stress, interleukin-6 induction and matrix deposition. EGFR activation in AAA was also observed in humans. In conclusion, EGFR inhibition appears to protect mice from AAA formation induced by Ang II plus BAPN. The mechanism seems to involve suppression of vascular EGFR and ER stress.

  6. Mycotic Abdominal Aneurysm Caused by Campylobacter Fetus: A Case Report for Surgical Management

    PubMed Central

    Noda, Yukihiro; Sawada, Ko-ichiro; Yoshida, Syu-hei; Nishida, Satoru; Yamamoto, Shinichiro; Otake, Yuji; Watanabe, Go

    2011-01-01

    We report a rare case of mycotic abdominal aortic aneurysm associated with Campylobacter fetus. A 72-year-old male admitted to the hospital because of pain in the right lower quadrant with pyrexia. The enhanced abdominal computed tomography (CT) examination showed abdominal aortic aneurysm (AAA) measuring 50 mm in maximum diameter and a high-density area of soft tissue density from the right lateral wall to the anterior wall of the aorta. However, since the patient showed no significant signs of defervescence after antibiotics administration, so we performed emergency surgery on the patient based on the diagnosis of impending rupture of mycotic AAA. The aneurysm was resected in situ reconstruction using a bifurcated albumin-coated knitted Dacron graft was performed. The cultures of blood and aneurysmal wall grew Campylobacter fetus, allowing early diagnosis and appropriate surgical management in this case, and the patient is making satisfactory progress. This is the fifth report of mycotic AAA characterizing culture positive for Campylobacter fetus in blood and tissue culture of the aortic aneurysm wall. PMID:23555431

  7. Fiber diameter distributions in the chinchilla's ampullary nerves

    NASA Technical Reports Server (NTRS)

    Hoffman, Larry F.; Honrubia, Vicente

    2002-01-01

    A morphometric study of the chinchilla's ampullary nerves was conducted to produce an unbiased accounting of the diameter distribution of their constituent fibers. Diameter analyses were determined from 1 microm plastic-embedded nerve sections taken at a plane immediately proximal to the sensory epithelium. We found these nerves to be composed of 2094+/-573 fibers, having diameters that ranged from 0.5 to 8 microm. The distributions of diameters were positively skewed, where approximately 75% of the fibers were found to have diameters less than 3.5 microm. An analysis of the spatial distribution of diameters within the nerve section revealed that the lateralmost areas of the nerve contained larger fractions of fibers within the smallest diameter quintiles, and the central area harbored greater proportions of the larger diameter quintiles. However, significant fractions of all quintiles were found in all areas. These data were integrated with available data of Fernandez et al. (1998) to produce diameter estimates of calyx, dimorphic, and bouton morphology subpopulations. In view of a general relationship between diameter, innervation locus, and an afferent's physiologic characteristics, these data provide the basis for developing a perspective for the in situ distribution of afferent response dynamics.

  8. [Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain].

    PubMed

    Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila

    2016-01-01

    Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.

  9. Abdominal compliance: A bench-to-bedside review.

    PubMed

    Blaser, Annika Reintam; Björck, Martin; De Keulenaer, Bart; Regli, Adrian

    2015-05-01

    Abdominal compliance (AC) is an important determinant and predictor of available workspace during laparoscopic surgery. Furthermore, critically ill patients with a reduced AC are at an increased risk of developing intra-abdominal hypertension and abdominal compartment syndrome, both of which are associated with high morbidity and mortality. Despite this, AC is a concept that has been neglected in the past.AC is defined as a measure of the ease of abdominal expansion, expressed as a change in intra-abdominal volume (IAV) per change in intra-abdominal pressure (IAP):AC = ΔIAV / ΔIAPAC is a dynamic variable dependent on baseline IAV and IAP as well as abdominal reshaping and stretching capacity. Whereas AC itself can only rarely be measured, it always needs to be considered an important component of IAP. Patients with decreased AC are prone to fulminant development of abdominal compartment syndrome when concomitant risk factors for intra-abdominal hypertension are present.This review aims to clarify the pressure-volume relationship within the abdominal cavity. It highlights how different conditions and pathologies can affect AC and which management strategies could be applied to avoid serious consequences of decreased AC.We have pooled all available human data to calculate AC values in patients acutely and chronically exposed to intra-abdominal hypertension and demonstrated an exponential abdominal pressure-volume relationship. Most importantly, patients with high level of IAP have a reduced AC. In these patients, only small reduction in IAV can significantly increase AC and reduce IAPs.A greater knowledge on AC may help in selecting a better surgical approach and in reducing complications related to intra-abdominal hypertension.

  10. The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts

    PubMed Central

    Şimşek, Mehmet; Kuloğlu, Tuncay; Pala, Şehmus; Boztosun, Abdullah; Can, Behzat; Atilgan, Remzi

    2015-01-01

    Objectives To examine the effect of 95% ethanol sclerotherapy (EST) administered over 5 minutes on cyst diameter and ovarian tissue in experimentally induced simple ovarian cysts in a rat model. Materials and methods In order to induce ovarian cysts, unilateral total salpingectomy was performed in regularly menstruating adult female Wistar albino rats (n=20) between 12 and 14 weeks of age and weighing between 200 and 220 g. One month after the procedure, the abdominal cavity was opened and 14 rats (70%) were found to have developed macroscopic cysts. Rats with macroscopic cysts (n=14) were assigned into two groups in a prospective and single-blinded manner: group 1 (G1) (n=7), control rats; and group 2 (G2) (n=7), 5-minute EST 95% group. Cyst diameter was measured and recorded for each rat. In G2, after whole cyst fluid was aspirated the cystic cavity was irrigated with 95% ethanol, approximately equal to half of the aspirated cyst volume, after which an interval of 5 minutes was allowed and same amount was re-aspirated and the abdominal cavity was closed. One month after this procedure, abdominal cavities were reopened and intra-abdominal adhesion scoring was performed in both groups. Cyst diameter was measured for each rat, and the right ovary was removed, fixed in 10% formaldehyde, and transported to the laboratory. A histologic assessment of the ovarian tissues was performed under light microscopy following staining with hematoxylin and eosin. Mann–Whitney U-test was used for statistical analysis. A P-level less than 0.05 was considered significant. Results In comparison with G1, there was a statistically significant reduction in the mean ovarian cyst dimensions in G2, while there were no significant differences between the two groups with respect to total number of follicles. Again, a significant increase in apoptotic activity and germinal epithelial degeneration was observed in G2 as compared to G1. The two groups were similar in terms of adhesion formation

  11. Abdominal Lipomatosis with Secondary Self-Strangulation of Masses in an Adult Rhesus Macaque (Macaca mulatta)

    PubMed Central

    Chum, Helen H; Long, C Tyler; McKeon, Gabriel P; Chang, Angela G; Luong, Richard H; Albertelli, Megan A

    2014-01-01

    An 10-y-old, intact male rhesus macaque (Macaca mulatta) presented for bilateral scrotal swelling and a distended abdomen. A soft mass in the left upper quadrant of the abdomen was palpated. A barium study did not reveal any gastrointestinal abnormalities. Exploratory laparotomy revealed a large (1.25 kg, 15.0 × 13.0 × 9.5 cm), red and tan, soft, circumscribed, spherical mass within the greater omentum and 10 to 20 smaller (diameter, 1 to 4 cm), soft to firm masses in the mesentery and greater omentum. The resected mass was a self-strangulating abdominal lipoma, a pedunculated neoplasm composed of white adipocytes arising from peritoneal adipose tissue undergoing secondary coagulation necrosis after strangulation of the blood supply due to twisting of the mass around the peduncle. The smaller masses were histologically consistent with simple or self-strangulating pedunculated abdominal lipomas. The macaque presented again 9 mo later with a firm, 5.0-cm mass in the midabdomen, with intestinal displacement visible on radiographs. Given this animal's medical history and questionable prognosis, euthanasia was elected. Necropsy revealed numerous, multifocal to coalescing, 1.0- to 15.0-cm, pale tan to yellow, circumscribed, soft to firm, spherical to ellipsoid, pedunculated masses that were scattered throughout the mesentery, greater omentum, lesser omentum, and serosal surfaces of the gastrointestinal tract. All of the masses were pedunculated abdominal lipomas, and most demonstrated coagulation necrosis due to self-strangulation of the blood supply. To our knowledge, this report is the first to describe abdominal lipomatosis with secondary self-strangulation of masses in a rhesus macaque. PMID:25402181

  12. Abdominal lipomatosis with secondary self-strangulation of masses in an adult rhesus macaque (Macaca mulatta).

    PubMed

    Chum, Helen H; Long, C Tyler; McKeon, Gabriel P; Chang, Angela G; Luong, Richard H; Albertelli, Megan A

    2014-10-01

    An 10-y-old, intact male rhesus macaque (Macaca mulatta) presented for bilateral scrotal swelling and a distended abdomen. A soft mass in the left upper quadrant of the abdomen was palpated. A barium study did not reveal any gastrointestinal abnormalities. Exploratory laparotomy revealed a large (1.25 kg, 15.0 × 13.0 × 9.5 cm), red and tan, soft, circumscribed, spherical mass within the greater omentum and 10 to 20 smaller (diameter, 1 to 4 cm), soft to firm masses in the mesentery and greater omentum. The resected mass was a self-strangulating abdominal lipoma, a pedunculated neoplasm composed of white adipocytes arising from peritoneal adipose tissue undergoing secondary coagulation necrosis after strangulation of the blood supply due to twisting of the mass around the peduncle. The smaller masses were histologically consistent with simple or self-strangulating pedunculated abdominal lipomas. The macaque presented again 9 mo later with a firm, 5.0-cm mass in the midabdomen, with intestinal displacement visible on radiographs. Given this animal's medical history and questionable prognosis, euthanasia was elected. Necropsy revealed numerous, multifocal to coalescing, 1.0- to 15.0-cm, pale tan to yellow, circumscribed, soft to firm, spherical to ellipsoid, pedunculated masses that were scattered throughout the mesentery, greater omentum, lesser omentum, and serosal surfaces of the gastrointestinal tract. All of the masses were pedunculated abdominal lipomas, and most demonstrated coagulation necrosis due to self-strangulation of the blood supply. To our knowledge, this report is the first to describe abdominal lipomatosis with secondary self-strangulation of masses in a rhesus macaque.

  13. Dilatation of Common Iliac Arteries after Endovascular Infrarenal Abdominal Aortic Repair with Bell-Bottom Extension

    PubMed Central

    Telles, Gustavo José Politzer; Razuk Filho, Álvaro; Karakhanian, Walter Khegan; Saad, Paulo Fernandes; Saad, Karen Ruggeri; Park, Jong Hun; Siqueira, Leticia Cristina Dalledone; Caffaro, Roberto Augusto

    2016-01-01

    Objective Endovascular techniques to treat abdominal aortic aneurysms results in lower morbidity and mortality rates. However, dilation of the common iliac arteries prevents adequate distal sealing, which compromises the procedure success. The aim of this study is report the long-term outcomes of patients with abdominal aortic aneurysms associated with aneurysm of the common iliac artery following endovascular repair using a bifurcated bell-bottom stent graft. Methods This is a retrospective study that evaluated patients treated with bifurcated bell-bottom extension stent grafts to repair an infrarenal abdominal aortic aneurysm and who had at least one common iliac artery with dilatation > 1.5 cm for at least 12 months after the endovascular intervention. Results Thirty-eight patients with a mean age of 70.4±8.2 years were included. Stent graft placement was followed by dilation of the common iliac artery aneurysms in 35.3% of cases; endoleak and reoperation rates were 17.6% and 15.7%, respectively. Younger patients showed a higher rate of artery diameter increase following the procedure. The average arterial dilation was 16% in the first year, 29% in the second year, 57% in the third year and 95% from the fourth year until the end of follow-up. Conclusion Repair of infrarenal abdominal aortic aneurysms with bifurcated bell-bottom type stents when there is common iliac artery dilation is a good therapeutic option to preserve hypogastric flow. The rate of endoleak was 17.6%, and 15.7% of cases required reoperation. Younger patients are more likely to experience dilation of the common iliac artery after the procedure. PMID:27556314

  14. Diameter Controlled of Carbon Nanotubes Synthesized on Nanoporous Silicon Support

    NASA Astrophysics Data System (ADS)

    Asli, N. A.; Shamsudin, M. S.; Maryam, M.; Yusop, S. F. M.; Suriani, A. B.; Rusop, M.; Abdullah, S.

    2013-06-01

    Carbon nanotubes (CNTs) have been successfully synthesized on nanoporous silicon template (NPSiT) using botanical source, camphor oil. Diameter of CNTs synthesized was controlled by pore size of NPSiT prepared by photo-electrochemical anodization method. The diameter of CNTs grown on different NPSiT corresponded to the pore diameter of NPSiT. FESEM images showed self-organized bundles of fiber-like structures of CNTs with diameter of around 20nm which were successfully grown directly on nanoporous silicon while raman spectra obtained ratio of ID/IG at 0.67.

  15. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-01-01

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended. PMID:26698210

  16. The role of antidepressants in the treatment of abdominal obesity.

    PubMed

    Rosmond, R; Björntorp, P

    2000-06-01

    The pathophysiology of abdominal obesity is unclear and controversial. Recent evidence now suggests that inadequate cortisol secretion is associated with abnormalities in glucose, insulin and lipid metabolism, including hypertension, bringing the importance of the hypothalamic-pituitary-adrenal (HPA) axis in the pathogenesis of abdominal obesity to the forefront. In addition, abnormal gonadal steroid concentrations and impaired plasma growth hormone levels accompany the abdominally obese state. Since the reproductive and growth axes are inhibited at many levels by various components of the HPA axis, increasing cortisol levels results in further depression of testosterone and growth hormone concentrations. Over the last decade, antidepressant (serotoninergic) drugs have proved useful as equalizers of HPA axis hyperactivity. Such therapy may interrupt the vicious circle of a hyperactive HPA axis leading to increasing abdominal obesity and endocrine perturbations that, in turn, leads to progressive accumulation of abdominal fat. Additionally, preliminary results indicate that serotoninergic agents decrease abdominal fat mass with improvements in related risk factors.

  17. Functional Abdominal Pain: "Get" the Function, Loose the Pain.

    PubMed

    Draeger-Muenke, Reinhild

    2015-07-01

    Functional abdominal pain is a mind-body, psychosocial, and self-reinforcing experience with significant consequences for the sufferer and the surrounding support network. The occurrence of unpredictable symptoms and their severity add an element of dread and feeling out-of-control to daily life and often reduce overall functioning in a downward spiral. Two clinical presentations of functional abdominal pain are offered in this article (composites to protect confidentiality) dealing with abdominal pain syndrome and abdominal migraines. The treatment demonstrates the use of hypnotic principles for self-regulation, exploration, and meaning-making. Hypnosis treatment is conducted in combination with mindfulness-based interventions and Traditional Chinese Medicine's (TCM) teachings regarding abdominal health and illness. The clinical examples illustrate medical findings that suggest children with early life stress and an early onset of gastrointestinal somatization may not simply outgrow their functional abdominal pain but may suffer into adulthood. PMID:26046716

  18. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-12-23

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended.

  19. Spinal ischemia following abdominal aortic surgery.

    PubMed

    Ferguson, L R; Bergan, J J; Conn, J; Yao, J S

    1975-03-01

    Serious spinal cord ischemia may follow infrarenal abdominal aortic surgery. Five cases are summarized and added to the 23 previously published cases in order to identify this syndrome, emphasize its importance, and draw attention to the possibility of spontaneous recovery which may occur. The multifactorial complex which comprises each patient's clinical picture clouds a precise and specific cause for paraplegia in these cases. However, neither hypotension, steal phenomena nor emboli are necessary for completion of the syndrome. The relevant spinal cord arterial anatomy indicates that the common anomalies which occur favor development of spinal cord ischemia in the arteriosclerotic population which requires aortic surgery. No means of prevention is possible at this time.

  20. [Abdominal pain and gastritis in children].

    PubMed

    Gottrand, Frédéric

    2011-05-01

    Gastritis, as gastric and duodenal ulcer, is associated with epigastric abdominal pain, influenced by meals, associated with nausea and vomiting and weight loss. Diagnosis s based upon upper gastrointestinal fibre endoscopy that allows direct visualisation of gastric lesions and realization of antral and fundic biopsies for anatomopathology and culture. Main etiologies are drug induced, stress and H. pylori infection. Looking for H. pylori is only justified in those children presenting with digestive symptoms requiring upper gastrointestinal endoscopy. Therefore non invasive test are only indicated for control of eradication. Treatment of H. pylori infection associates proton pump inhibitors and two antibiotics for 7 to 10 days.

  1. [Unusual abdominal complication of ventriculoperitoneal shunt].

    PubMed

    Guillén, A; Costa, J M; Castelló, I; Claramunt, E; Cardona, E

    2002-10-01

    The most common complications after CSF shunting to treat hydrocephalus are shunt infection and obstruction. Although ventriculoperitoneal (VP) diversion of the CSF using artificial shunt devices is an accepted method for the management of hydrocephalus, high rates of various complications have been reported, ranging from 24% to 47%. Among these, abdominal complications account for approximately 25%. The incidence of bowel perforation by shunt-catheter is known to be as low as 0.1-0.7%. We describe a case of migration af a peritoneal catheter through a congenital hernia of Morgagni.

  2. [Pheochromocytoma with retroperitoneal hemorrhage after abdominal trauma].

    PubMed

    Hayashi, Takuji; Nin, Mikio; Yamamoto, Yoshiyuki; Kamoto, Akihito; Ujike, Takeshi; Nishimura, Kensaku; Miyoshi, Susumu

    2009-11-01

    A 35-year-old man was delivered to the emergency room complaining of right flank pain because of blunt abdominal trauma sustained while playing baseball. Enhanced computed tomography (CT) revealed a right adrenal mass and fluid collection around the mass. We diagnosed the mass as pheochromocytoma by endocrinological examination and radioisotopical imaging test. After absorption of the hematoma three months after the injury, laparoscopic right adrenalectomy was performed. He had an uncomplicated postoperative course without supplementation of catecholamine. Pathological findings were compatible with pheochromocytoma. Eight months after the operation, he had no evidence of recurrence.

  3. Large posterior abdominal masses: computed tomographic localization.

    PubMed

    Engel, I A; Auh, Y H; Rubenstein, W A; Whalen, J P; Kazam, E

    1983-10-01

    Large posterior abdominal masses, particularly those in the right upper abdomen, may be difficult to localize correctly into the peritoneal or retroperitoneal compartments. The following signs were found to be reliable CT indicators of retroperitoneal location: obliteration of the perinephric fat outlining the psoas muscle; lateral displacement of the fat outlining the posterior right lobe of the liver; rotation of the intrahepatic portal veins to the left; anterior displacement of the inferior vena cava and renal veins; and anterior displacement of the ascending colon, descending duodenum, or pancreatic head.

  4. Pilot Mouse Study of 1 mm Inner Diameter (ID) Vascular Graft Using Electrospun Poly(ester urea) Nanofibers.

    PubMed

    Gao, Yaohua; Yi, Tai; Shinoka, Toshiharu; Lee, Yong Ung; Reneker, Darrell H; Breuer, Christopher K; Becker, Matthew L

    2016-09-01

    An off-the-shelf, small diameter tissue engineered vascular graft (TEVG) would be transformative to surgeons in multiple subspecialties. Herein, the results of a small diameter (ID ≈ 1 mm) vascular graft constructed from resorbable, amino acid-based poly(ester urea) (PEU) are reported. Electrospun PEU grafts of two different wall thicknesses (type A: 250 μm; type B: 350 μm) are implanted as abdominal infra-renal aortic grafts in a severe combined immune deficient/beige mouse model and evaluated for vessel remodeling over one year. Significantly, the small diameter TEVG does not rupture or lead to acute thrombogenic events during the intervals tested. The pilot TEVG in vivo shows long-term patency and extensive tissue remodeling with type A grafts. Extensive tissue remodeling in type A grafts leads to the development of well-circumscribed neovessels with an endothelial inner lining, a neointima containing smooth muscle cells. However, due to slow degradation of the PEU scaffold materials in vivo, the grafts remain after one year. The type B grafts, which have 350 μm thick walls, experience occlusion over the one year interval due to intimal hyperplasia. This study affords significant findings that will guide the design of future generations of small diameter vascular grafts.

  5. Comparison of Liver Tumor Motion With and Without Abdominal Compression Using Cine-Magnetic Resonance Imaging

    SciTech Connect

    Eccles, Cynthia L.; Patel, Ritesh; Simeonov, Anna K.; Lockwood, Gina; Haider, Masoom; Dawson, Laura A.

    2011-02-01

    Purpose: Abdominal compression (AC) can be used to reduce respiratory liver motion in patients undergoing liver stereotactic body radiotherapy. The purpose of the present study was to measure the changes in three-dimensional liver tumor motion with and without compression using cine-magnetic resonance imaging. Patients and Methods: A total of 60 patients treated as a part of an institutional research ethics board-approved liver stereotactic body radiotherapy protocol underwent cine T2-weighted magnetic resonance imaging through the tumor centroid in the coronal and sagittal planes. A total of 240 cine-magnetic resonance imaging sequences acquired at one to three images each second for 30-60 s were evaluated using an in-house-developed template matching tool (based on the coefficient correlation) to measure the magnitude of the tumor motion. The average tumor edge displacements were used to determine the magnitude of changes in the caudal-cranial (CC) and anteroposterior (AP) directions, with and without AC. Results: The mean tumor motion without AC of 11.7 mm (range, 4.8-23.3) in the CC direction was reduced to 9.4 mm (range, 1.6-23.4) with AC. The tumor motion was reduced in both directions (CC and AP) in 52% of the patients and in a single direction (CC or AP) in 90% of the patients. The mean decrease in tumor motion with AC was 2.3 and 0.6 mm in the CC and AP direction, respectively. Increased motion occurred in one or more directions in 28% of patients. Clinically significant (>3 mm) decreases were observed in 40% and increases in <2% of patients in the CC direction. Conclusion: AC can significantly reduce three-dimensional liver tumor motion in most patients, although the magnitude of the reduction was smaller than previously reported.

  6. Handlebar Hernia: A Rare Type of Abdominal Wall Hernia

    PubMed Central

    Hassan, Khairi A. F.; Elsharawy, Mohamed A.; Moghazy, Khaled; AlQurain, Abdulaziz

    2008-01-01

    Handlebar hernias are abdominal wall hernias resulting from direct trauma to the anterior abdominal wall. They usually result at weak anatomic locations of the abdominal wall. Such traumatic hernias are rare, requiring a high index of suspicion for a clinical diagnosis. We report the case of a handlebar hernia resulting from an injury sustained during a vehicular injury, and discuss the management of such injuries. PMID:19568493

  7. Abdominal Compartment Syndrome: Risk Factors, Diagnosis, and Current Therapy

    PubMed Central

    Luckianow, Gina M.; Ellis, Matthew; Governale, Deborah; Kaplan, Lewis J.

    2012-01-01

    Abdominal compartment syndrome's manifestations are difficult to definitively detect on physical examination alone. Therefore, objective criteria have been articulated that aid the bedside clinician in detecting intra-abdominal hypertension as well as the abdominal compartment syndrome to initiate prompt and potentially life-saving intervention. At-risk patient populations should be routinely monitored and tiered interventions should be undertaken as a team approach to management. PMID:22720147

  8. Cost and Reimbursement for Three Fibroid Treatments: Abdominal Hysterectomy, Abdominal Myomectomy, and Uterine Fibroid Embolization

    SciTech Connect

    Goldberg, Jay Bussard, Anne; McNeil, Jean; Diamond, James

    2007-02-15

    Purpose. To compare costs and reimbursements for three different treatments for uterine fibroids. Methods. Costs and reimbursements were collected and analyzed from the Thomas Jefferson University Hospital decision support database from 540 women who underwent abdominal hysterectomy (n 299), abdominal myomectomy (n = 105), or uterine fibroid embolization (UFE) (n = 136) for uterine fibroids during 2000-2002. We used the chi-square test and ANOVA, followed by Fisher's Least Significant Difference test, for statistical analysis. Results. The mean total hospital cost (US$) for UFE was $2,707, which was significantly less than for hysterectomy ($5,707) or myomectomy ($5,676) (p < 0.05). The mean hospital net income (hospital net reimbursement minus total hospital cost) for UFE was $57, which was significantly greater than for hysterectomy (-$572) or myomectomy (-$715) (p < 0.05). The mean professional (physician) reimbursements for UFE, hysterectomy, and myomectomy were $1,306, $979, and $1,078, respectively. Conclusion. UFE has lower hospital costs and greater hospital net income than abdominal hysterectomy or abdominal myomectomy for treating uterine fibroids. UFE may be more financially advantageous than hysterectomy or myomectomy for the insurer, hospital, and health care system. Costs and reimbursements may vary amongst different hospitals and regions.

  9. Intra-abdominal pulmonary secuestration as an exceptional cause of abdominal mass in the adult☆

    PubMed Central

    Moreno-Sanz, C.; Herrero Bogajo, M.L.; Picazo-Yeste, J.; Morandeira Rivas, A.; Manzanera-Diaz, M.; Sedano-Vizcaino, C.

    2013-01-01

    INTRODUCTION Pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue isolated from the pulmonary system. PSs are classified into intralobar type and intra-abdominal PS that represents only 2.5% of cases. There are 20 cases of PS reported in adults and only two were managed by laparoscopic approach. We report a case of intra-abdominal PS mimicking a gastroesophageal duplication cyst in an adult. Besides its rarity, this is the first intra-abdominal PS in an adult managed by an anterior laparoscopic approach. PRESENTATION OF CASE A 60-year-old female patient had had epigastric and left upper quadrant pain for several days. Physical examination was normal. Image test were consistent with a gastroesophageal duplication. The patient was taken to the operating room for laparoscopic exploration and resection. The pathological diagnosis was extralobar pulmonary sequestration. DISCUSSION Less than 20 cases of PS have been reported in adults and only two cases were managed by a lateral laparoscopic approach. In contrast to these reports, we used an anterior approach due to the GEJ suspected origin of the mass. CONCLUSION Extralobar intra-abdominal PS is an extremely rare condition during adulthood but this diagnosis should be included in the differential diagnosis of a left-sided suprarenal mass. Due to the difficulty in achieving a definitive preoperative diagnosis, surgery is recommended. Laparoscopic resection is safe and effective but careful preoperative imaging studies are recommended in order to plan the most suitable approach. PMID:24091075

  10. Prevalence of abdominal migraine and recurrent abdominal pain in a Japanese clinic.

    PubMed

    Hikita, Toshiyuki

    2016-07-01

    Prevalence of abdominal migraine (AM) and recurrent abdominal pain (RAP) was evaluated in patients who visited Hikita Pediatric Clinic between May 2010 and April 2015. Patient data were collected prospectively using a questionnaire. Out of a total of 3611 cases, observed prevalence was 2.44% for repeated abdominal pain over a period of ≥3 months, 1.47% for RAP, and 0.19% for AM. Duration of abdominal pain was longer for AM than for non-AM RAP. Certain clinical features were significantly different between AM and non-AM RAP. No correlations were found among age at onset, frequency of attack, and duration of attack for various types of RAP. It was difficult to determine useful diagnostic criteria for distinguishing between AM and non-AM RAP. They did not appear to be separate disease entities but, instead, lie on a disease spectrum. The present prevalence of AM (0.19%) was lower than that in many previous studies from countries other than Japan. PMID:27460403

  11. A comparison of angled sagittal MRI and conventional MRI in the diagnosis of herniated disc and stenosis in the cervical foramen.

    PubMed

    Shim, Jung Hyun; Park, Choon Keun; Lee, Ju Hyun; Choi, Jin Wook; Lee, Dong Chan; Kim, Dong Hyun; Kim, Jae Keon; Hwang, Jang Hoe

    2009-08-01

    The object of this study is to demonstrate that angled sagittal magnetic resonance imaging (MRI) enables the precise diagnosis of herniated disc and stenosis in the cervical foramen, which is not available with conventional MRI. Due to both the anatomic features of the cervical foramen and the limitations of conventional MR techniques, it has been difficult to identify disease in the lateral aspects of the spinal canal and foramen using only conventional MRI. Angled sagittal MRI oriented perpendicular to the true course of the foramina facilitates the identification of the lateral disease. A review of 43 patients, who underwent anterior cervical discectomy and interbody fusion, is presented with a herniated disc and/or stenosis in the cervical foramen. They all had undergone conventional MRI and angled sagittal MRI. Fifty levels were surgically explored for evidence of foraminal herniated disc and stenosis. The results of each test were correlated with what was found at each explored surgical level. The sensitivity, specificity, and accuracy of both examinations for making the diagnosis of foraminal herniated disc and stenosis were compared. During the diagnosis of foraminal herniated disc, the sensitivity, specificity, and accuracy of angled sagittal MRI were 96.7, 95.0, and 96.0%, respectively, compared with 56.7, 85.0, and 68.0% for conventional MRI. In making the diagnosis of foraminal stenosis, the sensitivity, specificity, and accuracy of angled sagittal MRI were 96.3, 95.7, and 96.0%, respectively, compared with 40.7, 91.3, and 66.0% for conventional MRI. In the above groups, the difference between the tests for making the diagnosis of both foraminal herniated disc and stenosis was found to be statistically significant in sensitivity and accuracy. Angled sagittal MRI was a more accurate test compared to conventional MRI for making the diagnosis of herniated disc and stenosis in the cervical foramen. It can be utilized for the precise diagnosis of foraminal

  12. Brain Arterial Diameters as a Risk Factor for Vascular Events

    PubMed Central

    Gutierrez, Jose; Cheung, Ken; Bagci, Ahmet; Rundek, Tatjana; Alperin, Noam; Sacco, Ralph L; Wright, Clinton B; Elkind, Mitchell S V

    2015-01-01

    Background Arterial luminal diameters are routinely used to assess for vascular disease. Although small diameters are typically considered pathological, arterial dilatation has also been associated with disease. We hypothesize that extreme arterial diameters are biomarkers of the risk of vascular events. Methods and Results Participants in the Northern Manhattan Study who had a time-of-flight magnetic resonance angiography were included in this analysis (N=1034). A global arterial Z-score, called the brain arterial remodeling (BAR) score, was obtained by averaging the measured diameters within each individual. Individuals with a BAR score <−2 SDs were considered to have the smallest diameters, individuals with a BAR score >−2 and <2 SDs had average diameters, and individuals with a BAR score >2 SDs had the largest diameters. All vascular events were recorded prospectively after the brain magnetic resonance imaging. Spline curves and incidence rates were used to test our hypothesis. The association of the BAR score with death (P=0.001), vascular death (P=0.02), any vascular event (P=0.05), and myocardial infarction (P=0.10) was U-shaped except for ischemic stroke (P=0.74). Consequently, incidence rates for death, vascular death, myocardial infarction, and any vascular event were higher in individuals with the largest diameters, whereas individuals with the smallest diameters had a higher incidence of death, vascular death, any vascular event, and ischemic stroke compared with individuals with average diameters. Conclusions The risk of death, vascular death, and any vascular event increased at both extremes of brain arterial diameters. The pathophysiology linking brain arterial remodeling to systemic vascular events needs further research. PMID:26251284

  13. [Ruptured abdominal aortic aneurysm. A rare form of presentation].

    PubMed

    Rettedal, E A; Vennesland, O

    1993-05-10

    In most cases a ruptured abdominal aortic aneurism is dramatic, with rapid deterioration of the clinical condition of the patient. With abdominal and back pain, pulsatile tumour, and development of bleeding shock the diagnosis is obvious. In some cases the symptoms are not clear and the condition can be misinterpreted. The authors describe a case to illustrate this. A 74 year-old male was admitted to hospital with vague abdominal pain and left inguinal hernia. It later turned out that a ruptured abdominal aortic aneurism was the reason for his symptoms and signs. 14 similar cases are reported in the literature. PMID:8332976

  14. [Abdominal pseudocyst as a complication of ventriculoperitoneal shunt].

    PubMed

    Shakir, Shawnim; Hegelund, Sture

    2013-09-16

    The abdominal pseudocyst is an unfrequent complication in patients with ventriculoperitoneal shunts. Although many cases have been reported in children, it is rare in adult patients. However, a 47-year-old man with congenital hydrocephalus who had been treated with ventriculoperitoneal shunt since the age of three months, was admitted to hospital due to abdominal pain. He was eventually diagnosed radiologically as having an abdominal pseudocyst. Despite this complication being rare, especially in adults, it should be highly suspected whenever an abdominal cyst co-occurs with a ventriculoperitoneal shunt.

  15. Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings*

    PubMed Central

    Vermelho, Marli Batista Fernandes; Correia, Ademir Silva; Michailowsky, Tânia Cibele de Almeida; Suzart, Elizete Kazumi Kuniyoshi; Ibanês, Aline Santos; Almeida, Lanamar Aparecida; Khoury, Zarifa; Barba, Mário Flores

    2015-01-01

    Objective To evaluate the incidence and spectrum of abdominal computed tomography imaging findings in patients with paracoccidioidomycosis. Materials and Methods Retrospective analysis of abdominal computed tomography images of 26 patients with disseminated paracoccidioidomycosis. Results Abnormal abdominal tomographic findings were observed in 18 patients (69.2%), while no significant finding was observed in the other 8 (30.8%) patients. Conclusion Computed tomography has demonstrated to play a relevant role in the screening and detection of abdominal abnormalities in patients with disseminated paracoccidioidomycosis. PMID:25987748

  16. Intra-abdominal bronchogenic cyst: report of five cases.

    PubMed

    Choi, Kang Kook; Sung, Ji-Youn; Kim, Jung-Sun; Kim, Min Jung; Park, Hyojun; Choi, Dong Wook; Choi, Seong Ho; Heo, Jin Seok

    2012-05-01

    An intra-abdominal bronchogenic cyst (BC) is a very rare congenital anomaly caused by abnormal budding of the developing tracheobronchial tree. Intra-abdominal BCs are reported as retroperitoneal masses in most cases, many of which are located on the left side of the midline, the perigastric area, the left adrenal gland, or the superior body of the pancreas. Intra-abdominal BCs are frequently misdiagnosed due to the rarity, location, and variable cystic content. We report five patients with intra-abdominal BCs who underwent surgery in a single institution.

  17. Fatigue and cardiorespiratory function following abdominal surgery.

    PubMed

    Christensen, T; Bendix, T; Kehlet, H

    1982-07-01

    Subjective feelings of fatigue were assessed before operation and 10, 20 and 30 days after uncomplicated elective abdominal surgery in 16 otherwise healthy patients, using a constructed fatigue scale model. In addition, all patients had an orthostatic stress test performed at the same times. Six of the patients also underwent a bicycle ergometer test measuring heart rate and oxygen consumption. Subjective feelings of fatigue were increased (P less than 0.01) at all three postoperative observations, and only 5 of 16 patients returned to their preoperative level. The increased subjective feeling of fatigue correlated positively (RS = 0.53, P less than 0.001) with the increased pulse rate seen during orthostatic stress after operation. Heart rate was about 5 per cent higher (n.s.) after operation when bicycling at the same work loads, while oxygen consumption decreased by about 2 per cent (P less than 0.01) at all three postoperative bicycle tests. It is concluded that even electric uncomplicated abdominal surgery is followed by a pronounced feeling of fatigue, which may persist 1 month after surgery in about one-third of patients. The fatigue scale model seems applicable for future studies on the pathogenesis and treatment of the postoperative fatigue syndrome.

  18. Abdominal aneurysm and horseshoe kidney: a review.

    PubMed Central

    Bietz, D S; Merendino, K A

    1975-01-01

    Two patients with aortic abdominal aneurysms in association with horseshoe kidney are presented, making a total of 34 cases recorded in the literature. In 29 patients, the aneurysm was resected and five patients were non-resectable. Because of the abnormalities in vascular supply to the abnormal kidney, it is important to diagnose the combination of aneurysm and horseshoe kidney preoperatively. An error in diagnosis should be unusual if an intravenous pyelogram is routinely obtained on all patients. This study may reveal abnormalities which will allow the diagnosis of horseshoe kidney to be made or suspected. If the intravenous pyelogram is abnormal, it should be followed by an aortogram. This may substantiate the diagnosis of aneurysm and horseshoe kidney and provide the necessary detailed information regarding the pattern of blood supply and its relationship to functioning tissue. The amount and disposition of functioning renal parenchyma may be further amplified by renal scan. If this sequence is followed, the unanticipated combination of abdominal aneurysm and horseshoe kidney should be rare. PMID:1130850

  19. Methods for abdominal respiratory motion tracking.

    PubMed

    Spinczyk, Dominik; Karwan, Adam; Copik, Marcin

    2014-01-01

    Non-invasive surface registration methods have been developed to register and track breathing motions in a patient's abdomen and thorax. We evaluated several different registration methods, including marker tracking using a stereo camera, chessboard image projection, and abdominal point clouds. Our point cloud approach was based on a time-of-flight (ToF) sensor that tracked the abdominal surface. We tested different respiratory phases using additional markers as landmarks for the extension of the non-rigid Iterative Closest Point (ICP) algorithm to improve the matching of irregular meshes. Four variants for retrieving the correspondence data were implemented and compared. Our evaluation involved 9 healthy individuals (3 females and 6 males) with point clouds captured in opposite breathing phases (i.e., inhalation and exhalation). We measured three factors: surface distance, correspondence distance, and marker error. To evaluate different methods for computing the correspondence measurements, we defined the number of correspondences for every target point and the average correspondence assignment error of the points nearest the markers.

  20. Abdominal Drainage Following Appendectomy and Cholecystectomy

    PubMed Central

    Stone, H. Harlan; Hooper, C. Ann; Millikan, William J.

    1978-01-01

    Consecutive patients undergoing emergency appendectomy (283) or urgent cholecystectomy (51) were prospectively studied for the development of post-operative incisional or peritoneal sepsis. Severity of the original peritoneal infection was carefully recorded, while use of a Penrose dam to drain the peritoneum was randomized according to pre-assigned hospital number. Both aerobic and anaerobic cultures were taken from the abdomen at the time of operation as well as from all postoperative infectious foci. Results demonstrated no essential differences in incidence of wound and peritoneal infection following appendectomy for simple or suppurative appendicitis (187) or following cholecystectomy for acute cholecystitis (51). However, with gangrenous or perforative appendicitis (94), incisional and intra-abdominal infection rates were 43% and 45%, respectively, when a drain was used; yet only 29 and 13%, respectively, without a drain. These latter differences were significant (p < 0.001). In addition, intra-abdominal abscesses were three times as likely to drain through the incision than along any tract provided by the rubber conduit. Cultures revealed that hospital pathogens accounted for a greater proportion of wound and peritoneal sepsis after cholecystectomy and appendectomy for simple or suppurative appendicitis if a drain had been inserted than if managed otherwise. By contrast, a mixed bacterial flora was responsible for most infections following appendectomy for gangrenous or perforated appendicitis, irrespective as to use of a drain. PMID:646499