Arthroscopic treatment of acute acromioclavicular joint dislocation by coracoclavicular ligament augmentation.

PubMed

Liu, Xudong; Huangfu, Xiaoqiao; Zhao, Jinzhong

2015-05-01

Coracoclavicular (CC) ligament augmentation has been a method to treat acromioclavicular (AC) joint dislocation in recent years. The purpose of this paper is to describe our arthroscopic CC ligament augmentation technique in treating type III and V acute AC joint dislocations and to report the early clinical and radiological results. From 2010 to 2011, twelve patients suffering from acute type III or V AC joint dislocations were arthroscopically treated in our department, by CC ligament augmentation after AC joint reduction. The post-operative outcomes were assessed through physical examination, radiographic examination and the Constant-Murley Shoulder Score. All patients post-operatively experienced anatomical reduction in their AC joint dislocation. No intraoperative complications occurred. At a mean follow-up at 24 months (ranging from 18 to 32 months), the mean Constant-Murley Shoulder Score significantly improved from 24.3 pre-operatively to 91.1 post-operatively. No neurovascular complications or secondary degenerative changes of the AC joint were detected in any of the patients. In one case, a second dislocation occurred 1 month post-operation because the patient had had another traumatic injury. This patient accepted a revision operation, but his AC joint eventually fixated into a subluxated position after his second injury. Based on the resultant successful repair in all cases, the arthroscopic CC ligament augmentation method has thus far proven to be a safe and reliable technique for treatment of acute type III or V AC joint dislocation. The arthroscopic CC ligament augmentation with a flip button/polyethylene belt repair is an efficient method to treat acute type III and V AC joint dislocations which should be popularized. IV.

Acute acromioclavicular dislocation: a cheaper, easier and all-arthroscopic system. Is it effective in nowadays economical crisis?

PubMed

Sastre, Sergi; Dada, Michelle; Santos, Simon; Lozano, Lluis; Alemany, Xavier; Peidro, Lluis

2015-03-01

The objective of this manuscript is to show an effective, easier and cheaper way to reduce acute acromioclavicular (AC) dislocation type III and V (Rockwood classification). Numerous procedures have been described for surgical management of acromioclavicular joint disruption. Newest devices involve an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. Arthroscopically assisted treatment of acute AC joint dislocation is advantageous because it provides good clinical results and few complications. It also allows reviewing glenohumeral associated lesions. This surgical technique requires no specific implants to achieve a correct AC reduction. Actually, economical advantages are very important factors to decide the use of determinate surgical techniques.

Rotational and translational stability of different methods for direct acromioclavicular ligament repair in anatomic acromioclavicular joint reconstruction.

PubMed

Beitzel, Knut; Obopilwe, Elifho; Apostolakos, John; Cote, Mark P; Russell, Ryan P; Charette, Ryan; Singh, Hardeep; Arciero, Robert A; Imhoff, Andreas B; Mazzocca, Augustus D

2014-09-01

Many reconstructions of acromioclavicular (AC) joint dislocations have focused on the coracoclavicular (CC) ligaments and neglected the functional contribution of the AC ligaments and the deltotrapezial fascia. To compare the modifications of previously published methods for direct AC reconstruction in addition to a CC reconstruction. The hypothesis was that there would be significant differences within the variations of surgical reconstructions. Controlled laboratory study. A total of 24 cadaveric shoulders were tested with a servohydraulic testing system. Two digitizing cameras evaluated the 3-dimensional movement. All reconstructions were based on a CC reconstruction using 2 clavicle tunnels and a tendon graft. The following techniques were used to reconstruct the AC ligaments: a graft was shuttled underneath the AC joint back from anterior and again sutured to the acromial side of the joint (group 1), a graft was fixed intramedullary in the acromion and distal clavicle (group 2), a graft was passed over the acromion and into an acromial tunnel (group 3), and a FiberTape was fixed in a cruciate configuration (group 4). Anterior, posterior, and superior translation, as well as anterior and posterior rotation, were tested. Group 1 showed significantly less posterior translation compared with the 3 other groups (P < .05) but did not show significant differences compared with the native joint. Groups 3 and 4 demonstrated significantly more posterior translation than the native joint. Group 1 showed significantly less anterior translation compared with groups 2 and 3. Group 3 demonstrated significantly more anterior translation than the native joint. Group 1 demonstrated significantly less superior translation compared with the other groups and with the native joint. The AC joint of group 1 was pulled apart less compared with all other reconstructions. Only group 1 reproduced the native joint for the anterior rotation at the posterior marker. Group 4 showed

Clinical outcomes of the Cadenat procedure in the treatment of acromioclavicular joint dislocations.

PubMed

Moriyama, Hiroaki; Gotoh, Masafumi; Mitsui, Yasuhiro; Yoshikawa, Eiichirou; Uryu, Takuya; Okawa, Takahiro; Higuchi, Fujio; Shirahama, Masahiro; Shiba, Naoto

2014-01-01

We report our clinical experience using the modified Cadenat method to treat acromioclavicular joint dislocation, and discuss the usefulness of this method. This study examined 6 shoulders in 6 patients (5 males, 1 female) who were diagnosed with acromioclavicular joint dislocation and treated with the modified Cadenat method at our hospital. Average age at onset was 49.3 years (26-78 years), average time interval from injury until surgery was 263.8 days (10 to 1100 days), and the average follow-up period was 21.7 months (12 to 42 months). Post-operative assessment was performed using plain radiographs to determine shoulder joint dislocation rate and Japanese Orthopaedic Association (JOA) score. The average post-operative JOA score was 94.1 points (91 to 100 points). The acromioclavicular joint dislocation rate improved from 148.7% (72 to 236%) before surgery to 28.6% (0 to 60%) after surgery. Conservative treatment has been reported to achieve good outcomes in acromioclavicular joint dislocations. However, many patients also experience chronic pain or a sensation of fatigue upon putting the extremity in an elevated posture, and therefore ensuring the stability of the acromioclavicular joint is crucial for highly active patients. In this study, we treated acromioclavicular joint dislocations by the modified Cadenat method, and were able to achieve favorable outcomes.

Surgical treatment of acute acromioclavicular joint dislocations: hook plate versus minimally invasive reconstruction.

PubMed

Metzlaff, S; Rosslenbroich, S; Forkel, P H; Schliemann, B; Arshad, H; Raschke, M; Petersen, W

2016-06-01

This study was performed to compare the clinical results of a minimally invasive technique for acute acromioclavicular (AC) joint dislocation repair with the traditional hook plate fixation. Forty-four patients with an acute (within 2 weeks after trauma) complete AC joint separation (35 male, nine female; median age 36.2 years, range 18-56) underwent surgical repair with either a minimally invasive AC joint repair or a conventional hook plate. Functional outcome was evaluated using the Constant-Murley Score (CMS), the TAFT score and the AC joint instability score (ACJI). Radiographic evaluation was performed with bilateral anterior-posterior (a.p.) stress and Alexander views. All patients were available after a median follow-up of 32 months (range 24-51). There were no significant differences in the mean CMS, Taft score and the ACJI between the two groups. The radiological assessment revealed no significant difference in the coracoclavicular distance. In both groups, a slight loss of reduction was observed. Periarticular ossification was seen in 11 patients of the minimally invasive AC joint repair and eight patients of the hook plate group but this did not affect the final outcome. Hook plates were removed after a median interval of 11.9 weeks (range 10-13). Good clinical results can be achieved with both minimally invasive AC joint repair and hook plate fixation. However, in the hook plate group a second operation is mandatory for plate removal. III.

What role do plain radiographs have in assessing the skeletally immature acromioclavicular joint?

PubMed

Lee, Seung Yeol; Kwon, Soon-Sun; Chung, Chin Youb; Lee, Kyoung Min; Park, Moon Seok

2014-01-01

Because of incomplete ossification of the coracoid process and acromion, acromioclavicular joint configuration in the skeletally immature patient differs from that of adults. Although comparison to radiographic standards for this joint is critical in the evaluation of acromioclavicular joint injuries, these standards are not well defined for children or adolescents. We therefore sought to determine (1) the reliability of numerous radiographic measurements of the skeletally immature acromioclavicular joint, including the vertical and shortest coracoclavicular interval, and the acromioclavicular joint offset; (2) the timing of ossification of the acromion and coracoid in males and females; and (3) the differences in the values of these radiographic measurements based on age and sex. This study was based on a total of 485 subjects, 8 to 18 years old, who underwent conventional AP view radiographs of both shoulders. The 485 subjects were included to assess normal configuration around the acromioclavicular joint and 466 of these subjects were evaluated for comparison between both sides. The vertical and shortest coracoclavicular interval, coracoclavicular clavicle width ratio, acromioclavicular joint offset, and difference of the coracoclavicular interval of both sides were measured. A reliability test was conducted before obtaining the main measurements. The relationship of measurements with sex, age, and stage of ossification was evaluated. The vertical and shortest coracoclavicular interval showed excellent reliability (intraclass correlation coefficient ([ICC], 0.918 and 0.934). The acromioclavicular joint offset showed low reliability (ICC, 0.543). The ossification centers of the acromion and the coracoid processes appeared and fused earlier in females than in males. The vertical coracoclavicular interval, which was not affected by partial ossification of the coracoid process, was less than 11 mm in the 90% quantile of total subjects in males and 10 mm in the 90

Help Desk Answers: Surgery vs conservative management for AC joint repair: How do the 2 compare?

PubMed

Matchin, Bruce; Yee, Bruce; Mott, Timothy

2016-04-01

When not considering the grade of acromioclavicular (AC) joint dislocation, both conservative and surgical management lead to positive outcomes, although surgically managed patients require more time out of work.

Ipsilateral Closed Clavicle and Scapular spine Fracture with Acromioclavicular Joint Disruption.

PubMed

Kembhavi, Raghavendra S; James, Boblee

2015-01-01

Injuries around shoulder and clavicle are quite common. Injuries involving lateral end of clavicle involving acromioclavicular joints are commoner injuries. In this rare injury, we report about a case involving clavicle and scapular spine fracture with acromioclavicular disruption which has never been described in English literature as per our knowledge. A patient with closed clavicle and scapular spine fracture with acromioclavicular joint disruption was treated with open reduction and internal fixation of clavicle and scapular spine as a staged procedures. Six months post operatively, patient had excellent functional recovery with near full range of movements. Though rare complex injury, clavicle fracture with scapular spine fracture with acromioclavicular disruption, when managed properly with good physiotherapy protocol post operatively will result in good clinical and functional outcome.

Simultaneous Middle Third Clavicle Fracture and Type 3 Acromioclavicular Joint Dislocation; A Case Report

PubMed Central

Solooki, Saeed; Azad, Ali

2014-01-01

Simultaneous middle third clavicle fracture and acromioclavicular joint dislocation is a rare combination injury, as a result of high-energy trauma. We report a patient with a middle third clavicle fracture and ipsilateral grade three-acromioclavicular joint dislocation, which is a rare combination. The patient wanted to get back to work as soon as possible, so the fracture was fixed with reconstruction plate after open reduction and plate contouring; and acromioclavicular joint dislocation was reduced and fixed with two full threaded cancellous screws. One screw was inserted through the plate to the coracoid process. Clinical and radiographic finding revealed complete union of clavicle fracture and anatomical reduction of acromioclavicular joint with pain free full joint range of motion one year after operation. PMID:25207318

A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

PubMed Central

Marchie, Anthony; Kumar, Arun; Catre, Melanio

2009-01-01

We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations. PMID:20671868

Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study.

PubMed

Maier, Dirk; Jaeger, Martin; Reising, Kilian; Feucht, Matthias J; Südkamp, Norbert P; Izadpanah, Kaywan

2016-09-06

Horizontal instability impairs clinical outcome following acute acromioclavicular joint (ACJ) reconstruction and may be caused by insufficient healing of the superior acromioclavicular ligament complex (ACLC). However, characteristics of acute ACLC injuries are poorly understood so far. Purposes of this study were to identify different ACLC tear types, assess type-specific prevalence and determine influencing cofactors. This prospective, cross-sectional study comprised 65 patients with acute-traumatic Rockwood-5 (n = 57) and Rockwood-4 (n = 8) injuries treated operatively by means of mini-open ACJ reduction and hook plate stabilization. Mean age at surgery was 38.2 years (range, 19-57 years). Standardized pre- and intraoperative evaluation included assessment of ACLC tear patterns and cofactors related to the articular disc, the deltoid-trapezoidal (DT) fascia and bony ACJ morphology. Articular disc size was quantified as 0 = absent, 1 = remnant, 2 = meniscoid and 3 = complete. All patients showed complete ruptures of the superior ACLC, which could be assigned to four different tear patterns. Clavicular-sided (AC-1) tears were observed in 46/65 (70.8 %), oblique (AC-2) tears in 12/65 (18.5 %), midportion (AC-3) tears in 3/65 (4.6 %) and acromial-sided (AC-4) tears in 4/65 (6.1 %) of cases. Articular disc size manifestation was significantly (P < .001) more pronounced in patients with AC-1 tears (1.89 ± 0.57) compared to patients with AC-2 tears (0.67 ± 0.89). Other cofactors did not influence ACLC tear patterns. ACLC dislocation with incarceration caused mechanical impediment to anatomical ACJ reduction in 14/65 (21.5 %) of cases including all Rockwood-4 dislocations. Avulsion "in continuity" was a consistent mode of failure of the DT fascia. Type-specific operative strategies enabled anatomical ACLC repair of all observed tear types. Acute ACLC injuries follow distinct tear patterns. There exist clavicular-sided (AC-1

Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation.

PubMed

Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

2014-01-01

Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate.

Biomechanical evaluation of native acromioclavicular joint ligaments and two reconstruction techniques in the presence of the sternoclavicular joint: A cadaver study.

PubMed

Masionis, Povilas; Šatkauskas, Igoris; Mikelevičius, Vytautas; Ryliškis, Sigitas; Bučinskas, Vytautas; Griškevičius, Julius; Martin Oliva, Xavier; Monzó Planella, Mariano; Porvaneckas, Narūnas; Uvarovas, Valentinas

2017-01-01

Where is over 100 reconstruction techniques described for acromioclavicular (AC) joint reconstruction. Although, it is not clear whether the presence of the sternoclavicular (SC) joint influences the biomechanical properties of native AC ligaments and reconstruction techniques. The purpose of the present study was to investigate the biomechanical properties of native AC joint ligaments and two reconstruction techniques in cadavers with the SC joint still present. We tested eight fresh-frozen cadaver hemithoraces for superior translation (70 N load) and translation increment after 1000 cycles (loading from 20 to 70 N) in a controlled laboratory study. There were three testing groups created: native ligaments, the single coracoclavicular loop (SCL) technique, and the two coracoclavicular loops (TCL) technique. Superior translation was measured after static loading. Translation increment was calculated as the difference between superior translation after cyclic and static loading. Native AC ligaments showed significantly lower translation than the SCL ( p = 0.023) and TCL ( p = 0.046) groups. The SCL had a significantly lower translation increment than native AC ligaments ( p = 0.028). There was no significant difference between reconstruction techniques in terms of translation ( p = 0.865) and translation increment ( p = 0.113). Native AC joint ligaments had better static properties than both reconstruction techniques and worse dynamic biomechanical properties than the SCL technique. The SCL technique appeared to be more secure than the TCL technique. The presence of the SC joint did not have an observable influence on test results.

Prevalence and pattern of glenohumeral injuries among acute high-grade acromioclavicular joint instabilities.

PubMed

Pauly, Stephan; Kraus, Natascha; Greiner, Stefan; Scheibel, Markus

2013-06-01

With increasing numbers of arthroscopically assisted acromioclavicular (AC) joint stabilization procedures has come an increase in reports of concomitant glenohumeral injuries among AC joint separations. The aim of the present study was to evaluate the prevalence, pattern, and cause of glenohumeral pathologies among a large patient population with acute high-grade AC joint instability. A total of 125 patients (13 women, 112 men) with high-grade AC joint dislocation (6 Rockwood II; 119 Rockwood V) underwent diagnostic glenohumeral arthroscopy before AC joint repair. Pathologic lesions were evaluated for acute or degenerative origin and, if considered relevant, treated all-arthroscopically. Concomitant glenohumeral pathologies were found in 38 of 125 patients (30.4%). Analysis of pathogenesis distinguished different patterns of accompanying injuries: acute intra-articular lesions, related to the recent shoulder trauma, were found in 9 patients (7.2%), degenerative lesions, considered to be unrelated to the recent trauma, were found in 18 (14.4%), and 11 (8.8%) had an unclear traumatic correlation (intermediate group). Within the acute and the degenerative group, affected structures were predominantly partial, articular-sided tears of the anterosuperior rotator cuff, including instabilities of the pulley complex, followed by pathologies of the long head of the biceps and superior labrum anteroposterior lesions. The intermediate group presented mainly with articular-sided partial tears of the subscapularis tendon. This prospective study showed a high prevalence (30%) of concomitant glenohumeral pathologies, of which some indicate additional surgical therapy and could be missed by an isolated open AC repair. Hence, the arthroscopic approach for AC joint stabilization allows for the diagnosis and treatment of associated intra-articular pathologies. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

A Case Report of an Acromioclavicular Joint Ganglion Associated with a Rotator Cuff Tear.

PubMed

Tanaka, Suguru; Gotoh, Masafumi; Mitsui, Yasuhiro; Shirachi, Isao; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto

2017-04-13

We report a case of subcutaneous ganglion adjacent to the acromioclavicular joint with massive rotator cuff tear [1-7]. An 81-year-old woman presented with a ganglion adjacent to the acromioclavicular joint that had first been identified 9 months earlier. The ganglion had recurred after having been aspirated by her local physician, so she was referred to our hospital. The puncture fluid was yellowish, clear and viscous. Magnetic resonance imaging identified a massive rotator cuff tear with multi- lobular cystic lesions continuous to the acromioclavicular joint, presenting the "geyser sign". During arthroscopy, distal clavicular resection and excision of the ganglion were performed together with joint debridement. At present, the ganglion has not recurred and the patient has returned to normal daily activity. In this case, the ganglion may have developed subsequent to the concomitant massive cuff tear, due to subcutaneous fluid flow through the damaged acromioclavicular joint.

Palpation Versus Ultrasound-Guided Acromioclavicular Joint Intra-articular Corticosteroid Injections: A Retrospective Comparative Clinical Study.

PubMed

Park, Ki Deok; Kim, Tai Kon; Lee, Jihae; Lee, Woo Yong; Ahn, Jae Ki; Park, Yongbum

2015-01-01

Primary osteoarthritis (OA) is the most common cause of pain arising from the acromioclavicular (AC) joint. The true incidence is unknown because of differences in the criteria used to define arthritis in various studies. The proper diagnosis of AC joint OA requires a thorough physical examination, radiographic findings, and a diagnostic local anesthetic injection. The goal of this study was to assess the effects and safety of ultrasound (US) versus palpation-guided acromioclavicular (AC) joint intra-articular (IA) corticosteroid injection for patients with osteoarthritis (OA) of the AC joint. Retrospective, compared clinical study. University hospital outpatient pain clinic. We retrospectively reviewed the charts of patients with AC joint degenerative OA who had undergone US or palpation-guided AC joint IA corticosteroid injection between January 2012 and December 2013 at our outpatient clinic. One hundred consecutive patients identified from chart review met inclusion criteria. Patients (N = 50) in US guide AC joint IA steroid injection group were administered a mixture of 0.5% lidocaine (1 mL) with triamcinolone (20 mg/mL; 0.5 mL) and radiographic contrast material (0.5 mL) and patients (N = 50) in palpation-guided AC joint IA steroid injection group were administered a mixture of 0.5% lidocaine (1 mL) with triamcinolone (20 mg/mL; 0.5 mL) and 0.5 mL of radiographic contrast material. Results were measured using the Shoulder Pain and Disability Index (SPADI), Verbal Numeric pain Scale (VNS) at rest (VNSar), under local pressure (VNSlp) ,and the arm adduction test (VNSaat) at the joint space area before injections and at one, 3, and 6 months after the injections. Successful treatment occurred when patients obtained significant pain relief (as measured by > 50% improvement in the VNS score and 20 point improvement in the SPADI) at one, 3, and 6 months after the injections. Univariable analysis was performed to evaluate the relationship between possible outcome

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia.

PubMed

Wang, Chaoliang; Huang, Sufang; Wang, Yingzhen; Sun, Xuesheng; Zhu, Tao; Li, Qiang; Lin, Chu

2015-01-01

We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100). The results were excellent in eight patients (66.7%) and good in four patients (33.3%). Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia

PubMed Central

Wang, Chaoliang; Huang, Sufang; Wang, Yingzhen; Sun, Xuesheng; Zhu, Tao; Li, Qiang; Lin, Chu

2015-01-01

We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100). The results were excellent in eight patients (66.7%) and good in four patients (33.3%). Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries. PMID:28352721

A Case of Acromioclavicular Joint Dislocation Associated with Coracoid Process Fracture.

PubMed

Nakamura, Yosuke; Gotoh, Masafumi; Mitsui, Yasuhiro; Shirachi, Isao; Yoshikawa, Eiichiro; Uryu, Takuya; Murakami, Hidetaka; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto

2015-01-01

Rupture of any two or more parts of the superior shoulder suspensory complex (SSSC) including the distal clavicle, acromion, coracoid process, glenoid cavity of the scapula, acromioclavicular ligament, and coracoclavicular ligament is associated with shoulder girdle instability and is an indication for surgery. Here we report a case of acromioclavicular joint dislocation associated with coracoid process fracture. A 48-year-old man sustained a hard blow to the left shoulder from a fall, and simple radiography detected a coracoid process fracture and acromioclavicular joint dislocation. The injury consisted of a rupture of two parts of the SSSC. For the coracoid process fracture, osteosynthesis was performed using hollow cancellous bone screws. For the acromioclavicular joint dislocation, hook plate fixation and the modified Neviaser's procedure were performed. The bone healed well 5 months after surgery, at which time the screws were removed. At 18 months after initial surgery, the coracoid process fracture had healed with a 10% rate of dislocation on radiography, and the patient currently has no problem performing daily activities, no range of motion limitations, and a Japanese Orthopaedic Association scale score of 93.

Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

PubMed Central

Liu, Qingjun; Miao, Jianyun; Lin, Bin; Guo, Zhimin

2012-01-01

Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate. Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years) with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months). Results: The mean Constant score was 94 (range, 78 to 100). The results were excellent in 12 patients (75.0%), good in 3 patients (18.8%) and satisfactory in 1patient (6.2%). Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients. Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique. PMID:23091410

Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation

PubMed Central

Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

2014-01-01

Introduction: Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. Methods: A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. Results: According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). Conclusion: The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate. PMID

Arthroscopic fixation of acute acromioclavicular joint disruption with TightRope™: Outcome and complications after minimum 2 (2-5) years follow-up.

PubMed

Zhang, Li-Feng; Yin, Bo; Hou, Su; Han, Bing; Huang, De-Fa

2017-01-01

To evaluate the midterm results of arthroscopic reconstruction of acute acromioclavicular (AC) joint disruption using TightRope™ system. We retrospectively assess the results of 24 patients of acute AC joint dislocation who were operated using TightRope system. Constant and University of California, Los Angeles (UCLA) scores and coracoclavicular distance were calculated pre- and postoperatively. Data was entered into MS excel and analyzed using the SPSS version 17. The mean follow-up was 39.45 months. Constant and UCLA scores were significantly increased postoperatively. Six patients had partial loss of reduction within 3-6 months and two patients had a failure of construct. Constant score was significantly lower in these patients. TightRope reconstruction of the AC joint is a reproducible and safe alternative to many other techniques of AC joint reconstruction. Early subluxation remains a concern and may reflect the need for technique modification.

Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results.

PubMed

Li, Haoqing; Wang, Chuanshun; Wang, Jiandong; Wu, Kai; Hang, Donghua

2013-11-13

Our purpose was to investigate the clinical efficacy of arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton coracoclavicular ligament reconstruction for the treatment of complete acromioclavicular joint dislocation. During the period from February 2010 to October 2012, ten patients with Rockwood types IV and V acromioclavicular joint dislocation were hospitalized and nine were treated with acromioclavicular ligament reconstruction combined with double endobutton of coracoclavicular ligament reconstruction. The improvement in shoulder functions was assessed using a Constant score and visual analog scale (VAS) system. The mean follow-up period was 33.6 ± 5.4 months. The mean Constant scores improved from 25.2 ± 6.6 preoperatively to 92.4 ± 6.5 postoperatively, while the mean VAS score decreased from 5.9 ± 1.4 to 1.2 ± 0.9; significant differences were observed. The final follow-up revealed that excellent outcomes were achieved in eight patients and good outcome in two patients. Arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton of coracoclavicular ligament reconstruction is an effective approach for treatment of acute complete acromioclavicular joint dislocation.

Arthroscopic procedures and therapeutic results of anatomical reconstruction of the coracoclavicular ligaments for acromioclavicular Joint dislocation.

PubMed

Takase, K; Yamamoto, K

2016-09-01

Surgical treatment is recommended for type 5 acromioclavicular joint dislocation on Rockwood's classification. We believe that anatomic repair of the coracoclavicular ligaments best restores the function of the acromioclavicular joint. We attempted to correctly reconstruct the anatomy of the coracoclavicular ligaments under arthroscopy, and describe the minimally invasive arthroscopic procedure. There were 22 patients; mean age at surgery, 38.1 years. Mean time to surgery was 13.2 days. Mean follow-up was 3 years 2 months. The palmaris longus tendon was excised from the ipsilateral side to replace the conoid ligament, while artificial ligament was used for reconstructing the trapezoid ligament. Both ligament reconstructions were performed arthroscopically. No temporary fixation of the acromioclavicular joint was performed. On postoperative radiographic evaluation, 4 patients showed subluxation and 2 showed dislocation of the acromioclavicular joint; the other 16 patients had maintained reduction at the final consultation. MR images 1year after surgery clearly revealed the reconstructed ligaments in 19 patients. Only 1 patient showed osteoarthritis of the acromioclavicular joint. Although it requires resection of the ipsilateral palmaris longus for grafting, we believe that anatomic reconstruction of both coracoclavicular ligaments best restores the function of the acromioclavicular joint. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The biomechanical influence of the deltotrapezoid fascia on horizontal and vertical acromioclavicular joint stability.

PubMed

Pastor, M F; Averbeck, A K; Welke, B; Smith, T; Claassen, L; Wellmann, M

2016-04-01

Many studies have investigated the biomechanical influence of the acromioclavicular (AC) and coracoclavicular (CC) ligaments on the stability of the acromioclavicular joint (ACJ). It has been shown that augmentation of the CC ligaments alone can result in residual horizontal instability. Our hypothesis was that the DTF would have a significant stabilizing effect on horizontal ACJ stability. In a biomechanical in vitro study a sequential injury of the ACJ was created on eight shoulders from full body, which were placed in an upright sitting position. The translation and rotation of the clavicle were measured in relation to the acromion using an optical navigation system in various states during thoracic-humeral elevation, abduction, and horizontal adduction. The three states were: an intact shoulder, complete sectioning of the AC ligaments, and a circular lesion of the DTF. Compared to the intact state we found a significant increase in anterior rotation of the clavicle of 1.11° (p = 0.012) and a tendency in lateral translation of 2.71 mm (p = 0.017) in relation to the acromion, with a combined lesion of AC ligaments and DTF. No significant differences were found between the intact state and the isolated dissected AC ligaments as well in adduction as elevation. A combined lesion of the AC ligaments and the DTF resulted in a quantitatively small but significant increase in anterior rotation and a tendency in lateral translation of the clavicle in relation to the acromion. These differences were quantitatively small, so that the clinical relevance of the stabilization effect of combined AC ligaments and DTF injuries is questionable.

Changes in surgical procedures for acromioclavicular joint dislocation over the past 30 years.

PubMed

Takase, Katsumi; Yamamoto, Kengo

2013-10-01

Generally, surgical treatment is recommended for Rockwood type 5 traumatic acromioclavicular joint dislocations. Since 1980, the authors have performed the modified Dewar procedure, the modified Cadenat procedure, and anatomical reconstruction of the coracoclavicular ligaments for this injury. The goal of this study was to determine the ideal surgical procedure for acromioclavicular joint dislocations by comparing these 3 procedures. The modified Dewar procedure was performed on 55 patients (Dewar group), the modified Cadenat procedure was performed on 73 patients (Cadenat group), and anatomical reconstruction of the coracoclavicular ligaments was performed on 11 patients (reconstruction group). According to the UCLA scoring system, therapeutic results averaged 27.3 points in the Dewar group, 28.2 in the Cadenat group, and 28.4 in the reconstruction group. The incidence of residual subluxation or dislocation in the acromioclavicular joint was evaluated at final radiographic follow-up. Subluxation occurred in 21 patients in the Dewar group, 18 in the Cadenat group, and 3 in the reconstruction group. Dislocation occurred in 3 patients in the Dewar group. Osteoarthritic changes in the acromioclavicular joint occurred in 20 patients in the Dewar group, 9 in the Cadenat group, and 1 in the reconstruction group. The modified Cadenat procedure can provide satisfactory therapeutic results and avoid postoperative failure or loss of reduction compared with the modified Dewar procedure. However, the modified Cadenat procedure does not anatomically restore the coracoclavicular ligaments. Anatomic restoration of both coracoclavicular ligaments can best restore acromioclavicular joint function. Copyright 2013, SLACK Incorporated.

A retrospective comparative study of arthroscopic fixation in acute Rockwood type IV acromioclavicular joint dislocation: single versus double paired Endobutton technique.

PubMed

Xu, Jian; Liu, Haifeng; Lu, Wei; Li, Dingfu; Zhu, Weimin; Ouyang, Kan; Wu, Bing; Peng, Liangquan; Wang, Daping

2018-05-24

Rockwood type IV acromioclavicular joint (ACJ) dislocation is a trauma usually needs surgical treatment. Paired EndoButton technique (PET) is used in treating such condition. However, the effect of using different types of PET (single versus double PET) for fixation remains controversial. This study aims to evaluate and compare the efficacy of single and double PET and to provide a suitable option for the surgeons. We retrospectively reviewed the charts of patients with acute Rockwood type IV ACJ dislocation who had undergone arthroscopic fixation using single or double PET fixation between March 2009 and March 2015. Seventy-eight consecutive patients identified from chart review were picked and were divided into the single and double PET group with 39 cases in each group. The indexes of visual analog scale score (VAS) for pain, the radiographs of the affected shoulder at different time points of the follow-up, the time of return to activities and sports, the constant functional score, and the Karlsson acromioclavicular joint (ACJ) score, were assessed in a minimum of 2 years postoperation. The average coracoclavicular (CC) and acromioclavicular (AC) distances of the affected joints in the double PET group were significantly smaller than those of the single PET group 2 years postoperation (P < 0.05). The average AC and CC distances in the healthy shoulder joints were significantly smaller than those of the affected joints in the single PET group (P < 0.05); however, these values were not significantly different from those of the affected joints in the double PET group (P > 0.05). The mean VAS pain score was not significantly different, while significant difference was found for the number and times of cases return to activities and sports, constant functional score, and Karlsson ACJ score (P < 0.05) between the two groups. Therefore, the double PET group has better outcome than the single PET group. Complications including redislocation, button

Acromioclavicular joint injuries in the National Football League: epidemiology and management.

PubMed

Lynch, T Sean; Saltzman, Matthew D; Ghodasra, Jason H; Bilimoria, Karl Y; Bowen, Mark K; Nuber, Gordon W

2013-12-01

Previous studies investigating acromioclavicular (AC) joint injuries in professional American football players have only been reported on quarterbacks during the 1980s and 1990s. These injuries have not been evaluated across all position players in the National Football League (NFL). The purpose of this study was 4-fold: (1) to determine the incidence of AC joint injuries among all NFL position players; (2) to investigate whether player position, competition setting, type of play, and playing surface put an athlete at an increased risk for this type of injury; (3) to determine the incidence of operative and nonoperative management of these injuries; and (4) to compare the time missed for injuries treated nonoperatively to the time missed for injuries requiring surgical intervention. Descriptive epidemiological study. All documented injuries of the AC joint were retrospectively analyzed using the NFL Injury Surveillance System (NFLISS) over a 12-season period from 2000 through 2011. The data were analyzed by the anatomic location, player position, field conditions, type of play, requirement of surgical management, days missed per injury, and injury incidence. Over 12 NFL seasons, there were a total of 2486 shoulder injuries, with 727 (29.2%) of these injuries involving the AC joint. The overall rate of AC joint injuries in these athletes was 26.1 injuries per 10,000 athlete exposures, with the majority of these injuries occurring during game activity on natural grass surfaces (incidence density ratio, 0.79) and most often during passing plays. These injuries occurred most frequently in defensive backs, wide receivers, and special teams players; however, the incidence of these injuries was greatest in quarterbacks (20.9 injuries per 100 players), followed by special teams players (20.7/100) and wide receivers (16.5/100). Overall, these athletes lost a mean of 9.8 days per injury, with quarterbacks losing the most time to injury (mean, 17.3 days). The majority of

A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review.

PubMed

Krill, Michael K; Rosas, Samuel; Kwon, KiHyun; Dakkak, Andrew; Nwachukwu, Benedict U; McCormick, Frank

2018-02-01

The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology. Individual test characteristics were combined in series and in parallel to improve sensitivities and specificities. A secondary analysis utilized subjective pre-test probabilities to create a clinical decision tree algorithm with post-test probabilities. The optimal special test combination to screen and confirm AC joint pathology combined Paxinos sign and O'Brien's Test, with a specificity of 95.8% when performed in series; whereas, Paxinos sign and Hawkins-Kennedy Test demonstrated a sensitivity of 93.7% when performed in parallel. Paxinos sign and O'Brien's Test demonstrated the greatest positive likelihood ratio (2.71); whereas, Paxinos sign and Hawkins-Kennedy Test reported the lowest negative likelihood ratio (0.35). No combination of special tests performed in series or in parallel creates more than a small impact on post-test probabilities to screen or confirm AC joint pathology. Paxinos sign and O'Brien's Test is the only special test combination that has a small and sometimes important impact when used both in series and in parallel. Physical examination testing is not beneficial for diagnosis of AC joint pathology when pretest probability is unequivocal. In these instances, it is of benefit to proceed with procedural tests to evaluate AC joint pathology. Ultrasound-guided corticosteroid injections are diagnostic and therapeutic. An ultrasound-guided AC joint

Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results

PubMed Central

2013-01-01

Background Our purpose was to investigate the clinical efficacy of arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton coracoclavicular ligament reconstruction for the treatment of complete acromioclavicular joint dislocation. Methods During the period from February 2010 to October 2012, ten patients with Rockwood types IV and V acromioclavicular joint dislocation were hospitalized and nine were treated with acromioclavicular ligament reconstruction combined with double endobutton of coracoclavicular ligament reconstruction. The improvement in shoulder functions was assessed using a Constant score and visual analog scale (VAS) system. Results The mean follow-up period was 33.6 ± 5.4 months. The mean Constant scores improved from 25.2 ± 6.6 preoperatively to 92.4 ± 6.5 postoperatively, while the mean VAS score decreased from 5.9 ± 1.4 to 1.2 ± 0.9; significant differences were observed. The final follow-up revealed that excellent outcomes were achieved in eight patients and good outcome in two patients. Conclusion Arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton of coracoclavicular ligament reconstruction is an effective approach for treatment of acute complete acromioclavicular joint dislocation. PMID:24225119

Acromioclavicular joint reconstruction using the LockDown synthetic implant: a study with cadavers.

PubMed

Taranu, R; Rushton, P R P; Serrano-Pedraza, I; Holder, L; Wallace, W A; Candal-Couto, J J

2015-12-01

Dislocation of the acromioclavicular joint is a relatively common injury and a number of surgical interventions have been described for its treatment. Recently, a synthetic ligament device has become available and been successfully used, however, like other non-native solutions, a compromise must be reached when choosing non-anatomical locations for their placement. This cadaveric study aimed to assess the effect of different clavicular anchorage points for the Lockdown device on the reduction of acromioclavicular joint dislocations, and suggest an optimal location. We also assessed whether further stability is provided using a coracoacromial ligament transfer (a modified Neviaser technique). The acromioclavicular joint was exposed on seven fresh-frozen cadaveric shoulders. The joint was reconstructed using the Lockdown implant using four different clavicular anchorage points and reduction was measured. The coracoacromial ligament was then transferred to the lateral end of the clavicle, and the joint re-assessed. If the Lockdown ligament was secured at the level of the conoid tubercle, the acromioclavicular joint could be reduced anatomically in all cases. If placed medial or 2 cm lateral, the joint was irreducible. If the Lockdown was placed 1 cm lateral to the conoid tubercle, the joint could be reduced with difficulty in four cases. Correct placement of the Lockdown device is crucial to allow anatomical joint reduction. Even when the Lockdown was placed over the conoid tubercle, anterior clavicle displacement remained but this could be controlled using a coracoacromial ligament transfer. ©2015 The British Editorial Society of Bone & Joint Surgery.

Inter- and intraobserver reliability of the Rockwood classification in acute acromioclavicular joint dislocations.

PubMed

Schneider, M M; Balke, M; Koenen, P; Fröhlich, M; Wafaisade, A; Bouillon, B; Banerjee, M

2016-07-01

The reliability of the Rockwood classification, the gold standard for acute acromioclavicular (AC) joint separations, has not yet been tested. The purpose of this study was to investigate the reliability of visual and measured AC joint lesion grades according to the Rockwood classification. Four investigators (two shoulder specialists and two second-year residents) examined radiographs (bilateral panoramic stress and axial views) in 58 patients and graded the injury according to the Rockwood classification using the following sequence: (1) visual classification of the AC joint lesion, (2) digital measurement of the coracoclavicular distance (CCD) and the horizontal dislocation (HD) with Osirix Dicom Viewer (Pixmeo, Switzerland), (3) classification of the AC joint lesion according to the measurements and (4) repetition of (1) and (2) after repeated anonymization by an independent physician. Visual and measured Rockwood grades as well as the CCD and HD of every patient were documented, and a CC index was calculated (CCD injured/CCD healthy). All records were then used to evaluate intra- and interobserver reliability. The disagreement between visual and measured diagnosis ranged from 6.9 to 27.6 %. Interobserver reliability for visual diagnosis was good (0.72-0.74) and excellent (0.85-0.93) for measured Rockwood grades. Intraobserver reliability was good to excellent (0.67-0.93) for visual diagnosis and excellent for measured diagnosis (0.90-0.97). The correlations between measurements of the axial view varied from 0.68 to 0.98 (good to excellent) for interobserver reliability and from 0.90 to 0.97 (excellent) for intraobserver reliability. Bilateral panoramic stress and axial radiographs are reliable examinations for grading AC joint injuries according to Rockwood's classification. Clinicians of all experience levels can precisely classify AC joint lesions according to the Rockwood classification. We recommend to grade acute ACG lesions by performing a digital

[Complications of treatment of acromioclavicular joint dislocation and unstable distal clavicular fracture with clavicular hook plate].

PubMed

Zhu, Yi-Yong; Cui, Heng-Yan; Jiang, Pan-Qiang; Wang, Jian-Liang

2013-11-01

To investigate the causes and prevention of the complications about treatment of acromioclavicular joint dislocation (Tossy III) and unstable distal clavicular fracture (Neer II) with clavicular hook plate. From January 2001 to December 2011, 246 patients with acromioclavicular joint dislocation (Tossy III) and 222 patients with unstable distal clavicular fracture (Neer II) were treated with acromioclvicular hook plate fixation,including 348 males and 120 females with an average age of 45.4 years old ranging from 21 to 80 years old. The mean time from injury to operation was 30.8 hours (ranged from 1 h to 15 d). All patients had normal shoulder function before injury. According to Karlsson evaluation standard, the cases with excellent and good function of the shoulder joint were regarded as the normal group, and the cases with poor function of shoulder joint as the abnormal group. The comparison of the range of forward flexion,backward stretch, adduction, abduction and elevation of shoulder joints between two groups was performed. The data of impingement, subacromial osteolysis, acromioclavicular arthritis, clavicular stress fracture, downward acromioclavicular joint subluxation, hook cut-out and hook break were summarized. All patients were followed up from 8 to 48 months with an average of 12.5 months. The results were excellent in 308 cases,good in 76,and poor in 84 according to Karlsson evaluation. The excellent and good rate was 82.1%. The difference of the range of forward flexion, backward stretch, adduction, abduction and elevation of shoulder joints between two groups had a statistically significant difference (P < 0.01). Among 84 poor cases, there were 41 (8.76%) in acromial impingement or inadequate place of plate hook, 12 (2.56%) with subacromial osteolysis or/and bursitis, 10 (2.14%) with acromioclavicular arthritis or painful shoulder caused by delayed dirigation,7 (1.50%) with clavicular stress fracture or interal plate upward, 6 (1.28%) with

Anatomical principles for minimally invasive reconstruction of the acromioclavicular joint with anchors.

PubMed

Xiong, Chuanzhi; Lu, Yaojia; Wang, Qiang; Chen, Gang; Hu, Hansheng; Lu, Zhihua

2016-11-01

The aim of this study was to evaluate the outcome of a minimally invasive surgical technique for the treatment of patients with acromioclavicular joint dislocation. Sixteen patients with complete acromioclavicular joint dislocation were enrolled in this study. All patients were asked to follow the less active rehabilitation protocol post-operatively. Computed tomography with 3-D reconstruction of the injured shoulder was performed on each patient post operatively for the assessment of the accuracy of the suture anchor placement in the coracoid process and the reduction of the acromioclavicular joint. Radiographs of Zanca view and axillary view of both shoulders were taken for evaluating the maintenance of the acromioclavicular joint reduction at each follow-up visit. The Constant shoulder score was used for function assessment at the final follow-up. Twenty seven of the 32 anchors implanted in the coracoid process met the criteria of good position. One patient developed complete loss of reduction and another had partial loss of reduction in the anteroposterior plane. For the other 14 patients, the mean Constant score was 90 (range, 82-95). For the patients with partial and complete loss of reduction, the Constant score were 92 and 76 respectively. All of them got nearly normal range of motion of the shoulders and restored to pre-operative life and works. With this minimally invasive approach and limited exposure of the coracoid, a surgeon can place the suture anchors at the anatomical insertions of the coracoclavicular ligament and allow the dislocated joint reduced and maintained well. Level IV, Case series; therapeutic study.

Controversies relating to the management of acromioclavicular joint dislocations.

PubMed

Modi, C S; Beazley, J; Zywiel, M G; Lawrence, T M; Veillette, C J H

2013-12-01

The aim of this review is to address controversies in the management of dislocations of the acromioclavicular joint. Current evidence suggests that operative rather than non-operative treatment of Rockwood grade III dislocations results in better cosmetic and radiological results, similar functional outcomes and longer time off work. Early surgery results in better functional and radiological outcomes with a reduced risk of infection and loss of reduction compared with delayed surgery. Surgical options include acromioclavicular fixation, coracoclavicular fixation and coracoclavicular ligament reconstruction. Although non-controlled studies report promising results for arthroscopic coracoclavicular fixation, there are no comparative studies with open techniques to draw conclusions about the best surgical approach. Non-rigid coracoclavicular fixation with tendon graft or synthetic materials, or rigid acromioclavicular fixation with a hook plate, is preferable to fixation with coracoclavicular screws owing to significant risks of loosening and breakage. The evidence, although limited, also suggests that anatomical ligament reconstruction with autograft or certain synthetic grafts may have better outcomes than non-anatomical transfer of the coracoacromial ligament. It has been suggested that this is due to better restoration horizontal and vertical stability of the joint. Despite the large number of recently published studies, there remains a lack of high-quality evidence, making it difficult to draw firm conclusions regarding these controversial issues.

Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

PubMed

Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip

2014-09-01

The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p < 0.05) and no significant change in coracoclavicular distance (10.4 ± 0.9 vs. 10.0 ± 0.8 mm). According to the Rockwood classification only type I and II lesions occurred. After additional coracoclavicular ligament cut, the acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p < 0.05. The mean coracoclavicular distance increased to 20.6 ± 2.1 mm resulting in type III-V lesions concerning the Rockwood classification. Trauma with intact coracoclavicular ligaments did not result in acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.

Horizontal and Vertical Stabilization of Acute Unstable Acromioclavicular Joint Injuries Arthroscopy-Assisted

PubMed Central

Cisneros, Luis Natera; Sarasquete Reiriz, Juan; Besalduch, Marina; Petrica, Alexandru; Escolà, Ana; Rodriguez, Joaquim; Fallone, Jan Carlo

2015-01-01

We describe the technical aspects of an arthroscopy-assisted procedure indicated for the management of acute unstable acromioclavicular joint injuries, consisting of a synthetic augmentation of both the coracoclavicular and acromioclavicular ligaments, that anatomically reproduces the coracoclavicular biomechanics and offers fixation that keeps the torn ends of the ligaments facing one another, thus allowing healing of the native structures without the need for a second surgical procedure for metal hardware removal. PMID:26870653

Biomechanical Comparison of an Intramedullary and Extramedullary Free-Tissue Graft Reconstruction of the Acromioclavicular Joint Complex

PubMed Central

Garg, Rishi; Javidan, Pooya; Lee, Thay Q.

2013-01-01

Background Several different surgical techniques have been described to address the coracoclavicular (CC) ligaments in acromioclavicular (AC) joint injuries. However, very few techniques focus on reconstructing the AC ligaments, despite its importance in providing stability. The purpose of our study was to compare the biomechanical properties of two free-tissue graft techniques that reconstruct both the AC and CC ligaments in cadaveric shoulders, one with an extramedullary AC reconstruction and the other with an intramedullary AC reconstruction. We hypothesized intramedullary AC reconstruction will provide greater anteroposterior translational stability and improved load to failure characteristics than an extramedullary technique. Methods Six matched cadaveric shoulders underwent translational testing at 10 N and 15 N in the anteroposterior and superoinferior directions, under AC joint compression loads of 10 N, 20 N, and 30 N. After the AC and CC ligaments were transected, one of the specimens was randomly assigned the intramedullary free-tissue graft reconstruction while its matched pair received the extramedullary graft reconstruction. Both reconstructed specimens then underwent repeat translational testing, followed by load to failure testing, via superior clavicle distraction, at a rate of 50 mm/min. Results Intramedullary reconstruction provided significantly greater translational stability in the anteroposterior direction than the extramedullary technique for four of six loading conditions (p < 0.05). There were no significant differences in translational stability in the superoinferior direction for any loading condition. The intramedullary reconstructed specimens demonstrated improved load to failure characteristics with the intramedullary reconstruction having a lower deformation at yield and a higher ultimate load than the extramedullary reconstruction (p < 0.05). Conclusions Intramedullary reconstruction of the AC joint provides greater stability in the

Surgical treatment of acute type V acromioclavicular joint dislocations in professional athletes: an anatomic ligament reconstruction with synthetic implant augmentation.

PubMed

Triantafyllopoulos, Ioannis K; Lampropoulou-Adamidou, Kalliopi; Schizas, Nikitas P; Karadimas, Eleftherios V

2017-12-01

Most acromioclavicular (AC) joint injuries occur in men in their third decade of life during high-speed or high-impact body contact sports. The management of acute complete AC joint dislocation is surgical. Current surgical techniques include anatomic reconstruction of the main restraints of the AC joint and aim to improve functional outcomes and to reduce the complication rate. We present 10 cases of acute type V AC joint dislocation in professional athletes treated surgically with anatomic reconstruction of the coracoclavicular and AC ligaments and augmentation with the use of a synthetic polyester tape. The minimum follow-up of the patients was 2 years (mean, 48 months; range, 24-86 months). The postoperative functional outcome was assessed at 1 year and 2 years using the Constant-Murley, American Shoulder and Elbow Surgeons, and modified University of California-Los Angeles scoring systems. In all cases, the postoperative scores were significantly improved (P < .005 in all comparisons with the preoperative scores), and all patients returned to their preinjury high level of activity 6 months postoperatively. Radiographs at 1 month and 6 months revealed the maintenance of reduction. There were no complications. According to the results of our series of patients, demanding cases of acute AC joint dislocation Rockwood type V, in professional athletes, require anatomic fixation of both coracoclavicular and AC ligaments for return to sports as soon as possible and at the preinjury level of performance. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Scapulothoracic dissociation with acromioclavicular separation: a case report of a novel fixation method.

PubMed

Merk, Bradley R; Minihane, Keith P; Shah, Nirav A

2008-09-01

We present a case of 39-year-old female with a scapulothoracic dissociation and acromioclavicular (AC) separation and who had fixation of the AC joint with a locking plate, coracoclavicular screw, and transarticular AC screw. The coracoclavicular and AC relationships were maintained during postoperative rehabilitation and after hardware removal. Use of a locking plate can lead to good functional outcome without the complications associated with the use of pin and wire constructs or without violating the subacromial space.

Open capsular and ligament reconstruction with semitendinosus hamstring autograft successfully controls superior and posterior translation for type V acromioclavicular joint dislocation.

PubMed

Garofalo, Raffaele; Ceccarelli, Enrico; Castagna, Alessandro; Calvisi, Vittorio; Flanagin, Brody; Conti, Marco; Krishnan, Sumant G

2017-07-01

Appropriate surgical management for type V complete acromioclavicular (AC) joint dislocation remains controversial. The purpose of this paper is to retrospectively report the clinical and radiographic outcomes of an open surgical technique consisting for AC joint ligamentous and capsular reconstruction using autologous hamstring tendon grafts and semi-permanent sutures. Between January 2005 and December 2011, 32 consecutive patients with symptomatic type V complete AC joint dislocation underwent surgical treatment using the same technique. The median time from injury to surgery was 45 days (range 24-90). The average median postoperative clinical and radiographic follow-up time was 30 months (range 24-33). Clinical outcomes measures included the ASES score, the visual analog score (VAS), and subjective patient satisfaction score. Minimum follow-up was 2 years. ASES score increased from a median of 38.2 ± 6.2 preoperative to 92.1 ± 4.7 postoperatively (p ≤ 0.05). The median VAS score improved from 62 mm (range 45-100 mm) preoperatively to 8 mm (range 0-20 mm) at final follow-up (p ≤ 0.05). No patient experienced pain or discomfort with either direct palpation of the AC joint or with cross-body adduction. Final radiographs demonstrated symmetric AC joint contour in 25/32 (78%) patients. Seven patients (22%) radiographically demonstrated superior translation of the distal clavicle relative to the superior margin of the acromion but less than 50% of the clavicular width. 30/32 patients (93%) were able to return to their pre-injury level of work and sports activities. This novel surgical technique using a free graft and braided suture for simultaneous coracoclavicular ligament and AC joint capsular reconstruction successfully controls superior and posterior translations after type V AC joint dislocation and minimizes the incidence of persistent postoperative AC joint subluxation. Retrospective case series, Level IV.

[Case-control study on measurement of coracoclavicular and acromioclavicular ligament injuries during internal fixation operation for the treatment of fresh acromioclavicular joint dislocation of Tossy type III].

PubMed

Guan, Ting-Jin; Sun, Peng; Zheng, Liang-Guo; Qi, Xiang-Yang

2014-01-01

To study measurement methods of acromioclavicular and coracoclavicular ligament injuries,its therapeutic effects and complications during internal fixation operation for the treatment of fresh acromioclavicular joint dislocations of Tossy type III. From July 2003 to May 2012,127 patients with acromioclavicular joint dislocations of Tossy type III were treated with wire fixation from coracoid process to clavicle or hook-plate fixation. The patients were divided into group A (63 cases) and group B (64 cases) according to whether acromioclavicular ligament and coracoclavicular ligament were repaired or not. In group A (ligaments repaired), there were 39 males and 24 females with an average age of (33.25 +/- 8.46) years old (ranged from 17 to 59 years). And in group B (no ligaments repaired), there were 41 males and 23 females with an average age of (34.10 +/- 7.19) years (ranged from 19 to 57 years). The operation times, intraoperative blood loss, postoperative infections, internal fixation failure, recurrence and other complications, together with therapeutic effects were compared between two groups. The outcome was analyzed according to Karlsson standard. In group A, 54 patients got an excellent result and 9 good according to Karlsson standard;the average operative time was (55.90 +/- 26.56) min; the average intraoperative bleeding amount was (99.80 +/- 50.30) ml; 1 patient had wire broken without re-dislocation at 16 weeks after operation, 3 patients got wound fat liquefaction and recovered after treatment, 1 patient had pain after shoulder joint motion and pain disappeared after implants were taken out. In group B, 52 patients got an excellent result and 12 good according to Karlsson standard; the average operative time was (49.50 +/- 23.14) min; the average intraoperative bleeding amount was (87.30 +/- 46.41) ml; 2 patients got wound fat liquefaction, and 2 patients had pain after shoulder joint motion. All the patients were followed up, and the duration ranged

Transarticular fixation by hook plate versus coracoclavicular stabilization by single multistrand titanium cable for acute Rockwood grade-V acromioclavicular joint dislocation: a case-control study.

PubMed

Gao, You-Shui; Zhang, Yue-Lei; Ai, Zi-Sheng; Sun, Yu-Qiang; Zhang, Chang-Qing; Zhang, Wei

2015-11-19

Hook plate (HP) is popularly used for acute and severely displaced acromioclavicular (AC) dislocations. However, subacromial impingement and acromion osteolysis induced by transarticular fixation are notorious. The current case-control study was to compare transarticular fixation by HP to coracoclavicular (CC) stabilization by single multistrand titanium cable (MSTC). Between January 2006 and August 2009, 24 patients with acute AC dislocations were surgically treated by open reduction and transarticular fixation with HP. These patients were matched to a series of 24 patients, who were managed by CC stabilization with MSTC in the same period. All AC dislocations were graded as Rockwood type V. Implant was removed 8-12 months after the primary operation in all patients, and 12 months at least were needed to assess the maintenance of AC joint. Functional results were evaluated before implant removal as well as in the last follow-up based on Constant-Murley criteria. There were no differences of demographic data including age, dominant gender and side, injury-to-surgery interval, operation time and follow-up period. In terms of functionality, Constant score was 95.8 ± 4.1 in MSTC group, while 76.7 ± 8.0 in HP group before implant removal (P < 0.001). In detail, MSTC was superior to HP in pain, ROM and activities. Constant score was significantly improved to 86.1 ± 5.7 after hardware removal for patients in HP (P < 0.001). Degenerative change of acromioclavicular joint presented in 16 patients (66.7%) in patients treated by HP, while it was found in only 3 patients (12.5%) treated by MSTC (P < 0.001). MSTC is superior to HP for the treatment of Rockwood type-V acromioclavicular dislocation both before and after removal of the implant. Hardware removal is of great benefits for functional improvement in patients treated by HP.

[Surgical repair of complete acromioclavicular separation (Tossy III) by tension wire bending and suture of the ligaments (author's transl)].

PubMed

Meeder, P J; Wentzensen, A; Weise, K

1980-01-01

The diagnosis of a complete acromioclavicular separation (Tossy III) is a indication for a surgical repair. Many and different methods are reported in history. 33 patients with a fresh, complete acromioclavicular separation are treated at the BG-Unfallklinik Tübingen from 1. 1. 1970--31. 12. 1978 by suturing the ligaments, inserting pins across the joint and tension-bending. With this method good results have been achieved, possible intra- and postoperative complications are reported. The incision along the clavicula gives quite often scar problems. Therefore we now use an arched incision across the AC-joint.

Operative Versus Non-operative Treatment of Grade III Acromioclavicular Joint Dislocations and the Use of SurgiLig: a Retrospective Review.

PubMed

Younis, Fizan; Ajwani, Sanil; Bibi, Asia; Riley, Eleanor; Hughes, Peter J

2017-12-30

Acromioclavicular joint dislocations are common shoulder girdle injuries. The treatment of grade III acromioclavicular joint dislocations is controversial. Furthermore, the literature on the use of the Sur-giligTM synthetic ligament for reconstruction of dislocations is sparse. This retrospective review aimed to establish whether operative treatment was superior to non-operative treatment in grade III acromioclavicular joint dislocations treated at our institute over a 5-year period. We also reviewed the effectiveness of reconstruction with SurgiligTM after acute and chronic dislocations across all grades of acromioclavicular joint dislocations. Twenty-five patients completed full follow-up with grade III dislocations. The mean follow-up in the operated group was 3.56 years and in the non-operated group this was 3.29 years. The mean Oxford Shoul-der Score (OSS) in the operated group was 39.8, whereas the mean OSS in the non-operated group was 45.9 (p=0.01). The mean pain score in the operated group was 2.2, and in the non-operated group this was 1.6. The mean satisfaction score in the operated group was 8.2 and that in the non-operated group was 7.8. There was no statistically significant difference in pain or satisfaction scores. In respect to the cohort treated with Surg-iligTM synthetic ligament, 22 patients across all grades of dislocations had this procedure performed. The mean post-operative Oxford Shoulder Score (OSS) was 40. 1. Non-operative treatment is not inferior to operative treatment for grade III acromioclavicular joint dislocations. The data from this study demonstrat-ed that the non-operated group had superior Ox-ford Shoul-der Scores that were statistically significant. 2. Additionally, the use of the SurgiligTM ligament appears to be effective in treating both chronic and acute acromioclavicular joint dislocations.

Concomitant glenohumeral pathologies associated with acute and chronic grade III and grade V acromioclavicular joint injuries.

PubMed

Jensen, Gunnar; Millett, Peter J; Tahal, Dimitri S; Al Ibadi, Mireille; Lill, Helmut; Katthagen, Jan Christoph

2017-08-01

The purpose of this study was to identify the risk of concomitant glenohumeral pathologies with acromioclavicular joint injuries grade III and V. Patients who underwent arthroscopically-assisted stabilization of acromioclavicular joint injuries grade III or grade V between 01/2007 and 12/2015 were identified in the patient databases of two surgical centres. Gender, age at index surgery, grade of acromioclavicular joint injury (Rockwood III or Rockwood V), and duration between injury and index surgery (classified as acute or chronic) were of interest. Concomitant glenohumeral pathologies were noted and their treatment was classified as debridement or reconstructive procedure. A total of 376 patients (336 male, 40 female) were included. Mean age at time of arthroscopic acromioclavicular joint reconstruction surgery was 42.1 ± 14.0 years. Overall, 201 patients (53%) had one or more concomitant glenohumeral pathologies. Lesions of the biceps tendon complex and rotator cuff were the most common. Forty-five patients (12.0%) had concomitant glenohumeral pathologies that required an additional repair. The remaining 156 patients (41.5%) received a debridement of their concomitant pathologies. Rockwood grade V compared to Rockwood grade III (p = 0.013; odds ratio 1.7), and chronic compared to acute injury were significantly associated with having a concomitant glenohumeral pathology (p = 0.019; odds ratio 1.7). The probability of having a concomitant glenohumeral pathology was also significantly associated with increasing age (p < 0.0001). Concomitant glenohumeral pathologies were observed in 53% of surgically treated patients with an acute or chronic acromioclavicular joint injury of either grade III or V. Twenty-two percent of these patients with concomitant glenohumeral pathologies received an additional dedicated repair procedure. Although a significant difference in occurrence of concomitant glenohumeral pathologies was seen between Rockwood grades III and V

Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction.

PubMed

Hegazy, Galal; Safwat, Hesham; Seddik, Mahmoud; Al-Shal, Ehab A; Al-Sebai, Ibrahim; Negm, Mohame

2016-01-01

The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 - 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure.

Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction

PubMed Central

Hegazy, Galal; Safwat, Hesham; Seddik, Mahmoud; Al-shal, Ehab A.; Al-Sebai, Ibrahim; Negm, Mohame

2016-01-01

Background: The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. Objective: To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Methods: Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 – 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. Results: In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Conclusion: Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure. PMID:27347245

[Case-control study on endobutton plate or clavicular hook plate for the repair of acromioclavicular joint dislocations].

PubMed

Zhu, Li; Yang, He-Jie; Zhao, Wan-Jun; Yang, Wu-Min; Zhou, Hui

2012-02-01

To compare the treatment results between Endobutton plate and clavicular hook plate for the treatment of acromioclavicular joint dislocations. From January 2009 to September 2010, 30 patients with acromioclavicular joint dislocations were treated with two different fixations: Endobutton plate (15 patients, including 12 males and 3 females, with a mean age of 38.5 +/- 8.2 years) and clavicular hook plate (15 patients, including 14 males and 1 female, with the mean age of 33.8 +/- 5.9 years). The mean operative time and blood loss were compared between the two groups. Joint function was assessed by the Karlsson standard. The mean operative time of the Endobutton group and the hook plate group were (61 +/- 8.6) min and (40 +/- 5.6) min. The average blood loss were (93 +/- 8.4) ml and (100 +/- 12.6) ml. There was no statistical difference between the two groups in the average blood loss and the mean operative time. According to the Karlsson standard, 13 patients got an excellent result, 2 good in the Endobutton group; and 7 patients got an excellent result and 7 good in hook plate group. The therapeutic effect in Endobutton group was better than that of hook plate group. In the treatment of acromioclavicular dislocation, fixation with Endobutton plate is believed to be better than hook plate fixation. It is an effective method for the repair of acromioclavicular joint dislocations in a short term. But its long term effects still need further follow up.

Biomechanical analysis of acromioclavicular joint dislocation treated with clavicle hook plates in different lengths.

PubMed

Shih, Cheng-Min; Huang, Kui-Chou; Pan, Chien-Chou; Lee, Cheng-Hung; Su, Kuo-Chih

2015-11-01

Clavicle hook plates are frequently used in clinical orthopaedics to treat acromioclavicular joint dislocation. However, patients often exhibit acromion osteolysis and per-implant fracture after undergoing hook plate fixation. With the intent of avoiding future complications or fixation failure after clavicle hook plate fixation, we used finite element analysis (FEA) to investigate the biomechanics of clavicle hook plates of different materials and sizes when used in treating acromioclavicular joint dislocation. Using finite element analysis, this study constructed a model comprising four parts: clavicle, acromion, clavicle hook plate and screws, and used the model to simulate implanting different types of clavicle hook plates in patients with acromioclavicular joint dislocation. Then, the biomechanics of stainless steel and titanium alloy clavicle hook plates containing either six or eight screw holes were investigated. The results indicated that using a longer clavicle hook plate decreased the stress value in the clavicle, and mitigated the force that clavicle hook plates exert on the acromion. Using a clavicle hook plate material characterized by a smaller Young's modulus caused a slight increase in the stress on the clavicle. However, the external force the material imposed on the acromion was less than the force exerted on the clavicle. The findings of this study can serve as a reference to help orthopaedic surgeons select clavicle hook plates.

Acromioclavicular joint reconstruction by coracoid process transfer augmented with hook plate.

PubMed

Wang, Yeming; Zhang, Jianguo

2014-06-01

Various techniques have been reported for the treatment of chronic acromioclavicular (AC) joint separation. The purpose of this study was to evaluate the results of surgical construction of coracoclavicular ligament using coracoid process transfer augmented with a hook plate fixation. Twenty-one patients treated with coracoid process transfer augmented with a hook plate fixation for chronic type III and V AC injuries were retrospectively analysed in 2003-2009. The age of the patients ranged from 23 to 58 years with an average age of 41.6 years. The patients were followed up clinically and radiographically, with an average of 33.0 months. Functional status and the ability to return to work were recorded during follow-up. Constant score and visual analogue scale (VAS) for pain were measured. The mean Constant score has increased from 70.9 points preoperatively to 90.7 points at follow-up. The mean VAS score has decreased from 4.7 preoperatively to 1.2 at follow-up. The average abduction was 172°, forward flexion was 170° and external rotation was 56°. There were 10 excellent results, 10 good results and one fair result. All patients had resumed their job or returned to original sport activity at mean 3.7 months postoperatively. No reduction loss was observed after plate removal and the final follow-up. Despite retrospective nature of the study, the outcomes of surgical construction with process transfer augmented with hook plate fixation are promising for chronic type III and V AC injuries. Therapeutic level IV. Retrospective case series, treatment study. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Orientation and Variation of the Acromioclavicular Ligament: An Anatomic Study.

PubMed

Nakazawa, Masataka; Nimura, Akimoto; Mochizuki, Tomoyuki; Koizumi, Masahiro; Sato, Tatsuo; Akita, Keiichi

2016-10-01

Several biomechanical studies have shown that the acromioclavicular (AC) ligament prevents posterior translation of the clavicle in the horizontal plane. In anatomy textbooks, however, the AC ligament is illustrated as running straight across the AC joint surface. The AC ligament does not run straight across the joint surface, and the configuration of the AC ligament may vary. Descriptive laboratory study. We used 16 pairs of shoulder girdles in this study. After identifying the AC ligament, we macroscopically investigated the orientation and attachment of the ligament and measured the angle between the ligament and the line perpendicular to the AC joint surface by using a digital goniometer. In addition, the AC joint inclination angle was measured, and the Spearman rank correlation coefficient between the joint inclination and the ligament angle was calculated. Finally, we sought to classify the AC ligament based on its configuration. Of the 16 pairs of specimens, 3 pairs of shoulders were histologically examined. The AC ligament was divided into 2 parts: a bundle at the superoposterior (SP) part and a bundle at the anteroinferior (AI) part of the joint. The well-developed SP bundle was consistent and ran obliquely at an average ± SD 30° ± 6° in relation to the AC joint surface, from the anterior part of the acromion to the posterior part of the distal clavicle. The joint inclination was 70° ± 12°, and a negative moderate correlation was found between the joint inclination and the ligament angle (P = .02, r = -0.46). In comparison, the AI bundle was thin and narrow, and it could be categorized into 3 types according to its various configurations. The AC ligament could be separated into the SP bundle and the AI bundle. The SP bundle ran posteriorly toward the distal clavicle from the acromion at an average angle of 30° to the joint surface. Anatomic reconstruction, based on the current findings in combination with findings regarding the coracoclavicular

Quantification of dynamic posterior translation in modified bilateral Alexander views and correlation with clinical and radiological parameters in patients with acute acromioclavicular joint instability.

PubMed

Minkus, Marvin; Hann, Carmen; Scheibel, Markus; Kraus, Natascha

2017-06-01

Classification of AC-joint instability is based on radiologic evaluation of anteroposterior (a.p.) stress views of both shoulders, neglecting the horizontal component of instability. Recent studies have proposed an association of dynamic posterior translation (DPT) and inferior clinical results. The purpose of this study was to quantify DPT in modified Alexander views and correlate it with other radiological and clinical data. Thirty-two patients (4 f, 28 m, mean age 34.1) with acute AC-joint dislocation (16 = RW III, 16 = RW V) underwent radiological examination including bilateral a.p. stress views with measurement of the coracoclavicular distance (CCD) and bilateral modified Alexander views with different approaches to quantify DPT (overlapping area OA AC , overlapping length OL AC ). In addition, the Constant Score, Subjective Shoulder Value, Taft Score (TF), and the Acromioclavicular Joint Instability Score (ACJI) were obtained. In Rockwood (RW) type III injuries, a mean CCD of 15.8 (9.8-22.8) mm, OA AC of 50.9 (0-216.6) mm 2 , and OL AC of 6.5 (-4.7-17.9) mm were found. RW V patients showed a CCD of 23.1 (13.7-32.0) mm; OA AC 7.0 (0-92.3) mm 2 ; and OL AC -4.8 (-19.6-9.8) mm. Particularly in RW III the CCD, OA AC and OL AC revealed significant correlation with the ACJI (r = -0.64/r = 0.72/r = 0.68, p < 0.05) and TF (r = -0.56/r = 0.68/r = 0.51, p < 0.05). The proposed quantification tools for DPT were found to have a moderate-to-strong correlation with the score results, especially with AC-joint specific scores. RW type V injuries had a moderate correlation with clinical parameters (OA AC with ACJI: r = 0.44, p > 0.05 and OL AC with TF: r = -0.45, p > 0.05). Measuring the OL AC is a convenient way for quantifying DPT in modified Alexander views. It showed significant correlation with clinical scores, indicating the relevance of DPT in patients with AC-joint injury.

Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 1: Sternoclavicular, Acromioclavicular, and Scapulothoracic Joints

PubMed Central

LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

2015-01-01

STUDY DESIGN Cross-sectional. OBJECTIVES To compare sternoclavicular, acromioclavicular, and scapulothoracic joint motion between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Differences in scapulothoracic kinematics are associated with shoulder pain. Several studies have measured these differences using surface sensors, but the results of this technique may be affected by skin-motion artifact. Furthermore, previous studies have not included the simultaneous measurement of sternoclavicular and acromioclavicular joint motion. METHODS Transcortical bone pins were inserted into the clavicle, scapula, and humerus of 12 asymptomatic and 10 symptomatic individuals for direct, bone-fixed tracking using electromagnetic sensors. Angular positions for the sternoclavicular, acromioclavicular, and scapulothoracic joints were measured during shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups were found for sternoclavicular and scapulothoracic joint positions. Symptomatic individuals consistently demonstrated less sternoclavicular posterior rotation, regardless of angle, phase, or plane of shoulder motion. Symptomatic individuals also demonstrated less scapulothoracic upward rotation at 30° and 60° of humerothoracic elevation during shoulder abduction and scapular plane abduction. CONCLUSION The results of this study show that differences in shoulder complex kinematics exist between symptomatic and asymptomatic individuals. However, the magnitude of these differences was small, and the resulting clinical implications are not yet fully understood. The biomechanical coupling of the sternoclavicular and acromioclavicular joints requires further research to better understand scapulothoracic movement deviations and to improve manual therapy and exercise-based physical therapy interventions. PMID:25103135

[Design and clinical application of the drilling guide in the treatment of acromioclavicular joint dislocation with closed reduction and Kirschner fixation].

PubMed

Zhou, Song; Hao, Yong-qiang; Shi, Xiao-lin; Zhao, Huan-li; Gao, Kai-tuo; Sun, Jin-xu

2011-03-01

To investigate a drilling guide in the treatment of acromioclavicular joint dislocation with closed reduction and Kirschner fixation and explore the therapeutic effect. From June 2008 to December 2009, 36 patients with acromioclavicular joint dislocation (Tossy III) were treated with closed reduction and Kirschner fixation using a self-designed drilling guide as well as percutaneous repair of acromioclavicular joint. Among the patients, 24 patients were male and 12 patients were female,ranging in age from 20 to 61 years, averaged 38.6 years. The duration from injury to operation ranged from 3.5 to 72 h,with a mean of 15.2 h. No clavicle fracture was found in all cases. The operative time, intra-operative bleeding and therapeutic effects were observed. There were no complications including neurovascular problems. The mean operating time were 20 min,mean blood loss were about 10 ml. According to the observation of postoperative X-ray examination, all Kirschners in acromioclavicular joint were in place. All Kirschners were removed in 6 postoperative weeks. All the patients were followed up ranging from 2 to 26 months (averaged 14.3 months). According to the Karlsson standard,22 patients got an excellent result, 13 good and 1 poor. This method has following advantages: easy operation and fixation; minimum injuries to articular surface; and which would be widely used in clinical practice.

Surgical versus conservative management of Type III acromioclavicular dislocation: a systematic review.

PubMed

Longo, Umile Giuseppe; Ciuffreda, Mauro; Rizzello, Giacomo; Mannering, Nicholas; Maffulli, Nicola; Denaro, Vincenzo

2017-06-01

The management of Type III acromioclavicular (AC) dislocations is still controversial. We wished to compare the rate of recurrence and outcome scores of operative versus non-operative treatment of patients with Type III AC dislocations. A systematic review of the literature was performed by applying the PRISMA guidelines according to the PRISMA checklist and algorithm. A search in Medline, PubMed, Cochrane and CINAHL was performed using combinations of the following keywords: 'dislocation', 'Rockwood', 'type three', 'treatment', 'acromioclavicular' and 'joint'. Fourteen studies were included, evaluating 646 shoulders. The rate of recurrence in the surgical group was 14%. No statistical significant differences were found between conservative and surgical approaches in terms of postoperative osteoarthritis and persistence of pain, although persistence of pain seemed to occur less frequently in patients undergoing a surgical treatment. Persistence of pain seemed to occur less frequently in patients undergoing surgery. Persistence of pain seems to occur less frequently in patients treated surgically for a Type III AC dislocation. There is insufficient evidence to establish the effects of surgical versus conservative treatment on functional outcome of patients with AC dislocation. High-quality randomized controlled clinical trials are needed to establish whether there is a difference in functional outcome. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Arthroscopic treatment of acute acromioclavicular dislocations using a double button device: Clinical and MRI results.

PubMed

Loriaut, P; Casabianca, L; Alkhaili, J; Dallaudière, B; Desportes, E; Rousseau, R; Massin, P; Boyer, P

2015-12-01

Arthroscopic treatment of acute grade 3 and 4 acromioclavicular dislocation is controversial, due to the risk of recurrence and of postoperative reduction defect. The purpose of the present study was to investigate whether the healing of the acromioclavicular (AC) and coracoclavicular (CC) ligaments and the accurate 3D positioning parameters of the AC joint using MRI were correlated with satisfactory functional outcome. Thirty-nine patients were enrolled from 2009 to 2011 and managed arthroscopically by CC lacing using a double-button device. Clinical assessment included the Shoulder and Hand (QuickDash) score, Constant-Murley score and visual analog scale (VAS) for residual pain. Time and rate to return to work and return to sport were assessed according to type of sport and work. Postoperative complications were recorded. Radiological examination consisted of anteroposterior clavicle and lateral axillary radiographs. AC ligament healing and 3D joint congruency were assessed on MRI and correlated to the clinical results. Mean patient age was 35.7 years (range, 20-55). Mean follow-up was 42.3±10.6 months (range, 24-60). At final follow-up, mean QuickDash score, Constant score and VAS were respectively 1.7±4 (range, 0-11), 94.7±7.3 (range, 82-100) and 0.5±1.4 (range, 0-2). Thirty-five (90%) patients were able to resume work, including heavy manual labor, and sport. Radiology found accurate 3D joint congruency in 34 patients (87%) and CC and AC ligament healing in 36 (93%). Complications included reduction loss at 6 weeks in 3 patients, requiring surgical stabilization. Satisfactory functional results were associated with accurate AC joint congruency in the coronal and axial planes (P<0.05) and good AC and CC ligament healing (P<0.04). An initial 25% reduction defect in the coronal plane was not associated with poor functional results (P=0.07). Arthroscopic treatment by CC lacing satisfactorily restored ligament and joint anatomy in the present series. These

Comparative study on the treatment of Rockwood type III acute acromioclavicular dislocation: Clinical results from the TightRope® technique vs. K-wire fixation.

PubMed

Horst, K; Garving, C; Thometzki, T; Lichte, P; Knobe, M; Dienstknecht, T; Hofman, M; Pape, H-C

2017-04-01

The aim of this study was to address the inconsistency regarding the operative treatment of Rockwood type III acromioclavicular joint separation. We compared results after single- and double TightRope ® reduction with results after acromioclavicular transfixation via K-wires only and additional ligament augmentation in acute acromioclavicular (AC) joint separations graded Rockwood type III, and hypothesized that the TightRope ® technique leads to better clinical and radiological results. We conducted a retrospective clinical cohort study and included 42 consecutive patients (mean age 43 years [24-66]) diagnosed and operatively treated between 2004 and 2012 (mean follow-up was 54.6 months [15-118]). Specific shoulder scores as well as scores reflecting the patients' overall mental and physical health status were used. Radiological evaluation was also performed. The SF12 test revealed comparability between all subgroups. Specific shoulder tests and a visual analogue scale demonstrated comparable results. Radiographic measurements showed a significant reduction in the AC distance and CC distance after surgery in all subgroups. The early complication rate was 9.5% for all patients, while late complications occurred in 14.3% of all cases. Compared to the established methods, the operative TightRope ® procedures represent a safe alternative in Rockwood III injuries. All investigated techniques predominantly led to good and excellent clinical results in acute Rockwood type III AC joint instabilities. Avoidance of material removal and shorter hospital stays appear to speak in favour for the TightRope ® technique. IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Secondary infection of haematoma following closed acromioclavicular joint dislocation

PubMed Central

Dupley, Leanne; Berg, Andrew James; Mohil, Randeep

2016-01-01

An unusual case of a patient presenting with a large infected haematoma following a traumatic grade II acromioclavicular joint dislocation is reported. Diagnosis of this rare complication, of an otherwise common self-limiting injury, was delayed until 19 days postinjury despite several presentations during this time with worsening swelling and pain. The patient was found to have significant tissue destruction by the time washout was performed and required multiple procedures to treat the infection. This case highlights the need for a high index of suspicion for complications, even following common self-limiting injuries, when patients represent with symptoms that do not fit the usual natural history of the condition, particularly if they have risk factors for bleeding and infection. PMID:26786526

[CT measurement and clinical application of double-row suture anchor reconstruction for the treatment of Tossy type III acromioclavicular joint dislocation].

PubMed

Zhang, Chuan-Kai; Liu, Chen; Han, Bing; Feng, Hui; Chen, Qi-Zhong; Sunx, Sun Yi-Yan

2017-04-25

To study feasibility and reliability of reconstruction of the acromioclavicular ligament with double-row suture anchor for the treatment of acromioclavicular joint dislocation through coracoid coronal CT measurement, and to provide a new operation method for treating acromioclavicular joint dislocation. Total 60 healthy people received CT examination of shoulder joint, including 30 males and 30 females, ranging in age from 18 to 50 years old. The coronal width, thickness and 20 degree camber angle in the medial part of the toot of coronal were measured using CT scan. The results were applied to clinical treatment for 12 patients with acromioclavicular joint dislocation of Tossy III type. The width in the medial part of the root of the coracoid was(17.65±1.82) mm(left side) and (17.67±1.80) mm(right side) in males; (16.55±1.78) mm(left side) and (16.52±1.74) mm (right side) in females. The vertical thickness of the roots of the coracoid: (13.11±2.11) mm(left side) and (13.16±2.09) mm(right side) in males;(12.79±2.21) mm(left side) and (12.76±2.19) mm (right side) in females. The thickness of 20 degrees camber angle of the coracoid roots: (16.32±1.74) mm (left side) and (16.30±1.69) mm(right side) in males; (15.68±1.44) mm(left side) and (15.67±1.43) mm(right side) in females. Total 12 patients were treated with anchor nail with extraversion 20 degrees. The postoperative X-ray films showed bone anchors were located in the coracoid process, no bone splitting. Double-row suture anchor of 5 mm diameter nails can be placed into coracoid with extraversion 20 degrees, which is safety.

Base of coracoid process fracture with acromioclavicular dislocation in a child

PubMed Central

2010-01-01

Fracture of the coracoid process is a rare injury. It can be easily missed when associated with other injuries to the shoulder girdle, for instance, acromioclavicular joint (ACJ) dislocation. Clinical attention is easily drawn to the more obvious ACJ dislocation, hence, the need for further radiological evaluation. We report an unusual case of fracture of the base of coracoid process associated with a true acromioclavicular joint dislocation in a 12 year old boy, with no separation of the epiphyseal plate, as one might expect. Treatment also remains controversial. Our patient underwent open reduction internal fixation of the acromioclavicular joint and coracoid process. He subsequently made an uneventful progress with pain free full range of shoulder movement at 5 months, and was discharged at 9 months. PMID:20955595

The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

PubMed Central

2009-01-01

Background This study was aimed at evaluating whether or not patients with chronic type III acromioclavicular dislocation develop cervical spine pain and degenerative changes more frequently than normal subjects. Methods The cervical spine of 34 patients with chronic type III AC dislocation was radiographically evaluated. Osteophytosis presence was registered and the narrowing of the intervertebral disc and cervical lordosis were evaluated. Subjective cervical symptoms were investigated using the Northwick Park Neck Pain Questionnaire (NPQ). One-hundred healthy volunteers were recruited as a control group. Results The rate and distribution of osteophytosis and narrowed intervertebral disc were similar in both of the groups. Patients with chronic AC dislocation had a lower value of cervical lordosis. NPQ score was 17.3% in patients with AC separation (100% = the worst result) and 2.2% in the control group (p < 0.05). An inverse significant nonparametric correlation was found between the NPQ value and the lordosis degree in the AC dislocation group (p = 0.001) wheras results were not correlated (p = 0.27) in the control group. Conclusions Our study shows that chronic type III AC dislocation does not interfere with osteophytes formation or intervertebral disc narrowing, but that it may predispose cervical hypolordosis. The higher average NPQ values were observed in patients with chronic AC dislocation, especially in those that developed cervical hypolordosis. PMID:20015356

Anatomical Evaluation of the Proximity of Neurovascular Structures During Arthroscopically Assisted Acromioclavicular Joint Reconstruction: A Cadaveric Pilot Study.

PubMed

Banaszek, Daniel; Pickell, Michael; Wilson, Evan; Ducsharm, Melissa; Hesse, Daniel; Easteal, Ron; Bardana, Davide D

2017-01-01

The purpose of this study was to examine the safety of an arthroscopic technique for acromioclavicular joint (ACJ) reconstruction by investigating its proximity to important neurovascular structures. Six shoulders from 4 cadaveric specimens were used for ACJ reconstruction in this study. The procedure consists of performing an arthroscopic acromioclavicular (AC) reduction with a double button construct, followed by coracoclavicular ligament reconstruction without drilling clavicular tunnels. Shoulders were subsequently dissected in order to identify and measure distances to adjacent neurovascular structures. The suprascapular artery and nerve were the closest neurovascular structures to implanted materials. The mean distances were 8.2 (standard deviation [SD] = 3.6) mm to the suprascapular nerve and 5.6 (SD = 4.2) mm to the suprascapular artery. The mean distance of the suprascapular nerve from implants was found to be greater than 5 mm (P = .040), while the distance to the suprascapular artery was not (P > .5). Neither difference was statistically significant (P = .80 for artery; P = .08 for nerve). Mini-open, arthroscopically assisted ACJ reconstruction safely avoids the surrounding nerves, with no observed damage to any neurovascular structures including the suprascapular nerve and artery, and may be a viable alternative to open techniques. However, surgeons must remain cognizant of possible close proximity to the suprascapular artery. This study represents an evaluation of the safety and feasibility of a minimally invasive ACJ reconstruction as it relates to the proximity of neurovascular structures. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

BiPOD Arthroscopic Acromioclavicular Repair Restores Bidirectional Stability.

PubMed

De Beer, Joe; Schaer, Michael; Latendresse, Kim; Raniga, Sumit; Moor, Beat K; Zumstein, Matthias A

2017-01-01

Stabilizing the acromioclavicular joint in the vertical and horizontal planes is challenging, and most current techniques do not reliably achieve this goal. The BiPOD repair is an arthroscopically assisted procedure performed with image intensifier guidance that reconstructs the coracoclavicular ligaments as well as the acromioclavicular ligaments to achieve bidirectional stability. Repair is achieved with a combination of 2-mm FiberTape (Arthrex, Naples, Florida) and 20-mm Poly-Tape (Neoligaments, Leeds, England) to achieve rigid repair, prevent bone abrasion, and promote tissue ingrowth. This study is a prospective review of the first 6 patients treated for high-grade acute acromioclavicular injury with the BiPOD technique. The study included 6 men who were 21 to 36 years old (mean, 27 years). At 6-month follow-up, complications were recorded and radiographic analysis was used to determine the coracoclavicular distance for vertical reduction and the amount of acromioclavicular translation on the Alexander axillary view was used to determine horizontal reduction. One patient had a superficial infection over the tape knot. The difference in coracoclavicular distance between the operated side and the uninvolved side was 9±2 mm preoperatively and 0.3±2 mm at 6-month follow-up. On Alexander axillary view, all 6 patients showed stable reduction, which is defined as a clavicle that is in line with the acromion. The findings show that BiPOD acromioclavicular reconstruction restores bidirectional stability of the acromioclavicular joint at 6 months. [Orthopedics. 2017; 40(1):e35-e43.]. Copyright 2016, SLACK Incorporated.

Acromioclavicular Joint Fixation Using an Acroplate Combined With a Coracoclavicular Screw

PubMed Central

Tavakoli Darestani, Reza; Ghaffari, Arash; Hosseinpour, Mehrdad

2013-01-01

Background Appropriate treatment of acromioclavicular joint dislocation is controversial. Acroplate fixation is one of the most common treatment methods of acromioclavicular joint (ACJ) dislocation. Based on the risk of re-dislocation after Acroplate fixation, we assumed that combined fixation with an Acroplate and a coracoclavicular screw helps improve the outcome. Objectives The main purpose of the current study was to compare the outcome of ACJ dislocation treated with an Acroplate alone and in combination with coracoclavicular screw. Patients and Methods This study was carried out on 40 patients with ACJ dislocation types III to VI who were divided randomly into two equal groups: Acroplate group (P) and Acroplate in combination with coracoclavicular screw group (P + S). The screws were extracted 3-6 months postoperatively. The patients were followed for 1 year and Imatani’s score was calculated. Finally, the data were compared between the groups. Results The mean Imatani’s score was significantly higher in P + S group (83.4 ± 14.1) than P group (81.2 ± 10.3) (P < 0.001). The mean duration of surgery was the same in the two groups (59.8 ± 9.4 minutes in group P V.s 64.3 ± 10.9 minutes in group P + S; P = 0.169). There were no cases of re-dislocation, degenerative changes and ossification and all patients returned to their previous jobs or sporting activities. Conclusions Using a coracoclavicular screw combined with an Acroplate can improve the patients’ function after ACJ disruption without any significant increase in surgical duration. Authors recommend this technique in the fixation of ACJ dislocation. PMID:24396788

Is coracoclavicular stabilisation alone sufficient for the endoscopic treatment of severe acromioclavicular joint dislocation (Rockwood types III, IV, and V)?

PubMed

Barth, J; Duparc, F; Andrieu, K; Duport, M; Toussaint, B; Bertiaux, S; Clavert, P; Gastaud, O; Brassart, N; Beaudouin, E; De Mourgues, P; Berne, D; Bahurel, J; Najihi, N; Boyer, P; Faivre, B; Meyer, A; Nourissat, G; Poulain, S; Bruchou, F; Ménard, J F

2015-12-01

The primary objective was to evaluate correlations linking anatomical to functional outcomes after endoscopically assisted repair of acute acromioclavicular joint dislocation (ACJD). Combined acromioclavicular and coracoclavicular stabilisation improves radiological outcomes compared to coracoclavicular stabilisation alone. A prospective multicentre study was performed. Clinical outcome measures were pain intensity on a visual analogue scale (VAS), subjective functional impairment (QuickDASH score), and Constant's score. Anatomical outcomes were assessed on standard radiographs (anteroposterior view of the acromioclavicular girdle and bilateral axillary views) obtained preoperatively and postoperatively and on postoperative dynamic radiographs taken as described by Tauber et al. Of 116 patients with acute ACJD included in the study, 48% had type III, 30% type IV, and 22% type V ACJD according to the Rockwood classification. Coracoclavicular stabilisation was achieved using a double endobutton in 93% of patients, and concomitant acromioclavicular stabilisation was performed in 50% of patients. The objective functional outcome was good, with an unweighted Constant's score ≥ 85/100 and a subjective QuickDASH functional disability score ≤ 10 in 75% of patients. The radiographic analysis showed significant improvements from the preoperative to the 1-year postoperative values in the vertical plane (decrease in the coracoclavicular ratio from 214 to 128%, p=10(-6)) and in the horizontal plane (decrease in posterior displacement from 4 to 0mm, p=5×10(-5)). The anatomical outcome correlated significantly with the functional outcome (absolute R value=0.19 and p=0.045). We found no statistically significant differences across the various types of constructs used. Intra-operative control of the acromioclavicular joint did not improve the result. Implantation of a biological graft significantly improved both the anatomical outcome in the vertical plane (p=0.04) and

The surgical treatment of acromioclavicular joint injuries

PubMed Central

Boffano, Michele; Mortera, Stefano; Wafa, Hazem; Piana, Raimondo

2017-01-01

Acromioclavicular joint (ACJ) injuries are common, but their incidence is probably underestimated. As the treatment of some sub-types is still debated, we reviewed the available literature to obtain an overview of current management. We analysed the literature using the PubMed search engine. There is consensus on the treatment of Rockwood type I and type II lesions and for high-grade injuries of types IV, V and VI. The treatment of type III injuries remains controversial, as none of the studies has proven a significant benefit of one procedure when compared with another. Several approaches can be considered in reaching a valid solution for treating ACJ lesions. The final outcome is affected by both vertical and horizontal post-operative ACJ stability. Synthetic devices, positioned using early open or arthroscopic procedures, are the main choice for young people. Type III injuries should be managed surgically only in cases with high-demand sporting or working activities. Cite this article: EFORT Open Rev 2017;2:432–437. DOI: 10.1302/2058-5241.2.160085. PMID:29209519

Evaluation and management of adult shoulder pain: a focus on rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral arthritis.

PubMed

Armstrong, April

2014-07-01

Shoulder pain is a common reason for a patient to see their primary care physician. This article focuses on the evaluation and management of 3 common shoulder disorders; rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral joint arthritis. The typical history and physical examination findings for each of these entities are highlighted, in addition to treatment options. Copyright © 2014 Elsevier Inc. All rights reserved.

Modeling of Human Joint Structures.

DTIC Science & Technology

1982-09-01

Acromioclavicular Joint .... ............. ... 20 Glenohumeral Joint .... ................ . 20 HIP JOINT .................. ...... 21 Iliofemoral Ligament...clavicle articulates with the manubrium of the sternum, and the acromioclavicular joint, where the clavicle articulates with the acromion process of the...the interclavicular ligament. Acromioclavicular Joint This articulation between the distal end of the clavicle and the acromion of the scapula is

Biomechanical evaluation of a novel reverse coracoacromial ligament reconstruction for acromioclavicular joint separation.

PubMed

Shu, Beatrice; Johnston, Tyler; Lindsey, Derek P; McAdams, Timothy R

2012-02-01

Enhancing anterior-posterior (AP) stability in acromioclavicular (AC) reconstruction may be advantageous. To compare the initial stability of AC reconstructions with and without augmentation by either (1) a novel "reverse" coracoacromial (CA) ligament transfer or (2) an intramedullary AC tendon graft. Reverse CA transfer will improve AP stability compared with isolated coracoclavicular (CC) reconstruction. Controlled laboratory study. Six matched pairs of cadaveric shoulders underwent distal clavicle resection and CC reconstruction. Displacement (mm) was measured during cyclic loading along AP (±25 N) and superior-inferior (SI; 10-N compression, 70-N tension) axes. Pairs were randomized to receive each augmentation and the same loading protocol applied. Reverse CA transfer (3.71 ± 1.3 mm, standard error of the mean [SEM]; P = .03) and intramedullary graft (3.41 ± 1.1 mm; P = .03) decreased AP translation compared with CC reconstruction alone. The SI displacement did not differ. Equivalence tests suggest no difference between augmentations in AP or SI restraint. Addition of either reverse CA transfer or intramedullary graft demonstrates improved AP restraint and provides similar SI stability compared with isolated CC reconstruction. Reverse CA ligament transfer may be a reasonable alternative to a free tendon graft to augment AP restraint in AC reconstruction.

Clinical therapeutic effects of AO/ASIF clavicle hook plate on distal clavicle fractures and acromioclavicular joint dislocations.

PubMed

Dou, Qingjun; Ren, Xiaofeng

2014-07-01

The aim of this study was to evaluate the security and effectiveness of AO/ASIF clavicle hook plate in the treatment of distal clavicle fractures and acromioclavicular joint dislocations. One hundred patients with distal clavicle fractures and acromioclavicular joint dislocations who were admitted in our hospital from January 2012 to January 2013 were selected as the study subjects. They were then randomly divided into a control group and an observation group (n=50). The observation group was treated with AO/ASIF clavicle hook plates, and the control group was treated with Kirschner-wire tension bands. The outcomes were recorded and compared. The JOA scores of the two groups were similar before surgery (P>0.05). The two groups both had obviously increased JOA scores in the postoperative 6th and 12th weeks, and the score in the postoperative 12th week was higher. There were statistically significant intra-group differences (P<0.05). The postoperative 6th-week and 12th-week JOA scores of the observation group were (83.2±1.8) and (97.4±1.5) respectively, and those of the control group were (71.6±2.2) and (82.3±2.6) respectively, with statistically significant inter-group differences (P<0.05). Significantly more patients in the observation group (100%) were evaluated as excellent or good outcomes after fixation than those in the control group (60%). After removal of the surgical apparatus, the recurrence rates of bone fracture and joint dislocation in the observation group were significantly lower than those of the control group (P<0.05). AO/ASIF clavicle hook plate functioned more effectively than Kirschner-wire tension band in clinical treatment of distal clavicle fractures and acromioclavicular joint dislocations. The former protocol enjoyed small incisions, firm fixation and early shoulder mobility. Therefore, it is a safe and effective surgical method that is worthy of being widely applied in clinical practice.

Comparison of the Tight Rope Technique and Clavicular Hook Plate for the Treatment of Rockwood Type III Acromioclavicular Joint Dislocation.

PubMed

Cai, Leyi; Wang, Te; Lu, Di; Hu, Wei; Hong, Jianjun; Chen, Hua

2018-06-01

Acromioclavicular joint dislocation is one of the most common shoulder problems and may lead to instability or degenerative changes. The aim of this study was to compare the clinical outcomes of the Tight Rope system and clavicular hook plate for Rockwood type III acromioclavicular joint dislocation in adults. This was a prospective, randomized study in a hospital setting. From January 2012 to December 2014, 69 patients with type III injury were reviewed. Patients were randomly divided into two groups: Group A was treated using the TightRope system and Group B with the clavicular hook plate. All participants were followed up for 12 months. Clinical outcomes, radiological results and postoperative complications were recorded. The length of incision was significantly shorter in Goup A than that in Group B. The blood loss of surgery was significantly less in the Group A. Significant difference could be found between the two groups regarding the Visual Analogue Scale scores one day after surgery, at the 3 and 12 months follow-up. There were no differences according to the improvement of the Constant-Murley score and the coracoclavicular distance between the groups. The two groups have similar clinical and radiological outcomes. Both treatments could relieve the pain of dislocation, improve the function of Acromioclavicular joint and rectify the coracoclavicular distance measured in plain films. However, the TightRope system exhibited some advantages in terms of length of incision, blood loss of surgery, the pain postoperatively and no need for a second surgery.

Radiographic failure and rates of re-operation after acromioclavicular joint reconstruction: a comparison of surgical techniques.

PubMed

Spencer, H T; Hsu, L; Sodl, J; Arianjam, A; Yian, E H

2016-04-01

To compare radiographic failure and re-operation rates of anatomical coracoclavicular (CC) ligament reconstructional techniques with non-anatomical techniques after chronic high grade acromioclavicular (AC) joint injuries. We reviewed chronic AC joint reconstructions within a region-wide healthcare system to identify surgical technique, complications, radiographic failure and re-operations. Procedures fell into four categories: (1) modified Weaver-Dunn, (2) allograft fixed through coracoid and clavicular tunnels, (3) allograft loop coracoclavicular fixation, and (4) combined allograft loop and synthetic cortical button fixation. Among 167 patients (mean age 38.1 years, (standard deviation (sd) 14.7) treated at least a four week interval after injury, 154 had post-operative radiographs available for analysis. Radiographic failure occurred in 33/154 cases (21.4%), with the lowest rate in Technique 4 (2/42 4.8%, p = 0.001). Half the failures occurred by six weeks, and the Kaplan-Meier survivorship at 24 months was 94.4% (95% confidence interval (CI) 79.6 to 98.6) for Technique 4 and 69.9% (95% CI 59.4 to 78.3) for the other techniques when combined. In multivariable survival analysis, Technique 4 had better survival than other techniques (Hazard Ratio 0.162, 95% CI 0.039 to 0.068, p = 0.013). Among 155 patients with a minimum of six months post-operative insurance coverage, re-operation occurred in 9.7% (15 patients). However, in multivariable logistic regression, Technique 4 did not reach a statistically significant lower risk for re-operation (odds ratio 0.254, 95% CI 0.05 to 1.3, p = 0.11). In this retrospective series, anatomical CC ligament reconstruction using combined synthetic cortical button and allograft loop fixation had the lowest rate of radiographic failure. Anatomical coracoclavicular ligament reconstruction using combined synthetic cortical button and allograft loop fixation had the lowest rate of radiographic failure. ©2016 The British Editorial

[Analysis on the long-term effects of modified double endobutton technique in the treatment of Tossy type III acromioclavicular joint dislocations].

PubMed

Yan, Rui-Jian; Lu, Jian-Wei; Zhang, Chun

2014-01-01

To investigate the long-term clinical effects of modified double Endobutton technique for the treatment of acromioclavicular joint dislocations of Tossy type III. A retrospective study was done in 42 patients with acromioclavicular joint dislocations of Tossy type III treated with modified double Endobutton technique from December 2008 to December 2010. There were 24 males and 18 females, ranging in age from 21 to 56 years old (averaged, 32.5 years old). All the patients were treated with open reduction, coracoclavicular ligament reconstruction using double Endobutton technique, and repair of acromioclavicular ligament. The Karlsson system was used to evaluate therapeutic effects. The distance from coracoid to clavicle was measured to evaluate reduction loss. All the patients were followed up, and the duration ranged from 2.0 to 3.2 years (averaged,2.4 years). According to Karlsson system, 32 patients got an A degree and 10 patients got a B degree at three months post-operatively; 26 patients got an A degree and 16 patients got a B degree at the latest follow-up; 6 patients got an A degree at 3 months after operation lowered to B degree at the latest follow-up. The coracoid-clavicle distance increased from (26.91 +/- 0.91) mm at 3 months after operation to (27.41 +/- 1.10) mm at the latest follow-up. Te patients treated with over-reduction during operation or with heavy physical labour work after operation had obvious widened coracoid-clavicle distance. Bone absorption was found around the plate in most cases, mainly in the clavicular side. Treatment for acromioclavicular joint dislocations of Tossy type III with modified double Endobutton technique has satisfactory early clinical results. But with time passing, loss of reduction and bone absorption around the plate could be observed, and clinical outcomes of some cases downgrade during the long-term follow-up.

Morphological analysis of acromion and hook plate for the fixation of acromioclavicular joint dislocation.

PubMed

Yoon, Jong Pil; Lee, Yeon Soo; Song, Geun Soo; Oh, Joo Han

2017-03-01

Acromioclavicular (AC) joint dislocation is a common sports injury. Hook plate fixation is currently widely used to treat this injury, as it can promote the natural healing of the ligament with good clinical outcomes. However, subacromial erosion and impingement are frequently observed post-operatively. It was hypothesized that the morphology and the contact characteristics between the hook portion and the acromion are the main causes of complications after hook plate fixation with the currently available commercial designs. Three-dimensional reconstructed models of the AC joint obtained from the computed tomographic scans of 23 male and 23 female patients (mean age, 61.1 ± 6.3 years) were evaluated, and multiple anatomical parameters were measured. For the subacromial positioning of the hook plate, an actual hook plate (Synthes Inc., West Chester, PA, USA) was scanned, and the contact between the hook plate and the acromion was estimated. The thicknesses of the acromion and distal clavicle were 9.7 ± 1.5 mm (10.7 mm in men; 8.6 mm in women) and 11.3 ± 1.6 mm (11.6 mm in men; 10.0 mm in women), respectively. The width of the acromion was 28.5 ± 3.6 mm. The mean inclination angle between the hook plate and the acromion was 29.3° ± 9.7° (27.9° in men; 30.6° in women). The hook plate made a point contact with the acromion at 9.2 ± 3.3 mm (31.5 %) from the lateral end of the acromion. The results revealed that the hook made a pinpoint contact with the undersurface of the acromion, and this might explain why complications commonly occur after hook plate fixation. The force concentration phenomenon associated with the hook plate of existing designs results from cases of morphological mismatch, such as excessive inclination and improper occupation of the subacromial space.

[COMPARISON OF EFFECTIVENESS BETWEEN TWO OPERATIVE TECHNIQUES OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION FOR TREATMENT OF Tossy TYPE III ACROMIOCLAVICULAR JOINT DISLOCATION].

PubMed

Tang, Hongwei; Gao, Sheng; Yin, Yong; Li, Yunfei; Han, Qingtian; Li, Huizhang

2015-11-01

To evaluate and compare the effectiveness of double Endobutton technique and suture anchor combined Endobutton plate in the treatment of Tossy type III acromioclavicular joint dislocation. Between May 2010 and March 2014, a retrospective study was preformed on 56 patients with Tossy type III acromioclavicular joint dislocation. The coracoclavicular ligament was reconstructed with double Endobutton technique in 31 cases (Endobutton group), and with suture anchor combined Endobutton plate in 25 cases (Anchor group). There was no significant difference in age, gender, injury causes, injury side, associated injury, medical comorbidities, and disease duration between 2 groups (P>0.05). The operation time, medical device expenses, postoperative complications, preoperative and postoperative Constant-Murley scores, and postoperative Karlsson grading of the injured shoulder were compared between 2 groups. The average operation time in Endobutton group was significantly greater than that in Anchor group (t = 4.285, P = 0.000); there was no significant difference in the medical device expenses between 2 groups (t = 1.555, P = 0.126). Primary healing of incision was obtained in all patients of 2 groups; no early complications of infection and skin necrosis occurred. All patients were followed up 15.6 months on average (range, 11-35 months). During follow-up, some loss of reduction and ectopic ossification in the coracoclavicular gap were observed in 1 case and 6 cases of Endobutton group, respectively. No recurrence of acromioclavicular joint dislocation, implant fixation loosening and broken, and secondary fractures occurred in the other patients. There was significant difference in the incidence of postoperative complications between 2 groups (P = 0.013). Constant-Murley scores of the injured shoulder significantly increased at 9 months after operation when compared with preoperative values in 2 groups (P < 0.05), but no significant difference was observed between 2 groups

Minimally invasive reconstruction of acute type IV and Type V acromioclavicular separations.

PubMed

Katsenis, Dimitris L; Stamoulis, Dimitris; Begkas, Dimitris; Tsamados, Stamatis

2015-04-01

The goal of this study was to evaluate the midterm radiologic, clinical, and functional results of the early reconstruction of the severe acromioclavicular joint dislocation using the flipptack fixation button technique. Between December 2006 and December 2009, one hundred thirty-five consecutive patients with acromioclavicular joint separations were admitted to the authors' institution. Fifty patients were included in the study. According to Rockwood classification, 29 (58%) dislocations were type IV and 21 (42%) were type V. Surgery was performed at an average of 4.2 days (range, 0-12 days) after dislocation. All dislocations were treated with the flipptack fixation button technique. All patients were evaluated at a final postoperative follow-up of 42 months (range, 36-49 months). The clinical outcome was assessed using the Constant score. The functional limitation was assessed using the bother index of the short Musculoskeletal Function Assessment. Radiographs taken immediately postoperatively and at the final follow-up assessed acromioclavicular joint reduction, coracoclavicular distance, and joint arthrosis. At the final follow-up, mean Constant score was 93.04 (range, 84-100). The average (±SD) short Musculoskeletal Function Assessment bother index was 20.88±8.95 (range, 2.0-49). No statistically significant difference was found between the acromioclavicular joint dislocation type and the clinical result (P=.227; chi-square, 6.910, Kruskal Wallis test). The regression of the coracoclavicular distance at final follow-up was not statistically significant (P=.276; chi-square, 6.319, Kruskal Wallis test). The flipptack fixation button technique is an effective alternative for the treatment of severe acromioclavicular joint dislocation. Because all objectives of the treatment were obtained, the results do not deteriorate over time. Copyright 2015, SLACK Incorporated.

[Treatment of complete acromioclavicular joint dislocation with transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament].

PubMed

Dong, Wen-Wei; Shi, Zeng-Yuan; Liu, Zheng-Xin; Mao, Hai-Jiao

2015-04-01

To explore the operation methods and clinical effects of transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament in treating complete acromioclavicular joint dislocation. From January 2006 to June 2012,26 patients with acute complete acromioclavicular joint dislocation underwent surgery. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional clavical hoot plate and Kirschner wires fixation, were performed in all the patients. Among the patients, 18 patients were male and 8 patients were female, with an average age of 36.7 years old (ranged from 25 to 51 years). The duration from injury to operation was from 3 to 12 days with an average of 5 days. According to the Rockwood classification, 4 cases were grade III and 22 cases were grade V . Clinical manifestation included local swelling, tenderness with snapping, limitation of shoulder joint motion. In preoperative bilateral shoulder joint X-rays, the injured coracoclavicular distance was (16.2 ± 5.0) mm which was significantly wider than that of uninjured sides (7.6 ± 1.0) mm. Clinical results were evaluated according to X-rays and Constant-Murley score. All incisions obtained primary healing after operation without complication of infection, internal fixation breakage, redislocation. All the patients were followed up from 12 to 30 months with an average of 18 months. Kirschner wires and internal fixation plate were removed at 1 month and 8-10 months after operation, respectively. At final follow-up, the motion of shoulder joint recovered to normal and a no pain joint was obtained. According to Constant-Murley score, 24 cases got excellent results and 2 cases good. There was no significant difference after operation between the injured coracoclavicular distance and the uninjured contralateral side [(7.7 ± 1.2) mm vs (7.6 ± 1.0) mm), P > 0.05]. Transfer of the medial half of the coracoacromial ligament to

[Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament at stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V].

PubMed

Hu, Wen-yue; Yu, Chong; Huang, Zhong-ming; Han, Lei

2015-06-01

To explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V . From January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects. All patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up. Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Biomechanical Analysis of Implanted Clavicle Hook Plates With Different Implant Depths and Materials in the Acromioclavicular Joint: A Finite Element Analysis Study.

PubMed

Lee, Cheng-Hung; Shih, Cheng-Min; Huang, Kui-Chou; Chen, Kun-Hui; Hung, Li-Kun; Su, Kuo-Chih

2016-11-01

Clinical implantation of clavicle hook plates is often used as a treatment for acromioclavicular joint dislocation. However, it is not uncommon to find patients that have developed acromion osteolysis or had peri-implant fracture after hook plate fixation. With the aim of preventing complications or fixation failure caused by implantation of inappropriate clavicle hook plates, the present study investigated the biomechanics of clavicle hook plates made of different materials and with different hook depths in treating acromioclavicular joint dislocation, using finite element analysis (FEA). This study established four parts using computer models: the clavicle, acromion, clavicle hook plate, and screws, and these established models were used for FEA. Moreover, implantations of clavicle hook plates made of different materials (stainless steel and titanium alloy) and with different depths (12, 15, and 18 mm) in patients with acromioclavicular joint dislocation were simulated in the biomechanical analysis. The results indicate that deeper implantation of the clavicle hook plate reduces stress on the clavicle, and also reduces the force applied to the acromion by the clavicle hook plate. Even though a clavicle hook plate made of titanium alloy (a material with a lower Young's modulus) reduces the force applied to the acromion by the clavicle hook plate, slightly higher stress on the clavicle may occur. The results obtained in this study provide a better reference for orthopedic surgeons in choosing different clavicle hook plates for surgery. Copyright © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Acute high-grade acromioclavicular dislocations treated with triple button device (MINAR): Preliminary results.

PubMed

Cano-Martínez, José Antonio; Nicolás-Serrano, Gregorio; Bento-Gerard, Julio; Picazo-Marín, Francisco; Andrés-Grau, Josefina

2016-11-01

Describe the clinical and radiological results of triple button device in the treatment of high-grade AC dislocations (Rockwood, type V) and assess whether improves vertical and horizontal stability compared to the techniques previously described. This retrospective study included 39 patients with type V acromioclavicular dislocations treated with Twin Tail TightRope™ system (triple button device). Of the 39 patients, 33 (26 men and 7 women) were able to participate in clinical and radiographic follow up. At the time of surgery, the mean age was 25years±7(range, 17-49). All patients underwent bilateral-weighted Zanca (CC distance) and Alexander view (AC distance) as well as the Constant Score (CS) and Acromioclavicular Joint Instability Scoring System (ACJI). Radiological and clinical outcome was assessed during routine follow-up examinations preoperatively, postoperatively, 1, 3, 6 months and every year after the surgery. The presence of calcification, degenerative changes, mobilization of implants and bone resorption were also assessed. After a mean follow up of 25±4months (range 14-38), the results of the Constant (CS) were 94.1±5,5 (range 76-100) and test ACJI 87.3±9,8 (range 65-100), showing no significant differences with the uninjured shoulder (CS 95.8±2.5, range 83-100; ACJI 94.1±3.7, range 80-100). At final review, we observed that preoperative coracoclavicular distance (Zanca View) improved from 21,75±1.97mm to 8,73mm±0.75 and the acromioclavicular distance (Alexander View) from 12,65mm±1.99 to 0,35±0.3mm. Compared with healthy shoulder, these differences were not significant. There was no loss of reduction with this system in the vertical plane. 4 patients (12.12%) revealed signs of posterior instability with worse clinical test results. The presence of degenerative joint changes (6,06%), calcifications (27,2%) or mobilization of the implant (18,18%) was not associated with worse clinical outcomes. Twin Tail device using minimally invasive

ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

PubMed Central

GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

2015-01-01

Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

Sports activity after anatomic acromioclavicular joint stabilisation with flip-button technique.

PubMed

Porschke, Felix; Schnetzke, Marc; Aytac, Sara; Studier-Fischer, Stefan; Gruetzner, Paul Alfred; Guehring, Thorsten

2017-07-01

Sports activity after surgical AC joint stabilisation has not been comprehensively evaluated to date. The aim of this study was to determine rate, level and time to return to sports after AC joint stabilisation and to identify the influence of overhead sports on post-operative sports activity. In this retrospective case series, a total of 68 patients with a high-grade AC joint dislocation (Rockwood type V) were stabilised using a single TightRope technique. Fifty-five patients (80.9 %) with median age of 42.0 (range, 18-65) years completed questionnaires regarding sports activity before and after surgery. Clinical outcome and complications were also evaluated. Forty-three patients participated in sports regularly before injury. Their sports activity was rated according to Allain, and non-overhead and overhead sports were differentiated. At median follow-up of 24 (18-45) months, 41 of 43 patients (95.3 %) had returned to sports. 63 % returned to the same sports activity as before injury. 16.3 % needed to adapt the type of sports to reduce demanding activities. 11.6 % reduced the frequency and 32.5 % the intensity of sports. The median time to return to sports was 9.5 (3-18) months. Overhead athletes (Allain Type III and IV) had to reduce their sports activity significantly more often (11.8 vs. 53.8 %; p = 0.011) and needed more time to return to sports (9.5 vs. 4.5 months; p = 0.009). After stabilisation of AC joint dislocation, the majority of patients returned to sports after a substantial period of time. Overhead athletes, in particular, required more time and had to considerably reduce their sports activity. The findings impact therapeutic decision-making after AC joint injury and help with the prognosis and assessment of rehabilitation progress. IV.

[Case-control study on shoulder pain caused by hook palte for the treatment of acromioclavicular joint dislocation].

PubMed

Yang, Ying-guo; Cai, Xiao-bing; Wang, Xiao-min; Zhu, Yong-gan; Pan, He-yong

2015-06-01

To explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation. From January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (Tossy III) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of (40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living (ADL), range of motion, deltoid muscle strength were compared. Anteflexion,rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared. All patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group ; while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5

[EFFECTIVENESS COMPARISON OF CORACOCLAVICULAR LIGAMENT RECONSTRUCTION BETWEEN BY AUTOLOGOUS AND ALLOGENEIC TENDON GRAFTS COMBINED WITH HOOK PLATE FIXATION FOR TREATING ACROMIOCLAVICULAR JOINT DISLOCATION].

PubMed

Yin, Fei; Sun, Zhenzhong; Wei, Xuming; Liu, Xueguang; Zhou, Ming; Zhuang, Yin; Song, Sheng

2016-05-08

To compare the effectiveness of coracoclavicular ligament reconstruction between by using autologous plantaris tendon graft combined with hook plate fixation and allogeneic tendon graft combined with hook plate fixation for treating acromiocavicular joint dislocation. Thirty-three patients with acromioclavicular joint dislocation who accorded with the inclusion criteria between January 2013 and June 2014 were assigned into 2 groups. The patients were treated with autologous plantaris tendon graft combined with hook plate fixation in group A ( n =17), and with allogeneic tendon graft combined with hook plate fixation in group B ( n =16). Thirteen-one patients was followed up more than 12 months (15 in group A and 16 in group B). There was no significant difference in gender, age, cause of injury, sides, time between injury and surgery, and type of dislocation ( P >0.05). The assessments included operation time, hospitalization time, hospitalization expenses, shoulder range of motion, gap of acromioclavicular, Constant-Murley scores, and visual analogue scale (VAS) for pain. The operation time of group A was significantly longer than that of group B, and the hospitalization expense was significantly lower than that of group B ( P <0.05). There was no significant difference in hospitalization time ( t =1.046, P =0.316). The incisions healed by first intention, and hook plate was removed after 3 months. The mean follow-up time was 21.3 months (range, 19-34 months) in group A and was 23.7 months (range, 18-37 months) in group B. X-ray examination showed no osteolysis. There was no significant difference in gap of acromiocavicular between 2 groups at preoperation, 1 week after operation, and last follow-up ( P >0.05). No redislocation of acromioclavicular joint and rejection reaction occurred during follow-up. At last follow-up, there was no significant difference in shoulder range of motion, Constant-Murley score, and VAS score between 2 groups ( P >0

Clinical factors that affect perceived quality of life in arthroscopic reconstruction for acromioclavicular joint dislocation.

PubMed

Abat, F; Gich, I; Natera, L; Besalduch, M; Sarasquete, J

To analyse the results of arthroscopic repair of acromioclavicular dislocation in terms of health-related quality of life. Prospective study of patients with acromioclavicular dislocation Rockwood grade iii-v, treated arthroscopically with a mean follow up of 25.4 months. The demographics of the series were recorded and evaluations were performed preoperatively, at 3 months and 2 years with validated questionnaires as Short Form-36 Health Survey (SF-36), visual analogue scale (VAS), The Disabilities of the Arm, Shoulder and Hand (DASH), Constant-Murley Shoulder Outcome Score (Constant) and Walch-Duplay Score (WD). Twenty patients, 17 men and 3 women with a mean age of 36.1 years, were analysed. According to the classification of Rockwood, 3 patients were grade iii, 3 grade iv and 14 grade v. Functional and clinical improvement was detected in all clinical tests (SF-36, VAS and DASH) at 3 months and 2 years follow up (P<.001). The final Constant score was 95.3±2.4 and the WD was 1.8±0.62. It was not found that the health-related quality of life was affected by any variable studied except the evolution of DASH. The health-related quality of life (assessed by SF-36) in patients undergoing arthroscopic repair of acromioclavicular joint dislocation grades iii-v was not influenced by gender, age, grade, displacement, handedness, evolution of the VAS, scoring of the Constant or by the WD. However, it is correlated with the evolution in the DASH score. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Ultrasound of the coracoclavicular ligaments in the acute phase of an acromioclavicular disjonction: Comparison of radiographic, ultrasound and MRI findings.

PubMed

Faruch Bilfeld, Marie; Lapègue, Franck; Chiavassa Gandois, Hélène; Bayol, Marie Aurélie; Bonnevialle, Nicolas; Sans, Nicolas

2017-02-01

Acromioclavicular joint injuries are typically diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. The purpose of this study was to describe how the ultrasound findings of acromioclavicular joint injury compare with radiography and MRI findings. Forty-seven patients with suspected unilateral acromioclavicular joint injury after acute trauma were enrolled in this prospective study. All patients underwent digital radiography, ultrasound and 3T MRI. A modified Rockwood classification was used to evaluate the coracoclavicular ligaments. The classifications of acromioclavicular joint injuries diagnosed with radiography, ultrasound and MRI were compared. MRI was used as the gold standard. The agreement between the ultrasound and MRI findings was very good, with a correlation coefficient of 0.83 (95 % CI: 0.72-0.90; p < 0.0001). Ultrasound detected coracoclavicular ligament injuries with a sensitivity of 88.9 %, specificity of 90.0 %, positive predictive value of 92.3 % and negative predictive value of 85.7 %. The agreement between the ultrasound and radiography findings was poor, with a correlation coefficient of 0.69 (95 % CI: 0.51-0.82; p < 0.0001). Ultrasound is an effective examination for the diagnostic work-up of lesions of the coracoclavicular ligaments in the acute phase of an acromioclavicular injury. • Ultrasound is appropriate for acute acromioclavicular trauma due to its accessibility. • Ultrasound contributes to the diagnostic work-up of acute lesions of the coracoclavicular ligaments. • Ultrasound is appropriate in patients likely to benefit from surgical treatment. • Ultrasound could be a supplement to standard radiography in acute acromioclavicular trauma.

A stress MRI of the shoulder for evaluation of ligamentous stabilizers in acute and chronic acromioclavicular joint instabilities.

PubMed

Izadpanah, Kaywan; Winterer, Jan; Vicari, Marco; Jaeger, Martin; Maier, Dirk; Eisebraun, Leonie; Ute Will, Jutta; Kotter, Elmar; Langer, Mathias; Südkamp, Norbert P; Hennig, Jürgen; Weigel, Mathias

2013-06-01

To show the feasibility of a stress magnetic resonance imaging (MRI) as a new method for simultaneous evaluation of the morphology and the functional integrity of the acromioclavicular joint (ACJ) ligamentous stabilizers. MRI of four volunteers, 10 patients with acute, and six with chronic ACJ injuries was performed using a 0.25 T open MRI scanner. A 2D-proton-density and a 3D-gradient-echo sequence at rest and under 6.5 kg shoulder traction were performed. Comparative measurements of the coracoclavicular and the acromioclavicular distance were performed. Additionally, the conoid and trapezoid ligament lengths were measured with multiplanar reconstructions. MRI at rest correctly identified tears of the coracoclavicular and the acromioclavicular ligaments in eight patients suffering acute ACJ injuries. Stress application helped to distinguish between partial and complete coracoclavicular ligament tears in two cases. Insufficiency of the ACJ ligaments was present in all acute and chronic ACJ injuries. Stress application in chronic ACJ ligaments revealed isolated insufficiency of the conoid ligament in three cases and of the trapezoid ligament in one case. Combined insufficiency was present in two cases. Stress MRI facilitates simultaneous acquisition of morphologic and functional information of the ACJ stabilizers. In acute ACJ injuries it helps to distinguish between partial and complete ligament tears. In chronic ACJ injuries it provides functional information of the ligament regrinds. Copyright © 2012 Wiley Periodicals, Inc.

Biomechanical analysis of clavicle hook plate implantation with different hook angles in the acromioclavicular joint.

PubMed

Hung, Li-Kun; Su, Kuo-Chih; Lu, Wen-Hsien; Lee, Cheng-Hung

2017-08-01

A clavicle hook plate is a simple and effective method for treating acromioclavicular dislocation and distal clavicle fractures. However, subacromial osteolysis and peri-implant fractures are complicated for surgeons to manage. This study uses finite element analysis (FEA) to investigate the post-implantation biomechanics of clavicle hook plates with different hook angles. This FEA study constructed a model with a clavicle, acromion, clavicle hook plate, and screws to simulate the implantation of clavicle hook plates at different hook angles (90°, 95°, 100°, 105°, and 110°) for treating acromioclavicular joint dislocations. This study investigated the biomechanics of the acromion, clavicle, hook plate, and screws. A smaller hook angle increases the stress on the middle third of the clavicle. A larger hook angle increases the force exerted by the clavicle hook plate on the acromion. The screw at the most medial position on the plate generated the highest stress. The highest stress on the implanted clavicle hook plate was on the turning corner of the hook. A clavicle hook plate with different hook angles may induce different biomechanical behaviors in the clavicle and acromion. Orthopedic surgeons must select a suitable clavicle hook plate based on the anatomical structure of each patient.

Arthroscopically assisted reduction of acute acromioclavicular joint dislocation using a single double-button device: Medium-term clinical and radiological outcomes.

PubMed

Issa, S-P; Payan, C; Le Hanneur, M; Loriaut, P; Boyer, P

2018-02-01

Double-button devices for endoscopic management of acute acromioclavicular joint dislocation (ACJD) provide satisfactory short-term functional and radiological results. However, little exists in the literature regarding the long- and medium-term results of these implants, especially regarding the evolution of the acromioclavicular joint (ACJ). Satisfactory and steady long- and medium-term outcomes can be achieved in patients with acute ACJD undergoing endoscopically assisted ACJ repair using a single double-button device. A retrospective single-center study was conducted in patients with acute Rockwood III and IV ACJD treated endoscopically with a single double-button device from October 2008 to October 2010, allowing a minimum 5-year follow-up. Functional evaluation used Constant and Quick-DASH scores. Clinical evidence of dislocation recurrence was combined with bilateral Zanca views to assess coracoclavicular distance. Acromioclavicular osteoarthritis was evaluated on the Paxinos test and Zanca views. Nineteen of the 25 operated patients were seen at a mean 76.9±8.5 months' follow-up. Mean age was 34.4±8.3 years. Mean Constant and Quick-DASH scores were 96.2±5.1 and 0.9±1.6 points, respectively. Four patients had a recurrence of their initial dislocation, 3 of whom had positive Paxinos test, whereas the 15 patients without recurrence had a negative test (p=0.004). Five patients had radiological evidence of ACJ osteoarthritis: all 4 patients with recurrence and 1 without (p=0.001). Long- and medium-term radioclinical outcome of endoscopically assisted management of acute ACJD using a single double-button device seems to be satisfactory and steady over time. Recurrence of the initial dislocation appears to be related to onset of degenerative ACJ arthropathy. Therapeutic type IV-Retrospective case series. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Truly anatomic coracoclavicular ligament reconstruction with 2 Endobutton devices for acute Rockwood type V acromioclavicular joint dislocations.

PubMed

Xue, Cheng; Song, Li-Jun; Zhang, Hao; Tang, Guo-Long; Li, Xiang; Fang, Jia-Hu

2018-06-01

Truly anatomic coracoclavicular ligament reconstruction (TACCR) according to the original insertions is a creative new method for the treatment of severe acromioclavicular separation. This research analyzed the clinical and radiologic results of TACCR in 25 patients with at least 2-year follow-up. The study enrolled 25 patients with Rockwood type V acromioclavicular joint dislocations who underwent TACCR using 2 Endobutton (Smith & Nephew Inc., Andover, MA, USA) devices from May 2013 to October 2015. Patients were assessed with clinical and radiologic follow-up at 3, 6, 12, 18, and 24 months postoperatively. The clinical assessments consisted of the visual analog scale and the Constant score. The radiographic evaluations were performed by measurements of the coracoclavicular distance. The mean follow-up was 34 ± 6.8 months (range, 24-48 months). The visual analog scale and Constant scores revealed significant advancements from 5 ± 0.9 (range, 4-7) and 45 ± 5.6 (range, 30-54) scores preoperatively to 0 ± 0.5 (range, 0-2) and 95 ± 2.9 (range, 91-98) scores at 24 months postoperatively, respectively. The coracoclavicular distance significantly decreased from 23 ± 5.4 mm (range, 16-34 mm) preoperatively to 8 ± 0.9 mm (range, 7-10 mm) at the final follow-up. TACCR represents a safe, reliable and creative surgical technique that yields good to excellent clinical and radiologic outcomes in the treatment of severe acromioclavicular separation. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Coronal plane radiographic evaluation of the single TightRope technique in the treatment of acute acromioclavicular joint injury.

PubMed

Yi, Young; Kim, Jeong Woo

2015-10-01

This study aimed to demonstrate the technical aspects of the single TightRope (Arthrex, Naples, FL, USA) procedure for acute acromioclavicular-coracoclavicular joint dislocation, identify the predictive factors influencing its outcome, and assess and validate the significance of specific radiologic parameters. We reviewed true anteroposterior shoulder radiographs of 62 consecutive patients who had undergone surgical reconstruction using TightRope for an acute acromioclavicular-coracoclavicular injury. All patients were followed up for at least 12 months between October 2009 and March 2012 and were divided into dissociated or nondissociated groups according to their surgical outcome. We measured the clavicle tunnel anteroposterior angle, distal clavicular tunnel placement, and tunnel-to-medial coracoid ratio, and compared the parameters in each group after a satisfactory intraclass correlation coefficient reliability test result. The angles of patients in the dissociated group were more acute compared with the angles of those in the nondissociated group, which were perpendicular, as verified statistically using the paired t test. The difference in the distal clavicular tunnel placement and tunnel-to-medial coracoid ratio between the groups was not significant. Therefore, tunnel placement is not influenced by coracoclavicular dissociation. The clavicle tunnel anteroposterior angle can be used as a predictor of surgical outcome in coracoclavicular augmentation surgery. The surgeon should strive to place a perpendicular hole from the clavicle to the coracoid process for the TightRope fixation to enable a successful reconstruction of the acute acromioclavicular-coracoclavicular injury. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Outcomes of surgery for acromioclavicular joint dislocation using different angled hook plates: a prospective study.

PubMed

Xu, Ding; Luo, Peng; Chen, Jukun; Ji, Liefeng; Yin, Luxu; Wang, WeiKang; Zhu, Jiang

2017-12-01

Hook plate fixation is widely used to treat acromioclavicular joint dislocation. However, there are many post-operative complications affecting the effect of treatment. The aim of this study is to evaluate the efficacy of the clavicular hook plate with different hook angles as a method of treatment in AC joint dislocation, and to guide the clinical application of hook plate. We prospectively analysed 54 patients who were diagnosed with AC joint dislocation and treated with hook plate fixation by different hook angles. The patients were randomised into three groups: the -20° < AHP < 0° group, the 20° > AHP > 0° group and the 40° > AHP > 20° group. All patients were required to conform to regular follow-up post-operatively. Routine imaging to the shoulder was obtained to evaluate maintenance of the dislocation and the implant. Constant-Murley criteria were used to evaluate functional results. There were 19 patients in the -20° < AHP < 0° group, with one lost to follow-up, 22 patients in the 20° > AHP > 0° group, with two male patients lost to follow-up, and one female patient excluded because of no follow-up consent, and 19 patients in the 40° > AHP > 20° group, with one female and one male patient lost to follow-up. The Constant score was 61.8 ± 12.8, 74.7 ± 9.2 and 70.7 ± 9.4 before implant removal, and 78.8 ± 8.3, 87.1 ± 6.4 and 85.0 ± 6.1 after implant removal in the -20° < AHP < 0°, 20° > AHP > 0° and 40° > AHP > 20° groups, respectively. The functional results of the 20° > AHP > 0° and 40° > AHP > 20° groups were significantly better than the -20° < AHP < 0° group (P < 0.05), but the functional results of the 20° > AHP > 0° and 40° > AHP > 20° groups were not statistically significant. The CCD was 98.1 ± 4.8%, 107.5 ± 5.1% and 105.5 ± 4.1% before implant removal, and 98.8 ± 4.6%, 108.3 ± 4.8% and 107.2 ± 3.3% after implant removal in the

Acromioclavicular dislocation: treatment and rehabilitation. Current perspectives and trends among Brazilian orthopedists☆

PubMed Central

Arliani, Gustavo Gonçalves; Utino, Artur Yudi; Nishimura, Eduardo Misao; Terra, Bernardo Barcellos; Belangero, Paulo Santoro; Astur, Diego Costa

2015-01-01

Objective To evaluate the approaches and procedures used by Brazilian orthopedic surgeons in treatment and rehabilitation of acromioclavicular dislocation of the shoulder. Methods A questionnaire comprising eight closed questions that addressed topics relating to treatment and rehabilitation of acromioclavicular dislocation was applied to Brazilian orthopedic surgeons over the three days of the 45th Brazilian Congress of Orthopedics and Traumatology, in 2013. Results A total of 122 surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them came from the southeastern region of the country. In this sample, 67% of the participants would choose surgical treatment for patients with grade 3 acromioclavicular dislocation. Regarding the preferred technique for surgical treatment of acute acromioclavicular dislocation, a majority of the surgeons used subcoracoid ligature with acromioclavicular fixation and transfer of the coracoacromial ligament (25.4%). Regarding complications found after surgery had been performed, 43.4% and 32.8% of the participants, respectively, stated that residual deformity of the operated joint and pain were the complications most seen during the postoperative period. Conclusions Although there was no consensus regarding the treatment and rehabilitation of acromioclavicular dislocation, evolution had occurred in some of the topics analyzed in this questionnaire applied to Brazilian orthopedists. However, further controlled prospective studies are needed in order to evaluate the clinical and scientific benefit of these trends. PMID:26535196

Acromioclavicular dislocation: treatment and rehabilitation. Current perspectives and trends among Brazilian orthopedists.

PubMed

Arliani, Gustavo Gonçalves; Utino, Artur Yudi; Nishimura, Eduardo Misao; Terra, Bernardo Barcellos; Belangero, Paulo Santoro; Astur, Diego Costa

2015-01-01

To evaluate the approaches and procedures used by Brazilian orthopedic surgeons in treatment and rehabilitation of acromioclavicular dislocation of the shoulder. A questionnaire comprising eight closed questions that addressed topics relating to treatment and rehabilitation of acromioclavicular dislocation was applied to Brazilian orthopedic surgeons over the three days of the 45th Brazilian Congress of Orthopedics and Traumatology, in 2013. A total of 122 surgeons completely filled out the questionnaire and formed part of the sample analyzed. Most of them came from the southeastern region of the country. In this sample, 67% of the participants would choose surgical treatment for patients with grade 3 acromioclavicular dislocation. Regarding the preferred technique for surgical treatment of acute acromioclavicular dislocation, a majority of the surgeons used subcoracoid ligature with acromioclavicular fixation and transfer of the coracoacromial ligament (25.4%). Regarding complications found after surgery had been performed, 43.4% and 32.8% of the participants, respectively, stated that residual deformity of the operated joint and pain were the complications most seen during the postoperative period. Although there was no consensus regarding the treatment and rehabilitation of acromioclavicular dislocation, evolution had occurred in some of the topics analyzed in this questionnaire applied to Brazilian orthopedists. However, further controlled prospective studies are needed in order to evaluate the clinical and scientific benefit of these trends.

Complications after arthroscopic coracoclavicular reconstruction using a single adjustable-loop-length suspensory fixation device in acute acromioclavicular joint dislocation.

PubMed

Shin, Sang-Jin; Kim, Nam-Ki

2015-05-01

The purpose of this study was to evaluate clinical and radiological outcomes after arthroscopically assisted coracoclavicular (CC) fixation using a single adjustable-loop-length suspensory fixation device for acute acromioclavicular dislocation and to report intraoperative and postoperative complications. Eighteen consecutive patients with acute acromioclavicular dislocation underwent arthroscopically assisted CC fixation using a single TightRope (Arthrex, Naples, FL). Using the Rockwood classification, 3 patients had grade III dislocations, one patient had a grade IV dislocation, and 14 patients had grade V dislocations. The preoperative CC distance of the injured shoulder was 16.1 ± 2.7 mm (range, 11.2 to 21.0 mm), and it increased by 99% ± 36% (range, 17% to 153%) on average compared with the contralateral shoulder. The average CC distance was 10.5 ± 2.5 mm (range, 7.7 to 15.5 mm), and it increased by 30% ± 30% (range, -9.4% to 90%) at the final follow-up. Compared with immediate postoperative radiographs, the CC distance was maintained in 12 patients, increased between 50% and 100% in 4 patients, and increased more than 100% in 2 patients at final follow-up. However, there was no statistical difference in Constant scores between 6 patients with reduction loss (95.6 ± 4.5) and 12 patients with reduction maintenance (98.4 ± 2.5; P = .17). Perioperative complications occurred in 8 patients, including one case of acromioclavicular arthritis, one case of delayed distal clavicular fracture at the clavicular hole of the device, 3 cases of clavicular or coracoid button failures, and 3 cases of clavicular bony erosion. Satisfactory clinical outcomes were obtained after CC fixation using the single adjustable-loop-length suspensory fixation device for acute acromioclavicular joint dislocation. However, CC fixation failure of greater than 50% of the unaffected side in radiological examinations occurred in 33% of the patients within 3 months after the operation

[EFFECTIVENESS OF CLAVICULAR HOOK PLATE COMBINED WITH TRAPEZIUS MUSCLE FASCIA FOR RECONSTRUCTION OF ACROMIOCLAVICULAR AND CORACOCLAVICULAR LIGAMENTS TO TREAT COMPLETE ACROMIOCLAVICULAR JOINT DISLOCATION].

PubMed

Wang, Chaoliang; Wang, Yingzhen; Zhu, Tao; Sun, Xuesheng; Lin, Chu; Gao, Bo; Li, Xinxia

2015-02-01

To explore the effectiveness of the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments to treat acute complete acromioclavicular dislocations. Between January 2008 and April 2012, 66 patients with acromioclavicular dislocation were treated with the clavicular hook plate combined with trapezius muscle fascia for reconstruction of acromioclavicular and coracoclavicular ligaments in 32 cases (experimental group) and with the clavicular hook plate in 34 cases (control group). There was no significant difference in gender, age, injured side, the cause of injury, and the time from injury to operation between 2 groups (P > 0.05). Visual analogue scale (VAS), Constant shoulder scores, and coracoid clavi-cledistance (CC. Dist) were measured at preoperation and at 2 years after operation. Signal/noise quotiem (SNQ) was measured by MRI at 2 years after operation. The operation complications were observed. The patients of 2 groups obtained primary healing of incision. The morbidity of complication in experimental group (12.5%, 4/32) was significantly lower than that in control group (91.2%, 31/34) (Χ2 = 40.96, P = 0.00). All the cases were followed up 2.8 years on average (range, 2 to 4 years). VAS scores and CC.Dist significantly decreased at 2 years after operation when compared with preoperative values in the 2 groups (P < 0.05). VAS scores and CC.Dist of the experimental group were significantly lower than those in the control group (P < 0.05). According to Constant shoulder scores at 2 years after operation, the results were excellent in 19 cases, good in 11 cases, and general in 2 cases with an excellent and good rate of 93.75% in the experimental group; the results were excellent in 7 cases, good in 8 cases, general in 16 cases, and poor in 3 cases with an excellent and good rate of 44.11% in the control group; and significant difference was shown between 2 groups (t = 2.30, P = 0.03). SNQ

Shoulder Acromioclavicular and Coracoclavicular Ligament Injuries: Common Problems and Solutions.

PubMed

Wylie, James D; Johnson, Jeremiah D; DiVenere, Jessica; Mazzocca, Augustus D

2018-04-01

Injuries to the acromioclavicular joint and coracoclavicular ligaments are common. Many of these injuries heal with nonoperative management. However, more severe injuries may lead to continued pain and shoulder dysfunction. In these patients, surgical techniques have been described to reconstruct the function of the coracoclavicular ligaments to provide stable relationship between the clavicle and scapula. These surgeries have been fraught with high complication rates including clavicle and coracoid fractures, infection, loss of reduction and fixation, hardware migration, and osteolysis. This article reviews common acromioclavicular and coracoclavicular repair and reconstruction techniques and associated complications, and provides recommendations for prevention and management. Copyright © 2018 Elsevier Inc. All rights reserved.

Simultaneous anatomic reconstruction of the acromioclavicular and coracoclavicular ligaments using a single tendon graft.

PubMed

Shin, Sang-Jin; Campbell, Sean; Scott, Jonathan; McGarry, Michelle H; Lee, Thay Q

2014-09-01

The purpose of this study was to introduce a novel surgical technique for simultaneous anatomic reconstruction of the acromioclavicular and coracoclavicular ligaments using a single tendon graft and to compare its biomechanical characteristics to those of a coracoid cerclage reconstruction of the coracoclavicular ligaments. Six matched pairs of human acromioclavicular joints with an average age of 54.8 ± 7.8 years were used. One shoulder from each pair received the single tendon acromioclavicular-coracoclavicular reconstruction; the contralateral shoulder received the coracoid cerclage reconstruction. Bovine extensor tendon was used for both techniques. The single tendon acromioclavicular-coracoclavicular reconstruction technique provided anatomic restoration of the two coracoclavicular ligaments and the superior and inferior acromioclavicular ligaments simultaneously using one coracoid hole, one acromion hole, and two clavicular holes with interference screws. Anterior-posterior and superior-inferior translations were quantified for all specimens before and after reconstruction, followed by load to failure testing. Following coracoid cerclage reconstruction, total anterior-posterior translation was significantly greater than intact (10.0 ± 5.7 mm; p = 0.008). Following single tendon acromioclavicular-coracoclavicular reconstruction, there was no significant difference in anterior-posterior translation compared to intact (-1.6 ± 2.2 mm; n.s.). The coracoid cerclage technique demonstrated significantly greater anterior-posterior translation than the single tendon acromioclavicular-coracoclavicular technique (p = 0.007). Both techniques restored superior-inferior translation to the intact condition (n.s.). Ultimate load, deformation at ultimate load, and energy absorbed at ultimate load were significantly greater after acromioclavicular-coracoclavicular reconstruction than after coracoid cerclage reconstruction (p < 0.05). This novel single tendon

Resident accuracy of joint line palpation using ultrasound verification.

PubMed

Rho, Monica E; Chu, Samuel K; Yang, Aaron; Hameed, Farah; Lin, Cindy Yuchin; Hurh, Peter J

2014-10-01

To determine the accuracy of knee and acromioclavicular (AC) joint line palpation in Physical Medicine and Rehabilitation (PM&R) residents using ultrasound (US) verification. Cohort study. PM&R residency program at an academic institution. Twenty-four PM&R residents participating in a musculoskeletal US course (7 PGY-2, 8 PGY-3, and 9 PGY4 residents). Twenty-four PM&R residents participating in an US course were asked to palpate the AC joint and lateral joint line of the knee in a female and male model before the start of the course. Once the presumed joint line was localized, the residents were asked to tape an 18-gauge, 1.5-inch, blunt-tip needle parallel to the joint line on the overlying skin. The accuracy of needle placement over the joint line was verified using US. US verification of correct needle placement over the joint line. Overall AC joint palpation accuracy was 16.7%, and knee lateral joint line palpation accuracy was 58.3%. Based on the resident level of education, using a value of P < .05, there were no statistically significant differences in the accuracy of joint line palpation. Residents in this study demonstrate poor accuracy of AC joint and lateral knee joint line identification by palpation, using US as the criterion standard for verification. There were no statistically significant differences in the accuracy rates of joint line palpation based on resident level of education. US may be a useful tool to use to advance the current methods of teaching the physical examination in medical education. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

[Stabilization of the injured acromioclavicular joint using a new type of fixation plate].

PubMed

Sánta, S; Záborszky, Z; Varga, Z

1992-01-01

The opinions in the question of transitory fixation of the joint during the treatment of the acromioclavicular articulation are rather different. The complications of the widely used methods--break of the implant, its tear from the bone, the wandering and the disturbances of wound healing--are well known. To decrease the number of complications authors have developed a new type of hooked plate. The plate is fitted to the anterior surface of the acromial end of the clavicle and its hook is fixed from below in the bore hole of the acromion. To choose the optimal place of the bore hole a drill guide was prepared. The operative method is described and the advantages of the method are summarized. The "Debrecen-plate" was used during 2 years in 39 injuries. 35 patients were controlled 6-24 months after the operation. Based on the results of the treatment a wider use of the method is suggested.

Anatomic ligament consolidation of the superior acromioclavicular ligament and the coracoclavicular ligament complex after acute arthroscopically assisted double coracoclavicular bundle stabilization.

PubMed

Jobmann, S; Buckup, J; Colcuc, C; Roessler, P P; Zimmermann, E; Schüttler, K F; Hoffmann, R; Welsch, F; Stein, T

2017-09-18

The consolidation of the acromioclavicular (AC) and coracoclavicular (CC) ligament complex after arthroscopically assisted stabilization of acute acromioclavicular joint (ACJ) separation is still under consideration. Fifty-five consecutive patients after arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation were studied prospectively. All patients were clinically analysed preoperatively (FU0) and post-operatively (FU1 = 6 months; FU2 = 12 months). The structural MRI assessments were performed at FU0 (injured ACJ) and at FU2 bilateral (radiologic control group) and assessed separately the ligament thickness and length at defined regions for the conoid, trapezoid and the superior AC ligament. Thirty-seven patients were assessed after 6.5 months and after 16.0 months. The 16-month MRI analysis revealed for all patients continuous ligament healing for the CC-complex and the superior AC ligament with in the average hypertrophic consolidation compared to the control side. Separate conoid and trapezoid strands (double-strand configuration) were detected in 27 of 37 (73%) patients, and a single-strand configuration was detected in 10 of 37 (27%) patients; both configurations showed similar CCD data. The ligament healing was not influenced by the point of surgery, age at surgery and heterotopic ossification. The clinical outcome was increased (FU0-FU2): Rowe, 47.7-97.0 pts.; TAFT, 3.9-10.6 pts.; NAS pain , 8.9-1.4 pts. (all P < 0.05). The arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation showed 16 months after surgery sufficient consolidations of the AC and double-CC ligament complex in 73%. III, Case series.

A modified technique of reconstruction for complete acromioclavicular dislocation: a prospective study.

PubMed

Tienen, Tony G; Oyen, Jan F C H; Eggen, Peter J G M

2003-01-01

Many procedures, both nonoperative and operative, have been described for treatment of complete acromioclavicular dislocations. The best primary treatment, however, still remains unclear. We present a new surgical technique in which the clavicle is reduced to an anatomic position, the coracoacromial ligament is transferred to the clavicle, and acromioclavicular joint fixation is accomplished with the use of absorbable, braided suture cord. Twenty-one patients underwent the modified technique of reconstruction. Patients were included only if they had sustained a Rockwood type V acromioclavicular dislocation and were extremely active in competitive sports before dislocation occurred. Eighteen patients returned to their sports without pain within 2.5 months after operation. The mean follow-up was 35.7 months. The average Constant score at last follow-up was 97. Radiographs taken at this time confirmed anatomic reduction in 18 patients, residual subluxation in 2 patients, and, in 1 patient, redislocation of the joint that occurred because of infection. Six patients had radiographic evidence of coracoclavicular ossifications. All patients developed a wide scar. Considering its operative simplicity, the advantage of absorbable augmentation of the clavicular reduction, and the low rate of recurrence, this technique may be an attractive alternative in this particular group of patients.

Should all acromioclavicular joint injections be performed under image guidance?

PubMed

Javed, S; Sadozai, Z; Javed, A; Din, A; Schmitgen, G

2017-01-01

Steroid and local anaesthetic injection to the acromioclavicular joint (ACJ) is a very common diagnostic and therapeutic procedure, which is often performed in the outpatient department. However, it can be difficult to localize this joint because of its small size, presence of osteophytes and variable morphology in the population. We performed a study to determine whether the use of an image intensifier (X-ray guidance), in theatre, improves the accuracy of this injection. This was a prospective study carried out between March 2014 and March 2015. The injections were performed by two senior orthopaedic surgeons. First, we clinically palpated the ACJ and marked the area over this point as A. Then, with the use of a needle and an image intensifier in a single plane, we identified the actual location of the ACJ and marked this point as B. We measured the distance between A and B in millimetres (mm) and determined the accuracy of the injections. Further analysis taking into account the ACJ capsular attachments was also performed. In total, 45 patients and 50 injections were included in the study; five patients had repeated injections at different times. We found that only 12 injections (24%) were palpated to be correct with no discrepancies between A and B (95% confidence interval: 14-37%). For the remaining 38 injections (76%), the use of an image intensifier had significantly improved the accuracy of ACJ location ( p < 0.05). Taking the capsular attachments of the ACJ into consideration reduced the number of inaccurate injections to 27 (54%). We recommend the use of an image intensifier (or ultrasound guidance) to accurately determine the location of the ACJ for steroid and local anaesthetic injections. This prevents an injection into the wrong place, which can lead to wrong diagnosis and/or suboptimal treatment.

[Outcomes and complications of Tightrope button plate for repairing acromioclavicular dislocation].

PubMed

Zuo, Yong-Xiang; Ma, Zi-Ping

2017-10-25

To study the clinical outcome and complications of Tightrope button plate for repairing acromioclavicular dislocation of Rockwood type III to V. From May 2014 to December 2016, 17 patients with acromioclavicular dislocation of type III-V were treated with Tightrope button plate including 10 males and 7 females with an average age 39.8 years old ranging from 20 to 68 years old. Four patients were treated with arthroscopy and 17 patients were treated with mini-invasive by X-ray assisted. Shoulder function, X-ray and complications after operation were assessed. All patients were followed up for 5 to 23 months with a mean of 10.8 months. All patients got satisfying reduction immediately postoperatively. Among them, 1 case of clavicle end wound foreign body reaction, rupture, effusion, healing after the second suture; 1 case of foreign body granuloma formation at the end of clavicle were resected and removed at 4 months after operation; 3 cases loss reduction(less than 50% of acromioclavicular joint). No coracoid fracture and suture breakage observed. The shoulder mobility was restored in 15 cases at 4 to 6 weeks postoperatively, and the shoulder adhesion in 2 cases was delayed to 5 to 7 months after operation. The Constant scores were improved from 46.9±6.0 preoperatively to 92.7±4.0 at the final follow-up. X-ray evaluation of postoperative coracoclavicular tunnel location, patients' coracoclavicular tunnel with mini-invasive fluoroscopy all closed to the ideal position (across the clavicle vertically through the coracoid base center), while different degree of tunnel position deviation were observed in arthroscopic patients. Tightrope button plate for the treatment of acromioclavicular joint dislocation had advantages of minimally invasive, effective, good clinical results, the majority of common complications does not affect efficacy. Small incision X-ray method can provide more satisfactory and reliable tunnel location.

Clavicular hook plate for grade-III acromioclavicular dislocation.

PubMed

Steinbacher, Gilbert; Sallent, Andrea; Seijas, Roberto; Boffa, Juan Manuel; Espinosa, Wenceslao; Cugat, Ramón

2014-12-01

To review the outcomes of clavicular hook plate fixation for grade-III acromioclavicular (AC) dislocation in young athletes. Medical records of 14 male and 5 female athletes aged 18 to 49 (mean, 29) years who underwent fixation with a 3.5-mm-thick, 15-mm-long clavicular hook plate for acute grade-III AC dislocation were reviewed. The visual analogue score for pain and the Constant shoulder score were assessed. The mean follow-up was 4.2 years. The mean visual analogue score for pain was 1.8 (range, 1-3). The Constant shoulder score was excellent (≥ 90) in 14 patients and good (83-89) in 5 patients. All patients achieved range of motion equal to that of the contralateral side at week 5. Sports activities were resumed by month 6 at the latest. The clavicular hook plate for grade- III AC dislocation enables quick return to sports activities and achieves good-to-excellent functional outcome.

[Triple no loop Endobutton plate combined with Orthcord line for the treatment of acromioclavicular dislocation of Tossy type III].

PubMed

Xia, Ming-Hua; Xie, Shui-Hua; Wu, Jun; Zhang, Wen-Qing; Chen, Wei-Dong; He, Jian-Hua; Ding, Hao; Hu, Qian-Qin; Wang, Xiao-Peng

2016-07-25

To explore the clinical effects of the triple no loop Endobutton plate combined with Orthcord line in treating acromioclavicular dislocation of Tossy type III. Between February 2011 and September 2013, 36 patients with acromioclavicular dislocation of Tossy type III were treated with triple no loop Endobutton plate and Orthcord line. There were 21 males and 15 females, aged from 9 to 48 years old with an average of (26.41±14.05) years. Couse of disease was from 2 to 7 days in the patients. The patients had the clinical manifestations such as shoulder pain, extension limited, acromioclavicular tenderness, positive organ point sign. Clinical effects were assessed by acromioclavicular scoring system. Thirty six patients were followed up from 8 to 15 months with an average of (12.2±4.3) months. All incisions got primary healing. At the final follow up, all shoulder pain vanished, acromioclavicular joints without tenderness, negative organ point sign. No redislocation and steel plate loosening were found. According to the acromioclavicular scoring system, 31 cases obtained excellent results, 5 good. The method of triple no loop Endobutton plate combined with Orthcord line for acromioclavicular dislocation of Tossy type III has advantage of less risk and complication, good functional rehabilitation and is an ideal method.

EXTRA-ARTICULAR FRACTURE OF THE MEDIAL END OF THE CLAVICLE ASSOCIATED WITH TYPE IV ACROMIOCLAVICULAR DISLOCATION: CAAE REPORT

PubMed Central

Correa, Mário Chaves; Gonçalves, Lucas Braga Jacques; Vilela, Jose Carlos Souza; Leonel, Igor Lima; Costa, Lincoln Paiva; de Andrade, Ronaldo Percopi

2015-01-01

Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV) associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3) in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12 months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture. PMID:27027060

EXTRA-ARTICULAR FRACTURE OF THE MEDIAL END OF THE CLAVICLE ASSOCIATED WITH TYPE IV ACROMIOCLAVICULAR DISLOCATION: CAAE REPORT.

PubMed

Correa, Mário Chaves; Gonçalves, Lucas Braga Jacques; Vilela, Jose Carlos Souza; Leonel, Igor Lima; Costa, Lincoln Paiva; de Andrade, Ronaldo Percopi

2011-01-01

Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV) associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3) in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12 months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture.

Influence of disruption of the acromioclavicular and coracoclavicular ligaments on glenohumeral motion: a kinematic evaluation.

PubMed

Walley, Kempland C; Haghpanah, Babak; Hingsammer, Andreas; Harlow, Ethan R; Vaziri, Ashkan; DeAngelis, Joseph P; Nazarian, Ara; Ramappa, Arun J

2016-11-17

Changes to the integrity of the acromioclavicular (AC) joint impact scapulothoracic and clavicular kinematics. AC ligaments provide anterior-posterior stability, while the coracoclavicular (CC) ligaments provide superior-inferior stability and a restraint to scapular internal rotation. The purpose of this cadaveric study was to describe the effect of sequential AC and CC sectioning on glenohumeral (GH) kinematics during abduction (ABD) of the arm. We hypothesized that complete AC ligament insult would result in altered GH translation in the anterior-posterior plane during abduction, while subsequent sectioning of both CC ligaments would result in an increasing inferior shift in GH translation. Six cadaveric shoulders were studied to evaluate the impact of sequential sectioning of AC and CC ligaments on GH kinematics throughout an abduction motion in the coronal plane. Following an examination of the baseline, uninjured kinematics, the AC ligaments were then sectioned sequentially: (1) Anterior, (2) Inferior, (3) Posterior, and (4) Superior. Continued sectioning of CC ligamentous structures followed: the (5) trapezoid and then the (6) conoid ligaments. For each group, the GH translation and the area under the curve (AUC) were measured during abduction using an intact cadaveric shoulder. Total translation was calculated for each condition between ABD 30° and ABD 150° using the distance formula, and a univariate analysis was used to compare total translation for each axis during the different conditions. GH kinematics were not altered following sequential resection of the AC ligaments. Disruption of the trapezoid resulted in significant anterior and lateral displacement of the center of GH rotation. Sectioning the conoid ligament further increased the inferior shift in GH displacement. A combined injury of the AC and CC ligaments significantly alters GH kinematics during abduction. Type III AC separations, result in a significant change in the shoulder's motion and

A combined technique for acromioclavicular reconstruction after acute dislocation - technical description and functional outcomes.

PubMed

Moura, Diogo Lino; Reis E Reis, Augusto; Ferreira, João; Capelão, Manuel; Braz Cardoso, José

2018-01-01

This study aims to describe the surgical approach to such injuries and to present the clinical and functional outcomes obtained in a cohort of patients. This is an observational retrospective study that included 153 patients with acute acromioclavicular joint dislocation, operated between 1999 and 2015. Clinical evaluation included the following outcomes: Constant functional scale, development of complications, time to return to previous work/sport activities, and satisfaction index. The contra-lateral (uninjured) shoulder was used as control in subjective outcomes. Radiological evaluation was performed in order to monitor signs of loss of reduction, degenerative joint changes, and coracoclavicular calcifications. The mean age was 29.20 ± 9.53 (16-71), with a large male predominance (91.5%). Follow-up lasted 55.41 ± 24.87 (12-108) months. The mean Constant score attained was 96.45 ± 4.00 (84-100) on operated shoulders and 98.28 ± 1.81 (93-100) on contralateral ones. Almost all patients (98.69%) were satisfied with the surgical results. Worse outcomes were observed in acromioclavicular joint dislocations of increasing grade (from type III to V, but worse for type IV), both concerning the Constant score and return to work or sport. The overall incidence of complications was considered low, with the most prevalent being Kirschner wire failure and isolated coracoclavicular ligament calcifications. The surgical technique described is an excellent option in the treatment of acute acromioclavicular joint dislocations of Rockwood grades III to V. This is corroborated by the excellent clinical and functional outcomes and the low rate of complications.

In vivo analysis of acromioclavicular joint motion after hook plate fixation using three-dimensional computed tomography.

PubMed

Kim, Yoon Sang; Yoo, Yon-Sik; Jang, Seong Wook; Nair, Ayyappan Vijayachandran; Jin, Hyonki; Song, Hyun-Seok

2015-07-01

The clavicle hook plate can be used to treat acromioclavicular and coracoclavicular ligament injury or distal clavicular fracture with comminution. However, the hook plate can induce subacromial impingement, resulting in discomfort from the hardware. Our inclusion criteria were (1) men and women aged older than 20 years and (2) the presence of comminuted distal clavicular fractures (Neer type IIB) fixed with a hook plate (Synthes, Oberdorf, Switzerland). Three-dimensional computed tomography was obtained before removal of the hook plate. Seven patients were enrolled prospectively. The mean age was 42 years (range, 24-60 years). Zero degree images and abduction images were obtained. The sagittal cut surface was obtained 5 mm medial from the distal clavicle. The equator of the cut surface of the clavicle was compared with the full abduction model to analyze rotation. The center of the cut surface of the clavicle was compared with the full abduction model to analyze translation. The average difference in rotation of the distal clavicle between both shoulders was 16° (range, 3°-22°; P = .001). The mean difference in anterior translation of the distal clavicle was 2.2 mm (range, -0.7 to 5.6 mm; P = .030). Hook plate fixation at the acromioclavicular joint causes decreased internal rotation and increased anterior translation of the distal clavicle with respect to the medial acromion, indicating that the scapula relative to the thorax has decreased posterior tilting and increased external rotation in shoulders fixed using a hook plate. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Concomitant glenohumeral pathologies in high-grade acromioclavicular separation (type III - V).

PubMed

Markel, Jochen; Schwarting, Tim; Malcherczyk, Dominik; Peterlein, Christian-Dominik; Ruchholtz, Steffen; El-Zayat, Bilal Farouk

2017-11-10

Acromioclavicular joint (ACJ) dislocations are common injuries of the shoulder associated with physical activity. The diagnosis of concomitant injuries proves complicated due to the prominent clinical symptoms of acute ACJ dislocation. Because of increasing use of minimally invasive surgery techniques concomitant pathologies are diagnosed more often than with previous procedures. The aim of this study was to identify the incidence of concomitant intraarticular injuries in patients with high-grade acromioclavicular separation (Rockwood type III - V) as well as to reveal potential risk constellations. The concomitant pathologies were compiled during routine arthroscopically assisted treatment in altogether 163 patients (147 male; 16 female; mean age 36.8 years) with high-grade acromioclavicular separation (Rockwood type III: n = 60; Rockwood type IV: n = 6; Rockwood type V: n = 97). Acromioclavicular separation occurred less often in women than men (1:9). In patients under 35, the most common cause for ACJ dislocation was sporting activity (37.4%). Rockwood type V was observed significantly more often than the other types with 57.5% (Rockwood type III = 36.8%, Rockwood type IV 3.7%). Concomitant pathologies were diagnosed in 39.3% of the patients with that number rising to as much as 57.3% in patients above 35 years. Most common associated injuries were rotator cuff injuries (32.3%), chondral defects (30.6%) and SLAP-lesions (22.6%). Of all patients, 8.6% needed additional reconstructive surgery. Glenohumeral injuries are a much more common epiphenomenon during acromioclavicular separation than previously ascertained. High risk group for accompanying injuries are patients above 35 years with preexisting degenerative disease. The increasing use of minimally invasive techniques allows for an easier diagnosis and simultaneous treatment of the additional pathologies.

New insights in the treatment of acromioclavicular separation

PubMed Central

van Bergen, Christiaan J A; van Bemmel, Annelies F; Alta, Tjarco D W; van Noort, Arthur

2017-01-01

A direct force on the superior aspect of the shoulder may cause acromioclavicular (AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types I and II are treated nonoperatively, while types IV, V and VI are generally treated operatively. Controversy exists regarding the optimal treatment of type III dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially. Classic surgical techniques were associated with high complication rates, including recurrent dislocations and hardware breakage. In recent years, many new techniques have been introduced in order to improve the outcomes. Arthroscopic reconstruction or repair techniques have promising short-term results. This article aims to provide a current concepts review on the treatment of AC dislocations with emphasis on recent developments. PMID:29312844

Measure of horizontal and vertical displacement of the acromioclavicular joint after cutting ligament using X-ray and opto-electronic system.

PubMed

Rochcongar, Goulven; Emily, Sébastien; Lebel, Benoit; Pineau, Vincent; Burdin, Gilles; Hulet, Christophe

2012-09-01

Surgical versus orthopedic treatments of acromioclavicular disjunction are still debated. The aim of this study was to measure horizontal and vertical acromion's displacement after cutting the ligament using standard X-ray and an opto-electronic system on cadaver. Ten cadaveric shoulders were studied. A sequential ligament's section was operated by arthroscopy. The sequence of cutting was chosen to fit with Rockwood's grade. The displacement of the acromion was measured on standard X-ray and with an opto-electronic system allowing measuring of the horizontal displacement. Statistical comparisons were performed using a paired Student's t test with significance set at p < 0.05. Cutting the coracoclavicular ligament and delto-trapezius muscles cause a statistical downer displacement of the acromion, but not after sectioning the acromioclavicular ligament. The contact surface between the acromion and the clavicle decreases statistically after sectioning the acromioclavicular ligament and the coracoclavicular ligament with no effect of sectioning the delto-trapezius muscles. Those results are superposing with those dealing with the anterior translation. The measure concerning the acromioclavicular distance and the coracoclavicular distance are superposing with those of Rockwood. However, there is a significant horizontal translation after cutting the acromioclavicular ligament. Taking into account this displacement, it may be interesting to choose either surgical or orthopedic treatment. There is a correlation between anatomical damage and importance of instability. Horizontal instability is misevaluated in clinical practice.

Comparison of hook plate with versus without double-tunnel coracoclavicular ligament reconstruction for repair of acute acromioclavicular joint dislocations: A prospective randomized controlled clinical trial.

PubMed

Yin, Jian; Yin, Zhaoyang; Gong, Ge; Zhu, Chao; Sun, Chao; Liu, Xinhui

2018-06-01

This study was designed to compare the surgical outcomes of a hook plate with double-tunnel coracoclavicular (CC) ligament reconstruction by conjoined tendon transfer versus single hook plate surgery for the repair of acute type of Rockwood type III and V acromioclavicular (AC) joint dislocations. The study cohort included 62 patients with acute (within 6 weeks after trauma) Rockwood type III and V AC joint dislocations who underwent surgery from February 2012 to September 2015. The patients were randomly allocated to the ligament reconstruction group (LR group, n = 31) or the single hook plate group (HP group, n = 31). In both groups, reduction of the AC joint by hook plate and repair of the ruptured AC ligament with absorbable Vicryl sutures were performed homoplastically. The lateral half of the short tendon of the biceps brachii muscle and the lateral half of the flexor tendon were used to reconstruct the trapezoid and conoid ligaments, respectively. Differences in surgical duration, intraoperative blood loss, incision length, and total cost were compared between the two groups. Furthermore, the preoperative and postoperative visual analogue score (VAS), postoperative American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score (CMS), Karlsson score, complication rates, and patient satisfaction at the last follow-up were compared to evaluate the curative effects of the surgical treatments. Magnetic resonance imaging (MRI) after hook plate removal was used to evaluate the reconstructed ligaments and tendon-bone interface. In total, 25 patients in the LR group and 26 in the HP group completed the follow-up. There were no statistically significant differences in age, sex, Rockwood type, placing time, total cost, and follow-up duration between the LR and HP groups (p > 0.05). However, as compared with the HP group, the surgical duration and incision length were longer in the LR group (92.08 ± 19.25 vs. 56.54 ± 21.29 min and 13

PREFERED SURGICAL TECHNIQUE USED BY ORTHOPEDISTS IN ACUTE ACROMIOCLAVICULAR DISLOCATION

PubMed Central

NISHIMI, ALEXANDRE YUKIO; ARBEX, DEMETRIO SIMÃO; MARTINS, DIOGO LUCAS CAMPOS; GUSMÃO, CARLOS VINICIUS BUARQUE DE; BONGIOVANNI, ROBERTO RANGEL; PASCARELLI, LUCIANO

2016-01-01

ABSTRACT Objective: To determine whether training on shoulder and elbow surgery influences the orthopedist surgeons' preferred technique to address acute acromioclavicular joint dislocation (ACD). Methods: A survey was conducted with shoulder and elbow specialists and general orthopedists on their preferred technique to address acute ACD. Results: Thirty specialists and forty-five general orthopedists joined the study. Most specialists preferred the endobutton technique, while most general orthopedists preferred the modified Phemister procedure for coracoclavicular ligament repair using anchors. We found no difference between specialists and general orthopedists in the number of tunnels used to repair the coracoclavicular ligament; preferred method for wire insertion through the clavicular tunnels; buried versus unburied Kirschner wire insertion for acromioclavicular temporary fixation; and time for its removal; and regarding the suture thread used for deltotrapezoidal fascia closure. Conclusion: Training on shoulder and elbow surgery influences the surgeons' preferred technique to address acute ACD. Level of Evidence V, Expert Opinion. PMID:28149190

Electromigration analysis of solder joints under ac load: A mean time to failure model

NASA Astrophysics Data System (ADS)

Yao, Wei; Basaran, Cemal

2012-03-01

In this study, alternating current (ac) electromigration (EM) degradation simulations were carried out for Sn95.5%Ag4.0%Cu0.5 (SAC405- by weight) solder joints. Mass transport analysis was conducted with viscoplastic material properties for quantifying damage mechanism in solder joints. Square, sine, and triangle current wave forms ac were used as input signals. dc and pulsed dc (PDC) electromigration analysis were conducted for comparison purposes. The maximum current density ranged from 2.2×106A/cm2 to 5.0×106A/cm2, frequency ranged from 0.05 Hz to 5 Hz with ambient temperature varying from 350 K to 450 K. Because the room temperature is nearly two-thirds of SAC solder joint's melting point on absolute temperature scale (494.15 K), viscoplastic material model is essential. Entropy based damage evolution model was used to investigate mean time to failure (MTF) behavior of solder joints subjected to ac stressing. It was observed that MTF was inversely proportional to ambient temperature T1.1 in Celsius and also inversely proportional to current density j0.27 in A/cm2. Higher frequency will lead to a shorter lifetime with in the frequency range we studied, and a relationship is proposed as MTF∝f-0.41. Lifetime of a solder joint subjected to ac is longer compared with dc and PDC loading conditions. By introducing frequency, ambient temperature and current density dependency terms, a modified MTTF equation was proposed for solder joints subjected to ac current stressing.

A validation of the Nottingham Clavicle Score: a clavicle, acromioclavicular joint and sternoclavicular joint-specific patient-reported outcome measure.

PubMed

Charles, Edmund R; Kumar, Vinod; Blacknall, James; Edwards, Kimberley; Geoghegan, John M; Manning, Paul A; Wallace, W Angus

2017-10-01

Patients with acromioclavicular joint (ACJ) and sternoclavicular joint (SCJ) injuries and with clavicle fractures are typically younger and more active than those with other shoulder pathologies. We developed the Nottingham Clavicle Score (NCS) specifically for this group of patients to improve sensitivity for assessing the outcomes of treatment of these conditions compared with the more commonly used Constant Score (CS) and Oxford Shoulder Score (OSS). This was a cohort study in which the preoperative and 6-month postoperative NCS evaluations of outcome in 90 patients were compared with the CS, OSS, Imatani Score (IS), and the EQ-5D scores. Reliability was assessed using the Cronbach α. Reproducibility of the NCS was assessed using the test/retest method. Effect sizes were calculated for each score to assess sensitivity to change. Validity was examined by correlations between the NCS and the CS, OSS, IS, and EQ-5D scores obtained preoperatively and postoperatively. Significant correlations were demonstrated preoperatively with the OSS (P = .025) and all subcategories of the EQ-5D (P < .05) and postoperatively with the OSS (P < .001), CS (P = .008), IS (P < .001), and all subcategories of EQ-5D (P < .02). The NCS had the largest effect size (1.92) of the compared scores. Internal consistency was excellent (Cronbach α = 0.87). The NCS has been proven to be a valid, reliable and sensitive outcome measure that accurately measures the level of function and disability in the ACJ, SCJ and clavicle after traumatic injury and in degenerative disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

[Tossy III injuries of the acromioclavicular joint. In what circumstances is surgery still justified? Personal results and literature review].

PubMed

Prokop, A; Helling, H J; Andermahr, J; Mönig, S; Rehm, K E

2003-05-01

In Germany AC-joint-dislocations type Tossy III are treated in most of the cases operatively. Over two times of period we treated AC-joint-dislocations type Tossy III with biodegradable PDS-cords. 54 patients were operated between 1989 and 1997 and followed up after 39 months. 87.5% of patients are satisfied with results and have 10.2 points at Taftscore. In this period we couldn't differentiated the results by Rockwood classification. 12 patients with Rockwood V were operated between 1998 and 2002 and followed up after 14 months. Excellent and good results were seen in 92% of cases. At Taftscore we seen 10.7 points. 3 patients with Rockwood III were treated conservative with 10.3 points and 3 patients were operated with 10.7 points at Taftscore. AC-joint dislocations should be classified to Rockwood. No differences were seen between operation and conservative treatment in Rockwood III in literature. We recommend operation with PDS cords with good results in Rockwood V.

Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations in a coracoclavicular Double-TightRope technique: V-shaped versus parallel drill hole orientation.

PubMed

Kraus, Natascha; Haas, Norbert P; Scheibel, Markus; Gerhardt, Christian

2013-10-01

The arthroscopically assisted Double-TightRope technique has recently been reported to yield good to excellent clinical results in the treatment of acute, high-grade acromioclavicular dislocation. However, the orientation of the transclavicular-transcoracoidal drill holes remains a matter of debate. A V-shaped drill hole orientation leads to better clinical and radiologic results and provides a higher vertical and horizontal stability compared to parallel drill hole placement. This was a cohort study; level of evidence, 2b. Two groups of patients with acute high-grade acromioclavicular joint instability (Rockwood type V) were included in this prospective, non-randomized cohort study. 15 patients (1 female/14 male) with a mean age of 37.7 (18-66) years were treated with a Double-TightRope technique using a V-shaped orientation of the drill holes (group 1). 13 patients (1 female/12 male) with a mean age of 40.9 (21-59) years were treated with a Double-TightRope technique with a parallel drill hole placement (group 2). After 2 years, the final evaluation consisted of a complete physical examination of both shoulders, evaluation of the Subjective Shoulder Value (SSV), Constant Score (CS), Taft Score (TF) and Acromioclavicular Joint Instability Score (ACJI) as well as a radiologic examination including bilateral anteroposterior stress views and bilateral Alexander views. After a mean follow-up of 2 years, all patients were free of shoulder pain at rest and during daily activities. Range of motion did not differ significantly between both groups (p > 0.05). Patients in group 1 reached on average 92.4 points in the CS, 96.2 % in the SSV, 10.5 points in the TF and 75.9 points in the ACJI. Patients in group 2 scored 90.5 points in the CS, 93.9 % in the SSV, 10.5 points in the TF and 84.5 points in the ACJI (p > 0.05). Radiographically, the coracoclavicular distance was found to be 13.9 mm (group 1) and 13.4 mm (group 2) on the affected side and 9.3 mm (group 1

Prevalence of remaining horizontal instability in high-grade acromioclavicular joint injuries surgically managed.

PubMed

Cisneros, Luis Natera; Reiriz, Juan Sarasquete

2017-04-01

To determine the prevalence of remaining horizontal instability in high-grade acromioclavicular joint (ACJ) injuries surgically managed by means of four different surgical strategies and to assess its relation to the clinical outcomes and the quality of life. In this multicentric non-randomized retrospective study, 53 patients with high-grade ACJ injuries surgically managed (by means of open or arthroscopic surgery) were clinically and radiographically assessed at 24 months or more after shoulder surgery. The presence of post-surgical remaining horizontal instability was evaluated by means of Alexander or axillary X-ray views. The study population was divided into two groups: patients with evidence of post-surgical remaining horizontal instability and patients without evidence of post-surgical remaining horizontal instability at the last follow-up visit. The relationship between remaining horizontal instability and the quality-of-life questionnaires was analyzed. 18.87% (10/53) of the Alexander or axillary X-rays views showed post-surgical remaining horizontal instability at the last follow-up visit (INSTAB-group). Results of the questionnaires were: (1) physical SF36 score (INSTAB-group 57.02 ± 3.17  and NO-INSTAB-group 57.66 ± 3.30, p = 0.583); (2) mental SF36 score (INSTAB-group 53.95 ± 3.98  and NO-INSTAB-group 55.71 ± 3.30, p = 0.150); (3) NRS for pain (INSTAB-group 1.30 ± 1.49 and NO-INSTAB-group 0.83  ± 1.08, p = 0.260); (4) DASH questionnaire (INSTAB-group 5.27 ± 5.42 and NO-INSTAB-group 3.06 ± 2.30, p = 0.049); (5) Constant score (INSTAB-group 93.4 ± 3.5 and NO-INSTAB-group 94.83  ± 4.3, p = 0.333); and Global satisfaction (INSTAB-group 8.7  ± 0.95 and NO-INSTAB-group 8.64 ± 1.03, p = 0.874). Independently of the type of procedure, post-surgical remaining horizontal instability was present in almost one-fifth of the patients, and this group of patients showed a significantly worse DASH score. The

Intraspinal migration of a Kirschner wire as a late complication of acromioclavicular joint repair: a case report.

PubMed

Mankowski, Bartosz; Polchlopek, Tadeusz; Strojny, Marcin; Grala, Pawel; Slowinski, Krzysztof

2016-03-24

Penetrating neck trauma involving foreign bodies is a rare event in European countries. Due to its relatively high mortality rate, the correct management strategy must be initiated from the beginning to prevent fatal complications. In the medical literature, there are only a few cases describing foreign bodies penetrating the cervical spine. Because of its rareness, many trauma centers lack the proper routine to adequately manage such injuries. This case report describes a 34-year-old white man of Central European descent with Kirschner wire migration and perforation of his vertebral foramen. He underwent acromioclavicular joint repair surgery 7 years ago, presented with a painful sensation around the area of his left clavicle and left side of his neck after a motorcycle accident. No neurological deficit was detected. In such cases, a thorough radiological evaluation of the spinal cord and the surrounding vasculature is mandatory for a complete understanding of the extent of the injury and determining the proper surgical management. In cases of vertebral artery trauma both an endovascular and an open approach can be contemplated.

Return to play after nonoperative management for a severe type III acromioclavicular separation in the throwing shoulder of a collegiate pitcher.

PubMed

Watson, Scott T; Wyland, Douglas J

2015-02-01

Treatment of type III acromioclavicular (AC) separations is controversial, especially in the dominant shoulder of a high-level throwing athlete. This case report describes the return to play after nonoperative management of a collegiate baseball pitcher with a severe type III AC separation in his throwing shoulder. Case report of return to play with nonoperative management of a type III AC separation in the throwing shoulder of a collegiate pitcher. A case report of a single patient. Prospective data were recorded in the case of a collegiate pitcher who suffered an acute injury to the dominant shoulder, resulting in a severe type III AC separation. He was initially treated with a figure-of-8 brace and a sling. Postinjury, strengthening of the wrist, hand, and elbow began at 3½ weeks, and shoulder range of motion (ROM) and a periscapular strengthening program began at 6 weeks. At 2 months postinjury, a deformity was still present, but the athlete was pain free, with full shoulder ROM and strength without tenderness at the AC joint. Formal physical therapy was initiated to include an accelerated interval throwing program. At 12 weeks postinjury, the athlete was pitching asymptomatically, and gradually returned to regular play. At 6 months and now through 24 months postinjury, the athlete reported full strength, full ROM, and return to his previous level of throwing and velocity without complication. He volunteered that he was 100% satisfied with the result, and feels he is the same pitcher as, if not stronger than, prior to this injury. This case demonstrates a collegiate baseball pitcher who returned to his preinjury level of pitching with nonoperative treatment of a severe type III AC separation.

Acromioclavicular joint dislocation: a Dog Bone button fixation alone versus Dog Bone button fixation augmented with acromioclavicular repair-a finite element analysis study.

PubMed

Sumanont, Sermsak; Nopamassiri, Supachoke; Boonrod, Artit; Apiwatanakul, Punyawat; Boonrod, Arunnit; Phornphutkul, Chanakarn

2018-03-20

Suspension suture button fixation was frequently used to treat acromioclavicular joint (ACJ) dislocation. However, there were many studies reporting about complications and residual horizontal instability after fixation. Our study compared the stability of ACJ after fixation between coracoclavicular (CC) fixation alone and CC fixation combined with ACJ repair by using finite element analysis (FEA). A finite element model was created by using CT images from the normal shoulder. The model 1 was CC fixation with suture button alone, and the model 2 was CC fixation with suture button combined with ACJ repair. Three different forces (50, 100, 200 N) applied to the model in three planes; inferior, anterior and posterior direction load to the acromion. The von Mises stress of the implants and deformation at ACJs was recorded. The ACJ repair in the model 2 could reduce the peak stress on the implant after applying the loading forces to the acromion which the ACJ repair could reduce the peak stress of the FiberWire at suture button about 90% when compared to model 1. And, the ACJ repair could reduce the deformation of the ACJ after applying the loading forces to the acromion in both vertical and horizontal planes. This FEA supports that the high-grade injuries of the ACJ should be treated with CC fixation combined with ACJ repair because this technique provides excellent stability in both vertical and horizontal planes and reduces stress to the suture button.

Loss of reduction and complications of coracoclavicular ligament reconstruction with autogenous tendon graft in acute acromioclavicular dislocations.

PubMed

Choi, Nam Hong; Lim, Seok Min; Lee, Sang Young; Lim, Tae Kang

2017-04-01

This study was conducted to report loss of reduction and complications after single-tunnel coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus tendon graft for acute acromioclavicular (AC) joint dislocations. This retrospective study included patients with acute, unstable AC dislocations (surgery within 6 weeks after trauma). We excluded patients with chronic injury and distal clavicle fractures with CC ligaments disruption. We measured the CC distance on anteroposterior radiographs of both clavicles, preoperatively, immediately postoperatively, and at the final follow-up visit. We evaluated clinical outcomes using the American Shoulder and Elbow Surgeons Shoulder Assessment and the University of California, Los Angeles Shoulder Rating Scale scores and perioperative complications. There were 30 patients (27 men and 3 women) with mean age of 41 years (range, 19-70 years). The mean follow-up period was 31 months (range, 12-186 months). Mean CC distance was 15.5 ± 3.7 mm (84% ± 14% of the contralateral shoulder) preoperatively, 8.9 ± 2.6 mm (9% ± 40%) immediately postoperatively (P < .001), and 10.6 ± 3.3 mm (24% ± 39%) at the final assessment (P < .001), showing an increase of the CC distance during the follow-up. Loss of reduction (defined as >25% increase of CC distance) developed in 14 patients (47%), and complications occurred in 6 patients (20%), including 3 distal clavicle fractures through the tunnel. Final clinical scores were significantly lower in patients with complications (27 vs. 33 of the University of California, Los Angeles assessment [P < .001] and 81 vs. 95 of the American Shoulder and Elbow Surgeons Shoulder assessment [P < .001]). In acute AC joint dislocation, single-tunnel CC ligament reconstruction using autogenous tendon graft resulted in loss of reduction rate of 47% and a complication rate of 20%. The development of complications adversely affected clinical outcomes

Simultaneous Anterior Glenohumeral Dislocation and Ipsilateral Acromioclavicular Separation: A Dual Injury of the Shoulder.

PubMed

Kılıçaslan, Ömer Faruk; Acar, Baver; Atik, Aziz; Kose, Ozkan

2017-08-19

Isolated acromioclavicular separations or shoulder dislocations are common injuries. However, a combination of complete acromioclavicular separation and anterior shoulder dislocation is extremely rare. Herein we present a combination of anterior shoulder dislocation and type III acromioclavicular separation that was succesfully treated conservatively. Orthopaedic surgeons should have a high clinical suspicion in daily practice. We believe that both pathologies can be treated conservatively.

Simultaneous Anterior Glenohumeral Dislocation and Ipsilateral Acromioclavicular Separation: A Dual Injury of the Shoulder

PubMed Central

Acar, Baver; Atik, Aziz; Kose, Ozkan

2017-01-01

Isolated acromioclavicular separations or shoulder dislocations are common injuries. However, a combination of complete acromioclavicular separation and anterior shoulder dislocation is extremely rare. Herein we present a combination of anterior shoulder dislocation and type III acromioclavicular separation that was succesfully treated conservatively. Orthopaedic surgeons should have a high clinical suspicion in daily practice. We believe that both pathologies can be treated conservatively. PMID:29062614

Treatment and evolution of grade III acromioclavicular dislocations in soccer players.

PubMed

Pereira-Graterol, Ernesto; Álvarez-Díaz, Pedro; Seijas, Roberto; Ares, Oscar; Cuscó, Xavier; Cugat, Ramón

2013-07-01

To evaluate postoperative functional results in soccer players diagnosed with acute grade III acromioclavicular dislocation, stabilized with clavicular hook plate. Between 2006 and 2010, 11 soccer players were diagnosed with acute acromioclavicular dislocation. Mean age was 22.9 years. The clavicular hook plate was used for stabilization. The follow-up was 4 years (2-6 years). Constant score showed 82 % excellent results and 18 % good functional results. Average pain measured with VAS was 1.8 (±0.59) mm out of 10. We did not report any complication within the process. Use of the clavicular hook plate is considered adequate for the treatment of acute acromioclavicular dislocation in soccer players, allowing a quick return to sports. Retrospective case series, Level IV.

Intra-articular kinematics of the upper limb joints: a six degrees of freedom study of coupled motions.

PubMed

Cattrysse, Erik; Baeyens, Jean-Pierre; Van Roy, Peter; Van de Wiele, Olivier; Roosens, Tom; Clarys, Jan-Pieter

In sport, leisure and certain occupational activities, joint lesions of the upper limb are very common. To understand their aetiology in order to prevent and treat these pathologies on a scientific basis, a comprehensive knowledge of the involved stress and kinematics is imperative. For many years intra-articular joint kinematics have been described hypothetically in terms of the convex-concave principle. This principle, however, has not been validated. The in vitro research on the acromioclavicular, glenohumeral and elbow joints was performed using an electromagnetic tracking device (Flock of Birds). By recalculating the positions of the trackers to an embedded coordinate system on the joint surface, the intra-articular joint movements can be analysed. Therefore, the bony configurations and articular surface features were registered with a 3D drawing stylus (Microscribe). Thirteen acromioclavicular joints, six glenohumeral joints and seven elbows were studied. The coupled intra-articular movements were analysed using the Euler angles and finite helical axis approaches. The results of the acromioclavicular joint analysis indicate that during movements in the scapular plane a superior rotation of the clavicle was coupled with an inferior translation and vice versa, whilst during movements in the plane perpendicular to the scapular plane the anterior rotation was coupled with an anterior translation and vice versa. In the glenohumeral joint, the abduction-elevation was coupled with an external rotation. In the humero-ulnar joint, the extension was coupled with an external rotation and varus movement. This intra-articular behaviour was in contradiction to currently accepted convex-concave concepts in arthrokinematics and manual therapy. The results may have major implications for manual therapy and orthopaedic medical practice.

The anterior borders of the clavicle and the acromion are not always aligned in the intact acromioclavicular joint: a cadaveric study.

PubMed

Barth, Johannes; Boutsiadis, Achilleas; Narbona, Pablo; Lädermann, Alexandre; Arrigoni, Paolo; Adams, Christopher R; Burkhart, Stephen S; Denard, Patrick J

2017-07-01

The aim of this study was to find reliable anatomic landmarks of the normal acromioclavicular joint (ACJ) that could enable the precise evaluation of the horizontal displacement of the clavicle after dislocation. The hypothesis was that the anterior borders of the acromion and the clavicle are always aligned in intact ACJs. In 30 cadaveric specimens, the anterior and posterior borders of the ACJ's articular facets and the most prominent anterior and posterior bony landmarks of the acromion and the clavicle were identified. The anterior and posterior overhang of the acromion and the clavicle was measured in relation to the borders of the articular facets. Therefore, the possible anterior and posterior alignment of the ACJ was evaluated. Anteriorly, only 18 ACJs (60%) were aligned whereas 7 (24%) had major overhang of the acromion and 3 (10%) had major overhang of the clavicle. Similarly, 18 cases (60%) were posteriorly aligned, whereas 6 (20%) had major clavicular overhang and 4 (14%) had major overhang of the acromion. In 78% of these cases, the ACJ was aligned as well anteriorly as posteriorly (P < .001). Finally, the larger the width of the acromion (P = .032) or the clavicle (P = .049), the better the posterior joint alignment. Our hypothesis was not verified. The acromion and clavicle are not perfectly aligned in a significant number of specimens with intact ACJs (40% of cases). The most reliable landmarks remain their articular facets. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Hook plate fixation for acute acromioclavicular dislocations without coracoclavicular ligament reconstruction: a functional outcome study in military personnel.

PubMed

Kumar, Narinder; Sharma, Vyom

2015-08-01

The aim of our study was to evaluate the shoulder function after clavicular hook plate fixation of acute acromioclavicular dislocations (Rockwood type III) in a population group consisting exclusively of high-demand military personnel. This prospective study was carried out at a tertiary care military orthopaedic centre during 2012-2013 using clavicular hook plate for management of acromioclavicular injuries without coracoclavicular ligament reconstruction in 33 patients. All patients underwent routine implant removal after 16 weeks. The functional outcome was assessed at 3, 6 and 12 months after hook plate removal and 2 years from the initial surgery using the Constant Murley and UCLA Scores. All the patients were male serving soldiers and had sustained acromioclavicular joint dislocation (Rockwood type III). Mean age of the patient group was 34.24 years (21-55 years). The mean follow-up period in this study was 23.5 months (20-26 months) after hook plate fixation and an average of 19.9 months (17-22 months) after hook plate removal. The average Constant Score at 3 months after hook plate removal was 60.3 as compared to 83.7 and 90.3 at 6 months and 1 year, respectively, and an average of 91.8 at the last follow-up that was approximately 2 years after initial surgery which was statistically significant (p value <0.05). The UCLA Score was an average of 15.27, 25.9 and 30.1 at 3, 6 months and 1 year, respectively, after removal of hook plate which improved further an average of 32.3 at the last follow-up, which was also statistically significant (p value <0.05). Clavicular hook plate fixation without coracoclavicular ligament reconstruction is a good option for acute acromioclavicular dislocations producing excellent medium-term functional results in high-demand soldiers.

A Biomechanical Analysis of Different Clavicular Tunnel Diameters in Anatomic Acromioclavicular Ligament Reconstruction.

PubMed

Voss, Andreas; Beitzel, Knut; Alaee, Farhang; Dukas, Alex; Herbst, Elmar; Obopilwe, Elifho; Apostolakos, John; DiVenere, Jessica; Singh, Hardeep; Cote, Mark P; Mazzocca, Augustus D

2016-08-01

To evaluate the biomechanical stability of a tendon-to-clavicle bone interface fixation of a graft in revision acromioclavicular reconstruction. Fifteen fresh-frozen cadaveric shoulders were used. All specimens underwent bone density evaluation. For the primary reconstruction, a 5-mm semitendinosus allograft was inserted into a 5-mm bone tunnel at 25 and 45 mm from the lateral end of the clavicle using a 5.5 × 8-mm PEEK (polyether ether ketone) tenodesis screw. Each single graft was fixed in a cryo-clamp and cyclically loaded from 5 to 70 N for 3,000 cycles, followed by load-to-failure testing at a rate of 120 mm/min to simulate the revision case. To simulate tunnel widening, the tunnels of the revision series were over-drilled with an 8-mm drill, and a 5-mm semitendinosus graft with an 8 × 12-mm PEEK tenodesis screw was inserted. Biomechanical testing was then repeated. The bone mineral density analysis showed a significantly higher density at the 45-mm hole compared with the 25-mm hole (P = .001). The ultimate load to failure increased from the 5.5-mm screw to the 8-mm screw at the 45-mm hole position (P = .001). There was no statistically significant difference at the 25-mm hole position (P = .934). No statistical significance for graft elongation comparing the 5.5-mm screw and the 8-mm screw at the 25-mm (P = .156) and 45-mm (P = .334) positions could be found. Comparable biomechanical stability for the tendon-to-bone interface fixation in different clavicular tunnel diameters simulating primary and revision reconstruction was achieved. There is a lack of literature regarding revision acromioclavicular joint reconstruction, but our biomechanical results show comparable stability to primary reconstruction. These data provide support for the use of anatomic acromioclavicular ligament reconstruction in revision cases. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Surgical treatment of acromioclavicular dislocation using the endobutton.

PubMed

Teodoro, Renato Loureiro; Nishimi, Alexandre Yukio; Pascarelli, Luciano; Bongiovanni, Roberto Rangel; Velasco, Marcelo Andreotti Perez; Dobashi, Eiffel Tsuyoshi

2017-01-01

To evaluate the clinical and radiographic results of 23 patients diagnosed with acute type III acromioclavicular dislocation treated with the Endobutton. Twenty-three patients with a diagnosis of type III acromioclavicular dislocation were treated surgically. Twenty-one patients were male (91.3%) and 2 (8.7%) were female. The dominant side was affected in 15 patients (65.21%) and the non-dominant side in 8 patients (34.79%). All patients were operated on by the same surgical team within 4 weeks of the trauma. According to the UCLA score, 14 patients (60.86%) presented excellent results, 7 patients (30.43%) had good results and 2 patients (8.69%) had regular results. The technique was effective in treating acute type III dislocations with a high degree of patient satisfaction. Level of Evidence IV, Case Series.

A comparison between two double-button endoscopically assisted surgical techniques for the treatment acute acromioclavicular dislocations.

PubMed

Vulliet, P; Le Hanneur, M; Cladiere, V; Loriaut, P; Boyer, P

2018-04-01

To compare clinical and radiological outcomes between two endoscopically assisted double-button techniques in high-grade acute acromioclavicular separations. A retrospective single-center study was conducted in patients with acute acromioclavicular joint dislocation Rockwood types III and V, from 2009 to 2014. All were treated endoscopically, with a 1-year minimum follow-up. Two consecutive series were conducted; the first (TR group) received the TightRope ® system, whereas last series (DB group) was treated with the Dog Bone ® button technology (Arthrex, Naples, FL, USA). Primary endpoints were last follow-up values of Constant score (CS) and Quick-DASH (QD) score. Moreover, the posttraumatic displacement and its evolution were assessed on bilateral Zanca radiographs. A displacement of 5 mm or greater the day after surgery was considered as a lack of reduction; the same difference on last follow-up X-rays was considered as a loss of reduction. Forty patients were reviewed: 22 in the TR group and 18 in the DB group. After a mean follow-up of 27.7 ± 8.3 months, CS and QD averaged, respectively, 94.3 ± 4.4 and 2.0 ± 2.6 in the TR series, whereas they averaged, respectively, 95 ± 6.1 and 3.4 ± 3.3 in the DB series after a mean follow-up of 24.1 ± 5 months (PCS = 0.16, PQDS = 0.08). Lack of reduction and loss of reduction rates were significantly higher in the DB group, with P = 0.0005 and P < 0.0001, respectively. Both techniques provided good to excellent functional outcomes. However, considering inferior radiological results using the Dog Bone ® device, we would prefer the TightRope ® device in acute acromioclavicular dislocations. IV: Therapeutic study-cases series.

Operative treatment of acute acromioclavicular dislocations Rockwood III and V-Comparative study between K-wires combined with FiberTape(®) vs. TightRope System(®).

PubMed

Vrgoč, G; Japjec, M; Jurina, P; Gulan, G; Janković, S; Šebečić, B; Starešinić, M

2015-11-01

Acromioclavicular (AC) joint dislocations usually occur in a young active population as a result of a fall on the shoulder. Rockwood divided these dislocations into six types. Optimal treatment is still a matter of discussion. Many operative techniques have been developed, but the main choice is between open and minimally-invasive arthroscopic procedures. The aim of this study was to compare two different surgical methods on two groups of patients to find out which method is superior in terms of benefit to the patient. The methods were evaluated through objective and subjective scores, with a focus on complications and material costs. A retrospective two-centre study was conducted in patients with acute AC joint dislocation Rockwood types III and V. The two methods conducted were an open procedure using K-wires combined with FiberTape(®) (Arthrex, Naples, USA) (Group 1) and an arthroscopic procedure using the TightRope System(®) (Arthrex, Naples, USA) (Group 2). Groups underwent procedures during a two-year period. Diagnosis was based on the clinical and radiographic examination of both AC joints. Surgical treatment and rehabilitation were performed. Sixteen patients were included in this study: Group 1 comprised 10 patients, all male, average age 41.6 years (range 17-64 years), Rockwood type III (eight patients) and Rockwood type V (two patients); Group 2 had six patients, one female and five male, average age 37.8 years (range 18-58 years), Rockwood type III (two patients) and Rockwood type V (four patients). Time from injury to surgery was shorter and patients needed less time to return to daily activities in Group 1. Duration of the surgical procedure was shorter in Group 2 compared with Group 1. Complications of each method were noted. According to the measured scores and operative outcome between dislocation Rockwood type III and V, no significant difference was found. Implant material used in Group 2 was 4.7 times more expensive than that used in Group 1

Prognostic factors to succeed in surgical treatment of chronic acromioclavicular dislocations.

PubMed

Barth, J; Duparc, F; Baverel, L; Bahurel, J; Toussaint, B; Bertiaux, S; Clavert, P; Gastaud, O; Brassart, N; Beaudouin, E; De Mourgues, P; Berne, D; Duport, M; Najihi, N; Boyer, P; Faivre, B; Meyer, A; Nourissat, G; Poulain, S; Bruchou, F; Ménard, J F

2015-12-01

Treatment of chronic acromioclavicular joint dislocation (ACJD) remains a poorly known and controversial subject. Given the many surgical options, it is not always easy to determine which steps are indispensable. This article reports a multicenter prospective study. The clinical and radiological follow-up involved a comparative analysis of the preoperative and postoperative data at 1 year, including pain (visual analogue scale), subjective functional incapacity (QuickDASH), and the objective Constant score, as well as a comparative analysis of vertical and horizontal movements measured on simple x-rays. Based on a series of 140 operated ACJDs, we included 24 chronic ACJDs. The mean time to surgery was 46 weeks (range, 1 month to 4 years). The patients' mean age was 41 years, with a majority of males (75%), 72% of whom participated in recreational sports. Professionally, 40% of the subjects had jobs involving manual labor. We noted 40% grade III, 24% grade IV, and 36% grade V injury according to the Rockwood classification. In 92% of cases, coracoclavicular stabilization was provided by a double button implant, reinforced with a biological graft in 88% of the cases. In 29%, millimeters to centimeters of the distal clavicle were resected and acromioclavicular stabilization was associated in 54%. We observed complications in 33% of the cases. At 1 year postoperative, 21 patients underwent clinical and radiological follow-up (87.5%). Only 35% of the patients were satisfied or very satisfied, whereas 100% of them would recommend the operation. Full-time work was resumed in 91% of the cases and all sports could be resumed in 86%. The pre- and postoperative values at 1 year changed as follows: the mean Constant score improved from 61 to 87 (p=0.00002); the subjective QuickDASH score decreased from 41 to 9 (p=0.00002); and radiologically significant reduction of the initial displacement was observed in the vertical plane (p<10(-3)) and the horizontal plane (p=0

Three-dimensional scapular dyskinesis in hook-plated acromioclavicular dislocation including hook motion.

PubMed

Kim, Eugene; Lee, Seunghee; Jeong, Hwa-Jae; Park, Jai Hyung; Park, Se-Jin; Lee, Jaewook; Kim, Woosub; Park, Hee Jin; Lee, So Yeon; Murase, Tsuyoshi; Sugamoto, Kazuomi; Ikemoto, Sumika

2018-06-01

The purpose of this study is to analyze the 3-dimensional scapular dyskinesis and the kinematics of a hook plate relative to the acromion after hook-plated acromioclavicular dislocation in vivo. Reported complications of acromioclavicular reduction using a hook plate include subacromial erosion and impingement. However, there are few reports of the 3-dimensional kinematics of the hook and scapula after the aforementioned surgical procedure. We studied 15 cases of acromioclavicular dislocation treated with a hook plate and 15 contralateral normal shoulders using computed tomography in the neutral and full forward flexion positions. Three-dimensional motion of the scapula relative to the thorax during arm elevation was analyzed using a computer simulation program. We also measured the distance from the tip of the hook plate to the greater tuberosity, as well as the angular motion of the plate tip in the subacromial space. Decreased posterior tilting (22° ± 10° vs 31° ± 8°) in the sagittal plane and increased external rotation (19° ± 9° vs 7° ± 5°) in the axial plane were evident in the affected shoulders. The mean values of translation of the hook plate and angular motion against the acromion were 4.0 ± 1.6 mm and 15° ± 8°, respectively. The minimum value of the distance from the hook plate to the humeral head tuberosity was 6.9 mm during arm elevation. Acromioclavicular reduction using a hook plate may cause scapular dyskinesis. Translational and angular motion of the hook plate against the acromion could lead to subacromial erosion. However, the hook does not seem to impinge directly on the humeral head. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Short-term outcomes of arthroscopic TightRope® fixation are better than hook plate fixation in acute unstable acromioclavicular joint dislocations.

PubMed

Bin Abd Razak, Hamid Rahmatullah; Yeo, Eng-Meng Nicholas; Yeo, William; Lie, Tijauw-Tjoen Denny

2018-07-01

The aim of this study was to compare the short-term outcomes of arthroscopic TightRope ® fixation with that of hook plate fixation in patients with acute unstable acromioclavicular joint dislocations. We conducted a prospective case-control study of twenty-six patients with an acute ACJ dislocation who underwent surgical repair with either an arthroscopic TightRope ® fixation or a hook plate from 2013 to 2016. Clinical and radiological data were collected prospectively. Clinical outcomes were evaluated using the Constant Score, the University of California at Los Angeles (UCLA) Shoulder Score, Oxford Shoulder Score as well as the visual analogue scale. Radiological outcomes were assessed with the coracoclavicular distance (CCD). Sixteen patients underwent arthroscopic TightRope ® fixation, while 10 patients underwent hook plate fixation. There were no significant differences in the preoperative variables except for the mean UCLA 4b infraspinatus score (TightRope ® 2.8 vs. hook plate 3.8; p = 0.030). Duration of surgery was significantly longer in the TightRope ® group. At 1 year post-operatively, the TightRope ® group had a significantly better Constant Score and CCD with no complications. All patients with hook plate fixation had to undergo a second procedure for removal of implant, and 3 patients had complications. Arthroscopic TightRope ® fixation is a good option for the treatment of acute unstable ACJ dislocations. It has better short-term clinical and radiological outcomes as well as lesser complications when compared to hook plate fixation. Therapeutic, Level III.

Quantitative and qualitative analyses of subacromial impingement by kinematic open MRI.

PubMed

Tasaki, Atsushi; Nimura, Akimoto; Nozaki, Taiki; Yamakawa, Akira; Niitsu, Mamoru; Morita, Wataru; Hoshikawa, Yoshimitsu; Akita, Keiichi

2015-05-01

Quantitative and qualitative kinematic analyses of subacromial impingement by 1.2T open MRI were performed to determine the location of impingement and the involvement of the acromioclavicular joint. In 20 healthy shoulders, 10 sequential images in the scapular plane were taken in a 10-s pause at equal intervals from 30° to maximum abduction in neutral and internal rotation. The distances between the rotator cuff (RC) and the acromion and the acromioclavicular joint were measured. To comprehend the positional relationships, cadaveric specimens were also observed. Although asymptomatic, the RC came into contact with the acromion and the acromioclavicular joint in six and five cases, respectively. The superior RC acted as a depressor for the humeral head against the acromion as the shoulder elevated. The mean elevation angle and distance at the closest position between the RC and the acromion in neutral rotation were 93.5° and 1.6 mm, respectively, while those between the RC and the acromioclavicular joint were 86.7° and 2.0 mm. When comparing this distance and angle, there was no significant difference between the RC to the acromion and to the acromioclavicular joint. The minimum distance between the RC and the acromion was significantly shorter than that between the greater tuberosity and the acromion. The location of RC closest to the acromion and the acromioclavicular joint differed significantly. Although asymptomatic, contact was found between the RC and the acromion and the acromioclavicular joint. The important role of the RC to prevent impingement was observed, and hence, dysfunction of the RC could lead to impingement that could result in a RC lesion. The RC lesions may differ when they are caused by impingement from either the acromion or the acromioclavicular joint.

Results of Operative and Nonoperative Treatment of Rockwood Types III and V Acromioclavicular Joint Dislocation

PubMed Central

Joukainen, Antti; Kröger, Heikki; Niemitukia, Lea; Mäkelä, E. Antero; Väätäinen, Urho

2014-01-01

Background: The optimal treatment of acute, complete dislocation of the acromioclavicular joint (ACJ) is still unresolved. Purpose: To determine the difference between operative and nonoperative treatment in acute Rockwood types III and V ACJ dislocation. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: In the operative treatment group, the ACJ was reduced and fixed with 2 transarticular Kirschner wires and ACJ ligament suturing. The Kirschner wires were extracted after 6 weeks. Nonoperatively treated patients received a reduction splint for 4 weeks. At the 18- to 20-year follow-up, the Constant, University of California at Los Angeles Shoulder Rating Scale (UCLA), Larsen, and Simple Shoulder Test (SST) scores were obtained, and clinical and radiographic examinations of both shoulders were performed. Results: Twenty-five of 35 potential patients were examined at the 18- to 20-year follow-up. There were 11 patients with Rockwood type III and 14 with type V dislocations. Delayed surgical treatment for ACJ was used in 2 patients during follow-up: 1 in the operatively treated group and 1 in the nonoperatively treated group. Clinically, ACJs were statistically significantly less prominent or unstable in the operative group than in the nonoperative group (normal/prominent/unstable: 9/4/3 and 0/6/3, respectively; P = .02) and in the operative type III (P = .03) but not type V dislocation groups. In operatively and nonoperatively treated patients, the mean Constant scores were 83 and 85, UCLA scores 25 and 27, Larsen scores 11 and 11, and SST scores 11 and 12 at follow-up, respectively. There were no statistically significant differences in type III and type V dislocations. In the radiographic analysis, the ACJ was wider in the nonoperative than the operative group (8.3 vs 3.4 mm; P = .004), and in the type V dislocations (nonoperative vs operative: 8.5 vs 2.4 mm; P = .007). There was no statistically significant difference between study groups in

Portable Handheld Laser Small Area Supplemental Coatings Removal System, Version 2.0

DTIC Science & Technology

2005-08-17

awkward posture can cause unnecessary stress at the shoulder ( acromioclavicular joint and the glenohumeral joint) and may contribute to bursitis or...order to point the laser at the surface to be cleaned. This awkward posture can cause unnecessary stress at the shoulder ( acromioclavicular joint and

POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES.

PubMed

Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

2012-01-01

To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.

[Clavicular hook plate combined with suture anchor for the treatment of type Tossy III chronic acromioclavicular dislocation].

PubMed

Xu, Zhi-Bin; Wang, Jin

2014-05-01

To observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation. From January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect. All patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor. Clavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.

POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES

PubMed Central

Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

2015-01-01

Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients’ mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature. PMID:27047866

Coracoid bypass procedure: surgical technique for coracoclavicular reconstruction with coracoid insufficiency.

PubMed

Virk, Mandeep S; Lederman, Evan; Stevens, Christopher; Romeo, Anthony A

2017-04-01

Failed acromioclavicular (AC) joint reconstruction secondary to a coracoid fracture or insufficiency of the coracoid is an uncommon but challenging clinical situation. We describe a surgical technique of revision coracoclavicular (CC) reconstruction, the coracoid bypass procedure, and report short-term results with this technique in 3 patients. In the coracoid bypass procedure, reconstruction of the CC ligaments is performed by passing a tendon graft through a surgically created bone tunnel in the scapular body (inferior to the base of the coracoid) and then fixing the graft around the clavicle or through bone tunnels in the clavicle. Three patients treated with this technique were retrospectively reviewed. AC joint reconstruction performed for a traumatic AC joint separation failed in the 3 patients reported in this series. The previous procedures were an anatomic CC reconstruction in 2 patients and a modified Weaver-Dunn procedure in 1 patient. The coracoid fractures were detected postoperatively, and the mean interval from the index surgery to the coracoid bypass procedure was 8 months. The patients were a mean age of 44 years, and average follow-up was 21 months. At the last follow-up, all 3 patients were pain free, with full range of shoulder motion, preserved CC distance, and a stable AC joint. The coracoid bypass procedure is a treatment option for CC joint reconstruction during revision AC joint surgery in the setting of a coracoid fracture or coracoid insufficiency. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

[Case control study on the treatment of acromioclavicular dislocation with Endobutton plates combined with an anchor].

PubMed

Hu, Jin-Tao; Lu, Jian-Wei; Fu, Li-Feng

2016-09-25

To compare the clinical effect of Endobutton plates combined with an anchor and clavicle hook plate in the treatment of acromioclavicular dislocation. From January 2012 to August 2014, 83 patients with Rockwood type III acromioclavicular dislocation underwent surgical treatments. Among them, 34 patients were treated with Endobutton plate and anchor repair(Endobutton group), including 23 males and 11 females, and the mean age was(39.0±6.3) years old (26 to 51 years old); the average time from injury to operation was(4.1±1.3) days(3 to 7 days);the injured side:14 left, 20 right; the dislocation in 28 patients dues to fall, 6 patients dues traffic accident. There were 49 patients treated with clavicular hook plate(hook plate group), including 33 males and 16 females;the mean age was(37.9±6.3) years old (27 to 53 years old); the average time from injury to operation was(4.1±1.1) days (2 to 7 days);the injured side: 18 left, 31 right;the dislication in 36 patients dues to fall, 13 patients dues traffic accidents. The indexes such as intraoperative bleeding volume, operation time, incision size, postoperative complication and postoperative coracoclavicular space, shoulder joint function, and life quality were compared between two groups. In the hook plate group with 49 patients, the plates in 43 patients were removed at the secondary operation, and 32 patients had shoulder pain or limited active range. Thirty four patients in the Endobutton group had no pain symptoms and limited active range. All the patients did not suffer acromioclavicular dislocation again. There was no significant difference between the two groups in operation time, and intraoperative bleeding volume( P >0.05). The incision length in the hook plate group was longer than that in Endobutton group( P <0.05). The coracoclavicular space of the uninjured and injured side in two groups respectively had no significant differences, and the coracoclavicular space in the injured side between two group had

Mechanically Evoked Torque and Electromyographic Responses During Passive Elbow Extension in Upper Limb Tension Test Position

DTIC Science & Technology

2001-10-25

axis during passive elbow extension. A padded shoulder block was placed superior to the subject’s acromioclavicular joint to stabilize the shoulder...girdle position. A pressure sensor was used between the padded shoulder block and the acromioclavicular joint to monitor and standardize the pressure

Treatment of complete acromioclavicular dislocation: present indications and surgical technique with biodegradable cords.

PubMed

Mönig, S P; Burger, C; Helling, H J; Prokop, A; Rehm, K E

1999-11-01

We report a retrospective study of 48 patients with complete acromioclavicular dislocation (Tossy III). All patients (38 male; 10 female) with an average age of 33.4 years underwent surgery including PDS-augmentation. More than half of the injuries were caused by sport accidents. There were no complications during surgery. 87% of the patients were free of complaints and subjectively very satisfied with the surgical results. By radiological examination we diagnosed a subluxation of the clavicula in 25% of the cases and arthrosis in 17% of the cases. Assessment of subjective complaints, the clinical examination, and the radiological diagnostic according to the Taft Score (0-12 points) resulted in an average value of 10.2 points. The surgical intervention using PDS-cord augmentation in cases of complete acromioclavicular separation is a safe and economic method with a low complication rate. Advantages are possible early-functional treatment, no risk of movement of implants, and avoidance of metal removal.

Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain

PubMed Central

2013-01-01

Background Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. Methods Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. Following a standardised clinical examination and diagnostic injection into the subacromial bursa, all participants received a fluoroscopically guided diagnostic block of 1% lidocaine hydrochloride (XylocaineTM) into the ACJ. Diagnostic accuracy statistics including sensitivity, specificity, predictive values, positive and negative likelihood ratios (LR+ and LR-) were calculated for traditional ACJ tests (Active Compression/O’Brien’s test, cross-body adduction, localised ACJ tenderness and Hawkins-Kennedy test), and for individual and combinations of clinical examination variables that were associated with a positive anaesthetic response (PAR) (P≤0.05) defined as 80% or more reduction in post-injection pain intensity during provocative clinical tests. Results Twenty two of 153 participants (14%) reported an 80% PAR. None of the traditional ACJ tests were associated with an 80% PAR (P<0.05) and combinations of traditional tests were not able to discriminate between a PAR and a negative anaesthetic response (AUC 0.507; 95% CI: 0.366, 0.647; P>0.05). Five clinical examination variables (repetitive mechanism of pain onset, no referred pain below the elbow, thickened or swollen ACJ, no symptom provocation during passive glenohumeral abduction and external rotation) were associated with an 80% PAR (P<0.05) and demonstrated an ability to accurately discriminate between an PAR and NAR

Coracoclavicular joint: osteologic study of 1020 human clavicles

PubMed Central

Gumina, S; Salvatore, M; De Santis, P; Orsina, L; Postacchini, F

2002-01-01

We examined 1020 dry clavicles from cadavers of Italian origin to determine the prevalence of the coracoclavicular joint (ccj), a diarthrotic synovial joint occasionally present between the conoid tubercle of the clavicle and the superior surface of the horizontal part of the coracoid process. Five hundred and nine clavicles from individuals of different ages were submitted to X-ray examination. Using radiography, we measured the entire length and the index of sinuosity of the anterior lateral curve, on which the distance between the conoid tubercle and the coracoid process depends. We also used radiography to record the differences in prevalence of arthritis in two neighbouring joints, the acromioclavicular and sternoclavicular joints. Of the 1020 clavicles, eight (0.8%) displayed the articular facet of the ccj. No statistical correlation was found between clavicular length and the index of sinuosity of the anterior lateral curve. The prevalence of arthritis in clavicles with ccj was higher than that revealed in clavicles without ccj. The prevalence of ccj in the studied clavicles is lower than that observed in Asian cohorts. Furthermore, ccj is not conditioned by either length or sinuosity of the anterior lateral curve of the clavicle. Finally, the assumption that ccj is a predisposing factor for degenerative changes of neighbouring joints is statistically justified. PMID:12489763

PCC/AC shoulder joint seal evaluation

DOT National Transportation Integrated Search

1999-05-07

This report presents the findings on the evaluation of Crafco Incorporated Roadsaver 903 SL Silicone Sealant and Dow Corning 890 SL Silicone Sealant. The Research Technical Panel had proposed to use the two self-leveling silicone joint sealants in te...

The ACS NSQIP Risk Calculator Is a Fair Predictor of Acute Periprosthetic Joint Infection.

PubMed

Wingert, Nathaniel C; Gotoff, James; Parrilla, Edgardo; Gotoff, Robert; Hou, Laura; Ghanem, Elie

2016-07-01

Periprosthetic joint infection (PJI) is a severe complication from the patient's perspective and an expensive one in a value-driven healthcare model. Risk stratification can help identify those patients who may have risk factors for complications that can be mitigated in advance of elective surgery. Although numerous surgical risk calculators have been created, their accuracy in predicting outcomes, specifically PJI, has not been tested. (1) How accurate is the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Surgical Site Infection Calculator in predicting 30-day postoperative infection? (2) How accurate is the calculator in predicting 90-day postoperative infection? We isolated 1536 patients who underwent 1620 primary THAs and TKAs at our institution during 2011 to 2013. Minimum followup was 90 days. The ACS NSQIP Surgical Risk Calculator was assessed in its ability to predict acute PJI within 30 and 90 days postoperatively. Patients who underwent a repeat surgical procedure within 90 days of the index arthroplasty and in whom at least one positive intraoperative culture was obtained at time of reoperation were considered to have PJI. A total of 19 cases of PJI were identified, including 11 at 30 days and an additional eight instances by 90 days postoperatively. Patient-specific risk probabilities for PJI based on demographics and comorbidities were recorded from the ACS NSQIP Surgical Risk Calculator website. The area under the curve (AUC) for receiver operating characteristic (ROC) curves was calculated to determine the predictability of the risk probability for PJI. The AUC is an effective method for quantifying the discriminatory capacity of a diagnostic test to correctly classify patients with and without infection in which it is defined as excellent (AUC 0.9-1), good (AUC 0.8-0.89), fair (AUC 0.7-0.79), poor (AUC 0.6-0.69), or fail/no discriminatory capacity (AUC 0.5-0.59). A p value of < 0.05 was considered to be

Acromioclavicular Joint Separations

DTIC Science & Technology

2013-01-01

including tension pneumothorax ) have been reported in the literature and should be promptly ruled out [32–34]. The patient typically presents using their...pulmonary contusion or pneumothorax . Abrasions, swelling, and ecchymoses may be present on a prominent distal clavicle secondary to inferior displacement of

Bilateral weighted radiographs are required for accurate classification of acromioclavicular separation: an observational study of 59 cases.

PubMed

Ibrahim, E F; Forrest, N P; Forester, A

2015-10-01

Misinterpretation of the Rockwood classification system for acromioclavicular joint (ACJ) separations has resulted in a trend towards using unilateral radiographs for grading. Further, the use of weighted views to 'unmask' a grade III injury has fallen out of favour. Recent evidence suggests that many radiographic grade III injuries represent only a partial injury to the stabilising ligaments. This study aimed to determine (1) whether accurate classification is possible on unilateral radiographs and (2) the efficacy of weighted bilateral radiographs in unmasking higher-grade injuries. Complete bilateral non-weighted and weighted sets of radiographs for patients presenting with an acromioclavicular separation over a 10-year period were analysed retrospectively, and they were graded I-VI according to Rockwood's criteria. Comparison was made between grading based on (1) a single antero-posterior (AP) view of the injured side, (2) bilateral non-weighted views and (3) bilateral weighted views. Radiographic measurements for cases that changed grade after weighted views were statistically compared to see if this could have been predicted beforehand. Fifty-nine sets of radiographs on 59 patients (48 male, mean age of 33 years) were included. Compared with unilateral radiographs, non-weighted bilateral comparison films resulted in a grade change for 44 patients (74.5%). Twenty-eight of 56 patients initially graded as I, II or III were upgraded to grade V and two of three initial grade V patients were downgraded to grade III. The addition of a weighted view further upgraded 10 patients to grade V. No grade II injury was changed to grade III and no injury of any severity was downgraded by a weighted view. Grade III injuries upgraded on weighted views had a significantly greater baseline median percentage coracoclavicular distance increase than those that were not upgraded (80.7% vs. 55.4%, p=0.015). However, no cut-off point for this value could be identified to predict an

Geared Electromechanical Rotary Joint

NASA Technical Reports Server (NTRS)

Vranish, John M.

1994-01-01

Geared rotary joint provides low-noise ac or dc electrical contact between electrical subsystems rotating relative to each other. Designed to overcome some disadvantages of older electromechanical interfaces, especially intermittency of sliding-contact and rolling-contact electromechanical joints. Hollow, springy planetary gears provide continuous, redundant, low-noise electrical contact between inner and outer gears.

Evaluation of the clavicular tunnel placement on coracoclavicular ligament reconstruction for acromioclavicular dislocations: a finite element analysis.

PubMed

Kocadal, Onur; Yüksel, Korcan; Güven, Melih

2018-01-27

The two-tunnel coracoclavicular ligament reconstruction (CLR) technique is one of the treatment approaches commonly used in the surgical treatment of acromioclavicular (AC) injuries. Clavicular tunnel malposition is one of the major causes of failure in coracoclavicular ligament reconstruction. The main purpose of this study was to investigate the effects of clavicular tunnel placement on tendon loading in the CLR technique with finite element analysis. Models of clavicle and scapula were constructed using computerized tomography images. Two clavicular bone tunnel reconstruction models were created with the tendon passing through the conoid and trapezoid tunnels. Four models based on the tunnel ratio (TR) method and defined as primary, anatomic, medialized, and lateralized were constructed to evaluate the effect of tunnel placement on loading conditions during tendon graft. All models were loaded by insertion from the trapezius and sternocleidomastoid muscles. The loading on the tendon were evaluated with the finite element analysis. The highest load value measured on the tendon was in the anatomic model (0.789 kPa), and the lowest load value (0.598 kPa) was measured in the lateralized tunnel model. The load value of the primary model was (0.657 kPa), and the medialized model's value was (0.752 kPa). In two-tunnel CLR technique, tendon loadings are related to tunnel placement. Medialized tunnel placement increases tendon loading. The TR method may be an appropriate option for determining tunnel placement.

Ergonomic Assessment of Handheld Laser Technology in De-painting Process

DTIC Science & Technology

2004-03-11

glenohumeral joint) and may contribute to bursitis or tendonitis in that region. (5) Starting the laser is a three-step process. First, the operator...awkward posture can cause unnecessary stress at the shoulder (acromioclavicular joint and the glenohumeral joint) and may contribute to bursitis or

Joint correction of respiratory motion artifact and partial volume effect in lung/thoracic PET/CT imaging.

PubMed

Chang, Guoping; Chang, Tingting; Pan, Tinsu; Clark, John W; Mawlawi, Osama R

2010-12-01

Respiratory motion artifacts and partial volume effects (PVEs) are two degrading factors that affect the accuracy of image quantification in PET/CT imaging. In this article, the authors propose a joint motion and PVE correction approach (JMPC) to improve PET quantification by simultaneously correcting for respiratory motion artifacts and PVE in patients with lung/thoracic cancer. The objective of this article is to describe this approach and evaluate its performance using phantom and patient studies. The proposed joint correction approach incorporates a model of motion blurring, PVE, and object size/shape. A motion blurring kernel (MBK) is then estimated from the deconvolution of the joint model, while the activity concentration (AC) of the tumor is estimated from the normalization of the derived MBK. To evaluate the performance of this approach, two phantom studies and eight patient studies were performed. In the phantom studies, two motion waveforms-a linear sinusoidal and a circular motion-were used to control the motion of a sphere, while in the patient studies, all participants were instructed to breathe regularly. For the phantom studies, the resultant MBK was compared to the true MBK by measuring a correlation coefficient between the two kernels. The measured sphere AC derived from the proposed method was compared to the true AC as well as the ACs in images exhibiting PVE only and images exhibiting both PVE and motion blurring. For the patient studies, the resultant MBK was compared to the motion extent derived from a 4D-CT study, while the measured tumor AC was compared to the AC in images exhibiting both PVE and motion blurring. For the phantom studies, the estimated MBK approximated the true MBK with an average correlation coefficient of 0.91. The tumor ACs following the joint correction technique were similar to the true AC with an average difference of 2%. Furthermore, the tumor ACs on the PVE only images and images with both motion blur and PVE effects

Whole-body MRI assessment of disease activity and structural damage in rheumatoid arthritis: first step towards an MRI joint count.

PubMed

Axelsen, Mette Bjørndal; Eshed, Iris; Duer-Jensen, Anne; Møller, Jakob M; Pedersen, Susanne Juhl; Østergaard, Mikkel

2014-05-01

The aim of this study was to investigate the ability of whole-body MRI (WBMRI) to visualize inflammation [synovitis, bone marrow oedema (BME) and enthesitis] and structural damage in patients with RA. The 3T WBMR images were acquired in a head-to-toe scan in 20 patients with RA and at least one swollen or tender joint. Short Tau Inversion Recovery and pre- and post-contrast T1-weighted images were evaluated for readability and the presence/absence of inflammation (synovitis, BME and enthesitis) and structural damage (erosions and fat infiltrations) in 76 peripheral joints, 30 entheseal sites and in the spine. The readability was >70% for all individual joints, except for the most peripheral joints of the hands and feet. Synovitis was most frequent in the wrist, first tarsometatarsal, first CMC joints and glenohumeral joints (67-61%); BME in the wrist, CMC, acromioclavicular and glenohumeral joints (45-35%) and erosions in the wrist, MTP and CMC joints (19-16%). Enthesitis at ≥ 1 site was registered in 16 patients. BME was frequently seen in the cervical (20%) but not the thoracic and lumbar spine, while fat infiltrations and erosions were rare. The intrareader agreement was high (85-100%) for all pathologies. The agreement between WBMRI and clinical findings was low. Peripheral and axial inflammation and structural damage at joints and entheses was frequently identified by WBMRI, and more frequently than by clinical examination. WBMRI is a promising tool for evaluation of the total inflammatory load of inflammation (an MRI joint count) and structural damage in RA patients.

[The effects of hook plates on the subacromial space--a clinical and MRT study].

PubMed

Hackenberger, J; Schmidt, J; Altmann, T

2004-01-01

The analysis of middle- and long-term results after treatment of acromioclavicular joint injuries with a hook plate as a temporary implant and a comparison of the results with those described in literature have been made. In a retrospective study we were able to conduct follow-up examinations on 28 out of 39 Tossy III patients (72 %) who received surgical treatment using a hook plate according to Dreithaler. Examinations took place on average 3.0 (1.2-5.6) years after surgery. A special focus of attention was the effect of the hook plate on the subacromial space. Accordingly, physical examination was supplemented by sonography of the shoulder as well as comparative bilateral shoulder MRI. 86 % of our patients expressed satisfaction with the functional outcome of surgery as opposed to 54 % concerning its cosmetic result. In shoulder sonography no patient turned out to have suffered a higher grade rotator cuff lesion, whereas age-related degenerative alterations were found in 46 % of the patients. Instability under load was found in 7 patients (25 %). Among these were 3 with severe instability (11 %). 2 patients (7 %) were found to have a permanent subluxation of the acromioclavicular joint with partial range of motion impairment. All scores monitored (DASH, Taft, Constant-Murley) on average returned good to excellent results. MRI scans displayed no case of higher grade rotator cuff lesion. In accordance with the findings of ultrasound imaging a higher incidence of extraarticular ossification was found as well as, in some cases, arthrosis of the acromioclavicular joint. In our opinion, the hook plate designed by Dreithaler is easy to handle and serves as a qualified implant for temporary stabilisation of the acromioclavicular joint with middle- and long-term good to excellent results.

Return-to-activity after anatomical reconstruction of acute high-grade acromioclavicular separation.

PubMed

Saier, T; Plath, J E; Beitzel, K; Minzlaff, P; Feucht, J M; Reuter, S; Martetschläger, F; Imhoff, Andreas B; Aboalata, M; Braun, S

2016-04-02

To evaluate return-to-activity (RtA) after anatomical reconstruction of acute high-grade acromioclavicular joint (ACJ) separation. A total of 42 patients with anatomical reconstruction of acute high-grade ACJ-separation (Rockwood Type V) were surveyed to determine RtA at a mean 31 months follow-up (f-u). Sports disciplines, intensity, level of competition, participation in overhead and/or contact sports, as well as activity scales (DASH-Sport-Module, Tegner Activity Scale) were evaluated. Functional outcome evaluation included Constant score and QuickDASH. All patients (42/42) participated in sporting activities at f-u. Neither participation in overhead/contact sports, nor level of activity declined significantly (n.s.). 62 % (n = 26) of patients reported subjective sports specific ACJ integrity to be at least the same as prior to the trauma. Sporting intensity (hours/week: 7.3 h to 5.4 h, p = .004) and level of competition (p = .02) were reduced. If activity changed, in 50 % other reasons but clinical symptoms/impairment were named for modified behavior. QuickDASH (mean 6, range 0-54, SD 11) and DASH-Sport-Module (mean 6, range 0-56, SD 13) revealed only minor disabilities at f-u. Over time Constant score improved significant to an excellent score (mean 94, range 86-100, SD 4; p < .001). Functional outcome was not correlated with RtA (n.s.). All patients participated in sporting activities after anatomical reconstruction of high-grade (Rockwood Type V) ACJ-separation. With a high functional outcome there was no significant change in activity level (Tegner) and participation in overhead and/or contact sports observed. There was no correlation between functional outcome and RtA. Limiting, there were alterations in time spent for sporting activities and level of competition observed. But in 50 % those were not related to ACJ symptoms/impairment. Unrelated to successful re-established integrity and function of the ACJ it should be considered that

Saipan and Joint Operations

DTIC Science & Technology

1990-02-12

following postwar joint education objectives for ths armed forces: Objective i: To oroduce within each component of the armed forces a general knowledge...had acquired the pradtical knowledge to establieh::thvoe Joint educational goals which are as relevant today as when they were written. ENDNOTES 1...F2:", (- 1-1 1’A I’rn ,r’ lqA ,! Vim l ;` thO? C’~~~~~~~ a m in A i h9%t ý A din r, a INi m i t z% "h e haa I.z a:wn naval. +ac! lit! es, line~i n+f

Athletic Injury Research Study.

DTIC Science & Technology

treatment, and results of treatment; Recurrent shoulder dislocation and/or subluxation in cadets at the U.S. Military Academy; Evaluation of acromioclavicular joint injuries at the U.S. Military Academy.

Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study.

PubMed

Kawasaki, Yoshiteru; Hirano, Tetsuya; Miyatake, Katsutoshi; Fujii, Koji; Takeda, Yoshitsugu

2014-07-01

Coracoid base fracture accompanied by acromioclavicular joint dislocation with intact coracoclavicular ligaments is a rare injury. Generally, an open reduction with screw fixation is the first treatment choice, as it protects the important structures around the coracoid process. This report presents a new technique of screw fixation for coracoid base fracture and provides anatomic information on cross-sectional size of the coracoid base obtained by computed tomography (CT). An axial image of the coracoid base was visualized over the neck of the scapula, and a guidewire was inserted into this circle under fluoroscopic guidance. The wire was inserted easily into the neck of scapula across the coracoid base fracture with imaging in only 1 plane. In addition, 25 measurements of the coracoid base were made in 25 subjects on axial CT images. Average length of the long and short axes at the thinnest part of the coracoid base was 13.9 ± 2.0 mm (range 10.6-17.0) and 10.5 ± 2.2 mm (6.6-15.1), respectively. This new screw fixation technique and measurement data on the coracoid base may be beneficial for safety screw fixation of coracoid base fracture.

AC Initiation System.

DTIC Science & Technology

An ac initiation system is described which uses three ac transmission signals interlocked for safety by frequency, phase, and power discrimination...The ac initiation system is pre-armed by the application of two ac signals have the proper phases, and activates a load when an ac power signal of the proper frequency and power level is applied. (Author)

The effect of distal clavicle excision on in situ graft forces in coracoclavicular ligament reconstruction.

PubMed

Kowalsky, Marc S; Kremenic, Ian J; Orishimo, Karl F; McHugh, Malachy P; Nicholas, Stephen J; Lee, Steven J

2010-11-01

Recently, some have suggested that the acromioclavicular articulation confers stability to the construct after coracoclavicular ligament reconstruction for acromioclavicular joint separation. Therefore, it has been suggested that distal clavicle excision should not be performed in this context to protect the graft during healing. Sectioning the acromioclavicular ligaments would significantly increase in situ forces of a coracoclavicular ligament graft, whereas performing a distal clavicle resection would not further increase in situ graft forces. Controlled laboratory study. A simulated coracoclavicular reconstruction was performed on 5 cadaveric shoulders. Static loads of 80 N and 210 N were applied directly to the clavicle in 5 directions: anterior, anterosuperior, superior, posterosuperior, and posterior. The in situ graft force was measured using a force transducer under 3 testing conditions: (1) intact acromioclavicular ligaments, (2) sectioned acromioclavicular ligaments, and (3) distal clavicle excision. For both magnitudes of load, in all directions, in situ graft force with intact acromioclavicular ligaments was significantly less than that with sectioned acromioclavicular ligaments (P < .001). Distal clavicle excision did not further increase the in situ graft forces with load applied to the clavicle in an anterior, anterosuperior, or superior direction. However, in situ graft forces were increased with distal clavicle excision when the clavicle was loaded with 210 N in the posterosuperior direction (60.4 ± 6.3 N vs 52.5 ± 7.1 N; P = .048) and tended to be increased with posterior loading of the clavicle (71.8 ± 6.2 N vs 53.1 ± 8.8 N; P = .125). Intact acromioclavicular ligaments protect the coracoclavicular reconstruction by decreasing the in situ graft force. The slight increase in the in situ graft force only in the posterosuperior and posterior direction after distal clavicle excision suggests only a marginal protective role of the

The EIT- and N- joint resonance lineshape asymmetry

NASA Astrophysics Data System (ADS)

Crescimanno, Michael; Hancox, Cindy; Hohensee, Michael; Phillips, David; Walsworth, Ron

2008-03-01

The solution of a quantum optics model for the joint EIT- and N- resonance explains the experimentally observed two-photon lineshape asymmetry as arising from interference and AC stark effects. This solution is evaluated for various light field intensities, detunings and couplings associated with experiments performed on the D1 and D2 transition of 87Rb. Because of its contribution to clock instability, lineshape asymmetry remains perhaps the main impediment to improving all-optical time standards based on the joint resonance.

Symposium introduction: the first joint American Chemical Society Agricultural and Food Chemistry Division and the American Chemical Society International Chemical Sciences Chapter in Thailand

USDA-ARS?s Scientific Manuscript database

The American Chemical Society (ACS) Agricultural and Food Chemistry Division (AGFD) and the ACS International Chemical Sciences Chapter in Thailand (ICSCT) worked together to stage the “1st Joint ACS AGFD - ACS ICSCT Symposium on Agricultural and Food Chemistry,” which was held in Bangkok, Thailand ...

AC-130 Employment

DTIC Science & Technology

2006-01-01

1 AC -130 Employment Subject Area Aviation EWS 2006 Author Captain Robert Hornick, USMC Report Documentation Page Form ApprovedOMB No. 0704...00-2006 4. TITLE AND SUBTITLE AC -130 Employment 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER... AC -130 gunship is an aircraft that can provide all of these needs. Regrettably, there are too few AC -130’s in the inventory to cover all the needs

Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview

PubMed Central

2012-01-01

Background The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years) of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%). Nine patients (32%) developed impingement symptoms and in 7 patients (25%) subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14%) developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11%) had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate. PMID:22236647

The Feasibility of Applying AC Driven Low-Temperature Plasma for Multi-Cycle Detonation Initiation

NASA Astrophysics Data System (ADS)

Zheng, Dianfeng

2016-11-01

Ignition is a key system in pulse detonation engines (PDE). As advanced ignition methods, nanosecond pulse discharge low-temperature plasma ignition is used in some combustion systems, and continuous alternating current (AC) driven low-temperature plasma using dielectric barrier discharge (DBD) is used for the combustion assistant. However, continuous AC driven plasmas cannot be used for ignition in pulse detonation engines. In this paper, experimental and numerical studies of pneumatic valve PDE using an AC driven low-temperature plasma igniter were described. The pneumatic valve was jointly designed with the low-temperature plasma igniter, and the numerical simulation of the cold-state flow field in the pneumatic valve showed that a complex flow in the discharge area, along with low speed, was beneficial for successful ignition. In the experiments ethylene was used as the fuel and air as oxidizing agent, ignition by an AC driven low-temperature plasma achieved multi-cycle intermittent detonation combustion on a PDE, the working frequency of the PDE reached 15 Hz and the peak pressure of the detonation wave was approximately 2.0 MPa. The experimental verifications of the feasibility in PDE ignition expanded the application field of AC driven low-temperature plasma. supported by National Natural Science Foundation of China (No. 51176001)

Hazardous and Medical Waste Destruction Using the AC Plasmatron Final Report CRADA No. TC-1560-98

DOE Office of Scientific and Technical Information (OSTI.GOV)

Caplan, M.; Bucher, K.; Tulupov, A.

The goal of this project was to develop a prototype medical waste destruction facility based on the AC plasma torch capable of processing 150 kg of waste per hour while satisfying US EPA emission standards. The project was to provide the first opportunity for a joint U.S.-Russian project using an AC Plasma Torch in a hazardous waste destruction system to be assembled and operated in the U.S. thus promoting the commercialization in the U.S. of this joint U.S.-Russian developed technology. This project was a collaboration between the Russian Institute Soliton- NTT, the U.S industrial partner Scientific Utilization Inc. (SUI) andmore » Lawrence Livermore National Laboratory ( LLNL). The project was funded by DOE for a total of $1.2 million with $600K for allocated for Phase I and $600K for Phase II. The Russian team received about $800K over the two (2) year period while LLNL received $400K. SUI was to provide in kind matching funds totaling $1.2 million.« less

The morphological characteristics of the antebrachiocarpal joint of the cheetah (Acinonyx jubatus).

PubMed

Ohale, L O C; Groenewald, H B

2003-03-01

A morphological study of the structures of the antebrachiocarpal (AC) joint of the cheetah was carded out by dissection of eight forelimbs obtained from four adult cheetahs culled from the Kruger National Park, Republic of South Africa. The aim was to evaluate the deviations of this joint from the normal feline pattern and to consider their possible relationship to the cheetah's adaptation to speed. Although published data on the AC joint of the other felids show general resemblance to that of the cheetah, there are nevertheless slight, but significant variations and modifications which tend to suggest adaptation to speed. The shafts of the radius and ulna of the cheetah are relatively straight and slender, with poorly developed distal ends. The ulnar notch is reduced to a very shallow concavity while the corresponding ulnar facet is a barely noticeable convexity, separated from the distal ulnar articular facet by an ill-defined groove. The movement of the distal radio-ulnar joint is highly restricted by the presence of a fibro-cartilaginous structure and a strong interrosseous membrane, limiting pronation and supination normally achieved by the rotation of the radius around the ulna. The extensor grooves at the distal extremity of the radius are deep and narrow and are guarded by prominent ridges. A thick extensor retinaculum anchors the strong extensor tendons in these grooves. The distal articular surface of the radius is concave in all directions except at the point where it moves into its stylold process. At this point it is convex in the dorsopalmar direction, with a surface that is rather deep and narrow. The proximal row of carpal bones presents a strongly convex surface, which is more pronounced in the dorsopalmar direction with the greatest convexity on the lateral aspect. Medially, there is a ridge-like concavity across the base of the tubercle, which rocks on the flexor surface of the radius, limiting excessive flexion as well as restricting lateral

Low Offset AC Correlator.

DTIC Science & Technology

This patent describes a low offset AC correlator avoids DC offset and low frequency noise by frequency operating the correlation signal so that low...noise, low level AC amplification can be substituted for DC amplification. Subsequently, the high level AC signal is demodulated to a DC level. (Author)

US/Australia Collaborative Research Project on Corrosion Fatigue in D6AC Steel Joints

DTIC Science & Technology

1978-12-01

Life of Exposure Groups at 80,000 psi Max Load Level (R=0.1) 77 10 Location of Observable Fatigue Cracks on Failed D6AC Steel Specimen Surfaces 78 11...ing the machining and assembly process. Such liquids might have a serious deleterious effect on the fatigue life of the aircraft. Further, there was...control tests were to provide a base for determining the various corrosion effects on fatigue life , and to deter- mine any differences in laboratory

Alternating current (AC) iontophoretic transport across human epidermal membrane: effects of AC frequency and amplitude.

PubMed

Yan, Guang; Xu, Qingfang; Anissimov, Yuri G; Hao, Jinsong; Higuchi, William I; Li, S Kevin

2008-03-01

As a continuing effort to understand the mechanisms of alternating current (AC) transdermal iontophoresis and the iontophoretic transport pathways in the stratum corneum (SC), the objectives of the present study were to determine the interplay of AC frequency, AC voltage, and iontophoretic transport of ionic and neutral permeants across human epidermal membrane (HEM) and use AC as a means to characterize the transport pathways. Constant AC voltage iontophoresis experiments were conducted with HEM in 0.10 M tetraethyl ammonium pivalate (TEAP). AC frequencies ranging from 0.0001 to 25 Hz and AC applied voltages of 0.5 and 2.5 V were investigated. Tetraethyl ammonium (TEA) and arabinose (ARA) were the ionic and neutral model permeants, respectively. In data analysis, the logarithm of the permeability coefficients of HEM for the model permeants was plotted against the logarithm of the HEM electrical resistance for each AC condition. As expected, linear correlations between the logarithms of permeability coefficients and the logarithms of resistances of HEM were observed, and the permeability data were first normalized and then compared at the same HEM electrical resistance using these correlations. Transport enhancement of the ionic permeant was significantly larger than that of the neutral permeant during AC iontophoresis. The fluxes of the ionic permeant during AC iontophoresis of 2.5 V in the frequency range from 5 to 1,000 Hz were relatively constant and were approximately 4 times over those of passive transport. When the AC frequency decreased from 5 to 0.001 Hz at 2.5 V, flux enhancement increased to around 50 times over passive transport. While the AC frequency for achieving the full effect of iontophoretic enhancement at low AC frequency was lower than anticipated, the frequency for approaching passive diffusion transport at high frequency was higher than expected from the HEM morphology. These observations are consistent with a transport model of multiple

Fires, A Joint Professional Bulletin for US Field & Air Defense Artillerymen. March-April 2008

DTIC Science & Technology

2008-04-01

actions. However, if the effects synchronization division were not added to the lineup , just the teaming of joint fires division and IO division still...ADAFCO would be the liaison between the two Services who coordinates fires and facilitates track identification thus preventing fratricide. Joint...decisions to be made based on current air users versus planned control measures. Interoperability. Identification is a key feature that enables AC2 nodes

Joint Force Quarterly. Number 13, Autumn 1996

DTIC Science & Technology

1996-10-01

specifically ac- knowledges a 1986 study, “Ecuadorian- Peruvian Rivalry in the Upper Amazon,” as his source. That inaccurate account by William Krieg—based...joint Peruvian -Ecuadorian and U.S. records dating from 1942 to 1949 (released this year by Peru’s foreign ministry) clarify the historical account...despite the fact that Peruvian and Ecuadorian experts agreed in September 1948 to define the small stretch of the Cordillera del Cóndor which remains

Joint Test Director. Joint Logistics Over-the-Shore II. Test and Evaluation. Analysis and Evaluation Report. JLOTS II Throughput Test.

DTIC Science & Technology

1985-08-01

Class high - speed containerships and their subsequent conversion to a cargo configuration specifically designed for rapid load-offload of military unit...Rough Terrain Forklift SLWT Side-Loadable Warping Tug ST Short Ton STON Short Ton SUROB Surf Observations T-ACS Auxiliary Crane Ship T- AKR Auxiliary Cargo ...their delivery systems for container, breakbulk, and bulk liquid cargo , and to define the operating performance of the combined systems in a joint test

FLUIDIC AC AMPLIFIERS.

DTIC Science & Technology

Several fluidic tuned AC Amplifiers were designed and tested. Interstage tuning and feedback designs are considered. Good results were obtained...corresponding Q’s as high as 12. Element designs and test results of one, two, and three stage amplifiers are presented. AC Modulated Carrier Systems

Development of a hardware-based AC microgrid for AC stability assessment

NASA Astrophysics Data System (ADS)

Swanson, Robert R.

As more power electronic-based devices enable the development of high-bandwidth AC microgrids, the topic of microgrid power distribution stability has become of increased interest. Recently, researchers have proposed a relatively straightforward method to assess the stability of AC systems based upon the time-constants of sources, the net bus capacitance, and the rate limits of sources. In this research, a focus has been to develop a hardware test system to evaluate AC system stability. As a first step, a time domain model of a two converter microgrid was established in which a three phase inverter acts as a power source and an active rectifier serves as an adjustable constant power AC load. The constant power load can be utilized to create rapid power flow transients to the generating system. As a second step, the inverter and active rectifier were designed using a Smart Power Module IGBT for switching and an embedded microcontroller as a processor for algorithm implementation. The inverter and active rectifier were designed to operate simultaneously using a synchronization signal to ensure each respective local controller operates in a common reference frame. Finally, the physical system was created and initial testing performed to validate the hardware functionality as a variable amplitude and variable frequency AC system.

Modeling Anisotropic Elastic Wave Propagation in Jointed Rock Masses

NASA Astrophysics Data System (ADS)

Hurley, R.; Vorobiev, O.; Ezzedine, S. M.; Antoun, T.

2016-12-01

We present a numerical approach for determining the anisotropic stiffness of materials with nonlinearly-compliant joints capable of sliding. The proposed method extends existing ones for upscaling the behavior of a medium with open cracks and inclusions to cases relevant to natural fractured and jointed rocks, where nonlinearly-compliant joints can undergo plastic slip. The method deviates from existing techniques by incorporating the friction and closure states of the joints, and recovers an anisotropic elastic form in the small-strain limit when joints are not sliding. We present the mathematical formulation of our method and use Representative Volume Element (RVE) simulations to evaluate its accuracy for joint sets with varying complexity. We then apply the formulation to determine anisotropic elastic constants of jointed granite found at the Nevada Nuclear Security Site (NNSS) where the Source Physics Experiments (SPE), a campaign of underground chemical explosions, are performed. Finally, we discuss the implementation of our numerical approach in a massively parallel Lagrangian code Geodyn-L and its use for studying wave propagation from underground explosions. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

A joint swarm intelligence algorithm for multi-user detection in MIMO-OFDM system

NASA Astrophysics Data System (ADS)

Hu, Fengye; Du, Dakun; Zhang, Peng; Wang, Zhijun

2014-11-01

In the multi-input multi-output orthogonal frequency division multiplexing (MIMO-OFDM) system, traditional multi-user detection (MUD) algorithms that usually used to suppress multiple access interference are difficult to balance system detection performance and the complexity of the algorithm. To solve this problem, this paper proposes a joint swarm intelligence algorithm called Ant Colony and Particle Swarm Optimisation (AC-PSO) by integrating particle swarm optimisation (PSO) and ant colony optimisation (ACO) algorithms. According to simulation results, it has been shown that, with low computational complexity, the MUD for the MIMO-OFDM system based on AC-PSO algorithm gains comparable MUD performance with maximum likelihood algorithm. Thus, the proposed AC-PSO algorithm provides a satisfactory trade-off between computational complexity and detection performance.

Acute high-grade acromioclavicular joint injuries: quality of life comparison between patients managed operatively with a hook plate versus patients managed non-operatively.

PubMed

Natera Cisneros, Luis Gerardo; Sarasquete Reiriz, Juan

2017-04-01

Surgical indication for acromioclavicular joint (ACJ) injuries still represents a reason for shoulder and trauma debate. In high-grade injuries, surgery is advocated because some of the non-operatively managed patients may have persistent shoulder pain that could make them unable to return to their previous activity. It has been shown that many of the patients with high-grade ACJ injuries that are managed non-operatively involve the development of scapular dyskinesis, situation that may result in loss of strength and weakness. On the other side, it has been widely reported that the period while the hook plate is present involves functional limitations and pain. The purpose of this study was to compare the quality of life (QoL) of patients with acute high-grade ACJ injuries (Rockwood grade III-V), managed operatively with a hook plate versus the QoL of patients managed non-operatively, 24 months or more after shoulder injury. Patients with acute high-grade ACJ injuries managed operatively (hook plate) or non-operatively, between 2008 and 2012 were included. The QoL was evaluated by means of the Health Survey questionnaire (SF36), the Visual Analogue Scale (VAS) for pain, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Constant score and the Global Satisfaction (scale from 0 to 10) assessed at the last follow-up visit. The presence of scapular dyskinesis was assessed. Comparison between groups was made. Thirty-two patients were included: 11 hook plate-group (PLATE group) (5 Rockwood III and 6 V) and 21 conservative-group (CONS group) (4 Rockwood III and 17 V). The mean age was 41 [19-55] years old for the PLATE group and 38 [19-55] for the CONS group (p = 0.513). The mean follow-up was 32.50 ± 11.64 months for the PLATE group and 34.77 ± 21.98 months for the CONS group (p = 0.762). The mean results of the questionnaires assessed at the last follow-up visit were: (1) physical SF36 score (PLATE group 53.70 ± 4.33 and CONS group

Performance trends of rehabilitated AC pavements

DOT National Transportation Integrated Search

2000-10-01

The General Pavement Study (GPS) 6 experiment, "AC Overlay of AC Pavements," involves pavement test sections where an asphalt concrete (AC) overlay was placed on an existing AC pavement. This TechBrief summarizes the results of a study of the GPS-6 e...

Joint Services Electronics Program.

DTIC Science & Technology

1985-03-31

COJNRACT ON GRANT NuuSER(.j M. Tinkham N00014-84-K-0465 S. PeRFOR MING ORGANIZATION NAME AND ADORESS 𔃺. PROGRAM EL.,IT. P0OJECT. TASA Division of...2 7 R.W. Brockett DlAG29-83-K-0040 TW.osbr AFosR- 81-7401 R.W. Brockett -: DE -FGD2-84-EEw4O1 5B T.T. Wui sER xB-2-02144-l W. Paul JOINT SERVICES...0465, NSF DMR-81-08327 and SERI Subcontract XB-2-02144-1 of DOE Prime Contract DE -AC-02-83-CHI0093; Research Unit 2 (former #3). During this period we

Estimating BrAC from transdermal alcohol concentration data using the BrAC estimator software program.

PubMed

Luczak, Susan E; Rosen, I Gary

2014-08-01

Transdermal alcohol sensor (TAS) devices have the potential to allow researchers and clinicians to unobtrusively collect naturalistic drinking data for weeks at a time, but the transdermal alcohol concentration (TAC) data these devices produce do not consistently correspond with breath alcohol concentration (BrAC) data. We present and test the BrAC Estimator software, a program designed to produce individualized estimates of BrAC from TAC data by fitting mathematical models to a specific person wearing a specific TAS device. Two TAS devices were worn simultaneously by 1 participant for 18 days. The trial began with a laboratory alcohol session to calibrate the model and was followed by a field trial with 10 drinking episodes. Model parameter estimates and fit indices were compared across drinking episodes to examine the calibration phase of the software. Software-generated estimates of peak BrAC, time of peak BrAC, and area under the BrAC curve were compared with breath analyzer data to examine the estimation phase of the software. In this single-subject design with breath analyzer peak BrAC scores ranging from 0.013 to 0.057, the software created consistent models for the 2 TAS devices, despite differences in raw TAC data, and was able to compensate for the attenuation of peak BrAC and latency of the time of peak BrAC that are typically observed in TAC data. This software program represents an important initial step for making it possible for non mathematician researchers and clinicians to obtain estimates of BrAC from TAC data in naturalistic drinking environments. Future research with more participants and greater variation in alcohol consumption levels and patterns, as well as examination of gain scheduling calibration procedures and nonlinear models of diffusion, will help to determine how precise these software models can become. Copyright © 2014 by the Research Society on Alcoholism.

Lack of genotoxicity in vivo for food color additive Allura Red AC.

PubMed

Bastaki, Maria; Farrell, Thomas; Bhusari, Sachin; Pant, Kamala; Kulkarni, Rohan

2017-07-01

Allura Red AC is an approved food color additive internationally with INS number 129, in the United States as food color subject to batch certification "Food, Drug, and Cosmetic" (FD&C) Red No. 40, and in Europe as food color additive with E number 129. In their evaluation of the color (2013), the European Food Safety Authority (EFSA) expressed concerns of potential genotoxicity, based primarily on one genotoxicity study that was not conducted according to Guidelines. The present in vivo genotoxicity study was conducted according to OECD Guidelines in response to EFSA's request for additional data. The animal species and strain, and the tissues examined were selected specifically to address the previously reported findings. The results show clear absence of genotoxic activity for Allura Red AC, in the bone marrow micronucleus assay and the Comet assay in the liver, stomach, and colon. These data addressed EFSA's concerns for genotoxicity. The Joint WHO/FAO Committee on Food Additives (JECFA) (2016) also reviewed the study and concluded that there is no genotoxicity concern for Allura Red AC. Negative findings in parallel genotoxicity studies on Tartrazine and Ponceau 4R (published separately) are consistent with lack of genotoxicity for azo dyes used as food colors. Copyright © 2017 Elsevier Ltd. All rights reserved.

AC/RC Force Integration

DTIC Science & Technology

1991-05-01

ib qeocie. Thki document may not be rdeaed for open publicado. untit hu been deared by die appropriate military seavice or a veunent agency. AC /RC...A N/A N/A 11. TITLE (Include Security Classification) AC /RC Force Structure Integraticn 12. PERSONAL AUTHOR(S) Russell A. Eggers 13a. TYPE OF REPORT... AC ) and Reserve Components (RC) Force Integration is critical in today’s Total Army. The Army of soldiers, Active and Reserve, exists to play a key

Characterizing fiber-reinforced composite structures using AC-impedance spectroscopy (AC-IS)

NASA Astrophysics Data System (ADS)

Woo, Leta Y.

Property enhancement in composites depends largely on the reinforcement. For fiber-reinforced composites, the distribution of fibers is crucial in determining the electrical and mechanical performance. Image analysis methods for characterization can be time-consuming and/or destructive. This work explores the capability of AC-impedance spectroscopy (AC-IS), an electrical measurement technique, to serve as a rapid, non-destructive tool for characterizing composite microstructure. The composite requirements include a filler that is electrically conducting or semi-conducting with higher conductivity than the matrix, and a high-impedance interface or coating between the filler and the matrix. To establish an AC-IS characterization method, cement-matrix composites with steel reinforcement were employed as both a technologically important and a model system to investigate how fibers affect the electrical response. Beginning with spherical particulates and then fibers, composites were examined using composite theory and an "intrinsic conductivity" approach. The intrinsic conductivity approach applies to composites with low volume fractions of fibers (i.e., in the dilute regime) and relates how the composite conductivity varies relative to the matrix as a function of volume fraction. A universal equivalent circuit model was created to understand the AC-IS response of composites based on the geometry and volume fraction of the filler. Deviation from predicted behavior was assessed using a developed f-function, which quantifies how fibers contribute to the overall electrical response of the composite. Using the f-function, an AC-IS method for investigating fiber dispersion was established to characterize alignment, settling/segregation, and aggregation. Alignment was investigated using measurements made in three directions. A point-probe technique characterized settling and/or large-scale inhomogeneous mixing in samples. Aggregation was quantified using a "dispersion factor

Absorption and Attenuation Coefficients Using the WET Labs ac-s in the Mid-Atlantic Bight: Field Measurements and Data Analysis

NASA Technical Reports Server (NTRS)

Ohi, Nobuaki; Makinen, Carla P.; Mitchell, Richard; Moisan, Tiffany A.

2008-01-01

Ocean color algorithms are based on the parameterization of apparent optical properties as a function of inherent optical properties. WET Labs underwater absorption and attenuation meters (ac-9 and ac-s) measure both the spectral beam attenuation [c (lambda)] and absorption coefficient [a (lambda)]. The ac-s reports in a continuous range of 390-750 nm with a band pass of 4 nm, totaling approximately 83 distinct wavelengths, while the ac-9 reports at 9 wavelengths. We performed the ac-s field measurements at nine stations in the Mid-Atlantic Bight from water calibrations to data analysis. Onboard the ship, the ac-s was calibrated daily using Milli Q-water. Corrections for the in situ temperature and salinity effects on optical properties of water were applied. Corrections for incomplete recovery of the scattered light in the ac-s absorption tube were performed. The fine scale of spectral and vertical distributions of c (lambda) and a (lambda) were described from the ac-s. The significant relationships between a (674) and that of spectrophotometric analysis and chlorophyll a concentration of discrete water samples were observed.

The ACS statistical analyzer

DOT National Transportation Integrated Search

2010-03-01

This document provides guidance for using the ACS Statistical Analyzer. It is an Excel-based template for users of estimates from the American Community Survey (ACS) to assess the precision of individual estimates and to compare pairs of estimates fo...

The AC photovoltaic module is here!

NASA Astrophysics Data System (ADS)

Strong, Steven J.; Wohlgemuth, John H.; Wills, Robert H.

1997-02-01

This paper describes the design, development, and performance results of a large-area photovoltaic module whose electrical output is ac power suitable for direct connection to the utility grid. The large-area ac PV module features a dedicated, integrally mounted, high-efficiency dc-to-ac power inverter with a nominal output of 250 watts (STC) at 120 Vac, 60 H, that is fully compatible with utility power. The module's output is connected directly to the building's conventional ac distribution system without need for any dc wiring, string combiners, dc ground-fault protection or additional power-conditioning equipment. With its advantages, the ac photovoltaic module promises to become a universal building block for use in all utility-interactive PV systems. This paper discusses AC Module design aspects and utility interface issues (including islanding).

A Transplant-Specific Quality Initiative-Introducing TransQIP: A Joint Effort of the ASTS and ACS.

PubMed

Parekh, J; Ko, C; Lappin, J; Greenstein, S; Hirose, R

2017-07-01

In an attempt to improve surgical quality in the field of transplantation, the American College of Surgeons (ACS) and American Society of Transplant Surgeons have initiated a national quality improvement program in transplantation. This transplant-specific quality improvement program, called TransQIP, has been built from the ground up by transplant surgeons and captures detailed information on donor and recipient factors as well as transplant-specific outcomes. It is built upon the existing ACS/National Surgical Quality Improvement Program infrastructure and is designed to capture 100% of liver and kidney transplants performed at participating sites. TransQIP has completed its alpha pilot and will embark upon its beta phase at approximately 30 centers in the spring of 2017. Going forward, we anticipate TransQIP will help satisfy Centers for Medicare and Medicaid Services requirements for a quality improvement program, surgeon requirements for maintenance of certification, and qualify as a clinical practice improvement activity under the Merit-Based Incentive Payment System. Most importantly, we believe TransQIP will provide insight into surgical outcomes in transplantation that will allow the field to provide better care to our patients. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Slow-onset and fast-onset symptom presentations in acute coronary syndrome (ACS): new perspectives on prehospital delay in patients with ACS.

PubMed

O'Donnell, Sharon; McKee, Gabrielle; Mooney, Mary; O'Brien, Frances; Moser, Debra K

2014-04-01

Patient decision delay is the main reason why many patients fail to receive timely medical intervention for symptoms of acute coronary syndrome (ACS). This study examines the validity of slow-onset and fast-onset ACS presentations and their influence on ACS prehospital delay times. A fast-onset ACS presentation is characterized by sudden, continuous, and severe chest pain, and slow-onset ACS pertains to all other ACS presentations. Baseline data pertaining to medical profiles, prehospital delay times, and ACS symptoms were recorded for all ACS patients who participated in a large multisite randomized control trial (RCT) in Dublin, Ireland. Patients were interviewed 2-4 days after their ACS event, and data were gathered using the ACS Response to Symptom Index. Only baseline data from the RCT, N = 893 patients, were analyzed. A total of 65% (n = 577) of patients experienced slow-onset ACS presentation, whereas 35% (n = 316) experienced fast-onset ACS. Patients who experienced slow-onset ACS were significantly more likely to have longer prehospital delays than patients with fast-onset ACS (3.5 h vs. 2.0 h, respectively, t = -5.63, df 890, p < 0.001). A multivariate analysis of delay revealed that, in the presence of other known delay factors, the only independent predictors of delay were slow-onset and fast-onset ACS (β = -.096, p < 0.002) and other factors associated with patient behavior. Slow-onset ACS and fast-onset ACS presentations are associated with distinct behavioral patterns that significantly influence prehospital time frames. As such, slow-onset ACS and fast-onset ACS are legitimate ACS presentation phenomena that should be seriously considered when examining the factors associated with prehospital delay. Copyright © 2014 Elsevier Inc. All rights reserved.

Transient AC voltage related phenomena for HVDC schemes connected to weak AC systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pilotto, L.A.S.; Szechtman, M.; Hammad, A.E.

1992-07-01

In this paper a didactic explanation of voltage stability associated phenomena at HVDC terminals is presented. Conditions leading to ac voltage collapse problems are identified. A mechanism that excites control-induced voltage oscillations is shown. The voltage stability factor is used for obtaining the maximum power limits of ac/dc systems operating with different control strategies. Correlation to Pd {times} Id curves is given. Solutions for eliminating the risks of voltage collapse and for avoiding control-induced oscillations are discussed. The results are supported by detailed digital simulations of a weak ac/dc system using EMTP.

Microfabricated AC impedance sensor

DOEpatents

Krulevitch, Peter; Ackler, Harold D.; Becker, Frederick; Boser, Bernhard E.; Eldredge, Adam B.; Fuller, Christopher K.; Gascoyne, Peter R. C.; Hamilton, Julie K.; Swierkowski, Stefan P.; Wang, Xiao-Bo

2002-01-01

A microfabricated instrument for detecting and identifying cells and other particles based on alternating current (AC) impedance measurements. The microfabricated AC impedance sensor includes two critical elements: 1) a microfluidic chip, preferably of glass substrates, having at least one microchannel therein and with electrodes patterned on both substrates, and 2) electrical circuits that connect to the electrodes on the microfluidic chip and detect signals associated with particles traveling down the microchannels. These circuits enable multiple AC impedance measurements of individual particles at high throughput rates with sufficient resolution to identify different particle and cell types as appropriate for environmental detection and clinical diagnostic applications.

High voltage AC/AC electrochemical capacitor operating at low temperature in salt aqueous electrolyte

NASA Astrophysics Data System (ADS)

Abbas, Qamar; Béguin, François

2016-06-01

We demonstrate that an activated carbon (AC)-based electrochemical capacitor implementing aqueous lithium sulfate electrolyte in 7:3 vol:vol water/methanol mixture can operate down to -40 °C with good electrochemical performance. Three-electrode cell investigations show that the faradaic contributions related with hydrogen chemisorption in the negative AC electrode are thermodynamically unfavored at -40 °C, enabling the system to work as a typical electrical double-layer (EDL) capacitor. After prolonged floating of the AC/AC capacitor at 1.6 V and -40°C, the capacitance, equivalent series resistance and efficiency remain constant, demonstrating the absence of ageing related with side redox reactions at this temperature. Interestingly, when temperature is increased back to 24 °C, the redox behavior due to hydrogen storage reappears and the system behaves as a freshly prepared one.

High susceptibility and low resistance allele frequency of Chrysodeixis includens (Lepidoptera: Noctuidae) field populations to Cry1Ac in Brazil.

PubMed

Yano, Silvia Ac; Specht, Alexandre; Moscardi, Flávio; Carvalho, Renato A; Dourado, Patrick M; Martinelli, Samuel; Head, Graham P; Sosa-Gómez, Daniel R

2016-08-01

The soybean looper (SBL), Chrysodeixis includens (Walker), is one of the most important soybean pests in Brazil. MON 87701 × MON 89788 soybean expressing Cry1Ac has been recently deployed in Brazil, providing high levels of control against the primary lepidopteran pests. To support insect resistance management (IRM) programmes, the baseline susceptibility of SBL to Cry1Ac was assessed, and the resistance allele frequency was estimated on the basis of an F2 screen. The toxicity (LC50 ) of Cry1Ac ranged from 0.39 to 2.01 µg mL(-1) diet among all SBL field populations collected from crop seasons 2008/09 to 2012/13, which indicated approximately fivefold variation. Cry1Ac diagnostic concentrations of 5.6 and 18 µg mL(-1) diet were established for monitoring purposes, and no shift in mortality was observed. A total of 626 F2 family lines derived from SBL collected from locations across Brazil during crop season 2014/15 were screened for the presence of Cry1Ac resistance alleles. None of the 626 families survived on MON 87701 × MON 89788 soybean leaf tissue (joint frequency 0.0004). SBL showed high susceptibility and low resistance allele frequency to Cry1Ac across the main soybean-producing regions in Brazil. These findings meet important criteria for effective IRM strategy. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

21 CFR 886.4440 - AC-powered magnet.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered magnet. 886.4440 Section 886.4440 Food... DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4440 AC-powered magnet. (a) Identification. An AC-powered magnet is an AC-powered device that generates a magnetic field intended to find and remove...

The AC 2000.2 Catalogue

NASA Astrophysics Data System (ADS)

Urban, S. E.; Corbin, T. E.; Wycoff, G. L.; Makarov, V. V.; Høg, E.; Fabricius, C.

2001-12-01

For over 100 years, the international project known as the Astrographic Catalogue -- which involved 20 observatories tasked to photograph the sky -- has held an unfulfilled promised of yielding a wealth of astrometric information. This promise was not realized due to the inadequate reductions of the project's plates. However, in 1997 the U.S. Naval Observatory (USNO) completed the reductions of the 22,660 plates. That catalogue, named the AC 2000, contained positions and magnitudes for 4.6 million stars down to about v magnitude 12.5. Due to the early epochs of the data -- averaging 1907 -- and the positional accuracies -- between 150 and 400 milliarcseconds -- the data are extremely valuable in computing proper motions. In 1997, these positions were used to form the proper motions of the ACT Reference Catalogue. In 1999, USNO and Copenhagen University Observatory (CUO) partnered to create the Tycho-2 Catalogue. The CUO group re-analyzed the data from the Tycho experiment on the Hipparcos satellite. The USNO group re-analyzed over 140 positional catalogs which were combined with the expanded Tycho positions from the CUO group to compute the Tycho-2 proper motions. The largest contributor to these proper motions was the re-analyzed Astrographic Catalogue; the latest version being known as the AC 2000.2 Catalogue. There are two major differences between the AC 2000 and the AC 2000.2. First, the reference catalog used in AC 2000.2 was an expanded version of the Astrographic Catalogue Reference Stars that was rigorously derived on the Hipparcos Celestial Reference Frame. The second is that AC 2000.2 contains photometry from Tycho-2, where available. A description of the AC 2000.2 Catalogue, the reduction techniques used, how it compares with the 1997 version, and information on obtaining the data will be presented.

Initial NIST AC QHR Measurements

PubMed Central

Cage, M. E.; Shields, S. H.; Jeffery, A.

2004-01-01

We demonstrate that dc quantized Hall resistance (dc QHR) guideline properties and dc and ac QHR values can be measured without changing sample probe lead connections at the QHR device, and report ac QHR values that converge to the dc QHR value when using four-terminal-pair ac QHR measurements. This was accomplished during one cooldown using single-series and quadruple-series connections outside the sample probe. The QHR was measured from 0 Hz to 5500 Hz in 1:1 ratio at 20 µA to ±1 part in 107 uncertainties with a poor-quality QHR device. A good device would allow an order of magnitude smaller uncertainties over this frequency range. We exchanged positions of the QHR device and reference resistor in the bridge and remeasured the resistance ratios to remove dominant ac bridge effects. PMID:27366620

Simultaneous distribution of AC and DC power

DOEpatents

Polese, Luigi Gentile

2015-09-15

A system and method for the transport and distribution of both AC (alternating current) power and DC (direct current) power over wiring infrastructure normally used for distributing AC power only, for example, residential and/or commercial buildings' electrical wires is disclosed and taught. The system and method permits the combining of AC and DC power sources and the simultaneous distribution of the resulting power over the same wiring. At the utilization site a complementary device permits the separation of the DC power from the AC power and their reconstruction, for use in conventional AC-only and DC-only devices.

Is arthrocentesis of temporomandibular joint with corticosteroids beneficial? A systematic review.

PubMed

Davoudi, A; Khaki, H; Mohammadi, I; Daneshmand, M; Tamizifar, A; Bigdelou, M; Ansaripoor, F

2018-05-01

Temporomandibular disorders (TMDs) are musculoskeletal conditions that can inhibit the normal function of temporomandibular joints (TMJs) and affect the patient's quality of life, negatively. Arthrocentesis (AC) is a minimally invasive surgical procedure used for treating TMDs. The aim of present paper is to evaluate the advantages of administrating corticosteroid (CS) during AC by reviewing high quality released articles. Searching on Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, and Scopus databases were performed with focusing on proper key words. Related titles and abstracts, up to December 2017, were screened and selected based on inclusion criteria. The full text of all randomized controlled trials (RCTs) was extensively read and subjected to quality assessments. After initial search, a total of 2067 articles were included into the study. Finally, 7 studies were reliable enough in methodology and randomization to be included into the study. All of the observed studies showed improvements in jaw functions and pain relief with no statistical differences in both AC and control groups. One study reported painless maximum incisal opening in CS group than the control group. Based on available RCTs, the AC of TMJ with CS seems to result in similar findings to other therapeutic drugs, with no significant differences.

IL-8 -251T/A and IL-12B 1188A/C polymorphisms are associated with gout in a Chinese male population.

PubMed

Liu, S; Yin, C; Chu, N; Han, L; Li, C

2013-01-01

Gout is caused by monosodium urate (MSU) crystal-induced inflammation of the joints and periarticular tissues. MSU crystals activate NALP3 and mediate interleukin (IL)-1β generation from its inactive pro-form, resulting in cellular activation and an IL-8-mediated neutrophil influx into the joint. IL-8 and IL-12 are important chemokines related to the initiation and amplification of acute and chronic inflammatory processes. In this study, we investigated whether the IL-8 -251T/A and IL-12 1188A/C polymorphisms are associated with susceptibility to gout in a Chinese Han male population. Overall, 387 patients with gout and 576 controls were included in this study. Genotyping was performed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). An association analysis was carried out using the χ2 test. A genotype-phenotype analysis was also conducted. The T allele of IL-8 -251 was associated with risk of gout [p = 0.031 (odds ratio (OR) 1.229, 95% confidence interval (CI) 1.019-1.483]. There was a clear link between the IL-12 1188 AA and AC genotypic and A allelic frequencies between gout cases and controls (p < 0.001, df = 2 by genotype; p < 0.001, OR 1.404, 95% CI 1.165-1.691 by allele). Our results suggest that the IL-8 -251T/A and IL-12B 1188A/C polymorphisms may be relevant host susceptibility factors for the development of gout.

New Composites LnBDC@AC and CB[6]@AC: From Design toward Selective Adsorption of Methylene Blue or Methyl Orange

PubMed Central

Santos, Guilherme de C.; Barros, Amanda L.; de Oliveira, Carlos A. F.; da Luz, Leonis L.; da Silva, Fausthon F.; Demets, Grégoire J.-F.; Alves Júnior, Severino

2017-01-01

New porous composites LnBDC@AC (AC = Activated carbon, Ln = Eu and Gd and BDC = 1,4-benzenedicaboxylate) and CB[6]@AC (CB[6] = Cucurbit[6]uril) were obtained using hydrothermal route. The LnBDC and CB[B] are located inside the pore of the carbon materials as was observed in SEM-EDS, XRPD and FT-IR analysis. Porosimetry analysis showed values typically between AC and LnBDC material, with pore size and surface area, respectively, 29,56 Å and 353.98 m2g-1 for LnBDC@AC and 35,53 Å and 353.98 m2g-1 for CB[6]@AC. Both materials showed good absorptive capacity of metil orange (MO) and methylene blue (MB) with selectivity as a function of pH. For acid pH, both materials present selectivity by MB and alkaline pH for MO, with notable performance for CB[6]@AC. Additionally, europium luminescence was used as structural probe to investigate the coordination environment of Eu3+ ions in the EuBDC@AC composite after adsorption experiment. PMID:28107440

21 CFR 886.1850 - AC-powered slitlamp biomicroscope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered slitlamp biomicroscope. 886.1850... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1850 AC-powered slitlamp biomicroscope. (a) Identification. An AC-powered slitlamp biomicroscope is an AC-powered device that is a...

Fatigue Strength and Related Characteristics of Aircraft Joints I : Comparison of Spot-Weld and Rivet Patterns in 24s-t Alclad and 75s-t Alclad

NASA Technical Reports Server (NTRS)

Russell, H W; Jackson, L R; Grover, H J; Beaver, W W

1944-01-01

Report contains detailed results of a number of fatigue tests on spot-welded joints in aluminum alloys. The tests described include: (1) fatigue tests on spot-welded lap joints in sheets of unequal thickness of alclad 24s-t. These tests indicate that the fatigue strength of a spot-welded joint in sheets of two different gages is slightly higher than that of a similar joint in two sheets of the thinner gage but definitely lower than that of a similar joint in two sheets of the thicker gage. (2) Fatigue tests on spot-welded alclad 75s-t spot-welded lap-joint specimens of alclad 75s-t were not any stronger in fatigue than similar specimens of alclad 24s-t. (3) Fatigue tests on lap-joint specimens spot -welded after various surface preparations--these included ac welding wire-brushed surfaces, dc welding wire-brushed surfaces, and dc welding chemically cleaned surfaces. While the ac welds were strongest statically, the dc welds on wire-brushed surfaces were strongest in fatigue. Specimens prepared in this way were very nearly as strong as the best riveted specimens tested for comparison. (4) Fatigue tests on specimens spot-welded with varying voltage so as to include a wide range of static spot-weld strengths. The fatigue strengths were in the same order as the static strengths but showed less range. (author)

Results of surgical treatment of acromioclavicular dislocations type III using modified Weaver Dunn technique.

PubMed

López-Alameda, S; Fernández-Santás, T; García-Villanueva, A; Varillas-Delgado, D; Garcia de Lucas, F

To evaluate the clinical and radiological results of the surgical treatment of type III acromioclavicular dislocations using the Weaver-Dunn technique in the delayed phase. A non-randomised controlled retrospective observational study of 38 patients operated between January 2006 and December 2014. We excluded 10 patients due to death or non-localisation. We collected demographic data, time to intervention, complications, analysing the Visual Analog Scale, DASH and Oxford Shoulder Score and the updated radiological result. mean age of patients with right-dominant shoulder affected in 71% of cases predominantly by non-level falls was 35. 70% of the cases had subjective perception of both recovery of strength and disappearance of deformity. Full radiological reduction was observed in 95% of the cases with the appearance of mild osteoarthritis in 44% and moderate osteoarthritis in 5.6%. The results of the DASH presented values of 12,939 (±16,851) and the OSS of 42,736 (±7,794), indicating satisfactory articular function. The data from this study shows similar results to previous studies regarding subjective recovery of strength, maintenance of anatomical reduction, functional test results and efficacy of the Weaver-Dunn technique. The modified Weaver-Dunn technique provided good clinical and radiological results with patient reincorporation to their usual activities and maintenance over time. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Scapulothoracic Dissociation: Evaluation and Management.

PubMed

Choo, Andrew M; Schottel, Patrick C; Burgess, Andrew R

2017-05-01

Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint. Although vascular injury occurs in most patients, emergent surgery is performed only in patients with either limb-threatening ischemia or active arterial hemorrhage. Management of neurologic injury can be delayed if necessary. The location and severity of neurologic injury determine whether observation, nerve grafting, nerve transfer, or above-elbow amputation is performed. Skeletal stabilization procedures include plate fixation of clavicle fractures and reduction of distracted acromioclavicular or sternoclavicular joints. The extent of neurologic injury determines clinical outcomes. Medical Outcomes Study 36-Item Short Form scores are significantly lower in patients with complete brachial plexus avulsion injury than in patients with postganglionic injury.

Minerva: using a software program to improve resident performance during independent call

NASA Astrophysics Data System (ADS)

Itri, Jason N.; Redfern, Regina O.; Cook, Tessa; Scanlon, Mary H.

2010-03-01

We have developed an application called Minerva that allows tracking of resident discrepancy rates and missed cases. Minerva mines the radiology information system (RIS) for preliminary interpretations provided by residents during independent call and copies both the preliminary and final interpretations to a database. Both versions are displayed for direct comparison by Minerva and classified as 'in agreement', 'minor discrepancy' or 'major discrepancy' by the resident program director. Minerva compiles statistics comparing minor, major and total discrepancy rates for individual residents relative to the overall group. Discrepant cases are categorized according to date, modality and body part and reviewed for trends in missed cases. The rate of minor, major and total discrepancies for residents on-call at our institution was similar to rates previously published, including a 2.4% major discrepancy rate for second year radiology residents in the DePICTORS study and a 2.6% major discrepancy rate for resident at a community hospital. Trend analysis of missed cases was used to generate a topic-specific resident missed case conference on acromioclavicular (AC) joint separation injuries, which resulted in a 75% decrease in the number of missed cases related to AC separation subsequent to the conference. Using a software program to track of minor and major discrepancy rates for residents taking independent call using modified RadPeer scoring guidelines provides a competency-based metric to determine resident performance. Topic-specific conferences using the cases identified by Minerva can result in a decrease in missed cases.

High-Frequency ac Power-Distribution System

NASA Technical Reports Server (NTRS)

Hansen, Irving G.; Mildice, James

1987-01-01

Loads managed automatically under cycle-by-cycle control. 440-V rms, 20-kHz ac power system developed. System flexible, versatile, and "transparent" to user equipment, while maintaining high efficiency and low weight. Electrical source, from dc to 2,200-Hz ac converted to 440-V rms, 20-kHz, single-phase ac. Power distributed through low-inductance cables. Output power either dc or variable ac. Energy transferred per cycle reduced by factor of 50. Number of parts reduced by factor of about 5 and power loss reduced by two-thirds. Factors result in increased reliability and reduced costs. Used in any power-distribution system requiring high efficiency, high reliability, low weight, and flexibility to handle variety of sources and loads.

78 FR 39345 - ACS Wireless, Inc.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

... on July 31, 1995 under the name MACTEL INC. Alaska Communications Systems Group, Inc. (``ACS Group...-owned subsidiary of ACS Group, held through ACS Group's wholly-owned subsidiary Alaska Communications... presently an investment company as defined in section 3(a) of the Act. 2. On June 4, 2012, ACS Group, ACS...

AC conductivity and dielectric behavior of bulk Furfurylidenemalononitrile

NASA Astrophysics Data System (ADS)

El-Nahass, M. M.; Ali, H. A. M.

2012-06-01

AC conductivity and dielectric behavior for bulk Furfurylidenemalononitrile have been studied over a temperature range (293-333 K) and frequency range (50-5×106 Hz). The frequency dependence of ac conductivity, σac, has been investigated by the universal power law, σac(ω)=Aωs. The variation of the frequency exponent (s) with temperature was analyzed in terms of different conduction mechanisms, and it was found that the correlated barrier hopping (CBH) model is the predominant conduction mechanism. The temperature dependence of σac(ω) showed a linear increase with the increase in temperature at different frequencies. The ac activation energy was determined at different frequencies. Dielectric data were analyzed using complex permittivity and complex electric modulus for bulk Furfurylidenemalononitrile at various temperatures.

Pixel-based CTE Correction of ACS/WFC: Modifications To The ACS Calibration Pipeline (CALACS)

NASA Astrophysics Data System (ADS)

Smith, Linda J.; Anderson, J.; Armstrong, A.; Avila, R.; Bedin, L.; Chiaberge, M.; Davis, M.; Ferguson, B.; Fruchter, A.; Golimowski, D.; Grogin, N.; Hack, W.; Lim, P. L.; Lucas, R.; Maybhate, A.; McMaster, M.; Ogaz, S.; Suchkov, A.; Ubeda, L.

2012-01-01

The Advanced Camera for Surveys (ACS) was installed on the Hubble Space Telescope (HST) nearly ten years ago. Over the last decade, continuous exposure to the harsh radiation environment has degraded the charge transfer efficiency (CTE) of the CCDs. The worsening CTE impacts the science that can be obtained by altering the photometric, astrometric and morphological characteristics of sources, particularly those farthest from the readout amplifiers. To ameliorate these effects, Anderson & Bedin (2010, PASP, 122, 1035) developed a pixel-based empirical approach to correcting ACS data by characterizing the CTE profiles of trails behind warm pixels in dark exposures. The success of this technique means that it is now possible to correct full-frame ACS/WFC images for CTE degradation in the standard data calibration and reduction pipeline CALACS. Over the past year, the ACS team at STScI has developed, refined and tested the new software. The details of this work are described in separate posters. The new code is more effective at low flux levels (< 50 electrons) than the original Anderson & Bedin code, and employs a more accurate time and temperature dependence for CTE. The new CALACS includes the automatic removal of low-level bias stripes (produced by the post-repair ACS electronics) and pixel-based CTE correction. In addition to the standard cosmic ray corrected, flat-fielded and drizzled data products (crj, flt and drz files) there are three new equivalent files (crc, flc and drc) which contain the CTE-corrected data products. The user community will be able to choose whether to use the standard or CTE-corrected products.

Assay Methods for ACS Activity and ACS Phosphorylation by MAP Kinases In Vitro and In Vivo.

PubMed

Han, Xiaomin; Li, Guojing; Zhang, Shuqun

2017-01-01

Ethylene, a gaseous phytohormone, has profound effects on plant growth, development, and adaptation to the environment. Ethylene-regulated processes begin with the induction of ethylene biosynthesis. There are two key steps in ethylene biosynthesis. The first is the biosynthesis of 1-aminocyclopropane-1-carboxylic acid (ACC) from S-Adenosyl-Methionine (SAM), a common precursor in many metabolic pathways, which is catalyzed by ACC synthase (ACS). The second is the oxidative cleavage of ACC to form ethylene under the action of ACC oxidase (ACO). ACC biosynthesis is the committing and generally the rate-limiting step in ethylene biosynthesis. As a result, characterizing the cellular ACS activity and understanding its regulation are important. In this chapter, we detail the methods used to measure, (1) the enzymatic activity of both recombinant and native ACS proteins, and (2) the phosphorylation of ACS protein by mitogen-activated protein kinases (MAPKs) in vivo and in vitro.

Gamma-irradiation produces active chlorine species (ACS) in physiological solutions: Secoisolariciresinol diglucoside (SDG) scavenges ACS - A novel mechanism of DNA radioprotection

PubMed Central

Mishra, Om P.; Popov, Anatoliy V.; Pietrofesa, Ralph A.; Christofidou-Solomidou, Melpo

2017-01-01

Background Secoisolariciresinol diglucoside (SDG), the main lignan in whole grain flaxseed, is a potent antioxidant and free radical scavenger with known radioprotective properties. However, the exact mechanism of SDG radioprotection is not well understood. The current study identified a novel mechanism of DNA radioprotection by SDG in physiological solutions by scavenging active chlorine species (ACS) and reducing chlorinated nucleobases. Methods The ACS scavenging activity of SDG was determined using two highly specific fluoroprobes: hypochlorite-specific 3′-(p-aminophenyl) fluorescein (APF) and hydroxyl radical-sensitive 3′-(p-hydroxyphenyl) fluorescein (HPF). Dopamine, an SDG structural analog, was used for proton 1H NMR studies to trap primary ACS radicals. Taurine N-chlorination was determined to demonstrate radiation-induced generation of hypochlorite, a secondary ACS. DNA protection was assessed by determining the extent of DNA fragmentation and plasmid DNA relaxation following exposure to ClO− and radiation. Purine base chlorination by ClO− and γ-radiation was determined by using 2-aminopurine (2-AP), a fluorescent analog of 6-aminopurine. Results: Chloride anions (Cl−) consumed >90% of hydroxyl radicals in physiological solutions produced by γ-radiation resulting in ACS formation, which was detected by 1H NMR. Importantly, SDG scavenged hypochlorite- and γ-radiation-induced ACS. In addition, SDG blunted ACS-induced fragmentation of calf thymus DNA and plasmid DNA relaxation. SDG treatment before or after ACS exposure decreased the ClO− or γ-radiation-induced chlorination of 2-AP. Exposure to γ-radiation resulted in increased taurine chlorination, indicative of ClO− generation. NMR studies revealed formation of primary ACS radicals (chlorine atoms (Cl•) and dichloro radical anions (Cl2−•)), which were trapped by SDG and its structural analog dopamine. Conclusion We demonstrate that γ-radiation induces the generation of ACS in

Gamma-irradiation produces active chlorine species (ACS) in physiological solutions: Secoisolariciresinol diglucoside (SDG) scavenges ACS - A novel mechanism of DNA radioprotection.

PubMed

Mishra, Om P; Popov, Anatoliy V; Pietrofesa, Ralph A; Christofidou-Solomidou, Melpo

2016-09-01

Secoisolariciresinol diglucoside (SDG), the main lignan in whole grain flaxseed, is a potent antioxidant and free radical scavenger with known radioprotective properties. However, the exact mechanism of SDG radioprotection is not well understood. The current study identified a novel mechanism of DNA radioprotection by SDG in physiological solutions by scavenging active chlorine species (ACS) and reducing chlorinated nucleobases. The ACS scavenging activity of SDG was determined using two highly specific fluoroprobes: hypochlorite-specific 3'-(p-aminophenyl) fluorescein (APF) and hydroxyl radical-sensitive 3'-(p-hydroxyphenyl) fluorescein (HPF). Dopamine, an SDG structural analog, was used for proton (1)H NMR studies to trap primary ACS radicals. Taurine N-chlorination was determined to demonstrate radiation-induced generation of hypochlorite, a secondary ACS. DNA protection was assessed by determining the extent of DNA fragmentation and plasmid DNA relaxation following exposure to ClO(-) and radiation. Purine base chlorination by ClO(-) and γ-radiation was determined by using 2-aminopurine (2-AP), a fluorescent analog of 6-aminopurine. Chloride anions (Cl(-)) consumed >90% of hydroxyl radicals in physiological solutions produced by γ-radiation resulting in ACS formation, which was detected by (1)H NMR. Importantly, SDG scavenged hypochlorite- and γ-radiation-induced ACS. In addition, SDG blunted ACS-induced fragmentation of calf thymus DNA and plasmid DNA relaxation. SDG treatment before or after ACS exposure decreased the ClO(-) or γ-radiation-induced chlorination of 2-AP. Exposure to γ-radiation resulted in increased taurine chlorination, indicative of ClO(-) generation. NMR studies revealed formation of primary ACS radicals (chlorine atoms (Cl) and dichloro radical anions (Cl2¯)), which were trapped by SDG and its structural analog dopamine. We demonstrate that γ-radiation induces the generation of ACS in physiological solutions. SDG treatment scavenged

Superconductor coil geometry and ac losses

NASA Technical Reports Server (NTRS)

Pierce, T. V., Jr.; Zapata, R. N.

1976-01-01

An empirical relation is presented which allows simple computation of volume-averaged winding fields from central fields for coils of small rectangular cross sections. This relation suggests that, in certain applications, ac-loss minimization can be accomplished by use of low winding densities, provided that hysteresis losses are independent of winding density. The ac-loss measurements on coils wound of twisted multifilamentary composite superconductors show no significant dependence on ac losses on winding density, thus permitting the use of winding density as an independent design parameter in loss minimization.

DC-biased AC-electroosmotic and AC-electrothermal flow mixing in microchannels.

PubMed

Ng, Wee Yang; Goh, Shireen; Lam, Yee Cheong; Yang, Chun; Rodríguez, Isabel

2009-03-21

This paper presents a novel approach of mixing two laminar flowing streams in microchannels. The mixer consists of a pair of electrodes disposed along a fluidic channel. By energizing the electrodes with a DC-biased (2.5 V) AC voltage (20 Vpp), an electrokinetic flow is induced with a flow profile perpendicular to that of the incoming laminar streams of liquids to be mixed. As a result, the flow lines of the incoming streams and the induced flow are forced to crossover and very efficient stirring and mixing at short mixing length can be achieved. The mixer can be operated from the AC-electroosmotic (ACEO) (sigma=1 mS/m, f=100 kHz) to the AC-electrothermal (ACET) (sigma=500 mS/m, f=500 kHz) flow regimes. The mixing efficiency in the ACEO regime was 92%, with a mixing length of 600 microm (Q=2 microL/min), an estimated mixing time of 69 ms and an induced ACEO flow velocity of approximately 725 microm/s. The mixing efficiency in the ACET regime was 65% for a mixing length of approximately 1200 microm. The mixer is efficient and suitable for mixing reagents in a fluid media from low to high conductivity as required in diverse microfluidic applications.

Use of an AC induction motor system for producing finger movements in human subjects.

PubMed

Proudlock, F A; Scott, J J

1998-12-01

This report describes the set-up and evaluation of a novel system for producing precise finger movements, for tests of movement perception. The specifications were to construct a system using commercially available components that were easy to use but which offered both flexibility and also high precision control. The system was constructed around an industrial AC induction motor with an optical encoder, controlled by an AC servo digital control module that could be programmed using a simple, high-level language. This set-up fulfilled the requirements regarding position and velocity control for a range of movements and also the facility for the subject to move the joint voluntarily while still attached to the motor. However a number of problems were encountered, the most serious being the level of vibration and the inability to vary the torque during movements. The vibration was reduced to the point where it did not affect the subject, by the introduction of mechanical dampening using an anti-vibration coupling and a pneumatic splint. The torque control could not be modified during rotation and so the system could only be operated using constant torque for any given movement.

Geomechanical Response of Jointed Caprock During CO2 Geological Sequestration

NASA Astrophysics Data System (ADS)

Newell, P.; Martinez, M. J.; Bishop, J. E.

2014-12-01

Geological sequestration of CO2 refers to the injection of supercritical CO2 into deep reservoirs trapped beneath a low-permeability caprock formation. Maintaining caprock integrity during the injection process is the most important factor for a successful injection. In this work we evaluate the potential for jointed caprock during injection scenarios using coupled three-dimensional multiphase flow and geomechanics modeling. Evaluation of jointed/fractured caprock systems is of particular concern to CO2 sequestration because creation or reactivation of joints (mechanical damage) can lead to enhanced pathways for leakage. In this work, we use an equivalent continuum approach to account for the joints within the caprock. Joint's aperture and non-linear stiffness of the caprock will be updated dynamically based on the effective normal stress. Effective permeability field will be updated based on the joints' aperture creating an anisotropic permeability field throughout the caprock. This feature would add another coupling between the solid and fluid in addition to basic Terzaghi's effective stress concept. In this study, we evaluate the impact of the joint's orientation and geometry of caprock and reservoir layers on geomechanical response of the CO2 geological systems. This work is supported as part of the Center for Frontiers of Subsurface Energy Security, an Energy Frontier Research Center funded by the U.S. Department of Energy, Office of Science, Office of Basic Energy Sciences under Award Number DE-SC0001114. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

Spectroscopic Determination of the AC Voltammetric Response.

DTIC Science & Technology

1984-01-06

characterization of electrode processes. More recently, with the advent of linear sweep cyclic AC voltanmetry(12’ 13), it has been shown that AC methods...implemented with the same instrumentation ( 7 ) as previously used in MSRS and retains both the qualitative and quantitative utility of linear sweep ...voltammetric response (eg. peak width at balf-height, peak separation and cross-over potential in cyclic AC voltametry ) apply equally well to the SACRS

Joint DIII-D/EAST Experiments Toward Steady State AT Demonstration

NASA Astrophysics Data System (ADS)

Garofalo, A. M.; Meneghini, O.; Staebler, G. M.; van Zeeland, M. A.; Gong, X.; Ding, S.; Qian, J.; Ren, Q.; Xu, G.; Grierson, B. A.; Solomon, W. M.; Holcomb, C. T.

2015-11-01

Joint DIII-D/EAST experiments on fully noninductive operation at high poloidal beta have demonstrated several attractive features of this regime for a steady-state fusion reactor. Very large bootstrap fraction (>80 %) is desirable because it reduces the demands on external noninductive current drive. High bootstrap fraction with an H-mode edge results in a broad current profile and internal transport barriers (ITBs) at large minor radius, leading to high normalized energy confinement and high MHD stability limits. The ITB radius expands with higher normalized beta, further improving both stability and confinement. Electron density ITB and large Shafranov shift lead to low AE activity in the plasma core and low anomalous fast ion losses. Both the ITB and the current profile show remarkable robustness against perturbations, without external control. Supported by US DOE under DE-FC02-04ER54698, DE-AC02-09CH11466 & DE-AC52-07NA27344 & by NMCFSP under contracts 2015GB102000 and 2015GB110001.

THERMIONIC AC GENERATION

DTIC Science & Technology

is shown that the maximum ac efficiency is equal to approximately 70% of the corresponding dc value. An illustrative example, including a proposed design for a rather unconventional transformer, is appended. (Author)

78 FR 49318 - Availability of Draft Advisory Circular (AC) 90-106A and AC 20-167A

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration [Docket No FAA-2013-0485] Availability of Draft Advisory Circular (AC) 90-106A and AC 20- 167A AGENCY: Federal Aviation Administration..., Federal Aviation Administration, 800 Independence Avenue SW., Washington, DC 20591; telephone (202) 385...

Differential Roles of AC2 and AC4 of Cassava Geminiviruses in Mediating Synergism and Suppression of Posttranscriptional Gene Silencing

PubMed Central

Vanitharani, Ramachandran; Chellappan, Padmanabhan; Pita, Justin S.; Fauquet, Claude M.

2004-01-01

Posttranscriptional gene silencing (PTGS) in plants is a natural defense mechanism against virus infection. In mixed infections, virus synergism is proposed to result from suppression of the host defense mechanism by the viruses. Synergistic severe mosaic disease caused by simultaneous infection with isolates of the Cameroon strain of African cassava mosaic virus (ACMV-[CM]) and East African cassava mosaic Cameroon virus (EACMCV) in cassava and tobacco is characterized by a dramatic increase in symptom severity and a severalfold increase in viral-DNA accumulation by both viruses compared to that in singly infected plants. Here, we report that synergism between ACMV-[CM] and EACMCV is a two-way process, as the presence of the DNA-A component of ACMV-[CM] or EACMCV in trans enhanced the accumulation of viral DNA of EACMCV and ACMV-[CM], respectively, in tobacco BY-2 protoplasts. Furthermore, transient expression of ACMV-[CM] AC4 driven by the Cauliflower mosaic virus 35S promoter (p35S-AC4) enhanced EACMCV DNA accumulation by ∼8-fold in protoplasts, while p35S-AC2 of EACMCV enhanced ACMV-[CM] DNA accumulation, also by ∼8-fold. An Agrobacterium-based leaf infiltration assay determined that ACMV-[CM] AC4 and EACMCV AC2, the putative synergistic genes, were able to suppress PTGS induced by green fluorescent protein (GFP) and eliminated the short interfering RNAs associated with PTGS, with a correlated increase in GFP mRNA accumulation. In addition, we have identified AC4 of Sri Lankan cassava mosaic virus and AC2 of Indian cassava mosaic virus as suppressors of PTGS, indicating that geminiviruses evolved differently in regard to interaction with the host. The specific and different roles played by these AC2 and AC4 proteins of cassava geminiviruses in regulating anti-PTGS activity and their relation to synergism are discussed. PMID:15308741

21 CFR 880.6320 - AC-powered medical examination light.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered medical examination light. 880.6320... Miscellaneous Devices § 880.6320 AC-powered medical examination light. (a) Identification. An AC-powered medical examination light is an AC-powered device intended for medical purposes that is used to illuminate body...

Joint SSRTNet/ALS-MES Workshop report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shuh, David; Van Hove, Michel

2001-11-30

This joint workshop brought together experimentalists and theorists interested in synchrotron radiation and highlighted subjects relevant to molecular environmental science (MES). The strong mutual interest between the participants resulted in joint sessions on the first day, followed by more specialized parallel sessions on the second day. Held in conjunction with the Advanced Light Source (ALS) Users' Association Annual Meeting at the Lawrence Berkeley National Laboratory (Berkeley Lab), the Synchrotron Radiation Research Theory Network (SRRTNet) workshop was co-organized by Michel Van Hove (Berkeley Lab and University of California, Davis) and Andrew Canning (Berkeley Lab), while David Shuh (Berkeley Lab) organized themore » ALS-MES workshop. SRRTNet is a global network that promotes the interaction of theory and experiment (http://www.cse.clrc.ac.uk/Activity/SRRTnet). The ALS-MES project is constructing Beamline 11.0.2.1-2, a new soft x-ray beamline for MES investigations at photon energies from 75 eV to 2 keV, to provide photons for wet spectroscopy end stations and an upgraded scanning transmission x-ray microscope (STXM). The ALS-MES beamline and end stations will be available for users in the late fall of 2002.« less

High-frequency ac power distribution in Space Station

NASA Technical Reports Server (NTRS)

Tsai, Fu-Sheng; Lee, Fred C. Y.

1990-01-01

A utility-type 20-kHz ac power distribution system for the Space Station, employing resonant power-conversion techniques, is presented. The system converts raw dc voltage from photovoltaic cells or three-phase LF ac voltage from a solar dynamic generator into a regulated 20-kHz ac voltage for distribution among various loads. The results of EASY5 computer simulations of the local and global performance show that the system has fast response and good transient behavior. The ac bus voltage is effectively regulated using the phase-control scheme, which is demonstrated with both line and load variations. The feasibility of paralleling the driver-module outputs is illustrated with the driver modules synchronized and sharing a common feedback loop. An HF sinusoidal ac voltage is generated in the three-phase ac input case, when the driver modules are phased 120 deg away from one another and their outputs are connected in series.

Transcranial Alternating Current Stimulation (tACS) Mechanisms and Protocols

PubMed Central

Tavakoli, Amir V.; Yun, Kyongsik

2017-01-01

Perception, cognition and consciousness can be modulated as a function of oscillating neural activity, while ongoing neuronal dynamics are influenced by synaptic activity and membrane potential. Consequently, transcranial alternating current stimulation (tACS) may be used for neurological intervention. The advantageous features of tACS include the biphasic and sinusoidal tACS currents, the ability to entrain large neuronal populations, and subtle control over somatic effects. Through neuromodulation of phasic, neural activity, tACS is a powerful tool to investigate the neural correlates of cognition. The rapid development in this area requires clarity about best practices. Here we briefly introduce tACS and review the most compelling findings in the literature to provide a starting point for using tACS. We suggest that tACS protocols be based on functional brain mechanisms and appropriate control experiments, including active sham and condition blinding. PMID:28928634

Challenges and solutions in medically managed ACS in the Asia-Pacific region: expert recommendations from the Asia-Pacific ACS Medical Management Working Group.

PubMed

Huo, Yong; Thompson, Peter; Buddhari, Wacin; Ge, Junbo; Harding, Scott; Ramanathan, Letchuman; Reyes, Eugenio; Santoso, Anwar; Tam, Li-Wah; Vijayaraghavan, Govindan; Yeh, Hung-I

2015-03-15

Acute coronary syndromes (ACS) remain a leading cause of mortality and morbidity in the Asia-Pacific (APAC) region. International guidelines advocate invasive procedures in all but low-risk ACS patients; however, a high proportion of ACS patients in the APAC region receive solely medical management due to a combination of unique geographical, socioeconomic, and population-specific barriers. The APAC ACS Medical Management Working Group recently convened to discuss the ACS medical management landscape in the APAC region. Local and international ACS guidelines and the global and APAC clinical evidence-base for medical management of ACS were reviewed. Challenges in the provision of optimal care for these patients were identified and broadly categorized into issues related to (1) accessibility/systems of care, (2) risk stratification, (3) education, (4) optimization of pharmacotherapy, and (5) cost/affordability. While ACS guidelines clearly represent a valuable standard of care, the group concluded that these challenges can be best met by establishing cardiac networks and individual hospital models/clinical pathways taking into account local risk factors (including socioeconomic status), affordability and availability of pharmacotherapies/invasive facilities, and the nature of local healthcare systems. Potential solutions central to the optimization of ACS medical management in the APAC region are outlined with specific recommendations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Infrequent transposition of Ac in lettuce, Lactuca sativa.

PubMed

Yang, C H; Ellis, J G; Michelmore, R W

1993-08-01

The maize transposable element Activator (Ac) is being used to develop a transposon mutagenesis system in lettuce, Lactuca sativa. Two constructs containing the complete Ac from the waxy-m7 locus of maize were introduced into lettuce and monitored for activity using Southern analysis and PCR amplification of the excision site. No transposition of Ac was detected in over 32 transgenic R1 plants, although these constructs were known to provide frequent transposition in other species. Also, no transposition was observed in later generations. In subsequent experiments, transposition was detected in lettuce calli using constructs that allowed selection for excision events. In these constructs, the neomycin phosphotransferase II gene was interrupted by either Ac or Ds. Excision was detected as the ability of callus to grow on kanamycin. Synthesis of the transposase from the cDNA of Ac expressed from the T-DNA 2' promoter resulted in more frequent excision of Ds than was observed with the wild-type Ac. No excision was observed with Ds in the absence of the transposase. The excision events were confirmed by amplification of the excision site by PCR followed by DNA sequencing. Excision and reintegration were also confirmed by Southern analysis. Ac/Ds is therefore capable of transposition in at least calli of lettuce.

Obtaining continuous BrAC/BAC estimates in the field: A hybrid system integrating transdermal alcohol biosensor, Intellidrink smartphone app, and BrAC Estimator software tools.

PubMed

Luczak, Susan E; Hawkins, Ashley L; Dai, Zheng; Wichmann, Raphael; Wang, Chunming; Rosen, I Gary

2018-08-01

Biosensors have been developed to measure transdermal alcohol concentration (TAC), but converting TAC into interpretable indices of blood/breath alcohol concentration (BAC/BrAC) is difficult because of variations that occur in TAC across individuals, drinking episodes, and devices. We have developed mathematical models and the BrAC Estimator software for calibrating and inverting TAC into quantifiable BrAC estimates (eBrAC). The calibration protocol to determine the individualized parameters for a specific individual wearing a specific device requires a drinking session in which BrAC and TAC measurements are obtained simultaneously. This calibration protocol was originally conducted in the laboratory with breath analyzers used to produce the BrAC data. Here we develop and test an alternative calibration protocol using drinking diary data collected in the field with the smartphone app Intellidrink to produce the BrAC calibration data. We compared BrAC Estimator software results for 11 drinking episodes collected by an expert user when using Intellidrink versus breath analyzer measurements as BrAC calibration data. Inversion phase results indicated the Intellidrink calibration protocol produced similar eBrAC curves and captured peak eBrAC to within 0.0003%, time of peak eBrAC to within 18min, and area under the eBrAC curve to within 0.025% alcohol-hours as the breath analyzer calibration protocol. This study provides evidence that drinking diary data can be used in place of breath analyzer data in the BrAC Estimator software calibration procedure, which can reduce participant and researcher burden and expand the potential software user pool beyond researchers studying participants who can drink in the laboratory. Copyright © 2017. Published by Elsevier Ltd.

Bioinformatics and Astrophysics Cluster (BinAc)

NASA Astrophysics Data System (ADS)

Krüger, Jens; Lutz, Volker; Bartusch, Felix; Dilling, Werner; Gorska, Anna; Schäfer, Christoph; Walter, Thomas

2017-09-01

BinAC provides central high performance computing capacities for bioinformaticians and astrophysicists from the state of Baden-Württemberg. The bwForCluster BinAC is part of the implementation concept for scientific computing for the universities in Baden-Württemberg. Community specific support is offered through the bwHPC-C5 project.

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 11 2011-01-01 2011-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 11 2013-01-01 2013-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 11 2012-01-01 2012-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b...

7 CFR 1737.31 - Area Coverage Survey (ACS).

Code of Federal Regulations, 2014 CFR

2014-01-01

... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage Survey (ACS) is a market forecast of service requirements of subscribers in a proposed service area. (b... 7 Agriculture 11 2014-01-01 2014-01-01 false Area Coverage Survey (ACS). 1737.31 Section 1737.31...

21 CFR 880.5500 - AC-powered patient lift.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered patient lift. 880.5500 Section 880.5500... Devices § 880.5500 AC-powered patient lift. (a) Identification. An AC-powered lift is an electrically powered device either fixed or mobile, used to lift and transport patients in the horizontal or other...

21 CFR 880.5500 - AC-powered patient lift.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false AC-powered patient lift. 880.5500 Section 880.5500... Devices § 880.5500 AC-powered patient lift. (a) Identification. An AC-powered lift is an electrically powered device either fixed or mobile, used to lift and transport patients in the horizontal or other...

AC-electric field dependent electroformation of giant lipid vesicles.

PubMed

Politano, Timothy J; Froude, Victoria E; Jing, Benxin; Zhu, Yingxi

2010-08-01

Giant vesicles of larger than 5 microm, which have been of intense interest for their potential as drug delivery vehicles and as a model system for cell membranes, can be rapidly formed from a spin-coated lipid thin film under an electric field. In this work, we explore the AC-field dependent electroformation of giant lipid vesicles in aqueous media over a wide range of AC-frequency from 1 Hz to 1 MHz and peak-to-peak field strength from 0.212 V/mm to 40 V/mm between two parallel conducting electrode surfaces. By using fluorescence microscopy, we perform in-situ microscopic observations of the structural evolution of giant vesicles formed from spin-coated lipid films under varied uniform AC-electric fields. The real-time observation of bilayer bulging from the lipid film, vesicle growth and fusing further examine the critical role of AC-induced electroosmotic flow of surrounding fluids for giant vesicle formation. A rich AC-frequency and field strength phase diagram is obtained experimentally to predict the AC-electroformation of giant unilamellar vesicles (GUVs) of l-alpha-phosphatidylcholine, where a weak dependence of vesicle size on AC-frequency is observed at low AC-field voltages, showing decreased vesicle size with a narrowed size distribution with increased AC-frequency. Formation of vesicles was shown to be constrained by an upper field strength of 10 V/mm and an upper AC-frequency of 10 kHz. Within these parameters, giant lipid vesicles were formed predominantly unilamellar and prevalent across the entire electrode surfaces. Copyright 2010 Elsevier B.V. All rights reserved.

The AC-120: The advanced commercial transport

NASA Technical Reports Server (NTRS)

Duran, David; Griffin, Ernest; Mendoza, Saul; Nguyen, Son; Pickett, Tim; Noernberg, Clemm

1993-01-01

The main objective of this design was to fulfill a need for a new airplane to replace the aging 100 to 150 passenger, 1500 nautical mile range aircraft such as the Douglas DC9 and Boeing 737-100 airplanes. After researching the future aircraft market, conducting extensive trade studies, and analysis on different configurations, the AC-120 Advanced Commercial Transport final design was achieved. The AC-120's main design features include the incorporation of a three lifting surface configuration which is powered by two turboprop engines. The AC-120 is an economically sensitive aircraft which meets the new FM Stage Three noise requirements, and has lower NO(x) emissions than current turbofan powered airplanes. The AC-120 also improves on its contemporaries in passenger comfort, manufacturing, and operating cost.

Cry1Ac production is costly for native plants attacked by non-Cry1Ac-targeted herbivores in the field.

PubMed

McGale, Erica; Diezel, Celia; Schuman, Meredith C; Baldwin, Ian T

2018-05-13

Plants are the primary producers in most terrestrial ecosystems and have complex defense systems to protect their produce. Defense-deficient, high-yielding agricultural monocultures attract abundant nonhuman consumers, but are alternatively defended through pesticide application and genetic engineering to produce insecticidal proteins such as Cry1Ac (Bacillus thuringiensis). These approaches alter the balance between yield protection and maximization but have been poorly contextualized to known yield-defense trade-offs in wild plants. The native plant Nicotiana attenuata was used to compare yield benefits of plants transformed to be defenseless to those with a full suite of naturally evolved defenses, or additionally transformed to ectopically produce Cry1Ac. An insecticide treatment allowed us to examine yield under different herbivore loads in N. attenuata's native habitat. Cry1Ac, herbivore damage, and growth parameters were monitored throughout the season. Biomass and reproductive correlates were measured at season end. Non-Cry1Ac-targeted herbivores dominated on noninsecticide-treated plants, and increased the yield drag of Cry1Ac-producing plants in comparison with endogenously defended or undefended plants. Insecticide-sprayed Cry1Ac-producing plants lagged less in stalk height, shoot biomass, and flower production. In direct comparison with the endogenous defenses of a native plant, Cry1Ac production did not provide yield benefits for plants under observed herbivore loads in a field study. © 2018 The Authors New Phytologist © 2018 New Phytologist Trust.

ACS from development to operations

NASA Astrophysics Data System (ADS)

Caproni, Alessandro; Colomer, Pau; Jeram, Bogdan; Sommer, Heiko; Chiozzi, Gianluca; Mañas, Miguel M.

2016-08-01

The ALMA Common Software (ACS), provides the infrastructure of the distributed software system of ALMA and other projects. ACS, built on top of CORBA and Data Distribution Service (DDS) middleware, is based on a Component- Container paradigm and hides the complexity of the middleware allowing the developer to focus on domain specific issues. The transition of the ALMA observatory from construction to operations brings with it that ACS effort focuses primarily on scalability, stability and robustness rather than on new features. The transition came together with a shorter release cycle and a more extensive testing. For scalability, the most problematic area has been the CORBA notification service, used to implement the publisher subscriber pattern because of the asynchronous nature of the paradigm: a lot of effort has been spent to improve its stability and recovery from run time errors. The original bulk data mechanism, implemented using the CORBA Audio/Video Streaming Service, showed its limitations and has been replaced with a more performant and scalable DDS implementation. Operational needs showed soon the difference between releases cycles for Online software (i.e. used during observations) and Offline software, which requires much more frequent releases. This paper attempts to describe the impact the transition from construction to operations had on ACS, the solution adopted so far and a look into future evolution.

ACS and STEMI treatment: gender-related issues.

PubMed

Chieffo, Alaide; Buchanan, Gill Louise; Mauri, Fina; Mehilli, Julinda; Vaquerizo, Beatriz; Moynagh, Anouska; Mehran, Roxana; Morice, Marie-Claude

2012-08-01

Cardiovascular disease is the leading cause of death amongst women, with acute coronary syndromes (ACS) representing a significant proportion. It has been reported that in women presenting with ACS there is underdiagnosis and consequent undertreatment leading to an increase in hospital and long-term mortality. Several factors have to be taken into account, including lack of awareness both at patient and at physician level. Women are generally not aware of the cardiovascular risk and symptoms, often atypical, and therefore wait longer to seek medical attention. In addition, physicians often underestimate the risk of ACS in women leading to a further delay in accurate diagnosis and timely appropriate treatment, including cardiac catheterisation and primary percutaneous coronary intervention, with consequent delayed revascularisation times. It has been acknowledged by the European Society of Cardiology that gender disparities do exist, with a Class I, Level of Evidence B recommendation that both genders should be treated in the same way when presenting with ACS. However, there is still a lack of awareness and the mission of Women in Innovation, in association with Stent for Life, is to change the perception of women with ACS and to achieve prompt diagnosis and treatment.

Electrostatic coalescence system with independent AC and DC hydrophilic electrodes

DOEpatents

Hovarongkura, A. David; Henry, Jr., Joseph D.

1981-01-01

An improved electrostatic coalescence system is provided in which independent AC and DC hydrophilic electrodes are employed to provide more complete dehydration of an oil emulsion. The AC field is produced between an AC electrode array and the water-oil interface wherein the AC electrode array is positioned parallel to the interface which acts as a grounded electrode. The emulsion is introduced into the AC field in an evenly distributed manner at the interface. The AC field promotes drop-drop and drop-interface coalescence of the water phase in the entering emulsion. The continuous oil phase passes upward through the perforated AC electrode array and enters a strong DC field produced between closely spaced DC electrodes in which small dispersed droplets of water entrained in the continuous phase are removed primarily by collection at hydrophilic DC electrodes. Large droplets of water collected by the electrodes migrate downward through the AC electrode array to the interface. All phase separation mechanisms are utilized to accomplish more complete phase separation.

Use of an AC/DC/AC Electrochemical Technique to Assess the Durability of Protection Systems for Magnesium Alloys

NASA Astrophysics Data System (ADS)

Song, Sen; McCune, Robert C.; Shen, Weidian; Wang, Yar-Ming

One task under the U.S. Automotive Materials Partnership (USAMP) "Magnesium Front End Research and Development" (MFERD) Project has been the evaluation of methodologies for the assessment of protective capability for a variety of proposed protection schemes for this hypothesized multi-material, articulated structure. Techniques which consider the entire protection system, including both pretreatments and topcoats are of interest. In recent years, an adaptation of the classical electrochemical impedance spectroscopy (EIS) approach using an intermediate cathodic DC polarization step (viz. AC/DC/AC) has been employed to accelerate breakdown of coating protection, specifically at the polymer-pretreatment interface. This work reports outcomes of studies to employ the AC/DC/AC approach for comparison of protective coatings to various magnesium alloys considered for front end structures. In at least one instance, the protective coating system breakdown could be attributed to the poorer intrinsic corrosion resistance of the sheet material (AZ31) relative to die-cast AM60B.

Should fee-for-service be for all guideline-advocated acute coronary syndrome (ACS) care? Observations from the Snapshot ACS study.

PubMed

Briffa, Thomas G; Hammett, Christopher J; Cross, David B; Macisaac, Andrew I; Rankin, James M; Board, Neville; Carr, Bridie; Hyun, Karice K; French, John; Brieger, David B; Chew, Derek P

2015-09-01

The aim of the present study was to explore the association of health insurance status on the provision of guideline-advocated acute coronary syndrome (ACS) care in Australia. Consecutive hospitalisations of suspected ACS from 14 to 27 May 2012 enrolled in the Snapshot study of Australian and New Zealand patients were evaluated. Descriptive and logistic regression analysis was performed to evaluate the association of patient risk and insurance status with the receipt of care. In all, 3391 patients with suspected ACS from 247 hospitals (23 private) were enrolled in the present study. One-third of patients declared private insurance coverage; of these, 27.9% (304/1088) presented to private facilities. Compared with public patients, privately insured patients were more likely to undergo in-patient echocardiography and receive early angiography; furthermore, in those with a discharge diagnosis of ACS, there was a higher rate of revascularisation (P < 0.001). Each of these attracts potential fee-for-service. In contrast, proportionately fewer privately insured ACS patients were discharged on selected guideline therapies and were referred to a secondary prevention program (P = 0.056), neither of which directly attracts a fee. Typically, as GRACE (the Global Registry of Acute Coronary Events) risk score rose, so did the level of ACS care; however, propensity-adjusted analyses showed lower in-hospital adverse events among the insured group (odds ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.004). Fee-for-service reimbursement may explain differences in the provision of selected guideline-advocated components of ACS care between privately insured and public patients.

Cadmium-induced ethylene production and responses in Arabidopsis thaliana rely on ACS2 and ACS6 gene expression

PubMed Central

2014-01-01

Background Anthropogenic activities cause metal pollution worldwide. Plants can absorb and accumulate these metals through their root system, inducing stress as a result of excess metal concentrations inside the plant. Ethylene is a regulator of multiple plant processes, and is affected by many biotic and abiotic stresses. Increased ethylene levels have been observed after exposure to excess metals but it remains unclear how the increased ethylene levels are achieved at the molecular level. In this study, the effects of cadmium (Cd) exposure on the production of ethylene and its precursor 1-aminocyclopropane-1-carboxylic acid (ACC), and on the expression of the ACC Synthase (ACS) and ACC Oxidase (ACO) multigene families were investigated in Arabidopsis thaliana. Results Increased ethylene release after Cd exposure was directly measurable in a system using rockwool-cultivated plants; enhanced levels of the ethylene precursor ACC together with higher mRNA levels of ethylene responsive genes: ACO2, ETR2 and ERF1 also indicated increased ethylene production in hydroponic culture. Regarding underlying mechanisms, it was found that the transcript levels of ACO2 and ACO4, the most abundantly expressed members of the ACO multigene family, were increased upon Cd exposure. ACC synthesis is the rate-limiting step in ethylene biosynthesis, and transcript levels of both ACS2 and ACS6 showed the highest increase and became the most abundant isoforms after Cd exposure, suggesting their importance in the Cd-induced increase of ethylene production. Conclusions Cadmium induced the biosynthesis of ACC and ethylene in Arabidopsis thaliana plants mainly via the increased expression of ACS2 and ACS6. This was confirmed in the acs2-1acs6-1 double knockout mutants, which showed a decreased ethylene production, positively affecting leaf biomass and resulting in a delayed induction of ethylene responsive gene expressions without significant differences in Cd contents between wild-type and

Microstructure and Properties of Lap Joint Between Aluminum Alloy and Galvanized Steel by CMT

NASA Astrophysics Data System (ADS)

Niu, Song; Chen, Su; Dong, Honggang; Zhao, Dongsheng; Zhang, Xiaosheng; Guo, Xin; Wang, Guoqiang

2016-05-01

Lap joining of 1-mm-thick Novelist AC 170 PX aluminum alloy to 1.2-mm-thick ST06 Z galvanized steel sheets for automotive applications was conducted by cold metal transfer advanced welding process with ER4043 and ER4047 filler wires. Under the optimized welding parameters with ER4043 filler wire, the tensile shear strength of joint was 189 MPa, reaching 89% of the aluminum alloy base metal. Microstructure and elemental distribution were characterized by optical metalloscope and electron probe microanalysis. The lap joints with ER4043 filler wire had smaller wetting angle and longer bonded line length with better wettability than with ER4047 filler wire during welding with same parameters. The needle-like Al-Fe-Si intermetallic compounds (IMCs) were spalled into the weld and brought negative effect to the tensile strength of joints. With increasing welding current, the needle-like IMCs grew longer and spread further into the weld, which would deteriorate the tensile shear strength.

Modelling ac ripple currents in HTS coated conductors

NASA Astrophysics Data System (ADS)

Xu, Zhihan; Grilli, Francesco

2015-10-01

Dc transmission using high temperature superconducting (HTS) coated conductors (CCs) offers a promising solution to the globally growing demand for effective, reliable and economic transmission of green energy up to the gigawatt level over very long distances. The credible estimation of the losses and thereby the heat dissipation involved, where ac ripples (introduced in rectification/ac-dc conversion) are viewed as a potential source of notable contribution, is highly essential for the rational design of practical HTS dc transmission cables and corresponding cryogenic systems to fulfil this demand. Here we report a targeted modelling study into the ac losses in a HTS CC subject to dc and ac ripple currents simultaneously, by solving Maxwell’s equations using the finite element method (FEM) in the commercial software package COMSOL. It is observed that the instantaneous loss exhibits only one peak per cycle in the HTS CC subject to sinusoidal ripples, given that the amplitude of the ac ripples is smaller than approximately 20% of that of the dc current. This is a distinct contrast to the usual observation of two peaks per cycle in a HTS CC subject to ac currents only. The unique mechanism is also revealed, which is directly associated with the finding that, around any local minima of the applied ac ripples, the critical state of -J c is never reached at the edges of the HTS CC, as it should be according to the Bean model. When running further into the longer term, it is discovered that the ac ripple loss of the HTS CC in full-wave rectification decays monotonically, at a speed which is found to be insensitive to the frequency of the applied ripples within our targeted situations, to a relatively low level of approximately 1.38 × 10-4 W m-1 in around 1.7 s. Comparison between this level and other typical loss contributions in a HTS dc cable implies that ac ripple currents in HTS CCs should only be considered as a minor source of dissipation in superconducting dc

ACS Data Handbook v.6.0

NASA Astrophysics Data System (ADS)

Gonzaga, S.; et al.

2011-03-01

ACS was designed to provide a deep, wide-field survey capability from the visible to near-IR using the Wide Field Camera (WFC), high resolution imaging from the near-UV to near-IR with the now-defunct High Resolution Camera (HRC), and solar-blind far-UV imaging using the Solar Blind Camera (SBC). The discovery efficiency of ACS's Wide Field Channel (i.e., the product of WFC's field of view and throughput) is 10 times greater than that of WFPC2. The failure of ACS's CCD electronics in January 2007 brought a temporary halt to CCD imaging until Servicing Mission 4 in May 2009, when WFC functionality was restored. Unfortunately, the high-resolution optical imaging capability of HRC was not recovered.

POEM: Identifying Joint Additive Effects on Regulatory Circuits.

PubMed

Botzman, Maya; Nachshon, Aharon; Brodt, Avital; Gat-Viks, Irit

2016-01-01

Expression Quantitative Trait Locus (eQTL) mapping tackles the problem of identifying variation in DNA sequence that have an effect on the transcriptional regulatory network. Major computational efforts are aimed at characterizing the joint effects of several eQTLs acting in concert to govern the expression of the same genes. Yet, progress toward a comprehensive prediction of such joint effects is limited. For example, existing eQTL methods commonly discover interacting loci affecting the expression levels of a module of co-regulated genes. Such "modularization" approaches, however, are focused on epistatic relations and thus have limited utility for the case of additive (non-epistatic) effects. Here we present POEM (Pairwise effect On Expression Modules), a methodology for identifying pairwise eQTL effects on gene modules. POEM is specifically designed to achieve high performance in the case of additive joint effects. We applied POEM to transcription profiles measured in bone marrow-derived dendritic cells across a population of genotyped mice. Our study reveals widespread additive, trans-acting pairwise effects on gene modules, characterizes their organizational principles, and highlights high-order interconnections between modules within the immune signaling network. These analyses elucidate the central role of additive pairwise effect in regulatory circuits, and provide computational tools for future investigations into the interplay between eQTLs. The software described in this article is available at csgi.tau.ac.il/POEM/.

ACS-Hach Programs: Supporting Excellence in High School Chemistry Teaching

NASA Astrophysics Data System (ADS)

Taylor, Terri

2009-05-01

In January 2009, the ACS received a gift of approximately $33 million from the Hach Scientific Foundation, the largest gift in the society's 133-year history. The foundation's programs will be continued by the ACS and will complement pre-existing ACS resources that support high school chemistry teaching. Three activities serve as the pillars of the ACS-Hach programs—the High School Chemistry Grant Program, the Second Career Teacher Scholarship Program, and the Land Grant University Scholars Program. Collectively, the ACS-Hach programs support high school chemistry teaching and learning by responding to the needs of both in-service and pre-service secondary teachers. The goals of each of the ACS-Hach programs align well with the ACS Mission—to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and its people.

ACS Presents Science Education Report to Congress.

ERIC Educational Resources Information Center

Krieger, James

1989-01-01

Discusses an American Chemical Society (ACS)'s report on science education which is a synthesis of a series of policies developed by ACS. Summarizes recommendations in four areas: elementary teacher education; pre-high school curricula; university research funding; and underrepresented populations. (YP)

A dry-cooled AC quantum voltmeter

NASA Astrophysics Data System (ADS)

Schubert, M.; Starkloff, M.; Peiselt, K.; Anders, S.; Knipper, R.; Lee, J.; Behr, R.; Palafox, L.; Böck, A. C.; Schaidhammer, L.; Fleischmann, P. M.; Meyer, H.-G.

2016-10-01

The paper describes a dry-cooled AC quantum voltmeter system operated up to kilohertz frequencies and 7 V rms. A 10 V programmable Josephson voltage standard (PJVS) array was installed on a pulse tube cooler (PTC) driven with a 4 kW air-cooled compressor. The operating margins at 70 GHz frequencies were investigated in detail and found to exceed 1 mA Shapiro step width. A key factor for the successful chip operation was the low on-chip power consumption of 65 mW in total. A thermal interface between PJVS chip and PTC cold stage was used to avoid a significant chip overheating. By installing the cryocooled PJVS array into an AC quantum voltmeter setup, several calibration measurements of dc standards and calibrator ac voltages up to 2 kHz frequencies were carried out to demonstrate the full functionality. The results are discussed and compared to systems with standard liquid helium cooling. For dc voltages, a direct comparison measurement between the dry-cooled AC quantum voltmeter and a liquid-helium based 10 V PJVS shows an agreement better than 1 part in 1010.

Combined 677CC/1298AC genotypes of methylenetetrahydrofolate reductase (MTHFR ) reduce susceptibility to precursor B lymphoblastic leukemia in a Chinese population.

PubMed

Lv, Ling; Wu, Cuie; Sun, Henjuan; Zhu, Saijuan; Yang, Yongchen; Chen, Xi; Fu, Hua; Bao, Liming

2010-06-01

The methylenetetrahydrofolate reductase (MTHFR) encodes a major enzyme in folate metabolism. It has been suggested that two MTHFR polymorphisms, 677C>T and 1298A>C, influence risk of acute lymphoblastic leukemia (ALL). Most studies on relation of MTHFR polymorphisms to ALL susceptibility have been in pediatric populations because ALL is relatively rare in adults. Here, we report a case-control study of 127 Chinese patients with adult precursor B lymphoblastic leukemia (B-ALL) to examine correlation between the MTHFR polymorphisms and B-ALL susceptibility in adults. Our data show that although the prevalence of genotype 1298CC was significantly higher in the female patients than in the controls (P = 0.04), the differences in distributions of combined genotypes of 1298CC with either 677CC or 677CT between the cases and the controls were statistically insignificant. Haplotype analysis revealed no significant difference between the cases and the controls. The prevalence for joint MTHFR genotypes 677CC/1298AC was significantly lower in the female B-ALL cases than in the controls [odds ratio (OR) = 0.06, 95% CI = 0.00-0.53, P = 0.0033] and no differences among the men [OR = 0.71, 95% CI = 0.20-2.53, P = 0.55], suggesting that protective effects of combined MTHFR 677CC/1298AC genotypes on susceptibility of adult B-ALL are gender bias toward women with 677CC/1298AC women being at a 17-fold reduced odds to develop B-ALL.

From Beamline to Scanner with 225Ac

NASA Astrophysics Data System (ADS)

Robertson, Andrew K. H.; Ramogida, Caterina F.; Kunz, Peter; Rodriguez-Rodriguez, Cristina; Schaffer, Paul; Sossi, Vesna

2016-09-01

Due to the high linear energy transfer and short range of alpha-radiation, targeted radiation therapy using alpha-emitting pharmaceuticals that successfully target small disease clusters will kill target cells with limited harm to healthy tissue, potentially treating the most aggressive forms of cancer. As the parent of a decay chain with four alpha- and two beta-decays, 225Ac is a promising candidate for such a treatment. However, this requires retention of the entire decay chain at the target site, preventing the creation of freely circulating alpha-emitters that reduce therapeutic effect and increase toxicity to non-target tissues. Two major challenges to 225Ac pharmaceutical development exist: insufficient global supply, and the difficulty of preventing toxicity by retaining the entire decay chain at the target site. While TRIUMF works towards large-scale (C i amounts) production of 225Ac, we already use our Isotope Separation On-Line facility to provide small (< 1 mCi) quantities for in-house chemistry and imaging research that aims to improve and assess 225Ac radiopharmaceutical targeting. This presentation provides an overview of this research program and the journey of 225Ac from the beamline to the scanner. This research is funded by the Natural Sciences and Engineering Research Council of Canada.

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

A Case Study of Wind-PV-Thermal-Bundled AC/DC Power Transmission from a Weak AC Network

NASA Astrophysics Data System (ADS)

Xiao, H. W.; Du, W. J.; Wang, H. F.; Song, Y. T.; Wang, Q.; Ding, J.; Chen, D. Z.; Wei, W.

2017-05-01

Wind power generation and photovoltaic (PV) power generation bundled with the support by conventional thermal generation enables the generation controllable and more suitable for being sent over to remote load centre which are beneficial for the stability of weak sending end systems. Meanwhile, HVDC for long-distance power transmission is of many significant technique advantages. Hence the effects of wind-PV-thermal-bundled power transmission by AC/DC on power system have become an actively pursued research subject recently. Firstly, this paper introduces the technical merits and difficulties of wind-photovoltaic-thermal bundled power transmission by AC/DC systems in terms of meeting the requirement of large-scale renewable power transmission. Secondly, a system model which contains a weak wind-PV-thermal-bundled sending end system and a receiving end system in together with a parallel AC/DC interconnection transmission system is established. Finally, the significant impacts of several factors which includes the power transmission ratio between the DC and AC line, the distance between the sending end system and receiving end system, the penetration rate of wind power and the sending end system structure on system stability are studied.

21 CFR 888.1240 - AC-powered dynamometer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false AC-powered dynamometer. 888.1240 Section 888.1240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Diagnostic Devices § 888.1240 AC-powered dynamometer. (a...

21 CFR 888.1240 - AC-powered dynamometer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false AC-powered dynamometer. 888.1240 Section 888.1240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Diagnostic Devices § 888.1240 AC-powered dynamometer. (a...

21 CFR 888.1240 - AC-powered dynamometer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false AC-powered dynamometer. 888.1240 Section 888.1240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Diagnostic Devices § 888.1240 AC-powered dynamometer. (a...

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered adjustable hospital bed. 880.5100 Section 880.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

Nonlinear AC susceptibility, surface and bulk shielding

NASA Astrophysics Data System (ADS)

van der Beek, C. J.; Indenbom, M. V.; D'Anna, G.; Benoit, W.

1996-02-01

We calculate the nonlinear AC response of a thin superconducting strip in perpendicular field, shielded by an edge current due to the geometrical barrier. A comparison with the results for infinite samples in parallel field, screened by a surface barrier, and with those for screening by a bulk current in the critical state, shows that the AC response due to a barrier has general features that are independent of geometry, and that are significantly different from those for screening by a bulk current in the critical state. By consequence, the nonlinear (global) AC susceptibility can be used to determine the origin of magnetic irreversibility. A comparison with experiments on a Bi 2Sr 2CaCu 2O 8+δ crystal shows that in this material, the low-frequency AC screening at high temperature is mainly due to the screening by an edge current, and that this is the unique source of the nonlinear magnetic response at temperatures above 40 K.

AC BREAKDOWN IN GASES

DTIC Science & Technology

electron- emission (multipactor) region, and (3) the low-frequency region. The breakdown mechanism in each of these regions is explained. An extensive bibliography on AC breakdown in gases is included.

Assessing the allelotypic effect of two aminocyclopropane carboxylic acid synthase-encoding genes MdACS1 and MdACS3a on fruit ethylene production and softening in Malus

PubMed Central

Dougherty, Laura; Zhu, Yuandi; Xu, Kenong

2016-01-01

Phytohormone ethylene largely determines apple fruit shelf life and storability. Previous studies demonstrated that MdACS1 and MdACS3a, which encode 1-aminocyclopropane-1-carboxylic acid synthases (ACS), are crucial in apple fruit ethylene production. MdACS1 is well-known to be intimately involved in the climacteric ethylene burst in fruit ripening, while MdACS3a has been regarded a main regulator for ethylene production transition from system 1 (during fruit development) to system 2 (during fruit ripening). However, MdACS3a was also shown to have limited roles in initiating the ripening process lately. To better assess their roles, fruit ethylene production and softening were evaluated at five time points during a 20-day post-harvest period in 97 Malus accessions and in 34 progeny from 2 controlled crosses. Allelotyping was accomplished using an existing marker (ACS1) for MdACS1 and two markers (CAPS866 and CAPS870) developed here to specifically detect the two null alleles (ACS3a-G289V and Mdacs3a) of MdACS3a. In total, 952 Malus accessions were allelotyped with the three markers. The major findings included: The effect of MdACS1 was significant on fruit ethylene production and softening while that of MdACS3a was less detectable; allele MdACS1–2 was significantly associated with low ethylene and slow softening; under the same background of the MdACS1 allelotypes, null allele Mdacs3a (not ACS3a-G289V) could confer a significant delay of ethylene peak; alleles MdACS1–2 and Mdacs3a (excluding ACS3a-G289V) were highly enriched in M. domestica and M. hybrid when compared with those in M. sieversii. These findings are of practical implications in developing apples of low and delayed ethylene profiles by utilizing the beneficial alleles MdACS1-2 and Mdacs3a. PMID:27231553

Successful enrichment of the ubiquitous freshwater acI Actinobacteria.

PubMed

Garcia, Sarahi L; McMahon, Katherine D; Grossart, Hans-Peter; Warnecke, Falk

2014-02-01

Actinobacteria of the acI lineage are often the numerically dominant bacterial phylum in surface freshwaters, where they can account for > 50% of total bacteria. Despite their abundance, there are no described isolates. In an effort to obtain enrichment of these ubiquitous freshwater Actinobacteria, diluted freshwater samples from Lake Grosse Fuchskuhle, Germany, were incubated in 96-well culture plates. With this method, a successful enrichment containing high abundances of a member of the lineage acI was established. Phylogenetic classification showed that the acI Actinobacteria of the enrichment belonged to the acI-B2 tribe, which seems to prefer acidic lakes. This enrichment grows to low cell densities and thus the oligotrophic nature of acI-B2 was confirmed. © 2013 Society for Applied Microbiology and John Wiley & Sons Ltd.

21 CFR 880.5510 - Non-AC-powered patient lift.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Non-AC-powered patient lift. 880.5510 Section 880... Devices § 880.5510 Non-AC-powered patient lift. (a) Identification. A non-AC-powered patient lift is a hydraulic, battery, or mechanically powered device, either fixed or mobile, used to lift and transport a...

21 CFR 880.5510 - Non-AC-powered patient lift.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Non-AC-powered patient lift. 880.5510 Section 880... Devices § 880.5510 Non-AC-powered patient lift. (a) Identification. A non-AC-powered patient lift is a hydraulic, battery, or mechanically powered device, either fixed or mobile, used to lift and transport a...

Nuclear structure of 231Ac

NASA Astrophysics Data System (ADS)

Boutami, R.; Borge, M. J. G.; Mach, H.; Kurcewicz, W.; Fraile, L. M.; Gulda, K.; Aas, A. J.; García-Raffi, L. M.; Løvhøiden, G.; Martínez, T.; Rubio, B.; Taín, J. L.; Tengblad, O.

2008-10-01

The low-energy structure of 231Ac has been investigated by means of γ ray spectroscopy following the β decay of 231Ra. Multipolarities of 28 transitions have been established by measuring conversion electrons with a MINI-ORANGE electron spectrometer. The decay scheme of 231Ra → 231Ac has been constructed for the first time. The Advanced Time Delayed βγγ(t) method has been used to measure the half-lives of five levels. The moderately fast B(E1) transition rates derived suggest that the octupole effects, albeit weak, are still present in this exotic nucleus.

Autographa californica multiple nucleopolyhedrovirus ac53 plays a role in nucleocapsid assembly

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu Chao; Li Zhaofei; Wu Wenbi

2008-12-05

Autographa californica multiple nucleopolyhedrovirus (AcMNPV) orf53 (ac53) is a highly conserved gene existing in all sequenced Lepidoptera and Hymenoptera baculoviruses, but its function remains unknown. To investigate its role in the baculovirus life cycle, an ac53 deletion virus (vAc{sup ac53KO-PH-GFP}) was generated through homologous recombination in Escherichia coli. Fluorescence and light microscopy and titration analysis revealed that vAc{sup ac53KO-PH-GFP} could not produce infectious budded virus in infected Sf9 cells. Real-time PCR demonstrated that the ac53 deletion did not affect the levels of viral DNA replication. Electron microscopy showed that many lucent tubular shells devoid of the nucleoprotein core are presentmore » in the virogenic stroma and ring zone, indicating that the ac53 knockout affected nucleocapsid assembly. With a recombinant virus expressing an Ac53-GFP fusion protein, we observed that Ac53 was distributed within the cytoplasm and nucleus at 24 h post-infection, but afterwards accumulated predominantly near the nucleus-cytoplasm boundary. These data demonstrate that ac53 is involved in nucleocapsid assembly and is an essential gene for virus production.« less

Optimization of spin-torque switching using AC and DC pulses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dunn, Tom; Kamenev, Alex; Fine Theoretical Physics Institute, University of Minnesota, Minneapolis, Minnesota 55455

2014-06-21

We explore spin-torque induced magnetic reversal in magnetic tunnel junctions using combined AC and DC spin-current pulses. We calculate the optimal pulse times and current strengths for both AC and DC pulses as well as the optimal AC signal frequency, needed to minimize the Joule heat lost during the switching process. The results of this optimization are compared against numeric simulations. Finally, we show how this optimization leads to different dynamic regimes, where switching is optimized by either a purely AC or DC spin-current, or a combination AC/DC spin-current, depending on the anisotropy energies and the spin-current polarization.

AC power generation from microbial fuel cells

NASA Astrophysics Data System (ADS)

Lobo, Fernanda Leite; Wang, Heming; Forrestal, Casey; Ren, Zhiyong Jason

2015-11-01

Microbial fuel cells (MFCs) directly convert biodegradable substrates to electricity and carry good potential for energy-positive wastewater treatment. However, the low and direct current (DC) output from MFC is not usable for general electronics except small sensors, yet commercial DC-AC converters or inverters used in solar systems cannot be directly applied to MFCs. This study presents a new DC-AC converter system for MFCs that can generate alternating voltage in any desired frequency. Results show that AC power can be easily achieved in three different frequencies tested (1, 10, 60 Hz), and no energy storage layer such as capacitors was needed. The DC-AC converter efficiency was higher than 95% when powered by either individual MFCs or simple MFC stacks. Total harmonic distortion (THD) was used to investigate the quality of the energy, and it showed that the energy could be directly usable for linear electronic loads. This study shows that through electrical conversion MFCs can be potentially used in household electronics for decentralized off-grid communities.

Joint feedback analysis modeling of nonesterified fatty acids in obese Zucker rats and normal Sprague-Dawley rats after different routes of administration of nicotinic acid.

PubMed

Tapani, Sofia; Almquist, Joachim; Leander, Jacob; Ahlström, Christine; Peletier, Lambertus A; Jirstrand, Mats; Gabrielsson, Johan

2014-08-01

Data were pooled from several studies on nicotinic acid (NiAc) intervention of fatty acid turnover in normal Sprague-Dawley and obese Zucker rats in order to perform a joint PKPD of data from more than 100 normal Sprague-Dawley and obese Zucker rats, exposed to several administration routes and rates. To describe the difference in pharmacodynamic parameters between obese and normal rats, we modified a previously published nonlinear mixed effects model describing tolerance and oscillatory rebound effects of NiAc on nonesterified fatty acids plasma concentrations. An important conclusion is that planning of experiments and dose scheduling cannot rely on pilot studies on normal animals alone. The obese rats have a less-pronounced concentration-response relationship and need higher doses to exhibit desired response. The relative level of fatty acid rebound after cessation of NiAc administration was also quantified in the two rat populations. Building joint normal-disease models with scaling parameter(s) to characterize the "degree of disease" can be a useful tool when designing informative experiments on diseased animals, particularly in the preclinical screen. Data were analyzed using nonlinear mixed effects modeling, for the optimization, we used an improved method for calculating the gradient than the usually adopted finite difference approximation. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

A Single-Phase Embedded Z-Source DC-AC Inverter

PubMed Central

Kim, Se-Jin; Lim, Young-Cheol

2014-01-01

In the conventional DC-AC inverter consisting of two DC-DC converters with unipolar output capacitors, the output capacitor voltages of the DC-DC converters must be higher than the DC input voltage. To overcome this weakness, this paper proposes a single-phase DC-AC inverter consisting of two embedded Z-source converters with bipolar output capacitors. The proposed inverter is composed of two embedded Z-source converters with a common DC source and output AC load. Though the output capacitor voltages of the converters are relatively low compared to those of a conventional inverter, an equivalent level of AC output voltages can be obtained. Moreover, by controlling the output capacitor voltages asymmetrically, the AC output voltage of the proposed inverter can be higher than the DC input voltage. To verify the validity of the proposed inverter, experiments were performed with a DC source voltage of 38 V. By controlling the output capacitor voltages of the converters symmetrically or asymmetrically, the proposed inverter can produce sinusoidal AC output voltages. The experiments show that efficiencies of up to 95% and 97% can be achieved with the proposed inverter using symmetric and asymmetric control, respectively. PMID:25133241

A single-phase embedded Z-source DC-AC inverter.

PubMed

Kim, Se-Jin; Lim, Young-Cheol

2014-01-01

In the conventional DC-AC inverter consisting of two DC-DC converters with unipolar output capacitors, the output capacitor voltages of the DC-DC converters must be higher than the DC input voltage. To overcome this weakness, this paper proposes a single-phase DC-AC inverter consisting of two embedded Z-source converters with bipolar output capacitors. The proposed inverter is composed of two embedded Z-source converters with a common DC source and output AC load. Though the output capacitor voltages of the converters are relatively low compared to those of a conventional inverter, an equivalent level of AC output voltages can be obtained. Moreover, by controlling the output capacitor voltages asymmetrically, the AC output voltage of the proposed inverter can be higher than the DC input voltage. To verify the validity of the proposed inverter, experiments were performed with a DC source voltage of 38 V. By controlling the output capacitor voltages of the converters symmetrically or asymmetrically, the proposed inverter can produce sinusoidal AC output voltages. The experiments show that efficiencies of up to 95% and 97% can be achieved with the proposed inverter using symmetric and asymmetric control, respectively.

Post-Flash Validation of the new ACS/WFC Subarrays

NASA Astrophysics Data System (ADS)

Bellini, A.; Grogin, N. A.; Lim, P. L.; Golimowski, D.

2017-05-01

We made use of the new ACS/WFC subarray images of CAL-14410, taken taken with a large range of flash exposure times (0.1-30 seconds), to probe the temporal stability of the reference flash file and to validate the current post-flash correction pipeline of CALACS and ACS DESTRIPE PLUS on the new subarray modes. No statistically-significant deviations are found between the new post-flashed subarray exposures and the flash reference file, indicating that the LED lamp used to post-flash ACS images has been stable over several years. The current calibration pipelines (both CALACS and ACS DESTRIPE PLUS can be successfully used with the new subarray modes.

POEM: Identifying Joint Additive Effects on Regulatory Circuits

PubMed Central

Botzman, Maya; Nachshon, Aharon; Brodt, Avital; Gat-Viks, Irit

2016-01-01

Motivation: Expression Quantitative Trait Locus (eQTL) mapping tackles the problem of identifying variation in DNA sequence that have an effect on the transcriptional regulatory network. Major computational efforts are aimed at characterizing the joint effects of several eQTLs acting in concert to govern the expression of the same genes. Yet, progress toward a comprehensive prediction of such joint effects is limited. For example, existing eQTL methods commonly discover interacting loci affecting the expression levels of a module of co-regulated genes. Such “modularization” approaches, however, are focused on epistatic relations and thus have limited utility for the case of additive (non-epistatic) effects. Results: Here we present POEM (Pairwise effect On Expression Modules), a methodology for identifying pairwise eQTL effects on gene modules. POEM is specifically designed to achieve high performance in the case of additive joint effects. We applied POEM to transcription profiles measured in bone marrow-derived dendritic cells across a population of genotyped mice. Our study reveals widespread additive, trans-acting pairwise effects on gene modules, characterizes their organizational principles, and highlights high-order interconnections between modules within the immune signaling network. These analyses elucidate the central role of additive pairwise effect in regulatory circuits, and provide computational tools for future investigations into the interplay between eQTLs. Availability: The software described in this article is available at csgi.tau.ac.il/POEM/. PMID:27148351

Flexible, polymer gated, AC-driven organic electroluminescence devices

NASA Astrophysics Data System (ADS)

Xu, Junwei; Carroll, David L.

2017-08-01

Comparing rigid inorganic layer, polymeric semiconducting gate layer exhibits superior flexibility as well as efficient carrier manipulation in high frequency AC cycles. Mechanism of the carrier manipulation at the gate in forward and reversed bias of AC cycle is studied. The flexible PET-based AC-OEL device with poly[(9,9-bis(3'-((N,N-dimethyl)-Nethylammonium)- propyl)-2,7-fluorene)-alt-2,7-(9,9-dioctylfluorene)] (PFN-Br) gate shows a stable electroluminescent performance in frequency sweep with a color rendering index (CRI) over 81 at 2800K color temperature.

dc Arc Fault Effect on Hybrid ac/dc Microgrid

NASA Astrophysics Data System (ADS)

Fatima, Zahra

The advent of distributed energy resources (DER) and reliability and stability problems of the conventional grid system has given rise to the wide spread deployment of microgrids. Microgrids provide many advantages by incorporating renewable energy sources and increasing the reliability of the grid by isolating from the main grid in case of an outage. AC microgrids have been installed all over the world, but dc microgrids have been gaining interest due to the advantages they provide over ac microgrids. However the entire power network backbone is still ac and dc microgrids require expensive converters to connect to the ac power network. As a result hybrid ac/dc microgrids are gaining more attention as it combines the advantages of both ac and dc microgrids such as direct integration of ac and dc systems with minimum number of conversions which increases the efficiency by reducing energy losses. Although dc electric systems offer many advantages such as no synchronization and no reactive power, successful implementation of dc systems requires appropriate protection strategies. One unique protection challenge brought by the dc systems is dc arc faults. A dc arc fault is generated when there is a gap in the conductor due to insulation degradation and current is used to bridge the gap, resulting in an arc with very high temperature. Such a fault if it goes undetected and is not extinguished can cause damage to the entire system and cause fires. The purpose of the research is to study the effect of the dc arc fault at different locations in the hybrid ac/dc microgrid and provide insight on the reliability of the grid components when it is impacted by arc faults at various locations in the grid. The impact of dc arc fault at different locations on the performance of the PV array, wind generation, and constant power loads (CPL) interfaced with dc/dc converters is studied. MATLAB/Simulink is used to model the hybrid ac/dc microgrid and arc fault.

Arthroscopic-assisted Locking Compression Plate clavicular hook fixation for unstable fractures of the lateral end of the clavicle: a prospective study

PubMed Central

Lee, Kwang Won; Kim, Kap Jung; Kim, Yong In; Kwon, Won Cho; Choy, Won Sik

2009-01-01

The aim of this prospective study was to assess the clinical outcomes of an unstable fracture of the lateral end of the clavicle treated with an arthroscopic-assisted locking compressive plate (LCP) clavicular hook plate. Twenty-three patients underwent arthroscopic assisted LCP clavicular hook plate fixation for these fractures. All patients achieved clinical and radiological union over a mean of 4.2 months (range, 3.4–5 months). Four patients (17%) showed some degree of acromial osteolysis. Three patients (13%) showed radiological signs of arthrosis of the acromioclavicular joint. In one patient, a second fracture (stress) was observed between the medial two screws of the plate without an additional injury. Five patients (22%) showed subacromial bursitis on dynamic ultrasonography. The mean Constant and Murley score was 91 points (range, 81–98). The average level of pain in the shoulder at rest and on abduction was 1 (range, 0–2) and 2.4 (range, 0–4), respectively. Based on our experience, arthroscopic-assisted LCP hook plate fixation for the treatment of unstable fractures of the lateral end of the clavicle is not without complications. However, it is an acceptable alternative method that is easy to apply with good results. Furthermore, it prevents rotator cuff impingement, allows early mobilisation and maintains the acromioclavicular joint biomechanics. PMID:19998033

Frequency-dependent tACS modulation of BOLD signal during rhythmic visual stimulation.

PubMed

Chai, Yuhui; Sheng, Jingwei; Bandettini, Peter A; Gao, Jia-Hong

2018-05-01

Transcranial alternating current stimulation (tACS) has emerged as a promising tool for modulating cortical oscillations. In previous electroencephalogram (EEG) studies, tACS has been found to modulate brain oscillatory activity in a frequency-specific manner. However, the spatial distribution and hemodynamic response for this modulation remains poorly understood. Functional magnetic resonance imaging (fMRI) has the advantage of measuring neuronal activity in regions not only below the tACS electrodes but also across the whole brain with high spatial resolution. Here, we measured fMRI signal while applying tACS to modulate rhythmic visual activity. During fMRI acquisition, tACS at different frequencies (4, 8, 16, and 32 Hz) was applied along with visual flicker stimulation at 8 and 16 Hz. We analyzed the blood-oxygen-level-dependent (BOLD) signal difference between tACS-ON vs tACS-OFF, and different frequency combinations (e.g., 4 Hz tACS, 8 Hz flicker vs 8 Hz tACS, 8 Hz flicker). We observed significant tACS modulation effects on BOLD responses when the tACS frequency matched the visual flicker frequency or the second harmonic frequency. The main effects were predominantly seen in regions that were activated by the visual task and targeted by the tACS current distribution. These findings bridge different scientific domains of tACS research and demonstrate that fMRI could localize the tACS effect on stimulus-induced brain rhythms, which could lead to a new approach for understanding the high-level cognitive process shaped by the ongoing oscillatory signal. © 2018 Wiley Periodicals, Inc.

Apple MdACS6 Regulates Ethylene Biosynthesis During Fruit Development Involving Ethylene-Responsive Factor.

PubMed

Li, Tong; Tan, Dongmei; Liu, Zhi; Jiang, Zhongyu; Wei, Yun; Zhang, Lichao; Li, Xinyue; Yuan, Hui; Wang, Aide

2015-10-01

Ethylene biosynthesis in plants involves different 1-aminocyclopropane-1-carboxylic acid synthase (ACS) genes. The regulation of each ACS gene during fruit development is unclear. Here, we characterized another apple (Malus×domestica) ACS gene, MdACS6. The transcript of MdACS6 was observed not only in fruits but also in other tissues. During fruit development, MdACS6 was initiated at a much earlier stage, whereas MdACS3a and MdACS1 began to be expressed at 35 d before harvest and immediateley after harvest, respectively. Moreover, the enzyme activity of MdACS6 was significantly lower than that of MdACS3a and MdACS1, accounting for the low ethylene biosynthesis in young fruits. Overexpression of MdACS6 (MdACS6-OE) by transient assay in apple showed enhanced ethylene production, and MdACS3a was induced in MdACS6-OE fruits but not in control fruits. In MdACS6 apple fruits silenced by the virus-induced gene silencing (VIGS) system (MdACS6-AN), neither ethylene production nor MdACS3a transcript was detectable. In order to explore the mechanism through which MdACS3a was induced in MdACS6-OE fruits, we investigated the expression of apple ethylene-responsive factor (ERF) genes. The results showed that the expression of MdERF2 was induced in MdACS6-OE fruits and inhibited in MdACS6-AN fruits. Yeast one-hybrid assay showed that MdERF2 protein could bind to the promoter of MdACS3a. Moreover, down-regulation of MdERF2 in apple flesh callus led to a decrease of MdACS3a expression, demonstrating the regulation of MdERF2 on MdACS3a. The mechanism through which MdACS6 regulates the action of MdACS3a was discussed. © The Author 2015. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Ac electroosmotic flows above coplanar electrodes

NASA Astrophysics Data System (ADS)

Kweon Suh, Yong

2009-03-01

Interactive numerical method has been proposed to calculate the ac electroosmotic flows above a pair of coplanar electrodes. The thin electrical triple layer (ETL) has been modeled by an asymptotic theory developed by the authors. The model corresponds to a simple dynamic equation for the surface charge density representing the integrated charge over the inner layer. Interactive calculation of the dynamic equation and the Laplace equation for several periods of ac frequency then yielded steady-state distribution of potential and the potential drop across the Stern and inner layers. The Smoluchowski's slip velocity was then determined from those two set of data and used as the boundary condition for the calculation of the Stokes' flow above the electrodes. We have shown that our solutions compared well with the experimental data reported in the literature. We investigated the effect of various parameters on the slip velocity distribution, such as the ac frequency, the electrode length, the effective Stern-layer thickness and the adsorption coefficients.

An AC electroosmotic micropump for circular chromatographic applications.

PubMed

Debesset, S; Hayden, C J; Dalton, C; Eijkel, J C T; Manz, A

2004-08-01

Flow rates of up to 50 microm s(-1) have been successfully achieved in a closed-loop channel using an AC electroosmotic pump. The AC electroosmotic pump is made of an interdigitated array of unequal width electrodes located at the bottom of a channel, with an AC voltage applied between the small and the large electrodes. The flow rate was found to increase linearly with the applied voltage and to decrease linearly with the applied frequency. The pump is expected to be suitable for circular chromatography for the following reasons: the driving forces are distributed over the channel length and the pumping direction is set by the direction of the interdigitated electrodes. Pumping in a closed-loop channel can be achieved by arranging the electrode pattern in a circle. In addition the inherent working principle of AC electroosmotic pumping enables the independent optimisation of the channel height or the flow velocity.

Characterizing superconducting thin films using AC Magnetic Susceptibility

NASA Astrophysics Data System (ADS)

Mahoney, C. H.; Porzio, J.; Sullivan, M. C.

2014-03-01

We present our work on using ac magnetic susceptibility to determine the critical temperature of superconducting thin films. In ac magnetic susceptibility, the thin film is placed between two coils. One coil carries an ac signal, creating a varying external magnetic field. We measure the voltage induced in the pick-up coil on the opposite side of the sample and measure how the sample magnetization changes as the temperature changes. We will present our work to use ac susceptibility to determine critical temperature and superconducting volume fraction. Using our own analysis program, we are able to accurately locate the critical temperatures of the samples and determine the transition width. For the superconducting volume fraction, we etch samples in order to control the thicknesses of the sample and measure how much of the material grown on the surface is superconducting. Supported by NFS grant DMR-1305637.

Introducing high performance distributed logging service for ACS

NASA Astrophysics Data System (ADS)

Avarias, Jorge A.; López, Joao S.; Maureira, Cristián; Sommer, Heiko; Chiozzi, Gianluca

2010-07-01

The ALMA Common Software (ACS) is a software framework that provides the infrastructure for the Atacama Large Millimeter Array and other projects. ACS, based on CORBA, offers basic services and common design patterns for distributed software. Every properly built system needs to be able to log status and error information. Logging in a single computer scenario can be as easy as using fprintf statements. However, in a distributed system, it must provide a way to centralize all logging data in a single place without overloading the network nor complicating the applications. ACS provides a complete logging service infrastructure in which every log has an associated priority and timestamp, allowing filtering at different levels of the system (application, service and clients). Currently the ACS logging service uses an implementation of the CORBA Telecom Log Service in a customized way, using only a minimal subset of the features provided by the standard. The most relevant feature used by ACS is the ability to treat the logs as event data that gets distributed over the network in a publisher-subscriber paradigm. For this purpose the CORBA Notification Service, which is resource intensive, is used. On the other hand, the Data Distribution Service (DDS) provides an alternative standard for publisher-subscriber communication for real-time systems, offering better performance and featuring decentralized message processing. The current document describes how the new high performance logging service of ACS has been modeled and developed using DDS, replacing the Telecom Log Service. Benefits and drawbacks are analyzed. A benchmark is presented comparing the differences between the implementations.

Particle Line Assembly/Patterning by Microfluidic AC Electroosmosis

NASA Astrophysics Data System (ADS)

Lian, Meng; Islam, Nazmul; Wu, Jie

2006-04-01

Recently AC electroosmosis has attracted research interests worldwide. This paper is the first to investigate particle line assembly/patterning by AC electroosmosis. Since AC electroosmotic force has no dependence on particle sizes, this technique is particularly useful for manipulating nanoscale substance, and hopefully constructs functional nanoscale devices. Two types of ACEO devices, in the configurations of planar interdigitated electrodes and parallel plate electrodes, and a biased ACEO technique are studied, which provides added flexibility in particle manipulation and line assembly. The paper also investigates the effects of electrical field distributions on generating microflows for particle assembly. The results are corroborated experimentally.

AC Coupled Interconnect for Low Power Spaceborne Electronics

DTIC Science & Technology

2006-09-30

Final Report 3. DATES COVERED (From - To) 20/05/2003 to 30/09/2006 4. TITLE AND SUBTITLE AC COUPLED INTERCONNECT FOR LOW POWER SPACEBORNE...14. ABSTRACT The primary objective of this effort was to establish that AC Coupled Interconnect could be used to create multiple solutions to...

Modified closed-loop double-endobutton technique for repair of rockwood type III acromioclavicular dislocation

PubMed Central

Zhang, Lei; Zhou, Xin; Qi, Ji; Zeng, Yan; Zhang, Shaoqun; Liu, Gang; Ping, Ruiyue; Li, Yikai; Fu, Shijie

2018-01-01

Acromioclavicular dislocation (ACD) is a common injury. According to the Rockwood classification, ACD is classified into six types (type I–VI); however, for type III injuries, it remains controversial whether or not operative treatment should be applied. Numerous studies have advocated early surgical treatment to ensure early rehabilitation activities. Thus, the present study aimed to investigate a modified closed-loop double-endobutton technique (MCDT), that may be used to repair Rockwood type III ACD. In the current study, 61 patients with Rockwood type III ACD were enrolled during a period of 5 years at the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. Patients were divided into three groups according to the surgical method used, the MCDT group (n=20), the common closed-loop double-endobutton technique (CCDT) group (n=21), and the clavicular hook plate fixation (CHPF) group (n=20). Preoperative and intraoperative information were recorded. Furthermore, the functional scores of injured shoulder were evaluated prior to surgery and following surgery with a 1-year follow-up. Among the three groups, postoperative functional scores were significantly more improved compared with those prior to surgery (P<0.05), and no significant difference was observed regarding the coracoclavicular interval with the 1-year follow-up (P>0.05). Postoperative functional scores in the MCDT and CCDT groups were significantly more improved compared those in the CHPF group (P<0.05). In addition, the duration of surgery in the MCDT group was significantly shorter compared with that in the CCDT group (P<0.05). Furthermore, compared with the CHPF group, the incision length was significantly shorter with reduced hemorrhage in the MCDT group (P<0.05). In conclusion, the results of the current study suggest that MCDT is more simple, convenient and efficient compared with CCDT, and is worth popularizing. PMID:29399102

[Ru/AC catalyzed ozonation of recalcitrant organic compounds].

PubMed

Wang, Jian-Bing; Hou, Shao-Pei; Zhou, Yun-Rui; Zhu, Wan-Peng; He, Xu-Wen

2009-09-15

Ozonation and Ru/AC catalyzed ozonation of dimethyl phthalate (DMP), phenols and disinfection by-products precursors were studied. It shows that Ru/AC catalyst can obviously enhance the mineralization of organic compounds. In the degradation of DMP, TOC removal was 28.84% by ozonation alone while it was 66.13% by catalytic ozonation. In the oxidation of 23 kinds of phenols, TOC removals were 9.57%-56.08% by ozonation alone while they were 41.81%-82.32% by catalytic ozonation. Compared to ozonation alone, Ru/AC catalyzed ozonation was more effective for the reduction of disinfection by-products formation potentials in source water. The reduction of haloacetic acids formation potentials was more obvious than thichlomethane formation potentials. After the treatment by catalytic ozonation, the haloacetic acids formation potentials decreased from 144.02 microg/L to 58.50 microg/L, which was below the standard value of EPA. However ozonation alone could not make it reach the standard. The treatments of source water by BAC, O3 + BAC, O3/AC + BAC and Ru/AC + O3 + BAC were also studied. In the four processes, TOC removal was 3.80%, 20.14%, 27.45% and 48.30% respectively, COD removal was 4.37%, 27.22%, 39.91% and 50.00% respectively, UV254 removal was 8.16%, 62.24%, 67.03% and 84.95% respectively. Ru/AC + O3 + BAC process is more effective than the other processes for the removal of TOC, COD and UV254 and no ruthenium leaching observed in the solution. It is a promising process for the treatment of micro polluted source water.

Methods for Addressing Missing Data with Applications from ACS Exams

ERIC Educational Resources Information Center

Brandriet, Alexandra; Holme, Thomas

2015-01-01

As part of the ACS Examinations Institute (ACS-EI) national norming process, student performance data sets are collected from professors at colleges and universities from around the United States. Because the data sets are collected on a volunteer basis, the ACS-EI often receives data sets with only students' total scores and without the students'…

Diagnostics of the Fermilab Tevatron using an AC dipole

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miyamoto, Ryoichi

2008-08-01

The Fermilab Tevatron is currently the world's highest energy colliding beam facility. Its counter-rotating proton and antiproton beams collide at 2 TeV center-of-mass. Delivery of such intense beam fluxes to experiments has required improved knowledge of the Tevatron's beam optical lattice. An oscillating dipole magnet, referred to as an AC dipole, is one of such a tool to non-destructively assess the optical properties of the synchrotron. We discusses development of an AC dipole system for the Tevatron, a fast-oscillating (f ~ 20 kHz) dipole magnet which can be adiabatically turned on and off to establish sustained coherent oscillations of themore » beam particles without affecting the transverse emittance. By utilizing an existing magnet and a higher power audio amplifier, the cost of the Tevatron AC dipole system became relatively inexpensive. We discuss corrections which must be applied to the driven oscillation measurements to obtain the proper interpretation of beam optical parameters from AC dipole studies. After successful operations of the Tevatron AC dipole system, AC dipole systems, similar to that in the Tevatron, will be build for the CERN LHC. We present several measurements of linear optical parameters (beta function and phase advance) for the Tevatron, as well as studies of non-linear perturbations from sextupole and octupole elements.« less

Aragonite coating solutions (ACS) based on artificial seawater

NASA Astrophysics Data System (ADS)

Tas, A. Cuneyt

2015-03-01

Aragonite (CaCO3, calcium carbonate) is an abundant biomaterial of marine life. It is the dominant inorganic phase of coral reefs, mollusc bivalve shells and the stalactites or stalagmites of geological sediments. Inorganic and initially precipitate-free aragonite coating solutions (ACS) of pH 7.4 were developed in this study to deposit monolayers of aragonite spherules or ooids on biomaterial (e.g., UHMWPE, ultrahigh molecular weight polyethylene) surfaces soaked in ACS at 30 °C. The ACS solutions of this study have been developed for the surface engineering of synthetic biomaterials. The abiotic ACS solutions, enriched with calcium and bicarbonate ions at different concentrations, essentially mimicked the artificial seawater composition and started to deposit aragonite after a long (4 h) incubation period at the tropical sea surface temperature of 30 °C. While numerous techniques for the solution deposition of calcium hydroxyapatite (Ca10(PO4)6(OH)2), of low thermodynamic solubility, on synthetic biomaterials have been demonstrated, procedures related to the solution-based surface deposition of high solubility aragonite remained uncommon. Monolayers of aragonite ooids deposited at 30 °C on UHMWPE substrates soaked in organic-free ACS solutions were found to possess nano-structures similar to the mortar-and-brick-type botryoids observed in biogenic marine shells. Samples were characterized using SEM, XRD, FTIR, ICP-AES and contact angle goniometry.

ac electroosmotic pumping induced by noncontact external electrodes

PubMed Central

Wang, Shau-Chun; Chen, Hsiao-Ping; Chang, Hsueh-Chia

2007-01-01

Electroosmotic (EO) pumps based on dc electroosmosis is plagued by bubble generation and other electrochemical reactions at the electrodes at voltages beyond 1 V for electrolytes. These disadvantages limit their throughput and offset their portability advantage over mechanical syringe or pneumatic pumps. ac electroosmotic pumps at high frequency (>100 kHz) circumvent the bubble problem by inducing polarization and slip velocity on embedded electrodes,1 but they require complex electrode designs to produce a net flow. We report a new high-throughput ac EO pump design based on induced-polarization on the entire channel surface instead of just on the electrodes. Like dc EO pumps, our pump electrodes are outside of the load section and form a cm-long pump unit consisting of three circular reservoirs (3 mm in diameter) connected by a 1×1 mm channel. The field-induced polarization can produce an effective Zeta potential exceeding 1 V and an ac slip velocity estimated as 1 mm∕sec or higher, both one order of magnitude higher than earlier dc and ac pumps, giving rise to a maximum throughput of 1 μl∕sec. Polarization over the entire channel surface, quadratic scaling with respect to the field and high voltage at high frequency without electrode bubble generation are the reasons why the current pump is superior to earlier dc and ac EO pumps. PMID:19693362

ac electroosmotic pumping induced by noncontact external electrodes.

PubMed

Wang, Shau-Chun; Chen, Hsiao-Ping; Chang, Hsueh-Chia

2007-09-21

Electroosmotic (EO) pumps based on dc electroosmosis is plagued by bubble generation and other electrochemical reactions at the electrodes at voltages beyond 1 V for electrolytes. These disadvantages limit their throughput and offset their portability advantage over mechanical syringe or pneumatic pumps. ac electroosmotic pumps at high frequency (>100 kHz) circumvent the bubble problem by inducing polarization and slip velocity on embedded electrodes,1 but they require complex electrode designs to produce a net flow. We report a new high-throughput ac EO pump design based on induced-polarization on the entire channel surface instead of just on the electrodes. Like dc EO pumps, our pump electrodes are outside of the load section and form a cm-long pump unit consisting of three circular reservoirs (3 mm in diameter) connected by a 1x1 mm channel. The field-induced polarization can produce an effective Zeta potential exceeding 1 V and an ac slip velocity estimated as 1 mmsec or higher, both one order of magnitude higher than earlier dc and ac pumps, giving rise to a maximum throughput of 1 mulsec. Polarization over the entire channel surface, quadratic scaling with respect to the field and high voltage at high frequency without electrode bubble generation are the reasons why the current pump is superior to earlier dc and ac EO pumps.

ac propulsion system for an electric vehicle

NASA Technical Reports Server (NTRS)

Geppert, S.

1980-01-01

It is pointed out that dc drives will be the logical choice for current production electric vehicles (EV). However, by the mid-80's, there is a good chance that the price and reliability of suitable high-power semiconductors will allow for a competitive ac system. The driving force behind the ac approach is the induction motor, which has specific advantages relative to a dc shunt or series traction motor. These advantages would be an important factor in the case of a vehicle for which low maintenance characteristics are of primary importance. A description of an EV ac propulsion system is provided, taking into account the logic controller, the inverter, the motor, and a two-speed transmission-differential-axle assembly. The main barrier to the employment of the considered propulsion system in EV is not any technical problem, but inverter transistor cost.

AC Resistance measuring instrument

DOEpatents

Hof, Peter J.

1983-01-01

An auto-ranging AC resistance measuring instrument for remote measurement of the resistance of an electrical device or circuit connected to the instrument includes a signal generator which generates an AC excitation signal for application to a load, including the device and the transmission line, a monitoring circuit which provides a digitally encoded signal representing the voltage across the load, and a microprocessor which operates under program control to provide an auto-ranging function by which range resistance is connected in circuit with the load to limit the load voltage to an acceptable range for the instrument, and an auto-compensating function by which compensating capacitance is connected in shunt with the range resistance to compensate for the effects of line capacitance. After the auto-ranging and auto-compensation functions are complete, the microprocessor calculates the resistance of the load from the selected range resistance, the excitation signal, and the load voltage signal, and displays of the measured resistance on a digital display of the instrument.

Joint Feedback Analysis Modeling of Nonesterified Fatty Acids in Obese Zucker Rats and Normal Sprague–Dawley Rats after Different Routes of Administration of Nicotinic Acid

PubMed Central

Tapani, Sofia; Almquist, Joachim; Leander, Jacob; Ahlström, Christine; Peletier, Lambertus A; Jirstrand, Mats; Gabrielsson, Johan

2014-01-01

Data were pooled from several studies on nicotinic acid (NiAc) intervention of fatty acid turnover in normal Sprague–Dawley and obese Zucker rats in order to perform a joint PKPD of data from more than 100 normal Sprague–Dawley and obese Zucker rats, exposed to several administration routes and rates. To describe the difference in pharmacodynamic parameters between obese and normal rats, we modified a previously published nonlinear mixed effects model describing tolerance and oscillatory rebound effects of NiAc on nonesterified fatty acids plasma concentrations. An important conclusion is that planning of experiments and dose scheduling cannot rely on pilot studies on normal animals alone. The obese rats have a less-pronounced concentration–response relationship and need higher doses to exhibit desired response. The relative level of fatty acid rebound after cessation of NiAc administration was also quantified in the two rat populations. Building joint normal-disease models with scaling parameter(s) to characterize the “degree of disease” can be a useful tool when designing informative experiments on diseased animals, particularly in the preclinical screen. Data were analyzed using nonlinear mixed effects modeling, for the optimization, we used an improved method for calculating the gradient than the usually adopted finite difference approximation. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 103:2571–2584, 2014 PMID:24986056

Modeling and Correcting the Time-Dependent ACS PSF

NASA Technical Reports Server (NTRS)

Rhodes, Jason; Massey, Richard; Albert, Justin; Taylor, James E.; Koekemoer, Anton M.; Leauthaud, Alexie

2006-01-01

The ability to accurately measure the shapes of faint objects in images taken with the Advanced Camera for Surveys (ACS) on the Hubble Space Telescope (HST) depends upon detailed knowledge of the Point Spread Function (PSF). We show that thermal fluctuations cause the PSF of the ACS Wide Field Camera (WFC) to vary over time. We describe a modified version of the TinyTim PSF modeling software to create artificial grids of stars across the ACS field of view at a range of telescope focus values. These models closely resemble the stars in real ACS images. Using 10 bright stars in a real image, we have been able to measure HST s apparent focus at the time of the exposure. TinyTim can then be used to model the PSF at any position on the ACS field of view. This obviates the need for images of dense stellar fields at different focus values, or interpolation between the few observed stars. We show that residual differences between our TinyTim models and real data are likely due to the effects of Charge Transfer Efficiency (CTE) degradation. Furthermore, we discuss stochastic noise that is added to the shape of point sources when distortion is removed, and we present MultiDrizzle parameters that are optimal for weak lensing science. Specifically, we find that reducing the MultiDrizzle output pixel scale and choosing a Gaussian kernel significantly stabilizes the resulting PSF after image combination, while still eliminating cosmic rays/bad pixels, and correcting the large geometric distortion in the ACS. We discuss future plans, which include more detailed study of the effects of CTE degradation on object shapes and releasing our TinyTim models to the astronomical community.

AC conductivity of a quantum Hall line junction

NASA Astrophysics Data System (ADS)

Agarwal, Amit; Sen, Diptiman

2009-09-01

We present a microscopic model for calculating the AC conductivity of a finite length line junction made up of two counter- or co-propagating single mode quantum Hall edges with possibly different filling fractions. The effect of density-density interactions and a local tunneling conductance (σ) between the two edges is considered. Assuming that σ is independent of the frequency ω, we derive expressions for the AC conductivity as a function of ω, the length of the line junction and other parameters of the system. We reproduce the results of Sen and Agarwal (2008 Phys. Rev. B 78 085430) in the DC limit (\\omega \\to 0 ), and generalize those results for an interacting system. As a function of ω, the AC conductivity shows significant oscillations if σ is small; the oscillations become less prominent as σ increases. A renormalization group analysis shows that the system may be in a metallic or an insulating phase depending on the strength of the interactions. We discuss the experimental implications of this for the behavior of the AC conductivity at low temperatures.

AC propulsion system for an electric vehicle, phase 2

NASA Astrophysics Data System (ADS)

Slicker, J. M.

1983-06-01

A second-generation prototype ac propulsion system for a passenger electric vehicle was designed, fabricated, tested, installed in a modified Mercury Lynx vehicle and track tested at the Contractor's site. The system consisted of a Phase 2, 18.7 kw rated ac induction traction motor, a 192-volt, battery powered, pulse-width-modulated, transistorized inverter packaged for under rear seat installation, a 2-axis, 2-speed, automatically-shifted mechanical transaxle and a microprocessor-based powertrain/vehicle controller. A diagnostics computer to assist tuning and fault finding was fabricated. Dc-to-mechanical-system efficiency varied from 78% to 82% as axle speed/torque ranged from 159 rpm/788 nm to 65 rpm/328 nm. Track test efficiency results suggest that the ac system will be equal or superior to dc systems when driving urban cycles. Additional short-term work is being performed under a third contract phase (AC-3) to raise transaxle efficiency to predicted levels, and to improve starting and shifting characteristics. However, the long-term challenge to the system's viability remains inverter cost. A final report on the Phase 2 system, describing Phase 3 modifications, will be issued at the conclusion of AC-3.

AC propulsion system for an electric vehicle, phase 2

NASA Technical Reports Server (NTRS)

Slicker, J. M.

1983-01-01

A second-generation prototype ac propulsion system for a passenger electric vehicle was designed, fabricated, tested, installed in a modified Mercury Lynx vehicle and track tested at the Contractor's site. The system consisted of a Phase 2, 18.7 kw rated ac induction traction motor, a 192-volt, battery powered, pulse-width-modulated, transistorized inverter packaged for under rear seat installation, a 2-axis, 2-speed, automatically-shifted mechanical transaxle and a microprocessor-based powertrain/vehicle controller. A diagnostics computer to assist tuning and fault finding was fabricated. Dc-to-mechanical-system efficiency varied from 78% to 82% as axle speed/torque ranged from 159 rpm/788 nm to 65 rpm/328 nm. Track test efficiency results suggest that the ac system will be equal or superior to dc systems when driving urban cycles. Additional short-term work is being performed under a third contract phase (AC-3) to raise transaxle efficiency to predicted levels, and to improve starting and shifting characteristics. However, the long-term challenge to the system's viability remains inverter cost. A final report on the Phase 2 system, describing Phase 3 modifications, will be issued at the conclusion of AC-3.

Probable alpha and 14C cluster emission from hyper Ac nuclei

NASA Astrophysics Data System (ADS)

Santhosh, K. P.

2013-10-01

A systematic study on the probability for the emission of 4He and 14C cluster from hyper {Λ/207-234}Ac and non-strange normal 207-234Ac nuclei are performed for the first time using our fission model, the Coulomb and proximity potential model (CPPM). The predicted half lives show that hyper {Λ/207-234}Ac nuclei are unstable against 4He emission and 14C emission from hyper {Λ/217-228}Ac are favorable for measurement. Our study also show that hyper {Λ/207-234}Ac are stable against hyper {Λ/4}He and {Λ/14}C emission. The role of neutron shell closure ( N = 126) in hyper {Λ/214}Fr daughter and role of proton/neutron shell closure ( Z ≈ 82, N = 126) in hyper {Λ/210}Bi daughter are also revealed. As hyper-nuclei decays to normal nuclei by mesonic/non-mesonic decay and since most of the predicted half lives for 4He and 14C emission from normal Ac nuclei are favourable for measurement, we presume that alpha and 14C cluster emission from hyper Ac nuclei can be detected in laboratory in a cascade (two-step) process.

Mathematical model for the dc-ac inverter for the Space Shuttle

NASA Technical Reports Server (NTRS)

Berry, Frederick C.

1987-01-01

The reader is informed of what was done for the mathematical modeling of the dc-ac inverter for the Space Shuttle. The mathematical modeling of the dc-ac inverter is an essential element in the modeling of the electrical power distribution system of the Space Shuttle. The electrical power distribution system which is present on the Space Shuttle is made up to 3 strings each having a fuel cell which provides dc to those systems which require dc, and the inverters which convert the dc to ac for those elements which require ac. The inverters are units which are 2 wire structures for the main dc inputs and 2 wire structures for the ac output. When 3 are connected together a 4 wire wye connection results on the ac side. The method of modeling is performed by using a Least Squares curve fitting method. A computer program is presented for implementation of the model along with graphs and tables to demonstrate the accuracy of the model.

[Expression of AC133 vs. CD34 in acute childhood leukemias].

PubMed

Ebener, U; Brinkmann, A; Zotova, V; Niegemann, E; Wehner, S

2000-01-01

AC133, a newly discovered antigen on human progenitor cells, demonstrating 5-transmembranous domains is expressed by 30-60% out of all CD34+ cells. Our aim therefore was to investigate the extent of human stem-/progenitor cells expressing AC133 antigen in umbilical cord blood, peripheral blood without or following an application of granulocyte-colony stimulating factor (rhG-CSF). The main task was the investigation of bone marrow aspirates derived from children suffering from newly diagnosed acute leukemias, as well as from patients with a relapse or during a complete remission. The determination of antigen expression was done by application of flow cytometry (FACScan analysis) and the usage of newly developed monoclonal antibodies (AC133/1 and AC133/2; Miltenyi Biotec GmbH) in combination with monoclonal antibody directed against CD34-antigens (HPCA-2; BD). Our studies till now show average percentages in umbilical cord blood derived from 43 newborns about 0.294 +/- 0.165% AC133+ vs. 0.327 +/- 0.156% CD34+ hematopoietic stem-/progenitor cells (HSPC). In peripheral blood from 11 healthy donors we verified up to 0.15% CD34+ as well as AC133+ HSPC's. The concentration of progenitor cells was found to be obviously higher in peripheral blood from children with various diseases (neuroblastoma, rhabdomyosarcoma, ALL/AML) and undergoing application with rhG-CSF in order to be prepared for PBSC-transplantation. In those cases we found up to 3.51% AC133+ cells as well as slightly higher values (3.94%) for CD34 antigens. Additionally we quantified 128 bone marrow (BM) samples for AC133+ and CD34+ cells. In 10 BM samples, derived from patients without any neoplasia, the CD34+ cells were about 0.03% and 1.49%, whereas AC133 values were up to 0.64%. Bone marrow aspirates from 53 children with acute leukemias at time of diagnosis (ALL: n = 41/AML: n = 12) have been immunophenotyped and leukemic blast cells have been proved for AC133- and CD34 antigen expression. 32/41 (78%) of

Gulf of Mexico Gas Hydrate Joint Industry Project Leg II: Results from the Alaminos Canyon 21 Site

NASA Astrophysics Data System (ADS)

Godfriaux, P. D.; Shedd, W.; Frye, M.; Collett, T. S.; Lee, M. W.; Boswell, R. M.; Cook, A.; Mrozewski, S.; Guerin, G.; McConnell, D.; Dufrene, R.; Jones, E.

2009-12-01

The Gulf of Mexico Gas Hydrate Joint Industry Project Leg II drilling program visited three sites in the Gulf of Mexico during a 21 day drilling program in April and May, 2009. Using both petroleum systems and seismic stratigraphic approaches, the exploration focus for Leg II was to identify sites with the potential for gas hydrate-saturated sand reservoirs. Two holes were drilled at the AC 21 site in the Diana Basin located in the western Gulf of Mexico. The data acquired consist of a comprehensive suite of high resolution LWD logs including gamma ray, density, porosity, sonic, and resistivity tools. No physical samples were taken in the field. The primary objective of each well was to determine the presence or absence of gas hydrate from the log data at the predetermined primary targets in a Pleistocene basin floor turbidite complex approximately 500 ft below seafloor. At the AC 21-A location, two high net to gross target sands were encountered that measured 15 ft and 60 ft, respectively. The AC 21-A well was drilled through the interpreted base of gas hydrate stability to a depth approximately 1500 ft below sea floor. The AC 21-B well encountered a single high net to gross target sand measuring over 120 ft thick. At both AC 21 well locations, all target sand intervals had elevated formation resistivity measurements relative to clearly wet, stratigraphically equivalent sands encountered in the region, interpreted to indicate low to moderate levels of gas hydrate saturation. The likely discovery of thick gas hydrate-filled sands at the AC 21 site validates the exploration approach, and strongly indicates that gas hydrate can be found in reservoir quality sands. The LWD acquired data provided unprecedented information on the nature of the sediments and the occurrence of gas hydrate in the Gulf of Mexico.

System and method for determining stator winding resistance in an AC motor

DOEpatents

Lu, Bin [Kenosha, WI; Habetler, Thomas G [Snellville, GA; Zhang, Pinjia [Atlanta, GA; Theisen, Peter J [West Bend, WI

2011-05-31

A system and method for determining stator winding resistance in an AC motor is disclosed. The system includes a circuit having an input connectable to an AC source and an output connectable to an input terminal of an AC motor. The circuit includes at least one contactor and at least one switch to control current flow and terminal voltages in the AC motor. The system also includes a controller connected to the circuit and configured to modify a switching time of the at least one switch to create a DC component in an output of the system corresponding to an input to the AC motor and determine a stator winding resistance of the AC motor based on the injected DC component of the voltage and current.

Lamin A/C might be involved in the EMT signalling pathway.

PubMed

Zuo, Lingkun; Zhao, Huanying; Yang, Ronghui; Wang, Liyong; Ma, Hui; Xu, Xiaoxue; Zhou, Ping; Kong, Lu

2018-07-15

We have previously reported a heterogeneous expression pattern of the nuclear membrane protein lamin A/C in low- and high-Gleason score (GS) prostate cancer (PC) tissues, and we have now found that this change is not associated with LMNA mutations. This expression pattern appears to be similar to the process of epithelial to mesenchymal transition (EMT) or to that of mesenchymal to epithelial transition (MET). The role of lamin A/C in EMT or MET in PC remains unclear. Therefore, we first investigated the expression levels of and the associations between lamin A/C and several common EMT markers, such as E-cadherin, N-cadherin, β-catenin, snail, slug and vimentin in PC tissues with different GS values and in different cell lines with varying invasion abilities. Our results suggest that lamin A/C might constitute a type of epithelial marker that better signifies EMT and MET in PC tissue, since a decrease in lamin A/C expression in GS 4 + 5 cases is likely associated with the EMT process, while the re-expression of lamin A/C in GS 5 + 4 cases is likely linked with MET. The detailed GS better exhibited the changes in lamin A/C and the EMT markers examined. Lamin A/C overexpression or knockdown had an impact on EMT biomarkers in a cell model by direct regulation of β-catenin. Hence, we suggest that lamin A/C might serve as a reliable epithelial biomarker for the distinction of PC cell differentiation and might also be a fundamental factor in the occurrence of EMT or MET in PC. Copyright © 2018. Published by Elsevier B.V.

The Cryogenic Anti-Coincidence detector for ATHENA X-IFU: pulse analysis of the AC-S7 single pixel prototype

NASA Astrophysics Data System (ADS)

D'Andrea, M.; Argan, A.; Lotti, S.; Macculi, C.; Piro, L.; Biasotti, M.; Corsini, D.; Gatti, F.; Torrioli, G.

2016-07-01

The ATHENA observatory is the second large-class mission in ESA Cosmic Vision 2015-2025, with a launch foreseen in 2028 towards the L2 orbit. The mission addresses the science theme "The Hot and Energetic Universe", by coupling a high-performance X-ray Telescope with two complementary focal-plane instruments. One of these is the X-ray Integral Field Unit (X-IFU): it is a TES based kilo-pixel order array able to provide spatially resolved high-resolution spectroscopy (2.5 eV at 6 keV) over a 5 arcmin FoV. The X-IFU sensitivity is degraded by the particles background expected at L2 orbit, which is induced by primary protons of both galactic and solar origin, and mostly by secondary electrons. To reduce the background level and enable the mission science goals, a Cryogenic Anticoincidence (CryoAC) detector is placed < 1 mm below the TES array. It is a 4- pixel TES based detector, with wide Silicon absorbers sensed by Ir:Au TESes. The CryoAC development schedule foresees by Q1 2017 the delivery of a Demonstration Model (DM) to the X-IFU FPA development team. The DM is a single-pixel detector that will address the final design of the CryoAC. It will verify some representative requirements at single-pixel level, especially the detector operation at 50 mK thermal bath and the threshold energy at 20 keV. To reach the final DM design we have developed and tested the AC-S7 prototype, with 1 cm2 absorber area sensed by 65 Ir TESes. Here we will discuss the pulse analysis of this detector, which has been illuminated by the 60 keV line from a 241Am source. First, we will present the analysis performed to investigate pulses timings and spectrum, and to disentangle the athermal component of the pulses from the thermal one. Furthermore, we will show the application to our dataset of an alternative method of pulse processing, based upon Principal Component Analysis (PCA). This kind of analysis allow us to recover better energy spectra than achievable with traditional methods

Bcl-2△21 and Ac-DEVD-CHO Inhibit Death of Wheat Microspores

PubMed Central

Sinha, Rakesh K.; Pospíšil, Pavel; Maheshwari, Priti; Eudes, François

2016-01-01

Microspore cell death and low green plant production efficiency are an integral obstacle in the development of doubled haploid production in wheat. The aim of the current study was to determine the effect of anti-apoptotic recombinant human B-cell lymphoma-2 (Bcl-2△21) and caspase-3-inhibitor (Ac-DEVD-CHO) in microspore cell death in bread wheat cultivars AC Fielder and AC Andrew. Induction medium containing Bcl-2△21 and Ac-DEVD-CHO yielded a significantly higher number of viable microspores, embryo-like structures and total green plants in wheat cultivars AC Fielder and AC Andrew. Total peroxidase activity was lower in Bcl-2△21 treated microspore cultures at 96 h of treatment compared to control and Ac-DEVD-CHO. Electron paramagnetic resonance study of total microspore protein showed a different scavenging activity for Bcl-2△21 and Ac-DEVD-CHO. Bcl-2△21 scavenged approximately 50% hydroxyl radical (HO•) formed, whereas Ac-DEVD-CHO scavenged approximately 20% of HO•. Conversely, reduced caspase-3-like activities were detected in the presence of Bcl-2△21 and Ac-DEVD-CHO, supporting the involvement of Bcl-2△21 and Ac-DEVD-CHO in increasing microspore viability by reducing oxidative stress and caspase-3-like activity. Our results indicate that Bcl-2△21 and Ac-DEVD-CHO protects cells from cell death following different pathways. Bcl-2△21 prevents cell damage by detoxifying HO• and suppressing caspase-3-like activity, while Ac-DEVD-CHO inhibits the cell death pathways by modulating caspase-like activity. PMID:28082995

Cascaded Quadruple Active Bridge Structures for Multilevel DC to Three-Phase AC Conversion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, Brian B; Achanta, Prasanta K; Maksimovic, Dragan

This paper introduces a multilevel architecture comprised of interconnected dc to three-phase ac converter units. To enable series connected operation, each converter unit contains a quadruple active bridge (QAB) converter that provides isolation between the dc side and each of the three ac sides. Since each converter unit transfers dc-side power as constant balanced three-phase power on the ac side, this implies instantaneous input-output power balance and allows elimination of bulk capacitive energy storage. In addition to minimizing required capacitance, the proposed approach simultaneously enables simplified dc-link controllers amenable to decentralized implementation, supports bidirectional power transfer, and exhibits a modularmore » structure to enhance scalability. Isolation provided by the QAB allows a wide range of electrical configurations among multiple units in various dc-ac, ac-dc or ac-ac applications. In this paper, the focus is on series connections on the ac side to emphasize multilevel operation, and the approach is experimentally validated in a dc-ac system containing two cascaded converter units.« less

Non-oxidized porous silicon-based power AC switch peripheries.

PubMed

Menard, Samuel; Fèvre, Angélique; Valente, Damien; Billoué, Jérôme; Gautier, Gaël

2012-10-11

We present in this paper a novel application of porous silicon (PS) for low-power alternating current (AC) switches such as triode alternating current devices (TRIACs) frequently used to control small appliances (fridge, vacuum cleaner, washing machine, coffee makers, etc.). More precisely, it seems possible to benefit from the PS electrical insulation properties to ensure the OFF state of the device. Based on the technological aspects of the most commonly used AC switch peripheries physically responsible of the TRIAC blocking performances (leakage current and breakdown voltage), we suggest to isolate upper and lower junctions through the addition of a PS layer anodically etched from existing AC switch diffusion profiles. Then, we comment the voltage capability of practical samples emanating from the proposed architecture. Thanks to the characterization results of simple Al-PS-Si(P) structures, the experimental observations are interpreted, thus opening new outlooks in the field of AC switch peripheries.

The Effects of Theta and Gamma tACS on Working Memory and Electrophysiology

PubMed Central

Pahor, Anja; Jaušovec, Norbert

2018-01-01

A single blind sham-controlled study was conducted to explore the effects of theta and gamma transcranial alternating current stimulation (tACS) on offline performance on working memory tasks. In order to systematically investigate how specific parameters of tACS affect working memory, we manipulated the frequency of stimulation (theta frequency vs. gamma frequency), the type of task (n-back vs. change detection task) and the content of the tasks (verbal vs. figural stimuli). A repeated measures design was used that consisted of three sessions: theta tACS, gamma tACS and sham tACS. In total, four experiments were conducted which differed only with respect to placement of tACS electrodes (bilateral frontal, bilateral parietal, left fronto-parietal and right-fronto parietal). Healthy female students (N = 72) were randomly assigned to one of these groups, hence we were able to assess the efficacy of theta and gamma tACS applied over different brain areas, contrasted against sham stimulation. The pre-post/sham resting electroencephalogram (EEG) analysis showed that theta tACS significantly affected theta amplitude, whereas gamma tACS had no significant effect on EEG amplitude in any of the frequency bands of interest. Gamma tACS did not significantly affect working memory performance compared to sham, and theta tACS led to inconsistent changes in performance on the n-back tasks. Active theta tACS significantly affected P3 amplitude and latency during performance on the n-back tasks in the bilateral parietal and right-fronto parietal protocols. PMID:29375347

Development of a Portable AC/DC Welding Power Supply Module

DTIC Science & Technology

1975-03-01

REPORT DATE MAR 1975 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Development of a Portable AC /DC Welding Power Supply...achieved. Additional bypass capacitors were added to reduce further switch heating and voltage transients. November AC welding was achieved with...Investigate the conversion of inversion frequency back to 60 Hz for AC welding. 4) Investigate a 120V single phase mini supply. VI I Objectives A) Goals

Study on AC loss measurements of HTS power cable for standardizing

NASA Astrophysics Data System (ADS)

Mukoyama, Shinichi; Amemiya, Naoyuki; Watanabe, Kazuo; Iijima, Yasuhiro; Mido, Nobuhiro; Masuda, Takao; Morimura, Toshiya; Oya, Masayoshi; Nakano, Tetsutaro; Yamamoto, Kiyoshi

2017-09-01

High-temperature superconducting power cables (HTS cables) have been developed for more than 20 years. In addition of the cable developments, the test methods of the HTS cables have been discussed and proposed in many laboratories and companies. Recently the test methods of the HTS cables is required to standardize and to common in the world. CIGRE made the working group (B1-31) for the discussion of the test methods of the HTS cables as a power cable, and published the recommendation of the test method. Additionally, IEC TC20 submitted the New Work Item Proposal (NP) based on the recommendation of CIGRE this year, IEC TC20 and IEC TC90 started the standardization work on Testing of HTS AC cables. However, the individual test method that used to measure a performance of HTS cables hasn’t been established as world’s common methods. The AC loss is one of the most important properties to disseminate low loss and economical efficient HTS cables in the world. We regard to establish the method of the AC loss measurements in rational and in high accuracy. Japan is at a leading position in the AC loss study, because Japanese researchers have studied on the AC loss technically and scientifically, and also developed the effective technologies for the AC loss reduction. The JP domestic commission of TC90 made a working team to discussion the methods of the AC loss measurements for aiming an international standard finally. This paper reports about the AC loss measurement of two type of the HTS conductors, such as a HTS conductor without a HTS shield and a HTS conductor with a HTS shield. The AC loss measurement method is suggested by the electrical method..

Clinical and radiological outcome following treatment of displaced lateral clavicle fractures using a locking compression plate with lateral extension: a prospective study.

PubMed

Beirer, Marc; Siebenlist, Sebastian; Crönlein, Moritz; Postl, Lukas; Huber-Wagner, Stefan; Biberthaler, Peter; Kirchhoff, Chlodwig

2014-11-19

Treatment of lateral fractures of the clavicle is challenging and has been controversially discussed for a long time due to high non-union rates in non-operative treatment and high complication rates in surgical treatment. Acromioclavicular joint instability due to the injury of the closely neighbored coraco-clavicular ligaments can result in a cranialization of the medial clavicle shaft. A recently developed implant showed a promising functional outcome in a small collective of patients. In this prospective study, 20 patients with a mean age of 40.7 ± 11.3 years with a dislocated fracture of the lateral clavicle (Jäger&Breitner I-III, Neer I-III) were enrolled. All patients were surgically treated using the locking compression plate (LCP) for the superior anterior clavicle (Synthes®). Functional outcome was recorded using the Munich Shoulder Questionnaire (MSQ) allowing for qualitative self-assessment of the Shoulder Pain and Disability Index (SPADI), of the Disability of the Arm, Shoulder and Hand (DASH) score and of the Constant Score. Acromioclavicular joint stability was evaluated using the Taft-Score. The mean follow-up was 14.2 ± 4.0 months. The mean MSQ was 87.0 ± 7.4 points, the mean SPADI 91.1 ± 11.3 points, the mean DASH score 7.6 ± 7.3 points and the mean normative age- and sex-specific Constant Score 85.6 ± 8.0 points. The mean Taft Score resulted in 10.7 ± 1.0 points. The mean Taft Score in lateral clavicular fractures with fracture gap between the coracoclavicular ligaments in combination with a rupture of the conoid ligament (J&B II a, Neer II B; n =11) was with 10.3 ± 0.9 points significantly lower than the mean Taft Score of all other types of lateral clavicle fractures (J&B I, II b, III; n =9) which resulted in 11.3 ± 0.9 points (p<0.05). The Synthes® LCP superior anterior clavicle plate allows for a safe stabilization and good functional outcome with high patient satisfaction in fractures of the lateral clavicle. However, in

AC resistance measuring instrument

DOEpatents

Hof, P.J.

1983-10-04

An auto-ranging AC resistance measuring instrument for remote measurement of the resistance of an electrical device or circuit connected to the instrument includes a signal generator which generates an AC excitation signal for application to a load, including the device and the transmission line, a monitoring circuit which provides a digitally encoded signal representing the voltage across the load, and a microprocessor which operates under program control to provide an auto-ranging function by which range resistance is connected in circuit with the load to limit the load voltage to an acceptable range for the instrument, and an auto-compensating function by which compensating capacitance is connected in shunt with the range resistance to compensate for the effects of line capacitance. After the auto-ranging and auto-compensation functions are complete, the microprocessor calculates the resistance of the load from the selected range resistance, the excitation signal, and the load voltage signal, and displays of the measured resistance on a digital display of the instrument. 8 figs.

40 CFR Appendixes A-C to Part 403 - [Reserved

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true [Reserved] A Appendixes A-C to Part 403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PRETREATMENT REGULATIONS FOR EXISTING AND NEW SOURCES OF POLLUTION Appendixes A-C to Part 403...

Exenatide: AC 2993, AC002993, AC2993A, exendin 4, LY2148568.

PubMed

2004-01-01

Exenatide [AC002993, AC2993A, AC 2993, LY2148568, exendin 4], a glucagon-like peptide-1 (GLP-1) agonist, is a synthetic exendin 4 compound under development with Amylin Pharmaceuticals for the treatment of type 2 diabetes. Both exendin 4 and its analogue, exendin 3, are 39-amino acid peptides isolated from Heloderma horridum lizard venom that have different amino acids at positions 2 and 3, respectively. Exendins are able to stimulate insulin secretion in response to rising blood glucose levels, and modulate gastric emptying to slow the entry of ingested sugars into the bloodstream. Amylin Pharmaceuticals acquired exclusive patent rights for the two exendin compounds (exendin 3 and exendin 4) from the originator, Dr John Eng (Bronx, NY, US). On 20 September 2002, Amylin and Eli Lilly signed a collaborative agreement for the development and commercialisation of exenatide for type 2 diabetes. Under the terms of the agreement, Eli Lilly has paid Amylin a licensing fee of 80 million US dollars and bought Amylin's stock worth 30 million US dollars at 18.69 US dollars a share. After the initial payment, Eli Lilly will pay Amylin up to 85 US dollars million upon reaching certain milestones and also make an additional payment of up to 130 million US dollars upon global commercialisation of exenatide. Both companies will share the US development and commercialisation costs, while Eli Lilly will pick up up to 80% of development costs and all commercialisation costs outside the US. Amylin and Eli Lilly will equally share profit from sales in the US, while Eli Lilly will get 80% of the profit outside the US and Amylin will get the rest. This agreement has also enabled Amylin to train its sales force to co-promote Lilly's human growth hormone Humatrope. Alkermes will receive research and development funding and milestone payments, and also a combination of royalty payments and manufacturing fees based on product sales. Alkermes undertakes the responsibility for the development

Study on the anatomic relationship between the clavicle and the coracoid process using computed tomography scans of the shoulder.

PubMed

Sella, Guilherme do Val; Miyazaki, Alberto N; Nico, Marcelo A C; Filho, Guinel H; Silva, Luciana A; Checchia, Sergio L

2017-10-01

The current trend in the treatment of acromioclavicular dislocations is to reconstruct the coracoclavicular ligaments by using transosseous tunnels in the coracoid process or in the clavicle, yet there is no definition as to the location of these. To study the anatomic relationship between the coracoid process and the clavicle, we made measurements to find a convergence point (cP) between them that has intraoperative applicability for creating transosseous tunnels. We analyzed 74 computed tomography scans (40 female and 34 male patients). Measurements were taken in the axial and sagittal planes and obtained from a cP, as determined by the intersection of the cortical surface of the clavicle and the coracoid process, with various relationships having been established. On average, the cP was determined to be about 2.9 cm and 2.5 cm distant from the coracoid process apex for male and female patients, respectively, whereas the width at this position was determined to be 2.1 cm and 1.9 cm. In the clavicle, this point is on average 2.9 cm and 2.5 cm distant from the acromioclavicular joint in male and female patients, respectively, and its anteroposterior width at this point is on average 1.9 cm and 1.6 cm. The cP of the clavicle and the coracoid process was determined with the aim of preparing bone tunnels in operations for treating acromioclavicular dislocations. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Autographa californica Nucleopolyhedrovirus AC141 (Exon0), a Potential E3 Ubiquitin Ligase, Interacts with Viral Ubiquitin and AC66 To Facilitate Nucleocapsid Egress.

PubMed

Biswas, Siddhartha; Willis, Leslie G; Fang, Minggang; Nie, Yingchao; Theilmann, David A

2018-02-01

During the infection cycle of Autographa californica multiple nucleopolyhedrovirus (AcMNPV), two forms of virions are produced, budded virus (BV) and occlusion-derived virus (ODV). Nucleocapsids that form BV have to egress from the nucleus, whereas nucleocapsids that form ODV remain inside the nucleus. The molecular mechanism that determines whether nucleocapsids remain inside or egress from the nucleus is unknown. AC141 (a predicted E3 ubiquitin ligase) and viral ubiquitin (vUbi) have both been shown to be required for efficient BV production. In this study, it was hypothesized that vUbi interacts with AC141, and in addition, that this interaction was required for BV production. Deletion of both ac141 and vubi restricted viral infection to a single cell, and BV production was completely eliminated. AC141 was ubiquitinated by either vUbi or cellular Ubi, and this interaction was required for optimal BV production. Nucleocapsids in BV, but not ODV, were shown to be specifically ubiquitinated by vUbi, including a 100-kDa protein, as well as high-molecular-weight conjugates. The viral ubiquitinated 100-kDa BV-specific nucleocapsid protein was identified as AC66, which is known to be required for BV production and was shown by coimmunoprecipitation and mass spectrometry to interact with AC141. Confocal microscopy also showed that AC141, AC66, and vUbi interact at the nuclear periphery. These results suggest that ubiquitination of nucleocapsid proteins by vUbi functions as a signal to determine if a nucleocapsid will egress from the nucleus and form BV or remain in the nucleus to form ODV. IMPORTANCE Baculoviruses produce two types of virions called occlusion-derived virus (ODV) and budded virus (BV). ODVs are required for oral infection, whereas BV enables the systemic spread of virus to all host tissues, which is critical for killing insects. One of the important steps for BV production is the export of nucleocapsids out of the nucleus. This study investigated the

Cell cycle-dependent changes in H3K56ac in human cells

PubMed Central

Stejskal, Stanislav; Stepka, Karel; Tesarova, Lenka; Stejskal, Karel; Matejkova, Martina; Simara, Pavel; Zdrahal, Zbynek; Koutna, Irena

2015-01-01

The incorporation of histone H3 with an acetylated lysine 56 (H3K56ac) into the nucleosome is important for chromatin remodeling and serves as a marker of new nucleosomes during DNA replication and repair in yeast. However, in human cells, the level of H3K56ac is greatly reduced, and its role during the cell cycle is controversial. Our aim was to determine the potential of H3K56ac to regulate cell cycle progression in different human cell lines. A significant increase in the number of H3K56ac foci, but not in H3K56ac protein levels, was observed during the S and G2 phases in cancer cell lines, but was not observed in embryonic stem cell lines. Despite this increase, the H3K56ac signal was not present in late replication chromatin, and H3K56ac protein levels did not decrease after the inhibition of DNA replication. H3K56ac was not tightly associated with the chromatin and was primarily localized to active chromatin regions. Our results support the role of H3K56ac in transcriptionally active chromatin areas but do not confirm H3K56ac as a marker of newly synthetized nucleosomes in DNA replication. PMID:26645646

Energy saving in ac generators

NASA Technical Reports Server (NTRS)

Nola, F. J.

1980-01-01

Circuit cuts no-load losses, without sacrificing full-load power. Phase-contro circuit includes gate-controlled semiconductor switch that cuts off applied voltage for most of ac cycle if generator idling. Switch "on" time increases when generator is in operation.

Function analysis of Ac-PCNA and Sf-PCNA during the Autographa californica multiple nucleopolyhedrovirus infection process.

PubMed

Fu, Yuejun; Wang, Ruisheng; Liang, Aihua

2018-06-01

The baculovirus Autographa californica multiple nucleopolyhedrovirus (AcMNPV) possesses a gene, ac-pcna or ac49, which encodes a protein with similarity to proliferating cell nuclear antigen (PCNA). Homologs of this gene code for DNA polymerase processivity factors and are essential in the DNA replication systems. But the function of ac-pcna still remains unclear. To define the function of Ac-pcna in AcMNPV and Sf-pcna in host Sf9 cells, Bac-to-Bac baculovirus expression system was used to generate two recombinant baculoviruses: AcMNPV-Ac-pcna-EGFP and AcMNPV-Sf-pcna-EGFP. Results indicated that AcMNPV-mediated overexpression of Ac-PCNA and Sf-PCNA could stimulate replication of AcMNPV genome in the host Sf9 cells. Meanwhile, either AcMNPV-Ac-pcna-EGFP or AcMNPV-Sf-pcna-EGFP had a significant stimulating effect on Sf9 genome replication during infection. We also found that Ac-PCNA and Sf-PCNA could promote the production of budded virus. Ac-PCNA could improve the transcription level of ie2 gene dramatically and further improved the transcription of late gene, for example 38 K and vp39, at 12 h p.i.. Moreover, insecticidal potency test showed that the larvae of Beet armyworm in the AcMNPV-Ac-pcna-EGFP and AcMNPV-Sf-pcna-EGFP groups had a higher mortality rate (83.33 and 91.67%), a lower pupation rate (16.67 and 8.33%), and a lower emergence rate (6.67 and 3.33%), compared with those in AcMNPV-EGFP group. The function of Ac-PCNA and Sf-PCNA was confirmed in this study, which provided the theoretical foundation for using and modifying AcMNPV.

Context based computational analysis and characterization of ARS consensus sequences (ACS) of Saccharomyces cerevisiae genome.

PubMed

Singh, Vinod Kumar; Krishnamachari, Annangarachari

2016-09-01

Genome-wide experimental studies in Saccharomyces cerevisiae reveal that autonomous replicating sequence (ARS) requires an essential consensus sequence (ACS) for replication activity. Computational studies identified thousands of ACS like patterns in the genome. However, only a few hundreds of these sites act as replicating sites and the rest are considered as dormant or evolving sites. In a bid to understand the sequence makeup of replication sites, a content and context-based analysis was performed on a set of replicating ACS sequences that binds to origin-recognition complex (ORC) denoted as ORC-ACS and non-replicating ACS sequences (nrACS), that are not bound by ORC. In this study, DNA properties such as base composition, correlation, sequence dependent thermodynamic and DNA structural profiles, and their positions have been considered for characterizing ORC-ACS and nrACS. Analysis reveals that ORC-ACS depict marked differences in nucleotide composition and context features in its vicinity compared to nrACS. Interestingly, an A-rich motif was also discovered in ORC-ACS sequences within its nucleosome-free region. Profound changes in the conformational features, such as DNA helical twist, inclination angle and stacking energy between ORC-ACS and nrACS were observed. Distribution of ACS motifs in the non-coding segments points to the locations of ORC-ACS which are found far away from the adjacent gene start position compared to nrACS thereby enabling an accessible environment for ORC-proteins. Our attempt is novel in considering the contextual view of ACS and its flanking region along with nucleosome positioning in the S. cerevisiae genome and may be useful for any computational prediction scheme.

[Analysis of AC/A ratio after myopic excimer laser in situ keratomileusis].

PubMed

Wu, Xiao-ying; Liu, Shuang-zhen

2003-03-01

To study the changes of AC/A ratio of myopia after excimer laser in situ keratomileusis (LASIK). 135 myopia patients were treated by LASIK, their AC/A ratios were measured with synoptohore before surgery and 3 months after surgery. The average AC/A ratios of naked eyes or eyes wearing glasses before surgery and the naked after surgery were (0.724 +/- 0.587) (Delta)/D, (2.754 +/- 1.565) (Delta)/D, (1.618 +/- 1.027) (Delta)/D in turn. There were significant difference among those groups (P < 0.001). That also appeared in different degree of myopia naked before surgery (P < 0.01). We found no significant difference between the groups wearing glasses before surgery and naked after surgery (P > 0.05). A positive correlation was built up between postoperative AC/A ratio and AC/A ratio of wearing glasses or refractive diopter before surgery (r = 0.550, P < 0.001; r = 0.185, P < 0.005). And the postoperative AC/A ratios had a negative correlation to age or length of ocular axis (r = -0.340, P < 0.001; r = -0.192, P < 0.002). The regression equation for postoperative AC/A ratios was figured out as Y((Delta)/D) = 4.080 0 - 0.031 8X(1) - 0.097 1X(2) + 0.325 0X(3) (P < 0.001). X(1) = age (year), X(2) = length of ocular axis (mm), X(3) = preoperative AC/A ratio with weaning glasses ((Delta)/D). The naked AC/A ratios are higher than the preoperative's after LASIK, but lower than the wearing glasses's before surgery. It is influenced by the factors, such as: the preoperative AC/A ratio of wearing glasses, the length of ocular axis and the age.

Data representation for joint kinematics simulation of the lower limb within an educational context.

PubMed

Van Sint Jan, Serge; Hilal, Isam; Salvia, Patrick; Sholukha, Victor; Poulet, Pascal; Kirokoya, Ibrahim; Rooze, Marcel

2003-04-01

Three-dimensional (3D) visualization is becoming increasingly frequent in both qualitative and quantitative biomechanical studies of anatomical structures involving multiple data sources (e.g. morphological data and kinematics data). For many years, this kind of experiment was limited to the use of bi-dimensional images due to a lack of accurate 3D data. However, recent progress in medical imaging and computer graphics has forged new perspectives. Indeed, new techniques allow the development of an interactive interface for the simulation of human motions combining data from both medical imaging (i.e., morphology) and biomechanical studies (i.e., kinematics). Fields of application include medical education, biomechanical research and clinical research. This paper presents an experimental protocol for the development of anatomically realistic joint simulation within a pedagogical context. Results are shown for the lower limb. Extension to other joints is straightforward. This work is part of the Virtual Animation of the Kinematics of the Human project (VAKHUM) (http://www.ulb.ac.be/project/vakhum).

Editorial Commentary: The Larger Holes or Larger Number of Holes We Drill in the Coracoid, the Weaker the Coracoid Becomes.

PubMed

Brady, Paul

2016-06-01

The larger holes or larger number of holes we drill in the coracoid, the weaker the coracoid becomes. Thus, minimizing bone holes (both size and number) is required to lower risk of coracoid process fracture, in patients in whom transosseous shoulder acromioclavicular joint reconstruction is indicated. A single 2.4-mm-diameter tunnel drilled through both the clavicle and the coracoid lowers the risk of fracture, but the risk cannot be entirely eliminated. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

[Acute and overuse injuries of the shoulder in sports].

PubMed

Doyscher, R; Kraus, K; Finke, B; Scheibel, M

2014-03-01

During sports the shoulder complex is exposed to considerable load especially where throwing is important and various pathological changes can occur. In the last two decades the shoulder in athletes has become a special term in clinical sports medicine Selective literature review in PubMed and consideration of personal experience, research results as well as national and international recommendations In general acute lesions of the shoulder caused by sudden sport injuries, such as traumatic luxation, acromioclavicular (AC) joint disruption, traumatic tendon ruptures, labral lesions, cartilage defects and fractures have to be distinguished from chronic or long-standing pathologies due to recurrent microtrauma, such as overuse bursitis and tendinitis, as well as secondary forms of impingement along with rotator cuff tears and labral lesions. Besides common pathological changes that can be observed in almost all overhead-sports, there are also injuries that are more sport-specific due to the particular load profile in each sport. These injuries are especially common in racquet and throwing sports (e.g. golf, tennis, handball and volleyball) as well as in individual and artistic sports (e.g. swimming, gymnastics, dancing and rowing), contact and extreme sports (e.g. judo, mixed martial arts, bodybuilding, weightlifting, motocross and downhill mountain biking). Knowledge about sport-specific load profiles as well as about the variety of treatment options is crucial for successful treatment of these injuries.

The application of Halbach cylinders to brushless ac servo motors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Atallah, K.; Howe, D.

1998-07-01

Halbach cylinders are applied to brushless ac servo motors. It is shown that a sinusoidal back-emf waveform and a low cogging torque can be achieved without recourse to conventional design features such as distributed windings and/or stator/rotor skew. A technique for imparting a multipole Halbach magnetization distribution on an isotropic permanent magnet cylinder is described, and it is shown that the torque capability of a Halbach ac servo motor can be up to 33% higher than conventional brushless permanent magnet ac motors.

Reconstitutional Mutagenesis of the Maize P Gene by Short-Range Ac Transpositions

PubMed Central

Moreno, M. A.; Chen, J.; Greenblatt, I.; Dellaporta, S. L.

1992-01-01

The tendency for Ac to transpose over short intervals has been utilized to develop insertional mutagenesis and fine structure genetic mapping strategies in maize. We recovered excisions of Ac from the P gene and insertions into nearby chromosomal sites. These closely linked Ac elements reinserted into the P gene, reconstituting over 250 unstable variegated alleles. Reconstituted alleles condition a variety of variegation patterns that reflect the position and orientation of Ac within the P gene. Molecular mapping and DNA sequence analyses have shown that reinsertion sites are dispersed throughout a 12.3-kb chromosomal region in the promoter, exons and introns of the P gene, but in some regions insertions sites were clustered in a nonrandom fashion. Transposition profiles and target site sequence data obtained from these studies have revealed several features of Ac transposition including its preference for certain target sites. These results clearly demonstrate the tendency of Ac to transpose to nearby sites in both proximal and distal directions from the donor site. With minor modifications, reconstitutional mutagenesis should be applicable to many Ac-induced mutations in maize and in other plant species and can possibly be extended to other eukaryotic transposon systems as well. PMID:1325389

Hybrid inverter for HVDC/weak AC system interconnection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tam, K.S.

1985-01-01

The concept of the hybrid converter is introduced. By independently controlling a naturally commutated converter (NCC) and an artificially commutated converter (ACC), real power and reactive power can be controlled independently. Alternatively, the ac bus voltage can be regulated without affecting the real power transfer. Independent control is feasible only within certain operating boundaries. Twelve pulse operation, sequential control, and complementary circuits may be viewed as variations of the hybrid converter. The concept of the hybrid converter is demonstrated by digital simulation. At the current state of technology, the NCC is best implemented by a 6-pulse bridge using thyristors asmore » the switching elements. A survey of power electronics applicable to HVDC applications reveals that the capacitively commutated current-sourced converters are either technically or economically better than the other alternatives for the implementation of the ACC. The digital simulation results show that the problems of operating an HVDC system into a weak ac system can be solved by using a hybrid inverter. A new control scheme, the zero Q control, is developed. With no reactive power interaction between the dc system and the ac system, the stability of the HVDC/weak ac system operation is significantly improved. System start-up and fault recovery is fast and stable.« less

Abscisic Acid Antagonizes Ethylene Production through the ABI4-Mediated Transcriptional Repression of ACS4 and ACS8 in Arabidopsis.

PubMed

Dong, Zhijun; Yu, Yanwen; Li, Shenghui; Wang, Juan; Tang, Saijun; Huang, Rongfeng

2016-01-04

Increasing evidence has revealed that abscisic acid (ABA) negatively modulates ethylene biosynthesis, although the underlying mechanism remains unclear. To identify the factors involved, we conducted a screen for ABA-insensitive mutants with altered ethylene production in Arabidopsis. A dominant allele of ABI4, abi4-152, which produces a putative protein with a 16-amino-acid truncation at the C-terminus of ABI4, reduces ethylene production. By contrast, two recessive knockout alleles of ABI4, abi4-102 and abi4-103, result in increased ethylene evolution, indicating that ABI4 negatively regulates ethylene production. Further analyses showed that expression of the ethylene biosynthesis genes ACS4, ACS8, and ACO2 was significantly decreased in abi4-152 but increased in the knockout mutants, with partial dependence on ABA. Chromatin immunoprecipitation-quantitative PCR assays showed that ABI4 directly binds the promoters of these ethylene biosynthesis genes and that ABA enhances this interaction. A fusion protein containing the truncated ABI4-152 peptide accumulated to higher levels than its full-length counterpart in transgenic plants, suggesting that ABI4 is destabilized by its C terminus. Therefore, our results demonstrate that ABA negatively regulates ethylene production through ABI4-mediated transcriptional repression of the ethylene biosynthesis genes ACS4 and ACS8 in Arabidopsis. Copyright © 2016 The Author. Published by Elsevier Inc. All rights reserved.

Here Be Dragons: Characterization of ACS/WFC Scattered Light Anomalies

NASA Astrophysics Data System (ADS)

Porterfield, B.; Coe, D.; Gonzaga, S.; Anderson, J.; Grogin, N.

2016-11-01

We present a study characterizing scattered light anomalies that occur near the edges of Advanced Camera for Surveys (ACS) Wide Field Channel (WFC) images. We inspected all 8,573 full-frame ACS/WFC raw images with exposure times longer than 350 seconds obtained in the F606W and F814W filters from 2002 to October 2013. We visually identified two particular scattered light artifacts known as "dragon's breath" and edge glow. Using the 2MASS point source catalog and Hubble Guide Star Catalog (GSC II), we identified the stars that caused these artifacts. The stars are all located in narrow bands ( 3" across) just outside the ACS/WFC field of view (2" - 16" away). We provide a map of these risky areas around the ACS/WFC detectors - users should avoid positioning bright stars in these regions when designing ACS/WFC imaging observations. We also provide interactive webpages which display all the image artifacts we identified, allowing users to see examples of the severity of artifacts they might expect for a given stellar magnitude at a given position relative to the ACS/WFC field of view. On average, 10th (18th) magnitude stars produce artifacts about 1,000 (100) pixels long. But the severity of these artifacts can vary strongly with small positional shifts (∼ 1"). The results are similar for both filters (F606W and F814W) when expressed in total fluence, or flux multiplied by exposure time.

Characterization on performance of micromixer using DC-biased AC electroosmosis

NASA Astrophysics Data System (ADS)

Park, Bi-O.; Song, Simon

2010-11-01

An active micromixer using DC-biased AC-Electroosmosis (ACEO) is investigated to figure out the effects of design parameters on the mixing performance. The mixer consists of a straight microchannel, with a cross section of 60 x 100 μm, and gold electrode pairs fabricated in the microchannel. The design parameters include the number of electrode pairs, flow rate, DC-biased voltage, AC voltage and AC frequency. First, we found that a mixing index became 80% 100 μm downstream of a single electrode pair with a length of 2 mm when applying a 25Vpp, 2.0 VDC, 100 kHz sine signal to the electrodes. With decreasing AC frequency, the mixing index is affected little. But the mixing index significantly increases with increasing either DC-biased voltage or AC voltage. Also, we were able to increase the mixing index up to 90% by introducing alternating vortices with multiple electrode pairs. Finally, we discovered that the mixing index decreases as the flow rate increases in the microchannel, and there is an optimal number of electrode pairs with respect to a flow rate. Detailed quantitative measurement results will be presented at the meeting.

Hybrid AC-High Voltage DC Grid Stability and Controls

NASA Astrophysics Data System (ADS)

Yu, Jicheng

The growth of energy demands in recent years has been increasing faster than the expansion of transmission facility construction. This tendency cooperating with the continuous investing on the renewable energy resources drives the research, development, and construction of HVDC projects to create a more reliable, affordable, and environmentally friendly power grid. Constructing the hybrid AC-HVDC grid is a significant move in the development of the HVDC techniques; the form of dc system is evolving from the point-to-point stand-alone dc links to the embedded HVDC system and the multi-terminal HVDC (MTDC) system. The MTDC is a solution for the renewable energy interconnections, and the MTDC grids can improve the power system reliability, flexibility in economic dispatches, and converter/cable utilizing efficiencies. The dissertation reviews the HVDC technologies, discusses the stability issues regarding the ac and HVDC connections, proposes a novel power oscillation control strategy to improve system stability, and develops a nonlinear voltage droop control strategy for the MTDC grid. To verify the effectiveness the proposed power oscillation control strategy, a long distance paralleled AC-HVDC transmission test system is employed. Based on the PSCAD/EMTDC platform simulation results, the proposed power oscillation control strategy can improve the system dynamic performance and attenuate the power oscillations effectively. To validate the nonlinear voltage droop control strategy, three droop controls schemes are designed according to the proposed nonlinear voltage droop control design procedures. These control schemes are tested in a hybrid AC-MTDC system. The hybrid AC-MTDC system, which is first proposed in this dissertation, consists of two ac grids, two wind farms and a five-terminal HVDC grid connecting them. Simulation studies are performed in the PSCAD/EMTDC platform. According to the simulation results, all the three design schemes have their unique salient

Study of dielectric relaxation and AC conductivity of InP:S single crystal

NASA Astrophysics Data System (ADS)

El-Nahass, M. M.; Ali, H. A. M.; El-Shazly, E. A.

2012-07-01

The dielectric relaxation and AC conductivity of InP:S single crystal were studied in the frequency range from 100 to 5.25 × 105 Hz and in the temperature range from 296 to 455 K. The dependence of the dielectric constant (ɛ1) and the dielectric loss (ɛ2) on both frequency and temperature was investigated. Since no peak was observed on the dielectric loss, we used a method based on the electric modulus to evaluate the activation energy of the dielectric relaxation. Scaling of the electric modulus spectra showed that the charge transport dynamics is independent of temperature. The AC conductivity (σAC) was found to obey the power law: Aωs. Analysis of the AC conductivity data and the frequency exponent showed that the correlated barrier hopping (CBH) model is the dominant mechanism for the AC conduction. The variation of AC conductivity with temperature at different frequencies showed that σAC is a thermally activated process.

AC conductivity and Dielectric Study of Chalcogenide Glasses of Se-Te-Ge System

NASA Astrophysics Data System (ADS)

Salman, Fathy

2004-01-01

The ac conductivity and dielectric properties of glassy system SexTe79 - xGe21, with x = 11, 14, 17 at.%, has been studied at temperatures 300 to 450 K and over a wide range of frequencies (50 Hz to 500 kHz). Experimental results indicate that the ac conductivity and the dielectric constants depend on temperature, frequency and Se content. The conductivity as a function of frequency exhibited two components: dc conductivity s dc, and ac conductivity s ac, where s ac ˜ w s. The mechanism of ac conductivity can be reasonably interpreted in terms of the correlated barrier hopping model (CBH). The activation energies are estimated and discussed. The dependence of ac conductivity and dielectric constants on the Se content x can be interpreted as the effect of Se fraction on the positional disorder. The impedance plot at each temperature appeared as a semicircle passes through the origin. Each semicircle is represented by an equivalent circuit of parallel resistance Rb and capacitance Cb.

Dielectric behavior of AC aged polyethylene in humid environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Scarpa, P.C.N.; Das-Gupta, D.K.; Bulinski, A.T.

1996-12-31

The present paper reports the results of a study of electrical aging of low density polyethylene (LDPE) aged in humid environment (0.1M NaCl) at an AC stress of 6kV/mm, 1kHz, at room temperature (RT) and at 65 C, and cross-linked polyethylene (XLPE) AC aged in humid environment (water) at an AC stress of 6kV/mm, 50Hz, at RT, for an extended period of time. For this study the dielectric spectroscopy data in the frequency range of 10{sup {minus}5}Hz to 10{sup 6}Hz and their comparative analysis, have been used to provide electrical analog models of the aging.

Numerical and theoretical evaluations of AC losses for single and infinite numbers of superconductor strips with direct and alternating transport currents in external AC magnetic field

NASA Astrophysics Data System (ADS)

Kajikawa, K.; Funaki, K.; Shikimachi, K.; Hirano, N.; Nagaya, S.

2010-11-01

AC losses in a superconductor strip are numerically evaluated by means of a finite element method formulated with a current vector potential. The expressions of AC losses in an infinite slab that corresponds to a simple model of infinitely stacked strips are also derived theoretically. It is assumed that the voltage-current characteristics of the superconductors are represented by Bean's critical state model. The typical operation pattern of a Superconducting Magnetic Energy Storage (SMES) coil with direct and alternating transport currents in an external AC magnetic field is taken into account as the electromagnetic environment for both the single strip and the infinite slab. By using the obtained results of AC losses, the influences of the transport currents on the total losses are discussed quantitatively.

Optimal Power Scheduling for a Medium Voltage AC/DC Hybrid Distribution Network

DOE PAGES

Zhu, Zhenshan; Liu, Dichen; Liao, Qingfen; ...

2018-01-26

With the great increase of renewable generation as well as the DC loads in the distribution network; DC distribution technology is receiving more attention; since the DC distribution network can improve operating efficiency and power quality by reducing the energy conversion stages. This paper presents a new architecture for the medium voltage AC/DC hybrid distribution network; where the AC and DC subgrids are looped by normally closed AC soft open point (ACSOP) and DC soft open point (DCSOP); respectively. The proposed AC/DC hybrid distribution systems contain renewable generation (i.e., wind power and photovoltaic (PV) generation); energy storage systems (ESSs); softmore » open points (SOPs); and both AC and DC flexible demands. An energy management strategy for the hybrid system is presented based on the dynamic optimal power flow (DOPF) method. The main objective of the proposed power scheduling strategy is to minimize the operating cost and reduce the curtailment of renewable generation while meeting operational and technical constraints. The proposed approach is verified in five scenarios. The five scenarios are classified as pure AC system; hybrid AC/DC system; hybrid system with interlinking converter; hybrid system with DC flexible demand; and hybrid system with SOPs. Results show that the proposed scheduling method can successfully dispatch the controllable elements; and that the presented architecture for the AC/DC hybrid distribution system is beneficial for reducing operating cost and renewable generation curtailment.« less

Optimal Power Scheduling for a Medium Voltage AC/DC Hybrid Distribution Network

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, Zhenshan; Liu, Dichen; Liao, Qingfen

With the great increase of renewable generation as well as the DC loads in the distribution network; DC distribution technology is receiving more attention; since the DC distribution network can improve operating efficiency and power quality by reducing the energy conversion stages. This paper presents a new architecture for the medium voltage AC/DC hybrid distribution network; where the AC and DC subgrids are looped by normally closed AC soft open point (ACSOP) and DC soft open point (DCSOP); respectively. The proposed AC/DC hybrid distribution systems contain renewable generation (i.e., wind power and photovoltaic (PV) generation); energy storage systems (ESSs); softmore » open points (SOPs); and both AC and DC flexible demands. An energy management strategy for the hybrid system is presented based on the dynamic optimal power flow (DOPF) method. The main objective of the proposed power scheduling strategy is to minimize the operating cost and reduce the curtailment of renewable generation while meeting operational and technical constraints. The proposed approach is verified in five scenarios. The five scenarios are classified as pure AC system; hybrid AC/DC system; hybrid system with interlinking converter; hybrid system with DC flexible demand; and hybrid system with SOPs. Results show that the proposed scheduling method can successfully dispatch the controllable elements; and that the presented architecture for the AC/DC hybrid distribution system is beneficial for reducing operating cost and renewable generation curtailment.« less

Operation of AC Adapters Visualized Using Light-Emitting Diodes

ERIC Educational Resources Information Center

Regester, Jeffrey

2016-01-01

A bridge rectifier is a diamond-shaped configuration of diodes that serves to convert alternating current(AC) into direct current (DC). In our world of AC outlets and DC electronics, they are ubiquitous. Of course, most bridge rectifiers are built with regular diodes, not the light-emitting variety, because LEDs have a number of disadvantages. For…

AC Loss Measurements on a 2G YBCO Coil

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rey, Christopher M; Duckworth, Robert C; Schwenterly, S W

2011-01-01

The Oak Ridge National Laboratory (ORNL) is collaborating with Waukesha Electric Systems (WES) to continue development of HTS power transformers. For compatibility with the existing power grid, a commercially viable HTS transformer will have to operate at high voltages in the range of 138 kV and above, and will have to withstand 550-kV impulse voltages as well. Second-generation (2G) YBCO coated conductors will be required for an economically-competitive design. In order to adequately size the refrigeration system for these transformers, the ac loss of these HTS coils must be characterized. Electrical AC loss measurements were conducted on a prototype highmore » voltage (HV) coil with co-wound stainless steel at 60 Hz in a liquid nitrogen bath using a lock-in amplifier technique. The prototype HV coil consisted of 26 continuous (without splice) single pancake coils concentrically centered on a stainless steel former. For ac loss measurement purposes, voltage tap pairs were soldered across each set of two single pancake coils so that a total of 13 separate voltage measurements could be made across the entire length of the coil. AC loss measurements were taken as a function of ac excitation current. Results show that the loss is primarily concentrated at the ends of the coil where the operating fraction of critical current is the highest and show a distinct difference in current scaling of the losses between low current and high current regimes.« less

The FL/AC ratio for prediction of shoulder dystocia in women with gestational diabetes.

PubMed

Duryea, Elaine L; Casey, Brian M; McIntire, Donald D; Twickler, Diane M

2017-10-01

To determine if sonographic variables, including fetal femur length to abdominal circumference (FL/AC) ratio, are associated with shoulder dystocia in women with gestational diabetes. This was a retrospective cohort study of women with gestational diabetes who delivered singleton infants at Parkland Hospital from 1997 to 2015. Diagnosis and treatment of gestational diabetes were uniform including sonography at 32-36 weeks. Biometric calculations were evaluated for correlation with shoulder dystocia. During the study period, 6952 women with gestational diabetes underwent a sonogram at a mean gestation of 34.8 ± 1.8 weeks. Of 4183 vaginal deliveries, 66 experienced shoulder dystocia (16/1000). The FL/AC was associated with shoulder dystocia (p < 0.001) with an AUC of 0.70 (95% CI: 0.64-0.77). This was similar to age-adjusted AC and head circumference to AC ratio (HC/AC) (both with an AUC of 0.72). All other measurements, including estimated fetal weight, were inferior. When examining the 257 women with multiple sonograms after 32 weeks' gestation, FL/AC was stable with advancing gestational age (p = 0.54) whereas age-adjusted AC and HC/AC were not (p < 0.001). The FL/AC is associated with shoulder dystocia in women with gestational diabetes. Additionally, it is a simple ratio that is independent of the reference used and remains stable, unlike age-adjusted AC and HC/AC ratio.

Early function of the Abutilon mosaic virus AC2 gene as a replication brake.

PubMed

Krenz, Björn; Deuschle, Kathrin; Deigner, Tobias; Unseld, Sigrid; Kepp, Gabi; Wege, Christina; Kleinow, Tatjana; Jeske, Holger

2015-04-01

The C2/AC2 genes of monopartite/bipartite geminiviruses of the genera Begomovirus and Curtovirus encode important pathogenicity factors with multiple functions described so far. A novel function of Abutilon mosaic virus (AbMV) AC2 as a replication brake is described, utilizing transgenic plants with dimeric inserts of DNA B or with a reporter construct to express green fluorescent protein (GFP). Their replicational release upon AbMV superinfection or the individual and combined expression of epitope-tagged AbMV AC1, AC2, and AC3 was studied. In addition, the effects were compared in the presence and in the absence of an unrelated tombusvirus suppressor of silencing (P19). The results show that AC2 suppresses replication reproducibly in all assays and that AC3 counteracts this effect. Examination of the topoisomer distribution of supercoiled DNA, which indicates changes in the viral minichromosome structure, did not support any influence of AC2 on transcriptional gene silencing and DNA methylation. The geminiviral AC2 protein has been detected here for the first time in plants. The experiments revealed an extremely low level of AC2, which was slightly increased if constructs with an intron and a hemagglutinin (HA) tag in addition to P19 expression were used. AbMV AC2 properties are discussed with reference to those of other geminiviruses with respect to charge, modification, and size in order to delimit possible reasons for the different behaviors. The (A)C2 genes encode a key pathogenicity factor of begomoviruses and curtoviruses in the plant virus family Geminiviridae. This factor has been implicated in the resistance breaking observed in agricultural cotton production. AC2 is a multifunctional protein involved in transcriptional control, gene silencing, and regulation of basal biosynthesis. Here, a new function of Abutilon mosaic virus AC2 in replication control is added as a feature of this protein in viral multiplication, providing a novel finding on

pH sensing via bicarbonate-regulated “soluble” adenylyl cyclase (sAC)

PubMed Central

Rahman, Nawreen; Buck, Jochen; Levin, Lonny R.

2013-01-01

Soluble adenylyl cyclase (sAC) is a source of the second messenger cyclic adenosine 3′, 5′ monophosphate (cAMP). sAC is directly regulated by bicarbonate (HCO−3) ions. In living cells, HCO−3 ions are in nearly instantaneous equilibrium with carbon dioxide (CO2) and pH due to the ubiquitous presence of carbonic anhydrases. Numerous biological processes are regulated by CO2, HCO−3, and/or pH, and in a number of these, sAC has been shown to function as a physiological CO2/HCO3/pH sensor. In this review, we detail the known pH sensing functions of sAC, and we discuss two highly-studied, pH-dependent pathways in which sAC might play a role. PMID:24324443

[Microbiological characteristics and patterns of resistance in prosthetic joint infections in a referral hospital].

PubMed

Ortega-Peña, Silvestre; Colín-Castro, Claudia; Hernández-Duran, Melissa; López-Jácome, Esaú; Franco-Cendejas, Rafael

2015-01-01

The prosthetic joint infection is the most feared and catastrophic complication for cause severe physical damage to patients and, generates high economic costs. To describe the microbiological characteristics and to determine the resistance pattern in prosthetic joint infections in a reference hospital in Mexico. Patients whose prosthetic devices were withdrawn due to suspicion of septic and aseptic loosening were included. Cultures were performed to identify microorganisms and susceptibility analysis. Of the 111 patients included, 55% were diagnosed with prosthetic joint infection, with the most frequent prosthesis being of the hip (43%). Positive cultures were obtained in 97% of the infected cases, of which 75% were monomicrobial infections. The most frequent bacterial species isolated were: Staphylococcus epidermidis (31%), Enterococcus faecalis (16%), Staphylococcus aureus (13%), and Escherichia coli (8%). The resistance patterns for the Staphylococcus genus were: oxacillin (79%), erythromycin (45%) and ciprofloxacin (37%). Enterococcus faecalis showed a high percentage of resistance to erythromycin and clindamycin (86%), and fluoroquinolones (43%). The large majority (86%) of Escherichia coli were extended spectrum beta-lactamases positive, in addition to having high resistance to fluoroquinolones (86%), trimethoprim/sulfamethoxazole (86%) and gentamicin (72%). The microbiological characteristics found in prosthetic joint infections vary according to the hospitals. In this series, a high proportion of coagulase-negative Staphylococci and Enterococcus spp. were found, as well as a high bacterial resistance. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Improved transistorized AC motor controller for battery powered urban electric passenger vehicles

NASA Technical Reports Server (NTRS)

Peak, S. C.

1982-01-01

An ac motor controller for an induction motor electric vehicle drive system was designed, fabricated, tested, evaluated, and cost analyzed. A vehicle performance analysis was done to establish the vehicle tractive effort-speed requirements. These requirements were then converted into a set of ac motor and ac controller requirements. The power inverter is a three-phase bridge using power Darlington transistors. The induction motor was optimized for use with an inverter power source. The drive system has a constant torque output to base motor speed and a constant horsepower output to maximum speed. A gear shifting transmission is not required. The ac controller was scaled from the base 20 hp (41 hp peak) at 108 volts dec to an expanded horsepower and battery voltage range. Motor reversal was accomplished by electronic reversal of the inverter phase sequence. The ac controller can also be used as a boost chopper battery charger. The drive system was tested on a dynamometer and results are presented. The current-controlled pulse width modulation control scheme yielded improved motor current waveforms. The ac controller favors a higher system voltage.

System and method for determining stator winding resistance in an AC motor using motor drives

DOEpatents

Lu, Bin; Habetler, Thomas G; Zhang, Pinjia

2013-02-26

A system and method for determining the stator winding resistance of AC motors is provided. The system includes an AC motor drive having an input connectable to an AC source and an output connectable to an input terminal of an AC motor, a pulse width modulation (PWM) converter having switches therein to control current flow and terminal voltages in the AC motor, and a control system connected to the PWM converter. The control system generates a command signal to cause the PWM converter to control an output of the AC motor drive corresponding to an input to the AC motor, selectively generates a modified command signal to cause the PWM converter to inject a DC signal into the output of the AC motor drive, and determines a stator winding resistance of the AC motor based on the DC signal of at least one of the voltage and current.

Adaptive Liquid Crystal TV Based Joint Transform Correlator as Applied to Real-Time Pattern Recognition

DTIC Science & Technology

1991-05-23

rotational objects can b ec-tetd. E-Ac Ceedent 3exp-erimental demon ct r-ati ons for these tuo zethodsc hare L-en nerfor-med.A aner atohi naturve xs...dependent nature ---f the Joint rransifore f.Iter. Unlike theVa.dr %g~ii ssignal indepndent. a0. eir -las 3advata in real-tim ’-n14-a-entatio-n...a-tit reI ra-’ t --er is n -) 0 s-’ow Uha thsthoesc~-heo 8 spectral content of the target. A paper of this nature is published in the Optics and

Improved Tribological Performance of Amorphous Carbon (a-C) Coating by ZrO₂ Nanoparticles.

PubMed

Tang, Jinzhu; Ding, Qi; Zhang, Songwei; Wu, Guizhi; Hu, Litian

2016-09-22

Nanomaterials, such as Graphene, h-BN nanoparticles and MoS₂ nanotubes, have shown their ability in improving the tribological performance of amorphous carbon (a-C) coatings. In the current study, the effectiveness of ZrO₂ nanoparticles (ZrO₂-NPs) in lubricating the self-mated nonhydrogenated a-C contacts was investigated in boundary lubrication regime. The results showed that 13% less friction and 50% less wear compared to the base oil were achieved by employing ZrO₂-NPs in the base oil in self-mated a-C contacts. Via analyzing the ZrO₂-NPs and the worn a-C surface after tests, it was found that the improved lubrication by ZrO₂-NPs was based on "polishing effects", which is a new phenomenon observed between a-C and nanoparticles. Under the "polishing effect", micro-plateaus with extremely smooth surface and uniform height were produced on the analyzed a-C surface. The resulting topography of the a-C coating is suitable for ZrO₂-NPs to act as nano-bearings between rubbing surfaces. Especially, the ZrO₂-NPs exhibited excellent mechanical and chemical stability, even under the severe service condition, suggesting that the combination of nonhydrogenated a-C coating with ZrO₂-NPs is an effective, long lasting and environment-friendly lubrication solution.

Dielectrophoretic particle-particle interaction under AC electrohydrodynamic flow conditions.

PubMed

Lee, Doh-Hyoung; Yu, Chengjie; Papazoglou, Elisabeth; Farouk, Bakhtier; Noh, Hongseok M

2011-09-01

We used the Maxwell stress tensor method to understand dielectrophoretic particle-particle interactions and applied the results to the interpretation of particle behaviors under alternating current (AC) electrohydrodynamic conditions such as AC electroosmosis (ACEO) and electrothermal flow (ETF). Distinct particle behaviors were observed under ACEO and ETF. Diverse particle-particle interactions observed in experiments such as particle clustering, particles keeping a certain distance from each other, chain and disc formation and their rotation, are explained based on the numerical simulation data. The improved understanding of particle behaviors in AC electrohydrodynamic flows presented here will enable researchers to design better particle manipulation strategies for lab-on-a-chip applications. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Promising efficacy of novel BTK inhibitor AC0010 in mantle cell lymphoma.

PubMed

Yan, Xiao; Zhou, Yile; Huang, Shujuan; Li, Xia; Yu, Mengxia; Huang, Jiansong; Wang, Jinghan; Ma, Zhixin; Jin, Jingrui; Pan, Jiajia; Li, Chenying; Li, Fenglin; Jin, Jie

2018-04-01

We researched into the effect and mechanism of AC0010, a novel BTK inhibitor, in MCL, and compared its efficacy and safety with Ibrutinib to develop a preclinical study for the future therapy of MCL. MTS assay was used to detect the growth inhibition caused by AC0010 and Ibrutinib, respectively, in MCL cell lines (Jeko-1 and JVM-2), primary MCL cells, and normal peripheral lymphocytes. Apoptosis of Jeko-1 and JVM-2 after exposure into AC0010 and Ibrutinib was conducted by flow cytometry; the expression of apoptosis-related proteins was checked by Western blot. q-PCR and Western blot were applied to examine the expression of BTK and p-BTK at mRNA and protein level as well as the BTK-ralated signaling pathways. MCL xenograft was developed to testify the efficacy and safety of AC0010 in vivo. In contrast with Ibrutinib, AC0010 proved to be more toxic to MCL cells in vitro (p < 0.01) with no augment in cytotoxicity to normal peripheral lymphocytes, and it can induce obvious apoptosis in MCL cell lines (p < 0.01) through caspase family and Bcl-2 family. AC0010 at 300 mg/kg can prolong the survival rate in MCL xenograft (p < 0.01). The phosphorylation of BTK is inhibited by AC0010 following simultaneously inhibition of BCR-BTK and PI3K/AKT signaling pathway in MCL cells. AC0010 is a novel BTK inhibitor of great efficacy and safety in MCL.

AC to DC Bridgeless Boost Converter for Ultra Low Input Energy Harvesting

NASA Astrophysics Data System (ADS)

Dawam, A. H. A.; Muhamad, M.

2018-03-01

This paper presents design of circuit which converts low input AC voltage to a higher output DC voltage. A buck-boost topology and boost topology are combined to condition cycle of an AC input voltage. the unique integration of a combining circuit of buck-boost and boost circuit have been proposed in order to introduce a new direct ac-dc power converter topology without conventional diode bridge rectifier. The converter achieved to convert a milli-volt scale of input AC voltage into a volt scale of output DC voltages which is from 400mV to 3.3V.

Analytical theory and possible detection of the ac quantum spin Hall effect

DOE PAGES

Deng, W. Y.; Ren, Y. J.; Lin, Z. X.; ...

2017-07-11

Here, we develop an analytical theory of the low-frequency ac quantum spin Hall (QSH) effect based upon the scattering matrix formalism. It is shown that the ac QSH effect can be interpreted as a bulk quantum pumping effect. When the electron spin is conserved, the integer-quantized ac spin Hall conductivity can be linked to the winding numbers of the reflection matrices in the electrodes, which also equal to the bulk spin Chern numbers of the QSH material. Furthermore, a possible experimental scheme by using ferromagnetic metals as electrodes is proposed to detect the topological ac spin current by electrical means.

The Hubble Legacy Archive ACS grism data

NASA Astrophysics Data System (ADS)

Kümmel, M.; Rosati, P.; Fosbury, R.; Haase, J.; Hook, R. N.; Kuntschner, H.; Lombardi, M.; Micol, A.; Nilsson, K. K.; Stoehr, F.; Walsh, J. R.

2011-06-01

A public release of slitless spectra, obtained with ACS/WFC and the G800L grism, is presented. Spectra were automatically extracted in a uniform way from 153 archival fields (or "associations") distributed across the two Galactic caps, covering all observations to 2008. The ACS G800L grism provides a wavelength range of 0.55-1.00 μm, with a dispersion of 40 Å/pixel and a resolution of ~80 Å for point-like sources. The ACS G800L images and matched direct images were reduced with an automatic pipeline that handles all steps from archive retrieval, alignment and astrometric calibration, direct image combination, catalogue generation, spectral extraction and collection of metadata. The large number of extracted spectra (73,581) demanded automatic methods for quality control and an automated classification algorithm was trained on the visual inspection of several thousand spectra. The final sample of quality controlled spectra includes 47 919 datasets (65% of the total number of extracted spectra) for 32 149 unique objects, with a median iAB-band magnitude of 23.7, reaching 26.5 AB for the faintest objects. Each released dataset contains science-ready 1D and 2D spectra, as well as multi-band image cutouts of corresponding sources and a useful preview page summarising the direct and slitless data, astrometric and photometric parameters. This release is part of the continuing effort to enhance the content of the Hubble Legacy Archive (HLA) with highly processed data products which significantly facilitate the scientific exploitation of the Hubble data. In order to characterize the slitless spectra, emission-line flux and equivalent width sensitivity of the ACS data were compared with public ground-based spectra in the GOODS-South field. An example list of emission line galaxies with two or more identified lines is also included, covering the redshift range 0.2 - 4.6. Almost all redshift determinations outside of the GOODS fields are new. The scope of science projects

A MEMS sensor for AC electric current

NASA Astrophysics Data System (ADS)

Leland, Eli Sidney

This manuscript describes the development of a new MEMS sensor for the measurement of AC electric current. The sensor is comprised of a MEMS piezoelectric cantilever with a microscale permanent magnet mounted to the cantilever's free end. When placed near a wire carrying AC current, the magnet couples to the oscillating magnetic field surrounding the wire, causing the cantilever to deflect, and piezoelectric coupling produces a sinusoidal voltage proportional to the current in the wire. The sensor is itself passive, requiring no power supply to operate. It also operates on proximity and need only be placed near a current carrier in order to function. The sensor does not need to encircle the current carrier and it therefore can measure current in two-wire zip-cords without necessitating the separation of the two conductors. Applications for tins sensor include measuring residential and commercial electricity use and monitoring electric power distribution networks. An analytical model describing the behavior of the current sensor was developed. This model was also adapted to describe the power output of an energy scavenger coupled to a wire carrying AC current. A mesoscale sensor exhibited a sensitivity of 75 mV/A when measuring AC electric current in a zip-cord. A mesoscale energy scavenger produced 345 muW when coupled to a zip-cord carrying 13 A. MEMS current sensors were fabricated from aluminum nitride piezoelectric cantilevers and composite permanent magnets. The cantilevers were fabricated using a four-mask process. Microscale permanent magnets were dispenser-printed using NdFeB magnetic powder with an epoxy binder. The MEMS AC current sensor was interfaced with amplification circuitry and packaged inside an almninum enclosure. The sensor was also integrated with a mesoscale energy scavenger and power conditioning circuitry to create a fully self-powered current sensor. Unamplified sensitivity of the sensor was 0.1-1.1 mV/A when measuring currents in single

On-Chip AC self-test controller

DOEpatents

Flanagan, John D [Rhinebeck, NY; Herring, Jay R [Poughkeepsie, NY; Lo, Tin-Chee [Fishkill, NY

2009-09-29

A system for performing AC self-test on an integrated circuit that includes a system clock for normal operation is provided. The system includes the system clock, self-test circuitry, a first and second test register to capture and launch test data in response to a sequence of data pulses, and a logic circuit to be tested. The self-test circuitry includes an AC self-test controller and a clock splitter. The clock splitter generates the sequence of data pulses including a long data capture pulse followed by an at speed data launch pulse and an at speed data capture pulse followed by a long data launch pulse. The at speed data launch pulse and the at speed data capture pulse are generated for a common cycle of the system clock.

The Use of AC-DC-AC Methods in Assessing Corrosion Resistance Performance of Coating Systems for Magnesium Alloys

NASA Astrophysics Data System (ADS)

McCune, Robert C.; Upadhyay, Vinod; Wang, Yar-Ming; Battocchi, Dante

The potential utility of AC-DC-AC electrochemical methods in comparative measures of corrosion-resisting coating system performance for magnesium alloys under consideration for the USAMP "Magnesium Front End Research and Development" project was previously shown in this forum [1]. Additional studies of this approach using statistically-designed experiments have been conducted with focus on alloy types, pretreatment, topcoat material and topcoat thickness as the variables. Additionally, sample coupons made for these designed experiments were also subjected to a typical automotive cyclic corrosion test cycle (SAE J2334) as well as ASTM B117 for comparison of relative performance. Results of these studies are presented along with advantages and limitations of the proposed methodology.

Superconducting shielded core reactor with reduced AC losses

DOEpatents

Cha, Yung S.; Hull, John R.

2006-04-04

A superconducting shielded core reactor (SSCR) operates as a passive device for limiting excessive AC current in a circuit operating at a high power level under a fault condition such as shorting. The SSCR includes a ferromagnetic core which may be either closed or open (with an air gap) and extends into and through a superconducting tube or superconducting rings arranged in a stacked array. First and second series connected copper coils each disposed about a portion of the iron core are connected to the circuit to be protected and are respectively wound inside and outside of the superconducting tube or rings. A large impedance is inserted into the circuit by the core when the shielding capability of the superconducting arrangement is exceeded by the applied magnetic field generated by the two coils under a fault condition to limit the AC current in the circuit. The proposed SSCR also affords reduced AC loss compared to conventional SSCRs under continuous normal operation.

Scanning AC Nanocalorimetry and Its Applications

NASA Astrophysics Data System (ADS)

Xiao, Kechao

This thesis presents an AC nanocalorimetry technique that enables calorimetry measurements on very small quantities of materials over a wide range of scanning rates (from isothermal to 3x10. 3 K/s), temperatures(up to 1200 K), and environments. Such working range bridges the gap between traditional scanning calorimetry of bulk materials and nanocalorimetry. The method relies on a micromachined nanocalorimeter with negligible thermal lags between heater, thermometer, and sample. The ability to perform calorimetry measurements over such a broad range of scanning rates makes it an ideal tool to characterize the kinetics of phase transformations, reactions at elevated temperatures or to explore the behavior of materials far from equilibrium. We demonstrate the technique by performing measurements on thin-film samples of Sn, In, and Bi with thicknesses ranging from 100 to 300 nm. The experimental heat capacities and melting temperatures agree well with literature values. The measured heat capacities are insensitive to the applied AC frequency, scan rate, and heat loss to the environment over a broad range of experimental conditions. The dynamic range of scanning AC nanocalorimetry enables the combination of nanocalorimetry with in-situ x-ray diffraction (XRD) to facilitate interpretation of the calorimetry measurements. Time-resolved XRD during in-situ operation of nanocalorimetry sensors using intense, high-energy synchrotron radiation allows unprecedented characterization of thermal and structural material properties. We demonstrate this experiment with detailed characterization of the melting and solidification of elemental Bi, In and Sn thin-film samples, using heating and cooling rates up to 300 K/s. By combining scanning DC and AC nano-calorimetry techniques, we study the nucleation behavior of undercooled liquid Bi at cooling rates ranging from 10. 1 to 10. 4 K/s. Upon initial melting, the Bi thin-film sample breaksup into isolated islands. The number of islands

Roebel assembled coated conductor cables (RACC): Ac-Losses and current carrying potential

NASA Astrophysics Data System (ADS)

Frank, A.; Heller, R.; Goldacker, W.; Kling, A.; Schmidt, C.

2008-02-01

Low ac-loss HTS cables for transport currents well above 1 kA are required for application in transformers and generators and are taken into consideration for future generations of fusion reactor coils. Coated conductors (CC) are suitable candidates for high field application at an operation temperature in the range 50-77 K. Ac-field applications require cables with low ac-losses and hence twisting of the individual strands. We solved this problem using the Roebel technique. Short lengths of Roebel bar cables were prepared from industrial DyBCO and YBCO-CC. Meander shaped tapes of 4 or 5 mm width with twist pitches of 123 or 127 mm were cut from the 10 or 12 mm wide CC tapes using a specially designed tool. Eleven or twelve of these strands were assembled to a cable. The electrical and mechanical connection of the tapes was achieved using a silver powder filled conductive epoxy resin. Ac-losses of a short sample in an external ac-field were measured as a function of frequency and field amplitude as well as the coupling current decay time constant. We discuss the results in terms of available theories and compare measured time constants in transverse field with measured coupling losses. Finally the potential of this cable type for ac-use is discussed with respect to ac-losses and current carrying capability.

Comparative single-cell genomics reveals potential ecological niches for the freshwater acI Actinobacteria lineage.

PubMed

Ghylin, Trevor W; Garcia, Sarahi L; Moya, Francisco; Oyserman, Ben O; Schwientek, Patrick; Forest, Katrina T; Mutschler, James; Dwulit-Smith, Jeffrey; Chan, Leong-Keat; Martinez-Garcia, Manuel; Sczyrba, Alexander; Stepanauskas, Ramunas; Grossart, Hans-Peter; Woyke, Tanja; Warnecke, Falk; Malmstrom, Rex; Bertilsson, Stefan; McMahon, Katherine D

2014-12-01

Members of the acI lineage of Actinobacteria are the most abundant microorganisms in most freshwater lakes; however, our understanding of the keys to their success and their role in carbon and nutrient cycling in freshwater systems has been hampered by the lack of pure cultures and genomes. We obtained draft genome assemblies from 11 single cells representing three acI tribes (acI-A1, acI-A7, acI-B1) from four temperate lakes in the United States and Europe. Comparative analysis of acI SAGs and other available freshwater bacterial genomes showed that acI has more gene content directed toward carbohydrate acquisition as compared to Polynucleobacter and LD12 Alphaproteobacteria, which seem to specialize more on carboxylic acids. The acI genomes contain actinorhodopsin as well as some genes involved in anaplerotic carbon fixation indicating the capacity to supplement their known heterotrophic lifestyle. Genome-level differences between the acI-A and acI-B clades suggest specialization at the clade level for carbon substrate acquisition. Overall, the acI genomes appear to be highly streamlined versions of Actinobacteria that include some genes allowing it to take advantage of sunlight and N-rich organic compounds such as polyamines, di- and oligopeptides, branched-chain amino acids and cyanophycin. This work significantly expands the known metabolic potential of the cosmopolitan freshwater acI lineage and its ecological and genetic traits.

AC magnetic field measurement using a small flip coil system for rapid cycling AC magnets at the China Spallation Neutron Source (CSNS)

NASA Astrophysics Data System (ADS)

Zhou, Jianxin; Kang, Wen; Li, Shuai; Liu, Yudong; Liu, Yiqin; Xu, Shouyan; Guo, Xiaoling; Wu, Xi; Deng, Changdong; Li, Li; Wu, Yuwen; Wang, Sheng

2018-02-01

The China Spallation Neutron Source (CSNS) has two major accelerator systems, a linear accelerator and a rapid cycling synchrotron (RCS). The RCS accelerator is used to accumulate and accelerate protons from the energy of 80 MeV to the design energy of 1.6 GeV at the repetition rate of 25 Hz, and extract the high energy beam to the target. The main magnets of the RCS accelerator are excited by AC current with DC bias. The magnetic field quality is very important for the RCS accelerator operation, since it should guarantee and focus a circulating beam. In order to characterize the AC magnets, a small flip coil measurement system has been developed and one of each type of AC magnets has been studied. The measurement system and selected measurement results are presented in this paper.

Degenerative joint disease: multiple joint involvement in young and mature dogs.

PubMed

Olsewski, J M; Lust, G; Rendano, V T; Summers, B A

1983-07-01

Radiologic, pathologic, and ancillary methods were used to determine the occurrence of degenerative joint disease involving multiple joints of immature and adult dogs. Animals were selected for the development of hip joint dysplasia and chronic degenerative joint disease. Of disease-prone dogs, 82% (45 of 55 dogs) had radiologic changes, indicative of hip dysplasia, by 1 year of age. At necropsy, more abnormal joints were identified than by radiographic examination. Among 92 dogs between 3 to 11 months of age that had joint abnormalities, 71% had hip joint involvement; 38%, shoulder joint involvement; 22%, stifle joint involvement; and 40% had multiple joint involvement. Polyarthritis was asymptomatic and unexpected. Radiographic examination of older dogs also revealed evidence of degenerative joint disease in many joints. Multiple joint involvement was substantiated at necropsy of young and mature dogs. A similar pattern of polyarticular osteoarthritis was revealed in a survey (computer search) of necropsy reports from medical case records of 100 adult and elderly dogs. Usually, the joint disease was an incidental observation, unrelated to the clinical disease or to the cause of death. The frequent occurrence of degenerative changes in several joints of dogs aged 6 months to 17 years indicated that osteoarthritis may be progressive in these joints and raises the possibility that systemic factors are involved in the disease process.

Ion trajectory simulations of axial ac dipolar excitation in the Orbitrap

NASA Astrophysics Data System (ADS)

Wu, Guangxiang; Noll, Robert J.; Plass, Wolfgang R.; Hu, Qizhi; Perry, Richard H.; Cooks, R. Graham

2006-07-01

The newly developed version of the multi-particle ion trajectory simulation program, ITSIM 6.0, was applied to simulate ac dipolar excitation of ion axial motion in the Orbitrap. The Orbitrap inner and outer electrodes were generated in AutoCAD, a 3D drawing program. The electrode geometry was imported into the 3D field solver COMSOL; the field array was then imported into ITSIM 6.0. Ion trajectories were calculated by solving Newton's equations using Runge-Kutta integration methods. Compared to the analytical solution, calculated radial components of the field at the device's "equator" (z = 0) were within 0.5% and calculated axial components midway between the inner and outer electrodes were within 0.2%. The experiments simulated here involved the control of axial motion of ions in the Orbitrap by the application of dipolar ac signals to the split outer electrodes, as described in a recently published paper from this laboratory [Hu et al., J. Phys. Chem. A 110 (2006) 2682]. In these experiments, ac signal was applied at the axial resonant frequency of a selected ion. Axial excitation and eventual ion ejection resulted when the ac was in phase with, i.e., had 0° phase relative to ion axial motion. De-excitation of ion axial motion until the ions were at z = 0 and at rest with respect to the z-axis resulted if the applied ac was out of phase with ion motion, with re-excitation of ion axial motion occurring if the dipolar ac was continued beyond this point. Both de-excitation and re-excitation could be achieved mass-selectively and depended on the amplitude and duration (number of cycles) of the applied ac. The effects of ac amplitude, frequency, phase relative to ion motion, and bandwidth of applied waveform were simulated. All simulation results were compared directly with the experimental data and good agreement was observed. Such ion motion control experiments and their simulation provide the possibility to improve Orbitrap performance and to develop tandem mass

Transposition of the maize transposable element Ac in barley (Hordeum vulgare L.).

PubMed

Scholz, S; Lörz, H; Lütticke, S

2001-01-01

Transposition of the maize autonomous element Ac (Activator) was investigated in barley (Hordeum vulgare L.) with the aim of developing a transposon tagging system for the latter. The Ac element was introduced into meristematic tissue of barley by microprojectile bombardment. Transposon activity was then examined in the resulting transgenic plants. Multiple excision events were detected in leaf tissue of all plant lines. The mobile elements generated empty donor sites with small DNA sequence alterations, similar to those found in maize. Reintegration of Ac at independent genomic loci in somatic tissue was demonstrated by isolation of new element-flanking regions by AIMS-PCR (amplification of insertion-mutagenized sites). In addition, transmission of transposed Ac elements to progeny plants was confirmed. The results indicate that the introduced Ac element is able to transpose in barley. This is a first step towards the establishment of a transposon tagging system in this economically important crop.

Determination of Parachute Joint Factors using Seam and Joint Testing

NASA Technical Reports Server (NTRS)

Mollmann, Catherine

2015-01-01

This paper details the methodology for determining the joint factor for all parachute components. This method has been successfully implemented on the Capsule Parachute Assembly System (CPAS) for the NASA Orion crew module for use in determining the margin of safety for each component under peak loads. Also discussed are concepts behind the joint factor and what drives the loss of material strength at joints. The joint factor is defined as a "loss in joint strength...relative to the basic material strength" that occurs when "textiles are connected to each other or to metals." During the CPAS engineering development phase, a conservative joint factor of 0.80 was assumed for each parachute component. In order to refine this factor and eliminate excess conservatism, a seam and joint testing program was implemented as part of the structural validation. This method split each of the parachute structural joints into discrete tensile tests designed to duplicate the loading of each joint. Breaking strength data collected from destructive pull testing was then used to calculate the joint factor in the form of an efficiency. Joint efficiency is the percentage of the base material strength that remains after degradation due to sewing or interaction with other components; it is used interchangeably with joint factor in this paper. Parachute materials vary in type-mainly cord, tape, webbing, and cloth -which require different test fixtures and joint sample construction methods. This paper defines guidelines for designing and testing samples based on materials and test goals. Using the test methodology and analysis approach detailed in this paper, the minimum joint factor for each parachute component can be formulated. The joint factors can then be used to calculate the design factor and margin of safety for that component, a critical part of the design verification process.

ACS (Alma Common Software) operating a set of robotic telescopes

NASA Astrophysics Data System (ADS)

Westhues, C.; Ramolla, M.; Lemke, R.; Haas, M.; Drass, H.; Chini, R.

2014-07-01

We use the ALMA Common Software (ACS) to establish a unified middleware for robotic observations with the 40cm Optical, 80cm Infrared and 1.5m Hexapod telescopes located at OCA (Observatorio Cerro Armazones) and the ESO 1-m located at La Silla. ACS permits to hide from the observer the technical specifications, like mount-type or camera-model. Furthermore ACS provides a uniform interface to the different telescopes, allowing us to run the same planning program for each telescope. Observations are carried out for long-term monitoring campaigns to study the variability of stars and AGN. We present here the specific implementation to the different telescopes.

Spacesuit mobility joints

NASA Technical Reports Server (NTRS)

Vykukal, H. C. (Inventor)

1978-01-01

Joints for use in interconnecting adjacent segments of an hermetically sealed spacesuit which have low torques, low leakage and a high degree of reliability are described. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics. Linkages which restrain the joint from longitudinal distension and a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli are featured. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

Numerical minimization of AC losses in coaxial coated conductor cables

NASA Astrophysics Data System (ADS)

Rostila, L.; Suuriniemi, S.; Lehtonen, J.; Grasso, G.

2010-02-01

Power cables are one of the most promising applications for the superconducting coated conductors. In the AC use, only small resistive loss is generated, but the removal of the dissipated heat from the cryostat is inefficient due to the large temperature difference. The aim of this work is to minimize the AC losses in a multilayer coaxial cable, in which the tapes form current carrying cylinders. The optimized parameters are the tape numbers and lay angles in these cylinders. This work shows how to cope with the mechanical constraints for the lay angles and discrete tape number in optimization. Three common types of coaxial cables are studied here to demonstrate the feasibility of optimization, in which the AC losses were computed with a circuit analysis model formulated here for arbitrary phase currents, number of phases, and layers. Because the current sharing is practically determined by the inductances of the layers, the optima were obtained much faster by neglecting the nonlinear resistances caused by the AC losses. In addition, the example calculations show that the optimal cable structure do not usually depend on the AC loss model for the individual tapes. On the other hand, depending on the cable type, the losses of the optimized cables may be sensitive to the lay angles, and therefore, we recommend to study the sensitivity for the new cable designs individually.

Travel Support for Scientists to Participate in ACS Symposium

DTIC Science & Technology

2017-08-31

Report: Travel Support for Scientists to Participate in ACS Symposium The views, opinions and/or findings contained in this report are those of the...to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data...Number: W911NF-16-1-0110 Organization: University of Notre Dame Title: Travel Support for Scientists to Participate in ACS Symposium Report Term

Investigation of the transition of multicycle AC operation in ISTTOK under edge electrode biasing

NASA Astrophysics Data System (ADS)

Malaquias, A.; Henriques, R. B.; Silva, C.; Figueiredo, H.; Nedzelskiy, I. S.; Fernandes, H.; Sharma, R.; Plyusnin, V. V.

2017-11-01

In this paper we present recent results obtained on plasma edge electrode biasing during AC discharges. The goal is to obtain experimental evidence on a number of plasma parameters that can play a role during the AC transition on the repeatability and reproducibility of AC operation. The control of the plasma density in the quiescent phase is made just before the AC transition by means of positive edge biasing leading to a transitory improved of density (30%-40%). Gas puff experiments show that the increase of background gas pressure during discharge led to a better success of the AC transition. The experimental results indicate that the increase of density during the AC transition induced by edge biasing is followed by an electron temperature drop. The drop in electron temperature leads in most cases the formation of runaway electrons. It has been observed that the runaway population during discharge flattop depends on the interplay between gas content and plasma density and temperature. The results also confirm that the correct balance of external magnetic fields is crucial during the AC transition phase where drift electron currents are formed. The results from the heavy ion beam diagnostic show that the formation of plasma current during consecutive AC transitions is asymmetric. Numerical simulations indicate that for some particular conditions this result could be reproduced from assuming the presence of two counter-currents during AC transition.

Introducing AC inductive reactance with a power tool

NASA Astrophysics Data System (ADS)

Bryant, Wesley; Baker, Blane

2016-09-01

The concept of reactance in AC electrical circuits is often non-intuitive and difficult for students to grasp. In order to address this lack of conceptual understanding, classroom exercises compare the predicted resistance of a power tool, based on electrical specifications, to measured resistance. Once students discover that measured resistance is smaller than expected, they are asked to explain these observations using previously studied principles of magnetic induction. Exercises also introduce the notion of inductive reactance and impedance in AC circuits and, ultimately, determine self-inductance of the motor windings within the power tool.

AC electrothermal technique in microchannels

NASA Astrophysics Data System (ADS)

Salari, Alinaghi; Navi, Maryam; Dalton, Colin

2017-02-01

Electrokinetic techniques have a wide range of applications in droplet, particle, and fluid manipulation systems. In general, they can be categorized into different subgroups including electroosmosis, electrothermal, electrophoresis, dielectrophoresis, etc. The AC electrothermal (ACET) technique has been shown to be very effective in applications which involve high conductivity fluids, such as blood, which are typically used in biomedical applications. In the past few years, the ACET effect has received considerable attention. Unlike AC electroosmosis (ACEO), the ACET effect shows plateaus in force in a wide frequency range. In other words, with electrothermal force, velocity is more steady and predictable at different frequencies, compared to ACEO and dielectrophoresis (DEP). Although electrothermal microflows form as a result of Joule heating in the fluid, due to high conduction of heat to the ambience, the temperature rise in the fluid is not so high as to threaten the nature of the biofluids. The average temperature rise resulting from the ACET effect is below 5 °K. In order to generate high strength AC electric fields, microfabricated electrode arrays are commonly used in microchannels. For pumping applications, it is essential to create asymmetry in the electric field, typically by having asymmetrical electrode pairs. There is no defined border between many electrokinetic techniques, and as such the point where electrothermal processes interferes with other electrokinetic techniques is not clear in the literature. In addition, there have been comprehensive reviews on micropumps, electrokinetics, and their subcategories, but the literature lacks a detailed up-to-date review on electrothermal microdevices. In this paper, a brief review is made specifically on electric fields in ACET devices, in order to provide an insight for the reader about the importance of this aspect of ACET devices and the improvements made to date.

Modeling AC ripple currents in HTS coated conductors by integral equations

NASA Astrophysics Data System (ADS)

Grilli, Francesco; Xu, Zhihan

2016-12-01

In several HTS applications, the superconducting tapes experience the simultaneous presence of DC and AC excitations. For example in high-current DC cables, where the transport current is not perfectly constant, but it exhibits some ripples at different frequencies introduced by the rectification process (AC-DC conversion). These ripples give rise to dissipation, whose magnitude and possible influence on the device's cooling requirements need to be evaluated. Here we report a study of the AC losses in a HTS coated conductor subjected to DC currents and AC ripples simultaneously. The modeling approach is based on an integral equation method for thin superconductors: the superconducting tape is modeled as a 1-D object with a non-linear resistivity, which includes the dependence of the critical current density Jc on the magnetic field. The model, implemented in a commercial finite-element program, runs very fast (the simulation of one AC cycle typically takes a few seconds on standard desktop workstation): this allows simulating a large number of cycles and estimating when the AC ripple losses stabilize to a constant value. The model is used to study the influence of the flux creep power index n on the stabilization speed and on the AC loss values, as well as the effect of using a field-dependent Jc instead of a constant one. The simulations confirm that the dissipation level should not be a practical concern in HTS DC cables. At the same time, however, they reveal a strong dependence of the results upon the power index n and the form of Jc , which spurs the question whether the power-law is the most suitable description of the superconductor's electrical behavior for this kind of analysis.

Cosmic shear analysis of archival HST/ACS data. I. Comparison of early ACS pure parallel data to the HST/GEMS survey

NASA Astrophysics Data System (ADS)

Schrabback, T.; Erben, T.; Simon, P.; Miralles, J.-M.; Schneider, P.; Heymans, C.; Eifler, T.; Fosbury, R. A. E.; Freudling, W.; Hetterscheidt, M.; Hildebrandt, H.; Pirzkal, N.

2007-06-01

Context: This is the first paper of a series describing our measurement of weak lensing by large-scale structure, also termed “cosmic shear”, using archival observations from the Advanced Camera for Surveys (ACS) on board the Hubble Space Telescope (HST). Aims: In this work we present results from a pilot study testing the capabilities of the ACS for cosmic shear measurements with early parallel observations and presenting a re-analysis of HST/ACS data from the GEMS survey and the GOODS observations of the Chandra Deep Field South (CDFS). Methods: We describe the data reduction and, in particular, a new correction scheme for the time-dependent ACS point-spread-function (PSF) based on observations of stellar fields. This is currently the only technique which takes the full time variation of the PSF between individual ACS exposures into account. We estimate that our PSF correction scheme reduces the systematic contribution to the shear correlation functions due to PSF distortions to <2 × 10-6 for galaxy fields containing at least 10 stars, which corresponds to ⪉5% of the cosmological signal expected on scales of a single ACS field. Results: We perform a number of diagnostic tests indicating that the remaining level of systematics is consistent with zero for the GEMS and GOODS data confirming the success of our PSF correction scheme. For the parallel data we detect a low level of remaining systematics which we interpret to be caused by a lack of sufficient dithering of the data. Combining the shear estimate of the GEMS and GOODS observations using 96 galaxies arcmin-2 with the photometric redshift catalogue of the GOODS-MUSIC sample, we determine a local single field estimate for the mass power spectrum normalisation σ8, CDFS=0.52+0.11-0.15 (stat) ± 0.07(sys) (68% confidence assuming Gaussian cosmic variance) at a fixed matter density Ω_m=0.3 for a ΛCDM cosmology marginalising over the uncertainty of the Hubble parameter and the redshift distribution. We

Comparing the ACS/WFC and WFC3/UVIS Calibration and Photometry

NASA Astrophysics Data System (ADS)

Deustua, S. E.; Mack, J.

2018-03-01

A study was undertaken using synthetic photometry of CALSPEC stars to compare the ACS Wide Field Channel (WFC) photometry to the WFC3 UVIS imaging channel in eight similarly named passbands corresponding to the broadband filters F435W (ACS/WFC) F438W (WFC3/UVIS) and F475W, F555W, F606W, F625W, F775W, F814W and F850LP (both ACS/WFC and WFC3/UVIS). The uncertainty of the photometric calibration of ACS/WFC and WFC3/UVIS with respect to the white dwarf standard stars is within ± 0.5% for F814W, F775W, F606W and F475W, and within ±1% for F625W and F850LP. For F555W the apparent difference in the calibration is 2% for F555W and 6% for UVIS/F438W and ACS/F435W due to inherent differences in the filter passbands. Comparing the ACS/WFC to WFC3/UVIS mean flux for stars having a range of spectral types shows a color dependence. The WFC to UVIS F814W color dependence is ± 0.02 mags for F814W, F775W, F475W and F606W. For the other filters the range is -0.06 to +0.02 mags. Aperture photometry of the 47 Tucanae cluster confirm the results from using synthetic photometry of CALSPEC stars.

Established and potential physiological roles of bicarbonate-sensing soluble adenylyl cyclase (sAC) in aquatic animals

PubMed Central

Tresguerres, Martin; Barott, Katie L.; Barron, Megan E.; Roa, Jinae N.

2014-01-01

Soluble adenylyl cyclase (sAC) is a recently recognized source of the signaling molecule cyclic AMP (cAMP) that is genetically and biochemically distinct from the classic G-protein-regulated transmembrane adenylyl cyclases (tmACs). Mammalian sAC is distributed throughout the cytoplasm and it may be present in the nucleus and inside mitochondria. sAC activity is directly stimulated by HCO3−, and sAC has been confirmed to be a HCO3− sensor in a variety of mammalian cell types. In addition, sAC can functionally associate with carbonic anhydrases to act as a de facto sensor of pH and CO2. The two catalytic domains of sAC are related to HCO3−-regulated adenylyl cyclases from cyanobacteria, suggesting the cAMP pathway is an evolutionarily conserved mechanism for sensing CO2 levels and/or acid/base conditions. Reports of sAC in aquatic animals are still limited but are rapidly accumulating. In shark gills, sAC senses blood alkalosis and triggers compensatory H+ absorption. In the intestine of bony fishes, sAC modulates NaCl and water absorption. And in sea urchin sperm, sAC may participate in the initiation of flagellar movement and in the acrosome reaction. Bioinformatics and RT-PCR results reveal that sAC orthologs are present in most animal phyla. This review summarizes the current knowledge on the physiological roles of sAC in aquatic animals and suggests additional functions in which sAC may be involved. PMID:24574382

Superconducting ac cable

NASA Astrophysics Data System (ADS)

Schmidt, F.

1980-11-01

The components of a superconducting 110 kV ac cable for power ratings or = 2000 MVA were developed. The cable design is of the semiflexible type, with a rigid cryogenic envelope containing a flexible hollow coaxial cable core. The cable core consists of spirally wound Nb-A1 composite wires electrically insulated by high pressure polyethylene tape wrappings. A 35 m long single phase test cable with full load terminals rated at 110 kV and 10 kA was constructed and successfully tested. The results obtained prove the technical feasibility and capability of this cable design.

Diode-rectified multiphase AC arc for the improvement of electrode erosion characteristics

NASA Astrophysics Data System (ADS)

Tanaka, Manabu; Hashizume, Taro; Saga, Koki; Matsuura, Tsugio; Watanabe, Takayuki

2017-11-01

An innovative multiphase AC arc (MPA) system was developed on the basis of a diode-rectification technique to improve electrode erosion characteristics. Conventionally, electrode erosion in AC arc is severer than that in DC arc. This originated from the fact that the required properties for the cathode and anode are different, although an AC electrode works as the cathode and the anode periodically. To solve this problem, a separation of AC electrodes into pairs of thoriated tungsten cathode and copper anode by diode-rectification was attempted. A diode-rectified multiphase AC arc (DRMPA) system was then successfully established, resulting in a drastic improvement of the erosion characteristics. The electrode erosion rate in the DRMPA was less than one-third of that in the conventional MPA without the diode rectification. In order to clarify its erosion mechanism, electrode phenomena during discharge were visualized by a high-speed camera system with appropriate band-pass filters. Fluctuation characteristics of the electrode temperature in the DRMPA were revealed.

The Dorsal 4-finger Technique: A Novel Method to Examine Metacarpophalangeal Joints in Patients with Rheumatoid Arthritis.

PubMed

Omair, Mohammed A; Akhavan, Pooneh; Naraghi, Ali; Mittoo, Shikha; Xiong, Juan; Weber, Deborah; Lin, Daming; Weber, Melissa; Keystone, Edward C

2018-03-01

To describe the dorsal 4-finger technique (DFFT) in examining metacarpophalangeal (MCP) joints of patients with rheumatoid arthritis (RA) and compare it to the traditional 2-finger technique (TFT) using ultrasound (US) as a gold standard. Four rheumatologists evaluated 180 MCP joints of 18 patients with RA. All patients underwent US for greyscale (GSUS) and power Doppler US (PDUS). Agreements between rheumatologists, the 2 techniques, and US were evaluated using Cohen κ and the first-order agreement coefficient (AC1) κ methods. The population comprised 17 females (94.4%) with a mean (SD) age and disease duration of 56.8 (14.4) and 21.8 (12.9) years, respectively. Eight patients (44.4%) were taking methotrexate monotherapy, while 10 patients (55.6%) were receiving biologics. US evaluation revealed 69 (38.3%) and 30 (16.7%) joints exhibited synovitis grade 2-3 by GSUS and PDUS, respectively. Effusion was documented in 30 joints (16.7%). The mean intraobserver agreement using the DFFT and TFT were 80.5% and 86%, respectively. The mean interobserver agreements using the DFFT and TFT were 84% and 74%, respectively. κ agreement with US findings was similar for both techniques in tender joints but was higher for the DFFT in nontender joints (0.33 vs 0.07, p = 0.015 for GSUS) and (0.48 vs 0.11, p = 0.002 for PDUS). The DFFT had a higher sensitivity in detecting ballottement by GSUS (0.47 vs 0.2, p < 0.001) and PDUS (0.60 vs 0.27, p < 0.001). The DFFT is a novel, reproducible, and reliable method to examine MCP joints, and it has a better correlation with US than the traditional TFT.

Faradaic AC Electrokinetic Flow and Particle Traps

NASA Astrophysics Data System (ADS)

Ben, Yuxing; Chang, Hsueh-Chia

2004-11-01

Faradaic reaction at higher voltages can produce co-ion polarization at AC electrodes instead of counter-ion polarization due to capacitive charging from the bulk. The Faradaic co-ion polarization also does not screen the external field and hence can produce large net electro-kinetic flows at frequencies lower than the inverse RC time of the double layer. Due to the opposite polarization of capacitve and Faradaic charging, we can reverse the direction of AC flows on electrodes by changing the voltage and frequency. Particles and bacteria are trapped and then dispersed at stagnation lines, at locations predicted by our theory, by using these two flows sequentially. This technique offers a good way to concentrate and detect bacteria.

AC application of second generation HTS wire

NASA Astrophysics Data System (ADS)

Thieme, C. L. H.; Gagnon, K.; Voccio, J.; Aized, D.; Claassen, J.

2008-02-01

For the production of Second Generation (2G) YBCO High Temperature Superconductor wire American Superconductor uses a wide-strip MOD-YBCO/RABiTSTM process, a low-cost approach for commercial manufacturing. It can be engineered with a high degree of flexibility to manufacture practical 2G conductors with architectures and properties tailored for specific applications and operating conditions. For ac applications conductor and coil design can be geared towards low hysteretic losses. For applications which experience high frequency ac fields, the stabilizer needs to be adjusted for low eddy current losses. For these applications a stainless-steel laminate is used. An example is a Low Pass Filter Inductor which was developed and built in this work.

AC Application of HTS Conductors in Highly Dynamic Electric Motors

NASA Astrophysics Data System (ADS)

Oswald, B.; Best, K.-J.; Setzer, M.; Duffner, E.; Soell, M.; Gawalek, W.; Kovalev, L. K.

2006-06-01

Based on recent investigations we design highly dynamic electric motors up to 400 kW and linear motors up to 120 kN linear force using HTS bulk material and HTS tapes. The introduction of HTS tapes into AC applications in electric motors needs fundamental studies on double pancake coils under transversal magnetic fields. First theoretical and experimental results on AC field distributions in double-pancake-coils and corresponding AC losses will be presented. Based on these results the simulation of the motor performance confirms extremely high power density and efficiency of both types of electric motors. Improved characteristics of rare earth permanent magnets used in our motors at low temperatures give an additional technological benefit.

AC-Induced Bias Potential Effect on Corrosion of Steels

DTIC Science & Technology

2009-02-05

induction, variable conduction Experimental Setup Super- martensitic stainless steel composition Analysis: C Mn Si Cr Ni Mo Cu N Typical 13 Cr ɘ.01 0.6... stainless steel used in pipelines. •Low carbon (ɘ.01): allows the formation of a “soft” martensite that is more resistant than standard martensitic ...Proposed AC Corrosion Models  AC Simulated Corrosion testing  Stainless steel pipe and coating  Cathodic protection  Experimental Setup  Preliminary

AC losses in horizontally parallel HTS tapes for possible wireless power transfer applications

NASA Astrophysics Data System (ADS)

Shen, Boyang; Geng, Jianzhao; Zhang, Xiuchang; Fu, Lin; Li, Chao; Zhang, Heng; Dong, Qihuan; Ma, Jun; Gawith, James; Coombs, T. A.

2017-12-01

This paper presents the concept of using horizontally parallel HTS tapes with AC loss study, and the investigation on possible wireless power transfer (WPT) applications. An example of three parallel HTS tapes was proposed, whose AC loss study was carried out both from experiment using electrical method; and simulation using 2D H-formulation on the FEM platform of COMSOL Multiphysics. The electromagnetic induction around the three parallel tapes was monitored using COMSOL simulation. The electromagnetic induction and AC losses generated by a conventional three turn coil was simulated as well, and then compared to the case of three parallel tapes with the same AC transport current. The analysis demonstrates that HTS parallel tapes could be potentially used into wireless power transfer systems, which could have lower total AC losses than conventional HTS coils.

AC Conductivity and Dielectric Properties of Borotellurite Glass

NASA Astrophysics Data System (ADS)

Taha, T. A.; Azab, A. A.

2016-10-01

Borotellurite glasses with formula 60B2O3-10ZnO-(30 - x)NaF- xTeO2 ( x = 0 mol.%, 5 mol.%, 10 mol.%, and 15 mol.%) have been synthesized by thermal melting. X-ray diffraction (XRD) analysis confirmed that the glasses were amorphous. The glass density ( ρ) was determined by the Archimedes method at room temperature. The density ( ρ) and molar volume ( V m) were found to increase with increasing TeO2 content. The direct-current (DC) conductivity was measured in the temperature range from 473 K to 623 K, in which the electrical activation energy of ionic conduction increased from 0.27 eV to 0.48 eV with increasing TeO2 content from 0 mol.% to 15 mol.%. The dielectric parameters and alternating-current (AC) conductivity ( σ ac) were investigated in the frequency range from 1 kHz to 1 MHz and temperature range from 300 K to 633 K. The AC conductivity and dielectric constant decreased with increasing TeO2 content from 0 mol.% to 15 mol.%.

AC Electric Field Communication for Human-Area Networking

NASA Astrophysics Data System (ADS)

Kado, Yuichi; Shinagawa, Mitsuru

We have proposed a human-area networking technology that uses the surface of the human body as a data transmission path and uses an AC electric field signal below the resonant frequency of the human body. This technology aims to achieve a “touch and connect” intuitive form of communication by using the electric field signal that propagates along the surface of the human body, while suppressing both the electric field radiating from the human body and mutual interference. To suppress the radiation field, the frequency of the AC signal that excites the transmitter electrode must be lowered, and the sensitivity of the receiver must be raised while reducing transmission power to its minimally required level. We describe how we are developing AC electric field communication technologies to promote the further evolution of a human-area network in support of ubiquitous services, focusing on three main characteristics, enabling-transceiver technique, application-scenario modeling, and communications quality evaluation. Special attention is paid to the relationship between electro-magnetic compatibility evaluation and regulations for extremely low-power radio stations based on Japan's Radio Law.

Dielectric Breakdown Characteristics of Oil-pressboard Insulation System against AC/DC Superposed Voltage

NASA Astrophysics Data System (ADS)

Ebisawa, Yoshihito; Yamada, Shin; Mori, Shigekazu; Ikeda, Masami

This paper describes breakdown characteristics of an oil-pressboard insulation system to a superposition voltage of AC and DC voltages. Although AC electric field is decided by the ratio of the relative permittivity of a pressboard and insulating oil, DC electric field is decided by ratio α of volume resistivities. From the measurement in this study, 13—78 and 1.8—5.7 are obtained as the volume resistivity ratios α at temperature of 30°C and 80°C, respectively. The breakdown voltages against AC, DC, and those superposition voltages are surveyed to insulation models. In normal temperature, the breakdown voltage to the superposition voltage of AC and DC is determined by AC electric field applied to the oil duct. Since the α becomes as low as 2-3 at temperature of 80°C, AC and DC voltages almost equally contribute to the electric field of the oil duct as a result. That is, it became clear that superposed DC voltage boosts the electric field across oil ducts at operating high temperature.

ARC-1978-AC78-1040-172

NASA Image and Video Library

1978-11-14

Lockheed YO-3A (USA 69-18010 NASA 718) A/C & BELL COBRA HELICOPTER FLIGHT & GROUND TESTS AT EDWARDS AIR FORCE BASE. Rotorcraft Research. NASA SP-1998-3300 Flight Research at Ames: 57 Years of Development and Validation of Aeronautical Technology Fig. 143

Photovoltaic system with improved AC connections and method of making same

DOEpatents

Cioffi, Philip Michael; Todorovic, Maja Harfman; Herzog, Michael Scott; Korman, Charles Steven; Doherty, Donald M.; Johnson, Neil Anthony

2018-02-13

An alternating current (AC) harness for a photovoltaic (PV) system includes a wire assembly having a first end and a second end, the wire assembly having a plurality of lead wires, and at least one AC connection module positioned at a location along a length of the wire assembly between the first end and the second end. Further, the at least one AC connection module includes a first connection terminal electrically coupled to the plurality of lead wires of the wire assembly and constructed to electrically couple the wire assembly with an output of a first PV module of the PV system. The at least one AC connection module also includes a second connection terminal electrically coupled to the plurality of lead wires of the wire assembly and constructed to electrically couple the wire assembly with an output of a second PV module of the PV system.

Chance-Constrained AC Optimal Power Flow for Distribution Systems With Renewables

DOE Office of Scientific and Technical Information (OSTI.GOV)

DallAnese, Emiliano; Baker, Kyri; Summers, Tyler

This paper focuses on distribution systems featuring renewable energy sources (RESs) and energy storage systems, and presents an AC optimal power flow (OPF) approach to optimize system-level performance objectives while coping with uncertainty in both RES generation and loads. The proposed method hinges on a chance-constrained AC OPF formulation where probabilistic constraints are utilized to enforce voltage regulation with prescribed probability. A computationally more affordable convex reformulation is developed by resorting to suitable linear approximations of the AC power-flow equations as well as convex approximations of the chance constraints. The approximate chance constraints provide conservative bounds that hold for arbitrarymore » distributions of the forecasting errors. An adaptive strategy is then obtained by embedding the proposed AC OPF task into a model predictive control framework. Finally, a distributed solver is developed to strategically distribute the solution of the optimization problems across utility and customers.« less

Periprosthetic joint infection: are patients with multiple prosthetic joints at risk?

PubMed

Jafari, S Mehdi; Casper, David S; Restrepo, Camilo; Zmistowski, Benjamin; Parvizi, Javad; Sharkey, Peter F

2012-06-01

Patients who present with a periprosthetic joint infection in a single joint may have multiple prosthetic joints. The risk of these patients developing a subsequent infection in another prosthetic joint is unknown. Our purposes were (1) to identify the risk of developing a subsequent infection in another prosthetic joint and (2) to describe the time span and organism profile to the second prosthetic infection. We retrospectively identified 55 patients with periprosthetic joint infection who had another prosthetic joint in place at the time of presentation. Of the 55 patients, 11 (20%) developed a periprosthetic joint infection in a second joint. The type of organism was the same as the first infection in 4 (36%) of 11 patients. The time to developing a second infection averaged 2.0 years (range, 0-6.9 years). Copyright © 2012 Elsevier Inc. All rights reserved.

Calorimetric method of ac loss measurement in a rotating magnetic field.

PubMed

Ghoshal, P K; Coombs, T A; Campbell, A M

2010-07-01

A method is described for calorimetric ac-loss measurements of high-T(c) superconductors (HTS) at 80 K. It is based on a technique used at 4.2 K for conventional superconducting wires that allows an easy loss measurement in parallel or perpendicular external field orientation. This paper focuses on ac loss measurement setup and calibration in a rotating magnetic field. This experimental setup is to demonstrate measuring loss using a temperature rise method under the influence of a rotating magnetic field. The slight temperature increase of the sample in an ac-field is used as a measure of losses. The aim is to simulate the loss in rotating machines using HTS. This is a unique technique to measure total ac loss in HTS at power frequencies. The sample is mounted on to a cold finger extended from a liquid nitrogen heat exchanger (HEX). The thermal insulation between the HEX and sample is provided by a material of low thermal conductivity, and low eddy current heating sample holder in vacuum vessel. A temperature sensor and noninductive heater have been incorporated in the sample holder allowing a rapid sample change. The main part of the data is obtained in the calorimetric measurement is used for calibration. The focus is on the accuracy and calibrations required to predict the actual ac losses in HTS. This setup has the advantage of being able to measure the total ac loss under the influence of a continuous moving field as experienced by any rotating machines.

Microwave ac Zeeman force for ultracold atoms

NASA Astrophysics Data System (ADS)

Fancher, C. T.; Pyle, A. J.; Rotunno, A. P.; Aubin, S.

2018-04-01

We measure the ac Zeeman force on an ultracold gas of 87Rb due to a microwave magnetic field targeted to the 6.8 GHz hyperfine splitting of these atoms. An atom chip produces a microwave near field with a strong amplitude gradient, and we observe a force over three times the strength of gravity. Our measurements are consistent with a simple two-level theory for the ac Zeeman effect and demonstrate its resonant, bipolar, and spin-dependent nature. We observe that the dressed-atom eigenstates gradually mix over time and have mapped out this behavior as a function of magnetic field and detuning. We demonstrate the practical spin selectivity of the force by pushing or pulling a specific spin state while leaving other spin states unmoved.

A type III ACC synthase, ACS7, is involved in root gravitropism in Arabidopsis thaliana

PubMed Central

Chang, Ing-Feng

2013-01-01

Ethylene is an important plant hormone that regulates developmental processes in plants. The ethylene biosynthesis pathway is a highly regulated process at both the transcriptional and post-translational level. The transcriptional regulation of these ethylene biosynthesis genes is well known. However, post-translational modifications of the key ethylene biosynthesis enzyme 1-aminocyclopropane-1-carboxylate (ACC) synthase (ACS) are little understood. In vitro kinase assays were conducted on the type III ACS, AtACS7, fusion protein and peptides to determine whether the AtACS7 protein can be phosphorylated by calcium-dependent protein kinase (CDPK). AtACS7 was phosphorylated at Ser216, Thr296, and Ser299 by AtCDPK16 in vitro. To investigate further the function of the ACS7 gene in Arabidopsis, an acs7-1 loss-of-function mutant was isolated. The acs7-1 mutant exhibited less sensitivity to the inhibition of root gravitropism by treatment with the calcium chelator ethylene glycol tetraacetic acid (EGTA). Seedlings were treated with gradient concentrations of ACC. The results showed that a certain concentration of ethylene enhanced the gravity response. Moreover, the acs7-1 mutant was less sensitive to inhibition of the gravity response by treatment with the auxin polar transport inhibitor 1-naphthylphthalamic acid, but exogenous ACC application recovered root gravitropism. Altogether, the results indicate that AtACS7 is involved in root gravitropism in a calcium-dependent manner in Arabidopsis. PMID:23943848

A type III ACC synthase, ACS7, is involved in root gravitropism in Arabidopsis thaliana.

PubMed

Huang, Shih-Jhe; Chang, Chia-Lun; Wang, Po-Hsun; Tsai, Min-Chieh; Hsu, Pang-Hung; Chang, Ing-Feng

2013-11-01

Ethylene is an important plant hormone that regulates developmental processes in plants. The ethylene biosynthesis pathway is a highly regulated process at both the transcriptional and post-translational level. The transcriptional regulation of these ethylene biosynthesis genes is well known. However, post-translational modifications of the key ethylene biosynthesis enzyme 1-aminocyclopropane-1-carboxylate (ACC) synthase (ACS) are little understood. In vitro kinase assays were conducted on the type III ACS, AtACS7, fusion protein and peptides to determine whether the AtACS7 protein can be phosphorylated by calcium-dependent protein kinase (CDPK). AtACS7 was phosphorylated at Ser216, Thr296, and Ser299 by AtCDPK16 in vitro. To investigate further the function of the ACS7 gene in Arabidopsis, an acs7-1 loss-of-function mutant was isolated. The acs7-1 mutant exhibited less sensitivity to the inhibition of root gravitropism by treatment with the calcium chelator ethylene glycol tetraacetic acid (EGTA). Seedlings were treated with gradient concentrations of ACC. The results showed that a certain concentration of ethylene enhanced the gravity response. Moreover, the acs7-1 mutant was less sensitive to inhibition of the gravity response by treatment with the auxin polar transport inhibitor 1-naphthylphthalamic acid, but exogenous ACC application recovered root gravitropism. Altogether, the results indicate that AtACS7 is involved in root gravitropism in a calcium-dependent manner in Arabidopsis.

DC and AC conductivity properties of bovine dentine hydroxyapatite (BDHA)

NASA Astrophysics Data System (ADS)

Dumludag, F.; Gunduz, O.; Kılıc, O.; Ekren, N.; Kalkandelen, C.; Ozbek, B.; Oktar, F. N.

2017-12-01

Bovine dentine bio-waste may be used as a potential natural source of hydroxyapatite (BDHA), thus extraction of bovine dentin hydroxyapatite (BDHA) from bio-waste is significantly important to fabricate in a simple, economically and environmentally preferable. DC and AC conductivity properties of BDHA were investigated depending on sintering temperature (1000ºC - 1300°C) in air and vacuum (<10-2 mbar) ambient at room temperature. DC conductivity measurements performed between -1 and 1 V. AC conductivity measurements performed in the frequency range of 40 Hz - 100 kHz. DC conductivity results showed that dc conductivity values of the BDHA decrease with increasing sintering temperature in air ambient. It is not observed remarkable/systematic behavior for ac conductivity depending on sintering temperature.