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Sample records for acute proximal humerus

  1. Proximal humerus fractures.

    PubMed

    Price, Matthew C; Horn, Pamela L; Latshaw, James C

    2013-01-01

    Proximal humerus fractures are among the most common fractures associated with osteoporosis. With an aging population, incidence of these fractures will only increase. The proximal humerus not only forms the lateral portion of the shoulder articulation but also has significant associations with musculoskeletal and neurovascular structures. As a result, fractures of the proximal humerus can significantly impact not only the function of the shoulder joint, but the health and function of the entire upper extremity as well. Understanding of these fractures, the management options, and associated nursing care, can help reduce morbidity rate and improve functional outcomes.

  2. Hemiarthroplasty versus reverse total shoulder arthroplasty for acute proximal humerus fractures in elderly patients.

    PubMed

    Garrigues, Grant E; Johnston, Peter S; Pepe, Matthew D; Tucker, Bradford S; Ramsey, Matthew L; Austin, Luke S

    2012-05-01

    Proximal humerus fractures are the third most common fracture in elderly patients. Hemiarthroplasty has been the treatment of choice in patients with bone quality and fracture patterns not amenable to open reduction and internal fixation. Reverse total shoulder arthroplasty is a newer option that appears to be less dependent on tuberosity healing than hemiarthroplasty. The authors hypothesized that reverse total shoulder arthroplasty provides improved functional outcomes compared with hemiarthroplasty for fractures in elderly patients.A retrospective review was performed of all patients treated with arthroplasty for acute proximal humerus fractures in an orthopedic practice using a Current Procedural Terminology code search, patient charts, and radiographs. Validated outcome scores were used to assess satisfaction, function, and general well-being. Twenty-three patients were treated for acute proximal humerus fractures (11 reverse total shoulder arthroplasties and 12 hemiarthroplasties). Three patients were lost to follow-up, and 6 patients were deceased. Mean follow-up was 3.6 years (range, 1.3-8 years). Reverse total shoulder arthroplasty outperformed hemiarthroplasty with regard to forward flexion, American Shoulder and Elbow Society score, University of Pennsylvania shoulder score, and Single Assessment Numerical Evaluation score.Reverse total shoulder arthroplasty is a reliable option for acute, proximal humerus fractures that are not amenable to closed treatment or reconstruction in elderly patients. Improved functional outcomes when compared with hemiarthroplasty must be balanced against the increased cost and limited life expectancy of patients with this injury.

  3. Reverse shoulder arthroplasty in acute fractures of the proximal humerus: A systematic review

    PubMed Central

    Brorson, Stig; Rasmussen, Jeppe V.; Olsen, Bo S.; Frich, Lars H.; Jensen, Steen L.; Hróbjartsson, Asbjørn

    2013-01-01

    The indications for surgical intervention in complex fractures of the proximal humerus are disputed. In elderly patients with poor bone stock it may be impossible to obtain satisfactory fixation of the tuberosities to a hemiarthroplasty (HA). In such cases primary insertion of a reverse shoulder arthroplasty (RSA) has been suggested. We aimed to review clinical studies reporting benefits and harms of RSA in acute fractures. A systematic review. We included 18 studies containing 430 RSA in acute fractures. We found no randomized clinical trials. Four studies compared outcome after RSA with a historical control group of HA. The median constant score was 58 (range 44-68) which is comparable to previous reviews of HA in 4-part fractures. Complications included dislocation, infection, hematoma, instability, neurological injury, reflex sympathetic dystrophy, intraoperative fractures, periprosthetic fractures, and baseplate failure. Scapular notching was reported in 11 studies with a median value of 25% (range 0-94). Heterogeneity of study designs and lack of primary data precluded statistical pooling of data. No high quality evidence was identified. Based on the available evidence the use of RSA in acute fractures is questionable. The complication rate was high and the clinical implications of long term scapular notching are worrying. Randomized studies with long term follow up using the latest techniques of tubercular reinsertion in RSA toward HA should be encouraged. PMID:23960366

  4. Evaluation and Management of Proximal Humerus Fractures

    PubMed Central

    Khmelnitskaya, Ekaterina; Lamont, Lauren E.; Taylor, Samuel A.; Lorich, Dean G.; Dines, David M.; Dines, Joshua S.

    2012-01-01

    Proximal humerus fractures are common injuries, especially among older osteoporotic women. Restoration of function requires a thorough understanding of the neurovascular, musculotendinous, and bony anatomy. This paper addresses the relevant anatomy and highlights various management options, including indication for arthroplasty. In the vast majority of cases, proximal humerus fractures may be treated nonoperatively. In the case of displaced fractures, when surgical intervention may be pursued, numerous constructs have been investigated. Of these, the proximal humerus locking plate is the most widely used. Arthroplasty is generally reserved for comminuted 4-part fractures, head-split fractures, or fractures with significant underlying arthritic changes. Reverse total shoulder arthroplasty is reserved for patients with a deficient rotator cuff, or highly comminuted tuberosities. PMID:23316376

  5. Management of proximal humerus fractures in adults

    PubMed Central

    Vachtsevanos, Leonidas; Hayden, Lydia; Desai, Aravind S; Dramis, Asterios

    2014-01-01

    The majority of proximal humerus fractures are low-energy osteoporotic injuries in the elderly and their incidence is increasing in the light of an ageing population. The diversity of fracture patterns encountered renders objective classification of prognostic value challenging. Non-operative management has been associated with good functional outcomes in stable, minimally displaced and certain types of displaced fractures. Absolute indications for surgery are infrequent and comprise compound, pathological, multi-fragmentary head-splitting fractures and fracture dislocations, as well as those associated with neurovascular injury. A constantly expanding range of reconstructive and replacement options however has been extending the indications for surgical management of complex proximal humerus fractures. As a result, management decisions are becoming increasingly complicated, in an attempt to provide the best possible treatment for each individual patient, that will successfully address their specific fracture configuration, comorbidities and functional expectations. Our aim was to review the management options available for the full range of proximal humerus fractures in adults, along with their specific advantages, disadvantages and outcomes. PMID:25405098

  6. Impacted valgus fractures of the proximal humerus.

    PubMed

    Ribeiro, Fabiano Rebouças; Takesian, Fernando Hovaguim; Bezerra, Luiz Eduardo Pimentel; Filho, Rômulo Brasil; Júnior, Antonio Carlos Tenor; da Costa, Miguel Pereira

    2016-01-01

    Impacted valgus fractures of the proximal humerus are considered to be a special type fracture, since impaction of the humeral head on the metaphysis with maintenance of the posteromedial periosteum improves the prognosis regarding occurrences of avascular necrosis. This characteristic can also facilitate the reduction maneuver and increase the consolidation rate of these fractures, even in more complex cases. The studies included were obtained by searching the Bireme, Medline, PubMed, Cochrane Library and Google Scholar databases for those published between 1991 and 2013. The objective of this study was to identify the most common definitions, classifications and treatment methods used for these fractures in the orthopedic medical literature.

  7. Axillary artery injury as a complication of proximal humerus fractures.

    PubMed

    McLaughlin, J A; Light, R; Lustrin, I

    1998-01-01

    Proximal humerus fractures are common injuries and represent approximately 5% of all fractures. These fractures are infrequently associated with neurovascular injuries. Brachial plexus injuries are uncommon, whereas axillary artery injuries are rare. A review of 19 previously reported cases of axillary artery injury after proximal humerus fracture revealed that 84% occurred in patients older than 50 years, 53% were associated with brachial plexus injury, and 21% resulted in upper extremity amputation. This study describes a case of axillary artery injury after proximal humerus fracture and, on the basis of a literature review, offers suggestions for the early diagnosis and effective treatment of this uncommon injury.

  8. Post-traumatic osteonecrosis of the proximal humerus.

    PubMed

    Patel, Shelain; Colaco, Henry B; Elvey, Michael E; Lee, Marcus H

    2015-10-01

    Post-traumatic osteonecrosis of the proximal humerus represents a challenging problem to the surgeon. It is commonly seen following multi-fragmentary fractures of the proximal humerus which may affect the long-term functional recovery after such injuries. This review summarises the current evidence on risk factors, reasons why estimating its epidemiology is difficult, the vascular supply of the humeral head, classification, and management options.

  9. Design and Clinical Application of Proximal Humerus Memory Connector

    NASA Astrophysics Data System (ADS)

    Xu, Shuo-Gui; Zhang, Chun-Cai

    2011-02-01

    Treatment for comminuted proximal humerus fractures and nonunions are a substantial challenge for orthopedic surgeons. Plate and screw fixation does not provide enough stability to allow patients to begin functional exercises early after surgery. Using shape memory material nickel titanium alloy, we designed a new device for treating severe comminuted proximal humerus fractures that accommodates for the anatomical features of the proximal humerus. Twenty-two cases of comminuted fracture, malunion, and nonunion of the proximal humerus were treated with the proximal humeral memory connector (PHMC). No external fixation was needed after the operation and patients began active shoulder exercises an average of 8 days after the operation. Follow-up evaluation (mean 18.5 months) revealed that bone healing with lamellar bone formation occurred an average of 3.6 months after surgery for the fracture cases and 4.5 months after surgery for the nonunion cases. Average shoulder function was 88.5 according to the criteria of Michael Reese. PHMC is an effective new device to treat comminuted proximal humerus fractures and nonunions. The use of this device may reduce the need for shoulder joint arthroplasty.

  10. Proximal humerus fracture after keyhole biceps tenodesis.

    PubMed

    Reiff, Stefanie N; Nho, Shane J; Romeo, Anthony A

    2010-07-01

    A biceps tenodesis is a common surgical procedure that is often carried out in conjunction with other surgical shoulder repairs to relieve biceps tendonitis. This case presents a 50-year-old woman who suffered a humerus fracture following an open keyhole biceps tenodesis. The potential reasons for the fracture as well as a brief analysis of the technique itself are presented. To our knowledge, this is the first case report of a humerus fracture following keyhole biceps tenodesis in the English-language literature.

  11. Metastatic transitional cell carcinoma in proximal humerus of a dog

    PubMed Central

    Malek, Sarah; Murphy, Kimberly A.; Nykamp, Stephanie G.; Allavena, Rachel

    2011-01-01

    Transitional cell carcinoma (TCC) was diagnosed in the proximal humerus of a dog that was presented with persistent right forelimb lameness with no clinical signs of urinary tract involvement. A diagnosis of TCC was made from surgical biopsy of the humeral lesion with subsequent necropsy revealing the prostatic urethra as the primary site of the tumor. PMID:22379204

  12. [Fibrocartilaginous mesenchymoma of the proximal humerus: case report].

    PubMed

    Masquijo, Julio Javier; Sartori, Federico; Innocenti, Sergio

    2014-10-01

    Fibrocartilaginous mesenchymoma (FCM) is a rare tumor that primarily affects the long bones. Few cases have been reported since its description. A case of a 4-year-old boy with FCM located in the humerus is presented. Radiological examination showed an expansive lytic lesion located in the metaphyseal proximal humerus. Magnetic resonance imaging showed soft tissue expansion. Histopathological diagnosis was confirmatory of FCM. Curettage, adjuvant phenolization, and bone grafting with bone substitute, and autologous bone marrow was performed. During a follow-up period of 2 years, there was no evidence of disease progression. FCM should be considered in the differential diagnosis of lytic bone lesions in children and adolescents.

  13. Intramedullary Nailing for Pathological Fractures of the Proximal Humerus

    PubMed Central

    Choi, Eun-Seok; Han, Ilkyu; Cho, Hwan Seong; Park, In Woong; Park, Jong Woong

    2016-01-01

    Background Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. Methods We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes. Results The mean follow-up period was 14.2 months. The mean Musculoskeletal Tumor Society functional score and Karnofsky performance status scale score were 27.7 and 75.6, respectively. Improvement of pain assessed using the visual analogue scale was 6.2 on average. Thirty-one patients (97%) experienced no pain after surgery. The mean ranges of forward flexion and abduction were 115° and 112.6°, respectively. All patients achieved stability and had no local recurrence without failure of fixation until the last follow-up. Conclusions Proximal interlocking IM nailing with cement augmentation appears to be a reliable treatment option for pathological or impending fractures of the proximal humerus in selected patients with metastatic tumors, even with extensive bone destruction. PMID:27904730

  14. Conservative Treatment for Bilateral Displaced Proximal Humerus Head Fracture

    PubMed Central

    Velutini-Becker, Ricardo; Aguilar-Alcalá, Luis D

    2016-01-01

    Proximal humerus fracture represents five to eight percent of all fractures and is twice as common in women than in men. Most cases of displaced fracture of the proximal humerus are treated surgically; it is probable that more cases are preferred to be treated surgically greater than required. The optimal treatment for these fractures remains controversial, but physicians have a tendency to treat via open reduction and fixation with angular locking plates or glenohumeral arthroplasty.  We present a case of a 71-year-old woman with bilateral displaced proximal humeral fracture. Conservative treatment was initiated with two hanging casts, achieving radiological reduction on week one. After two additional weeks of casting, treatment continued with radiologic control and home physical therapy, ultimately an excellent functional outcome and adequate radiological reduction was obtained.    Even in bilaterally displaced proximal humerus fractures, conservative treatment can be an efficient option, reducing complications, reaching adequate functional results and acceptable radiographic reduction.​ PMID:27489750

  15. Reverse shoulder arthroplasty for the management of proximal humerus fractures.

    PubMed

    Jobin, Charles M; Galdi, Balazs; Anakwenze, Oke A; Ahmad, Christopher S; Levine, William N

    2015-03-01

    The use of reverse shoulder arthroplasty is becoming increasingly popular for the treatment of complex three- and four-part proximal humerus fractures in the elderly compared with the often unpredictable and poor outcomes provided by open reduction and internal fixation and by hemiarthroplasty. Inferior results with plate osteosynthesis are often a result of complications of humeral head osteonecrosis, loss of fixation, and screw penetration through the humeral head, whereas major concerns with hemiarthroplasty are tuberosity resorption, malunion, and nonunion resulting in pseudoparalysis. Comparative studies support the use of reverse shoulder arthroplasty in elderly patients with complex proximal humerus fractures because the functional outcomes and relief of pain are reliably improved. Repair and union of the greater tuberosity fragment during reverse shoulder arthroplasty demonstrates improved external rotation, clinical outcomes, and patient satisfaction compared with outcomes after tuberosity resection, nonunion, or resorption. Satisfactory results can be obtained with careful preoperative planning and attention to technical details.

  16. Proximal Humerus Fracture Plating Through the Extended Anterolateral Approach.

    PubMed

    Gardner, Michael J

    2016-08-01

    Several approaches to the proximal humerus for fracture fixation are possible. The traditional utilitarian approach to the shoulder, the deltopectoral, has distinct disadvantages when performing fracture reduction and locked plating. The anterolateral acromial approach exploits the intermuscular plane between the anterior and middle heads of the deltoid. After identifying the position of the axillary nerve as it crosses this interval, fracture reduction and fixation is performed. Direct access to both the greater and the lesser tuberosities is facilitated. The cancellous surface of the humeral head fragment provides an excellent surface for direct manipulation without further endangering the extraosseous soft tissue attachments.

  17. Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fracture

    PubMed Central

    Pathak, Abhishek; Gaur, Sanjiv

    2016-01-01

    Introduction Proximal humerus fractures account for approximately 5% of all fractures. Stable minimally displaced fractures can be treated nonoperatively but the management of displaced fractures remain controversial with various modalities of treatment available. Locking plates provide stable fixation and enable early postoperative mobilization specially in osteoporotic proximal humerus fracture. Aim To evaluate the functional outcome of locking plate fixation and to compare the results of two approaches used for fixation. Materials and Methods This prospective study was conducted at a tertiary level hospital between September 2011 to December 2013. PHILOS plates were used for internal fixation of displaced proximal humerus fractures Neer’s type 2 part, 3 part and 4 part fractures on 26 patients (M/F ratio 1.36:1; mean age 46 years). According to Neer classification, 5,12 and 9 patients had displaced 2, 3 and 4 part fractures respectively. Deltopectoral and deltoid splitting approaches were used for fixation on 13 patients each. Functional outcome was assessed using Constant-Murley shoulder score. Graphpad software version 6.0 was used with Chi-square test and Fisher-exact test are used to compare data. The p-value< 0.05 is considered significant. Results Of the 26 patients, all fractures united radiologically and clinically and average constant score at final follow-up was 72.5. At the final follow-up 8 patients had good score, 10 patients had moderate score, 6 patients had excellent outcome and 2 patients had poor outcome according to Constant score. Mean time to union was 12.3 weeks (9 –15 weeks). Four complications (15.4%) were encountered, 2 cases of varus malunion, 1 case of wound infection which required wound debridement and 1 case of screw cut-out in which screw removal was done. Mean constant score in delto splitting approach was 70.9 and 74 in deltopectoral group (p-value= 0.54). No significant difference existed in constant score in 2 approaches

  18. Influence of Early Bisphosphonate Administration for Fracture Healing in Patients with Osteoporotic Proximal Humerus Fractures

    PubMed Central

    Yoo, Jae-Sung; Ryu, Jee-Won; Yu, Kun-Woong

    2016-01-01

    Background Bisphosphonates are generally known to adversely affect fracture healing because they inhibit osteoclastic bone resorption. However, some authors argue that bisphosphonates have no adverse effect on the restoration of the mechanical integrity of long bones after fractures. It is unclear whether bisphosphonates can be initiated safely in patients with acute proximal humerus fractures. The aim of this study was to determine whether the early use of a bisphosphonate affects healing and outcomes of osteoporotic proximal humerus fractures treated with a locking compression plate. Methods Between August 2004 and June 2013, a total of 82 osteoporotic patients who underwent locking plate fixation of proximal humerus fractures were enrolled retrospectively. The patients were divided into two groups according to the timing of the commencement of treatment with alendronate after surgery: group A (n = 34, initiation of the bisphosphonate treatment within two weeks after surgery) and group B (n = 48, control group, initiation of the treatment three months after surgery). Patients were assessed for radiographic union at 2, 6, 10, and 16 weeks, 6 months, and 1 year after surgery. Clinical assessments were performed using the Constant score and American Shoulder and Elbow Surgeons (ASES) score at 1 year after surgery. Results No significant differences were observed between the two groups with respect to radiographic and clinical outcomes after locking plate fixation. All patients obtained fracture union, and the mean time to radiographic union was similar in group A and group B (6.3 and 6.6 weeks, respectively; p = 0.67). Conclusions This study shows that the early initiation of bisphosphonate treatment does not affect bone union or clinical outcomes in patients with an osteoporotic proximal humerus fracture treated by locking compression plate fixation. PMID:27904727

  19. Treatment of proximal humerus fractures in the elderly

    PubMed Central

    Launonen, Antti P; Lepola, Vesa; Flinkkilä, Tapio; Laitinen, Minna; Paavola, Mika; Malmivaara, Antti

    2015-01-01

    Background and purpose There is no consensus on the treatment of proximal humerus fractures in the elderly. Patients and methods We conducted a systematic search of the medical literature for randomized controlled trials and controlled clinical trials from 1946 to Apr 30, 2014. Predefined PICOS criteria were used to search relevant publications. We included randomized controlled trials involving 2- to 4-part proximal humerus fractures in patients over 60 years of age that compared operative treatment to any operative or nonoperative treatment, with a minimum of 20 patients in each group and a minimum follow-up of 1 year. Outcomes had to be assessed with functional or disability measures, or a quality-of-life score. Results After 2 independent researchers had read 777 abstracts, 9 publications with 409 patients were accepted for the final analysis. No statistically significant differences were found between nonoperative treatment and operative treatment with a locking plate for any disability, for quality-of-life score, or for pain, in patients with 3- or 4-part fractures. In 4-part fractures, 2 trials found similar shoulder function between hemiarthroplasty and nonoperative treatment. 1 trial found slightly better health-related quality of life (higher EQ-5D scores) at 2-year follow-up after hemiarthroplasty. Complications were common in the operative treatment groups (10–29%). Interpretation Nonoperative treatment over locking plate systems and tension banding is weakly supported. 2 trials provided weak to moderate evidence that for 4-part fractures, shoulder function is not better with hemiarthroplasty than with nonoperative treatment. 1 of the trials provided limited evidence that health-related quality of life may be better at 2-year follow-up after hemiarthroplasty. There is a high risk of complications after operative treatment. PMID:25574643

  20. Risk factors associated with the occurrence of proximal humerus fractures in patients with rheumatoid arthritis: a custom strategy for preventing proximal humerus fractures.

    PubMed

    Ochi, Kensuke; Furuya, Takefumi; Ishibashi, Mina; Watanabe, Makiko; Ikari, Katsunori; Taniguchi, Atsuo; Yamanaka, Hisashi; Momohara, Shigeki

    2016-02-01

    To our knowledge, no prior report focused on the risk factors for proximal humerus fractures in patients with rheumatoid arthritis. The purpose of this study was to evaluate the association between potential risk factors and the occurrence of proximal humerus fractures in patients with rheumatoid arthritis. A total of 11,907 patients with rheumatoid arthritis were enrolled in our observational cohort rheumatoid arthritis study between 2000 and 2012. Self-reported proximal humerus fractures were verified using the patients' medical records. Cox proportional hazard models were used to analyze the independent contribution of risk factors to the occurrence of proximal humerus fractures. During follow-up (mean 5.6 years), 92 proximal humerus fractures were verified in 91 patients. Multivariate Cox regression analyses estimated that the hazard ratios of sustaining a proximal humerus fracture were 1.37 for every 10-year increase in age [95 % confidence interval (CI) 1.10-1.70; P < 0.01], 1.95 for increases in serum C-reactive protein levels (mg/100 mL; 95 % CI 1.15-3.34; P < 0.05), 2.13 for a history of fractures (95 % CI 1.34-3.40; P < 0.01), 1.07 for the daily prednisolone dose (per mg; 95 % CI 1.01-1.13; P < 0.05), and 1.97 for oral bisphosphonate use (95 % CI 1.20-3.23; P < 0.01). Better control of rheumatoid arthritis with a smaller daily prednisolone dose in elderly patients with a history of fractures may be important for preventing proximal humerus fractures.

  1. Axillary Artery Injury Associated with Proximal Humerus Fracture: A Report of 6 Cases

    PubMed Central

    Peters, Rinne M.; Menendez, Mariano E.; Mellema, Jos J.; Ring, David; Smith, R. Malcolm

    2017-01-01

    Proximal humerus fractures are common, but associated injury of the axillary artery is uncommon. The majority of published blunt traumatic axillary artery injuries are associated with anterior glenohumeral dislocation; a few are associated with isolated proximal humerus fractures or fracture-dislocation. Experience within our institution demonstrates that axillary artery injury is often unrecognized on initial presentation owing to palpable peripheral pulses and the absence of ischemia and places the hand at risk of necrosis and amputation if there is prolonged ischemia and the forearm at risk of compartment syndrome after revascularization. Accurate physical examination in combination with a low threshold for Doppler examination or angiography can establish the diagnosis of axillary artery injury. We present 6 cases of axillary artery injury associated with proximal humerus fractures in order to highlight the potential for this vascular injury in the setting of a proximal humerus fracture. PMID:28271088

  2. A new surgical technique for extensive exposure of the proximal humerus and shoulder.

    PubMed

    Puthezhath, Kishore; Puthur, Dominic K

    2013-11-01

    Different techniques have been described for surgical exposure of the shoulder and proximal humerus. However, the neurovascular and muscular anatomy in the proximity of the humerus precludes the use of a "safe" extensive approach. We here present a new technique for extensive exposure of the proximal humerus and shoulder for wide resection of tumors. By reflecting the deltoid with its origin as an osteomyocutaneous flap downwards and backwards, the entire shoulder, including the rotator cuff and proximal humerus, are exposed with minimal damage to the blood supply and function of the deltoid muscle. This approach, which is a logical combination of anterior, transacromial and deltoid splitting approaches, was used in 17 patients, 11 achieving satisfactory functional results. Our new surgical approach reduces intraoperative damage to the blood supply of the deltoid and results in better function of the shoulder postoperatively because both the powerful intermediate muscle fibers of the deltoid and its acromial origin remain intact.

  3. Open reduction internal fixation for proximal humerus fractures indications, techniques, and pitfalls.

    PubMed

    Shulman, Brandon S; Egol, Kenneth A

    2013-01-01

    Proximal humerus fractures account for approximately 5% of all fractures. It is estimated that due to our aging population, orthopaedic surgeons will see a three-fold increase in proximal humerus fractures over the next 30 years. Internal fixation with locked plating is the current mainstay of treatment for functionally active patients who desire minimal loss of function. A thorough understanding of the indications, techniques, and drawbacks of treatment with internal fixation is essential to achieve the highest quality of patient care.

  4. Proximal humeral reconstruction using nail cement spacer in primary and metastatic tumours of proximal humerus.

    PubMed

    Kundu, Zile Singh; Gogna, Paritosh; Gupta, Vinay; Kamboj, Pradeep; Singla, Rohit; Sangwan, Sukhbir Singh

    2013-11-01

    Limb salvage surgery for malignant tumours of proximal humerus is an operative challenge, where the surgeon has to preserve elbow and hand functions and retain shoulder stability with as much function as possible. We treated 14 consecutive patients with primary malignant or isolated metastasis of proximal humerus with surgical resection and reconstruction by nail cement spacer. There were 8 females and 6 males, with a mean age of 28.92 years (range 16-51 years) and a mean follow-up of 30.14 months (range 12-52 months). The diagnosis was osteosarcoma in 8 patients, chondrosarcoma in 4 patients and metastasis from thyroid and breast carcinoma in 1 patient each. One of our patients had radial nerve neuropraxia, 1 developed inferior subluxation and 3 developed distant metastasis. Two patients died of disease and one developed local recurrence leading to forequarter amputation, leaving a total of 11 patients with functional extremities for assessment at the time of final follow-up which was done using the Musculoskeletal Tumour Society (MSTS) score. Though we were able to preserve the elbow, wrist and hand functions in all patients, the abductor mechanism, deltoid muscle and axillary nerve were not salvageable in any of cases. The mean MSTS score at the time of final follow-up was 19.09. Thus, proximal humeral reconstruction using nail cement spacer is a technical simple, cost-effective and reproducible procedure which makes it a reliable option in subset of patients where the functions around the shoulder cannot be preserved despite costlier prosthesis.

  5. The Mechanical Benefit of Medial Support Screws in Locking Plating of Proximal Humerus Fractures

    PubMed Central

    Liu, Yanjie; Pan, Yao; Zhang, Wei; Zhang, Changqing; Zeng, Bingfang; Chen, Yunfeng

    2014-01-01

    Background The purpose of this study was to evaluate the biomechanical advantages of medial support screws (MSSs) in the locking proximal humeral plate for treating proximal humerus fractures. Methods Thirty synthetic left humeri were randomly divided into 3 subgroups to establish two-part surgical neck fracture models of proximal humerus. All fractures were fixed with a locking proximal humerus plate. Group A was fixed with medial cortical support and no MSSs; Group B was fixed with 3 MSSs but without medial cortical support; Group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsional stiffness, shear stiffness, and failure tests were performed. Results Constructs with medial support from cortical bone showed statistically higher axial and shear stiffness than other subgroups examined (P<0.0001). When the proximal humerus was not supported by medial cortical bone, locking plating with medial support screws exhibited higher axial and torsional stiffness than locking plating without medial support screws (P≤0.0207). Specimens with medial cortical bone failed primarily by fracture of the humeral shaft or humeral head. Specimens without medial cortical bone support failed primarily by significant plate bending at the fracture site followed by humeral head collapse or humeral head fracture. Conclusions Anatomic reduction with medial cortical support was the stiffest construct after a simulated two-part fracture. Significant biomechanical benefits of MSSs in locking plating of proximal humerus fractures were identified. The reconstruction of the medial column support for proximal humerus fractures helps to enhance mechanical stability of the humeral head and prevent implant failure. PMID:25084520

  6. EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH PROXIMAL HUMERUS FRACTURE TREATED AT HOSPITAL SÃO PAULO, BRAZIL

    PubMed Central

    de Oliveira, Ana Paula Cortes; Mestieri, Mariana Christovam; Pontin, José Carlos Baldocchi

    2015-01-01

    ABSTRACT Objective: To analyze the epidemiological aspects of proximal humerus fractures and describe the profile of patients with proximal humerus fractures hospitalized and treated at Hospital São Paulo, between 2008 and 2013. Methods: Hospital records were retrospectively analyzed for surgically treated patients diagnosed with proximal humerus fracture. Age, gender, injury mechanism, length of hospital stay, performed treatment and associated diseases were considered. Results: From all patients studied, 52 were female at their sixth decade of life. As for the injury mechanism, fall from height was the main cause for women (88.46%) and for man it was motorcycle accidents (31.42%). Fixation with locked plate was the most frequently used treatment. Conclusion: Most patients were female in their fifth decade of life, injured mainly by fall from height. Fixation with locked plate was the most frequently used treatment and the patients were admitted for 7 days, on average. Level of Evidence II, Retrospective Study. PMID:26981037

  7. Fibular Strut Graft Augmentation for Open Reduction and Internal Fixation of Proximal Humerus Fractures

    PubMed Central

    Saltzman, Bryan M.; Erickson, Brandon J.; Harris, Joshua D.; Gupta, Anil K.; Mighell, Mark; Romeo, Anthony A.

    2016-01-01

    Background: Proximal humerus fractures are common problems plaguing the elderly population. Purpose: The purposes of this study were to determine the outcomes of fibular strut allografts in treatment of proximal humerus fractures with open reduction internal fixation (ORIF) and to present the authors’ preferred surgical technique. The hypothesis was that the use of fibular strut allografts in treating proximal humerus fractures with ORIF will provide low reoperation rates with acceptable outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was registered with PROSPERO and performed with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using 3 publicly available free databases. Therapeutic clinical outcome investigations reporting arthroscopic elbow outcomes with levels of evidence 1 through 4 were eligible for inclusion. All study, subject, and surgical technique demographics were analyzed and compared between continents and countries. Statistics were calculated using Student t tests, 1-way analysis of variance, chi-square tests, and 2-proportion Z tests. Results: Four studies met the inclusion criteria. While there is great heterogeneity existing in the literature surrounding use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures, current evidence shows a humeral head screw penetration rate of 3.7% with acceptable functional outcome scores, with a reoperation rate of 4.4% at a weighted mean 80.78 weeks (1.55 years) of postoperative follow-up. Conclusion: There is great heterogeneity that exists in the literature surrounding the use of a fibular strut allograft as an adjunct to ORIF of proximal humerus fractures. Current evidence shows a screw penetration rate of 3.7% with acceptable functional outcome scores, demonstrating fibular strut allograft is a viable option for treating proximal humerus fractures. PMID:27504463

  8. 3D geometric morphometric analysis of the proximal epiphysis of the hominoid humerus

    PubMed Central

    Arias-Martorell, Julia; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pastor, Juan Francisco; Pérez-Pérez, Alejandro

    2012-01-01

    In this study we perform a three-dimensional geometric morphometric (3D GM) analysis of the proximal epiphysis of the humerus in extant great apes, including humans, in order to accurately describe the functional anatomical differences between these taxa. In addition, a fossil hominin specimen of Australopithecus afarensis was included in a multivariate GM analysis in order to test the potential of this methodological approach for making locomotor inferences from fossil remains. The results obtained show significant differences in proximal humeral morphology among the taxa studied, which had thus far largely remained unnoticed. Based on morphofunctional considerations, these anatomical differences can be correlated to differences in the locomotor repertoires of the taxa, thus confirming that the proximal humerus is suitable for constructing paleobiological inferences about locomotion. Modern humans display markedly divergent features, which set them apart from both the extant great apes and the fossil hominin A. afarensis. The morphology of the proximal epiphysis of the humerus of the latter more closely resembles that of the orangutans, thus suggesting that despite hindlimb adaptations to bipedalism, the forelimb of this taxon was still functionally involved in arboreal behaviors, such as climbing or suspension. PMID:22946496

  9. Open glenohumeral dislocation: skeletonization of the proximal humerus without associated fracture.

    PubMed

    Maroney, Samuel S; Devinney, D Scott

    2011-11-09

    Shoulder dislocations are common injuries. In the realm of high-energy trauma, enough force can be dissipated to violate the entire soft tissue envelope surrounding the shoulder girdle, generating an open injury. This article presents a case of a young man involved in a motorcycle accident in which he sustained an open glenohumeral dislocation with complete skeletonization of the proximal humerus. There were no associated fractures with his injury. Our patient underwent staged irrigation and debridement of his shoulder with delayed tendoligamentous reconstruction of the skeletonized proximal humerus. After reconstruction, he was immobilized for 3 weeks and then began a progressive shoulder rehabilitation protocol. He healed with no evidence of infection, residual instability, or avascular necrosis at his 4-month follow-up examination. At that point, he had regained functional use of his shoulder for activities of daily living and had no pain. His range of active motion was limited to 90° of flexion and abduction, 0° of external rotation, and internal rotation to the L4. He had complete resolution of a sensory and motor axillary neuropraxia that resulted from his initial injury. It was felt that the patient had potential for continued gains in range of motion and strength.Our patient is only the second description of an open glenohumeral dislocation with no associated fractures of the proximal humerus. This skeletonization of the proximal humerus represents a complex soft tissue injury that severely compromises the functional capacity of the shoulder. Understanding the nature of the injury and the involved structures and maintaining a sound treatment algorithm allow orthopedic surgeons to maximize the patient's functional outcome.

  10. OSTEOCHONDROMA OF THE PROXIMAL HUMERUS WITH FRICTIONAL BURSITIS AND SECONDARY SYNOVIAL OSTEOCHONDROMATOSIS.

    PubMed

    De Groote, J; Geerts, B; Mermuys, K; Verstraete, K

    2015-01-01

    We report a case of multiple hereditary exostosis in a 33-year old patient with clinical symptoms of pain and impression of a growing mass of the left shoulder alerting potential risk of malignant transformation of an osteochondroma. Imaging studies illustrated perilesional bursitis surrounding an osteochondroma of the proximal humerus. Malignant transformation was excluded with MRI. Fragments of the osteochondroma were dislocated in the inflammatory synovial bursa illustrating a case of secondary synovial osteochondromatosis.

  11. Evaluation of upper-extremity function following surgical treatment of displaced proximal humerus fractures in children.

    PubMed

    Canavese, Federico; Athlani, Lionel; Marengo, Lorenza; Rousset, Marie; Rouel-Rabiau, Nadege; Samba, Antoine; Andreacchio, Antonio

    2014-03-01

    This study aims to assess the functional outcome of children treated with elastic stable intramedullary nailing (ESIN) for displaced proximal humerus fractures using the short version of the disabilities of the arm, shoulder, and hand outcome questionnaire (Quick DASH). Fifty-eight consecutive children with displaced proximal humerus fractures were treated with ESIN. Fifty-two children (89.7%) were available for follow-up and responded to the questionnaire after hardware removal. Average age at time of injury was 11.1 ± 2.8 years (range, 4-15.9). Among the 52 patients available for evaluation, 37 had a Quick DASH score of 0 (71.1%), seven a score of 2.3 (13.5%), four a score of 4.5 (7.7%), and four a score of 6.5 (7.7%). Shoulder and elbow ranges of motion were comparable with the noninjured side. No skin irritation or local infections were observed. There was no radiographic evidence of delayed union, refracture, hardware migration, or secondary displacement. Mean follow-up was 18.3 ± 8.3 months (range, 6-39.5). Our study reports good functional outcomes in children with closed isolated fractures, both physeal and metaphyseal, of the proximal humerus treated with ESIN. The use of a standardized rating scale is recommended to homogeneously compare functional outcome and may facilitate the comparison of clinical outcome in different patient populations.

  12. [Humerus varus: correction by proximal valgus osteotomy with precontourned plate fixation in children].

    PubMed

    Tallón-López, J; Domínguez-Amador, J J; Andrés-García, J A

    2014-01-01

    Varus deformity of the proximal humerus in children is a little known pathology due to its low incidence of presentation. Progress has been made in recent years in understanding the possible etiology and pathophysiological causes. Radiological criteria for diagnosis and functional impairment that occurs have also been defined. However, there are few reports in the literature about the surgical treatment of this deformity in children. In this paper we present a case of surgical treatment of this deformity by corrective osteotomy fixed with precontoured external maleolar plate osteosynthesis.

  13. Functional outcome after primary hemiarthroplasty in three or four part proximal humerus fracture: A short term followup

    PubMed Central

    Agarwal, Saurabh; Rana, Ashish; Sharma, Rajeev K

    2016-01-01

    Background: Several modalities of treatment are being used for the management of proximal humerus fractures. Primary hemiarthroplasty in proximal humerus fracture is indicated in three or four part fracture or fracture dislocations. It is also indicated if fracture involves a large area of articular cartilage loss and viability of head is doubtful. We studied the functional outcome of hemiarthroplasty in comminuted proximal humerus fracture. Materials and Methods: 29 patients of three or four part proximal humerus fractures, (according to Neer's classification) who underwent primary shoulder hemiarthroplasty were included in this retrospective study. 20 patients were of more than 55 years of age. Functional evaluation based on Constant score and radiological assessment by periodic X-rays were done. All patients were operated in a ‘beach chair position’. The lesser and greater tuberosities were dissected with their tendinous attachments and were later reattached to the proximal humerus for stability of the prosthesis. Cemented prosthesis was used in all cases. Results: Three patients died and two patients were lost to followup during the course of the study, so 24 patients were finally included in the study. Mean Constant score was 56.62 (range 42.5-65.5) after mean followup of 18.28 months (range 12-24 months). Mean anterior elevation was 118.2° (range 75°-150°) and mean active abduction was 102°(range 50°-135°). Nineteen patients (79.16%) were satisfied about their functional outcome. Proximal migration of tuberosity was present in four patients. These patients had decreased abduction with impingement. One patient had higher placement of prosthesis and one patient had radiolucency at bone cement interface. There were no heterotopic ossification, dislocation, superficial, or deep infection. Conclusion: This study showed that hemiarthroplasty in a grossly comminuted proximal humerus fracture is a viable alternative to osteosynthesis. Tuberosity healing

  14. Reverse shoulder replacement after resection of the proximal humerus for bone tumours.

    PubMed

    Kaa, A K S; Jørgensen, P H; Søjbjerg, J O; Johannsen, H V

    2013-11-01

    We investigated the functional outcome in patients who underwent reverse shoulder replacement (RSR) after removal of a tumour of the proximal humerus. A total of 16 patients (ten women and six men) underwent this procedure between 1998 and 2011 in our hospital. Five patients died and one was lost to follow-up. Ten patients were available for review at a mean follow-up of 46 months (12 to 136). Eight patients had a primary and two patients a secondary bone tumour. At final follow up the mean range of active movement was: abduction 78° (30° to 150°); flexion 98° (45° to 180°); external rotation 32° (10° to 60°); internal rotation 51° (10° to 80°). The mean Musculoskeletal Tumor Society score was 77% (60% to 90%) and the mean Toronto Extremity Salvage Score was 70% (30% to 91%). Two patients had a superficial infection and one had a deep infection and underwent a two-stage revision procedure. In two patients there was loosening of the RSR; one dislocated twice. All patients had some degree of atrophy or pseudo-atrophy of the deltoid muscle. Use of a RSR in patients with a tumour of the proximal humerus gives acceptable results.

  15. In-home telerehabilitation for proximal humerus fractures: a pilot study.

    PubMed

    Tousignant, Michel; Giguère, Anne-Marie; Morin, Marilène; Pelletier, Julie; Sheehy, Annie; Cabana, François

    2014-01-01

    The objective of this study was to investigate the feasibility of an in-home telerehabilitation program for proximal humerus fractures. Seventeen patients with proximal humerus fractures were recruited by an orthopedic specialist during emergency room visits. Telerehabilitation treatments were given at the patient's home over an 8-week period using a videoconferencing system. Pain (Short-Form McGill Pain Questionnaire [SF-MPQ]), disabilities including shoulder range of motion (flexion, extension, internal rotation, external rotation, abduction), and upper limb function (Disability of the Arm, Shoulder and Hand questionnaire [DASH]) were measured in face-to-face evaluations before (T1) and immediately after (T2) the program. Participant satisfaction with the health care received was also evaluated at T2 with the Health care satisfaction questionnaire. All the clinical outcomes improved post-intervention (p < 0.05). Also, patient satisfaction was high (overall score of 82 ± 7%). Therefore, in-home teletreatment seems to be a promising way to dispense rehabilitation services for this population.

  16. Reverse total shoulder replacement for nonunion of a fracture of the proximal humerus.

    PubMed

    Zafra, M; Uceda, P; Flores, M; Carpintero, P

    2014-09-01

    Patients with pain and loss of shoulder function due to nonunion of a fracture of the proximal third of the humerus may benefit from reverse total shoulder replacement. This paper reports a prospective, multicentre study, involving three hospitals and three surgeons, of 35 patients (28 women, seven men) with a mean age of 69 years (46 to 83) who underwent a reverse total shoulder replacement for the treatment of nonunion of a fracture of the proximal humerus. Using Checchia's classification, nine nonunions were type I, eight as type II, 12 as type III and six as type IV. The mean follow-up was 51 months (24 to 99). Post-operatively, the patients had a significant decrease in pain (p < 0.001), and a significant improvement in flexion, abduction, external rotation and Constant score (p < 0.001), but not in internal rotation. A total of nine complications were recorded in seven patients: six dislocations, one glenoid loosening in a patient who had previously suffered dislocation, one transitory paresis of the axillary nerve and one infection. Reverse total shoulder replacement may lead to a significant reduction in pain, improvement in function and a high degree of satisfaction. However, the rate of complications, particularly dislocation, was high.

  17. Modular prostheses in the treatment of proximal humerus metastases: review of 40 cases

    PubMed Central

    Scotti, C.; Peretti, G. M.; Fontana, F.; Fraschini, G.

    2008-01-01

    Background The humerus is the second most common site of metastatic bone disease involving long bones. Tumors which have a predilection for dissemination to bone are those of breast, prostate, thyroid, lung and kidney. The rationale for surgical treatment of these lesions is to prevent or treat pathological fractures in order to relieve pain and improve function. Materials and methods Forty patients who had resection of the proximal humerus for metastatic bone disease and reconstruction with a modular prosthesis were retrospectively reviewed. Results Mean functional outcome was 73.1% (Enneking score) and better results were achieved when a reverse prosthesis was implanted. Overall survival was 70% at 1 year, 42.5% at 2 years and 20% at 5 years. Local recurrence occurred in 4 patients, each of whom had initially been treated for a pathological fracture. Conclusions It is important to follow rational guidelines, like those of Capanna and Mirels, in order to prevent pathological fractures and to give the patient a definitive treatment, as the advances in the management of cancer prolong the survival of these patients. In this series, satisfactory results were obtained, giving the patients an acceptable quality of life. PMID:19384474

  18. The overlooked side of convulsion: bilateral posterior fracture and dislocation of proximal humerus.

    PubMed

    Yigit, Mehmet; Yaman, Asli; Yigit, Eda; Turkdogan, Kenan Ahmet

    2016-05-01

    Injuries after an epileptic convulsion have been seen commonly such as burns, head injury and dislocation of the extremities. But fractures of the extremities due to convulsion are rare. External trauma mechanism is not necessary for extremity fractures. Muscle contractions can cause increased load on the skeleton and it can be complicated by dislocation andor fracture of extremities. Almost 1-4% of all the shoulder dislocations are posterior. In this case report we present a 32 year old male patient who had bilateral posterior fracture and dislocation of proximal humerus after convulsion. We would like to emphasize that it is so important to make systemic examination and evaluation of the patients who were admitted to emergency department after epileptic convulsion.

  19. PTH 1-34 (teriparatide) may not improve healing in proximal humerus fractures

    PubMed Central

    2016-01-01

    Background and purpose There is solid evidence from animal experiments that parathyroid hormone (PTH) improves fracture healing. So far, only 3 papers on PTH and fracture repair in humans have been published. They suggest that PTH may enhance fracture healing, but the results do not appear to justify specific clinical recommendations. This study was carried out to determine whether teriparatide enhances fracture healing of proximal humerus fractures. Patients and methods 40 post-menopausal women with a proximal humerus fracture were randomized to either daily injections with 20 µg teriparatide (PTH 1-34 (Forteo)) for 4 weeks or control treatment. At randomization, the patients were asked to assess how their pain at rest and during activity (visual analog scale (VAS)) and also function (DASH score) had been prior to the fracture. At 7 weeks and again at 3 months, their current state was assessed and the tests were repeated, including radiographs. 2 radiologists performed a blind qualitative scoring of the callus at 7 weeks. Callus formation was arbitrarily classified as ”normal” or “better”. Results 39 patients completed the follow-up. The radiographic assessment showed a correct correlation, “better” in the teriparatide group and “normal” in the control group, in 21 of the 39 cases. There were no statistically significant differences in pain, in use of strong analgesics, or in function between the groups at the follow-up examinations. Interpretation There were no radiographic signs of enhanced healing or improved clinical results in the group treated with teriparatide PMID:26179771

  20. Histomorphometric Assessment of Cancellous and Cortical Bone Material Distribution in the Proximal Humerus of Normal and Osteoporotic Individuals

    PubMed Central

    Sprecher, Christoph M.; Schmidutz, Florian; Helfen, Tobias; Richards, R. Geoff; Blauth, Michael; Milz, Stefan

    2015-01-01

    Abstract Osteoporosis is a systemic disorder predominantly affecting postmenopausal women but also men at an advanced age. Both genders may suffer from low-energy fractures of, for example, the proximal humerus when reduction of the bone stock or/and quality has occurred. The aim of the current study was to compare the amount of bone in typical fracture zones of the proximal humerus in osteoporotic and non-osteoporotic individuals. The amount of bone in the proximal humerus was determined histomorphometrically in frontal plane sections. The donor bones were allocated to normal and osteoporotic groups using the T-score from distal radius DXA measurements of the same extremities. The T-score evaluation was done according to WHO criteria. Regional thickness of the subchondral plate and the metaphyseal cortical bone were measured using interactive image analysis. At all measured locations the amount of cancellous bone was significantly lower in individuals from the osteoporotic group compared to the non-osteoporotic one. The osteoporotic group showed more significant differences between regions of the same bone than the non-osteoporotic group. In both groups the subchondral cancellous bone and the subchondral plate were least affected by bone loss. In contrast, the medial metaphyseal region in the osteoporotic group exhibited higher bone loss in comparison to the lateral side. This observation may explain prevailing fracture patterns, which frequently involve compression fractures and certainly has an influence on the stability of implants placed in this medial region. It should be considered when planning the anchoring of osteosynthesis materials in osteoporotic patients with fractures of the proximal humerus. PMID:26705200

  1. The metaphyseal bone defect predicts outcome in reverse shoulder arthroplasty for proximal humerus fracture sequelae.

    PubMed

    Greiner, Stefan; Uschok, Stephan; Herrmann, Sebastian; Gwinner, Clemens; Perka, Carsten; Scheibel, Markus

    2014-06-01

    Reverse shoulder arthroplasty (RSA) represents an established procedure for treatment of fracture sequelae (FS) after proximal humerus fractures. The present work evaluates which factors are of influence for the clinical outcome. Fifty cases (mean age 69, range 44-89) have been evaluated postoperatively clinically [Constant Score (CS)] and radiographically (mean FU 34; range 24-93 months). The type of primary treatment, the amount of a metaphyseal bone defect, the preoperative status of the rotator cuff, the number of previous operative interventions and the type of FS according to Boileau were analysed whether they are of influence for clinical outcome. The mean CS increased significantly from 16.9 ± 6.7 preoperatively to 54.1 ± 15.7 points postoperatively. The CS of primary conservative treatment was significantly higher in comparison to primary operative treatment. Patients with a metaphyseal bone defect of more than 3 cm had significantly lower CS results. Degenerative changes of the teres minor muscle also had a significant negative influence on clinical results. Score results decreased with increasing number of previous operations. There were no significant difference in between patients classified as Boileau type I and II (category 1) compared to types III and IV (category 2). RSA significantly improved the clinical result. A metaphyseal bone defect and preoperative degeneration of the teres minor showed to be negative prognostic factors. Primary operative treatment and the number of previous operations also negatively influenced the clinical result.

  2. Reconstruction of the proximal humerus for bone neoplasm using an anatomic prosthesis-bone graft composite.

    PubMed

    Hartigan, David E; Veillette, Christian J H; Sanchez-Sotelo, Joaquin; Sperling, John W; Shives, Thomas C; Cofield, Robert H

    2012-08-01

    This study assesses function after limb sparing bone tumour resections of the proximal humerus. Twenty-seven patients had an intraarticular resection with reconstruction using an anatomic prosthesis-bone graft composite with average clinical follow-up of 63 years (range: 13-15.8 years). Pain relief was achieved for 22 shoulders (81%); 19 of 25 patients responding (76%) were satisfied. Active elevation averaged 62 degrees, external rotation 25 degrees, and internal rotation to L-4. Complications included instability in 7, nonunion in 4, implant loosening in 3 of these and tumour recurrence in 1. There were 7 reoperations. Using the Neer rating, 19 primary operations (70%) were successful. The Musculoskeletal Tumor Society Score averaged 18.5 (62%), the American Shoulder and Elbow Surgeons functional score 18.4 (37%) with a total score of 51 (51%), and on the Simple Shoulder Test 5.4 of 12 questions were answered affirmatively. This procedure is oncologically safe. There are structural complications, notably shoulder instability. Function ratings are one-third to one-half normal.

  3. Treatment and outcome of malignant bone tumors of the proximal humerus: biological versus endoprosthetic reconstruction

    PubMed Central

    2014-01-01

    Background The purpose of this study was to compare the outcome, complications and survival of the commonly used surgical reconstructions of the proximal humerus after intrarticular tumour resection in our hospital. Methods Between 1998 and 2010, 41 consecutive proximal humeral reconstructions using prosthesis (group P, n = 25) or recycled pasteurized autograft combined with non-vascularised fibula autograft (group B, n = 16) were performed. Results The mean follow-up was 57.7 months. Fourteen patients (8 patients in group P and 6 in group B) died during the follow-up period, the disease-specific survival of patients in group P was 74.5% at 5 years and in group B was 67.0%. Local recurrences were occurred in 3 cases (12.0%) in group P and 2 (12.5%) in group B. Pulmonary metastases were observed in 4 patients (16.0%) in group P and 4 (25.0%) in group B. There was no significant difference in the incidence of local recurrence, pulmonary metastasis or death of disease. Revisions were indicated in 9 patients (36.0%) in group P and 5 (31.25%) in group B. Thought the incidence of revisions was higher in group P, there was no significant difference in these two groups. The Kaplan-Meier 5-year implant survival estimates, with revision for any reason as the end point, were 80.6% and 68.8% for group P and group B, respectively. The mean MSTS Score was 63.6% in group P and 63.0% in group B. These differences were not statistically significant. Conclusions The study could show that prosthetic reconstruction and reconstruction with recycled pasteurized autograft are similar in terms of their local recurrence and metastasis, while the incidence of revisions was higher for patients with prosthetic reconstruction. PMID:24607200

  4. Return-to-Work Following Open Reduction and Internal Fixation of Proximal Humerus Fractures

    PubMed Central

    Dietrich, Michael; Wasmer, Mathias; Platz, Andreas; Spross, Christian

    2014-01-01

    Objectives : Shoulder disorders have an important impact on a patient’s capacity to work. We investigated whether there is a relationship between subjective or objective outcome measures and the ability and time for returning to work (RTW) after a proximal humerus fracture (PHF). Design : Retrospective single-centre study from March 2003 to June 2008. Setting : City hospital, trauma level one centre. Intervention : All PHF stabilized with a PHILOS®. Main Outcome Measurements : Routine follow-up examinations (X-ray, Constant-Murley Score (CMS), Short-Form 36 (SF-36)) were performed prospectively after 1.5, 3, 6 and 12 months or until RTW. Primary interest was the comparison of the outcome scores with the time needed for RTW. Results : 72 patients (52 years (22-64), 37 (51%) women) fulfilled the inclusion criteria. We distinguished “office-workers” (OW) (n = 49, 68%) from patients who worked at a physically demanding job (PW) (n = 23, 32%). Although time for RTW was fundamentally different (42 (OW) vs 118 days (PW), p<0.001), CMS (64.7 vs 64.1) and SF-36 (66.8 vs 69.9) at time of RTW were almost identical. At follow-up, CMS and SF-36 were always lower in the PW group. Conclusion : Jobs which require higher physical demands were likely to influence and to delay RTW. This study identifies cut off values for CMS and SF-36 at which a patient feels capable or willing to RTW after PHF. These values show the importance and impact of a patient’s occupation or demands on RTW. We were able to show, that besides age, sex and fracture, the type of occupation might alter the scores in postoperative outcomes. PMID:25246994

  5. Range of motion implications of proximal humerus fractures: a case study.

    PubMed

    Vochteloo, Anne J H; Krekel, Peter R; van de Sande, Michiel A J; Nagels, Jochem

    2011-12-01

    BACKGROUND: Functional outcome in surgical treatment of Neer three- and four-part proximal humerus fractures (PHF) varies greatly and depends on multiple parameters. Important parameters are the amount and direction of displacement and the necessary reduction of fragments during surgery. These are patient-specific parameters and are difficult to determine using traditional modalities such as radiographs and computed tomography (CT). METHODS: A 58-year-old female patient was reported in the emergency department with a three-part PHF. CT scan images showed that the humeral shaft was medialised and internally rotated, but with a marginally displaced greater tuberosity fragment. Using a bone-determined range of motion (ROM) simulation system, we analysed the CT scan and calculated the required correction needed to prevent post-operative impingement. The fracture was reduced and stabilised by a locking plate, realigning the medialised and internally rotated humeral shaft. The post-operative bone-determined ROM was determined using a post-operative CT scan and the motion simulation system. RESULTS: ROM limitations due to bony impingement visible in the simulations of the pre-operative CT scan had mostly disappeared in the simulations of the post-operative CT scan. Twelve weeks post-surgery the patient has regained close to 80% of her ROM. CONCLUSIONS: This case demonstrates the applicability of a new diagnostic tool that can be used to identify bony impingement and helps in making the decision for conservative or surgical treatment of a PHF. The simulation of post-trauma function was indicative of functional outcome. This supports our claim that the system may be used to facilitate the treatment decision regarding PHF.

  6. Distribution of CD105 and CD166 positive cells in the proximal epiphysis of developing rat humerus.

    PubMed

    Ozbey, Ozlem; Sahin, Zeliha; Acar, Nuray; Ustunel, Ismail

    2010-11-01

    The expression of cell surface receptors, CD105 and CD166, are characteristic of mesenchymal stem cells in cartilage. However, there is limited data regarding their immunolocalization in the cartilage of developing rat epiphysis. The purpose of this study was to determine the presence of CD105 and CD 166 positive cells in the proximal epiphysis of developing rat humerus and specify their zonal distribution with age. The tissues of rat humerus were taken on embryonic day 15 (E15), embryonic day 19 (E19), postnatal day 10 (PN10), postnatal day 20 (PN20) and adult rats and studied for the immunolocalization of CD105 and CD166. Our results showed that CD105 and CD166 positive cells were scattered in early stages of development of humerus epiphysis. For E15, only the hypertrophic zone was positive, whereas for E19 almost all zones of the epiphysis were positively stained for these markers. For PN10 and PN20, the CD105 and CD166 positive cells were mainly localized on the surface of the articular cartilage. In adult articular cartilage the CD105 and CD166 positive cells were localized in the superficial and transitional zones and in the upper regions of the deep zone. Our study provides evidence that in the developing cartilage tissue the localization of CD105 and CD166 positive cells is both dynamic and stage dependent, which may imply the existence of stem cell-like cells in cartilage from an early age to adult.

  7. Reconstruction of the proximal humerus by combined use of extracorporeally-irradiated osteochondral graft and free vascularized fibula following resection of Ewing sarcoma.

    PubMed

    Muramatsu, Keiichi; Fukano, Reiji; Ihara, Koichiro; Iwanaga, Ryuta; Taguchi, Toshihiko

    2010-12-01

    Reconstruction of the proximal humerus following limb-saving resection of malignant bone tumor is extremely challenging. We describe here a novel anatomical reconstruction technique in a young patient. A 6-year-old girl with Ewing sarcoma of the proximal humerus was treated by wide excision of the tumor followed by reconstruction with extracorporeally-irradiated osteoarticular autograft combined with an intramedullary inserted free vascularized fibula graft. Proper alignment of the shoulder joint was maintained with no osteoarthritic changes after 16 months. The resulting limb function was satisfactory. This biological reconstruction method was safe and without serious complication. It is indicated for the reconstruction of non-weight-bearing joints and is ideal for the proximal humerus.

  8. Preliminary results after reconstruction of bony defects of the proximal humerus with an allograft-resurfacing composite.

    PubMed

    Ruggieri, P; Mavrogenis, A F; Guerra, G; Mercuri, M

    2011-08-01

    We retrospectively studied 14 patients with proximal and diaphyseal tumours and disappearing bone (Gorham's) disease of the humerus treated with wide resection and reconstruction using an allograft-resurfacing composite (ARC). There were ten women and four men, with a mean age of 35 years (8 to 69). At a mean follow-up of 25 months (10 to 89), two patients had a fracture of the allograft. In one of these it was revised with a similar ARC and in the other with an intercalary prosthesis. A further patient had an infection and a fracture of the allograft that was revised with a megaprosthesis. In all patients with an ARC, healing of the ARC-host bone interface was observed. One patient had failure of the locking mechanism of the total elbow replacement. The mean post-operative Musculoskeletal Tumor Society score for the upper extremity was 77% (46.7% to 86.7%), which represents good and excellent results; one patient had a poor result (46.7%). In the short term ARC effectively relieves pain and restores shoulder function in patients with wide resection of the proximal humerus. Fracture and infection remain significant complications.

  9. The reverse shoulder prosthesis in the treatment of fractures of the proximal humerus in the elderly.

    PubMed

    Cazeneuve, J F; Cristofari, D-J

    2010-04-01

    We have previously described the short-term outcome of the use of reverse shoulder arthroplasty in the treatment of acute complex proximal humeral fractures in the elderly. We now report the clinical and radiological outcome of 36 fractures at a mean of 6.6 years (1 to 16). Previously, at a mean follow-up of 6 years (1 to 12) the mean Constant score was 58.5; this was reduced to 53 points with the further follow-up. A total of 23 patients (63%) had radiological evidence of loosening of the glenoid component. Nevertheless, only one patient had aseptic loosening of the baseplate at 12 years' follow-up. The reduction in the mean Constant score with longer follow-up and the further development of scapular notching is worrying. New developments in design, bearing surfaces and surgical technique, and further follow-up, will determine whether reverse shoulder arthroplasty has a place in the management of complex proximal humeral fractures in the elderly.

  10. Intramedullary Allograft Fibula as a Reduction and Fixation Tool for Treatment of Complex Proximal Humerus Fractures with Diaphyseal Extension.

    PubMed

    Berkes, Marschall B; Little, Milton Tm; Lazaro, Lionel E; Cymerman, Rachel M; Pardee, Nadine C; Helfet, David L; Dines, Joshua S; Lorich, Dean G

    2013-05-15

    SUMMARY:: In this study, we present a novel technique for reduction and fixation of complex, unstable, proximal humerus fractures with diaphyseal extension with the assistance of fibula allograft. We treated 14 patients using this technique since 2009 and found that it improves the reduction and enhances fixation while making the surgical procedure technically more manageable, and allows for early postoperative motion. In the first part of this study, we describe in detail the indications and surgical technique applied to these fractures. In the second part, we review the clinical and radiographic outcomes of these patients. Using this new technique, we have achieved an excellent union rate with minimal incidence of complications when treating these challenging fractures.

  11. Results of nerve grafting in radial nerve injuries occurring proximal to the humerus, including those within the posterior cord.

    PubMed

    Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio

    2016-01-01

    OBJECT Results of radial nerve grafting are largely unknown for lesions of the radial nerve that occur proximal to the humerus, including those within the posterior cord. METHODS The authors describe 13 patients with proximal radial nerve injuries who were surgically treated and then followed for at least 24 months. The patients' average age was 26 years and the average time between accident and surgery was 6 months. Sural nerve graft length averaged 12 cm. Recovery was scored according to the British Medical Research Council (BMRC) scale, which ranges from M0 to M5 (normal muscle strength). RESULTS After grafting, all 7 patients with an elbow extension palsy recovered elbow extension, scoring M4. Six of the 13 recovered M4 wrist extension, 6 had M3, and 1 had M2. Thumb and finger extension was scored M4 in 3 patients, M3 in 2, M2 in 2, and M0 in 6. CONCLUSIONS The authors consider levels of strength of M4 for elbow and wrist extension and M3 for thumb and finger extension to be good results. Based on these criteria, overall good results were obtained in only 5 of the 13 patients. In proximal radial nerve lesions, the authors now advocate combining nerve grafts with nerve or tendon transfers to reconstruct wrist, thumb, and finger extension.

  12. Fracture of the proximal humerus with disruption of the tendon of the pectoralis major

    PubMed Central

    Berghs, Bart M.; Tongel, Alexander Van; Bo, Thomas De; De Wilde, Lieven F.

    2016-01-01

    Combined pectoralis major disruption and proximal humeral fractures are uncommon. A simple radiologic diagnostic tool which consists of the measurement of the displacement from the humeral shaft to the lateral side of the humeral head (lateral to the outer proximal cortex) can help to diagnose this combined lesion. PMID:26980990

  13. The Role of Reverse Shoulder Arthroplasty in Management of Proximal Humerus Fractures with Fracture Sequelae: A Systematic Review of the Literature

    PubMed Central

    Holton, James; Yousri, Tahir; Arealis, George; Levy, Ofer

    2017-01-01

    Fracture sequelae of the proximal humerus poses a complex management decision due to the frequent deformity and its consequences on the peri-articular soft tissues. These patients are frequently elderly with significant medical comorbidities. Due to the age of the patient there is frequently rotator cuff deficiency and therefore the reverse shoulder arthroplasty (RSA) becomes the arthroplasty of choice. We have performed a systematic review of the literature and report nine studies presenting RSA for the treatment of fracture sequelae of the proximal humerus. It is clear that RSA can improve the range of movement and function following proximal humerus fracture sequelae. However, there is a risk of significant complications including dislocation (16.7%), infection (6.7%), intra-operative fracture (3%) and neurological injury (2.6%). There is a need to invest in future prospective comparative studies and randomised trials to further test RSA in fracture sequelae patients. This will provide us with information regarding the longevity of different prosthesis, outcomes and cost-effectiveness of treatment. PMID:28286622

  14. Shape analysis of the proximal humerus in orthograde and semi-orthograde primates: correlates of suspensory behavior.

    PubMed

    Arias-Martorell, Julia; Tallman, Melissa; Potau, Josep Maria; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-01-01

    "Suspensory locomotion" is an expression that encompasses a series of specialized forms of locomotion that mainly orthograde primates use to achieve below-branch traveling. It implies a number of features in the entire body associated with the use of the forelimb in overhead positions. The glenohumeral joint is one of the main joints involved in effective suspensory locomotion, being subject to a delicate balance between the high degree of mobility and stabilization needed to successfully engage in suspensory behaviors. Here, we present a 3D geometric morphometric study that explores the form of the proximal humerus of six orthograde and semi-orthograde genera (Hylobates, Pongo, Pan, Gorilla, Ateles, and Lagothrix) and a pronograde genus, Colobus, to determine to what extent suspensory locomotor requirements are driving the shape of this epiphysis. Results show the presence of a morphocline related to degree of suspension in the shape of the articular surface, with highly suspensory taxa (i.e., Hylobates) exhibiting particular morphological traits at the articular surface that provide a greater range of circumduction. The placement and orientation of the rotator cuff muscles' insertion sites on the tubercles appear associated with the divergent forces operating at the joint in quadrupedal or above-head use of the hand.

  15. Trials based on specific fracture configuration and surgical procedures likely to be more relevant for decision making in the management of fractures of the proximal humerus

    PubMed Central

    Patel, N. K.; Griffiths, D.; Athanasiou, T.; Gupte, C. M.; Reilly, P.

    2016-01-01

    Objectives The objective of this study was to perform a meta-analysis of all randomised controlled trials (RCTs) comparing surgical and non-surgical management of fractures of the proximal humerus, and to determine whether further analyses based on complexity of fracture, or the type of surgical intervention, produced disparate findings on patient outcomes. Methods A systematic review of the literature was performed identifying all RCTs that compared surgical and non-surgical management of fractures of the proximal humerus. Meta-analysis of clinical outcomes was performed where possible. Subgroup analysis based on the type of fracture, and a sensitivity analysis based on the type of surgical intervention, were also performed. Results Seven studies including 528 patients were included. The overall meta-analysis found that there was no difference in clinical outcomes. However, subgroup and sensitivity analyses found improved patient outcomes for more complex fractures managed surgically. Four-part fractures that underwent surgery had improved long-term health utility scores (mean difference, MD 95% CI 0.04 to 0.28; p = 0.007). They were also less likely to result in osteoarthritis, osteonecrosis and non/malunion (OR 7.38, 95% CI 1.97 to 27.60; p = 0.003). Another significant subgroup finding was that secondary surgery was more common for patients that underwent internal fixation compared with conservative management within the studies with predominantly three-part fractures (OR 0.15, 95% CI 0.04 to 0.63; p = 0.009). Conclusion This meta-analysis has demonstrated that differences in the type of fracture and surgical treatment result in outcomes that are distinct from those generated from analysis of all types of fracture and surgical treatments grouped together. This has important implications for clinical decision making and should highlight the need for future trials to adopt more specific inclusion criteria. Cite this article: S. Sabharwal, N. K. Patel, D

  16. Morphological affinities of the proximal humerus of Epipliopithecus vindobonensis and Pliopithecus antiquus: suspensory inferences based on a 3D geometric morphometrics approach.

    PubMed

    Arias-Martorell, Julia; Alba, David M; Potau, Josep M; Bello-Hellegouarch, Gaëlle; Pérez-Pérez, Alejandro

    2015-03-01

    Suspension plays a major adaptive role in shaping primate postcranial morphology, which therefore enables this positional behavior to be inferred in extinct taxa. The proximal humerus stands as a key region for inferring forelimb suspensory capabilities because its morphology can be effectively linked, from a functional viewpoint, to differences in suspension use between primate taxa. Here we provide an assessment of the suspensory capabilities of two pliopithecoids (Epipliopithecus vindobonensis and Pliopithecus antiquus) by means of a 3D geometric morphometric analysis of proximal humeral shape. The comparative sample includes proximal humeri from eight extant anthropoid genera, as well as other extinct catarrhines (the propliopithecoid Aegyptopithecus zeuxis, the stem hominoid Nyanzapithecus vancouveringorum, and an unascribed small catarrhine, GSP 28062, from the Middle Miocene of Pakistan). Body mass estimates based on allometric regressions of humeral head superoinferior diameter are also provided. Our results support some degree of forelimb suspensory behaviors for Epipliopithecus and GSP 28062. In contrast, and unlike previous qualitative assessments, our analysis shows that P. antiquus has a distinct glenohumeral morphology, much closer to that displayed by generalized arboreal quadrupeds with no evidence of suspensory adaptations (as in Aegyptopithecus and stem hominoids from Africa).

  17. Delta III reverse shoulder arthroplasty in the treatment of complex 3- and 4-part fractures of the proximal humerus: 6 to 42 months of follow up

    PubMed Central

    2013-01-01

    Background There is a growing tendency for complex proximal humerus fractures (PHF) in osteoporotic patients to be treated with reverse shoulder arthroplasty (RSA). It has been proposed that RSA has more benefits than other treatment options. The aim of our study was to investigate preoperative characteristics as well as clinical and radiological outcomes in patients with complex 3- or 4-part PHF who had undergone primary RSA. Methods Patients with a minimum follow-up of 6 months who had undergone a primary RSA after 3- or 4-part PHF in the period between 2008 and 2011 were eligible for the study. Clinical records, X-rays and CT-scans were investigated and a clinical examination was performed. Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant-Murley score (CMS) were calculated. Sixteen patients were examined as part of the study. The mean follow-up was 20 months (range 6-42 months). According to Codman-Hertel classification we encountered 15 Hertel “12” and 1 Hertel “8” type fractures. Results Thirty-two patients (27 female – 84.4%) with a mean age of 72 years underwent operations to treat complex 3- and 4-part fractures of the proximal humerus. Sixteen patients were reexamined. In 14 cases the dominant upper extremity was on the right, in 2 cases it was on the left, in 6 cases the right side was affected and in 10 cases the left side was affected. The mean CMS was 54.8 (range 18-95) and the mean DASH was 37.5 (range 2.9-81). A trend was established between the CMS and dominance of the affected shoulder. The CMS was better if the affected shoulder was on the non-dominant side (p-value 0.051). No statistical difference was noted between age and clinical outcome. Conclusions Our mid-term follow-up shows satisfying results in terms of the treatment of severe displaced fractures in elderly patients with RSA. RSA can provide immediate relief and good shoulder function in elderly patients. Nevertheless, the question of longevity of these

  18. Management of acute 'pink pulseless' hand in pediatric supracondylar fractures of the humerus.

    PubMed

    Ramesh, Perumal; Avadhani, Ashwin; Shetty, Ajoy Prasad; Dheenadhayalan, Jayaramaraju; Rajasekaran, S

    2011-05-01

    The management of a persistent pink pulseless hand after a satisfactory closed reduction in a pediatric supracondylar fracture of the humerus is controversial. Several recent publications have recommended vascular exploration in contrast to a more conservative approach accepted traditionally. We report the results of seven patients with a mean follow-up of 36.6 months with a persistent pulseless, but well-perfused hand postreduction. All patients were managed conservatively without vascular exploration. A palpable return of the radial pulse was seen in six patients at 3 weeks and at 6 weeks follow-up in the other patient with no long-term dysfunction. We believe that the management of a persistent pink pulseless hand remains a 'watchful expectancy'. Surgical exploration should be recommended only if there is either severe pain in the forearm persisting for more than 12 h after the injury or if there are signs of a deteriorating neurological function.

  19. The surgical manegement of metastases to humerus-clinical evaluation.

    PubMed

    Chrobok, Adam; Spindel, Jerzy; Miszczyk, Leszek; Koczy, Bogdan; Pilecki, Bogdan; Jarosz, Adam; Mrozek, Tomasz

    2003-06-30

    Background. The humerus is a common localisation of cancer metastases. The restoration of anatomical order and tumor resection within humerus is important for patients quality of everyday life and for their pain relief. The surgical treatment is one of the most important part of the whole oncological ways of tratment.
    The study objective was a clinical assesment of tumor resection and reconstruction within humerus according to matastasis localisation and the choice of surgical technique.
    Material and methods. In the years 1999-2002 19 patients underwent surgery due to pathological fracture or/and cancer metastasis within humerus. The shaft localisation of the tumor was found in 8 cases and in 11 patients the metastatic foci were found in proximnal diaphysis. In patients with proximal diaphysis localisation of the tumor the partial resection with subsequent joint exchange procedure was made. The humeral shaft metastatic cancer changes were treated by the segmental resection with subsequent surgical cement filling or auto/allogenical bone grafting combined with intramedullary nail or AO/ASIF plate stabilisation. The average follow-up period was 8,5 months.
    Results. In patients after resection with shoulder joint alloplasty according to the Enneking test a very good result was found in 7 and very good in 4 cases.
    In patients with femoral shaft metastatic tumor locaslisation, 6 good and 2 fair results were found. In 1 patient after 2 months rehabilitation a reoperation was needed due to the mechanical destabilisation. The best results were found in patients after intramedullary nailing.An acute soft tissue inflamation requiering surgical treatment was found in 1 patient after shoulder joint replacement.
    Conclusions. After clinical analysis of the material we highly recomend the partial humeral bone resection with subsequent shoulder alloplasty in patients with proximal humeral diaphysis metastatic localisation. In cases with shaft

  20. Transphyseal Distal Humerus Fracture.

    PubMed

    Abzug, Joshua; Ho, Christine Ann; Ritzman, Todd F; Brighton, Brian

    2016-01-01

    Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal distal humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.

  1. Acute Calcific Periarthritis of Proximal Interphalangeal Joint in a Professional Golfer's Hand

    PubMed Central

    Song, Kyung-Jin; Kwak, Hyo-Sung; Lee, Sang-Yong

    2004-01-01

    This report describes a 22-yr-old professional golfer with acute calcific periarthritis of the proximal interphalangeal joint of the 4th finger. We considered that the major cause for this condition may be the repeated minor traumas to the affected site. Also, since this condition is self-limiting, a correct diagnosis is required to avoid unnecessary tests and surgery. PMID:15608408

  2. Cementless anatomical prosthesis for the treatment of 3-part and 4-part proximal humerus fractures: cadaver study and prospective clinical study with minimum 2 years followup

    PubMed Central

    Obert, Laurent; Saadnia, Rachid; Loisel, François; Uhring, Julien; Adam, Antoine; Rochet, Séverin; Clappaz, Pascal; Lascar, Tristan

    2016-01-01

    Introduction: The purpose of this study was to evaluate the functional and radiological outcomes of a cementless, trauma-specific locked stem for 3- and 4-part proximal humeral fractures. Materials and methods: This study consisted of two parts: a cadaver study with 22 shoulders and a multicenter prospective clinical study of 23 fracture patients evaluated at least 2 years after treatment. In the cadaver study, the locked stem (HumelockTM, FX Solutions) and its instrumentation were evaluated. In the clinical study, five senior surgeons at four different hospitals performed the surgical procedures. An independent surgeon evaluated the patients using clinical (Constant score, QuickDASH) and radiological (X-rays, CT scans) outcome measures. Results: The cadaver study allowed us to validate the height landmarks relative to the pectoralis major tendon. In the clinical study, at the review, abduction was 95° (60–160), forward flexion was 108° (70–160), external rotation (elbow at body) was 34° (0–55), the QuickDASH was 31 (4.5–59), the overall Constant score was 54 (27–75), and the weighted Constant score was 76 (31.5–109). Discussion: This preliminary study of hemiarthroplasty (HA) with a locked stem found results that were at least equivalent to published series. As all patients had at least a 2-year follow-up, integration of the locked stem did not cause any specific complications. These results suggest that it is possible to avoid using cement when hemiarthroplasty is performed for the humeral stem. This implant makes height adjustment and transosseous suturing of the tuberosities more reproducible. PMID:27194107

  3. Graduated compression stockings to treat acute leg pain associated with proximal DVT. A randomised controlled trial.

    PubMed

    Kahn, S R; Shapiro, S; Ducruet, T; Wells, P S; Rodger, M A; Kovacs, M J; Anderson, D; Tagalakis, V; Morrison, D R; Solymoss, S; Miron, M-J; Yeo, E; Smith, R; Schulman, S; Kassis, J; Kearon, C; Chagnon, I; Wong, T; Demers, C; Hanmiah, R; Kaatz, S; Selby, R; Rathbun, S; Desmarais, S; Opatrny, L; Ortel, T L; Galanaud, J-P; Ginsberg, J S

    2014-12-01

    Acute deep venous thrombosis (DVT) causes leg pain. Elastic compression stockings (ECS) have potential to relieve DVT-related leg pain by diminishing the diameter of distended veins and increasing venous blood flow. It was our objective to determine whether ECS reduce leg pain in patients with acute DVT. We performed a secondary analysis of the SOX Trial, a multicentre randomised placebo controlled trial of active ECS versus placebo ECS to prevent the post-thrombotic syndrome.The study was performed in 24 hospital centres in Canada and the U.S. and included 803 patients with a first episode of acute proximal DVT. Patients were randomised to receive active ECS (knee length, 30-40 mm Hg graduated pressure) or placebo ECS (manufactured to look identical to active ECS, but lacking therapeutic compression). Study outcome was leg pain severity assessed on an 11-point numerical pain rating scale (0, no pain; 10, worst possible pain) at baseline, 14, 30 and 60 days after randomisation. Mean age was 55 years and 60% were male. In active ECS patients (n=409), mean (SD) pain severity at baseline and at 60 days were 5.18 (3.29) and 1.39 (2.19), respectively, and in placebo ECS patients (n=394) were 5.38 (3.29) and 1.13 (1.86), respectively. There were no significant differences in pain scores between groups at any assessment point, and no evidence for subgroup interaction by age, sex or anatomical extent of DVT. Results were similar in an analysis restricted to patients who reported wearing stockings every day. In conclusion, ECS do not reduce leg pain in patients with acute proximal DVT.

  4. Residential Proximity to Agricultural Pesticide Applications and Childhood Acute Lymphoblastic Leukemia

    PubMed Central

    Rull, Rudolph P.; Gunier, Robert; Von Behren, Julie; Hertz, Andrew; Crouse, Vonda; Buffler, Patricia A.; Reynolds, Peggy

    2009-01-01

    Ambient exposure from residential proximity to applications of agricultural pesticides may contribute to the risk of childhood acute lymphoblastic leukemia (ALL). Using residential histories collected from the families of 213 ALL cases and 268 matched controls enrolled in the Northern California Childhood Leukemia Study, the authors assessed residential proximity within a half-mile (804.5 meters) of pesticide applications by linking address histories with reports of agricultural pesticide use. Proximity was ascertained during different time windows of exposure, including the first year of life and the child’s lifetime through the date of diagnosis for cases or reference for controls. Agricultural pesticides were categorized a priori into groups based on similarities in toxicological effects, physicochemical properties, and target pests or uses. The effects of moderate and high exposure for each group of pesticides were estimated using conditional logistic regression. Elevated ALL risk was associated with lifetime moderate exposure, but not high exposure, to certain physicochemical categories of pesticides, including organophosphates, cholorinated phenols, and triazines, and with pesticides classified as insecticides or fumigants. A similar pattern was also observed for several toxicological groups of pesticides. These findings suggest future directions for the identification of specific pesticides that may play a role in the etiology of childhood leukemia. PMID:19700145

  5. Cellular localization of uranium in the renal proximal tubules during acute renal uranium toxicity.

    PubMed

    Homma-Takeda, Shino; Kitahara, Keisuke; Suzuki, Kyoko; Blyth, Benjamin J; Suya, Noriyoshi; Konishi, Teruaki; Terada, Yasuko; Shimada, Yoshiya

    2015-12-01

    Renal toxicity is a hallmark of uranium exposure, with uranium accumulating specifically in the S3 segment of the proximal tubules causing tubular damage. As the distribution, concentration and dynamics of accumulated uranium at the cellular level is not well understood, here, we report on high-resolution quantitative in situ measurements by high-energy synchrotron radiation X-ray fluorescence analysis in renal sections from a rat model of uranium-induced acute renal toxicity. One day after subcutaneous administration of uranium acetate to male Wistar rats at a dose of 0.5 mg uranium kg(-1) body weight, uranium concentration in the S3 segment of the proximal tubules was 64.9 ± 18.2 µg g(-1) , sevenfold higher than the mean renal uranium concentration (9.7 ± 2.4 µg g(-1) ). Uranium distributed into the epithelium of the S3 segment of the proximal tubules and highly concentrated uranium (50-fold above mean renal concentration) in micro-regions was found near the nuclei. These uranium levels were maintained up to 8 days post-administration, despite more rapid reductions in mean renal concentration. Two weeks after uranium administration, damaged areas were filled with regenerating tubules and morphological signs of tissue recovery, but areas of high uranium concentration (100-fold above mean renal concentration) were still found in the epithelium of regenerating tubules. These data indicate that site-specific accumulation of uranium in micro-regions of the S3 segment of the proximal tubules and retention of uranium in concentrated areas during recovery are characteristics of uranium behavior in the kidney.

  6. The humerus of Aegyptopithecus zeuxis: a primitive anthropoid.

    PubMed

    Fleagle, J G; Simons, E L

    1982-10-01

    Two complete humeri of Aegyptopithecus zeuxis have been recovered from Oligocene deposits in the Fayum Province of Egypt. These new specimens support previous interpretations of the locomotor adaptations of this species and indicate that A. zeuxis was a robust, slowly moving arboreal quadruped. While the previously described distal articular region of the humerus is virtually identical with the same region in many extant ceboids and the Miocene hominoid Pliopithecus vindobonensis, the more proximal parts of the humerus show many primitive "prosimianlike" features not found the limbs of extant anthropoids. The primitive features include the absence of a distinct deltoid plane, a broad shallow bicipital groove, a large brachialis flange, and an entepicondylar foramen. In most features, the humerus of Aegyptopithecus zeuxis is more primitive than the hypothetical last common ancestor of extant cercopithecoids and hominoids based on neontological comparisons. This supports other lines of evidence indicating that the hominoids from the Egyptian Oligocene are morphologically ancestral to both Old World monkeys and apes.

  7. Acute Left Arm Ischemia Associated with Floating Thrombus in the Proximal Descending Aorta: Combined Endovascular and Surgical Therapy

    SciTech Connect

    Fanelli, F.; Gazzetti, M.; Boatta, E.; Ruggiero, M.; Lucatelli, P.; Speziale, F.

    2011-02-15

    Free floating thrombus in the proximal descending aorta is an uncommon and dangerous condition that can be associated with acute peripheral embolization. The few cases described were solved with surgical and/or medical therapy. We report the case of a patient with acute left arm ischemia secondary to the presence of floating thrombus in the proximal descending aorta extending into the left subclavian artery, solved with combined endovascular and surgical therapy. Treatment was successfully performed with thrombembolectomy combined with temporary deployment, into the descending aorta, of a Wallstent in a 'basket-fashion' to avoid distal embolization secondary to thrombus fragmentation. At 1 year follow-up the patient remained symptom-free.

  8. Thrower's fracture of the humerus.

    PubMed

    Miller, Andrew; Dodson, Christopher C; Ilyas, Asif M

    2014-10-01

    Thrower's fractures are spiral fractures of the humerus caused by forceful throwing of a ball. Although these fractures have been cited in the literature, little research exists regarding the significance of stress fractures and fatigue injuries that may precede these injuries. This article presents 3 cases of middle-aged recreational baseball pitchers who sustained mid to distal third spiral humerus fractures, reviews the biomechanics of a thrower's fracture, and provides a detailed review of the literature to help better understand this condition and guide treatment.

  9. Proximal femoral replacement in the management of acute periprosthetic fractures of the hip: a competing risks survival analysis

    PubMed Central

    Colman, Matthew; Choi, Lisa; Chen, Antonia; Crossett, Lawrence; Tarkin, Ivan; McGough, Richard

    2014-01-01

    To examine the mortality and implant survivorship of proximal femoral replacement (PFR), revision total hip arthroplasty (REV) and open reduction internal fixation (ORIF) in the treatment of acute periprosthetic fractures of the proximal femur, we retrospectively reviewed 97 consecutive acute periprosthetic proximal femoral fractures from 2000–2010. Three groups were defined: PFR (n=21), REV (n=19), and ORIF (n=57). Outcome measures were all-cause mortality, implant failure, and reoperation. Competing Risks survival analysis of overall mortality during the mean 35-month follow-up showed no statistical difference between the three groups (p=0.65; 12 and 60 month mortality for PFR: 37%, 45%; REV: 16%, 46%; ORIF: 14%, 100%). Implant survival was worse for the PFR group (p=0.03, 12 and 60-month implant failure rate for PFR: 5%, 39%; REV: 7%, 7%; ORIF 2%, 2%). We conclude that PFR as compared with REV or ORIF may have worse medium-term implant survival, primarily due to instability and dislocation. PMID:23856062

  10. Proximal femoral replacement in the management of acute periprosthetic fractures of the hip: a competing risks survival analysis.

    PubMed

    Colman, Matthew; Choi, Lisa; Chen, Antonia; Crossett, Lawrence; Tarkin, Ivan; McGough, Richard

    2014-02-01

    To examine the mortality and implant survivorship of proximal femoral replacement (PFR), revision total hip arthroplasty (REV) and open reduction internal fixation (ORIF) in the treatment of acute periprosthetic fractures of the proximal femur, we retrospectively reviewed 97 consecutive acute periprosthetic proximal femoral fractures from 2000 to 2010. Three groups were defined: PFR (n=21), REV (n=19), and ORIF (n=57). Outcome measures were all-cause mortality, implant failure, and reoperation. Competing Risks survival analysis of overall mortality during the mean 35-month follow-up showed no statistical difference between the three groups (P=0.65; 12 and 60 month mortality for PFR: 37%, 45%; REV: 16%, 46%; ORIF: 14%, 100%). Implant survival was worse for the PFR group (P=0.03, 12 and 60-month implant failure rate for PFR: 5%, 39%; REV: 7%, 7%; ORIF 2%, 2%). We conclude that PFR as compared with REV or ORIF may have worse medium-term implant survival, primarily due to instability and dislocation.

  11. Long-term outcomes of palliative colonic stenting versus emergency surgery for acute proximal malignant colonic obstruction: a multicenter trial

    PubMed Central

    Siddiqui, Ali; Cosgrove, Natalie; Yan, Linda H.; Brandt, Daniel; Janowski, Raymond; Kalra, Ankush; Zhan, Tingting; Baron, Todd H.; Repici, Allesandro; Taylor, Linda Jo; Adler, Douglas. G.

    2017-01-01

    Background and study aims Long-term data are limited regarding clinical outcomes of self-expanding metal stents as an alternative for surgery in the treatment of acute proximal MBO. The aim of this study was to compare the long-term outcomes of stenting to surgery for palliation in patients with incurable obstructive CRC for lesions proximal to the splenic flexure. Patients and methods Retrospective multicenter cohort study of obstructing proximal CRC patients with who underwent insertion of a SEMS (n = 69) or surgery (n = 36) from 1999 to 2014. The primary endpoint was relief of obstruction. Secondary endpoints included technical success, duration of hospital stay, early and late adverse events (AEs) and survival. Results Technical success was achieved in 62/69 (89.8 %) patients in the SEMS group and in 36 /36 (100 %) patients who underwent surgery (P = 0.09). In the SEMS group, 10 patients underwent stenting as a bridge to surgery and 59 underwent stent placement for palliation. Clinical relief was achieved in 78 % of patients with stenting and in 100 % of patients who underwent surgery (P < 0.001). Patients with SEMS had significantly less acute AEs compared to the surgery group (7.2 % vs. 30.5 %, P = 0.003). Hospital mortality for the SEMS group was 0 % compared to 5.6 % in the surgery group (P = 0.11). Patients in the SEMS group had a significantly shorter median hospital stay (4 days) as compared to the surgery group (8 days) (P < 0.01). Maintenance of decompression without the recurrence of bowel obstruction until death or last follow-up was lower in the SEMS group (73.9 %) than the surgery group (97.3 %; P = 0.003). SEMS placement was associated with higher long-term complication rates compared to surgery (21 % and 11 % P = 0.27). Late SEMS AEs included occlusion (10 %), migration (5 %), and colonic ulcer (6 %). At 120 weeks, survival in the SEMS group was 5.6 % vs. 0 % in the

  12. Tennis service stroke benefits humerus bone: is torsion the cause?

    PubMed

    Ireland, Alex; Degens, Hans; Maffulli, Nicola; Rittweger, Jörn

    2015-08-01

    Regular tennis play is associated with impressive asymmetries in bone strength in favor of the racquet arm, particularly in the humerus. However, the relative effects of service and ground strokes are not known. Serendipitously, we encountered a 46-year-old regular tennis player who has played service and ground strokes with different arms for over 30 years, and thus allowed differentiation of stroke effects. Grip strength and peripheral quantitative computed tomography scans of both arms of radius at 4 % distal-proximal ulna length, radius and ulna at 60 % distal-proximal ulna length, and at distal (35 % length) humerus were analyzed in this player, and 12 male veteran players of similar age, height, and mass who played a conventional single-sided style. Confidence intervals (95 %) were calculated for asymmetries and bone, muscle and force parameters in the control players-values in the case study player were compared to these intervals. Sizeable differences in bone strength in favor of the serving arm humerus were observed in this player-comparable to those found in the control players. While asymmetries in favor of the ground stroke arm ulna were also evident, no sizeable asymmetry was found in proximal or distal radius, forearm or upper arm muscle size or hand grip force. These results suggest that the service stroke is responsible for the humeral hypertrophy observed in tennis players, and that ulna adaptation may be attributable to the ground strokes. The osteogenic potential of the service stroke may be related to the large torsional stresses it produces.

  13. Proximal tubule-targeted heme oxygenase-1 in cisplatin-induced acute kidney injury.

    PubMed

    Bolisetty, Subhashini; Traylor, Amie; Joseph, Reny; Zarjou, Abolfazl; Agarwal, Anupam

    2016-03-01

    Heme oxygenase-1 (HO-1) is a cytoprotective enzyme that catalyzes the breakdown of heme to biliverdin, carbon monoxide, and iron. The beneficial effects of HO-1 expression are not merely due to degradation of the pro-oxidant heme but are also credited to the by-products that have potent, protective effects, including antioxidant, anti-inflammatory, and prosurvival properties. This is well reflected in the preclinical animal models of injury in both renal and nonrenal settings. However, excessive accumulation of the by-products can be deleterious and lead to mitochondrial toxicity and oxidative stress. Therefore, use of the HO system in alleviating injury merits a targeted approach. Based on the higher susceptibility of the proximal tubule segment of the nephron to injury, we generated transgenic mice using cre-lox technology to enable manipulation of HO-1 (deletion or overexpression) in a cell-specific manner. We demonstrate the validity and feasibility of these mice by breeding them with proximal tubule-specific Cre transgenic mice. Similar to previous reports using chemical modulators and global transgenic mice, we demonstrate that whereas deletion of HO-1, specifically in the proximal tubules, aggravates structural and functional damage during cisplatin nephrotoxicity, selective overexpression of HO-1 in proximal tubules is protective. At the cellular level, cleaved caspase-3 expression, a marker of apoptosis, and p38 signaling were modulated by HO-1. Use of these transgenic mice will aid in the evaluation of the effects of cell-specific HO-1 expression in response to injury and assist in the generation of targeted approaches that will enhance recovery with reduced, unwarranted adverse effects.

  14. The proximal effects of acute alcohol use on female aggression: A meta-analytic review of the experimental literature.

    PubMed

    Crane, Cory A; Licata, MacKenzie L; Schlauch, Robert C; Testa, Maria; Easton, Caroline J

    2017-02-01

    Experimental research on alcohol-related aggression has focused largely upon male participants, providing only a limited understanding of the proximal effects of acute alcohol use on aggression among females extrapolated from the male literature. The current meta-analysis was undertaken to summarize the effects of alcohol, compared to placebo or no alcohol, on female aggression as observed across experimental investigations. A review of the literature yielded 11 articles and 12 effect sizes for further analysis. The overall effect size of alcohol on female aggression was small and reached statistical significance (d = .17, p = .02, 95% confidence interval [.03, .30]). Meta-analytic examination of the experimental literature indicated that alcohol is a significant factor in female aggression. The overall alcohol-aggression effect was smaller than has been observed among male samples. Additional research is required to evaluate the influence of other factors on alcohol-related aggressive responding among female participants. (PsycINFO Database Record

  15. Fracture Supracondylar Humerus: A Review

    PubMed Central

    Kumar, Vineet

    2016-01-01

    Fracture supracondylar humerus is one of the most common fractures encountered in pediatric age group at all levels (both rural and urban). Thus it needs a special review in its management protocol as per the changing trend. Modified Gartland classification is the most accepted classification and has its importance in decision making regarding management and prognosis. Neurovascular complications are mostly associated with Type III A, III B and Type IV variety and they most of the time need surgical intervention for stabilization, exploration of brachial artery, sometimes median nerve exploration and reduction of fracture. Cubitus varus is the most common associated deformity associated with this fracture (especially in Type III A). The aim of the review was to develop an insight for the understanding of variations in presentation and management of supracondylar fracture of the humerus (both simplicity and complexity) and the flowing trend in addition to the recent advances to deal with this particular pediatric orthopaedic entity which often presents as an emergency. PMID:28208961

  16. [Modular tumor prostheses of the humerus].

    PubMed

    Funovics, P T; Dominkus, M

    2010-10-01

    The humerus is a common location of musculoskeletal tumors. Modular prostheses of the humerus, besides APC and biological reconstructions, allow restoration of resulting bone defects. The functional outcome is determined by the extent of bone and soft tissue loss. Anatomical shoulder prostheses have a limited abductor function, while shoulder function could be improved by an inverse prosthetic design and implants for ligament repair. Elbow prostheses provide satisfactory function. Our own results in 101 patients showed a 23% revision rate. The median overall survival was 171 months with an overall 5-year survival of 53%. With respect to good oncological outcomes modular reconstruction of the humerus is a feasible treatment option for cancer patients.

  17. [Clinical analysis of prosthesis replacement for proximal humerus tumors].

    PubMed

    Weng, Xiaojun; Liao, Qiande; Li, Xiaosheng; Wang, Jing

    2016-01-01

    目的:探讨人工假体置换术和软组织重建对肱骨近端良恶性肿瘤患者预后和肩关节功能的影响以及手术策略。方法:2007年4月至2014年4月间对17例肱骨近端侵袭性良性肿瘤和原发恶性肿瘤患者行瘤段切除人工假体置换并软组织重建。从病理类型、肿瘤分期、手术方式对患者预后情况、肩关节功能状况的影响进行评估。结果:17例均获随访,随访时间8~96(平均58.9)个月。11例原发恶性肿瘤中有5例患者死于肿瘤复发或转移,6例无瘤生存24~91(平均54.83)个月。6例侵袭性良性肱骨肿瘤患者均无死亡,目前生存39~96(平均72.33)个月。17例患者肢体功能平均达到正常功能的64.88%,全肩关节置换患者肢体功能(平均72.56%)与半肩关节置换患者(平均56.25%)比较差异有统计学意义(P<0.05);保留外展肌及肌肩袖的IA型切除患者的术后肩关节功能(平均68.75%)与切除外展肌及肌肩袖IB型切除患者(平均61.44%)比较差异有统计学意义(P<0.05)。结论:肱骨近端侵袭性良性肿瘤和原发恶性肿瘤人工假体置换患者的生存期主要与肿瘤病理类型有关,术后肩关节功能的恢复与假体的选择、软组织切除范围有关。.

  18. Humerus varus: a complication of neonatal, infantile, and childhood injury and infection.

    PubMed

    Ellefsen, B K; Frierson, M A; Raney, E M; Ogden, J A

    1994-01-01

    Sixteen cases of humerus varus consequent to proximal humeral fracture and osteomyelitis are described. A similar, but variably severe pattern of progressive deformity occurred in all cases. The medial region of the proximal humeral physis usually either developed slowly or failed to develop, whereas the lateral region developed more normally. This caused progressive angular rotation of the proximal humeral epiphysis and physis, so that the lateral region of the growth plate, in its most severe expression, was almost aligned with the longitudinal axis of the shaft. In the majority of the cases, there was a medial-metaphyseal lucency and adjacent medial-osseous bridge. In some cases, a flattened epiphysis and central bridge were present, with less varus deformation with progressive growth. Shortening of the humerus occurred in all cases. Functional impairment, usually a mild to moderate limitation of glenohumeral abduction, was infrequent, even when the dominant arm was involved. Axial lengthening may yet be undertaken. Surgical realignment with a corrective (valgus) osteotomy of the proximal humerus does not, however, appear functionally necessary for all patients.

  19. Acute leptin exposure reduces megalin expression and upregulates TGFβ1 in cultured renal proximal tubule cells.

    PubMed

    Briffa, Jessica F; Grinfeld, Esther; Mathai, Michael L; Poronnik, Phillip; McAinch, Andrew J; Hryciw, Deanne H

    2015-02-05

    Increased leptin concentrations observed in obesity can lead to proteinuria, suggesting that leptin may play a role in obesity-related kidney disease. Obesity reduces activation of AMP-activated protein kinase (AMPK) and increases transforming growth factor-β1 (TGF-β1) expression in the kidney, leading to albuminuria. Thus we investigated if elevated leptin altered AMPK and TGF-β1 signaling in proximal tubule cells (PTCs). In opossum kidney (OK) PTCs Western blot analysis demonstrated that leptin upregulates TGF-β1 secretion (0.50 µg/ml) and phosphorylated AMPKα (at 0.25, and 0.50 µg/ml), and downregulates megalin expression at all concentrations (0.05-0.50 µg/ml). Using the AMPK inhibitor, Compound C, leptin exposure regulated TGF-β1 expression and secretion in PTCs via an AMPK mediated pathway. In addition, elevated leptin exposure (0.50 µg/ml) reduced albumin handling in OK cells independently of megalin expression. This study demonstrates that leptin upregulates TGF-β1, reduces megalin, and reduces albumin handling in PTCs by an AMPK mediated pathway.

  20. OSTEOSYNTHESIS OF PROXIMAL HUMERAL END FRACTURES WITH FIXED-ANGLE PLATE AND LOCKING SCREWS: TECHNIQUE AND RESULTS

    PubMed Central

    Cohen, Marcio; Amaral, Marcus Vinicius; Monteiro, Martim; Brandão, Bruno Lobo; Motta Filho, Geraldo Rocha

    2015-01-01

    Describe the results of proximal humeral fractures surgically treated with the Philos locking plate system. Method: Between March 2003 and October 2004 we prospectively reviewed 24 of 26 patients with proximal humerus fractures treated with a Philos plate. The mean follow-up time was 12 months and the mean age of patients was 57 years. Six patients had four-part proximal humerus fractures, 11 patients had three-part proximal humerus fractures, and nine patients had two-part proximal humerus fractures. Clinical evaluation was performed using the University of California at Los Angeles (UCLA) criteria. Results: The mean UCLA score was 30 points (17-34). All fractures showed union. Three patients showed fracture union at varus position. The mean UCLA score for these patients was 27 points. Conclusion: Osteosynthesis with Philos plate provides a stable fixation method with good functional outcome. PMID:26998460

  1. Reconstruction of the distal humerus and elbow joint using a pedicled scapular flap: case report.

    PubMed

    Nthumba, Peter; George, Susan; Jami, Michael; Nyoro, Partick

    2013-06-01

    Loss of elbow function resulting from major bone loss negatively affects quality of life and leaves limited options for reconstruction and restoration of function. To overcome this disabling problem, we reconstructed the distal humerus of a child in a single stage using a scapular flap based on the angular branch of the thoracodorsal artery as a pedicled flap. We also reconstructed the proximal ulna using an iliac crest bone graft with dermal graft interposition arthroplasty, which enabled the restoration of useful elbow function.

  2. Application of a navigation system for contouring anatomical plasty of the distal end of the humerus.

    PubMed

    Ikeda, Masayoshi; Kobayashi, Yuka; Saito, Ikuo; Ishii, Takayuki; Shimizu, Ayuko; Oka, Yoshinori

    2012-01-01

    The effectiveness of navigation systems in performing accurate orthopaedic surgery has been reported previously, but there have been no reports on the application of navigation in surgeries involving bone resection around the elbow joint. In this study, anatomical plasty or bone resection was performed to restore anatomical morphology in 10 cases of osteoarthritis of the elbow and deformity of the distal end of the humerus. Bone resection was performed on the distal end of the humerus using navigation and on the proximal end of the ulna via freehand surgery. Postoperatively, the elbow function was evaluated and pre- and postoperative CT images were used to measure the bone resection. There were no complications arising from the use of navigation, and elbow function was improved in all cases. By evaluating the CT images, it was found that navigated resection of the fossae of the distal humerus was more effective than freehand resection of the processes of the proximal ulna, thus confirming the usefulness of navigation. In future, to fully confirm this finding, it will be necessary to conduct prospective controlled studies of cases in which navigation is used to perform arthroplasty, including those that involve the proximal end of the ulna.

  3. Application of a navigation system for contouring anatomical plasty of the distal end of the humerus

    PubMed Central

    Ikeda, Masayoshi; Kobayashi, Yuka; Saito, Ikuo; Ishii, Takayuki; Shimizu, Ayuko; Oka, Yoshinori

    2012-01-01

    The effectiveness of navigation systems in performing accurate orthopaedic surgery has been reported previously, but there have been no reports on the application of navigation in surgeries involving bone resection around the elbow joint. In this study, anatomical plasty or bone resection was performed to restore anatomical morphology in 10 cases of osteoarthritis of the elbow and deformity of the distal end of the humerus. Bone resection was performed on the distal end of the humerus using navigation and on the proximal end of the ulna via freehand surgery. Postoperatively, the elbow function was evaluated and pre- and postoperative CT images were used to measure the bone resection. There were no complications arising from the use of navigation, and elbow function was improved in all cases. By evaluating the CT images, it was found that navigated resection of the fossae of the distal humerus was more effective than freehand resection of the processes of the proximal ulna, thus confirming the usefulness of navigation. In future, to fully confirm this finding, it will be necessary to conduct prospective controlled studies of cases in which navigation is used to perform arthroplasty, including those that involve the proximal end of the ulna. PMID:22681497

  4. [Redo surgery for residual distal dissection after the limited proximal aortic replacement for Stanford type A acute aortic dissection].

    PubMed

    Ogino, Hitoshi

    2013-07-01

    Redo surgery for residual distal dissection after the limited proximal aortic repair for Stanford type A acute aortic dissection remains challenging with some difficulties. In essence, redo aortic repair predominantly depends on the significantly dilated parts of the residual dissection. According to that, the strategy including median or lateral approach and 1 or 2 staged repair would be determined with careful consideration for patients' age and function of the vital organs such as brain, heart, lung, liver, and kidney. Generally, for relatively young and low-risk patients, an aggressive 1 stage repair of the entire arch to descending aorta through a left thoracotomy is feasible. Meanwhile, 2 stage repair is beneficial for elderly high-risk patients, which consists of the 1st total arch replacement with elephant trunk through a median sternotomy followed secondly by the open descending aortic repair through a lateral thoracotomy or recently-advanced less-invasive endovascular aortic repair. In the initial repair, more aggressive total arch replacement with elephant trunk or frozen elephant trunk might be another useful option to potentially prevent such troublesome behaviors of the residual dissecting aorta requiring redo surgery in the late stage.

  5. Endovascular treatment of acute limb ischemia and proximal deep vein thrombosis using rotational thrombectomy: A review of published literature.

    PubMed

    Lichtenberg, Michael; Stahlhoff, Friedrich-Wilhelm; Boese, Dirk

    2013-01-01

    Acute and subacute ischemia of the lower extremity is still a common reason for amputation. The treatment of this condition includes the well known procedure of local thrombolysis, surgical thrombectomy and, in recent times, percutaneous mechanical thrombectomy procedures such as rotational thrombectomy. However, in randomized studies Fogarty's procedure of surgical thrombectomy was associated with a high rate of perioperative complications and, in part, low technical success rates. On the other hand, local thrombolysis is associated with hemorrhage as well as high costs because of measures requiring substantial resources, such as intensive care monitoring or repeat angiographies. In several studies, the endovascular therapy options of Straub Rotarex® and Aspirex® systems, both products of technical advancements in the field, were shown to be successful in terms of amputation-free survival. Their use was also associated with low complication rates. The majority of studies were focused on arterial blood flow in the femur. However, in the meantime several registers and studies have shown that the systems can also be effectively used to treat proximal deep vein thrombosis. In the present report we review the current study-based value of rotational thrombectomy in the venous and arterial system.

  6. Proximal tubule-derived Colony Stimulating Factor-1 mediates polarization of renal macrophages and dendritic cells, and recovery in acute kidney injury

    PubMed Central

    Wang, Yinqiu; Chang, Jian; Yao, Bing; Niu, Aolei; Kelly, Emily; Breeggemann, Matthew C.; Abboud Werner, Sherry L.; Harris, Raymond C.; Zhang, Ming-Zhi

    2015-01-01

    Infiltrating cells play an important role in both the development of and recovery from acute kidney injury (AKI). Macrophages and renal dendritic cells are of particular interest because they can exhibit distinctly different functional phenotypes, broadly characterized as proinflammatory (M1) or tissue reparative (M2). Resident renal macrophages and dendritic cells participate in recovery from AKI in response to either ischemia/reperfusion or a model of selective proximal tubule injury induced by diphtheria toxin-induced apoptosis in transgenic mice expressing the human diphtheria toxin receptor on proximal tubule cells. Colony Stimulating Factor-1 (CSF-1) is an important factor mediating the recovery from AKI, and CSF-1 can stimulate macrophage and dendritic cell proliferation and polarization during the recovery phase of AKI. The kidney, and specifically the proximal tubule, is a major source of intrarenal CSF-1 production in response to AKI. We induced selective deletion of proximal tubule CSF-1 to determine its role in expansion and proliferation of renal macrophages and dendritic cells and in recovery from AKI. In both models of AKI, there was decreased M2 polarization, delayed functional and structural recovery and increased tubulointerstitial fibrosis. Thus, intrarenal CSF-1 is an important mediator of macrophage/dendritic cell polarization and recovery from AKI. PMID:26422503

  7. Plate selection for fixation of extra-articular distal humerus fractures: a biomechanical comparison of three different implants.

    PubMed

    Scolaro, John A; Hsu, Jason E; Svach, David J; Mehta, Samir

    2014-12-01

    Operative fixation of extra-articular distal humerus using a single posterolateral column plate has been described but the biomechanical properties or limits of this technique is undefined. The purpose of this study was to evaluate the mechanical properties of distal humerus fracture fixation using three standard fixation constructs. Two equal groups were created from forty sawbones humeri. Osteotomies were created at 80mm or 50mm from the tip of the trochlea. In the proximal osteotomy group, sawbones were fixed with an 8-hole 3.5mm LCP or with a 6-hole posterolateral plate. In the distal group, sawbones were fixed with 9-hole medial and lateral 3.5mm distal humerus plates and ten sawbones were fixed with a 6-hole posterolateral plate. Biomechanical testing was performed using a servohydraulic testing machine. Testing in extension as well as internal and external rotation was performed. Destructive testing was also performed with failure being defined as hardware pullout, sawbone failure or cortical contact at the osteotomy. In the proximal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than with the 3.5mm LCP. In the distal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than the 3.5mm LCP. In extension testing, the yield strength was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. The yield strength of specimens in axial torsion was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. Limited biomechanical data to support the use of a pre-contoured posterolateral distal humerus LCP for fixation of extra-articular distal humerus exists. We have found that this implant provided significantly greater

  8. A geometric-morphometric study of the Cretan humerus for sex identification.

    PubMed

    Kranioti, Elena F; Bastir, Markus; Sánchez-Meseguer, Andrea; Rosas, Antonio

    2009-08-10

    Various scholars have pioneered sex assessment from different parts of the skeleton based on metrical or qualitative morphological characteristics. Lately though, a new technique which combines both traditional methods is becoming popular in forensic anthropology. Geometric-morphometrics is a field of multivariate statistical biometric analysis which allows the quantification of the shape and size components of morphological variation. The purpose of this investigation is to assess sex from the humerus in a contemporary Greek population using geometric-morphometric analysis of shape data derived from digital radiographs. The study population consists of 97 well-preserved adult humeri from two cemeteries of Heraklion, Crete. The left humeri are radiographed using digital radiograph machine (TCA 4R PLUS). Assuming fragmentary patterns, the proximal and distal ends are studied separately. Five landmarks are selected on the radiograph of the proximal epiphysis and seven landmarks on the distal. Generalised Procrustes analysis (GPA) and thin-plate splines are used to obtain the shape and size variables for statistical analysis. Then three discriminant function analyses were carried out: one uses the PC scores from Procrustes shape space, the second the centroid size alone and the third the PC scores of GPA residuals plus lnCS for analysis in Procrustes form space. Results indicate the existence of shape differences between the sexes. In females the greater tubercle is smoother, with its superior border less pronounced. Additionally, females have a relatively squared distal epiphysis, while males exhibit a more rectangular shape. Shape differences between genders, for the cross-validated data, give slightly better classification results in the proximal humerus (73%) compared with the distal humerus (71%). Size alone performed better (86.5% for proximal and 85.6% for distal humerus). As anticipated, the classification accuracy improves (89.6% for proximal and 89.7% for

  9. Hemiarthroplasty for proximal humeral fracture: restoration of the Gothic arch.

    PubMed

    Krishnan, Sumant G; Bennion, Phillip W; Reineck, John R; Burkhead, Wayne Z

    2008-10-01

    Proximal humerus fractures are the most common fractures of the shoulder girdle, and initial management of these injuries often determines final outcome. When arthroplasty is used to manage proximal humeral fractures, surgery remains technically demanding, and outcomes have been unpredictable. Recent advances in both technique and prosthetic implants have led to more successful and reproducible results. Key technical points include restoration of the Gothic arch, anatomic tuberosity reconstruction, and minimal soft tissue dissection.

  10. Outcome of venous stenting following catheter directed thrombolysis for acute proximal lower limb venous thrombosis: a prospective study with venous Doppler follow-up at 1-year.

    PubMed

    Srinivas, B C; Patra, Soumya; Reddy, Babu; Nagesh, C M; Agarwal, Naveen; Manjunath, C N

    2015-10-01

    Functional outcome of venous stent placement for the management of acute iliofemoral deep vein thrombosis (DVT) following catheter-directed thrombolysis (CDT), remain undefined. The purpose of this study was to assess immediate and intermediate term outcomes among patients treated with venous stenting following CDT in patients with proximal lower limb DVT. Thirty consecutive patients aged between 20-70 years with proximal lower limb DVT formed the study group. The mean duration of CDT done with streptokinase was 4.5 ± 1.3 days. Patients with residual venous obstruction and/or large clot burden were treated further with venous angioplasty and/or stenting. Primary endpoint was to evaluate the safety, efficacy and patency of venous stenting in the management of incomplete result following CDT. After 12 months, post-thrombotic syndrome (PTS) was assessed clinically using Villalta scale and deep venous patency was assessed through duplex ultrasound. We studied 8 (5 female and 3 male) patients with 9 (3 left and 6 right) limb involvement and 13 stent (4 balloon expandable and 9 self expandable) placement. All patients improved clinically immediately following venous stenting. Technical success was achieved in all patients. One patient developed pulmonary embolism during course of hospital stay. One patient had stent thrombosis and PTS and another patient died due to carcinoma breast during follow-up. Deep venous stenting is an effective mode of treatment in proximal acute lower limb DVT with high late patency rate up to 1-year.

  11. Proximal Arterial Occlusion in Acute Ischemic Stroke with Low NIHSS Scores Should Not Be Considered as Mild Stroke

    PubMed Central

    Kim, Joon-Tae; Park, Man-Seok; Chang, Jane; Lee, Ji Sung; Choi, Kang-Ho; Cho, Ki-Hyun

    2013-01-01

    Background Untreated acute mild stroke patients have substantial 90-day disability rates and worse outcomes than those who are treated with thrombolysis. There is little information regarding which patients with acute mild stroke will benefit from thrombolysis. We sought to investigate factors that are associated with early neurological deterioration (END) and poor prognosis in patients with acute mild stroke. Methods This was a retrospective study of consecutively registered patients with acute mild stroke (NIHSS ≤3) at our tertiary stroke center between October 2008 and December 2011. END was defined as an increase in NIHSS ≥2 points between hospital days 0 and 5. Modified Rankin Scale (mRS) scores of 0–1 at 90 days post-stroke were defined as favorable outcomes. Results A total of 378 (mean age, 65.9±13.0 years) patients were included in this study. END occurred in 55 patients (14.6%). IV-thrombolysis was performed in only 9 patients. Symptomatic arterial occlusion on the initial MRA was independently associated with END (OR, 2.206; 95% CI, 1.219–3.994; p = 0.009) by multivariate logistic regression. Of the 119 patients with symptomatic arterial occlusion, ICA occlusion was independently associated with END (OR, 8.606; 95% CI, 2.312–32.043; p = 0.001). Conclusions This study demonstrates that symptomatic arterial occlusion may be an important predictor of END in patients with acute mild stroke. It may therefore be important to consider that acute ischemic stroke with symptomatic arterial occlusion and low NIHSS scores may not represent mild stroke in acute periods. PMID:23976971

  12. [METHOD OF OSTEOSYNTHESIS OF SUPRACONDULAR FRACTURES OF THE HUMERUS].

    PubMed

    Neverov, V A; Chernyaev, S N; Shinkarenko, D V

    2015-01-01

    A treatment of fractures of distal metadiaphysis of the humeral bone remains an actual problem of modern traumatology at present time. This is associated with immediate proximity of the radial nerve and risk of iatrogenic injury in external fixation, presence of short distal fragment, comminuted nature of fracture, complexity of treatment method selection, need of extensible approach. Biomechanical features of different fixators were analyzed in consideration of presence of short distal fragment, traumatic of. external fixation and risk of iatrogenic injury of the nerve. The authors suggested the method of osteosynthesis of the humerus by using blocking osteosynthesis with preliminary extension of intra-medullary canal of distal fragment for obtaining stable osteosynthesis (priority No 2014105323 from 14.02.2014). The proposed method allowed avoiding the iatrogenic neuropathy of the radial nerve, providing the stability of fixation higher, than in case of external fixation. It excludes the need of external immobilization and combines the period of bony union with the period of rehabilitation and socially integrates the patient in minimal terms.

  13. Total Elbow Arthroplasty for Distal Humerus Fractures.

    PubMed

    Harmer, Luke S; Sanchez-Sotelo, Joaquin

    2015-11-01

    Total elbow arthroplasty is a good treatment alternative for selected patients with distal humerus fractures. Its attractiveness is related to several factors, including the possibility of performing the procedure; leaving the extensor mechanism intact; faster, easier rehabilitation compared with internal fixation; and overall good outcomes reported in terms of both pain relief and function. Implant failure leading to revision surgery does happen, and patients must comply with certain limitations to extend the longevity of their implant. Development of high-performance implants may allow expanding the indications of elbow arthroplasty for fractures.

  14. Impacted valgus fractures of the proximal humerus☆

    PubMed Central

    Ribeiro, Fabiano Rebouças; Takesian, Fernando Hovaguim; Bezerra, Luiz Eduardo Pimentel; Filho, Rômulo Brasil; Júnior, Antonio Carlos Tenor; da Costa, Miguel Pereira

    2016-01-01

    Impacted valgus fractures of the proximal humerus are considered to be a special type fracture, since impaction of the humeral head on the metaphysis with maintenance of the posteromedial periosteum improves the prognosis regarding occurrences of avascular necrosis. This characteristic can also facilitate the reduction maneuver and increase the consolidation rate of these fractures, even in more complex cases. The studies included were obtained by searching the Bireme, Medline, PubMed, Cochrane Library and Google Scholar databases for those published between 1991 and 2013. The objective of this study was to identify the most common definitions, classifications and treatment methods used for these fractures in the orthopedic medical literature. PMID:27069878

  15. Complications of Proximal Biceps Tenotomy and Tenodesis.

    PubMed

    Virk, Mandeep S; Nicholson, Gregory P

    2016-01-01

    The long head of biceps tendon (LHBT) is a well-recognized cause of anterior shoulder pain. Tenotomy or tenodesis of the LHBT is an effective surgical solution for relieving pain arising from the LHBT. Cosmetic deformity of the arm, cramping or soreness in the biceps muscle, and strength deficits in elbow flexion and supination are the three most common adverse events associated with tenotomy of the LHBT. Complications associated with tenodesis of the LHBT include loss of fixation resulting in cosmetic deformity, residual groove pain, pain or soreness in the biceps muscle, infection, stiffness, hematoma, neurologic injury, vascular injury, proximal humerus fracture, and reflex sympathetic dystrophy.

  16. CBFB and MYH11 in inv(16)(p13q22) of acute myeloid leukemia displaying close spatial proximity in interphase nuclei of human hematopoietic stem cells.

    PubMed

    Weckerle, Allison B; Santra, Madhumita; Ng, Maggie C Y; Koty, Patrick P; Wang, Yuh-Hwa

    2011-09-01

    To gain a better understanding of the mechanism of chromosomal translocations in cancer, we investigated the spatial proximity between CBFB and MYH11 genes involved in inv(16)(p13q22) found in patients with acute myeloid leukemia. Previous studies have demonstrated a role for spatial genome organization in the formation of tumorigenic abnormalities. The nonrandom localization of chromosomes and, more specifically, of genes appears to play a role in the mechanism of chromosomal translocations. Here, two-color fluorescence in situ hybridization and confocal microscopy were used to measure the interphase distance between CBFB and MYH11 in hematopoietic stem cells (HSCs), where inv(16)(p13q22) is believed to occur, leading to leukemia development. The measured distances in HSCs were compared with mesenchymal stem cells, peripheral blood lymphocytes, and fibroblasts, as spatial genome organization is determined to be cell-type specific. Results indicate that CBFB and MYH11 are significantly closer in HSCs compared with all other cell types examined. Furthermore, the CBFB-MYH11 distance is significantly reduced compared with CBFB and a control locus in HSCs, although separation between CBFB and the control is ∼70% of that between CBFB and MYH11 on metaphase chromosomes. HSCs were also treated with fragile site-inducing chemicals because both the genes contain translocation breakpoints within these regions. However, treatment with fragile site-inducing chemicals did not significantly affect the interphase distance. Consistent with previous studies, our results suggest that gene proximity may play a role in the formation of cancer-causing rearrangements, providing insight into the mechanism of chromosomal abnormalities in human tumors.

  17. CBFB and MYH11 in inv(16)(p13q22) of Acute Myeloid Leukemia Display Close Spatial Proximity in Interphase Nuclei of Human Hematopoietic Stem Cells

    PubMed Central

    Weckerle, Allison B.; Santra, Madhumita; Ng, Maggie C.Y.; Koty, Patrick P.; Wang, Yuh-Hwa

    2013-01-01

    To gain a better understanding of the mechanism of chromosomal translocations in cancer, we investigated the spatial proximity between CBFB and MYH11 genes involved in inv(16)(p13q22) found in acute myeloid leukemia patients. Previous studies have demonstrated a role for spatial genome organization in the formation of tumorigenic abnormalities. The non-random localization of chromosomes and, more specifically, of genes appears to play a role in the mechanism of chromosomal translocations. Here, two-color fluorescence in situ hybridization and confocal microscopy were used to measure the interphase distance between CBFB and MYH11 in hematopoietic stem cells, where inv(16)(p13q22) is believed to occur, leading to leukemia development. The measured distances in hematopoietic stem cells were compared to mesenchymal stem cells, peripheral blood lymphocytes and fibroblasts, as spatial genome organization is determined to be cell-type specific. Results indicate that CBFB and MYH11 are significantly closer in hematopoietic stem cells compared to all other cell types examined. Furthermore, the CBFB-MYH11 distance is significantly reduced compared to CBFB and a control locus in hematopoietic stem cells, although separation between CBFB and the control is ~70% of that between CBFB and MYH11 on metaphase chromosomes. Hematopoietic stem cells were also treated with fragile site-inducing chemicals since both genes contain translocation breakpoints within these regions. However, treatment with fragile site-inducing chemicals did not significantly affect the interphase distance. Consistent with previous studies, our results suggest that gene proximity may play a role in the formation of cancer-causing rearrangements, providing insight into the mechanism of chromosomal abnormalities in human tumors. PMID:21638519

  18. Acute cytotoxicity and apoptotic effects after l-Pam exposure in different cocultures of the proximal and distal respiratory system.

    PubMed

    Pohl, Christine; Hofmann, Helene; Moisch, Michaela; Papritz, Mirko; Iris Hermanns, M; Dei-Anang, Jasmin; Mayer, Eckhard; Kehe, Kai; Kirkpatrick, Charles James

    2010-07-01

    Sulphur and nitrogen mustard are strong alkylating agents which can cause after inhalation acute lung injury in the larynx, trachea and large bronchi and can lead to alveolar edema. In our study we tested the N-Lost l-Phenylalanine Mustard (l-Pam). Therefore we seeded the alveolar type II cell line NCI H441 on the upper membrane of a Transwell filter plate and the endothelial cell line ISO-Has-1 on the lower side of the membrane for the alveolar model and combined the human bronchial explant-outgrowth cells and fibroblasts in the bronchial model and exposed both models with various concentrations of l-Pam. Treatment with l-Pam led to a concentration-dependent decrease of the transepithelial electrical resistance and therefore impairment of barrier function in both models. Changes in morphology could be observed. In the bronchial model damaged cell organelles whereas in the alveolar model a widening of intercellular spaces could be seen. Loss of cell-matrix adhesion as well as apoptotic and necrotic cell death could be demonstrated. In conclusion, treatment with the nitrogen mustard in the coculture models showed comparable results to sulphur mustard treatment and thus this model could be useful to explore similarities and differences in signal transduction pathways after treatment with both sulphur and nitrogen mustard.

  19. Proximal Nephron

    PubMed Central

    Zhuo, Jia L.; Li, Xiao C.

    2013-01-01

    The kidney plays a fundamental role in maintaining body salt and fluid balance and blood pressure homeostasis through the actions of its proximal and distal tubular segments of nephrons. However, proximal tubules are well recognized to exert a more prominent role than distal counterparts. Proximal tubules are responsible for reabsorbing approximately 65% of filtered load and most, if not all, of filtered amino acids, glucose, solutes, and low molecular weight proteins. Proximal tubules also play a key role in regulating acid-base balance by reabsorbing approximately 80% of filtered bicarbonate. The purpose of this review article is to provide a comprehensive overview of new insights and perspectives into current understanding of proximal tubules of nephrons, with an emphasis on the ultrastructure, molecular biology, cellular and integrative physiology, and the underlying signaling transduction mechanisms. The review is divided into three closely related sections. The first section focuses on the classification of nephrons and recent perspectives on the potential role of nephron numbers in human health and diseases. The second section reviews recent research on the structural and biochemical basis of proximal tubular function. The final section provides a comprehensive overview of new insights and perspectives in the physiological regulation of proximal tubular transport by vasoactive hormones. In the latter section, attention is particularly paid to new insights and perspectives learnt from recent cloning of transporters, development of transgenic animals with knockout or knockin of a particular gene of interest, and mapping of signaling pathways using microarrays and/or physiological proteomic approaches. PMID:23897681

  20. Pyruvate dehydrogenase-E1α deficiency presenting as recurrent acute proximal muscle weakness of upper and lower extremities in an 8-year-old boy.

    PubMed

    Kara, Bülent; Genç, Hülya Maraş; Uyur-Yalçın, Emek; Sakarya-Güneş, Ayfer; Topçu, Uğur; Mülayim, Serap; Ceylaner, Serdar

    2017-01-01

    The mitochondrial pyruvate dehydrogenase enzyme complex (PDHC) plays an important role in aerobic energy metabolism and acid-base equilibrium. PDHC contains of 5 enzymes, 3 catalytic (E1, E2, E3) and 2 regulatory, as well as 3 cofactors and an additional protein (E3-binding protein) encoded by nuclear genes. The clinical presentation of PDHC deficiency ranges from fatal neonatal lactic acidosis to chronic neurologic dysfunction without lactic acidosis. Paroxysmal neurologic problems such as intermittent ataxia, episodic weakness, exercise-induced dystonia and recurrent demyelination may also be seen although they are rare. Here, we present an 8-year-old boy complaining of acute proximal muscle weakness of upper and lower extremities with normal mental status. He had a history of Guillain-Barré-like syndrome at the age of 2 years. Electrophysiologic studies showed sensorial polyneuropathy findings in the first attack and sensorimotor axonal polyneuropathy findings in the last attack. The genetic analysis revealed a previously reported hemizygote novel mutation of the PDHA1 gene (p.A353T/c.1057G > A), which encodes the E1α subunit of PDHC. Thiamine was ordered (15 mg/kg/day), dietary carbohydrates were restricted and clinical findings improved in a few weeks. This rare phenotype of PDHC deficiency is discussed.

  1. Management of fractures of the humerus in Ancient Egypt, Greece, and Rome: an historical review.

    PubMed

    Brorson, Stig

    2009-07-01

    Fractures of the humerus have challenged medical practitioners since the beginning of recorded medical history. In the earliest known surgical text, The Edwin Smith Papyrus (copied circa 1600 BC), three cases of humeral fractures were described. Reduction by traction followed by bandaging with linen was recommended. In Corpus Hippocraticum (circa 440-340 BC), the maneuver of reduction was fully described: bandages of linen soaked in cerate and oil were applied followed by splinting after a week. In The Alexandrian School of Medicine (third century BC), shoulder dislocations complicated with fractures of the humerus were mentioned and the author discussed whether the dislocation should be reduced before or after the fracture. Celsus (25 BC-AD 50) distinguished shaft fractures from proximal and distal humeral fractures. He described different fracture patterns, including transverse, oblique, and multifragmented fractures. In Late Antiquity, complications from powerful traction or tight bandaging were described by Paul of Aegina (circa AD 625-690). Illustrations from sixteenth and seventeenth century surgical texts are included to show the ancient methods of reduction and bandaging. The richness of written sources points toward a multifaceted approach to the diagnosis, reduction, and bandaging of humeral fracture in Ancient Egypt, Greece, and Rome.

  2. [Surgical treatment of humerus condylar fracture].

    PubMed

    Gorodnichenko, A I; Guseĭnov, T Sh; Uskov, O N

    2014-01-01

    55 patients with intra-articular condyles fractures of humerus were operated in terms 1998 to 2013 year in the Clinic of Traumatology and Orthopedics of the Presidential Administration. All patients were operated by using of perosseous osteosynthesis method with external fixing device design A.I. Gorodnichenko. Indications for osteosynthesis were open and closed fractures of C1,2,3 types accordingly to AO Classification. Closed, atraumatic and reliable fixation of bone fragments intensifies patients faster, improves their life quality, decreases time of hospitalization and minimizes complications rate. Fractures consolidation was achieved in all cases. It was observed such complications as soft tissue inflammatory around shafts in 4 (7.3%) observations. Long-term results were studied in 51 (92.7%) patients including 9 (17.6%) patients with excellent results, 24 (47.1%) patients with good results and 18 (35.3%) patients with satisfactory results. It was not detected unsatisfactory results. The method permits early reconstructive treatment of patients and improves functional results in case of condyles fractures. This preserves active moving function of damaged elbow from the first day after operation and during all period of treatment.

  3. Effect of acute acid-base disturbances on the phosphorylation of phospholipase C-γ1 and Erk1/2 in the renal proximal tubule

    PubMed Central

    Skelton, Lara A; Boron, Walter F

    2015-01-01

    The renal proximal tubule (PT) plays a major role in whole-body pH homeostasis by secreting H+ into the tubule lumen. Previous work demonstrated that PTs respond to basolateral changes in [CO2] and [] by appropriately altering H+ secretion—responses blocked by the ErbB inhibitor PD168393, or by eliminating signaling through AT1 angiotensin receptors. In the present study, we analyze phosphorylation of three downstream targets of both ErbBs and AT1: phospholipase C-γ1 (PLC-γ1), extracellular-regulated kinase 1 (Erk1), and Erk2. We expose rabbit PT suspensions for 5 and 20 min to our control (Ctrl) condition (5% CO2, 22 mmol/L , pH 7.40) or one of several conditions that mimic acid-base disturbances. We found that each disturbance produces characteristic phosphorylation patterns in the three enzymes. For example, respiratory acidosis (elevated [CO2], normal []) at 20 min decreases PLC-γ1 phosphorylation at tyrosine-783 (relative to Ctrl). Metabolic acidosis (normal [CO2], decreased []) for 5 min increases Erk1 phosphorylation (p-Erk1) but not p-Erk2, whereas metabolic alkalosis (normal [CO2], elevated []) for 5 min decreases p-Erk1 and p-Erk2. In the presence of CO2/, PD168393 blocks only two of eight induced decreases in phosphorylation. In two cases in which disturbances have no remarkable effects on phosphorylation, PD168393 unmasks decreases and in two others, increases. These drug effects provide insight into the roles of PD168393-sensitive kinases. Our results indicate that PLC-γ1.pY783, p-Erk1, and p-Erk2 in the PT change in characteristic ways in response to acute acid-base disturbances, and thus presumably contribute to the transduction of acid-base signals. PMID:25780091

  4. A musculoskeletal model of the equine forelimb for determining surface stresses and strains in the humerus--part I. Mathematical modeling.

    PubMed

    Pollock, Sarah; Hull, M L; Stover, Susan M; Galuppo, Larry D

    2008-08-01

    Knowledge of the forces that act upon the equine humerus while the horse is standing and the resulting strains experienced by the bone is useful for the prevention and treatment of fractures and for assessing the proximolateral aspect of the bone as a site for obtaining autogenous bone graft material. The first objective was to develop a mathematical model to predict the loads on the proximal half of the humerus created by the surrounding musculature and ground reaction forces while the horse is standing. The second objective was to calculate surface bone stresses and strains at three cross sections on the humerus corresponding to the donor site for bone grafts, a site predisposed to stress fracture, and the middle of the diaphysis. A three-dimensional mathematical model employing optimization techniques and asymmetrical beam analysis was used to calculate shoulder muscle forces and surface strains on the proximal and mid-diaphyseal aspects of the humerus. The active shoulder muscles, which included the supraspinatus, infraspinatus, subscapularis, and short head of the deltoid, produced small forces while the horse is standing; all of which were limited to 4.3% of their corresponding maximum voluntary contraction. As a result, the strains calculated at the proximal cross sections of the humerus were small, with maximum compressive strains of -104microepsilon at the cranial aspect of the bone graft donor cross section. The middle of the diaphysis experienced larger strain magnitudes with compressive strains at the lateral and the caudal aspects and tensile strains at the medial and cranial aspects (-377microepsilon and 258microepsilon maximum values, respectively) while the horse is standing. Small strains at the donor bone graft site do not rule out using this location to harvest bone graft tissue, although strains while rising to a standing position during recovery from anesthesia are unknown. At the site common to stress fractures, small strains imply that the

  5. Pulmonary cement embolism in a child following total elbow replacement for primitive neuroectodermal tumour (PNET) of the humerus.

    PubMed

    Ramanathan, Subramaniam; Vora, Tushar; Gulia, Ashish; Mahajan, Abhishek; Desai, Subhash

    2017-05-01

    Pulmonary bone cement embolism (PCE) is an uncommon event occurring after implantation of polymethylmethacrylate (PMMA) in orthopaedic surgeries involving adult patients, more so in the elderly. Its incidence in the paediatric population is extremely rare. We herein describe a case of PCE in a 15-year-old girl, 9 days after she underwent total elbow replacement with PMMA placement for a primitive neuroectodermal tumour (PNET) of the distal humerus. This report describes the occurrence of a common post-operative complication of bone cement embolism in an uncommon scenario of total elbow replacement for a bone tumour in a child, which masqueraded initially as acute pneumonitis.

  6. Analysis of Early Neurovascular Complications of Pediatric Supracondylar Humerus Fractures: A Long-Term Observation

    PubMed Central

    Wozowicz, Artur; Wysocka-Wojakiewicz, Paulina

    2017-01-01

    Purpose. Analysis of early vascular and nerve complications of supracondylar humerus fractures in children. Material and Methods. 220 children hospitalized in the Pediatric Trauma-Orthopedic Department in the years 2004–2014. The group consisted of 143 males and 77 females. Results. Acute neurovascular complications occurred in 16.81% of patients with displaced supracondylar fracture (37 children). Nerve damage was found in 10% of patients with displaced fracture (22 children). The most injured nerve was median nerve; this complication occurred in 15 patients (68.18%). The total nerve function returned after average of 122 days (0–220 days after surgery). Symptoms of vascular injury occurred in 7.7% children with displaced fracture (17 children). Conclusions. (1) In children with supracondylar fracture the most often injured nerve is median nerve. (2) The incidence of vascular and nerve complications positively correlates with the progression of fracture according to Gartland classification. PMID:28367440

  7. WITHDRAWN: The treatment of proximal humerus nonunions in older patients with the reverse shoulder arthroplasty.

    PubMed

    Martinez, Angel A; Bejarano, Carlos; Carbonel, Ignacio; Iglesias, Daniel; Gil-Alvaroba, Jorge; Herrera, Antonio

    2012-01-04

    This article has been withdrawn at the request of the editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

  8. Proximity fuze

    DOEpatents

    Harrison, Thomas R.

    1989-08-22

    A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation cirtcuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance form the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation.

  9. Proximity fuze

    DOEpatents

    Harrison, T.R.

    1987-07-10

    A proximity fuze system includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation circuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance from the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation. 3 figs.

  10. Proximity fuze

    SciTech Connect

    Harrison, T.R.

    1989-08-22

    A proximity fuze system is described. It includes an optical ranging apparatus, a detonation circuit controlled by the optical ranging apparatus, and an explosive charge detonated by the detonation circuit. The optical ranging apparatus includes a pulsed laser light source for generating target ranging light pulses and optical reference light pulses. A single lens directs ranging pulses to a target and collects reflected light from the target. An optical fiber bundle is used for delaying the optical reference pulses to correspond to a predetermined distance from the target. The optical ranging apparatus includes circuitry for providing a first signal depending upon the light pulses reflected from the target, a second signal depending upon the light pulses from the optical delay fiber bundle, and an output signal when the first and second signals coincide with each other. The output signal occurs when the distance from the target is equal to the predetermined distance from the target. Additional circuitry distinguishes pulses reflected from the target from background solar radiation.

  11. Bilateral asymmetry of the humerus during growth and development.

    PubMed

    Blackburn, Amanda

    2011-08-01

    The development of handedness throughout growth can be investigated by using bilateral asymmetry of the humerus as a proxy for this trait. A large skeletal sample of nonadults from English archaeological sites was examined using standard metric techniques to assess when right-sided asymmetry first appears in the human skeleton. Results of this work indicate a change in directional asymmetry during growth and development, with infants and young children exhibiting no significant asymmetry and older children and adolescents demonstrating right-sidedness. This trend is consistent with what has been observed in previous studies of upper limb asymmetry in skeletal material and behaviorally in living children, adding further strength to the premise that biomechanical forces strongly influence bilateral asymmetry in the upper limb bones. Variability in the magnitude of asymmetry between different features of the humerus was also noted. This characteristic can be explained by differing degrees of genetic canalization, with length and articular dimensions being more strongly canalized than diaphyseal properties.

  12. Treatment of Pediatric Open Supracondylar Humerus Fractures: Case Report

    PubMed Central

    Al-Sadek, Tabet A.; Niklev, Desislav; Al-Sadek, Ahmed

    2016-01-01

    BACKGROUND: Open supracondylar fractures of the humerus are rare in children, and the treatment strategy for these fractures is yet to be standardised. AIM: We present the case of a 7-year-old boy with open supracondylar humerus fracture that was managed with an external wrist fixator. CASE PRESENTATION: A 7-year-boy was brought to our department with pain in the right arm after a fall from a height about 3 hours before admission. On examination, the elbow was found to be markedly swollen with restriction of movement of the right arm. A 4-cm-wide wound was also observed on the flexural aspect of the elbow, indicating severe contamination of the fractured site. Neurological examination revealed restriction of hand movement and decreased sensations, which suggested the possibility of nerve injuries. CONCLUSION: A good clinical outcome was achieved in this case, without the development of any complications over a 6-month follow-up period. PMID:28028413

  13. Clinical results of using the proximal humeral internal locking system plate for internal fixation of displaced proximal humeral fractures.

    PubMed

    Norouzi, Masoud; Naderi, Mohammad Nasir; Komasi, Mehdi Hemmati; Sharifzadeh, Seyyed Reza; Shahrezaei, Mostafa; Eajazi, Alireza

    2012-05-01

    Proximal humerus fractures are accounting for 4-5% of all fractures with increasing incidence. Proximal Humeral Internal Locking System (PHILOS) plate is a new plate which permits early mobility and lowers the risk of complications. The aim of this study was to evaluate the functional outcome and the complication rate after using this plate. Between 2006-2008, 37 patients with displaced 2-, 3-, and 4-part fractures of the proximal humerus underwent surgery using PHILOS plate. The mean range of follow-up was 12 months. Twenty patients were aged 60 years and younger, and 17 were aged older than 60 years. The average American Shoulder and Elbow Surgeons (ASES) score at the final follow-up was 77.62. According to Michener and colleagues classification, 5.4% of patients had an excellent outcome, 72.9% were minimally functionally limited, 16.2% were moderately functionally limited, and 5.4% were maximally functionally limited. The average ASES score between patients 60 years and older and those 60 years and younger was not different significantly. One patient developed avascular necrosis of the humeral head, 2 patients developed an infection, and no patients developed a nonunion. Fixation with PHILOS plate can be considered a good method with high union rates for this kind of fracture, especially in the older population with osteoporotic bone.

  14. Gorham's disease in humerus treated with autogenous vascularized fibular graft

    PubMed Central

    Kim, Jeung Woo; Kang, Hong Je; Kim, Dong Chul; Shin, Chang Hyun

    2017-01-01

    Gorham's disease is a rare disorder of the bone characterized by progressive massive osteolysis. The pathophysiology is unknown, and diagnosis is often difficult. Most cases are often recognized retrospectively. There is no standardized treatment and management for Gorham's disease. We report a case of an 18-year-old male presenting with a pathologic fracture in the humerus shaft diagnosed with Gorham's disease. Patient was treated with autogenous vascularized fibular graft with wide excision and a 10 years followup after first surgery.

  15. Corrective Osteotomy for Intra-Articular Distal Humerus Malunion

    PubMed Central

    Kinaci, Ahmet; Buijze, Geert A.; Leeuwen, Diederik H.van; Jupiter, Jesse B.; Marti, Rene K.; Kloen, Peter

    2016-01-01

    Background: An intra-articular distal humerus malunion can be disabling. To improve function, reduce pain and/or prevent further secondary osteoarthritis an intra-articular corrective osteotomy can be considered. Herein we present the indications, practical guidelines for pre- operative planning and surgical technique. Subsequently, we provide long-term results in a small series. Methods: We included six consecutive patients operated for intra-articular distal humerus malunion. Mean follow-up was 88 months. At lastest follow up elbow function was assessed according to standardized questionnaires and classification systems. Results: All six patients healed their osteotomies. Three patients had a postoperative complication which were treated succesfully. Range of motion improved significantly and all patients were satisfied with the outcome. The elbow performance scores were good to excellent in all. Correlation analyses showed that age and level of osteoarthritis are very strong predictors for the long-term elbow function and quality of life. Conclusion: An intra-articular corrective osteotomy for a malunited distal humerus fracture is a worthwhile procedure. Based on our results it should particularly be considered in young patients with minimal osteoarthritis and moderate to severe functional disability and/or pain. PMID:27200396

  16. Guided bone regeneration with beta-tricalcium phosphate and poly L-lactide-co-glycolide-co-epsilon-caprolactone membrane in partial defects of canine humerus.

    PubMed

    Oh, Taehoon; Rahman, Md Mizanur; Lim, Ji-Hey; Park, Mi-Sun; Kim, Dae-Yong; Yoon, Jung-hee; Kim, Wan Hee; Kikuchi, Masanori; Tanaka, Junzo; Koyama, Yoshihisa; Kweon, Oh-Kyeong

    2006-03-01

    This study was performed to evaluate the effect of betatricalcium phosphate and poly L-lactide-co-glycolide-coepsilon- caprolactone (TCP/PLGC) membrane in the repair of partial bone defects in canine proximal humerus. Three adult mixed-breed dogs were used during the experimental period. The length of the defect was quarter of the full length of humerus, and width of the defect was quarter of middle diameter of the lateral aspect of humerus. The humeri of each dog were divided into treatment (TCP/ PLGC) and control groups. The defect was covered with TCP/PLGC membrane in treatment group. To evaluate regeneration of the bone, computerized tomography (CT) and histopathologic examination were performed. The radiopaque lines were appeared at the original defect sites in TCP/PLGC group but below the original site in control at 4th week. Radiopacity and thickness of the defect sites, and radiopaque lines were more increased at 8th week than those of 4th week. Histopathologic findings revealed fibrous connective tissue migration into the defect and the migration inhibited the structure of new cortex to be placed in the original level in control whereas new cortex growth was found in the level of original line in TCP/ PLGC group. However, the new cortical bone in the TCP/ PLGC group was thinner and less organized than the adjacent intact cortex, and the amount of new cancellous bones were also scanty. The result suggested that TCP/ PLGC membrane is a good guided bone regeneration material to restore the original morphology of humerus in partial defect.

  17. [Surgical treatment of pathologic fractures of the humerus and femur].

    PubMed

    Gruber, G; Zacherl, M; Leithner, A; Giessauf, C; Glehr, M; Clar, H; Windhager, R

    2009-04-01

    The life expectancy of patients with malignant tumours and the incidence of osseous metastases have increased over the last decades. Operations for skeletal metastases of the extremities represent the most frequent surgery in orthopaedic oncology. The purpose of this study was to evaluate and compare the different operative treatment options for patients with pathologic fractures of the humerus and femur in terms of complications, postoperative recovery, and survival.From 2000 to 2005, 109 patients were surgically treated for pathologic fractures of the humerus (n=19) or femur (n=90). The study group consisted of 60 women and 43 men, with a mean age of 67 years (13-88). Breast carcinoma (36%) was the most common primary tumour, followed by kidney (17%) and bronchial (16%) carcinoma. Of all patients, 75 (73%) had numerous skeletal metastases, and 38 (37%) had visceral metastases.Wide or marginal resection was performed in seven fractures of the humerus and 14 fractures of the femur; intralesional resection was done in seven humeral and 73 femoral fractures; and stabilisation alone was done in five fractures of the humerus and three fractures of the femur. The median survival time for all patients was 6 months (0-102). The survival rate at 1 year was 25% (25% for both humeral and femoral fractures), 15% at 2 years (17% for humeral and 15% for femoral fractures), and 8% at 3 years (16% for humeral and 7% for femoral fractures). The overall complication rate was 11%, and revision surgeries were performed in seven patients (6.4%). The majority of patients (n=65; 60%), especially those with fractures close to the articular joint, were successfully treated with endoprosthetic replacement. Patients with fractures stabilised by intramedullary nails had shorter operating times, a shorter hospital stay, and fewer complications than patients treated with plating systems. Therefore, we recommend intralesional resection of the metastasis and stabilisation with intramedullary

  18. Proximal humeral replacement using a fixed-fulcrum endoprosthesis.

    PubMed

    Griffiths, D; Gikas, P D; Jowett, C; Bayliss, L; Aston, W; Skinner, J; Cannon, S; Blunn, G; Briggs, T W R; Pollock, R

    2011-03-01

    Between 1997 and 2007, 68 consecutive patients underwent replacement of the proximal humerus for tumour using a fixed-fulcrum massive endoprosthesis. Their mean age was 46 years (7 to 87). Ten patients were lost to follow-up and 16 patients died. The 42 surviving patients were assessed using the Musculoskeletal Tumor Society (MSTS) Score and the Toronto Extremity Salvage Score (TESS) at a mean follow-up of five years and 11 months (one year to ten years and nine months). The mean MSTS score was 72.3% (53.3% to 100%) and the mean TESS was 77.2% (58.6% to 100%). Four of 42 patients received a new constrained humeral liner to reduce the risk of dislocation. This subgroup had a mean MSTS score of 77.7% and a mean TESS of 80.0%. The dislocation rate for the original prosthesis was 25.9; none of the patients with the new liner had a dislocation at a mean of 14.5 months (12 to 18). Endoprosthetic replacement for tumours of the proximal humerus using this prosthesis is a reliable operation yielding good results without the documented problems of unconstrained prostheses. The performance of this prosthesis is expected to improve further with a new constrained humeral liner, which reduces the risk of dislocation.

  19. Bone remodelling analysis of the humerus after a shoulder arthroplasty.

    PubMed

    Quental, Carlos; Folgado, João; Fernandes, Paulo R; Monteiro, Jacinto

    2012-10-01

    The shoulder arthroplasty has become an efficient treatment for some pathologies. However there are complications that can compromise its success. Among them, the stress shielding effect on the humerus has been reported as a possible cause of failure. The objective of this work was to investigate the bone remodelling in the humerus after a shoulder arthroplasty. For this purpose, computational models were developed to analyse the stress shielding contribution to the humeral component failure of shoulder arthroplasties, with a cemented and an uncemented prosthesis. A computational remodelling model was used to characterize the bone apparent density at each site of the humerus. The density distribution was obtained by the solution of a problem that takes into account both structural stiffness and the metabolic cost of bone maintenance. Bone was subjected to 6 load cases that include the glenohumeral reaction force and the action of 10 muscles. In the implanted models, different interface conditions were tested for the bone-implant and the cement-implant interfaces. Moreover, a pathological case defined by a poorer quality of bone was considered. In the healthy situation, the models that better model in vivo conditions showed no significant changes in bone mass. However, the results for the pathological case showed some bone resorption which supports the importance given to the quality of bone in the success of the joint replacement. Bearing in mind the conditions addressed, the results lead to conclude that the stress shielding is not a key factor for the humeral component failure of shoulder arthroplasties in a healthy situation though several issues, including muscle function and bone quality, may heighten its effect.

  20. Humerus Diaphysis Fracture in a Newborn during Vaginal Breech Delivery

    PubMed Central

    Kaya, Baris; Daglar, Korkut; Kirbas, Ayse; Tüten, Abdullah

    2015-01-01

    While most obstetricians are familiar with fracture of the clavicle in newborns during birth, an unlucky minority of obstetricians has encountered long-bone fractures in newborns as well. This complication is traumatic not only for the neonate, but also for the family and the obstetrician; it is also difficult to explain. Fortunately, the long-term prognosis for fracture of the long bones is excellent. Both vaginal and cesarean breech deliveries and maneuvers can be responsible for birth traumas, including long-bone fractures. This case report presents a newborn with breech presentation delivered vaginally that resulted in humerus diaphysis fracture. PMID:26770851

  1. Long bone (humerus, femur, tibia) measuring procedure in cadavers.

    PubMed

    Menéndez Garmendia, Antinea; Gómez-Valdés, Jorge A; Hernández, Francisco; Wesp, Julie K; Sánchez-Mejorada, Gabriela

    2014-09-01

    In this work, we present a measuring methodology for long bones of the limbs (humerus, femur, and tibia) of human corpses. Measurements of cadaveric height and long bone lengths were conducted on 72 corpses (20 females and 52 males) from the School of Medicine at the National Autonomous University of Mexico. Additionally, these measurements were compared with those taken from dry bones of a subsample of individuals. Our results show marginal differences (TEM% = 0.59) between cadaveric and dry bone measurements, resulting from different osteometric technical procedures. This note outlines the measuring methodology, which will be subsequently used to create regression formulas for stature estimation.

  2. Proximal Tibial Bone Graft

    MedlinePlus

    ... All Site Content AOFAS / FootCareMD / Treatments Proximal Tibial Bone Graft Page Content What is a bone graft? Bone grafts may be needed for various ... the proximal tibia. What is a proximal tibial bone graft? Proximal tibial bone graft (PTBG) is a ...

  3. Study on Impact Loading and Humerus Injury for Baseball

    NASA Astrophysics Data System (ADS)

    Sakai, Shinobu; Oda, Juhachi; Yonemura, Shigeru; Sakamoto, Jiro

    In the United States and Japan, baseball is a very popular sport played by many people. However, the ball used is hard and moves fast. A professional baseball pitcher in good form can throw a ball at speeds upwards of 41.7m/s (150km/hr). If a ball at this speed hits the batter, serious injury can occur. In this paper we will describe our investigations on the impact of a baseball with living tissues by finite element analysis. Baseballs were projected at a load cell plate using a specialized pitching machine. The dynamic properties of the baseball were determined by comparing the wall-ball collision experimentally measuring the time history of the force and the displacement using dynamic finite element analysis software (ANSYS/ LS-DYNA). The finite element model representing a human humerus and its surrounding tissue was simulated for balls pitched at variable speeds and pitch types (knuckle and fastball). In so doing, the stress distribution and stress wave in the bone and soft tissue were obtained. From the results, the peak stress of the bone nearly yielded to the stress caused by a high fast ball. If the collision position or direction is moved from the center of the upper arm, it is assumed that the stress exuded on the humerus will be reduced. Some methods to reduce the severity of the injury which can be applied in actual baseball games are also discussed.

  4. Flowerpot sequestrum of the Humerus Neglect for 10 years!!

    PubMed Central

    Sharma, Rakesh

    2012-01-01

    Introduction: Neglected cases of osteomyelitis are not uncommon. We present a case of humerus osteomyelitis neglected for 10 years and presented with a sequestrum protruding out of the arm in the shape of a flowerpot. Such a long duration of neglect and a startling presentation are rare and have implications not only on healthcare but also reflect the socio-economic and cultural fabric of the society. Case Report: 22 year old lady presented with history of bone jutting out of right arm since last 10 years. She had a trivial injury to the arm 10 years back followed by pain and fever. She was treated by local osteopath and ‘registered’ doctors but developed wound over the arm with purulent discharge. On and off treatment with dressing was continued with symptomatic relief but in few weeks bone fragment started protruding out of the wound. The size of bone protruding from the wound increased gradually with on and off history of discharge since 10 years. Clinically a flowerpot shaped sequestrum was seen protruding from the arm. Radiographs showed a defined diaphyseal sequestrum of the humerus with continuity of the bone maintained by new bone formation. Sequestrectomy was done and at one year follow up patient was fine with no recurrence of infection Conclusions: Lack of health infrastructure, ignorance, and other social and cultural factors lead to such bad wounds. Even with such long history a single surgery for debridement and sequestrectomy was all that was needed for healing the patient.

  5. 4D-CTA improves diagnostic certainty and accuracy in the detection of proximal intracranial anterior circulation occlusion in acute ischemic stroke

    PubMed Central

    Wagemans, Bart A. J. M.; van Zwam, Wim H.; Nelemans, Patricia J.; van Oostenbrugge, Robert J.; Postma, Alida A.

    2017-01-01

    Introduction In acute ischemic stroke, imaging of the cranio-cervical vessels is essential for intra-arterial treatment selection. Fast, reliable and easy accessible imaging is necessary 24 hours a day, 7 days a week. Radiologists in training and non-expert readers often perform initial reviewing. In this pilot study, the potential benefit of adding 4Dimensional-CT Angiography (4D-CTA) to the patient selection protocol for intra-arterial therapy is investigated. Materials and methods Twenty-five datasets of prospectively recruited patients, eligible for intra-arterial treatment, were enrolled. Four radiologists-in-training consecutively reviewed CTA, CT-Perfusion and 4D-CTA (post-processed from CTP datasets) and scored: occlusion-presence and diagnostic certainty (scale 1–10). Time-to-diagnosis was registered. Results Arterial occlusion was present in 8 patients. Accuracy improved from 88–92% after CTA and CTP assessment to 96–100% after 4D-CTA assessment (P-values >0,05). Mean diagnostic certainty improved from 7,2–8,6 to 8,8–9,3 (P-values all < 0,05). Mean time to diagnosis increased from 3, 5, 5 and 4 minutes after CTA to 9, 14, 12, and 10 minutes after 4D-CTA. Conclusion 4D-CTA as an additive to regular CTA and CT-Perfusion in patients with acute ischemic stroke eligible for intra-arterial treatment shows a tendency to increase diagnostic accuracy and improves diagnostic certainty, when reviewed by radiologist in training, while only mildly prolonging time to diagnosis. PMID:28234928

  6. The management of nonunion and malunion of the distal humerus--a 30-year experience.

    PubMed

    Jupiter, Jesse B

    2008-01-01

    This personal series of nonunions of the distal humerus reviews unique features of this problem, categorizes them according to unique anatomic features, and presents pitfalls and pearls in the management of these complex reconstructive problems.

  7. Occult fractures of the greater tuberosity of the humerus.

    PubMed

    Gumina, S; Carbone, S; Postacchini, F

    2009-02-01

    We studied the highest reported number of patients with occult fracture of the greater tuberosity of the humerus and we analysed why fracture was not diagnosed, shoulder function and prevalence of eventually associated rotator cuff tear (RCT). Twenty-four patients with a missed fracture of the greater tuberosity underwent MR study for a suspect RCT. We evaluated shoulder function and self-assessed comfort with the Constant score (CS) and Simple Shoulder Test (SST). Nine patients showed evidence of cuff tendinosis, 11 of partial (p) RCT (2: subscapularis; 6: supraspinatus and 3: supraspinatus and infraspinatus). All patients with pRCT were older than 40. Initially, the mean CS and SST were 54% and 5/12; at follow-up, values increased to 36% and 5 points. MR should be performed in patients apparently negative for fracture but with painful shoulders and decreased ROM. Of our patients, 45.8% had pRCT; nevertheless function recovery was verified in 16 weeks.

  8. Biomechanical study of different plate configurations for distal humerus osteosynthesis.

    PubMed

    Bogataj, M; Kosel, F; Norris, R; Krkovic, M; Brojan, M

    2015-05-01

    Fractures of the distal humerus are most commonly fixed by open reduction and internal fixation, using plates and screws, either in a locking or in a non-locking construct. Three different plating systems are commonly used in practice. The most important differences between them are in plate orientation, which affects both the rigidity of the osteosynthesis and invasiveness of the surgical procedure. Unfortunately, there is no common agreement between surgeons about which plate configuration brings the best clinical outcome. In this study, we investigate the theoretical rigidity of plate osteosyntheses considering two types of AO/ASIF configurations (90° angle between plates), Mayo clinic (Acumed) configuration (180° between plates) and dorsal fixation of both plates. We also compared the results for cases with and without contact between the bone fragments. In the case of no bone contact, the Mayo clinic plate configuration is found to be the most rigid, followed by both AO/ASIF plate configurations, and the least rigid system is the Korosec plate configuration. On the other hand, no significant differences between all types of fixation configurations are found in cases with contact in-between the bone fragments. Our findings show that this contact is very important and can compensate for the lack of load carrying capacity of the implants. This could therefore incite other implant fixation solutions, leading to less invasive surgical procedures and consequently improved clinical outcome.

  9. Effects of spaceflight on rat humerus geometry, biomechanics, and biochemistry

    NASA Technical Reports Server (NTRS)

    Vailas, A. C.; Zernicke, R. F.; Grindeland, R. E.; Kaplansky, A.; Durnova, G. N.; Li, K. C.; Martinez, D. A.

    1990-01-01

    The effects of a 12.5-day spaceflight (Cosmos 1887 biosatellite) on the geometric, biomechanical, and biochemical characteristics of humeri of male specific pathogen-free rats were examined. Humeri of age-matched basal control, synchronous control, and vivarium control rats were contrasted with the flight bones to examine the influence of growth and space environment on bone development. Lack of humerus longitudinal growth occurred during the 12.5 days in spaceflight. In addition, the normal mid-diaphysial periosteal appositional growth was affected; compared with their controls, the spaceflight humeri had less cortical cross-sectional area, smaller periosteal circumferences, smaller anterior-posterior periosteal diameters, and smaller second moments of area with respect to the bending and nonbending axes. The flexural rigidity of the flight humeri was comparable to that of the younger basal control rats and significantly less than that of the synchronous and vivarium controls; the elastic moduli of all four groups, nonetheless, were not significantly different. Generally, the matrix biochemistry of the mid-diaphysial cross sections showed no differences among groups. Thus, the spaceflight differences in humeral mechanical strength and flexural rigidity were probably a result of the differences in humeral geometry rather than material properties.

  10. The humerus of Cryptotis colombiana and its bearing on the species? phylogenetic relationships (Soricomorpha: Soricidae)

    USGS Publications Warehouse

    Woodman, N.; Cuartas-Calle, C.A.; Delgado-V., C.A.

    2003-01-01

    The Colombian small-eared shrew, Cryptotis colombiana Woodman and Timm, was described from the Colombian Andes in 1993. Its original allocation to the Cryptotis nigrescens-group recently was questioned based on several cranial characters the species appeared to share with some members of the Cryptotis thomasi-group. We review characteristics of the C. nigrescens- and C. thomasi-groups, and we describe the humerus of C. colombiana and the humerus and manus of Cryptotis medellinia. The morphology of the humerus joins the suite of characters that supports the hypotheses that C. colombiana is not a member of the C. thomasi-group and that all remaining South American species form a cohesive, definable set that is probably monophyletic.

  11. Role of proximal tubules in the pathogenesis of kidney disease.

    PubMed

    Nakhoul, Nazih; Batuman, Vecihi

    2011-01-01

    The proximal tubules make up a significant portion of the kidneys; proximal tubule epithelial cells are the most populous cell type in the kidney, and carry out diverse regulatory and endocrine functions where numerous transporters are located. Under normal circumstances, more than two thirds of filtered salt and water, and all filtered bicarbonate is reabsorbed in the proximal tubule. A number of inherited and acquired acid-base and tubule disorders are linked to impaired transporters in the proximal tubule cells. Equally important is the intrinsic immune characteristics of proximal tubule cells that give them the ability to also function as immune responders to a wide range of immunologic, ischemic or toxic injury. It is therefore not surprising that proximal tubule-related phenomena are closely related to the pathogenesis of a vast array of kidney diseases. Many kidney diseases, acute and chronic, first manifest with proximal tubule disorders. Recent insight into molecular characteristics of transport functions in the proximal tubules, and the recognition that proximal tubule cells possess intrinsic immune responses have contributed to an improved understanding of important areas in nephrology, such as Fanconi's syndrome, renal tubular acidosis, phosphate wasting syndromes, Dent's disease, cystinuria and other amino acid transport disorders, acute kidney injury, and the role of proximal tubules in progressive kidney disease. Megalin/ cubilin-mediated endocytosis by proximal tubule cells of increased quantities of filtered proteins (protein overloading) in glomerular diseases appears to evoke cell stress responses resulting in increased inflammatory cytokines leading to tubulointerstitial inflammation and fibrosis. Finally, the proximal tubule may be the site of both active vitamin D synthesis through the action of 1-α-hydroxylase, and the site where erythropoietin synthesis takes place. Thus, proximal tubule injury also contributes to two distressing

  12. Capacitive proximity sensor

    DOEpatents

    Kronberg, J.W.

    1994-05-31

    A proximity sensor based on a closed field circuit is disclosed. The circuit comprises a ring oscillator using a symmetrical array of plates that creates an oscillating displacement current. The displacement current varies as a function of the proximity of objects to the plate array. Preferably the plates are in the form of a group of three pair of symmetric plates having a common center, arranged in a hexagonal pattern with opposing plates linked as a pair. The sensor produces logic level pulses suitable for interfacing with a computer or process controller. The proximity sensor can be incorporated into a load cell, a differential pressure gauge, or a device for measuring the consistency of a characteristic of a material where a variation in the consistency causes the dielectric constant of the material to change. 14 figs.

  13. Capacitive proximity sensor

    DOEpatents

    Kronberg, James W.

    1994-01-01

    A proximity sensor based on a closed field circuit. The circuit comprises a ring oscillator using a symmetrical array of plates that creates an oscillating displacement current. The displacement current varies as a function of the proximity of objects to the plate array. Preferably the plates are in the form of a group of three pair of symmetric plates having a common center, arranged in a hexagonal pattern with opposing plates linked as a pair. The sensor produces logic level pulses suitable for interfacing with a computer or process controller. The proximity sensor can be incorporated into a load cell, a differential pressure gauge, or a device for measuring the consistency of a characteristic of a material where a variation in the consistency causes the dielectric constant of the material to change.

  14. Intercondylar fracture of the distal humerus in a 7-year-old child

    PubMed Central

    Tomori, Yuji; Sudo, Yoshihiro; Iizawa, Norishige; Nanno, Mitsuhiko; Takai, Shinro

    2017-01-01

    Abstract Rationale: Intercondylar fracture of the distal humerus is an extremely rare injury in children, especially in those under 8 years of age. To our best knowledge, there have been 55 reported cases of this fracture type in children in the English literature, 12 of which involved children under 8 years of age. Patient Concerns: We report a case of intercondylar fracture of the distal humerus in a7-year-old boy fell in a gymnasium, injuring his left elbow. Interventions: Closed reduction was initially attempted under fluoroscopic guidance, but anatomic reduction could not be achieved because the fragments were extremely unstable and irreducible. Considering the displacement and the failure of closed reduction, ORIF through a posterior approach was performed. Open reduction and double cross-pinning across the medial and lateral condylar fragments were performed through a posterior approach. Diagnoses: Plain radiographs showed a displaced intercondylar fracture of the distal humerus. Arthrography under general anesthesia showed a severely displaced intra-articular fracture, with rotational displacement of the lateral condyle. Outcomes: Thirteen months after surgery, there was no functional disturbance or radiographic evidence of avascular necrosis or epiphyseal growth arrest. Lessons: Open reduction and double cross-pinning through a posterior approach can be a reliable procedure for intercondylar fracture of the distal humerus in children. PMID:28178167

  15. Treatment of the external epicondylitis of the humerus with a magnetic field

    NASA Technical Reports Server (NTRS)

    Degen, I. L.

    1974-01-01

    The therapeutic effect of a constant and varying magnetic field on epicondylitis of the humerus is studied on ninety patients. Good results are obtained from the treatment (recovery of 80%, considerable improvement in 14.5%). The method is recommended for clinical application.

  16. Proximal Hamstring Repair Strength

    PubMed Central

    Harvey, Margaret Ann; Singh, Hardeep; Obopilwe, Elifho; Charette, Ryan; Miller, Suzanne

    2015-01-01

    Background: Proximal hamstring repair for complete ruptures has become a common treatment. There is no consensus in the literature about postoperative rehabilitation protocols following proximal hamstring repair. Some protocols describe bracing to prevent hip flexion or knee extension while others describe no immobilization. There are currently no biomechanical studies evaluating proximal hamstring repairs; nor are there any studies evaluating the effect of different hip flexion angles on these repairs. Hypothesis: As hip flexion increases from 0° to 90°, there will be a greater gap with cyclical loading. Study Design: Controlled laboratory study. Methods: Proximal hamstring insertions were detached from the ischial tuberosity in 24 cadavers and were repaired with 3 single-loaded suture anchors in the hamstring footprint with a Krakow suture technique. Cyclic loading from 10 to 125 N at 1 Hz was then performed for 0°, 45°, and 90° of hip flexion for 1500 cycles. Gap formation, stiffness, yield load, ultimate load, and energy to ultimate load were compared between groups using paired t tests. Results: Cyclic loading demonstrated the least amount of gap formation (P < .05) at 0° of hip flexion (2.39 mm) and most at 90° of hip flexion (4.19 mm). There was no significant difference in ultimate load between hip flexion angles (326, 309, and 338 N at 0°, 45°, and 90°, respectively). The most common mode of failure occurred with knot/suture failure (n = 17). Conclusion: Increasing hip flexion from 0° to 90° increases the displacement across proximal hamstring repairs. Postoperative bracing that limits hip flexion should be considered. Clinical Relevance: Repetitive motion involving hip flexion after a proximal hamstring repair may cause compromise of the repair. PMID:26665049

  17. Traumatic proximal tibiofibular dislocation.

    PubMed

    Burgos, J; Alvarez-Montero, R; Gonzalez-Herranz, P; Rapariz, J M

    1997-01-01

    Proximal tibiofibular dislocation is an exceptional lesion. Rarer still is its presentation in childhood. We describe the clinical case of a 6-year-old boy, the victim of a road accident. He had a tibiofibular dislocation associated with a metaphyseal fracture of the tibia.

  18. Steerable Capacitive Proximity Sensor

    NASA Technical Reports Server (NTRS)

    Jenstrom, Del T.; Mcconnell, Robert L.

    1994-01-01

    Steerable capacitive proximity sensor of "capaciflector" type based partly on sensing units described in GSC-13377 and GSC-13475. Position of maximum sensitivity adjusted without moving sensor. Voltage of each driven shield adjusted separately to concentrate sensing electric field more toward one side or other.

  19. Proximate Analysis of Coal

    ERIC Educational Resources Information Center

    Donahue, Craig J.; Rais, Elizabeth A.

    2009-01-01

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,…

  20. Subacute diabetic proximal neuropathy

    NASA Technical Reports Server (NTRS)

    Pascoe, M. K.; Low, P. A.; Windebank, A. J.; Litchy, W. J.

    1997-01-01

    OBJECTIVE: To evaluate the clinical, electrophysiologic, autonomic, and neuropathologic characteristics and the natural history of subacute diabetic proximal neuropathy and its response to immunotherapy. MATERIAL AND METHODS: For the 12-year period from 1983 to 1995, we conducted a retrospective review of medical records of Mayo Clinic patients with diabetes who had subacute onset and progression of proximal weakness. The responses of treated versus untreated patients were compared statistically. RESULTS: During the designated study period, 44 patients with subacute diabetic proximal neuropathy were encountered. Most patients were middle-aged or elderly, and no sex preponderance was noted. The proximal muscle weakness often was associated with reduced or absent lower extremity reflexes. Associated weight loss was a common finding. Frequently, patients had some evidence of demyelination on nerve conduction studies, but it invariably was accompanied by concomitant axonal degeneration. The cerebrospinal fluid protein concentration was usually increased. Diffuse and substantial autonomic failure was generally present. In most cases, a sural nerve biopsy specimen suggested demyelination, although evidence of an inflammatory infiltrate was less common. Of 12 patients who received treatment (with prednisone, intravenous immune globulin, or plasma exchange), 9 had improvement of their conditions, but 17 of 29 untreated patients (59%) with follow-up also eventually had improvement, albeit at a much slower rate. Improvement was usually incomplete. CONCLUSION: We suggest that the entity of subacute diabetic proximal neuropathy is an extensive and severe variant of bilateral lumbosacral radiculoplexopathy, with some features suggestive of an immune-mediated cause. It differs from chronic inflammatory demyelinating polyradiculoneuropathy in that most cases have a more restricted distribution and seem to be monophasic and self-limiting. The efficacy of immunotherapy is unproved

  1. Proximity Networks and Epidemics

    NASA Astrophysics Data System (ADS)

    Guclu, Hasan; Toroczkai, Zoltán

    2007-03-01

    We presented the basis of a framework to account for the dynamics of contacts in epidemic processes, through the notion of dynamic proximity graphs. By varying the integration time-parameter T, which is the period of infectivity one can give a simple account for some of the differences in the observed contact networks for different diseases, such as smallpox, or AIDS. Our simplistic model also seems to shed some light on the shape of the degree distribution of the measured people-people contact network from the EPISIM data. We certainly do not claim that the simplistic graph integration model above is a good model for dynamic contact graphs. It only contains the essential ingredients for such processes to produce a qualitative agreement with some observations. We expect that further refinements and extensions to this picture, in particular deriving the link-probabilities in the dynamic proximity graph from more realistic contact dynamics should improve the agreement between models and data.

  2. A new technique of endoprosthetic replacement for osteosarcoma of proximal femur with intra-articular extension

    PubMed Central

    Oragui, E.; Nannaparaju, M.; Sri-Ram, K.; Khan, W.; Hashemi-Nejad, A.; Skinner, J.

    2012-01-01

    INTRODUCTION Osteosarcoma is the most common primary malignant tumour of bone and commonly involved sites are the distal femur, proximal tibia, and humerus. Osteosarcoma of proximal femur usually arises at the metaphysis and articular cartilage acts as a relative barrier to tumour spread, with extension into the hip joint being extremely rare. PRESENTATION OF CASE A previously fit and well sixteen-year-old male presented with a 2 month history of right hip pain and a limp. Plain radiographs and magnetic resonance imaging (MRI) showed an expansile lesion in the right femoral neck, extending 16 cm distally from the proximal femoral articular surface through the intertrochanteric region into the upper right femoral shaft. There was also clear evidence of intra-articular extension into the acetabulum. DISCUSSION Endoprosthetic replacement following resection is a good treatment option for proximal femoral tumours due to the low complication rate and achievement of good postoperative function. However, treatment of a proximal femoral lesion with intra-articular involvement by prosthetic reconstruction is challenging. We report a patient who presented with osteosarcoma of the proximal femur extending into the hip joint and describe the technique of en-bloc extra-articular resection of the acetabulum and proximal femur with reconstruction using a custom made prosthesis. CONCLUSION We conclude that extra-articular resection and endoprosthetic reconstruction using a coned hemi-pelvic implant with fluted stem and a modular femoral implant is a useful treatment option in the management of a proximal femoral lesion involving the hip-joint. It allows adequate tumour clearance and stable reconstruction for rapid post-operative recovery with early mobilisation. PMID:23147775

  3. [Lesions of the peripheral nerves after surgical treatment of fractures of the distal humerus].

    PubMed

    Avdić, Dijana; Gavrankapetanović, Ismet; Gavrankapetanović, Faris

    2003-01-01

    In the work we have examined 44 patients (16 women and 28 men), which the break of distal humerus is saned with operation, using adequate OSM. The average years of women patients was 29 (from 3 to 79), and of male patients 24 (from 1 to 75). After thr operative sanitary breaks distal part of humerus, using adequate OSM (fillo Kurschneri, platho metalico, clavo spiralis), it can come on lesion of perifer nerves of the arm, and mostly of n. radialis. Lesions of n. radialis we have notice on 5 patients. The rehabilitation our patients was made with prevention contraction of shoulder, elbow, hand and fingers using kinesitherapy, hydrotherapy and electrotherapy paralysis musculature with intentional exercises to the reinervation of perifer motor neuron and raising the force of musculus.

  4. [Fractures of the head and tuberosities of the humerus: treatment of malposition (author's transl)].

    PubMed

    Kipfer, M

    1979-01-27

    Fractures of the head and tuberosities of the humerus combine "horizontalisation" with impaction of the head of the humerus into the cortical funnel of the upper metaphysis which then forms a "buffer" with a sub-acromial "camshaft effect". In addition, there may be a subjacent metaphyseal comminution or even a split in the head. These various factors render surgical treatment difficult, when it is sought to restore normal anatomical conditions by osteosynthesis, with uncertain anatomical and functional results because of the double risk of early separation of the fragments and of secondary necrosis. There exists the possibility of operation vis a transdeltoid approach which combines resection of the cortical cuff and lateral transposition with bringing down of the capsulo-tendinous layer. This simple technique has the advantage of almost invariably offering a satisfactory functional result.

  5. Location of treatment of supracondylar fractures of the humerus in children.

    PubMed

    Kasser, James R

    2005-05-01

    A change in the locations where children are treated for supracondylar fractures of the humerus has occurred during the past 13 years. Pediatric orthopaedic surgeons at specialist centers are seeing an increased number of such fractures. In New England, the number of supracondylar fractures of the humerus treated by closed reduction and percutaneous pinning has remained relatively constant between 1991 and 1999 with a range of 276 to 346 fractures per year, averaging 320 per year. In 1991, 63% of patients were treated by general orthopaedic surgeons in a nonspecialist setting. By 1999, 68% of the fractures were treated at centers with pediatric orthopaedic specialists available whereas only 32% were treated in a general orthopaedic setting. Associated with this change is a decreased length of stay from 2.2 (+/- 0.6) days in nonspecialist centers to 1.4 (+/- 0.4) days average in specialist centers.

  6. Atypical Presentation of Tuberculosis of Elbow Joint in Operated Case of Distal Humerus Fracture

    PubMed Central

    Gaikwad, Yogesh; Khadilkar, Madhav; Ranade, Ashish S.; Vartak, Devendra N.

    2015-01-01

    Introduction: A typical presentations of tuberculosis are not uncommon. Periprosthetic infection with tuberculosis after total joint replacement has well published. Tuberculosis of the elbow following open reduction internal fixation of a distal humerus fraeture is extremely rare. Case Report: We report case of a healthy, immunocompetenet 49-year-old male who underwent open reduction and internal fixation with bicolumnar plating for distal humerus fracture and presented after 18 month with cystic swelling over medial aspect of operated site. There was no wound dehiscence and the underlying fracture was healed well without any signs of implant loosening or bony involvement. Cystic swelling was excised and histopathology provided the diagnosis of tuberculosis. Patient was treated with anti tubercular chemotherapy and patient made uneventful recovery. Conclusion: Although synovial tuberculosis after fracture fixation is a rare entity, tuberculosis should be kept as a differential diagnosis. Surgeons should have high index of suspicion to diagnose atypical presentations of tuberculosis. PMID:27299044

  7. Use of orthogonal or parallel plating techniques to treat distal humerus fractures.

    PubMed

    Abzug, Joshua M; Dantuluri, Phani K

    2010-08-01

    Distal humerus fractures continue to be a complex fracture to treat. This article describes two surgical techniques that can be used to tackle these difficult fractures: Parallel plating and orthogonal plating. Both techniques have yielded excellent outcomes after open reduction and internal fixation; yet each has its own set of unique considerations. However, the key to successful treatment of these difficult fractures regardless of technique remains obtaining anatomic reduction with stable fixation and the implementation of early motion.

  8. Functional outcome of intraarticular distal humerus fracture fixation using triceps-sparing paratricipital approach

    PubMed Central

    Yadav, Vishal; Sharma, Pulak; Gohiya, Ashish

    2016-01-01

    Background: Displaced intraarticular distal humerus fracture has been conventionally treated operatively with various triceps disrupting approaches. These approaches are associated with several complications, such as triceps weakness, nonunion or delayed union of osteotomy, implant prominence, and delayed mobilization of the elbow. We present the functional outcome of intraarticular distal humerus fracture fixation using a triceps-sparing paratricipital approach which allows early elbow mobilization and preserving triceps strength. Materials and Methods: Twenty five patients with intraarticular distal humerus fracture were operated using triceps-sparing paratricipital approach with orthogonal plate construct. There were 16 male and 9 female patients and average age was 42.16 years (range 23-65 years). The mechanism of injury was fall from height (n = 8), road traffic accident (n = 13) and ground level fall (n = 4). Clinical, radiological, and functional assessment with Mayo Elbow Performance Index (MEPI) were obtained at follow up period. Results: All fractures united primarily. At the mean follow up of 13.58 months (range 6-22 months), mean elbow flexion was 121.08° (range 94°–142°) and mean motion arc was 114.92°(range 65°-140°). The mean MEPI score was 94.40 points (range 70–100) with 17 excellent, five good, and three fair results. The mean flexion deformity or extension loss was 6.16° (range 5°–15°). Conclusion: Open reduction and internal fixation of intraarticular distal humerus fractures with triceps-sparing paratricipital approach provide adequate exposure with no adverse effect on triceps muscle strength and allows early initiation of elbow motion. We analyzed, age and injury to surgical interval with relation to functional range of elbow using Z-test which is insignificant. PMID:27904213

  9. Short-Term Complications of Distal Humerus Fractures in Elderly Patients

    PubMed Central

    Keswani, Aakash; Koehler, Steven M.; Kim, Jaehon; Hausman, Michael

    2016-01-01

    Background: The purpose of this study was to evaluate 30-day postoperative complications of open reduction and internal fixation [ORIF] and total elbow arthroplasty [TEA] for the treatment of distal humerus fractures in elderly patients using a validated national database. Methods: Review of the National Surgical Quality Improvement Program (NSQIP) Database identified all elderly patients (>65 years) who underwent TEA or ORIF for the treatment of closed intra-articular distal humerus fractures from 2007 to 2013. Bivariate and multivariate analyses of risk factors for 30-day adverse events as defined by NSQIP between ORIF and TEA groups were assessed using preoperative and intraoperative variables. Results: Among the 176 patients with distal humerus fractures, there were 33 TEA and 143 ORIF. There was no difference in age, medical comorbidities, or functional status. Total elbow arthroplasty was associated with an increased odds of severe adverse event compared to ORIF (odds ratio = 1.57, P = .16), although it did not achieve statistical significance. Infection rate was 0.7% in ORIF and 0.0% in TEA (P = .99). Insulin-dependent diabetes and functional status were significant independent predictors of postoperative adverse events. Operative time (165 minutes vs 140 minutes, P = .06) and postoperative length of stay (3.6 days vs 2.3 days, P = 0.03) were longer for TEA compared to ORIF. Conclusion: Open reduction and internal fixation and TEA have similar 30-day postoperative complications for the treatment of distal humerus fractures among elderly patients. Despite favorable trends for TEA in recent studies, additional clinical results are needed to understand complications and limitation of TEA. Level of evidence: Level III, prognostic study. PMID:26929856

  10. Mega Prosthetic Replacement of Elbow for Resistant Nonunion of Distal Humerus

    PubMed Central

    Vaishya, Raju; Vijay, Vipul; Pandit, Ram Sagar; Agarwal, Amit K

    2016-01-01

    Introduction: Fractures of the distal humerus are a rare entity accounting for approximately 2% of the humeral fractures. Non union of the distal humerus is further rare and poses a major challenge. These fractures usually respond to open reduction and bone grafting but some may fail multiple surgical attempts at union and hence are labelled as “resistant” non union. We report a case of resistant non union of the distal humerus which was managed by total elbow arthroplasty. Case Presentation: A 49-year-old male presented to the out patient department with history of a compound comminuted fracture of the distal end of the humerus approximately 25 years back. The fracture was treated with multiple debridements and plaster cast application. There was involvement of the radial and the ulnar nerves as well. The patient continued to use the disabled upper limb with severe difficulties in activities of daily living (ADL). The patient finally presented to us for regaining some range of motion and improvement in his ADL. In view of the grossly distorted anatomy, bone loss and chronic nature of the problem, patient was offered total elbow arthroplasty. The Wadsworth extensile posterior approach was used for exposure of the non union site. The fragments were found to be small, osteoporotic and deformed. In view of the distorted anatomy, the elbow was finally salvaged with mega-prosthetic replacement of the elbow. Posterior elbow splint was used for 2 weeks and active as well as passive range of motion was started after that. The post-operative Mayo elbow score improved from 50 to 80 and the patient was able to achieve a range of motion from 10 degrees to 110 degrees. Conclusion: Total elbow arthroplasty can be used as a salvage procedure for resistant non union of the elbow with failed multiple failed attempts at union. It can also be used as a definitive procedure for severely distorted non union with massive bone loss with satisfactory functional results. PMID:27703937

  11. The humerus of Eusthenopteron: a puzzling organization presaging the establishment of tetrapod limb bone marrow

    PubMed Central

    Sanchez, S.; Tafforeau, P.; Ahlberg, P. E.

    2014-01-01

    Because of its close relationship to tetrapods, Eusthenopteron is an important taxon for understanding the establishment of the tetrapod body plan. Notably, it is one of the earliest sarcopterygians in which the humerus of the pectoral fin skeleton is preserved. The microanatomical and histological organization of this humerus provides important data for understanding the evolutionary steps that built up the distinctive architecture of tetrapod limb bones. Previous histological studies showed that Eusthenopteron's long-bone organization was established through typical tetrapod ossification modalities. Based on a three-dimensional reconstruction of the inner microstructure of Eusthenopteron's humerus, obtained from propagation phase-contrast X-ray synchrotron microtomography, we are now able to show that, despite ossification mechanisms and growth patterns similar to those of tetrapods, it also retains plesiomorphic characters such as a large medullary cavity, partly resulting from the perichondral ossification around a large cartilaginous bud as in actinopterygians. It also exhibits a distinctive tubular organization of bone-marrow processes. The connection between these processes and epiphyseal structures highlights their close functional relationship, suggesting that either bone marrow played a crucial role in the long-bone elongation processes or that trabecular bone resulting from the erosion of hypertrophied cartilage created a microenvironment for haematopoietic stem cell niches. PMID:24648231

  12. Ontogenetic scaling of the humerus in sea turtles and its implications for locomotion.

    PubMed

    Nishizawa, Hideaki; Asahara, Masakazu; Kamezaki, Naoki

    2013-03-01

    In the present study, we analyzed the ontogenetic scaling of humeri in the green turtle (Chelonia mydas) and loggerhead turtle (Caretta caretta). Green turtles have relatively thicker humeri than loggerhead turtles, indicating that the humerus of the green turtle can resist greater loads. Our results are consistent with isometry, or slightly negative allometry, of diameter in relation to length of the humerus in both species. Geometric similarity or isometry of the humerus in relation to body mass is supported by estimates of the cross-sectional properties of green turtles. Sea turtles are adapted for aquatic life, but also perform terrestrial locomotion. Thus, during terrestrial locomotion, which requires support against gravity, the observed scaling relationships indicate that there may be greater stress and fracture risk on the humeri of larger green turtles than on the humeri of smaller turtles. In aquatic habitats, in which limbs are mainly used for propulsion, the stress and fracture risk for green turtle humeri are estimated to increase with greater speed. This scaling pattern may be related to the possibility that smaller turtles swim at a relatively faster speed per body length.

  13. New endemic platyrrhine humerus from Haiti and the evolution of the Greater Antillean platyrrhines.

    PubMed

    Tallman, Melissa; Cooke, Siobhán B

    2016-02-01

    Much debate surrounds the phylogenetic affinities of the endemic Greater Antillean platyrrhines. Thus far, most phylogenetic analyses have been constructed and tested using craniodental characters. We add to this dialog by considering how features of the distal humerus support or refute existing hypotheses for the origins of fossil Caribbean primates, utilizing three-dimensional geometric morphometric data in combination with character based cladistic analyses. We also add to the sample of fossil platyrrhine humeri with the description of UF 114718, a new distal humerus from Haiti. We reconstruct UF 114718 to be a generalized, arboreal quadruped attributed to the species Insulacebus toussantiana. Our results from phylogenetic analyses lend some support to the idea that some Greater Antillean fossil taxa including Xenothrix mcgregori, Antillothrix bernensis, and Insulacebus toussaintiana could form a monophyletic clade that is sister to either extant Platyrrhini or basal pitheciids. Based on the distal humeral data, we reconstruct the earliest ancestral platyrrhine to be a generalized, arboreal quadruped that potentially emphasized pronated arm postures during locomotion and may have engaged in some limited climbing, most similar in shape to early anthropoids and some of the earliest Antillean forms. However, aspects of shape and standard qualitative characters relating to the distal humerus seem to be variable and prone to both homoplasy and reversals; thus these results must be interpreted cautiously and (where possible) within the context provided by other parts of the skeleton.

  14. Antegrade Unreamed Locked Intramedullary Nailing in Open Fractures of Shaft of Humerus

    PubMed Central

    Singh, Jasbir; Lal, Mukand; Chandel, Desh Raj

    2016-01-01

    Introduction Open fractures of shaft of humerus have been treated conservatively as well as operatively. Plate osteosynthesis has been considered as the gold standard treatment. Intramedullary nailing also has same success rate in closed fractures. The results of 30 open fractures of shaft humerus fixed with locked unreamed antegrade intramedullary nailing were evaluated. Aim The purpose of the study was to evaluate the role of locked intramedullary nailing in open fractures of shaft humerus in terms of bone union, secondary procedure required, complication, shoulder dysfunction and infection. Materials and Methods Of consecutive 365 humeral shaft fractures, 63 fractures were open. Thirty-two patients were operated with plate osteosynthesis, while 31 patients who were treated with locked unreamed intramedullary nails fulfilling the inclusion criteria entered the study. Results Twenty eight of thirty patients united in mean duration of 10.5 weeks. There were two non-unions both of them united with bone grafting and plate osteosynthesis. Seven patients had superficial infection which healed with antibiotic course, while two patients had deep infection, which healed with repeat debridement. Eleven patients had preoperative radial nerve palsy, nine of which healed completely in average of six months. Twenty eight patients had excellent functional outcome at final follow-up while two patients had good outcome. Conclusion Antegrade nailing is associated with good union rates and low infection rates and is a good option in open fractures and in polytrauma patients. PMID:27790533

  15. The humerus of Eusthenopteron: a puzzling organization presaging the establishment of tetrapod limb bone marrow.

    PubMed

    Sanchez, S; Tafforeau, P; Ahlberg, P E

    2014-05-07

    Because of its close relationship to tetrapods, Eusthenopteron is an important taxon for understanding the establishment of the tetrapod body plan. Notably, it is one of the earliest sarcopterygians in which the humerus of the pectoral fin skeleton is preserved. The microanatomical and histological organization of this humerus provides important data for understanding the evolutionary steps that built up the distinctive architecture of tetrapod limb bones. Previous histological studies showed that Eusthenopteron's long-bone organization was established through typical tetrapod ossification modalities. Based on a three-dimensional reconstruction of the inner microstructure of Eusthenopteron's humerus, obtained from propagation phase-contrast X-ray synchrotron microtomography, we are now able to show that, despite ossification mechanisms and growth patterns similar to those of tetrapods, it also retains plesiomorphic characters such as a large medullary cavity, partly resulting from the perichondral ossification around a large cartilaginous bud as in actinopterygians. It also exhibits a distinctive tubular organization of bone-marrow processes. The connection between these processes and epiphyseal structures highlights their close functional relationship, suggesting that either bone marrow played a crucial role in the long-bone elongation processes or that trabecular bone resulting from the erosion of hypertrophied cartilage created a microenvironment for haematopoietic stem cell niches.

  16. Proximal and distal muscle fatigue differentially affect movement coordination

    PubMed Central

    Cowley, Jeffrey C.

    2017-01-01

    Muscle fatigue can cause people to change their movement patterns and these changes could contribute to acute or overuse injuries. However, these effects depend on which muscles are fatigued. The purpose of this study was to determine the differential effects of proximal and distal upper extremity muscle fatigue on repetitive movements. Fourteen subjects completed a repetitive ratcheting task before and after a fatigue protocol on separate days. The fatigue protocol either fatigued the proximal (shoulder flexor) or distal (finger flexor) muscles. Pre/Post changes in trunk, shoulder, elbow, and wrist kinematics were compared to determine how proximal and distal fatigue affected multi-joint movement patterns and variability. Proximal fatigue caused a significant increase (7°, p < 0.005) in trunk lean and velocity, reduced humeral elevation (11°, p < 0.005), and increased elbow flexion (4°, p < 0.01). In contrast, distal fatigue caused small but significant changes in trunk angles (2°, p < 0.05), increased velocity of wrench movement relative to the hand (17°/s, p < 0.001), and earlier wrist extension (4%, p < 0.005). Movement variability increased at proximal joints but not distal joints after both fatigue protocols (p < 0.05). Varying movements at proximal joints may help people adapt to fatigue at either proximal or distal joints. The identified differences between proximal and distal muscle fatigue adaptations could facilitate risk assessment of occupational tasks. PMID:28235005

  17. Non-Melanoma-Associated Dyschromia of the Proximal Nail Fold

    PubMed Central

    Cohen, Philip R

    2016-01-01

    Subungual melanoma with pigmentation beneath the nail that extends to involve the proximal nail fold is referred to as Hutchinson’s sign. Black or brown subungual discoloration involving the proximal nail fold secondary to other etiologies has been referred to as pseudo-Hutchinson’s sign. Three patients with nail discoloration and concurrent dyschromia of the proximal nail fold are described: a female with a chronic subungual hematoma and pseudo-Hutchinson’s sign, a male with culture-confirmed Pseudomonas aeruginosa (P. aeruginosa) of the nail with green discoloration involving the proximal nail fold, and a male with an acute subungual hematoma with red-purple subungual discoloration affecting the proximal nail fold. PubMed was searched for the following: black, brown, chloronychia, discoloration, dyschromia, green, hematoma, Hutchinson’s sign, nail, nail fold, proximal, pseudo-Hutchinson’s sign, red, subungual melanoma, syndrome. The papers were reviewed and appropriate references evaluated. In conclusion, melanoma-associated black proximal nail fold pigmentation is referred to as Hutchinson’s sign, and non-melanoma-associated black pigmentation has been designated as pseudo-Hutchinson’s sign. Subungual nail plate discoloration extending to involve the proximal nail fold may be black, green, or red-purple in patients with melanocytic and non-melanocytic lesions, bacterial infection (Pseudomonas), and acute subungual hematoma, respectively. Instead of creating a new terminology, we suggest that non-black subungual discoloration (green or red-purple) extending to involve the proximal nail fold be referred to as pseudo pseudo-Hutchinson’s sign. PMID:28090415

  18. Echosonography with proximity sensors

    NASA Astrophysics Data System (ADS)

    Thaisiam, W.; Laithong, T.; Meekhun, S.; Chaiwathyothin, N.; Thanlarp, P.; Danworaphong, S.

    2013-03-01

    We propose the use of a commercial ultrasonic proximity sensor kit for profiling an altitude-varying surface by employing echosonography. The proximity sensor kit, two identical transducers together with its dedicated operating circuit, is used as a profiler for the construction of an image. Ultrasonic pulses are emitted from one of the transducers and received by the other. The time duration between the pulses allows us to determine the traveling distance of each pulse. In the experiment, the circuit is used with the addition of two copper wires for directing the outgoing and incoming signals to an oscilloscope. The time of flight of ultrasonic pulses can thus be determined. Square grids of 5 × 5 cm2 are made from fishing lines, forming pixels in the image. The grids are designed to hold the detection unit in place, about 30 cm above a flat surface. The surface to be imaged is constructed to be height varying and placed on the flat surface underneath the grids. Our result shows that an image of the profiled surface can be created by varying the location of the detection unit along the grid. We also investigate the deviation in relation to the time of flight of the ultrasonic pulse. Such an experiment should be valuable for conveying the concept of ultrasonic imaging to physical and medical science undergraduate students. Due to its simplicity, the setup could be made in any undergraduate laboratory relatively inexpensively and it requires no complex parts. The results illustrate the concept of echosonography.

  19. Throwing induces substantial torsional adaptation within the midshaft humerus of male baseball players.

    PubMed

    Warden, Stuart J; Bogenschutz, Elizabeth D; Smith, Heather D; Gutierrez, Anthony R

    2009-11-01

    Athletes participating in unilateral dominant sports are useful models for investigating skeletal responses to mechanical loading as they provide controlled evidence in the absence of completing a randomized controlled trial. Throwing athletes may be an additional model for this purpose as they overload their dominant upper extremity enabling the contralateral side to act as an internal control and load the bones of the upper extremity purely via the generation of internal (i.e. muscular) forces without superposition of externally applied loads (i.e. impact with an external object). The aim of this study was to investigate upper extremity bone adaptation in throwing athletes and explore factors that predict this adaptation. Two cohorts were recruited-male baseball players (throwers; n=15) and matched controls (controls; n=15). Each subject was assessed for shoulder range and strength, and upper extremity bone mass, structure and estimated strength. Throwers had substantially greater skeletal differences between their dominant and nondominant upper extremities than controls, indicating that throwing induces greater adaptation than induced by habitual loading of the dominant upper extremity. Bone adaptation in throwers was localized to the humerus, with the midshaft humerus in the dominant upper extremity of throwers having enhanced bone mass, structure and estimated strength. The largest effect was for estimated strength of the midshaft humerus which had 30% greater polar moment of inertia (I(P)) in throwers and suggests adaptation to resist torsional loads. The skeletal effect of throwing at the midshaft humerus was influenced by playing position with pitchers and catchers displaying greater dominant-to-nondominant differences than fielders, and was predicted by years throwing and dominant-to-nondominant difference in upper arm lean cross-sectional area. The latter two variables explained 67% of the variance in dominant-to-nondominant differences in I

  20. Some Properties of Fuzzy Soft Proximity Spaces

    PubMed Central

    Demir, İzzettin; Özbakır, Oya Bedre

    2015-01-01

    We study the fuzzy soft proximity spaces in Katsaras's sense. First, we show how a fuzzy soft topology is derived from a fuzzy soft proximity. Also, we define the notion of fuzzy soft δ-neighborhood in the fuzzy soft proximity space which offers an alternative approach to the study of fuzzy soft proximity spaces. Later, we obtain the initial fuzzy soft proximity determined by a family of fuzzy soft proximities. Finally, we investigate relationship between fuzzy soft proximities and proximities. PMID:25793224

  1. Some properties of fuzzy soft proximity spaces.

    PubMed

    Demir, İzzettin; Özbakır, Oya Bedre

    2015-01-01

    We study the fuzzy soft proximity spaces in Katsaras's sense. First, we show how a fuzzy soft topology is derived from a fuzzy soft proximity. Also, we define the notion of fuzzy soft δ-neighborhood in the fuzzy soft proximity space which offers an alternative approach to the study of fuzzy soft proximity spaces. Later, we obtain the initial fuzzy soft proximity determined by a family of fuzzy soft proximities. Finally, we investigate relationship between fuzzy soft proximities and proximities.

  2. Improved comfort and function of arm prosthesis after implantation of a Humerus-T-Prosthesis in trans-humeral amputees.

    PubMed

    Witsø, Eivind; Kristensen, Tomm; Benum, Pål; Sivertsen, Svein; Persen, Leif; Funderud, Are; Magne, Tordis; Aursand, Hans Petter; Aamodt, Arild

    2006-12-01

    The use of arm prosthesis in trans-humeral amputees is limited; due to the cone form of the amputation stump. A Humerus-T-Prosthesis was implanted in three patients to create artificial humerus condyles. Two of the patients were successfully rehabilitated with the application of a new type trans-humeral arm prosthesis. This arm prosthesis had a socket which is suspended and stabilized by the humerus and implant only. Traction and rotational stability were secured by adjustable pressure adaptation around the artificial condyles. The third patient developed a pressure wound over the lateral part of the artificial condyle that later healed. He also was subject to a new trauma with a fracture of the ipsilateral scapula and until now has had limited the use of his new arm prosthesis. It was concluded that this new concept for prosthesis fitting of trans-humeral amputees looks promising, but alternative designs of the implant should be tested.

  3. Current Strategies for the Management of Pediatric Supracondylar Humerus Fractures: Tips and Techniques for Successful Closed Treatment.

    PubMed

    Brighton, Brian; Abzug, Joshua M; Ho, Christine Ann; Ritzman, Todd F

    2016-02-15

    Pediatric supracondylar humerus fractures are the most commonly encountered type of elbow fractures in children that require surgical fixation. Many pediatric supracondylar humerus fractures can be treated with closed reduction and percutaneous skeletal fixation. In difficult fractures, adjunct pin techniques, such as joystick wires and leverage pins, can be used to help attain a satisfactory and stable reduction before an open approach is used. After the fracture is reduced, optimal pinning, with the use of either crossed or lateral-entry techniques, and fixation that achieves maximal spread at the fracture site as well as bicortical engagement in both fragments are essential to maintain reduction and avoid complications that are associated with malunion. A practical approach as well as several tips and techniques may help surgeons attain and maintain stable closed reduction of pediatric supracondylar humerus fractures.

  4. Current Strategies for the Management of Pediatric Supracondylar Humerus Fractures: Tips and Techniques for Successful Closed Treatment.

    PubMed

    Brighton, Brian; Abzug, Joshua; Ho, Christine Ann; Ritzman, Todd F

    2016-01-01

    Pediatric supracondylar humerus fractures are the most commonly encountered type of elbow fractures in children that require surgical fixation. Many pediatric supracondylar humerus fractures can be treated with closed reduction and percutaneous skeletal fixation. In difficult fractures, adjunct pin techniques, such as joystick wires and leverage pins, can be used to help attain a satisfactory and stable reduction before an open approach is used. After the fracture is reduced, optimal pinning, with the use of either crossed or lateral-entry techniques, and fixation that achieves maximal spread at the fracture site as well as bicortical engagement in both fragments are essential to maintain reduction and avoid complications that are associated with malunion. A practical approach as well as several tips and techniques may help surgeons attain and maintain stable closed reduction of pediatric supracondylar humerus fractures.

  5. The skull and humerus in the determination of sex: reliability of discriminant function equations.

    PubMed

    Robinson, Meredith Stacy; Bidmos, Mubarak Ariyo

    2009-04-15

    Sex determination plays a crucial role in the identification of human remains as it narrows the possibility for identification by 50%. The purpose of this study is to test the validity of five discriminant function equations, with accuracies of 80% and higher, that have been derived by Steyn and Işcan [M. Steyn, M.Y. Işcan, Sexual dimorphism in the crania and mandibles of South African Whites, Forensic Sci. Int. 98 (1998) 9-16; M. Steyn, M.Y. Işcan, Osteometric variation in the humerus: sexual dimorphism in South Africans, Forensic Sci. Int. 106 (1999) 77-85] for the skull and humerus of South Africans of European Descent (SAED). These equations were tested on different regional populations of SAED within South Africa. While the validity of some of the discriminant functions has been assessed by the authors who derived them, no other previous independent study has been carried out to assess the reliability of these equations. In addition, these equations have not been tested on skeletons located outside the Gauteng province. The study sample consisted of 230 skulls and 264 humeri of SAED obtained from four South African skeletal collections: Raymond A. Dart Collection of Human Skeletons (Johannesburg); Pretoria Bone Collection; Cape Town Skeletal Collection; and the Osteology Archive Student Collection (Stellenbosch). A total of 14 measurements (12 cranial and 2 humeral) were taken on these skeletal elements. The observed accuracies from the present study (72.0-95.5%), with the exception of one sample's accuracy, compared well with the original classification rates (80.2-92.5%) for most of the functions thereby confirming the validity of the discriminant function equations for sex determination for the skull and humerus of SAED, for SAED in all regions of South Africa.

  6. Elbow loading promotes longitudinal bone growth of the ulna and the humerus.

    PubMed

    Zhang, Ping; Yokota, Hiroki

    2012-01-01

    Mechanical stimulation plays a critical role in bone development and growth. In view of recently recognized anabolic responses promoted by a joint-loading modality, we examined the effects of elbow loading on longitudinal growth of the ulna and the humerus. Using a custom-made piezoelectric loader, the left elbow of growing C57/BL/6 female mice was given daily 5-min bouts of dynamic loading for 10 days. The right forelimbs of those mice served as contralateral controls, and the limbs of non-treated mice were used as age-matched controls. The effects of elbow loading were evaluated through measurement of bone length, weight, bone mineral density (BMD), and bone mineral content (BMC), as well as mRNA expression levels of load-sensitive transcription factors such as c-fos, egr1, and atf3. The results revealed that the humerus was elongated by 1.2% compared to the contralateral and age-matched controls (both p < 0.001), while the ulna had become longer than the contralateral control (1.7%; p < 0.05) and the age-match control (3.4%; p < 0.001). Bone lengthening was associated with increases in bone weight, BMD and BMC. Furthermore, the mRNA levels of the selected transcription factors were elevated in the loaded ulna and humerus. Interestingly, the increase was observed not only at the elbow but also at the wrist and shoulder in the loaded limb. The present study demonstrates that joint loading is potentially useful for stimulating bone lengthening and treating limb length discrepancy.

  7. Feeding strategies as revealed by the section moduli of the humerus bones in bipedal theropod dinosaurs

    NASA Astrophysics Data System (ADS)

    Lee, Scott; Richards, Zachary

    2015-03-01

    The section modulus of a bone is a measure of its ability to resist bending torques. Carnivorous dinosaurs presumably had strong arm bones to hold struggling prey during hunting. Some theropods are believed to have become herbivorous and such animals would not have needed such strong arms. In this work, the section moduli of the humerus bones of bipedal theropod dinosaurs (from Microvenator celer to Tyrannosaurus rex) are studied to determine the maximum bending loads their arms could withstand. The results show that bending strength is not of uniform importance to these magnificent animals. The predatory theropods had strong arms for use in hunting. In contrast, the herbivorous dinosaurs had weaker arms.

  8. Triangular Fixation Technique for Bicolumn Restoration in Treatment of Distal Humerus Intercondylar Fracture

    PubMed Central

    Kang, Seung-Hoon; Jeong, Min; Lim, Hae-Seong

    2016-01-01

    Background Distal humerus intercondylar fractures are intra-articular and comminuted fractures involving soft tissue injury. As distal humerus is triangle-shaped, parallel plating coupled with articular fixation would be suitable for bicolumn restoration in treatment of distal humerus intercondylar fracture. Methods This study included 38 patients (15 males and 23 females) who underwent olecranon osteotomy, open reduction and internal fixation with the triangle-shaped cannulated screw and parallel locking plates (triangular fixation technique). Functional results were assessed with the visual analog scale (VAS) scores, Mayo elbow performance (MEP) scores and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Anteroposterior and lateral elbow radiographs were assessed for reduction, alignment, fracture union, posttraumatic arthrosis, and heterotopic ossification, and computed tomography (CT) scans were used to obtain more accurate measurements of articular discrepancy. Results All fractures healed primarily with no loss of reduction. The mean VAS, MEP, and DASH scores of the affected elbow were not significantly different from those of the unaffected elbow (p = 0.140, p = 0.090, and p = 0.262, respectively). The mean degree of flexion was significantly lower in the affected elbow than in the unaffected elbow, but was still considered as functional (p = 0.001, > 100° in 33 of 38 patients). Two cases of articular step-offs (> 2 mm) were seen on follow-up CT scans, but not significantly higher in the affected elbow than in the unaffected elbow (p = 0.657). Binary logistic regression analysis revealed that only Association for Osteosynthesis (AO) type C3 fractures correlated with good/excellent functional outcome (p = 0.012). Complications occurred in 12 of the 38 patients, and the overall reoperation rate for complications was 10.5% (4 of 38 patients). Conclusions Triangular fixation technique for bicolumn restoration was an effective and reliable

  9. Intra-articular osteoid osteoma of the distal humerus: a diagnostic challenge.

    PubMed

    Challawar, Nikhil Subhash; Shah, Hitesh Hasmukhlal

    2014-03-06

    Osteoid osteoma rarely presents in an intra-articular or juxta-articular location, leading to synovitis and flexion deformity, which can easily mislead the diagnosis. We present a case of an intra-articular osteoid osteoma of the distal humerus in a 19-year-old woman with pain and flexion deformity of the elbow. Although radiographs were normal, a nidus was demonstrated on CT scan. Appropriate surgical treatment provided relief to the patient and the diagnosis was confirmed on histopathology. Thus, an intra-articular osteoid osteoma may be mistaken for more common causes of synovitis unless there is an index of suspicion and appropriate imaging is undertaken.

  10. Ultimate fracture load of cadaver proximal humeri correlates more strongly with mean combined cortical thickness than with areal cortical index, DEXA density, or canal-to-calcar ratio

    PubMed Central

    Mears, C. S.; Burkhead, W. Z.

    2017-01-01

    Objectives This investigation sought to advance the work published in our prior biomechanical study (Journal of Orthopaedic Research, 2016). We specifically sought to determine whether there are additional easy-to-measure parameters on plain radiographs of the proximal humerus that correlate more strongly with ultimate fracture load, and whether a parameter resembling the Dorr strength/quality characterisation of proximal femurs can be applied to humeri. Materials and Methods A total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs. The bones were fractured in a simulated backwards fall with the humeral head loaded at 2 mm/second via a frustum angled at 30° from the long axis of the bone. Correlations were assessed with ultimate fracture load and these new parameters: cortical index expressed in areas (“areal cortical index”) of larger regions of the diaphysis; the canal-to-calcar ratio used analogous to its application in proximal femurs; and the recently described medial cortical ratio. Results The three new parameters showed the following correlations with ultimate fracture load: areal cortical index (r = 0.56, p < 0.001); canal-to-calcar ratio (r = 0.38, p = 0.03); and medial cortical ratio (r = 0.49, p < 0.005). These correlations were weaker when compared with those that we previously reported: mean cortical thickness of the proximal diaphysis versus ultimate fracture load (r = 0.71; p < 0.001); and mean density in the central humeral head versus ultimate fracture load (r = 0.70; p < 0.001). Conclusion Simple-to-measure radiographic parameters of the proximal humerus reported previously are more useful in predicting ultimate fracture load than are areal cortical index, canal-to-calcar ratio, and medial cortical ratio. Cite this article: J. G. Skedros, C

  11. Lateral closing wedge supracondylar osteotomy of humerus for post-traumatic cubitus varus in children.

    PubMed

    Devnani, A S

    1997-01-01

    Cubitus varus deformity following mal-union of a supracondylar fracture of the humerus in children causes no functional disability, but surgical correction is often requested to improve the appearance of the arm. Maintaining the correction after supracondylar osteotomy is a difficult aspect of the operative treatment and remains controversial. Nine children aged between 6 and 12 years (average 8 years and 11 months) underwent lateral closing wedge supracondylar osteotomy of the humerus, for deformity ranging between 10 and 20 degrees (average 13 degrees). The correction required ranged between 16 and 30 degrees (average 21 degrees). The osteotomy was internally fixed with a two hole marrow plate. At follow-up, which ranged between 3 months and 6 years (average 34 months), six patients were graded as good, two as satisfactory and one as a poor result. One patient had transient radial nerve palsy which recovered completely in 2 months. The patient who was graded poor had undercorrection of the deformity at the original operation. There was no incidence of loss of correction due to implant failure. Complete section of the bone to allow medial displacement of the distal fragment is recommended, thereby avoiding lateral bony prominence at the elbow.

  12. Hirayama Disease with Proximal Involvement

    PubMed Central

    2016-01-01

    Hirayama disease is a slowly progressing benign motor neuron disease that affects the distal upper limb. A 29-year-old man visited the hospital with a 1-year history of weakened left proximal upper limb. He was diagnosed with Hirayama disease 9 years ago, while there was no further progression of the muscle weakness afterward. Atrophy and weakness was detected in proximal upper limb muscles. Magnetic resonance imaging and somatosensory evoked potentials were normal. Needle electromyography showed abnormal findings in proximal upper limb muscles. Our patient had Hirayama disease involving the proximal portion through secondary progression. Clinical manifestation and accurate electromyography may be useful for diagnosis. Rare cases with progression patterns as described here are helpful and have clinical meaning for clinicians. PMID:27550499

  13. Tools for proximal soil sensing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Proximal soil sensing (i.e. near-surface geophysical methods) are used to study soil phenomena across spatial scales. Geophysical methods exploit contrasts in physical properties (dielectric permittivity, apparent electrical conductivity or resistivity, magnetic susceptibility) to indirectly measur...

  14. [Therapeutically effect of the physical procedures on the elbow contractures in children with supracondylar humerus fractures].

    PubMed

    Jandrić, S Dj

    2007-01-01

    Supracondylar humerus fractures are the most common fracture around the elbow in the pediatric population. These fractures in children may lead to functional disturbance with loss or reduction of range of motion in the elbow joint. The aim of this study was to investigate the effect of the physical therapy on the range of the motion of the elbow joint in the post-traumatic elbow contractures in the childhood after supracondylar fractures. We analyzed in this research 34 children (average age 8.57+/-2.94 years) with elbow contractures that were treated by physical therapy after orthopedic treatment. Functional outcome was presented in degree from 1 to 3 (Flynn). The difference in the grade at the beginning and the end of the therapy is statistically significant (t=16.38, p<0.001). 91.18 %, of the children had excellent result. Complex of various therapeutically physical procedures can significant improve range of motion of the elbow joint.

  15. Revision surgery for nonunion after early failure of fixation of fractures of the distal humerus.

    PubMed

    Ali, A; Douglas, H; Stanley, D

    2005-08-01

    Sixteen patients who underwent a revision operation for nonunion of fractures of the distal humerus following previous internal fixation were reviewed at a mean follow-up of 39 months (8 to 69). The Mayo elbow performance score was excellent in 11, good in two, fair in two and poor in one. In 15 patients union was achieved and in one with an infected nonunion a subsequent bone graft was necessary in order to obtain union.Age, gender, a history of smoking, mechanism of the injury and the AO classification of the initial fracture did not correlate with the development of nonunion. In 12 patients (75%), the initial fixation was assessed as being suboptimal. The primary surgery was regarded as adequate in only three patients. Our findings suggest that the most important determinant of nonunion of a distal humeral fracture after surgery is the adequacy of fixation.

  16. Saving a Child's Elbow Joint: A Novel Reconstruction for a Tumour of the Distal Humerus

    PubMed Central

    Graci, Calogero; Gaston, Czar Louie; Grimer, Robert; Jeys, Lee; Ozkan, Korhan

    2015-01-01

    Reconstruction after wide resection of a malignant bone tumor can be obtained using several techniques such as the use of prostheses, allograft, autograft, or combined procedure. We describe a 12-year-old girl with parosteal osteosarcoma of the distal right humerus treated by en bloc resection, intraoperative extracorporeal irradiation, and implantation. We inserted a nonvascularised fibular autograft through the middle of irradiated graft to obtain a greater stability. We have not recorded any complication associated with this technique such as nonunion, pathological fracture, infection, and bone necrosis and we obtained an excellent functional result. 10 years after surgery, the patient had no recurrence. Extracorporeal irradiation and reimplantation is a valid and inexpensive technique for the treatment of bone tumors when there is reasonable residual bone stock. With this procedure we have a precise fit being the patient's own bone. In this way we avoid all the problems related to the adaptation of the shape and size. PMID:25648359

  17. [Drill wire osteosynthesis in subcapital humerus fractures: percutaneous or open procedure?].

    PubMed

    Imhoff, M; Sadr, I; Lehner, J H; Hasse, F M; Gahr, R H

    1992-04-01

    Between 1978 and mid-1990, 135 patients suffering from dislocated, non-luxated fracture of the humerus at the anatomical neck (fractura colli anatomici) were treated by means of open or closed percutaneous drill wire osteosynthesis. Follow-up examination after an average of 9 months did not show any significant differences between the two surgical approaches in 117 patients, independent of the shape of the fracture. However, in about 30% of the cases it was impossible to employ the percutaneous approach due to the presence of an obstacle to reduction, so that open reduction and fixation was the only choice. A great majority of the functional results must be considered as good, fractures of the tubercles having the most unfavourable prognosis independent of the surgical technique. It is, therefore, recommended to first try closed reduction with percutaneous drill wire osteosynthesis. If there are any obstacles to reduction, open reduction should be restored to during the surgery session.

  18. Management of pin tract infection in pediatric supracondylar humerus fractures: a comparative study of three methods.

    PubMed

    Lu, Di; Wang, Te; Chen, Hua; Sun, Liao-Jun

    2017-03-01

    The objective of this study was to prospectively compare the incidence of pin tract infection in pediatric supracondylar humerus fractures managed with pin care daily or every other day or weekly. We hypothesized that there were some differences between these three methods. From June 2012 to May 2015, 135 children with supracondylar humerus fractures were randomized to postoperative pin care by cleaning pin tracts daily (group A, 45 cases) or cleaning every 2 days (group B, 45 cases) or cleaning weekly (group C, 45 cases). The three groups were comparable with respect to age, gender, affected side, body mass index (BMI), fracture type, injury to surgery time, number of intraoperative percutaneous pinning, and follow-up time. We collected data on pin retention time, union time, and pin tract infection. The average follow-up time of group A was 4.5 ± 1.3 and 4.2 ± 1.6 months in group B and 4.3 ± 1.4 months in group C. The patient demographics and intraoperative variables of three groups were comparable. No significant difference between these three groups was found in union time and pin fixation time. Of the 135 children, 48 (35.6%) cases had pin tract infection. Grade I infections (Checketts-Otterburns classification) occurred around 28.9% of 270 pin and grade II around 6.7%. We found no differences between three groups as regards frequency and severity of pin tract infections (both P > 0.05). However, complain of pain was more frequent in group A than other two groups (P < 0.05).

  19. Outcome after pin fixation of supracondylar humerus fractures in children: postoperative radiographic examinations are unnecessary.

    PubMed

    Tuomilehto, Noora; Kivisaari, Reetta; Sommarhem, Antti; Nietosvaara, Aarno Y

    2017-02-01

    Background and purpose - The quality of pin fixation of displaced supracondylar humerus fractures in children has not been assessed, and the clinical value of radiographic examinations after pin fixation is unclear. We evaluated pin configuration, quality of osteosynthesis, and outcome in 264 supracondylar fractures. The clinical significance of postoperative radiographs was analyzed. Patients and methods - 252 Gartland-III and 12 flexion-type supracondylar humerus fractures were pin-fixed in the periods 2002-2006 and 2012-2014. During 2012-2014, staff were intructed that postoperative radiographs should not be taken. Quality of reduction was assessed by measuring Baumann and lateral capitellohumeral angles (LCHA) and also by recording the crossing point of the anterior humeral line (AHL) with bony capitellum. Rotatory alignment was registered as normal or abnormal. Pin configuration and quality of osteosynthesis were evaluated. The clinical significance of postoperative radiographs was analyzed. Results - Postoperatively, Baumann angle was normal in 66% of the fractures, AHL crossed the capitellum in 84%, and no malrotation was evident in 85% of the fractures. Crossed pins were used in 89% of the cases. 2 or more pins fixed both fracture fragments in 66%. Radiographic examinations were inadequate for assessment of LCHA in 13%, of Bauman angle in 8%, of AHL in 2%, of rotation in 1%, and of pin fixation in 2% of the cases. Postoperative radiographs did not give useful information except in 1 patient who had corrective osteotomy. All 94 patients with follow-up (97%) who were treated during 2012-2014 were satisfied with the outcome. Interpretation - Despite pin fixation being deemed unsatisfactory in one-third of the cases, significant malunion was rare. Postoperative radiography did not alter management or outcome.

  20. Outcome after pin fixation of supracondylar humerus fractures in children: postoperative radiographic examinations are unnecessary

    PubMed Central

    Tuomilehto, Noora; Kivisaari, Reetta; Sommarhem, Antti; Nietosvaara, Aarno Y

    2017-01-01

    Background and purpose — The quality of pin fixation of displaced supracondylar humerus fractures in children has not been assessed, and the clinical value of radiographic examinations after pin fixation is unclear. We evaluated pin configuration, quality of osteosynthesis, and outcome in 264 supracondylar fractures. The clinical significance of postoperative radiographs was analyzed. Patients and methods — 252 Gartland-III and 12 flexion-type supracondylar humerus fractures were pin-fixed in the periods 2002–2006 and 2012–2014. During 2012–2014, staff were intructed that postoperative radiographs should not be taken. Quality of reduction was assessed by measuring Baumann and lateral capitellohumeral angles (LCHA) and also by recording the crossing point of the anterior humeral line (AHL) with bony capitellum. Rotatory alignment was registered as normal or abnormal. Pin configuration and quality of osteosynthesis were evaluated. The clinical significance of postoperative radiographs was analyzed. Results — Postoperatively, Baumann angle was normal in 66% of the fractures, AHL crossed the capitellum in 84%, and no malrotation was evident in 85% of the fractures. Crossed pins were used in 89% of the cases. 2 or more pins fixed both fracture fragments in 66%. Radiographic examinations were inadequate for assessment of LCHA in 13%, of Bauman angle in 8%, of AHL in 2%, of rotation in 1%, and of pin fixation in 2% of the cases. Postoperative radiographs did not give useful information except in 1 patient who had corrective osteotomy. All 94 patients with follow-up (97%) who were treated during 2012–2014 were satisfied with the outcome. Interpretation — Despite pin fixation being deemed unsatisfactory in one-third of the cases, significant malunion was rare. Postoperative radiography did not alter management or outcome. PMID:27774833

  1. Multibody kinematics optimization with marker projection improves the accuracy of the humerus rotational kinematics.

    PubMed

    Begon, Mickaël; Bélaise, Colombe; Naaim, Alexandre; Lundberg, Arne; Chèze, Laurence

    2016-10-20

    Markers put on the arm undergo large soft tissue artefact (STA). Using markers on the forearm, multibody kinematics optimization (MKO) helps improve the accuracy of the arm kinematics especially its longitudinal rotation. However deleterious effect of STA may persist and affect other segment estimate. The objective was to present an innovative multibody kinematics optimization algorithm with projection of markers onto a requested axis of the local system of coordinates, to cancel their deleterious effect on this degree-of-freedom. Four subjects equipped with markers put on intracortical pins inserted into the humerus, on skin (scapula, arm and forearm) and subsequently on rigid cuffs (arm and forearm) performed analytic, daily-living, sports and range-of-motion tasks. Scapulohumeral kinematics was estimated using 1) pin markers (reference), 2) single-body optimization, 3) MKO, 4) MKO with projection of all arm markers and 5) MKO with projection of a selection of arm markers. Approaches 2-4 were applied to markers put on the skin and the cuff. The main findings were that multibody kinematics optimization improved the accuracy of 40-50% and the projection algorithm added an extra 20% when applied to cuff markers or a selection of skin markers (all but the medial epicondyle). Therefore, the projection algorithm performed better than multibody and single-body optimizations, especially when using markers put on a cuff. Error of humerus orientation was reduced by half to finally be less than 5°. To conclude, this innovative algorithm is a promising approach for estimating accurate upper-limb kinematics.

  2. Cubesat Proximity Operations Demonstration (CPOD)

    NASA Technical Reports Server (NTRS)

    Villa, Marco; Martinez, Andres; Petro, Andrew

    2015-01-01

    The CubeSat Proximity Operations Demonstration (CPOD) project will demonstrate rendezvous, proximity operations and docking (RPOD) using two 3-unit (3U) CubeSats. Each CubeSat is a satellite with the dimensions 4 inches x 4 inches x 13 inches (10 centimeters x 10 centimeters x 33 centimeters) and weighing approximately 11 pounds (5 kilograms). This flight demonstration will validate and characterize many new miniature low-power proximity operations technologies applicable to future missions. This mission will advance the state of the art in nanosatellite attitude determination,navigation and control systems, in addition to demonstrating relative navigation capabilities.The two CPOD satellites are scheduled to be launched together to low-Earth orbit no earlier than Dec. 1, 2015.

  3. The throw: biomechanics and acute injury.

    PubMed

    Gainor, B J; Piotrowski, G; Puhl, J; Allen, W C; Hagen, R

    1980-01-01

    The throw and its modifications are integral components of many sports. This study correlates case histories of acute injuries in throwing with a biomechanical analysis of the throwing mechanism. Comparisons are made with a similar analysis of the kick analyzed by the same film technique and computer program. Just prior to ball release, the pitching arm extends through an arc of about 73 degress in 40 msec, beginning with the elbow flexed at 80 degrees. This produces an axial load on the humerus and coincides with a pulse of external torque at the shoulder. This acts as stress protection to the humerus which is developing an internal torque of 14,000 inch-lb prior to ball release. The change in angular velocity, or the angular acceleration, during the throw is acquired in a much shorter time than in the kick. Torque is directly proportional to angular acceleration. This necessitates the development of substantially higher torques in the humerus during the throw than about the knee during a kick. The kinetic energy in the arm is 27,000 inch-lb during the throw. This is much higher than the kinetic energy in the kicking leg because the kinetic energy varies proportionally with the square of the angular velocity of the extremity. The angular velocity of the arm is about twice that of the leg. Thus, the pitching arm contains about four times as much kinetic energy as the kicking leg. These severe overloading conditions predispose the upper extremity to injury in the throwing mechanism.

  4. Driven shielding capacitive proximity sensor

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor); McConnell, Robert L. (Inventor)

    2000-01-01

    A capacitive proximity sensing element, backed by a reflector driven at the same voltage as and in phase with the sensor, is used to reflect the field lines away from a grounded robot arm towards an intruding object, thus dramatically increasing the sensor's range and sensitivity.

  5. Proximity Sensors Make Robot Dexterous

    NASA Technical Reports Server (NTRS)

    Hess, Cliff; Li, Larry C. H.

    1990-01-01

    Control system enables robot hand to grasp objects of varied shapes. Key features of system: reflective proximity sensors furnishing data on position, orientation, and distance of object and software protocol controlling sequence of operations in approaching and grasping objects. Reflected-beam sensing concept applied to simple opposed-jaw industrial grippers as well as to dexterous robot hands.

  6. Proximity and Anti-proximity effects in nanowires

    NASA Astrophysics Data System (ADS)

    Chan, Moses

    Near a superconductor/normal-metal interface, the leakage of Cooper pairs extends superconducting behavior into the metal. The spatial range of this proximity effect in a normal metal can be as long as 1 µm. However, when a ferromagnet is placed in contact with a superconductor, the Cooper pairs from the superconductor are not expected to survive beyond at most a few nanometers into the ferromagnet. Surprisingly we find when a cobalt nanowire as long as 600 nm is sandwiched between superconducting electrodes, it attains zero resistance at low temperature. For even longer wires, the transition to incomplete superconductivity via this (long range) proximity effect is foreshadowed by a large resistance peak (1). On the other hand when Zn nanowires of 40 nm diameter are contacted by superconducting electrodes, their superconductivity is unexpectedly suppressed (2). Worked supported by Penn State MRSEC.

  7. Non-invasive determination of coupled motion of the scapula and humerus--an in-vitro validation.

    PubMed

    Massimini, Daniel F; Warner, Jon J P; Li, Guoan

    2011-02-03

    Measuring the motion of the scapula and humerus with sub-millimeter levels of accuracy in six-degrees-of-freedom (6-DOF) is a challenging problem. The current methods to measure shoulder joint motion via the skin do not produce clinically significant levels of accuracy. Thus, the purpose of this study was to validate a non-invasive markerless dual fluoroscopic imaging system (DFIS) model-based tracking technique for measuring dynamic in-vivo shoulder kinematics. Our DFIS tracks the positions of bones based on their projected silhouettes to contours on recorded pairs of fluoroscopic images. For this study, we compared markerlessly tracking the bones of the scapula and humerus to track them with implanted titanium spheres using a radiostereometric analysis (RSA) while manually manipulating a cadaver specimen's arms. Additionally, we report the repeatability of the DFIS to track the scapula and humerus during dynamic shoulder motion. The difference between the markerless model-based tracking technique and the RSA was ±0.3 mm in translation and ±0.5° in rotation. Furthermore, the repeatability of the markerless DFIS model-based tracking technique for the scapula and humerus was ±0.2 mm and ±0.4°, respectively. The model-based tracking technique achieves an accuracy that is similar to an invasive RSA tracking technique and is highly suited for non-invasively studying the in-vivo motion of the shoulder. This technique could be used to investigate the scapular and humeral biomechanics in both healthy individuals and in patients with various pathologies under a variety of dynamic shoulder motions encountered during the activities of daily living.

  8. Delayed Open Reduction and K-Wire Fixation of Widely Displaced Supracondylar Fractures of Humerus in Children using Medial Approach

    PubMed Central

    Waikhom, Sanjib; Ibomcha, Irom; Digendra, Akoijam; Sohkhlet, Handboy R

    2016-01-01

    Introduction Supracondylar fractures of humerus in children are usually treated with percutaneous pinning on emergency basis. When the operating time is delayed, percutaneous pinning is difficult due to massive swelling. Late presentation is common in developing countries. Aim To assess the outcome of open reduction and internal fixation with K-wire of widely displaced supracondylar fracture when operated later than 2 days after the injury. Materials and Methods A total of 52 children (aged 3-12 years) with widely displaced supracondylar fracture of humerus (Gartland type-III) who presented later than 2 days after injury were treated with open reduction through medial approach and fixation with cross K-wires. Results were assessed with Flynn’s criteria. Result: A total of 40 patients completed follow-up. Mean age of all (n=52) patients was 4.8 years (range 3-12 years). Mean delay of presentation was 7.5 days (range 2-14 days). Hundred percent patients had satisfactory results according to Flynn’s criteria. Two patients had pin infections. Conclusion Open reduction through medial approach and fixation with two cross K-wires is a reliable method of treatment for supracondylar fractures of humerus in children when the operation is delayed. PMID:27656516

  9. Shoulder 3D range of motion and humerus rotation in two volleyball spike techniques: injury prevention and performance.

    PubMed

    Seminati, Elena; Marzari, Alessandra; Vacondio, Oreste; Minetti, Alberto E

    2015-06-01

    Repetitive stresses and movements on the shoulder in the volleyball spike expose this joint to overuse injuries, bringing athletes to a career threatening injury. Assuming that specific spike techniques play an important role in injury risk, we compared the kinematic of the traditional (TT) and the alternative (AT) techniques in 21 elite athletes, evaluating their safety with respect to performance. Glenohumeral joint was set as the centre of an imaginary sphere, intersected by the distal end of the humerus at different angles. Shoulder range of motion and angular velocities were calculated and compared to the joint limits. Ball speed and jump height were also assessed. Results indicated the trajectory of the humerus to be different for the TT, with maximal flexion of the shoulder reduced by 10 degrees, and horizontal abduction 15 degrees higher. No difference was found for external rotation angles, while axial rotation velocities were significantly higher in AT, with a 5% higher ball speed. Results suggest AT as a potential preventive solution to shoulder chronic pathologies, reducing shoulder flexion during spiking. The proposed method allows visualisation of risks associated with different overhead manoeuvres, by depicting humerus angles and velocities with respect to joint limits in the same 3D space.

  10. Micropower RF material proximity sensor

    DOEpatents

    McEwan, T.E.

    1998-11-10

    A level detector or proximity detector for materials capable of sensing through plastic container walls or encapsulating materials is disclosed. Thus, it can be used in corrosive environments, as well as in a wide variety of applications. An antenna has a characteristic impedance which depends on the materials in proximity to the antenna. An RF oscillator, which includes the antenna and is based on a single transistor in a Colpitt`s configuration, produces an oscillating signal. A detector is coupled to the oscillator which signals changes in the oscillating signal caused by changes in the materials in proximity to the antenna. The oscillator is turned on and off at a pulse repetition frequency with a low duty cycle to conserve power. The antenna consists of a straight monopole about one-quarter wavelength long at the nominal frequency of the oscillator. The antenna may be horizontally disposed on a container and very accurately detects the fill level within the container as the material inside the container reaches the level of the antenna. 5 figs.

  11. Micropower RF material proximity sensor

    DOEpatents

    McEwan, Thomas E.

    1998-01-01

    A level detector or proximity detector for materials capable of sensing through plastic container walls or encapsulating materials is of the sensor. Thus, it can be used in corrosive environments, as well as in a wide variety of applications. An antenna has a characteristic impedance which depends on the materials in proximity to the antenna. An RF oscillator, which includes the antenna and is based on a single transistor in a Colpitt's configuration, produces an oscillating signal. A detector is coupled to the oscillator which signals changes in the oscillating signal caused by changes in the materials in proximity to the antenna. The oscillator is turned on and off at a pulse repetition frequency with a low duty cycle to conserve power. The antenna consists of a straight monopole about one-quarter wavelength long at the nominal frequency of the oscillator. The antenna may be horizontally disposed on a container and very accurately detects the fill level within the container as the material inside the container reaches the level of the antenna.

  12. Proximate and polyphenolic characterization of cranberry pomace

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The proximate composition and identification and quantification of polyphenolic compounds in dried cranberry pomace were determined. Proximate analysis was conducted based on AOAC methods for moisture, protein, fat, and ash. Total carbohydrates were determined by the difference method. Polyphenolic ...

  13. Active Targets For Capacitive Proximity Sensors

    NASA Technical Reports Server (NTRS)

    Jenstrom, Del T.; Mcconnell, Robert L.

    1994-01-01

    Lightweight, low-power active targets devised for use with improved capacitive proximity sensors described in "Capacitive Proximity Sensor Has Longer Range" (GSC-13377), and "Capacitive Proximity Sensors With Additional Driven Shields" (GSC-13475). Active targets are short-distance electrostatic beacons; they generate known alternating electro-static fields used for alignment and/or to measure distances.

  14. Direct U-series analysis of the Lezetxiki humerus reveals a Middle Pleistocene age for human remains in the Basque Country (northern Iberia).

    PubMed

    de-la-Rúa, Concepción; Altuna, Jesús; Hervella, Monserrat; Kinsley, Leslie; Grün, Rainer

    2016-04-01

    In 1964, a human humerus was found in a sedimentary deposit in Lezetxiki Cave (Basque Country, northern Iberia). The first studies on the stratigraphy, associated mammal faunal remains and lithic implements placed the deposits containing the humerus into the Riss glacial stage. Direct chronometric evidence has so far been missing, and the previous chronostratigraphic framework and faunal dating gave inconsistent results. Here we report laser ablation U-series analyses on the humerus yielding a minimum age of 164 ± 9 ka, corresponding to MIS 6. This is the only direct dating analysis of the Lezetxiki humerus and confirms a Middle Pleistocene age for this hominin fossil. Morphometric analyses suggest that the Lezetxiki humerus has close affinities to other Middle Pleistocene archaic hominins, such as those from La Sima de los Huesos at Atapuerca. This emphasizes the significance of the Lezetxiki fossil within the populations that predate the Neanderthals in south-western Europe. It is thus an important key fossil for the understanding of human evolution in Europe during the Middle Pleistocene, a time period when a great morphological diversity is observed but whose phylogenetic meaning is not yet fully understood.

  15. The HTV Proximity Communication System

    NASA Astrophysics Data System (ADS)

    Harada, Motoyuki; Takahashi, Tetsuo; Tanaka, Tetsuo

    2002-01-01

    National Space Development Agency of Japan (NASDA) is developing the H-II Transfer Vehicle (HTV) as an unmanned logistic support vehicle for the International Space Station (ISS). The HTV, which is launched by the H-IIA rocket, transports both pressurized and un-pressurized cargoes to the ISS, reloads disposal items from the ISS and performs destructive reentry over ocean area. NASDA plans the first flight of HTV in 2005 for demonstration. The HTV will contribute the ISS assembly and logistic re-supply operations with international commonality. For unmanned vehicle operation, communication link is critical with commanding and control, especially in proximity region to the ISS. As for the HTV operation, NASDA is developing dedicated communication system installed on the Japanese Experiment Module (JEM) of the ISS, which is called the Proximity Communication System (PROX). The HTV receives commands and transmits telemetry data through the PROX in its proximity operation to the ISS. To achieve this, the PROX can communicate with the HTV on its nominal trajectory within 23km of the ISS. Especially within 3km of the ISS, the PROX has capability to perform omni-directional communication to the HTV. The PROX also has GPS receiver and send GPS data to the HTV to support the HTV navigation for relative GPS navigation used in "far" range (500m away from the ISS). In addition to the above fundamental functions, the PROX has a capability of range and range-rate measurement between the ISS and the HTV by the pseudo noise (PN) code epoch and the Doppler shift frequency. This provides a reference data independent of "main" navigation methods (rendezvous sensor navigation or GPS navigation) of the HTV. The PROX also assists the ISS crew with its commanding device, called the Hardware Command Panel (HCP), to issue time-dependent safety-related critical commands for HTV berthing/un-berthing operation. When a failure occurs somewhere on "communication path" from the PROX Base Band

  16. Proximal Biceps in Overhead Athletes.

    PubMed

    Chalmers, Peter N; Verma, Nikhil N

    2016-01-01

    The proximal long head of the biceps tendon and its attachment at the superior glenoid tubercle and labrum are subject to a spectrum of disorders in overhead athletes. Biceps disorders are commonly characterized by intermittent anterior or deep-seated shoulder pain exacerbated by activity. Diagnosis is reached via various physical examination maneuvers; MRI can be uncertain. Nonsteroidal anti-inflammatory medications, targeted ultrasound-guided corticosteroid injections, and supervised physical therapy are the mainstays of nonoperative treatment. Operative treatment, which remains controversial, provides reliable pain relief, restoration of function for activities of daily living, and low complication rates, but return to play can be unpredictable.

  17. Proximal Fifth Metatarsal Fractures: Anatomy, Classification, Treatment and Complications

    PubMed Central

    Cheung, Chi Nok; Lui, Tun Hing

    2016-01-01

    Context Fractures of proximal fifth metatarsal are one of the most common fractures of the foot. Evidence Acquisition A search of PubMed for studies on proximal fifth metatarsal fracture and Jones fracture focusing on the classification and management was performed. The reference list of the retrieved articles was searched for additional related studies. Results The vascular supply and soft tissue anatomy of the fifth metatarsal explains the increased risk of delayed union and non-union in fractures at the metaphyseal-diaphyseal junction. Lawrence and Botte classify proximal fifth metatarsal fractures according to their location: tuberosity avulsion fractures (zone 1), fractures at metaphyseal-diaphyseal junction extending into the fourth-fifth intermetatarsal joint (zone 2) and proximal diaphyseal fractures (zone 3). Zone 1 fractures are treated conservatively with functional immobilization and early mobilization with excellent outcome. For zone 2 and zone 3 fractures, acute forms can be treated conservatively but with a risk of delayed union time and time for return to function. Therefore, early surgical fixation with intramedullary screw is advised in athletic individuals. For cases presented with signs of delayed union and non-union, surgical treatment with or without bone grafting is recommended. Complications of these fractures and their management are discussed in this report. Conclusions Lawrence and Botte’s classification of proximal fifth metatarsal fractures is recommended by experts, due to its implication on prognosis and treatment strategy. Zone 1 fractures should be treated conservatively due to their excellent healing potential. Early operative treatment is advised for zone 2 and zone 3 fractures, especially in the athletic group. Complications of delayed union, non-union and refractures should be treated by revision fixation and bone grafting. PMID:28144601

  18. Protein Neighbors and Proximity Proteomics.

    PubMed

    Rees, Johanna S; Li, Xue-Wen; Perrett, Sarah; Lilley, Kathryn S; Jackson, Antony P

    2015-11-01

    Within cells, proteins can co-assemble into functionally integrated and spatially restricted multicomponent complexes. Often, the affinities between individual proteins are relatively weak, and proteins within such clusters may interact only indirectly with many of their other protein neighbors. This makes proteomic characterization difficult using methods such as immunoprecipitation or cross-linking. Recently, several groups have described the use of enzyme-catalyzed proximity labeling reagents that covalently tag the neighbors of a targeted protein with a small molecule such as fluorescein or biotin. The modified proteins can then be isolated by standard pulldown methods and identified by mass spectrometry. Here we will describe the techniques as well as their similarities and differences. We discuss their applications both to study protein assemblies and to provide a new way for characterizing organelle proteomes. We stress the importance of proteomic quantitation and independent target validation in such experiments. Furthermore, we suggest that there are biophysical and cell-biological principles that dictate the appropriateness of enzyme-catalyzed proximity labeling methods to address particular biological questions of interest.

  19. Fibrosis: ultimate and proximate causes

    PubMed Central

    Thannickal, Victor J.; Zhou, Yong; Gaggar, Amit; Duncan, Steven R.

    2014-01-01

    Fibrotic disorders account for an increasing burden of disease-associated morbidity and mortality worldwide. Although numerous risk factors have been recognized, the etiologies of many of these clinical syndromes have not been identified, and they are often termed idiopathic or cryptogenic. Here, we provide an evolutionary perspective on fibrosis aimed at elucidating its etiopathogenesis. By asking the ultimate question of “why” this process evolved in multicellular organisms, we hope to uncover proximate explanations for “how” it causes disease in humans. We posit that physiological fibrosis-like reactions evolved as an essential process in host defense against pathogens and in normal wound healing. Based on this premise, we reason that pathological fibrosis is related to one or more of the following: unidentified infectious or noninfectious antigens, autoimmunity, impaired regenerative responses, and the antagonistically pleiotropic action of genes involved in wound healing or development. The importance of genetic susceptibility, epigenetics, aging, and the modern-day environment are highlighted. Consideration of both ultimate and proximate causation goes beyond philosophical cogitations, as it will better inform pathobiological mechanisms of disease and aid in the prevention and treatment of fibrotic diseases. PMID:25365073

  20. Ash Aggregates in Proximal Settings

    NASA Astrophysics Data System (ADS)

    Porritt, L. A.; Russell, K.

    2012-12-01

    Ash aggregates are thought to have formed within and been deposited by the eruption column and plume and dilute density currents and their associated ash clouds. Moist, turbulent ash clouds are considered critical to ash aggregate formation by facilitating both collision and adhesion of particles. Consequently, they are most commonly found in distal deposits. Proximal deposits containing ash aggregates are less commonly observed but do occur. Here we describe two occurrences of vent proximal ash aggregate-rich deposits; the first within a kimberlite pipe where coated ash pellets and accretionary lapilli are found within the intra-vent sequence; and the second in a glaciovolcanic setting where cored pellets (armoured lapilli) occur within <1 km of the vent. The deposits within the A418 pipe, Diavik Diamond Mine, Canada, are the residual deposits within the conduit and vent of the volcano and are characterised by an abundance of ash aggregates. Coated ash pellets are dominant but are followed in abundance by ash pellets, accretionary lapilli and rare cored pellets. The coated ash pellets typically range from 1 - 5 mm in diameter and have core to rim ratios of approximately 10:1. The formation and preservation of these aggregates elucidates the style and nature of the explosive phase of kimberlite eruption at A418 (and other pipes?). First, these pyroclasts dictate the intensity of the kimberlite eruption; it must be energetic enough to cause intense fragmentation of the kimberlite to produce a substantial volume of very fine ash (<62 μm). Secondly, the ash aggregates indicate the involvement of moisture coupled with the presence of dilute expanded eruption clouds. The structure and distribution of these deposits throughout the kimberlite conduit demand that aggregation and deposition operate entirely within the confines of the vent; this indicates that aggregation is a rapid process. Ash aggregates within glaciovolcanic sequences are also rarely documented. The

  1. A review of current surgical practice in the operative treatment of proximal humeral fractures

    PubMed Central

    Jones, L. D.; Palmer, A. J. R.; Macnair, R. D.; Brewer, P. E.; Jayadev, C.; Wheelton, A. N.; Ball, D. E. J.; Nandra, R. S.; Aujla, R. S.; Sykes, A. E.; Carr, A. J.

    2016-01-01

    Objectives The PROximal Fracture of the Humerus: Evaluation by Randomisation (PROFHER) trial has recently demonstrated that surgery is non-superior to non-operative treatment in the management of displaced proximal humeral fractures. The objective of this study was to assess current surgical practice in the context of the PROFHER trial in terms of patient demographics, injury characteristics and the nature of the surgical treatment. Methods A total of ten consecutive patients undergoing surgery for the treatment of a proximal humeral fracture from each of 11 United Kingdom hospitals were retrospectively identified over a 15 month period between January 2014 and March 2015. Data gathered for the 110 patients included patient demographics, injury characteristics, mode of surgical fixation, the grade of operating surgeon and the cost of the surgical implants. Results A majority of the patients were female (66%, 73 of 110). The mean patient age was 62 years (range 18 to 89). A majority of patients met the inclusion criteria for the PROFHER trial (75%, 83 of 110). Plate fixation was the most common mode of surgery (68%, 75 patients), followed by intramedullary fixation (12%, 13 patients), reverse shoulder arthroplasty (10%, 11 patients) and hemiarthroplasty (7%, eight patients). The consultant was either the primary operating surgeon or supervising the operating surgeon in a large majority of cases (91%, 100 patients). Implant costs for plate fixation were significantly less than both hemiarthroplasty (p < 0.05) and reverse shoulder arthroplasty (p < 0.0001). Implant costs for intramedullary fixation were significantly less than plate fixation (p < 0.01), hemiarthroplasty (p < 0.0001) and reverse shoulder arthroplasty (p < 0.0001). Conclusions Our study has shown that the majority of a representative sample of patients currently undergoing surgical treatment for a proximal humeral fracture in these United Kingdom centres met the inclusion criteria for the PROFHER trial

  2. An osteological study of supratrochlear foramen of humerus of south Indian population with reference to anatomical and clinical implications

    PubMed Central

    Afroze, Khizer Hussain; S., Lakshmiprabha

    2016-01-01

    The supratrochlear foramen (STF) is an important and relatively common anatomic variation in the lower end of the humerus in humans. The present study on south Indian population is an attempt to highlight the incidence, morphological features and clinical importance of STF. The study was conducted on dried human humeri of unknown sex and free of pathological changes. The presence of a STF was noted for its shape and divided into three types (oval, round, and irregular). In bones where the foramen was absent the translucency of the septum between the coronoid and the radial fossa was noted by placing the lower end of the humerus against the X-ray view box. Out of the 142 humeri studied, 72 humeri (50.7%) were right sided and 70 humeri (49.2%) were left sided. In these 142 humeri, 38 humeri (26.7%) showed the presence of STF. The majority of STF were round shaped in 47.37%, followed by oval shaped in 42.11% and 10.53% were irregular in shape. The STF was absent in 36 humeri (25.35%) and 68 humeri (47.89%) showed the translucency of septum. The mean transverse diameter on right side was 4.50±3.183 mm and 3.32±3.222 mm on left side. The mean vertical diameter was 3.88±2.391 on right side and 3.68±3.532 mm on left side. Its existence is important to the orthopaedician in the preoperative planning of nailing fractures of the distal humerus and to the radiologist for differentiating it from an osteolytic or cystic lesion. PMID:28127499

  3. Surgical interventions to treat humerus shaft fractures: A network meta-analysis of randomized controlled trials

    PubMed Central

    Wang, Jia; Meng, Xiao-Hui; Zeng, Xian-Tie; Kan, Shi-Lian

    2017-01-01

    Background There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO). We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures. Methods MEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016. We only included randomized controlled trials (RCTs) comparing two or more of the three surgical procedures, including the ORPF, IMN, and MIPO techniques, for humeral shaft fractures in adults. The methodological quality was evaluated based on the Cochrane risk of bias tool. We used WinBUGS1.4 to conduct this Bayesian network meta-analysis. We used the odd ratios (ORs) with 95% confidence intervals (CIs) to calculate the dichotomous outcomes and analyzed the percentages of the surface under the cumulative ranking curve. Results Seventeen eligible publications reporting 16 RCTs were included in this study. Eight hundred and thirty-two participants were randomized to receive one of three surgical procedures. The results showed that shoulder impingement occurred more commonly in the IMN group than with either ORPF (OR, 0.13; 95% CI, 0.03–0.37) or MIPO fixation (OR, 0.08; 95% CI, 0.00–0.69). Iatrogenic radial nerve injury occurred more commonly in the ORPF group than in the MIPO group (OR, 11.09; 95% CI, 1.80–124.20). There were no significant differences among the three procedures in nonunion, delayed union, and infection. Conclusion Compared with IMN and ORPF, MIPO technique is the preferred treatment method for humeral shaft fractures. PMID:28333947

  4. Supracondylar humerus fractures in children treated with closed reduction and percutaneous pinning.

    PubMed

    Scaglione, Michelangelo; Giovannelli, Daniele; Fabbri, Luca; Dell'omo, Dario; Goffi, Andrea; Guido, Giulio

    2012-08-01

    Supracondylar fractures of the humerus in children are important for frequency and type of associated serious complications. The management of this kind of fractures is still controversial (Skaggs et al. in J Bone Joint Surg Am 86:702-707, 2004; Kalllio et al. in J Pediatr Orthop 12:11-15, 1992). We are going to present our experience in the treatment of supracondylar humeral fracture in children. In the Orthopedic Department of Pisa, we treated 150 cases from 1989 to 2006. We are used to perform, emergency or within 12 h, reduction and two lateral-entry percutaneous pins fixation. The mean age was 7.5 years. We checked 125 cases, because we excluded all the cases with follow up less then 5 years. The mean follow up was 8.2 years. We used Gartland classification modified by Wilkins. We evaluated 125 cases by using the Flynn classification: 100 % of patients did not have impairment of the elbow joint mobility. We had seven valgus deviation, one of which was more then 10°. We also had 17 varus deviations, 11 of which were not over 8° and only 2 of them were 15°. The average value of the joint Baumann angle was calculated as great as 16°. The obtained results were classified as very good 80 %, good 11 %, sufficiently good 6 %, and bad 3 %. In our experience, all the fractures type II and III by Gartland have to be treated within 12 h, with closed reduction and stabilization with lateral-entry K-wire technique. The conservative treatment by cast is indicated only in type I fracture. The trans olecranic treatment is not realizable, for the stiffness which can occur, for the risk of iatrogenic ulnar nerve lesion, and for long-time hospitalization. The open reduction remains the first choice treatment for exposed or nonreducible fractures, and in cases of vascular injury.

  5. The locomotion of Babakotia radofilai inferred from epiphyseal and diaphyseal morphology of the humerus and femur.

    PubMed

    Marchi, Damiano; Ruff, Christopher B; Capobianco, Alessio; Rafferty, Katherine L; Habib, Michael B; Patel, Biren A

    2016-09-01

    Palaeopropithecids, or "sloth lemurs," are a diverse clade of large-bodied Malagasy subfossil primates characterized by their inferred suspensory positional behavior. The most recently discovered genus of the palaeopropithecids is Babakotia, and it has been described as more arboreal than Mesopropithecus, but less than Palaeopropithecus. In this article, the within-bone and between-bones articular and cross-sectional diaphyseal proportions of the humerus and femur of Babakotia were compared to extant lemurs, Mesopropithecus and Palaeopropithecus in order to further understand its arboreal adaptations. Additionally, a sample of apes and sloths (Choloepus and Bradypus) are included as functional outgroups composed of suspensory adapted primates and non-primates. Results show that Babakotia and Mesopropithecus both have high humeral/femoral shaft strength proportions, similar to extant great apes and sloths and indicative of forelimb suspensory behavior, with Babakotia more extreme in this regard. All three subfossil taxa have relatively large femoral heads, also associated with suspension in modern taxa. However, Babakotia and Mesopropithecus (but not Palaeopropithecus) have relatively small femoral head surface area to shaft strength proportions suggesting that hind-limb positioning in these taxa during climbing and other behaviors was different than in extant great apes, involving less mobility. Knee and humeral articular dimensions relative to shaft strengths are small in Babakotia and Mesopropithecus, similar to those found in modern sloths and divergent from those in extant great apes and lemurs, suggesting more sloth-like use of these joints during locomotion. Mesopropithecus and Babakotia are more similar to Choloepus in humerofemoral head and length proportions while Palaeopropithecus is more similar to Bradypus. These results provide further evidence of the suspensory adaptations of Babakotia and further highlight similarities to both extant suspensory

  6. Low incidence of flexion-type supracondylar humerus fractures but high rate of complications

    PubMed Central

    Kuoppala, Eira; Parviainen, Roope; Pokka, Tytti; Sirviö, Minna; Serlo, Willy; Sinikumpu, Juha-Jaakko

    2016-01-01

    Background and purpose Supracondylar humerus fractures are the most common type of elbow fracture in children. A small proportion of them are flexion-type fractures. We analyzed their current incidence, injury history, clinical and radiographic findings, treatment, and outcomes. Patients and methods We performed a population-based study, including all children <16 years of age. Radiographs were re-analyzed to include only flexion-type supracondylar fractures. Medical records were reviewed and outcomes were evaluated at a mean of 9 years after the injury. In addition, we performed a systematic literature review of all papers published on the topic since 1990 and compared the results with the findings of the current study. Results During the study period, the rate of flexion-type fractures was 1.2% (7 out of 606 supracondylar humeral fractures). The mean annual incidence was 0.8 per 105. 4 fractures were multidirectionally unstable, according to the Gartland-Wilkins classification. All but 1 were operatively treated. Reduced range of motion, changed carrying angle, and ulnar nerve irritation were the most frequent short-term complications. Finally, in the long-term follow-up, mean carrying angle was 50% more in injured elbows (21°) than in uninjured elbows (14°). 4 patients of the 7 achieved a satisfactory long-term outcome according to Flynn’s criteria. Interpretation Supracondylar humeral flexion-type fractures are rare. They are usually severe injuries, often resulting in short-term and long-term complications regardless of the original surgical fixation used. PMID:27168001

  7. A Comparison of Proximal Tibia, Proximal Humerus and Distal Femur Infusion Rates of Blood Under High Pressure Using the EX IO Intraosseous Device in the Adult Swine (Sus scrofa) Hypovolemic Model

    DTIC Science & Technology

    2012-07-25

    of Blood Under High Pressure Using the EZ IO Intraosseous Device on the Adult Swine (Sus scrofa) hypovolemic Model.” 4. Principal Investigator... hypovolemic period and decreased after infusion of blood. In the femur arm the serum lactate increased until the experiment ended. Histopathologic...vascular resistance in our pilot, dose-finding hemorrhagic shock swine model. The blood pressure response paralleled increasing drug dose

  8. A Comparison of Proximal Tibia and Proximal Humerus Infusion Rates of Plasma Under High Pressure Using the EZ IO Intraosseous Device in the Adult Swine (Sus scrofa) Hypovolemic Model

    DTIC Science & Technology

    2013-01-10

    plasma under high pressure using the EZ IO intraosseous device in the adult swine (Sus scrofa ) hypovolemic model. FWH20100171A FWH20100171ALairet...resuscitation, swine, sus scrofa U U U SAR Vikhyat Bebarta, MD 210-275-3794 WHASC- Animal Final Report 170ct2012 1. Protocol Number: FWH20100171A 2...the EZ 10 intraosseous device in the adult swine (Sus scrofa ) hypovolemic model. 4. Principal Investigator PI): Name Rank Date of Branch Staff

  9. ADAM17 substrate release in proximal tubule drives kidney fibrosis

    PubMed Central

    Kefaloyianni, Eirini; Muthu, Muthu Lakshmi; Kaeppler, Jakob; Sun, Xiaoming; Sabbisetti, Venkata; Chalaris, Athena; Rose-John, Stefan; Wong, Eitan; Sagi, Irit; Waikar, Sushrut S.; Rennke, Helmut; Bonventre, Joseph V.

    2016-01-01

    Kidney fibrosis following kidney injury is an unresolved health problem and causes significant morbidity and mortality worldwide. In a study into its molecular mechanism, we identified essential causative features. Acute or chronic kidney injury causes sustained elevation of a disintegrin and metalloprotease 17 (ADAM17); of its cleavage-activated proligand substrates, in particular of pro-TNFα and the EGFR ligand amphiregulin (pro-AREG); and of the substrates’ receptors. As a consequence, EGFR is persistently activated and triggers the synthesis and release of proinflammatory and profibrotic factors, resulting in macrophage/neutrophil ingress and fibrosis. ADAM17 hypomorphic mice, specific ADAM17 inhibitor–treated WT mice, or mice with inducible KO of ADAM17 in proximal tubule (Slc34a1-Cre) were significantly protected against these effects. In vitro, in proximal tubule cells, we show that AREG has unique profibrotic actions that are potentiated by TNFα-induced AREG cleavage. In vivo, in acute kidney injury (AKI) and chronic kidney disease (CKD, fibrosis) patients, soluble AREG is indeed highly upregulated in human urine, and both ADAM17 and AREG expression show strong positive correlation with fibrosis markers in related kidney biopsies. Our results indicate that targeting of the ADAM17 pathway represents a therapeutic target for human kidney fibrosis. PMID:27642633

  10. Deformed proximity potential for heavy ion reactions

    SciTech Connect

    Baltz, A.J.

    1989-09-01

    The proximity potential is discussed for the inelastic scattering of a spherical nucleus on a deformed nucleus or the mutual interaction of two deformed nuclei. It is shown that the proximity potential is, in general, geometrically more correct than the usual centerline prescription used in inelastic scattering analyses. For the cases where the proximity potential is inadequate a folding model approach is advocated. Techniques to facilitate the coupled channels analysis are presented. 11 refs., 6 figs.

  11. Functional Results of Intercondylar Fractures of the Humerus Fixed with Dual Y-Plate; A Technical Note  

    PubMed Central

    Mahapatra, Swagat; Abraham, Vineet Thomas

    2017-01-01

    Objective: To evaluate and report the functional results of surgical management of intercondylar fractures of the humerus in adults using a novel dual plating technique. Methods: A total number of 60 patients with Riseborough and Radin type II, III, and IV intercondylar humerus fractures were operated with open reduction through a Trans-olecranon approach and internal fixation using two plates in inverted-Y configuration. Patients were followed for 3 weeks, 3 and 6 months were evaluated using the Mayo Elbow performance score and Quick-DASH score. Results: There were 50(83.33%)men and 10 (16.67%)women with mean age of 34.9 ± 12.63 years. 63.3% of the cases were following Motor vehicle accident and rest following fall. The right upper limb was more commonly affected than the left side. Riseborough and Radin type II fractures accounted for 3.33% of cases; type III fractures accounted for 50% of cases and type IV accounted for 46.67%. Excellent to Good results were seen in almost 80% of cases as per the Mayo Elbow performance score at 6-month follow-up. Quick-DASH scores for the series at 6-month follow-up was on average of 15.96 ± 9.92. Conclusion: Dual plating in inverted Y configuration offers a reliable fixation, which permits early mobilization and good functional outcome. PMID:28246622

  12. Range gated strip proximity sensor

    DOEpatents

    McEwan, T.E.

    1996-12-03

    A range gated strip proximity sensor uses one set of sensor electronics and a distributed antenna or strip which extends along the perimeter to be sensed. A micro-power RF transmitter is coupled to the first end of the strip and transmits a sequence of RF pulses on the strip to produce a sensor field along the strip. A receiver is coupled to the second end of the strip, and generates a field reference signal in response to the sequence of pulse on the line combined with received electromagnetic energy from reflections in the field. The sensor signals comprise pulses of radio frequency signals having a duration of less than 10 nanoseconds, and a pulse repetition rate on the order of 1 to 10 MegaHertz or less. The duration of the radio frequency pulses is adjusted to control the range of the sensor. An RF detector feeds a filter capacitor in response to received pulses on the strip line to produce a field reference signal representing the average amplitude of the received pulses. When a received pulse is mixed with a received echo, the mixing causes a fluctuation in the amplitude of the field reference signal, providing a range-limited Doppler type signature of a field disturbance. 6 figs.

  13. Proximal Priority Laser Therapy: PPLT

    NASA Astrophysics Data System (ADS)

    Ohshiro, Toshio

    2004-09-01

    The author has, in the past, classified treatment methods for pain geometrically as point, line, two-dimensional, three-dimensional treatment and has used these over the years. However as a practitioner of western medicine, the author originally treated pain only directed at the painful site, and encountered cases where local treatment did not suffice. The author proved with SPECT and the Rand Phantom that treating the neck which is the midpoint of the brain, the center of the nervous system and the heart, the center of circulation, increased cerebral blood flow and also that laser emitted to neck will reach the spinal chord no matter from where on the neck the laser is emitted. From such research and 25 years of clinical experience, the author has created an anatomy based, systemic treatment method called the Proximal Priority Laser Therapy (PPLT) where not only the cerebral cortex, spinal chord and peripheral nerves are treated but also the tracts of blood vessels and lymph ducts are treated as well. Treatment method and cases are presented herein.

  14. Range gated strip proximity sensor

    DOEpatents

    McEwan, Thomas E.

    1996-01-01

    A range gated strip proximity sensor uses one set of sensor electronics and a distributed antenna or strip which extends along the perimeter to be sensed. A micro-power RF transmitter is coupled to the first end of the strip and transmits a sequence of RF pulses on the strip to produce a sensor field along the strip. A receiver is coupled to the second end of the strip, and generates a field reference signal in response to the sequence of pulse on the line combined with received electromagnetic energy from reflections in the field. The sensor signals comprise pulses of radio frequency signals having a duration of less than 10 nanoseconds, and a pulse repetition rate on the order of 1 to 10 MegaHertz or less. The duration of the radio frequency pulses is adjusted to control the range of the sensor. An RF detector feeds a filter capacitor in response to received pulses on the strip line to produce a field reference signal representing the average amplitude of the received pulses. When a received pulse is mixed with a received echo, the mixing causes a fluctuation in the amplitude of the field reference signal, providing a range-limited Doppler type signature of a field disturbance.

  15. Comparative limb bone loading in the humerus and femur of the tiger salamander: testing the 'mixed-chain' hypothesis for skeletal safety factors.

    PubMed

    Kawano, Sandy M; Economy, D Ross; Kennedy, Marian S; Dean, Delphine; Blob, Richard W

    2016-02-01

    Locomotion imposes some of the highest loads upon the skeleton, and diverse bone designs have evolved to withstand these demands. Excessive loads can fatally injure organisms; however, bones have a margin of extra protection, called a 'safety factor' (SF), to accommodate loads that are higher than normal. The extent to which SFs might vary amongst an animal's limb bones is unclear. If the limbs are likened to a chain composed of bones as 'links', then similar SFs might be expected for all limb bones because failure of the system would be determined by the weakest link, and extra protection in other links could waste energetic resources. However, Alexander proposed that a 'mixed-chain' of SFs might be found amongst bones if: (1) their energetic costs differ, (2) some elements face variable demands, or (3) SFs are generally high. To test whether such conditions contribute to diversity in limb bone SFs, we compared the biomechanical properties and locomotor loading of the humerus and femur in the tiger salamander (Ambystoma tigrinum). Despite high SFs in salamanders and similar sizes of the humerus and femur that would suggest similar energetic costs, the humerus had lower bone stresses, higher mechanical hardness and larger SFs. SFs were greatest in the anatomical regions where yield stresses were highest in the humerus and lowest in the femur. Such intraspecific variation between and within bones may relate to their different biomechanical functions, providing insight into the emergence of novel locomotor capabilities during the invasion of land by tetrapods.

  16. Grouping by proximity in haptic contour detection.

    PubMed

    Overvliet, Krista E; Krampe, Ralf Th; Wagemans, Johan

    2013-01-01

    We investigated the applicability of the Gestalt principle of perceptual grouping by proximity in the haptic modality. To do so, we investigated the influence of element proximity on haptic contour detection. In the course of four sessions ten participants performed a haptic contour detection task in which they freely explored a haptic random dot display that contained a contour in 50% of the trials. A contour was defined by a higher density of elements (raised dots), relative to the background surface. Proximity of the contour elements as well as the average proximity of background elements was systematically varied. We hypothesized that if proximity of contour elements influences haptic contour detection, detection will be more likely when contour elements are in closer proximity. This should be irrespective of the ratio with the proximity of the background elements. Results showed indeed that the closer the contour elements were, the higher the detection rates. Moreover, this was the case independent of the contour/background ratio. We conclude that the Gestalt law of proximity applies to haptic contour detection.

  17. Sugar proximity and human grip strength.

    PubMed

    Quintanar, A F; Hill, T V

    1988-12-01

    In a double-blind experiment with 90 undergraduate students the hypothesis was tested that proximity to sugar reduces human grip strength. An earlier study indicated that sugar proximity does indeed significantly reduce human grip strength. When additional controls were added to this design to reduce random sampling error, the hypothesis was not supported.

  18. Grouping by Proximity in Haptic Contour Detection

    PubMed Central

    Overvliet, Krista E.; Krampe, Ralf Th.; Wagemans, Johan

    2013-01-01

    We investigated the applicability of the Gestalt principle of perceptual grouping by proximity in the haptic modality. To do so, we investigated the influence of element proximity on haptic contour detection. In the course of four sessions ten participants performed a haptic contour detection task in which they freely explored a haptic random dot display that contained a contour in 50% of the trials. A contour was defined by a higher density of elements (raised dots), relative to the background surface. Proximity of the contour elements as well as the average proximity of background elements was systematically varied. We hypothesized that if proximity of contour elements influences haptic contour detection, detection will be more likely when contour elements are in closer proximity. This should be irrespective of the ratio with the proximity of the background elements. Results showed indeed that the closer the contour elements were, the higher the detection rates. Moreover, this was the case independent of the contour/background ratio. We conclude that the Gestalt law of proximity applies to haptic contour detection. PMID:23762364

  19. Proximal Participation: A Pathway into Work

    ERIC Educational Resources Information Center

    Chan, Selena

    2013-01-01

    In a longitudinal case study of apprentices, the term proximal participation was coined to describe the entry process of young people, with unclear career destinations, into the trade of baking. This article unravels the significance of proximal participation in the decision-making processes of young people who enter a trade through initial…

  20. Cystitis - acute

    MedlinePlus

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  1. Two stage reconstruction of septic non-union of the humerus with the use of circular external fixation.

    PubMed

    Ferreira, Nando; Marais, Leonard Charles; Serfontein, Charles

    2016-08-01

    Achieving quiescence in chronic osteomyelitis remains challenging. Wide resection of all infected and necrotic tissues improves the chances of achieving remission of the disease. Extensive debridement however decreases the already compromised bone stock that increases the complexity of reconstruction. We report on the outcome of eight patients with Cierny and Mader stage IV chronic osteomyelitis of the humerus who underwent debridement followed by bone graft and circular fixator application as a second stage procedure. Resolution of infection and humeral shaft union was achieved in all patients. Our study finds that two-stage reconstruction of stage IV chronic osteomyelitis with the use of circular external fixation is effective in achieving infection control and union in these complex cases.

  2. Sexual dimorphism of the humerus in contemporary Cretans--a population-specific study and a review of the literature*.

    PubMed

    Kranioti, Elena F; Michalodimitrakis, Manolis

    2009-09-01

    Sex determination is the first essential step for positive identification when a decomposed body is recovered. Taking into consideration the population aspect of sexual dimorphism of the skeleton, the present study aimed to create a sex identification technique using osteometric standards, derived from a contemporary Cretan population. A total of 168 left humeri were measured according to standard osteometric techniques. The differences between the means in males and females were significant (p < 0.0005). About 92.3% of cases were correctly classified when all measurements were applied jointly. Stepwise procedure produced an accuracy rate of 92.9%. The most effective single dimension was vertical head diameter (89.9%). The current study provides standards for a population that has not been represented so far in the existing databases. It demonstrates that the humerus is an effective bone for the estimation of sex because even in a fragmentary state it can give high classification accuracy.

  3. Use of the coventry infant hip screw in the treatment of nonunion of fractures of the distal humerus.

    PubMed

    Simonis, R B; Nuñez, V A; Khaleel, A

    2003-01-01

    Between 1993 and 2000 we treated 14 patients with nonunion of fractures of the distal humerus; 11 had already had previous fixation which had failed. The mean time to surgery was 21 months after injury. All the fractures were very low which made it difficult to obtain a firm hold of the small distal fragment. The problem of fixation was addressed by inserting a Coventry infant hip screw into the humeral condyles. The screw has a thread of wide diameter which gives excellent purchase on the small distal fragment. The condyles can then be compressed on to the humeral shaft using a 4.5 mm narrow tibial dynamic plate. Of these 14 difficult cases of nonunion, 12 progressed to union.

  4. Biomechanical evaluation of the fixation methods for transcondylar fracture of the humerus:ONI plate versus conventional plates and screws.

    PubMed

    Shimamura, Yasunori; Nishida, Keiichiro; Imatani, Junya; Noda, Tomoyuki; Hashizume, Hiroyuki; Ohtsuka, Aiji; Ozaki, Toshifumi

    2010-04-01

    We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I) during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 conventional fixation methods:an LCP reconstruction plate 3.5 using a locking mechanism (Group II), a conventional reconstruction plate 3.5 (CRP) with a cannulated cancellous screw (Group III), and a CRP with 2 cannulated cancellous screws (CS) in a crisscross orientation (Group IV). In the axial loading test, the mean failure loads were:Group I, 98.9+/-32.6;Group II, 108.5+/-27.2;Group III, 50.0+/-7.5;and Group IV, 34.5+/-12.2 (N). Group I fixations failed at a significantly higher load than those of Groups III and IV (p<0.05). In the extension loading test, the mean failure loads were:Group I, 34.0+/-12.4;Group II, 51.0+/-14.8;Group III, 19.3+/-6.0;and Group IV, 14.7+/-3.1 (N). Group IV fixations showed a significantly lower failure load than those of Group I (p<0.05). The fixation rigidities against mechanical loading by the ONI plate and LCP plate were comparable. These results suggested that an ONI system might be superior to the CRP and CS method, and comparable to the LCP method in terms of fixation rigidity for distal humerus fractures.

  5. The massive fossil humerus from the Oldowan horizon of Gombore I, Melka Kunture (Ethiopia, >1.39 Ma)

    NASA Astrophysics Data System (ADS)

    Di Vincenzo, Fabio; Rodriguez, Laura; Carretero, José Miguel; Collina, Carmine; Geraads, Denis; Piperno, Marcello; Manzi, Giorgio

    2015-08-01

    A well-preserved distal portion of a left humerus was discovered in 1976 during excavations directed by J. Chavaillon at the Gombore I site, in the Melka Kunture area (Ethiopia). The specimen, labelled Gombore IB-7594 (formally Melka Kunture 3, or MK3), was found in situ within unit 2 of level B, which is dated to >1.39 Ma and includes a rich Oldowan Paleolithic assemblage. Although MK3 has never been described in detail, it appeared in the literature several times and, from a taxonomic point of view, has been alternatively regarded as Homo, Australopithecus or Paranthropus. According to our analysis, MK3 exhibits a suite of features that fit the variability of the genus Homo and does not display any clear Australopithecus/Paranthropus affinity. Nevertheless, MK3 adds a great deal of variability to the genus Homo, at least as far as the Early Pleistocene fossil record is concerned. In particular, our quantitative approach, which combines traditional morphometric analyses and geometric morphometrics, highlights traits that are uncommon among the Plio-Pleistocene fossil record, while affinities with Mid-to-Late Pleistocene representatives of Homo are observed. In addition, the large size of MK3 suggests that this humerus belonged to an individual whose body weight approached 90 kg, far from the range of body size known for Homo representatives in the Early Pleistocene and as big as those of extant humans or even gorillas. We suggest that such peculiar features are of interest when regarded from an ecological perspective; thus, dimension and morphology of MK3 may be considered as an exaptation that became useful when early humans dispersed to high altitudes such as those of the upper Awash basin on the Ethiopian plateau, at heights above 2000 m.

  6. Promoting proximal formative assessment with relational discourse

    NASA Astrophysics Data System (ADS)

    Scherr, Rachel E.; Close, Hunter G.; McKagan, Sarah B.

    2012-02-01

    The practice of proximal formative assessment - the continual, responsive attention to students' developing understanding as it is expressed in real time - depends on students' sharing their ideas with instructors and on teachers' attending to them. Rogerian psychology presents an account of the conditions under which proximal formative assessment may be promoted or inhibited: (1) Normal classroom conditions, characterized by evaluation and attention to learning targets, may present threats to students' sense of their own competence and value, causing them to conceal their ideas and reducing the potential for proximal formative assessment. (2) In contrast, discourse patterns characterized by positive anticipation and attention to learner ideas increase the potential for proximal formative assessment and promote self-directed learning. We present an analysis methodology based on these principles and demonstrate its utility for understanding episodes of university physics instruction.

  7. A Brief Index for Proximity Searching

    NASA Astrophysics Data System (ADS)

    Téllez, Eric Sadit; Chávez, Edgar; Camarena-Ibarrola, Antonio

    Many pattern recognition tasks can be modeled as proximity searching. Here the common task is to quickly find all the elements close to a given query without sequentially scanning a very large database.

  8. Polarization proximity effect in isolator crystal pairs.

    PubMed

    Linzon, Y; Ferrera, M; Razzari, L; Pignolet, A; Morandotti, R

    2008-12-01

    We experimentally study the polarization dynamics (orientation and ellipticity) of near-infrared light transmitted through magneto-optical yttrium iron garnet isolator crystal pairs using a modified balanced detection scheme. When the pair separation is in the submillimeter range, we observed a proximity effect in which the saturation field is reduced by up to 20%. One-dimensional calculations suggest that the proximity effect originates from magnetostatic interactions between the dipole moments of the isolator crystals.

  9. Extracorporeal shockwave therapy for chronic proximal plantar fasciitis.

    PubMed

    Strash, Walter W; Perez, Richard R

    2002-10-01

    Although much enthusiasm surrounds applying extracorporeal shock wave therapy for various musculoskeletal conditions, its effects are not well understood and warrant continued study. Certain body tissues or organs may be damaged either acutely or chronically by ESWT; however, it is unequivocal that lung tissue may be damaged. It is theorized that neovascularization is responsible for improvement in symptoms of plantar fasciitis. Neovascularization is the direct effect of macrophage stimulation through cytokines. ESWT has effects at the cellular level--does it interfere with metabolic activity or enhance it? The noninvasive nature and minimal complications of appropriately applied ESWT are its primary advantages. Symptoms may continue to improve for three weeks to six months after treatment; the effects of shock wave therapy seem to be time dependent. ESWT is an effective form of treatment for proximal insertional plantar fasciitis after exhaustive, conservative forms of treatment have failed.

  10. Proximity sensor system development. CRADA final report

    SciTech Connect

    Haley, D.C.; Pigoski, T.M.

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

  11. Proximity operations considerations affecting spacecraft design

    NASA Technical Reports Server (NTRS)

    Staas, Steven K.

    1991-01-01

    Experience from several recent spacecraft development programs, such as Space Station Freedom (SSF) and the Orbital Maneuvering Vehicle (OMV) has shown the need for factoring proximity operations considerations into the vehicle design process. Proximity operations, those orbital maneuvers and procedures which involve operation of two or more spacecraft at ranges of less than one nautical mile, are essential to the construction, servicing, and operation of complex spacecraft. Typical proximity operations considerations which drive spacecraft design may be broken into two broad categories; flight profile characteristics and concerns, and use of various spacecraft systems during proximity operations. Proximity operations flight profile concerns include the following: (1) relative approach/separation line; (2) relative orientation of the vehicles; (3) relative translational and rotational rates; (4) vehicle interaction, in the form of thruster plume impingement, mating or demating operations, or uncontrolled contact/collision; and (5) active vehicle piloting. Spacecraft systems used during proximity operations include the following: (1) sensors, such as radar, laser ranging devices, or optical ranging systems; (2) effector hardware, such as thrusters; (3) flight control software; and (4) mating hardware, needed for docking or berthing operations. A discussion of how these factors affect vehicle design follows, addressing both active and passive/cooperative vehicles.

  12. Bryan and Morrey type IV intra-articular fracture of the distal extremity of the humerus treated surgically with anterior access: case report.

    PubMed

    Dressler, Hugo Bertani; de Paula, Ricardo Nunes Borges

    2015-01-01

    Within the context of elbow-level trauma, fractures with a coronal line at the distal extremity of the humerus are rare and result from indirect axial trauma with the arm extended. These are difficult-to-treat intra-articular fractures, since they require stable anatomical reduction in order to maintain joint congruence and diminish complications such as stiffness. This paper reports a case that occurred in a young man who suffered a fall from a ladder that resulted in a Bryan and Morrey type IV intra-articular fracture of the humerus. The injury was treated surgically by means of an anterior access, using osteosynthesis with two Herbert screws that were inserted from anterior to posterior.

  13. Proximal Tubules Have the Capacity to Regulate Uptake of Albumin.

    PubMed

    Wagner, Mark C; Campos-Bilderback, Silvia B; Chowdhury, Mahboob; Flores, Brittany; Lai, Xianyin; Myslinski, Jered; Pandit, Sweekar; Sandoval, Ruben M; Wean, Sarah E; Wei, Yuan; Satlin, Lisa M; Wiggins, Roger C; Witzmann, Frank A; Molitoris, Bruce A

    2016-02-01

    Evidence from multiple studies supports the concept that both glomerular filtration and proximal tubule (PT) reclamation affect urinary albumin excretion rate. To better understand these roles of glomerular filtration and PT uptake, we investigated these processes in two distinct animal models. In a rat model of acute exogenous albumin overload, we quantified glomerular sieving coefficients (GSC) and PT uptake of Texas Red-labeled rat serum albumin using two-photon intravital microscopy. No change in GSC was observed, but a significant decrease in PT albumin uptake was quantified. In a second model, loss of endogenous albumin was induced in rats by podocyte-specific transgenic expression of diphtheria toxin receptor. In these albumin-deficient rats, exposure to diphtheria toxin induced an increase in albumin GSC and albumin filtration, resulting in increased exposure of the PTs to endogenous albumin. In this case, PT albumin reabsorption was markedly increased. Analysis of known albumin receptors and assessment of cortical protein expression in the albumin overload model, conducted to identify potential proteins and pathways affected by acute protein overload, revealed changes in the expression levels of calreticulin, disabled homolog 2, NRF2, angiopoietin-2, and proteins involved in ATP synthesis. Taken together, these results suggest that a regulated PT cell albumin uptake system can respond rapidly to different physiologic conditions to minimize alterations in serum albumin level.

  14. The outcome and parents-based cosmetic satisfaction following fixation of paediatric supracondylar humerus fractures treated by closed method with or without small medial incision.

    PubMed

    Basaran, Serdar Hakan; Ercin, Ersin; Bayrak, Alkan; Bilgili, Mustafa Gokhan; Kizilkaya, Cemal; Dasar, Uygar; Avkan, Mustafa Cevdet

    2016-01-01

    Supracondylar humerus fractures are common in children. Displaced fractures are usually treated with closed reduction and cross pin fixation. But, medial pinning may cause the ulnar nerve injury. The aim of this study was to compare the parents-based cosmetic satisfaction of the incision scars in children with displaced supracondylar humerus fractures treated by closed reduction and cross pin fixation with or without small medial incision. We retrospectively reviewed the medical records of 72 children with displaced supracondylar humerus fractures treated two different closed reduction and percutaneous pinning methods at our institution from January 2010 through December 2013. A group has 36 patients treated with small medial incision and crossed K-wires fixation after closed reduction. The other group has 36 patients treated with closed reduction and K-wires fixation. At the final follow-up, the patients were evaluated radiologically and clinically with Flynn's criteria. Furthermore, a visual analogue scale was used to determine of the parents-based cosmetic satisfaction score. All fractures healed without major complications at the final clinical and radiological assessment. Although, between the two groups did not differ in terms of Flynn cosmetic and functional outcomes, there were statistically significant differences between both groups according to the parents-based cosmetic satisfaction scores. The closed reduction and crossed pin fixation without small medial incision should be preferred first because of better the parents-based cosmetic satisfaction.

  15. Acute Bronchitis

    MedlinePlus

    ... can also cause acute bronchitis. To diagnose acute bronchitis, your health care provider will ask about your symptoms and listen to your breathing. You may also have other tests. Treatments include rest, fluids, and aspirin (for adults) or ...

  16. Two-Dimensional Optical Proximity Effects

    NASA Astrophysics Data System (ADS)

    Flanner, Philip D.; Subramanian, Shankar; Neureuther, Andrew R.

    1986-08-01

    In projection printing the proximity effects between adjacent two-dimensional features such as concentric elbows can be the limiting factor in designing layout rules. An aerial image simulation code based on the imaging algorithms in SAMPLE has been developed and used to investigate these proximity effects. The program accepts arbitrary polygonal shapes constructed of rectangular and triangular patches. The image is calculated using Hopkins transmission cross coefficient formulation and uses rapid integral evaluation techniques. The cpu time for this FORTRAN F77 program depends on the size of the mask and the partial coherence factor as 0.25[(1 + σ) 2A(NA/λ)2]2 seconds on a DEC VAX 11/780 using double precision, where A is the mask area, σ the coherence factor, NA the numerical aperture and λ the wavelength. The output intensity can be displayed with graphics tools such as UNIGRAFIX or cross-sectioned for input to SAMPLE development simulation along critical paths. Proximity effects in critical regions between features such as nested elbows, contacts near contacts and lines, and lines near large pads are studied. For small contacts studies show that a contact hole can be placed as close as 0.5λ/NA microns to another contact hole. For nested elbows the critical effect is the variation in intensity in the straight regions just adjacent to the corner. This undesirable variation is primarily due to the intrafeature intensity interactions and is not greatly influenced by the proximity of another nested elbow. For general feature shapes the proximity effects are reduced by increasing the partial coherence factor to 0.5 or higher but at the cost of reducing contrast and peak intensity. For contact masks a partial coherence of 0.3 is recommended for higher edge slope and peak intensities. Proximity effects of small defects are also illustrated.

  17. Strategy for photostable proximity bioassays using lanthanides

    PubMed Central

    Haushalter, Jeanne P.; Faris, Gregory W.

    2011-01-01

    We report initial findings for research aimed at creating photostable lanthanide chelate reporters for proximity assays. These reporters take advantage of the nanometer scale distance dependence of fluorescence enhancement for molecules in the vicinity of noble metal nanoparticles and also capitalize on some unique properties of lanthanide chelates. This approach promises to lead to proximity assays that do not suffer from photobleaching and offer very high on/off enhancement ratios. Results for lanthanide chelates on silver island films and in colloidal suspensions are reported. Enhancement factors range from 1 to 2 orders of magnitude, with larger enhancements for strongly quenched lanthanides. PMID:17356638

  18. Small Bowel Obstruction Secondary to Acute Pancreatitis

    PubMed Central

    Sunkara, Tagore; Etienne, Denzil; Caughey, Megan E.; Gaduputi, Vinaya

    2017-01-01

    While an uncommon occurrence, it is possible for patients diagnosed with acute pancreatitis to develop colonic ileus, obstruction, or perforation. By extension, it is also possible to develop a small bowel obstruction following an episode of acute pancreatitis. Here, we present the case of a 44-year-old male, who after repeated attacks of acute pancreatitis, came to the emergency department with continuous, non-bloody vomiting. This patient also complained of both left upper quadrant and epigastric pain, and was subsequently diagnosed with a small bowel obstruction involving the proximal jejunum. PMID:28270876

  19. Small Bowel Obstruction Secondary to Acute Pancreatitis.

    PubMed

    Sunkara, Tagore; Etienne, Denzil; Caughey, Megan E; Gaduputi, Vinaya

    2017-02-01

    While an uncommon occurrence, it is possible for patients diagnosed with acute pancreatitis to develop colonic ileus, obstruction, or perforation. By extension, it is also possible to develop a small bowel obstruction following an episode of acute pancreatitis. Here, we present the case of a 44-year-old male, who after repeated attacks of acute pancreatitis, came to the emergency department with continuous, non-bloody vomiting. This patient also complained of both left upper quadrant and epigastric pain, and was subsequently diagnosed with a small bowel obstruction involving the proximal jejunum.

  20. A musculoskeletal model of the equine forelimb for determining surface stresses and strains in the humerus-part II. Experimental testing and model validation.

    PubMed

    Pollock, Sarah; Stover, Susan M; Hull, M L; Galuppo, Larry D

    2008-08-01

    The first objective of this study was to experimentally determine surface bone strain magnitudes and directions at the donor site for bone grafts, the site predisposed to stress fracture, the medial and cranial aspects of the transverse cross section corresponding to the stress fracture site, and the middle of the diaphysis of the humerus of a simplified in vitro laboratory preparation. The second objective was to determine whether computing strains solely in the direction of the longitudinal axis of the humerus in the mathematical model was inherently limited by comparing the strains measured along the longitudinal axis of the bone to the principal strain magnitudes and directions. The final objective was to determine whether the mathematical model formulated in Part I [Pollock et al., 2008, ASME J. Biomech. Eng., 130, p. 041006] is valid for determining the bone surface strains at the various locations on the humerus where experimentally measured longitudinal strains are comparable to principal strains. Triple rosette strain gauges were applied at four locations circumferentially on each of two cross sections of interest using a simplified in vitro laboratory preparation. The muscles included the biceps brachii muscle in addition to loaded shoulder muscles that were predicted active by the mathematical model. Strains from the middle grid of each rosette, aligned along the longitudinal axis of the humerus, were compared with calculated principal strain magnitudes and directions. The results indicated that calculating strains solely in the direction of the longitudinal axis is appropriate at six of eight locations. At the cranial and medial aspects of the middle of the diaphysis, the average minimum principal strain was not comparable to the average experimental longitudinal strain. Further analysis at the remaining six locations indicated that the mathematical model formulated in Part I predicts strains within +/-2 standard deviations of experimental strains at

  1. [Proximity and breastfeeding at the maternity hospital].

    PubMed

    Fradin-Charrier, Anne-Claire

    2015-01-01

    The establishment of breastfeeding, as well as its duration, are facilitated through the proximity of the mother with her new baby. However, in maternity hospitals, breastfeeding mothers very often leave their baby in the nursery at night time. A study carried out in 2014 in several maternity hospitals put forward suggestions and highlighted areas to improve in everyday practice.

  2. Vortices in normal part of proximity system

    DOE PAGES

    Kogan, V. G.

    2015-05-26

    It is shown that the order parameter Δ induced in the normal part of superconductor-normal-superconductor proximity system is modulated in the magnetic field differently from vortices in bulk superconductors. Whereas Δ turns zero at vortex centers, the magnetic structure of these vortices differs from that of Abrikosov's.

  3. Current status of proximal gastric vagotomy.

    PubMed Central

    Schirmer, B D

    1989-01-01

    Proximal gastric vagotomy is nearing its twentieth year in clinical use as an operation for peptic ulcer disease. No other acid-reducing operation has undergone as much scrutiny or study. At this time, the evidence of such studies and long-term follow-up strongly supports the use of proximal gastric vagotomy as the treatment of choice for chronic duodenal ulcer in patients who have failed medical therapy. Its application in treating the complications of peptic ulcer disease, which recently have come to represent an increasingly greater percentage of all operations done for peptic ulcer disease, is well-tested. However, initial series suggest that it should probably occupy a prominent role in treating some of these complications, particularly in selected patients, in the future. The operation has the well-documented ability to reduce gastric acid production, not inhibit gastric bicarbonate production, and also minimally inhibit gastric motility. The combination of these physiologic results after proximal gastric vagotomy, along with preservation of the normal antropyloroduodenal mechanism of gastrointestinal control, serve to allow patients with proximal gastric vagotomy the improved benefits of significantly fewer severe gastrointestinal side effects than are seen after other operations for peptic ulcer disease. PMID:2644897

  4. Encoding Direction when Interpreting Proximal Terms

    ERIC Educational Resources Information Center

    Ashley, Aaron; Carlson, Laura A.

    2007-01-01

    The location of an object is often described by spatially relating it to a known landmark. The spatial terms used in such descriptions can provide various types of information. For example, projective terms such as "above" indicate direction but not distance, whereas proximal terms such as "near" indicate distance but not direction. Previous…

  5. Object detection system using SPAD proximity detectors

    NASA Astrophysics Data System (ADS)

    Stark, Laurence; Raynor, Jeffrey M.; Henderson, Robert K.

    2011-10-01

    This paper presents an object detection system based upon the use of multiple single photon avalanche diode (SPAD) proximity sensors operating upon the time-of-flight (ToF) principle, whereby the co-ordinates of a target object in a coordinate system relative to the assembly are calculated. The system is similar to a touch screen system in form and operation except that the lack of requirement of a physical sensing surface provides a novel advantage over most existing touch screen technologies. The sensors are controlled by FPGA-based firmware and each proximity sensor in the system measures the range from the sensor to the target object. A software algorithm is implemented to calculate the x-y coordinates of the target object based on the distance measurements from at least two separate sensors and the known relative positions of these sensors. Existing proximity sensors were capable of determining the distance to an object with centimetric accuracy and were modified to obtain a wide field of view in the x-y axes with low beam angle in z in order to provide a detection area as large as possible. Design and implementation of the firmware, electronic hardware, mechanics and optics are covered in the paper. Possible future work would include characterisation with alternative designs of proximity sensors, as this is the component which determines the highest achievable accur1acy of the system.

  6. Laparoscopic Proximal Gastrectomy With Gastric Tube Reconstruction

    PubMed Central

    Shiraishi, Norio; Toujigamori, Manabu; Shiroshita, Hidefumi; Etoh, Tsuyoshi; Inomata, Masafumi

    2016-01-01

    Background and Objectives: There is no standardized method of reconstruction in laparoscopic proximal gastrectomy (LPG). We present a novel technique of reconstruction with a long, narrow gastric tube in LPG for early gastric cancer (EGC). Methods: During the laparoscopic procedure, the upper part of the stomach is fully mobilized with perigastric and suprapancreatic lymphadenectomy, and then the abdominal esophagus is transected. After a minilaparotomy is created, the entire stomach is pulled outside. A long, narrow gastric tube (20 cm long, 3 cm wide) is created with a linear stapler. The proximal part of the gastric tube is formed into a cobra head shape for esophagogastric tube anastomosis, which is then performed with a 45-mm linear stapler under laparoscopic view. The end of the esophagus is fixed on the gastric tube to prevent postoperative esophageal reflux. Results: Thirteen patients with early proximal gastric cancer underwent the procedure. The mean operative time was 283 min, and median blood loss was 63 ml. There were no conversions to open surgery, and no intraoperative complications. Conclusion: This new technique of reconstruction after LPG is simple and feasible. The procedure has the potential of becoming a standard reconstruction technique after LPG for proximal EGC. PMID:27547027

  7. Goal-Proximity Decision-Making

    ERIC Educational Resources Information Center

    Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.

    2013-01-01

    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…

  8. Proximity correction for electron beam lithography

    NASA Astrophysics Data System (ADS)

    Marrian, Christie R.; Chang, Steven; Peckerar, Martin C.

    1996-09-01

    As the critical dimensions required in mask making and direct write by electron beam lithography become ever smaller, correction for proximity effects becomes increasingly important. Furthermore, the problem is beset by the fact that only a positive energy dose can be applied with an electron beam. We discuss techniques such as chopping and dose shifting, which have been proposed to meet the positivity requirement. An alternative approach is to treat proximity correction as an optimization problem. Two such methods, local area dose correction and optimization using a regularizer proportional to the informational entropy of the solution, are compared. A notable feature of the regularized proximity correction is the ability to correct for forward scattering by the generation of a 'firewall' set back from the edge of a feature. As the forward scattering width increases, the firewall is set back farther from the feature edge. The regularized optimization algorithm is computationally time consuming using conventional techniques. However, the algorithm lends itself to a microelectronics integrated circuit coprocessor implementation, which could perform the optimization faster than even the fastest work stations. Scaling the circuit to larger number of pixels is best approached with a hybrid serial/parallel digital architecture that would correct for proximity effects over 108 pixels in about 1 h. This time can be reduced by simply adding additional coprocessors.

  9. Proximity correction for e-beam lithography

    NASA Astrophysics Data System (ADS)

    Marrian, Christie R.; Chang, Steven; Peckerar, Martin C.

    1995-12-01

    As the critical dimensions required for masks and e-beam direct write become ever smaller, the correction of proximity effects becomes more necessary. Furthermore, the problem is beset by the fact that only a positive energy dose can be applied with the e-beam. We discuss here approaches such as chopping and dose shifting which have been proposed to meet the positivity requirement. An alternative approach is to treat proximity correction as an optimization problem. Two such methods, local area dose correction and optimization using a regularizer proportional to the informational entropy of the solution, are compared. A notable feature of the regularized proximity correction is the ability to correct for forward scattering by the generation of a 'firewall' set back from the edge of a feature. As the forward scattering width increases, the firewall is set back further from the feature edge. The regularized optimization algorithm is computationally time consuming using conventional techniques. However, the algorithm lends itself to a microelectronics integrated circuit coprocessor implementation which could perform the optimization much faster than even the fastest work stations. Scaling the circuit to larger number of pixels is best approached with a hybrid serial/parallel digital architecture which would correct for proximity effects over 108 pixels about one hour. This time can be reduced by simply adding additional coprocessors.

  10. Proximal Contact Repair of Complex Amalgam Restorations.

    PubMed

    Zguri, M N; Casey, J A; Jessup, J P; Vandewalle, K S

    2017-01-12

    The carving of a complex amalgam restoration may occasionally result in light proximal contact with the adjacent tooth. The purpose of this study was to investigate the strength of complex amalgam restorations repaired with a proximal slot amalgam preparation. Extracted human third molars of similar coronal size were sectioned 1 mm apical to the height of the contour using a saw and were randomly distributed into 9 groups of 10 teeth each. One pin was placed at each line angle of the flattened dentinal tooth surface. A metal matrix band was placed and an admixed alloy was condensed and carved to create a full crown contour but with a flat occlusal surface. A proximal slot was prepared with or without a retention groove and repaired using a single-composition spherical amalgam 15 minutes, 24 hours, one week, or six months after the initial crown condensation. The specimens were stored for 24 hours in 37°C water before fracture at the marginal ridge using a round-ended blade in a universal testing machine. The control group was not repaired. The mean maximum force in newtons and standard deviation were determined per group. Data were analyzed with a 2-way analysis of variance as well as Tukey and Dunnett tests (α=0.05). Significant differences were found between groups based on type of slot preparation (p=0.017) but not on time (p=0.327), with no significant interaction (p=0.152). No significant difference in the strength of the marginal ridge was found between any repair group and the unrepaired control group (p>0.076). The proximal repair strength of a complex amalgam restoration was not significantly different from an unrepaired amalgam crown. Placing a retention groove in the proximal slot preparation resulted in significantly greater fracture strength than a slot with no retention grooves. Time of repair had no significant effect on the strength of the repair.

  11. Characteristics of He II Proximity Profiles

    NASA Astrophysics Data System (ADS)

    Zheng, Wei; Syphers, David; Meiksin, Avery; Kriss, Gerard A.; Schneider, Donald P.; York, Donald G.; Anderson, Scott F.

    2015-06-01

    The proximity profile in the spectra of z≈ 3 quasars, where fluxes extend blueward of the He ii Lyα wavelength 304 (1+z) Å, is one of the most important spectral features in the study of the intergalactic medium (IGM). Based on the Hubble Space Telescope spectra of 24 He ii quasars, we find that the majority of them display a proximity profile, corresponding to an ionization radius as large as 20 Mpc in the source's rest frame. In comparison with those in the H i spectra of the quasars at z ≈ 6, the He ii proximity effect is more prominent and is observed over a considerably longer period of reionization. The He ii proximity zone sizes decrease at higher redshifts, particularly at z\\gt 3.3. This trend is similar to that for H i, signaling an onset of He ii reionization at z≳ 4. For quasar SDSS1253+6817 (z = 3.48), the He ii absorption trough displays a gradual decline and serves as a good case for modeling the He ii reionization. To model such a broad profile requires a quasar radiation field whose energy distribution between 4 and 1 Rydberg is considerably harder than normally assumed. The UV continuum of this quasar is indeed exceptionally steep, and the He ii ionization level in the quasar vicinity is higher than the average level in the IGM. These results are evidence that a very hard EUV continuum from this quasar produces a large ionized zone around it. Distinct exceptions are the two brightest He ii quasars at z ≈ 2.8, for which no significant proximity profile is present, probably implying that they are very young.

  12. Sensors on the humerus are not necessary for an accurate assessment of humeral kinematics in constrained movements.

    PubMed

    Lin, Yin-Liang; Karduna, Andrew R

    2013-08-01

    The measurement of humeral kinematics with a sensor on the humerus is susceptible to large errors due to skin motion artifacts. An alternative approach is to use data from a forearm sensor, combined with data from either a scapular or thoracic sensor. We used three tasks to assess the errors of these approaches: humeral elevation, elbow flexion and humeral internal rotation. Compared with the humeral method, the forearm methods (using either a scapular or thoracic sensor) demonstrated significantly smaller root mean square errors in humeral elevation and humeral internal rotation tasks. Although the errors of the forearm methods were significantly larger than those of the humeral method during elbow flexion, the errors of the forearm methods still were below 3°. Therefore, these forearm methods may be able to accurately measure humeral motion. In addition, since no difference was found between the forearm methods using the scapular or thoracic sensor, it may be possible to accurately assess both shoulder and elbow kinematics with only two sensors: one on the forearm and one on the scapula.

  13. [Difficulties in the management of supracondylar fractures of the humerus in children living in Central African Republic].

    PubMed

    Gaudeuille, A; Douzima, P M; Sanze, B M; Ndemanga, J K; Mandaba, J L

    1998-01-01

    Like many developing countries, the Central African Republic lacks the technology and skills to perform certain medical procedures. One example of this situation can be found in the Pediatric Surgery Department of Bangui with regard to first intention management of supracondylar fractures of the humerus (SCF). Due to a lack of proper technological facilities (e.g. absence of brightness enhancement) and to insufficient staff training, management of SCF must be limited to orthopedic reduction followed cast application and brachio-anti-brachio-palmar traction such problems. This retrospective study describes management of 119 cases of SCF involving children between the ages of 0 and 15 years. Special emphasis was placed on factors impairing outcome, namely, inadequate staff training, availability of brightness enhancement, and poor awareness on the part of the parents concerning the seriousness of SCF. The quality of reduction was compared according to whether reduction was done with or without brightness enhancement (reduction without brightness enhancement was imperfect in most cases: 78/119) and according to fracture grade (high number of imperfect reductions in grade 3 and 4:69%). Assessment of outcome at one month showed a high incidence of poor results due to severe fracture or imperfect reduction. A prospective study including 35 cases with a follow-up of three years showed poor results for the same reasons. Comparison of these results with those reported by previous authors showed a large gap which must be filled by upgrading technical facilities and training staff.

  14. Autophagy in Acute Kidney Injury

    PubMed Central

    Livingston, Man J.; Dong, Zheng

    2014-01-01

    Acute kidney injury is a major kidney disease associated with poor clinical outcomes. The pathogenesis of acute kidney injury is multifactorial and is characterized by tubular cell injury and death. Recent studies have demonstrated autophagy induction in proximal tubular cells during acute kidney injury. The regulatory mechanisms of tubular cell autophagy are poorly understood; however, some recent findings have set up a foundation for further investigation. Although autophagy may promote cell death under certain experimental conditions, pharmacological and autophagy-related gene knockout studies have established a renoprotective role for autophagy in acute kidney injury. The mechanisms by which autophagy protects cells from injury and how, possibly, its pro-survival role switches to pro-death under certain conditions are discussed. Further research is expected to help us understand the regulatory network of tubular cell autophagy, define its precise roles in specific context of acute kidney injury, and identify autophagy-targeting strategies for the prevention and treatment of acute kidney injury. PMID:24485026

  15. Clinical Impact of Proximal Autosomal Imbalances

    PubMed Central

    Hamid, AB; Weise, A; Voigt, M; Bucksch, M; Kosyakova, N; Liehr, T; Klein, E

    2012-01-01

    Centromere-near gain of copy number can be induced by intra- or inter-chromosomal rearrangements or by the presence of a small supernumerary marker chromosome (sSMC). Interestingly, partial trisomy to hexasomy of euchromatic material may be present in clinically healthy or affected individuals, depending on origin and size of chromosomal material involved. Here we report the known minimal sizes of all centromere-near, i.e., proximal auto-somal regions in humans, which are tolerated; over 100 Mb of coding DNA are comprised in these regions. Additionally, we have summarized the typical symptoms for nine proximal autosomal regions including genes obviously sensitive to copy numbers. Overall, studying the carriers of specific chromosomal imbalances using genomics-based medicine, combined with single cell analysis can provide the genotype-phenotype correlations and can also give hints where copy-number-sensitive genes are located in the human genome. PMID:24052727

  16. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    PubMed Central

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despite routine post-operative skeletal traction in all cases and careful soft tissue interposition. One case showed significant heterotopic ossification which restricted prolonged sitting. This patient needed some occasional medication for pain. PMID:12180614

  17. Space robotic system for proximity operations

    NASA Technical Reports Server (NTRS)

    Magnani, P. G.; Colomba, M.

    1989-01-01

    Key to an efficient accomplishment of space station servicing operations is the development of a scenario where the presence of man in space is well integrated with the capability of teleoperated and automatic robot system outside the stations. Results focusing on mission requirements, trajectory sequences, propulsion subsystem features, and manipulative kit characteristics relevant to proximity servicing during a Man Tended Free Flyers Robotic Mission (MTFF-RM) are illustrated.

  18. Capacitive Proximity Sensor Has Longer Range

    NASA Technical Reports Server (NTRS)

    Vranish, John M.

    1992-01-01

    Capacitive proximity sensor on robot arm detects nearby object via capacitive effect of object on frequency of oscillator. Sensing element part of oscillator circuit operating at about 20 kHz. Total capacitance between sensing element and ground constitutes tuning capacitance of oscillator. Sensor circuit includes shield driven by replica of alternating voltage applied to sensing element. Driven shield concentrates sensing electrostatic field in exterior region to enhance sensitivity to object. Sensitivity and dynamic range has corresponding 12-to-1 improvement.

  19. Proximal monomelic amyotrophy of the upper limb.

    PubMed

    Amir, D; Magora, A; Vatine, J J

    1987-07-01

    A 30-year-old patient of Central European origin, suffering from monomelic amyotrophy, is presented. The disease was characterized by proximal weakness of one upper limb, mainly of the shoulder girdle, accompanied by atrophy. The electrodiagnostic examination revealed signs of partial denervation in the presence of normal motor and sensory conduction. The disease, which is probably of the anterior horn cells, had a benign course and good prognosis, as evident from repeated examinations during a follow-up of eight years.

  20. Children's memory and proximity to violence.

    PubMed

    Pynoos, R S; Nader, K

    1989-03-01

    The study examined 133 school-age children's memory of a sniper attack at their elementary school. Researchers analyzed the role that spatial representation, memory markers, inner plans of action, and strategies of recall played in the memory process. In recalling the event, exposed children reduced their degree of life threat, while nonexposed children increased their proximity to the violence. Clinical and forensic implications are discussed.

  1. Endoscopic Proximal Hamstring Repair and Ischial Bursectomy

    PubMed Central

    Dierckman, Brian D.; Guanche, Carlos A.

    2012-01-01

    With the significant increase in use of the arthroscope around the hip have come several less invasive techniques to manage pathologies around this joint. This technical note with a video details one such technique that allows for the endoscopic management of proximal hamstring tears and chronic ischial bursitis, which until now have been managed exclusively with much larger open approaches. This procedure allows for complete exposure of the posterior aspect of the hip in a safe, minimally invasive fashion. PMID:23766996

  2. Technical implications in proximal forearm transplantation.

    PubMed

    Haddock, Nicholas T; Chang, Benjamin; Bozentka, David J; Steinberg, David R; Levin, Lawrence Scott

    2013-12-01

    The field of vascularized composite allotransplantation has developed for more than a decade. Investigators are defining patient selection criteria, transplant indications, immunologic regimens, and tolerance. The majority of the current reported hand transplantations have been for treatment of distal forearm or hand amputations. In more proximal amputees, the functional outcome of the transplanted arm has some unique variables that require a different surgical approach. We present a single case of bilateral proximal forearm transplantation in effort to describe the unique technical considerations in this complex procedure. The surgical procedure is described in detail. At 19 months, our patient had 4/5 strength of finger and thumb flexors and protective extensor as well as 4/5 wrist flexors and extensors. Our patient had recovery of sensation. Our patient now lives independently and does her lower extremity prosthesis independently using her hands. These results are expected to continue to improve with more time. In hand transplantation, functional results have been very promising. The described approach of forearm transplantation allows the transfer of the entire functional unit, which should optimize the ultimate outcome for these more proximal injuries.

  3. Trajectories in Close Proximity to Asteroids

    NASA Technical Reports Server (NTRS)

    Scheeres, D. J.

    2000-01-01

    Spacecraft motion in close proximity to irregularly shaped, rotating bodies such as asteroids presents a unique dynamical environment as compared to most space missions. There are several fundamental novelties in this environment that spacecraft must deal with. These include the possibility of orbital instabilities that can act over very short time spans (on the order of hours for some systems), possible non-uniform rotation of the central gravity field, divergence of traditional gravity field representations when close to the asteroid surface, dominance of perturbing forces, an extremely large asteroid model parameter space that must be prepared for in the absence of reliable information, and the possibility of employing new and novel trajectory control techniques such as hovering and repeated landings on the asteroid surface. An overview of how these novelties impact the space of feasible close proximity operations and how different asteroid model properties will affect their implementation is given. In so doing, four fundamental types of close proximity operations will be defined. Listed in order of increasing technical difficulty these are: (1) close, stable orbits; (2) low-altitude flyovers; (3) landing trajectories; and (4) hovering trajectories. The feasibility and difficulty of implementing these operations will vary as a function of the asteroid shape, size, density, and rotation properties, and as a function of the spacecraft navigation capability. Additional information is contained in the original extended abstract.

  4. Proximity effect correction concerning forward scattering

    NASA Astrophysics Data System (ADS)

    Tsunoda, Dai; Shoji, Masahiro; Tsunoe, Hiroyuki

    2010-09-01

    The Proximity Effect is a critical problem in EB Lithography which is used in Photomask writing. Proximity Effect means that an electron shot by gun scatters by collided with resist molecule or substrate atom causes CD variation depending on pattern density [1]. Scattering by collision with resist molecule is called as "forward scattering", that affects in dozens of nanometer range, and with substrate atom is called as "backward scattering, that affects approximately 10 micrometer in 50keV acceleration voltage respectively. In conventional Proximity Effect Correction (PEC) for mask writing, we don't need to think forward scattering effect. However we should think about forward scattering because of smaller feature size. We have proposed a PEC software product named "PATACON PC-Cluster"[2], which can concern forward scattering and calculate optimum dose modulation. In this communication, we explain the PEC processing throughput when the that takes forward scattering into account. The key technique is to use different processing field size for forward scattering calculation. Additionally, the possibility is shown that effective PEC may be available by connecting forward scattering and backward scattering.

  5. Calibrating animal-borne proximity loggers.

    PubMed

    Rutz, Christian; Morrissey, Michael B; Burns, Zackory T; Burt, John; Otis, Brian; St Clair, James J H; James, Richard

    2015-06-01

    Growing interest in the structure and dynamics of animal social networks has stimulated efforts to develop automated tracking technologies that can reliably record encounters in free-ranging subjects. A particularly promising approach is the use of animal-attached 'proximity loggers', which collect data on the incidence, duration and proximity of spatial associations through inter-logger radio communication. While proximity logging is based on a straightforward physical principle - the attenuation of propagating radio waves with distance - calibrating systems for field deployment is challenging, since most study species roam across complex, heterogeneous environments.In this study, we calibrated a recently developed digital proximity-logging system ('Encounternet') for deployment on a wild population of New Caledonian crows Corvus moneduloides. Our principal objective was to establish a quantitative model that enables robust post hoc estimation of logger-to-logger (and, hence, crow-to-crow) distances from logger-recorded signal-strength values. To achieve an accurate description of the radio communication between crow-borne loggers, we conducted a calibration exercise that combines theoretical analyses, field experiments, statistical modelling, behavioural observations, and computer simulations.We show that, using signal-strength information only, it is possible to assign crow encounters reliably to predefined distance classes, enabling powerful analyses of social dynamics. For example, raw data sets from field-deployed loggers can be filtered at the analysis stage to include predominantly encounters where crows would have come to within a few metres of each other, and could therefore have socially learned new behaviours through direct observation. One of the main challenges for improving data classification further is the fact that crows - like most other study species - associate across a wide variety of habitats and behavioural contexts, with different signal

  6. Methods and theory in bone modeling drift: comparing spatial analyses of primary bone distributions in the human humerus.

    PubMed

    Maggiano, Corey M; Maggiano, Isabel S; Tiesler, Vera G; Chi-Keb, Julio R; Stout, Sam D

    2016-01-01

    This study compares two novel methods quantifying bone shaft tissue distributions, and relates observations on human humeral growth patterns for applications in anthropological and anatomical research. Microstructural variation in compact bone occurs due to developmental and mechanically adaptive circumstances that are 'recorded' by forming bone and are important for interpretations of growth, health, physical activity, adaptation, and identity in the past and present. Those interpretations hinge on a detailed understanding of the modeling process by which bones achieve their diametric shape, diaphyseal curvature, and general position relative to other elements. Bone modeling is a complex aspect of growth, potentially causing the shaft to drift transversely through formation and resorption on opposing cortices. Unfortunately, the specifics of modeling drift are largely unknown for most skeletal elements. Moreover, bone modeling has seen little quantitative methodological development compared with secondary bone processes, such as intracortical remodeling. The techniques proposed here, starburst point-count and 45° cross-polarization hand-drawn histomorphometry, permit the statistical and populational analysis of human primary tissue distributions and provide similar results despite being suitable for different applications. This analysis of a pooled archaeological and modern skeletal sample confirms the importance of extreme asymmetry in bone modeling as a major determinant of microstructural variation in diaphyses. Specifically, humeral drift is posteromedial in the human humerus, accompanied by a significant rotational trend. In general, results encourage the usage of endocortical primary bone distributions as an indicator and summary of bone modeling drift, enabling quantitative analysis by direction and proportion in other elements and populations.

  7. The pattern of hominin postcranial evolution reconsidered in light of size-related shape variation of the distal humerus.

    PubMed

    Lague, Michael R

    2014-10-01

    Previous research suggests that some hominin postcranial features do not follow a linear path of increasing modernization through geological time. With respect to the distal humerus, in particular, the earliest known hominin specimens are reportedly among the most modern in morphology, while some later humeri appear further removed from the average modern human shape. Although Plio-Pleistocene humeri vary widely in size, previous studies have failed to account for size-related shape variation when making morphometric comparisons. This study reexamines hominin postcranial evolution in light of distal humeral allometry. Using two-dimensional landmark data, the relationship between specimen size and shape among modern humans is quantified using multivariate regression and principal components analysis of size-shape space. Fossils are compared with modern human shapes expected at a given size, as well as with the overall average human shape. The null hypothesis of humeral isometry in modern humans is rejected. Subsequently, if one takes allometry into account, the apparent pattern of hominin humeral evolution does not resemble the pattern described above. All 14 of the Plio-Pleistocene hominin fossils examined here share a similar pattern of shape differences from equivalently-sized modern humans, though they vary in the extent to which these differences are expressed. The oldest specimen in the sample (KNM-KP 271; Australopithecus anamensis) exhibits the least human-like elbow morphology. Similarly primitive morphology characterizes all younger species of Australopithecus as well as Paranthropus robustus. After 2 Ma, a subtly more human-like elbow morphology is apparent among specimens attributed to early Homo, as well as among isolated specimens that may represent either Homo or Paranthropus boisei. This study emphasizes the need to consider size-related shape variation when individual fossil specimens are compared with the average shape of a comparative group

  8. Influence of uranium speciation on normal rat kidney (NRK-52E) proximal cell cytotoxicity.

    PubMed

    Carrière, M; Avoscan, L; Collins, R; Carrot, F; Khodja, H; Ansoborlo, E; Gouget, B

    2004-03-01

    Uranium is a naturally occurring heavy metal. Its extensive use in the nuclear cycle and for military applications has focused attention on its potential health effects. Acute exposures to uranium are toxic to the kidneys where they mainly cause damage to proximal tubular epithelium. The purpose of this study was to investigate the biological consequences of acute in vitro uranyl exposure and the influence of uranyl speciation on its cytotoxicity. NRK-52E cells, representative of rat kidney proximal epithelium, were exposed to uranyl-carbonate and -citrate complexes, which are the major complexes transiting through renal tubules after acute in vivo contamination. Before NRK-52E cell exposure, these complexes were diluted in classical or modified cell culture media, which can possibly modify uranyl speciation. In these conditions, uranium cytotoxicity appears after 16 h of exposure. The CI50 cytotoxicity index, the uranium concentration leading to 50% dead cells after 24 h of exposure, is 500 microM (+/-100 microM) and strongly depends on uranyl counterion and cell culture medium composition. Computer modeling of uranyl speciation is reported, enabling one to draw a parallel between uranyl speciation and its cytotoxicity.

  9. [Value of bony resection-reconstruction by avascular autologous fibular graft in the tropical milieu. Treatment of a giant cavernous hemangioma of the humerus].

    PubMed

    Thiery, J F; Martet, G; Lemesle, L; Vaujany, P; Escarment, J; Merrien, Y

    1994-01-01

    In a poorly equipped tropical setting, limb amputation is often considered as the only therapeutic solution for malignant tumors or large benign tumors. However it can be avoided by bone replacement using an avascular autologous fibular graft. This method was used in a young girl from Tchad presenting a giant cavernous hemangioma of the humerus. This technique allowed salvage of the extremity but resulted inevitably in radial paralysis. The time needed for bone healing was normal. This technique required minimum facilities and was perfectly biocompatible. It can be used in tropical settings where allograft techniques and prosthetic replacement are not available.

  10. Repair of injured proximal tubule does not involve specialized progenitors

    PubMed Central

    Humphreys, Benjamin D.; Czerniak, Suzanne; DiRocco, Derek P.; Hasnain, Wirasat; Cheema, Rabia; Bonventre, Joseph V.

    2011-01-01

    Recently we have established that the kidney tubular epithelium is repaired by surviving epithelial cells. It is not known, however, whether a population of intratubular adult progenitor cells are responsible for this epithelial repair after acute kidney injury. In this study, we used an unbiased DNA analog-based approach that does not rely on candidate markers to track multiple rounds of cell division in vivo. In the proximal tubule, robust thymidine analog incorporation was observed postinjury. Cell division was stochastic and enriched among cells that were injured and dedifferentiated. There was no evidence for the presence of a population of specialized progenitors that repeatedly divide in response to injury. Instead, these results indicate that after injury, new epithelial cells arise from self-duplication of surviving cells, most of which are injured. Because the renal papilla contains DNA label-retaining cells and has been proposed as a stem cell niche, we examined the proliferative behavior of these putative progenitors after ischemia-reperfusion injury. Although label-retaining cells in the renal papilla diminished with time after ischemia-reperfusion injury, they neither proliferated nor migrated to the outer medulla or cortex. Thus, nonlethally injured cells repopulate the kidney epithelium after injury in the absence of any specialized progenitor cell population. PMID:21576461

  11. Discerning the role of mechanosensors in regulating proximal tubule function.

    PubMed

    Raghavan, Venkatesan; Weisz, Ora A

    2016-01-01

    All cells in the body experience external mechanical forces such as shear stress and stretch. These forces are sensed by specialized structures in the cell known as mechanosensors. Cells lining the proximal tubule (PT) of the kidney are continuously exposed to variations in flow rates of the glomerular ultrafiltrate, which manifest as changes in axial shear stress and radial stretch. Studies suggest that these cells respond acutely to variations in flow by modulating their ion transport and endocytic functions to maintain glomerulotubular balance. Conceptually, changes in the axial shear stress in the PT could be sensed by three known structures, namely, the microvilli, the glycocalyx, and primary cilia. The orthogonal component of the force produced by flow exhibits as radial stretch and can cause expansion of the tubule. Forces of stretch are transduced by integrins, by stretch-activated channels, and by cell-cell contacts. This review summarizes our current understanding of flow sensing in PT epithelia, discusses challenges in dissecting the role of individual flow sensors in the mechanosensitive responses, and identifies potential areas of opportunity for new study.

  12. 14 CFR 135.153 - Ground proximity warning system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Ground proximity warning system. 135.153... Equipment § 135.153 Ground proximity warning system. (a) No person may operate a turbine-powered airplane... equipped with an approved ground proximity warning system. (b) (c) For a system required by this...

  13. 14 CFR 135.153 - Ground proximity warning system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Ground proximity warning system. 135.153... Equipment § 135.153 Ground proximity warning system. (a) No person may operate a turbine-powered airplane... equipped with an approved ground proximity warning system. (b) (c) For a system required by this...

  14. Acute Pancreatitis and Pregnancy

    MedlinePlus

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  15. Superconductivity in Magnetic and Proximity Effect Systems.

    NASA Astrophysics Data System (ADS)

    Stephan, Walter Hugo

    Some aspects of the theory of superconductors containing paramagnetic impurities in the model of Shiba and Rusinov (SR) are examined. The critical magnetic field deviation function is shown to be very sensitive to the SR scattering parameter varepsilon_0 , with improved agreement with experiment for Zn -Mn as compared to the theory of Abrikosov and Gor'Kov (AG). Optical absorption and thermal conductivity experiments involving a variety of transition metal alloys are reanalyzed including up to three scattering phase shifts, with no significant improvement found over the agreement obtained with only a single phase shift. The electromagnetic coherence length with SR impurities is also considered. Model calculations for superconducting spin-glasses show that systems such as Gd{_ {x}Ce}_{1-{rm x} }{rm Ru_2}, which exhibit significant deviations from the AG prediction for the reduction of the critical temperature with impurity concentration, are also expected to exhibit significant deviations from AG behavior for properties such as the thermodynamic critical field and the electromagnetic penetration depth. The model of Lee for reentrant ferromagnetic superconductors is shown to be only in qualitative agreement with the free energy difference and thermal conductivity determined experimentally for ErRh_{4}B _{4}. A variety of properties of proximity effect junctions are considered within the McMillan model. The temperature dependence of the free energy difference differs significantly from that of a BCS superconductor, with the deviation function becoming much more negative than the BCS prediction. The optical absorption and the low temperature magnetic penetration depth of the normal side of a proximity effect junction with magnetic impurities are also calculated. Finally, the temperature dependence of the zero bias tunneling conductance of a proximity effect induced superconducting spin glass is calculated and found to be in reasonable agreement with experiments

  16. Hand Replantation with Proximal Row Carpectomy

    PubMed Central

    Lee, Young-Keun; Lee, Hang-Ho; Park, Ji-Kang; Kim, Joo-Yong; Dhawan, Vikas

    2008-01-01

    The purpose of this study is to present our operative technique and postoperative results of the hand replantation with proximal row carpectomy in cases of complete amputation at the level of wrist joint. From May 2003 to April 2005, five patients suffered from complete amputation of the hand due to industrial trauma. Amputation level was radiocarpal joint in three cases and midcarpal joint in two cases. Three cases represented guillotine type and two cases with local crush type injuries. All were men and the mean age was 26.6 years. The mean follow-up period was 26.8 months. At the time of replantation, the wrist joint was stabilized with transarticular fixation using three to four Kirschner’s wires after performing proximal row carpectomy. Postoperatively, functional results such as muscle strength, range of motion of the wrist and fingers, and sensory recovery were assessed according to Chen’s criteria. Joint width and arthritic changes of the radio-capitate joint were evaluated with radiologic tools. According to Chen’s criteria, the overall results in five cases were classified as grade II. Intrinsic muscle power of hands was found to be grade 4. The mean grip and pinch powers were 41% and 45%, respectively, compared to contralateral hand. The mean arc of flexion–extension of wrist was 53°. Total mean active motion of fingers was 215 degrees. Static two-point discrimination of fingertip ranged from 8 to 13 mm. On the follow-up, computerized tomography showed well-preserved radio-capitate joint space without any arthritic changes. While performing hand replantation after amputation at the radiocarpal or midcarpal level, proximal row carpectomy is a useful procedure to preserve joint motion of the wrist in selected cases. PMID:18855073

  17. Periprosthetic proximal femur fractures: current concepts.

    PubMed

    Parvizi, Javad; Vegari, David N

    2011-06-01

    With the increase in demand for total hip and knee arthroplasty, the orthopaedic community has seen a dramatic increase in periprosthetic fractures. Given the high morbidity and mortality associated with these fractures, the orthopaedic surgeon needs to be prepared to deal with this difficult problem. The purpose of this article is to provide the surgeon with an algorithmic approach that allows for easy classification and treatment options for periprosthetic fractures of the proximal femur. Such an approach should prevent the mismanagement of these complications.

  18. Fractures of the proximal humeral epiphysis.

    PubMed

    Burgos-Flores, J; Gonzalez-Herranz, P; Lopez-Mondejar, J A; Ocete-Guzman, J G; Amaya-Alarcón, S

    1993-01-01

    Twenty-two patients with marked displacement of a fracture of the proximal humeral epiphysis have been treated with closed or open reduction and fixation by Kirschner wires. At an average follow-up of 6.8 years there have been good functional results in almost all patients (91.1), with better results in patients under 13 years of age particularly with less residual displacement or angulation. Since there is a greater occurrence of residual deformity and symmetria and limitation of motion in older patients, a more aggressive approach to correct the initial displacement and angulation is warranted in those over the age of 13 years.

  19. Unilateral Isolated Proximal Femoral Focal Deficiency

    PubMed Central

    Doğer, Emek; Köpük, Şule Y.; Çakıroğlu, Yiğit; Çakır, Özgür; Yücesoy, Gülseren

    2013-01-01

    Objective. To discuss a patient with a prenatal diagnosis of unilateral isolated femoral focal deficiency. Case. Antenatal diagnosis of unilateral isolated femoral focal deficiency was made at 20 weeks of gestation. The length of left femur was shorter than the right, and fetal femur length was below the fifth percentile. Proximal femoral focal deficiency was diagnosed. After delivery, the diagnosis was confirmed with skeletal radiographs and magnetic resonance imaging. In prenatal ultrasonographic examination, the early recognition and exclusion of skeletal dysplasias is important; moreover, treatment plans should be initiated, and valuable information should be provided to the family. PMID:23984135

  20. Management of posttraumatic proximal interphalangeal joint contracture.

    PubMed

    Houshian, Shirzad; Jing, Shan Shan; Chikkamuniyappa, Chandrasekar; Kazemian, Gholam Hussein; Emami-Moghaddam-Tehrani, Mohammad

    2013-08-01

    Chronic flexion contracture of the proximal interphalangeal (PIP) joint presents a common yet challenging problem to hand surgeons. Over the years, multiple treatment modalities have been described for this problem, producing limited results. Nonoperative treatment using serial casting and splints should be tried before attempting open surgical release, which should be done in selected patients. The use of external fixation for treating PIP contracture has been encouraging and can be a useful alterative. This review provides an update on the current management of PIP joint contractures and presents a flowchart of treatment to aid decision making.

  1. Fiber optical ranging sensor for proximity fuse

    NASA Astrophysics Data System (ADS)

    Du, Fang; Chi, Zeying; You, Mingjun; Chen, Wenjian

    1996-09-01

    A fiber optical ranging sensor used in laser proximity fuze is described in this paper. In the fuze, pulse laser diode (LD) is used as light source and trigger signal is generated by comparing the reflected light pulses with the reference pulses by a correlator after they were converted into electric signals by PIN photodiodes. Multi-mode fibers and integrated optical devices are used in the system so that the structure can be more compact. Optical fiber delay line is used to offer precise delay time for reference channel.

  2. Open Subpectoral Tenodesis of the Proximal Biceps.

    PubMed

    Voss, Andreas; Cerciello, Simone; Yang, Justin; Beitzel, Knut; Cote, Mark P; Mazzocca, Augustus D

    2016-01-01

    This article summarizes both the various techniques for an open subpectoral biceps tenodesis as well as the biomechanics associated with these procedures. It provides information regarding the indications and contraindications to support the surgeon's decision. Furthermore, a postoperative protocol as well as an outcome overview is presented to address postoperative care. A short summary of the recent literature regarding potential complications is included to provide further insight on this technique. The open subpectoral tenodesis of the long head of the biceps is a safe and reproducible technique with a low complication rate for patients with pathologies of the proximal biceps.

  3. Space station proximity operations and window design

    NASA Technical Reports Server (NTRS)

    Haines, Richard F.

    1988-01-01

    On-orbit proximity operations (PROX-OPS) consist of all extravehicular activity (EVA) within 1 km of the space station. Because of the potentially large variety of PROX-OPS, very careful planning for space station windows is called for and must consider a great many human factors. The following topics are discussed: (1) basic window design philosophy and assumptions; (2) the concept of the local horizontal - local vertical on-orbit; (3) window linear dimensions; (4) selected anthropomorphic considerations; (5) displays and controls relative to windows; and (6) full window assembly replacement.

  4. Proximate determinants of fertility in peninsular Malaysia.

    PubMed

    Tey, Nai Peng; Ng, Sor Tho; Yew, Siew Yong

    2012-05-01

    The continuing decline in fertility despite a contraction in contraceptive use in Peninsular Malaysia since the mid-1980s has triggered considerable interest in the reasons behind this phenomenon, such as increase in abortion, sterility, and out-of-wedlock pregnancy. Fertility decline has been attributed to rapid socioeconomic development, which can only influence fertility through the intermediate variables. Application of vital statistics, population census, and survey data of Peninsular Malaysia on Bongaarts's model vindicates that marriage postponement and contraceptive use are the 2 most important proximate determinants of fertility, but the effects are not uniform across the ethnic groups. For instance, the predicted total fertility rate for Chinese and Malays are 2.9 and 1.6, respectively, compared with the observed level of 3.0 and 1.9. Postpartum infecundability and abortion also play a part in explaining ethnic fertility differentials. The fertility inhibiting effects of these proximate determinants have significant implications on reproductive health and future population growth.

  5. Phylogenetic proximity revealed by neurodevelopmental event timings.

    PubMed

    Nagarajan, Radhakrishnan; Clancy, Barbara

    2008-01-01

    Statistical properties such as distribution and correlation signatures were investigated using a temporal database of common neurodevelopmental events in the three species most frequently used in experimental studies, rat, mouse, and macaque. There was a fine nexus between phylogenetic proximity and empirically derived dates of the occurrences of 40 common events including the neurogenesis of cortical layers and outgrowth milestones of developing axonal projections. Exponential and power-law approximations to the distribution of the events reveal strikingly similar decay patterns in rats and mice when compared to macaques. Subsequent hierarchical clustering of the common event timings also captures phylogenetic proximity, an association further supported by multivariate linear regression data. These preliminary results suggest that statistical analyses of the timing of developmental milestones may offer a novel measure of phylogenetic classifications. This may have added pragmatic value in the specific support it offers for the reliability of rat/mouse comparative modeling, as well as in the broader implications for the potential of meta-analyses using databases assembled from the extensive empirical literature.

  6. Synostosis of the Proximal Tibiofibular Joint

    PubMed Central

    Sferopoulos, Nikolaos K.

    2010-01-01

    The incidence of synostosis of the proximal tibiofibular joint (TFJ) was assessed among 1029 patients examined for osteoarthritis of the knee in a 4-year period. Radiographic evidence of a synostosis of the proximal TFJ was demonstrated in 3 knees (3 patients). The synostosis appeared incidental and was not the cause of symptoms in any of them. These patients were further examined with MRI and/or CT scans. In two cases, which were found to be primary (idiopathic), the synostosis was complete and bony. In a third case the lesion was secondary (acquired) to surgical reconstruction for a depressed fracture of the lateral tibial plateau. This iatrogenic complication followed open reduction, internal fixation, and grafting with synthetic bone. The bridging of the joint on the CT views was partial and compatible with ectopic calcification rather than ossification. The patients were treated conservatively and were followed for an average period of 3 years. No evidence that the synostosis accelerated the onset or progression of the degenerative changes to the ipsilateral knee could be verified. PMID:20592991

  7. An improved proximity force approximation for electrostatics

    SciTech Connect

    Fosco, Cesar D.; Lombardo, Fernando C.; Mazzitelli, Francisco D.

    2012-08-15

    A quite straightforward approximation for the electrostatic interaction between two perfectly conducting surfaces suggests itself when the distance between them is much smaller than the characteristic lengths associated with their shapes. Indeed, in the so called 'proximity force approximation' the electrostatic force is evaluated by first dividing each surface into a set of small flat patches, and then adding up the forces due two opposite pairs, the contributions of which are approximated as due to pairs of parallel planes. This approximation has been widely and successfully applied in different contexts, ranging from nuclear physics to Casimir effect calculations. We present here an improvement on this approximation, based on a derivative expansion for the electrostatic energy contained between the surfaces. The results obtained could be useful for discussing the geometric dependence of the electrostatic force, and also as a convenient benchmark for numerical analyses of the tip-sample electrostatic interaction in atomic force microscopes. - Highlights: Black-Right-Pointing-Pointer The proximity force approximation (PFA) has been widely used in different areas. Black-Right-Pointing-Pointer The PFA can be improved using a derivative expansion in the shape of the surfaces. Black-Right-Pointing-Pointer We use the improved PFA to compute electrostatic forces between conductors. Black-Right-Pointing-Pointer The results can be used as an analytic benchmark for numerical calculations in AFM. Black-Right-Pointing-Pointer Insight is provided for people who use the PFA to compute nuclear and Casimir forces.

  8. Proteomics of Primary Cilia by Proximity Labeling

    PubMed Central

    Mick, David U.; Rodrigues, Rachel B.; Leib, Ryan D.; Adams, Christopher M.; Chien, Allis S.; Gygi, Steven P.; Nachury, Maxence V.

    2015-01-01

    SUMMARY While cilia are recognized as important signaling organelles, the extent of ciliary functions remains unknown because of difficulties in cataloguing proteins from mammalian primary cilia. We present a method that readily captures rapid snapshots of the ciliary proteome by selectively biotinylating ciliary proteins using a cilia-targeted proximity labeling enzyme (cilia-APEX). Besides identifying known ciliary proteins, cilia-APEX uncovered several ciliary signaling molecules. The kinases PKA, AMPK and LKB1 were validated as bona fide ciliary proteins and PKA was found to regulate Hedgehog signaling in primary cilia. Furthermore, proteomics profiling of Ift27/Bbs19 mutant cilia correctly detected BBSome accumulation inside Ift27−/− cilia and revealed that β-arrestin 2 and the viral receptor CAR are candidate cargoes of the BBSome. This work demonstrates that proximity labeling can be applied to proteomics of non-membrane-enclosed organelles and suggests that proteomics profiling of cilia will enable a rapid and powerful characterization of ciliopathies. PMID:26585297

  9. Carbon nanotube proximity influences rice DNA

    NASA Astrophysics Data System (ADS)

    Katti, Dinesh R.; Sharma, Anurag; Pradhan, Shashindra Man; Katti, Kalpana S.

    2015-07-01

    The uptake of carbon nanotubes (CNT) influences the output of plants, potentially through interactions between the DNA and CNTs. However, little is known about the changes in the plant DNA due to CNT proximity. We report changes in rice plant DNA in the proximity of single walled CNT (SWCNT) using molecular dynamics simulations. The DNA experiences breaking and forming of hydrogen bonds due to unzipping of Watson-Crick (WC) nucleobase pairs and wrapping onto SWCNT. The number of hydrogen bonds between water and DNA nucleobases decreases due to the presence of SWCNT. A higher number of guanine-cytosine (Gua-Cyt) WC hydrogen bonds break as compared to adenine-thymine (Ade-Thy), which suggests that Gua and Cyt bases play a dominant role in DNA-SWCNT interactions. We also find that changes to non-WC nucleobase pairs and van der Waals attractive interactions between WC nucleobase pairs and SWCNT cause significant changes in the conformation of the DNA.

  10. Empathy: Its ultimate and proximate bases.

    PubMed

    Preston, Stephanie D; de Waal, Frans B M

    2002-02-01

    There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors (e.g., alarm, social facilitation, vicariousness of emotions, mother-infant responsiveness, and the modeling of competitors and predators) that are crucial for the reproductive success of animals living in groups. The Perception-Action Model (PAM), together with an understanding of how representations change with experience, can explain the major empirical effects in the literature (similarity, familiarity, past experience, explicit teaching, and salience). It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations.

  11. [Acute pancreatitis].

    PubMed

    Hecker, M; Mayer, K; Askevold, I; Collet, P; Weigand, M A; Krombach, G A; Padberg, W; Hecker, A

    2014-03-01

    Acute pancreatitis is a potentially fatal disease with individually differing expression of systemic involvement. For this reason early diagnosis with subsequent risk stratification is essential in the clinical management of this frequent gastroenterological disorder. Severe forms of acute pancreatitis occur in approximately 20 % of cases often requiring intensive care monitoring and interdisciplinary therapeutic approaches. In the acute phase adequate fluid replacement and sufficient analgesic therapy is of major therapeutic importance. Concerning the administration of antibiotics and the nutritional support of patients with acute pancreatitis a change in paradigms could be observed in recent years. Furthermore, endoscopic, radiological or surgical interventions can be necessary depending on the severity of the disease and potential complications.

  12. Bronchitis - acute

    MedlinePlus

    ... to breathe. Other symptoms of bronchitis are a cough and coughing up mucus. Acute means the symptoms ... diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least ...

  13. Acute Bronchitis

    MedlinePlus

    ... bronchitis? Acute bronchitis is inflammation of your bronchial tree. The bronchial tree consists of tubes that carry air into your ... weeks or months. This happens because the bronchial tree takes a while to heal. A lasting cough ...

  14. The antiquity of riverine adaptations in Iniidae (Cetacea, Odontoceti) documented by a humerus from the late Miocene of the Ituzaingó Formation, Argentina.

    PubMed

    Gutstein, Carolina Simon; Cozzuol, Mario Alberto; Pyenson, Nicholas D

    2014-06-01

    "River dolphins" are a paraphyletic group of toothed whales (Odontoceti) that represent independent secondary invasions of freshwater habitats. Different "river dolphin" lineages display suites of convergent morphological specializations that commonly reflect adaptations to riverine and freshwater environments, such as longirostry, reduced orbits, and wide, paddle-like flippers. One lineage, the Iniidae, is presently endemic to South America, and includes several extinct Neogene taxa along with their sole extant genus, Inia (the Amazon River dolphin). We report here a humerus recovered from the late Miocene deposits of the Ituzaingó Formation in the Paraná Basin of Argentina. The specimen exhibits diagnostic features of the family Iniidae, including a scapular-sternal joint of the humerus, which is a unique anatomical connection among mammals. This joint permits enhanced parasagittal adduction of the flipper as a control surface, relative to other odontocetes, providing Inia with a high degree of maneuverability in its structurally complex and heterogenous riverine habitat. This unique anatomical connection, here documented from the late Miocene (∼9 million years-6.5 million years old), not only provides the oldest diagnostic record for Iniidae, but it also indicates a similar habitat use for this lineage, a finding coincident with the current paleoenvironmental interpretation for the Ituzaingó Formation.

  15. Myocardial Bridge and Acute Plaque Rupture

    PubMed Central

    Perl, Leor; Daniels, David; Schwartz, Jonathan; Tanaka, Shige; Yeung, Alan; Tremmel, Jennifer A.; Schnittger, Ingela

    2016-01-01

    A myocardial bridge (MB) is a common anatomic variant, most frequently located in the left anterior descending coronary artery, where a portion of the coronary artery is covered by myocardium. Importantly, MBs are known to result in a proximal atherosclerotic lesion. It has recently been postulated that these lesions predispose patients to acute coronary events, even in cases of otherwise low-risk patients. One such mechanism may involve acute plaque rupture. In this article, we report 2 cases of patients with MBs who presented with acute coronary syndromes despite having low cardiovascular risk. Their presentation was life-risking and both were treated urgently and studied with coronary angiographies and intravascular ultrasound. This latter modality confirmed a rupture of an atherosclerotic plaque proximal to the MB as a likely cause of the acute events. These cases, of unexplained acute coronary syndrome in low-risk patients, raise the question of alternative processes leading to the event and the role MB play as an underlying cause of ruptured plaques. In some cases, an active investigation for this entity may be warranted, due to the prognostic implications of the different therapeutic modalities, should an MB be discovered. PMID:28251167

  16. The convergence rate of the proximal alternating direction method of multipliers with indefinite proximal regularization.

    PubMed

    Sun, Min; Liu, Jing

    2017-01-01

    The proximal alternating direction method of multipliers (P-ADMM) is an efficient first-order method for solving the separable convex minimization problems. Recently, He et al. have further studied the P-ADMM and relaxed the proximal regularization matrix of its second subproblem to be indefinite. This is especially significant in practical applications since the indefinite proximal matrix can result in a larger step size for the corresponding subproblem and thus can often accelerate the overall convergence speed of the P-ADMM. In this paper, without the assumptions that the feasible set of the studied problem is bounded or the objective function's component [Formula: see text] of the studied problem is strongly convex, we prove the worst-case [Formula: see text] convergence rate in an ergodic sense of the P-ADMM with a general Glowinski relaxation factor [Formula: see text], which is a supplement of the previously known results in this area. Furthermore, some numerical results on compressive sensing are reported to illustrate the effectiveness of the P-ADMM with indefinite proximal regularization.

  17. Treatment of proximal fifth metatarsal bone fractures in athletes.

    PubMed

    Japjec, M; Starešinić, M; Starjački, M; Žgaljardić, I; Štivičić, J; Šebečić, B

    2015-11-01

    Proximal fifth metatarsal (V MT) bone fractures are common injuries that are a major diagnostic and therapeutic challenge. Lawrence and Botte considered different treatment options and the possibility of recovery and divided these fractures into three different regions: tuberosity avulsion fractures (zone I), acute fractures of the metaphysis at the level of the intermetatarsal junction (zone II) and proximal diaphysis stress fracture (zone III). A total of 42 athletes with fracture of the V MT bone in zone II and III were treated in our institution during a 6-year period. All patients were offered surgical treatment, but nine patients refused surgery. Thus, the patients were divided into two groups: group 1 comprised 33 patients who underwent an intramedullary screw fixation operation under regional anaesthesia immediately after the fracture was diagnosed; group 2 contained the remaining nine patients who had refused surgery and received conservative therapy with non-weight-bearing short-leg casts or orthosis. Follow-up ranged from 6 to 24 months. All fractures healed in group 1: healing occurred within 8 weeks in 26 patients and was prolonged to 16 to 18 weeks in four patients. In group 2, fractures healed in four patients but did not heal in five patients even after 6 months. Four of the five patients in whom the fracture did not heal required subsequent osteosynthesis because they had constant problems that caused absence from sport. After the operation, their fractures healed in an average of 10 weeks. One patient decided not to undergo the operation due to the absence of subjective symptoms. Three patients in group 1 who started intensive training sustained a refracture and underwent re-operation in which osteosynthesis was performed with a stronger screw. The fractures then healed again. Treatment results were evaluated radiologically and clinically using the Modified Foot Score. Results in group 1 were significantly better than those in group 2 and there

  18. [Fractures of the proximal femur: rehabilitation and socioeconomic repercussions].

    PubMed

    Meine, J; Regazzoni, P; König, W

    1993-01-01

    Only insufficient statistical data for epidemiologic analysis and calculations of socioeconomic costs are available in Switzerland. The total number of fractures of the proximal femur per year has nearly doubled in the 10 years from 1980 to 1990, climbing from 5500 to 9800 cases. A number of 15,000 cases is foreseen for the year 2020. In 85% of the cases the patients are older than 65 years. The global annual incidence is estimated to be 145/100,000, the partial incidence for the population of more than 65 years being 825/100,000. The mean hospitalization is 30 days. The total number of hospital days per year climbed from 200,000 to 300,000 in ten years, thus increasing the number of required beds by 50%. The mean costs for primary hospitalization is estimated to 15,000.-Swiss francs per case in 1990 and 146 Million francs globally per annum, i.e. the double of the amount in 1980. In the statistics of the National Accident Insurance Company the mean global economic costs for a fracture of the proximal femur in the active population is 57,000.-Swiss francs approximately and 72,000.-francs for patients of more than 45 years of age. Only roughly 20% of the costs are caused by medical treatment, whereas pensions, per diems and other compensations produce 80% of the costs. The mortality for patients over 65 varies from 2-7% during the primary hospitalization and rises up to 30% after 1 to 2 years after the accident. The relationship between the duration of acute hospitalization and rehabilitation is essential for planning. The evaluation of the chances for a successful rehabilitation is very important, the general medical conditions of the patients before the accident being the main determinant factor. A mean hospitalization of 3 weeks in a surgical unit and 6 to 7 weeks in a rehabilitation hospital seems to be realistic. Appropriate criteria for the selection of patients amenable to successful rehabilitation are essential. The question of the social outcome of these

  19. Physiological pH. Effects on posthypoxic proximal tubular injury.

    PubMed

    Zager, R A; Schimpf, B A; Gmur, D J

    1993-04-01

    After O2 deprivation, tissue acidosis rapidly self-corrects. This study assessed the effect of this pH correction on the induction, and pathways, of posthypoxic proximal tubular injury. In addition, ways to prevent the resultant injury were explored. Isolated rat proximal tubular segments (PTSs) were subjected to hypoxia/reoxygenation (50/30 or 30/50 minutes) under the following incubation conditions: 1) continuous pH 7.4, 2) continuous pH 6.8, or 3) hypoxia at pH 6.8 and reoxygenation at pH 7.4 (NaHCO3 or Tris base addition). Continuously oxygenated PTSs maintained under these same pH conditions served as controls. Lethal cell injury was assessed by lactate dehydrogenase (LDH) release. pH effects on several purported pathways of hypoxia/reoxygenation injury were also assessed (ATP depletion, lipid peroxidation, and membrane deacylation). Acidosis blocked hypoxic LDH release (pH 7.4, 50 +/- 2%; pH 6.8, 6 +/- 1%) without mitigating membrane deacylation or ATP depletion. During reoxygenation, minimal LDH was released (3-5%) if pH was held constant. However, if posthypoxic pH was corrected, immediate (< or = 5 minutes) and marked cell death (e.g., 55 +/- 3% with Tris) occurred. This was dissociated from lipid peroxidation or new deacylation, and it was preceded by a depressed ATP/ADP ratio (suggesting an acidosis-associated defect in hypoxic/posthypoxic cell energetics). Realkalinization injury was not inevitable, since it could be substantially blocked by 1) posthypoxic glycine addition, 2) transient posthypoxic hypothermia, or 3) allowing a 10-minute reoxygenation (cell recovery) period before base addition. Neither mannitol nor graded buffer Ca2+ deletion conferred protection. Acute pH correction caused no injury to continuously oxygenated PTSs. Conclusions are as follows: 1) Posthypoxic "pH shock" causes virtually immediate cell death, not by causing de novo injury but, rather, by removing the cytoprotective effect of acidosis. 2) This injury can be prevented by a

  20. Pesamosca osteoplasty: surgical procedure for the spatial correction of cubitus varus or valgus post malunited supracondylar fractures of the humerus

    PubMed Central

    Burnei, G; Gavriliu, Ş; Nepaliuc, I; Vlad, C; Drăgoescu, M; Georgescu, I; Ghita, RA; Muntean, L; Pârvan, AA; Dughilă, C; Ţiripa, I; Hamei, Ş; Klinaku, I

    2014-01-01

    Introduction. Supracondylar fractures of the humerus represent a current concern in the child’s and adolescent’s osteo-articular pathology. Even though orthopedic reductions are made correctly, fractures can become displaced when managed only by cast immobilization and complications may arise. The most frequent complications encountered in “Prof. Dr. Alexandru Pesamosca” Clinique, Bucharest, Romania, due to supracondylar humeral fractures, are valgus or varus deviations with angles that can sometimes exceed 40 degrees as a result of malunion. Varus or valgus deformations were rarely encountered after surgical treatment. The goal of this study is to present an alternative surgical technique to correct varus and valgus deformations as well as malrotation. Material and method. The study is a retrospective analysis of a 96 children study group surgically managed during 1985 and 2013. In the first period, various surgical techniques have been performed: cuneiform resections, step-cut osteotomies, open wedge osteotomies with external fixation, epiphysiodesis, hemichondrodiatasis and Pesamosca metaphyseal diaphyseal osteoplasty. Starting with 2005, all the cases that presented such complications – 28 out of 96 (29.1%) – were managed with the Pesamosca procedure. Due to the malunion of supracondylar humeral fractures only varus or valgus deformities were admitted in the study. The malunion due to the pathologic fractures encountered in osteogenesis imperfecta or fibrous dysplasia was precluded. The experience accumulated with the other surgical techniques used in 68 out of 96 patients (70.9%) determined us to exclusively use the Pesamosca osteoplasty following the year 2005, seeing the simplicity and the efficiency of this procedure. Results. The outcome was very good. In 5 cases out of the 28 (17%) an apparent residual elbow was encountered and one case of relapse (3%) was noted due to inadequate term of cast immobilization. The elbow’s mobility was

  1. Rhabdomyolysis and acute kidney injury after acupuncture sessions.

    PubMed

    Papasotiriou, Marios; Betsi, Grigoria; Tsironi, Maria; Assimakopoulos, Georgios

    2014-05-01

    Rhabdomyolysis is usually caused by muscle injury, drugs or alcohol and presents with muscle weakness and pain. It is characterized by rise in serum creatine kinase, aminotransferases and electrolytes as well as myoglobinuria. Myoglobinuria may cause acute kidney injury by direct proximal tubule cytotoxicity, renal vasoconstriction, intraluminal cast formation and distal tubule obstruction. Muscle pain and weakness as well as vascular injury have been reported after acupuncture. We report a case of severe rhabdomyolysis and acute kidney injury after acupuncture sessions.

  2. Proximity effects in ferromagnet-superconductor structures

    NASA Astrophysics Data System (ADS)

    Halterman, Klaus Byron

    I present an extensive theoretical investigation of the proximity effects that occur in ferromagnet/superconductor systems. I use a numerical method to solve self consistently the Bogoliubov-de Gennes equations in the continuum. I obtain the pair amplitude and the local density of states (DOS), and use these results to extract the relevant lengths characterizing both the leakage of superconductivity into the magnet and to study spin splitting induced in the superconductor. These phenomena are investigated as a function of parameters such as temperature, magnet polarization, interfacial scattering, sample size and Fermi wave vector mismatch, all of which turn out to have an important influence on the results. These comprehensive results should help characterize and analyze future data, and are shown to be in agreement with existing experiments.

  3. Parallel Proximity Detection for Computer Simulations

    NASA Technical Reports Server (NTRS)

    Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

    1998-01-01

    The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are included by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

  4. Parallel Proximity Detection for Computer Simulation

    NASA Technical Reports Server (NTRS)

    Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

    1997-01-01

    The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are includes by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

  5. [Ophthalmologists in the proximity of Adolf Hitler].

    PubMed

    Rohrbach, J M

    2012-10-01

    Adolf Hitler met or at least knew about 5 ophthalmologists. The chair of ophthalmology in Berlin, Walther Löhlein, personally examined Hitler's eyes at least two times. The chair of ophthalmology in Breslau, Walter Dieter, developed "air raid protection spectacles" with the aid of high representatives of the NS-system and probably Adolf Hitler himself. Heinrich Wilhelm Kranz became rector of the universities of Giessen and Frankfurt/Main. He was known as a very strict advocate of the NS-race hygiene. Werner Zabel made plans for Hitler's diet and tried to interfere with Hitler's medical treatment. Finally, Hellmuth Unger was an influential representative of the medical press and a famous writer. Three of his novels with medical topics were made into a film which Hitler probably saw. Hitler had, so to say, a small "ophthalmological proximity" which, however, did not play a significant role for himself or the NS-state.

  6. Isosmotic volume reabsorption in rat proximal tubule

    PubMed Central

    1980-01-01

    A theoretical model incorporation both active and passive forces has been developed for fluid reabsorption from split oil droplets in rat intermediate and late proximal tubule. Of necessity, simplifying assumptions have been introduced; we have assumed that the epithelium can be treated as a single membrane and that the membrane "effective" HCO3 permeability is near zero. Based on this model with its underlying assumptions, the following conclusions are drawn. Regardless of the presence or absence of active NaCl transport, fluid reabsorption from the split oil droplet is isosmotic. The reabsorbate osmolarity can be affected by changes in tubular permeability parameters and applied forces but is not readily altered from an osmolarity essentially equal to that of plasma. In a split droplet, isosmotic flow need not be a special consequence of active Na transport, is not the result of a particular set of permeability properties, and is not merely a trivial consequence of a very high hydraulic conductivity; isosmotic flow can be obtained with hydraulic conductivity nearly an order of magnitude lower than that previously measured in the rat proximal convoluted tubule. Isosmotic reabsorption is, in part, the result of the interdependence of salt and water flows, their changing in parallel, and thus their ratio, the reabsorbate concentration being relatively invariant. Active NaCl transport can cause osmotic water flow by reducing the luminal fluid osmolarity. In the presence of passive forces the luminal fluid can be hypertonic to plasma, and active NaCl transport can still exert its osmotic effect on volume flow. There are two passive forces for volume flow: the Cl gradient and the difference in effective osmotic pressure; they have an approximately equivalent effect on volume flow. Experimentally, we have measured volume changes in a droplet made hyperosmotic by the addition of 50 mM NaCl; the experimental results are predicted reasonably well by our theoretical model

  7. Isosmotic volume reabsorption in rat proximal tubule.

    PubMed

    Warner, R R; Lechene, C

    1980-11-01

    A theoretical model incorporation both active and passive forces has been developed for fluid reabsorption from split oil droplets in rat intermediate and late proximal tubule. Of necessity, simplifying assumptions have been introduced; we have assumed that the epithelium can be treated as a single membrane and that the membrane "effective" HCO3 permeability is near zero. Based on this model with its underlying assumptions, the following conclusions are drawn. Regardless of the presence or absence of active NaCl transport, fluid reabsorption from the split oil droplet is isosmotic. The reabsorbate osmolarity can be affected by changes in tubular permeability parameters and applied forces but is not readily altered from an osmolarity essentially equal to that of plasma. In a split droplet, isosmotic flow need not be a special consequence of active Na transport, is not the result of a particular set of permeability properties, and is not merely a trivial consequence of a very high hydraulic conductivity; isosmotic flow can be obtained with hydraulic conductivity nearly an order of magnitude lower than that previously measured in the rat proximal convoluted tubule. Isosmotic reabsorption is, in part, the result of the interdependence of salt and water flows, their changing in parallel, and thus their ratio, the reabsorbate concentration being relatively invariant. Active NaCl transport can cause osmotic water flow by reducing the luminal fluid osmolarity. In the presence of passive forces the luminal fluid can be hypertonic to plasma, and active NaCl transport can still exert its osmotic effect on volume flow. There are two passive forces for volume flow: the Cl gradient and the difference in effective osmotic pressure; they have an approximately equivalent effect on volume flow. Experimentally, we have measured volume changes in a droplet made hyperosmotic by the addition of 50 mM NaCl; the experimental results are predicted reasonably well by our theoretical model.

  8. Proximity to mining industry and cancer mortality.

    PubMed

    Fernández-Navarro, Pablo; García-Pérez, Javier; Ramis, Rebeca; Boldo, Elena; López-Abente, Gonzalo

    2012-10-01

    Mining installations are releasing toxic substances into the environment which could pose a health problem to populations in their vicinity. We sought to investigate whether there might be excess cancer-related mortality in populations residing in towns lying in the vicinity of Spanish mining industries governed by the Integrated Pollution Prevention and Control Directive, and the European Pollutant Release and Transfer Register Regulation, according to the type of extraction method used. An ecologic study was designed to examine municipal mortality due to 32 types of cancer, across the period 1997 through 2006. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Poisson regression models, using the Bayesian conditional autoregressive model proposed by Besag, York and Molliè and Integrated Nested Laplace Approximations for Bayesian inference, were used: to analyze risk of dying from cancer in a 5-kilometer zone around mining installations; effect of type of industrial activity; and to conduct individual analyses within a 50-kilometer radius of each installation. Excess mortality (relative risk, 95% credible interval) of colorectal cancer (1.097, 1.041-1.157), lung cancer (1.066, 1.009-1.126) specifically related with proximity to opencast coal mining, bladder cancer (1.106, 1.016-1.203) and leukemia (1.093, 1.003-1.191) related with other opencast mining installations, was detected among the overall population in the vicinity of mining installations. Other tumors also associated in the stratified analysis by type of mine, were: thyroid, gallbladder and liver cancers (underground coal installations); brain cancer (opencast coal mining); stomach cancer (coal and other opencast mining installations); and myeloma (underground mining installations). The results suggested an association between risk of dying due to digestive, respiratory, hematologic and thyroid cancers and proximity to Spanish mining

  9. Changes in Proximal and Distal Tubular Reabsorption Produced by Rapid Expansion of Extracellular Fluid*

    PubMed Central

    Hayslett, John P.; Kashgarian, Michael; Epstein, Franklin H.

    1967-01-01

    Acute infusions of isotonic saline in the rat cause an increase in glomerular filtration rate and in the excretion of salt and water. The kidney swells, due to expansion of tubular and interstitial volume. Despite the increase in tubular diameter, transit time through the proximal tubules and loops of Henle is decreased, presumably owing to a greatly accelerated rate of tubular flow. Proximal tubular reabsorption, measured in blocked tubules, is inhibited in a way that cannot be ascribed to changes in tubular diameter. The prolongation of proximal reabsorptive half-time is not affected by the administration of aldosterone. It occurs equally in rats chronically loaded with or deprived of salt, and it is therefore not likely that it is influenced by the renal content of renin. In contrast, reabsorption from the distal convoluted tubule is enhanced by saline infusion. This change is observed in segments of tubules blocked with oil and isolated from their glomeruli and thus appears to occur independently of changes in glomerular filtration or tubular flow. Images PMID:6027087

  10. The missing button sign as a tool for detecting proximal internal carotid artery occlusion.

    PubMed

    Choi, Jun Young; Kim, Eun Jin; Kim, Ho Sung; Joo, In Soo; Huh, Kyoon; Lee, Phil Hyu; Heo, Ji Hoe; Nam, Hyo Suk

    2010-12-01

    The aim of this study was to develop a simple and reliable sign for detecting proximal internal carotid artery occlusion (ICAO) using conventional CT scanning. The missing button sign (MBS) is defined as the absence of the ICA at the level of the foramen magnum on contrast-enhanced CT (CECT) scans. Two raters independently reviewed random CECT samples from consecutive patients with acute ischaemic stroke. A total of 399 patients with 798 carotid arteries were analysed. Rater A identified the MBS in 41 (5%) of the carotid arteries, and did not identify the MBS in 735 (92%) carotid arteries. Rater B identified the MBS in 45 (6%) of the arteries, and lack of the MBS in 731 (91%) arteries. The kappa value for agreement was 0.90 (95% CI 0.84-0.95). Compared with CT angiography, Rater A's sensitivity, specificity, positive predictive value, and negative predictive value for detecting proximal ICAO were 85%, 100%, 100%, and 99%, respectively, while Rater B's values were 87%, 99%, 93%, and 99%, respectively. This study indicated that the MBS on CECT scanning is both a consistent and specific tool for the early identification of proximal ICAO.

  11. [Effect of proximate environment on drug susceptibility of mice (author's transl)].

    PubMed

    Tanase, H; Matsunuma, N; Suzuki, Y

    1979-10-01

    The present study was performed in order to elucidate the effect of proximate environment on drug susceptibility of mice. Three experiments were carried out independently. In the first experiment, mongrel and ddS mice produced under an unsatisfactory control of proximate environment were purchased, and acute toxicity tests of thiamine hydrochloride (B1HCl) and isonicotinic acid hydrazide (INAH) were practiced at two different conditioned rooms. In the second experiment, ddY mice produced under the conventional environment controlled to a certain extent were purchased, and the toxic effect of B1HCl was examined under the similar environment. In the third experiment, the sensitivity to B1HCl of RFVL mice produced under the strict barrier system was tested at the severe air-conditioned room. LD50 and their fLD50 values were calculated by Litchfield-Wilcoxon's method, and the variance analyses were carried out. The severer the environmental control after the purchase of mice turned to the higher the drug sensitivity. This respect was more remarkable in INAH of which the toxic response is appeared slowly compared with B1HCl. Furthermore, seasonal variation was found in LD50 values. However, seasonal effect differed from rearing and experimental conditions. In the third experiment which these proximate environments were controlled severely, seasonal variation was very small. From the results of these experiments, it was defined that the use of animals produced under the satisfactory rearing condition and severe environmental control are necessary for animal experiments.

  12. EPSPs Measured in Proximal Dendritic Spines of Cortical Pyramidal Neurons.

    PubMed

    Acker, Corey D; Hoyos, Erika; Loew, Leslie M

    2016-01-01

    EPSPs occur when the neurotransmitter glutamate binds to postsynaptic receptors located on small pleomorphic membrane protrusions called dendritic spines. To transmit the synaptic signal, these potentials must travel through the spine neck and the dendritic tree to reach the soma. Due to their small size, the electrical behavior of spines and their ability to compartmentalize electrical signals has been very difficult to assess experimentally. In this study, we developed a method to perform simultaneous two-photon voltage-sensitive dye recording with two-photon glutamate uncaging in order to measure the characteristics (amplitude and duration) of uncaging-evoked EPSPs in single spines on the basal dendrites of L5 pyramidal neurons in acute brain slices from CD1 control mice. We were able to record uncaging-evoked spine potentials that resembled miniature EPSPs at the soma from a wide range of spine morphologies. In proximal spines, these potentials averaged 13.0 mV (range, 6.5-30.8 mV; N = 20) for an average somatic EPSP of 0.59 mV, whereas the mean attenuation ratio (spine/soma) was found to be 25.3. Durations of spine EPSP waveforms were found to be 11.7 ms on average. Modeling studies demonstrate the important role that spine neck resistance (Rneck) plays in spine EPSP amplitudes. Simulations used to estimate Rneck by fits to voltage-sensitive dye measurements produced a mean of 179 MΩ (range, 23-420 MΩ; N = 19). Independent measurements based on fluorescence recovery after photobleaching of a cytosolic dye from spines of the same population of neurons produced a mean R eck estimate of 204 MΩ (range, 52-521 MΩ; N = 34).

  13. Vaccination Rates are Associated With Functional Proximity But Not Base Proximity of Vaccination Clinics

    PubMed Central

    Beshears, John; Choi, James J.; Laibson, David I.; Madrian, Brigitte C.

    2016-01-01

    Background: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of US adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is low. Objective: To determine whether employees are significantly more likely to get vaccinated if they have a higher probability of walking by the clinic for reasons other than vaccination. Method: We obtained data from an employer with a free workplace influenza vaccination clinic. Using each employee’s building entry/exit swipe card data, we test whether functional proximity—the likelihood that the employee walks by the clinic for reasons other than vaccination—predicts whether the employee gets vaccinated at the clinic. We also test whether base proximity—the inverse of walking distance from the employee’s desk to the clinic—predicts vaccination probability. Participants: A total of 1801 employees of a health benefits administrator that held a free workplace influenza vaccination clinic. Results: A 2 SD increase in functional proximity is associated with a 6.4 percentage point increase in the probability of vaccination (total vaccination rate at company=40%), even though the average employee’s desk is only 166 meters from the clinic. Base proximity does not predict vaccination probability. Conclusions and Relevance: Minor changes in the environment can have substantial effects on the probability of vaccination. If these results generalize, health systems should emphasize functional proximity over base proximity when locating preventive health services. PMID:27177295

  14. Proximity Operations and Docking Sensor Development

    NASA Technical Reports Server (NTRS)

    Howard, Richard T.; Bryan, Thomas C.; Brewster, Linda L.; Lee, James E.

    2009-01-01

    The Next Generation Advanced Video Guidance Sensor (NGAVGS) has been under development for the last three years as a long-range proximity operations and docking sensor for use in an Automated Rendezvous and Docking (AR&D) system. The first autonomous rendezvous and docking in the history of the U.S. Space Program was successfully accomplished by Orbital Express, using the Advanced Video Guidance Sensor (AVGS) as the primary docking sensor. That flight proved that the United States now has a mature and flight proven sensor technology for supporting Crew Exploration Vehicles (CEV) and Commercial Orbital Transport Systems (COTS) Automated Rendezvous and Docking (AR&D). NASA video sensors have worked well in the past: the AVGS used on the Demonstration of Autonomous Rendezvous Technology (DART) mission operated successfully in spot mode out to 2 km, and the first generation rendezvous and docking sensor, the Video Guidance Sensor (VGS), was developed and successfully flown on Space Shuttle flights in 1997 and 1998. 12 Parts obsolescence issues prevent the construction of more AVGS units, and the next generation sensor was updated to allow it to support the CEV and COTS programs. The flight proven AR&D sensor has been redesigned to update parts and add additional capabilities for CEV and COTS with the development of the Next Generation AVGS at the Marshall Space Flight Center. The obsolete imager and processor are being replaced with new radiation tolerant parts. In addition, new capabilities include greater sensor range, auto ranging capability, and real-time video output. This paper presents some sensor hardware trades, use of highly integrated laser components, and addresses the needs of future vehicles that may rendezvous and dock with the International Space Station (ISS) and other Constellation vehicles. It also discusses approaches for upgrading AVGS to address parts obsolescence, and concepts for minimizing the sensor footprint, weight, and power requirements

  15. Acute Pancreatitis

    PubMed Central

    Geokas, Michael C.

    1972-01-01

    For many decades two types of acute pancreatitis have been recognized: the edematous or interstitial and the hemorrhagic or necrotic. In most cases acute pancreatitis is associated with alcoholism or biliary tract disease. Elevated serum or urinary α-amylase is the most important finding in diagnosis. The presence of methemalbumin in serum and in peritoneal or pleural fluid supports the diagnosis of the hemorrhagic form of the disease in patients with a history and enzyme studies suggestive of pancreatitis. There is no characteristic clinical picture in acute pancreatitis, and its complications are legion. Pancreatic pseudocyst is probably the most common and pancreatic abscess is the most serious complication. The pathogenetic principle is autodigestion, but the precise sequence of biochemical events is unclear, especially the mode of trypsinogen activation and the role of lysosomal hydrolases. A host of metabolic derangements have been identified in acute pancreatitis, involving lipid, glucose, calcium and magnesium metabolism and changes of the blood clotting mechanism, to name but a few. Medical treatment includes intestinal decompression, analgesics, correction of hypovolemia and other supportive and protective measures. Surgical exploration is advisable in selected cases, when the diagnosis is in doubt, and is considered imperative in the presence of certain complications, especially pancreatic abscess. PMID:4559467

  16. Plate osteosynthesis of the humerus shaft fracture an its association with radial nerve injury--a retrospective study in Melaka General Hospital.

    PubMed

    Lim, K E; Yap, C K; Ong, S C; Aminuddin

    2001-06-01

    Over a seven-year period, 170 cases of humerus fractures were plated in Hospital Melaka. Of these, 131 cases were successfully traced for this study. Besides looking at fracture epidemiology, its relationship with radial nerve injury was examined. The incidence of post-traumatic wrist drop in closed and compound fractures were 14.9% and 35.3% respectively. In relation to the site of fracture, lower third fracture had the highest incidence of wrist drop (29%). The recovery from post-traumatic wrist drop was 83%. The average duration taken for recovery was 11.8 weeks. The incidence of post-operative wrist drop was high at 17.6% but all recovered during follow-up.

  17. Morphometry of Proximal Femur in Indian Population

    PubMed Central

    Joshi, Sheetal; Tuli, Anita; Raheja, Shashi; Jain, Priyanka; Srivastava, Priyanka

    2017-01-01

    Introduction Total hip arthroplasty is a commonly performed surgery now-a-day. There are regional and racial variations in the stature of the population worldwide. So there is always need of population specific data for making best fit prosthesis. Aim The present study was done to measure the parameters of proximal femur and to analyse their correlation by using standard statistical analysis. Materials and Methods Ninety one dry bones (44 left and 47 right) were used. Femur Head Diameter (FHD), Femur Neck Length (FNL), Femur Neck Diameter (FND), Femur Neck Thickness (FNT), Cervicodiaphyseal Angle (CDA) was directly measured with the help of anthropometric instruments. Femur Head Offset (FHO) and Vertical Offset (VO) were measured in the anteroposterior digital photographs. Results Normally distributed variables were compared using Student’s t-test (Unpaired data) to analyse significant effect. There was a significant difference between right and left side of FND and CDA. Pearson correlation coefficient was used to analyse the relationship among variables. FHO had high correlation with the VO (0.687, p<0.001). Conclusion These parameters can be used for designing the prosthesis and plates for hip joint reconstructive surgeries suitable for Indian population. PMID:28384844

  18. Proximity Navigation of Highly Constrained Spacecraft

    NASA Technical Reports Server (NTRS)

    Scarritt, S.; Swartwout, M.

    2007-01-01

    Bandit is a 3-kg automated spacecraft in development at Washington University in St. Louis. Bandit's primary mission is to demonstrate proximity navigation, including docking, around a 25-kg student-built host spacecraft. However, because of extreme constraints in mass, power and volume, traditional sensing and actuation methods are not available. In particular, Bandit carries only 8 fixed-magnitude cold-gas thrusters to control its 6 DOF motion. Bandit lacks true inertial sensing, and the ability to sense position relative to the host has error bounds that approach the size of the Bandit itself. Some of the navigation problems are addressed through an extremely robust, error-tolerant soft dock. In addition, we have identified a control methodology that performs well in this constrained environment: behavior-based velocity potential functions, which use a minimum-seeking method similar to Lyapunov functions. We have also adapted the discrete Kalman filter for use on Bandit for position estimation and have developed a similar measurement vs. propagation weighting algorithm for attitude estimation. This paper provides an overview of Bandit and describes the control and estimation approach. Results using our 6DOF flight simulator are provided, demonstrating that these methods show promise for flight use.

  19. Proximal Row Carpectomy Combined with Wrist Hemiarthroplasty

    PubMed Central

    Culp, Randall W.; Bachoura, Abdo; Gelman, Scott E.; Jacoby, Sidney M.

    2012-01-01

    Proximal row carpectomy (PRC) combined with distal radius hemiarthroplasty is a relatively novel procedure that rivals total wrist arthrodesis and offers a new surgical treatment option for select patients with painful, end-stage wrist disease. We present our early experience with this procedure. A retrospective chart review was conducted for nonrheumatoid patients diagnosed with wrist arthritis and subsequently treated with wrist hemiarthroplasty combined with PRC. The minimum follow-up duration was 12 months. Preoperative and postoperative flexion, extension, and grip strength were recorded. Postoperative radiographic findings were assessed. The Patient-Rated Wrist Evaluation (PRWE) questionnaire was administered to gauge postoperative pain and function. The records of 10 patients were reviewed. The mean age was 64 years and the mean postoperative follow-up duration was 19 months. Postoperative flexion, extension, and grip strength were all found to be less than the preoperative levels. The mean postoperative PRWE score for pain and function were 26 and 23, respectively. The complications were diverse and occurred at a relatively high rate. PRC combined with distal radius hemiarthroplasty is a novel procedure that offers a potential surgical option for the treatment of wrist arthritis in select patients. Our early experience has lead us to modify our technique with regard to the implant material, and at this stage, the surgical technique and the most appropriate implant may require further optimization. The level of evidence for this study is IV (therapeutic). PMID:23904978

  20. Distal radius fracture after proximal row carpectomy

    PubMed Central

    Igeta, Yuka; Naito, Kiyohito; Sugiyama, Yoichi; Obata, Hiroyuki; Aritomi, Kentaro; Kaneko, Kazuo; Obayashi, Osamu

    2015-01-01

    Introduction We encountered a patient with distal radius fracture (DRF) after proximal row carpectomy (PRC). The mechanism of the DRF after PRC is discussed in this report. Presentation of case The patient was a 73-year-old female who had undergone PRC due to Kienböck disease before. The wrist range of motion was: 45° on dorsiflexion and 20° on flexion. DRF has occurred at 3 years after PRC. The fracture type was extra-articular fracture. Osteosynthesis was performed using a volar locking plate. No postoperative complication developed, the Mayo score was excellent at 6 months after surgery, and the daily living activity level recovered to that before injury. Discussion Since the wrist range of motion decreased and the lunate fitted into the joint surface after PRC, making the forearm join with the hand like a single structure, pressure may have been loaded on the weak distal end of the radius from the dorsal side, causing volar displacement and fracture. Conclusion The pressure distribution and range of motion of the radiocarpal joint after PRC are different from those of a normal joint, and the mechanism of fracture also changes due to PRC. PMID:25623755

  1. Semiconductor detectors with proximity signal readout

    SciTech Connect

    Asztalos, Stephen J.

    2014-01-30

    Semiconductor-based radiation detectors are routinely used for the detection, imaging, and spectroscopy of x-rays, gamma rays, and charged particles for applications in the areas of nuclear and medical physics, astrophysics, environmental remediation, nuclear nonproliferation, and homeland security. Detectors used for imaging and particle tracking are more complex in that they typically must also measure the location of the radiation interaction in addition to the deposited energy. In such detectors, the position measurement is often achieved by dividing or segmenting the electrodes into many strips or pixels and then reading out the signals from all of the electrode segments. Fine electrode segmentation is problematic for many of the standard semiconductor detector technologies. Clearly there is a need for a semiconductor-based radiation detector technology that can achieve fine position resolution while maintaining the excellent energy resolution intrinsic to semiconductor detectors, can be fabricated through simple processes, does not require complex electrical interconnections to the detector, and can reduce the number of required channels of readout electronics. Proximity electrode signal readout (PESR), in which the electrodes are not in physical contact with the detector surface, satisfies this need.

  2. Proximity Resonance and Localized Surface Plasmons

    NASA Astrophysics Data System (ADS)

    Liu, Bo; Heller, Eric

    2014-03-01

    The collective excitation of conduction electrons in subwavelength nanostructures is known as Localized Surface Plasmon(LSP)[1]. Such plasmon modes has been intensively studied using noble nanoparticles . More recently, the possibility of building terahertz metamaterials supporting such LSP modes has been explored in graphene microribbons and microdisks. Unlike Surface Plasmon Polaritons(SPPs) at metal-insulator interface, LSP can be directly excited by light illumination and holds promise for applications in ultrasensitive biosensing, nano-optical tweezers and improved photovoltaic devices. In this paper, we consider the interaction of two LSPs in the weak coupling regime and show how an effect similar to the proximity resonance in the quantum scattering theory) gives rise to an asymmetric(quadrupole) mode with increased damping rate. The existence of this asymmetric mode relies on a small phase retardation between the two LSPs. This phase retardation, though small, is key to both increased damping rate for the asymmetric mode and reduced damping rate for the symmetric mode. When this small phase retardation is removed by changing the polarization of the exciting light,we show that the asymmetric mode can not be excited and the symmetric mode shows increased damping.

  3. Effective proximity retrieval by ordering permutations.

    PubMed

    Chavez, Edgar; Figueroa, Karina; Navarro, Gonzalo

    2008-09-01

    We introduce a new probabilistic proximity search algorithm for range and K-nearest neighbor (K-NN) searching in both coordinate and metric spaces. Although there exist solutions for these problems, they boil down to a linear scan when the space is intrinsically high-dimensional, as is the case in many pattern recognition tasks. This, for example, renders the K-NN approach to classification rather slow in large databases. Our novel idea is to predict closeness between elements according to how they order their distances towards a distinguished set of anchor objects. Each element in the space sorts the anchor objects from closest to farthest to it, and the similarity between orders turns out to be an excellent predictor of the closeness between the corresponding elements. We present extensive experiments comparing our method against state-of-the-art exact and approximate techniques, both in synthetic and real, metric and non-metric databases, measuring both CPU time and distance computations. The experiments demonstrate that our technique almost always improves upon the performance of alternative techniques, in some cases by a wide margin.

  4. Ranging/tracking system for proximity operations

    NASA Technical Reports Server (NTRS)

    Nilsen, P.; Udalov, S.

    1982-01-01

    The hardware development and testing phase of a hand held radar for the ranging and tracking for Shuttle proximity operations are considered. The radar is to measure range to a 3 sigma accuracy of 1 m (3.28 ft) to a maximum range of 1850 m (6000 ft) and velocity to a 3 sigma accuracy of 0.03 m/s (0.1 ft/s). Size and weight are similar to hand held radars, frequently seen in use by motorcycle police officers. Meeting these goals for a target in free space was very difficult to obtain in the testing program; however, at a range of approximately 700 m, the 3 sigma range error was found to be 0.96 m. It is felt that much of this error is due to clutter in the test environment. As an example of the velocity accuracy, at a range of 450 m, a 3 sigma velocity error of 0.02 m/s was measured. The principles of the radar and recommended changes to its design are given. Analyses performed in support of the design process, the actual circuit diagrams, and the software listing are included.

  5. Effects of thrust reversing in ground proximity

    NASA Technical Reports Server (NTRS)

    Joshi, P. B.; Hughes, R. V.

    1987-01-01

    The changes in stability and control characteristics encountered by a thrust reversing aircraft during its final approach, landing, and ground roll are described. These changes include a strong pitch-up accompanied by the loss of horizontal tail and aileron control effectiveness. The magnitude of reverser induced changes in ground effect are much larger than corresponding changes in free air. Some unexpected unsteady motions exhibited in wind tunnel by an aircraft model with reversers operating in ground proximity are also described. The cause of this oscillatory behavior was determined to be an unsteady interaction between the wall jets formed by impingement of reverser jets on the ground and the on-coming free stream. Time histories of rolling moments measured by the wind tunnel balance or support system were removed and frequencies were scaled by Strouhal number to full scale. Corrected time series were used to simulate the motion of a fighter aircraft with thrust reversers in ground effect. The simulation predicted large roll angles and nose down attitude at touchdown. Some phenomena of jet attachment to solid surfaces are discussed and areas for future research are recommended.

  6. Proximity effects in cold atom artificial graphene

    NASA Astrophysics Data System (ADS)

    Graß, Tobias; Chhajlany, Ravindra W.; Tarruell, Leticia; Pellegrini, Vittorio; Lewenstein, Maciej

    2017-03-01

    Cold atoms in an optical lattice with brick-wall geometry have been used to mimic graphene, a two-dimensional material with characteristic Dirac excitations. Here we propose to bring such artificial graphene into the proximity of a second atomic layer with a square lattice geometry. For non-interacting fermions, we find that such bilayer system undergoes a phase transition from a graphene-like semi-metal phase, characterized by a band structure with Dirac points, to a gapped band insulator phase. In the presence of attractive interactions between fermions with pseudospin-1/2 degree of freedom, a competition between semi-metal and superfluid behavior is found at the mean-field level. Using the quantum Monte Carlo method, we also investigate the case of strong repulsive interactions. In the Mott phase, each layer exhibits a different amount of long-range magnetic order. Upon coupling both layers, a valence-bond crystal is formed at a critical coupling strength. Finally, we discuss how these bilayer systems could be realized in existing cold atom experiments.

  7. Interactive orbital proximity operations planning system

    NASA Technical Reports Server (NTRS)

    Grunwald, Arthur J.; Ellis, Stephen R.

    1989-01-01

    An interactive, graphical proximity operations planning system was developed which allows on-site design of efficient, complex, multiburn maneuvers in the dynamic multispacecraft environment about the space station. Maneuvering takes place in, as well as out of, the orbital plane. The difficulty in planning such missions results from the unusual and counterintuitive character of relative orbital motion trajectories and complex operational constraints, which are both time varying and highly dependent on the mission scenario. This difficulty is greatly overcome by visualizing the relative trajectories and the relative constraints in an easily interpretable, graphical format, which provides the operator with immediate feedback on design actions. The display shows a perspective bird's-eye view of the space station and co-orbiting spacecraft on the background of the station's orbital plane. The operator has control over two modes of operation: (1) a viewing system mode, which enables him or her to explore the spatial situation about the space station and thus choose and frame in on areas of interest; and (2) a trajectory design mode, which allows the interactive editing of a series of way-points and maneuvering burns to obtain a trajectory which complies with all operational constraints. Through a graphical interactive process, the operator will continue to modify the trajectory design until all operational constraints are met. The effectiveness of this display format in complex trajectory design is presently being evaluated in an ongoing experimental program.

  8. Interactive orbital proximity operations planning system

    NASA Technical Reports Server (NTRS)

    Grunwald, Arthur J.; Ellis, Stephen R.

    1988-01-01

    An interactive graphical proximity operations planning system was developed, which allows on-site design of efficient, complex, multiburn maneuvers in a dynamic multispacecraft environment. Maneuvering takes place in and out of the orbital plane. The difficulty in planning such missions results from the unusual and counterintuitive character of orbital dynamics and complex time-varying operational constraints. This difficulty is greatly overcome by visualizing the relative trajectories and the relevant constraints in an easily interpretable graphical format, which provides the operator with immediate feedback on design actions. The display shows a perspective bird's-eye view of a Space Station and co-orbiting spacecraft on the background of the Station's orbital plane. The operator has control over the two modes of operation: a viewing system mode, which enables the exporation of the spatial situation about the Space Station and thus the ability to choose and zoom in on areas of interest; and a trajectory design mode, which allows the interactive editing of a series of way points and maneuvering burns to obtain a trajectory that complies with all operational constraints. A first version of this display was completed. An experimental program is planned in which operators will carry out a series of design missions which vary in complexity and constraints.

  9. The Proximal Tubule and Albuminuria: Really!

    PubMed Central

    Dickson, Landon E.; Wagner, Mark C.; Sandoval, Ruben M.

    2014-01-01

    Recent data highlight the role of the proximal tubule (PT) in reabsorbing, processing, and transcytosing urinary albumin from the glomerular filtrate. Innovative techniques and approaches have provided exciting insights into these processes, and numerous investigators have shown that selective PT cell defects lead to significant albuminuria, even reaching nephrotic range in animal models. Thus, the mechanisms of albumin reabsorption and transcytosis are undergoing intense study. Working in concert with megalin and cubilin, a nonselective multireceptor complex that predominantly directs proteins for lysosomal degradation, the neonatal Fc receptor (FcRn) located at the brush border of the apical membrane has been implicated as the “receptor” mediating albumin transcytosis. The FcRn pathway facilitates reabsorption and mediates transcytosis by its pH-dependent binding affinity in endosomal compartments. This also allows for selective albumin sorting within the PT cell. This reclamation pathway minimizes urinary losses and catabolism of albumin, thus prolonging its serum half-life. It may also serve as a molecular sorter to preserve and reclaim normal albumin while allowing “altered” albumin to be catabolized via lysosomal pathways. Here, we critically review the data supporting this novel mechanism. PMID:24408874

  10. [Hemodynamic adaptations in proximal cerebrovascular occlusion].

    PubMed

    De Ley, G

    1990-01-01

    In order to gain more insight into the pathophysiology of extracerebral cerebrovascular occlusion, the cerebral hemodynamic behaviour after uni- or bilateral carotid occlusion was investigated. In Wistar rats, acute occlusion of one common carotid artery leads to a moderate bilateral lowering of the resting hemispheric brain blood flow; no interhemispheric perfusion asymmetry is observed. During hypercapnia, however, a manyfold increase of the hemispheric blood flow is seen at the intact side, whereas blood flow increase at the side of the occlusion is suppressed indicating that the cerebrovascular reserve at the side of the occlusion is largely used to preserve resting hemispheric perfusion. During the days (1, 5, 15 and 30) following the occlusion, resting hemispheric blood flow is progressively restored rather rapidly (bilateral normalization on the fifth day) whereas restoration of the cerebrovascular reserve (hemispheric blood flow increase in hypercapnia) proceeds more slowly and a nearly normal hypercapnic response is reached on day thirty. Spontaneously Hypertensive Rats (SHR) show structural abnormalities of their blood vessels during the development of hypertension, leading to impaired adaptation possibilities of the cerebral vasculature after unilateral common carotid occlusion. This is indicated by the striking comparability of the compensation of hemispheric cerebral blood flow (in normo- and hypercapnia) of SH rats five days after unilateral carotid occlusion with the cerebral hemodynamic status of normotensive animals already seen 24 hours after the same occlusion. Consecutive bilateral common carotid occlusion shows that survival rate increases by increasing the interval between both occlusions. This survival relation is much more unfavorable in SH rats. The parallelism between the restoration of the measured CO2-reactivity of the blood flow in the involved hemisphere after unilateral carotid occlusion and the evolution of survival rate after

  11. Analysis of pattern density on process proximity compensation

    NASA Astrophysics Data System (ADS)

    Jung, Sunwook; Lo, Fred; Yang, Tien-Chu; Yang, Ta-Hong; Chen, Kuang-Chao; Lu, Chih-Yuan

    2007-03-01

    The challenges of ever-smaller CD (Critical Dimension) budget for advanced memory product requires tight ACLV (Across-Chip Line-width Variation) control. In addition to the lithographic MOPC (Model-based Optical Proximity Correction) for DCD (photo CD) control, the process correction for etch proximity effect can no longer be ignored. To meet on our requirement on final CD accuracy for critical layer, a set of test pattern, that represents memory array in one of our critical layers, has been generated for both photo and etch process characterizations. Through the combination of different pattern-coverage areas in the test mask and wafer map design, various local (chip-level) pattern densities of 40%~70% and global (wafer-level) pattern densities of 35%~65% were achieved for optical and etch proximity study. The key contributors to the process proximity effect were identified and voluminous data has been extracted from the memory block like patterns for statistical analysis. The photo and etch proximity effects were hence modeled as function of memory block separation, local pattern density as well as global pattern density. Finally, the respective photo and etch proximity effects through model-based proximity correction and rule-based proximity correction were applied in a multi-step flow to products.

  12. Wrist level and proximal-upper extremity replantation.

    PubMed

    Hanel, Douglas P; Chin, Simon H

    2007-02-01

    Since Malt and McKhan's first successful arm replantation in 1962, upper extremity replantation surgery techniques have been refined and spread worldwide. Nevertheless, replantation at or proximal to the wrist, referred to as wrist-proximal replants, remains a daunting challenge that presents the hand surgeon with an array of difficulties distinct from digital replantation.

  13. Comparative studies for different proximity potentials applied to α decay

    NASA Astrophysics Data System (ADS)

    Yao, Y. J.; Zhang, G. L.; Qu, W. W.; Qian, J. Q.

    2015-09-01

    Half-lives of α decay of even-even nuclei calculated by using fourteen different versions of proximity potentials are compared to experimental data. The results show that the results of the generalized proximity potential 1977 are very much in agreement with the experimental data. In comparison with the distributions of nuclear potentials at small distances and the distributions of total potentials above the released energy Q α , it is found that at small distances the distributions of nuclear potentials have large difference and the distributions of total potentials are different among the listed proximity potentials. The different potential distributions affect the penetration probability of α, which is related to the half-life of the α decay for each nucleus. The generalized proximity potential 1977 is also used to calculate the half-lives of α decay of nuclei with odd mass numbers. The results show that the generalized proximity potential 1977 can calculate the half-lives of the α decay of almost all nuclei, which underlines and supports the use of the generalized proximity potential 1977 by Santhosh et al. in the Coulomb and proximity potential model (CPPM) and the Coulomb and proximity potential model for deformed nuclei (CPPMDN).

  14. Differences in regional bone perfusion and turnover between lumbar spine and distal humerus: (18)F-fluoride PET study of treatment-naïve and treated postmenopausal women.

    PubMed

    Frost, Michelle L; Blake, Glen M; Cook, Gary J R; Marsden, Paul K; Fogelman, Ignac

    2009-11-01

    The functional imaging technique of (18)F-fluoride positron emission tomography ((18)F-PET) allows the non-invasive assessment of regional bone blood perfusion and turnover. Bone perfusion and turnover measured using (18)F-PET correlate closely with those obtained experimentally and so they can be readily applied in clinical research studies. The aim of this study was to compare bone perfusion and turnover between the lumbar spine and humerus in both treatment naïve postmenopausal women (n=11) and those on stable antiresorptive therapy (n=12). All women had a BMD T-score of less than -2 at the spine and/or hip. Each woman had a dynamic PET scan of the lumbar spine and distal humerus after injection of 90 MBq (18)F-fluoride. Using a three-compartmental model bone perfusion (K(1)), the net plasma clearance of tracer to bone mineral (K(i)) reflecting regional bone turnover and the rate constants k(2)-k(4) describing the transport of fluoride between plasma, an extravascular bone compartment and bone mineral compartment were calculated. Mean bone perfusion (K(1)) and bone turnover (K(i)) were significantly higher at the lumbar spine compared to the humerus for both treatment-naïve and antiresorptive groups. K(1) values were on average 3 times greater while K(i) was approximately 50% greater at the lumbar spine. The rate constant k(2), the reverse transport of fluoride from the extravascular compartment to plasma, was significantly lower at the humerus compared to the lumbar spine in both groups. The ratio K(i)/K(1) describing the unidirectional extraction efficiency to bone mineral was significantly greater at the humerus compared to the lumbar spine for both study groups. No significant differences between skeletal sites were observed for k(3) or k(4). In conclusion a significant skeletal heterogeneity was observed in terms of bone perfusion and turnover between the lumbar spine and humerus. (18)F-PET may aid in our understanding of the importance of bone perfusion

  15. Hypospadias and Residential Proximity to Pesticide Applications

    PubMed Central

    Yang, Wei; Roberts, Eric M.; Kegley, Susan E.; Wolff, Craig; Guo, Liang; Lammer, Edward J.; English, Paul; Shaw, Gary M.

    2013-01-01

    BACKGROUND: Experimental evidence suggests pesticides may be associated with hypospadias. OBJECTIVE: Examine the association of hypospadias with residential proximity to commercial agricultural pesticide applications. METHODS: The study population included male infants born from 1991 to 2004 to mothers residing in 8 California counties. Cases (n = 690) were ascertained by the California Birth Defects Monitoring Program; controls were selected randomly from the birth population (n = 2195). We determined early pregnancy exposure to pesticide applications within a 500-m radius of mother’s residential address, using detailed data on applications and land use. Associations with exposures to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for maternal race or ethnicity and age and infant birth year. RESULTS: Forty-one percent of cases and controls were classified as exposed to 57 chemical groups and 292 chemicals. Despite >500 statistical comparisons, there were few elevated odds ratios with confidence intervals that excluded 1 for chemical groups or specific chemicals. Those that did were for monochlorophenoxy acid or ester herbicides; the insecticides aldicarb, dimethoate, phorate, and petroleum oils; and adjuvant polyoxyethylene sorbitol among all cases; 2,6-dinitroaniline herbicides, the herbicide oxyfluorfen, and the fungicide copper sulfate among mild cases; and chloroacetanilide herbicides, polyalkyloxy compounds used as adjuvants, the insecticides aldicarb and acephate, and the adjuvant nonyl-phenoxy-poly(ethylene oxy)ethanol among moderate and severe cases. Odds ratios ranged from 1.9 to 2.9. CONCLUSIONS: Most pesticides were not associated with elevated hypospadias risk. For the few that were associated, results should be interpreted with caution until replicated in other study populations. PMID:24167181

  16. Interactive orbital proximity operations planning system

    NASA Technical Reports Server (NTRS)

    Grunwald, Arthur J.; Ellis, Stephen R.

    1990-01-01

    An interactive graphical planning system for on-site planning of proximity operations in the congested multispacecraft environment about the space station is presented. The system shows the astronaut a bird's eye perspective of the space station, the orbital plane, and the co-orbiting spacecraft. The system operates in two operational modes: (1) a viewpoint mode, in which the astronaut is able to move the viewpoint around in the orbital plane to range in on areas of interest; and (2) a trajectory design mode, in which the trajectory is planned. Trajectory design involves the composition of a set of waypoints which result in a fuel-optimal trajectory which satisfies all operational constraints, such as departure and arrival constraints, plume impingement constraints, and structural constraints. The main purpose of the system is to present the trajectory and the constraints in an easily interpretable graphical format. Through a graphical interactive process, the trajectory waypoints are edited until all operational constraints are satisfied. A series of experiments was conducted to evaluate the system. Eight airline pilots with no prior background in orbital mechanics participated in the experiments. Subject training included a stand-alone training session of about 6 hours duration, in which the subjects became familiar with orbital mechanics concepts and performed a series of exercises to familiarize themselves with the control and display features of the system. They then carried out a series of production runs in which 90 different trajectory design situations were randomly addressed. The purpose of these experiments was to investigate how the planning time, planning efforts, and fuel expenditures were affected by the planning difficulty. Some results of these experiments are presented.

  17. Nanocrystal Bioassembly: Asymmetry, Proximity, and Enzymatic Manipulation

    SciTech Connect

    Claridge, Shelley A.

    2008-05-01

    Research at the interface between biomolecules and inorganic nanocrystals has resulted in a great number of new discoveries. In part this arises from the synergistic duality of the system: biomolecules may act as self-assembly agents for organizing inorganic nanocrystals into functional materials; alternatively, nanocrystals may act as microscopic or spectroscopic labels for elucidating the behavior of complex biomolecular systems. However, success in either of these functions relies heavily uponthe ability to control the conjugation and assembly processes.In the work presented here, we first design a branched DNA scaffold which allows hybridization of DNA-nanocrystal monoconjugates to form discrete assemblies. Importantly, the asymmetry of the branched scaffold allows the formation of asymmetric2assemblies of nanocrystals. In the context of a self-assembled device, this can be considered a step toward the ability to engineer functionally distinct inputs and outputs.Next we develop an anion-exchange high performance liquid chromatography purification method which allows large gold nanocrystals attached to single strands of very short DNA to be purified. When two such complementary conjugates are hybridized, the large nanocrystals are brought into close proximity, allowing their plasmon resonances to couple. Such plasmon-coupled constructs are of interest both as optical interconnects for nanoscale devices and as `plasmon ruler? biomolecular probes.We then present an enzymatic ligation strategy for creating multi-nanoparticle building blocks for self-assembly. In constructing a nanoscale device, such a strategy would allow pre-assembly and purification of components; these constructs can also act as multi-label probes of single-stranded DNA conformational dynamics. Finally we demonstrate a simple proof-of-concept of a nanoparticle analog of the polymerase chain reaction.

  18. Acute Vestibulopathy

    PubMed Central

    Cha, Yoon-Hee

    2011-01-01

    The presentation of acute vertigo may represent both a common benign disorder or a life threatening but rare one. Familiarity with the common peripheral vestibular disorders will allow the clinician to rapidly “rule-in” a benign disorder and recognize when further testing is required. Key features of vertigo required to make an accurate diagnosis are duration, chronicity, associated symptoms, and triggers. Bedside tests that are critical to the diagnosis of acute vertigo include the Dix-Hallpike maneuver and canalith repositioning manuever, occlusive ophthalmoscopy, and the head impulse test. The goal of this review is to provide the clinician with the clinical and pathophysiologic background of the most common disorders that present with vertigo to develop a logical differential diagnosis and management plan. PMID:23983835

  19. Acute Blindness.

    PubMed

    Meekins, Jessica M

    2015-09-01

    Sudden loss of vision is an ophthalmic emergency with numerous possible causes. Abnormalities may occur at any point within the complex vision pathway, from retina to optic nerve to the visual center in the occipital lobe. This article reviews specific prechiasm (retina and optic nerve) and cerebral cortical diseases that lead to acute blindness. Information regarding specific etiologies, pathophysiology, diagnosis, treatment, and prognosis for vision is discussed.

  20. Modeling tunneling for the unconventional superconducting proximity effect

    NASA Astrophysics Data System (ADS)

    Zareapour, Parisa; Xu, Jianwei; Zhao, Shu Yang F.; Jain, Achint; Xu, Zhijun; Liu, T. S.; Gu, G. D.; Burch, Kenneth S.

    2016-12-01

    Recently there has been reinvigorated interest in the superconducting proximity effect, driven by predictions of the emergence of Majorana fermions. To help guide this search, we have developed a phenomenological model for the tunneling spectra in anisotropic superconductor-normal metal proximity devices. We combine successful approaches used in s-wave proximity and standard d-wave tunneling to reproduce tunneling spectra in d-wave proximity devices, and clarify the origin of various features. Different variations of the pair potential are considered, resulting from the proximity-induced superconductivity. Furthermore, the effective pair potential felt by the quasiparticles is momentum-dependent in contrast to s-wave superconductors. The probabilities of reflection and transmission are calculated by solving the Bogoliubov equations. Our results are consistent with experimental observations of the unconventional proximity effect and provide important experimental parameters such as the size and length scale of the proximity induced gap, as well as the conditions needed to observe the reduced and full superconducting gaps.

  1. Na sup + -H sup + exchanger in proximal cells isolated from kidney. II. Short-term regulation by glucocorticoids

    SciTech Connect

    Bidet, M.; Merot, J.; Tauc, M.; Poujeol, P. )

    1987-11-01

    The purpose of this study was to investigate the acute regulation by glucocorticoid of the Na{sup +}-H{sup +} exchanger in isolated renal proximal cells of the rabbit. The changes of intracellular pH (pH{sub i}) were determined in a bicarbonate-free buffer by the use of a fluorescent pH probe that may be trapped intracellularly, 2,7-biscarboxyethyl- 5(6)- carboxyfluorescein (BCECF). The activity of the Na{sup +}-H{sup +} exchanger was estimated by measuring the Na{sup +}-induced H{sup +} efflux in BCECF-loaded cells acid loaded with nigericin in choline medium. The uptake of 1.5 mM {sup 22}Na was also studied in Na{sup +}-depleted cells. Acute application of dexamethasone increased the activity of the Na{sup +}-H{sup +} exchanger. The effect on the kinetics of amiloride-sensitive Na{sup +}-H{sup +} exchange indicated that dexamethasone (DEX) increased the activity by increasing the V{sub max} of the carrier for external sodium and for external H{sup +}. The apparent affinity was not modified either for Na{sup +} or for H{sup +}. The glucocorticoid action was undetectable after pretreatment of cells with actinomycin D or cycloheximide. Acute glucocorticoid activation of the Na{sup +}-H{sup +} exchanger in isolated proximal cells required RNA and protein synthesis and was consistent with an increase in the number of carriers in the membrane.

  2. Light-operated proximity detector with linear output

    DOEpatents

    Simpson, Marc L.; McNeilly, David R.

    1985-01-01

    A light-operated proximity detector is described in which reflected light intensity from a surface whose proximity to the detector is to be gauged is translated directly into a signal proportional to the distance of the detector from the surface. A phototransistor is used to sense the reflected light and is connected in a detector circuit which maintains the phototransistor in a saturated state. A negative feedback arrangement using an operational amplifier connected between the collector and emitter of the transistor provides an output at the output of the amplifier which is linearly proportional to the proximity of the surface to the detector containing the transistor. This direct proportional conversion is true even though the light intensity is varying with the proximity in proportion to the square of the inverse of the distance. The detector may be used for measuring the distance remotely from any target surface.

  3. Light-operated proximity detector with linear output

    DOEpatents

    Simpson, M.L.; McNeilly, D.R.

    1984-01-01

    A light-operated proximity detector is described in which reflected light intensity from a surface whose proximity to the detector is to be gauged is translated directly into a signal proportional to the distance of the detector from the surface. A phototransistor is used to sense the reflected light and is connected in a detector circuit which maintains the phtotransistor in a saturated state. A negative feedback arrangement using an operational amplifier connected between the collector and emitter of the transistor provides an output at the output of the amplifier which is linearly proportional to the proximity of the surface to the detector containing the transistor. This direct proportional conversion is true even though the light intensity is varying with the proximity in proportion to the square of the inverse of the distance. The detector may be used for measuring the distance remotely from any target surface.

  4. An unusual case of glipizide-induced proximal myopathy

    PubMed Central

    Das, Saibal; Ramasamy, Anand; De, Soumyadip; Mondal, Somnath

    2016-01-01

    This case report outlines a very rare case of glipizide-induced severe proximal myopathy in a 61-year-old diabetic man. After taking 10 mg glipizide for 5 months, diabetes was well controlled but the patient presented with progressive proximal muscle weakness in all the four limbs. Clinical examination and relevant investigations suggested it to be a case of proximal myopathy and might be drug induced. De-challenge was done and was treated resulting in reversal of the diseased state. After 3 more months, controlled re-challenge was done and there was recurrence of proximal muscle weakness. There were no evidences of any other possible metabolic, infective, organic or other pathologic causes giving rise to that condition and Naranjo adverse drug reaction probability scale suggested that it was “probable” that glipizide was responsible for the development of myopathy in this patient. PMID:27440956

  5. 1. General view to southwest showing proximity of house to ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. General view to southwest showing proximity of house to bridge and north elevation of house. - Locke Avenue Bridge, Bridge Tender's House, East side of Locke Avenue, 12 feet south of Locke Avenue Bridge, Swedesboro, Gloucester County, NJ

  6. View to northeast, showing west elevation and south side. Proximity ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View to northeast, showing west elevation and south side. Proximity of fence of adjacent subdivision precluded photography of north side. - Drew-Sherwood Farm, Barn, 7927 Elk Grove Boulevard, Elk Grove, Sacramento County, CA

  7. Abnormalities of proximal femoral growth after severe Perthes' disease.

    PubMed

    Sponseller, P D; Desai, S S; Millis, M B

    1989-08-01

    We studied the pattern of proximal femoral growth after severe Perthes' disease (Catterall grade III or IV) by retrospective analysis of serial radiographs in 52 hips (46 patients). Our aim was to determine the relationship between proximal femoral growth abnormalities and metaphyseal cysts, epiphyseal extrusion, physeal narrowing, and extensive epiphyseal necrosis. The average follow-up after treatment was 9.8 years (range 4 to 16 years), and 37 of the hips were followed to skeletal maturity. Slowing of proximal femoral growth was common: symmetrical abnormality was seen in 26 hips and asymmetrical abnormality in nine. However, definite premature closure of the proximal femoral physis was seen in only three hips. Abnormality seemed to be due to altered growth velocity rather than to bar formation in most cases. Metaphyseal cysts, epiphyseal extrusion and physeal narrowing during the active stage of the disease, alone or in combination, were found to be neither sensitive nor specific predictors of the subsequent growth pattern.

  8. Differential permeability of the proximal and distal rabbit small bowel

    PubMed Central

    Ross, Allan; Rubin, Allen W.; Deren, Julius J.

    1972-01-01

    The permeability of the proximal and distal rabbit intestine for two to six carbon polyhydric alcohols was compared. Intestinal segments were mounted in chambers that permitted the measurement of the unidirectional flux across the brush border membrane. For both proximal and distal intestine, the permeability for a series of polyhydric alcohols decreased with increasing size. The proximal intestine was more permeable for four, five, and six carbon polyhydric alcohols than distal intestine. This regional permeability difference can be attributed to variations in the permeability characteristics of the brush border specifically. The uptake of alcohols was nonsaturable and was not inhibited by phlorizine or n-ethylmaleimide. The results are compatible with the concept that the brush border membrane has properties similar to artificial porous membranes and that the equivalent radius of the pores of the proximal intestine exceeds that of the distal gut. PMID:4639025

  9. Analysis on the characteristics of pulsed laser proximity fuze's echo

    NASA Astrophysics Data System (ADS)

    Wang, Kun; Chen, Huimin

    2011-06-01

    With the rapid development of semiconductor technology and laser technology, a kind of proximity fuze named pulsed laser proximity fuze has been applied. Compared with other fuzes, pulsed laser proximity fuze has high ranging precision and strong resistance to artificial active interference. It is an important development tendency of proximity fuze. The paper analyze the characteristic of target echo of laser signal, and then make theoretical analysis and calculation on the laser signal transmission in the smog. Firstly, use the pulse width of 10ns semiconductor laser fuze to do typical targets experiment, to get the echo information of target distance is 5m; then to do smog interference experiment, by comparing the pulse width amplitude and backscattering signal amplitude of laser fuze in simulation and experiment, analyzing the effect of anti-clutter, providing the evidence for the subsequent of circuit of signal amplification and processing.

  10. [Merle D'Aubigne's oblique proximal femoral osteotomy. Surgical technique].

    PubMed

    López Sosa, Francisco H; Valentín-Guerrero, Santiago; Miranda-López, Eduardo

    2008-01-01

    Proximal femoral osteotomy with the technique described by Merle D'AubignC and Valliant was used in the treatment of adult patients with osteoarthritis or idiopathic avascular necrosis. Dr. Antonio Flores applied this technique to children with subluxation and acetabular dysplasia, identified with exaggerated anteversion and valgus of the proximal femur. He reported correction of the deformity in 75% of patients. The purpose of this paper is to describe the technique, its indications and complications.

  11. Initial experience with proximal ligation for profunda femoris artery aneurysms: report of three cases.

    PubMed

    Shintani, Tsunehiro; Norimatsu, Togo; Atsuta, Koji; Saitou, Takaaki; Higashi, Shigeki; Mitsuoka, Hiroshi

    2014-04-01

    Profunda femoris artery aneurysms (PFAAs) are rare and difficult to diagnose in the early stage. They are often found due to the presence of complicated conditions, such as rapid expansion, rupture, or acute lower limb ischemia. Surgical procedures such as aneurysmectomy and endoaneurysmorrhaphy tend to be technically challenging because of the patient status and the extent of the aneurysm. We experienced three cases of PFAAs that were treated by proximal ligation (PL) without complete control of the distal branches. The exclusion of PFAAs was confirmed by duplex ultrasound or angiography at the end of the operation. There was no mortality in the perioperative period. During a 12-month follow-up, all cases exhibited complete exclusion of aneurysms with marked size reduction. Based on these findings, we propose that PL, with a careful follow-up for PFAA exclusion and distal limb circulation, could be an alternative treatment for complicated PFAAs.

  12. Proximal small bowel obstruction caused by a massive intraluminal thrombus from a stress ulcer

    PubMed Central

    Siddiky, AH; Gupta, P

    2012-01-01

    We describe a case of proximal small bowel obstruction caused by an occlusive thrombus as a result of bleeding from a duodenal ulcer, which is likely to be stress induced. Initial presentation was confused as a bleeding duodenal ulcer and resultant ileus. Such reports are incredibly rare in the literature and never has one been reported as a result of a stress ulcer. Obstructive symptoms in the acute postoperative patient may be confused for an ileus but mechanical causes must be excluded. The presence of upper gastrointestinal bleeding must not detract from that possibility. Future identification of an occlusive clot on endoscopy that is impossible to circumnavigate may benefit from intraluminal injection of thrombolytic agents to prevent obstruction but this must be weighed with the risk of exacerbating any bleeding. Clearly a risk versus benefit analysis will be necessary on an individual basis. PMID:24960721

  13. Wnt signaling induces transcription, spatial proximity, and translocation of fusion gene partners in human hematopoietic cells.

    PubMed

    Ugarte, Giorgia D; Vargas, Macarena F; Medina, Matías A; León, Pablo; Necuñir, David; Elorza, Alvaro A; Gutiérrez, Soraya E; Moon, Randall T; Loyola, Alejandra; De Ferrari, Giancarlo V

    2015-10-08

    Chromosomal translocations are frequently associated with a wide variety of cancers, particularly hematologic malignancies. A recurrent chromosomal abnormality in acute myeloid leukemia is the reciprocal translocation t(8;21) that fuses RUNX1 and ETO genes. We report here that Wnt/β-catenin signaling increases the expression of ETO and RUNX1 genes in human hematopoietic progenitors. We found that β-catenin is rapidly recruited into RNA polymerase II transcription factories (RNAPII-Ser5) and that ETO and RUNX1 genes are brought into close spatial proximity upon Wnt3a induction. Notably, long-term treatment of cells with Wnt3a induces the generation a frequent RUNX1-ETO translocation event. Thus, Wnt/β-catenin signaling induces transcription and translocation of RUNX1 and ETO fusion gene partners, opening a novel window to understand the onset/development of leukemia.

  14. Proximal rectus femoris avulsion in an elite, olympic-level sprinter.

    PubMed

    Langer, Phillip R; Selesnick, Harlan

    2010-11-01

    Quadriceps injuries, ranging from simple strains to disabling muscle ruptures, are common athletic injuries. The rectus femoris is the most commonly injure portion of the quadriceps musculature. This article is, to our knowledge, the first report of a proximal rectus femoris avulsion in an elite, Olympic-level 100-meter sprinter, acutely managed with surgical repair. Several key factors must be considered and carefully assessed when determining the appropriate course of management (ie, deciding between operative and nonoperative treatment): amount of distal retraction of the tendon, severity of associated soft-tissue trauma, physical examination, and postoperative goals (eg, return to elite-level competitive sports involving running or kicking vs resuming basic activities of daily living). We believe that these factors in our elite, high-performance athlete dictated an operative course of management.

  15. Acute iliopsoas and adductor brevis abscesses presenting with proximal leg muscle weakness.

    PubMed

    Devetag Chalaupka, F

    2006-06-01

    Pyomyositis is a bacterial infection of skeletal muscle. We describe the clinical case of a 77-year-old woman affected by gait disturbance, repetitive falls, low back pain and left thigh and groin pain, but without symptoms of systemic infection. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed abscesses in the left psoas and adductor brevis muscles. Investigations of urogenital tract and gastrointestinal system were normal. Systemic antibiotic treatment alone was not efficient, while surgical drainage improved the clinical picture. The aetiological organism, isolated from the abscess, was Staphylococcus aureus. We suggest that this patient had a primary pyomyositis rather than a secondary form. This is the first report of concomitant abscesses of psoas and adductor brevis muscles with early neurological involvement.

  16. Psychological responses to the proximity of climate change

    NASA Astrophysics Data System (ADS)

    Brügger, Adrian; Dessai, Suraje; Devine-Wright, Patrick; Morton, Thomas A.; Pidgeon, Nicholas F.

    2015-12-01

    A frequent suggestion to increase individuals' willingness to take action on climate change and to support relevant policies is to highlight its proximal consequences, that is, those that are close in space and time. But previous studies that have tested this proximizing approach have not revealed the expected positive effects on individual action and support for addressing climate change. We present three lines of psychological reasoning that provide compelling arguments as to why highlighting proximal impacts of climate change might not be as effective a way to increase individual mitigation and adaptation efforts as is often assumed. Our contextualization of the proximizing approach within established psychological research suggests that, depending on the particular theoretical perspective one takes on this issue, and on specific individual characteristics suggested by these perspectives, proximizing can bring about the intended positive effects, can have no (visible) effect or can even backfire. Thus, the effects of proximizing are much more complex than is commonly assumed. Revealing this complexity contributes to a refined theoretical understanding of the role that psychological distance plays in the context of climate change and opens up further avenues for future research and for interventions.

  17. Megalin and cubilin in proximal tubule protein reabsorption: from experimental models to human disease.

    PubMed

    Nielsen, Rikke; Christensen, Erik Ilsø; Birn, Henrik

    2016-01-01

    Proximal tubule protein uptake is mediated by 2 receptors, megalin and cubilin. These receptors rescue a variety of filtered ligands, including biomarkers, essential vitamins, and hormones. Receptor gene knockout animal models have identified important functions of the receptors and have established their essential role in modulating urinary protein excretion. Rare genetic syndromes associated with dysfunction of these receptors have been identified and characterized, providing additional information on the importance of these receptors in humans. Using various disease models in combination with receptor gene knockout, the implications of receptor dysfunction in acute and chronic kidney injury have been explored and have pointed to potential new roles of these receptors. Based on data from animal models, this paper will review current knowledge on proximal tubule endocytic receptor function and regulation, and their role in renal development, protein reabsorption, albumin uptake, and normal renal physiology. These findings have implications for the pathophysiology and diagnosis of proteinuric renal diseases. We will examine the limitations of the different models and compare the findings to phenotypic observations in inherited human disorders associated with receptor dysfunction. Furthermore, evidence from receptor knockout mouse models as well as human observations suggesting a role of protein receptors for renal disease will be discussed in light of conditions such as chronic kidney disease, diabetes, and hypertension.

  18. Acute laminitis.

    PubMed

    Baxter, G M

    1994-12-01

    Laminitis is an inflammation of the sensitive laminae along the dorsal aspect of the digit and is considered to be a secondary complication of several predisposing or primary factors. Affected horses are usually very lame, have increased digital pulses, are painful to hoof testers along the toe of the foot, and have evidence of downward rotation or distal displacement of the distal phalanx present on radiographs. Treatments for acute laminitis include anti-inflammatory drugs, anti-endotoxin therapy, vasodilators, antithrombotic therapy, corrective trimming and shoeing, and surgical procedures. Treatment regimens are very controversial and the true efficacy of these treatments is unknown. The quality of laminae damage that occurs with laminitis, however, probably has greater influence on the success of treatment and outcome of the horse than the treatment regimen itself.

  19. Regulation of glomerulotubular balance: flow-activated proximal tubule function.

    PubMed

    Wang, Tong; Weinbaum, Sheldon; Weinstein, Alan M

    2017-03-07

    The purpose of this review is to summarize our knowledge and understanding of the physiological importance and the mechanisms underlying flow-activated proximal tubule transport. Since the earliest micropuncture studies of mammalian proximal tubule, it has been recognized that tubular flow is an important regulator of sodium, potassium, and acid-base transport in the kidney. Increased fluid flow stimulates Na(+) and HCO3(-) absorption in the proximal tubule via stimulation of Na/H-exchanger isoform 3 (NHE3) and H(+)-ATPase. In the proximal tubule, brush border microvilli are the major flow sensors, which experience changes in hydrodynamic drag and bending moment as luminal flow velocity changes and which transmit the force of altered flow to cytoskeletal structures within the cell. The signal to NHE3 depends upon the integrity of the actin cytoskeleton; the signal to the H(+)-ATPase depends upon microtubules. We have demonstrated that alterations in fluid drag impact tubule function by modulating ion transporter availability within the brush border membrane of the proximal tubule. Beyond that, there is evidence that transporter activity within the peritubular membrane is also modulated by luminal flow. Secondary messengers that regulate the flow-mediated tubule function have also been delineated. Dopamine blunts the responsiveness of proximal tubule transporters to changes in luminal flow velocity, while a DA1 antagonist increases flow sensitivity of solute reabsorption. IP3 receptor-mediated intracellular Ca(2+) signaling is critical to transduction of microvillus drag. In this review, we summarize our findings of the regulatory mechanism of flow-mediated Na(+) and HCO3(-) transport in the proximal tubule and review available information about flow sensing and regulatory mechanism of glomerulotubular balance.

  20. Induced spectral gap and pairing correlations from superconducting proximity effect

    NASA Astrophysics Data System (ADS)

    Chiu, Ching-Kai; Cole, William S.; Das Sarma, S.

    2016-09-01

    We theoretically consider superconducting proximity effect, using the Bogoliubov-de Gennes (BdG) theory, in heterostructure sandwich-type geometries involving a normal s -wave superconductor and a nonsuperconducting material with the proximity effect being driven by Cooper pairs tunneling from the superconducting slab to the nonsuperconducting slab. Applications of the superconducting proximity effect may rely on an induced spectral gap or induced pairing correlations without any spectral gap. We clarify that in a nonsuperconducting material the induced spectral gap and pairing correlations are independent physical quantities arising from the proximity effect. This is a crucial issue in proposals to create topological superconductivity through the proximity effect. Heterostructures of three-dimensional topological insulator (TI) slabs on conventional s -wave superconductor (SC) substrates provide a platform, with proximity-induced topological superconductivity expected to be observed on the "naked" top surface of a thin TI slab. We theoretically study the induced superconducting gap on this naked surface. In addition, we compare against the induced spectral gap in heterostructures of SC with a normal metal or a semiconductor with strong spin-orbit coupling and a Zeeman splitting potential (another promising platform for topological superconductivity). We find that for any model for the non-SC metal (including metallic TI) the induced spectral gap on the naked surface decays as L-3 as the thickness (L ) of the non-SC slab is increased in contrast to the slower 1 /L decay of the pairing correlations. Our distinction between proximity-induced spectral gap (with its faster spatial decay) and pairing correlation (with its slower spatial decay) has important implications for the currently active search for topological superconductivity and Majorana fermions in various superconducting heterostructures.

  1. Operative treatment of type C intercondylar fractures of the distal humerus: results after a mean follow-up of 2 years in a series of 18 patients.

    PubMed

    Pajarinen, Jarkko; Björkenheim, Jan-Magnus

    2002-01-01

    We reviewed the results of internal fixation in a series of 18 patients (mean age, 44.4 years; SD, 19.1 years; range, 16-81 years) with type C intraarticular fractures of the distal humerus after a mean follow-up of 24.7 months (range, 10-41 months; SD, 9.3 months). An excellent or good result was observed in 10 patients (56%), according to the rating system of the Orthopaedic Trauma Association. All patients younger than 40 years (n = 8) had an excellent or good result, whereas those rates were found in only 2 of 10 patients older than 50 years. Low range of elbow motion (extension-flexion) and, consequently, inferior postoperative score were also correlated to male sex, the triceps-splitting approach, and immobilization exceeding 3 weeks. When stability of the humeral columns is achieved and the articular platform is reconstructed, satisfactory results can be obtained, even in comminuted supracondylar fractures. However, age over 50 years, poor bone quality, and open fracture are correlated with increased risk for an inferior postoperative result. Early mobilization, when possible, and the use of an olecranon osteotomy are recommended.

  2. RADIOGRAPHIC ASSESSMENT OF THE OPENING WEDGE PROXIMAL TIBIAL OSTEOTOMY

    PubMed Central

    Silva, Carlos Francisco Bittencourt; Camara, Eduardo Kastrup Bittencourt; Vieira, Luiz Antonio; Adolphsson, Fernando; Rodarte, Rodrigo Ribeiro Pinho

    2015-01-01

    Objective: To radiographically evaluate individuals who underwent opening wedge proximal tibial osteotomy, with the aim of analyzing the proximal tibial slope in the frontal and sagittal planes, and the patellar height. Method: The study included 22 individuals who were operated at the National Traumatology and Orthopedics Institute (INTO) for correction of varus angular tibial deviation using the opening wedge osteotomy (OWO) technique with the Orthofix monolateral external fixator. Patients with OWO whose treatment was completed between January 2000 and December 2006 were analyzed. The measurement technique consisted of using anteroposterior radiographs with loading and lateral views with the operated knees flexed at 30°. Results: There were no statistically significant differences between the pre and postoperative tibial slope and patellar height values in the patients evaluated. Conclusion: Opening wedge proximal tibial osteotomy is a technique that avoids the problems presented by high proximal tibial osteotomy, since it is done without causing changes to the extensor mechanism, ligament imbalance or distortions in the proximal tibia. PMID:27022577

  3. Developmental Changes in Proximal Tubule Tight Junction Proteins

    PubMed Central

    HADDAD, MAHA; LIN, FANGMING; DWARAKANATH, VANGIPURAM; CORDES, KIMBERLY; BAUM, MICHEL

    2014-01-01

    We demonstrated previously that neonatal proximal tubules have a lower passive paracellular permeability to chloride ions and higher resistance than that of adult proximal tubules. In addition, administration of thyroid hormone to neonates, before the normal maturational increase in serum thyroid hormone levels, prematurely accelerates the developmental increase in chloride permeability to adult levels. To test the hypothesis that there is a maturational change in tight junction proteins and that thyroid hormone mediates these changes, we examined the two known tight junction proteins present in proximal tubules, occludin and claudin 2. Using immunoblot and immunohistochemistry, we demonstrated that claudin 2 has a 4-fold greater abundance in neonatal proximal tubules than in adult tubules. Occludin, however, has a 4-fold greater expression in adult tubules than in neonatal tubules. Administration of thyroid hormone to neonates did not affect claudin 2 expression, occludin expression, or the transepithelial resistance in rat proximal tubule cells in vitro. In conclusion, there are postnatal maturational changes in tight junction proteins. The factors that cause these maturational changes are unknown but unlikely to be due solely to the maturational increase in thyroid hormone. PMID:15585672

  4. Fluoroscopically Guided Peritendinous Corticosteroid Injection for Proximal Hamstring Tendinopathy

    PubMed Central

    Nicholson, Luke T.; DiSegna, Steven; Newman, Joel S.; Miller, Suzanne L.

    2014-01-01

    Background: Proximal hamstring tendinopathy is an uncommon but debilitating cause of posterior thigh pain in athletes subjected to repetitive eccentric hamstring contraction, such as runners. Minimal data exist evaluating treatment options for proximal hamstring tendinopathy. Purpose: This retrospective study evaluates the effectiveness of fluoroscopically guided corticosteroid injections in treating proximal hamstring tendinopathy. Study Design: Case series; Level of evidence, 4. Methods: Eighteen athletes with 22 cases of magnetic resonance imaging–confirmed proximal hamstring tendinopathy were treated with corticosteroid injection and later contacted to evaluate the efficacy of the injection with the use of a questionnaire. Results: The visual analog score decreased from 7.22 preinjection to 3.94 postinjection (P < .001), level of athletic participation increased from 28.76% to 68.82% (P < .001) at a mean follow-up of 21 months, and 38.8% of patients experienced complete resolution at a mean follow-up of 24.8 months. The mean lower extremity function score at the time of follow-up was 60. Conclusion: A trial of fluoroscopically guided corticosteroid injection is warranted in patients presenting with symptoms of proximal hamstring tendinopathy refractory to conservative therapy. PMID:26535310

  5. A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation

    PubMed Central

    Ozkan, Korhan; Türkmen, İsmail; Sahin, Adem; Yildiz, Yavuz; Erturk, Selim; Soylemez, Mehmet Salih

    2015-01-01

    Background: The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly people with osteoporosis. Although dynamic hip screw fixation is the gold standard for the treatment of stable intertrochanteric femur fractures, treatment of unstable intertrochanteric femur fractures still remains controversial. Intramedullary devices such as Gamma nail or proximal femoral nail and proximal anatomic femur plates are in use for the treatment of intertrochanteric femur fractures. There are still many investigations to find the optimal implant to treat these fractures with minimum complications. For this reason, we aimed to perform a biomechanical comparison of the proximal femoral nail and the locking proximal anatomic femoral plate in the treatment of unstable intertrochanteric fractures. Materials and Methods: Twenty synthetic, third generation human femur models, obtained for this purpose, were divided into two groups of 10 bones each. Femurs were provided as a standard representation of AO/Orthopedic Trauma Associationtype 31-A2 unstable fractures. Two types of implantations were inserted: the proximal femoral intramedullary nail in the first group and the locking anatomic femoral plate in the second group. Axial load was applied to the fracture models through the femoral head using a material testing machine, and the biomechanical properties of the implant types were compared. Result: Nail and plate models were locked distally at the same level. Axial steady load with a 5 mm/m velocity was applied through the mechanical axis of femur bone models. Axial loading in the proximal femoral intramedullary nail group was 1.78-fold greater compared to the plate group. All bones that had the plate applied were fractured in the portion containing the distal locking screw. Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of

  6. Spontaneous Bacterial Peritonitis due to Actinomyces Mimicking a Perforation of the Proximal Jejunum

    PubMed Central

    Eenhuis, Louise L.; de Lange, Marleen E.; Samson, Anda D.; Busch, Olivier R.C.

    2016-01-01

    Patient: Female, 42 Final Diagnosis: Spontaneous pelvic-abdominal peritonitis due to actinomyces Symptoms: Abdominal distension • abdominal pain • acute abdomen • fever • intermenstrual bleeding • nausea • sepsis • septic shock Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Pelvic-abdominal actinomycosis is a rare chronic condition caused by an anaerobic, gram-negative rod-shaped commensal bacterium of the Actinomyces species. When Actinomyces becomes pathogenic, it frequently causes a chronic infection with granulomatous abscess formation with pus. Due to diversity in clinical and radiological presentation, actinomycosis can easily be mistaken for several other conditions. Peritonitis without preceding abscess formation caused by Actinomyces species has been described in only few cases before in literature. Case report: We report a case of spontaneous pelvic-abdominal peritonitis with presence of pneumoperitoneum and absence of preceding abscesses due to acute actinomycosis mimicking a perforation of the proximal jejunum in a 42-year-old female with an intra-uterine contraceptive device in place. Explorative laparotomy revealed 2 liters of odorless pus but no etiological explanation for the peritonitis. The intra-uterine contraceptive device was removed. Cultivation showed growth of Actinomyces turicensis. The patient was successfully treated with penicillin. Conclusions: In the case of primary bacterial peritonitis or lower abdominal pain without focus in a patient with an intrauterine device in situ, Actinomyces should be considered as a pathogen. PMID:27561364

  7. Leukemia and non-Hodgkin's lymphoma and residential proximity to industrial plants

    SciTech Connect

    Linos, A.; Blair, A.; Gibson, R.W.; Everett, G.; Van Lier, S.; Cantor, K.P.; Schuman, L.; Burmeister, L. )

    1991-03-01

    The risks of developing leukemia and non-Hodgkin's lymphoma from living near industrial facilities were evaluated among men from Iowa and Minnesota in a population-based, case-control study. We found a statistically significant increase in the risk of developing non-Hodgkin's lymphoma (RR = 1.4) and a slight, nonsignificant excess for leukemia (RR = 1.2) among individuals who lived .8-3.2 km (1/2-2 miles) from a factory. Risks were greater for certain histologic types: follicular lymphoma (RR = 1.5), acute lymphocytic leukemia (RR = 5.4), and acute myelocytic leukemia (RR = 2.2). For non-Hodgkin's lymphoma (but not for leukemia), the relative risks for those living within .8 km (1/2 mile) of a factory were similar or slightly larger than for those living .8-3.2 km (1/2-2 miles) from a factory. Risks did not increase with duration of residence near a factory. The elevated risks of non-Hodgkin's lymphoma were particularly associated with residing near stone, clay, or glass industry facilities. The risk of developing leukemia was greater among persons who resided near chemical and petroleum plants. These preliminary findings raise the possibility that general environmental exposure associated with certain industrial activities may elevate the risk of developing leukemia and non-Hodgkin's lymphoma. Evaluation of data on proximity to industrial plants from studies in other geographic locations is needed to determine whether our results represent a meaningful association.

  8. Ejecta emplacement: from distal to proximal

    NASA Astrophysics Data System (ADS)

    Artemieva, N.

    2008-09-01

    Introduction Most part of impact ejecta is deposited ballistically at some distance from a crater, defined by ejection velocity V and ejection angle α: d=v2sinα/g. In case of giant impacts, planetary curvature should be taken into account [1]. Combined with ejecta scaling [2], these relations allow to define ejecta thickness as a function of distance. Ejecta from large craters are deposited at velocity high enough to mobilize substrate material and to thicken ejecta deposits [3]. Ballistic approximation is valid for airless bodies (if impact vaporization is not vast) or for proximal ejecta of large impact craters, where ejecta mass per unit area is substantially greater than the mass of involved vapor/atmosphere (M-ratio). Deposition of distal ejecta, in which ejecta mass is negligible compared to the atmosphere, may be also treated in a simplified manner, i.e. as 1) passive motion of ejected particles within an impact plume and 2) later, as sedimentation of particles in undisturbed atmosphere (equilibrium between gravity and drag). In all intermediate M-ratio values, impact ejecta move like a surge, i.e. dilute suspension current in which particles are carried in turbulent flows under the influence of gravity. Surges are well-known for near-surface explosive tests, described in detail for volcanic explosions (Plinian column collapse, phreato-magmatic eruption, lateral blast), and found in ejecta from the Chicxulub [4] and the Ries [5]. Important aspects of surge transport include its ability to deposit ejecta over a larger area than that typical of continuous ballistic ejecta and to create multiple ejecta layers. Numerical model Two-phase hydrodynamics. Surges should be modeled in the frame of two-phase hydrodynamics, i.e. interaction between solid/molten particles and atmospheric gas/impact vapor should be taken into account. There are two techniques of solving equations for dust particle motion in a gas flow. The first one describes solid/molten particles as a

  9. Common relationships among proximate composition components in fishes

    USGS Publications Warehouse

    Hartman, K.J.; Margraf, F.J.

    2008-01-01

    Relationships between the various body proximate components and dry matter content were examined for five species of fishes, representing anadromous, marine and freshwater species: chum salmon Oncorhynchus keta, Chinook salmon Oncorhynchus tshawytscha, brook trout Salvelinus fontinalis, bluefish Pomatomus saltatrix and striped bass Morone saxatilis. The dry matter content or per cent dry mass of these fishes can be used to reliably predict the per cent composition of the other components. Therefore, with validation it is possible to estimate fat, protein and ash content of fishes from per cent dry mass information, reducing the need for costly and time-consuming laboratory proximate analysis. This approach coupled with new methods of non-lethal estimation of per cent dry mass, such as from bioelectrical impedance analysis, can provide non-destructive measurements of proximate composition of fishes. ?? 2008 The Authors.

  10. The thermometer of social relations: mapping social proximity on temperature.

    PubMed

    Ijzerman, Hans; Semin, Gün R

    2009-10-01

    "Holding warm feelings toward someone" and "giving someone the cold shoulder" indicate different levels of social proximity. In this article, we show effects of temperature that go beyond these metaphors people live by. In three experiments, warmer conditions, compared with colder conditions, induced (a) greater social proximity, (b) use of more concrete language, and (c) a more relational focus. Different temperature conditions were created by either handing participants warm or cold beverages (Experiment 1) or placing them in comfortable warm or cold ambient conditions (Experiments 2 and 3). These studies corroborate recent findings in the field of grounded cognition revealing that concrete experiences ground abstract concepts with which they are coexperienced. Our studies show a systemic interdependence among language, perception, and social proximity: Environmentally induced conditions shape not only language use, but also the perception and construal of social relationships.

  11. Bringing proximate neighbours into the study of US residential segregation.

    PubMed

    Friedman, Samantha

    2011-01-01

    The race and ethnicity of neighbours are thought to be critical in shaping household mobility underlying residential segregation. However, studies on this topic have used data at the census-tract level of analysis rather than at the proximate-neighbour level. Using a non-publicly available version of the neighbour-cluster sample within the American Housing Survey, this study incorporates data on the race, ethnicity and socioeconomic characteristics of the proximate neighbours of White, Black and Latino households and examines their impact on household residential satisfaction, out- and in-mobility. Results indicate that proximate-neighbour race and ethnicity matter in influencing endpoints of the mobility process and do not necessarily parallel those at the census-tract level. Implications of these findings are discussed as they relate to the study of residential segregation.

  12. VCSEL-based microsensors for photonic proximity fuzing of munitions

    NASA Astrophysics Data System (ADS)

    Keeler, G. A.; Mar, A.; Geib, K. M.; Hsu, A. Y.; Serkland, D. K.; Peake, G. M.

    2008-08-01

    This paper describes technologies developed at Sandia National Laboratories to support a joint DoD/DoE initiative to create a compact, robust, and affordable photonic proximity sensor for munitions fuzing. The proximity fuze employs high-power vertical-cavity surface-emitting laser (VCSEL) arrays, resonant-cavity photodetectors (RCPDs), and refractive micro-optics that are integrated within a microsensor whose volume is approximately 0.01 cm3. Successful development and integration of these custom photonic components should enable a g-hard photonic proximity fuze that replaces costly assemblies of discrete lasers, photodetectors, and bulk optics. Additional applications of this technology include void sensing, ladar and short-range 3-D imaging.

  13. Modular endoprosthetic replacement for metastatic tumours of the proximal femur

    PubMed Central

    Chandrasekar, Coonoor R; Grimer, Robert J; Carter, Simon R; Tillman, Roger M; Abudu, Adesegun T

    2008-01-01

    Background and aims Endoprosthetic replacements of the proximal femur are commonly required to treat destructive metastases with either impending or actual pathological fractures at this site. Modular prostheses provide an off the shelf availability and can be adapted to most reconstructive situations for proximal femoral replacements. The aim of this study was to assess the clinical and functional outcomes following modular tumour prosthesis reconstruction of the proximal femur in 100 consecutive patients with metastatic tumours and to compare them with the published results of patients with modular and custom made endoprosthetic replacements. Methods 100 consecutive patients who underwent modular tumour prosthetic reconstruction of the proximal femur for metastases using the METS system from 2001 to 2007 were studied. The patient, tumour and treatment factors in relation to overall survival, local control, implant survival and complications were analysed. Functional scores were obtained from surviving patients. Results and conclusion There were 45 male and 55 female patients. The mean age was 60.2 years. The indications were metastases. Seventy five patients presented with pathological fracture or with failed fixation and 25 patients were at a high risk of developing a fracture. The mean follow up was 15.9 months [range 0–77]. Three patients died within 2 weeks following surgery. 69 patients have died and 31 are alive. Of the 69 patients who were dead 68 did not need revision surgery indicating that the implant provided single definitive treatment which outlived the patient. There were three dislocations (2/5 with THR and 1/95 with unipolar femoral heads). 6 patients had deep infections. The estimated five year implant survival (Kaplan-Meier analysis) was 83.1% with revision as end point. The mean TESS score was 64% (54%–82%). We conclude that METS modular tumour prosthesis for proximal femur provides versatility; low implant related complications and

  14. Proximal arm kinematics affect grip force-load force coordination.

    PubMed

    Vermillion, Billy C; Lum, Peter S; Lee, Sang Wook

    2015-10-01

    During object manipulation, grip force is coordinated with load force, which is primarily determined by object kinematics. Proximal arm kinematics may affect grip force control, as proximal segment motion could affect control of distal hand muscles via biomechanical and/or neural pathways. The aim of this study was to investigate the impact of proximal kinematics on grip force modulation during object manipulation. Fifteen subjects performed three vertical lifting tasks that involved distinct proximal kinematics (elbow/shoulder), but resulted in similar end-point (hand) trajectories. While temporal coordination of grip and load forces remained similar across the tasks, proximal kinematics significantly affected the grip force-to-load force ratio (P = 0.042), intrinsic finger muscle activation (P = 0.045), and flexor-extensor ratio (P < 0.001). Biomechanical coupling between extrinsic hand muscles and the elbow joint cannot fully explain the observed changes, as task-related changes in intrinsic hand muscle activation were greater than in extrinsic hand muscles. Rather, between-task variation in grip force (highest during task 3) appears to contrast to that in shoulder joint velocity/acceleration (lowest during task 3). These results suggest that complex neural coupling between the distal and proximal upper extremity musculature may affect grip force control during movements, also indicated by task-related changes in intermuscular coherence of muscle pairs, including intrinsic finger muscles. Furthermore, examination of the fingertip force showed that the human motor system may attempt to reduce variability in task-relevant motor output (grip force-to-load force ratio), while allowing larger fluctuations in output less relevant to task goal (shear force-to-grip force ratio).

  15. Evolution and proximate expression of human paternal investment.

    PubMed

    Geary, D C

    2000-01-01

    In more than 95% of mammalian species, males provide little direct investment in the well-being of their offspring. Humans are one notable exception to this pattern and, to date, the factors that contributed to the evolution and the proximate expression of human paternal care are unexplained (T. H. Clutton-Brock, 1989). The nature, extent, and influence of human paternal investment on the physical and social well-being of children are reviewed in light of the social and ecological factors that are associated with paternal investment in other species. On the basis of this review, discussion of the evolution and proximate expression of human paternal investment is provided.

  16. Investigation of proximity effects in electron microscopy and lithography

    SciTech Connect

    Walz, M.-M.; Vollnhals, F.; Rietzler, F.; Schirmer, M.; Steinrueck, H.-P.; Marbach, H.

    2012-01-30

    A fundamental challenge in lithographic and microscopic techniques employing focused electron beams are so-called proximity effects due to unintended electron emission and scattering in the sample. Herein, we apply a method that allows for visualizing electron induced surface modifications on a SiN substrate covered with a thin native oxide layer by means of iron deposits. Conventional wisdom holds that by using thin membranes proximity effects can be effectively reduced. We demonstrate that, contrary to the expectation, these can be indeed larger on a 200 nm SiN-membrane than on the respective bulk substrate due to charging effects.

  17. Double-driven shield capacitive type proximity sensor

    NASA Technical Reports Server (NTRS)

    Vranish, John M. (Inventor)

    1993-01-01

    A capacity type proximity sensor comprised of a capacitance type sensor, a capacitance type reference, and two independent and mutually opposing driven shields respectively adjacent to the sensor and reference and which are coupled in an electrical bridge circuit configuration and driven by a single frequency crystal controlled oscillator is presented. The bridge circuit additionally includes a pair of fixed electrical impedance elements which form adjacent arms of the bridge and which comprise either a pair of precision resistances or capacitors. Detection of bridge unbalance provides an indication of the mutual proximity between an object and the sensor. Drift compensation is also utilized to improve performance and thus increase sensor range and sensitivity.

  18. Longitudinal spin Seebeck effect free from the proximity Nernst effect.

    PubMed

    Kikkawa, T; Uchida, K; Shiomi, Y; Qiu, Z; Hou, D; Tian, D; Nakayama, H; Jin, X-F; Saitoh, E

    2013-02-08

    This Letter provides evidence for intrinsic longitudinal spin Seebeck effects (LSSEs) that are free from the anomalous Nernst effect (ANE) caused by an extrinsic proximity effect. We report the observation of LSSEs in Au/Y(3)Fe(5)O(12) (YIG) and Pt/Cu/YIG systems, showing that the LSSE appears even when the mechanism of the proximity ANE is clearly removed. In the conventional Pt/YIG structure, furthermore, we separate the LSSE from the ANE by comparing the voltages in different magnetization and temperature-gradient configurations; the ANE contamination was found to be negligibly small even in the Pt/YIG structure.

  19. Inverse Proximity Effect in Superconductor-ferromagnet Bilayer Structures

    SciTech Connect

    Xia, Jing

    2010-04-05

    Measurements of the polar Kerr effect using a zero-area-loop Sagnac magnetometer on Pb/Ni and Al/(Co-Pd) proximity-effect bilayers show unambiguous evidence for the 'inverse proximity effect,' in which the ferromagnet (F) induces a finite magnetization in the superconducting (S) layer. To avoid probing the magnetic effects in the ferromagnet, the superconducting layer was prepared much thicker than the light's optical penetration depth. The sign and size of the effect, as well as its temperature dependence agree with recent predictions by Bergeret et al.[1].

  20. Superconductor disorder and strong proximity coupling effects in Majorana nanowires

    NASA Astrophysics Data System (ADS)

    Cole, William; Sau, Jay

    Topological superconductivity induced by proximity to a conventional superconductor is only robust against moderate disorder in the parent superconductor, and only when the energy scale of the interface coupling is much smaller than the parent gap. I present detailed calculations of proximity-induced superconductivity in one-dimensional, spin-orbit coupled, semiconductor nanowires when the parent superconductor disorder and interface coupling exceed this limit. This parameter regime is characterized by unique spectroscopic signatures on both sides of the external field tuned topological phase transition. This work is supported by LPS-MPO-CMTC, Microsoft Q, and JQI-NSF-PFC.

  1. Proximity Operations Nano-Satellite Flight Demonstration (PONSFD) Rendezvous Proximity Operations Design and Trade Studies

    NASA Astrophysics Data System (ADS)

    Griesbach, J.; Westphal, J. J.; Roscoe, C.; Hawes, D. R.; Carrico, J. P.

    2013-09-01

    The Proximity Operations Nano-Satellite Flight Demonstration (PONSFD) program is to demonstrate rendezvous proximity operations (RPO), formation flying, and docking with a pair of 3U CubeSats. The program is sponsored by NASA Ames via the Office of the Chief Technologist (OCT) in support of its Small Spacecraft Technology Program (SSTP). The goal of the mission is to demonstrate complex RPO and docking operations with a pair of low-cost 3U CubeSat satellites using passive navigation sensors. The program encompasses the entire system evolution including system design, acquisition, satellite construction, launch, mission operations, and final disposal. The satellite is scheduled for launch in Fall 2015 with a 1-year mission lifetime. This paper provides a brief mission overview but will then focus on the current design and driving trade study results for the RPO mission specific processor and relevant ground software. The current design involves multiple on-board processors, each specifically tasked with providing mission critical capabilities. These capabilities range from attitude determination and control to image processing. The RPO system processor is responsible for absolute and relative navigation, maneuver planning, attitude commanding, and abort monitoring for mission safety. A low power processor running a Linux operating system has been selected for implementation. Navigation is one of the RPO processor's key tasks. This entails processing data obtained from the on-board GPS unit as well as the on-board imaging sensors. To do this, Kalman filters will be hosted on the processor to ingest and process measurements for maintenance of position and velocity estimates with associated uncertainties. While each satellite carries a GPS unit, it will be used sparsely to conserve power. As such, absolute navigation will mainly consist of propagating past known states, and relative navigation will be considered to be of greater importance. For relative observations

  2. Lymphatic Vascular Response to Acute Inflammation

    PubMed Central

    Lachance, Pier-Anne; Hazen, Amy; Sevick-Muraca, Eva M.

    2013-01-01

    During acute inflammation, functioning lymphatics are believed to reduce edema and to provide a transiting route for immune cells, but the extent at which the dermal lymphatic remodeling impacts lymphatic transport or the factors regulating these changes remains unclear. Herein we quantify the increase in lymphatic endothelial cells (LECs) and examine the expression of pro-angiogenenic and lymphangiogenic factors during acute cutaneous hypersensitivity (CHS). We found that LECs actively proliferate during CHS but that this proliferation does not affect the lymphatic vessel density. Instead, lymphatic remodeling is accompanied by lymphatic vessel leakiness and lower ejection of lymph fluid, which is observed only in the proximal lymphatic vessel draining the inflamed area. LECs and the immune cells release growth factors and cytokines during inflammation, which impact the lymphatic microenvironment and function. We identified that FGF-2, PLGF-2, HGF, EGF, and KC/CXCL17 are differentially expressed within tissues during acute CHS, but both VEGF-C and VEGF-D levels do not significantly change. Our results indicate that VEGF-C and VEGF-D are not the only players and other factors may be responsible for the LECs proliferation and altered lymphatic function in acute CHS. PMID:24086691

  3. The theoretical simulation on electrostatic distribution of 1st proximity region in proximity focusing low-light-level image intensifier

    NASA Astrophysics Data System (ADS)

    Zhang, Liandong; Bai, Xiaofeng; Song, De; Fu, Shencheng; Li, Ye; Duanmu, Qingduo

    2015-03-01

    Low-light-level night vision technology is magnifying low light level signal large enough to be seen by naked eye, which uses the photons - photoelectron as information carrier. Until the micro-channel plate was invented, it has been possibility for the realization of high performance and miniaturization of low-light-level night vision device. The device is double-proximity focusing low-light-level image intensifier which places a micro-channel plate close to photocathode and phosphor screen. The advantages of proximity focusing low-light-level night vision are small size, light weight, small power consumption, no distortion, fast response speed, wide dynamic range and so on. It is placed parallel to each other for Micro-channel plate (both sides of it with metal electrode), the photocathode and the phosphor screen are placed parallel to each other. The voltage is applied between photocathode and the input of micro-channel plate when image intensifier works. The emission electron excited by photo on the photocathode move towards to micro-channel plate under the electric field in 1st proximity focusing region, and then it is multiplied through the micro-channel. The movement locus of emission electrons can be calculated and simulated when the distributions of electrostatic field equipotential lines are determined in the 1st proximity focusing region. Furthermore the resolution of image tube can be determined. However the distributions of electrostatic fields and equipotential lines are complex due to a lot of micro-channel existing in the micro channel plate. This paper simulates electrostatic distribution of 1st proximity region in double-proximity focusing low-light-level image intensifier with the finite element simulation analysis software Ansoft maxwell 3D. The electrostatic field distributions of 1st proximity region are compared when the micro-channel plates' pore size, spacing and inclination angle ranged. We believe that the electron beam movement

  4. Performance characteristics of proximity focused ultraviolet image converters

    NASA Technical Reports Server (NTRS)

    Williams, J. T.; Feibelman, W. A.

    1973-01-01

    Performance characteristics of Bendix type BX 8025-4522 proximity focused image tubes for ultraviolet to visible light conversion are presented. Quantum efficiency, resolution, background, geometric distortion, and environmental test results are discussed. The converters use magnesium fluoride input windows with Cs - Te photocathodes, and P-11 phosphors on fiber optic output windows.

  5. Sharpening a Tool for Teaching: The Zone of Proximal Development

    ERIC Educational Resources Information Center

    Wass, Rob; Golding, Clinton

    2014-01-01

    Vygotsky's Zone of Proximal Development (ZPD) provides an important understanding of learning, but its implications for teachers are often unclear or limited and could be further explored. We use conceptual analysis to sharpen the ZPD as a teaching tool, illustrated with examples from teaching critical thinking in zoology. Our conclusions are…

  6. Scaffolding Critical Thinking in the Zone of Proximal Development

    ERIC Educational Resources Information Center

    Wass, Rob; Harland, Tony; Mercer, Alison

    2011-01-01

    This paper explores student experiences of learning to think critically. Twenty-six zoology undergraduates took part in the study for three years of their degree at the University of Otago, New Zealand. Vygotsky's developmental model of the Zone of Proximal Development (ZPD) provided a framework as we examined how critical thinking was developed.…

  7. Unconventional oil and gas: The role of politics and proximity

    NASA Astrophysics Data System (ADS)

    Schelly, Chelsea

    2016-10-01

    Political divisions are important in understanding public perceptions of unconventional oil and natural gas development, but so is proximity to drilling activities. New research highlights that, as geographical distance from development areas increases, political ideology becomes more influential in explaining diverging perceptions.

  8. Children's Attentional Processing of Mother and Proximity Seeking

    PubMed Central

    2015-01-01

    Attachment expectations regarding the availability of mother as a source for support are supposed to influence distressed children’s support seeking behavior. Because research is needed to better understand the mechanisms related to support seeking behavior, this study tested the hypothesis that the cognitive processing of mother-related information is linked to proximity and support seeking behavior. Uncertainty in maternal support has been shown to be characterized by a biased attentional encoding of mother, reducing the breadth of children’s attentional field around her. We investigated whether this attentional bias is related to how long distressed children wait before seeking their mother’s proximity. Thirty-three children (9-11 years) participated in this study that consisted of experimental tasks to measure attentional breadth and to observe proximity seeking behavior and of questionnaires to measure confidence in maternal support and experienced distress. Results suggested that distressed children with a more narrow attentional field around their mother wait longer to seek her proximity. Key Message: These findings provide a first support for the hypothesis that the attentional processing of mother is related to children’s attachment behavior. PMID:25927921

  9. Housing Projects and Crime: Testing a Proximity Hypothesis.

    ERIC Educational Resources Information Center

    Roncek, Dennis W.; And Others

    1981-01-01

    Proximity to public housing projects has a small but statistically significant effect on the incidence of violent crime. However, adjacency to public housing is a weak predictor of violent crime once the socioeconomic and housing characteristics of the adjacent blocks are taken into account. (Author/GC)

  10. Bridging Pedagogies: Drama, Multiliteracies, and the Zone of Proximal Development

    ERIC Educational Resources Information Center

    Macy, Leonora

    2016-01-01

    This article examines how one educator embraced Vygotsky's concept of the zone of proximal development (ZPD) while using drama to scaffold learning about Dr. Seuss's "The Lorax" for first-grade students. This learning event is interpreted with reference to the ZPD and the New London Group's pedagogy of multiliteracies. The author asserts…

  11. Vygotsky's Zone of Proximal Development: Implications for Gifted Education.

    ERIC Educational Resources Information Center

    Shaughnessy, Michael F.

    This paper reviews Lev Vygotsky's theories concerning optimizing of potential through assistance, support, or instruction. The paper notes that there is a "zone of proximal development" or a band around intelligence quotient (IQ) scores reflecting one's true potential. IQ tests are generally well-standardized and "static,"…

  12. A pedunculated intraluminal foregut reduplication cyst of the proximal esophagus.

    PubMed

    Craig, S R; Wallace, W H; Scott, D J; Cameron, E W

    1998-06-01

    A 66-year-old woman with a 3-month history of progressive dysphagia underwent transoral excision of a pedunculated cyst arising in the proximal esophagus. Histologic examination confirmed a pedunculated intraluminal foregut reduplication cyst. She remains well 1 year after excision with no recurrence of dysphagia.

  13. A Region of Proximal Learning Model of Study Time Allocation

    ERIC Educational Resources Information Center

    Metcalfe, J.; Kornell, N.

    2005-01-01

    A Region of Proximal Learning model is proposed emphasizing two components to people's study time allocation, controlled by different metacognitive indices. The first component is choice, which is further segmented into two stages: (1) a decision of whether to study or not and (2) the order of priority of items chosen. If the people's Judgments of…

  14. Proximal Positioning: A Strategy of Practice in Violin Pedagogy.

    ERIC Educational Resources Information Center

    Gholson, Sylvia A.

    1998-01-01

    Attempts to identify and characterize patterns of expert teaching practice as they occur in context, and to confirm these patterns through processes of verification. Observes teacher Dorothy DeLay in her studio, documenting her teaching through notes, audiotapes, and contextual artifacts. Discusses DeLay's theory of proximal positioning in…

  15. Proximal versus Distal Validity Coefficients for Teacher Observational Instruments

    ERIC Educational Resources Information Center

    Marzano, Robert J.

    2014-01-01

    This study examined the use of measures of student learning computed using end-of-year assessments (distal measures) versus measures of student learning associated with a single lesson (proximal measures) as criterion scores for the validity of observations of teachers' pedagogical skills. The validity coefficients computed using distal…

  16. Proximity to Coast Is Linked to Climate Change Belief

    PubMed Central

    Milfont, Taciano L.; Evans, Laurel; Sibley, Chris G.; Ries, Jan; Cunningham, Andrew

    2014-01-01

    Psychologists have examined the many psychological barriers to both climate change belief and concern. One barrier is the belief that climate change is too uncertain, and likely to happen in distant places and times, to people unlike oneself. Related to this perceived psychological distance of climate change, studies have shown that direct experience of the effects of climate change increases climate change concern. The present study examined the relationship between physical proximity to the coastline and climate change belief, as proximity may be related to experiencing or anticipating the effects of climate change such as sea-level rise. We show, in a national probability sample of 5,815 New Zealanders, that people living in closer proximity to the shoreline expressed greater belief that climate change is real and greater support for government regulation of carbon emissions. This proximity effect held when adjusting for height above sea level and regional poverty. The model also included individual differences in respondents' sex, age, education, political orientation, and wealth. The results indicate that physical place plays a role in the psychological acceptance of climate change, perhaps because the effects of climate change become more concrete and local. PMID:25047568

  17. Residential proximity to gasoline service stations and preterm birth.

    PubMed

    Huppé, Vicky; Kestens, Yan; Auger, Nathalie; Daniel, Mark; Smargiassi, Audrey

    2013-10-01

    Preterm birth (PTB) is a growing public health problem potentially associated with ambient air pollution. Gasoline service stations can emit atmospheric pollutants, including volatile organic compounds potentially implicated in PTB. The objective of this study was to evaluate the relationship between residential proximity to gasoline service stations and PTB. Singleton live births on the Island of Montreal from 1994 to 2006 were obtained (n=267,478). Gasoline service station locations, presence of heavy-traffic roads, and neighborhood socioeconomic status (SES) were determined using a geographic information system. Multivariable logistic regression was used to analyze the association between PTB and residential proximity to gasoline service stations (50, 100, 150, 200, 250, and 500 m), accounting for maternal covariates, neighborhood SES, and heavy-traffic roads. For all distance categories beyond 50 m, presence of service stations was associated with a greater odds of PTB. Associations were robust to adjustment for maternal covariates for distance categories of 150 and 200 m but were nullified when adjusting for neighborhood SES. In analyses accounting for the number of service stations, the likelihood of PTB within 250 m was statistically significant in unadjusted models. Associations were, however, nullified in models accounting for maternal covariates or neighborhood SES. Our results suggest that there is no clear association between residential proximity to gasoline service stations in Montreal and PTB. Given the correlation between proximity of gasoline service stations and SES, it is difficult to delineate the role of these factors in PTB.

  18. Osteosynthesis of the proximal femur anchorage of a cervical nail.

    PubMed

    el Banna, S; Burny, F; Bourgois, R; Donkerwolcke, M; Moulart, F

    1994-01-01

    One of the factors determining the stability of osteosynthesis is the mechanical strength of the bone fragments required for the anchorage of the implant. The aim is to study the driving of a Thornton nail in the proximal epiphysis of a human femur as a way to measure the strength of the trabecular bone and to predict the stability of the implanted system.

  19. Distal and variably proximal causes: education, obesity, and health.

    PubMed

    Schafer, Markus H; Ferraro, Kenneth F

    2011-11-01

    Medical sociologists hold that social conditions generate disparities across a host of health conditions through exposure to a variety of more proximate risk factors. Though distal and proximal causes jointly influence disease, the nature of risk accumulation may differ appreciably by the link of a proximal cause to the outcome in question. This paper employs a representative sample of over 3000 American older adults to examine whether position in the educational gradient amplifies the effect of obesity on two health outcomes. Results indicate that educational inequalities amplify the effect of high body mass index on disability (unstandardized coefficients across education groups range from -.05 [ns] to .26 [p < .01] among overweight respondents yet reach .17 [ns] to .73 [p < .001] among severely obese adults), but fail to amplify the consequences of severe obesity in the case of C-reactive protein (CRP) levels. Instead, educational gradients in CRP are most pronounced at lower levels of body mass. Sex-specific analyses further clarify these patterns, as the connections between CRP and body mass are particularly strong among women. We conclude that risk accumulation processes differ based on the proximity of causes to the health outcome under examination.

  20. Constructing a MEZOPED (Multiple Electronic Zone of Proximal Development).

    ERIC Educational Resources Information Center

    Murfin, Brian

    1994-01-01

    This paper presents the theoretical background for using computer-mediated communication to link children and scientists in a multiple electronic zone of proximal development. It is postulated that students will be able to perform at higher cognitive levels as a result of this increased interment contact with many adults. (LZ)

  1. Reflections on the Ecolab and the Zone of Proximal Development

    ERIC Educational Resources Information Center

    Luckin, Rosemary; du Boulay, Benedict

    2016-01-01

    In 1999 we reported a study that explored the way that Vygotsky's Zone of Proximal Development could be used to inform the design of an Interactive Learning Environment called the Ecolab. Two aspects of this work have subsequently been used for further research. Firstly, there is the interpretation of the ZPD and its associated theory that was…

  2. Proximal dup(10q): Case report and literature review

    SciTech Connect

    Barritt, J.A.; Teague, K.E.; Bodurtha, J.N.

    1994-09-01

    We report a case of a proximal dir dup(10q) in a female with multiple congenital anomalies. During infancy she was noted to gave growth retardation, microcephaly, microphthalmia, coloboma, a long, beaked nose, posteriorly rotated ears with simple helices, full bowed lips, widely-spaced nipples, broad first toes, hypermobile and proximally placed thumbs, a heart murmur, PDA, and coarctation of the aorta. Additional findings at age 13 included a full columella, short philtrum, thin limbs, bilateral blindness, and mental retardation, as well as continued growth retardation. Her medical history included precocious puberty at age 8 and a diagnosis of hyperactivity. Using FISH with multiple probes combined with GTG-banding, the aberrant chromosome was determined to be a dir dup(10)(q21{r_arrow}q22). Parental chromosomes were normal and the family history was unremarkable. The parental origin of the dir dup(10) is being assessed using DNA markers. Five similar cases of proximal dup(10q) have been reported previously. Consistent characteristics include low birth weight, developmental and psychomotor delay, growth retardation, and microcephaly. Also found in most cases were short prominent philtrum, bowed mouth, PDA, thin limbs, coloboma, micropthalmia, deep set eyes, and other ocular anomalies. Our case is unique in that she has a long, beaked nose, precocious puberty, and hyperactivity. Future studies such as this, using molecular cytogenetic techniques to better define the chromatin involved in proximal dup(10q), may lead to its recognition as a distinct clinical phenotype.

  3. Proximity to coast is linked to climate change belief.

    PubMed

    Milfont, Taciano L; Evans, Laurel; Sibley, Chris G; Ries, Jan; Cunningham, Andrew

    2014-01-01

    Psychologists have examined the many psychological barriers to both climate change belief and concern. One barrier is the belief that climate change is too uncertain, and likely to happen in distant places and times, to people unlike oneself. Related to this perceived psychological distance of climate change, studies have shown that direct experience of the effects of climate change increases climate change concern. The present study examined the relationship between physical proximity to the coastline and climate change belief, as proximity may be related to experiencing or anticipating the effects of climate change such as sea-level rise. We show, in a national probability sample of 5,815 New Zealanders, that people living in closer proximity to the shoreline expressed greater belief that climate change is real and greater support for government regulation of carbon emissions. This proximity effect held when adjusting for height above sea level and regional poverty. The model also included individual differences in respondents' sex, age, education, political orientation, and wealth. The results indicate that physical place plays a role in the psychological acceptance of climate change, perhaps because the effects of climate change become more concrete and local.

  4. Approximate proximal point methods for convex programming problems

    SciTech Connect

    Eggermont, P.

    1994-12-31

    We study proximal point methods for the finite dimensional convex programming problem minimize f(x) such that x {element_of} C, where f : dom f {contained_in} RIR is a proper convex function and C {contained_in} R is a closed convex set.

  5. Constructing Proximity: Relating to Readers in Popular and Professional Science

    ERIC Educational Resources Information Center

    Hyland, Ken

    2010-01-01

    The view of academic discourse as a rhetorical activity involving interactions between writers and readers is now central to most perspectives on EAP, but these interactions are conducted differently in different disciplinary and generic contexts. In this paper I use the term "proximity" to refer to a writer's control of those rhetorical features…

  6. West and south elevations, view to northeast. Proximity of house ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West and south elevations, view to northeast. Proximity of house and trees precluded photography of north and east elevations, but building is symmetrical. Entry is in east elevation; windmill was mounted at third story level on north elevation. - Drew-Sherwood Farm, Tank House, 7927 Elk Grove Boulevard, Elk Grove, Sacramento County, CA

  7. Proximal femoral diaphyseal cross-sectional geometry in Orrorin tugenensis.

    PubMed

    Bleuze, M

    2012-06-01

    Functional adaptations in femora attributed to Orrorin tugenensis provide a unique opportunity to examine locomotor behavior very early in the hominin lineage. This study examines relative cortical thickness, cortical area (CA) relative to the polar moment of area (J), and J relative to femoral head superoinferior diameter (FHD) in the proximal femur of O. tugenensis (BAR 1002'00 and BAR 1003'00), and compares patterns in this early hominin with those in a sample of modern humans (N=31), Plio-Pleistocene fossil hominins (N=8), Pan troglodytes troglodytes (N=13), and Pan paniscus (N=3). Relative cortical thickness and CA relative to J in the proximal femur of O. tugenensis are comparable to patterns generally found in other fossil hominins. Proximal femoral diaphyseal J relative to FHD in BAR 1002'00 is similar to patterns found in fossil hominins typically attributed to a non-Homo genus (i.e. SK 82, SK 97, and KNM-ER 738). Cross-sectional geometric patterns in the proximal femur of Orrorin are not unlike those generally found in australopithecines and fossil Homo. While the results of this study cannot confirm unequivocally that Orrorin was an obligate biped, a mode of locomotion comparable to that proposed for australopithecines cannot be ruled out.

  8. Rendezvous and Proximity Operations of the Space Shuttle

    NASA Technical Reports Server (NTRS)

    Goodman, John L.

    2005-01-01

    Space Shuttle rendezvous missions present unique challenges that were not fully recognized when the Shuttle was designed. Rendezvous targets could be passive (i.e., no lights or transponders), and not designed to facilitate Shuttle rendezvous, proximity operations, and retrieval. Shuttle reaction control system jet plume impingement on target spacecraft presented induced dynamics, structural loading, and contamination concerns. These issues, along with limited reaction control system propellant in the Shuttle nose, drove a change from the legacy Gemini/Apollo coelliptic profile to a stable orbit profile, and the development of new proximity operations techniques. Multiple scientific and on-orbit servicing missions, and crew exchange, assembly and replenishment flights to Mir and to the International Space Station drove further profile and piloting technique changes. These changes included new proximity operations, relative navigation sensors, and new computer generated piloting cues. However, the Shuttle's baseline rendezvous navigation system has not required modification to place the Shuttle at the proximity operations initiation point for all rendezvous missions flown.

  9. On the Surprising Salience of Curvature in Grouping by Proximity

    ERIC Educational Resources Information Center

    Strother, Lars; Kubovy, Michael

    2006-01-01

    The authors conducted 3 experiments to explore the roles of curvature, density, and relative proximity in the perceptual organization of ambiguous dot patterns. To this end, they developed a new family of regular dot patterns that tend to be perceptually grouped into parallel contours, dot-sampled structured grids (DSGs). DSGs are similar to the…

  10. Interlanguage Pragmatics in the Zone of Proximal Development

    ERIC Educational Resources Information Center

    Ohta, Amy Snyder

    2005-01-01

    Vygotsky's zone of proximal development (ZPD) has been fruitfully applied in L2 research that examines second and foreign language learning. This paper considers the applicability of the ZPD to interlanguage pragmatics instruction and research. First, the ZPD is defined [Vygotsky, L.S., 1978. Mind in Society: The Development of Higher…

  11. Pentoxifylline Treatment in Acute Pancreatitis (AP)

    ClinicalTrials.gov

    2016-09-14

    Acute Pancreatitis (AP); Gallstone Pancreatitis; Alcoholic Pancreatitis; Post-ERCP/Post-procedural Pancreatitis; Trauma Acute Pancreatitis; Hypertriglyceridemia Acute Pancreatitis; Idiopathic (Unknown) Acute Pancreatitis; Medication Induced Acute Pancreatitis; Cancer Acute Pancreatitis; Miscellaneous (i.e. Acute on Chronic Pancreatitis)

  12. Long-term Results, Functional Outcomes and Complications after Open Reduction and Internal Fixation of Neglected and Displaced Greater Tuberosity of Humerus Fractures

    PubMed Central

    Amroodi, Morteza Nakhaei; Behshad, Vahid; Motaghi, Paniz

    2016-01-01

    Background: Humerus fractures include 5% to 8% of total fractures. Non-union and delayed union of GT (GT) fractures is uncommon; however they present a challenge to the orthopedic surgeons. Significant controversy surrounds optimal treatment of neglected fractures. The purpose of this article was to perform a comparative study to evaluate the outcomes of open reduction and internal fixation (ORIF) of neglected GT fractures. Methods: We retrospectively evaluated the results of surgical intervention in 12 patients with displaced nonunion of GT fractures who were referred to our center. Before and minimally 25 months after surgery ROM, muscle forces, Constant Shoulder Score (Constant-Murley score) (CSS), Visual Analogue Scale (VAS), Activities of Daily Living (ADL) Score and American Shoulder and Elbow Surgeons (ASES) Score were all recorded. Additionally, the results were compared with undamaged shoulder. Results: Between March 2006 and January 2013, 12 patients underwent surgical intervention and followed for 36.2 months in average. All fractures healed. Anatomic reduction achieved only in 6 cases with no report of avascular necrosis or infection. All ROMs and muscle forces increased significantly (Mean Forward Flexion: 49.16 to 153.3, Mean Internal Rotation: 3 to 9, Mean External Rotation: -5 to 27.5) (P value<0.0001). All functional scores including CSS, VAS, ADL and ASES score improved significantly (Mean VAS: 6.5 to 1.3, Mean CSS: 29.83 to 86, Mean ADL: 6.6 to 27.1,: Mean ASES: 28.6 to 88.9) (P value<0.0001). Conclusion: ORIF for neglected and displaced GT fractures has satisfactory functional outcomes, despite of non-anatomical reduction of the fracture. PMID:27847845

  13. Proximity effects and pair currents in cuprate junctions

    NASA Astrophysics Data System (ADS)

    Koren, Gad

    2017-04-01

    Proximity effects and pair currents were measured in epitaxial trilayer c-axis junctions comprised of a {{{PrBa}}}2{{{Cu}}}3{{{O}}}7-δ barrier sandwiched in between an overdoped {{{Y}}}0.94{{{Ca}}}0.06{{{Ba}}}2{{{Cu}}}3{{{O}}}7-δ layer and underdoped {{{YBa}}}2{{{Cu}}}2.7{{{Co}}}0.3{{{O}}}{y} layer. These junctions had two T c values of {{T}}{{c}}({high})=84{--}86 K and {{T}}{{c}}({low})=50{--}55 K, allowing investigation when both electrodes are superconducting, or when only one is superconducting while the other is in its pseudogap regime. For T below T c(high) but much above T c(low), two distinct proximity effect transitions were observed in the resistance at two temperature regimes, between 80 and 84 K, and 76 to 80 K. The first is a conventional proximity effect with the T c(high) electrode, while the second is a second order proximity effect of this electrode with uncorrelated pairs in the pseudogap regime. Conductance spectra measured between 2 and 86 K showed four different I c pair currents which were attributed to coherent pairs tunneling through the barrier below 42 K, to a fluctuating pairs current up to ∼77 K, and to a proximity pairs current between 77 and 84 K. All pair currents were suppressed under magnetic fields, with two distinct decay parameters that originated in the two different electrodes, with a significant suppression observed in the pseudogap regime.

  14. Proximal Scaphoid Arthroplasty Using the Medial Femoral Trochlea Flap

    PubMed Central

    Higgins, James P.; Burger, Heinze K.

    2013-01-01

    Background The medial trochlea of the femur (medial femoral trochlea, MFT) provides a source of convex osteocartilaginous vascularized bone that has been demonstrated to have a similar contour to the proximal scaphoid. This provides a potential solution for difficult recalcitrant proximal pole scaphoid nonunions. Materials and Methods Sixteen consecutive patients who underwent MFT proximal scaphoid arthroplasty were reviewed. Follow-up data were recorded at a minimum of 6 months, with an average of 14 months. The results of this cohort were previously reported in detail but are summarized herein. Description of Technique The ability to reconstruct both bone and cartilage of the nonunion enables the surgeon to resect the nonunited proximal pole to prepare for scaphoid reconstruction. A segment of osteocartilaginous MFT is harvested in dimensions required by the scaphoid defect. The MFT segment is harvested on the transverse branch of the descending geniculate vessels. Fixation may be achieved with ease due to the size of the reconstructed segment. Results Computed tomography imaging demonstrated 15 of 16 reconstructed scaphoids achieving osseous union. Follow-up range of motion (ROM) of the wrist averaged 46.0° extension (range 28-80°) and 43.8° flexion (range 10-80°), which was similar to preoperative (average 45.7° extension and 43.0° flexion). Scapholunate angles remained unaffected (51.6° preoperatively and 48.6° postoperatively), indicating preservation of carpal relationships. Conclusions Vascularized MFT flaps provide a useful tool in the treatment of difficult proximal pole scaphoid nonunions. Early follow-up demonstrates high rate of achieving union with acceptable ROM and good pain relief. PMID:24436821

  15. A procedure to estimate proximate analysis of mixed organic wastes.

    PubMed

    Zaher, U; Buffiere, P; Steyer, J P; Chen, S

    2009-04-01

    In waste materials, proximate analysis measuring the total concentration of carbohydrate, protein, and lipid contents from solid wastes is challenging, as a result of the heterogeneous and solid nature of wastes. This paper presents a new procedure that was developed to estimate such complex chemical composition of the waste using conventional practical measurements, such as chemical oxygen demand (COD) and total organic carbon. The procedure is based on mass balance of macronutrient elements (carbon, hydrogen, nitrogen, oxygen, and phosphorus [CHNOP]) (i.e., elemental continuity), in addition to the balance of COD and charge intensity that are applied in mathematical modeling of biological processes. Knowing the composition of such a complex substrate is crucial to study solid waste anaerobic degradation. The procedure was formulated to generate the detailed input required for the International Water Association (London, United Kingdom) Anaerobic Digestion Model number 1 (IWA-ADM1). The complex particulate composition estimated by the procedure was validated with several types of food wastes and animal manures. To make proximate analysis feasible for validation, the wastes were classified into 19 types to allow accurate extraction and proximate analysis. The estimated carbohydrates, proteins, lipids, and inerts concentrations were highly correlated to the proximate analysis; correlation coefficients were 0.94, 0.88, 0.99, and 0.96, respectively. For most of the wastes, carbohydrate was the highest fraction and was estimated accurately by the procedure over an extended range with high linearity. For wastes that are rich in protein and fiber, the procedure was even more consistent compared with the proximate analysis. The new procedure can be used for waste characterization in solid waste treatment design and optimization.

  16. SGLT2 mediates glucose reabsorption in the early proximal tubule.

    PubMed

    Vallon, Volker; Platt, Kenneth A; Cunard, Robyn; Schroth, Jana; Whaley, Jean; Thomson, Scott C; Koepsell, Hermann; Rieg, Timo

    2011-01-01

    Mutations in the gene encoding for the Na(+)-glucose co-transporter SGLT2 (SLC5A2) associate with familial renal glucosuria, but the role of SGLT2 in the kidney is incompletely understood. Here, we determined the localization of SGLT2 in the mouse kidney and generated and characterized SGLT2-deficient mice. In wild-type (WT) mice, immunohistochemistry localized SGLT2 to the brush border membrane of the early proximal tubule. Sglt2(-/-) mice had glucosuria, polyuria, and increased food and fluid intake without differences in plasma glucose concentrations, GFR, or urinary excretion of other proximal tubular substrates (including amino acids) compared with WT mice. SGLT2 deficiency did not associate with volume depletion, suggested by similar body weight, BP, and hematocrit; however, plasma renin concentrations were modestly higher and plasma aldosterone levels were lower in Sglt2(-/-) mice. Whole-kidney clearance studies showed that fractional glucose reabsorption was significantly lower in Sglt2(-/-) mice compared with WT mice and varied in Sglt2(-/-) mice between 10 and 60%, inversely with the amount of filtered glucose. Free-flow micropuncture revealed that for early proximal collections, 78 ± 6% of the filtered glucose was reabsorbed in WT mice compared with no reabsorption in Sglt2(-/-) mice. For late proximal collections, fractional glucose reabsorption was 93 ± 1% in WT and 21 ± 6% in Sglt2(-/-) mice, respectively. These results demonstrate that SGLT2 mediates glucose reabsorption in the early proximal tubule and most of the glucose reabsorption by the kidney, overall. This mouse model mimics and explains the glucosuric phenotype of individuals carrying SLC5A2 mutations.

  17. Studies of the electrical potential difference in rat proximal tubule.

    PubMed

    Seely, J F; Chirito, E

    1975-07-01

    The electrical potential difference (PD) in the rat proximal convoluted tubule was investigated in vivo as a function of distance from the glomerulus. The PD was found to be invariably negative (up to -4.5 mV) in the earliest segments (less than 0.5 mm from the glomerulus) and rose to positive values (+2 to +4) in the later segments (1 mm beyond the glomerulus). This change in PD correlated with the bubule fluid-to-plasma (TF/P) chloride ratios, which rose from unity in the early segments to approximately 1.3 in the late. Corresponding changes in PD and chloride ratios could be elicited by single-nephron stop-flow techniques in the early segments. Luminal perfusion techniques demonstrated a direct relationship between PD and tubule fluid chloride concentration. Acetazolamide was found to significantly reduce both late proximal PD (less than +2 mV) and TF/P chloride ratios (less than 1.06). Split-drop studies demonstrated that the negative PD in the early proximal tubule was dependent on the presence of glucose and alanine and the absence of a chloride gradient, whereas in the late proximal tubule under the same conditions the PD was not significantly different from zero. In this segment of the nephron the positive PD in free flow appeared to result from the chloride diffusion potential generated by preferential HCO3 reabsorption. These results provide further demonstration of intrinsic differences in the transport properties along the length of the proximal convoluted tubule.

  18. The He II Proximity Effect and The Lifetime of Quasars

    NASA Astrophysics Data System (ADS)

    Khrykin, I. S.; Hennawi, J. F.; McQuinn, M.; Worseck, G.

    2016-06-01

    The lifetime of quasars is fundamental for understanding the growth of supermassive black holes, and is an important ingredient in models of the reionization of the intergalactic medium (IGM). However, despite various attempts to determine quasar lifetimes, current estimates from a variety of methods are uncertain by orders of magnitude. This work combines cosmological hydrodynamical simulations and 1D radiative transfer to investigate the structure and evolution of the He ii Lyα proximity zones around quasars at z ≃ 3-4. We show that the time evolution in the proximity zone can be described by a simple analytical model for the approach of the He ii fraction {x}{He{{II}}}(t) to ionization equilibrium, and use this picture to illustrate how the transmission profile depends on the quasar lifetime, quasar UV luminosity, and the ionization state of Helium in the ambient IGM (i.e., the average He ii fraction, or equivalently the metagalactic He ii ionizing background). A significant degeneracy exists between the lifetime and the average He ii fraction, however the latter can be determined from measurements of the He ii Lyα optical depth far from quasars, allowing the lifetime to be measured. We advocate stacking existing He ii quasar spectra at z ˜ 3, and show that the shape of this average proximity zone profile is sensitive to lifetimes as long as ˜30 Myr. At higher redshift z ˜ 4 where the He ii fraction is poorly constrained, degeneracies will make it challenging to determine these parameters independently. Our analytical model for He ii proximity zones should also provide a useful description of the properties of H i proximity zones around quasars at z ≃ 6-7.

  19. CFTR mediated chloride secretion in the avian renal proximal tubule.

    PubMed

    Laverty, Gary; Anttila, Ashley; Carty, Jenava; Reddy, Varudhini; Yum, Jamie; Arnason, Sighvatur S

    2012-01-01

    In primary cell cultures of the avian (Gallus gallus) renal proximal tubule parathyroid hormone and cAMP activation generate a Cl(-)-dependent short circuit current (I(SC)) response, consistent with net transepithelial Cl(-) secretion. In this study we investigated the expression and physiological function of the Na-K-2Cl (NKCC) transporter and CFTR chloride channel, both associated with Cl(-) secretion in a variety of tissues, in these proximal tubule cells. Using both RT-PCR and immunoblotting approaches, we showed that NKCC and CFTR are expressed, both in proximal tubule primary cultures and in a proximal tubule fraction of non-cultured (native tissue) fragments. We also used electrophysiological methods to assess the functional contribution of NKCC and CFTR to forskolin-activated I(SC) responses in filter grown cultured monolayers. Bumetanide (10 μM), a specific blocker of NKCC, inhibited forskolin activated I(SC) by about 40%, suggesting that basolateral uptake of Cl(-) is partially mediated by NKCC transport. In monolayers permeabilized on the basolateral side with nystatin, forskolin activated an apical Cl(-) conductance, manifested as bidirectional diffusion currents in the presence of oppositely directed Cl(-) gradients. Under these conditions the apical conductance appeared to show some bias towards apical-to-basolateral Cl(-) current. Two selective CFTR blockers, CFTR Inhibitor 172 and GlyH-101 (both at 20 μM) inhibited the forskolin activated diffusion currents by 38-68%, with GlyH-101 having a greater effect. These data support the conclusion that avian renal proximal tubules utilize an apical CFTR Cl(-) channel to mediate cAMP-activated Cl(-) secretion.

  20. Acute stress does not affect the impairing effect of chronic stress on memory retrieval

    PubMed Central

    Ozbaki, Jamile; Goudarzi, Iran; Salmani, Mahmoud Elahdadi; Rashidy-Pour, Ali

    2016-01-01

    Objective(s): Due to the prevalence and pervasiveness of stress in modern life and exposure to both chronic and acute stresses, it is not clear whether prior exposure to chronic stress can influence the impairing effects of acute stress on memory retrieval. This issue was tested in this study. Materials and Methods: Adult male Wistar rats were randomly assigned to the following groups: control, acute, chronic, and chronic + acute stress groups. The rats were trained with six trials per day for 6 consecutive days in the water maze. Following training, the rats were either kept in control conditions or exposed to chronic stress in a restrainer 6 hr/day for 21 days. On day 22, a probe test was done to measure memory retention. Time spent in target and opposite areas, platform location latency, and proximity were used as indices of memory retention. To induce acute stress, 30 min before the probe test, animals received a mild footshock. Results: Stressed animals spent significantly less time in the target quadrant and more time in the opposite quadrant than control animals. Moreover, the stressed animals showed significantly increased platform location latency and proximity as compared with control animals. No significant differences were found in these measures among stress exposure groups. Finally, both chronic and acute stress significantly increased corticosterone levels. Conclusion: Our results indicate that both chronic and acute stress impair memory retrieval similarly. Additionally, the impairing effects of chronic stress on memory retrieval were not influenced by acute stress. PMID:27635201

  1. Acute aortic syndromes: definition, prognosis and treatment options.

    PubMed

    Carpenter, S W; Kodolitsch, Y V; Debus, E S; Wipper, S; Tsilimparis, N; Larena-Avellaneda, A; Diener, H; Kölbel, T

    2014-04-01

    Acute aortic syndromes (AAS) are life-threatening vascular conditions of the thoracic aorta presenting with acute pain as the leading symptom in most cases. The incidence is approximately 3-5/100,000 in western countries with increase during the past decades. Clinical suspicion for AAS requires immediate confirmation with advanced imaging modalities. Initial management of AAS addresses avoidance of progression by immediate medical therapy to reduce aortic shear stress. Proximal symptomatic lesions with involvement of the ascending aorta are surgically treated in the acute setting, whereas acute uncomplicated distal dissection should be treated by medical therapy in the acute period, followed by surveillance and repeated imaging studies. Acute complicated distal dissection requires urgent invasive treatment and thoracic endovascular aortic repair has become the treatment modality of choice because of favorable outcomes compared to open surgical repair. Intramural hematoma, penetrating aortic ulcers, and traumatic aortic injuries of the descending aorta harbor specific challenges compared to aortic dissection and treatment strategies are not as uniformly defined as in aortic dissection. Moreover these lesions have a different prognosis. Once the acute period of aortic syndrome has been survived, a lifelong medical treatment and close surveillance with repeated imaging studies is essential to detect impending complications which might need invasive treatment within the short-, mid- or long-term.

  2. Acute bacterial parotitis following acute stroke.

    PubMed

    Lee, V K; Kimbrough, D J; Jarquin-Valdivia, A A

    2009-06-01

    Acute bacterial parotitis (ABP) is a relatively uncommon condition that tends to occur in debilitated older patients. We report a case of an older woman that presented with an acute intracerebral hemorrhage who developed ABP. This morbidity led to endotracheal intubation, mechanical ventilation, tracheostomy and gastrostomy, all of which were not initially needed. We discuss the proposed physiopathology and etiopathogenesis of ABP in adults.

  3. Effects of inorganic iron and myoglobin on in vitro proximal tubular lipid peroxidation and cytotoxicity.

    PubMed

    Zager, R A; Foerder, C A

    1992-03-01

    Recent in vivo studies suggest that heme Fe causes proximal tubular lipid peroxidation and cytotoxicity, thereby contributing to the pathogenesis of myoglobinuric (Mgb) acute renal failure. Because hydroxyl radical (.OH) scavengers [dimethylthiourea (DMTU), benzoate, mannitol] can mitigate this injury, it is postulated that .OH is a mediator of Mgb-induced renal damage. The present study has tested these hypotheses using an isolated rat proximal tubular segment (PTS) system. An equal mixture of Fe2+/Fe3+ (4 mM total), when added to PTS, caused marked cytotoxicity [as defined by lactate dehydrogenase (LDH) release] and lipid peroxidation [assessed by malondialdehyde (MDA) increments]. Fe2+ or Fe3+ alone each induced massive MDA elevations, but only Fe2+ caused cytotoxicity. Although both DMTU and benzoate decreased LDH release during the Fe2+/Fe3+ challenge, mannitol and GSH did not, despite equivalent reductions in .OH (gauged by the salicylate trap method). GSH and catalase (but not DMTU, benzoate, or mannitol) decreased MDA concentrations, suggesting the Fe-driven lipid peroxidation was more H2O2 than .OH dependent. Deferoxamine totally blocked Fe-induced LDH release, even under conditions in which it caused an apparent increase in .OH generation. Mgb paradoxically protected against Fe-mediated PTS injury, an effect largely reproduced by albumin. In conclusion, these data suggest that: (a) Fe can cause PTS lipid peroxidation and cytotoxicity by a non-.OH-dependent mechanism; (b) Fe-mediated cytotoxicity and lipid peroxidation are not necessarily linked; and (c) Mgb paradoxically protects PTS against Fe-mediated injury, suggesting that: (i) Mgb Fe may require liberation from its porphyrin ring before exerting toxicity; and (ii) the protein residue may blunt the resulting injury.

  4. Acute Lymphocytic Leukemia

    MedlinePlus

    ... hard for blood to do its work. In acute lymphocytic leukemia (ALL), also called acute lymphoblastic leukemia, there are too ... of white blood cells called lymphocytes or lymphoblasts. ALL is the most common type of cancer in ...

  5. Acute arterial occlusion - kidney

    MedlinePlus

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  6. Acute kidney failure

    MedlinePlus

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

  7. Acute phosphate nephropathy.

    PubMed

    Monfared, Ali; Habibzadeh, Seyed Mahmoud; Mesbah, Seyed Alireza

    2014-05-01

    We present acute phosphate nephropathy in a 28-year-old man, which was developed after a car accident due to rhabdomyolysis. Treatment of acute kidney injury was done with administration of sodium bicarbonate.

  8. Acute Pancreatitis and Pregnancy

    MedlinePlus

    ... and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as the sudden inflammation ... the incidence of recurrent attacks minimized. Timothy Gardner, MD is Director of Pancreatic Disorders at Dartmouth-Hitchcock ...

  9. Acute Appendicitis in Patients with Acute Leukemia

    PubMed Central

    Kim, Ki Up; Kim, Jin Kyeung; Won, Jong Ho; Hong, Dae Sik; Park, Hee Sook; Park, Kyeung Kyu

    1993-01-01

    The decision to operate for abdominal pain in patients with leukopenia can be exceedingly difficult. Surgical exploration may be the only effective way to differentiate acute appendicitis from other causes, but it involves considerable risk of infectious complications due to immunesuppression. Leukemic patients, who presented significant RLQ pain, had been indicated for operation, despite having advanced disease or having had received chemotherapy or steroids. Four adult leukemia patients, complicated by acute appendictis, were reviewed. Two patients were in induction chemotherapy, one receiving salvage chemotheapy due to relapse and the other was in conservative treatment. Two patients were acute myelocytic leukemia (AML), one had acute lymphocytic leukemia (ALL), and the other had aleukemic leukemia. All patients underwent appendectomy and recovered without complication. Our experience supports the theory that the surgical management of appendicitis in acute leukemia is the most effective way, in spite of leukopenia. PMID:8268146

  10. The Utility of Proximal-Accretion Stratigraphy in Lateral Moraines

    NASA Astrophysics Data System (ADS)

    Samolczyk, M. A.; Osborn, G.

    2010-12-01

    Lateral-moraine stratigraphy is a valuable tool that can be used to constrain the timing and magnitude of alpine glacier fluctuations. Numerous lateral moraines, conventionally thought to have been constructed during the Little Ice Age (LIA), have been shown to be composite landforms that contain multiple till layers deposited by successively larger glacier advances. Organic matter and/or tephra sandwiched between the till layers constrain times of advance and retreat; wood fragments within till may provide the age of the till. Observation of contemporary lateral moraines has lead to the recognition of two means of lateral moraine construction: (1) accretion of tills onto the distal flank of the pre-existing lateral moraine, and (2) accretion or plastering of tills onto the proximal flank of the pre-existing moraine. In composite lateral moraines, distal and proximal accretion result in paleosurfaces that trend parallel to the current distal and proximal slope, respectively. Published work using lateral-moraine stratigraphy, for example at Bugaboo and Stutfield glaciers in the Canadian Rockies, has used evidence only from distal-accretion moraines. However, proximal-accretion moraines that provide chronological information have been found at Nisqually Glacier on Mount Rainier in Washington State, USA, and Columbia Glacier, an outlet of the Columbia Icefield in the Canadian Rockies. A gully cut into the left-lateral moraine at Nisqually Glacier exposes a sandy seam, with associated wood fragments, that runs parallel to the proximal moraine flank for ~20 m. Wood collected from different elevations along the seam have radiocarbon ages of 1715±15, 1700±15, and 1670±50 14C yr BP, indicating that the seam is similar in age along its extent and likely marks a paleosurface separating older till below and till of the First Millennium advance above. At Columbia Glacier, some till exposures in the prominent right-lateral moraine show a fissility dipping variably 40 to 50

  11. Proximate and landscape factors influence grassland bird distributions

    USGS Publications Warehouse

    Cunningham, M.A.; Johnson, D.H.

    2006-01-01

    Ecologists increasingly recognize that birds can respond to features well beyond their normal areas of activity, but little is known about the relative importance of landscapes and proximate factors or about the scales of landscapes that influence bird distributions. We examined the influences of tree cover at both proximate and landscape scales on grassland birds, a group of birds of high conservation concern, in the Sheyenne National Grassland in North Dakota, USA. The Grassland contains a diverse array of grassland and woodland habitats. We surveyed breeding birds on 2015 100 m long transect segments during 2002 and 2003. We modeled the occurrence of 19 species in relation to habitat features (percentages of grassland, woodland, shrubland, and wetland) within each 100-m segment and to tree cover within 200-1600 m of the segment. We used information-theoretic statistical methods to compare models and variables. At the proximate scales, tree cover was the most important variable, having negative influences on 13 species and positive influences on two species. In a comparison of multiple scales, models with only proximate variables were adequate for some species, but models combining proximate with landscape information were best for 17 of 19 species. Landscape-only models were rarely competitive. Combined models at the largest scales (800-1600 m) were best for 12 of 19 species. Seven species had best models including 1600-m landscapes plus proximate factors in at least one year. These were Wilson's Phalarope (Phalaropus tricolor), Sedge Wren (Cistothorus platensis), Field Sparrow (Spizella pusilla), Grasshopper Sparrow (Ammodramus savannarum), Bobolink (Dolychonix oryzivorus), Red-winged Blackbird (Agelaius phoeniceus), and Brown-headed Cowbird (Molothrus ater). These seven are small-bodied species; thus larger-bodied species do not necessarily respond most to the largest landscapes. Our findings suggest that birds respond to habitat features at a variety of

  12. Proximate and landscape factors influence grassland bird distributions.

    PubMed

    Cunningham, Mary Ann; Johnson, Douglas H

    2006-06-01

    Ecologists increasingly recognize that birds can respond to features well beyond their normal areas of activity, but little is known about the relative importance of landscapes and proximate factors or about the scales of landscapes that influence bird distributions. We examined the influences of tree cover at both proximate and landscape scales on grassland birds, a group of birds of high conservation concern, in the Sheyenne National Grassland in North Dakota, USA. The Grassland contains a diverse array of grassland and woodland habitats. We surveyed breeding birds on 2015 100 m long transect segments during 2002 and 2003. We modeled the occurrence of 19 species in relation to habitat features (percentages of grassland, woodland, shrubland, and wetland) within each 100-m segment and to tree cover within 200-1600 m of the segment. We used information-theoretic statistical methods to compare models and variables. At the proximate scales, tree cover was the most important variable, having negative influences on 13 species and positive influences on two species. In a comparison of multiple scales, models with only proximate variables were adequate for some species, but models combining proximate with landscape information were best for 17 of 19 species. Landscape-only models were rarely competitive. Combined models at the largest scales (800-1600 m) were best for 12 of 19 species. Seven species had best models including 1600-m landscapes plus proximate factors in at least one year. These were Wilson's Phalarope (Phalaropus tricolor), Sedge Wren (Cistothorus platensis), Field Sparrow (Spizella pusilla), Grasshopper Sparrow (Ammodramus savannarum), Bobolink (Dolychonix oryzivorus), Red-winged Blackbird (Agelaius phoeniceus), and Brown-headed Cowbird (Molothrus ater). These seven are small-bodied species; thus larger-bodied species do not necessarily respond most to the largest landscapes. Our findings suggest that birds respond to habitat features at a variety of

  13. Interlaminated ice-proximal glacimarine sediments in Muir Inlet, Alaska

    USGS Publications Warehouse

    Mackiewicz, N.E.; Powell, R.D.; Carlson, P.R.; Molnia, B.F.

    1984-01-01

    Muir Inlet in Glacier Bay, Alaska, is a glacial fjord receiving a tremendous volume of sediment annually. The rate of sediment accumulation is greatest proximal to Muir Glacier (about 9 m yr-1) and decreases away from the glacier. The primary sediment sources are meltwater streams discharging at subglacial and ice-marginal positions to form overflows, interflows, and underflows (continuous turbidity currents). Overflows and interflows interact with diurnal tidal currents and their volume and sediment concentration varies diurnally and annually with meltwater discharge. These effects produce cyclic deposits of a thin fine-grained sand or silt lamina that grades normally to a thicker poorly to very poorly sorted mud lamina. This lamina couplet is termed a cyclopel. Underflows are suggested to occur in this glacimarine environment because of conditions unique to subglacial fluvial systems. Underflow deposits occur only in proximal positions (177 ??m) is ubiquitous, though low (<5% by weight), and occurs as isolated particles, frozen pellets, or as lenses that in cores may have a lamina appearance. Proximally, ice-rafted debris is difficult to identify because proximal sediment is often as coarse-grained. Deposited sediment may be reworked by tidal currents, and sediment gravity flows. Depositional processes operating in Muir Inlet produce interlaminated sand/silt/clay that characterizes sediment proximal to a glacier and fines seaward to mud. Sediment is classified into one of three sediment types: 1. (1) Type I sediment is very fine grained (mean 8.65-7.17 ??), low in sand (0.1-11.2%), and very poorly to poorly sorted. It is the dominant sediment type in Muir Inlet, and is transported by plumes and deposited by suspension settling. 2. (2) Type II sediment is fine- to coarse-grained (mean 6.70-3.12 ??), low to high in sand (5.1-86.6%), and very poorly to moderately sorted. It represents reworked sediment, proximal plume deposits, or coarse-grained laminae of cyclopels

  14. Cryptosporidium, chronic diarrhoea and the proximal small intestinal mucosa.

    PubMed Central

    Phillips, A D; Thomas, A G; Walker-Smith, J A

    1992-01-01

    The association between Cryptosporidium, chronic diarrhoea and a proximal small intestinal mucosal enteropathy was reviewed over a six and a half year period. One hundred and twenty three children with cryptosporidiosis and no clinical evidence of immune deficiency were identified. 50% of children excreting only Cryptosporidium had chronic diarrhoea. Most cases (63%) of chronic diarrhoea occurred in the first two years of life. A mild to moderate enteropathy was present in all nine children undergoing a small intestinal biopsy and seven showed the presence of Cryptosporidium adhering to villous epithelium. All patients eventually recovered spontaneously. Cryptosporidium is a cause of chronic diarrhoea and a proximal small intestinal mucosal enteropathy in children without immune deficiency. Screening for the parasite should be part of the investigative procedures in children with chronic diarrhoea. Images Figure 4 PMID:1398230

  15. Ionic requirements of proximal tubular sodium transport. II. Hydrogen ion.

    PubMed

    Green, R; Giebisch, G

    1975-11-01

    Simultaneous perfusion to proximal convoluted tubules and peritubular capillaries was used to study the effects of different perfusion fluids on sodium reabsorption and hydrogen secretion, which was calculated as bicarbonate reabsorption and titratable acid. Results show that sodium reabsorption was not tightly coupled to hydrogen secretion. Bicarbonate stimulates both sodium reabsorption and hydrogen secretion, but Tris stimulates only sodium reabsorption. Imposing an adverse chloride gradient across the proximal tubule (C1- peritubular greater than C1- luminal) decreased sodium reabsorption but did not diminish hydrogen secretion. Diamox inhibited both net sodium and hydrogen transport. It is concluded that there is not firm linkage between sodium reabsorption and hydrogen secretion and that bicarbonate probably stimulates sodium transport by a number of mechanisms, including an effect on the sodium transport unrelated to its ability to increase hydrogen ion secretion.

  16. Upgrade of the proximity focusing RICH at Jlab

    SciTech Connect

    Cisbani, Evaristo; Colilli, Stefano; Cusanno, Francesco; Fratoni, Rolando; Frullani, Salvatore; Garibaldi, Franco; Giuliani, Fausto; Gricia, Massimo; Lucentini, Maurizio; Santavenere, Fabio; Urciuoli, Guido; Iodice, Mauro; Argentieri, A.; de Cataldo, Giacinto; De Leo, Raffaele; Lagamba, Luigi; Marrone, Stefano; Nappi, E.; Camsonne, Alexandre; Kross, Brian; Michaels, Robert; Reitz, Bodo; Segal, John; Wojtsekhowski, Bogdan; Zorn, Carl; Monno, E.; Breuer, Herbert

    2009-09-01

    The Hall A RICH at Jefferson Lab is undergoing an upgrade to adapt to the higher momentum kinematics of the neutron spin structure Transversity experiments planned to run in 2008. The JLab RICH is a proximity focusing detector using liquid C6F14 as Cherenkov radiator, a thin layer of CsI as photon converter, evaporated on segmented pad panels of a proportional chamber. The original RICH had a superior hadron identification up to 2 GeV/c with pion/kaon rejection at the level of 1:1000 at ~ similar90% intrinsic efficiency. The upgrade will extend this performance above 2.4 GeV/c by means of a larger photon detector (a multiwire-multipad proportional chamber) and a longer proximity gap which will improve the photon detection geometrical efficiency and the angular resolution, respectively.

  17. STRaND-2: Visual inspection, proximity operations & nanosatellite docking

    NASA Astrophysics Data System (ADS)

    Bridges, C. P.; Taylor, B.; Horri, N.; Underwood, C. I.; Kenyon, S.; Barrera-Ars, J.; Pryce, L.; Bird, R.

    The Surrey Training Research and Nanosatellite Demonstrator (STRaND) programme has been success in identifying and creating a leading low-cost nanosatellite programme with advanced attitude and orbit control system (AOCS) and experimental computing platforms based on smart-phone technologies. The next demonstration capabilities, that provide a challenging mission to the existing STRaND platform, is to perform visual inspection, proximity operations and nanosatellite docking. Visual inspection is to be performed using a COTS LIDAR system to estimate range and pose under 100 m. Proximity operations are controlled using a comprehensive guidance, navigation and control (GNC) loop in a polar form of the Hills Clohessy Wiltshire (HCW) frame including J2 perturbations. And finally, nanosatellite docking is performed at under 30 cm using a series of tuned magnetic coils. This paper will document the initial experiments and calculations used to qualify LIDAR components, size the mission thrust and tank requirements, and air cushion table demonstrations of the docking mechanism.

  18. Longitudinal Proximity Effects in Superconducting Transition-Edge Sensors

    NASA Technical Reports Server (NTRS)

    Sadlier, John E.; Smith, Stephen J.; Bandler, Simon R.; Chervenak, James A.; Clem, John R.

    2009-01-01

    We have found experimentally that the critical current of a square thin-film superconducting transition-edge sensor (TES) depends exponentially upon the side length L and the square root of the temperature T, a behavior that has a natural theoretical explanation in terms of longitudinal proximity effects if the TES is regarded as a weak link between superconducting leads. As a consequence, the effective transition temperature T(sub c) of the TES is current-dependent and at fixed current scales as 1/L(sup 2). We also have found that the critical current can show clear Fraunhofer-like oscillations in an applied magnetic field, similar to those found in Josephson junctions. We have observed the longitudinal proximity effect in these devices over extraordinarily long lengths up to 290 micrometers, 1450 times the mean-free path.

  19. Longitudinal Proximity Effects in Superconducting Transition-Edge Sensors

    NASA Technical Reports Server (NTRS)

    Sadleir, John E.; Smith, Stephen J.; Bandler, SImon R.; Chervenak, James A.; Clem, John R.

    2009-01-01

    We have found experimentally that the critical current of a square superconducting transition-edge sensor (TES) depends exponentially upon the side length L and the square root of the temperature T. As a consequence, the effective transition temperature T(sub c) of the TES is current-dependent and at fixed current scales as 1/L(sup 2). We also have found that the critical current can show clear Fraunhofer-like oscillations in an applied magnetic field, similar to those found in Josephson junctions. The observed behavior has a natural theoretical explanation in terms of longitudinal proximity effects if the TES is regarded as a weak link between superconducting leads. We have observed the proximity effect in these devices over extraordinarily long lengths exceeding 100 microns.

  20. Longitudinal Proximity Effects in Superconducting Transition-Edge Sensors

    NASA Technical Reports Server (NTRS)

    Sadleir, John E.; Smith, Stephen J.; Bandler, Simon R.; Chervenak, James A.; Clem, John R.

    2010-01-01

    We have found experimentally that the critical current of a square thin-film superconducting transition-edge sensor (TES) depends exponentially upon the side length L and the square root of the temperature T, a behavior that has a natural theoretical explanation in terms of longitudinal proximity effects if the TES is regarded as a weak link between superconducting leads. As a consequence, the effective transition temperature T(sub c) of the TES is current-dependent and at fixed current scales as 1/L(sup 2). We also have found that the critical current can show clear Fraunhofer-like oscillations in an applied magnetic field, similar to those found in Josephson junctions. We have observed the longitudinal proximity effect in these devices over extraordinarily long lengths up to 290 micrometers, 1450 times the mean-free path.

  1. A critical assessment of proximal macrotexturing on cemented femoral components.

    PubMed

    Duffy, G P; Muratoglu, O K; Biggs, S A; Larson, S L; Lozynsky, A J; Harris, W H

    2001-12-01

    We analyzed the cement-metal interface of 3 different types of femoral components that had proximal macrotexturing after in vitro insertion and after fatigue testing designed to produce debonding and micromotion. These components were compared with clinical retrieval specimens. The cement did not flow into the macrotexturing; rather, hollow, brittle volcanoes or calderas were formed. These fragile protrusions of cement become worn down or abraded by debonded components. This abrasion of cement may contribute to the early and aggressive osteolysis seen in some of these early failures with proximal macrotextured components. The formation of these volcanos and calderas can be aborted by placing bone-cement onto the macrotexturing before stem insertion. This simple technique allows the macrotexturing to be filled with cement.

  2. Proximal symphalangism: Evidence of linkage to 17q

    SciTech Connect

    Francomano, C.A.; Rubenstein, J.R.; Polymeropoulos, M.H.

    1994-09-01

    Proximal symphalangism (PS; OMIM 185800) is an autosomal dominant disorder which is characterized by ankylosis of the proximal interphalangeal joints and an increased incidence of conductive deafness in some families. A large American kindred with PS was originally described by Cushing in 1916, segregating for this disorder in many generations. Several follow-up studies have confirmed the disorder in members of this kindred and have also suggested that conductive deafness is a pleiotropic effect of the mutant gene in this family. In an effort to localize the gene, we have studied 55 members of Cushing`s kindred with 85 microsatellite repeat polymorphisms spanning the human genome. Genetic linkage analysis with data for marker D17S809 gave significant evidence for linkage with Zmax=3.4 at recombination fraction {theta}=0.05.

  3. Rendezvous and Proximity Operations of the Space Shuttle

    NASA Technical Reports Server (NTRS)

    Goodman, John L.

    2005-01-01

    Space Shuttle rendezous missions presented unique challenges that were not fully recognized when the Shuttle was designed. Rendezvous targets could be passive (i.e., no lights or transponders), and not designed to facilitate Shuttle rendezvous, proximity operations and retrieval. Shuttle reaction control system jet plume impingement on target spacecraft presented induced dynamics, structural loading and contamination concerns. These issues, along with limited forward reaction control system propellant, drove a change from the Gemimi/Apollo coelliptic profile heritage to a stable orbit profile, and the development of new proximity operations techniques. Multiple scientific and on-orbit servicing missions and crew exchange, assembly and replinishment flights to Mir and to the International Space Station drove further profile and piloting technique changes, including new relative navigation sensors and new computer generated piloting cues.

  4. Synostosis of proximal phalangeal bases for loss of distal metacarpal

    PubMed Central

    Jindal, Pankaj

    2016-01-01

    A finger rendered unstable due to loss of metacarpal head can be stabilized by creating a synostosis at the base of the proximal phalanx of the affected finger with the adjacent normal finger. A cortico cancellous graft bridges the two adjacent proximal phalanges at their bases which are temporarily stabilized with an external fixator. The procedure can be done for, recurrence of giant cell tumor of metacarpal and for traumatic metacarpal loss. The procedure and long term follow up of one patient is presented who had giant cell tumor. This option should be considered before offering ray amputation. There is no micro vascular surgery involved, nor is there any donor site morbidity. The graft heals well without any absorption. The affected finger shows excellent function in the long term followup. PMID:27904227

  5. Space station proximity operations windows: Human factors design guidelines

    NASA Technical Reports Server (NTRS)

    Haines, Richard F.

    1987-01-01

    Proximity operations refers to all activities outside the Space Station which take place within a 1-km radius. Since there will be a large number of different operations involving manned and unmanned vehicles, single- and multiperson crews, automated and manually controlled flight, a wide variety of cargo, and construction/repair activities, accurate and continuous human monitoring of these operations from a specially designed control station on Space Station will be required. Total situational awareness will be required. This paper presents numerous human factors design guidelines and related background information for control windows which will support proximity operations. Separate sections deal with natural and artificial illumination geometry; all basic rendezvous vector approaches; window field-of-view requirements; window size; shape and placement criteria; window optical characteristics as they relate to human perception; maintenance and protection issues; and a comprehensive review of windows installed on U.S. and U.S.S.R. manned vehicles.

  6. Adamantinoma of the proximal femur: a case report.

    PubMed

    Ii, Sadao; Tsuchiya, Hiroyuki; Takazawa, Koutaro; Minato, Hiroshi; Tomita, Katsuro

    2004-01-01

    Adamantinoma is a rare low-grade malignant bone tumor with an indolent course. The tibia is involved in 85%-90% of long-bone cases. We encountered a patient with primary adamantinoma of the proximal femur. A 60-year-old woman fell and fractured her proximal left femur in the area of a cystic lesion. She underwent an osteosynthesis procedure, and bone union was obtained. After 3 years she developed pain in the left thigh, and a radiographic abnormality was found at the fracture site. A metastatic bone tumor was suspected, and curettage and cementing were carried out. Histologically, we found an epithelial component but failed to detect any primary cancer. Local recurrence became evident after another 6 years. A marginal excision was performed and a bipolar femoral prosthesis was implanted. We finally diagnosed the patient with adamantinoma. In this report we describe the characteristics of this tumor and discuss the reasoning concerning the differential diagnosis and therapeutic plan.

  7. PROXIMAL FEMORAL EPIPHYSIOLYSIS AND SUBCLINICAL HYPOTHYROIDISM: CASE REPORT

    PubMed Central

    de Mello, Grasiele Correa; Grossi, Gabriela; Coelho, Sílvio Pereira

    2015-01-01

    Proximal femoral epiphysiolysis is an orthopedic disease that is prevalent during adolescence, because this coincides with the time of greatest growth of osteomuscular structures. Curiously, some patients present this disease early, and this outcome converts to the possible etiological explanation that the slippage might occur through a growth spurt. For these patients, the genesis of the slippage has not yet been elucidated, but endocrine disorders have been noted as possible causes. In an attempt to strengthen the theory of endocrinological etiology and present the results from surgical treatment for this pathological condition, the case of a male patient aged 9 years and 3 months with proximal femoral epiphysiolysis and subclinical hypothyroidism who was diagnosed and treated at our university's teaching hospital is reported here. PMID:27047883

  8. Scintillation Proximity Radioimmunoassay Utilizing 125I-Labeled Ligands

    NASA Astrophysics Data System (ADS)

    Udenfriend, Sidney; Diekmann Gerber, Louise; Brink, Larry; Spector, Sydney

    1985-12-01

    A unique type of radioimmunoassay is described that does not require centrifugation or separation. Microbeads containing a fluorophor are covalently linked to antibody. When an 125I-labeled antigen is added it binds to the beads and, by its proximity, the emitted short-range electrons of the 125I excite the fluorophor in the beads. The light emitted can be measured in a standard scintillation counter. Addition of unlabeled antigen from tissue extracts displaces the labeled ligand and diminishes the fluorescent signal. Application of scintillation proximity immunoassay to tissue enkephalins, serum thyroxin, and urinary morphine is described. Applications of the principle to study the kinetics of interaction between receptors and ligands are discussed.

  9. Scintillation proximity radioimmunoassay utilizing 125I-labeled ligands

    SciTech Connect

    Udenfriend, S.; Gerber, L.D.; Brink, L.; Spector, S.

    1985-12-01

    A unique type of radioimmunoassay is described that does not require centrifugation or separation. Microbeads containing a fluorophor are covalently linked to antibody. When an /sup 125/I-labeled antigen is added it binds to the beads and, by its proximity, the emitted short-range electrons of the /sup 125/I excite the fluorophor in the beads. The light emitted can be measured in a standard scintillation counter. Addition of unlabeled antigen from tissue extracts displaces the labeled ligand and diminishes the fluorescent signal. Application of scintillation proximity immunoassay to tissue enkephalins, serum thyroxin, and urinary morphine is described. Applications of the principle to study the kinetics of interaction between receptors and ligands are discussed.

  10. Long range p -wave proximity effect into a disordered metal

    NASA Astrophysics Data System (ADS)

    Keser, Aydin Cem; Stanev, Valentin; Galitski, Victor

    2015-03-01

    We use quasiclassical methods of superconductivity to study the superconducting proximity effect from a topological p -wave superconductor into a disordered quasi-one-dimensional metallic wire. We demonstrate that the corresponding Eilenberger equations with disorder reduce to a closed nonlinear equation for the superconducting component of the matrix Green's function. Remarkably, this equation is formally equivalent to a classical mechanical system (i.e., Newton's equations), with the Green function corresponding to a coordinate of a fictitious particle and the coordinate along the wire corresponding to time. This mapping allows us to obtain exact solutions in the disordered nanowire in terms of elliptic functions. A surprising result that comes out of this solution is that the p -wave superconductivity proximity induced into the disordered metal remains long range, decaying as slowly as the conventional s -wave superconductivity. It is also shown that impurity scattering leads to the appearance of a zero-energy peak.

  11. Longitudinal proximity effects in superconducting transition-edge sensors.

    PubMed

    Sadleir, John E; Smith, Stephen J; Bandler, Simon R; Chervenak, James A; Clem, John R

    2010-01-29

    We have found experimentally that the critical current of a square thin-film superconducting transition-edge sensor (TES) depends exponentially upon the side length L and the square root of the temperature T, a behavior that has a natural theoretical explanation in terms of longitudinal proximity effects if the TES is regarded as a weak link between superconducting leads. As a consequence, the effective transition temperature T{c} of the TES is current dependent and at fixed current scales as 1/L{2}. We have also found that the critical current can show clear Fraunhofer-like oscillations in an applied magnetic field, similar to those found in Josephson junctions. We have observed the longitudinal proximity effect in these devices over extraordinarily long lengths up to 290 microm, 1450 times the mean-free path.

  12. Longitudinal Proximity Effects in Superconducting Transition-Edge Sensors

    SciTech Connect

    Sadleir, John E.; Smith, Stephen J.; Bandler, Simon R.; Chervenak, James A.; Clem, John R.

    2010-01-29

    We have found experimentally that the critical current of a square thin-film superconducting transition-edge sensor (TES) depends exponentially upon the side length L and the square root of the temperature T, a behavior that has a natural theoretical explanation in terms of longitudinal proximity effects if the TES is regarded as a weak link between superconducting leads. As a consequence, the effective transition temperature T{sub c} of the TES is current dependent and at fixed current scales as 1/L{sup 2}. We have also found that the critical current can show clear Fraunhofer-like oscillations in an applied magnetic field, similar to those found in Josephson junctions. We have observed the longitudinal proximity effect in these devices over extraordinarily long lengths up to 290 {micro}m, 1450 times the mean-free path.

  13. [Pathological proximal femur fracture: consider also primary bone tumour].

    PubMed

    van de Sande, Michiel A J; van Rijswijk, Carla S P; Dijkstra, P D Sander; Taminiau, Antonie M H

    2010-01-01

    Two male and one female patient, aged 64, 70 and 51 respectively, were surgically treated for pathological fracture of the proximal femur without preoperative biopsy. In contrast to their benign radiological diagnosis, all three patients were finally diagnosed as having a malignant primary bone tumour. The proximal femur is the primary location of pathological fractures in the appendicular skeleton. Metastases to bone are the most common cause of a destructive lesion of the skeleton in an adult. Although rare, a primary bone tumour must be included in differential diagnosis of a pathological fracture. A systematic diagnostic strategy is critical to avoid complications that make curative treatment impossible. A solitary bone lesion seen on radiography should never be assumed to be a bone metastasis. Without further diagnostic research, surgical treatment for a pathological fracture should never be commenced before a definitive diagnosis is made.

  14. Disproportionate Proximity to Environmental Health Hazards: Methods, Models, and Measurement

    PubMed Central

    Maantay, Juliana A.; Brender, Jean D.

    2011-01-01

    We sought to provide a historical overview of methods, models, and data used in the environmental justice (EJ) research literature to measure proximity to environmental hazards and potential exposure to their adverse health effects. We explored how the assessment of disproportionate proximity and exposure has evolved from comparing the prevalence of minority or low-income residents in geographic entities hosting pollution sources and discrete buffer zones to more refined techniques that use continuous distances, pollutant fate-and-transport models, and estimates of health risk from toxic exposure. We also reviewed analytical techniques used to determine the characteristics of people residing in areas potentially exposed to environmental hazards and emerging geostatistical techniques that are more appropriate for EJ analysis than conventional statistical methods. We concluded by providing several recommendations regarding future research and data needs for EJ assessment that would lead to more reliable results and policy solutions. PMID:21836113

  15. Copper in silicon: Quantitative analysis of internal and proximity gettering

    SciTech Connect

    McHugo, S.A.; Flink, C.; Weber, E.R.

    1997-08-01

    The behavior of copper in the presence of a proximity gettering mechanism and a standard internal gettering mechanism in silicon was studied. He implantation-induced cavities in the near surface region were used as a proximity gettering mechanism and oxygen precipitates in the bulk of the material provided internal gettering sites. Moderate levels of copper contamination were introduced by ion implantation such that the copper was not supersaturated during the anneals, thus providing realistic copper contamination/gettering conditions. Copper concentrations at cavities and internal gettering sites were quantitatively measured after the annealings. In this manner, the gettering effectiveness of cavities was measured when in direct competition with internal gettering sites. The cavities were found to be the dominant gettering mechanism with only a small amount of copper gettered at the internal gettering sites. These results reveal the benefits of a segregation-type gettering mechanism for typical contamination conditions.

  16. Pediatric Scaphoid Proximal Pole Nonunion With Avascular Necrosis.

    PubMed

    Jernigan, Edward W; Smetana, Brandon S; Patterson, J Megan M

    2016-12-24

    A 13-year-old, right hand-dominant, otherwise healthy boy presented with left wrist pain 19 months after a nonmotorized scooter injury. Radiographs and magnetic resonance imaging at presentation demonstrated proximal pole scaphoid nonunion with avascular necrosis of the proximal fragment. Operative and nonsurgical treatment options were discussed and the family elected for an attempt at nonsurgical management. The patient was placed in a short-arm thumb spica cast, with a window for a bone stimulator, for 14 weeks. At the conclusion of the treatment, the pain had resolved and x-ray and computed tomography scan demonstrated bony union. The authors recommend considering an initial trial of nonsurgical management for treatment of all pediatric scaphoid nonunions.

  17. Proximity- and Astigmatism-Tolerant Testsites For Electrical Linewidth Measurement

    NASA Astrophysics Data System (ADS)

    Lin, Burn J.

    1989-07-01

    Electrical linewidth measurement is well-known for high precision and throughput. However, the standard four-point probe testsite is only useful for measuring the width of an isolated conducting line. Line-and-space and isolated spaces can be simulated satisfactorily by adding dummy lines parallel to the active line but weak links or potential electrical shorting situations often prematurely cause these structures to fail before their true limits are reached. In this paper, fully wrapped proximity- and astigmatism-tolerant designs for line-and-space and isolated spaces are shown. They have been successfully demonstrated with printed images. An application in evaluating the exposure-defocus window of a one-layer i-line resist using the proximity-tolerant testsites is given.

  18. [Proximal and distal rupture of the m. biceps brachii].

    PubMed

    Lorbach, O; Kieb, M; Grim, C; Engelhardt, M

    2010-12-01

    Ruptures of the biceps tendon account for a high percentage of tendon ruptures. The aetiology of proximal ruptures of the long head of the biceps tendon is often degenerative and they are frequently associated with lesions of the rotator cuff. The clinical findings are often not specific and long lasting. Distal ruptures of the biceps tendon mostly occur during eccentric contraction of the biceps muscle.Clinical tests, the associated haematoma and a distalisation or proximalisation of the muscle belly in combination with ultrasound or MRI to rule out combined diseases lead to the diagnosis. The possible options include conservative and operative treatment. Tenotomy and tenodesis lead to comparable results in the literature. Therefore, conservative treatment is mostly recommended in proximal ruptures. Operative treatment is preferred in distal ruptures of the biceps tendon in order to achieve an anatomical reconstruction of the muscle function. Chronic ruptures of the distal biceps tendon can be successfully treated with free autografts or allografts.

  19. Proximity nanovalve with large phase-tunable thermal conductance

    SciTech Connect

    Strambini, E. Giazotto, F.; Bergeret, F. S.

    2014-08-25

    We propose a phase-controlled heat-flux quantum valve based on the proximity effect driven by a superconducting quantum interference proximity transistor (SQUIPT). Its operation relies on the phase-dependent quasiparticle density of states in the Josephson weak-link of the SQUIPT which controls thermal transport across the device. In a realistic Al/Cu-based setup the structure can provide efficient control of thermal current inducing temperature swings exceeding ∼100 mK, and flux-to-temperature transfer coefficients up to ∼500 mK/Φ{sub 0} below 100 mK. The nanovalve performances improve by lowering the bath temperature, making the proposed structure a promising building-block for the implementation of coherent caloritronic devices operating below 1 K.

  20. Proximity potential for heavy ion reactions on deformed nuclei

    SciTech Connect

    Baltz, A. J.; Bayman, B. F.

    1982-01-01

    The usual treatment of the deformed optical model for analysis of heavy ion induced inelastic scattering data involves a deformed (target) radius, a spherical (projectile) radius and a potential strength dependent on the surface separation along the line between the two centers. Several authors using various approaches have shown that this center line potential is geometrically inadequate especially for description of higher L deformation parameters probed in heavy ion induced inelastic scattering experiments. A quantitatively adequate form of the deformed proximity potential suitable for use with a coupled channels reaction code in the analysis of inelastic scattering data above the Coulomb barrier is described. A major objective is to be able to extract reliably higher deformed multipole moments from such data. The deformed potential calculated in the folding model will serve as a geometrically exact benchmark to evaluate the accuracy of the proximity potential prescriptions. (WHK)

  1. Superconducting proximity effect for in situ and model layered systems

    SciTech Connect

    Finnemore, D.K.

    1980-01-01

    The primary drawback for in situ composites is that the ac losses are higher than for mechanically produced multifilamentary wire. To develop an understanding of the proximity effect so that analytical expressions will be available for design, a model system is developed based on PbCd. Items discussed include boundary conditions at SN interface, phonon spectral function, supercurrents through normal barriers, flux entry fields, and implications for in situ composites. (GHT)

  2. Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis

    PubMed Central

    Garg, Gaurav; Gupta, Som P.

    2015-01-01

    Background: Presentation of proximal radioulnar synostosis varies from cosmetic concerns with no functional limitations to significant pronation deformity which hampers activities of daily living. Surgical management must be considered based on the position of the forearm and functional limitations. We describe the surgical technique, results, and complications of excision of the radial head along with the proximal radius up to the distal extent of the synostosis site and securing the osteotomized radial shaft with a tensor fascia lata graft. Materials and methods: Four patients having six affected elbows with delayed presentation of congenital proximal radioulnar synostosis with dislocated radial head managed surgically were included in the study. There were three males and one female with an average age of 20.25 years (ranging from 16 to 25 years). Preoperatively wrists were locked in the mean pronation position of 51.6° (ranging from 30° to 70°). The indications for surgery were limitation in activities of daily living and an obvious cosmetic deformity. Results: All patients were satisfied with the surgery and showed significant improvement in functional status. Mean active supination was 15° (ranging from 5 to 32°) with passive supination was a mean of 24.8° (ranging from 11° to 44°). Similarly, mean active pronation was 58.5° (ranging from 50° to 71°) with further passive correction up to a mean of 64.16° (ranging from 57° to 87°) at last follow up. Conclusions: This procedure is simple, cost effective, and a reasonable option for treatment of proximal radioulnar synostosis with a dislocated radial head in adult patients. The operation does not require any specialized team or implants, and can be performed in a moderately equipped hospital. PMID:27163088

  3. Stress fracture of the proximal fibula after total knee arthroplasty.

    PubMed

    Vaish, Abhishek; Vaishya, Raju; Agarwal, Amit Kumar; Vijay, Vipul

    2016-04-22

    We report a rare case of proximal fibular fatigue fracture developing 14 years after total knee arthroplasty in a known case of rheumatoid arthritis. A valgus deformity of the knee can put abnormal stress on the upper fibula leading to its failure. We believe that, as the fibula acts as an important lateral strut, its disruption due to a fracture led to rapid progress of the valgus deformity of the knee in this patient.

  4. Lung cancer, proximity to industry, and poverty in northeast England.

    PubMed Central

    Pless-Mulloli, T; Phillimore, P; Moffatt, S; Bhopal, R; Foy, C; Dunn, C; Tate, J

    1998-01-01

    This study assesses whether deprived populations living close to industry experience greater mortality from lung cancer than populations with comparable socioeconomic characteristics living farther away. Mortality data, census data, a postal survey of living circumstances, historic and contemporary data on air quality and a historic land-use survey were used. Analysis was based on two conurbations in England, Teesside and Sunderland. Housing estates in Teesside were selected based on socioeconomic criteria and distinguished by proximity to steel and chemical industries; they were grouped into three zones: near (A), intermediate (B), and farther (C), with a single zone in Sunderland. We included 14,962 deaths in 27 estates. Standardized mortality ratios (SMR) for lung cancer [International Classification of Diseases #9 (ICD-9) 162] and cancers other than lung (ICD-9 140-239, excluding 162), and sex ratios were calculated. Mortality from lung cancer was well above national levels in all zones. For men, a weak gradient corresponding with proximity to industry at younger ages reversed at older ages. In women 0-64 years of age, stronger gradients in lung cancer mortality corresponded with proximity to industry across zones A, B, and C (SMR = 393, 251, 242, respectively). Overall rates in Teesside were higher than Sunderland rates for women aged 0-64 years (SMR = 287 vs. 185) and 65-74 years (SMR = 190 vs. 157). The association between raised lung cancer mortality and proximity to industry in women under 75 years of age could not be explained by smoking, occupation, socioeconomic factors, or artifact. Explanations for differences between men and women may include gender-specific occupational experiences and smoking patterns. Our judgment is that the observed gradient in women points to a role for industrial air pollution. Images Figure 1 Figure 2 PMID:9485483

  5. Effect of Shock Proximity on Richtmyer-Meshkov Growth

    SciTech Connect

    Glendinning, S G; Bolstad, J; Braun, D G; Edwards, M J; Hsing, W W; Lasinski, B F; Louis, H; Miles, A; Moreno, J; Peyser, T A; Remington, B A; Robey, H F; Turano, E J; Verdon, C P; Zhou, Y

    2002-10-31

    We report here experiments, conducted on the Omega laser [T.R. Boehly et al., Optics Commun. 133, 495 (1997)], and simulations that show reduced Richtmyer-Meshkov growth rates in a strongly shocked system with linear initial amplitudes (k{eta}{sub 0} {le} 0.9). The growth rate at early time is less than half the impulsive model prediction, rising at later time to near the impulsive prediction. An analytical model that accounts for shock proximity agrees with the results.

  6. A Proximate Biological Survey of San Diego Bay, California

    DTIC Science & Technology

    1975-01-01

    smoothhound) Carcharhinidac Galeorhinus zyoptems (soupfin sliark) Prionace glaum (blue sliark) Sphyrnidae Sphyrna zygaena ( hammerhead shark ...1 and 2, but an isolated group is also indicated in the south bay around station 10. The 28 Midshipman Bonito Sharks Croaker Bonito Figure 13...Species of fish most often collected at individual stat ions during Proximate Survey. 29 bonito and the sharks were taken, for the most part, at

  7. Distal and proximal factors related to aggression severity among patients in substance abuse treatment: family history, alcohol use and expectancies.

    PubMed

    Chermack, Stephen T; Wryobeck, John M; Walton, Maureen A; Blow, Frederic C

    2006-05-01

    This study examined the relationships among distal (paternal and maternal family history of alcohol problems and violence) and proximal (general alcohol use, acute use associated with conflict incidents, alcohol-aggression expectancies) factors and physical aggression severity among 125 men and 125 women recruited from substance abuse treatment. Paternal alcohol problem history (PA) was related to alcohol-aggression expectancies, but no family history factors were related to general or acute alcohol use. Separate analyses examining predictors of aggression were conducted, one with general alcohol use and one with acute alcohol use. In both analyses, alcohol use and the maternal violence (MV) by PA interaction were significant. Specifically, MV was associated with aggression severity for those with a history of PA. The general alcohol use model also revealed significant alcohol by expectancy and MV by gender interactions. The findings suggest that expectancies are not the primary mediator of the alcohol-aggression relationship, alcohol use measurement issues may impact whether expectancies are observed to moderate the alcohol-aggression relationship, and that both maternal and paternal family history factors appear to impact aggression severity.

  8. A fossil hominoid proximal femur from Kikorongo Crater, southwestern Uganda.

    PubMed

    DeSilva, Jeremy; Shoreman, Eleanor; MacLatchy, Laura

    2006-06-01

    The external morphology of a fragmentary right proximal femur from southwestern Uganda is described here. Discovered in the Kikorongo Crater of Queen Elizabeth National Park in 1961, this specimen was informally assigned to Homo sapiens (although never described) and tentatively dated to the late Pleistocene. However, because aspects of the external morphology of the femur align the fossil with the African great apes, we suggest that the Kikorongo femur may be the first postcranial fossil of the genus Pan. Like the African apes, the Kikorongo specimen lacks both an obturator externus groove and an intertrochanteric line. It has a short femoral neck with a circular cross section, and a narrow and deep superior notch. Using resampling statistics and discriminant function analysis, the Kikorongo femur clustered with the genus Pan, as opposed to Gorilla or Homo. However, if the specimen is from Pan, it would be large for this taxon. Furthermore, features that clearly distinguish the external morphology of Plio-Pleistocene hominin proximal femora from African ape femora, such as the shape of the femoral neck in cross section and femoral neck length, have converged in Holocene humans and African apes. Unfortunately, the internal morphology of the femoral neck of the Kikorongo fossil was not discernable. Although we hypothesize that the Kikorongo femur is from the genus Pan, there is such variability in the proximal femora of modern humans that, although it would be an unusual human, it remains possible that this fossil represents H. sapiens.

  9. The role of physical proximity in nosocomial diarrhea.

    PubMed

    Chang, V T; Nelson, K

    2000-09-01

    To examine physical proximity as a risk factor for the nosocomial acquisition of Clostridium difficile-associated diarrhea (CDAD) and of antibiotic-associated diarrhea (AAD), we assessed a retrospective cohort of 2859 patients admitted to a community hospital from 1 March 1987 through 31 August 1987. Of these patients, 68 had nosocomial CDAD and 54 had nosocomial AAD. In multivariate analysis, physical proximity to a patient with CDAD (relative risk [RR], 1.86; 95% confidence interval [CI], 1.06-3.28), exposure to clindamycin (RR, 4.22; 95% CI, 2.11-8.45), and the number of antibiotics taken (RR, 1.49; 95% CI, 1.23-1.81) were significant. For patients with nosocomial AAD, exposure to a roommate with AAD (RR, 3.94; 95% CI, 1. 27-12.24), a stay in an intensive care unit or cardiac care unit (RR, 1.93; 95% CI, 1.05-3.53), and the number of antibiotics taken (RR, 2.01; 95% CI, 1.67-2.40) were significant risk factors. Physical proximity may be an independent risk factor for acquisition of nosocomial CDAD and AAD.

  10. Risk factors and predictors of mortality for proximal humeral fractures

    PubMed Central

    Gooding, Benjamin WT; Manning, Paul A; Wallace, W Angus; Geoghegan, John M

    2014-01-01

    Background Risk factors for mortality after proximal humeral fracture, including socioeconomic status, are poorly defined. This retrospective review of prospectively collected data defines the epidemiology and predictors of mortality in association with proximal humeral fractures. Methods Patients who sustained proximal humeral fractures were identified from fragility fracture and trauma databases between May 2001 and September 2012. Results In total, 1880 patients with a mean age of 69 years and a male to female ratio of 2 : 3 were identified. Socioeconomic distribution is skewed towards the lowest and highest quintiles. Low-energy mechanisms caused 88% of fractures. Men sustain fractures when they are aged 10 years younger and via higher-energy mechanisms. In total, 536 patients (29%) died within the study period with a 1-year mortality of 9.8%, rising to 28.2% at 5 years. Female gender, increasing age, pathological fracture and increased number of co-morbidities were independent variables for increased mortality. Conclusions The present study, which was conducted over an 11-year period, is the first to combine the epidemiology and risk factors for mortality with socioeconomic rank. One-year mortality risk is twice that of the background matched population. Patient counselling with respect to increased mortality should be considered, especially in higher-risk elderly females with multiple co-morbidities. PMID:27582921

  11. Proximate and mineral content of restaurant steak meals.

    PubMed

    Green, E M; Appledorf, H

    1983-02-01

    Restaurant steak meals were analyzed for proximate and mineral composition by standard methodology. Nutritional adequacy of the meals was determined by comparing analyzed values with Recommended Dietary Allowances for adults. The meals were considered to be adequate in a nutrient if they provided at least one-third the RDA for that nutrient. Analyzed values were also compared with values obtained from food composition tables. The results of this study indicate that: 1. Restaurant steak meals differ significantly in weight of meal components, proximate components, and mineral components. 2. Although the meals were adequate in kilocalories and protein, they could be considered to be excessive since they provided more than 50% of the RDA for energy and more than 100% of the RDA for protein. 3. The meals can be considered inadequate in calcium for both men and women (only 16% of the RDA) and in iron for women (only 25% of the RDA). 4. Tables of food composition are useful in predicting the proximate and mineral composition of restaurant steak meals.

  12. Proximal femur segmentation in conventional pelvic x ray

    SciTech Connect

    Pilgram, Roland; Walch, Claudia; Kuhn, Volker; Schubert, Rainer; Staudinger, Roland

    2008-06-15

    A solid and accurate proximal femur segmentation technique using the popular active shape model (ASM) is proposed. For generating an optimal shape prior, the minimum description length, based on 200 supervised manual segmented proximal femur shapes, is used. The segmentation is based on a coarse to fine scaling technique including a profile scale space method. The segmentation results are compared using an optimal defined initial pose and a pose based on a registration technique. Using ideal template initialization, 95% of the shapes have been recovered exactly (average point-to-point error {approx}13 pixels, average point-to-boundary error {approx}7 pixels). Using a template-based initialization based on a registration technique, a successful segmentation rate of {approx}89% is achieved, with an average point-to-point error {approx}12 pixels, and an average point-to-boundary error {approx}8 pixels. With an adequate template initialization and an improved ASM, this method seems to provide an accurate tool for segmentation of the proximal femur shapes on conventional hip overview x-ray images.

  13. Reconstruction of the extensor mechanism after proximal tibia endoprosthetic replacement.

    PubMed

    Bickels, J; Wittig, J C; Kollender, Y; Neff, R S; Kellar-Graney, K; Meller, I; Malawer, M M

    2001-10-01

    The proximal tibia is a difficult area in which to perform a wide resection of a bone tumor. This difficulty is due to the intimate relationship of tumor in this location to the nerves and blood vessels of the leg, inadequate soft tissue coverage after endoprosthetic reconstruction, and the need to reconstruct the extensor mechanism. Competence of the extensor mechanism is the major determinant of functional outcome of these patients. Between 1980 and 1997, 55 patients underwent proximal tibia resection with endoprosthetic reconstruction for a variety of malignant and benign-aggressive tumors. Reconstruction of the extensor mechanism included reattachment of the patellar tendon to the prosthesis with a Dacron tape, reinforcement with autologous bone-graft, and attachment of an overlying gastrocnemius flap. All patients were followed for a minimum of 2 years; 6 patients (11%) had a transient peroneal nerve palsy, 4 patients (7.2%) had a fasciocutaneous flap necrosis, and 2 patients (3.6%) had a deep wound infection. Full extension to extension lag of 20 degrees was achieved in 44 patients, and 8 patients required secondary reinforcement of the patellar tendon. Function was estimated to be good to excellent in 48 patients (87%). Reattachment of the patellar tendon to the prosthesis and reinforcement with an autologous bone-graft and a gastrocnemius flap are reliable means to restore extension after proximal tibia endoprosthetic reconstruction.

  14. Using Protein-Confined Proximity To Determine Chemical Reactivity.

    PubMed

    Kobayashi, Tomonori; Hoppmann, Christian; Yang, Bing; Wang, Lei

    2016-11-16

    Chemical reactivity is essential for functional modification of biomolecules with small molecules and the development of covalent drugs. The reactivity between a chemical functional group of a small molecule and that of a large biomolecule cannot be reliably predicted from the reactivity of the corresponding functional groups separately installed on two small molecules, because the proximity effect on reactivity resulting from the binding of the small molecule to the biomolecule is challenging to achieve by mixing two small molecules. Here we present a new strategy to determine the chemical reactivity of two functional groups in the context of close proximity afforded by proteins. The functional groups to be tested were separately installed at the interface of two interacting proteins in the format of amino acid side chains via the expansion of the genetic code. Reaction of the two functional groups resulted in covalent cross-linking of interacting proteins, readily detectable by gel electrophoresis. Using this strategy, we evolved new synthetases to genetically encode N(ε)-fluoroacetyllysine (FAcK), an isosteric fluorine analogue of acetyllysine. We demonstrated that fluoroacetamide installed on FAcK, previously thought inert to biological functional groups, actually reacted with the thiol group of cysteine when in proximity. This strategy should be valuable for accurately evaluating chemical reactivity of small molecules toward large biomolecules, which will help avoid undesired side reactions of drugs and expand the repertoire of functional groups to covalently target biomolecules.

  15. Proximal Rectus Femoris Avulsion: Ultrasonic Diagnosis and Nonoperative Management

    PubMed Central

    Esser, Stephan; Jantz, David; Hurdle, Mark F.; Taylor, Walter

    2015-01-01

    Objective To present a case of ultrasonic diagnosis and nonoperative management of a complete proximal rectus femoris avulsion in a National Collegiate Athletic Association Division 1 soccer goalkeeper. Background While delivering a goal kick, a previously uninjured 24-year-old collegiate soccer goalkeeper had the sudden onset of right anterior thigh pain. He underwent rehabilitation with rapid resolution of his presenting pain but frequent intermittent recurrence of anterior thigh pain. After he was provided a definitive diagnosis with musculoskeletal ultrasound, he underwent an extended period of rehabilitation and eventually experienced complete recovery without recurrence. Differential Diagnosis Rectus femoris avulsion, rectus femoris strain or partial tear, inguinal hernia, or acetabular labral tear. Treatment Operative and nonoperative options were discussed. In view of the player's recovery, nonoperative options were pursued with a good result. Uniqueness Complete proximal rectus femoris avulsions are rare. Our case contributes to the debate on whether elite-level kicking and running athletes can return to full on-field performance without surgery. Conclusions Complete proximal rectus femoris avulsions can be treated effectively using nonoperative measures with good preservation of function even in the elite-level athlete. In addition, musculoskeletal ultrasound is an excellent tool for on-site evaluation and may help guide prognosis and management. PMID:25978099

  16. Effects of Hip Geometry on Fracture Patterns of Proximal Femur

    PubMed Central

    Kazemi, Seyyed Morteza; Qoreishy, Mohamad; Keipourfard, Ali; Sajjadi, Mohammadreza Minator; Shokraneh, Shahram

    2016-01-01

    Background: Some studies have previously shown that geometry of proximal femur can affect the probability of fracture and type of fracture. It happens since the geometry of the proximal femur determines how a force is applied to its different parts. In this study, we have compared proximal femur’s geometric characteristics in femoral neck (FNF), intertrochanteric (ITF) and Subtrochanteric (STF) fractures. Methods: In this study, 60 patients who had hip fractures were studied as case studies. They were divided into FNF, ITF and STF groups based on their fracture types (20 patients in each group). Patients were studied with x-ray radiography and CT scans. Radiological parameters including femoral neck length from lateral cortex to center of femoral head (FNL), diameter of femoral head (FHD), diameter of femoral neck (FND), femoral head neck offset (FHNO), neck-shaft angle (alpha), femoral neck anteversion (beta) were measured and compared in all three groups. Results: Amount of FNL was significantly higher in STF group compared to FNF (0.011) while ITF and STF as well as FNT and ITF did not show a significant different. Also, FND in FNF group was significantly lower than the other two groups, i.e. ITF and STF. In other cases there were no instances of significant statistical difference. Conclusion: Hip geometry can be used to identify individuals who are at the risk of fracture with special pattern. Also, it is important to have more studies in different populations and more in men. PMID:27517071

  17. Calcium transport in the rabbit superficial proximal convoluted tubule

    SciTech Connect

    Ng, R.C.; Rouse, D.; Suki, W.N.

    1984-09-01

    Calcium transport was studied in isolated S2 segments of rabbit superficial proximal convoluted tubules. 45Ca was added to the perfusate for measurement of lumen-to-bath flux (JlbCa), to the bath for bath-to-lumen flux (JblCa), and to both perfusate and bath for net flux (JnetCa). In these studies, the perfusate consisted of an equilibrium solution that was designed to minimize water flux or electrochemical potential differences (PD). Under these conditions, JlbCa (9.1 +/- 1.0 peq/mm X min) was not different from JblCa (7.3 +/- 1.3 peq/mm X min), and JnetCa was not different from zero, which suggests that calcium transport in the superficial proximal convoluted tubule is due primarily to passive transport. The efflux coefficient was 9.5 +/- 1.2 X 10(-5) cm/s, which was not significantly different from the influx coefficient, 7.0 +/- 1.3 X 10(-5) cm/s. When the PD was made positive or negative with use of different perfusates, net calcium absorption or secretion was demonstrated, respectively, which supports a major role for passive transport. These results indicate that in the superficial proximal convoluted tubule of the rabbit, passive driving forces are the major determinants of calcium transport.

  18. Hand proximity facilitates spatial discrimination of auditory tones

    PubMed Central

    Tseng, Philip; Yu, Jiaxin; Tzeng, Ovid J. L.; Hung, Daisy L.; Juan, Chi-Hung

    2014-01-01

    The effect of hand proximity on vision and visual attention has been well documented. In this study we tested whether such effect(s) would also be present in the auditory modality. With hands placed either near or away from the audio sources, participants performed an auditory-spatial discrimination (Experiment 1: left or right side), pitch discrimination (Experiment 2: high, med, or low tone), and spatial-plus-pitch (Experiment 3: left or right; high, med, or low) discrimination task. In Experiment 1, when hands were away from the audio source, participants consistently responded faster with their right hand regardless of stimulus location. This right hand advantage, however, disappeared in the hands-near condition because of a significant improvement in left hand's reaction time (RT). No effect of hand proximity was found in Experiments 2 or 3, where a choice RT task requiring pitch discrimination was used. Together, these results that the perceptual and attentional effect of hand proximity is not limited to one specific modality, but applicable to the entire “space” near the hands, including stimuli of different modality (at least visual and auditory) within that space. While these findings provide evidence from auditory attention that supports the multimodal account originally raised by Reed et al. (2006), we also discuss the possibility of a dual mechanism hypothesis to reconcile findings from the multimodal and magno/parvocellular account. PMID:24966839

  19. Progenitor Cells in Proximal Airway Epithelial Development and Regeneration

    PubMed Central

    Lynch, Thomas J.; Engelhardt, John F.

    2015-01-01

    Multiple distinct epithelial domains are found throughout the airway that are distinguishable by location, structure, function, and cell-type composition. Several progenitor cell populations in the proximal airway have been identified to reside in confined microenvironmental niches including the submucosal glands (SMGs), which are embedded in the tracheal connective tissue between the surface epithelium and cartilage, and basal cells that reside within the surface airway epithelium (SAE). Current research suggests that regulatory pathways that coordinate development of the proximal airway and establishment of progenitor cell niches may overlap with pathways that control progenitor cell responses during airway regeneration following injury. SMGs have been shown to harbor epithelial progenitor cells, and this niche is dysregulated in diseases such as cystic fibrosis. However, mechanisms that regulate progenitor cell proliferation and maintenance within this glandular niche are not completely understood. Here we discuss glandular progenitor cells during development and regeneration of the proximal airway and compare properties of glandular progenitors to those of basal cell progenitors in the SAE. Further investigation into glandular progenitor cell control will provide a direction for interrogating therapeutic interventions to correct aberrant conditions affecting the SMGs in diseases such as cystic fibrosis, chronic bronchitis, and asthma. PMID:24818588

  20. Acute loss of consciousness.

    PubMed

    Tristán, Bekinschtein; Gleichgerrcht, Ezequiel; Manes, Facundo

    2015-01-01

    Acute loss of consciousness poses a fascinating scenario for theoretical and clinical research. This chapter introduces a simple yet powerful framework to investigate altered states of consciousness. We then explore the different disorders of consciousness that result from acute brain injury, and techniques used in the acute phase to predict clinical outcome in different patient populations in light of models of acute loss of consciousness. We further delve into post-traumatic amnesia as a model for predicting cognitive sequels following acute loss of consciousness. We approach the study of acute loss of consciousness from a theoretical and clinical perspective to conclude that clinicians in acute care centers must incorporate new measurements and techniques besides the classic coma scales in order to assess their patients with loss of consciousness.

  1. Decitabine in Treating Children With Relapsed or Refractory Acute Myeloid Leukemia or Acute Lymphoblastic Leukemia

    ClinicalTrials.gov

    2013-01-22

    Childhood Acute Myeloblastic Leukemia With Maturation (M2); Childhood Acute Promyelocytic Leukemia (M3); Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Secondary Acute Myeloid Leukemia

  2. Pathophysiology of Acute Kidney Injury

    PubMed Central

    Basile, David P.; Anderson, Melissa D.; Sutton, Timothy A.

    2014-01-01

    Acute kidney injury (AKI) is the leading cause of nephrology consultation and is associated with high mortality rates. The primary causes of AKI include ischemia, hypoxia or nephrotoxicity. An underlying feature is a rapid decline in GFR usually associated with decreases in renal blood flow. Inflammation represents an important additional component of AKI leading to the extension phase of injury, which may be associated with insensitivity to vasodilator therapy. It is suggested that targeting the extension phase represents an area potential of treatment with the greatest possible impact. The underlying basis of renal injury appears to be impaired energetics of the highly metabolically active nephron segments (i.e., proximal tubules and thick ascending limb) in the renal outer medulla, which can trigger conversion from transient hypoxia to intrinsic renal failure. Injury to kidney cells can be lethal or sublethal. Sublethal injury represents an important component in AKI, as it may profoundly influence GFR and renal blood flow. The nature of the recovery response is mediated by the degree to which sublethal cells can restore normal function and promote regeneration. The successful recovery from AKI depends on the degree to which these repair processes ensue and these may be compromised in elderly or CKD patients. Recent data suggest that AKI represents a potential link to CKD in surviving patients. Finally, earlier diagnosis of AKI represents an important area in treating patients with AKI that has spawned increased awareness of the potential that biomarkers of AKI may play in the future. PMID:23798302

  3. Acute otitis media and acute bacterial sinusitis.

    PubMed

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  4. Deferasirox-induced iron depletion promotes BclxL downregulation and death of proximal tubular cells.

    PubMed

    Martin-Sanchez, Diego; Gallegos-Villalobos, Angel; Fontecha-Barriuso, Miguel; Carrasco, Susana; Sanchez-Niño, Maria Dolores; Lopez-Hernandez, Francisco J; Ruiz-Ortega, Marta; Egido, Jesus; Ortiz, Alberto; Sanz, Ana Belén

    2017-01-31

    Iron deficiency has been associated with kidney injury. Deferasirox is an oral iron chelator used to treat blood transfusion-related iron overload. Nephrotoxicity is the most serious and common adverse effect of deferasirox and may present as an acute or chronic kidney disease. However, scarce data are available on the molecular mechanisms of nephrotoxicity. We explored the therapeutic modulation of deferasirox-induced proximal tubular cell death in culture. Deferasirox induced dose-dependent tubular cell death and AnexxinV/7AAD staining showed features of apoptosis and necrosis. However, despite inhibiting caspase-3 activation, the pan-caspase inhibitor zVAD-fmk failed to prevent deferasirox-induced cell death. Moreover, zVAD increased deferasirox-induced cell death, a feature sometimes found in necroptosis. Electron microscopy identified mitochondrial injury and features of necrosis. However, neither necrostatin-1 nor RIP3 knockdown prevented deferasirox-induced cell death. Deferasirox caused BclxL depletion and BclxL overexpression was protective. Preventing iron depletion protected from BclxL downregulation and deferasirox cytotoxicity. In conclusion, deferasirox promoted iron depletion-dependent cell death characterized by BclxL downregulation. BclxL overexpression was protective, suggesting a role for BclxL downregulation in iron depletion-induced cell death. This information may be used to develop novel nephroprotective strategies. Furthermore, it supports the concept that monitoring kidney tissue iron depletion may decrease the risk of deferasirox nephrotoxicity.

  5. PROXIMITY TO DELIVERY ALTERS INSULIN SENSITIVITY AND GLUCOSE METABOLISM IN PREGNANT MICE

    PubMed Central

    Musial, Barbara; Fernandez-Twinn, Denise S.; Vaughan, Owen R.; Ozanne, Susan E.; Voshol, Peter; Sferruzzi-Perri, Amanda N.; Fowden, Abigail L.

    2016-01-01

    In late pregnancy, maternal insulin resistance occurs to support fetal growth but little is known about insulin-glucose dynamics close to delivery. This study measured insulin sensitivity in mice in late pregnancy, day (D) 16, and near term, D19, (term 20.5D). Non-pregnant (NP) and pregnant mice were assessed for metabolite and hormone concentrations, body composition by dual energy X-ray absorptiometry, tissue insulin signalling protein abundance by Western blotting, glucose tolerance and utilisation, and insulin sensitivity using acute insulin administration and hyperinsulinaemic-euglycaemic clamps with 3H-glucose infusion. Whole body insulin resistance occurred in D16 pregnant dams in association with basal hyperinsulinaemia, insulin-resistant endogenous glucose production and downregulation of several proteins in hepatic and skeletal muscle insulin signalling pathways relative to NP and D19 values. Insulin resistance was less pronounced at D19 with restoration of NP insulin concentrations, improved hepatic insulin sensitivity and increased abundance of hepatic insulin signalling proteins. At D16, insulin resistance at whole body, tissue and molecular levels will favour fetal glucose acquisition while improved D19 hepatic insulin sensitivity will conserve glucose for maternal use in anticipation of lactation. Tissue sensitivity to insulin, therefore, alters differentially with proximity to delivery in pregnant mice with implications for human and other species. PMID:26740602

  6. Mitogenic action of lysophosphatidic acid in proximal tubular epithelial cells obtained from voided human urine.

    PubMed

    Kumagai, N; Inoue, C N; Kondo, Y; Iinuma, K

    2000-12-01

    Focal tubular cell multiplication at sites on an injured nephron is a critical event in the recovery phase following acute tubular necrosis. During this process, numerous viable tubular cells exfoliate and are shed into the urine. Lysophosphatidic acid (LPA) is generated in the plasma membrane of injured cells and acts as an intercellular mediator of various biological processes, including inflammation, proliferation and repair. In the present study, exfoliated proximal tubule (PT) cells were isolated from human urine and the mitogenic effects of LPA were investigated as a model of repair and proliferation following renal injury. LPA stimulated a 23. 5% increase in DNA synthesis, a 29.4% increase in cell number and an 86.6% decrease in cAMP content. All of these responses were pertussis toxin sensitive, indicating the involvement of G(i)-type G-proteins in LPA signalling. Conversely, the LPA-induced DNA synthesis and the decrease in intracellular cAMP content were insensitive to wortmannin, an inhibitor of phosphatidylinositol 3-kinase (PI3K), suggesting a mitogenic response via PI3K-independent mechanisms. Furthermore, we detected specific mRNA transcripts for the recently cloned human LPA-receptors, endothelial differentiation gene (Edg)-2 and Edg-4 (Edg-2>Edg-4) by reverse transcription-PCR in PT cells. Our data suggest that LPA may behave as a local growth factor in PT cells following tubular injury.

  7. Deferasirox-induced iron depletion promotes BclxL downregulation and death of proximal tubular cells

    PubMed Central

    Martin-Sanchez, Diego; Gallegos-Villalobos, Angel; Fontecha-Barriuso, Miguel; Carrasco, Susana; Sanchez-Niño, Maria Dolores; Lopez-Hernandez, Francisco J; Ruiz-Ortega, Marta; Egido, Jesus; Ortiz, Alberto; Sanz, Ana Belén

    2017-01-01

    Iron deficiency has been associated with kidney injury. Deferasirox is an oral iron chelator used to treat blood transfusion-related iron overload. Nephrotoxicity is the most serious and common adverse effect of deferasirox and may present as an acute or chronic kidney disease. However, scarce data are available on the molecular mechanisms of nephrotoxicity. We explored the therapeutic modulation of deferasirox-induced proximal tubular cell death in culture. Deferasirox induced dose-dependent tubular cell death and AnexxinV/7AAD staining showed features of apoptosis and necrosis. However, despite inhibiting caspase-3 activation, the pan-caspase inhibitor zVAD-fmk failed to prevent deferasirox-induced cell death. Moreover, zVAD increased deferasirox-induced cell death, a feature sometimes found in necroptosis. Electron microscopy identified mitochondrial injury and features of necrosis. However, neither necrostatin-1 nor RIP3 knockdown prevented deferasirox-induced cell death. Deferasirox caused BclxL depletion and BclxL overexpression was protective. Preventing iron depletion protected from BclxL downregulation and deferasirox cytotoxicity. In conclusion, deferasirox promoted iron depletion-dependent cell death characterized by BclxL downregulation. BclxL overexpression was protective, suggesting a role for BclxL downregulation in iron depletion-induced cell death. This information may be used to develop novel nephroprotective strategies. Furthermore, it supports the concept that monitoring kidney tissue iron depletion may decrease the risk of deferasirox nephrotoxicity. PMID:28139717

  8. Short term exposure to elevated levels of leptin reduces proximal tubule cell metabolic activity.

    PubMed

    Briffa, Jessica F; Grinfeld, Esther; McAinch, Andrew J; Poronnik, Philip; Hryciw, Deanne H

    2014-01-25

    Leptin plays a pathophysiological role in the kidney, however, its acute effects on the proximal tubule cells (PTCs) are unknown. In opossum kidney (OK) cells in vitro, Western blot analysis identified that exposure to leptin increases the phosphorylation of the mitogen-activated protein kinase (MAPK) p44/42 and the mammalian target of rapamycin (mTOR). Importantly leptin (0.05, 0.10, 0.25 and 0.50 μg/ml) significantly reduced the metabolic activity of PTCs, and significantly decreased protein content per cell. Investigation of the role of p44/42 and mTOR on metabolic activity and protein content per cell, demonstrated that in the presence of MAPK inhibitor U0126 and mTOR inhibitor Ku-63794, that the mTOR pathway is responsible for the reduction in PTC metabolic activity in response to leptin. However, p44/42 and mTOR play no role the reduced protein content per cell in OKs exposed to leptin. Therefore, leptin modulates metabolic activity in PTCs via an mTOR regulated pathway.

  9. 14 CFR 121.360 - Ground proximity warning-glide slope deviation alerting system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Ground proximity warning-glide slope... Equipment Requirements § 121.360 Ground proximity warning-glide slope deviation alerting system. (a) No... turbine-powered airplane unless it is equipped with a ground proximity warning/glide slope...

  10. 14 CFR 121.360 - Ground proximity warning-glide slope deviation alerting system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Ground proximity warning-glide slope... Equipment Requirements § 121.360 Ground proximity warning-glide slope deviation alerting system. (a) No... turbine-powered airplane unless it is equipped with a ground proximity warning/glide slope...

  11. Proximity association in polygynous western black crested gibbons (Nomascus concolor jingdongensis): network structure and seasonality.

    PubMed

    Guan, Zhen-Hua; Huang, Bei; Ning, Wen-He; Ni, Qing-Yong; Jiang, Xue-Long

    2013-01-01

    We investigated the structure and seasonality of the proximity network in a group of polygynous western black crested gibbons (Nomascus concolor) using social network analysis. The spatial proximity changed seasonally and was affected by temperature and rainfall. Preferred proximity association was not distributed randomly among individuals. Kinship was one explanation for the social structure, as offspring preferred to maintain close proximity with their mothers. The proximity of infants to mothers decreased with age, and independent offspring had lower proximity to mothers than dependent ones. We found that the adult male had different proximity relationships with two different adult females. The frequency of proximity between the male and the infant-carrying female was significantly higher than that between the male and the female who had immigrated carrying one offspring of uncertain paternity into the group. Infanticide avoidance and/or predation protection for dependent infants might explain the proximity relationship differences. Temperature influenced group proximity association, with individual proximity increasing in the cold months and decreasing in the hot months. Group proximity decreased in months with higher anthropogenic disturbance.

  12. Tubular cell apoptosis and cidofovir-induced acute renal failure.

    PubMed

    Ortiz, Alberto; Justo, Pilar; Sanz, Ana; Melero, Rosa; Caramelo, Carlos; Guerrero, Manuel Fernández; Strutz, Frank; Müller, Gerhard; Barat, Antonio; Egido, Jesus

    2005-01-01

    Cidofovir is an antiviral drug with activity against a wide array of DNA viruses including poxvirus. The therapeutic use of cidofovir is marred by a dose-limiting side effect, nephrotoxicity, leading to proximal tubular cell injury and acute renal failure. Treatment with cidofovir requires the routine use of prophylactic measures. A correct knowledge of the cellular and molecular mechanisms of cidofovir toxicity may lead to the development of alternative prophylactic strategies. We recently cared for a patient with irreversible acute renal failure due to cidofovir. Renal biopsy showed tubular cell apoptosis. Cidofovir induced apoptosis in primary cultures of human proximal tubular cells in a temporal (peak apoptosis at 7 days) and concentration (10-40 microg/ml) pattern consistent with that of clinical toxicity. Apoptosis was identified by the presence of hypodiploid cells, by the exposure of annexin V binding sites and by morphological features and was associated with the appearance of active caspase-3 fragments. Cell death was specific as it was also present in a human proximal tubular epithelial cell line (HK-2), but not in a human kidney fibroblast cell line, and was prevented by probenecid. An inhibitor of caspase-3 (DEVD) prevented cidofovir apoptosis. The survival factors present in serum, insulin-like growth factor-1 and hepatocyte growth factor, were also protective. The present data suggest that apoptosis induction is a mechanism contributing to cidofovir nephrotoxicity. The prophylactic administration of factors with survival activity for tubular epithelium should be further explored in cidofovir renal injury.

  13. Phosphorylation of rat kidney Na-K pump at Ser938 is required for rapid angiotensin II-dependent stimulation of activity and trafficking in proximal tubule cells.

    PubMed

    Massey, Katherine J; Li, Quanwen; Rossi, Noreen F; Keezer, Susan M; Mattingly, Raymond R; Yingst, Douglas R

    2016-02-01

    How angiotensin (ANG) II acutely stimulates the Na-K pump in proximal tubules is only partially understood, limiting insight into how ANG II increases blood pressure. First, we tested whether ANG II increases the number of pumps in plasma membranes of native rat proximal tubules under conditions of rapid activation. We found that exposure to 100 pM ANG II for 2 min, which was previously shown to increase affinity of the Na-K pump for Na and stimulate activity threefold, increased the amount of the Na-K pump in plasma membranes of native tubules by 33%. Second, we tested whether previously observed increases in phosphorylation of the Na-K pump at Ser(938) were part of the stimulatory mechanism. These experiments were carried out in opossum kidney cells, cultured proximal tubules stably coexpressing the ANG type 1 (AT1) receptor, and either wild-type or a S938A mutant of rat kidney Na-K pump under conditions found by others to stimulate activity. We found that 10 min of incubation in 10 pM ANG II stimulated activity of wild-type pumps from 2.3 to 3.5 nmol K · mg protein(-1) · min(-1) and increased the amount of the pump in the plasma membrane by 80% but had no effect on cells expressing the S938A mutant. We conclude that acute stimulation of Na-K pump activity in native rat proximal tubules includes increased trafficking to the plasma membrane and that phosphorylation at Ser(938) is part of the mechanism by which ANG II directly stimulates activity and trafficking of the rat kidney Na-K pump in opossum kidney cells.

  14. Proximity Effects and Nonequilibrium Superconductivity in Transition-Edge Sensors

    NASA Technical Reports Server (NTRS)

    Sadleir, John E.; Smith, Stephen J.; Robinson, Ian K.; Finkbeiner, Fred M.; Chervenak, James A.; Bandler, Simon R.; Eckart, Megan E.; Kilbourne, Caroline A.

    2011-01-01

    We have recently shown that normal-metal/superconductor (N/S) bilayer TESs (superconducting Transition-Edge Sensors) exhibit weak-link behavior.l Here we extend our understanding to include TESs with added noise-mitigating normal-metal structures (N structures). We find TESs with added Au structures also exhibit weak-link behavior as evidenced by exponential temperature dependence of the critical current and Josephson-like oscillations of the critical current with applied magnetic field. We explain our results in terms of an effect converse to the longitudinal proximity effect (LoPE) 1, the lateral inverse proximity effect (LaiPE), for which the order parameter in the N/S bilayer is reduced due to the neighboring N structures. Resistance and critical current measurements are presented as a function of temperature and magnetic field taken on square Mol Au bilayer TESs with lengths ranging from 8 to 130 {\\mu}m with and without added N structures. We observe the inverse proximity effect on the bilayer over in-plane distances many tens of microns and find the transition shifts to lower temperatures scale approximately as the inverse square of the in- plane N-structure separation distance, without appreciable broadening of the transition width. We also present evidence for nonequilbrium superconductivity and estimate a quasiparticle lifetime of 1.8 \\times 10-10 s for the bilayer. The LoPE model is also used to explain the increased conductivity at temperatures above the bilayer's steep resistive transition.

  15. [Proximate analysis of straw by near infrared spectroscopy (NIRS)].

    PubMed

    Huang, Cai-jin; Han, Lu-jia; Liu, Xian; Yang, Zeng-ling

    2009-04-01

    Proximate analysis is one of the routine analysis procedures in utilization of straw for biomass energy use. The present paper studied the applicability of rapid proximate analysis of straw by near infrared spectroscopy (NIRS) technology, in which the authors constructed the first NIRS models to predict volatile matter and fixed carbon contents of straw. NIRS models were developed using Foss 6500 spectrometer with spectra in the range of 1,108-2,492 nm to predict the contents of moisture, ash, volatile matter and fixed carbon in the directly cut straw samples; to predict ash, volatile matter and fixed carbon in the dried milled straw samples. For the models based on directly cut straw samples, the determination coefficient of independent validation (R2v) and standard error of prediction (SEP) were 0.92% and 0.76% for moisture, 0.94% and 0.84% for ash, 0.88% and 0.82% for volatile matter, and 0.75% and 0.65% for fixed carbon, respectively. For the models based on dried milled straw samples, the determination coefficient of independent validation (R2v) and standard error of prediction (SEP) were 0.98% and 0.54% for ash, 0.95% and 0.57% for volatile matter, and 0.78% and 0.61% for fixed carbon, respectively. It was concluded that NIRS models can predict accurately as an alternative analysis method, therefore rapid and simultaneous analysis of multicomponents can be achieved by NIRS technology, decreasing the cost of proximate analysis for straw.

  16. Functional results after proximal row carpectomy to salvage a wrist.

    PubMed

    Kremer, Thomas; Sauerbier, Michael; Trankle, Markus; Dragu, Adrian; Germann, Guenter; Baumeister, Steffen

    2008-01-01

    Proximal row carpectomy is a movement-preserving procedure in the treatment of arthrosis of the wrist. We have retrospectively assessed the objective and subjective functional results after proximal row carpectomy. Assessment of outcome included measurement of range of movement (ROM), grip strength and self-assessment of pain relief with a visual analogue scale (VAS) and the Disabilities of arm, shoulder, and hand (DASH) questionnaire. Results were graded using the Mayo and Krimmer wrist scores. Fourty-five patients (mean age 48 (30-67) years) were evaluated with a follow-up of 32 (8-115) months. Underlying conditions included: degenerative arthritis secondary to scapholunate advanced collapse deformity, or chronic scaphoid non-union (n=35), Kienbock disease stage III (n=4), chronic perilunate dislocation and fracture-dislocation (n=4), avascular necrosis of the scaphoid (n=1), and severe radiocarpal arthrosis secondary to distal radial fracture (n=1). Active ROM for wrist extension and flexion was 70 degrees and mean radial and ulnar deviation 30.8 degrees . Grip strength was 51% of the unaffected side. The average DASH score was 26. The intensity of the pain, measured by VAS, was reduced by 44% after strenuous activities and by 71% at rest. The Mayo and Krimmer wrist scores were 55 and 62 points indicating good results; 32 patients returned to work and 25 patients to their former occupation. Our results show that proximal row carpectomy is a technically easy operation that preserves a satisfying ROM and pain relief, and is recommended when the head of the capitate and the lunate fossa are not affected by arthrosis.

  17. Proximate composition and caloric content of eight Lake Michigan fishes

    USGS Publications Warehouse

    Rottiers, Donald V.; Tucker, Robert M.

    1982-01-01

    We measured the proximate composition (percentage lipid, water, fat-free dry material, ash) and caloric content of eight species of Lake Michigan fish: lake trout (Salvelinus namaycush), coho salmon (Oncorhynchus kisutch), lake whitefish (Coregonus clupeaformis), bloater (Coregonus hoyi), alewife (Alosa pseudoharengus), rainbow smelt (Osmerus mordax), deepwater sculpin (Myoxocephalus quadricornis), and slimy sculpin (Cottus cognatus). Except for alewives, proximate composition and caloric content did not differ significantly between males and females. And, for coho salmon, there was no significant difference in composition between fish collected in different years. Lipid and caloric content of lake trout increased directly with age. In all species examined, lipids and caloric contents were significantly lower in small, presumably immature, fish than in larger, older fish. Lipid content of lake trout, lake whitefish, and bloaters (range of means, 16-22%) was nearly 3 times higher than that of coho salmon, sculpins, rainbow smelt, and alewives (range of means, 5.2-7.0%). The mean caloric content ranged from 6.9 to 7.1 kcal/g for species high in lipids and from 5.8 to 6.3 kcal/g for species low in lipids. Although the caloric content of all species varied directly with lipid content and inversely with water content, an increase in lipid content did not always coincide with a proportional increase in caloric content when other components of fish composition were essentially unchanged. This observation suggests that the energy content of fish estimated from the proximate composition by using universal conversion factors may not necessarily be accurate.

  18. Dynamic knee loads during gait predict proximal tibial bone distribution.

    PubMed

    Hurwitz, D E; Sumner, D R; Andriacchi, T P; Sugar, D A

    1998-05-01

    This study tested the validity of the prediction of dynamic knee loads based on gait measurements. The relationship between the predicted loads at the knee and the distribution of bone between the medial and lateral sides of the tibia was examined. The motion and external forces and moments at the knee were measured during gait and a statically determinate muscle model was used to predict the corresponding forces on the medial and lateral tibial plateaus. In particular, the relationship between the knee adduction moment during gait and the ratio or distribution of medial to lateral tibial bone mineral content was studied. Bone mineral content was measured with dual energy X-ray absorptiometry in four regions, two proximal regions 20 mm in height, one medial and one lateral and two distal regions 20 mm in height, one medial and one lateral. The best single predictor of the medial lateral ratio of proximal bone mineral content (bone distribution) was the adduction moment (R2=0.31, p=0.003). Adding weight (negative coefficient. p=0.0004) and the ratio of the average predicted peak force on the medial plateau to the predicted peak force on the lateral plateau (positive coefficient, p=0.0033) to the regression model significantly increased the ability to predict the proximal medial lateral bone distribution (R2=0.72, p=0.0001). Distally neither the subject characteristics nor the gait moments and predicted forces were significant predictors of the bone distribution. The lack of a correlation distally may be reflective of the forces being more evenly distributed further from the tibial plateau. While it has long been suggested that the adduction moment is the primary determinate of the distribution of load between the medial and lateral plateaus, this is the first evidence of its relationship to the underlying bone distribution.

  19. Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur

    SciTech Connect

    Deschamps, Frederic Farouil, Geoffroy Hakime, Antoine Teriitehau, Christophe Barah, Ali Baere, Thierry de

    2012-12-15

    Objective: Percutaneous osteosynthesis plus cementoplasty (POPC) is a minimally invasive technique that has never been reported before and that we have prospectively evaluated for patients with impending pathological fracture of the proximal femur. Methods: We performed POPC in 12 patients (3 males, 9 females) with metastasis of the proximal femur with a high risk of fracture (Mirels' score {>=}8) between February 2010 and July 2011. Patients were not candidates for standard surgical stabilization. We analyzed the feasibility, duration, and complication of the procedure, the risk of fracture, the decrease in pain (Visual Analog Scale, VAS), and length of stay in hospital. Data were prospectively collected in all patients. Results: The mean Mirels' score was 9.8 {+-} 1.2 (range, 8-11). The technical success was 100%. POPC was performed under general anesthesia (n = 6) or conscious sedation (n = 6). The mean duration was 110 {+-} 43 (range, 60-180) minutes. All patients stood up and walked the second day after the procedure. The average length of stay in the hospital was 4 {+-} 1.6 (range, 2-7) days. We experienced two hematomas in two patients and no thromboembolic complication. For symptomatic patients (n = 8), VAS decreased from 6.5/10 (range, 2-9) before treatment to 1/10 (range, 0-3) 1 month after. No fracture occurred after a median follow-up of 145 (range, 12-608) days. Conclusions: POPC for impending pathological fracture of the proximal femur seems to be a promising alternative for cancer patients who are not candidates for surgical stabilization. Further studies are required to confirm this preliminary experience.

  20. Ultimate Drivers and Proximate Correlates of Polyandry in Predatory Mites

    PubMed Central

    Schausberger, Peter; Patiño-Ruiz, J. David; Osakabe, Masahiro; Murata, Yasumasa; Sugimoto, Naoya; Uesugi, Ryuji; Walzer, Andreas

    2016-01-01

    Polyandry is more widespread than anticipated from Bateman’s principle but its ultimate (evolutionary) causes and proximate (mechanistic) correlates are more difficult to pinpoint than those of polygyny. Here, we combined mating experiments, quantification of reproductive traits and microsatellite genotyping to determine the fitness implications of polyandry in two predatory mite species, where males are highly polygynous (up to 45 fertilized females during life), whereas females range from monandry to various polyandry levels. The medium-level polyandrous (up to eight male mates possible) Neoseiulus californicus received clear direct and indirect benefits: multiply mated females produced more offspring with higher survival chances over longer times than singly mated females. In contrast, singly and multiply mated females of the low-level polyandrous (commonly two male mates at maximum) Phytoseiulus persimilis produced similar numbers of offspring having similar survival chances. In both species, multiple mating resulted in mixed offspring paternities, opening the chance for indirect fitness benefits such as enhanced genetic compatibility, complementarity and/or variability. However, the female re-mating likelihood and the paternity chance of non-first male mates were lower in P. persimilis than in N. californicus. Regarding proximate factors, in both species first mating duration and female re-mating likelihood were negatively correlated. Based on occasional fertilization failure of first male mates in P. persimilis, and mixed offspring paternities in both species, we argue that fertilization assurance and the chance to gain indirect fitness benefits are the ultimate drivers of polyandry in P. persimilis, whereas those of N. californicus are higher offspring numbers coupled with enhanced offspring viability and possibly other indirect fitness benefits. Overall, the adaptive significance and proximate events well reflected the polyandry levels. Our study provides