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Sample records for anterior scj instability

  1. Anterior instability in the throwing shoulder.

    PubMed

    Savoie, Felix H; O'Brien, Michael J

    2014-06-01

    The disabled throwing shoulder is a multifactorial problem. Laxity of the glenohumeral joint is necessary to achieve a satisfactory velocity. Normal wear and tear with throwing may convert this normal amount of excessive translation into instability. Instability in the throwing athlete manifests itself in 2 forms: traumatic anterior instability that happens to occur in a throwing athlete and excessive anterior subluxation because of overuse that occurs in conjunction with the disabled throwing shoulder. In most cases, it is difficult to determine by physical examination or imaging how much laxity is too much; therefore, the managing physician should always err on the side of caution. A trial of rest and rehabilitation should always be attempted before any consideration of surgery. The multifactorial issues in the disabled throwing athlete should be corrected during this phase of treatment, including assessment and treatment of hip abnormalities, restoration of satisfactory core strength, correction of scapular dyskinesis, and an evaluation and correction of any biomechanical abnormalities in the throwing mechanism. Surgical management of anterior instability in the throwing shoulder depends on the mechanism of injury. The traumatic anterior instability patient is managed by acute surgical repair without a shift, utilizing mattress sutures to prevent suture chondromalacia on the humeral head or glenoid. The anterior laxity management centers on the posterior superior labrum, although occasionally the anterior labrum or capsule may be involved as well. Overall, symptomatic anterior instability is less common in the throwing shoulder. Jobe and colleagues are credited with the first successful technique for the correction of anterior instability in the throwing athlete, the anterior capsulolabral reconstruction by a subscapularis split. The success of this technique paved the way for the adoption of the current arthroscopic techniques that are utilized to correct

  2. Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

    PubMed Central

    Durban, Claire Marie C.; Kim, Je Kyun; Kim, Sae Hoon

    2016-01-01

    Background The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed. PMID:27247742

  3. Mini-Open Latarjet Procedure for Recurrent Anterior Shoulder Instability

    PubMed Central

    Mercier, Numa; Saragaglia, Dominique

    2011-01-01

    Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure. PMID:22191039

  4. Arthroscopic Management of Anterior, Posterior, and Multidirectional Shoulder Instabilities.

    PubMed

    Field, Larry D; Ryu, Richard K N; Abrams, Jeffrey S; Provencher, Matthew

    2016-01-01

    Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability. The treating physician also must be familiar with diagnostic imaging and physical examination maneuvers that are required to accurately diagnose shoulder instability.

  5. Effect of bone loss in anterior shoulder instability

    PubMed Central

    Garcia, Grant H; Liu, Joseph N; Dines, David M; Dines, Joshua S

    2015-01-01

    Anterior shoulder instability with bone loss can be a difficult problem to treat. It usually involves a component of either glenoid deficiency or a Hill-Sachs lesion. Recent data shows that soft tissue procedures alone are typically not adequate to provide stability to the shoulder. As such, numerous surgical procedures have been described to directly address these bony deficits. For glenoid defects, coracoid transfer and iliac crest bone block procedures are popular and effective. For humeral head defects, both remplissage and osteochondral allografts have decreased the rates of recurrent instability. Our review provides an overview of current literature addressing these treatment options and others for addressing bone loss complicating anterior glenohumeral instability. PMID:26085984

  6. Arthroscopic Bone Graft Procedure for Anterior Inferior Glenohumeral Instability

    PubMed Central

    Taverna, Ettore; D'Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido

    2014-01-01

    There are many described surgical techniques for the treatment of recurrent anterior shoulder instability. Numerous authors have performed anterior bone block procedures with good results for the treatment of anterior shoulder instability with glenoid bone loss. The benefits of using arthroscopic procedures for surgical stabilization of the shoulder include smaller incisions with less soft-tissue dissection, better visualization of the joint, better repair accessibility, and the best possible outcome for external rotation. We describe an arthroscopic anteroinferior shoulder stabilization technique with an iliac crest tricortical bone graft and capsulolabral reconstruction. It is an all-arthroscopic technique with the advantage of not using fixation devices, such as screws, but instead using special buttons to fix the bone graft. The steps of the operation are as follows: precise placement of a specific posterior glenoid guide that allows the accurate positioning of the bone graft on the anterior glenoid neck; fixation of the graft flush with the anterior glenoid rim using specific buttons under arthroscopic control; and finally, subsequent capsular, labral, and ligament reconstruction on the glenoid rim using suture anchors and leaving the graft as an extra-articular structure. PMID:25685669

  7. Posterior shoulder pain and anterior instability: a preliminary clinical study.

    PubMed

    Castagna, Alessandro; Conti, Marco; Borroni, Mario; Massazza, Giuseppe; Vinci, Enzo; Franceschi, Giorgio; Garofalo, Raffaele

    2008-02-01

    Different clinical tests have been suggested in the literature as significant indicators of anterior shoulder instability. Sometimes patients with recurrent anterior shoulder instability may show some muscular guarding thus making the evaluation of specific clinical tests very difficult. These patients may also report a medical history with posterior shoulder pain that can be also elicited during some clinical manoeuvres. From September 2005 to September 2006 we prospectively studied patients who underwent an arthroscopic anterior capsuloplasty. Shoulder clinical examination was performed including anterior shoulder instability tests (drawer, apprehension and relocation tests). Furthermore the exam was focused on the presence of scapular dyskinesia and posterior shoulder pain. The patients were also evaluated with ASES, Rowe, SST (Simple Shoulder Test), Constant and UCLA (University of California at Los Angeles) scoring system preoperatively and at the latest follow-up time. In the period of this study we observed 16 patients treated for anterior gleno-humeral arthroscopic stabilisation, who preoperatively complained also of a posterior scapular pain. The pain was referred at the level of lower trapezium and upper rhomboids tendon insertion on the medial border of the scapula. It was also reproducible upon local palpation by the examiner. Four of these patients also referred pain in the region of the insertion of the infraspinatus and teres minor. After arthroscopic stabilisation the shoulder was immobilised in a sling with the arm in the neutral rotation for a period of 4 weeks. A single physician supervised shoulder rehabilitation. After a mean time of 6.8 months of follow-up, all the shoulder scores were significantly improved and, moreover, at the same time the patients referred the disappearance of the posterior pain. Posterior scapular shoulder pain seems to be another complaint and sign that can be found in patients affected by anterior shoulder instability

  8. FUNCTIONAL ASSESSMENT OF ARTHROSCOPIC REPAIR FOR RECURRENT ANTERIOR SHOULDER INSTABILITY

    PubMed Central

    de Almeida Filho, Ildeu Afonso; de Castro Veado, Marco Antônio; Fim, Márcio; da Silva Corrêa, Lincoln Vargas; de Carvalho Junior, Antônio Enéas Rangel

    2015-01-01

    Objective: To clinically and radiologically evaluate patients who underwent arthroscopic surgical treatment for anterior shoulder instability by means of the Bankart technique, using metal anchors. Methods: This was a retrospective study on 49 patients who underwent arthroscopic repair of anterior shoulder instability between 2002 and 2007. The patients were evaluated using the Carter-Rowe score and the Samilson and Prieto classification. The mean age at the time of surgery was 30 years. The mean length of follow-up was 42.7 months (ranging from 18 to 74). 85% of the patients were male. Results: The mean Carter-Rowe score was 83 points (ranging from 30 to 100) including 31 excellent results, 7 good, 3 fair and 8 poor. Recurrent dislocation was observed in 16% (8 patients), and 37.5% of them were of traumatic origin. Joint degeneration was present in 32.5% of the cases, including 5 cases of grade 1, 6 cases of grade 2 and 2 cases of grade 3. The average loss of external rotation was 12° and the loss of anterior elevation was 8°. There was a statistically significant relationship (p < 0.05) between arthritis and age at first dislocation, age at surgery and crackling. 92% of the patients reported high degrees of satisfaction after the procedure. Among the complications, there were two cases of stiff shoulder, one patient with prominence of the synthesis material and one case of anchor loosening. Conclusion: Arthroscopic repair of anterior shoulder instability using metal anchors was shown to be effective, with a low complication rate. PMID:27042624

  9. Superior labrum anterior to posterior tears and glenohumeral instability.

    PubMed

    Virk, Mandeep S; Arciero, Robert A

    2013-01-01

    Cadaver experiments and clinical studies suggest that the superior labrum-biceps complex plays a role in glenohumeral stability. Superior labrum anterior to posterior (SLAP) tears can be present in acute and recurrent glenohumeral dislocations and contribute to glenohumeral instability. Isolated SLAP tears can cause instability, especially in throwing athletes. Diagnosing a SLAP tear on the basis of the clinical examination alone is difficult because of nonspecific history and physical examination findings and the presence of coexisting intra-articular lesions. Magnetic resonance arthrography is the imaging study of choice for diagnosing SLAP tears; however, arthroscopy remains the gold standard for diagnosis. Arthroscopy is the preferred technique for the repair of a type II SLAP tear and its variant types (V through X) in acute glenohumeral dislocations and instability in younger populations. Clinical outcome studies report a low recurrence of glenohumeral instability after the arthroscopic repair of a SLAP tear in addition to a Bankart repair. Long-term follow-up studies and further advances in arthroscopic fixation techniques will allow a better understanding and improvement in outcomes in patients with SLAP tears associated with glenohumeral instability. PMID:23395054

  10. Osseous Defects Seen in Patients with Anterior Shoulder Instability

    PubMed Central

    Itoi, Eiji

    2015-01-01

    Shoulder surgeons need to be aware of the critical size of the glenoid or humeral osseous defects seen in patients with anterior shoulder instability, since the considerable size of osseous defect is reported to cause postoperative instability. Biomechanical studies have identified the size of the osseous defect which affects stability. Since engagement always occurs between a Hill-Sachs lesion and the glenoid rim, when considering the critical size of the Hill-Sachs lesion, we have to simultaneously consider the size of the glenoid osseous defect. With the newly developed concept of the glenoid track, we are able to evaluate whether a large Hill-Sachs lesion is an "on-track" or "off-track" lesion, and to consider both osseous defects together. In case of an off-track Hill-Sachs lesion, if the glenoid defect is less than 25%, no treatment is required. In this case, the Latarjet procedure or arthroscopic remplissage procedure can be a treatment option. However, if the glenoid defect is more than 25%, treatment such as bone grafting is required. This will convert an off-track lesion to an on-track lesion. After the bone graft or Latarjet procedure, if the Hill-Sachs lesion persists as off-track, then further treatment is necessitated. In case with an on-track Hill-Sachs lesion and a less than 25% glenoid defect, arthroscopic Bankart repair alone is enough. PMID:26640623

  11. Posterior humeral avulsion of the glenohumeral ligament (PHAGL) in anterior shoulder instability

    PubMed Central

    Vedova, Franco Della; Ibáñez, Maximiliano; Alvarez, Victoria; Lépore, Salvador; Sulzle, Vanina Ojeda; Galan, Hernán; Slullitel, Daniel

    2015-01-01

    Introduction: Bankart lesion is the anterior glenohumeral instability most common associated injury. Tears at glenohumeral ligaments can be intra substance or at humeral insertion, this location may be the cause of instability. Posterior humeral avulsion of the glenohumeral ligament (PHAGL) can be an isolated or associated cause of instability and it is usually related to the posterior glenohumeral instability. The aim of this article is to report the clinical assessment and postoperative outcomes of 6 patients with PHAGL with anterior shoulder instability. Materials and Methods: We evaluated six patients with PHAGL due to anterior glenohumeral instability arthroscopically repaired. All 6 patients developed the lesion after a sports-related trauma. Sixty six per cent of patients had associated intra-articular shoulder pathologies. The diagnosis with MRI arthrogram (with gadolinium) was performed preoperatively in 50% of patients. Postoperative evaluation was made with Rowe, ASES and WOSI scores. Results: All patients returned to their previous sports level. One patient had a recurrence. Postoperative scores results are WOSI: 13.13%, Rowe 83.33 and ASES 95.83. Discussion: Humeral avulsions of glenohumeral ligaments represent 25% of capsulolabral injuries. PHAGL injury was initially described as a cause of posterior instability, but according to two other series, our study shows that this lesion may also cause anterior instability. It is critical to have a high index of suspicion and make a correct arthroscopic examination to diagnose this injury, because arthroscopic repair of PHAGL has good postoperative outcomes.

  12. Glenoid avulsion of the glenohumeral ligaments as a cause of recurrent anterior shoulder instability.

    PubMed

    Wolf, Eugene M; Siparsky, Patrick N

    2010-09-01

    Although the Bankart lesion is accepted as the primary pathology responsible for recurrent shoulder instability, recognition of other soft-tissue lesions has improved the surgical treatment for this common problem. Whereas humeral avulsion of the glenohumeral ligaments has been acknowledged as a cause of anterior shoulder instability, we have not found any reported cases of glenoid avulsion of the glenohumeral ligaments. We describe 3 cases of recurrent anterior shoulder instability due to glenoid avulsion of the glenohumeral ligaments. The avulsed ligaments were repaired to the labrum and glenoid, restoring the glenohumeral ligament-labral complex.

  13. Evaluation of functional outcomes and complications following modified Latarjet reconstruction in athletes with anterior shoulder instability

    PubMed Central

    van der Watt, Christelle; de Beer, Joe F

    2015-01-01

    Background The optimal management of anterior shoulder instability in athletes continues to be a challenge. The present study aimed to evaluate the functional outcomes of athletes with anterior shoulder instability following modified Latarjet reconstruction through assessing the timing of return to sport and complications. Methods Retrospective assessment was performed of athletes (n = 56) who presented with recurrent anterior shoulder instability and were treated with modified congruent arc Latarjet reconstruction over a 1-year period. Rugby union was the predominant sport performed. Pre-operative instability severity index scores were assessed. Postoperative complications were recorded as was the time taken for the athlete to return to sport. Results Arthroscopic evaluation revealed that 86% of patients had associated bony lesions affecting the glenohumeral joint. The overall complication rate relating to the Latarjet reconstruction was 7%. No episodes of recurrent shoulder instability were noted. Of the patients, 89% returned to competitive sport at the same level as that prior to surgery. The mean time post surgery to returning to full training was 3.2 months. Conclusions The modified congruent arc Latarjet procedure facilitates early rehabilitation and return to sport. These results support our systematic management protocol of performing modified Latarjet surgery in contact sport athletes with recurrent anterior instability. PMID:27582973

  14. The natural history of the anterior knee instability by stress radiography

    PubMed Central

    de Rezende, Márcia Uchôa; Hernandez, Arnaldo José; Camanho, Gilberto Luis

    2014-01-01

    OBJECTIVE: To analyze the anteroposterior displacement of the knee by means of stress radiography in individuals with unilateral anterior knee instability and relate to time of instability. METHODS: Sixty individuals with intact knees (control group) and 125 patients with unilateral anterior instability (AI group) agreed to participate in the study. Gender, age, weight, height, age at injury, time between injury and testing, and surgical findings are studied. Both groups are submitted to anterior and posterior stress radiographies of both knees. Anterior (ADD) and posterior displacement difference (PDD) were calculated between sides. RESULTS: In the control group ADD and PDD are in average, zero, whereas in the AI group ADD averaged 9.8mm and PDD, 1.92mm. Gender, age, weight, height, age at trauma and presence of menisci's lesions do not intervene in the values of ADD and PDD. Meniscal injuries increase with time. ADD and PDD do not relate with the presence or absence of associated menisci's lesions. The ADD and the PDD are related to each other and increase with time. CONCLUSION: There is a permanent anterior subluxation of the injured knee that is related to the amount of anterior displacement that increases with time. Level of Evidence III, Study Types Case-control study. PMID:25246846

  15. The Latarjet-Patte procedure for recurrent anterior shoulder instability in contact athletes.

    PubMed

    Joshi, Mithun A; Young, Allan A; Balestro, Jean-Christian; Walch, Gilles

    2015-01-01

    Recurrent anterior shoulder instability is common in contact athletes and the high-energy injuries seen in this group make them more prone to bone loss. Athletes with recurrent instability and associated bone loss have high failure rates when treated with a soft tissue reconstruction procedure. Therefore it is preferred to manage recurrent instability in contact athletes with the Latarjet-Patte procedure. In this article, the authors describe their technique. They have found this procedure to be safe and effective, with very low recurrence and early return to sport. A meticulous surgical technique is important to avoid intraoperative and postoperative complications.

  16. Bony Versus Soft Tissue Reconstruction for Anterior Shoulder Instability

    PubMed Central

    McLaughlin, Richard James; Miniaci, Anthony; Jones, Morgan H.

    2015-01-01

    Background: One complication of anteroinferior glenohumeral shoulder dislocation is a critical bone defect that requires surgical repair to prevent recurrent instability. However, controversy exists regarding the surgical management because both open and arthroscopic surgeries have respective advantages and disadvantages. Moreover, it is difficult to determine the patient’s preferred treatment, as factors that influence treatment choice include recurrence rates, morbidity of the procedures, and patient preferences. Hypothesis: Patients who have a higher probability of recurrent instability after arthroscopic surgery will select open surgery whereas patients with a lower probability of recurrent instability after arthroscopic surgery will favor arthroscopy. Study Design: Economic and decision analysis; Level of evidence, 2. Methods: A decision tree was constructed to model each hypothetical outcome after open or arthroscopic surgery for glenohumeral instability in patients with bone defects. A literature review was performed to determine the probability of occurrence for each node while utility values for each outcome were obtained via patient-administered surveys given to 50 patients without prior history of shoulder injury or dislocation. Fold-back analysis was then performed to show the optimal treatment strategy. Finally, sensitivity analysis established the thresholds at which open treatment becomes the optimal treatment. Results: The ultimate expected value—the objective evaluation of all potential outcomes after choosing either open or arthroscopic surgery—was found to be greater for arthroscopic surgery than for open surgery (87.17 vs 81.64), indicating it to be the preferred treatment. Results of sensitivity analysis indicated that open surgery becomes the preferred treatment when probability of recurrence after arthroscopic treatment is ≥23.8%, although varying the utility, defined as an aggregate patient preference for a particular outcome, has no

  17. Surgical interventions for anterior shoulder instability in rugby players: A systematic review

    PubMed Central

    Sabharwal, Sanjeeve; Patel, Nirav K; Bull, Anthony MJ; Reilly, Peter

    2015-01-01

    AIM: To systematically evaluate the evidence-based literature on surgical treatment interventions for elite rugby players with anterior shoulder instability. METHODS: We conducted a systematic review according to the PRISMA guidelines. A literature search was performed in PubMed, EMBASE and Google Scholar using the following search terms: “rugby” and “shoulder” in combination with “instability” or “dislocation”. All articles published from inception of the included data sources to January 1st 2014 that evaluated surgical treatment of elite rugby players with anterior shoulder instability were examined. RESULTS: Only five studies were found that met the eligibility criteria. A total of 379 shoulders in 376 elite rugby union and league players were included. All the studies were retrospective cohort or case series studies. The mean Coleman Methodological Score for the 5 studies was 47.4 (poor). Owing to heterogeneity amongst the studies, quantitative synthesis was not possible, however a detailed qualitative synthesis is reported. The overall recurrence rate of instability after surgery was 8.7%, and the mean return to competitive play, where reported, was 13 mo. CONCLUSION: Arthroscopic stabilization has been performed successfully in acute anterior instability and there is a preference for open Latarjet-type procedures when instability is associated with osseous defects. PMID:25992318

  18. Modified Arthroscopic Latarjet Procedure With Coracoid Exteriorization for Treatment of Anterior Glenohumeral Instability

    PubMed Central

    Ranne, Juha O.; Kainonen, Terho U.; Lehtinen, Janne T.; Heinonen, Olli J.

    2013-01-01

    The Latarjet procedure for treating anterior glenohumeral instability includes transfer of the coracoid and biceps tendon to the anterior glenoid. A modified method for the arthroscopic procedure was developed to facilitate the procedure and minimize the risk of injury to the brachial plexus. The detached coracoid was exteriorized through the anteroinferior portal for drilling and shaping. A Coracoid Drill Guide (Arthrex, Naples, FL) was used to help cut the coracoid to the desired size and make 2 drill holes in the coracoid for fixation to the glenoid. The Coracoid Transfer Instrument (Acierart, Masku, Finland) was designed to facilitate coracoid transfer and serve as a pin guide for fixation. Ten patients with severe anterior glenohumeral instability were treated with this technique. They had only mild to moderate postoperative pain. There were no postoperative infections or recurrent dislocations. The safety of this operation was similar to that of other operations on the coracoid process in the proximity of the brachial plexus. The modified arthroscopic Latarjet procedure may be applied successfully to the treatment of anterior glenohumeral instability, with good patient satisfaction and functional outcome. PMID:24400183

  19. Arthroscopic Remplissage for Engaging Hill-Sachs Lesions in Patients With Anterior Shoulder Instability

    PubMed Central

    Camp, Christopher L.; Dahm, Diane L.; Krych, Aaron J.

    2015-01-01

    Anterior shoulder instability is often accompanied by a Hill-Sachs defect on the humeral head that can contribute to recurrent instability if not addressed at the time of surgery. We describe a method of performing arthroscopic remplissage to treat engaging Hill-Sachs lesions in patients with glenohumeral instability. It has the benefits of being an efficient procedure that can be performed with minimal technical difficulty and can be used to augment other stabilization procedures such as labral repair. The indications for this technique include the presence of an engaging Hill-Sachs defect in patients will little or no glenoid bone loss. In appropriately selected patients, arthroscopic remplissage has shown reduced rates of recurrent instability. PMID:26697311

  20. Iliac crest allograft glenoid reconstruction for recurrent anterior shoulder instability in athletes: Surgical technique and results

    PubMed Central

    Mascarenhas, Randy; Raleigh, Eden; McRae, Sheila; Leiter, Jeff; Saltzman, Bryan; MacDonald, Peter B.

    2014-01-01

    Performing a labral repair alone in patients with recurrent anterior instability and a large glenoid defect has led to poor outcomes. We present a technique involving the use of the iliac crest allograft inserted into the glenoid defect in athletes with recurrent anterior shoulder instability and large bony defects of the glenoid (>25% of glenoid diameter). All athletes with recurrent anterior shoulder instability and a large glenoid defect that underwent open anterior shoulder stabilization and glenoid reconstruction with the iliac crest allograft were followed over a 4-year period. Preoperatively, a detailed history and physical exam were obtained along with standard radiographs and magnetic resonance imaging of the affected shoulder. All patients also completed the Simple Shoulder Test (SST) and American Shoulder and Elbow Surgeons (ASES) evaluation forms preoperatively. A computed tomography scan was obtained postoperatively to assess osseous union of the graft and the patient again went through a physical exam in addition to completing the SST, ASES, and Western Ontario Shoulder Instability Index (WOSI) forms. 10 patients (9 males, 1 female) were followed for an average of 16 months (4–36 months) and had a mean age of 24.4 years. All patients exhibited a negative apprehension/relocation test and full shoulder strength at final follow-up. Eight of 10 patients had achieved osseous union at 6 months (80.0%). ASES scores improved from 64.3 to 97.8, and SST scores improved from 66.7 to 100. Average postoperative WOSI scores were 93.8%. The use of the iliac crest allograft provides a safe and clinically useful alternative compared to previously described procedures for recurrent shoulder instability in the face of glenoid deficiency. PMID:25538432

  1. Use of 3-Dimensional Printing for Preoperative Planning in the Treatment of Recurrent Anterior Shoulder Instability

    PubMed Central

    Sheth, Ujash; Theodoropoulos, John; Abouali, Jihad

    2015-01-01

    Recurrent anterior shoulder instability often results from large bony Bankart or Hill-Sachs lesions. Preoperative imaging is essential in guiding our surgical management of patients with these conditions. However, we are often limited to making an attempt to interpret a 3-dimensional (3D) structure using conventional 2-dimensional imaging. In cases in which complex anatomy or bony defects are encountered, this type of imaging is often inadequate. We used 3D printing to produce a solid 3D model of a glenohumeral joint from a young patient with recurrent anterior shoulder instability and complex Bankart and Hill-Sachs lesions. The 3D model from our patient was used in the preoperative planning stages of an arthroscopic Bankart repair and remplissage to determine the depth of the Hill-Sachs lesion and the degree of abduction and external rotation at which the Hill-Sachs lesion engaged. PMID:26759768

  2. Recurrent anterior shoulder instability: a review of the Latarjet procedure and its postoperative rehabilitation.

    PubMed

    Fedorka, Catherine J; Mulcahey, Mary K

    2015-02-01

    The shoulder is the most common joint to dislocate in the human body, with the dislocation often occurring in the anterior direction. This injury frequently results in soft tissue injury (eg, labral tear, capsular stretching) or bone injury (eg, glenoid or humeral head bone loss), which commonly leads to persistent deficits of shoulder function and a high risk of subsequent instability episodes in young, active patients. Patients with a significant degree of glenoid bone loss (> 25%) may require surgical intervention using the Latarjet procedure, which is an open bony augmentation of the glenoid. This procedure involves transferring the tip of the coracoid to the anteroinferior glenoid, creating a bony block and musculotendinous sling to prevent instability. Rehabilitation after the procedure is a slow progression over 4 to 6 months to regain range of motion and strength, while protecting the bony augmentation. Recent reports have shown success with the Latarjet procedure, as indicated by patient satisfaction scores and a low rate of recurrent instability.

  3. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation.

    PubMed

    D'Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido; Taverna, Ettore

    2015-01-01

    This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process.

  4. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation

    PubMed Central

    D’Ambrosi, Riccardo; Perfetti, Carlo; Garavaglia, Guido; Taverna, Ettore

    2015-01-01

    This case presents the challenges of the surgical management for a patient with a history of recurrent posterior shoulder instability and subsequently traumatic anterior dislocation. The patient was already on the waiting list for an arthroscopic posterior stabilization with anchors, when a car accident caused an additional anterior shoulder dislocation. This traumatic anterior dislocation created a bone loss with a glenoid fracture and aggravated the preexisting posterior instability. In order to address both problems, we decided to perform an arthroscopically assisted Latarjet procedure for anterior instability and to stabilize with a bone graft for posterior instability. To our best knowledge, this type of surgical procedure has so far never been reported in the literature. The purpose of this report is to present the surgical technique and to outline the decision making process. PMID:26288539

  5. Capsular tear in line with the inferior glenohumeral ligament: a cause of anterior glenohumeral instability in 2 patients.

    PubMed

    Rothberg, David L; Burks, Robert T

    2009-08-01

    Anterior glenohumeral instability typically involves lesions associated with the inferior glenohumeral ligament complex. Multiple lesions have been described in this setting, including Bankart, humeral avulsion of the inferior glenohumeral ligament complex, and mid-substance capsular tears. These lesions are indicative of the high-force traumatic nature of anterior shoulder dislocation. Two cases of recurrent anterior shoulder instability are presented with a capsular tear perpendicular to the usual orientation and not consistent to the amount of force involved in a dislocation. Arthroscopy revealed a capsular defect from the glenoid to the humeral head in the anterior inferior glenohumeral ligamentous complex in both. This lesion is an unusual circumstance, providing another pathology to include in the differential diagnosis of anterior glenohumeral instability.

  6. Active Stiffness and Strength in People With Unilateral Anterior Shoulder Instability: A Bilateral Comparison

    PubMed Central

    Olds, Margie; McNair, Peter; Nordez, Antoine; Cornu, Christophe

    2011-01-01

    Context: Active muscle stiffness might protect the unstable shoulder from recurrent dislocation. Objective: To compare strength and active stiffness in participants with unilateral anterior shoulder instability and to examine the relationship between active stiffness and functional ability. Design: Cross-sectional study. Setting: University research laboratory. Patients or Other Participants: Participants included 16 males (age range, 16–40 years; height = 179.4 ± 6.1 cm; mass = 79.1 ± 6.8 kg) with 2 or more episodes of unilateral traumatic anterior shoulder instability. Main Outcome Measure(s): Active stiffness and maximal voluntary strength were measured bilaterally in participants. In addition, quality of life, function, and perceived instability were measured using the Western Ontario Stability Index, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, and Single Alpha Numeric Evaluation, respectively. Results: We found less horizontal adduction strength (t15 = −4.092, P = .001) and less stiffness at 30% (t14 = −3.796, P = .002) and 50% (t12 = −2.341, P = .04) maximal voluntary strength in the unstable than stable shoulder. Active stiffness was not correlated with quality of life, function, or perceived instability (r range, 0.0–0.25; P > .05). Conclusions: The observed reduction in stiffness in the unstable shoulder warrants inclusion of exercises in the rehabilitation program to protect the joint from perturbations that might lead to dislocation. The lack of association between active stiffness and quality of life, function, or perceived instability might indicate that stiffness plays a less direct role in shoulder stability. PMID:22488190

  7. Recurrent anterior shoulder instability: Review of the literature and current concepts

    PubMed Central

    Sofu, Hakan; Gürsu, Sarper; Koçkara, Nizamettin; Öner, Ali; Issın, Ahmet; Çamurcu, Yalkın

    2014-01-01

    The purpose of this review article is to discuss the clinical spectrum of recurrent traumatic anterior shoulder instability with the current concepts and controversies at the scientific level. Because of increasing participation of people from any age group of the population in sports activities, health care professionals dealing with the care of trauma patients must have a thorough understanding of the anatomy, patho-physiology, risk factors, and management of anterior shoulder instability. The risk factors for recurrent shoulder dislocation are young age, participation in high demand contact sports activities, presence of Hill-Sachs or osseous Bankart lesion, previous history of ipsilateral traumatic dislocation, ipsilateral rotator cuff or deltoid muscle insufficiency, and underlying ligamentous laxity. Achieving the best result for any particular patient depends on the procedure that allows observation of the joint surfaces, provides the anatomical repair, maintains range of motion, and also can be applied with low rates of complications and recurrence. Although various surgical techniques have been described, a consensus does not exist and thus, orthopedic surgeons should follow and try to improve the current evidence-based treatment modalities for the patients. PMID:25405191

  8. Increasing preoperative dislocations and total time of dislocation affect surgical management of anterior shoulder instability

    PubMed Central

    Denard, Patrick J.; Dai, Xuesong; Burkhart, Stephen S.

    2015-01-01

    Purpose: Our purpose was to determine the relationship between number of preoperative shoulder dislocations and total dislocation time and the need to perform bone deficiency procedures at the time of primary anterior instability surgery. Our hypothesis was that need for bone deficiency procedures would increase with the total number and hours of dislocation. Materials and Methods: A retrospective review was performed of primary instability surgeries performed by a single surgeon. Patients with <25% glenoid bone loss were treated with an isolated arthroscopic Bankart repair. Those who also had an engaging Hill-Sachs lesion underwent arthroscopic Bankart repair with remplissage. Patients with >25% glenoid bone loss were treated with Latarjet reconstruction. Number of dislocations and total dislocation time were examined for their relationship with the treatment method. Results: Ten arthroscopic Bankart repairs, 13 arthroscopic Bankart plus remplissage procedures, and 9 Latarjet reconstructions were available for review. Total dislocations (P = 0.012) and total hours of dislocation (P = 0.019) increased from the Bankart, to the remplissage, to the Latarjet groups. Patients with a total dislocation time of 5 h or more were more likely to require a Latarjet reconstruction (P = 0.039). Patients with only 1 preoperative dislocation were treated with an isolated Bankart repair in 64% (7 of 11) of cases, whereas those with 2 or more dislocations required a bone loss procedure in 86% (18 of 21) of cases (P = 0.013). Conclusion: Increasing number of dislocations and total dislocation time are associated with the development of glenoid and humeral head bony lesions that alter surgical management of anterior shoulder instability. The necessity for the addition of a remplissage to an arthroscopic Bankart repair or the use of a Latarjet reconstruction increases with only 1 recurrent dislocation. Level of evidence: Level III, retrospective comparative study. PMID:25709237

  9. The Impact of Superior Labral Anterior to Posterior Lesions on Functional Status in Shoulder Instability

    PubMed Central

    Gaudelli, Cinzia; Hébert-Davies, Jonah; Balg, Frédéric; Pelet, Stéphane; Djahangiri, Ali; Godbout, Véronique; Rouleau, Dominique M.

    2014-01-01

    Background: Type IV superior labral anterior to posterior (SLAP) lesions, which are superior labral detachments associated with Bankart tears, are reported to occur in up to 25% of recurrent shoulder instability patients. However, the clinical implications of this finding are debatable. Purpose: To determine whether there are any functional differences between anterior instability patients with and without type IV SLAP lesions at the time of presentation and at short-term follow-up after surgical intervention. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective, multicenter database was established to follow the clinical evolution of patients with shoulder instability. Patients were diagnosed as having a type IV SLAP lesion at the time of arthroscopic Bankart surgery (SLAP+). These patients were compared with a group of patients who simply had a Bankart lesion (SLAP–). The 2 groups had their functional outcomes (Western Ontario Shoulder Instability Index [WOSI]; Disability of the Arm, Shoulder, and Hand [QuickDASH]; and Walch-Duplay) compared prior to surgery and 1 year postoperatively. Results: A total of 103 subjects were included in the study; of these, 56 (43 men, 13 women) completed 1-year follow-up. Twenty-three subjects had a type IV SLAP tear, and most had this repaired along with their Bankart lesion. At baseline, SLAP+ subjects had inferior QuickDASH scores compared with SLAP– subjects (37.8 vs 29.0) as well as poorer pain subscores on both the WOSI and QuickDASH. At 1-year follow-up, however, there were no significant differences in any of the outcome measures. Conclusion: A type IV SLAP lesion can be expected in 22% of patients with recurrent shoulder instability. This finding implies that at baseline, the patient will have slightly worse functional scores related to pain. However, following surgical management of the labral pathology, these patients will have equivalent functional outcomes at short-term follow-up. Clinical

  10. Minimally Invasive Modified Latarjet Procedure in Patients With Traumatic Anterior Shoulder Instability

    PubMed Central

    Ebrahimzadeh, Mohammad Hossein; Moradi, Ali; Zarei, Ahmad Reza

    2015-01-01

    Background: Despite recent advances in arthroscopic soft tissue repair and reconstruction for shoulder instability, Latarjet procedure is continuously a method of choice for many cases of unstable shoulders. Objectives: To evaluate the clinical results of minimally invasive modified Latarjet technique in recurrent, traumatic anterior shoulder instability associated with obvious Hill-Sachs and Bankart lesions. Patients and Methods: Between 2007 and 2013, 36 consequent patients with traumatic anterior shoulder instability who underwent modified Latarjet operation were enrolled in this prospective study. The MRI studies revealed labrum detachment and Hill-Sachs lesion in all shoulders. For all patients, demographic and injury data were obtained and Constant Shoulder score, Rowe score, and UCLA scores were completed by related surgeon. Stability of the shoulder was assessed with the Jobe’s relocation test preoperatively. The patients were followed up at two weeks, one month, three months, and six months from the date of the surgery and evaluated for probable complications. Above mentioned assessments were completed again at the time of the final follow-up. Results: The average age of the enrolled patients was 24.6 (ranging from 18 to 33 years) and 35 patients out of the total of 36 patients were males. Motor-vehicle accidents were the major cause of the injuries (52%) with the average interval between the injury and operation of 3.1 ± 1.2 years (Ranging from 1 to 5 years). The average number of incidents of dislocations between the injury date and the surgery was 7.2 ± 2.1 (Ranging from 4 to 20). The average follow-up period was 37 months (Ranging from 12 to 65 months). All patients had Jobe’s relocation test (Apprehension sign) pre-operatively and negative Jobe’s relocation test post-operation. Significant improvements in functional scores were demonstrated postoperatively compared to preoperational assessment in all cases. Final follow up radiographs showed

  11. Anterior cruciate ligament augmentation for rotational instability following primary reconstruction with an accelerated physical therapy protocol.

    PubMed

    Carey, Timothy; Oliver, David; Pniewski, Josh; Mueller, Terry; Bojescul, John

    2013-01-01

    The purpose of the present study is to present the results of anterior cruciate ligament (ACL) augmentation for patients having rotational instability despite an intact vertical graft in lieu of conventional revision ACL reconstruction. ACL augmentation surgery with a horizontal graft was performed to augment a healed vertical graft on five patients and an accelerated rehabilitation protocol was instituted. Functional outcomes were assessed by the Lower Extremity Functional Scale (LEFS) and the Modified Cincinnati Rating System (MCRS). All patients completed physical therapy within 5 months and were able to return to full military duty without limitation. LEFS and MCRS were significantly improved. ACL augmentation with a horizontal graft provides an excellent alternative to ACL revision reconstruction for patients with an intact vertical graft, allowing an earlier return to duty for military service members.

  12. Anterior-inferior shoulder instability: treatment based on the Thal method.

    PubMed

    Russo, R; Giudice, G; Ciccarelli, M; Vernaglia Lombardi, L; Cautiero, F

    2005-01-01

    Purpose of this study is to analyze the results of a consecutive series of 139 patients affected with anterior-inferior shoulder instability and treated by arthroscopic capsuloplasty using the Thal method with absorbable and non-absorbable Mitek knotless anchors. Much attention was paid to the preoperative and intraoperative selection of patients, excluding from the arthroscopic procedure those with bony Bankart lesions measuring more than 25%, with an inverted-pear glenoid, with engaged Hill-Sachs lesions and patients with HAGL lesions. Pre- and postoperative clinical evaluation was carried out using the Rowe scale. Scores rose from 45-55 to 96 postoperatively. Intra-articular mobilization of the anchors did not occur and peri-metallic lysis was not manifested. Areas of bone resorption were observed in 7 cases (7/38, 18.4%) with the presence of peri-insertional geodes with biological anchors, but this had no effect on the clinical results.

  13. Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

    PubMed Central

    Ramhamadany, Eamon; Modi, Chetan S

    2016-01-01

    The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures. PMID:27335809

  14. Technique for selecting capsular tightness in repair of anterior-inferior shoulder instability.

    PubMed

    Warner, J J; Johnson, D; Miller, M; Caborn, D N

    1995-01-01

    Part I of our study consisted of sending a survey questionnaire to all members of the American Shoulder and Elbow Surgeons in which specific questions were asked about their technique of surgical repair in patients with anterior instability who had capsular laxity or injury in conjunction with marked inferior laxity. Part II is a description of the technique and preliminary results in 18 patients of a modified anterior-inferior capsular shift technique that tightens the inferior capsule with the shoulder positioned in abduction and external rotation and the superior capsule with the shoulder in adduction and external rotation. Of the members of the Society of the American Shoulder and Elbow Surgeons who responded to the survey, 80% agreed that preservation of external rotation was important and that shoulder position at the time of capsular repair might influence the ultimate range of motion obtained. However, no more than 50% of the respondents agreed on any one position for the arm when repairing the capsule. The most common responses for each position were flexion 0 degrees (49%) (range, 0 degrees to 40 degrees), abduction 30 degrees (24%) (range, 0 degrees to 80 degrees), and external rotation 30 degrees (37%) (range, 0 degrees to 70 degrees). The average postoperative follow-up period for the 18 patients was 27 months (range, 24 to 39 months). Of the 18 patients, 11 (61%) maintained symmetric motion; the others had minimal loss of external rotation compared with that of the contralateral shoulder. Six of eight patients with repair on the dominant side were able to return to full premorbid recreational throwing or racquet sports, and seven with repair on the nondominant side returned to full participation in overhead sports such as basketball and swimming. We conclude that this method of "selective" capsular repair may be a useful guideline to gauge the degree of capsular tightening in patients who have capsular injury or laxity.

  15. Gene expression analysis in patients with traumatic anterior shoulder instability suggests deregulation of collagen genes.

    PubMed

    Belangero, Paulo Santoro; Leal, Mariana Ferreira; Figueiredo, Eduardo Antônio; Cohen, Carina; Pochini, Alberto de Castro; Smith, Marília Cardoso; Andreoli, Carlos Vicente; Belangero, Sintia Iole; Ejnisman, Benno; Cohen, Moises

    2014-10-01

    Shoulder dislocation occurs in 1-2% of the population. Capsular deformation is a key factor in shoulder dislocation; however, little is known about capsule biology. We evaluated, for the first time in literature, the expression of COL1A1, COL1A2, COL3A1 and COL5A1 in the antero-inferior, antero-superior and posterior regions of the glenohumeral capsule of 31 patients with anterior shoulder instability and eight controls. The expression of collagen genes was evaluated by quantitative reverse transcription-PCR. The expression of COL1A1, COL3A1 and the ratio of COL1A1/COL1A2 were increased in all three portions of the capsule in patients compared to controls (p < 0.05). COL1A2 expression was upregulated in the antero-superior and posterior sites of the capsule of patients (p < 0.05). The ratio of COL1A2/COL3A1 expression was reduced in capsule antero-inferior and posterior sites of patients compared to controls (p < 0.05). In the capsule antero-inferior site of patients, the ratios of COL1A1/COL5A1, CO1A2/COL5A1 and COL3A1/COL5A1 expression were increased (p < 0.05). In patients, COL1A1/COL5A1 was also increased in the posterior site (p < 0.05). We found deregulated expression of collagen genes across the capsule of shoulder instability patients. These molecular alterations may lead to modifications of collagen fibril structure and impairment of the healing process, possibly with a role in capsular deformation. PMID:25042113

  16. Arthroscopic Latarjet and Capsular Shift (ALCS) procedure: a new "freehand" technique for anterior shoulder instability associated with significant bone defects.

    PubMed

    Bhatia, Deepak N

    2015-03-01

    Anterior shoulder instability associated with significant bone loss has been described as "bony-instability," and this condition is usually treated with an anterior glenoid bone grafting procedure (Latarjet procedure). The Latarjet procedure involves transfer of the horizontal limb of the coracoid process along with the conjoint tendon to the anterior glenoid rim, and is traditionally performed as an open surgical procedure. Recently, an arthroscopic technique for the Latarjet procedure has been described; the technique necessitates the use of specialized instrumentation and involves excision of the entire anterior capsule to facilitate coracoid fixation. We describe a new "freehand" arthroscopic technique for the Latarjet procedure, and, in addition, a simultaneous capsular shift to further optimize mid and end range stability. This technique eliminates the use of additional instrumentation and can be done using routine arthroscopic instruments. Preliminary experience with this technique suggests that the arthroscopic Latarjet and capsular shift is a technically demanding procedure. Glenohumeral capsule can be preserved, and this should be attempted wherever possible to optimize stability. Additional specialized instrumentation would probably reduce surgical time; however, the procedure can be performed with routine instruments.

  17. Bristow-Latarjet Technique: Still a Very Successful Surgery for Anterior Glenohumeral Instability - A Forty Year One Clinic Experience

    PubMed Central

    Ruci, Vilson; Duni, Artid; Cake, Alfred; Ruci, Dorina; Ruci, Julian

    2015-01-01

    AIM: To evaluate the functional outcomes of the Bristow-Latarjet procedure in patients with recurrent anterior glenohumeral instability. PATIENTS AND METHODS: Personal clinical records of 42 patients with 45 operated shoulders were reviewed retrospectively. Patient age at time of first dislocation, injury mechanism, and number of recurring dislocations before surgery were recorded. The overall function and stability of the shoulder was evaluated. RESULTS: Thirty five (78%) of the scapulohumeral humeral instabilities were caused by trauma. The mean number of recurring dislocations was 9 (95% confidence interval [CI], 0–18); one patient had had 17 recurrences. Mean follow-up 46 months (95% CI, 16-88). No dislocation happened postoperatively. Four patients have fibrous union (9%). Only two had clinical sign of pain and discomfort. One of them was reoperated for screw removal with very good post-operative result. The overall functional outcome was good, with a mean Rowe score of 88 points (95% CI, 78–100). Scores of 27 (64%) of the patients were excellent, 9 (22%) were good, 4 (9.5%) were fair, and 2 (4.5%) were poor. CONCLUSION: The Bristow-Latarjet procedure is a very good surgical treatment for recurrent anterior-inferior instability of the glenohumeral joint. It must not be used for multidirectional instability or psychogenic habitual dislocations. PMID:27275242

  18. Management of sternoclavicular dislocation in young children: considerations about diagnosis and treatment of four cases.

    PubMed

    Gil-Albarova, J; Rebollo-González, S; Gómez-Palacio, V E; Herrera, A

    2013-08-01

    The records of 4 children of under 14 years of age treated at our institution for traumatic sternoclavicular dislocation (SCJ) were reviewed. Closed reduction in posterior SCJ after computed tomography (CT) was successful as immediate procedure. For anterior SCJ instability, open reduction and SCJ reconstruction obtained satisfactory results. Conservative treatment of SCJ subluxation for asymptomatic children was sufficient. Radiographs in "serendipity view" were useful for confirming reduction and stability in children. No postoperative CT was needed for this purpose. Closed reduction in posterior SCJ dislocation and surgical treatment in anterior SCJ dislocation in young children can provide stability and a satisfactory return to a normal function, but with some limitation when intense or competitive shoulder motion is required during sport. Young children and parents should be aware about this possibility. Conservative treatment of SCJ subluxation for asymptomatic children is useful. Reflection is required regarding the correct imaging examination after treatment to check stable reduction in a SCJ injury. PMID:23314981

  19. A review of ultrasonographic methods for the assessment of the anterior cruciate ligament in patients with knee instability – diagnostics using a posterior approach

    PubMed Central

    Kielar, Maciej

    2016-01-01

    Aim The purpose of the study was to improve the ultrasonographic assessment of the anterior cruciate ligament by an inclusion of a dynamic element. The proposed functional modification aims to restore normal posterior cruciate ligament tension, which is associated with a visible change in the ligament shape. This method reduces the risk of an error resulting from subjectively assessing the shape of the posterior cruciate ligament. It should be also emphasized that the method combined with other ultrasound anterior cruciate ligament assessment techniques helps increase diagnostic accuracy. Methods Ultrasonography is used as an adjunctive technique in the diagnosis of anterior cruciate ligament injury. The paper presents a sonographic technique for the assessment of suspected anterior cruciate ligament insufficiency supplemented by the use of a dynamic examination. This technique can be recommended as an additional procedure in routine ultrasound diagnostics of anterior cruciate ligament injuries. Results Supplementing routine ultrasonography with the dynamic assessment of posterior cruciate ligament shape changes in patients with suspected anterior cruciate ligament injury reduces the risk of subjective errors and increases diagnostic accuracy. This is important especially in cases of minor anterior knee instability and bilateral anterior knee instability. Conclusions An assessment of changes in posterior cruciate ligament using a dynamic ultrasound examination effectively complements routine sonographic diagnostic techniques for anterior cruciate ligament insufficiency.

  20. A review of ultrasonographic methods for the assessment of the anterior cruciate ligament in patients with knee instability – diagnostics using a posterior approach

    PubMed Central

    Kielar, Maciej

    2016-01-01

    Aim The purpose of the study was to improve the ultrasonographic assessment of the anterior cruciate ligament by an inclusion of a dynamic element. The proposed functional modification aims to restore normal posterior cruciate ligament tension, which is associated with a visible change in the ligament shape. This method reduces the risk of an error resulting from subjectively assessing the shape of the posterior cruciate ligament. It should be also emphasized that the method combined with other ultrasound anterior cruciate ligament assessment techniques helps increase diagnostic accuracy. Methods Ultrasonography is used as an adjunctive technique in the diagnosis of anterior cruciate ligament injury. The paper presents a sonographic technique for the assessment of suspected anterior cruciate ligament insufficiency supplemented by the use of a dynamic examination. This technique can be recommended as an additional procedure in routine ultrasound diagnostics of anterior cruciate ligament injuries. Results Supplementing routine ultrasonography with the dynamic assessment of posterior cruciate ligament shape changes in patients with suspected anterior cruciate ligament injury reduces the risk of subjective errors and increases diagnostic accuracy. This is important especially in cases of minor anterior knee instability and bilateral anterior knee instability. Conclusions An assessment of changes in posterior cruciate ligament using a dynamic ultrasound examination effectively complements routine sonographic diagnostic techniques for anterior cruciate ligament insufficiency. PMID:27679732

  1. Prevention of knee instability. Experimental model for prosthetic anterior cruciate ligament.

    PubMed

    Rubin, R M; Marshall, J L; Wang, J

    1975-01-01

    Loss of the anterior cruciate ligament (ACL) in the dog results in a predictable type of arthritis. This condition can be prevented by successful prosthetic substitution of the anterior cruciate ligament (ACL). The condition is a practical model, and a sensitive index of success and failure for evaluation of prototype prostheses. Changes in the joint can be differentiated on the basis of cruciate insufficiency and reaction to the synthetic implant. The model was defined by replacing the ACL with a mesh or tape Dacron prosthesis in 16 Beagle dogs. Gait and anterior drawer sign are unreliable parameters of ACL insufficiency in dogs. At sacrifice up to 3 years postoperatively, 8 joints out of 32 joints were without arthritic changes. Arthritis developed in all joints in which the prosthesis elongated or broke. Failure always occurred intra-articularly at the mouth of a bone tunnel. Successes were inconsistent even with a single material and animal breed. The drillhole techniques used in ACL reconstructions are difficult to standardize. Variability in placement of the prosthesis is compounded by cutting action of bone edges. Porous mesh did not provide a lattice for true ligament regeneration through the joint. Fixation was not a problem in this series. PMID:1192669

  2. INTEGRITY OF THE SUBSCAPULARIS TENDON AFTER OPEN SURGERY FOR THE TREATMENT OF ANTERIOR SHOULDER INSTABILITY: A CLINICAL AND RADIOLOGICAL EVALUATION

    PubMed Central

    Lech, Osvandré; Piluski, Paulo; Tambani, Renato; Castro, Nero; Pimentel, Gilnei

    2015-01-01

    Objective: To evaluate the integrity of the subscapularis tendon by strength, function and magnetic resonance imaging after deltopectoralis access for anterior shoulder instability. Methods: 20 patients with anterior shoulder instability have been evaluated. Minimum follow-up was 12 months, with a mean of 40 months. Only male patients were included, with a mean of age of 29 years (20 − 42 years). The patients have been submitted to physical examinations of mobility, muscular strength, Belly Test and Gerber Test. The isokinetic strength in internal and external rotation, in angular speeds of 600/s and 1800/s, for both shoulders was measured using a dynamometer. In 15 patients magnetic resonance imaging (MRI) was carried out on both shoulders for evaluating the thickness, cross-sectional area and atrophy of the subscapularis muscle. Results: A significant difference was found between torque peaks at the speed of 600/s for internal (p=0.036) and external (p=0.008) rotation. However, at 1800/s the opposite happens (internal rotation: p=0.133; external rotation: p=0.393). Subscapularis muscle thickness and area are significantly smaller than the normal side, with a deficit of 19% and 23%, respectively. According to Rowe and UCLA scores, we find excellent and good results for the majority of patients, with a mean of 88 and 31.6 points, respectively. Conclusion: Despite of the good functional results, open surgery can limit strength and reduce the thickness and the cross-sectional area of subscapularis muscle. However, the best results were found in the patients who had the dominant side operated. PMID:27004190

  3. Management of mid-season traumatic anterior shoulder instability in athletes.

    PubMed

    Owens, Brett D; Dickens, Jonathan F; Kilcoyne, Kelly G; Rue, John-Paul H

    2012-08-01

    Shoulder dislocation and subluxation injuries are common in young athletes and most frequently occur during the competitive season. Controversy exists regarding optimal treatment of an athlete with an in-season shoulder dislocation, and limited data are available to guide treatment. Rehabilitation may facilitate return to sport within 3 weeks, but return is complicated by a moderate risk of recurrence. Bracing may reduce the risk of recurrence, but it restricts motion and may not be tolerated in patients who must complete certain sport-specific tasks such as throwing. Surgical management of shoulder dislocation or subluxation with arthroscopic or open Bankart repair reduces the rate of recurrence; however, the athlete is unable to participate in sport for the remainder of the competitive season. When selecting a management option, the clinician must consider the natural history of shoulder instability, pathologic changes noted on examination and imaging, sport- and position-specific demands, duration of treatment, and the athlete's motivation.

  4. Arthroscopic Reinsertion of Lateral Collateral Ligament, Anterior Capsular Plication, and Coronoid Tunneling Technique for Chronic Elbow Posterolateral Rotatory Instability.

    PubMed

    Arrigoni, Paolo; D'Ambrosi, Riccardo; Nicoletti, Simone; Randelli, Pietro

    2016-06-01

    Posterolateral rotatory instability (PLRI) of the elbow is a chronic condition that results from lateral collateral ligament complex injury and presents with pain, clicking, and subluxation within the flexion and extension arcs of elbow motion. The primary cause involves a lesion of the lateral collateral ligament complex and its avulsion from the lateral epicondyle. In most cases, it is the result of trauma such as a fall on an outstretched hand or any other mechanism that imparts axial compression, valgus force, and supination. Several surgical techniques have been described for the treatment of PLRI, but there is no consensus regarding the ideal surgical treatment. The advantages of an arthroscopic approach for the treatment of PLRI are first diagnostic. Arthroscopy allows for visualization and diagnosis of every compartment of the elbow. The main steps of the surgical procedure consist of reinsertion of the lateral collateral ligament, anterior capsular plication, and coronoid tunneling. By use of this technique, it is possible to perform an anatomic repair and provide stability of the elbow. PMID:27656364

  5. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes.

    PubMed

    Sewell, M D; Al-Hadithy, N; Le Leu, A; Lambert, S M

    2013-06-01

    The sternoclavicular joint (SCJ) is a pivotal articulation in the linked system of the upper limb girdle, providing load-bearing in compression while resisting displacement in tension or distraction at the manubrium sterni. The SCJ and acromioclavicular joint (ACJ) both have a small surface area of contact protected by an intra-articular fibrocartilaginous disc and are supported by strong extrinsic and intrinsic capsular ligaments. The function of load-sharing in the upper limb by bulky periscapular and thoracobrachial muscles is extremely important to the longevity of both joints. Ligamentous and capsular laxity changes with age, exposing both joints to greater strain, which may explain the rising incidence of arthritis in both with age. The incidence of arthritis in the SCJ is less than that in the ACJ, suggesting that the extrinsic ligaments of the SCJ provide greater stability than the coracoclavicular ligaments of the ACJ. Instability of the SCJ is rare and can be difficult to distinguish from medial clavicular physeal or metaphyseal fracture-separation: cross-sectional imaging is often required. The distinction is important because the treatment options and outcomes of treatment are dissimilar, whereas the treatment and outcomes of ACJ separation and fracture of the lateral clavicle can be similar. Proper recognition and treatment of traumatic instability is vital as these injuries may be life-threatening. Instability of the SCJ does not always require surgical intervention. An accurate diagnosis is required before surgery can be considered, and we recommend the use of the Stanmore instability triangle. Most poor outcomes result from a failure to recognise the underlying pathology. There is a natural reluctance for orthopaedic surgeons to operate in this area owing to unfamiliarity with, and the close proximity of, the related vascular structures, but the interposed sternohyoid and sternothyroid muscles are rarely injured and provide a clear boundary to the

  6. “8 Plate”: An Alternative Device to Fix Highly Recurrent Traumatic Anterior Gleno-Humeral Instability in Patients with Severe Impairment of the Anterior Capsule

    PubMed Central

    Tudisco, C; Bisicchia, S; Savarese, E; Ippolito, E

    2014-01-01

    Background: There is still debate about the best treatment option for highly recurrent anterior shoulder dislocation in patients with severe impairment of the anterior capsule and/or recurrence after either arthroscopic or open capsulorrhaphy. Materials and Methods: The clinical and radiological findings of 7 patients treated with an open capsulorrhaphy stabilized with an “8 plate” for a highly recurrent traumatic anterior shoulder dislocation with severe impairment of the anterior capsule and a large Bankart lesion were retrospectively reviewed. Follow-up evaluation included VAS for pain, Constant-Murley, Simple Shoulder Test, ASES, UCLA, Quick DASH, Rowe, Walsch-Duplay scores, as well as X-rays of the operated shoulder. Results: At follow-up none of the patients reported subsequent dislocations. Range of motion of the shoulder was complete in all cases, but one. Results of the functional scoring systems were satisfactory. X-rays showed no osteolysis and good position of the plate. Conclusion: To our knowledge, this is the first report in the literature about an open capsular tensioning and Bankart lesion repair performed with an “8 plate”. We believe that this is a reliable and effective procedure to address traumatic anterior re-dislocation of the gleno-humeral joint when the capsule is extensively torn and frayed or in revision cases. Moreover the “8 plate” is ideal to be applied in such a narrow space on the slant surface of the scapular neck close to the glenoid rim. PMID:25621080

  7. Profile of collagen gene expression in the glenohumeral capsule of patients with traumatic anterior instability of the shoulder☆☆☆

    PubMed Central

    Belangero, Paulo Santoro; Leal, Mariana Ferreira; de Castro Pochini, Alberto; Andreoli, Carlos Vicente; Ejnisman, Benno; Cohen, Moises

    2014-01-01

    Objective To evaluate the expression of the genes COL1A1, COL1A2, COL3A1 and COL5A1 in the glenohumeral capsule of patients with traumatic anterior instability of the shoulder. Methods Samples from the glenohumeral capsule of 18 patients with traumatic anterior instability of the shoulder were evaluated. Male patients with a positive grip test and a Bankart lesion seen on magnetic resonance imaging were included. All the patients had suffered more than one episode of shoulder dislocation. Samples were collected from the injured glenohumeral capsule (anteroinferior region) and from the macroscopically unaffected region (anterosuperior region) of each patient. The expression of collagen genes was evaluated using the polymerase chain reaction after reverse transcription with quantitative analysis (qRT-PCR). Results The expression of COL1A1, COL1A2 and COL3A1 did not differ between the two regions of the shoulder capsule. However, it was observed that the expression of COL5A1 was significantly lower in the anteroinferior region than in the anterosuperior region (median ± interquartile range: 0.057 ± 0.052 vs. 0.155 ± 0.398; p = 0.028) of the glenohumeral capsule. Conclusion The affected region of the glenohumeral capsule in patients with shoulder instability presented reduced expression of COL5A1. PMID:26229875

  8. Simultaneous surgical management of chronic grade-2 valgus instability of the knee and anterior cruciate ligament deficiency in athletes.

    PubMed

    Osti, Leonardo; Papalia, Rocco; Del Buono, Angelo; Merlo, Franco; Denaro, Vincenzo; Maffulli, Nicola

    2010-03-01

    We report on 22 patients with chronic grade-2 valgus laxity of the knee combined with chronic anterior cruciate ligament (ACL) insufficiency, in whom the two lesions were addressed at the same surgical setting. At a minimum follow-up of 24 months, clinical and functional variables had improved significantly (P < 0.001), and 20 of the 22 patients (91%) had returned to sport at pre-injury level. There were no operative complications in this series. In selected athletes with chronic symptomatic valgus laxity of the knee combined with ACL insufficiency, surgical repair of the MCL in association with ACL reconstruction is a suitable and reliable option to restore knee stability and allow return to pre-injury activity level.

  9. Hip instability.

    PubMed

    Smith, Matthew V; Sekiya, Jon K

    2010-06-01

    Hip instability is becoming a more commonly recognized source of pain and disability in patients. Traumatic causes of hip instability are often clear. Appropriate treatment includes immediate reduction, early surgery for acetabular rim fractures greater than 25% or incarcerated fragments in the joint, and close follow-up to monitor for avascular necrosis. Late surgical intervention may be necessary for residual symptomatic hip instability. Atraumatic causes of hip instability include repetitive external rotation with axial loading, generalized ligamentous laxity, and collagen disorders like Ehlers-Danlos. Symptoms caused by atraumatic hip instability often have an insidious onset. Patients may have a wide array of hip symptoms while demonstrating only subtle findings suggestive of capsular laxity. Traction views of the affected hip can be helpful in diagnosing hip instability. Open and arthroscopic techniques can be used to treat capsular laxity. We describe an arthroscopic anterior hip capsular plication using a suture technique. PMID:20473129

  10. Management of subaxial cervical instability in very young or small-for-age children using a static single-screw anterior cervical plate: indications, results, and long-term follow-up.

    PubMed

    Garber, Sarah T; Brockmeyer, Douglas L

    2016-06-01

    OBJECTIVE Subaxial cervical instability in very young or small-for-age children is uncommon and typically arises from trauma or skeletal dysplasia. Various operative techniques have been used to achieve stabilization in pediatric patients with evidence of instability, including anterior, posterior, and combined approaches. In this study, the authors report their results with subaxial cervical instability in this patient population treated using a static single-screw anterior cervical plate (ACP) system and allograft fusion. METHODS In a retrospective chart review, the authors identified all patients 6 years of age or younger who underwent an anterior cervical fusion procedure using a static single-screw ACP system either as a stand-alone construct or as part of an anterior-posterior stabilization procedure. Reasons for fusion included trauma, tumor, and congenital anomalies. RESULTS Five patients 6 years of age or younger underwent anterior cervical fusion using a static single-screw system during the 19-year study period. Follow-up ranged from 12 to 51 months (mean 26.8 months). Two patients underwent repeat surgery, one 7 days after and the other 21 months after their initial procedure. At last follow-up, a mean vertical growth of 22.8% was seen across the fused segments, with no evidence of kyphotic or lordotic abnormalities. CONCLUSIONS In very young or small-for-age children, the use of a static single-screw ACP system appears to be a safe and effective option to manage subaxial cervical instability. Bony fusion and continued longitudinal growth occur within the fused segments, with no evidence of long-term cervical malalignment.

  11. Management of subaxial cervical instability in very young or small-for-age children using a static single-screw anterior cervical plate: indications, results, and long-term follow-up.

    PubMed

    Garber, Sarah T; Brockmeyer, Douglas L

    2016-06-01

    OBJECTIVE Subaxial cervical instability in very young or small-for-age children is uncommon and typically arises from trauma or skeletal dysplasia. Various operative techniques have been used to achieve stabilization in pediatric patients with evidence of instability, including anterior, posterior, and combined approaches. In this study, the authors report their results with subaxial cervical instability in this patient population treated using a static single-screw anterior cervical plate (ACP) system and allograft fusion. METHODS In a retrospective chart review, the authors identified all patients 6 years of age or younger who underwent an anterior cervical fusion procedure using a static single-screw ACP system either as a stand-alone construct or as part of an anterior-posterior stabilization procedure. Reasons for fusion included trauma, tumor, and congenital anomalies. RESULTS Five patients 6 years of age or younger underwent anterior cervical fusion using a static single-screw system during the 19-year study period. Follow-up ranged from 12 to 51 months (mean 26.8 months). Two patients underwent repeat surgery, one 7 days after and the other 21 months after their initial procedure. At last follow-up, a mean vertical growth of 22.8% was seen across the fused segments, with no evidence of kyphotic or lordotic abnormalities. CONCLUSIONS In very young or small-for-age children, the use of a static single-screw ACP system appears to be a safe and effective option to manage subaxial cervical instability. Bony fusion and continued longitudinal growth occur within the fused segments, with no evidence of long-term cervical malalignment. PMID:26895532

  12. Results of Arthroscopic Bankart Lesion Repair in Patients with Post-Traumatic Anterior Instability of the Shoulder and a Non-Engaging Hill-Sachs Lesion with a Suture Anchor after a Minimum of 6-Year Follow-Up

    PubMed Central

    Szyluk, Karol; Jasiński, Andrzej; Widuchowski, Wojciech; Mielnik, Michał; Koczy, Bogdan

    2015-01-01

    Background Shoulder instability is an important clinical problem. Arthroscopic surgery is an established treatment modality in shoulder instability, but it continues to be associated with a high rate of recurrences and complications. The purpose of the study was to analyze late outcomes of arthroscopic repair of Bankart lesions in patients with post-traumatic anterior shoulder instability and non-engaging Hill-Sachs lesion, with special focus on the incidence and causes of recurrences and complications. Material/Methods We investigated 92 patients (92 shoulders) who underwent surgery on account of post-traumatic anterior shoulder instability. The duration of follow-up ranged from 6 to 12.5 years (mean: 8.2 years). All patients were operated on in the lateral decubitus position using FASTak 2.8-mm suture anchors (FASTak, Arthrex, Naples, Florida). Treatment outcomes were evaluated using the Rowe and University of California at Los Angeles rating system (UCLA). Results According to Rowe scores, there were 71 (81.5%) excellent, 12 (12.6%) good, 5 (5.3%) satisfactory, and 2 (2.1%) poor results. Rowe scores improved in a statistically significant manner (p=0.00) post-surgery, to a mean of 90 (range: 25–100). Treatment outcomes measured as UCLA scores improved in a statistically significant manner (p=0.00), reaching post-operative levels of 12–35 (mean: 33.5). There were 9 recurrences, 1 case of axillary nerve praxia, and 1 case of anchor loosening. Conclusions With rigorous criteria for qualifying patients for surgery, arthroscopic treatment of post-traumatic anterior shoulder instability produces good outcomes and low recurrence and complication rates irrespective of the number of previous dislocations, age, or sex. PMID:26256225

  13. The Sheffield bone block procedure: a new operation for the treatment of glenoid bone loss in patients with anterior traumatic shoulder instability

    PubMed Central

    Storey, Phil; Macinnes, Scott J; Ali, Amjid; Potter, David

    2015-01-01

    Background The purpose of the present study was to evaluate the results of the Sheffield bone block procedure for anteroinferior bone loss in traumatic shoulder instability. In this modified open technique, the medial half of coracoid process without its soft tissue attachments is used to provide congruent augmentation of the anteroinferior glenoid and secured with two screws. Methods In this retrospective consecutive case series (2007–11), all patients having recurrent traumatic instability with glenoid bone loss > 20% and/or a large Hill–Sachs lesion were included. The shoulder function was evaluated clinically and by Oxford Shoulder Instability Score (OSIS; by post/telephone). Results There were 84 patients in this series with a large proportion engaged in contact sports. Mean (range) age was 33 years (16 years to 45 years); male : female, 59 : 8; mean (range) follow-up period was 48 months (36 months to 84 months) and the response rate 89% (75/84). Mean postoperative OSIS was 43 (33 to 46) and one patient had re-dislocation (1.3%). No neurovascular complications/hardware failure/non-union/infections were noted. By 6 months, 85% patients had returned to pre-injury sport and 93% had returned to pre-injury work. Conclusions The Sheffield bone block procedure provides reliable and satisfactory results in patients having recurrent instability with glenoid bone loss and/or a large Hill–Sachs lesion with minimal complications and an excellent chance of returning to original sport and occupation. PMID:27583007

  14. RESULTS FROM LATARJET SURGERY FOR TREATING TRAUMATIC ANTERIOR SHOULDER INSTABILITY ASSOCIATED WITH BONE EROSION IN THE GLENOID CAVITY, AFTER MINIMUM FOLLOW-UP OF ONE YEAR

    PubMed Central

    Ikemoto, Roberto Yukio; Murachovisky, Joel; Nascimento, Luis Gustavo Prata; Bueno, Rogério Serpone; Almeida, Luiz Henrique Oliveira; Strose, Eric; Helmer, Fábio Fernando

    2015-01-01

    Objective: Evaluate the results from the Latarjet procedure in patients with anterior recurrent dislocation of the shoulder who present bone loss of the glenoid cavity greater than 25%. Methods: Twenty six male patients underwent the Latarjet procedure, The bone loss was evaluated by means of radiography using the Bernageau view and by means of CAT scan. The patients were evaluated with regard to range of motion, using the Rowe and UCLA scales, before and after the operation, and by radiographs to assess the presence of arthrosis, position and consolidation of the graft and positioning of the screws. Statistical analysis was used to assess whether there was any relationship between the number of episodes of dislocation and the presence of arthrosis, , and any relationship between arthrosis and limitations on lateral rotation. Differences in range of motion between the operated and unaffected sides and in the UCLA and Rowe scale. Results: The means for elevation and lateral rotation were statistically poorer on the operated side. The UCLA and Rowe scale showed that there was a statistically significant improvement in the clinical-functional results (P < 0.001 for both). There was a relationship between the number of episodes of dislocation and the presence of arthrosis, We also did not observe any correlation between limitations on lateral rotation and arthrosis. Conclusion: The Latarjet procedure is an efficient method for cases of severe erosion of the glenoid margin. PMID:27027053

  15. Tibialis Anterior Tendon Transfer.

    PubMed

    Mulhern, Jennifer L; Protzman, Nicole M; Brigido, Stephen A

    2016-01-01

    Tendon transfer procedures are used commonly for the correction of soft tissue imbalances and instabilities. The complete transfer and the split transfer of the tibialis anterior tendon are well-accepted methods for the treatment of idiopathic equinovarus deformity in children and adults. Throughout the literature, complete and split transfer have been shown to yield significant improvements in ankle and foot range of motion and muscle function. At present, there is insufficient evidence to recommend one procedure over the other, although the split procedure has been advocated for consistently achieving inversion to eversion muscle balance without overcorrection.

  16. Magnetic resonance imaging in glenohumeral instability

    PubMed Central

    Jana, Manisha; Gamanagatti, Shivanand

    2011-01-01

    The glenohumeral joint is the most commonly dislocated joint of the body and anterior instability is the most common type of shoulder instability. Magnetic resonance (MR) imaging, and more recently, MR arthrography, have become the essential investigation modalities of glenohumeral instability, especially for pre-procedure evaluation before arthroscopic surgery. Injuries associated with glenohumeral instability are variable, and can involve the bones, the labor-ligamentous components, or the rotator cuff. Anterior instability is associated with injuries of the anterior labrum and the anterior band of the inferior glenohumeral ligament, in the form of Bankart lesion and its variants; whereas posterior instability is associated with reverse Bankart and reverse Hill-Sachs lesion. Multidirectional instability often has no labral pathology on imaging but shows specific osseous changes such as increased chondrolabral retroversion. This article reviews the relevant anatomy in brief, the MR imaging technique and the arthrographic technique, and describes the MR findings in each type of instability as well as common imaging pitfalls. PMID:22007285

  17. Muscle activation patterns in patients with recurrent shoulder instability

    PubMed Central

    Jaggi, Anju; Noorani, Ali; Malone, Alex; Cowan, Joseph; Lambert, Simon; Bayley, Ian

    2012-01-01

    Purpose: The aim of this study is to present muscle patterns observed with the direction of instability in a series of patients presenting with recurrent shoulder instability. Materials and Methods: A retrospective review was carried out on shoulder instability cases referred for fine wire dynamic electromyography (DEMG) studies at a specialist upper limb centre between 1981 and 2003. An experienced consultant clinical neurophysiologist performed dual needle insertion into four muscles (pectoralis major (PM), latissimus dorsi (LD), anterior deltoid (AD) and infraspinatus (IS)) in shoulders that were suspected to have increased or suppressed activation of muscles that could be contributing to the instability. Raw EMG signals were obtained while subjects performed simple uniplanar movements of the shoulder. The presence or absence of muscle activation was noted and compared to clinical diagnosis and direction of instability. Results: A total of 140 (26.6%) shoulders were referred for fine wire EMG, and 131 studies were completed. Of the shoulders tested, 122 shoulders (93%) were identified as having abnormal patterns and nine had normal patterns. PM was found to be more active in 60% of shoulders presenting with anterior instability. LD was found to be more active in 81% of shoulders with anterior instability and 80% with posterior instability. AD was found to be more active in 22% of shoulders with anterior instability and 18% with posterior instability. IS was found to be inappropriately inactive in only 3% of shoulders with anterior instability but in 25% with posterior instability. Clinical assessment identified 93% of cases suspected to have muscle patterning, but the specificity of the clinical assessment was only correct in 11% of cases. Conclusion: The DEMG results suggest that increased activation of LD may play a role in both anterior and posterior shoulder instability; increased activation of PM may play a role in anterior instability. PMID:23493512

  18. Management of anterior cruciate ligament injury: pathophysiology and treatment.

    PubMed

    Alazzawi, Sulaiman; Sukeik, Mohamed; Ibrahim, Mazin; Haddad, Fares S

    2016-04-01

    Anterior cruciate ligament injury, a common soft tissue injury of the knee joint, is increasing in incidence particularly in young active people. It causes instability of the knee that leads to meniscal tears, cartilage defects and early osteoarthritis. This review summarizes aspects of anterior cruciate ligament injury management.

  19. Collective instabilities

    SciTech Connect

    K.Y. Ng

    2003-08-25

    The lecture covers mainly Sections 2.VIII and 3.VII of the book ''Accelerator Physics'' by S.Y. Lee, plus mode-coupling instabilities and chromaticity-driven head-tail instability. Besides giving more detailed derivation of many equations, simple interpretations of many collective instabilities are included with the intention that the phenomena can be understood more easily without going into too much mathematics. The notations of Lee's book as well as the e{sup jwt} convention are followed.

  20. An Evaluation of the Clinical and Anatomic Predictors of Outcomes at a Minimum of 2 yrs Following the Latarjet Procedure for Recurrent Anterior Shoulder Instability with Glenoid Bone Loss

    PubMed Central

    Mook, William R.; Petri, Maximilian; Greenspoon, Joshua A.; Horan, Marilee P.; Millett, Peter J.

    2015-01-01

    Objectives: Although the Latarjet procedure for the treatment of recurrent shoulder instability is highly successful, reasons for failure are often unclear. The purpose of our study was to evaluate clinical and anatomic characteristics that were predictive of continued instability or poor outcomes following the Latarjet procedure. Methods: In this IRB approved study, patients who underwent open coracoid Latarjet procedures for anteroinferior instability with glenoid bone loss (>20%) prior to October of 2012 were included. Anatomic measurements of coracoid size (anteroposterior surface area, maximal coracoid width), conjoint and subscapularis tendon widths, estimated glenoid defect surface area, Hill-Sach's Interval, and projected postoperative glenoid track engagement were obtained from preoperative cross-sectional imaging. When the projected glenoid track was smaller than the Hill-Sach's interval, the lesion was determined to be outside-&-engaged compared to inside-&-non-engaged. Patient reported subjective data that was prospectively collected and retrospectively reviewed included patient satisfaction, instability events, SANE score, ASES score, DASH score, and SF-12 PCS. Patients that progressed to another shoulder surgery not related to instability were considered complications and patients that continued to experience dislocations or who underwent revision instability surgeries were considered failures. Results: Thirty-nine shoulders in 39 patients (34 men, 5 women) with a mean age of 26 (range 16-43) were included at a mean follow-up was 3.3 years (2- 7.9 years). There were 25 out of 39 that had prior stabilization surgery and 6 workman's compensation claims. One patient was revised due to broken hardware at 2 months and one because of coracoid nonunion at 18 months. One patient experienced postsurgical adhesive capsulitis treated surgically at a year. All subjective outcome scores significantly improved (p<.05) and a 9 out of 10 median satisfaction score was

  1. Turbulence and instabilities

    NASA Astrophysics Data System (ADS)

    Belotserkovskii, Oleg

    2001-06-01

    The main principles for constructing of mathematical models for fully developed free shear turbulence and hydrodynamic instabilities are considered in the report. Such a “rational” modeling is applied for a variety of unsteady multidimensional problems. For the wide class of phenomena, by the large Reynolds numbers within the low-frequency and inertial intervals of turbulent motion, the effect of molecular viscosity and of the small elements of flow in the largest part of perturbation domain are not practically essential neither for the general characteristics of macroscopic structures of the flow developed, nor the flow pattern as a whole. This makes it possible not to take into consideration the effects of molecular viscosity when studying the dynamics of large vortices, and to implement the study of those on the basis of models of the ideal gas (using the methods of “rational” averaging, but without application of semi-empirical models of turbulence). Among the problems, which have been studied by such a way, there are those of the jet-type flow in the wake behind the body, the motions of ship frames with stern shearing, the formation of anterior stalling zones by the flow about blunted bodies with jets or needles directed to meet the flow, etc. As applications the problems of instability development and of spreading of smoke cloud from large-scale source of the fire are considered.

  2. [Carpal instability].

    PubMed

    Redeker, J; Vogt, P M

    2011-01-01

    Carpal instability can be understood as a disturbed anatomical alignment between bones articulating in the carpus. This disturbed balance occurs either only dynamically (with movement) under the effect of physiological force or even statically at rest. The most common cause of carpal instability is wrist trauma with rupture of the stabilizing ligaments and adaptive misalignment following fractures of the radius or carpus. Carpal collapse plays a special role in this mechanism due to non-healed fracture of the scaphoid bone. In addition degenerative inflammatory alterations, such as chondrocalcinosis or gout, more rarely aseptic bone necrosis of the lunate or scaphoid bones or misalignment due to deposition (Madelung deformity) can lead to wrist instability. Under increased pressure the misaligned joint surfaces lead to bone arrosion with secondary arthritis of the wrist. In order to arrest or slow down this irreversible process, diagnosis must occur as early as possible. Many surgical methods have been thought out to regain stability ranging from direct reconstruction of the damaged ligaments, through ligament replacement to partial stiffening of the wrist joint.

  3. Bilateral Anterior Shoulder Dislocation

    PubMed Central

    Siu, Yuk Chuen; Lui, Tun Hing

    2014-01-01

    Introduction: Unilateral anterior shoulder dislocation is one of the most common problems encountered in orthopedic practice. However, simultaneous bilateral anterior dislocation of the shoulders is quite rare. Case Presentation: We report a case of a 75-year-old woman presented with simultaneous bilateral anterior shoulder dislocation following a trauma, complicated with a traction injury to the posterior cord of the brachial plexus. Conclusions: Bilateral anterior shoulder dislocation is very rare. The excessive traction force during closed reduction may lead to nerve palsy. Clear documentation of neurovascular status and adequate imaging before and after a reduction should be performed. PMID:25685749

  4. Inferior capsular shift operation for multidirectional instability of the shoulder in players of contact sports

    PubMed Central

    Choi, C; Ogilvie-Harris, D

    2002-01-01

    Objectives: To assess the results of inferior capsular shift for multidirectional instability of the shoulder in athletes. Methods: Multidirectional instability was surgically corrected in 53 shoulders in 47 athletes who engaged in contact sports. A history of major trauma was found in eight patients, the others having had minor episodes. Before surgery, all patients had complex combinations of instabilities. The surgical approach was selected according to the predominant direction of instability. Results: Anterior inferior capsular shift was carried out in 37 shoulders, and anterior dislocation recurred in three. In one of these, it was anterior alone, one was anterior and inferior, and one was unstable in all three directions. After posterior inferior capsular shift in 16 shoulders, one dislocation occurred anteriorly and one posteriorly. With the anterior approach, four athletes could not return to sport. Two patients treated with the posterior approach could not return to sport. Of these six failures, five patients had had bilateral repairs. Successful repair based on the criteria of the American Shoulder and Elbow Association was achieved in 92% of anterior repairs and 81% of posterior repairs. Successful return to sport was noted in 82% of patients with anterior repairs, 75% with posterior repairs, and 17% with bilateral repairs. Overall, there were five subsequent dislocations, three in the anterior repair group (8%), and two in the posterior repair group (12%). Conclusions: Inferior capsular shift can successfully correct multidirectional instability in most players of contact sports, but the results in bilateral cases are poor. PMID:12145120

  5. Predictors for Surgery in Shoulder Instability

    PubMed Central

    Lebus, George F.; Raynor, Martin B.; Nwosu, Samuel K.; Wagstrom, Emily; Jani, Sunil S.; Carey, James L.; Hettrich, Carolyn M.; Cox, Charles L.; Kuhn, John E.

    2015-01-01

    Background: Shoulder instability is a common cause of pain and dysfunction in young, active patients. While studies have analyzed risk factors for recurrent instability and failure after instability surgery, few have examined which variables are associated with initial surgery in this patient population. Purpose: To identify variables that may be associated with surgical intervention in patients with shoulder instability in the context of the FEDS (frequency, etiology, direction, severity) classification, a system that may be useful in the surgical treatment of shoulder instability patients. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: A database of patients treated for shoulder instability from 3 separate institutions from 2005 to 2010 was generated using International Classification of Diseases–9th Revision data. Data were collected via retrospective review. Injury data were categorized according to the FEDS system. Data were analyzed for significance, with the primary outcome of surgical intervention. Summary statistics were used to assess which variables were associated with eventual surgery. To test the unadjusted bivariate associations between shoulder surgery and each data point, Pearson chi-square tests were used for categorical variables and Wilcoxon tests were used for continuous variables. Results: Over the study time period, 377 patients were treated for shoulder instability. Patients who had surgery were more likely younger, had recurrent instability, and had their initial injury while playing a sport. Most patients had anterior instability; however, there was a greater proportion of posterior instability patients in the operative group. Severity of dislocation, measured by whether the patient required help to relocate the shoulder, was not significantly associated with eventual surgery. While imaging was not available for all patients, surgical patients were more likely to have magnetic resonance imaging findings of

  6. Sternoclavicular joint dislocation and its management: A review of the literature

    PubMed Central

    Morell, Daniel J; Thyagarajan, David S

    2016-01-01

    Dislocations of the sternoclavicular joint (SCJ) occur with relative infrequency and can be classified into anterior and posterior dislocation, with the former being more common. The SCJ is inherently unstable due to its lack of articular contact and therefore relies on stability from surrounding ligamentous structures, such as the costoclavicular, interclavicular and capsular ligaments. The posterior capsule has been shown in several studies to be the most important structure in determining stability irrespective of the direction of injury. Posterior dislocation of the SCJ can be associated with life threatening complications such as neurovascular, tracheal and oesophageal injuries. Due to the high mortality associated with such complications, these injuries need to be recognised acutely and managed promptly. Investigations such as X-ray imaging are poor at delineating anatomy at the level of the mediastinum and therefore CT imaging has become the investigation of choice. Due to its rarity, the current guidance on how to manage acute and chronic dislocations is debatable. This analysis of historical and recent literature aims to determine guidance on current thinking regarding SCJ instability, including the use of the Stanmore triangle. The described methods of reduction for both anterior and posterior dislocations and the various surgical reconstructive techniques are also discussed. PMID:27114931

  7. [Secondary ligament instabilities in the area of the elbow joint].

    PubMed

    Wirth, C J

    1988-08-01

    Secondary capsular or ligamentous injuries around the elbow joint, which are generally a rare finding, can give rise to medial, lateral, anterior, and posterior instability. Medial instability is especially bothersome during sporting activities, such as javelin throwing and baseball, and requires tightening or replacement of the ulnar collateral ligament. On the lateral side it is particularly the subluxation of the head of the radius that makes surgical tightening of the annular ligament essential. Anterior instability, which would cause the joint to dislocate anteriorly, is extremely rare and does not lead to secondary problems. Posterolateral, chronically recurrent, dislocation of the elbow joint, however, is intolerable for the patient, and many operative stabilizing procedures have been performed, mostly in isolated patients, in attempts at correction. The current method of choice consists in tightening of the dorsoradial capsular pouch in combination with osseous refixation of the slack radial ligament.

  8. Arthroscopic Reverse Remplissage for Posterior Instability.

    PubMed

    Lavender, Chad D; Hanzlik, Shane R; Pearson, Sara E; Caldwell, Paul E

    2016-02-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a "reverse Hill-Sachs lesion." The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor-based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  9. Arthroscopic Reverse Remplissage for Posterior Instability

    PubMed Central

    Lavender, Chad D.; Hanzlik, Shane R.; Pearson, Sara E.; Caldwell, Paul E.

    2016-01-01

    Posterior shoulder dislocation is an unusual injury often associated with electrical shock or seizure. As with anterior instability, patients frequently present with an impaction injury to the anterior aspect of the humeral head known as a “reverse Hill-Sachs lesion.” The treatment of this bony defect is controversial, and multiple surgical procedures to fill the defect in an effort to decrease recurrence have been described. Most of the reports have focused on an open approach using variations of lesser tuberosity and subscapularis transfers, bone allograft, and even arthroplasty to assist with persistent instability. We advocate an arthroscopic technique that involves a suture anchor–based distal tenodesis of the subscapularis tendon or a reverse remplissage procedure. PMID:27073776

  10. Anterior knee pain

    MedlinePlus

    ... as running, jumping or twisting, skiing, or playing soccer). You have flat feet. Anterior knee pain is ... to the kneecap Runners, jumpers, skiers, bicyclists, and soccer players who exercise often Teenagers and healthy young ...

  11. Revision Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Wilde, Jeffrey; Bedi, Asheesh; Altchek, David W.

    2014-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is one of the most common surgical procedures, with more than 200,000 ACL tears occurring annually. Although primary ACL reconstruction is a successful operation, success rates still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database (1988-2013) as well as from textbook chapters and surgical technique papers. Study Design: Clinical review. Level of Evidence: Level 4. Results: The clinical outcomes after revision ACL reconstruction are largely based on level IV case series. Much of the existing literature is heterogenous with regard to patient populations, primary and revision surgical techniques, concomitant ligamentous injuries, and additional procedures performed at the time of the revision, which limits generalizability. Nevertheless, there is a general consensus that the outcomes for revision ACL reconstruction are inferior to primary reconstruction. Conclusion: Excellent results can be achieved with regard to graft stability, return to play, and functional knee instability but are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal graft selection, tunnel position, graft fixation, or biological milieu for tendon-bone healing. Strength-of-Recommendation Taxonomy (SORT): Good results may still be achieved with regard to graft stability, return to play, and functional knee instability, but results are generally inferior to primary ACL reconstruction: Level B. PMID:25364483

  12. Knee instability scores for ACL reconstruction.

    PubMed

    Rahnemai-Azar, Ata A; Naendrup, Jan-Hendrik; Soni, Ashish; Olsen, Adam; Zlotnicki, Jason; Musahl, Volker

    2016-06-01

    Despite abundant biological, biomechanical, and clinical research, return to sport after anterior cruciate ligament (ACL) injury remains a significant challenge. Residual rotatory knee laxity has been identified as one of the factors responsible for poor functional outcome. To improve and standardize the assessment of knee instability, a variety of instability scoring systems is available. Recently, devices to objectively quantify static and dynamic clinical exams have been developed to complement traditional subjective grading systems. These devices enable an improved evaluation of knee instability and possible associated injuries. This additional information may promote the development of new treatment algorithms and allow for individualized treatment. In this review, the different subjective laxity scores as well as complementary objective measuring systems are discussed, along with an introduction of injury to an individualized treatment algorithm. PMID:26980119

  13. Anterior skull base oncocytoma.

    PubMed

    López, Fernando; Vivanco, Blanca; Suárez, Carlos; Llorente, José L

    2013-03-01

    Oncocytic neoplasms are tumors composed of oncocytes (ie, epithelial cells with a large cytoplasm that is rich in mitochondria). Most cases are benign and originate from the salivary glands. Although there have been a few reported cases of oncocytomas being found in the sinonasal tract, most if not all cases seem not to involve the anterior skull base. We report a rare case of oncocytoma involving the anterior skull base occurring in a 44-year-old male patient. Preoperative carotid angiography and selective embolization was performed. The patient underwent an expanded endoscopic endonasal anterior craniofacial resection, which allowed complete resection of the tumor, with a low morbidity. The pathological diagnosis was oncocytoma. At 36 months after the initial treatment, the patient is free of disease. Based on our literature search, this may be the first such reported case. A brief review of the available literature examining the known body of knowledge regarding these neoplasms is presented.

  14. Anterior tibial striations.

    PubMed

    Daffner, R H

    1984-09-01

    Radiolucent horizontal striations of the anterior cortex of the tibia were seen in 10 athletes who were evaluated for "shin-splints." There were seven basketball players, two professional dancers, and one hurdler. Each patient's history included vigorous leaping in performance of athletic feats. All the lesions were similar in location and appearance and were accompanied by thickening of the anterior tibial cortex. These striations are considered stress fractures and were not observed in a group of runners who were evaluated for shin-splints.

  15. Congenital anterior urethral diverticulum.

    PubMed

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  16. Clinical Outcomes Following Revision Anterior Shoulder Stabilization

    PubMed Central

    Frank, Rachel M.; Mellano, Chris; Shin, Jason J.; Feldheim, Terrence F.; Mascarenhas, Randhir; Yanke, Adam Blair; Cole, Brian J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

    2015-01-01

    Objectives: The purpose of this study was to determine the clinical outcomes following revision anterior shoulder stabilization performed either via all-arthroscopic soft tissue repair or via Latarjet coracoid transfer. Methods: A retrospective review of prospectively collected data on 91 shoulders undergoing revision anterior shoulder stabilization was performed. All patients underwent prior soft tissue stabilization; those with prior open bone grafting procedures were excluded. For patients with 25% glenoid bone loss, Latarjet was performed (n=28). Patients were queried regarding recurrent instability (subluxation or dislocation). Clinical outcomes were evaluated using validated patient reported outcome questionnaires including the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Western Ontario Shoulder Instability Index (WOSI). Results: A total of 63 shoulders in 62 patients (46 males, 16 females) with an average age of 23.2 ± 6.9 years were included in the revision arthroscopy group. At an average follow-up of 46.9 ± 16.8 months (range, 15 to 78), the mean WOSI score was 80.1 (range, 15.0 to 100), and there were significant improvements (p<0.001) in ASES (63.7 to 85.1), SST (6.2 to 9.1), and VAS pain scores (2.89 to 0.81). Recurrent instability occurred in 12 of 63 shoulders (19%); the number of prior surgeries and baseline hyperlaxity were significant risk factors for failure (p<0.001 and p=0.04, respectively). No patients developed clinical or radiographic evidence of arthritis. A total of 28 shoulders in 28 patients (21 male, 7 female) with an average age of 27.5 years (range 14 to 45) were included in the Latarjet group. Thirteen (46%) had more than one previous stabilization attempt. ), the average WOSI score was 71.9, and there were significant improvements (p<0.001) in ASES (65.7 to 87.0), SST (7.2 to 10.3), and VAS (3.1 to 1.1). Recurrent instability occurred in 2 of 28 shoulders

  17. Turbine instabilities: Case histories

    NASA Technical Reports Server (NTRS)

    Laws, C. W.

    1985-01-01

    Several possible causes of turbine rotor instability are discussed and the related design features of a wide range of turbomachinery types and sizes are considered. The instrumentation options available for detecting rotor instability and assessing its severity are also discussed.

  18. Under-air staining of the anterior capsule using Trypan blue with a 30 G needle

    PubMed Central

    Giammaria, Daniele; Giannotti, Michele; Scopelliti, Angelo; Pellegrini, Giacomo; Giannotti, Bruno

    2013-01-01

    The original technique of staining the anterior capsule of the lens with Trypan blue involves the injection of an air bubble in the anterior chamber. A drawback of this technique is the possible instability of the anterior chamber caused by the sudden exit of air when the dye is injected with the cannula through the side-port incision. Other staining techniques that use viscoelastic substances to increase the stability of the anterior chamber and to dose the injected dye have been described. The authors present an under-air staining technique of the anterior capsule using one drop of Trypan blue injected with a 30 G needle through the peripheral cornea. This procedure prevents the air bubble from escaping the anterior chamber and allows fast and selective staining of the capsule. PMID:23386783

  19. Instability of rectangular jets

    NASA Technical Reports Server (NTRS)

    Tam, Christopher K. W.; Thies, Andrew T.

    1992-01-01

    The instability of rectangular jets is investigated using a vortex sheet model. It is shown that such jets support four linearly independent families of instability waves. Within each family there are infinitely many modes. A way to classify these modes according to the characteristics of their mode shapes or eigenfunctions is proposed. A parametric study of the instability wave characteristics has been carried out. A sample of the numerical results is reported here. It is found that the first and third modes of each instability wave family are corner modes. The pressure fluctuations associated with these instability waves are localized near the corners of the jet. The second mode, however, is a center mode with maximum fluctuations concentrated in the central portion of the jet flow. The center mode has the largest spatial growth rate. It is anticipated that as the instability waves propagate downstream the center mode would emerge as the dominant instability of the jet.

  20. Anterior capsulolabral reconstruction of the shoulder in athletes.

    PubMed

    Rubenstein, D L; Jobe, F W; Glousman, R E; Kvitne, R S; Pink, M; Giangarra, C E

    1992-09-01

    We did an anterior capsulolabral reconstruction for recurrent subluxation or dislocation of the shoulder in 75 athletes after failure of conservative therapy. Average follow-up was 39 months (range 28 to 60 months). The results were 77% excellent, 75% good, 3% fair, and 5% poor. Seventy-five percent of the professional and 100% of the college baseball players returned to their previous level of competition. Seventy-seven percent of the professional pitchers were able to return to professional pitching. The range of motion at follow-up was full in 79% of the athletes. No infections or nerve injuries occurred. The anterior capsulolabral reconstruction procedure combined with an early rehabilitation program appears to provide an improved outcome compared with previously reported procedures for anterior instability of the shoulder in athletes.

  1. Flow instabilities in turbomachines

    NASA Astrophysics Data System (ADS)

    Greitzer, E. M.

    Instabilities occurring in systems involving the movement of a fluid through pipes, ducts, etc., by means of turbomachinery are discussed. While static instabilities may be inferred from system transient performance that is viewed as a sequence of quasi-steady states, such parameters as system interfaces and capacitances must be included in the prediction of dynamic instability, since they play an essential role in determining the transient response of the system to disturbances. A pumping system can be statically stable and still exhibit dynamic instability. Attention is given to rotating stall compressor instability, inlet distortion effects on axial compressor instability, the stability effects of downstream components, and the stability of centrifugal compressors and pumps.

  2. Joint Instability and Osteoarthritis

    PubMed Central

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  3. Instability in Rotating Machinery

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The proceedings contain 45 papers on a wide range of subjects including flow generated instabilities in fluid flow machines, cracked shaft detection, case histories of instability phenomena in compressors, turbines, and pumps, vibration control in turbomachinery (including antiswirl techniques), and the simulation and estimation of destabilizing forces in rotating machines. The symposium was held to serve as an update on the understanding and control of rotating machinery instability problems.

  4. Nonlocal magnetorotational instability

    SciTech Connect

    Mikhailovskii, A. B.; Erokhin, N. N.; Lominadze, J. G.; Galvao, R. M. O.; Churikov, A. P.; Kharshiladze, O. A.; Amador, C. H. S.

    2008-05-15

    An analytical theory of the nonlocal magnetorotational instability (MRI) is developed for the simplest astrophysical plasma model. It is assumed that the rotation frequency profile has a steplike character, so that there are two regions in which it has constant different values, separated by a narrow transition layer. The surface wave approach is employed to investigate the MRI in this configuration. It is shown that the main regularities of the nonlocal MRI are similar to those of the local instability and that driving the nonaxisymmetric MRI is less effective than the axisymmetric one, also for the case of the nonlocal instability. The existence of nonlocal instabilities in nonmagnetized plasma is predicted.

  5. Anterior endoscopic correction of scoliosis.

    PubMed

    Picetti, George D; Ertl, Janos P; Bueff, H Ulrich

    2002-04-01

    Our technique of anterior endoscopic scoliosis correction demonstrates the ability to perform an anterior approach through a minimally invasive technique with minimal disruption of the local biology. The initial results appear to equal curve correction and fusion rates to those of a formal open anterior approach. Additional benefits are: 1) shortened operative time, 2) lower blood loss, 3) shortened rehabilitation time, 4) less pain, and 5) shortened hospital stays. Endoscopic technique shows great promise in the management of scoliosis curves; however, this is a technically demanding procedure that requires cross-training in endoscopic discectomy and scoliosis management as well as familiarity with the anterior approach anatomy. PMID:12389288

  6. Bioengineered anterior cruciate ligament

    NASA Technical Reports Server (NTRS)

    Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor); Martin, Ivan (Inventor)

    2001-01-01

    The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

  7. [Anterior cervical hypertrichosis: case report].

    PubMed

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.

  8. [Anterior cervical hypertrichosis: case report].

    PubMed

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years. PMID:27606653

  9. GLENOHUMERAL INSTABILITY AND GLENOID BONE LOSS IN A THROWING ATHLETE

    PubMed Central

    Mair, Scott; Lattermann, Christian

    2013-01-01

    This case presents the challenges of management associated with a young throwing athlete presenting with a history of bilateral anterior shoulder instability. This athlete had multiple surgical interventions over a three‐year period. The imaging modalities provided partial elucidation (at best) of the true picture of the pathology. This case report outlines the decision making process utilized to provide individualized care to a young throwing athlete with bilateral glenohumeral joint instability, recurrent dislocations, and resultant glenoid bone loss. Level of Evidence: 5 (Single Case report) PMID:23593558

  10. [Surgical treatment of craniocervical instability. Review paper].

    PubMed

    Alpizar-Aguirre, Armando; Lara Cano, Jorge Giovanni; Rosales, Luis; Míramontes, Victor; Reyes-Sánchez, Alejandro Antonio

    2007-01-01

    The concept of spinal instability is still controversial. Anatomical, biomechanical, clinical and radiographic variants are involved and make the definition complicated. There are solid diagnostic bases in cases of fractures and degenerative disorders; however, pure spinal instability is still under study. The latter may be defined as increased mobility that goes beyond the physiological limits of one vertebra over another in at least one of the three spinal planes of motion. In the case of the craniocervical region, its understanding becomes even more challenging, since its anatomy and physiology are more complex and it is more mobile. Surgical treatment is possible with either an anterior or a posterior approach. Best results are obtained with occipitocervical or atlantoaxial stabilization through a posterior approach, since the anterior one has its limitations. For example, a transoral approach with a bone graft provides compression strength but does not enable immediate appropriate fixation and involves the risk of infection. The choice of the surgical approach must consider the patient's medical status, the specific spine levels involved, the extent of neurological compromise, the X-ray abnormalities and the individual pathology. The goals of surgery are achieved through an appropriate anatomical alignment, assuring the protection of the neural elements and achieving proper spine stabilization with as much preservation of the mobile vertebral segments as possible. PMID:17970561

  11. [Surgical treatment of craniocervical instability. Review paper].

    PubMed

    Alpizar-Aguirre, Armando; Lara Cano, Jorge Giovanni; Rosales, Luis; Míramontes, Victor; Reyes-Sánchez, Alejandro Antonio

    2007-01-01

    The concept of spinal instability is still controversial. Anatomical, biomechanical, clinical and radiographic variants are involved and make the definition complicated. There are solid diagnostic bases in cases of fractures and degenerative disorders; however, pure spinal instability is still under study. The latter may be defined as increased mobility that goes beyond the physiological limits of one vertebra over another in at least one of the three spinal planes of motion. In the case of the craniocervical region, its understanding becomes even more challenging, since its anatomy and physiology are more complex and it is more mobile. Surgical treatment is possible with either an anterior or a posterior approach. Best results are obtained with occipitocervical or atlantoaxial stabilization through a posterior approach, since the anterior one has its limitations. For example, a transoral approach with a bone graft provides compression strength but does not enable immediate appropriate fixation and involves the risk of infection. The choice of the surgical approach must consider the patient's medical status, the specific spine levels involved, the extent of neurological compromise, the X-ray abnormalities and the individual pathology. The goals of surgery are achieved through an appropriate anatomical alignment, assuring the protection of the neural elements and achieving proper spine stabilization with as much preservation of the mobile vertebral segments as possible.

  12. Buckling instability in arteries.

    PubMed

    Vandiver, Rebecca M

    2015-04-21

    Arteries can become tortuous in response to abnormal growth stimuli, genetic defects and aging. It is suggested that a buckling instability is a mechanism that might lead to artery tortuosity. Here, the buckling instability in arteries is studied by examining asymmetric modes of bifurcation of two-layer cylindrical structures that are residually stressed. These structures are loaded by an axial force, internal pressure and have nonlinear, anisotropic, hyperelastic responses to stresses. Strain-softening and reduced opening angle are shown to lower the critical internal pressure leading to buckling. In addition, the ratio of the media thickness to the adventitia thickness is shown to have a dramatic impact on arterial instability.

  13. Preliminary report on the Jones, Ellison, Slocum (JES) repair for symptomatic anterior cruciate deficient knees.

    PubMed

    Ritter, M A; Leaming, E S; McCarroll, J R

    1983-01-01

    A modified Jones intraarticular anterior cruciate reconstruction was combined with a distal iliotibial band transfer (Ellison) and a pes anserinus transfer (Slocum) for patients with symptomatic anterior cruciate deficient knees. The procedure was performed on 15 young (average age, 22.5 years) athletes, in a single operation through a long, straight, anterior, midline incision. Preoperatively, all 15 patients (15 knees) had symptomatic instability and all but one had a positive pivot shift. At follow up (averaging 39 month range 24-60 months) 13 (93%) had the pivot shift eliminated and only one, with 36 months followup, had instability on return to sports. Postoperatively, patients were immobilized 3 weeks and then were started on a physical therapy program which ended in return to sports at 1 year.

  14. [Anterior pituitary hypersecretion syndromes].

    PubMed

    Gómez, F; Steinhäuslin, F; Crottaz, B; Temler, E

    1987-01-17

    Anterior pituitary hypersecretion can be due to abnormal hypothalamic regulation, decreased peripheral hormone feedback or pituitary tumor. In some cases hypersecretion gives rise to a typical clinical syndrome involving acromegaly, hyperprolactinemia, and excess corticotropin (ACTH). The etiology of acromegaly is a growth hormone (GH)-secreting pituitary tumor in the vast majority of cases. Hyperprolactinemia and excess cortisol, however, may be due to many causes among which prolactin (PRL)- and ACTH-secreting pituitary tumors are not frequent. Glycoprotein-secreting pituitary tumors, especially gonadotropin (LH and FSH) and free subunits usually do not cause a typical excess hormone syndrome. Perhaps for this reason they are seldom recognized clinically, although histopathological studies are increasingly disclosing the gonadotrope nature of many pituitary tumors. Mixed hormonal secretions are common. When pituitary hormone secretion can be selectively suppressed by medical therapy, a significant reduction of tumor size is by no means rare. In other cases, pituitary irradiation or surgery, or even treatment aimed at a peripheral target gland, may be necessary. PMID:3029861

  15. Imaging in carpal instability.

    PubMed

    Ramamurthy, N K; Chojnowski, A J; Toms, A P

    2016-01-01

    Carpal instability is a complex and heterogeneous clinical condition. Management requires accurate identification of structural injury with an understanding of the resultant movement (kinematic) and load transfer (kinetic) failure. Static imaging techniques, such as plain film radiography, stress views, ultrasound, magnetic resonance, MR arthrography and computerized tomography arthrography, may accurately depict major wrist ligamentous injury. Dynamic ultrasound and videofluoroscopy may demonstrate dynamic instability and kinematic dysfunction. There is a growing evidence base for the diagnostic accuracy of these techniques in detecting intrinsic ligament tears, but there are limitations. Evidence of their efficacy and relevance in detection of non-dissociative carpal instability and extrinsic ligament tears is weak. Further research into the accuracy of existing imaging modalities is still required. Novel techniques, including four-dimensional computerized tomography and magnetic resonance, can evaluate both cross-sectional and functional carpal anatomy. This is a narrative review of level-III studies evaluating the role of imaging in carpal instability. PMID:26586689

  16. Bacterial Genome Instability

    PubMed Central

    Darmon, Elise

    2014-01-01

    SUMMARY Bacterial genomes are remarkably stable from one generation to the next but are plastic on an evolutionary time scale, substantially shaped by horizontal gene transfer, genome rearrangement, and the activities of mobile DNA elements. This implies the existence of a delicate balance between the maintenance of genome stability and the tolerance of genome instability. In this review, we describe the specialized genetic elements and the endogenous processes that contribute to genome instability. We then discuss the consequences of genome instability at the physiological level, where cells have harnessed instability to mediate phase and antigenic variation, and at the evolutionary level, where horizontal gene transfer has played an important role. Indeed, this ability to share DNA sequences has played a major part in the evolution of life on Earth. The evolutionary plasticity of bacterial genomes, coupled with the vast numbers of bacteria on the planet, substantially limits our ability to control disease. PMID:24600039

  17. Anterior knee pain: an update of physical therapy.

    PubMed

    Werner, Suzanne

    2014-10-01

    Anterior knee pain is one of the most common knee problems in physically active individuals. The reason for anterior knee pain has been suggested to be multifactorial with patella abnormalities or extensor mechanism disorder leading to patellar malalignment during flexion and extension of the knee joint. Some patients complain mostly of non-specific knee pain, while others report patellar instability problems. The patients present with a variety of symptoms and clinical findings, meaning that a thorough clinical examination is the key for optimal treatment. Weakness of the quadriceps muscle, especially during eccentric contractions, is usually present in the majority of anterior knee pain patients. However, irrespective of whether pain or instability is the major problem, hypotrophy and reduced activity of the vastus medialis are often found, which result in an imbalance between vastus medialis and vastus lateralis. This imbalance needs to be corrected before quadriceps exercises are started. The non-operative rehabilitation protocol should be divided into different phases based on the patient's progress. The goal of the first phase is to reduce pain and swelling, improve the balance between vastus medialis and vastus lateralis, restore normal gait, and decrease loading of the patello-femoral joint. The second phase should include improvement of postural control and coordination of the lower extremity, increase of quadriceps strength and when needed hip muscle strength, and restore good knee function. The patient should be encouraged to return to or to start with a suitable regular physical exercise. Therefore, the third phase should include functional exercises. Towards the end of the treatment, single-leg functional tests and functional knee scores should be used for evaluating clinical outcome. A non-operative treatment of patients with anterior knee pain should be tried for at least 3 months before considering other treatment options.

  18. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    PubMed

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed. PMID:26545750

  19. Anterior Cruciate Ligament: Structure, Injuries and Regenerative Treatments.

    PubMed

    Negahi Shirazi, Ali; Chrzanowski, Wojciech; Khademhosseini, Ali; Dehghani, Fariba

    2015-01-01

    Anterior cruciate ligament (ACL) is one of the most vulnerable ligaments of the knee. ACL impairment results in episodic instability, chondral and meniscal injury and early osteoarthritis. The poor self-healing capacity of ACL makes surgical treatment inevitable. Current ACL reconstructions include a substitution of torn ACL via biological grafts such as autograft, allograft. This review provides an insight of ACL structure, orientation and properties followed by comparing the performance of various constructs that have been used for ACL replacement. New approaches, undertaken to induce ACL regeneration and fabricate biomimetic scaffolds, are also discussed.

  20. Anterior Knee Pain (Chondromalacia Patellae).

    ERIC Educational Resources Information Center

    Garrick, James G.

    1989-01-01

    This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

  1. Prevention of anterior cruciate ligament injuries.

    PubMed

    Hewett, T E; Myer, G D; Ford, K R

    2001-12-01

    Numerous studies have found that female athletes who participate in jumping and pivoting sports are four to six times more likely to sustain a knee ligament injury, such as anterior cruciate ligament (ACL) injury, than male athletes participating in the same sports [1-8]. A widening gender gap in the number of serious knee ligament injuries exists due to geometric growth in female athletic participation, coupled with the four- to sixfold higher injury rate. More than 50,000 serious knee injuries are projected to occur in female varsity intercollegiate and high school athletics each year [9, 10]. Most ACL injuries occur by noncontact mechanisms, often during landing from a jump or making a lateral pivot while running [2, 11]. Knee instability, due to ligament dominance (decreased medial-lateral neuromuscular control of the joint), quadriceps dominance (increased quadriceps recruitment and decreased hamstring recruitment and strength), and leg dominance (side-to-side differences in strength, flexibility, and coordination) are possible contributing factors to the increased incidence of knee injury in female athletes [5, 6]. In this review, dynamic neuromuscular analysis (DNA) training is defined, and a rationale is presented for correcting the neuromuscular imbalances that may result in dynamic knee instability during sports play. Dynamic neuromuscular training has been shown to increase knee stability and decrease knee injury rates in female athletes [5, 12.., 13.]. Preliminary research on athlete screening and injury prediction based on the three aforementioned imbalances also is presented with recommendations for developing screening protocols for the identification of high-risk athletes.

  2. Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Arcuri, Francisco; Barclay, Fernando; Nacul, Ivan

    2015-01-01

    Introduction: The most recent advances in ACL reconstruction try to reproduce the anatomic femoral and tibial footprints as close as possible. Creating independent tunnels would allow an optimal of the entry point and the femoral tunnel obliquity, and together with an adequate reamer diameter they wouldreproduce with greater certainty the anatomy. Objective: To compare the radiographic parameters of the femoral and tibial tunnel positions in two groups of patients, one operated with a transtibial and other with transportal anatomic techniques. Materials and Methods: From December 2012 to December 2013, 59 patients with a primary ACL reconstruction divided in two groups, a trans tibial technique (TT), 19 patients, and an transportal one (TP) with 40 patients were prospectively evaluated with AP and lateral X-rays. The femoral tunnel angle, the insertion site with respect of the Blumensaat line, the trans osseous distance, the tibial tunnel position as a percentage of the tibial plateau in the AP and lateral views. And finally the tibial tunnel angle in the AP and Lateral views. Results: The femoral tunnel angle was in the TP group of 45,92º and in the TT one 24,53º, p 0,002. The insertion site percentage of the Blumensaat line was of 20,96 in TP and 20,74 in the TT, p 0,681.Trans osseous distance was in the TP of 3,43 cm and in the TT of 4,79 cm, p <0,000. The tibial tunnel position as a percentage in the AP tibial plateau was of 44,35 in TP and of 40,80 TT with a p of 0,076. The tibial tunnel position as a percentage of the lateral tibial plateau was of 28,70 in TP and 34,53 in TT with a p 0,367. Tibial tunnel angle in the AP was of 73,48º in TP and 62,81 in TT with a p of 0,002, and in the lateral plateau of 114,69º in TP and 112,79º in TT with a p of 0,427. Conclusion: It is possible to create tibial and femoral tunnel in optimal positions but not equal between both groups. Creating independent tunnels allow a more anterior and vertical tibial tunnel

  3. Cervical ligamentous instability in a canine in vivo model.

    PubMed

    Whitehill, R; Moran, D J; Fechner, R E; Ruch, W W; Drucker, S; Hooper, W E; McCoig, J A

    1987-12-01

    A canine in vivo model of midcervical ligamentous instability was developed by dividing the anterior longitudinal ligament, anulus fibrosus, and all posterior ligamentous structures including the ligamentum flavum. The natural history of healing in the model, the effect on its healing by an adjacent one-level arthrodesis, and the effect of a one-level arthrodesis on normal adjacent ligamentous structures were studied radiographically, mechanically, and histologically. The authors determined that healing takes place primarily by anterior scar formation in their instability model but not to a degree sufficient to recreate normal mechanical stability. After three months, healing in the model was not affected by an adjacent arthrodesis; however, acutely, instability apparently was increased as three animals became quadriplegic between the second and fourth postoperative days. Arthrodesis did not affect adjacent normal ligamentous structures, during this period. Incomplete healing in the authors' model supports those who advocate arthrodesis as the treatment of choice for destabilizing cervical ligamentous injury. The authors previously reported the case of a patient who sustained bilateral facet dislocations adjacent to an arthrodesed segment and questioned whether this resulted from a stress-concentrating effect. This study indicates that this could well have been the case acutely. Thus, inadvertent exclusion of an unstable segment from an arthrodesis has potentially catastrophic results. Finally, the authors also have previously questioned whether arthrodesis of a midcervical segment could lead to instability of adjacent normal segments. This project does not support such a concern, at least for the three postoperative months of study. PMID:3441821

  4. Late Anterior Dislocation Due to Posterior Pelvic Tilt in Total Hip Arthroplasty

    PubMed Central

    Kobayashi, Hiroki; Nakashima, Yasuharu; Yamamoto, Takuaki; Motomura, Goro; Kanazawa, Masayuki; Takagishi, Kenji; Iwamoto, Yukihide

    2016-01-01

    Background: Excessive pelvic tilt may be one of the factors leading to instability in total hip arthroplasty (THA), even when the acetabular cup is placed properly. To our knowledge, only a few studies have described late anterior dislocation due to posterior pelvic tilt. We present 3 cases with late anterior dislocations possibly due to posterior pelvic tilt. Cases Presentations: Case-1: An 84-years-old woman fell and presented with an anterior dislocation 12-years after THA. Her pelvis had tilted to approximately 30° posteriorly in a supine position. After conservative treatment, she presented with 10 recurrent anterior dislocations. She had thoracolumbar kyphosis due to multiple compression fractures. Revision with anterior placement of an elevated liner and a 32-mm head corrected the dislocation, and no further dislocations occurred. Case-2: A 78-years-old woman fell and presented with an anterior dislocation 4-years after THA. Her posterior pelvic tilt had increased 23° due to a lumbar compression fracture. Revision by decreasing the cup anteversion was performed, but recurrent posterior dislocations occurred. Owing to her worsened general condition, further treatment was abandoned. Case-3: A 79-years-old woman twisted her body and presented an anterior dislocation 3-years after THA. After manual reduction and conservative treatment, the dislocation recurred. Her posterior pelvic tilt had increased 16°. Conclusion: Although minor trauma triggered the anterior instability in these patients, the underlying pathomechanism existed in the progressive pelvic posterior tilt due to thoracolumbar kyphosis. As longer life expectancy as well as implant survivorship is predicted, attention must be paid to the change of pelvic tilt in elderly patients. PMID:27398108

  5. Gauging magnetorotational instability

    NASA Astrophysics Data System (ADS)

    Herron, Isom; Goodman, Jeremy

    2010-08-01

    Previously (Z. Angew. Math. Phys. 57:615-622, 2006), we examined the axisymmetric stability of viscous resistive magnetized Couette flow with emphasis on flows that would be hydrodynamically stable according to Rayleigh’s criterion: opposing gradients of angular velocity and specific angular momentum. A uniform axial magnetic field permeates the fluid. In this regime, magnetorotational instability (MRI) may occur. It was proved that MRI is suppressed, in fact no instability at all occurs, with insulating boundary conditions, when a term multipling the magnetic Prandtl number is neglected. Likewise, in the current work, including this term, when the magnetic resistivity is sufficiently large, MRI is suppressed. This shows conclusively that small magnetic dissipation is a feature of this instability for all magnetic Prandtl numbers. A criterion is provided for the onset of MRI.

  6. The Walking Droplet Instability

    NASA Astrophysics Data System (ADS)

    Bostwick, Joshua; Steen, Paul

    2013-11-01

    A droplet of liquid that partially wets a solid substrate assumes a spherical-cap equilibrium shape. We show that the spherical-cap with a mobile contact-line is unstable to a non-axisymmetric disturbance and we characterize the instability mechanism, as it depends upon the wetting properties of the substrate. We then solve the hydrodynamic problem for inviscid motions showing that the flow associated with the instability correlates with horizontal motion of the droplet's center-of-mass. We calculate the resulting ``walking speed.'' A novel feature is that the energy conversion mechanism is not unique, so long as the contact-line is mobilized. Hence, the walking droplet instability is potentially significant to a number of industrial applications, such as self-cleansing surfaces or energy harvesting devices.

  7. Dislocation motion and instability

    NASA Astrophysics Data System (ADS)

    Zhu, Yichao; Chapman, Stephen Jonathan; Acharya, Amit

    2013-08-01

    The Peach-Koehler expression for the stress generated by a single (non-planar) curvilinear dislocation is evaluated to calculate the dislocation self stress. This is combined with a law of motion to give the self-induced motion of a general dislocation curve. A stability analysis of a rectilinear, uniformly translating dislocation is then performed. The dislocation is found to be susceptible to a helical instability, with the maximum growth rate occurring when the dislocation is almost, but not exactly, pure screw. The non-linear evolution of the instability is determined numerically, and implications for slip band formation and non-Schmid behavior in yielding are discussed.

  8. Anterior Orbit and Adnexal Amyloidosis

    PubMed Central

    Al Hussain, Hailah; Edward, Deepak P.

    2013-01-01

    Purpose: To describe six cases of anterior orbital and adnexal amyloidosis and to report on proteomic analysis to characterize the nature of amyloid in archived biopsies in two cases. Materials and Methods: The clinical features, radiological findings, pathology, and outcome of six patients with anterior orbit and adnexal amyloidosis were retrieved from the medical records. The biochemical nature of the amyloid was determined using liquid chromatography/mass spectroscopy archived paraffin-embedded tissue in two cases. Results: Of the six cases, three had unilateral localized anterior orbit and lacrimal gland involvement. Four of the six patients were female with an average duration of 12.8 years from the time of onset to presentation eyelid infiltration by amyloid caused ptosis in five cases. CT scan in patients with lacrimal gland involvement (n = 3) demonstrated calcified deformable anterior orbital masses and on pathological exmaintionamyloid and calcific deposits replaced the lacrimal gland acini. Ptosis repair was performed in three patients with good outcomes. One patient required repeated debulking of the mass and one patient had recurrenct disease. Proteomic analysis revealed polyclonal IgG-associated amyloid deposition in one patient and AL kappa amyloid in the second patient. Conclusion: Amyloidosis of the anterior orbit and lacrimal gland can present with a wide spectrum of findings with good outcomes after surgical excision. The nature of amyloid material can be precisely determined in archival pathology blocks using diagnostic proteomic analysis. PMID:24014979

  9. Failure of Anterior Cruciate Ligament Reconstruction.

    PubMed

    Samitier, Gonzalo; Marcano, Alejandro I; Alentorn-Geli, Eduard; Cugat, Ramon; Farmer, Kevin W; Moser, Michael W

    2015-10-01

    The present review classifies and describes the multifactorial causes of anterior cruciate ligament (ACL) surgery failure, concentrating on preventing and resolving such situations. The article particularly focuses on those causes that require ACL revision due to recurrent instability, without neglecting those that affect function or produce persistent pain. Although primary ACL reconstruction has satisfactory outcome rates as high as 97%, it is important to identify the causes of failure, because satisfactory outcomes in revision surgery can drop to as much as 76%. It is often possible to identify a primary or secondary cause of ACL surgery failure; even the most meticulous planning can give rise to unexpected findings during the intervention. The adopted protocol should therefore be sufficiently flexible to adapt to the course of surgery. Preoperative patient counseling is essential. The surgeon should limit the patient's expectations for the outcome by explaining the complexity of this kind of procedure. With adequate preoperative planning, close attention to details and realistic patient expectations, ACL revision surgery may offer beneficial and satisfactory results for the patient. PMID:26550585

  10. Failure of Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Samitier, Gonzalo; Marcano, Alejandro I.; Alentorn-Geli, Eduard; Cugat, Ramon; Farmer, Kevin W; Moser, Michael W

    2015-01-01

    The present review classifies and describes the multifactorial causes of anterior cruciate ligament (ACL) surgery failure, concentrating on preventing and resolving such situations. The article particularly focuses on those causes that require ACL revision due to recurrent instability, without neglecting those that affect function or produce persistent pain. Although primary ACL reconstruction has satisfactory outcome rates as high as 97%, it is important to identify the causes of failure, because satisfactory outcomes in revision surgery can drop to as much as 76%. It is often possible to identify a primary or secondary cause of ACL surgery failure; even the most meticulous planning can give rise to unexpected findings during the intervention. The adopted protocol should therefore be sufficiently flexible to adapt to the course of surgery. Preoperative patient counseling is essential. The surgeon should limit the patient’s expectations for the outcome by explaining the complexity of this kind of procedure. With adequate preoperative planning, close attention to details and realistic patient expectations, ACL revision surgery may offer beneficial and satisfactory results for the patient. PMID:26550585

  11. A Case of Nonunion Avulsion Fracture of the Anterior Tibial Eminence

    PubMed Central

    Atsumi, Satoru; Arai, Yuji; Nakagawa, Shuji; Inoue, Hiroaki; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Kubo, Toshikazu

    2016-01-01

    Avulsion fracture of the anterior tibial eminence is an uncommon injury. If bone union does not occur, knee extension will be limited by impingement of the avulsed fragment and knee instability will be induced by dysfunction of the anterior cruciate ligament (ACL). This report describes a 55-year-old woman who experienced an avulsion fracture of the right anterior tibial eminence during recreational skiing. Sixteen months later, she presented at our hospital with limitation of right knee extension. Plain radiography showed nonunion of the avulsion fracture region, and arthroscopy showed that the avulsed fragment impinged the femoral intercondylar notch during knee extension. The anterior region of the bony fragment was debrided arthroscopically until the knee could be extended completely. There was no subsequent instability, and the patient was able to climb a mountain 6 months after surgery. These findings indicate that arthroscopic debridement of an avulsed fragment for nonunion of an avulsion fracture of the anterior tibial eminence is a minimally invasive and effective treatment for middle-aged and elderly patients with a low level of sports activity. PMID:27119035

  12. Global Linear Instability

    NASA Astrophysics Data System (ADS)

    Theofilis, Vassilios

    2011-01-01

    This article reviews linear instability analysis of flows over or through complex two-dimensional (2D) and 3D geometries. In the three decades since it first appeared in the literature, global instability analysis, based on the solution of the multidimensional eigenvalue and/or initial value problem, is continuously broadening both in scope and in depth. To date it has dealt successfully with a wide range of applications arising in aerospace engineering, physiological flows, food processing, and nuclear-reactor safety. In recent years, nonmodal analysis has complemented the more traditional modal approach and increased knowledge of flow instability physics. Recent highlights delivered by the application of either modal or nonmodal global analysis are briefly discussed. A conscious effort is made to demystify both the tools currently utilized and the jargon employed to describe them, demonstrating the simplicity of the analysis. Hopefully this will provide new impulses for the creation of next-generation algorithms capable of coping with the main open research areas in which step-change progress can be expected by the application of the theory: instability analysis of fully inhomogeneous, 3D flows and control thereof.

  13. Capillary instability of jets

    NASA Astrophysics Data System (ADS)

    Chauhan, Anuj

    This thesis studies the capillary instability of a compound jet. A compound jet comprises an inner core of a primary fluid surrounded by an annulus of an immiscible secondary fluid. The compound jet is unstable due to capillarity. A compound jet finds applications in a variety of fields, such as, ink jet printing, particle sorting, extrusion, molding, particle production etc. In some of these applications such as molding, the disturbances that could cause the jet breakup start as periodic spatial disturbances of Fourier wave number k and grow in time. This is the temporal instability. In some other applications, such as, ink-jet printing, the disturbances initiate at the edge of the nozzle from which the jet issues out. These disturbances grow in space. This is the spatial instability. At small velocities, even if the initial disturbances are periodic in time, they grow exponentially in time. This is the absolute instability. We perform the temporal, spatial and the absolute stability analysis of an inviscid compound jet in a unified framework using the theory of transforms. Further, we solve the temporal instability problem for a viscous jet to understand the effect of viscosity on breakup dynamics. In the temporal analysis, we show that each interface of the compound jet contributes one mode to the instability. The modes contributed by the inner and outer interfaces grow for waves longer than the inner and the outer circumference of the undisturbed jet, respectively. The inner interface mode has a higher growth rate and hence dominates the breakup. The two interfaces grow exactly in phase in this mode and hence it is refereed to as the stretching mode. The other mode is the squeezing mode because the two interfaces grow exactly out of phase. The same two modes are also present in the spatial analysis. At high Weber numbers the predictions of the spatial theory reduce to those of the temporal theory because the waves simply convect with the jet velocity and there

  14. Simultaneous anterior and posterior surgical approach to the thoracic and lumbar spine.

    PubMed

    Spencer, D L; DeWald, R L

    1979-01-01

    A technique for the simultaneous anterior and posterior surgical approach to the thoracic and lumbar spine is presented. No intraoperative repositioning of the patient is required. The procedure requires a surgical team of two spinal surgeons and two assistant surgeons, as well as an anesthesiologist familiar with hypotensive techniques. The procedure as utilized in 14 cases has proven to be safe and expeditious. The simultaneous anteroposterior approach has proven to be especially useful in cases with combined anterior and posterior instability. The technique described provides the experienced spinal surgeon with the best solution to certain complex spinal problems. PMID:432713

  15. [Anterior cerebral artery aneurism presenting as a third ventricular mass and hydrocephalus. Case report].

    PubMed

    Castro Castro, Julián; Agulleiro Díaz, Jesús Patricio; Villa Fernández, Juan Manuel; Pinzón Millán, Alfonso

    2013-01-01

    Aneurysms which appear as third ventricular masses are uncommon; most are giant aneurysms arising from the basilar apex. We present the case of a 67-year-old male who was admitted to hospital with a 4-week history of gait instability, urinary incontinence and progressive visual loss. A cranial computed tomography scan revealed a hyperdense mass in the third ventricle with triventricular dilatation. Cerebral magnetic resonance imaging, magnetic resonance-angiography and conventional angiography identified this lesion as a partially thrombosed aneurysm of the anterior cerebral artery. To our knowledge, this is the first report of an anterior cerebral artery aneurysm with these clinical and radiological features. PMID:23098766

  16. [Anterior cerebral artery aneurism presenting as a third ventricular mass and hydrocephalus. Case report].

    PubMed

    Castro Castro, Julián; Agulleiro Díaz, Jesús Patricio; Villa Fernández, Juan Manuel; Pinzón Millán, Alfonso

    2013-01-01

    Aneurysms which appear as third ventricular masses are uncommon; most are giant aneurysms arising from the basilar apex. We present the case of a 67-year-old male who was admitted to hospital with a 4-week history of gait instability, urinary incontinence and progressive visual loss. A cranial computed tomography scan revealed a hyperdense mass in the third ventricle with triventricular dilatation. Cerebral magnetic resonance imaging, magnetic resonance-angiography and conventional angiography identified this lesion as a partially thrombosed aneurysm of the anterior cerebral artery. To our knowledge, this is the first report of an anterior cerebral artery aneurysm with these clinical and radiological features.

  17. Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports.

    PubMed

    Jobe, F W; Giangarra, C E; Kvitne, R S; Glousman, R E

    1991-01-01

    From April 1, 1985, through June 30, 1987, 25 skilled athletes with shoulder pain secondary to anterior glenohumeral instability that had failed to improve with conservative therapy had an anterior capsulolabral reconstruction. All but one athlete completed a formal rehabilitation program with an average followup of 39 months. The results at followup were rated excellent in 68%, good in 24%, fair in 4%, and poor in 4%. Seventeen patients returned to their prior competitive level for at least 1 year. This operation and rehabilitation program may allow many athletes who participate in overhand activities or throwing sports to return to their prior level of competition.

  18. Dynamic electromyographic analysis of the throwing shoulder with glenohumeral instability.

    PubMed

    Glousman, R; Jobe, F; Tibone, J; Moynes, D; Antonelli, D; Perry, J

    1988-02-01

    Fifteen male athletes who were skilled in throwing and who had chronic anterior instability of the shoulder (Group 1) were evaluated by dynamic intramuscular electromyography while pitching a baseball. Indwelling wire electrodes recorded the levels of activity in the biceps, middle deltoid, supraspinatus, infraspinatus, pectoralis major, subscapularis, latissimus dorsi, and serratus anterior throughout the entire pitching sequence. These signals were synchronized electronically with records of the pitch that were made using high-speed photography. The pitch was divided into five phases: wind-up, early cocking, late cocking, acceleration, and follow-through. The results were compared with previous identical studies of twelve healthy, uninjured male athletes who were skilled in throwing (Group 2). Activity increased mildly in the biceps and supraspinatus in Group 1 as compared with Group 2. Similar patterns of activity were demonstrated in the deltoid. In Group 1 the infraspinatus had increased activity during early cocking and follow-through but had decreased activity during late cocking. The pectoralis major, subscapularis, latissimus dorsi, and serratus anterior in Group 1 all were shown to have markedly decreased activity. The study revealed a difference between Groups 1 and 2 in all of the muscles of the shoulder that were tested with the exception of the deltoid. The mildly increased activity levels of the biceps and supraspinatus that were found in Group 1 may compensate for anterior laxity. The marked reduction in activity in the pectoralis major, subscapularis, and latissimus dorsi added to the anterior instability by decreasing the normal internal-rotation force that is needed during the phases of late cocking and acceleration.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Intraarticular iliotibial band reconstruction for anterior cruciate ligament insufficiency.

    PubMed

    Yost, J G; Chekofsky, K; Schoscheim, P; Nolan, P; Slovin, H; Scott, W N

    1981-01-01

    Intraarticular reconstruction of the anterior cruciate ligament by transferring the distal aspect and insertion of the iliotibial band has been clinically successful. Our surgical technique theoretically retains normal neurovascular supply, and thus, the potential for dynamic repair exists. Thirty-five patients, 28 men and 7 women, underwent this reconstruction. The average age was 24 years, with a range from 18 to 46. There were 27 chronic and 8 acute injuries. Pathological findings included an absent anterior cruciate (14 knees), severe stretching (13), failed reconstruction or repair (4), midportion tears (3), and avulsion (1). Postoperative patients were evaluated according to the Kennedy criteria. An anterior drawer of 2+ was not observed in any patient. There were no cases of 2+ rotary instability, and no pivot shifts. The possibility of a dynamic or proprioceptive repair was assessed by electromyography. While no evidence of electrical activity was recorded on the gluteus maximus on 60 normal knee examinations, all 10 tested postoperative iliotibial band patients had electrical activity. The failed results of the series showed no evidence of activity.

  20. Anterior cruciate ligament - updating article.

    PubMed

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques. PMID:27517015

  1. Anterior cruciate ligament - updating article.

    PubMed

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  2. Genomic Instability and Cancer

    PubMed Central

    Yao, Yixin; Dai, Wei

    2014-01-01

    Genomic instability is a characteristic of most cancer cells. It is an increased tendency of genome alteration during cell division. Cancer frequently results from damage to multiple genes controlling cell division and tumor suppressors. It is known that genomic integrity is closely monitored by several surveillance mechanisms, DNA damage checkpoint, DNA repair machinery and mitotic checkpoint. A defect in the regulation of any of these mechanisms often results in genomic instability, which predisposes the cell to malignant transformation. Posttranslational modifications of the histone tails are closely associated with regulation of the cell cycle as well as chromatin structure. Nevertheless, DNA methylation status is also related to genomic integrity. We attempt to summarize recent developments in this field and discuss the debate of driving force of tumor initiation and progression. PMID:25541596

  3. A trickle instability

    NASA Astrophysics Data System (ADS)

    Bossa, Benjamin

    2005-11-01

    We address the problem of the free fall of a long, horizontal and narrow liquid layer squeezed in a vertical open Hele-Shaw cell. The layer destabilizes as it falls down, evolving into a series of liquid blobs linked together by thin bridges, which ultimately break, leaving the initially connex fluid layer as a set a disjointed drops. The mechanism of this instability is the onset of a vertical pressure gradient due to the curvature difference of the moving contact line between the advancing interface and the rear interface. This instability, whose growth rate scales with a non-trivial power of the capillary number, amplifies indifferently a broad band of wavenumbers because of the flat shape of its dispersion relation in the thin layer limit. We will finally comment on the nature of the final fragmentation process and drop size distributions.

  4. Sessile Rayleigh drop instability

    NASA Astrophysics Data System (ADS)

    Steen, Paul; Bostwick, Josh

    2012-11-01

    Rayleigh (1879) determined the mode shapes and frequencies of the inviscid motion of a free drop held by surface tension. We study the inviscid motions of a sessile Rayleigh drop - a drop which rests on a planar solid and whose contact-line is free to move. Linear stability analysis gives the modes and frequencies of the droplet motions. In this talk, we focus on the ``walking instability,'' an unstable mode wherein the drop moves across a planar substrate in an inviscid rocking-like motion. The mode shape is non-axisymmetric. Although the experimental literature has hinted at such a mode, this is the first prediction from linear stability analysis, as far as we are aware. The ``walking instability'' of the drop converts energy stored in the liquid shape into the energy of liquid motion - which represents a heretofore unknown pathway of energy conversion of potentially wide significance for a broad range of applications.

  5. Open field lines instabilities

    SciTech Connect

    Pozzoli, R. |

    1995-09-01

    The results of some recent theoretical papers dealing with flute-like instabilities in the scrape-off layer of a tokamak with limiter configuration, where the magnetic field intersects conducting walls, are briefly recalled. Attention is then paid to the instability driven by the electron temperature gradient across the field in conjunction with the formation of the Debye sheath at the boundary, and to the effects due to the inclination of the end walls with respect to the magnetic field. When a divertor configuration is considered, important modifications are found owing to the strong deformations of the flux tubes passing near the {ital x}-point, which contrast the onset of flute-like perturbations, and to the stochasticity of field lines that can be excited by magnetic field perturbations. {copyright} {ital 1995 American Institute of Physics.}

  6. Instabilities in sensory processes

    NASA Astrophysics Data System (ADS)

    Balakrishnan, J.

    2014-07-01

    In any organism there are different kinds of sensory receptors for detecting the various, distinct stimuli through which its external environment may impinge upon it. These receptors convey these stimuli in different ways to an organism's information processing region enabling it to distinctly perceive the varied sensations and to respond to them. The behavior of cells and their response to stimuli may be captured through simple mathematical models employing regulatory feedback mechanisms. We argue that the sensory processes such as olfaction function optimally by operating in the close proximity of dynamical instabilities. In the case of coupled neurons, we point out that random disturbances and fluctuations can move their operating point close to certain dynamical instabilities triggering synchronous activity.

  7. Modulation instability: The beginning

    NASA Astrophysics Data System (ADS)

    Zakharov, V. E.; Ostrovsky, L. A.

    2009-03-01

    We discuss the early history of an important field of “sturm and drang” in modern theory of nonlinear waves. It is demonstrated how scientific demand resulted in independent and almost simultaneous publications by many different authors on modulation instability, a phenomenon resulting in a variety of nonlinear processes such as envelope solitons, envelope shocks, freak waves, etc. Examples from water wave hydrodynamics, electrodynamics, nonlinear optics, and convection theory are given.

  8. Robust dynamic mitigation of instabilities

    NASA Astrophysics Data System (ADS)

    Kawata, S.; Karino, T.

    2015-04-01

    A dynamic mitigation mechanism for instability growth was proposed and discussed in the paper [S. Kawata, Phys. Plasmas 19, 024503 (2012)]. In the present paper, the robustness of the dynamic instability mitigation mechanism is discussed further. The results presented here show that the mechanism of the dynamic instability mitigation is rather robust against changes in the phase, the amplitude, and the wavelength of the wobbling perturbation applied. Generally, instability would emerge from the perturbation of the physical quantity. Normally, the perturbation phase is unknown so that the instability growth rate is discussed. However, if the perturbation phase is known, the instability growth can be controlled by a superposition of perturbations imposed actively: If the perturbation is induced by, for example, a driving beam axis oscillation or wobbling, the perturbation phase could be controlled, and the instability growth is mitigated by the superposition of the growing perturbations.

  9. Robust dynamic mitigation of instabilities

    SciTech Connect

    Kawata, S.; Karino, T.

    2015-04-15

    A dynamic mitigation mechanism for instability growth was proposed and discussed in the paper [S. Kawata, Phys. Plasmas 19, 024503 (2012)]. In the present paper, the robustness of the dynamic instability mitigation mechanism is discussed further. The results presented here show that the mechanism of the dynamic instability mitigation is rather robust against changes in the phase, the amplitude, and the wavelength of the wobbling perturbation applied. Generally, instability would emerge from the perturbation of the physical quantity. Normally, the perturbation phase is unknown so that the instability growth rate is discussed. However, if the perturbation phase is known, the instability growth can be controlled by a superposition of perturbations imposed actively: If the perturbation is induced by, for example, a driving beam axis oscillation or wobbling, the perturbation phase could be controlled, and the instability growth is mitigated by the superposition of the growing perturbations.

  10. Instabilities of twisted strings

    NASA Astrophysics Data System (ADS)

    Forgács, Péter; Lukács, Árpád

    2009-12-01

    A linear stability analysis of twisted flux-tubes (strings) in an SU(2) semilocal theory — an Abelian-Higgs model with two charged scalar fields with a global SU(2) symmetry — is carried out. Here the twist refers to a relative phase between the two complex scalars (with linear dependence on, say, the z coordinate), and importantly it leads to a global current flowing along the the string. Such twisted strings bifurcate with the Abrikosov-Nielsen-Olesen (ANO) solution embedded in the semilocal theory. Our numerical investigations of the small fluctuation spectrum confirm previous results that twisted strings exhibit instabilities whose amplitudes grow exponentially in time. More precisely twisted strings with a single magnetic flux quantum admit a continuous family of unstable eigenmodes with harmonic z dependence, indexed by a wavenumber kin[-km, km]. Carrying out a perturbative semi-analytic analysis of the bifurcation, it is found that the purely numerical results are very well reproduced. This way one obtains not only a good qualitative description of the twisted solutions themselves as well as of their instabilities, but also a quantitative description of the numerical results. Our semi-analytic results indicate that in close analogy to the known instability of the embedded ANO vortex a twisted string is also likely to expand in size caused by the spreading out of its magnetic flux.

  11. Combustion instability analysis

    NASA Technical Reports Server (NTRS)

    Chung, T. J.

    1990-01-01

    A theory and computer program for combustion instability analysis are presented. The basic theoretical foundation resides in the concept of entropy-controlled energy growth or decay. Third order perturbation expansion is performed on the entropy-controlled acoustic energy equation to obtain the first order integrodifferential equation for the energy growth factor in terms of the linear, second, and third order energy growth parameters. These parameters are calculated from Navier-Stokes solutions with time averages performed on as many Navier-Stokes time steps as required to cover at least one peak wave period. Applications are made for a 1-D Navier-Stokes solution for the Space Shuttle Main Engine (SSME) thrust chamber with cross section area variations taken into account. It is shown that instability occurs when the mean pressure is set at 2000 psi with 30 percent disturbances. Instability also arises when the mean pressure is set at 2935 psi with 20 percent disturbances. The system with mean pressures and disturbances more adverse that these cases were shown to be unstable.

  12. Instabilities and constitutive modelling.

    PubMed

    Wilson, Helen J

    2006-12-15

    The plastics industry today sees huge wastage through product defects caused by unstable flows during the manufacturing process. In addition, many production lines are throughput-limited by a flow speed threshold above which the process becomes unstable. Therefore, it is critically important to understand the mechanisms behind these instabilities. In order to investigate the flow of a molten plastic, the first step is a model of the liquid itself, a relation between its current stress and its flow history called a constitutive relation. These are derived in many ways and tested on several benchmark flows, but rarely is the stability of the model used as a criterion for selection. The relationship between the constitutive model and the stability properties of even simple flows is not yet well understood. We show that in one case a small change to the model, which does not affect the steady flow behaviour, entirely removes a known instability. In another, a change that makes a qualitative difference to the steady flow makes only tiny changes to the stability.The long-term vision of this research is to exactly quantify what are the important properties of a constitutive relation as far as stability is concerned. If we could understand that, not only could very simple stability experiments be used to choose the best constitutive models for a particular material, but our ability to predict and avoid wasteful industrial instabilities would also be vastly improved.

  13. Carpal instability nondissociative.

    PubMed

    Wolfe, Scott W; Garcia-Elias, Marc; Kitay, Alison

    2012-09-01

    Carpal instability nondissociative (CIND) represents a spectrum of conditions characterized by kinematic dysfunction of the proximal carpal row, often associated with a clinical "clunk." CIND is manifested at the midcarpal and/or radiocarpal joints, and it is distinguished from carpal instability dissociative (CID) by the lack of disruption between bones within the same carpal row. There are four major subcategories of CIND: palmar, dorsal, combined, and adaptive. In palmar CIND, instability occurs across the entire proximal carpal row. When nonsurgical management fails, surgical options include arthroscopic thermal capsulorrhaphy, soft-tissue reconstruction, or limited radiocarpal or intercarpal fusions. In dorsal CIND, the capitate subluxates dorsally from its reduced resting position. Dorsal CIND usually responds to nonsurgical management; refractory cases respond to palmar ligament reefing and/or dorsal intercarpal capsulodesis. Combined CIND demonstrates signs of both palmar and dorsal CIND and can be treated with soft-tissue or bony procedures. In adaptive CIND, the volar carpal ligaments are slackened and are less capable of inducing the physiologic shift of the proximal carpal row from flexion into extension as the wrist ulnarly deviates. Treatment of choice is a corrective osteotomy to restore the normal volar tilt of the distal radius.

  14. Results of meniscectomy and meniscal repair in anterior cruciate ligament reconstruction

    PubMed Central

    DELEDDA, DAVIDE; ROSSO, FEDERICA; COTTINO, UMBERTO; BONASIA, DAVIDE EDOARDO; ROSSI, ROBERTO

    2015-01-01

    Meniscal tears are commonly associated with anterior cruciate ligament (ACL) injuries. A deficient medial meniscus results in knee instability and could lead to higher stress forces on the ACL reconstruction. Comparison of results in meniscectomy and meniscal repairs revealed worse clinical outcomes in meniscectomy, but higher re-operation rates in meniscal repairs. Our aim was to review the results of ACL reconstruction associated with meniscectomy or meniscal repair. PMID:26889472

  15. 38 CFR 3.379 - Anterior poliomyelitis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it...

  16. [Is meniscal repair an adequate procedure to prevent early osteoarthritis in athletes with chronic anterior knee instabilitity?].

    PubMed

    Jäger, A; Braune, C; Welsch, F; Khoudeir, S; Rauschmann, M A

    2002-10-01

    We retrospectively evaluated the clinical outcome of arthroscopic assisted meniscal suture repair in athletes on different competitive sports levels with stable joint function and persisting anterior knee instability. Return to former sports levels and early osteoarthrotic changes were especially focussed. Examination included 50 athletes (32 men, 18 women) who underwent meniscal repair in inside-out technique during the period of 1989 to 1998. 23 patients had isolated full-thickness meniscal tears, 27 an associated rupture of the anterior cruciate ligament which was reconstructed in 13 cases with a patellar-tendon autograft. 3 study groups were formed referring to the athletes preoperative sports level evaluated with Tegner's score. Reexamination included Lysholm score, IKDC score and Fairbank's score. With a mean age of 32.1 years (range 13-53 years) and an average follow-up of 6.3 years 72 % of the patients (n = 36) showed a stable joint function on reexamination. With no persisting anterior knee instability 86 % of the professional athletes returned to former full sports activities on competitive levels. Non competitive athletes returned in all cases (100 %) to their former level. Fairbank's score increased by 0.1 observing minimal osteoarthitic signs. However, persisting anterior knee instability showed on reexamination poor results. Only one third of all athletes were able to return to former activity levels. Osteoarthritic changes were observed in all patients. Professional athletes had the most severe osteoarthritic changes with a significant (p = 0.03) increase of 0.8 in Fairbank's score. The results demonstrate that complete recovery on sports activities after meniscal repair is not possible without reconstruction of the anterior cruciate ligament. Isolated meniscal repair shows poor results in persisting anterior knee instability and does not prevent increasing osteoarthritic changes in athletes.

  17. Double figure-of-eight reconstruction technique for chronic anterior sternoclavicular joint dislocation.

    PubMed

    Kawaguchi, Kohei; Tanaka, Sayo; Yoshitomi, Hiroki; Nagai, Ichiro; Sato, Wakyo; Karita, Tasturo; Kondo, Taiji

    2015-05-01

    Sternoclavicular joint dislocations account for <5 % of all dislocations of the shoulder girdle. Whereas most cases of anterior dislocation do not experience symptoms, some patients with anterior instability remain symptomatic and require reconstructive surgery to stabilize the sternoclavicular joint. We present the case of a 57-year-old male diagnosed with sternoclavicular joint anterior dislocation and unusual swallowing difficulty while bending the neck forward. The patient was treated using a new and effective surgical technique of sternoclavicular joint reconstruction named "double figure-of-eight" using the ipsilateral gracilis tendon. Surgical outcome was successful, based on the Rockwood SC joint rating scale, and the patient maintained excellent stability even after 2 years. This new surgical technique offers superior stability, without harvest site morbidity, to patients with rare, severe, and chronic sternoclavicular joint dislocation. Level of evidence IV. PMID:24722676

  18. Specificity and sensitivity of the anterior slide test in throwing athletes with superior glenoid labral tears.

    PubMed

    Kibler, W B

    1995-06-01

    This study documents the sensitivity and specificity of a clinical test to aid in the diagnosis of superior glenoid labral lesions. The anterior slide test, a method of applying an anteriorly and superiorly directed force to the glenohumeral joint, was performed on several groups of athletes. These included symptomatic athletes with isolated superior labral tears, rotator cuff tears, and instabilities, and asymptomatic athletes with rotational deficits. In addition, non-throwing athletes were tested. The sensitivity of the test was 78.4%, and the specificity was 91.5%. This study shows that the anterior slide test can be used in the clinical examination, in that it has high specificity for superior labral lesions, but not enough sensitivity to be the sole diagnostic criterion for these lesions.

  19. First-time anterior shoulder dislocations: should they be arthroscopically stabilised?

    PubMed Central

    Sedeek, Sedeek Mohamed; Bin Abd Razak, Hamid Rahmatullah; Ee, Gerard WW; Tan, Andrew HC

    2014-01-01

    The glenohumeral joint is inherently unstable because the large humeral head articulates with the small shadow glenoid fossa. Traumatic anterior dislocation of the shoulder is a relatively common athletic injury, and the high frequency of recurrent instability in young athletes after shoulder dislocation is discouraging to both the patient and the treating physician. Management of primary traumatic shoulder dislocation remains controversial. Traditionally, treatment involves initial immobilisation for 4–6 weeks, followed by functional rehabilitation. However, in view of the high recurrence rates associated with this traditional approach, there has been an escalating interest in determining whether immediate surgical intervention can lower the rate of recurrent shoulder dislocation, improving the patient’s quality of life. This review article aims to provide an overview of the nature and pathogenesis of first-time primary anterior shoulder dislocations, the widely accepted management modalities, and the efficacy of primary surgical intervention in first-time primary anterior shoulder dislocations. PMID:25631890

  20. Open reduction of a lateral femoral notch associated with an acute anterior cruciate ligament tear.

    PubMed

    Garth, W P; Wilson, T

    2001-10-01

    The lateral notch is a radiographic sign that describes a depression in the lateral femoral condyle near the terminal sulcus. The sign was first described in association with chronic instability in an anterior cruciate ligament-deficient knee. Recently, the senior author, after a prospective study, reported that these lateral notches might occur acutely at the time of anterior cruciate ligament injury. We report such a case in which the lateral femoral condylar depression fracture resulted in symptoms of lateral compartment incongruity. Open reduction and internal fixation were required. Anterior cruciate ligament reconstruction was performed as a staged procedure 2 months after fracture reduction. The postoperative result has been excellent for over 5 years. This case is an example that lateral femoral notches may be acute and a source of symptoms. In some cases, reduction and fixation of significant depressions in association with ligament reconstruction can alleviate these symptoms and may improve the patient's long-term result.

  1. Radiation Induced Genomic Instability

    SciTech Connect

    Morgan, William F.

    2011-03-01

    Radiation induced genomic instability can be observed in the progeny of irradiated cells multiple generations after irradiation of parental cells. The phenotype is well established both in vivo (Morgan 2003) and in vitro (Morgan 2003), and may be critical in radiation carcinogenesis (Little 2000, Huang et al. 2003). Instability can be induced by both the deposition of energy in irradiated cells as well as by signals transmitted by irradiated (targeted) cells to non-irradiated (non-targeted) cells (Kadhim et al. 1992, Lorimore et al. 1998). Thus both targeted and non-targeted cells can pass on the legacy of radiation to their progeny. However the radiation induced events and cellular processes that respond to both targeted and non-targeted radiation effects that lead to the unstable phenotype remain elusive. The cell system we have used to study radiation induced genomic instability utilizes human hamster GM10115 cells. These cells have a single copy of human chromosome 4 in a background of hamster chromosomes. Instability is evaluated in the clonal progeny of irradiated cells and a clone is considered unstable if it contains three or more metaphase sub-populations involving unique rearrangements of the human chromosome (Marder and Morgan 1993). Many of these unstable clones have been maintained in culture for many years and have been extensively characterized. As initially described by Clutton et al., (Clutton et al. 1996) many of our unstable clones exhibit persistently elevated levels of reactive oxygen species (Limoli et al. 2003), which appear to be due dysfunctional mitochondria (Kim et al. 2006, Kim et al. 2006). Interestingly, but perhaps not surprisingly, our unstable clones do not demonstrate a “mutator phenotype” (Limoli et al. 1997), but they do continue to rearrange their genomes for many years. The limiting factor with this system is the target – the human chromosome. While some clones demonstrate amplification of this chromosome and thus lend

  2. Combined Posterior and Anterior Ankle Arthroscopy

    PubMed Central

    Scholten, Peter E.; van Dijk, C. Niek

    2012-01-01

    Treatment of combined anterior and posterior ankle pathology usually consists of either combined anterior and posterior arthrotomies or anterior ankle arthroscopy with an additional posterolateral portal. The first technique bears the risk of complications associated with the extensive exposure, the latter technique provides limited access to the posterior ankle joint. A case is described of combined anterior and posterior arthroscopy, with the patient lying prone and then turned supine, addressing both anterior and posterior ankle pathologies in one tempo. This minimally invasive combined approach allows quick recovery and early return to work and sports activities. PMID:23227391

  3. Radiative-convective instability

    NASA Astrophysics Data System (ADS)

    Emanuel, Kerry; Wing, Allison A.; Vincent, Emmanuel M.

    2014-03-01

    equilibrium (RCE) is a simple paradigm for the statistical equilibrium the earth's climate would exhibit in the absence of lateral energy transport. It has generally been assumed that for a given solar forcing and long-lived greenhouse gas concentration, such a state would be unique, but recent work suggests that more than one stable equilibrium may be possible. Here we show that above a critical specified sea surface temperature, the ordinary RCE state becomes linearly unstable to large-scale overturning circulations. The instability migrates the RCE state toward one of the two stable equilibria first found by Raymond and Zeng (2000). It occurs when the clear-sky infrared opacity of the lower troposphere becomes so large, owing to high water vapor concentration, that variations of the radiative cooling of the lower troposphere are governed principally by variations in upper tropospheric water vapor. We show that the instability represents a subcritical bifurcation of the ordinary RCE state, leading to either a dry state with large-scale descent, or to a moist state with mean ascent; these states may be accessed by finite amplitude perturbations to ordinary RCE in the subcritical state, or spontaneously in the supercritical state. As first suggested by Raymond (2000) and Sobel et al. (2007), the latter corresponds to the phenomenon of self-aggregation of moist convection, taking the form of cloud clusters or tropical cyclones. We argue that the nonrobustness of self-aggregation in cloud system resolving models may be an artifact of running such models close to the critical temperature for instability.

  4. The cosmic Doppler instability

    NASA Technical Reports Server (NTRS)

    Hogan, Craig J.

    1993-01-01

    The equations governing the behavior of perturbations of a mixture of nearly homogeneous and isotropic matter and radiation are derived, using a diffusion approximation where spatial perturbations in the radiation spectrum are allowed to vary with frequency. A simple model of line opacity leads to dispersion relations which display a new bulk instability. The model is used to derive an approximate dispersion relation for radiation interacting via resonance scattering opacity in atomic hydrogen at low density and low temperature. Possible applications to cosmology are briefly discussed.

  5. Gas turbine combustion instability

    SciTech Connect

    Richards, G.A.; Lee, G.T.

    1996-09-01

    Combustion oscillations are a common problem in development of LPM (lean premix) combustors. Unlike earlier, diffusion style combustors, LPM combustors are especially susceptible to oscillations because acoustic losses are smaller and operation near lean blowoff produces a greater combustion response to disturbances in reactant supply, mixing, etc. In ongoing tests at METC, five instability mechanisms have been identified in subscale and commercial scale nozzle tests. Changes to fuel nozzle geometry showed that it is possible to stabilize combustion by altering the timing of the feedback between acoustic waves and the variation in heat release.

  6. Chemically Driven Hydrodynamic Instabilities

    NASA Astrophysics Data System (ADS)

    Almarcha, C.; Trevelyan, P. M. J.; Grosfils, P.; de Wit, A.

    2010-01-01

    In the gravity field, density changes triggered by a kinetic scheme as simple as A+B→C can induce or affect buoyancy-driven instabilities at a horizontal interface between two solutions containing initially the scalars A and B. On the basis of a general reaction-diffusion-convection model, we analyze to what extent the reaction can destabilize otherwise buoyantly stable density stratifications. We furthermore show that, even if the underlying nonreactive system is buoyantly unstable, the reaction breaks the symmetry of the developing patterns. This is demonstrated both numerically and experimentally on the specific example of a simple acid-base neutralization reaction.

  7. Booming Dune Instability

    NASA Astrophysics Data System (ADS)

    Andreotti, B.; Bonneau, L.

    2009-12-01

    Sand avalanches flowing down the leeward face of some desert dunes spontaneously produce a loud sound with a characteristic vibrato around a well-defined frequency, a phenomenon called the “song of dunes.” Here, we show through theory that a homogenous granular surface flow is linearly unstable towards growing elastic waves when a localized shear band forms at the interface between the avalanche and the static part of the dune. We unravel the nature of the acoustic amplifying mechanism at the origin of this booming instability. The dispersion relation and the shape of the most unstable modes are computed and compared to field measurements.

  8. Booming dune instability.

    PubMed

    Andreotti, B; Bonneau, L

    2009-12-01

    Sand avalanches flowing down the leeward face of some desert dunes spontaneously produce a loud sound with a characteristic vibrato around a well-defined frequency, a phenomenon called the "song of dunes." Here, we show through theory that a homogenous granular surface flow is linearly unstable towards growing elastic waves when a localized shear band forms at the interface between the avalanche and the static part of the dune. We unravel the nature of the acoustic amplifying mechanism at the origin of this booming instability. The dispersion relation and the shape of the most unstable modes are computed and compared to field measurements. PMID:20366176

  9. Shilnikov instabilities in laser systems

    SciTech Connect

    Swetits, J.J.; Buoncristiani, A.M.

    1988-11-15

    Experiments on a CO/sub 2/ laser with feedback (F. T. Arecchi, R. Meucci, and W. Gadomski, Phys. Rev. Lett. 58, 2205 (1987)) displayed an extraordinary set of instabilities, identified as Shilnikov chaos. We have investigated the stability structure of a theoretical model developed to describe this laser system and carried out an extensive numerical search for the Shilnikov instability. No computational evidence to support the claim of a Shilnikov instability for model parameters corresponding to the experimental region can be found.

  10. Locally aggressive aneurysmal bone cyst of C4 vertebra treated by total en bloc excision and anterior plus posterior cervical instrumentation

    PubMed Central

    Parmar, Himanshu N.; Agrawal, Vinod A.; Shah, Munjal S.; Nanda, Saurav N.

    2015-01-01

    We are presenting a case of cervical (C4) aneurysmal bone cyst in a 13-year-old girl, came to the outpatient department with neck pain and stiffness since 6 months and normal neurology. We did an en bloc excision of locally aggressive tumor through anterior plus posterior approach and stabilization by lateral mass screw fixation and anterior cervical instrumentation. Involvement of several adjacent cervical vertebrae by an aneurysmal bone cyst is rare, and conventional treatment with curettage and bone grafting is most likely to carry a high rate of recurrence and spinal instability. We recommend complete excision of the tumor and instrumentation in a single stage to avoid instability. PMID:26288549

  11. Combined anterolateral ligament and anatomic anterior cruciate ligament reconstruction of the knee.

    PubMed

    Smith, James O; Yasen, Sam K; Lord, Breck; Wilson, Adrian J

    2015-11-01

    Although anatomic anterior cruciate ligament (ACL) reconstruction is established for the surgical treatment of anterolateral knee instability, there remains a significant cohort of patients who continue to experience post-operative instability. Recent advances in our understanding of the anatomic, biomechanical and radiological characteristics of the native anterolateral ligament (ALL) of the knee have led to a resurgent interest in reconstruction of this structure as part of the management of knee instability. This technical note describes our readily reproducible combined minimally invasive technique to reconstruct both the ACL and ALL anatomically using autologous semitendinosus and gracilis grafts. This method of ALL reconstruction can be easily integrated with all-inside ACL reconstruction, requiring minimal additional operative time, equipment and expertise. Level of evidence V.

  12. Study of cavitating inducer instabilities

    NASA Technical Reports Server (NTRS)

    Young, W. E.; Murphy, R.; Reddecliff, J. M.

    1972-01-01

    An analytic and experimental investigation into the causes and mechanisms of cavitating inducer instabilities was conducted. Hydrofoil cascade tests were performed, during which cavity sizes were measured. The measured data were used, along with inducer data and potential flow predictions, to refine an analysis for the prediction of inducer blade suction surface cavitation cavity volume. Cavity volume predictions were incorporated into a linearized system model, and instability predictions for an inducer water test loop were generated. Inducer tests were conducted and instability predictions correlated favorably with measured instability data.

  13. Validity and reliability of the SPORTS score for shoulder instability

    PubMed Central

    BLONNA, DAVIDE; BELLATO, ENRICO; CARANZANO, FRANCESCO; BONASIA, DAVIDE E.; MARMOTTI, ANTONGIULIO; ROSSI, ROBERTO; CASTOLDI, FILIPPO

    2014-01-01

    Purpose athletes affected by shoulder instability cannot be judged solely according to the criteria used for non-athletes. In order to improve the assessment of shoulder instability surgery outcomes, the SPORTS score was tested in a cohort of athletes. Methods ninety-eight athletes at an average follow-up of 4.6 years (range 1–9.2) after open or arthroscopic surgery for recurrent anterior shoulder instability were included in this study. The patients were asked to complete the SPORTS score questionnaire twice, with an interval of 2–3 weeks between the two assessments. The Bland-Altman method and the intra-class correlation coefficient were used to measure reliability. Criterion validity was assessed by calculating the Spearman correlation coefficient between the SPORTS score and the Western Ontario Shoulder Instability Index (WOSI) score, the Rowe score, the Oxford Shoulder Instability Score (OSIS), and the Subjective Shoulder Value (SSV). Results the SPORTS score showed excellent test-retest reliability. The systematic error between the first and the second assessment was 0.3 points (95% upper limit of agreement = 2.3 points). The criterion validity was found to be strong for the SPORTS score, which correlated best with the SSV and the “sport, recreation, and work” component of the WOSI score. The SPORTS score had an acceptable floor effect (8%). The ceiling effect was 46%, which was better than the ceiling effects seen with the Rowe, OSIS and WOSI scores. Conclusions this study suggests that the SPORTS score is a valid score in the assessment of athletes after surgery for shoulder instability and that it adds important information to the currently available scores. Level of evidence Level III, diagnostic study of nonconsecutive patients. PMID:25606544

  14. [Aspirin suppresses microsatellite instability].

    PubMed

    Wallinger, S; Dietmaier, W; Beyser, K; Bocker, T; Hofstädter, F; Fishel, R; Rüschoff, J

    1999-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) exhibit cancer preventive effects and have been shown to induce regression of adenomas in FAP patients. In order to elucidate the probable underlying mechanism, the effect of NSAIDs on mismatch repair related microsatellite instability was investigated. Six colorectal cancer cell lines all but one deficient for human mismatch repair (MMR) genes were examined for microsatellite instability (MSI) prior and after treatment with Aspirin or Sulindac. For rapid in vitro analysis of MSI a microcloning assay was developed by combining Laser microdissection and random (PEP-) PCR prior to specific MSI-PCR. Effects of NSAIDs on cell cycle and apoptosis were systematically investigated by using flow cytometry and cell-sorting. MSI frequency in cells deficient of MMR genes (hMSH2, hMLH1, hMSH6) was markedly reduced after long-term (> 10 weeks) NSAID treatment. This effect was reversible, time- and concentration dependent. However, in the hPMS2 deficient endometrial cancer cell line (HEC-1-A) the MSI phenotype kept unchanged. According to cell sorting, non-apoptotic cells were stable and apoptotic cells were unstable. These results suggest that aspirin/sulindac induces a genetic selection for microsatellite stability in a subset of MMR-deficient cells and may thus provide an effective prophylactic therapy for HNPCC related colorectal carcinomas.

  15. Does surgery for instability of the shoulder truly stabilize the glenohumeral joint?

    PubMed Central

    Lädermann, Alexandre; Denard, Patrick J.; Tirefort, Jérôme; Kolo, Frank C.; Chagué, Sylvain; Cunningham, Grégory; Charbonnier, Caecilia

    2016-01-01

    Abstract Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects glenohumeral translation. The purpose of this prospective clinical study was to analyze the effect of surgical stabilization on glenohumeral translation. Glenohumeral translation was assessed in 11 patients preoperatively and 1 year postoperatively following surgical stabilization for anterior shoulder instability. Translation was measured using optical motion capture and computed tomography. Preoperatively, anterior translation of the affected shoulder was bigger in comparison to the normal contralateral side. Differences were significant for flexion and abduction movements (P < 0.001). Postoperatively, no patients demonstrated apprehension and all functional scores were improved. Despite absence of apprehension, postoperative anterior translation for the surgically stabilized shoulders was not significantly different from the preoperative values. While surgical treatment for anterior instability limits the chance of dislocation, it does not seem to restore glenohumeral translation during functional range of motion. Such persistent microinstability may explain residual pain, apprehension, inability to return to activity and even emergence of dislocation arthropathy that is seen in some patients. Further research is necessary to better understand the causes, effects, and treatment of residual microinstability following surgical stabilization of the shoulder. PMID:27495043

  16. Anterior cruciate ligament tunnel placement.

    PubMed

    Wolf, Brian R; Ramme, Austin J; Britton, Carla L; Amendola, Annunziato

    2014-08-01

    The purpose of this cadaveric study was to analyze variation in anterior cruciate ligament (ACL) tunnel placement between surgeons and the influence of preferred surgical technique and surgeon experience level using three-dimensional (3D) computed tomography (CT). In this study, 12 surgeons drilled ACL tunnels on six cadaveric knees each. Surgeons were divided by experience level and preferred surgical technique (two-incision [TI], medial portal [MP], and transtibial [TT]). ACL tunnel aperture locations were analyzed using 3D CT scans and compared with radiographic ACL footprint criteria. The femoral tunnel location from front to back within the notch demonstrated a range of means of 16% with the TI tunnels the furthest back. A range of means of only 5% was found for femoral tunnel low to high positions by technique. The anterior to posterior tibial tunnel measure demonstrated wider variation than the medial to lateral position. The mean tibial tunnel location drilled by TT surgeons was more posterior than surgeons using the other techniques. Overall, 82% of femoral tunnels and 78% of tibial tunnels met all radiographic measurement criteria. Slight (1-7%) differences in mean tunnel placement on the femur and tibia were found between experienced and new surgeons. The location of the femoral tunnel aperture in the front to back plane relative to the notch roof and the anterior to posterior position on the tibia were the most variable measures. Surgeon experience level did not appear to significantly affect tunnel location. This study provides background information that may be beneficial when evaluating multisurgeon and multicenter collaborative ACL studies.

  17. Anterior femoroacetabular impingement: an update.

    PubMed

    Lequesne, Michel; Bellaïche, Laurence

    2012-05-01

    Anterior femoroacetabular impingement can cause early hip osteoarthritis. The typical patient is an adult younger than 50 years of age, often with a history of sporting activities. The main symptom is intermittent pain triggered by static flexion (low seats) or dynamic flexion (during sporting or occupational activities that require repeated hip flexion). The characteristic physical finding is pain triggered by placing the hip in internal rotation and 70 to 110° of flexion. In additional to anteroposterior and false-profile radiographs, lateral Dunn or Ducroquet views should be obtained on both sides to visualize the anterior part of the head-neck junction. Instead of being concave, the head-neck junction is either flat or convex, causing a cam effect that damages the labrum and anterosuperior cartilage. Non-sphericity of the femoral head with an anterior ovoid bulge induces a similar cam effect. In pincer impingement, which is less common, over-coverage by the anterosuperior acetabular rim pinches the labrum between the rim and the femoral head-neck junction when the hip is flexed. Pincer impingement is related to acetabular retroversion or protrusion. Arthrography coupled with computed tomography or magnetic resonance imaging visualizes the morphological abnormalities (e.g., ovoid shape of the femoral head or retroversion of the acetabulum) and detects secondary lesions such as labral tears or separation or damage to the anterosuperior cartilage. Arthroscopy allows removal of the damaged labrum and correction of the morphological abnormalities via femoroplasty to restore the normal concave shape of the neck and/or acetabuloplasty to eliminate over-coverage. Short- or mid-term results are satisfactory in 75 to 80% of patients. However, the presence of degenerative lesions in about two-thirds of patients at the time of arthroplastic surgery limits the probability of achieving good long-term results. PMID:22281229

  18. Relativistic electromagnetic ion cyclotron instabilities.

    PubMed

    Chen, K R; Huang, R D; Wang, J C; Chen, Y Y

    2005-03-01

    The relativistic instabilities of electromagnetic ion cyclotron waves driven by MeV ions are analytically and numerically studied. As caused by wave magnetic field and in sharp contrast to the electrostatic case, interesting characteristics such as Alfve nic behavior and instability transition are discovered and illuminated in detail. The instabilities are reactive and are raised from the coupling of slow ions' first-order resonance and fast ions' second-order resonance, that is an essential extra mechanism due to relativistic effect. Because of the wave magnetic field, the nonresonant plasma dielectric is usually negative and large, that affects the instability conditions and scaling laws. A negative harmonic cyclotron frequency mismatch between the fast and slow ions is required for driving a cubic (and a coupled quadratic) instability; the cubic (square) root scaling of the peak growth rate makes the relativistic effect more important than classical mechanism, especially for low fast ion density and Lorentz factor being close to unity. For the cubic instability, there is a threshold (ceiling) on the slow ion temperature and density (the external magnetic field and the fast ion energy); the Alfve n velocity is required to be low. This Alfve nic behavior is interesting in physics and important for its applications. The case of fast protons in thermal deuterons is numerically studied and compared with the analytical results. When the slow ion temperature or density (the external magnetic field or the fast ion energy) is increased (reduced) to about twice (half) the threshold (ceiling), the same growth rate peak transits from the cubic instability to the coupled quadratic instability and a different cubic instability branch appears. The instability transition is an interesting new phenomenon for instability. PMID:15903591

  19. Research on aviation fuel instability

    NASA Technical Reports Server (NTRS)

    Baker, C. E.; Bittker, D. A.; Cohen, S. M.; Seng, G. T.

    1983-01-01

    The underlying causes of fuel thermal degradation are discussed. Topics covered include: nature of fuel instability and its temperature dependence, methods of measuring the instability, chemical mechanisms involved in deposit formation, and instrumental methods for characterizing fuel deposits. Finally, some preliminary thoughts on design approaches for minimizing the effects of lowered thermal stability are briefly discussed.

  20. Liquid propellant rocket combustion instability

    NASA Technical Reports Server (NTRS)

    Harrje, D. T.

    1972-01-01

    The solution of problems of combustion instability for more effective communication between the various workers in this field is considered. The extent of combustion instability problems in liquid propellant rocket engines and recommendations for their solution are discussed. The most significant developments, both theoretical and experimental, are presented, with emphasis on fundamental principles and relationships between alternative approaches.

  1. Cohabitation and Children's Family Instability

    ERIC Educational Resources Information Center

    Kelly Raley, R.; Wildsmith, Elizabeth

    2004-01-01

    This study estimates how much children's family instability is missed when we do not count transitions into and out of cohabitation, and examines early life course trajectories of children to see whether children who experience maternal cohabitation face more family instability than children who do not. Using data from the 1995 National Survey of…

  2. Neurocardiovascular Instability and Cognition

    PubMed Central

    O’Callaghan, Susan; Kenny, Rose Anne

    2016-01-01

    Neurocardiovascular instability (NCVI) refers to abnormal neural control of the cardiovascular system affecting blood pressure and heart rate behavior. Autonomic dysfunction and impaired cerebral autoregulation in aging contribute to this phenomenon characterized by hypotension and bradyarrhythmia. Ultimately, this increases the risk of falls and syncope in older people. NCVI is common in patients with neurodegenerative disorders including dementia. This review discusses the various syndromes that characterize NCVI icluding hypotension, carotid sinus hypersensitivity, postprandial hypotension and vasovagal syncope and how they may contribute to the aetiology of cognitive decline. Conversely, they may also be a consequence of a common neurodegenerative process. Regardless, recognition of their association is paramount in optimizing management of these patients. PMID:27505017

  3. The booming dune instability

    NASA Astrophysics Data System (ADS)

    Andreotti, B.; Bonneau, L.

    2009-12-01

    Sand avalanches flowing down the leeward face of some desert dunes spontaneously produce a loud sound with a characteristic vibrato around a well defined frequency, a phenomenon called the "song of dunes". Here, we show theoretically that an homogenous granular surface flow is linearly unstable towards growing elastic waves when a localized shear band form at the interface between the avalanche and the static part of the dune. We unravel the nature of the acoustic amplifying mechanism at the origin of this booming instability. The dispersion relation and the shape of the most unstable modes are computed and compared to field records performed in the Atlantic Sahara. We finally show that several characteristics predicted by the model and observed in the field allow to dismiss former hypothesis based on resonances or the synchronisation of sand grain collisions.

  4. Instability of canopy flows

    NASA Astrophysics Data System (ADS)

    Zampogna, Giuseppe A.; Pluvinage, Franck; Kourta, Azeddine; Bottaro, Alessandro

    2016-07-01

    Honami and monami waves are caused by large-scale coherent vortex structures which form in shear layers generated by canopies. In order to reach new insights on the onset of such waves, the instability of these shear layers is studied. Two different approaches are used. In the first approach, the presence of the canopy is modeled via a drag coefficient, taken to vary along the canopy as by experimental indications. The second approach considers the canopy as a porous medium and different governing equations for the fluid flow are deduced. In this second case, the anisotropy of the canopy, composed by rigid cylindrical elements, is accounted for via an apparent permeability tensor. The results obtained with the latter approach approximate better experimental correlations for the synchronous oscillations of the canopy.

  5. Internal rotor friction instability

    NASA Technical Reports Server (NTRS)

    Walton, J.; Artiles, A.; Lund, J.; Dill, J.; Zorzi, E.

    1990-01-01

    The analytical developments and experimental investigations performed in assessing the effect of internal friction on rotor systems dynamic performance are documented. Analytical component models for axial splines, Curvic splines, and interference fit joints commonly found in modern high speed turbomachinery were developed. Rotor systems operating above a bending critical speed were shown to exhibit unstable subsynchronous vibrations at the first natural frequency. The effect of speed, bearing stiffness, joint stiffness, external damping, torque, and coefficient of friction, was evaluated. Testing included material coefficient of friction evaluations, component joint quantity and form of damping determinations, and rotordynamic stability assessments. Under conditions similar to those in the SSME turbopumps, material interfaces experienced a coefficient of friction of approx. 0.2 for lubricated and 0.8 for unlubricated conditions. The damping observed in the component joints displayed nearly linear behavior with increasing amplitude. Thus, the measured damping, as a function of amplitude, is not represented by either linear or Coulomb friction damper models. Rotordynamic testing of an axial spline joint under 5000 in.-lb of static torque, demonstrated the presence of an extremely severe instability when the rotor was operated above its first flexible natural frequency. The presence of this instability was predicted by nonlinear rotordynamic time-transient analysis using the nonlinear component model developed under this program. Corresponding rotordynamic testing of a shaft with an interference fit joint demonstrated the presence of subsynchronous vibrations at the first natural frequency. While subsynchronous vibrations were observed, they were bounded and significantly lower in amplitude than the synchronous vibrations.

  6. Combustion Instabilities Modeled

    NASA Technical Reports Server (NTRS)

    Paxson, Daniel E.

    1999-01-01

    NASA Lewis Research Center's Advanced Controls and Dynamics Technology Branch is investigating active control strategies to mitigate or eliminate the combustion instabilities prevalent in lean-burning, low-emission combustors. These instabilities result from coupling between the heat-release mechanisms of the burning process and the acoustic flow field of the combustor. Control design and implementation require a simulation capability that is both fast and accurate. It must capture the essential physics of the system, yet be as simple as possible. A quasi-one-dimensional, computational fluid dynamics (CFD) based simulation has been developed which may meet these requirements. The Euler equations of mass, momentum, and energy have been used, along with a single reactive species transport equation to simulate coupled thermoacoustic oscillations. A very simple numerical integration scheme was chosen to reduce computing time. Robust boundary condition procedures were incorporated to simulate various flow conditions (e.g., valves, open ends, and choked inflow) as well as to accommodate flow reversals that may arise during large flow-field oscillations. The accompanying figure shows a sample simulation result. A combustor with an open inlet, a choked outlet, and a large constriction approximately two thirds of the way down the length is shown. The middle plot shows normalized, time-averaged distributions of the relevant flow quantities, and the bottom plot illustrates the acoustic mode shape of the resulting thermoacoustic oscillation. For this simulation, the limit cycle peak-to-peak pressure fluctuations were 13 percent of the mean. The simulation used 100 numerical cells. The total normalized simulation time was 50 units (approximately 15 oscillations), which took 26 sec on a Sun Ultra2.

  7. Stereopsis after anterior temporal lobectomy.

    PubMed

    Verhoef, Bram-Ernst; Decramer, Thomas; van Loon, Johannes; Goffin, Jan; Van Paesschen, Wim; Janssen, Peter; Theys, Tom

    2016-09-01

    Brain areas critical for stereopsis have been investigated in non-human primates but are largely unknown in the human brain. Microelectrode recordings and functional MRI (fMRI) studies in monkeys have shown that in monkeys the inferior temporal cortex is critically involved in 3D shape categorization. Furthermore, some human fMRI studies similarly suggest an involvement of visual areas in the temporal lobe in depth perception. We aimed to investigate the role of the human anterior temporal neocortex in stereopsis by assessing stereoscopic depth perception before and after anterior temporal lobectomy. Eighteen epilepsy surgery patients were tested, pre- and postoperatively, in 3 different depth discrimination tasks. Sensitivity for local and global disparity was tested in a near-far discrimination task and sensitivity for 3D curvature was assessed in a convex-concave discrimination task, where 3D shapes were presented at different positions in depth. We found no evidence that temporal lobe epilepsy surgery has a significant effect on stereopsis. In contrast with earlier findings, we conclude that local as well as global stereopsis is maintained after unilateral resection of the temporal pole in epilepsy surgery patients. Our findings, together with previous studies, suggest that in humans more posterior visual regions underlie depth perception. PMID:27344239

  8. Combined anterior cruciate ligament and posterolateral reconstruction of the knee using allograft tissue in chronic knee injuries.

    PubMed

    Fanelli, Gregory C; Fanelli, David G; Edson, Craig J; Fanelli, Matthew G

    2014-10-01

    Combined anterior cruciate ligament (ACL) and posterolateral injury of the knee can result in significant functional instability for the affected individual. Both components of the instability must be treated to maximize the probability of success for the surgical procedure. Higher failure rates of the ACL reconstruction have been reported when the posterolateral instability has been left untreated. The purpose of this article is to describe our surgical technique, and present the results of 34 chronic combined ACL posterolateral reconstructions in 34 knees using allograft tissue, and evaluating these patient outcomes with KT 1000 knee ligament arthrometer, Lysholm, Tegner, and Hospital for Special Surgery knee ligament rating scales. In addition, observations regarding patient demographics with combined ACL posterolateral instability, postoperative range of motion loss, postinjury degenerative joint disease, infection rate, return to function, and the use of radiated and nonirradiated allograft tissues will be presented.

  9. Combined anterior cruciate ligament and posterolateral reconstruction of the knee using allograft tissue in chronic knee injuries.

    PubMed

    Fanelli, Gregory C; Fanelli, David G; Edson, Craig J; Fanelli, Matthew G

    2014-10-01

    Combined anterior cruciate ligament (ACL) and posterolateral injury of the knee can result in significant functional instability for the affected individual. Both components of the instability must be treated to maximize the probability of success for the surgical procedure. Higher failure rates of the ACL reconstruction have been reported when the posterolateral instability has been left untreated. The purpose of this article is to describe our surgical technique, and present the results of 34 chronic combined ACL posterolateral reconstructions in 34 knees using allograft tissue, and evaluating these patient outcomes with KT 1000 knee ligament arthrometer, Lysholm, Tegner, and Hospital for Special Surgery knee ligament rating scales. In addition, observations regarding patient demographics with combined ACL posterolateral instability, postoperative range of motion loss, postinjury degenerative joint disease, infection rate, return to function, and the use of radiated and nonirradiated allograft tissues will be presented. PMID:24949986

  10. Anterior cruciate ligament reconstruction in patients older than 35 years.

    PubMed

    El-Sallakh, Sameh; Pastides, Philip; Thomas, Panos

    2014-12-01

    Anterior cruciate ligament (ACL) reconstruction is an increasingly established method even in patients older than 35 years. Our hypothesis is that functional outcome after ACL reconstruction is comparable in patients younger and older than 35 years. A total of 28 patients (5 women and 23 men) with average age of 41.5 years (36-68) were retrospectively evaluated. The average follow-up period was 33 months. All of them were treated operatively with arthroscopic single-bundle four-strand hamstring tendon autograft. The functional outcome was determined by clinical scores (Tegner activity scale and Lysholm knee score). The median values for the Lysholm knee score were preoperatively 77 and postoperatively 96 points (range, 90-100) with significant improvement (p < 0.05) and that for the Tegner activity scale were preoperatively 4.6 points (range, 3-6), which is the same pre- and postoperatively with an overall return to baseline for all patients. No significant correlation between functional outcome and patients' age was present and no reported significant complications. The good results and a high level of patient satisfaction show that ACL reconstruction is justified even in patients (older than 35 years) with symptomatic anterior knee instability. We commonly propose surgical treatment in symptomatic patients who express the need to restore their preinjury activity levels, regardless of their age.

  11. Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction.

    PubMed

    Fanelli, G C; Giannotti, B F; Edson, C J

    1996-02-01

    This article presents the minimum 2-year results (range, 24 to 48 months) of 20 arthroscopically assisted combined anterior cruciate ligament/posterior cruciate ligament (ACL/PCL) reconstructions, evaluated preoperatively and postoperatively using the Tegner, Lysholm, and Hospital for Special Surgery knee ligament rating scales, and the KT 1000 knee ligament arthrometer (Medmetric Corp, San Diego, CA). There were 16 men or boys, 4 women or girls; 9 right, 11 left; 10 acute, and 10 chronic knee injuries. Ligament injuries included 1 ACL/PCL tear, 2 ACL/PCL/medial collateral ligament (MCL)/posterior lateral corner tears. 7 ACL/PCL/MCL tears, and 10 ACL/PCL/posterior lateral corner tears. ACLs were reconstructed using autograft or allograft patellar tendons. PCLs were reconstructed using allograft Achilles tendon, or autograft patellar tendon. MCL tears were successfully treated with bracing. Posterior lateral instability was successfully treated with long head of the biceps femoris tendon tenodesis. Tegner, Lysholm, and Hospital for Special Surgery knee ligament rating scales significantly improved preoperatively to postoperatively (P = .0001). Corrected anterior KT 1000 measurements improved from preoperative to postoperative status (P = .0078).

  12. Results of the surgical reconstruction of the anterior cruciate ligament.

    PubMed

    Zelić, Zoran; Jovanović, Savo; Wertheimer, Vjekoslav; Sarić, Gordan; Biuk, Egon; Gulan, Gordan

    2012-03-01

    Results of the surgical reconstruction of the anterior cruciate ligament (ACL), using as a graft fourfold hamstring tendons (gracilis and semitendinosus) and middle third of the patellar ligament, were compared. In all patients that were participating in this study clinical examination and magnetic resonance showed ACL rupture, and apart from the choice of the graft, surgical technique was identical. We evaluated 112 patients with implemented patellar ligament graft and fourfold hamstring tendons graft six months after the procedure. Both groups were similar according to age, sex, activity level, knee instability level and rehabilitation program. The results showed that there was no significant difference between groups regarding Lysholm Knee score, IKDC 2000 score, activity level, musculature hypotrophy, and knee joint stability 6 months after the surgery. Anterior knee pain incidence is significantly higher in the group with patellar ligament graft (44% vs. 21%). Both groups had a significant musculature hypotrophy of the upper leg of the knee joint that was surgically treated, six months after the procedure. Both grafts showed good subjective and objective results.

  13. Gravitational Instabilities in Circumstellar Disks

    NASA Astrophysics Data System (ADS)

    Kratter, Kaitlin; Lodato, Giuseppe

    2016-09-01

    Star and planet formation are the complex outcomes of gravitational collapse and angular momentum transport mediated by protostellar and protoplanetary disks. In this review, we focus on the role of gravitational instability in this process. We begin with a brief overview of the observational evidence for massive disks that might be subject to gravitational instability and then highlight the diverse ways in which the instability manifests itself in protostellar and protoplanetary disks: the generation of spiral arms, small-scale turbulence-like density fluctuations, and fragmentation of the disk itself. We present the analytic theory that describes the linear growth phase of the instability supplemented with a survey of numerical simulations that aim to capture the nonlinear evolution. We emphasize the role of thermodynamics and large-scale infall in controlling the outcome of the instability. Despite apparent controversies in the literature, we show a remarkable level of agreement between analytic predictions and numerical results. In the next part of our review, we focus on the astrophysical consequences of the instability. We show that the disks most likely to be gravitationally unstable are young and relatively massive compared with their host star, Md/M*≥0.1. They will develop quasi-stable spiral arms that process infall from the background cloud. Although instability is less likely at later times, once infall becomes less important, the manifestations of the instability are more varied. In this regime, the disk thermodynamics, often regulated by stellar irradiation, dictates the development and evolution of the instability. In some cases the instability may lead to fragmentation into bound companions. These companions are more likely to be brown dwarfs or stars than planetary mass objects. Finally, we highlight open questions related to the development of a turbulent cascade in thin disks and the role of mode-mode coupling in setting the maximum angular

  14. Incidental Anterior Cruciate Ligament Calcification: Case Report

    PubMed Central

    Hayashi, Hisami; Fischer, Hans

    2016-01-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding. PMID:27200163

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

    PubMed

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

    2015-07-01

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

  16. Incidental Anterior Cruciate Ligament Calcification: Case Report.

    PubMed

    Hayashi, Hisami; Fischer, Hans

    2016-03-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding.

  17. Biomechanical benefits of anterior offsetting of humeral head component in posteriorly unstable total shoulder arthroplasty: A cadaveric study.

    PubMed

    Kim, Hyun-Min Mike; Chacon, Alexander C; Andrews, Seth H; Roush, Evan P; Cho, Edward; Conaway, William K; Kunselman, Allen R; Lewis, Gregory S

    2016-04-01

    Restoration of joint stability during total shoulder arthroplasty can be challenging in the face of severe glenoid retroversion. A novel technique of humeral head component anterior-offsetting has been proposed to address posterior instability. We evaluated the biomechanical benefits of this technique in cadaveric specimens. Total shoulder arthroplasty was performed in 14 cadaveric shoulders from 7 donors. Complementary shoulders were assigned to either 10° or 20° glenoid retroversion, with retroversion created by eccentric reaming. Two humeral head component offset positions were tested in each specimen: The anatomic (posterior) and anterior (reverse). With loads applied to the rotator cuff and deltoid, joint contact pressures and the force and energy required for posterior humeral head translation were measured. The force and energy required to displace the humeral head posteriorly increased significantly with the anterior offset position compared to the anatomic offset position. The joint contact pressures were significantly shifted anteriorly, and the joint contact area significantly increased with the anterior offset position. Anterior offsetting of the humeral head component increased the resistance to posterior humeral head translation, shifted joint contact pressures anteriorly, and increased joint contact area, thus, potentially increasing the joint stability in total shoulder arthroplasty with simulated glenoid retroversion. PMID:26356804

  18. Partial tearing of the anterior cruciate ligament: diagnosis and treatment

    PubMed Central

    Temponi, Eduardo Frois; de Carvalho Júnior, Lúcio Honório; Sonnery-Cottet, Bertrand; Chambat, Pierre

    2015-01-01

    Partial tears of the anterior cruciate ligament (ACL) are common and represent 10–27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process. There is controversy regarding the definition of these injuries, which is based on anatomy, clinical examination, translation measurements, imaging examinations and arthroscopy. The way in which it is treated will depend on the existing laxity and instability. Conservative treatment is optional for cases without instability, with a focus on motor rehabilitation. Surgical treatment is a challenge, since it requires correct positioning of the bone tunnels and conservation of the remnants of the torn bundle. The pivot shift test under anesthesia, the magnetic resonance findings, the previous level and type of sports activity and the arthroscopic appearance and mechanical properties of the remnants will aid the orthopedist in the decision-making process between conservative treatment, surgical treatment with strengthening of the native ACL (selective reconstruction) and classical (anatomical) reconstruction. PMID:26229890

  19. Partial tearing of the anterior cruciate ligament: diagnosis and treatment.

    PubMed

    Temponi, Eduardo Frois; de Carvalho Júnior, Lúcio Honório; Sonnery-Cottet, Bertrand; Chambat, Pierre

    2015-01-01

    Partial tears of the anterior cruciate ligament (ACL) are common and represent 10-27% of the total. The main reasons for attending to cases of non-torn bundles are biomechanical, vascular and proprioceptive. Continued presence of the bundle also serves as protection during the healing process. There is controversy regarding the definition of these injuries, which is based on anatomy, clinical examination, translation measurements, imaging examinations and arthroscopy. The way in which it is treated will depend on the existing laxity and instability. Conservative treatment is optional for cases without instability, with a focus on motor rehabilitation. Surgical treatment is a challenge, since it requires correct positioning of the bone tunnels and conservation of the remnants of the torn bundle. The pivot shift test under anesthesia, the magnetic resonance findings, the previous level and type of sports activity and the arthroscopic appearance and mechanical properties of the remnants will aid the orthopedist in the decision-making process between conservative treatment, surgical treatment with strengthening of the native ACL (selective reconstruction) and classical (anatomical) reconstruction.

  20. Temperature anisotropy and beam type whistler instabilities

    NASA Technical Reports Server (NTRS)

    Hashimoto, K.; Matsumoto, H.

    1976-01-01

    Whistler instabilities have been investigated for two different types; i.e., a temperature-anisotropy type instability and a beam-type instability. A comparison between the two types of whistler instabilities is made within the framework of linear theory. A transition from one type to the other is also discussed, which is an extension of the work on electrostatic beam and Landau instabilities performed by O'Neil and Malmberg (1968) for electromagnetic whistler instabilities. It is clarified that the essential source of the whistler instability is not beam kinetic energy but a temperature anisotropy, even for the beam-type whistler instability.

  1. Anterior knee pain associated with an anterior superior patellar bony spur: a case report.

    PubMed

    Adekoya-Cole, T O; Enweluzo, G O; Akinmokun, O I; Olugbemi, O O

    2013-01-01

    Anterior knee pain is a common presentation in Orthopaedic out patient practice. However anterior superior patellar spur is an uncommon cause.This case presentation is to highlight an anterior superior patellar spur with quadriceps tendonitis. The patient is a 52 year old man who presented with a recurrent anterior knee pain. The radiographic study revealed an anterio-superior patellar spur. The patient had a depo steroid injection as an adjunct therapy to physiotherapy and has been pain free.

  2. Yet another instability in glasma

    NASA Astrophysics Data System (ADS)

    Tsutsui, Shoichiro; Iida, Hideaki; Kunihiro, Teiji; Ohnishi, Akira

    2014-09-01

    In relativistic heavy ion collisions (HIC), hydrodynamic models can describe many experimental data and suggest that the quark-gluon plasma formed at RHIC and LHC is almost perfect fluid. We need very short thermalization time and far-from-equilibrium dynamics may be important in thermalization processes of HIC. In the earliest stages of HIC, classical gluon dynamics is dominant and many types of instabilities emerge there. These instabilities may strongly affect the later stages of dynamics; realization of chaoticity and field-particle conversions. We investigate instabilities of classical gluon fields under the homogeneous, but time dependent background color magnetic fields. The background field become periodic function of time and we can analyze the stability of fluctuations based on the Floquet theory which consists the basis of the Bloch theory. As a result, we get the complete structure of instability bands for physical degrees of freedom appearing from parametric resonance. We also find that the parametric instabilities considered here have different natures from the several known instabilities; Weibel and Nielsen-Olesen instabilities. We also discuss some implications of parametric resonance to the particle productions in HIC.

  3. Anterior facetal realignment and distraction for atlanto-axial subluxation with basilar invagination …. a technical note.

    PubMed

    Patkar, Sushil

    2016-08-01

    Unilateral anterior retropharyngeal approach was used in a case of basilar invagination with atlanto-axial instability. This approach provided easy access to both atlanto-axial joints. Wedge-shaped titanium cages were used to distract the joints and reduce the basilar invagination. Titanium plates with screws were used to fix the lateral mass of atlas with the body of axis, bilaterally. The anterior atlanto-axial joint distraction procedure has not been described in literature before seems to be an easy option in selected cases of craniovertebral anomalies and needs to be investigated by more surgeons.

  4. Microbunching Instability in Velocity Bunching

    SciTech Connect

    Xiang, D; Wu, J.; /SLAC

    2009-05-26

    Microbunching instability is one of the most challenging threats to FEL performances. The most effective ways to cure the microbunching instability include suppression of the density modulation sources and suppression of the amplification process. In this paper we study the microbunching instability in velocity bunching. Our simulations show that the initial current and energy modulations are suppressed in velocity bunching process, which may be attributed to the strong plasma oscillation and Landau damping from the relatively low beam energy and large relative slice energy spread. A heating effect that may be present in a long solenoid is also preliminarily analyzed.

  5. Longitudinal instability of the forearm.

    PubMed

    Phadnis, J; Watts, A C

    2016-10-01

    The Essex Lopresti lesion is a rare triad of injury to the radial head, interosseous membrane of the forearm and distal radio-ulnar joint, which results in longitudinal instability of the radius. If unrecognized this leads to chronic pain and disability which is difficult to salvage. Early recognition and appropriate treatment is therefore desirable to prevent long-term problems. The aim of this article is to review the pathoanatomy of longitudinal radius instability and use the existing literature and authors' experience to provide recommendations for recognition and treatment of acute and chronic forearm instability, including description of the author's technique for interosseous membrane reconstruction. PMID:27628434

  6. Hydrodynamic instability modeling for ICF

    SciTech Connect

    Haan, S.W.

    1993-03-31

    The intent of this paper is to review how instability growth is modeled in ICF targets, and to identify the principal issues. Most of the material has been published previously, but is not familiar to a wide audience. Hydrodynamic instabilities are a key issue in ICF. Along with laser-plasma instabilities, they determine the regime in which ignition is possible. At higher laser energies, the same issues determine the achievable gain. Quantitative predictions are therefore of the utmost importance to planning the ICF program, as well as to understanding current Nova results. The key fact that underlies all this work is the stabilization of short wavelengths.

  7. New instability of Saturn's ring

    SciTech Connect

    Goertz, C.K.; Morfill, G.

    1988-05-01

    Perturbations in the Saturn ring's mass density are noted to be prone to instabilities through the sporadic elevation of submicron-size dust particles above the rings, which furnishes an effective angular momentum exchange between the rings and Saturn. The dust thus elevated from the ring settles back onto it at a different radial distance. The range of wavelength instability is determinable in light of the dust charge, the average radial displacement of the dust, and the fluctuation of these quantities. It is suggested that at least some of the B-ring's ringlets may arise from the instability.

  8. Instabilities in counterstreaming plasmas

    NASA Astrophysics Data System (ADS)

    Park, Hye-Sook

    2013-10-01

    We are performing high power laser experiments showing large, stable, reproducible electromagnetic field structures that arise in counter-streaming interpenetrating supersonic plasma flows in the laboratory. Self organization, whereby energy progressively transfers from smaller to larger scales in an inverse cascade, is widely observed in fluid flows, such as in the nonlinear evolution of multimode Rayleigh-Taylor and Kelvin-Helmholtz instabilities. There are many scenarios in astrophysics where self organization involving magnetic or electric fields in collisionless settings is observed. These surprising structures, predominantly oriented transverse to the primary flow direction, extend for much larger distances than the intrinsic plasma spatial scales, and persist for much longer than the plasma kinetic timescales. Their origin may be magnetic field advection from the recompression of the Biermann battery fields in the midplane. Understanding interactions of high velocity plasma flows is interests to the ICF and astrophysics. This paper will present experimental results and interpretation of these counterstreaming plasma experiments. This work was performed under the auspices of the Lawrence Livermore National Security, LLC, (LLNS) under Contract No. DE-AC52-07NA27344.

  9. Resistive instabilities in tokamaks

    SciTech Connect

    Rutherford, P.H.

    1985-10-01

    Low-m tearing modes constitute the dominant instability problem in present-day tokamaks. In this lecture, the stability criteria for representative current profiles with q(0)-values slightly less than unit are reviewed; ''sawtooth'' reconnection to q(0)-values just at, or slightly exceeding, unity is generally destabilizing to the m = 2, n = 1 and m = 3, n = 2 modes, and severely limits the range of stable profile shapes. Feedback stabilization of m greater than or equal to 2 modes by rf heating or current drive, applied locally at the magnetic islands, appears feasible; feedback by island current drive is much more efficient, in terms of the radio-frequency power required, then feedback by island heating. Feedback stabilization of the m = 1 mode - although yielding particularly beneficial effects for resistive-tearing and high-beta stability by allowing q(0)-values substantially below unity - is more problematical, unless the m = 1 ideal-MHD mode can be made positively stable by strong triangular shaping of the central flux surfaces. Feedback techniques require a detectable, rotating MHD-like signal; the slowing of mode rotation - or the excitation of non-rotating modes - by an imperfectly conducting wall is also discussed.

  10. Instabilities in the aether

    SciTech Connect

    Carroll, Sean M.; Dulaney, Timothy R.; Gresham, Moira I.; Tam, Heywood

    2009-03-15

    We investigate the stability of theories in which Lorentz invariance is spontaneously broken by fixed-norm vector 'aether' fields. Models with generic kinetic terms are plagued either by ghosts or by tachyons, and are therefore physically unacceptable. There are precisely three kinetic terms that are not manifestly unstable: a sigma model ({partial_derivative}{sub {mu}}A{sub {nu}}){sup 2}, the Maxwell Lagrangian F{sub {mu}}{sub {nu}}F{sup {mu}}{sup {nu}}, and a scalar Lagrangian ({partial_derivative}{sub {mu}}A{sup {mu}}){sup 2}. The timelike sigma-model case is well defined and stable when the vector norm is fixed by a constraint; however, when it is determined by minimizing a potential there is necessarily a tachyonic ghost, and therefore an instability. In the Maxwell and scalar cases, the Hamiltonian is unbounded below, but at the level of perturbation theory there are fewer degrees of freedom and the models are stable. However, in these two theories there are obstacles to smooth evolution for certain choices of initial data.

  11. Basic biomechanic principles of knee instability.

    PubMed

    Zlotnicki, Jason P; Naendrup, Jan-Hendrik; Ferrer, Gerald A; Debski, Richard E

    2016-06-01

    Motion at the knee joint is a complex mechanical phenomenon. Stability is provided by a combination of static and dynamic structures that work in concert to prevent excessive movement or instability that is inherent in various knee injuries. The anterior cruciate ligament (ACL) is a main stabilizer of the knee, providing both translational and rotatory constraint. Despite the high volume of research directed at native ACL function, pathogenesis and surgical reconstruction of this structure, a gold standard for objective quantification of injury and subsequent repair, has not been demonstrated. Furthermore, recent studies have suggested that novel anatomic structures may play a significant role in knee stability. The use of biomechanical principles and testing techniques provides essential objective/quantitative information on the function of bone, ligaments, joint capsule, and other contributing soft tissues in response to various loading conditions. This review discusses the principles of biomechanics in relation to knee stability, with a focus on the objective quantification of knee stability, the individual contributions of specific knee structures to stability, and the most recent technological advances in the biomechanical evaluation of the knee joint. PMID:27007474

  12. Anterior cervical hypertrichosis: a sporadic case

    PubMed Central

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-01-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  13. Dentulous appliance for upper anterior edentulous span.

    PubMed

    Chalakkal, Paul; Devi, Ramisetty Sabitha; Srinivas, G Vijay; Venkataramana, Pammi

    2013-12-01

    This article discusses about a fixed dentulous appliance that was constructed to replace the primary upper anterior edentulous span in a four year old girl. It constituted a design, whereby the maxillary primary second molars were used to support the appliance through bands and a wire that contained an acrylic flange bearing trimmed acrylic teeth, anteriorly. The appliance was functionally and aesthetically compliant.

  14. Differential expression of extracellular matrix genes in glenohumeral capsule of shoulder instability patients.

    PubMed

    Belangero, Paulo Santoro; Leal, Mariana Ferreira; Figueiredo, Eduardo Antônio; Cohen, Carina; Andreoli, Carlos Vicente; Smith, Marília Cardoso; Pochini, Alberto de Castro; Ejnisman, Benno; Cohen, Moises

    2016-07-01

    Anterior shoulder instability is a common orthopedic problem. After a traumatic shoulder dislocation, patients present a plastic deformation of the capsule. The shoulder instability biology remains poorly understood. We evaluated the expression of genes that encode the cartilage oligomeric matrix protein (COMP), fibronectin 1 (FN1), tenascin C (TNC) and tenascin XB (TNXB) in the glenohumeral capsule of anterior shoulder instability patients and controls. Moreover, we investigated the associations between gene expression and clinical parameters. The gene expression was evaluated by quantitative reverse transcription-polymerase chain reaction in the antero-inferior (macroscopically injured region), antero-superior and posterior regions of the capsule of 29 patients with shoulder instability and 8 controls. COMP expression was reduced and FN1 and TNC expression was increased in the antero-inferior capsule region of cases compared to controls (p < 0.05). TNC expression was increased in the posterior capsule portion of shoulder instability patients (p = 0.022). COMP expression was reduced in the antero-inferior region compared to the posterior region of shoulder instability patients (p = 0.007). In the antero-inferior region, FN1 expression was increased in the capsule of patients with more than one year of symptoms (p = 0.003) and with recurrent dislocations (p = 0.004) compared with controls. FN1 and TNXB expression was correlated with the duration of symptoms in the posterior region (p < 0.05). Thus, COMP, FN1, TNC and TNXB expression was altered across the capsule of shoulder instability patients. Dislocation episodes modify FN1, TNC and TNXB expression in the injured tissue. COMP altered expression may be associated with capsule integrity after shoulder dislocation, particularly in the macroscopically injured portion.

  15. Coupling of Kelvin-Helmholtz instability and buoyancy instability in a thermally laminar plasma

    SciTech Connect

    Ren Haijun; Wu Zhengwei; Cao Jintao; Dong Chao; Chu, Paul K.

    2011-02-15

    Thermal convective instability is investigated in a thermally stratified plasma in the presence of shear flow, which is known to give rise to the Kelvin-Helmholtz (KH) instability. We examine how the KH instability and magnetothermal instability (MTI) affect each other. Based on the sharp boundary model, the KH instability coupled with the MTI is studied. We present the growth rate and instability criteria. The shear flow is shown to significantly alter the critical condition for the occurrence of thermal convective instability.

  16. Cosmic instability from radiation pressure

    NASA Technical Reports Server (NTRS)

    Hogan, Craig J.

    1990-01-01

    The Cosmic Background Explorer has recently confirmed the blackbody character of the microwave background to high accuracy (Mather et al., 1990), and will have the capability to detect other cosmic backgrounds throughout the infrared. A detection of cosmic background radiation dating from the pregalactic era would have important consequences for theories of cosmic structure. During the creation of such a background the pressure of the radiation itself causes an instability which leads inevitably to the growth of large-scale structure in the matter distribution. In contrast to conventional gravitational-instability models, the statistical properties of this structure are determined primarily by the self-organizing dynamics of the instability rather than details of cosmological initial conditions. The behavior of the instability is described here.

  17. Instabilities of High Temperature Superconductors

    PubMed Central

    Matthias, B. T.; Corenzwit, E.; Cooper, A. S.; Longinotti, L. D.

    1971-01-01

    We have observed the transition temperature of both the cubic and tetragonal phases of several high-temperature β-W superconductors. The instability of the cubic lattice appears to be characteristic of high-temperature superconductors. PMID:16591897

  18. Instability-driven quantum dots

    NASA Astrophysics Data System (ADS)

    Aqua, Jean-Noël; Frisch, Thomas

    2015-10-01

    When a film is strained in two dimensions, it can relax by developing a corrugation in the third dimension. We review here the resulting morphological instability that occurs by surface diffusion, called the Asaro-Tiller-Grinfel'd instability (ATG), especially on the paradigmatic silicon/germanium system. The instability is dictated by the balance between the elastic relaxation induced by the morphological evolution, and its surface energy cost. We focus here on its development at the nanoscales in epitaxial systems when a crystal film is coherently deposited on a substrate with a different lattice parameter, thence inducing epitaxial stresses. It eventually leads to the self-organization of quantum dots whose localization is dictated by the instability long-time dynamics. In these systems, new effects, such as film/substrate wetting or crystalline anisotropy, come into play and lead to a variety of behaviors. xml:lang="fr"

  19. Fluid Instabilities inside Astrophysical Explosions

    NASA Astrophysics Data System (ADS)

    Chen, Ke-Jung; Woosley, Stan; Heger, Alexander; Almgren, Ann; Zheng, Weiqun

    2014-11-01

    We present our results from the simulations of fluid instabilities inside supernovae with a new radiation-hydrodynamic code, CASTRO. Massive stars are ten times more massive than Sun. Observational and theoretical studies suggest that these massive stars tend to end their lives with energetic explosions, so-called supernovae. Many fluid instabilities occur during the supernova explosions. The fluid instabilities can be driven by hydrodynamics, nuclear burning, or radiation. In this talk, we discuss about the possible physics of fluid instabilities found in our simulations and how the resulting mixing affects the observational signatures of supernovae. This work was supported by the DOE HEP Program under contract DE-SC0010676; the National Science Foundation (AST 0909129) and the NASA Theory Program (NNX14AH34G).

  20. Movement adjustments in preparation for single-leg jumps in individuals with functional ankle instability.

    PubMed

    Nunes, Guilherme S; de Noronha, Marcos; Wageck, Bruna; Scirea, Juliana Bonetti; Haupenthal, Alessandro; Michaelsen, Stella Maris

    2016-10-01

    There is some evidence showing that people with functional ankle instability (FAI) can present changes in postural control during the landing phase of a jump. These studies also show preliminary results indicating possible changes during phases prior to landing. Therefore, the objective of this study was to investigate whether movement adjustments prior to a jump are different between people with and without FAI. Sixty participants with (n=30) and without (n=30) FAI participated in this study. The main outcome measures were the variability of range of motion in ankle inversion/eversion and dorsiflexion/plantarflexion; and variability of center of pressure for the directions anterior-posterior and medio-lateral during the pre-jump period for drop jump, vertical jump and during single-leg stance. The group with instability showed more variability of center of pressure in anterior-posterior direction (p=0.04) and variability of range of motion in ankle dorsiflexion/plantar flexion (p=0.04) compared to control in the single-leg stance test. For the within-group comparisons, the group with instability showed more variability of center of pressure in anterior-posterior direction in the drop jump higher than single-leg stance and vertical jump. The same pattern was seen for the control group. Thus, this study suggests that people with FAI have greater ankle range of motion variability and center of pressure variability in the anterior-posterior axis when compared to healthy individuals during single-leg stance. For those same two variables, preparation for a drop jump causes more postural instability when compared to the preparation for a vertical jump and to single-leg stance. PMID:27543811

  1. Waves and instabilities in plasmas

    SciTech Connect

    Chen, L.

    1987-01-01

    The contents of this book are: Plasma as a Dielectric Medium; Nyquist Technique; Absolute and Convective Instabilities; Landau Damping and Phase Mixing; Particle Trapping and Breakdown of Linear Theory; Solution of Viasov Equation via Guilding-Center Transformation; Kinetic Theory of Magnetohydrodynamic Waves; Geometric Optics; Wave-Kinetic Equation; Cutoff and Resonance; Resonant Absorption; Mode Conversion; Gyrokinetic Equation; Drift Waves; Quasi-Linear Theory; Ponderomotive Force; Parametric Instabilities; Problem Sets for Homework, Midterm and Final Examinations.

  2. Material Instabilities in Particulate Systems

    NASA Technical Reports Server (NTRS)

    Goddard, J. D.

    1999-01-01

    Following is a brief summary of a theoretical investigation of material (or constitutive) instability associated with shear induced particle migration in dense particulate suspensions or granular media. It is shown that one can obtain a fairly general linear-stability analysis, including the effects of shear-induced anisotropy in the base flow as well as Reynolds dilatancy. A criterion is presented here for simple shearing instability in the absence of inertia and dilatancy.

  3. Aerodynamic instability: A case history

    NASA Technical Reports Server (NTRS)

    Eisenmann, R. C.

    1985-01-01

    The identification, diagnosis, and final correction of complex machinery malfunctions typically require the correlation of many parameters such as mechanical construction, process influence, maintenance history, and vibration response characteristics. The progression is reviewed of field testing, diagnosis, and final correction of a specific machinery instability problem. The case history presented addresses a unique low frequency instability problem on a high pressure barrel compressor. The malfunction was eventually diagnosed as a fluidic mechanism that manifested as an aerodynamic disturbance to the rotor assembly.

  4. Coracoid syndrome: a neglected cause of anterior shoulder pain

    PubMed Central

    GIGANTE, ANTONIO; BOTTEGONI, CARLO; BARBADORO, PAMELA

    2016-01-01

    Purpose the present prospective open-label study was designed to gain further insights into a condition thought to constitute a neglected but not uncommon syndrome characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process, not related to rotator cuff or pectoralis minor tendinopathy, long head of the biceps tendon disorders, or instability. The aim was to clarify its prevalence, clinical characteristics, differential diagnosis and response to corticosteroid injections. Methods patients with primary anterior shoulder pain precisely reproduced by deep pressure on the apex of the coracoid process were recruited. Patients with clinical or instrumental signs of other shoulder disorders were excluded. Patients were given an injection of triamcinolone acetonide 40 mg/ml 1 ml at the coracoid trigger point. They were evaluated after 15, 30 and 60 days and at 2 years using Equal Visual Analog Scale (EQ-VAS) and the Italian version of the Simple Shoulder Test (SST). Results between January 1 and December 31 2010, we treated 15 patients aged 26–66 years. The majority were women (86.67%). At 15 days, 6 (40%) patients reported complete resolution of their symptoms, while 9 (60%) complained of residual symptoms and received another injection. At 30 days, 14 (93.33%) patients were pain-free and very satisfied. At 2 years, the 14 patients who had been asymptomatic at 30 days reported that they had experienced no further pain or impaired shoulder function. The analysis of variance for repeated measures showed a significant effect of time on EQ-VAS and SST scores. Conclusions the present study documents the existence, and characteristics, of a “coracoid syndrome” characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process and showed that the pain is usually amenable to steroid treatment. This syndrome should be clearly distinguished from anterior shoulder pain due to other causes, in

  5. Pattern Formation in Convective Instabilities

    NASA Astrophysics Data System (ADS)

    Friedrich, R.; Bestehorn, M.; Haken, H.

    The present article reviews recent progress in the study of pattern formation in convective instabilities. After a brief discussion of the relevant basic hydrodynamic equations as well as a short outline of the mathematical treatment of pattern formation in complex systems the self-organization of spatial and spatio-temporal structures due to convective instabilities is considered. The formation of various forms of convective patterns arising in the Bénard experiment, i.e. in a horizontal fluid layer heated from below, is discussed. Then the review considers pattern formation in the Bénard instability in spherical geometries. In that case it can be demonstrated how the interaction among several convective cells may lead to time dependent as well as chaotic evolution of the spatial structures. Finally, the convective instability in a binary fluid mixture is discussed. In contrast to the instability in a single component fluid the instability may be oscillatory. In that case convection sets in in the form of travelling wave patterns which in addition to a complicated and chaotic temporal behaviour exhibit more or less spatial irregularity already close to threshold.

  6. Instability of enclosed horizons

    NASA Astrophysics Data System (ADS)

    Kay, Bernard S.

    2015-03-01

    We point out that there are solutions to the scalar wave equation on dimensional Minkowski space with finite energy tails which, if they reflect off a uniformly accelerated mirror due to (say) Dirichlet boundary conditions on it, develop an infinite stress-energy tensor on the mirror's Rindler horizon. We also show that, in the presence of an image mirror in the opposite Rindler wedge, suitable compactly supported arbitrarily small initial data on a suitable initial surface will develop an arbitrarily large stress-energy scalar near where the two horizons cross. Also, while there is a regular Hartle-Hawking-Israel-like state for the quantum theory between these two mirrors, there are coherent states built on it for which there are similar singularities in the expectation value of the renormalized stress-energy tensor. We conjecture that in other situations with analogous enclosed horizons such as a (maximally extended) Schwarzschild black hole in equilibrium in a (stationary spherical) box or the (maximally extended) Schwarzschild-AdS spacetime, there will be similar stress-energy singularities and almost-singularities—leading to instability of the horizons when gravity is switched on and matter and gravity perturbations are allowed for. All this suggests it is incorrect to picture a black hole in equilibrium in a box or a Schwarzschild-AdS black hole as extending beyond the past and future horizons of a single Schwarzschild (/Schwarzschild-AdS) wedge. It would thus provide new evidence for 't Hooft's brick wall model while seeming to invalidate the picture in Maldacena's ` Eternal black holes in AdS'. It would thereby also support the validity of the author's matter-gravity entanglement hypothesis and of the paper ` Brick walls and AdS/CFT' by the author and Ortíz.

  7. Clinical Outcomes of High Tibial Osteotomy for Knee Instability

    PubMed Central

    Dean, Chase S.; Liechti, Daniel J.; Chahla, Jorge; Moatshe, Gilbert; LaPrade, Robert F.

    2016-01-01

    Background: In recent years there has been an increasing interest in high tibial osteotomy (HTO) to treat patients with chronic knee instability due to posterolateral corner (PLC), posterior cruciate ligament (PCL), and anterior cruciate ligament (ACL) insufficiencies with concurrent malalignment in the coronal and/or sagittal plane. Purpose: To perform a systematic review of the use of HTO for the treatment of knee ligament instability with concurrent malalignment. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was conducted for the treatment of combined knee ligament instability and malalignment with HTO using the Cochrane Central Register of Controlled Trials, PubMed, and MEDLINE (1980 to present); the queries were performed in July 2015. Terms searched included the following: high or proximal tibial osteotomy, unstable, instability, laxity, subluxation, tibial slope, and malalignment, in the knee joint. Inclusion criteria were as follows: HTO to treat instability of the knee joint in the sagittal and/or coronal plane, minimum 2-year follow-up with reported outcomes measures, English language, and human studies. Animal, basic science, and cadaveric studies were excluded as well as editorials, reviews, expert opinions, surveys, special topics, letters to the editor, and correspondence. Results: The search resulted in 460 studies. After applying exclusion criteria and removing duplicates, 13 studies were considered. Of the studies reviewed, knee ligament pathologies, previous surgeries, and measurement of knee stability were heterogeneous. However, all studies reported an improvement in knee stability after HTO. Most studies reported improvement in outcome scores. However, other studies did not provide preoperative scores for comparison. Reported complication rates ranged from 0% to 47%. Conclusion: Although HTO has been highly advocated and used in treating patients with ligamentous knee instability, there

  8. Pharyngocutaneous fistula after anterior cervical spine surgery

    PubMed Central

    Sansur, Charles A.; Early, Stephen; Reibel, James

    2009-01-01

    Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closure and esophageal exclusion with a Jpeg tube. The patient was eventually successfully treated with a three-stage procedure consisting of firstly a posterior approach to reinforce the posterior stabilization of the cervical spine that was felt to be inadequate, secondly an anterior approach with removal of all the anterior instrumentation followed by iliac crest bone graft and thirdly a superior based sternocleidomastoid flap that was interposed between the esophagus and the anterior cervical spine. The patient's fistula healed successfully. However, yet asymptomatic, the anterior iliac crest bone graft resorbed almost completely at 16 months follow up. In light of this complication, we discuss the surgical options for the treatment of pharyngocutaneous fistulae and the closure of this fistula using a superiorly based sternocleidomastoid muscle flap. PMID:19330360

  9. Trypan blue dye for anterior segment surgeries

    PubMed Central

    Jhanji, V; Chan, E; Das, S; Zhang, H; Vajpayee, R B

    2011-01-01

    Use of vital dyes in ophthalmic surgery has gained increased importance in the past few years. Trypan blue (TB) has been a popular choice among anterior segment surgeons mainly due to its safety, ease of availability, and remarkable ability to enable an easy surgery in difficult situations mostly related to visibility of the targeted tissue. It is being used in cataract surgery since nearly a decade and its utilization has been extended to other anterior segment surgeries like trabeculectomy and corneal transplantation. This review will discuss the techniques and outcome of TB dye-assisted anterior segment surgeries. PMID:21681214

  10. Quadriceps muscle contraction protects the anterior cruciate ligament during anterior tibial translation.

    PubMed

    Aune, A K; Cawley, P W; Ekeland, A

    1997-01-01

    The proposed skiing injury mechanism that suggests a quadriceps muscle contraction can contribute to anterior cruciate ligament rupture was biomechanically investigated. The effect of quadriceps muscle force on a knee specimen loaded to anterior cruciate ligament failure during anterior tibial translation was studied in a human cadaveric model. In both knees from six donors, average age 41 years (range, 31 to 65), the joint capsule and ligaments, except the anterior cruciate ligament, were cut. The quadriceps tendon, patella, patellar tendon, and menisci were left intact. One knee from each pair was randomly selected to undergo destructive testing of the anterior cruciate ligament by anterior tibial translation at a displacement rate of 30 mm/sec with a simultaneously applied 889 N quadriceps muscle force. The knee flexion during testing was 30 degrees. As a control, the contralateral knee was loaded correspondingly, but only 5 N of quadriceps muscle force was applied. The ultimate load for the knee to anterior cruciate ligament failure when tested with 889 N quadriceps muscle force was 22% +/- 18% higher than that of knees tested with 5 N of force. The linear stiffness increased by 43% +/- 30%. These results did not support the speculation that a quadriceps muscle contraction contributes to anterior cruciate ligament failure. In this model, the quadriceps muscle force protected the anterior cruciate ligament from injury during anterior tibial translation.

  11. How I do it: Anterior pull-through tympanoplasty for anterior eardrum perforations.

    PubMed

    Harris, Jeffrey P; Wong, Yu-Tung; Yang, Tzong-Hann; Miller, Mia

    2016-01-01

    Conclusions This technique is offered as a convenient and reliable method for cases with anterior TM perforation and inadequate anterior remnant. Objectives Chronic otitis media surgery is one of the most common procedures in otology. Anterior tympanic membrane (TM) perforation with inadequate anterior remnant is associated with higher rates of graft failure. It was the goal of this series to evaluate the anatomical and functional outcomes of a modified underlay myringoplasty technique-the anterior pull-through method. Materials and methods In a retrospective clinical study, 13 patients with anterior TM perforations with inadequate anterior remnants underwent tympanoplasty with anterior pull-through technique. The anterior tip of the temporalis fascia was pulled through and secured in a short incision lateral to the anterior part of the annulus. Data on graft take rate, pre-operative, and post-operative hearing status were analyzed. Results A graft success rate of 84.6% (11 out of 13) was achieved, without lateralization, blunting, atelectasia, or epithelial pearls. The air-bone gap was 21.5 ± 6.8 dB before intervention and 11.75 ± 5.7 dB after surgery (p = 0.003). PMID:26988908

  12. C1 anterior arch preservation in transnasal odontoidectomy using three-dimensional endoscope: A case report

    PubMed Central

    Zenga, Francesco; Marengo, Nicola; Pacca, Paolo; Pecorari, Giancarlo; Ducati, Alessandro

    2015-01-01

    Background: The transoral ventral corridor is the most common approach used to reach the craniovertebral junction (CVJ). Over the last decade, many case reports have demonstrated the transnasal corridor to the odontoid peg represents a practicable route to remove the tip of the odontoid process. The biomechanical consequences of the traditional odontoidectomy led to the necessity of a cervical spine stabilization. Preserving the inferior portion of the C1 anterior arch should prevent instability. Case Description: This is the first report in which the technique to remove the tip of the odontoid while preserving the C1 anterior arch is described by means of a three-dimensional (3D) endoscope. A 53-year-old man underwent a transnasal 3D endoscopic approach because of a complex CVJ malformation. The upper-medial portion of the C1 anterior arch was removed preserving its continuity, and the odontoidectomy was performed. After surgery, a dynamic X-ray scan showed no difference in CVJ motility in comparison with the preoperative one. Conclusions: The stereoscopic perception augmented the precision of the surgical gesture in the deep field. The importance of a 3D view relates to the depth of field, which a two-dimensional endoscopy cannot provide. This affects the preservation of the C1 anterior arch because of the presence of critical structures that are exposed to potential damage if not displayed. PMID:26759737

  13. Can arthroscopic revision surgery for shoulder instability be a fair option?

    PubMed Central

    De Giorgi, Silvana; Garofalo, Raffaele; Tafuri, Silvio; Cesari, Eugenio; Rose, Giacomo Delle; Castagna, Alessandro

    2014-01-01

    Summary Background: the aim of this study was to evaluate the role of arthroscopic capsuloplasty in the treatment of failed primary arthroscopic treatment of glenohumeral instability. Methods: we retrospectively examined at a minimum of 3-years follow-up 22 patients who underwent arthroscopic treatment between 1999 and 2007 who had recurrent anterior shoulder instability with a post-surgical failure. A statistical analysis was performed to evaluate which variable could influence the definitive result and clinical outcomes at final follow-up. A p value of less than 0.05 was considered significant. Results: we observed after revision surgery an overall failure rate of 8/22 (36.4%) including frank dislocations, subluxations and also apprehension that seriously inhibit the patient's quality of life. No significant differences were observed in the examined parameters. Conclusions: according to our outcomes we generally do not recommend an arthroscopic revision procedure for failed instability surgery. PMID:25332940

  14. The Energetics of Centrifugal Instability

    NASA Astrophysics Data System (ADS)

    Dewar, W. K.; Jiao, Y.

    2014-12-01

    A recent study has argued that the California Undercurrent, and poleward eastern boundary currents in general, generate mixing events through centrifugal instability (CI). Conditions favorable for CI are created by the strong horizontal shears developed in turbulent bottom layers of currents flowing in the direction of topographic waves. At points of abrupt topographic change, like promontories and capes, the coastal current separates from the boundary and injects gravitationally stable but dynamically unstable flow into the interior. The resulting finite amplitude development of the instability involves overturnings and diabatic mixing. The purpose of this study is to examine the energetics of CI in order to characterize it as has been done for other instabilities and develop a framework in which to estimate its regional and global impacts. We argue that CI is roughly twice as efficient at mixing as is Kelvin-Helmholtz instability, and that roughly 10% of the initial energy in a CUC-like current is lost to either local mixing or the generation of unbalanced flows. The latter probably leads to non-local mixing. Thus centrifugal instability is an effective process by which energy is lost from the balanced flow and spent in mixing neighboring water masses. We argue the importance of the mixing is regional in nature, but of less importance to the global budgets given its regional specificity.

  15. A new method to evaluate glenoid erosion in instable shoulder

    PubMed Central

    2013-01-01

    Background We aimed to establish values and parameters using multislice reconstruction in axial computerized tomography (CT) in order to quantify the erosion of the glenoid cavity in cases of shoulder instability. Methods We studied two groups using CT. Group I had normal subjects and Group II had patients with shoulder instability. We measured values of the vertical segment, the superior horizontal, medial and inferior segments, and also calculated the ratio of the horizontal superior and inferior segments of the glenoid cavity in both normal subjects and those with shoulder instability. These variables were recorded during arthroscopy for cases with shoulder instability. Results The mean values were 40.87 mm, 17.86 mm, 26.50 mm, 22.86 mm and 0.79 for vertical segment, the superior horizontal, medial and inferior segments, and the ratio between horizontal superior and inferior segments of the glenoid cavity respectively, in normal subjects. For subjects with unstable shoulders the mean values were 37.33 mm, 20.83 mm, 23.07 mm and 0.91 respectively. Arthroscopic measurements yielded an inferior segment value of 24.48 mm with a loss of 2.39 mm (17.57%). The ratio between the superior and inferior segments of the glenoid cavity was 0.79. This value can be used as a normative value for evaluating degree of erosion of the anterior border of the glenoid cavity. However, values found using CT should not be used on a comparative basis with values found during arthroscopy. Conclusions Computerized tomographic measurements of the glenoid cavity yielded reliable values consistent with those in the literature. PMID:24134872

  16. A Comparison between Clinical Results of Selective Bundle and Double Bundle Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Yoo, Yon-Sik; Song, Si Young; Yang, Cheol Jung; Ha, Jong Mun; Kim, Yoon Sang

    2016-01-01

    Purpose The purpose of this study was to compare the clinical outcomes of arthroscopic anatomical double bundle (DB) anterior cruciate ligament (ACL) reconstruction with either selective anteromedial (AM) or posterolateral (PL) bundle reconstruction while preserving a relatively healthy ACL bundle. Materials and Methods The authors evaluated 98 patients with a mean follow-up of 30.8±4.0 months who had undergone DB or selective bundle ACL reconstructions. Of these, 34 cases underwent DB ACL reconstruction (group A), 34 underwent selective AM bundle reconstruction (group B), and 30 underwent selective PL bundle reconstructions (group C). These groups were compared with respect to Lysholm and International Knee Documentation Committee (IKDC) score, side-to-side differences of anterior laxity measured by KT-2000 arthrometer at 30 lbs, and stress radiography and Lachman and pivot shift test results. Pre- and post-operative data were objectively evaluated using a statistical approach. Results The preoperative anterior instability measured by manual stress radiography at 90° of knee flexion in group A was significantly greater than that in groups B and C (all p<0.001). At last follow-up, mean side-to-side instrumented laxities measured by the KT-2000 and manual stress radiography were significantly improved from preoperative data in all groups (all p<0.001). There were no significant differences between the three groups in anterior instability measured by KT-2000 arthrometer, pivot shift, or functional scores. Conclusion Selective bundle reconstruction in partial ACL tears offers comparable clinical results to DB reconstruction in complete ACL tears. PMID:27401652

  17. From the unstable painful shoulder to multidirectional instability in the young athlete.

    PubMed

    Ren, Haifeng; Bicknell, Ryan T

    2013-10-01

    In conclusion, instability as a cause of shoulder pain in the young athlete is a difficult and often missed diagnosis. These young patients often seek treatment of shoulder pain but do not recall any episodes of shoulder instability. As a result, these uncommon, poorly described forms of instability are often misdiagnosed. A heightened clinical suspicion and an accurate, prompt diagnosis of instability is of paramount importance in this athletic group. It dictates appropriate treatment of the condition, avoids treatment delays and failure, provides better outcomes, and ensures timely return to play. UPS and MDI are two forms of this diagnosis. In UPS, patients at risk are young hyperlax athletes with a history of direct trauma or forceful overextension of the shoulder. They have shoulder pain that is described as deep anterior, reproduced with an anterior apprehension test and relieved with a relocation test. Soft tissue and/or bony lesions consistent with instability (observed on imaging or at arthroscopy) are necessary to confirm the diagnosis of UPS. Once the diagnosis is made, standard arthroscopic techniques with labrum reinsertion and/or anteroinferior capsule plication can lead to predictable good results and return to sport. In MDI, patients at risk are also young hyperlax athletes. However, these patients often do not have a history of trauma. They have shoulder pain that is often somewhat vague in location and is reproduced with a sulcus and/or hyper abduction test. Soft tissue and/or bony lesions consistent with instability are uncommon, with the exception of capsular laxity. The mainstay of treatment is physiotherapy rehabilitation. When surgery is necessary, open capsular shift and arthroscopic capsular plication are effective.

  18. Dynamic relationships of the mandibular anterior segment.

    PubMed

    Braun, S; Hnat, W P

    1997-05-01

    The hyperbolic cosine function is shown to be an accurate representation of the form of the mandibular anterior teeth from the canine/first premolar contact on one side around the perimeter to the opposite side (r = 0.951). On the basis of this mathematical function, the changes in canine width, anterior segment depth, arch perimeter, and their related incisor angular alterations are forecastable. This knowledge will allow the clinician to predict the effects on various aspects of the anterior segment arch form as one or more of these variables are altered without resorting to trial and error or performing a wax-up. For example, the clinician can predict the change in the anterior segment arch depth and incisor angulation that would occur with alterations in canine width.

  19. Interfacial Instability during Granular Erosion

    NASA Astrophysics Data System (ADS)

    Lefebvre, Gautier; Merceron, Aymeric; Jop, Pierre

    2016-02-01

    The complex interplay between the topography and the erosion and deposition phenomena is a key feature to model granular flows such as landslides. Here, we investigated the instability that develops during the erosion of a wet granular pile by a dry dense granular flow. The morphology and the propagation of the generated steps are analyzed in relation to the specific erosion mechanism. The selected flowing angle of the confined flow on a dry heap appears to play an important role both in the final state of the experiment, and for the shape of the structures. We show that the development of the instability is governed by the inertia of the flow through the Froude number. We model this instability and predict growth rates that are in agreement with the experiment results.

  20. Hydrodynamick instabilities on ICF capsules

    SciTech Connect

    Haan, S.W.

    1991-06-07

    This article summarizes our current understanding of hydrodynamic instabilities as relevant to ICF. First we discuss classical, single mode Rayleigh-Taylor instability, and nonlinear effects in the evolution of a single mode. Then we discuss multimode systems, considering: (1) the onset of nonlinearity; (2) a second order mode coupling theory for weakly nonlinear effects, and (3) the fully nonlinear regime. Two stabilization mechanisms relevant to ICF are described next: gradient scale length and convective stabilization. Then we describe a model which is meant to estimate the weakly nonlinear evolution of multi-mode systems as relevant to ICF, given the short-wavelength stabilization. Finally, we discuss the relevant code simulation capability, and experiments. At this time we are quite optimistic about our ability to estimate instability growth on ICF capsules, but further experiments and simulations are needed to verify the modeling. 52 refs.

  1. Instability of EDS maglev systems

    SciTech Connect

    Cai, Y.; Chen, S.S.

    1993-09-01

    Instabilities of an EDS maglev suspension system with 3 D.O.F. and 5 D.O.F. vehicles traveling on a double L-shaped set of guideway conductors have been investigated with various experimentally measured magnetical force data incorporated into the theoretical models. Divergence and flutter are obtained from both analytical and numerical solutions for coupled vibration of the 3 D.O.F. maglev vehicle model. Instabilities of five direction motions (heave, slip, rill, pitch and yaw) are observed for the 4 D.O.F. vehicle model. It demonstrates that system parameters, such as, system damping, vehicle geometry and coupling effects among five different motions play very important roles in the occurrence of dynamic instabilities of maglev vehicles.

  2. Performance through Deformation and Instability

    NASA Astrophysics Data System (ADS)

    Bertoldi, Katia

    2015-03-01

    Materials capable of undergoing large deformations like elastomers and gels are ubiquitous in daily life and nature. An exciting field of engineering is emerging that uses these compliant materials to design active devices, such as actuators, adaptive optical systems and self-regulating fluidics. Compliant structures may significantly change their architecture in response to diverse stimuli. When excessive deformation is applied, they may eventually become unstable. Traditionally, mechanical instabilities have been viewed as an inconvenience, with research focusing on how to avoid them. Here, I will demonstrate that these instabilities can be exploited to design materials with novel, switchable functionalities. The abrupt changes introduced into the architecture of soft materials by instabilities will be used to change their shape in a sudden, but controlled manner. Possible and exciting applications include materials with unusual properties such negative Poisson's ratio, phononic crystals with tunable low-frequency acoustic band gaps and reversible encapsulation systems.

  3. Faraday instability in deformable domains

    NASA Astrophysics Data System (ADS)

    Pucci, Giuseppe; Ben Amar, Martine; Couder, Yves

    2014-11-01

    We investigate the Faraday instability in floating liquid lenses, as an example of hydrodynamic instability that develops in a domain with flexible boundaries. We show that a mutual adaptation of the instability pattern and the domain shape occurs, as a result of the competition between the wave radiation pressure and the capillary response of the lens border. Two archetypes of behaviour are observed. In the first, stable shapes are obtained experimentally and predicted theoretically as the exact solutions of a Riccati equation, and they result from the equilibrium between wave radiation pressure and capillarity. In the second, the radiation pressure exceeds the capillary response of the lens border and leads to non-equilibrium behaviours, with breaking into smaller domains that have a complex dynamics including spontaneous propagation. The authors are grateful to Université Franco-Italienne (UFI) for financial support.

  4. Interfacial instabilities and Kapitsa pendula

    NASA Astrophysics Data System (ADS)

    Krieger, Madison

    2015-11-01

    Determining the critera for onset and amplitude growth of instabilities is one of the central problems of fluid mechanics. We develop a parallel between the Kapitsa effect, in which a pendulum subject to high-frequency low-amplitude vibrations becomes stable in the inverted position, and interfaces separating fluids of different density. It has long been known that such interfaces can be stabilized by vibrations, even when the denser fluid is on top. We demonstrate that the stability diagram for these fluid interfaces is identical to the stability diagram for an appopriate Kapitsa pendulum. We expand the robust, ``dictionary''-type relationship between Kapitsa pendula and interfacial instabilities by considering the classical Rayleigh-Taylor, Kelvin-Helmholtz and Plateau instabilities, as well as less-canonical examples ranging in scale from the micron to the width of a galaxy.

  5. Stellar explosions, instabilities, and turbulence

    SciTech Connect

    Drake, R. P.; Kuranz, C. C.; Miles, A. R.; Muthsam, H. J.; Plewa, T.

    2009-04-15

    It has become very clear that the evolution of structure during supernovae is centrally dependent on the pre-existing structure in the star. Modeling of the pre-existing structure has advanced significantly, leading to improved understanding and to a physically based assessment of the structure that will be present when a star explodes. It remains an open question whether low-mode asymmetries in the explosion process can produce the observed effects or whether the explosion mechanism somehow produces jets of material. In any event, the workhorse processes that produce structure in an exploding star are blast-wave driven instabilities. Laboratory experiments have explored these blast-wave-driven instabilities and specifically their dependence on initial conditions. Theoretical work has shown that the relative importance of Richtmyer-Meshkov and Rayleigh-Taylor instabilities varies with the initial conditions and does so in ways that can make sense of a range of astrophysical observations.

  6. Gravitational instabilities in protostellar disks

    NASA Technical Reports Server (NTRS)

    Tohline, J. E.

    1994-01-01

    The nonaxisymmetric stability of self-gravitating, geometrically thick accretion disks has been studied for protostellar systems having a wide range of disk-to-central object mass ratios. Global eigenmodes with four distinctly different characters were identified using numerical, nonlinear hydrodynamic techniques. The mode that appears most likely to arise in normal star formation settings, however, resembles the 'eccentric instability' that was identified earlier in thin, nearly Keplerian disks: It presents an open, one-armed spiral pattern that sweeps continuously in a trailing direction through more than 2-pi radians, smoothly connecting the inner and outer edges of the disk, and requires cooperative motion of the point mass for effective amplification. This particular instability promotes the development of a single, self-gravitating clump of material in orbit about the point mass, so its routine appearance in our simulations supports the conjecture that the eccentric instability provides a primary route to the formation of short-period binaries in protostellar systems.

  7. Interfacial Instability during Granular Erosion.

    PubMed

    Lefebvre, Gautier; Merceron, Aymeric; Jop, Pierre

    2016-02-12

    The complex interplay between the topography and the erosion and deposition phenomena is a key feature to model granular flows such as landslides. Here, we investigated the instability that develops during the erosion of a wet granular pile by a dry dense granular flow. The morphology and the propagation of the generated steps are analyzed in relation to the specific erosion mechanism. The selected flowing angle of the confined flow on a dry heap appears to play an important role both in the final state of the experiment, and for the shape of the structures. We show that the development of the instability is governed by the inertia of the flow through the Froude number. We model this instability and predict growth rates that are in agreement with the experiment results. PMID:26919014

  8. Chondral Injury in Patellofemoral Instability

    PubMed Central

    Lustig, Sébastien; Servien, Elvire; Neyret, Philippe

    2014-01-01

    Objective: Patellofemoral instability is common and affects a predominantly young age group. Chondral injury occurs in up to 95%, and includes osteochondral fractures and loose bodies acutely and secondary degenerative changes in recurrent cases. Biomechanical abnormalities, such as trochlear dysplasia, patella alta, and increased tibial tuberosity-trochlear groove distance, predispose to both recurrent dislocations and patellofemoral arthrosis. Design: In this article, we review the mechanisms of chondral injury in patellofemoral instability, diagnostic modalities, the distribution of lesions seen in acute and episodic dislocation, and treatments for articular cartilage lesions of the patellofemoral joint. Results: Little specific evidence exists for cartilage treatments in patellofemoral instability. In general, the results of reparative and restorative procedures in the patellofemoral joint are inferior to those observed in other compartments of the knee. Conclusion: Given the increased severity of chondral lesions and progression to osteoarthritis seen with recurrent dislocations, careful consideration should be given to early stabilisation in patients with predisposing factors. PMID:26069693

  9. Dentulous Appliance for Upper Anterior Edentulous Span

    PubMed Central

    Chalakkal, Paul; Devi, Ramisetty Sabitha; Srinivas, G. Vijay; Venkataramana, Pammi

    2013-01-01

    This article discusses about a fixed dentulous appliance that was constructed to replace the primary upper anterior edentulous span in a four year old girl. It constituted a design, whereby the maxillary primary second molars were used to support the appliance through bands and a wire that contained an acrylic flange bearing trimmed acrylic teeth, anteriorly. The appliance was functionally and aesthetically compliant. PMID:24551736

  10. Erlotinib-related bilateral anterior uveitis

    PubMed Central

    Ali, Kashif; Kumar, Indu; Usman-Saeed, Muniba; Usman Saeed, Muhammad

    2011-01-01

    The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors’ knowledge, this is the first case of erlotinib-related anterior uveitis. PMID:22694887

  11. Rehabilitation of anterior cruciate ligament injuries.

    PubMed

    Halling, A H; Howard, M E; Cawley, P W

    1993-04-01

    Rehabilitation of the anterior cruciate ligament absent or reconstructed knee is becoming a true artform. Accelerated, but controlled rehabilitation, is becoming more commonplace. Scientific-based data along with clinical experiences are the basis of the rehabilitation guidelines brought forth in this article. Anterior cruciate ligament strain and implications for exercise, continuous passive motion, proprioceptive exercise, and the role of knee bracing are all discussed in relation to the overall rehabilitation program.

  12. Two-Stage Revision Anterior Cruciate Ligament Reconstruction.

    PubMed

    Erickson, Brandon J; Cvetanovich, Gregory; Waliullah, Khalid; Khair, Michael; Smith, Patrick; Bach, Bernard; Sherman, Seth

    2016-05-01

    The number of primary anterior cruciate ligament (ACL) tears is rapidly increasing. In patients who wish to return to their preoperative level of function, specifically as it pertains to participation in sports, the gold standard of treatment following an ACL tear remains an anterior cruciate ligament (ACL) reconstruction. Despite a majority of good/excellent results following primary ACL reconstruction, there is a growing subset of patients with persistent or recurrent functional instability who require revision ACL reconstruction. Preoperative planning for revision ACL reconstruction requires a careful understanding of the root cause of ACL failure, including possible technical causes of primary ACL failure and the presence of combined knee pathology that was not addressed at the index ACL reconstruction. The decision to perform 2-stage revision ACL reconstruction is multifactorial and is reached by technical considerations that may make a 1-stage revision less optimal, including tunnel widening, arthrofibrosis, active infection, and others. Concomitant knee pathology such as meniscal deficiency, malalignment (including an increase in posterior tibial slope), chondral lesions, and other ligamentous laxity may also require a staged approach to treatment. This evidence-based review covers the indications for 2-stage revision ACL reconstruction, surgical techniques, evidence for and technique of bone grafting prior ACL tunnels, and outcomes of 2-stage revision stratified by initial cause of ACL reconstruction failure. With proper preoperative planning and an understanding of the cause of failure following the primary ACL reconstruction, revision ACL reconstruction can offer excellent outcomes in the motivated patient. [Orthopedics. 2016; 39(3):e456-e464.]. PMID:27045480

  13. Anterior capsular defect with acute anterior subcapsular cataract in herpetic keratouveitis

    PubMed Central

    Arora, Tarun; Sharma, Namrata; Arora, Supriya; Titiyal, Jeewan S

    2014-01-01

    A 20-year-old man presented with a recurrent episode of herpetic keratouveitis in his right eye. The patient was treated with oral acyclovir and topical steroids. One week later the patient reported a sudden diminution of vision. Slitlamp biomicroscopy revealed the presence of a central anterior capsular defect and anterior subcapsular cataract. Dosage of steroids was temporarily increased and progression of cataract monitored. Subsequently, the anterior chamber reaction decreased and steroids were tapered. PMID:25228677

  14. A combination of Latarjet and Remplissage for treatment of severe glenohumeral instability and bone loss. A case report

    PubMed Central

    Ranne, Juha O.; Sarimo, Janne J.; Heinonen, Olli J.; Orava, Sakari Y.

    2013-01-01

    Recurrent glenohumeral instability is challenging to treat when large bony defects are present in the anterior glenoid and there is a large Hill–Sachs lesion. We present a case with extensive glenoid and humeral bone loss treated with open Latarjet procedure combined with posterior arthroscopic Remplissage. 3.5 years after surgery, there have been no dislocations or any subjective signs of instability. After half a year, the patient was able to return to work as an airline pilot. Constant score has improved from 33 to 74 and the Oxford instability score from 8 to 46. We find that in young patients with difficult instability combining the Latarjet and Remplissage is a good and replicable method. PMID:24403748

  15. A combination of Latarjet and Remplissage for treatment of severe glenohumeral instability and bone loss. A case report.

    PubMed

    Ranne, Juha O; Sarimo, Janne J; Heinonen, Olli J; Orava, Sakari Y

    2013-01-01

    Recurrent glenohumeral instability is challenging to treat when large bony defects are present in the anterior glenoid and there is a large Hill-Sachs lesion. We present a case with extensive glenoid and humeral bone loss treated with open Latarjet procedure combined with posterior arthroscopic Remplissage. 3.5 years after surgery, there have been no dislocations or any subjective signs of instability. After half a year, the patient was able to return to work as an airline pilot. Constant score has improved from 33 to 74 and the Oxford instability score from 8 to 46. We find that in young patients with difficult instability combining the Latarjet and Remplissage is a good and replicable method.

  16. Laboratory blast wave driven instabilities

    NASA Astrophysics Data System (ADS)

    Kuranz, Carolyn

    2008-11-01

    This presentation discusses experiments involving the evolution of hydrodynamic instabilities in the laboratory under high-energy-density (HED) conditions. These instabilities are driven by blast waves, which occur following a sudden, finite release of energy, and consist of a shock front followed by a rarefaction wave. When a blast wave crosses an interface with a decrease in density, hydrodynamic instabilities will develop. Instabilities evolving under HED conditions are relevant to astrophysics. These experiments include target materials scaled in density to the He/H layer in SN1987A. About 5 kJ of laser energy from the Omega Laser facility irradiates a 150 μm plastic layer that is followed by a low-density foam layer. A blast wave structure similar to those in supernovae is created in the plastic layer. The blast wave crosses an interface having a 2D or 3D sinusoidal structure that serves as a seed perturbation for hydrodynamic instabilities. This produces unstable growth dominated by the Rayleigh-Taylor (RT) instability in the nonlinear regime. We have detected the interface structure under these conditions using x-ray backlighting. Recent advances in our diagnostic techniques have greatly improved the resolution of our x-ray radiographic images. Under certain conditions, the improved images show some mass extending beyond the RT spike and penetrating further than previously observed or predicted by current simulations. The observed effect is potentially of great importance as a source of mass transport to places not anticipated by current theory and simulation. I will discuss the amount of mass in these spike extensions, the associated uncertainties, and hypotheses regarding their origin We also plan to show comparisons of experiments using single mode and multimode as well as 2D and 3D initial conditions. This work is sponsored by DOE/NNSA Research Grants DE-FG52-07NA28058 (Stewardship Sciences Academic Alliances) and DE-FG52-04NA00064 (National Laser User

  17. Acromioclavicular joint instability: anatomy, biomechanics and evaluation.

    PubMed

    Saccomanno, Maristella F; DE Ieso, Carmine; Milano, Giuseppe

    2014-01-01

    Acromioclavicular (AC) joint instability is a common source of pain and disability. The injury is most commonly a result of a direct impact to the AC joint. The AC joint is surrounded by a capsule and has an intra-articular synovium and an articular cartilage interface. An articular disc is usually present in the joint, but this varies in size and shape. The AC joint capsule is quite thin, but has considerable ligamentous support; there are four AC ligaments: superior, inferior, anterior and posterior. The coracoclavicular (CC) ligament complex consists of the conoid and trapezoid ligaments. They insert on the posteromedial and anterolateral region of the undersurface of the distal clavicle, respectively. The coracoid origin of the trapezoid covers the posterior half of the coracoid dorsum; the conoid origin is more posterior on the base of the coracoid. Several biomechanical studies showed that horizontal stability of the AC joint is mediated by the AC ligaments while vertical stability is mediated by the CC ligaments. The radiographic classification of AC joint injuries described by Rockwood includes six types: in type I injuries the AC ligaments are sprained, but the joint is intact; in type II injuries, the AC ligaments are torn, but the CC ligaments are intact; in type III injuries both the AC and the CC ligaments are torn; type IV injuries are characterized by complete dislocation with posterior displacement of the distal clavicle into or through the fascia of the trapezius; type V injuries are characterized by a greater degree of soft tissue damage; type VI injuries are inferior AC joint dislocations into a subacromial or subcoracoid position. The diagnosis of AC joint instability can be based on historical data, physical examination and imaging studies. The cross body adduction stress test has the greatest sensitivity, followed by the AC resisted extension test and the O'Brien test. Proper radiographic evaluation of the AC joint is necessary. The Zanca view

  18. Anterior Eye Imaging with Optical Coherence Tomography

    NASA Astrophysics Data System (ADS)

    Huang, David; Li, Yan; Tang, Maolong

    The development of corneal and anterior segment optical coherence tomography (OCT) technology has advanced rapidly in recently years. The scan geometry and imaging wavelength are both important choices to make in designing anterior segment OCT systems. Rectangular scan geometry offers the least image distortion and is now used in most anterior OCT systems. The wavelength of OCT light source affects resolution and penetration. An optimal choice of the OCT imaging wavelength (840, 1,050, or 1,310 nm) depends on the application of interest. Newer generation Fourier-domain OCT technology can provide scan speed 100-1000 times faster than the time-domain technology. Various commercial anterior OCT systems are available on the market. A wide spectrum of diagnostic and surgical applications using anterior segment OCT had been investigated, including mapping of corneal and epithelial thicknesses, keratoconus screening, measuring corneal refractive power, corneal surgery planning and evaluation in LASIK, intracorneal ring implantation, assessment of angle closure glaucoma, anterior chamber biometry and intraocular lens implants, intraocular lens power calculation, and eye bank donor cornea screening.

  19. Beam instabilities in hadron synchrotrons

    DOE PAGESBeta

    Metral, E.; T. Argyropoulos; Bartosik, H.; Biancacci, N.; Buffat, X.; Esteban Muller, J. F.; Herr, W.; Iadarola, G.; Lasheen, A.; Li, K.; et al

    2016-04-01

    Beam instabilities cover a wide range of effects in particle accelerators and they have been the subjects of intense research for several decades. As the machines performance was pushed new mechanisms were revealed and nowadays the challenge consists in studying the interplays between all these intricate phenomena, as it is very often not possible to treat the different effects separately. Furthermore, the aim of this paper is to review the main mechanisms, discussing in particular the recent developments of beam instability theories and simulations.

  20. Hopf bifurcation and plasma instabilities

    SciTech Connect

    Crawford, J.D.

    1983-11-01

    Center manifold theory and the theory of normal forms are applied to examples of Hopf bifurcation in two models of plasma dynamics. A finite dimensional model of a 3-wave system with quadratic nonlinearities provides a simple example of both supercritical and subcritical Hopf bifurcation. In the second model, the electrostatic instabilities of a collisional plasma correspond to Hopf bifurcations. In this problem, the Vlasov-Poisson equations with a Krook collision term describe the electron dynamics in a weakly ionized gas. The one mode in instability is analyzed in detail; near criticality it always saturates in a small amplitude nonlinear oscillation.

  1. Undulation Instability of Epithelial Tissues

    NASA Astrophysics Data System (ADS)

    Basan, Markus; Joanny, Jean-François; Prost, Jacques; Risler, Thomas

    2011-04-01

    Treating the epithelium as an incompressible fluid adjacent to a viscoelastic stroma, we find a novel hydrodynamic instability that leads to the formation of protrusions of the epithelium into the stroma. This instability is a candidate for epithelial fingering observed in vivo. It occurs for sufficiently large viscosity, cell-division rate and thickness of the dividing region in the epithelium. Our work provides physical insight into a potential mechanism by which interfaces between epithelia and stromas undulate and potentially by which tissue dysplasia leads to cancerous invasion.

  2. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature.

    PubMed

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic bilateral acute anterior shoulder dislocations with associated Hill-Sachs lesions in a young, fit and well patient with no comorbidities. MRI illustrated the Hill-Sachs lesions with superior labral tear from anterior to posterior, and confirmed the acute nature of the injury by demonstrating the bone marrow oedema. The patient was treated surgically with arthroscopic anterior stabilisation. At 6 months following surgery, the patient has a pain free full range of movement of both shoulders with no further dislocations and has returned to work.

  3. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    PubMed Central

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic bilateral acute anterior shoulder dislocations with associated Hill-Sachs lesions in a young, fit and well patient with no comorbidities. MRI illustrated the Hill-Sachs lesions with superior labral tear from anterior to posterior, and confirmed the acute nature of the injury by demonstrating the bone marrow oedema. The patient was treated surgically with arthroscopic anterior stabilisation. At 6 months following surgery, the patient has a pain free full range of movement of both shoulders with no further dislocations and has returned to work. PMID:24895390

  4. Subsidence and Nonunion after Anterior Cervical Interbody Fusion Using a Stand-Alone Polyetheretherketone (PEEK) Cage

    PubMed Central

    Yang, Jae Jun; Yu, Chang Hun; Yeom, Jin Sup; Lee, Jae Hyup; Lee, Choon-Ki

    2011-01-01

    Background The purposes of the present study are to evaluate the subsidence and nonunion that occurred after anterior cervical discectomy and fusion using a stand-alone intervertebral cage and to analyze the risk factors for the complications. Methods Thirty-eight patients (47 segments) who underwent anterior cervical fusion using a stand-alone polyetheretherketone (PEEK) cage and an autologous cancellous iliac bone graft from June 2003 to August 2008 were enrolled in this study. The anterior and posterior segmental heights and the distance from the anterior edge of the upper vertebra to the anterior margin of the cage were measured on the plain radiographs. Subsidence was defined as ≥ a 2 mm (minor) or 3 mm (major) decrease of the segmental height at the final follow-up compared to that measured at the immediate postoperative period. Nonunion was evaluated according to the instability being ≥ 2 mm in the interspinous distance on the flexion-extension lateral radiographs. Results The anterior and posterior segmental heights decreased from the immediate postoperative period to the final follow-up at 1.33 ± 1.46 mm and 0.81 ± 1.27 mm, respectively. Subsidence ≥ 2 mm and 3 mm were observed in 12 segments (25.5%) and 7 segments (14.9%), respectively. Among the expected risk factors for subsidence, a smaller anteroposterior (AP) diameter (14 mm vs. 12 mm) of cages (p = 0.034; odds ratio [OR], 0.017) and larger intraoperative distraction (p = 0.041; OR, 3.988) had a significantly higher risk of subsidence. Intervertebral nonunion was observed in 7 segments (7/47, 14.9%). Compared with the union group, the nonunion group had a significantly higher ratio of two-level fusion to one-level fusions (p = 0.001). Conclusions Anterior cervical fusion using a stand-alone cage with a large AP diameter while preventing anterior intraoperative over-distraction will be helpful to prevent the subsidence of cages. Two-level cervical fusion might require more careful attention

  5. Magnetic dipole discharges. III. Instabilities

    SciTech Connect

    Stenzel, R. L.; Urrutia, J. M.; Ionita, C.; Schrittwieser, R.

    2013-08-15

    Instabilities in a cross-field discharge around a permanent magnet have been investigated. The permanent magnet serves as a cold cathode and the chamber wall as an anode. The magnet is biased strongly negative and emits secondary electrons due to impact of energetic ions. The electrons outside the sheath are confined by the strong dipolar magnetic field and by the ion-rich sheath surrounding the magnet. The electron energy peaks in the equatorial plane where most ionization occurs and the ions are trapped in a negative potential well. The discharge mechanism is the same as that of cylindrical and planar magnetrons, but here extended to a 3-D cathode geometry using a single dipole magnet. While the basic properties of the discharge are presented in a companion paper, the present focus is on various observed instabilities. The first is an ion sheath instability which oscillates the plasma potential outside the sheath below the ion plasma frequency. It arises in ion-rich sheaths with low electron supply, which is the case for low secondary emission yields. Sheath oscillations modulate the discharge current creating oscillating magnetic fields. The second instability is current-driven ion sound turbulence due to counter-streaming electrons and ions. The fluctuations have a broad spectrum and short correlation lengths in all directions. The third type of fluctuations is spiky potential and current oscillations in high density discharges. These appear to be due to unstable emission properties of the magnetron cathode.

  6. Lending sociodynamics and economic instability

    NASA Astrophysics Data System (ADS)

    Hawkins, Raymond J.

    2011-11-01

    We show how the dynamics of economic instability and financial crises articulated by Keynes in the General Theory and developed by Minsky as the Financial Instability Hypothesis can be formalized using Weidlich’s sociodynamics of opinion formation. The model addresses both the lending sentiment of a lender in isolation as well as the impact on that lending sentiment of the behavior of other lenders. The risk associated with lending is incorporated through a stochastic treatment of loan dynamics that treats prepayment and default as competing risks. With this model we are able to generate endogenously the rapid changes in lending opinion that attend slow changes in lending profitability and find these dynamics to be consistent with the rise and collapse of the non-Agency mortgage-backed securities market in 2007/2008. As the parameters of this model correspond to well-known phenomena in cognitive and social psychology, we can both explain why economic instability has proved robust to advances in risk measurement and suggest how policy for reducing economic instability might be formulated in an experimentally sound manner.

  7. Finite element shell instability analysis

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Formulation procedures and the associated computer program for finite element thin shell instability analysis are discussed. Data cover: (1) formulation of basic element relationships, (2) construction of solution algorithms on both the conceptual and algorithmic levels, and (3) conduction of numerical analyses to verify the accuracy and efficiency of the theory and related programs therein are described.

  8. The Chemistry of Beer Instability

    ERIC Educational Resources Information Center

    Stewart, Graham G.

    2004-01-01

    Brewing of beer, one of the oldest biotechnology industries was one of the earliest processes to be undertaken on commercial basis. Biological instability involves contamination of bacteria, yeast, or mycelia fungi and there is always a risk in brewing that beer can become contaminated by micro-organisms.

  9. Urge incontinence and detrusor instability.

    PubMed

    Jabs, C F; Stanton, S L

    2001-01-01

    Detrusor instability is a syndrome of urinary frequency, urgency and urge incontinence which can be demonstrated using urodynamic studies to document uninhibited bladder contractions. Idiopathic cases account for 90% and 10% are related to neurologic disorders. Several different treatment modalities are available, including bladder training/drill, electrical stimulation, medical and surgical therapies.

  10. Edge instabilities of topological superconductors

    NASA Astrophysics Data System (ADS)

    Hofmann, Johannes S.; Assaad, Fakher F.; Schnyder, Andreas P.

    2016-05-01

    Nodal topological superconductors display zero-energy Majorana flat bands at generic edges. The flatness of these edge bands, which is protected by time-reversal and translation symmetry, gives rise to an extensive ground-state degeneracy. Therefore, even arbitrarily weak interactions lead to an instability of the flat-band edge states towards time-reversal and translation-symmetry-broken phases, which lift the ground-state degeneracy. We examine the instabilities of the flat-band edge states of dx y-wave superconductors by performing a mean-field analysis in the Majorana basis of the edge states. The leading instabilities are Majorana mass terms, which correspond to coherent superpositions of particle-particle and particle-hole channels in the fermionic language. We find that attractive interactions induce three different mass terms. One is a coherent superposition of imaginary s -wave pairing and current order, and another combines a charge-density-wave and finite-momentum singlet pairing. Repulsive interactions, on the other hand, lead to ferromagnetism together with spin-triplet pairing at the edge. Our quantum Monte Carlo simulations confirm these findings and demonstrate that these instabilities occur even in the presence of strong quantum fluctuations. We discuss the implications of our results for experiments on cuprate high-temperature superconductors.

  11. Weathering instability and landscape evolution

    NASA Astrophysics Data System (ADS)

    Phillips, Jonathan D.

    2005-04-01

    The argument in this paper is that the fundamental control on landscape evolution in erosional landscapes is weathering. The possibility of and evidence for instability in weathering at four scales is examined. The four scales are concerned with weathering processes, allocation of weathered products, the interrelations of weathering and denudation, and the topographic and isostatic responses to weathering-limited denudation (the regolith, hillslope, landscape unit, and landscape scales, respectively). The stability conditions for each model, and the circumstances under which the models themselves are relevant, are used to identify scale-related domains of stability and instability. At the regolith scale, the interactions among weathering rates, resistance, and moisture are unstable, but there are circumstances—over long timescales and where weathering is well advanced—under which the instability is irrelevant. At the hillslope scale, the system is stable when denudation is transport rather than weathering limited and where no renewal of exposure via regolith stripping occurs. At the level of landscape units, the stability model is based entirely on the mutual reinforcements of weathering and erosion. While this should generally lead to instability, the model would be stable where other, external controls of both weathering and erosion rates are stronger than the weathering-erosion feedbacks. At the broadest landscape scale, the inclusion of isostatic responses destabilizes erosion-topography-uplift relationships. Thus, if the spatial or temporal scale is such that isostatic responses are not relevant, the system may be stable. Essentially, instability is prevalent at local spatial scales at all but the longest timescales. Stability at intermediate spatial scales is contingent on whether weathering-erosion feedbacks are strong or weak, with stability being more likely at shorter and less likely at longer timescales. At the broadest spatial scales, instability is

  12. Singlet and triplet instability theorems

    SciTech Connect

    Yamada, Tomonori; Hirata, So

    2015-09-21

    A useful definition of orbital degeneracy—form-degeneracy—is introduced, which is distinct from the usual energy-degeneracy: Two canonical spatial orbitals are form-degenerate when the energy expectation value in the restricted Hartree–Fock (RHF) wave function is unaltered upon a two-electron excitation from one of these orbitals to the other. Form-degenerate orbitals tend to have isomorphic electron densities and occur in the highest-occupied and lowest-unoccupied molecular orbitals (HOMOs and LUMOs) of strongly correlated systems. Here, we present a mathematical proof of the existence of a triplet instability in a real or complex RHF wave function of a finite system in the space of real or complex unrestricted Hartree–Fock wave functions when HOMO and LUMO are energy- or form-degenerate. We also show that a singlet instability always exists in a real RHF wave function of a finite system in the space of complex RHF wave functions, when HOMO and LUMO are form-degenerate, but have nonidentical electron densities, or are energy-degenerate. These theorems provide Hartree–Fock-theory-based explanations of Hund’s rule, a singlet instability in Jahn–Teller systems, biradicaloid electronic structures, and a triplet instability during some covalent bond breaking. They also suggest (but not guarantee) the spontaneous formation of a spin density wave (SDW) in a metallic solid. The stability theory underlying these theorems extended to a continuous orbital-energy spectrum proves the existence of an oscillating (nonspiral) SDW instability in one- and three-dimensional homogeneous electron gases, but only at low densities or for strong interactions.

  13. Singlet and triplet instability theorems

    NASA Astrophysics Data System (ADS)

    Yamada, Tomonori; Hirata, So

    2015-09-01

    A useful definition of orbital degeneracy—form-degeneracy—is introduced, which is distinct from the usual energy-degeneracy: Two canonical spatial orbitals are form-degenerate when the energy expectation value in the restricted Hartree-Fock (RHF) wave function is unaltered upon a two-electron excitation from one of these orbitals to the other. Form-degenerate orbitals tend to have isomorphic electron densities and occur in the highest-occupied and lowest-unoccupied molecular orbitals (HOMOs and LUMOs) of strongly correlated systems. Here, we present a mathematical proof of the existence of a triplet instability in a real or complex RHF wave function of a finite system in the space of real or complex unrestricted Hartree-Fock wave functions when HOMO and LUMO are energy- or form-degenerate. We also show that a singlet instability always exists in a real RHF wave function of a finite system in the space of complex RHF wave functions, when HOMO and LUMO are form-degenerate, but have nonidentical electron densities, or are energy-degenerate. These theorems provide Hartree-Fock-theory-based explanations of Hund's rule, a singlet instability in Jahn-Teller systems, biradicaloid electronic structures, and a triplet instability during some covalent bond breaking. They also suggest (but not guarantee) the spontaneous formation of a spin density wave (SDW) in a metallic solid. The stability theory underlying these theorems extended to a continuous orbital-energy spectrum proves the existence of an oscillating (nonspiral) SDW instability in one- and three-dimensional homogeneous electron gases, but only at low densities or for strong interactions.

  14. Singlet and triplet instability theorems.

    PubMed

    Yamada, Tomonori; Hirata, So

    2015-09-21

    A useful definition of orbital degeneracy—form-degeneracy—is introduced, which is distinct from the usual energy-degeneracy: Two canonical spatial orbitals are form-degenerate when the energy expectation value in the restricted Hartree-Fock (RHF) wave function is unaltered upon a two-electron excitation from one of these orbitals to the other. Form-degenerate orbitals tend to have isomorphic electron densities and occur in the highest-occupied and lowest-unoccupied molecular orbitals (HOMOs and LUMOs) of strongly correlated systems. Here, we present a mathematical proof of the existence of a triplet instability in a real or complex RHF wave function of a finite system in the space of real or complex unrestricted Hartree-Fock wave functions when HOMO and LUMO are energy- or form-degenerate. We also show that a singlet instability always exists in a real RHF wave function of a finite system in the space of complex RHF wave functions, when HOMO and LUMO are form-degenerate, but have nonidentical electron densities, or are energy-degenerate. These theorems provide Hartree-Fock-theory-based explanations of Hund's rule, a singlet instability in Jahn-Teller systems, biradicaloid electronic structures, and a triplet instability during some covalent bond breaking. They also suggest (but not guarantee) the spontaneous formation of a spin density wave (SDW) in a metallic solid. The stability theory underlying these theorems extended to a continuous orbital-energy spectrum proves the existence of an oscillating (nonspiral) SDW instability in one- and three-dimensional homogeneous electron gases, but only at low densities or for strong interactions. PMID:26395692

  15. Rehabilitation of anterior teeth with customised incisal guide table

    PubMed Central

    Mall, Priyanka; Singh, Kamleshwar; Rao, Jitendra; Kumar, Lakshya

    2013-01-01

    Restoration of anterior guidance is a major challenge to the clinician in planning of all restorative treatments. An accurate anterior guidance is important for proper function, aesthetics, comfort and phonetics. This article describes anterior rehabilitation of a patient who met with a road traffic accident and lost his anterior teeth. Anterior guidance developed in the provisional restorations was accurately recorded in the customised incisal guide table and permanent restorations were fabricated accordingly. PMID:23709546

  16. Measurements of fast transition instability in RHIC

    SciTech Connect

    Ptitsyn, V.; Blaskiewicz, M.; Fischer, W.; Lee, R.; Zhang, S.Y.

    2010-05-23

    A fast transition instability presents a limiting factor for ion beam intensity in RHIC. Several pieces of evidence show that electron clouds play an important role in establishing the threshold of this instability. In RHIC Runs8 the measurements of the instability, using a button BPM, were done in order to observe details of the instability development on the scale over hundreds and thousands turns. The paper presents and discusses the results of those measurements in time and frequency domains.

  17. [Surgical anatomy of the anterior mediastinum].

    PubMed

    Biondi, Alberto; Rausei, Stefano; Cananzi, Ferdinando C M; Zoccali, Marco; D'Ugo, Stefano; Persiani, Roberto

    2007-01-01

    The mediastinum is located from the thoracic inlet to the diaphragm between the left and right pleural cavities and contains vital structures of the circulatory, respiratory, digestive, and nervous system. Over the years, since there are no fascial or anatomic planes, anatomists and radiologists have suggested various schemes for subdividing the mediastinum and several anatomical and radiological classifications of the mediastinum are reported in the literature. The most popular of these scheme divides medistinum, for purposes of description, into two parts: an upper portion, above the upper level of the pericardium, which is named the superior mediastinum; and a lower portion, below the upper level of the pericardium. For clinical purposes, the mediastinum may be subdivided into three major areas, i.e. anterior, middle, and posterior compartments. The anterior mediastinum is defined as the region posterior to the sternum and anterior to the heart and brachiocephalic vessels. It extends from the thoracic inlet to the diaphragm and contains the thymus gland, fat, and lymph nodes. This article will review surgical anatomy of the anterior mediastinum and will focus on the surgical approch to anterior mediastinum and thymic diseases.

  18. Warfare-related secondary anterior cranioplasty

    PubMed Central

    Ebrahimi, Ali; Nejadsarvari, Nasrin; Rasouli, Hamid Reza; Ebrahimi, Azin

    2016-01-01

    Background: Anterior cranial bone defects secondary to global war cranial defects pose a unique reconstructive challenge. The objective of this study was to evaluate the outcomes of alloplastic reconstructions of cranial bone with titanium mesh and fat graft after warfare-related cranial trauma. Patients and Methods: Thirty-five patients at the plastic and reconstructive surgery ward of our hospital underwent anterior cranioplasty with titanium mesh with or without fat grafts from lower abdominal wall. Inclusion criteria were anterior cranial bone defect due to warfare injuries, the mean age of these patients was 31 years (range, 23–48 years). Ninety-five percent were male, and 5% were female. Average follow-up was 12 months. Fat grafts were used to help obliterate endocranial dead spaces. Results: Twenty-five patients (71%) had more than 0.5 cm dead space under cranial defects, and we used fat graft under the titanium mesh. The majority groups of patients (80%) were injured as a result of previous explosive device blasts with or without neurosurgical procedures in the past. The average patient age was 31 years, and 95% of patients were male. The mean anterior cranial defect size was 6 cm × 8 cm, and there were no wound infection or flap necrosis after operations. Conclusion: We recommend this procedure (titanium mesh with or without fat graft) for warfare injured cranial defects in secondary anterior cranial reconstructions. Fat grafts eliminates dead space and reduce secondary complications. PMID:27563609

  19. Anterior approach in THA improves outcomes: affirms.

    PubMed

    Moskal, Joseph T

    2011-09-01

    In general, the literature makes numerous positive claims regarding the direct anterior approach with a fracture table for total hip arthroplasty (THA), including quicker recovery and return to unassisted ambulation, along with reduced soft tissue damage, surgery time, pain, and risk of dislocation with early elimination of hip precautions. The benefits of the direct anterior approach are mostly due from muscle preservation rather than muscle splitting, which occurs with the more traditional approaches. With the use of the muscle-preserving direct anterior approach for THA, there is less muscle damage and earlier return to function, and postoperative precautions are not needed. The most significant improvements in THA have been allowing patients to be immediately weight bearing as tolerated after THA, incorporating a multimodal pain management protocol, and now using the direct anterior approach. There is a learning curve, and I strongly recommend that people attend cadaver-based learning centers as well as surgeon visitations. We must always remember the oath we took to "do no harm," especially when embarking on a new procedure such as the direct anterior approach in THA or any other new procedure or technology. My position in the debate is not whether we should embrace this technique or other new techniques, but rather how they should be introduced.

  20. Management of anterior cruciate ligament injuries in skeletally immature individuals.

    PubMed

    Moksnes, Håvard; Engebretsen, Lars; Risberg, May Arna

    2012-03-01

    Anterior cruciate ligament (ACL) injuries in skeletally immature individuals remain a challenge for the child, the parents, orthopaedic surgeons, and physical therapists. The main challenges are the potential risk of recurrent instability, secondary injuries following nonoperative treatment, and the risks involved with surgical treatment due to the vulnerability of the epiphyseal growth plates. We first present the physiological background for considerations that must be made when advising on treatment alternatives for skeletally immature individuals after ACL injury. The implications of continuous musculoskeletal development for treatment decisions are emphasized. No randomized controlled trials have been performed to investigate outcomes of different treatment algorithms. There is no consensus in the literature on clinical treatment decision criteria for whether a skeletally immature child should undergo transphyseal ACL reconstruction, physeal sparing ACL reconstruction, or nonoperative treatment. Additionally, well-described rehabilitation programs designed for either nonoperative treatment or postoperative rehabilitation have not been published. Based on the currently available evidence, we propose a treatment algorithm for the management of ACL injuries in skeletally immature individuals. Finally, we suggest directions for future prospective studies, which should include development of valid and reliable outcome measures and specific rehabilitation programs. PMID:21891880

  1. Adjacent level spondylodiscitis after anterior cervical decompression and fusion.

    PubMed

    Basu, Saumyajit; Sreeramalingam, Rathinavelu

    2012-05-01

    Postoperative spondylodiscitis after anterior cervical decompression and fusion (ACDF) is rare, but the same occurring at adjacent levels without disturbing the operated level is very rare. We report a case, with 5 year followup, who underwent ACDF from C5 to C7 for cervical spondylotic myelopathy. He showed neurological improvement after surgery but developed discharging sinus after 2 weeks, which healed with antibiotics. He improved on his preoperative symptoms well for the first 2 months. He started developing progressive neck pain and myelopathy after 3 months and investigations revealed spondylodiscitis at C3 and C4 with erosion, collapse, and kyphosis, without any evidence of implant failure or graft rejection at the operated level. He underwent reexploration and implant removal at the operated level (there was good fusion from C5 to C7) followed by debridement/decompression at C3, C4 along with iliac crest bone grafting and stabilization with plate and screws after maximum correction of kyphosis. The biopsy specimen grew Pseudomonas aeruginosa and appropriate sensitive antibiotics (gentamycin and ciprofloxacin) were given for 6 weeks. He was under regular followup for 5 years his myelopathy resolved completely and he is back to work. Complete decompression of the cord and fusion from C2 to C7 was demonstrable on postoperative imaging studies without any evidence of implant loosening or C1/C2 instability at the last followup. PMID:22719127

  2. Mood instability: significance, definition and measurement.

    PubMed

    Broome, M R; Saunders, K E A; Harrison, P J; Marwaha, S

    2015-10-01

    Mood instability is common, and an important feature of several psychiatric disorders. We discuss the definition and measurement of mood instability, and review its prevalence, characteristics, neurobiological correlates and clinical implications. We suggest that mood instability has underappreciated transdiagnostic potential as an investigational and therapeutic target. PMID:26429679

  3. Control of laser plasma instabilities in hohlraums

    SciTech Connect

    Kruer, W.L.

    1996-12-01

    Laser plasma instabilities are an important constraint on the operating regime for inertial fusion. Many techniques have been developed to control the various laser-driven instabilities. Experiments with long scale length plasmas are testing these instability levels, the nonlinear regimes, and the control mechanisms.

  4. Particular Threshold Behavior of Dusty Plasma Instabilities

    SciTech Connect

    Mikikian, M.; Cavarroc, M.; Coueedel, L.; Tessier, Y.; Boufendi, L.

    2008-09-07

    We show that some experimentally observed instabilities, concerning the void region of a dust cloud, are similar to oscillations obtained in chemical systems or neuronal dynamics. The time evolution of these instabilities follows a well-defined process particularly visible in the instability shape and frequency.

  5. Transverse instability at the recycler ring

    SciTech Connect

    Ng, K.Y.; /Fermilab

    2004-10-01

    Sporadic transverse instabilities have been observed at the Fermilab Recycler Ring leading to increase in transverse emittances and beam loss. The driving source of these instabilities has been attributed to the resistive-wall impedance with space-charge playing an important role in suppressing Landau damping. Growth rates of the instabilities are computed. Remaining problems are discussed.

  6. Generalized laser filamentation instability coupled to cooling instability

    SciTech Connect

    Liang, E.P.; Wong, J.; Garrison, J.

    1984-04-24

    We consider the propagation of laser light in an initially slightly nonuniform plasma. The classical dispersion relation for the laser filamentation growth rate (see e.g., B. Langdon, in the 1980 Lawrence Livermore National Laboratory Laser Program Annual Report, pp. 3-56, UCRL-50021-80, 1981) can be generalized to include other acoustical effects. For example, we find that the inclusion of potential imbalances in the heating and cooling rates of the ambient medium due to density and temperature perturbations can cause the laser filamentation mode to bifurcate into a cooling instability mode at long acoustic wavelengths. We also attempt to study semi-analytically the nonlinear evolution of this and related instabilities. These results have wide applications to a variety of chemical gas lasers and phenomena related to laser-target interactions (e.g., jet-like behavior).

  7. Amplitude Equation for Instabilities Driven at Deformable Surfaces - Rosensweig Instability

    NASA Astrophysics Data System (ADS)

    Pleiner, Harald; Bohlius, Stefan; Brand, Helmut R.

    2008-11-01

    The derivation of amplitude equations from basic hydro-, magneto-, or electrodynamic equations requires the knowledge of the set of adjoint linear eigenvectors. This poses a particular problem for the case of a free and deformable surface, where the adjoint boundary conditions are generally non-trivial. In addition, when the driving force acts on the system via the deformable surface, not only Fredholm's alternative in the bulk, but also the proper boundary conditions are required to get amplitude equations. This is explained and demonstrated for the normal field (or Rosensweig) instability in ferrofluids as well as in ferrogels. An important aspect of the problem is its intrinsic dynamic nature, although at the end the instability is stationary. The resulting amplitude equation contains cubic and quadratic nonlinearities as well as first and (in the gel case) second order time derivatives. Spatial variations of the amplitudes cannot be obtained by using simply Newell's method in the bulk.

  8. Anatomy of the capsulolabral complex and rotator interval related to glenohumeral instability.

    PubMed

    Itoigawa, Yoshiaki; Itoi, Eiji

    2016-02-01

    The glenohumeral joint with instability is a common diagnosis that often requires surgery. The aim of this review was to present an overview of the anatomy of the glenohumeral joint with emphasis on instability based on the current literature and to describe the detailed anatomy and anatomical variants of the glenohumeral joint associated with anterior and posterior shoulder instability. A review was performed using PubMed/MEDLINE using key words: Search terms were "glenohumeral", "shoulder instability", "cadaver", "rotator interval", "anatomy", and "anatomical study". During the last decade, the interest in both arthroscopic repair techniques and surgical anatomy of the glenohumeral ligament (superior, middle, and inferior), labrum, and rotator interval has increased. Understanding of the rotator interval and attachment of the inferior glenohumeral ligament on the glenoid or humeral head have evolved significantly. The knowledge of the detailed anatomy and anatomical variations is essential for the surgeon in order to understand the pathology, make a correct diagnosis of instability, and select proper treatment options. Proper understanding of anatomical variants can help us avoid misdiagnosis. Level of evidence V.

  9. Interface instability modes in freezing colloidal suspensions: revealed from onset of planar instability

    PubMed Central

    Wang, Lilin; You, Jiaxue; Wang, Zhijun; Wang, Jincheng; Lin, Xin

    2016-01-01

    Freezing colloidal suspensions widely exists in nature and industry. Interface instability has attracted much attention for the understandings of the pattern formation in freezing colloidal suspensions. However, the interface instability modes, the origin of the ice banding or ice lamellae, are still unclear. In-situ experimental observation of the onset of interface instability remains absent up to now. Here, by directly imaging the initial transient stage of planar interface instability in directional freezing colloidal suspensions, we proposed three interface instability modes, Mullins-Sekerka instability, global split instability and local split instability. The intrinsic mechanism of the instability modes comes from the competition of the solute boundary layer and the particle boundary layer, which only can be revealed from the initial transient stage of planar instability in directional freezing. PMID:26996630

  10. Front instability in stratified media

    NASA Astrophysics Data System (ADS)

    Beltrame, Philippe

    2013-04-01

    Preferential flow in unsaturated soil may due to local heterogeneities like worm burrows but also to front instability leading to unstable finger flow (fingered pattern) in sandy textured soils. This last spontaneous preferential flow cannot be described by the standard Richards equation. Cueto-Felgueroso and Juanes proposed recently a phase field model in order to take into account a macroscopic surface tension effect at the front [1]. Their model simulates successfully the interface instability of an advancing front. We aim at simulating and understanding front instability passing a textural soil discontinuity for which the finger flow is particularly visible. We consider sand layers with different characteristics such as granulometry. Moreover, the wettability is taken into account by adding a hydrophobic term in the free energy of the phase field model. The hydrophobicity part is not only relevant for repellent soil but also to model the ultra-thin films [2]. Therefore, in our framework, this may have an influence at the front because the water saturation is nearly zero. Such a wettability influence on infiltration in porous media has recently been measured in [3]. The governing equation is analogous to the lubrication equation for which we pointed out the specific numerical difficulties [4]. A numerical code to perform time integration and bifurcation analysis was developed in [4] allowing to determine the onset of instability and its resulting dynamics in the parameter space [5]. We compute the parameter range for which the front stops when reaching the layers interface. As in [4], there is two main mechanisms that allow water to cross over the discontinuity. A first mechanism, called «depinning», leads to an intermittent flow and the second one, to a front instability and then to a finger flow. There is a parameter domain where both instabilities are present leading to a complex spatio-temporal dynamics. Finally, it is noteworthy that the wettability

  11. Anterior compartment syndrome: a case report.

    PubMed

    Pearl, A J

    1981-01-01

    The chronic form of the anterior compartment syndrome can be overlooked if the symptoms of leg pain are attributed to shin splints. Herein is presented a case report which I feel represents an acute exacerbation of the chronic form of anterior compartment syndrome in a long-distance runner secondary to bleeding into the extensor digitorum longus muscle. Chronic anterior compartment syndrome can be a disabling injury which may require a fasciotomy, depending upon the severity and duration of the patient's symptoms and the intracompartmental pressures. The lay term "shin splints" should be separated from medical use, and a more reliable assessment of the etiology of the patient's symptoms should be made. The term shin splints should be utilized only for pain localized to the posterior medial border of the tibia at the origin of the posterior tibialis muscle.

  12. Esthetic crown lengthening for maxillary anterior teeth.

    PubMed

    Sonick, M

    1997-08-01

    In the maxillary anterior region, the gingival labial margin position is an important parameter in the achievement of an ideal smile. The relationship between the periodontium and the restoration is critical if gingival health and esthetics are to be achieved. Periodontal therapy is a necessary and useful adjunct when any anterior restoration is undertaken. Anterior surgical crown lengthening may be undertaken to avoid restorative margin impingement on the biologic width. Crown lengthening is also used to alter the gingival labial profiles. This article discusses the esthetic parameters of ideal gingival labial positions and presents a classification of crown-lengthening procedures and the procedure for a two-stage crown-lengthening technique. The two-stage crown-lengthening technique is surgically precise because healing is predictable.

  13. Tumors of the anterior skull base.

    PubMed

    Ivan, Michael E; Han, Seunggu J; Aghi, Manish K

    2014-04-01

    A variety of histologic tumor types are present in the anterior skull base. Primary tumors of this area may be derived from the bone, paranasal sinuses, nasopharynx, dura, cranial nerves, pituitary gland and brain. Symptoms are caused mostly through mass effect but, if the tumor becomes aggressive, also through invasion. Selection of surgical approaches to the anterior skull base is based upon balancing risk reduction with maximizing extent of resection. Here we review a spectrum of neoplastic entities found in the anterior skull base in adults and discuss clinical and radiographic presentation, treatment options, and outcomes. Surgical resection remains the mainstay in treatment of these tumors, particularly in the hands of experienced surgeons exercising proper patient and case selection. PMID:24564556

  14. Anterior eye development and ocular mesenchyme

    PubMed Central

    Cvekl, Aleš; Tamm, Ernst R.

    2007-01-01

    Summary During development of the anterior eye segment, cells that originate from the surface epithelium or the neuroepithelium need to interact with mesenchymal cells, which predominantly originate from the neural crest. Failures of proper interaction result in a complex of developmental disorders such Peters’ anomaly, Axenfeld-Rieger’s syndrome or aniridia. Here we review the role of transcription factors that have been identified to be involved in the coordination of anterior eye development. Among these factors is PAX6, which is active in both epithelial and mesenchymal cells during ocular development, albeit at different doses and times. We propose that PAX6 is a key element that synchronizes the complex interaction of cell types of different origin, which are all needed for proper morphogenesis of the anterior eye. We discuss several molecular mechanisms that might explain the effects of haploinsufficiency of PAX6 and other transcription factors, and the broad variation of the resulting phenotypes. PMID:15057935

  15. Deep Transverse Lateral Retinaculum Reconstruction for Medial Patellar Instability.

    PubMed

    Sanchis-Alfonso, Vicente; Montesinos-Berry, Erik; Monllau, Joan Carles; Andrish, Jack

    2015-06-01

    Medial patellar instability can be a disabling complication of an extensive lateral retinaculum release. It is often overlooked, and for the diagnosis, it is necessary to have a high index of suspicion. Typically, the patient feels a new pain and new instability after the lateral retinaculum release that are distinct from, and much worse than, those before surgery. All of our patients had significant relief from their pain with "reverse" McConnell taping. If there is a significant improvement in symptoms after this taping and stress radiographs or stress axial computed tomography scans show an objective pathologic medial patellar displacement, reconstruction of the lateral retinaculum should be considered. This article details our technique for reconstruction of the deep transverse layer of the lateral retinaculum using an anterior strip of the iliotibial band. This strip is detached from its insertion onto the Gerdy tubercle and then reflected proximally beyond the level of the lateral femoral epicondyle. Finally, it is attached either by direct suture to the remaining prepatellar and peripatellar retinaculum if there is adequate tissue present or by a suture anchor. PMID:26258038

  16. Device for simulating anterior segment surgery.

    PubMed

    Otto, Clifton S

    2005-07-01

    To provide a more realistic method for practicing anterior segment surgery, a device was designed that incorporates aspects of currently available cadaver globe fixation methods. A Styrofoam head was fitted with a funnel and tubing system that allows for direct application of variable external suction to a globe placed in an artificial socket. Prototypes were tested in a wet lab environment, which demonstrated that this method provides reliable globe fixation and allows for variable control of intraocular pressure during a variety of anterior and posterior segment surgical techniques.

  17. Treatment selection for anterior endodontically involved teeth.

    PubMed

    Rifkin, Robert; McLaren, Ed

    2004-09-01

    Innovations in material science and clinical techniques have expanded the number of treatment options available for nonvital anterior teeth. These options include the use of composite to fill the access opening with no additional treatment, crown placement, orthodontic extrusion, crown lengthening with or without orthodontic extrusion, dowel restorations with crown placement, and fixed bridge or implant therapy when extraction is necessary. Clinicians need to understand the benefits and limitations of each option in order to provide their patients with optimum function and aesthetics. Using case presentations, this article describes predictable approaches for the diagnosis, treatment planning, and restoration or replacement of endodontically treated teeth in the anterior region.

  18. A Numerical Study of Feathering Instability

    NASA Astrophysics Data System (ADS)

    Lee, Wing-Kit; Wang, Hsiang-Hsu

    2016-06-01

    The stability of a spiral shock of self-gravitating, magnetized interstellar medium is studied by performing two-dimensional numerical simulations of a local patch of tight-winding spiral arm. As previously suggested by the linear studies, two types of instabilities are identified, namely, wiggle instability and feathering instability. The former instability occurs in the hydrodynamics limit and results in short wavelength perturbations. On the other hand, the feathering instability requires both self-gravitating and magnetic fields and results in wider structures.

  19. New Instabilities in Line Driven Winds

    NASA Technical Reports Server (NTRS)

    Martens, P. C. H.

    1985-01-01

    The physical mechanisms which potentially lead to instabilities in line driven winds, the drift instability and the line shape instability, are discussed. A general three dimensional treatment of the stability problem of line driven winds which leads to the general dispersion equation is proposed. From this dispersion equation automatically a third physical mechanism driving instability in stellar winds is deduced; the thermal drift instability which is related to changes in absorption of radiation caused by temperature perturbations. This mechanism results in growing inwardly propagating sound waves.

  20. Effect of pressure anisotropy on magnetorotational instability

    SciTech Connect

    Mikhailovskii, A. B.; Lominadze, J. G. Churikov, A. P.; Erokhin, N. N.; Erokhin, N. S.; Tsypin, V. S

    2008-02-15

    It is shown that two new instabilities of hybrid type can occur in a rotating magnetized plasma with anisotropic pressure, i.e., the rotational firehose instability and the rotational mirror instability. In the case of {beta}{sub parallel} > {beta}{sub perpendicular}, where {beta}{sub parallel} and {beta}{sub -perpendicular} are the ratios of the parallel and perpendicular plasma pressure to the magnetic field pressure, the pressure anisotropy tends to suppress both new instabilities; in the case {beta}{sub perpendicular} > {beta}{sub parallel}, it leads to their strengthening. In the latter case, the perturbations considered can be unstable even if the Velikhov instability criterion is not satisfied.

  1. Lumbar instability: an evolving and challenging concept

    PubMed Central

    Beazell, James R; Mullins, Melise; Grindstaff, Terry L

    2010-01-01

    Identification and management of chronic lumbar spine instability is a clinical challenge for manual physical therapists. Chronic lumbar instability is presented as a term that can encompass two types of lumbar instability: mechanical (radiographic) and functional (clinical) instability (FLI). The components of mechanical and FLI are presented relative to the development of a physical therapy diagnosis and management. The purpose of this paper is to review the historical framework of chronic lumbar spine instability from a physical therapy perspective and to summarize current research relative to clinical diagnosis in physical therapy. PMID:21655418

  2. MHD Instabilities at the Heliopause

    SciTech Connect

    Dasgupta, B.; Florinski, V.; Heerikhuisen, J.; Zank, G. P.

    2006-09-26

    The heliopause (HP) is the outer edge of the heliosphere which separates the tenuous and hot heliosheath plasma on one side and the relatively dense and cool magnetized interstellar plasma on the other side. As a surface of tangential discontinuity, the HP is subjected to both Rayleigh-Taylor (RT) and Kelvin-Helmholtz (KH) instabilities. The coupling between plasma ions and neutral atoms through the process of charge exchange provides an ''effective gravity'' at the HP, while a shear flow exists across it. We derive analytically the linearized dispersion relation for waves propagating along the surface of this discontinuity, which represents a combined RT/KH analysis. We investigate both the purely hydrodynamic, as well as magnetohydrodynamic, cases, and find that interstellar and heliospheric magnetic fields can help stabilize the HP for RT and KH-type instabilities.

  3. Granular Rayleigh-Taylor instability

    SciTech Connect

    Vinningland, Jan Ludvig; Johnsen, Oistein; Flekkoey, Eirik G.; Maaloey, Knut Joergen; Toussaint, Renaud

    2009-06-18

    A granular instability driven by gravity is studied experimentally and numerically. The instability arises as grains fall in a closed Hele-Shaw cell where a layer of dense granular material is positioned above a layer of air. The initially flat front defined by the grains subsequently develops into a pattern of falling granular fingers separated by rising bubbles of air. A transient coarsening of the front is observed right from the start by a finger merging process. The coarsening is later stabilized by new fingers growing from the center of the rising bubbles. The structures are quantified by means of Fourier analysis and quantitative agreement between experiment and computation is shown. This analysis also reveals scale invariance of the flow structures under overall change of spatial scale.

  4. Instability of supersymmetric microstate geometries

    NASA Astrophysics Data System (ADS)

    Eperon, Felicity C.; Reall, Harvey S.; Santos, Jorge E.

    2016-10-01

    We investigate the classical stability of supersymmetric, asymptotically flat, microstate geometries with five non-compact dimensions. Such geometries admit an "evanescent ergosurface": a timelike hypersurface of infinite redshift. On such a surface, there are null geodesics with zero energy relative to infinity. These geodesics are stably trapped in the potential well near the ergosurface. We present a heuristic argument indicating that this feature is likely to lead to a nonlinear instability of these solutions. We argue that the precursor of such an instability can be seen in the behaviour of linear perturbations: nonlinear stability would require that all linear perturbations decay sufficiently rapidly but the stable trapping implies that some linear perturbation decay very slowly. We study this in detail for the most symmetric microstate geometries. By constructing quasinormal modes of these geometries we show that generic linear perturbations decay slower than any inverse power of time.

  5. A cosmic ray driven instability

    NASA Technical Reports Server (NTRS)

    Dorfi, E. A.; Drury, L. O.

    1985-01-01

    The interaction between energetic charged particles and thermal plasma which forms the basis of diffusive shock acceleration leads also to interesting dynamical phenomena. For a compressional mode propagating in a system with homogeneous energetic particle pressure it is well known that friction with the energetic particles leads to damping. The linear theory of this effect has been analyzed in detail by Ptuskin. Not so obvious is that a non-uniform energetic particle pressure can addition amplify compressional disturbances. If the pressure gradient is sufficiently steep this growth can dominate the frictional damping and lead to an instability. It is important to not that this effect results from the collective nature of the interaction between the energetic particles and the gas and is not connected with the Parker instability, nor with the resonant amplification of Alfven waves.

  6. Feedback control of resistive instabilities

    SciTech Connect

    White, R.B.; Rutherford, P.H.; Furth, H.P.; Park, W.; Chen, L.

    1985-12-01

    Resistive instabilities are responsible for much of the global behavior and the determination of the possible domains of operation of tokamaks. Their successful control could have definite advantages, even making available new regimes of operation. Elimination of sawtoothing might allow operation with higher currents and more peaked current profiles, with q on axis well below unity. In this work different feedback schemes are explored. Simple analytical derivations of the effects of local heating and current drive feedback are presented. Although control of modes with m greater than or equal to 2 is fairly straightforward, the control of the m = 1 mode is more difficult because of its proximity to ideal instability. The most promising scheme utilizes high energy trapped particles. 20 refs., 3 figs.

  7. Combustion instability modeling and analysis

    SciTech Connect

    Santoro, R.J.; Yang, V.; Santavicca, D.A.; Sheppard, E.J.

    1995-12-31

    It is well known that the two key elements for achieving low emissions and high performance in a gas turbine combustor are to simultaneously establish (1) a lean combustion zone for maintaining low NO{sub x} emissions and (2) rapid mixing for good ignition and flame stability. However, these requirements, when coupled with the short combustor lengths used to limit the residence time for NO formation typical of advanced gas turbine combustors, can lead to problems regarding unburned hydrocarbons (UHC) and carbon monoxide (CO) emissions, as well as the occurrence of combustion instabilities. The concurrent development of suitable analytical and numerical models that are validated with experimental studies is important for achieving this objective. A major benefit of the present research will be to provide for the first time an experimentally verified model of emissions and performance of gas turbine combustors. The present study represents a coordinated effort between industry, government and academia to investigate gas turbine combustion dynamics. Specific study areas include development of advanced diagnostics, definition of controlling phenomena, advancement of analytical and numerical modeling capabilities, and assessment of the current status of our ability to apply these tools to practical gas turbine combustors. The present work involves four tasks which address, respectively, (1) the development of a fiber-optic probe for fuel-air ratio measurements, (2) the study of combustion instability using laser-based diagnostics in a high pressure, high temperature flow reactor, (3) the development of analytical and numerical modeling capabilities for describing combustion instability which will be validated against experimental data, and (4) the preparation of a literature survey and establishment of a data base on practical experience with combustion instability.

  8. Secular instability of Saturn's rings.

    NASA Astrophysics Data System (ADS)

    Griv, E.; Chiueh, T.

    1996-07-01

    Kinetic theory with the Boltzmann and Poisson's equations is used to determine the stability and oscillations of the two-dimensional collisional system of identical particles of Saturn's rings. The effects of physical collisions between particles are taken into account by using in the Bolztmann kinetic equation a phenomenological Bhatnagar-Gross-Krook collisional integral (Bhatnagar et al. 1954). This model collisional integral was modified following Shu & Stewart (1985) to allow collisions to be inelastic. The dynamics of a system with rare collisions is considered, that is, {OMEGA}^2^>>ν_c_^2^, with {OMEGA} being the orbital angular frequency and ν_c_ the collision frequency. It is shown that in a Jeans-stable system the simultaneous action of self-gravity and collisions leads to a secular dissipative type instability. It is also shown that generally the growth rate of this aperiodic instability is small, Im ω_*_~ν_c_. However, in the marginally Jeans-stable gravitationally parts of the disk, the growth rate is a maximum, and may become a large, Im ω_*_=~(ν_cOMEGA^2^)^1/3^>>ν_c_. In such parts of the Saturn's system the instability will develop on the time scale only of several revolutions even at moderately low values of the local optical depth, τ=~ν_c_/{OMEGA}~0.1. The radial wavelength of the most unstable oscillations is of the order λ=~2πρ, where ρ=~c/{OMEGA} is the epicyclic radius and c is the mean dispersion of random velocities of particles. The secular instability may be suggested as the cause of much of the irregular, narrow ~2πρ~100m structure in low optical depth regions of Saturn's rings. Cassini spacecraft high-resolution images may resolve such hyperfine structure in the C ring, the inner B ring and the A ring.

  9. Microphysics of Cosmic Ray Driven Plasma Instabilities

    NASA Astrophysics Data System (ADS)

    Bykov, A. M.; Brandenburg, A.; Malkov, M. A.; Osipov, S. M.

    2013-10-01

    Energetic nonthermal particles (cosmic rays, CRs) are accelerated in supernova remnants, relativistic jets and other astrophysical objects. The CR energy density is typically comparable with that of the thermal components and magnetic fields. In this review we discuss mechanisms of magnetic field amplification due to instabilities induced by CRs. We derive CR kinetic and magnetohydrodynamic equations that govern cosmic plasma systems comprising the thermal background plasma, comic rays and fluctuating magnetic fields to study CR-driven instabilities. Both resonant and non-resonant instabilities are reviewed, including the Bell short-wavelength instability, and the firehose instability. Special attention is paid to the longwavelength instabilities driven by the CR current and pressure gradient. The helicity production by the CR current-driven instabilities is discussed in connection with the dynamo mechanisms of cosmic magnetic field amplification.

  10. Microphysics of Cosmic Ray Driven Plasma Instabilities

    NASA Astrophysics Data System (ADS)

    Bykov, A. M.; Brandenburg, A.; Malkov, M. A.; Osipov, S. M.

    Energetic nonthermal particles (cosmic rays, CRs) are accelerated in supernova remnants, relativistic jets and other astrophysical objects. The CR energy density is typically comparable with that of the thermal components and magnetic fields. In this review we discuss mechanisms of magnetic field amplification due to instabilities induced by CRs. We derive CR kinetic and magnetohydrodynamic equations that govern cosmic plasma systems comprising the thermal background plasma, comic rays and fluctuating magnetic fields to study CR-driven instabilities. Both resonant and non-resonant instabilities are reviewed, including the Bell short-wavelength instability, and the firehose instability. Special attention is paid to the longwavelength instabilities driven by the CR current and pressure gradient. The helicity production by the CR current-driven instabilities is discussed in connection with the dynamo mechanisms of cosmic magnetic field amplification.

  11. Migrational Instabilities in Particle Suspensions

    NASA Technical Reports Server (NTRS)

    Goddard, Joe D.

    1996-01-01

    This work deals with an instability arising from the shear-induced migration of particles in dense suspensions coupled with a dependence of viscosity on particle concentration. The analysis summarized here treats the inertialess (Re = O) linear stability of homogeneous simple shear flows for a Stokesian suspension model of the type proposed by Leighton and Acrivos (1987). Depending on the importance of shear-induced migration relative to concentration-driven diffusion, this model admits short-wave instability arising from wave-vector stretching by the base flow and evolving into particle-depleted shear bands. Moreover, this instability in the time-dependent problem corresponds to loss of ellipticity in the associated static problem (Re = O, Pe = O). While the isotropic version of the Leighton-Acrivos model is found to be stable with their experimentally determined parameters for simple shear, it is known that the stable model does not give a good quantitative description of particle clustering in the core of pipe flow (Nott and Brady 1994). This leads to the conjecture that an appropriate variant on the above model could explain such clustering as a two-phase bifurcation in the base flow.

  12. Hopf bifurcation and plasma instabilities

    SciTech Connect

    Crawford, J.D.

    1983-01-01

    In this research, center manifold theory and the theory of normal forms are applied to examples of Hopf bifurcation in two models of plasma dynamics. A finite dimensional model of a 3-wave system with quadratic nonlinearities provides a simple example of both supercritical and subcritical Hopf bifurcation. In the second model, the electrostatic instabilities of a collisional plasma correspond to Hopf bifurcations. In this problem, the Vlasov-Poisson equations with a Krook collision term describe the electron dynamics in a weakly ionized gas. The one mode in instability is analyzed in detail; near criticality it always saturates in a small amplitude nonlinear oscillation. The theory of the center manifold accomplishes two things. First, it establishes that the dynamics of a finite mode instability is always of a finite dimensional character, even when the equations of motion are partial differential equations. Secondly, it provides practical methods for deriving the relevant reduced set of equations that describe the transition. Thus the center manifold methods provide a geometric and rigorous basis for the reduction in dimension which characterizes classical amplitude expansions.

  13. Non-linear mirror instability

    NASA Astrophysics Data System (ADS)

    Rincon, F.; Schekochihin, A. A.; Cowley, S. C.

    2015-02-01

    Slow dynamical changes in magnetic-field strength and invariance of the particles' magnetic moments generate ubiquitous pressure anisotropies in weakly collisional, magnetized astrophysical plasmas. This renders them unstable to fast, small-scale mirror and firehose instabilities, which are capable of exerting feedback on the macroscale dynamics of the system. By way of a new asymptotic theory of the early non-linear evolution of the mirror instability in a plasma subject to slow shearing or compression, we show that the instability does not saturate quasi-linearly at a steady, low-amplitude level. Instead, the trapping of particles in small-scale mirrors leads to non-linear secular growth of magnetic perturbations, δB/B ∝ t2/3. Our theory explains recent collisionless simulation results, provides a prediction of the mirror evolution in weakly collisional plasmas and establishes a foundation for a theory of non-linear mirror dynamics with trapping, valid up to δB/B = O(1).

  14. Anterior Cervical Spine Surgery for Degenerative Disease: A Review

    PubMed Central

    SUGAWARA, Taku

    Anterior cervical spine surgery is an established surgical intervention for cervical degenerative disease and high success rate with excellent long-term outcomes have been reported. However, indications of surgical procedures for certain conditions are still controversial and severe complications to cause neurological dysfunction or deaths may occur. This review is focused mainly on five widely performed procedures by anterior approach for cervical degenerative disease; anterior cervical discectomy, anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, anterior cervical foraminotomy, and arthroplasty. Indications, procedures, outcomes, and complications of these surgeries are discussed. PMID:26119899

  15. Low anterior resection without defunctioning stoma.

    PubMed

    Kanellos, I; Zacharakis, E; Christoforidis, E; Demetriades, H; Betsis, D

    2002-12-01

    The aim of our study was to determine the anastomotic leakage rate after the performance of low anterior resection without protective stoma. During the time period from 1989 to 2001, 82 consecutive patients underwent low anterior resection for rectal carcinoma without protective stoma. Thirteen anastomoses were hand sewn (15.8%) and the remaining 69 (84.2%) were constructed with the use of a circular stapling gun. The mean distance of the anastomoses from the anal margin was 6.2 cm (range, 3-9 cm). None of the 82 low anterior resections was covered by a defunctioning stoma. Clinical anastomotic leakage occurred in 4 patients (4.9%) and 4 other patients presented radiologically detected leakage (4.9%). No death occurred in the 8 patients that presented anastomotic dehiscence. Non-specific complications were detected in 11 (13.4%) of 82 patients. In conclusion, the low leakage rate of the anastomoses in our patients allows us to recommend low anterior resection without defunctioning stoma.

  16. 38 CFR 3.379 - Anterior poliomyelitis.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it is... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Anterior poliomyelitis. 3.379 Section 3.379 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  17. 38 CFR 3.379 - Anterior poliomyelitis.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it is... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Anterior poliomyelitis. 3.379 Section 3.379 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  18. 38 CFR 3.379 - Anterior poliomyelitis.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it is... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Anterior poliomyelitis. 3.379 Section 3.379 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  19. Anterior Chamber Live Loa loa: Case Report.

    PubMed

    Kagmeni, G; Cheuteu, R; Bilong, Y; Wiedemann, P

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  20. Anterior Chamber Live Loa loa: Case Report

    PubMed Central

    Kagmeni, G.; Cheuteu, R.; Bilong, Y.; Wiedemann, P.

    2016-01-01

    We reported a case of unusual intraocular Loa loa in a 27-year-old patient who presented with painful red eye. Biomicroscopy revealed a living and active adult worm in the anterior chamber of the right eye. After surgical extraction under local anesthesia, parasitological identification confirmed L. loa filariasis. PMID:27441005

  1. Causes of anterior cruciate ligament injuries.

    PubMed

    Ristić, Vladimir; Ninković, Srdan; Harhaji, Vladimir; Milankov, Miroslav

    2010-01-01

    In order to prevent anterior cruciate ligament injuries it is necessary to define risk factors and to analyze the most frequent causes of injuries--that being the aim of this study. The study sample consisted of 451 surgically treated patients, including 400 sportsmen (65% of them being active and 35% recreational sportsmen), 29% female and 71% male; of whom 90% were younger than 35. Sports injuries, as the most frequent cause of anterior cruciate ligament injuries, were recorded in 88% of patients (non-contact ones in 78% and contact ones in 22%), injuries occurring in everyday activities in 11% and in traffic in 1%. Among sportsmen, reconstruction of the anterior cruciate ligament was most frequently performed in football players (48%), then in handball players (22%), basketball players (13%), volleyball players (8%), martial arts fighters (4%). However, the injury incidence was the highest among the active basketball players (1 injured among 91 active players). Type of footwear, warming up before the activity, genetic predisposition and everyday therapy did not have a significant influence on getting injured. Anterior cruciate ligament injuries happened three times more often during matches, in the middle and at the end of a match and training session (79%), at landing after the jump or when changing direction of movement (75%) without a contact with other competitors, on dry surfaces (79%), among not so well prepared sportsmen.

  2. Effects of balance training by knee joint motions on muscle activity in adult men with functional ankle instability

    PubMed Central

    Nam, Seung-min; Kim, Won-bok; Yun, Chang-kyo

    2016-01-01

    [Purpose] This study examined the effects of balance training by applying knee joint movements on muscle activity in male adults with functional ankle instability. [Subjects and Methods] 28 adults with functional ankle instability, divided randomly into an experimental group, which performed balance training by applying knee joint movements for 20 minutes and ankle joint exercises for 10 minutes, and a control group, which performed ankle joint exercise for 30 minutes. Exercises were completed three times a week for 8 weeks. Electromyographic values of the tibialis anterior, peroneus longus, peroneus brevis, and the lateral gastrocnemius muscles were obtained to compare and analyze muscle activity before and after the experiments in each group. [Results] The experimental group had significant increases in muscle activity in the tibialis anterior, peroneus longus, and lateral gastrocnemius muscles, while muscle activity in the peroneus brevis increased without significance. The control group had significant increases in muscle activity in the tibialis anterior and peroneus longus, while muscle activity in the peroneus brevis and lateral gastrocnemius muscles increased without significance. [Conclusion] In conclusion, balance training by applying knee joint movements can be recommended as a treatment method for patients with functional ankle instability. PMID:27313386

  3. Modes of storage ring coherent instabilities

    SciTech Connect

    Wang, J.M.

    1986-12-01

    Longitudinal impedance in a beam and various modes of longitudinal coherent instabilities are discussed. The coasting beam coherent instability, microwave instability, and single-bunch longitudinal coherent instabilities are considered. The Vlasov equation is formulated, and a method of solving it is developed. The synchrotron modes are treated, which take the possible bunch shape distortion fully into consideration. A method of treating the synchrotron mode coupling in the case of a small bunch is discussed which takes advantage of the fact that only a few of the synchrotron modes can contribute in such a case. The effect of many bunches on the coherent motion of the beam and the longitudinal symmetric coupled bunch modes are discussed. The transverse impedance is then introduced, and the transverse coasting beam instability is discussed. Various bunched beam instabilities are discussed, including both single bunch instabilities and coupled bunch instabilities. The Vlasov equation for transverse as well as longitudinal motion of particles is introduced as well as a method of solving it within a linear approximation. Head-tail modes and short bunch instabilities and strong coupling instabilities in the long bunch case are covered. (LEW)

  4. Microscale instabilities in stream interaction regions

    NASA Technical Reports Server (NTRS)

    Eviatar, A.; Goldstein, M. L.

    1979-01-01

    The microstructure of solar wind stream interaction regions is considered theoretically with emphasis on the role of several electrostatic kinetic instabilities which may be important within the stream interface and the compression region. Inside of 1 AU, the interface is likely to be stable against the electrostatic streaming instabilities considered. Between 1 and 2 AU, the interface will excite the magnetized ion-ion instability. The compression region is also found to be unstable beyond 1 AU where the modified two-stream instability, beam-cyclotron instability, and ion-acoustic instability are important in determining the structure of the compressive pulses as they evolve into forward and reverse shocks. It is concluded that the modified two-stream instability and beam-cyclotron instability predominately play a role in heating the electrons to the threshold for the ion-acoustic instability. Various electrostatic plasma waves, ranging in frequency from the lower-hybrid to harmonics of the electron cyclotron frequency, would be produced by these instabilities. Their signature should also be seen by high time resolution measurements of the temperature of the various plasma species.

  5. Current approach in diagnosis and management of anterior uveitis

    PubMed Central

    Agrawal, Rupesh V; Murthy, Somasheila; Sangwan, Virender; Biswas, Jyotirmay

    2010-01-01

    Uveitis is composed of a diverse group of disease entities, which in total has been estimated to cause approximately 10% of blindness. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis based on the anatomical involvement of the eye. Anterior uveitis is, however, the commonest form of uveitis with varying incidences reported in worldwide literature. Anterior uveitis can be very benign to present with but often can lead to severe morbidity if not treated appropriately. The present article will assist ophthalmologists in accurately diagnosing anterior uveitis, improving the quality of care rendered to patients with anterior uveitis, minimizing the adverse effects of anterior uveitis, developing a decision-making strategy for management of patients at risk of permanent visual loss from anterior uveitis, informing and educating patients and other healthcare practitioners about the visual complications, risk factors, and treatment options associated with anterior uveitis. PMID:20029142

  6. Convergent instability in the ionosphere

    SciTech Connect

    Ponyatov, A.A.

    1994-04-01

    A linear theory of the convergent instability (CI) of ionospheric plasma associated with the nonuniform nature of its regular motion is examined. The conditions under which CI appears in the E- and F-layers for vertical ion motion caused by various physical factors are analyzed. The possibility of small-scale strongly geomagnetic-field-aligned nonuniformities of electron concentration (l{sub min} {approximately} 10-30 m) is demonstrated. The altitude dependence of collision frequency is shown to play a large role in CI.

  7. Convective Instabilities in Liquid Foams

    NASA Technical Reports Server (NTRS)

    Veretennikov, Igor; Glazier, James A.

    2004-01-01

    The main goal of this work is to better understand foam behavior both on the Earth and in microgravity conditions and to determine the relation between a foam's structure and wetness and its rheological properties. Our experiments focused on the effects of the bubble size distribution (BSD) on the foam behavior under gradual or stepwise in the liquid flow rate and on the onset of the convective instability. We were able to show experimentally, that the BSD affects foam rheology very strongly so any theory must take foam texture into account.

  8. Dynamic Instability of Barlike Modes

    NASA Astrophysics Data System (ADS)

    Durisen, Richard H.; Pickett, Brian K.; Bate, Matthew R.; Imamura, James N.; Brandl, Andreas; Sterzik, Michael F.

    Numerical simulations during the 1980's established that prompt binary formation (or ``fission'') through dynamic growth of barlike modes is aborted by gravitational torques. Because these instabilities may occur during star formation and because their outcome over long times is still uncertain, we have combined various linear analyses with simulations by hydrodynamics codes to refine our understanding. We show that it is in fact the torques which cause nonlinear saturation of the mode amplitude. Excellent agreement for the early nonlinear phase is obtained using radically different hydrodynamics codes. However, the ultimate outcome is sensitive to assumptions about dissipative heating and is also somewhat code-dependent.

  9. Ergoregion instability: The hydrodynamic vortex

    NASA Astrophysics Data System (ADS)

    Oliveira, Leandro A.; Cardoso, Vitor; Crispino, Luís C. B.

    2014-06-01

    Four-dimensional, asymptotically flat spacetimes with an ergoregion but no horizon have been shown to be linearly unstable against a superradiant-triggered mechanism. This result has wide implications in the search for astrophysically viable alternatives to black holes, but also in the understanding of black holes and Hawking evaporation. Here we investigate this instability in detail for a particular setup that can be realized in the laboratory: the hydrodynamic vortex, an effective geometry for sound waves, with ergoregion and without an event horizon.

  10. Sheet Beam Klystron Instability Analysis

    SciTech Connect

    Bane, K.L.F.; Jensen, A.; Li, Z.; Stupakov, G.; Adolphsen, C.; /SLAC

    2009-05-08

    Using the principle of energy balance we develop a 2D theory for calculating growth rates of instability in a two-cavity model of a sheet beam klystron. An important ingredient is a TE-like mode in the gap that also gives a longitudinal kick to the beam. When compared with a self-consistent particle-in-cell calculation, with sheet beam klystron-type parameters, agreement is quite good up to half the design current, 65 A; at full current, however, other, current-dependent effects come in and the results deviate significantly.

  11. Arthroscopic Repair of Ankle Instability.

    PubMed

    Sorensen, Matthew D; Baca, John; Arbuckle, Keith

    2016-10-01

    Arthroscopic lateral ankle stabilization procedures have been described for many years. New technological advances and a deeper understanding of the pathobiomechanics involved in chronic lateral ankle instability have allowed an expansion of arthroscopic approaches to this common pathology. As experience is gained and outcomes within the patient profile are understood, the authors feel that the arthroscopic approach to lateral ankle stabilization may prove superior to traditional methods secondary to the risk and traditional complications that are mitigated within minimally invasive arthroscopic approaches. Additionally, the arthroscopic approach may allow a quicker return to ballistic sport and decrease time for rehabilitation. PMID:27599440

  12. Acceleration-based joint stability parameters for total knee arthroplasty that correspond with patient-reported instability.

    PubMed

    Roberts, Dustyn; Khan, Humera; Kim, Joo H; Slover, James; Walker, Peter S

    2013-10-01

    There is no universally accepted definition of human joint stability, particularly in nonperiodic general activities of daily living. Instability has proven to be a difficult parameter to define and quantify, since both spatial and temporal measures need to be considered to fully characterize joint stability. In this preliminary study, acceleration-based parameters were proposed to characterize the joint stability. Several time-statistical parameters of acceleration and jerk were defined as potential stability measures, since anomalous acceleration or jerk could be a symptom of poor control or stability. An inertial measurement unit attached at the level of the tibial tubercle of controls and patients following total knee arthroplasty was used to determine linear acceleration of the knee joint during several activities of daily living. The resulting accelerations and jerks were compared with patient-reported instability as determined through a standard questionnaire. Several parameters based on accelerations and jerks in the anterior/posterior direction during the step-up/step-down activity were significantly different between patients and controls and correlated with patient reports of instability in that activity. The range of the positive to negative peak acceleration and infinity norm of acceleration, in the anterior/posterior direction during the step-up/step-down activity, proved to be the best indicators of instability. As time derivatives of displacement, these acceleration-based parameters represent spatial and temporal information and are an important step forward in developing a definition and objective quantification of human joint stability that can complement the subjective patient report.

  13. Mode-locking via dissipative Faraday instability

    PubMed Central

    Tarasov, Nikita; Perego, Auro M.; Churkin, Dmitry V.; Staliunas, Kestutis; Turitsyn, Sergei K.

    2016-01-01

    Emergence of coherent structures and patterns at the nonlinear stage of modulation instability of a uniform state is an inherent feature of many biological, physical and engineering systems. There are several well-studied classical modulation instabilities, such as Benjamin–Feir, Turing and Faraday instability, which play a critical role in the self-organization of energy and matter in non-equilibrium physical, chemical and biological systems. Here we experimentally demonstrate the dissipative Faraday instability induced by spatially periodic zig-zag modulation of a dissipative parameter of the system—spectrally dependent losses—achieving generation of temporal patterns and high-harmonic mode-locking in a fibre laser. We demonstrate features of this instability that distinguish it from both the Benjamin–Feir and the purely dispersive Faraday instability. Our results open the possibilities for new designs of mode-locked lasers and can be extended to other fields of physics and engineering. PMID:27503708

  14. Mode-locking via dissipative Faraday instability

    NASA Astrophysics Data System (ADS)

    Tarasov, Nikita; Perego, Auro M.; Churkin, Dmitry V.; Staliunas, Kestutis; Turitsyn, Sergei K.

    2016-08-01

    Emergence of coherent structures and patterns at the nonlinear stage of modulation instability of a uniform state is an inherent feature of many biological, physical and engineering systems. There are several well-studied classical modulation instabilities, such as Benjamin-Feir, Turing and Faraday instability, which play a critical role in the self-organization of energy and matter in non-equilibrium physical, chemical and biological systems. Here we experimentally demonstrate the dissipative Faraday instability induced by spatially periodic zig-zag modulation of a dissipative parameter of the system--spectrally dependent losses--achieving generation of temporal patterns and high-harmonic mode-locking in a fibre laser. We demonstrate features of this instability that distinguish it from both the Benjamin-Feir and the purely dispersive Faraday instability. Our results open the possibilities for new designs of mode-locked lasers and can be extended to other fields of physics and engineering.

  15. Absolute instability of the Gaussian wake profile

    NASA Technical Reports Server (NTRS)

    Hultgren, Lennart S.; Aggarwal, Arun K.

    1987-01-01

    Linear parallel-flow stability theory has been used to investigate the effect of viscosity on the local absolute instability of a family of wake profiles with a Gaussian velocity distribution. The type of local instability, i.e., convective or absolute, is determined by the location of a branch-point singularity with zero group velocity of the complex dispersion relation for the instability waves. The effects of viscosity were found to be weak for values of the wake Reynolds number, based on the center-line velocity defect and the wake half-width, larger than about 400. Absolute instability occurs only for sufficiently large values of the center-line wake defect. The critical value of this parameter increases with decreasing wake Reynolds number, thereby indicating a shrinking region of absolute instability with decreasing wake Reynolds number. If backflow is not allowed, absolute instability does not occur for wake Reynolds numbers smaller than about 38.

  16. Mode-locking via dissipative Faraday instability.

    PubMed

    Tarasov, Nikita; Perego, Auro M; Churkin, Dmitry V; Staliunas, Kestutis; Turitsyn, Sergei K

    2016-01-01

    Emergence of coherent structures and patterns at the nonlinear stage of modulation instability of a uniform state is an inherent feature of many biological, physical and engineering systems. There are several well-studied classical modulation instabilities, such as Benjamin-Feir, Turing and Faraday instability, which play a critical role in the self-organization of energy and matter in non-equilibrium physical, chemical and biological systems. Here we experimentally demonstrate the dissipative Faraday instability induced by spatially periodic zig-zag modulation of a dissipative parameter of the system-spectrally dependent losses-achieving generation of temporal patterns and high-harmonic mode-locking in a fibre laser. We demonstrate features of this instability that distinguish it from both the Benjamin-Feir and the purely dispersive Faraday instability. Our results open the possibilities for new designs of mode-locked lasers and can be extended to other fields of physics and engineering. PMID:27503708

  17. Transverse Instabilities in the Fermilab Recycler

    SciTech Connect

    Prost, L.R.; Burov, A.; Shemyakin, A.; Bhat, C.M.; Crisp, J.; Eddy, N.; /Fermilab

    2011-07-01

    Transverse instabilities of the antiproton beam have been observed in the Recycler ring soon after its commissioning. After installation of transverse dampers, the threshold for the instability limit increased significantly but the instability is still found to limit the brightness of the antiprotons extracted from the Recycler for Tevatron shots. In this paper, we describe observations of the instabilities during the extraction process as well as during dedicated studies. The measured instability threshold phase density agrees with the prediction of the rigid beam model within a factor of 2. Also, we conclude that the instability threshold can be significantly lowered for a bunch contained in a narrow and shallow potential well due to effective exclusion of the longitudinal tails from Landau damping.

  18. Anterolateral Extra-articular Soft Tissue Reconstruction in Anterolateral Rotatory Instability of the Knee.

    PubMed

    Kernkamp, Willem A; van de Velde, Samuel K; Bakker, Eric W P; van Arkel, Ewoud R A

    2015-12-01

    Anterolateral rotatory instability (ALRI) occurs after injury to the anterior cruciate ligament (ACL) and the anterolateral structures of the knee. We present a technique for anterolateral extra-articular soft-tissue (ALES) reconstruction of the knee that can be used in revision ACL reconstruction cases, cases of persistent ALRI after adequate ACL reconstruction, and cases with severe ALRI after primary ACL rupture. The surgeon performs ALES reconstruction with a strip of iliotibial tract autograft while respecting the anatomic origin and insertion of the anterolateral ligament. The purpose of this reconstruction is to restore the normal anterolateral rotatory stability of the knee in ALES-deficient patients. PMID:27284525

  19. Observation of Parametric Instability in Advanced LIGO.

    PubMed

    Evans, Matthew; Gras, Slawek; Fritschel, Peter; Miller, John; Barsotti, Lisa; Martynov, Denis; Brooks, Aidan; Coyne, Dennis; Abbott, Rich; Adhikari, Rana X; Arai, Koji; Bork, Rolf; Kells, Bill; Rollins, Jameson; Smith-Lefebvre, Nicolas; Vajente, Gabriele; Yamamoto, Hiroaki; Adams, Carl; Aston, Stuart; Betzweiser, Joseph; Frolov, Valera; Mullavey, Adam; Pele, Arnaud; Romie, Janeen; Thomas, Michael; Thorne, Keith; Dwyer, Sheila; Izumi, Kiwamu; Kawabe, Keita; Sigg, Daniel; Derosa, Ryan; Effler, Anamaria; Kokeyama, Keiko; Ballmer, Stefan; Massinger, Thomas J; Staley, Alexa; Heinze, Matthew; Mueller, Chris; Grote, Hartmut; Ward, Robert; King, Eleanor; Blair, David; Ju, Li; Zhao, Chunnong

    2015-04-24

    Parametric instabilities have long been studied as a potentially limiting effect in high-power interferometric gravitational wave detectors. Until now, however, these instabilities have never been observed in a kilometer-scale interferometer. In this Letter, we describe the first observation of parametric instability in a gravitational wave detector, and the means by which it has been removed as a barrier to progress. PMID:25955042

  20. Observations of the PSR transverse instability

    SciTech Connect

    Colton, E. ); Fitzgerald, D.; Hardek, T.; Macek, R.J.; Plum, M.A.; Thiessen, H.A.; Wang, T.S. ); Neuffer, D. )

    1991-01-01

    A fast instability with beam loss is observed in the Los Alamos Proton Storage Ring (PSR) when the injected beam current exceeds thresholds, with both bunched and unbunched beams. Large coherent transverse oscillations occur before and during beam loss. Recent observations of the instability indicate that it is an e-p''-type instability, driven by coupled oscillations due to electrons trapped within the proton beam. 5 refs., 3 figs.

  1. Filamentation instability in a quantum magnetized plasma

    SciTech Connect

    Bret, A.

    2008-02-15

    The filamentation instability occurring when a nonrelativistic electron beam passes through a quantum magnetized plasma is investigated by means of a cold quantum magnetohydrodynamic model. It is proved that the instability can be completely suppressed by quantum effects if and only if a finite magnetic field is present. A dimensionless parameter is identified that measures the strength of quantum effects. Strong quantum effects allow for a much smaller magnetic field to suppress the instability than in the classical regime.

  2. Surgical treatment of anterior cruciate ligament injury in adults.

    PubMed

    Alazzawi, Sulaiman; Sukeik, Mohamed; Ibrahim, Mazin; Haddad, Fares S

    2016-04-01

    Anterior cruciate ligament injury is among the most common soft tissue injuries of the knee joint and reconstruction of the anterior cruciate ligament is the gold standard treatment for young active symptomatic patients. This review summarizes the surgical treatment of anterior cruciate ligament injury.

  3. Two-Fluid Interface Instability Being Studied

    NASA Technical Reports Server (NTRS)

    Niederhaus, Charles E.

    2003-01-01

    The interface between two fluids of different density can experience instability when gravity acts normal to the surface. The relatively well known Rayleigh-Taylor (RT) instability results when the gravity is constant with a heavy fluid over a light fluid. An impulsive acceleration applied to the fluids results in the Richtmyer-Meshkov (RM) instability. The RM instability occurs regardless of the relative orientation of the heavy and light fluids. In many systems, the passing of a shock wave through the interface provides the impulsive acceleration. Both the RT and RM instabilities result in mixing at the interface. These instabilities arise in a diverse array of circumstances, including supernovas, oceans, supersonic combustion, and inertial confinement fusion (ICF). The area with the greatest current interest in RT and RM instabilities is ICF, which is an attempt to produce fusion energy for nuclear reactors from BB-sized pellets of deuterium and tritium. In the ICF experiments conducted so far, RM and RT instabilities have prevented the generation of net-positive energy. The $4 billion National Ignition Facility at Lawrence Livermore National Laboratory is being constructed to study these instabilities and to attempt to achieve net-positive yield in an ICF experiment.

  4. Phase space evolution in linear instabilities

    SciTech Connect

    Pantellini, F.G.E.; Burgess, D.; Schwartz, S.J. )

    1994-12-01

    A simple and powerful way to investigate the linear evolution of particle distribution functions in kinetic instabilities in a homogeneous collisionless plasma is presented. The method can be applied to any kind of instability, provided the characteristics (growth rate, frequency, wave vector, and polarization) of the mode are known and can also be used to estimate the amplitude of the waves at the end of the linear phase of growth. Two didactic examples are used to illustrate the versatility of the technique: the Alfven Ion Cyclotron (AIC) instability, which is electromagnetic, and the Electron Ion Cyclotron (EIC) instability, which is electrostatic.

  5. Two-Beam Instability in Electron Cooling

    SciTech Connect

    Burov, Alexey V.; /Fermilab

    2006-04-01

    The drift motion of cooling electrons makes them able to respond to transverse perturbations of a cooled ion beam. This response may lead to dipole or quadrupole transverse instabilities at specific longitudinal wave numbers. While the dipole instabilities can be suppressed by a combination of the Landau damping, machine impedance, and the active damper, the quadrupole and higher order modes can lead to either emittance growth, or a lifetime degradation, or both. The growth rates of these instabilities are strongly determined by the machine x-y coupling. Thus, tuning out of the coupling resonance and/or reduction of the machine coupling can be an efficient remedy for these instabilities.

  6. [Cervical spine instability in the surgical patient].

    PubMed

    Barbeito, A; Guerri-Guttenberg, R A

    2014-03-01

    Many congenital and acquired diseases, including trauma, may result in cervical spine instability. Given that airway management is closely related to the movement of the cervical spine, it is important that the anesthesiologist has detailed knowledge of the anatomy, the mechanisms of cervical spine instability, and of the effects that the different airway maneuvers have on the cervical spine. We first review the normal anatomy and biomechanics of the cervical spine in the context of airway management and the concept of cervical spine instability. In the second part, we review the protocols for the management of cervical spine instability in trauma victims and some of the airway management options for these patients.

  7. Higgs instability in gapless superfluidity/superconductivity

    SciTech Connect

    Giannakis, Ioannis; Hou Defu; Huang Mei; Ren Haicang

    2007-01-01

    In this letter we explore the Higgs instability in the gapless superfluid/superconducting phase. This is in addition to the (chromo)magnetic instability that is related to the fluctuations of the Nambu-Goldstone bosonic fields. While the latter may induce a single-plane-wave Larkin-Ovchinnikov-Fulde-Ferrel state, the Higgs instability favors spatial inhomogeneity. In the case of the 2-flavor color superconductivity state the Higgs instability can only be partially removed by the electric Coulomb energy. But this does not exclude the possibility that it can be completely removed in other exotic states such as the gapless color-flavor locked state.

  8. Internet worms and global routing instabilities

    NASA Astrophysics Data System (ADS)

    Cowie, James; Ogielski, Andy T.; Premore, B. J.; Yuan, Yougu

    2002-07-01

    We analyze the global BGP routing instabilities observed during the Code Red II and Nimda worm attacks in July and September 2001, respectively. Compelling analysis is shown on the correlation between the observed instabilities and the worm attacks. We analyze router failure modes that can be triggered by the abnormal traffic during the worm attack and how they can lead to global routing instability. Independent research has partially confirmed that such failure modes can and likely do occur in practice. Highly detailed large-scale simulations help close the loop, indicating that such failure modes do in fact trigger the kind of widespread BGP instabilities that were observed empirically.

  9. Cataract Surgery in Anterior Megalophthalmos: A Review

    PubMed Central

    GALVIS, Virgilio; TELLO, Alejandro; M. RANGEL, Carlos

    2015-01-01

    Anterior megalophthalmos is characterized by megalocornea associated with a very broad anterior chamber and ciliary ring elongation. It is also called X-linked megalocornea. It is accompanied by early development of cataracts, zonular anomalies, and, rarely, vitreoretinal disorders. Subluxation of a cataract can occur in cataract surgery because of zonular weakness. In addition, in most patients, standard intraocular lens (IOL) decentration is a risk because of the enlarged sulcus and capsular bag. These unique circumstances make cataract surgery challenging. To date, several approaches have been developed. Implantation of a retropupillary iris-claw aphakic intraocular lens may be a good option because it is easier than suturing the IOL and can have better and more stable anatomic and visual outcomes, compared to other techniques. PMID:27350950

  10. Anterior insular cortex and emotional awareness.

    PubMed

    Gu, Xiaosi; Hof, Patrick R; Friston, Karl J; Fan, Jin

    2013-10-15

    This paper reviews the foundation for a role of the human anterior insular cortex (AIC) in emotional awareness, defined as the conscious experience of emotions. We first introduce the neuroanatomical features of AIC and existing findings on emotional awareness. Using empathy, the awareness and understanding of other people's emotional states, as a test case, we then present evidence to demonstrate: 1) AIC and anterior cingulate cortex (ACC) are commonly coactivated as revealed by a meta-analysis, 2) AIC is functionally dissociable from ACC, 3) AIC integrates stimulus-driven and top-down information, and 4) AIC is necessary for emotional awareness. We propose a model in which AIC serves two major functions: integrating bottom-up interoceptive signals with top-down predictions to generate a current awareness state and providing descending predictions to visceral systems that provide a point of reference for autonomic reflexes. We argue that AIC is critical and necessary for emotional awareness.

  11. Hypnotic induction decreases anterior default mode activity.

    PubMed

    McGeown, William J; Mazzoni, Giuliana; Venneri, Annalena; Kirsch, Irving

    2009-12-01

    The 'default mode' network refers to cortical areas that are active in the absence of goal-directed activity. In previous studies, decreased activity in the 'default mode' has always been associated with increased activation in task-relevant areas. We show that the induction of hypnosis can reduce anterior default mode activity during rest without increasing activity in other cortical regions. We assessed brain activation patterns of high and low suggestible people while resting in the fMRI scanner and while engaged in visual tasks, in and out of hypnosis. High suggestible participants in hypnosis showed decreased brain activity in the anterior parts of the default mode circuit. In low suggestible people, hypnotic induction produced no detectable changes in these regions, but instead deactivated areas involved in alertness. The findings indicate that hypnotic induction creates a distinctive and unique pattern of brain activation in highly suggestible subjects. PMID:19782614

  12. Anterior Insular Cortex and Emotional Awareness

    PubMed Central

    Gu, Xiaosi; Hof, Patrick R.; Friston, Karl J.; Fan, Jin

    2014-01-01

    This paper reviews the foundation for a role of the human anterior insular cortex (AIC) in emotional awareness, defined as the conscious experience of emotions. We first introduce the neuroanatomical features of AIC and existing findings on emotional awareness. Using empathy, the awareness and understanding of other people’s emotional states, as a test case, we then present evidence to demonstrate: 1) AIC and anterior cingulate cortex (ACC) are commonly coactivated as revealed by a meta-analysis, 2) AIC is functionally dissociable from ACC, 3) AIC integrates stimulus-driven and top-down information, and 4) AIC is necessary for emotional awareness. We propose a model in which AIC serves two major functions: integrating bottom-up interoceptive signals with top-down predictions to generate a current awareness state and providing descending predictions to visceral systems that provide a point of reference for autonomic reflexes. We argue that AIC is critical and necessary for emotional awareness. PMID:23749500

  13. Active control of combustion instability

    SciTech Connect

    Lang, W.; Poinsot, T.; Candel, S.

    1987-12-01

    The principle of 'antisound' is used to construct a method for the suppression of combustion instabilities. This active instability control (AIC) method uses external acoustic excitation by a loudspeaker to suppress the oscillations of a flame. The excitation signal is provided by a microphone located upstream of the flame. This signal is filtered, processed, amplified, and sent to the loudspeaker. The AIC method is validated on a laboratory combustor. It allows the suppression of all unstable modes of the burner for any operating ratio. The influence of the microphone and loudspeaker locations on the performance of the AIC system is described. For a given configuration, domains of stability, i.e., domains where the AIC system parameters provide suppression of the oscillation, are investigated. Measurements of the electric input of the loudspeaker show that the energy consumption of the AIC system is almost negligible and suggest that this method could be used for industrial combustor stabilization. Finally, a simple model describing the effects of the AIC system is developed and its results compared to the experiment.

  14. The Chemistry of Beer Instability

    NASA Astrophysics Data System (ADS)

    Stewart, Graham G.

    2004-07-01

    Compared to most other alcoholic beverages, beer is unique because it is unstable when in the final package. This instability can be divided into biological and nonbiological instability. Nonbiological stability of beer involves a wide range of chemical processes and can be considered in a number of categories: physical, flavor, light, foam, and gushing. It is the balance between flavanoid polyphenols (tannoids) and sensitive proteins that specifically combine with polyphenols to form haze that largely dictates physical stability. The flavor stability of beer primarily depends on the oxygen concentration of packaged beer but is influenced by all stages of the brewing process. Foam stability in a glass of beer reflects the quality of the beverage. The backbone of foam is hydrophobic polypeptides. Novel brewing processes such as high-gravity brewing result in a disproportionate loss of these polypeptides and have a negative effect on the foam stability of the resulting beer. Beer is light sensitive, especially in the 350 500 nm range. Beer exposed to this wavelength range in clear or green glass containers quickly develop nauseous skunky-like off-flavors resulting from the formation of 3-methyl-2-butene-1-thiol. Methods of enhancing all of these types of beer stability are discussed.

  15. Electric Field Induced Interfacial Instabilities

    NASA Technical Reports Server (NTRS)

    Kusner, Robert E.; Min, Kyung Yang; Wu, Xiao-Lun; Onuki, Akira

    1996-01-01

    The study of the interface in a charge-free, nonpolar, critical and near-critical binary fluid in the presence of an externally applied electric field is presented. At sufficiently large fields, the interface between the two phases of the binary fluid should become unstable and exhibit an undulation with a predefined wavelength on the order of the capillary length. As the critical point is approached, this wavelength is reduced, potentially approaching length-scales such as the correlation length or critical nucleation radius. At this point the critical properties of the system may be affected. In zero gravity, the interface is unstable at all long wavelengths in the presence of a field applied across it. It is conjectured that this will cause the binary fluid to break up into domains small enough to be outside the instability condition. The resulting pattern formation, and the effects on the critical properties as the domains approach the correlation length are of acute interest. With direct observation, laser light scattering, and interferometry, the phenomena can be probed to gain further understanding of interfacial instabilities and the pattern formation which results, and dimensional crossover in critical systems as the critical fluctuations in a particular direction are suppressed by external forces.

  16. Genome instability, cancer and aging

    PubMed Central

    Maslov, Alexander Y.; Vijg, Jan

    2015-01-01

    DNA damage-driven genome instability underlies the diversity of life forms generated by the evolutionary process but is detrimental to the somatic cells of individual organisms. The cellular response to DNA damage can be roughly divided in two parts. First, when damage is severe, programmed cell death may occur or, alternatively, temporary or permanent cell cycle arrest. This protects against cancer but can have negative effects on the long term, e.g., by depleting stem cell reservoirs. Second, damage can be repaired through one or more of the many sophisticated genome maintenance pathways. However, erroneous DNA repair and incomplete restoration of chromatin after damage is resolved, produce mutations and epimutations, respectively, both of which have been shown to accumulate with age. An increased burden of mutations and/or epimutations in aged tissues increases cancer risk and adversely affects gene transcriptional regulation, leading to progressive decline in organ function. Cellular degeneration and uncontrolled cell proliferation are both major hallmarks of aging. Despite the fact that one seems to exclude the other, they both may be driven by a common mechanism. Here, we review age related changes in the mammalian genome and their possible functional consequences, with special emphasis on genome instability in stem/progenitor cells. PMID:19344750

  17. Combustion instability modeling and analysis

    SciTech Connect

    Santoro, R.J.; Yang, V.; Santavicca, D.A.

    1995-10-01

    It is well known that the two key elements for achieving low emissions and high performance in a gas turbine combustor are to simultaneously establish (1) a lean combustion zone for maintaining low NO{sub x} emissions and (2) rapid mixing for good ignition and flame stability. However, these requirements, when coupled with the short combustor lengths used to limit the residence time for NO formation typical of advanced gas turbine combustors, can lead to problems regarding unburned hydrocarbons (UHC) and carbon monoxide (CO) emissions, as well as the occurrence of combustion instabilities. Clearly, the key to successful gas turbine development is based on understanding the effects of geometry and operating conditions on combustion instability, emissions (including UHC, CO and NO{sub x}) and performance. The concurrent development of suitable analytical and numerical models that are validated with experimental studies is important for achieving this objective. A major benefit of the present research will be to provide for the first time an experimentally verified model of emissions and performance of gas turbine combustors.

  18. Feedback control of multibunch instabilities

    SciTech Connect

    Galayda, J. )

    1992-03-10

    This lecture is intended to be an introduction to the use of feedback control to counteract multibunch instabilities. Furthermore, the intent is to make the most direct connection possible between feedback system design and the linear equations of motion of a single particle in an accelerator. Descriptions of the electronic design and considerations of gain versus stability have been treated in the literature (1,2,3) and will be glossed over in this lecture. The exposition is aimed at an audience with reasonable background in linear charged particle optics and minimal familiarity with circuit theory and electronics design. We begin with a brief description of the sources of instability and a description of the function of a feedback system in terms of the equation of motion of a beam bunch. We will try to list the fundamentals of the design process of a feedback system in such a way as to give the reader a framework within which to evaluate the subsequent material. Section 2 develops simple definitions of feedback system performance parameters: damping time constant, gain, and power requirements. Sections 3 and 4 give a perspective on feedback signal processing, using several betatron damping systems to exemplify time domain signal processing. Section 5 views the signal processing problem in frequency domain, using the CERN PS Booster longitudinal damper as an example.

  19. Adhesional instabilities and gecko locomotion

    NASA Astrophysics Data System (ADS)

    Williams, John A.

    2015-01-01

    Geckos possess a remarkable ability to run rapidly on both walls and ceilings and in recent years the mechanisms that underlie this facility have come under close scrutiny. It is now generally agreed that one of the principal mechanisms of adhesion relies on the action of van der Waal forces acting between the final extremely fine structure of the gecko toe and the underlying substrate. High speed video analysis shows that adhesive contact is both made and broken in intervals of less than 20 ms and this suggests that the mechanism of detachment is one of adhesive instability rather than steady-state peeling. By considering the gecko seta/spatula as a Euler-Bernoulli cantilever it is possible to model this instability in non-dimensional terms and thus to test the analysis at a much larger scale with more conventional engineering materials. When applied to the scale and material combination appropriate to a gecko spatula, the predicted critical load, of around 10 nN, is close to values that have been observed using and AFM cantilever and a single detached spatula.

  20. Electrokinetic instability of isotachophoresis shocks

    NASA Astrophysics Data System (ADS)

    Garcia, Giancarlo; Santiago, Juan; Mani, Ali

    2013-11-01

    Isotachophoresis (ITP) is an electrokinetic focusing technique used in a variety of life science and analytical chemistry applications. In ITP, an electrokinetic shock wave forms at the interface between leading and trailing electrolytes with relatively high and low conductivities. The ITP interface is self-sharpening, as restoring electromigration fluxes counteract molecular diffusion. However, the large electric field gradient at the shock interface also gives rise to free charge and strong electrostatic body forces. At large applied currents, electrostatic forces cause recirculating flows which destabilize the ITP interface. We performed stability analysis and direct simulation of ITP shocks through numerical solutions to the coupled Nernst-Planck and Navier-Stokes equations using a quasi-electroneutral approximation. In both experiments and numerical simulations, we observe two modes of instability: 1) a distorted ITP interface which is steady in time, and 2) an oscillating perturbation which persists. In addition, at the highest simulated electric fields, we observe transition towards more chaotic oscillatory modes. We use our stability analysis and numerical simulations to characterize instability of ITP shocks using two dimensionless parameters.

  1. Radiation-induced genomic instability

    NASA Technical Reports Server (NTRS)

    Kronenberg, A.

    1994-01-01

    Quantitative assessment of the heritable somatic effects of ionizing radiation exposures has relied upon the assumption that radiation-induced lesions were 'fixed' in the DNA prior to the first postirradiation mitosis. Lesion conversion was thought to occur during the initial round of DNA replication or as a consequence of error-prone enzymatic processing of lesions. The standard experimental protocols for the assessment of a variety of radiation-induced endpoints (cell death, specific locus mutations, neoplastic transformation and chromosome aberrations) evaluate these various endpoints at a single snapshot in time. In contrast with the aforementioned approaches, some studies have specifically assessed radiation effects as a function of time following exposure. Evidence has accumulated in support of the hypothesis that radiation exposure induces a persistent destabilization of the genome. This instability has been observed as a delayed expression of lethal mutations, as an enhanced rate of accumulation of non-lethal heritable alterations, and as a progressive intraclonal chromosomal heterogeneity. The genetic controls and biochemical mechanisms underlying radiation-induced genomic instability have not yet been delineated. The aim is to integrate the accumulated evidence that suggests that radiation exposure has a persistent effect on the stability of the mammalian genome.

  2. Rogue Waves and Modulational Instability

    NASA Astrophysics Data System (ADS)

    Zakharov, V. E.; Dyachenko, A.

    2015-12-01

    The most plausible cause of rogue wave formation in a deep ocean is development of modulational instability of quasimonochromatic wave trains. An adequate model for study of this phenomenon is the Euler equation for potential flow of incompressible fluid with free surface in 2-D geometry. Numerical integration of these equations confirms completely the conjecture of rogue wave formation from modulational instability but the procedure is time consuming for determination of rogue wave appearance probability for a given shape of wave energy spectrum. This program can be realized in framework of simpler model using replacement of the exact interaction Hamiltonian by more compact Hamiltonian. There is a family of such models. The popular one is the Nonlinear Schrodinger equation (NLSE). This model is completely integrable and suitable for numerical simulation but we consider that it is oversimplified. It misses such important phenomenon as wave breaking. Recently, we elaborated much more reliable model that describes wave breaking but is as suitable as NLSE from the point of numerical modeling. This model allows to perform massive numerical experiments and study statistics of rogue wave formation in details.

  3. Sudden onset odontoid fracture caused by cervical instability in hypotonic cerebral palsy.

    PubMed

    Shiohama, Tadashi; Fujii, Katsunori; Kitazawa, Katsuhiko; Takahashi, Akiko; Maemoto, Tatsuo; Honda, Akihito

    2013-11-01

    Fractures of the upper cervical spine rarely occur but carry a high rate of mortality and neurological disabilities in children. Although odontoid fractures are commonly caused by high-impact injuries, cerebral palsy children with cervical instability have a risk of developing spinal fractures even from mild trauma. We herein present the first case of an odontoid fracture in a 4-year-old boy with cerebral palsy. He exhibited prominent cervical instability due to hypotonic cerebral palsy from infancy. He suddenly developed acute respiratory failure, which subsequently required mechanical ventilation. Neuroimaging clearly revealed a type-III odontoid fracture accompanied by anterior displacement with compression of the cervical spinal cord. Bone mineral density was prominently decreased probably due to his long-term bedridden status and poor nutritional condition. We subsequently performed posterior internal fixation surgically using an onlay bone graft, resulting in a dramatic improvement in his respiratory failure. To our knowledge, this is the first report of an odontoid fracture caused by cervical instability in hypotonic cerebral palsy. Since cervical instability and decreased bone mineral density are frequently associated with cerebral palsy, odontoid fractures should be cautiously examined in cases of sudden onset respiratory failure and aggravated weakness, especially in hypotonic cerebral palsy patients.

  4. Reconstruction for persistent instability of the elbow after coronoid fracture-dislocation.

    PubMed

    Papandrea, Rick F; Morrey, Bernard F; O'Driscoll, Shawn W

    2007-01-01

    The results of reconstruction for chronic instability after coronoid fracture have not been previously described. Patients with persistent instability after coronoid fracture-dislocation were assessed after reconstruction. A satisfactory outcome was considered to be present based on the Mayo Elbow Performance Score and on the patient's willingness to repeat the operation. The length of follow-up was a minimum of 2 years, averaging over 5 years. Overall, 13 of 21 patients (62%) were classified as having a successful outcome objectively, and 17 of 21 (81%) were classified as having a successful outcome subjectively. The duration of the delay to definitive treatment was closely associated with the ultimate outcome (P < .01), as the outcome of only 1 of 7 elbows with a delay greater than 7 weeks was classified as an objective success. Of the patients, 19 had a fractured radial head, 11 of which were initially treated with a radial head excision; none was subsequently reconstructed. Sixteen patients were treated with a hinged external fixator. Of the elbows, 13 remained reduced whereas 8 had variable amounts of anterior or posterior instability. Two failures were ultimately reconstructed with a total elbow arthroplasty. Instability that persists after the initial unsuccessful management of a coronoid fracture and an elbow dislocation is a difficult problem to salvage with subsequent reconstruction. This experience emphasizes the need for better reconstructive options and especially underscores the need for appropriate initial management of this difficult injury.

  5. The Anterior Approach for Total Hip Replacement.

    PubMed

    Hochfelder, Jason P; Davidovitch, Roy I

    2016-03-01

    The anterior approach for total hip replacements has recently gained popularity. Some authors report faster recoveries and decreased dislocation rated with no increased risk of complications. However others claim no difference in outcomes when compared to other approaches yet an increase in complication rates. This paper provides a brief history of the approach, discusses various indications and contraindications, preoperative considerations, surgical techniques, and postoperative protocols. PMID:26977549

  6. A direct approach to restore anterior teeth.

    PubMed

    Denehy, G E

    2000-11-01

    When selecting the correct treatment for a patient with anterior esthetic problems, the dentist must choose between direct and indirect procedures. With situations allowing conservative treatment, direct resin restoration should be given strong consideration. Advances in materials and techniques that can positively affect this choice include pre-restorative bleaching procedures, new bonding agents, and new highly esthetic direct resin systems. A procedure is described to maximize esthetics and minimize finishing time during direct resin placement.

  7. Anorgasmia in anterior spinal cord syndrome.

    PubMed Central

    Berić, A; Light, J K

    1993-01-01

    Three male and two female patients with anorgasmia and dissociated sensory loss due to an anterior spinal cord syndrome are described. Clinical, neurophysiological and quantitative sensory evaluation revealed preservation of the large fibre dorsal column functions from the lumbosacral segments with concomitant severe dysfunction or absence of the small fibre neospinothalamic mediated functions. These findings indicate a role for the spinothalamic system in orgasm. PMID:8505649

  8. Anterior segment dysgenesis in mosaic Turner syndrome

    PubMed Central

    Lloyd, I; Haigh, P; Clayton-Smith, J; Clayton, P; Price, D; Ridgway, A; Donnai, D

    1997-01-01

    AIMS/BACKGROUND—Females with Turner syndrome commonly exhibit ophthalmological abnormalities, although there is little information in the literature documenting findings specific to Turner syndrome mosaics. Ophthalmic findings are described in four patients with mosaic Turner syndrome. All had anterior chamber abnormalities and all four had karyotypic abnormalities with a 45, X cell line. The possible relation between the karyotypic and the phenotypic findings in these patients is discussed.
METHODS—Four girls with mosaic Turner syndrome underwent a full ophthalmological assessment, including examination under anaesthesia where indicated.
RESULTS—Three of the four patients presented with congenital glaucoma. Two had the karyotype 45, X/46, X, idic(Y) and one a 45, X/47, XXX karyotype. The remaining child had a Rieger malformation of the iris and the karyotype 45, X/46, X, r(X).
CONCLUSIONS—These findings suggest that Turner syndrome mosaicism (where there are two abnormal cell lines) is associated with anterior segment dysgenesis. The findings in these four patients are compared with those seen in other mosaic phenotypes and it is postulated that the presence of two or more genetically different cell lines may have an adverse effect on anterior segment development.

 PMID:9349149

  9. The thoracic anterior spinal cord adhesion syndrome

    PubMed Central

    Taylor, T R; Dineen, R; White, B; Jaspan, T

    2012-01-01

    Objectives This study included a series of middle-aged male and female patients who presented with chronic anterior hemicord dysfunction progressing to paraplegia. Imaging of anterior thoracic cord displacement by either a dural adhesion or a dural defect with associated cord herniation is presented. Methods This is a retrospective review of cases referred to a tertiary neuroscience centre over a 19-year period. Imaging series were classified by two experienced neuroradiologists against several criteria and correlated with clinical examination and/or findings at surgery. Results 16 cases were available for full review. Nine were considered to represent adhesions (four confirmed surgically) and four to represent true herniation (three confirmed surgically). In the three remaining cases the diagnosis was radiologically uncertain. Conclusion The authors propose “thoracic anterior spinal cord adhesion syndrome” as a novel term to describe this patient cohort and suggest appropriate clinicoradiological features for diagnosis. Several possible aetiologies are also suggested, with disc rupture and inflammation followed by disc resorption and dural pocket formation being a possible mechanism predisposing to herniation at the extreme end of a clinicopathological spectrum. PMID:22665931

  10. Simultaneous Excitation and Analysis of Three Instabilities in Magnetized Plasma

    SciTech Connect

    Dimitriu, D. G.; Ionita, C.; Schrittwieser, R. W.

    2008-03-19

    Experimental results are presented on the simultaneous excitation of three low-frequency instabilities in the magnetized plasma column of a Q-machine, namely the potential relaxation instability, the electrostatic ion-cyclotron instability and the Kelvin-Helmholtz instability. The influence of the magnetic field intensity on the appearance of these instabilities was investigated.

  11. Revision anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft and extra-articular iliotibial band tenodesis.

    PubMed

    Mascarenhas, Randy; McConkey, Mark O; Forsythe, Brian; Harner, Christopher D

    2015-04-01

    Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding procedure with outcomes that generally fail to reach those seen with primary ACL reconstruction. With most index procedures using autograft tissue, it is not uncommon for allograft tissue to be required for revision ACL reconstruction. Compared with autografts, allografts take longer to incorporate and lead to more episodes of instability. In this article, we describe ipsilateral iliotibial band tenodesis performed to augment use of bone-patellar tendon-bone allograft in revision ACL reconstruction. This technique adds rotational stability to protect the allograft tissue while it incorporates. PMID:25844596

  12. Revision anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft and extra-articular iliotibial band tenodesis.

    PubMed

    Mascarenhas, Randy; McConkey, Mark O; Forsythe, Brian; Harner, Christopher D

    2015-04-01

    Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding procedure with outcomes that generally fail to reach those seen with primary ACL reconstruction. With most index procedures using autograft tissue, it is not uncommon for allograft tissue to be required for revision ACL reconstruction. Compared with autografts, allografts take longer to incorporate and lead to more episodes of instability. In this article, we describe ipsilateral iliotibial band tenodesis performed to augment use of bone-patellar tendon-bone allograft in revision ACL reconstruction. This technique adds rotational stability to protect the allograft tissue while it incorporates.

  13. Interfacial instabilities in vibrated fluids

    NASA Astrophysics Data System (ADS)

    Porter, Jeff; Laverón-Simavilla, Ana; Tinao Perez-Miravete, Ignacio; Fernandez Fraile, Jose Javier

    2016-07-01

    Vibrations induce a range of different interfacial phenomena in fluid systems depending on the frequency and orientation of the forcing. With gravity, (large) interfaces are approximately flat and there is a qualitative difference between vertical and horizontal forcing. Sufficient vertical forcing produces subharmonic standing waves (Faraday waves) that extend over the whole interface. Horizontal forcing can excite both localized and extended interfacial phenomena. The vibrating solid boundaries act as wavemakers to excite traveling waves (or sloshing modes at low frequencies) but they also drive evanescent bulk modes whose oscillatory pressure gradient can parametrically excite subharmonic surface waves like cross-waves. Depending on the magnitude of the damping and the aspect ratio of the container, these locally generated surfaces waves may interact in the interior resulting in temporal modulation and other complex dynamics. In the case where the interface separates two fluids of different density in, for example, a rectangular container, the mass transfer due to vertical motion near the endwalls requires a counterflow in the interior region that can lead to a Kelvin-Helmholtz type instability and a ``frozen wave" pattern. In microgravity, the dominance of surface forces favors non-flat equilibrium configurations and the distinction between vertical and horizontal applied forcing can be lost. Hysteresis and multiplicity of solutions are more common, especially in non-wetting systems where disconnected (partial) volumes of fluid can be established. Furthermore, the vibrational field contributes a dynamic pressure term that competes with surface tension to select the (time averaged) shape of the surface. These new (quasi-static) surface configurations, known as vibroequilibria, can differ substantially from the hydrostatic state. There is a tendency for the interface to orient perpendicular to the vibrational axis and, in some cases, a bulge or cavity is induced

  14. Electric Field Induced Interfacial Instabilities

    NASA Technical Reports Server (NTRS)

    Kusner, Robert E.; Min, Kyung Yang; Wu, Xiao-lun; Onuki, Akira

    1999-01-01

    The study of the interface in a charge-free, critical and near-critical binary fluid in the presence of an externally applied electric field is presented. At sufficiently large fields, the interface between the two phases of the binary fluid should become unstable and exhibit an undulation with a predefined wavelength on the order of the capillary length. As the critical point is approached, this wavelength is reduced, potentially approaching length-scales such as the correlation length or critical nucleation radius. At this point the critical properties of the system may be affected. In this paper, the flat interface of a marginally polar binary fluid mixture is stressed by a perpendicular alternating electric field and the resulting instability is characterized by the critical electric field E(sub c) and the pattern observed. The character of the surface dynamics at the onset of instability is found to be strongly dependent on the frequency f of the field applied. The plot of E(sub c) vs. f for a fixed temperature shows a sigmoidal shape, whose low and high frequency limits are well described by a power-law relationship, E(sub c) = epsilon(exp zeta) with zeta = 0.35 and zeta = 0.08, respectively. The low-limit exponent compares well with the value zeta = 4 for a system of conducting and non-conducting fluids. On the other hand, the high-limit exponent coincides with what was first predicted by Onuki. The instability manifests itself as the conducting phase penetrates the non-conducting phase. As the frequency increases, the shape of the pattern changes from an array of bifurcating strings to an array of column-like (or rod-like) protrusions, each of which spans the space between the plane interface and one of the electrodes. For an extremely high frequency, the disturbance quickly grows into a parabolic cone pointing toward the upper plate. As a result, the interface itself changes its shape from that of a plane to that of a high sloping pyramid.

  15. Testing the gravitational instability hypothesis?

    NASA Technical Reports Server (NTRS)

    Babul, Arif; Weinberg, David H.; Dekel, Avishai; Ostriker, Jeremiah P.

    1994-01-01

    We challenge a widely accepted assumption of observational cosmology: that successful reconstruction of observed galaxy density fields from measured galaxy velocity fields (or vice versa), using the methods of gravitational instability theory, implies that the observed large-scale structures and large-scale flows were produced by the action of gravity. This assumption is false, in that there exist nongravitational theories that pass the reconstruction tests and gravitational theories with certain forms of biased galaxy formation that fail them. Gravitational instability theory predicts specific correlations between large-scale velocity and mass density fields, but the same correlations arise in any model where (a) structures in the galaxy distribution grow from homogeneous initial conditions in a way that satisfies the continuity equation, and (b) the present-day velocity field is irrotational and proportional to the time-averaged velocity field. We demonstrate these assertions using analytical arguments and N-body simulations. If large-scale structure is formed by gravitational instability, then the ratio of the galaxy density contrast to the divergence of the velocity field yields an estimate of the density parameter Omega (or, more generally, an estimate of beta identically equal to Omega(exp 0.6)/b, where b is an assumed constant of proportionality between galaxy and mass density fluctuations. In nongravitational scenarios, the values of Omega or beta estimated in this way may fail to represent the true cosmological values. However, even if nongravitational forces initiate and shape the growth of structure, gravitationally induced accelerations can dominate the velocity field at late times, long after the action of any nongravitational impulses. The estimated beta approaches the true value in such cases, and in our numerical simulations the estimated beta values are reasonably accurate for both gravitational and nongravitational models. Reconstruction tests

  16. Waves and instabilities in a magnetized plasma

    NASA Technical Reports Server (NTRS)

    Dawson, J. M.

    1982-01-01

    Work on computer simulation of waves and instabilities in magnetized plasmas is reviewed. Included are verification of linear theory. Particular emphasis is given to investigation of nonlinear processes involved in the saturation of instabilities and of wave damping; these include a nonlinear cyclotron resonance and particle trapping in intense waves.

  17. Perception of Job Instability in Europe

    ERIC Educational Resources Information Center

    Bockerman, Petri

    2004-01-01

    The perception of job instability is an important measure of subjective wellbeing of individuals, because most people derive their income from selling their labour services. The study explores the determination of perception of job instability in Europe. The study is based on a large-scale survey from the year 1998. There are evidently large…

  18. Transverse instability digital damper for the Recycler

    SciTech Connect

    Balbekov, V.; /Fermilab

    2006-02-01

    Transverse beam instability of a coasting beam with a digital damper is examined. Threshold of instability is calculated in specific cases with Landau damping taken into account. The results are applied to the Fermilab Recycler Ring. Some improvement of existing RR damper is proposed.

  19. Cultural Diversity, Economic Development and Societal Instability

    PubMed Central

    Nettle, Daniel; Grace, James B.; Choisy, Marc; Cornell, Howard V.; Guégan, Jean-François; Hochberg, Michael E.

    2007-01-01

    Background Social scientists have suggested that cultural diversity in a nation leads to societal instability. However, societal instability may be affected not only by within-nation or α diversity, but also diversity between a nation and its neighbours or β diversity. It is also necessary to distinguish different domains of diversity, namely linguistic, ethnic and religious, and to distinguish between the direct effects of diversity on societal instability, and effects that are mediated by economic conditions. Methodology/Principal Findings We assembled a large cross-national dataset with information on α and β cultural diversity, economic conditions, and indices of societal instability. Structural equation modeling was used to evaluate the direct and indirect effects of cultural diversity on economics and societal stability. Results show that different types and domains of diversity have interacting effects. As previously documented, linguistic α diversity has a negative effect on economic performance, and we show that it is largely through this economic mechanism that it affects societal instability. For β diversity, the higher the linguistic diversity among nations in a region, the less stable the nation. But, religious β diversity has the opposite effect, reducing instability, particularly in the presence of high linguistic diversity. Conclusions Within-nation linguistic diversity is associated with reduced economic performance, which, in turn, increases societal instability. Nations which differ linguistically from their neighbors are also less stable. However, religious diversity between neighboring nations has the opposite effect, decreasing societal instability. PMID:17895970

  20. Curvature instability in passive diffractive resonators.

    PubMed

    Tlidi, M; Vladimirov, A G; Mandel, Paul

    2002-12-01

    We study the stability of localized structures in a passive optical bistable system. We show that there is a critical value of the input field intensity above which localized structures are unstable with respect to a curvature instability. Beyond this instability boundary, a transition from the localized branch of solutions to stable hexagons is found. PMID:12485009

  1. Partnership Instability, School Readiness, and Gender Disparities

    ERIC Educational Resources Information Center

    Cooper, Carey E.; Osborne, Cynthia A.; Beck, Audrey N.; McLanahan, Sara S.

    2011-01-01

    Trends in family formation during the past several decades have increased children's exposure to mothers' partnership instability, defined as an entrance into or exit from a coresidential union or a dating partnership. Instability, in turn, is associated with negative outcomes for children and adolescents. This study uses data from the Fragile…

  2. Ion-cyclotron instability in magnetic mirrors

    SciTech Connect

    Pearlstein, L.D.

    1987-02-02

    This report reviews the role of ion-cyclotron frequency instability in magnetic mirrors. The modes discussed here are loss-cone or anisotropy driven. The discussion includes quasilinear theory, explosive instabilities of 3-wave interaction and non-linear Landau damping, and saturation due to non-linear orbits. (JDH)

  3. Observations on instabilities of cavitating inducers

    NASA Technical Reports Server (NTRS)

    Braisted, D.; Brennen, C.

    1978-01-01

    Experimental observations of instability of cavitating inducers were made for two different inducers operating at different flow coefficients. In general, instability occurred just before head breakdown. Auto-oscillation and rotating cavitation were observed. Analysis of small-amplitude behavior of the inducer and hydraulic system is carried out, and analytical predictions of stability limits were compared with experiment.

  4. Cultural diversity, economic development and societal instability

    USGS Publications Warehouse

    Nettle, D.; Grace, J.B.; Choisy, M.; Cornell, H.V.; Guegan, J.-F.; Hochberg, M.E.

    2007-01-01

    Background. Social scientists have suggested that cultural diversity in a nation leads to societal instability. However, societal instability may be affected not only by within-nation on ?? diversity, but also diversity between a nation and its neighbours or ?? diversity. It is also necessary to distinguish different domains of diversity, namely linguistic, ethnic and religious, and to distinguish between the direct effects of diversity on societal instability, and effects that are mediated by economic conditions. Methodology/Principal Findings. We assembled a large cross-national dataset with information on ?? and ?? cultural diversity, economic conditions, and indices of societal instability. Structural equation modeling was used to evaluate the direct and indirect effects of cultural diversity on economics and societal stability. Results show that different type and domains of diversity have interacting effects. As previously documented, linguistic ?? diversity has a negative effect on economic performance, and we show that it is largely through this economic mechanism that it affects societal instability. For ?? diversity, the higher the linguistic diversity among nations in a region, the less stable the nation. But, religious ?? diversity has the opposite effect, reducing instability, particularly in the presence of high linguistic diversity. Conclusions. Within-nation linguistic diversity is associated with reduced economic performance, which, in turn, increases societal instability. Nations which differ linguistically from their neighbors are also less stable. However, religious diversity between, neighboring nations has the opposite effect, decreasing societal instability.

  5. Multiscale instabilities in soft heterogeneous dielectric elastomers

    PubMed Central

    Rudykh, S.; Bhattacharya, K.; deBotton, G.

    2014-01-01

    The development of instabilities in soft heterogeneous dielectric elastomers is investigated. Motivated by experiments and possible applications, we use in our analysis the physically relevant referential electric field instead of electric displacement. In terms of this variable, a closed form solution is derived for the class of layered neo-Hookean dielectrics. A criterion for the onset of electromechanical multiscale instabilities for the layered composites with anisotropic phases is formulated. A general condition for the onset of the macroscopic instability in soft multiphase dielectrics is introduced. In the example of the layered dielectrics, the essential influence of the microstructure on the onset of instabilities is revealed. We found that: (i) macroscopic instabilities dominate at moderate volume fractions of the stiffer phase, (ii) interface instabilities appear at small volume fractions of the stiffer phase and (iii) instabilities of a finite scale, comparable to the microstructure size, occur at large volume fractions of the stiffer phase. The latest new type of instabilities does not appear in the purely mechanical case and dominates in the region of large volume fractions of the stiff phase. PMID:24511258

  6. Superresonant instability of a compressible hydrodynamic vortex

    NASA Astrophysics Data System (ADS)

    Oliveira, Leandro A.; Cardoso, Vitor; Crispino, Luís C. B.

    2016-06-01

    We show that a purely circulating and compressible system, in an adiabatic regime of acoustic propagation, presents superresonant instabilities. To show the existence these instabilities, we compute the quasinormal mode frequencies of this system numerically using two different frequency domain methods.

  7. Instabilities in coaxial rotating jets

    NASA Astrophysics Data System (ADS)

    Ivanic, Tanja; Foucault, Eric; Pecheux, Jean; Gilard, Virginie

    2000-12-01

    The aim of this study is the characterization of the cylindrical mixing layer resulting from the interaction of two coaxial swirling jets. The experimental part of this study was performed in a cylindrical water tunnel, permitting an independent rotation of two coaxial jets. The rotations are generated by means of 2×36 blades localized in two swirling chambers. As expected, the evolution of the main instability modes presents certain differences compared to the plane-mixing-layer case. Experimental results obtained by tomography showed the existence of vortex rings and streamwise vortex pairs in the near field region. This method also permitted the observation of the evolution and interaction of different modes. PIV velocity measurements realized in the meridian plans and the plans perpendicular to the jet axis show that rotation distorts the typical top-hat axial velocity profile. The transition of the axial velocity profile from jet-like into wake-like is also observed.

  8. RADIATIVE RAYLEIGH-TAYLOR INSTABILITIES

    SciTech Connect

    Jacquet, Emmanuel; Krumholz, Mark R. E-mail: krumholz@ucolick.org

    2011-04-01

    We perform analytic linear stability analyses of an interface separating two stratified media threaded by a radiation flux, a configuration relevant in several astrophysical contexts. We develop a general framework for analyzing such systems and obtain exact stability conditions in several limiting cases. In the optically thin, isothermal regime, where the discontinuity is chemical in nature (e.g., at the boundary of a radiation pressure-driven H II region), radiation acts as part of an effective gravitational field, and instability arises if the effective gravity per unit volume toward the interface overcomes that away from it. In the optically thick 'adiabatic' regime where the total (gas plus radiation) specific entropy of a Lagrangian fluid element is conserved, for example at the edge of radiation pressure-driven bubble around a young massive star, we show that radiation acts like a modified equation of state and derive a generalized version of the classical Rayleigh-Taylor stability condition.

  9. Morphological instabilities of polymer crystals.

    PubMed

    Grozev, N; Botiz, I; Reiter, G

    2008-09-01

    We present experimental observations at comparatively low supercooling of morphology transitions from dendritic to faceted structures in polymer crystals growing in thin films of a poly-2-vinylpyridine-block-polyethyleneoxid copolymer. Our results are compared with theoretical concepts describing morphological instabilities of single crystals. Although these concepts originally were not developed for polymers, they allow to describe and interpret our experimental results quite well. In particular, the measured temperature dependence of the width W and frequency of dendritic side branches and the radius of curvature p of the growth tips of the crystals follow these concepts. We present preliminary evidence for the influence of polymer attachment kinetics and reorganisation processes behind the growth front. Polymer thin films provide valuable model systems for studying general concepts of crystallisation and allow to distinguish at which point the connectivity of the crystallising units within chain-like molecules starts to play a measurable role.

  10. Robinson instability and beam loading

    SciTech Connect

    Craft, B.C. III

    1985-01-01

    The Robinson instability problem is developed in three stages. The first step is to derive the synchrotron oscillation equations in the absence of beam loading (unloaded case). Next, the equations are evaluated in the presence of beam loading at the fundamental rf frequency (statically loaded case). Finally, the system is redeveloped taking into account beam loading at the synchrotron sidebands (dynamically loaded case). Following the theoretical development, the results are applied to calculate the synchrotron frequency in the presence of beam-loading, automatic-gain-control, and automatic-tune-control. The results of this calculation are compared with data from the NSLS vuv-ring, a 750 MeV electron storage ring. 1 ref., 3 figs.

  11. Gravitational Instability in Suspension Flows

    NASA Technical Reports Server (NTRS)

    Carpen, Ileana C.; Brady, John F.

    2002-01-01

    The gravity-driven flow of non-neutrally buoyant suspensions is shown to be unstable to spanwise perturbations when the shearing motion generates a density profile that increases with height. The instability is simply due to having heavier material over light. The wavelength of the perturbation is found to be on the order of the thickness of the suspension layer. The parameters important to the problem are the angle of inclination of the layer relative to gravity, the relative density difference between the particles and fluid, the ratio of the particle size to the suspension layer, and the bulk volume fraction of particles. An example showing the growth rate as a function of wave number is shown.

  12. Visco-resistive plasmoid instability

    NASA Astrophysics Data System (ADS)

    Comisso, Luca; Grasso, Daniela

    2016-03-01

    The plasmoid instability in visco-resistive current sheets is analyzed in both the linear and nonlinear regimes. The linear growth rate and the wavenumber are found to scale as S1 /4(1+Pm ) -5 /8 and S3 /8(1+Pm ) -3 /16 with respect to the Lundquist number S and the magnetic Prandtl number Pm. Furthermore, the linear layer width is shown to scale as S-1 /8(1+Pm ) 1 /16 . The growth of the plasmoids slows down from an exponential growth to an algebraic growth when they enter into the nonlinear regime. In particular, the time-scale of the nonlinear growth of the plasmoids is found to be τNL˜S-3 /16(1+Pm) 19 /32τA,L . The nonlinear growth of the plasmoids is radically different from the linear one, and it is shown to be essential to understand the global current sheet disruption. It is also discussed how the plasmoid instability enables fast magnetic reconnection in visco-resistive plasmas. In particular, it is shown that the recursive plasmoid formation can trigger a collisionless reconnection regime if S ≳Lc s(ɛclk) -1(1+Pm) 1 /2 , where Lcs is the half-length of the global current sheet and lk is the relevant kinetic length scale. On the other hand, if the current sheet remains in the collisional regime, the global (time-averaged) reconnection rate is shown to be ≈ɛcvA ,uBu(1+Pm) -1 /2 , where ɛc is the critical inverse aspect ratio of the current sheet, while vA,u and Bu are the Alfvén speed and the magnetic field upstream of the global reconnection layer.

  13. Evolution of genetic instability in heterogeneous tumors.

    PubMed

    Asatryan, Ani D; Komarova, Natalia L

    2016-05-01

    Genetic instability is an important characteristic of cancer. While most cancers develop genetic instability at some stage of their progression, sometimes a temporary rise of instability is followed by the return to a relatively stable genome. Neither the reasons for these dynamics, nor, more generally, the role of instability in tumor progression, are well understood. In this paper we develop a class of mathematical models to study the evolutionary competition dynamics among different sub-populations in a heterogeneous tumor. We observe that despite the complexity of this multi-component and multi-process system, there is only a small number of scenarios expected in the context of the evolution of instability. If the penalty incurred by unstable cells (the decrease in the growth due to deleterious mutations) is high compared with the gain (the production rate of advantageous mutations), then instability does not evolve. In the opposite case, instability evolves and comes to dominate the system. In the intermediate parameter regime, instability is generated but later gives way to stable clones. Moreover, the model also informs us of the patterns of instability for cancer lineages corresponding to different stages of progression. It is predicted that mutations causing instability are merely "passengers" in tumors that have undergone only a small number of malignant mutations. Further down the path of carcinogenesis, however, unstable cells are more likely to give rise to the winning clonal wave that takes over the tumor and carries the evolution forward, thus conferring a causal role of the instability in such cases. Further, each individual clonal wave (i.e. cells harboring a fixed number of malignant driver mutations) experiences its own evolutionary history. It can fall under one of three types of temporal behavior: stable throughout, unstable to stable, or unstable throughout. Which scenario is realized depends on the subtle (but predictable) interplay among

  14. Evolution of genetic instability in heterogeneous tumors.

    PubMed

    Asatryan, Ani D; Komarova, Natalia L

    2016-05-01

    Genetic instability is an important characteristic of cancer. While most cancers develop genetic instability at some stage of their progression, sometimes a temporary rise of instability is followed by the return to a relatively stable genome. Neither the reasons for these dynamics, nor, more generally, the role of instability in tumor progression, are well understood. In this paper we develop a class of mathematical models to study the evolutionary competition dynamics among different sub-populations in a heterogeneous tumor. We observe that despite the complexity of this multi-component and multi-process system, there is only a small number of scenarios expected in the context of the evolution of instability. If the penalty incurred by unstable cells (the decrease in the growth due to deleterious mutations) is high compared with the gain (the production rate of advantageous mutations), then instability does not evolve. In the opposite case, instability evolves and comes to dominate the system. In the intermediate parameter regime, instability is generated but later gives way to stable clones. Moreover, the model also informs us of the patterns of instability for cancer lineages corresponding to different stages of progression. It is predicted that mutations causing instability are merely "passengers" in tumors that have undergone only a small number of malignant mutations. Further down the path of carcinogenesis, however, unstable cells are more likely to give rise to the winning clonal wave that takes over the tumor and carries the evolution forward, thus conferring a causal role of the instability in such cases. Further, each individual clonal wave (i.e. cells harboring a fixed number of malignant driver mutations) experiences its own evolutionary history. It can fall under one of three types of temporal behavior: stable throughout, unstable to stable, or unstable throughout. Which scenario is realized depends on the subtle (but predictable) interplay among

  15. Top-Down Dysregulation-From ADHD to Emotional Instability.

    PubMed

    Petrovic, Predrag; Castellanos, F Xavier

    2016-01-01

    Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., "cool" executive functions) to mainly emotional regulatory processes (including "hot" executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in "cool" processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while "hot" processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with "cool" regulatory circuits) or emotional information related to the interoceptive environment (associated with "hot" regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental conditions.

  16. Top-Down Dysregulation—From ADHD to Emotional Instability

    PubMed Central

    Petrovic, Predrag; Castellanos, F. Xavier

    2016-01-01

    Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., “cool” executive functions) to mainly emotional regulatory processes (including “hot” executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in “cool” processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while “hot” processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with “cool” regulatory circuits) or emotional information related to the interoceptive environment (associated with “hot” regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental

  17. Top-Down Dysregulation-From ADHD to Emotional Instability.

    PubMed

    Petrovic, Predrag; Castellanos, F Xavier

    2016-01-01

    Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., "cool" executive functions) to mainly emotional regulatory processes (including "hot" executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in "cool" processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while "hot" processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with "cool" regulatory circuits) or emotional information related to the interoceptive environment (associated with "hot" regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental conditions. PMID:27242456

  18. Tensile Instability in a Thick Elastic Body

    NASA Astrophysics Data System (ADS)

    Overvelde, Johannes T. B.; Dykstra, David M. J.; de Rooij, Rijk; Weaver, James; Bertoldi, Katia

    2016-08-01

    A range of instabilities can occur in soft bodies that undergo large deformation. While most of them arise under compressive forces, it has previously been shown analytically that a tensile instability can occur in an elastic block subjected to equitriaxial tension. Guided by this result, we conducted centimeter-scale experiments on thick elastomeric samples under generalized plane strain conditions and observed for the first time this elastic tensile instability. We found that equibiaxial stretching leads to the formation of a wavy pattern, as regions of the sample alternatively flatten and extend in the out-of-plane direction. Our work uncovers a new type of instability that can be triggered in elastic bodies, enlarging the design space for smart structures that harness instabilities to enhance their functionality.

  19. Magnetothermal instability with generalized Ohm's law

    SciTech Connect

    Bora, M.P.; Talwar, S.P. )

    1993-03-01

    The problem of thermal instability, having bearing on the formation of astrophysical condensations, is investigated for a hydromagnetic fluid obeying generalized Ohm's law, both for self-gravitating and nongravitating configurations. Effects of finite Larmor frequency, resistivity, and finite plasma frequency on the stability of the system are studied and the condition of instabilities are derived for a temperature-dependent and density-dependent heat-loss function. It is found that the condition of instability for propagation parallel to the ambient magnetic field is independent of finite resistivity, Hall current, and electron inertia effects and also of the magnetic field strength. For transverse propagation, however, the instability criterion involves the field strength, resistivity, and electron inertia terms. The Hall current is found to modify the growth rates for generally inclined propagation only. Both monotonically unstable and overstable modes of instability arise in the system depending on the dependence of the heat-loss function on the local density and temperature.

  20. Tidal instability in exoplanetary systems evolution

    NASA Astrophysics Data System (ADS)

    Cébron, D.; Moutou, C.; Le Bars, M.; Le Gal, P.; Farès, R.

    2011-02-01

    A new element is proposed to play a role in the evolution of extrasolar planetary systems: the tidal (or elliptical) instability. It comes from a parametric resonance and takes place in any rotating fluid whose streamlines are (even slightly) elliptically deformed. Based on theoretical, experimental and numerical works, we estimate the growth rate of the instability for hot-jupiter systems, when the rotation period of the star is known. We present the physical process, its application to stars, and preliminary results obtained on a few dozen systems, summarized in the form of a stability diagram. Most of the systems are trapped in the so-called "forbidden zone", where the instability cannot grow. In some systems, the tidal instability is able to grow, at short timescales compared to the system evolution. Implications are discussed in the framework of misaligned transiting systems, as the rotational axis of the star would be unstable in systems where this elliptical instability grows.

  1. Parametric instabilities in the LCGT arm cavity

    NASA Astrophysics Data System (ADS)

    Yamamoto, K.; Uchiyama, T.; Miyoki, S.; Ohashi, M.; Kuroda, K.; Numata, K.

    2008-07-01

    We evaluated the parametric instabilities of LCGT (Japanese interferometric gravitational wave detector project) arm cavity. The number of unstable modes of LCGT is 10-times smaller than that of Advanced LIGO (USA). Since the strength of the instabilities of LCGT depends on the mirror curvature more weakly than that of Advanced LIGO, the requirement of the mirror curvature accuracy is easier to be achieved. The difference in the parametric instabilities between LCGT and Advanced LIGO is because of the thermal noise reduction methods (LCGT, cooling sapphire mirrors; Advanced LIGO, fused silica mirrors with larger laser beams), which are the main strategies of the projects. Elastic Q reduction by the barrel surface (0.2 mm thickness Ta2O5) coating is effective to suppress instabilities in the LCGT arm cavity. Therefore, the cryogenic interferometer is a smart solution for the parametric instabilities in addition to thermal noise and thermal lensing.

  2. Multidirectional Instability Accompanying an Inferior Labral Cyst

    PubMed Central

    Ji, Jong-Hun; Kim, Sung-Jae

    2010-01-01

    Paralabral cyst of the shoulder joint can be observed in 2% to 4% of the general population, particularly in men during the third and fourth decade. On average, these cysts measure 10 mm to 20 mm in diameter and are located preferentially on the postero-superior aspect of the glenoid. The MRI has increased the frequency of the diagnosis of paralabral cysts of the shoulder joint. Paralabral cysts of the shoulder joint usually develop in the proximity of the labrum. The relationship between shoulder instability and labral tears is well known, however, the association of shoulder instability with a paralabral cyst is rare. Shoulder instability may cause labral injury or labral injury may cause shoulder instability, and then injured tear develops paralabral cyst. In our patient, the inferior paralabral cyst may be associated with inferior labral tears and instability MRI. PMID:20514270

  3. Taming contact line instability for pattern formation

    PubMed Central

    Deblais, A.; Harich, R.; Colin, A.; Kellay, H.

    2016-01-01

    Coating surfaces with different fluids is prone to instability producing inhomogeneous films and patterns. The contact line between the coating fluid and the surface to be coated is host to different instabilities, limiting the use of a variety of coating techniques. Here we take advantage of the instability of a receding contact line towards cusp and droplet formation to produce linear patterns of variable spacings. We stabilize the instability of the cusps towards droplet formation by using polymer solutions that inhibit this secondary instability and give rise to long slender cylindrical filaments. We vary the speed of deposition to change the spacing between these filaments. The combination of the two gives rise to linear patterns into which different colloidal particles can be embedded, long DNA molecules can be stretched and particles filtered by size. The technique is therefore suitable to prepare anisotropic structures with variable properties. PMID:27506626

  4. Taylor instability in rhyolite lava flows

    NASA Technical Reports Server (NTRS)

    Baum, B. A.; Krantz, W. B.; Fink, J. H.; Dickinson, R. E.

    1989-01-01

    A refined Taylor instability model is developed to describe the surface morphology of rhyolite lava flows. The effect of the downslope flow of the lava on the structures resulting from the Taylor instability mechanism is considered. Squire's (1933) transformation is developed for this flow in order to extend the results to three-dimensional modes. This permits assessing why ridges thought to arise from the Taylor instability mechanism are preferentially oriented transverse to the direction of lava flow. Measured diapir and ridge spacings for the Little and Big Glass Mountain rhyolite flows in northern California are used in conjunction with the model in order to explore the implications of the Taylor instability for flow emplacement. The model suggests additional lava flow features that can be measured in order to test whether the Taylor instability mechanism has influenced the flows surface morphology.

  5. Tensile Instability in a Thick Elastic Body.

    PubMed

    Overvelde, Johannes T B; Dykstra, David M J; de Rooij, Rijk; Weaver, James; Bertoldi, Katia

    2016-08-26

    A range of instabilities can occur in soft bodies that undergo large deformation. While most of them arise under compressive forces, it has previously been shown analytically that a tensile instability can occur in an elastic block subjected to equitriaxial tension. Guided by this result, we conducted centimeter-scale experiments on thick elastomeric samples under generalized plane strain conditions and observed for the first time this elastic tensile instability. We found that equibiaxial stretching leads to the formation of a wavy pattern, as regions of the sample alternatively flatten and extend in the out-of-plane direction. Our work uncovers a new type of instability that can be triggered in elastic bodies, enlarging the design space for smart structures that harness instabilities to enhance their functionality. PMID:27610857

  6. Effect of pressure anisotropy on magnetorotational instability

    SciTech Connect

    Mikhailovskii, A. B.; Lominadze, J. G.; Churikov, A. P.; Erokhin, N. N.; Erokhin, N. S.; Tsypin, V. S.

    2008-02-15

    It is shown that two new instabilities of hybrid type can occur in a rotating magnetized plasma with anisotropic pressure, i.e., the rotational firehose instability and the rotational mirror instability. In the case of {beta}{sub Parallel-To} > {beta}{sub Up-Tack }, where {beta}{sub Parallel-To} and {beta}{sub Up-Tack} are the ratios of the parallel and perpendicular plasma pressure to the magnetic field pressure, the pressure anisotropy tends to suppress both new instabilities; in the case {beta}{sub Up-Tack} > {beta}{sub Parallel-To }, it leads to their strengthening. In the latter case, the perturbations considered can be unstable even if the Velikhov instability criterion is not satisfied.

  7. Taming contact line instability for pattern formation

    NASA Astrophysics Data System (ADS)

    Deblais, A.; Harich, R.; Colin, A.; Kellay, H.

    2016-08-01

    Coating surfaces with different fluids is prone to instability producing inhomogeneous films and patterns. The contact line between the coating fluid and the surface to be coated is host to different instabilities, limiting the use of a variety of coating techniques. Here we take advantage of the instability of a receding contact line towards cusp and droplet formation to produce linear patterns of variable spacings. We stabilize the instability of the cusps towards droplet formation by using polymer solutions that inhibit this secondary instability and give rise to long slender cylindrical filaments. We vary the speed of deposition to change the spacing between these filaments. The combination of the two gives rise to linear patterns into which different colloidal particles can be embedded, long DNA molecules can be stretched and particles filtered by size. The technique is therefore suitable to prepare anisotropic structures with variable properties.

  8. An anterior signaling center patterns and sizes the anterior neuroectoderm of the sea urchin embryo.

    PubMed

    Range, Ryan C; Wei, Zheng

    2016-05-01

    Anterior signaling centers help specify and pattern the early anterior neuroectoderm (ANE) in many deuterostomes. In sea urchin the ANE is restricted to the anterior of the late blastula stage embryo, where it forms a simple neural territory comprising several types of neurons as well as the apical tuft. Here, we show that during early development, the sea urchin ANE territory separates into inner and outer regulatory domains that express the cardinal ANE transcriptional regulators FoxQ2 and Six3, respectively. FoxQ2 drives this patterning process, which is required to eliminate six3 expression from the inner domain and activate the expression of Dkk3 and sFRP1/5, two secreted Wnt modulators. Dkk3 and low expression levels of sFRP1/5 act additively to potentiate the Wnt/JNK signaling pathway governing the positioning of the ANE territory around the anterior pole, whereas high expression levels of sFRP1/5 antagonize Wnt/JNK signaling. sFRP1/5 and Dkk3 levels are rigidly maintained via autorepressive and cross-repressive interactions with Wnt signaling components and additional ANE transcription factors. Together, these data support a model in which FoxQ2 initiates an anterior patterning center that implements correct size and positions of ANE structures. Comparisons of functional and expression studies in sea urchin, hemichordate and chordate embryos reveal striking similarities among deuterostome ANE regulatory networks and the molecular mechanism that positions and defines ANE borders. These data strongly support the idea that the sea urchin embryo uses an ancient anterior patterning system that was present in the common ambulacrarian/chordate ancestor.

  9. An anterior signaling center patterns and sizes the anterior neuroectoderm of the sea urchin embryo.

    PubMed

    Range, Ryan C; Wei, Zheng

    2016-05-01

    Anterior signaling centers help specify and pattern the early anterior neuroectoderm (ANE) in many deuterostomes. In sea urchin the ANE is restricted to the anterior of the late blastula stage embryo, where it forms a simple neural territory comprising several types of neurons as well as the apical tuft. Here, we show that during early development, the sea urchin ANE territory separates into inner and outer regulatory domains that express the cardinal ANE transcriptional regulators FoxQ2 and Six3, respectively. FoxQ2 drives this patterning process, which is required to eliminate six3 expression from the inner domain and activate the expression of Dkk3 and sFRP1/5, two secreted Wnt modulators. Dkk3 and low expression levels of sFRP1/5 act additively to potentiate the Wnt/JNK signaling pathway governing the positioning of the ANE territory around the anterior pole, whereas high expression levels of sFRP1/5 antagonize Wnt/JNK signaling. sFRP1/5 and Dkk3 levels are rigidly maintained via autorepressive and cross-repressive interactions with Wnt signaling components and additional ANE transcription factors. Together, these data support a model in which FoxQ2 initiates an anterior patterning center that implements correct size and positions of ANE structures. Comparisons of functional and expression studies in sea urchin, hemichordate and chordate embryos reveal striking similarities among deuterostome ANE regulatory networks and the molecular mechanism that positions and defines ANE borders. These data strongly support the idea that the sea urchin embryo uses an ancient anterior patterning system that was present in the common ambulacrarian/chordate ancestor. PMID:26952978

  10. Nonlinear Dynamics of Single Bunch Instability

    SciTech Connect

    Stupakov, G.V.; Breizman, B.N.; Pekker, M.S.; /Texas U.

    2011-09-09

    A nonlinear equation is derived that governs the evolution of the amplitude of unstable oscillations with account of quantum diffusion effects due to the synchrotron radiation. Numerical solutions to this equation predict a variety of possible scenarios of nonlinear evolution of the instability some of which are in good qualitative agreement with experimental observations. Microwave single bunch instability in circular accelerators has been observed in many machines. The instability usually arises when the number of particles in the bunch exceeds some critical value, Nc, which varies depending on the parameters of the accelerating regime. Recent observations on the SLC damping rings at SLAC with a new low-impedance vacuum chamber revealed new interesting features of the instability. In some cases, after initial exponential growth, the instability eventually saturated at a level that remained constant through the accumulation cycle. In other regimes, relaxation-type oscillations were measured in nonlinear phase of the instability. In many cases, the instability was characterized by a frequency close to the second harmonic of the synchrotron oscillations. Several attempts have been made to address the nonlinear stage of the instability based on either computer simulations or some specific assumptions regarding the structure of the unstable mode. An attempt of a more general consideration of the problem is carried out in this paper. We adopt an approach recently developed in plasma physics for analysis of nonlinear behavior of weakly unstable modes in dynamic systems. Assuming that the growth rate of the instability is much smaller than its frequency, we find a time dependent solution to Vlasov equation and derive an equation for the complex amplitude of the oscillations valid in the nonlinear regime. Numerical solutions to this equation predict a variety of possible scenarios of nonlinear evolution of the instability some of which are in good qualitative agreement

  11. Parametric instabilities in large nonuniform laser plasmas

    SciTech Connect

    Baldis, H.A.; Montgomery, D.S.; Moody, J.D.; Estabrook, K.G.; Berger, R.L.; Kruer, W.L.; Labaune, C.; Batha, S.H.

    1992-09-01

    The study of parametric instabilities in laser plasmas is of vital importance for inertial confinement fusion (ICF). The long scale-length plasma encountered in the corona of an ICF target provides ideal conditions for the growth of instabilities such as stimulated Brillouin scattering (SBS), stimulated Raman scattering (SRS), and filamentation. These instabilities can have detrimental effects in ICF and their characterization and understanding is of importance. Scattering instabilities are driven through a feedback loop by which the beating between the electromagnetic EM fields of the laser and the scattered light matches the frequency of a local longitudinal mode of the plasma. Any process which interferes with the coherence of this mechanism can substantially alter the behavior of the instability. Of particular interest is the study of laser beam smoothing techniques on parametric instabilities. These techniques are used to improve irradiation uniformity which can suppress hydrodynamic instabilities. Laser beam smoothing techniques have the potential to control the scattering level from parametric instabilities since they provide not only a smoother laser intensity distribution, but also reduced coherence. Beam smoothing techniques that affect the growth of parametric instabilities include spatial smoothing and temporal smoothing by laser bandwidth. Spatial smoothing modifies the phase fronts and temporal distribution of intensities in the focal volume. The transverse intensity spectrum is shifted towards higher spatial wavenumber and can significantly limit the growth of filamentation. Temporal smoothing reduces the coherence time and consequently limits the growth time. Laser bandwidth is required for most smoothing techniques, and can have an independent effect on the instabilities as well.

  12. Injury to the Anterior Tibial Artery during Bicortical Tibial Drilling in Anterior Cruciate Ligament Reconstruction.

    PubMed

    Kim, Sang Bum; Lim, Jin Woo; Seo, Jeong Gook; Ha, Jeong Ku

    2016-03-01

    Many complications have been reported during or after anterior cruciate ligament (ACL) reconstruction, including infection, bleeding, tibial tunnel widening, arthrofibrosis, and graft failure. However, arterial injury has been rarely reported. This paper reports a case of an anterior tibial arterial injury during bicortical tibial drilling in arthroscopic ACL reconstruction, associated with an asymptomatic occlusion of the popliteal artery. The patient had a vague pain which led to delayed diagnosis of compartment syndrome and delayed treatment with fasciotomy. All surgeons should be aware of these rare but critical complications because the results may be disastrous like muscle necrosis as in this case. PMID:26929808

  13. Injury to the Anterior Tibial Artery during Bicortical Tibial Drilling in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Kim, Sang Bum; Lim, Jin Woo; Seo, Jeong Gook

    2016-01-01

    Many complications have been reported during or after anterior cruciate ligament (ACL) reconstruction, including infection, bleeding, tibial tunnel widening, arthrofibrosis, and graft failure. However, arterial injury has been rarely reported. This paper reports a case of an anterior tibial arterial injury during bicortical tibial drilling in arthroscopic ACL reconstruction, associated with an asymptomatic occlusion of the popliteal artery. The patient had a vague pain which led to delayed diagnosis of compartment syndrome and delayed treatment with fasciotomy. All surgeons should be aware of these rare but critical complications because the results may be disastrous like muscle necrosis as in this case. PMID:26929808

  14. Rotordynamic Instability Problems in High-Performance Turbomachinery

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Rotor dynamic instability problems in high performance turbomachinery are reviewed. Mechanical instability mechanisms are discussed. Seal forces and working fluid forces in turbomachinery are discussed. Control of rotor instability is also investigated.

  15. Evaporation-driven instability of the precorneal tear film.

    PubMed

    Peng, Cheng-Chun; Cerretani, Colin; Braun, Richard J; Radke, C J

    2014-04-01

    Tear-film instability is widely believed to be a signature of eye health. When an interblink is prolonged, randomly distributed ruptures occur in the tear film. "Black spots" and/or "black streaks" appear in 15 to 40 s for normal individuals. For people who suffer from dry eye, tear-film breakup time (BUT) is typically less than a few seconds. To date, however, there is no satisfactory quantitative explanation for the origin of tear rupture. Recently, it was proposed that tear-film breakup is related to locally high evaporative thinning. A spatial variation in the thickness of the tear-film lipid layer (TFLL) may lead to locally elevated evaporation and subsequent tear-film breakup. We examine the local-evaporation-driven tear-film-rupture hypothesis in a one-dimensional (1-D) model for the evolution of a thin aqueous tear film overriding the cornea subject to locally elevated evaporation at its anterior surface and osmotic water influx at its posterior surface. Evaporation rate depends on mass transfer both through the coating lipid layer and through ambient air. We establish that evaporation-driven tear-film breakup can occur under normal conditions but only for higher aqueous evaporation rates. Predicted roles of environmental conditions, such as wind speed and relative humidity, on tear-film stability agree with clinical observations. More importantly, locally elevated evaporation leads to hyperosmolar spots in the tear film and, hence, vulnerability to epithelial irritation. In addition to evaporation rate, tear-film instability depends on the strength of healing flow from the neighboring region outside the breakup region, which is determined by the surface tension at the tear-film surface and by the repulsive thin-film disjoining pressure. This study provides a physically consistent and quantitative explanation for the formation of black streaks and spots in the human tear film during an interblink.

  16. Mesenchymal Stem Cells for Enhancing Biologic Healing after Anterior Cruciate Ligament Injuries.

    PubMed

    Jang, Ki-Mo; Lim, Hong Chul; Bae, Ji Hoon

    2015-01-01

    Arthroscopic anterior cruciate ligament (ACL) reconstruction using tendon grafts is the current gold standard for the treatment of ACL tears in active patients. However, many patients still experience residual knee instability, knee pain and progressive cartilage degeneration following ACL reconstruction. Recent developments in mesenchymal stem cell (MSC)-based approaches for treating musculoskeletal injuries have led to the application of MSCs for enhancing healing after ACL injuries. The purpose of this article is to review recent pre-clinical and clinical studies using MSCs for the enhancement of biologic healing of ACL injuries. Because of the success of pre-clinical studies, MSC-based approaches are now thought to be promising treatment options for enhancing biologic healing of ACL grafts and restoring the functional properties to the levels of the native ACL, and ultimately improving clinical outcomes.

  17. Surgical Treatment of a Rare Isolated Bilateral Agenesis of Anterior and Posterior Cruciate Ligaments

    PubMed Central

    2014-01-01

    The isolated bilateral agenesis of both cruciate ligaments is a rare congenital disorder. A 17-year-old male came to our attention due to an alteration in gait pattern, pain, and tendency to walk on the forefoot with his knee flexed. The patient did not recall previous injuries. Upon physical examination anterior and posterior chronic instability were observed. Radiographic examination of both knees showed hypoplasia of the tibial eminence, a hypoplastic lateral femoral condyle, and a narrow intercondylar notch. MRI brought to light a bilateral agenesis of both posterior cruciate ligaments. Arthroscopic evaluation confirmed bilateral isolated agenesis of both cruciate ligaments. We recommended a rehabilitation program to prepare the patient for the arthroscopic construction of both cruciate ligaments. PMID:25197599

  18. Surgical treatment of a rare isolated bilateral agenesis of anterior and posterior cruciate ligaments.

    PubMed

    Cerulli, G; Amanti, A; Placella, G

    2014-01-01

    The isolated bilateral agenesis of both cruciate ligaments is a rare congenital disorder. A 17-year-old male came to our attention due to an alteration in gait pattern, pain, and tendency to walk on the forefoot with his knee flexed. The patient did not recall previous injuries. Upon physical examination anterior and posterior chronic instability were observed. Radiographic examination of both knees showed hypoplasia of the tibial eminence, a hypoplastic lateral femoral condyle, and a narrow intercondylar notch. MRI brought to light a bilateral agenesis of both posterior cruciate ligaments. Arthroscopic evaluation confirmed bilateral isolated agenesis of both cruciate ligaments. We recommended a rehabilitation program to prepare the patient for the arthroscopic construction of both cruciate ligaments.

  19. Extranodal large B cell lymphoma of the anterior maxilla. Case report and review of literature.

    PubMed

    Webber, Brian; Webber, Mariel; Keinan, David

    2015-01-01

    In the oral cavity, lymphoproliferative disorders can manifest in various ways, often as an extranodal externalization. In the case presented here, it was a B cell lymphoma originating in the periapical bone of the anterior maxilla. X-ray revealed a periapical radiolucency associated with an intact tooth with no decay, fillings or history of trauma. The tooth tested non-vital. After root canal treatment, an apicoectomy was performed with a biopsy. The most common diagnosis would be of dental etiology. The pathology report revealed a non-Hodgkin's B cell lymphoma. Most often, this disease appears as localized dental or oral pathology. Non-specific signs and symptoms present in association with lymphoproliferative disorders include lymphadenopathy, trismus, pain, swelling, sinusitis, fever, sepsis, prosthetic instability and paresthesia. Early detection results in decreased morbidity and a better prognosis for the patient. PMID:25707167

  20. Bilateral Medial Tibial Plateau Fracture after Arthroscopic Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Cho, Chul Hyun; Lee, Kyung Jae; Jeon, Jong Hyuk

    2015-01-01

    Tibial plateau fractures after arthroscopic anterior cruciate ligament (ACL) reconstruction are rare, and only isolated cases have been reported. The authors describe a case of bilateral medial tibial plateau fracture following a minor motorcycle accident in a patient who underwent arthroscopic ACL reconstruction in the past. Two years and four months before the accident, the patient underwent an arthroscopically assisted ACL reconstruction using double-bundle technique on his left knee at a hospital. He had the same surgery using single-bundle technique on his right knee about eight months ago at another hospital. The fractures in his both involved knees occurred through the tibial tunnel and required open reduction with internal fixation. At three weeks after fixation, a second-look arthroscopy revealed intact ACLs in both knees. At five months follow-up, he was able to walk without instability on physical examination. Follow-up radiographs of the patient showed callus formations with healed fractures. PMID:26060613

  1. Imaging of superior labral anterior to posterior (SLAP) tears of the shoulder.

    PubMed

    Simoni, P; Scarciolla, L; Kreutz, J; Meunier, B; Beomonte Zobel, B

    2012-12-01

    Superior labral anterior to posterior (SLAP) tears include a number of abnormal changes of the superior glenoid labrum. SLAP tears have been first reported in elite young atlete and are caused by repetitive overhead motion or by a fall on an outstretched arm. SLAP can lead to chronic pain and instability of shoulder. A diagnosis of SLAP may be difficult on the basis of clinical tests. Hence, modern imaging, including computed tomography arthrography (CTA), magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) play a key role in the diagnosis of SLAP. The large number of normal anatomic variants of the superior labrum and the surrounding structures make the interpretation of SLAP challenging on imaging and at arthroscopy. In this article the imaging of SLAP are discussed in detail along with relevant anatomy, anatomic variants and biomechanics.

  2. Differences among mechanoreceptors in healthy and injured anterior cruciate ligaments and their clinical importance

    PubMed Central

    Dhillon, Mandeep Sing; Bali, Kamal; Prabhakar, Sharad

    2012-01-01

    Summary Mechanoreceptors in an intact Anterior Cruciate Ligament (ACL) contribute towards functional stability of the knee joint. Injury to the ACL not only causes mechanical instability, but also leads to a disturbance in the neuromuscular control of the injured knee due to loss or damage to mechanoreceptors. ACL reconstruction restores proprioceptive potential of the knee to some extent, but the results vary. Although the remnant ACL contains residual mechanoreceptors, the number and functionality of these receptors is dependent, to some extent, on the physical characteristics of the remnant and duration of injury. Remnants, especially that adherent to the PCL, may actually act as a possible source of reinnervation of the graft. These remnants are worth preserving during ACL reconstruction and can play an important role in restoration of proprioception of knee following ACL reconstruction. PMID:23738272

  3. Anterolateral Ligament of the Knee: Back to the Future in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Bonasia, Davide Edoardo; D’Amelio, Andrea; Pellegrino, Pietro; Rosso, Federica; Rossi, Roberto

    2015-01-01

    Although the importance of the anterolateral stabilizing structures of the knee in the setting of anterior cruciate ligament (ACL) injuries has been recognized since many years, most of orthopedic surgeons do not take into consideration the anterolateral structures when performing an ACL reconstruction. Anatomic single or double bundle ACL reconstruction will improve knee stability, but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason, some researchers have turned again towards the anterolateral aspect of the knee and specifically the anterolateral ligament. The goal of this review is to summarize the existing knowledge regarding the anterolateral ligament of the knee, including anatomy, histology, biomechanics and imaging. In addition, the most common anterolateral reconstruction/tenodesis techniques are described together with their respective clinical outcomes. PMID:26330991

  4. Risk Factors for Anterior Cruciate Ligament Injury

    PubMed Central

    Smith, Helen C.; Vacek, Pamela; Johnson, Robert J.; Slauterbeck, James R.; Hashemi, Javad; Shultz, Sandra

    2012-01-01

    Context: Injuries to the anterior cruciate ligament (ACL) of the knee are immediately debilitating and can cause long-term consequences, including the early onset of osteoarthritis. It is important to have a comprehensive understanding of all possible risk factors for ACL injury to identify individuals who are at risk for future injuries and to provide an appropriate level of counseling and programs for prevention. Objective: This review, part 1 of a 2-part series, highlights what is known and still unknown regarding anatomic and neuromuscular risk factors for injury to the ACL from the current peer-reviewed literature. Data Sources: Studies were identified from MEDLINE (1951–March 2011) using the MeSH terms anterior cruciate ligament, knee injury, and risk factors. The bibliographies of relevant articles and reviews were cross-referenced to complete the search. Study Selection: Prognostic studies that utilized the case-control and prospective cohort study designs to evaluate risk factors for ACL injury were included in this review. Results: A total of 50 case-control and prospective cohort articles were included in the review, and 30 of these studies focused on neuromuscular and anatomic risk factors. Conclusions: Several anatomic and neuromuscular risk factors are associated with increased risk of suffering ACL injury—such as female sex and specific measures of bony geometry of the knee joint, including decreased intercondylar femoral notch size, decreased depth of concavity of the medial tibial plateau, increased slope of the tibial plateaus, and increased anterior-posterior knee laxity. These risk factors most likely act in combination to influence the risk of ACL injury; however, multivariate risk models that consider all the aforementioned risk factors in combination have not been established to explore this interaction. PMID:23016072

  5. [LAPAROSCOPIC ANTERIOR UTERINE LIGAMENTOPEXY--OUR EXPERIENCE].

    PubMed

    Blagovest, Bechev; Magunska, Nadya; Kovachev, Emil; Ivanov, Stefan

    2015-01-01

    A great number operative techniques for correction of retroverted uterus are reported in the last years. The aim of these different methods is correction of the retroversion of the uterus, which is connected with pelvic congestion and symptomatic relief. We present a clinical case of 26 years old patient with one Caesarean section. The lady complains of chronic pelvic pain, dispareunia and dismenorrhea. The US exam shows an uterus in strong retroversion position. We restored the anatomic position of the uterus using laparoscopic anterior ligementopexy.

  6. [Prevention and management of anterior resection syndrome].

    PubMed

    Gu, Jin; Pan, Hongda

    2016-04-01

    Because of the improvement of surgical technique and the widely use of multimodality therapy, more patients with rectal cancer undergo sphincter-preserving surgery. However, it has been reported that up to 90% of such patients will suffer from bowel dysfunction, ranging from increased bowel frequency to faecal incontinence or evacuatory dysfunction. This wide spectrum of symptoms after resection of the rectum has been termed anterior resection syndrome (ARS). This disordered bowel function has a substantial negative effect on quality of life, however, the causal mechanisms have not been clarified. The present review discusses the clinical manifestation, underlying mechanisms, as well as prevention and treatment strategies. PMID:27112463

  7. All-inside anterior cruciate ligament reconstruction.

    PubMed

    Blackman, Andrew J; Stuart, Michael J

    2014-10-01

    All-inside anterior cruciate ligament (ACL) reconstruction has undergone a series of modifications over the past 20 years. Current techniques offer the advantages of improved cosmesis, less postoperative pain, decreased bone removal, and gracilis preservation. Few all-inside ACL reconstruction outcome studies are available; therefore, additional research is necessary to compare the results to conventional techniques. The purpose of this article is to review the evolution of all-inside ACL reconstruction, the advantages and disadvantages, our preferred technique, and clinical experience to date.

  8. Anterior ethmoidal artery aneurysm and intracerebral hemorrhage.

    PubMed

    da Costa, L B; Valiante, T; Terbrugge, K; Tymianski, M

    2006-09-01

    The association between the formation of intracranial aneurysms and situations of increased blood flow in certain areas of the brain is well accepted today. It has been seen in association with arteriovenous malformations of the brain, carotid occlusion, and Moyamoya disease. The occurrence of aneurysms in small arteries of the skull base, with the exception of the intracavernous carotid artery, however, is rare. We report a case of a 55-year-old woman who presented with an intracerebral hemorrhage caused by a ruptured anterior ethmoidal artery aneurysm. To the best of our knowledge, this is only the second case of documented intracranial bleeding from such a lesion.

  9. Anterior Shoulder Dislocations in Busy Emergency Departments

    PubMed Central

    Janitzky, Angelika A.; Akyol, Can; Kesapli, Mustafa; Gungor, Faruk; Imak, Arefe; Hakbilir, Oktay

    2015-01-01

    Abstract Shoulder joint is the most common joint requiring reduction by emergency physicians. Successful reduction is based on the overcoming of resistance of the shoulder muscles. Pain is the most important factor in resistance increase and sedation; analgesia and, in certain cases, intra-articular anesthesia are preferred for reduction. The external rotation (ER) method can provide successful reduction without causing an increase in muscle resistance if applied slowly and gently. The aim of this study was, therefore, to determine the usefulness of the ERWOSA method in the reduction of acute anterior shoulder dislocations (AASDs). This was a retrospective descriptive study. The records of patients admitted to the emergency department with anterior shoulder dislocation between 2009 and 2011 were reviewed for demographic data, sedation, analgesia, and discharge times. Patients were then divided into ERWOSA (n = 80) and external rotation and sedation-analgesia (ERASA, n = 59) groups, with regard to the application of SA (sedation-analgesia). The study data were analyzed using SPSS version 22.0 software for Windows. Numerical data were presented as mean ± standard deviation and categorical data as rates. A total of 139 patients were included in the study. The patients’ average age was 35 ± 14 years, 108 (77.7%) were male. Successful reduction rates for 59 male and 21 female patients in the ERWOSA group were 83% and 66.7% (78.7% total success), respectively. Successful reduction rates for 49 male and 10 female patients in the ERASA group were 87.7% and 90% (88.1% total success), respectively. The length of stay of the ERWOSA and ERASA groups in emergency services were found to be significantly different, with 55 ± 17 and 118 ± 23 minutes for each group, respectively. There were no complications. The ER method can be used in reduction of anterior shoulder dislocations without sedation and analgesia, if applied slowly enough to overcome

  10. Results of Latarjet Coracoid Transfer to Revise Failed Arthroscopic Instability Repairs

    PubMed Central

    Nicholson, Gregory P.; Rahman, Zain; Verma, Nikhil N.; Romeo, Anthony A.; Cole, Brian J.; Gupta, Anil Kumar; Bruce, Benjamin

    2014-01-01

    Objectives: Arthroscopic instability repair has supplanted open techniques to anatomically reconstruct anteroinferior instability pathology. Arthroscopic technique can fail for a variety of reasons. We have utilized the Latarjet as a revision option in failed arthroscopic instability repairs when there is altered surgical anatomy, capsular deficiency and/or glenoid bone compromise and recurrent glenohumeral instability. Methods: We reviewed 51 shoulders (40 ♀, 11♂) that underwent Latarjet coracoid transfer for the revision of failed previous arthroscopic instability repair. The avg. age was 32.6 yrs (16-58). All patients had recurrent symptomatic anterior instability after previous arthroscopic surgery, and avg. time from arthroscopic repair to Latarjet was 13 months (4-40 mn). All had either CT or MRI that revealed suture anchor material in the glenoid, labral and capsular stripping, and anteroinferior glenoid bone loss or erosion. Advanced bone loss percentage analysis was not performed for this study. We excluded all patients that had a previous open repair, a seizure disorder, or if the Latarjet was a primary procedure. Outcome scores pre-operatively avg: SST: 6.7 (1-12); VAS: 3 (0-8); ASES: 63 (32-89). Coracoid transfer was performed thru a subscapularis split in 38, and with tendon takedown in 13. The coracoid was osteotomized along its long axis parallel to the undersurface of the lateral aspect. This provided at least 2.5 to 3.5 cm of graft with the conjoined tendon attached. The coracoacromial (CA) ligament was incised leaving a 1 cm. stump. The transfer was affixed flush with the articular surface but not lateral to it, with two 3.5 mm cortical screws in lag fashion overdrilling the coracoid with the CA ligament directed laterally. The capsule was then repaired to the CA ligament to make the transfer extra-articular. Results: At avg. 4 yr (2-7 yrs) follow-up stability had been maintained in 51 (100%).without further instability surgery. There were no

  11. Arthroscopic Distal Clavicular Autograft for Treating Shoulder Instability With Glenoid Bone Loss

    PubMed Central

    Tokish, John M.; Fitzpatrick, Kelly; Cook, Jay B.; Mallon, William J.

    2014-01-01

    Glenoid bone loss is a significant risk factor for failure after arthroscopic shoulder stabilization. Multiple options are available to reconstruct this bone loss, including coracoid transfer, iliac crest bone graft, and osteoarticular allograft. Each technique has strengths and weaknesses. Coracoid grafts are limited to anterior augmentation and, along with iliac crest, do not provide an osteochondral reconstruction. Osteochondral allografts do provide a cartilage source but are challenged by the potential for graft rejection, infection, cost, and availability. We describe the use of a distal clavicular osteochondral autograft for bony augmentation in cases of glenohumeral instability with significant bone loss. This graft has the advantages of being readily available and cost-effective, it provides an autologous osteochondral transplant with minimal donor-site morbidity, and it can be used in both anterior and posterior bone loss cases. The rationale and technical aspects of arthroscopic performance will be discussed. Clinical studies are warranted to determine the outcomes of the use of the distal clavicle as a graft in shoulder instability. PMID:25264509

  12. Flapping instability of a liquid jet

    NASA Astrophysics Data System (ADS)

    Matas, Jean-Philippe; Cartellier, Alain

    2013-01-01

    We study the flapping instability observed when a liquid jet is incompletely atomized by a fast parallel gas stream: the remaining liquid jet is destabilized over a scale large compared with its radius, and breaks into liquid fragments. We characterize the symmetry of this instability and its frequency. The intact liquid length is measured as a function of gas and liquid velocity, and turns out to be longer than the one predicted by Raynal (1997) for a planar mixing layer. The frequency of the instability is measured with a spectral method, and is in agreement with the frequency observed for the planar shear instability, though slightly smaller. The planar, and not helical, symmetry of the instability makes it akin to a flapping instability, observed when a planar liquid sheet is atomized by two planar gas streams. We next measure drop sizes when the flapping instability is present, with a method based on image processing. Measured size distributions are in agreement with distributions observed in a mixing layer geometry for low gas velocities (long tail distribution). The mean drop diameter depends weakly on liquid velocity, and decreases as d10˜Ug0.9. On the contrary, Sauter diameter depends strongly on liquid velocity.

  13. Baroclinic instability in stellar radiation zones

    SciTech Connect

    Kitchatinov, L. L.

    2014-03-20

    Surfaces of constant pressure and constant density do not coincide in differentially rotating stars. Stellar radiation zones with baroclinic stratification can be unstable. Instabilities in radiation zones are of crucial importance for angular momentum transport, mixing of chemical species, and, possibly, for magnetic field generation. This paper performs linear analysis of baroclinic instability in differentially rotating stars. Linear stability equations are formulated for differential rotation of arbitrary shape and then solved numerically for rotation nonuniform in radius. As the differential rotation increases, r- and g-modes of initially stable global oscillations transform smoothly into growing modes of baroclinic instability. The instability can therefore be interpreted as stability loss to r- and g-modes excitation. Regions of stellar parameters where r- or g-modes are preferentially excited are defined. Baroclinic instability onsets at a very small differential rotation of below 1%. The characteristic time of instability growth is about 1000 rotation periods. Growing disturbances possess kinetic helicity. Magnetic field generation by the turbulence resulting from baroclinic instability in differentially rotating radiation zones is therefore possible.

  14. Secondary instabilities in compressible boundary layers

    NASA Technical Reports Server (NTRS)

    Ng, Lian; Erlebacher, Gordon

    1990-01-01

    Secondary instabilities are examined in compressible boundary layers at Mach numbers M(sub infinity) = 0, 0.8, 1.6, and 4.5. It is found that there is a broad-band of highly unstable 3-d secondary disturbances whose growth rates increase with increasing primary wave amplitude. At M(sub infinity) is less than or equal to 1.6, fundamental resonance dominates at relatively high (2-d) primary disturbance amplitude, while subharmonic resonance is characterized by a low (2-d) primary amplitude. At M(sub infinity) = 4.5, the subharmonic instability which arises from the second mode disturbance is the strongest type of secondary instability. The influence of the inclination, theta, of the primary wave with respect to the mean flow direction on secondary instability is investigated at M(sub infinity) = 1.6 for small to moderate values of theta. It is found that the strongest fundamental instability occurs when the primary wave is inclined at 10 deg to the mean flow direction, although a 2-d primary mode yields the most amplified subharmonic. The subharmonic instability at a high value of theta (namely, theta = 45 deg) is also discussed. Finally, a subset of the secondary instability results are compared against direct numerical simulations.

  15. Elliptical instability in the planetary fluid cores

    NASA Astrophysics Data System (ADS)

    Moradi, Ali

    Elliptical instability may be excited in any rotating flow with elliptically deformed streamlines. Investigating this instability in containers with spheroidal or ellipsoidal boundaries is of geophysical and astrophysical interest as many stars and planets are either rotating ellipsoidal fluid bodies or have substantial fluid cores which are either ellipsoidal, in the absence of a solid inner core, or ellipsoidal shells such as the Earth's fluid core; elliptical instability may be excited in these bodies as a result of the gravitational pull of a secondary body such as a moon or a large asteroid orbiting these bodies. In this thesis, the nonlinear evolution of elliptical instability in an inviscid incompressible rotating triaxial ellipsoid is numerically studied using the least-square finite element method. After validating the method by reproducing some known results, it is applied to other configurations in order to investigate some open questions on this subject, namely, the effects of the oblateness of the ellipsoid and the frequency ratio of the orbital speed of the secondary body on the evolution of the elliptical instability. We have found that if the parameters of the system, i.e. the flattening ratio and the frequency ratio of the background rotation, are in the range of the spin-over instability, a repetitive three-dimensional rigorous motion is maintained indefinitely; otherwise, instability may be excited initially, once the streamlines become elliptical, for certain ranges of the system parameters; however, as time elapses the motion becomes two dimensional with small displacement amplitudes in x- and y- directions.

  16. Smectic layer instabilities in liquid crystals.

    PubMed

    Dierking, Ingo; Mitov, Michel; Osipov, Mikhail A

    2015-02-01

    Scientists aspire to understand the underlying physics behind the formation of instabilities in soft matter and how to manipulate them for diverse investigations, while engineers aim to design materials that inhibit or impede the nucleation and growth of these instabilities in critical applications. The present paper reviews the field-induced rotational instabilities which may occur in chiral smectic liquid-crystalline layers when subjected to an asymmetric electric field. Such instabilities destroy the so-named bookshelf geometry (in which the smectic layers are normal to the cell surfaces) and have a detrimental effect on all applications of ferroelectric liquid crystals as optical materials. The transformation of the bookshelf geometry into horizontal chevron structures (in which each layer is in a V-shaped structure), and the reorientation dynamics of these chevrons, are discussed in details with respect to the electric field conditions, the material properties and the boundary conditions. Particular attention is given to the polymer-stabilisation of smectic phases as a way to forbid the occurrence of instabilities and the decline of related electro-optical performances. It is also shown which benefit may be gained from layer instabilities to enhance the alignment of the liquid-crystalline geometry in practical devices, such as optical recording by ferroelectric liquid crystals. Finally, the theoretical background of layer instabilities is given and discussed in relation to the experimental data.

  17. Radiative heat transport instability in ICF plasmas

    NASA Astrophysics Data System (ADS)

    Rozmus, W.; Bychenkov, V. Yu.

    2015-11-01

    A laser produced high-Z plasma in which an energy balance is achieved due to radiation losses and radiative heat transfer supports ion acoustic wave instability. A linear dispersion relation is derived and instability is compared to the radiation cooling instability. This instability develops in the wide range of angles and wavenumbers with the typical growth rate on the order of cs/LT (cs is the sound speed, LT is the temperature scale length). In addition to radiation dominated systems, a similar thermal transport driven ion acoustic instability was found before in plasmas where the thermal transport coefficient depends on electron density. However, under conditions of indirect drive ICF experiments the driving term for the instability is the radiative heat flux and in particular, the density dependence of the radiative heat conductivity. A specific example of thermal Bremsstrahlung radiation source has been considered corresponding to a thermal conductivity coefficient that is inversely proportional to the square of local particle density. In the nonlinear regime this instability may lead to plasma jet formation and anisotropic x-ray generation.

  18. Anterior segment spectral domain optical coherence tomography imaging of patients with anterior scleritis.

    PubMed

    Levison, Ashleigh L; Lowder, Careen Y; Baynes, Kimberly M; Kaiser, Peter K; Srivastava, Sunil K

    2016-08-01

    The purpose of the study was to describe the findings seen on anterior segment spectral domain optical coherence tomography (SD-OCT) in patients with anterior scleritis and determine the feasibility of using SD-OCT to image and grade the degree of scleral inflammation and monitor response to treatment. All patients underwent slit lamp examination by a uveitis specialist, and the degree of scleral inflammation was recorded. Spectral domain OCT imaging was then performed of the conjunctiva and scleral tissue using a standardized acquisition protocol. The scans were graded and compared to clinical findings. Twenty-eight patients with anterior scleritis and ten patients without ocular disease were included in the study. Seventeen of the scleritis patients were followed longitudinally. Common findings on SD-OCT in patients with active scleritis included changes in hyporeflectivity within the sclera, nodules, and visible vessels within the sclera. There was significant variation in findings on SD-OCT within each clinical grade of active scleritis. These changes on SD-OCT improved with treatment and clinical improvement. SD-OCT imaging provided various objective measures that could be used in the future to grade inflammatory activity in patients with anterior scleritis. Longitudinal imaging of patients with active scleritis demonstrated that SD-OCT may have great utility in monitoring response to treatment.

  19. Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly.

    PubMed

    Zhao, Jie; Lian, Xiao Feng; Hou, Tie Sheng; Ma, Hui; Chen, Zhi Ming

    2007-12-01

    Between 2000 and 2004, 40 cases (average age 38, range 16-65 years) of spinal tuberculosis were treated with anterior debridement and iliac bone graft with one-stage anterior or posterior instrumentation in our unit. All patients received at least 2 weeks of regular antituberculous chemotherapy before surgery. We followed up all patients for 12-48 months (mean 22 months). Local symptoms of all patients were relieved significantly 1-3 weeks postoperatively; 23 of 25 cases (92%) with neurogical deficit had excellent or good clinical results. Erythrocyte sedimentation rates (ESR) returned from 51 mm/h to 32 mm/h (average) two weeks postoperatively. Kyphosis degrees were corrected by a mean of 16 degrees . Fusion rate of the grafting bone was 72.5% one year postoperatively and 90% two years postoperatively. Severe complications did not occur. We therefore believe that patients undergoing anterior debridement and iliac bone grafting with one-stage anterior or posterior instrumentation achieve satisfactory clinical and radiographic outcomes.

  20. Weakly nonlinear instability of planar viscoelastic sheets

    NASA Astrophysics Data System (ADS)

    Wang, Chen; Yang, Li-jun; Xie, Luo; Chen, Pi-min

    2015-01-01

    A second-order weakly nonlinear analysis has been made of the temporal instability for the linear sinuous mode of two-dimensional planar viscoelastic liquid sheets moving in an inviscid gas. The convected Jeffreys models including the corotational Jeffreys model, Oldroyd A model, and the Oldroyd B model are considered as the rheology model of the viscoelastic fluid of the sheet. The solution for the second-order gas-to-liquid interface displacement has been derived, and the temporal evolution leading to the breakup has been shown. The second-order interface displacement of the linear sinuous mode is varicose, which causes the sheet to fragment into ligaments. First-order constitutive relations of the three rheology models become identical after linearization, so the linear instability results are also the same. For the second-order weakly nonlinear instability, the second-order constitutive relation varies among the corotational Jeffreys model, Oldroyd A model, and the Oldroyd B model, but although they have different disturbance pressures, their disturbance velocities and interface displacements are the same, and therefore, the sheets of the corotational Jeffreys fluid, Oldroyd A fluid, and the Oldroyd B fluid have the same instability behavior characterized by the wave profile and breakup time. The reason for the identical instability behavior is that the effect of different codeformations of the corotational frame, covariant frame, and the contravariant frame is counteracted by the corresponding change in the second-order disturbance pressure, leaving no influence on the second-order velocity. At wavenumbers with maximum instabilities, an increase in the elasticity, or a reduction of the deformation retardation time, leads to a larger linear temporal growth rate, greater second-order disturbance amplitude, and shorter breakup time, thereby enhancing instability. The mechanism of linear instability has been examined using an energy approach, which shows that the

  1. Allograft safety in anterior cruciate ligament reconstruction.

    PubMed

    Cohen, Steven B; Sekiya, Jon K

    2007-10-01

    Allograft tissue seems to provide an excellent option for reconstruction of the ACL in the primary and revision setting. Although in general the risks of using allograft tissue in ACL reconstruction are low, the consequences of complications associated with disease or infection transmission or of recurrent instability secondary to graft failure are large. Surgeons should provide patients with the information available regarding allograft risks and should have thorough knowledge of the source and preparation of the grafts by their tissue bank before implantation for ACL reconstruction.

  2. Allograft safety in anterior cruciate ligament reconstruction.

    PubMed

    Cohen, Steven B; Sekiya, Jon K

    2007-10-01

    Allograft tissue seems to provide an excellent option for reconstruction of the ACL in the primary and revision setting. Although in general the risks of using allograft tissue in ACL reconstruction are low, the consequences of complications associated with disease or infection transmission or of recurrent instability secondary to graft failure are large. Surgeons should provide patients with the information available regarding allograft risks and should have thorough knowledge of the source and preparation of the grafts by their tissue bank before implantation for ACL reconstruction. PMID:17920955

  3. Anterior chamber angle in the exfoliation syndrome.

    PubMed Central

    Wishart, P K; Spaeth, G L; Poryzees, E M

    1985-01-01

    The gonioscopic findings of 76 patients with the exfoliation syndrome were reviewed. A high frequency of narrowness of the anterior chamber (AC) angle was found (32%). 18% had angles considered occludable, and 14% had obvious angle-closure glaucoma as shown by the presence of peripheral anterior synechias (PAS). Increased pigmentation of the posterior trabecular meshwork (PTM) was noted in all cases. When this pigmentation was markedly asymmetrical, unilateral exfoliation with glaucoma was common in the more pigmented eye. In addition heavy angle pigmentation in the absence of exfoliation was noted in the fellow eye of patients with characteristic exfoliated material in the other eye. Increased pigmentation of the PTM may be the earliest detectable sign of the exfoliation syndrome (ES). The clinical significance of our estimating PTM pigmentation at the 12 o'clock position is discussed. In view of the accelerated optic nerve damage associated with the development of glaucoma secondary to ES, routine estimation of the pigmentation of the PTM at 12 o'clock is recommended in the hope of early detection of cases of otherwise inapparent ES. Images PMID:3966996

  4. Graft impingement in anterior cruciate ligament reconstruction.

    PubMed

    Iriuchishima, Takanori; Shirakura, Kenji; Fu, Freddie H

    2013-03-01

    Anterior cruciate ligament (ACL) graft impingement is one of the most troubling complications in ACL reconstruction. In the previous strategy of isometric "non-anatomical" ACL reconstruction, posterior tibial tunnel placement and notchplasty were recommended to avoid graft impingement. Recently, the strategy of ACL reconstruction is shifting towards "anatomical" reconstruction. In anatomical ACL reconstruction, the potential risk of graft impingement is higher than in non-anatomical reconstruction because the tibial tunnel is placed at a more anterior portion on the tibia. However, there have been few studies reporting on graft impingement in anatomical ACL reconstruction. This study will provide a review of graft impingement status in both non-anatomical and the more recent anatomical ACL reconstruction techniques. In conclusion, with the accurate creation of bone tunnels within ACL native footprint, the graft impingement might not happen in anatomical ACL reconstruction. For the clinical relevance, to prevent graft impingement, surgeons should pay attention of creating correct anatomical tunnels when they perform ACL reconstruction. Level of evidence IV.

  5. The anterior loop of the carotid siphon.

    PubMed

    Alencastro, L C

    1991-01-01

    The extracavernous-presubarachnoid segment of the carotid artery (EPCA), medial to the clinoid process, was studied in 48 sphenoid bones. Ten specimens were submitted to microdissection; the remainders were cut in 1 mm thick slices after electrolytic decalcification. The studies showed that the EPCA has a mean length of 3.09 mm (0.5 to 6.5 mm). It has a shorter length than the whole medioclinoid (paraclinoid) segment of the artery because the subarachnoid space may enter between the artery and the clinoid process, as well as the venous space of the cavernous sinus. Venous channels of extremely small diameter were found between the EPCA and the clinoid process in 30.3% of the cases and between the EPCA and the sphenoid body in 48.6%. The distal limit of the intracavernous cartoid artery is the projection of the caudal surface of the clinoid process, which is coincident with the vertex of the anterior loop of the carotid siphon in 91.7% of the cases. The origin of the ophthalmic artery was verified to be from the EPCA in 9.7%, at the transition to the subarachnoid space in 6.5%, and intracavernous in 3.2%. Immediately proximal to the EPCA, the anterior horizontal segment of the carotid artery may be reached without entering the venous space of the cavernous sinus through the superior wall in 27.8% and through the lateral wall in 66.6%.

  6. Adjacent Segment Pathology after Anterior Cervical Fusion.

    PubMed

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon; Kim, Sung Kyu

    2016-06-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion.

  7. Lesion-negative anterior cingulate epilepsy.

    PubMed

    Lacuey, Nuria; Davila, Javier Chapa; Zonjy, Bilal; Amina, Shahram; Couce, Marta; Turnbull, John; Miller, Jonathan; Lüders, Hans; Lhatoo, Samden D

    2015-06-01

    MRI-negative anterior cingulate epilepsy is a rare entity. Herein, we describe a case of MRI and functional imaging-negative intractable frontal lobe epilepsy in which, initially, secondary bilateral synchrony of surface and intracranial EEG and non-lateralizing semiology rendered identification of the epileptogenic zone difficult. A staged bilateral stereotactic EEG exploration revealed a very focal, putative ictal onset zone in the right anterior cingulate gyrus, as evidenced by interictal and ictal high-frequency oscillations (at 250Hz) and induction of seizures from the same electrode contacts by 50-Hz low-intensity cortical stimulation. This was subsequently confirmed by ILAE class 1 outcome following resection of the ictal onset and irritative zones. Histopathological examination revealed focal cortical dysplasia type 1b (ILAE Commission, 2011) as the cause of epilepsy. The importance of anatomo-electro-clinical correlation is illustrated in this case in which semiological and electrophysiological features pointed to the anatomical localization of a challenging, MRI-negative epilepsy. PMID:26056053

  8. Adjacent Segment Pathology after Anterior Cervical Fusion

    PubMed Central

    Chung, Jae Yoon; Park, Jong-Beom; Seo, Hyoung-Yeon

    2016-01-01

    Anterior cervical fusion has become a standard of care for numerous pathologic conditions of the cervical spine. However, subsequent development of clinically significant disc disease at levels adjacent to fused discs is a serious long-term complication of this procedure. As more patients live longer after surgery, it is foreseeable that adjacent segment pathology (ASP) will develop in increasing numbers of patients. Also, ASP has been studied more intensively with the recent popularity of motion preservation technologies like total disc arthroplasty. The true nature and scope of ASP remains poorly understood. The etiology of ASP is most likely multifactorial. Various factors including altered biomechanical stresses, surgical disruption of soft tissue and the natural history of cervical disc disease contribute to the development of ASP. General factors associated with disc degeneration including gender, age, smoking and sports may play a role in the development of ASP. Postoperative sagittal alignment and type of surgery are also considered potential causes of ASP. Therefore, a spine surgeon must be particularly careful to avoid unnecessary disruption of the musculoligamentous structures, reduced risk of direct injury to the disc during dissection and maintain a safe margin between the plate edge and adjacent vertebrae during anterior cervical fusion. PMID:27340541

  9. High-resolution computational fluid dynamics detects flow instabilities in the carotid siphon: implications for aneurysm initiation and rupture?

    PubMed

    Valen-Sendstad, Kristian; Piccinelli, Marina; Steinman, David A

    2014-09-22

    The carotid siphon is by nature a tortuous vessel segment with sharp bends and large area variations, and of relevance to the study of intracranial aneurysm initiation and rupture. The aim of this paper was to determine whether the siphon might harbor flow instabilities, if care is taken to resolve them. This study focused on five consecutive internal carotid artery (ICA) aneurysm cases from the open-source Aneurisk dataset. The aneurysm, always downstream of the siphon, was digitally removed using previously developed and verified tools. Computational fluid dynamic (CFD) models included long cervical segments upstream, and middle and anterior cerebral arteries downstream. High-resolution pulsatile simulations were performed using the equivalent of ~24 million linear tetrahedra on average (range 16-32 M) and 30,000 time-steps/cycle. Two of the five cases were laminar with mild flow instabilities right after peak systole. One of the cases experienced strong periodic vortex shedding at a frequency of around 100 Hz. The remaining two cases harbored higher frequency flow instabilities and complex 3D vortical structures, extending to the cerebral arteries downstream. Our findings suggest that the carotid siphon, a conduit to the majority of anterior intracranial aneurysms, may experience flow instabilities, consistent with in vitro reports, but seemingly at odds with the majority of CFD studies, which have been done at lower resolutions. This has obvious implications for elucidating the forces involved in aneurysm initiation; and propagation of flow instabilities into ICA or downstream aneurysms could also impact understanding of the forces involved in aneurysm rupture.

  10. Anterior segment imaging in glaucoma: An updated review

    PubMed Central

    Maslin, Jessica S; Barkana, Yaniv; Dorairaj, Syril K

    2015-01-01

    Anterior segment imaging allows for an objective method of visualizing the anterior segment angle. Two of the most commonly used devices for anterior segment imaging include the anterior segment optical coherence tomography (AS-OCT) and the ultrasound biomicroscopy (UBM). AS-OCT technology has several types, including time-domain, swept-source, and spectral-domain-based configurations. We performed a literature search on PubMed for articles containing the text “anterior segment OCT,” “ultrasound biomicroscopy,” and “anterior segment imaging” since 2004, with some pertinent references before 2004 included for completeness. This review compares the advantages and disadvantages of AS-OCT and UBM, and summarizes the most recent literature regarding the importance of these devices in glaucoma diagnosis and management. These devices not only aid in visualization of the angle, but also have important postsurgical applications in bleb and tube imaging. PMID:26576519

  11. Fingering instability in combustion: an extended view.

    PubMed

    Zik, O; Moses, E

    1999-07-01

    We detail the experimental situation concerning the fingering instability that occurs when a solid fuel is forced to burn against a horizontal oxidizing wind. The instability appears when the Rayleigh number for convection is below criticality. The focus is on the developed fingering state. We present direct measurements of the depletion of oxygen by the front as well as new results that connect heat losses to the characteristic scale of the instability. In addition, we detail the experimental system, elaborate (qualitatively and quantitatively) on the results that were previously presented, and discuss new observations. We also show that the same phenomenological model applies to electrochemical deposition.

  12. Black Hole Instabilities and Local Penrose Inequalities

    NASA Astrophysics Data System (ADS)

    Figueras, Pau; Murata, Keiju; Reall, Harvey S.

    2015-01-01

    Various higher-dimensional black holes have been shown to be unstable by studying linearized gravitational perturbations. A simpler method for demonstrating instability is to find initial data that describes a small perturbation of the black hole and violates a Penrose inequality. We use the method to confirm the existence of the "ultraspinning" instability of Myers-Perry black holes. We also study black rings and show that "fat" black rings are unstable. We find no evidence of any rotationally symmetric instability of "thin" black rings.

  13. Anatomy, pathophysiology, and biomechanics of shoulder instability.

    PubMed

    Doukas, W C; Speer, K P

    2001-07-01

    Instability in the athlete presents a unique challenge to the orthopaedic surgeon. A spectrum of both static and dynamic pathophysiology, as well as gross and microscopic histopathology, contribute to this complex clinical continuum. Biomechanical studies of the shoulder and ligament cutting studies in recent years have generated a more precise understanding of the individual contributions of the various ligaments and capsular regions to shoulder instability. An understanding of the underlying pathology and accurate assessment of degree and direction of the instability by clinical examination and history are essential to developing appropriate treatment algorithms.

  14. Inviscid instability of streamwise corner flow

    NASA Technical Reports Server (NTRS)

    Balachandar, S.; Malik, M. R.

    1993-01-01

    Linear stability of the incompressible flow along a stream wise corner is studied by solving the two-dimensional eigenvalue problem governed by partial differential equations. It is found that this fully three-dimensional flow is subject to inviscid instability due to the inflectional nature of the stream wise velocity profile. The higher growth rates for the inviscid instability mode, which is symmetric about the corner bisector, as compared to the viscous Tollmien-Schlichting instability operative away from the corner is consistent with the experimental findings that the corner flow transitions to turbulence earlier than the two-dimensional Blasius flow away from the corner.

  15. Rayleigh-Taylor instability in binary condensates

    SciTech Connect

    Gautam, S.; Angom, D.

    2010-05-15

    We propose a well-controlled experimental scheme to initiate and examine the Rayleigh-Taylor instability in two-species Bose-Einstein condensates. We identify the {sup 85}Rb-{sup 87}Rb mixture as an excellent candidate to observe experimentally. The instability is initiated by tuning the {sup 85}Rb-{sup 85}Rb interaction through a magnetic Feshbach resonance. We show that the observable signature of the instability is the damping of the radial oscillations. We also propose a semianalytic scheme to determine the stationary state of binary condensates with the Thomas-Fermi approximation for axisymmetric traps.

  16. A drift model of interchange instability

    SciTech Connect

    Benilov, E. S.; Power, O. A.

    2007-08-15

    A set of asymptotic equations is derived, describing the dynamics of the flute mode in a magnetized plasma with cold ions, under a 'local' approximation (i.e., near a particular point). The asymptotic set is then used to calculate the growth rate of interchange instability in the slab model. It is shown that, unlike the magnetohydrodynamic ordering, the drift one allows instability to occur for either sign of the pressure gradient (i.e., for both 'bad' and 'good' curvature of the magnetic field). It is also demonstrated that finite beta gives rise to an extra instability that does not exist in the small-beta limit.

  17. A new formulation of longitudinal coherent instabilities

    SciTech Connect

    Zhang, S.Y.; Weng, W.T.

    1993-01-01

    The quadrature response of longitudinal impedance is shown to be the effective impedance for the beam instability. The results of the application of this formulation are compared with that obtained using the Robinson-Pedersen approach and the Sacherer integral equation. The formulation is further generalized to the rigid bunch motion using signal analysis method, where a form factor shows up naturally. Finally, the formulation is applied to solve the coupled bunch instabilities. Examples of the AGS Booster and the AGS coupled bunch instabilities are used to illustrate the applications of the formulation.

  18. A new formulation of longitudinal coherent instabilities

    SciTech Connect

    Zhang, S.Y.; Weng, W.T.

    1993-06-01

    The quadrature response of longitudinal impedance is shown to be the effective impedance for the beam instability. The results of the application of this formulation are compared with that obtained using the Robinson-Pedersen approach and the Sacherer integral equation. The formulation is further generalized to the rigid bunch motion using signal analysis method, where a form factor shows up naturally. Finally, the formulation is applied to solve the coupled bunch instabilities. Examples of the AGS Booster and the AGS coupled bunch instabilities are used to illustrate the applications of the formulation.

  19. Meniscus Instability in a Thin Elastic Film

    NASA Astrophysics Data System (ADS)

    Ghatak, Animangsu; Chaudhury, Manoj K.; Shenoy, Vijay; Sharma, Ashutosh

    2000-11-01

    A new kind of meniscus instability leading to the formation of stationary fingers with a well-defined spacing has been observed in experiments with elastomeric films confined between a plane rigid glass and a thin curved glass plate. The wavelength of the instability increases linearly with the thickness of the confined film, but it is remarkably insensitive to the compliance and the energetics of the system. However, lateral amplitude (length) of the fingers depends on the compliance of the system and on the radius of curvature of the glass plate. A simple linear stability analysis is used to explain the underlying physics and the key observed features of the instability.

  20. Sawtooth Stabilization and Onset of Alfvenic Instabilities

    NASA Astrophysics Data System (ADS)

    Nishimura, Y.; Cheng, C. Z.

    2011-10-01

    Tokamak sawtooth instabilities can be stabilized by high energy particles as a consequence of conservation of the third adiabatic invariant.On the other hand, termination of the stabilized period is reported due to the onset of Alfvenic instabilities (and thus the absence of the stabilizing mechanism). In this work, employing a kinetic-fluid model, the interaction of m=1 resistive kink mode and high energy particles is investigated. The onset of Alfvenic instabilities is examined as a function of the inversion radius location. D.J. Campbell et al., Phys. Rev. Lett. 60, 2148 (1988); F. Porcelli, Plasma Phys. Controlled Fusion 33, 1601 (1991).

  1. Prognosis of anterior cruciate ligament reconstruction: a data-driven approach

    PubMed Central

    Chandra, Abhijit; Kar, Oliva; Wu, Kuan-Chuen; Hall, Michelle; Gillette, Jason

    2015-01-01

    Individuals who suffer anterior cruciate ligament (ACL) injury are at higher risk of developing knee osteoarthritis (OA) and almost 50% display symptoms 10–20 years post injury. Anterior cruciate ligament reconstruction (ACLR) often does not protect against knee OA development. Accordingly, a multi-scale formulation for data-driven prognosis (DDP) of post-ACLR is developed. Unlike traditional predictive strategies that require controlled off-line measurements or ‘training’ for determination of constitutive parameters to derive the transitional statistics, the proposed DDP algorithm relies solely on in situ measurements. The proposed DDP scheme is capable of predicting onset of instabilities. As the need for off-line testing (or training) is obviated, it can be easily implemented for ACLR, where such controlled a priori testing is almost impossible to conduct. The DDP algorithm facilitates hierarchical handling of the large dataset and can assess the state of recovery in post-ACLR conditions based on data collected from stair ascent and descent exercises of subjects. The DDP algorithm identifies inefficient knee varus motion and knee rotation as primary difficulties experienced by some of the post-ACLR population. In such cases, levels of energy dissipation rate at the knee, and its fluctuation may be used as measures for assessing progress after ACL reconstruction. PMID:27547072

  2. Failure of the human lumbar motion-segments resulting from anterior shear fatigue loading

    PubMed Central

    SKRZYPIEC, Daniel M.; NAGEL, Katrin; SELLENSCHLOH, Kay; KLEIN, Anke; PÜSCHEL, Klaus; MORLOCK, Michael M.; HUBER, Gerd

    2016-01-01

    An in-vitro experiment was designed to investigate the mode of failure following shear fatigue loading of lumbar motion-segments. Human male lumbar motion-segments (age 32–42 years, n=6) were immersed in Ringer solution at 37°C and repeatedly loaded, using a modified materials testing machine. Fatigue loading consisted of a sinusoidal shear load from 0 N to 1,500 N (750 N±750 N) applied to the upper vertebra of the motion-segment, at a frequency of 5 Hz. During fatigue experiments, several failure events were observed in the dynamic creep curves. Post-test x-ray, CT and dissection revealed that all specimens had delamination of the intervertebral disc. Anterior shear fatigue predominantly resulted in fracture of the apophyseal processes of the upper vertebrae (n=4). Exposure to the anterior shear fatigue loading caused motion-segment instability and resulted in vertebral slip corresponding to grade I and ‘mild’ grade II spondylolisthesis, as observed clinically. PMID:26829975

  3. Chromosomal instability determines taxane response

    PubMed Central

    Swanton, Charles; Nicke, Barbara; Schuett, Marion; Eklund, Aron C.; Ng, Charlotte; Li, Qiyuan; Hardcastle, Thomas; Lee, Alvin; Roy, Rajat; East, Philip; Kschischo, Maik; Endesfelder, David; Wylie, Paul; Kim, Se Nyun; Chen, Jie-Guang; Howell, Michael; Ried, Thomas; Habermann, Jens K.; Auer, Gert; Brenton, James D.; Szallasi, Zoltan; Downward, Julian

    2009-01-01

    Microtubule-stabilizing (MTS) agents, such as taxanes, are important chemotherapeutics with a poorly understood mechanism of action. We identified a set of genes repressed in multiple cell lines in response to MTS agents and observed that these genes are overexpressed in tumors exhibiting chromosomal instability (CIN). Silencing 22/50 of these genes, many of which are involved in DNA repair, caused cancer cell death, suggesting that these genes are involved in the survival of aneuploid cells. Overexpression of these “CIN-survival” genes is associated with poor outcome in estrogen receptor–positive breast cancer and occurs frequently in basal-like and Her2-positive cases. In diploid cells, but not in chromosomally unstable cells, paclitaxel causes repression of CIN-survival genes, followed by cell death. In the OV01 ovarian cancer clinical trial, a high level of CIN was associated with taxane resistance but carboplatin sensitivity, indicating that CIN may determine MTS response in vivo. Thus, pretherapeutic assessment of CIN may optimize treatment stratification and clinical trial design using these agents. PMID:19458043

  4. Chromosomal instability determines taxane response.

    PubMed

    Swanton, Charles; Nicke, Barbara; Schuett, Marion; Eklund, Aron C; Ng, Charlotte; Li, Qiyuan; Hardcastle, Thomas; Lee, Alvin; Roy, Rajat; East, Philip; Kschischo, Maik; Endesfelder, David; Wylie, Paul; Kim, Se Nyun; Chen, Jie-Guang; Howell, Michael; Ried, Thomas; Habermann, Jens K; Auer, Gert; Brenton, James D; Szallasi, Zoltan; Downward, Julian

    2009-05-26

    Microtubule-stabilizing (MTS) agents, such as taxanes, are important chemotherapeutics with a poorly understood mechanism of action. We identified a set of genes repressed in multiple cell lines in response to MTS agents and observed that these genes are overexpressed in tumors exhibiting chromosomal instability (CIN). Silencing 22/50 of these genes, many of which are involved in DNA repair, caused cancer cell death, suggesting that these genes are involved in the survival of aneuploid cells. Overexpression of these "CIN-survival" genes is associated with poor outcome in estrogen receptor-positive breast cancer and occurs frequently in basal-like and Her2-positive cases. In diploid cells, but not in chromosomally unstable cells, paclitaxel causes repression of CIN-survival genes, followed by cell death. In the OV01 ovarian cancer clinical trial, a high level of CIN was associated with taxane resistance but carboplatin sensitivity, indicating that CIN may determine MTS response in vivo. Thus, pretherapeutic assessment of CIN may optimize treatment stratification and clinical trial design using these agents. PMID:19458043

  5. Taylor Instability of Incompressible Liquids

    DOE R&D Accomplishments Database

    Fermi, E.; von Neumann, J.

    1955-11-01

    A discussion is presented in simplified form of the problem of the growth of an initial ripple on the surface of an incompressible liquid in the presence of an acceleration, g, directed from the outside into the liquid. The model is that of a heavy liquid occupying at t = 0 the half space above the plane z = 0, and a rectangular wave profile is assumed. The theory is found to represent correctly one feature of experimental results, namely the fact that the half wave of the heavy liquid into the vacuum becomes rapidly narrower while the half wave pushing into the heavy liquid becomes more and more blunt. The theory fails to account for the experimental results according to which the front of the wave pushing into the heavy liquid moves with constant velocity. The case of instability at the boundary of 2 fluids of different densities is also explored. Similar results are obtained except that the acceleration of the heavy liquid into the light liquid is reduced.

  6. Gravitational Instability in Planetesimal Disks

    NASA Astrophysics Data System (ADS)

    Bolin, Bryce T.; Lithwick, Yoram; Pan, Margaret; Rein, Hanno; Wu, Yanqin

    2014-11-01

    Gravitational instability (GI) has been proposed as a method of forming giant gas planets enhanced by disk thermodynamics in a protoplanetary disk (Boss, 1997, Science 276; Durisen et al., 2007, Protostars and Planets V) and as a method of forming planetesimals through the focusing of boulders by the interaction between solids and gases in a turbulent circumstellar disk (Johansen et al., 2007, Nature 448; Youdin & Goodman, 2005, Astrophys. J. 620). GI is mediated through a gaseous circumstellar disk in each each of these scenarios. We explore the possibility of GI occurring in a planetesimal disk devoid of gas. In this regime, mutual collisions between planetesimals are required to dissipate their orbital shear and velocity dispersion enough for collapse to occur as described by the Toomre stability criterion (Toomre, 1964, Astrophys. J. 139; Toomre, 1981, Structure and Evolution of Normal Galaxies). How frequent must collisions be between planetesimals in a gravitationally stable planetesimal disk for GI to occur? Are there collisional rates where GI is postponed indefinitely in an equilibrium state between gravitational stirring and collisional cooling? We present 3D shearing sheet simulations using the REBOUND N-body code with the symplectic epicyclic integrator (Rein & Liu, 2011, A&A 537; Rein & Tremaine, 2011, MNRAS 415) in which the candidate collision rates are within a few orders of magnitude of the disk dynamical lifetime. Our simulations suggest that collisions rate directly controls disk cooling. The shape of the disk cooling curve is independent of the collision rate when scaled to the collision time.

  7. Boyle's law and gravitational instability

    NASA Astrophysics Data System (ADS)

    Lombardi, M.; Bertin, G.

    2001-09-01

    We have re-examined the classical problem of the macroscopic equation of state for a hydrostatic isothermal self-gravitating gas cloud bounded by an external medium at constant pressure. We have obtained analytical conditions for its equilibrium and stability without imposing any specific shape and symmetry to the cloud density distribution. The equilibrium condition can be stated in the form of an upper limit to the cloud mass; this is found to be inversely proportional to the power 3/2 of a form factor mu characterizing the shape of the cloud. In this respect, the spherical solution, associated with the maximum value of the form factor, mu = 1, turns out to correspond to the shape that is most difficult to realize. Surprisingly, the condition that defines the onset of the Bonnor instability (or gravothermal catastrophe) can be cast in the form of an upper limit to the density contrast within the cloud that is independent of the cloud shape. We have then carried out a similar analysis in the two-dimensional case of infinite cylinders, without assuming axisymmetry. The results obtained in this paper generalize well-known results available for spherical or axisymmetric cylindrical isothermal clouds that have had wide astrophysical applications, especially in the study of the interstellar medium.

  8. Thermal instability of cell nuclei

    NASA Astrophysics Data System (ADS)

    Warmt, Enrico; Kießling, Tobias R.; Stange, Roland; Fritsch, Anatol W.; Zink, Mareike; Käs, Josef A.

    2014-07-01

    DNA is known to be a mechanically and thermally stable structure. In its double stranded form it is densely packed within the cell nucleus and is thermo-resistant up to 70\\:^\\circ {\\rm{C}}. In contrast, we found a sudden loss of cell nuclei integrity at relatively moderate temperatures ranging from 45 to 55\\:^\\circ {\\rm{C}}. In our study, suspended cells held in an optical double beam trap were heated under controlled conditions while monitoring the nuclear shape. At specific critical temperatures, an irreversible sudden shape transition of the nuclei was observed. These temperature induced transitions differ in abundance and intensity for various normal and cancerous epithelial breast cells, which clearly characterizes different cell types. Our results show that temperatures slightly higher than physiological conditions are able to induce instabilities of nuclear structures, eventually leading to cell death. This is a surprising finding since recent thermorheological cell studies have shown that cells have a lower viscosity and are thus more deformable upon temperature increase. Since the nucleus is tightly coupled to the outer cell shape via the cytoskeleton, the force propagation of nuclear reshaping to the cell membrane was investigated in combination with the application of cytoskeletal drugs.

  9. Polygonal instability of Marangoni flows

    NASA Astrophysics Data System (ADS)

    Roché, Matthieu; Labousse, Matthieu; El Hadj Maiga, Baba; Nya, Loïc; Le Roux, Sébastien; Cantat, Isabelle; Saint-Jalmes, Arnaud

    2015-11-01

    The transport of pepper grains floating at the surface of a bowl of water after the release of a drop of dishwashing liquid is a classical experiment to demonstrate the Marangoni effect, i.e. the flow of a liquid layer induced by interfacial tension gradients at its surface. In this case, the interfacial tension gradient results from a surfactant interfacial concentration gradient. Recently, we showed that continuous injection of an aqueous solution of hydrosoluble surfactants at the surface of a cm-thick pure water layer induced finite-size Marangoni flows surrounded by a region characterized by the presence of several pairs of interfacial vortices arranged along the the vertices of polygons. During this talk, I will show that we can understand the flow structure induced by these Marangoni flows, in particular their tendency to have polygonal shapes. I will describe how flow features such as the number of interfacial vortices or bulk recirculation flows depend on flow geometry. Finally, I will compare these results to a model that explains similar polygonal instabilities in other flows such as the hydraulic jump.

  10. THE MAGNETOVISCOUS-THERMAL INSTABILITY

    SciTech Connect

    Islam, Tanim

    2012-02-10

    Accretion flows onto underluminous black holes, such as Sagittarius A* at the center of our galaxy, are dilute (mildly collisional to highly collisionless), optically thin, and radiatively inefficient. Therefore, the accretion properties of such dilute flows are expected to be modified by their large viscosities and thermal conductivities. Second, turbulence within these systems needs to transport angular momentum as well as thermal energy generated through gravitational infall outward in order to allow accretion to occur. This is in contrast to classical accretion flows, in which the energy generated through accretion down a gravitational well is locally radiated. In this paper, using an incompressible fluid treatment of an ionized gas, we expand on previous research by considering the stability properties of a magnetized rotating plasma wherein the thermal conductivity and viscosity are not negligible and may be dynamically important. We find a class of MHD instabilities that can transport angular momentum and thermal energy outward. They are plausible candidates to describe accretion in radiatively inefficient accretion flows. We finish by discussing the implications for analytic models and numerical MHD simulations of mildly dilute or collisionless astrophysical plasmas, and immediate directions for further research.

  11. Instability of viscoelastic compound jets

    NASA Astrophysics Data System (ADS)

    Ye, Han-Yu; Yang, Li-Jun; Fu, Qing-Fei

    2016-04-01

    This paper investigates the axisymmetric instability of a viscoelastic compound jet, for which the constitutive relation is described by the Oldroyd B model. It is found that a viscoelastic compound jet is more unstable than a Newtonian compound jet, regardless of whether the viscoelastic compound jet is inner-Newtonian-outer-viscoelastic, inner-viscoelastic-outer-Newtonian, or fully viscoelastic. It is also found that an increase in the stress relaxation time of the inner or outer fluid renders the jet more unstable, while an increase in the time constant ratio makes the jet less unstable. An analysis of the energy budget of the destabilization process is performed, in which a formulation using the relative rate of change of energy is adopted. The formulation is observed to provide a quantitative analysis of the contribution of each physical factor (e.g., release of surface energy and viscous dissipation) to the temporal growth rate. The energy analysis reveals the mechanisms of various trends in the temporal growth rate, including not only how the growth rate changes with the parameters, but also how the growth rate changes with the wavenumber. The phenomenon of the dispersion relation presenting two local maxima, which occurred in previous research, is explained by the present energy analysis.

  12. Dural arteriovenous fistula involving the anterior condylar canal.

    PubMed

    Cyril, Chivot; Ofélia, Marabotto; Hervé, Deramond

    2013-07-01

    Dural arteriovenous fistula (DAVF) of the anterior condylar canal is a rare subgroup of posterior fossa DAVF. Successful treatment of this DAVF requires an accurate image diagnosis and the knowledge of the anatomy of the anterior condylar confluent. We present the imaging features of angiography and MR angiography of a 54-year-old man, who presented progressive right synchronous tinnitus due to a DAVF of the anterior condylar confluent, successfully treated by transvenous embolization. PMID:22607489

  13. Crumbs Affects Protein Dynamics In Anterior Regions Of The Developing Drosophila Embryo

    PubMed Central

    Firmino, João; Tinevez, Jean-Yves; Knust, Elisabeth

    2013-01-01

    Maintenance of apico-basal polarity is essential for epithelial integrity and requires particular reinforcement during tissue morphogenesis, when cells are reorganised, undergo shape changes and remodel their junctions. It is well established that epithelial integrity during morphogenetic processes depends on the dynamic exchange of adherens junction components, but our knowledge on the dynamics of other proteins and their dynamics during these processes is still limited. The early Drosophila embryo is an ideal system to study membrane dynamics during morphogenesis. Here, morphogenetic activities differ along the anterior-posterior axis, with the extending germband showing a high degree of epithelial remodelling. We developed a Fluorescence Recovery After Photobleaching (FRAP) assay with a higher temporal resolution, which allowed the distinction between a fast and a slow component of recovery of membrane proteins during the germband extension stage. We show for the first time that the recovery kinetics of a general membrane marker, SpiderGFP, differs in the anterior and posterior parts of the embryo, which correlates well with the different morphogenetic activities of the respective embryonic regions. Interestingly, absence of crumbs, a polarity regulator essential for epithelial integrity in the Drosophila embryo, decreases the fast component of SpiderGFP and of the apical marker Stranded at Second-Venus specifically in the anterior region. We suggest that the defects in kinetics observed in crumbs mutant embryos are the first signs of tissue instability in this region, explaining the earlier breakdown of the head epidermis in comparison to that of the trunk, and that diffusion in the plasma membrane is affected by the absence of Crumbs. PMID:23555600

  14. ANTERIOR CRUCIATE LIGAMENT INJURY: TREATMENT AND REHABILITATION. CURRENT PERSPECTIVES AND TRENDS

    PubMed Central

    Arliani, Gustavo Gonçalves; Astur, Diego da Costa; Kanas, Michel; Kaleka, Camila Cohen; Cohen, Moises

    2015-01-01

    Objective: The aim of this study was to evaluate the procedures used by knee surgeons in Brazil for treating and rehabilitating anterior cruciate ligament injuries. Methods: A questionnaire consisting of 21 closed questions was developed, addressing topics relating to treatment and rehabilitation after anterior cruciate ligament reconstruction. The questionnaire was applied to Brazilian knee surgeons during the three days of the 42nd Brazilian Congress of Orthopedics and Traumatology in 2010. Results: A total of 226 surgeons filled out the questionnaire completely. The most commonly used types of graft were hamstrings tendons and the central third of the ipsilateral patellar tendon, which were used by 82.3% and 53.5% of the sample, respectively. The technique of reconstruction with a single transtibial band was the first preference and was used by 66.4% of the participants. A period of 1 to 4 weeks between injury and surgical procedure was considered ideal by most participants (52.65%). Complaints from patients that the knee was ‘giving way’ or unstable and presence of a positive pivot shift maneuver were the most decisive factors considered in making the decision to operate the patient. Patient satisfaction and absence of complaints of instability during the postoperative period were the criteria deemed to be most important for the surgery to be considered a success. Conclusions: There are clearly evolving trends in treating and rehabilitating the anterior cruciate ligament in Brazil. However, more prospective controlled studies are needed in order to evaluate the clinical and scientific benefits of these trends. PMID:27042620

  15. Changes to the mechanical properties of the glenohumeral capsule during anterior dislocation.

    PubMed

    Browe, Daniel P; Voycheck, Carrie A; McMahon, Patrick J; Debski, Richard E

    2014-01-22

    The glenohumeral joint is the most frequently dislocated major joint in the body, and instability due to permanent deformation of the glenohumeral capsule is a common pathology. The corresponding change in mechanical properties may have implications for the ideal location and extent of plication, which is a common clinical procedure used to repair the capsule. Therefore, the objective of this study was to quantify the mechanical properties of four regions of the glenohumeral capsule after anterior dislocation and compare the properties to the normal glenohumeral capsule. Six fresh-frozen cadaveric shoulders were dislocated in the anterior direction with the joint in the apprehension position using a robotic testing system. After dislocation, mechanical testing was performed on the injured glenohumeral capsule by loading the tissue samples in tension and shear. An inverse finite element optimization routine was used to simulate the experiments and obtain material coefficients for each tissue sample. Cauchy stress-stretch curves were then generated to represent the mechanical response of each tissue sample to theoretical loading conditions. Based on several comparisons (average of the material coefficients, average stress-stretch curve for each region, and coefficients representing the average curves) between the normal and injured tissue samples, the mechanical properties of the injured tissue samples from multiple regions were found to be lower than those of the normal tissue in tension but not in shear. This finding indicates that anterior dislocation primarily affects the tensile behavior of the glenohumeral capsule rather than the shear behavior, and this phenomenon could be caused by plastic deformation of the matrix, permanent collagen fiber rotation, and/or collagen fiber failure. These results suggest that plication and suturing may not be sufficient to return stability to the shoulder after dislocation in all individuals. Thus, surgeons may need to perform

  16. Isolated Right Ventricular Infarction Mimicking Anterior ST-Segment Elevation

    PubMed Central

    Oktay, Veysel; Coskun, Ugur; Yildiz, Ahmet; Gurmen, Tevfik

    2016-01-01

    Acute coronary syndromes in patients with presence of ST-segment elevation in the anterior precordial leads indicates left anterior descending coronary artery occlusion. However, anterior ST-segment elevation has also been described in right ventricular myocardial infarction and is thought to be due to right coronary artery (RCA) occlusion. We present a rare case of isolated RVMI presenting with anterior ST-segment elevation due to proximal occlusion of a right coronary artery that was treated by primary coronary angioplasty. Primary coronary angioplasty and stenting of this artery was performed resulting in resolution of the chest pain and ST- segment elevation. PMID:27190867

  17. Overview of Rayleigh-Taylor instability

    SciTech Connect

    Sharp, D.H.

    1983-01-01

    The aim of this talk is to survey Rayleigh-Taylor instability, describing the phenomenology that occurs at a Taylor unstable interface, and reviewing attempts to understand these phenomena quantitatively.

  18. Magnetorotational decay instability in Keplerian disks.

    PubMed

    Shtemler, Yuri; Liverts, Edward; Mond, Michael

    2013-12-01

    The saturation of the magnetorotational instability (MRI) in thin Keplerian disks through three-wave resonant interactions is introduced and discussed. That mechanism is a natural generalization of the fundamental decay instability discovered five decades ago for infinite, homogeneous, and immovable plasmas. The decay instability relies on the energy transfer from the MRI to stable slow Alfvén-Coriolis as well as magnetosonic waves. A second-order forced Duffing amplitude equation for the initially unstable MRI as well as two first-order equations for the other two waves are derived. The solutions of those equations exhibit bounded bursty nonlinear oscillations for the MRI as well as unbounded growth for the linearly stable slow Alfvén-Coriolis and magnetosonic perturbations, thus giving rise to the magnetorotational decay instability. PMID:24476249

  19. Hydrodynamic instability of solar thermosyphon water heaters

    SciTech Connect

    Du, S.C.; Huang, B.J.; Yen, R.H. . Dept. of Mechanical Engineering)

    1994-02-01

    The flow instability of a solar thermosyphon water heater is studied analytically. A system dynamics model is derived by means of a one-dimensional approach and a linear perturbation method. The characteristic equation is obtained and the Nyquist criterion is used to examine the flow stability. The parameter M is a dimensionless parameter of system stability. The stability maps are plotted in terms of 14 parameters. The occurrence of hydrodynamic instability is determined by comparing the stability curves and the designed values of M. Flow instability is shown not to occur in most of solar water heaters commercially available, because the loop friction is relatively high in the design and because solar irradiation in field operation is still not high enough to cause flow instability.

  20. Nonlinear dynamics: When instability makes sense

    NASA Astrophysics Data System (ADS)

    Ashwin, Peter; Timme, Marc

    2005-07-01

    Mathematical models that use instabilities to describe changes of weather patterns or spacecraft trajectories are well established. Could such principles apply to the sense of smell, and to other aspects of neural computation?

  1. Stepper motor instabilities in an aerospace application

    NASA Technical Reports Server (NTRS)

    Kackley, Russell; Mccully, Sean

    1992-01-01

    Stepper motors are frequently used in positioning mechanisms because they have several advantages over ordinary DC motors. However, there is frequently no feedback loop and the motor may exhibit instabilities under some conditions. A stepper motor in an aerospace positioning mechanism was investigated. During testing, the motor exhibited unstable behavior, such as backrunning and forward running. The instability was dependent on voltage pulse characteristics, temperature, positioning angle, step rate, and interaction between the two motors in the system. Both testing and analysis results verified the instability. A special purpose FORTRAN code was written to simulate the system. This code was combined with another simpler code to show the performance of the system in the phase plane so that instability boundaries could be displayed along with the motor performance. The analysis was performed to verify that proposed modifications would produce stable performance before implementation in the hardware. Subsequent testing verified the analytic stability predictions.

  2. INSTABILITY ISSUES AT THE SNS STORAGE RING

    SciTech Connect

    ZHANG,S.Y.

    1999-06-28

    The impedance and beam instability issues of the SNS storage ring is reviewed, and the effort toward solutions at the BNL is reported. Some unsettled issues are raised, indicating the direction of planned works.

  3. Experimental Replication of an Aeroengine Combustion Instability

    NASA Technical Reports Server (NTRS)

    Cohen, J. M.; Hibshman, J. R.; Proscia, W.; Rosfjord, T. J.; Wake, B. E.; McVey, J. B.; Lovett, J.; Ondas, M.; DeLaat, J.; Breisacher, K.

    2000-01-01

    Combustion instabilities in gas turbine engines are most frequently encountered during the late phases of engine development, at which point they are difficult and expensive to fix. The ability to replicate an engine-traceable combustion instability in a laboratory-scale experiment offers the opportunity to economically diagnose the problem (to determine the root cause), and to investigate solutions to the problem, such as active control. The development and validation of active combustion instability control requires that the causal dynamic processes be reproduced in experimental test facilities which can be used as a test bed for control system evaluation. This paper discusses the process through which a laboratory-scale experiment was designed to replicate an instability observed in a developmental engine. The scaling process used physically-based analyses to preserve the relevant geometric, acoustic and thermo-fluid features. The process increases the probability that results achieved in the single-nozzle experiment will be scalable to the engine.

  4. Parametric instabilities in weakly magnetized plasma

    SciTech Connect

    Weatherall, J.C.; Goldman, M.V.; Nicholson, D.R.

    1981-05-15

    Parametric instabilities in a weakly magnetized plasma are discussed. The results are applied to waves excited by electron streams which travel outward from the Sun along solar-wind magnetic field lines, as in a type III solar radio burst.

  5. Instabilities of geared couplings: Theory and practice

    NASA Technical Reports Server (NTRS)

    Kirk, R. G.; Mondy, R. E.; Murphy, R. C.

    1982-01-01

    The use of couplings for high speed turbocompressors or pumps is essential to transmit power from the driver. Typical couplings are either of the lubricated gear or dry diaphragm type design. Gear couplings have been the standard design for many years and recent advances in power and speed requirements have pushed the standard design criteria to the limit. Recent test stand and field data on continuous lube gear type couplings have forced a closer examination of design tolerances and concepts to avoid operational instabilities. Two types of mechanical instabilities are reviewed in this paper: (1) entrapped fluid, and (2) gear mesh instability resulting in spacer throw-out onset. Test stand results of these types of instabilities and other directly related problems are presented together with criteria for proper coupling design to avoid these conditions. An additional test case discussed shows the importance of proper material selection and processing and what can happen to an otherwise good design.

  6. Electrostatic ion cyclotron velocity shear instability

    NASA Technical Reports Server (NTRS)

    Lemons, D. S.; Winske, D.; Gary, S. P.

    1992-01-01

    A local electrostatic dispersion equation is derived for a shear flow perpendicular to an ambient magnetic field, which includes all kinetic effects and involves only one important parameter. The dispersion equation is cast in the form of Gordeyev integrals and is solved numerically. Numerical solutions indicate that an ion cyclotron instability is excited. The instability occurs roughly at multiples of the ion cyclotron frequency (modified by the shear), with the growth rate or the individual harmonics overlapping in the wavenumber. At large values of the shear parameter, the instability is confined to long wavelengths, but at smaller shear, a second distinct branch at shorter wavelengths also appears. The properties of the instability obtained are compared with those obtained in the nonlocal limit by Ganguli et al. (1985, 1988).

  7. The universal instability in general geometry

    SciTech Connect

    Helander, P.; Plunk, G. G.

    2015-09-15

    The “universal” instability has recently been revived by Landreman et al. [Phys. Rev. Lett. 114, 095003 (2015)], who showed that it indeed exists in plasma geometries with straight (but sheared) magnetic field lines. Here, it is demonstrated analytically that this instability can be presented in more general sheared and toroidal geometries. In a torus, the universal instability is shown to be closely related to the trapped-electron mode, although the trapped-electron drive is usually dominant. However, this drive can be weakened or eliminated, as in the case in stellarators with the maximum-J property, leaving the parallel Landau resonance to drive a residual mode, which is identified as the universal instability.

  8. The nature of symmetric instability and its similarity to convective and inertial instability

    NASA Technical Reports Server (NTRS)

    Xu, Q.; Clark, J. H. E.

    1985-01-01

    It is shown that there exists a local similarity among SI (Symmetric Instability), BI (Buoyancy or Convective Instability), and II (Inertial Instability) even for fully nonlinear viscous motion. The most unstable slope angles for SI and Moist SI motions are analyzed based on parcel energetics. These considerations also suggest qualitatively that CSI (Conditional SI) circulations will be slantwise and lie between the moist most unstable slope and dry least stable slope of the basic state.

  9. Reduced modeling of the magnetorotational instability

    NASA Astrophysics Data System (ADS)

    Jamroz, Ben F.

    2009-06-01

    Accretion describes the process by which matter in an astrophysical disk falls onto a central massive object. Accretion disks are present in many astrophysical situations including binary star systems, young stellar objects, and near black holes at the center of galaxies. Measurements from observations of these disks have shown that viscous processes are unable to transport the necessary levels of angular momentum needed for accretion. Therefore, accretion requires an efficient mechanism of angular momentum transport. Mixing by turbulent processes greatly enhances the level of angular momentum transport in a turbulent fluid. Thus, the generation of turbulence in these disks may provide the mechanism needed for accretion. A classical result of hydrodynamic theory is that typical accretion disks are hydrodynamically stable to shear instabilities, since the specific angular momentum increases outwards. Other processes of generating hydrodynamic turbulence (barotropic instability, baroclinic instability, sound wave, shock waves, finite amplitude instabilities) may be present in these disks, however, none of these mechanisms has been shown to produce the level of angular momentum transport needed for accretion. Hydrodynamical turbulence does not produce enough angular momentum transport to produce the level of accretion observed in astrophysical accretion disks. The leading candidate for the source of turbulence leading to the transport of angular momentum is the magnetorotational instability, a linear axisymmetric instability of electrically conducting fluid in the presence of an imposed magnetic field and shear (or differential rotation). This instability is an efficient mechanism of angular momentum transport generating the level of transport needed for accretion. The level of effective angular momentum transport is determined by the saturated state of sustained turbulence generated by the instability. The mechanism of nonlinear saturation of this instability is not

  10. Delay in surgery predisposes to meniscal and chondral injuries in anterior cruciate ligament deficient knees

    PubMed Central

    Gupta, Ravi; Masih, Gladson David; Chander, Gaurav; Bachhal, Vikas

    2016-01-01

    Background: Despite improvements in instability after anterior cruciate ligament (ACL) reconstruction, associated intraarticular injuries remain a major cause of concern and important prognostic factor for long term results as it may lead to osteoarthritis. Delay in ACL reconstruction has been in variably linked to increase in these injuries but there is lack of consensus regarding optimal timing of reconstruction. The goal of this study was to investigate delay in surgery and other factors, associated with intraarticular injuries in ACL deficient knees. Materials and Methods: A total of 438 patients (42 females; 396 males) enrolled for this prospective observational study. The average age of patients was 26.43 (range 17–51 years) years with a mean surgical delay of 78.91 (range 1 week - 18 years) weeks after injury. We analyzed the factors of age, sex, surgical delay, instability, and level of activity for possible association with intraarticular injuries. Results: Medial meniscus injuries had a significant association with surgical delay (P = 0.000) after a delay of 6 months. Lateral meniscus injuries had a significant association with degree of instability (P = 0.001). Medial-sided articular injuries were significantly affected by age (0.005) with an odds ratio (OR) of 1.048 (95% confidence interval [CI] of 1.014–1.082) reflecting 4.8% rise in incidence with each year. Lateral-sided injuries were associated with female sex (P = 0.018) with OR of 2.846 (95% CI of 1.200–6.752). The level of activity failed to reveal any significant associations. Conclusion: Surgical delay predicts an increase in medial meniscal and lateral articular injuries justifying early rather than delayed reconstruction in ACL deficient knees. Increasing age is positively related to intraarticular injuries while females are more susceptible to lateral articular injuries. PMID:27746491

  11. A new inclination instability in planetary systems

    NASA Astrophysics Data System (ADS)

    Madigan, Ann-Marie

    2015-08-01

    I describe a new instability in Keplerian disks of massive particles on eccentric orbits. Gravitational torques between the orbits align their angles of pericenter and drive exponential growth in orbital inclination. This instability implies specific ratios for Kepler elements of the orbits, similar to what is seen in the inner Oort Cloud of our solar system. I also discuss implications for extra-solar planetary systems and for nuclear star clusters in the centers of galaxies.

  12. High-pressure mechanical instability in rocks

    USGS Publications Warehouse

    Byerlee, J.D.; Brace, W.F.

    1969-01-01

    At a confining pressure of a few kilobars, deformation of many sedimentary rocks, altered mafic rocks, porous volcanic rocks, and sand is ductile, in that instabilities leading to audible elastic shocks are absent. At pressures of 7 to 10 kilobars, however, unstable faulting and stick-slip in certain of these rocks was observed. This high pressure-low temperature instability might be responsible for earthquakes in deeply buried sedimentary or volcanic sequences.

  13. Flow instabilities in transonic small disturbance theory

    NASA Technical Reports Server (NTRS)

    Williams, M. H.; Bland, S. R.; Edwards, J. W.

    1985-01-01

    The dynamics of unsteady transonic small disturbance flows about two-dimensional airfoils is examined, with emphasis on the behavior in the region where the steady state flow is nonunique. It is shown that nonuniqueness results from an extremely long time scale instability which occurs in a finite Mach number and angle of attack range. The similarity scaling rules for the instability are presented and the possibility of similar behavior in the Euler equations is discussed.

  14. Computational methods for probability of instability calculations

    NASA Technical Reports Server (NTRS)

    Wu, Y.-T.; Burnside, O. H.

    1990-01-01

    This paper summarizes the development of the methods and a computer program to compute the probability of instability of a dynamic system than can be represented by a system of second-order ordinary linear differential equations. Two instability criteria based upon the roots of the characteristics equation or Routh-Hurwitz test functions are investigated. Computational methods based on system reliability analysis methods and importance sampling concepts are proposed to perform efficient probabilistic analysis. Numerical examples are provided to demonstrate the methods.

  15. Observation of noisy precursors of dynamical instabilities

    SciTech Connect

    Jeffries, C.; Wiesenfeld, K.

    1985-02-01

    We have measured the power spectra of a periodically driven p-n junction in the vicinity of a dynamical instability. The addition of external noise introduces new lines in the spectra, which become more prominent as a bifurcation point is approached. The scaling of the peak, width, area, and line shape of these lines is measured near the onset of two different codimension-one instabilities: the period doubling and Hopf bifurcations. The results are in excellent agreement with recent theoretical predictions.

  16. Energetic particle instabilities in fusion plasmas

    NASA Astrophysics Data System (ADS)

    Sharapov, S. E.; Alper, B.; Berk, H. L.; Borba, D. N.; Breizman, B. N.; Challis, C. D.; Classen, I. G. J.; Edlund, E. M.; Eriksson, J.; Fasoli, A.; Fredrickson, E. D.; Fu, G. Y.; Garcia-Munoz, M.; Gassner, T.; Ghantous, K.; Goloborodko, V.; Gorelenkov, N. N.; Gryaznevich, M. P.; Hacquin, S.; Heidbrink, W. W.; Hellesen, C.; Kiptily, V. G.; Kramer, G. J.; Lauber, P.; Lilley, M. K.; Lisak, M.; Nabais, F.; Nazikian, R.; Nyqvist, R.; Osakabe, M.; Perez von Thun, C.; Pinches, S. D.; Podesta, M.; Porkolab, M.; Shinohara, K.; Schoepf, K.; Todo, Y.; Toi, K.; Van Zeeland, M. A.; Voitsekhovich, I.; White, R. B.; Yavorskij, V.; TG, ITPA EP; Contributors, JET-EFDA

    2013-10-01

    Remarkable progress has been made in diagnosing energetic particle instabilities on present-day machines and in establishing a theoretical framework for describing them. This overview describes the much improved diagnostics of Alfvén instabilities and modelling tools developed world-wide, and discusses progress in interpreting the observed phenomena. A multi-machine comparison is presented giving information on the performance of both diagnostics and modelling tools for different plasma conditions outlining expectations for ITER based on our present knowledge.

  17. High-pressure mechanical instability in rocks.

    PubMed

    Byerlee, J D; Brace, W F

    1969-05-01

    At a confining pressure of a few kilobars, deformation of many sedimentary rocks, altered mafic rocks, porous volcanic rocks, and sand is ductile, in that instabilities leading to audible elastic shocks are absent. At pressures of 7 to 10 kilobars, however, unstable faulting and stick-slip in certain of these rocks was observed. This high pressure-low temperature instability might be responsible for earthquakes in deeply buried sedimentary or volcanic sequences.

  18. Relativistically modulational instability by strong Langmuir waves

    SciTech Connect

    Liu, X. L.; Liu, S. Q.; Li, X. Q.

    2012-09-15

    Based on the set of nonlinear coupling equations, which has considered the relativistic effects of electrons, modulational instability by strong Langmuir waves has been investigated in this paper. Both the characteristic scale and maximum growth rate of the Langmuir field will enhance with the increase in the electron relativistic effect. The numerical results indicate that longitudinal perturbations induce greater instability than transverse perturbations do, which will lead to collapse and formation of the pancake-like structure.

  19. Magnetorotational instabilities and pulsar kick velocities

    NASA Astrophysics Data System (ADS)

    Heras, Ricardo

    2016-02-01

    At the end of their birth process, neutron stars can be subject to a magnetorotational instability in which a conversion of kinetic energy of differential rotation into radiation and kinetic energies is expected to occur at the Alfvén timescale of a few ms. This birth energy conversion predicts the observed large velocity of neutron stars if during the evolving of this instability the periods are of a few ms and the magnetic fields reach values of 1016 G.

  20. Instabilities In The Flow Between Rotating Disks

    NASA Astrophysics Data System (ADS)

    Moisy, F.; Gauthier, G.; Gondret, P.; Rabaud, M.

    Instabilities in the flow between two close rotating disks enclosed by a cylinder are investigated experimentally. This flow undergoes a large gallery of instability patterns, presented in the plane of parameters (Reb, Ret) of the Reynolds numbers based on the velocity of each disk and the distance between them. The corotation case and the counter-rotation case with low counter-rotation ratio are very similar to the rotor-stator case: instabilities of the Bödewadt type boundary layer leads to axisymmetric vortices and positive spirals. The counter-rotation case with higher counter-rotation ratio is more complex: above a given rotation ratio, the radial recirculation flow gets organized in a two-cell structure with the apparition of a stagnation circle on the slower disk. A new kind of instability pattern is observed, called negative spirals, that may coexist with the positive spirals (Gauthier et al, subm. J. Fluid Mech. 2001). This new spiral pattern seems to arise from an azimuthal shear layer instability, rather than a boundary layer instability as for the two other patterns. Negative spirals are characterized for different aspect ratios (azimuthal mode, phase velocity), allowing comparisons with recent numerical simulations (Lopez et al, to appear in J. Fluid Mech. 2002).

  1. On the chiral imbalance and Weibel instabilities

    NASA Astrophysics Data System (ADS)

    Kumar, Avdhesh; Bhatt, Jitesh R.; Kaw, P. K.

    2016-06-01

    We study the chiral-imbalance and the Weibel instabilities in presence of the quantum anomaly using the Berry-curvature modified kinetic equation. We argue that in many realistic situations, e.g. relativistic heavy-ion collisions, both the instabilities can occur simultaneously. The Weibel instability depends on the momentum anisotropy parameter ξ and the angle (θn) between the propagation vector and the anisotropy direction. It has maximum growth rate at θn = 0 while θn = π / 2 corresponds to a damping. On the other hand the pure chiral-imbalance instability occurs in an isotropic plasma and depends on difference between the chiral chemical potentials of right and left-handed particles. It is shown that when θn = 0, only for a very small values of the anisotropic parameter ξ ∼ξc, growth rates of the both instabilities are comparable. For the cases ξc < ξ ≪ 1 or ξ ≳ 1 at θn = 0, the Weibel modes dominate over the chiral-imbalance instability if μ5 / T ≤ 1. However, when μ5 / T ≥ 1, it is possible to have dominance of the chiral-imbalance modes at certain values of θn for an arbitrary ξ.

  2. Charge instabilities in strongly correlated bilayer systems

    NASA Astrophysics Data System (ADS)

    Seibold, G.

    2003-09-01

    We investigate the charge-instabilities of the Hubbard-Holstein model with two coupled layers. In this system the scattering processes naturally separate into contributions which are either symmetric or antisymmetric combinations with respect to exchange of the layers. It turns out that the short-range strong correlations suppress finite wave-vector nesting instabilities for both symmetries but favor the occurrence of phase separation in the symmetric channel. Inclusion of a sizeable long-range Coulomb (LRC) interaction frustrates the q=0 instabilities and supports the formation of incommensurate charge-density waves (CDW). Upon reducing doping from half-filling and for small electron-phonon coupling g the CDW instability first occurs in the antisymmetric channel but both instability lines merge with increasing g. While LRC forces always suppress the phase separation instability in the symmetric channel, the CDW period in the antisymmetric sector tends to infinity (q_cto 0) for sufficiently small Coulomb interaction. This feature allows for the possibility of singular scattering over the whole Fermi surface. We discuss possible implications of our results for the bilayer high- T c cuprates.

  3. Paradox of inductionless magnetorotational instability

    NASA Astrophysics Data System (ADS)

    Priede, J.; Grants, I.; Gerbeth, G.

    2007-04-01

    We consider the magnetorotational instability (MRI) of a hydrodynamically stable Taylor-Couette flow with a helical external magnetic field in the inductionless approximation defined by a zero magnetic Prandtl number (Pm = 0). This leads to a considerable simplification of the problem eventually containing only hydrodynamic variables. First, we point out that the energy of any perturbation growing in the presence of magnetic field has to grow faster without the field. This is a paradox because the base flow is stable without the magnetic while it is unstable in the presence of a helical magnetic field without being modified by the latter as it has been found recently by Hollerbach and Rüdiger [Phys. Rev. Lett. 95, 124501 (2005)]. We revisit this problem by using a Chebyshev collocation method to calculate the eigenvalue spectrum of the linearized problem. In this way, we confirm that MRI with helical magnetic field indeed works in the inductionless limit where the destabilization effect appears as an effective shift of the Rayleigh line. Second, we integrate the linearized equations in time to study the transient behavior of small amplitude perturbations, thus showing that the energy arguments are correct as well. However, there is no real contradiction between both facts. The linear stability theory predicts the asymptotic development of an arbitrary small-amplitude perturbation, while the energy stability theory yields the instant growth rate of any particular perturbation, but it does not account for the evolution of this perturbation. Thus, although switching off the magnetic field instantly increases the energy growth rate, in the same time the critical perturbation ceases to be an eigenmode without the magnetic field. Consequently, this perturbation is transformed with time and so looses its ability to extract energy from the base flow necessary for the growth.

  4. Combined operative technique with anterior surgical approach and video-assisted thoracoscopic surgical lobectomy for anterior superior sulcus tumours.

    PubMed

    Yokoyama, Yuhei; Chen, Fengshi; Aoyama, Akihiro; Sato, Toshihiko; Date, Hiroshi

    2014-11-01

    Video-assisted thoracoscopic surgery (VATS) has been widely used, but surgical resections of superior sulcus tumours remain challenging because of their anatomical location. For such cases, less-invasive procedures, such as the anterior transcervical-thoracic and transmanubrial approaches, have been widely performed because of their excellent visualization of the subclavian vessels. Recently, a combined operative technique with an anterior surgical approach and VATS for anterior superior sulcus tumours has been introduced. Herein, we report three cases of anterior superior sulcus tumours successfully resected by surgical approaches combined with a VATS-based lobectomy. In all cases, operability was confirmed by VATS, and upper lobectomies with hilar and mediastinal lymph node dissections were performed. Subsequently, dissections of the anterior inlet of the tumours were performed using the transmanubrial approach in two patients and the anterior trans-cervical-thoracic approach in one patient. Both approaches provided excellent access to the anterior inlet of the tumour and exposure of the subclavian vessels, resulting in radical resection of the tumour with concomitant resection of the surrounding anatomical structures, including the chest wall and vessels. In conclusion, VATS lobectomy combined with the anterior surgical approach might be an excellent procedure for the resection of anterior superior sulcus tumours.

  5. Superior Labrum Anterior Posterior Lesions and Associated Injuries

    PubMed Central

    Beyzadeoglu, Tahsin; Circi, Esra

    2015-01-01

    Background: Superior labrum anterior posterior (SLAP) lesions often cause shoulder pain, dysfunction, and instability. Professional athletes require a high level of shoulder function for competition and overhead activities. Purpose: To evaluate elite athletes who had arthroscopic surgery for common shoulder pathologies and SLAP lesions with a follow-up of more than 3 years. The associated intra-articular pathologies and return to play were documented. Study Design: Case series; Level of evidence, 4. Methods: Thirty-five shoulders in 34 elite athletes (4 women and 30 men; mean age, 25 years [range, 18-32 years]) had arthroscopic repair of SLAP lesions and accompanying Bankart or rotator cuff tears between January 2008 and November 2011. The documentation included patient symptoms, physical examination, radiological analysis with radiographs, and magnetic resonance imaging. Shoulder function was evaluated preoperatively and at follow-up using American Shoulder and Elbow Surgeons (ASES) and Kerlan Jobe Orthopaedic Clinic (KJOC) scores. The mean follow-up was 52 months. Results: Isolated SLAP lesions were seen in 17.1% of patients, SLAP lesions and partial cuff tear occurred in 25.7%, associated Bankart lesions in 37.1%, full-thickness rotator cuff tears in 8.6%, Bankart and posterior labrum lesions in 8.6%, and Bankart and full-thickness rotator cuff tears in 2.9%. Return to play was a mean 6.4 ± 1.5 months. The mean postoperative ASES and KJOC scores were 89.6 ± 4.6 and 80.9 ± 6.8, respectively, compared with preoperative scores of 64.0 ± 7.2 and 50.5 ± 10.3 (t test, P < .01). Conclusion: The majority (88.2%) of professional athletes returned to their preinjury levels. SLAP lesions may frequently occur with Bankart lesions and rotator cuff tears. A high rate of return to sport at the same level of athletic performance can be achieved by anatomic repair and effective rehabilitation. PMID:26665050

  6. Societal and Economic Impact of Anterior Cruciate Ligament Tears

    PubMed Central

    Mather, Richard C.; Koenig, Lane; Kocher, Mininder S.; Dall, Timothy M.; Gallo, Paul; Scott, Daniel J.; Bach, Bernard R.; Spindler, Kurt P.

    2013-01-01

    Background: An anterior cruciate ligament (ACL) tear is a common knee injury, particularly among young and active individuals. Little is known, however, about the societal impacts of ACL tears, which could be large given the typical patient age and increased lifetime risk of knee osteoarthritis. This study evaluates the cost-effectiveness of ACL reconstruction compared with structured rehabilitation only. Methods: A cost-utility analysis of ACL reconstruction compared with structured rehabilitation only was conducted with use of a Markov decision model over two time horizons: the short to intermediate term (six years), on the basis of Level-I evidence derived from the KANON Study and the Multicenter Orthopaedic Outcomes Network (MOON) database; and the lifetime, on the basis of a comprehensive literature review. Utilities were assessed with use of the SF-6D. Costs (in 2012 U.S. dollars) were estimated from the societal perspective and included the effects of the ACL tear on work status, earnings, and disability. Effectiveness was expressed as quality-adjusted life years (QALYs) gained. Results: In the short to intermediate term, ACL reconstruction was both less costly (a cost reduction of $4503) and more effective (a QALY gain of 0.18) compared with rehabilitation. In the long term, the mean lifetime cost to society for a typical patient undergoing ACL reconstruction was $38,121 compared with $88,538 for rehabilitation. ACL reconstruction resulted in a mean incremental cost savings of $50,417 while providing an incremental QALY gain of 0.72 compared with rehabilitation. Effectiveness gains were driven by the higher probability of an unstable knee and associated lower utility in the rehabilitation group. Results were most sensitive to the rate of knee instability after initial rehabilitation. Conclusions: ACL reconstruction is the preferred cost-effective treatment strategy for ACL tears and yields reduced societal costs relative to rehabilitation once indirect cost

  7. Subsequent Surgery after Revision Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Ding, David; Group, Mars

    2016-01-01

    Objectives: Failure or reinjury after anterior cruciate ligament (ACL) reconstruction can lead to recurrent instability and concomitant intra-articular injuries. While revision ACL reconstruction (rACLR) can be performed to restore knee stability and improve patient activity level, outcomes after these surgeries are reported to be inferior to primary ACL reconstruction. Further reoperation after rACLR can have an even more profound effect on patient satisfaction and outcome. Yet, there is a current lack of information regarding the rate and risk factors for subsequent surgery after rACLR. Methods: 1205 patients who underwent rACLR were enrolled between 2006 and 2011, comprising the prospective cohort. Two-year questionnaire follow-up was obtained on 989 (82%), while telephone follow-up was obtained on 1112 (92%). If a patient reported having a subsequent surgery, operative reports detailing the subsequent procedure(s) were obtained and categoriezed. A repeated meaures ANOVA was used to reveal significatnt differences in patient reported outcomes. Multivariate regression analysis was performed to determine independent risk factors for reoperation. Results: One hundred and twenty-two patients (10.1%) underwent a total of 172 subsequent procedures on the ipsilateral knee at 2-year follow-up. Of the reoperation procedures, 26.7% were meniscus procedures (69% meniscectomy, 26% repair), 18.6% were subsequent rACLR, 17.4% were cartilage procedures (61% chondroplasty, 17% microfracture, and 13% mosaicplasty), 10% hardware removal, and 9.3% were procedures for arthrofibrosis such has lysis of adhesions and synovectomy. Patients who had reoperations had significantly lower IKDC, KOOS symptoms and pain scores, and WOMAC stiffness scores at two-year follow up. Multivariate analysis revealed that patients under 20 years old were 2.1 times more likely than patients aged 20-29 to have a reoperation. Use of allograft at the time of rACLR and staged revision (bone grafting of

  8. Anterior cruciate ligament tears: reconstruction and rehabilitation.

    PubMed

    Smith, Mary Atkinson; Smith, W Todd; Kosko, Paul

    2014-01-01

    Tears of the anterior cruciate ligament (ACL) are common knee injuries experienced by athletes and people with active lifestyles. It is important for members of the healthcare team to take an evidence-based approach to the diagnosis, surgical management, and postoperative rehabilitation of patients with an ACL-deficient knee. Mechanism of ACL injury and diagnostic testing is consistent throughout the literature. Patients frequently opt for ACL reconstruction, and many surgical techniques for ACL reconstruction are available with no clear consensus regarding superiority. Surgeon preference dictates the type of reconstruction and graft choice utilized. No standardized pre- and postoperative rehabilitation protocol exists. However, rehabilitation plays an important role in functional outcomes. A comprehensive rehabilitation program is needed pre- and postoperatively to produce positive patient outcomes.

  9. Multiple signals in anterior cingulate cortex

    PubMed Central

    Kolling, N; Behrens, TEJ; Wittmann, MK; Rushworth, MFS

    2016-01-01

    Activity in anterior cingulate cortex (ACC) has been linked both to commitment to a course of action, even when it is associated with costs, and to exploring or searching for alternative courses of action. Here we review evidence that this is due to the presence of multiple signals in ACC reflecting the updating of beliefs and internal models of the environment and encoding aspects of choice value, including the average value of choices afforded by the environment (‘search value’). We contrast this evidence with the influential view that ACC activity is better described as reflecting task difficulty. A consideration of cortical neural network properties explains why ACC may carry such signals and also exhibit sensitivity to task difficulty. PMID:26774693

  10. Infections in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Stucken, Charlton; Garras, David N.; Shaner, Julie L.; Cohen, Steven B.

    2013-01-01

    Context: Anterior cruciate ligament (ACL) reconstruction is a safe, common, and effective method of restoring stability to the knee after injury, but evolving techniques of reconstruction carry inherent risk. Infection after ACL reconstruction, while rare, carries a high morbidity, potentially resulting in a poor clinical outcome. Evidence Acquisition: Data were obtained from previously published peer-reviewed literature through a search of the entire PubMed database (up to December 2012) as well as from textbook chapters. Results: Treatment with culture-specific antibiotics and debridement with graft retention is recommended as initial treatment, but with persistent infection, consideration should be given to graft removal. Graft type likely has no effect on infection rates. Conclusion: The early diagnosis of infection and appropriate treatment are necessary to avoid the complications of articular cartilage damage and arthrofibrosis. PMID:24427432

  11. Alternaria keratitis after deep anterior lamellar keratoplasty.

    PubMed

    Naik, Mekhla; Mohd Shahbaaz; Sheth, Jay; Sunderamoorthy, S K

    2014-01-01

    To describe a case of Alternaria keratitis in a 30-year-old male patient who presented with bilateral vascularised central corneal opacity and underwent deep anterior lamellar keratoplasty (DALK) in the left eye. Patient was treated for recurrent epithelial defect with a bandage contact lens in the follow-up visits after DALK. Subsequently, patient presented with pigmented fungal keratitis, which on culture examination of the corneal scrapping demonstrated Alternaria species. Patient had to undergo a repeat DALK as the keratitis did not resolve with medical therapy alone. Patient did not have a recurrence for 11 months following the regraft. This case report highlights the importance of considering the Alternaria species as a possibile cause of non-resolving fungal keratitis after DALK.

  12. Individualized anatomic anterior cruciate ligament reconstruction.

    PubMed

    van Eck, Carola F; Widhalm, Harrald; Murawski, Christopher; Fu, Freddie H

    2015-02-01

    Anterior cruciate ligament (ACL) injuries are often seen in young participants in sports such as soccer, football, and basketball. Treatment options include conservative management as well as surgical intervention, with the goal of enabling the patient to return to cutting and pivoting sports and activities. Individualized anatomic ACL reconstruction is a surgical technique that tailors the procedure to the individual patient using preoperative measurements on plain radiographs and magnetic resonance imaging and intraoperative measurement to map the patients' native ACL anatomy in order to replicate it as closely as possible. Anatomic ACL reconstruction, therefore, is defined as reconstruction of the ACL to its native dimensions, collagen orientation, and insertion site. The surgical reconstruction is followed by a specific rehabilitation protocol that is designed to enable the patient to regain muscle strength and proprioception while facilitating healing of the reconstructed ACL prior to the patient's returning to sports activities.

  13. Essentials of anterior cruciate ligament rupture management.

    PubMed

    Klinge, Stephen A; Sawyer, Gregory A; Hulstyn, Michael J

    2013-05-01

    Anterior cruciate ligament (ACL) rupture is a common knee injury and an understanding of current medical knowledge regarding its management is essential. Accurate and prompt diagnosis requires an awareness of injury mechanisms and risk factors, common symptoms and physical/radiologic findings. Early mobilization and physical therapy improves outcomes regardless of treatment modality. Many older patients regain sufficient stability and function after non-operative rehabilitation. Early ACL reconstruction is appropriate for younger patients and those who engage in activities requiring frequent pivoting and rapid direction changes. ACL surgery involves reconstruction of the torn ligament tissue with various replacement graft options, each with advantages and disadvantages. The guidance of a knowledgeable and experienced therapist is required throughout an intensive and prolonged rehabilitation course. Generally excellent outcomes and low complication rates are expected, but treatment does not prevent late osteoarthritis.

  14. Anterior cruciate ligament injuries: etiology and prevention.

    PubMed

    Brophy, Robert H; Silvers, Holly J; Mandelbaum, Bert R

    2010-03-01

    The relatively high risk of noncontact anterior cruciate ligament (ACL) rupture among female athletes has been a major impetus for investigation into the etiology of this injury. A number of risk factors have been identified, both internal and external to the athlete, including neuromuscular, anatomical, hormonal, shoe-surface interaction, and environmental, such as weather. The anatomic and neuromuscular risk factors, often gender related, are the focus of most ACL injury prevention programs. Although studies have shown that biomechanic- centered prevention programs can reduce the risk of ACL injury, many questions remain unanswered. More research is needed to increase our understanding of the risk factors for ACL injury; how injury prevention programs work and can the clinical application of such programs be optimized. PMID:20160623

  15. Neurologic complication after anterior sciatic nerve block.

    PubMed

    Shah, Shruti; Hadzic, Admir; Vloka, Jerry D; Cafferty, Maureen S; Moucha, Calin S; Santos, Alan C

    2005-05-01

    The lack of reported complications related to lower extremity peripheral nerve blocks (PNBs) may be related to the relatively infrequent application of these techniques and to the fact that most such events go unpublished. Our current understanding of the factors that lead to neurologic complications after PNBs is limited. This is partly the result of our inability to conduct meaningful retrospective studies because of a lack of standard and objective monitoring and documentation procedures for PNBs. We report a case of permanent injury to the sciatic nerve after sciatic nerve block through the anterior approach and discuss mechanisms that may have led to the injury. Intraneural injection and nerve injury can occur in the absence of pain on injection and it may be heralded by high injection pressure (resistance).

  16. Conjoint activity of anterior insular and anterior cingulate cortex: awareness and response

    PubMed Central

    Critchley, Hugo D.

    2010-01-01

    There is now a wealth of evidence that anterior insular and anterior cingulate cortices have a close functional relationship, such that they may be considered together as input and output regions of a functional system. This system is typically engaged across cognitive, affective, and behavioural contexts, suggesting that it is of fundamental importance for mental life. Here, we review the literature and reinforce the case that these brain regions are crucial, firstly, for the production of subjective feelings and, secondly, for co-ordinating appropriate responses to internal and external events. This model seeks to integrate higher-order cortical functions with sensory representation and autonomic control: it is argued that feeling states emerge from the raw data of sensory (including interoceptive) inputs and are integrated through representations in conscious awareness. Correspondingly, autonomic nervous system reactivity is particularly important amongst the responses that accompany conscious experiences. Potential clinical implications are also discussed. PMID:20512367

  17. Plasma instabilities in electronegative inductive discharges

    NASA Astrophysics Data System (ADS)

    Marakhtanov, Alexei Mikhail

    Plasma instabilities have been observed in low-pressure inductive discharges, in the transition between low density capacitive mode and high density inductive mode of the discharge when attaching gases such as SF6 and Ar/SF 6 mixtures are used. Oscillations of charged particles, plasma potential and light emitted from the plasma with the frequencies from a few hertz to tens of kilohertz are seen for gas pressures between 1 and 100 mTorr and the discharge power in the range of 75--1200 W. The region of instability increases as the plasma becomes more electronegative and the frequency of plasma oscillations increases as the power, pressure, and gas flow rate increase. The instability frequencies may also depend on the settings of a matching network. A volume-averaged (global) model of the instability has been developed, for a discharge containing time varying densities of electrons, positive ions, and negative ions, and time invariant excited states and neutral densities. The particle and energy balance equations are integrated to produce the dynamical behavior. As pressure or power is varied to cross a threshold, the instability goes through a series of oscillatory states to large scale relaxation oscillations between higher and lower density states. The model qualitatively agrees with experimental observations, and also shows a significant influence of the matching network. A stability analysis of an electronegative discharge has been performed, using a Hurwitz criterion, for a system of linearized particle and power balance differential equations. Capacitive coupling plays a crucial role in the instability process. A variable electrostatic (Faraday) shield has been used to control the capacitive coupling from the excitation coil to the plasma. The plasma instability disappears when the shielded area exceeds 65% of the total area of the coil. The global model of instability gives a slightly higher value of 85% for instability suppression with the same discharge

  18. Anterior visceral endoderm SMAD4 signaling specifies anterior embryonic patterning and head induction in mice.

    PubMed

    Li, Cuiling; Li, Yi-Ping; Fu, Xin-Yuan; Deng, Chu-Xia

    2010-09-27

    SMAD4 serves as a common mediator for signaling of TGF-β superfamily. Previous studies illustrated that SMAD4-null mice die at embryonic day 6.5 (E6.5) due to failure of mesoderm induction and extraembryonic defects; however, functions of SMAD4 in each germ layer remain elusive. To investigate this, we disrupted SMAD4 in the visceral endoderm and epiblast, respectively, using a Cre-loxP mediated approach. We showed that mutant embryos lack of SMAD4 in the visceral endoderm (Smad4(Co/Co);TTR-Cre) died at E7.5-E9.5 without head-fold and anterior embryonic structures. We demonstrated that TGF-β regulates expression of several genes, such as Hex1, Cer1, and Lim1, in the anterior visceral endoderm (AVE), and the failure of anterior embryonic development in Smad4(Co/Co);TTR-Cre embryos is accompanied by diminished expression of these genes. Consistent with this finding, SMAD4-deficient embryoid bodies showed impaired responsiveness to TGF-β-induced gene expression and morphological changes. On the other hand, embryos carrying Cre-loxP mediated disruption of SMAD4 in the epiblasts exhibited relatively normal mesoderm and head-fold induction although they all displayed profound patterning defects in the later stages of gastrulation. Cumulatively, our data indicate that SMAD4 signaling in the epiblasts is dispensable for mesoderm induction although it remains critical for head patterning, which is significantly different from SMAD4 signaling in the AVE, where it specifies anterior embryonic patterning and head induction.

  19. Transphyseal anterior cruciate ligament reconstruction in a skeletally immature knee using anterior tibialis allograft.

    PubMed

    Cho, Yool; Jang, Soo-Jin; Son, Jung-Hwan

    2011-05-18

    Anterior cruciate ligament (ACL) injury in the skeletally immature individual is being recognized with increasing frequency. Nonoperative treatment of ACL injuries in skeletally immature patients have not been favorable. Surgical treatment options for complete ACL tears include primary ligament repair, extraarticular tenodesis, transphyseal reconstruction, partial transphyseal reconstruction, and physeal-sparing reconstruction. The advantage of transphyseal reconstruction is placement of the graft tissue in an isometric position, which provides better results, according to the literature. The potential disadvantage is angular or limb-length discrepancy caused by physeal violation. Controversy exists in allograft selection about whether bone or soft tissue passes into physes. The use of standard tunnels provides reliable results, but carries the risk of iatrogenic growth disturbance from physeal injury.This article presents 4 cases of transphyseal ACL reconstruction using anterior tibialis allograft in skeletally immature patients that had satisfactory functional outcomes with no growth disturbances. This is the first report of transphyseal ACL reconstruction using anterior tibialis allograft in skeletally immature patients in the English-speaking literature. All patients underwent transphyseal ACL reconstruction using anterior tibialis tendon allograft. None of the patients had angular deformities. No early physeal arrest was measured between the preoperative and postoperative radiographs. At last follow-up, the results of the Lachman test were normal for 3 patients and nearly normal for 1 patient. All patients demonstrated full range of knee motion (comparing the reconstructed knee to the contralateral knee). The results of the pivot-shift test were normal for 3 patients and nearly normal for 1 patient. No patients reported giving way.

  20. [Key points in anterior esthetic restorations with all ceramic].

    PubMed

    Luo, Xiaoping; Qian, Dongdong; Yuan, Yu; Meng, Xiangfeng

    2013-04-01

    This paper introduced the key points in fabricating anterior esthetic restorations with all ceramic materials, including pre-operative smile design, standard tooth preparation, provisional restoration fabrication, all ceramic materials selection, all ceramic restoration bonding, ceramic crack and fracture prevention. And then, the authors summarized and reviewed the clinical common problems in anterior esthetic restorations. PMID:23662547