Peroneal tendon displacement accompanying intra-articular calcaneal fractures.

PubMed

Toussaint, Rull James; Lin, Darius; Ehrlichman, Lauren K; Ellington, J Kent; Strasser, Nicholas; Kwon, John Y

2014-02-19

Peroneal tendon displacement (subluxation or dislocation) accompanying an intra-articular calcaneal fracture is often undetected and under-treated. The goals of this study were to determine (1) the prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures, (2) the association of tendon displacement with fracture classifications, (3) the association of tendon displacement with heel width, and (4) the rate of missed diagnosis of the tendon displacement on radiographs and computed tomography (CT) scans and the resulting treatment rate. A retrospective radiographic review of all calcaneal fractures presenting at three institutions from June 30, 2006, to June 30, 2011, was performed. CT imaging of 421 intra-articular calcaneal fractures involving the posterior facet was available for review. The prevalence of peroneal tendon displacement was noted and its associations with fracture classification and heel width were evaluated. Peroneal tendon displacement was identified in 118 (28.0%) of the 421 calcaneal fracture cases. The presence of tendon displacement was significantly associated with joint-depression fractures compared with tongue-type fractures (p < 0.001). Only twelve (10.2%) of the 118 cases of peroneal tendon displacement had been identified in the radiology reports. Although sixty-five (55.1%) of the fractures with tendon displacement had been treated with internal fixation, the tendon displacement was treated surgically in only seven (10.8%) of these cases. Analysis of CT images showed a 28% prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures. Surgeons and radiologists are encouraged to consider this association.

Low Wound Complication Rates for the Lateral Extensile Approach for Calcaneal ORIF When the Lateral Calcaneal Artery Is Patent.

PubMed

Bibbo, Christopher; Ehrlich, David A; Nguyen, Hoang M L; Levin, L Scott; Kovach, Stephen J

2014-07-01

Historically, the lateral extensile approach for calcaneal fracture osteosynthesis has had relatively high rates of wound healing problems. The vascular territory (angiosome) of the lateral foot is now known to be dependent upon the lateral calcaneal branch of the peroneal artery (LCBP artery). We postulated that patency of the LCBP artery may have a profound positive impact on incisional wound healing for calcaneal open reduction and internal fixation (ORIF). Ninety consecutive calcaneal fractures that met operative criteria were preoperatively evaluated for the presence of a Doppler signal in the LCBP artery and were followed for the development of wound healing problems. Among these 90 fractures, 85 had a positive preoperative Doppler signal along the course of the LCBP artery (94%) and 5 had no Doppler signal (6%). All patients underwent ORIF via a lateral extensile approach. Overall, incisional wound healing problems occurred in 6 of 90 calcaneal incisions (6.5%). All 5 feet that exhibited an absent Doppler signal in the LCPB artery developed an incisional wound healing complication (5/6, approximately 83%): 2 large apical wounds and 3 major dehiscence/slough. However, among the 84 feet that possessed a positive preoperative Doppler signal in the LCBP artery, there was only 1 (1/84, approximately 1%) incisional wound healing problem (P < .0001, Fischer's exact test). Smokers with a positive Doppler signal in the LCBP artery did not develop a wound healing complication. This study suggests a strong link to low incisional wound healing complications for the lateral extensile approach to the calcaneus when a preoperative Doppler signal is present in the LCBP artery. We believe this simple examination should be routinely performed prior to calcaneal ORIF. Level III, comparative case series. © The Author(s) 2014.

Evolution and Allometry of Calcaneal Elongation in Living and Extinct Primates

PubMed Central

Boyer, Doug M.; Seiffert, Erik R.; Gladman, Justin T.; Bloch, Jonathan I.

2013-01-01

Specialized acrobatic leaping has been recognized as a key adaptive trait tied to the origin and subsequent radiation of euprimates based on its observed frequency in extant primates and inferred frequency in extinct early euprimates. Hypothesized skeletal correlates include elongated tarsal elements, which would be expected to aid leaping by allowing for increased rates and durations of propulsive acceleration at takeoff. Alternatively, authors of a recent study argued that pronounced distal calcaneal elongation of euprimates (compared to other mammalian taxa) was related primarily to specialized pedal grasping. Testing for correlations between calcaneal elongation and leaping versus grasping is complicated by body size differences and associated allometric affects. We re-assess allometric constraints on, and the functional significance of, calcaneal elongation using phylogenetic comparative methods, and present an evolutionary hypothesis for the evolution of calcaneal elongation in primates using a Bayesian approach to ancestral state reconstruction (ASR). Results show that among all primates, logged ratios of distal calcaneal length to total calcaneal length are inversely correlated with logged body mass proxies derived from the area of the calcaneal facet for the cuboid. Results from phylogenetic ANOVA on residuals from this allometric line suggest that deviations are explained by degree of leaping specialization in prosimians, but not anthropoids. Results from ASR suggest that non-allometric increases in calcaneal elongation began in the primate stem lineage and continued independently in haplorhines and strepsirrhines. Anthropoid and lorisid lineages show stasis and decreasing elongation, respectively. Initial increases in calcaneal elongation in primate evolution may be related to either development of hallucal-grasping or a combination of grasping and more specialized leaping behaviors. As has been previously suggested, subsequent increases in calcaneal

[Avulsion fracture of the calcaneal tuberosity in athletes].

PubMed

Glanzmann, M; Veréb, L; Habegger, R

2005-04-01

Avulsion fractures of the calcaneal tuberosity are rare injuries. Several surgical treatment options have been described. The size of the calcaneal fragment is the limiting factor in choosing the method for restoration. Finding the right type of fixation modality remains challenging in this rare kind of injury. In the case presented one Mitek Super Anchor was used to reattach the small fragment of the tuberosity to the calcaneus. Stable fixation with bony reunion and excellent functional outcome were achieved by this technique within 10 weeks. Therefore, we recommend the use of an anchor system for the treatment of small fragment calcaneal avulsion fractures.

Effect of Field Size and Length of Plantar Spur on Treatment Outcome in Radiation Therapy of Plantar Fasciitis: The Bigger the Better?

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

Hermann, Robert Michael, E-mail: hermann@strahlentherapie-westerstede.com; Abteilung Strahlentherapie und Spezielle Onkologie, Medizinische Hochschule Hannover; Meyer, Andreas

2013-12-01

Purpose: Radiation therapy is well established in the treatment of painful plantar fasciitis or heel spur. A retrospective analysis was conducted to investigate the effect of field definition on treatment outcome and to determine the impact of factors potentially involved. Methods and Materials: A review of treatment data of 250 patients (285 heels) with a mean follow-up time of 11 months showed that complete symptom remission occurred in 38%, partial remission in 32%, and no change in 19% (11% were lost to follow-up). Variables such as radiologic evidence of plantar spurs, their length, radiation dose, field size, age, sex, andmore » onset of pain before administration of radiation therapy were investigated in univariate and multivariate regression analyses. Results: Treatment response depended upon age >53 years, length of heel spur ≤6.5 mm (or no radiologic evidence of a heel spur), and onset of pain <12 months before radiation therapy. Patients with these clinical prerequisites stood a 93% chance of clinical response. Without these prerequisites, only 49% showed any impact. No influence of field size on treatment outcome became evident. Conclusion: Patients with short plantar heel spurs benefit from radiation therapy equally well as patients without any radiologic evidence. Moreover, smaller field sizes have the same positive effect as commonly used large field definitions covering the entire calcaneal bone. This leads to a recommendation of a considerable reduction of field size in future clinical practice.« less

Complications in operative fixation of calcaneal fractures

PubMed Central

Li, Ying; Bao, Rong-Hua; Jiang, Zhi-Qiang; Wu, Huo-Yan

2016-01-01

Objective: The purpose of this study focused on a number of factors that have been implicated in calcaneal complications and find the incidence of wound complications. Methods: This was a retrospective study. A total of 162 patients (176 feet) who underwent calcaneal fractures between 2007 and 2012 were included. The patient’s personal details, age, time from injury to surgery, cause of injury, type of fracture, operative details, operating and tourniquet times were collected from hospital computers and paper records. Evidence of complications including wound infection, wound necrosis, pain, malunion, nonunion, impingement, loss of fixation, ect were studied. Results: Forty-seven of one hundred and seventy-six fractures (26.704%) had complications, wound infection was noted in seven fractures (3.977%), twelve fractures developed necrosis (6.818%), 14 fractures (7.955%) developed pain. Malunion was found in five fractures (2.841%), nonunion in two fractures (1.136%) and loss of fixation in four fractures (2.272%). Three neurologic injury was also seen in our study (1.705%). Operating time, time from injury to surgery and type of fracture had some association with complications in operative fixation of calcaneal fractures, which showed a statistically significant improvement (P=0.000, 0.031, 0.020, respectively), but there were no evidence that age and tourniquet time affect the incidence of complication after calcaneal fracture surgery (P=0.119, 0.682, respectively). Conclusions: Despite developments in the surgical treatment of calcaneal fracture, wound complications still remain inevitable. Advanced imaging techniques, less invasive surgical procedures, wealth of anatomical knowledge, surgical experience and better postoperative care should be ensured. PMID:27648028

Preoperative planning and intraoperative technique for accurate realignment of the Dwyer calcaneal osteotomy.

PubMed

Lamm, Bradley M; Gesheff, Martin G; Salton, Heather L; Dupuis, Travis W; Zeni, Ferras

2012-01-01

The Dwyer calcaneal osteotomy is an effective procedure for the correction of calcaneal varus deformity. However, no intraoperative method has been described to determine the amount of bone resection. We describe a simple intraoperative method for assuring accurate bone resection and measure the realignment effects of the Dwyer calcaneal osteotomy. We also review radiographic outcomes associated with 20 Dwyer calcaneal osteotomies (in 17 patients) using the intraoperative realignment technique described in this report. Preoperative and postoperative radiographs at a mean of 2.5 (range 1.5 to 5) years taken after Dwyer osteotomy were measured and compared, which revealed a mean reduction in calcaneal varus of 18° (range 2° to 36°) (p < .001), a mean decrease in the calcaneal inclination angle of 5° (range -40° to 7°) (p < .05), a mean decrease in medial calcaneal translation of 10 (range 0 to 18) mm (p < .001) relative to the tibia, and a mean dorsal translation of 2 (range 0 to 7) mm (p = .002). In an effort to attempt to structurally realign the calcaneus to a more rectus alignment, by means of Dwyer osteotomy, we recommend the use of the intraoperative bone wedge resection technique described in this report. Our experience with the patients described in this report demonstrates the usefulness of the intraoperative method that we describe in order to accurately restore the axial tibial and calcaneal relationship. Copyright © 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Calcaneal loading during walking and running

NASA Technical Reports Server (NTRS)

Giddings, V. L.; Beaupre, G. S.; Whalen, R. T.; Carter, D. R.

2000-01-01

PURPOSE: This study of the foot uses experimentally measured kinematic and kinetic data with a numerical model to evaluate in vivo calcaneal stresses during walking and running. METHODS: External ground reaction forces (GRF) and kinematic data were measured during walking and running using cineradiography and force plate measurements. A contact-coupled finite element model of the foot was developed to assess the forces acting on the calcaneus during gait. RESULTS: We found that the calculated force-time profiles of the joint contact, ligament, and Achilles tendon forces varied with the time-history curve of the moment about the ankle joint. The model predicted peak talocalcaneal and calcaneocuboid joint loads of 5.4 and 4.2 body weights (BW) during walking and 11.1 and 7.9 BW during running. The maximum predicted Achilles tendon forces were 3.9 and 7.7 BW for walking and running. CONCLUSIONS: Large magnitude forces and calcaneal stresses are generated late in the stance phase, with maximum loads occurring at approximately 70% of the stance phase during walking and at approximately 60% of the stance phase during running, for the gait velocities analyzed. The trajectories of the principal stresses, during both walking and running, corresponded to each other and qualitatively to the calcaneal trabecular architecture.

A "reverse" Maffucci's syndrome: case report and short review of the literature.

PubMed

Matzaroglou, Charalampos; Megas, Panagiotis; Panagiotopoulos, Elias; Notopoulos, Athanasios; Saridis, Alkis; Sourgiadaki, Efrosini; Koumoundourou, Dimitra; Dimakopoulos, Panagiotis

2005-01-01

Maffucci's syndrome is a congenital, non-hereditary mesodermal dysplasia associated with multiple enchondromas and after some years accompanied by hemangiomas. We describe a rare case of "reverse" Maffucci's syndrome in a 42-year-old woman who has suffered from multiple hemangiomas for the last 24 years. The last two years she complained for heel pain. Bone scintigraphic examination showed abnormal findings in the left calcaneal bone. The scintigraphy, radiology and histology findings revealed multiple enchondromas, so the diagnosis was changed into Maffucci's syndrome. After one year, the left calcaneal bone showed sarcomatous transformation.

Conservation implications of spur length variation in long-spur columbines (Aquilegia longissima)

Treesearch

Christopher J. Stubben; Brook G. Milligan

2007-01-01

Populations of long-spur columbine (Aquilegia longissima) with spurs 10-16 cm long are known only from a few populations in Texas, a historical collection near Baboquivari Peak, Arizona, and scattered populations in Coahuila, Chihuahua, and Nuevo Leon, Mexico. Populations of yellow columbine with spurs 7-10 cm long are also found in Arizona, Texas,...

Subtalar distraction osteogenesis for posttraumatic arthritis following intra-articular calcaneal fractures.

PubMed

Fan, Wei-Li; Sun, Hong-Zhen; Wu, Si-Yu; Wang, Ai-Min

2013-03-01

The most common treatment for old calcaneal fractures accompanied by subtalar joint injury is the use of subtalar in situ arthrodesis and subtalar distraction bone-block arthrodesis or osteotomy. This article describes the introduction of a novel surgical treatment, gradual subtalar distraction with external fixation and restoration of the calcaneal height, and presents an assessment of its efficacy. The protruding lateral calcaneus and the articular surfaces and subchondral bone of the posterior facet of the subtalar joint were surgically removed. An external fixator, attached with 2 pins in the subcutaneous tibia and 2 pins in the posterolateral calcaneus, was used to fix the subtalar joint for 7 to 10 days followed by gradual subtalar distraction at 1 mm/d. The lengthening procedure was stopped when the calcaneal height was restored according to radiography. The external fixator was removed after bone fusion. Seven cases of old calcaneal fractures accompanied by severe subtalar joint injury (8 feet) were treated using this method. Average follow-up was 14.3 months (range, 7-36 months). In all 7 cases (1 case of both feet), the postoperative wound healed primarily. The calcaneal heights of all 8 feet were partially restored. Subtalar joint bone fusion was completed within 4 to 6 months after the operation. The average preoperative American Orthopedic Foot & Ankle Society (AOFAS) hindfoot score was 25.3, and the average postoperative AOFAS score was 76.3. Subtalar distraction osteogenesis with external fixation was a novel and effective method for the treatment of old calcaneal fractures accompanied by severe subtalar joint injury in this small group of patients. Level IV, retrospective case series.

Calcaneal Scoring as an Adjunct to Modified Oxford Hip Scores: Prediction of Contralateral Slipped Capital Femoral Epiphysis.

PubMed

Nicholson, Allen D; Huez, Coridon M; Sanders, James O; Liu, Raymond W; Cooperman, Daniel R

2016-03-01

In 2 recent studies, modified Oxford hip scores of 16 through 18 have been shown to predict an extremely high risk of contralateral slipping in unilateral slipped capital femoral epiphysis (SCFE). However, the modified Oxford system is not widely used. This may be due, in part, to the complexity of the scoring system, difficulty in viewing all 5 radiographic features on a single x-ray and phenotypic variation in the features. Ossification of the calcaneal apophysis provides an osteologic marker of skeletal maturation in relation to peak height velocity and has been described previously. We examine the value of the calcaneal apophyseal ossification sequence for predicting modified Oxford hip scores. We examined 279 pelvis and matching foot x-rays that were taken at the same session from 94 healthy children aged 3 to 18 years. A fellowship-trained pediatric orthopaedist determined the modified Oxford hip score for each hip radiograph. The calcaneal x-rays had been previously graded. Modified Oxford hip scores were compared with calcaneal scores for each set of matched hip and calcaneal x-rays. Stage 0 to 2 calcanei had 94% of corresponding hip radiographs rated as modified Oxford scores of 16 to 18. Stage 3 calcanei had 54% rated as 16 to 18 and 31% rated as scores 19 to 21. Stage 4 calcanei had 31% rated as scores 19 to 21, and 68% rated as scores 22 to 26. Stage 5 calcanei had 100% rated as 22 to 26. Using data from Popejoy and colleagues' study, the weighted risk of contralateral SCFE was 94% for calcaneal stage 0, 86.5% for calcaneal stage 1, 90.3% for calcaneal stage 2, 55.8% for calcaneal stage 3, 6.1% for calcaneal stage 4, and 0 for calcaneal stage 5. Calcaneal stages 0 to 3 correspond entirely to modified Oxford scores indicating elevated risk of contralateral SCFE. The calcaneal scoring system has potential for adjunctive use with the modified Oxford score for prediction of contralateral SCFE.

The "safe zone" in medial percutaneous calcaneal pin placement.

PubMed

Gamie, Zakareya; Donnelly, Leo; Tsiridis, Eleftherios

2009-05-01

Percutaneous pin insertion into the medial calcaneus places a number of structures at risk. Evidence suggests that the greatest risk is to the medial calcaneal nerve (MCN). The medial calcaneal region of 24 cadavers was dissected to determine the major structures at risk. By using four palpable anatomical landmarks, the inferior tip of the medial malleolus (point A), the posterior superior portion of the calcaneal tuberosity (point B), the navicular tuberosity (point C), and the medial process of the calcaneal tuberosity (point D), we attempted to define the safe zone taking into account all possible variables in our dissections including ankle position, side, gender, and possible anatomical variations of the MCN. The commonest arrangement of the MCN was two MCNs that arose independently, one arising before the bifurcation of the tibial nerve and the other arising from the medial plantar nerve. A zone could be defined posterior to 75% of the distance along the lines AB, CD, AD, and CB which would avoid most structures. The posterior branches of the MCN, however, would still be at risk and placing the pin too far posteriorly risks an avulsion fracture. This is the first study to employ four palpable anatomical landmarks to identify a zone to minimize damage to neurovascular structures. It may not be possible, however, to avoid injury of the MCN and consequent sensory loss to the sole of the foot.

CT findings of a unicameral calcaneal bone cyst containing a fluid-fluid level.

PubMed

Gallagher, Thomas A; Lim-Dunham, Jennifer E; Vade, Aruna

2007-03-01

Calcaneal unicameral bone cysts often contain fluid, but rarely contain fluid-fluid levels. We present a case focusing on the CT findings of a large calcaneal bone cyst with a fluid-fluid level and a review of the literature.

Selection on spur shape in Impatiens capensis.

PubMed

Young, Helen J

2008-06-01

Rapid speciation within some plant families has been attributed to the evolution of floral spurs and to the effect of spur length on plant reproductive success. The flowers of Impatiens capensis (jewelweed) possess a long, curved spur in which nectar is produced and stored. Spur length and curvature varies among plants within one population. Here I document that spur shape is variable in natural populations, variation within plants is less than variation among plants, and spur shape is correlated with components of female and male reproductive success. The apparent natural selection is weakly directional in 1 of 2 years, with greatest seed production and pollen removal occurring in flowers with the greatest spur curvature. Bee pollinator visit length is longest at flowers with highly curved spurs, and they leave less nectar in these spurs than in flowers with straighter spurs. Spur angle evolution may be limited, at least in part, by opposing selection by nectar-robbers who prefer to visit flowers with greater spur curvature. Other factors that might contribute to the maintenance of spur angle variation are temporal variation in the strength of selection and potential genetic correlations of spur shape with other traits under selection.

Reconstruction of soft tissue after complicated calcaneal fractures.

PubMed

Koski, E Antti; Kuokkanen, Hannu O M; Koskinen, Seppo K; Tukiainen, Erkki J

2004-01-01

A total of 35 flap reconstructions were done to cover exposed calcaneal bones in 31 patients. All patients had calcaneal fractures, 19 of which were primarily open. Soft tissue reconstruction for the closed fractures was indicated by a postoperative wound complication. A microvascular flap was used for reconstruction in 21 operations (gracilis, n = 11; anterolateral thigh, n = 5; rectus abdominis, n = 3; and latissimus dorsi, n = 2). A suralis neurocutaneous flap was used in eight, local muscle flaps in three, and local skin flaps in three cases. The mean follow-up time was 14 months (range 3 months-4 years). One suralis flap failed and was replaced by a latissimus dorsi flap. Necrosis of the edges that required revision affected three flaps. Deep infection developed in two patients and delayed wound healing in another four. During the follow-up the soft tissues healed in all patients and there were no signs of calcaneal osteitis. Flaps were considered too bulky in five patients. Soft tissues heal most rapidly with microvascular flaps. In the long term, gracilis muscle covered with free skin grafts gives a good contour to the foot. The suralis flap is reliable and gives a good final aesthetic outcome. Local muscles can be transposed for reconstruction in small defects.

Vertical ground reaction forces in patients after calcaneal trauma surgery.

PubMed

van Hoeve, S; Verbruggen, J; Willems, P; Meijer, K; Poeze, M

2017-10-01

Vertical ground reaction forces (VGRFs) are altered in patients after foot trauma. It is not known if this correlates with ankle kinematics. The aim of this study was to analyze VGRFs in patients after calcaneal trauma and correlate them to patient-reported outcome measures (PROMs), radiographic findings and kinematic analysis, using a multi-segment foot model. In addition, we determined the predictive value of VGRFs to identify patients with altered foot kinematics. Thirteen patients (13 feet) with displaced intra-articular calcaneal fractures, were included an average of two years after trauma surgery. PROMs, radiographic findings on postoperative computed tomography scans, gait analysis using the Oxford foot model and VGRFs were analysed during gait. Results were compared with those of 11 healthy subjects (20 feet). Speed was equal in both groups, with healthy subjects walking at self-selected slow speed (0.94±0.18m/s) and patients after surgery walking at self-selected normal speed (0.94±0.29m/s). ROC curves were used to determine the predictive value. Patients after calcaneal surgery showed a lower minimum force during midstance (p=0.004) and a lower maximum force during toe-off (p=0.011). This parameter correlated significantly with the range of motion in the sagittal plane during the push-off phase (r 0.523, p=0.002), as well as with PROMs and with postoperative residual step-off (r 0.423, p=0.016). Combining these two parameters yielded a cut-off value of 193% (p<0.001), area under the curve 0.93 (95%confidence interval 0.84-1.00). Patients after calcaneal fracture showed lower minimum force during midstance and lower maximum force during toe-off compared to healthy subjects. This lower maximum force during push-off correlated significantly with PROMs, range of motion in the sagittal plane during push-off and radiographic postoperative residual step-off in the posterior facet of the calcaneal bone. VGRFs are a valuable screening tool for identifying

The association between bone health indicated by calcaneal quantitative ultrasound and metabolic syndrome in Malaysian men.

PubMed

Chin, Kok-Yong; Ima-Nirwana, Soelaiman; Mohamed, Isa Naina; Ahmad, Fairus; Mohd Ramli, Elvy Suhana; Aminuddin, Amilia; Wan Ngah, Wan Zurinah

2015-01-01

Previous studies on the relationship between bone health and metabolic syndrome (MS) have revealed heterogeneous results. There are limited studies employing bone quantitative ultrasonometry in evaluating this relationship. This study aimed to determine the relationship between MS and bone health in a group of Malaysian middle-aged and elderly men using bone quantitative ultrasonometry. This cross-sectional study recruited 309 free living Chinese and Malay men aged 40 years and above residing in Klang Valley, Malaysia. Their demographic and anthropometric data were collected. Their calcaneal speed of sound (SOS) was measured using a CM-200 bone ultrasonometer. Their blood was collected for the evaluation of lipid profile, total testosterone and sex hormone-binding globulin. The joint interim MS definition was used for the classification of subjects. Multiple linear regression analysis was used to assess the association between SOS and indicators of MS and the presence of MS, with suitable adjustment for confounders. There was no significant difference in SOS value between MS and non-MS subjects (p > 0.05). The SOS values among subjects with different MS scores did not differ significantly (p > 0.05). There were no significant associations between SOS values and indicators of MS or the presence of MS (p > 0.05). The relationship between bone health and MS is not significant in Malaysian middle-aged and elderly men. A longitudinal study should be conducted to evaluate the association between bone loss and MS to confirm this finding.

Treatment of Displaced Intra-articular Calcaneal Fractures by Intramedullary Nail. Preliminary Report.

PubMed

Falis, Mirosław; Pyszel, Krystian

2016-03-23

Open reduction and plate stabilisation is a recognised method of treatment of intra-articular calcaneal fractures. The surgical approach to the calcaneal bone used in these procedures is associated with a high risk of complications. The aim of this paper is to present the author's experience with a new surgical method and analyse early outcomes of the treatment of calcaneal fractures by Calcanail intramedullary nailing. The study encompassed 17 patients (5 women and 12 men) with 18 calcaneal fractures (5 in the right foot and 13 in the left foot). The mean age of the patients was 47 years (range: 22-68 years). The mean time between the injury and surgery was 6 days (range: 3-14 days). The mean duration of follow-up was 12 months (range: 6-18 months). The fractures were classified according to the system presented by Guy Utheza. Bone union was achieved in all patients within 12 weeks of surgery. No infectious complications were observed. The mean AOFAS score was 82/100. Mean Bohler's angle was -3 degrees pre-operatively and +29 degrees post-operatively. 1. The use of Calcanail intramedullary nailing in the treatment of displaced intra-articular fractures is a minimally invasive procedure associated with a low risk of complications. 2. The innovative posterior approach allows for the intrafocal reduction of an articular surface fracture through the prepared intramedullary canal.

A Comparison of Removal Rates of Headless Screws Versus Headed Screws in Calcaneal Osteotomy.

PubMed

Kunzler, Daniel; Shazadeh Safavi, Pejma; Jupiter, Daniel; Panchbhavi, Vinod K

2017-11-01

Calcaneal osteotomy has been used to successfully treat both valgus and varus hindfoot deformities. Pain associated with implanted hardware may lead to further surgical intervention for hardware removal. Headless screws have been used to reduce postoperative hardware-associated pain and accompanying hardware removal, but data proving their effectiveness in this regard is lacking. The purpose of this study is to compare the rates of removal of headed and headless screws utilized in calcaneal osteotomy. We conducted a retrospective chart review of 74 patients who underwent calcaneal osteotomy between January 2010 and December 2014. The cohort was divided into 2 groups by fixation method: a headed screw and a headless screw group. Bivariate associations between infection or hardware removal, and screw type, screw head width, gender, smoking status, alcohol, hypertension, diabetes, hyperlipidemia, age, and body mass index were assessed using t-tests and Fisher's exact/χ 2 tests for continuous and discrete variables, respectively. Headed screws were removed more frequently than headless screws (P < .0001): 15 of 30 (50%) feet that received headed screws and 4 of 44 (9%) of feet that received headless screws underwent subsequent revision for screw removal. In all cases, screws were removed because of pain. The calcaneal union rate was 100% in both cohorts. The rate of screw removal in calcaneal osteotomies is significantly lower in patients who receive headless screws than in those receiving headed screws. Level IV.

The effects of age, physical activity level, and body anthropometry on calcaneal speed of sound value in men.

PubMed

Chin, Kok-Yong; Soelaiman, Ima-Nirwana; Mohamed, Isa Naina; Ibrahim, Suraya; Wan Ngah, Wan Zurinah

2012-01-01

The influences of age, physical activity, and body anthropometry on calcaneal speed of sound are different among young adults, middle-aged, and elderly men. Quantitative ultrasound assessment of bone health status is much needed for developing countries in the screening of osteoporosis, but further studies on the factors that influence the quantitative ultrasound indices are required. The present study examined the influence of age, lifestyle factors, and body anthropometry on calcaneal speed of sound (SOS) in a group of Malaysian men of diverse age range. A cross-sectional study was conducted, and data from 687 eligible males were used for analysis. They answered a detailed questionnaire on their physical activity status, and their anthropometric measurements were taken. Their calcaneal SOS values were evaluated using the CM-200 sonometer (Furuno, Nishinomiya City, Japan). Subjects with higher body mass index (BMI) had higher calcaneal SOS values albeit significant difference was only found in the elderly subjects (p < 0.05). Sedentary subjects had lower calcaneal SOS values than physically active subjects, but significant difference was only found in the middle-aged subjects (p < 0.05). Calcaneal SOS was significantly (p < 0.05) correlated with age in young men; height, BMI, and physical activity score in middle-aged men; height and physical activity score in elderly men; and age and physical activity score for overall subjects. In a multivariate regression model, significant (p < 0.05) predictors for calcaneal SOS included age for young men; physical activity, BMI, body fat percentage, and height for middle-aged men; height for elderly men; and age, height, physical activity, weight, and body fat percentage for overall subjects. Age, body anthropometry, and physical activity level have significant effects on the calcaneal SOS value in men.

The ICI classification for calcaneal injuries: a validation study.

PubMed

Frima, Herman; Eshuis, Rienk; Mulder, Paul; Leenen, Luke

2012-06-01

The integral classification of injuries (ICI), by Zwipp et al. has been developed as a classification system for injuries of the bones, joints, cartilage and ligaments of the foot. It follows the principles of the comprehensive classification of fractures by Müller et al. The ICI was developed for 'everyday use' and scientific purposes. Our aim was to perform a validation study for this classification system applied to the calcaneal injuries. A panel of five experienced trauma and orthopaedic surgeons evaluated the ICI score in 20 calcaneal injuries. After 2 months, a second classification was performed in a different order. Inter- and intra-observer variability were evaluated by kappa statistics. Panel members were not able to evaluate capsule and ligamental injuries based on X-ray and computed tomography (CT) films. Two injuries were excluded for logistical reasons. The inter-observer agreement based on 18 injuries of bone and joints was slight; kappa 0.14 (90% confidence interval (CI): 0.05-0.22). The intra-observer agreement was fair; kappa 0.31 (90% CI: 0.22-0.41). Overall, the panel rated the system as very complicated and not practical. The ICI is a complicated classification system with slight to fair inter- and intra-observer variabilities. It might not be a practical classification system for calcaneal injuries in 'everyday use' or scientific purposes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Bilateral calcaneal epiphysiolysis in a dog.

PubMed

Font, J; Pèlach, M; Font, C; Cairo, J

2013-01-01

A case of bilateral calcaneal epiphysiolysis in a six-month-old female Dobermann Pinscher is described in this report. The absence of a traumatic event and the clinical, radiographic and histopathological abnormalities led us to the diagnosis of simultaneous bilateral epiphysiolysis of the calcaneus. A tension band and a type II transarticular external fixator were placed. The clinical signs were resolved only temporarily because of the gravity of the bone changes.

Minimally invasive (sinus tarsi) approach for calcaneal fractures.

PubMed

Wang, Zhe; Wang, Xiu Hui; Li, Sheng Long; Tang, Xin; Fu, Bei Gang; Wang, Ming Hui; Xia, Sheng Li

2016-12-23

According to the anatomic characteristics of the calcaneus and the sinus tarsi approach, we designed a combined plate. The goal of this study was to retrospectively assess the functional outcomes and complications of treatment with our self-designed plate. From March 2014 to October 2015, 18 patients with closed calcaneal fractures (14 Sanders type II and 4 type III) were treated with our combined locking plate through a minimally invasive sinus tarsi approach. All patients underwent both clinical and radiological evaluations. The follow-up duration for all patients ranged from 6 to 13.5 months. The radiographs demonstrated significant corrections of the calcaneal width, length, height, Böhler angle, and Gissane angle from preoperatively to 3 months postoperatively and the last follow-up. However, there were no significant differences in the variables between 3 months postoperatively and the last follow-up. The mean Maryland foot score was 88.1 ± 8.8, in which excellent outcomes were achieved in 11 patients, good in 4, and fair in 3 (excellent and good rate, 83.3% (15 of 18)). No statistical significances in the mean Maryland foot score (88.1 ± 8.8 vs 87.8 ± 10.1, p = 0.9), and the excellent and good rate (85.7 vs 75.0%, p = 1.0) was found between type II and type III fractures. No complications were observed in all fractured feet. Treatment with our self-designed combined plate through a sinus tarsi approach may be safe and effective for type II and type III calcaneal fractures.

A Novel Technique for Closed Reduction and Fixation of Paediatric Calcaneal Fracture Dislocation Injuries

PubMed Central

Faroug, Radwane; Stirling, Paul; Ali, Farhan

2013-01-01

Paediatric calcaneal fractures are rare injuries usually managed conservatively or with open reduction and internal fixation (ORIF). Closed reduction was previously thought to be impossible, and very few cases are reported in the literature. We report a new technique for closed reduction using Ilizarov half-rings. We report successful closed reduction and screwless fixation of an extra-articular calcaneal fracture dislocation in a 7-year-old boy. Reduction was achieved using two Ilizarov half-ring frames arranged perpendicular to each other, enabling simultaneous application of longitudinal and rotational traction. Anatomical reduction was achieved with restored angles of Bohler and Gissane. Two K-wires were the definitive fixation. Bony union with good functional outcome and minimal pain was achieved at eight-weeks follow up. ORIF of calcaneal fractures provides good functional outcome but is associated with high rates of malunion and postoperative pain. Preservation of the unique soft tissue envelope surrounding the calcaneus reduces the risk of infection. Closed reduction prevents distortion of these tissues and may lead to faster healing and mobilisation. Closed reduction and screwless fixation of paediatric calcaneal fractures is an achievable management option. Our technique has preserved the soft tissue envelope surrounding the calcaneus, has avoided retained metalwork related complications, and has resulted in a good functional outcome. PMID:23819090

Pulsed Compared to Thermal Radiofrequency to the Medial Calcaneal Nerve for Management of Chronic Refractory Plantar Fasciitis: A Prospective Comparative Study.

PubMed

Osman, Ayman M; El-Hammady, Dina H; Kotb, Mohamed M

2016-01-01

Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for more than 3 decades in treating various chronic pain syndromes. Conventional (continuous) RF treatment occasionally results in worsening or even initiating a new type of pain. The use of pulsed radiofrequency (PRF), which has a non- or minimally neurodestructive neuromodulatory effect, serves as an alternative to conventional RF therapy in many medical situations. To evaluate the effect of applying PRF for 6 minutes vs. thermal radiofrequency (TRF) for 90 seconds to the medial calcaneal nerve for treatment of chronic refractory plantar fasciitis pain. Prospective comparative study. Pain, Orthopedic, and Rheumatology and Rehabilitation Clinics of Assiut University Hospital. Twenty patients with refractory chronic bilateral plantar fasciitis received PRF to the medial calcaneal nerve for 6 minutes for one heel and TRF to the same nerve on the other heel (as their own control) for 90 seconds. Numerical verbal rating scale (NVRS) at waking up from bed and after prolonged walking, and satisfaction score were used for assessment of studied patients at one, 3, 6, 12, and 24 weeks from the intervention. All studied patients showed significant improvement in their pain scale after the intervention that lasted for 24 weeks; however, the PRF heels had significantly better pain scale and satisfaction scores at the first and third weeks assessments when compared to the TRF heels. Effective analgesia was achieved after one week or less after PRF compared to 3 weeks for the TRF (P < 0.001). No randomization. PRF to the medial calcaneal nerve is a safe and effective method for treatment of chronic plantar fasciitis pain. The onset of effective analgesia can be achieved more rapidly with PRF compared to TRF on the same nerve. Further randomized trials are needed to confirm the therapeutic effect and optimizing the dose of RF needed.Key words: Pulsed radiofrequency, thermal radiofrequency, medial

[Operative treatment of displaced intra-articular calcaneal fractures].

PubMed

Zwipp, H; Rammelt, S; Amlang, M; Pompach, M; Dürr, C

2013-12-01

Anatomic reduction of displaced intra-articular calcaneal fractures with restoration of height, length, and axial alignment and reconstruction of the subtalar and calcaneocuboid joints. Displaced intra-articular calcaneal fractures with incongruity of the posterior facet of the subtalar joint, loss of height, and axial malalignment. High perioperative risk, soft tissue infection, advanced peripheral arterial disease (stage III), neurogenic osteoarthropathy, poor patient compliance (e. g., substance abuse). Extended lateral approach with the patient placed on the uninjured side. Reduction of the anatomic shape and joint surfaces according to the preoperative CT-based planning. Reduction of the medial wall and step-wise reconstruction of the posterior facet from medial to lateral. Reduction of the tuberosity and anterior process fragments to the posterior joint block and temporary fixation with Kirschner wires. Internal fixation with an anatomic lateral plate in a locking or nonlocking mode. Alternatively less invasive internal fixation with a calcaneus nail over a sinus tarsi approach for less severe fracture types. The lower leg is immobilized in a brace until the wound is healed. Range of motion exercises of the ankle and subtalar joints are initiated on the second postoperative day. Patients are mobilized in their own shoe with partial weight bearing of 20 kg for 6-12 weeks depending on fracture severity and bone quality. Over a 4-year period, 163 patients with 184 displaced, intra-articular calcaneal fractures were treated with a lateral plate via an extended approach. In all, 102 patients with 116 fractures were followed for a mean of 8 years. A surgical revision was necessary in 4 cases (3.4%) of postoperative hematoma, 2 (1.7%) superficial and 5 (4.3%) deep infections. Of the latter, 2 patients needed a free flap for definite wound coverage, no calcanectomy or amputation was needed. Secondary subtalar fusion for symptomatic posttraumatic arthritis was

[Endoscopic calcaneoplasty (ECP) in Haglund's syndrome. Indication, surgical technique, surgical findings and results].

PubMed

Jerosch, J; Sokkar, S; Dücker, M; Donner, A

2012-06-01

Posterior calcaneal exostosis treatment modalities have given rise to many controversial opinions. After failure of the conservative treatment, surgical bursectomy and resection of the calcaneal exostosis are indicated by many authors. But clinical studies also show a high rate of unsatisfactory results with a relative high incidence of complications. The minimally invasive surgical technique by an endoscopic calcaneoplasty (ECP) could be an option to overcome some of these problems. Between 1999 und 2010 we operated 164 patients with an age range between 16 and 67 years, 81 males and 83 females. The radiological examination prior to surgery documented in all cases a posterior superior calcaneal exostosis that showed friction to the Achilles tendon. All patients included in the study had no clinical varus of the hind foot, nor cavus deformities. All patients had undergone a trial of conservative treatment for at least 6 months and did not show a positive response. The average follow-up was 46.3 (range: 8-120) months. According to the Ogilvie-Harris score 71 patients presented good and 84 patients excellent results, while 5 patients showed fair results, and 4 patients only poor results. All the post-operative radiographs showed sufficient resection of the calcaneal spur. In 61 patients the preoperative MRI showed a partial rupture of the Achilles tendon close to the insertion side. In no case could we observe a complete tear at the time of follow-up. Only minor postoperative complications were observed. In many patients we could observe a chondral layer at the posterior aspect of the calcaneus. Close to the intersion the Achilles tendon showed also in many patients a chondroide metaplasia. ECP is an effective and minimally invasive procedure for the treatment of patients with calcaneal exostosis. After a short learning curve the endoscopic exposure is superior to the open technique, has less morbidity, less operating time, and nearly no complications. Moreover, the

Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures.

PubMed

Ni, Ming; Wong, Duo Wai-Chi; Mei, Jiong; Niu, Wenxin; Zhang, Ming

2016-09-01

The locking plate and percutaneous crossing metallic screws and crossing absorbable screws have been used clinically to treat intra-articular calcaneal fractures, but little is known about the biomechanical differences between them. This study compared the biomechanical stability of calcaneal fractures fixed using a locking plate and crossing screws. Three-dimensional finite-element models of intact and fractured calcanei were developed based on the CT images of a cadaveric sample. Surgeries were simulated on models of Sanders type III calcaneal fractures to produce accurate postoperative models fixed by the three implants. A vertical force was applied to the superior surface of the subtalar joint to simulate the stance phase of a walking gait. This model was validated by an in vitro experiment using the same calcaneal sample. The intact calcaneus showed greater stiffness than the fixation models. Of the three fixations, the locking plate produced the greatest stiffness and the highest von Mises stress peak. The micromotion of the fracture fixated with the locking plate was similar to that of the fracture fixated with the metallic screws but smaller than that fixated with the absorbable screws. Fixation with both plate and crossing screws can be used to treat intra-articular calcaneal fractures. In general, fixation with crossing metallic screws is preferable because it provides sufficient stability with less stress shielding.

Contribution of calcaneal and leg segment rotations to ankle joint dorsiflexion in a weight-bearing task.

PubMed

Chizewski, Michael G; Chiu, Loren Z F

2012-05-01

Joint angle is the relative rotation between two segments where one is a reference and assumed to be non-moving. However, rotation of the reference segment will influence the system's spatial orientation and joint angle. The purpose of this investigation was to determine the contribution of leg and calcaneal rotations to ankle rotation in a weight-bearing task. Forty-eight individuals performed partial squats recorded using a 3D motion capture system. Markers on the calcaneus and leg were used to model leg and calcaneal segment, and ankle joint rotations. Multiple linear regression was used to determine the contribution of leg and calcaneal segment rotations to ankle joint dorsiflexion. Regression models for left (R(2)=0.97) and right (R(2)=0.97) ankle dorsiflexion were significant. Sagittal plane leg rotation had a positive influence (left: β=1.411; right: β=1.418) while sagittal plane calcaneal rotation had a negative influence (left: β=-0.573; right: β=-0.650) on ankle dorsiflexion. Sagittal plane rotations of the leg and calcaneus were positively correlated (left: r=0.84, P<0.001; right: r=0.80, P<0.001). During a partial squat, the calcaneus rotates forward. Simultaneous forward calcaneal rotation with ankle dorsiflexion reduces total ankle dorsiflexion angle. Rear foot posture is reoriented during a partial squat, allowing greater leg rotation in the sagittal plane. Segment rotations may provide greater insight into movement mechanics that cannot be explained via joint rotations alone. Copyright © 2012 Elsevier B.V. All rights reserved.

Role of the calcaneal heel pad and polymeric shock absorbers in attenuation of heel strike impact.

PubMed

Noe, D A; Voto, S J; Hoffmann, M S; Askew, M J; Gradisar, I A

1993-01-01

The capacity of the calcaneal heel pad, with and without augmentation by a polymeric shock absorbing material (Sorbothane 0050), to attenuate heel strike impulses has been studied using five fresh human cadaveric lower leg specimens. The specimens, instrumented with an accelerometer, were suspended and impacted with a hammer; a steel rod was similarly suspended and impacted. The calcaneal heel pad attenuated the peak accelerations by 80%. Attenuations of up to 93% were achieved by the shock absorbing material when tested against the steel rod; however, when tested in series with the calcaneal heel pad, the reduction in peak acceleration due to the shock absorbing material dropped to 18%. Any evaluation of the effectiveness of shock absorbing shoe materials must take into account their mechanical interaction with the body.

Minimally Invasive Calcaneal Displacement Osteotomy Site Using a Reference Kirschner Wire: A Technique Tip.

PubMed

Lee, Moses; Guyton, Gregory P; Zahoor, Talal; Schon, Lew C

2016-01-01

As a standard open approach, the lateral oblique incision has been widely used for calcaneal displacement osteotomy. However, just as with other orthopedic procedures that use an open approach, complications, including wound healing problems and neurovascular injury in the heel, have been reported. To help avoid these limitations, a percutaneous technique using a Shannon burr for calcaneal displacement osteotomy was introduced. However, relying on a free-hand technique without direct visualization at the osteotomy site has been a major obstacle for this technique. To address this problem, we developed a technical tip using a reference Kirschner wire. A reference Kirschner wire technique provides a reliable and accurate guide for minimally invasive calcaneal displacement osteotomy. Also, the technique should be easy to learn for surgeons new to the procedure. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Lateral plantar nerve release with or without calcaneal drilling for resistant plantar fasciitis.

PubMed

Sadek, Ahmed Fathy; Fouly, Ezzat Hassan; Elian, Mostafa Mohammed

2015-08-01

To compare the outcome following lateral plantar nerve release with or without calcaneal drilling for resistant plantar fasciitis. 30 women and 3 men aged 30 to 60 (mean, 45) years with resistant plantar fasciitis were randomised to undergo release of the first branch of the lateral plantar nerve with (group 1, n=18) or without (group 2, n=15) calcaneal drilling. Patients were followed up for a mean of 27 months. According to the modified Mayo scoring system for plantar fasciotomy, group 1 was superior to group 2 in terms of score (93.9±6.97 vs. 83±8.2, p<0.001) and grading (15 excellent, 2 good, and one fair vs. 6 excellent, 4 good, and 5 fair; p=0.031). Three patients in group one and one patient in group 2 (16.7% vs. 6.6%, p=0.381) developed complications of heel numbness, foot oedema, and 2 cases of superficial wound infection, respectively. Adding calcaneal drilling to release of the first branch of the lateral plantar nerve achieves better outcome than release alone in patients with resistant plantar fasciitis.

[Estimation of spur dike-affected fish habitat area].

PubMed

Ray-Shyan, Wu; Yan-Ru, Chen; Yi-Liang, Ge

2012-04-01

Based on the HEC-RAS and River 2D modes, and taking 5% change rate of weighted usable area (WUA) as the threshold to define the spur dike- affected area of target fish species Acrossocheilus paradoxus in Fazi River in Taiwan, this paper studied the affected area of the fish habitat by spur dike, and, in combining with the references about the installations of spur dikes in Taiwan in recent 10 years, analyzed the relative importance of related affecting factors such as dike height, dike length (water block rate), average slope gradient of river way, single or double spur dike, and flow discharge. In spite of the length of the dike, the affected area in downstream was farther, and was about 2-6 times as large as that in upstream. The ratio of the affected area in downstream / upstream decreased with increasing slope gradient, but increased with increasing dike length and flow discharge. When the discharge was approximate to 10 years return periods, the ratio of the affected area would be close to a constant of 2. Building double spur dike would produce a better WUA than building single spur dike.

[New techniques in the operative treatment of calcaneal fractures].

PubMed

Rammelt, S; Amlang, M; Sands, A K; Swords, M

2016-03-01

The ideal treatment of displaced intra-articular calcaneal fractures is still controversially discussed. Because of the variable fracture patterns and the vulnerable soft tissue coverage an individual treatment concept is advisable. In order to minimize wound edge necrosis associated with extended lateral approaches, selected fractures may be treated percutaneously or in a less invasive manner while controlling joint reduction via a sinus tarsi approach. Fixation in these cases is achieved with screws, intramedullary locking nails or modified plates that are slid in subcutaneously. A thorough knowledge of the three dimensional calcaneal anatomy and open reduction maneuvers is a prerequisite for good results with less invasive techniques. Early functional follow-up treatment aims at early rehabilitation independent of the kind of fixation. Peripheral fractures of the talus and calcaneus frequently result from subluxation and dislocation at the subtalar and Chopart joints. They are still regularly overlooked and result in painful arthritis if left untreated. If an exact anatomical reduction of these intra-articular fractures is impossible, resection of small fragments is indicated.

Comparison of Bone Preserving and Radical Surgical Treatment in 32 Cases of Calcaneal Osteomyelitis.

PubMed

Babiak, Ireneusz; Pędzisz, Piotr; Kulig, Mateusz; Janowicz, Jakub; Małdyk, Paweł

2016-01-01

Introduction. Radical procedures like calcanectomy and amputation performed for calcaneal osteomyelitis are regarded as effective in eradication of infection even though potentially functionally disabling. Bone sparing procedures offer better functional result at the expense of potentially worse infection control. The aim of the study has been to assess the influence of the surgical radicalism as much as the extent of bone infection on the final outcome in the surgical therapy of chronic calcaneal osteomyelitis (CO). Material and method. 32 patients with chronic CO have comprised the group under study: 8 with superficial type, 12 localised type and 12 with diffuse type according to Cierny-Mader classification. The aim of the treatment was to heal infection, preserve the heel shape and achieve good skin coverage over the calcaneus. The therapy consisted of 9 debridement surgeries with or without flaps, 8 drilling-operations of the calcaneus with application of collagen-gentamicin-sponge in bore holes, 15 partial and 2 total calcanectomies, and 4 below-the knee amputations. Results. The healing of infection and wound has been achieved after 7 of 9 debridements, 6 of 8 drilling-operations, 13 of 15 partial and all total calcanectomies. Conclusion. Bone preserving operations in chronic calcaneal osteomyelitis provided inferior infection control (76,47% vs 88,24%) and worse patient satisfaction (88,24% vs 100%) and almost camparable ambulation (100% vs 93,33%). Drilling of the calcaneus with application of collagen sponge containing gentamicin performed in chronic diffuse calcaneal osteomyelitis seems to offer a viable alternative to partial or radical calcanectomy. V.

Comparison of Bone Preserving and Radical Surgical Treatment in 32 Cases of Calcaneal Osteomyelitis

PubMed Central

Babiak, Ireneusz; Pędzisz, Piotr; Kulig, Mateusz; Janowicz, Jakub; Małdyk, Paweł

2016-01-01

Introduction. Radical procedures like calcanectomy and amputation performed for calcaneal osteomyelitis are regarded as effective in eradication of infection even though potentially functionally disabling. Bone sparing procedures offer better functional result at the expense of potentially worse infection control. The aim of the study has been to assess the influence of the surgical radicalism as much as the extent of bone infection on the final outcome in the surgical therapy of chronic calcaneal osteomyelitis (CO). Material and method. 32 patients with chronic CO have comprised the group under study: 8 with superficial type, 12 localised type and 12 with diffuse type according to Cierny-Mader classification. The aim of the treatment was to heal infection, preserve the heel shape and achieve good skin coverage over the calcaneus. The therapy consisted of 9 debridement surgeries with or without flaps, 8 drilling-operations of the calcaneus with application of collagen-gentamicin-sponge in bore holes, 15 partial and 2 total calcanectomies, and 4 below-the knee amputations. Results. The healing of infection and wound has been achieved after 7 of 9 debridements, 6 of 8 drilling-operations, 13 of 15 partial and all total calcanectomies. Conclusion. Bone preserving operations in chronic calcaneal osteomyelitis provided inferior infection control (76,47% vs 88,24%) and worse patient satisfaction (88,24% vs 100%) and almost camparable ambulation (100% vs 93,33%). Drilling of the calcaneus with application of collagen sponge containing gentamicin performed in chronic diffuse calcaneal osteomyelitis seems to offer a viable alternative to partial or radical calcanectomy. Level of evidence: V. PMID:28529846

Global Modeling of Spur Formation in Spiral Galaxies

NASA Astrophysics Data System (ADS)

Shetty, Rahul; Ostriker, Eve C.

2006-08-01

We investigate the formation of substructure in spiral galaxies using global MHD simulations, including gas self-gravity. Local modeling by Kim & Ostriker previously showed that self-gravity and magnetic fields cause rapid growth of overdensities in spiral arms; differential compression of gas flowing through the arms then results in the formation of sheared structures in the interarms. These sheared structures resemble features described as spurs or feathers in optical and IR observations of many spiral galaxies. Global modeling extends previous local models by including the full effects of curvilinear coordinates, a realistic log-spiral perturbation, self-gravitational contribution from five radial wavelengths of the spiral shock, and variation of density and epicyclic frequency with radius. We show that with realistic Toomre Q-values self-gravity and galactic differential rotation produce filamentary gaseous structures with kiloparsec-scale separations, regardless of the strength-or even presence-of a stellar spiral potential. However, a sufficiently strong spiral potential is required to produce true spurs, consisting of interarm structures emerging from gas concentrations in the main spiral arms. In models where Q is initially constant, filaments due to interarm self-gravity grow mainly in the outer regions, whereas true arm spurs grow only in the inner regions. For models with Q~R, outer regions are intrinsically more stable, so background interarm filaments do not grow, but arm spurs can develop if the spiral potential is strong. Unlike independently growing background filaments, the orientation of arm spurs depends on galactic location. Inside corotation, spurs emanate outward, on the convex side of the arm; outside corotation, spurs grow inward, on the concave side of the arm. Based on orientation and the relation to arm clumps, it is possible to distinguish true spurs that originate as instabilities in the arms from independently growing background

Factors Associated with Pain Severity in Children with Calcaneal Apophysitis (Sever Disease).

PubMed

James, Alicia M; Williams, Cylie M; Luscombe, Michelle; Hunter, Reshele; Haines, Terry P

2015-08-01

To identify any association between the pain experienced as a result of calcaneal apophysitis, anthropometric data, and lower limb measurements. This study was a cross-sectional study, nested within a wider randomized, comparative efficacy trial. One hundred twenty-four children between the ages of 8 and 14 years with a clinical diagnosis of calcaneal apophysitis were recruited for this study. Of the participating children, 72 were male. The measures recorded were height, weight, waist circumference, body mass index, foot posture, and ankle joint range of motion; comparison with normative values was also completed. Univariate and multivariable regression analyses were undertaken to identify factors associated with the severity of pain experienced (visual analog scale). The children within this study had a higher mean body mass index (P < .001), increased weight (P < .001), and were taller (P < .001) compared with normative values. The children also demonstrated differences in foot posture and ankle joint range of motion. Multivariable regression analyses identified that older participants (P = .046) and those who had experienced pain for longer (P = .043) reported higher pain severity. Children presenting with calcaneal apophysitis were anthropometrically different from their peers and had experienced a lengthy period of pain. Therefore, early management focussing on the anthropometric differences may minimize the intensity and duration of pain experienced. Registered with Australian New Zealand Clinical Trials Registry: ACTRN12609000696291. Copyright © 2015 Elsevier Inc. All rights reserved.

Correlation between Parameters of Calcaneal Quantitative Ultrasound and Hip Structural Analysis in Osteoporotic Fracture Patients

PubMed Central

Zheng, Hailiang; Li, Ming; Yin, Pengbin; Peng, Ye; Gao, Yuan; Zhang, Lihai; Tang, Peifu

2015-01-01

Background Calcaneal quantitative ultrasound (QUS), which is used in the evaluation of osteoporosis, is believed to be intimately associated with the characteristics of the proximal femur. However, the specific associations of calcaneal QUS with characteristics of the hip sub-regions remain unclear. Design A cross-sectional assessment of 53 osteoporotic patients was performed for the skeletal status of the heel and hip. Methods We prospectively enrolled 53 female osteoporotic patients with femoral fractures. Calcaneal QUS, dual energy X-ray absorptiometry (DXA), and hip structural analysis (HSA) were performed for each patient. Femoral heads were obtained during the surgery, and principal compressive trabeculae (PCT) were extracted by a three-dimensional printing technique-assisted method. Pearson’s correlation between QUS measurement with DXA, HSA-derived parameters and Young’s modulus were calculated in order to evaluate the specific association of QUS with the parameters for the hip sub-regions, including the femoral neck, trochanteric and Ward’s areas, and the femoral shaft, respectively. Results Significant correlations were found between estimated BMD (Est.BMD) and BMD of different sub-regions of proximal femur. However, the correlation coefficient of trochanteric area (r = 0.356, p = 0.009) was higher than that of the neck area (r = 0.297, p = 0.031) and total proximal femur (r = 0.291, p = 0.034). Furthermore, the quantitative ultrasound index (QUI) was significantly correlated with the HSA-derived parameters of the trochanteric area (r value: 0.315–0.356, all p<0.05) as well as with the Young’s modulus of PCT from the femoral head (r = 0.589, p<0.001). Conclusion The calcaneal bone had an intimate association with the trochanteric cancellous bone. To a certain extent, the parameters of the calcaneal QUS can reflect the characteristics of the trochanteric area of the proximal hip, although not specifically reflective of those of the femoral neck

[Manipulative reduction and external fixation with cardboard splint for the treatment of calcaneal fractures: a 60-case report].

PubMed

Hao, Bo-Chuan; Xie, Ke-Bo

2014-07-01

To investigate the therapeutic effects of manipulative reduction for calcaneal fractures. From January 2009 to June 2012, 53 cases (60 affected feet) of Sanders type I-IV calcaneal fractures were treated by manipulative reduction and external fixation with cardboard splint,including 45 males and 8 females with an average age of (33.5 +/- 1.54) years old ranging from 18 to 65. The course of disease ranged 0.5 h to 7 d. Before treatment the feet were swelling, ache and activity limitation in evidence, some feet were wide flat deformity, the cortical bone was broken in the imaging examination. All selected cases were evaluated using Creighton-Nebraska health foundation assessment scale for fractures of calcaneus. All cases were followed up at 12 months after treatment, 13 feet got excellent curative effect, 34 good, 11 moderate and 2 poor. Manipulative reduction for Sanders type I-IV calcaneal fractures could get excellent curative effect. Manipulative reduction for calcaneal fractures could avoid surgical trauma while assure high curative effects. Manipulative reduction is not only economical and easy therapy, but also can restore maximum function of the calcaneus with few complications and facilitate early rehabilitation of ankle and joint function.

Relationship between markers of body fat and calcaneal bone stiffness differs between preschool and primary school children: results from the IDEFICS baseline survey.

PubMed

Sioen, Isabelle; Mouratidou, Theodora; Herrmann, Diana; De Henauw, Stefaan; Kaufman, Jean-Marc; Molnár, Dénes; Moreno, Luis A; Marild, Staffan; Barba, Gianvincenzo; Siani, Alfonso; Gianfagna, Francesco; Tornaritis, Michael; Veidebaum, Toomas; Ahrens, Wolfgang

2012-10-01

The aim of this study was to investigate the relationship between markers of body fat and bone status assessed as calcaneal bone stiffness in a large sample of European healthy pre- and primary school children. Participants were 7,447 children from the IDEFICS study (spread over eight different European countries), age 6.1 ± 1.8 years (range 2.1-9.9), 50.5 % boys. Anthropometric measurements (weight, height, bioelectrical impedance, waist and hip circumference, and tricipital and subscapular skinfold thickness) as well as quantitative ultrasonographic measurements to determine calcaneal stiffness index (SI) were performed. Partial correlation analysis, linear regression analysis, and ANCOVA were stratified by sex and age group: preschool boys (n = 1,699) and girls (n = 1,599) and primary school boys (n = 2,062) and girls (n = 2,087). In the overall study population, the average calcaneal SI was equal to 80.2 ± 14.0, ranging 42.4-153. The results showed that preschool children with higher body fat had lower calcaneal SI (significant correlation coefficients between -0.05 and -0.20), while primary school children with higher body fat had higher calcaneal SI (significant correlation coefficients between 0.05 and 0.13). After adjusting for fat-free mass, both preschool and primary school children showed an inverse relationship between body fat and calcaneal stiffness. To conclude, body fat is negatively associated with calcaneal bone stiffness in children after adjustment for fat-free mass. Fat-free mass may confound the association in primary school children but not in preschool children. Muscle mass may therefore be an important determinant of bone stiffness.

Calcaneal Insufficiency Fracture Secondary to Celiac Disease-Induced Osteomalacia: A Rare Cause of Heel Pain.

PubMed

Kose, Ozkan; Kilicaslan, Omer Faruk; Ozyurek, Selahattin; Ince, Ahmet

2016-04-01

Plantar fasciitis is a common cause of plantar heel pain; however, a broad spectrum of disorders may also present with plantar heel pain. A detailed history, physical examination, laboratory testing, and imaging studies may be necessary to reach an accurate diagnosis. Herein, the clinical presentation of a 33-year-old woman with calcaneal insufficiency fracture secondary to celiac disease-induced osteomalacia is presented, and its diagnosis and treatment are discussed. Calcaneal insufficiency fractures should be kept in mind in a patient with celiac disease that presents with heel pain. Therapeutic, Level IV: Case study. © 2015 The Author(s).

Method and apparatus for spur-reduced digital sinusoid synthesis

NASA Technical Reports Server (NTRS)

Zimmerman, George A. (Inventor); Flanagan, Michael J. (Inventor)

1995-01-01

A technique for reducing the spurious signal content in digital sinusoid synthesis is presented. Spur reduction is accomplished through dithering both amplitude and phase values prior to word-length reduction. The analytical approach developed for analog quantization is used to produce new bounds on spur performance in these dithered systems. Amplitude dithering allows output word-length reduction without introducing additional spurs. Effects of periodic dither similar to that produced by a pseudo-noise (PN) generator are analyzed. This phase dithering method provides a spur reduction of 6(M + 1) dB per phase bit when the dither consists of M uniform variates. While the spur reduction is at the expense of an increase in system noise, the noise power can be made white, making the power spectral density small. This technique permits the use of a smaller number of phase bits addressing sinusoid look-up tables, resulting in an exponential decrease in system complexity. Amplitude dithering allows the use of less complicated multipliers and narrower data paths in purely digital applications, as well as the use of coarse-resolution, highly-linear digital-to-analog converters (DAC's) to obtain spur performance limited by the DAC linearity rather than its resolution.

[Treatment of calcaneal avulsion fractures with twinfix suture anchors fixation].

PubMed

Zhao, Bin-xiu; Wang, Kun-zheng; Wang, Chun-sheng; Xie, Yue; Dai, Zhi-tang; Liu, Gang; Liu, Wei-dong

2011-06-01

For the calcaneal avulsion fracture, the current method is more commonly used screws or Kirschner wire to fix fracture fragment. This article intended to explore the feasibility and clinical efficacy for the treatment of avulsion fractures with TwinFix suture anchors. From July 2007 to November 2010, 21 patients were reviewed, including 15 males and 6 females, ranging in age from 49 to 65 years,with a mean of 58.7 years. Twelve patients had nodules in the right heel and 9 patients had nodules in the left heel. All the patients had closed fractures. The typical preoperative symptoms of the patients included pain in the upper heel and weak in heel lift. Body examination results: palpable sense of bone rubbing in the back of the heel, and swelling in the heel. Surgery treatment with TwinFix suture anchors performed as follows : to fix TwinFix suture anchors into the calcaneal body, then to drill the fracture block, to make the double strand suture through the fracture holes, to knot the suture eachother to fix the block, and to use stitch to fix the remaining suture in the Achilles tendon in order to improve the block fixation. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional recovery was used to evaluate the Achilles tendon. Total average score was (95.5 +/- 3.12) points, including pain items of(38.5 +/- 2.18) points,the average score of functional items of (49.5 +/- 3.09) points,and power lines of 10 points in all patients. Twenty-one patients got an excellent result, 16 good and 5 poor. The methods of treatment for the calcaneal avulsion fractures with TwinFix suture anchors is a simple operation, and have excellent clinical effect, which is worthy of promotion.

Post-traumatic in situ fusion after calcaneal fractures: a retrospective study with 7-28 years follow-up.

PubMed

Ågren, Per-Henrik; Tullberg, Tycho; Mukka, Sebastian; Wretenberg, Per; Sayed-Noor, Arkan S

2015-03-01

In situ fusion as salvage operation after calcaneal fractures has been used. In this retrospective investigation, a group of in situ fused patients is analyzed with long-term follow-up. Twenty-nine patients with in situ single or multiple fusions performed between 1970 and 1990 were included. In 1998 these patients were examined with plain radiographs and computerized tomography (CT) scan of the affected foot. Also, a visual analogue score (VAS) for calcaneal fractures, short form health survey (SF-36), Olerud Molander score and American Orthopaedic Foot and Ankle society (AOFAS) hindfoot score were evaluated. The plain radiographs and CT scan showed severe remaining deformities in these patients. The outcome parameters were generally poor and correlated to the degree of remaining deformity. Simple in situ fusion, without consideration of the deformity at hand, after a calcaneal fracture is not an adequate treatment and generally associated with poor outcome. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Relationship and Classification of Plantar Heel Spurs in Patients With Plantar Fasciitis.

PubMed

Ahmad, Jamal; Karim, Ammar; Daniel, Joseph N

2016-09-01

This study classified plantar heel spurs and their relationship to plantar fasciitis. Patients included those with plantar fasciitis who were treated from 2012 through 2013. Plantar heel spur shape and size were assessed radiographically and correlated to function and pain before and after treatment. Function and pain were scored with the Foot and Ankle Ability Measures and a visual analog scale, respectively. This study included 109 patients with plantar fasciitis. The plantar heel spur shape was classified as 0/absent in 26 patients, 1/horizontal in 66 patients, 2/vertical in 4 patients, and 3/hooked in 13 patients. The plantar heel spur size was less than 5 mm in 75 patients, 5-10 mm in 28 patients, and greater than 10 mm in 6 patients. Initially, patients with any shape or size to their spur had no difference in function and pain. With treatment, patients with horizontal and hooked spurs had the greatest improvement in function and pain (P < .05). With treatment, patients with larger spurs had the greatest improvement in function and pain (P < .05). Plantar heel spurs can be classified by shape and size in patients with plantar fasciitis. Before treatment, neither the spur shape nor size significantly correlated with symptoms. After treatment, patients with larger horizontal or hooked spurs had the greatest improvement in function and pain. These findings may be important when educating patients about the role of heel spurs with plantar fasciitis and the effect of nonsurgical treatment with certain spurs. Level III, comparative series. © The Author(s) 2016.

Pedicled Sensate Composite Calcaneal Flap in Children With Congenital Tibial Pseudoarthrosis.

PubMed

Mongon, Mauricio L D; Ribera, Fernando C; de Souza, Antonio M A; Sposito, Aurelio L; Belangero, William D; Livani, Bruno

2017-06-01

The preservation and functionality of a limb affected by a malformation (such as congenital pseudoarthrosis of the tibia) or a severely mangled lower limb in children, despite modern reconstructive techniques, remains challenging, often eventually requiring amputation to achieve a better outcome. The classical Syme and Boyd procedures are functionally better than transtibial (TT) amputation, but are not feasible for congenital tibial pseudoarthrosis. TT amputation delivers an excellent, effective, and functional stump that usually leads, after prosthetization, to a functional gait. Unfortunately, in some situations, particularly when amputation is performed conventionally, the stump is also associated with complications. Future surgical revisions are often needed, particularly in children, because of stump overgrowth. Between 2008 and 2010, three patients diagnosed with congenital pseudoarthrosis of the tibia associated with neurofibromatosis who were indicated for TT amputation with calcaneal flap after failure of all previous surgical reconstructive procedures were selected. The chosen method for osteosynthesis was an external fixator of Ilizarov. At 12 weeks of follow-up, the stump had healed in all three patients, and tibiocalcaneal fusion was achieved without complications. All patients were prosthetized and had an asymptomatic gait. After a minimum follow-up of 6 years, all three cases with the pedicled sensate composite calcaneal flap still had a strong, full weight-bearing surface and have adapted easily to the conventional prosthesis, providing a painless stump with excellent functionality. With a 0 rate of needed revisions, all 3 cases with the pedicled sensate composite calcaneal flap preserving the hind foot still have a strong, full weight-bearing surface and have easily adapted to the conventional prosthesis, providing a painless and excellent functional stump that could last a lifetime. Level IV.

Displaceable Spur Gear Torque Controlled Driver and Method

NASA Technical Reports Server (NTRS)

Cook, Joseph S., Jr. (Inventor)

1996-01-01

Methods and apparatus are provided for a torque driver including a laterally displaceable gear support member to carry an output spur gear. A biasing assembly biases the output spur gear into engagement with a pinion to which is applied an input torque greater than a desired output torque limit for a threaded fastener such as a nut or screw. A coiled output linkage connects the output spur gear with a fastener adaptor which may be a socket for a nut. A gear tooth profile provides a separation force that overcomes the bias to limit torque at the desired torque limit. Multiple fasteners may be rotated simultaneously to a desired torque limit if additional output spur gears are provided. A gauged selector mechanism is provided to laterally displace multiple driven members for fasteners arranged in differing configurations. The torque limit is selectably adjustable and may be different for fasteners within the same fastener configuration.

Displaceable spur gear torque controlled driver and method

NASA Technical Reports Server (NTRS)

Cook, Joseph S., Jr. (Inventor)

1994-01-01

Methods and apparatus are provided for a torque driver including a laterally displaceable gear support member to carry an output spur gear. A biasing assembly biases the output spur gear into engagement with a pinion to which is applied an input torque greater than a desired output torque limit for a threaded fastener such as a nut or screw. A coiled output linkage connects the output spur gear with a fastener adaptor which may be a socket for a nut. A gear tooth profile provides a separation force that overcomes the bias to limit torque at the desired torque limit. Multiple fasteners may be rotated simultaneously to a desired torque limit if additional output spur gears are provided. A gauged selector mechanism is provided to laterally displace multiple driver members for fasteners arranged in differing configurations. The torque limit is selectably adjustable and may be different for fasteners within the same fastener configuration.

Relationships between spur- and orchard-level fruit bearing in almond (Prunus dulcis).

PubMed

Tombesi, Sergio; Lampinen, Bruce D; Metcalf, Samuel; DeJong, Theodore M

2011-12-01

Almond is often considered to be a moderately alternate-bearing species but historical yield data typically do not exhibit clear patterns of alternate bearing at the orchard level, while research has indicated that spurs (the main fruit bearing unit in almond trees) rarely produce fruit in two subsequent years. The objective of the present work was to analyze the bearing behavior of almond trees at both the orchard level and the individual spur level over multiple years to explain this apparent paradox. The 10-year yield patterns of three almond cultivars grown at three different sites within California were analyzed for tendencies of alternate bearing at the orchard level. At the individual spur level, data on spur viability, and number of flowers and fruits per spur were collected on 2400 individually tagged spurs that were observed over 6 years to characterize bearing at that level. At the orchard level one cultivar (Nonpareil) did exhibit a tendency for alternate bearing at one site (Kern) but other cultivars and sites did not. The orchard and the individual trees in which the spur population study was conducted showed tendencies for alternate bearing but the spur population did not. Only a relatively small percentage of the total tagged spur population bore fruit in any given year and therefore while individual fruiting spurs exhibited a high level of non-bearing after fruiting the previous year the spurs that did produce fruit in any year generally did not constitute enough of the total spur population to exhibit alternate bearing at the whole population level. Our results suggest that annual bearing fluctuations in almond are probably mainly due to year-to-year variations of parameters affecting fruit set and that high rates of fruit set in a given year may involve a larger-than-normal percentage of a spur population in fruit bearing. This would limit the size of the spur population available for flowering in the subsequent year and could cause alternate

Availability of the lateral calcaneal region as a donor site of free flaps.

PubMed

Cho, Seung Woo; Park, Ji Ung; Kwon, Sung Tack

2017-09-01

Various methods have been used for the coverage of soft-tissue defects, such as local and free flaps, as well as perforator flaps performed using even supermicrosurgery. However, the techniques have some limitations regarding flap size and location when used to reconstruct small defects. We introduced the lateral calcaneal region as a donor site for free flaps in order to overcome these disadvantages and presented the results from a series of cases. A retrospective chart review was performed on 10 patients with small soft-tissue defects who underwent reconstruction with a lateral calcaneal free flap between January 2011 and May 2014. The reconstruction was performed on the defects at medial and lateral plantar area, dorsum of the foot, great toes and preauricular area. The size of the flaps ranged from 2.5 × 2.5 cm to 4.5 × 4.5 cm. The flaps exhibited complete survival in five cases. Partial necrosis occurred in three cases, two cases healed with secondary intention, and one case required a skin graft. The donor sites were treated with skin grafts and healed completely, with no complications. Lateral calcaneal free flaps have several advantages, such as anatomically constant pedicles, a pliable and thin texture, and the ability to be used as sensory flaps. They therefore represent an alternative option when conventional local or free flaps are not suitable, especially in cases of small defects. © 2016 Wiley Periodicals, Inc. Microsurgery 37:494-501, 2017. © 2016 Wiley Periodicals, Inc.

Design of Spur Gears for Improved Efficiency

NASA Technical Reports Server (NTRS)

Anderson, N. E.; Loewenthal, S. H.

1981-01-01

A method to calculate spur gear system loss for a wide range of gear geometries and operating conditions was used to determine design requirements for an efficient gearset. The effects of spur gear size, pitch, ratio, pitch line velocity and load on efficiency were determined. Peak efficiencies were found to be greater for large diameter and fine pitched gears and tare (no-load) losses were found to be significant.

Effectiveness of footwear and foot orthoses for calcaneal apophysitis: a 12-month factorial randomised trial.

PubMed

James, Alicia M; Williams, Cylie M; Haines, Terry P

2016-10-01

Calcaneal apophysitis, is a relatively common cause of heel pain in children. Very few randomised studies have evaluated treatment options. This trial compared the effectiveness of currently employed treatment options for the relief of pain and disability associated with calcaneal apophysitis. Factorial 2×2 randomised comparative effectiveness trial with 1, 2, 6 and 12-month follow-up. Participants were recruited from the caseload of podiatrists at Monash health and Peninsula Health. Children aged 8-14 years with clinically diagnosed calcaneal apophysitis. Treatment factor 1: two different types of in-shoe orthoses: a heel raise or prefabricated orthoses. Treatment factor 2: footwear replacement or no footwear replacement. Our primary outcome was functional disability, the secondary outcomes were pain and ankle dorsiflexion range. A total of 133 children and their parents responded to the recruitment advertisement, 124 participated in the trial.At the 1 and 2-month follow-up points, there was a main effect of the shoe insert (heel raise) in only the physical domain for the Oxford ankle foot questionnaire (p=0.04). At the 6 and 12-month follow-up points, there was no main effect or interaction effect for any outcome measure. This trial indicates at the 2-month time point there is a relative advantage in the use of heel raises over prefabricated orthoses for the treatment for calcaneal apophysitis. At 12 months there was no relative advantage to any one of the investigated treatment choices over another. Therefore, if a physical impact is experienced for greater than 2 months, the selection of treatment choice may defer to clinical judgement, cost-minimisation and or patient preference. ACTRN12609000696291. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Apodization of spurs in radar receivers using multi-channel processing

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

Doerry, Armin W.; Bickel, Douglas L.

The various technologies presented herein relate to identification and mitigation of spurious energies or signals (aka "spurs") in radar imaging. Spurious energy in received radar data can be a consequence of non-ideal component and circuit behavior. Such behavior can result from I/Q imbalance, nonlinear component behavior, additive interference (e.g. cross-talk, etc.), etc. The manifestation of the spurious energy in a radar image (e.g., a range-Doppler map) can be influenced by appropriate pulse-to-pulse phase modulation. Comparing multiple images which have been processed using the same data but of different signal paths and modulations enables identification of undesired spurs, with subsequent croppingmore » or apodization of the undesired spurs from a radar image. Spurs can be identified by comparison with a threshold energy. Removal of an undesired spur enables enhanced identification of true targets in a radar image.« less

[Treatment of calcaneal fractures with a locking nail (C-Nail)].

PubMed

Pompach, M; Carda, M; Amlang, M; Zwipp, H

2016-06-01

Anatomic reconstruction of the posterior facet by primary stabilization of the calcaneal fracture with a locking nail. All intraarticular calcaneal fractures and unstable two-part fractures independent of the degree of closed/open soft tissue trauma. High perioperative risk, soft tissue infection, beak fracture (type II fracture) and still open apophysis. Anatomic reduction of the posterior facet using a sinus tarsi approach. Reduction and temporary fixation of the sustentacular, tuberosity, and anterior process fragments with 1.8-2.0 mm Kirschner wires. Thereafter, the C-Nail (calcaneus nail) is introduced with its guiding device stabilizing the sustentacular, tuberostity, and anterior process fragments through its three guiding arms with 6 or 7 locking screws. Passive and active motion starts on postoperative day 2. Lymph drains help reduce swelling. Partial weightbearing with 20 kg for 6-8 weeks in the patient's own shoes is recommended. X‑ray controls are done at 4 and 8 weeks as well as after 6 and 12 months. A total of 107 calcaneal fractures treated with the C-Nail between 2011 and 2014 were evaluated according to the AOFAS score 6 months and 1 year after surgery. The measured values were on average 93.0 (range 65-100) points at 6 months and 94.1 (range 75-100) points 12 months after the surgery. Böhler's angle with initial traumatic values of 6.2° (-30 to +13°) improved postoperatively to 31.8°, after 3 months slightly decreased to 29.6°, and after 12 months to 28.3°. There were 2 cases of superficial wound necrosis (1.9 %) and 1 case a deep infection (0.93 %) with need of early C-Nail removal.

[Tibio-talo-calcaneal arthrodesis by retrograde intramedullary nail--a case report].

PubMed

Lipiński, Łukasz; Synder, Marek; Sibiński, Marcin

2011-01-01

We described a case of 64 year old overweight women, who was treated with revision tibio-talo-calcaneal artrodesis with the use of retrograde intramedullary nail. The procedure was performed after failed primary arthrodesis with the use of lateral approach and fibula osteotomy. Stabilization with intramedullary nail gave good clinical and functional result with a good bone healing.

Fibrolipomatous hamartoma of the inferior calcaneal nerve (Baxter nerve).

PubMed

Zeng, Rong; Frederick-Dyer, Katherine; Ferguson, N Lynn; Lewis, James; Fu, Yitong

2012-09-01

Fibrolipomatous hamartoma (FLH) is a rare, benign lesion of the peripheral nerves most frequently involving the median nerve and its digital branches (80 %). Pathognomonic MR features of FLH such as coaxial-cable-like appearance on axial planes and a spaghetti-like appearance on coronal planes have been described by Marom and Helms, obviating the need for diagnostic biopsy. We present a case of fibrolipomatous hamartoma of the inferior calcaneal nerve (Baxter nerve) with associated subcutaneous fat proliferation.

Histological evaluation of calcaneal tuberosity cartilage--A proposed donor site for osteochondral autologous transplant for talar dome osteochondral lesions.

PubMed

Calder, James D F; Ballal, Moez S; Deol, Rupinderbir S; Pearce, Christopher J; Hamilton, Paul; Lutz, Michael

2015-09-01

Osteochondral Autologous Transplant (OATs) as a treatment option for Osteochondral lesions (OCLs) of the talar dome frequently uses the distal femur as the donor site which is associated with donor site morbidity in up to 50%. Some studies have described the presence of hyaline cartilage in the posterior superior calcaneal tuberosity. The aim of this study was to evaluate the posterior superior calcaneal tuberosity to determine if it can be a suitable donor site for OATs of the talus In this cadaveric study, we histologically evaluated 12 osteochondral plugs taken from the posterior superior calcaneal tuberosity and compared them to 12 osteochondral plugs taken from the talar dome. In the talar dome group, all samples had evidence of hyaline cartilage with varying degrees of GAG staining. The average hyaline cartilage thickness in the samples was 1.33 mm. There was no evidence of fibrocartilage, fibrous tissue or fatty tissue in this group. In contrast, the Calcaneal tuberosity samples had no evidence of hyaline cartilage. Fibrocartilage was noted in 3 samples only. We believe that the structural differences between the talus and calcanium grafts render the posterior superior clancaneal tuberosity an unsuitable donor site for OATs in the treatment of OCL of the talus. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Double calcaneal osteotomy with percutaneous Steinmann pin fixation as part of treatment for flexible flatfoot deformity: a review of consecutive cases highlighting our experience with pin fixation.

PubMed

Boffeli, Troy J; Abben, Kyle W

2015-01-01

Surgical correction of flexible flatfoot deformity and posterior tibial tendon dysfunction has been extensively reported in published studies. When appropriate, calcaneal osteotomies for flatfoot correction have been a favorite of foot and ankle surgeons because of the corrective power achieved without the need to fuse any rearfoot joints. The medial displacement calcaneal osteotomy and Evans calcaneal osteotomy, together termed the double calcaneal osteotomy, have been reported several times by various investigators with a wide variety of fixation options. We undertook an institutional review board-approved retrospective review of 9 consecutive patients (11 feet), who had undergone double calcaneal osteotomy with 2 percutaneous Steinmann pin fixation for the correction of flexible flatfoot deformity, with or without posterior tibial tendon dysfunction. All patients had radiographic evidence of bone healing of the posterior calcaneal osteotomy and incorporation of the Evans osteotomy bone graft at 6 weeks and demonstrated clinical healing at 6 weeks. All patients had 2 percutaneous Steinmann pins placed through both osteotomies, and these were removed an average of 6 weeks postoperatively. No patient developed pin site complications. The only complication noted was sural neuritis, which was likely incision related. No patients had delayed union or nonunion, and we did not identify any graft shifting postoperatively. The present retrospective series highlights our experience with 2 percutaneous Steinmann pin fixation, demonstrating equal or better results than many previous published fixation methods for double calcaneal osteotomy. It is cost-effective and minimizes the potential risk of iatrogenic Achilles pathologic features associated with screw fixation. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Treatment of Calcaneal Fracture With Severe Soft Tissue Injury and Osteomyelitis: A Case Report.

PubMed

Karns, Michael; Dailey, Steven K; Archdeacon, Michael T

2015-01-01

Advancements in surgical technique have resulted in the ability to reconstruct lower extremity injuries that would have previously been treated by amputation. Currently, a paucity of data is available specifically addressing limb amputation versus reconstruction for calcaneal fractures with severe soft tissue compromise. Reconstruction leaves the patient with their native limb; however, multiple surgeries, infections, chronic pain, and a poor functional outcome are very real possibilities. We present the case of a complex calcaneal fracture complicated by soft tissue injury and osteomyelitis that highlights the importance of shared decision-making between patient and surgeon when considering reconstruction versus amputation. This case exemplifies the need for open communication concerning the risks and benefits of treatment modalities while simultaneously considering the patient's expectations and desired outcomes. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Design of spur gears for improved efficiency

NASA Technical Reports Server (NTRS)

Anderson, N. E.; Loewenthal, S. H.

1981-01-01

A method to calculate spur gear system power loss for a wide range of gear geometries and operating conditions is used to determine design requirements for an efficient gearset. The effects of spur gear size, pitch, ratio, pitch-line-velocity and load on efficiency are shown. A design example is given to illustrate how the method is to be applied. In general, peak efficiencies were found to be greater for larger diameter and fine pitched gears and tare (no-load) losses were found to be significant.

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Woods Hole Oceanographic Institution Senior Engineer Steve Faluotico works on the SPURS buoy prior to it being loaded onto the Institute's research vessel Knorr, Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The SPURS buoy will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

[Tibio-talo-calcaneal arthrodesis with the retrograde intramedullary nail MEDIN].

PubMed

Popelka, S; Vavřík, P; Landor, I; Bek, J; Popelka ml, S; Hromádka, R

2013-01-01

When the talus and the talocalcaneal joint are both affected, their fusion is the method of treatment. Ankle arthrodesis is carried out using various osteosynthetic materials such as external fixators, screws and plates. One of the options is retrograde nailing. Tibio-talo-calcaneal arthrodesis is frequently indicated in patients with rheumatoid arthritis (RA) in whom both the talus and the subtalar joint are often affected. A retrograde nail for tibio-talo-calcaneal arthrodesis was developed at our department in cooperation with MEDIN Company. This is a titanium double-curved nail, with the distal part bent at 8 degrees ventrally and 10 degrees laterally. It is inserted from the transfibular approach. Sixty-two patients, 35 women and 27 men, were treated at our department from 2005. Since one patient had bilateral surgery, 63 ankles were included. The indications for arthrodesis involved rheumatoid arthritis in 42, post-traumatic arthritis in 10, failed ankle arthrodesis in two and failed total ankle arthroplasty in five ankles; tibial stress fractures close above the ankle in two RA patients, one patient with dermatomyositis and one with lupus erythematodes. The average age at the time of surgery was 64.2 years (range, 30 to 80). The average follow-up was 4.5 years (range, 1 to 9 years), Satisfaction with the treatment outcome and willingness to undergo surgery on the other side were reported by 82% of the patients. The AOFAS score improved from 35 to 74 points. Three (4.8%) patients complained of painful feet due to the fact that exact correction of the calcaneus was not achieved and the heel after arthrodesis remained in a slightly varus position. Of them, two had a failed total ankle arthroplasty. Post-operative complications included early infection managed by antibiotic treatment and early surgical revision with irrigation.in two (3.2%) RA patients, who were undergoing biological therapy. Late infection developed at 2 to 3 years after surgery in three (4

Stabilization of displaced articular fragments in calcaneal fractures using bioabsorbable pin fixation: a technique guide.

PubMed

Min, William; Munro, Mark; Sanders, Roy

2010-12-01

Successful operative intervention in displaced intra-articular calcaneal fractures depends in part on the maintenance of an anatomic reduction of the posterior facet. This guide describes our use of bioabsorbable implants to solve this problem.

Achilles tenodesis for calcaneal insufficiency avulsion fractures associated with diabetes mellitus.

PubMed

Choi, Youngrak; Kwon, Young-Woo; Sim, Young-Suk; Kim, Taeho; Song, Dayoung; Lee, Soohyun

2017-12-13

Calcaneal insufficiency avulsion (CIA) fractures often present with neuropathic etiology, such as Charcot neuroarthropathy (CN). Under the same surgical procedures, the outcomes of CIA fractures are less desirable, compared to the outcomes of the traumatic calcaneal avulsion fractures. Here, the study suggests Achilles tenodesis technique using suture anchor after resection of the CIA fracture fragments could provide satisfactory clinical results in the cases of surgically indicated CIA fractures. This retrospective study included seven patients of calcaneal avulsion fracture who had underlying diabetes mellitus (DM) and no specific traumatic event. The patients were treated with Achilles tenodesis techniques for their CIA fractures. Achilles tenodesis was performed using suture anchor with removal of the fracture fragments. The patients were evaluated with the Foot and Ankle Outcome Score (FAOS), visual analogue scale (VAS), single-heel rise test, and X-ray images on their final follow-ups. Initially, three of the CIA fracture cases treated with traditional open reduction and internal fixation reported pullout failure. Consequently, all patients received Achilles tenodesis using suture anchor after bone fragment resection and had good clinical outcomes. Only one subject with low compliance reported poor outcome. The FAOS of each patient were obtained at a mean of 16.3 months after surgery. The results are as follows: pain 80.6 (SD = 6.2), symptom 83.8 (SD = 4.9), activities of daily living 80.5 (SD = 8.0), sport and recreation function 75.6 (SD = 11.93), and foot- and ankle-related quality of life 77.9 (SD = 6.7). On their final follow-ups, the average VAS was 2.6 (range, 1 to 4). Achilles tenodesis using suture anchor after bone fragment resection achieved competent clinical results in the patients with CIA fractures. The study proposes that this surgical procedure could be an appropriate treatment option for patients with CIA fractures. The

SPURS: Salinity Processes in the Upper-Ocean Regional Study: THE NORTH ATLANTIC EXPERIMENT

NASA Technical Reports Server (NTRS)

Lindstrom, Eric; Bryan, Frank; Schmitt, Ray

2015-01-01

In this special issue of Oceanography, we explore the results of SPURS-1, the first part of the ocean process study Salinity Processes in the Upper-ocean Regional Study (SPURS). The experiment was conducted between August 2012 and October 2013 in the subtropical North Atlantic and was the first of two experiments (SPURS come in pairs!). SPURS-2 is planned for 20162017 in the tropical eastern Pacific Ocean.

Ankle fracture spur sign is pathognomonic for a variant ankle fracture.

PubMed

Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G

2015-02-01

The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.

Urinary Mineral Concentrations in European Pre-Adolescent Children and Their Association with Calcaneal Bone Quantitative Ultrasound Measurements †

PubMed Central

Van den Bussche, Karen; Herrmann, Diana; De Henauw, Stefaan; Kourides, Yiannis A.; Lauria, Fabio; Marild, Staffan; Molnár, Dénes; Moreno, Luis A.; Veidebaum, Toomas; Ahrens, Wolfgang; Sioen, Isabelle

2016-01-01

This study investigates differences and associations between urinary mineral concentrations and calcaneal bone measures assessed by quantitative ultrasonography (QUS) in 4322 children (3.1–11.9 years, 50.6% boys) from seven European countries. Urinary mineral concentrations and calcaneal QUS parameters differed significantly across countries. Clustering revealed a lower stiffness index (SI) in children with low and medium urinary mineral concentrations, and a higher SI in children with high urinary mineral concentrations. Urinary sodium (uNa) was positively correlated with urinary calcium (uCa), and was positively associated with broadband ultrasound attenuation and SI after adjustment for age, sex and fat-free mass. Urinary potassium (uK) was negatively correlated with uCa but positively associated with speed of sound after adjustment. No association was found between uCa and QUS parameters after adjustment, but when additionally adjusting for uNa, uCa was negatively associated with SI. Our findings suggest that urinary mineral concentrations are associated with calcaneal QUS parameters and may therefore implicate bone properties. These findings should be confirmed in longitudinal studies that include the food intake and repeated measurement of urinary mineral concentrations to better estimate usual intake and minimize bias. PMID:27164120

Natural Fatigue Crack Initiation and Detection in High Quality Spur Gears

DTIC Science & Technology

2012-06-01

Natural Fatigue Crack Initiation and Detection in High Quality Spur Gears by David “Blake” Stringer, Ph.D., Kelsen E. LaBerge, Ph.D., Cory...0383 June 2012 Natural Fatigue Crack Initiation and Detection in High Quality Spur Gears David “Blake” Stringer and Ph.D., Kelsen E. LaBerge...Quality Spur Gears 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) David “Blake” Stringer, Ph.D., Kelsen E

The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis.

PubMed

Park, Jaeyong; Lee, Sang Gil; Bae, Jongjin; Lee, Jung Chul

2015-12-01

[Purpose] This study aimed to provide a predictable evaluation method for the progression of scoliosis in adolescents based on quick and reliable measurements using the naked eye, such as the calcaneal valgus angle of the foot, which can be performed at public facilities such as schools. [Subjects and Methods] Idiopathic scoliosis patients with a Cobb's angle of 10° or more (96 females, 22 males) were included in this study. To identify relationships between factors, Pearson's product-moment correlation coefficient was computed. The degree of scoliosis was set as a dependent variable to predict thoracic and lumbar scoliosis using ankle angle and physique factors. Height, weight, and left and right calcaneal valgus angles were set as independent variables; thereafter, multiple regression analysis was performed. This study extracted variables at a significance level (α) of 0.05 by applying a stepwise method, and calculated a regression equation. [Results] Negative correlation (R=-0.266) was shown between lumbar lordosis and asymmetrical lumbar rotation angles. A correlation (R=0.281) was also demonstrated between left calcaneal valgus angles and asymmetrical thoracic rotation angles. [Conclusion] Prediction of scoliosis progress was revealed to be possible through ocular inspection of the calcaneus and Adams forward bending test and the use of a scoliometer.

Experimental Investigation of Shrouding on Meshed Spur Gear Windage Power Loss

NASA Technical Reports Server (NTRS)

Delgado, Irebert; Hurrell, Michael

2017-01-01

Windage power loss in high-speed gearboxes result in efficiency losses and increased heating due to drag on the gear teeth. Meshed spur gear windage power loss test results are presented at ambient oil inlet temperatures both with and without shrouding. The rate of windage power loss is observed to increase above 10,000 ft.min., gear surface speed, similar to results presented in the literature. Shrouding is observed to become more effective above 15,000 ft.min., decreasing power loss by 10 at 25,000 ft.min. The need for gearbox oil drain slots limits the effectiveness of shrouding on reducing windage power loss. Also, windage power loss is observed to decrease with increasing gearbox temperatures and to increase with oil flow. Windage power losses for the unshrouded meshed spur gears are 7x more than losses determined from unshrouded single spur gear tests. A 6x to 12x increase in windage power is observed comparing shrouded single spur gear data with shrouded meshed spur gear data. Based on this preliminary study additional research is suggested to determine the effect of oil drain slot configurations, axial and radial shroud clearances, and higher gear surface speeds on windage power loss. Additional work is also suggested to determine the sensitivity of windage power loss to oil temperature and oil flow. Windage power loss of meshed spur gears tested in both the shrouded and unshrouded configurations is shown to be more than double versus the same spur gears run individually in the same shroud configurations. Further study of the physical processes behind these results is needed for optimizing gearbox shrouds for minimum windage power loss.

Comparison of the Conventional Surgery and the Surgery Assisted by 3d Printing Technology in the Treatment of Calcaneal Fractures.

PubMed

Zheng, Wenhao; Tao, Zhenyu; Lou, Yiting; Feng, Zhenhua; Li, Hang; Cheng, Liang; Zhang, Hui; Wang, Jianshun; Guo, Xiaoshan; Chen, Hua

2017-09-19

This study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of calcaneal fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients. we enrolled 75 patients with calcaneal fracture from April 2014 to August 2016. They were divided randomly into two groups: 35 cases of 3D printing group, 40 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan in 3D printing group. Operation duration, blood loss volume during the surgery, number of intraoperative fluoroscopy and fracture union time were recorded. The radiographic outcomes Böhler angle, Gissane angle, calcaneal width and calcaneal height and final functional outcomes including VAS and AOFAS score as well as the complications were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. The operation duration, blood loss volume and number of intraoperative fluoroscopy for 3D printing group was 71.4 ± 6.8 minutes, 226.1 ± 22.6 ml and 5.6 ± 1.9 times, and for conventional group was 91.3 ± 11.2 minutes, 288.7 ± 34.8 ml and 8.6 ± 2.7 times respectively. There was statistically significant difference between the conventional group and 3D printing group (p < 0.05). Additionally, 3D printing group achieved significantly better radiographic results than conventional group both postoperatively and at the final follow-up (p < 0.05). However, No significant difference was noted in the final functional outcomes between the two groups. As for complications, there was no significant difference between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D printing model. This study suggested the clinical feasibility of 3D printing

Evolution of spur-length diversity in Aquilegia petals is achieved solely through cell-shape anisotropy.

PubMed

Puzey, Joshua R; Gerbode, Sharon J; Hodges, Scott A; Kramer, Elena M; Mahadevan, L

2012-04-22

The role of petal spurs and specialized pollinator interactions has been studied since Darwin. Aquilegia petal spurs exhibit striking size and shape diversity, correlated with specialized pollinators ranging from bees to hawkmoths in a textbook example of adaptive radiation. Despite the evolutionary significance of spur length, remarkably little is known about Aquilegia spur morphogenesis and its evolution. Using experimental measurements, both at tissue and cellular levels, combined with numerical modelling, we have investigated the relative roles of cell divisions and cell shape in determining the morphology of the Aquilegia petal spur. Contrary to decades-old hypotheses implicating a discrete meristematic zone as the driver of spur growth, we find that Aquilegia petal spurs develop via anisotropic cell expansion. Furthermore, changes in cell anisotropy account for 99 per cent of the spur-length variation in the genus, suggesting that the true evolutionary innovation underlying the rapid radiation of Aquilegia was the mechanism of tuning cell shape.

Patient satisfaction after open reduction and internal fixation through lateral extensile approach in displaced intraarticular calcaneal fractures (Sander's type II and III).

PubMed

Kavin, Khatri; Vijay, Sharma; Devendra, Lakhotia; Kamran, Farooque

2016-01-01

To determine patient satisfaction in the patients of displaced intraarticular calcaneal fractures treated with standard lateral approach. The patients of displaced calcaneal fractures (Sander's type II and III) treated between March 2009 and March 2012 were included in the retrospective review and functional outcome was evaluated using American Orthopaedic Foot and Ankle Society (AOFAS) hind foot score, Creighton Nebraska Health Foundation Assessment (CNHFA) scale and foot function index (FFI). The cohort included 26 patients (19 males: seven were females) with a mean age of 38.16 ± 13.53 years (range 18-64 years). The mean period of follow-up was 24.42 ± 6.68 months. The patients achieved good functional scores after anatomical reduction of the fracture. The complication rate was low following strict inclusion criteria. Careful patient selection in displaced intraarticular calcaneal fractures treated through lateral extensile approach achieves good patient satisfaction.

Soft tissue reconstruction for calcaneal fractures or osteomyelitis.

PubMed

Attinger, C; Cooper, P

2001-01-01

A systematic approach of the surgical management of a calcaneal fracture can minimize the potential of soft tissue complications. When reducing a closed calcaneal fracture, the incision used affects the postoperative complications. The L-shaped incision with the horizontal limb lying on the lateral glabrous junction ensures maximum blood flow to either side of the incision. Whether or not the wound can be closed primarily depends on the preexisting edema, the lost calcaneal height, and the delay between the fracture and reduction (Fig. 20). The wrinkle test is a good indicator that the incision can be closed primarily if the amount of height restored is minimal. If the edema is too great, steps should be taken to reduce it sufficiently to allow successful wound closure. If the wound, after reduction, is too wide to allow primary closure, an ADM flap laterally or an AHM flap medially should be used. For larger defects, a free flap should be considered. The three important steps to reconstruction of soft tissue defects around the calcaneus include good blood supply, a infection-free wound, and the simplest soft tissue reconstructive option that covers the wound successfully. Adequate blood supply can be determined by the use of Doppler. If the supply is inadequate, revascularization is necessary before proceeding. Achieving a clean wound requires aggressive debridement, intravenous antibiotics, and good wound care. Adjuncts that can help in achieving a clean wound include topical antibiotics (silver sulfadiazine), the VAC, and hyperbaric oxygen. Osteomyelitis has to be treated aggressively. Any suspicious bone has to be removed. Only clean, healthy, bleeding bone is left behind. Antibiotic beads can be useful when there is doubt as to whether the cancellous bone is infection-free. The beads are not a substitute for good debridement, however. Soft tissue reconstruction ranges from delayed primary closure to the use of microsurgical free flaps (Fig. 21). When bone or

Pollinator shifts and the evolution of spur length in the moth-pollinated orchid Platanthera bifolia.

PubMed

Boberg, Elin; Alexandersson, Ronny; Jonsson, Magdalena; Maad, Johanne; Ågren, Jon; Nilsson, L Anders

2014-01-01

Plant-pollinator interactions are thought to have shaped much of floral evolution. Yet the relative importance of pollinator shifts and coevolutionary interactions for among-population variation in floral traits in animal-pollinated species is poorly known. This study examined the adaptive significance of spur length in the moth-pollinated orchid Platanthera bifolia. Geographical variation in the length of the floral spur of P. bifolia was documented in relation to variation in the pollinator fauna across Scandinavia, and a reciprocal translocation experiment was conducted in south-east Sweden between a long-spurred woodland population and a short-spurred grassland population. Spur length and pollinator fauna varied among regions and habitats, and spur length was positively correlated with the proboscis length of local pollinators. In the reciprocal translocation experiment, long-spurred woodland plants had higher pollination success than short-spurred grassland plants at the woodland site, while no significant difference was observed at the grassland site. The results are consistent with the hypothesis that optimal floral phenotype varies with the morphology of the local pollinators, and that the evolution of spur length in P. bifolia has been largely driven by pollinator shifts.

Pollinator shifts and the evolution of spur length in the moth-pollinated orchid Platanthera bifolia

PubMed Central

Boberg, Elin; Alexandersson, Ronny; Jonsson, Magdalena; Maad, Johanne; Ågren, Jon; Nilsson, L. Anders

2014-01-01

Background and Aims Plant–pollinator interactions are thought to have shaped much of floral evolution. Yet the relative importance of pollinator shifts and coevolutionary interactions for among-population variation in floral traits in animal-pollinated species is poorly known. This study examined the adaptive significance of spur length in the moth-pollinated orchid Platanthera bifolia. Methods Geographical variation in the length of the floral spur of P. bifolia was documented in relation to variation in the pollinator fauna across Scandinavia, and a reciprocal translocation experiment was conducted in south-east Sweden between a long-spurred woodland population and a short-spurred grassland population. Key Results Spur length and pollinator fauna varied among regions and habitats, and spur length was positively correlated with the proboscis length of local pollinators. In the reciprocal translocation experiment, long-spurred woodland plants had higher pollination success than short-spurred grassland plants at the woodland site, while no significant difference was observed at the grassland site. Conclusions The results are consistent with the hypothesis that optimal floral phenotype varies with the morphology of the local pollinators, and that the evolution of spur length in P. bifolia has been largely driven by pollinator shifts. PMID:24169591

Erosional development of bedrock spur and gully topography in the Valles Marineris, Mars

NASA Technical Reports Server (NTRS)

Patton, Peter C.

1990-01-01

Gully networks separated by resistant bedrock spurs are a common erosional feature along the escarpments that border the Valles Marineris. The resistant spur topography is best developed where the base of the slope is truncated by linear scarps interpreted as fault scarps. Regional variations in slope morphology imply that spur and gully topography undergoes a systematic progressive degradation through time associated with the erosional destruction of the basal fault scarps. The comparative morphometry of the divide networks indicates that the density of the spur networks and the number of first-order unbranched spurs decreases as the basal slope break becomes more sinuous. Abstraction of the spurs occurs through regolith storage in adjacent gullies at the slope base and the most degraded slope forms are entirely buried in talus. The basal fault scarps apparently control regolith transport by allowing debris to drain from the slope. As these basal scarps decay the slope base becomes increasingly sinuous and the slopes become transport limited. Dry mass-wasting may be the most important process acting on these slopes where a continually lowered base level is required to maintain the spur topography. In contrast to the Martian slopes, range front fault escarpments in the western U.S. show no systematic trend in spur network geometry as they are eroded. These weathering limited slopes are controlled by the more efficient removal of regolith through fluvial processes which rapidly create quasi-equilibrium drainage networks.

"SPURS" in the North Atlantic Salinity Maximum

NASA Astrophysics Data System (ADS)

Schmitt, Raymond

2014-05-01

The North Atlantic Salinity Maximum is the world's saltiest open ocean salinity maximum and was the focus of the recent Salinity Processes Upper-ocean Regional Study (SPURS) program. SPURS was a joint venture between US, French, Irish, and Spanish investigators. Three US and two EU cruises were involved from August, 1012 - October, 2013 as well as surface moorings, glider, drifter and float deployments. Shipboard operations included underway meteorological and oceanic data, hydrographic surveys and turbulence profiling. The goal is to improve our understanding of how the salinity maximum is maintained and how it may be changing. It is formed by an excess of evaporation over precipitation and the wind-driven convergence of the subtropical gyre. Such salty areas are getting saltier with global warming (a record high SSS was observed in SPURS) and it is imperative to determine the relative roles of surface water fluxes and oceanic processes in such trends. The combination of accurate surface flux estimates with new assessments of vertical and horizontal mixing in the ocean will help elucidate the utility of ocean salinity in quantifying the changing global water cycle.

Calcaneal stress fracture: an adverse event following total hip and total knee arthroplasty: a report of five cases.

PubMed

Miki, Takaaki; Miki, Takahito; Nishiyama, Akihiro

2014-01-15

Stress fractures have been reported to occur in the pubis, femoral neck, proximal part of the tibia, and fabella during the postoperative period following total knee or total hip arthroplasty. However, to our knowledge, calcaneal stress fractures after total hip or total knee arthroplasty have not been reported in the English-language literature. Most orthopaedic surgeons are not familiar with calcaneal stress fractures that may occur in elderly patients after a total knee or total hip arthroplasty. We retrospectively reviewed the clinical features, imaging findings, and bone mineral content of the proximal part of the femur and the distal end of the radius in five patients who had a calcaneal stress fracture after a total knee or total hip arthroplasty. All patients were women with a mean age of 76.8 years. All fractures occurred in the calcaneus on the same side as the arthroplasty. The fracture appeared at a mean of 10.2 weeks postoperatively. All patients reported heel pain on walking. Swelling and local heat were found in four and three patients, respectively. Pain was elicited by squeezing the calcaneus in all patients. Early radiographs had normal findings in two patients, and an irregular sclerotic line appeared later in the radiographs of all patients. All fractures were treated conservatively. Four fractures healed uneventfully, but one fracture displaced. All patients had osteoporosis. Calcaneal stress fractures during the postoperative period following total knee or total hip arthroplasty may not be as rare as previously thought. Because clinical symptoms of the fracture appear insidiously and radiographic findings are absent or subtle in the early stage, a high index of suspicion is needed for orthopaedic surgeons to make the correct diagnosis. Magnetic resonance imaging or repeated radiographs may be necessary to make the correct diagnosis when no abnormality is apparent on the initial radiograph.

Experimental Investigation of Shrouding on Meshed Spur Gear Windage Power Loss

NASA Technical Reports Server (NTRS)

Delgado, Irebert R.; Hurrell, Michael J.

2017-01-01

Windage power loss in high-speed gearboxes results in efficiency losses and increased heating due to drag on the gear teeth. Test results for meshed spur gear windage power loss are presented at ambient oil inlet temperatures, both with and without shrouding. The rate of windage power loss is observed to increase above a gear surface speed of 10,000 feet per minute (51 meters per second), similar to results presented in the literature. Shrouding is observed to become more effective above 15,000 feet per minute (76 meters per second), decreasing power loss by 10 percent at 25,000 feet per minute (127 meters per second). The need for gearbox oil drain slots limits the effectiveness of shrouding in reducing windage power loss. Windage power loss is observed to decrease with increasing gearbox temperatures and to increase with oil flow. Windage power losses for unshrouded meshed spur gears are 7 times greater than losses determined from unshrouded single spur gear tests. A 6- to 12-times increase in windage power loss is observed in the shrouded meshed spur gear data compared with shrouded single spur gear data. Based on this preliminary study, additional research is suggested to determine the effect of oil drain slot configurations, axial and radial shroud clearances, and higher gear surface speeds on windage power loss. Additional work is also suggested to determine the sensitivity of windage power loss to oil temperature and oil flow. Windage power loss for meshed spur gears tested in both the shrouded and unshrouded configurations is shown to be more than double versus windage power loss for the same spur gears run individually in the same shroud configurations. Further study of the physical processes behind these results is needed to optimize gearbox shrouds for minimum windage power loss.

Effects of medially wedged foot orthoses on knee and hip joint running mechanics in females with and without patellofemoral pain syndrome.

PubMed

Boldt, Andrew R; Willson, John D; Barrios, Joaquin A; Kernozek, Thomas W

2013-02-01

We examined the effects of medially wedged foot orthoses on knee and hip joint mechanics during running in females with and without patellofemoral pain syndrome (PFPS). We also tested if these effects depend on standing calcaneal eversion angle. Twenty female runners with and without PFPS participated. Knee and hip joint transverse and frontal plane peak angle, excursion, and peak internal knee and hip abduction moment were calculated while running with and without a 6° full-length medially wedged foot orthoses. Separate 3-factor mixed ANOVAs (group [PFPS, control] x condition [medial wedge, no medial wedge] x standing calcaneal angle [everted, neutral, inverted]) were used to test the effect of medially wedged orthoses on each dependent variable. Knee abduction moment increased 3% (P = .03) and hip adduction excursion decreased 0.6° (P < .01) using medially wedged foot orthoses. No significant group x condition or calcaneal angle x condition effects were observed. The addition of medially wedged foot orthoses to standardized running shoes had minimal effect on knee and hip joint mechanics during running thought to be associated with the etiology or exacerbation of PFPS symptoms. These effects did not appear to depend on injury status or standing calcaneal posture.

The nectar spur is not only a simple specialization for long-proboscid pollinators.

PubMed

Vlašánková, Anna; Padyšáková, Eliška; Bartoš, Michael; Mengual, Ximo; Janečková, Petra; Janeček, Štěpán

2017-09-01

Since the time of Darwin, biologists have considered the floral nectar spur to be an adaptation representing a high degree of plant specialization. Nevertheless, some researchers suggest that nature is more complex and that even morphologically specialized plants attract a wide spectrum of visitors. We observed visitors on Impatiens burtonii (Balsaminaceae) and measured the depth of the proboscis insertion into the spur, the distance of the nectar surface from the spur entrance and the visitor's effectiveness. The hoverfly Melanostoma sp., with the shortest proboscis, was most active early in the morning and fed on pollen and nectar near the spur entrance. The honeybee Apis mellifera and the hoverfly Rhingia mecyana were the most frequent visitors before and after noon, respectively. Although R. mecyana, the only visitor able to reach the end of the spur, was the most frequent, it did not deposit the largest number of pollen grains per visit. Nectar spurs may function as complex structures allowing pollination by both short- and long-proboscid visitors and separating their spatial and temporal niches. Spurred plants should be considered as more generalized and exposed to more diverse selection pressures than previously believed. © 2017 The Authors. New Phytologist © 2017 New Phytologist Trust.

Plantar Pressure Anomalies After Open Reduction With Internal Fixation of High-Grade Calcaneal Fractures.

PubMed

Hetsroni, Iftach; Ben-Sira, David; Nyska, Meir; Ayalon, Moshe

2014-07-01

Plantar pressure abnormalities after open reduction with internal fixation (ORIF) of intra-articular calcaneal fractures have been observed previously, but high-grade fractures were not selectively investigated and follow-up times were shorter than 2 years. The purpose of this study was to characterize plantar pressure anomalies in patients with exclusively high-grade calcaneal fractures after ORIF with a minimum 2 years of follow-up, and to test the association between plantar pressure distribution and the clinical outcome. The orthopaedic registry was reviewed to identify patients with isolated high-grade calcaneal fractures (Sanders types III-IV) who were operated on and had a minimum 2 years of follow-up. Sixteen patients were evaluated. Mean age was 47 years and follow-up was between 2 and 6 years. The Pedar-Mobile system was used to measure 3 loading and 3 temporal variables and compare these between the operated and the uninjured limbs. Mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 76 ± 7 at latest follow-up. Bohler's angle was 5 ± 8 degrees before surgery and 25 ± 7 degrees at latest follow-up. Stance was shorter in operated limbs (P = .001). Timing of the peak of pressure was delayed in operated limbs under the hallux and the second toe (P ≤ .03). Peak pressure, force time integral, and pressure time integral were increased under the lateral midfoot (P ≤ .03) and decreased under the second metatarsal (P ≤ .03). Force time integral was decreased under the first metatarsal (P = .02) and under the hallux and the lateral toes (P ≤ .05). Increased loading under the lateral midfoot and decreased loading under the lateral toes were correlated with poorer clinical outcome (r = -.53, P < .05, and r = .63, P < .01, respectively). Side-to-side plantar pressure mismatch persisted at more than 2 years after ORIF of high-grade calcaneal fractures performed via lateral approach, despite improvement of Bohler's angle. This was characterized

Posterior symphyseal spurs--an unusual differential diagnosis in athletes with groin pain.

PubMed

Hopp, Sascha Jörg; Ojodu, Ishaq; Pohlemann, Tim; Kelm, Jens

2015-05-01

We set out to highlight the significance of posterior symphyseal spurs as an unusual diagnostic possibility in athletes with chronic groin pain and to demonstrate that operative resection was successful in quickly and safely returning the patients to sporting activities. Five competitive nonprofessional male athletes, three soccer players, and two marathon runners (median age: 30 [26/33] years), who presented to us with significant groin and central pubic pain with duration of at least 12 months, and who had failed conservative or surgical interventions (symphyseal plating), were evaluated. Physical examination as well as pelvic radiographs confirmed the diagnosis of posterior symphyseal spurs. Four out of five athletes underwent complete resection of the spur. Size of spurs was 2.2 (1.3/2.9) cm (median) with four of them posterosuperiorly and one posterocentrally located. All of them had uneventful postoperative recovery period and were still pain-free at the latest follow up after 26.6 months (24/30). Median time-to-return to competitive sports level was 10 weeks (8/13). None of the patients developed pubic instability due to symphyseal spur resection. The results of considerable postoperative improvement in our patients highlight the significance of posterior symphyseal spurs as a diagnostic possibility in athletes with chronic groin pain.

Optimal design of compact spur gear reductions

NASA Technical Reports Server (NTRS)

Savage, M.; Lattime, S. B.; Kimmel, J. A.; Coe, H. H.

1992-01-01

The optimal design of compact spur gear reductions includes the selection of bearing and shaft proportions in addition to gear mesh parameters. Designs for single mesh spur gear reductions are based on optimization of system life, system volume, and system weight including gears, support shafts, and the four bearings. The overall optimization allows component properties to interact, yielding the best composite design. A modified feasible directions search algorithm directs the optimization through a continuous design space. Interpolated polynomials expand the discrete bearing properties and proportions into continuous variables for optimization. After finding the continuous optimum, the designer can analyze near optimal designs for comparison and selection. Design examples show the influence of the bearings on the optimal configurations.

Flow near a model spur dike with a fixed scoured bed

USDA-ARS?s Scientific Manuscript database

Three-dimensional flow velocities were measured using an acoustic Doppler velocimeter at a closely spaced grid over a fixed scoured bed with a submerged spur dike. Three-dimensional flow velocities were measured at 3484 positions around the trapezoidal shaped submerged model spur dike over a fixed ...

Correlates between calcaneal morphology and locomotion in extant and extinct carnivorous mammals.

PubMed

Panciroli, Elsa; Janis, Christine; Stockdale, Maximilian; Martín-Serra, Alberto

2017-10-01

Locomotor mode is an important component of an animal's ecology, relating to both habitat and substrate choice (e.g., arboreal versus terrestrial) and in the case of carnivores, to mode of predation (e.g., ambush versus pursuit). Here, we examine how the morphology of the calcaneum, the 'heel bone' in the tarsus, correlates with locomotion in extant carnivores. Other studies have confirmed the correlation of calcaneal morphology with locomotion behaviour and habitat. The robust nature of the calcaneum means that it is frequently preserved in the fossil record. Here, we employ linear measurements and 2D-geometric morphometrics on a sample of calcanea from eighty-seven extant carnivorans and demonstrate a signal of correlation between calcaneal morphology and locomotor mode that overrides phylogeny. We used this correlation to determine the locomotor mode, and hence aspects of the palaeobiology of, 47 extinct carnivorous mammal taxa, including both Carnivora and Creodonta. We found ursids (bears), clustered together, separate from the other carnivorans. Our results support greater locomotor diversity for nimravids (the extinct 'false sabertooths', usually considered to be more arboreal), than previously expected. However, there are limitations to interpretation of extinct taxa because their robust morphology is not fully captured in the range of modern carnivoran morphology. © 2017 Wiley Periodicals, Inc.

An Innovative Approach to the Repair of Distal Tibia Nonunion Using a Retrograde Buried Tibio-Talar-Calcaneal Nail: A Case Report.

PubMed

Van Steyn, Peter; Romash, Michael

We report a case using retrograde tibial nailing as treatment of nonunion of a distal tibial osteotomy, which was performed as part of a complex reconstruction of distal tibial malunion with ankle arthritis. Although retrograde nailing has classically been used for tibial-talar-calcaneal arthrodesis, this method spares the subtalar joint. Preservation of some hindfoot motion by subtalar mobility allows for a decrease in the loss of function typically seen with tibial-talar-calcaneal arthrodesis. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Effect of the calcaneal medializing osteotomy on soft tissues supporting the plantar arch: A computational study.

PubMed

Larrainzar-Garijo, R; Cifuentes de la Portilla, C; Gutiérrez-Narvarte, B; Díez-Nicolás, E; Bayod, J

2018-06-12

Medializing calcaneal osteotomy forms part of the treatment options for adult acquired flat foot. The structural correction that is achieved is widely known. However, the effect of this procedure on the soft tissues that support the plantar arch has been little studied, since it is not possible to quantify experimentally the tension and deformation variations generated. Therefore, the objective of this study was to evaluate the effect of medializing calcaneal osteotomy on the soft tissue that supports the plantar arch, using a computational model of the human foot designed with a clinical approach. The proposed finite element model was reconstructed from computerized tomography images of a healthy patient. All the bones of the foot, the plantar fascia, cartilages, plantar ligaments and the calcaneus-navicular ligament were included, respecting their anatomical distribution and biomechanical properties. Simulations were performed emulating the monopodal support phase of the human walk of an adult. The effect on each tissue was evaluated according to clinical and biomechanical criteria. The results show that calcaneal osteotomy reduces the tension normally generated on the evaluated tissues, with the effect on the calcaneus-navicular ligament and the plantar fascia being the most notable. The deformation results obtained are consistent with experimental tests and clinical knowledge. The versatility of this model allows the objective assessment of different conditions and supports decision making for the treatment of adult acquired flat foot in middle and advanced stages. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of calcaneal eversion on three-dimensional kinematics of the hip, pelvis and thorax in unilateral weight bearing.

PubMed

Tateuchi, Hiroshige; Wada, Osamu; Ichihashi, Noriaki

2011-06-01

Understanding the kinematic chain from foot to thorax will provide a better basis for assessment of malalignment of the body. The purpose of this study was to investigate the effects of induced calcaneal eversion on the kinematics of the hip, pelvis and thorax in three dimensions under unilateral weight-bearing. Twenty-eight healthy males were requested to stand on one leg under three conditions: normal (standing directly on the floor), and on wedges producing 5° and 10° calcaneal eversion. Recorded kinematic parameters included the angles of the hip joint, pelvis, and thorax in three dimensions. Eversion induced by wedges produced significant increases in hip flexion, hip medial rotation, pelvic anterior tilt, and thoracic lateral tilt and axial rotation to the standing side. In the frontal plane, pelvic lateral tilt to the standing side was decreased in 5° eversion condition compared with normal condition; conversely, it was increased in 10° eversion condition compared with 5° eversion condition. Arch height was negatively correlated with change in thoracic axial rotation to standing side from the normal to 10° eversion (r=-.528, p<.01). We concluded that induced calcaneal eversion affects the three-dimensional kinematics of the thorax through the hip joint and the pelvis. Copyright © 2011 Elsevier B.V. All rights reserved.

Interlocking Nailing Versus Interlocking Plating in Intra-articular Calcaneal Fractures: A Biomechanical Study.

PubMed

Reinhardt, Sophia; Martin, Heiner; Ulmar, Benjamin; Döbele, Stefan; Zwipp, Hans; Rammelt, Stefan; Richter, Martinus; Pompach, Martin; Mittlmeier, Thomas

2016-08-01

Open reduction and internal fixation with a plate is deemed to represent the gold standard of surgical treatment for displaced intra-articular calcaneal fractures. Standard plate fixation is usually placed through an extended lateral approach with high risk for wound complications. Minimally invasive techniques might avoid wound complications but provide limited construct stability. Therefore, 2 different types of locking nails were developed to allow for minimally invasive technique with sufficient stability. The aim of this study was to quantify primary stability of minimally invasive calcaneal interlocking nail systems in comparison to a variable-angle interlocking plate. After quantitative CT analysis, a standardized Sanders type IIB fracture model was created in 21 fresh-frozen cadavers. For osteosynthesis, 2 different interlocking nail systems (C-Nail; Medin, Nov. Město n. Moravě, Czech Republic; Calcanail; FH Orthopedics SAS; Heimsbrunn, France) as well as a polyaxial interlocking plate (Rimbus; Intercus GmbH; Rudolstadt, Germany) were used. Biomechanical testing consisted of a dynamic load sequence (preload 20 N, 1000 N up to 2500 N, stepwise increase of 100 N every 100 cycles, 0.5 mm/s) and a load to failure sequence (max. load 5000 N, 0.5 mm/s). Interfragmentary movement was detected via a 3-D optical measurement system. Boehler angle was measured after osteosynthesis and after failure occurred. No significant difference regarding load to failure, stiffness, Boehler angle, or interfragmentary motion was found between the different fixation systems. A significant difference was found with the dynamic failure testing sequence where 87.5% of the Calcanail implants failed in contrast to 14% of the C-Nail group (P < .01) and 66% of the Rimbus plate. The highest load to failure was observed for the C-Nail. Boehler angle showed physiologic range with all implants before and after the biomechanical tests. Both minimally invasive interlocking nail systems

Unusual presentation of calcaneal osteomyelitis. Twenty-five years after inoculation.

PubMed

Rogoff, R S; Tinkle, J D; Bartis, D G

1997-03-01

An unusual presentation of calcaneal osteomyelitis is described, where-by the infection remained undiagnosed for 25 years. The 36-year-old patient recently sought medical treatment for a reported ankle sprain, but the pain was recalcitrant to conservative care. Further investigation yielded a history significant for stepping on a chicken bone as a child, which entered the inferior lateral heel. Magnetic resonance imaging revealed what plain radiographs did not: a well demarcated lytic lesion in the body of the calcaneus. Intraoperative findings were consistent with an abscess of chronic osteomyelitis. The treatment included incision and drainage, antibiotic beads, and a tricortical bone graft.

Introduction of a New Locking Nail for Treatment of Intraarticular Calcaneal Fractures.

PubMed

Zwipp, Hans; Paša, Libor; Žilka, Luboš; Amlang, Michael; Rammelt, Stefan; Pompach, Martin

2016-03-01

To reduce the complication rate associated with open reduction and internal fixation of displaced intraarticular calcaneal fractures through extensile approaches, a locking nail system (C-Nail) was developed for internal fixation. Prospective case-control study. Two level I trauma centers (university hospital) and 1 large regional hospital in the Czech Republic and Germany. One hundred three patients (89 male and 14 female; mean age, 45.6 years) with 106 calcaneal fractures were treated between February 2011 and October 2013. In all 106 cases, the stainless steel C-Nail with a length of 65 mm, a diameter of 8 mm, and 7 locking options was used for internal fixation. Previous reduction of the posterior facet was performed in 15 cases percutaneously, assisted by arthroscopy and fluoroscopy, and in 91 cases by a sinus tarsi approach. The reduced joint surface was fixed by 1 or 2 compression screws. All other fragments were fixed after reduction and temporary K-wire fixation with the C-Nail introduced percutaneously through the tuberosity and 5 to 6 interlocking screws. The latter were introduced into the sustentacular, the tuberosity, and the anterior process fragments with an aiming device consisting of 3 arms. Patients were assessed for complications, restoration of Böhler angle, posterior facet reduction with postoperative computed tomography, and weight-bearing radiographs at 6 months. Functional outcome was assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot scale after 6 and 12 months for all patients. Wound edge necrosis was seen in 2 cases (1.9%), and soft tissue infection was observed in 1 case (0.9%). Böhler angle improved from 7.3 degree preoperatively to 28.7 degree at 6 months. The posterior facet step-off was reduced from 5.3 mm preoperatively to 0.7 mm postoperatively. The average AOFAS score averaged 89.5 at 6-month and 92.6 at 12-month follow-up. The C-Nail is a new locking system for treatment of displaced

The SPURS Data Management System: Real-time Situational Awareness at Sea

NASA Astrophysics Data System (ADS)

Bingham, F.; Chao, Y.; Li, P.; Vu, Q. A.

2012-12-01

SPURS (Salinity Processes in the Upper ocean Regional Study) is a field program in the North Atlantic to study the subtropical surface salinity maximum. It is a heterogeneous array consisting of research ships, profiling floats, surface drifters, gliders, microstructure profilers and moorings, as well as satellite observations and models. The SPURS Data Management System aims to capture the status of the observing system in near-real time and allow SPURS science team members to deploy observational assets "on the fly". At the heart of this is a visualization system that tracks the positions of the various assets and displays them in a an interface using Google Earth. The interface was used by program participants on land and at sea to coordinate the deployment of instrumentation. Before the Fall AGU, SPURS will have completed the first part of its mission with a 6-week cruise to the study area. This poster presents some of the highlights of the field campaign, and details the lessons learned in doing real-time oceanography on the high seas.

Michael J. Fox: Spurring Research on Parkinson's

MedlinePlus

... on. Feature: Parkinson's Disease Michael J. Fox: Spurring Research on Parkinson's Past Issues / Winter 2014 Table of ... founded the Michael J. Fox Foundation for Parkinson's Research in the year 2000. Photo courtesy of Shutterstock " ...

Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures.

PubMed

Zhou, Hai-Chao; Yu, Tao; Ren, Hao-Yang; Li, Bing; Chen, Kai; Zhao, You-Guang; Yang, Yun-Feng

2017-02-01

To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra-articular calcaneal fractures. We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group. All patients were asked to return for a research visit that included radiography and clinical evaluation. The postoperative function was evaluated using the ankle and hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and the visual analogue scale (VAS). No significant difference was found in demographics between the two groups. The corrected value of the calcaneal varus angle between the two groups is statistically significant (P < 0.05). The overall wound complication rate was 3.6% in the minimally invasive group versus 13.5% in the extensile group. Four patients in the extensile lateral approach group had developed hindfoot varus deformity at last follow-up. At the last follow-up, the average AOFAS ankle and the hindfoot score of the minimal group was 88.4 ± 6.6, and the VAS score was 1.9 ± 0.7, while that of the extensile lateral approach group was 83.2 ± 5.6 and 2.3 ± 1.0, respectively. Limited open reduction via the sinus tarsi approach for intra-articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful for correcting the calcaneus varus deformity. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Comparative anatomy of the nectary spur in selected species of Aeridinae (Orchidaceae).

PubMed

Stpiczyńska, Małgorzata; Davies, Kevin L; Kamińska, Magdalena

2011-03-01

To date, the structure of the nectary spur of Aeridinae has not been studied in detail, and data relating to the nectaries of ornithophilous orchids remain scarce. The present paper compares the structural organization of the floral nectary in a range of Aeridinae species, including both entomophilous and ornithophilous taxa. Nectary spurs of Ascocentrum ampullaceum (Roxb.) Schltr. var. aurantiacum Pradhan, A. curvifolium (Lindl.) Schltr., A. garayi Christenson, Papilionanthe vandarum (Rchb.f.) Garay, Schoenorchis gemmata (Lindl.) J.J. Sm., Sedirea japonica (Rchb.f.) Garay & H.R. Sweet and Stereochilus dalatensis (Guillaumin) Garay were examined by means of light microscopy, scanning electron microscopy and transmission electron microscopy. The diverse anatomy of the nectary is described for a range of Aeridinae species. All species of Ascocentrum investigated displayed features characteristic of ornithophilous taxa. They have weakly zygomorphic, scentless, red or orange flowers, display diurnal anthesis, possess cryptic anther caps and produce nectar that is secluded in a relatively massive nectary spur. Unicellular, secretory hairs line the lumen at the middle part of the spur. Generally, however, with the exception of Papilionanthe vandarum, the nectary spurs of all entomophilous species studied here (Schoenorchis gemmata, Sedirea japonica, Stereochilus dalatensis) lack secretory trichomes. Moreover, collenchymatous secretory tissue, present only in the nectary spur of Asiatic Ascocentrum species, closely resembles that found in nectaries of certain Neotropical species that are hummingbird-pollinated and assigned to subtribes Maxillariinae Benth., Laeliinae Benth. and Oncidiinae Benth. This similarity in anatomical organization of the nectary, regardless of geographical distribution and phylogeny, indicates convergence.

Comparative anatomy of the nectary spur in selected species of Aeridinae (Orchidaceae)

PubMed Central

Stpiczyńska, Małgorzata; Davies, Kevin L.; Kamińska, Magdalena

2011-01-01

Background and Aims To date, the structure of the nectary spur of Aeridinae has not been studied in detail, and data relating to the nectaries of ornithophilous orchids remain scarce. The present paper compares the structural organization of the floral nectary in a range of Aeridinae species, including both entomophilous and ornithophilous taxa. Methods Nectary spurs of Ascocentrum ampullaceum (Roxb.) Schltr. var. aurantiacum Pradhan, A. curvifolium (Lindl.) Schltr., A. garayi Christenson, Papilionanthe vandarum (Rchb.f.) Garay, Schoenorchis gemmata (Lindl.) J.J. Sm., Sedirea japonica (Rchb.f.) Garay & H.R. Sweet and Stereochilus dalatensis (Guillaumin) Garay were examined by means of light microscopy, scanning electron microscopy and transmission electron microscopy. Key Results and Conclusions The diverse anatomy of the nectary is described for a range of Aeridinae species. All species of Ascocentrum investigated displayed features characteristic of ornithophilous taxa. They have weakly zygomorphic, scentless, red or orange flowers, display diurnal anthesis, possess cryptic anther caps and produce nectar that is secluded in a relatively massive nectary spur. Unicellular, secretory hairs line the lumen at the middle part of the spur. Generally, however, with the exception of Papilionanthe vandarum, the nectary spurs of all entomophilous species studied here (Schoenorchis gemmata, Sedirea japonica, Stereochilus dalatensis) lack secretory trichomes. Moreover, collenchymatous secretory tissue, present only in the nectary spur of Asiatic Ascocentrum species, closely resembles that found in nectaries of certain Neotropical species that are hummingbird-pollinated and assigned to subtribes Maxillariinae Benth., Laeliinae Benth. and Oncidiinae Benth. This similarity in anatomical organization of the nectary, regardless of geographical distribution and phylogeny, indicates convergence. PMID:21183455

Outcome Determining Factors for displaced Intra-articular Calcaneal Fractures treated operatively

PubMed Central

Chan, KL; Idham, HM; Izani, IM; Nahulan, T

2015-01-01

Introduction: Calcaneal fractures are caused by high energy trauma and mostly are intra-articular fractures. Nondisplaced intra-articular calcaneal fracture (IACF) can be treated non-operatively. However, displaced intra-articular need to be reduced and fixed anatomically to facilitate early ankle rehabilitation and minimize functional impairment. This study was done to find out the outcome of the IACF patients who underwent operative treatment. Methods: 62 patients with IACF were selected in this study and had been followed up from June 2009 to May 2013. They were placed into two groups; the operative treated and non-operative treated groups. Bilateral ankle lateral view plain radiographs were taken for comparison of the Bohler and Gissane angles. Both groups of patients were assessed by the Maryland Foot Score (MFS) and the SF-36v2 general health survey questionnaire. The ability of the patients to perform activity of daily living (ADL) and /or return to work (RTW) was assessed as well. Results: The operative treatment group of displaced IACF patients achieved no significant better scores in the mean MFS and SF-36v2 mean scores as compared to non operated cases. There was no difference in RTW between the 2 groups, but earlier ADL was recorded in the operated group. However, this study had found 5 associated factors which causes major effect to the patients’ outcome to treatment. Conclusions: The patient’s compliance with post-operative rehabilitation regimen were found to be significantly related with the outcomes. PMID:28611903

Treatment of displaced intra-articular calcaneal fractures with triangular tube-to-bar external fixation: long-term clinical follow-up and radiographic analysis.

PubMed

Roukis, Thomas S; Wünschel, Markus; Lutz, Hans-Peter; Kirschner, Peter; Zgonis, Thomas

2008-04-01

Sixty-six feet (62 patients) with displaced intra-articular calcaneal fractures underwent manual reduction and distraction with the use of a triangular tube-to-bar external fixation device and were retrospectively reviewed at a minimum of 1-year post-operative. Final radiographic follow-up revealed complete consolidation in all fractures, maintenance of reduction, and limited degenerative osteoarthrosis about the subtalar joint. Our results indicate that with proper application and attention to detail, restoration of calcaneal morphology using triangular tube-to-bar external fixation should be considered a viable alternative in the treatment of displaced intra-articular fractures of the calcaneus.

Osseous spurs at the fovea capitis femoris-a frequent finding in asymptomatic volunteers.

PubMed

Bensler, Susanne; Agten, Christoph A; Pfirrmann, Christian W A; Sutter, Reto

2018-01-01

To investigate the different morphologic types of the fovea capitis femoris and the spectrum of osseous spurs/osteophytes of the fovea in asymptomatic volunteers and patients with hip osteoarthritis. Sixty-five patients (mean age 63.6 years) with radiographically confirmed osteoarthritis of the hip and 59 asymptomatic healthy volunteers (mean age 33.9 years) underwent non-contrast MRI of the hip joint. Two radiologists independently evaluated all images. Fovea morphology (standard type, diamond type, flat type, triangular type) as well as the frequency, size and location of spurs/osteophytes of the fovea were assessed. Descriptive and inferential statistics were applied. The most frequent morphologic type of the fovea capitis femoris was the standard type for both asymptomatic volunteers (average 45%) and patients (average 49%). Osseous spurs were detected in 70% of the asymptomatic volunteers, and 97% of the patients had osteophytes. Spur size at all locations was significantly smaller in asymptomatic volunteers (range 1-2 mm) than osteophyte size in patients (range 1-4 mm) (p ≤ 0.035). In volunteers and patients, the spurs/osteophytes were most frequently located at the anterior border of the fovea capitis femoris. Smaller osseous spurs (<2 mm) at the border of the fovea capitis femoris are very common in asymptomatic volunteers and do not seem to be pathologic.

Design of spur-type streambank stabilization structures.

DOT National Transportation Integrated Search

1985-07-01

streambank stabilization structures has been conducted to establish design guidelines and other criteria for the use of spurs. The recommendations and findings are based on a thorough review of pertinent literature, analysis of several hundred field ...

Sanders II type calcaneal fractures: a retrospective trial of percutaneous versus operative treatment.

PubMed

Wang, Ye-ming; Wei, Wan-fu

2015-02-01

The purpose of this study was to compare the clinical results of percutaneous reduction and Steinman pin fixation for Sanders II calcaneal fractures with those of operative management through an extensile lateral approach. Fifty-three patients treated with standard open reduction and internal fixation (ORIF group) and 54 patients who had undergone percutaneous reduction and Steinman pin fixation (CRIF group) were retrospectively reviewed. There were no differences between the groups regarding sex, age or fracture classification. Pain and functional outcome were evaluated with a visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. Wound complications and radiological results were compared. At a mean follow-up of 40.4 months (24 to 56 months), there were no differences between the two groups in mean AOFAS score, VAS score or radiologically determined variables. Two cases of deep infection and six of poor wound healing occurred in the ORIF group and none in the CRIF group. Subtalar and ankle motion was found to be better in the CRIF group. Percutaneous reduction and Steinman pin fixation minimizes complications and achieves functional outcomes comparable to those of the open techniques in patients with Sanders II calcaneal fractures. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Comparative floral spur anatomy and nectar secretion in four representatives of Ranunculaceae.

PubMed

Antoń, Sebastian; Kamińska, Magdalena

2015-11-01

Nectaries are common in Ranunculaceae. These secretory structures, however, have not been studied in detail despite their importance in plant-animal interactions, and data relating to the structure of nectary spurs, which are so characteristic of several genera of this family, remain scarce. In order to redress this imbalance, we sought, in the present paper, to analyze the anatomical and ultrastructural organization of the nectary spurs of four representatives of Ranunculaceae, i.e., Aconitum lycoctonum L., Aquilegia vulgaris L., Consolida regalis Gray, and Delphinium elatum L. Nectary spurs were examined using light, fluorescence, scanning electron, and transmission electron microscopy. The floral nectaries of A. lycoctonum and A. vulgaris are situated at the apices of the spurs, whereas in C. regalis and D. elatum, the nectary is located along the floor surface of the spurs. Nectar in C. regalis and D. elatum is exuded through micro-channels in the cuticle, whereas in A. lycoctonum and A. vulgaris, it is released by means of cell wall disruption, indicating that the method of nectar secretion here is holocrine. Structurally, the nectary of all four investigated species is quite similar, and its cells are typical of nectar-producing cells described in the literature. It is proposed that in A. lycoctonum and A. vulgaris, disruption of the cell wall and the release of the entire cell contents into the spur cavity contribute to the composition of the nectar that the latter contains, enriching it with cytoplasmic components. We conclude that the manner of nectar exudation may vary considerably between closely related plant species, regardless of their geographical origin and phylogeny.

Increased mast cell numbers in a calcaneal tendon overuse model.

PubMed

Pingel, J; Wienecke, J; Kongsgaard, M; Behzad, H; Abraham, T; Langberg, H; Scott, A

2013-12-01

Tendinopathy is often discovered late because the initial development of tendon pathology is asymptomatic. The aim of this study was to examine the potential role of mast cell involvement in early tendinopathy using a high-intensity uphill running (HIUR) exercise model. Twenty-four male Wistar rats were divided in two groups: running group (n = 12); sedentary control group (n = 12). The running-group was exposed to the HIUR exercise protocol for 7 weeks. The calcaneal tendons of both hind limbs were dissected. The right tendon was used for histologic analysis using Bonar score, immunohistochemistry, and second harmonic generation microscopy (SHGM). The left tendon was used for quantitative polymerase chain reaction (qPCR) analysis. An increased tendon cell density in the runners were observed compared to the controls (P = 0.05). Further, the intensity of immunostaining of protein kinase B, P = 0.03; 2.75 ± 0.54 vs 1.17 ± 0.53, was increased in the runners. The Bonar score (P = 0.05), and the number of mast cells (P = 0.02) were significantly higher in the runners compared to the controls. Furthermore, SHGM showed focal collagen disorganization in the runners, and reduced collagen density (P = 0.03). IL-3 mRNA levels were correlated with mast cell number in sedentary animals. The qPCR analysis showed no significant differences between the groups in the other analyzed targets. The current study demonstrates that 7-week HIUR causes structural changes in the calcaneal tendon, and further that these changes are associated with an increased mast cell density. © 2013 The Authors. Scand J Med Sci Sports published by John Wiley & Sons Ltd.

Minimally invasive reduction and fixation of displaced calcaneal fractures: surgical technique and radiographic analysis.

PubMed

Arastu, Mateen; Sheehan, Brendan; Buckley, Richard

2014-03-01

The optimal treatment of calcaneal fractures is controversial. A specific subgroup of healthy patients has good outcomes with open reduction and internal fixation using an extensile lateral approach. However, there are many patients who do not fit into this category. Consequently, they are either denied surgical intervention or put at significant risk of developing complications as a result of open surgical intervention. Minimally invasive reduction and fixation (MIRF) of calcaneal fractures can restore the height, width, length and shape of the hindfoot in addition to restoring the orientation of the posterior facet of the calcaneus (Böhler's angle). We present a series of 31 patients treated with minimally invasive reduction and fixation technique using threaded K wires and Steinmann pins as an alternative treatment method in patients who are not suitable for open reduction and internal fixation. The mean time to surgery from injury was six days (range one to ten days). The mean duration of surgery was 35 minutes (range 11-52 minutes). The mean followup was 14.9 months (range of seven to 30 months). The mean change in Böhler's angle and length of the calcaneus from intra-operative fixation to final followup were 18.7° and 4.7 mm, respectively. The complication rate was low and there was one case of a superficial wound infection and no cases of deep infection or peroneal impingement in this series. The MIRF technique with the use of threaded K wires has not been previously described in the literature. In our experience, the operative time is short and can be safely performed even in the presence of extensive soft tissue swelling in the immediate period following injury. The infection risk is low and calcaneal morphology was improved and maintained in terms of Böhler's angle. This technique is suitable to be considered in patients who have significant medical co-morbidities (smokers, diabetics, peripheral vascular disease) and in those patients who are

Intermediate term follow-up of calcaneal osteotomy and flexor digitorum longus transfer for treatment of posterior tibial tendon dysfunction.

PubMed

Fayazi, Amir H; Nguyen, Hoan-Vu; Juliano, Paul J

2002-12-01

Twenty-three patients with stage II posterior tibial tendon dysfunction who had failed non-surgical therapy were treated with flexor digitorum longus transfer and calcaneal osteotomy. At latest follow-up averaging 35 +/- 7 months (range, 24 to 51 months), 22 patients (96%) were subjectively "better" or "much better." No patient had difficulty with shoe wear; however, four patients (17%) required routine orthotic use consisting of a molded shoe insert. AOFAS scores were available on 21 patients and improved from a preoperative mean of 50 +/- 14 (range, 27 to 85) to a postoperative mean of 89 +/- 10 (range, 70 to 100). Our experience, at an intermediate date follow-up is that calcaneal osteotomy and flexor digitorum longus transfer is a safe and effective form of treatment for stage II posterior tibial tendon dysfunction.

The Effectiveness of Shrouding on Reducing Meshed Spur Gear Power Loss - Test Results

NASA Technical Reports Server (NTRS)

Delgado, I. R.; Hurrell, M. J.

2017-01-01

Gearbox efficiency is reduced at high rotational speeds due to windage drag and viscous effects on rotating, meshed gear components. A goal of NASA aeronautics rotorcraft research is aimed at propulsion technologies that improve efficiency while minimizing vehicle weight. Specifically, reducing power losses to rotorcraft gearboxes would allow gains in areas such as vehicle payload, range, mission type, and fuel consumption. To that end, a gear windage rig has been commissioned at NASA Glenn Research Center to measure windage drag on gears and to test methodologies to mitigate windage power losses. One method used in rotorcraft gearbox design attempts to reduce gear windage power loss by utilizing close clearance walls to enclose the gears in both the axial and radial directions. The close clearance shrouds result in reduced drag on the gear teeth, and reduced power loss. For meshed spur gears, the shrouding takes the form of metal side plates and circumferential metal sectors. Variably positioned axial and radial shrouds are incorporated in the NASA rig to study the effect of shroud clearance on gearbox power loss. A number of researchers have given experimental and analytical results for single spur gears, with and without shrouding. Shrouded meshed spur gear test results are sparse in the literature. Windage tests were run at NASA Glenn using meshed spur gears at four shroud configurations: unshrouded, shrouded (max. axial, max radial), and two intermediate shrouding conditions. Results are compared to available meshed spur gear power loss data analyses as well as single spur gear data/analyses. Recommendations are made for future work.

The Effectiveness of Shrouding on Reducing Meshed Spur Gear Power Loss Test Results

NASA Technical Reports Server (NTRS)

Delgado, I. R.; Hurrell, M. J.

2017-01-01

Gearbox efficiency is reduced at high rotational speeds due to windage drag and viscous effects on rotating, meshed gear components. A goal of NASA aeronautics rotorcraft research is aimed at propulsion technologies that improve efficiency while minimizing vehicle weight. Specifically, reducing power losses to rotorcraft gearboxes would allow gains in areas such as vehicle payload, range, mission type, and fuel consumption. To that end, a gear windage rig has been commissioned at NASA Glenn Research Center to measure windage drag on gears and to test methodologies to mitigate windage power losses. One method used in rotorcraft gearbox design attempts to reduce gear windage power loss by utilizing close clearance walls to enclose the gears in both the axial and radial directions. The close clearance shrouds result in reduced drag on the gear teeth and reduced power loss. For meshed spur gears, the shrouding takes the form of metal side plates and circumferential metal sectors. Variably positioned axial and radial shrouds are incorporated in the NASA rig to study the effect of shroud clearance on gearbox power loss. A number of researchers have given experimental and analytical results for single spur gears, with and without shrouding. Shrouded meshed spur gear test results are sparse in the literature. Windage tests were run at NASA Glenn using meshed spur gears at four shroud configurations: unshrouded, shrouded (max. axial, max. radial), and two intermediate shrouding conditions. Results are compared to available meshed spur gear power loss data analyses as well as single spur gear data analyses.

A Spur to Atavism: Placing Platypus Poison.

PubMed

Hobbins, Peter

2015-11-01

For over two centuries, the platypus (Ornithorhynchus anatinus) has been constructed and categorized in multiple ways. An unprecedented mélange of anatomical features and physiological functions, it long remained a systematic quandary. Nevertheless, since 1797, naturalists and biologists have pursued two recurring obsessions. Investigations into platypus reproduction and lactation have focused attention largely upon females of the species. Despite its apparent admixture of avian, reptilian and mammalian characters, the platypus was soon placed as a rudimentary mammal--primitive, naïve and harmless. This article pursues a different taxonomic trajectory, concentrating on a specifically male anatomical development: the crural spur and venom gland on the hind legs. Once the defining characteristic of both the platypus and echidna (Tachyglossus aculeatus), by 1830 this sexed spur had been largely dismissed as inactive and irrelevant. For a creature regularly depicted as a biological outlier, the systematic and evolutionary implications of platypus poison have remained largely overlooked. In Australia, however, sporadic cases of 'spiking' led to consistent homologies being remarked between the platypus crural system and the venom glands of snakes. As with its reproductive reliance upon eggs, possession of an endogenous poison suggested significant reptilian affinities, yet the platypus has rarely been classed as an advanced reptile. Indeed, ongoing uncertainty regarding the biological purpose of the male's spur has ostensibly posed a directional puzzle. As with so many of its traits, however, platypus poison has been consistently described as a redundant remnant, rather than an emergent feature indicating evolutionary advance.

Factors in daily physical activity related to calcaneal mineral density in men.

PubMed

Hutchinson, T M; Whalen, R T; Cleek, T M; Vogel, J M; Arnaud, S B

1995-05-01

To determine the factors in daily physical activity that influence the mineral density of the calcaneus, we recorded walking steps and the type and duration of exercise in 43 healthy 26-to 51-yr-old men. Areal (g.cm-2) calcaneal bone mineral density (CBMD) was measured by single energy x-ray densitometry (SXA, Osteon, Inc., Wahiawa, HI). Subjects walked a mean (+/- SD) of 7902 (+/- 2534) steps per day or approximately 3.9 (+/- 1.2) miles daily. Eight subjects reported no exercise activities. The remaining 35 subjects spent 143 (2-772) (median and range) min.wk-1 exercising. Twenty-eight men engaged in exercise activities that generate single leg peak vertical ground reaction forces (GRFz) of 2 or more body weights (high loaders, HL), and 15 reported exercise or daily activities that typically generate GRFz less than 1.5 body weights (low loaders, LL). CBMD was 12% higher in HL than LL (0.668 +/- 0.074 g.cm-2 vs 0.597 +/- 0.062 g.cm-2, P < 0.004). In the HL group, CBMD correlated to reported minutes of high load exercise (r = 0.41, P < 0.03). CBMD was not related to the number of daily walking steps (N = 43, r = 0.03, NS). The results of this study support the concept that the dominant factor in daily physical activity relating to bone mineral density is the participation in site specific high loading activities, i.e., for the calcaneus, high calcaneal loads.

Factors in Daily Physical Activity Related to Calcaneal Mineral Density in Men

NASA Technical Reports Server (NTRS)

Hutchinson, Teresa M.; Whalen, Robert T.; Cleek, Tammy M.; Vogel, John M.; Arnaud, Sara B.

1995-01-01

To determine the factors in daily physical activity that influence the mineral density of the calcaneus, we recorded walking steps and the type and duration of exercise in 43 healthy 26-to 51-yr-old men. Areal (g/sq cm) calcaneal bone mineral density (CBMD) was measured by single energy x-ray densitometry. Subjects walked a mean (+/- SD) of 7902(+/-2534) steps per day or approximately 3.9(+/-1.2) miles daily. Eight subjects reported no exercise activities. The remaining 35 subjects spent 143(2-772) (median and range) min/wk exercising. Twenty-eight men engaged in exercise activities that generate single leg peak vertical ground reaction forces (GRF(sub z)) of 2 or more body weights (high loaders, HL), and 15 reported exercise or daily activities that typically generate GRF(sub z) less than 1.5 body weights (low loaders, LL). CBMD was 12% higher in HL than LL (0.668 +/- 0.074 g/sq cm vs 0.597 +/- 0.062 g/sq cm, P less than 0.004). In the HL group, CBMD correlated to reported minutes of high load exercise (r = 0.41, P less than 0.03). CBMD was not related to the number of daily walking steps (N = 43, r = 0.03, NS). The results of this study support the concept that the dominant factor in daily physical activity relating to bone mineral density is the participation in site specific high loading activities, i.e., for the calcaneus, high calcaneal loads.

Older women track and field athletes have enhanced calcaneal stiffness.

PubMed

Welch, J M; Rosen, C J

2005-08-01

Vigorous weight-bearing exercise is recommended to women as a method of osteoporosis prevention. This study examined older women athletes to see if they indeed were less likely to develop osteoporosis than those in the general population, and to investigate which factors could have contributed to these results. One hundred and thirty-nine women 40-88 years old, all competitors in a USA National Masters Track and Field Championships, volunteered for the study. Masters refers to competitors > or =40 years old. Their calcaneal stiffness (SI) was measured by a Lunar Achilles+ ultrasonometer. Subjects were also measured for height and weight, and completed a questionnaire on exercise history, diet, lifestyle factors, medical and menopausal issues, and use of hormone replacement therapy (HRT). The women, mean age 57.3 years, had an overall average SI of 99.5 (T-score = 0.04) which is equivalent to that of a 20-year-old woman and 20.8% higher than expected for women of their age. Their median SI remained not different from expected peak bone SI until the age of 70. For analysis, this cohort of women was divided into two groups: premenopausal and postmenopausal athletes. The SI of both groups was correlated with the earliest age at which they had first participated in sports or exercises that impart moderate to high strain rates to the lower limbs and with current participation in high impact track and field events. Variables correlated with SI in the general population, such as weight, HRT, previous fracture, hysterectomy, and current menopausal status, did not predict SI in this cohort. In conclusion, women competing in Masters track and field at the national level had calcaneal stiffness substantially higher than expected for women of their age in the general population, and their participation in vigorous sports and activities, either currently or at a younger age, was predictive of this association.

Tibio-talo-calcaneal arthrodesis by a retrograde intramedullary nail.

PubMed

Haaker, Rolf; Kohja, E Y; Wojciechowski, Mariusz; Gruber, Gerd

2010-01-01

The paper presents the results of tibio-talo-calcaneal fusions using Retrograde Nailing System and Bone Grafting. From May 2006 to January 2008, we performed 13 fusions in 11 consecutive patients with advanced ankle and hindfoot disease. Patients underwent 13 tibiotalocalcaneal fusions (2 patients had initial tibiotalocalcaneal fusion using screws and subsequently developed a non-union) and all 11 patients were available for follow up. The procedure was performed unilaterally in all cases; there were 4 males and 7 females. The average age at the time of surgery was 65.25 years (range 51-81 years). The average duration of follow-up was 8 months (range between 6-15 months). Solid fusion was achieved in all 11 cases. The average AOFAS score (maximum 78 points) improved from a pre-operative mean of 16 points [range 3 to 29] to a mean of 54 points [range 42 to 70], excluding the scores for stability and range of motion. Patient satisfaction scale (maximum 10 points) improved from 3 to 7 in both pain and function. 1- Arthrodesis should be considered only after all conservative treatments fails; it is one of the most challenging surgical procedures that must be undertaken with care in order to provide the best possible outcome. 2- Thorough evaluation and examination will help the surgeon to find the correct indication and identify patients who are not suitable for the procedure. It is crucial to assess the vascular and neurological status and to obtain weight-bearing radiographs (possibly CT) of the ankle to evaluate the deformity. 3- The optimal position of the ankle is in neutral flexion, 0-5 degrees valgus, and 10 degrees external rotation, similar to the contralateral foot and posterior translation of the talus under the tibia (5mm). 4- Tibio-talo-calcaneal fusion with retrograde nailing and bone grafting is a successful salvage procedure in severe ankle and hind foot arthrosis with deformity.

75 FR 67303 - Determinations of Attainment by the Applicable Attainment Date for the Hayden, Nogales, Paul Spur...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

... of Attainment by the Applicable Attainment Date for the Hayden, Nogales, Paul Spur/Douglas PM 10... proposes to determine that the Hayden, Nogales, and Paul Spur/Douglas nonattainment areas in Arizona... Hayden, Nogales and Paul Spur/Douglas nonattainment areas are not currently attaining the PM 10 standard...

Error associated with a reduced order linear model of a spur gear pair

NASA Technical Reports Server (NTRS)

Kahraman, A.; Singh, R.

1991-01-01

The paper proposes a reduced-order analytical model of a spur gear pair which consists of two identical spur gears, two identical flexible shafts, and four identical rolling element bearings of a given radial stiffness. The error associated with the undamped eigensolution is estimated by a comparison with a benchmark finite element model.

Traumatic ipsilateral multiple open metatarsal and calcaneal fractures with first metatarsophalangeal joint dislocation: a case report.

PubMed

Ozkan, Namik Kemal; Unay, Koray; Cift, Hakan; Eceviz, Engin; Ozkan, Korhan

2010-06-01

A 17-year-old man fell from a height of 10 m onto his right forefoot and sustained ipsilateral calcaneal, comminuted cuboid, and second, third, and fourth metatarsal neck fractures and first metatarsophalangeal joint open dislocation. This report discusses this rare injury. The authors believe that initial debridement with immediate surgical fixation and reduction with appropriate antibiotic treatment saved the patient's extremity.

Normative calcaneal quantitative ultrasound data for the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon.

PubMed

Madimenos, Felicia C; Snodgrass, J Josh; Blackwell, Aaron D; Liebert, Melissa A; Cepon, Tara J; Sugiyama, Lawrence S

2011-01-01

Minimal data on bone mineral density changes are available from populations in developing countries. Using calcaneal quantitative ultrasound (QUS) techniques, the current study contributes to remedying this gap in the literature by establishing a normative data set on the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon. The paucity of bone mineral density (BMD) data from populations in developing countries partially reflects the lack of diagnostic resources in these areas. Portable QUS techniques now enable researchers to collect bone health data in remote field-based settings and to contribute normative data from developing regions. The main objective of this study is to establish normative QUS data for two Ecuadorian Amazonian populations-the indigenous Shuar and non-Shuar Colonos. The effects of ethnic group, sex, age, and body size on QUS parameters are also considered. A study cohort consisting of 227 Shuar and 261 Colonos (15-91 years old) were recruited from several small rural Ecuadorian communities in the Upano River Valley. Calcaneal QUS parameters were collected on the right heel of each participant using a Sahara bone sonometer. Three ultrasound generated parameters were employed: broadband ultrasound attenuation (BUA), speed of sound (SOS), and calculated heel BMD (hBMD). In both populations and sexes, all QUS values were progressively lower with advancing age. Shuar have significantly higher QUS values than Colonos, with most pronounced differences found between pre-menopausal Shuar and Colono females. Multiple regression analyses show that age is a key predictor of QUS while weight alone is a less consistent determinant. Both Shuar males and females display comparatively greater QUS parameters than other reference populations. These normative data for three calcaneal QUS parameters will be useful for predicting fracture risk and determining diagnostic QUS criteria of osteoporosis in non-industrialized populations in South America and

Maximum life spur gear design

NASA Technical Reports Server (NTRS)

Savage, M.; Mackulin, M. J.; Coe, H. H.; Coy, J. J.

1991-01-01

Optimization procedures allow one to design a spur gear reduction for maximum life and other end use criteria. A modified feasible directions search algorithm permits a wide variety of inequality constraints and exact design requirements to be met with low sensitivity to initial guess values. The optimization algorithm is described, and the models for gear life and performance are presented. The algorithm is compact and has been programmed for execution on a desk top computer. Two examples are presented to illustrate the method and its application.

Double Crush of L5 Spinal Nerve Root due to L4/5 Lateral Recess Stenosis and Bony Spur Formation of Lumbosacral Transitional Vertebra Pseudoarticulation: A Case Report and Review

PubMed Central

Iwasaki, Motoyuki; Akiyama, Masahiko; Koyanagi, Izumi; Niiya, Yoshimasa; Ihara, Tatsuo; Houkin, Kiyohiro

2017-01-01

We present a case of double-crushed L5 nerve root symptoms caused by inside and outside of the spinal canal with spur formation of the lumbosacral transitional vertebra (LSTV). A 78-year-old man presented with 7-year history of moderate paresis of his toe and left leg pain when walking. Magnetic resonance imaging (MRI) revealed spinal stenosis at the L3/4 and 4/5 spinal levels and he underwent wide fenestration of both levels. Leg pain disappeared and 6-min walk distance (6MWD) improved after surgery, however, the numbness in his toes increased and 6MWD decreased 9 months after surgery. Repeated MR and 3D multiplanar reconstructed computed tomography (CT) images showed extraforaminal impingement of the L5 root by bony spur of the left LSTV. He underwent second decompression surgery of the L5/S via the left sided Wiltse approach, resulting in the improvement of his symptoms. The impingement of L5 spinal nerve root between the transverse process of the fifth lumbar vertebra and the sacral ala is a rare entity of the pathology called “far-out syndrome (FOS)”. Especially, the bony spur formation secondary to the anomalous articulation of the LSTV (LSPA) has not been reported. These articulations could be due to severe disc degeneration, following closer distance and contact between the transverse process and the sacral ala. To our knowledge, this is the first report describing a case with this pathology and may be considered in cases of failed back surgery syndromes (FBSS) of the L5 root symptoms. PMID:29018654

Pseudoelastic intramedullary nailing for tibio-talo-calcaneal arthrodesis.

PubMed

Yakacki, Christopher M; Gall, Ken; Dirschl, Douglas R; Pacaccio, Douglas J

2011-03-01

Tibio-talo-calcaneal (TTC) arthrodesis is a procedure to treat severe ankle arthropathy by providing a pain-free and stable fusion. Intramedullary (IM) nails offer a method of internal fixation for TTC arthrodesis by providing compressive stability, as well as shear and torsional rigidity. IM nails have been developed to apply compression to the TTC complex during installation; however, current designs are highly susceptible to a loss of compression when exposed to small amounts of bone resorption and cyclic loading. Nickel titanium (NiTi) is a shape-memory alloy capable of recovering large amounts of deformation via shape-memory or pseudoelasticity. Currently, the next generation of IM nails is being developed to utilize the adaptive, pseudoelastic properties of NiTi and provide a fusion nail that is resistant to loss of compression or loosening. Specifically, the pseudoelastic IM nail contains an internal NiTi compression element that applies sustained compression during the course of fusion, analogous to external fixators. © 2011 Expert Reviews Ltd

Dynamic Analysis of Spur Gear Transmissions (DANST). PC Version 3.00 User Manual

NASA Technical Reports Server (NTRS)

Oswald, Fred B.; Lin, Hsiang Hsi; Delgado, Irebert R.

1996-01-01

DANST is a FORTRAN computer program for static and dynamic analysis of spur gear systems. The program can be used for parametric studies to predict the static transmission error, dynamic load, tooth bending stress and other properties of spur gears as they are influenced by operating speed, torque, stiffness, damping, inertia, and tooth profile. DANST performs geometric modeling and dynamic analysis for low- or high-contact-ratio spur gears. DANST can simulate gear systems with contact ratios ranging from one to three. It was designed to be easy to use and it is extensively documented in several previous reports and by comments in the source code. This report describes installing and using a new PC version of DANST, covers input data requirements and presents examples.

Armament Imbalances: Match and Mismatch in Plant-Pollinator Traits of Highly Specialized Long-Spurred Orchids

PubMed Central

Moré, Marcela; Amorim, Felipe W.; Benitez-Vieyra, Santiago; Medina, A. Martin; Sazima, Marlies; Cocucci, Andrea A.

2012-01-01

Background Some species of long-spurred orchids achieve pollination by a close association with long-tongued hawkmoths. Among them, several Habenaria species present specialized mechanisms, where pollination success depends on the attachment of pollinaria onto the heads of hawkmoths with very long proboscises. However, in the Neotropical region such moths are less abundant than their shorter-tongued relatives and are also prone to population fluctuations. Both factors may give rise to differences in pollinator-mediated selection on floral traits through time and space. Methodology/Principal Findings We characterized hawkmoth assemblages and estimated phenotypic selection gradients on orchid spur lengths in populations of three South American Habenaria species. We examined the match between hawkmoth proboscis and flower spur lengths to determine whether pollinators may act as selective agents on flower morphology. We found significant directional selection on spur length only in Habenaria gourlieana, where most pollinators had proboscises longer than the mean of orchid spur length. Conclusions/Significance Phenotypic selection is dependent on the mutual match between pollinator and flower morphologies. However, our findings indicate that pollinator-mediated selection may vary through time and space according to local variations in pollinator assemblages. PMID:22848645

Surgical management for avulsion fracture of the calcaneal tuberosity.

PubMed

Yu, Guang-rong; Pang, Qing-jiang; Yu, Xiao; Chen, Da-wei; Yang, Yun-feng; Li, Bing; Zhou, Jia-qian

2013-08-01

To discuss the operative methods and curative effect of calcaneal tuberosity fracture. A retrospective study was done to analyze 15 patients with calcaneal tuberosity fracture who received surgical management between January 2008 and June 2011. There were nine males and six females, with the age ranging from 31 to 68 years (average, 51.4 years). All the patients had unilateral acute injury, with the left foot in 7 cases and the right foot in 8 cases. According to the Beavis classification, there were three cases in type I and 12 cases in type II. All the cases in type I and 10 cases in type II were treated with open reduction and screw fixation. The other two cases in type II with larger fragment involving a portion of the subtalar joint were treated with plate and screw fixation. The effect of the treatment was assessed according to the ankle and hindfoot score system of American Orthopaedic Foot and Ankle Society (AOFAS) after the operation. Ten patients were followed up for 12 to 36 months (average, 20 months). The healing time in these patients ranged from 8 to 25 weeks (average, 12 weeks). The postoperative score ranged from 47 to 100 points (average, 91.1 points). Seven cases were rated as excellent, two as good, and one as poor. The rate of excellent and good was 90%. Necrosis of skin and soft tissue and exposure of the plate happened in one patient, who eventually healed after 3 weeks by debridement with plate preserved and peroneal artery perforator flap transplantation. Loss of reduction happened to another patient, who was treated with revision surgery by open reduction and screw fixation again. To patients with obvious fracture displacement, whose soft tissues are irritated severely, emergency open reduction and internal fixation operation should be offered to prevent the necrosis of the flaps as far as possible. To patients with small fractures, it is advisable to choose open reduction and large diameter screw fixation, while plate and screw fixation

SPURS-2: Multi-month and multi-scale observations of upper ocean salinity in a rain-dominated salinity minimum region.

NASA Astrophysics Data System (ADS)

Rainville, L.; Farrar, J. T.; Shcherbina, A.; Centurioni, L. R.

2017-12-01

The Salinity Processes in the Upper-ocean Regional Study (SPURS) is a program aimed at understanding the patterns and variability of sea surface salinity. Following the first SPURS program in an evaporation-dominated region (2012-2013), the SPURS-2 program targeted wide range of spatial and temporal scales associated with processes controlling salinity in the rain-dominated Eastern Pacific Fresh Pool. Autonomous instruments were delivered in August and September 2016 using research vessels conducted observations over one complete annual cycle. The SPURS-2 field program used coordinated observations from many different autonomous platforms, and a mix of Lagrangian and Eulerian approaches. Here we discuss the motivation, implementation, and the early of SPURS-2.

The coupling between hydrodynamic and purification efficiencies of ecological porous spur-dike in field drainage ditch

NASA Astrophysics Data System (ADS)

Rao, Lei; Wang, Pei-fang; Dai, Qing-song; Wang, Chao

2018-05-01

In this study, a series of ecological porous spur-dikes are arranged in an experiment channel to simulate a real field drainage ditch. The inside and outside flow fields of spur-dikes are determined by numerical simulations and experimental methods. An Ammonia-Nitrogen (NH3-N) degradation evaluation model is built to calculate the pollution removal rate by coupling with the inner flow field of the porous spur-dikes. The variations of the total pollutant removal rate in the channel are discussed in terms of different porosities and gap distances between spur-dikes and inlet flow velocities. It is indicated that a reasonable parameter matching of the porosity and the gap distance with the flow velocity of the ditch can bring about a satisfactory purification efficiency with a small delivery quantity of ecological porous materials.

Lubricant and additive effects on spur gear fatigue life

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Zaretsky, E. V.; Scibbe, H. W.

1985-01-01

Spur gear endurance tests were conducted with six lubricants using a single lot of consumable-electrode vacuum melted (CVM) AISI 9310 spur gears. The sixth lubricant was divided into four batches each of which had a different additive content. Lubricants tested with a phosphorus-type load carrying additive showed a statistically significant improvement in life over lubricants without this type of additive. The presence of sulfur type antiwear additives in the lubricant did not appear to affect the surface fatigue life of the gears. No statistical difference in life was produced with those lubricants of different base stocks but with similar viscosity, pressure-viscosity coefficients and antiwear additives. Gears tested with a 0.1 wt % sulfur and 0.1 wt % phosphorus EP additives in the lubricant had reactive films that were 200 to 400 (0.8 to 1.6 microns) thick.

Observations of near-surface fresh layers during SPURS-2

NASA Astrophysics Data System (ADS)

Drushka, Kyla; E Asher, William; Thompson, Elizabeth; Jessup, Andrew T.; Clark, Dan

2017-04-01

One of the primary objectives of the ongoing SPURS-2 program is to understand the fate of rainfall deposited on the sea surface. Rain produces stable near-surface fresh layers that persist for O(1-10) hours. The depth, strength, and lifetime of surface fresh layers are known to be related to the local rain and wind conditions, but available observational data are too sparse to allow definitive quantification of cause-and-effect relationships. In this paper, the formation and evolution of rain-formed fresh layers are examined using observations of near-surface salinity made during the 2016 SPURS-2 field experiment, which took place in the Intertropical Convergence Zone of the eastern tropical Pacific Ocean in August-September 2016. During 2016 SPURS-2, over 30 rain events were captured with the Surface Salinity Profiler (SSP), a towed platform that measures salinity and temperature at five discrete depths in the upper meter of the ocean. Differences in salinity measured by the SSP at depths of 0.02 m and at 1 m are correlated with local meteorological conditions. The field results show that the salinity difference increases linearly with rain rate, a result that is consistent with calculations done with a one-dimensional ocean turbulence model. The field data also demonstrate that there is an inverse correlation between wind speed and the vertical salinity difference, which is also consistent with numerical models. The implications of these results are discussed in the context of satellite salinity observations and the representation of rainfall events in climate models.

12. VIEW OF SWITCHES AND SPURS FROM NEAR EAST END ...

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

12. VIEW OF SWITCHES AND SPURS FROM NEAR EAST END OF CEDAR MILL CREEK TRESTLE NEAR MERLO ROAD, FACING SOUTHEAST - Oregon Electric Railway Westside Corridor, Between Watson & 185th Avenues, Beaverton, Washington County, OR

Surgical treatment of displaced intra-articular calcaneal fracture using a single small lateral approach

PubMed Central

El-Adl, Gamal; Hassanin, Ehab Y.; Abdellatif, M-Serry

2010-01-01

The objective of this study was to evaluate the outcome of semi-open reduction and minimal internal fixation through a single small lateral approach as a minimally invasive technique for treatment of displaced intra-articular calcaneal fractures. This prospective study was conducted on eighteen patients (16 men and 2 women). The average age was 37.7 (22–55). The most common cause of injury was a fall from height in fourteen patients. Patients were operated on within a mean time of 4.8 days of admission (1–11 days) and were followed up for an average period of 24.1 months (6–39 months). Patients were evaluated clinically using the Creighton-Nebraska Heath Foundation Assessment score of Crosby and Fitzgibbons (J Bone Joint Surg (Am) 72-A:852–859, 1990). The scoring system proposed by Knirk and Jupiter was used for radiological assessment of the posterior subtalar joint (Knirk and Jupiter in J Bone Joint Surg (Am) 68-A: 647–659, 1986). The skin incision healed in all cases without necrosis, infection, or sural nerve injury. All fractures healed after an average of 8 weeks (7–10 weeks), and patients returned to the routine daily activities after an average time of 4.3 months (3–7 months). In conclusion, semi-open reduction and minimal internal fixation through a small lateral approach is an effective treatment for carefully selected cases of displaced intra-articular calcaneal fractures. PMID:21811904

The contribution of medializing calcaneal osteotomy on hindfoot alignment in the reconstruction of the stage II adult acquired flatfoot deformity.

PubMed

Chan, Jeremy Y; Williams, Benjamin R; Nair, Pallavi; Young, Elizabeth; Sofka, Carolyn; Deland, Jonathan T; Ellis, Scott J

2013-02-01

Successful correction of hindfoot alignment in adult acquired flatfoot deformity (AAFD) is likely influenced by the degree of medializing calcaneal osteotomy (MCO) performed, but it is not known if other reconstruction procedures significantly contribute as well. The purpose of this study was to evaluate the correlation between common preoperative and postoperative variables and hindfoot alignment. Thirty patients with stage II AAFD undergoing flatfoot reconstruction were followed prospectively. Preoperative and postoperative radiographs were reviewed to assess for correction in hindfoot alignment as measured by the change in hindfoot moment arm. Nineteen variables were analyzed, including age, gender, height, weight, body mass index (BMI), medial cuneiform-fifth metatarsal height, anteroposterior (AP) talonavicular coverage, AP talus-first metatarsal, lateral talus-first metatarsal and calcaneal pitch angles as well as intraoperative use of the MCO, lateral column lengthening (LCL), Cotton osteotomy, first tarsometatarsal fusion, flexor digitorum longus transfer, spring ligament reconstruction, and gastrocnemius recession or Achilles lengthening. Mean age was 57.3 years (range, 22-77). Final radiographs were obtained at a mean of 47 weeks (range, 25-78) postoperatively. Seven variables were found to significantly affect hindfoot moment arm. These were gender (P < .05), the amount of MCO performed (P < .001), LCL (P < .01), first tarsometatarsal fusion (P < .01), spring ligament reconstruction (P < .01), medial cuneiform-fifth metatarsal height (P < .001), and calcaneal pitch angle (P < .05). Multivariate regression analysis revealed that MCO was the only significant predictor of hindfoot moment arm. The final regression model for MCO showed a good fit (R(2) = .93, P < .001). Correction of hindfoot valgus alignment obtained in flatfoot reconstruction is primarily determined by the MCO procedure and can be modeled linearly. We believe that the hindfoot alignment

The Flemish Cap - Goban Spur conjugate margins: New evidence of asymmetry

NASA Astrophysics Data System (ADS)

Gerlings, J.; Louden, K. E.; Minshull, T. A.; Nedimović, M. R.

2011-12-01

The combined results of deep multichannel seismic (MCS) and refraction/wide-angle reflection seismic (R/WAR) profiles across the Flemish Cap-Goban Spur conjugate margin pair will be presented to help constrain rifting and breakup processes. Both profiles cross magnetic anomaly 34 and extend into oceanic crust, which makes it possible to observe the complete extensional history from continental rifting through the formation of initial oceanic crust. Kirchhoff poststack time and prestack time and depth migration images of the Flemish Cap MCS data are produced using a velocity model constructed from the MCS and R/WAR data. These new images show improved continuity of the Moho under the thick continental crust of Flemish Cap. The basement morphology image is sharper and reflections observed in the thin crust of the transition zone are more coherent. A basement high at the seaward-most end of the transition zone now displays clear diapiric features. To compare the two margins, the existing migrated MCS data across Goban Spur has been time-to-depth converted using the R/WAR velocity model of the margin. These reimaged seismic profiles demonstrate asymmetries in continental rifting and breakup with a complex transition to oceanic spreading: (1) During initial phases of rifting, the Flemish Cap margin displays a sharper necking profile than that of the Goban Spur margin. (2) Within the ocean-continent-transition zone, constraints from S-wave velocities on both margins indentifies previously interpreted oceanic crust as thinned continental crust offshore Flemish Cap in contrast with primarily serpentinized mantle offshore Goban Spur. (3) Continental breakup and initial seafloor spreading occur in a complex, asymmetric manner where the initial ~50 km of oceanic crust appears different on the two margins. Offshore Flemish Cap, both R/WAR and MCS results indicate a sharp boundary immediately seaward of a ridge feature, where the basement morphology becomes typical of slow

Measuring surface salinity in the N. Atlantic subtropical gyre. The SPURS-MIDAS cruise, spring 2013

NASA Astrophysics Data System (ADS)

Font, Jordi; Ward, Brian; Emelianov, Mikhail; Morisset, Simon; Salvador, Joaquin; Busecke, Julius

2014-05-01

SPURS-MIDAS (March-April 2013) on board the Spanish R/V Sarmiento de Gamboa was a contribution to SPURS (Salinity Processes in the Upper ocean Regional Study) focused on the processes responsible for the formation and maintenance of the salinity maximum associated to the North Atlantic subtropical gyre. Scientists from Spain, Ireland, France and US sampled the mesoscale and submesoscale structures in the surface layer (fixed points and towed undulating CTD, underway near surface TSG) and deployed operational and experimental drifters and vertical profilers, plus additional ocean and atmospheric data collection. Validation of salinity maps obtained from the SMOS satellite was one of the objectives of the cruise. The cruise included a joint workplan and coordinated sampling with the US R/V Endeavor, with contribution from SPURS teams on land in real time data and analysis exchange. We present here an overview of the different kinds of measurements made during the cruise, as well as a first comparison between SMOS-derived sea surface salinity products and salinity maps obtained from near-surface sampling in the SPURS-MIDAS area and from surface drifters released during the cruise.

17. VIEW OF SETTLING BASIN, SHOWING FLUME TRACK SPUR CROSSING ...

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

17. VIEW OF SETTLING BASIN, SHOWING FLUME TRACK SPUR CROSSING OVER SETTLING BASIN, SPARE BENT MATERIAL IN RIGHT-HAND FOREGROUND, BYPASS FLUME, AND SHACK #6 IN BACKGROUND, LOOKING NORTHWEST - Electron Hydroelectric Project, Along Puyallup River, Electron, Pierce County, WA

Percutaneous reduction and fixation of an intra-articular calcaneal fracture using an inflatable bone tamp: description of a novel and safe technique

PubMed Central

2012-01-01

Calcaneal fractures are common injuries involving the hind foot and often a source of significant long-term morbidity. Treatment options have changed throughout the ages from periods of preferred nonoperative management to closed reduction with a mallet, and more recently, open reduction and anatomic internal fixation. The current treatment of choice; however, is often debated, as open management of these fractures carries many risks to include wound breakdown and infection. A less invasive form of surgical management through small incisions, while maintaining the ability to obtain joint congruency, anatomic alignment, and restore calcaneal height and width would be ideal. We propose a novel form of fracture reduction using an inflatable bone tamp and percutaneous fracture fixation. Preoperative planning and experienced fluoroscopy is crucial to successful management using this method. Although we achieved successful radiographic outcome in this case, long-term functional outcome of this technique are yet to be published. PMID:22420710

9. VIEW OF FLOOR 2 LOOKING EAST; SHOWS GREAT SPUR ...

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

9. VIEW OF FLOOR 2 LOOKING EAST; SHOWS GREAT SPUR WHEEL AND TWO STONE NUTS, AND THE CHUTES, HOPPERS, HORSES AND SHOES OF THE GRAIN FEED SYSTEM - Hook Windmill, North Main Street at Pantigo Road, East Hampton, Suffolk County, NY

5. VIEW OF THE LOCATION FOR A PROPOSED SPUR ROAD ...

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

5. VIEW OF THE LOCATION FOR A PROPOSED SPUR ROAD FROM KINGS CANYON ROAD TO THE PROPOSED HELICOPTER LANDING SITE #11. LOCATED AT MILEPOST 0.55, FACING NORTH 53ø EAST (53 ). - Kings Canyon Road, Carson City, Carson City, NV

New generation methods for spur, helical, and spiral-bevel gears

NASA Technical Reports Server (NTRS)

Litvin, F. L.; Tsung, W.-J.; Coy, J. J.; Handschuh, R. F.; Tsay, C.-B. P.

1986-01-01

New methods for generating spur, helical, and spiral-bevel gears are proposed. These methods provide the gears with conjugate gear tooth surfaces, localized bearing contact, and reduced sensitivity to gear misalignment. Computer programs have been developed for simulating gear meshing and bearing contact.

New generation methods for spur, helical, and spiral-bevel gears

NASA Technical Reports Server (NTRS)

Litvin, F. L.; Tsung, W.-J.; Coy, J. J.; Handschuh, R. F.; Tsay, C.-B. P.

1987-01-01

New methods for generating spur, helical, and spiral-bevel gears are proposed. These methods provide the gears with conjugate gear tooth surfaces, localized bearing contact, and reduced sensitivity to gear misalignment. Computer programs have been developed for simulating gear meshing and bearing contact.

Comparing fixation used for calcaneal displacement osteotomies: a look at removal rates and cost.

PubMed

Lucas, Douglas E; Simpson, G Alex; Philbin, Terrence M

2015-02-01

The calcaneal displacement osteotomy is a procedure frequently used by foot and ankle surgeons for hindfoot angular deformity. Traditional techniques use compression screw fixation that can result in prominent hardware. While the results of the procedure are generally good, a common concern is the development of plantar heel pain related to prominent hardware. The primary purpose of this study is to retrospectively compare clinical outcomes of 2 fixation methods for the osteotomy. Secondarily a cost analysis will compare implant costs to hardware removal costs. Records were reviewed for patients who had undergone a calcaneal displacement osteotomy fixated with either lag screw or a locked lateral compression plate (LLCP). Neuropathy, previous ipsilateral calcaneus surgery, heel pad trauma, or incomplete radiographic follow-up were exclusionary. Thirty-two patients (19.4%) required hardware removal from the screw fixation group compared to 1 (1.6%) of the LLCP group, which is significant (P < .05). Time to radiographic healing was not significantly different (P = .87). The screw fixation group required more follow-up visits over a longer period of time (P < .05). Implant cost was remarkably different with screw fixation costing on average $247.12, compared to the LLCP costing $1175.59. Although the LLCP cost was significantly higher, cost savings were identified when the cost of removal and removal rates were included. This study demonstrates that this device provides adequate stabilization for healing in equivalent time to screw fixation. The LLCP required decreased rates of hardware removal with fewer postoperative visits over a shorter period of time. Significant savings were demonstrated in the LLCP group despite the higher implant cost. Therapeutic, Level III, Retrospective Comparative Study. © 2014 The Author(s).

Drivers of epibenthic megafaunal composition in the sponge grounds of the Sackville Spur, northwest Atlantic

NASA Astrophysics Data System (ADS)

Beazley, Lindsay; Kenchington, Ellen; Yashayaev, Igor; Murillo, Francisco Javier

2015-04-01

Deep-water sponges are considered ecosystem engineers, and the presence of large aggregations of these organisms, commonly referred to as sponge grounds, is associated with enhanced biodiversity and abundance of epibenthic fauna compared to non-sponge habitat. However, the degree and magnitude to which the presence of these sponge grounds elicits large changes in composition of the associated megafaunal community remains unknown. Here we identify the external drivers of epibenthic megafaunal community composition and explore the patterns and magnitude of compositional change in the megafaunal community within the sponge grounds of the Sackville Spur, northwest Atlantic. Epibenthic megafauna were quantified from five image transects collected on the Sackville Spur in 2009 between 1080 and 1723 m depth. Using Gradient Forest Modelling we found that the abundance of structure-forming sponges was the most important variable for predicting compositional patterns in the Sackville Spur megafaunal community, followed by depth, range in bottom current speed, in situ salinity, and longitude. Along the gradient in structure-forming sponge abundance, the largest turnover in megafaunal community composition occurred when the sponges reached 15 individuals m-2. Examination of the regional hydrographic conditions suggests that the dense sponge grounds of the Sackville Spur are associated with a warm, salty water mass that occurs between ~1300 and 1800 m.

75 FR 72964 - Determinations of Attainment by the Applicable Attainment Date for the Hayden, Nogales, Paul Spur...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-29

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [R09-OAR-2010-0718; FRL-9233-1] Determinations of Attainment by the Applicable Attainment Date for the Hayden, Nogales, Paul Spur/Douglas PM10 Nonattainment... November 2, 2010 (75 FR 67220), direct final rule determining that the Hayden, Nogales, and Paul Spur...

Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures: Finite element analysis and clinical outcome.

PubMed

Pan, M; Chai, L; Xue, F; Ding, L; Tang, G; Lv, B

2017-07-01

The aim of this study was to compare the biomechanical stability and clinical outcome of external fixator combined with limited internal fixation (EFLIF) and open reduction and internal fixation (ORIF) in treating Sanders type 2 calcaneal fractures. Two types of fixation systems were selected for finite element analysis and a dual cohort study. Two fixation systems were simulated to fix the fracture in a finite element model. The relative displacement and stress distribution were analysed and compared. A total of 71 consecutive patients with closed Sanders type 2 calcaneal fractures were enrolled and divided into two groups according to the treatment to which they chose: the EFLIF group and the ORIF group. The radiological and clinical outcomes were evaluated and compared. The relative displacement of the EFLIF was less than that of the plate (0.1363 mm to 0.1808 mm). The highest von Mises stress value on the plate was 33% higher than that on the EFLIF. A normal restoration of the Böhler angle was achieved in both groups. No significant difference was found in the clinical outcome on the American Orthopedic Foot and Ankle Society Ankle Hindfoot Scale, or on the Visual Analogue Scale between the two groups (p > 0.05). Wound complications were more common in those who were treated with ORIF (p = 0.028). Both EFLIF and ORIF systems were tested to 160 N without failure, showing the new construct to be mechanically safe to use. Both EFLIF and ORIF could be effective in treating Sanders type 2 calcaneal fractures. The EFLIF may be superior to ORIF in achieving biomechanical stability and less blood loss, shorter surgical time and hospital stay, and fewer wound complications. Cite this article : M. Pan, L. Chai, F. Xue, L. Ding, G. Tang, B. Lv. Comparisons of external fixator combined with limited internal fixation and open reduction and internal fixation for Sanders type 2 calcaneal fractures: Finite element analysis and clinical outcome. Bone Joint Res 2017

Surface fatigue life of CBN and vitreous ground carburized and hardened AISI 9310 spur gears

NASA Technical Reports Server (NTRS)

Townsend, Dennis P.; Patel, P. R.

1988-01-01

Spur gear surface endurance tests were conducted to investigate CBN ground AISI 9310 spur gears for use in aircraft applications, to determine their endurance characteristics and to compare the results with the endurance of standard vitreous ground AISI 9310 spur gears. Tests were conducted with VIM-VAR AISI 9310 carburized and hardened gears that were finish ground with either CBN or vitreous grinding methods. Test conditions were an inlet oil temeprature of 320 K (116 F), an outlet oil temperature of 350 K (170 F), a maximum Hertz stress of 1.71 GPa (248 ksi), and a speed of 10,000 rpm. The CBN ground gears exhibited a surface fatigue life that was slightly better than the vitreous ground gears. The subsurface residual stress of the CBN ground gears was approximately the same as that for the standard vitreous ground gears for the CBN grinding method used.

Effect of five lubricants on life of AISI 9310 spur gears

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Zaretsky, E. V.

1985-01-01

Spur-gear surface fatigue tests were conducted with five lubricants using a single lot of consumable-electrode vacuum melted (CVM) AISI 9310 spur gears. The lot of gears was divided into five groups, each of which was tested with a different lubricant. The test lubricants are classified as either a synthetic hydrocarbon, mineral oil, or ester-based lubricant. All five lubricants have imilar viscosity and pressure-viscosity coefficients. A pentaerythritol base stock without sufficient antiwear additives produced a surface fatigue life pproximately 22 percent that of the same base stock with chlorine and phosphorus type additives. The presence of sulfur type antiwear additives in the lubricant did not appear to affect the surface fatigue life of the gears tested. No statistical difference in the 10-percent surface fatigue life was produced with four of the five lubricants.

Bohler's angle's role in assessing the injury severity and functional outcome of internal fixation for displaced intra-articular calcaneal fractures: a retrospective study.

PubMed

Su, Yanling; Chen, Wei; Zhang, Tao; Wu, Xingwang; Wu, Zhanpo; Zhang, Yingze

2013-09-24

Controversy exits over the role of Böhler's angle in assessing the injury severity of displaced intra-articular calcaneal fractures and predicting the functional outcome following internal fixation. This study aims to investigate whether a correlation exists between Böhler's angle and the injury severity of displaced calcaneal fractures, and between surgical improvement of Böhler's angle and functional outcome. Patients treated operatively for unilateral closed displaced intra-articular calcaneal fractures from January 1, 2004 to March 31, 2008 were identified. The Böhler's angles of both calcaneus were measured, and the measurement of the uninjured foot was used as its normal control. The difference in the value of Böhler's angle measured preoperatively or postoperatively between the angle of the injured foot and that of the contralateral calcaneus were calculated, respectively. The change in Böhler's angle by ratio was calculated by dividing the difference value of Böhler's angle between bilateral calcaneus by its normal control. The injury severity was assessed according to Sanders classification. The functional outcomes were assessed using American Orthopaedic Foot & Ankle Society hindfoot scores. 274 patients were included into the study with a mean follow-up duration of 71 months. According to Sanders classification, the fracture pattern included 105 type II, 121 type III and 48 type IV fractures. According to American Orthopaedic Foot & Ankle Society hindfoot scoring system, the excellent, good, fair and poor results were achieved in 104, 132, 27, and 11 patients, respectively. The preoperative Böhler's angle, difference value of Böhler's angle between bilateral calcaneus, and change in Böhler's angle by ratio each has a significant correlation with Sanders classification (rs=-0.178, P=0.003; rs=-0.174, P=0.004; rs=-0.172, P=0.005, respectively), however, is not correlated with functional outcome individually. The three postoperative measurements

West 73rd Street pedestrian underpass, with spur of old Miller ...

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

West 73rd Street pedestrian underpass, with spur of old Miller Highway, Trump Place towers in background, looking south. - Henry Hudson Parkway, Extending 11.2 miles from West 72nd Street to Bronx-Westchester border, New York County, NY

The development and production of thermo-mechanically forged tool steel spur gears

NASA Technical Reports Server (NTRS)

Bamberger, E. N.

1973-01-01

A development program to establish the feasibility and applicability of high energy rate forging procedures to tool steel spur gears was performed. Included in the study were relatively standard forging procedures as well as a thermo-mechanical process termed ausforming. The subject gear configuration utilized was essentially a standard spur gear having 28 teeth, a pitch diameter of 3.5 inches and a diametral pitch of 8. Initially it had been planned to use a high contact ratio gear design, however, a comprehensive evaluation indicated that severe forging problems would be encountered as a result of the extremely small teeth required by this type of design. The forging studies were successful in achieving gear blanks having integrally formed teeth using both standard and thermo-mechanical forging procedures.

Phenotype profiling and multivariate statistical analysis of Spur-pruning type Grapevine in National Clonal Germplasm Repository (NCGR, Davis)

USDA-ARS?s Scientific Manuscript database

Most Korean vineyards employed spur-pruning type modified-T trellis system. This produce system is suitable to spur-pruning type cultivars. But most European table grape is not adaptable to this produce system because their fruitfulness is sufficient to cane-pruning type system. Total 20 of fruit ch...

Ankle Fusion Combined With Calcaneal Sliding Osteotomy for Severe Arthritic Ball and Socket Ankle Deformity.

PubMed

Cho, Byung-Ki; Park, Kyoung-Jin; Choi, Seung-Myung; Kang, Sang-Woo; Lee, Hyung-Ki

2016-12-01

Although a ball and socket ankle deformity is usually congenital and asymptomatic, abnormal inversion and eversion mobility can result in recurrent ankle sprain and osteoarthritis. This retrospective study was performed to evaluate the clinical and radiologic outcomes of ankle fusion combined with calcaneal sliding osteotomy for severe arthritic ball and socket ankle deformity. Fourteen patients with severe arthritic ball and socket ankle deformity were followed for more than 3 years after operation. The clinical evaluation consisted of American Orthopaedic Foot & Ankle Society (AOFAS) score, Foot and Ankle Ability Measure (FAAM), visual analog scale (VAS) for pain, and subjective satisfaction score. The period to fusion and union of osteotomy, the change of hindfoot alignment angle, and complications were evaluated radiologically. AOFAS and FAAM scores were significantly improved from an average of 37.4 and 34.5 points to 74.6 and 78.5 points, respectively. VAS for pain with walking over 20 minutes was significantly improved from an average of 8.4 points to 1.9 points. The average satisfaction score of patients was 88.9 points. The difference in heel alignment angle (compared to contralateral side) was significantly improved from an average of 34.8 to 5.4 degrees. There were 2 cases of progressive arthritis in an adjacent joint and 1 case of failed fusion. Ankle fusion combined with calcaneal sliding osteotomy can be an effective operative option for ball and socket ankle deformity with advanced arthritis. In spite of increased complication rate, reliable pain relief, and restoration of gait ability through correcting hindfoot malalignment could improve the quality of life. Level IV, retrospective case series. © The Author(s) 2016.

35. SOUTH PLANT NORTHCENTER RAILROAD SPUR, SHOWING POWER PLANT (BUILDINGS ...

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

35. SOUTH PLANT NORTH-CENTER RAILROAD SPUR, SHOWING POWER PLANT (BUILDINGS 325 AND 321) AT LEFT, FUEL TOWER AT CENTER AND CHLORINE EVAPORATOR (BUILDING 251) AT RIGHT. VIEW TO WEST - Rocky Mountain Arsenal, Bounded by Ninety-sixth Avenue & Fifty-sixth Avenue, Buckley Road, Quebec Street & Colorado Highway 2, Commerce City, Adams County, CO

Telephoto lens view of Silver Spur in the Hadley Delta region from Apollo 15

NASA Technical Reports Server (NTRS)

1971-01-01

A telephoto lens view of the prominent feature called Silver Spur in the Hadley Delta region, photographed during the Apollo 15 lunar surface extravehicular activity at the Hadley-Apennine landing site. The distance from the camera to the spur is about 10 miles. The field of view across the bottom is about one mile. Structural formations in the mountain are clearly visible. There are two major units. The upper unit is characterized by massive subunits, each one of which is approximately 200 feet deep. The lower major unit is characterized by thinner bedding and cross bedding.

Suzaku and XMM-Newton observations of the North Polar Spur: Charge exchange or ISM absorption?

NASA Astrophysics Data System (ADS)

Gu, Liyi; Mao, Junjie; Costantini, Elisa; Kaastra, Jelle

2016-10-01

By revisiting the Suzaku and XMM-Newton data of the North Polar Spur, we discovered that the spectra are inconsistent with the traditional model consisting of pure thermal emission and neutral absorption. The most prominent discrepancies are the enhanced O vii and Ne ix forbidden-to-resonance ratios, and a high O viii Lyβ line relative to other Lyman series. A collisionally ionized absorption model can naturally explain both features, while a charge exchange component can only account for the former. By including the additional ionized absorption, the plasma in the North Polar Spur can be described by a single-phase collisional ionization equilibrium (CIE) component with a temperature of 0.25 keV, and nitrogen, oxygen, neon, magnesium, and iron abundances of 0.4-0.8 solar. The abundance pattern of the North Polar Spur is well in line with those of the Galactic halo stars. The high nitrogen-to-oxygen ratio reported in previous studies can be migrated to the large transmission of the O viii Lyα line. The ionized absorber is characterized by a balance temperature of 0.17-0.20 keV and a column density of 3-5 × 1019 cm-2. Based on the derived abundances and absorption, we speculate that the North Polar Spur is a structure in the Galactic halo, so that the emission is mostly absorbed by the Galactic interstellar medium in the line of sight.

Insertion of a solo LTR retrotransposon associates with spur mutations in 'Red Delicious' apple (Malus × domestica).

PubMed

Han, Mengxue; Sun, Qibao; Zhou, Junyong; Qiu, Huarong; Guo, Jing; Lu, Lijuan; Mu, Wenlei; Sun, Jun

2017-09-01

Insertion of a solo LTR, which possesses strong bidirectional, stem-specific promoter activities, is associated with the evolution of a dwarfing apple spur mutation. Spur mutations in apple scions revolutionized global apple production. Since long terminal repeat (LTR) retrotransposons are tightly related to natural mutations, inter-retrotransposon-amplified polymorphism technique and genome walking were used to find sequences in the apple genome based on these LTRs. In 'Red Delicious' spur mutants, a novel, 2190-bp insertion was identified as a spur-specific, solo LTR (sLTR) located at the 1038th nucleotide of another sLTR, which was 1536 bp in length. This insertion-within-an-insertion was localized within a preexisting Gypsy-50 retrotransposon at position 3,762,767 on chromosome 4. The analysis of transcriptional activity of the two sLTRs (the 2190- and 1536-bp inserts) indicated that the 2190-bp sLTR is a promoter, capable of bidirectional transcription. GUS expression in the 2190-bp-sense and 2190-bp-antisense transgenic lines was prominent in stems. In contrast, no promoter activity from either the sense or the antisense strand of the 1536-bp sLTR was detected. From ~150 kb of DNA on each side of the 2190 bp, sLTR insertion site, corresponding to 300 kb of the 'Golden Delicious' genome, 23 genes were predicted. Ten genes had predicted functions that could affect shoot development. This first report, of a sLTR insertion associated with the evolution of apple spur mutation, will facilitate apple breeding, cloning of spur-related genes, and discovery of mechanisms behind dwarf habit.

A multi-purpose method for analysis of spur gear tooth loading

NASA Technical Reports Server (NTRS)

Kasuba, R.; Evans, J. W.; August, R.; Frater, J. L.

1981-01-01

A large digitized approach was developed for the static and dynamic load analysis of spur gearing. An iterative procedure was used to calculate directly the "variable-variable" gear mesh stiffness as a function of transmitted load, gear tooth profile errors, gear tooth deflections and gear hub torsional deformation, and position of contacting profile points. The developed approach can be used to analyze the loads, Hertz stresses, and PV for the normal and high contrast ratio gearing, presently the modeling is limited to the condition that for a given gear all teeth have identical spacing and profiles (with or without surface imperfections). Certain types of simulated sinusoidal profile errors and pitting can cause interruptions of the gear mesh stiffness function and, thus, increase the dynamic loads in spur gearing. In addition, a finite element stress and mesh subprogram was developed for future introduction into the main program for calculating the gear tooth bending stresses under dynamic loads.

Telephoto lens view of Silver Spur in the Hadley Delta region from Apollo 15

NASA Image and Video Library

1971-07-31

AS15-84-11250 (31 July-2 Aug. 1971) --- A telephoto lens view of the prominent feature called Silver Spur in the Hadley Delta region, photographed during the Apollo 15 lunar surface extravehicular activity (EVA) at the Hadley-Apennine landing site. The distance from the camera to the spur is about 10 miles. The field of view across the bottom is about one mile. Structural formations in the mountain are clearly visible. There are two major units. The upper unit is characterized by massive subunits, each one of which is approximately 200 feet deep. The lower major unit is characterized by thinner bedding and cross bedding.

Agreement between calcaneal quantitative ultrasound and osteoporosis self-assessment tool for Asians in identifying individuals at risk of osteoporosis

PubMed Central

Chin, Kok-Yong; Low, Nie Yen; Kamaruddin, Alia Annessa Ain; Dewiputri, Wan Ilma; Soelaiman, Ima-Nirwana

2017-01-01

Background Calcaneal quantitative ultrasound (QUS) is a useful tool in osteoporosis screening. However, QUS device may not be available at all primary health care settings. Osteoporosis self-assessment tool for Asians (OSTA) is a simple algorithm for osteoporosis screening that does not require any sophisticated instruments. This study explored the possibility of replacing QUS with OSTA by determining their agreement in identifying individuals at risk of osteoporosis. Methods A cross-sectional study was conducted to recruit Malaysian men and women aged ≥50 years. Their bone health status was measured using a calcaneal QUS device and OSTA. The association between OSTA and QUS was determined using Spearman’s correlation and their agreement was assessed using Cohen Kappa and receiver-operating curve. Results All QUS indices correlated significantly with OSTA (p<0.05). The agreement between QUS and OSTA was minimal but statistically significant (p<0.05). The performance of OSTA in identifying subjects at risk of osteoporosis according to QUS was poor-to-fair in women (p<0.05), but not statistically significant for men (p>0.05). Changing the cut-off values improved the performance of OSTA in women but not in men. Conclusion The agreement between QUS and OSTA is minimal in categorizing individuals at risk of osteoporosis. Therefore, they cannot be used interchangeably in osteoporosis screening. PMID:29070951

Radiofrequency Thermal Lesioning and Extracorporeal Shockwave Therapy: A Comparison of Two Methods in the Treatment of Plantar Fasciitis.

PubMed

Ozan, Fırat; Koyuncu, Şemmi; Gürbüz, Kaan; Öncel, Eyyüp Sabri; Altay, Taşkın

2017-06-01

We compared the results of radiofrequency thermal lesioning (RTL) and extracorporeal shockwave therapy (ESWT) in patients with chronic plantar fasciitis. This prospective study included 56 patients diagnosed with plantar fasciitis who had complaints for ≥6 months: 40 (group 1) underwent ESWT and 16 (group 2) underwent RTL. The presence of calcaneal spurs was investigated with imaging studies. All patients were followed up clinically at baseline and 1, 3, and 6 months after treatment. Clinical evaluations were performed by the visual analog scale (VAS) and the modified Roles-Maudsley (RM) scoring system. There was no significant difference in the age, sex, body mass index, and side of involvement between the groups (all P > .05). Radiographic evaluation showed calcaneal spurs in 22 patients (55%) in group 1 and 7 patients (43%) in group 2. There was no significant difference in the baseline and posttreatment values between the groups; however, group 2 had significantly different RM values at 1 month than group 1 ( P < .05). In both groups, the VAS scores significantly decreased at 1, 3, and 6 months after treatment ( P < .05). The RM scores at 1, 3, and 6 months after treatment significantly decreased in both groups, except for the RM values at 1 month after treatment in group 1 ( P < .05). Our study results suggest that RTL and ESWT are safe and effective treatments in patients with chronic plantar fasciitis. Level II: Therapeutic study.

Spur, helical, and spiral bevel transmission life modeling

NASA Technical Reports Server (NTRS)

Savage, Michael; Rubadeux, Kelly L.; Coe, Harold H.; Coy, John J.

1994-01-01

A computer program, TLIFE, which estimates the life, dynamic capacity, and reliability of aircraft transmissions, is presented. The program enables comparisons of transmission service life at the design stage for optimization. A variety of transmissions may be analyzed including: spur, helical, and spiral bevel reductions as well as series combinations of these reductions. The basic spur and helical reductions include: single mesh, compound, and parallel path plus revert star and planetary gear trains. A variety of straddle and overhung bearing configurations on the gear shafts are possible as is the use of a ring gear for the output. The spiral bevel reductions include single and dual input drives with arbitrary shaft angles. The program is written in FORTRAN 77 and has been executed both in the personal computer DOS environment and on UNIX workstations. The analysis may be performed in either the SI metric or the English inch system of units. The reliability and life analysis is based on the two-parameter Weibull distribution lives of the component gears and bearings. The program output file describes the overall transmission and each constituent transmission, its components, and their locations, capacities, and loads. Primary output is the dynamic capacity and 90-percent reliability and mean lives of the unit transmissions and the overall system which can be used to estimate service overhaul frequency requirements. Two examples are presented to illustrate the information available for single element and series transmissions.

Posttraumatic impingement syndrome of the ankle--indication and results of arthroscopic therapy.

PubMed

Arnold, Heino

2011-06-01

Persisting pain after an ankle sprain is often caused by the development of intraarticular fibrous scars or even tibiotalar spurs due to repetitive trauma. This may result in a posttraumatic impingement syndrome of the ankle. Pain is typically provoked by dorsiflexion of the ankle and palpation of the tibiotalar anterior joint space. The study evaluates the outcome of arthroscopic treatment of the ankle impingement syndrome. 32 patients are included (16-65 years, mean age 38 years) who underwent an arthroscopic operation because of an impingement syndrome of the ankle grades I-III (Scranton) due to a trauma without therapeutic response to conservative therapy over 3 months. Diagnostic criteria were palpatoric anterior ankle joint pain and pain provoked by dorsiflexion, in cases of grades II and III lesions spurs on the X-ray as well. The mean follow-up time was 49 months. The evaluation of the results was done with the West Point Ankle Score. The study is designed as a retrospective case series. 26 patients reached more than 80 points in the West Point Ankle Score corresponding to a good or excellent result (mean result 86 points, ranging from 80 to 98 points). The preoperative mean score reached up to 64 points overall (57-70). Five patients rated the postoperative result fair, one bad with 73 points at mean (62-78). Preoperatively they reached 56 point on an average (48-62). The fair and the poor results were associated with severe ankle sprain leading to ligament ruptures or fractures where severe chondral lesions were to be found with arthroscopy. The results of the study show that ankle arthroscopy with resection of hypertrophic synovium and fibrous bands (type I) or tibial spurs (types II and III injuries) after an ankle sprain haven proven to be a reliable therapy for a posttraumatic impingement syndrome of the ankle that does not respond to conservative treatment. It is characterized by low morbidity and good to excellent results in most cases. The outcome

111. DETAIL OF NORTH PLANT RAILROAD SPUR, WITH ASSEMBLY PLANT/WAREHOUSE ...

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

111. DETAIL OF NORTH PLANT RAILROAD SPUR, WITH ASSEMBLY PLANT/WAREHOUSE (BUILDING 1601/1606/1701) AT LEFT AND GB MANUFACTURING PLANT (BUILDING 1501) AT CENTER. VIEW TO NORTH. - Rocky Mountain Arsenal, Bounded by Ninety-sixth Avenue & Fifty-sixth Avenue, Buckley Road, Quebec Street & Colorado Highway 2, Commerce City, Adams County, CO

Combined medial displacement calcaneal osteotomy, subtalar joint arthrodesis, and ankle arthrodiastasis for end-stage posterior tibial tendon dysfunction.

PubMed

Stapleton, John J; Belczyk, Ronald; Zgonis, Thomas; Polyzois, Vasilios D

2009-04-01

Combining an ankle arthrodiastasis with a medial displacement calcaneal osteotomy and a subtalar joint arthrodesis offers surgeons a joint-sparing procedure for young and active patients who have end-stage posterior tibial tendon dysfunction and ankle joint involvement. An isolated subtalar joint arthrodesis or triple arthrodesis combined with an ankle arthrodiastasis is an option that can be used in certain case scenarios. Delaying the need for a joint destructive procedure through an ankle arthrodiastasis, however, may have a great impact in the near future, as advancements are underway to improve the use of ankle endoprosthesis.

Formation of Spiral-Arm Spurs and Bound Clouds in Vertically Stratified Galactic Gas Disks

NASA Astrophysics Data System (ADS)

Kim, Woong-Tae; Ostriker, Eve C.

2006-07-01

We investigate the growth of spiral-arm substructure in vertically stratified, self-gravitating, galactic gas disks, using local numerical MHD simulations. Our new models extend our previous two-dimensional studies, which showed that a magnetized spiral shock in a thin disk can undergo magneto-Jeans instability (MJI), resulting in regularly spaced interarm spur structures and massive gravitationally bound fragments. Similar spur (or ``feather'') features have recently been seen in high-resolution observations of several galaxies. Here we consider two sets of numerical models: two-dimensional simulations that use a ``thick-disk'' gravitational kernel, and three-dimensional simulations with explicit vertical stratification. Both models adopt an isothermal equation of state with cs=7 km s-1. When disks are sufficiently magnetized and self-gravitating, the result in both sorts of models is the growth of spiral-arm substructure similar to that in our previous razor-thin models. Reduced self-gravity due to nonzero disk thickness increases the spur spacing to ~10 times the Jeans length at the arm peak. Bound clouds that form from spur fragmentation have masses ~(1-3)×107 Msolar each, similar to the largest observed GMCs. The mass-to-flux ratios and specific angular momenta of the bound condensations are lower than large-scale galactic values, as is true for observed GMCs. We find that unmagnetized or weakly magnetized two-dimensional models are unstable to the ``wiggle instability'' previously identified by Wada & Koda. However, our fully three-dimensional models do not show this effect. Nonsteady motions and strong vertical shear prevent coherent vortical structures from forming, evidently suppressing the wiggle instability. We also find no clear traces of Parker instability in the nonlinear spiral arm substructures that emerge, although conceivably Parker modes may help seed the MJI at early stages since azimuthal wavelengths are similar.

Test Facility Simulation Results for Aerospace Loss-of-Lubrication of Spur Gears

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Gargano, Lucas J.

2014-01-01

Prior to receiving airworthiness certification, extensive testing is required during the development of rotary wing aircraft drive systems. Many of these tests are conducted to demonstrate the drive system's ability to operate at extreme conditions, beyond that called for in the normal to maximum power operating range. One of the most extreme tests is referred to as the loss-of-lubrication or run dry test. During this test, the drive system is expected to last at least 30 min without failure while the primary lubrication system is disabled for predetermined, scripted flight conditions. Failure of this test can lead to a partial redesign of the drive system or the addition of an emergency lubrication system. Either of these solutions can greatly increase the aircraft drive system cost and weight and extend the schedule for obtaining airworthiness certification. Recent work at NASA Glenn Research Center focused on performing tests, in a relevant aerospace environment, to simulate the behavior of spur gears under loss-of-lubrication conditions. Tests were conducted using a test facility that was used in the past for spur gear contact fatigue testing. A loss-oflubrication test is initiated by shutting off the single into mesh lubricating jet. The test proceeds until the gears fail and can no longer deliver the applied torque. The observed failures are typically plastically deformed gear teeth, due to the high tooth temperatures, that are no longer in mesh. The effect of several different variables to gear tooth condition during loss-of-lubrication have been tested such as gear pitch, materials, shrouding, lubrication condition, and emergency supplied mist lubrication in earlier testing at NASA. Recent testing has focused on newer aerospace gear steels and imbedding thermocouples in the shrouding to measure the air-oil temperatures flung off the gear teeth. Along with the instrumented shrouding, an instrumented spur gear was also tested. The instrumented spur gear had

3. ONE OF SIX SPUR GEARS AND CABLE SPOOLS INSTALLED ...

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

3. ONE OF SIX SPUR GEARS AND CABLE SPOOLS INSTALLED IN THE UPPER FALLS GATE HOUSE. THE SHIFTING LEVER IS VISIBLE IN FOREGROUND, AS IS THE 3X3 1/16 SHAFT, LOOKING EAST, NORTHEAST. - Washington Water Power Spokane River Upper Falls Hydroelectric Development, Gates & Gate-Lifting Mechanisms, Spokane River, approximately 0.5 mile northeast of intersection of Spokane Falls Boulevard & Post Street, Spokane, Spokane County, WA

Space-Spurred Metallized Materials

NASA Technical Reports Server (NTRS)

1990-01-01

Spurred R&D toward improved vacuum metallizing techniques led to an extensive line of commercial products, from insulated outdoor garments to packaging for foods, from wall coverings to window shades, from life rafts to candy wrappings, reflective blankets to photographic reflectors. Metallized Products, Inc. (MPI) was one of the companies that worked with NASA in development of the original space materials. MPI markets its own metallized products and supplies materials to other manufacturers. One of the most widely used MPI products is TXG laminate. An example is a reflective kite, the S.O.S. Signal Kite that can be flown as high as 200 feet to enhance radar and visual detectability. It offers a boon to campers, hikers, mountain climbers and boaters. It is produced by Solar Reflections, Inc. The company also markets a solar reflective hat. Another example is by Pro-Tektion, Inc. to provide protection for expensive musical equipment that have sensitive electronic components subject to damage from the heat of stage lights, dust, or rain at outdoor concerts. MP supplied the material and acceptance of the covers by the sound industry has been excellent.

Experimental study on skin irritation of bone spur powder on rabbit

NASA Astrophysics Data System (ADS)

Ma, Zhenzhen; Zhang, Xuhui; Hao, Shaojun; Shen, Huiling; Wang, Huamin; Ji, Xianghui; Zhang, Zhengchen; Huang, Youling

2018-04-01

To observe the effect of bone powder of rabbit skin, provide the basis for the safety of clinical use of bone powder, 24 rabbits were randomly divided into 6 groups, complete skin test and damaged skin test each divided into 3 groups (n=4), high, low, 3 doses tested daily administered 1 times, continuous administration for 7 days, in 24 hours after the last administration of drug residues, wash with warm water, the removal of L hours after drug for 24 hours, 48 hours, 72 hours and seventh days, observed and recorded to apply position before administration and administration during the skin no erythema and edema, and observe the smear Parts of any pigmentation, bleeding, rough skin or thin skin etc., record the occurrence time and duration time. Through comparative observation, intact skin group before administration and dosing period, there were no erythema and edema, pigmentation, bleeding, rough skin or thin skin etc., there is no difference with the control group; the damaged skin group after administration of 1 to 5 days, each rabbit skin there are different degrees of erythema and edema, especially to skin injury after 24-48 hours is obvious, 2 days (48 hours) after 4 days gradually reduced, significantly subsided after 6 days, erythema and edema phenomenon subsided completely, not out of blood, pigmentation, rough skin or thin skin and so on. The bone spur powder has no irritation on the intact skin of rabbits. The bone spur powder has moderate irritation on the damaged skin of rabbits, but after 48 hours, the stimulation reaction subsided spontaneously, which is caused by the inflammatory reaction caused by skin injury, rather than the medication. The bone spur powder is safe for clinical use.

Internal fixation combined with bone grafting for large intraosseous calcaneal lipoma: A case report

PubMed Central

Cao, Yongxing

2017-01-01

Intraosseous lipoma is a rare benign bone tumor that has been reported to occur in the calcaneus and long bones. The etiology of intraosseous lipoma is unknown, although several theories have been proposed. The majority of the cases of intraosseous calcaneal lipoma reported in the literature were localized in the anterior portion of the calcaneus and were treated by curettage and bone grafting. However, for larger lipomas, no specific treatment protocol has been developed to date. We herein present a rare case involving a large intraosseous lipoma of the calcaneus in a 36-year-old man following hindfoot trauma. The lesion was treated by decortication followed by bone grafting and internal fixation, a surgical approach that, to the best of our knowledge, has not been previously described in the literature. PMID:29181183

Procedure for Tooth Contact Analysis of a Face Gear Meshing With a Spur Gear Using Finite Element Analysis

NASA Technical Reports Server (NTRS)

Bibel, George; Lewicki, David G. (Technical Monitor)

2002-01-01

A procedure was developed to perform tooth contact analysis between a face gear meshing with a spur pinion using finite element analysis. The face gear surface points from a previous analysis were used to create a connected tooth solid model without gaps or overlaps. The face gear surface points were used to create a five tooth face gear Patran model (with rim) using Patran PCL commands. These commands were saved in a series of session files suitable for Patran input. A four tooth spur gear that meshes with the face gear was designed and constructed with Patran PCL commands. These commands were also saved in a session files suitable for Patran input. The orientation of the spur gear required for meshing with the face gear was determined. The required rotations and translations are described and built into the session file for the spur gear. The Abaqus commands for three-dimensional meshing were determined and verified for a simplified model containing one spur tooth and one face gear tooth. The boundary conditions, loads, and weak spring constraints were determined to make the simplified model work. The load steps and load increments to establish contact and obtain a realistic load was determined for the simplified two tooth model. Contact patterns give some insight into required mesh density. Building the two gears in two different local coordinate systems and rotating the local coordinate systems was verified as an easy way to roll the gearset through mesh. Due to limitation of swap space, disk space and time constraints of the summer period, the larger model was not completed.

Melorheostosis of the hand with complicating bony spur formation and bursal inflammation: diagnosis and treatment.

PubMed

Ameen, S; Nagy, L; Gerich, U; Anderson, S E

2002-08-01

A 37-year old woman presented with intolerable pain associated with a slowly growing mass on the dorsum of the right hand. The radiographs were characteristic of melorheostosis involving the third and fourth metacarpals, with a cortical bony projection extending from the base of the third metacarpal eroding slightly into the fourth metacarpal, associated with bursal formation. Magnetic resonance imaging (MRI) demonstrated an inflamed bursal collection adjacent to the spur. This region corresponded to the patient's severe clinical, focal pain. To our knowledge, this is the first case report in which melorheostosis of the hand has been associated with bony spur formation and complicated by an inflamed bursa.

Partitioning of 13C-photosynthate from Spur Leaves during Fruit Growth of Three Japanese Pear (Pyrus pyrifolia) Cultivars Differing in Maturation Date

PubMed Central

ZHANG, CAIXI; TANABE, KENJI; TAMURA, FUMIO; ITAI, AKIHIRO; WANG, SHIPING

2005-01-01

• Background and Aims In fruit crops, fruit size at harvest is an important aspect of quality. With Japanese pears (Pyrus pyrifolia), later maturing cultivars usually have larger fruits than earlier maturing cultivars. It is considered that the supply of photosynthate during fruit development is a critical determinant of size. To assess the interaction of assimilate supply and early/late maturity of cultivars and its effect on final fruit size, the pattern of carbon assimilate partitioning from spur leaves (source) to fruit and other organs (sinks) during fruit growth was investigated using three genotypes differing in maturation date. • Methods Partitioning of photosynthate from spur leaves during fruit growth was investigated by exposure of spurs to 13CO2 and measurement of the change in 13C abundance in dry matter with time. Leaf number and leaf area per spur, fresh fruit weight, cell number and cell size of the mesocarp were measured and used to model the development of the spur leaf and fruit. • Key Results Compared with the earlier-maturing cultivars ‘Shinsui’ and ‘Kousui’, the larger-fruited, later-maturing cultivar ‘Shinsetsu’ had a greater total leaf area per spur, greater source strength (source weight × source specific activity), with more 13C assimilated per spur and allocated to fruit, smaller loss of 13C in respiration and export over the season, and longer duration of cell division and enlargement. Histology shows that cultivar differences in final fruit size were mainly attributable to the number of cells in the mesocarp. • Conclusions Assimilate availability during the period of cell division was crucial for early fruit growth and closely correlated with final fruit size. Early fruit growth of the earlier-maturing cultivars, but not the later-maturing ones, was severely restrained by assimilate supply rather than by sink limitation. PMID:15655106

9. "SANTA FE RAILWAY SPUR TO OPERATIONAL AREA, DIRECTORATE OF ...

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

9. "SANTA FE RAILWAY SPUR TO OPERATIONAL AREA, DIRECTORATE OF MISSILE CAPTIVE TEST, EDWARDS AFB"; Photo no. "11,381 57; G-AFFTC 18 SEPT 57". Test Area 1-115. Photo shows engine no. 712 pulling one car. The superstructure of Test Stand 1-4 is prominent in the background. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Leuhman Ridge near Highways 58 & 395, Boron, Kern County, CA

Thermal Behavior of Aerospace Spur Gears in Normal and Loss-of-Lubrication Conditions

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.

2015-01-01

Testing of instrumented spur gears operating at aerospace rotorcraft conditions was conducted. The instrumented gears were operated in a normal and in a loss-of-lubrication environment. Thermocouples were utilized to measure the temperature at various locations on the test gears and a test utilized a full-field, high-speed infrared thermal imaging system. Data from thermocouples was recorded during all testing at 1 hertz. One test had the gears shrouded and a second test was run without the shrouds to permit the infrared thermal imaging system to take data during loss-of-lubrication operation. Both tests using instrumented spur gears were run in normal and loss-of-lubrication conditions. Also the result from four other loss-of-lubrication tests will be presented. In these tests two different torque levels were used while operating at the same rotational speed (10000 revolutions per minute).

Thermal Behavior of Aerospace Spur Gears in Normal and Loss-of-Lubrication Conditions

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.

2015-01-01

Testing of instrumented spur gears operating at aerospace rotorcraft conditions was conducted. The instrumented gears were operated in a normal and in a loss-of-lubrication environment. Thermocouples were utilized to measure the temperature at various locations on the test gears and a test utilized a full-field, high-speed infrared thermal imaging system. Data from thermocouples was recorded during all testing at 1 Hz. One test had the gears shrouded and a second test was run without the shrouds to permit the infrared thermal imaging system to take date during loss-of-lubrication operation. Both tests using instrumented spur gears were run in normal and loss-of-lubrication conditions. Also the result from four other loss-of-lubrication tests will be presented. In these tests two different torque levels were used while operating at the same rotational speed (10000 rpm).

Dynamic Forces in Spur Gears - Measurement, Prediction, and Code Validation

NASA Technical Reports Server (NTRS)

Oswald, Fred B.; Townsend, Dennis P.; Rebbechi, Brian; Lin, Hsiang Hsi

1996-01-01

Measured and computed values for dynamic loads in spur gears were compared to validate a new version of the NASA gear dynamics code DANST-PC. Strain gage data from six gear sets with different tooth profiles were processed to determine the dynamic forces acting between the gear teeth. Results demonstrate that the analysis code successfully simulates the dynamic behavior of the gears. Differences between analysis and experiment were less than 10 percent under most conditions.

Scavenging and recombination kinetics in a radiation spur: The successive ordered scavenging events

NASA Astrophysics Data System (ADS)

Al-Samra, Eyad H.; Green, Nicholas J. B.

2018-03-01

This study describes stochastic models to investigate the successive ordered scavenging events in a spur of four radicals, a model system based on a radiation spur. Three simulation models have been developed to obtain the probabilities of the ordered scavenging events: (i) a Monte Carlo random flight (RF) model, (ii) hybrid simulations in which the reaction rate coefficient is used to generate scavenging times for the radicals and (iii) the independent reaction times (IRT) method. The results of these simulations are found to be in agreement with one another. In addition, a detailed master equation treatment is also presented, and used to extract simulated rate coefficients of the ordered scavenging reactions from the RF simulations. These rate coefficients are transient, the rate coefficients obtained for subsequent reactions are effectively equal, and in reasonable agreement with the simple correction for competition effects that has recently been proposed.

Calcaneocuboid joint subluxation after calcaneal lengthening for planovalgus foot deformity in children with cerebral palsy.

PubMed

Adams, Samuel B; Simpson, Andrew W; Pugh, Linda I; Stasikelis, Peter J

2009-03-01

Calcaneal lengthening is a common procedure for the treatment of symptomatic planovalgus deformity in children with cerebral palsy. Stabilization of the calcaneocuboid joint to prevent subluxation at the time of lengthening has been described. The purpose of this study was to evaluate the magnitude of calcaneocuboid joint subluxation and associated degenerative changes in patients with cerebral palsy who underwent calcaneal lengthening for planovalgus foot deformity with and without stabilization of the calcaneocuboid joint. We conducted a retrospective review of children with cerebral palsy who underwent lateral column lengthening through the calcaneus. For the purposes of statistical analysis, the feet were divided into 2 groups: stabilized (those that received Steinmann pin stabilization at the time of lengthening) and nonstabilized (those feet that did not receive Steinmann pin stabilization). Initial, intraoperative, and most recent follow-up radiographs were reviewed for segmental foot analysis of planovalgus deformity, calcaneocuboid joint subluxation, and osteoarthritic changes. A minimum of 3-year follow-up was required. Sixty-one feet were included in this study; 28 feet in the stabilized group and 33 in the nonstabilized group. Radiographic assessment of segmental foot analysis demonstrated significant improvement with regard to planovalgus deformity (P<0.05, 5 measurements). Calcaneocuboid joint subluxation occurred in 24 feet in the stabilized group and 29 feet in the nonstabilized group (P=0.5269). At final follow-up, the magnitude of subluxation was not significantly different between the groups (P=0.076). There was no difference in the incidence of osteoarthritic changes at the calcaneocuboid joint between the groups (P=0.2856). Lateral column lengthening through the calcaneus, for planovalgus foot deformity, significantly improved the segmental alignment of the foot with respect to radiographic assessment. Stabilization of the calcaneocuboid joint

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

The top bow deck of the Woods Hole Oceanographic Institution's research vessel Knorr is seen on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Woods Hole Oceanographic Institution workers load scientific instruments onboard the Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

The bow of the Woods Hole Oceanographic Institution's research vessel Knorr is seen from the bridge on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Scientific instruments are seen on the stern of the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

The Woods Hole Oceanographic Institution's research vessel Knorr is seen docked on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Scientific instruments are loaded onboard the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

The Bridge of the Woods Hole Oceanographic Institution's research vessel Knorr is seen on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Food and supplies are loaded onboard the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

NASA Physical Oceanography Program Scientist Eric Lindstrom boards the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Lindstrom will depart on Knorr Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Spur-Gear-System Efficiency at Part and Full Load

NASA Technical Reports Server (NTRS)

Anderson, N. E.; Loewenthal, S. H.

1980-01-01

A simple method for predicting the part- and full-load power loss of a steel spur gearset of arbitrary geometry supported by ball bearings is described. The analysis algebraically accounts for losses due to gear sliding, rolling traction, and windage in addition to support-ball-bearing losses. The analysis compares favorably with test data. A theoretical comparison of the component losses indicates that losses due to gear rolling traction, windage, and support bearings are significant and should be included along with gear sliding loss in a calculation of gear-system power loss.

Effects of rim thickness on spur gear bending stress

NASA Technical Reports Server (NTRS)

Bibel, G. D.; Reddy, S. K.; Savage, M.; Handschuh, R. F.

1991-01-01

Thin rim gears find application in high-power, light-weight aircraft transmissions. Bending stresses in thin rim spur gear tooth fillets and root areas differ from the stresses in solid gears due to rim deformations. Rim thickness is a significant design parameter for these gears. To study this parameter, a finite element analysis was conducted on a segment of a thin rim gear. The rim thickness was varied and the location and magnitude of the maximum bending stresses reported. Design limits are discussed and compared with the results of other researchers.

Thermal elastohydrodynamic lubrication of spur gears

NASA Technical Reports Server (NTRS)

Wang, K. L.; Cheng, H. S.

1980-01-01

An analysis and computer program called TELSGE were developed to predict the variations of dynamic load, surface temperature, and lubricant film thickness along the contacting path during the engagement of a pair of involute spur gears. The analysis of dynamic load includes the effect of gear inertia, the effect of load sharing of adjacent teeth, and the effect of variable tooth stiffness which are obtained by a finite-element method. Results obtained from TELSGE for the dynamic load distributions along the contacting path for various speeds of a pair of test gears show patterns similar to that observed experimentally. Effects of damping ratio, contact ratio, tip relief, and tooth error on the dynamic load were examined. In addition, two dimensionless charts are included for predicting the maximum equilibrium surface temperature, which can be used to estimate directly the lubricant film thickness based on well established EHD analysis.

2. GATELIFTING SPUR GEAR DRIVE IN FOREGROUND, ATTACHED TO A ...

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

2. GATE-LIFTING SPUR GEAR DRIVE IN FOREGROUND, ATTACHED TO A GENERAL ELECTRIC COMPANY CRANE MOTOR, WITH COMPANION SOLENOID BRAKE IN RIGHT BACKGROUND, WITH BOTH MOUNTED ON A CONCRETE PEDESTAL. PORTIONS OF THE STEEL DERRICK LIFTING FRAME ARE VISIBLE IN THE FOREGROUND AND BACKGROUND, LOOKING EAST/NORTHEAST. - Washington Water Power Spokane River Upper Falls Hydroelectric Development, Gates & Gate-Lifting Mechanisms, Spokane River, approximately 0.5 mile northeast of intersection of Spokane Falls Boulevard & Post Street, Spokane, Spokane County, WA

Investigation of Low-Cycle Bending Fatigue of AISI 9310 Steel Spur Gears

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Krantz, Timothy L.; Lerch, Bradley A.; Burke, Christopher S.

2007-01-01

An investigation of the low-cycle bending fatigue of spur gears made from AISI 9310 gear steel was completed. Tests were conducted using the single-tooth bending method to achieve crack initiation and propagation. Tests were conducted on spur gears in a fatigue test machine using a dedicated gear test fixture. Test loads were applied at the highest point of single tooth contact. Gear bending stresses for a given testing load were calculated using a linear-elastic finite element model. Test data were accumulated from 1/4 cycle to several thousand cycles depending on the test stress level. The relationship of stress and cycles for crack initiation was found to be semi-logarithmic. The relationship of stress and cycles for crack propagation was found to be linear. For the range of loads investigated, the crack propagation phase is related to the level of load being applied. Very high loads have comparable crack initiation and propagation times whereas lower loads can have a much smaller number of cycles for crack propagation cycles as compared to crack initiation.

Investigation of Low-Cycle Bending Fatigue of AISI 9310 Steel Spur Gears

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Krantz, Timothy L.; Lerch, Bradley A.; Burke, Christopher S.

2007-01-01

An investigation of the low-cycle bending fatigue of spur gears made from AISI 9310 gear steel was completed. Tests were conducted using the single-tooth bending method to achieve crack initiation and propagation. Tests were conducted on spur gears in a fatigue test machine using a dedicated gear test fixture. Test loads were applied at the highest point of single tooth contact. Gear bending stresses for a given testing load were calculated using a linear-elastic finite element model. Test data were accumulated from 1/4 cycle to several thousand cycles depending on the test stress level. The relationship of stress and cycles for crack initiation was found to be semilogarithmic. The relationship of stress and cycles for crack propagation was found to be linear. For the range of loads investigated, the crack propagation phase is related to the level of load being applied. Very high loads have comparable crack initiation and propagation times whereas lower loads can have a much smaller number of cycles for crack propagation cycles as compared to crack initiation.

Strength Evaluation and Failure Prediction of Short Carbon Fiber Reinforced Nylon Spur Gears by Finite Element Modeling

NASA Astrophysics Data System (ADS)

Hu, Zhong; Hossan, Mohammad Robiul

2013-06-01

In this paper, short carbon fiber reinforced nylon spur gear pairs, and steel and unreinforced nylon spur gear pairs have been selected for study and comparison. A 3D finite element model was developed to simulate the multi-axial stress-strain behaviors of the gear tooth. Failure prediction has been conducted based on the different failure criteria, including Tsai-Wu criterion. The tooth roots, where has stress concentration and the potential for failure, have been carefully investigated. The modeling results show that the short carbon fiber reinforced nylon gear fabricated by properly controlled injection molding processes can provide higher strength and better performance.

Surgical management of calcaneal unicameral bone cysts.

PubMed

Glaser, D L; Dormans, J P; Stanton, R P; Davidson, R S

1999-03-01

Unicameral bone cysts are not seen commonly in the calcaneus. Little is known about the etiology and natural history of these lesions. Calcaneal cysts often are symptomatic, although some of these lesions are detected as incidental findings. Treatment has been advocated based on the fear of pathologic fracture and collapse. Several published series have been divided in their favor for either open treatment or injection management. These series are small, and the optimal treatment is still in question. The current study compared the efficacy of methylprednisolone acetate injection treatment with curettage and bone grafting in the treatment of unicameral bone cysts of the calcaneus. All patients treated for unicameral bone cysts of the calcaneus during the past 7 years at two institutions were reviewed. Eleven patients met inclusion criteria. All diagnoses were confirmed radiographically or histologically. Demographic information, presenting complaints, diagnostic imaging, treatment modalities, and outcome were analyzed. Long term radiographic and subjective followup was obtained. Eighteen surgical procedures were performed on 11 patients with 12 cysts. Nine injections performed on six patients failed to show healing of the cyst. Nine cysts treated with curettage and bone grafting showed cyst healing. At mean followup of 28 months (range, 12-77 months), all 11 patients had no symptoms; there were no recurrences of the cyst in the nine patients who underwent bone grafting and persistence of the cyst in the two patients who underwent injection therapy. This review reports one of the largest series of cysts in this location. The results indicate that steroid injection treatment, although useful in other locations, may not be the best option for the management of unicameral bone cysts in the calcaneus. Curettage and bone grafting yielded uniformly good results.

110. NORTH PLANT RAILROAD SPUR, WITH ASSEMBLY PLANT/WAREHOUSE (BUILDING 1601/1606/1701) ...

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

110. NORTH PLANT RAILROAD SPUR, WITH ASSEMBLY PLANT/WAREHOUSE (BUILDING 1601/1606/1701) AT LEFT AND GB MANUFACTURING PLANT (BUILDING 1501) AT CENTER. VIEW TO NORTH. - Rocky Mountain Arsenal, Bounded by Ninety-sixth Avenue & Fifty-sixth Avenue, Buckley Road, Quebec Street & Colorado Highway 2, Commerce City, Adams County, CO

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Autonomous wave gliders are seen onboard the the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The autonomous gliders will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Crates containing scientific instruments are seen on the stern of the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-05

A sensor-laden buoy is lifted onboard the Woods Hole Oceanographic Institution's research vessel Knorr on wednesday, Sept. 5, 2012, in Woods Hole, Mass. The buoy will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Two NOAA Pacific Marine Environmental Laboratory (PMEL) buoys are seen on the stern of the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

An engineer is raised by crane to work on the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

A Rosette water sampler system that will be used during the Salinity Processes in the Upper Ocean Regional Study (SPURS) is seen onboard the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart for the NASA-sponsored expedition on Sept. 6 and will head into the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Scientific instruments, buoys, and shipping crates are seen on the stern of the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

International maritime signal flags are seen on the bridge of the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

A sculpture resembling the Roman god Neptune is seen dockside of the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

NASA Physical Oceanography Program Scientist Eric Lindstrom poses for a photograph next to the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Lindstrom will depart on Knorr Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

A low complexity, low spur digital IF conversion circuit for high-fidelity GNSS signal playback

NASA Astrophysics Data System (ADS)

Su, Fei; Ying, Rendong

2016-01-01

A low complexity high efficiency and low spur digital intermediate frequency (IF) conversion circuit is discussed in the paper. This circuit is key element in high-fidelity GNSS signal playback instrument. We analyze the spur performance of a finite state machine (FSM) based numerically controlled oscillators (NCO), by optimization of the control algorithm, a FSM based NCO with 3 quantization stage can achieves 65dB SFDR in the range of the seventh harmonic. Compare with traditional lookup table based NCO design with the same Spurious Free Dynamic Range (SFDR) performance, the logic resource require to implemented the NCO is reduced to 1/3. The proposed design method can be extended to the IF conversion system with good SFDR in the range of higher harmonic components by increasing the quantization stage.

Retrospective evaluation of the effectiveness of radiotherapy in patients with plantar fascitis (heel spurs).

PubMed

Kędzierawski, Piotr; Stando, Rafał; Macek, Paweł

2017-01-01

The aim of the study was the evaluation of the effectiveness of radiotherapy in patients with the feet pain caused by heel spurs. Treatment options for patients reporting these symptoms include use of suitable orthopedic footwear, the use of general or topical non-steroidal anti-inflammatory drugs or steroids, physiotherapy, manual therapy, shock wave or appropriate surgical procedures. Radiotherapy is one of the method used in patients with chronic pain syndrome. The material consisted of 47 patients treated in Radiotherapy Department at the Holycross Cancer Center. The time of follow-up ranged from 1 to 129 months. After treatment patients were observed. During the first follow-up visit a complete relief of symptoms was observed in 37 patients, and the pain was felt by 10 patients for 4 months after the treatment. One patient was re-irradiated 6 months after treatment because of persistent pain. At 16 and 17 months after the onset of treatment, pain was reported by two patients. These patients were re-irradiated. One patient had recurrence of pain 48 months after completion of radiation. After the second irradiation the pain was relieved. The remaining patients, with the exception of two, experienced remission of pain, which has been documented. Tolerance of the treatment was very good. No complications of radiation were observed. Radiotherapy remains an attractive treatment for patients with inflammation of the heel fascia.

Lynch Syndrome: Genomics Update and Imaging Review.

PubMed

Cox, Veronica L; Saeed Bamashmos, Anas A; Foo, Wai Chin; Gupta, Shiva; Yedururi, Sireesha; Garg, Naveen; Kang, Hyunseon Christine

2018-01-01

Lynch syndrome is the most common hereditary cancer syndrome, the most common cause of heritable colorectal cancer, and the only known heritable cause of endometrial cancer. Other cancers associated with Lynch syndrome include cancers of the ovary, stomach, urothelial tract, and small bowel, and less frequently, cancers of the brain, biliary tract, pancreas, and prostate. The oncogenic tendency of Lynch syndrome stems from a set of genomic alterations of mismatch repair proteins. Defunct mismatch repair proteins cause unusually high instability of regions of the genome called microsatellites. Over time, the accumulation of mutations in microsatellites and elsewhere in the genome can affect the production of important cellular proteins, spurring tumorigenesis. Universal testing of colorectal tumors for microsatellite instability (MSI) is now recommended to (a) prevent cases of Lynch syndrome being missed owing to the use of clinical criteria alone, (b) reduce morbidity and mortality among the relatives of affected individuals, and (c) guide management decisions. Organ-specific cancer risks and associated screening paradigms vary according to the sex of the affected individual and the type of germline DNA alteration causing the MSI. Furthermore, Lynch syndrome-associated cancers have different pathologic, radiologic, and clinical features compared with their sporadic counterparts. Most notably, Lynch syndrome-associated tumors tend to be more indolent than non-Lynch syndrome-associated neoplasms and thus may respond differently to traditional chemotherapy regimens. The high MSI in cases of colorectal cancer reflects a difference in the biologic features of the tumor, possibly with a unique susceptibility to immunotherapy. © RSNA, 2018.

Injection of Mesenchymal Stem Cells as a Supplementary Strategy of Marrow Stimulation Improves Cartilage Regeneration After Lateral Sliding Calcaneal Osteotomy for Varus Ankle Osteoarthritis: Clinical and Second-Look Arthroscopic Results.

PubMed

Kim, Yong Sang; Koh, Yong Gon

2016-05-01

To compare the clinical and second-look arthroscopic outcomes in patients undergoing arthroscopic marrow stimulation combined with lateral sliding calcaneal osteotomy for varus ankle osteoarthritis, with or without adipose-derived mesenchymal stem cell (MSC) injection. In this retrospective comparative study, 49 patients with varus ankle osteoarthritis underwent second-look arthroscopy after arthroscopic marrow stimulation combined with lateral sliding calcaneal osteotomy between January 2010 and November 2012; 23 ankles underwent marrow stimulation alone (group 1), and 26 underwent marrow stimulation with MSC injection (group 2). The decision whether to receive the MSC injection, which was free of charge, was solely up to the patients. Second-look arthroscopies were performed at a mean of 12.5 months and 12.4 months postoperatively in group 1 and group 2, respectively. Clinical outcome measures included a visual analog scale (VAS) score for pain and the American Orthopaedic Foot & Ankle Society (AOFAS) score. The radiologic outcome variable was the talar tilt angle. On second-look arthroscopy, cartilage regeneration was evaluated using the International Cartilage Repair Society (ICRS) grade. The mean VAS score improved significantly from 7.3 ± 0.9 to 3.9 ± 1.2 in group 1 and from 7.4 ± 0.8 to 3.1 ± 1.5 in group 2 at final follow-up (P < .001 for both groups). The mean AOFAS score also improved significantly from 64.4 ± 4.1 to 79.6 ± 7.7 in group 1 and from 63.5 ± 4.2 to 84.2 ± 7.9 in group 2 at final follow-up (P < .001 for both groups). The VAS and AOFAS scores were significantly better in group 2 than in group 1 (P = .040 and P = .047, respectively). ICRS grades were significantly correlated with clinical outcomes in both groups (all P < .05), and there were significant differences in ICRS grades between the groups (P < .05). The mean talar tilt angle improved significantly after lateral sliding calcaneal osteotomy in both groups and was significantly

Mobile Element Studies in Rocks (RAT) from Columbia Hills/West Spur at Gusev

NASA Technical Reports Server (NTRS)

Rao, M. N.; Nyquist, L. E.; Sutton, S. R.; Garrison, D. H.

2007-01-01

Using elemental abundances determined by SPIRIT APX spectrometer on rocks and soils at Gusev Plains and Columbia Hills/ West Spur regions, the Athena Team discussed the aqueous geochemical implications at these sites on Mars. They suggested that these rocks were exposed to variable degrees of aqueous alteration (low to high) at Gusev crater. Earlier, we developed analytical procedures for studying aqueous geochemical behavior of fluids on rocks at Meridiani. In the present study, we apply these methods to rocks at Columbia Hills/West Spur in order to understand the significance of the Gusev rock results in reference to aqueous geochemical processes on Mars . The data analysis procedure is based on treating SO3 ("a") and Cl ("b") as two variables and tracking the relationship between "a" and "b" when the fluids undergo evaporation. This process of evaporation leads to concentration changes in these two elements finally producing salt assemblages on Martian rocks. In some cases on plotting "a"/ "b" versus "b" in salt assemblages, they yield a hyperbolic distribution. The relationship is transformed into a straight line when "a"/"b" is again plotted against 1/"b" in the system. Earlier, we used this procedure in the case of Merdiani rock abrasion tool (RAT) rocks and in this study, we discuss the application of this procedure to Gusev rocks. This study shows that the Gusev Plains rocks were exposed to low SO3/Cl solutions (sulfate-poor) for short period of time (weak interaction), whereas solutions with high SO3/Cl ratios (sulfate-rich) seem to have pervasively interacted with Columbia Hills/ West Spur rocks (strong interaction) at Gusev crater. Our conclusions seem to be consistent with the Mossbauer results given for these rocks

Infestation of the spur-thighed tortoise (Testudo graeca) by Hyalomma aegyptium in Tunisia.

PubMed

Gharbi, Mohamed; Rjeibi, Mohamed Ridha; Rouatbi, Mariem; Mabrouk, Moez; Mhadhbi, Moez; Amairia, Safa; Amdouni, Yosra; Boussaadoun, Mohamed Anis

2015-04-01

We examined 210 spur-thighed tortoises (Testudo graeca) for the presence of ticks in Tunisia during May 2014. A total number of 602 adult ticks were collected and identified leading to the estimation of parasitological indicators. All the ticks belonged to a single species: Hyalomma aegyptium. The mean infestation prevalence was 66.2%, mean overall infestation intensity and abundance were 4.33 and 2.86 ticks/tortoise respectively. Our survey showed that tortoises were significantly more infested by male ticks than females (p<0.001). The ticks were mainly present in the posterior limbs compared to other body regions (p<0.05). There was no significance variation of length and weight of tortoises according to sex (p<0.05). There was a significant correlation between the tortoises' size (length and weight) and tick infestation. This study showed high tick burdens of spur-thighed tortoises in Tunisia; further investigations are needed to determine exactly the role of this tick species in the transmission of different zoonotic pathogens. Copyright © 2015 Elsevier GmbH. All rights reserved.

Improvement of retinal blood vessel detection by spur removal and Gaussian matched filtering compensation

NASA Astrophysics Data System (ADS)

Xiao, Di; Vignarajan, Janardhan; An, Dong; Tay-Kearney, Mei-Ling; Kanagasingam, Yogi

2016-03-01

Retinal photography is a non-invasive and well-accepted clinical diagnosis of ocular diseases. Qualitative and quantitative assessment of retinal images is crucial in ocular diseases related clinical application. In this paper, we proposed approaches for improving the quality of blood vessel detection based on our initial blood vessel detection methods. A blood vessel spur pruning method has been developed for removing the blood vessel spurs both on vessel medial lines and binary vessel masks, which are caused by artifacts and side-effect of Gaussian matched vessel enhancement. A Gaussian matched filtering compensation method has been developed for removing incorrect vessel branches in the areas of low illumination. The proposed approaches were applied and tested on the color fundus images from one publicly available database and our diabetic retinopathy screening dataset. A preliminary result has demonstrated the robustness and good performance of the proposed approaches and their potential application for improving retinal blood vessel detection.

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

A full suite of instruments are seen onboard the the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The various instruments will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

University of Washington Graduate Student Jesse Anderson tries to find her cabin onboard the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Anderson will work with the Argo Floats instruments in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

University of Washington Graduate Student Jesse Anderson settles into her cabin onboard the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Anderson will work with the Argo Floats instruments in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

CTD instruments used to measure Conductivity, Temperature, and Depth, are seen onboard the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The CTDs will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Autonomous wave gliders, right, are seen onboard the the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The autonomous gliders will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

A sensor-laden buoy is seen prior to being loaded onboard the Woods Hole Oceanographic Institution's vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The buoy will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Buoys used to support scientific instruments at sea are seen in the foreground prior to being loaded onboard the Woods Hole Oceanographic Institution's research vessel Knorr, seen in the background, on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Ken Decoteau, left, and Chip Beniot, both of the Woods Hole Oceanographic Institution, move scientific instruments to the research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The instruments will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Chip Beniot, left, and Ken Decoteau, both of the Woods Hole Oceanographic Institution, move scientific instruments to the research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The instruments will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

NASA Physical Oceanography Program Scientist Eric Lindstrom talks about the instruments onboard the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Various scientific instruments will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

NASA Physical Oceanography Program Scientist Eric Lindstrom inspects an autonomous wave glider onboard the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The autonomous gliders will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Woods Hole Oceanographic Institution Senior Scientist Ray Schmitt, left, and NASA Physical Oceanography Program Scientist Eric Lindstrom pose for a photograph in front of the Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Woods Hole Oceanographic Institution Scientist Dave Fratantoni works on the EcoMapper AUVs (autonomous underwater vehicles) onboard the Institute's research vessel Knorr, Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The EcoMappers will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Two EcoMapper AUVs (autonomous underwater vehicles) are seen onboard the the Woods Hole Oceanographic Institution research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The EcoMappers will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

[Calcaneal fractures treated by open reduction and internal fixation with a locking compression plate (LCP). A prospective study. part I: basic analysis of the group].

PubMed

Svatoš, F; Bartoška, R; Skála-Rosenbaum, J; Douša, P; Pacovský, V; Krbec, M

2011-01-01

In a prospective study of patients with calcaneal fractures treated by open reduction from an extensile lateral approach and LCP osteosynthesis, the authors evaluated the basic epidemiological data, mechanism of injury, type of fracture, essential data on surgery, days of hospital stay and the number of complications. In the period from September 1, 2006 to July 31, 2010, a total of 230 patients with 243 calcaneal fractures were treated. The fractures were classified as either open or closed and according to the Essex-Lopresti system. Of the total number of patients, 135 (55.6 % of all fractures) were indicated for conservative treatment and 108 (44.4% of all fractures) for surgical intervention. Indications for surgery based on the generally accepted criteria enabled us to select 77 patients with 82 fractures (33.7 % of all fractures) for treatment by the method of open reduction and LCP osteosynthesis. These patients constituted the group evaluated here. The other patients were treated using other techniques (21 fractures, i.e., 8.6 % of all fractures, by the Stehlík-Štulík transfixation method and further five [2.1 %] by screw osteosynthesis). Six surgeons were involved in the treatment of this group. For the diagnosis of fractures, plain radiographs in lateral and axial projection and axial and coronal CT images were used. All fractures were treated after subsidence of oedema by the method of open reduction and LCP fixation from an extensile lateral approach, with the use of a tourniquet. The follow-up period for the evaluation of functional outcome and bone union was 3 to 48 months. Fifty patients were followed up for over one year. The group evaluated comprised 58 men (75.3 %) with 63 fractures (76.8 %) and 19 women (24.7 %) with 19 fractures (23.2 %). The average age of the group was 42 years, with 41 years (range, 22-61 years) in men and 47 years (range, 30-70 years) in women. The most frequent cause of injury was a fall from a height below 1 metre and

What to measure when determining orthotic needs in children with Down syndrome: a pilot study.

PubMed

Looper, Julia; Benjamin, Danielle; Nolan, Mindy; Schumm, Laura

2012-01-01

To compare the effects of off-the-shelf foot orthoses and supramalleolar orthoses on the gait of children with Down syndrome (DS), and establish criteria for determining orthoses prescription for a child with DS. We assessed the gait of 6 children (aged 4-7 years) with DS using the GAITRite system, and obtained height, weight, leg length, hypermobility, calcaneal eversion, navicular drop, and tibial torsion measurements. Supramalleolar orthoses lead to a longer cycle time than foot orthoses (P = .05) and barefoot walking (P = .03) and a lower cadence than barefoot walking (P = .04). Significant strong correlations with gait parameters were obtained for height, leg length, and hypermobility. Biomechanical measurements showed no significant correlations with gait parameters. The role of physical examination data, including anthropometric and biomechanical measurements in the prescription of orthoses requires further investigation.

Predicted effect of dynamic load on pitting fatigue life for low-contact-ratio spur gears

NASA Technical Reports Server (NTRS)

Lewicki, David G.

1986-01-01

How dynamic load affects the surface pitting fatigue life of external spur gears was predicted by using the NASA computer program TELSGE. Parametric studies were performed over a range of various gear parameters modeling low-contact-ratio involute spur gears. In general, gear life predictions based on dynamic loads differed significantly from those based on static loads, with the predictions being strongly influenced by the maximum dynamic load during contact. Gear mesh operating speed strongly affected predicted dynamic load and life. Meshes operating at a resonant speed or one-half the resonant speed had significantly shorter lives. Dynamic life factors for gear surface pitting fatigue were developed on the basis of the parametric studies. In general, meshes with higher contact ratios had higher dynamic life factors than meshes with lower contact ratios. A design chart was developed for hand calculations of dynamic life factors.

Efficiency of nonstandard and high contact ratio involute spur gears

NASA Technical Reports Server (NTRS)

Anderson, N. E.; Loewenthal, S. H.

1984-01-01

A power loss prediction was extended to include involute spur gears of nonstandard proportions. The method is used to analyze the effects of modified addendum, tooth thickness, and gear center distance in addition to the parameters previously considered which included gear diameter, pitch, pressure angle, face width, oil viscosity, speed, and torque. Particular emphasis was placed on high contact ratio gearing (contact ratios greater than two). Despite their higher sliding velocities, high contact ratio gears are designed to levels of efficiency comparable to those of conventional gears while retaining their advantages through proper selection of gear geometry.

Efficiency of nonstandard and high contact ratio involute spur gears

NASA Technical Reports Server (NTRS)

Anderson, N. E.; Loewenthal, S. H.

1986-01-01

A power loss prediction was extended to include involute spur gears of nonstandard proportions. The method is used to analyze the effects of modified addendum, tooth thickness, and gear center distance in addition to the parameters previously considered which included gear diameter, pitch, pressure angle, face width, oil viscosity, speed, and torque. Particular emphasis was placed on high contact ratio gearing (contact ratios greater than two). Despite their higher sliding velocities, high contact ratio gears are designed to levels of efficiency comparable to those of conventional gears while retaining their advantages through proper selection of gear geometry.

An Overview of the Percutaneous Antibiotic Delivery Technique for Osteomyelitis Treatment and a Case Study of Calcaneal Osteomyelitis.

PubMed

Karr, Jeffrey C

2017-11-01

A percutaneous antibiotic delivery technique (PAD-T) used for the adjunctive management of osteomyelitis is presented. This surgical technique incorporates a calcium sulfate and hydroxyapatite (calcium phosphate) bone void filler acting as a carrier vehicle with either an antibiotic or an antifungal medicine, delivering this combination directly into the area of osteomyelitis. The benefit of the PAD-T is reviewed with a case presentation of a successfully treated calcaneal osteomyelitis. No previously reported PAD-T using a simple bone cortex incision in the adjunctive treatment of osteomyelitis has been reported. The PAD-T safely and effectively uses a calcium sulfate and hydroxyapatite bone void filler carrier vehicle to deliver either an antibiotic or an antifungal medicine directly into the area of osteomyelitis.

Surfers ankle: a bony spur of the talar neck

PubMed Central

Brooks, Francis Michael; Williams, Paul; Carpenter, E C

2009-01-01

A 27-year-old competitive surfer presented with a history of a painful right ankle. He was able to recall an injury to his right ankle 4–5 years previously, sustained while surfing. The mechanism described was that he had dropped a considerable height during take-off, sustaining an impact injury from the board. He recalled immediate pain and swelling followed by 2–3 weeks of pain and a limp; he continued to surf, albeit with difficulty, despite this. Investigations found him to have a bony spur on the anterolateral part of the talus. This case shows how this injury is similar to those observed in other sports. PMID:21709829

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-05

An worker prepares to attached a crane hook onto a sensor-laden buoy so that it may be loaded onboard the Woods Hole Oceanographic Institution's research vessel Knorr on wednesday, Sept. 5, 2012, in Woods Hole, Mass. The buoy will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

Sean Whelan, a Marine Technician for the Woods Hole Oceanographic Institution, prepares CTD instruments used to measure Conductivity, Temperature, and Depth, onboard the Institute's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The CTDs will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

NASA Physical Oceanography Program Scientist Eric Lindstrom inspects a sensor-laden buoy prior to it being loaded onboard the Woods Hole Oceanographic Institution's vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. The buoy will be deployed in the Atlantic Ocean as part of the Salinity Processes in the Upper Ocean Regional Study (SPURS) which is set to sail on Sept. 6. The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

University of Washington Applied Physics Laboratory Senior Oceanographer Andrey Shcherbina, left, and University of Washington Applied Physics Laboratory Senior Principal Oceanographer Jason Gobat work one of their instruments onboard the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Salinity Processes in the Upper Ocean Regional Study (SPURS)

NASA Image and Video Library

2012-09-04

University of Washington Applied Physics Laboratory Senior Oceanographer Andrey Shcherbina, left, and University of Washington Applied Physics Laboratory Senior Principal Oceanographer Jason Gobat carry one of their instruments onboard the Woods Hole Oceanographic Institution's research vessel Knorr on Tuesday, Sept. 4, 2012, in Woods Hole, Mass. Knorr is scheduled to depart on Sept. 6 to take part in the Salinity Processes in the Upper Ocean Regional Study (SPURS). The NASA-sponsored expedition will sail to the North Atlantic's saltiest spot to get a detailed, 3-D picture of how salt content fluctuates in the ocean's upper layers and how these variations are related to shifts in rainfall patterns around the planet. Photo Credit: (NASA/Bill Ingalls)

Spatial variation in pollinator-mediated selection on phenology, floral display and spur length in the orchid Gymnadenia conopsea.

PubMed

Chapurlat, Elodie; Ågren, Jon; Sletvold, Nina

2015-12-01

Spatial variation in plant-pollinator interactions may cause variation in pollinator-mediated selection on floral traits, but to establish this link conclusively experimental studies are needed. We quantified pollinator-mediated selection on flowering phenology and morphology in four populations of the fragrant orchid Gymnadenia conopsea, and compared selection mediated by diurnal and nocturnal pollinators in two of the populations. Variation in pollinator-mediated selection explained most of the among-population variation in the strength of directional and correlational selection. Pollinators mediated correlational selection on pairs of display traits, and on one display trait and spur length, a trait affecting pollination efficiency. Only nocturnal pollinators selected for longer spurs, and mediated stronger selection on the number of flowers compared with diurnal pollinators in one population. The two types of pollinators caused correlational selection on different pairs of traits and selected for different combinations of spur length and number of flowers. The results demonstrate that spatial variation in interactions with pollinators may result in differences in directional and correlational selection on floral traits in a plant with a semi-generalized pollination system, and suggest that differences in the relative importance of diurnal and nocturnal pollinators can cause variation in selection. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

The utility of dual-energy X-ray absorptiometry, calcaneal quantitative ultrasound, and fracture risk indices (FRAX® and Osteoporosis Risk Assessment Instrument) for the identification of women with distal forearm or hip fractures: A pilot study.

PubMed

Esmaeilzadeh, Sina; Cesme, Fatih; Oral, Aydan; Yaliman, Ayse; Sindel, Dilsad

2016-08-01

Dual-energy X-ray absorptiometry (DXA) is considered the "gold standard" in predicting osteoporotic fractures. Calcaneal quantitative ultrasound (QUS) variables are also known to predict fractures. Fracture risk assessment tools may also guide us for the detection of individuals at high risk for fractures. The aim of this case-control study was to evaluate the utility of DXA bone mineral density (BMD), calcaneal QUS parameters, FRAX® (Fracture Risk Assessment Tool), and Osteoporosis Risk Assessment Instrument (ORAI) for the discrimination of women with distal forearm or hip fractures. This case-control study included 20 women with a distal forearm fracture and 18 women with a hip fracture as cases and 76 age-matched women served as controls. BMD at the spine, proximal femur, and radius was measured using DXA and acoustic parameters of bone were obtained using a calcaneal QUS device. FRAX® 10-year probability of fracture and ORAI scores were also calculated in all participants. Receiver operating characteristic (ROC) analysis was used to assess fracture discriminatory power of all the tools. While all DXA BMD, and QUS variables and FRAX® fracture probabilities demonstrated significant areas under the ROC curves for the discrimination of hip-fractured women and those without, only 33% radius BMD, broadband ultrasound attenuation (BUA), and FRAX® major osteoporotic fracture probability calculated without BMD showed significant discriminatory power for distal forearm fractures. It can be concluded that QUS variables, particularly BUA, and FRAX® major osteoporotic fracture probability without BMD are good candidates for the identification of both hip and distal forearm fractures.

Compliance and stress sensitivity of spur gear teeth

NASA Technical Reports Server (NTRS)

Cornell, R. W.

1983-01-01

The magnitude and variation of tooth pair compliance with load position affects the dynamics and loading significantly, and the tooth root stressing per load varies significantly with load position. Therefore, the recently developed time history, interactive, closed form solution for the dynamic tooth loads for both low and high contact ratio spur gears was expanded to include improved and simplified methods for calculating the compliance and stress sensitivity for three involute tooth forms as a function of load position. The compliance analysis has an improved fillet/foundation. The stress sensitivity analysis is a modified version of the Heywood method but with an improvement in the magnitude and location of the peak stress in the fillet. These improved compliance and stress sensitivity analyses are presented along with their evaluation using test, finite element, and analytic transformation results, which showed good agreement.

DETERMINING OSTEOPOROSIS RISK IN OLDER COLONO ADULTS FROM RURAL AMAZONIAN ECUADOR USING CALCANEAL ULTRASONOMETRY

PubMed Central

MADIMENOS, FELICIA C.; LIEBERT, MELISSA A.; CEPON-ROBINS, TARA J.; SNODGRASS, J. JOSH; SUGIYAMA, LAWRENCE S.

2014-01-01

Objective Low bone density and osteoporosis prevalence, while well-documented in wealthy nations, are poorly studied in rural, non-clinical contexts in economically-developing regions such as Latin America. This study contributes preliminary osteoporosis risk data for a rural Colono (mestizo) population from Amazonian Ecuador. Methods Anthropometrics were collected for 119 adult participants (74 females, 45 males [50–90 years old]). Heel bone density and T-scores were recorded using calcaneal ultrasonometry Results Approximately 33.6% of the participants had low bone density and were at high-risk for osteoporosis. Four times as many females as males were considered high-risk. Consistent with epidemiological literature, advancing age was significantly associated with lower bone density values (p=0.001). Conclusions Low bone density and osteoporosis prevalence are expected to increase in this and other economically-transitioning populations, yet infrastructure to monitor this changing epidemiological landscape is almost non-existent. Human biologists are uniquely positioned to contribute data from remote populations, a critical step towards initiating increased resource allocation for diagnosis and prevention. PMID:25242164

X-ray evidence of low-energy photon therapy for cervical lordosis restoration and radial head spur healing

NASA Astrophysics Data System (ADS)

Fitz-Ritson, Donald; Filonenko, Natalia; Salansky, Norman M.

1994-09-01

X rays were used for low energy photon therapy (LEPT) efficacy assessment for cervical lordosis restoration and radial head spur healing. Two cases, their evaluation, and treatment are discussed along with the follow-up results.

76 FR 1532 - Determinations of Attainment by the Applicable Attainment Date for the Hayden, Nogales, Paul Spur...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-11

... indicated that we plan to address the PM 10 needs for Nogales and Paul Spur/Douglas areas over the next few... certain columns and rows and thereby causes a mismatch between concentrations and the corresponding years...

miRNA and Degradome Sequencing Reveal miRNA and Their Target Genes That May Mediate Shoot Growth in Spur Type Mutant “Yanfu 6”

PubMed Central

Song, Chunhui; Zhang, Dong; Zheng, Liwei; Zhang, Jie; Zhang, Baojuan; Luo, Wenwen; Li, Youmei; Li, Guangfang; Ma, Juanjuan; Han, Mingyu

2017-01-01

The spur-type growth habit in apple trees is characterized by short internodes, increased number of fruiting spurs, and compact growth that promotes flowering and facilitates management practices, such as pruning. The molecular mechanisms responsible for regulating spur-type growth have not been elucidated. In the present study, miRNAs and the expression of their potential target genes were evaluated in shoot tips of “Nagafu 2” (CF) and spur-type bud mutation “Yanfu 6” (YF). A total of 700 mature miRNAs were identified, including 202 known apple miRNAs and 498 potential novel miRNA candidates. A comparison of miRNA expression in CF and YF revealed 135 differentially expressed genes, most of which were downregulated in YF. YF also had lower levels of GA, ZR, IAA, and ABA hormones, relative to CF. Exogenous applications of GA promoted YF shoot growth. Based on the obtained results, a regulatory network involving plant hormones, miRNA, and their potential target genes is proposed for the molecular mechanism regulating the growth of YF. miRNA164, miRNA166, miRNA171, and their potential targets, and associated plant hormones, appear to regulate shoot apical meristem (SAM) growth. miRNA159, miRNA167, miRNA396, and their potential targets, and associated plant hormones appear to regulate cell division and internode length. This study provides a foundation for further studies designed to elucidate the mechanism underlying spur-type apple architecture. PMID:28424721

Tibio-talo-calcaneal arthrodesis with retrograde compression intramedullary nail fixation for salvage of failed total ankle replacement: a systematic review.

PubMed

Donnenwerth, Michael P; Roukis, Thomas S

2013-04-01

Failed total ankle replacement is a complex problem that should only be treated by experienced foot and ankle surgeons. Significant bone loss can preclude revision total ankle replacement and obligate revision though a complex tibio-talo-calcaneal arthrodesis. A systematic review of the world literature reveals a nonunion rate of 24.2%. A weighted mean of modified American Orthopaedic Foot and Ankle Society Ankle and Hindfoot Scale demonstrated fair patient outcomes of 58.1 points on an 86-point scale (67.6 points on a 100-point scale). Complications were observed in 38 of 62 (62.3%) patients reviewed, with the most common complication being nonunion. Copyright © 2013 Elsevier Inc. All rights reserved.

Baseline Experimental Results on the Effect of Oil Temperature on Shrouded Meshed Spur Gear Windage Power Loss

NASA Technical Reports Server (NTRS)

Delgado, Irebert R.; Hurrell, Michael

2017-01-01

Rotorcraft gearbox efficiencies are reduced at increased surface speeds due to viscous and impingement drag on the gear teeth. This windage power loss can affect overall mission range, payload, and frequency of transmission maintenance. Experimental and analytical studies on shrouding for single gears have shown it to be potentially effective in mitigating windage power loss. Efficiency studies on unshrouded meshed gears have shown the effect of speed, oil viscosity, temperature, load, lubrication scheme, etc. on gear windage power loss. The open literature does not contain experimental test data on shrouded meshed spur gears. Gear windage power loss test results are presented on shrouded meshed spur gears at elevated oil inlet temperatures and constant oil pressure both with and without shrouding. Shroud effectiveness is compared at four oil inlet temperatures. The results are compared to the available literature and follow-up work is outlined.

Baseline Experimental Results on the Effect of Oil Temperature on Shrouded Meshed Spur Gear Windage Power Loss

NASA Technical Reports Server (NTRS)

Delgado, Irebert R.; Hurrell, Michael James

2017-01-01

Rotorcraft gearbox efficiencies are reduced at increased surface speeds due to viscous and impingement drag on the gear teeth. This windage power loss can affect overall mission range, payload, and frequency of transmission maintenance. Experimental and analytical studies on shrouding for single gears have shown it be potentially effective in mitigating windage power loss. Efficiency studies on unshrouded meshed gears have shown the effect of speed, oil viscosity, temperature, load, lubrication scheme, etc. on gear windage power loss. The open literature does not cite data on shrouded meshed spur gears. Gear windage power loss test results are presented on shrouded meshed spur gears at elevated oil inlet temperatures and constant oil pressure both with and without shrouding. Shroud effectiveness is compared at four oil inlet temperatures. The results are compared to the available literature and follow-up work is outlined.

Effects of lubrication on the performance of high speed spur gears

NASA Technical Reports Server (NTRS)

Mizutani, Hachiro; Isikawa, Yuuichi; Townsend, Dennis P.

1989-01-01

An experimental analysis was conducted to determine power loss and gear noise of high speed spur gears with long addendum under various conditions of load, speed, and oil jet pressure for into mesh lubrication. Power losses were calculated from temperature measurements of lubricating oil, gears, gear box, and oil flow rate. Furthermore, power loss was divided into windage loss, friction loss and churning loss. The results show that windage loss and churning loss were the main components of gear power loss of high gear speed. In addition, lubricating conditions had some influences on gear noise especially under low oil temperature or high viscosity.

Formation Mechanisms for Spur and Groove Features on Fringing Reefs

NASA Astrophysics Data System (ADS)

Bramante, J. F.; Ashton, A. D.; Perron, J. T.

2016-12-01

Spur and groove systems (SAGs) are ubiquitous morphological features found on fore-reef slopes globally. SAGs consist of parallel, roughly shore-normal ridges of actively growing coral and coralline algae (spurs) separated by offshore-sloping depressions typically carpeted by a veneer of sediment (grooves). Although anecdotal observations and recent statistical analyses have reported correlations between wave exposure and the distribution of SAGs on fore-reef slopes, the physical mechanisms driving SAG formation remain poorly understood. For example, there remains significant debate regarding the importance of coral growth versus bed erosion for SAG formation. Here we investigate a hypothesis that SAG formation is controlled by feedbacks between sediment production and diffusion and coral growth. Using linear stability analysis, we find that sediment production, coral growth, and the feedbacks between them are unable to produce stable periodic structures without a sediment sink. However, if incipient grooves act as conduits for sediment transport offshore, a positive feedback can develop as the groove bed erodes through wave-driven abrasion during offshore transport. Eventually a negative feedback slows groove deepening when the groove bed is armored by sediment, and the groove bed relaxes to a sediment-veneered equilibrium profile analogous to sediment-rich shorefaces. To test this hypothesis, we apply a numerical model that incorporates coral growth and sediment production, sediment diffusion, non-linear wave-driven abrasion, and sediment advection offshore. This model produces the periodic, linear features characteristic of SAG morphology. The relative magnitude of growth, production, diffusion, abrasion, and advection rates affect periodic spacing or wavelength of the modeled SAGs. Finally, we evaluate the ability of the model to replicate geographical variability in SAG characteristics using previously published datasets and reanalysis wave data.

Effects of intra-operative fluoroscopic 3D-imaging on peri-operative imaging strategy in calcaneal fracture surgery.

PubMed

Beerekamp, M S H; Backes, M; Schep, N W L; Ubbink, D T; Luitse, J S; Schepers, T; Goslings, J C

2017-12-01

Previous studies demonstrated that intra-operative fluoroscopic 3D-imaging (3D-imaging) in calcaneal fracture surgery is promising to prevent revision surgery and save costs. However, these studies limited their focus to corrections performed after 3D-imaging, thereby neglecting corrections after intra-operative fluoroscopic 2D-imaging (2D-imaging). The aim of this study was to assess the effects of additional 3D-imaging on intra-operative corrections, peri-operative imaging used, and patient-relevant outcomes compared to 2D-imaging alone. In this before-after study, data of adult patients who underwent open reduction and internal fixation (ORIF) of a calcaneal fracture between 2000 and 2014 in our level-I Trauma center were collected. 3D-imaging (BV Pulsera with 3D-RX, Philips Healthcare, Best, The Netherlands) was available as of 2007 at the surgeons' discretion. Patient and fracture characteristics, peri-operative imaging, intra-operative corrections and patient-relevant outcomes were collected from the hospital databases. Patients in whom additional 3D-imaging was applied were compared to those undergoing 2D-imaging alone. A total of 231 patients were included of whom 107 (46%) were operated with the use of 3D-imaging. No significant differences were found in baseline characteristics. The median duration of surgery was significantly longer when using 3D-imaging (2:08 vs. 1:54 h; p = 0.002). Corrections after additional 3D-imaging were performed in 53% of the patients. However, significantly fewer corrections were made after 2D-imaging when 3D-imaging was available (Risk difference (RD) -15%; 95% Confidence interval (CI) -29 to -2). Peri-operative imaging, besides intra-operative 3D-imaging, and patient-relevant outcomes were similar between groups. Intra-operative 3D-imaging provides additional information resulting in additional corrections. Moreover, 3D-imaging probably changed the surgeons' attitude to rely more on 3D-imaging, hence a 15%-decrease of

Near-surface temperature and salinity stratification as observed with dual-sensor Lagrangian drifters deployed during SPURS-2 field campaign

NASA Astrophysics Data System (ADS)

Volkov, Denis; Dong, Shenfu; Goni, Gustavo; Lumpkin, Rick; Foltz, Greg

2017-04-01

Despite the importance of sea surface salinity (SSS) as an indicator of the hydrological cycle, many details of air-sea interaction responsible for freshwater fluxes and processes determining the near-surface salinity stratification and its variability are still poorly understood. This is primarily due to the lack of dedicated observations. The advent of satellites capable of monitoring SSS, such as the Soil Moisture and Ocean Salinity (SMOS), Aquarius, and Soil Moisture Active-Passive (SMAP) missions, has greatly advanced our knowledge of SSS distribution and variability. However, the spatial resolution of satellite retrievals is too coarse to study the upper-ocean salinity changes due to patchy and transient rain events. Furthermore, the satellites measure salinity within the upper 1 cm skin layer, which can significantly differ from in situ SSS measured at 5 m depth by most Argo floats. Differences between the Aquarius and Argo SSS can be as large as ±0.5 psu. In order to study the near-surface salinity structure in great detail and to link the satellite observations of SSS with all the oceanic and atmospheric processes that control its variability, the National Aeronautics and Space Administration has initiated two field campaigns within the framework of Salinity Processes in the Upper-Ocean Regional Study (SPURS) project (http://spurs.jpl.nasa.gov/). The first campaign, SPURS-1, took place in the evaporation-dominated subtropical North Atlantic Ocean in 2012-2013. The second campaign, SPURS-2, focused on a 3×3° domain in the Inter-Tropical Convergence Zone (ITCZ) in the eastern equatorial Pacific (123.5-126.5°W and 8.5-11.5°N), where the near-surface salinity is strongly dominated by precipitation. The first SPURS-2 cruise took place in Aug-Sep 2016 on board the R/V Roger Revelle, during which a complex multi-instrument oceanographic survey was conducted. As part of this field campaign, we deployed 6 dual-sensor Lagrangian drifters, specifically designed

Bending strength model for internal spur gear teeth

NASA Technical Reports Server (NTRS)

Savage, Michael; Rubadeux, K. L.; Coe, H. H.

1995-01-01

Internal spur gear teeth are normally stronger than pinion teeth of the same pitch and face width since external teeth are smaller at the base. However, ring gears which are narrower have an unequal addendum or are made of a material with a lower strength than that of the meshing pinion may be loaded more critically in bending. In this study, a model for the bending strength of an internal gear tooth as a function of the applied load pressure angle is presented which is based on the inscribed Lewis constant strength parabolic beam. The bending model includes a stress concentration factor and an axial compression term which are extensions of the model for an external gear tooth. The geometry of the Lewis factor determination is presented, the iteration to determine the factor is described, and the bending strength J factor is compared to that of an external gear tooth. This strength model will assist optimal design efforts for unequal addendum gears and gears of mixed materials.

Ankle joint pressure changes in a pes cavovarus model: supramalleolar valgus osteotomy versus lateralizing calcaneal osteotomy.

PubMed

Schmid, Timo; Zurbriggen, Sebastian; Zderic, Ivan; Gueorguiev, Boyko; Weber, Martin; Krause, Fabian G

2013-09-01

A fixed cavovarus foot deformity can be associated with anteromedial ankle arthrosis due to elevated medial joint contact stresses. Supramalleolar valgus osteotomies (SMOT) and lateralizing calcaneal osteotomies (LCOT) are commonly used to treat symptoms by redistributing joint contact forces. In a cavovarus model, the effects of SMOT and LCOT on the lateralization of the center of force (COF) and reduction of the peak pressure in the ankle joint were compared. A previously published cavovarus model with fixed hindfoot varus was simulated in 10 cadaver specimens. Closing wedge supramalleolar valgus osteotomies 3 cm above the ankle joint level (6 and 11 degrees) and lateral sliding calcaneal osteotomies (5 and 10 mm displacement) were analyzed at 300 N axial static load (half body weight). The COF migration and peak pressure decrease in the ankle were recorded using high-resolution TekScan pressure sensors. A significant lateral COF shift was observed for each osteotomy: 2.1 mm for the 6 degrees (P = .014) and 2.3 mm for the 11 degrees SMOT (P = .010). The 5 mm LCOT led to a lateral shift of 2.0 mm (P = .042) and the 10 mm LCOT to a shift of 3.0 mm (P = .006). Comparing the different osteotomies among themselves no significant differences were recorded. No significant anteroposterior COF shift was seen. A significant peak pressure reduction was recorded for each osteotomy: The SMOT led to a reduction of 29% (P = .033) for the 6 degrees and 47% (P = .003) for the 11 degrees osteotomy, and the LCOT to a reduction of 41% (P = .003) for the 5 mm and 49% (P = .002) for the 10 mm osteotomy. Similar to the COF lateralization no significant differences between the osteotomies were seen. LCOT and SMOT significantly reduced anteromedial ankle joint contact stresses in this cavovarus model. The unloading effects of both osteotomies were equivalent. More correction did not lead to significantly more lateralization of the COF or more reduction of peak pressure but a trend was

[CT morphometry for calcaneal fractures and comparison of the Zwipp and Sanders classifications].

PubMed

Andermahr, J; Jesch, A B; Helling, H J; Jubel, A; Fischbach, R; Rehm, K E

2002-01-01

The aim of the study is to correlate the CT-morphological changes of fractured calcaneus and the classifications of Zwipp and Sanders with the clinical outcome. In a retrospective clinical study, the preoperative CT scans of 75 calcaneal fractures were analysed. The morphometry of the fractures was determined by measuring height, length diameter and calcaneo-cuboidal angle in comparison to the intact contralateral side. At a mean of 38 months after trauma 44 patients were clinically followed-up. The data of CT image morphometry were correlated with the severity of fracture classified by Zwipp or Sanders as well as with the functional outcome. There was a good correlation between the fracture classifications and the morphometric data. Both fracture classifying systems have a predictive impact for functional outcome. The more exacting and accurate Zwipp classification considers the most important cofactors like involvement of the calcaneo-cuboidal joint, soft tissue damage, additional fractures etc. The Sanders classification is easier to use during clinical routine. The Zwipp classification includes more relevant cofactors (fracture of the calcaneo-cuboidal-joint, soft tissue swelling, etc.) and presents a higher correlation to the choice of therapy. Both classification systems present a prognostic impact concerning the clinical outcome.

[Treatment of calcaneal fractures using the medial approach for open reduction].

PubMed

Vanĕcek, L; Malkus, T; Dungl, P

2003-01-01

A comprehensive evaluation of the treatment of calcaneal fractures by open reduction is presented. The long-term results are compared with the relevant literature data. In the period from 1987 to 2000, 60 displaced fractures of the calcaneus were treated in 51 patients. Of these, 49 patients suffered the fracture by falling from a height, which is generally the most common cause. Only two patients were injured during sports activities. Thirty eight injuries were classified as fractures of the joint depression type and 22 as fractures of the tongue type. The patients had surgery on the day they sustained the injury or after edema had subsided, if this was present on admission. The interval between injury and surgery was 4.6 days on the average. The fracture was fixed with Kirschner's wires (Kw) in 53 cases, a Kirshcner's wire and a hook-nail in five cases and a Kirchner's wire and a spongious screw in two patients. In May 2001, 23 patients were available for evaluation after a follow-up period of 6 to 120 months. The patients underwent clinical and radiographic examination and filled a questionnaire. The fracture type was defined on the basis of the Essex-Lopresti classification system. Outcomes were scored according to the Creighton-Nebraska Health Foundation rating system that assessed pain, range of motion, edema, a change in shoe size, patient's activity after therapy termination and return to a job. In May 2001, 23 patients, with a follow-up ranging from 6 to 120 months were checked up. Of them, 20 (86.9%) had neither clinical manifestations nor subjective complaints. Three patients retired because of persisting complaints, two with disability pensions and one with an old-age pension. A total of 19 patients were evaluated by the Creighton-Nebraska Health Foundation rating system. The average score was 90.8 points. The results were excellent in 15 patients, good in three and poor in one patient. The complications reported by the patients included superficial

A non-linear mathematical model for dynamic analysis of spur gears including shaft and bearing dynamics

NASA Technical Reports Server (NTRS)

Ozguven, H. Nevzat

1991-01-01

A six-degree-of-freedom nonlinear semi-definite model with time varying mesh stiffness has been developed for the dynamic analysis of spur gears. The model includes a spur gear pair, two shafts, two inertias representing load and prime mover, and bearings. As the shaft and bearing dynamics have also been considered in the model, the effect of lateral-torsional vibration coupling on the dynamics of gears can be studied. In the nonlinear model developed several factors such as time varying mesh stiffness and damping, separation of teeth, backlash, single- and double-sided impacts, various gear errors and profile modifications have been considered. The dynamic response to internal excitation has been calculated by using the 'static transmission error method' developed. The software prepared (DYTEM) employs the digital simulation technique for the solution, and is capable of calculating dynamic tooth and mesh forces, dynamic factors for pinion and gear, dynamic transmission error, dynamic bearing forces and torsions of shafts. Numerical examples are given in order to demonstrate the effect of shaft and bearing dynamics on gear dynamics.

Conservation assessment for great-spurred violet in the Black Hills National Forest, South Dakota and Wyoming

Treesearch

J. Hope Hornbeck; Carolyn Hull Sieg; Deanna J. Reyher

2003-01-01

Great-spurred violet (Viola selkirkii Pursh ex Goldie; Violaceae) is an early spring flowering herb that occurs in the boreal and Rocky Mountain regions of North America, and cool temperate regions of Eurasia, eastern China and Japan. In the Black Hills, the species is restricted to spruce-dominated forests in cold, shady ravines from 5,400 to 7,000...

Effect of extended tooth contact on the modeling of spur gear transmissions

NASA Technical Reports Server (NTRS)

Oswald, Fred B.; Coy, John J.; Lin, Hsiang Hsi; Wang, Jifeng

1993-01-01

In some gear dynamic models, the effect of tooth flexibility is ignored when the model determines which pairs of teeth are in contact. Deflection of loaded teeth is not introduced until the equations of motion are solved. This means the zone of tooth contact and average tooth meshing stiffness are underestimated and the individual tooth load is overstated, especially for heavily-loaded gears. The static transmission error and dynamic load of heavily-loaded, low-contact-ratio spur gears is compared with this effect both neglected and included. Neglecting the effect yields an underestimate of resonance speeds and an overestimate of the dynamic load.

Increased Surface Fatigue Lives of Spur Gears by Application of a Coating

NASA Technical Reports Server (NTRS)

Krantz, Timothy L.; Cooper, Clark V.; Townsend, Dennis P.; Hansen, Bruce D.

2003-01-01

Hard coatings have potential for increasing gear surface fatigue lives. Experiments were conducted using gears both with and without a metal-containing, carbonbased coating. The gears were case-carburized AISI 9310 steel spur gears. Some gears were provided with the coating by magnetron sputtering. Lives were evaluated by accelerated life tests. For uncoated gears, all of fifteen tests resulted in fatigue failure before completing 275 million revolutions. For coated gears, eleven of the fourteen tests were suspended with no fatigue failure after 275 million revolutions. The improved life owing to the coating, approximately a six-fold increase, was a statistically significant result.

Seismic characterization of fluid migration and Pockmarks in the Estremadura Spur, West Iberian Margin, Portugal

NASA Astrophysics Data System (ADS)

Duarte, Débora; Magalhães, Vitor Hugo; Terrinha, Pedro; Ribeiro, Carlos; Madureira, Pedro; Menezes Pinheiro, Luís; Benazzouz, Omar; Kim, Jung-Hyun; Duarte, Henrique

2017-04-01

Recently a field with more than 70 pockmarks was discovered in the NW region of the Estremadura Spur outer shelf (West Iberian margin), a trapezoidal promontory elongated in an east-west direction, between Cabo Carvoeiro and Cabo da Roca, extending until the Tore seamount. Pockmarks are the seabed culminations of fluid migration through the sedimentary column and their characteristic seabed morphologies correspond to cone-shaped circular or elliptical depressions. These features and the associated fluid escape process are the main objectives of this work. Here we characterize these structures to understand their structural and stratigraphic control based on: 1) Seismic processing and interpretation of the high resolution 2D single-channel sparker seismic dataset, 2) Bathymetric and Backscatter interpretation and 3) ROV direct observation of the seafloor. The analysis of the seismic profiles allowed the identification of six seismic units, disturbed by the migration and accumulation of fluids. The Estremadura Spur outer shelf has been affected by several episodes of fluid migration and fluid escape during the Pliocene-Quaternary that are expressed by a vast number of seabed and buried pockmarks. At present, the pockmarks are mainly inactive, as the seabed pockmarks are covered by recent sediments. The stacking of various pockmarks suggests a cyclical fluid flow activity that can possibly be the result of the eustatic sea level variations and the subsequent changes of the hydrostatic pressure. The origin of the seep fluids is still under debate but considering the low-sedimentation rate of the area and the low productivity a deep source for the fluids is most probable, possibly related with the Jurassic hydrocarbon system. It was concluded that the migration of fluids to the seabed occurred over the Pliocene-Quaternary in several episodes, as indicated by the buried pockmarks at different depths. Acknowledgements: This work was carried out in the framework of the PES

The Spectrum of Monogenic Autoinflammatory Syndromes: Understanding Disease Mechanisms and Use of Targeted Therapies

PubMed Central

Glaser, Rachel L.; Goldbach-Mansky, Raphaela

2009-01-01

Monogenic autoinflammatory diseases encompass a distinct and growing clinical entity of multisystem inflammatory diseases with known genetic defects in the innate immune system. The diseases present clinically with episodes of seemingly unprovoked inflammation (fever, rashes, and elevation of acute phase reactants). Understanding the genetics has led to discovery of new molecules involved in recognizing exogenous and endogenous danger signals, and the inflammatory response to these stimuli. These advances have furthered understanding of innate inflammatory pathways and spurred collaborative research in rheumatology and infectious diseases. The pivotal roles of interleukin (IL)-1β in cryopyrin-associated periodic syndromes, tumor necrosis factor (TNF) in TNF receptor-associated periodic syndrome, and links to inflammatory cytokine dysregulation in other monogenic autoinflammatory diseases have resulted in effective therapies targeting proinflammatory cytokines IL-1β and TNF and uncovered other new potential targets for anti-inflammatory therapies. PMID:18606080

Imaging study of the painful heel syndrome

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

Williams, P.L.; Smibert, J.G.; Cox, R.

1987-06-01

A total of 45 patients with the painful heel syndrome without evidence of an associated inflammatory arthritis, seven of whom had pain in both heels, were studied using technetium-99 isotope bone scans and lateral and 45 degrees medial oblique radiographs of both feet. Of the 52 painful heels 31 (59.6%) showed increased uptake of tracer at the calcaneum. Patients with scans showing increased uptake tended to have more severe heel pain and responded more frequently to a local hydrocortisone injection. On plain x-ray, 39 of 52 painful heels (75%) and 24 of the 38 opposite nonpainful heels (63%) showed plantarmore » spurs, compared with five of 63 (7.9%) heels in 59 age- and sex-matched controls. No evidence of stress fractures was seen.« less

Calcaneal Quantitative Ultrasound Indicates Reduced Bone Status Among Physically Active Adult Forager-Horticulturalists.

PubMed

Stieglitz, Jonathan; Madimenos, Felicia; Kaplan, Hillard; Gurven, Michael

2016-03-01

Sedentary lifestyle contributes to osteoporosis and fragility fracture risks among modern humans, but whether such risks are prevalent in physically active preindustrial societies with lower life expectancies is unclear. Osteoporosis should be readily observable in preindustrial societies if it was regularly experienced over human history. In this study of 142 older adult Tsimane forager-horticulturalists (mean age ± SD, 62.1 ± 8.6 years; range, 50 to 85 years; 51% female) we used calcaneal quantitative ultrasonography (qUS) to assess bone status, document prevalence of adults with reduced bone status, and identify factors (demographic, anthropometric, immunological, kinesthetic) associated with reduced bone status. Men (23%) are as likely as women (25%) to have reduced bone status, although age-related decline in qUS parameters is attenuated for men. Adiposity and fat-free mass positively co-vary with qUS parameters for women but not men. Leukocyte count is inversely associated with qUS parameters controlling for potential confounders; leukocyte count is positively correlated within adults over time, and adults with persistently low counts have higher adjusted qUS parameters (6% to 8%) than adults with a high count. Reduced bone status characteristic of osteoporosis is common among active Tsimane with minimal exposure to osteoporosis risk factors found in industrialized societies, but with energetic constraints and high pathogen burden. © 2015 American Society for Bone and Mineral Research.

Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality

PubMed Central

Thapa, Deepak; Ahuja, Vanita

2014-01-01

Plantar fasciitis (PF) is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF). Following a diagnostic medial calcaneal nerve (MCN) block at its origin, we observed reduction in verbal numerical rating scale (VNRS) in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF). All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF. PMID:24963184

Dynamic Capacity and Surface Fatigue Life for Spur and Helical Gears

NASA Technical Reports Server (NTRS)

Coy, J. J.; Townsend, D. P.; Zaretsky, E. V.

1975-01-01

A mathematical model for surface fatigue life of gear, pinion, or entire meshing gear train is given. The theory is based on a previous statistical approach for rolling-element bearings. Equations are presented which give the dynamic capacity of the gear set. The dynamic capacity is the transmitted tangential load which gives a 90 percent probability of survival of the gear set for one million pinion revolutions. The analytical results are compared with test data for a set of AISI 9310 spur gears operating at a maximum Hertz stress of 1.71 billion N/sq m and 10,000 rpm. The theoretical life predictions are shown to be good when material constants obtained from rolling-element bearing tests were used in the gear life model.

The ESR1 (6q25) Locus Is Associated with Calcaneal Ultrasound Parameters and Radial Volumetric Bone Mineral Density in European Men

PubMed Central

Thomson, Wendy; Boonen, Steven; Borghs, Herman; Vanderschueren, Dirk; Gielen, Evelien; Huhtaniemi, Ilpo T.; Adams, Judith E.; Ward, Kate A.; Bartfai, Gyorgy; Casanueva, Felipe; Finn, Joseph D.; Forti, Gianni; Giwercman, Aleksander; Han, Thang S.; Kula, Krzysztof; Labrie, Fernand; Lean, Michael E. J.; Pendleton, Neil; Punab, Margus; Wu, Frederick C. W.; O'Neill, Terence W.

2011-01-01

Purpose Genome-wide association studies (GWAS) have identified 6q25, which incorporates the oestrogen receptor α gene (ESR1), as a quantitative trait locus for areal bone mineral density (BMDa) of the hip and lumbar spine. The aim of this study was to determine the influence of this locus on other bone health outcomes; calcaneal ultrasound (QUS) parameters, radial peripheral quantitative computed tomography (pQCT) parameters and markers of bone turnover in a population sample of European men. Methods Eight single nucleotide polymorphisms (SNP) in the 6q25 locus were genotyped in men aged 40–79 years from 7 European countries, participating in the European Male Ageing Study (EMAS). The associations between SNPs and measured bone parameters were tested under an additive genetic model adjusting for centre using linear regression. Results 2468 men, mean (SD) aged 59.9 (11.1) years had QUS measurements performed and bone turnover marker levels measured. A subset of 628 men had DXA and pQCT measurements. Multiple independent SNPs showed significant associations with BMD using all three measurement techniques. Most notably, rs1999805 was associated with a 0.10 SD (95%CI 0.05, 0.16; p = 0.0001) lower estimated BMD at the calcaneus, a 0.14 SD (95%CI 0.05, 0.24; p = 0.004) lower total hip BMDa, a 0.12 SD (95%CI 0.02, 0.23; p = 0.026) lower lumbar spine BMDa and a 0.18 SD (95%CI 0.06, 0.29; p = 0.003) lower trabecular BMD at the distal radius for each copy of the minor allele. There was no association with serum levels of bone turnover markers and a single SNP which was associated with cortical density was also associated with cortical BMC and thickness. Conclusions Our data replicate previous associations found between SNPs in the 6q25 locus and BMDa at the hip and extend these data to include associations with calcaneal ultrasound parameters and radial volumetric BMD. PMID:21760950

Effect of geometry and operating conditions on spur gear system power loss

NASA Technical Reports Server (NTRS)

Anderson, N. E.; Loewenthal, S. H.

1980-01-01

The results of an analysis of the effects of spur gear size, pitch, width, and ratio on total mesh power loss for a wide range of speeds, torques, and oil viscosities are presented. The analysis uses simple algebraic expressions to determine gear sliding, rolling, and windage losses and also incorporates an approximate ball bearing power loss expression. The analysis shows good agreement with published data. Large diameter and fine pitched gears had higher peak efficiencies but low part load efficiency. Gear efficiencies were generally greater than 98 percent except at very low torque levels. Tare (no-load) losses are generally a significant percentage of the full load loss except at low speeds.

Effect of geometry and operating conditions on spur gear system power loss

NASA Technical Reports Server (NTRS)

Anderson, N. E.; Loewenthal, S. H.

1980-01-01

The results of an analysis of the effects of spur gear size, pitch, width and ratio on total mesh power loss for a wide range of speeds, torques and oil viscosities are presented. The analysis uses simple algebraic expressions to determine gear sliding, rolling and windage losses and also incorporates an approximate ball bearing power loss expression. The analysis shows good agreement with published data. Large diameter and fine-pitched gears had higher peak efficiencies but lower part-load efficiency. Gear efficiencies were generally greater than 98 percent except at very low torque levels. Tare (no-load) losses are generally a significant percentage of the full-load loss except at low speeds.

Treatment of unicameral calcaneal bone cysts in children: review of literature and results using a cannulated screw for continuous decompression of the cyst.

PubMed

Saraph, Vinay; Zwick, Ernst-Bernhard; Maizen, Claudia; Schneider, Frank; Linhart, Wolfgang E

2004-01-01

Nine unicameral bone cysts of the calcaneus in children were managed surgically using the technique of continuous decompression with titanium cannulated cancellous screws. The average age of the patients at surgery was 12.8 years. At follow-up a minimum of 2 years after surgery, eight cysts showed complete healing; one patient showed healing with residuals. Irritation at the screw insertion site necessitated early removal of the screw in one patient; implant-related problems were not observed in the other patients. Patients were allowed to bear weight after surgery. Implant extraction was performed after full consolidation of the cyst and was uneventful in all patients. A review of the literature and the different treatment modalities used for managing calcaneal cysts is also presented.

Active vibration control of a single-stage spur gearbox

NASA Astrophysics Data System (ADS)

Dogruer, C. U.; Pirsoltan, Abbas K.

2017-02-01

The dynamic transmission error between driving and driven gears of a gear mechanism with torsional mode is induced by periodic time-varying mesh stiffness. In this study, to minimize the adverse effect of this time-varying mesh stiffness, a nonlinear controller which adjusts the torque acting on the driving gear is proposed. The basic approach is to modulate the input torque such that it compensates the periodic change in mesh stiffness. It is assumed that gears are assembled with high precision and gearbox is analyzed by a finite element software to calculate the mesh stiffness curve. Thus, change in the mesh stiffness, which is inherently nonlinear, can be predicted and canceled by a feed-forward loop. Then, remaining linear dynamics is controlled by pole placement techniques. Under these premises, it is claimed that any acceleration and velocity profile of the input shaft can be tracked accurately. Thereby, dynamic transmission error is kept to a minimum possible value and a spur gearbox, which does not emit much noise and vibration, is designed.

Risk factors affecting chronic rupture of the plantar fascia.

PubMed

Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung

2014-03-01

Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis. We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups. Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33. Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture. Level III, retrospective comparative study.

Handbook on Face Gear Drives with a Spur Involute Pinion

NASA Technical Reports Server (NTRS)

Litvin, F. L.; Egelja, A.; Tan, J.; Chen, D. Y.-D.; Heath, G.

2000-01-01

The use of face gears in power transmission and drive systems has a significant number of benefits. Face gears allow a variety of new transmission arrangements as well as high reduction ratio capability. This leads to drive system weight reduction and improvements in performance. In this work, basic information about the design and analysis of face gear drives is presented. The work considers face gears in mesh with spur involute pinions for both intersecting axes and offset drives. Tooth geometry, kinematics, generation of face gears with localized bearing contact by cutting and grinding, avoidance of tooth undercutting, avoidance of tooth pointing, tooth contact analysis, and algorithms for the simulation of meshing and contact arc all topics which are discussed. In addition, applications of face gear drives are presented. Included are design uses in aerospace applications such as helicopter transmissions, split-torque face gear arrangements, comparisons of face gears with bevel gears, and general design considerations.

Outcomes of a Stepcut Lengthening Calcaneal Osteotomy for Adult-Acquired Flatfoot Deformity.

PubMed

Demetracopoulos, Constantine A; Nair, Pallavi; Malzberg, Andrew; Deland, Jonathan T

2015-07-01

Lateral column lengthening is used to correct abduction deformity at the midfoot and improve talar head coverage in patients with flatfoot deformity. It was our hypothesis that following a stepcut lengthening calcaneal osteotomy (SLCO), patients would have adequate correction of the deformity, a high union rate of the osteotomy, and improvement in clinical outcome scores. We retrospectively reviewed 37 consecutive patients who underwent SLCO for the treatment of stage IIB flatfoot deformity with a minimum 2-year follow-up. Deformity correction was assessed using preoperative and postoperative weight-bearing radiographs. Healing of the osteotomy was assessed by computed tomography. Clinical outcomes included the FAOS and SF-36 questionnaires. The Wilcoxon signed-rank test was used to compare clinical outcome scores. An alpha level of .05 was deemed statistically significant. Healing of the osteotomy occurred at a mean of 7.7 weeks postoperatively. The talonavicular (TN) coverage angle improved from 34.0 to 8.8 (P < .001), the percentage of TN uncoverage improved from 40.9% to 17.7% (P < .001), and the TN incongruency angle improved from 68.1 to 8.7 (P < .001). In addition, there was an improvement in FAOS pain (P < .001), daily activities (P < .001), sport activities (P = .006), and quality of life scores (P < .001). Overall SF-36 scores also showed improvement postoperatively (P < .001). There was no incidence of delayed union, nonunion, or graft collapse. Following SLCO, patients demonstrated excellent healing, good correction of the deformity, and improvement in clinical outcomes scores. The SLCO is an alternative to the Evans osteotomy for lateral column lengthening. Level IV, retrospective case review. © The Author(s) 2015.

Contact stresses in meshing spur gear teeth: Use of an incremental finite element procedure

NASA Technical Reports Server (NTRS)

Hsieh, Chih-Ming; Huston, Ronald L.; Oswald, Fred B.

1992-01-01

Contact stresses in meshing spur gear teeth are examined. The analysis is based upon an incremental finite element procedure that simultaneously determines the stresses in the contact region between the meshing teeth. The teeth themselves are modeled by two dimensional plain strain elements. Friction effects are included, with the friction forces assumed to obey Coulomb's law. The analysis assumes that the displacements are small and that the tooth materials are linearly elastic. The analysis procedure is validated by comparing its results with those for the classical two contacting semicylinders obtained from the Hertz method. Agreement is excellent.

The vascularization of the os calcaneum and the clinical consequences.

PubMed

Andermahr, J; Helling, H J; Rehm, K E; Koebke, Z

1999-06-01

This study was conducted to analyze extraosseous and intraosseous vascularization of the os calcaneum and to elucidate possible clinical manifestations. The arteries of 13 lower leg and foot specimens of human cadavers were injected with a polymer and subjected to maceration or were embedded in plastic. The examination revealed that 45% of the bone is vascularized via medial arteries and 45% via lateral arteries, whereas the remaining 10% is supplied by the sinus tarsi artery. From the medial side, two or three vessels branch off the posterior tibial artery, penetrate the calcaneus below the sustentaculum, and supply the medial part of the posterior joint. The lateral calcaneal artery normally is a branch from the posterior tibial artery. In two of 13 specimens, this lateral supply comes from the peroneal artery. The medial and lateral intraosseous arterial supply for the calcaneus is equal. Inside the bone there is a water-shed zone where the medial and lateral arterial supply meet in the midline. Only 10% of the blood flow is supplied by vessels in the sinus tarsi. Clinically, interruption of the lateral calcaneal artery during the conventional lateral surgical approach for a calcaneus fracture may result in ischemic bone necrosis. The lateral calcaneal artery could supply a local microvascular flap to cover soft tissue defects of the heel. A compartment syndrome after a calcaneus fracture may be caused by bleeding from the medial calcaneal arteries into the quadratus plantae compartment.

Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts.

PubMed

Wu, Zhanpo; Su, Yanling; Chen, Wei; Zhang, Qi; Liu, Yueju; Li, Ming; Wang, Haili; Zhang, Yingze

2012-09-01

The purpose of this study is to assess the clinical results of a minimally invasive treatment featured the concept of internal compression, including an anatomic plate and multiple compression bolts compared with open reduction and internal fixation for displaced intra-articular calcaneal fractures (DIACFs). We retrospectively analyzed 329 patients (383 feet) who were identified from trauma inpatient database in our hospital for DIACFs from January 2004 to December 2009. Of them, 148 patients (170 feet) were treated with open reduction and internal fixation (OR group), which involved using a traditional L-shaped extended lateral approach, and fractures were fixed by plate and screws from January 2004 to December 2006; 181 patients (213 feet) were treated with a minimally invasive approach featured the concept of calcaneal internal compression (CIC group), which was achieved by an anatomic plate and multiple compression bolts through a small lateral incision from January 2007 to December 2009. Postoperative complications were recorded. During follow-up, pain and functional outcome were evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) scores and compared between the two groups. Subsequent subtalar arthrodesis and early implant removal were performed when indicated. Routine hardware removal was scheduled for all patients at 1-year follow-up. There were no significant differences in sex, age, and fracture classification (Sanders classification) between the two groups. Wound healing complications were 4 of 213 (1.88%) in CIC group and 20 of 170 (11.76%) in OR group. Subtalar arthrodesis had to be performed in one case in OR group. Four cases in CIC group and four cases in OR group had the hardware removed earlier due to complications. The average time after surgery to start weight-bearing exercise is 5.64 weeks in CIC group and 9.38 weeks in OR group (p < 0.001). The mean AOFAS score is higher in CIC group than in OR group, although the difference

PTT functional recovery in early stage II PTTD after tendon balancing and calcaneal lengthening osteotomy.

PubMed

Brilhault, Jean; Noël, Vincent

2012-10-01

The decision to offer surgery for Stage II posterior tibial tendon deficiency (PTTD) is a difficult one since orthotic treatment has been documented to be a viable alternative to surgery at this stage. Taking this into consideration we limited our treatment to bony realignment by a lengthening calcaneus Evans osteotomy and tendon balancing. The goal of the study was to clinically evaluate PTT functional recovery with this procedure. The patient population included 17 feet in 13 patients. Inclusion was limited to early Stage II PTTD flatfeet with grossly intact but deficient PTT. Deficiency was assessed by the lack of hindfoot inversion during single heel rise test. The surgical procedure included an Evans calcaneal opening wedge osteotomy with triceps surae and peroneus brevis tendon lengthening. PTT function at follow up was evaluated by an independent examiner. Evaluation was performed at an average of 4 (range, 2 to 6.3) years. One case presented postoperative subtalar pain that required subtalar fusion. Every foot could perform a single heel rise with 13 feet having active inversion of the hindfoot during elevation. The results of this study provide evidence of PTT functional recovery without augmentation in early Stage II. It challenges our understanding of early Stage II PTTD as well as the surgical guidelines recommending PTT augmentation at this specific stage.

Effect of contact ratio on spur gear dynamic load

NASA Technical Reports Server (NTRS)

Liou, Chuen-Huei; Lin, Hsiang Hsi; Oswald, Fred B.; Townsend, Dennis P.

1992-01-01

A computer simulation is presented which shows how the gear contact ratio affects the dynamic load on a spur gear transmission. The contact ratio can be affected by the tooth addendum, the pressure angle, the tooth size (diametral pitch), and the center distance. The analysis presented was performed using the NASA gear dynamics code, DANST. In the analysis, the contact ratio was varied over the range 1.20 to 2.40 by changing the length of the tooth addendum. In order to simplify the analysis, other parameters related to contact ratio were held constant. The contact ratio was found to have a significant influence on gear dynamics. Over a wide range of operating speeds, a contact ratio close to 2.0 minimized dynamic load. For low contact ratio gears (contact ratio less than 2.0), increasing the contact ratio reduced the gear dynamic load. For high contact ratio gears (contact ratio = or greater than 2.0), the selection of contact ratio should take into consideration the intended operating speeds. In general, high contact ratio gears minimized dynamic load better than low contact ratio gears.

The rs3736228 polymorphism in the LRP5 gene is associated with calcaneal ultrasound parameter but not with body composition in a cohort of young Caucasian adults.

PubMed

Correa-Rodríguez, María; Schmidt-RioValle, Jacqueline; Rueda-Medina, Blanca

2017-11-01

The aim of the present study was to investigate the possible influence of low-density lipoprotein receptor-related protein 5 (LRP5) and sclerostin (SOST) genes as genetic factors contributing to calcaneal quantitative ultrasound (QUS) and body composition variables in a population of young Caucasian adults. The study population comprised a total of 575 individuals (mean age 20.41years; SD 2.36) whose bone mass was assessed through QUS to determine broadband ultrasound attenuation (BUA, dB/MHz). Body composition measurements were performed using a body composition analyser. Seven single-nucleotide polymorphisms (SNPs) of LRP5 (rs2306862, rs599083, rs556442 and rs3736228) and SOST (rs4792909, rs851054 and rs2023794) were selected as genetic markers and genotyped using TaqMan OpenArray ® technology. Linear regression analysis was used to test the possible association of the tested SNPs with QUS and body composition parameters. Linear regression analysis revealed that the rs3736228 SNP of LPR5 was significantly associated with BUA after adjustment for age, sex, weight, height, physical activity and calcium intake (P = 0.028, β (95% CI) = 0.089 (0.099-1.691). For the remaining SNPs, no significant association with the QUS measurement was observed. Regarding body composition, no significant association was found between LRP5 and SOST polymorphisms and body mass index, total fat mass and total lean mass after adjustment for age and sex as covariates. We concluded that the rs3736228 LRP5 genetic polymorphism influences calcaneal QUS parameter in a population of young Caucasian adults. This finding suggests that LRP5 might be an important genetic marker contributing to bone mass accrual early in life.

A Preliminary Study on the Vapor/Mist Phase Lubrication of a Spur Gearbox

NASA Technical Reports Server (NTRS)

Morales, Wilfredo; Handschuh, Robert F.

1999-01-01

Organophosphates have been the primary compounds used in vapor/mist phase lubrication studies involving ferrous bearing material. Experimental results have indicated that the initial formation of an iron phosphate film on a rubbing ferrous surface, followed by the growth (by cationic diffusion) of a lubricious pyrophosphate-type coating over the iron phosphate, is the reason organophosphates work well as vapor/mist phase lubricants. Recent work, however, has shown that this mechanism leads to the depletion of surface iron atoms and to eventual lubrication failure. A new organophosphate formulation was developed which circumvents surface iron depletion. This formulation was tested by generating an iron phosphate coating on an aluminum surface. The new formulation was then used to vapor/mist phase lubricate a spur gearbox in a preliminary study.

Ecomorphological analysis of the astragalo-calcaneal complex in rodents and inferences of locomotor behaviours in extinct rodent species

PubMed Central

Hautier, Lionel; Marivaux, Laurent; Vianey-Liaud, Monique

2016-01-01

Studies linking postcranial morphology with locomotion in mammals are common. However, such studies are mostly restricted to caviomorphs in rodents. We present here data from various families, belonging to the three main groups of rodents (Sciuroidea, Myodonta, and Ctenohystrica). The aim of this study is to define morphological indicators for the astragalus and calcaneus, which allow for inferences to be made about the locomotor behaviours in rodents. Several specimens were dissected and described to bridge the myology of the leg with the morphology of the bones of interest. Osteological characters were described, compared, mechanically interpreted, and correlated with a “functional sequence” comprising six categories linked to the lifestyle and locomotion (jumping, cursorial, generalist, fossorial, climber and semi-aquatic). Some character states are typical of some of these categories, especially arboreal climbers, fossorial and “cursorial-jumping” taxa. Such reliable characters might be used to infer locomotor behaviours in extinct species. Linear discriminant analyses (LDAs) were used on a wider sample of species and show that astragalar and calcaneal characters can be used to discriminate the categories among extant species whereas a posteriori inferences on extinct species should be examined with caution. PMID:27761303

The effect of gait velocity on calcaneal balance at heel strike; Implications for orthotic prescription in injury prevention.

PubMed

Shanthikumar, Shivanthan; Low, Zi; Falvey, Eanna; McCrory, Paul; Franklyn-Miller, Andy

2010-01-01

Exercise related lower limb injuries (ERLLI), are common in the recreational and competitive sporting population. Although ERLLI are thought to be multi-factorial in aetiology, one of the critical predisposing factors is known to gait abnormality. There is little published evidence comparing walking and running gait in the same subjects, and no evidence on the effect of gait velocity on calcaneal pronation, even though this may have implications for orthotic prescription and injury prevention. In this study, the walking and running gait of 50 physically active subjects was assessed using pressure plate analysis. The results show that rearfoot pronation occurs on foot contact in both running and walking gait, and that there is significantly more rearfoot pronation in walking gait (p<0.01). The difference in the magnitude of rearfoot pronation affected foot orthoses prescription. A 63% fall in computerized correction suggested by RSscan D3D software prescription was seen, based on running vs. walking gait. The findings of this study suggest that in the athletic population orthoses prescription should be based on dynamic assessment of running gait. Crown Copyright 2009. Published by Elsevier B.V. All rights reserved.

Design and Analysis of Tooth Impact Test Rig for Spur Gear

NASA Astrophysics Data System (ADS)

Ghazali, Wafiuddin Bin Md; Aziz, Ismail Ali Bin Abdul; Daing Idris, Daing Mohamad Nafiz Bin; Ismail, Nurazima Binti; Sofian, Azizul Helmi Bin

2016-02-01

This paper is about the design and analysis of a prototype of tooth impact test rig for spur gear. The test rig was fabricated and analysis was conducted to study its’ limitation and capabilities. The design of the rig is analysed to ensure that there will be no problem occurring during the test and reliable data can be obtained. From the result of the analysis, the maximum amount of load that can be applied, the factor of safety of the machine, the stresses on the test rig parts were determined. This is important in the design consideration of the test rig. The materials used for the fabrication of the test rig were also discussed and analysed. MSC Nastran Patran software was used to analyse the model, which was designed by using SolidWorks 2014 software. Based from the results, there were limitations found from the initial design and the test rig design needs to be improved in order for the test rig to operate properly.

Balancing Dynamic Strength of Spur Gears Operated at Extended Center Distance

NASA Technical Reports Server (NTRS)

Lin, Hsiang Hsi; Liou, Chuen-Huei; Oswald, Fred B.; Townsend, Dennis P.

1996-01-01

This paper presents an analytical study on using hob offset to balance the dynamic tooth strength of spur gears operated at a center distance greater than the standard value. This study is an extension of a static study by Mabie and others. The study was limited to the offset values that assure the pinion and gear teeth will neither be undercut nor become pointed. The analysis presented in this paper was performed using DANST-PC, a new version of the NASA gear dynamics code. The operating speed of the transmission influences the amount of hob offset required to equalize the dynamic stresses in the pinion and gear. The optimum hob offset for the pinion was found to vary within a small range as the speed changes. The optimum value is generally greater than the optimum value found by static procedures. For gears that must operate over a wide range of speeds, an average offset value may be used.

Nonlinear dynamics analysis of the spur gear system for railway locomotive

NASA Astrophysics Data System (ADS)

Wang, Junguo; He, Guangyue; Zhang, Jie; Zhao, Yongxiang; Yao, Yuan

2017-02-01

Considering the factors such as the nonlinearity backlash, static transmission error and time-varying meshing stiffness, a three-degree-of-freedom torsional vibration model of spur gear transmission system for a typical locomotive is developed, in which the wheel/rail adhesion torque is considered as uncertain but bounded parameter. Meantime, the Ishikawa method is used for analysis and calculation of the time-varying mesh stiffness of the gear pair in meshing process. With the help of bifurcation diagrams, phase plane diagrams, Poincaré maps, time domain response diagrams and amplitude-frequency spectrums, the effects of the pinion speed and stiffness on the dynamic behavior of gear transmission system for locomotive are investigated in detail by using the numerical integration method. Numerical examples reveal various types of nonlinear phenomena and dynamic evolution mechanism involving one-period responses, multi-periodic responses, bifurcation and chaotic responses. Some research results present useful information to dynamic design and vibration control of the gear transmission system for railway locomotive.

Targeting the Plantar Fascia for Corticosteroid Injection.

PubMed

Salvi, Andrea Emilio

2015-01-01

Plantar fasciitis is often a difficult condition to treat. It is related to repetitive strain of the fascia at its attachment to the heel bone. This condition quite often appears with the concomitant presence of a plantar calcaneal heel spur. Corticosteroid injection is a popular treatment choice for plantar fasciitis, and accurate localization of the injected medication is essential for successful resolution of symptoms after the injection. In the present brief technical communication, a method for targeting the attachment of the plantar fascia to the medial tubercle of the tuberosity of the calcaneus is described. The targeting method uses the lateral radiograph of the foot to aid in localization of the proximal attachment of the plantar fascia to the calcaneus. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Diagnostic and pathogenetic role of café-au-lait macules in nevoid basal cell carcinoma syndrome

PubMed Central

2012-01-01

Café au lait spots (CALS) are common dermatologic findings that can at the same time arise in a variety of pathologic conditions such as Neurofibromatosis type 1 (NF1), together with numerous hereditary syndromes for which they represent either diagnostic criteria or associated elements (McCune Albright, Silver-Russell, LEOPARD, Ataxia-Telangiectasia). A review of the literature also revealed two cases of association with NBCCS. We report here the case of a female proband with CALS associated to Nevoid Basal Cell Carcinoma Syndrome (NBCCS) with known PTCH1 germline mutation (C.1348-2A>G) who had been misdiagnosed with NF1 in her childhood because of 5 CALS and cutaneous nodules. The patient presented a giant cell tumor of the skin, palmar and calcaneal epidermoidal cystic nodules, odontogenic keratocystic tumors and deformity of the jaw profile. Her family history brought both her brother and father to our attention because of the presence of KCOTs diagnosed at early age: after genetic testing, the same PTCH1 germline mutation was identified in the three family members. Clinical criteria are used for discerning NF1 diagnosis (size, number and onset age), while there are no definite guidelines concerning CALS except for their presence. In our experience, we have noted an association of CALS with NBCCS; this seems interesting because we already know clinical criteria are a dynamic entity and can be modified by epidemiologic evidences. PMID:23107377

Put Your Imperfections behind You: Temporal Landmarks Spur Goal Initiation When They Signal New Beginnings

PubMed Central

Dai, Hengchen; Milkman, Katherine L.; Riis, Jason

2016-01-01

People often fail to muster the motivation needed to initiate goal pursuit. Across five laboratory experiments, we explore when people naturally experience enhanced motivation to take actions that facilitate goal pursuit and why certain days are more likely to spur goal initiation than others. We provide causal evidence that emphasizing a temporal landmark marking the beginning of a new time period increases people’s intentions to initiate goal pursuit. In addition, we propose and show that people’s strengthened motivation to begin pursuing their aspirations following such temporal landmarks originates in part from the psychological disassociation these landmarks induce from a person’s past, imperfect self. PMID:26546079

Surface fatigue life of M50NiL and AISI 9310 spur gears and R C bars

NASA Technical Reports Server (NTRS)

Townsend, Dennis P.; Bamberger, Eric N.

1991-01-01

Spur gear endurance tests and rolling element surface fatigue tests were conducted to study vacuum induction melted, vacuum arc remelted (VIM-VAR) M50NiL steel for use as a gear steel in advanced aircraft applications, to determine its endurance characteristics, and to compare the results with those for standard VAR and VIM-VAR AISI 9310 gear material. Tests were conducted with spur gears and rolling contact bars manufactured from VIM-VAR M50NiL and VAR and VIM-VAR AISI 9310. The gear pitch diameter was 8.9 cm. Gear test conditions were an inlet oil temperature of 320 K, and outlet oil temperature of 350 K, a maximum Hertz stress of 1.71 GPa, and a speed of 10000 rpm. Bench rolling element fatigue tests were conducted at ambient temperatures with a bar speed of 12,500 rpm and a maximum Hertz stress of 4.83 GPa. The VIM-VAR M50NiL gears had a surface fatigue life that was 4.5 and 11.5 times that for VIM-VAR and VAR AISI 9310 gears, respectively. The surface fatigue life of the VIM-VAR M50NiL rolling contact bars was 13.2 and 21.6 times that for the VIM-VAR and VAR AISI 9310, respectively. The VIM-VAR M50NiL material was shown to have good resistance to fracture through a fatigue spall and superior fatigue life to both other gears.

Intra-articular calcaneal fractures: effect of open reduction and internal fixation on the contact characteristics of the subtalar joint.

PubMed

Mulcahy, D M; McCormack, D M; Stephens, M M

1998-12-01

Intra-articular calcaneal fractures are associated with significant long-term morbidity, and considerable controversy exists regarding the optimum method of treating them. The contact characteristics in the intact subtalar joint were determined at known loads and for different positions of the ankle and subtalar joint, using pressure-sensitive film (Super Low; Fuji, Itochu Canada Ltd, Montreal, Quebec). We measured the contact area to joint area ratio (pressure > 5 kg force/cm2 [kgf/cm2]) which normalizes for differences in joint size and the ratio of high pressure zone (>20 kgf/cm2) as a reflection of overall increase in joint pressure. Three simulated fracture patterns were then created and stabilized with either 1 or 2 mm of articular incongruity. Eight specimens were prepared with a primary fracture line through the posterior facet, eight with a joint depression-type fracture, and six with a central joint depression fracture. A measure of 1 to 2 mm of incongruity in the posterior facet for all three fracture patterns produced significant unloading of the depressed fragment, with a redistribution of the overall pattern of pressure distribution to parts of the facet that were previously unloaded.

Analysis of dynamic capacity of low-contact-ratio spur gears using Lundberg-Palmgren theory

NASA Technical Reports Server (NTRS)

Coy, J. J.

1975-01-01

A concise mathematical model is developed for surface fatigue life of low-contact-ratio spur gears. The expected fatigue life of the pinion, gear, or gear sets may be calculated from the model. An equation for the dynamic capacity of the gear set was also derived in terms of the transmitted tangential tooth load which will give a 10-percent fatigue life of one million pinion revolutions. The theoretical life was compared with experimental data for a set of VAR AISI 9310 gears operating at a Hertz stress of 1.71X10 to the 9th power newtons per square meter (248,000 psi) and 10 000 revolutions per minute. Good agreement was obtained between the experimental and theoretical surface fatigue life of the gears.

A Study of Spur Gears Lubricated With Grease-Observations From Seven Experiments

NASA Technical Reports Server (NTRS)

Krantz, Timothy L.; Handschuh, Robert F.

2005-01-01

To improve understanding of gears operating with a perfluoro type space-qualified grease, seven spur gear experiments were performed. Test conditions were selected to study the influences of torque, lubricant type, and atmosphere. Two testing torques provided nominal pitch-line Hertz stresses greater and lesser than the contact stress limit as recommended by the grease manufacturer. As was expected, all tests resulted in some gear tooth wear. Discoloration of the perfluoro type grease occurred for all tests. Tests in dry nitrogen produced some dark-grey colored perfluoro type grease. Testing in either ambient or dry air produced red debris after short test duration, and for tests of longer duration large amounts of red debris, red grease, and wear were evident. Tests using higher torques produced more debris. The first indications of discoloration occurred more quickly with higher test torques. Total amounts of wear were quite significant, up to four times the profile tolerance for AGMA Class 10 gears.

Intracorporeal pneumatic shock application for the treatment of chronic plantar fasciitis: a randomized, double blind prospective clinical trial.

PubMed

Dogramaci, Yunus; Kalaci, Aydiner; Emir, Anil; Yanat, Ahmet Nedim; Gökçe, Ahmet

2010-04-01

Plantar fasciitis (PF) is a common clinical condition that usually resolves with non-operative treatments. Extracorporeal shock wave therapy (ESWT) has been used in the treatment of chronic PF not responding to other conservative measures; however, ESWT devices are expensive and available for daily practice in only few centers (In developing countries). A pneumatic lithotripter is a cheap and readily available device which uses pneumatic shock application for the intracorporeal lithotripsy. The aim of this study was to investigate the clinical efficacy of intracorporeal pneumatic shock therapy (IPST) application for the treatment of chronic PF using a cheap and readily available pneumatic lithotripter. A randomized, double-blind, placebo-controlled study was conducted. A total of 50 patients with clinically and radiologically confirmed PF were randomly allocated to either an active- (treatment) (n = 25) or inactive (placebo) (n = 25) group. Under local anesthesia and posterior tibial nerve block, a rigid probe was directly introduced into the calcaneal spur under fluoroscopic control; a standard protocol of 1,000 shock was applied during a single session into the calcaneal spur. The main outcome measure was the patients' subjective assessment of pain by means of a Visual Analog Scale (VAS) and the Roles and Maudsley Score before the treatment and 6 months later. At the 6 months, the rate of successful outcomes (excellent + good results) in the treatment group (92%) were significantly higher comparing to the control group (24%) (P < 0.001). Heel pain measured 6 months after using the VAS were 2.04 +/- 1.67 in treatment group and 7.16 +/- 1.57 in control group as compared to 8.92 +/- 1.22 and 9.12 +/- 1.23 before the commencement of the treatment. No complications attributable to the procedure such as rupture of the planter fascia, hematoma, or infection were observed during the study. This pilot study showed that IPST is an effective and safe method of treatment of

Universities as Hubs for Next-Generation Networks: A Model for Universities to Spur 21st Century Internet Access and Innovation in Their Communities

ERIC Educational Resources Information Center

Lennett, Benjamin; Morris, Sarah J.; Byrum, Greta

2012-01-01

Based on a request for information (RFI) submitted to The University Community Next Generation Innovation Project (Gig.U), the paper describes a model for universities to develop next generation broadband infrastructure in their communities. In the our view universities can play a critical role in spurring next generation networks into their…

The Relevance of Depressive Symptoms and Social Support to Disability in Women with Multiple Sclerosis or Fibromyalgia

ERIC Educational Resources Information Center

Phillips, Lorraine J.

2010-01-01

Multiple sclerosis and fibromyalgia syndrome may spur substantial disability for those affected. Using structural equation modeling, this secondary analysis examined predictors of disability in women with multiple sclerosis (n = 118) and fibromyalgia syndrome (n = 197) recruited for separate wellness studies. Greater functional limitations, lower…

Sinus tarsi approach (STA) versus extensile lateral approach (ELA) for treatment of closed displaced intra-articular calcaneal fractures (DIACF): A meta-analysis.

PubMed

Bai, L; Hou, Y-L; Lin, G-H; Zhang, X; Liu, G-Q; Yu, B

2018-04-01

Our aim was to compare the effect of sinus tarsi approach (STA) vs extensile lateral approach (ELA) for treatment of closed displaced intra-articular calcaneal fractures (DIACF) is still being debated. A thorough research was carried out in the MEDLINE, EMBASE and Cochrane library databases from inception to December 2016. Only prospective or retrospective comparative studies were selected in this meta-analysis. Two independent reviewers conducted literature search, data extraction and quality assessment. The primary outcomes were anatomical restoration and prevalence of complications. Secondary outcomes included operation time and functional recovery. Four randomized controlled trials involving 326 patients and three cohort studies involving 206 patients were included. STA technique for DIACFs led to a decline in both operation time and incidence of complications. There were no significant differences between the groups in American Orthopedic Foot and Ankle Society scores, nor changes in Böhler angle. This meta-analysis suggests that STA technique may reduce the operation time and incidence of complications. In conclusion, STA technique is reasonably an optimal choice for DIACF. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.

PubMed

Joseph, Seth; Sow, Max; Furukawa, Michael F; Posnack, Steven; Chaffee, Mary Ann

2014-09-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted to increase electronic health record (EHR) adoption by providers and hospitals. Experts expressed skepticism about whether the program would indeed hasten adoption and could be implemented in time for the initial reporting period. Could EHR vendors meet the certification requirements, and could the industry innovate to meet small-practice needs? This study, in addition to documenting increased provider adoption, provides the first evidence of increased competitiveness and innovation in the EHR industry spurred by HITECH. For example, the number of EHR vendors certified for e-prescribing with Surescripts increased from 96 to 229 over the program's first 3 years. We also find that prescribers in small practices increasingly adopted lower-cost, Web-based e-prescribing and EHR applications at significantly higher rates (15%-35%) than did large practices (3%-4%), which generally have more human and capital resources to make significant investments. These findings suggest that EHR vendors were highly responsive to HITECH requirements and have been adapting their strategies to meet nuanced market needs, providing reason to be optimistic about the Programs' future.

Face Gear Drive with Spur Involute Pinion: Geometry, Generation by a Worm, Stress Analysis

NASA Technical Reports Server (NTRS)

Litvin, Faydor L.; Fuentes, Alfonso; Zanzi, Claudio; Pontiggia, Matteo; Handschuh, Robert F. (Technical Monitor)

2002-01-01

A face gear drive with a spur involute pinion is considered. The generation of the face gear is based on application of a grinding or cutting worm whereas the conventional method of generation is based on application of an involute shaper. An analytical approach is proposed for the determination of: (1) the worm thread surface; (2) avoidance of singularities of the worm thread surface, (air) dressing of the worm; and (3) determination of stresses of the face-gear drive. A computer program for simulation of meshing and contact of the pinion and face-gear has been developed. Correction of machine-tool settings is proposed for reduction of the shift of the bearing contact caused by misalignment. An automatic development of the model of five contacting teeth has been proposed for stress analysis. Numerical examples for illustration of the developed theory are provided.

Work- and travel-related physical activity and alcohol consumption: relationship with bone mineral density and calcaneal quantitative ultrasonometry.

PubMed

Sritara, Chanika; Thakkinstian, Ammarin; Ongphiphadhanakul, Boonsong; Pornsuriyasak, Prapaporn; Warodomwichit, Daruneewan; Akrawichien, Tawatchai; Vathesatogkit, Prin; Sritara, Piyamitr

2015-01-01

A number of healthy workers rarely exercise because of a lack of time or resources. Physical activity related to work and everyday travel may be more feasible, but evidence of its beneficial effect on bone health is scarce. We assessed if this form of physical activity was associated with higher bone mineral density (BMD) and stiffness index (SI) when adjusted for recreational physical activity, age, body mass index, smoking, alcohol consumption, education, and serum level of 25-hydroxyvitamin D. Healthy workers, aged 25-54 yr, of the Electricity Generating Authority of Thailand were surveyed. The outcomes were BMD (lumbar spine, femoral neck, and total hip) and calcaneal SI. Physical activity was estimated using the global physical activity questionnaire and considered active when >600 metabolic equivalent tasks (min). Of 2268 subjects, 74% were men. Active male subjects had significantly higher BMD at the femoral neck and total hip (p<0.005). However, the association was not significant with male lumbar spine BMD, male SI, or any bone parameters in women (p>0.05). In men, work and travel physical activity seems beneficial to male bone health; hence, it should be encouraged. Furthermore, smoking appeared harmful while moderate alcohol consumption was beneficial. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

FARADAY TOMOGRAPHY OF THE NORTH POLAR SPUR: CONSTRAINTS ON THE DISTANCE TO THE SPUR AND ON THE MAGNETIC FIELD OF THE GALAXY

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

Sun, X. H.; Gaensler, B. M.; Landecker, T. L.

2015-09-20

We present radio continuum and polarization images of the North Polar Spur (NPS) from the Global Magneto-ionic Medium Survey conducted with the Dominion Radio Astrophysical Observatory 26 m Telescope. We fit polarization angle versus wavelength squared over 2048 frequency channels from 1280 to 1750 MHz to obtain a Faraday rotation measure (RM) map of the NPS. Combining this RM map with a published Faraday depth (FD) map of the entire Galaxy in this direction, we derive the FD introduced by the NPS and the Galactic interstellar medium (ISM) in front of and behind the NPS. The FD contributed by themore » NPS is close to zero, indicating that the NPS is an emitting only feature. The FD caused by the ISM in front of the NPS is consistent with zero at b > 50°, implying that this part of the NPS is local at a distance of approximately several hundred parsecs. The FD contributed by the ISM behind the NPS gradually increases with Galactic latitude up to b = 44°, and decreases at higher Galactic latitudes. This implies that either the part of the NPS at b < 44° is distant or the NPS is local but there is a sign change of the large-scale magnetic field. If the NPS is local, there is then no evidence for a large-scale anti-symmetry pattern in the FD of the Milky Way. The FD introduced by the ISM behind the NPS at latitudes b > 50° can be explained by including a coherent vertical magnetic field.« less

Comparative Study of Vibration Condition Indicators for Detecting Cracks in Spur Gears

NASA Technical Reports Server (NTRS)

Nanadic, Nenad; Ardis, Paul; Hood, Adrian; Thurston, Michael; Ghoshal, Anindya; Lewicki, David

2013-01-01

This paper reports the results of an empirical study on the tooth breakage failure mode in spur gears. Of four dominant gear failure modes (breakage, wear, pitting, and scoring), tooth breakage is the most precipitous and often leads to catastrophic failures. The cracks were initiated using a fatigue tester and a custom-designed single-tooth bending fixture to simulate over-load conditions, instead of traditional notching using wire electrical discharge machining (EDM). The cracks were then propagated on a dynamometer. The ground truth of damage level during crack propagation was monitored with crack-propagation sensors. Ten crack propagations have been performed to compare the existing condition indicators (CIs) with respect to their: ability to detect a crack, ability to assess the damage, and sensitivity to sensor placement. Of more than thirty computed CIs, this paper compares five commonly used: raw RMS, FM0, NA4, raw kurtosis, and NP4. The performance of combined CIs was also investigated, using linear, logistic, and boosted regression trees based feature fusion.

Reduction and internal fixation of displaced intra-articular calcaneal fractures with a locking nail: a prospective study of sixty nine cases.

PubMed

Simon, P; Goldzak, M; Eschler, A; Mittlmeier, T

2015-10-01

The best treatment for intra-articular fractures of the calcaneus is still debated. The aims of this study were to determine whether intrafocal reduction of thalamic fractures is effective, to evaluate whether a locking nail is able to maintain reduction of the articular surface and to analyse the functional results of this original method. This prospective study assessed 69 fractures treated with a locking fracture nail in 63 cases and with primary subtalar fusion in six (Calcanail (®), FH). Articular congruity and global reduction of the calcaneus was assessed in all patients by computed tomography (CT) scan three months postoperatively. Functional results were evaluated according to the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS-AHS) and all complications recorded. For the 63 fracture nails, the average AOFAS score was 85.9 at a mean final follow-up of 12 months. Only three secondary fusions were performed. For the six comminuted fractures requiring primary fusion, the average AOFAS score was 75.9 at the last follow-up. The posterior intrafocal approach for both reduction and locked nailing of intra-articular calcaneal fractures has been proven as an effective and reliable procedure.

A method of selecting grid size to account for Hertz deformation in finite element analysis of spur gears

NASA Technical Reports Server (NTRS)

Coy, J. J.; Chao, C. H. C.

1981-01-01

A method of selecting grid size for the finite element analysis of gear tooth deflection is presented. The method is based on a finite element study of two cylinders in line contact, where the criterion for establishing element size was that there be agreement with the classical Hertzian solution for deflection. The results are applied to calculate deflection for the gear specimen used in the NASA spur gear test rig. Comparisons are made between the present results and the results of two other methods of calculation. The results have application in design of gear tooth profile modifications to reduce noise and dynamic loads.

Operational limit conditions of the spur gears in lubricated modes

NASA Astrophysics Data System (ADS)

Benilha, S.; Belarifi, F.

2018-01-01

The calculation of the gear teeth resistance, shows the using of a certain number of coefficients determined experimentally and which are accepted by the various international standards. However, this kind of calculation determines the gears by excess material and does not support the tribological parameters of operation. We propose in this work the support of these parameters, to determine the limit operation conditions of the spur gears, using the equivalent geometry. This is represented by two cylinders, which geometrically models of the contact between two teeth of a gear and whose lubrication is generally in mixed lubrication mode. The concept of Mc cool is used to determine the distribution of the load and the friction force, which are distributed in liquid (elastohydrodynamic) and solid domains and interact with each other. The phenomenon of interaction between the two domains is used, to predict the tribological limit conditions of operation. The proposed model is based on the resolution of elastohydrodynamic equations for the determination of load and friction as well as the deduction of mixed friction by tracing the Stribeck curve. This is calculated by the model of the decomposition of the patterns profile of rough surfaces in contacts. The results of non-dimensional calculations allow us to deduce the boundary conditions and can be adapted for any type of gear pair defined according to pre-established operating conditions.

Functional outcome following tibio-talar-calcaneal nailing for unstable osteoporotic ankle fractures.

PubMed

Jonas, S C; Young, A F; Curwen, C H; McCann, P A

2013-07-01

Fragility fractures of the ankle are increasing in incidence. Such fractures typically occur from low-energy injuries but lead to disproportionately high levels of morbidity. Ankle fractures in this age group are managed conservatively in plaster or by open reduction and internal fixation. Both modalities have shown high rates of failure in terms of delayed union or mal-union together with perioperative complications such as implant failure and wound breakdown. The optimal treatment of these patients remains controversial. We aimed to review the functional outcome of patients with ankle fragility fractures primarily managed using a tibio-talar-calcaneal nail (TTC). We retrospectively reviewed 31 consecutive patients primarily managed with a TCC nail for osteoporotic fragility fractures about the ankle. Data were collected via case notes, radiographic reviews and by clinical reviews at the outpatient clinic or a telephone follow-up. Information regarding patient characteristics, indication for operation, Arbeitsgemeinschaft für Osteosynthesefragen (AO) fracture classification, operative and postoperative complications, time to radiographic union and current clinical state including Olerud and Molander scores were recorded (as a measure of ankle function). Nine of 31 patients had died by the time of follow-up. Mean preoperative and postoperative Olerud and Molander scores were 56 and 45, respectively. There were no postoperative wound complications. Twenty-nine of 31 patients returned to the same level of mobility as pre-injury. There were three peri-prosthetic fractures managed successfully with nail removal and replacement or plaster cast. There were two nail failures, both in patients who mobilised using only a stick, which were managed by nail removal. Ten of 31 patients were not followed up radiographically due to either infirmity or death. Thirteen of 21 followed up radiographically had evidence of union and 8/21 had none. None, however, had clinical evidence

Calcaneal quantitative ultrasound value for middle-aged and elderly Malaysian Chinese men and its association with age and body anthropometry.

PubMed

Chin, Kok-Yong; Ima-Nirwana, Soelaiman; Isa Naina, Mohamed; Norazlina, Mohamed; Ahmad Nazrun, Shuid; Norliza, Muhammad; Faizah, Othman; Farihah, H Suhaimi; Elvy Suhana, Mohd Ramli; Wan Zurinah, Wan Ngah

2012-01-01

Quantitative ultrasound (QUS) is a relatively easy, reliable, and safe method for bone status assessment, but reference data for Asian males remain scarce. Our study aimed to determine the values for one QUS parameter, the speed of sound (SOS) at the calcaneus, in Malaysian Chinese men and to determine the association between the SOS and several demographic characteristics, such as age, weight, height, and body mass index. Three hundred forty-eight Malaysian Chinese men aged 40 yr and older were recruited, and their calcaneal QUS value was determined using the CM-200 densitometer (Furuno Electric, Nishinomiya City, Japan). The results indicated a significant correlation between SOS and age, and multiple stepwise regression analysis indicated that age and height were important predictors of SOS. A significant reduction in SOS value was observed when men 60 yr and older were compared with men aged 40-49 yr. Compared with the reference data for Japanese males, Chinese men in Malaysia showed higher SOS values across all the age groups studied. In conclusion, there is an age-related decrease in SOS values in Malaysian Chinese men, and the SOS values established in this study can be used as a reference for future studies. Copyright © 2012 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Comparison of analysis and experiment for dynamics of low-contact-ratio spur gears

NASA Technical Reports Server (NTRS)

Oswald, Fred B.; Rebbechi, Brian; Zakrajsek, James J.; Townsend, Dennis P.; Lin, Hsiang Hsi

1991-01-01

Low-contact-ratio spur gears were tested in NASA gear-noise-rig to study gear dynamics including dynamic load, tooth bending stress, vibration, and noise. The experimental results were compared with a NASA gear dynamics code to validate the code as a design tool for predicting transmission vibration and noise. Analytical predictions and experimental data for gear-tooth dynamic loads and tooth-root bending stress were compared at 28 operating conditions. Strain gage data were used to compute the normal load between meshing teeth and the bending stress at the tooth root for direct comparison with the analysis. The computed and measured waveforms for dynamic load and stress were compared for several test conditions. These are very similar in shape, which means the analysis successfully simulates the physical behavior of the test gears. The predicted peak value of the dynamic load agrees with the measurement results within an average error of 4.9 percent except at low-torque, high-speed conditions. Predictions of peak dynamic root stress are generally within 10 to 15 percent of the measured values.

Treatment of subtalar calcanean fractures using trans-osseous limited lateral approach.

PubMed

Ragab, Abdelaleem H; Mubark, Islam M; Nagi, Ahmed M; Abdelnaby, Mohamed Aly

2014-01-01

Calcaneal fractures are the most common fractures of the tarsal bones. The majority of these fractures are produced by axial force like a fall from a height. Controversy still exists on the best line of treatment. This study is to evaluate the results of trans-osseous limited lateral approach as a minimally invasive surgical treatment of the displaced intra-articular calcaneal fractures. The study included forty two patients (46 feet) with displaced intra-articular calcaneal fractures admitted to El-Hadra University Hospital. They were treated by trans-osseous open reduction of subtalar joint and internal fixation by k-wires consuming the trans-osseous limited lateral approach. Out of 42 patients, 36 pateints (85.7%) were males. Using calcaneal fracture scoring system, the mean score was 67.55+17.35. Satisfactory results were found in 26 patients (61.9%), while 16 patients (38.1%) had unsatisfactory results. There was significant relationship between classification of the fracture and the final results (the more the grade of the fracture, the worse the final score) (x 2 =5.914, p=0.05). The value of calcaneal angles were significantly improved after surgery including bohler angle (p=0.0001), gissane angle (p=0.0001), calcaneal pitch angle (p=0.001) and calcaneofibular space (p=0.0021). 1. Trans-osseous limited lateral approach is an effective method for management of intra articular calcaneal fractures. 2. Anatomical reduction for intra articular calcaneal fractures is essential. 3. Functional outcome of intra articular calcaneal fractures depends upon the initial damage of the articular cartilage. 4. There is a need for multi-center prospective randomized study for accurate assessment of the results of operative management of intra articular calcaneal fractures involving pre and post-operative CT for assessment of reduction and using a rational scoring system and a long period of follow up.

The role of thermal and lubricant boundary layers in the transient thermal analysis of spur gears

NASA Technical Reports Server (NTRS)

El-Bayoumy, L. E.; Akin, L. S.; Townsend, D. P.; Choy, F. C.

1989-01-01

An improved convection heat-transfer model has been developed for the prediction of the transient tooth surface temperature of spur gears. The dissipative quality of the lubricating fluid is shown to be limited to the capacity extent of the thermal boundary layer. This phenomenon can be of significance in the determination of the thermal limit of gears accelerating to the point where gear scoring occurs. Steady-state temperature prediction is improved considerably through the use of a variable integration time step that substantially reduces computer time. Computer-generated plots of temperature contours enable the user to animate the propagation of the thermal wave as the gears come into and out of contact, thus contributing to better understanding of this complex problem. This model has a much better capability at predicting gear-tooth temperatures than previous models.

Three new models for evaluation of standard involute spur gear mesh stiffness

NASA Astrophysics Data System (ADS)

Liang, Xihui; Zhang, Hongsheng; Zuo, Ming J.; Qin, Yong

2018-02-01

Time-varying mesh stiffness is one of the main internal excitation sources of gear dynamics. Accurate evaluation of gear mesh stiffness is crucial for gear dynamic analysis. This study is devoted to developing new models for spur gear mesh stiffness evaluation. Three models are proposed. The proposed model 1 can give very accurate mesh stiffness result but the gear bore surface must be assumed to be rigid. Enlighted by the proposed model 1, our research discovers that the angular deflection pattern of the gear bore surface of a pair of meshing gears under a constant torque basically follows a cosine curve. Based on this finding, two other models are proposed. The proposed model 2 evaluates gear mesh stiffness by using angular deflections at different circumferential angles of an end surface circle of the gear bore. The proposed model 3 requires using only the angular deflection at an arbitrary circumferential angle of an end surface circle of the gear bore but this model can only be used for a gear with the same tooth profile among all teeth. The proposed models are accurate in gear mesh stiffness evaluation and easy to use. Finite element analysis is used to validate the accuracy of the proposed models.

Plantar Fascia Release Through a Single Lateral Incision in the Operative Management of a Cavovarus Foot: A Cadaver Model Analysis of the Operative Technique.

PubMed

Kiskaddon, Eric M; Meeks, Brett D; Roberts, Joseph G; Laughlin, Richard T

2018-04-04

Plantar fascia release and calcaneal slide osteotomy are often components of the surgical management for cavovarus deformities of the foot. In this setting, plantar fascia release has traditionally been performed through an incision over the medial calcaneal tuberosity, and the calcaneal osteotomy through a lateral incision. Two separate incisions can potentially increase the operative time and morbidity. The purpose of the present study was threefold: to describe the operative technique, use cadaveric dissection to analyze whether a full release of the plantar fascia was possible through the lateral incision, and examine the proximity of the medial neurovascular structures to both the plantar fascia release and calcaneal slide osteotomy when performed together. In our cadaveric dissections, we found that full release of the plantar fascia is possible through the lateral incision with no obvious damage to the medial neurovascular structures. We also found that the calcaneal branch of the tibial nerve reliably crossed the osteotomy in all specimens. We have concluded that both the plantar fascia release and the calcaneal osteotomy can be safely performed through a lateral incision, if care is taken when completing the calcaneal osteotomy to ensure that the medial neurovascular structures remain uninjured. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Wear of Spur Gears Having a Dithering Motion and Lubricated with a Perfluorinated Polyether Grease

NASA Technical Reports Server (NTRS)

Krantz, Timothy; Oswald, Fred; Handschuh, Robert

2007-01-01

Gear contact surface wear is one of the important failure modes for gear systems. Dedicated experiments are required to enable precise evaluations of gear wear for a particular application. The application of interest for this study required evaluation of wear of gears lubricated with a grade 2 perfluorinated polyether grease and having a dithering (rotation reversal) motion. Experiments were conducted using spur gears made from AISI 9310 steel. Wear was measured using a profilometer at test intervals encompassing 10,000 to 80,000 cycles of dithering motion. The test load level was 1.1 GPa maximum Hertz contact stress at the pitch-line. The trend of total wear as a function of test cycles was linear, and the wear depth rate was approximately 1.2 nm maximum wear depth per gear dithering cycle. The observed wear rate was about 600 times greater than the wear rate for the same gears operated at high speed and lubricated with oil.

An Investigation of the Dynamic Response of Spur Gear Teeth with Moving Loads

NASA Technical Reports Server (NTRS)

Passerello, C. E.; Shuey, L. W.

1987-01-01

Two concepts relating to gear dynamics were studied. The first phase of the analysis involved the study of the effect of the speed of a moving load on the dynamic deflections of a gear tooth. A single spur gear tooth modelled using finite elements was subjected to moving loads with variable velocities. The tooth tip deflection time histories were plotted, from which it was seen that the tooth tip deflection consisted of a quasistatic response with an oscillatory response superimposed on it whose amplitude was dependent on the type of load engagement. Including the rim in the analysis added flexibility to the model but did not change the general behavior of the system. The second part of the analysis involved an investigation to determine the effect on the dynamic response of the inertia of the gear tooth. A simplified analysis using meshing cantilever beams was used. In one case, the beams were assumed massless. In the other, the mass (inertia) of the beams was included. From this analysis it was found that the inertia of the tooth did not affect the dynamic response of meshing cantilever beams.

Endurance and failure characteristics of modified Vasco X-2, CBS 600 and AISI 9310 spur gears. [aircraft construction materials

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Zaretsky, E. V.

1980-01-01

Gear endurance tests and rolling-element fatigue tests were conducted to compare the performance of spur gears made from AISI 9310, CBS 600 and modified Vasco X-2 and to compare the pitting fatigue lives of these three materials. Gears manufactured from CBS 600 exhibited lives longer than those manufactured from AISI 9310. However, rolling-element fatigue tests resulted in statistically equivalent lives. Modified Vasco X-2 exhibited statistically equivalent lives to AISI 9310. CBS 600 and modified Vasco X-2 gears exhibited the potential of tooth fracture occurring at a tooth surface fatigue pit. Case carburization of all gear surfaces for the modified Vasco X-2 gears results in fracture at the tips of the gears.

Cold tolerance of the Australian spur-throated locust, Austracris guttulosa.

PubMed

Woodman, James D

2012-03-01

The cold tolerance of overwintering adult Spur-throated locusts, Austracris guttulosa, was examined using measures of supercooling point relative to gender, environmental acclimation and feeding state as well as mortality for a range of sub-zero temperature exposure treatments. Freezing was lethal and supercooling points ranged from -6 to -12.8°C, but were statistically independent of fresh mass, body water content, acclimation, and/or gut content in fed and starved individuals. A significant interaction effect of gender and feeding status showed that the larger bodied females had decreased supercooling capacity with increased food material in the digestive tract. Post-freezing dissections revealed differences in the amount of freshly consumed and retained food material in the digestive tract between fed and starved individuals of each gender, which could explain this effect based on inoculation of ice crystallisation by food particles. Above supercooling temperatures, neither gender nor the rate of cooling had a significant effect on mortality. When cooled from 25°C at 0.1 or 0.5°Cmin(-1) to a range of experimental minimum temperatures held for 3h, survival was ~74% to -7°C, but declined sharply to ~37% when cooled to -8°C or lower. Although the laboratory experiments reported here suggest that A. guttulosa is not freeze tolerant and unable to rapidly cold harden, exposure to typical cold and frosty nights that very rarely reach below -8°C as a night minimum in the field would be unlikely to cause mortality in the vast majority of overwintering aggregations. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Negative Pressure Wound Therapy Followed by Basic Fibroblast Growth Factor Spray as a Recovery Technique in Partial Necrosis of Distally Based Sural Flap for Calcaneal Osteomyelitis: A Case Report.

PubMed

Mikami, Taro; Kaida, Eriko; Yabuki, Yuichiro; Kitamura, Sho; Kokubo, Ken'ichi; Maegawa, Jiro

2018-03-28

The distally based sural flap is regarded as the first choice for reconstruction in the distal part of the lower leg because the flap is easy to raise, reliable in its blood supply, and prone to only a few complications. Limited data have investigated the details of treatment in cases of failure of distally based sural flaps. We report a case of calcaneal osteomyelitis in which a successful outcome was finally obtained with a partially necrosed, distally based sural flap using negative pressure wound therapy with basic fibroblast growth factor spray. The 2-year follow-up examination was uneventful. Moreover, the patient was able to walk freely with an ankle-foot orthosis in her house. This technique can be considered as a useful and effective option to recover unfavorable results of distally based sural flaps. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Mid-Sole Release of the Plantar Fascia Combined With Percutaneous Drilling of the Calcaneus for Treatment of Resistant Heel Pain.

PubMed

Rizk, Ahmed Shawkat; Kandel, Wael A; Tabl, Eslam Abd Elshafi; Kandil, Mahmoud I

2017-11-01

Heel pain with or without calcaneal spur is a challenging problem. Once conservative measures have failed, surgery may be indicated; there has been debate about the best surgical procedure. Two standard operative procedures have been either releasing the plantar fascia or removing the spur with drilling of the calcaneus. In this study, we evaluated the results of percutaneous drilling of the calcaneus combined with mid-sole release of the plantar fascia for treatment of resistant heel pain. This study included 20 cases with resistant heel pain after failure of conservative measures for 6 months. Clinical, radiological evaluation and scoring patients' conditions according to the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scale was done preoperatively and postoperatively. Percutaneous drilling of the calcaneus combined with mid-sole release of the plantar fascia was done in all cases, and the functional results were evaluated through the follow-up period that extended from 9 to 16 months with a mean duration of 12 ± 2.3 months. There was statistically significant improvement in the mean AOFAS Ankle-Hindfoot scale score from 50.8 ± 7.5 preoperatively to 91.6 ± 7 postoperatively at the last follow-up. There were no surgery-related complications, and the mean time for full recovery was 8 ± 3.7 weeks with no recurrence of pain by the last follow-up. The results were very satisfactory with using this minimally invasive and simple technique for treatment for resistant heel pain. Level IV, retrospective case series.

The X-ray attenuation characteristics and density of human calcaneal marrow do not change significantly during adulthood

NASA Technical Reports Server (NTRS)

Les, C. M.; Whalen, R. T.; Beaupre, G. S.; Yan, C. H.; Cleek, T. M.; Wills, J. S.

2002-01-01

Changes in the material characteristics of bone marrow with aging can be a significant source of error in measurements of bone density when using X-ray and ultrasound imaging modalities. In the context of computed tomography, dual-energy computed techniques have been used to correct for changes in marrow composition. However, dual-energy quantitative computed tomography (DE-QCT) protocols, while increasing the accuracy of the measurement, reduce the precision and increase the radiation dose to the patient in comparison to single-energy quantitative computed tomography (SE-QCT) protocols. If the attenuation properties of the marrow for a particular bone can be shown to be relatively constant with age, it should be possible to use single-energy techniques without experiencing errors caused by unknown marrow composition. Marrow was extracted by centrifugation from 10 mm thick frontal sections of 34 adult cadaver calcanei (28 males, 6 females, ages 17-65 years). The density and energy-dependent linear X-ray attenuation coefficient of each marrow sample were determined. For purposes of comparing our results, we then computed an effective CT number at two GE CT/i scan voltages (80 and 120 kVp) for each specimen. The coefficients of variation for the density, CT number at 80 kVp and CT number at 120 kVp were each less than 1%, and the parameters did not change significantly with age (p > 0.2, r2 < 0.02, power > 0.8 where the minimum acceptable r2 = 0.216). We could demonstrate no significant gender-associated differences in these relationships. These data suggest that calcaneal bone marrow X-ray attenuation properties and marrow density are essentially constant from the third through sixth decades of life.

Comparative study of subtalar arthrodesis after calcaneal frature malunion with autologous bone graft or freeze-dried xenograft.

PubMed

Henning, Carlo; Poglia, Gabriel; Leie, Murilo Anderson; Galia, Carlos Roberto

2015-12-01

Calcaneal fracture malunion may evolve into arthrosis and severe foot deformities. The aim of this study was to identify differences in bony union following corrective subtalar arthrodesis with interposition of autologous tricortical bone graft or freeze-dried bovine xenograft. We prospectively evaluated 12 patients who underwent subtalar arthrodesis, six patients received autografts and 6 received freeze-dried bovine xenografts. After a mean followup of 58 weeks, the patients were clinical assessed using AOFAS scale and the visual analog scale (VAS) for pain and for final radiographic parameters measurement. Two blind raters evaluated the length of time required for solid union of the arthrodesis and graft integration by retrospective radiographic examination. In the autograft group, AOFAS score improved from a preoperative average of 37 to 64 points postoperatively (p = 0.02) and mean VAS score improved from 4.7 to 1.9 (p = 0.028). In the xenograft group, AOFAS score improved from 38 to 74 points (p = 0.02) and VAS from 5.5 to 2.7 (p = 0.046). Solid union was achieved in all cases in the autograft group at an average of 5.3 weeks and in five cases in the xenograft group at 8.8 weeks (p = 0.077). Graft integration occurred after an average of 10.7 weeks in the autograft group and 28.8 weeks in the xenograft group (p = 0.016). With the numbers available, no significant difference could be detected in the length of time required for solid union of subtalar arthrodesis between groups, although time to integration of freeze-dried bovine xenografts was statistically higher. Clinical and functional improvement was observed in both groups.

Selection criteria of the addendum modification coefficients of spur gear pairs with smaller number of pinion teeth

NASA Astrophysics Data System (ADS)

Atanasiu, V.; Oprişan, C.; Leohchi, D.

2016-08-01

A design procedure for the optimum distribution of the addendum modification coefficients of spur gear pairs with smaller number of pinion teeth is presented for the case of a fixed centred distance. The geometrical, kinematics and load capacity criteria are considered in the design analysis. The geometric and kinematics criteria are used to prevent the negative phenomena of the generating and engagement processes. The relation between the contact pressure of meshing teeth and specific sliding are analysed in relation with addendum modification coefficients. A dynamic model is developed to simulate the load sharing characteristics through a mesh cycle. The specific phenomenon of contact tooth pairs alternation during mesh cycle is integrated in this dynamic load modelling. A comparative study is included, which shows the effects of the distribution factor of the addendum modification coefficients on the contact surface characteristics of the gear pairs.

Comparative Outcomes Between Step-Cut Lengthening Calcaneal Osteotomy vs Traditional Evans Osteotomy for Stage IIB Adult-Acquired Flatfoot Deformity.

PubMed

Saunders, Stuart M; Ellis, Scott J; Demetracopoulos, Constantine A; Marinescu, Anca; Burkett, Jayme; Deland, Jonathan T

2018-01-01

The forefoot abduction component of the flexible adult-acquired flatfoot can be addressed with lengthening of the anterior process of the calcaneus. We hypothesized that the step-cut lengthening calcaneal osteotomy (SLCO) would decrease the incidence of nonunion, lead to improvement in clinical outcome scores, and have a faster time to healing compared with the traditional Evans osteotomy. We retrospectively reviewed 111 patients (143 total feet: 65 Evans, 78 SLCO) undergoing stage IIB reconstruction followed clinically for at least 2 years. Preoperative and postoperative radiographs were analyzed for the amount of deformity correction. Computed tomography (CT) was used to analyze osteotomy healing. The Foot and Ankle Outcome Scores (FAOS) and lateral pain surveys were used to assess clinical outcomes. Mann-Whitney U tests were used to assess nonnormally distributed data while χ 2 and Fisher exact tests were used to analyze categorical variables (α = 0.05 significant). The Evans group used a larger graft size ( P < .001) and returned more often for hardware removal ( P = .038) than the SLCO group. SLCO union occurred at a mean of 8.77 weeks ( P < .001), which was significantly lower compared with the Evans group ( P = .02). The SLCO group also had fewer nonunions ( P = .016). FAOS scores improved equivalently between the 2 groups. Lateral column pain, ability to exercise, and ambulation distance were similar between groups. Following SLCO, patients had faster healing times and fewer nonunions, similar outcomes scores, and equivalent correction of deformity. SLCO is a viable technique for lateral column lengthening. Level III, retrospective cohort study.

Systematic review of innovation design contests for health: spurring innovation and mass engagement

PubMed Central

Pan, Stephen W; Stein, Gabriella; Bayus, Barry; Tang, Weiming; Mathews, Allison; Wang, Cheng; Wei, Chongyi; Tucker, Joseph D

2018-01-01

We undertook a systematic review evaluating the effectiveness and cost of health-focused innovation design contests. We followed Cochrane guidance and systematically searched eight databases. Articles were included if they reported an open contest focused on improving health, required participants submit finished design solutions and contained a prize structure. We searched 3579 citations, identifying 29 health-focused innovation design contests which collectively received 15494 contest submissions. Contests solicited submissions worldwide (7) and exclusively from North America (13), Asia (4), Africa (2), Australia (2) and Europe (1). Submissions per contest ranged from 3 to 11354 (median of 73). Contest entrants were tasked with helping develop health promotion messages (HPM) (25) and improve predictive clinical models, protocols and/or algorithms (4). Two types of contests emerged—those focused on high-quality, innovative outcomes and those focused on the process of mass community engagement. All outcome-oriented contests had innovation design contest solutions equivalent or superior to the comparator (100%; 7/7). Two of two studies found that innovation design contests saved money (100%; 2/2). Five of seven process-oriented contests concluded the contest improved at least one health indicator (71%; 5/7). Innovation design contests are an effective way to solicit innovative solutions to health problems and spur mass community engagement. PMID:29576873

Systematic review of innovation design contests for health: spurring innovation and mass engagement.

PubMed

Pan, Stephen W; Stein, Gabriella; Bayus, Barry; Tang, Weiming; Mathews, Allison; Wang, Cheng; Wei, Chongyi; Tucker, Joseph D

2017-01-01

We undertook a systematic review evaluating the effectiveness and cost of health-focused innovation design contests. We followed Cochrane guidance and systematically searched eight databases. Articles were included if they reported an open contest focused on improving health, required participants submit finished design solutions and contained a prize structure. We searched 3579 citations, identifying 29 health-focused innovation design contests which collectively received 15494 contest submissions. Contests solicited submissions worldwide (7) and exclusively from North America (13), Asia (4), Africa (2), Australia (2) and Europe (1). Submissions per contest ranged from 3 to 11354 (median of 73). Contest entrants were tasked with helping develop health promotion messages (HPM) (25) and improve predictive clinical models, protocols and/or algorithms (4). Two types of contests emerged-those focused on high-quality, innovative outcomes and those focused on the process of mass community engagement. All outcome-oriented contests had innovation design contest solutions equivalent or superior to the comparator (100%; 7/7). Two of two studies found that innovation design contests saved money (100%; 2/2). Five of seven process-oriented contests concluded the contest improved at least one health indicator (71%; 5/7). Innovation design contests are an effective way to solicit innovative solutions to health problems and spur mass community engagement.

The X-ray Spectrum of the North Polar Spur

NASA Technical Reports Server (NTRS)

Willingale, Richard; Hands, A. D. P.; Warwick, R. S.; Snowden, S. L.; Burrows, David N.

2003-01-01

An analysis is presented of the soft X-ray background spectrum measured by the EPIC MOS cameras on XMM-Newton in three observations targeted on the North Polar Spur (NPS). Three distinct Galactic plasma components are identified, a cool Local Hot Bubble (LHB) component, T(sub lo) approx. 0.1 keV, a cool Galactic Halo component at a similar temperature and a hotter component, T(sub hi) approx. 0.26 keV, associated with the NPS itself. Using the new data in combination with the Rosat All-Sky Survey count rates measured in the 0.1-0.4 keV band, we estimate the emission measure of the LHB material to be 0.0040-0.0052 cm(exp -6) pc, which implies an electron density of 0.008-0.011 cm(exp -3) and pressure of approx. 22000 cm(exp -3) K. The halo and NPS components lie behind at least 50% of the line-of-sight cold gas for which the total Galactic column density is in the range (2 - 8) x 10(exp 20) cm(exp -2). Modelling the X-ray emitting superbubble as a sphere at distance 210 pc, radius 140 pc and center l(sub II) = 352 deg, b(sub II) = 15 deg, the implied electron density in the NPS is approx. 0.03 cm(exp -3) with pressure approx. 150000 cm(exp -3) K. The observed spectral line complexes from OVII, OVIII, FeXVII, NeIX, NeX and MgXI provide constraints on the composition of the plasma. The hot component in the NPS is depleted in oxygen, neon and, to some extent, magnesium and iron. Assuming the effective line of sight across the halo emission is 1 kpc, the electron density in the halo is 0.007-0.011 cm(exp -3) and the pressure is approx. 16500 cm(exp -3) K, conditions very similar to those in the LHB.

Effect of lubricant extreme-pressure additives on surface fatigue life of AISI 9310 spur gears

NASA Technical Reports Server (NTRS)

Scibbe, H. W.; Townsend, D. P.; Aron, P. R.

1984-01-01

Surface fatigue tests were conducted with AISI 9310 spur gears using a formulated synthetic tetraester oil (conforming to MIL-L-23699 specifications) as the lubricant containing either sulfur or phosphorus as the EP additive. Four groups of gears were tested. One group of gears tested without an additive in the lubricant acted as the reference oil. In the other three groups either a 0.1 wt % sulfur or phosphorus additive was added to the tetraester oil to enhance gear surface fatigue life. Test conditions included a gear temperature of 334 K (160 F), a maximum Hertz stress of 1.71 GPa (248 000 psi), and a speed of 10,000 rpm. The gears tested with a 0.1 wt % phosphorus additive showed pitting fatigue life 2.6 times the life of gears tested with the reference tetraester based oil. Although fatigue lives of two groups of gears tested with the sulfur additive in the oil showed improvement over the control group gear life, the results, unlike those obtained with the phosphorus oil, were not considered to be statistically significant.

A Life Study of Ausforged, Standard Forged and Standard Machined AISI M-50 Spur Gears

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Bamberger, E. N.; Zaretsky, E. V.

1975-01-01

Tests were conducted at 350 K (170 F) with three groups of 8.9 cm (3.5 in.) pitch diameter spur gears made of vacuum induction melted (VIM) consumable-electrode vacuum-arc melted (VAR), AISI M-50 steel and one group of vacuum-arc remelted (VAR) AISI 9310 steel. The pitting fatigue life of the standard forged and ausforged gears was approximately five times that of the VAR AISI 9310 gears and ten times that of the bending fatigue life of the standard machined VIM-VAR AISI M-50 gears run under identical conditions. There was a slight decrease in the 10-percent life of the ausforged gears from that for the standard forged gears, but the difference is not statistically significant. The standard machined gears failed primarily by gear tooth fracture while the forged and ausforged VIM-VAR AISI M-50 and the VAR AISI 9310 gears failed primarily by surface pitting fatigue. The ausforged gears had a slightly greater tendency to fail by tooth fracture than the standard forged gears.

Cryoultrasound therapy in the treatment of chronic plantar fasciitis with heel spurs. A randomized controlled clinical study.

PubMed

Costantino, C; Vulpiani, M C; Romiti, D; Vetrano, M; Saraceni, V M

2014-02-01

Plantar fasciitis is one of the most common causes of pain in the inferior heel and is very frequent in some running sports. It affects up to 10% of general population and accounts for 11% to 15% of all foot pain symptomatology. Several treatments have been suggested, but there is no evidence supporting a specific conservative management strategy. Evaluation of the efficacy of combined cryoultrasound therapy on chronic plantar fasciitis with heel spurs resistant to pharmacological and instrumental therapies. Single-blind randomized clinical trial. 102 consecutive patients affected by chronic plantar fasciitis with painful symptomatology for at least 6 months, intensity of pain higher than 5 on the VAS score, presence of heel spurs, use of plantar orthoses and ineffectiveness of previous therapies. The patients were randomized into two groups: Group A treated with cryoultrasound therapy and Group B with cryotherapy. Our protocol was based on 10 daily treatments, lasting 20 minutes. Each participant was evaluated using VAS score before (T0) the treatment and 3 months (T1), 12 months (T2) and 18 months (T3) after. Effectiveness index was calculated from T1 to T3. Both treatments have been found effective. The difference in pain intensity on the VAS scale between the two groups at T2 was 4.35 points in favor of Group A (IC 95% 3.75; 4.95; P<0.001), reaching the primary end point. The difference in pain intensity on the VAS scale between the two groups at T1, T2 and T3 was 3.00, 4.35 and 4.81 respectively, showing a statistically significant difference between VAS average scores at all follow-ups in favor of Group A. Scores of at least 66% at the effectiveness index were only achieved in Group A (P values <0.001). Cryoultrasound therapy could be an efficient treatment option for chronic plantar fasciitis. Cryoultrasound therapy promises an effective and long-lasting clinical improvement in patients with chronic plantar fasciitis, granted its high therapeutic efficiency

Unbiased estimation of the calcaneus volume using the Cavalieri principle on computed tomography images.

PubMed

Acer, N; Bayar, B; Basaloglu, H; Oner, E; Bayar, K; Sankur, S

2008-11-20

The size and shape of tarsal bones are especially relevant when considering some orthopedic diseases such as clubfoot. For this reason, the measurements of the tarsal bones have been the subject of many studies, none of which has used stereological methods to estimate the volume. In the present stereological study, we estimated the volume of calcaneal bone of normal feet and dry bones. We used a combination of the Cavalieri principle and computer tomographic scans taken from eight males and nine dry calcanei to estimate the volumes of calcaneal bones. The mean volume of dry calcaneal bones was estimated, producing mean results using the point-counting method and Archimedes principle being 49.11+/-10.7 or 48.22+/-11.92 cm(3), respectively. A positive correlation was found between anthropometric measurements and the volume of calcaneal bones. The findings of the present study using the stereological methods could provide data for the evaluation of normal and pathological volumes of calcaneal bones.

Comparison of calcaneal fixation of a retrograde intramedullary nail with a fixed-angle spiral blade versus a fixed-angle screw.

PubMed

Klos, Kajetan; Gueorguiev, Boyko; Schwieger, Karsten; Fröber, Rosemarie; Brodt, Steffen; Hofmann, Gunther O; Windolf, Markus; Mückley, Thomas

2009-12-01

Retrograde intramedullary nailing is an established technique for tibiotalocalcaneal arthrodesis (TTCA). In poor bone stock (osteoporosis, neuroarthropathy), device fixation in the hindfoot remains a problem. Fixed-angle spiral-blade fixation of the nail in the calcaneus could be useful. In seven matched pairs of human below-knee specimens, bone mineral density (BMD) was determined, and TTCA was performed with an intramedullary nail (Synthes Hindfoot Arthrodesis Nail HAN Expert Nailing System), using a conventional screw plus a fixed-angle spiral blade versus a conventional screw plus a fixed-angle screw, in the calcaneus. The constructs were subjected to quasi-static loading (dorsiflexion/plantarflexion, varus/valgus, rotation) and to cyclic loading to failure. Parameters studied were construct neutral zone (NZ) and range of motion (ROM), and number of cycles to failure. With dorsiflexion/plantarflexion loading, the screw-plus-spiral-blade constructs had a significantly smaller ROM in the quasi-static test (p = 0.028) and early in the cyclic test (p = 0.02); differences in the other parameters were not significant. There was a significant correlation between BMD and cycles to failure for the two-screw constructs (r = 0.94; p = 0.002) and for the screw-plus-spiral-blade constructs (r = 0.86; p = 0.014). In TTCA with a HAN Expert Nailing System, the use of a calcaneal spiral blade can further reduce motion within the construct. This may be especially useful in poor bone stock. Results obtained in this study could be used to guide the operating surgeon's TTCA strategy.

Multi-scale Salinity Fronts Observed by Saildrones During the SPURS-2 Field Campaign

NASA Astrophysics Data System (ADS)

Cronin, M. F.; Zhang, D.; Sutton, A. J.; Meinig, C.; Jenkins, R.; Keene, J.

2017-12-01

As part of the Tropical Pacific Observing System (TPOS)-2020 project, two Saildrone Inc. "Saildrones" will be deployed to test the ability of these new autonomous sailing vessel drones for making climate quality meteorological, oceanic and biogeochemical measurements. During the first part of the 6-month mission, in October 2017, the two Saildrones will participate in the Salinity Processes in the Upper Ocean Regional Study-2 (SPURS-2) final field campaign in the eastern tropical Pacific. In this presentation we will show early results from the mission, including intercomparisons of Saildrone measurements against similar measurements from moorings and a research vessel, and Saildrone observations of multi-scale fronts in the eastern Pacific Intertropical Convergence Zone (ITCZ). With its ability to transit at speeds of up to 3-5 knots (for 10-20 knot winds) and to adapt its course and sampling scheme upon demand, Saildrones offer a powerful new tool for oceanographic research. If the measurements are shown to be climate quality, this exciting new platform could play a major new role in the TPOS, either as stationary pseudo-moorings, and/or for making repeat sections (e.g., across cold tongue front, or ITCZ), and/or monitoring evolving conditions, such as the eastern edge of the warm pool as it shifts eastward during an El Niño.

Effect of shot peening on surface fatigue life of carburized and hardened AISI 9310 spur gears

NASA Technical Reports Server (NTRS)

Townsend, D. P.; Zaretsky, E. V.

1982-01-01

Surface fatigue tests were conducted on two groups of AISI 9310 spur gears. Both groups were manufactured with standard ground tooth surfaces, with the second group subjected to an additional shot peening process on the gear tooth flanks. The gear pitch diameter was 8.89 cm (3.5 in.). Test conditions were a gear temperature of 350 K (170 F), a maximum Hertz stress of 1.71 billion N/sq m (248,000 psi), and a speed of 10,000 rpm. The shot peened gears exhibited pitting fatigue lives 1.6 times the life of standard gears without shot peening. Residual stress measurements and analysis indicate that the longer fatigue life is the result of the higher compressive stress produced by the shot peening. The life for the shot peened gear was calculated to be 1.5 times that for the plain gear by using the measured residual stress difference for the standard and shot peened gears. The measured residual stress for the shot peened gears was much higher than that for the standard gears.

Calcaneus Fractures: A Possible Musculoskeletal Emergency.

PubMed

Snoap, Tyler; Jaykel, Matthew; Williams, Cayla; Roberts, Jason

2017-01-01

Calcaneal fractures are commonly seen and treated in the emergency department. There are subsets of calcaneal fractures that pose a high risk to the adjacent soft tissue of the heel and can result in full-thickness tissue necrosis. To identify which calcaneal fractures need to be managed within hours and triaged to the orthopedic team and which can be temporized in a neutral or plantarflexed ankle splint and seen in an outpatient setting. Tongue-type calcaneal fractures and tuberosity fractures must be triaged appropriately within the first few hours of presentation to prevent skin compromise. This requires the emergency physician to understand the radiographic morphology of the fracture as well as the clinical signs of skin compromise. Communication with the orthopedic surgery service is essential and splinting in a specific manner is important to stabilize the soft tissue envelope. Recognizing the calcaneal injury pattern and implementing the correct treatment strategy is paramount to having successful patient outcomes. A delay or error in treatment can turn a closed fracture into an open fracture. Copyright © 2016 Elsevier Inc. All rights reserved.

A morphometric assessment and classification of coral reef spur and groove morphology

NASA Astrophysics Data System (ADS)

Duce, S.; Vila-Concejo, A.; Hamylton, S. M.; Webster, J. M.; Bruce, E.; Beaman, R. J.

2016-07-01

Spurs and grooves (SaGs) are a common and important feature of coral reef fore slopes worldwide. However, they are difficult to access and hence their morphodynamics and formation are poorly understood. We use remote sensing, with extensive ground truthing, to measure SaG morphometrics and environmental factors at 11,430 grooves across 17 reefs in the southern Great Barrier Reef, Australia. We revealed strong positive correlations between groove length, orientation and wave exposure with longer, more closely-spaced grooves oriented easterly reflecting the dominant swell regime. Wave exposure was found to be the most important factor controlling SaG distribution and morphology. Gradient of the upper reef slope was also an important limiting factor, with SaGs less likely to develop in steeply sloping (> 5°) areas. We used a subset of the morphometric data (11 reefs) to statistically define four classes of SaG. This classification scheme was tested on the remaining six reefs. SaGs in the four classes differ in morphology, groove substrate and coral cover. These differences provide insights into SaG formation mechanisms with implications to reef platform growth and evolution. We hypothesize SaG formation is dominated by coral growth processes at two classes and erosion processes at one class. A fourth class may represent relic features formed earlier in the Holocene transgression. The classes are comparable with SaGs elsewhere, suggesting the classification could be applied globally with the addition of new classes if necessary. While further research is required, we show remotely sensed SaG morphometrics can provide useful insights into reef platform evolution.

Discriminative capacity of calcaneal quantitative ultrasound and of osteoporosis and fracture risk factors in postmenopausal women with osteoporotic fractures.

PubMed

Hernández, J L; Marin, F; González-Macías, J; Díez-Pérez, A; Vila, J; Giménez, S; Galán, B; Arenas, M S; Suárez, F; Gayola, L; Guillén, G; Sagredo, T; Belenguer, R; Moron, A; Arriaza, E

2004-04-01

Bone fragility fractures constitute the principal complication of osteoporosis. The identification of individuals at high risk of sustaining osteoporotic fractures is important for implementing preventive measures. The purpose of this study is to analyze the discriminative capacity of a series of osteoporosis and fracture risk factors, and of calcaneal quantitative ultrasound (QUS), in a population of postmenopausal women with a history of osteoporotic fracture. A cross-sectional analysis was made of a cohort of 5195 women aged 65 or older (mean +/- SD: 72.3 +/- 5.4 years) seen in 58 primary care centers in Spain. A total of 1042 women (20.1%) presented with a history of osteoporotic fracture. Most fractures (93%) were non-vertebral. Age-adjusted odds ratios corresponding to each decrease in one standard deviation of the different QUS parameters ranged from 1.47 to 1.55 (P < 0.001) for fractures. The age-adjusted multivariate analysis yielded the following risk factors independently associated with a history of osteoporotic fracture: number of fertile years, a family history of fracture, falls in the previous year, a history of chronic obstructive airway disease, the use of antiarrhythmic drugs, and a low value for any of the QUS parameters. The area under the receiver operating characteristic curve of the best model was 0.656. In summary, a series of easily assessable osteoporotic fracture risk factors has been identified. QUS was shown to discriminate between women with and without a history of fracture, and constitutes a useful tool for assessing fracture risk. Various of the vertebral and hip fracture risk factors frequently cited in North American and British populations showed no discriminative capacity in our series--thus suggesting that such factors may not be fully applicable to our population and/or to the predominant type of fractures included in the present study.

Understanding Bartter syndrome and Gitelman syndrome.

PubMed

Fremont, Oliver T; Chan, James C M

2012-02-01

We aim to review the clinical features of two renal tubular disorders characterized by sodium and potassium wasting: Bartter syndrome and Gitelman syndrome. Selected key references concerning these syndromes were analyzed, together with a PubMed search of the literature from 2000 to 2011. The clinical features common to both conditions and those which are distinct to each syndrome were presented. The new findings on the genetics of the five types of Bartter syndrome and the discrete mutations in Gitelman syndrome were reviewed, together with the diagnostic workup and treatment for each condition. Patients with Bartter syndrome types 1, 2 and 4 present at a younger age than classic Bartter syndrome type 3. They present with symptoms, often quite severe in the neonatal period. Patients with classic Bartter syndrome type 3 present later in life and may be sporadically asymptomatic or mildly symptomatic. The severe, steady-state hypokalemia in Bartter syndrome and Gitelman syndrome may abruptly become life-threatening under certain aggravating conditions. Clinicians need to be cognizant of such renal tubular disorders, and promptly treat at-risk patients.

Surface fatigue and failure characteristics of hot forged powder metal AISI 4620, AISI 4640, and machined AISI 4340 steel spur gears

NASA Technical Reports Server (NTRS)

Townsend, D. P.

1986-01-01

Spur gear surface fatigue endurance tests were conducted to investigate hot forged powder metal AISI 4620 and 4640 steel for use as a gear material, to determine endurance characteristics and to compare the results with machined AISI 4340 and 9310 steel gear materials. The as-forged and unground SISI 4620 gear exhibited a 10 percent fatigue life that was approximately one-fourth of that for AISI 9310 and less than one-half that for the AISI 4340 gears. The forged and finish ground AISI 4620 gears exhibited a 10 percent life, approximately 70 percent that of AISI 9310 and slightly better than that of AISI 4340. The AISI 4640 hot forged gears had less fracture toughness and slightly less fatigue life than the AISI 4620 test gears.

Endoscopically guided removal of cloacal calculi in three African spurred tortoises (Geochelone sulcata).

PubMed

Mans, Christoph; Sladky, Kurt K

2012-04-01

3 female African spurred tortoises (Geochelone sulcata) of various body weights (0.22, 0.77, and 2.86 kg [0.48, 1.69, and 6.29 lb]) were examined because of reduced food intake and lack of fecal output. Owners reported intermittent tenesmus in 2 of the tortoises. Physical examinations revealed no clinically important abnormalities in the tortoises. Cloacal calculi were diagnosed on the basis of radiography and cloacoscopy in all 3 tortoises. One tortoise had another calculus in the urinary bladder. Tortoises were anesthetized, and cloacal calculi were removed by use of a cutting burr (plain-fissure cutting burr and a soft tissue protector mounted to a dental handpiece that had a low-speed motor and a straight nose cone) and warm water irrigation with endoscopic guidance. Complete removal of calculus fragments was achieved by use of forceps and irrigation. In 1 tortoise, removal of the cloacal calculus was staged (2 separate procedures). In another tortoise, a second cloacal calculus (which had been located in the urinary bladder during the first examination) was successfully removed 25 days after removal of the first calculus. All 3 tortoises recovered uneventfully, and serious complications secondary to removal of the cloacal calculi were not detected. Cloacoscopy combined with the use of a low-speed dental drill and warm water irrigation should be considered a simple, safe, and nontraumatic treatment option for removal of obstructive cloacal calculi in tortoises.

Quantitative scintigraphy in diagnosis and management of plantar fasciitis (Calcaneal periostitis): concise communication

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

Sewell, J.R.; Black, C.M.; Chapman, A.H.

1980-07-01

We have found that Tc-99m methylene diphosphonate imaging of the heel is of diagnostic value in the painful heel syndrome, permitting positive identification of the site of inflammation in cases where radiography is unhelpful. With this technique, tracer uptake in the heel is susceptible to quantification, allowing a serial and objective assessment of response to therapy.

The immediate effects of foot orthoses on functional performance in individuals with patellofemoral pain syndrome.

PubMed

Barton, C J; Menz, H B; Crossley, K M

2011-03-01

Patellofemoral pain syndrome (PFPS) often results in reduced functional performance. There is growing evidence for the use of foot orthoses to treat this multifactorial condition. In this study, the immediate effects of foot orthoses on functional performance and the association of foot posture and footwear with improvements in function were evaluated. Fifty-two individuals with PFPS (18-35 years) were prescribed prefabricated foot orthoses (Vasyli Pro; Vasyli International, Labrador, Australia). Functional outcome measures evaluated included the change in (1) pain and (2) ease of a single-leg squat on a five-point Likert scale, and change in the number of (3) pain-free step downs and (4) single-leg rises from sitting. The association of foot posture using the Foot Posture Index, navicular drop and calcaneal angle relative to subtalar joint neutral; and the footwear motion control properties scale score with improved function were evaluated using Spearman's ρ statistics. Prefabricated foot orthoses produced significant improvements (p<0.05) for all functional outcome measures. A more pronated foot type and poorer footwear motion control properties were found to be associated with reduced pain during the single-leg squat and improvements in the number of pain-free single-leg rises from sitting when wearing foot orthoses. In addition, a more pronated foot type was also found to be associated with improved ease of completing a single-leg squat when wearing foot orthoses. Prefabricated foot orthoses provide immediate improvements in functional performance, and these improvements are associated with a more pronated foot type and poorer footwear motion control properties.

Arthroscopic Talar Dome Access Using a Standard Versus Wire-Based Traction Method for Ankle Joint Distraction.

PubMed

Barg, Alexej; Saltzman, Charles L; Beals, Timothy C; Bachus, Kent N; Blankenhorn, Brad D; Nickisch, Florian

2016-07-01

To evaluate the accessibility of the talar dome through anterior and posterior portals for ankle arthroscopy with the standard noninvasive distraction versus wire-based longitudinal distraction using a tensioned wire placed transversely through the calcaneal tuberosity. Seven matched pairs of thigh-to-foot specimens underwent ankle arthroscopy with 1 of 2 methods of distraction: a standard noninvasive strapping technique or a calcaneal tuberosity wire-based technique. The order of the arthroscopic approach and use of a distraction method was randomly determined. The areas accessed from both 2-portal anterior and 2-portal posterior approaches were determined by using a molded translucent grid. The mean talar surface accessible by anterior ankle arthroscopy was comparable with noninvasive versus calcaneal wire distraction with 57.8% ± 17.2% (range, 32.9% to 75.7%) versus 61.5% ± 15.2% (range, 38.5% to 79.1%) of the talar dome, respectively (P = .590). The use of calcaneal wire distraction significantly improved posterior talar dome accessibility compared with noninvasive distraction, with 56.4% ± 20.0% (range, 14.4% to 78.0%) versus 39.8% ± 14.9% (range, 20.0% to 57.6%) of the talar dome, respectively (P = .031). Under the conditions studied, our cadaveric model showed equivalent talar dome access with 2-portal anterior arthroscopy of calcaneal wire-based distraction versus noninvasive strap distraction, but improved access for 2-portal posterior arthroscopy with calcaneal wire-based distraction versus noninvasive strap distraction. The posterior 40% of the talar dome is difficult to access via anterior ankle arthroscopy. Posterior calcaneal tuberosity wire-based longitudinal distraction improved arthroscopic access to the centro-posterior talar dome with a posterior arthroscopic approach. Published by Elsevier Inc.

Formation of a spatter-rich pyroclastic density current deposit in a Neogene sequence of trachytic-mafic igneous rocks at Mason Spur, Erebus volcanic province, Antarctica

NASA Astrophysics Data System (ADS)

Martin, A. P.; Smellie, J. L.; Cooper, A. F.; Townsend, D. B.

2018-01-01

Erosion has revealed a remarkable section through the heart of a volcanic island, Mason Spur, in the southwestern Ross Sea, Antarctica, including an unusually well-exposed section of caldera fill. The near-continuous exposure, 10 km laterally and > 1 km vertically, cuts through Cenozoic alkalic volcanic rocks of the Erebus volcanic province (McMurdo Volcanic Group) and permits the study of an ancient volcanic succession that is rarely available due to subsequent burial or erosion. The caldera filling sequence includes an unusual trachytic spatter-rich lapilli tuff (ignimbrite) facies that is particularly striking because of the presence of abundant black fluidal, dense juvenile spatter clasts of trachytic obsidian up to 2 m long supported in a pale cream-coloured pumiceous lapilli tuff matrix. Field mapping indicates that the deposit is an ignimbrite and, together with petrological considerations, it is suggested that mixing of dense spatter and pumiceous lapilli tuff in the investigated deposit occurred during emplacement, not necessarily in the same vent, with the mixed fragmental material emplaced as a pyroclastic density current. Liquid water was not initially present but a steam phase was probably generated during transport and may represent water ingested during passage of the current as it passed over either wet ground, stream, shallow lake or (possibly) snow. Well-exposed caldera interiors are uncommon and that at Mason Spur is helping understand eruption dynamics associated with a complex large island volcano. The results of our study should help to elucidate interpretations of other, less well exposed, pyroclastic density current deposits elsewhere in Antarctica and globally.

Endoscopic Plantar Fasciotomy Through Two Medial Portals for the Treatment of Recalcitrant Plantar Fasciopathy.

PubMed

Al-Ashhab, Mohamed Ebrahim; Elbegawy, Hossam El-Dein A; Hasan, Hala Ali Abed

Plantar fasciopathy is a common cause of heel pain. Endoscopic plantar fasciotomy has the advantage of less surgical trauma and rapid recovery. The aim of the present prospective study was to delineate the results of endoscopic plantar fascia release through 2 medial portals. The present study included 2 groups. The first group included 27 feet in 25 patients that had undergone endoscopic plantar fascia release followed up for 19.7 (range 12 to 33) months. The second group, the control group, included 20 feet in 16 patients treated conservatively and followed up for 16.4 (range 12 to 24) months. The results of endoscopic plantar fascia release were superior to the conservative methods. The surgically treated group experienced significantly less pain, activity limitations, and gait abnormality. The presence of a calcaneal spur had no effect on the final postoperative score. In conclusion, endoscopic plantar fascia release through 2 medial portals is an effective procedure for treatment of resistant plantar fasciopathy that fails to respond to conservative management options. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

The Athletic Foot and Its Import to Performance during Running.

ERIC Educational Resources Information Center

Bogdan, Richard

In this paper, problems and conditions of the foot, including flat feet, achilles tendon problems, heel spur syndrome, digital problems, shin splints, and leg stress fractures, are examined. Ways to examine the athlete's foot and leg are described, including the one-foot test and the off weight-bearing examination. (CJ)

Ankle impingement syndromes.

PubMed

Umans, Hilary

2002-06-01

The term "ankle impingement" encompasses a broad range of conditions that are typically post-traumatic and often chronic. Various forms of mechanical impingement can result from synovial proliferation, bone spur formation, or ligamentous scarring and hypertrophy. Since symptoms and physical findings can mimic a variety of disorders, accurate diagnosis may remain elusive, and proper effective therapy may be delayed. The objective of this article is to define and elucidate the etiology of the various forms of ankle impingement, clarify the range of associated osseous and soft-tissue pathology, and describe the imaging features and therapeutic options.

Using Behavior Over Time Graphs to Spur Systems Thinking Among Public Health Practitioners.

PubMed

Calancie, Larissa; Anderson, Seri; Branscomb, Jane; Apostolico, Alexsandra A; Lich, Kristen Hassmiller

2018-02-01

Public health practitioners can use Behavior Over Time (BOT) graphs to spur discussion and systems thinking around complex challenges. Multiple large systems, such as health care, the economy, and education, affect chronic disease rates in the United States. System thinking tools can build public health practitioners' capacity to understand these systems and collaborate within and across sectors to improve population health. BOT graphs show a variable, or variables (y axis) over time (x axis). Although analyzing trends is not new to public health, drawing BOT graphs, annotating the events and systemic forces that are likely to influence the depicted trends, and then discussing the graphs in a diverse group provides an opportunity for public health practitioners to hear each other's perspectives and creates a more holistic understanding of the key factors that contribute to a trend. We describe how BOT graphs are used in public health, how they can be used to generate group discussion, and how this process can advance systems-level thinking. Then we describe how BOT graphs were used with groups of maternal and child health (MCH) practitioners and partners (N = 101) during a training session to advance their thinking about MCH challenges. Eighty-six percent of the 84 participants who completed an evaluation agreed or strongly agreed that they would use this BOT graph process to engage stakeholders in their home states and jurisdictions. The BOT graph process we describe can be applied to a variety of public health issues and used by practitioners, stakeholders, and researchers.

The developmental trajectory of disruptive behavior in Down syndrome, fragile X syndrome, Prader-Willi syndrome and Williams syndrome.

PubMed

Rice, Lauren J; Gray, Kylie M; Howlin, Patricia; Taffe, John; Tonge, Bruce J; Einfeld, Stewart L

2015-06-01

The aim of this study was to investigate the developmental trajectories of verbal aggression, physical aggression, and temper tantrums in four genetic syndrome groups. Participants were part of the Australian Child to Adult Development Study (ACAD), which collected information from a cohort of individuals with an intellectual disability at five time points over 18 years. Data were examined from a total of 248 people with one of the four following syndromes: Down syndrome, Fragile X syndrome, Prader-Willi syndrome, or Williams syndrome. Changes in behaviors were measured using validated items from the Developmental Behavior Checklist (DBC). The results indicate that, while verbal aggression shows no evidence of diminishing with age, physical aggression, and temper tantrums decline with age before 19 years for people with Down syndrome, Fragile X syndrome, and William syndrome; and after 19 years for people with Prader-Willi syndrome. These findings offer a somewhat more optimistic outlook for people with an intellectual disability than has previously been suggested. Research is needed to investigate the mechanisms predisposing people with PWS to persistence of temper tantrums and physical aggression into adulthood. © 2015 Wiley Periodicals, Inc.

Morphological and histochemical observations on the crural gland-spur apparatus of the echidna (Tachyglossus aculeatus) together with comparative observations on the femoral gland-spur apparatus of the duckbilled platypus (Ornithorhyncus anatinus).

PubMed

Krause, William J

2010-01-01

The echidna and platypus have a crural/femoral gland that is linked by a large duct to a canalized, keratinous spur located on the medial side of the ankle. The echidna crural gland, like the femoral gland of the platypus, exhibits cyclic activity, being prominent in both monotremes when they are sexually active. In the present study, we compared the structure and histochemistry of these glands. During the active phase, the secretory epithelium forming the respective glands of both species increased in height and became packed with secretory granules that differed markedly in structure. Secretory granules of the echidna crural gland were electron dense and characterized by cores or areas of increased electron density. Those of the platypus were initially electron dense, but then became less dense and coalesced into irregular complexes of secretory material. Large cytoplasmic blebs extended from epithelial cell apices and appeared to be shed into the lumen, resulting in an apocrine mode of secretion. Exocytosis was also observed. A similar form of release of secretory product was not observed in the echidna. Secretory granules of both species were periodic acid-Schiff positive and stained for protein, suggesting that much of the secretory product was glycoprotein. Myoepithelial cells enveloped the secretory tubules of the platypus femoral gland, whereas they were not observed surrounding tubules comprising the echidna crural gland. During the quiescent phase, the epithelial cells of both species lost their secretory granules and decreased in height. As a result, the secretory tubules became smaller, intralobular connective tissue increased and the glands decreased in overall size.

The metabolic syndrome in polycystic ovary syndrome.

PubMed

Essah, P A; Nestler, J E

2006-03-01

Much overlap is present between the polycystic ovary syndrome (PCOS) and the metabolic syndrome. This article reviews the existing data regarding the prevalence, characteristics, and treatment of the metabolic syndrome in women with PCOS. The prevalence of the metabolic syndrome in PCOS is approximately 43-47%, a rate 2-fold higher than that for women in the general population. High body mass index and low serum HDL cholesterol are the most frequently occurring components of the metabolic syndrome in PCOS. The pathogenic link between the metabolic syndrome and PCOS is most likely insulin resistance. Therefore, the presence of the metabolic syndrome in PCOS suggests a greater degree of insulin resistance compared to PCOS without the metabolic syndrome. Obesity, atherogenic dyslipidemia, hypertension, impaired fasting glucose/impaired glucose tolerance, and vascular abnormalities are all common metabolic abnormalities present in PCOS. Lifestyle modification has proven benefit and pharmacological therapy with insulin-sensitizing agents has potential benefit in the treatment of the metabolic syndrome in women with PCOS.

Elimination of viruses through thermotherapy and meristem culture in apple cultivar 'Oregon Spur-II'.

PubMed

Vivek, Manu; Modgil, Manju

2018-03-01

In the present study, an attempt was made to eliminate apple chlorotic leaf spot virus, apple mosaic virus, apple stem grooving virus and apple stem pitting virus from apple cultivar 'Oregon Spur-II'. Thermotherapy was carried out at 37-40 °C for 4 weeks followed by culturing of meristems of different sizes. During establishment of explants, highest survival percentage (62.35%) and proliferation (30.68%) was recorded during summer season. However, size of meristems and position of buds from where meristems were excised also influenced their survival. The meristems of size 0.6-0.7 mm were found to be the most appropriate for maximum establishment. Meristems excised from buds positioned on distil portions of actively growing shoots showed better results. MS medium supplemented with BA (1.0 mg/l), IBA (0.05 mg/l) and GA 3 (0.1 mg/l) resulted in 56.62% establishment of explants, while maximum number of meristems proliferated with low BA (0.5 mg/l), IBA (0.08 mg/l) and same GA 3 concentration. Two to fourfold multiplication was observed. Virus indexing of shoots raised from different sizes of meristems was carried out and found that 0.3-0.6 mm size was able to eliminate ACLSV, ApMV, ASGV and ASPV. However, some of 0.5-0.6 mm sized shoots were found infected with ACLSV. Larger meristems could not completely eliminate the viruses under study.

Separating selection by diurnal and nocturnal pollinators on floral display and spur length in Gymnadenia conopsea.

PubMed

Sletvold, Nina; Trunschke, Judith; Wimmergren, Carolina; Agren, Jon

2012-08-01

Most plants attract multiple flower visitors that may vary widely in their effectiveness as pollinators. Floral evolution is expected to reflect interactions with the most important pollinators, but few studies have quantified the contribution of different pollinators to current selection on floral traits. To compare selection mediated by diurnal and nocturnal pollinators on floral display and spur length in the rewarding orchid Gymnadenia conopsea, we manipulated the environment by conducting supplemental hand-pollinations and selective pollinator exclusions in two populations in central Norway. In both populations, the exclusion of diurnal pollinators significantly reduced seed production compared to open pollination, whereas the exclusion of nocturnal pollinators did not. There was significant selection on traits expected to influence pollinator attraction and pollination efficiency in both the diurnal and nocturnal pollination treatment. The relative strength of selection among plants exposed to diurnal and nocturnal visitors varied among traits and populations, but the direction of selection was consistent. The results suggest that diurnal pollinators are more important than nocturnal pollinators for seed production in the study populations, but that both categories contribute to selection on floral morphology. The study illustrates how experimental manipulations can link specific categories of pollinators to observed selection on floral traits, and thus improve our understanding of how species interactions shape patterns of selection.

A Rare Variant of Wallenberg’s Syndrome: Opalski syndrome

PubMed Central

KK, Parathan; P, Chitrambalam; Aiyappan, Senthil Kumar; N, Deepthi

2014-01-01

Lateral Medullary Syndrome (LMS) is a well-documented vascular syndrome of the posterior circulation territory. This syndrome is easily localised because of characteristic presentation, unique territory of blood supply and very small area of involvement. We present a case of Wallenberg’s syndrome which did not have all the classical components of the syndrome, like Horner’s syndrome. Opalski syndrome is a rare variant of Wallenberg syndrome, where lateral medullary syndrome is associated with ipsilateral hemiparesis. This case report highlights how differential involvement of the lateral part of medulla can result in varied presentation. PMID:25177595

Duane Syndrome

MedlinePlus

... is Duane Syndrome? Duane syndrome, also called Duane retraction syndrome (DRS), is a congenital and non-progressive ... Is Duane syndrome congenital (present from birth)? Duane retraction syndrome is present from birth, even if it ...

Seckel syndrome: an overdiagnosed syndrome.

PubMed Central

Thompson, E; Pembrey, M

1985-01-01

Five children in whom a diagnosis of Seckel syndrome had previously been made were re-examined in the genetic unit. One child had classical Seckel syndrome, a sib pair had the features of the syndrome with less severe short stature, and in two children the diagnosis was not confirmed. Seckel syndrome is only one of a group of low birth weight microcephalic dwarfism and careful attention should be paid to fulfillment of the major criteria defined by Seckel before the diagnosis is made. There remains a heterogeneous group of low birth weight microcephalic dwarfism yet to be defined. Images PMID:4040172

Ultrasonographic assessment of tendon thickness, Doppler activity and bony spurs of the elbow in patients with lateral epicondylitis and healthy subjects: a reliability and agreement study.

PubMed

Krogh, T P; Fredberg, U; Christensen, R; Stengaard-Pedersen, K; Ellingsen, T

2013-10-01

Tennis elbow, also known as lateral epicondylitis (LE), is a common disorder often assessed by ultrasound. The aim of this study was to evaluate the ultrasonographic outcomes and methods used in LE research and clinical practice. This study was designed as an intra- and interobserver reliability and agreement study. Ultrasonographic examination of the common extensor tendon of the elbow was performed. The intraobserver study examined tendon thickness twice in 20 right elbows from 20 healthy individuals at an interval of 7 to 12 days. The interobserver study examined tendon thickness, color Doppler activity, and bony spurs in 18 right elbows in 9 healthy individuals and 9 patients with LE. Two trained rheumatologists performed the interobserver examinations with the same scanner on the same day. The main outcomes were intra- and interclass correlation (ICC) and agreement. In the intraobserver study, the ICC with regard to tendon thickness ranged from 0.76 to 0.81, depending on the measurement techniques used. The agreement ranged from 0.06 to 0.13 mm. In the interobserver study, the tendon thickness ICC ranged from 0.45 to 0.65 and the agreement ranged from -0.17 to 0.13 mm. The ICC for color Doppler activity was 0.93, with agreement in 14/18 (78 %) of the cases. A perfect reliability was demonstrated for bony spurs, with an ICC of 1 and exact agreement in 18/18 (100 %) of the cases. Good to excellent reliability was obtained for all measurements. The ultrasonographic techniques evaluated in this trial can be recommended for use in both research and clinical practice. © Georg Thieme Verlag KG Stuttgart · New York.

Brief Report: Repetitive Behaviour Profiles in Williams syndrome: Cross Syndrome Comparisons with Prader-Willi and Down syndromes.

PubMed

Royston, R; Oliver, C; Moss, J; Adams, D; Berg, K; Burbidge, C; Howlin, P; Nelson, L; Stinton, C; Waite, J

2018-01-01

This study describes the profile of repetitive behaviour in individuals with Williams syndrome, utilising cross-syndrome comparisons with people with Prader-Willi and Down syndromes. The Repetitive Behaviour Questionnaire was administered to caregivers of adults with Williams (n = 96), Prader-Willi (n = 103) and Down (n = 78) syndromes. There were few group differences, although participants with Williams syndrome were more likely to show body stereotypies. Individuals with Williams syndrome also showed more hoarding and less tidying behaviours than those with Down syndrome. IQ and adaptive ability were negatively associated with repetitive questioning in people with Williams syndrome. The profile of repetitive behaviour amongst individuals with Williams syndrome was similar to the comparison syndromes. The cognitive mechanisms underlying these behaviours in genetic syndromes warrant further investigation.

[Association Budd Chiari syndrome, antiphospholipid syndrome and Grave's disease].

PubMed

Mouelhi, Leila; Chaieb, Mouna; Debbeche, Radhouane; Salem, Mohamed; Sfar, Imene; Trabelsi, Sinda; Gorgi, Yosr; Najjar, Taoufik

2009-02-01

Antiphospholipid syndrome is revealed by Budd Chiari syndrome in 5% of the cases. Antiphospholipid syndrome is characterized by venous or arterial thrombosis, foetal loss and positivity of antiphospholipid antibodies, namely lupus anticoagulant, anticardiolipin antibodies and anti-beta2-glycoprotein I. Anticardiolipin antibodies was reported in auto-immune thyroid disorders, particularly in Grave's disease. Antiphospholipid syndrome associated to Grave's disease was reported in only three cases. To describe a case report of association of Grave's disease and antiphospholipid syndrome. We report the first case of Grave's disease associated with antiphospholipid syndrome, revealed by Budd Chiari syndrome. Our observation is particular by the fact that it is about a patient presenting a Grave's disease associated with antiphospholipid syndrome revealed by Budd Chiari syndrome. This triple association has never been reported in literature. Although association between antiphospholipid syndrome and Grave's disease was previously described, further studies evaluating the coexistence of these two affections in the same patient would be useful.

Wells syndrome and its relationship to Churg-Strauss syndrome.

PubMed

Ratzinger, Gudrun; Zankl, Julia; Zelger, Bernhard

2013-08-01

  Wells syndrome has been described as an inflammatory disorder based on typical clinical appearance combined with the histopathological presence of eosinophilic infiltrates and flame figures in the absence of vasculitis. Churg-Strauss syndrome, on the other hand, is primarily a diffuse, necrotizing vasculitis but is also typically displaying eosinophils and flame figures. Despite several parallels, the present understanding of these two diseases excludes any pathogenetic relationship.   We describe the clinical course and histopathological appearance of three patients who had initially been diagnosed with Wells syndrome that developed into Churg-Strauss syndrome during the course of their disease.   The clinical presentation of all three patients led to the diagnosis of Wells syndrome by independent specialists. Histopathology showed an eosinophilic infiltrate and flame figures next to features of leukocytoclastic vasculitis. Detailed examination revealed asthma bronchiale and additional symptoms indicating Churg-Strauss syndrome. The initial diagnosis of Wells syndrome had to be revised to Churg-Strauss syndrome.   We conclude that Wells syndrome could be the starting point of a pathogenetic process that might reach its maximum in Churg-Strauss syndrome. As a clinical consequence, patients with Wells syndrome should be evaluated and followed for Churg-Strauss syndrome. © 2013 The International Society of Dermatology.

Kindler syndrome.

PubMed

Kaviarasan, P K; Prasad, P V S; Shradda; Viswanathan, P

2005-01-01

Kindler syndrome is a rare autosomal recessive disorder associated with skin fragility. It is characterized by blistering in infancy, photosensitivity and progressive poikiloderma. The syndrome involves the skin and mucous membrane with radiological changes. The genetic defect has been identified on the short arm of chromosome 20. This report describes an 18-year-old patient with classical features like blistering and photosensitivity in childhood and the subsequent development of poikiloderma. The differential diagnosis of Kindler syndrome includes diseases like Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. Our patient had classical cutaneous features of Kindler syndrome with phimosis as a complication.

"Syndrome in syndrome": Wernicke syndrome due to afferent loop syndrome. Case report and review of the literature.

PubMed

D'Abbicco, D; Praino, S; Amoruso, M; Notarnicola, A; Margari, A

2011-01-01

Wernicke syndrome is a rare neurological pathology due to a deficit in vitamin B1. The syndrome is common among alcohol abusers, patients with malignant tumor or gastrointestinal diseases, those who undergo hemodialysis or long-term peritoneal dialysis, pregnant women with hyperemesis, women who breast-feed, patients with hyperthyroidism or anorexia nervosa or gastric or jejunal-ileal bypass surgery for obesity, patients submitted to gastric surgery or prolonged total parenteral nutrition or prolonged intravenous therapy. We report a case of Wernicke syndrome due to afferent loop syndrome characterized by incoercible vomiting.

Fanconi syndrome

MedlinePlus

De Toni-Fanconi syndrome ... Fanconi syndrome can be caused by faulty genes, or it may result later in life due to kidney damage. Sometimes the cause of Fanconi syndrome is unknown. Common causes of Fanconi syndrome in ...

[Kenny-Caffey syndrome and its related syndromes].

PubMed

Isojima, Tsuyoshi; Kitanaka, Sachiko

2015-11-01

Kenny-Caffey syndrome (KCS) is a very rare dysmorphologic syndrome characterized by proportionate short stature, cortical thickening and medullary stenosis of tubular bones, delayed closure of anterior fontanelle, eye abnormalities, and hypoparathyroidism. Two types of KCS were known: the autosomal recessive form (KCS type 1), which is caused by mutations of the TBCE gene, and the autosomal dominant form (KCS type 2), which is caused by mutations of the FAM111A gene. TBCE mutation also causes hypoparathyroidism-retardation-dysmorphism syndrome, and FAM111A mutation also causes gracile bone dysplasia. These two diseases can be called as KCS-related syndromes. In this article, we review the clinical manifestations of KCS and discuss its related syndromes.

Metabolic syndrome and polycystic ovary syndrome: an intriguing overlapping.

PubMed

Caserta, Donatella; Adducchio, Gloria; Picchia, Simona; Ralli, Eleonora; Matteucci, Eleonora; Moscarini, Massimo

2014-06-01

Metabolic syndrome is an increasing pathology in adults and in children, due to a parallel rise of obesity. Sedentary lifestyle, food habits, cultural influences and also a genetic predisposition can cause dyslipidemia, hypertension, abdominal obesity and insulin resistance which are the two main features of metabolic syndrome. Polycystic ovary syndrome (PCOS) is a condition directly associated with obesity, insulin resistance (HOMA index) and metabolic syndrome, and it is very interesting for its relationship and overlap with the metabolic syndrome. The relationship between the two syndromes is mutual: PCOS women have a higher prevalence of metabolic syndrome and also women with metabolic syndrome commonly present the reproductive/endocrine trait of PCOS. Prevention and treatment of metabolic syndrome and PCOS are similar for various aspects. It is necessary to treat excess adiposity and insulin resistance, with the overall goals of preventing cardiovascular disease and type 2 diabetes and improving reproductive failure in young women with PCOS. First of all, lifestyle changes, then pharmacological therapy, bariatric surgery and laparoscopic ovarian surgery represent the pillars for PCOS treatment.

Comparing acoustic measurement data in eastern margin of Sea of Japan and Umitaka Spur

NASA Astrophysics Data System (ADS)

Kondo, M., IV; Aoyama, C.

2017-12-01

Recently, methane hydrate is gaining remarkable attention for the abundant amount in the sea area around Japan, and also for its carbon dioxide emission amount being as little as that of natural resources when being combusted. Two types of methane hydrates are known to exist, depending on the settings. Sand layer type methane hydrate contains sand particles and is extracted mainly in the Pacific Ocean, around 100 to 400m below seafloor. On the other hand, shallow type is found around 100m below seafloor in the Sea of Japan, in clumps, veins, and particles. One of the extraction methods of shallow type methane hydrate observed in the Sea of Japan is the seabed exploration system using acoustic equipment, which Chiharu Aoyama owns patent. Methane plumes often exist in the vicinity of shallow type methane hydrate and these seeping plumes are visualized as images on acoustic instruments such as quantitative echo sounder and multi-beam echo sounder (hereinafter referred to as MBES). These images look like rising beams on monitors and are called gas plumes. Methane hydrate can be explored effectively in the area using this method and it is understood that even when the same plume is examined, backscattering strength data (hereinafter referred as SV) observed using acoustic equipment will not be the same on quantitative echo sounder and MBES. In June 2017, measurement of acoustic data using multi-beam sonar (EM122) and quantitative echo sounder (EA600) were performed onboard DAIICHI KAIYOMARU (KAIYO ENGINEERING CO., LTD) at eastern margin of Sea of Japn and at Umitaka Spur. In this study, author will make comparisons of the acoustic data.

Iris concavity, corneal biomechanics, and their correlations with ocular biometry in a cohort of 10- to 12-year-old UK school boys: baseline data.

PubMed

Shah, Ameet; Low, Sancy; Garway-Heath, David F; Foster, Paul J; Barton, Keith

2014-04-17

Pigment dispersion syndrome is associated with iris concavity. This study investigated the prevalence of iris concavity, defined as a measurement of ≤-0.1 mm, in a cohort of 10- to 12-year-old boys, and explored the relationship between iris curvature and anterior segment biometry. Associations with corneal biomechanical parameters also were explored. A cohort of school boys (n = 96) was recruited from a local school. Anterior segment optical coherence tomography (AS-OCT) was performed under accommodative and nonaccommodative conditions, and iris curvature quantified. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with the ocular response analyzer (ORA). Noncontact axial biometry was performed using laser interferometry. The prevalence of iris concavity was 24% on distance fixation, increasing to 65% on accommodation. Variables significantly associated with nonaccommodating iris curvature were lens vault (P = 0.02) and mean keratometry (P = 0.02). For both variables acting jointly, R(2) = 0.30. Variables associated significantly with accommodating iris curvature were anterior chamber depth (P = 0.009), lens vault (P = 0.049), and mean scleral spur angle (P < 0.0001). For these three variables acting jointly, R(2) = 0.33. Significant association was found between CH and spur-to-spur distance (R(2) = 0.07, P = 0.025). Iris concavity was a common finding in this cohort and related to anterior segment biometric parameters. Further work is required to clarify whether anatomical differences exist between iris concavity seen in the adolescent eye and that found in adults with pigment dispersion syndrome. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

West syndrome in a patient with Schinzel-Giedion syndrome.

PubMed

Miyake, Fuyu; Kuroda, Yukiko; Naruto, Takuya; Ohashi, Ikuko; Takano, Kyoko; Kurosawa, Kenji

2015-06-01

Schinzel-Giedion syndrome is a rare recognizable malformation syndrome defined by characteristic facial features, profound developmental delay, severe growth failure, and multiple congenital anomalies. The causative gene of Schinzel-Giedion syndrome, SETBP1, has been identified, but limited cases have been confirmed by molecular analysis. We present a 9-month-old girl affected by West syndrome with Schinzel-Giedion syndrome. Congenital severe hydronephrosis, typical facial features, and multiple anomalies suggested a clinical diagnosis of Schinzel-Giedion syndrome. Hypsarrhythmia occurred at 7 months of age and was temporarily controlled by adrenocorticotropic hormone (ACTH) therapy during 5 weeks. SETBP1 mutational analysis showed the presence of a recurrent mutation, p.Ile871Thr. The implications in management of Schinzel-Giedion syndrome are discussed. © The Author(s) 2014.

Calcaneotalar ratio: a new concept in the estimation of the length of the calcaneus.

PubMed

David, Vikram; Stephens, Terry J; Kindl, Radek; Ang, Andy; Tay, Wei-Han; Asaid, Rafik; McCullough, Keith

2015-01-01

Maintaining the calcaneal length after calcaneal fractures is vital to restoring the normal biomechanics of the foot, because it acts as an important lever arm to the plantarflexors of the foot. However, estimation of the length of the calcaneus to be reconstructed in comminuted calcaneal fractures can be difficult. We propose a new method to reliably estimate the calcaneal length radiographically by defining the calcaneotalar length ratio. A total of 100 ankle radiographs with no fracture in the calcaneus or talus taken in skeletally mature patients were reviewed by 6 observers. The anteroposterior lengths of the calcaneus and talus were measured, and the calcaneotalar length ratio was determined. The ratio was then used to estimate the length of the calcaneus. Interobserver reliability was determined using Cronbach's α coefficient and Pearson's correlation coefficient. The mean length of the calcaneus was 75 ± 0.6 mm, and the mean length of the talus was 59 ± 0.5 mm. The calcaneotalar ratio was 1.3. Using this ratio and multiplying it by the talar length, the mean average estimated length of the calcaneus was within 0.7 mm of the known calcaneal length. Cronbach's α coefficient and Pearson's correlation coefficient showed excellent interobserver reliability. The proposed calcaneotalar ratio is a new and reliable method to radiographically estimate the normal length of the calcaneus when reconstructing the calcaneus. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Kindler syndrome.

PubMed

Lai-Cheong, Joey E; McGrath, John A

2010-01-01

Kindler syndrome (MIM173650) is an autosomal recessive genodermatosis characterized by poikiloderma, trauma-induced skin blistering, mucosal inflammation, and photosensitivity. Loss-of-function mutations in the FERMT1 gene are the cause of Kindler syndrome. Kindler syndrome is categorized as a subtype of epidermolysis bullosa (EB). During infancy and childhood, there is clinical overlap between Kindler syndrome and dystrophic EB. Unlike other forms of EB, Kindler syndrome is characterized by impaired actin cytoskeleton-extracellular matrix interactions and a variable plane of blister formation at or close to the dermal-epidermal junction. This article reviews clinicopathologic and molecular features of Kindler syndrome and discusses patient management.

Obstructive sleep apnoea/hypopnoea syndrome in adults with Down syndrome

PubMed Central

2016-01-01

Key points Adults with Down syndrome are predisposed to obstructive sleep apnoea/hypopnoea syndrome (OSAHS) due to overlap between the Down syndrome phenotype and OSAHS risk factors. The prevalence of OSAHS in adults with Down syndrome is estimated at 35–42%. This is up to ten-times higher than in the general adult population. Symptoms of OSAHS, including behavioural and emotional disturbances as well as standard symptoms such as sleepiness, should be monitored as part of regular health surveillance in adults with Down syndrome. There is evidence that the use of continuous positive airway pressure (CPAP) therapy in adults with Down syndrome and comorbid OSAHS can lead to significant improvements in subjective sleepiness, behaviour and cognitive function, though further large-scale trials are required. Educational aims To discuss the relationship between the phenotypic features of Down syndrome and the risk factors for obstructive sleep apnoea/hypopnoea syndrome (OSAHS). To examine the prevalence of OSAHS in adults with Down syndrome. To review recent research into the effectiveness of treatment of OSAHS in adults with Down syndrome using continuous positive airway pressure (CPAP) therapy. Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is characterised by repeated cycles of upper airway obstruction during sleep, leading to diurnal symptoms. Individuals with Down syndrome are predisposed to OSAHS due to overlap between the Down syndrome phenotype and OSAHS risk factors. Recent large studies using subjective and objective measures estimate that OSAHS affects around 40% of adults with Down syndrome, in contrast to 2–4% of the general adult population. The “double-hit” of comorbid Down syndrome and OSAHS may accelerate cognitive decline in adults with Down syndrome. However, with the appropriate care and support, OSAHS can be treated effectively in this group using continuous positive airway pressure (CPAP) therapy, improving daytime function and behaviour

Obstructive sleep apnoea/hypopnoea syndrome in adults with Down syndrome.

PubMed

Hill, Elizabeth A

2016-12-01

Adults with Down syndrome are predisposed to obstructive sleep apnoea/hypopnoea syndrome (OSAHS) due to overlap between the Down syndrome phenotype and OSAHS risk factors.The prevalence of OSAHS in adults with Down syndrome is estimated at 35-42%. This is up to ten-times higher than in the general adult population.Symptoms of OSAHS, including behavioural and emotional disturbances as well as standard symptoms such as sleepiness, should be monitored as part of regular health surveillance in adults with Down syndrome.There is evidence that the use of continuous positive airway pressure (CPAP) therapy in adults with Down syndrome and comorbid OSAHS can lead to significant improvements in subjective sleepiness, behaviour and cognitive function, though further large-scale trials are required. To discuss the relationship between the phenotypic features of Down syndrome and the risk factors for obstructive sleep apnoea/hypopnoea syndrome (OSAHS).To examine the prevalence of OSAHS in adults with Down syndrome.To review recent research into the effectiveness of treatment of OSAHS in adults with Down syndrome using continuous positive airway pressure (CPAP) therapy. Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is characterised by repeated cycles of upper airway obstruction during sleep, leading to diurnal symptoms. Individuals with Down syndrome are predisposed to OSAHS due to overlap between the Down syndrome phenotype and OSAHS risk factors. Recent large studies using subjective and objective measures estimate that OSAHS affects around 40% of adults with Down syndrome, in contrast to 2-4% of the general adult population. The "double-hit" of comorbid Down syndrome and OSAHS may accelerate cognitive decline in adults with Down syndrome. However, with the appropriate care and support, OSAHS can be treated effectively in this group using continuous positive airway pressure (CPAP) therapy, improving daytime function and behaviour. Symptoms of OSAHS should be routinely

Assessment of bone in Ehlers Danlos syndrome by ultrasound and densitometry.

PubMed

Dolan, A L; Arden, N K; Grahame, R; Spector, T D

1998-10-01

Ehlers Danlos syndrome (EDS) is an inherited disorder of connective tissue characterised by hyperextensible skin, joint laxity, and easy bruising. There are phenotypic similarities with osteogenesis imperfecta, but in EDS a tendency to fracture or altered bone mass has not previously been considered to be a cardinal feature. This case-control design study investigates whether 23 patients with EDS had differences in fracture rates, bone mass, and calcaneal ultrasound parameters compared with age and sex matched controls. 23 cases of EDS (mean (SD) age 38.5 (15.5)) were compared with 23 controls (mean age 37.8 (14.5)). A significant reduction in bone density measured by dual energy x ray absorptiometry was found at the neck of femur by 0.9 SD, p = 0.05, and lumbar spine by 0.74 SD, p = 0.02. At the calcaneum, broad band ultrasound attenuation and speed of sound were significantly reduced compared with controls by 0.95 SD (p = 0.004) and 0.49 SD (p = 0.004) for broad band ultrasound attenuation and speed of sound respectively. Broad band ultrasound attenuation and speed of sound remained significantly reduced after adjusting for bone mineral density (BMD). After adjusting for functional status (HAQ), age and sex, hypermobility was inversely correlated with broad band ultrasound attenuation and SOS, but not BMD at hip or spine. Previous fracture was 10 times more common in EDS (p < 0.001), with 86.9% of patients reporting a total of 47 low impact fractures, compared with 8.7% of controls. This study has identified a tendency of EDS patients to fracture, have low bone mass and abnormal bone structure. The aetiology is likely to be multifactorial, with an inherited structural element, accentuated by immobility or reduced exercise. This is one of the first clinical studies to suggest ultrasound can detect structural differences in bone, independent of dual energy x ray absorptiometry.

Cushing syndrome

MedlinePlus

Hypercortisolism; Cortisol excess; Glucocorticoid excess - Cushing syndrome ... The most common cause of Cushing syndrome is taking too much ... Cushing syndrome . Prednisone, dexamethasone, and prednisolone ...

[Cockett's syndrome, May-Thurner syndrome, or iliac vein compression syndrome].

PubMed

Gil Martín, A R; Carreras Aja, M; Arrieta Ardieta, I; Labayen Azparren, I

2014-01-01

Iliac vein compression syndrome (also known as May-Thurner syndrome or Cockett's syndrome) is a rare clinical entity in which the left common iliac vein is compressed when it passes between the right common iliac artery and the spine. The sustained compression and trauma caused by the pulsatile force of the artery on the vein damage the intima and lead to the formation of membranes or bands in the vascular lumen that hinder or obstruct the flow of blood in the vein, favoring thrombus formation. The current treatment strategy of choice is endovascular vein patch angioplasty and stenting with the aim of improving the caliber of the lumen and enabling normal venous drainage. We present two cases of May-Thurner syndrome and review the clinical and CT findings. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

LEOPARD syndrome

MedlinePlus

Multiple lentigines syndrome; Noonan syndrome with multiple lentigines ... Genetics Home Reference -- ghr.nlm.nih.gov/condition/noonan-syndrome-with-multiple-lentigines National Organization for Rare Disorders -- ...

Irritable Bowel Syndrome

MedlinePlus

... Staying Safe Videos for Educators Search English Español Irritable Bowel Syndrome KidsHealth / For Teens / Irritable Bowel Syndrome What's in ... intestinal disorder called irritable bowel syndrome. What Is Irritable Bowel Syndrome? Irritable bowel syndrome (IBS) is a common intestinal ...

A Chinese patient with pusher syndrome and unilateral spatial neglect syndrome.

PubMed

Chen, Xiao-Wei; Lin, Cheng-He; Zheng, Hua; Lin, Zhen-Lan

2014-07-01

To observe clinical manifestations, behavioral characteristics, and effects of rehabilitation on a patient with pusher syndrome and unilateral spatial neglect caused by right thalamic hemorrhage. Assessment of pusher syndrome was made by the Scale for Contraversive pushing (SCP), and unilateral spatial neglect syndrome was diagnosed using line cancellation, letter and star cancellation, line bisection tests and copy and continuation of graphic sequence test. Behavioral therapy, occupational therapy, reading training and traditional Chinese medicine methods were adopted for treatment of pusher syndrome and unilateral spatial neglect. The patient showed typical pusher syndrome and unilateral spatial neglect symptoms. The pusher syndrome and unilateral spatial neglect symptoms were significantly improved following rehabilitation treatments. Pusher syndrome and unilateral spatial neglect syndrome occurred simultaneously after right thalamic hemorrhage. Early rehabilitation therapy can reduce the symptoms of pusher syndrome and unilateral spatial neglect syndrome and improve motor function.

Aarskog syndrome

MedlinePlus

Aarskog disease; Aarskog-Scott syndrome; AAS; Faciodigitogenital syndrome; Gaciogenital dysplasia ... Aarskog syndrome is a genetic disorder that is linked to the X chromosome. It affects mainly males, but females ...

Malabsorption Syndromes

MedlinePlus

... foods you eat. If you have a malabsorption syndrome, your small intestine cannot absorb nutrients from foods. Causes of malabsorption syndromes include Celiac disease Lactose intolerance Short bowel syndrome. ...

[XYY syndrome (diplo-Y syndrome)].

PubMed

Braun-Scharm, H; Schroeder-Kurth, T M

1986-01-01

A case is reported of a 12-year-old boy with the XYY syndrome and unusual clinical symptoms. In addition, past research on the XYY syndrome and the current state of knowledge is reviewed, with special emphasis on psychopathology, psychiatry and genetic counseling.

Wear Characterization of Carbon Nanotubes Reinforced Acetal Spur, Helical, Bevel and Worm Gears Using a TS Universal Test Rig

NASA Astrophysics Data System (ADS)

Yousef, Samy; Osman, T. A.; Abdalla, Abdelrahman H.; Zohdy, Gamal A.

2015-12-01

Although the applications of nanotechnologies are increasing, there remains a significant barrier between nanotechnology and machine element applications. This work aims to remove this barrier by blending carbon nanotubes (CNT) with common types of acetal polymer gears (spur, helical, bevel and worm). This was done by using adhesive oil (paraffin) during injection molding to synthesize a flange and short bars containing 0.02% CNT by weight. The flanges and short bars were machined using hobbing and milling machines to produce nanocomposite polymer gears. Some defects that surfaced in previous work, such as the appearance of bubbles and unmelted pellets during the injection process, were avoided to produce an excellent dispersion of CNT in the acetal. The wear resistances of the gears were measured by using a TS universal test rig using constant parameters for all of the gears that were fabricated. The tests were run at a speed of 1420 rpm and a torque of 4 Nm. The results showed that the wear resistances of the CNT/acetal gears were increased due to the addition of CNT, especially the helical, bevel and worm gears.

Polycystic ovary syndrome and metabolic syndrome.

PubMed

Ali, Aus Tariq

2015-08-01

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder, where the main clinical features include menstrual irregularities, sub-fertility, hyperandrogenism, and hirsutism. The prevalence of PCOS depends on ethnicity, environmental and genetic factors, as well as the criteria used to define it. On the other hand, metabolic syndrome is a constellation of metabolic disorders which include mainly abdominal obesity, insulin resistance, impaired glucose metabolism, hypertension and dyslipidaemia. These associated disorders directly increase the risk of Type 2 diabetes mellitus (DMT2), coronary heart disease (CHD), cardiovascular diseases (CVD) and endometrial cancer. Many patients with PCOS have features of metabolic syndrome such as visceral obesity, hyperinsulinaemia and insulin resistance. These place patients with PCOS under high risk of developing cardiovascular disease (CVD), Type 2 diabetes (DMT2) and gynecological cancer, in particular, endometrial cancer. Metabolic syndrome is also increased in infertile women with PCOS. The aim of this review is to provide clear and up to date information about PCOS and its relationship with metabolic syndrome, and the possible interaction between different metabolic disorders.

Ectrodactyly-ectodermal dysplasia clefting syndrome (EEC syndrome).

PubMed

Koul, Monika; Dwivedi, Rahul; Upadhyay, Vinod

2014-01-01

Ectrodactyly-ectodermal dysplasia- clefting syndrome (also k/a. split hand- split foot malformation /split hand-split foot ectodermal dysplasia- cleft syndrome/ectodermal dysplasia cleft lip/cleft palate syndrome) a rare form of ectodermal dysplasia, is an autosomal dominant disorder inherited as a genetic trait and characterized by a triad of (i) ectrodactyly, (ii) ectodermal dysplasia and, (iii) & facial clefts.

Williams syndrome

MedlinePlus

... with Williams syndrome may show: A flattened nasal bridge with small upturned nose Long ridges in the ... Alternative Names Williams-Beuren syndrome Images Low nasal bridge Chromosomes and DNA References Morris CA. Williams syndrome. ...

Exogenous Cushing syndrome

MedlinePlus

Cushing syndrome - corticosteroid induced; Corticosteroid-induced Cushing syndrome; Iatrogenic Cushing syndrome ... Cushing syndrome is a disorder that occurs when your body has a higher than normal level of the hormone ...

The Achilles Tendon Insertion is Crescent-shaped: An In Vitro Anatomic Investigation

PubMed Central

Arentz, Sabine; Nauck, Tanja; Dorn-Lange, Nadja V.; Konerding, Moritz A.

2008-01-01

Anatomic and operative textbooks and current literature do not clearly describe the Achilles tendon interface to the calcaneal tuberosity. We dissected 51 specimens to identify the detailed anatomy of the Achilles tendon insertion. Achilles tendon fascicles expanded from the anterior aspect of the distal Achilles tendon over the retrocalcaneal bursa to the anterior part of the Haglund’s tuberosity in nearly half of the specimens. The insertion of the transverse section of the Achilles tendon regularly had a crescent-shape corresponding to the posterior calcaneal prominence. In transverse sections, all specimens had a curved appearance with a radius of curvature ranging from 13.8 mm to 43.6 mm (mean, 20.4 mm) and Achilles tendon extensions to the lateral and medial calcaneal surfaces reached 1.0 mm (mean) and 3.5 mm (mean) anterior in relation to the most posterior point of the calcaneal tuberosity. Knowledge of the arcuate configuration and of the medial and lateral extensions of the plantaris and the Achilles tendon insertion with respect to the transverse plane is important to avoid iatrogenic complications during resection of Haglund’s tuberosity. PMID:18506561

Modified tension band wiring fixation for avulsion fractures of the calcaneus in osteoporotic bone: a review of three patients.

PubMed

Nagura, Issei; Fujioka, Hiroyuki; Kurosaka, Masahiro; Mori, Hiroyuki; Mitani, Makoto; Ozaki, Akihiro; Fujii, Hideo; Nabeshima, Yuji

2012-01-01

Calcaneal avulsion fractures are not uncommon, and they are probably more likely in patients with osteoporosis. Closed manipulation for this type of fracture often fails to achieve acceptable reduction, and open reduction and internal fixation are usually required. However, open reduction and internal fixation with either a lag screw or Steinmann pins do not provide satisfactory fixation in patients with diabetes and elderly patients because of the presence of porotic bone. Levi described a tension band fixation system used to treat a calcaneal avulsion fracture using a simple technique performed with a transverse Kirschner wire through the os calcaneus, securing a figure-of-8 metal tension band wiring to the fragment. We report the successful treatment of 3 patients with calcaneal avulsion fractures using a modified tension band wiring technique, resulting in satisfactory recovery. Re-displacement of the fragment during the initial follow-up period was not reported, and bony union was achieved in all patients. We believe this technique is a useful surgical option for the treatment of calcaneal avulsion fractures. Copyright © 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Targets to treat metabolic syndrome in polycystic ovary syndrome

PubMed Central

Mahalingaiah, Shruthi; Diamanti-Kandarakis, Evanthia

2016-01-01

Introduction Metabolic syndrome is comprised of a combination of the following states: increased insulin resistance, dyslipidemia, cardiovascular disease, and increased abdominal obesity. Women with polycystic ovary syndrome (PCOS) have an increased risk of developing metabolic syndrome over the course of their lives. Metabolic syndrome increases risk of major cardiovascular events, morbidity, quality of life, and overall health care costs. Though metabolic syndrome in women with PCOS is an area of great concern, there is no effective individual medical therapeutic to adequately treat this issue. Areas Covered This article will review key aspects of metabolic syndrome in PCOS. We will discuss classic and novel therapeutics to address metabolic syndrome in women with PCOS. We will conclude with the importance of developing strategic interventions to increase the compliance to lifestyle and dietary modification, in addition to appreciation of the emerging pharmaceutical therapeutics available. Expert Opinion Innovation in lifestyle modification, including diet, exercise, with and without dedicated stress reduction techniques is the future in treatment of metabolic syndrome in PCOS. Application of novel interventions, such as group medical care, may improve future adherence to lifestyle modification recommendations, in addition to or in combination with pharmaceutical therapeutics. PMID:26488852

Concurrent Van der Woude syndrome and Turner syndrome: A case report.

PubMed

Los, Evan; Baines, Hayley; Guttmann-Bauman, Ines

2017-01-01

Most cases of Van der Woude syndrome are caused by a mutation to interferon regulatory factor 6 on chromosome 1. Turner syndrome is caused by complete or partial absence of the second sex chromosome in girls. We describe a unique case of the two syndromes occurring concurrently though apparently independently in a girl with Van der Woude syndrome diagnosed at birth and Turner syndrome at 14 years 9 months. Short stature was initially misattributed to Van der Woude syndrome and pituitary insufficiency associated with clefts before correctly diagnosing Turner syndrome. We discuss the prevalence of delayed diagnosis of Turner syndrome, the rarity of reports of concurrent autosomal chromosome mutation and sex chromosome deletion, as well as the need to consider the diagnosis of Turner syndrome in all girls with short stature regardless of prior medical history.

Marfan Syndrome

MedlinePlus

Marfan syndrome is a disorder that affects connective tissue. Connective tissues are proteins that support skin, bones, blood vessels, ... A problem with the fibrillin gene causes Marfan syndrome. Marfan syndrome can be mild to severe, and ...

Brief Report: Repetitive Behaviour Profiles in Williams Syndrome: Cross Syndrome Comparisons with Prader-Willi and Down Syndromes

ERIC Educational Resources Information Center

Royston, R.; Oliver, C.; Moss, J.; Adams, D.; Berg, K.; Burbidge, C.; Howlin, P.; Nelson, L.; Stinton, C.; Waite, J.

2018-01-01

This study describes the profile of repetitive behaviour in individuals with Williams syndrome, utilising cross-syndrome comparisons with people with Prader-Willi and Down syndromes. The Repetitive Behaviour Questionnaire was administered to caregivers of adults with Williams (n = 96), Prader-Willi (n = 103) and Down (n = 78) syndromes. There were…

Obesity Hypoventilation Syndrome

MedlinePlus

... Home / < Back To Health Topics / Obesity Hypoventilation Syndrome Obesity Hypoventilation Syndrome Also known as Pickwickian Syndrome What ... your neck is larger than normal. Complications of Obesity Hypoventilation Syndrome When left untreated, OHS can cause ...

Loeys-Dietz Syndrome

MedlinePlus

... to the signs and symptoms of Loeys-Dietz syndrome. Marfan syndrome is different from Loeys-Dietz syndrome in that the gene mutation which causes Marfan syndrome is in fibrillin-1 (FBN-1), a protein ...

Refeeding syndrome.

PubMed

Fernández López, M T; López Otero, M J; Alvarez Vázquez, P; Arias Delgado, J; Varela Correa, J J

2009-01-01

Refeeding syndrome is a complex syndrome that occurs as a result of reintroducing nutrition (oral, enteral or parenteral) to patients who are starved or malnourished. Patients can develop fluid-balance abnormalities, electrolyte disorders (hypophosphataemia, hypokalaemia and hypomagnesaemia), abnormal glucose metabolism and certain vitamin deficiencies. Refeeding syndrome encompasses abnormalities affecting multiple organ systems, including neurological, pulmonary, cardiac, neuromuscular and haematological functions. Pathogenic mechanisms involved in the refeeding syndrome and clinical manifestations have been reviewed. We provide suggestions for the prevention and treatment of refeeding syndrome. The most important steps are to identify patients at risk, reintroduce nutrition cautiously and correct electrolyte and vitamin deficiencies properly.

Pre-Menstrual Syndrome in Women with Down Syndrome

ERIC Educational Resources Information Center

Mason, Linda; Cunningham, Cliff

2009-01-01

Background: Prevalence of pre-menstrual syndrome (PMS) may be higher in women with Down syndrome due to syndrome specific characteristics in biochemistry, psychopathology and lifestyle. Recognition of PMS may be difficult for women with intellectual disabilities and their carers. Method: A daily diary, used to diagnose PMS with typical women, was…

Protective Role of Angiogenin Against Hematopoietic Syndrome of the Acute Radiation Syndrome

DTIC Science & Technology

2016-09-01

Syndrome of the Acute Radiation Syndrome PRINCIPAL...SUBTITLE 5a. CONTRACT NUMBER Protective Role of Angiogenin Against Hematopoietic Syndrome of the Acute Radiation Syndrome 5b. GRANT NUMBER W81XWH-15...protective role against hematopoietic syndrome of the acute radiation syndrome (H-ARS) and is able to attenuate the effect of residual bone marrow

Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome).

PubMed

Bresler, Scott C; Padwa, Bonnie L; Granter, Scott R

2016-06-01

Nevoid basal cell carcinoma syndrome, or basal cell nevus syndrome (Gorlin syndrome), is a rare autosomal dominantly inherited disorder that is characterized by development of basal cell carcinomas from a young age. Other distinguishing clinical features are seen in a majority of patients, and include keratocystic odontogenic tumors (formerly odontogenic keratocysts) as well as dyskeratotic palmar and plantar pitting. A range of skeletal and other developmental abnormalities are also often seen. The disorder is caused by defects in hedgehog signaling which result in constitutive pathway activity and tumor cell proliferation. As sporadic basal cell carcinomas also commonly harbor hedgehog pathway aberrations, therapeutic agents targeting key signaling constituents have been developed and tested against advanced sporadically occurring tumors or syndromic disease, leading in 2013 to FDA approval of the first hedgehog pathway-targeted small molecule, vismodegib. The elucidation of the molecular pathogenesis of nevoid basal cell carcinoma syndrome has resulted in further understanding of the most common human malignancy.

Ehlers-Danlos Syndrome

MedlinePlus

... Danlos syndrome care at Mayo Clinic Symptoms Classic Ehlers-Danlos syndrome Signs and symptoms of the most common form ... but few or none of the skin symptoms. Ehlers-Danlos syndrome, vascular type People who have Ehlers-Danlos syndrome, ...

The short arm deletion syndrome of chromosome 4 (4p- syndrome).

PubMed

Zellweger, H; Bardach, J; Bordwell, J; Williams, K

1975-01-01

Partial deletion of the short arm of chromosome 4 (4p-) represents another (rare) cause of cleft lip and cleft palate. Further characteristic manifestations of the syndrome (also called Wolf or Wolf-Hirschhorn syndrome) are growth failure, microcephaly, prominent glabella, hypertelorism, beaked nose, poorly differentiated and low set ears, cardiac and renal malformation and hypospadias. Life expectancy is often shortened. The 4p- syndrome has many features in common with another deletion syndrome, the cri-du-chat syndrome, and also with the Smith-Lemli-Opitz syndrome. The latter is a hereditary condition with normal karyotype. The cri-du-chat syndrome is characterized by a peculiar high-pitched, mewing cry and can be differentiated from the Wolf syndrome by the different staining characteristics (banding) of chromosomes 4 and 5.

Fournier gangrene associated with hyper IgE syndrome (Job syndrome).

PubMed

Hori, Junichi; Yamaguchi, Satoshi; Watanabe, Masaki; Osanai, Hiroaki; Hori, Masako

2008-04-01

We report a case of a 32-year-old man with hyper IgE syndrome (Job syndrome) who developed Fournier gangrene due to infectious multiple atheromas of the scrotal skin that progressed to the right groin and thigh. The patient required surgical debridement and subsequent skin grafting. This is a rare case of Fournier gangrene associated with hyper IgE syndrome (Job syndrome). When a patient without diabetes mellitus has repeated infections and atopic-like dermatitis, Job syndrome should be considered.

Down Syndrome

MedlinePlus

... Down syndrome increases as a woman gets older. Down syndrome cannot be cured. Early treatment programs can help improve skills. They may include ... occupational, and/or educational therapy. With support and treatment, many ... Down syndrome live happy, productive lives. NIH: National Institute of ...

TAFRO Syndrome.

PubMed

Igawa, Takuro; Sato, Yasuharu

2018-02-01

TAFRO syndrome is a newly recognized variant of idiopathic multicentric Castleman disease (iMCD) that involves a constellation of syndromes: thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O). Thrombocytopenia and severe anasarca accompanied by relatively low serum immunoglobulin levels are characteristic clinical findings of TAFRO syndrome that are not present in iMCD-not otherwise specified (iMCD-NOS). Lymph node biopsy is recommended to exclude other diseases and to diagnose TAFRO syndrome, which reveals characteristic histopathological findings similar to hyaline vascular-type CD. TAFRO syndrome follows a more aggressive course, compared with iMCD-NOS, and there is no standard treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

Diversity of the Genes Implicated in Algerian Patients Affected by Usher Syndrome.

PubMed

Abdi, Samia; Bahloul, Amel; Behlouli, Asma; Hardelin, Jean-Pierre; Makrelouf, Mohamed; Boudjelida, Kamel; Louha, Malek; Cheknene, Ahmed; Belouni, Rachid; Rous, Yahia; Merad, Zahida; Selmane, Djamel; Hasbelaoui, Mokhtar; Bonnet, Crystel; Zenati, Akila; Petit, Christine

2016-01-01

Usher syndrome (USH) is an autosomal recessive disorder characterized by a dual sensory impairment affecting hearing and vision. USH is clinically and genetically heterogeneous. Ten different causal genes have been reported. We studied the molecular bases of the disease in 18 unrelated Algerian patients by targeted-exome sequencing, and identified the causal biallelic mutations in all of them: 16 patients carried the mutations at the homozygous state and 2 at the compound heterozygous state. Nine of the 17 different mutations detected in MYO7A (1 of 5 mutations), CDH23 (4 of 7 mutations), PCDH15 (1 mutation), USH1C (1 mutation), USH1G (1 mutation), and USH2A (1 of 2 mutations), had not been previously reported. The deleterious consequences of a missense mutation of CDH23 (p.Asp1501Asn) and the in-frame single codon deletion in USH1G (p.Ala397del) on the corresponding proteins were predicted from the solved 3D-structures of extracellular cadherin (EC) domains of cadherin-23 and the sterile alpha motif (SAM) domain of USH1G/sans, respectively. In addition, we were able to show that the USH1G mutation is likely to affect the binding interface between the SAM domain and USH1C/harmonin. This should spur the use of 3D-structures, not only of isolated protein domains, but also of protein-protein interaction interfaces, to predict the functional impact of mutations detected in the USH genes.

Development and characteristics of children with Usher syndrome and CHARGE syndrome.

PubMed

Dammeyer, Jesper

2012-09-01

Individuals with Usher syndrome or CHARGE syndrome are faced with a number of difficulties concerning hearing, vision, balance, and language development. The aim of the study is to describe the developmental characteristics of children with Usher syndrome and CHARGE syndrome, respectively. Data about the developmental characteristics of 26 children with Usher syndrome and 17 children with CHARGE syndrome was obtained. Associations between deafblindness (dual sensory loss), motor development (age of walking), language abilities, and intellectual outcome of these children were explored for each group independently. Both groups of children face a number of difficulties associated with vision, hearing, language, balance and intellectual outcome. Intellectual disability and/or language delay was found among 42% of the children with Usher syndrome and among 82% of the children with CHARGE syndrome. Intellectual disability was associated with language delay and age of walking for both groups. Even though Usher and CHARGE are two different genetic syndromes, both groups are challenged with a number of similar developmental delays. Clinicians need to be aware of several developmental issues in order to offer adequate support to children with Usher or CHARGE syndrome. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Pregnancy outcome in joint hypermobility syndrome and Ehlers-Danlos syndrome.

PubMed

Sundelin, Heléne E K; Stephansson, Olof; Johansson, Kari; Ludvigsson, Jonas F

2017-01-01

An increased risk of preterm birth in women with joint hypermobility syndrome or Ehlers-Danlos syndrome is suspected. In this nationwide cohort study from 1997 through 2011, women with either joint hypermobility syndrome or Ehlers-Danlos syndrome or both disorders were identified through the Swedish Patient Register, and linked to the Medical Birth Register. Thereby, 314 singleton births to women with joint hypermobility syndrome/Ehlers-Danlos syndrome before delivery were identified. These births were compared with 1 247 864 singleton births to women without a diagnosis of joint hypermobility syndrome/Ehlers-Danlos syndrome. We used logistic regression, adjusted for maternal age, smoking, parity, and year of birth, to calculate adjusted odds ratios for adverse pregnancy outcomes. Maternal joint hypermobility syndrome/Ehlers-Danlos syndrome was not associated with any of our outcomes: preterm birth (adjusted odds ratio = 0.6, 95% confidence interval 0.3-1.2), preterm premature rupture of membranes (adjusted odds ratio = 0.8; 95% confidence interval 0.3-2.2), cesarean section (adjusted odds ratio = 0.9, 95% confidence interval 0.7-1.2), stillbirth (adjusted odds ratio = 1.1, 95% confidence interval 0.2-7.9), low Apgar score (adjusted odds ratio = 1.6, 95% confidence interval 0.7-3.6), small for gestational age (adjusted odds ratio = 0.9, 95% confidence interval 0.4-1.8) or large for gestational age (adjusted odds ratio = 1.2, 95% confidence interval 0.6-2.1). Examining only women with Ehlers-Danlos syndrome (n = 62), we found a higher risk of induction of labor (adjusted odds ratio = 2.6; 95% confidence interval 1.4-4.6) and amniotomy (adjusted odds ratio = 3.8; 95% confidence interval 2.0-7.1). No excess risks for adverse pregnancy outcome were seen in joint hypermobility syndrome. Women with joint hypermobility syndrome/Ehlers-Danlos syndrome do not seem to be at increased risk of adverse pregnancy outcome. © 2016 Nordic Federation of

[Poland's syndrome].

PubMed

Slezak, R; Sasiadek, M

2000-08-01

Poland's syndrome consists of the variable clinical features, but always includes unilateral aplasia of the chest wall muscles and ipsilateral anomalies of upper extremity. The incidence of Poland's syndrome, reported by different authors ranges from 1:10,000 to 1:100,000 and is observed more frequently in males than in females with the right side of the body affected more often than the left. The etiology of this syndrome is still discussed. However most of described cases were sporadic, rare familial incidence of Poland's syndrome were also presented. Therefore different etiologic factors of the Poland's syndrome are taken into account: genetic, vascular compromise during early stages of embriogenesis but also teratogenic effect of environmental xenobiotics (e.g. cigarette smoking by pregnant women). The authors present also the case of 20-years old man with inherited bilateral syndactyly with the right side aplasia of major pectoralis muscle and face asymmetry. The familial history was negative in respect to the features, associated with Poland's syndrome.

[Gardner syndrome--parent alienation syndrome (PAS). Diagnosis or family reality?].

PubMed

Namysłowska, Irena; Heitzman, Janusz; Siewierska, Anna

2009-01-01

The authors present characteristics of Parental Alienation Syndrome (PAS) proposed by Gardner as well as data, which may help to differentiate that syndrome with real psychological, physical and sexual abuse. The consequences of Gardner Syndrome for legal decisions in the court cases of child custody and the critique of this syndrome in forensic and psychiatric literature are also discussed, and several questions posed. Authors propose to treat Gardner Syndrome not as as a child disorder but as a specific, dynamic family situation, which occurs sometimes, during divorce and fight about child custody.

Protective Role of Angiogenin Against Hematopoietic Syndrome of the Acute Radiation Syndrome

DTIC Science & Technology

2017-05-01

AWARD NUMBER: W81XWH-15-1-0207 TITLE: “Protective Role of Angiogenin Against Hematopoietic Syndrome of the Acute Radiation Syndrome ...SUBTITLE Protective Role of Angiogenin Against Hematopoietic Syndrome 5a. CONTRACT NUMBER of the Acute Radiation Syndrome 5b. GRANT NUMBER 5c...hematopoietic syndrome of the acute radiation syndrome (H-ARS) and is able to attenuate the effect of residual bone marrow damage (RBMD) after

Burning Mouth Syndrome and "Burning Mouth Syndrome".

PubMed

Rifkind, Jacob Bernard

2016-03-01

Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome.

Lethal pallister-killian syndrome: Phenotypic similarity with fryns syndrome

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

Ignacio Rodriquez, J.; Garcia, I.; Alvarez, J.

1994-11-01

The Pallister-Killian syndrome is a sporadic multiple congenital anomaly syndrome characterized by {open_quotes}coarse{close_quotes} face, profound mental retardation, and epilepsy. Chromosomes of peripheral lymphocytes are usually normal, but tissue cultures show varying degrees of mosaicism for isochromosome 12p. In babies who die neonatally of severe malformations, including diaphragmatic hernia, and who also have a {open_quotes}coarse{close_quotes} face, acral hypoplasia, and other internal anomalies, Fryns syndrome is more likely to be suspected than Pallister-Killian syndrome, especially if karyotyping is unavailable or if peripheral lumphocytes have a normal chromosome constitution. An initial diagnosis of Fryns syndrome had to be modified in 3 successive newbornmore » infants since chromosome analysis or in situ hybridization with a chromosome 12 probe on kidney tissue demonstrated the mosaic aneuploidy characteristic of Pallister-Killian syndrome. These 3 patients confirm that a similar pattern of malformations can be present in both conditions at birth. It consists of {open_quotes}coarse{close_quotes} face, acral hypoplasia, diaphragmatic hernia, and other defects. Newborn infants who present this phenotype, but lack a conclusively normal chromosome test, may not have Fryns syndrome. A diagnosis of Fryns syndrome should be made carefully to avoid the risk of inappropriate genetic counseling. 31 refs., 10 figs., 1 tab.« less

Marfan Syndrome (For Teens)

MedlinePlus

... genetic disorder called Marfan syndrome. What Is Marfan Syndrome? Marfan syndrome is named after Antoine Marfan, the French ... immediately. What's Life Like for Teens With Marfan Syndrome? Marfan syndrome affects people differently, so life is not ...

Swyer-James syndrome associated with Noonan syndrome: report of a case.

PubMed

Lin, Y M; Huang, W L; Hwang, J J; Ko, Y L; Lien, W P

1995-12-01

A 28-year-old man with Noonan syndrome associated with unilateral hyperlucent lung is reported. He had the typical craniofacial appearance and short stature of Noonan syndrome; he had mild mental retardation, atrophic testis, mild funnel chest and kyphosis. cardiovascular abnormalities included asymmetric hypertrophic cardiomyopathy and a significantly different caliber of the left and right pulmonary arteries. The unilateral hyperlucent lung was shown to result from acquired nondestructive emphysema caused by nonvalvular obstruction of the bronchi (Swyer-James syndrome or Macleod's syndrome). To the authors' knowledge, this is the first reported case of Noonan syndrome associated with Swyer-James syndrome.

Divorce in families of children with Down Syndrome or Rett Syndrome.

PubMed

Lederman, Vivian Renne Gerber; Alves, Bianca dos Santos; Negrão, Juliana; Maria, Juliana Negrão; Schwartzman, José Salomão; D'Antino, Maria Eloisa Famá; Brunoni, Decio

2015-05-01

This study evaluates the impact in the stability and management of the marriage of parents of a child with Down or Rett Syndrome. Morbidity of the syndromes and the marital status of the couples before and after the birth of the affected children were considered variables. The divorce rate in families with Down syndrome was 10%, similar to the Brazilian rate population. In Rett Syndrome, the divorce rate was significantly higher, 23.5%. The higher morbidity of Rett Syndrome, and the moment of diagnosis could be relevant factors for the increased divorce rate related to this syndrome.

Basal cell nevus syndrome or Gorlin syndrome.

PubMed

Thalakoti, Srikanth; Geller, Thomas

2015-01-01

Basal cell nevus syndrome (BCNS) or Gorlin syndrome is a rare neurocutaneous syndrome sometimes known as the fifth phacomatosis, inherited in autosomal dominant fashion with complete penetrance and variable expressivity. Gorlin syndrome is characterized by development of multiple basal cell carcinomas (BCCs), jaw cysts, palmar or plantar pits, calcification of falx cerebri, various developmental skeletal abnormalities such as bifid rib, hemi- or bifid vertebra and predisposition to the development of various tumors. BCNS is caused by a mutation in the PTCH1 gene localized to 9q22.3. Its estimated prevalence varies between 1/55600 and 1/256000 with an equal male to female ratio. The medulloblastoma variant seen in Gorlin syndrome patients is of the desmoplastic type, characteristically presenting during the first 3 years of life. Therefore, children with desmoplastic medulloblastoma should be carefully screened for other features of BCNS. Radiation therapy for desmoplastic medulloblastoma should be avoided in BCNS patients as it may induce development of invasive BCCs and other tumors in the skin area exposed to radiation. This syndrome is a multisystem disorder so involvement of multiple specialists with a multimodal approach to detect and treat various manifestations at early stages will reduce the long-term sequelae and severity of the condition. Life expectancy is not significantly altered but morbidity from complications and cosmetic scarring can be substantial. © 2015 Elsevier B.V. All rights reserved.

Gorlin-goltz syndrome.

PubMed

Pandeshwar, Padma; Jayanthi, K; Mahesh, D

2012-01-01

The Gorlin-Goltz syndrome (GGS) (the nevoid basal cell carcinoma syndrome-NBCCS) is a rare autosomal dominant syndrome caused due to mutations in the PTCH (patched) gene found on chromosome arm 9q. The syndrome, characterized by increased predisposition to develop basal cell carcinoma and associated multiorgan anomalies, has a high level of penetrance and variable expressiveness. GGS is a multidisciplinary problem, early diagnosis of which allows introduction of secondary prophylaxis and following an appropriate treatment to delay the progress of the syndrome. The following report emphasizes the need for awareness of the diagnostic criteria of this syndrome in cases with no typical skin lesions.

Syndromes with supernumerary teeth.

PubMed

Lubinsky, Mark; Kantaputra, Piranit Nik

2016-10-01

While most supernumerary teeth are idiopathic, they can be associated with a number of Mendelian syndromes. However, this can also be a coincidental finding, since supernumerary teeth occur in 6% or more of the normal population. To better define this relationship, we analyzed the evidence for specific associations. We excluded conditions with a single affected patient reported, supernumerary teeth adjacent to clefts or other forms of alveolar disruption (as secondary rather than primary findings), and natal teeth, which can involve premature eruption of a normal tooth. Since, the cause of supernumerary teeth shows considerable heterogeneity, certain findings are less likely to be coincidental, such as five or more supernumerary teeth in a single patient, or locations outside of the premaxilla. We found only eight genetic syndromes with strong evidence for an association: cleidocranial dysplasia; familial adenomatous polyposis; trichorhinophalangeal syndrome, type I; Rubinstein-Taybi syndrome; Nance-Horan syndrome; Opitz BBB/G syndrome; oculofaciocardiodental syndrome; and autosomal dominant Robinow syndrome. There is also suggestive evidence of an association with two uncommon disorders, Kreiborg-Pakistani syndrome (craniosynostosis and dental anomalies), and insulin-resistant diabetes mellitus with acanthosisnigricans. An association of a Mendelian disorder with a low frequency manifestation of supernumerary teeth is difficult to exclude without large numbers, but several commonly cited syndromes lacked evidence for clear association, including Hallermann-Streiff syndrome, Fabry disease, Ehlers-Danlos syndrome, Apert and Crouzon syndromes, Zimmermann-Laband syndrome, and Ellis-van Creveld syndrome. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Velocardiofacial Syndrome

ERIC Educational Resources Information Center

Gothelf, Doron; Frisch, Amos; Michaelovsky, Elena; Weizman, Abraham; Shprintzen, Robert J.

2009-01-01

Velocardiofacial syndrome (VCFS), also known as DiGeorge, conotruncal anomaly face, and Cayler syndromes, is caused by a microdeletion in the long arm of Chromosome 22. We review the history of the syndrome from the first clinical reports almost half a century ago to the current intriguing molecular findings associating genes from the…

Fluency Disorders in Genetic Syndromes

ERIC Educational Resources Information Center

Van Borsel, John; Tetnowski, John A.

2007-01-01

The characteristics of various genetic syndromes have included "stuttering" as a primary symptom associated with that syndrome. Specifically, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Tourette syndrome, Neurofibromatosis type I, and Turner syndrome all list "stuttering" as a characteristic of that syndrome. An extensive review of…

[Münchhausen syndrome].

PubMed

Robert, J C; Cremniter, D; Lejonc, J L

1991-04-20

Münchhausen's syndrome is characterized by fictitious illnesses associated with hospital peregrination, pseudologia fantastica with a mythomanic discourse that includes strongly structured medical elements, passivity and dependance at examinations, and aggressiveness. The whole picture is so typical that the syndrome can easily be recognized. Cases of Münchhausen's syndrome by proxy (Meadow's syndrome) have been reported during the last few years; the condition concerns children suffering from diseases which are entirely due to their parents and can be compared with the battered child syndrome. In terms of nosology, among pathomimias Münchhausen's syndrome figures as a borderline state. Since it is impossible to establish positive relations with these patients, treatment fails in almost every case.

The Source for Syndromes.

ERIC Educational Resources Information Center

Richard, Gail J.; Hoge, Debra Reichert

Designed for practicing speech-language pathologists, this book discusses different syndrome disabilities, pertinent speech-language characteristics, and goals and strategies to begin intervention efforts at a preschool level. Chapters address: (1) Angelman syndrome; (2) Asperger syndrome; (3) Down syndrome; (4) fetal alcohol syndrome; (5) fetal…

The 22q13.3 Deletion Syndrome (Phelan-McDermid Syndrome)

PubMed Central

Phelan, K.; McDermid, H.E.

2012-01-01

The 22q13.3 deletion syndrome, also known as Phelan-McDermid syndrome, is a contiguous gene disorder resulting from deletion of the distal long arm of chromosome 22. In addition to normal growth and a constellation of minor dysmorphic features, this syndrome is characterized by neurological deficits which include global developmental delay, moderate to severe intellectual impairment, absent or severely delayed speech, and neonatal hypotonia. In addition, more than 50% of patients show autism or autistic-like behavior, and therefore it can be classified as a syndromic form of autism spectrum disorders (ASD). The differential diagnosis includes Angelman syndrome, velocardiofacial syndrome, fragile X syndrome, and FG syndrome. Over 600 cases of 22q13.3 deletion syndrome have been documented. Most are terminal deletions of ∼100 kb to >9 Mb, resulting from simple deletions, ring chromosomes, and unbalanced translocations. Almost all of these deletions include the gene SHANK3 which encodes a scaffold protein in the postsynaptic densities of excitatory synapses, connecting membrane-bound receptors to the actin cytoskeleton. Two mouse knockout models and cell culture experiments show that SHANK3 is involved in the structure and function of synapses and support the hypothesis that the majority of 22q13.3 deletion syndrome neurological defects are due to haploinsufficiency of SHANK3, although other genes in the region may also play a role in the syndrome. The molecular connection to ASD suggests that potential future treatments may involve modulation of metabotropic glutamate receptors. PMID:22670140

Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld's syndrome) - An update.

PubMed

Watad, A; Quaresma, M; Brown, S; Cohen Tervaert, J W; Rodríguez-Pint, I; Cervera, R; Perricone, C; Shoenfeld, Y

2017-06-01

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) has been widely described in many studies conducted thus far. The syndrome incorporates five immune-mediated conditions, all associated with previous exposure to various agents such as vaccines, silicone implants and several others. The emergence of ASIA syndrome is associated with individual genetic predisposition, for instance those carrying HLA-DRB1*01 or HLA-DRB4 and results from exposure to external or endogenous factors triggering autoimmunity. Such factors have been demonstrated as able to induce autoimmunity in both animal models and humans via a variety of proposed mechanisms. In recent years, physicians have become more aware of the existence of ASIA syndrome and the relationship between adjuvants exposure and autoimmunity and more cases are being reported. Accordingly, we have created a registry that includes at present more than 300 ASIA syndrome cases that have been reported by different physicians worldwide, describing various autoimmune conditions induced by diverse adjuvants. In this review, we have summarized the updated literature on ASIA syndrome and the knowledge accumulated since 2013 in order to elucidate the association between the exposure to various adjuvant agents and its possible clinical manifestations. Furthermore, we especially referred to the relationship between ASIA syndrome and systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).

Neuroligins Provide Molecular Links Between Syndromic and Non-Syndromic Autism

PubMed Central

Singh, Sandeep K.; Eroglu, Cagla

2014-01-01

Autism is a common and heritable neuropsychiatric disorder that can be categorized into two types: syndromic and non-syndromic, the former of which are associated with other neurological disorders or syndromes. Molecular and functional links between syndromic and non-syndromic autism genes were lacking until studies aimed at understanding role of trans-synaptic adhesion molecule neuroligin, which is associated with non-syndromic autism, provided important connections. Here, we integrate data from these studies into a model of how neuroligin functions to control synaptic connectivity in the central nervous system and how neuroligin dysfunction may participate in the pathophysiology of autism. Understanding the complex functional interactions between neuroligins and other autism-associated proteins at the synapse is crucial to understand the pathology of autism. This understanding might bring us closer to development of therapeutic approaches for autism. PMID:23838185

Foraminiferal, lithic, and isotopic changes across four major unconformities at Deep Sea Drilling Project Site 548, Goban Spur: Chapter 14 in Initial reports of the Deep Sea Drilling Project

USGS Publications Warehouse

Poag, C. Wylie; Reynolds, Leslie A.; Mazzullo, James M.; Keigwin, Loyd D.

1985-01-01

Sediment samples taken at close intervals across four major unconformities (middle Miocene/upper Miocene, lower Oligocene/upper Oligocene, lower Eocene/upper Eocene, lower Paleocene/upper Paleocene) at DSDP-IPOD Site 548, Goban Spur, reveal that coeval biostratigraphic gaps, sediment discontinuities, and seismic unconformities coincide with postulated low stands of sea level. Foraminiferal, lithic, and isotopic analyses demonstrate that environments began to shift prior to periods of marine erosion, and that sedimentation resumed in the form of turbidites derived from nearby upper-slope sources. The unconformities appear to have developed where a water-mass boundary intersected the continental slope, rhythmically crossing the drill site in concert with sea-level rise and fall.

[Prevalence of metabolic syndrome components in patients with acute coronary syndromes].

PubMed

Zaliūnas, Remigijus; Slapikas, Rimvydas; Luksiene, Dalia; Slapikiene, Birute; Statkeviciene, Audrone; Milvidaite, Irena; Gustiene, Olivija

2008-01-01

Many studies report that the components of the metabolic syndrome--arterial hypertension, abdominal obesity, diabetes mellitus, and atherogenic dyslipidemia--are associated with an increased risk of cardiovascular disease. We investigated the prevalence of different components of the metabolic syndrome and frequency of their combinations and acute hyperglycemia among patients with acute coronary syndromes. The study population consisted of 2756 patients (1670 men and 1086 women with a mean age of 63.3+/-11.3 years) with acute coronary syndromes: Q-wave myocardial infarction was present in 41.8% of patients; non-Q-wave MI, in 30.7%; and unstable angina pectoris, in 27.5%. The metabolic syndrome was found in 59.6% of the patients according to modified NCEP III guidelines. One component of the metabolic syndrome was found in 13.5% of patients; two, in 23.0%; and none, in 3.9%. Less than one-third (29.2%) of the patients had three components of the metabolic syndrome, and 30.4% of the patients had four or five components. Arterial hypertension and abdominal obesity were the most common components of the metabolic syndrome (82.2% and 65.8%, respectively). Nearly half of the patients had hypertriglyceridemia and decreased level of high-density lipoprotein cholesterol (55.0% and 51.1%, respectively), and 23.9% of patients had diabetes mellitus. Acute hyperglycemia (> or =6.1 mmol/L) without known diabetes mellitus was found in 38.1% of cases. The combination of arterial hypertension and abdominal obesity was reported in 57.8% of patients in the case of combinations of two-five metabolic syndrome components. More than half of patients with acute coronary syndromes had three or more components of the metabolic syndrome, and arterial hypertension and abdominal obesity were the most prevalent components of the metabolic syndrome.

Are Numerical Impairments Syndrome Specific? Evidence from Williams Syndrome and Down's Syndrome

ERIC Educational Resources Information Center

Paterson, Sarah J.; Girelli, Luisa; Butterworth, Brian; Karmiloff-Smith, Annette

2006-01-01

Background: Several theorists maintain that exact number abilities rely on language-relevant processes whereas approximate number calls on visuo-spatial skills. We chose two genetic disorders, Williams syndrome and Down's syndrome, which differ in their relative abilities in verbal versus spatial skills, to examine this hypothesis. Five…

Reye syndrome - resources

MedlinePlus

Resources - Reye syndrome ... The following organizations are good resources for information on Reye Syndrome : National Reye's Syndrome Foundation, Inc. -- www.reyessyndrome.org National Institute of Neurologic Disorders and Stroke -- www. ...

Toxic shock syndrome

MedlinePlus

Staphylococcal toxic shock syndrome; Toxic shock-like syndrome; TSLS ... Toxic shock syndrome is caused by a toxin produced by some types of staphylococcus bacteria. A similar problem, called toxic shock- ...

Brain infarction due to vertebral artery dissection caused by a bone protrusion from the condylar fossa in a juvenile case.

PubMed

Fujii, Mutsumi; Ohgushi, Miki; Chin, Takaaki

2018-02-06

A 16-year-old boy presented with multiple posterior circulation ischemic strokes resulting from vertebral artery (VA) dissection. Three-dimensional computed tomography showed aberrant sub-occipital bone protuberance, proximal to the VA dissection. Since the patient was a habitual neck cracker, VA dissection was thought to result from the impact shock of the rotational head movement. This could be due to either the osseous prominence or the compression between the prominence and the C1. Although it is a rare etiology of Bow Hunter's syndrome, VA dissection due to sub-occipital bone spur because of neck cracking should be considered in the diagnosis of Bow Hunter's syndrome in juvenile patients.

Eosinophilic leukocytoclastic vasculitis - a spectrum ranging from Wells' syndrome to Churg-Strauss syndrome?

PubMed

Ratzinger, Gudrun; Zankl, Julia; Eisendle, Klaus; Zelger, Bernhard

2014-01-01

Wells' syndrome is defined as an inflammatory disorder with the histopathological presence of eosinophilic infiltrates and flame figures in the absence of vasculitis. Eosinophilic leukocytoclastic vasculitis shows eosinophilic infiltrates in combination with vasculitic changes. And Churg Strauss Syndrome comprises all three characteristics - eosinophilic infiltrates, vasculitis and flame figures. To determine whether these three diseases are distinct entities or different manifestations of a similar clinicopathologic process. Histopathological samples and clinical courses of 17 patients with eosinophilic infiltrates, flame figures and clinical features of Wells' syndrome were re-evaluated. Histopathologically, we focused on the presence or absence of vasculitic features. Clinically, we included only patients who were diagnosed with Wells' syndrome at least once in the course of their disease. 4 patients were finally diagnosed with Wells' syndrome, 5 with eosinophilic leukocytoclastic vasculitis and 6 with Churg Strauss syndrome. Further, we had one case of an overlap between Wells' syndrome and eosinophilic vasculitis and one case of Wegener granulomatosis. Vasculitic features were found in the samples of all patients. Histologically, we find vasculitic features in typical presentations of Wells' syndrome. Clinically, we find typical features of Wells' syndrome in patients finally diagnosed with eosinophilic leukocytoclastic vasculitis or Churg Strauss syndrome. Furthermore, we have observed and formerly reported 3 patients with progression from Wells' syndrome to Churg Strauss syndrome. Thus, we assume that eosinophilic leukocytoclastic vasculitis might form a bridge between Wells' syndrome and Churg Strauss syndrome.

Modeling and monitoring of tooth fillet crack growth in dynamic simulation of spur gear set

NASA Astrophysics Data System (ADS)

Guilbault, Raynald; Lalonde, Sébastien; Thomas, Marc

2015-05-01

This study integrates a linear elastic fracture mechanics analysis of the tooth fillet crack propagation into a nonlinear dynamic model of spur gear sets. An original formulation establishes the rigidity of sound and damaged teeth. The formula incorporates the contribution of the flexible gear body and real crack trajectories in the fillet zone. The work also develops a KI prediction formula. A validation of the equation estimates shows that the predicted KI are in close agreement with published numerical and experimental values. The representation also relies on the Paris-Erdogan equation completed with crack closure effects. The analysis considers that during dN fatigue cycles, a harmonic mean of ΔK assures optimal evaluations. The paper evaluates the influence of the mesh frequency distance from the resonances of the system. The obtained results indicate that while the dependence may demonstrate obvious nonlinearities, the crack progression rate increases with a mesh frequency augmentation. The study develops a tooth fillet crack propagation detection procedure based on residual signals (RS) prepared in the frequency domain. The proposed approach accepts any gear conditions as reference signature. The standard deviation and mean values of the RS are evaluated as gear condition descriptors. A trend tracking of their responses obtained from a moving linear regression completes the analysis. Globally, the results show that, regardless of the reference signal, both descriptors are sensitive to the tooth fillet crack and sharply react to tooth breakage. On average, the mean value detected the crack propagation after a size increase of 3.69 percent as compared to the reference condition, whereas the standard deviation required crack progressions of 12.24 percent. Moreover, the mean descriptor shows evolutions closer to the crack size progression.

Management of moyamoya syndrome in patients with Noonan syndrome.

PubMed

Gupta, Mihir; Choudhri, Omar A; Feroze, Abdullah H; Do, Huy M; Grant, Gerald A; Steinberg, Gary K

2016-06-01

A few isolated reports have described an association between Noonan syndrome and cerebrovascular abnormalities, including moyamoya syndrome. These reports have been limited to pediatric patients presenting with recurrent transient ischemic attacks (TIA) or headaches. Management has primarily been pharmacologic, with only one prior report of surgical revascularization to our knowledge. We report four cases of Noonan syndrome patients presenting with headaches and/or sensorimotor strokes in childhood that caused unilateral sensorimotor impairment. Cerebral angiography and MRI revealed bilateral moyamoya syndrome. All patients underwent successful bilateral extracranial-to-intracranial revascularization. The first patient was a 10-year-old girl who presented following a hemorrhagic stroke and recovered well after indirect bypass. The second patient was an adult with a history of childhood stroke whose symptoms progressed in adulthood. She underwent a direct bypass and improved, but continued to experience TIA at her 4 year follow-up. The third patient was a 7-year-old girl with headaches and a new onset TIA who failed pharmacological therapy and subsequently underwent bilateral indirect bypass. The fourth patient was a 24-year-old woman with worsening headaches and an occluded left middle cerebral artery from unilateral moyamoya syndrome. A left sided direct bypass was completed given delayed MRI perfusion with poor augmentation. To our knowledge these are the first reported surgical cases of combined Noonan and moyamoya syndrome. These cases highlight the need to recognize moyamoya syndrome in patients with Noonan syndrome. Early surgical revascularization should be pursued in order to prevent symptom progression. Copyright © 2015 Elsevier Ltd. All rights reserved.

Polycystic ovary syndrome and metabolic syndrome: the worrisome twosome?

PubMed

Shah, D; Rasool, S

2016-01-01

By virtue of insulin resistance being the common etiology for polycystic ovary syndrome (PCOS) and metabolic syndrome, the cardiometabolic risks of these two syndromes are shared. The usual concerns of a PCOS patient are cosmetic or reproductive. However, there are more serious concerns past the reproductive age. Early treatment of insulin resistance, hypertension and hyperlipidemia reduces the long-term risk. This review highlights the unhealthy association of metabolic syndrome with PCOS and emphasizes the importance of early diagnosis, patient education and long-term follow-up beyond the reproductive age into menopause to prevent the long-term serious co-morbidities.

Fat embolism syndrome.

PubMed

Stein, Paul D; Yaekoub, Abdo Y; Matta, Fadi; Kleerekoper, Michael

2008-12-01

To assess the incidence and risk factors for fat embolism syndrome. Data from the National Hospital Discharge Survey (NHDS) were analyzed using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. From 1979 through 2005 among 928,324,000 patients discharged from short-stay hospitals in the United States, 41,000 (0.004%) had fat embolism syndrome. Among 21,538,000 patients with an isolated fracture of the femur (any site), tibia, fibula, pelvis, ribs, humerus, radius, or ulna, 25,000 (0.12%) developed fat embolism syndrome. Patients with multiple fractures of the femur (excluding neck) more often had fat embolism syndrome than those with isolated fractures (1.29% versus 0.54%). The incidence of fat embolism syndrome was lower with isolated fractures of the tibia or fibula (0.30%) and even lower with isolated fractures of the neck of the femur (0.06%). The incidence of fat embolism was too low to calculate with isolated fractures of the pelvis, ribs, humerus, radius, or ulna. Nonorthopedic conditions rarely, if ever, were accompanied by fat embolism syndrome. The fat embolism syndrome was more frequent in men (relative risk 5.71). Children, aged 0 to 9 years rarely had fat embolism syndrome. The fat embolism syndrome most commonly affected patients aged 10 to 39 years. The incidence of the fat embolism syndrome depends on the bone involved, whether fractures are isolated or multiple, the age of the patient and the gender. It rarely occurs as a result of medical conditions.

Recurrent Fever Syndromes in Patients After Recovery From Kawasaki Syndrome

PubMed Central

Tremoulet, Adriana H.; Burns, Jane C.; Bastian, John F.; Hoffman, Hal M.

2011-01-01

The recurrence of fever in a child with a history of Kawasaki syndrome (KS) poses a dilemma for clinicians who must consider the possibility of recurrent KS. In this report we present the cases of 4 patients who presented with classical symptoms of KS, were successfully treated with intravenous immunoglobulin, and later experienced a reappearance of inflammatory symptoms in a pattern consistent with a recurrent fever syndrome. The association of these syndromes within the same patient suggests that some patients may have a genetic propensity toward altered immune responses and autoinflammatory syndromes. We propose that these 2 syndromes exist within a family of febrile disorders related to innate immune dysregulation. PMID:21220401

Hantavirus pulmonary syndrome.

PubMed

Simpson, Steven Q; Spikes, Leslie; Patel, Saurin; Faruqi, Ibrahim

2010-03-01

Hantavirus pulmonary syndrome, also known as hantavirus cardiopulmonary syndrome, is a recently described infectious syndrome found throughout the Americas. Although infection is sporadic and uncommon compared with other atypical pneumonia syndromes, its high mortality rate warrants the maintenance of a high index of suspicion in rural settings. Because no specific therapies are available for the disease, prevention and early recognition play an important role in reducing mortality from the disease. This article reviews the nature of the viruses that cause hantavirus pulmonary syndrome, the epidemiology and ecology of disease transmission, and disease recognition, treatment, and prevention. Copyright 2010 Elsevier Inc. All rights reserved.

Fat embolism syndrome

PubMed Central

George, Jacob; George, Reeba; Dixit, R.; Gupta, R. C.; Gupta, N.

2013-01-01

Fat embolism syndrome is an often overlooked cause of breathlessness in trauma wards. Presenting in a wide range of clinical signs of varying severity, fat embolism is usually diagnosed by a physician who keeps a high degree of suspicion. The clinical background, chronology of symptoms and corroborative laboratory findings are instrumental in a diagnosis of fat embolism syndrome. There are a few diagnostic criteria which are helpful in making a diagnosis of fat embolism syndrome. Management is mainly prevention of fat embolism syndrome, and organ supportive care. Except in fulminant fat embolism syndrome, the prognosis is usually good. PMID:23661916

What Is Antiphospholipid Antibody Syndrome?

MedlinePlus

... or rheumatic (ru-MAT-ik) disorders, such as lupus . ("Rheumatic" refers to disorders that affect the joints, ... aCL syndrome Antiphospholipid syndrome aPL syndrome Hughes syndrome Lupus anticoagulant syndrome Causes Antiphospholipid antibody syndrome (APS) occurs ...

Proteus syndrome*

PubMed Central

Rocha, Ritha de Cássia Capelato; Estrella, Mariani Paulino Soriano; do Amaral, Danielle Mechereffe; Barbosa, Angela Marques; de Abreu, Marilda Aparecida Milanez Morgado

2017-01-01

Proteus syndrome is a rare syndrome characterized by disproportionate overgrowth of limbs, multiple hamartomas, and vascular malformations. The cerebriform connective tissue nevi, also called cerebriform plantar hyperplasia, are present in most patients, and is the main characteristic of the syndrome. If present, even alone, they can be considered as a pathognomonic sign. This article reports a classic case of Proteus syndrome in a 2-year-old male patient who began to show a discrete asymmetry of the right hemibody in relation to the left one after birth, which increased over the months. He also showed cerebriform plantar hyperplasia and Port-wine stains, among other alterations. PMID:29166516

Gorlin syndrome.

PubMed

Devi, Basanti; Behera, Binodini; Patro, Sibasish; Pattnaik, Subhransu S; Puhan, Manas R

2013-05-01

Gorlin Syndrome, a rare genodermatosis, otherwise known as Nevoid basal cell carcinoma syndrome (NBCCS) is a multisystem disease affecting skin, nervous system, eyes, endocrine glands, and bones. It is characterized by multiple basal cell carcinomas, palmoplantar pits, jaw cysts, and bony deformities like kyphoscoliosis and frontal bossing. We would like to report a case of Gorlin syndrome with classical features, as this is a rare genodermatosis.

Fluency disorders in genetic syndromes.

PubMed

Van Borsel, John; Tetnowski, John A

2007-01-01

The characteristics of various genetic syndromes have included "stuttering" as a primary symptom associated with that syndrome. Specifically, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Tourette syndrome, Neurofibromatosis type I, and Turner syndrome all list "stuttering" as a characteristic of that syndrome. An extensive review of these syndromes indicated clients diagnosed with these syndromes do show evidence of nonfluency patterns, but not all would be considered stuttering. Many of the syndromes are marked by degrees of mental retardation that probably contribute to a higher than average prevalence of stuttering, as well as a higher than average prevalence of other fluency disorders (when compared to the population at large). An in-depth analysis of the available data indicates that some of these genetic syndromes show patterns of stuttering that may be indicative of only that syndrome (or similar syndromes) that can be differentially diagnosed from developmental stuttering. Among these patterns are the word-final nonfluencies noted in Prader-Willi syndrome; the presence of stuttering in the absence of secondary behaviors noted in Prader-Willi syndrome and; the presence of palilalia, word-final and word-medial nonfluencies, and word-medial and word-final nonfluencies in Tourette syndrome. Implications for future research are discussed in light of these findings. The reader will be able to: (1) describe the various different genetic syndromes that are associated with fluency disorders; (2) describe the types of nonfluencies that are associated with the major types of genetic syndromes that have fluency disorders; (3) describe the behaviors that may assist in differentially diagnosing different types of speech characteristics associated with various genetic syndromes.

Radiological study of the secondary reduction effect of early functional exercise on displaced intra-articular calcaneal fractures after internal compression fixation.

PubMed

Chen, Wei; Liu, Bo; Lv, Hongzhi; Su, Yanling; Chen, Xiao; Zhu, Yanbin; Du, Chenguang; Zhang, Xiaolin; Zhang, Yingze

2017-09-01

Early post-operative exercise and weight-bearing activities are found to improve the functional recovery of patients with displaced intra-articular calcaneal fractures (DIACFs). We hypothesized that early functional exercise after surgery might have a secondary reduction effect on the subtalar joint, in particular the smaller fracture fragments that were not fixed firmly. A prospective study was conducted to verify this hypothesis. From December 2012 to September 2013, patients with unilateral DIACFs were enrolled and received a treatment consisting of percutaneous leverage and minimally invasive fixation. After surgery, patients in the study group started exercising on days two to three, using partial weight bearing starting week three, and full weight bearing starting week 12. Patients in the control group followed a conventional post-operative protocol of partial weight bearing after week six and full weight bearing after the bone healed. Computed tomography (CT) scanning was performed at post-operative day one, week four, week eight, and week 12 to reconstruct coronal, sagittal, and axial images, on which the maximal residual displacements of the fractures were measured. Function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale at the 12th post-operative month. Twenty-eight patients in the study group and 32 in the control group were followed up for more than 12 months; their data were collected and used for the final analysis. Repeated-measures analysis of variance (ANOVA) of the maximal residual displacements of the fracture measured on CT images revealed significant differences between the study and the control groups. There were interaction effects between group and time point. Except for the first time point, the differences between the groups at all studied time points were significant. In the study group, the differences between all studied time points were significant. Strong correlations were observed between

Learning about WAGR Syndrome

MedlinePlus

... children who have WAGR syndrome may have normal intelligence. Other symptoms of WAGR syndrome may also include: ... mild. Some individuals with WAGR syndrome have normal intelligence. Children with WAGR syndrome should be referred for ...

Nevoid basal cell carcinoma syndrome

MedlinePlus

NBCC syndrome; Gorlin-Goltz syndrome; Basal cell nevus syndrome; BCNS; Basal cell cancer - nevoid basal cell carcinoma syndrome ... Nevoid basal cell carcinoma nevus syndrome is a rare genetic condition. The gene linked to the syndrome is known as PTCH (" ...

[Pigment dispersion syndrome and pigmentary glaucoma. Morphometric analysis of the anterior chamber segment with SL-OCT].

PubMed

Birner, B; Tourtas, T; Wessel, J M; Jünemann, A G; Mardin, C Y; Kruse, F E; Laemmer, R

2014-01-01

The purpose of this study was to analyze if anterior chamber parameters are risk factors for the development of pigment dispersion syndrome (PDS) and/or for the conversion to pigmentary glaucoma (PG). This study included a total of 63 eyes from 35 patients with PDS and PG and 65 eyes from 49 unaffected volunteers as the control group. The following parameters were measured by slit lamp optical coherence tomography (SL-OCT): anterior chamber volume (ACV) and depth (ACD), angle opening distance (AOD) and the trabecular iris space area (TISA) at 500 µm and 750 μm from the scleral spur. Comparisons between the following groups were performed: between the PDS/PG and the control group, between PDS and PG and between male and female patients. The results of ACV, ACD, AOD and TISA were significantly higher in PDS/PG patients when compared to the control group. There were no significant differences between PDS and PG. The gender-specific comparison also showed no significant differences. Significantly higher anterior chamber parameters are a possible risk factor for development of PDS; however, a higher risk of conversion to PG does not seem to correlate with increased anterior chamber parameters. The parameters of the anterior chamber are apparently not associated with the male predominance of PDS and PG.

Toxic Shock Syndrome

MedlinePlus

... toxic shock syndrome results from toxins produced by Staphylococcus aureus (staph) bacteria, but the condition may also be ... a skin or wound infection. Causes Most commonly, Staphylococcus aureus (staph) bacteria cause toxic shock syndrome. The syndrome ...

Turner Syndrome: Other FAQs

MedlinePlus

... Other FAQs Share Facebook Twitter Pinterest Email Print Turner Syndrome: Other FAQs Basic information for topics, such as " ... been diagnosed with Turner syndrome. Now what? Is Turner syndrome inherited? Turner syndrome is usually not inherited, but ...

Bardet-Biedl syndrome and Usher syndrome.

PubMed

Koenig, Rainer

2003-01-01

Bardet-Biedl syndrome (BBS) and Usher syndrome (USH) are the most prevalent syndromic forms of retinitis pigmentosa (RP), together they make up almost a quarter of the patients with RP. BBS is defined by the association of retinopathy, obesity, hypogonadism, renal dysfunction, postaxial polydactyly and mental retardation. This clinically complex syndrome is genetically heterogeneous with linkage to more than 6 loci, and 4 genes have been cloned so far. Recent molecular data present evidence that, in some instances, the clinical manifestation of BBS requires recessive mutations in 1 of the 6 BBS loci plus one or two additional mutations in a second BBS locus (tri- or tetra-allelic inheritance). USH is characterized by the combination of congenital or early-onset sensorineural deafness, RP, and variable degrees of vestibular dysfunction. Each of the three clinical types is genetically heterogeneous: 7 loci have been mapped for type 1, three loci for type 2, and two loci for type 3. Currently, 6 USH genes (MYO7A, USH1C, CDH23, PCDH15, USH2A, USH3) have been identified. Pathogenetically, mutations of the USH1 genes seem to result in defects of auditory and retinal sensory cells, the USH 2 phenotype is caused by defects of extracellular matrix or cell surface receptor proteins, and USH3 may be due to synaptic disturbances. The considerable contribution of syndromic forms of RP requires interdisciplinary approaches to the clinical and diagnostic management of RP patients.

Munchausen syndrome and Munchausen syndrome by proxy in dermatology.

PubMed

Boyd, Alan S; Ritchie, Coleman; Likhari, Sunaina

2014-08-01

Patients with Munchausen syndrome purposefully injure themselves, often with the injection of foreign materials, to gain hospital admission and the attention associated with having a difficult-to-identify condition. Munchausen syndrome by proxy occurs when a child's caregiver, typically the mother, injures the child for the same reasons. Cases of Munchausen syndrome and Munchausen syndrome by proxy with primary cutaneous involvement appear to be rarely described in the literature suggesting either that diagnosis is not made readily or that it is, in fact, an uncommon disorder. At the center of both conditions is significant psychological pathology and treatment is difficult as many patients with Munchausen syndrome when confronted with these diagnostic possibilities simply leave the hospital. Little is known about the long-term outcome or prognosis of these patients. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

National Down Syndrome Society

MedlinePlus

... individuals with Down syndrome. Help us fix the law and end #LawSyndrome. Law Syndrome affects 100% of people with Down syndrome. It’s a series of antiquated laws that impede the pursuit of a career or ...

Angelman Syndrome: Genetic Mechanisms and Relationship to Prader-Willi Syndrome.

ERIC Educational Resources Information Center

Smith, Arabella

1994-01-01

Research points to two distinct regions within the Prader-Willi chromosome region: one for Prader Willi syndrome and one for Angelman syndrome. Genetic mechanisms in Angelman syndrome are complex, and at present, three mechanisms are recognized: maternal deletion, paternal uniparental disomy, and a nondeleted nondisomic form. (Author/JDD)

Dangerous triplet: Polycystic ovary syndrome, oral contraceptives and Kounis syndrome.

PubMed

Erol, Nurdan; Karaagac, Aysu Turkmen; Kounis, Nicholas G

2014-12-26

Polycystic ovary syndrome is characterized by ovulatory dysfunction, androgen excess and polycystic ovaries and is associated with hypertension, diabetes, metabolic syndrome and cardiovascular events. Oral contraceptives constitute first-line treatment, particularly when symptomatic hyperandrogenism is present. However, these drugs are associated with cardiovascular events and hypersensitivity reactions that pose problem in differential diagnosis and therapy. We present a 14 year-old female with polycystic ovary syndrome taking oral contraceptive and suffering from recurrent coronary ischemic attacks with increased eosinophils, and troponin levels suggesting Kounis syndrome.

["Refuse hoarding syndrome"].

PubMed

Jürgens, A

2000-01-01

The "litter hoarding syndrome" is described only occasionally during the past decades. It seems to be rather unknown in the psychiatric literature. In the course of the syndrome the patients gather more and more litter in their homes until it becomes unhabitable. Physicians and social psychiatric services are often confronted with this manifestation of a psychiatric illness. Because of the dramatic development, the extent and the specific circumstances this paper reports case of a young female patient with the litter hoarding syndrome. The term "litter hoarding syndrome" was first coined by Dettmering [3] during a lecture on 25.1.1984 in the Psychiatric Clinic of the Eppendorf University Hospital in Hamburg. In 1985 Klosterkötter et al. [7] described the "diogenes syndrome" which offered some nosological similarities. With the exception of this publications an the PhD thesis by Pastenaci [11] only a few reports have been published during the last 28 years throughout the world and no epidemiological data about the syndrome can be found. Based on this case some ideas about differential diagnosis and syndrome classification shall be presented.

Psychological Well-Being of Mothers of Youth with Fragile X Syndrome: Syndrome Specificity and within-Syndrome Variability

ERIC Educational Resources Information Center

Lewis, P.; Abbeduto, L.; Murphy, M.; Richmond, E.; Giles, N.; Bruno, L.; Schroeder, S.; Anderson, J.; Orsmond, G.

2006-01-01

Background: Research on parental well-being has focused largely on Down syndrome and autism; however, fragile X syndrome is likely to pose different challenges for parents compared with these other diagnostic conditions. Moreover, there is considerable variability among youth with fragile X syndrome; for example, 25% to 33% of affected youth meet…

Gorlin-Goltz Syndrome

PubMed Central

Pandeshwar, Padma; Jayanthi, K.; Mahesh, D.

2012-01-01

The Gorlin-Goltz syndrome (GGS) (the nevoid basal cell carcinoma syndrome—NBCCS) is a rare autosomal dominant syndrome caused due to mutations in the PTCH (patched) gene found on chromosome arm 9q. The syndrome, characterized by increased predisposition to develop basal cell carcinoma and associated multiorgan anomalies, has a high level of penetrance and variable expressiveness. GGS is a multidisciplinary problem, early diagnosis of which allows introduction of secondary prophylaxis and following an appropriate treatment to delay the progress of the syndrome. The following report emphasizes the need for awareness of the diagnostic criteria of this syndrome in cases with no typical skin lesions. PMID:23082255

Burning mouth syndrome.

PubMed

Crow, Heidi C; Gonzalez, Yoly

2013-02-01

Pain in the tongue or oral tissues described as "burning" has been referred to by many terms including burning mouth syndrome. When a burning sensation in the mouth is caused by local or systemic factors, it is called secondary burning mouth syndrome and when these factors are treated the pain will resolve. When burning mouth syndrome occurs in the absence of identified risk indicators, the term primary burning mouth syndrome is utilized. This article focuses on descriptions, etiologic theories, and management of primary burning mouth syndrome, a condition for which underlying causative agents have been ruled out. Copyright © 2013. Published by Elsevier Inc.

Prospective study of percutaneous radiofrequency nerve ablation for chronic plantar fasciitis.

PubMed

Erken, H Yener; Ayanoglu, Semih; Akmaz, Ibrahim; Erler, Kaan; Kiral, Ahmet

2014-02-01

Chronic plantar heel pain is one of the most painful foot conditions and is generally associated with plantar fasciitis. This study reports 2-year follow-up results of radiofrequency nerve ablation (RFNA) of the calcaneal branches of the inferior calcaneal nerve in patients with chronic heel pain associated with plantar fasciitis. After receiving approval from the institutional review board, we prospectively evaluated the results of the RFNA of the calcaneal branches of the inferior calcaneal nerve on 35 feet in 29 patients with plantar heel pain between 2008 and 2011. All of the patients who were treated had been complaining of heel pain for more than 6 months and had failed conservative treatment. All of the patients were evaluated (quantitatively) using the average 10-point Visual Analog Scale (VAS) before treatment, as well as at their 1-month, 1-year, and 2-year follow-up after the procedure. We also evaluated 26 feet in 20 patients with American Orthopaedic Foot and Ankle Society scale (AOFAS) scores before the treatment, as well as at their 1-month, 1-year, and 2-year follow-up after the procedure. The average VAS score of the feet was 9.2 ± 1.9 before treatment, 0.5 ± 1.3 at 1 month after the procedure, 1.5 ± 2.1 at 1-year follow-up, and 1.3 ± 1.8 at 2-year follow-up (P < .001). The average AOFAS scores of the patients were 66.9 ± 8.1 (range, 44-80) before treatment, 95.2 ± 6.1 (range, 77-100) at 1 month after the procedure, 93 ± 7.5 (range, 71-100) at the 1-year follow-up, and 93.3 ± 7.9 (range, 69-100) at the 2-year follow-up. At the 1- and 2-year follow-up, 85.7% of the patients rated their treatment as very successful or successful. These findings suggest that RFNA of the calcaneal branches of the inferior calcaneal nerve was an effective pain treatment option for chronic heel pain associated with plantar fasciitis that did not respond to other conservative treatment options. Level IV, retrospective case series.

Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome)

PubMed Central

Kiran, N. K.; Tilak Raj, T. N.; Mukunda, K. S.; Rajashekar Reddy, V.

2012-01-01

The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by odontogenic keratocysts in the jaw, multiple basal cell nevi carcinomas and skeletal abnormalities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the odontogenic keratocysts are usually one of the first manifestations of the syndrome. This case report presents a patient diagnosed as NBCCS by clinical, radiographic and histological findings in a 13-year-old boy. This paper highlights the importance of early diagnosis of NBCCS which can help in preventive multidisciplinary approach to provide a better prognosis for the patient. PMID:23633824

Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome).

PubMed

Kiran, N K; Tilak Raj, T N; Mukunda, K S; Rajashekar Reddy, V

2012-10-01

The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by odontogenic keratocysts in the jaw, multiple basal cell nevi carcinomas and skeletal abnormalities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the odontogenic keratocysts are usually one of the first manifestations of the syndrome. This case report presents a patient diagnosed as NBCCS by clinical, radiographic and histological findings in a 13-year-old boy. This paper highlights the importance of early diagnosis of NBCCS which can help in preventive multidisciplinary approach to provide a better prognosis for the patient.

[Klinefelter's syndrome associated with mixed connective tissue disease (Sharp's syndrome) and thrombophilia with postthrombotic syndrome].

PubMed

Kasten, Robert; Pfirrmann, Gudrun; Voigtländer, Volker

2005-08-01

A 43-year-old male with eunuchoid body proportions and a history of deep venous thromboses in the right leg presented with recurrent ulcers in the right perimalleolar region for 6 years. Karyotyping revealed a 47 XXY Klinefelter's syndrome, while serologic testing showed protein S deficiency, hyperhomocysteinemia and positive lupus anticoagulant. He also had mixed connective tissue disease (Sharp's syndrome) with acrosclerosis, proximal finger edema, Raynaud's phenomenon, and high titers of ANA and U1-RNP-antibodies, as well as osteoporosis. There is evidence that patients with Klinefelter's syndrome are prone to develop connective tissue diseases and thrombophilia as a result of low androgen levels. Substitution of testosterone in Klinefelter's syndrome can have a favorable therapeutic effect on the associated connective tissue disease, thrombophilia and osteoporosis.

Artiss Symposium 2014: Psychiatry and Pain Management

DTIC Science & Technology

2014-01-01

1983 to spur military psychiatry residents to con - duct high quality research. This award still exists today and was presented at the conclusion of...important to understand, in con - text, what it means to take care of severe trauma over great distances with the team of people that impact on the...perception and how it affects the psyche are extremely important. There is a post- con - cussive syndrome called chronic traumatic encephalopathy (CTE

Turner Syndrome (For Teens)

MedlinePlus

... Staying Safe Videos for Educators Search English Español Turner Syndrome KidsHealth / For Teens / Turner Syndrome What's in this ... en español El síndrome de Turner What Is Turner Syndrome? Turner syndrome (TS) is a genetic condition found ...

Fragile X syndrome

MedlinePlus

Martin-Bell syndrome; Marker X syndrome ... Fragile X syndrome is caused by a change in a gene called FMR1 . A small part of the gene ... repeated several times in one area of the X chromosome. The more repeats, the more likely the ...

[PATHOPHYSIOLOGY OF THE CARDIORENAL SYNDROME].

PubMed

Balint, I; Vučak, J; Bašić-Marković, N; Klarić, D; Šakić, V Amerl

2016-12-01

Cardiorenal syndrome, a complex pathophysiological disorder of both the heart and kidneys, is a condition in which acute or chronic damage to one organ can lead to acute or chronic dysfunction of the other organ. Depending on primary organ dysfunction and disease duration, there are five different types of cardiorenal syndrome. Type 1 cardiorenal syndrome (acute cardiorenal syndrome) is defined as acute kidney injury caused by sudden decrease in heart function. Type 2 cardiorenal syndrome (chronic cardiorenal syndrome) refers to chronic kidney disease linked to chronic heart failure. Type 3 cardiorenal syndrome (acute renocardial syndrome) is caused by acute kidney injury that leads to heart failure. Type 4 cardiorenal syndrome (chronic renocardial syndrome) includes chronic heart failure due to chronic kidney disease. Type 5 cardiorenal syndrome (secondary cardiorenal syndrome) is reversible or irreversible condition marked by simultaneous heart and kidney insufficiency, as a result of multiorgan disease such as sepsis, diabetes mellitus, sarcoidosis, amyloidosis, etc. The pathophysiological patterns of cardiorenal syndrome are extremely complicated. Despite numerous publications, perplexed physiological, biochemical and hormonal disturbances as parts of the main pathogenic mechanisms of cardiorenal syndrome remain obscure. Even though there are guidelines for the treatment of patients with heart failure and chronic kidney disease, similar guidelines for the treatment of cardiorenal syndrome are lacking. In everyday practice, it is crucial to diagnose cardiorenal syndrome and use all diagnostic and therapeutic procedures available to prevent or alleviate kidney and heart failure.

Genetics Home Reference: Alagille syndrome

MedlinePlus

... my area? Other Names for This Condition Alagille-Watson Syndrome Alagille's syndrome arteriohepatic dysplasia (AHD) cardiovertebral syndrome ... hypoplasia hepatofacioneurocardiovertebral syndrome paucity of interlobular bile ducts Watson-Miller syndrome Related Information How are genetic conditions ...

Klinefelter's syndrome and Prader-Willi syndrome: a rare combination.

PubMed

Verhoeven, W M A; de Vries, B B A; Duffels, S J H; Egger, J I M; Noordam, C; Tuinier, S

2007-01-01

In this paper a review is presented of the rare combination of Klinefelter's syndrome and Prader-Willi syndrome (PWS) and a second case of this combination with a uniparental disomy (UPD) etiology of PWS is described. Patients outlined in all other 8 reports and the present case have a PWS phenotype. Virtually no information is available on the behavioral and psychopathological phenotype in this combination. The latter may be explained by the observation that psychiatric syndromes are especially prevalent in PWS patients with a UPD. It is concluded that instability in mood and behavior in this and other syndromes should be preferentially treated with mood stabilizing agents. Copyright (c) 2007 S. Karger AG, Basel.

Diversity of the Genes Implicated in Algerian Patients Affected by Usher Syndrome

PubMed Central

Abdi, Samia; Bahloul, Amel; Behlouli, Asma; Hardelin, Jean-Pierre; Makrelouf, Mohamed; Boudjelida, Kamel; Louha, Malek; Cheknene, Ahmed; Belouni, Rachid; Rous, Yahia; Merad, Zahida; Selmane, Djamel; Hasbelaoui, Mokhtar; Bonnet, Crystel; Zenati, Akila; Petit, Christine

2016-01-01

Usher syndrome (USH) is an autosomal recessive disorder characterized by a dual sensory impairment affecting hearing and vision. USH is clinically and genetically heterogeneous. Ten different causal genes have been reported. We studied the molecular bases of the disease in 18 unrelated Algerian patients by targeted-exome sequencing, and identified the causal biallelic mutations in all of them: 16 patients carried the mutations at the homozygous state and 2 at the compound heterozygous state. Nine of the 17 different mutations detected in MYO7A (1 of 5 mutations), CDH23 (4 of 7 mutations), PCDH15 (1 mutation), USH1C (1 mutation), USH1G (1 mutation), and USH2A (1 of 2 mutations), had not been previously reported. The deleterious consequences of a missense mutation of CDH23 (p.Asp1501Asn) and the in-frame single codon deletion in USH1G (p.Ala397del) on the corresponding proteins were predicted from the solved 3D-structures of extracellular cadherin (EC) domains of cadherin-23 and the sterile alpha motif (SAM) domain of USH1G/sans, respectively. In addition, we were able to show that the USH1G mutation is likely to affect the binding interface between the SAM domain and USH1C/harmonin. This should spur the use of 3D-structures, not only of isolated protein domains, but also of protein-protein interaction interfaces, to predict the functional impact of mutations detected in the USH genes. PMID:27583663

Could metabolic syndrome, lipodystrophy, and aging be mesenchymal stem cell exhaustion syndromes?

PubMed

Mansilla, Eduardo; Díaz Aquino, Vanina; Zambón, Daniel; Marin, Gustavo Horacio; Mártire, Karina; Roque, Gustavo; Ichim, Thomas; Riordan, Neil H; Patel, Amit; Sturla, Flavio; Larsen, Gustavo; Spretz, Rubén; Núñez, Luis; Soratti, Carlos; Ibar, Ricardo; van Leeuwen, Michiel; Tau, José María; Drago, Hugo; Maceira, Alberto

2011-01-01

One of the most important and complex diseases of modern society is metabolic syndrome. This syndrome has not been completely understood, and therefore an effective treatment is not available yet. We propose a possible stem cell mechanism involved in the development of metabolic syndrome. This way of thinking lets us consider also other significant pathologies that could have similar etiopathogenic pathways, like lipodystrophic syndromes, progeria, and aging. All these clinical situations could be the consequence of a progressive and persistent stem cell exhaustion syndrome (SCES). The main outcome of this SCES would be an irreversible loss of the effective regenerative mesenchymal stem cells (MSCs) pools. In this way, the normal repairing capacities of the organism could become inefficient. Our point of view could open the possibility for a new strategy of treatment in metabolic syndrome, lipodystrophic syndromes, progeria, and even aging: stem cell therapies.

Could Metabolic Syndrome, Lipodystrophy, and Aging Be Mesenchymal Stem Cell Exhaustion Syndromes?

PubMed Central

Mansilla, Eduardo; Díaz Aquino, Vanina; Zambón, Daniel; Marin, Gustavo Horacio; Mártire, Karina; Roque, Gustavo; Ichim, Thomas; Riordan, Neil H.; Patel, Amit; Sturla, Flavio; Larsen, Gustavo; Spretz, Rubén; Núñez, Luis; Soratti, Carlos; Ibar, Ricardo; van Leeuwen, Michiel; Tau, José María; Drago, Hugo; Maceira, Alberto

2011-01-01

One of the most important and complex diseases of modern society is metabolic syndrome. This syndrome has not been completely understood, and therefore an effective treatment is not available yet. We propose a possible stem cell mechanism involved in the development of metabolic syndrome. This way of thinking lets us consider also other significant pathologies that could have similar etiopathogenic pathways, like lipodystrophic syndromes, progeria, and aging. All these clinical situations could be the consequence of a progressive and persistent stem cell exhaustion syndrome (SCES). The main outcome of this SCES would be an irreversible loss of the effective regenerative mesenchymal stem cells (MSCs) pools. In this way, the normal repairing capacities of the organism could become inefficient. Our point of view could open the possibility for a new strategy of treatment in metabolic syndrome, lipodystrophic syndromes, progeria, and even aging: stem cell therapies. PMID:21716667

Piriformis syndrome

MedlinePlus

Pseudosciatica; Wallet sciatica; Hip socket neuropathy; Pelvic outlet syndrome; Low back pain - piriformis ... Sciatica is the main symptom of piriformis syndrome. Other symptoms include: Tenderness or a dull ache in ...

Is the metabolic syndrome a "small baby" syndrome?: the bogalusa heart study.

PubMed

Harville, Emily W; Srinivasan, Sathanur; Chen, Wei; Berenson, Gerald S

2012-12-01

Metabolic syndrome has been called a "small baby syndrome," but other analyses suggest that postnatal growth is more important than birthweight, or that large babies are also at risk. The aim of this analysis was to examine whether there was a relationship between both low and high birthweight and metabolic syndrome, using multiple definitions of metabolic syndrome, and to determine whether this relationship varied by body size across the life course. Data from the Bogalusa Heart Study, a study of cardiovascular disease in children and young adults, were linked to birth certificate data. Metabolic syndrome was defined by the National Cholesterol Education Program, the International Diabetes Foundation, and the World Health Organization (WHO) definition. Small-for-gestational-age (SGA) was defined as birthweight <10(th) percentile by sex for gestational age and large-for-gestational-age (LGA) as birthweight >90(th) percentile. Birthweight-for-gestational-age was also examined as a continuous predictor. Chi-squared tests and logistic regression were used to examine the relationship between birth size and metabolic syndrome. Higher birthweight-for-gestational-age was associated with a reduced risk of metabolic syndrome, especially by the WHO definition. After adjustment for body mass index (BMI), categorized birthweight was associated with metabolic syndrome, with the protective associations with LGA being stronger than the positive associations with SGA. Among the individual components of metabolic syndrome, higher waist circumference was associated with both SGA and LGA after BMI was controlled for. Effects of SGA and BMI at any age were largely independent rather than interactive. SGA is associated with some, but not all, components of metabolic syndrome. The relationship between SGA and metabolic syndrome is partially confounded by later BMI.

Epidemiological survey of the feasibility of broadband ultrasound attenuation measured using calcaneal quantitative ultrasound to predict the incidence of falls in the middle aged and elderly.

PubMed

Ou, Ling-Chun; Chang, Yin-Fan; Chang, Chin-Sung; Chiu, Ching-Ju; Chao, Ting-Hsing; Sun, Zih-Jie; Lin, Ruey-Mo; Wu, Chih-Hsing

2017-01-09

We investigated whether calcaneal quantitative ultrasound (QUS-C) is a feasible tool for predicting the incidence of falls. Prospective epidemiological cohort study. Community-dwelling people sampled in central western Taiwan. A cohort of community-dwelling people who were ≥40 years old (men: 524; women: 676) in 2009-2010. Follow-up questionnaires were completed by 186 men and 257 women in 2012. Structured questionnaires and broadband ultrasound attenuation (BUA) data were obtained in 2009-2010 using QUS-C, and follow-up surveys were done in a telephone interview in 2012. Using a binary logistic regression model, the risk factors associated with a new fall during follow-up were analysed with all significant variables from the bivariate comparisons and theoretically important variables. The incidence of falls was determined when the first new fall occurred during the follow-up period. The mean follow-up time was 2.83 years. The total incidence of falls was 28.0 per 1000 person-years for the ≥40 year old group (all participants), 23.3 per 1000 person-years for the 40-70 year old group, and 45.6 per 1000 person-years for the ≥70 year old group. Using multiple logistic regression models, the independent factors were current smoking, living alone, psychiatric drug usage and lower BUA (OR 0.93; 95% CI 0.88 to 0.99, p<0.05) in the ≥70 year old group. The incidence of falls was highest in the ≥70 year old group. Using QUS-C-derived BUA is feasible for predicting the incidence of falls in community-dwelling elderly people aged ≥70 years. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evidence of phyllosilicates in Wooly Patch, an altered rock encountered at West Spur, Columbia Hills, by the Spirit rover in Gusev crater, Mars

USGS Publications Warehouse

Wang, A.; Korotev, R.L.; Jolliff, B.L.; Haskin, L.A.; Crumpler, L.; Farrand, W. H.; Herkenhoff, K. E.; de Souza, Jr.; Kusack, A.G.; Hurowitz, J.A.; Tosca, N.J.

2006-01-01

On its traverse to Columbia Hills, the Mars Exploration Rover Spirit investigated an outcrop designated "Wooly Patch" that exhibited morphological, mineralogical, and geochemical characteristics at the extreme ends of ranges observed among rocks studied at West Spur, a westward projecting salient near the foot of the Columbia Hills, Gusev crater. The major-element composition and Fe-mineralogy, as determined by the Alpha-Particle X-ray Spectrometer and Mo??ssbauer Spectrometer, are inconsistent with any reasonable assemblage of basaltic minerals in that there is an excess of Si and Al. The combined data are best explained by the presence of 14-17% phyllosilicate minerals. Phyllosilicates that account for the composition and cation ratios include members of the kaolinite, serpentine, chlorite, and septechlorite groups. The potential existence of kaolinite-type Al-rich phyllosilicates within the Wooly Patch outcrop suggests a mildly acidic environment (pH 4-6) in the past and an open hydrologic system with good drainage conditions in the environment where these rocks were altered. Copyright 2006 by the American Geophysical Union.

Felty syndrome

MedlinePlus

Seropositive rheumatoid arthritis (RA); Felty's syndrome ... The cause of Felty syndrome is unknown. It is more common in people who have had rheumatoid arthritis (RA) for a long time. People with ...

Unusual headache syndromes.

PubMed

Queiroz, Luiz P

2013-01-01

Some headache syndromes have few cases reported in the literature. Their clinical characteristics, pathogenesis, and treatment may have not been completely defined. They may not actually be uncommon but rather under-recognized and/or underreported. A literature review of unusual headache syndromes, searching PubMed and ISI Web of Knowledge, was performed. After deciding which disorders to study, relevant publications in scientific journals, including original articles, reviews, meeting abstracts, and letters or correspondences to the editors were searched. This paper reviewed the clinical characteristics, the pathogenesis, the diagnosis, and the treatment of five interesting and unusual headache syndromes: exploding head syndrome, red ear syndrome, neck-tongue syndrome, nummular headache, and cardiac cephalgia. Recognizing some unusual headaches, either primary or secondary, may be a challenge for many non-headache specialist physicians. It is important to study them because the correct diagnosis may result in specific treatments that may improve the quality of life of these patients, and this can even be life saving. © 2013 American Headache Society.

Prevalence of Burnout Syndrome in patients admitted with acute coronary syndrome.

PubMed

Prosdócimo, Ana Cláudia Giaxa; Lucina, Luciane Boreki; Marcia, Olandoski; Jobs, Priscila Megda João; Schio, Nicolle Amboni; Baldanzi, Fernanda Fachin; Costantini, Costantino Ortiz; Benevides-Pereira, Ana Maria Teresa; Guarita-Souza, Luiz Cesar; Faria-Neto, José Rocha

2015-03-01

Burnout Syndrome is the extreme emotional response to chronic occupational stress, manifesting as physical and mental exhaustion. Although associated with higher prevalence of cardiovascular risk factors, no study so far has evaluated whether the Burnout Syndrome could be a prevalent factor in non-elderly individuals active in the labor market, admitted for acute coronary syndrome (ACS). To evaluate the prevalence of the Burnout Syndrome in non-elderly, economically active patients, hospitalized with ACS. Cross-sectional study conducted in a tertiary and private cardiology center, with economically active patients aged <65 years, hospitalized with diagnosis of ACS. The Burnout Syndrome was evaluated with the Burnout Syndrome Inventory (BSI), which assesses workplace conditions and four dimensions that characterize the syndrome: emotional exhaustion (EE), emotional distancing (EmD), dehumanization (De) and professional fulfillment (PF). The Lipp's Stress Symptoms Inventory for Adults (LSSI) was applied to evaluate global stress. Of 830 patients evaluated with suspected ACS, 170 met the study criteria, 90% of which were men, overall average age was 52 years, and 40.5% had an average income above 11 minimum wages. The prevalence of the Burnout Syndrome was 4.1%. When we evaluated each dimension individually, we found high EE in 34.7%, high De in 52.4%, high EDi in 30.6%, and low PF in 5.9%. The overall prevalence of stress was 87.5%. We found a low prevalence of Burnout Syndrome in an economically active, non-elderly population among patients admitted for ACS in a tertiary and private hospital.

Prevalence of Burnout Syndrome in Patients Admitted with Acute Coronary Syndrome

PubMed Central

Prosdócimo, Ana Cláudia Giaxa; Lucina, Luciane Boreki; Marcia, Olandoski; Jobs, Priscila Megda João; Schio, Nicolle Amboni; Baldanzi, Fernanda Fachin; Costantini, Costantino Ortiz; Benevides-Pereira, Ana Maria Teresa; Guarita-Souza, Luiz Cesar; Faria-Neto, José Rocha

2015-01-01

Background Burnout Syndrome is the extreme emotional response to chronic occupational stress, manifesting as physical and mental exhaustion. Although associated with higher prevalence of cardiovascular risk factors, no study so far has evaluated whether the Burnout Syndrome could be a prevalent factor in non-elderly individuals active in the labor market, admitted for acute coronary syndrome (ACS). Objective To evaluate the prevalence of the Burnout Syndrome in non-elderly, economically active patients, hospitalized with ACS. Methods Cross-sectional study conducted in a tertiary and private cardiology center, with economically active patients aged <65 years, hospitalized with diagnosis of ACS. The Burnout Syndrome was evaluated with the Burnout Syndrome Inventory (BSI), which assesses workplace conditions and four dimensions that characterize the syndrome: emotional exhaustion (EE), emotional distancing (EmD), dehumanization (De) and professional fulfillment (PF). The Lipp’s Stress Symptoms Inventory for Adults (LSSI) was applied to evaluate global stress. Results Of 830 patients evaluated with suspected ACS, 170 met the study criteria, 90% of which were men, overall average age was 52 years, and 40.5% had an average income above 11 minimum wages. The prevalence of the Burnout Syndrome was 4.1%. When we evaluated each dimension individually, we found high EE in 34.7%, high De in 52.4%, high EDi in 30.6%, and low PF in 5.9%. The overall prevalence of stress was 87.5%. Conclusion We found a low prevalence of Burnout Syndrome in an economically active, non-elderly population among patients admitted for ACS in a tertiary and private hospital. PMID:25517388

Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture.

PubMed

Wang, Chien-Shun; Tzeng, Yun-Hsuan; Lin, Chun-Cheng; Huang, Ching-Kuei; Chang, Ming-Chau; Chiang, Chao-Ching

2016-09-01

The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability. Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively. The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively). The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures. Level II, comparative study. © The Author(s) 2016.

Lessons from the Bone Chapter of the Malaysian Aging Men Study

PubMed Central

Chin, Kok-Yong; Wan Ngah, Wan Zurinah; Ima-Nirwana, Soelaiman

2016-01-01

Male osteoporosis in Malaysia is a largely neglected problem. Therefore, a bone health study in men using quantitative ultrasonometry was launched as part of the Malaysian Aging Men Study in 2009–2012. This review aimed to summarize the findings of the aforementioned bone health study. The study examined the bone health of Chinese and Malaysian men aged 20 years and above living in Kuala Lumpur using a quantitative ultrasound device. Participants answered a questionnaire on their demographic details and physical activity status. Body anthropometry of the participants was measured and their blood collected for biochemical analysis. Results showed that a significant proportion of the Malaysian Chinese and Malay men had suboptimal bone health indicated by calcaneal speed of sound and vitamin D status. Age-related decline of the calcaneal speed of sound in these men was gradual and biphasic without ethnic difference. Body anthropometry such as height, weight, body mass index, and body fat percentage contributed to the variation of the calcaneal speed of sound in Malaysian men. Age-related changes in testosterone, insulin-like growth factor 1, and thyroid stimulating hormone also influenced the calcaneal speed of sound in these men. This study serves as a reminder that male osteoporosis in Malaysia should be an issue of concern. It is also a basis for a more comprehensive study on bone health in men in the future. PMID:27231930